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Sample records for acetabular labral tears

  1. MRI morphometric hip comparison analysis of anterior acetabular labral tears

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    Aly, Abdel Rahman [University of Saskatchewan, Department of Physical Medicine and Rehabilitation, Saskatoon, SK (Canada); Saskatoon City Hospital, Saskatoon, SK (Canada); Rajasekaran, Sathish [HealthPointe, Pain, Spine and Sport Medicine, Alberta (Canada); Obaid, Haron [Royal University Hospital, University of Saskatchewan, Department of Medical Imaging, Saskatoon, SK (Canada)

    2013-09-15

    Anterior (3 o'clock) acetabular labral tears (AALTs) have been reported to be associated with iliopsoas impingement (IPI). However, no study has examined the association between anatomical bony variables of the hip joint and AALTs. The purpose of this study was to evaluate the association between AALTs, femoroacetabular impingement (FAI) and other bony variables of the hip. Seventy-six out of 274 hip MRI records met the inclusion criteria. Two independent blinded investigators evaluated the location of acetabular labral tears (ALTs), edema at the musculotendinous junction of the iliopsoas insertion, femoral neck anteversion angle, femoral neck shaft angle, acetabular anteversion angle, alpha angle, lateral central edge angle (LCEA), acetabular index, and acetabular depth. Comparison analyses between groups were performed. Twenty-two patients had no ALTs (controls), 19 patients had AALTs, and 35 patients had ALTs not isolated at the 3 o'clock position (25 with cam-bony deformities [FAI-cam] and 10 with pincer-bony deformities [FAI-pincer]). The alpha angle mean was significantly higher (p < 0.001) in the FAI-cam group (62.7 , 95 % confidence interval [CI]: 56.2-69.2 ) compared with the AALTs group (46.9 , 95 % CI: 40.1-53.7 ). The LCEA mean was significantly higher (p < 0.001) in FAI-pincer group (41.9 , 95 % CI: 39.3 -44.5 ) compared to AALTs group (29.4 , 95 % CI: 24.2 -34.6 ). There was no statistically significant difference in any of the bony variables between the controls and the AALTs group. Our study demonstrated that AALTs are pathologically distinct and not associated with FAI or other bony abnormalities. This supports the previous studies, which proposed that AALTs are associated with IPI. (orig.)

  2. MRI morphometric hip comparison analysis of anterior acetabular labral tears

    International Nuclear Information System (INIS)

    Anterior (3 o'clock) acetabular labral tears (AALTs) have been reported to be associated with iliopsoas impingement (IPI). However, no study has examined the association between anatomical bony variables of the hip joint and AALTs. The purpose of this study was to evaluate the association between AALTs, femoroacetabular impingement (FAI) and other bony variables of the hip. Seventy-six out of 274 hip MRI records met the inclusion criteria. Two independent blinded investigators evaluated the location of acetabular labral tears (ALTs), edema at the musculotendinous junction of the iliopsoas insertion, femoral neck anteversion angle, femoral neck shaft angle, acetabular anteversion angle, alpha angle, lateral central edge angle (LCEA), acetabular index, and acetabular depth. Comparison analyses between groups were performed. Twenty-two patients had no ALTs (controls), 19 patients had AALTs, and 35 patients had ALTs not isolated at the 3 o'clock position (25 with cam-bony deformities [FAI-cam] and 10 with pincer-bony deformities [FAI-pincer]). The alpha angle mean was significantly higher (p < 0.001) in the FAI-cam group (62.7 , 95 % confidence interval [CI]: 56.2-69.2 ) compared with the AALTs group (46.9 , 95 % CI: 40.1-53.7 ). The LCEA mean was significantly higher (p < 0.001) in FAI-pincer group (41.9 , 95 % CI: 39.3 -44.5 ) compared to AALTs group (29.4 , 95 % CI: 24.2 -34.6 ). There was no statistically significant difference in any of the bony variables between the controls and the AALTs group. Our study demonstrated that AALTs are pathologically distinct and not associated with FAI or other bony abnormalities. This supports the previous studies, which proposed that AALTs are associated with IPI. (orig.)

  3. Ultrasound versus Magnetic Resonance Arthrography in Acetabular Labral Tear Diagnostics: A Prospective Comparison in 20 Dysplastic Hips

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    Troelsen, A.; Jacobsen, S.; Bolvig, L.; Gelineck, J.; Roemer, L.; Soeballe, K. [Orthopedic Research Unit and Dept. of Radiology, Univ. Hospital of Aarhus, A arhus (Denmark)

    2007-11-15

    Background: Acetabular labral tears are highly associated with hip dysplasia. Magnetic resonance arthrography (MR arthrography) is the expensive and time-consuming contemporary gold-standard method in the radiological assessment of acetabular labral tears. Purpose: To assess the diagnostic ability of noninvasive ultrasound (US) examination compared to MR arthrography in diagnosing acetabular labral tears in dysplastic hip joints. Material and Methods: The study compared US examination and MR arthrography diagnosis of labral tears in 20 consecutively referred dysplastic hip joints. Results: The ability to diagnose acetabular labral tears upon US examination was calculated: sensitivity 44%, specificity 75%, positive predictive value 88%, and negative predictive value 25%. Conclusion: The ability of US examination in diagnosing acetabular labral tears is not yet good enough. The technique is still to be developed, and more experience, especially with the interpretation of US examinations, is needed.

  4. Acetabular labral tears: contrast-enhanced MR imaging under continuous leg traction

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    Nishii, T. [Div. of Functional Diagnostic Imaging, Biomedical Research Center, Osaka Univ. Medical School, Suita (Japan); Nakanishi, K. [Dept. of Radiology, Osaka Univ. Medical School, Suita (Japan); Sugano, N. [Dept. of Orthopaedic Surgery, Osaka Univ. Medical School, Suita (Japan); Naito, H. [Div. of Functional Diagnostic Imaging, Biomedical Research Center, Osaka Univ. Medical School, Suita (Japan); Tamura, S. [Div. of Functional Diagnostic Imaging, Biomedical Research Center, Osaka Univ. Medical School, Suita (Japan); Ochi, T. [Dept. of Orthopaedic Surgery, Osaka Univ. Medical School, Suita (Japan)

    1996-05-01

    The objective of this study was to evaluate the effects of continuous leg traction on contrast-enhanced MR imaging of the hip joint and to determine whether MR imaging under these conditions is useful for demonstrating acetabular labral tears. Nineteen hips underwent MR imaging with a T1-weighted spin-echo sequence, followed by MR imaging under continuous leg traction after intravenous injection of gadolinium-DTPA. Joint fluid enhancement and labral contour detection were evaluated. Eleven hips had labral tears shown by conventional arthrography, arthroscopy and macroscopic surgical findings. Assessment of labral tears by MR imaging was correlated with the diagnosis based on these standard techniques. Joint fluid enhancement was obtained in all hips at 30 min after injection. Superior and inferior labral surfaces were completely delineated in 1 hip on the unenhanced MR images, and in 7 and 13 hips, respectively, on the enhanced images under traction. The enhanced images under traction depicted 9 of the 11 labral tears. Comparison between the unenhanced image and the enhanced image under traction avoided mistaking undercutting of the labrum for a tear in 4 hips. Contrast-enhanced MR imaging under traction was valuable for detecting labral tears non-invasively and without radiation. Follow-up examinations using this method in patients with acetabular dysplasia can help to clarify the natural course of labral disorders and enable better treatment planning. (orig./MG)

  5. What is the role of clinical tests and ultrasound in acetabular labral tear diagnostics?

    DEFF Research Database (Denmark)

    Troelsen, Anders; Mechlenburg, Inger; Gelineck, John;

    2009-01-01

    BACKGROUND AND PURPOSE: An acetabular labral tear is a diagnostic challenge. Various clinical tests have been described, but little is known about their diagnostic sensitivity and specificity. We investigated the diagnostic validity of clinical tests and ultrasound as compared with MR arthrograph...

  6. 3.0 T conventional hip MR and hip MR arthrography for the acetabular labral tears confirmed by arthroscopy

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    Tian, Chun-Yan [Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191 (China); Wang, Jian-Quan [Department of Sports Medicine, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191,PR China (China); Zheng, Zhuo-Zhao, E-mail: zzhuozhao@aliyun.com [Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191 (China); Ren, A.-Hong [Department of Radiology, Beijing Daxing Hospital, 26 West Huangcun Road, Daxing District, Beijing 102600 (China)

    2014-10-15

    Highlights: • MR is the preferred imaging modality for diagnosing acetabular labral tears. • The diagnostic performance of MR arthrography are superior than conventional hip MR. • The hip MR arthrography is recommended for diagnosing acetabular labral lesions. - Abstract: Objective: To evaluate the value of hip MR for diagnosing acetabular labrum tears, and to further compare the diagnostic performances of conventional MR with MR arthrography in acetabular labrum tears. Methods: 90 patients undergoing both hip MR examination and subsequent hip arthroscopy were retrospectively evaluated. Of these patients, 34 accepted both conventional MR and MR arthrography; while the other 56 only underwent conventional MR examination. All hip MR images were independently reviewed by two radiologists, and further compared with the results of hip arthroscopy. Results: 59 of 90 patients were confirmed with acetabular labral tears by hip arthroscopy and 31 without tears. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of conventional MR for evaluating the acetabular labral tears were 61.0%, 77.4%, 83.7% and 51.1% (radiologist A), and 66.1%, 74.2%, 82.9% and 53.4% (radiologist B), respectively, with good consistency between the two observers (K = 0.645). The sensitivity, specificity, PPV and NPV of MR arthrography for assessing the acetabular labral tears were 90.5%, 84.6%, 90.5% and 84.6% (radiologist A), and 95.2%, 84.6%, 90.9% and 91.7% (radiologist B), respectively, with excellent good consistency between the two observers (K = 0.810). The sensitivity and NPV of MR arthrography for diagnosing the acetabular labral tears were significantly higher than those of conventional MR (both P < 0.05). Conclusion: Hip MR arthrography is a reliable evaluation modality for diagnosing the acetabular labral tears, and its diagnostic performance is superior to that of conventional MR at 3.0 T.

  7. Examination and treatment of a professional ballet dancer with a suspected acetabular labral tear: A case report.

    Science.gov (United States)

    Khoo-Summers, Lynnette; Bloom, Nancy J

    2015-08-01

    Dancers are at risk for developing groin pain that is due to acetabular labral tears. Although surgical management of labral tears has been reported extensively, conservative management has been poorly described. This case report describes the examination, diagnosis, and treatment of groin pain in a professional ballet dancer with a suspected acetabular labral tear. Treatment focused on decreasing anterior hip joint stresses and improving the precision of hip motion through correction of alignment and movement impairments noted during functional activities and dance. Successful outcomes included a reduction in pain and return to professional ballet dancing. PMID:25725589

  8. The diagnostic value of direct CT arthrography using MDCT in the evaluation of acetabular labral tear: with arthroscopic correlation

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    Ha, Yong-Chan; Kim, Jae Yoon [Chung-Ang University College of Medicine, Department of Orthopaedic Surgery, Seoul (Korea, Republic of); Choi, Jung-Ah; Lee, Guen Young; Kang, Heung Sik [Seoul National University Bundang Hospital, Departments of Radiology, Seoul National University College of Medicine, 166 Gumi-ro, Bundang-gu, Seongnam (Korea, Republic of); Lee, Young-Kyun; Koo, Kyung-Hoi [Seoul National University Bundang Hospital, Orthopaedic Surgery, Seoul National University College of Medicine, Seongnam (Korea, Republic of)

    2013-05-15

    The purpose of this study was first, to determine the sensitivity, specificity, and accuracy of MDCT arthrography (CTA) for the diagnosis of acetabular labral tear and sulcus; second, to correlate tear types using the Lage classification system on CTA compared with the arthroscopic classification; and third, to correlate CTA localization with arthroscopic localization. Direct CTA was performed using 16- or 64-slice MDCT in 126 hips (124 patients) who had chronic groin pain and positive impingement test. Images were reviewed and evaluated by two experienced musculoskeletal radiologists preoperatively. CTA findings were compared with arthroscopic findings in 58 hips (56 patients) under consensus by two orthopedic surgeons. Forty-one of the 58 hips were diagnosed as labral tears on CT arthrography. Forty-three of the 58 hips were shown to have a labral tear on arthroscopy. Sensitivity, specificity, and accuracy for detecting labral tear and sulcus by CTA were 90.7%, 86.7%, and 89.7%, and 93.8%, 97.6% and 96.6% respectively for observer 1, and 90.7% and 80.0%, 87.9% and 87.5%, 95.2%, and 93.1 % respectively for observer 2. Thirty-five out of 41 hips (85%) that were diagnosed with labral tear on CTA correlated substantially with arthroscopic Lage classification (kappa coefficient = 0.65). CTA and arthroscopic findings showed similar distribution patterns of the tears with most lesions located in antero- and postero-superior areas (p = 0.013). Direct CT arthrography using MDCT may be a useful diagnostic technique in the detection of acetabular labral tear. (orig.)

  9. Arthroscopic Technique for Acetabular Labral Reconstruction Using Iliotibial Band Autograft.

    Science.gov (United States)

    Chahla, Jorge; Soares, Eduardo; Bhatia, Sanjeev; Mitchell, Justin J; Philippon, Marc J

    2016-06-01

    The dynamic function of the acetabular labrum makes it an important structure for both hip stability and motion. Because of this, injuries to the labrum can cause significant dysfunction, leading to altered hip kinematics. Labral repair is the gold standard for symptomatic labral tears to keep as much labral tissue as possible; however, in cases where the labrum has been injured to such a degree that it is either deficient or repair is not possible, arthroscopic labral reconstruction is preferred. This article describes our preferred approach for reconstruction of the acetabular labrum using iliotibial band autograft.

  10. Transosseous Acetabular Labral Repair as an Alternative to Anchors

    OpenAIRE

    Pérez-Carro, Luis; Cabello, Andres Gonzalez; Rakha, Mohamed Ibrahim; Patnaik, Sarthak; Centeno, Elias; Miranda, Victor; Fernández, Ana Alfonso

    2015-01-01

    Labral tears are the most common pathology in patients undergoing hip arthroscopy and the most common cause of mechanical hip symptoms. Labral repair techniques have been described in the literature using suture anchors placed as close as possible to the acetabular rim without penetrating the articular surface. Optimal surgical technique for labral repair is very important, and an inappropriate entry point and guide angulation may lead to intra-articular penetration of the anchor, chondral da...

  11. Early outcome of hip arthroscopy for acetabular labrale tears%髋臼盂唇损伤的关节镜手术

    Institute of Scientific and Technical Information of China (English)

    王卫国; 李子荣; 岳德波; 张念非; 洪闻

    2010-01-01

    Objective To investigate the clinical diagnosis and the results of arthroscopic treatment for acetabular labrale tears. Methods From November 2008 to December 2009, 21 patients with unilateral acetabular labrale tears underwent hip arthroscopy were entered in the study, including 9 males and 12 females with an average age of 37.1 years. Physical examination, X-ray examination and magnetic resonance arthrography (MRA) were carried out preoperatively to make the definite diagnosis. Of 21 cases, including labrale debridement in 14 cases, labrale debridement plus femoral osteoplasty in 5 cases and labrale repair plus osteoplasty in 2 cases. Patients were followed-up either by telephone inquiring or out-patient interview.The visual analogue scale (VAS) and Harris hip score were recorded before operation and 6 months after operation respectively. Results All 21 patients showed a positive Fadir impingement sign on the affected hips,meanwhile 15 cases showed a positive Fabir impingement sign, and positive McCarthy test was observed in 9cases. X-ray film showed 11 cases have cam type impingement, among which 6 combined with pincer type impingement. Two cases had acetabulum retroversion alone. On MRA images, signals of contrast agent infiltration in anterior superior quadrant which indicated labrale tear were observed among all cases. All labrale tears were confirmed under arthroscopy. All patients were followed up for average 11.6 months (range, 6-19).The symptoms were obviously released after operation. The VAS decreased from (5.3±1.3) preoperatively to (1.4±-0.9) 6 months postoperatively. The mean Harris hip score improved from (63±9) preoperatively to (84±10) 6 months postoperatively. All the differences had statistical significance. Conclusion Acetabular labrale injury has a close correlation with femoroacetabular impingement. Impingement test and MRA have a high sensitivity and accuracy on clinical diagnosis of labrale tears. Arthroscopic debridement, repair and

  12. Achados em ressonância magnética artrográfica de indivíduos com lesão do labrum acetabular Magnetic resonance arthrographic findings in subjects with acetabular labral tears

    Directory of Open Access Journals (Sweden)

    André Luiz Almeida Pizzolatti

    2011-01-01

    Full Text Available OBJETIVO: Descrever os achados em artro RM de sujeitos com suspeita de lesão do labrum acetabular. MÉTODO: Foram analisadas 108 artro RM de quadris em 2007/2008. Dois radiologistas independentemente analisaram as imagens e foi considerada a resposta comum entre eles. Com base em seus pareceres observou-se o local e estadiamento das lesões labrais e condrais, as alterações anatômicas, e a presença de tendinite e bursite trocantérica. RESULTADO: As lesões labrais grau I ocorreram em 41% dos casos, grau II em 31%, e grau III em 29%. O IFA tipo cam foi frequente em 36% dos casos, tipo pincer em 11%, e IFA misto em 13%, nestes casos 57% apresentaram lesão labral grau III, A lesão condral grau I foi observada em 51% acetábulos, as de grau II em 13%, e grau III em 18%. CONCLUSÃO: As alterações morfológicas que provocam IFA do tipo cam foram as mais prevalentes. Em relação ao grau de lesão labral e condral foram predominantes as lesões grau I independente da presença ou do tipo de IFA, exceto em IFAs mistos onde houve predomínio de lesão labral grau III. Não foi observada uma relação entre o grau de lesão labral e condral.OBJECTIVE: To describe the MR arthrographic findings in subjects with suspected acetabular labral tears of the hip. METHOD: 108 hip MRa results were analyzed in 2007-2008. Two radiologists independently interpreted the images, and the consensual answers between them were considered for analysis. Based on their opinions, information was obtained on the location, staging of the chondral and labral lesions, anatomic alterations, and the presence of trochanteric bursitis and tendonitis. RESULTS: 1st degree labral lesions occurred in 41% of cases, 2nd degree in 31%, and 3rd degree in 29%. The cam type FAI was common in 36% of cases, pincer FAI in 11%, and mixed cam-pincer FAI in 13%; in these cases 57% had grade III labral lesions. 1st degree chondral lesions were observed in 51% of acetabulum, 2nd degree in 13

  13. Diagnostic accuracy of clinical tests for the diagnosis of hip femoroacetabular impingement/labral tear

    DEFF Research Database (Denmark)

    Reiman, M P; Goode, A P; Cook, C E;

    2015-01-01

    BACKGROUND: Surgery for hip femoroacetabular impingement/acetabular labral tear (FAI/ALT) is exponentially increasing despite lacking investigation of the accuracy of various diagnostic measures. Useful clinical utility of these measures is necessary to support diagnostic imaging and subsequent...

  14. Imaging Evaluation of Superior Labral Anteroposterior (SLAP) Tears.

    Science.gov (United States)

    Grubin, Jeremy; Maderazo, Alex; Fitzpatrick, Darren

    2015-10-01

    Superior labral anteroposterior (SLAP) tears are common injuries that are best evaluated with magnetic resonance arthrography (MRA), as it provides the most detailed evaluation of the bicipital labral complex. Given the variety and complexity of SLAP tears, distention of the joint with intra-articular dilute gadolinium contrast properly separates the intra-articular biceps tendon, superior labrum, glenoid cartilage and glenohumeral ligaments to optimize assessment of these structures. This allows for increased diagnostic confidence of the interpreting radiologist and provides a better road map for the surgeon prior to arthroscopy. Indirect MRA and high-field magnetic resonance imaging are sensitive and specific alternative modalities if MRA cannot be performed.

  15. X-ray, magnetic resonance imaging and hip arthroscopy manifestations of acetabular labral tears%髋臼盂唇损伤的X线、磁共振成像与关节镜表现分析

    Institute of Scientific and Technical Information of China (English)

    尚西亮; 陈疾忤; 吴子英; 陈世益

    2013-01-01

    Objective  To analyse the X-ray and Magnetic resonance imaging (MRI) features of acetabular labral tears, so that to improve the recognition of the disease. Methods  Imaging features of 19 patients with acetabular labral tears confirmed by arthroscopy were analyzed retrospectively (All cases were examined by X-ray, 14 patients underwent MRI examinations). Results  ①17 of the 19 patients had at least one osseous abnormality consistent with femoroacetabular impingement (FAI) under arthroscopy, among them 7 cases were cam impingement, 3 cases were pincer impingement and 7 cases were mixed impingement.  ② X-ray manifestations: 12 of the 19 patients had FAI, among them 6 cases were cam impingement, 2 cases were pincer impingement and 4 cases were mixed impingement. 5 cases showed various degrees of degenerations of hip joint. 2 patients had no identifiable structural abnormalities. ③MRI showed various degrees of injury of labrum in 6 patients, joint effusion in 5 cases, bone marrow edema of femoral head in 3 cases. Conclusion  FAI has much to do with acetabular labral tears. X-ray examination is important for FAI diagnosis. Given its high sensitivity and accuracy, MRI is an effective preoperative tool for defining the location and extent of labral tears. Combined with X-ray imaging and clinical manifestation, MRI can provide a reliable basis for clinical diagnosis and treatment.%  目的  分析髋臼盂唇损伤的X线及MRI表现,为临床诊断髋臼盂唇损伤提供影像学依据.方法  回顾性分析19例经关节镜

  16. Anterior labral tear: diagnostic value of MR arthrography of the shoulder

    International Nuclear Information System (INIS)

    To assess the accuracy of magnetic resonance(MR) arthrography in the diagnosis of anterior labral tear of the shoulder Between september 1996 and February 2000, MR arthrography of the shoulder was performed in 281 patients with a history of shoulder pain or instability. Among this total, only 157 shoulders in 154 patients who underwent arthroscopy or open surgery 0 to 230 (average, 20.9) days after MR arthrography were included in this study; the subjects comprised of 150 males and 4 females with an average age of 23.3 years. MR arthrographs of these 154 patients were analyzed for the presence of anterior labral tears, and the findings were correlated with the arthroscopic and surgical findings. Anterior labral tear was classified as A to D according to its location, as determined by arthroscopy and surgery. (A=4 to 6 o'clock direction, anteroinferior; B=2 to 4 o'clock direction, central; C=12 to 2 o'clock direction, anterosuperior; D= SLAP lesion). The retrospective analysis of MR arthrographs showing false-positive and negative findings was also underthken.. In the diagnosis of anterior labral tear, MR arthrography showed a sensitivity of 94%, a specificity of 90% and an accuracy of 91%. Anterior labral tears were confirmed by arthroscopy or surgery in 62 of the 157 shoulders (39%). Among 62 lesion, two (3%) were observed in area A, 32(52%) in area A+B, nine (15%) in area A+B+C, one(2%) in area A+B+D,13(21%) in area A+B+C+D, two (3%) in area B+C, one(2%) in area B+D, and two(3%) in area C. Among ten false-positive cases, seven were focal lessions (two, three and two lesions in area A, B and C, respectively), and in the remaining three cases, lacated in area A+B, MR arthrography revealed thickening and deformation. All four false negatives were focal lesions (two in area A and two in area C). Other than in focal lesions, in which accuracy was relatively low, MR arthrography showed high sensitivity, specificity and accuracy in the diagnosis of anterior labral tear

  17. Magnetic resonance imaging evaluation of meniscoid superior labrum: normal variant or superior labral tear*

    Science.gov (United States)

    Simão, Marcelo Novelino; Vinson, Emily N.; Spritzer, Charles E.

    2016-01-01

    Objective The objective of this study was to determine the incidence of a "meniscoid" superior labrum. Materials and Methods This was a retrospective analysis of 582 magnetic resonance imaging examinations of shoulders. Of those 582 examinations, 110 were excluded, for a variety of reasons, and the final analysis therefore included 472 cases. Consensus readings were performed by three musculoskeletal radiologists using specific criteria to diagnose meniscoid labra. Results A meniscoid superior labrum was identified in 48 (10.2%) of the 472 cases evaluated. Arthroscopic proof was available in 21 cases (43.8%). In 10 (47.6%) of those 21 cases, the operative report did not include the mention a superior labral tear, thus suggesting the presence of a meniscoid labrum. In only one of those cases were there specific comments about a mobile superior labrum (i.e., meniscoid labrum). In the remaining 11 (52.4%), surgical correlation demonstrated superior labral tears. Conclusion A meniscoid superior labrum is not an infrequent finding. Depending upon assumptions and the requirement of surgical proof, the prevalence of a meniscoid superior labrum in this study was between 2.1% (surgically proven) and 4.8% (projected). However, superior labral tears are just as common and are often confused with meniscoid labra. PMID:27777474

  18. Imaging of superior labral anterior to posterior (SLAP) tears of the shoulder.

    Science.gov (United States)

    Simoni, P; Scarciolla, L; Kreutz, J; Meunier, B; Beomonte Zobel, B

    2012-12-01

    Superior labral anterior to posterior (SLAP) tears include a number of abnormal changes of the superior glenoid labrum. SLAP tears have been first reported in elite young atlete and are caused by repetitive overhead motion or by a fall on an outstretched arm. SLAP can lead to chronic pain and instability of shoulder. A diagnosis of SLAP may be difficult on the basis of clinical tests. Hence, modern imaging, including computed tomography arthrography (CTA), magnetic resonance imaging (MRI) and magnetic resonance arthrography (MRA) play a key role in the diagnosis of SLAP. The large number of normal anatomic variants of the superior labrum and the surrounding structures make the interpretation of SLAP challenging on imaging and at arthroscopy. In this article the imaging of SLAP are discussed in detail along with relevant anatomy, anatomic variants and biomechanics.

  19. The MR arthrographic anatomy of the biceps labral insertion and its morphological significance with labral tears in patients with shoulder instability

    Energy Technology Data Exchange (ETDEWEB)

    Jakanani, G.C., E-mail: gcjakanani@gmail.com [Leicester Royal Infirmary, Leicester (United Kingdom); Botchu, R., E-mail: drrajeshb@gmail.com [Leicester Royal Infirmary, Leicester (United Kingdom); Rennie, W.J., E-mail: winston.rennie@gmail.com [Leicester Royal Infirmary, Leicester (United Kingdom)

    2012-11-15

    Introduction: Most of the fibres of the long head of biceps tendon attach on the superior labrum just posterior to the supraglenoid tubercle. Aim: Our hypothesis was that posteriorly attached biceps tendons predispose to posterior superior labral tears and SLAP lesions. Methods and materials: A prospective analysis of all MR shoulder arthrograms for shoulder instability referred from the shoulder specialist clinics, performed during a one year period were reviewed by two independent observers who were blinded to clinical history. The biceps attachment was classified into four groups according to the method described in an earlier cadaveric study into four groups; posterior-type 1, predominantly posterior-type 2, equal contributions to both anterior and posterior labrum-type 3 and predominantly anterior labral attachment-type 4. Data was analysed using Kappa statistics and Fischer's exact test. Results: 48 patients (33 males and 15 females) were included in this study with a mean age of 32 years. Majority, 22 patients (46%) had a type 1 attachment of the biceps on the superior labrum. There was moderate intra-observer and good interobserver agreement with a Kappa of 0.58 and 0.63 respectively. There was a significant association between a type 2 attachment and posterior tears (p {<=} 0.04) and also between a type 2 attachment and SLAP tears (p {<=} 0.04). Conclusion: Our results suggest that variation in anatomy of biceps origin influences the type of labral tears that occur in patients with shoulder instability. The importance of these findings could influence selection of individuals in throwing sports like cricket and baseball.

  20. Osteopathic diagnosis of an acetabular injury.

    Science.gov (United States)

    Morthland, Tim; Cote, Nicholas S; Humphrey, Jon; Fulk, Doug

    2010-05-01

    Physical findings demarking pathologic somatovisceral reflex activity and fascial strain patterns may lead the osteopathic physician to diagnoses that are masked within the initial presentation of a patient. The authors present a case report that demonstrates the use of osteopathic principles in the diagnosis of a chronic acetabular fracture and acetabular labral tear in a 19-year-old man. The injuries resulted from a posterior hip dislocation sustained during a basketball game more than 1 year before presentation. Osteopathic manipulative treatment and diagnostic techniques also relieved the patient's persistent thoracic pain, nausea, and vomiting. Subsequent orthopedic repair had the potential to avert or delay degenerative hip disease in the patient. PMID:20538751

  1. Hip labral cyst caused by psoas impingement.

    Science.gov (United States)

    Tey, Marc; Alvarez, Sonia; Ríos, Jose L

    2012-08-01

    Hip labral impingement can cause labral tears and secondary paralabral cyst formation. Femoroacetabular impingement is the main cause of labral impingement, but other conditions such as iliopsoas tendon impingement are described. There is no description of labral cyst resulting from psoas impingement treated arthroscopically in the literature. We present the case of a young sportsman with groin pain caused by psoas impingement with a labral tear and secondary paralabral cyst who was treated arthroscopically by cyst debridement, psoas tenotomy, and labral repair. PMID:22840990

  2. Three-dimensional magnetic resonance imaging analysis of hip morphology in the assessment of femoral acetabular impingement

    Energy Technology Data Exchange (ETDEWEB)

    Kavanagh, E.C. [Department of Radiology, Mater Misericordiae Hospital, Dublin (Ireland); Read, P.; Carty, F.; Zoga, A.C. [Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA (United States); Parvizi, J. [The Rothman Institute of Orthopedics, Philadelphia, PA (United States); Morrison, W.B., E-mail: William.Morrison@Jefferson.edu [Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA (United States)

    2011-08-15

    Aim: To determine a possible association between femoral-acetabular impingement (FAI) volume and the development of labral tear using a three-dimensional (3D) model reconstruction of the acetabulum and the femoral head. Materials and methods: Magnetic resonance arthrography images of the hip in 42 patients with pain and suspected labral tear were acquired using a 1.5 T MRI machine. Using 3D analysis software, outlines of the acetabular cup and femoral head were drawn and 3D reconstruction obtained. To control for differences in patient size, ratios of acetabulum : femoral head volume (AFV) and acetabulum : femoral head surface area (AFA) were used for analysis. The association between volume of acetabulum : femoral head and FAI was investigated using ANOVA analysis. Results: There were 19 men and 23 women with a mean age of 39 years (range 18-78 years). The average AFV was 0.64 (range 0.37-1.05, SD 0.16) and AFA was 0.73 (range 0.36-1.26, SD 0.23). Herniation pit was significantly associated with a small AFV. Conclusion: Femoral neck herniation pits are associated with a low AFV. Gross volume and surface area ratios do not appear to correlate with labral tears or cartilage loss. This technique will enable more advanced analysis of morphological variations associated with FAI.

  3. Magnetic resonance imaging of labral cysts of the hip

    Energy Technology Data Exchange (ETDEWEB)

    Schnarkowski, P. [Department of Radiology, University of California, San Francisco, CA (United States)]|[Department of Radiology, Ludwig-Maximilians-University, Munich (Germany); Steinbach, L.S. [Department of Radiology, University of California, San Francisco, CA (United States); Tirman, P.F.J. [Department of Radiology, University of California, San Francisco, CA (United States)]|[San Francisco Magnetic Resonance Center, San Francisco, CA (United States); Peterfy, C.G. [Department of Radiology, University of California, San Francisco, CA (United States); Genant, H.K. [Department of Radiology, University of California, San Francisco, CA (United States)

    1996-11-01

    Objective. To present the magnetic resonance (MR) imaging findings in patients with labral cysts adjacent to the acetabulum and to examine their association with hip pathology. Design. MR images and conventional radiographs of seven patients with paralabral cysts were retrospectively reviewed by three musculoskeletal radiologists. Patients. The patients included three men and four women with hip pain, ranging in age from 29 to 82 years. Two patients had developmental dysplasia of the hip and six had a history of remote trauma/dislocation. Clinical history and follow-up were obtained in all patients. Surgery was performed on one patient. Results and conclusions. Paralabral cysts were located in the posterosuperior aspect of the hip joint in five patients and in the anterior aspect in two patients. A tear of the adjacent acetabular labrum was confirmed surgically in one patient, and in all patients the MR features suggested the presence of an abnormal labrum. Osteoarthritis was observed in three patients and there was associated subchondral cyst formation in the acetabulum adjacent to the cyst in three patients. The paralabral cyst of the hip is well visualized on MR imaging and is seen in patients with a predisposition to labral pathology. (orig.). With 3 figs., 1 tab.

  4. Magnetic resonance imaging and magnetic resonance arthography of the acetabular labrum: Comparison with surgical findings; Magnetresonanztomographie und Magnetresonanzarthrographie des Labrum acetabulare: Vergleich mit operativen Ergebnissen

    Energy Technology Data Exchange (ETDEWEB)

    Czerny, C. [Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria). Abt. fuer Osteologie; Kramer, J. [Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria). Abt. fuer Osteologie; Institut fuer bildgebende Diagnostik am Schillerpark, Linz (Austria); Neuhold, A. [Krankenhaus Rudolfinerhaus, Vienna (Austria). Inst. fuer bildgebende Diagnostik; Urban, M. [Krankenhaus Sozialmedizinisches Zentrum Ost, Vienna (Austria). Abt. fuer Radiodiagnostik; Tschauner, C. [Orthopaedisches Landeskrankenhaus Stolzalpe (Austria); Hofmann, S. [Krankenhaus Sozialmedizinisches Zentrum Ost, Vienna (Austria). Abt. fuer Radiodiagnostik; Orthopaedisches Landeskrankenhaus Stolzalpe (Austria)

    2001-08-01

    Aim of the study: To evaluate the accuracy of magnetic resonance imaging (MRI) and magnetic resonance (MR) arthrography in detecting acetabular labral lesions in correlation to surgical findings. Patients and methods: Forty patients (40 hips) with chronic hip pain and a strong clinical suspicion of labral lesions were examined with MRI in the coronal and axial plane by obtaining T{sub 1} weighted and proton density-weighted spin echo sequences. Additionally, MR arthrography of the high joint in the coronal oblique and sagittal oblique plane was performed by obtaining T{sub 1}-weighted three-dimensional gradient echo sequences after the intraarticular injection of gadopentate dimeglumine. The labra were prospectively evaluated on the basis of morphology, signal intensity, the presence or absence of a tear, and their attachment to the acetabulum. All patients underwent surgery, and the MRI findings and MR arthrography findings were compared with the surgical results. Results: Surgically, 34 labral lesions, and 6 normal labra were detected. MRI correctly depicted labral lesions in 24 patients and two normal labra, and MR arthrography correctly depicted labral lesions in 30 patients and 5 normal labra compared with the surgical results. The sensitivity of MRI was 80%, the accuracy of MRI was 65%, the sensitivity of MR arthrography was 95%, and the accuracy of MR arthgrography was 88%. Conclusions: MR arthrography enables considerably more accurate detection of acetabular labral lesions than MRI. MR arthrography should be the method of choice for the diagnosis of the presence or absence of acetabular labral lesions in patients with chronic hip pain and a strong clinical suspicion of labral lesions. (orig.) [German] Ziel: Die Bestimmung der Wertigkeit der konventionellen Magnetresonanztomographie (MRT) und der Magnetresonanzarthrographie (MR-Arthrographie) in der Abklaerung von Laesionen des Labrum acetabulare im Vergleich mit Operationsbefunden (Goldstandard). Methode

  5. High frequency of labral pathology in dysplastic hips with a CE angle between 20-25

    DEFF Research Database (Denmark)

    Jakobsen, Stig Storgaard; Hartig-Andreasen, Charlotte; Mikkelsen, Lone Rømer;

    Background: Hip dysplasia becomes symptomatic due to labral pathology and secondary muscular pain. A CE angle pathologic and defined as dysplasia in PAO centres in Denmark. However, it is debated whether a CE angle between 20 and 25 is borderline. Purpose / Aim of Study: We aimed...... to investigate the degree of labral pathology in symptomatic patients with CE between 20 and 25 compared with patients with CE ... of osteoarthritis 0 or 1. All patients had a magnetic resonance arthrography (MRA) performed. The MRA was assessed for labral pathology in terms of degeneration, hypertrophic changes, tears and paralabral cysts. Labral lesions were graded according to the Czerny classification. Findings / Results: In the group...

  6. All-arthroscopic iliotibial band autograft harvesting and labral reconstruction technique.

    Science.gov (United States)

    Deshmane, Prashant P; Kahlenberg, Cynthia A; Patel, Ronak M; Han, Brian; Terry, Michael A

    2013-02-01

    The labrum is essential for stability, movement, and prevention of arthritis in the hip. In cases of labral damage where repair of a labral tear is not possible, reconstruction can be a useful alternative. Several different autografts have been used, including the iliotibial band (ITB), the ligamentum teres capitis, and the gracilis tendon. Authors have reported both open and arthroscopic techniques for reconstruction with good preliminary results. However, an all-arthroscopic labral reconstruction technique including the graft harvest and reconstruction portions of a labral reconstruction procedure using an ITB autograft has not been previously described. We describe a technique for an all-arthroscopic labral reconstruction performed using a novel method for arthroscopic harvest of the ITB. The decreased invasiveness of our described technique for labral reconstruction may potentially minimize scarring, bodily disfigurement, infection, and postoperative pain associated with the graft harvesting incision.

  7. The role of the acetabular labrum in hip dysplasia

    DEFF Research Database (Denmark)

    Hartig-Andreasen, Charlotte; Søballe, Kjeld; Troelsen, Anders

    2013-01-01

    A periacetabular osteotomy (PAO) is the preferred joint preserving treatment for young adults with symptomatic hip dysplasia and no osteoarthritis. In symptomatic dysplasia of the hip, there is labral pathology in up to 90% of cases. However, no consensus exists as to whether a labral tear should...

  8. Osteocondroma acetabular Acetabular osteochondroma

    Directory of Open Access Journals (Sweden)

    Reynaldo Jesus Garcia

    2005-01-01

    Full Text Available Apresentamos o relato de um caso de osteocondroma solitário acetabular, tumor ósseo comum em diversas regiões do esqueleto porém raro nesta localização. O tratamento realizado foi a ressecção do tumor por uma via posterior ao quadril e o paciente evoluiu com resolução do quadro clínico.This is a case report of a patient with a intra-articular hip osteochondroma, an extremely rare location for this kind of lesion. The patient was treated with resection of the lesion and presented a very good evolution with total recovery of the hip movements.

  9. Arthroscopic isolated posterior labral repair in rugby players

    Directory of Open Access Journals (Sweden)

    Badge Ravi

    2009-01-01

    Full Text Available Background: The shoulder is the second most frequently injured joint after the knee in rugby players and labral tears appear to be common. There is limited data available in the literature regarding the mechanisms of posterior labral injury in rugby players and the management of these injuries. Objective: The aim of this study is to report the clinical presentation, arthroscopic findings, surgical technique for repair, and the functional outcome in elite English rugby players with isolated posterior labral injuries. Study Design: Case series (level IV evidence Materials and m0 ethods: Over a 5-year period we surgically treated 142 elite rugby players, of whom 11 (7.8% had isolated posterior labral injuries.All these 11 patients had significant contact injury. Only three (24% patients had a true posterior shoulder dislocation. Pre- and postoperative assessment included Constant score, Oxford shoulder score, and Oxford instability score. We also assessed the time taken to return to preinjury level of fitness and the complications of surgery. Results: Average follow-up was for 32 months (range 17-54 months. The mean Constant score improved from 66 to 99. The Oxford score indicated improvement, decreasing from 33 to 18; similarly, the Oxford instability score also decreased from 52.2 to 12.3. Return to playing rugby at peak level was at a mean of 4.3 months after arthroscopic repair. Conclusion: Successful clinical results and rapid return to play can be achieved by appropriate early arthroscopic repair and supervised accelerated rehabilitation for posterior labral tears in elite rugby players.

  10. The role of the acetabular labrum in hip dysplasia

    OpenAIRE

    Hartig-Andreasen, Charlotte; Søballe, Kjeld; Troelsen, Anders

    2013-01-01

    A periacetabular osteotomy (PAO) is the preferred joint preserving treatment for young adults with symptomatic hip dysplasia and no osteoarthritis. In symptomatic dysplasia of the hip, there is labral pathology in up to 90% of cases. However, no consensus exists as to whether a labral tear should be treated before the periacetabular osteotomy (PAO), treated simultaneously with the PAO, or left alone and only treated if symptoms persist after the PAO. This review is an update of aspects of lab...

  11. Prevalence of the acetabular sublabral sulcus at MR arthrography in patients under 17 years of age: does it exist?

    Energy Technology Data Exchange (ETDEWEB)

    Magerkurth, Olaf [University of Michigan, Department of Radiology, Ann Arbor, MI (United States); Hospital Baden, Department of Radiology, Baden (Switzerland); Jacobson, Jon A.; Morag, Yoav; Fessell, David [University of Michigan, Department of Radiology, Ann Arbor, MI (United States); Bedi, Asheesh; Sekiya, Jon K. [University of Michigan, Department of Orthopedic Surgery, Ann Arbor, MI (United States)

    2015-04-18

    To retrospectively determine characteristics of contrast-filled acetabular labral clefts in patients under the age of 17 years at MR arthrography (Mra) correlated with arthroscopy, which may impact the thinking regarding the existence of a sublabral sulcus. After IRB approval, 41 patients under the age of 17 who had MRa were identified. The following observations of contrast-filled clefts were assessed: (1) presence/absence, (2) location, (3) depth, (4) abnormal signal within the labrum and (5) shape (linear, gaping, complex). Fisher's exact and the Wilcoxon matched-pairs signed-rank test were performed. Interreader agreement was calculated with Cohen's k. Reader 1 found clefts in 41 %. Depth was less than half in 6 %, more than half in 65 % and full thickness in 29 %. Shape was linear in 53 %, gaping in 18 % and complex in 29 %. Signal changes occurred in 88 %. Reader 2 found clefts in 29 %. Depth was less than half in 17 %, more than half in 58 % and full thickness in 25 %. Shape was linear in 50 %, gaping in 42 % and complex in 17 %. Signal changes occurred in 50 %. None of the clefts fulfilled the criteria for a sublabral sulcus at MRa and arthroscopy. None of the clefts found in our subjects under the age of 17 years met the MRa and arthroscopy criteria for a sublabral sulcus, which supports the theory that such clefts represent labral tears. (orig.)

  12. MR imaging findings of acetabular dysplasia in adults

    Energy Technology Data Exchange (ETDEWEB)

    James, Steven; Connell, David [The Royal National Orthopaedic Hospital, Radiology Department, London, Middlesex (United Kingdom); Miocevic, Miranda; Malara, Frank; Pike, Jonathan [Victoria House Hospital, Radiology Department, Melbourne (Australia); Young, David [Melbourne Orthopaedic Group, Orthopaedic Surgery, Melbourne (Australia)

    2006-06-15

    To evaluate the diagnostic accuracy of MR imaging in the identification of labral and articular cartilage lesions in patients with acetabular dysplasia. Pre-operative MR imaging was performed on 27 hips in 25 consecutive patients (16 males, 9 females, age range 19-52 years, mean age 31.2 years) with radiographic evidence of acetabular dysplasia (centre-edge angle of Wiberg <20 degrees). The average duration of symptoms was 16.2 months. Two musculoskeletal radiologists assessed MR images in consensus for the presence of abnormality involving the acetabular labrum and adjacent acetabular articular cartilage. A high resolution, non-arthrographic technique was used to assess the labrum and labral chondral transitional zone. Surgical correlation was obtained in all cases by a single surgeon experienced in hip arthroscopy and ten patients with normal hip MRI were included to provide a control group. The acetabular labra in the dysplastic hips demonstrated abnormal signal intensity, and had an elongated appearance when compared with the control group (mean length 10.9 mm vs 6.4 mm). Morphological appearances in the labra included surface irregularity, fissures and cleft formation. MR imaging correctly identified the severity of chondral abnormality in 24 of 27 hips (89%) when compared with arthroscopic findings. MR imaging demonstrates an elongated labrum, focal intra-substance signal change and irregularity and fissuring of the margins in patients with acetabular dysplasia. Abnormality is also identified at the labral chondral transitional zone, where fissuring, focal clefts, chondral deficiency and subchondral cyst formation may be apparent. A high-resolution, non-arthrographic technique can provide an accurate preoperative assessment and evaluate the presence of premature osteoarthritis. (orig.)

  13. The Association of Femoral Neck Stress Fractures with Femoral Acetabular Impingement

    Science.gov (United States)

    Safran, Marc R.; Goldin, Michael; Anderson, Christian; Fredericson, Michael; Stevens, Kathryn J.

    2013-01-01

    Objectives: To determine if there is an increased incidence of femoral acetabular impingement (FAI) in patients presenting with stress fractures of the femoral neck. Methods: After IRB approval, the imaging studies of 25 athletes (22 females, 3 males, mean age 26, range 19 - 39 years) with femoral neck stress injuries were assessed for the presence of features suggesting FAI, including acetabular retroversion, coxa profunda, abnormal femoral head-neck junction, fibrocystic change, os acetabulae, labral tear and chondral injury. All subjects had to have an adequate AP Pelvis radiograph, a lateral radiograph of the affected hip, and an MRI of the affected hip. The alpha angle, anterior offset ratio, and center to edge (CE) angle were measured on radiographs. The grade of stress injury was determined on MR images. All images and measurements were made by a musculoskeletal fellowship trained radiologist, a fellowship trained orthopaedic surgeon, an orthopaedic sports medicine fellow and a physical medicine and rehabilitation resident. Charts were reviewed to determine treatment of the stress fracture, outcome and final follow up, as well as to determine if the patient had any further treatment for their hip. Results: Of the 25 hips (18 right, 7 left) with femoral neck stress reactions, 9 were grade 2 (bone marrow edema), 5 were grade 3 (high T2 and low T1 marrow signal), and 11 were grade 4 (stress fracture). Twenty patients (80%) had coxa profunda - where the floor of the cotyloid fossa touches or extends beyond the ilioischial line (incidence in general population is 15.2% of males, and 19.4% of females). Coxa profunda, defined by the floor of the cotyloid fossa touching or extending beyond the ilioischial line and a center edge angle of more than 35o, was present in 28% of subjects. Acetabular retroversion as assessed by the crossover sign was present in 42% (normal incidence is 5% of population). Center edge angle was greater than 35o in 20% and greater than 40 o

  14. Magnetic resonance appearance of posterosuperior labral peel back during humeral abduction and external rotation

    Energy Technology Data Exchange (ETDEWEB)

    Borrero, Camilo G.; Casagranda, Bethany U.; Towers, Jeffrey D. [Department of Radiology, Pittsburgh, PA (United States); Bradley, James P. [Department of Orthopedics, Pittsburgh, PA (United States)

    2010-01-15

    To describe the magnetic resonance appearance of posterosuperior labral peel back and determine the reliability of MR in the abducted and externally rotated (ABER) position for the prospective diagnosis of arthroscopically proven cases of posterosuperior labral peel back. After approval by the institutional review board (IRB) of the University of Pittsburgh Medical Center, USA, databases of patients who underwent arthroscopy over a 2-year period for one of three clinical diagnoses [suspected type 2 superior labrum anterior to posterior (SLAP) tears, posterior instability, or multidirectional instability] were reviewed after anonymization by an honest broker. Sixty-three cases were selected by the following inclusion criteria: operative report documenting labral peel back in the ABER position, age <40 years, and preceding MR arthrogram evaluations with images in the ABER position (n = 34). Inclusion criteria for the control group differed from those for the case group insofar as the operative note documented the absence of posterosuperior labral peel back (n = 29). Cases and controls were randomized in one list and evaluated independently by two fellowship-trained musculoskeletal radiologists unaware of the surgical results and using a three-point grading system (0 = posterosuperior labrum normally positioned lateral/craniad to glenoid articular plane in ABER; 1 = posterosuperior labral tissue flush with the glenoid articular plane in ABER; 2 = posterosuperior labral tissue identified medial/caudal to glenoid articular plane in ABER). Only one image in ABER showing abnormal posterosuperior labral position was required for a grade of 1 or 2 to be assigned. Sensitivity, specificity, and positive and negative predictive value were calculated as well as the level of agreement between readers (kappa). Both readers assigned a grade of 2 to 25 of 34 patients with surgically proven labral peel back. Of the patients with surgically proven SLAP tears with peel back in ABER

  15. Labral reconstruction: when to perform and how

    Directory of Open Access Journals (Sweden)

    Brian J White

    2015-07-01

    Full Text Available Over the past decade, the understanding of the anatomy and function of the hip joint has continuously evolved, and surgical treatment options for the hip have significantly progressed. Originally, surgical treatment of the hip primarily involved resection of damaged tissue. Procedures that maintain and preserve proper hip anatomy, such as labral repair and femoroacetabular impingement (FAI correction, have shown superior results, in terms of pain reduction, increased function, and ability to return to activities. Labral reconstruction is a treatment option that uses a graft to reconstruct the native labrum. The technique and outcomes of labral reconstruction have been described relatively recently, and labral reconstruction is a cutting edge procedure that has shown promising early outcomes. The aim of this article is to review the current literature on hip labral reconstruction. We will review the indications for labral reconstruction, surgical technique and graft options, and surgical outcomes that have been described to date. Labral reconstruction provides an alternative treatment option for challenging intra-articular hip problems. Labral reconstruction restores the original anatomy of the hip and has the potential to preserve the longevity of the hip joint. This technique is an important tool in the orthopaedic surgeon’s arsenal for hip joint treatment and preservation.

  16. Normal anatomy and common labral lesions at MR arthrography of the shoulder

    International Nuclear Information System (INIS)

    MR arthrography of the shoulder is the most accurate imaging modality in demonstrating abnormalities of the glenoid labrum and associated structures. Tears of the labrum, the capsule or the gleno-humeral ligaments can lead to pain, catching, popping or instability. The anatomy of this region is complex. We present the normal anatomy of the glenoid labrum, biceps anchor and gleno-humeral ligaments together with their normal variants and then describe common labral-ligamentous pathologies

  17. Indirect magnetic resonance arthrography of the shoulder; a reliable diagnostic tool for investigation of suspected labral pathology

    Energy Technology Data Exchange (ETDEWEB)

    Fallahi, Farshid [North Cumbria University Hospitals NHS Trust, Carlisle (United Kingdom); North Cumbria University Hospitals, Department of Radiology, Carlisle (United Kingdom); Green, Nick; Gadde, Sarat; Jeavons, Lisa; Armstrong, Patrick; Jonker, Leon [North Cumbria University Hospitals NHS Trust, Carlisle (United Kingdom)

    2013-09-15

    Indirect magnetic resonance arthrography (I-MRA) confers significant logistical advantages over direct MRA and does not require articular injection. In this study, we determined the diagnostic performance of I-MRA in relation to conventional MRI and arthroscopy or surgery in detecting tears of the glenoid labrum, including Bankart lesions and superior labral antero-posterior (SLAP) tears in a standard clinical setting. Ninety-one symptomatic patients underwent conventional MRI and I-MRA of the affected shoulder, followed by either arthroscopy or open surgery. The scans were interpreted independently by two experienced radiology consultants with a special interest in musculoskeletal radiology. Using the surgical findings as the standard of reference, sensitivity, specificity, and diagnostic accuracy of conventional non-contrast MRI and I-MRA in the detection of labral tears were calculated. The sensitivity of I-MRA was 95 and 97 %, respectively, for two radiologists as opposed to 79 and 83 % for conventional MRI. For both radiologists, the specificity of I-MRA, as well as MRI, was 91 % for detection of labral tears of all types. Accuracy of diagnosis was 93 and 95 %, respectively, for two radiologists with indirect MRA, compared to 84 and 86 % with non-contrast MRI. This retrospective study shows that I-MRA is a highly accurate and sensitive method for the detection of labral tears. The data obtained supports the use of I-MRA as standard practice in patients with shoulder instability due to suspected labral pathology where further investigative imaging is indicated. (orig.)

  18. Labral and cartilage abnormalities in young patients with hip pain: accuracy of 3-Tesla indirect MR arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Petchprapa, Catherine N.; Rybak, Leon D. [NYU Langone Medical Center-Hospital for Joint Diseases, Department of Radiology, New York, NY (United States); Dunham, Kevin S.; Recht, Michael P. [NYU Langone Medical Center, Department of Radiology, New York, NY (United States); Lattanzi, Riccardo [NYU Langone Medical Center, The Bernard and Irene Schwartz Center for Biomedical Imaging, New York, NY (United States)

    2015-01-15

    Assess the diagnostic accuracy of 3-T indirect magnetic resonance arthrography (iMRA) for hip cartilage and labral pathology detection using arthroscopy as the reference standard and compare it to the published performance of direct magnetic resonance arthrography (dMRA). Between 2009 and 2011, 290 patients suspected of having femoroacetabular impingement underwent iMRA. Our study group consisted of 41 of these patients (17 males, mean age 35 years; 24 females, mean age 33 years) who did not have a prior history of hip surgery and who subsequently underwent arthroscopy. Two experienced musculoskeletal radiologists separately evaluated the randomized and anonymized studies for the presence and quadrant location of labral and cartilage pathology. These recorded data were compared to arthroscopic reports. Forty-one patients had labral pathology, 34 patients had acetabular and 5 patients had femoral cartilage pathology at arthroscopy. Sensitivity, specificity, accuracy, negative- and positive-predictive values for labral lesion detection were respectively 98, 99, 99, 99 and 98 %; for acetabular cartilage lesion detection they were 69, 98, 89, 87 and 95 %; for femoral cartilage lesion detection they were 69, 95, 93 and 39 %. Sensitivities of iMRA by quadrant (anteroinferior, anterosuperior, posteroinferior, posterosuperior) for the labrum were 100.0, 95.0, NA and 85.7 %, for acetabular cartilage were NA, 58.8, NA and 39.5 % and for femoral cartilage were 50.0, 33.3, 75.0 and 75.0 %. NA indicates results not available because of the absence of findings in those quadrants. Specificities of iMRA by quadrant (anteroinferior, anterosuperior, posteroinferior, posterosuperior) for the labrum (95.0, 100.0, 95.1, 67.5 %), acetabular (100.0, 85.7, 92.6, 79.5 %) and femoral cartilage (100.0, 94.7, 96.2, 85.9 %). iMRA at 3 T is accurate in detecting labral pathology suggesting that it is a viable alternative to dMRA. (orig.)

  19. Diagnostic performance of direct traction MR arthrography of the hip: detection of chondral and labral lesions with arthroscopic comparison

    Energy Technology Data Exchange (ETDEWEB)

    Schmaranzer, Florian; Klauser, Andrea; Henninger, Benjamin [Medical University Innsbruck, Department of Radiology, Innsbruck (Austria); Kogler, Michael; Schmaranzer, Ehrenfried [District Hospital St. Johann in Tyrol, Department of Radiology, St. Johann in Tyrol (Austria); Forstner, Thomas [Johannes Keppler University, Department for Applied Systems Research and Statistics, Linz (Austria); Reichkendler, Markus [District Hospital St. Johann in Tyrol, Department of Orthopedic Surgery, St. Johann in Tyrol (Austria)

    2015-06-01

    To assess diagnostic performance of traction MR arthrography of the hip in detection and grading of chondral and labral lesions with arthroscopic comparison. Seventy-five MR arthrograms obtained ± traction of 73 consecutive patients (mean age, 34.5 years; range, 14-54 years) who underwent arthroscopy were included. Traction technique included weight-adapted traction (15-23 kg), a supporting plate for the contralateral leg, and intra-articular injection of 18-27 ml (local anaesthetic and contrast agent). Patients reported on neuropraxia and on pain. Two blinded readers independently assessed femoroacetabular cartilage and labrum lesions which were correlated with arthroscopy. Interobserver agreement was calculated using κ values. Joint distraction ± traction was evaluated in consensus. No procedure had to be stopped. There were no cases of neuropraxia. Accuracy for detection of labral lesions was 92 %/93 %, 91 %/83 % for acetabular lesions, and 92 %/88 % for femoral cartilage lesions for reader 1/reader 2, respectively. Interobserver agreement was moderate (κ = 0.58) for grading of labrum lesions and substantial (κ = 0.7, κ = 0.68) for grading of acetabular and femoral cartilage lesions. Joint distraction was achieved in 72/75 and 14/75 hips with/without traction, respectively. Traction MR arthrography safely enabled accurate detection and grading of labral and chondral lesions. (orig.)

  20. SLAP tear associated with a minimally displaced proximal humerus fracture.

    Science.gov (United States)

    Kendall, Corey B; Tanner, Stephanie L; Tolan, Stefan J

    2007-12-01

    Nondisplaced proximal humerus fracture may be associated with soft tissue injury. This case report examines 2 cases of superior labral anterior-posterior (SLAP) tears in association with nondisplaced fractures of the proximal humerus. In the first case, the patient fell from a jet ski, causing a traction injury to his arm. A greater tuberosity fracture was identified. Magnetic resonance imaging (MRI) did not reveal a definitive labral tear. After conservative management had failed, a type IV SLAP tear and a small rotator cuff tear were arthroscopically identified and repaired. In the second case, a power company lineman fell from a lift and attempted to hold on with his dominant arm. A nondisplaced greater tuberosity and a surgical neck fracture were discovered. MR arthrography revealed no evidence of SLAP tear. Four months after injury, a type II SLAP tear was arthroscopically identified and repaired. In these 2 cases, the presence of the fracture likely slowed operative intervention because pain was attributed to the fracture itself, and not to the SLAP tear. If patients do not follow the usual course of improvement after a proximal humerus fracture from a superior traction mechanism, consideration should be given to associated superior labral tears that may require surgical intervention.

  1. Loosening After Acetabular Revision

    DEFF Research Database (Denmark)

    Beckmann, Nicholas A.; Weiss, Stefan; Klotz, Matthias C.M.;

    2014-01-01

    The best method of revision acetabular arthroplasty remains unclear. Consequently, we reviewed the literature on the treatment of revision acetabular arthroplasty using revision rings (1541 cases; mean follow-up (FU) 5.7 years) and Trabecular Metal, or TM, implants (1959 cases; mean FU 3.7 years)...

  2. Rotator cuff tears in children and adolescents: experience at a large pediatric hospital

    Energy Technology Data Exchange (ETDEWEB)

    Zbojniewicz, Andrew M.; Emery, Kathleen H. [University of Cincinnati College of Medicine, Department of Radiology, Cincinnati Children' s Hospital Medical Center, Cincinnati, OH (United States); Maeder, Matthew E. [University of Cincinnati College of Medicine, Department of Radiology, Cincinnati Children' s Hospital Medical Center, Cincinnati, OH (United States); Lenox Hill Hospital, Department of Radiology, New York, NY (United States); Salisbury, Shelia R. [University of Cincinnati College of Medicine, Division of Biostatistics and Epidemiology, Cincinnati Children' s Hospital Medical Center, Cincinnati, OH (United States)

    2014-06-15

    Prior literature, limited to small case series and case reports, suggests that rotator cuff tears are rare in adolescents. However, we have identified rotator cuff tears in numerous children and adolescents who have undergone shoulder MRI evaluation. The purpose of this study is to describe the prevalence and characteristics of rotator cuff tears in children and adolescents referred for MRI evaluation of the shoulder at a large pediatric hospital and to correlate the presence of rotator cuff tears with concurrent labral pathology, skeletal maturity and patient activity and outcomes. We reviewed reports from 455 consecutive non-contrast MRI and magnetic resonance arthrogram examinations of the shoulder performed during a 2-year period, and following exclusions we yielded 205 examinations in 201 patients (ages 8-18 years; 75 girls, 126 boys). Rotator cuff tears were classified by tendon involved, tear thickness (partial or full), surface and location of tear (when partial) and presence of delamination. We recorded concurrent labral pathology when present. Physeal patency of the proximal humerus was considered open, closing or closed. Statistical analysis was performed to evaluate for a relationship between rotator cuff tears and degree of physeal patency. We obtained patient activity at the time of injury, surgical reports and outcomes from clinical records when available. Twenty-five (12.2%) rotator cuff tears were identified in 17 boys and 7 girls (ages 10-18 years; one patient had bilateral tears). The supraspinatus tendon was most frequently involved (56%). There were 2 full-thickness and 23 partial-thickness tears with articular-side partial-thickness tears most frequent (78%). Insertional partial-thickness tears were more common (78%) than critical zone tears (22%) and 10 (43%) partial-thickness tears were delamination tears. Nine (36%) patients with rotator cuff tears had concurrent labral pathology. There was no statistically significant relationship between

  3. Rotator cuff tears in children and adolescents: experience at a large pediatric hospital

    International Nuclear Information System (INIS)

    Prior literature, limited to small case series and case reports, suggests that rotator cuff tears are rare in adolescents. However, we have identified rotator cuff tears in numerous children and adolescents who have undergone shoulder MRI evaluation. The purpose of this study is to describe the prevalence and characteristics of rotator cuff tears in children and adolescents referred for MRI evaluation of the shoulder at a large pediatric hospital and to correlate the presence of rotator cuff tears with concurrent labral pathology, skeletal maturity and patient activity and outcomes. We reviewed reports from 455 consecutive non-contrast MRI and magnetic resonance arthrogram examinations of the shoulder performed during a 2-year period, and following exclusions we yielded 205 examinations in 201 patients (ages 8-18 years; 75 girls, 126 boys). Rotator cuff tears were classified by tendon involved, tear thickness (partial or full), surface and location of tear (when partial) and presence of delamination. We recorded concurrent labral pathology when present. Physeal patency of the proximal humerus was considered open, closing or closed. Statistical analysis was performed to evaluate for a relationship between rotator cuff tears and degree of physeal patency. We obtained patient activity at the time of injury, surgical reports and outcomes from clinical records when available. Twenty-five (12.2%) rotator cuff tears were identified in 17 boys and 7 girls (ages 10-18 years; one patient had bilateral tears). The supraspinatus tendon was most frequently involved (56%). There were 2 full-thickness and 23 partial-thickness tears with articular-side partial-thickness tears most frequent (78%). Insertional partial-thickness tears were more common (78%) than critical zone tears (22%) and 10 (43%) partial-thickness tears were delamination tears. Nine (36%) patients with rotator cuff tears had concurrent labral pathology. There was no statistically significant relationship between

  4. Posterior labral injury in contact athletes.

    Science.gov (United States)

    Mair, S D; Zarzour, R H; Speer, K P

    1998-01-01

    Nine athletes (seven football offensive linemen, one defensive lineman, and one lacrosse player) were found at arthroscopy to have posterior labral detachment from the glenoid. In our series, this lesion is specific to contact athletes who engage their opponents with arms in front of the body. All patients had pain with bench pressing and while participating in their sport, diminishing their ability to play effectively. Conservative measures were ineffective in relieving their symptoms. Examination under anesthesia revealed symmetric glenohumeral translation bilaterally, without evidence of posterior instability. Treatment consisted of glenoid rim abradement and posterior labral repair with a bioabsorbable tack. All patients returned to complete at least one full season of contact sports and weightlifting without pain (minimum follow-up, > or = 2 years). Although many injuries leading to subluxation of the glenohumeral joint occur when an unanticipated force is applied, contact athletes ready their shoulder muscles in anticipation of impact with opponents. This leads to a compressive force at the glenohumeral joint. We hypothesize that, in combination with a posteriorly directed force at impact, the resultant vector is a shearing force to the posterior labrum and articular surface. Repeated exposure leads to posterior labral detachment without capsular injury. Posterior labral reattachment provides consistently good results, allowing the athlete to return to competition.

  5. Magnetic resonance imaging evaluation of capsulolabral tears after traumatic primary anterior shoulder dislocation. A prospective comparison with arthroscopy of 25 cases

    DEFF Research Database (Denmark)

    Suder, P.A.; Frich, Lars Henrik; Hougaard, K.;

    1995-01-01

    . Subacute MRI evaluation identified 15 labral tears, 12 Hill-Sachs lesions, 1 total rotator cuff lesion, 1 partial joint side rotator cuff lesion, and 1 partial rupture of the biceps tendon. Arthroscopic examination revealed 22 labral tears, 15 Hill-Sachs lesions, 1 total rotator cuff lesion, 1 partial...... joint side rotator cuff tear, 1 partial rupture of the biceps tendon, and 1 osseous Bankart lesion. Anterior capsulolabral tears and Hill-Sachs lesions appeared with a high incidence after acute anterior primary shoulder dislocation. Conventional MRI was only moderately reliable in the preoperative...... evaluation of labral tears and Hill-Sachs lesions, and it failed to give an accurate, differentiated preoperative diagnosis of the capsulolabral lesions....

  6. MR-arthrography of the acetabular labrum - radiologic-pathologic correlation in 20 cadaveric hip joints; MR-Arthrographie des Labrum acetabulare - Radiologisch-anatomische Korrelation an 20 Leichenhueften

    Energy Technology Data Exchange (ETDEWEB)

    Brossmann, J.; Steffens, J.C.; Heller, M. [Kiel Univ. (Germany). Klinik fuer Diagnostische Radiologie; Ploetz, G.M.J.; Hassenpflug, J. [Kiel Univ. (Germany). Klinik fuer Orthopadie

    1999-08-01

    Purpose: To investigate frequency of acetabular labral lesions in elderly hip joints, and to determine sensitivity and specificity of MR arthrography (MRa) for the detection of these abnormalities. Materials and Methods: Twenty cadaveric hip joints were examined by MRa. For MRa, 15 ml of a solution of iodinated contrast solution (Solutrast 300) and Gd-DTPA (100:1) were injected under fluoroscopic guidance. MR imaging was performed on a 1.5 TM scanner (Vision, Siemens; FOV 16 cm, matrix 256x256, fat-suppressed 3D-FLASH). Multiplanar image reconstructions were done perpendicular to the acetabulum in the oblique-coronal, oblique-axial, and radial planes. The labral specimens were examined macroscopically. Results: In 12/20 hips (60%), a labral lesion was found on pathologic examination. In 7 specimens, the labrum was partially or completely detached in the weight-bearing superior region. One flap-like variant of the labrum was seen; in 4 hip joints, the labrum was degenerated (one cystic degeneration). Pathologic findings were confirmed by MRa in 8/12 specimens (sensitivity 67%). All degenerated labra were correctly diagnosed on MRa. Three small labral detachments and the flap-like variant were misinterpreted as being normal. There were no false positive findings (specificity 100%). The accuracy was 80%. Labral lesions were seen in 6/8 and in 6/12 of hips with and without osteoarthritis, respectively. Conclusion: MRa is well suited to delineate the acetabular labrum and to diagnose labral abnormalities. Detection of small labral detachments and anatomic variants is difficult and requires some experience. Labral lesions are correlated to osteoarthritis of the hip, but may be frequently seen in the elderly without underlying osteoarthritis. (orig.) [German] Ziel: Feststellung der Haeufigkeit von Laesionen des Labrum acetabulare bei aelteren Hueftgelenkspraeparaten und Untersuchung der Sensitivitaet und Spezifitaet der MR-Arthrographie (MRa) fuer die Darstellung dieser

  7. Classification of normal labral variants and labral injuries; Klassifikation von Normvarianten des Labrums und Labrumverletzungen

    Energy Technology Data Exchange (ETDEWEB)

    Waldt, S. [Klinikum rechts der Isar, Technische Universitaet Muenchen, Institut fuer diagnostische und interventionelle Radiologie, Muenchen (Germany); Bruegel, M. [Radiologie am Stiglmaierplatz, Muenchen (Germany)

    2015-03-01

    The glenoid labrum is an important stabilizer of the glenohumeral joint. Labral injuries affect the stability of the shoulder joint to varying degrees depending on the localization, the extension and the structures involved. Because of the complex anatomy and the high variability of the glenoid labrum, in-depth knowledge concerning normal variations and labral injury patterns is required as well as high-resolution imaging with intra-articular contrast in order to discriminate anatomical variants from pathological findings. Therefore, magnetic resonance (MR) and alternatively computed tomography (CT) arthrography have become established as the imaging methods of choice. In this review MR arthrographic findings of normal labral variants and different labral injury patterns are portrayed. (orig.) [German] Das Labrum glenoidale ist ein wichtiger Stabilisator des Glenohumeralgelenks. Verletzungen des Labrums beeintraechtigen in Abhaengigkeit von der Lokalisation, der Ausdehnung und den beteiligten Strukturen die Stabilitaet des Schultergelenks in unterschiedlichem Masse. Die komplexe Anatomie und die hohe anatomische Variabilitaet erfordern detaillierte Kenntnisse und eine hochaufgeloeste bildgebende Darstellung mit intraartikulaerer Kontrastmittelgabe, um pathologische Befunde von Normvarianten zu unterscheiden. Die MR-Arthrographie, alternativ auch die CT-Arthrographie, haben sich als bildgebende Verfahren der Wahl etabliert. In dieser Uebersichtsarbeit werden MR-arthrographische Befunde von Normvarianten und labralen Verletzungsmustern gegenuebergestellt. (orig.)

  8. Skin tears.

    Science.gov (United States)

    Baranoski, S

    2001-08-01

    Skin tears are a serious, painful problem for older patients. Find out how your staff can recognize patients at risk, what they can do to prevent skin tears, and how to manage them effectively if they occur.

  9. Femoro-acetabular impingement and hip pain with conventionally normal x-rays.

    LENUS (Irish Health Repository)

    Baker, J F

    2010-06-01

    There has in recent years been a fundamental change in the understanding of hip pain in the young adult and hip pain without plain radiographic findings of arthritis. Pain in these groups has long represented a diagnostic and therapeutic challenge. With new appreciation of hip biomechanics, pathological processes and the arrival of modern imaging modalities we now have a greater understanding of non-arthritic hip pathology. One of the commonest yet least well recognized \\'new\\' diagnoses around the hip is femoro-acetabular impingement (FAI). FAI is a developmental condition of the hip joint that is associated with abnormal anatomical configuration and thus joint mechanics on either the femoral or acetabular sides or both. It is hypothesized to have a variety of precipitants and may ultimately lead to labral and chondral injury and what has previously been referred to as \\'primary\\' or \\'idiopathic\\' hip osteoarthritis.

  10. Estudio de la función del rodete acetabular en la biomecánica de la cadera: estudio cadavérico de la repercusión de la lesión y la reparación del rodete acetabular en la cinética articular de la cadera

    OpenAIRE

    Tey Pons, Marc

    2015-01-01

    Trabajo experimental en espécimen de cadera para valorar la repercusión de la lesión labral, parcial o completa, en la distribución de cargas de la superficie acetabular, así como el papel de la reconstrucción labral por reanclaje al reborde acetabular en la misma. Este trabajo implica el diseño y desarrollo previo de una bancada de prueba, el uso de tecnología de sensores piezoeléctricos para medir la presión intraarticular y la medición dinámica de las mismas en cinco especímenes anatómi...

  11. Operative strategy of acetabular fractures

    Institute of Scientific and Technical Information of China (English)

    WANG Yan; TANG Pei-fu; HUANG Peng

    2006-01-01

    Anatomic structure of acetabular fractures are complex and operative exposure and fixation are extremely difficult.For those obviously displaced acetabular fractures, close reduction is doomed to cause deformative healing. Open reduction with internal fixation (ORIF) not only results in anatomic reduction, but also brings complications. No matter which method will be adopted, traumatic arthritis or avascular necrosis of femoral head might occur. In order to treat acetabular fractures more effectively, orthopedic surgeons should be required to fully master the acetabular anatomy, biomechanics, classification and the necessary knowledge for complication prevention.

  12. Comparison of three-dimensional isotropic and conventional MR arthrography with respect to the diagnosis of rotator cuff and labral lesions: Focus on isotropic fat-suppressed proton density and VIBE sequences

    International Nuclear Information System (INIS)

    Aim: To compare the diagnostic accuracies of three-dimensional (3D) isotropic magnetic resonance arthrography (MRA) using fat-suppressed proton density (PD) or volume interpolated breath-hold examination (VIBE) sequences with that of conventional MRA for the diagnosis of rotator cuff and labral lesions. Materials and methods: Eighty-six patients who underwent arthroscopic surgery were included. 3D isotropic sequences were performed in the axial plane using fat-suppressed PD (group A) in 53 patients and using VIBE (group B) in 33 patients. Reformatted images were obtained corresponding to conventional images, and evaluated for the presence of labral and rotator cuff lesions using conventional and 3D isotropic sequences. The diagnostic performances of each sequence were determined using arthroscopic findings as the standard. Results: Good to excellent interobserver agreements were obtained for both 3D isotropic sequences for the evaluation of rotator cuff and labral lesions. Excellent agreement was found between two-dimensional (2D) and 3D isotropic MRA, except for supraspinatus tendon (SST) tears by both readers and for subscapularis tendon (SCT) tears by reader 2 in group B. 2D MRA and 3D isotropic sequences had high diagnostic performances for rotator and labral tears, and the difference between the two imaging methods was insignificant. Conclusions: The diagnostic performances of 3D isotropic VIBE and PD sequences were similar to those of 2D MRA

  13. MR arthrographic assessment of suspected posteroinferior labral lesions using flexion, adduction, and internal rotation positioning of the arm: preliminary experience

    International Nuclear Information System (INIS)

    Imaging the shoulder in the position of flexion, adduction, and internal rotation (FADIR) may be useful in characterizing lesions of the posteroinferior labrum. The purpose of this preliminary study is to illustrate the diagnostic utility of FADIR positioning in the assessment and characterization of posteroinferior labral tears. In the FADIR position, the arm is placed across the chest, with the hand on the contralateral shoulder and palm facing outwards. FADIR positioning was performed if there was a subtle or equivocal abnormality of the posteroinferior labrum on conventional MR arthrography sequences. A retrospective review of the charts of 9 people who were imaged using FADIR positioning in addition to routine MR arthrographic sequences of the shoulder was performed. The review included the indication for the study, documentation of presence of clinical posterior instability, and surgical correlation, where available. In all 9 patients, FADIR positioning helped confirm, exclude, or better characterize a posteroinferior labral abnormality by increasing the diagnostic confidence. Flexion, adduction, and internal rotation positioning appears to be a useful adjunct in evaluating patients with equivocal or subtle posteroinferior labral abnormalities on conventional MR arthrography sequences. (orig.)

  14. Hip arthroscopy with labral repair for femoroacetabular impingement

    DEFF Research Database (Denmark)

    Dippmann, Christian; Thorborg, Kristian; Kraemer, Otto;

    2014-01-01

    PURPOSE: The purpose of this study was to examine the progression of clinical outcomes 3, 6 and 12 months after hip arthroscopy with labral repair for femoroacetabular impingement (FAI). METHODS: From May 2009 to December 2011, 87 consecutive patients [55 females (median age 38, range 17-63) and 32...

  15. SLAP Tears

    Science.gov (United States)

    ... it is above the level of the shoulder • Shoulder dislocation People who participate in repetitive overhead sports, such as throwing athletes or weightli ers, can experience labrum tears as a result of repeated shoulder motion. This cross-section view of the shoulder ...

  16. Options for acetabular fixation surfaces.

    Science.gov (United States)

    Klika, Alison K; Murray, Trevor G; Darwiche, Hussein; Barsoum, Wael K

    2007-01-01

    Aseptic loosening is the most common cause for revision total hip arthroplasty (THA). Due to poor long-term results with cemented acetabular components, cementless implants that rely on biologic fixation became popular in the United States for both primary and revision procedures in the early 1980s. Cementless acetabular components used in THA have been reported to have superior radiographic performance compared with cemented fixation, although the optimal method of acetabular fixation remains controversial. Cementless acetabular components require initial implant stability to allow for bone ingrowth and remodeling into the acetabular shell, providing long-term durability of the prosthesis. Many improved implant materials are available to facilitate bone growth and remodeling, including the 3 most common surface treatments; fibermesh, sintered beads, and plasma spray coatings. Recently added to these are porous metal surfaces, which have increased porosity and optimal pore sizes when compared with titanium fibermesh. The most studied of these materials is the titanium fibermesh fixation surface, which has demonstrated a mechanical failure rate of 1% at 10 to 15 years. This technology utilizes the diffusion bonding process to attach fiber metal pads to a titanium substrate using heat and pressure. The sintered bead fixation surface offers a porous coating of various sizes of spherical beads, achieved by the sintering process, and has been shown to provide long-term fixation. While there are less long-term published data regarding the titanium plasma spray surface, its early results have provided evidence of its durability, even in the face of significant osteolysis. The most recently added alternative fixation surface is porous tantalum metal, which offers potentially greater bone ingrowth and bone graft incorporation due to its high porosity (80%) and low modulus of elasticity (3 MPa). Porous tantalum implants have shown early favorable clinical results and have

  17. Options for acetabular fixation surfaces.

    Science.gov (United States)

    Klika, Alison K; Murray, Trevor G; Darwiche, Hussein; Barsoum, Wael K

    2007-01-01

    Aseptic loosening is the most common cause for revision total hip arthroplasty (THA). Due to poor long-term results with cemented acetabular components, cementless implants that rely on biologic fixation became popular in the United States for both primary and revision procedures in the early 1980s. Cementless acetabular components used in THA have been reported to have superior radiographic performance compared with cemented fixation, although the optimal method of acetabular fixation remains controversial. Cementless acetabular components require initial implant stability to allow for bone ingrowth and remodeling into the acetabular shell, providing long-term durability of the prosthesis. Many improved implant materials are available to facilitate bone growth and remodeling, including the 3 most common surface treatments; fibermesh, sintered beads, and plasma spray coatings. Recently added to these are porous metal surfaces, which have increased porosity and optimal pore sizes when compared with titanium fibermesh. The most studied of these materials is the titanium fibermesh fixation surface, which has demonstrated a mechanical failure rate of 1% at 10 to 15 years. This technology utilizes the diffusion bonding process to attach fiber metal pads to a titanium substrate using heat and pressure. The sintered bead fixation surface offers a porous coating of various sizes of spherical beads, achieved by the sintering process, and has been shown to provide long-term fixation. While there are less long-term published data regarding the titanium plasma spray surface, its early results have provided evidence of its durability, even in the face of significant osteolysis. The most recently added alternative fixation surface is porous tantalum metal, which offers potentially greater bone ingrowth and bone graft incorporation due to its high porosity (80%) and low modulus of elasticity (3 MPa). Porous tantalum implants have shown early favorable clinical results and have

  18. Editorial Commentary: Iliotibial Band Allograft Shows Promise for Arthroscopic Hip Labral Reconstruction.

    Science.gov (United States)

    Rossi, Michael J

    2016-01-01

    Arthroscopic hip labral reconstruction using iliotibial band allograft in a modified front-to-back technique results in improved outcomes after 2-year follow-up. The authors' reasoning for reconstruction are reminiscent of similar arguments for restoring hoop stresses in knee meniscal surgery. Results are comparable to reported outcomes of labral repair, and allograft is particularly indicated for severe labral damage when repair is not possible. Don't miss the related technical note with video in Arthroscopy Techniques.

  19. Editorial Commentary: Iliotibial Band Allograft Shows Promise for Arthroscopic Hip Labral Reconstruction.

    Science.gov (United States)

    Rossi, Michael J

    2016-01-01

    Arthroscopic hip labral reconstruction using iliotibial band allograft in a modified front-to-back technique results in improved outcomes after 2-year follow-up. The authors' reasoning for reconstruction are reminiscent of similar arguments for restoring hoop stresses in knee meniscal surgery. Results are comparable to reported outcomes of labral repair, and allograft is particularly indicated for severe labral damage when repair is not possible. Don't miss the related technical note with video in Arthroscopy Techniques. PMID:26743407

  20. Editorial Commentary: Risk Factors for Chondral Lesions in the Hip-There Is More to It Than Cam and Pincer.

    Science.gov (United States)

    Hohmann, Erik

    2016-08-01

    Age has been cited in a recent article as the largest predictor of both chondral and labral lesions in patients with hip dysplasia. But it was not surprising that there is also a direct relation between a small lateral center-edge angle, acetabular head index, and cartilage degeneration and an increased acetabular index and labral tears in patients with hip dysplasia. The severity of the congenital disease determines the severity of the intra-articular lesions. PMID:27495863

  1. Management of acetabular fractures: challenging work

    Institute of Scientific and Technical Information of China (English)

    CHEN Zheng-rong; YANG Yi

    2006-01-01

    @@ Acetabular fractures are complex and special intraarticular fractures. For most orthopaedic surgeons management of acetabular fractures is hard and challenging because the fractures are the results of high-energy trauma, and usually accompany with severe associated injuries. In addition, these fractures are uncommon except in a few trauma centers. The number of cases a surgeon can encounter is scarce.

  2. Biceps Tenodesis for Type II SLAP Tears.

    Science.gov (United States)

    Tayrose, Gregory A; Karas, Spero G; Bosco, Joseph

    2015-06-01

    Tears of the superior glenoid labrum are a common cause of shoulder pain and disability, especially in overhead athletes such as pitchers, swimmers, and volleyball players. Type II SLAP lesions have been the most clinically important superior labral pathology, and the management of this lesion has been a very controversial topic. Currently, there are no high level studies in the literature to guide treatment. While the few level 3 and level 4 evidence studies that are available following arthroscopic repair of type II SLAP lesions all report reasonable overall patient satisfaction, persistent postoperative pain is common and associated with a low return to pre-injury level of sports participation. There has been a recent school of thought that biceps tenodesis, which maintains the length-tension relationship of the long head of biceps, should be the procedure of choice for patients with isolated type II SLAP lesions. The current paper reviews the role biceps tenodesis plays in the management of type II SLAP tears.

  3. An Unusual Combination of Acetabular and Pelvic Fracture: Is This a New Subtype of Acetabular Fracture?

    Directory of Open Access Journals (Sweden)

    Reza Tavakoli Darestani

    2013-01-01

    Full Text Available Introduction: Acetabular fractures are a common problem among young males. An acetabular fracture with disruption of the joint surface, if untreated, will rapidly lead to post-traumatic osteoarthritis. Proper reduction and internal fixation depend on accurate classification and the quality of imaging.Case Presentation: We present an unusual form of acetabular fracture, which is not included in the conventional classification (Judet and Letournel ; this occurred in a middle-aged male who was operatively treated without any complications. In this case due to posterior extension of the fracture into the SI joint and concomitant anterior column fracture in the area above the acetabular dome, no portion of the acetabular anterior surface remained connected to the innominate bone.Conclusions: We recognized this type of fracture and treated it similarly to both column fractures. We recommend that the classification of acetabular fractures be modified to include this type of fracture.

  4. Primary total hip arthroplasty for acetabular fracture

    Institute of Scientific and Technical Information of China (English)

    WANG Zi-ming; SUN Hong-zhen; WANG Ai-min; DU Quan-yin; WU Siyu; ZHAO Yu-feng; TANG Ying

    2006-01-01

    Objective: To explore the operative indications and operative methods of primary total hip arthroplasty for acetabular fracture and to observe the clinical curative effect.Methods: We retrospectively summarized and analyzed the traumatic conditions, fracture types, complications,operative time, operative techniques, and short-term curative effect of 11 patients( 10 males and 1 female, with a mean age of 42. 4 years ) with acetabular fracture who underwent primary total hip arthroplasty.Results: The patients were followed up for 6-45 months ( mean = 28 months). Their average Harris score of postoperative hip joint was 78.Conclusion: Under strict mastery of indications,patients with acetabular fracture may undergo primary total hip arthroplasty, but stable acetabular components should be made.

  5. Comparison of MDCTA (16-slice multi-detector row computed tomography arthrography) and MRA (magnetic resonance arthrography) for detecting labral lesions of the shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Seung A; Cha, Jang Gyu; Hong, Hyun Sook; Choi, Deuk Lin; Park, Jai Soung; Lee, Hae Kyung; Kim, Dae Ho [Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of)

    2007-11-15

    To compare the accuracy of 16-slice multi-detector row computed tomographic arthrography (MDCTA) and magnetic resonance arthrography (MRA) for making the diagnosis and classification of labroligamentous injuries. This study is a prospective series that used MRA and MDCTA to examine 23 patients who complained of shoulder instability. Two radiologists independently analyzed the MRA and MDCTA. The sensitivity, specificity, accuracy, positive and negative predictive values were calculated from the arthrograms and the arthroscopic findings. The images of MDCTA and MRA corresponded with the findings on arthroscopy. Both imaging modalities had the same sensitivity for detecting Bankart lesions (n = 10, 90%) and posterior labral tears (n = 2, 50%) on McNemar test ({rho} = 1.00). For superior labrum anterior-to-posterior (SLAP) lesions, 6 MRA cases and 4 MDCTA cases corresponded with the arthroscopic findings. The difference between the sensitivities of MDCTA (66.7%) and MRA (100%) was not significant ({rho} 0.09). We suggest that the sensitivity of diagnosing labral lesions that induce shoulder instability is similar for MDCTA and MRA. MDCTA is effective for diagnosing and evaluating shoulder instability.

  6. Osteoarthritis of the hip and acetabular dysplasia.

    OpenAIRE

    Croft, P.; Cooper, C.; Wickham, C; Coggon, D

    1991-01-01

    The relation between acetabular dysplasia and osteoarthritis of the hip was examined in a series of 1516 pelvic radiographs taken for non-skeletal indications. Osteoarthritis was assessed by measuring joint space, and dysplasia by the centre-edge angle and acetabular depth. In contrast with previous studies of patients with symptomatic osteoarthritis of the hip, no evidence that dysplasia predisposes to osteoarthritis was found. Possible reasons for the discrepancy are discussed. It was concl...

  7. Rotator Cuff Tears

    Science.gov (United States)

    .org Rotator Cuff Tears Page ( 1 ) A rotator cuff tear is a common cause of pain and disability among adults. In ... went to their doctors because of a rotator cuff problem. A torn rotator cuff will weaken your ...

  8. Management of Labral and Chondral Disease in Hip Preservation Surgery.

    Science.gov (United States)

    Salata, Michael J; Vasileff, William K

    2015-12-01

    The techniques utilized for the management of articular cartilage and labrum injuries during hip preservation surgery have changed dramatically recently. Conservative treatment may involve image-guided injection of cortisone or viscosupplementation in conjunction with oral NSAIDs and physical therapy. Damage to the labrum runs a broad spectrum, and the treatments are individualized, but span from debridement to repair and reconstruction. The overarching goal of labral treatment is to restore the native functions of the labrum to allow for more normal biomechanical function. Similarly, cartilage injuries can be managed a number of different ways, including with debridement, microfracture or drilling, cartilage transplants, and higher level restorative techniques. These cartilage restoration techniques have evolved rapidly as well, and may include the use of scaffolds, allograft cartilage cells, and other stem-cell-related procedures.

  9. Anteroinferior tears of the glenoid labrum: fat-suppressed fast spin-echo T2 versus gradient-recalled echo MR images

    International Nuclear Information System (INIS)

    Objective. To compare fat-suppressed fast spin-echo (FSE) T2-weighted images with gradient-recalled echo (GRE) T2*-weighted images in the evaluation of anteroinferior labral tears. Design. MR images were retrospectively reviewed by two radiologists masked to the history and arthroscopic findings. They separately interpreted the anteroinferior labrum as torn or intact, first on one pulse sequence and then, 4 weeks later, on the other sequence. The MR interpretations were correlated with the arthroscopic findings. Patients. Nine patients with anteroinferior labral tears, and nine similarly-aged patients with normal, labra were studied. Results and conclusions. Observer 1 had a sensitivity of 0.56 on the GRE images and 0.67 on the FSE images (P>0.5), with a specificity of 1.0 for both sequences. Observer 2 had a sensitivity of 0.78 and a specificity of 0.89 for both sequences. In this small study there is no significant difference between GRE and fat-suppressed FSE images in their ability to diagnose anteroinferior labral tears. When evaluating the labrum with conventional MRI, axial fat-suppressed FSE T2-weighted images can be used in place of GRE images without a loss of accuracy. (orig.). With 3 figs., 1 tab

  10. Surgical treatment for complicated acetabular fractures

    Institute of Scientific and Technical Information of China (English)

    Ning An; Yang Yanmin

    2004-01-01

    Objective: To sum up the surgical approaches and clinical outcome of complicated acetabular fractures. Methods: 17 patients with complicated acetabular fractures (including 4 cases of transverse with posterior wall fractures, 7 cases of posterior column and wall fractures, 4 cases of anterior and posterior columns fractures, 1 cases of T-type fracture and 1 cases of anterior column with posterior hemitransverse fractures) underwent open reduction and internal fixation with screws and plates by Kocher-Langenbeck (8 cases), ilio-inguinal (2 cases), extended iliofemoral (4 cases) or ilio-inguinal combined with K-L approaches (3 cases). Results: 12 patients with anatomical reduction, 4 patients with satisfactory reduction and 1 patient with non-satisfactory reduction. 15 out of 17 cases were followed up for 6 months to 5 years, and the excellent and good rate was 70.5%. Conclusion: Surgical treatment for complicated acetabular fractures can get a satisfactory reduction and a good clinical outcome.

  11. Iatrogenic tracheal tear.

    LENUS (Irish Health Repository)

    Dias, A

    2010-10-01

    Large post intubation tracheal tears are usually detected intra-operatively due to unstable signs namely impaired ventilation and mediastinal emphysema and often require surgical management. Smaller tracheal tears are often missed during anaesthesia and recognized during the postoperative period. Conservative management should be considered in these latter cases.

  12. CT evaluation of acetabular dysplasta in adults.

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To evaluate methods of measurement by CT and their clinical significance for acetabular dysplasia(AD) in adults. Methods: CT imaging was examined and measured in 33 adult patients with AD, compared with the normal control group of 210 adults. Results: This study showed the results of AD patients

  13. Acetabular fractures in children and adolescents

    NARCIS (Netherlands)

    Heeg, M; de Ridder, VA; Tornetta, P; de Lange, S; Klasen, HJ

    2000-01-01

    A retrospective study of 29 acetabular fractures in children 2 to 16 years of age with an average followup of 14 years is presented. Nineteen patients had an additional dislocation of the femoral head and 14 patients had an associated neurologic injury. Surgical treatment was performed in 16 patient

  14. Arthroscopic Labral Reconstruction of the Hip Using Iliotibial Band Allograft and Front-to-Back Fixation Technique.

    Science.gov (United States)

    White, Brian J; Herzog, Mackenzie M

    2016-02-01

    Labral repair has been shown to be an effective treatment option with excellent early outcomes; however, in cases of severe labral damage or when the labral tissue is too large or diminutive, labral repair may be less effective. The purpose of this article is to present a modified technique for hip labral reconstruction using iliotibial band allograft tissue and a front-to-back fixation technique. The described technique is modified from the original report of a technique for arthroscopic labral reconstruction. The front-to-back technique allows the surgeon to make a graft that is longer than necessary and cut excess graft after front-to-back fixation, resulting in the correct graft size and a reproducible procedure. Allograft tissue offers several advantages, including the ability to control graft thickness and length, as well as the ability to eliminate donor-site morbidity. This procedure adds to the available techniques for treatment of labral pathology by providing a labral reconstruction technique using allograft tissue.

  15. Arthroscopic Labral Reconstruction of the Hip Using Iliotibial Band Allograft and Front-to-Back Fixation Technique.

    Science.gov (United States)

    White, Brian J; Herzog, Mackenzie M

    2016-02-01

    Labral repair has been shown to be an effective treatment option with excellent early outcomes; however, in cases of severe labral damage or when the labral tissue is too large or diminutive, labral repair may be less effective. The purpose of this article is to present a modified technique for hip labral reconstruction using iliotibial band allograft tissue and a front-to-back fixation technique. The described technique is modified from the original report of a technique for arthroscopic labral reconstruction. The front-to-back technique allows the surgeon to make a graft that is longer than necessary and cut excess graft after front-to-back fixation, resulting in the correct graft size and a reproducible procedure. Allograft tissue offers several advantages, including the ability to control graft thickness and length, as well as the ability to eliminate donor-site morbidity. This procedure adds to the available techniques for treatment of labral pathology by providing a labral reconstruction technique using allograft tissue. PMID:27073784

  16. Idiopathic Bilateral Bloody Tearing

    Directory of Open Access Journals (Sweden)

    Emrullah Beyazyıldız

    2015-01-01

    Full Text Available Bloody tear is a rare and distinct clinic phenomenon. We report a case presenting with the complaint of recurrent episodes of bilateral bloody tearing. A 16-year-old girl presented to our clinic with complaint of bloody tearing in both eyes for 3 months. Bloody tearing was not associated with her menses. A blood-stained discharge from the punctum was not observed during the compression of both nasolacrimal ducts. Nasolacrimal passage was not obstructed. Imaging studies such as dacryocystography and gradient-echo magnetic resonance imaging (MRI of nasolacrimal canal were normal. Intranasal endoscopic evaluation was normal. We collected samples from bloody tears two times and pathological examination was performed. Pathological analysis showed lots of squamous cells and no endometrial cells; dysplastic cells were found. Further evaluations for underlying causes were unremarkable. No abnormalities were found in ophthalmologic, radiologic, and pathologic investigations. This condition is likely a rare abnormality and the least recognized aetiology for the idiopathic phenomenon.

  17. Antimicrobial compounds in tears.

    Science.gov (United States)

    McDermott, Alison M

    2013-12-01

    The tear film coats the cornea and conjunctiva and serves several important functions. It provides lubrication, prevents drying of the ocular surface epithelia, helps provide a smooth surface for refracting light, supplies oxygen and is an important component of the innate defense system of the eye providing protection against a range of potential pathogens. This review describes both classic antimicrobial compounds found in tears such as lysozyme and some more recently identified such as members of the cationic antimicrobial peptide family and surfactant protein-D as well as potential new candidate molecules that may contribute to antimicrobial protection. As is readily evident from the literature review herein, tears, like all mucosal fluids, contain a plethora of molecules with known antimicrobial effects. That all of these are active in vivo is debatable as many are present in low concentrations, may be influenced by other tear components such as the ionic environment, and antimicrobial action may be only one of several activities ascribed to the molecule. However, there are many studies showing synergistic/additive interactions between several of the tear antimicrobials and it is highly likely that cooperativity between molecules is the primary way tears are able to afford significant antimicrobial protection to the ocular surface in vivo. In addition to effects on pathogen growth and survival some tear components prevent epithelial cell invasion and promote the epithelial expression of innate defense molecules. Given the protective role of tears a number of scenarios can be envisaged that may affect the amount and/or activity of tear antimicrobials and hence compromise tear immunity. Two such situations, dry eye disease and contact lens wear, are discussed here.

  18. Subpectoral biceps tenodesis for bicipital tendonitis with SLAP tear.

    Science.gov (United States)

    Gupta, Anil K; Chalmers, Peter N; Klosterman, Emma L; Harris, Joshua D; Bach, Bernard R; Verma, Nikhil N; Cole, Brian J; Romeo, Anthony A

    2015-01-01

    The purpose of this study was to evaluate the outcomes of patients undergoing subpectoral biceps tenodesis for bicipital tendonitis with a superior labral anterior-posterior (SLAP) tear. Patients undergoing primary subpectoral biceps tenodesis for arthroscopically confirmed SLAP tears with signs or findings of bicipital tendonitis were included. An independent observer collected data prospectively as part of a data repository, which was then analyzed retrospectively. Primary outcome measures were the American Shoulder and Elbow Surgeons (ASES) score and pain relief via visual analog scale (VAS). Secondary outcome measures included the Simple Shoulder Test (SST), Constant, Single Assessment Numeric Evaluation (SANE), and Short Form 12 (SF-12) scores. Twenty-eight patients with a mean±SD age of 43.7±13.4 years and a mean±SD follow-up of 2.0±1.0 years met inclusion criteria. Workers' compensation was involved with 43% of cases, and 46% of the included patients were manual laborers. Eight (32%) patients were athletes, and 88% of the athletes were overhead athletes. Intraoperatively, 15 (54%) patients had type I SLAP tears, 10 (36%) had type II SLAP tears, 1 (3%) had a type III SLAP tear, and 2 (7%) had type IV SLAP tears. Significant improvements were seen in the following outcome measures pre- vs postoperatively: ASES score (58±23 vs 89±18; P=.001), SST score (6.3±3.6 vs 10.6±3.3; P=.001), SANE score (54±24 vs 88±25; P=.003), VAS score (3.8±2.0 vs 1.1±1.8; P=.001), SF-12 overall score (35±6 vs 42±6; P=.001), and SF-12 physical component score (39±6 vs 50±10; P=.001). Overall satisfaction was excellent in 80% of patients. Subpectoral biceps tenodesis demonstrates excellent clinical outcomes in select patients with SLAP tears. [Orthopedics. 2015; 38(1):e48-e53.].

  19. Computed tomography analysis of acetabular anteversion and abduction

    Energy Technology Data Exchange (ETDEWEB)

    Stem, Eric S. [Mayo Clinic, Department of Orthopedic Surgery, Jacksonville, FL (United States); South Carolina Sports Medicine and Orthopaedic Center, North Charleston, SC (United States); O' Connor, Mary I. [Mayo Clinic, Department of Orthopedic Surgery, Jacksonville, FL (United States); Kransdorf, Mark J. [Mayo Clinic, Department of Radiology, Jacksonville, FL (United States); Crook, Julia [Mayo Clinic, Biostatistic Unit, Jacksonville, FL (United States)

    2006-06-15

    The purpose of this study is to define the normal range of acetabular abduction and anteversion in relation to pelvic anatomy as depicted on conventional CT scan. We retrospectively reviewed 100 pelvic CT scans performed on patients presenting for evaluation of non-orthopaedic pathology. The study group consisted of 58 women and 42 men, aged between 18 and 88 years. Standard imaging protocol included an anteroposterior (AP) topogram with contiguous 5-mm thick axial images from the superior margin of the iliac crest to the lesser trochanter of the femur. The acetabular abduction was measured from the AP topogram by obtaining the angle between a line drawn from the acetabular teardrop to the lateral acetabular margin and a horizontal line between the ischial tuberosities. Acetabular anteversion was measured on axial images at the level of the mid-femoral head. We found the mean acetabular abduction to be 39 degrees (standard deviation 4 degrees, range 27 to 51 degrees) and the mean acetabular anteversion to be 23 degrees (standard deviation 5 degrees, range 12 to 39 degrees). Data suggests that acetabular anteversion may average 2.7 degrees lower in males than females and increase slightly with age, while abduction may tend to decrease with age. Ninety percent of patients had acetabular abduction between 31 and 46 degrees; the 90% central range for acetabular anteversion was estimated to be from 14 to 31 degrees. CT scanning is useful in accurately defining the normal range of acetabular abduction and antiversion. Knowledge of this normal anatomy will allow accurate assessment of acetabular component position as delineated on conventional CT scanning. (orig.)

  20. Hip Labral Reconstruction: The "Kite Technique" for Improved Efficiency and Graft Control.

    Science.gov (United States)

    Bhatia, Sanjeev; Chahla, Jorge; Dean, Chase S; Ellman, Michael B

    2016-04-01

    Although the merits of labral reconstruction have been well established, the technical difficulty of presently used reconstruction techniques-particularly with graft passage and fixation-limit its efficacy and potentiates the risk of iatrogenic damage within the hip joint. The unwieldy nature of a floating labral graft anchored on one end may impede accurate fixation of the other end, which is critical for restoration of the fluid hip seal and preservation of graft integrity. In this technique narrative, we present a "kite technique" for introduction, control, and efficient fixation of a labral reconstruction graft. The principles of this method are founded on the belief that a soft-tissue graft in an arthroscopic environment is much easier to guide into position with 2 control sutures using a pulley system similar to flying a kite with 2 fly lines. Although we herein detail the technique as it applies to labral reconstruction in the hip, the concept of the kite technique may also be employed in arthroscopic-assisted soft-tissue reconstructions of other joints. PMID:27354954

  1. Surgical treatment for complex acetabular fractures

    Institute of Scientific and Technical Information of China (English)

    LIU Qiang; WU Dou; LI Ping; HAN Shu-feng

    2006-01-01

    Objective: To explore the effect of surgical treatment on complex acetabular fractures.Methods: The data of 46 patients (38 males and 8 females, aged 16-75 years, mean = 38. 5 years ) with complex acetabular fractures, who were admitted to our hospital from January 1998 to December 2005, were analyzed retrospectively in this study. According to Letournel rules, posterior wall and posterior column fractures were found in 11 patients, transverse and posterior wall fractures in 13, T-type fracture in 4, both columns fracture in 10, and anterior column and posterior transverse fracture in 8. The choice of surgical approach was based on the individual fractures, which included ilioinguinal approach in 5 patients, Kocher-Langenbech approach in 7, combined approach in 26, and extended iliofemoral approach in 8.Results: All the patients were followed up for 3.5 years averagely. The clinical outcomes were analyzed with Harris hip score and radiography. In 36 patients (78.3%), the surgical procedure was successful (Harris hip score > 80 points). The rate of excellent and good was about 86 %.Conclusions: The keys to increase the effectiveness of surgical treatment on acetabular fractures are correct preoperative classification of factures and choices of appropriate surgical approach and time.

  2. The influence of acetabular inclination angle on the penetration of polyethylene and migration of the acetabular component: a prospective, radiostereometric study on cemented acetabular components.

    Science.gov (United States)

    Kadar, T; Furnes, O; Aamodt, A; Indrekvam, K; Havelin, L I; Haugan, K; Espehaug, B; Hallan, G

    2012-03-01

    In this prospective study we studied the effect of the inclination angle of the acetabular component on polyethylene wear and component migration in cemented acetabular sockets using radiostereometric analysis. A total of 120 patients received either a cemented Reflection All-Poly ultra-high-molecular-weight polyethylene or a cemented Reflection All-Poly highly cross-linked polyethylene acetabular component, combined with either cobalt-chrome or Oxinium femoral heads. Femoral head penetration and migration of the acetabular component were assessed with repeated radiostereometric analysis for two years. The inclination angle was measured on a standard post-operative anteroposterior pelvic radiograph. Linear regression analysis was used to determine the relationship between the inclination angle and femoral head penetration and migration of the acetabular component. We found no relationship between the inclination angle and penetration of the femoral head at two years' follow-up (p = 0.9). Similarly, our data failed to reveal any statistically significant correlation between inclination angle and migration of these cemented acetabular components (p = 0.07 to p = 0.9).

  3. Ketofol for monitored anesthesia care in shoulder arthroscopy and labral repair: a case report

    OpenAIRE

    Lee KC; Shi H.; Lee BC

    2016-01-01

    Kevin C Lee,1 Hanyuan Shi,2 Brian C Lee3 1Columbia University College of Dental Medicine, New York, NY, 2Vanderbilt University School of Medicine, Nashville, TN, 3Department of Anesthesiology, Columbia University Medical Center, New York, NY, USA Abstract: A 21-year-old male (body mass index: 28.3) with a history of asthma and reactive airway disease since childhood underwent left shoulder arthroscopy and labral repair surgery under monitored anesthesia care. Because the procedure was perform...

  4. Is there evidence for accelerated polyethylene wear in uncemented compared to cemented acetabular components? A systematic review of the literature

    NARCIS (Netherlands)

    van der Veen, Hugo; van Jonbergen, H.P.W.; Poolman, R.W.; Bulstra, S.K.; van Raay, J.J.A.M.

    2013-01-01

    Joint arthroplasty registries show an increased rate of aseptic loosening in uncemented acetabular components as compared to cemented acetabular components. Since loosening is associated with particulate wear debris, we postulated that uncemented acetabular components demonstrate a higher polyethyle

  5. Osteochondritis dissecans after rotational acetabular osteotomy for dysplastic hip

    Energy Technology Data Exchange (ETDEWEB)

    Nozawa, Masahiko; Maezawa, Katsuhiko; Yuasa, Takahito; Morimoto, Kouichi; Asakura, Taro; Kurosawa, Hisashi [Juntendo University School of Medicine, Department of Orthopaedic Surgery, Tokyo (Japan)

    2005-12-01

    We encountered a rare case of osteochondritis dissecans of the femoral head after rotational acetabular osteotomy that recovered with conservative treatment 4 years after the detection of characteristic radiological findings. (orig.)

  6. Bilateral Superior Labrum Anterior to Posterior (SLAP) Tears With Abnormal Anatomy of Biceps Tendon.

    Science.gov (United States)

    Morris, Dan; Guettler, Joseph; Morris, Sean

    2015-08-01

    There have been several descriptions of variant anatomy of the long head of the biceps tendon (LHBT). A recent literature review identified 8 cases of anomalous intracapsular attachment of the LHBT. In this report, we discuss a distinctive case of a young athlete who presented with symptoms consistent with bilateral superior labrum anterior to posterior (SLAP) tears that were unresponsive to conservative measures. Magnetic resonance imaging and arthroscopic findings of this patient confirmed that the patient had type II SLAP tears, a Buford complex anteriorly, and perhaps most important, confluence of the biceps tendon itself to the undersurface of the capsule within the rotator interval. Our case proposes that anomalous insertion of the LHBT, as well as other labral and biceps anchor variations, are not always a benign finding at the time of arthroscopy. In this particular case, the tethering of the biceps tendon to the capsule is thought to have increased stress on the superior labrum and contributed to the development of the bilateral symptomatic type II SLAP tears that were identified and treated in this young athlete.

  7. Trabecular metal acetabular revision system (cup-cage construct to address the massive acetabular defects in revision arthroplasty

    Directory of Open Access Journals (Sweden)

    Rajesh Malhotra

    2012-01-01

    Full Text Available The increasing number of total hip replacements in the younger clique has added to the demand for revision procedures. Revision situations are often encountered with infection, loss of bone stock and bone defects. There are various methods of reconstruction of acetabular defects. The management options of type 3B Paprosky acetabular defects are limited with allograft and conventional cages. Trabecular metal technology has evolved to address these bone defects. Trabecular metal acetabular revision system (TMARS cup-cage construct is a new technique to address massive acetabular defects. We describe a case of failed hip reconstruction done for a Giant cell tumour of proximal femur managed by a two stage procedure, initial debridement and second stage reconstruction of acetabulum with TMARS cup-cage construct and femur with allograft prosthesis composite.

  8. Initial Results of an Acetabular Center Axis Registration Technique in Navigated Hip Arthroplasty with Deformed Acetabular Rims

    OpenAIRE

    Wada, Hiroshi; Mishima, Hajime; Yoshizawa, Tomohiro; Sugaya, Hisashi; Nishino, Tomofumi; Yamazaki, Masashi

    2016-01-01

    Background In cementless total hip arthroplasty, imageless computer-assisted navigation is usually used to register the anterior pelvic plane (APP). The accuracy of this method is influenced by the subcutaneous tissues overlying the registration landmarks. On the other hand, the acetabular center axis (ACA) is determined from the acetabular rim. Precise registration of the ACA is possible because of direct palpation using a pointer. Imageless navigation using the ACA usually targets patients ...

  9. Three-fin acetabular prosthesis for superior acetabular bone defects: a three-dimensional finite element analysis

    Institute of Scientific and Technical Information of China (English)

    LIU Yu-zeng; HAI Yong; ZHAO Hui

    2012-01-01

    Background Given that three-dimensional finite element models have been successfully used to analyze biomechanics in orthopedics-related research,this study aimed to establish a finite element model of the pelvic bone and three-fin acetabular component and evaluate biomechanical changes in this model after implantation of a three-fin acetabular prosthesis in a superior segmental bone defect of the acetabulum.Methods In this study,three-dimensional finite element models of the pelvic bone and three-fin acetabular component were first established.The prosthesis model was characterized by three different conformational fins to facilitate and optimize the prosthetic design.The spongy and cortical bones were evaluated using a different modulus of elasticity in this established model.Results The maximum and minimum von Mises stresses on the fins of the acetabular component were 15.2 and 0.74,respectively.The maximum and minimum micromotion between the three-fin acetabular component and the acetabulum bone interface were 27 and 13 μm,respectively.A high primary stability and implied better clinical outcome were revealed.Conclusion Finite element analysis may be an optimal strategy for biomechanics-related research of prosthetic design for segmental acetabular bone defects.

  10. Arthroscopic Fixation of Glenoid Rim Fractures After Reduction by Labral Repair.

    Science.gov (United States)

    Voleti, Pramod B; Camp, Christopher L; Sinatro, Alec L; Dines, Joshua S

    2016-04-01

    Surgical fixation of displaced, intra-articular glenoid fractures represents a clinical challenge. These fractures have traditionally been treated through open approaches to the glenohumeral joint; however, the morbidity associated with open surgery may be reduced with arthroscopic techniques. Previously described arthroscopic methods commonly use clamps and/or Kirschner wires to obtain and maintain provisional fixation. We describe our technique for minimally invasive, arthroscopic fixation of glenoid rim fractures using labral repair as an indirect reduction maneuver, followed by final fixation with an extra-articular screw. This method is safe, efficient, and reliable, and it can be used to approach a variety of intra-articular glenoid fractures. PMID:27462537

  11. Skin tears: prevention and treatment.

    Science.gov (United States)

    Wick, Jeannette Y; Zanni, Guido R

    2008-07-01

    While skin tears are common among the elderly in general, and residents of long-term care facilities in particular, there has been limited research into their treatment. Many facilities voluntarily track skin tears, and some states require facilities to report these events. Risk factors include age, xerosis (abnormal eye, skin, or mouth dryness), need for help in activities of daily living, presence of senile purpura, visual impairment, and poor nutrition. Plans to prevent skin tears that employ skin sleeves, padded side rails, gentle skin cleansers, moisturizing lotions, as well as staff education, can decrease by half the number of skin tears incurred in a long-term care facility. Although the treatment process seems simple, it is time consuming and can be painful for the patient. Residents with dementia or agitation often try to remove bulky dressings used to cover skin tears. Dressing changes may injure the fragile wound via skin stripping.

  12. Accuracy of the modified Hardinge approach in acetabular positioning

    Science.gov (United States)

    Goyal, Prateek; Lau, Adrian; McCalden, Richard; Teeter, Matthew G.; Howard, James L.; Lanting, Brent A.

    2016-01-01

    Background The surgical approach chosen for total hip arthroplasty (THA) may affect the positioning of the acetabular component. The purpose of this study was to examine the accuracy in orienting the acetabular component using the modified Hardinge approach. Methods We used our institutional arthroplasty database to identify patients with primary, press-fit, hemispherical acetabular components of a metal-on-polyethylene THA performed between 2003 and 2011. Patients with radiographs obtained 1–3 years after the index procedure were included for measurement of anteversion and inclination angles. Acceptable values of anteversion and abduction angles were defined as 15° ± 10° and 40° ± 10°, respectively. Results We identified 1241 patients from the database, and the modified Hardinge approach was used in 1010 of the patients included in our analysis. The acetabular component was anteverted in the acceptable zone in 54.1% of patients. The abduction angle was within the defined range in 79.2% of patients. Combined anteversion and abduction angles within the defined zone were present in 43.6% of patients. Conclusion Consistent with studies examining accuracy from other approaches, our study reveals that the modified Hardinge approach was only moderately accurate in positioning the acetabular component in the acceptable zone. PMID:27240130

  13. The 'bridging sign', a MR finding for combined full-thickness tears of the subscapularis tendon and the supraspinatus tendon

    International Nuclear Information System (INIS)

    Background: In daily practice, we discovered one of the secondary magnetic resonance (MR) findings of the subscapularis (SSC) tendon tear, the 'bridging sign', which has not been previously described. Purpose: To describe the 'bridging sign' on shoulder MR imaging and its radiological and clinical significance in patients with SSC tendon tear. Material and Methods: Twenty-nine patients who had undergone shoulder arthroscopy and had full-thickness tear of the subscapularis tendon were enrolled. The medical records of the 29 patients were retrospectively reviewed for the duration of shoulder pain, rotator cuff tears, and associated arthroscopic findings: biceps tendon abnormality and superior glenoid labral tear. Then, preoperative shoulder MR images were retrospectively reviewed for the presence or absence of the 'bridging sign' and associated MR findings: periarticular fluid and fatty atrophy of the supraspinatus and subscapularis muscles. The type of rotator cuff tear associated with the 'bridging sign' was assessed and the sensitivity, specificity, and accuracy of the 'bridging sign' for the diagnosis of a certain type of rotator cuff tear were calculated. Associated arthroscopic and MR findings and mean duration of the shoulder pain between the patients with and without the 'bridging sign' were compared. Results: The 'bridging sign' was seen in 17 of 29 patients and corresponded to a complex of the torn and superomedially retracted subscapularis tendon, coracohumeral ligament, and superior glenohumeral ligament, adhered to the anterior margin of the torn supraspinatus (SSP) tendon on arthroscopy. All patients with the 'bridging sign' had combined full-thickness tear (FTT) of the cranial 1/2 portion of the subscapularis tendon and anterior 1/2 portion of the SSP tendon. The sensitivity, specificity, and accuracy of the 'bridging sign' for the diagnosis of combined FTTs of the SSC tendon and anterior portion of the SSP tendon were 81.0%, 100%, and 86

  14. Influence of rotator cuff tears on glenohumeral stability during abduction tasks.

    Science.gov (United States)

    Hölscher, Thomas; Weber, Tim; Lazarev, Igor; Englert, Carsten; Dendorfer, Sebastian

    2016-09-01

    One of the main goals in reconstructing rotator cuff tears is the restoration of glenohumeral joint stability, which is subsequently of utmost importance in order to prevent degenerative damage such as superior labral anterior posterior (SLAP) lesion, arthrosis, and malfunction. The goal of the current study was to facilitate musculoskeletal models in order to estimate glenohumeral instability introduced by muscle weakness due to cuff lesions. Inverse dynamics simulations were used to compute joint reaction forces for several static abduction tasks with different muscle weakness. Results were compared with the existing literature in order to ensure the model validity. Further arm positions taken from activities of daily living, requiring the rotator cuff muscles were modeled and their contribution to joint kinetics computed. Weakness of the superior rotator cuff muscles (supraspinatus; infraspinatus) leads to a deviation of the joint reaction force to the cranial dorsal rim of the glenoid. Massive rotator cuff defects showed higher potential for glenohumeral instability in contrast to single muscle ruptures. The teres minor muscle seems to substitute lost joint torque during several simulated muscle tears to maintain joint stability. Joint instability increases with cuff tear size. Weakness of the upper part of the rotator cuff leads to a joint reaction force closer to the upper glenoid rim. This indicates the comorbidity of cuff tears with SLAP lesions. The teres minor is crucial for maintaining joint stability in case of massive cuff defects and should be uprated in clinical decision-making. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1628-1635, 2016. PMID:26756861

  15. Electronic enhancement of tear secretion

    Science.gov (United States)

    Brinton, Mark; Lim Chung, Jae; Kossler, Andrea; Kook, Koung Hoon; Loudin, Jim; Franke, Manfred; Palanker, Daniel

    2016-02-01

    Objective. To study electrical stimulation of the lacrimal gland and afferent nerves for enhanced tear secretion, as a potential treatment for dry eye disease. We investigate the response pathways and electrical parameters to safely maximize tear secretion. Approach. We evaluated the tear response to electrical stimulation of the lacrimal gland and afferent nerves in isofluorane-anesthetized rabbits. In acute studies, electrical stimulation was performed using bipolar platinum foil electrodes, implanted beneath the inferior lacrimal gland, and a monopolar electrode placed near the afferent ethmoid nerve. Wireless microstimulators with bipolar electrodes were implanted beneath the lacrimal gland for chronic studies. To identify the response pathways, we applied various pharmacological inhibitors. To optimize the stimulus, we measured tear secretion rate (Schirmer test) as a function of pulse amplitude (1.5-12 mA), duration (0.1-1 ms) and repetition rate (10-100 Hz). Main results. Stimulation of the lacrimal gland increased tear secretion by engaging efferent parasympathetic nerves. Tearing increased with stimulation amplitude, pulse duration and repetition rate, up to 70 Hz. Stimulation with 3 mA, 500 μs pulses at 70 Hz provided a 4.5 mm (125%) increase in Schirmer score. Modulating duty cycle further increased tearing up to 57%, compared to continuous stimulation in chronically implanted animals (36%). Ethmoid (afferent) nerve stimulation increased tearing similar to gland stimulation (3.6 mm) via a reflex pathway. In animals with chronically implanted stimulators, a nearly 6 mm increase (57%) was achieved with 12-fold less charge density per pulse (0.06-0.3 μC mm-2 with 170-680 μs pulses) than the damage threshold (3.5 μC mm-2 with 1 ms pulses). Significance. Electrical stimulation of the lacrimal gland or afferent nerves may be used as a treatment for dry eye disease. Clinical trials should validate this approach in patients with aqueous tear deficiency, and

  16. Peri-acetabular bone mineral density in total hip replacement

    OpenAIRE

    Gauthier, L.(University of Illinois at Chicago (UIC), Chicago, USA); Dinh, L.; Beaulé, P. E.

    2013-01-01

    Objectives To quantify and compare peri-acetabular bone mineral density (BMD) between a monoblock acetabular component using a metal-on-metal (MoM) bearing and a modular titanium shell with a polyethylene (PE) insert. The secondary outcome was to measure patient-reported clinical function. Methods A total of 50 patients (25 per group) were randomised to MoM or metal-on-polyethlene (MoP). There were 27 women (11 MoM) and 23 men (14 MoM) with a mean age of 61.6 years (47.7 to 73.2). Measurement...

  17. Acetabular Dysplasia and Surgical Approaches Other Than Direct Anterior Increases Risk for Malpositioning of the Acetabular Component in Total Hip Arthroplasty

    DEFF Research Database (Denmark)

    Gromov, Kirill; Greene, Meridith E; Huddleston, James I;

    2016-01-01

    BACKGROUND: Persistent acetabular dysplasia (AD) after periacetabular osteotomy has been hypothesized to increase the risk for malpositioning of the acetabular component. In this study, we investigate whether AD is an independent risk factor for cup malpositioning during primary total hip...... arthroplasty (THA). METHODS: Patient demographics, surgical approach, presence of AD assessed using the lateral center-edge angle, and acetabular cup positioning determined using Martell Hip Analysis Suite were investigated in 836 primary THA patients enrolled in a prospective multicenter study. RESULTS: We...

  18. Percutaneous acetabuloplasty for metastatic acetabular lesions

    Directory of Open Access Journals (Sweden)

    Logroscino Giandomenico

    2008-05-01

    Full Text Available Abstract Background Osteolytic metastases around the acetabulum are frequent in tumour patients, and may cause intense and drug-resistant pain of the hip. These lesions also cause structural weakening of the pelvis, limping, and poor quality of life. Percutaneous acetabuloplasty is a mini-invasive procedure for the management of metastatic lesions due to carcinoma of the acetabulum performed in patients who cannot tolerate major surgery, or in patients towards whom radiotherapy had already proved ineffective. Methods We report a retrospective study in 25 such patients (30 acetabuli who were evaluated before and after percutaneous acetabuloplasty, with regard to pain, mobility of the hip joint, use of analgesics, by means of evaluation forms: Visual Analog Scale, Harris Hip Score, Western Ontario and McMaster Universities Index of Osteoarthritis (WOMAC, Eastern Cooperative Oncology Group (ECOG. The results obtained were analysed using the χ2 Test and Fisher's exact test. Significance was sent at P Results Marked clinical improvement was observed in all patients during the first six post-operative months, with gradual a worsening thereafter from deterioration of their general condition. Complete pain relief was achieved in 15 of our 25 (59% of patients, and pain reduction was achieved in the remaining 10 (41% patients. The mean duration of pain relief was 7.3 months. Pain recurred in three patients (12% between 2 weeks to 3 months. No major complications occurred. There was transient local pain in most cases, and 2 cases of venous injection of cement without clinical consequences. Conclusion Percutaneous acetabuloplasty is effective in improving the quality of life of patients with osteolytic bone tumours, even though the improvement is observed during the first 6 months only. It can be an effective aid to chemo- and radiotherapy in the management of acetabular metastases.

  19. The management of skin tears.

    Science.gov (United States)

    Meuleneire, Frans

    During the ageing process the layers of the skin start to atrophy; the epidermis becomes thin and fragile, and dermal thickness decreases by 20 per cent (White et al, 1994). This makes skin tears a common problem among older people.

  20. Functional outcome of the surgical management of acute acetabular fractures

    Institute of Scientific and Technical Information of China (English)

    Naseem Munshi; Asad Abbas; Mohamed Amirali Gulamhussein; Ghulam Mehboob; Rija Aitzaz Qureshi

    2015-01-01

    Objective:To assess the functional outcome of early surgical management of displaced acetabular fractures and the complications associated with the procedure. Methods: This is a case series study and data was collected using specialized performance. The study included 75 patients and the sampling technique was a non-probability purposive type. Patients presenting with close displaced acetabular fractures of more than 2 mm within 10 days of injury were included. However, elderly patients presenting after 10 days of injury, with evidence of local infection, severe osteoporotic bone and co-morbid such as chronic obstructive pulmonary disease were not included in the study. New acetabular scoring system was used for assessing outcome of patients. Results:A total of 75 patients were operated on. Union was achieved in anatomical position in 66 (88%) patients and in malposition in 9 (12%) patients. Excellent results were obtained in 18 (24%) patients, good results in 41 (54.6%), fair results in 12 (16%), and poor results in 4 (5.4%) patients. Postoperative complications included infection [5 (6.7%)], heterotropic ossification [3 (4%)], sciatic nerve injury [10 (13.3%)], avascular necrosis [3 (4%)] patients. Conclusions: Patients with displaced acetabular fractures should be referred to specialised centres. Early surgical intervention and experienced management is a prime factor in achieving good results.

  1. Editorial Commentary: It Is Best to Be on the Safe Side: Which Portal to Use for Safe Anchor Insertion for Hip Labral Repair.

    Science.gov (United States)

    Konyves, Arpad

    2016-09-01

    When repairing hip labra arthroscopically, labral anchors seem to have a better trajectory and less risk of joint penetration when placed from the distal anterolateral accessory portal compared with the traditional anterolateral and midanterior portals. PMID:27594330

  2. Anterior cruciate ligament tear: comparison of MR features between complete and partial tear

    Energy Technology Data Exchange (ETDEWEB)

    Song, Ki Young; Lee, Joo Hyuk; Park, Jin Hee; Lee, Yu Jin; Rho, Eun Jin; Kim, Young Hoon [Kangnam General Hospital, Seoul (Korea, Republic of); Yi, Jeong Geun [Hallym Univ. College of Medicine, Seoul (Korea, Republic of); Ahn, Joong Mo [Samsung Medical Center, Seoul (Korea, Republic of)

    1997-04-01

    To determine the MRI features which distinguish complete and partial tear of the anterior cruciate ligament(ACL) and to thus improve MRI interpretation. In 80 patients, we analyzed MR findings of direct and indirect signs of ACL tear (complete tear, 61 cases, partial tear, 19 cases) confirmed by arthroscopy or surgery, and compared the relative incidence of each sign in cases of complete and partial tear. Direct and indirect signs were found in 61 (100%) and 60 cases (98.4%), respectively, in complete tears, but in 16 (84.2%) and 15 cases (78.9%), respectively, in partial tears. Poor visualization, discontinuity and hyperintensity were seen in all complete tears but in only nine cases (47.4%) of partial tear. A wavy or abnormal contour was seen in 53 cases (86.9%) of complete tear and 14 (73.7%) of partial tear. A wavy contour without other direct signs was seen in only five cases (26.3%) of partial tear. Three cases (15.8%) of partial tear showed normal MR finding. Indirect signs, i.e. abnormal ACL angle, abnormal ACL-Blumensaat line angle, abnormal posterior cruciate ligament (PCL) line, abnormal PCL angle, PCL buckling, anterior displacement of tibia, posterior displacement of lateral meniscus, bone bruise, Segond fracture, tear of collateral ligaments, PCL, and tear of meniscus were commoner in complete than in partial tears. Two cases of O'Donoghue's triad and two of popliteus injury were seen only in complete tears. Direct and indirect signs of ACL tear were more commonly noted in complete than in partial tears. The latter showed MR features varying from normal to almost complete tear. We suggest that a wavy contour without other direct signs is indicative of a partial tear, and that O'Donoghue's triad and popliteus muscle injury are indirect signs of a complete tear.

  3. Anterior cruciate ligament tear: comparison of MR features between complete and partial tear

    International Nuclear Information System (INIS)

    To determine the MRI features which distinguish complete and partial tear of the anterior cruciate ligament(ACL) and to thus improve MRI interpretation. In 80 patients, we analyzed MR findings of direct and indirect signs of ACL tear (complete tear, 61 cases, partial tear, 19 cases) confirmed by arthroscopy or surgery, and compared the relative incidence of each sign in cases of complete and partial tear. Direct and indirect signs were found in 61 (100%) and 60 cases (98.4%), respectively, in complete tears, but in 16 (84.2%) and 15 cases (78.9%), respectively, in partial tears. Poor visualization, discontinuity and hyperintensity were seen in all complete tears but in only nine cases (47.4%) of partial tear. A wavy or abnormal contour was seen in 53 cases (86.9%) of complete tear and 14 (73.7%) of partial tear. A wavy contour without other direct signs was seen in only five cases (26.3%) of partial tear. Three cases (15.8%) of partial tear showed normal MR finding. Indirect signs, i.e. abnormal ACL angle, abnormal ACL-Blumensaat line angle, abnormal posterior cruciate ligament (PCL) line, abnormal PCL angle, PCL buckling, anterior displacement of tibia, posterior displacement of lateral meniscus, bone bruise, Segond fracture, tear of collateral ligaments, PCL, and tear of meniscus were commoner in complete than in partial tears. Two cases of O'Donoghue's triad and two of popliteus injury were seen only in complete tears. Direct and indirect signs of ACL tear were more commonly noted in complete than in partial tears. The latter showed MR features varying from normal to almost complete tear. We suggest that a wavy contour without other direct signs is indicative of a partial tear, and that O'Donoghue's triad and popliteus muscle injury are indirect signs of a complete tear

  4. Association of peripheral vertical meniscal tears with anterior cruciate ligament tears

    Energy Technology Data Exchange (ETDEWEB)

    Vinson, Emily N.; Gage, Jeffrey A.; Lacy, Joe N. [Duke University Medical Center, Department of Radiology, Durham, NC (United States)

    2008-07-15

    The purpose of this article is to describe a type of meniscal tear seen on magnetic resonance (MR) imaging, the peripheral vertical tear, and to determine the prevalence of anterior cruciate ligament (ACL) tears in knees with this type of meniscal tear compared to knees with other types of meniscal tears. Following Institutional Review Board approval, a retrospective review of 200 knee MR examinations with imaging diagnoses of 'meniscal tear' was performed to assess the location and morphology of the meniscal tear, and to assess the status of the ACL. Nineteen peripheral vertical meniscal tears were identified in 17 patients, 14 of whom had acute ACL tears, prior ACL reconstruction, or chronic ACL deficiency. Three peripheral vertical tears were seen in the setting of a normal ACL. Of the 183 examinations with other types of meniscal tears, there were 17 cases with acute ACL tears, prior ACL reconstruction, or chronic ACL deficiency. The difference in the prevalence of ACL tear, reconstruction, or deficiency in knees with meniscal tears of the peripheral vertical type (82.4%) compared with the prevalence of ACL tear, reconstruction, or deficiency in knees with other types of meniscal tears (9.3%) was statistically significant (P < 0.001). The calculated specificity of the presence of peripheral vertical tear morphology in detecting an ACL injury in patients with meniscal tears was 98.2%. Peripheral vertical meniscal tears, particularly when involving the posterior horn, are highly associated with ACL tear, deficiency, or reconstruction. The finding of this type of tear on knee MR imaging should prompt close inspection of the ACL for evidence of acute or chronic injury, and its presence may help make the diagnosis of ACL tear in equivocal cases. (orig.)

  5. Wear and Tear - Mechanical

    Science.gov (United States)

    Swanson, Theodore

    2008-01-01

    The focus of this chapter is on the long term wear and tear, or aging, of the mechanical subsystem of a spacecraft. The mechanical subsystem is herein considered to be the primary support structure (as in a skeleton or exoskeleton) upon which all other spacecraft systems rest, and the associated mechanisms. Mechanisms are devices which have some component that moves at least once, in response to some type of passive or active control system. For the structure, aging may proceed as a gradual degradation of mechanical properties and/or function, possibly leading to complete structural failure over an extended period of time. However, over the 50 years of the Space Age such failures appear to be unusual. In contrast, failures for mechanisms are much more frequent and may have a very serious effect on mission performance. Just as on Earth, all moving devices are subject to normal (and possibly accelerated) degradation from mechanical wear due to loss or breakdown of lubricant, misalignment, temperature cycling effects, improper design/selection of materials, fatigue, and a variety of other effects. In space, such environmental factors as severe temperature swings (possibly 100's of degrees C while going in and out of direct solar exposure), hard vacuum, micrometeoroids, wear from operation in a dusty or contaminated environment, and materials degradation from radiation can be much worse. In addition, there are some ground handling issues such as humidity, long term storage, and ground transport which may be of concern. This chapter addresses the elements of the mechanical subsystem subject to wear, and identifies possible causes. The potential impact of such degradation is addressed, albeit with the recognition that the impact of such wear often depends on when it occurs and on what specific components. Most structural elements of the mechanical system typically are conservatively designed (often to a safety factor of greater than approximately 1.25 on yield for

  6. Aumento acetabular pela técnica de Stahelli modificada Acetabular increase with modified Stahelli technique

    Directory of Open Access Journals (Sweden)

    Sílvio Pereira Coelho

    2000-09-01

    Full Text Available Os autores apresentam neste trabalho um estudo retrospectivo realizado em 18 pacientes submetidos a tratamento cirúrgico de insuficiência acetabular pela osteotomia da pelve seguindo a técnica descrita por Lynn T. Staheli. Enfatizam a modificação da técnica deste autor, com a introdução do enxerto ósseo, retirado da tábua externa do ilíaco, numa fenda aprofundada até cerca da cortical interna do ilíaco. Os pacientes foram acompanhados através de consultas ambulatoriais previamente a cirurgia e pós-operatoriamente com seguimento que variou de 2 meses a 4 anos no serviço de ortopedia infantil do Hospital Independência - Complexo Hospitalar ULBRA/Porto Alegre-RS. O objetivo do trabalho foi avaliar o quadril acometido pré e pós-operatoriamente, demonstrando a evolução e vantagens da variação da técnica de Staheli desenvolvida neste serviço. Observou-se que a cirurgia, se realizada sob técnica adequada e em mãos experientes, torna-se uma fonte válida de tratamento para aquelas patologias que levam a uma insuficiente cobertura da cabeça femoral.The authors present in this paper a retrospective study of eighteen patients treated surgically for insufficiency of the acetabular coverage with the shelf procedure according to Lynn T. Staheli. This study was done at the Service of Pediatric Orthopedics of Hospital Independência - Complexo Hospitalar ULBRA/Porto Alegre-RS. They call attention to the modification of the surgical technique in that the bone graft taken from outer cortex of the iliac bone, is deepened in the slot in the superior rim of the acetabulum. The follow-up ranged from two months to four years. The aim of this paper was to evaluate the affected hip pre and postoperatively showing the results and the advantages of the modified shelf technique. They observed that if the surgery is performed according to the correct technique and by an experienced surgeon, it is a very good alternative to the treatment of those

  7. Relationship between Wiberg's lateral center edge angle, Lequesne's acetabular index, and medial acetabular bone stock

    Energy Technology Data Exchange (ETDEWEB)

    Werner, Clement M.L. [Balgrist University Hospital Zurich, Department of Orthopaedics, Zurich (Switzerland); University of Maryland Medical Systems, R. Adams Cowley Shock Trauma Center, Baltimore, MD (United States); Copeland, Carol E.; Stromberg, Jeff; Turen, Clifford H. [University of Maryland Medical Systems, R. Adams Cowley Shock Trauma Center, Baltimore, MD (United States); Ruckstuhl, Thomas; Bouaicha, Samy [Balgrist University Hospital Zurich, Department of Orthopaedics, Zurich (Switzerland)

    2011-11-15

    Knowledge of acetabular anatomy is crucial for cup positioning in total hip replacement. Medial wall thickness of the acetabulum is known to correlate with the degree of developmental dysplasia of the hip (DDH). No data exist about the relationship of routinely used radiographic parameters such as Wiberg's lateral center edge angle (LCE-angle) or Lequesne's acetabular index (AI) with thickness of the medial acetabular wall in the general population. The aim of our study was to clarify the relationship between LCE, AI, and thickness of the medial acetabular wall. Measurements on plain radiographs (LCE and AI) and axial CT scans (quadrilateral plate acetabular distance QPAD) of 1,201 individuals (2,402 hips) were obtained using a PACS imaging program and statistical analyses were performed. The mean thickness of the medial acetabulum bone stock (QPAD) was 1.08 mm (95% CI: 1.05-1.10) with a range of 0.1 to 8.8 mm. For pathological values of either the LCE (<20 ) or the AI (>12 ) the medial acetabular wall showed to be thicker than in radiological normal hips. The overall correlation between coxometric indices and medial acetabular was weak for LCE (r =-0.21. 95% CI [-0.25, -0.17]) and moderate for AI (r = 0.37, [0.33, 0.41]). We did not find a linear relationship between Wiberg's lateral center edge angle, Lequesne's acetabular index and medial acetabular bone stock in radiological normal hips but medial acetabular wall thickness increases with dysplastic indices. (orig.)

  8. Treatment of acetabular dysplasia by triple pelvic osteotomy and its short-term results

    OpenAIRE

    Dogan, Ahmet; Zorer, Gazi; Ozer, Utku Erdem

    2004-01-01

    Objectives: We evaluated the effect of triple pelvic osteotomy on acetabular coverage and its clinical implications by clinical and radiographic parameters in patients with acetabular dysplasia. Methods: Triple pelvic osteotomy was performed in 21 hips of 19 patients (13 females, 6 males; mean age during operation 16.3 years; range 8 to 32 years). Acetabular dysplasia was bilateral in two, and unilateral in 17 patients. Etiology was developmental dysplasia of the hip in 12 patients, Legg-C...

  9. The current management of skin tears.

    Science.gov (United States)

    Xu, Xiaoti; Lau, Kwan; Taira, Breena R; Singer, Adam J

    2009-07-01

    Each year, there are more than 1 million skin tears among the elderly and disabled. Because of their fragile nature, management of skin tears can be very challenging. Methods of wound closure should minimize additional trauma to the skin and promote an optimal wound healing environment while minimizing the risk of infection. The current article reviews the etiology, risk factors, classification, and therapeutic options for treating skin tears. We also review preventive measures to help reduce the incidence of skin tears.

  10. Difference in the acetabular cup orientation in standing and supine radiographs.

    Science.gov (United States)

    Khan, Munir; Beckingsale, Tom; Marsh, Martin; Holland, Jim

    2016-09-01

    Acetabular orientation changes with that of the pelvis during lying and standing. This study was designed to measure these changes. We assessed 17 BHR replacements using EBRA software. The mean acetabular anteversion was more (p = 0.02) on erect than supine radiographs. Linear regression analysis showed that anteversion and inclination increased in some while decreased in others, and Bland and Altman analysis showed wide limits of agreement. The changes in acetabular orientation are thus subject to significant variations between the patients. We suggest studying the factors affecting acetabular orientation in standing to help reduce joint reaction forces and improve outcomes. PMID:27408490

  11. Validation of a new radiographic measurement of acetabular version: the transverse axis distance (TAD)

    International Nuclear Information System (INIS)

    This study has three aims: (1) validate a new radiographic measure of acetabular version, the transverse axis distance (TAD) by showing equivalent TAD accuracy in predicting CT equatorial acetabular version when compared to a previously validated, but more cumbersome, radiographic measure, the p/a ratio; (2) establish predictive equations of CT acetabular version from TAD; (3) calculate a sensitive and specific cut point for predicting excessive CT acetabular anteversion using TAD. A 14-month retrospective review was performed of patients who had undergone a dedicated MSK CT pelvis study and who also had a technically adequate AP pelvis radiograph. Two trained observers measured the radiographic p/a ratio, TAD, and CT acetabular equatorial version for 110 hips on a PACS workstation. Mixed model analysis was used to find prediction equations, and ROC analysis was used to evaluate the diagnostic accuracy of p/a ratio and TAD. CT equatorial acetabular version can accurately be predicted from either p/a ratio (p < 0.001) or TAD (p < 0.001). The diagnostic accuracies of p/a ratio and TAD are comparable (p =0.46). Patients whose TAD is higher than 17 mm may have excessive acetabular anteversion. For that cutpoint, the sensitivity of TAD is 0.73, with specificity of 0.82. TAD is an accurate radiographic predictor of CT acetabular anteversion and provides an easy-to-use and intuitive point-of-care assessment of acetabular version in patients with hip pain. (orig.)

  12. Validation of a new radiographic measurement of acetabular version: the transverse axis distance (TAD)

    Energy Technology Data Exchange (ETDEWEB)

    Nitschke, Ashley [University of Colorado School of Medicine, University of Colorado Denver, Division of Musculoskeletal Radiology, Department of Radiology, Aurora, CO (United States); Lambert, Jeffery R. [University of Colorado, Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO (United States); Glueck, Deborah H. [University of Colorado, Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO (United States); University of Colorado School of Medicine, University of Colorado Denver, Department of Radiology, Aurora, CO (United States); Jesse, Mary Kristen; Strickland, Colin [University of Colorado School of Medicine, University of Colorado Denver, Division of Musculoskeletal Radiology, Department of Radiology and Orthopaedics, Aurora, CO (United States); Mei-Dan, Omer [University of Colorado School of Medicine, University of Colorado Denver, Division of Sports Medicine and Hip Preservation, Department of Orthopaedics, Aurora, CO (United States); Petersen, Brian [University of Colorado School of Medicine, University of Colorado Denver, Division of Musculoskeletal Radiology, Department of Radiology and Orthopaedics, Aurora, CO (United States); Inland Imaging, Division of Musculoskeletal Radiology, Spokane, WA (United States)

    2015-11-15

    This study has three aims: (1) validate a new radiographic measure of acetabular version, the transverse axis distance (TAD) by showing equivalent TAD accuracy in predicting CT equatorial acetabular version when compared to a previously validated, but more cumbersome, radiographic measure, the p/a ratio; (2) establish predictive equations of CT acetabular version from TAD; (3) calculate a sensitive and specific cut point for predicting excessive CT acetabular anteversion using TAD. A 14-month retrospective review was performed of patients who had undergone a dedicated MSK CT pelvis study and who also had a technically adequate AP pelvis radiograph. Two trained observers measured the radiographic p/a ratio, TAD, and CT acetabular equatorial version for 110 hips on a PACS workstation. Mixed model analysis was used to find prediction equations, and ROC analysis was used to evaluate the diagnostic accuracy of p/a ratio and TAD. CT equatorial acetabular version can accurately be predicted from either p/a ratio (p < 0.001) or TAD (p < 0.001). The diagnostic accuracies of p/a ratio and TAD are comparable (p =0.46). Patients whose TAD is higher than 17 mm may have excessive acetabular anteversion. For that cutpoint, the sensitivity of TAD is 0.73, with specificity of 0.82. TAD is an accurate radiographic predictor of CT acetabular anteversion and provides an easy-to-use and intuitive point-of-care assessment of acetabular version in patients with hip pain. (orig.)

  13. PATHOLOGICAL AND MORPHOLOGICAL RESEARCH OF EXPERIMENTAL ACETABULAR DYSPLASIA

    Institute of Scientific and Technical Information of China (English)

    张自明; 马瑞雪; 吉士俊; 牛之彬

    2004-01-01

    Objective To investigate the pathological mechanism of hip dysplasia. Methods The left knee joints of eighteen rabbits were fixed in extending position with plaster cylinder for four weeks, but their hip joints were flexed. The right side served as control. Roentgenogram was made in all animals. The changes of the xray films and the pathological findings between left and right hips were compared. Results Appearance of hip dysplasia was obvious at four weeks after plaster fixation. There were pathological changes, including shallow acetabulum and flat femoral head, increased acetabular index and decreased acetabular head index on the x-ray films.Conclusion The hip dysplasia is the result of prolonged extending position of the knee joint. Abnormal knee posture seems to be one of the important factors of hip dysplasia. This kind of deformation may be worsened with time.

  14. Nonunion of acetabular fractures: evaluation with interactive multiplanar CT

    International Nuclear Information System (INIS)

    Nonunions involving fractures of the acetabulum are reportedly rare, with few citings and little discussion in the literature. It is possible that acetabular nonunions go undetected because imaging of the acetabulum is difficult by conventional radiography. We report two cases of fracture nonunion involving the weight-bearing surface of the acetabulum diagnosed with the aid of computed tomography (CT) and a newly developed interactive 2D/3D orthotool that uniquely processes and reformats routine CT data. The interactive 2D/3D orthotool is a sophisticated computer program that allows dynamic viewing of standard multiplanar reconstructions in the axial, coronal, and sagittal planes as well as multiple oblique projections. The 2D/3D orthotool provides on screen correlation of two-dimensional multiplanar images with three-dimensional reconstructions of the pelvis. The authors found this capability ideally suited for studying fractures with off-axis orientation such as those through the acetabular dome, greatly facilitating the diagnosis of nonunion

  15. Early total hip arthroplasty for severe displaced acetabular fractures

    Institute of Scientific and Technical Information of China (English)

    YANG Shu-hua; ZHANG Yu-kun; XU Wei-hua; LI Jin; LIU Guo-hui; YANG Cao; LIU Yong; TIAN Hong-tao

    2006-01-01

    Objective : To investigate the effect of early total hip arthroplasty for severe displaced acetabular fractures.Methods: Total hip arthroplasty was performed on 17 cases of severe fracture of the acetabulum from 1997 to 2003. The mean follow-up was 2.1 years (1-6 years) and the average period from fracture to operation was 8 days (5-21 day). The average age of the patients was 53 years (26-69 years).Results: At the final follow-up the Harris hip score averaged 82(69-100) points and 15 cases have got a good outcome. There was one case of heterotopic bone formation. There were no radiographic evidences of late loosening of the prosthesis. One patient had severe central displacement of the cup.Conclusions: In patients with severe displaced acetabular fractures, particularly in elderly patients, early total hip arthroplasty is probably an alternative efficient way to achieve a painless and stable hip.

  16. Acetabular prosthesis: Proff of migration with ruler and pencil?

    International Nuclear Information System (INIS)

    Conventional X-ray films were made with varying degrees of tilt of a pelvic phantom containing an acetabular prosthesis. The position of the prosthesis was then reconstructed graphically. The measurement errors were calculated and an estimate was made for the tilt. There is a linear correlation between the measurement error and the tilt of the prosthesis. Therefore a tilt dependent maximum error can be calculated. This error is very small for small degrees of tilt, so that acetabular migration can in this instance be evaluated with greater confidence than with other graphical methods. The error also correlates with the determination of the selected region of the acetabulum, but not with the position of the central focus spot or image magnification. (orig.)

  17. The 'bridging sign', a MR finding for combined full-thickness tears of the subscapularis tendon and the supraspinatus tendon

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Jin Young [Dept. of Radiology, Saint Paul' s Hospital, The Catholic Univ. of Korea, Seoul (Korea, Republic of); Yoon, Young Cheol; Cha, Dong Ik [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan Univ, School of Medicine, Seoul (Korea, Republic of)], e-mail: ycyoon@skku.edu; Yoo, Jae-Chul [Dept. of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan Univ. School of Medicine, Seoul (Korea, Republic of); Jung, Jee Young [Dept. of Radiology, School of Medicine, Chung-Ang Univ., Seoul (Korea, Republic of)

    2013-02-15

    Background: In daily practice, we discovered one of the secondary magnetic resonance (MR) findings of the subscapularis (SSC) tendon tear, the 'bridging sign', which has not been previously described. Purpose: To describe the 'bridging sign' on shoulder MR imaging and its radiological and clinical significance in patients with SSC tendon tear. Material and Methods: Twenty-nine patients who had undergone shoulder arthroscopy and had full-thickness tear of the subscapularis tendon were enrolled. The medical records of the 29 patients were retrospectively reviewed for the duration of shoulder pain, rotator cuff tears, and associated arthroscopic findings: biceps tendon abnormality and superior glenoid labral tear. Then, preoperative shoulder MR images were retrospectively reviewed for the presence or absence of the 'bridging sign' and associated MR findings: periarticular fluid and fatty atrophy of the supraspinatus and subscapularis muscles. The type of rotator cuff tear associated with the 'bridging sign' was assessed and the sensitivity, specificity, and accuracy of the 'bridging sign' for the diagnosis of a certain type of rotator cuff tear were calculated. Associated arthroscopic and MR findings and mean duration of the shoulder pain between the patients with and without the 'bridging sign' were compared. Results: The 'bridging sign' was seen in 17 of 29 patients and corresponded to a complex of the torn and superomedially retracted subscapularis tendon, coracohumeral ligament, and superior glenohumeral ligament, adhered to the anterior margin of the torn supraspinatus (SSP) tendon on arthroscopy. All patients with the 'bridging sign' had combined full-thickness tear (FTT) of the cranial 1/2 portion of the subscapularis tendon and anterior 1/2 portion of the SSP tendon. The sensitivity, specificity, and accuracy of the 'bridging sign' for the diagnosis of combined FTTs of

  18. Plate Tearing by a Cone

    DEFF Research Database (Denmark)

    Simonsen, Bo Cerup

    1997-01-01

    The present paper is concerned with steady-state plate tearing by a cone. This is a scenario where a cone is forced through a ductile metal plate with a constant lateral tip penetration in a motion in the plane of the plate. The considered process could be an idealisaton of the damage, which...

  19. Plate Tearing by a Cone

    DEFF Research Database (Denmark)

    Simonsen, Bo Cerup

    1998-01-01

    The present paper is concerned with steady-state plate tearing by a cone. This is a scenario where a cone is forced through a ductile metal plate with a constant lateral tip penetration in a motion in the plane of the plate. The considered process could be an idealisation of the damage, which...

  20. Multiplanar and 3D CT of acetabular fractures

    Energy Technology Data Exchange (ETDEWEB)

    Haveri, M.; Suramo, I.; Laehde, S. [Oulu Univ., Dept. of Diagnostic Radiology (Finland); Junila, J. [Oulu Univ., Dept. of Orthopaedic Surgery (Finland)

    1998-05-01

    Purpose: To establish a standard protocol for the multiplanar (MPR) and 3D shaded surface display (SSD) reconstruction of CT data on acetabular fractures, and to assess the usefulness of these reformats. Material and Methods: Acetabular fractures in 15 patients were imaged by means of plain radiographs, transaxial CT, MPR reformats, and SSD reformats. Results: The classification of the acetabular fracture was revised in 7/15 cases when the transaxial CT images were read after the plain radiographs. Although the MPR and SSD reformats did not alter the classification, they did add to the degree of confidence in the diagnosis in 9/15 cases. In 2 patients, the MPR and SSD reformats indicated operative instead of conservative treatment. In the MPR reformats, the following views were considered essential in all cases: (a) along the anterior column; (b) along the posterior column; and (c) along both columns and the inferior ramus. In the SSD reformats, the following views were considered essential in all cases: (d) the latero-caudal en face view into the acetabulum; and 180 opposite to this, (e) the medio-cranial view (facing the quadrilateral plate). In 10/15 cases, these views were all that was needed for classification. It was, however, essential to remove the femur from the images before reconstructing the SSD views. Conclusion: Complex acetabular fractures with displacement should be evaluated by means of transaxial CT and additional MPR and SSD reformats. The use of appropriate standard MPR and SSD views shortens the time required to produce the reformats and thereby maximizes the benefit gained. (orig.).

  1. Imaging diagnosis of acetabular dysplastic coxarthrosis in adult

    International Nuclear Information System (INIS)

    Objective: To investigate the imaging diagnosis of acetabular dysplastic coxarthrosis. Method: The imaging of the acetabular dysplasia was analyzed in 51 patients (87 hips). All but four patients were women. The age ranged from 22 to 78 years, and the mean age was 42.6 years. Pelvis radiographs were studied in all cases, and CT scan was performed in 18 cases and MRI in 10 cases. Results: The fundamental signs on the plain film included shallow acetabulum, increased obliquity and insufficient coverage of the femoral head by the acetabulum. The CE angles were determined in all the cases, ranging from -10 degree to 30 degree, mean 12.9 degree. The sharp angles ranged from 35 degree to 67 degree, mean 45.3 degree. The secondary osteoarthritis were revealed in 75 hips (84.2%). 54 hips (62.1%) had cyst-like lesions in weight-bear area of the acetabulum or femoral head. 19 hips had subluxation of femoral head. CT and MRI displayed small cyst-like lesions and forward shift of the femoral head, which could not be shown on plain film, respectively in 13 and 10 hips. Conclusion: The cyst-like lesion of subarticular region is a common sign in acetabular dysplastic coxarthrosis. CT or MRI can show the early osteolytic lesion and forward subluxations

  2. Effect of increased pushoff during gait on hip joint forces

    OpenAIRE

    Lewis, Cara L.; Garibay, Erin J.

    2014-01-01

    Anterior acetabular labral tears and anterior hip pain may result from high anteriorly directed forces from the femur on the acetabulum. While providing more pushoff is known to decrease sagittal plane hip moments, it is unknown if this gait modification also decreases hip joint forces. The purpose of this study was to determine if increasing pushoff decreases hip joint forces. Nine healthy subjects walked on an instrumented force treadmill at 1.25 m/s under two walking conditi...

  3. Physical properties of stimulated and unstimulated tears.

    Science.gov (United States)

    Pandit, J C; Nagyová, B; Bron, A J; Tiffany, J M

    1999-02-01

    It has long been assumed that unstimulated tears are more thoroughly equilibrated with epithelial secretions than stimulated tears, since they are in contact with tarsal, bulbar and corneal surfaces for longer. It was also believed from results with model solutions that soluble mucin is responsible for the observed surface tension and viscosity of tears. If longer contact means more mucin is dissolved in the aqueous tears, then the surface activity (surface tension lowered by mucin) and viscosity (raised by mucin) of tears should therefore be enhanced in unstimulated over stimulated tears. Pools of stimulated and minimally-stimulated tears were collected from a group of healthy adult volunteers by glass capillary. Viscosities were measured in the Contraves Low Shear 30 rheometer over the range of shear rates 0-130 sec-1. Surface tension was measured in the collection capillaries by a micro-technique, before and after refrigerated storage. Both surface tension and viscosity were determined for a variety of tear proteins and mucins. No significant difference was found between the viscosity/shear rate plots of stimulated and unstimulated tear samples. The viscosities of solutions of individual tear proteins were low, except for the combination of lysozyme and secretory IgA. Surface tensions were also similar in both cases, and unchanged by storage at room temperature or refrigeration, indicating no significant loss of surface-active material by adsorption on the capillary walls. Results with model mucin solutions gave a variety of results indicating either little surface activity or losses due to wall adsorption. Tear proteins, individually or in combination, did not lower surface tension to the level of tears. Tear viscosity seems not to depend on the level of dissolved mucins. This suggests either that a constant level of these is picked up even by short-term contact with ocular surfaces, or that viscosity arises from currently unknown materials which vary little

  4. 21 CFR 888.3370 - Hip joint (hemi-hip) acetabular metal cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... prosthesis. 888.3370 Section 888.3370 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... (hemi-hip) acetabular metal cemented prosthesis. (a) Identification. A hip joint (hemi-hip) acetabular metal cemented prosthesis is a device intended to be implanted to replace a portion of the hip...

  5. Software Simulation of Hot Tearing

    DEFF Research Database (Denmark)

    Andersen, S.; Hansen, P.N.; Hattel, Jesper Henri

    1999-01-01

    the solidification rate and the strain rate of the hot tear prone areas. But, until recently it was only possible to simulate the solidification rate, so that the criteria could not be used effectively.Today, with new software developments, it is possible to also simulate the strain rate in the hot tear prone areas....... With this additional information, the criteria can, for the first time, be used to their full potential.The purpose of this paper is to first give an introduction to a stress/strain simulation procedure that can be used in any foundry. Then, some results how to predict the hot cracking tendency in a casting are shown......, and the use of simulation to reduce this tendency is illustrated....

  6. Pelvic Discontinuity Caused by Acetabular Overreaming during Primary Total Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Iori Takigami

    2011-01-01

    Full Text Available Intraoperative acetabular fracture is a rare complication of primary total hip arthroplasty (THA, typically occurring during impaction of the cementless acetabular component. Here we report an unusual case of pelvic discontinuity caused by overreaming of the acetabulum during primary THA. Restoration of posterior columnar continuity was achieved with an autologous fibular graft and a reconstruction plate. Wall defects and cavitary defects were reconstructed with metal mesh and femoral head allograft, followed by placement and fixation of a Kerboull-type acetabular reinforcement device. Previous reports of acetabular fracture during THA have indicated that it has a relatively good prognosis without extensive treatment. However, to our knowledge, there has been no report of pelvic discontinuity necessitating acetabular reconstruction surgery as an intraoperative complication of primary THA.

  7. Artificial tears potpourri: a literature review

    Directory of Open Access Journals (Sweden)

    Moshirfar M

    2014-07-01

    Full Text Available Majid Moshirfar,1 Kasey Pierson,2,* Kamalani Hanamaikai,3,* Luis Santiago-Caban,1 Valliammai Muthappan,1 Samuel F Passi11Department of Ophthalmology, John A Moran Eye Center, University of Utah, Salt Lake City, UT, USA; 2University of Arizona College of Medicine, Phoenix, Phoenix, AZ, USA; 3A T Still University, School of Osteopathic Medicine in Arizona, Mesa, AZ, USA *These authors contributed equally to this work Abstract: Numerous brands and types of artificial tears are available on the market for the treatment of dysfunctional tear syndrome. Past literature has focused on comparing the components of these products on patient’s clinical improvement. The wide array of products on the market presents challenges to both clinicians and patients when trying to choose between available tear replacement therapies. Different formulations affect patients based on etiology and severity of disease. In order to provide an unbiased comparison between available tear replacement therapies, we conducted a literature review of existing studies and National Institutes of Health clinical trials on commercially available, brand name artificial tears. Outcomes evaluated in each study, as well as the percent of patients showing clinical and symptomatic improvement, were analyzed. Fifty-one studies evaluating different brands of artificial tears, and their efficacy were identified. Out of the 51 studies, 18 were comparison studies testing brand name artificial tears directly against each other. Nearly all formulations of artificial tears provided significant benefit to patients with dysfunctional tear syndrome, but some proved superior to others. From the study data, a recommended treatment flowchart was derived. Keywords: dry eye, tear film, dysfunctional tear syndrome, ophthalmic lubricant, artificial tears, lipid layer, tear osmolarity, TBUT, Systane®, Refresh®, Blink®, GenTeal®, Soothe®, Lacrisert®, ocular surface inflammatory disease, Sjogren

  8. Comparison of acetabular version angle measurements between prone and reformatted supine computed tomography images

    Energy Technology Data Exchange (ETDEWEB)

    Chong, Le Roy [Changi General Hospital, Department of Radiology, Singapore (Singapore); Too, Chow Wei [Singapore General Hospital, Department of Diagnostic Radiology, Singapore (Singapore)

    2014-03-15

    To compare acetabular version angle measurements of CT scans in the prone and reformatted supine positions. CT acetabular version angle measurements have previously been done in the prone position to correct for pelvic tilt. With the advent of multidetector CT, recent studies have evaluated acetabular version angles measured in the supine position. To our knowledge, a comparison between these two approaches has not been performed. Case series in which consecutive CT urography studies of 49 adult patients performed in both prone and supine positions were retrospectively reviewed, and acetabular version angles of both hips measured. Retrospective review of 49 consecutive CT urography studies performed in both prone and supine positions was done, and acetabular version angles of both hips were measured. Two radiologists measured the acetabular version angles independently. Multiplanar reformation of the supine CT images was performed to compensate for pelvic tilt and rotation prior to angle measurements. There was excellent interobserver agreement between the two readers (ICC = 0.90). Acetabular version angle measurements from the prone CT images were larger compared to reformatted supine images (24.0 and 21.3 , respectively, p < 0.0001), with greater angles found in women. There was strong correlation between supine and prone acetabular version angle measurements with a Pearson correlation coefficient of 0.743. Acetabular version angles measured from prone and reformatted supine CT images show strong correlation but are significantly different with larger angles obtained from the former and in women; clinical implications of these findings may require further study in other to determine the best method of version angle measurement. CT acetabular version angle measurement is also reliable with excellent interobserver correlation. (orig.)

  9. Magnetic resonance arthrography of the shoulder: accuracy of gadolinium versus saline for rotator cuff and labral pathology

    Energy Technology Data Exchange (ETDEWEB)

    Helms, Clyde A.; McGonegle, Shane J.; Vinson, Emily N.; Whiteside, Michael B. [Duke University Medical Center, Department of Radiology, Durham, NC (United States)

    2011-02-15

    The purpose of this study was to evaluate the necessity of intra-articular gadolinium versus saline alone in magnetic resonance arthrography (MRA) of the shoulder. Our database was reviewed for 100 consecutive shoulder MRA examinations performed between January 2007 and December 2007. Patient information was blinded and images were retrospectively reviewed by at least two radiologists with dedicated musculoskeletal training. T2-weighted (T2W) images were initially analyzed in isolation to simulate MRA with saline alone. After a delay, the full study was analyzed including T1-weighted (T1W) and T2W images. If there was a significant discordance between the two analyses with regard to rotator cuff or labral pathology, the study was again reviewed by all evaluators in consensus to determine if the T1W images offered additional diagnostic information and increased diagnostic confidence. Of the 100 MRA examinations, there were 15 discordant cases. Two cases were discordant with regard to rotator cuff pathology and 13 were discordant on the basis of labral pathology. When the discordant cases were reviewed in consensus, the T2W images appeared to display rotator cuff and labral pathology as definitively as the T1W images. Interobserver and intraobserver variability was favored to have played a role in causing the discordances. MRA of the shoulder performed with joint distention provided by saline alone appears to offer equivalent diagnostic information to MRA performed with gadolinium enhancement. This protocol modification improves efficiency by eliminating several image series and provides a small cost savings by eliminating gadolinium. (orig.)

  10. Efficacy of labral repair, biceps tenodesis, and diagnostic arthroscopy for SLAP Lesions of the shoulder: a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Mowinckel Petter

    2010-10-01

    Full Text Available Abstract Background Surgery for type II SLAP (superior labral anterior posterior lesions of the shoulder is a promising but unproven treatment. The procedures include labral repair or biceps tenodesis. Retrospective cohort studies have suggested that the benefits of tenodesis include pain relief and improved function, and higher patient satisfaction, which was reported in a prospective non-randomised study. There have been no completed randomised controlled trials of surgery for type II SLAP lesions. The aims of this participant and observer blinded randomised placebo-controlled trial are to compare the short-term (6 months and long-term (2 years efficacy of labral repair, biceps tenodesis, and placebo (diagnostic arthroscopy for alleviating pain and improving function for type II SLAP lesions. Methods/Design A double-blind randomised controlled trial are performed using 120 patients, aged 18 to 60 years, with a history for type II SLAP lesions and clinical signs suggesting type II SLAP lesion, which were documented by MR arthrography and arthroscopy. Exclusion criteria include patients who have previously undergone operations for SLAP lesions or recurrent shoulder dislocations, and ruptures of the rotator cuff or biceps tendon. Outcomes will be assessed at baseline, three, six, 12, and 24 months. Primary outcome measures will be the clinical Rowe Score (1988-version and the Western Ontario Instability Index (WOSI at six and 24 months. Secondary outcome measures will include the Shoulder Instability Questionnaire (SIQ, the generic EuroQol (EQ-5 D and EQ-VAS, return to work and previous sports activity, complications, and the number of reoperations. Discussion The results of this trial will be of international importance and the results will be translatable into clinical practice. Trial Registration [ClinicalTrials.gov NCT00586742

  11. Preventing and managing skin tears: a review.

    Science.gov (United States)

    Roberts, Mary J

    2007-01-01

    Skin tears are an increasingly common problem in frail elders, and the wound, ostomy, and continence (WOC) nurse must be knowledgeable regarding both prevention and management of these lesions. A literature review was conducted to identify current concepts regarding management of skin tears. Articles reviewed provided numerous suggested interventions and protocols. Recurring themes were prevention of skin tears whenever possible and management of existing lesions with products that manage the exudate, maintain a moist surface, and prevent additional trauma.

  12. Danish translation and validation of the International Skin Tear Advisory Panel Skin Tear Classification System

    DEFF Research Database (Denmark)

    Skiveren, J; Bermark, S; LeBlanc, K;

    2015-01-01

    OBJECTIVE: The aim of this study was to translate, validate and establish reliability of the International Skin Tear Classification System in Danish. METHOD: Phase 1 of the project involved the translation of the International Skin Tear Advisory Panel (ISTAP) Skin Tear Classification System into ...... the earlier ISTAP study and further validates the classification system. The Danish translation of the classification system is vital to the promotion of skin tears in both research and the clinical settings in Denmark....

  13. The use of cementless acetabular component in revision surgery without pelvic discontinuity.

    Science.gov (United States)

    Cherubino, Paolo; D'Angelo, Fabio; Surace, Michele Francesco; Murena, Luigi; Vulcano, Ettore

    2010-10-01

    Reconstruction of the failed acetabular component in total hip arthroplasty (THA) can be challenging. Although there are multiple reconstructive options available, a cementless acetabular component inserted with screws has been shown to have good intermediate-term results and is the reconstructive method of choice for the majority of acetabular revisions This reconstruction is feasible provided at least 50% of the implant contacts host bone. When such contact is not possible, and there is adequate medial and peripheral bone, techniques using alternative uncemented implants can be used for acetabular reconstruction. An uncemented cup can be placed at a "high hip center." Alternatively, the acetabular cavity can be progressively reamed to accommodate extra-large cups. Oblong cups, which take advantage of the oval-shaped cavity resulting from many failed acetabular components, can also be used. The success of these cementless techniques depends on the degree and location of bone loss. The correct indication to revision and the choice of the correct implant is the keystone for the success of this type of surgery and follows an accurate preoperative planning in order to understand the specific pathologic scenario. The aim of this paper is to review some technical options for the revision of the acetabular component also taking into account our personal experiences and series. PMID:21082580

  14. FUNCTIONAL OUTCOME OF SURGICAL MANAGEMENT OF ACETABULAR FRACTURES BY INTERNAL FIXATION

    Directory of Open Access Journals (Sweden)

    Sagar

    2015-06-01

    Full Text Available BACKGROUND: The treatment of acetabular fractures has seen major advances in the field of orthopaedic traumatology. Conservative treatment of acetabular fractures leads to poor results. Newer diagnostic tools like the Computed Tomography (CT scan help in analyzing the three dimensional disturbance in the normal anatomy and plan the surgical management accordingly. In recent years operative treatment has become the treat ment of choice in the management of acetabular fractures as precise anatomical reduction with adequate internal fixation can be attained. OBJECTIVES : To evaluate the functional outcome of operatively managed acetabular fractures , and assess the efficacy of operative fixation of acetabular fractures , and also study the complications of operative fixation of acetabular fractures. MATERIALS AND METHODS: Fifty five patients (49 male & six female admitted to Sanjay Gandhi Institute of Trauma and Orthopaedics wi th acetabular fractures underwent open reduction and internal fixation. All patients were evaluated with Matta et al score with a minimum of follow up of six months. RESULTS: There were 24 (43.6% patients with bicolumnar fractures , 15(27.3% had posterior column fractures , 10(18.1% had posterior wall fractures , five (9.1% had transverse fractures , and one (1.8% patient had an anterior column fracture. Full weight bearing was attained in thirty five (63.6% patients in 16 weeks and in twenty (36.4% pati ents after 16 weeks. Forty five (81.8% patients were free of complications. According to Matta et al score 27(49.1% had excellent , 15(27.3% had good , nine (16.4% had fair , and four (7.3% had poor results. CONCLUSION: Open reduction and internal fixati on of acetabular fractures is a reliable technique , minimizes healing time and provides congruent joint reduction. Operative treatment of acetabular fractures results in predictable union and good clinical results with a low rate of complications.

  15. Massive acetabular bone loss: Limits of trabecular metal cages

    Directory of Open Access Journals (Sweden)

    Villanueva-Martínez Manuel

    2011-01-01

    Full Text Available Massive acetabular bone loss (more than 50% of the acetabular area can result in insufficient native bone for stable fixation and long-term bone ingrowth of conventional porous cups. The development of trabecular metal cages with osteoconductive properties may allow a more biological and versatile approach that will help restore bone loss, thus reducing the frequency of implant failure in the short-to-medium term. We report a case of massive bone loss affecting the dome of the acetabulum and the ilium, which was treated with a trabecular metal cage and particulate allograft. Although the trabecular metal components had no intrinsic stability, they did enhance osseointegration and incorporation of a non-impacted particulate graft, thus preventing failure of the reconstruction. The minimum 50% contact area between the native bone and the cup required for osseointegration with the use of porous cups may not hold for new trabecular metal cups, thus reducing the need for antiprotrusio cages. The osteoconductive properties of trabecular metal enhanced allograft incorportation and iliac bone rebuilding without the need to fill the defect with multiple wedges nor protect the reconstruction with an antiprotrusio cage.

  16. Acetabular fractures following rugby tackles: a case series

    LENUS (Irish Health Repository)

    Good, Daniel W

    2011-10-05

    Abstract Introduction Rugby is the third most popular team contact sport in the world and is increasing in popularity. In 1995, rugby in Europe turned professional, and with this has come an increased rate of injury. Case presentation In a six-month period from July to December, two open reduction and internal fixations of acetabular fractures were performed in young Caucasian men (16 and 24 years old) who sustained their injuries after rugby tackles. Both of these cases are described as well as the biomechanical factors contributing to the fracture and the recovery. Acetabular fractures of the hip during sport are rare occurrences. Conclusion Our recent experience of two cases over a six-month period creates concern that these high-energy injuries may become more frequent as rugby continues to adopt advanced training regimens. Protective equipment is unlikely to reduce the forces imparted across the hip joint; however, limiting \\'the tackle\\' to only two players may well reduce the likelihood of this life-altering injury.

  17. Para-acetabular peritendinitis calcarea; its radiographic manifestations

    International Nuclear Information System (INIS)

    Peritendinitis calcarea and os acetabuli have long been confused during interpretations of hip-joint radiographs. Such confusion is reflected in the medical literature. The present study differentiated these two entities according to their interval radiographic progression and regression. There were 137 instances of para-acetabular calcifications among 110 subjects (59 men and 51 women), whose mean age was 46.8 years at the time of their initial detection. Twenty-six of the subjects had lumbago, which was probably unrelated. Other abnormalities including narrowed intervertebral spaces, scoliosis, and spondylolysis were observed in 21 of the subjects. These could have been responsible for any symptoms they had had, but none of the subjects complained of local hip-joint pain when the radiographs in question were made. Ninety-three of these instances of calcification were reviewed by means of serial radiographs. Interval changes in the sizes and shapes of the calcifications occurred among 90 of them, indicative of the latent type of peritendinitis calcarea. No interval changes were noted in the remaining three cases, indicating they were secondary ossification centers; namely, os acetabuli. This study showed that in asymptomatic adults, most para-acetabular calcifications were really not os acetabuli, but actually peritendinitis calcarea. (author)

  18. Core decompression and labral support for the treatment of juvenile osteonecrosis.

    Science.gov (United States)

    Herrera-Soto, Jose Antonio; Price, Charles T

    2011-09-01

    The final outcome of Legg-Calvé-Perthes disease is variable and depends mostly on the age of the patient at onset and the amount of femoral head involvement. The goals of treatment are to achieve a round femoral head with a congruous hip joint and to contain the femoral head to avoid extrusion. We will term this condition in the adolescent age, "juvenile osteonecrosis," as we understand that the osteonecrosis pattern responds differently to that in younger patients who develop Perthes and it is similar to adult osteonecrosis. Most of the deformity comes from the collapse and enlargement in size of the femoral head. Therefore, the treatment rationale should be tailored to address these differences. We believe that early core decompression combined with containment in the form of a shelf acetabuloplasty can change the natural history of the disease based on both adolescent and adult literature. The core allows removal of the necrotic segment; it improves vascularization to the affected area and may provide structural support in some cases. The shelf provides support to distribute the forces across the joint and prevents lateral migration. It also provides better acetabular roof to prevent early dysplastic changes that lead to arthritis. PMID:21857441

  19. A review on hot tearing of magnesium alloys

    Directory of Open Access Journals (Sweden)

    Jiangfeng Song

    2016-09-01

    Full Text Available Hot tearing is often a major casting defect in magnesium alloys and has a significant impact on the quality of their casting products. Hot tearing of magnesium alloys is a complex solidification phenomenon which is still not fully understood, it is of great importance to investigate the hot tearing behaviour of magnesium alloys. This review attempts to summarize the investigations on hot tearing of magnesium alloys over the past decades. The hot tearing criteria including recently developed Kou's criterion are summarized and compared. The numeric simulation and assessing methods of hot tearing, factors influencing hot tearing, and hot tearing susceptibility (HTS of magnesium alloys are discussed.

  20. Diagnostics of femoroacetabular impingement and labral pathology of the hip: a systematic review of the accuracy and validity of physical tests

    NARCIS (Netherlands)

    Tijssen, M.P.W.; Cingel, R. van; Willemsen, L.; Visser, E. de

    2012-01-01

    PURPOSE: Femoroacetabular impingement (FAI) and labral pathology have been recognized as causative factors for hip pain. The clinical diagnosis is now based on MRI-A (magnetic resonance imaging-arthrogram) because the physical diagnostic tests available are diverse and information on diagnostic accu

  1. The Effects of Hemodialysis on Tear Osmolarity

    Directory of Open Access Journals (Sweden)

    Muhittin Taskapili

    2015-01-01

    Full Text Available Aim. To determine the effects of hemodialysis (HD on tear osmolarity and to define the blood biochemical tests correlating with tear osmolarity among patients with end stage renal disease (ESRD. Material-Method. Tear osmolarity of ESRD patients before and after the hemodialysis program was determined as well as the blood biochemical data including glucose, sodium, potassium, calcium, urea, and creatinine levels. Results. Totally 43 eyes of 43 patients (20 females and 23 males with a mean age of 53.98±18.06 years were included in the study. Tear osmolarity of patients was statistically significantly decreased after hemodialysis (314.06±17.77 versus 301.88±15.22 mOsm/L, p=0.0001. In correlation analysis, pre-HD tear osmolarity was negatively correlated with pre-HD blood creatinine level (r=-0.366,  p=0.016. Post-HD tear osmolarity was statistically significantly correlated with the post-HD glucose levels (r=0.305  p=0.047. Tear osmolarity alteration by HD was negatively correlated with creatinine alteration, body weight alteration, and ultrafiltration (r=-0.426,  p=0.004; r=-0.365,  p=0.016; and r=-0.320, p=0.036, resp.. There was no correlation between tear osmolarity and Kt/V and URR values. Conclusion. HD effectively decreases tear osmolarity to normal values and corrects the volume and composition of the ocular fluid transiently. Tear osmolarity alteration induced by HD is correlated with body weight changes, creatinine alterations, and ultrafiltration.

  2. Acute tears of the anterior cruciate ligament: analysis of the tear site and the degree using MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Jin, Uk; Ryu, Kyung Nam; Kim, Eui Jong; Yoon, Yup; Ahn, Jin Whan [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    1995-05-15

    To evaluate the sensitivity of MR imaging in determining tear sites and degrees in acute anterior cruciate ligament tear. MR imagings were undertaken in 19 patients who had trauma on their knee joints. All imaging studies were performed within 2 weeks after trauma and compared with operative findings. The degree of ligament tear were divided into complete and incomplete, and sites of tears were divided into superior, middle and inferior portions. MR findings were compared with operative findings. There were 14 cases of complete ligament tear and 5 cases of partial ligament tear. We could diagnose correctly in all 14 cases with complete tear and in 3 of 5 cases with partial tear. The tear sites were correctly predicted in 10 of 14 cases with complete tear(71%) and 1 of 5 cases with partial tear(20%). In complete tears, MR findings were transversely or obliquely coursed band-like high signal intensity within the ACL or abrupt switch over to as indistinct signal intensity. In partial tears, the tear sites could not be evaluated mostly and the tear appeared as linear low signal intensity lesions in posterolateral bundles of ACL. MR revealed higher sensitivity in determining the degree and sites of ACL tear in complete tear as compared with partial tear.

  3. Acute tears of the anterior cruciate ligament: analysis of the tear site and the degree using MR imaging

    International Nuclear Information System (INIS)

    To evaluate the sensitivity of MR imaging in determining tear sites and degrees in acute anterior cruciate ligament tear. MR imagings were undertaken in 19 patients who had trauma on their knee joints. All imaging studies were performed within 2 weeks after trauma and compared with operative findings. The degree of ligament tear were divided into complete and incomplete, and sites of tears were divided into superior, middle and inferior portions. MR findings were compared with operative findings. There were 14 cases of complete ligament tear and 5 cases of partial ligament tear. We could diagnose correctly in all 14 cases with complete tear and in 3 of 5 cases with partial tear. The tear sites were correctly predicted in 10 of 14 cases with complete tear(71%) and 1 of 5 cases with partial tear(20%). In complete tears, MR findings were transversely or obliquely coursed band-like high signal intensity within the ACL or abrupt switch over to as indistinct signal intensity. In partial tears, the tear sites could not be evaluated mostly and the tear appeared as linear low signal intensity lesions in posterolateral bundles of ACL. MR revealed higher sensitivity in determining the degree and sites of ACL tear in complete tear as compared with partial tear

  4. A reduction clamp for an aiming component in associated acetabular fractures

    Directory of Open Access Journals (Sweden)

    Zhang-Fu Wang

    2015-01-01

    Full Text Available Background: The treatment of acetabular fractures is complex and requires specialized equipment. However, all currently available instruments have some disadvantages. A new reduction clamp that can firmly enable reduction and not hinder subsequent fixation procedures for some special fracture types is needed. Materials and Methods: In this study, we introduce a new acetabular clamp and its preliminary clinical application in three T-shaped acetabular fractures. Results: This new clamp can successfully pull the posterior column back to the anterior column and firmly maintain the reduction. This clamp′s aiming plate can facilitate the insertion of long lag screws. The clamp is also easy to assemble and use. Conclusion: This reduction clamp is a useful instrument that can facilitate open reduction and internal fixation of acetabular fractures.

  5. Comparison of acetabular reamings during hip resurfacing versus uncemented total hip arthroplasty.

    LENUS (Irish Health Repository)

    Brennan, S A

    2009-04-01

    PURPOSE: To compare the quantity of bone removed from the acetabulum during resurfacing hip arthroplasty versus uncemented total hip arthroplasty (THA). METHODS: 62 consecutive patients with osteoarthritis of the hip were prospectively studied. 24 men and 7 women aged 40 to 86 (mean, 59) years underwent Birmingham hip resurfacing. 13 men and 18 women aged 34 to 88 (mean, 61) years underwent uncemented THA using the trident acetabular cup. Obese elderly women at risk of femoral neck fracture and patients with large subchondral pseudocysts or a history of avascular necrosis of the femoral head were assigned to uncemented THA. Acetabular reamings were collected; marginal osteophytes were not included. The reamings were dehydrated, defatted, and weighed. RESULTS: The mean weight of acetabular reamings was not significantly different between patients undergoing hip resurfacing and uncemented THA (p=0.57). CONCLUSION: In hip resurfacing, the use of an appropriately small femoral component avoids oversizing the acetabular component and removal of excessive bone stock.

  6. Treatment of severe bone deficiency in acetabular revision surgery using a reinforcement device and bone grafting

    Institute of Scientific and Technical Information of China (English)

    ZHAI Ji-liang; LIN Jin; JIN Jin; QIAN Wen-wei; WENG Xi-sheng

    2011-01-01

    Background Severe acetabular bone deficiency is a major challenge in acetabular revision surgery. Most cases require reconstruction of the acetabulum with bone grafting and a reinforcement device. The purpose of this study was to evaluate the results of this procedure for severe acetabular bone deficiency in acetabular revision surgery.Methods This study involved 12 patients (2 males and 10 females) with severe acetabular bone defects who underwent implantation of a reinforcement device (ring or cage) and bone grafting between February 2003 and October 2008. Using the Paprosky classification, 2 cases were Paprosky ⅡC, 6 were ⅢA, and 4 were ⅢB. The mean age at the time of surgery was 63.0 years (range, 46-78 years). During revision surgery, a reinforcement ring was implanted in 6patients, and a cage in 6 patients. The clinical and radiographic results were evaluated retrospectively. The mean duration of follow-up was 37 months (range, 9-71 months).Results The average Harris Hip Score improved from 35.2 preoperatively to 82.9 at the time of the final follow-up visit.The results were excellent in 8 hips (66.7%), good in 2 (16.7%), and fair in 2 (16.7%). Osteolysis was found in 1 case, but did not worsen. Three patients had yellow wound effusion, with healing after administration of dressing changes,debridement, and antibiotics. Dislocation occurred in a 62-year-old woman. Closed reduction was performed, and dislocation did not recur. There was no evidence of intraoperative acetabular fracture, nerve injury, ectopic ossification,aseptic loosening, or infection.Conclusion Reconstruction with a reinforcement device and bone grafting is an effective approach to the treatment of acetabular bone deficiency in acetabular revision surgery, given proper indications and technique.

  7. SeIectlng the incision In the surgical treatment of acetabular fractures

    OpenAIRE

    Asik, Mehmet; Basturk, Sırrı; Akpinar, Sercan; Taser, Omer; Akalin, Yilmaz

    2004-01-01

    In acetabular fractures which may have totally differing three dimensional appearances selecting the incision directly influences the quality, directly influences the quality of the surgical reduction and, therefore, the postoperative clinical outcome of the patierit. Becauseof this, it is a subject that has to be meticulously done. According to the fracture types, we used 6 distinct incisions on the 35 acetabular fractures which were operated in our clinic between 1988 and 1992. We presente...

  8. A novel classification to guide total hip arthroplasty for adult acetabular dysplasia

    OpenAIRE

    Zhu, Chen; CHENG, MENG-QI; Cheng, Tao; MA, RUI-XIANG; Kong, Rong; GUO, YONG-YUAN; Qin, Hui; SHI, SI FENG; Zhang, Xian-long

    2013-01-01

    In the field of hip arthroplasties, the secondary fixation of the implants depends directly on the quality of the primary stability. A good acetabular fit and metaphyseal filling between the prostheses and implants improve the initial stabilization, and optimize the transmission of forces to the bone. A precise knowledge of the three-dimensional acetabular or femoral shape is essential to the selection of adapted implants. A total of 63 patients diagnosed with developmental dysplasia were ana...

  9. Numerical modelling of the pelvis and acetabular construct following hip arthroplasty

    OpenAIRE

    Phillips, Andrew T. M.

    2005-01-01

    The study presents finite element models of the acetabular construct and the pelvis. Particular attention is given to investigating the behaviour of the acetabular construct following revision hip arthroplasty, carried out using the Slooff-Ling impaction grafting technique. Mechanical tests are carried out on bone graft, and constitutive models are developed to describe its non-linear elasto-plastic behaviour, for inclusion in finite element analyses. Impaction of bone graft was found to have...

  10. Radiologic analysis of femoral acetabular impingement: from radiography to MRI

    Energy Technology Data Exchange (ETDEWEB)

    Dwek, Jerry R. [University of California at San Diego, Department of Radiology, Rady Children' s Hospital and Health Center, San Diego, CA (United States); San Diego Imaging, San Diego, CA (United States); Monazzam, Shafagh [Rady Children' s Hospital and Health Center, Department of Orthopedics, San Diego, CA (United States); Chung, Christine B. [University of California at San Diego, Department of Radiology, San Diego, CA (United States)

    2013-03-15

    Femoral acetabular impingement is a set of morphologic abnormalities that are considered to be a major cause of degenerative disease in the hip joint. Early changes are already present in adolescence when it is the pediatric radiologist who must assess current damage with the aim of averting progression to more severe and debilitating osteoarthritis. A multimodality approach is used for diagnosis, that includes conventional radiography and CT to assess the osseous structures. MR arthrography is the primary advanced imaging modality for assessment of morphologic changes as well as injuries of the labrum and articular cartilage. Details of radiologic imaging are offered to guide the radiologist and provide an avenue for the accurate description of the osseous and articular alterations and injury. (orig.)

  11. Computerized tomography in evaluation of decreased acetabular and femoral anteversion

    International Nuclear Information System (INIS)

    Computerized tomography has received a new importance. It has been shown that decreased anteversion of femur and acetabulum, when both have decreased angles, are causing pain and osteoarthritis of the hip joint. Operative treatment should be performed before osteoarthritis develops. Exact measurements therefore are necessary. The investigation should be performed in prone position to have the pelvis lying in a defined and normal position. Femoral torsion is measured between the transverse axis of the knee and the femoral neck. The transverse axis for measurement of the femoral anteversion is defined by a rectangular line to the sagittal plane. For evaluation of the femoral anteversion in total the angle of the condyles has to be added to the femoral neck angle when the knee is found in internal rotation. Acetabular anteversion should be measured at the level where the femoral head is still in full contact and congruence with the anterior margin of the acetabulum. (orig.)

  12. The concentric all-polyethylene Exeter acetabular component in primary total hip replacement.

    Science.gov (United States)

    Veitch, S W; Whitehouse, S L; Howell, J R; Hubble, M J W; Gie, G A; Timperley, A J

    2010-10-01

    We report the outcome of the flangeless, cemented all-polyethylene Exeter acetabular component at a mean of 14.6 years (10 to 17) after operation. Of the 263 hips in 243 patients, 122 prostheses are still in situ; 112 patients (119 hips) have died, 18 hips have been revised, and three patients (four hips) were lost to follow-up. Radiographs at the final review were available for 110 of the 122 surviving hips. There were acetabular radiolucent lines in 54 hips (49%). Two acetabular components had migrated but neither patient required revision. The Kaplan-Meier survivorship at 15 years with 61 hips at risk with revision for any cause as the endpoint was 89.9% (95% confidence interval (CI) 84.6 to 95.2) and for aseptic loosening of the acetabular component or lysis 91.7% (95% CI 86.6 to 96.8). In 210 hips with a diagnosis of primary osteoarthritis, survivorship with revision for any cause as the endpoint was 93.2% (95% CI 88.1 to 98.3), and for aseptic loosening of the acetabular component 95.0% (95% CI 90.3 to 99.7). The cemented all-polyethylene Exeter acetabular component has an excellent long-term survivorship.

  13. Patient-specific acetabular shape modelling: comparison among sphere, ellipsoid and conchoid parameterisations.

    Science.gov (United States)

    Cerveri, Pietro; Manzotti, Alfonso; Baroni, Guido

    2014-04-01

    The shape of the human acetabular cup was commonly represented as a hemisphere, but different geometries and patient-specific shapes have been recently proposed in the literature. Our aim was to test the limits of the sphericity assumption by comparing three different parameterisations, namely the sphere, the ellipsoid and the rotational conchoid. Models of hip surfaces, reconstructed from CT scans taken from Caucasian race cadavers and patients, were automatically processed to extract the acetabular surface. Two separate analyses were carried out on the overall acetabular shape, including both the acetabular fossa and the lunate surface (case A) and acetabular cup represented by the lunate surface only (case B). Nonlinear gradient-based and evolutionary computation approaches were implemented for the fitting process. Minor differences from the three idealised geometries were detected (median values of the fitting errors different from both the ellipsoid (p difference was detected between the ellipsoid and the conchoid for case A. Significance of the difference between ellipsoid and sphere (p difference was detected between the ellipsoid and the conchoid. In conclusion, we synthesise that the morphology of the overall acetabular cup can be parameterised both with an ellipsoid shape and with a conchoid shape as well with superior quality than the simple sphere. Differently, if one considers just the lunate surface, better fitting results are expected when using the ellipsoid. PMID:22789071

  14. Three-dimensional computed tomography analysis of non-osteoarthritic adult acetabular dysplasia

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Hiroshi; Matsuno, Takeo; Hirayama, Teruhisa; Tanino, Hiromasa; Yamanaka, Yasuhiro [Asahikawa Medical College, Department of Orthopaedic Surgery, Asahikawa (Japan); Minami, Akio [Hokkaido University School of Medicine, Department of Orthopaedic Surgery, Sapporo (Japan)

    2009-02-15

    Little data exists on the original morphology of acetabular dysplasia obtained from patients without radiographic advanced osteoarthritic changes. The aim of this study was to investigate the distribution and degree of acetabular dysplasia in a large number of patients showing no advanced degenerative changes using three-dimensional computed tomography (3DCT). Eighty-four dysplastic hips in 55 consecutive patients were studied. All 84 hips were in pre- or early osteoarthritis without radiographic evidence of joint space narrowing, formation of osteophytes or cysts, or deformity of femoral heads. The mean age at the time of CT scan was 35 years (range 15-64 years). 3D images were reconstructed and analyzed using recent computer imaging software (INTAGE Realia and Volume Player). Deficiency types and degrees of acetabular dysplasia were precisely evaluated using these computer software. The average Harris hip score at CT scans was 82 points. Twenty-two hips (26%) were classified as anterior deficiency, 17 hips (20%) as posterior deficiency, and 45 hips (54%) as lateral deficiency. No significant difference was found in the Harris hip score among these groups. The analysis of various measurements indicated wide variations. There was a significant correlation between the Harris hip score and the acetabular coverage (p < 0.001). Our results indicated wide variety of deficiency type and degree of acetabular dysplasia. Hips with greater acetabular coverage tended to have a higher Harris hip score. (orig.)

  15. Failure analysis of retrieved PE-UHMW acetabular liners.

    Science.gov (United States)

    Laska, Anna; Archodoulaki, Vasiliki-Maria; Duscher, Bernadette

    2016-08-01

    Ultra-high molecular weight polyethylene (PE-UHMW) acetabular liners have a limited lifespan in a patient's body. There are many factors affecting the performance of the implant and furthermore the properties of the polymeric material are changing after implantation. In this work material changes according to structure and morphology and their implication on mechanical properties are in focus. The physical and mechanical properties of ten crosslinked (xL) PE-UHMW and nine conventional (conv) gamma-sterilized PE-UHMW hip components, used as sliding surface in total hip joint replacement, with different in-vivo times are compared. The evaluation of the retrieved acetabular liners is performed in view of crosslinking and conventional gamma-sterilization but also in terms of the influence of gender concerning alteration in properties. The oxidative degradation in the PE-UHMW is investigated by means of Fourier Transformed Infrared Spectroscopy (FTIR). The characterization of the morphology is carried out via differential scanning calorimetry (DSC). A depth profile of the micro-hardness and elastic modulus is taken over the cross-section of the components in order to find the influence of chemical constitution and morphology on the micro-mechanical properties. It could be shown that crosslinking and oxidative degradation influence the degree of crystallinity of the polymer. Oxidation occurs for both types of the material due to in-vivo time. Higher degree of crystallinity can be correlated to higher hardness and indentation modulus. No unequivocal superiority of crosslinked over conventional liners can be observed. The influence of sex concerning alteration of the evaluated properties matters but need to be further investigated.

  16. Surgical Outcome of Acetabular Fracture Using Trochanteric Flip Osteotomy

    Directory of Open Access Journals (Sweden)

    Espandar R

    2012-01-01

    Full Text Available Background: One of the difficulties in acetabulum surgery is appropriate exposure of the site of surgery. Trochanteric flip osteotomy is one of the surgical methods for superoposterior and posterior acetabulum exposure. However, due to possible complications some surgeons prefer to avoid this procedure. This study was undertaken to determine the outcome of surgical treatment of acetabular fracture using trochanteric flip osteotomy. Methods : In this prospective cohort study, 14 patients with acetabular fracture who had been admitted in Imam Khomeini Hospital in Tehran, Iran, during 2003-2006 underwent trochanteric flip osteotomy. The patients were followed for at least one year post-surgically. Demographics, radiologic findings, intensity of pain using visual analogue scale (VAS, Harris hip score (HHS, force of hip abductors and complications were noted. Data analysis was performed using SPSS ver. 13.Results : The mean HHS was 82.5 (55-95. Heterotopic ossification was observed in three patients. There were no cases of postoperative infection or nonunion. Only two patients showed displacement of osteotomized fragments. Reduction was anatomic in 10 patients. In one patient, the force of hip abductors was three-fifth. The mean hip pain was 3.4 based on VAS. There were no cases of femoral head osteonecrosis. With respect to HHS, the final hip status was excellent and good in four and six patients, respectively. Three patients had fair and only one patient had poor condition.Conclusion: It seems that trochanteric flip osteotomy has much fewer complications in comparison to other methods justifying its use in such cases.

  17. ARTIFICIAL TEAR SUBSTITUTES: WHICH ONE & WHEN?

    Directory of Open Access Journals (Sweden)

    Prashanth

    2013-06-01

    Full Text Available ABSTRACT: Dry eye is a multi-factorial disease; the therapy should improve the symptoms and signs of dry eye as well as address the underlying pathophysiology of the disease. Artificial tear substitutes have been used for treating dry eye syndromes for decades and succeeded in enhancing the comfort of patients. They are currently the main therapy for dry eye and likely to remain the mainstay treatment modality. However, the currently used artificial tears have obvious limitations and its usage has to be personalized based on the patient’s need. This article briefs you on silent features in usage of artificial tears.

  18. Quantitative Computerized Assessment of the Degree of Acetabular Bone Deficiency: Total radial Acetabular Bone Loss (TrABL

    Directory of Open Access Journals (Sweden)

    Frederik Gelaude

    2011-01-01

    Full Text Available A novel quantitative, computerized, and, therefore, highly objective method is presented to assess the degree of total radical acetabular bone loss. The method, which is abbreviated to “TrABL”, makes use of advanced 3D CT-based image processing and effective 3D anatomical reconstruction methodology. The output data consist of a ratio and a graph, which can both be used for direct comparison between specimens. A first dataset of twelve highly deficient hemipelves, mainly Paprosky types IIIB, is used as illustration. Although generalization of the findings will require further investigation on a larger population, it can be assumed that the presented method has the potential to facilitate the preoperative use of existing classifications and related decision schemes for treatment selection in complex revision cases.

  19. An Athlete's Nightmare: Tearing the ACL

    Science.gov (United States)

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

  20. Rotator Cuff Tears: Surgical Treatment Options

    Science.gov (United States)

    .org Rotator Cuff Tears: Surgical Treatment Options Page ( 1 ) The following article provides in-depth information about surgical treatment for rotator cuff injuries, and is a continuation of the article “ ...

  1. On the tear resistance of skin

    Science.gov (United States)

    Yang, Wen; Sherman, Vincent R.; Gludovatz, Bernd; Schaible, Eric; Stewart, Polite; Ritchie, Robert O.; Meyers, Marc A.

    2015-03-01

    Tear resistance is of vital importance in the various functions of skin, especially protection from predatorial attack. Here, we mechanistically quantify the extreme tear resistance of skin and identify the underlying structural features, which lead to its sophisticated failure mechanisms. We explain why it is virtually impossible to propagate a tear in rabbit skin, chosen as a model material for the dermis of vertebrates. We express the deformation in terms of four mechanisms of collagen fibril activity in skin under tensile loading that virtually eliminate the possibility of tearing in pre-notched samples: fibril straightening, fibril reorientation towards the tensile direction, elastic stretching and interfibrillar sliding, all of which contribute to the redistribution of the stresses at the notch tip.

  2. A novel way to treat skin tears.

    Science.gov (United States)

    Moradian, Scott; Klapper, Andrew M

    2016-04-01

    Skin tears are one of the most commonly treated wounds in the elderly population. In their most basic form, they are essentially traumatic random pattern flaps. We postulate that the injured blood flow to these skin flaps should be ignored and the tissue should be treated as a skin graft. A case report is presented of an 86-year-old female with an 8 × 3·5 cm skin tear to her right upper extremity after a hip fracture. In addition to conventional wound closure strips re-approximating the tissues, a disposable negative pressure wound therapy device was placed to act as bolster. Upon its removal on day 5, the opposed skin tear tissue was found to be 100% viable. We therefore propose that this update may be an improvement over classical skin tear treatments and should be followed up with a case series.

  3. Oral presentation of an oesophageal mucosal tear

    OpenAIRE

    Uppal, S; De P, R

    1999-01-01

    Tears of the oesophageal wall following sudden forceful vomiting are well documented in literature. In Boerhaave's syndrome there is transmural rupture associated with complications including pneumothorax, pneumomediastinum, surgical emphysema and shock. In Mallory-Weiss syndrome mucosal tears are associated with haematemesis and shock. In neither of these conditions has intraluminal obstruction been described as an aetiological factor. We present a case with similar pathophysiology where oes...

  4. Delivery Practices and Perineal Tears: Midwives’ Experiences

    OpenAIRE

    2015-01-01

    Objective: The aim of this study is to explore the experiences and views of midwives regarding third- and fourth-degree perineal tears. Method: Focus group interviews with midwives from a university hospital. Qualitative analysis using principles from ‘grounded theory’. Findings: The participants mentioned several factors that they considered important for the prevention of tears that may cause injury to the anal sphincter. A crucial aspect was the way in which the midwife deals with the phys...

  5. Human tears reveal insights into corneal neovascularization.

    Directory of Open Access Journals (Sweden)

    Nadia Zakaria

    Full Text Available Corneal neovascularization results from the encroachment of blood vessels from the surrounding conjunctiva onto the normally avascular cornea. The aim of this study is to identify factors in human tears that are involved in development and/or maintenance of corneal neovascularization in humans. This could allow development of diagnostic tools for monitoring corneal neovascularization and combination monoclonal antibody therapies for its treatment. In an observational case-control study we enrolled a total of 12 patients with corneal neovascularization and 10 healthy volunteers. Basal tears along with reflex tears from the inferior fornix, superior fornix and using a corneal bath were collected along with blood serum samples. From all patients, ocular surface photographs were taken. Concentrations of the pro-angiogenic cytokines interleukin (IL-6, IL-8, Vascular Endothelial Growth Factor (VEGF, Monocyte Chemoattractant Protein 1 (MCP-1 and Fas Ligand (FasL were determined in blood and tear samples using a flow cytometric multiplex assay. Our results show that the concentration of pro-angiogenic cytokines in human tears are significantly higher compared to their concentrations in serum, with highest levels found in basal tears. Interestingly, we could detect a significantly higher concentration of IL- 6, IL-8 and VEGF in localized corneal tears of patients with neovascularized corneas when compared to the control group. This is the first study of its kind demonstrating a significant difference of defined factors in tears from patients with neovascularized corneas as compared to healthy controls. These results provide the basis for future research using animal models to further substantiate the role of these cytokines in the establishment and maintenance of corneal neovascularization.

  6. Mallory-Weiss Tear during Esophagogastroduodenoscopy

    Directory of Open Access Journals (Sweden)

    Ji Wan Kim

    2015-02-01

    Full Text Available Mallory-Weiss tears (MWTs are mucosal lacerations caused by forceful retching and are typically located at the gastroesophageal junction. Reported cases of MWT with serious complications seen in esophagogastroduodenoscopy are limited. We report MWT in an 81-year-old woman who presented with gastric perforation by esophagogastroduodenoscopy. We discuss and indicate that hiatal hernia, atrophic gastritis and old age may be associated with the gastric perforation in comparison to typical tears occurring at the gastroesophageal junction.

  7. Rotator cuff tear: A detailed update

    Directory of Open Access Journals (Sweden)

    Vivek Pandey

    2015-01-01

    Full Text Available Rotator cuff tear has been a known entity for orthopaedic surgeons for more than two hundred years. Although the exact pathogenesis is controversial, a combination of intrinsic factors proposed by Codman and extrinsic factors theorized by Neer is likely responsible for most rotator cuff tears. Magnetic resonance imaging remains the gold standard for the diagnosis of rotator cuff tears, but the emergence of ultrasound has revolutionized the diagnostic capability. Even though mini-open rotator cuff repair is still commonly performed, and results are comparable to arthroscopic repair, all-arthroscopic repair of rotator cuff tear is now fast becoming a standard care for rotator cuff repair. Appropriate knowledge of pathology and healing pattern of cuff, strong and biological repair techniques, better suture anchors, and gradual rehabilitation of postcuff repair have led to good to excellent outcome after repair. As the healing of degenerative cuff tear remains unpredictable, the role of biological agents such as platelet-rich plasma and stem cells for postcuff repair augmentation is still under evaluation. The role of scaffolds in massive cuff tear is also being probed.

  8. Increasing thickness and fibrosis of the cartilage in acetabular dysplasia: a rabbit model research

    Institute of Scientific and Technical Information of China (English)

    LI Tian-you; MA Rui-xue

    2010-01-01

    Background The order and mechanism of pathological changes in acetabular dysplasia are still unclear. This study investigated cartilage changes in rabbit acetabular dysplasia models at different ages.Methods Twenty-seven 1-month-old New Zealand rabbits underwent cast immobilization of the left hind limb in knee extension. Serial acetabular dysplasia models were established by assessment of the acetabular index and Sharp's angle on radiographs. The thickness of the acetabular cartilage was measured under a microscope, and fibrosis was observed. Ultrastructural changes were investigated with scanning electron microscopy and transmission electron microscopy. The messenger RNA expression of collagen Ⅰ and Ⅱ, β1 integrin, and caspase-9 were measured by real-time fluorescence quantitative polymerase chain reaction.Results In an immature group of rabbits, the acetabular index of the treated hip increased with animal growth. The cartilage on the brim of the left acetabulum was significantly thicker than that on the right side. The collagen fibrils on the surface of the cartilage became gross, and the chondrocytes in the enlargement layer underwent necrosis. In a mature group of rabbits, the left Sharp's angle increased in the rabbits with 6-week casting. The cartilage on the brim of the left acetabulum underwent fibrosis. The chondrocytes were weakly stained, and the number of lysosomes was much larger than normal. The messenger RNA expression of collagen Ⅰ and Ⅱ, β1 integrin, and caspase-9 in the cartilage differed significantly at different ages.Conclusions Increasing thickness followed by fibrosis may be the order of pathological cartilage changes in acetabular dysplasia, with changes in ultrastructure and collagen expression contributing to the process.

  9. Acetabular lateral reconstruction after total hip arthroplasty:understanding and application of core technology%人工髋关节翻修髋臼侧重建:对技术核心的认识及应用

    Institute of Scientific and Technical Information of China (English)

    张文贤; 范有福; 王小燕; 吕江宏

    2014-01-01

    BACKGROUND:After the initial hip replacement, aseptic or infective loosening and subsidence of the prosthesis, acetabular wear, pain, osteolysis and other factors may lead to the loss of prosthesis stability and loss of joint function, which are the common cause of hip arthroplasty. Among the hip arthroplasty, acetabular lateral reconstruction is essential and largely determines the success or failure of revision surgery. OBJECTIVE:To explore the present situation of reconstructing acetabulum after total hip arthroplasty. METHODS:A computer-based online search of PubMed database (http://www.ncbi.nlm.nih.gov/PubMed) between January 1998 and March 2014, and CNKI database (http://www.cnki.net/) from January 2003 to March 2014 was undertaken for the articles about reconstructing acetabulum after total hip arthroplasty. The key words were“artificial joint, reconstruction, acetabular lateral reconstruction, current situation”in Chinese and“reconstructed acetabulum, total hip arthroplasty”in English. Article about hip reconstruction, acetabyular reconstruction, bone defect reconstruction, prosthesis choice and reconstruction, and soft tissue balance were also selected. Repetitive researches were excluded. RESULTS AND CONCLUSION:According to inclusion criteria, 26 articles were involved in this study. A perfect acetabular revision should achieve the fol owing goals:stabilize acetabular prosthesis after acetabular revision;recover hip rotation center and biomechanical properties;repair acetabular bone defects and increase hip bone. Adequate preparation before surgery is an important prerequisite for the success of surgery and good results, aseptic and septic loosening or subsidence of the prosthesis, as wel as acetabular wear and tear are common causes of hip revision. Intraoperative reconstruction of acetabular anteversion and camber angles, acetabular rotation center reconstruction, reconstruction of acetabular bone defects, selection of reconstruction of

  10. Roles of radiograph, magnetic resonance imaging, threedimensional computed tomography in early diagnosis of femoro-acetabular impingement in 17 cases

    Institute of Scientific and Technical Information of China (English)

    GU Gui-shan; ZHU Dong; WANG Gang; WANG Cheng-xue

    2009-01-01

    Objective: To evaluate the roles of radiograph, magnetic resonance imaging (MRI), three-dimensional computed tomography (3-D CT) in early diagnosis of femoro-acetabular impingement (FAI) in 17 cases. Methods: Plain radiographs of the pelvis, 3-D CT, and MRI of the hip were made on 17 patients with groin pain, which was worse with prolonged sitting (i.e. hip flexion). There was no history of trauma or childhood hip disorders in the patients who did not complain of any other joint problems or neurologic symptoms. All patients had positive anterior or posterior impingement test. Plain radiographs included an antero-posterior (AP) view of the hip and a cross table lateral view with slight internal rotation of the hip. CT scan was performed with the Lightspeed 16 row spiral (General Electric Company, USA) at 1.25 mm slice reconstruction. MRI scan was performed on the Siemens Avanto (Siemens Company, Germany)1.5T supraconducfion magnetic resonance meter. The CT and MRI scans were taken from 1 cm above the acetabulum to the lesser trochanter in 5 series. Results: The plain radiographs of the pelvis showed that among the 17 patients, 12 (70.59%) had "Cam" change of the femoral head, 6 (35.29%) had positive "cross-over" sign, and 17 (100%) had positive "Pincer" change of the acetabulum. The 16 row spiral CT noncontrast enhanced scan and 3-D reconstruction could discover minus femoral offset and ossification and osteophyte of the acetabulum labrum in all the 17 cases (100%). The MRI noncontrast enhanced scan could discover more fluid in the hip joint in 15 cases (88.33%), subchondral ossification in 3 cases (17.6%), and labium tears in 3 cases (17.6%). Conclusions: Plain radiographs can provide the initial mainstay for the diagnosis of FAI, 3-D CT can tell us the femoral offset, while MRI can show labrum tears in the very early stage of FAI. Basically, X-ray examination is enough for the early diagnosis of FAI, but 3-D CT and MRI may be useful for the treatment.

  11. Failure of dual radius hydroxyapatite-coated acetabular cups

    Directory of Open Access Journals (Sweden)

    Zatti Giovanni

    2008-08-01

    Full Text Available Abstract Introduction Many kind of hydroxyapatite-coated cups were used, with favorable results in short term studies; it was supposed that its use could improve osteointegration of the cup, enhancing thus stability and survivorship. The purpose of this study is to analyze the long term behavior of the hemispheric HA coated, Dual Radius Osteonics cup and to discuss the way of failure through the exam of the revised components and of both periacetabular and osteolysis tissue. Materials and Methods Between 1994 and 1997, at the Department of Orthopedic Sciences of the Insubria University, using the posterolateral approach, were implanted 276 Dual Radius Osteonics® in 256 patients, with mean age of 63 years. Results At a mean follow-up of 10 years (range 8–12 years, 183 cups in 165 patients, were available for clinical and radiographical evaluation. 22 Cups among the 183 were revised (11%. The cause of revision was aseptic loosening in 17 cases, septic loosening in one case, periprosthetic fracture in another case, osteolysis and polyethylene wear in two cases and, finally, recurrent dislocations in the last one. In the remaining patients, mean HHS increased from a preoperative value of 50,15 to a postoperative value of 92,69. The mean polyethylene wear was 1,25 mm (min. 0,08, max. 3,9 mm, with a mean annual wear of 0,17 mm. The mean acetabular migration on the two axis was 1,6 mm and 1,8 mm. Peri-acetabular osteolysis were recorded in 89% of the implants (163 cases. The cumulative survivorship (revision as endpoint at the time was 88,9%. Conclusion Our study confirms the bad behavior of this type of cup probably related to the design, to the method of HA fixation. The observations carried out on the revised cup confirm these hypotheses but did not clarify if the third body wear could be a further problem. Another interesting aspect is the high incidence of osteolysis, which are often asymptomatic becoming a problem for the surgeon as the

  12. Radiographic and clinical analysis of cementless acetabular fixation in total hip arthroplasty

    Institute of Scientific and Technical Information of China (English)

    ZHANG Hui; PEI Fu-xing; YANG Jing; SHEN Bin; SHI Rui

    2005-01-01

    Objective: To investigate the factors affecting the fixation, loosening and therapeutic effect of cementless acetabular prosthesis through following up the patients with total hip arthroplasty clinically and radiographically.Methods: From February 1998 to May 1999, 139 patients (148 hips) underwent total hip arthroplasty with cementless acetabular prosthesis in our department. In this study, the clinical therapeutic effect and the anteroposterior radiographs of the pelvis and anteroposterior and lateral radiographs of the hips of 109 patients (116 hips) made before operation, at 1 week, 3, 6, and 12 months after operation and annually thereafter were analyzed retrospectively. The clinical therapeutic effects were evaluated with Harris hip score. Radiographs were used to observe the position of prostheses and the bone changes around the implant, and to measure the wearing speed and direction of the acetabular cup. All evaluations were made by an independent examiner who did not participate in the operation. The patients were followed up for 5-6 years.Results: The mean Harris score was 44 points (range, 10-70 points) before operation, but it increased to 92.4 points (range, 80-100 points) at the latest review after operation, which was significantly higher than that before operation (P<0.05). No acetabular component was revised because of infection or aseptic loosening. And no acetabular component migrated. There was no revision of fixed acetabular component because of pelvic osteolysis secondary to polyethylene wear. The mean linear wear rate was 0.15 mm per year. All the acetabular prostheses were classified as stable on the radiographs.Conclusions: In terms of fixation, total hip arthroplasty with cementless acetabular components was successful. Although there is no aseptic loosening and a low incidence of osteolysis at the latest follow-up evaluation, polyethylene wear cannot be avoided and can lead to expansile osteolysis near the cups. This kind of osteolysis

  13. Pelvic Incidence: A Predictive Factor for Three-Dimensional Acetabular Orientation—A Preliminary Study

    Directory of Open Access Journals (Sweden)

    Christophe Boulay

    2014-01-01

    Full Text Available Acetabular cup orientation (inclination and anteversion is a fundamental topic in orthopaedics and depends on pelvis tilt (positional parameter emphasising the notion of a safe range of pelvis tilt. The hypothesis was that pelvic incidence (morphologic parameter could yield a more accurate and reliable assessment than pelvis tilt. The aim was to find out a predictive equation of acetabular 3D orientation parameters which were determined by pelvic incidence to include in the model. The second aim was to consider the asymmetry between the right and left acetabulae. Twelve pelvic anatomic specimens were measured with an electromagnetic Fastrak system (Polhemus Society providing 3D position of anatomical landmarks to allow measurement of acetabular and pelvic parameters. Acetabulum and pelvis data were correlated by a Spearman matrix. A robust linear regression analysis provided prediction of acetabulum axes. The orientation of each acetabulum could be predicted by the incidence. The incidence is correlated with the morphology of acetabula. The asymmetry of the acetabular roof was correlated with pelvic incidence. This study allowed analysis of relationships of acetabular orientation and pelvic incidence. Pelvic incidence (morphologic parameter could determine the safe range of pelvis tilt (positional parameter for an individual and not a group.

  14. Acetabular rim and surface segmentation for hip surgery planning and dysplasia evaluation

    Science.gov (United States)

    Tan, Sovira; Yao, Jianhua; Yao, Lawrence; Summers, Ronald M.; Ward, Michael M.

    2008-03-01

    Knowledge of the acetabular rim and surface can be invaluable for hip surgery planning and dysplasia evaluation. The acetabular rim can also be used as a landmark for registration purposes. At the present time acetabular features are mostly extracted manually at great cost of time and human labor. Using a recent level set algorithm that can evolve on the surface of a 3D object represented by a triangular mesh we automatically extracted rims and surfaces of acetabulae. The level set is guided by curvature features on the mesh. It can segment portions of a surface that are bounded by a line of extremal curvature (ridgeline or crestline). The rim of the acetabulum is such an extremal curvature line. Our material consists of eight hemi-pelvis surfaces. The algorithm is initiated by putting a small circle (level set seed) at the center of the acetabular surface. Because this surface distinctively has the form of a cup we were able to use the Shape Index feature to automatically extract an approximate center. The circle then expands and deforms so as to take the shape of the acetabular rim. The results were visually inspected. Only minor errors were detected. The algorithm also proved to be robust. Seed placement was satisfactory for the eight hemi-pelvis surfaces without changing any parameters. For the level set evolution we were able to use a single set of parameters for seven out of eight surfaces.

  15. Minimum ten-year follow-up of acetabular fracture fixation from the Irish tertiary referral centre.

    LENUS (Irish Health Repository)

    Magill, Paul

    2012-04-01

    Successful outcome from acetabular fracture fixation is multi-factorial. Long-term results are not frequently reported. Pooling such data from high output centres will help progress acetabular fixation. This paper presents the first ten-year data from the Irish tertiary referral centre.

  16. 21 CFR 888.3330 - Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis.

    Science.gov (United States)

    2010-04-01

    ... uncemented acetabular component, prosthesis. 888.3330 Section 888.3330 Food and Drugs FOOD AND DRUG..., prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis is a two-part device intended to be implanted to replace a hip joint. The...

  17. 21 CFR 888.3320 - Hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis.

    Science.gov (United States)

    2010-04-01

    ... cemented acetabular component, prosthesis. 888.3320 Section 888.3320 Food and Drugs FOOD AND DRUG..., prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis is a two-part device intended to be implanted to replace a hip joint. The...

  18. Cemented total hip arthroplasty with impacted morcellized bone-grafts to restore acetabular bone defects in congenital hip dysplasia.

    NARCIS (Netherlands)

    Bolder, S.B.T.; Melenhorst, J.; Gardeniers, J.W.M.; Slooff, T.J.J.H.; Veth, R.P.H.; Schreurs, B.W.

    2001-01-01

    We evaluated the results of 27 acetabular reconstructions in 21 patients with secondary osteoarthritis resulting from congenital dysplasia of the hip in which the acetabular bone defects were restored with impacted morcellized bone-grafts in combination with a cemented cup. At an average follow-up o

  19. Results of Chiari pelvic osteotomy for acetabular dysplasia in adults

    International Nuclear Information System (INIS)

    In an attempt to determine indications of Chiari pelvic osteotomy in acetabular dysplasia, postoperative outcome of hip joint (64 joints) was examined on the basis of findings of bone scintigraphy. The subjects were 61 patients with osteoarthrosis of hip joint who underwent preoperative bone scintigraphy. The follow-up period ranged from 2 years to 9 years and 7 months with a mean of 4 years and 9 months. According to X-ray findings, 37 osteoarthrosis joints were staged as early and 27 as progressive. Preoperative bone scintigraphic findings fell into three: (I) normal or slight hot type (33 joints), (II) hot type at the weighting part (16 joints), and (III) double hot type in the weighting part and inside part (15 joints). None of the patients had severe surgical complications such as deep-seated infection, neuroparalysis and pseudojoint. According to the clinical staging for hip joint function, 7 (47%) of 64 joints were judged as poor after osteotomy, belonging to type III. Deterioration of osteoarthrosis was seen in 11 joints (41%) on X-ray films. Of these, 9 had type III. In conclusion, Chiari pelvic osteotomy should not be indicated when type III is shown on bone scintigrams. (N.K.)

  20. 髋臼发育不良与髋臼盂唇撕裂120例临床分析%Analysis of 120 cases of developmental displasia of the hip and acetabular labral avulsion

    Institute of Scientific and Technical Information of China (English)

    李可大; 庞智晖; 何伟

    2007-01-01

    目的 探讨髋臼发育不良(DDH)患者的髋部疼痛与髋臼盂唇撕裂(ALA)的关系.方法 128例DDH患者均接受手术治疗并在术中探查髋臼盂唇的完整性.128例患者中有124例为ALA(96.87%),分别为左侧99例,右侧25例;其中105例是女性,19例是男性,平均年龄 37.4 岁 (16~52 岁).其中120例获得了随访,时间为3~8年,平均5年.结果 参照Severin髋关节功能临床评价标准,120例患者中获得优、良、可、差的例数分别是98例(81.66%)、12 例(10%) 、8例 (6%)和2例 (1.66%).结论 ALA是引起DDH疼痛的主要原因.采用改良Chairi截骨加盖、切除撕裂的盂唇的手术方法对治疗DDH的髋臼盂唇撕裂有较好的疗效,明显改善了髋关节功能,包括行走活动能力.

  1. A case of recurrent bloody tears

    Directory of Open Access Journals (Sweden)

    Karslıoğlu Ş

    2011-07-01

    Full Text Available Şafak Karslioğlu1, Ilke Bahçeci Şimşek2, Müslime Akbaba11Ìstanbul Oculoplastic and Orbital Surgery and Ocular Oncology Center, 2Ophthalmology Department, Medicine Hospital, Ìstanbul, TurkeyAbstract: Well-known causes of blood-tinged epiphora are conjunctival lesions, tumors of the lacrimal apparatus, and systemic bleeding disorders. We describe an unusual patient who presented with recurrent episodes of bloody tearing which began following an erythema multiforme-like drug eruption. He experienced chronic conjunctivitis which resulted in a few minor symblephara. One year later, the patient developed attacks of bloody tearing. All clinical, radiologic, and laboratory investigations related to bloody epiphora were within normal limits except for a mild, nonspecific chronic inflammatory reaction in the perivascular tissues of the lacrimal gland and orbital soft tissues. Also, an increase in vascular permeability and contrast extravasation on carotid angiography was detected. High-dose vitamin C was administered. The patient continued to have unilateral bloody tears intermittently for two years, but the episodes became much less frequent and had resolved by three years. It is conceivable that increased vascular permeability following the systemic inflammatory process could have played a role in the etiology of recurrent bloody tears in this atypical patient.Keywords: bloody tears, erythema multiforme, drug eruption, vitamin C

  2. Energetic Ion Interactions with Tearing Mode Stability

    Science.gov (United States)

    Halfmoon, Michael; Brennan, Dylan

    2015-11-01

    This study focuses on the interactions between energetic ions and pressure-driven, slow growing tearing modes in high beta tokamaks. Previous studies have shown that energetic ions interact with and affect the tearing mode stability, in a mechanism similar to those of ideal MHD instabilities and resistive wall modes. The 2/1 tearing mode is found to be damped or stabilized in the presence of energetic ions, with the most significant effects on the slow-growing resistive mode. To gain an understanding of the underlying physics of these effects, we have investigated a combination of reduced analytics and numerical simulations. In the reduced model, a high aspect ratio, step function equilibrium is investigated, where the dynamics of high-energy ions interacting with the tearing mode is implemented through integration over the pressure step. In the simulations, a series of experimentally relevant D-shaped equilibria with fixed monotonic safety factor and varying peaked pressure profiles is analyzed using the δf hybrid kinetic-mhd code in NIMROD. Results show a damping effect from the ions that is consistent between the reduced model and the simulations. The stabilizing effect is mainly due to trapped particle resonance, causing the tearing mode to have a finite frequency. US DOE Grant DE- SC0004125.

  3. Oxidation and other property changes of retrieved sequentially annealed UHMWPE acetabular and tibial bearings.

    Science.gov (United States)

    Reinitz, Steven D; Currier, Barbara H; Van Citters, Douglas W; Levine, Rayna A; Collier, John P

    2015-04-01

    This investigation analyzed retrieved sequentially crosslinked and annealed (SXL) ultra-high molecular weight polyethylene bearings to determine whether the material is chemically stable in vivo. A series of retrieved tibial and acetabular components were analyzed for changes in ketone oxidation, crosslink density, and free radical concentration. Oxidation was observed to increase with in vivo duration, and the rate of oxidation in tibial inserts was significantly greater than in acetabular liners. SXL acetabular bearings oxidized at a rate comparable to gamma-sterilized liners, while SXL tibial inserts oxidized at a significantly faster rate than their gamma-sterilized counterparts. A significant decrease in crosslink density with increased mean ketone oxidation index was observed, suggesting that in vivo oxidation may be causing material degradation. Furthermore, a subsurface whitened damage region was also found in a subset of the bearings, indicating the possibility of a clinically relevant decrease in mechanical properties of these components.

  4. Central acetabular fracture with dislocation treated by minimally invasive plate osteosynthesis.

    Science.gov (United States)

    2015-06-01

    Central acetabular fractures with dislocation are usually the result of high-energy trauma, resulting in joint incongruity, and are frequently associated with other injuries. Open reduction and internal fixation has been the standard treatment for acetabular fractures, but it is associated with extensive surgical trauma, and complications such as haematoma formation, iatrogenic nerve injury, and heterotopic ossification. We present the case of a 63-year-old female who sustained a central acetabular fracture of the hip with dislocation as a result of an automobile collision. Closed reduction of the dislocation was performed, and the fracture was managed by minimally invasive plate osteosynthesis using a specially prepared plate. At 01 year postoperatively, radiographs showed the fracture to have been well-healed with good congruity of the joint. However, heterotopic ossification of the joint was noted. The technique allowed reduction of the fracture with minimal surgical trauma.

  5. Quantifying the contribution of pincer deformity to femoro-acetabular impingement using 3D computerised tomography

    Energy Technology Data Exchange (ETDEWEB)

    Dandachli, Wael; Najefi, Ali; Iranpour, Farhad; Lenihan, Jonathan; Hart, Alister; Cobb, Justin [Imperial College London, Charing Cross Hospital, Department of Orthopaedic Surgery, London (United Kingdom)

    2012-10-15

    To provide a simple, reliable method for the three-dimensional quantification of pincer-type hip deformity. Computerised tomography scans of 16 normal female hips and 15 female hips with clinical femoro-acetabular impingement (FAI) and radiographic signs of pincer secondary to acetabular protrusio were analysed. After orientating the pelvis in the anterior pelvic plane, the acetabular centre was determined, and the ratios of its coordinates to the corresponding pelvic dimensions were calculated. Acetabular coverage of the femoral head and centre-edge angles were also measured for the two groups. In hips with a pincer, the hip was medialised by 37 % (p = 0.03), more proximal by 5 % (p = 0.05) and more posterior by 9 % (p = 0.03) compared with the normal hips. Coverage of the femoral head in protrusio hips was significantly greater than normal (average 71 % vs 82 %, p = 0.0001). Both the lateral centre-edge angle and the combined anterior-posterior centre-edge angle were greater in protrusio hips than in the normal ones (48 vs 37 , p < 0.001; and 216 vs 176 , p < 0.0001 respectively). Displacement in acetabular protrusio occurs in all planes. This CT-based method allows for the accurate and standardised quantification of the extent of displacement, as well as 3D measurement of femoral head coverage. In the adult female population, a combined centre-edge angle of over 190 suggests an acetabulum that is too deep and a potential cause of symptoms of femoro-acetabular impingement. Conversely, an acetabulum that has a combined centre-edge angle of less than 190 may be considered to be of normal depth, and therefore not contributing a pincer to FAI should it occur. (orig.)

  6. Acetabular stress fractures in military endurance athletes and recruits: incidence and MRI and scintigraphic findings

    Energy Technology Data Exchange (ETDEWEB)

    Williams, T.R. [Portsmouth Naval Medical Center, Radiology Department, Charette Health Care Center, Portsmouth, VA (United States); Puckett, M.L.; Shin, A.Y.; Gorman, J.D. [Naval Medical Center San Diego, Radiology Department, San Diego, CA (United States); Denison, G. [US Naval Hospital Guam (United States)

    2002-05-01

    Objective: To evaluate the incidence and the MRI and scintigraphic appearance of acetabular stress (fatigue) fractures in military endurance athletes and recruits. Design and patients: One hundred and seventy-eight active duty military endurance trainees with a history of activity-related hip pain were evaluated by both MRI and bone scan over a 2-year period. Patients in the study ranged in age from 17 to 45 years. They had hip pain related to activity and had plain radiographs of the hip and pelvis that were interpreted as normal or equivocal. The study was originally designed to evaluate the MRI and scintigraphic appearance of femoral neck stress fractures. Patients had scintigraphy and a limited MRI examination (coronal imaging only) within 48 h of the bone scan. Twelve patients demonstrated imaging findings compatible with acetabular stress fractures. Results: Stress fractures are common in endurance athletes and in military populations; however, stress fracture of the acetabulum is uncommon. Twelve of 178 patients (6.7%) in our study had imaging findings consistent with acetabular stress fractures. Two patterns were identified. Seven of the 12 (58%) patients had acetabular roof stress fractures. In this group, two cases of bilateral acetabular roof stress fractures were identified, one with a synchronous tensile sided femoral neck stress fracture. The remaining five of 12 (42%) patients had anterior column stress fractures, rarely occurring in isolation, and almost always occurring with inferior pubic ramus stress fracture (4 of 5, or 80%). One case of bilateral anterior column stress fractures was identified without additional sites of injury. Conclusions: Stress fractures are commonplace in military populations, especially endurance trainees. Acetabular stress fractures are rare and therefore unrecognized, but do occur and may be a cause for activity-related hip pain in a small percentage of military endurance athletes and recruits. (orig.)

  7. Quantifying the contribution of pincer deformity to femoro-acetabular impingement using 3D computerised tomography

    International Nuclear Information System (INIS)

    To provide a simple, reliable method for the three-dimensional quantification of pincer-type hip deformity. Computerised tomography scans of 16 normal female hips and 15 female hips with clinical femoro-acetabular impingement (FAI) and radiographic signs of pincer secondary to acetabular protrusio were analysed. After orientating the pelvis in the anterior pelvic plane, the acetabular centre was determined, and the ratios of its coordinates to the corresponding pelvic dimensions were calculated. Acetabular coverage of the femoral head and centre-edge angles were also measured for the two groups. In hips with a pincer, the hip was medialised by 37 % (p = 0.03), more proximal by 5 % (p = 0.05) and more posterior by 9 % (p = 0.03) compared with the normal hips. Coverage of the femoral head in protrusio hips was significantly greater than normal (average 71 % vs 82 %, p = 0.0001). Both the lateral centre-edge angle and the combined anterior-posterior centre-edge angle were greater in protrusio hips than in the normal ones (48 vs 37 , p < 0.001; and 216 vs 176 , p < 0.0001 respectively). Displacement in acetabular protrusio occurs in all planes. This CT-based method allows for the accurate and standardised quantification of the extent of displacement, as well as 3D measurement of femoral head coverage. In the adult female population, a combined centre-edge angle of over 190 suggests an acetabulum that is too deep and a potential cause of symptoms of femoro-acetabular impingement. Conversely, an acetabulum that has a combined centre-edge angle of less than 190 may be considered to be of normal depth, and therefore not contributing a pincer to FAI should it occur. (orig.)

  8. Application of porous tantalum in acetabular revision after total hip arthroplasty%多孔金属钽髋臼在全髋关节置换术后髋臼翻修中的应用

    Institute of Scientific and Technical Information of China (English)

    李亮; 赵阳; 王志强

    2013-01-01

    To review the application effects of the porous tantalum acetabular cup in acetabular revision for acetabular failure after total hip arthroplasty ( THA ). The related literatures about the characteristics of porous tantalum and its application in acetabular revision in recent 10 years were retrieved from China National Knowledge Internet ( CNKI ) and PubMed databases, and a review was made. The porous tantalum acetabular cup had unique high porosity, low elasticity, high friction coefficient and good function to promote bone ingrowth inwardly. Good clinical results could be obtained using the porous tantalum acetabular cup in acetabular revision for patients with initial fixation failure using the artificial acetabular cup. In acetabular revision, the porous tantalum acetabular cup can provide superior mechanical stability, with good early and medium-term results.

  9. Patellotibial contusions in anterior cruciate ligament tears.

    Science.gov (United States)

    Wissman, Robert D; England, Eric; Mehta, Kaushal; Nepute, Joshua; Von Fischer, Nathaniel; Apgar, Josh; Javadi, Ariyan

    2014-02-01

    Bone contusions are an important ancillary finding of many knee injuries. Not only are they a source of pain, they may suggest a mechanism of injury or a specific derangement of the knee joint. We have encountered a small number of patients being evaluated for anterior cruciate ligament (ACL) tears with unexplained patellar and tibial edema at magnetic resonance (MR) imaging. We present three individuals with contusions of the inferior patella with a corresponding contusion of the anteromedial tibial plateau. Internal derangements in these patients were similar to other individuals with acute ACL tears, however osseous contusions were more widespread. In conclusion, patellotibial contusions are rare and may indicate an injury with forces greater than usually encountered in most ACL tears. A careful search for uncommon associated injuries is prudent in these high-energy knee injuries. PMID:24037484

  10. Langmuir films study on lipid-containing artificial tears.

    Science.gov (United States)

    Torrent-Burgués, J

    2016-04-01

    Lipid-containing artificial tears are a type of artificial tears that use lipid components in order to restore the lipid layer of the tear film. One of these components is lecithin which can be applied in spray solutions containing lecithin liposomes. In this work the behavior of three of these commercial tears based on lecithin, Innoxa, Opticalm and Optrex, are studied using the Langmuir technique. The obtained isotherms are presented, discussed and compared. This technique seems useful in order to see the film behavior of the lipid components of these tears and determine some important parameters such as fluidity and extension at the air-water interface, and allows us to discern differences between these commercial tears. Innoxa and Optrex tears are more similar to each other than to Opticalm tears. Opticalm presents more fluidity, probably due to the presence of more insaturations in the fatty acid chains of the phospholipids of the lecithin used in fabrication. PMID:26764100

  11. Analysis of tear glucose concentration with electrospray ionization mass spectrometry.

    Science.gov (United States)

    Taormina, Christopher R; Baca, Justin T; Asher, Sanford A; Grabowski, Joseph J; Finegold, David N

    2007-02-01

    We have developed a mass spectrometry-based method that allows one to accurately determine the glucose concentration of tear fluid. We used a 1 microL micro-capillary to collect tear fluid from the tear meniscus with minimal irritation of the eye. We analyzed the 1 muL volume of collected tear fluid with liquid-chromatography electrospray ionization mass spectrometry with the use of D-glucose-6,6-d2 as an internal standard. Repeated measurements and a recovery experiment on pooled, onion-induced tears showed that the analysis of the glucose in tears was precise (4% relative standard deviation) and provided 100% recovery. We found the tear glucose concentration of one fasting nondiabetic subject to be 13 to 51 microM while the onion-induced tear glucose concentration of a different nondiabetic subject to be 211 to 256 microM. PMID:17084090

  12. Acetabular anteversion is associated with gluteal tendinopathy at MRI

    Energy Technology Data Exchange (ETDEWEB)

    Moulton, Kyle M. [University of Saskatchewan, Department of Medical Imaging, Saskatoon, SK (Canada); Royal University Hospital, Department of Medical Imaging, Saskatoon, SK (Canada); Aly, Abdel-Rahman [University of Saskatchewan, Department of Physical Medicine and Rehabilitation, Saskatoon, SK (Canada); Rajasekaran, Sathish [Health Pointe - Pain, Spine and Sport Medicine, Edmonton, AB (Canada); Shepel, Michael; Obaid, Haron [University of Saskatchewan, Department of Medical Imaging, Saskatoon, SK (Canada)

    2015-01-15

    Gluteal tendinopathy and greater trochanteric pain syndrome (GTPS) remain incompletely understood despite their pervasiveness in clinical practice. To date, no study has analyzed the morphometric characteristics of the hip on magnetic resonance imaging (MRI) that may predispose to gluteal tendinopathy. This study aimed to evaluate whether acetabular anteversion (AA), femoral neck anteversion (FNA), and femoral neck-shaft angle (FNSA) are associated with MRI features of gluteal tendinopathy. A total of 203 MRI examinations of the hip met our inclusion and exclusion criteria. A single blinded investigator measured AA, FNA, and FNSA according to validated MRI techniques. Two blinded subspecialty-trained musculoskeletal radiologists then independently evaluated the presence of gluteal tendinosis, trochanteric bursitis, and subgluteal bursitis. Statistical analysis was performed using a one-way analysis of variance (ANOVA; post-hoc Tukey's range test). At MRI, 57 patients had gluteal tendinosis with or without bursitis, 26 had isolated trochanteric bursitis, and 11 had isolated subgluteal bursitis. AA was significantly (p = 0.01) increased in patients with MRI evidence of gluteal tendinosis with or without bursitis [mean: 18.4 , 95 % confidence interval (CI): 17.2 -19.6 ] compared with normal controls (mean: 15.7 , 95 % CI: 14.7 -16.8 ). Similarly, AA was significantly (p = 0.04) increased in patients with isolated trochanteric bursitis (mean: 18.8 , 95 % CI: 16.2 -21.6 ). No association was found between FNA or FNSA and the presence of gluteal tendinopathy. Interobserver agreement for the presence and categorization of gluteal tendinopathy was very good (kappa = 0.859, 95 % CI: 0.815-0.903). Our MRI study suggests that there is an association between increased AA and gluteal tendinopathy, which supports a growing body of evidence implicating abnormal biomechanics in the development of this condition. (orig.)

  13. Biomechanical Study of Acetabular Tridimensional Memoryalloy Fixation System

    Science.gov (United States)

    Liu, Xin-Wei; Xu, Shuo-Gui; Zhang, Yun-Tong; Zhang, Chun-Cai

    2011-07-01

    We developed the acetabular tridimensional memoryalloy fixation system (ATMFS), which is made of NiTi shape memory alloy, according to the specific mechanical properties of biological memory material, NiTi shape memory alloy and measured distribution of contact area and pressure between the acetabulum and the femoral head of cadaveric pelvis. Seven formalin-preserved cadaveric pelves were used for this investigation. Pressure-sensitive film was used to measure contact area and pressure within the anterior, superior, and posterior regions of the acetabulum. The pelves were loaded under the following four conditions: (1) intact; (2) following a creation posterior wall fracture defect; (3) following reduction and standard internal fixation with reconstruction plate; and (4) following reduction and internal fixation with a new shape memory alloy device named ATMFS. A posterior wall fracture was created along an arc of 40° to 90° about the acetabulur rim. Creation of a posterior wall defect resulted in increased load in the superior acetabulum (1485 N) as compared to the intact condition (748 N, P = 0.009). Following reduction and internal fixation, the load distributed to the superior acetabulum (1545 N) was not statistically different from the defect condition. Following the fixation with ATMFS, the load seen at the superior region of the actabulum (964 N) was familiar with fixation with reconstruction plate and was not different from intact state ( P = 0.45). These data indicate that the use of ATMFS as a fracture internal fixation device resulted a partial restoration of joint loading parameters toward the intact state. ATMFS fixation may result in a clinical benefit.

  14. 49 CFR 173.340 - Tear gas devices.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Tear gas devices. 173.340 Section 173.340... SHIPMENTS AND PACKAGINGS Gases; Preparation and Packaging § 173.340 Tear gas devices. (a) Packagings for tear gas devices must be approved prior to initial transportation by the Associate Administrator....

  15. Arthroscopic intervention in early hip disease.

    Science.gov (United States)

    McCarthy, Joseph C; Lee, Jo-Ann

    2004-12-01

    Advancement in diagnostic and therapeutic applications for hip arthroscopy have dispelled previous myths about early hip disease. Arthroscopic findings have established the following facts: Acetabular labral tears do occur; acetabular chondral lesions do exist; tears are most frequently anterior and often associated with sudden twisting or pivoting motions; and labral tears often occur in association with articular cartilage lesions of the adjacent acetabulum or femoral head, and if present for years, contribute to the progression of delamination process of the chondral cartilage. Magnetic resonance arthrography represents an improvement over conventional magnetic resonance imaging, it does have limitations when compared with direct observation. Although indications for hip arthroscopy are constantly expanding, the most common indications include: labral tears, loose bodies, chondral flap lesions of the acetabular or femoral head, synovial chondromatosis, foreign body removal, and crystalline hip arthropathy (gout, pseudogout, and others). Contraindications include conditions that limit the potential for hip distraction such as joint ankylosis, dense heterotopic bone formation, considerable protrusio, or morbid obesity. Complication rates have been reported between 0.5 and 5%, most often related to distraction and include sciatic or femoral nerve palsy, avascular necrosis, and compartment syndrome. Transient peroneal or pudendal nerve effects and chondral scuffing have been associated with difficult or prolonged distraction. Meticulous consideration to patient positioning, distraction time and portal placement are essential. Judicious patient selection and diagnostic expertise are critical to successful outcomes. Candidates for hip arthroscopy should include only those patients with mechanical symptoms (catching, locking, or buckling) that have failed to respond to conservative therapy. The extent of articular cartilage involvement has the most direct relationship

  16. Changes of tear film and tear secretion after phacoemulsification in diabetic patients

    Institute of Scientific and Technical Information of China (English)

    Xi LIU; Yang-shun GU; Ye-sheng XU

    2008-01-01

    Objective: To evaluate tear film stability and tear secretion in patients with diabetes after phacoemulsification. Methods: Twenty-five diabetic cataract patients and 20 age-matched non-diabetic cataract patients as control underwent phacoemulsification. Tear film break-up time (TFBUT), Schirmer I test (SIT), corneal fluorescein staining, and dry eye symptoms were measured pre- and postoperatively. Results: Diabetics had a decreased preoperative TFBUT and SIT. TFBUT was reduced on Day 1 and recovered on Day 180 postoperatively in both groups. SIT was increased after phacoemulsification, but returned to preoperative levels by Day 180 in non-diabetics, whereas it was lower than preoperative level in diabetics. Positive corneal fluorescein staining was elevated in both groups, and returned to preoperative levels only in controls. Dry eye symptoms were similar to fluorescein staining in both groups. Conclusion: Tear secretion was reduced in diabetic cataract patients after phacoemulsification, which worsened dry eye symptoms and predisposed those patients to ocular damage.

  17. 49 CFR 178.818 - Tear test.

    Science.gov (United States)

    2010-10-01

    ... IBC design types. (b) Special preparation for the tear test. The flexible IBC must be filled to not...) Test method. Once the IBC is placed on the ground, a 100-mm (4-inch) knife score, completely penetrating the wall of a wide face, is made at a 45° angle to the principal axis of the IBC, halfway...

  18. Treatment for acute anterior cruciate ligament tear

    DEFF Research Database (Denmark)

    Frobell, Richard B; Roos, Harald P; Roos, Ewa M;

    2013-01-01

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

  19. Determinación del desgaste del componente acetabular en prótesis totales de cadera. // Wear determination of acetabular component in total hip prosthesis.

    Directory of Open Access Journals (Sweden)

    G. García del Pino

    2002-01-01

    Full Text Available En este trabajo se realiza un estudio a través del Método de los Elementos Finitos “MEF” sobre el desgaste del componenteacetabular durante el ciclo de marcha y considerando algunos casos extremos de cargas como subir y bajar escaleras,levantarse de una silla, etc. Utilizando el MEF fueron modelados independientemente los componentes acetabular yfemoral de la prótesis total de cadera y puestos en contacto posteriormente. Fueron estudiadas varias posiciones delacetábulo así como diferentes casos de carga simulando pacientes con diferente peso corporal y actividades físicas. Paraevaluar los resultados se crearon rutinas en lenguaje C que organizaron los mismos para un tratamiento estadísticoposterior.Palabras claves: biomecánica, ortopedia, elementos finitos, modelación, desgaste, prótesis de cadera.___________________________________________________________________________Abstract.A wear study of acetabular component during the marching cycle, considering some extreme loads cases as: ascend anddescend stairways, get up from a seat, etc , by means of Finite Elements Method ( FEM , is carried out. The acetabular andfemoral component of the total hip prosthesis were independently modeled and placed in contact lastly. Several acetabulpositions were studied as well as different load cases, simulating patients with different body weight and different physicalactivities. To evaluate the results routines in C language were created in order to organized the same ones for a laterstatistical treatment.Key words. biomechanics, ortophedy, finite elements, modelation, wear, hip bone prosthesis.

  20. A Controlled Study on the Correlation between Tear Film Volume and Tear Film Stability in Diabetic Patients.

    Science.gov (United States)

    Eissa, Iman M; Khalil, Noha M; El-Gendy, Heba A

    2016-01-01

    Purpose. To assess the tear film quantity and correlate it with the quality and stability of the tear film in diabetics and compare them to age matched controls. Introduction. Diabetes affects tear film parameters in multiple ways. Poor metabolic control and neuropathy are postulated factors. To further understand how diabetes affects tear film parameters this study was conducted. Subjects and Methods. Tear meniscus height was measured by anterior segment OCT, along with tear thinning time, a subtype of noninvasive tear break-up time, and blinking rate per minute which were all recorded for 22 diabetic patients. Correlations between these tear film parameters were studied and then compared to 16 age matched controls. Results. A statistically significant difference was found in blinking rate between the diabetic and the control group (P = 0.002), with higher blinking rate among diabetics. All tear film parameters were negatively correlated with duration of diabetes. A positive correlation was found between tear film volume and stability. Conclusion. Diabetes affects the tear film in various ways. Diabetics should be examined for dry eye signs even in absence of symptoms which may be masked by associated neuropathy. Duration of diabetes has an impact on tear film status.

  1. Evaporation-driven instability of the precorneal tear film.

    Science.gov (United States)

    Peng, Cheng-Chun; Cerretani, Colin; Braun, Richard J; Radke, C J

    2014-04-01

    Tear-film instability is widely believed to be a signature of eye health. When an interblink is prolonged, randomly distributed ruptures occur in the tear film. "Black spots" and/or "black streaks" appear in 15 to 40 s for normal individuals. For people who suffer from dry eye, tear-film breakup time (BUT) is typically less than a few seconds. To date, however, there is no satisfactory quantitative explanation for the origin of tear rupture. Recently, it was proposed that tear-film breakup is related to locally high evaporative thinning. A spatial variation in the thickness of the tear-film lipid layer (TFLL) may lead to locally elevated evaporation and subsequent tear-film breakup. We examine the local-evaporation-driven tear-film-rupture hypothesis in a one-dimensional (1-D) model for the evolution of a thin aqueous tear film overriding the cornea subject to locally elevated evaporation at its anterior surface and osmotic water influx at its posterior surface. Evaporation rate depends on mass transfer both through the coating lipid layer and through ambient air. We establish that evaporation-driven tear-film breakup can occur under normal conditions but only for higher aqueous evaporation rates. Predicted roles of environmental conditions, such as wind speed and relative humidity, on tear-film stability agree with clinical observations. More importantly, locally elevated evaporation leads to hyperosmolar spots in the tear film and, hence, vulnerability to epithelial irritation. In addition to evaporation rate, tear-film instability depends on the strength of healing flow from the neighboring region outside the breakup region, which is determined by the surface tension at the tear-film surface and by the repulsive thin-film disjoining pressure. This study provides a physically consistent and quantitative explanation for the formation of black streaks and spots in the human tear film during an interblink.

  2. High-precision measurements of cementless acetabular components using model-based RSA: an experimental study

    DEFF Research Database (Denmark)

    Baad-Hansen, Thomas; Kold, Søren; Kaptein, Bart L;

    2007-01-01

    BACKGROUND: In RSA, tantalum markers attached to metal-backed acetabular cups are often difficult to detect on stereo radiographs due to the high density of the metal shell. This results in occlusion of the prosthesis markers and may lead to inconclusive migration results. Within the last few yea...

  3. Bone impaction grafting and a cemented cup after acetabular fracture at 3-18 years.

    NARCIS (Netherlands)

    Schreurs, B.W.; Zengerink, M.; Welten, M.L.M.; Kampen, A. van; Slooff, T.J.J.H.

    2005-01-01

    The outcome of total hip arthroplasty after acetabular fracture is compromised. We studied if the bone impaction grafting technique could provide long-term prosthesis survival in deformed and irregular acetabula. We studied 20 hips in 20 patients (mean age, 53.3 years; range, 35-75 years) that were

  4. An unusual mode of failure of a tripolar constrained acetabular liner: a case report.

    LENUS (Irish Health Repository)

    Banks, Louisa N

    2012-02-01

    Dislocation after primary total hip arthroplasty (THA) is the most commonly encountered complication and is unpleasant for both the patient and the surgeon. Constrained acetabular components can be used to treat or prevent instability after primary total hip arthroplasty. We present the case of a 42-year-old female with a BMI of 41. At 18 months post-primary THA the patient underwent further revision hip surgery after numerous (more than 20) dislocations. She had a tripolar Trident acetabular cup (Stryker-Howmedica-Osteonics, Rutherford, New Jersey) inserted. Shortly afterwards the unusual mode of failure of the constrained acetabular liner was noted from radiographs in that the inner liner had dissociated from the outer. The reinforcing ring remained intact and in place. We believe that the patient\\'s weight, combined with poor abductor musculature caused excessive demand on the device leading to failure at this interface when the patient flexed forward. Constrained acetabular components are useful implants to treat instability but have been shown to have up to 42% long-term failure rates with problems such as dissociated inserts, dissociated constraining rings and dissociated femoral rings being sited. Sometimes they may be the only option left in difficult cases such as illustrated here, but still unfortunately have the capacity to fail in unusual ways.

  5. Free iliac crest grafts with periosteum for treatment of old acetabular defects

    Institute of Scientific and Technical Information of China (English)

    ZHAO De-wei; SUN Qiang; WANG Ben-jie; CUI Da-ping

    2006-01-01

    Objective: To inquire into the therapeutic effectiveness of free iliac crest grafts with periosteum on old acetabular defects.Methods: From February 1996 to June 2005, 9 patients were treated with free iliac crest grafts with periosteum to reconstruct old acetabular defects. There were 7 males and 2 females and the average age was 41.3 years. The acetabular defects were caused by traffic accidents in 6 cases and fall injury in 3 cases. The time from injury to treatment was 4-13 months and averaged 8 months. Intraoperatively we firstly removed the acetabular fracture fragments of the posterior wall. The femoral head was then reducted. Bone graft was harvested from the iliac crest with periosteum, which was sculpted with a rongeur to conform to the defect. The concave (iliac fossa) side of the graft was placed toward the femoral head. The graft was securedly fixed by two to three leg screws.Results: Postoperative syndrome was not found in any of the cases. Harris' score system showed that the score raised from 32. 3 points preoperatively to 81 points postoperatively. The hip function was evaluated as excellent in 3 cases, good in 4 cases and fair in 2 cases.Conclusions: Although this procedure could not exactly reproduce the anatomy of the hip joint, it enables to restore the posterior stability, provide bone-stock for the hip joints and prevent dislocation of the femoral head.

  6. Relationship between developmental dislocation of the hip in infant and acetabular dysplasia at skeletal maturity.

    Science.gov (United States)

    Okano, Kunihiko; Yamaguchi, Kazumasa; Ninomiya, Yoshikazu; Matsubayashi, Shohei; Aoyagi, Kiyoshi; Osaki, Makoto; Enomoto, Hiroshi; Takahashi, Katsuro

    2015-01-01

    Previous reports demonstrated 8-60% patients treated for developmental dislocation of hip (DDH) in infancy have residual acetabular dysplasia (AD) at skeletal maturity. AD patients reportedly exhibit abnormal morphology of the pelvis, high rates of comorbid spinal congenital anomalies and high bone mineral density. These physical findings suggest that AD patients have genetic background. We examined the percentage of AD patients with hip pain at skeletal maturity having a history of DDH in infancy and the correlation between the severity of AD at skeletal maturity and history of DDH treatment to investigate the relationship between AD and DDH.A total of 245 patients were radiographically examined for any history of DDH treatment in infancy. The study included 226 women and 19 men with a mean age at examination of 40.7 years (range 17-59 years).Eighty-eight patients (36%) had a history of DDH treatment (DDH group) and the remaining 157 patients (64%) had no history of DDH treatment (non-DDH group). The average age was lower and acetabular angle was larger in the DDH group. There was a significant increasing trend of the percentage of DDH patients associated with the severity of AD classified with CE, acetabular angle, and acetabular roof angle.Our data suggest that there are several AD patients without a history of DDH in Japan, and AD in patients without a history of DDH has different characteristics from AD in patients with a history of DDH. PMID:25569642

  7. Skin tears: achieving positive clinical and financial outcomes.

    Science.gov (United States)

    Stephen-Haynes, Jackie

    2012-03-01

    Skin tears are one of the most common wounds found among frail, older individuals, and are considered to be largely preventable. Skin tears occur frequently in those with fragile skin, in neonates and the elderly; particularly those with comorbidities affecting their balance, e.g. postural hypotension, motor neurone disease, diabetes and cerebral vascular accident (CVA). Those taking oral medications including steroids and anticoagulants are also at risk of developing skin tears. The increase in the population of older people is likely to produce a concurrent rise in the number of skin tears. Health professionals and health care assistants have a significant role to play in skin tear prevention, assessment and management.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-05-15

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

  9. The epidemiology of skin tears in the institutionalized elderly.

    Science.gov (United States)

    Malone, M L; Rozario, N; Gavinski, M; Goodwin, J

    1991-06-01

    While skin tears are a common occurrence in the institutionalized elderly population, nothing has been written about this problem. We retrospectively studied all incident reports during a 1-year period at a large, urban, long-term-care facility to identify residents with skin tears. The overall incidence of skin tears was 0.92 per patient per year. The incidence rate for females, but not for males, increased significantly with age (P = 0.012). The mean length of the skin tear was 1.9 cm +/- 1.4 (mean +/- SD). Eighty percent occurred in the upper extremities, with the most frequent location being the forearm. Almost half of the skin tears reported had an unknown cause. Wheelchairs and accidentally bumping into an object each accounted for a quarter of the skin tears where the cause was known. Transfers and falls contributed to a lesser extent. Impaired mental status was no more likely to be present in residents experiencing a skin tear than in all nursing home residents. Twenty-four of the 147 residents with skin tears had four or more tears, accounting for 40% of all skin tears reported. Ninety-seven percent of the episodes resulted in no attending physicians' orders other than the standing orders. Future studies should be designed to determine if there are adverse consequences of skin tears and to suggest programs to reduce their occurrence.

  10. In vivo tear film thickness measurement and tear film dynamics visualization using spectral domain optical coherence tomography.

    Science.gov (United States)

    Aranha Dos Santos, Valentin; Schmetterer, Leopold; Gröschl, Martin; Garhofer, Gerhard; Schmidl, Doreen; Kucera, Martin; Unterhuber, Angelika; Hermand, Jean-Pierre; Werkmeister, René M

    2015-08-10

    Dry eye syndrome is a highly prevalent disease of the ocular surface characterized by an instability of the tear film. Traditional methods used for the evaluation of tear film stability are invasive or show limited repeatability. Here we propose a new non-invasive fully automated approach to measure tear film thickness based on spectral domain optical coherence tomography and on an efficient delay estimator. Silicon wafer phantom were used to validate the thickness measurement. The technique was applied in vivo in healthy subjects. Series of tear film thickness maps were generated, allowing for the visualization of tear film dynamics. Our results show that the in vivo central tear film thickness measurements are precise and repeatable with a coefficient of variation of about 0.65% and that repeatable tear film dynamics can be observed. The presented approach could be used in clinical setting to study patients with dry eye disease and monitor their treatments.

  11. Cranial acetabular retroversion is common in developmental dysplasia of the hip as assessed by the weight bearing position

    DEFF Research Database (Denmark)

    Troelsen, Anders; Mikkelsen, Lone Rømer; Jacobsen, Steffen;

    2010-01-01

    The appearance of acetabular version differs between the supine and weight bearing positions in developmental dysplasia of the hip. Weight bearing radiographic evaluation has been recommended to ensure the best coherence between symptoms, functional appearance, and hip deformities. Previous preva...

  12. Open reduction and internal fixation aided by intraoperative 3-dimensional imaging improved the articular reduction in 72 displaced acetabular fractures

    DEFF Research Database (Denmark)

    Eckardt, Henrik; Lind, Dennis; Toendevold, Erik

    2015-01-01

    Background and purpose - During acetabular fracture surgery, the acetabular roof is difficult to visualize with 2-dimensional fluoroscopic views. We assessed whether intraoperative 3-dimensional (3D) imaging can aid the surgeon to achieve better articular reduction and improve implant fixation....... Patients and methods - We operated on 72 acetabular fractures using intraoperative 3D imaging and compared the operative results, duration of surgery, and complications with those for 42 consecutive acetabular fracture operations conducted using conventional fluoroscopic imaging. Postoperative reduction...... was evaluated on reconstructed coronal and sagittal images of the acetabulum. Results - The fracture severity and patient characteristics were similar in the 2 groups. In the 3D group, 46 of 72 patients (0.6) had a perfect result after open reduction and internal fixation, and in the control group, 17 of 42 (0...

  13. Tantalum acetabular augments in one-stage exchange of infected total hip arthroplasty: a case-control study.

    Science.gov (United States)

    Klatte, Till Orla; Kendoff, Daniel; Sabihi, Reza; Kamath, Atul F; Rueger, Johannes M; Gehrke, Thorsten

    2014-07-01

    During the one-stage exchange procedure for periprosthetic joint infection (PJI) after total hip arthroplasty (THA), acetabular defects challenge reconstructive options. Porous tantalum augments are an established tool for addressing acetabular destruction in aseptic cases, but their utility in septic exchange is unknown. This retrospective case-control study presents the initial results of tantalum augmentation during one-stage exchange for PJI. Primary endpoints were rates of re-infection and short-term complications associated with this technique. Study patients had no higher risk of re-infection with equivalent durability at early follow-up with a re-infection rate in both groups of 4%. In conclusion, tantalum augments are a viable option for addressing acetabular defects in one-stage exchange for septic THA. Further study is necessary to assess long-term durability when compared to traditional techniques for acetabular reconstruction. PMID:24559522

  14. Tearing mode stability calculations with pressure flattening

    CERN Document Server

    Ham, C J; Cowley, S C; Hastie, R J; Hender, T C; Liu, Y Q

    2013-01-01

    Calculations of tearing mode stability in tokamaks split conveniently into an external region, where marginally stable ideal MHD is applicable, and a resonant layer around the rational surface where sophisticated kinetic physics is needed. These two regions are coupled by the stability parameter. Pressure and current perturbations localized around the rational surface alter the stability of tearing modes. Equations governing the changes in the external solution and - are derived for arbitrary perturbations in axisymmetric toroidal geometry. The relationship of - with and without pressure flattening is obtained analytically for four pressure flattening functions. Resistive MHD codes do not contain the appropriate layer physics and therefore cannot predict stability directly. They can, however, be used to calculate -. Existing methods (Ham et al. 2012 Plasma Phys. Control. Fusion 54 025009) for extracting - from resistive codes are unsatisfactory when there is a finite pressure gradient at the rational surface ...

  15. MR imaging of anterior cruciate ligament tears

    Energy Technology Data Exchange (ETDEWEB)

    Takaki, Kazuhiro; Tomari, Kazuhide; Asao, Tsunenori [Shinbeppu Hospital, Oita (Japan)

    1995-09-01

    To investigate magnetic resonance (MR) imaging of anterior cruciate ligament (ACL) tears, the authors retrospectively reviewed 39 MR imaging examinations in 39 patients. We classified the MR imaging patterns of the torn ACL into four types. Torn ACL appears as a homogeneous iso-intensity mass on Type I images; as a continuous thin and waving low-intensity band with or without high-signal-intensity spots on the Type II images; as a disrupted band with a high-signal-intensity area on Type III images and as an absence of the ACL on Type IV images. We also report secondary lesions on MR imaging findings associated with tears of the ACL, posterior cruciate ligament index and bone bruising, in our patients. (author).

  16. MR imaging of anterior cruciate ligament tears

    International Nuclear Information System (INIS)

    To investigate magnetic resonance (MR) imaging of anterior cruciate ligament (ACL) tears, the authors retrospectively reviewed 39 MR imaging examinations in 39 patients. We classified the MR imaging patterns of the torn ACL into four types. Torn ACL appears as a homogeneous iso-intensity mass on Type I images; as a continuous thin and waving low-intensity band with or without high-signal-intensity spots on the Type II images; as a disrupted band with a high-signal-intensity area on Type III images and as an absence of the ACL on Type IV images. We also report secondary lesions on MR imaging findings associated with tears of the ACL, posterior cruciate ligament index and bone bruising, in our patients. (author)

  17. Treatment of the subject of tearing instability

    International Nuclear Information System (INIS)

    A simple approach is taken to the mechanics of potential instability associated with the steady tearing portion of J-Integral R-curves. The analysis is developed from simple examples of structural component (or test specimen) configurations with cracks, examining their instability possibilities individually, in order to draw more general conclusions about elastic-plastic cracking instability as contrasted to linear-elastic behavior. Finally, an attempt is made to model a more local cleavage-like instability for material in the fracture process zone just ahead of a crack tip. Results are then presented of a testing program which clearly demonstrates the appropriateness of the tearing instability analysis and which illustrates its broad potential for future application, as well as presenting guidelines for its further development. The material selected for analysis was Ni-Cr-Mo-V rotor steel

  18. Massive heterotopic ossification associated with late deficits in posterior wall of acetabulum after failed acetabular fracture operation

    OpenAIRE

    Zhang, Yuntong; Xie, Yang; Xu, Shuogui; Zhang, Chuncai

    2013-01-01

    Background Heterotopic ossification is a common postoperative complication of acetabular fracture. However, functionally significant heterotopic ossification with associated late bone defects in the posterior wall of the acetabulum is rare and challenging to treat. When heterotopic ossification is a late complication of failed acetabular fracture operation, it is disabling and may only be treated by THA. THA is highly susceptible to premature failure in young and active patients and may requi...

  19. Chemistry and Toxicity of Tear Gases

    Directory of Open Access Journals (Sweden)

    R. C. Malhotra

    1987-04-01

    Full Text Available The article presents a historical background on the use of tear gases in war and civilian riot control activity. The classification of chemical compounds used as irritants, and their structure - activity relationship established through different studies has been examined. A review of toxic effects which is different from irritancy of Adamsite, w- chloroacetophenone (CN, o-chlorobenzylidene malononitrile (CS and Dibenz (b,f, [1, 4] - oxazepine (CR has been presented.

  20. Determinación del desgaste del componente acetabular en prótesis totales de cadera. // Wear determination of acetabular component in total hip prosthesis.

    OpenAIRE

    G. García del Pino; Gonçalves, E; R. Gonzáles Lima; R. Dantas Queiroz; J. L. Valín Rivera

    2002-01-01

    En este trabajo se realiza un estudio a través del Método de los Elementos Finitos “MEF” sobre el desgaste del componenteacetabular durante el ciclo de marcha y considerando algunos casos extremos de cargas como subir y bajar escaleras,levantarse de una silla, etc. Utilizando el MEF fueron modelados independientemente los componentes acetabular yfemoral de la prótesis total de cadera y puestos en contacto posteriormente. Fueron estudiadas varias posiciones delacetábulo así como diferentes cas...

  1. Development of Job’s-tears ice cream recipe

    OpenAIRE

    Wiwat Wangcharoen

    2009-01-01

    Job’s tears ice cream recipe was developed by varying proportions of Job’s tears, sucrose, salt and coconut milk. Product positioning mapping was used to identify the sensory attributes that were drivers of preference, which appeared to be sweetness, smoothness, richness, and coconut milk and Job's-tears flavours of the product. Cluster analysis was used to differentiate consumers by their preference direction. Nutritional composition, antioxidant capacity and total phenolic content of th...

  2. Corrosion on the acetabular liner taper from retrieved modular metal-on-metal total hip replacements.

    Science.gov (United States)

    Gascoyne, Trevor C; Dyrkacz, Richard M; Turgeon, Thomas R; Burnell, Colin D; Wyss, Urs P; Brandt, Jan-M

    2014-10-01

    Eight retrieved metal-on-metal total hip replacements displayed corrosion damage along the cobalt-chromium alloy liner taper junction with the Ti alloy acetabular shell. Scanning electron microscopy indicated the primary mechanism of corrosion to be grain boundary and associated crevice corrosion, which was likely accelerated through mechanical micromotion and galvanic corrosion resulting from dissimilar alloys. Coordinate measurements revealed up to 4.3mm(3) of the cobalt-chromium alloy taper surface was removed due to corrosion, which is comparable to previous reports of corrosion damage on head-neck tapers. The acetabular liner-shell taper appears to be an additional source of metal corrosion products in modular total hip replacements. Patients with these prostheses should be closely monitored for signs of adverse reaction towards corrosion by-products.

  3. An Automated Size Recognition Technique for Acetabular Implant in Total Hip Replacement

    CERN Document Server

    Shapi'i, Azrulhizam; Hasan, Mohammad Khatim; Kassim, Abdul Yazid Mohd; 10.5121/ijcsit.2011.3218

    2011-01-01

    Preoperative templating in Total Hip Replacement (THR) is a method to estimate the optimal size and position of the implant. Today, observational (manual) size recognition techniques are still used to find a suitable implant for the patient. Therefore, a digital and automated technique should be developed so that the implant size recognition process can be effectively implemented. For this purpose, we have introduced the new technique for acetabular implant size recognition in THR preoperative planning based on the diameter of acetabulum size. This technique enables the surgeon to recognise a digital acetabular implant size automatically. Ten randomly selected X-rays of unidentified patients were used to test the accuracy and utility of an automated implant size recognition technique. Based on the testing result, the new technique yielded very close results to those obtained by the observational method in nine studies (90%).

  4. Analysis of Graves' ophthalmopathy patients' tear protein spectrum

    Institute of Scientific and Technical Information of China (English)

    JIANG Li-hong; WEI Rui-li

    2013-01-01

    Background Graves' ophthalmopathy/orbitopathy (GO) patients often suffer ocular surface damages and tear fluid proteins play a significant role in maintaining healthy ocular surfaces,while changes in tear protein components reflect the changes ocular surface abnormalities.In this study proteomics techniques were used to investigate tear protein compositions in GO patients.Methods We carried out a case-control study by comparing tear fluid contents of GO patients with that of healthy subjects.In the first step the tears were subjected to SDS-PAGE electrophoresis and then single protein bands were analyzed by to in-gel trypsin digestion and nano-flow liquid mass spectrometry (LC-MS/MS) using a MS software.Results In tear samples of GO subjects,the protein fractions of inflammation-related protein immunoglobulin kappa chain C region (IgKC) and serum albumin were essentially reduced,whereas a novel isoform of complement component 3 (C3),which we detected in control subjects,was completely absent in the GO patients' tears.Conclusions Reduced protein concentrations of particularly IgKC and complement C3 as well as albumin in the tears of GO patients may contribute to changes in their ocular surfaces via diminished reactive oxygen species (ROS) depletion and adaptive immune responses.The completely absent of C3 in the GO patients' tears,may imply that an important inflammatory signaling pathway is affected,which needs further investigation.

  5. Skin tears in institutionalized elderly: an epidemiological study.

    Science.gov (United States)

    McGough-Csarny, J; Kopac, C A

    1998-03-01

    Skin tears in the elderly are a common alteration of aging skin integrity. Very little is found in the literature on the prevention, identification, and treatment of skin tears. During a six-month period, 154 skin tears were studied in a convenience sample of residents in a VA Nursing Home Care Unit and nine community nursing homes. Data were collected on demographics, medication use, laboratory tests, cognitive function, and activities of daily living (ADLs). Descriptive data on the skin tears were also collected and these tears were graded according to the Payne-Martin Classification System. Data analysis revealed an at-risk sample of very old, frail elderly who are predominantly women, dependent in ADLs, nutritionally compromised, and suffering from dementia. Risk factors associated with the occurrence of skin tears included stiffness and spasticity, sensory loss, limited mobility, poor appetite, polypharmacy, use of an assistive device, presence of ecchymosis, and a history of previous skin tears. Skin tears were small, occurred more frequently on the upper extremities, and half had no tissue loss. Most skin tears occurred in patient care bedrooms. The findings of this study provide an outline for the development of an at-risk profile, and establish the basis for educational programs for caregivers.

  6. Superior labrum anterior to posterior tears in throwing athletes.

    Science.gov (United States)

    Lintner, David M

    2013-01-01

    Superior labrum anterior to posterior (SLAP) tears and partial undersurface tears of the rotator cuff are common in experienced throwers, may be adaptive, and are only occasionally symptomatic. Pain in the shoulder of a throwing athlete with an MRI-documented SLAP tear or partial undersurface tear of the rotator cuff can be managed nonsurgically, with attention to posterior capsular contracture, scapular dyskinesia, and rotator cuff strength. The results of the surgical repair of SLAP lesions in the throwing athlete, with or without rotator cuff repair, are inferior to those of nonsurgical treatment. The cause of pain in the throwing athlete must be accurately diagnosed without reliance on MRI findings. PMID:23395053

  7. Changes in the tear proteins of diabetic patients

    Directory of Open Access Journals (Sweden)

    Augustin A J

    2002-10-01

    Full Text Available Abstract Background Previous studies have shown a significant increase in tear protein peaks in the tears of diabetic patients suffering from dry eye. The aim of this study was to analyze the tear protein patterns from patients with diabetes mellitus who do not suffer from ocular surface diseases (DIA. Methods A total of 515 patients were examined in this study (255 healthy subjects (controls and 260 patients suffering from diabetes mellitus. Tear proteins were separated by sodium-dodecyl-sulfate polyacrylamide gel electrophoresis. After digital image analysis densitometric data files were created and subsequently used for multivariate statistical procedures. Results A significant increase in the number of peaks was detected in diabetic patients compared to controls (P Conclusions The tear protein patterns of diabetic patients are very different in the number and intensity of spots from those of healthy subjects. Furthermore, it could be demonstrated that the differences found in the tear patterns of diabetic patients are not equal to those found in previous studies in patients suffering from dry-eye disease. The alterations in the diabetic tears were correlated with the duration of the diabetic disease. With longer disease, history changes in the tear protein patterns increased. With the course of the disease some protein peaks appeared that are not present in healthy persons. Our study shows that the analysis of electrophoretic tear protein patterns is a new non-invasive approach in the early diagnosis and analysis of the pathogenesis of diabetes induced ocular surface disease.

  8. Magnetic resonance imaging of para-acetabular insufficiency fractures in patients with malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Theodorou, S.J. [Department of Radiology, School of Medicine, University of California, San Diego Medical Center, San Diego, CA (United States)]|[Department of Radiology, Veterans Administration Medical Center, San Diego, CA (United States)]|[Department of Clinical Radiology, University of Manchester, Manchester (United Kingdom); Theodorou, D.J. [Department of Radiology, School of Medicine, University of California, San Diego Medical Center, San Diego, CA (United States)]|[Department of Radiology, Veterans Administration Medical Center, San Diego, CA (United States)]. E-mail: daphne_theodorou@hotmail.com; Schweitzer, M.E. [Department of Radiology, New York University Hospital for Joint Diseases, NY (United States); Kakitsubata, Y. [Department of Radiology, School of Medicine, University of California, San Diego Medical Center, San Diego, CA (United States)]|[Department of Radiology, Veterans Administration Medical Center, San Diego, CA (United States); Resnick, D. [Department of Radiology, School of Medicine, University of California, San Diego Medical Center, San Diego, CA (United States)]|[Department of Radiology, Veterans Administration Medical Center, San Diego, CA (United States)

    2006-02-15

    AIM: To describe the characteristic magnetic resonance imaging (MRI) findings of para-acetabular insufficiency fractures in patients with malignancy, and compare the MRI appearance of these fractures with that of metastatic bone disease. MATERIALS AND METHODS: MRI examinations were reviewed in 16 patients with a known malignant tumour and severe hip pain that raised the possibility of local recurrence or metastatic disease. Six patients had received pelvic irradiation, and three patients were receiving steroid medication. RESULTS: The total number of fractures detected was 21: a solitary fracture was present in 11 patients and five patients had bilateral para-acetabular fractures. Two patients had associated sacral insufficiency fractures, and one of them had stress fractures involving both acetabular columns. Conventional radiography allowed the diagnosis of 14 (67%) fractures; six (28%) radiographic examinations were negative; and one (5%) examination was equivocal for fracture. Available scintigraphic and computed tomography (CT) studies revealed typical findings of fracture. Using MRI, insufficiency fractures appeared as linear regions of low signal intensity on T1- and T2-weighted images. Marked marrow oedema was evident in all cases. Fractures characteristically were parallel to the superior acetabulum in a curvilinear fashion in 18 (86%) instances, and were oblique in three (14%) instances. The fractures demonstrated considerable enhancement after intravenous gadolinium administration. No associated soft tissue masses were documented. CONCLUSION: Para-acetabular insufficiency fractures are a cause of hip pain, which may mimic skeletal metastasis in the patient with malignancy and pelvic irradiation. Recognition of the characteristic MRI findings of these fractures can preclude misdiagnosis and unnecessary bone biopsy.

  9. The place of computerized axial tomography in the evaluation of acetabular fractures

    OpenAIRE

    Asik, Mehmet; Akman, Senol; Taser, Omer; Aritamur, Ayhan

    2004-01-01

    Besides the importance of standard AP and Judet s 45° iliac and obturator pelvic views, CAT has proved to be very useful in the evaluation of the fractures of the acetabulum. Of 96 patients with acetabular fractures, who applied to the Orthopaedics and Traumatology Department, Istanbul Medical Faculty, Istanbul University between 1987 and 1991 in addition to conventional radiography, CAT investigation was done in 32 patients for whom it was considered necessary. The results of both convention...

  10. Long-term outcome of operative management of delayed acetabular fractures

    Institute of Scientific and Technical Information of China (English)

    ZHU Shi-wen; SUN Xu; YANG Ming-hui; LI Yu-neng; ZHAO Chun-peng; WU Hong-hua; CAO Qi-yong

    2013-01-01

    Background Surgical treatment of acetabular fracture has long been a challenging area in the field of orthopedic trauma.The aim of this research was to investigate the operative methods for delayed acetabular fractures and to assess the operation results.Methods The operative approaches,procedures,results,and complications of the delayed acetabular fractures between 1995 and 2005 were retrospectively evaluated at Beijing Jishuitan Hospital.Quality of life was assessed for each patient with the Merle d'Aubingne and Postel fracture function rating scale and the radiological result was assessed using the Matta radiological score.Results Sixty-eight cases (70 hips) were followed up with a minimal duration of five years (average of 5.8 years).Excellent functional results were observed in 10 hip joints,good results in 40,fair results in 11,and poor results in nine.The risks of poor prognosis include impact fracture or osteochondral fracture of femoral head,a time beyond 42 days from injury to operative management,and dislocation of femoral head during the injury.Some of the problems,which were observed included postoperative infection in two hips,iatrogenic sciatic nerve injury in eight hips,traumatic arthritis in 15 hips,heterotopic ossification in 17 hips,and necrosis of the femoral head in six hips.Conclusion A careful selection of operative indications for delayed acetabular fractures in combination with a proper ooerative aPProach and appropriate reduction and fixation could guarantee relatively good results.

  11. The effect of femoro-acetabular impingement on the kinematics and kinetics of the hip joint

    OpenAIRE

    Alshameeri, Zeiad; Khanduja, Vikas

    2014-01-01

    Gait analysis is an objective tool that has been used to assess and monitor treatment for many musculoskeletal conditions. Recently, it has been used to assess the impact of femoro-acetabular impingement (FAI) on the hip and lower limb movements. There have been a fairly limited number of studies published so far reporting unexpected and inconsistent results, which calls for more research to be conducted in this arena. In the light of the limited data available, it has been challenging to rec...

  12. Osteonecrosis and femoro-acetabular impingement: sequelae of developmental dysplasia of the hip

    OpenAIRE

    Cheung, Jason Pui Yin; Chow, Wang; To, Michael

    2012-01-01

    A 2-year-old girl with developmental dysplasia of the right hip underwent open reduction and capsulorrhaphy via the anterior approach with hip spica casting in an internally rotated position. During her 26 years of follow-up, she was found to have osteonecrosis and subsequently cam-type femoro-acetabular impingement at 28 years of age. She was treated with surgical dislocation of the hip and osteochondroplasty to recreate the normal contour of the head and neck offset.

  13. Surgical treatment of acetabular fractures: clinical and radiological results and its complications

    International Nuclear Information System (INIS)

    The objective of this work is to analyse a serie of consecutive cases of surigically treated acetabular fractures, evaluating middle-term clinical and radiological results. A retrospective analysis of clinical histories, surgical forms and X-rays was performed for 42 patients who underwent surgery in two centers (Instituto Nacional de Ortopedia y Traumatologia [INOT] and Banco de Protesis), from July 2001 through August 2007

  14. Rapid Hip Osteoarthritis Development in a Patient with Anterior Acetabular Cyst with Sagittal Alignment Change

    Directory of Open Access Journals (Sweden)

    Yasuhiro Homma

    2014-01-01

    Full Text Available Rapidly destructive coxarthrosis (RDC is rare and develops unusual clinical course. Recent studies suggest multiple possible mechanisms of the development of RDC. However the exact mechanism of RDC is still not clear. The difficulty of the study on RDC is attributed to its rareness and the fact that the data before the onset of RDC is normally unavailable. In this report, we presented the patient having the radiographic data before the onset who had rapid osteoarthritis (OA development after contralateral THA, which meets the current criteria of RDC. We thought that the increased posterior tilt of the pelvis after THA reinforced the stress concentration at pre-existed anterior acetabular cyst, thereby the destruction of the cyst was occurred. As a result the rapid OA was developed. We think that there is the case of rapid osteoarthritis developing due to alternating load concentration by posterior pelvic tilt on preexisting anterior acetabular cyst such as our patient among the cases diagnosed as RDC without any identifiable etiology. The recognition of sagittal alignment changes and anterior acetabular cyst may play important role in prediction and prevention of the rapid hip osteoarthritis development similar to RDC.

  15. Stabilization of tearing mode by current drive

    Institute of Scientific and Technical Information of China (English)

    WANG Zhong-tian; SHI Man-li; MAO Guo-ping; ZHAO Shan-zhong; ZHENG Xiao-hu

    2004-01-01

    The major disruption limits the operation of present tokamaks. Experimental evidences point out that the growth of tearing modes or the magnetic islands is primarily responsible for the occurrence. Taking the non-inductive current drive effects into account, a set of 3D nonlinear equation is derived. It is shown from simulation that the growth of the magnetic island is suppressed effectively by RF current drive. It is consistent with recent experiments on the HL-1 tokamak in which the plasma is stabilized by an RF current drive.

  16. Magnetic resonance imaging evaluation of acetabular orientation in normal Chinese children.

    Science.gov (United States)

    Li, YiQiang; Liu, YuanZhong; Zhou, QingHe; Chen, WeiDong; Li, JingChun; Yu, LingJia; Xu, HongWen; Xie, DengHui

    2016-09-01

    There are no data regarding the acetabular orientation on magnetic resonance imaging (MRI); this study investigates the changes of acetabular orientation with age in normal Chinese children.We retrospectively analyzed the medical records of children who underwent hip MRI examination at our hospital from January 2009 to December 2015. A total of 180 patients with normal MRI reading of the hip joints were included and were divided into 14 groups according to age: from 6 months of age and then for each year from 1 to 16 years. The bony and cartilage acetabular anteversion angle (AAA), acetabular inclination angle (AIA), and acetabular index (AI) were measured. Total bony and cartilage femoral head coverage angles were measured on axial section total femoral head coverage angle (a-TCA) and coronal section total femoral head coverage angle (c-TCA).The mean bony AAA and AIA were 12.2 ± 2.5° and 50.9 ± 2.5°, respectively; both of them stayed constant from the age of 6 months to 16 years. Similar results were found in cartilage AAA (12.1 ± 2.5°) and AIA (41.2 ± 3.0°). There was no difference between bony and cartilage AAA, but bony AIA was significantly larger than cartilage AIA. Bony AI was 24.1 ± 2.4° at the age of 6 months, decreasing to 12.5 ± 2.3° by 12 to 13 years of age; cartilage AI (5.9 ± 1.7°) maintained a steady value with age. The mean bony a-TCA and c-TCA at 6 months were 117.0 ± 5.8° and 127.5 ± 5.1°, increasing to 144.5 ± 4.6° and 140.7 ± 2.5° at the age of 16 years. However, the cartilage a-TCA (145.2 ± 7.2°) and c-TCA (154.1 ± 5.7°) did not change significantly with age.Both bony and cartilage AAA and AIA remain constant up to the age of 16 years in normal Chinese pediatric population. Although the cartilage coverage of femoral head by the acetabulum remains unchanged with age, the bony coverage of femoral head increases. PMID:27631258

  17. Bipolar hip arthroplasty as salvage treatment for loosening of the acetabular cup with significant bone defects

    Directory of Open Access Journals (Sweden)

    Ghanem, Mohamed

    2016-04-01

    Full Text Available Introduction: Revision arthroplasty of the hip is becoming increasingly important in recent years. Early primary arthroplasty and longer life expectancy of the patients increases the number of revision surgery. Revision surgery of hip arthroplasty is major surgery for the patients, especially the elderly, with significant risks concerning the general condition of the patient. The aim of this work is to evaluate the outcome of bipolar hip arthroplasty as a salvage procedure for treatment of loosening of the acetabular cup with significant acetabular bone defects after total hip replacement (THR in multi-morbid patients.Patients and methods: During the period from January 1 2007 to December 31 2011 19 revision hip surgeries were performed in , in which the loosened acetabular cup was replaced by a bipolar head. The examined patient group consisted exclusively of female patients with an average of 75 years. The predominant diagnosis was “aseptic loosening” (84.2%. All patients in our study were multi-morbid. We decided to resort to bipolar hip arthroplasty due to the compromised general condition of patients and the major acetabular bone defects, which were confirmed intraoperatively. The postoperative follow-up ranged from 0.5 to 67 months (average 19.1 months. Results: Evaluation of the modified Harris Hip Score showed an overall improvement of the function of the hip joint after surgery of approximately 45%.Surgery was less time consuming and thus adequate for patients with significantly poor general health condition. We noticed different complications in a significant amount of patients (68.4%. The most common complication encountered was the proximal migration of the bipolar head.The rate of revision following the use of bipolar hip arthroplasty in revision surgery of the hip in our patients was high (21%. Despite the high number of complications reported in our study, we have noticed significant improvement of hip joint function as well

  18. IgA antibodies to Toxoplasma gondii in human tears

    NARCIS (Netherlands)

    Meek, B.; Klaren, V.N.A.; Haeringen, van N.J.; Kijlstra, A.; Peek, R.

    2000-01-01

    PURPOSE. To investigate whether mucosal immune responses directed against the ubiquitous parasite Toxoplasma gondii can be detected in tears of healthy humans. METHODS. Nonstimulated tears and blood were obtained from 62 healthy humans (mean age, 35 ± 10 [SD] years). Serum anti-T. gondii immunoglobu

  19. Locking of Tearing Modes by the Error Field

    Institute of Scientific and Technical Information of China (English)

    XU Tao; HU Qi-Ming; HU Xi-Wei; YU Qing-Quan

    2011-01-01

    @@ The locking of tearing modes by the error field is studied by nonlinear numerical modeling.The threshold of mode locking for J-TEXT tokamak plasmas is found.%The locking of tearing modes by the error field is studied by nonlinear numerical modeling. The threshold of mode locking for J-TEXT tokamak plasmas is found.

  20. State Secret: North Carolina and the Cherokee Trail of Tears

    Science.gov (United States)

    Bryant, James

    2008-01-01

    This paper is an analytic essay that examines the treatment of the Cherokee Trail of Tears in a North Carolina fourth grade textbook. I begin by offering a satiric look at an imaginary textbook's treatment of the Holocaust that is based closely on the actual narrative of the Trail of Tears written in the fourth grade text. Following this, close…

  1. Gyrokinetic Simulation of Low-n Tearing Modes

    Science.gov (United States)

    Chen, Yang

    2015-11-01

    Direct gyrokinetic simulation of the low-n tearing mode in a tokamak plasma has been a great computational challenge, for two reasons. First, low-n tearing modes, unlike the micro-tearing modes, have very small growth rates and very fine mode structure in the tearing layer, which requires a large number of radial grid cells and fine control of numerical dissipation. Second, kinetic electron effects are needed in the tearing layer. Here, we first present linear gyrokinetic simulation of the low-n tearing mode in cylindrical geometry. Ions are gyrokinetic and electrons are either drift kinetic or fluid. New field solvers have been developed in the gyrokinetic code GEM [Chen and Parker, J. Comput. Phys. 220, 839 (2007)] to simulate low-n modes. For the fluid electron model, an eigenmode analysis with finite Larmor radius effects has been developed to study the linear resistive tearing mode. Excellent agreement between eigenmode analysis and initial value gyrokinetic simulation is obtained. The mode growth rate is shown to scale with resistivity as η 1 / 3, the same as the semi-collisional regime in previous kinetic treatments. Simulation of the collisionless and semi-collisional tearing mode with drift kinetic electrons has been carried out with GEM's direct split-weight control-variate algorithm. It is found that a full torus simulation of the m=2, n=1 tearing mode in a present day large tokamak is still difficult with kinetic electrons, but a generalized matching technique can be used to ameliorate the problem. The radial dimension is divided into an external region and the tearing region, with the external region described by a reduced model that gives the boundary condition for the tearing region. The size of the tearing region is small compared with the minor radius, but not arbitrarily small as done in the standard asymptotic matching approach. Gyrokinetic simulation verifies the collisionless tearing mode growth rate with finite electron mass, the semi

  2. Defining and classifying skin tears: need for a common language.

    Science.gov (United States)

    Payne, R L; Martin, M L

    1993-06-01

    Very little has been written about skin tears. A common taxonomy and definition for each type of skin tear can organize teaching, practice, and research in the field. In 1990, Payne and Martin published the results of a descriptive clinical nursing research study on the epidemiology and management of skin tears in older adults. The Payne-Martin Classification System for Skin Tears, definitions, and characteristics of skin tears were presented. The purpose of this article is to critique their classification system and definitions. Criteria for evaluating taxonomies, internal validity, external validity, and utility, are used for the critique. A revision based upon continuing research and work with the classification system is presented. Further testing and modification will refine the classification and advance the science of wound care.

  3. [Reconstrudive significance of stretch mark tears of the skin].

    Science.gov (United States)

    Schmidt, U; Bohnert, M; Pollak, S

    2000-01-01

    Stretchmark-like tears of the inguinal region are commonly referred to as typical lesions in pedestrian accidents when the victim is run over by a motorcar. These lesions can also be observed when a pedestrian is hit by a vehicle while being in an upright position. Stretchmark-like tears are due to hyperextension or excessive abduction of the hip joint. Characteristic morphological features are variable numbers of equally superficial and parallel tears of the skin following the skin's cleavage lines. Drivers of two-wheeled vehicles may exhibit inguinal stretchmark-like tears when they hit an obstacle with their bent knee, suffering excessive abduction of the hip joint. Finally, stretchmark-like tears are described in victims of collisions with railed vehicles, of aircraft crashes and--very rarely--in severely injured car passengers.

  4. Clinics in diagnostic imaging. 141. Complete anterior cruciate ligament tear.

    Science.gov (United States)

    Lim, Hollie M Y; Peh, Wilfred C G

    2012-09-01

    A 38-year-old man presented with right knee pain and swelling following a football injury. Magnetic resonance (MR) imaging showed a complete anterior cruciate ligament (ACL) tear and lateral meniscal tears. The torn ACL was repaired with a graft obtained from the semitendinosus muscle, and the menisci were debrided. The mechanisms of injury to the ACL are varied and may be due to direct or indirect contact with the knee as well as with twisting injuries. Knowledge of the ACL's normal anatomy, together with MR imaging technique and understanding of the appearance of the lesion on MR examination, is crucial to aid in the identification of an ACL tear. Diagnosis of an ACL tear should be based on direct MR imaging signs, although indirect signs may be helpful, particularly in chronic tears. Other associated injuries to be aware of include meniscal and other ligamentous injuries. Normal ACL graft and post-ACL graft reconstruction complications are also briefly discussed. PMID:23023908

  5. Acetabular bone density and metal ions after metal-on-metal versus metal-on-polyethylene total hip arthroplasty; short-term results

    NARCIS (Netherlands)

    Zijlstra, Wierd P.; van der Veen, Hugo C.; van den Akker-Scheek, Inge; Zee, Mark J. M.; Bulstra, Sjoerd K.; van Raay, Jos J. A. M.

    2014-01-01

    Information on periprosthetic acetabular bone density is lacking for metal-on-metal total hip arthroplasties. These bearings use cobalt-chromium instead of titanium acetabular components, which could lead to stress shielding and hence periprosthetic bone loss. Cobalt and chromium ions have detriment

  6. Eponym of Naso-Jugal Fold and Tear Trough.

    Science.gov (United States)

    Hwang, Kun

    2016-07-01

    The aim of this study is to find out the eponym of the naso-jugal fold and tear trough and to make a suggestion to standardize the terminology.In a PubMed search, the search terms (naso-jugal) and (fold OR groove); (tear trough) and (anatomy) were used, which resulted in 48 and 37 titles, respectively. Eliminating duplicated titles, 80 abstracts were reviewed. Among them, 18 full papers were reviewed. Two papers were excluded and 3 mined papers were added. Finally, 19 papers were reviewed.In a paper published by an ophthalmologist Dr David Miller, "tear trough" was first used for designating the circular trough carved into a scleral contact in 1969. In the remaining 18 papers including 1 conference presentation, 6 terms were used for the same structure; naso-jugal fold (4), naso-jugal groove (4), naso-jugal ditch (1), tear trough (5), tear trough deformity (6), and tear trough depression (1). Whitnall first used "naso-jugal" and 10 other papers stated "naso-jugal." Eight papers cited Whitnall (2), Duke-Elder (2), and Loeb (4) in the origin of the term "naso-jugal." Flowers adapted "tear trough" for the cheek groove and 12 other papers wrote "tear trough." Eleven papers cited Flowers (9), Le Louarn (1), Mendelson (1) when referring to the origin of the term "tear trough."The name of the structure should contain "naso-jugal" rather than "tear trough" because "naso-jugal" was coined earlier and expresses the location of the structure. The recommended term should be "the deepened naso-jugal groove" since it deepens with age. PMID:27315310

  7. Skin tears: state of the science: consensus statements for the prevention, prediction, assessment, and treatment of skin tears©.

    Science.gov (United States)

    LeBlanc, Kimberly; Baranoski, Sharon

    2011-09-01

    The appropriate management of patients with skin tears is an ongoing challenge for healthcare professionals. Skins tears are often painful, acute wounds resulting from trauma to the skin and are largely preventable. Healthcare professionals must be able to identify individuals at risk for skin tears and aid in the prevention of these wounds and in their treatment when they occur. Despite preliminary studies that suggest skin tears may be more prevalent than pressure ulcers, there remains a paucity of literature to guide prevention, assessment, and treatment of skin tears. As a result, these wounds are often mismanaged and misdiagnosed, leading to complications, including pain, infection, and delayed wound healing. In addition, skin tears increase caregiver time and facility costs, cause anxiety for patients and families, and may reflect poorly on the quality of care delivered in a facility. In an effort to shift awareness toward this largely unheeded healthcare issue, a consensus panel of 13 internationally recognized key opinion leaders convened to establish consensus statements on the prevention, prediction, assessment, and treatment of skin tears. The initial consensus panel meeting was held in January 2011 and was made possible by an unrestricted educational grant from Hollister Wound Care. This document details the consensus definition and statements, as well as recommendations for future research and steps toward establishing a validated, comprehensive program for managing skin tears.

  8. Metamorphic labral axis patterning in the beetle Tribolium castaneum requires multiple upstream, but few downstream, genes in the appendage patterning network.

    Science.gov (United States)

    Smith, Frank W; Angelini, David R; Gaudio, Matthew S; Jockusch, Elizabeth L

    2014-03-01

    The arthropod labrum is an anterior appendage-like structure that forms the dorsal side of the preoral cavity. Conflicting interpretations of fossil, nervous system, and developmental data have led to a proliferation of scenarios for labral evolution. The best supported hypothesis is that the labrum is a novel structure that shares development with appendages as a result of co-option. Here, we use RNA interference in the red flour beetle Tribolium castaneum to compare metamorphic patterning of the labrum to previously published data on ventral appendage patterning. As expected under the co-option hypothesis, depletion of several genes resulted in similar defects in the labrum and ventral appendages. These include proximal deletions and proximal-to-distal transformations resulting from depletion of the leg gap genes homothorax and extradenticle, large-scale deletions resulting from depletion of the leg gap gene Distal-less, and smaller distal deletions resulting from knockdown of the EGF ligand Keren. However, depletion of dachshund and many of the genes that function downstream of the leg gap genes in the ventral appendages had either subtle or no effects on labral axis patterning. This pattern of partial similarity suggests that upstream genes act through different downstream targets in the labrum. We also discovered that many appendage axis patterning genes have roles in patterning the epipharyngeal sensillum array, suggesting that they have become integrated into a novel regulatory network. These genes include Notch, Delta, and decapentaplegic, and the transcription factors abrupt, bric à brac, homothorax, extradenticle and the paralogs apterous a and apterous b.

  9. Tear glucose analysis for the noninvasive detection and monitoring of diabetes mellitus.

    Science.gov (United States)

    Baca, Justin T; Finegold, David N; Asher, Sanford A

    2007-10-01

    One approach to the noninvasive monitoring of blood glucose concentration is to monitor glucose concentrations in tear fluid. While several methods for sensing glucose in tear fluid have been proposed, controversy remains as to the precise concentrations of tear glucose in normal and diabetic subjects and as to whether tear fluid glucose concentrations correlate with blood glucose concentrations. This review covers the present understanding of the physiology of glucose transport in tears, the regulation of the aqueous tear fraction, and studies of tear glucose concentration over the last 80 years. The various tear collection methods employed greatly influence the measured tear glucose concentrations. Studies that involve mechanical irritation of the conjunctiva during sampling measure the highest tear glucose concentrations, while studies that avoid tear stimulation measure the lowest concentrations. Attempts to monitor tear glucose concentration in situ by using contact lens-based sensing devices are discussed, and new observations are presented of tear glucose concentration obtained by a method designed to avoid tear stimulation. These studies indicate the importance of the sampling method in determining tear glucose concentrations. On the basis of these results, we discuss the future of in vivo tear glucose sensing and outline the studies needed to resolve the remaining questions about the relationship between tear and blood glucose concentrations. PMID:17938838

  10. Idiopathic horseshoe-like macular tear: a case report

    Directory of Open Access Journals (Sweden)

    Kubota M

    2016-07-01

    Full Text Available Masaomi Kubota,1 Tomohiro Shibata,1 Hisato Gunji,1 Hiroshi Tsuneoka2 1Department of Ophthalmology, The Jikei University School of Medicine Kashiwa Hospital, Chiba, 2Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan Background: Although a few cases with idiopathic horseshoe-like macular tear have been reported, the mechanism remains unknown and a standard treatment has yet to be determined. Objective: To report the outcome for a patient with idiopathic horseshoe-like macular tear who underwent vitreous surgery. Case report: A 65-year-old man with no previous injury or ophthalmic disease presented with abnormal vision in his left eye. Best-corrected visual acuity was 0.8 in the right and 0.3 in the left, and the relative afferent pupillary defect was negative. Ophthalmoscopy revealed a horseshoe-like tear on the temporal side of the macula in the left eye. The tear size was 0.75 disc diameters (DD. Optical coherence tomography showed that the focal retinal detachment reached the fovea. A few days after the first visit, there was no longer adhesion of the flap of the tear to the retina and the tear size had increased to 1.5 DD. The patient underwent vitreous surgery similar to large macular hole surgery, with the tear closure repaired using the inverted internal limiting membrane flap technique with 20% SF6 gas tamponade. Although the tear decreased to 0.5 DD after the surgery, complete closure of the tear was not achieved. Conclusion: While cases with horseshoe-like macular tear following trauma and branch retinal vein occlusion have been reported, to the best of our knowledge, this is the first reported idiopathic case. In the present case, there was expansion of the tear until the patient actually underwent surgery. If vertical vitreous traction indeed plays a role in horseshoe-like macular tears, this will need to be taken into consideration at the time of the vitreous surgery in these types of cases. Keywords

  11. Posterior horn medial meniscal root tear: the prequel

    Energy Technology Data Exchange (ETDEWEB)

    Umans, H. [Albert Einstein College of Medicine, Bronx, NY (United States); Lenox Hill Radiology and Imaging Associates, New York, NY (United States); Morrison, W. [Thomas Jefferson University Hospital, Philadelphia, PA (United States); DiFelice, G.S. [Hospital for Special Surgery, New York, NY (United States); Vaidya, N. [Crystal Run Healthcare, Middletown, NY (United States); Winalski, C.S. [Cleveland Clinic, Imaging Institute, Department of Biomedical Engineering, Lerner Research Institute, Cleveland, OH (United States)

    2014-06-15

    To determine whether subarticular marrow changes deep to the posterior horn medial meniscal root anchor might predict subsequent medial meniscal root tear. Fifteen patients with MR-diagnosed posterior horn medial meniscal root (PHMMR) tear and a knee MRI antecedent to the tear were identified at three imaging centers over a 7-year period. The pre- and post-tear MR images were evaluated for marrow signal changes deep to the root anchor, meniscal root signal intensity, medial compartment articular cartilage thinning, and meniscal body extrusion. Images of 29 age- and gender-matched individuals with two MRIs of the same knee were reviewed as a control group. MRI in 11 of 15 (73 %) cases with subsequent PHMMR tear demonstrated linear subcortical marrow edema deep to the meniscal root anchor on the antecedent MRI compared to only 1 of 29 (3 %) non-tear controls (p < 0.0001). The abnormal signal resolved on post-tear MRI in all but two patients. Cyst-like changes deep to the PHMMR were present on initial MRI in three of 15 (23 %) cases and three of 29 (10 %) controls, persisting in all but one case on follow-up imaging. The PHMMR was gray on the initial MRI in seven of 15 (47 %) of cases that developed tears compared to four of 29 (14 %) controls (p < 0.0001). There was medial meniscal extrusion (MME) prior to tear in two of 15 (13 %) patients and in ten of 15 (67 %) patients after PHMMR failure. In the control group, MME was present in one (3 %) and three (10 %) of 29 subjects on the initial and follow-up MRIs, respectively. Articular cartilage loss was noted in two of 15 (15 %) cases before tear and nine of 15 (69 %) on follow-up imaging, as compared to one (3 %) and four (14 %) of 29 subjects in the control group. Subcortical marrow edema deep to the PHMMR may result from abnormal stresses and thus be a harbinger of meniscal root failure. This hypothesis is supported by resolution of these marrow signal changes after root tear. Following tear, extrusion of the

  12. Late fiber metal shedding of the first and second-generation Harris Galante acetabular component. A report of 5 cases.

    Science.gov (United States)

    Mayman, David J; González Della Valle, Alejandro; Lambert, Edward; Anderson, John; Wright, Timothy; Nestor, Bryan; Sculco, Thomas P; Salvati, Eduardo A

    2007-06-01

    Five patients presented with fiber metal mesh shedding of a Harris Galante II acetabular cup detected between 11 and 15 years after implantation. All patients presented with hip pain and 4 demonstrated gross acetabular loosening and fiber metal separation on preoperative radiographs. The remaining patient underwent revision surgery because of a liner dislodgment and had a radiographically well fixed shell. Loosening and fiber metal separation were detected intraoperatively. Scanning electron microscopy of the retrieved shells demonstrated isolated diffusion bonding marks in the areas where the mesh separated from the substrate and no evidence of corrosion. Progressive osteolysis in the iliac bone was evident in 4 of our cases. Progressive iliac osteolysis may lead to loss of bone support in well-fixed cups and excessive stresses transferred to the interface between the fiber metal mesh and the titanium substrate leading to the separation of the 2 layers. Fiber metal separation may contribute to long-term loosening in the Harris Galante acetabular component.

  13. Femoral anteversion is correlated with acetabular version and coverage in Asian women with anterior and global deficient subgroups of hip dysplasia: a CT study

    Energy Technology Data Exchange (ETDEWEB)

    Akiyama, Mio; Nakashima, Yasuharu; Fujii, Masanori; Sato, Taishi; Yamamoto, Takuaki; Mawatari, Taro; Motomura, Goro; Matsuda, Shuichi; Iwamoto, Yukihide [Kyushu University, Department of Orthopaedic Surgery, Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka (Japan)

    2012-11-15

    Morphological correlation between the acetabulum and femur at the hip joint is still controversial. We tested the hypothesis that femoral anteversion correlates with acetabular version and coverage in patients with developmental dysplasia of the hip (DDH). Using pelvic computed tomography (CT) images of 79 hips in 49 Asian women with DDH and 49 normal hips, we measured femoral anteversion, the axial and vertical acetabular version and the acetabular sector angle (ASA) to demarcate femoral head coverage. Depending on the location of the acetabular bone defect, dysplastic hips were divided into three subgroups: the anterior, global and posterior deficiency groups. We performed a comparative analysis between dysplastic and normal hips using the Wilcoxon rank sum test, and a relative analysis between femoral anteversion and acetabular measurements in dysplastic hips using Pearson's correlation coefficient. The amount of femoral anteversion in dysplastic hips was greater and more variable than in normal hips (p < 0.0001, p = 0.0277 respectively). Femoral anteversion in dysplastic hips correlated significantly with acetabular anteversion in the groups with anterior and global deficiency subgroups (p < 0.05, r = 0.2990, p < 0.05, r = 0.451 respectively), but not with the posterior deficiency subgroup. Femoral anteversion also correlated with vertical acetabular version. When acetabular coverage was examined, significant correlations were noted between femoral anteversion and anterior and superior coverage, but not with posterior coverage. These correlations were not observed in normal hips. Our results showed significantly greater and more variable femoral anteversion in DDH, and a significant correlation between femoral anteversion and acetabular version and coverage in DDH with anterior and global acetabular bone deficiency. (orig.)

  14. Femoral anteversion is correlated with acetabular version and coverage in Asian women with anterior and global deficient subgroups of hip dysplasia: a CT study

    International Nuclear Information System (INIS)

    Morphological correlation between the acetabulum and femur at the hip joint is still controversial. We tested the hypothesis that femoral anteversion correlates with acetabular version and coverage in patients with developmental dysplasia of the hip (DDH). Using pelvic computed tomography (CT) images of 79 hips in 49 Asian women with DDH and 49 normal hips, we measured femoral anteversion, the axial and vertical acetabular version and the acetabular sector angle (ASA) to demarcate femoral head coverage. Depending on the location of the acetabular bone defect, dysplastic hips were divided into three subgroups: the anterior, global and posterior deficiency groups. We performed a comparative analysis between dysplastic and normal hips using the Wilcoxon rank sum test, and a relative analysis between femoral anteversion and acetabular measurements in dysplastic hips using Pearson's correlation coefficient. The amount of femoral anteversion in dysplastic hips was greater and more variable than in normal hips (p < 0.0001, p = 0.0277 respectively). Femoral anteversion in dysplastic hips correlated significantly with acetabular anteversion in the groups with anterior and global deficiency subgroups (p < 0.05, r = 0.2990, p < 0.05, r = 0.451 respectively), but not with the posterior deficiency subgroup. Femoral anteversion also correlated with vertical acetabular version. When acetabular coverage was examined, significant correlations were noted between femoral anteversion and anterior and superior coverage, but not with posterior coverage. These correlations were not observed in normal hips. Our results showed significantly greater and more variable femoral anteversion in DDH, and a significant correlation between femoral anteversion and acetabular version and coverage in DDH with anterior and global acetabular bone deficiency. (orig.)

  15. Effects of tear gases on the eye.

    Science.gov (United States)

    Kim, Yonwook J; Payal, Abhishek R; Daly, Mary K

    2016-01-01

    Chemical agents that target the eyes have been a popular choice for law enforcement during riots and for military training for nearly a century. The most commonly used agents are chloroacetophenone (formerly sold as Mace), o-chlorobenzylidene malononitrile, and oleoresin capsicum (OC or pepper spray, current ingredient for Mace). Initially, most severe ocular injuries were caused by the explosive force rather than the chemical itself. The development of sprays reduced the mechanical severity of ocular injuries, but resulted in a variety of chemical injuries. The effects on eyes include conjunctival injection, complete corneal epithelial defects, pseudopterygium, corneal neovascularization, persistent conjunctivalization, corneal opacities, and reduced visual acuity. Current management, based on limited human studies, emphasizes decontamination and symptomatic treatment. We review the literature related to clinical and histopathologic effects of tear gas agents on the eye and their management. PMID:26808721

  16. Ion dynamics and the unified tearing mode

    Energy Technology Data Exchange (ETDEWEB)

    Lee, X. S.

    1980-08-01

    The general theory based on the E-parallel variational principle provides the framework used for both the investigation of the ion dynamic effects and the study of the unification of tearing modes. Along with the brief review of the general theory, we have presented additional details and discussions. In particular, we have presented a new, simple derivation of the ion magneto-viscosity terms and displayed the ultimate cancellation of their effects with those of the convective term's. It has been noted before that ..cap alpha../sup 1/2/x/sub A/ = i can lead to the derivation of the m = 1 classical modes; however we clarify how this root is obtained.

  17. Observation of Spontaneous Neoclassical Tearing Modes

    Energy Technology Data Exchange (ETDEWEB)

    E.D. Fredrickson

    2001-10-03

    We present data in this paper from the Tokamak Fusion Test Reactor (TFTR) which challenges the commonly held belief that extrinsic MHD events such as sawteeth or ELMs [edge localized modes] are required to provide the seed islands that trigger Neoclassical Tearing Modes (NTMs). While sawteeth are reported to provide the trigger for most of the NTMs on DIII-D [at General Atomics in San Diego, California] and ASDEX-U [at Max-Planck-Institut fuer Plasmaphysik in Garching, Germany], the majority of NTMs seen in TFTR occur in plasmas without sawteeth, that is which are above the beta threshold for sawtooth stabilization. Examples of NTMs appearing in the absence of any detectable extrinsic MHD activity will be shown. Conversely, large n=1 modes in plasmas above the NTM beta threshold generally do not trigger NTMs. An alternative mechanism for generating seed islands will be discussed.

  18. Clinical observation of particulate cancellous bone impaction grafting in combination with total hip arthroplasty for acetabular reconstruction

    Institute of Scientific and Technical Information of China (English)

    LIU Xian-zhe; YANG Shu-hua; XU Wei-hua; LIU Guo-hui; YANG Cao; LI Jin; YE Zhe-wei; LIU Yong; ZHANG Yu-kun

    2008-01-01

    Objective: To investigate the effect of particulate cancellous bone impaction grafting in combination with total hip arthroplasty (THA) for acetabular reconstruction in patients with posttraumatic arthritis and bone loss afteracetabular fractures.Methods: Totally 15 consecutive cases with unilateral acetabular fracture were treated with bone impaction grafting in combination with THA in our department.There were 10 males and 5 females with mean age of 48.2 years (ranging from 36 to 73 years).Eight cases had the fracture at left hips,7 at right hips.The average age at injury was 28 years (ranging from 18 to 68 years).The mean follow-up period was 4.3 years (ranging from 2 to 7 years).Results: Compared with mean 42 points (ranging from 10 to 62) of the preoperative Harris score,the survival cases at the final follow-up had mean 84 points (ranging from 58 to 98).One patient had mild pain in the hip.No revision of the acetabular or femoral component was undertaken during the follow-up.Normal rotational centre of most hips was recovered except 2 cases in which it was 0.8 mm higher than that in opposite side.All of them had a stable radiographic appearance.Progressive radiolucent fines were observed in I,III zones in 2 cases.One patient had a nonprogressive radiolucent fine in zone III.The cup prosthesis was obviously displaced (6 mm) in one patient,but had not been revised.Conclusion: Particulate cancellous bone impaction grafting in combination with THA as a biological solution is an attractive procedure for acetabular reconstruction in patients with posttraumatic arthritis and bone loss after acetabular fracture,which can not only restore acetabular bone stock but also repair normal hip anatomy and its function.

  19. A new tear pattern of the rotator cuff and its treatment: Fosbury flop tears

    Directory of Open Access Journals (Sweden)

    Alexandre Lädermann

    2015-01-01

    Full Text Available Purpose: The purpose of this report is to describe a new full-thickness tear pattern of the posterosuperior rotator cuff with reversal healing. We describe the specific radiologic signs associated with this tear pattern and the arthroscopic rotator cuff repair technique. Materials and Methods: A prospective radiologic and clinical study collected all patients with a magnetic resonance imaging arthrogram that underwent an arthroscopic rotator cuff repair over a 1 year period. Results: Among 97 patients, five demonstrated a tear of the posterosuperior rotator cuff with reversal healing. Characteristic radiographic findings included a thicker tendon than normal, the presence of a stump and accumulation of liquid in the superior-medial part of the subacromial bursa, and adhesions between the supraspinatus tendon and the wall of the subacromial bursa. Conclusion: Avulsion of the posterosuperior rotator cuff with reversal healing on its bursal-side is a less common condition. This type of lesion and distinct radiographic signs that can be recognized to facilitate anatomic repair of the rotator cuff. Level of evidence: Level IV.

  20. Correlation between Rotator Cuff Tears and Systemic Atherosclerotic Disease

    International Nuclear Information System (INIS)

    The purpose of this study was to investigate the association of aortic arch calcification, a surrogate marker of atherosclerosis, with rotator cuff tendinosis and tears given the hypothesis that decreased tendon vascularity is a contributing factor in the etiology of tendon degeneration. A retrospective review was performed to identify patients ages 50 to 90 years who had a shoulder MRI and a chest radiograph performed within 6 months of each other. Chest radiographs and shoulder MRIs from 120 patients were reviewed by two sets of observers blinded to the others' conclusions. Rotator cuff disease was classified as tendinosis, partial thickness tear, and full thickness tear. The presence or absence of aortic arch calcification was graded and compared with the MRI appearance of the rotator cuff. The tendon tear grading was positively correlated with patient age. However, the tendon tear grading on MRI was not significantly correlated with the aorta calcification scores on chest radiographs. Furthermore, there was no significant correlation between aorta calcification severity and tendon tear grading. In conclusion, rotator cuff tears did not significantly correlate with aortic calcification severity. This suggests that tendon ischemia may not be associated with the degree of macrovascular disease

  1. Relationships between rotator cuff tear types and radiographic abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Soo Hyun; Chun, Kyung Ah; Lee Soo Jung; Kang, Min Ho; Yi, Kyung Sik; Zhang, Ying [Dept. of Diagnostic Radiology, College of Medicine, Chungbuk National University, Cheongju (Korea, Republic of)

    2014-11-15

    To determine relationships between different types of rotator cuff tears and radiographic abnormalities. The shoulder radiographs of 104 patients with an arthroscopically proven rotator cuff tear were compared with similar radiographs of 54 age-matched controls with intact cuffs. Two radiologists independently interpreted all radiographs for; cortical thickening with subcortical sclerosis, subcortical cysts, osteophytes in the humeral greater tuberosity, humeral migration, degenerations of the acromioclavicular and glenohumeral joints, and subacromial spurs. Statistical analysis was performed to determine relationships between each type of rotator cuff tears and radiographic abnormalities. Inter-observer agreements with respect to radiographic findings were analyzed. Humeral migration and degenerative change of the greater tuberosity, including sclerosis, subcortical cysts, and osteophytes, were more associated with full-thickness tears (p < 0.01). Subacromial spurs were more common for full-thickness and bursal-sided tears (p < 0.01). No association was found between degeneration of the acromioclavicular or glenohumeral joint and the presence of a cuff tear. Different types of rotator cuff tears are associated with different radiographic abnormalities.

  2. Tear film lipid layer: A molecular level view.

    Science.gov (United States)

    Cwiklik, Lukasz

    2016-10-01

    Human cornea is covered by an aqueous tear film, and the outermost layer of the tear film is coated by lipids. This so-called tear film lipid layer (TFLL) reduces surface tension of the tear film and helps with the film re-spreading after blinks. Alterations of tear lipids composition and properties are related to dry eye syndrome. Therefore, unveiling structural and functional properties of TFLL is necessary for understanding tear film function under both normal and pathological conditions. Key properties of TFLL, such as resistance against high lateral pressures and ability to spread at the tear film surface, are directly related to the chemical identity of TFLL lipids. Hence, a molecular-level description is required to get better insight into TFLL properties. Molecular dynamics simulations are particularly well suited for this task and they were recently used for investigating TFLL. The present review discusses molecular level organization and properties of TFLL as seen by these simulation studies. This article is part of a Special Issue entitled: Biosimulations edited by Ilpo Vattulainen and Tomasz Róg.

  3. Acetabular morphometry and prevalence of hip dysplasia in the South Asian population

    Directory of Open Access Journals (Sweden)

    Masood Umer

    2009-07-01

    Full Text Available We carried out a cross-sectional study to measure the association of the seven acetabular parameters with pelvic morphometry and prevalence of hip dysplasia in our population. Convenience sampling was carried out and 250 consecutive patients who came to AKUH for intravenous pyelogram and had no complaints in the region of the hip joint were enrolled in the study. Post-micturition standardized plain antero-posterior pelvic radiographs of 250 asymptomatic adults (500 hip joints was studied. There were 136 males (54.4% and 114 females (45.6%. Mean age of our study population was 38 years (15-78 years. The average center edge angle was 35.5±6.6° standard deviation (SD, acetabular angle was 37.76±4.37°, depth to width ratio was 0.31±4.6°, roof obliquity was 10.6±6.2°, extrusion index was 0.1±5.8, lateral subluxation 8.9±2.7 mm, and peak to edge distance 17±3.98 mm. There was significant influence (p lower than  0.05 of age in all angles except depth to width ratio. A total of seven hip joints (1.4% were dysplastic with CE angle lower than 25° while four of the seven hips were severely dysplastic with CE angle  lower than 20°. In the dysplastic group there was significant correlation (p lower than 0.05 of CE angle with acetabular angle, depth to width ratio, extrusion index and peak to edge distance. Prevalence of hip dysplasia was found to be very low in our population. These results are consistent with the findings of studies carried out in other Asian countries.

  4. Inguinal Abnormalities in Male Patients with Acetabular Fractures Treated Using an Ilioinguinal Exposure

    Directory of Open Access Journals (Sweden)

    Reza Firoozabadi

    2015-09-01

    Full Text Available Purpose: Surgeons performing an ilioinguinal exposure for acetabular fracture surgery need to be aware of aberrant findings such as inguinal hernias and spermatic cord lesions. The purpose of this study is to report these occurrences in a clinical series of adult males undergoing acetabular fracture fixation and a series of adult male cadavers. The secondary aim is to characterize these abnormalities to aid surgeons in detecting these abnormalities preoperatively and coordinating a surgical plan with a general surgeon.Methods: Clinical study- Retrospective review of treated acetabular fractures through an ilioinguinal approach. Incidence of inguinal canal and spermatic cord abnormalities requiring general surgery consultation were identified. Corresponding CT scans were reviewed and radiographic characteristics of the spermatic cord abnormalities and/or hernias were noted.Cadaveric study- 18 male cadavers dissected bilaterally using an ilioinguinal exposure. The inguinal canal and the contents of the spermatic cord were identified and characterized.Results: Clinical Study- 5.7% (5/87 of patients had spermatic cord lesion and/or inguinal hernia requiring general surgical intervention. Preoperative pelvic CT scan review identified abnormalities noted intraoperatively in four of the five patients. Cord lipomas visualized as enlargements of the spermatic cord with homogeneous density. Hernias visualized as enlarged spermatic cords with heterogeneous density. Cadaver Study- 31% (11/36 of cadavers studied had spermatic cord and/or inguinal canal abnormalities. Average cord diameter in those with abnormalities was 24.9 mm (15-28 compared to 16 mm (11-22 in normal cords, which was statistically significant.Conclusion: The clinical and cadaveric findings emphasize the importance of understanding inguinal abnormalities and the value of detecting them preoperatively. The preoperative pelvic CT scans were highly sensitive in detecting inguinal abnormalities.

  5. Modified ilioinguinal approach in combined surgical exposures for displaced acetabular fractures involving two columns.

    Science.gov (United States)

    Wang, Peng; Zhu, Xiaodong; Xu, Peng; Zhang, Yan; Wang, Lubo; Liu, Xiangyan; Mu, Weidong

    2016-01-01

    The purpose of this study is to assess the advantages of modified ilioinguinal approach in combined surgical exposures for displaced acetabular fractures involving two columns management. 73 patients with displaced acetabular fractures involving two columns underwent open reduction and internal fixation through combined surgical approaches between 2006 and 2014 in our hospital. The modified ilioinguinal approach combined with Kocher-Langenbeck approach group (group A) included 46 patients. The standard ilioinguinal approach combined with Kocher-Langenbeck approach group (group B) included 27 patients. Outcome was assessed in operative time, blood loss, function outcomes and complications. In group A, the average operative time was 123.2 min, and the average blood loss was 586.2 ml. Anatomic reduction was achieved in 39 patients (84.8 %). The functional recovery was good in 37 patients (80.4 %). Complications related to the approach were observed in 10 patients (21.7 %). In group B, the average operative time was 161.5 min, and the average blood loss was 830 ml. Anatomic reduction was achieved in 24 patients (88.9 %). The functional recovery was good in 22 patients (81.5 %). Complications related to the approach were observed in 9 patients (33.3 %). This study demonstrates that both combined approaches permits good postoperative function results for treatment of acetabular fractures involving two columns. However, the modified ilioinguinal approach combined with Kocher-Langenbeck approach provides less operative time, blood loss and complications. PMID:27652175

  6. Experimental and analytical validation of a modular acetabular prosthesis in total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Aram Luke

    2007-05-01

    Full Text Available Abstract A finite element model has been developed to predict in vivo micro motion between a modular acetabular cup and liner after cement less total hip arthroplasty. The purpose of this study is to experimentally validate the model. Six LVDT sensors were used to monitor the micromotion of the liner when subjected to loading conditions ranging from 250 N to 5000 N. Deformations at points of interest for both the experiment and FEM were compared. Results of the FEM with different coefficient of friction between the liner and the cup were investigated to correlate with the experimental results.

  7. Migration measurement of acetabular components in cementless total hip arthroplasty; Messung der Pfannenwanderung bei zementfreien Hueftimplantaten

    Energy Technology Data Exchange (ETDEWEB)

    Eckardt, A.; Karbowski, A.; Schwitalle, M.; Vogel, J.; Boden, F.; Seeleitner, C. [Mainz Univ. (Germany). Orthopaedische Klinik und Poliklinik; Schunk, K. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Radiologie; Mayrhofer, P. [Innsbruck Univ. (Austria). Inst. fuer Mathematik und Geometrie

    1998-08-01

    Migration measurements of acetabular components using a special computer aided method (EBRA = abbrevation for the German term ``Ein-Bild-Roentgenanalyse``) were performed to evaluate early results of the implants and predict aseptic loosening. Methods: Standard ap-radiographs of the pelvis were marked, specific points were digitised. Simulating the spatial situation the programme computes lengitudinal and vertical migration of the cup. 74 acetabular components in 71 patients could be studied by migration measurements. Results: 14 patients showed migration of more than 1 mm, which is the confidence limit of this method. Each of these patients showed diverse reasons for the migration, i.e. osteoporosis of the acetabular bone stock or problems concerning the surgical technique which means malposition of the cup or insufficient reaming of the bone. There were some patients with severe congenital dysplasia of the hip and in some cases the inclination angle of the cup was too great. Conclusion: The technique applied for measuring migration of acetabular components can be useful for evaluating early instability of the implant and can be helpful in detecting problems concerning the surgical technique. (orig.) [Deutsch] Mittels der Ein-Bild-Roentgenanalyse wurden Pfannenwanderungen nach Implantation von zementfreien, sphaerischen Hueftgelenkspfannen erfasst, um Praediktoren fuer die langfristige Prognose der Implantate zu evaluieren. Methoden: Nach Markierung von Referenzpunkten in den Beckenuebersichtsaufnahmen wurden diese digitalisiert, vom Programm verrechnet und die Wanderung des Implantats im Verlauf angegeben. Bei 71 Patienten wurden von 74 Pfannen ueber einen Mindestnachuntersuchungszeitraum von 12 Monaten Migrationsmessungen durchgefuehrt. Das Konfidenzintervall der Methode liegt bei <1 mm. Bei jedem dieser Patienten fanden sich Hinweise entweder auf ein schlechtes Knochenlager, auf operationsbedingte Probleme, wenn keine ausreichende Primaerstabilitaet der Pfanne

  8. Non-linear evolution of double tearing modes in tokamaks

    Energy Technology Data Exchange (ETDEWEB)

    Fredrickson, E.; Bell, M.; Budny, R.V.; Synakowski, E.

    1999-12-17

    The delta prime formalism with neoclassical modifications has proven to be a useful tool in the study of tearing modes in high beta, collisionless plasmas. In this paper the formalism developed for the inclusion of neoclassical effects on tearing modes in monotonic q-profile plasmas is extended to plasmas with hollow current profiles and double rational surfaces. First, the classical formalism of tearing modes in the Rutherford regime in low beta plasmas is extended to q profiles with two rational surfaces. Then it is shown that this formalism is readily extended to include neoclassical effects.

  9. Development of Job’s-tears ice cream recipe

    Directory of Open Access Journals (Sweden)

    Wiwat Wangcharoen

    2009-10-01

    Full Text Available Job’s tears ice cream recipe was developed by varying proportions of Job’s tears, sucrose, salt and coconut milk. Product positioning mapping was used to identify the sensory attributes that were drivers of preference, which appeared to be sweetness, smoothness, richness, and coconut milk and Job's-tears flavours of the product. Cluster analysis was used to differentiate consumers by their preference direction. Nutritional composition, antioxidant capacity and total phenolic content of the final product were also determined.

  10. Exploring best practice in the management of skin tears in older people.

    Science.gov (United States)

    Battersby, Lisa

    This article discusses best practice in the management of skin tear injuries in older people. It considers what a skin tear wound is, examines skin tear classification systems currently available and discusses management and treatment of these wounds as well as strategies to prevent the recurrence of skin tears in this patient group.

  11. Dynamic interfacial properties of human tear-lipid films and their interactions with model-tear proteins in vitro.

    Science.gov (United States)

    Svitova, Tatyana F; Lin, Meng C

    2016-07-01

    This review summarizes the current state of knowledge regarding interfacial properties of very complex biological colloids, specifically, human meibum and tear lipids, and their interactions with proteins similar to the proteins found in aqueous part of human tears. Tear lipids spread as thin films over the surface of tear-film aqueous and play crucial roles in tear-film stability and overall ocular-surface health. The vast majority of papers published to date report interfacial properties of meibum-lipid monolayers spread on various aqueous sub-phases, often containing model proteins, in Langmuir trough. However, it is well established that natural human ocular tear lipids exist as multilayered films with a thickness between 30 and 100nm, that is very much disparate from 1 to 2nm thick meibum monolayers. We employed sessile-bubble tensiometry to study the dynamic interfacial and rheological properties of reconstituted multilayered human tear-lipid films. Small amounts (0.5-1μg) of human tear lipids were deposited on an air-bubble surface to produce tear-lipid films in thickness range 30-100nm corresponding to ocular lipid films. Thus, we were able to overcome major Langmuir-trough method limitations because ocular tear lipids can be safely harvested only in minute, sub-milligram quantities, insufficient for Langmuir through studies. Sessile-bubble method is demonstrated to be a versatile tool for assessing conventional synthetic surfactants adsorption/desorption dynamics at an air-aqueous solution interface. (Svitova T., Weatherbee M., Radke C.J. Dynamics of surfactant sorption at the air/water interface: continuous-flow tensiometry. J. Colloid Interf. Sci. 2003;261:1170-179). The augmented flow-sessile-bubble setup, with step-strain relaxation module for dynamic interfacial rheological properties and high-precision syringe pump to generate larger and slow interfacial area expansions-contractions, was developed and employed in our studies. We established that

  12. In vivo tear film thickness measurement and tear film dynamics visualization using spectral domain OCT and an efficient delay estimator

    Science.gov (United States)

    Aranha dos Santos, Valentin; Schmetterer, Leopold; Gröschl, Martin; Garhofer, Gerhard; Werkmeister, René M.

    2016-03-01

    Dry eye syndrome is a highly prevalent disease of the ocular surface characterized by an instability of the tear film. Traditional methods used for the evaluation of tear film stability are invasive or show limited repeatability. Here we propose a new noninvasive approach to measure tear film thickness using an efficient delay estimator and ultrahigh resolution spectral domain OCT. Silicon wafer phantoms with layers of known thickness and group index were used to validate the estimator-based thickness measurement. A theoretical analysis of the fundamental limit of the precision of the estimator is presented and the analytical expression of the Cramér-Rao lower bound (CRLB), which is the minimum variance that may be achieved by any unbiased estimator, is derived. The performance of the estimator against noise was investigated using simulations. We found that the proposed estimator reaches the CRLB associated with the OCT amplitude signal. The technique was applied in vivo in healthy subjects and dry eye patients. Series of tear film thickness maps were generated, allowing for the visualization of tear film dynamics. Our results show that the central tear film thickness precisely measured in vivo with a coefficient of variation of about 0.65% and that repeatable tear film dynamics can be observed. The presented method has the potential of being an alternative to breakup time measurements (BUT) and could be used in clinical setting to study patients with dry eye disease and monitor their treatments.

  13. Tears of wine: new insights on an old phenomenon

    Science.gov (United States)

    Venerus, David C.; Nieto Simavilla, David

    2015-11-01

    Anyone who has enjoyed a glass of wine has undoubtedly noticed the regular pattern of liquid beads that fall along the inside of the glass, or ‘tears of wine.’ The phenomenon is the result of a flow against gravity along the liquid film on the glass, which is induced by an interfacial tension gradient. It is generally accepted that the interfacial tension gradient is due to a composition gradient resulting from the evaporation of ethanol. We re-examine the tears of wine phenomenon and investigate the importance of thermal effects, which previously have been ignored. Using a novel experiment and simple model we find that evaporative cooling contributes significantly to the flow responsible for wine tears, and that this phenomenon occurs primarily because of the thermodynamic behavior of ethanol-water mixtures. Also, the regular pattern of tear formation is identified as a well-known hydrodynamic instability.

  14. Isolated medial meniscal tear in a Border Collie.

    Science.gov (United States)

    Ridge, P A

    2006-01-01

    A three-year-old, female Border Collie was successfully treated for an isolated, torn, medial meniscus by arthroscopic meniscal tear resection. The dog returned to agility competition without recurrence of lameness. PMID:16810354

  15. The Effect of Polar Lipids on Tear Film Dynamics

    KAUST Repository

    Aydemir, E.

    2010-06-17

    In this paper, we present a mathematical model describing the effect of polar lipids, excreted by glands in the eyelid and present on the surface of the tear film, on the evolution of a pre-corneal tear film. We aim to explain the interesting experimentally observed phenomenon that the tear film continues to move upward even after the upper eyelid has become stationary. The polar lipid is an insoluble surface species that locally alters the surface tension of the tear film. In the lubrication limit, the model reduces to two coupled non-linear partial differential equations for the film thickness and the concentration of lipid. We solve the system numerically and observe that increasing the concentration of the lipid increases the flow of liquid up the eye. We further exploit the size of the parameters in the problem to explain the initial evolution of the system. © 2010 Society for Mathematical Biology.

  16. Early Vitrectomy for Vitreous Hemorrhage Associated With Retinal Tears

    NARCIS (Netherlands)

    H.S. Tan; M. Mura; H.M. Bijl

    2010-01-01

    PURPOSE: To evaluate outcome of early surgery in vitreous hemorrhage, presumably associated with retinal tears. DESIGN: Retrospective, noncomparative interventional case series. METHODS: We included 40 consecutive cases in 39 patients treated with early vitrectomy for vitreous hemorrhage. Main outco

  17. Is Surgery Always Needed for Meniscal Tears of the Knee?

    Science.gov (United States)

    ... A meniscal tear is a common and disabling knee injury affecting many Americans at some point in their ... Services, or federal policy. More Health News on: Knee Injuries and Disorders Surgery Recent Health News Related MedlinePlus ...

  18. Rotator Cuff Tendinitis and Tear (Beyond the Basics)

    Science.gov (United States)

    ... of Use ©2016 UpToDate, Inc. Patient education: Rotator cuff tendinitis and tear (Beyond the Basics) Authors Stephen ... This topic last updated: Jun 16, 2016. ROTATOR CUFF INJURY OVERVIEW — Tendons are tough bands of tissue ...

  19. Zika May Be Passed on Through Tears, Sweat: Report

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_161204.html Zika May Be Passed on Through Tears, Sweat: Report ... 2016 WEDNESDAY, Sept. 28, 2016 (HealthDay News) -- The Zika virus might be able to pass from person ...

  20. Comparison of Medial and Lateral Meniscus Root Tears.

    Directory of Open Access Journals (Sweden)

    Ji Hyun Koo

    Full Text Available The meniscus root plays an essential role in maintaining the circumferential hoop tension and preventing meniscal displacement. Studies on meniscus root tears have investigated the relationship of osteoarthritis and an anterior cruciate ligament tear. However, few studies have directly compared the medial and lateral root tears. To assess the prevalence of meniscal extrusion and its relationship with clinical features in medial and lateral meniscus root tears, we performed a retrospective review of the magnetic resonance imaging (MRI results of 42 knee patients who had meniscus posterior horn root tears and who had undergone arthroscopic operations. The presence of meniscal extrusion was evaluated and the exact extent was measured from the tibial margin. The results were correlated with arthroscopic findings. Clinical features including patients' ages, joint abnormalities, and previous trauma histories were evaluated. Twenty-two patients had medial meniscus root tears (MMRTs and twenty patients had lateral meniscus root tears (LMRTs. Meniscal extrusion was present in 18 MMRT patients and one LMRT patient. The mean extent of extrusion was 4.2mm (range, 0.6 to 7.8 in the MMRT group and 0.9mm (range, -1.9 to 3.4 in the LMRT group. Five patients with MMRT had a history of trauma, while 19 patients with LMRT had a history of trauma. Three patients with MMRT had anterior cruciate ligament (ACL tears, while 19 patients with LMRT had ACL tears. The mean age of the patients was 52 years (range: 29-71 years and 30 years (range: 14-62 years in the MMRT and LMRT group, respectively. There was a significant correlation between a MMRT and meniscal extrusion (p<0.0001, and between an ACL tear and LMRT (p<0.0001. A history of trauma was significantly common in LMRT (p<0.0001. LMRT patients were significantly younger than MMRT patients (p<0.0001. Kellgren-Lawrence (K-L grade differed significantly between MMRT and LMRT group (p<0.0001. Meniscal extrusion is

  1. Evaluation of Oxford instability shoulder score, Western Ontario shoulder instability Index and Euroqol in patients with slap (superior labral anterior posterior) lesions or recurrent anterior dislocations of the shoulder

    OpenAIRE

    Skare, Øystein; Liavaag, Sigrud; Reikerås, Olav; Mowinckel, Petter; Brox, Jens Ivar

    2013-01-01

    Background Having an estimate of the measurement error of self-report questionnaires is important both for assessing follow-up results after treatment and when planning intervention studies. Specific questionnaires have been evaluated for patients with shoulder instability, but not in particular for patients with SLAP (superior labral anterior posterior) lesions or recurrent dislocations. The aim of this study was to evaluate the agreement, reliability, and validity of two commonly questionna...

  2. Evaluation of Medial Acetabular Wall Bone Stock in Patients with Developmental Dysplasia of the Hip Using a Helical Computed Tomography Multiplanar Reconstruction Technique

    Energy Technology Data Exchange (ETDEWEB)

    Rui Yu Liu; Kun Zheng Wang; Chun Sheng Wang; Xiao Qian Dang; Zhi Qin Tong (Second Hospital Affiliated to the Medical College of Xi' an Jiaotong Univ., Xi' an Shaanxi (China))

    2009-08-15

    Background: The technique of medialization has been used to reconstruct acetabula at the level of true acetabula in total hip arthroplasty (THA) in patients with developmental dysplasia of the hip (DDH). Appreciation of the bone stock in the medial acetabular wall is significant for making an optimal acetabular reconstruction plan and avoiding complications. Purpose: To evaluate the bone stock of the medial acetabular wall and its relation to the degree of subluxation in patients with DDH using computed tomography (CT). Material and Methods: Helical CT scans of 27 hips were obtained from 21 patients with osteoarthritis secondary to DDH who were scheduled for total hip arthroplasty. Eleven hips belonged to Crowe class I, while 16 hips belonged to Crowe class II/III. The raw CT data were reprocessed in various planes by scrolling multiplanar reformation (MPR). Acetabular opening, depth, and medial bone stock, as indicated by the minimum thickness of the medial acetabular wall, were measured in the transverse reformed MPR plane. Results: The minimum thicknesses of the medial acetabular wall in Crowe-I and Crowe-II/III hips were 3.8+-2.1 mm and 7.1+-3.1 mm, respectively, with statistically significant differences between the groups (P<0.05). Furthermore, the bone stock in the medial acetabular wall correlated with the degree of subluxation (R=0.69) and the acetabular depth (R= ;- ;0.71). Conclusion: There was significantly more bone stock in the medial acetabular wall in patients with higher-degree subluxation than there was in the less-severe class. This difference should be taken into consideration when reconstructing acetabula in THA in patients with DDH using the technique of medialization

  3. Predictive MRI correlates of lesser metatarsophalangeal joint plantar plate tear

    Energy Technology Data Exchange (ETDEWEB)

    Umans, Rachel L. [Cornell University Medical College, New York, NY (United States); Umans, Benjamin D. [Harvard University, Cambridge, MA (United States); Umans, Hilary [Albert Einstein College of Medicine, Bronx, NY (United States); Lenox Hill Radiology and Imaging Associates, New York, NY (United States); Elsinger, Elisabeth [Albert Einstein College of Medicine, Bronx, NY (United States); Montefiore Medical Center, Bronx, NY (United States)

    2016-07-15

    To identify correlated signs on non-enhanced MRI that might improve diagnostic detection of plantar plate (PP) tear. We performed an IRB-approved, HIPAA-compliant retrospective analysis of 100 non-contrast MRI (50 PP tear, 50 controls). All were anonymized, randomized, and reviewed; 20 were duplicated to assess consistency. One musculoskeletal radiologist evaluated qualitative variables. A trained non-physician performed measurements. Consistency and concordance were assessed. Pearson's Chi-square test was used to test the correlation between qualitative findings and PP tear status. Correlation between measurements and PP status was assessed using t tests and Wilcoxon's rank-sum test (p values < 0.05 considered significant). Classification and regression trees were utilized to identify attributes that, taken together, would consistently distinguish PP tear from controls. Quantitative measurements were highly reproducible (concordance 0.88-0.99). Elevated 2nd MT protrusion, lesser MT supination and rotational divergence of >45 between the 1st-2nd MT axis correlated with PP tear. Pericapsular soft tissue thickening correlated most strongly with PP tear, correctly classifying 95 % of cases and controls. Excluding pericapsular soft tissue thickening, sequential assessment of 2nd toe enthesitis, 2nd flexor tendon subluxation, and splaying of the second and third toes accurately classified PP status in 92 %. Pericapsular soft tissue thickening most strongly correlated with PP tear. For cases in which it might be difficult to distinguish pericapsular fibrosis from neuroma, sequential assessment of 2nd toe enthesitis, flexor tendon subluxation and splaying of the 2nd and 3rd toe is most helpful for optimizing accurate diagnosis of PP tear. (orig.)

  4. Endoscopic Treatment of Gluteus Medius Tears: A Review.

    Science.gov (United States)

    Lerebours, Frantz R; Cohn, Randy; Youm, Thomas

    2016-03-01

    Greater trochanteric pain syndrome (GTPS) is a term used to describe disorders of the peritrochanteric region. This constellation of conditions includes greater trochanteric bursitis, gluteus medius (GM) tears, and external coxa saltans or snapping hip syndrome. Tears of the abductor mechanism, more specifically gluteus medius tears, have recently gained a considerable amount of interest in the orthopaedic literature. Abductor tears were first described by Bunker and Kagan in the late 1990s. They used the rotator cuff as an analogous structure to describe the pathological process associated with gluteus medius tears. Tears of the gluteus medius tendon can often be difficult to recognize. The clinical presentation is often attributed to trochanteric bursal inflammation, without any further workup. Provocative hip physical examination findings are an important key to proper diagnosis of abductor injuries. Depending on the size of the tear, patients with abductor tendon pathology may present with a Trendelenburg gait and reduced resisted abduction strength accompanied by pain. Initial noninvasive management of greater trochanteric pain syndrome includes oral or topical anti-inflammatory medication and activity modification. Physical therapy or other treatment modalities can be considered, with a focus on core strengthening, truncal alignment, and iliotibial band stretching. Gluteus medius tears have historically been repaired in an open fashion; however, the advent of new endoscopic surgery techniques has allowed for a less invasive approach. Access to the peritrochanteric space affords the surgeon with access to pathology associated with the greater trochanter, iliotibial band, trochanteric bursa, sciatic nerve, short external-rota tors, iliopsoas tendon, and the gluteus medius and minimus tendon attachments. Over the last decade, we have seen rapid technological advances in hip arthroscopy, improved diagnostic imaging and interpretation, and an improved

  5. Percutaneous Fixation of Anterior Column Acetabular Fracture in a Renal Transplant Recipient

    Directory of Open Access Journals (Sweden)

    Halil Ceylan

    2013-01-01

    Full Text Available Renal transplantation, performed per million population, ranges from 30 to 60 in developed countries. The transplanted kidney is generally placed in iliac fossa; therefore the treatment procedure of the pelvic trauma in these patients should be selected carefully. The gold standard technique for the treatment of displaced acetabulum fractures is open reduction and internal fixation. Our patient had received a living-related-donor renal transplant due to chronic renal failure. In the second year of transplantation, she had been injured in a motor-vehicle accident, and radiographs showed a right acetabular anterior column fracture and left pubic rami fractures. The patient was treated with percutaneous fixation techniques and at one year of postoperative period there was no evidence of degenerative signs and the clinical outcome was good. Beside having the advantage of avoiding dissection through the iliac fossa by the standard ilioinguinal approach, percutaneous techniques, with shorter surgical time, decreasing soft tissue disruption, and the potential for early discharge from hospital might be ideal for a renal transplant recipient carrying a higher risk of infection. Percutaneous fixation of selected acetabular fractures in a renal transplant recipient would presumably have the potential to decrease the morbidity associated with traditional open surgical procedures.

  6. Meniscal Tear Film Fluid Dynamics Near Marx’s Line

    KAUST Repository

    Zubkov, V. S.

    2013-07-03

    Extensive studies have explored the dynamics of the ocular surface fluid, though theoretical investigations are typically limited to the use of the lubrication approximation, which is not guaranteed to be uniformly valid a-priori throughout the tear meniscus. However, resolving tear film behaviour within the meniscus and especially its apices is required to characterise the flow dynamics where the tear film is especially thin, and thus most susceptible to evaporatively induced hyperosmolarity and subsequent epithelial damage. Hence, we have explored the accuracy of the standard lubrication approximation for the tear film by explicit comparisons with the 2D Navier-Stokes model, considering both stationary and moving eyelids. Our results demonstrate that the lubrication model is qualitatively accurate except in the vicinity of the eyelids. In particular, and in contrast to lubrication theory, the solution of the full Navier-Stokes equations predict a distinct absence of fluid flow, and thus convective mixing in the region adjacent to the tear film contact line. These observations not only support emergent hypotheses concerning the formation of Marx\\'s line, a region of epithelial cell staining adjacent to the contact line on the eyelid, but also enhance our understanding of the pathophysiological consequences of the flow profile near the tear film contact line. © 2013 Society for Mathematical Biology.

  7. Precision of radiostereometric analysis (RSA) of acetabular cup stability and polyethylene wear improved by adding tantalum beads to the liner

    DEFF Research Database (Denmark)

    Nebergall, Audrey K; Rader, Kevin; Palm, Henrik;

    2015-01-01

    Background and purpose - In traditional radiostereometric analysis (RSA), 1 segment defines both the acetabular shell and the polyethylene liner. However, inserting beads into the polyethylene liner permits employment of the shell and liner as 2 separate segments, enabling distinct analysis of th...

  8. Reliability of ultrasonographic measurements in suspected patients of developmental dysplasia of the hip and correlation with the acetabular index

    Directory of Open Access Journals (Sweden)

    Cem Copuroglu

    2011-01-01

    Full Text Available Background: Ultrasonography is accepted as a useful imaging modality in the early detection of developmental dysplasia of the hip (DDH. Early detection and early treatment of DDH prevents hip dislocation and related physical, social, economic, and psychological problems. The purpose of this study was to evaluate the reliability of ultrasonographic and roentgenographic measurements measured by seven different observers. Materials and Methods: The alpha angles of 66 hips in 33 patients were measured using the Graf method by seven different observers. Acetabular index degrees on plane roentgenograms were measured in order to assess the correlation between the ultrasonographic alpha angle and the radiographic acetabular index, which both show the bony acetabular depth, retrospectively. Results: The interclass correlation coefficient, measuring the interobserver reliability, was high and statistically significant for the ultrasonographic measurements. There was a negative correlation between the alpha angle and the acetabular index. Conclusions: Ultrasonography, when applied properly, is a reliable technique between different observers, in the diagnosis and follow up of DDH. When assessed concomitantly with the roentgenographic measurements, the results are reliable and statistically meaningful.

  9. Tearing Mode Stability of Evolving Toroidal Equilibria

    Science.gov (United States)

    Pletzer, A.; McCune, D.; Manickam, J.; Jardin, S. C.

    2000-10-01

    There are a number of toroidal equilibrium (such as JSOLVER, ESC, EFIT, and VMEC) and transport codes (such as TRANSP, BALDUR, and TSC) in our community that utilize differing equilibrium representations. There are also many heating and current drive (LSC and TORRAY), and stability (PEST1-3, GATO, NOVA, MARS, DCON, M3D) codes that require this equilibrium information. In an effort to provide seamless compatibility between the codes that produce and need these equilibria, we have developed two Fortran 90 modules, MEQ and XPLASMA, that serve as common interfaces between these two classes of codes. XPLASMA provides a common equilibrium representation for the heating and current drive applications while MEQ provides common equilibrium and associated metric information needed by MHD stability codes. We illustrate the utility of this approach by presenting results of PEST-3 tearing stability calculations of an NSTX discharge performed on profiles provided by the TRANSP code. Using the MEQ module, the TRANSP equilibrium data are stored in a Fortran 90 derived type and passed to PEST3 as a subroutine argument. All calculations are performed on the fly, as the profiles evolve.

  10. Comparative study of lubricating properties of tear substitutes Systane® Ultra and Visine® Clear Tears

    Directory of Open Access Journals (Sweden)

    Yu. A. Pavlova

    2014-07-01

    Full Text Available Purpose: To compare tear substitutive properties of Systane® Ultra and Visine® Clear Tears in dry eye therapy.Methods: 20 patients with dry eye due to chronic blepharoconjunctivitis and 20 patients with neurotrophic dry eye following corneal refractive surgery were examined. Treatment schedule was the following: in the first 7 days, Systane® Ultra was instilled in the right eye and Visine® Clear Tears was instilled in the left eye, while from day 8 to day 30, only one medicine selected by the patient was applied. Their efficacy was measured by tear film stability and patients’ subjective sensations.Results: Norn test results improved to day 7 in patients with dry eye following corneal refractive surgery and to day 30 in patients with dry eye due to blepharoconjunctivitis regardless of eye drops used. As to patients’ comfort, Systane® Ultra is preferable to Visine® Clear Tears.Conclusion: Systane® Ultra is therapeutically similar to but preferable to Visine® Clear Tears due to good tolerability.

  11. 关节镜下修复肩关节V型从前到后上盂唇损伤的临床效果%Clinical effect of arthroscopic repair on V type superior labral anterior posterior lesions

    Institute of Scientific and Technical Information of China (English)

    魏民; 刘玉杰; 李众利; 王志刚; 蔡谞; 朱娟丽; 刘洋

    2013-01-01

    Objective To observe the clinical effect of arthroscopic repair on V type superior labral anterior posterior lesions. Methods Sixteen patients with V type superior labral anterior posterior lesions admitted to our hospital from March 2008 to December 2010 served as an experimental group and 16 patients with Bankart lesions served as a control group in this study. Their labral lesions were repaired by arthroscopy with absorbable lines. Their pain was scored according to the visual analogue scale (VAS) and their shoulder joint function was assessed according to the American Shoulder and Elbow Surgeons (ASES) Scoring System and the Rowe Shoulder Scoring System, respectively. Results The VAS, ASES and Rowe scores were higher in the two groups after operation than before operation (P0.05). Conclusion Arthroscopic repair with absorbable line can achieve satisfactory clinical outcomes in patients with should joint dislocation due to V type superior labral anterior posterior lesions.%目的:观察关节镜下对V型从前到后上盂唇损伤(superior labral anterior to posterior,SLAP)的复发性肩关节前脱位修复的临床疗效。方法收集我单位2008年3月-2010年12月V型SLAP损伤患者16例,选取同期单纯Bankart损伤病例16例作为对照组。在关节镜下采用可吸收带线锚钉修复盂唇。采用视觉模拟评分(visual analogue scale,VAS)评价疼痛,美国肩肘外科协会(American Shoulder and Elbow Surgeons,ASES)评分系统和Rowe肩关节评分系统评价关节功能。结果两组患者术后VAS评分、ASES评分和Rowe评分均优于术前(P<0.05),没有脱位复发。两组患者术后结果的差异无统计学意义(P>0.05)。结论对V型SLAP损伤的复发性肩关节前脱位,采用可吸收带线锚钉进行修复可获得良好的临床效果。

  12. Arthroscopic Superior Capsule Reconstruction for Irreparable Rotator Cuff Tears

    Science.gov (United States)

    Mihata, Teruhisa; Lee, Thay Q.; Itami, Yasuo; HASEGAWA, Akihiko; Ohue, Mutsumi; Neo, Masashi

    2016-01-01

    Objectives: An arthroscopic superior capsule reconstruction, in which the fascia lata autograft attached medially to the superior glenoid and laterally to the greater tuberosity, restores shoulder stability and muscle balance in patients with irreparable rotator cuff tears; consequently, it improves shoulder function specifically deltoid muscle function and relieves pain. We assessed the clinical outcome of arthroscopic superior capsule reconstruction (Figure 1) in 100 consecutive patients with irreparable rotator cuff tears. Specifically, we focused on the rates of return to sport and work. Methods: From 2007 to 2014, we performed arthroscopic superior capsule reconstruction on 107 consecutive patients (mean 66.7 years; range, 43 to 82) with irreparable rotator cuff tears that had failed conservative treatment. Seven patients were lost to follow-up because of other medical problems or reasons. In the remaining 100 patients there were 56 supraspinatus and infraspinatus tears; 39 supraspinatus, infraspinatus, and subscapularis tears; 3 supraspinatus, infraspinatus, teres minor, and subscapularis tears; and 2 supraspinatus, infraspinatus, and teres minor tears. Physical examination, radiography, and MRI were performed before surgery; at 3, 6, and 12 months after surgery; and yearly thereafter. Rates of return to sport and work were also investigated in those patients who had been employed (34 patients: 21 manual workers, 10 farmers, 1 butcher, 1 cook, and 1 athletic trainer) or played sport (26 patients: 6 golf, 4 table tennis, 4 swimming, 3 martial arts, 2 baseball, 2 yoga, 1 tennis, 1 badminton, 1 skiing, 1 mountain-climbing, and 1 ground golf) before injury. Results: The average preoperative American Shoulder and Elbow Surgeons (ASES) score was 31.6 points (range, 3.3 to 63.3 points) and the average Japanese Orthopaedic Association (JOA) score was 51.6 points (26.5 to 68.5 points). Average postoperative clinical outcome scores all improved significantly at final

  13. Glycan involvement in the adhesion of Pseudomonas aeruginosa to tears.

    Science.gov (United States)

    Kautto, Liisa; Nguyen-Khuong, Terry; Everest-Dass, Arun; Leong, Andrea; Zhao, Zhenjun; Willcox, Mark D P; Packer, Nicolle H; Peterson, Robyn

    2016-04-01

    The human eye is constantly bathed by tears, which protect the ocular surface via a variety of mechanisms. The O-linked glycans of tear mucins have long been considered to play a role in binding to pathogens and facilitating their removal in the tear flow. Other conjugated glycans in tears could similarly contribute to pathogen binding and removal but have received less attention. In the work presented here we assessed the contribution of glycan moieties, in particular the protein attached N-glycans, presented by the broad complement of tear proteins to the adhesion of the opportunistic pathogen Pseudomonas aeruginosa, a leading cause of microbial keratitis and ulceration of the cornea. Our adhesion assay involved immobilising the macromolecular components of tears into the wells of a polyvinyl difluoride (PVDF) microtitre filter plate and probing the binding of fluorescently labelled bacteria. Three P. aeruginosa strains were studied: a cytotoxic strain (6206) and an invasive strain (6294) from eye infections, and an invasive strain (320) from a urinary tract infection (UTI). The ocular isolates adhered two to three times more to human tears than to human saliva or porcine gastric mucin, suggesting ocular niche-specific adaptation. Support for the role of the N-glycans carried by human tear proteins in the binding and removal of P. aeruginosa from the eye was shown by: 1) pre-incubation of the bacteria with free component sugars, galactose, mannose, fucose and sialyl lactose (or combination thereof) inhibiting adhesion of all the P. aeruginosa strains to the immobilised tear proteins, with the greatest inhibition of binding of the ocular cytotoxic 6206 and least for the invasive 6294 strain; 2) pre-incubation of the bacteria with N-glycans released from the commercially available human milk lactoferrin, an abundant protein that carries N-linked glycans in tears, inhibiting the adhesion to tears of the ocular bacteria by up to 70%, which was significantly more

  14. Inter- and intraobserver variability of MR arthrography in the detection and classification of superior labral anterior posterior (SLAP) lesions: evaluation in 78 cases with arthroscopic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Holzapfel, Konstantin; Waldt, Simone; Bruegel, Melanie; Rummeny, Ernst J.; Woertler, Klaus [Technische Universitaet Muenchen, Department of Radiology, Klinikum rechts der Isar, Munich (Germany); Paul, Jochen; Imhoff, Andreas B. [Technische Universitaet Muenchen, Department of Sports Orthopedics, Klinikum rechts der Isar, Munich (Germany); Heinrich, Petra [Technische Universitaet Muenchen, Institute of Medical Statistics and Epidemiology, Klinikum rechts der Isar, Munich (Germany)

    2010-03-15

    The purpose of this study was to determine inter- and intraobserver variability of MR arthrography of the shoulder in the detection and classification of superior labral anterior posterior (SLAP) lesions. MR arthrograms of 78 patients who underwent MR arthrography before arthroscopy were retrospectively analysed by three blinded readers for the presence and type of SLAP lesions. MR arthrograms were reviewed twice by each reader with a time interval of 4 months between the two readings. Inter- and intraobserver agreement for detection and classification of SLAP lesions were calculated using {kappa} coefficients. Arthroscopy confirmed 48 SLAP lesions: type I (n = 4), type II (n = 37), type III (n = 3), type IV (n = 4). Sensitivity and specificity for detecting SLAP lesions with MR arthrography for each reader were 88.6%/93.3%, 90.9%/80.0% and 86.4%/76.7%. MR arthrographic and arthroscopic grading were concurrent for 72.7%, 68.2% and 70.5% of SLAP lesions for readers 1-3, respectively. Interobserver agreement was excellent ({kappa} = 0.82) for detection and substantial ({kappa} = 0.63) for classification of SLAP lesions. For each reader intraobserver agreement was excellent for detection ({kappa} = 0.93, {kappa} = 0.97, {kappa} = 0.97) and classification ({kappa} = 0.94, {kappa} = 0.84, {kappa} = 0.93) of SLAP lesions. MR arthrography allows reliable and accurate detection of SLAP lesions. In addition, SLAP lesions can be diagnosed and classified with substantial to excellent inter- and intraobserver agreement. (orig.)

  15. Acetabular deepening in the treatment of severe canine hip dysplasia Aprofundamento do acetábulo no tratamento de displasia coxofemoral grave em cães

    OpenAIRE

    Paulo Iamaguti; Luciana S. Iamaguti; Raquel Sartor

    2009-01-01

    A technique to restore acetabular anatomy by deepening the acetabular cavity and reconstructing the femoral head ligament and the joint capsule was tested on nine large breed dogs with severe hip dysplasia and acute subdislocation or dislocation. The technique consisted of two phases. First, all dogs were submitted to bilateral pectinotomy. In a second surgical intervention on the same dogs the acetabulum was approached and deepened, and the femoral head ligament and the joint capsule were re...

  16. Impact of Cigarette Smoking on Tear Function and Correlation between Conjunctival Goblet Cells and Tear MUC5AC Concentration in Office Workers.

    Science.gov (United States)

    Uchino, Yuichi; Uchino, Miki; Yokoi, Norihiko; Dogru, Murat; Kawashima, Motoko; Komuro, Aoi; Sonomura, Yukiko; Kato, Hiroaki; Argüeso, Pablo; Kinoshita, Shigeru; Tsubota, Kazuo

    2016-01-01

    The first aim of this study was to clarify whether cigarette smoking affects tear secretion, goblet cell density, and tear MUC5AC concentration. The second purpose was to evaluate the correlations of conjunctival goblet cell density with tear MUC5AC concentration and other ocular surface evaluation factors. This cross-sectional study included 88 office workers. All subjects were required to fill in dry eye and smoking questionnaires, in addition to ocular surface evaluation. Tear wash fluid was collected from inferior fornix, and conjunctival epithelium was obtained by impression cytology. Tear MUC5AC concentration was quantified using enzyme-linked immunoassay, and conjunctival goblet cell density was counted after Periodic-acid Schiff staining. Tear MUC5AC concentration had significant positive correlation with conjunctival goblet cell density (r = 0.181, P = 0.03). In current smokers, Schirmer I test value, goblet cell density and tear MUC5AC concentration were significantly lower than non-smokers. Pack-years of smoking have significant negative correlation with goblet cell density (r = -0.174, P = 0.036) and tear MUC5AC concentration (r = -0.183, P = 0.028). We concluded that smoking might decrease tear secretion, goblet cell density and tear MUC5AC concentration. In addition, MUC5AC concentration in tears depends on goblet cell density in the conjunctiva among office workers. PMID:27297822

  17. Tearing resistance of some co-polyester sheets

    International Nuclear Information System (INIS)

    A three-zone model consisting of initial, evolutionary and stabilised plastic zones for tearing resistance was proposed for polymer sheets. An analysis with the model, based on the essential work of fracture (EWF) approach, was demonstrated to be capable for predicting specific total work of fracture along the tear path across all the plastic zones although accuracy of specific essential work of fracture is subject to improvement. Photo-elastic images were used for identification of plastic deformation sizes and profiles. Fracture mode change during loading was described in relation with the three zones. Tearing fracture behaviour of extruded mono- and bi-layer sheets of different types of amorphous co-polyesters and different thicknesses was investigated. Thick material exhibited higher specific total work of tear fracture than thin mono-layer sheet in the case of amorphous polyethylene terephthalate (PET). This finding was explained in terms of plastic zone size formed along the tear path, i.e., thick material underwent larger plastic deformation than thin material. When PET and polyethylene terephthalate glycol (PETG) were laminated with each other, specific total work of fracture of the bi-layer sheets was not noticeably improved over that of the constituent materials

  18. Tear trough deformity: review of anatomy and treatment options.

    Science.gov (United States)

    Stutman, Ross L; Codner, Mark A

    2012-05-01

    The lower eyelid can be a challenging area in facial rejuvenation. While lower eyelid bags are commonly the reason that patients present for lower eyelid rejuvenation, a separate entity known as a tear trough deformity may occur in conjunction with lower eyelid bags or alone. In this article, the authors outline the current understanding of the tear trough anatomy; describe multiple classification systems, which provide an objective means of evaluating the deformity and aid the surgeon in choosing appropriate treatment options; and review surgical and nonsurgical techniques for correcting the tear trough deformity. Treatment options include hyaluronic acid filler, fat grafting, skeletal implants, and fat transposition. Each procedure is associated with advantages and disadvantages, and each should be considered more complex than traditional lower blepharoplasty alone. While lower blepharoplasty removes excess fat and may tighten the anterior lamella, tear trough procedures require the addition of volume to the underlying depression. These procedures requiring release of the ligamentous structures and orbicularis (of which the tear trough is composed), as well as fat transposition or fat grafting, are associated with additional complications, which are also reviewed. PMID:22523096

  19. Preference direction study of Job’s-tears ice cream

    Directory of Open Access Journals (Sweden)

    Wiwat Wangcharoen

    2007-09-01

    Full Text Available Job's-tears (Coix lachryma-jobi L. is a kind of cereal commonly used in Asia as food and medicine, but it is still not widely consumed in Thailand. Four prototype products of Job’s-tears ice cream were developed by varying 2 levels of glucose syrup (16 and 32% of Job's-tears used and coconut milk (50 and 100 % of Job's-tears used. Their sensory attribute profiles were evaluated by 3 groups of 10 selected panelists using Ratio profile test (RPT, and their acceptances, hedonic scores, were evaluated by 100 consumers. Results showed that there were significant effects of coconut milk quantity on several attributes, such as appearance (whiteness, texture (hardness, smoothness, and flavour (coconut milk aroma, sweetness, saltiness, but the effect of glucose syrup quantity was significant on hardness only. Acceptance data were analyzed by cluster analysis to find out the difference of preference directions and 3 clusters (n1 = 39, n2 = 25, n3 = 36 were found. The first cluster preferred Job's tears ice cream containing high glucose syrup and low coconut milk, whilst the second preferred high level of only one of these two ingredients, and the third preferred high level of both ingredients. External preference maps were created from RPT and acceptance data to express the preference direction of each cluster.

  20. MAGNETIC RESONANCE IMAGING EVALUATION OF LIGAMENTOUS TEARS OF THE KNEE JOINT AND ASSOCIATION OF MENISCAL TEARS WITH ANTERIOR CRUCIATE LIGAMENT TEARS

    Directory of Open Access Journals (Sweden)

    Bommandapalli Madhaiah

    2016-05-01

    Full Text Available Anterior cruciate ligament tears are most commonly sustained sports injury, often occurring in association with meniscal tears and trauma to other ligamentous structures around the knee. Magnetic resonance imaging is vital in assessing acute knee injuries and plays an important role in deciding treatment options and planning surgical intervention. Magnetic Resonance (MR imaging has emerged as investigation of choice to evaluate the status of the ACL and other associated structures in the knee. AIMS AND OBJECTIVES The purpose of this study is to determine the association of subtle meniscal injury in the presence of anterior cruciate ligament injury and other associated pathology on MR imaging. MATERIAL AND METHODS A prospective cross-sectional case study done on 40 patients including both the sexes in age group of 15 to 35 years presenting with knee joint injuries and subsequently underwent MRI of the knee joint. The data was analysed and the findings on MRI were correlated with that of arthroscopy and/or operative findings. RESULTS The commonest soft tissue injury identified on MRI of the knee joint was ACL injury and it was associated with injuries of medial meniscus followed by of lateral meniscus, medial collateral ligament and lateral collateral ligament. CONCLUSION MRI is an excellent, non-invasive, radiation free imaging modality with multiplanar capabilities and excellent soft tissue delineation. It can accurately detect, localize and characterize various internal derangements of the knee joint and help in arriving at a correct anatomical diagnosis, thereby guiding further management of the patient. Medial meniscal tears were more commonly associated with ACL tear. Various patterns of meniscal injuries were identified in this study, out of which bucket handle pattern was more common among medial meniscal tears and radial pattern was common in the lateral meniscal injuries. Radiologists while interpreting MR studies of knee injuries

  1. Polyethylene sterilized without irradiation in a polished uncemented acetabular component-a clinical and radiographic analysis.

    Science.gov (United States)

    Crockarell, John R

    2008-09-01

    Clinical and radiographic analysis of the Reflection uncemented acetabular component was performed. Features of this component include a polished inner shell and ethylene oxide sterilization. Clinical information was available for 158 hips (mean, 4.6 years follow-up). A total of 19 hips have undergone or were recommended revision, 8 for aseptic loosening or wear (5%). Wear analysis was performed for 38 hips with more than 5 years of follow-up (mean, 6.7 years). Osteolysis was present in 20 of these patients. Penetration rate averaged 0.15 mm/y. Patients with uncemented femoral fixation (vs cemented) had a significantly higher penetration rate. Increased volumetric wear was seen with uncemented femoral fixation, thin liners, and ceramic heads. This component demonstrated relatively high penetration and osteolysis rates. Continued surveillance is recommended, particularly for active patients with thin liners. PMID:18534518

  2. A Feasibility Study into the Use of Three-Dimensional Printer Modelling in Acetabular Fracture Surgery

    Directory of Open Access Journals (Sweden)

    A. W. Yu

    2015-01-01

    Full Text Available There are a number of challenges associated with the operative treatment of acetabular fractures. The approach used is often extensive, while operative time and perioperative blood loss can also be significant. With the proliferation of 3D printer technology, we present a fast and economical way to aid the operative planning of complex fractures. We used augmented stereoscopic 3D CT reconstructions to allow for an appreciation of the normal 3D anatomy of the pelvis on the fractured side and to use the models for subsequent intraoperative contouring of pelvic reconstruction plates. This leads to a reduction in the associated soft tissue trauma, reduced intraoperative time and blood loss, minimal handling of the plate, and reduced fluoroscopic screening times. We feel that the use of this technology to customize implants, plates, and the operative procedure to a patient’s unique anatomy can only lead to improved outcomes.

  3. Precooling an acetabular liner makes its insertion into a metal shell easier.

    Science.gov (United States)

    Kyle, Richard F; Bourgeault, Craig A; Lew, William D; Bechtold, Joan E

    2006-02-01

    Temporary shrinkage of an acetabular polyethylene liner due to precooling could reduce the force required to snap the liner into its metal shell. This study documented cooling and heating rates of liners with a particular locking mechanism design, determined forces required to seat liners in their shells as a function of temperature, and quantified the force surgeons can exert with their thumbs when seating a liner. It took up to 8 minutes to cool 58- and 70-mm liners in an ice-water bath from room temperature to near 0 degrees C, and up to 24 minutes to subsequently warm these liners to near body temperature. Forces required to seat liners were greater at room and body temperatures than at 0 degrees C. Liners precooled to 0 degrees C required insertion forces that could be generated manually by surgeons. PMID:16520215

  4. Tranexamic acid reduces the blood loss and blood transfusion requirements following peri-acetabular osteotomy.

    Science.gov (United States)

    Wassilew, G I; Perka, C; Janz, V; Krämer, M; Renner, L

    2015-12-01

    We have investigated the effect of using tranexamic acid (TXA) during peri-acetabular osteotomy (PAO) on peri-operative blood loss and blood transfusion requirements. In addition we analysed whether the use of TXA was associated with an increased risk of venous thromboembolism (VTE) following this procedure. A consecutive series of 96 PAOs, performed by a single surgeon, were reviewed. A total of 48 patients received TXA and 48 did not. The TXA group received a continuous infusion of TXA at a rate of 10 mg/kg/h. The primary outcome measure was the requirement for blood transfusion. Secondary outcomes included total blood loss, the decrease in the level of haemoglobin in the blood, the length of hospital stay, and the complications of this treatment. The mean rate of transfusion was significantly lower in the TXA group (62.5% vs 12.5%, p transfusion after PAO significantly, without adverse effects such as an increased rate of VTE.

  5. Simultaneous bilateral shoulder and bilateral central acetabular fracture dislocation: What to do?

    Institute of Scientific and Technical Information of China (English)

    Hardik Sheth; Abhijeet Ashok Salunke; Ramesh Panchal; Jimmy Chokshi; G.I.Nambi; Saranjeet Singh; Amit Patel

    2016-01-01

    Musculoskeletal injuries following seizures have a high morbidity and mortality.These injuries are often missed and the diagnosis is delayed due to a lack of clinical suspicion and appropriate investigations.We report a case of 72 years old male with simultaneous bilateral central acetabular fracture dislocation and bilateral posterior shoulder fracture dislocation secondary to an epileptic seizure.Present study highlights the significance of clinical suspicion and clinico-radiological evaluation for diagnosis of a rare injury following episode of seizures.Simultaneous fracture dislocation of all four limbs treated with a holistic approach can lead to a good functional recovery.Surgical management with open reduction and internal fixation is preferred and replacement arthroplasty should be reserved for cases with implant failure and elderly patients.

  6. Research on Transverse Acetabular Fracture Fixation Using Different Plate Attachment Methods

    Directory of Open Access Journals (Sweden)

    Gediminas Gaidulis

    2015-03-01

    Full Text Available The article deals with the problem of transverse acetabular fracture fixation using different plate attachment methods. A 3D model of pelvis and hip joint structure was created and the design of three different fixation plates using SolidWorks was made. The plates were fixed at distances of 10, 20 and 30 mm from the acetabulum. The model was meshed into finite elements, a static external load of 2500 N was added and the analysis of stress distribution in plates and fracture displacement was performed. The obtained results showed that fracture displacement was quite similar in all fixation methods. However, the maximal stress in the nearest from the acetabulum plate was higher than yield strength. Thus, this placement is not eligible. The plate fixed at a distance of 30 mm from the acetabulum appeared the most suitable because of the smallest and symmetrical stress distribution in the plate.

  7. 髋臼发育不良髋关节置换前髋臼侧的三维测量%Three-dimensional measurement of acetabular side before arthroplasty for acetabular dysplasia

    Institute of Scientific and Technical Information of China (English)

    许杰; 马若凡; 李登; 蔡志清; 李亮平

    2013-01-01

    BACKGROUND:The anatomical strucure of acetabulum is smal and shal ow in adult acetabular dysplasia patients. The large amount of cal us and scar tissues in the acetabulum make it difficult to identify and instal the acetabular cup during arthroplasty. The comprehensive understanding of the acetabulum before arthroplasty is the premise for selecting the appropriate acetabular prosthesis and making the acetabular reconstruction program. OBJECTIVE:To evaluate the application value of three-dimensional reconstruction technique in choosing the size of acetabular cup before total hip arthroplasty for acetabular dysplasia. METHODS:Spiral CT was carried out in the 11 acetabular dysplasia patients who waiting for total hip arthroplasty. The acetabulum was multi-planar reconstructed, and the size of the acetabular cup was determined through digitized acetabular cup template implantation, and then the mathching degree assessment was performed to compare with the actual size. RESULTS AND CONCLUSION:Spiral CT could clearly show the acetabular morphology, and the 71.4%of the acetabular size chosen in the three-dimensional preoperative plan was the same as actual one, the intraclass correlation coefficient was 0.888. The agreement was much higher than that of two-dimensional preoperative plan based on X-ray plain film. For the patients with acetabular dysplasia, the acetabulum became saml er and shal ower, and there were various extents of bone defects in the superior-lateral acetabulum. Three-dimensional multi-planar reconstruction can effectively evaluate the acetabular morphology, and three-dimensional preoperative plan can provide useful information for the choice of implant.%背景:成人髋臼发育不良髋臼小而浅,臼内有大量骨痂和瘢痕组织等都为人工髋关节置换术中真臼的辨认、臼杯的准确安装带来极大困难,关节置换前对髋臼的全面认识是选择合适的髋臼假体和制定个性化髋臼重建方案的前提。目

  8. Acetabular shell deformation as a function of shell stiffness and bone strength.

    Science.gov (United States)

    Dold, Philipp; Pandorf, Thomas; Flohr, Markus; Preuss, Roman; Bone, Martin C; Joyce, Tom J; Holland, James; Deehan, David

    2016-04-01

    Press-fit acetabular shells used for hip replacement rely upon an interference fit with the bone to provide initial stability. This process may result in deformation of the shell. This study aimed to model shell deformation as a process of shell stiffness and bone strength. A cohort of 32 shells with two different wall thicknesses (3 and 4 mm) and 10 different shell sizes (44- to 62-mm outer diameter) were implanted into eight cadavers. Shell deformation was then measured in the cadavers using a previously validated ATOS Triple Scan III optical system. The shell-bone interface was then considered as a spring system according to Hooke's law and from this the force exerted on the shell by the bone was calculated using a combined stiffness consisting of the measured shell stiffness and a calculated bone stiffness. The median radial stiffness for the 3-mm wall thickness was 4192 N/mm (range, 2920-6257 N/mm), while for the 4-mm wall thickness the median was 9633 N/mm (range, 6875-14,341 N/mm). The median deformation was 48 µm (range, 3-187 µm), while the median force was 256 N (range, 26-916 N). No statistically significant correlation was found between shell stiffness and deformation. Deformation was also found to be not fully symmetric (centres 180° apart), with a median angle discrepancy of 11.5° between the two maximum positive points of deformation. Further work is still required to understand how the bone influences acetabular shell deformation.

  9. Outcome of periacetabular osteotomy for the management of acetabular dysplasia: experience in an academic centre.

    LENUS (Irish Health Repository)

    Burke, Neil G

    2011-02-01

    Periacetabular osteotomy (PAO) is a very effective reconstructive procedure for treatment of acetabular dysplasia. An orthopaedic paediatric surgeon and a reconstructive hip arthroplasty surgeon performed this procedure together in the early phase of their learning curve and then performed it individually. The early clinical and radiographic results of 85 consecutive PAOs performed in this academic orthopaedic unit were reviewed. The mean Merle-d\\'Aubigné score increased from 12.4 preoperatively to 16 at follow-up. Pre-operatively 73 hips were anteverted and 12 were neutral or retroverted. The mean angle of Wiberg improved from 5 degrees to 21 degrees (p < 0.0001) in anteverted hips, and from 9 degrees to 30 degrees in neutral or retroverted hips. The mean angle of Lequesne and de Sèze improved from 6 degrees to 35 degrees (p < 0.0001) in anteverted hips, and in neutral or retroverted hips from 9 degrees to 30 degrees (p < 0.0001). The acetabular index improved from 26 degrees to 8 degrees (p < 0.0001) in anteverted hips, and from 21 degrees to 7 degrees (p < 0.0001) in neutral or retroverted hips. Over the 7 year period the blood loss and operative time improved from 2000 ml to 900 ml and 4 hours to 2 hours respectively. Four hips (four patients) required conversion to total hip replacement. The radiographic correction and improved clinical scores are similar to those in previous studies. This study shows a survival rate of 94% at 58 months following periacetabular osteotomy. The learning curve and the early results of this procedure performed in our academic unit are encouraging.

  10. Supra-Acetabular Brown Tumor due to Primary Hyperparathyroidism Associated with Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    Rosaria M. Ruggeri

    2010-01-01

    Full Text Available A 63-year-old woman presented to the Orthopedic Unit of our hospital complaining of right hip pain of 6 months'duration associated with a worsening limp. Her past medical history included chronic renal insufficiency. Physical examination revealed deep pain in the iliac region and severe restriction of the right hip's articular function in the maximum degrees of range of motion. X-rays and CT scan detected an osteolytic and expansive lesion of the right supra-acetabular region with structural reabsorption of the right iliac wing. 99mTc-MDP whole-body bone scan showed an abnormal uptake in the right iliac region. Bone biopsy revealed an osteolytic lesion with multinucleated giant cells, indicating a brown tumor. Serum intact PTH was elevated (1020 pg/ml; normal values, 12 62 pg/ml, but her serum calcium was normal (total = 9.4 mg/dl, nv 8.5–10.5; ionized = 5.0 mg/dl, nv 4.2–5.4 due to the coexistence of chronic renal failure. 99mTc-MIBI scintigraphy revealed a single focus of sestamibi accumulation in the left retrosternal location, which turned out to be an intrathoracic parathyroid adenoma at surgical exploration. After surgical removal of the parathyroid adenoma, PTH levels decreased to 212 pg/ml. Three months after parathyroidectomy, the imaging studies showed complete recovery of the osteolytic lesion, thus avoiding any orthopedic surgery. This case is noteworthy because (1 primary hyperparathyroidism was not suspected due to the normocalcemia, likely attributable to the coexistence of chronic renal failure; and (2 it was associated with a brown tumor of unusual location (right supra-acetabular region.

  11. Partial and complete tear of the anterior cruciate ligament. Direct and indirect MR signs

    International Nuclear Information System (INIS)

    Purpose: To analyze MR direct and indirect signs for knees with anterior cruciate ligament (ACL) partial or complete tear. Material and Methods: According to documented MR direct and indirect signs for ACL tear, we retrospectively reviewed the incidence of those signs in 15 partial ACL tear and 17 complete ACL tear patients. The findings were also compared with duration of injury (less or more than 6 weeks, as acute or chronic stages). Results: A residual straight and tight ACL fiber in at least one pulse sequence was more frequently detected in partial ACL tears. The empty notch sign, a wavy contour of ACL, bone contusion at lateral compartment and lateral meniscus posterior horn tear were significantly more frequently seen in complete tear cases. The posterior cruciate ligament angle in chronic complete ACL tear cases (109 deg ±20 deg) had a tendency to be less than in chronic partial ACL tear cases (119 deg ±18 deg). Conclusion: The empty notch sign, a wavy ACL, bone contusion, and posterior horn of lateral meniscus tears are suggestive of a complete ACL tear. A residual straight and tight ACL fiber seen in at least one image section is a helpful sign to diagnosis of partial ACL tear. In the acute ACL injury stage, a focal increase of the ACL signal intensity is more suggestive of a partial ACL tear

  12. Partial and complete tear of the anterior cruciate ligament. Direct and indirect MR signs

    Energy Technology Data Exchange (ETDEWEB)

    Chen, W.T.; Tu, H.Y.; Chen, R.C. [Taipei Municipal Jen-Ai Hospital, TW (China). Dept. of Radiology; Shih, T.T.F. [Medical College and Hospital, National Taiwan Univ., TW (China). Dept. of Radiology; Shau, W.Y. [The Graduate Inst. of Clinical Medicine, National Taiwan Univ., Taipei, TW (China). Dept. of Radiology

    2002-09-01

    Purpose: To analyze MR direct and indirect signs for knees with anterior cruciate ligament (ACL) partial or complete tear. Material and Methods: According to documented MR direct and indirect signs for ACL tear, we retrospectively reviewed the incidence of those signs in 15 partial ACL tear and 17 complete ACL tear patients. The findings were also compared with duration of injury (less or more than 6 weeks, as acute or chronic stages). Results: A residual straight and tight ACL fiber in at least one pulse sequence was more frequently detected in partial ACL tears. The empty notch sign, a wavy contour of ACL, bone contusion at lateral compartment and lateral meniscus posterior horn tear were significantly more frequently seen in complete tear cases. The posterior cruciate ligament angle in chronic complete ACL tear cases (109 deg {+-}20 deg) had a tendency to be less than in chronic partial ACL tear cases (119 deg {+-}18 deg). Conclusion: The empty notch sign, a wavy ACL, bone contusion, and posterior horn of lateral meniscus tears are suggestive of a complete ACL tear. A residual straight and tight ACL fiber seen in at least one image section is a helpful sign to diagnosis of partial ACL tear. In the acute ACL injury stage, a focal increase of the ACL signal intensity is more suggestive of a partial ACL tear.

  13. Modified arthroscopic double row repair of partial thickness tear of the rotator Cuff involving articular and bursal side

    Directory of Open Access Journals (Sweden)

    Kwon Oh

    2008-01-01

    Full Text Available Partial thickness of rotator cuff tears is considered as a common cause of shoulder disability. Various techniques for arthroscopic repair of partial thickness tear of rotator cuff have been reported in the literature. These techniques have addressed the articular side partial thickness cuff tear. We present an arthroscopic repair of partial thickness tear of rotator cuff involving both articular and bursal surfaces without converting into a full thickness tear. Each side of the tear was repaired with suture anchors separately.

  14. Rotator cuff tears noncontrast MRI compared to MR arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ji Hyun; Yoon, Young Cheol [Sungkyunkwan University, School of Medicine, Department of Radiology, Samsung Medical Center, Gangnam-gu, Seoul (Korea, Republic of); Jung, Jee Young [Chungang University School of Medicine, Department of Radiology, Chungang University Hospital, Seoul (Korea, Republic of); Yoo, Jae Chul [Sungkyunkwan University, School of Medicine, Department of Orthopedic Surgery, Samsung Medical Center, Seoul (Korea, Republic of)

    2015-12-15

    To compare the accuracy of indirect magnetic resonance arthrography and noncontrast magnetic resonance imaging for diagnosing rotator cuff tears. In total, 333 patients who underwent noncontrast magnetic resonance imaging or indirect magnetic resonance arthrography were included retrospectively. Two musculoskeletal radiologists evaluated the images for the presence of supraspinatus-infraspinatus and subscapularis tendon tears. The overall diagnostic performance was calculated using the arthroscopic findings as the reference standard. Statistical differences between the diagnostic performances of the two methods were analyzed. Ninety-six and 237 patients who underwent noncontrast magnetic resonance imaging and indirect magnetic resonance arthrography were assigned into groups A and B, respectively. Sensitivity for diagnosing articular-surface partial-thickness supraspinatus-infraspinatus tendon tear was slightly higher in group B than in group A. Statistical significance was confirmed by multivariate analysis using the generalized estimating equation (p = 0.046). The specificity for diagnosing subscapularis tendon tear (85 % vs. 68 %, p = 0.012) and grading accuracy (57 % vs. 40 %, p = 0.005) was higher in group B than in group A; the differences were statistically significant for one out of two readers. Univariate analysis using the generalized estimating equation showed that the accuracy for diagnosing subscapularis tendon tear in group B was higher than in group A (p = 0.042). There were no statistically significant differences between the diagnostic performances of both methods for any other parameters. Indirect magnetic resonance arthrography may facilitate more accurate diagnosis and grading of subscapularis tendon tears compared with noncontrast magnetic resonance imaging. (orig.)

  15. Arthroscopic Superior Capsule Reconstruction for Irreparable Rotator Cuff Tears.

    Science.gov (United States)

    Petri, Maximilian; Greenspoon, Joshua A; Millett, Peter J

    2015-12-01

    Massive irreparable rotator cuff tears in young patients are a particular challenge for the orthopaedic surgeon. Surgical treatment options include debridement, partial rotator cuff repair, patch-augmented rotator cuff repair, bridging rotator cuff reconstruction with graft interposition, tendon transfer, and reverse total shoulder arthroplasty. Recently, reconstruction of the superior glenohumeral capsule using a fascia lata autograft has been suggested to reduce superior glenohumeral translation and restore superior stability. Promising clinical results have been reported in 1 case series of 23 patients, indicating that superior capsular reconstruction may be a promising tool to manage massive irreparable rotator cuff tears. This article describes our preferred technique for arthroscopic superior capsule reconstruction. PMID:27284506

  16. Winging of scapula due to serratus anterior tear

    Directory of Open Access Journals (Sweden)

    Varun Singh Kumar

    2014-10-01

    Full Text Available 【Abstract】Winging of scapula occurs most commonly due to injury to long thoracic nerve supplying serratus anterior muscle. Traumatic injury to serratus anterior muscle itself is very rare. We reported a case of traumatic winging of scapula due to tear of serratus anterior muscle in a 19-year-old male. Winging was present in neutral position and in extension of right shoulder joint but not on "push on wall" test. Patient was managed conservatively and achieved satisfactory result. Key words: Serratus anterior tear; Scapula; Wounds and injuries

  17. Effects of Tearing on the Perception of Facial Expressions of Emotion

    Directory of Open Access Journals (Sweden)

    Lawrence Ian Reed

    2015-11-01

    Full Text Available What is the function of emotional tearing? Previous work has found a tear effect, which resolves ambiguity in neutral expressions and increases perceptions of sadness in sad expressions. Tearing, however, is associated with a variety of emotional states, and it remains unclear how the tear effect generalizes to other emotion expressions. Here we expand upon previous works by examining ratings of video clips depicting posed facial expressions presented with and without tears. We replicate Provine et al.’s (2009 findings that tearing increases perceptions of sadness in sad expressions. Furthermore, we find that tearing has specific effects on ratings of emotion (happiness, sadness, anger, and fear and ratings of intensity and valence in neutral, positive, and negative expressions. These results suggest that tearing may serve a specific and independent communicative function, interacting with those of various expressions.

  18. Exploring the prevalence of skin tears and skin properties related to skin tears in elderly patients at a long-term medical facility in Japan.

    Science.gov (United States)

    Koyano, Yuiko; Nakagami, Gojiro; Iizaka, Shinji; Minematsu, Takeo; Noguchi, Hiroshi; Tamai, Nao; Mugita, Yuko; Kitamura, Aya; Tabata, Keiko; Abe, Masatoshi; Murayama, Ryoko; Sugama, Junko; Sanada, Hiromi

    2016-04-01

    The identification of appropriate skin tear prevention guidelines for the elderly requires clinicians to focus on local risk factors such as structural alterations of the epidermis and dermis related to skin tears. The aim of this cross-sectional study is to explore the prevalence of skin tears and to explore skin properties related to skin tears in elderly Japanese patients at a long-term medical facility. After doing the prevalence study, 18 participants with skin tears and 18 without were recruited and an evaluation of their skin properties using 20-MHz ultrasonography, skin blotting and also Corneometer CM-825, Skin-pH-meterPH905, VapoMeter, Moisture Meter-D and CutometerMPA580 was undertaken. A total of 410 patients were examined, the median age was 87 years and 73·2% were women. The prevalence of skin tears was 3·9%, and 50% of skin tears occurred on the dorsal forearm. The changes in skin properties associated with skin tears included increased low-echogenic pixels (LEP) by 20-MHz ultrasonography, decreased type IV collagen and matrix metalloproteinase-2, and increased tumour necrosis factor-α by skin blotting. In conclusion, this study suggests that increased dermal LEP, including solar elastosis, may represent a risk factor for skin tears; this indicates that skin tear risk factors might not only represent chronological ageing but also photoageing.

  19. Delayed cementless total hip arthroplasty for neglected dislocation of hip combined with complex acetabular fracture and deficient bone stock

    Directory of Open Access Journals (Sweden)

    Gavaskar Ashok S

    2012-12-01

    Full Text Available 【Abstract】Total hip arthroplasty (THA for an un-treated acetabular fracture is technically challenging and the long-term result is not so favorable. A 45-year-old fe-male patient with untreated column and comminuted poste-rior wall fracture of the acetabulum was treated in our insti-tution by reconstruction of the posterior wall using iliac strut autograft and plate stabilization of the posterior col-umn with cancellous grafting and cementless THA in a single stage. At 3 years’ follow-up, the patient was independently mobile without limb length discrepancy. Radiological evalu-ation showed well integrated components and bone grafts. No evidence of aseptic loosening or osteolysis was found. This report aims to emphasize that bony acetabular recon-struction allows the use of primary hip components, which improves prosthesis longevity and preserves bone stock for a future revision. Key words: Acetabulum; Fractures, bone; Hip dislocation; Arthroplasty, replacement, hip

  20. Delayed cementless total hip arthroplasty for neglected dislocation of hip combined with complex acetabular fracture and deficient bone stock

    Institute of Scientific and Technical Information of China (English)

    Ashok S Gavaskar; Naveen Chowdary Tummala

    2012-01-01

    Total hip arthroplasty (THA) for an untreated acetabular fracture is technically challenging and the long-term result is not so favorable.A 45-year-old female patient with untreated column and comminuted posterior wall fracture of the acetabulum was treated in our institution by reconstruction of the posterior wall using iliac strut autograft and plate stabilization of the posterior column with cancellous grafting and cementless THA in a single stage.At 3 years' follow-up,the patient was independently mobile without limb length discrepancy.Radiological evaluation showed well integrated components and bone grafts.No evidence of aseptic loosening or osteolysis was found.This report aims to emphasize that bony acetabular reconstruction allows the use of primary hip components,which improves prosthesis longevity and preserves bone stock for a future revision.

  1. Contact lens physical properties and lipid deposition in a novel characterized artificial tear solution

    OpenAIRE

    Lorentz, Holly; Heynen, Miriam; Kay, Lise M.M.; Dominici, Claudia Yvette; Khan, Warda; Ng, Wendy W.S.; Jones, Lyndon

    2011-01-01

    Purpose To characterize various properties of a physiologically-relevant artificial tear solution (ATS) containing a range of tear film components within a complex salt solution, and to measure contact lens parameters and lipid deposition of a variety of contact lens materials after incubation in this ATS. Methods A complex ATS was developed that contains a range of salts, proteins, lipids, mucin, and other tear film constituents in tear-film relevant concentrations. This ATS was tested to co...

  2. Skin tears: care and management of the older adult at home.

    Science.gov (United States)

    Holmes, Regina F; Davidson, Martha W; Thompson, Bonnie J; Kelechi, Teresa J

    2013-02-01

    Skin tears experienced by older adults require special skills to promote healing. Home healthcare providers are in key positions to manage skin tears and prevent further skin trauma. Several guidelines, risk assessments, classifications, and products exist to manage high-risk patients. Frequent evaluation of the effectiveness of the treatment and prevention strategies in an overall skin care protocol for home care patients is critical to reduce skin tear incidence and promote prompt healing when skin tears are present.

  3. Study of the three-dimensional orientation of the labrum: its relations with the osseous acetabular rim

    Science.gov (United States)

    Bonneau, Noémie; Bouhallier, July; Baylac, Michel; Tardieu, Christine; Gagey, Olivier

    2012-01-01

    Understanding the three-dimensional orientation of the coxo-femoral joint remains a challenge as an accurate three-dimensional orientation ensure an efficient bipedal gait and posture. The quantification of the orientation of the acetabulum can be performed using the three-dimensional axis perpendicular to the plane that passes along the edge of the acetabular rim. However, the acetabular rim is not regular as an important indentation in the anterior rim was observed. An innovative cadaver study of the labrum was developed to shed light on the proper quantification of the three-dimensional orientation of the acetabulum. Dissections on 17 non-embalmed corpses were performed. Our results suggest that the acetabular rim is better represented by an anterior plane and a posterior plane rather than a single plane along the entire rim as it is currently assumed. The development of the socket from the Y-shaped cartilage was suggested to explain the different orientations in these anterior and posterior planes. The labrum forms a plane that takes an orientation in between the anterior and posterior parts of the acetabular rim, filling up inequalities of the bony rim. The vectors VL, VA2 and VP, representing the three-dimensional orientation of the labrum, the anterior rim and the posterior rim, are situated in a unique plane that appears biomechanically dependent. The three-dimensional orientation of the acetabulum is a fundamental parameter to understand the hip joint mechanism. Important applications for hip surgery and rehabilitation, as well as for physical anthropology, were discussed. PMID:22360458

  4. Analysis of acetabular version in the native hip: comparison between 2D axial CT and 3D CT measurements

    Energy Technology Data Exchange (ETDEWEB)

    Dandachli, Wael [Department of Orthopaedic Surgery, Imperial College London Hospitals, London (United Kingdom); Ul Islam, Saif; Tippett, Richard; Hall-Craggs, Margaret A.; Witt, Johan D. [University College London Hospitals, London (United Kingdom)

    2011-07-15

    To compare two-dimensional (2D) axial with three-dimensional (3D) computerized tomography (CT) measurements of acetabular version in native hips. CT scans of 34 hips in 17 consecutive patients being investigated for femoroacetabular impingement were analyzed. Acetabular version was measured using 2D CT at two different axial levels, one cranial (slice 2) and the other at the equator (slice 3). The measurements were repeated after correction for pelvic tilt. The results were compared to the measurements of anatomical version obtained using a 3D CT method that automatically corrects for pelvic tilt. The mean acetabular version using the 3D CT method was 15.7 (SD 6.9 ). The mean version using slice 2 was 9.3 (SD 6.5 ) before correction for pelvic tilt and 15.7 (SD 8.0 ) after the correction. The mean version using slice 3 was 16.4 (SD 4.2 ) before tilt correction and 19.0 (SD 5.0 ) after the correction. In relation to the 3D method, the intraclass correlation coefficient (ICC) was 0.58 for the uncorrected and 0.93 for the corrected slice 2 method. For the uncorrected and corrected slice 3 methods, the ICC was 0.64 and 0.89, respectively. The 2D axial methods produced variable results. The results that correlated best with the 3D method were those of the cranial slice (slice 2) after correction for pelvic tilt. Interpretation of 2D axial CT measurements of acetabular version should be done with caution. The level at which the measurement is done and the presence of pelvic tilt appear to be significant factors. (orig.)

  5. Role of Neutral Lipids in Tear Fluid Lipid Layer: Coarse-Grained Simulation Study

    DEFF Research Database (Denmark)

    Telenius, J.; Koivuniemi, A.; Kulovesi, P.;

    2012-01-01

    Tear fluid lipid layer (TFLL) residing at the air-water interface of tears has been recognized to play an important role in the development of dry eye syndrome. Yet, the composition, structure, and mechanical properties of TFLL are only partly known. Here, we report results of coarse...... behavior, which is important for the proper function of tear film....

  6. Absence or interruption of the supra-acetabular line: a subtle plain film indicator of hip pathology

    Energy Technology Data Exchange (ETDEWEB)

    Major, N.M. [Department of Radiology, University of California San Francisco, Box 0628, San Francisco, CA 94143 (United States); Helms, C.A. [Department of Radiology, University of California San Francisco, Box 0628, San Francisco, CA 94143 (United States)

    1996-08-01

    Objective. To show that absence or interruption of the supraacetabular line is a subtle plain film indicator of pathology in the acetabulum. Design. Nineteen hips from 17 patients with known disease processes involving the acetabulum as demonstrated by subsequent magnetic resonance imaging, bone scan or plain film follow-up were evaluated with antero-posterior (AP) plain films of the pelvis. Three additional cases were diagnosed prospectively using interruption of the supra-acetabular line as the criterion for inclusion. Fifty AP plain films of the pelvis in patients without hip pain were examined prospectively to determine normal imaging criteria. Results and conclusions. The normal supra-acetabular line measures 2-3 mm in thickness superiorly and is a thin sclerotic line in the medial aspect. In all 22 hips (with pathology) in this series, the line was interrupted or absent. Loss or interruption of the supra-acetabular line may thus be a subtle pain film indicator of a disease process involving the acetabulum. This plain film sign has not previously been reported. (orig.). With 8 figs., 1 tab.

  7. An investigation of non-invasive tear break up time and tear meniscus height of keratoconic versus non-keratoconic individuals

    Directory of Open Access Journals (Sweden)

    Deanne L. Nicholas

    2016-03-01

    Full Text Available Keratoconus is a debilitating condition where the cornea develops a conical shape rather than the characteristic round shape due to various physiological and structural changes taking place within the layers of the cornea. As a result of the pathogenesis of keratoconus, there are numerous changes that may occur within the tears of these patients. Research has shown changes in the tear metabolome, the presence of degradation products as well as loss of goblet cells into the tears. Could the changes occurring within the tear structure of these patients affect the results of various tear quantity and quality tests? Non-invasive tear break up time (NTBUT is a diagnostic test used to determine the quality of the tear film and has been used extensively when diagnosing dry eye disease. This test is utilised in order to determine the time taken for the tear film to begin breaking apart, signalling thinning of the tears. Shorter break up times are therefore indicative of instability or changes occurring within the tear film which could be diagnostic of dry eye disease. Tear meniscus height (TMH measurements have also been utilised in clinical practice, where these measurements provide an indication of the volume of tears contained within the upper and lower menisci. Lower tear volumes have been shown to be present in cases of dry eye disease where either tear production or tear drainage may be affected. Changes in the quality and quantity of the tear film in subjects with dry eye disease have been thoroughly investigated; however, the same cannot be said for subjects with keratoconus. Could the same findings be possible in subjects with keratoconus? Is it possible that the changes occurring within the tears of keratoconic subjects could lead to abnormal NTBUT and TMH measurements when compared to those of control subjects? Could the results of the NTBUT and TMH tests be related to one another? This study compares the NTBUT and TMH measurements of both

  8. Reprodutibilidade da classificação de Tile para fraturas do acetábulo Reproducibility of Tile's classification of acetabular fractures

    Directory of Open Access Journals (Sweden)

    Marcos Almeida Matos

    2006-01-01

    Full Text Available Classificar corretamente as fraturas acetabulares é crucial para bom planejamento pré-operatório e para redução cirúrgica eficiente. Entretanto, para cumprir seus objetivos, qualquer sistema de classificação deve ser simples e reprodutível. O objetivo deste artigo é avaliar a reprodutibilidade interobservador da classificação de Tile para fraturas do acetábulo. Foram utilizadas 30 imagens radiográficas de 10 fraturas acetabulares nas incidências de Judet, analisadas por 10 observadores, sendo cinco especialistas em cirurgia de quadril e cinco residentes do terceiro ano de ortopedia. A concordância global obtida foi de 72,44% com Kappa (K = 0,52 (0,48 entre residentes e 0,57 entre especialistas. Conclui-se que a classificação de Tile para fraturas acetabulares apresenta moderada concordância interobservador, não havendo diferença estatisticamente significante entre residentes e especialistas.Properly classifying acetabular fractures is crucial for a good preoperative planning and for an efficient surgical reduction. However, in order to accomplish its objectives, any classification system must be simple and reproducible. The objective of this article is to assess inter-observer reproducibility of Tile’s classification concerning acetabular fractures. Thirty X-ray images of 10 acetabular fractures at Judet planes were used and assessed by 10 observers, being five hip surgery experts and five 3rd-grade orthopaedic residents. The global consistency achieved was 72.44% to Kappa (K = 0.52 (0.48 among resident doctors and 0.57 among experts. It was concluded that the Tile’s classification of acetabular fractures reveals a moderate inter-observer consistency, with no statistically significant difference between resident doctors and experts.

  9. A comparative study of "plasmacup" and "porous-coated" acetabular components: survival after 10 to 12 years of follow-up

    Directory of Open Access Journals (Sweden)

    José Ricardo Negreiros Vicente

    2010-01-01

    Full Text Available OBJECTIVES: Our primary aim was to compare the long-term survivorship rates and the rates of successful osseointegration between two different types of uncemented acetabular components. INTRODUCTION: Two types of alloys have primarily been used for the manufacture of the uncemented acetabular components: titanium-based and cobalt-based alloys. A titanium-based alloy appears to be more effective with regard to interface stress transfer to the host bone because of its lower elastic modulus relative to a cobalt-based alloy. This supposed mechanical advantage of a titanium-based alloy component motivated this comparative study. METHODS: Two uncemented acetabular components, a porous-coated acetabulum and a Plasmacup®, were compared with a focus on long-term prosthesis survivorship and the development of acetabular osseointegration. Five radiographic signs of osseointegration were evaluated at the last follow-up appointment: (1 absence of radiolucent lines, (2 presence of a superolateral buttress, (3 medial stress-shielding, (4 radial trabeculae, and (5 an inferomedial buttress. We considered the presence of any three of these radiographic signs, in the absence of acetabular dislocation or symptoms, to be indicative of successful acetabular osseointegration. RESULTS: Among 70 patients implanted with the porous-coated acetabulum, 80% achieved osseointegration over a mean follow-up time of 11.9 years versus 75.3% of the 73 patients who received a Plasmacup insert over a mean of 10.7 years. Prosthesis survivorship rates were not different between the two groups. Revision surgery due to mild or severe acetabular osteolysis, polyethylene wear, and aseptic loosening occurred in eight patients (11.4% with a PCA versus nine (12.3% with a Plasmacup. CONCLUSIONS: We conclude that, during the first ten years after surgery, there is no significant difference between these two types of uncemented cups with regard to either prosthesis survivorship or successful

  10. Immunoglobulin Concentration in Tears of Contact Lens Wearers

    Directory of Open Access Journals (Sweden)

    Rajendra P Maurya

    2014-01-01

    Conclusion: The relation of immunoglobulin concentration with increasing duration of wear and material of contact lens shows that tear immunoglobulin rise accrues due to mechanical stimulation, hence contact lenses should not be used for a long period and lenses of hard nature should be discouraged. The maintenance, cleaning and deproteinization of the lenses are of high importance to avoid immunostimulation.

  11. Triplane ankle fracture with deltoid ligament tear and syndesmotic disruption

    OpenAIRE

    Cummings, Robert Jay

    2008-01-01

    In patients with immature skeletons, ligamentous injuries rarely accompany ankle fractures. In this article, we report about deltoid ligament tears and syndesmotic disruptions accompanying triplane ankle fractures in two children, and make recommendations as to the evaluation and treatment of children with such injuries.

  12. Reconnection dynamics with secondary tearing instability in compressible Hall plasmas

    Energy Technology Data Exchange (ETDEWEB)

    Ma, Z. W., E-mail: zwma@zju.edu.cn; Wang, L. C.; Li, L. J. [Institute for Fusion Theory and Simulation, Zhejiang University, Hangzhou 310027 (China)

    2015-06-15

    The dynamics of a secondary tearing instability is systematically investigated based on compressible Hall magnetohydrodynamic. It is found that in the early nonlinear phase of magnetic reconnection before onset of the secondary tearing instability, the geometry of the magnetic field in the reconnection region tends to form a Y-type structure in a weak Hall regime, instead of an X-type structure in a strong Hall regime. A new scaling law is found that the maximum reconnection rate in the early nonlinear stage is proportional to the square of the ion inertial length (γ∝d{sub i}{sup 2}) in the weak Hall regime. In the late nonlinear phase, the thin elongated current sheet associated with the Y-type geometry of the magnetic field breaks up to form a magnetic island due to a secondary tearing instability. After the onset of the secondary tearing mode, the reconnection rate is substantially boosted by the formation of the X-type geometries of magnetic field in the reconnection regions. With a strong Hall effect, the maximum reconnection rate linearly increases with the increase of the ion inertial length (γ∝d{sub i})

  13. Tear Resistance of Orthogonal Kevlar-PWF-reinforced TPU Film

    Institute of Scientific and Technical Information of China (English)

    BAI Jiangbo; XIONG Junjiang; CHENG Xu

    2011-01-01

    This work seeks to investigate the notch sensitivity and fracture behaviour of orthogonal Kevlar-plain woven fabric (PWF)reinforced thermoplastic polyurethanes (TPU) film applied to high altitude balloon. Four types of specimens are implemented to measure notched strength and fracture toughness by conducting static tension and tear tests on an MTS system respectively. The damage and failure mechanisms are discussed and the results for notched strength and tear resistance are evaluated and compared with each other. From the experiments, it is found that the notch sensitivity of the film increases with the increase in the size of the hole, but the notch sensitivity and the stress concentration of the notch are insignificant and there is a decrease of only about 4%-10% in tensile strength for the notched specimens with different hole sizes in diameter compared with the unnotched specimen. In contrast, the tear resistance containing a central slit with only 1 mm length is about half of tensile strength of the unnotched film, which implies that the tear resistance exists an significant notch sensitivity. The results of this study provide an insight into notch sensitivity and fracture behaviour of the Kevlar-PWF-reinforced TPU film and constitute a fundamental basis for the design of high altitude balloon.

  14. Observations on Mode I ductile tearing in sheet metals

    DEFF Research Database (Denmark)

    El-Naaman, Salim Abdallah; Nielsen, Kim Lau

    2013-01-01

    Cracked ductile sheet metals, subject to Mode I tearing, have been observed to display a variety of fracture surface morphologies depending on the material properties, and a range of studies on the fracture surface appearance have been published in the literature. Whereas classical fractures...

  15. Compensatory muscle activation in patients with glenohumeral cuff tears

    NARCIS (Netherlands)

    Steenbrink, Franciscus

    2010-01-01

    Patients suffering tendon tears in the glenohumeral cuff muscles show activation of muscles which pull the arm downwards during arm elevation tasks. This so-called co-activation deviates from healthy controls and is triggered by pain. Goal of this thesis was to demonstrate that deviating muscle acti

  16. Stop the Tears of Drug and Alcohol Abuse

    Science.gov (United States)

    Shimon, Jane; Gibson, Terry-Ann; Spear, Caile

    2009-01-01

    Objectives: By participating in this Stop the Tears teaching strategy, students will be able to: (1) analyze how alcohol and drug abuse could affect their lives as well as the lives of their friends and family and, (2) create a media message, such as a poster, pamphlet, poem, or song, in which alcohol and drug prevention is advocated specific to…

  17. Reconnection dynamics with secondary tearing instability in compressible Hall plasmas

    International Nuclear Information System (INIS)

    The dynamics of a secondary tearing instability is systematically investigated based on compressible Hall magnetohydrodynamic. It is found that in the early nonlinear phase of magnetic reconnection before onset of the secondary tearing instability, the geometry of the magnetic field in the reconnection region tends to form a Y-type structure in a weak Hall regime, instead of an X-type structure in a strong Hall regime. A new scaling law is found that the maximum reconnection rate in the early nonlinear stage is proportional to the square of the ion inertial length (γ∝di2) in the weak Hall regime. In the late nonlinear phase, the thin elongated current sheet associated with the Y-type geometry of the magnetic field breaks up to form a magnetic island due to a secondary tearing instability. After the onset of the secondary tearing mode, the reconnection rate is substantially boosted by the formation of the X-type geometries of magnetic field in the reconnection regions. With a strong Hall effect, the maximum reconnection rate linearly increases with the increase of the ion inertial length (γ∝di)

  18. Infraspinatus delamination does not affect supraspinatus tear repair.

    Science.gov (United States)

    Zilber, Sébastien; Carillon, Yannick; Lapner, Peter C; Walch, Gilles; Nové-Josserand, Laurent

    2007-05-01

    Supraspinatus full-thickness tears with associated infraspinatus delamination are a frequent lesion, although the results of repair have not been reported. We retrospectively identified 35 patients treated for this cuff lesion among 378 open repaired full-thickness cuff tears. The aim of the study was to assess the subjective, objective, and anatomic outcomes of a subset of patients with supraspinatus tears involving delamination of the whole infraspinatus tendon. Thirty of the 35 patients were reviewed with magnetic resonance imaging at a minimum followup of 2 years (mean, 3.5 years; range, 2-6.5 years). The mean nonweighted Constant-Murley score at followup was 80/100 points, with an average gain of 17 points. Magnetic resonance imaging revealed all supraspinatus tendons but two were continuous. We observed no tear of the infraspinatus tendon, although a persistent delamination was present in 11 cases. One half of the patients had minor weakness in external rotation. One third of the infraspinatus muscles had minor fatty infiltration. Conservation of the infraspinatus tendon after closing the delamination did not seem to compromise the outcome of the supraspinatus repair. Avoiding resection of the infraspinatus delamination and treatment with simple curettage and closure yields satisfactory midterm functional and anatomic results. PMID:17308479

  19. Nonlinear theory of high-m tearing modes

    International Nuclear Information System (INIS)

    A simplified nonlinear theory of short wavelength (high-m) electron temperature-gradient-driven tearing modes is presented. Saturation of the linear instability results from nonlinear mode coupling in which energy may cascade to both short and long wavelength modes. The resulting electron thermal conductivity exhibits the density scaling and absolute magnitude observed experimentally

  20. Aortic bifurcation tear following blunt trauma in childhood

    OpenAIRE

    Shlomo Yellinek; Dimitri Gimelrich; Ofer Merin; Petachia Reissman; Marc Arkovitz

    2015-01-01

    Rupture of the abdominal aorta from blunt trauma is rare and aortic biforcation tear is extremely rare. We will present the management of a 2 year old boy who suffered blunt abdominal trauma and was operated in urgent fashion in our institution.

  1. Biceps instability and Slap type II tear in overhead athletes.

    Science.gov (United States)

    Osti, Leonardo; Soldati, Francesco; Cheli, Andrea; Pari, Carlotta; Massari, Leo; Maffulli, Nicola

    2012-10-01

    Type II lesions are common lesions encountered in overhead athletes with controversies arising in term of timing for treatment, surgical approach, rehabilitation and functional results. The aim of our study was to evaluate the outcomes of arthroscopic repair of type II SLAP tears in overhead athletes, focusing on the time elapsed from diagnosis and treatment, time needed to return to sport, rate of return to sport and to previous level of performance, providing an overview concerning evidence for the effectiveness of different surgical approaches to type II SLAP tears in overhead athletes. A internet search on peer reviewed Journal from 1990, first descriprion of this pathology, to 2012, have been conducted evaluating the outcomes for both isolated Slap II tear overhead athletes and those who presented associated lesions treated. The results have been analyzed according to the scale reported focusing on return to sport and level of activity. Apart from a single study, non prospective level I and II studies were detected. Return to play at the same level ranged form 22% to 94% with different range of technique utilized with the majority of the authors recommending the fixation of these lesions but biceps tenodesis can lead to higher satisfaction racte when directly compated to the anchor fixation. Associated pathologies such as partial or full tickness rotator cuff tear did not clearly affect the outcomes and complications rate. There is no consensus regarding timing and treatment for type II SLAP, especially in overhead athletes who need to regain a high level of performance.

  2. MR imaging of the combined anterior and posterior cruciate ligament tears: focussing on the ratterns of injuries and associated findings

    International Nuclear Information System (INIS)

    To evaluate the patterns of injuries and frequency of associated findings on MR imaging in patients with both anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL)tears;to compare the associated findings, as seen on MR imaging, in cases with both ACL and PCL tears with those with ACL or PCL tears. Ten patients with compbined ACL and PCL tears, 16 with ACL tears and 18 with PCL tears, all confirmed by arthroscopy or open surgery, were involved in this study. To identify the associated knee injuries, MR images were retrospectively evaluated. In ten patients with combined ACL and PCL tears, open surgery led to the identification of six complete ACL tears (60%), four partial ACL tears (40%), eitht complete PCL tears (80%) and two partial PCL tears (20%). Injuries associated with these combined tears, and revealed by MR imaging, comprised six medial collateral ligament injuries (60%), six lateral collateral ligament jnjuries (60%), five medial meniscal injuries (50%), three lateral meniscal injuries (30%), nine bony injuries (90%), two posterior capsular injuries (20%), and three popliteus muscle injuries (30%). The frequency of popliteus muscle injury was significantly different (p<0.05, Fisher's exact test) between the group with both ACL and PCL tears and that with ACL or PCL tears. Associated findings in patients with combined ACL and PCL tears are more frequent than in those with ACL or PCL tears. In cases involving combined ACL and PCL tears, associated findings-as seen on MR images-should thus be carefully examined

  3. The prevalence of skin tears in the acute care setting in Singapore.

    Science.gov (United States)

    Chang, Yee Y; Carville, Keryln; Tay, Ai C

    2016-10-01

    Skin tears appear to be a hidden and extensive problem despite an increased focus in the literature on skin tear epidemiology, prevention strategies and management modalities. Currently, there has been no report of skin tear epidemiology published in Singapore. The aim of the present study was to pilot the methodology by WoundWest at one of the tertairy hospitals in Singapore. The secondary objective was to determine the prevalence and current nursing management of skin tears within two selected acute medical wards in the hospital. A point prevalence survey was conducted within the two medical wards. Six registered nurses acted as the surveyors and underwent pre-survey education. Inter-rater reliability testing was conducted. Surveyors were paired and performed skin examinations on all available patients in the two wards. Data were collected on age, gender, skin tear anatomical locations, their Skin Tear Audit Research categories, dressings used on identified skin tears and related documentation. A total of 144 (98%) patients consented to skin inspections. Findings demonstrated a skin tear prevalence of 6·2%; all skin tears were found to be hospital-acquired and located on the extremities. Most (78%) were in the age range of 70-89 years. There was a dearth in nursing documentation of the skin tears identified and their management. The findings suggested that nurses were lacking in the knowledge of skin tears, and documentation, if available, was not consistent. There is an urgent clinical need for the implementation of a validated skin tear classification tool; standardised protocols for skin tear prevention and management; and a comprehensive skin tear educational programme for hospital care staff. Quarterly hospital-wide skin tear prevalence surveys are also needed to evaluate improvement strategies. PMID:26833792

  4. The prevalence of skin tears in the acute care setting in Singapore.

    Science.gov (United States)

    Chang, Yee Y; Carville, Keryln; Tay, Ai C

    2016-10-01

    Skin tears appear to be a hidden and extensive problem despite an increased focus in the literature on skin tear epidemiology, prevention strategies and management modalities. Currently, there has been no report of skin tear epidemiology published in Singapore. The aim of the present study was to pilot the methodology by WoundWest at one of the tertairy hospitals in Singapore. The secondary objective was to determine the prevalence and current nursing management of skin tears within two selected acute medical wards in the hospital. A point prevalence survey was conducted within the two medical wards. Six registered nurses acted as the surveyors and underwent pre-survey education. Inter-rater reliability testing was conducted. Surveyors were paired and performed skin examinations on all available patients in the two wards. Data were collected on age, gender, skin tear anatomical locations, their Skin Tear Audit Research categories, dressings used on identified skin tears and related documentation. A total of 144 (98%) patients consented to skin inspections. Findings demonstrated a skin tear prevalence of 6·2%; all skin tears were found to be hospital-acquired and located on the extremities. Most (78%) were in the age range of 70-89 years. There was a dearth in nursing documentation of the skin tears identified and their management. The findings suggested that nurses were lacking in the knowledge of skin tears, and documentation, if available, was not consistent. There is an urgent clinical need for the implementation of a validated skin tear classification tool; standardised protocols for skin tear prevention and management; and a comprehensive skin tear educational programme for hospital care staff. Quarterly hospital-wide skin tear prevalence surveys are also needed to evaluate improvement strategies.

  5. Kissing contusion between the posterolateral tibial plateau and lateral femoral condyle: associated ligament and meniscal tears

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Hyun Pyo; Lee, Jae Gue; Park, Ji Seon; Ryu, Kyung Nam [Kyunghee Univ., Seoul (Korea, Republic of)

    2004-02-01

    Kissing contusion between the posterolateral tibial plateau and lateral femoral condyle is frequently found in association with a tear of the anterior cruciate liagment (ACL). The purpose of this study was to determine which ligamentous and meniscal tears are associated with kissing contusion. We retrospectively reviewed the findings depicted by 323 consecutive MR images of the knee and confirmed at arthroscopy. For the diagnosis of disruption, ligaments, medial menisci (MM) and lateral menisci (LM) were evaluated using accepted criteria. We compared the prevalence and location of meniscal and ligamentous tears between group I (44 knees with kissing contusion) and group II (279 knees without kissing contusion). For statistical analysis the chi-square test was used. ACLs were torn in all 44 knees (100%) with kissing contusion, and 78 (28%) of 279 without kissing contusion. There were ten medial collateral ligament (MCL) tears (23%) in group I, and 17 MCL tears (6%), five lateral collateral ligament (LCL) tears (2%) and ten posterior cruciate ligament (PCL) tears (4%) in group II. In group I, meniscal tears were found in 22 MM (50%) and in 19 LM (43%), while in group II, they occurred in 128 MM (46%) and 128 LM (46%), In group I, 17 (77%) of 22 MM tears and 13 (68%) of 19 LM tears were located in the posterior horn, while in group II, the corresponding figures were 97/128 (76%) and 60 of 128 (47%). The differing prevalence of ACL and MCL tears between the groups was statistically significant (p<0.05), but differences in the prevalence and location of meniscal tears were not (p>0.05). Although kissing contusion was a highly specific sign of ACL tears, its presence was also significant among MCL tears. There was no significant difference in meniscal tears with or without kissing contusion.

  6. Management of dysfunctional tear syndrome: a Canadian consensus.

    Science.gov (United States)

    Jackson, W Bruce

    2009-08-01

    Dry eye complaints are common, have a diverse etiology, and result from disruption of the normal tear film; hence, the term "dysfunctional tear syndrome." Recent research has shown that ocular surface disorders have an inflammatory origin, that inflammation of the ocular surface does not always manifest as "red eye," and that a patient does not have to have a systemic autoimmune disease to experience a local, ocular autoimmune event. A panel of Canadian cornea and external disease subspecialists met and developed a questionnaire and treatment algorithm to aid the comprehensive ophthalmologist. Management of ocular surface disorders begins with a review of the patient's medical history, with particular attention to medication use, and a thorough ophthalmological examination. Use of a simple questionnaire can aid in the diagnosis. A variety of treatment modalities are available, the most effective of which are those that target the underlying inflammatory process with the goal of restoring the normal tear film. A treatment algorithm is presented that matches the severity of symptoms with the intensity of treatment. Lifestyle modifications, regular hygiene, and tear supplements may be sufficient in patients with mild symptoms. Anti-inflammatory medications (topical cyclosporin A, short courses of topical steroids, and [or] oral tetracyclines) and physical measures (punctal plugs, moisture-retaining eye wear) are implemented for those with moderate-to-severe symptoms. Autologous serum tears, scleral contact lenses, and surgery are reserved for patients with severe symptoms who have an unsatisfactory response to anti-inflammatory medications. Patients with lid disease or rosacea and those with allergic conditions should be identified during the initial encounter and should receive specific therapy to relieve their symptoms.

  7. Tearing relaxation and the globalization of transport in field-reversed configurations

    International Nuclear Information System (INIS)

    Tearing instability of field-reversed configurations (FRC) is investigated using the method of neighboring equilibria. It is shown that the conducting wall position in experiment lies very close to the location needed for tearing stability. This strongly suggests that vigorous but benign tearing modes, acting globally, are the engine of continual self-organization in FRCs, i.e., tearing relaxation. It also explains the ''profile consistency'' and anomalous loss rate of magnetic flux. In effect, tearing globalizes the effect of edge-driven transport.

  8. Etiology, classification and clinical evaluation of partial-thickness tears of rotator cuff

    Institute of Scientific and Technical Information of China (English)

    TANG Kang-lai 唐康来; Peter Habermeryer; LI Qi-hong 李起鸿; Sven Lichtenberg; YANG Liu 杨柳

    2003-01-01

    @@ Since partial thickness tears of the rotator cuff were described well by Codman 1 in 1934, they have been extensively discussed in all kinds of literatures.Partial thickness tears of the rotator cuff are now considered to play a more significant role than previously in inducing patients disability. Partialthickness cuff tears deserve more clinical attention. Both accurate diagnosis and proper surgical repair are very essential. The cognition of partialthickness tears has been deepened in the last decades. In this paper we will review the etiology, classification and clinical evaluation of partial thickness tears of the rotator cuff.

  9. Efficient radiologic diagnosis of pelvic and acetabular trauma; Rationelle bildgebende Diagnostik von Becken- und Azetabulumverletzungen

    Energy Technology Data Exchange (ETDEWEB)

    Kreitner, K.F.; Mildenberger, P.; Thelen, M. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Radiologie; Rommens, P.M. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Unfallchirurgie

    2000-01-01

    In spite of the widespread availability of CT scanners, conventional X-ray radiographs remain the basic imaging modality in patients with pelvic and/or acetabular trauma. However, the extent of their use will depend on local utilities (e.g., availability of CT scanners) and on the patient's clinical condition. Regarding the inaccuracy of conventional radiography in the diagnosis of injuries of the dorsal pelvic ring and of the acetabulum, computed tomography represents the most important imaging modality in the clinically stable patient. CT provides an exact staging of the extent of trauma and allows for differentiation of pelvic instabilities. CT clearly demonstrates the severity of acetabular trauma and is superior in the detection of local complicating factors, i.e., impressions fractures and (sub-)luxations of the femoral head as well as free intraarticular fragments. CT findings provide the basis for definite treatment regimens of the injured patient. By extension of the examination, all relevant organs and systems (craniospinal, cardiovascular, gastrointestinal, respiratory, genitourinary) can be imaged during one session. The speed of spiral CT scanners and their diagnostic accuracy will play a major role in the management of, especially, polytraumatized patients. The indication for angiography with the option of therapeutic embolization exists if a pelvic bleeding persists even after reposition and operative fixation of the injury. (orig.) [German] Bei der Klaerung einer Verletzung des Beckens oder des Azetabulums stellen konventionelle Uebersichtsaufnahmen weiterhin die Basis der bildgebenden Diagnostik dar. Art und Umfang werden bestimmt von lokalen Gegebenheiten (z.B. Verfuegbarkeit von CT-Geraeten) sowie vom klinischen Zustand des Patienten. Aufgrund der diagnostischen Ungenauigkeit der konventionellen Roentgendiagnostik gerade im Bereich des stabilitaetsbedeutsamen dorsalen Beckenringes und des Azetabulums schliesst sich beim klinisch stabilen

  10. Chemosignalling effects of human tears revisited : Does exposure to female tears decrease males' perception of female sexual attractiveness?

    NARCIS (Netherlands)

    Gracanin, A.; van Assen, M.A.L.M.; Omrčen, Višnja; Koraj, Ivana; Vingerhoets, A.J.J.M.

    2016-01-01

    Gelstein et al. reported the results of three experiments suggesting a dampening influence of inhalation of female emotional tears on males' arousal and perception of female sexual attractiveness, specifically in non-sexual situations. This prompted the hypothesis that crying exerts its influence on

  11. HUBBLE WATCHES STAR TEAR APART ITS NEIGHBORHOOD

    Science.gov (United States)

    2002-01-01

    NASA's Hubble Space Telescope has snapped a view of a stellar demolition zone in our Milky Way Galaxy: a massive star, nearing the end of its life, tearing apart the shell of surrounding material it blew off 250,000 years ago with its strong stellar wind. The shell of material, dubbed the Crescent Nebula (NGC 6888), surrounds the 'hefty,' aging star WR 136, an extremely rare and short-lived class of super-hot star called a Wolf-Rayet. Hubble's multicolored picture reveals with unprecedented clarity that the shell of matter is a network of filaments and dense knots, all enshrouded in a thin 'skin' of gas [seen in blue]. The whole structure looks like oatmeal trapped inside a balloon. The skin is glowing because it is being blasted by ultraviolet light from WR 136. Hubble's view covers a small region at the northeast tip of the structure, which is roughly three light-years across. A picture taken by a ground-based telescope [lower right] shows almost the entire nebula. The whole structure is about 16 light-years wide and 25 light-years long. The bright dot near the center of NGC 6888 is WR 136. The white outline in the upper left-hand corner represents Hubble's view. Hubble's sharp vision is allowing scientists to probe the intricate details of this complex system, which is crucial to understanding the life cycle of stars and their impact on the evolution of our galaxy. The results of this study appear in the June issue of the Astronomical Journal. WR 136 created this web of luminous material during the late stages of its life. As a bloated, red super-giant, WR 136 gently puffed away some of its bulk, which settled around it. When the star passed from a super-giant to a Wolf-Rayet, it developed a fierce stellar wind - a stream of charged particles released from its surface - and began expelling mass at a furious rate. The star began ejecting material at a speed of 3.8 million mph (6.1 million kilometers per hour), losing matter equal to that of our Sun's every 10

  12. Complete versus partial-thickness tears of the posterior cruciate ligament: differential features at MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Sohn, Kwang Joon; Kim, Hyun Jeong; Juhng, Seon Kwan [Wonkwang University School of Medicine, Iksan (Korea, Republic of)

    1995-07-15

    To evaluate the differential features of complete and partial-thickness tears of the posterior cruciate ligament (PCL) and to describe associated knee injuries at magnetic resonance imaging (MRI). Twenty-four subjects were studied, including 15 with complete PCL tears and 9 with partial PCL tears. The PCL status was determined at arthroscopy in all cases. Knee MRI were performed at 1.0 Tesla using a dedicated knee surface coil. Two radiologists retrospectively reviewed MR images and correlated MRI findings to results of arthroscopy. There was no statistically significant difference between complete tears and partial tears with regard to thickness, margination, and signal intensity of the PCL. However, complete tears were more likely to show focal areas of ligamentous discontinuity (13/15: 3/9, {rho} = 0.0073). Associated knee injuries were seen in 22 (92%) patients and were seen more frequently in patients with complete PCL tears, which were bony injuries (n 16, 67%), tears of the medial collateral ligament (n = 12, 50%) and menisci (n = 11, 46%), and stage III joint effusion (n = 17, 71%). The most useful MRI criteria for distinguishing complete from partial PCL tear is focal area of ligamentous discontinuity, that is complete tears are more likely to show focal areas of discontinuity, whereas partial tears are more likely to show at least some intact fibers.

  13. Complete versus partial-thickness tears of the posterior cruciate ligament: differential features at MR imaging

    International Nuclear Information System (INIS)

    To evaluate the differential features of complete and partial-thickness tears of the posterior cruciate ligament (PCL) and to describe associated knee injuries at magnetic resonance imaging (MRI). Twenty-four subjects were studied, including 15 with complete PCL tears and 9 with partial PCL tears. The PCL status was determined at arthroscopy in all cases. Knee MRI were performed at 1.0 Tesla using a dedicated knee surface coil. Two radiologists retrospectively reviewed MR images and correlated MRI findings to results of arthroscopy. There was no statistically significant difference between complete tears and partial tears with regard to thickness, margination, and signal intensity of the PCL. However, complete tears were more likely to show focal areas of ligamentous discontinuity (13/15: 3/9, ρ = 0.0073). Associated knee injuries were seen in 22 (92%) patients and were seen more frequently in patients with complete PCL tears, which were bony injuries (n 16, 67%), tears of the medial collateral ligament (n = 12, 50%) and menisci (n = 11, 46%), and stage III joint effusion (n = 17, 71%). The most useful MRI criteria for distinguishing complete from partial PCL tear is focal area of ligamentous discontinuity, that is complete tears are more likely to show focal areas of discontinuity, whereas partial tears are more likely to show at least some intact fibers

  14. Acute and chronic tears of anterior cruciate ligament : role of gadolinium-enhanced MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Jung; Jee, Won Hee; Im, Soo A; Chun, Ho Jong; Jung, Hyun Seouk; Kim, Soo Young; Kwon, Tae An; Song, Sun Wha; Choi, Kyu Ho [Catholic Univ. Medical College. Kangnam St. Mary' s Hospital, Seoul (Korea, Republic of)

    1998-07-01

    To evaluate the efficacy of fat-suppressed gadolinium-enhanced MR imaging in differentiating acute from chronic ligament tears of anterior cruciate ligament. Materials and Methods : MR images of 22 patients with arthroscopically proven complete tear of the anterior cruciate ligament were retrospectively reviewed. The interval between injury and MR examination was one day to seven years. When ligament tear was detected on MR image with three months of injury, the case was considered acute;if detected after three months had elapsed, it was judged to be chronic. The extent of contrast enhancement was graded as 1, 2 or 3; grade 1, enhancement was confined to the expected ligament region; grade 2, enhancement extended to the joint capsule; grade 3, enhancement extended beyond the joint capsule. The grades of contrast enhancement correlated with the acute and chronic stages of ligament tears. Associated bone bruise and/or adjacent soft tissue edema were also evaluated. Results : Among 15 patients with acute ligament tear, nine (60%) showed grade 3 enhancement; among seven in whom tearing was chronic, four (57%) showed grade 1 enhancement. Bone bruising was present in 100% of acute tears (15/15) and 29 % of chronic tears (2/7). Soft tissue edema was associated in 87% of acute tears (13/15) and 29% of chronic tears(2/7). Conclusion : Fat-suppressed gadolinium-enhanced MR imaging could help differentiate acute from chronic tears of anterior cruciate ligament, as well as bone bruising and tissue edema.

  15. Acute and chronic tears of anterior cruciate ligament : role of gadolinium-enhanced MR imaging

    International Nuclear Information System (INIS)

    To evaluate the efficacy of fat-suppressed gadolinium-enhanced MR imaging in differentiating acute from chronic ligament tears of anterior cruciate ligament. Materials and Methods : MR images of 22 patients with arthroscopically proven complete tear of the anterior cruciate ligament were retrospectively reviewed. The interval between injury and MR examination was one day to seven years. When ligament tear was detected on MR image with three months of injury, the case was considered acute;if detected after three months had elapsed, it was judged to be chronic. The extent of contrast enhancement was graded as 1, 2 or 3; grade 1, enhancement was confined to the expected ligament region; grade 2, enhancement extended to the joint capsule; grade 3, enhancement extended beyond the joint capsule. The grades of contrast enhancement correlated with the acute and chronic stages of ligament tears. Associated bone bruise and/or adjacent soft tissue edema were also evaluated. Results : Among 15 patients with acute ligament tear, nine (60%) showed grade 3 enhancement; among seven in whom tearing was chronic, four (57%) showed grade 1 enhancement. Bone bruising was present in 100% of acute tears (15/15) and 29 % of chronic tears (2/7). Soft tissue edema was associated in 87% of acute tears (13/15) and 29% of chronic tears(2/7). Conclusion : Fat-suppressed gadolinium-enhanced MR imaging could help differentiate acute from chronic tears of anterior cruciate ligament, as well as bone bruising and tissue edema

  16. Prevalence of triceps tendon tears on MRI of the elbow and clinical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Koplas, Monica C. [University of Mississippi Medical Center, Section of Musculoskeletal Radiology, Department of Radiology, Jackson, MS (United States); Schneider, Erika [Cleveland Clinic, Imaging Institute, Cleveland, OH (United States); Sundaram, Murali [Cleveland Clinic, Section of Musculoskeletal Radiology, Imaging Institute, Cleveland, OH (United States)

    2011-05-15

    Triceps tendon injuries are reported to be very rare. To our knowledge, there have been no studies describing its prevalence or injury patterns on MR imaging. The purpose of this retrospective study was to determine the prevalence and patterns of triceps injuries based on a large series of consecutive MR examinations. Clinical correlation was obtained. From 801 consecutive elbow MR examinations over a 15-year period, 28 patients with 30 triceps tendon injuries were identified and graded as partial tendon tear and complete tendon tear. The patients' medical records were reviewed to determine age, gender, cause of tears, and management. The prevalence of triceps tendon injuries was 3.8%. There were 5 women and 23 men with partial or complete tears (mean age: 46.6 years; range: 2.7 to 75.1 years). The most common injury was partial tear, found in 18 patients. There were 10 patients with 12 complete tears (2 had re-torn following surgical repair). A tear was suspected in 12 out 28 (43%) patients prior to the MRI. The most common presenting symptom was pain. The most common cause was athletic injury (8 patients [29%], including weightlifting [2 patients]). Tendon tear was found to be a complication of infection in 6 patients, and in 3 patients the tears were a complication of steroid use. Thirteen tendon tears were surgically repaired (8 of these were complete tears). Triceps tendon injury is not as rare as commonly reported and may often be clinically underdiagnosed. (orig.)

  17. Acetabular retroversion as a rare cause of chronic hip pain: recognition of the ''figure-eight'' sign

    Energy Technology Data Exchange (ETDEWEB)

    Banks, Kevin P. [Brooke Army Medical Center, Department of Radiology, Fort Sam Houston, TX (United States); Grayson, David E. [Wilford Hall Medical Center, Department of Radiology, Lackland Air Force Base, TX (United States)

    2007-06-15

    While well-recognized in the orthopedic literature as a cause of chronic hip pain, acetabular retroversion has not been specifically described in the radiologic literature. Acetabular retroversion represents a particular form of hip dysplasia characterized by abnormal posterolateral orientation of the acetabulum. This pathophysiology predisposes the individual to subsequent anterior impingement of the femoral neck upon the anterior acetabular margin and fibrous labrum. Without treatment, cases may progress to damage of the anterior labrum and cartilage, with eventual early onset of osteoarthritic disease. This impinging condition has been described as occurring in isolation or as part of a complex dysplasia. We describe two cases of acetabular retroversion diagnosed by conventional radiographic evaluation of the pelvis, one in isolation and one occurring in the setting of a larger congenital syndrome. These cases illustrate the utility of the ''figure-eight'' sign in identifying abnormalities of acetabular version and thus assisting clinicians in properly identifying these individuals so that appropriate therapy may be instituted. (orig.)

  18. Predicting rotator cuff tears using data mining and Bayesian likelihood ratios.

    Directory of Open Access Journals (Sweden)

    Hsueh-Yi Lu

    Full Text Available OBJECTIVES: Rotator cuff tear is a common cause of shoulder diseases. Correct diagnosis of rotator cuff tears can save patients from further invasive, costly and painful tests. This study used predictive data mining and Bayesian theory to improve the accuracy of diagnosing rotator cuff tears by clinical examination alone. METHODS: In this retrospective study, 169 patients who had a preliminary diagnosis of rotator cuff tear on the basis of clinical evaluation followed by confirmatory MRI between 2007 and 2011 were identified. MRI was used as a reference standard to classify rotator cuff tears. The predictor variable was the clinical assessment results, which consisted of 16 attributes. This study employed 2 data mining methods (ANN and the decision tree and a statistical method (logistic regression to classify the rotator cuff diagnosis into "tear" and "no tear" groups. Likelihood ratio and Bayesian theory were applied to estimate the probability of rotator cuff tears based on the results of the prediction models. RESULTS: Our proposed data mining procedures outperformed the classic statistical method. The correction rate, sensitivity, specificity and area under the ROC curve of predicting a rotator cuff tear were statistical better in the ANN and decision tree models compared to logistic regression. Based on likelihood ratios derived from our prediction models, Fagan's nomogram could be constructed to assess the probability of a patient who has a rotator cuff tear using a pretest probability and a prediction result (tear or no tear. CONCLUSIONS: Our predictive data mining models, combined with likelihood ratios and Bayesian theory, appear to be good tools to classify rotator cuff tears as well as determine the probability of the presence of the disease to enhance diagnostic decision making for rotator cuff tears.

  19. A very rare case with neglected hip dislocation coexisted with posterior acetabular lip fracture

    Directory of Open Access Journals (Sweden)

    Samet Karabulut

    2011-06-01

    Full Text Available Neglected hip dislocation is a rare situation among children. The coexistence of acetabulum fracture is less common. The result of treatment depends on the time of diagnosis. Early treatment is mandatory in such cases. Seven years old female brought to our outpatient clinic with the complaints of right hip pain and walking difficulty. Her parents said that she had fallen from a horse one month ago. X-ray and CT showed a posterior dislocation of her right hip and a fracture on her right posterior acetabular lip. We performed an open reduction via posterior approach. Because the hip was unstable we fixed the femoral head to the acetabulum by a Kirshner wire. Pelvipedal cast was applied after the operation for 6 weeks. After 6 months avascular necrosis (AVN developed on her right femoral head, the range of motion (ROM of the hip was restricted and she had minimal pain on her right hip. J Clin Exp Invest 2011;2(2:228-31

  20. The effect of femoro-acetabular impingement on the kinematics and kinetics of the hip joint.

    Science.gov (United States)

    Alshameeri, Zeiad; Khanduja, Vikas

    2014-08-01

    Gait analysis is an objective tool that has been used to assess and monitor treatment for many musculoskeletal conditions. Recently, it has been used to assess the impact of femoro-acetabular impingement (FAI) on the hip and lower limb movements. There have been a fairly limited number of studies published so far reporting unexpected and inconsistent results, which calls for more research to be conducted in this arena. In the light of the limited data available, it has been challenging to reconcile the contradictions in some of these results, and therefore no coherent conclusions could be drawn. In this short article, we attempt to explain some of the abnormal kinematic and kinetic patterns associated with FAI by highlighting similarities between the gait seen in early osteoarthritis (OA) and that of FAI. We also propose an approach for future research in this field and emphasise the importance of quantifying early OA in FAI based on magnetic resonance imaging (MRI) scans and the amount of chondral damage seen during open or arthroscopic surgery. PMID:24687267

  1. Should money follow the patient: Financial implication for being the National Centre for the Treatment and Management of Pelvic and Acetabular Fractures in Ireland.

    LENUS (Irish Health Repository)

    Kelly, M E

    2013-03-13

    BACKGROUND: Pelvic and acetabular fractures are complex injuries requiring specialist treatment. Our institution is the National Centre for Treatment and Management of these injuries. AIM: To audit all referrals to our institution over a 6-month period and calculate the cost incurred by being the national referral centre. METHODS: Retrospective review of database, and subsequent allocation of Casemix points to assess total cost of treatment for each patient referred to our institution. RESULTS: 103 patients referred with pelvic or acetabular fracture for operative management. The furthest referral distance was 181miles. Over-all, the length of stay was 15.4 days. The average inclusive cost for a referral to our unit for operative management was €16,302. CONCLUSION: Pelvic and acetabular fractures are complex injuries that require specialist referral unit management. However for these units to remain sustainable money needs to "follow the patient".

  2. Influence of toroidal rotation on resistive tearing modes in tokamaks

    Energy Technology Data Exchange (ETDEWEB)

    Wang, S.; Ma, Z. W., E-mail: zwma@zju.edu.cn [Institute for Fusion Theory and Simulation, Zhejiang University, Hangzhou 310027 (China)

    2015-12-15

    Influence of toroidal equilibrium plasma rotation on m/n = 2/1 resistive tearing modes is studied numerically using a 3D toroidal MHD code (CLT). It is found that the toroidal rotation with or without shear can suppress the tearing instability and the Coriolis effect in the toroidal geometry plays a dominant role on the rotation induced stabilization. For a high viscosity plasma (τ{sub R}/τ{sub V} ≫ 1, where τ{sub R} and τ{sub V} represent resistive and viscous diffusion time, respectively), the effect of the rotation shear combined with the viscosity appears to be stabilizing. For a low viscosity plasmas (τ{sub R}/τ{sub V} ≪ 1), the rotation shear shows a destabilizing effect when the rotation is large.

  3. Influence of toroidal rotation on resistive tearing modes in tokamaks

    Science.gov (United States)

    Wang, S.; Ma, Z. W.

    2015-12-01

    Influence of toroidal equilibrium plasma rotation on m/n = 2/1 resistive tearing modes is studied numerically using a 3D toroidal MHD code (CLT). It is found that the toroidal rotation with or without shear can suppress the tearing instability and the Coriolis effect in the toroidal geometry plays a dominant role on the rotation induced stabilization. For a high viscosity plasma (τR/τV ≫ 1, where τR and τV represent resistive and viscous diffusion time, respectively), the effect of the rotation shear combined with the viscosity appears to be stabilizing. For a low viscosity plasmas (τR/τV ≪ 1), the rotation shear shows a destabilizing effect when the rotation is large.

  4. I.S.Mu.L.T - Rotator Cuff Tears Guidelines.

    Science.gov (United States)

    Oliva, Francesco; Piccirilli, Eleonora; Bossa, Michela; Via, Alessio Giai; Colombo, Alessandra; Chillemi, Claudio; Gasparre, Giuseppe; Pellicciari, Leonardo; Franceschetti, Edoardo; Rugiero, Clelia; Scialdoni, Alessandro; Vittadini, Filippo; Brancaccio, Paola; Creta, Domenico; Buono, Angelo Del; Garofalo, Raffaele; Franceschi, Francesco; Frizziero, Antonio; Mahmoud, Asmaa; Merolla, Giovanni; Nicoletti, Simone; Spoliti, Marco; Osti, Leonardo; Padulo, Johnny; Portinaro, Nicola; Tajana, Gianfranco; Castagna, Alex; Foti, Calogero; Masiero, Stefano; Porcellini, Giuseppe; Tarantino, Umberto; Maffulli, Nicola

    2015-01-01

    Despite the high level achieved in the field of shoulder surgery, a global consensus on rotator cuff tears management is lacking. This work is divided into two main sessions: in the first, we set questions about hot topics involved in the rotator cuff tears, from the etiopathogenesis to the surgical treatment. In the second, we answered these questions by mentioning Evidence Based Medicine. The aim of the present work is to provide easily accessible guidelines: they could be considered as recommendations for a good clinical practice developed through a process of systematic review of the literature and expert opinion, in order to improve the quality of care and rationalize the use of resources. PMID:26958532

  5. [Prevalence of skin tears among hospitalized patients with cancer].

    Science.gov (United States)

    Amaral, Ana Flávia dos Santos; Pulido, Kelly Cristina Strazzieri; Santos, Vera Lucia Conceição de Gouveia

    2012-10-01

    This study aimed to analyze the prevalence of skin tears (ST) among hospitalized oncology patients and associated demographic and clinical variables. This is an epidemiological cross-sectional study type, performed at Octavio Frias de Oliveira State of São Paulo Cancer Institute. All adult patients hospitalized from April 10th to 18th 2010 were evaluated by interview and physical examination. Chi-square test was used to compare demographic and clinical variables between patients with and without ST. Five patients among 157 had nine skin tears, resulting in a prevalence of 3.3%. Among demographic variables, only number of children showed statistically significant difference (p=0.027) between groups. Clinically, patients with ST had lower Karnofsky scores (p=0.031), lower scores at Braden Scale (p=0.026) and less collaborative behaviors (p=0.042) when compared to patients with no lesions. This study contributes to a better knowledge of ST in oncology patients.

  6. I.S.Mu.L.T - Rotator Cuff Tears Guidelines

    Science.gov (United States)

    Oliva, Francesco; Piccirilli, Eleonora; Bossa, Michela; Via, Alessio Giai; Colombo, Alessandra; Chillemi, Claudio; Gasparre, Giuseppe; Pellicciari, Leonardo; Franceschetti, Edoardo; Rugiero, Clelia; Scialdoni, Alessandro; Vittadini, Filippo; Brancaccio, Paola; Creta, Domenico; Buono, Angelo Del; Garofalo, Raffaele; Franceschi, Francesco; Frizziero, Antonio; Mahmoud, Asmaa; Merolla, Giovanni; Nicoletti, Simone; Spoliti, Marco; Osti, Leonardo; Padulo, Johnny; Portinaro, Nicola; Tajana, Gianfranco; Castagna, Alex; Foti, Calogero; Masiero, Stefano; Porcellini, Giuseppe; Tarantino, Umberto; Maffulli, Nicola

    2015-01-01

    Despite the high level achieved in the field of shoulder surgery, a global consensus on rotator cuff tears management is lacking. This work is divided into two main sessions: in the first, we set questions about hot topics involved in the rotator cuff tears, from the etiopathogenesis to the surgical treatment. In the second, we answered these questions by mentioning Evidence Based Medicine. The aim of the present work is to provide easily accessible guidelines: they could be considered as recommendations for a good clinical practice developed through a process of systematic review of the literature and expert opinion, in order to improve the quality of care and rationalize the use of resources. PMID:26958532

  7. The growth of the tearing mode - Boundary and scaling effects

    Science.gov (United States)

    Steinolfson, R. S.; Van Hoven, G.

    1983-01-01

    A numerical model of resistive magnetic tearing is developed in order to verify and relate the results of the principal approximations used in analytic analyses and to investigate the solutions and their growth-rate scalings over a large range of primary parameters which include parametric values applicable to the solar atmosphere. The computations cover the linear behavior for a variety of boundary conditions, emphasizing effects which differentiate magnetic tearing in astrophysical situations from that in laboratory devices. Eigenfunction profiles for long and short wavelengths are computed and the applicability of the 'constant psi' approximation is investigated. The growth rate is computed for values of the magnetic Reynolds number up to a trillion and of the dimensionless wavelength parameter down to 0.001. The analysis predicts significant effects due to differing values of the magnetic Reynolds number.

  8. Peroneal tendon tears, surgical management and its complications.

    Science.gov (United States)

    Cerrato, Rebecca A; Myerson, Mark S

    2009-06-01

    Peroneal tendon injuries in the athlete are recognized with increasing frequency as a pathologic entity. Once considered uncommon, they have been attributed to many cases of persistent lateral ankle symptoms after a "typical" ankle sprain. Acute tears of the peroneus brevis, and less commonly the peroneus longus, have been implicated in sport activities and are often coexistent with peroneal instability. Subluxation typically occurs when the foot is in a dorsiflexed position and the peroneal muscles strongly contract, causing an eversion force simultaneously. Peroneal instability, as well as tearing, has been linked to ballet dancing, skiing, soccer, tennis, American football, running, basketball, and ice skating. This article discusses the mechanism of injury, methods of patient evaluation and management, complications, and outcomes. PMID:19501808

  9. MR diagnosis of meniscal tears of the knee

    International Nuclear Information System (INIS)

    Many reports have been published about the utilization of MR imaging for the diagnosis of the meniscal injury of the knee. The grading system frequently used in these reports was proposed by Mink, although, this grading does not measure menisci with structural abnormality such as discoid deformity and bucket handle tear. Accordingly, there is ample room for further improvement in this evaluating system. To pursuit the accuracy of our newly designed grading system, we performed retrospective study on 128 patients who underwent MRI examination prior to arthroscopic examination. Furthermore, follow up study of the menisci, which showed high-intensity signal, was done to ascertain whether such abnormalities progress to meniscal tears. Based upon the newly developed grading system, the accuracy in identifying meniscal tears of lateral meniscus was 91.4% and median meniscus was 88.3% respectively. These accuracy compare favorably with the results of previously reported grading systems. Follow up MRIs and confirmation with arthroscopic examination were carried out in 13 cases which showed high-intensity signal in the meniscus. The mean interval between the initial and follow up imaging was 29 months (range, 15-50 months). In 7 cases of stable knee, increment of intra-meniscal intensity and zone were observed, although, there was no progression of grade and no tear was revealed by arthroscopic examination. On the other hand, in 6 cases with cruciate ligament injury, progression of the grade was observed. The results suggest that intra-meniscal derangement does not progress if the knee is stable and patient's activity is within recreation sports activity. (author)

  10. [Characteristics of exosomes andmicroparticles discovered in human tears].

    Science.gov (United States)

    Grigor'eva, A E; Tamkovich, S N; Eremina, A V; Tupikin, A E; Kabilov, M R; Chernykh, V V; Vlassov, V V; Laktionov, P P; Ryabchikova, E I

    2016-01-01

    Exosomes represent a sort of extracellular vesicles, which transfer molecular signals in organism and possess markers of producing cells. Our study was aimed at search of exosomes in the tears of healthy humans, confirmation of their nature and examination of exosome morphological and molecular-biological characteristics. The tears (110-340 ml) were collected from 24 healthy donors (aged 46-60 years); individual probes were centrifuged at 20000 g for 15 min to pellet cell debris. The supernatants were examined in electron microscope using negative staining; and they were also used for isolation and purification of the exosomes by filtration (100 nm pore-size) and double ultracentrifugation (90 min at 100000 g, 4°C). The "pellets" were subjected to electron microscopy, immunolabeling. The RNA and DNA were isolated from the samples, and their sizes were evaluated by capillary electrophoresis, the concentration and localization of nucleic acids were determined. Sequencing of DNA was performed using MiSeq ("Illumina", USA), data were analyzed using CLC GW 7.5 ("Qiagen", USA). Sequences were mapped on human genome (hg19). Electron microscopy revealed in supernatants of the tears cell debris, spherical microparticles (20-40 nm), membrane vesicles and macromolecular aggregates. The "pellets" obtained after ultracentrifugation, contained microparticles (17%), spherical and cup-shaped EVs (40-100 nm, 83%), which were positive for CD63, CD9 and CD24 receptors (specific markers of exosomes). Our study showed presence of high amount of exosomes in human tears, and relation of the exosomes with RNA (size less than 200 nt) and DNA (size was 3-9 kb). Sequencing of the DNA showed that about 92% of the reads mapped to human genome.

  11. The influence of humidity, temperature, and oral contraceptive in tear

    Science.gov (United States)

    Sousa, Raul A. R. C.; Ribeiro, Tânia L. C.; Moreira, Sandra M. B.; Baptista, António M. G.

    2013-11-01

    The aim of this study is to ascertain whether the quantity and quality of tear and eye subjective comfort are influenced by the temperature, humidity and oral Contraceptives Taking or Non-taking (CTNT). Forty-one students, females, from the University of Minho, Braga, Portugal, aged (mean+/-1standard deviation) of 21.51+/-1.85 years, ranging from 20 to 30 years, participated in this study. The McMonnies Questionnaire (MMQ), Break Up Time (BUT) and Phenol Red Test (PRT) were accessed between 14-17 hours in four sets of visits throughout the year: Visit 1, Visit 2, Visit 3 and Visit 4. The PRT and BUT values (mean+/-1standard deviation) for Visit 1, Visit 2, Visit 3 and Visit 4 were respectively 23.88+/-6.50mm, 22.29+/-8.00mm, 23.61+/-6.75mm, 22.88+/-7.00mm and 6.02+/-1.58s, 5.62+/-1.22s, 5.23+/-0.88s, 5.53+/-1. 42s. The MMQ scores for Visit 1, Visit 2, Visit 3 and Visit 4 ranged from 2-13, 2-15, 1-14 and 2-14 with medians of 6, 7, 6 and 6, respectively. The influence of temperature, humidity and CTNT on PRT, BUT and MMQ were evaluated using generalized linear mixed model. For BUT and MMQ statistical significant effects were found regarding temperature and humidity. The temperature and humidity influenced the tear quality and subjective comfort but did not influence the tear quantity. The CTNT did not influence tear quantity, quality or subjective eye comfort.

  12. Winging of scapula due to serratus anterior tear

    Institute of Scientific and Technical Information of China (English)

    Varun Kumar Singh; Gauresh Shantaram Vargaonkar

    2014-01-01

    Winging of scapula occurs most commonly due to injury to long thoracic nerve supplying serratus anterior muscle.Traumatic injury to serratus anterior muscle itself is very rare.We reported a case of traumatic winging of scapula due to tear of serratus anterior muscle in a 19-year-old male.Winging was present in neutral position and in extension of right shoulder joint but not on "push on wall" test.Patient was managed conservatively and achieved satisfactory result.

  13. The assessment and management of skin tears in care homes.

    Science.gov (United States)

    Stephen-Haynes, Jackie; Callaghan, Rosie; Bethell, Elaine; Greenwood, Michelle

    This article discusses a project conducted in Worcestershire nursing homes to review current practices in the management of skin tears and the subsequent development and implementation of guidelines resulting in a standardised client care package. An initial audit in five care homes was followed by an in-depth audit in 52 homes over a 12-week period. This led to the development of resources and the 'STAR box' to assist with implementation of timely and appropriate care delivery.

  14. Atraumatic quadriceps tendon tear associated with calcific tendonitis.

    Science.gov (United States)

    Abram, Simon G F; Sharma, Akash D; Arvind, Chinnakonda

    2012-11-27

    Calcific tendonitis of the quadriceps tendon is an uncommon condition. We present the first case of a quadriceps tendon tear associated with calcific tendonitis. In this case, the patient presented with symptoms mimicking a rupture of the quadriceps tendon. This case illustrates that although calcific tendonitis of the quadriceps is a rare condition it is not benign and should be considered when investigating acute symptoms associated with the extensor mechanism of the knee.

  15. High conductivity magnetic tearing instability. [of neutral plasma sheets

    Science.gov (United States)

    Cross, M. A.; Van Hoven, G.

    1976-01-01

    Linearized equations of magnetohydrodynamics are used to investigate the tearing mode, for arbitrary values of the conductivity, through a consideration of the additional effect of the electron-inertia contribution to Ohm's law. A description is provided of the equilibrium and subsequent instability in the magnetohydrodynamic approximation. A method for solving the perturbation equations in the linear approximation is discussed and attention is given to the results in the high conductivity limit.

  16. Emotional tears facilitate the recognition of sadness and the perceived need for social support.

    Science.gov (United States)

    Balsters, Martijn J H; Krahmer, Emiel J; Swerts, Marc G J; Vingerhoets, Ad J J M

    2013-01-01

    The tearing effect refers to the relevance of tears as an important visual cue adding meaning to human facial expression. However, little is known about how people process these visual cues and their mediating role in terms of emotion perception and person judgment. We therefore conducted two experiments in which we measured the influence of tears on the identification of sadness and the perceived need for social support at an early perceptional level. In two experiments (1 and 2), participants were exposed to sad and neutral faces. In both experiments, the face stimuli were presented for 50 milliseconds. In experiment 1, tears were digitally added to sad faces in one condition. Participants demonstrated a significant faster recognition of sad faces with tears compared to those without tears. In experiment 2, tears were added to neutral faces as well. Participants had to indicate to what extent the displayed individuals were in need of social support. Study participants reported a greater perceived need for social support to both sad and neutral faces with tears than to those without tears. This study thus demonstrated that emotional tears serve as important visual cues at an early (pre-attentive) level. PMID:23531802

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-02-15

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

  18. Noninvasive diagnostic devices for diabetes through measuring tear glucose.

    Science.gov (United States)

    Zhang, Jin; Hodge, William; Hutnick, Cindy; Wang, Xianbin

    2011-01-01

    This article reviews the development of a noninvasive diagnostic for diabetes by detecting ocular glucose. Early diagnosis and daily management are very important to diabetes patients to ensure a healthy life. Commercial blood glucose sensors have been used since the 1970s. Millions of diabetes patients have to prick their finger for a drop of blood 4-5 times a day to check blood glucose levels--almost 1800 times annually. There is a strong need to have a noninvasive device to help patients to manage the disease easily and painlessly. Instead of detecting the glucose in blood, monitoring the glucose level in other body fluids may provide a feasible approach for noninvasive diagnosis and diabetes control. Tear glucose has been studied for several decades. This article reviews studies on ocular glucose and its monitoring methods. Attempts to continuously monitor the concentration of tear glucose by using contact lens-based sensors are discussed as well as our current development of a nanostructured lens-based sensor for diabetes. This disposable biosensor for the detection of tear glucose may provide an alternative method to help patients manage the disease conveniently. PMID:21303640

  19. Anatomic Reconstruction Technique for a Plantar Calcaneonavicular (Spring) Ligament Tear.

    Science.gov (United States)

    Palmanovich, Ezequiel; Shabat, Shay; Brin, Yaron S; Feldman, Viktor; Kish, Benny; Nyska, Meir

    2015-01-01

    Acquired flatfoot deformity in adults is usually due to partial or complete tearing of the posterior tibial tendon, with secondary failure of other structures such as the plantar calcaneonavicular (spring) ligament (SL), which maintain the medial longitudinal arch. In flexible cases, the tibialis posterior can be replaced with the flexor digitorum longus. It is common practice to suture the SL directly in the case of a tear; however, if the tear is complete, suturing directly to the ligament alone will not be possible. Reconstruction of the ligament is needed; however, no validated methods are available to reconstruct this ligament. The operative technique of SL reconstruction described in this report as a part of acquired flatfoot deformity reconstruction consists of augmenting remnants of the spring from the navicularis to the sustentaculum tali and suspending it to the medial malleolus using 2-mm-wide, long-chain polyethylene suture tape. This technique results in the firm anatomic reconstruction of the SL, in addition to "classic" medial arch reconstruction. We recommend SL reconstruction for medial arch reconstruction when the SL is torn. PMID:26253476

  20. Simultaneous Periprosthetic Acetabular Fracture and Contralateral B-Type Compression Injury of the Pelvic Ring: A Case Report of a Rare Injury Combination

    Directory of Open Access Journals (Sweden)

    Sven Märdian

    2013-01-01

    Full Text Available The periprosthetic fracture of the acetabulum is a rare injury, and its management is only sporadically reported in the literature. A few case reports are available which mainly focus on periprosthetic acetabular fractures in the elderly population. In our case, a 32-year-old patient suffered from a periprosthetic acetabular fracture in combination with a pelvic ring injury following a high velocity accident. The fracture morphology allowed a salvage of the prosthesis with an open reduction and internal fixation with a good radiographic and functional outcome one year after trauma.

  1. The acetabular fossa hot spot on 18F-FDG PET/CT: epidemiology, natural history, and proposed etiology

    International Nuclear Information System (INIS)

    To describe a benign focus of increased activity in the acetabular fossa (the acetabular fossa hot spot, AFHS) on 18F-FDG PET/CT that can mimic a neoplasm. 18F-FDG PET/CT images from four patient populations were examined. Group 1 (n = 13) was collected from a search of radiology reports and used to define the AFHS and for hypothesis generation. Group 2 (n = 1,150) was used for prevalence of AFHS. Group 3 (n = 1,213) had PET/CT and MRI pelvis within a week of each other and was used to correlate metabolic and anatomic findings. Group 4 (n = 100) was used to generate the control group. Data were collected on demographics, common comorbidities, underlying cancer diagnosis and status, and hip symptoms. Prevalence of AFHS was 0.36 % (95 % CI 0.10-0.91 %). None progressed to malignancy or was associated with cancer status. The majority (71 %) were on the left, and 6 % were bilateral. Mean SUVmax of the AFHS was 4.8 (range, 2.7-7.8). Male patients were more likely to have the AFHS (OR = 8.69, 95 % CI 1.88-40.13). There was no difference with respect to other collected data, including hip symptoms. Average minimum duration of AFHS was 346 days (range, 50-1,010 days). Readers did not detect corresponding hip abnormalities on MRIs. AFHS is a benign finding that may be caused by subclinical ligamentum teres injury, focal synovitis, or degeneration of acetabular fossa fat. Despite uncertainty regarding its etiology, recognition of AFHS as a benign finding can prevent morbidity associated with unnecessary biopsy or initiation of therapy. (orig.)

  2. The acetabular fossa hot spot on {sup 18}F-FDG PET/CT: epidemiology, natural history, and proposed etiology

    Energy Technology Data Exchange (ETDEWEB)

    Kubicki, Shelby L. [Trinity University, San Antonio, TX (United States); Richardson, Michael L. [University of Washington, Department of Radiology, Seattle, WA (United States); Martin, Thomas [X-Ray Associates of New Mexico, Department of Radiology, Albuquerque, NM (United States); Rohren, Eric [The University of Texas M.D. Anderson Cancer Center, Department of Diagnostic Radiology, Division of Nuclear Medicine, Houston, TX (United States); Wei, Wei [The University of Texas M.D. Anderson Cancer Center, Department of Biostatistics, Houston, TX (United States); Amini, Behrang [The University of Texas M.D. Anderson Cancer Center, Department of Diagnostic Radiology, Division of Musculoskeletal Radiology, Houston, TX (United States)

    2015-01-15

    To describe a benign focus of increased activity in the acetabular fossa (the acetabular fossa hot spot, AFHS) on {sup 18}F-FDG PET/CT that can mimic a neoplasm. {sup 18}F-FDG PET/CT images from four patient populations were examined. Group 1 (n = 13) was collected from a search of radiology reports and used to define the AFHS and for hypothesis generation. Group 2 (n = 1,150) was used for prevalence of AFHS. Group 3 (n = 1,213) had PET/CT and MRI pelvis within a week of each other and was used to correlate metabolic and anatomic findings. Group 4 (n = 100) was used to generate the control group. Data were collected on demographics, common comorbidities, underlying cancer diagnosis and status, and hip symptoms. Prevalence of AFHS was 0.36 % (95 % CI 0.10-0.91 %). None progressed to malignancy or was associated with cancer status. The majority (71 %) were on the left, and 6 % were bilateral. Mean SUV{sub max} of the AFHS was 4.8 (range, 2.7-7.8). Male patients were more likely to have the AFHS (OR = 8.69, 95 % CI 1.88-40.13). There was no difference with respect to other collected data, including hip symptoms. Average minimum duration of AFHS was 346 days (range, 50-1,010 days). Readers did not detect corresponding hip abnormalities on MRIs. AFHS is a benign finding that may be caused by subclinical ligamentum teres injury, focal synovitis, or degeneration of acetabular fossa fat. Despite uncertainty regarding its etiology, recognition of AFHS as a benign finding can prevent morbidity associated with unnecessary biopsy or initiation of therapy. (orig.)

  3. The efficacy of a “double-D-shaped” wire marker for radiographic measurement of acetabular cup orientation and wear

    OpenAIRE

    Derbyshire, Brian; Raut, Videshnandan V.

    2013-01-01

    Historically, wire markers were attached to cemented all-plastic acetabular cups to demarcate the periphery and to measure socket wear. The wire shape was either a semi-circle passing over the pole of the cup, or a circle around the cup equator. More recently, “double-D” shaped markers were introduced with a part-circular aspect passing over the pole and a semi-circular aspect parallel to the equatorial plane. This configuration enabled cup retroversion to be distinguished from anteversion. I...

  4. Tear cytokine response to multipurpose solutions for contact lenses

    Directory of Open Access Journals (Sweden)

    Kalsow CM

    2013-06-01

    Full Text Available Carolyn M Kalsow,1 William T Reindel,2 Mohinder M Merchea,2 Kirk M Bateman,2,3 Joseph T Barr21Ocular Research Services, Mendon, NY, USA; 2Bausch and Lomb, Inc, Rochester, NY, USA; 3Statistics and Data Corporation, Tempe, AZ, USAPurpose: An increased risk of corneal infiltrative events has been noted with the use of certain contact lenses and multipurpose solutions (MPS. This study was designed to evaluate tear cytokine assay as a sensitive, objective, and quantitative measure of the ocular surface response to contact lens/MPS and to consider the assay's clinical relevance in the context of other measures of ocular surface response.Methods: Two MPS, ReNu® Fresh™ (RNF and Opti-Free® RepleniSH (OFR, were used with daily wear silicone hydrogel contact lenses in a randomized, prospective crossover study involving 26 subjects. Clinical data collection (conjunctival hyperemia, ocular surface sensitivity, solution induced corneal staining (SICS test score, and subjective responses and tear cytokine assays were conducted masked. Responses were tracked as change from baseline throughout the experimental schedule.Results: Similar response patterns for several inflammatory cytokines were seen throughout both phases: subjects who received OFR in Phase I had mean tear concentrations that were generally higher than those of the RNF Phase I group. OFR Phase I subjects had significant (P < 0.01 increases over baseline at day 1 and/or following washout for 13 cytokines (cc chemokine ligands [CCL] 3, CCL5, CCL11, granulocyte-macrophage colony-stimulating factor [GM-CSF], interferon [INF]-γ, interleukin [IL]-2, IL-4, IL-5, IL-6, IL-13, IL-15, IL-17, tumor necrosis factor [TNF]-α. These changes were not observed in RNF Phase I subjects, even though SICS test scores increased. Phase I OFR subjects also had increased dryness, while RNF Phase I subjects had decreased bulbar hyperemia. No changes were detected with respect to limbal hyperemia or surface

  5. HIGH-RESOLUTION ULTRASONOGRAPHY OF SHOULDER FOR ROTATOR CUFF TEAR: CORRELATION WITH ARTHROSCOPIC FINDINGS

    Directory of Open Access Journals (Sweden)

    Vishnumurthy H. Y

    2016-09-01

    Full Text Available INTRODUCTION Rotator cuff disease is the most common cause of shoulder pain. Ultrasonography being non-invasive, widely available, more cost-effective method and is the first choice in imaging of rotator cuff tears. Arthroscopy of shoulder is considered as the gold standard for diagnosis of rotator cuff tears. Objective of this study was to compare the diagnostic accuracy of high-resolution ultrasonography of shoulder for rotator cuff tears with arthroscopy of shoulder. METHODS Thirty patients clinically suspected to have rotator cuff tear who underwent ultrasonography and arthroscopy of shoulder were included in the study. Duration of study was for two years. All ultrasonography examinations were conducted in ultrasound machine using GE Voluson 730 PRO high frequency (10-12 MHz linear array transducer done by two experienced radiologists. Arthroscopies were done by two experienced shoulder arthroscopic surgeons. RESULTS Age of the patients with rotator cuff tears ranged from 40 to 80 years. 57% were females and 43% were males among the patients who had rotator cuff tears. 71.43% of the rotator cuff tears were found in the dominant arm. 64.28% of patients with rotator cuff tear had given history of fall or trauma to the corresponding shoulder within 6 months prior to presentation. 39.28% of patients who had rotator cuff tears were known diabetics. Supraspinatus tendon was the most commonly affected tendon, followed by infraspinatus and subscapularis tendons. For overall detection of rotator cuff tears, ultrasonography in comparison with the arthroscopy has sensitivity and specificity of 92.85% and 100%. For detection of full thickness rotator cuff tear, its sensitivity and specificity was 94.73% and 100% and for partial thickness rotator cuff tears 76.92% and 100%. Ultrasonography has 100% sensitivity and specificity for detection of supraspinatus full thickness tear. For supraspinatus partial thickness tear, sensitivity and specificity was 88

  6. The impact of lipid composition on the stability of the tear fluid lipid layer

    DEFF Research Database (Denmark)

    Kulovesi, P.; Telenius, J.; Koivuniemi, A.;

    2012-01-01

    The tear fluid protects the corneal epithelium from drying and pathogens and it also provides nutrients to these cells. Tear fluid is composed of an aqueous layer as well as a lipid layer that resides at the air-tear interface. The function of the lipid layer is to lower the surface tension...... of the tear fluid and probably prevent evaporation. We have studied the impact of lipid composition on the structural and dynamical properties of the tear lipid film using Langmuir films, X-ray diffraction, and coarse-grained molecular dynamics simulations. Based on recently published lipidomic data, we have...... and dynamics of the lipid layer, since physiologically this condition resembles the tear fluid of chronic blepharitis patients. Our results indicate that neutral lipids residing on top of phospholipids and facing the air phase are needed to produce a stable lipid film at the air-water interface for a wide...

  7. Protrusio of a ceramic femoral head through the acetabular metallic shell, extensive metallosis and 'bubble sign'.

    Science.gov (United States)

    Malizos, Konstantinos; Roidis, Nikolaos T; Poultsides, Lazaros; Basdekis, George; Moraitis, Theofanis; Xenakis, Theodoros

    2009-02-01

    A 24-year-old patient with a history of juvenile rheumatoid arthritis underwent a primary cementless left total hip arthroplasty (THA). The original THA consisted of an Optifix 54 cup with a 3-mm thick polyethylene liner, an Optifix size 4 stem (Smith & Nephew Richards, Memphis, Tennessee) and a Biolox aluminum 32-mm femoral head. Fourteen years later, radiographs demonstrated extensive wear of the polyethylene liner resulting in direct articulation and abrasion wear of the ceramic femoral head on the cup and a bubble sign. This article presents a case of a catastrophic failure of a ceramic/polyethylene bearing with destruction of the polyethylene liner and the metallic shell and protrusio of the nonfractured ceramic head through the metallic shell. To our knowledge this is the first description of extensive metallosis and subsequent radiograph bubble sign not presenting as a result of wear of a metal-on-metal articulation. At the time of revision surgery-Hydrocel TNT Monoblock 58 cup (Zimmer, Warsaw, Indiana), Wagner 265/14 stem (Zimmer), and a Co/Cr 28-mm head-copious metallic debris was seen both macroscopically and histologically, with the ceramic head protruding behind the metallic shell. Multiple factors may have been responsible for this failure including a thin polyethylene shell, a suboptimal locking mechanism, gamma in air sterilization for polyethylene, multiple screw-holes that reduce the contact surface between shell and polyethylene, the rough surface on the inside of the shell and non-articular wear at the metal polyethylene interface within the acetabular component and the high demands of this active young patient. PMID:19301791

  8. The effect of N-acetylcysteine on the microscopic fluid dynamics of rat tears.

    Science.gov (United States)

    Tragoulias, Sophia T; Anderton, Philip J

    2001-09-01

    BACKGROUND: The classical view of the tear film is of a 10-micron film of aqueous tears, sandwiched between thin layers of lipid and mucus. This has been challenged recently by the revelation that the tear film may be considerably thicker than 10 microns and that dissolved mucus and protein may play a much more important role than simply promoting tear adherence. In particular, the primary role of mucus may be to form a structured aqueous gel that adheres closely to the corneal surface and evens out its irregularities, thus providing a high-quality optical surface. METHODS: We have used the robust tear film of the rat eye as an animal model to investigate the contribution of mucus and low-molecular-weight (LMW) proteins to tear film structure. The ocular surface was first exposed to saline, which washed away the tear film. Single drops of a tear/saline mixture, treated with various concentrations of the thiol-reducing agent N-acetylcysteine (NAC), were placed on the ocular surface and the resulting fluid behaviour was recorded with video-microscopy. RESULTS: At five per cent concentration, NAC appeared to degrade the gap-filling and anti-evaporative qualities of the tears, features that give the rat tear film its robust characteristics. Lower concentrations had no significant effect. DISCUSSION: In a previous publication, we showed that five per cent NAC alters the profile of LMW proteins in rat tears. The present observations suggest that the robust wetting properties of rat tears depend critically on their mucus and/or LMW protein content and possibly are related to the formation of an aqueous/mucous gel.

  9. Pectoralis major tears: anatomy, classification, and diagnosis with ultrasound and MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Chiavaras, Mary M. [McMaster University, Department of Radiology, Hamilton, ON (Canada); Jacobson, Jon A. [University of Michigan, Department of Radiology, Ann Arbor, MI (United States); Smith, Jay [Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN (United States); Department of Radiology, Mayo Clinic, Rochester, MN (United States); Department of Anatomy, Mayo Clinic, Rochester, MN (United States); Dahm, Diane L. [Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN (United States)

    2014-09-09

    Accurate characterization of pectoralis major tears is important to guide management. Imaging evaluation with ultrasound and MR imaging can be difficult given the complex regional anatomy. In addition, recent literature has redefined the anatomy of the distal pectoralis major. The purpose of this study is to review pectoralis major injuries taking into account new anatomic descriptions using ultrasound and MR imaging, including cadaveric dissection, surgically produced pectoralis tears, and clinical pectoralis tendon tear with surgical correlation. (orig.)

  10. Evaluation of Tear Malate Dehydrogenase 2 in Mild Dry Eye Disease

    Institute of Scientific and Technical Information of China (English)

    Qing Guo; Houbin Huang; Yuli Pi; Hancheng Zhang

    2014-01-01

    Purpose: To evaluate the effect of tear malate dehydrogenase 2 on monitoring ocular surface injury in mild dry eye (DE) disease. Methods: A total of 15 DE patients (30 eyes) with mild sub-jective symptoms but no ocular surface fluorescein staining signs were enrolled in this study. (DE group)..The control group was 15 healthy age- and sex-matched volunteers (30 eyes)..All subjects were asked to fill out a DE symptoms questionnaire and take different tests including tear MDH and MDH2 activities evaluation,..tear breakup time. (TBUT), Schirmer I,.and slit-lamp examination of the ocular surface. We investigated different changes in tear MDH and MDH2 ac-tivities in the DE group and control group,.discussed the as-sociation between tear MDH2 activity and DE symptoms, and the relationship between tear MDH2 activity and diagnostic tests (Schirmer I and TBUT). We also analyzed the changes in tear MDH2 activities after the treatment with artificial tears. Results:.Tear MDH activities in the DE group and control group were 288 ±102 U/L and 259 ±112 U/L,.respectively, and this difference was not statistically significant (P>0.05). The tear MDH2 activities in DE group were significantly in-creased compared with control group. Tear MDH2 was signif-icantly and negatively correlated with the Schirmer’s value (r=-0.733,P Conclusion: Tear MDH2 activity can indicate ocular surface injury in mild DE patients and may be used to monitor the re-sponse to therapy.

  11. Skin tears: a review of the evidence to support prevention and treatment.

    Science.gov (United States)

    Ratliff, Catherine R; Fletcher, Kathleen R

    2007-03-01

    Physiological changes that occur as part of the aging process put the elderly at risk for developing skin tears. Lack of consistent care in the management of skin tears in the authors' community sparked a literature search to determine best evidence for the management of skin tears. Medline and Cochrane Library databases were searched for studies and systematic reviews on skin tear prevention and treatment. The literature suggested that the greatest number of skin tears occurs among the elderly (65 years and older). Factors reported to be associated with the occurrence of skin tears in addition to age include immobility and a history of skin tears. In the absence of systematic risk factor research, clinicians continue to report that all variables that may be associated with these wounds must be considered when assessing the elderly. Several small studies suggest that most skin tears occur on the extremities and seasonal incidence variations also have been reported. Despite consistent sample-size limitations, the results of controlled clinical studies and case series consistently suggest that education and implementation of prevention protocols reduce the incidence of skin tears in extended care facilities by almost 50%. Studies to evaluate and compare the effectiveness and cost-effectiveness of skin tear treatments are limited but when appropriate care is provided most skin tears can be expected to heal after 7 to 21 days depending on the severity of the wound. A combination of skin protection, preventive measures, and treatments that facilitate moist wound healing appear to be most effective. Risk factor and epidemiological studies as well as research to validate the existing skin tear classification system and improve clinician ability to provide evidence-based risk assessments, preventive care, and treatment are needed.

  12. Biomechanical Consequences of a Complete Radial Tear Adjacent to the Medial Meniscus Posterior Root Attachment Site

    OpenAIRE

    LaPrade, Robert F.; Padalecki, Jeffrey Ryan; Jansson, Kyle; Smith, Sean; Dornan, Grant; Pierce, Casey; Wijdicks, Coen A

    2014-01-01

    Objectives: Complete radial tears near the medial meniscus posterior root attachment site disrupt the circumferential integrity of the meniscus (similar to a posterior root avulsion). These tears can compromise the circumferential integrity and have been reported in biomechanical studies to simulate the meniscectomized state. The purpose of the study was to quantify the tibiofemoral contact load and contact area changes that occur in cadaveric knees from complete posterior horn radial tears a...

  13. Tears of anterior cruciate ligament and associated injury in the knee joint: MR imaging

    International Nuclear Information System (INIS)

    The objective of the study was to evaluate the characteristic findings in tears of the anterior cruciate ligament(ACL) and associated injury at MR imaging. We reviewed the findings of MR images and the corresponding arthroscopic results of 32 patients with ACL tears. We evaluated the signal intensity and contour of ACL surrounding bony structures, menisci and associated injury of the knee joint. Complete ACL tears were present in 25 patients and partial ACL tears were in 7 patients. Complete ACL tears showed heterogenously increased signal intensity with contour bulging of the ACL in 14 patients (56%) and without bulging or absence in 11 patients(44%). Most patients torn ACL with contour bulging(12/14) had bone bruise, but only one patient torn ACL without bulging contour had bone bruise. ACL with thin continuous low signal band surrounding heterogenously increased signal intensity suggests partial tear which was seen in three patients of seven proved partial ACL tears. Combined bone injury in ACL tear were in 23 patients (73%) and most of these(22/23) were at midportion of lateral notch of femur and/or posterior portion of lateral tibial plateu. Deepening of lateral notch of femur were noted in 17 patients(53%). Associated injuries of the other ligaments of knee joint were buckling of the posterior cruciate ligament(16/32, 50%) and tears of the medial collateral ligament(11/32, 34%). Posterior horns of menisci were more frequent site of combined injury within menisci in patients with ACL tear. Acute tearing of ACL in MRI is seen as heterogenously increased signal intensity with contour bulging of ACL and combined bone bruises. Patients with torn ACL frequently have various combined injury. In patient with knee injury, these associated or ancillary findings suggest that ACL tear is present

  14. The Effect Of Weave Construction On Tear Strength Of Woven Fabrics

    Directory of Open Access Journals (Sweden)

    Eryuruk Selin Hanife

    2015-09-01

    Full Text Available The tear strength of a woven fabric is very important, since it is more closely related to serviceability of the fabric. Tearing strength of the fabrics depend on the mobility of the yarn within the fabric structure. In this study, the tearing strength of four types of fabrics warp rib, weft rib, ripstop and plain weave were analysed, which were produced in different densities and with filament and texturised polyester yarns.

  15. Pectoralis major tears: anatomy, classification, and diagnosis with ultrasound and MR imaging

    International Nuclear Information System (INIS)

    Accurate characterization of pectoralis major tears is important to guide management. Imaging evaluation with ultrasound and MR imaging can be difficult given the complex regional anatomy. In addition, recent literature has redefined the anatomy of the distal pectoralis major. The purpose of this study is to review pectoralis major injuries taking into account new anatomic descriptions using ultrasound and MR imaging, including cadaveric dissection, surgically produced pectoralis tears, and clinical pectoralis tendon tear with surgical correlation. (orig.)

  16. The effect of N-acetylcysteine on the microscopic fluid dynamics of rat tears.

    Science.gov (United States)

    Tragoulias, Sophia T; Anderton, Philip J

    2001-09-01

    BACKGROUND: The classical view of the tear film is of a 10-micron film of aqueous tears, sandwiched between thin layers of lipid and mucus. This has been challenged recently by the revelation that the tear film may be considerably thicker than 10 microns and that dissolved mucus and protein may play a much more important role than simply promoting tear adherence. In particular, the primary role of mucus may be to form a structured aqueous gel that adheres closely to the corneal surface and evens out its irregularities, thus providing a high-quality optical surface. METHODS: We have used the robust tear film of the rat eye as an animal model to investigate the contribution of mucus and low-molecular-weight (LMW) proteins to tear film structure. The ocular surface was first exposed to saline, which washed away the tear film. Single drops of a tear/saline mixture, treated with various concentrations of the thiol-reducing agent N-acetylcysteine (NAC), were placed on the ocular surface and the resulting fluid behaviour was recorded with video-microscopy. RESULTS: At five per cent concentration, NAC appeared to degrade the gap-filling and anti-evaporative qualities of the tears, features that give the rat tear film its robust characteristics. Lower concentrations had no significant effect. DISCUSSION: In a previous publication, we showed that five per cent NAC alters the profile of LMW proteins in rat tears. The present observations suggest that the robust wetting properties of rat tears depend critically on their mucus and/or LMW protein content and possibly are related to the formation of an aqueous/mucous gel. PMID:12366370

  17. Radial tear of posterior horn of the medial meniscus and osteonecrosis of the knee

    International Nuclear Information System (INIS)

    We studied the relation between a radial tear of the posterior horn of the medial meniscus and osteonecrosis of the knee. Thirty-eight knees of 37 patients were diagnosed as medial meniscus tear and received arthroscopic knee surgery. We divided them into two groups: knees having radial tear of the posterior horn of the medial meniscus (posterior horn group) and knees containing radial tear except for posterior horn, horizontal tear, degenerative tear, and flap tear of the medial meniscus (non-posterior horn group). The posterior horn group consisted of 14 knees (average age: 65.1 years old) and the non-posterior horn group consisted of 24 knees (average age: 59.6 years old). All cases underwent MRI before arthroscopy. MRI findings were classified into three types (typical osteonecrosis, small osteonecrosis, and non-osteonecrosis). In the posterior horn group, typical osteonecrosis were five knees and small osteonecrosis were five knees, while in the non-posterior horn group only three knees were small osteonecrosis. These findings suggest the relevance between radial tear of the posterior horn of the medial meniscus and osteonecrosis of the knee (Mann-Whitney test p<0.01). The etiology of spontaneous osteonecrosis of the knee joint is unknown, however one etiology could be the radial tear of the posterior horn of the medial meniscus. (author)

  18. Review article: Risk factors for poor outcome following surgical treatment for rotator cuff tear.

    Science.gov (United States)

    Sahni, V; Narang, A M

    2016-08-01

    The Medline database was searched using key words: 'rotator cuff', 'tear', and 'treatment'. 12 studies that involved (1) surgical treatment for rotator cuff tear, (2) measurement of pre- and post-operative pain score, functional score, and/or patient satisfaction, (3) patients that failed to improve functionally or had poor satisfaction, (4) preoperative examination of risk factors that could lead to poor outcome, and (5) a minimum follow-up of 6 months were reviewed to identify risk factors associated with poor outcome following surgical treatment for rotator cuff tear. The most common risk factor was tear size, followed by open compensation claim, age, and time from injury to surgery. PMID:27574276

  19. Free medial meniscal fragment which mimics the dislocated bucket-handle tear on MRI.

    Science.gov (United States)

    Türkmen, Faik; Korucu, Ismail Hakkı; Sever, Cem; Demirayak, Mehmet; Goncü, Gani; Toker, Serdar

    2014-01-01

    The bucket-handle meniscal tear is a specific type of meniscal injuries which has specific signs on MRI. An attached fragment displaced away from the meniscus with any type of tear causes bucket-handle tear of the meniscus. Magnetic resonance imaging (MRI) is the most commonly used diagnostic tool for meniscal injuries. We present a case of free medial meniscal fragment which mimics the dislocated bucket-handle tear on MRI. The presence of "fragment within the intercondylar notch sign" and "the absence of the bow tie sign" may be an indication of a free meniscal fragment. This should be considered during diagnosis. PMID:25002980

  20. Free Medial Meniscal Fragment Which Mimics the Dislocated Bucket-Handle Tear on MRI

    Directory of Open Access Journals (Sweden)

    Faik Türkmen

    2014-01-01

    Full Text Available The bucket-handle meniscal tear is a specific type of meniscal injuries which has specific signs on MRI. An attached fragment displaced away from the meniscus with any type of tear causes bucket-handle tear of the meniscus. Magnetic resonance imaging (MRI is the most commonly used diagnostic tool for meniscal injuries. We present a case of free medial meniscal fragment which mimics the dislocated bucket-handle tear on MRI. The presence of “fragment within the intercondylar notch sign” and “the absence of the bow tie sign” may be an indication of a free meniscal fragment. This should be considered during diagnosis.

  1. Self-monitoring of tear glucose: the development of a tear based glucose sensor as an alternative to self-monitoring of blood glucose.

    Science.gov (United States)

    La Belle, Jeffrey T; Adams, Anngela; Lin, Chi-En; Engelschall, Erica; Pratt, Breanna; Cook, Curtiss B

    2016-07-28

    Tear glucose sensing for diabetes management has long been sought as an alternative to more invasive self-monitoring of blood glucose (SMBG). However, tear glucose sensors were known to have limitations, including correlation issues with blood glucose due to low sample volume, low concentration of glucose in the tear fluid, and evaporation of the tear sample. An engineering design approach to solve these problems led to the development of an integrated device capable of collecting the tear sample from the ocular surface with little to no stress on the eye, with an extremely low limit of detection, broad dynamic range, and rapid detection and analysis of sample. Here we present the development of a prototypical self-monitoring of tear glucose (SMTG) sensor, summarizing bench studies on the enzymes and their specificity, the development of the fluid capture device and its manufacture and performance and results of system testing in an animal study where safety, lag time and tear glucose to blood glucose correlation were assessed. PMID:27327531

  2. Supra-acetabular fixation and sacroiliac screws for treating unstable pelvic ring injuries: preliminary results from 20 patients☆

    Science.gov (United States)

    Guimarães, Rodrigo Pereira; de Góes Ribeiro, Arthur; Ulson, Oliver; de Ávila, Ricardo Bertozzi; Ono, Nelson Keiske; Polesello, Giancarlo Cavalli

    2016-01-01

    Objective To analyze the treatment results from 20 patients who underwent an alternative osteosynthesis method as definitive treatment for pelvic ring fractures. Methods A retrospective analysis was conducted on a series of 20 patients with pelvic ring fractures (Tile type C) and a high risk of postoperative infection, who were treated at Santa Casa de Misericórdia de São Paulo between August 2004 and December 2012. The patients underwent percutaneous supra-acetabular external fixation in association with cannulated 7.0 mm iliosacral screws. Results The patients’ mean age was 40 years (range 22–77 years) and the mean length of follow-up was 18.5 months (range 3–69 months). At the end of the treatment, ten patients (50%) were classified as having good results, nine patients (45%) had fair results and one patient (5%) did not have any improvement. Six patients presented complications, and paresthesia of the lateral femoral cutaneous nerve was the most frequent of these (two patients). Conclusion Supra-acetabular external fixation in association with iliosacral percutaneous osteosynthesis is a good definitive treatment method for patients with a high risk of postoperative infection. PMID:27069879

  3. Acetabular defect reconstruction with impacted morsellized bone grafts or TCP/HA particles. A study on the mechanical stability of cemented cups in an artificial acetabulum model.

    NARCIS (Netherlands)

    Bolder, S.B.T.; Verdonschot, N.J.J.; Schreurs, B.W.; Buma, P.

    2002-01-01

    In revision surgery of the acetabulum bone defects can be filled with impacted human morsellized bone grafts. Because of a worldwide limited availability of human bone, alternatives are being considered. In this study we compared the initial stability of acetabular cups after reconstructing a cavita

  4. Resistive Magnetohydrodynamics Simulations of the Ideal Tearing Mode

    Science.gov (United States)

    Landi, S.; Del Zanna, L.; Papini, E.; Pucci, F.; Velli, M.

    2015-06-01

    We study the linear and nonlinear evolution of the tearing instability on thin current sheets by means of two-dimensional numerical simulations, within the framework of compressible, resistive MHD. In particular we analyze the behavior of current sheets whose inverse aspect ratio scales with the Lundquist number S as {{S}-1/3}. This scaling has been recently recognized to yield the threshold separating fast, ideal reconnection, with an evolution and growth that are independent of S provided this is high enough, as it should be natural having the ideal case as a limit for S\\to ∞ . Our simulations confirm that the tearing instability growth rate can be as fast as γ ≈ 0.6 {{τ }A}-1, where {{τ }A} is the ideal Alfvénic time set by the macroscopic scales, for our least diffusive case with S={{10}7}. The expected instability dispersion relation and eigenmodes are also retrieved in the linear regime, for the values of S explored here. Moreover, in the nonlinear stage of the simulations we observe secondary events obeying the same critical scaling with S, here calculated on the local, much smaller lengths, leading to increasingly faster reconnection. These findings strongly support the idea that in a fully dynamic regime, as soon as current sheets develop, thin, and reach this critical threshold in their aspect ratio, the tearing mode is able to trigger plasmoid formation and reconnection on the local (ideal) Alfvénic timescales, as required to explain the explosive flaring activity often observed in solar and astrophysical plasmas.

  5. Curvature effect on tearing modes in presence of neoclassical friction

    Science.gov (United States)

    Maget, Patrick; Mellet, Nicolas; Lütjens, Hinrich; Meshcheriakov, Dmytro; Garbet, Xavier

    2013-11-01

    Neoclassical physics (here associated to the poloidal variation of the magnetic field strength along field lines in a tokamak) is well known for driving self-generated plasma current and nonlinear magnetic islands associated to it in high performance, ITER relevant plasma discharges. It is demonstrated that the neoclassical friction between a magnetic perturbation and plasma flow already impacts magnetic islands in the linear regime, by inducing a weakening of curvature stabilization for tearing modes. This conclusion holds in particular for regimes where convection is influencing the pressure dynamics, as shown using a simple analytical model and confirmed in full Magneto-Hydro-Dynamics simulations.

  6. Curvature effect on tearing modes in presence of neoclassical friction

    Energy Technology Data Exchange (ETDEWEB)

    Maget, Patrick; Mellet, Nicolas; Meshcheriakov, Dmytro; Garbet, Xavier [CEA, IRFM, F-13108 Saint Paul-lez-Durance (France); Lütjens, Hinrich [Centre de Physique Théorique, Ecole Polytechnique, CNRS (France)

    2013-11-15

    Neoclassical physics (here associated to the poloidal variation of the magnetic field strength along field lines in a tokamak) is well known for driving self-generated plasma current and nonlinear magnetic islands associated to it in high performance, ITER relevant plasma discharges. It is demonstrated that the neoclassical friction between a magnetic perturbation and plasma flow already impacts magnetic islands in the linear regime, by inducing a weakening of curvature stabilization for tearing modes. This conclusion holds in particular for regimes where convection is influencing the pressure dynamics, as shown using a simple analytical model and confirmed in full Magneto-Hydro-Dynamics simulations.

  7. The Linear Evolution of Tearing Mode in Toroidal Geometry*

    Institute of Scientific and Technical Information of China (English)

    任慎明; 俞国扬

    2001-01-01

    A set of linearly-reduced MHD equations in toroidal geometry has been solved numerically in flux coordinate with toroidal coupling. In the case of q > 1 on the magnetic axis.where q is the safety factor, the result shows that an unstable 2/1 tearing mode destabilizes both 1/1 and 3/1 modes. The 1/1 and 3/1 modes contribute local perturbations on the resonant surface of q = 2. And the 2/1 mode also contributes a local perturbation on the resonant surface of q = 3.``

  8. Recurrent hypertrophic peroneal tubercle associated with peroneus brevis tendon tear.

    Science.gov (United States)

    Ochoa, Leah M; Banerjee, Rahul

    2007-01-01

    Stenosing peroneal tenosynovitis resulting from hypertrophy of the peroneal tubercle has been well described. Successful surgical treatment addresses the hypertrophied peroneal tubercle as well as any intrinsic tendon pathology. We report a case of recurrent foot pain caused by stenosing peroneal tenosynovitis in a 16-year-old woman. Four months after excision of a hypertrophic peroneal tubercle, the patient developed a recurrence of symptoms. Imaging studies, repeat operative exploration, and pathologic specimen demonstrated a recurrence of the peroneal tubercle hypertrophy associated with a longitudinal tear of the peroneus brevis tendon. Re-resection of the hypertrophied tubercle and peroneal tendon repair resulted in a resolution of symptoms. PMID:17761327

  9. Transport threshold model of subsonic neoclassical tearing modes in tokamaks

    International Nuclear Information System (INIS)

    A transport threshold model of subsonic neoclassical tearing modes (NTMs) in tokamaks is developed. The basic procedure is to include the velocity-dependent term into the single-fluid heat-conductivity equation and to complement this equation with the single-fluid parallel plasma motion equation. These equations permit the determination of the perturbed plasma temperature and the bootstrap current drive of NTMs, for both strong and weak perpendicular heat transport, which is the precondition for developing the above model. It is shown that the subsonic NTMs transport threshold model can be more realistic than the standard transport model of NTMs suggested by Fitzpatrick [Phys. Plasmas 2, 825 (1995)

  10. The Changes of Tear Status after Conventional and Wavefront-Guided IntraLASIK

    Science.gov (United States)

    Foo, Say Kiang; Kaur, Sharanjeet; Abd Manan, Faudziah; Low, Aloysius Joseph

    2011-01-01

    Background: IntraLASIK is a LASIK surgery that involved IntraLase femtosecond laser for the corneal flap creating. The objective of this research was to investigate and compare the changes in tear status at 1 and 3 months after undergoing conventional IntraLASIK with Bausch & Lomb PlanoScan (PS) algorithm, Bausch & Lomb Zyoptix Tissue Saving (ZTS) algorithm, and wavefront-guided (WG) IntraLASIK with VISX CustomVue. Methods: Tear status of 36 patients who were divided into 3 groups depending on the type of IntraLASIK they underwent (PS, n = 13; ZTS, n = 9; WG, n = 14) was evaluated. Tear status was determined by classifying the category of the thickness of pre-corneal tear lipid layer, non-invasive tear break-up time, and tear meniscus height. Repeated measures analysis of variance (ANOVA) and one way ANOVA were used for the statistical analyses. Results: The category of the thickness of tear lipid layer, non-invasive tear break up time and tear meniscus height were neither significantly changed after IntraLASIK for all groups nor showed significant difference among groups at 1 and 3 months post-IntraLASIK (P > 0.05). Blinking rate and palpebral aperture also had no significant changed after IntraLASIK. Conclusion: Both conventional (PS and ZTS) and WG IntraLASIK did not affect tear status up to 3 months post-IntraLASIK. WG IntraLASIK did not show superiority in preserving tear status 1 and 3 months post-surgery compared with conventional IntraLASIK. PMID:22135584

  11. Bucket handle tears of the medial meniscus: meniscal intrusion rather than meniscal extrusion

    Energy Technology Data Exchange (ETDEWEB)

    Schlossberg, S. [Jacobi Medical Center, Department of Radiology, Bronx, NY (United States); Umans, H. [Jacobi Medical Center, Department of Radiology, Bronx, NY (United States); Jacobi Medical Center, Department of Surgery Division of Orthopedic Surgery, Bronx, NY (United States); Flusser, G. [Tel Aviv Sourasky Medical Center, Department of Radiology, Tel Aviv (Israel); DiFelice, G.S. [Jacobi Medical Center, Department of Surgery Division of Orthopedic Surgery, Bronx, NY (United States); Lerer, D.B. [Montefiore Medical Center, Department of Radiology, Bronx, NY (United States)

    2007-01-15

    To determine the frequency of medial meniscal extrusion (MME) versus ''medial meniscal intrusion'' in the setting of bucket handle tears. Images were evaluated for previously reported risk factors for MME, including: medial meniscal root tear, radial tear, degenerative joint disease and joint effusion. Forty-one consecutive cases of bucket handle tear of the medial meniscus were reviewed by consensus by two musculoskeletal radiologists. Imaging was performed using a 1.5 GE Signa MR unit. Patient age, gender, medial meniscal root integrity, MME, medial meniscal intrusion, degenerative joint disease, effusion and anterior cruciate ligament (ACL) tear were recorded. Thirteen females and 27 males (age 12-62 years, median=30 years) were affected; one had bucket handle tear of each knee. Effusion was small in 13, moderate in 9 and large in 18. Degenerative joint disease was mild in three, moderate in two and severe in one. 26 ACL tears included three partial and three chronic. Medial meniscal root tear was complete in one case and partial thickness in two. None of the 40 cases with an intact or partially torn medial meniscal root demonstrated MME. MME of 3.1 mm was seen in the only full-thickness medial meniscal root tear, along with chronic ACL tear, moderate degenerative joint disease and large effusion. Medial meniscal intrusion of the central bucket handle fragment into the intercondylar notch was present in all 41 cases. Given an intact medial meniscal root in the setting of a ''pure'' bucket handle tear, there is no MME. (orig.)

  12. MR imaging of the combined anterior and posterior cruciate ligament tears: focussing on the ratterns of injuries and associated findings

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Seon Young; Choi, Chang Lak; Park, Dal Soo; Park, Eun Hee; Lee, Sang Ho; Song, Mun Kab; Lee, Kwang Won [Eulji Medical College, Taejon (Korea, Republic of); Kwon, Soon Tae [Chungnam National Univ. College of Medicine, Taejon (Korea, Republic of)

    1997-09-01

    To evaluate the patterns of injuries and frequency of associated findings on MR imaging in patients with both anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL)tears;to compare the associated findings, as seen on MR imaging, in cases with both ACL and PCL tears with those with ACL or PCL tears. Ten patients with compbined ACL and PCL tears, 16 with ACL tears and 18 with PCL tears, all confirmed by arthroscopy or open surgery, were involved in this study. To identify the associated knee injuries, MR images were retrospectively evaluated. In ten patients with combined ACL and PCL tears, open surgery led to the identification of six complete ACL tears (60%), four partial ACL tears (40%), eitht complete PCL tears (80%) and two partial PCL tears (20%). Injuries associated with these combined tears, and revealed by MR imaging, comprised six medial collateral ligament injuries (60%), six lateral collateral ligament jnjuries (60%), five medial meniscal injuries (50%), three lateral meniscal injuries (30%), nine bony injuries (90%), two posterior capsular injuries (20%), and three popliteus muscle injuries (30%). The frequency of popliteus muscle injury was significantly different (p<0.05, Fisher's exact test) between the group with both ACL and PCL tears and that with ACL or PCL tears. Associated findings in patients with combined ACL and PCL tears are more frequent than in those with ACL or PCL tears. In cases involving combined ACL and PCL tears, associated findings-as seen on MR images-should thus be carefully examined.

  13. Computer assisted determination of acetabular cup orientation using 2D-3D image registration

    Energy Technology Data Exchange (ETDEWEB)

    Zheng, Guoyan; Zhang, Xuan [University of Bern, Institute for Surgical Technology and Biomechanics, Bern (Switzerland)

    2010-09-15

    2D-3D image-based registration methods have been developed to measure acetabular cup orientation after total hip arthroplasty (THA). These methods require registration of both the prosthesis and the CT images to 2D radiographs and compute implant position with respect to a reference. The application of these methods is limited in clinical practice due to two limitations: (1) the requirement of a computer-aided design (CAD) model of the prosthesis, which may be unavailable due to the proprietary concerns of the manufacturer, and (2) the requirement of either multiple radiographs or radiograph-specific calibration, usually unavailable for retrospective studies. In this paper, we propose a new method to address these limitations. A new formulation for determination of post-operative cup orientation, which couples a radiographic measurement with 2D-3D image matching, was developed. In our formulation, the radiographic measurement can be obtained with known methods so that the challenge lies in the 2D-3D image matching. To solve this problem, a hybrid 2D-3D registration scheme combining a landmark-to-ray 2D-3D alignment with a robust intensity-based 2D-3D registration was used. The hybrid 2D-3D registration scheme allows computing both the post-operative cup orientation with respect to an anatomical reference and the pelvic tilt and rotation with respect to the X-ray imaging table/plate. The method was validated using 2D adult cadaver hips. Using the hybrid 2D-3D registration scheme, our method showed a mean accuracy of 1.0 {+-} 0.7 (range from 0.1 to 2.0 ) for inclination and 1.7 {+-} 1.2 (range from 0.0 to 3.9 ) for anteversion, taking the measurements from post-operative CT images as ground truths. Our new solution formulation and the hybrid 2D-3D registration scheme facilitate estimation of post-operative cup orientation and measurement of pelvic tilt and rotation. (orig.)

  14. The effect of geometry and abduction angle on the stresses in cemented UHMWPE acetabular cups – finite element simulations and experimental tests

    Directory of Open Access Journals (Sweden)

    Santavirta Seppo S

    2005-05-01

    Full Text Available Abstract Background Contact pressure of UHMWPE acetabular cup has been shown to correlate with wear in total hip replacement (THR. The aim of the present study was to test the hypotheses that the cup geometry, abduction angle, thickness and clearance can modify the stresses in cemented polyethylene cups. Methods Acetabular cups with different geometries (Link®: IP and Lubinus eccentric were tested cyclically in a simulator at 45° and 60° abduction angles. Finite element (FE meshes were generated and two additional designs were reconstructed to test the effects of the cup clearance and thickness. Contact pressures at cup-head and cup-cement interfaces were calculated as a function of loading force at 45°, 60° and 80° abduction angles. Results At the cup-head interface, IP experienced lower contact pressures than the Lubinus eccentric at low loading forces. However, at higher loading forces, much higher contact pressures were produced on the surface of IP cup. An increase in the abduction angle increased contact pressure in the IP model, but this did not occur to any major extent with the Lubinus eccentric model. At the cup-cement interface, IP experienced lower contact pressures. Increased clearance between cup and head increased contact pressure both at cup-head and cup-cement interfaces, whereas a decreased thickness of polyethylene layer increased contact pressure only at the cup-cement interface. FE results were consistent with experimental tests and acetabular cup deformations. Conclusion FE analyses showed that geometrical design, thickness and abduction angle of the acetabular cup, as well as the clearance between the cup and head do change significantly the mechanical stresses experienced by a cemented UHMWPE acetabular cup. These factors should be taken into account in future development of THR prostheses. FE technique is a useful tool with which to address these issues.

  15. Periacetabular osteotomy for acetabular dysplasia%髋臼周围截骨术治疗髋臼发育不良

    Institute of Scientific and Technical Information of China (English)

    李华; 王云清; 魏东

    2011-01-01

    目的 探讨髋臼周围截骨术治疗髋臼发育不良的方法 及疗效.方法 对36例髋臼发育不良患者(43髋)行手术治疗,通过髋臼周围截骨、旋转髋臼向前外侧移位恢复髋臼的正确位置,并增加髋臼覆盖面.结果 36例均获随访,时间 6个月~3年.术后髋痛、跛行完全消失或有明显改善,髋关节活动范围基本正常.CE角和Sharp角均基本恢复正常.结论 髋臼周围截骨术可有效改善临床症状,恢复髋关节的生物力学特点,是治疗髋臼发育不良的有效方法.%Objective To discuss the method and effect of the treatment of acetabular dysplasia by periacetabular acetabular osteotomy. Methods Periacetabular osteotomy was performed to correct 36 patients( 43 hips )with dysplastic acetabulum through rotating the acetabulum anterolaterally, by which the position and acetabular coverage of the femoral head was restored to nearly normal. Results 36 patients with acetabular dysplasia were all followed up for six months to three years. After operation, in the majority, the hip limp or pain with exertion disappeared, and a satisfactory range of motion had been restored. CE angle and Sharp angle were restored to nearly normal value. Conclusions Periacetabular osteotomy is effectively to improve the clinical symptoms, and restore the hip biomechanics characteristics,which is ideal for the treatment of developmental acetabular dysplasia.

  16. A porous tantalum uncemented acetabular cup in acetabular revision arthroplasty%生物学固定骨小梁金属杯在髋臼翻修中的应用

    Institute of Scientific and Technical Information of China (English)

    徐卫东; 陈刚; 张东华

    2009-01-01

    前后X射线平片显示无假体移位下沉等不稳迹象,骨小梁金属杯周围骨质向内长入.本组患者无置换后并发症发生,截至最后1次随访有14例行走时无疼痛,2例轻度疼痛伴轻度跛行.未出现症状性深静脉血栓或神经损伤.无需要再度翻修病例.结论:初次固定人工髋臼杯失败的病例,若无骨缺损,翻修时使用骨小梁金属杯可以获得良好的早期效果.%BACKGROUND: Biological fixation refers to the treatment of coarse or porous prosthetic surface. It is favorable to "bone ingrowth" prosthesis to achieve long-term stability. Porous tantalum is the latest scientific product that appears suitable to prosthetic surface owing to its porous feature and has been attracting a great deal attention.OBJECTIVE: To investigate the therapeutic efficacy of a porous tantalum uncemented acetabular cup in acetabular revision arthroplasty.DESIGN, TIME AND SETTING: A retrospective case analysis was performed at the Department of Orthopedics, Changhai Hospital, Second Military Medical University of Chinese PLA between April and November 2006.PARTICIPANTS/MATERIALS: Sixteen patients (16 hips), 7 males and 9 females, aged 54-81 years old, who received treatment at the Department of Orthopedics, Changhai Hospital, Second Military Medical University of Chinese PLA were included in this study. Of these patients, 2 suffered from femoral neck fracture, 6 from aseptic femoral head necrosis, and 8 from osteoarthritis. Trabecular metal cup (Zimmer, Warsaw, Indiana) provided a titanium alloy bottom layer and porous tantalum-coated surface, which was realized by technical combination of bone trabecular tantalum and titanium alloy. The prosthesis contained an ultrahigh modulus polyethylene lining.METHODS: All patients underwent acetabular revision with modular porous tantalum uncemented acetabular cup. Prior to replacement, acetabular defects and femoral prosthesis were evaluated. A posterolateral approach of hip joint was made. Following

  17. Effect of loading on stable tearing of wide plates

    International Nuclear Information System (INIS)

    A series of wide plate tests using a 0.36% carbon steel have been carried out in the AEA Structural Features Test Facility to determine the stable tearing behaviour of cracks under different loading conditions, typical of pressurized components. The majority of the plates were edge cracked. They were tested in pure in-plane bending, pure ligament tension, nominal tension and cyclic tensile loading. These tests can be compared with large centre cracked wide plates, described in a companion paper at this conference. Small scale fracture toughness tests were also made of the same material. It was found that Failure Assessment Diagrams (FADs) could be used to plot out the results and showed that the assessment line gave a good failure prediction or was conservative. The very conservative evaluation of a plate in bending cannot currently be explained. Where there was combined fatigue and tearing, linearly adding crack growth due to the different processes well predicted the results. For a surface breaking defect, initiation is well predicted from using a local limit load in the FAD, but as loads increase towards net section yield, the global limit load is more appropriate. 4 figs., 1 tab

  18. Spanish Consensus Statement: The Treatment of Muscle Tears in Sport.

    Science.gov (United States)

    Fernandez-Jaén, Tomas F; Rey, Guillermo Álvarez; Cuesta, Jordi Ardevol; Loureda, Rafael Arriaza; España, Fernando Ávila; Matas, Ramón Balius; Pazos, Fernando Baró; de Dios Beas Jiménez, Juan; Rosell, Jorge Candel; Fernandez, César Cobián; Ros, Francisco Esparza; Colmenero, Josefina Espejo; de Prado, Jorge Fernández; Cota, Juan José García; González, Jose Ignacio Garrido; Santander, Manuela González; Munilla, Miguel Ángel Herrador; Ruiz, Francisco Ivorra; Díaz, Fernando Jiménez; Marqueta, Pedro Manonelles; Fernandez, Antonio Maestro; Benito, Juan José Muñoz; Vilás, Ramón Olivé; Teres, Xavier Peirau; Amaro, José Peña; Roque, Juan Pérez San; Parenteu, Christophe Ramírez; Serna, Juan Ribas; Álvarez, Mikel Sánchez; Marchori, Carlos Sanchez; Soto, Miguel Del Valle; Alonso, José María Villalón; García, Pedro Guillen; de la Iglesia, Nicolas Hugo; Alcorocho, Juan Manuel Lopez

    2015-12-01

    On the 21st of March, 2015, experts met at Clínica CEMTRO in Madrid, Spain, under the patronage of The Spanish Society for Sports Traumatology (SETRADE), The Spanish Federation of Sports Medicine (FEMEDE), The Spanish Association of Medical Services for Football Clubs (AEMEF), and The Spanish Association of Medical Services for Basketball Clubs (AEMB) with the aim of establishing a round table that would allow specialists to consider the most appropriate current general actions to be taken when treating muscle tears in sport, based on proven scientific data described in the medical literature. Each expert received a questionnaire prior to the aforementioned meeting comprising a set of questions concerning therapeutic indications generally applied in the different stages present during muscle repair. The present Consensus Document is the result of the answers to the questionnaire and resulting discussion and consensus over which are the best current indications in the treatment of muscle tears in sport. Avoiding immobilization, not taking nonsteroidal anti-inflammatory drugs (NSAIDs) randomly, fostering early mobilization, increasing vascularization of injured, site and regulating inflammatory mechanisms-without inhibiting these from the early stages of the recovery period-all stood out as main points of the Consensus Document. Additionally, there is controversy concerning cell stimulation techniques and the use of growth factors or cell inhibitors. The decision concerning discharge was unanimous, as was the criteria considered when it came to performing sport techniques without pain.

  19. Spanish Consensus Statement: The Treatment of Muscle Tears in Sport.

    Science.gov (United States)

    Fernandez-Jaén, Tomas F; Rey, Guillermo Álvarez; Cuesta, Jordi Ardevol; Loureda, Rafael Arriaza; España, Fernando Ávila; Matas, Ramón Balius; Pazos, Fernando Baró; de Dios Beas Jiménez, Juan; Rosell, Jorge Candel; Fernandez, César Cobián; Ros, Francisco Esparza; Colmenero, Josefina Espejo; de Prado, Jorge Fernández; Cota, Juan José García; González, Jose Ignacio Garrido; Santander, Manuela González; Munilla, Miguel Ángel Herrador; Ruiz, Francisco Ivorra; Díaz, Fernando Jiménez; Marqueta, Pedro Manonelles; Fernandez, Antonio Maestro; Benito, Juan José Muñoz; Vilás, Ramón Olivé; Teres, Xavier Peirau; Amaro, José Peña; Roque, Juan Pérez San; Parenteu, Christophe Ramírez; Serna, Juan Ribas; Álvarez, Mikel Sánchez; Marchori, Carlos Sanchez; Soto, Miguel Del Valle; Alonso, José María Villalón; García, Pedro Guillen; de la Iglesia, Nicolas Hugo; Alcorocho, Juan Manuel Lopez

    2015-12-01

    On the 21st of March, 2015, experts met at Clínica CEMTRO in Madrid, Spain, under the patronage of The Spanish Society for Sports Traumatology (SETRADE), The Spanish Federation of Sports Medicine (FEMEDE), The Spanish Association of Medical Services for Football Clubs (AEMEF), and The Spanish Association of Medical Services for Basketball Clubs (AEMB) with the aim of establishing a round table that would allow specialists to consider the most appropriate current general actions to be taken when treating muscle tears in sport, based on proven scientific data described in the medical literature. Each expert received a questionnaire prior to the aforementioned meeting comprising a set of questions concerning therapeutic indications generally applied in the different stages present during muscle repair. The present Consensus Document is the result of the answers to the questionnaire and resulting discussion and consensus over which are the best current indications in the treatment of muscle tears in sport. Avoiding immobilization, not taking nonsteroidal anti-inflammatory drugs (NSAIDs) randomly, fostering early mobilization, increasing vascularization of injured, site and regulating inflammatory mechanisms-without inhibiting these from the early stages of the recovery period-all stood out as main points of the Consensus Document. Additionally, there is controversy concerning cell stimulation techniques and the use of growth factors or cell inhibitors. The decision concerning discharge was unanimous, as was the criteria considered when it came to performing sport techniques without pain. PMID:27213161

  20. Resistive magnetohydrodynamic simulations of the ideal tearing mode

    CERN Document Server

    Landi, Simone; Papini, Emanuele; Pucci, Fulvia; Velli, Marco

    2015-01-01

    We study the linear and nonlinear evolution of the tearing instability on thin current sheets by means of two-dimensional numerical simulations, within the framework of compressible, resistive magnetohydrodynamics. In particular we analyze the behavior of current sheets whose inverse aspect ratio scales with the Lundquist number $S$ as $S^{-1/3}$. This scaling has been recently recognized to yield the threshold separating fast, ideal reconnection, with an evolution and growth which are independent of $S$ provided this is high enough, as it should be natural having the ideal case as a limit for $S\\to\\infty$. Our simulations confirm that the tearing instability growth rate can be as fast as $\\gamma\\approx 0.6\\,{\\tau_A}^{-1}$, where $\\tau_A$ is the ideal Alfv\\'enic time set by the macroscopic scales, for our least diffusive case with $S=10^7$. The expected instability dispersion relation and eigenmodes are also retrieved in the linear regime, for the values of $S$ explored here. Moreover, in the nonlinear stage ...

  1. The "ideal" tearing mode: theory and resistive MHD simulations

    CERN Document Server

    Del Zanna, L; Papini, E; Pucci, F; Velli, M

    2016-01-01

    Classical MHD reconnection theories, both the stationary Sweet-Parker model and the tearing instability, are known to provide rates which are too slow to explain the observations. However, a recent analysis has shown that there exists a critical threshold on current sheet's thickness, namely a/L~S^(-1/3), beyond which the tearing modes evolve on fast macroscopic Alfvenic timescales, provided the Lunquist number S is high enough, as invariably found in solar and astrophysical plasmas. Therefore, the classical Sweet-Parker scenario, for which the diffusive region scales as a/L~S^(-1/2) and thus can be up to ~100 times thinner than the critical value, is likely to be never realized in nature, as the current sheet itself disrupts in the elongation process. We present here two-dimensional, compressible, resistive MHD simulations, with S ranging from 10^5 to 10^7, that fully confirm the linear analysis. Moreover, we show that a secondary plasmoid instability always occurs when the same critical scaling is reached o...

  2. The ideal tearing mode: theory and resistive MHD simulations

    Science.gov (United States)

    Del Zanna, L.; Landi, S.; Papini, E.; Pucci, F.; Velli, M.

    2016-05-01

    Classical MHD reconnection theories, both the stationary Sweet-Parker model and the tearing instability, are known to provide rates which are too slow to explain the observations. However, a recent analysis has shown that there exists a critical threshold on current sheet's thickness, namely a/L ∼ S -1/3, beyond which the tearing modes evolve on fast macroscopic Alfvénic timescales, provided the Lunquist number S is high enough, as invariably found in solar and astrophysical plasmas. Therefore, the classical Sweet-Parker scenario, for which the diffusive region scales as a/L ∼ S -1/2 and thus can be up to ∼ 100 times thinner than the critical value, is likely to be never realized in nature, as the current sheet itself disrupts in the elongation process. We present here two-dimensional, compressible, resistive MHD simulations, with S ranging from 105 to 107, that fully confirm the linear analysis. Moreover, we show that a secondary plasmoid instability always occurs when the same critical scaling is reached on the local, smaller scale, leading to a cascading explosive process, reminiscent of the flaring activity.

  3. Autologous hamstring tendon used for revision of quadiceps tendon tears.

    Science.gov (United States)

    McCormick, Frank; Nwachukwu, Benedict U; Kim, Jaehon; Martin, Scott D

    2013-04-01

    A paucity of literature exists on quadriceps tendon reruptures. Failed quadriceps tendon repair can cause significant morbidity and disability. Surgical management of quadriceps tendon rerupture can be challenging due to tissue degeneration, tendon retraction, muscle atrophy, and poor bone fixation. A lack of guidance in the literature exists on the appropriate surgical techniques for managing quadriceps tendon reruptures.This article describes the case of a male recreational athlete with a failed primary quadriceps tendon repair who presented 10 months after rerupture. Examination was significant for morbid obesity, assisted ambulation, and a significant defect at the superior pole of the patella on the affected side. Intraoperative findings were consistent with a 2.0- to 4.5-cm tendon defect across the extensor mechanism with complete retinaculi tears. The authors performed a novel surgical approach for revision of quadriceps tears using a bilateral hamstring autograft through a quadriceps tendon weave and a transosseous patellar repair. Tendon length was restored, and extensor mechanism tension was reapproximated. Postoperatively, the patient achieved a good outcome and had returned to full, painless, sport participation at 2-year follow-up.This surgical technique is suitable for revision quadriceps tendon repairs of large tendon gap defects, repairs desiring tendon-to-bone in-growth, and repairs requiring large-force transmission across the repair.

  4. Fast reconnection in relativistic plasmas: the magnetohydrodynamics tearing instability revisited

    CERN Document Server

    Del Zanna, L; Landi, S; Bugli, M; Bucciantini, N

    2016-01-01

    Fast reconnection operating in magnetically dominated plasmas is often invoked in models for magnetar giant flares, for magnetic dissipation in pulsar winds, or to explain the gamma-ray flares observed in the Crab nebula, hence its investigation is of paramount importance in high-energy astrophysics. Here we study, by means of two dimensional numerical simulations, the linear phase and the subsequent nonlinear evolution of the tearing instability within the framework of relativistic resistive magnetohydrodynamics, as appropriate in situations where the Alfven velocity approaches the speed of light. It is found that the linear phase of the instability closely matches the analysis in classical MHD, where the growth rate scales with the Lundquist number S as S^-1/2, with the only exception of an enhanced inertial term due to the thermal and magnetic energy contributions. In addition, when thin current sheets of inverse aspect ratio scaling as S^-1/3 are considered, the so-called "ideal" tearing regime is retriev...

  5. Tearing resistance of aged cast austenitic stainless steels

    International Nuclear Information System (INIS)

    CF8 and CF8M type cast stainless steels containing about 10 to 25 % ferrite are used in the primary piping of light water reactors (PWRs and BWRs). It is now recognized that these materials are embrittled by thermal aging at the operating temperature (between 2900C and 3300C), mainly due to precipitation hardening of the ferrite by α', and other phases. Extensive research programs are under way in several countries to better understand the mechanisms of embrittlement and to determine the mechanical properties of components as a function of aging time and temperature. In earlier studies thermal aging embrittlement was mainly characterized by the evolutions of the tensile and Charpy impact properties. However the evaluation of reactor coolant circuit integrity through mechanical analyses requires the knowledge of fracture toughness properties. The first measurements of the tearing resistance of a CF8M type severely aged material were presented in 1983 by SLAMA, PETREQUIN and MAGER. Other contributions to the knowledge of the fracture toughness of aged materials were published, but were relative to medium or high toughness materials. The objective of this paper is to present the results of tearing resistance measurements made on a large spectrum of severely embrittled materials, which allow to give lower bound properties for aged CF8 and CF8M type cast stainless steels

  6. Measurement of tear glucose levels with amperometric glucose biosensor/capillary tube configuration.

    Science.gov (United States)

    Yan, Qinyi; Peng, Bo; Su, Gang; Cohan, Bruce E; Major, Terry C; Meyerhoff, Mark E

    2011-11-01

    An amperometric needle-type electrochemical glucose sensor intended for tear glucose measurements is described and employed in conjunction with a 0.84 mm i.d. capillary tube to collect microliter volumes of tear fluid. The sensor is based on immobilizing glucose oxidase on a 0.25 mm o.d. platinum/iridium (Pt/Ir) wire and anodically detecting the liberated hydrogen peroxide from the enzymatic reaction. Inner layers of Nafion and an electropolymerized film of 1,3-diaminobenzene/resorcinol greatly enhance the selectivity for glucose over potential interferences in tear fluid, including ascorbic acid and uric acid. Further, the new sensor is optimized to achieve very low detection limits of 1.5 ± 0.4 μM of glucose (S/N = 3) that is required to monitor glucose levels in tear fluid with a glucose sensitivity of 0.032 ± 0.02 nA/μM (n = 6). Only 4-5 μL of tear fluid in the capillary tube is required when the needle sensor is inserted into the capillary. The glucose sensor was employed to measure tear glucose levels in anesthetized rabbits over an 8 h period while also measuring the blood glucose values. A strong correlation between tear and blood glucose levels was found, suggesting that measurement of tear glucose is a potential noninvasive substitute for blood glucose measurements, and the new sensor configuration could aid in conducting further research in this direction. PMID:21961809

  7. Impact of type of meniscal tear on radiographic and symptomatic knee osteoarthritis

    DEFF Research Database (Denmark)

    Englund, M; Roos, Ewa M.; Lohmander, L S

    2003-01-01

    To investigate long-term radiographic and patient-relevant outcome of isolated limited meniscectomy with regard to type of meniscal tear and extent of surgical resection.......To investigate long-term radiographic and patient-relevant outcome of isolated limited meniscectomy with regard to type of meniscal tear and extent of surgical resection....

  8. The value of clinical tests in acute full-thickness tears of the supraspinatus tendon

    DEFF Research Database (Denmark)

    Bak, Klaus; Sørensen, Anne Kathrine Belling; Jørgensen, Uffe Viegh;

    2010-01-01

    Early repair of rotator cuff tears leads to superior results. To detect symptomatic full-thickness tears of the supraspinatus tendon at an early stage, we conducted a prospective study to evaluate the value of clinical examination with and without subacromial lidocaine within the first weeks after...

  9. Evaluation of a cyanoacrylate protectant to manage skin tears in the acute care population.

    Science.gov (United States)

    Mamrosh, Martha A; Valk, Debbie L; Milne, Catherine T

    2013-01-01

    Skin tears are a common problem that can impact the quality of life due to pain and the potential of becoming complicated wounds if not treated properly. The use of a cyanoacrylate skin protectant to manage skin tears was evaluated in 30 patients in an acute care setting.

  10. Measurement of the Time Course of Optical Quality and Visual Deterioration during Tear Break-Up

    OpenAIRE

    Liu, Haixia; THIBOS, LARRY; Begley, Carolyn G.; Bradley, Arthur

    2010-01-01

    In this study, a new optical system was developed that simultaneously measured optical quality and visual performance during monitoring of tear film instability. The results confirmed that blurry vision symptoms reported by contact lens patients are caused by the poor quality of the retinal image due to tear break-up.

  11. Nonlinear tearing mode study using the almost ideal magnetohydrodynamics (MHD) constraint

    International Nuclear Information System (INIS)

    The tearing mode is an important resistive magnetohydrodynamics (MHD) mode. It perturbs the initial equilibrium magnetic flux surfaces through magnetic field line reconnection to form new flux surfaces with magnetic islands. In the study of the tearing mode, usually the initial equilibria are one dimensional with two ignorable coordinates and the perturbed equilibria are two dimensional with one ignorable coordinate. The tearing mode can be linearly unstable and its growth saturates at a fine amplitude. The neoclassical tearing mode theory shows that the mode can be nonlinearly driven by the bootstrap current even when it is linearly stable to the classical tearing mode. It is important to study the nonlinear behavior of the tearing mode. As an intrinsically nonlinear approach, the use of the almost ideal MHD constraint is suited to study the nonlinear properties of the tearing mode. In this paper, as a validation of the method, the authors study two characteristics of the tearing mode using the almost ideal MHD constraint: (1) the linear stability condition for the initial one dimensional equilibrium; and (2) the final saturation level for the unstable case. In this work, they only consider the simplest case where no gradient of pressure or current density exists at the mode resonant surface

  12. Prediction of perineal tear during childbirth by assessment of striae gravidarum score

    Directory of Open Access Journals (Sweden)

    Shital Kapadia

    2014-02-01

    Conclusions: This study demonstrates a significant relation between severity of striae gravidarum and perineal tear. The findings suggest that striae gravidarum assessment may be used in the clinical setting even by paramedical staff as a simple and noninvasive tool to better define women at risk for perineal tear. [Int J Reprod Contracept Obstet Gynecol 2014; 3(1.000: 208-212

  13. Occupational kneeling and meniscal tears: a magnetic resonance imaging study in floor layers

    DEFF Research Database (Denmark)

    Rytter, Søren; Jensen, Lilli Kirkeskov; Bonde, Jens Peter;

    2009-01-01

    ). The presence of grade 3 MRI signal intensities indicating degenerative tears of the anterior, middle, and posterior one-third of the lateral and medial menisci was assessed on 1.5-Tesla MRI scans. The odds ratio (OR) of meniscal tears was determined among floor layers compared to graphic designers. Using...

  14. Computed tomography arthrography with traction in the human hip for three-dimensional reconstruction of cartilage and the acetabular labrum

    International Nuclear Information System (INIS)

    Aim: To develop and demonstrate the efficacy of a computed tomography arthrography (CTA) protocol for the hip that enables accurate three-dimensional reconstructions of cartilage and excellent visualization of the acetabular labrum. Materials and methods: Ninety-three subjects were imaged (104 scans); 68 subjects with abnormal anatomy, 11 patients after periacetabular osteotomy surgery, and 25 subjects with normal anatomy. Fifteen to 25 ml of contrast agent diluted with lidocaine was injected using a lateral oblique approach. A Hare traction splint applied traction during CT. The association between traction force and intra-articular joint space was assessed qualitatively under fluoroscopy. Cartilage geometry was reconstructed from the CTA images for 30 subjects; the maximum joint space under traction was measured. Results: Using the Hare traction splint, the intra-articular space and boundaries of cartilage could be clearly delineated throughout the joint; the acetabular labrum was also visible. Dysplastic hips required less traction (∼5 kg) than normal and retroverted hips required (>10 kg) to separate the cartilage. An increase in traction force produced a corresponding widening of the intra-articular joint space. Under traction, the maximum width of the intra-articular joint space during CT ranged from 0.98–6.7 mm (2.46 ± 1.16 mm). Conclusions: When applied to subjects with normal and abnormal hip anatomy, the CTA protocol presented yields clear delineation of the cartilage and the acetabular labrum. Use of a Hare traction splint provides a simple, cost-effective method to widen the intra-articular joint space during CT, and provides flexibility to vary the traction as required. - Highlights: • We present a hip CTA protocol to clearly delineate the intra-articular space. • A Hare traction splint provides a simple, cost-effective way to apply traction. • The required traction force depends on individual hip morphology. • The traction force

  15. Abordagem cirúrgica inédita para denervação acetabular em cães A new surgical approach to acetabular denervation in dogs

    OpenAIRE

    Cássio R.A. Ferrigno; Alexandre Schmaedecke; Vanessa C.M. Ferraz

    2007-01-01

    Este artigo tem por objetivo demonstrar nova abordagem cirúrgica para denervação seletiva das fibras sensitivas do periósteo acetabular, para tratamento da displasia coxo femoral em cães, conduzidas em 189 articulações. Para tanto, é descrita abordagem da região cranial e dorso-lateral do acetábulo de cães por incisão em forma de meia lua de aproximadamente de três centímetros de extensão, iniciando trocânter maior do fêmur e em direção ao corpo do ílio. Após rebatimento dorsal do músculo glú...

  16. Water soluble drug releasing soft contact lens in response to pH of tears

    Science.gov (United States)

    Kim, G.; Noh, H.

    2016-06-01

    Human tear characteristics including pH and compositions can vary significantly depending on physical and environmental factors. Contact lenses directly contact with human tears can be swelled or de-swelled depending on the pH of the solution due to the nature of the hydrogel. For examples, anionic hydrogels, when the solution's pH is low, is shrunken due to the electric attraction force within the hydrogel network; the opposite phenomenon appears when the solution is basic. The purpose of this study was to evaluate the extent of water soluble drug, hydroxyl propyl methyl cellulose, released from contact lens according to the pH of the artificial tears. Artificial tears are prepared by mixing lysozyme, albumin, sodium chloride, potassium chloride, and calcium chloride following physiological concentrations. Hydrogel contact lens was thermally polymerized using HEMA, EGDMA, and AIBN. The prepared hydrogel lens was immersed in drug for 3 hours and the eluted drug mass was measured as a function of the time. As a result, the drug was released from the lens for 12 hours in all the pH of artificial tears. At the lower pH of artificial tears (pH 5.8), the total amount of dye emitted from the lens was increased than the total amount of dye emitted at the basic tear (pH 8.4). Also, initial burst at acidic tears was increased within 1 hour. Release pattern of water-soluble drug from hydrogel lens turned out to be different depending on the pH of the artificial tears. When designing drug releasing contact lens, physiological pH of tears should be considered.

  17. Standard sonography and arthrosonography in the study of rotator cuff tears

    International Nuclear Information System (INIS)

    Purpose. The aim of this study was to evaluate the sensitivity of ultrasonography, integrating standard ultrasound and arthrosonography after injecting a saline solution into the glenohumeral cavity in cases of suspected rotator cuff tears. Materials and methods. We respectively examinated 40 patients awaiting shoulder arthroscopy for suspected or diagnosed tears of the rotator cuff. A radiologist, unaware of the pre-operative diagnosis, performed an ultrasound scan on all the patients before and after the injection of saline solution into the glenohumeral cavity. The parameters considered were presence or absence of a rotator cuff injury; type of injury according to Snyder and its extent along the longitudinal and transverse planes; presence or absence of effusion into the articular cavity; subacromial/subdeltoid bursal distension. All the patients underwent arthroscopy either the same day of the day after the ultrasound examination. Results. Standard sonography showed 26 complete rotator cuff tears (type C according to Snyder), 2 partial tears (type B according to Snyder) and 12 intact rotator cuffs. Arthrosonography detected 31 complete rotator cuff tears (type C according to Snyder), 1 partial tear (type B according to Snyder) and 8 intact rotator cuffs. Arthroscopy identified 32 complete rotator cuff tears (type C according to Snyder), 1 partial tear (type B according to Snyder) and 8 intact rotator cuffs. Analysis of the results shows that, taking arthroscopy as the gold standard, the sensitivity of normal sonography is 81.2%, whereas that of arthosonography is 96.8% (p<0.05). Conclusions. On the basis of the data obtained in this study, standard sonography , integrated with the injection of a saline solution into the glenohumeral cavity, considerably increases the diagnostic sensitivity for rotator cuff tears. The authors suggest that arthrosonography can be used in the event of suspected rotator tears, when MRI is contraindicated

  18. MRI of lesser metatarsophalangeal joint plantar plate tears and associated adjacent interspace lesions

    Energy Technology Data Exchange (ETDEWEB)

    Umans, Hilary [Albert Einstein College of Medicine and Lenox Hill Radiology Imaging and Associates, Bronx, NY (United States); Srinivasan, Ramya; Elsinger, Elisabeth [Albert Einstein College of Medicine, Bronx, NY (United States); Wilde, Gregory E. [Lenox Hill Radiology Imaging and Associates, Bronx, NY (United States)

    2014-10-15

    To identify the variety of second and third intermetatarsal space (IS) lesions that may coexist with and without adjacent metatarsophalangeal joint (MTP) plantar plate (PP) tears. One hundred forefoot MRIs in 96 patients with metatarsalgia obtained between 30 September 2011 and 21 July 2012 using 1.5- or 3-T MRI were retrospectively reviewed in consensus by two MSK radiologists and one podiatrist (DPM). MRI was evaluated for second and third MTP PP tear and the presence/nature of second and third IS lesions. Second and third IS neuromas were measured in transverse (trans) dimension. A total of 40 PP tears were identified: 36 at the second and 4 at the third MTP. Second MTP PP tear was identified in 33 % of females and 40.5 % of males. In the 63 female feet there were 21 second MTP PP tears, all of which also had second IS lesions: pericapsular fibrosis (16), bursitis (4), and ganglion (1). In the 37 male feet there were 15 second MTP PP tears, 14 of which had second IS lesions: pericapsular fibrosis (8), bursitis (5), and ganglion (1). There was no definite second IS neuroma adjacent to any second MTP PP tear. In females without PP tear, there were 24 second (3 mm trans average) and 43 third IS neuromas (4.1 mm trans average). In males without PP tear, there were 9 second (3.4 mm trans average) and 16 third IS neuromas (4.1 mm trans average). MTP PP tears occurred in 40 % of our cases, 90 % of which occurred at the second MTP. Almost all coexisted with non-neuromatous second IS lesions. (orig.)

  19. Anatomical and visual outcomes of ranibizumab injections in retinal pigment epithelium tears

    Directory of Open Access Journals (Sweden)

    Muhammet Kazım Erol

    2015-06-01

    Full Text Available ABSTRACT Purpose: To report the anatomical and visual results in patients diagnosed as having retinal pigment epithelium (RPE tears after receiving ranibizumab injections. Methods: Eyes diagnosed as having RPE tears with a minimum 6-month follow-up were retrospectively evaluated. Each eye was treated with at least three doses of ranibizumab at monthly intervals. Best-corrected visual acuity (BCVA, anterior segment findings, intraocular pressure, and fundus examination results were evaluated during control visits. Color fundus photography, fundus fluorescein angiographies, fundus autofluorescence, and spectral domain optical coherence tomography (SD-OCT images were obtained. The height of pigment epithelial detachment (PED was measured by SD-OCT. Results: Twelve eyes with RPE tears were studied. Nine eyes (75% developed RPE tears during ranibizumab injections for choroidal neovascularization (eight eyes with vascularized PED and one eye with choroidal osteoma, and tears occurred in three eyes before any injections. The median number of ranibizumab injections after diagnosis of RPE tears was 3 (min 2, max 5. In the most recent follow-up visit, there was no statistically significant correlation between the grade of RPE and logMAR of BCVA (p>0.05, r=0.112. Eight of twelve eyes had PED, and seven of these had irregular PED contours before injection therapy. The mean PED height was 447 ± 122 µm. Conclusions: In this series, RPE tears developed mostly after intravitreal anti-VEGF injections for vascularized PED. Increased vertical height and irregular contours of the PEDs can be risk factors for the formation of RPE tears. The continuation of anti-VEGF therapy after tear formation is beneficial for vision improvement in eyes with RPE tears.

  20. Trabecular microstructure and surface changes in the greater tuberosity in rotator cuff tears

    International Nuclear Information System (INIS)

    Abstract Objective. When planning surgery in patients with rotator cuff tear, strength of bone at the tendon insertion and trabecular bone structure in the greater tuberosity are usually taken into consideration. We investigated radiographic changes in bone structure of the greater tuberosity in rotator cuff tears.Design. Twenty-two human cadaveric shoulders from subjects ranging from 55 to 75 years of age were obtained. The integrity of the rotator cuff was examined by sonography to determine if it is intact without any tear, or torn partially or completely. The humeral head was sectioned in 3 mm thick coronal slab sections and microradiographed. After digitization of the microradiographs and imaging processing with in-house semi-automated image processing software tools developed using software interfaces on a Sun workstation, the trabecular histomorphometrical structural parameters and connectivity in the greater tuberosity were quantified. The degenerative changes on the surface of the greater tuberosity were interpreted blindly by 2 independent readers.Results. Among the 22 shoulder specimens, the rotator cuff was found intact in 10 shoulders, partially in 7 and fully torn in 5. Statistically significant loss in apparent trabecular bone volume fraction, number of trabecular nodes, and number of trabecular branches, and a statistically significant increase in apparent trabecular separation and number of trabecular free ends were found in the greater tuberosity of the shoulders with tears. The loss was greater in association with full tear than in partial tear. Thickening of the cortical margin of the enthesis, irregularity of its surface, and calcification beyond the tidemark were observed in 2 (20%) shoulders with intact rotator cuff, in 6 (86%) shoulders with partial tear, and in 5 (100%) shoulders with full tear.Conclusions. Rotator cuff tears are associated with degenerative changes on the bone surface and with disuse osteopenia of the greater tuberosity

  1. Effect of altered eating habits and periods during Ramadan fasting on intraocular pressure, tear secretion, corneal and anterior chamber parameters

    NARCIS (Netherlands)

    Kerimoglu, H.; Ozturk, B.; Gunduz, K.; Bozkurt, B.; Kamis, U.; Okka, M.

    2010-01-01

    Purpose To determine whether altered eating habits and periods, especially the pre-dawn meal, during Ramadan fasting have any significant effect on intraocular pressure (IOP), tear secretion, corneal and anterior chamber parameters. Methods IOP, basal tear secretion (BTS), reflex tear secretion (RTS

  2. Technical innovation: digital tomosynthesis of the hip following intra-articular administration of contrast

    Energy Technology Data Exchange (ETDEWEB)

    Gazaille, Roland E.; Flynn, Michael J.; Page, Walter; Finley, Sonia; Holsbeeck, Marnix van [Henry Ford Hospital, Department of Musculoskeletal Radiology, Detroit, MI (United States)

    2011-11-15

    To demonstrate the clinical use of digital tomosynthesis in the depiction of labral and chondral pathology in the setting of post-operative CAM-type impingement of the hip following intra-articular administration of dilute iodinated contrast. We present images from a 46 year-old African American female with suspected CAM-type femoroacetabular impingement (FAI) following percutaneous pinning of the right hip for slipped capital femoral epiphysis (SCFE). A partial tear of the labrum and clinically significant acetabular chondral abnormalities were demonstrated with the use of digital tomosynthesis with superb anatomic detail. Digital tomosynthesis can be of great clinical utility and can depict pathology in superb anatomic detail, particularly in situations in which MRI is not available as well as under circumstances in which artifact due to orthopedic hardware is of concern as shown in this case. (orig.)

  3. Influence of pelvic position on radiographic measurements of the prosthetic acetabular component; An experimental study on a pelvic model

    Energy Technology Data Exchange (ETDEWEB)

    Thoren, B.; Sahlstedt, B. (Uppsala Univ. (Sweden). Dept. of Orthopaedic Surgery Uppsala Univ. (Sweden). Dept. of Diagnostic Radiology)

    1990-03-01

    A change in the position of a prosthetic acetabular component between two different radiographic examinations indicates loosening, and may be observed as tilting or migration of the socket. To determine the apparent changes in socket position caused by improper positioning of the pelvis, a full-scale model of a pelvis with attached prosthetic sockets was examined radiographically in different positions. The projected alignment of the Charnley socket indicator wire against the inter-tuberosity line was markedly influenced by the positioning of the pelvis. An alternative way of measuring the alignment is to use the long axis of the projected ellipse of the outer circumferential groove in the socket polyethylene. The thus defined socket alignment was not influenced by the positioning of the pelvis within the investigated range. No apparent socket migration was recorded within the range of pelvic rotation and inclination studied. (orig.).

  4. CT false-profile view of the hip: a reproducible method of measuring anterior acetabular coverage using volume CT data

    Energy Technology Data Exchange (ETDEWEB)

    Needell, Steven D.; Borzykowski, Ross M. [Boca Radiology Group, Boca Raton, FL (United States); Carreira, Dominic S.; Kozy, John [Broward Health Orthopedics and Sports Medicine, Fort Lauderdale, FL (United States)

    2014-11-15

    To devise a simple, reproducible method of using CT data to measure anterior acetabular coverage that results in values analogous to metrics derived from false-profile radiographs. Volume CT images were used to generate simulated false-profile radiographs and cross-sectional false-profile views by angling a multiplanar reformat 115 through the affected acetabulum relative to a line tangential to the posterior margin of the ischial tuberosities. The anterolateral margin of the acetabulum was localized on the CT false-profile view corresponding with the cranial opening of the acetabular roof. Anterior center edge angle (CEA) was measured between a vertical line passing through the center of the femoral head and a line connecting the center of the femoral head with the anterior edge of the condensed line of the acetabulum (sourcil). Anterior CEA values measured on CT false-profile views of 38 symptomatic hips were compared with values obtained on simulated and projection false-profile radiographs. The CT false-profile view produces a cross-sectional image in the same obliquity as false-profile radiographs. Anterior CEA measured on CT false-profile views were statistically similar to values obtained with false-profile radiographs. CT technologists quickly mastered the technique of generating this view. Inter-rater reliability indicated this method to be highly reproducible. The CT false-profile view is simple to generate and anterior CEA measurements derived from it are similar to those obtained using well-positioned false-profile radiographs. Utilization of CT to assess hip geometry enables precise control of pelvic inclination, eliminates projectional errors, and minimizes limitations of image quality inherent to radiography. (orig.)

  5. Surface-gradient cross-linked polyethylene acetabular cups: oxidation resistance and wear against smooth and rough femoral balls.

    Science.gov (United States)

    Shen, Fu-Wen; McKellop, Harry

    2005-01-01

    Two methods were developed and evaluated for cross-linking the bearing surface of a polyethylene acetabular cup to a limited depth, in order to improve its resistance to wear without degrading the mechanical properties of the bulk of the component. In the first method, low-energy electron beams were used to cross-link only the bearing surface of the cups to a maximum depth of about 2 mm. The cups then were annealed at 100 degrees C in vacuum for 3 or 6 days to reduce the residual free radicals, and the resultant resistance to oxidation was compared by artificially aging the cups at 80 degrees C in air. Chemically cross-linked surface layers were produced by coating the bearing surfaces of the cups with a thin layer of polyethylene powder mixed with 1% weight peroxide, and compressing them at 6.9 MPa (1000 psi) and 170 degrees C. This resulted in a cross-linked surface layer that extended about 3 mm deep, with a gradual transition to conventional (noncross-linked) polyethylene in the bulk of the implant. In hip simulator wear tests with highly polished (implant quality) femoral balls, both types of surface cross-linking were found to improve markedly the wear resistance of the acetabular cups. In tests with roughened femoral balls, the wear rates were much higher and were comparable to those obtained with similarly roughened balls against noncross-linked polyethylene cups in a previous study, indicating that the full benefit of cross-linking may not be realized under conditions of severe third-body abrasion. Nevertheless, these results show a promising approach for optimizing the wear resistance and the bulk mechanical properties of polyethylene components in total joint arthroplasty.

  6. CT false-profile view of the hip: a reproducible method of measuring anterior acetabular coverage using volume CT data

    International Nuclear Information System (INIS)

    To devise a simple, reproducible method of using CT data to measure anterior acetabular coverage that results in values analogous to metrics derived from false-profile radiographs. Volume CT images were used to generate simulated false-profile radiographs and cross-sectional false-profile views by angling a multiplanar reformat 115 through the affected acetabulum relative to a line tangential to the posterior margin of the ischial tuberosities. The anterolateral margin of the acetabulum was localized on the CT false-profile view corresponding with the cranial opening of the acetabular roof. Anterior center edge angle (CEA) was measured between a vertical line passing through the center of the femoral head and a line connecting the center of the femoral head with the anterior edge of the condensed line of the acetabulum (sourcil). Anterior CEA values measured on CT false-profile views of 38 symptomatic hips were compared with values obtained on simulated and projection false-profile radiographs. The CT false-profile view produces a cross-sectional image in the same obliquity as false-profile radiographs. Anterior CEA measured on CT false-profile views were statistically similar to values obtained with false-profile radiographs. CT technologists quickly mastered the technique of generating this view. Inter-rater reliability indicated this method to be highly reproducible. The CT false-profile view is simple to generate and anterior CEA measurements derived from it are similar to those obtained using well-positioned false-profile radiographs. Utilization of CT to assess hip geometry enables precise control of pelvic inclination, eliminates projectional errors, and minimizes limitations of image quality inherent to radiography. (orig.)

  7. Assessment of Accuracy and Reliability in Acetabular Cup Placement Using an iPhone/iPad System.

    Science.gov (United States)

    Kurosaka, Kenji; Fukunishi, Shigeo; Fukui, Tomokazu; Nishio, Shoji; Fujihara, Yuki; Okahisa, Shohei; Takeda, Yu; Daimon, Takashi; Yoshiya, Shinichi

    2016-07-01

    Implant positioning is one of the critical factors that influences postoperative outcome of total hip arthroplasty (THA). Malpositioning of the implant may lead to an increased risk of postoperative complications such as prosthetic impingement, dislocation, restricted range of motion, polyethylene wear, and loosening. In 2012, the intraoperative use of smartphone technology in THA for improved accuracy of acetabular cup placement was reported. The purpose of this study was to examine the accuracy of an iPhone/iPad-guided technique in positioning the acetabular cup in THA compared with the reference values obtained from the image-free navigation system in a cadaveric experiment. Five hips of 5 embalmed whole-body cadavers were used in the study. Seven orthopedic surgeons (4 residents and 3 senior hip surgeons) participated in the study. All of the surgeons examined each of the 5 hips 3 times. The target angle was 38°/19° for operative inclination/anteversion angles, which corresponded to radiographic inclination/anteversion angles of 40°/15°. The simultaneous assessment using the navigation system showed mean±SD radiographic alignment angles of 39.4°±2.6° and 16.4°±2.6° for inclination and anteversion, respectively. Assessment of cup positioning based on Lewinnek's safe zone criteria showed all of the procedures (n=105) achieved acceptable alignment within the safe zone. A comparison of the performances by resident and senior hip surgeons showed no significant difference between the groups (P=.74 for inclination and P=.81 for anteversion). The iPhone/iPad technique examined in this study could achieve acceptable performance in determining cup alignment in THA regardless of the surgeon's expertise. [Orthopedics. 2016; 39(4):e621-e626.].

  8. Assessment of Accuracy and Reliability in Acetabular Cup Placement Using an iPhone/iPad System.

    Science.gov (United States)

    Kurosaka, Kenji; Fukunishi, Shigeo; Fukui, Tomokazu; Nishio, Shoji; Fujihara, Yuki; Okahisa, Shohei; Takeda, Yu; Daimon, Takashi; Yoshiya, Shinichi

    2016-07-01

    Implant positioning is one of the critical factors that influences postoperative outcome of total hip arthroplasty (THA). Malpositioning of the implant may lead to an increased risk of postoperative complications such as prosthetic impingement, dislocation, restricted range of motion, polyethylene wear, and loosening. In 2012, the intraoperative use of smartphone technology in THA for improved accuracy of acetabular cup placement was reported. The purpose of this study was to examine the accuracy of an iPhone/iPad-guided technique in positioning the acetabular cup in THA compared with the reference values obtained from the image-free navigation system in a cadaveric experiment. Five hips of 5 embalmed whole-body cadavers were used in the study. Seven orthopedic surgeons (4 residents and 3 senior hip surgeons) participated in the study. All of the surgeons examined each of the 5 hips 3 times. The target angle was 38°/19° for operative inclination/anteversion angles, which corresponded to radiographic inclination/anteversion angles of 40°/15°. The simultaneous assessment using the navigation system showed mean±SD radiographic alignment angles of 39.4°±2.6° and 16.4°±2.6° for inclination and anteversion, respectively. Assessment of cup positioning based on Lewinnek's safe zone criteria showed all of the procedures (n=105) achieved acceptable alignment within the safe zone. A comparison of the performances by resident and senior hip surgeons showed no significant difference between the groups (P=.74 for inclination and P=.81 for anteversion). The iPhone/iPad technique examined in this study could achieve acceptable performance in determining cup alignment in THA regardless of the surgeon's expertise. [Orthopedics. 2016; 39(4):e621-e626.]. PMID:27322169

  9. Deformation of the Durom acetabular component and its impact on tribology in a cadaveric model--a simulator study.

    Directory of Open Access Journals (Sweden)

    Feng Liu

    Full Text Available BACKGROUND: Recent studies have shown that the acetabular component frequently becomes deformed during press-fit insertion. The aim of this study was to explore the deformation of the Durom cup after implantation and to clarify the impact of deformation on wear and ion release of the Durom large head metal-on-metal (MOM total hips in simulators. METHODS: Six Durom cups impacted into reamed acetabula of fresh cadavers were used as the experimental group and another 6 size-paired intact Durom cups constituted the control group. All 12 Durom MOM total hips were put through a 3 million cycle (MC wear test in simulators. RESULTS: The 6 cups in the experimental group were all deformed, with a mean deformation of 41.78 ± 8.86 µm. The average volumetric wear rate in the experimental group and in the control group in the first million cycle was 6.65 ± 0.29 mm(3/MC and 0.89 ± 0.04 mm(3/MC (t = 48.43, p = 0.000. The ion levels of Cr and Co in the experimental group were also higher than those in the control group before 2.0 MC. However there was no difference in the ion levels between 2.0 and 3.0 MC. CONCLUSIONS: This finding implies that the non-modular acetabular component of Durom total hip prosthesis is likely to become deformed during press-fit insertion, and that the deformation will result in increased volumetric wear and increased ion release. CLINICAL RELEVANCE: This study was determined to explore the deformation of the Durom cup after implantation and to clarify the impact of deformation on wear and ion release of the prosthesis. Deformation of the cup after implantation increases the wear of MOM bearings and the resulting ion levels. The clinical use of the Durom large head prosthesis should be with great care.

  10. Traumatic Tear of the Latissimus Dorsi Myotendinous Junction

    Science.gov (United States)

    Friedman, Michael V.; Stensby, J. Derek; Hillen, Travis J.; Demertzis, Jennifer L.; Keener, Jay D.

    2015-01-01

    A case of a latissimus dorsi myotendinous junction strain in an avid CrossFit athlete is presented. The patient developed acute onset right axillary burning and swelling and subsequent palpable pop with weakness while performing a “muscle up.” Magnetic resonance imaging examination demonstrated a high-grade tear of the right latissimus dorsi myotendinous junction approximately 9 cm proximal to its intact humeral insertion. There were no other injuries to the adjacent shoulder girdle structures. Isolated strain of the latissimus dorsi myotendinous junction is a very rare injury with a scarcity of information available regarding its imaging appearance and preferred treatment. This patient was treated conservatively and was able to resume active CrossFit training within 3 months. At 6 months postinjury, he had only a mild residual functional deficit compared with his preinjury level. PMID:26502450

  11. Tearing mode stabilization in tokamaks with lower hybrid waves

    International Nuclear Information System (INIS)

    The possibility of using lower hybrid (LH) waves as a source of localized current for the control of MHD instabilities is investigated. A toroidal ray tracing code is used to define the requirements on the launched wave spectrum, in order to drive currents mostly localized inside the magnetic islands. Issues such as the radial diffusion of the non-inductive current, the impact of the radial profile of the power deposition on the stabilization process, the finite time response of the current to RF power modulations and its interplay with the island rotation are addressed by means of a three dimensional (3-D) Fokker-Planck code. It is shown that lower hybrid current drive (LHCD) is a viable option for the control of m = 2 tearing modes in present medium to large tokamaks: the method would be particularly elective in a reactor size machine. (author)

  12. Tears of a Chinese Premier Hussein Ismail Hussein

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    THE day Premier Wen took office he stated.""Leaders should be closer to the masses."" His visit to comfort and talk with everyday workers in Tongchuan City, Shaanxi Province on January 1, 2005, where a few weeks previously a gas blast in the Chenjiashan Coalmine had killed 166 workers, was by no means his first. But it was the first time he publicly shed tears. In one household that had lost its breadwinner, Wen Jiabao embraced the victim's son and shared his grief. He later had a simple lunch of steamed bread and tea in a tunnel 1,300 meters belowg round as he chatted with workers at another mine in the city.

  13. Coupled Simulations of RF Effects on Tearing Modes

    International Nuclear Information System (INIS)

    Full text: We present integrated feedback simulations of neoclassical tearing modes in tokamak plasmas. The implementation relies on the NIMROD and GENRAY codes, along with new codes for calculating a local quasilinear operator, and for performing the code coupling. The mathematical formulation relies on the formulation of a third-order electron drift-kinetic equation that captures the bootstrap current effects and is consistent with ECCD-driven kinetic distortion effects such as the Fisch-Boozer and Ohkawa current drives. Numerically solving the drift-kinetic equation relies on a new high-order continuum discretization scheme suitable for solving the equation in the presence of a macroscopic three-dimensional magnetic field. Implementing these new kinetic closures implicitly, along with the drift-kinetic terms, provides many numerical challenges and requires careful verification. (author)

  14. Tearing mode velocity braking due to resonant magnetic perturbations

    Science.gov (United States)

    Frassinetti, L.; Menmuir, S.; Olofsson, K. E. J.; Brunsell, P. R.; Drake, J. R.

    2012-10-01

    The effect of resonant magnetic perturbations (RMPs) on the tearing mode (TM) velocity is studied in EXTRAP T2R. Experimental results show that the RMP produces TM braking until a new steady velocity or wall locking is reached. The braking is initially localized at the TM resonance and then spreads to the other TMs and to the rest of the plasma producing a global velocity reduction via the viscous torque. The process has been used to experimentally estimate the kinematic viscosity profile, in the range 2-40 m2 s-1, and the electromagnetic torque produced by the RMP, which is strongly localized at the TM resonance. Experimental results are then compared with a theoretical model which gives a reasonable qualitative explanation of the entire process.

  15. A tear-free, SPF50 sunscreen product.

    Science.gov (United States)

    Yan, X Sherwin; Riccardi, Grace; Meola, Margaret; Tashjian, Anne; SaNogueira, James; Schultz, Thomas

    2008-01-01

    Sunscreen must provide protection against solar radiation and be safe and non-irritating to skin and eyes, especially for children. A unique water-in-oil emulsion sunscreen formula with a sun protection factor of 50 (SPF50) was developed that minimizes irritation potential through careful selection of ingredients, active combinations, preservatives, and the absence of fragrance. The SPF50 sunscreen formulation reported here is non-irritating to the skin or eyes, with an estimated Draize ocular score of 0.0 for lotion and 3.6 for spray lotion formulations. No eyelid inflammation, lacrimation, or palpebral or bulbar conjunctival irritation was observed in human eye instillation studies. This sunscreen provides a new tear-free formulation that protects from ultraviolet radiation. PMID:18988091

  16. A Simulation Study of Hall Effect on Double Tearing Modes

    Institute of Scientific and Technical Information of China (English)

    ZHANG Chenglong; MA Zhiwei; DONG Jiaqi

    2008-01-01

    A Hall magnetohydrodynamics (MHD) simulation is carried out to study the dy-namic process of double tearing mode. The results indicated that the growth rates in the earlier nonlinear and transition phases agree with the previous results. With further development of reconnection, the current sheet thickness is much smaller than the ion inertia length, which leads to a strong influence of the Hall effects. As a result, the reconnection in the late nonlinear phase exhibits an explosive nature with a time scale nearly independent of resistivity. A localized and severely intensified current density is observed and the maximum kinetic energy is over one order of magnitude higher in Hall MHD than that in resistive MHD.

  17. FUNCTIONAL OUTCOME OF ARTHROSCOPIC RECONSTRUCTION OF ANTERIOR CRUCIATE LIGAMENT TEARS

    Directory of Open Access Journals (Sweden)

    Ashok Kumar

    2016-02-01

    Full Text Available BACKGROUND Anterior Cruciate Ligament (ACL tear is the most common serious ligamentous injury to the knee joint. Anterior Cruciate Ligament (ACL injury is quite common among young active population, athletes and contact sports. The exact incidence of anterior cruciate ligament tears is not known as the cases are being under reported. The ACL is the primary stabilizer against anterior translation of the tibia on the femur and is important in counteracting rotation and valgus stress. MATERIALS AND METHODS Between November 2012 to October 2014, 34 consecutive patients who underwent arthroscopic assisted ACL reconstructions in the Department of Orthopedics and Traumatology, King George Hospital, Visakhapatnam were the material in our study. Age groups between 18 to 45 years considered. We utilised both BPTB and Quadrupled hamstring graft depending on the patient’s age, outcome testing in all cases was performed at the latest follow-up (at least 6 months. Post-operative physiotherapy rehabilitation protocol followed for 06 months. RESULTS Standard protocol of Lysholm and IKDC knee scoring system were used for evaluation of the results of the surgery during followup. Patients were evaluated periodically at preop, 3 months, 6 months, 12 months, 18 months and 24 months. CONCLUSION Patients with isolated ACL injury had better outcome compared to patients who underwent associated meniscectomy. Most common mechanism of injury was activity of sports in 20 patients. Postoperatively at 3 months, anterior drawer’s was 1+ in 6, 29 (85.2% patients had normal range of motion; 29 (85.29% patients had 5/5 quadriceps power (MRC grading 94% of them had 5/5 power at latest followup. No significant difference between outcomes of BPTB and Hamstrings graft. Functional outcome of our study were similar to the previously published studies.

  18. Fast reconnection in relativistic plasmas: the magnetohydrodynamics tearing instability revisited

    Science.gov (United States)

    Del Zanna, L.; Papini, E.; Landi, S.; Bugli, M.; Bucciantini, N.

    2016-08-01

    Fast reconnection operating in magnetically dominated plasmas is often invoked in models for magnetar giant flares, for magnetic dissipation in pulsar winds, or to explain the gamma-ray flares observed in the Crab nebula; hence, its investigation is of paramount importance in high-energy astrophysics. Here we study, by means of two-dimensional numerical simulations, the linear phase and the subsequent non-linear evolution of the tearing instability within the framework of relativistic resistive magnetohydrodynamics (MHD), as appropriate in situations where the Alfvén velocity approaches the speed of light. It is found that the linear phase of the instability closely matches the analysis in classical MHD, where the growth rate scales with the Lundquist number S as S-1/2, with the only exception of an enhanced inertial term due to the thermal and magnetic energy contributions. In addition, when thin current sheets of inverse aspect ratio scaling as S-1/3 are considered, the so-called ideal tearing regime is retrieved, with modes growing independently of S and extremely fast, on only a few light crossing times of the sheet length. The overall growth of fluctuations is seen to solely depend on the value of the background Alfvén velocity. In the fully non-linear stage, we observe an inverse cascade towards the fundamental mode, with Petschek-type supersonic jets propagating at the external Alfvén speed from the X-point, and a fast reconnection rate at the predicted value {R}˜ (ln S)^{-1}.

  19. Modeling of Neoclassical Tearing Mode Stability for Generalized Toroidal Geometry

    International Nuclear Information System (INIS)

    Neoclassical tearing modes (NTMs) can lead to disruption and loss of confinement. Previous analysis of these modes used large aspect ratio, low beta (plasma pressure/magnetic pressure) approximations to determine the effect of NTMs on tokamak plasmas. A more accurate tool is needed to predict the onset of these instabilities. As a follow-up to recent theoretical work, a code has been written which computes the tearing mode island growth rate for arbitrary tokamak geometry. It calls PEST-3 [A. Pletzer et al., J. Comput. Phys. 115, 530 (1994)] to compute delta prime, the resistive magnetohydrodynamic (MHD) matching parameter. The code also calls the FLUXGRID routines in NIMROD [A.H. Glasser et al., Plasma Phys. Controlled Fusion 41, A747 (1999)] for Dnc, DI and DR [C.C. Hegna, Phys. Plasmas 6, 3980 (1999); A.H. Glasser et al., Phys. Fluids 18, 875 (1975)], which are the bootstrap current driven term and the ideal and resistive interchange mode criterion, respectively. In addition to these components, the NIMROD routines calculate alphas-H, a new correction to the Pfirsch-Schlter term. Finite parallel transport effects were added and a National Spherical Torus Experiment (NSTX) [M. Ono et al., Nucl. Fusion 40, 557 (2000)] equilibrium was analyzed. Another program takes the output of PEST-3 and allows the user to specify the rational surface, island width, and amount of detail near the perturbed surface to visualize the total helical flux. The results of this work will determine the stability of NTMs in an spherical torus (ST) [Y.-K.M. Peng et al., Nucl. Fusion 26, 769 (1986)] plasma with greater accuracy than previously achieved

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

    Science.gov (United States)

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

    2015-08-01

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

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

    Science.gov (United States)

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

    2015-08-01

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

  2. Peripheral Neuropathy and Tear Film Dysfunction in Type 1 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Stuti L. Misra

    2014-01-01

    Full Text Available Purpose. To compare tear film metrics in patients with type 1 diabetes mellitus (DM and healthy controls and investigate the association between peripheral neuropathy and ocular surface quality. Methods. Dry eye symptoms were quantified in 53 patients with type 1 DM and 40 age-matched controls. Ocular examination included tear film lipid layer thickness grading, tear film stability and quantity measurement, and retinal photography. DM individuals additionally underwent a detailed neuropathy assessment. Results. Neither mean age nor dry eye symptom scores differed significantly between the DM and control groups (P=0.12 and P=0.33, resp.. Tear lipid thickness (P=0.02, stability (P<0.0001, and quantity (P=0.01 were significantly lower in the DM group. Corneal sensitivity was also reduced in the DM group (P<0.001 and tear film stability was inversely associated with total neuropathy score (r=-0.29, P=0.03. Conclusion. The DM group exhibited significantly reduced tear film stability, secretion, and lipid layer quality relative to the age-matched control group. The negative correlation between tear film parameters and total neuropathy score suggests that ocular surface abnormalities occur in parallel with diabetic peripheral neuropathy.

  3. Magnetic Resonance Imaging of Anterior Cruciate Ligament Tears: Evaluation of Standard Orthogonal and Tailored Paracoronal Images

    Energy Technology Data Exchange (ETDEWEB)

    Duc, S.R.; Zanetti, M.; Kramer, J.; Kaech, K.P.; Zollikofer, C.L.; Wentz, K.U. [Cantonal Hospital, Inst. of Radiology, Winterthur (Switzerland). MR Research Group

    2005-11-01

    Purpose: To evaluate the three standard orthogonal imaging planes and a paracoronal imaging plane for anterior cruciate ligament (ACL) tears. Material and Methods: Ninety patients (91 knees; 29 F and 61 M) aged between 15 and 84 years (mean 36.9{+-}16.4 years) underwent magnetic resonance imaging (MRI) of the knee prior to arthroscopy. At surgery, 32 knees had an intact ACL, 4 a partial tear, and 55 a complete ACL tear. In all patients, axial, sagittal, coronal, and paracoronal T2-weighted turbo-SE images were acquired. The ACL was classified as intact, partially, or completely torn. Partial and complete tears were combined for statistical evaluation. Results: Partial ACL tears (four cases) were not correctly diagnosed at MRI except in one knee by one observer on coronal images. Sensitivity in detecting ACL tears was 95%/63% (reader1/reader2) in the axial, 93%/95% in the sagittal, 93%/86% in the coronal, and 100%/93% in the paracoronal plane. Specificity was 75%/81% in the axial, 72%/81% in the sagittal, 78%/94% in the coronal, and 78%/88% in the paracoronal plane. Conclusion: ACL tears can be diagnosed accurately with each of the standard orthogonal planes. Based on reader confidence and interobserver agreement paracoronal images may be useful in equivocal cases.

  4. [Comparison of local acetylcysteine and artificial tears in the management of dry eye syndrome].

    Science.gov (United States)

    Pokupec, Rajko; Petricek, Igor; Sikić, Jakov; Bradić, Mirna; Popović-Suić, Smiljka; Petricek, Goranka

    2005-01-01

    Dry eye syndrome is a common clinical entity causing difficulties to many people, especially the elderly. Standard substitution therapy with artificial tears may frequently prove inadequate, thus any new treatment modality is highly welcome. The syndrome implies lacrimal hyperosmolality, which in turn results in mucus accumulation in the conjunctival sac causing additional irritation. Locally applied acetylcysteine, a mucolytic, regulates mucus secretion and reduces mucus accumulation. The aim of the study was to compare the efficacy of artificial tear therapy and therapy with local acetylcysteine. The study included 32 patients with the symptoms and signs of dry eye attending our department between March 20 and May 9, 2003. All study patients were on long-term substitution therapy with artificial tears. Upon evaluation of subjective discomforts and objective signs, the patients were switched from artificial tear therapy (Isopto-Tears, Alcon, with polyvinyl alcohol as active ingredient) to therapy with locally applied acetylcysteine (Brunac, Bruschettini). All parameters were re-evaluated at 2-week control visit. Thirty of 32 patients (94%) completed the study with control visit. Of these, 18 (60%) patients reported reduction of subjective discomforts, ten (33%) patients observed no change, and two (7%) patients experienced more discomforts with acetylcysteine than with artificial tear therapy. On objective sign evaluation, 12 (40%) patients showed less discomforts, unchanged condition was recorded in 13 (43%) patients, and five (17%) patients had more discomforts as compared with artificial tear therapy. A statistically significant difference (p=0.05) between artificial tear therapy and acetylcysteine therapy was found for the subjective symptom score but not for the objective sign score. Therapy with acetylcysteine proved more efficient than artificial tears in reducing subjective symptoms but had no effect on the objective signs of dry eye syndrome. The

  5. [Comparison of local acetylcysteine and artificial tears in the management of dry eye syndrome].

    Science.gov (United States)

    Pokupec, Rajko; Petricek, Igor; Sikić, Jakov; Bradić, Mirna; Popović-Suić, Smiljka; Petricek, Goranka

    2005-01-01

    Dry eye syndrome is a common clinical entity causing difficulties to many people, especially the elderly. Standard substitution therapy with artificial tears may frequently prove inadequate, thus any new treatment modality is highly welcome. The syndrome implies lacrimal hyperosmolality, which in turn results in mucus accumulation in the conjunctival sac causing additional irritation. Locally applied acetylcysteine, a mucolytic, regulates mucus secretion and reduces mucus accumulation. The aim of the study was to compare the efficacy of artificial tear therapy and therapy with local acetylcysteine. The study included 32 patients with the symptoms and signs of dry eye attending our department between March 20 and May 9, 2003. All study patients were on long-term substitution therapy with artificial tears. Upon evaluation of subjective discomforts and objective signs, the patients were switched from artificial tear therapy (Isopto-Tears, Alcon, with polyvinyl alcohol as active ingredient) to therapy with locally applied acetylcysteine (Brunac, Bruschettini). All parameters were re-evaluated at 2-week control visit. Thirty of 32 patients (94%) completed the study with control visit. Of these, 18 (60%) patients reported reduction of subjective discomforts, ten (33%) patients observed no change, and two (7%) patients experienced more discomforts with acetylcysteine than with artificial tear therapy. On objective sign evaluation, 12 (40%) patients showed less discomforts, unchanged condition was recorded in 13 (43%) patients, and five (17%) patients had more discomforts as compared with artificial tear therapy. A statistically significant difference (p=0.05) between artificial tear therapy and acetylcysteine therapy was found for the subjective symptom score but not for the objective sign score. Therapy with acetylcysteine proved more efficient than artificial tears in reducing subjective symptoms but had no effect on the objective signs of dry eye syndrome. The

  6. Interrelations between Dry Eye Syndrome and Tear Fluid Phospholipid Transfer Protein

    OpenAIRE

    SetÀlÀ, Niko

    2011-01-01

    The simplified model of human tear fluid (TF) is a three-layered structure composed of a homogenous gel-like layer of hydrated mucins, an aqueous phase, and a lipid-rich outermost layer found in the tear-air interface. It is assumed that amphiphilic phospholipids are found adjacent to the aqueous-mucin layer and externally to this a layer composed of non-polar lipids face the tear-air interface. The lipid layer prevents evaporation of the TF and protects the eye, but excess accumulation of li...

  7. Painful locking of the knee due to bucket handle tear of mediopatellar plica

    Institute of Scientific and Technical Information of China (English)

    HE Rui; YANG Liu; GUO Lin

    2011-01-01

    A case of swelling and anterior painful knee due to tear of mediopatellar plica is reported. The patient also felt clunk of the patellofemoral joint and knee locking. Under arthroscopic examination, a thick and fibrous plica was found medial to patellar, and a bucket tear along the plica fi.om medial patellar retinaculum to infrapatellar fat pad. Polarized microscopic examination showed collagen fiber fragment and loss of light reflecting property. Neuroimmunohistology suggested up-regulation of synovial plica innervation in the area around the crack. This may be related to the pain. The bucket tear of mediopatellar plicacaused pain and lock of knee are more common than previously reported.

  8. Comparison of TEAR and TFRC throughput for Drop tail and RED Queue Management Techniques

    Directory of Open Access Journals (Sweden)

    Parminderjeet Singh

    2014-12-01

    Full Text Available The comparison of throughput for TEAR (TCP emulation at receivers and TFRC TCP friendly rate control in MANETs is done with varying Active queue Management Techniques. The analysis reveals that for bandwidth constraint links, TEAR and TFRC perform far better than normal traffic propagation through TCP. In case of TEAR, the processing and route congestion algorithm load is shared by the receiver resulting in lesser load at the transmitters. In TFRC the TCP traffic is propagated via an algorithm to curb acknowledgement congestions. The effect of these two techniques is monitored on Droptail and RED, two of the most common Active Queue Management Techniques.

  9. Treating skin tears in nursing home residents: a pilot study comparing four types of dressings.

    Science.gov (United States)

    Edwards, H; Gaskill, D; Nash, R

    1998-03-01

    A pilot study was conducted to compare four types of dressings used to treat skin tears in nursing home residents. Wounds treated with a non-occlusive dressing healed more quickly than those dressed with occlusive dressings. The results suggest that ease of use and product wastage are important considerations when treating skin tears. The pilot study also highlights the need for further research into skin tear management and the need for ongoing education for nurses regarding skin integrity risk assessment and product information.

  10. Tear Film Break-Up Time: Comparison between Patients using Psychiatric Drugs and Healthy Individuals

    Directory of Open Access Journals (Sweden)

    Parvin Dibajnia

    2014-09-01

    Full Text Available Background: Ocular dryness is a well-recognized adverse side effect of many medications. The purpose of this study was to compare tear film stability between psychiatric patients that use lithium carbonate or carbamazepine and normal cases. Materials and Methods: Tear film break up time test was performed in three groups, 30 patients using lithium carbonate, 30 patients using carbamazepine and 30 normal cases. Values of the TBUTs were compared among groups by the independent t-test. Results: Differences between both of patients and control groups were significant (p<0.0001. Conclusion: The results show that these drugs contribute to decrease of tear film break up time.

  11. Effect of lodoxamide and disodium cromoglycate on tear eosinophil cationic protein in vernal keratoconjunctivitis

    OpenAIRE

    Leonardi, A.; Borghesan, F.; Avarello, A.; Plebani, M.; Secchi, A.

    1997-01-01

    AIM—To validate the use of tear eosinophil cationic protein (ECP) as a marker for eosinophil activation, and its pharmacological modulation, in addition to evaluating the efficacy of lodoxamide and sodium cromoglycate in the treatment of vernal keratoconjunctivitis (VKC).
METHODS—Tears were collected from 30 patients affected by active mild to moderate VKC before and after therapy with disodium cromoglycate 4% (DSCG) (n=15) or lodoxamide 0.1% (n=15) for 10 days. Tear cytology and ECP measurem...

  12. The effects of a shear flow on nonlinear evolutions of double tearing mode in Hall magnetohydrodynamics

    International Nuclear Information System (INIS)

    The effects of a shear flow on nonlinear evolution of double tearing mode in Hall magnetohydrodynamics are investigated. The parallel shear flow displays a suppressing effect on the double tearing mode. Due to the effect of the shear flow, the relative displacements between the magnetic islands are changed, and therefore their mutual interactions become weak. Furthermore, the nonlinear impulsive growth phase of the double tearing mode is delayed with increasing the shear flow velocity. When the magnetic islands are pushing against each other, the width of current sheets decreases drastically, and therefore the Hall effects are dominant and the magnetic reconnection enhances greatly.

  13. The quadruple cruciate sign of simultaneous bicompartmental medial and lateral bucket-handle meniscal tears

    Energy Technology Data Exchange (ETDEWEB)

    Bugnone, Alejandro N. [University of Miami School of Medicine/Jackson Memorial Hospital, Department of Radiology, Miami, FL (United States); Ramnath, R.R. [Neuroskeletal Imaging, Merritt Island, FL (United States); Davis, S.B. [Orthopedic Center, Huntsville, Alabama (United States); Sedaros, R. [Space Coast Orthopedics, Merritt Island, FL (United States)

    2005-11-01

    We report the second known case of bicompartmental bucket-handle tears of the medial and lateral menisci and the first documented case of the bucket-handle tears occurring simultaneously following trauma, which occurred after a motorcycle accident. Both bucket-handle fragments were displaced into the intercondylar notch. An anterior cruciate ligament tear was also present. Coronal images demonstrated four structures in the intercondylar notch: the anterior and posterior cruciate ligaments and the medial and lateral bucket-handle meniscal fragments. (orig.)

  14. Abordagem cirúrgica inédita para denervação acetabular em cães A new surgical approach to acetabular denervation in dogs

    Directory of Open Access Journals (Sweden)

    Cássio R.A. Ferrigno

    2007-02-01

    Full Text Available Este artigo tem por objetivo demonstrar nova abordagem cirúrgica para denervação seletiva das fibras sensitivas do periósteo acetabular, para tratamento da displasia coxo femoral em cães, conduzidas em 189 articulações. Para tanto, é descrita abordagem da região cranial e dorso-lateral do acetábulo de cães por incisão em forma de meia lua de aproximadamente de três centímetros de extensão, iniciando trocânter maior do fêmur e em direção ao corpo do ílio. Após rebatimento dorsal do músculo glúteo médio, secciona-se parcialmente a inserção do m. glúteo profundo para acesso às regiões citadas. Com auxílio de cureta foi removido, em todos os pacientes, periósteo na margem acetabular cranial e dorso lateral, até a exposição da cortical óssea. Em todos os animais foi possível a abordagem, tanto da face cranial como também acesso para a curetagem da face dorsal do acetábulo, com a técnica descrita, com incisão de pele de aproximadamente 3,2cm. A curetagem da porção cranial do acetábulo foi, em todos os casos realizados, sem visualização do osso, mas de fácil confecção e sem intercorrências de lesão de nervos ou músculos. Em todas as abordagens foi possível visualizar a cápsula articular da articulação coxo femoral, e em nenhum dos animais esta estrutura foi incisada por erro de técnica. Conclui-se que a abordagem cirúrgica descrita no presente trabalho é factível para este tipo de procedimento cirúrgico em cães, promovendo acesso adequado, com mínima invasão e sem complicações de qualquer natureza.The purpose of this study is to demonstrate a new surgical approach for the selective denervation of the sensitive fibers of the acetabular periosteum, for the treatment of hip dysplasia in dogs, conducted in 189 joints.The surgical approach of the cranial and dorso-lateral regions of the acetabular joint in dogs, by moon-shaped incision of approximately 3cm in extension, starting from the

  15. Retroperitoneal hematoma with bone resorption around the acetabular component after total hip arthroplasty: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Uchida Kenzo

    2012-09-01

    Full Text Available Abstract Introduction Vascular complications related to cup-fixating screws penetrating the medial acetabular wall during total hip arthroplasty are not uncommon but rarely are associated with serious adverse events in the late post-operative period. Case presentation We present the case of a 77-year-old Japanese woman who developed progressive extensive bone resorption and large hematoma in the acetabulum 13 years after total hip arthroplasty. On admission to our hospital, she was on oral warfarin (1.5mg/day for atrial fibrillation. About 5 months after the initiation of anticoagulant therapy, she suffered a major fall followed by massive subcutaneous and pelvic girdle bleeding, predominantly on the medial side of the right thigh, but a fracture or damage of total hip arthroplasty was not evident on an emergency orthopedic evaluation. One year after the accident, a routine follow-up examination showed an asymptomatic osteolytic lesion in the acetabulum on the right pelvis, and 2 years later our patient noticed progressive pain in her right hip during walking. A large osteolytic lesion was noted in the right acetabulum on a plain radiograph. On high-resolution computed tomography and magnetic resonance imaging, a huge granulomatous lesion in the acetabulum was suggestive of chronic hematoma in intrapelvic and extrapelvic gluteal regions. A closer computed tomography examination showed that one of the screws used for fixation of the acetabular component in the total hip arthroplasty had penetrated the acetabular bone and had reached the pelvic cavity. Surgery was performed in a single session by means of two approaches: anterior midline transperitoneal address to resect the low-density mass lesion followed by posterolateral acetabular implant re-settlement. Conclusions Though rare, total hip arthroplasty-related late vascular complications could be serious and potentially affect the limb and quality of life.

  16. A safe zone for acetabular component position in metal-on-metal hip resurfacing arthroplasty: winner of the 2012 HAP PAUL award.

    Science.gov (United States)

    Liu, Fei; Gross, Thomas P

    2013-08-01

    A safe zone for acetabular component positioning in hip resurfacing (RAIL: Relative Acetabular Inclination Limit) was calculated based on implant size and acetabular inclination angle (AIA). For AIA below the RAIL, there were no adverse wear failures or dislocations, and only 1% of cases with ion levels above 10 μg/L. Other than high inclination angle and small bearing size, female gender was the only other factor that correlated with high ion levels in the multivariate analysis. Seven hundred sixty-one hip resurfacing cases are included in this study. The UCLA activity score, femoral shaft angle, body mass index, weight, American Society of Anesthesiologists score, combined range of motion, diagnosis, age, gender, implant brand, AIA, bearing size, and duration of implantation were analyzed to determine the potential risk factors for elevated metal ion levels. These findings apply to sub hemispheric metal-on-metal bearings with similar coverage arcs as the Biomet and Corin hip resurfacing brands. Additional problems may occur when these bearings are connected with trunions on stems for total hip arthroplasty. PMID:23540536

  17. Comparison of Clinical Outcome of Autograft and Allograft Reconstruction for Anterior Cruciate Ligament Tears

    Directory of Open Access Journals (Sweden)

    Yu-Hua Jia

    2015-01-01

    Conclusions: In the repair of ACL tears, allograft reconstruction is as effective as the autograft reconstruction, but the allograft can lead to more tunnel widening evidently in the tibial tunnel, particularly.

  18. Degradation of Uniquely Glycosylated Secretory Immunoglobulin A in Tears From Patients With Pseudomonas aeruginosa Keratitis

    DEFF Research Database (Denmark)

    Lomholt, Jeanet Andersen; Kilian, Mogens

    2008-01-01

    PURPOSE. To investigate the integrity of secretory IgA (S-IgA) in tear fluid during bacterial keratitis and to evaluate the significance of specific Pseudomonas aeruginosa extracellular proteases in the observed degradation of S-IgA. METHODS. The integrity of component chains of S-IgA in tear fluid...... from patients with keratitis caused by P. aeruginosa, Streptococcus group G, Moraxella catarrhalis, Staphylococcus aureus, coagulase-negative staphylococci, and the IgA1 protease-producing Streptococcus pneumoniae were compared with S-IgA in tear fluid, colostrum, and saliva from healthy individuals......, and with tear S-IgA incubated with clinical isolates and genetically engineered P. aeruginosa strains with different protease profiles. Degradation of S-IgA and the significance of its glycosylation were analyzed in Western blots developed with antibodies against individual chains of S-IgA. RESULTS. Secretory...

  19. Rotator cuff tears in asymptomatic individuals: a clinical and ultrasonographic screening study

    Energy Technology Data Exchange (ETDEWEB)

    Schibany, N. E-mail: nadja.schibany@univie.ac.at; Zehetgruber, H.; Kainberger, F.; Wurnig, C.; Ba-Ssalamah, A.; Herneth, A.M.; Lang, T.; Gruber, D.; Breitenseher, M.J

    2004-09-01

    Objective: To determine the prevalence and clinical impact of rotator cuff tears in asymptomatic volunteers. Materials and Methods: Sonographic examinations of the shoulder of 212 asymptomatic individuals between 18 and 85 years old were performed by a single experienced operator. The prevalence and location of complete rotator cuff tears were evaluated. The clinical assessment was based on the Constant Score. Magnetic resonance imaging (MRI) of the shoulder was obtained in those patients where US showed rotator cuff pathology. Results: Ultrasound showed a complete rupture of the supraspinatus tendon in 6% of 212 patients from 56 to 83 years of age (mean: 67 years). MRI confirmed a complete rupture of the supraspinatus tendon in 90%. All patients reported no functional deficits, although strength was significantly lower in the patient group with complete supraspinatus tendon tear (P<0.01). Conclusion: There is a higher prevalence in older individuals of rotator cuff tendon tears that cause no pain or decrease in activities of daily living.

  20. Aortic tear and dissection related to connective tissues abnormalities resembling Marfan syndrome in a Great Dane.

    Science.gov (United States)

    Lenz, Jennifer A; Bach, Jonathan F; Bell, Cynthia M; Stepien, Rebecca L

    2015-06-01

    Aortic tears and acute aortic dissection are rarely reported in dogs. This report describes a case of aortic dissection and probable sinus of Valsalva rupture in a young Great Dane with associated histopathologic findings suggestive of a connective tissue abnormality.

  1. Rotator cuff tears in asymptomatic individuals: a clinical and ultrasonographic screening study

    International Nuclear Information System (INIS)

    Objective: To determine the prevalence and clinical impact of rotator cuff tears in asymptomatic volunteers. Materials and Methods: Sonographic examinations of the shoulder of 212 asymptomatic individuals between 18 and 85 years old were performed by a single experienced operator. The prevalence and location of complete rotator cuff tears were evaluated. The clinical assessment was based on the Constant Score. Magnetic resonance imaging (MRI) of the shoulder was obtained in those patients where US showed rotator cuff pathology. Results: Ultrasound showed a complete rupture of the supraspinatus tendon in 6% of 212 patients from 56 to 83 years of age (mean: 67 years). MRI confirmed a complete rupture of the supraspinatus tendon in 90%. All patients reported no functional deficits, although strength was significantly lower in the patient group with complete supraspinatus tendon tear (P<0.01). Conclusion: There is a higher prevalence in older individuals of rotator cuff tendon tears that cause no pain or decrease in activities of daily living

  2. Tearing analysis of a new airship envelope material under uniaxial tensile load

    Science.gov (United States)

    Wang, F. X.; Xu, W.; Chen, Y. L.; Fu, G. Y.

    2016-07-01

    This paper experimentally investigated the tearing properties of a new kind of coated woven fabrics, GQ-6, made of ultra-high molecular weight polyethylene fiber. Such material can be used for the envelope materials of a stratospheric airship. First, the uniaxial tearing tests were carried out. Effects of the stretching rate, the initial crack length, and the initial crack orientation on the material's tearing tensile strength were investigated. Experimental results showed that the initial crack length and the initial crack orientation can be represented by the equivalent initial crack length while the stretching rate has a slight influence on tearing behavior of the uniaxial tensile specimens. Then analytical studies using three methods, i.e. Griffith energy theory, the stress intensity factor theory, and Thiele's empirical theory, among which, the stress intensity factor theory gives the best correlation with the test data. Finally, a 48mm threshold of the equivalent initial crack length was recommended to the envelope material in operation.

  3. Clinical Outcomes of Medial Meniscus Posterior Root Tears

    Science.gov (United States)

    Krych, Aaron John; Reardon, Patrick J.; Pareek, Ayoosh; Peter, Logan; Dahm, Diane L.; Levy, Bruce A.; Stuart, Michael J.

    2016-01-01

    Objectives: Medial meniscus posterior root tears (MMPRTs) present a unique challenge for both patients and surgeons as these tears have shown to be biomechanically equivalent to complete meniscectomy. However, little is known about the natural history of these lesions. Therefore, the purpose of this study is to describe the clinical course of MMPRTs with respect to subsequent operative and non-operative treatments, and associated comorbidities. Methods: Over 2600 MRIs were identified by searching radiologist reads for the terms “root” or “root tear” from 2005-2013. Presence or absence of MMPRTs and other associated boney, meniscal, or ligamentous injuries were identified and recorded. Of these MRIs, 102 MRIs from 102 patients who had unrepaired MMPRTs with minimum 2-year follow-up and no prior ligamentous surgery were followed. These MRIs were evaluated to confirm the presence of a meniscal root tear and the presence or absence of associated meniscal or ligamentous injuries, as well as meniscal extrusion, subchondral edema, or insufficiency fractures. Chart review was performed to obtain the treatment summary after diagnosis. Radiographs from before and after the diagnosis of MMPRT were reviewed and Kellgren-Lawrence scores were determined. Finally, the association between concomitant boney, ligamentous, or meniscal injuries, patient factors, and rate of arthroplasty, as well as final Kellgren-Lawrence scores were evaluated. Chi-square analysis was used for categorical variables, and Wilcoxon Rank-Sums was used for continuous variables. Kaplan-Meier analysis was used to evaluate the effect of meniscal extrusion on the time-dependant rate of arthroplasty. Results: 104 patients (43 M:61F) were diagnosed with MMPRTs at a mean age of 54±13. These patients were followed for a mean of 66±26 months. 75 (74%) patients had associated meniscal extrusion, 64 (62%) had associated subchondral edema, and 14 (13%) had associated insufficiency fractures at the time of

  4. The role of pressure flattening in calculating tearing mode stability

    Science.gov (United States)

    Ham, C. J.; Connor, J. W.; Cowley, S. C.; Hastie, R. J.; Hender, T. C.; Liu, Y. Q.

    2013-12-01

    Calculations of tearing mode stability in tokamaks split conveniently into one in an external region, where marginally stable ideal magnetohydrodynamics (MHD) is applicable, and one in a resonant layer around the rational surface where sophisticated kinetic physics is needed. These two regions are coupled by the stability parameter Δ‧. Axisymmetric pressure and current perturbations localized around the rational surface significantly alter Δ‧. Equations governing the changes in the external solution and Δ‧ are derived for arbitrary perturbations in axisymmetric toroidal geometry. These equations can be used in two ways: (i) the Δ‧ can be calculated for a physically occurring perturbation to the pressure or current; (ii) alternatively we can use these equations to calculate Δ‧ for profiles with a pressure gradient at the rational surface in terms of the value when the perturbation removes this gradient. It is the second application we focus on here since resistive magnetohydrodynamics (MHD) codes do not contain the appropriate layer physics and therefore cannot predict stability for realistic hot plasma directly. They can, however, be used to calculate Δ‧. Existing methods (Ham et al 2012 Plasma Phys. Control. Fusion 54 025009) for extracting Δ‧ from resistive codes are unsatisfactory when there is a finite pressure gradient at the rational surface and favourable average curvature because of the Glasser stabilizing effect (Glasser et al 1975 Phys. Fluids 18 875). To overcome this difficulty we introduce a specific artificial pressure flattening function that allows the earlier approach to be used. The technique is first tested numerically in cylindrical geometry with an artificial favourable curvature. Its application to toroidal geometry is then demonstrated using the toroidal tokamak tearing mode stability code T7 (Fitzpatrick et al 1993 Nucl. Fusion 33 1533) which employs an approximate analytic equilibrium. The prospects for applying this

  5. CONTROL OF NEOCLASSICAL TEARING MODES IN DIII-D

    Energy Technology Data Exchange (ETDEWEB)

    R.J. LA HAYE; S. GUNTER; D.A. HUMPHREYS; J. LOHR; T.C. LUCE; M.E. MARASCHEK; C.C. PETTY; R.PRATER; J.T. SCOVILLE; E.J. STRAIT

    2001-11-01

    The development of techniques for neoclassical tearing mode (NTM) suppression or avoidance is crucial for successful high beta/high confinement tokamaks. Neoclassical tearing modes are islands destabilized and maintained by a helically perturbed bootstrap current and represent a significant limit to performance at higher poloidal beta. The confinement-degrading islands can be reduced or completely suppressed by precisely replacing the ''missing'' bootstrap current in the island O-point or by interfering with the fundamental helical harmonic of the pressure. Implementation of such techniques is being studied in the DIII-D tokamak [J.L. Luxon, et al., Plasma Phys. and Control. Fusion Research, Vol. 1 (International Atomic Energy Agency, Vienna, 1987) p. 159] in the presence of periodic q = 1 sawtooth instabilities, a reactor relevant regime. Radially localized off-axis electron cyclotron current drive (ECCD) must be precisely located on the island. In DIII-D the plasma control system is put into a ''search and suppress'' mode to make either small rigid radial position shifts of the entire plasma (and thus the island) or small changes in toroidal field (and thus, ECCD location) to find and lock onto the optimum position for complete island suppression by ECCD. This is based on real-time measurements of an m/n = 3/2 mode amplitude dB{sub {theta}}/dt. The experiment represents the first use of active feedback control to provide continuous, precise positioning. An alternative to ECCD makes use of the six toroidal section ''C-Coil'' on DIII-D to provide a large non-resonant static m = 1, n = 3 helical field to interfere with the fundamental harmonic of an m/n = 3/2 NTM. While experiments show success in inhibiting the NTM if a large enough n = 3 field is applied before the island onset, there is a considerable plasma rotation decrease due to n = 3 ''ripple''.

  6. The role of pressure flattening in calculating tearing mode stability

    International Nuclear Information System (INIS)

    Calculations of tearing mode stability in tokamaks split conveniently into one in an external region, where marginally stable ideal magnetohydrodynamics (MHD) is applicable, and one in a resonant layer around the rational surface where sophisticated kinetic physics is needed. These two regions are coupled by the stability parameter Δ′. Axisymmetric pressure and current perturbations localized around the rational surface significantly alter Δ′. Equations governing the changes in the external solution and Δ′ are derived for arbitrary perturbations in axisymmetric toroidal geometry. These equations can be used in two ways: (i) the Δ′ can be calculated for a physically occurring perturbation to the pressure or current; (ii) alternatively we can use these equations to calculate Δ′ for profiles with a pressure gradient at the rational surface in terms of the value when the perturbation removes this gradient. It is the second application we focus on here since resistive magnetohydrodynamics (MHD) codes do not contain the appropriate layer physics and therefore cannot predict stability for realistic hot plasma directly. They can, however, be used to calculate Δ′. Existing methods (Ham et al 2012 Plasma Phys. Control. Fusion 54 025009) for extracting Δ′ from resistive codes are unsatisfactory when there is a finite pressure gradient at the rational surface and favourable average curvature because of the Glasser stabilizing effect (Glasser et al 1975 Phys. Fluids 18 875). To overcome this difficulty we introduce a specific artificial pressure flattening function that allows the earlier approach to be used. The technique is first tested numerically in cylindrical geometry with an artificial favourable curvature. Its application to toroidal geometry is then demonstrated using the toroidal tokamak tearing mode stability code T7 (Fitzpatrick et al 1993 Nucl. Fusion 33 1533) which employs an approximate analytic equilibrium. The prospects for applying this

  7. Radiological classification of meniscocapsular tears of the anterolateral portion of the lateral meniscus of the knee

    International Nuclear Information System (INIS)

    In an arthroscopic-MRI correlation study of acute injuries to the knee it was found that anterolateral meniscocapsular separations of the lateral aspect of the knee were missed on MRI reporting. Eighty sports-related injuries of the knee were seen by experienced orthopaedic surgeons at the University of Malaya Medical Centre and at the National Sports Centre, Malaysia from January 1996 to July 1997. Fifty of the patients were suspected to have meniscal tears that were either lateral or medial on clinical examination and they were sent for MRI. Many of these patients were tertiary referrals. Magnetic resonance imaging examinations in 27 of the 50 patients were reported as not showing any intrasubstance or obvious meniscocapsular tears, but arthroscopy performed on them revealed anterolateral meniscocapsular tears of the lateral meniscus of varying degrees in nine of these patients. In retrospect the tears could be seen on MRI, and a pattern to the tears was noted and classified as follows. Type 0, normal; type 1, torn inferior or superior meniscocapsular attachment; type 2, both meniscofemoral and meniscotibial ligaments torn but with minimal separation of meniscus and capsule by fluid or synovitis; and type 3, marked separation of meniscus and capsule by fluid (> 3 mm). Ten patients who did not undergo arthroscopy for various personal and financial reasons underwent MRI which showed type 1 and type 2 tears, and were treated conservatively. These patients were all asymptomatic after 4-6 weeks with regard to clinical signs, suggesting a lateral meniscal tear. Magnetic resonance imaging therefore does reveal minor degrees of meniscocapsular tears anterolaterally when one understands the normal anatomy in this region. Copyright (1999) Blackwell Science Pty Ltd

  8. Tear ascorbic acid levels and the total antioxidant status in contact lens wearers: A pilot study

    Directory of Open Access Journals (Sweden)

    Venkata Sai

    2009-01-01

    Full Text Available Aims: The tear ascorbate owing to its high concentration, functions as an effective antioxidant against the oxidative damage of cornea. Contact lens wearers (CLW are prone to oxidative stress due to the lens-induced hypoxic conditions. A pilot study was done to compare the tear ascorbic acid level and the total antioxidant capacity give as in normal and CLW. Materials and Methods: In this study 21 CLW (Mean age 23 ± 3 years ; M-2, F-19, who were daily wear users, with duration of wear not more than four years, along with age-matched 28 controls (Mean age 28 ± 3 ; M-15, F-13 were recruited in the study for collection of reflex tears using Schirmer′s strip. Ascorbic acid in tears was determined using high-performance liquid chromatography (HPLC, total antioxidant capacity (TAC and total protein assay by spectrophotometric analysis. Results: CLW showed no significant change in the tear ascorbic acid levels (0.4 ± 0.26 mM compared to the control subjects (0.61 ± 0.59 mM. The amount of ascorbic acid in tears did not correlate with the TAC or the total protein of the tears. The mean TAC in CLW was 0.69 ± 0.16 mM, with a total protein of 1.35 ± 0.46 mg/ml while in controls it was 0.7 ± 0.18 mM and 1.21 ± 0.47 mg/ml respectively . Conclusions: Soft contact lens wear did not show any significant change in tear ascorbic acid, TAC and total protein levels compared to controls.

  9. Tear film inflammatory mediators during continuous wear of contact lenses and corneal refractive therapy

    OpenAIRE

    González-Pérez, Javier; Villa-Collar, César; Sobrino Moreiras, Tomás; Lema Gesto, Isabel; González-Méijome, José Manuel; Rodríguez Ares, María T.; Parafita, Manuel A.

    2012-01-01

    OBJECTIVES: To study changes in tear film inflammatory mediators following continuous wear of silicone-hydrogel lenses and corneal refractive therapy with reverse geometry contact lenses. DESIGN: A prospective, case-control study. METHODS: Twenty-eight subjects had worn silicone-hydrogel lenses on a 30-night continuous wear basis. Thirty-two subjects had worn corneal refractive therapy lenses on an overnight basis. Thirty-two matched control subjects were also recruited. Tear samples ...

  10. MR imaging characteristics and clinical symptoms related to displaced meniscal flap tears

    Energy Technology Data Exchange (ETDEWEB)

    Lance, Valentin; Heilmeier, Ursula R.; Joseph, Gabby B.; Steinbach, Lynne; Link, Thomas M. [University of California, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Ma, Benjamin [University of California, Department of Orthopedic Surgery and Sports Medicine, San Francisco (United States)

    2014-11-16

    The purpose of our study was (1) to analyze the flap tear location, direction of displacement and size on magnetic resonance (MR) imaging, (2) to describe associated knee abnormalities including presence of effusion, synovitis, bone marrow edema pattern or ligamentous tear, and (3) to assess clinical findings found with flap tears, including the pain score, and determine differences between operative and nonoperative groups. A retrospective radiology database search over the last 3 years identified 238 patients with flap tears, of which ultimately 58 with isolated flap tears were included after exclusion of patients with other significant knee internal derangement, severe degenerative change or prior surgery. MR studies of the knee were analyzed by two radiologists. Imaging characteristics were correlated with associated knee abnormalities and clinical findings. Statistical analysis employed linear and logistic regression models. Inter- and intrareader reliability was calculated. The medial meniscus was the most common site of flap tears (52/60, 87 %), with inferior displacement (47/60, 78 %). The degree of tibial cartilage loss had a positive correlation with the visual analog pain scale (p = 0.03). Patients who underwent arthroscopy were younger than those who did not (p = 0.01) and more likely to have a positive clinical McMurray test (p = 0.01). Medially and inferiorly displaced flap tears are the most common tear pattern. Those undergoing arthroscopy are more likely to have positive meniscal signs on clinical examination. A greater degree of cartilage loss involving the tibia on MR imaging was associated with increasing visual analog pain scores. (orig.)

  11. Sensitive and Real-Time Method for Evaluating Corneal Barrier Considering Tear Flow

    OpenAIRE

    Nakamura, Tadahiro; Teshima, Mugen; Kitahara, Takashi; Sasaki, Hitoshi; Uematsu, Masafumi; Kitaoka, Takashi; Nakashima, Mikiro; Nishida, Koyo; Nakamura, Junzo; Higuchi, Shun

    2010-01-01

    We developed a new electrophysiological method mimicking tear flow to evaluate the epithelial tight junction of rabbit cornea quantitatively. We investigated the effect of tear flow on the corneal damage induced by ophthalmic preservatives using this method. An Ussing chamber system with Ag/AgCl electrodes was used in the electrophysiological experiment. The excised rabbit cornea was mounted in the Ussing chamber and the precorneal solution in the chamber was perfused with a peristaltic pump ...

  12. Arthroscopic Knotless, Double-Row, Extended Linked Repair for Massive Rotator Cuff Tears.

    Science.gov (United States)

    Greenspoon, Joshua A; Petri, Maximilian; Millett, Peter J

    2016-02-01

    The management of massive rotator cuff tears remains a challenge for physicians, with failure rates being higher when compared with smaller tears. Many surgical treatment options exist including debridement with biceps tenodesis, complete repair, partial repair, repair with augmentation devices, superior capsule reconstruction, tendon transfer, and reverse total shoulder arthroplasty. The purpose of this article is to describe our preferred surgical technique for a complete arthroscopic repair using an extended linked, knotless, double-row construct. PMID:27330944

  13. Pharmacokinetic analysis of topical tobramycin in equine tears by automated immunoassay

    OpenAIRE

    Czerwinski Sarah L; Lyon Andrew W; Skorobohach Brian; Léguillette Renaud

    2012-01-01

    Abstract Background Ophthalmic antibiotic therapy in large animals is often used empirically because of the lack of pharmacokinetics studies. The purpose of the study was to determine the pharmacokinetics of topical tobramycin 0.3% ophthalmic solution in the tears of normal horses using an automated immunoassay analysis. Results The mean tobramycin concentrations in the tears at 5, 10, 15, 30 minutes and 1, 2, 4, 6 hours after administration were 759 (±414), 489 (±237), 346 (±227), 147 (±264)...

  14. Development of Job’s tears ice cream recipes with carrot juice and pumpkin paste

    OpenAIRE

    Wiwat Wangcharoen

    2011-01-01

    Carrot juice and pumpkin paste were used as ingredients in Job’s tears ice cream. Carrot juice or pumpkin paste added at 50% was equally preferred by 100 consumers compared to the original Job’s tears ice cream. The new types of ice cream were lower in antioxidant capacity and higher in total phenolic content but could still be considered as potential antioxidant products. Purchase intent was significantly increased (p

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

    OpenAIRE

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

    2013-01-01

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

  16. Evaluation and Treatment of the Tear Trough Deformity in Lower Blepharoplasty*

    OpenAIRE

    Espinoza, Gabriela Mabel; Holds, John Bryan

    2007-01-01

    The tear trough deformity is a natural consequence of the anatomic attachments of the periorbital tissues. A variety of techniques have evolved to address this cosmetic issue including subtractive blepharoplasty techniques, elevation of ptotic eyelid and midface tissues, and the injection or implantation of autogenous or alloplastic materials to diminish its appearance. Greater anatomic understanding of the pathogenesis of the tear trough deformity has led to more anatomically conservative an...

  17. Correction of tear trough deformity with a cohesive polydensified matrix hyaluronic acid: a case series

    OpenAIRE

    Huber-Vorländer J; Kürten M

    2015-01-01

    Jürgen Huber-Vorländer, Martin KürtenFort Malakoff Klinik, Mainz, GermanyAbstract: The tear trough or infraorbital hollow is a challenging area to treat, and only a few fillers are suitable for this delicate area. We report on a European case series of six subjects with mild to severe tear troughs who received treatment with cohesive polydensified matrix (CPM®) technology hyaluronic acid gel (Belotero® Balance). The product was injected as small depo...

  18. Results of reconstruction of massive irreparable rotator cuff tears using a fascia lata allograft

    Directory of Open Access Journals (Sweden)

    Dimitrios Varvitsiotis

    2015-01-01

    Conclusions: Despite advances in surgical methods, there is still not a universally accepted treatment for massive and irreparable rotator cuff tears, because the standard methods have dubious results, with excessive retear rates and poor outcomes, necessitating the need for new repair strategies. We documented significant clinical improvement using fascia lata allograft in the repair of massive irreparable r-c tear, acting as scaffold to bridge the defect, enhancing the healing at the repair site.

  19. Biophysical characterization of monofilm model systems composed of selected tear film phospholipids.

    Science.gov (United States)

    Patterson, Matthew; Vogel, Hans J; Prenner, Elmar J

    2016-02-01

    The tear film protects the eye from foreign particles and pathogens, prevents excess evaporation, provides lubrication, and maintains a high quality optical surface necessary for vision. The anterior layer of tear film consists of polar and non-polar lipid layers. The polar lipids form a monolayer on the aqueous subphase, acting as surfactants for the non-polar lipid multilayer. A tear film polar lipid biomimetic consisting of dipalmitoyl phosphatidylcholine (DPPC), dipalmitoyl phosphatidylethanolamine (DPPE), palmitoyl glucosylceramide (PGC), and palmitoyl sphingomyelin (PSM) was characterized using Langmuir monolayers and Brewster angle microscopy (BAM). Lipid combinations formed very stable monolayers, especially those containing DPPC or PSM. Surface experiments and elasticity analyses revealed that PGC resulted in more condensed and rigid mixed monolayers. DPPE provided resistance to large changes in lipid ordering over a wide surface pressure range. Ternary mixtures containing DPPE and PGC with either DPPC or PSM experienced the greatest lipid ordering within the natural tear film surface pressure range suggesting that these lipids are important to maintain tear film integrity during the inter-blink period. Finally, BAM images revealed unique structures within monolayers of DPPC, DPPE, and PGC at the natural tear film surface pressure. 3D analysis of these domains suggested either the formation of multilayers or outward protrusions at surface pressures far below the point of irreversible collapse as seen on the isotherm. This entails that the polar lipids of tear film may be capable of multilayer formation or outward folding as a mechanism to prevent rupture of the tear film during a blink.

  20. Acetabular trabecular direction between different species%不同物种髋臼的骨小梁方向*☆

    Institute of Scientific and Technical Information of China (English)

    孙剑伟; 颜冰珊; 尹望平; 张春才

    2013-01-01

      BACKGROUND: Some studies have shown that the morphological structure of bone is closely related with the stress environment. But the human walking upright movement may affect the direction of the acetabular trabecular bone. OBJECTIVE: To observe the differences of acetabular bone direction between different species. METHODS: Hip bones of human and rhesus monkey selected from Department of Anatomy, Second Military Medical University and the Shandong University School of Life Science were scanned by X-ray under the same conditions of shooting. The images were imported into Imagine pro plus 6.0 and transferred by fast fourier transform, then obtained the spectrum value of 0°-180° to calculate the number of trabeculae in a certain direction. RESULTS AND CONCLUSION: The human had highest spectrum value in 0° and 90° which were in accordance with Ilioischial bundle and sacropubic bundle. Rhesus monkeys distributed dispersedly and there was no obvious peak. The human trabecular in acetabular region mainly distributed along 90°-180° which were in accordance with Ilioischial bundle and sacropubic bundle, this indicated that there was relationship between Ilioischial bundle and human walking pattern.%  背景:有研究认为骨的形态结构与其所处的应力环境密切相关。由于人类直立行走的运动方式,可能会影响髋臼骨小梁的方向。目的:观察不同物种髋臼骨小梁方向的差异。方法:X射线观察由解放军第二军医大学解剖教研室和山东大学生命科学院提供的成人双侧髋骨干燥标本和成年恒河猴髋骨标本,将采集到的图像输入 Imagine pro plus 6.0,经快速傅里叶变换后,得出0°-180°的频谱值,计量不同的角度骨小梁的数量。结果与结论:人类髋骨在0°及90°频谱值最大,与骶耻束与髂坐束的方向符合。而恒河猴髋骨的频谱值分布较为弥散,没有明显的峰值。说明人类