Sample records for acromioclavicular joint reconstruction

  1. Reconstruction of chronic acromioclavicular joint disruption with artificial ligament prosthesis

    Devendra Kumar Chouhan; Uttam Chand Saini; Mandeep Singh Dhillon


    Objective:Management of Rockwood type 3 acromioclavicular disruptions is a matter of debate.Should we adopt conservative or operative measures at first presentation? It is not clear but most of the evidences are in favour of conservative management.We present our experience in managing these patients surgically.Methods:We present a prospective series of eight cases of chronic Rockwood type 3 acromioclavicular joint disruptions treated surgically.Anatomical reconstruction of the coracoclavicular ligament was done by artificial braided polyester ligament prosthesis.Results:All the patients were able to perform daily activities from an average of the 14th postoperative day.All patients felt an improvement in pain,with decrease in average visual analogue scale from preoperative 6.5 points (range 3-9 points) to 2.0 points (range 0-5 points),Constant score from 59% to 91% and American Shoulder and Elbow Surgeons shoulder score from 65 to 93 points postoperatively.These results improved or at least remained stationary on midterm follow-up,and no deterioration was recorded at an average follow-up of 46 months.Conclusion:This midterm outcome analysis of the artificial ligament prosthesis is the first such follow-up study with prosthesis.Our results are encouraging and justify the further use and evaluation of this relatively new and easily reproducible technique.

  2. Arthroscopically Assisted Acromioclavicular and Coracoclavicular Ligament Reconstruction for Chronic Acromioclavicular Joint Instability.

    Martetschläger, Frank; Tauber, Mark; Habermeyer, Peter; Hawi, Nael


    Acromioclavicular (AC) joint injuries are common injuries, especially in the young and active, male population. AC joint injuries account for 12% of all injuries of the shoulder girdle in the overall population. Although conservative treatment is recommended for Rockwood type I and type II injuries, there is controversial debate about optimal treatment for type III injuries. High-grade injuries are typically treated operatively to avoid painful sequelae. A vast number of different surgical methods have been described over the past few decades. Recent advances in arthroscopic surgery have enabled the shoulder surgeon to treat acute and chronic AC lesions arthroscopically assisted. Clinical studies have already shown good and reliable results. Although surgeons agree that a biological augmentation is required to minimize the risk of recurrent instability in chronic cases, a gold standard still needs to be defined. We present an arthroscopically assisted biological augmentation technique to reconstruct the AC and coracoclavicular ligaments, protected by a button-suture tape construct for chronic AC joint instability. The presented arthroscopic biological augmentation technique uses less and/or smaller drill holes in the clavicle and coracoid than previously described, thus reducing weakening of the bony structures. At the same time it enhances both horizontal and vertical stability.

  3. Arthroscopically Assisted Acromioclavicular and Coracoclavicular Ligament Reconstruction for Chronic Acromioclavicular Joint Instability

    Martetschläger, Frank; Tauber, Mark; Habermeyer, Peter; Hawi, Nael


    Acromioclavicular (AC) joint injuries are common injuries, especially in the young and active, male population. AC joint injuries account for 12% of all injuries of the shoulder girdle in the overall population. Although conservative treatment is recommended for Rockwood type I and type II injuries, there is controversial debate about optimal treatment for type III injuries. High-grade injuries are typically treated operatively to avoid painful sequelae. A vast number of different surgical me...

  4. Acromioclavicular Joint Separations


    Published online: 16 December 2012 # Springer Science+Business Media New York 2012 Abstract Acromioclavicular (AC) joint separations are common...injuries. The sports most likely to cause AC joint dislocations are football, soccer , hockey, rugby, and skiing, among others [9, 28, 29]. The major cause

  5. Acromioclavicular joint injuries: diagnosis and management.

    Simovitch, Ryan; Sanders, Brett; Ozbaydar, Mehmet; Lavery, Kyle; Warner, Jon J P


    Acromioclavicular joint injuries represent nearly half of all athletic shoulder injuries, often resulting from a fall onto the tip of the shoulder with the arm in adduction. Stability of this joint depends on the integrity of the acromioclavicular ligaments and capsule as well as the coracoclavicular ligaments and the trapezius and deltoid muscles. Along with clinical examination for tenderness and instability, radiographic examination is critical in the evaluation of acromioclavicular joint injuries. Nonsurgical treatment is indicated for type I and II injuries; surgery is almost always recommended for type IV, V, and VI injuries. Management of type III injuries remains controversial, with nonsurgical treatment favored in most instances and reconstruction of the acromioclavicular joint reserved for symptomatic instability. Recommended techniques for stabilization in cases of acute and late symptomatic instability include screw fixation of the coracoid process to the clavicle, coracoacromial ligament transfer, and coracoclavicular ligament reconstruction. Biomechanical studies have demonstrated that anatomic acromioclavicular joint reconstruction is the most effective treatment for persistent instability.

  6. Acromioclavicular joint reconstruction with coracoacromial ligament transfer using the docking technique

    Gobezie Reuben


    Full Text Available Abstract Background Symptomatic Acromioclavicular (AC dislocations have historically been surgically treated with Coracoclavicular (CC ligament reconstruction with transfer of the Coracoacromial (CA ligament. Tensioning the CA ligament is the key to success. Methods Seventeen patients with chronic, symptomatic Type III AC joint or acute Type IV and V injuries were treated surgically. The distal clavicle was resected and stabilized with CC ligament reconstruction using the CA ligament. The CA ligament was passed into the medullary canal and tensioned, using a modified 'docking' technique. Average follow-up was 29 months (range 12–57. Results Postoperative ASES and pain significantly improved in all patients (p = 0.001. Radiographically, 16 (94% maintained reduction, and only 1 (6% had a recurrent dislocation when he returned to karate 3 months postoperatively. His ultimate clinical outcome was excellent. Conclusion The docking procedure allows for tensioning of the transferred CA ligament and healing of the ligament in an intramedullary bone tunnel. Excellent clinical results were achieved, decreasing the risk of recurrent distal clavicle instability.

  7. Acromioclavicular joint injuries: anatomy, diagnosis, and treatment.

    Willimon, S Clifton; Gaskill, Trevor R; Millett, Peter J


    Acromioclavicular (AC) joint injuries are common in athletic populations and account for 40% to 50% of shoulder injuries in many contact sports, including lacrosse, hockey, rugby and football. The AC joint is stabilized by static and dynamic restraints, including the coracoclavicular (CC) ligaments. Knowledge of these supporting structures is important when identifying injury and directing treatment. Management of AC injuries should be guided by severity of injury, duration of injury and symptoms, and individual patient factors. These help determine how best to guide management, and whether patients should be treated surgically or nonsurgically. Treatment options for AC injuries continue to expand, and include arthroscopic-assisted anatomic reconstruction of the CC ligaments. The purpose of this article is to review the anatomy, diagnostic methods, and treatment options for AC joint injuries. In addition, the authors' preferred reconstruction technique and outcomes are presented.

  8. Acromioclavicular Reconstruction using Autogenous Semitendinosus Tendon Graft and the Importance of Postoperative Rehabilitation: A Case Report

    Jade PY Ho


    Full Text Available We present a case of chronic acromioclavicular joint dislocation (Rockwood type 5 in which the choice of acromioclavicular reconstruction using autogenous semitendinosus tendon graft was made due to its superiority in anatomical reconstruction of the coracoclavicular ligaments, and the impact of postoperative rehabilitation on the recovery of this patient. We also discuss the rationale behind this.

  9. Reconstrução coracoclavicular com enxerto tendíneo na luxação acromioclavicular crônica Coracoclavicular reconstruction using tendinous graft for chronic acromioclavicular joint dislocation

    Jorge Henrique Assunção


    Full Text Available OBJETIVO: Apresentar os resultados radiográficos e funcionais de pacientes submetidos ao tratamento da luxação acromioclavicular crônica com reconstrução dos ligamentos coracoclaviculares com enxerto de tendão semitendíneo. MÉTODO: Quinze pacientes, entre abril de 2007 e junho de 2008, foram submetidos a reconstrução dos ligamentos coracoclaviculares com enxerto tendíneo. Dois pacientes foram excluídos do estudo por seguimento inadequado. Treze pacientes foram seguidos clinicamente e radiograficamente, em média, por 16 meses (12-26 meses. Os pacientes foram submetidos a avaliação clinica pré e pós-operatória, utilizando os escores Constant e UCLA. Radiografias pré e pós-operatórias foram comparadas. RESULTADOS: Neste grupo de 13 pacientes com seguimento mínimo de um ano, o escore Constant variou de 60,9 (26-88 na avaliação pré-operatória para 87 (60-98 na última avaliação no período pós-operatório. O escore UCLA foi de 16,8 (11-27 no pré operatório para 33 (29-35 na avaliação pós-operatória (p=0,001. No controle radiográfico com um ano de pós-operatório, encontramos 12 pacientes (92% com a distância coracoclavicular igual comparando o ombro operado ao contralateral. Todos os ombros operados apresentavam-se sem translação na direção antero-posterior no perfil axilar. CONCLUSÃO: O resultado funcional e radiográfico foi muito satisfatório nos pacientes submetidos à reconstrução das luxações acromioclaviculares crônicas, com baixo indice de recidiva. Nivel de Evidência IV, série de casos.OBJECTIVE: The aim of this study is to present the radiographic and functional results of patients undergoing treatment for chronic acromioclavicular dislocation with coracoclavicular ligament reconstruction using tendon graft. METHOD: Between 2007 and 2008, fifteen patients with chronic Rockwood type III through V acromioclavicular joint dislocations underwent reconstruction of the coracoclavicular ligaments

  10. 肩锁关节脱位重建:金属植入物的选择%Reconstruction of acromioclavicular joint dislocation: Selection of metal implants

    蔡宇; 王凯; 梁晶峰


    OBJECTIVE: To introduce the metal implant internal fixation methods and implant selection of acromioclavicular joint dislocation,to evaluate the efficacy of clavicular hook plate in treatment of acromioclavicular joint dislocation.METHODS: Using "clavicular hook plate; acromioclavicular joint dislocation; internal fixation" as the key words, a computer-based online search of PubMed database and VIP database from 1996 to 2010 was performed for articles about metal implants fixation for the dislocation of acromioclavicular joint, focusing on the acromioclavicular joint dislocation treatments and the choice of internal fixation implant, and clinical validation was conducted. Patients who were treated with AO/ASIF clavicular hook plate for acromioclavicular joint dislocation and distal clavicle fractures in accordance with type Ⅲ- Ⅴ of Rockwood classification, were involved. Lazzcano score was applied to determine function.RESULTS : The present method of treating acromioclavicular joint dislocation includes a simple Kirschner wire internal fixation,Kirschner wire and tension band fixation, Bosworth method, coracoclavicular fixation between the wire, titanium wire cable instead of the wire fixation method, modified Weaver method, tendon or artificial ligament for coracoclavicular ligament reconstruction,clavicular hook plate and so on, each has their advantages and disadvantages. Clinical validation showed that, 34 patients after treatment of AO/ASIF clavicular hook plate were visited for 12 months as a follow-up. No plate or screw loosed and broken. At 6-12 months, the implants were taken out, 2 cases exhibited acromioclavicular subluxation, coracoclavicular ligament repair was not performed. Assessment criteria was in accordance with Lazzcano scores, 30 cases were excellent and 4 cases were good.CONCLUSION: The clavicular hook plate for acromioclavicular joint dislocation and distal clavicle fracture is a simple operation,with reliable fixation, less trauma, rapid

  11. Acromioclavicular joint reconstruction using a tendon graft: a biomechanical study comparing a novel “sutured throughout” tendon graft to a standard tendon graft

    Naziri, Qais; Williams, Nadine; Hayes, Westley; Kapadia, Bhaveen H.; Chatterjee, Dipal; Urban, William P.


    Background: With a recurrence rate of over 30%, techniques that offer stronger acromioclavicular (AC) joint reconstruction through increased graft strength may provide longevity. The purpose of our study was to determine the biomechanical strength of a novel tendon graft sutured throughout compared to a native tendon graft in Grade 3 anatomical AC joint reconstruction. Methods: For this in vitro experiment, nine paired (n = 18) embalmed cadaveric AC joints of three males and six females (age 86 years, range 51–94 years) were harvested. Anatomic repair with fresh bovine Achilles tendon grafts without bone block was simulated. Specimens were divided into two groups; with group 1 using grafts with ultra-high molecular-weight polyethylene (UHMWPE) suture ran throughout the entire length. In group 2, reconstruction with only native allografts was performed. The distal scapula and humerus were casted in epoxy compound and mounted on the mechanical testing machine. Tensile tests were performed using a mechanical testing machine at the rate of 50 mm/min. Maximum load and displacement to failure were collected. Results: The average load to failure was significantly higher for group 1 compared to group 2, with mean values of 437.5 N ± 160.7 N and 94.4 N ± 43.6 N, (p = 0.001). The average displacement to failure was not significantly different, with 29.7 mm ± 10.6 mm in group 1 and 25 mm ± 9.1 mm in group 2 (p = 0.25). Conclusion: We conclude that a UHMWPE suture reinforced graft can provide a 3.6 times stronger AC joint reconstruction compared to a native graft. PMID:27163106

  12. Acromioclavicular joint reconstruction using a tendon graft: a biomechanical study comparing a novel “sutured throughout” tendon graft to a standard tendon graft

    Naziri Qais


    Full Text Available Background: With a recurrence rate of over 30%, techniques that offer stronger acromioclavicular (AC joint reconstruction through increased graft strength may provide longevity. The purpose of our study was to determine the biomechanical strength of a novel tendon graft sutured throughout compared to a native tendon graft in Grade 3 anatomical AC joint reconstruction. Methods: For this in vitro experiment, nine paired (n = 18 embalmed cadaveric AC joints of three males and six females (age 86 years, range 51–94 years were harvested. Anatomic repair with fresh bovine Achilles tendon grafts without bone block was simulated. Specimens were divided into two groups; with group 1 using grafts with ultra-high molecular-weight polyethylene (UHMWPE suture ran throughout the entire length. In group 2, reconstruction with only native allografts was performed. The distal scapula and humerus were casted in epoxy compound and mounted on the mechanical testing machine. Tensile tests were performed using a mechanical testing machine at the rate of 50 mm/min. Maximum load and displacement to failure were collected. Results: The average load to failure was significantly higher for group 1 compared to group 2, with mean values of 437.5 N ± 160.7 N and 94.4 N ± 43.6 N, (p = 0.001. The average displacement to failure was not significantly different, with 29.7 mm ± 10.6 mm in group 1 and 25 mm ± 9.1 mm in group 2 (p = 0.25. Conclusion: We conclude that a UHMWPE suture reinforced graft can provide a 3.6 times stronger AC joint reconstruction compared to a native graft.

  13. Operative treatment of acromioclavicular joint dislocation: a new technique with suture anchors

    Zhang Jingwei


    Full Text Available 【Abstract】Objective: To evaluate clinical outcome of suture anchors in strengthening both acromioclavicular and coracoclavicular ligaments in the surgical treatment of acromioclavicular joint dislocation. Methods: Twenty-eight patients with acute traumatic Rockwood III, IV and V dislocations of the acromioclavicular joint surgically treated at our institute between October 2010 and January 2012 were recruited. All patients underwent open reduction combined with suture anchors. Function was evaluated using the ConstantMurley shoulder score. Clinical and radiographic shoulder ratings were evaluated using Taft criteria at 3, 6 and 12 months. Results:Two cases with fixation loosening were not included in final statistical analysis. Other patients obtained full joint reposition on immediate postoperative radiographs. Follow-up was performed with an average of 15.6 months (range, 12-19. After early range of motion exercises, 96.2% of the patients (25/26 could abduct and elevate their shoulders more than 90 degrees within postoperative 3 months. There was no infection. Average Constant-Murley score was 96.3 points (range, 94-100 and mean Taft shoulder rating was 10.7 points (range, 8-12 at 12 months. Conclusion: The suture anchor is a relatively simple technique and can avoid screw removal which is helpful in reconstructing both acromioclavicular and coracoclavicular ligaments in acute traumatic acromioclavicular joint dislocation. Key words: Acromioclavicular joint; Dislocations; Surgery; Suture anchors

  14. Septic arthritis of the acromioclavicular joint: an uncommon location.

    Martínez-Morillo, Melania; Mateo Soria, Lourdes; Riveros Frutos, Anne; Tejera Segura, Beatriz; Holgado Pérez, Susana; Olivé Marqués, Alejandro


    Septic pyogenic arthritis of the acromioclavicular joint is a rare entity that occurs in immunosuppressed patients or those with discontinuity of defense barriers. There are only 15 cases described in the literature. The diagnosis is based on clinical features and the isolation of a microorganism in synovial fluid or blood cultures. The evidence of arthritis by imaging (MRI, ultrasound or scintigraphy) may be useful. Antibiotic treatment is the same as in septic arthritis in other locations. Staphylococcus aureus is the microorganism most frequently isolated. Our objective was to describe the clinical features, treatment and outcome of patients diagnosed with septic arthritis of the acromioclavicular joint at a Rheumatology Department. We developed a study with a retrospective design (1989-2012). The medical records of patients with septic arthritis were reviewed (101 patients). Those involving the acromioclavicular joint were selected (6 patients; 6%).

  15. Endobutton technique for the treatment of acute acromioclavicular joint dislocations

    Raif Özden


    Full Text Available Objective: Acromioclavicular (AC joint dislocation is a common injury frequently affecting young athletes. The aim of this study is to evaluate postoperative functional results in cases diagnosed with acute AC joint dislocation stabilized with endobutton system. Methods: This fixation procedure has been applied on 10 patients. Indications of the technique included: a grade V AC joint dislocation (7 patients, and grade III AC joint dislocation (3 patient according to Rockwood classification. The coracoclavicular (CC interval and AC joint were reduced using two endobuttons. One endobutton was fitted on the clavicle and the second was placed at the undersurface of the coracoid. Outcomes were assessed with the Constant shoulder score and visual analog pain scale. Results: All the patients had powerful intraoperative fixation. Immediately after surgery, and 6 weeks, and 1 year postoperative radiographs showed adequate reduction of the CC distance and the AC joint. The mean Constant shoulder score was 89 (88–92 in the injured shoulder and 90 (88–93 in the uninjured shoulder. There was no statically significant difference between the injured and normal shoulder in terms of Constant shoulder score and there was no complication during the process. Conclusion: This technique is a safe and effective method for providing fixation for the AC joint.

  16. Clinical Effect of Acute Complete Acromioclavicular Joint Dislocation Treated with Micro-Movable and Anatomical Acromioclavicular Plate

    Qingjun Liu, Jianyun Miao, Bin Lin, Zhimin Guo


    Full Text Available Objectives: We evaluated the long-term clinical results of acute complete acromioclavicular dislocations treated with micro-movable and anatomical acromioclavicular plate.Methods: Open reduction and internal fixation was performed using the MAAP in 16 patients (10 males, 6 females; mean age 36 years; range16 to 63 years with acute complete acromioclavicular joint dislocation. Radiographic evaluations were routinely conducted every 3 weeks until 3 months postoperatively. The MAAP were removed under local anesthesia after 3 months postoperatively. We evaluated the functional results by using the constant scoring system and radiological results in the last follow-up time. The mean follow up was 26 months (range 16 to 38 months.Results: The mean Constant score was 94 (range, 78 to 100. The results were excellent in 12 patients (75.0%, good in 3 patients (18.8% and satisfactory in 1patient (6.2%. Three patients with scores of 80 to 90 had mild pain during activity, but have not affected the shoulder range of motion. One patient has both some pain and limited range of motion of shoulder joint. All patients but one have returned to their preoperative work without any limitations. Compared to the contralateral side, radiography showed anatomical reposition in the vertical plane in 14 cases, slight loss of reduction in 2 older patients.Conclusion: We recommend the MAAP fixation for surgical treatment of acute complete acromioclavicular joint dislocation as it could provide satisfactory shoulder functions and clinical results, with lower complication rate. However, it is necessary to continue to observe the clinical effects of this fixation technique.

  17. A modified method of coracoid transposition for the treatment of complete dislocation of acromioclavicular joint

    王世松; 杜敦进; 张鹏程; 杨泗华; 樊亚军


    Objective: To report a new method of coracoid transposition for the treatment of complete dislocation of acromioclavicular joint and to evaluate its efficacy. Methods: We modified Dewars surgical method as follows: (1) Two small incisions, a transversal incision on the acromioclavicular joint and a longitudinal incision on the coracoid, were made instead of a conventional large arc incision from the acromion to coracoid. (2) The foreign body in the acromioclavicular joint was cleared out. The chondral surface at the lateral segment of clavicle was resected to form a pseudarthrosis and meanwhile the residual joint capsule and ligaments were repaired. (3) The coracoid was moved to the anteroinferior edge of the clavicle instead of the anterior margin and (4) the coracoid was moved to the lateral border of the clavicle instead of the superior border of the coracoclavicular ligament.Results: The follow-up duration in 30 patients of the series was from 6 to 72 months (mean 41 months). Functional assessment was carried out by the criteria delineated previously by Karkson, in which Grade A was in 24 cases, Grade B in 4cases, and C in 2.Conclusions: This modified technique, having less postoperative complications and less injuries to tissues and according well with the requirement of biomechanics, can achieve a stable reduction of acromioclavicular joint with a good functional and cosmetic result and therefore is preferable to use clinically on a large scale.

  18. A modified method of coracoid transposition for the treatment of complete dislocation of acromioclavicular joint


    Objective:To eport a new method of coracoid transpostiton for the treatment of complete dislocation of acromioclavicular joint and to evaluate its efficacy.Methods:We modified Eewar's surgical method as follows:(1)Two small incisions,a transversal incision on the acromioclavicular joint and a longitudinal incision on the coracoid ,were made instead of a conventional large arc incision from the acromion to coracoid.(2)The foreign body in the acromioclavicular joint was cleared out.Thechondral surface at the lateral segment of clavicle was resected to form a pseudarthrosis and meanwhile the residual joint capsule and ligaments were repaired.(3)The coracoid was moved to the anteroinferior edge of the clavicle instead of the anterior margin and (4)the coracoid was moved to the lateral border of the clavicle instead of the superior border of the coracoclavicular ligament.Results:The follow-up duration in 30patients of the series was from6to 72months(mean41months).Functional assessment was carried out by the criteria delineated previously by Karkson,in which Grade Awas in 24 cases,Grade Bin4cases,and Cin2.Conclusions:This modified technique,having less postoperative complications and less injuries to tissues and according well with the requitement of biomechanics,can achieve a stable reduction of acromioclavicular joint with a good functional and cosmetic result and thereore is preferable to use clinically on a large scale.

  19. Correlation of macroscopic osteoarthrotic changes and radiographic findings in the acromioclavicular joint

    Stenlund, B.; Marions, O.; Engstroem, K.F.; Goldie, I.

    In a total of 108 acromioclavicular articulations from cadavers the osteoarthrotic changes were studied. The articulations were macroscopically and radiographically ranked according to their grade of osteoarthrosis. The two ranking lines were correlated statistically and showed a rank correlation of 0.741. In 38 articulations tomography was also carried out. These articulations were classified into five grades of osteoarthrosis and the macroscopic, conventional radiographic and tomographic gradings were compared. The correlation coefficient for tomography versus macroscopy was 0.714. Tomography versus standard radiography showed a correlation of 0.767 and standard radiography versus macroscopy a correlation of 0.841. The standard radiographic investigation reveals moderate and severe osteoarthrotic changes in the acromioclavicular joint but cannot depict smaller changes. Tomography does not seem to improve the specificity. There is a need for a better radiologic technique in the examination of the acromioclavicular joint. Radiography during some kind of loading might be a practical way of improving the specificity and make it possible to show early osteoarthrosis in the acromioclavicular articulation.

  20. [Results of surgical treatment for acromioclavicular dislocation using a modified Mitchell method].

    Król, M; Jarco, K; Sleczkowski, M; Delimat, J; Szot, J


    The paper presents the results of surgical treatment in acromioclavicular dislocation (grade III according to Tossy) in 53 patients. Joint reconstruction was performed using Mitchell's modified method--acromioclavicular reconstruction was achieved by applying a with Dallos poliester fiber prosthesis. Clinically in 90.5% of the cases a good or excellent result was achieved.

  1. Intra-articular fibroma of tendon sheath arising in the acromioclavicular joint.

    Glover, McKinley; Chebib, Ivan; Simeone, F Joseph


    Fibroma of the tendon sheath, a rare benign soft tissue tumor that most often occurs in the distal upper extremities (hands and wrist), is exceedingly rare to present as an intraarticular mass. Presented here is the first case in the English literature, to our knowledge, of a fibroma of the tendon sheath arising in the acromioclavicular joint. The patient presented with recurrent shoulder pain with activity without antecedent trauma. Radiographs were essentially normal. MR images demonstrated a lobulated, heterogeneous mass with contrast enhancement arising from the acromioclavicular joint. Following surgical resection, histopathology revealed hypocellular collagen matrix with spindle-shaped fibroblasts, confirming the diagnosis of fibroma of tendon sheath. The imaging features of the fibroma of the tendon sheath and a brief review of the literature are presented.

  2. Nonoperative management of a sagittal coracoid fracture with a concomitant acromioclavicular joint separation

    Thomas Kristen


    Full Text Available Separation of the acromioclavicular joint in conjunction with a coracoid fracture is a rare injury. Treatment decisions are traditionally based on the level of the fracture, the status of the coracoclavicular ligament and the activity level of the patient. We present a novel coracoid fracture pattern treated nonoperatively in a young, active patient and a thorough review of the literature regarding this topic.

  3. Coracoid Process Avulsion Fracture at the Coracoclavicular Ligament Attachment Site in an Osteoporotic Patient with Acromioclavicular Joint Dislocation

    Yoshihiro Onada


    Full Text Available Coracoid fractures are uncommon, mostly occur at the base or neck of the coracoid process (CP, and typically present with ipsilateral acromioclavicular joint (ACJ dislocation. However, CP avulsion fractures at the coracoclavicular ligament (CCL attachment with ACJ dislocation have not been previously reported. A 59-year-old woman receiving glucocorticoid treatment fell from bed and complained of pain in her shoulder. Radiographs revealed an ACJ dislocation with a distal clavicle fracture. Three-dimensional computed tomography (3D-CT reconstruction showed a small bone fragment at the medial apex of the CP. She was treated conservatively and achieved a satisfactory outcome. CP avulsion fractures at the CCL attachment can occur in osteoporotic patients with ACJ dislocations. Three-dimensional computed tomography is useful for identifying this fracture type. CP avulsion fractures should be suspected in patients with ACJ dislocations and risk factors for osteoporosis or osteopenia.

  4. Comparative study on treating complete dislocation of acromioclavicular joint with three different methods

    林斌; 练克俭; 郭林新; 郭志民; 庄泽民; 刘庆军; 周亮


    Objective: To comparatively study complete dislocation of acromioclavicular joint treated with three different methods.Methods:A total of 96 patients (81 males and 15 females, aged 16-59 years, mean =45 years) with complete dislocation of acromioclavicular joint were treated with Dewar's operation ( Group A, n = 32), internal fixation with Kirschner tension band wires ( Group B, n = 44), or internal fixation with Wolter plates ( Group C, n = 20 ),respectively, in this study. Eighty-five patients suffered from acute dislocations and eleven from chronic dislocations. Results: The patients were followed up for 50 months on an average. According to Karlsson's standard, in Group A, 26 patients were assessed as good, 5 as fair and 1 as poor. In Group B, 20 patients were assessed as good, 13 as fair and 11 as poor. In Group C, 15 patients were assessed as good, 4 as fair and 1 as poor. The good and fair rates were significantly different between Group A and Group B, and between Group C and Group B, but no statistical difference was found between Group A and Group C. The operating time was ( 52.36 ± 7.24 ) minutes, ( 67.43 ± 8.11) minutes and (69.73 ±8.04) minutes in Groups A, B and C, respectively. And the hospitalizing fees were (2 400 ±270) yuan, (2 100±190) yuan and (8450±360) yuan in Groups A, B and C, respectively. Conclusions: Dewar's operation is a good and safe method with shorter operating time and lower hospitalizing fee for treating complete dislocation of acromioclavicular joint. The method is simple without the need of a second operation to remove the implants and with few complications.

  5. Type IV acromioclavicular joint dislocation associated with a mid-shaft clavicle malunion

    Khalid D Mohammed


    Full Text Available This reports presents the case of a combined clavicle fracture malunion and chronic Type IV acromioclavicular (AC joint dislocation. The patient was seen acutely in the emergency department following a mountain bike accident at which time the clavicle fracture was identified and managed conservatively however the AC dislocation was not diagnosed. The patient presented 25 months following the injury with persistent pain and disability and was treated with clavicle osteotomy and AC stabilization. We document the clinical details, surgical treatment and outcome.

  6. Acute septic arthritis of the acromioclavicular joint caused by Haemophilus parainfluenzae: a rare causative origin.

    Hong, Myong-Joo; Kim, Yeon-Dong; Ham, Hyang-Do


    Septic arthritis of the acromioclavicular (AC) joint is a rare entity with symptoms that include erythema, swelling, and tenderness over the AC joint, fever, and limitation of shoulder motion with pain. In previous reports, Staphylococcus and Streptococcus species have been mentioned as common causative organisms. Haemophilus parainfluenzae is a normal inhabitant of the oral cavity, respiratory tract, gastrointestinal tract, and urogenital tract. However, it sometimes causes opportunistic infections leading to septic arthritis and osteomyelitis. AC joint infection associated with H.parainfluenzae is very rare, and only one case has been reported in the literature. Moreover, septic arthritis in immunocompetent patients is also very rare. Here, we report the case of a healthy patient with H. parainfluenzae-related septic arthritis of the AC joint.

  7. Arthroscopic resection of the distal clavicle in osteoarthritis of the acromioclavicular joint

    Tae-Soo Park


    Full Text Available Background: Symptomatic acromioclavicular joint (ACJ lesions are a common cause of shoulder complaints that can be treated successfully with both conservative and surgical methods. There are several operative techniques, including both open and arthroscopic surgery, for excising the distal end of the clavicle. Here, we present a new modified arthroscopic technique for painful osteoarthritis of the ACJ and evaluate its clinical outcomes. Our hypothesis was that 4- to 7-mm resection of the distal clavicle in an en bloc fashion would have several advantages, including no bony remnants, maintenance of stability of the ACJ, and reduced prevalence of heterotopic ossification, in addition to elimination of the pathologic portion of the distal clavicle. Materials and Methods: 20 shoulders of 20 consecutive patients with painful and isolated osteoarthritis of the ACJ who were treated by arthroscopic en bloc resection of the distal clavicle were included in the study. There were 10 males and 10 females with an average age of 56 years (range 42-70 years. The mean duration of followup was 6 years and 2 months (range 4-8 years 10 months. The results were evaluated using the University of California Los Angeles (UCLA shoulder rating score. Results: The overall UCLA score was 13.7 preoperatively, which improved to 33.4 postoperatively. All subscores were improved significantly ( P < 0.001. There were no specific complications at the latest followup. Conclusion: It is critical in this procedure to resect the distal clavicle evenly from superior to inferior in an en bloc fashion without any small bony remnants and to preserve the capsule and acromioclavicular ligament superoposteriorly. This arthroscopic procedure is a reliable and reproducible technique for painful osteoarthritis of the ACJ lesions in active patients engaged in overhead throwing sports and heavy labor.


    GÓmez Vieira, Luis Alfredo; Visco, Adalberto; Daneu Fernandes, Luis Filipe; GÓmez Cordero, Nicolas Gerardo


    Presenting the arthroscopic treatment by Tight Rope - Arthrex® system for acute acromioclavicular dislocation and to evaluate results obtained with this procedure. Methods: Between August 2006 and May 2007, 10 shoulders of 10 patients with acute acromioclavicular dislocation were submitted to arthroscopic repair using the Tight Rope - Arthrex® system. Minimum follow-up was 12 months, with a mean of 15 months. Age ranged from 26 to 42, mean 34 years. All patients were male. Radiology evaluation was made by trauma series x-ray. The patients were assisted in the first month weekly and after three months after the procedure. Clinical evaluation was based on the University of California at Los Angeles (UCLA) criteria. Results: All patients were satisfied after the arthroscopic procedure and the mean UCLA score was 32,5. Conclusion: The arthroscopic treatment by Tight Rope – Arthrex® system for acute acromioclavicular dislocation showed to be an efficient technique. PMID:26998453

  9. Acromioclavicular joint acceleration-deceleration injury as a cause of persistent shoulder pain: Outcome after arthroscopic resection

    Ehud Atoun


    Full Text Available Background: Shoulder pain in general and acromioclavicular joint (ACJ pain specifically is common after acceleration-deceleration injury following road traffic accident (RTA. The outcome of surgical treatment in this condition is not described in the literature. The aim of the present study was to report the outcome of arthroscopic resection of the ACJ in these cases. Materials and Methods: Nine patients with localized ACJ pain, resistant to nonoperative treatment were referred on an average 18 months after the injury. There were 3 male and 6 females. The right shoulder was involved in seven patients and the left in two. The average age was 38.9 years (range 29-46 years. All presented with normal X-rays but with torn acromioclavicular joint disc and effusion on magnetic resonance imaging (MRI. Arthroscopic ACJ excision arthroplasty was performed in all patients. Results: At a mean followup of 18 month, all patients had marked improvement. The Constant score improved from 36 to 81, the pain score from 3/15 to 10/15 and the patient satisfaction improved from 3.5/10 to 9.3/10. Conclusion: Arthroscopic ACJ excision arthroplasty, gives good outcomes in patients not responding to conservative management in ACJ acceleration-deceleration injury.

  10. BiPOD Arthroscopic Acromioclavicular Repair Restores Bidirectional Stability.

    De Beer, Joe; Schaer, Michael; Latendresse, Kim; Raniga, Sumit; Moor, Beat K; Zumstein, Matthias A


    Stabilizing the acromioclavicular joint in the vertical and horizontal planes is challenging, and most current techniques do not reliably achieve this goal. The BiPOD repair is an arthroscopically assisted procedure performed with image intensifier guidance that reconstructs the coracoclavicular ligaments as well as the acromioclavicular ligaments to achieve bidirectional stability. Repair is achieved with a combination of 2-mm FiberTape (Arthrex, Naples, Florida) and 20-mm Poly-Tape (Neoligaments, Leeds, England) to achieve rigid repair, prevent bone abrasion, and promote tissue ingrowth. This study is a prospective review of the first 6 patients treated for high-grade acute acromioclavicular injury with the BiPOD technique. The study included 6 men who were 21 to 36 years old (mean, 27 years). At 6-month follow-up, complications were recorded and radiographic analysis was used to determine the coracoclavicular distance for vertical reduction and the amount of acromioclavicular translation on the Alexander axillary view was used to determine horizontal reduction. One patient had a superficial infection over the tape knot. The difference in coracoclavicular distance between the operated side and the uninvolved side was 9±2 mm preoperatively and 0.3±2 mm at 6-month follow-up. On Alexander axillary view, all 6 patients showed stable reduction, which is defined as a clavicle that is in line with the acromion. The findings show that BiPOD acromioclavicular reconstruction restores bidirectional stability of the acromioclavicular joint at 6 months. [Orthopedics. 201x; xx(x):exx-exx.].

  11. 关节镜下喙锁韧带增强术治疗肩锁关节脱位%Arthroscopic treatment of acute acromioclavicular joint dislocations by coracoacromial ligament augmentation and suture

    皇甫小桥; 赵金忠; 何耀华; 杨星光; 刘旭东; 刘闻欣; 王海明


    目的:研究关节镜下缝线钢板增强喙锁韧带术治疗肩锁关节脱位的近期治疗效果。方法2010年3月至2011年3月,在关节镜下使用膝关节韧带重建技术的缝线钢板(德国 ASCULAP 公司, B′BRAUN)增强重建喙锁韧带(三角韧带与斜方韧带),治疗 Rockwood Ⅲ型9例、Ⅴ型3例新鲜肩锁关节脱位。行 X线片、美国肩肘关节外科医师(America Shoulder Elbow Surgeons,ASES)评分和 Constant 评分,随访12~18个月。结果 ASES 评分:术前28.7分,术后86.9分;Constant 评分:术前24分,术后91分。治疗组 X线片显示,肩锁关节复位良好。术后1年,91.7%(11/12)病例获得满意治疗效果,83.3%(10/12)恢复到术前运动水平,仅有1例出现肩锁关节半脱位。结论关节镜下缝线钢板喙锁韧带增强术治疗肩锁关节脱位,早期可以获得满意的治疗效果,术后复位良好,并发症少。%Objective Acromioclavicular joint dislocation is commonly seen in shoulder joint injuries. Dysfunction as well as pain and discomfort usually occurred when the integrity of shoulder is damaged,for the acromioclavicular (AC)joint is involved in the connection between the scapula and the body as well as the activities of shoulder joint.Therefore,a consensus has been reached to treat severe AC joint dislocation by surgery.Based on different anatomical and functional cognition,methods for AC joint dislocation are various,which are typically performed by incision to reconstruct its stability and restore function.Attempts had been made by many doctors in the reconstruction of AC joint dislocation with the development of arthroscopy.From March 2010 to March 2011,obvious therapeutic effect was obtained in treating Rockwood type Ⅲ and Ⅴ AC joint dislocation arthroscopically with the suture plate used for the reconstruction of ligaments of knee joint to augment the reconstructed CC ligaments (conoid ligament and trapezoid ligament).Methods From March 2010 to March 2011

  12. Clinical results of coracoacromial ligament transfer in acromioclavicular dislocations: A review of published literature

    Sood Aman


    Full Text Available Acromioclavicular joint dislocations are common injuries, which typically occur with trauma in young men. Treatment recommendations for these injuries are highly variable and controversial. There are greater than 100 surgical techniques described for operative treatment of this injury. One of the most widely recommended methods of surgical reconstruction for acromioclavicular joint dislocations is to utilize the coracoacromial ligament for stabilization of the distal clavicle. Several modifications of this procedure have been described which have involved adjunct coracoclavicular fixation or fixation across acromioclavicular joint. Although the literature is replete with descriptive papers, there is paucity of studies evaluating the surgical outcome of this procedure. We systematically reviewed the English language published literature in peer reviewed journals (Medline, EMBASE, SCOPUS and assigned a level of evidence for available studies. We critically reviewed each paper for the flaws and biases and then evaluated the comparable clinical outcomes for various procedures and their modifications. The published literature consists entirely of case series (Level IV evidence with variability in surgical technique and outcome measures. On review there is low level evidence to support the use of coracoacromial ligament for acromioclavicular dislocation but it has been associated with high rate of deformity recurrence. Adjunct fixation does not improve clinical results when compared to isolated coracoacromial ligament transfer. This is in part because of the high incidence of fixation related complications. Similar results are reported with coracoacromial ligament reconstruction for acute and chronic cases. The development of secondary acromioclavicular joint symptoms with distal clavicle retention is poorly reported with the incidence rate varying from 12% to 32%. Despite this, the retention or excision of distal clavicle did not affect overall

  13. Treatment of Rockwood type Ⅲ acromioclavicular joint dislocation with endobutton technique%应用 Endobutton 带袢钢板技术治疗RockwoodⅢ型肩锁关节脱位

    宋哲; 张堃; 朱养均; 李忠; 庄岩; 魏巍; 杨娜


    ,distal clavicle and coracoid.The fascias of deltoid muscle and trapezius muscle were divided along the long axis of clavicle and the periosteum was stripped to expose the distal clavicle.The interal between deltoid and pectoralis major muscle was opened and the medial and lateral boarders of coracoid was prepared.The residual coraco-clavicle ligament was reserved.The articular space of acromioclavicular joint was examined and the ruptured fibrous cartilage disc was removed.After reduction of acromioclavicular joint,one Kirschner wire was drilled through the articular surface from the lateral end of acromion to provisionally keep the joint in place.A 1.0 mm guide pin was drilled from distal clavicle into the base of coracoid perpendicularly,3.5 mm canulated drill bit drilled a bone tunnel along the guiding pin.The distance from the surface of clavicle to the base of coracoid was measured with depth scale.The Endobutton was selected properly.A shuttle wire was used to pull the button loop out of clavicle and left the button under coracoid.The distal clavicle was reduced with compression.The loop was pulled upward and the other Endobutton without loop was put into the loop with acutenaculum.First,the Endobutton was laid on its side with sutures pierced through its two holes. Then the Endobutton was laid flat and made sure to attach to the base of coracoid without sliding.The sutures were tightened and knotted to make the Endobutton without loop fixed on the loop.The reconstruction of conoid ligament was finished.Then the suture on the coracoclavicular ligament was tightened and knotted.The wound was irrigated.The acromioclavicular joint capsule was repaired and the deltoid and trapezius muscle were reconstructed at the distal clavicle.The incision was closed layer by layer.(3 )Post-operative management and outcome evaluation:Antibiotics were given to prevent infection for 24-48 hours.The shoulder was protected by a sling for 1 -2 weeks.Pendulum exercise began after pain relief and

  14. The relationship between chronic type III acromioclavicular joint dislocation and cervical spine pain

    Vestri Anna R


    Full Text Available Abstract Background This study was aimed at evaluating whether or not patients with chronic type III acromioclavicular dislocation develop cervical spine pain and degenerative changes more frequently than normal subjects. Methods The cervical spine of 34 patients with chronic type III AC dislocation was radiographically evaluated. Osteophytosis presence was registered and the narrowing of the intervertebral disc and cervical lordosis were evaluated. Subjective cervical symptoms were investigated using the Northwick Park Neck Pain Questionnaire (NPQ. One-hundred healthy volunteers were recruited as a control group. Results The rate and distribution of osteophytosis and narrowed intervertebral disc were similar in both of the groups. Patients with chronic AC dislocation had a lower value of cervical lordosis. NPQ score was 17.3% in patients with AC separation (100% = the worst result and 2.2% in the control group (p Conclusions Our study shows that chronic type III AC dislocation does not interfere with osteophytes formation or intervertebral disc narrowing, but that it may predispose cervical hypolordosis. The higher average NPQ values were observed in patients with chronic AC dislocation, especially in those that developed cervical hypolordosis.

  15. Conjoined tendon and coracoacromial ligament transfer in the treatment of RockwoodIII acromioclavicular joint dislocation:anatomical and clinical validation%联合腱与喙肩韧带双束重建喙锁韧带修复RockwoodⅢ型肩锁关节脱位:解剖学及临床试验验证

    王治洲; 伊力哈木•托合提; 徐超; 侯彦杰; 郭洪亮; 甘子明; 张爱红


      结果与结论:①尸体解剖形态学研究结果:试验获得了肩锁关节及其周围组织、肌皮神经较为详细的形态学参数,为该部位手术提供了解剖学资料。②临床病例分析结果:11例RockwoodⅢ型患者行联合腱外侧半肌腱与喙肩韧带内侧半肌腱双束共同重建喙锁韧带治疗肩锁关节脱位,随访2-24个月,平均美国肩肘外科协会评分为92.3分,平均Constant-Murley肩关节功能评分为90.4分,平均美国加州大学洛杉矶分校评分31.6分,平均目测类比评分1.4分,平均肩关节简明测试问卷肯定答案为8个,总体优良率为91%(10/11)。1例患者修复结果较差。课题通过解剖重建肩锁关节的静态稳定性结构(如喙锁韧带)和动态稳定性结构(如关节囊、斜方肌和三角肌)实现了肩锁关节的解剖复位。总而言之,联合腱与喙肩韧带双束重建喙锁韧带修复RockwoodⅢ型肩锁关节脱位是一种有效的修复方法。%BACKGROUND:There are many surgical methods for treatment of acromioclavicular joint dislocation. Through various internal fixation materials (such as hook plate, screws, K-wire, etc.), we can achieve the initial stability and restoration of the acromioclavicular joint. But these internal fixators can cause varying degrees of occupancy and damage to the acromioclavicular joint, and the joint reduction often miss after removal of the internal fixators. OBJECTIVE:To use conjoined tendon and coracoacromial ligament transfer for coracoclavicular ligament reconstruction in the repair of RockwoodIII acromioclavicular joint dislocation, to provide the theoretical foundation through the autopsy, and to analyze the clinical efficacy based on clinical fol ow-up results. METHODS:(1) Autopsy morphology research:From September 2012 to November 2012, total y 46 adult cadaveric human shoulders were dissected in the Department of Anatomy, Xinjiang Medical University. The anatomical

  16. The prevalence of chondrocalcinosis (CC) of the acromioclavicular (AC) joint on chest radiographs and correlation with calcium pyrophosphate dihydrate (CPPD) crystal deposition disease.

    Parperis, Konstantinos; Carrera, Guillermo; Baynes, Keith; Mautz, Alan; Dubois, Melissa; Cerniglia, Ross; Ryan, Lawrence M


    Digital imaging combined with picture archiving and communication system (PACS) access allows detailed image retrieval and magnification. Calcium pyrophosphate dihydrate (CPPD) crystals preferentially deposit in fibrocartilages, the cartilage of the acromioclavicular (AC) joint being one such structure. We sought to determine if examination of the AC joints on magnified PACS imaging of chest films would be useful in identifying chondrocalcinosis (CC). Retrospective radiographic readings and chart reviews involving 1,920 patients aged 50 or more who had routine outpatient chest radiographs over a 4-month period were performed. Knee radiographs were available for comparison in 489 patients. Medical records were reviewed to abstract demographics, chest film reports, and diagnoses. AC joint CC was identified in 1.1 % (21/1,920) of consecutive chest films. Patients with AC joint CC were 75 years of age versus 65.4 in those without CC (p AC joint CC, and of these, five also had knee CC (83 %). Of the 483 without AC joint CC, 62 (12 %) had knee CC (p = 0.002). Patients with AC joint CC were more likely to have a recorded history of CPPD crystal deposition disease than those without AC joint CC (14 versus 1 %, p = 0.0017). The prevalence of AC joint CC increases with age and is associated with knee CC. A finding of AC joint CC should heighten suspicion of pseudogout or secondary osteoarthritis in appropriate clinical settings and, in a young patient, should alert the clinician to the possibility of an associated metabolic condition.

  17. Clinical Value of Operation in the Treatment ofⅢ°Acromioclavicular Joint Dislocation%肩锁关节Ⅲ°脱位手术治疗的临床价值

    石铸; 马江川; 陈江; 毛剑


    目的:评估肩锁关节Ⅲ°脱位手术治疗的临床价值。方法58例肩锁关节Ⅲ°脱位患者随机分成两组,保守治疗组行冰敷、应用止痛药、吊带制动,手术治疗组行切开复位内固定。结果手术治疗组优23例、良6例,保守治疗组良3例,差26例。结论恢复肩锁关节完整性、稳定性的手术治疗组,避免了肩关节慢性疼痛、功能严重下降、无力、不稳的发生,Ⅲ型肩锁关节脱位患者首选手术治疗。%Objective Evaluation of the acromioclavicular joint dislocation of surgical treatment of Ⅲ°clinical val-ue.Methods Ⅲ°58 cases of the acromioclavicular joint dislocation were randomly divided into two groups , ice, con-servative treatment group used painkillers , condole belt brake , open reduction and internal fixation surgery treatment group.Results Surgery group of 23 cases, 6 cases, conservative treatment group 3 cases, 26 patients.Conclusions Restore the acromioclavicular joint integrity , stability, surgical treatment group , avoiding the shoulder joint function of chronic pain , serious decline , the weakness , the occurrence of instability , preferred surgical treatment in patients with type Ⅲacromioclavicular joint dislocation.

  18. Arthroscopic fixation in the treatment of Rockwood Ⅴ acute acromioclavicular joint dislocation%关节镜下四骨道双束固定治疗急性肩锁关节Rockwood Ⅴ型脱位

    陆伟; 王大平; 朱伟民; 欧阳侃; 柳海峰; 彭亮权; 李皓; 冯文哲


    优,1例良。患者均对治疗效果满意。结论采用关节镜下四骨道四袢双束固定方法修复急性肩锁关节 Rockwood-Ⅴ型脱位,生物固定牢固,手术创伤小,并且避免了双袢单骨道应力过于集中、拉力线单薄等缺点,是治疗急性肩锁关节 Rockwood Ⅴ型损伤较好的方法。%Background Treatment methods for acromioclavicular joint dislocation of Rockwood type V are numerous.The commonly used is the open surgery with large trauma (by clavicular hook plate fixation).In recent years,some scholars use clavicle-coracoid screws fixation method under arthroscopy,but the screws need to be removed after 6 weeks; there are also scholars using arthroscopic double Endobutton loops single bundle fixation method with good effect,but they found suture rupture between the Endobutton,redislocation or fracture,bone absorption under the loops in some patients. This article investigates the method of arthroscopic procedure with four-tunnel quadruple double-bundle Endobutton double-bundle fixation via self-designed positioning apparatus in the treatment of acute acromioclavicular joint (ACJ)Rockwood Ⅴ degree dislocations and their short-term therapeutic effect.Methods (1)Patient selection:12 patients (9 male and 3 female)with acute acromioclavicular joint dislocation of Rockwood type V were selected from October 2010 to June 2013. Their average age is 28.2 years.with sports injury in 10 cases and fall injury in 2 cases.All patients received surgical repair within 2 weeks after injury.The operations were performed by the same senior surgeon.(2)Preoperative bone tunnel positioning design:All patients had CT scan in the position of 90°internal rotating of bilateral shoulder joint (palm down).Measure the angle of scapular long axis and coronal section (A)separately,make the line in the coracoid neck parallel to the long axis of scapula (S),and then measure the width of parallel line in the part of coracoid neck (P).The midpoint of the

  19. Tratamento artroscópico da luxação acromio-clavicular pelo método "tight rope" (arthrex® Arthroscopic treatment of acromioclavicular joint dislocation by tight rope technique (arthrex®

    Luis Alfredo Gómez Vieira


    Full Text Available OBJETIVO: Apresentar a técnica cirúrgica artroscópica pelo método "Tight Rope" e a avaliação dos resultados com esta técnica no tratamento da luxação acrômio-clavicular aguda. MÉTODOS: entre agosto de 2006 e maio de 2007, 10 ombros de 10 pacientes com luxação acrômio-clavicular aguda foram submetidos a tratamento artroscópcio pela técnica Tight Rope-Arthrex®. O seguimento mínimo foi de 12 meses, com média de 15 meses. A idade variou de 26 e 42 anos com média de 34 anos. Todos os pacientes eram do sexo masculino. Todos os pacientes foram atendidos na fase aguda da lesão sendo avaliados por radiologia simples (série trauma. Os pacientes foram acompanhados semanalmente no primeiro mês e a cada três meses após o procedimento artroscópico. A avaliação clínica foi feita por meio dos critérios da University of Califórnia at Los Angeles (UCLA. RESULTADOS: Todos os pacientes operados agudamente encontravam-se satisfeitos com os resultados do tratamento cirúrgico artroscópico com uma média de 32,5 pontos na escala de avaliação da UCLA. CONCLUSÃO: O tratamento artroscópico da luxação acrômio-clavicular aguda pelo método "Tight Rope" é uma técnica cirúrgica minimamente invasiva que mostrou-se eficiente para o tratamento destas lesões.OBJECTIVE: Presenting the arthroscopic treatment by Tight Rope - Arthrex® system for acute acromioclavicular dislocation and to evaluate results obtained with this procedure. METHODS: Between August 2006 and May 2007, 10 shoulders of 10 patients with acute acromioclavicular dislocation were submitted to arthroscopic repair using the Tight Rope - Arthrex® system. Minimum follow-up was 12 months, with a mean of 15 months. Age ranged from 26 to 42, mean 34 years. All patients were male. Radiology evaluation was made by trauma series x-ray. The patients were assisted in the first month weekly and after three months after the procedure. Clinical evaluation was based on the University

  20. 带线铆钉治疗Tossy Ⅰ、Ⅲ型肩锁关节脱位%Treatment of Tossy Ⅱ & Ⅲ dislocation of acromioclavicular joint using rivets with thread

    张克刚; 陆芸


    目的 探讨带线铆钉治疗TossyⅡ、Ⅲ型肩锁关节脱位的疗效.方法 2008年1月至2009年2月,治疗TossyⅡ、Ⅲ型肩锁关节脱位患者31例,男19例,女12例;年龄33~49,平均41岁;TossyⅡ型9例,Ⅲ型22例.其中新鲜肩锁关节脱位19例,陈旧性肩锁关节脱位9例,锁骨钩接骨板固定失败3例;患者均不合并骨折.手术均采用Mitek 3.0 mm带线铆钉植入喙突,以不可吸收尾线穿过锁骨固定脱位,同时修复喙锁韧带或转移喙肩韧带;其中12例采用克氏针辅助固定.采用日本骨科协会(Japanese Orthopaedlic Association,JOA)肩关节疾患治疗判定标准和肩锁关节脱位评分系统对术后疗效进行评价.结果 31例患者均获得随访,随访时间11~23个月,平均17个月.单纯铆钉固定组术后JOA肩关节疾患评分为65~95分,其中优8例、良9例、可1例、差1例,优良率为89.47%(17/19);铆钉结合克氏针固定组术后JOA肩关节疾患评分为74~97分,其中优5例、良4例、可3例,优良率为75.00%(9/12).两组肩锁关节脱位评价系统的优良率分别为94.74%(18/19)和91.67%(11/12).5例患者在拔除克氏针1~3个月后出现肩锁关节复位部分丢失,但肩关节活动范围较术后无明显变化,未进一步治疗.结论 带线铆钉治疗TossyⅡ、Ⅲ型肩锁关节脱位,具有手术创伤小,并发症少,避免二次手术的特点,术后疗效肯定.%Objective To study the treatment effect of rivet with thread,instead of clavicular hook plate,for Tossy Ⅱ & Ⅲ dislocation of acromioclavicular joint.Methods From January 2008 to February 2009,totally 31 patients with Tossy Ⅱ or Ⅲ dislocation of acromioclavicular joint were treated using rivets with thread,including 19 males and 12 females at the age of 33-49 years(mean,41 years).Among these patients,19 suffered fresh acromioclavicular joint dislocation,9 suffered old acromioclavicular joint dislocation,and 3 did a failed fixation by clavicular hook plate.None of

  1. The Application of AO Collar Bone Hook Titanium Plate in the Treatment of Rockwood Ⅲ°-Ⅵ° Acromioclavicular Joint Disorder%AO锁骨钩钛板在RockwoodⅢ°~Ⅵ°肩锁关节损伤中的应用

    刘伟; 赖茂松; 熊浩; 林伟文; 区彩琼; 艾合买提江·玉素甫


    目的 总结AO锁骨钩钛板治疗RockwoodⅢ°~Ⅵ°肩锁关节损伤的临床疗效.方法 采用AO锁骨钩钛板治疗RockwoodⅢ°~Ⅵ°肩锁关节损伤27例.术中,于肩锁关节复位后放置钛板,并修补关节囊及肩锁、喙锁韧带.结果 患者术后切口均Ⅰ期愈合,肩锁关节脱位得到纠正,无血管、神经损伤等并发症发生.本组患者术后随访6~15个月.术后3~6个月取出锁骨钩钛板.术后6个月疗效评价,优23例,良3例,差1例,优良率为96.8%.结论 AO锁骨钩钛板治疗RockwoodⅢ°~Ⅵ°肩锁关节损伤具有创伤小,可早期锻炼等优点,值得临床推广.%Objective To explore the application of AO collar bone hook titanium plate in treating Rockwood Ⅲ°Ⅳ°acromioclavicular joint disorder. Methods Twenty-seven patients with Rockwood Ⅲ°Ⅳ° acromioclavicular joint disorder were treated using AO collar bone hook titanium plate. After the replacement of acromioclavicular joint fixed by AO collar bone hook titanium plate, the joint capsule, shoulder lock ligament and beak lock ligament were also fixed. Results All the patients were healed by first intension, the acromioclavicular joint disorder were corrected and no complications occurred. All the patients were followed for 6-15 months. The AO collar bone hook titanium plate were taken out 3-6 months after surgery. Function of the acromioclavicular joint was estimated by Karlsson criteria: the results were excellent in 23 cases, good in 3 cases and poor in 1 case. Choiceness rate was 96.8%. Conclusion Using AO collar bone hook titanium plate in treating Rockwood Ⅲ°Ⅳ° acromioclavicular joint disorder could minimize the surgical trauma, and early functional exercise could be performed. It should be advocated.

  2. The treatment of the acute acromioclavicular joint dislocation with LARS artificial ligament:a preliminary report%应用LARS人工韧带治疗急性肩锁关节脱位的初步报告

    陈爱民; 鹿楠; 叶添文; 杨鹏; 朱磊; 李菁


    Background Currently,the clinical perspectives of surgical treatment for Tossy Ⅲacromioclavicular(AC)joint dislocations are relatively identical.Due to the post-traumatic ruptures of the acromioclavicular ligament and coracoclavicular(CC)ligament which are used to maintain stability of the joint,the clavicle moves backward and upward,and the upper arm and the scapula drops downward for the gravity of the upper arm and the influence of the sternocleidomastoid muscle.Since such complications as reduction difficulties,redislocation after external fixation,pressure ulcers of the skin,and so forth are particularly prone to occur in the conservative therapy,the operative treatment is more inclined to be adopted for the Tossy Ⅲ dislocation of the AC joint.With the single repair and fixation of the CC ligament,redislocation is likely to happen after implant removal because the ruptured ligaments healed as scar tissue.Therefore,this study uses an operative method of reconstructing and augmenting the CC ligament with LARS artificial ligament for the treatment of Tossy Ⅲ AC joint dislocation,and evaluates its clinical effect.Methods From November 2006 to July 2009,8 patients with acute AC joint dislocation of Tossy Ⅲ were admitted into our hospital.Five patients were male and 3 were female,and their ages ranged from 21 to 45.Sides:3 injuries were on the left and 5 were on the right.Seven patients suffered from falling on the ground,and 1 patient was inj ured in a traffic accident.All the patients were treated with LARS artificial ligaments to reconstruct the CC ligament.Constant score and VAS score were adopted in clinical evaluation.Zanca view of the bilateral AC joint and the axillary radiograph of the affected shoulder joint were employed for imaging evaluation.All the patients were simple Tossy Ⅲ dislocation of AC joint with no trauma of other parts and skin breakdown.Regular pre-operative examinations and evaluations were carried out after admission,and LARS

  3. Temporomandibular joint reconstruction with total alloplastic joint replacement.

    Jones, R H B


    This paper is a preliminary paper which presents the early findings of an ongoing prospective trial on the use of the TMJ Concepts and Biomet Lorenz total joint replacement systems for the reconstruction of the temporomandibular joint (TMJ). Total alloplastic replacement of the TMJ has become a viable option for many people who suffer from TMJ disease where surgical reconstruction is indicated. Degenerative joint diseases such as osteoarthritis, rheumatoid arthritis, psoriatic arthritis, TMJ ankylosis, malunited condylar fractures and tumours can be successfully treated using this technique. There are a number of TMJ prostheses available. Two of the joint replacement products, which have been found to be most reliable and have FDA approval in the United States, are the TMJ Concepts system and the Biomet Lorenz system, and for this reason they are being investigated in this study. This study presents the findings of seven patients with a total of 12 joint replacements using either the TMJ Concepts system or the Biomet Lorenz joint system. Two patients (3 joints) had the TMJ Concepts system and five patients (9 joints) had the Biomet Lorenz system. Although still early, the results were generally pleasing, with the longest replacement having been in position for three years and the most recent six months. The average postoperative mouth opening was 29.7 mm (range 25-35 mm) with an average pain score of 1.7 (range 0-3, minimum score of 0 and maximum 10). Complications were minimal and related to sensory disturbance to the lip in one patient and joint dislocation in two patients.

  4. Acromioclavicular septic arthritis and sternoclavicular septic arthritis with contiguous pyomyositis.

    Corey, Sally A; Agger, William A; Saterbak, Andrew T


    Acromioclavicular (AC) and sternoclavicular (SC) septic arthritis with contiguous pyomyositis are rare, especially in immunocompetent individuals. We report a case of septic AC joint with pyomyositis of the deltoid and supraspinatus muscles and a separate case with septic SC joint with pyomysitis of the sternocleidomastoid muscle. Both patients had similar presentations of infections with Staphylococcus aureus and were successfully treated with surgical incision and drainage followed by prolonged antibiotic therapy.

  5. 锁骨钩钢板联合阔筋膜治疗陈旧性肩锁关节脱位%Management of chronic acromioclavicular joint dislocation with hook plate and fascia lata graft

    祝李霖; 黄东; 吴伟炽; 刘晓春; 余超群


    目的 探讨锁骨钩钢板联合阔筋膜治疗陈旧性肩锁关节脱位的临床疗效.方法 回顾性分析2012年5月至2014年3月应用锁骨钩钢板联合阔筋膜治疗的16例RoekwoodⅢ型陈旧性肩锁关节脱位患者资料,男10例,女6例;年龄19~57岁,平均34.7岁;左侧7例,右侧9例.均为直接暴力致伤,受伤至手术时间为8 ~ 54周,平均12.4周.末次随访时采用上肢功能评分(DASH)及视觉模拟评分(VAS)评定肩部功能及疼痛情况,采用Karlsson评价标准评定疗效. 结果 术后切口均一期愈合,肩锁关节脱位均得到纠正,无血管、神经损伤.所有患者术后获6~18个月(平均12个月)随访.术后复查无钢板断裂、螺钉松动、关节再脱位等情况发生.末次随访时患者DASH评分[(25.42±8.34)分]及肩关节VAS评分[(2.22±1.70)分]均优于术前[(43.72±12.35)、(6.33±1.37)分],差异有统计学意义(P<0.05);按Karlsson评价标准评定疗效:优10例,良4例,可2例. 结论 锁骨钩钢板联合阔筋膜治疗陈旧性肩锁关节脱位可恢复肩关节动力平衡及稳定性,具有固定牢靠、术后关节活动早、并发症少等优点.%Objective To evaluate the therapeutic efficacy of hook plate and fascia lata graft in management of chronic acromioclavicular joint dislocation.Methods From May 2012 to March 2014,a total of 16 cases of chronic acromioclavicular joint dislocation (Rockwood type Ⅲ) were treated with hook plate and fascia lata graft.They were 10 men and 6 women,from 19 to 57 years of age (mean,34.7 years).Seven cases were at the left side and 9 at the right side.All injuries resulted from direct violence.The time from injury to surgery ranged from 8 to 54 weeks (mean,12.4 weeks).At the final follow-ups,the shoulder function was assessed using the Quick Version of the Disabilities of the Arm,Shoulder and Hand Score (DASH) and visual analogue scale (VAS),and the efficacy using Karlsson's evaluation system.Results All surgical wounds

  6. The Evaluation study on diagnostic value of X-ray, CT, MRI on acromioclavicular joint dislocation%肩锁关节脱位的影像对比研究

    包磊; 姚伟武; 辛鸿婕


    目的 探讨X线、CT及MR三种影像诊断技术对肩锁关节脱位的诊断价值.方法 回顾性分析35例经手术或关节镜证实的肩锁关节脱住患者的X线平片、CT和MRI材料,按照Rockwood分型标准进行分型,对照手术或关节镜结果,比较三种影像学方法诊断肩锁关节脱位的准确率、漏诊率和误诊率.结果 在本组35例肩锁关节脱位病例诊断中,X线平片诊断符合28例,占80.0%(28/35);漏诊3例,占8.6%(3/35);误诊4例,占11.4%(4/35).CT诊断符合30例,占85.7%(30/35);漏诊2例,占5.7%(2/35);误诊3例,占8.6%(3/35).MR诊断符合33例,占94.3%(33/35);漏诊1例,占2.85%(1/35);误诊1例,占2.85%(1/35).结论 MRI能够更为精确地显示肩锁关节脱位的韧带损伤情况,为临床正确分型及确定治疗方案提供了可靠依据.%Objective To evaluate the value of X-ray,CT and MR imaging in the diagnosis of acromioclavicular joint dislocation.Methods A retrospective study was performed to evaluate 35 acromioclavicular joint dislocations.Retrospective analysis of the X-ray,CT and MRI material of 35 cases which was confirmed by surgery or arthroscopic.According to Rockwood classification criteria, X-ray, CT and MRI were compared with surgery or arthroscopic result by the accuracy rate and missed diagnosis rate and misdiagnosis rate.Results X-ray diagnosis in 28 cases, accounting for 80.0% (28/35);missed in 3 cases,accounting for 8.6% (3/35);misdiagnosed in 4 cases, accounting for 11.4% (4/35).CT diagnosis in 30 cases, accounting for 85.7% (30/35);missed in 2 cases,accounting for 5.7% (2/35);misdiagnosed in 3 cases, accounting for 8.6% (3/35).MR diagnosis in 33 cases, accounting for 94.3% (33/35); missed in 1 case,accounting for 2.85% (1/35); misdiagnosed in 1 case, accounting for 2.85%(1/35).Conclusion MRI can help to detect the ligament injury of acromioclavicular joint dislocation and make accurate clinical classification in oder to determine the correct treatment

  7. Biomechanics of Internal Fixation for Acromioclavicular Joint Dislocation and Scapula Neck Fracture%肩锁关节脱位并肩胛颈骨折内固定治疗的生物力学研究

    段连鸿; 黄继锋; 梁栋柱; 赵卫东; 夏平光


    Objective To evaluate the biomechanical stability of internal fixation for acromioclavicular joint dislocation and scapula neck fracture. Methods The superior shoulder suspensory complex (SSSC) was anatomized from 7 cases of right upper limb antisepsis specimens including collarbone and scapula. The damage models were established. The stability of the SSSC was compared among the normal group, injury group and fixation group. Results The mean ranges of motion (ROMs) and neutral zones (ZNs) in different directions of the fixation group were lower than those of the injury group (P<0.05), but higher than those of the normal group (P<0.05). Conclusion Open reduction and rigid internal fixation should be applied for the patients with acromioclavicular joint dislocation and scapula neck fracture to avoid the shoulder instability.%目的 从生物力学方面评价肩锁关节脱位并肩胛颈骨折采取手术内固定治疗后的稳定性.方法 取7例包含锁骨及肩胛骨的右侧上肢防腐标本,解剖出肩胛上悬吊复合体(superior shoulder suspensory complex,SSSC),制作损伤模型,并对正常组、损伤组、固定组3种状态标本的活动度进行检测并前后比较.结果 浮肩损伤固定状态在不同方向上的中性区(neutral zone,NZ)及活动范围(range of motion,ROM)均值都明显小于损伤状态(P<0.05),但仍大于正常状态(P<0.05).结论 对肩锁关节脱位并肩胛颈骨折的患者,需要进行切开复位坚强内固定,以避免造成肩关节不稳定.

  8. Acromioclavicular osteoarthritis: a common cause of shoulder pain.

    Menge, Travis J; Boykin, Robert E; Bushnell, Brandon D; Byram, Ian R


    Osteoarthritis of the acromioclavicular joint is a frequent cause of shoulder pain and can result in significant debilitation. It is the most common disorder of the acromioclavicular joint and may arise from a number of pathologic processes, including primary (degenerative), posttraumatic, inflammatory, and septic arthritis. Patients often present with nonspecific complaints of pain located in the neck, shoulder, and/or arm, further complicating the clinical picture. A thorough understanding of the pertinent anatomy, disease process, patient history, and physical examination is crucial to making the correct diagnosis and formulating a treatment plan. Initial nonoperative management is aimed at relieving pain and restoring function. Typical treatments include anti-inflammatory medications, physical therapy, and injections. Patients who continue to exhibit symptoms after appropriate nonsurgical treatment may be candidates for operative resection of the distal clavicle through either open or arthroscopic techniques.


    Brian J. Cole


    limited prosthetic resurfacing. Section VI is "Operative treatment-elbow" including chapters arthroscopy, nonprosthetic elbow arthroplasty, biological resurfacing. The Section VII is "Operative treatment-foot and ankle" including chapters about ankle arthroscopy and cartilage repair in the ankle.The text is one of the most comprehensive and up-to-date references in the treatment of cartilage pathologies and biological joint reconstruction. Some other minimal invasive surgical techniques such as prosthetic partial resurfacing or some osteotomies are also subjected as other alternative treatments for joint restoration. Basic sciences, diagnostic imaging, pharmacological treatment and neutraceuticals, and rehabilitation are making the text. The chapter about future developments in cartilage repair is not only describing the recent technology, different types of tissue engineering and related centers in the world but also gives an idea for the possibilities of future in cartilage repair. Chapters about surgical techniques and procedures are uniformly composed of parts including introduction, preoperative evaluation, surgical technique, postoperative issues, results and references in which the techniques and management described in detail. Numerous high quality images, rich illustrations and figures, page design and also colored tables about key points, protocols, or helpful hints makes the reading and understanding easier

  10. Bilateral Acromioclavicular Septic Arthritis as an Initial Presentation of Streptococcus pneumoniae Endocarditis

    Neda Hashemi-Sadraei


    Full Text Available Infective endocarditis (IE is infrequently associated with septic arthritis. Moreover, septic arthritis of the acromioclavicular (AC joint is rarely reported in the literature. We report a case of Streptococcus pneumoniae IE in a patient who presented with bilateral AC joint septic arthritis and we review the literature on the topic.

  11. Relação anatômica do nervo supraescapular com o processo coracoide, articulação acromioclavicular e acrômio Anatomical relationship of the suprascapular nerve to the coracoid process, acromio clavicular joint and acromion

    Bernardo Barcellos Terra


    Full Text Available OBJETIVO: Estabelecer a relação anatômica do nervo supraescapular (NSE localizado na fossa supraescapular com a borda medial da base do coracoide, face articular acromial da articulação acromioclavicular e a borda anterolateral do acrômio. MÉTODOS: Foram dissecados 16 ombros de 16 cadáveres, sendo nove masculinos e sete femininos, mensurando com auxílio do paquímetro a distância do nervo supraescapular (na sua passagem sob o ligamento transverso com pontos fixos determinados na borda medial da base do processo coracoide, na face articular do acrômio da articulação acromioclavicular e na borda anterolateral do acrômio, correlacionando com a idade e o sexo. Foram excluídos cadáveres com intervenção cirúrgica prévia. RESULTADOS: Com relação à medida do nervo supraescapular, na sua fossa à borda medial da base do processo coracoide, obtivemos uma média de 3,9cm (variando de 3,1cm a 5,2cm; com relação à articulação acromioclavicular, a média foi de 4,7 (3,9cm a 5,2cm; e, com relação à borda anterolateral do acrômio, a média foi de 6,1cm (5,7cm a 6,8cm. CONCLUSÃO: É fundamental o conhecimento exato da anatomia dos nervos da região anterior do ombro para evitar lesões iatrogênicas e para conseguir resultados satisfatórios no tratamento cirúrgico das doenças do ombro, seja ele realizado de forma aberta ou artroscópica.OBJECTIVE: To establish the anatomic relationship of the suprascapular nerve (SSN located in the suprascapular notch to the medial border of the base of the coracoid process, the medial acromial surface of the acromioclavicular joint and the anterolateral edge of the acromion. METHODS: We dissected 16 shoulders of 16 cadavers, 9 males and 7 females. The distance from the suprascapular nerve (in its course beneath the transverse ligament to certain fixed points in the medial base of the coracoid process was measured with the aid of a caliper, as well as to the articular surface of the acromion

  12. Biologic Joint Reconstruction: Alternatives to Arthroplasty

    Cole, Brian J.; Andreas H. Gmoll


    A comprehensive source of information in the management of cartilage lesions of major joints using nonoperative or surgical techniques other than total joint replacement. The text also includes chapters in basic sciences, imaging and rehabilitation.The editors are aiming to provide a reference about the latest concepts and techniques in the treatment of cartilage lesions including future aspects by a comprehensive approach to the alternative joint restoration procedures such as biological, ph...

  13. Elbow joint stability following experimental osteoligamentous injury and reconstruction

    Deutch, Søren R; Jensen, Steen Lund; Tyrdal, Stein;


    Elbow joint dislocation was simulated in cadaveric specimens to quantify laxity induced by radial head and coronoid process lesions, either alone or in combination with collateral ligament insufficiency. The effects of lateral ligament reconstruction and radial head prosthesis replacement were also...

  14. Rotationplasty with Vascular Reconstruction for Prosthetic Knee Joint Infection

    Masahide Fujiki


    Full Text Available Rotationplasty is used most often as a function-preserving salvage procedure after resection of sarcomas of the lower extremity; however, it is also used after infection of prosthetic knee joints. Conventional vascular management during rotationplasty is to preserve and coil major vessels, but recently, transection and reanastomosis of the major vessels has been widely performed. However, there has been little discussion regarding the optimal vascular management of rotationplasty after infection of prosthetic knee joints because rotationplasty is rarely performed for this indication. We reviewed four patients who had undergone resection of osteosarcomas of the femur, placement of a prosthetic knee joint, and rotationplasty with vascular reconstruction from 2010 to 2013. The mean interval between prosthetic joint replacement and rotationplasty was 10.4 years and the mean interval between the diagnosis of prosthesis infection and rotationplasty was 7.9 years. Rotationplasty was successful in all patients; however, in one patient, arterial thrombosis developed and necessitated urgent surgical removal and arterial reconstruction. All patients were able to walk independently with a prosthetic limb after rehabilitation. Although there is no consensus regarding the most appropriate method of vascular management during rotationplasty for revision of infected prosthetic joints, vascular transection and reanastomosis is a useful option.

  15. Joint Image Reconstruction and Segmentation Using the Potts Model

    Storath, Martin; Frikel, Jürgen; Unser, Michael


    We propose a new algorithmic approach to the non-smooth and non-convex Potts problem (also called piecewise-constant Mumford-Shah problem) for inverse imaging problems. We derive a suitable splitting into specific subproblems that can all be solved efficiently. Our method does not require a priori knowledge on the gray levels nor on the number of segments of the reconstruction. Further, it avoids anisotropic artifacts such as geometric staircasing. We demonstrate the suitability of our method for joint image reconstruction and segmentation from limited data in x-ray and photoacoustic tomography. For instance, our method is able to reconstruct the Shepp-Logan phantom from $7$ angular views only. We demonstrate the practical applicability in an experiment with real PET data.

  16. Joint regularization for spectro-temporal CT reconstruction

    Clark, D. P.; Badea, C. T.


    X-ray CT is widely used, both clinically and preclinically, for fast, high-resolution, anatomic imaging; however, compelling opportunities exist to expand its use in functional imaging applications. For instance, spectral information combined with nanoparticle contrast agents enables quantification of tissue perfusion levels, while temporal information details cardiac and respiratory dynamics. In previous work, we proposed and demonstrated a projection acquisition and reconstruction strategy for 5D CT (3D + dual-energy + time) which recovered spectral and temporal information without substantially increasing radiation dose or sampling time relative to anatomic imaging protocols. The approach relied on the approximate separability of the temporal and spectral reconstruction sub-problems, which enabled substantial projection undersampling and effective regularization. Here, we extend this previous work to more general, nonseparable 5D CT reconstruction cases (3D + muti-energy + time) with applicability to K-edge imaging of exogenous contrast agents. We apply the newly proposed algorithm in phantom simulations using a realistic system and noise model for a photon counting x-ray detector with six energy thresholds. The MOBY mouse phantom used contains realistic concentrations of iodine, gold, and calcium in water. Relative to weighted least-squares reconstruction, the proposed 5D reconstruction algorithm improved reconstruction and material decomposition accuracy by 3-18 times. Furthermore, by exploiting joint, low rank image structure between time points and energies, ~80 HU of contrast associated with the Kedge of gold and ~35 HU of contrast associated with the blood pool and myocardium were recovered from more than 400 HU of noise.

  17. Reconstruction of the hip joint in children after septic coxitis

    Михаил Павлович Тепленький


    Full Text Available Background.Surgical treatment of destructive dislocations is problematic, and controversial. Treatment options range from active monitoring to complex multistage reconstruction protocols.Materials and methods.The results of treatment of 17 children with disruptive dislocation of the hip (class IV according to the Choi classification are presented. The mean age at which treatment was started was 6.3 ± 0.5 years (range: 3-9 years. Treatment strategies included formation of the weight-bearing contact of the proximal femur and acetabulum and ilium osteotomy using an Ilizarov frame. The follow-up period lasted from 2 to 11 years. Clinical results were assessed using Colton’s criteria. Assessment of the radiology findings included the anatomy relations and congruence of the articular surfaces. The patients were divided into two groups, according to age, for data analysis.Results.The majority (88% of the children had positive anatomical and functional outcomes. The functional results were good (12-15 points, satisfactory (9-11 points, and unsatisfactory (8 points for 3, 5, and 1, respectively, among 3-6 year olds and 2, 6, and 0, respectively, among 7-9 year olds. The distribution of joint congruence types I, III, and IV was 2, 4, and 3, respectively, in the younger group and 1, 6, and 1, respectively, in the older group.Conclusion.The use of reconstructive surgery using the Ilizarov apparatus in children with a defect of the proximal femur creates conditions for the adaptation of incongruent articular components without causing decompensation of the joint.

  18. Fratura extra-articular da extremidade medial da clavícula associada à luxação acromioclavicular tipo IV: relato de caso Extra-articular fracture of the medial end of the clavicle associated with type IV acromioclavicular dislocation: case report

    Mário Chaves Correa


    months after the surgery, the patient was asymptomatic, with full active and passive mobility, and normal strength and endurance of the shoulder girdle. Radiographs and a three-dimensional CT scan showed persistent posterosuperior subluxation of the acromioclavicular joint and anatomical consolidation of the clavicular fracture.

  19. Protocol for concomitant temporomandibular joint custom-fitted total joint reconstruction and orthognathic surgery using computer-assisted surgical simulation.

    Movahed, Reza; Wolford, Larry M


    Combined orthognathic and total joint reconstruction cases can be predictably performed in 1 stage. Use of virtual surgical planning can eliminate a significant time requirement in preparation of concomitant orthognathic and temporomandibular joint (TMJ) prostheses cases. The concomitant TMJ and orthognathic surgery-computer-assisted surgical simulation technique increases the accuracy of combined cases. In order to have flexibility in positioning of the total joint prosthesis, recontouring of the lateral aspect of the rami is advantageous.

  20. Brief report: reconstruction of joint hyaline cartilage by autologous progenitor cells derived from ear elastic cartilage.

    Mizuno, Mitsuru; Kobayashi, Shinji; Takebe, Takanori; Kan, Hiroomi; Yabuki, Yuichiro; Matsuzaki, Takahisa; Yoshikawa, Hiroshi Y; Nakabayashi, Seiichiro; Ik, Lee Jeong; Maegawa, Jiro; Taniguchi, Hideki


    In healthy joints, hyaline cartilage covering the joint surfaces of bones provides cushioning due to its unique mechanical properties. However, because of its limited regenerative capacity, age- and sports-related injuries to this tissue may lead to degenerative arthropathies, prompting researchers to investigate a variety of cell sources. We recently succeeded in isolating human cartilage progenitor cells from ear elastic cartilage. Human cartilage progenitor cells have high chondrogenic and proliferative potential to form elastic cartilage with long-term tissue maintenance. However, it is unknown whether ear-derived cartilage progenitor cells can be used to reconstruct hyaline cartilage, which has different mechanical and histological properties from elastic cartilage. In our efforts to develop foundational technologies for joint hyaline cartilage repair and reconstruction, we conducted this study to obtain an answer to this question. We created an experimental canine model of knee joint cartilage damage, transplanted ear-derived autologous cartilage progenitor cells. The reconstructed cartilage was rich in proteoglycans and showed unique histological characteristics similar to joint hyaline cartilage. In addition, mechanical properties of the reconstructed tissues were higher than those of ear cartilage and equal to those of joint hyaline cartilage. This study suggested that joint hyaline cartilage was reconstructed from ear-derived cartilage progenitor cells. It also demonstrated that ear-derived cartilage progenitor cells, which can be harvested by a minimally invasive method, would be useful for reconstructing joint hyaline cartilage in patients with degenerative arthropathies.

  1. 应用不同手术方法治疗陈旧性肩锁关节脱位的疗效分析%Review of the results of different operative procedures for old acromioclavicular dislocation

    吴其常; 卞传华; 苗旭漫


    目的比较分析应用不同手术方法治疗陈旧性肩锁关节脱位的疗效。方法对43例陈旧性肩锁关节脱位患者分别应用单纯切开复位克氏针内固定(9例);切开复位内固定并肩锁关节韧带重建(14例);切开复位内固定并喙突上移(20例)三种手术方法进行治疗,术后平均随访4.8年,对其自觉症状、上肢肌力、肩关节功能和肩锁关节间隙等改善程度进行比较。结果三种术式的优良率分别为33%(3/9)、50%(7/14)和74%(15/20)。单纯切开复位克氏针内固定法的疗效与切开复位内固定并肩锁韧带重建法相比,差异无显著性意义(P>0.05),两者与切开复位内固定并喙突上移法比较,差异有显著性意义(均P 0.05). Modified Dewar's operation was better compared with Kirschner wire fixation and reconstruction of acromioclavicular ligament (P< 0.05). Conclusion A satisfactory surgical procedure for treatment of old acromioclavicular dislocation should accomplish the following points: removal of scar tissue and intra articular cartilaginous fragments, reconstruction of joint stability and effective internal fixation until complete healing of the ligament structures.

  2. Comparative analysis of clinical efficacy of double Endobutton plate and clavicular hook plate for treating Rockwood Ⅲ acromioclavicular joint dislocation%两种方法治疗RockwoodⅢ型肩锁关节脱位的疗效对比分析

    邹明; 骆宇春; 柏广富; 刘树坤; 张焱


    Objective To compare the clinical effects of the clavicular hook plate and double Endobutton plate in the treatment of Rockwood Ⅲ acromioclavicular dislocation. Methods 37 cases of Rockwood Ⅲ acromioclavicular joint dislocation in our hospital from January 2008 to September 2010 were selected and randomly divided into the clavicular hook plate group(group A,20 cases) and the double Endobutton plate groupCgroup B,17 cases). The clinical curative effects were compared between the two groups. Results The average operative time, incision length, average curative costs and the Constant scores were (66. 0 + 5. 8)min, (9.2 + 0. 9)cm,(23 159. 2 + 940. 1)Yuan and 87. 9 + 7. 3 in the group A and (100. 9 + 7. 8) min,(5. 9 + 0. 6)cm,(18 096. 2 + 872. 4) Yuan and 93. 4 + 6. 2 in the group B respectively, showing statistical difference between these two groups(P<0. 05). The complication rate was 15. 0% in the group A and 0. 0% in the group B(P<0. 05). By conversion of Karlsson standard qualitative results to quantitative data for comparison,the excellent rate was 85. 0% in the group A and 100. 0% in the group B,showing that the group B was significantly superior to the group A. Conclusion Double Endobutton plate for treating Rockwood HI acromioclavicular dislocation has the advantages of the smaller incision, economic, less interference on shoulder function, lower complication rate, better postoperative shoulder function by qualitative and quantitative comparison, without taking out of the internal fixation and so on.%目的 比较锁骨钩钢板与双Endobutton钢板治疗RockwoodⅢ型肩锁关节脱位的临床疗效.方法 选择2008年1月至2010年9月该院收治的RockwoodⅢ型肩锁关节脱位患者37例,随机分为锁骨钩钢板组(A组,n=20,采用锁骨钩钢板治疗)及双Endobutton钢板组(B组,n=17,采用双Endobutton钢板治疗),比较两组患者的临床疗效.结果 锁骨钩钢板组平均手术时间、切口长度、平均治疗费用、Constant

  3. MRI reconstruction with joint global regularization and transform learning.

    Tanc, A Korhan; Eksioglu, Ender M


    Sparsity based regularization has been a popular approach to remedy the measurement scarcity in image reconstruction. Recently, sparsifying transforms learned from image patches have been utilized as an effective regularizer for the Magnetic Resonance Imaging (MRI) reconstruction. Here, we infuse additional global regularization terms to the patch-based transform learning. We develop an algorithm to solve the resulting novel cost function, which includes both patchwise and global regularization terms. Extensive simulation results indicate that the introduced mixed approach has improved MRI reconstruction performance, when compared to the algorithms which use either of the patchwise transform learning or global regularization terms alone.

  4. Joint reconstruction strategy for structured illumination microscopy with unknown illuminations

    Labouesse, Simon; Idier, Jérôme; Bourguignon, Sébastien; Negash, Awoke; Liu, Penghuan; Sentenac, Anne


    The blind structured illumination microscopy (SIM) strategy proposed in (Mudry et al., 1992) is drastically revisited in this paper, unveiling the mechanism that drives the super-resolution in the method. A much improved numerical implementation is also provided for the reconstruction problem under the image positivity constraint. This algorithm rests on a new preconditioned proximal iteration faster than existing solutions, paving the way to 3D and real-time 2D reconstruction.

  5. Joint Line Reconstruction in Navigated Total Knee Arthroplasty Revision


    Revision Total Knee Arthroplasty Because of; Loosening; Instability; Impingement; or Other Reasons Accepted as Indications for TKA Exchange.; The Focus is to Determine the Precision of Joint Line Restoration in Navigated vs. Conventional Revision Total Knee Arthroplasty

  6. Hip and knee joint kinematics during a diagonal jump landing in anterior cruciate ligament reconstructed females.

    Delahunt, Eamonn; Prendiville, Anna; Sweeney, Lauren; Chawke, Mark; Kelleher, Judy; Patterson, Matt; Murphy, Katie


    Anterior cruciate ligament (ACL) injury is a common injury encountered by sport medicine clinicians. Surgical reconstruction is the recommended treatment of choice for those athletes wishing to return to full-contact sports participation and for sports requiring multi-directional movement patterns. The aim of ACL reconstruction is to restore knee joint mechanical stability such that the athlete can return to sporting participation. However, knowledge regarding the extent to which lower limb kinematic profiles are restored following ACL reconstruction is limited. In the present study the hip and knee joint kinematic profiles of 13 ACL reconstructed (ACL-R) and 16 non-injured control subjects were investigated during the performance of a diagonal jump landing task. The ACL-R group exhibited significantly less peak knee joint flexion (P=0.01). Significant between group differences were noted for time averaged hip joint sagittal plane (Pjoint frontal plane (Phip and knee joint kinematic profiles are present following ACL reconstruction, which could influence future injury risk.

  7. Therapeutic effect of clavicular hook plate combined with rivet for treatment of Rock-wood Ⅲpatient with acromio-clavicular joint dislocation%锁骨钩钢板联合锚钉治疗Rock-woodⅢ型肩锁关节脱位的疗效分析

    张辉; 薛锋


    Objective To observe the therapeutic effect of clavicular hook plate combined with rivet for treatment of Rock-wood Ⅲ and its impact on joint function. Methods From January 2012 to December 2014, a total of 90 Rock-wood Ⅲ pa-tients with acromioclavicular joint dislocation were enrolled, which included 56 males and 34 females, 18 - 60 years old. All of them were divided into observation group (n = 45) and control group (n = 45) for different surgical approach. The control group was treated with clavicular hook plate, and observation group with clavicular hook plate combined with rivet. The effica-cy and complications were observed after treatment. The intraoperative blood loss, operation time, incision length, hospitaliza-tion time and recovery time were also observed, and compared Constant shoulder score, subject should value (SSV) score, visu-al analogue scale (VAS) score before and after treatment, the coracoclavicular gap and acromioclavicular gap were detected. Results The excellent and good rate of 93.33 % in observation group was significant better than that of 73.33 % in control group, the difference was statistically significant ( χ2= 5.120, P 0.05). The pain, daily activity level, shoulder mobility and strength score in observation group were significantly higher than those in control group ( P 0.05). The levels after treatment were significantly lower than those of before treatment (P 0.05). Conclusion It is demonstrated that clavicular hook plate combined with rivet for treatment of Rock-woodⅢis significant curative effect with rapid postoperative recovery, and it helps to restore shoulder function.%目的:观察锁骨钩钢板联合锚钉治疗Rock-woodⅢ型肩锁关节脱位的疗效及其对关节功能的影响。方法选择2012年1月至2014年12月在上海交通大学附属第六人民医院南院就诊的Rock-woodⅢ型肩锁关节脱位患者90例,其中男性56例,女性34例;年龄18~60岁。根据手术方式不同分为

  8. Limb-threatening ischemia secondary to a congenital acromioclavicular remnant.

    Enlow, Jonathan M; McGregor, Walter E


    Upper extremity vascular compromise from thoracic outlet syndrome is rare and is usually the result of a "cervical rib," anterior scalene muscle abnormality, or clavicular trauma. We report a case of acute axillary artery thrombosis secondary to a congenital acromioclavicular remnant in a 40-year-old woman.

  9. Immediate effects of neuromuscular joint facilitation intervention after anterior cruciate ligament reconstruction

    Wang, Lei


    [Purpose] The aim of this study was to examine the immediate effects of neuromuscular joint facilitation (NJF) on the functional activity level after rehabilitation of anterior cruciate ligament (ACL) reconstruction. [Subjects and Methods] Ten young subjects (8 males and 2 females) who underwent ACL reconstruction were included in the study. The subjects were divided into two groups, namely, knee joint extension muscle strength training (MST) group and knee joint extension outside rotation pattern of NJF group. Extension strength was measured in both groups before and after the experiment. Surface electromyography (sEMG) of the vastus medialis and vastus lateralis muscles and joint position error (JPE) test of the knee joint were also conducted. [Results] JPE test results and extension strength measurements in the NJF group were improved compared with those in the MST group. Moreover, the average discharge of the vastus medialis and vastus lateralis muscles on sEMG in the NJF group was significantly increased after MST and NJF treatments. [Conclusion] The obtained results suggest that NJF training in patients with ACL reconstruction can improve knee proprioception ability and muscle strength. PMID:27512270

  10. Custom Anatomical 3D Spacer for Temporomandibular Joint Resection and Reconstruction

    Green, John Marshall; Lawson, Sarah T.; Liacouras, Peter C.; Wise, Edward M.; Gentile, Michael A.; Grant, Gerald Thomas


    Two cases are presented using a two-stage approach and a custom antibiotic spacer placement. Temporomandibular reconstruction can be very demanding and accomplished with a variety of methods in preparation of a total joint and ramus reconstruction with total joint prostheses (TMJ Concepts, Ventura, CA). Three-dimensional reconstructions from diagnostic computed tomography were used to establish a virtually planned resection which included the entire condyle-ramus complex. From these data, digital designs were used to manufacture molds to facilitate intraoperative fabrication of precise custom anatomic spacers from rapidly setting antibiotic-impregnated polymethyl methacrylate. Molds were manufactured using vat polymerization (stereolithography) with a photopolymer in the first case and powder bed fusion (electron beam melting) with Ti6AL4V for the second. Surgical methodology and the use of molds for intraoperative spacer fabrication for each case are discussed. PMID:26889353

  11. 锁骨钩钢板与带线铆钉修复Tossy Ⅲ型肩锁关节脱位:3个月随访比较%Clavicular hook plate versus threaded rivets for repair of Tossy III acromioclavicular joint dislocation:3-month follow-up

    匡澜; 张克刚; 石忠琪


    背景:锁骨钩钢板内固定是近年来广泛应用的肩锁关节脱位修复方案。由于锁骨钩钢板金属钩占据了肩峰下间隙,部分患者内固定后会出现关节疼痛等并发症,因此需要找到能更好的替代锁骨钩钢板的内固定材料。目的:对比观察带线铆钉弹力内固定、锁骨钩钢板内固定修复Tossy Ⅲ型肩锁关节脱位的临床疗效。方法:回顾性分析51例Tossy Ⅲ型肩锁关节完全脱位患者的临床资料,其中锁骨钩钢板内固定组27例、带线铆钉弹力内固定组24例获得完整随访资料。分别对两组患者内固定后的影像学结果、临床疗效及并发症进行对比分析。结果与结论:内固定后锁骨钩钢板内固定组与带线铆钉弹力内固定组之间JOA肩关节功能评分比较差异无显著性意义(P>0.05)。内固定后3个月,锁骨钩钢板组患者肩峰下撞击综合征、肩峰骨质吸收的发生率显著高于带线铆钉弹力组,目测类比评分显著高于带线铆钉弹力组(P 0.05). At 3 months after fixation, the incidences of subacromial impingement syndrome and acromial bone erosion were higher in the clavicular hook plate fixation group compared with the threaded rivets group, and the visual analogous scale scores were significantly higher than the threaded rivets group (P<0.05). Results suggested that both two methods can be used to treat type Tossy III acromioclavicular joint dislocation, with similar clinical curative effects, but the threaded rivets have the advantage of preventing the postoperative complications such as acromial bone impact and erosion, subacromial impingement and lysis.

  12. Total reconstruction of the temporomandibular joint. Up to 8 years of follow-up of patients treated with Biomet(®) total joint prostheses.

    Westermark, A


    12 patients underwent temporomandibular joint (TMJ) reconstruction with Biomet total joint prostheses. Indications for TMJ reconstruction included ankylosis, rheumatoid arthritis, degenerative joint disease and condylar resorption. Five patients had unilateral procedures, seven had bilateral. The follow-up ranged between 2 and 8 years. Amongst the ankylotic patients the mean jaw-opening capacity increased from 3.8mm preoperatively to 30.2mm 1 year after surgery, and in most of those patients the opening capacity remained stable over the years. The other patients maintained a mean opening capacity of more than 35 mm. Joint related pain and interference with eating were eliminated after TMJ reconstruction. There were no permanent facial nerve disturbance, no postoperative infections and no device related complications. The outcome supports prosthetic TMJ reconstruction as a useful treatment modality in patients with advanced TMJ disease.

  13. Protocol for concomitant temporomandibular joint custom-fitted total joint reconstruction and orthognathic surgery utilizing computer-assisted surgical simulation.

    Movahed, Reza; Teschke, Marcus; Wolford, Larry M


    Clinicians who address temporomandibular joint (TMJ) pathology and dentofacial deformities surgically can perform the surgery in 1 stage or 2 separate stages. The 2-stage approach requires the patient to undergo 2 separate operations and anesthesia, significantly prolonging the overall treatment. However, performing concomitant TMJ and orthognathic surgery (CTOS) in these cases requires careful treatment planning and surgical proficiency in the 2 surgical areas. This article presents a new treatment protocol for the application of computer-assisted surgical simulation in CTOS cases requiring reconstruction with patient-fitted total joint prostheses. The traditional and new CTOS protocols are described and compared. The new CTOS protocol helps decrease the preoperative workup time and increase the accuracy of model surgery.

  14. l1- and l2-Norm Joint Regularization Based Sparse Signal Reconstruction Scheme

    Chanzi Liu


    Full Text Available Many problems in signal processing and statistical inference involve finding sparse solution to some underdetermined linear system of equations. This is also the application condition of compressive sensing (CS which can find the sparse solution from the measurements far less than the original signal. In this paper, we propose l1- and l2-norm joint regularization based reconstruction framework to approach the original l0-norm based sparseness-inducing constrained sparse signal reconstruction problem. Firstly, it is shown that, by employing the simple conjugate gradient algorithm, the new formulation provides an effective framework to deduce the solution as the original sparse signal reconstruction problem with l0-norm regularization item. Secondly, the upper reconstruction error limit is presented for the proposed sparse signal reconstruction framework, and it is unveiled that a smaller reconstruction error than l1-norm relaxation approaches can be realized by using the proposed scheme in most cases. Finally, simulation results are presented to validate the proposed sparse signal reconstruction approach.

  15. Joint infection unique to hamstring tendon harvester used during anterior cruciate ligament reconstruction surgery.

    Tuman, Jeffrey; Diduch, David R; Baumfeld, Joshua A; Rubino, L Joseph; Hart, Joseph M


    Joint infection after anterior cruciate ligament (ACL) reconstruction is a rare but important clinical issue that must be resolved quickly to prevent secondary joint damage and preserve the graft. After careful analysis, we observed 3 infection cases within a 12-month period after ACL reconstruction, which represented an abnormally elevated risk. All reconstructions were performed by the same surgeon and used hamstring tendon allograft. For each surgery, the Target Tendon Harvester (DePuy Mitek, Raynham, MA) was used to harvest hamstring tendons. Through our review, we learned that this instrument was sterilized while assembled. It is our belief that ineffective sterilization of this hamstring graft harvester served as the origin for these infections. We have determined that appropriate sterilization technique involves disassembly of this particular hamstring tendon harvester before sterilization because of the tube-within-a-tube configuration. We have since continued to use the Target Tendon Harvester, disassembling it before sterilization. There have been no infections in the ensuing 12 months during which the surgeon performed over 40 primary ACL reconstructions via hamstring autograft. The information from this report is intended to provide arthroscopists with information about potential sources of infection after ACL reconstruction surgery.

  16. Joint reconstruction of white-matter pathways from longitudinal diffusion MRI data with anatomical priors.

    Yendiki, Anastasia; Reuter, Martin; Wilkens, Paul; Rosas, H Diana; Fischl, Bruce


    We consider the problem of reconstructing white-matter pathways in a longitudinal study, where diffusion-weighted and T1-weighted MR images have been acquired at multiple time points for the same subject. We propose a method for joint reconstruction of a subject's pathways at all time points given the subject's entire set of longitudinal data. We apply a method for unbiased within-subject registration to generate a within-subject template from the T1-weighted images of the subject at all time points. We follow a global probabilistic tractography approach, where the unknown pathway is represented in the space of this within-subject template and propagated to the native space of the diffusion-weighted images at all time points to compute its posterior probability given the images. This ensures spatial correspondence of the reconstructed pathway among time points, which in turn allows longitudinal changes in diffusion measures to be estimated consistently along the pathway. We evaluate the reliability of the proposed method on data from healthy controls scanned twice within a month, where no changes in white-matter microstructure are expected between scans. We evaluate the sensitivity of the method on data from Huntington's disease patients scanned repeatedly over the course of several months, where changes are expected between scans. We show that reconstructing white-matter pathways jointly using the data from all time points leads to improved reliability and sensitivity, when compared to reconstructing the pathways at each time point independently.

  17. Lateral collateral ligament reconstruction for chronic varus instability of the hallux interphalangeal joint.

    Cho, Jaeho


    Chronic varus instability of the hallux interphalangeal joint is a rare injury, and only a few reports of this injury have been published. In some studies, this injury has been related to taekwondo. Taekwondo is an essential martial art in the Korean military. We have described a case of varus instability of the hallux interphalangeal joint in a professional soldier who had practiced taekwondo for 5 years and the surgical outcome after reconstruction of the lateral collateral ligament with the fourth toe extensor tendon.

  18. Extensor-mechanism-reconstruction of the knee joint after traumatic loss of the entire extensor apparatus.

    Raschke, D; Schüttrumpf, J P; Tezval, M; Stürmer, K M; Balcarek, P


    Injuries to the extensor apparatus of the knee joint have an incidence of 0.5% to 6%. Although previous studies have described the advantages and disadvantages of operative treatment in cases of patellar tendon rupture, patella fracture or quadriceps tendon lesions, a report on the reconstruction of the extensor apparatus after traumatic loss of the patella, the patellar tendon, the tibial tuberosity and parts of the lateral quadriceps muscle is absent from the literature. We present the case of a young motorcyclist who underwent a reconstruction of the extensor apparatus using autologous tendon grafts. At a 24-month follow-up, the patient has a nearly physiological range of motion of the knee joint and is able to cope well with everyday life.

  19. Efficient compressed sensing SENSE parallel MRI reconstruction with joint sparsity promotion and mutual incoherence enhancement.

    Il Yong Chun; Adcock, Ben; Talavage, Thomas M


    Magnetic resonance imaging (MRI) is considered a key modality for the future as it offers several advantages, including the use of non-ionizing radiation and having no known side effects on the human body, and has recently begun to serve as a key component of multi-modal neuroimaging. However, two major intrinsic problems exist: slow acquisition and intrusive acoustic noise. Parallel MRI (pMRI) techniques accelerate acquisition by reducing the duration and coverage of conventional gradient encoding. The under-sampled k-space data is detected with several receiver coils surrounding the object, using distinct spatial encoding information for each coil element to reconstruct the image. However, this scanning remains slow compared to typical clinical imaging (e.g. X-ray CT). Compressed Sensing (CS), a sampling theory based on random sub-sampling, has potential to further reduce the sampling used in pMRI, accelerating acquisition further. In this work, we propose a new CS SENSE pMRI reconstruction model promoting joint sparsity across channels and enhancing mutual incoherence to improve reconstruction accuracy from limited k-space data. For fast image reconstruction and fair comparisons, all reconstructions are computed with split-Bregman and variable splitting techniques. Numerical results show that, with the introduced methods, reconstruction performance can be crucially improved with limited amount of k-space data.

  20. Reconstruction with autologous pasteurized whole knee joint I: experimental study in a rabbit model.

    Ahmed, Adel Refaat; Watanabe, Hideomi; Takagishi, Kenji


    Hyperthermia-treated bone has been used for skeletal reconstruction after resection of malignant bone tumors, and more favorable results have been seen after pasteurization than after autoclaving or boiling. Pasteurization destroys malignant cells while preserving the bone-inducing property. All previous experimental models have studied replantation of bone segments, but reconstruction of joints is more important clinically. We studied the effects of extracorporeal hyperthermia on the reintegration of autologous whole knee joint grafts over a period of 16 weeks in a rabbit model. The whole knee joint was resected from 32 animals, heat-treated at 65 degrees C for 30 min, and replanted. In the control group, resection and replantation were performed without heat treatment. Reintegration was assessed by macroscopic analysis, histology, histochemistry, and radiography. Reintegration of the pasteurized group showed excellent remodeling during the 16 weeks, similar to the control groups. Responses to the pasteurization and the subsequent reintegration of cartilage, menisci, and ligaments were similar at 4, 8, 12, and 16 weeks with no significant difference between the two groups, although cartilage degradation seemed to occur earlier in the study group than in the control group. These results suggest that pasteurization may be superior to other cell-lethal treatments for autotransplantation of the whole joint currently available.

  1. Diagnosis and reconstruction of the human temporomandibular joint after trauma or internal derangement.

    Bessette, R W; Katzberg, R; Natiella, J R; Rose, M J


    This study reviewed the standardized records of 1100 patients with the symptoms of temporomandibular joint syndrome. Of these patients, only 4.5 percent required surgical intervention. The remaining patients were found to have masticatory muscle spasm and were treated by conservative dental methods. Over half the surgical patients had significant macrotrauma to the jaws in their past history. In addition, electromyographic measurement of the masseteric silent period duration in these patients did not reveal muscle spasm. These factors further serve to differentiate the surgical patient from the patient with myofascial pain dysfunction. The patients selected for surgery demonstrated moderate to severe joint disease and required arthroplasty with partial meniscectomy. A surgical technique is presented demonstrating the reconstruction of the meniscus with silicone implant. This same surgical technique is studied in 10 monkeys, and their joints are examined histologically. The results of surgery reveal that 87 percent of the patients reported improvement 1 year after surgery. In all patients complaining of temporomandibular joint clicking or crepitus, surgery produced complete alleviation of these symptoms. The results of surgery were also associated with a 62 percent increase of jaw opening. Histologic evaluation of the human meniscal resections revealed that in addition to an anatomic displacement of the meniscus, there are also significant cellular changes. These changes consisted of calcification, a decrease in cellularity, hyperemia, and a decrease in elastin content.

  2. Predictors of Lateral Compartment Joint Space Difference at a Minimum of Two Years after ACL Reconstruction

    Jones, Morgan H.; Reinke, Emily; Duryea, Jeffrey; Fleming, Braden C.; Obuchowski, Nancy; Winalski, Carl S.; Spindler, Kurt P.


    Objectives: ACL reconstruction effectively restores knee stability and allows a return to athletic activities after ACL injury, but patients are still at higher risk of developing post-traumatic OA. Patient reported outcomes from the Multicenter Orthopaedic Outcomes Network (MOON) prospective longitudinal cohort of over 1500 patients undergoing ACL reconstruction showed no increase in OA symptoms (KOOS subscale) at 2 or 6 years after surgery. Therefore, identification of structural changes of OA that may precede the onset of symptoms is of critical importance for determining risk factors for the initiation and progression of post-traumatic OA in addition to measuring the effectiveness of potential disease-modifying treatments. One structural measure of OA is radiographic joint space width (JSW). We previously demonstrated that meniscus treatment and age predict narrower medial compartment JSW. Methods: 335 patients from the MOON cohort (154 males, 181 females, median age 18 years at the time of surgery) were recruited at a minimum of 2 years following surgery for on-site evaluations including bilateral metatarsophalangeal joint (MTP) radiographs to assess JSW. To minimize bias related to pre-existing knee injury or OA, subjects were 35 years or younger, were injured playing a sport, had primary ACL reconstruction without prior meniscus or articular cartilage surgery, did not undergo subsequent ACL revision, and had a surgically normal contralateral knee. Radiographic JSW was measured in the lateral compartment of both knees using a validated semiautomated method. The association of age, sex, BMI, meniscus treatment, and articular cartilage treatment with lateral compartment JSW differences (JSD) between the reconstructed and normal knees was examined using multivariable generalized linear models. The Holm-Bonferroni method was used to account for multiple comparisons. Results: The mean lateral compartment JSW was 7.73 mm and (95% CI 7.61-7.85 mm) for ACL

  3. Joint Simultaneous Reconstruction of Regularized Building Superstructures from Low-Density LIDAR Data Using Icp

    Wichmann, Andreas; Kada, Martin


    There are many applications for 3D city models, e.g., in visualizations, analysis, and simulations; each one requiring a certain level of detail to be effective. The overall trend goes towards including various kinds of anthropogenic and natural objects therein with ever increasing geometric and semantic details. A few years back, the featured 3D building models had only coarse roof geometry. But nowadays, they are expected to include detailed roof superstructures like dormers and chimneys. Several methods have been proposed for the automatic reconstruction of 3D building models from airborne based point clouds. However, they are usually unable to reliably recognize and reconstruct small roof superstructures as these objects are often represented by only few point measurements, especially in low-density point clouds. In this paper, we propose a recognition and reconstruction approach that overcomes this problem by identifying and simultaneously reconstructing regularized superstructures of similar shape. For this purpose, candidate areas for superstructures are detected by taking into account virtual sub-surface points that are assumed to lie on the main roof faces below the measured points. The areas with similar superstructures are detected, extracted, grouped together, and registered to one another with the Iterative Closest Point (ICP) algorithm. As an outcome, the joint point density of each detected group is increased, which helps to recognize the shape of the superstructure more reliably and in more detail. Finally, all instances of each group of superstructures are modeled at once and transformed back to their original position. Because superstructures are reconstructed in groups, symmetries, alignments, and regularities can be enforced in a straight-forward way. The validity of the approach is presented on a number of example buildings from the Vaihingen test data set.

  4. Hip Reconstruction Osteotomy by Ilizarov Method as a Salvage Option for Abnormal Hip Joints

    Masood Umer


    Full Text Available Hip joint instability can be secondary to congenital hip pathologies like developmental dysplasia (DDH or acquired such as sequel of infective or neoplastic process. An unstable hip is usually associated with loss of bone from the proximal femur, proximal migration of the femur, lower-extremity length discrepancy, abnormal gait, and pain. In this case series of 37 patients coming to our institution between May 2005 and December 2011, we report our results in treatment of unstable hip joint by hip reconstruction osteotomy using the Ilizarov method and apparatus. This includes an acute valgus and extension osteotomy of the proximal femur combined with gradual varus and distraction (if required for realignment and lengthening at a second, more distal, femoral osteotomy. 18 males and 19 females participated in the study. There were 17 patients with DDH, 12 with sequelae of septic arthritis, 2 with tuberculous arthritis, 4 with posttraumatic arthritis, and 2 with focal proximal femoral deficiency. Outcomes were evaluated by using Harris Hip Scoring system. At the mean follow-up of 37 months, Harris Hip Score had significantly improved in all patients. To conclude, illizarov hip reconstruction can successfully improve Trendelenburg’s gait. It supports the pelvis and simultaneously restores knee alignment and corrects lower-extremity length discrepancy (LLD.

  5. Multi-view TWRI scene reconstruction using a joint Bayesian sparse approximation model

    Tang, V. H.; Bouzerdoum, A.; Phung, S. L.; Tivive, F. H. C.


    This paper addresses the problem of scene reconstruction in conjunction with wall-clutter mitigation for com- pressed multi-view through-the-wall radar imaging (TWRI). We consider the problem where the scene behind- the-wall is illuminated from different vantage points using a different set of frequencies at each antenna. First, a joint Bayesian sparse recovery model is employed to estimate the antenna signal coefficients simultaneously, by exploiting the sparsity and inter-signal correlations among antenna signals. Then, a subspace-projection technique is applied to suppress the signal coefficients related to the wall returns. Furthermore, a multi-task linear model is developed to relate the target coefficients to the image of the scene. The composite image is reconstructed using a joint Bayesian sparse framework, taking into account the inter-view dependencies. Experimental results are presented which demonstrate the effectiveness of the proposed approach for multi-view imaging of indoor scenes using a reduced set of measurements at each view.

  6. Motion of the shoulder complex in individuals with isolated acromioclavicular osteoarthritis and associated with rotator cuff dysfunction: part 1 - Three-dimensional shoulder kinematics.

    Sousa, Catarina de Oliveira; Camargo, Paula Rezende; Ribeiro, Ivana Leão; Reiff, Rodrigo Bezerra de Menezes; Michener, Lori Ann; Salvini, Tania Fátima


    This study described the three-dimensional shoulder motion during the arm elevation in individuals with isolated acromioclavicular osteoarthritis (ACO) and ACO associated with rotator cuff disease (RCD), as compared to controls. Seventy-four participants (ACO=23, ACO+RCD=25, Controls=26) took part of this study. Disability was assessed with the DASH, three-dimensional kinematics were collected during arm elevation in the sagittal and scapular planes, and pain was assessed with the 11-point numeric pain rating scale. For each kinematic variable and demographic variables, separate linear mixed-model 2-way ANOVAs were performed to compare groups. Both ACO groups had higher DASH and pain scores. At the scapulothoracic joint, the isolated ACO group had greater internal rotation than control, and the ACO+RCD group had greater upward rotation than both other groups. At the sternoclavicular joint, both groups with ACO had less retraction, and the isolated ACO group had less elevation and posterior rotation. At the acromioclavicular joint, the isolated ACO group had greater upward rotation, and both ACO groups had greater posterior tilting. Patients with ACO had altered shoulder kinematics, which may represent compensatory responses to reduce pain and facilitate arm motion during arm elevation and lowering.

  7. Use of the Composite Pedicled Pectoralis Minor Flap after Resection of Soft Tissue Sarcoma in Reconstruction of the Glenohumeral Joint

    Michiel A. J. van de Sande


    Full Text Available The surgical repair of an extensive anterior glenohumeral soft tissue defect is complicated by glenohumeral instability and subsequent significant functional deficit. This surgical note offers a relatively simple reconstruction of the anterior capsule and subscapularis muscle using a pectoralis minor pedicle flap. This reconstruction is supplemented with functional reconstruction of the anterior glenohumeral joint. A conventional deltopectoral approach is utilized and pectoralis minor is freed from its coracoid insertion, released, and mobilized without compromising the pedicle entering from the dorsum and inferior one-third of the muscle. The mobilized pectoralis minor vascular pedicle has sufficient length for the pectoralis minor to be transferred to provide coverage of the anterior shoulder joint even in full external rotation, providing anterior stability. To further improve glenohumeral stability and shoulder function, the pectoralis major muscle can be split with the clavicular part reinserted lateral to the bicipital groove onto the lesser tuberosity replacing subscapularis function while stabilising the glenohumeral joint.

  8. 3D tracking the Brownian motion of colloidal particles using digital holographic microscopy and joint reconstruction

    Verrier, Nicolas; Fournel, Thierry


    In-line digital holography is a valuable tool for sizing, locating and tracking micro- or nano-objects in a volume. When a parametric imaging model is available, Inverse Problems approaches provide a straightforward estimate of the object parameters by fitting data with the model, thereby allowing accurate reconstruction. As recently proposed and demonstrated, combining pixel super-resolution techniques with Inverse Problems approaches improves the estimation of particle size and 3D-position. Here we demonstrate the accurate tracking of colloidal particles in Brownian motion. Particle size and 3D-position are jointly optimized from video holograms acquired with a digital holographic microscopy set up based on a "low-end" microscope objective ($\\times 20$, $\\rm NA\\ 0.5$). Exploiting information redundancy makes it possible to characterize particles with a standard deviation of 15 nm in size and a theoretical resolution of 2 x 2 x 5 nm$^3$ for position under additive white Gaussian noise assumption.

  9. Equilibrium reconstruction based on core magnetic measurement and its applications on equilibrium transition in Joint-TEXT tokamak

    Chen, J.; Zhuang, G.; Jian, X.; Li, Q.; Liu, Y.; Gao, L.; Wang, Z. J.


    Evaluation and reconstruction of plasma equilibrium, especially to resolve the safety factor profile, is imperative for advanced tokamak operation and physics study. Based on core magnetic measurement by the high resolution laser polarimeter-interferometer system (POLARIS), the equilibrium of Joint-TEXT (J-TEXT) plasma is reconstructed and profiles of safety factor, current density, and electron density are, therefore, obtained with high accuracy and temporal resolution. The equilibrium reconstruction procedure determines the equilibrium flux surfaces essentially from the data of POLARIS. Refraction of laser probe beam, a major error source of the reconstruction, has been considered and corrected, which leads to improvement of accuracy more than 10%. The error of reconstruction has been systematically assessed with consideration of realistic diagnostic performance and scrape-off layer region of plasma, and its accuracy has been verified. Fast equilibrium transitions both within a single sawtooth cycle and during the penetration of resonant magnetic perturbation have been investigated.

  10. An edge-preserving algorithm of joint image restoration and volume reconstruction for rotation-scanning 4D echocardiographic images

    GUO Qiang; YANG Xin


    A statistical algorithm for the reconstruction from time sequence echocardiographic images is proposed in this paper.The ability to jointly restore the images and reconstruct the 3D images without blurring the boundary is the main innovation of this algorithm. First, a Bayesian model based on MAP-MRF is used to reconstruct 3D volume, and extended to deal with the images acquired by rotation scanning method. Then, the spatiotemporal nature of ultrasound images is taken into account for the parameter of energy function, which makes this statistical model anisotropic. Hence not only can this method reconstruct 3D ultrasound images, but also remove the speckle noise anisotropically. Finally, we illustrate the experiments of our method on the synthetic and medical images and compare it with the isotropic reconstruction method.

  11. Total alloplastic temporomandibular joint reconstruction using Biomet stock prostheses: the University of Florida experience.

    Sanovich, R; Mehta, U; Abramowicz, S; Widmer, C; Dolwick, M F


    The purpose of this study was to report the subjective and objective outcomes of temporomandibular joint (TMJ) replacement with Biomet stock prostheses at a single institution in Florida. In this retrospective study, patients who underwent TMJ replacement using a Biomet stock prosthesis from 2005 to 2012 were analyzed. Subjective (pain, diet) and objective (maximal incisal opening) information was obtained. In addition, a quality of life measure was obtained pre- and postoperatively. Significance was set at Biomet stock prosthesis were eligible for the study. Maximal incisal opening improved from 26.1mm preoperatively to a mean of 34.4mm postoperatively. The pain score decreased from 7.9 preoperatively to a mean of 3.8 postoperatively. Diet restriction decreased from 6.8 preoperatively to a mean of 3.5 postoperatively. Quality of life improved from a median of 4 preoperatively to a postoperative median of 2. Four implants were removed/replaced because of heterotopic bone formation, infection, and/or loose hardware. Follow-up ranged from 6 to 83 months. Overall, TMJ reconstruction using the Biomet stock joint is effective and safe in this patient population.

  12. Joint palaeoclimate reconstruction from pollen data via forward models and climate histories

    Parnell, Andrew C.; Haslett, John; Sweeney, James; Doan, Thinh K.; Allen, Judy R. M.; Huntley, Brian


    We present a method and software for reconstructing palaeoclimate from pollen data with a focus on accounting for and reducing uncertainty. The tools we use include: forward models, which enable us to account for the data generating process and hence the complex relationship between pollen and climate; joint inference, which reduces uncertainty by borrowing strength between aspects of climate and slices of the core; and dynamic climate histories, which allow for a far richer gamut of inferential possibilities. Through a Monte Carlo approach we generate numerous equally probable joint climate histories, each of which is represented by a sequence of values of three climate dimensions in discrete time, i.e. a multivariate time series. All histories are consistent with the uncertainties in the forward model and the natural temporal variability in climate. Once generated, these histories can provide most probable climate estimates with uncertainty intervals. This is particularly important as attention moves to the dynamics of past climate changes. For example, such methods allow us to identify, with realistic uncertainty, the past century that exhibited the greatest warming. We illustrate our method with two data sets: Laguna de la Roya, with a radiocarbon dated chronology and hence timing uncertainty; and Lago Grande di Monticchio, which contains laminated sediment and extends back to the penultimate glacial stage. The procedure is made available via an open source R package, Bclim, for which we provide code and instructions.

  13. Isokinetic Identification of Knee Joint Torques before and after Anterior Cruciate Ligament Reconstruction.

    Adam Czaplicki

    Full Text Available The aim of this study was to evaluate the serial change of isokinetic muscle strength of the knees before and after anterior cruciate ligament reconstruction (ACLR in physically active males and to estimate the time of return to full physical fitness. Extension and flexion torques were measured for the injured and healthy limbs at two angular velocities approximately 1.5 months before the surgery and 3, 6, and 12 months after ACLR. Significant differences (p ≤ 0.05 in peak knee extension and flexion torques, hamstring/quadriceps (H/Q strength ratios, uninvolved/involved limb peak torque ratios, and the normalized work of these muscles between the four stages of rehabilitation were identified. Significant differences between extension peak torques for the injured and healthy limbs were also detected at all stages. The obtained results showed that 12 months of rehabilitation were insufficient for the involved knee joint to recover its strength to the level of strength of the uninvolved knee joint. The results helped to evaluate the progress of the rehabilitation and to implement necessary modifications optimizing the rehabilitation training program. The results of the study may also be used as referential data for physically active males of similar age.

  14. Isokinetic Identification of Knee Joint Torques before and after Anterior Cruciate Ligament Reconstruction.

    Czaplicki, Adam; Jarocka, Marta; Walawski, Jacek


    The aim of this study was to evaluate the serial change of isokinetic muscle strength of the knees before and after anterior cruciate ligament reconstruction (ACLR) in physically active males and to estimate the time of return to full physical fitness. Extension and flexion torques were measured for the injured and healthy limbs at two angular velocities approximately 1.5 months before the surgery and 3, 6, and 12 months after ACLR. Significant differences (p ≤ 0.05) in peak knee extension and flexion torques, hamstring/quadriceps (H/Q) strength ratios, uninvolved/involved limb peak torque ratios, and the normalized work of these muscles between the four stages of rehabilitation were identified. Significant differences between extension peak torques for the injured and healthy limbs were also detected at all stages. The obtained results showed that 12 months of rehabilitation were insufficient for the involved knee joint to recover its strength to the level of strength of the uninvolved knee joint. The results helped to evaluate the progress of the rehabilitation and to implement necessary modifications optimizing the rehabilitation training program. The results of the study may also be used as referential data for physically active males of similar age.

  15. Hip-joint and abductor-muscle forces adequately represent in vivo loading of a cemented total hip reconstruction.

    Stolk, J.; Verdonschot, N.J.J.; Huiskes, R.


    Using finite element analyses, we investigated which muscle groups acting around the hip-joint most prominently affected the load distributions in cemented total hip reconstructions with a bonded and debonded femoral stem. The purpose was to determine which muscle groups should be included in pre-cl




    Reconstruction of the hip joint by a saddle prosthesis after excision of a malignant pelvic tumor is a relatively new method, which thus far has been mainly used for revision of infected hip arthroplasties. One patient with a metastatic cystosarcoma phyllodes and one patient with a chondrosarcoma of

  17. Osteochondroma of the Temporomandibular Joint Treated by Means of Condylectomy and Immediate Reconstruction with a Total Stock Prosthesis

    Miguel-Angel Morey-Mas


    Full Text Available Background: Osteochondromas are one of the most common benign tumours of bone, but they are rare in the craniofacial region. These condylar tumours have been variably treated, including resection through local excision or condylectomy with or without reconstruction.Methods: A case of osteochondroma of the mandibular condyle and cranial base arising concurrently in the 76 years old patient was presented. The surgical excision of the skull base lesion and condylectomy with immediate reconstruction of temporomandibular joint was applied.Results: Based on the history, clinical examination and radiographic findings, osteochondroma of the skull base was diagnosed, with a concurrent lesion of the condylar process. Treatment methods for this patient included excision of the skull base tumour and condylectomy with immediate temporomandibular joint reconstruction using appropriately sized stock total temporomandibular joint prosthesis. At the 24 month follow-up, patient was free of pain and her maximal incisal opening was maintained, with no radiographic evidence of tumour recurrence or failure of the device.Conclusions: Temporomandibular joint stock total replacement prosthesis became a good option to reconstruct both the fossa and the condyle in a one-stage surgery, due to the fact that both the condylar/mandibular and the fossa implants were stable in situ from the moment of fixation, with a good outcome at 24 month follow-up, with no loosening of the screws nor failure of the device.

  18. Joint Reconstruction of Absorbed Optical Energy Density and Sound Speed Distribution in Photoacoustic Computed Tomography: A numerical Investigation

    Huang, Chao; Schoonover, Robert W; Wang, Lihong V; Anastasio, Mark A


    Photoacoustic computed tomography (PACT) is a rapidly emerging bioimaging modality that seeks to reconstruct an estimate of the absorbed optical energy density within an object. Conventional PACT image reconstruction methods assume a constant speed-of-sound (SOS), which can result in image artifacts when acoustic aberrations are significant. It has been demonstrated that incorporating knowledge of an object's SOS distribution into a PACT image reconstruction method can improve image quality. However, in many cases, the SOS distribution cannot be accurately and/or conveniently estimated prior to the PACT experiment. Because variations in the SOS distribution induce aberrations in the measured photoacoustic wavefields, certain information regarding an object's SOS distribution is encoded in the PACT measurement data. Based on this observation, a joint reconstruction (JR) problem has been proposed in which the SOS distribution is concurrently estimated along with the sought-after absorbed optical energy density ...

  19. Ligament reconstruction with tendon interposition arthroplasty for first carpometacarpal joint osteoarthritis

    Yang Yong; Huey Y.Tien; Kannan K.Kumar; Chen Shanlin; Li Zhongzhe; Tian Wen; Tian Guanglei


    Background Ligament reconstruction tendon interposition (LRTI) is the most commonly performed surgical procedure for first carpometacarpal joint osteoarthdtis.The purpose of this study was to examine the radiographic and clinical outcomes of LRTI arthroplasty and document the clinical results based on metacarpal subsidence.Methods From January 2008 to January 2011,19 patients (21 thumbs) underwent surgery for thumb carpometacarpal arthritis using ligament reconstruction tendon interposition arthroplasty with flexor carpi radialis (FCR) in Kleinert Kutz Hand Care Center of Louisville University,USA.The follow-up period was an average of 13.9 months.Pain,grip strength,tip pinch strength,range of motion,and radiographic measurements were recorded.Based on first metacarpal subsidence,the cases were classified in to mild,moderate,and severe.Clinical outcomes of the groups were evaluated and compared.Results Grip strength improved from 18.6 kg to 20.5 kg,and tip pinch strength increased from 4.4 kg to 4.5 kg after the surgery.Radial abduction and palmar abduction improved after surgery.Radial abduction increased from 55.7° to 60.6° and palmar abduction improved from 56.7° to 63.5° after the procedure.Visual analogue scores (VAS) were significantly reduced,from 6.6 to 0.5.Compared with the preoperative radiographs the first metacarpal had subsided about 54.6% of the arthroplasty space.The height of arthroplasty space and index of the arthroplasty space significantly decreased from 12.4 mm to 5.6 mm and from 0.27 to 0.12 respectively.Between the various groups (mild,moderate and severe metacarpal subsidence),there was no difference in grip strength,tip pinch strength,thumb range of motion,and VAS.Conclusions Ligament reconstruction tendon interposition arthroplasty resulted in excellent relief of pain and increase in range of motion.However,LRTI cannot maintain the arthroplasty space.Compared with the preoperative radiographs,the metacarpal subsided more than 50

  20. Moments of muscular strength of knee joint extensors and flexors during physiotherapeutic procedures following anterior cruciate ligament reconstruction in males.

    Czamara, Andrzej


    The objective of this paper was to evaluate maximal muscular strength moments of knee joint extensors and flexors in males subjected to physiotherapeutic procedures. 120 males were selected for the study. The first group consisted of 54 patients who underwent a 6 month physiotherapy programme following anterior cruciate ligament (ACL) reconstruction. The control group comprised 54 males without knee joint injuries. The measurement of muscular strength moments was performed in healthy and affected knee joint flexor and extensor muscles postoperatively, during the 13th and 21st week of physiotherapy. The patients' results were next compared with the results obtained in the control group. During the 13th week of physiotherapy, the values of postoperative maximal strength moments in knee joints were significantly lower compared to the results obtained in non-operated limbs and in the control group. The introduction of individual loads adjusted to the course of ACL graft reconstruction and fixation in the bone tunnel resulted in the improvement of maximal muscle strength values in the patients' knee joints from 13 to 21 weeks postoperatively. During the 21st week of physiotherapy, the values of the muscular strengths in the operated limbs were similar to those obtained in non-operated limbs of the patients and in the control group.

  1. Atomic modeling of cryo-electron microscopy reconstructions--joint refinement of model and imaging parameters.

    Chapman, Michael S; Trzynka, Andrew; Chapman, Brynmor K


    When refining the fit of component atomic structures into electron microscopic reconstructions, use of a resolution-dependent atomic density function makes it possible to jointly optimize the atomic model and imaging parameters of the microscope. Atomic density is calculated by one-dimensional Fourier transform of atomic form factors convoluted with a microscope envelope correction and a low-pass filter, allowing refinement of imaging parameters such as resolution, by optimizing the agreement of calculated and experimental maps. A similar approach allows refinement of atomic displacement parameters, providing indications of molecular flexibility even at low resolution. A modest improvement in atomic coordinates is possible following optimization of these additional parameters. Methods have been implemented in a Python program that can be used in stand-alone mode for rigid-group refinement, or embedded in other optimizers for flexible refinement with stereochemical restraints. The approach is demonstrated with refinements of virus and chaperonin structures at resolutions of 9 through 4.5 Å, representing regimes where rigid-group and fully flexible parameterizations are appropriate. Through comparisons to known crystal structures, flexible fitting by RSRef is shown to be an improvement relative to other methods and to generate models with all-atom rms accuracies of 1.5-2.5 Å at resolutions of 4.5-6 Å.

  2. dPIRPLE: a joint estimation framework for deformable registration and penalized-likelihood CT image reconstruction using prior images

    Dang, H.; Wang, A. S.; Sussman, Marc S.; Siewerdsen, J. H.; Stayman, J. W.


    Sequential imaging studies are conducted in many clinical scenarios. Prior images from previous studies contain a great deal of patient-specific anatomical information and can be used in conjunction with subsequent imaging acquisitions to maintain image quality while enabling radiation dose reduction (e.g., through sparse angular sampling, reduction in fluence, etc). However, patient motion between images in such sequences results in misregistration between the prior image and current anatomy. Existing prior-image-based approaches often include only a simple rigid registration step that can be insufficient for capturing complex anatomical motion, introducing detrimental effects in subsequent image reconstruction. In this work, we propose a joint framework that estimates the 3D deformation between an unregistered prior image and the current anatomy (based on a subsequent data acquisition) and reconstructs the current anatomical image using a model-based reconstruction approach that includes regularization based on the deformed prior image. This framework is referred to as deformable prior image registration, penalized-likelihood estimation (dPIRPLE). Central to this framework is the inclusion of a 3D B-spline-based free-form-deformation model into the joint registration-reconstruction objective function. The proposed framework is solved using a maximization strategy whereby alternating updates to the registration parameters and image estimates are applied allowing for improvements in both the registration and reconstruction throughout the optimization process. Cadaver experiments were conducted on a cone-beam CT testbench emulating a lung nodule surveillance scenario. Superior reconstruction accuracy and image quality were demonstrated using the dPIRPLE algorithm as compared to more traditional reconstruction methods including filtered backprojection, penalized-likelihood estimation (PLE), prior image penalized-likelihood estimation (PIPLE) without registration, and

  3. Phillips-Tikhonov regularization with a priori information for neutron emission tomographic reconstruction on Joint European Torus

    Bielecki, J.; Scholz, M.; Drozdowicz, K. [Institute of Nuclear Physics, Polish Academy of Sciences, PL-31342 Krakow (Poland); Giacomelli, L. [CCFE, Culham Science Centre, Abingdon OX14 3DB (United Kingdom); Istituto di Fisica del Plasma “P. Caldirola,” Milano (Italy); Kiptily, V.; Kempenaars, M. [CCFE, Culham Science Centre, Abingdon OX14 3DB (United Kingdom); Conroy, S. [CCFE, Culham Science Centre, Abingdon OX14 3DB (United Kingdom); Department of Physics and Astronomy, Uppsala University (Sweden); Craciunescu, T. [IAP, National Institute for Laser Plasma and Radiation Physics, Bucharest (Romania); Collaboration: EUROfusion Consortium, JET, Culham Science Centre, Abingdon OX14 3DB (United Kingdom)


    A method of tomographic reconstruction of the neutron emissivity in the poloidal cross section of the Joint European Torus (JET, Culham, UK) tokamak was developed. Due to very limited data set (two projection angles, 19 lines of sight only) provided by the neutron emission profile monitor (KN3 neutron camera), the reconstruction is an ill-posed inverse problem. The aim of this work consists in making a contribution to the development of reliable plasma tomography reconstruction methods that could be routinely used at JET tokamak. The proposed method is based on Phillips-Tikhonov regularization and incorporates a priori knowledge of the shape of normalized neutron emissivity profile. For the purpose of the optimal selection of the regularization parameters, the shape of normalized neutron emissivity profile is approximated by the shape of normalized electron density profile measured by LIDAR or high resolution Thomson scattering JET diagnostics. In contrast with some previously developed methods of ill-posed plasma tomography reconstruction problem, the developed algorithms do not include any post-processing of the obtained solution and the physical constrains on the solution are imposed during the regularization process. The accuracy of the method is at first evaluated by several tests with synthetic data based on various plasma neutron emissivity models (phantoms). Then, the method is applied to the neutron emissivity reconstruction for JET D plasma discharge #85100. It is demonstrated that this method shows good performance and reliability and it can be routinely used for plasma neutron emissivity reconstruction on JET.

  4. Effect of 12 Weeks of Accelerated Rehabilitation Exercise on Muscle Function of Patients with ACL Reconstruction of the Knee Joint.

    Lee, Joong-Chul; Kim, Ji Youn; Park, Gi Duck


    [Purpose] To examine changes in the knee joint's isokinetic muscle functions following systematic and gradual rehabilitation exercises lasting for 12 weeks for male and female patients who underwent anterior cruciate ligament (ACL) reconstruction. Differences in muscle functions between the uninvolved side (US) and the involved side (IS) before surgery, differences in muscle functions between US and IS after rehabilitation exercises lasting for 12 weeks, and changes in muscle functions on US and IS between before and after surgery were analyzed to examine the effects of accelerated rehabilitation exercises after ACL reconstruction. [Subjects] The study subjects were 10 patients, five females and five males, who underwent ACL reconstruction performed by the same surgeon. [Methods] As a measuring tool, a Biodex Multi-joint system 3pro (USA), which is an isokinetic measuring device, was used to examine the flexion and extension forces of the knee joint. During isokinetic muscle strength evaluation, the ROM of US was set to be the same as that of IS for consistency of measurement. [Results] At 60°/s, the isokinetic muscle functions of the females did not show any significant change between before and after surgery in any of the variables on both US and IS. At 60°/s, the isokinetic muscle functions of the males did not show any significant change between before and after surgery in the peak torque, average power, and entire work done on US. In extension, peak torque on IS did not show any significant change.

  5. Systematics of glenohumoral and acromioclavicular arthritis; Systematik der glenohumeralen und akromioklavikulaeren Arthrose

    Seifarth, A. [Klinikum Augsburg, Klinik fuer Diagnostische und Interventionelle Radiologie und Neuroradiologie, Augsburg (Germany); Roemer, F. [Klinikum Augsburg, Klinik fuer Diagnostische und Interventionelle Radiologie und Neuroradiologie, Augsburg (Germany); Universitaetsklinikum Erlangen, Radiologisches Institut, Erlangen (Germany)


    A common risk factor for osteoarthritis (OA) of the glenohumeral joint is instability and is often observed as a sequel to dislocation. Altered biomechanics will ultimately result in joint degeneration including osteophyte development at the lower margin of the humerus, glenoidal cartilage loss and surface deformity. An OA of the glenohumeral joint is often coexistent with soft tissue derangement of the shoulder. In advanced stages defects of the rotator cuff and OA of the glenohumeral joint may accelerate disease progression. Degenerative changes of the acromioclavicular joint (AC joint) are commonly seen in older persons with only modest correlation with clinical symptoms. Symptomatic OA of the AC joint is often concomitantly observed with degenerative changes of the glenohumeral joint. Standard radiographs are the basis of a structural assessment of shoulder OA but lack correlation with clinical symptoms and are insensitive for the detection of early degenerative changes. Magnetic resonance imaging (MRI) provides increased sensitivity for the detection of cartilage defects and reveals relevant soft tissue changes, such as lesions of the glenoid labrum and capsuloligamentous structures, which are seen in conjunction with instability. It is also the method of choice to detect clinically relevant bone marrow edema-like lesions or synovial changes that are associated with symptomatic OA. Standard radiographs are not applicable for detection of early degenerative changes. Once OA is suspected clinically, MRI is the method of choice for further structural assessment. The administration of an intravenous contrast agent is useful for assessing synovitis, which commonly correlates with clinical disease manifestations. For preoperative and surgical planning of joint replacement, MRI or CT should be used. (orig.) [German] Eine haeufige Ursache der Omarthrose ist die Mikro- und Makroinstabilitaet, oft infolge von Luxationen. Bei veraenderter Biomechanik kommt es im Verlauf

  6. Joint Cross-Range Scaling and 3D Geometry Reconstruction of ISAR Targets Based on Factorization Method.

    Lei Liu; Feng Zhou; Xue-Ru Bai; Ming-Liang Tao; Zi-Jing Zhang


    Traditionally, the factorization method is applied to reconstruct the 3D geometry of a target from its sequential inverse synthetic aperture radar images. However, this method requires performing cross-range scaling to all the sub-images and thus has a large computational burden. To tackle this problem, this paper proposes a novel method for joint cross-range scaling and 3D geometry reconstruction of steadily moving targets. In this method, we model the equivalent rotational angular velocity (RAV) by a linear polynomial with time, and set its coefficients randomly to perform sub-image cross-range scaling. Then, we generate the initial trajectory matrix of the scattering centers, and solve the 3D geometry and projection vectors by the factorization method with relaxed constraints. After that, the coefficients of the polynomial are estimated from the projection vectors to obtain the RAV. Finally, the trajectory matrix is re-scaled using the estimated rotational angle, and accurate 3D geometry is reconstructed. The two major steps, i.e., the cross-range scaling and the factorization, are performed repeatedly to achieve precise 3D geometry reconstruction. Simulation results have proved the effectiveness and robustness of the proposed method.

  7. Autologous temporomandibular joint reconstruction independent of exogenous additives: a proof-of-concept study for guided self-generation

    Wei, Jiao; Herrler, Tanja; Han, Dong; Liu, Kai; Huang, Rulin; Guba, Markus; Dai, Chuanchang; Li, Qingfeng


    Joint defects are complex and difficult to reconstruct. By exploiting the body’s own regenerative capacity, we aimed to individually generate anatomically precise neo-tissue constructs for autologous joint reconstruction without using any exogenous additives. In a goat model, CT scans of the mandibular condyle including articular surface and a large portion of the ascending ramus were processed using computer-aided design and manufacturing. A corresponding hydroxylapatite negative mold was printed in 3D and temporarily embedded into the transition zone of costal periosteum and perichondrium. A demineralized bone matrix scaffold implanted on the contralateral side served as control. Neo-tissue constructs obtained by guided self-generation exhibited accurate configuration, robust vascularization, biomechanical stability, and function. After autologous replacement surgery, the constructs showed stable results with similar anatomical, histological, and functional findings compared to native controls. Further studies are required to assess long-term outcome and possible extensions to other further applications. The absence of exogenous cells, growth factors, and scaffolds may facilitate clinical translation of this approach. PMID:27892493

  8. Comparison of Short-term Complications Between 2 Methods of Coracoclavicular Ligament Reconstruction

    Rush, Lane N.; Lake, Nicholas; Stiefel, Eric C.; Hobgood, Edward R.; Ramsey, J. Randall; O’Brien, Michael J.; Field, Larry D.; Savoie, Felix H.


    Background: Numerous techniques have been used to treat acromioclavicular (AC) joint dislocation, with anatomic reconstruction of the coracoclavicular (CC) ligaments becoming a popular method of fixation. Anatomic CC ligament reconstruction is commonly performed with cortical fixation buttons (CFBs) or tendon grafts (TGs). Purpose: To report and compare short-term complications associated with AC joint stabilization procedures using CFBs or TGs. Study Design: Cohort study; Level of evidence, 3. Methods: We conducted a retrospective review of the operative treatment of AC joint injuries between April 2007 and January 2013 at 2 institutions. Thirty-eight patients who had undergone a procedure for AC joint instability were evaluated. In these 38 patients with a mean age of 36.2 years, 18 shoulders underwent fixation using the CFB technique and 20 shoulders underwent reconstruction using the TG technique. Results: The overall complication rate was 42.1% (16/38). There were 11 complications in the 18 patients in the CFB group (61.1%), including 7 construct failures resulting in a loss of reduction. The most common mode of failure was suture breakage (n = 3), followed by button migration (n = 2) and coracoid fracture (n = 2). There were 5 complications in the TG group (25%), including 3 cases of asymptomatic subluxation, 1 symptomatic suture granuloma, and 1 superficial infection. There were no instances of construct failure seen in TG fixations. CFB fixation was found to have a statistically significant increase in complications (P = .0243) and construct failure (P = .002) compared with TG fixation. Conclusion: CFB fixation was associated with a higher rate of failure and higher rate of early complications when compared with TG fixation. PMID:27504468

  9. Painful knee joint after ACL reconstruction using biodegradable interference screws- SPECT/CT a valuable diagnostic tool? A case report

    Hirschmann Michael T


    Full Text Available Abstract With the presented case we strive to introduce combined single photon emission computerized tomography and conventional computer tomography (SPECT/CT as new diagnostic imaging modality and illustrate the possible clinical value in patients after ACL reconstruction. We report the case of a painful knee due to a foreign body reaction and delayed degradation of the biodegradable interference screws after ACL reconstruction. The MRI showed an intact ACL graft, a possible tibial cyclops lesion and a patella infera. There was no increased fluid collection within the bone tunnels. The 99mTc-HDP-SPECT/CT clearly identified a highly increased tracer uptake around and within the tibial and femoral tunnels and the patellofemoral joint. On 3D-CT out of the SPECT/CT data the femoral graft attachment was shallow (50% along the Blumensaat's line and high in the notch. At revision arthroscopy a diffuse hypertrophy of the synovium, scarring of the Hoffa fat pad and a cyclops lesion of the former ACL graft was found. The interference screws were partially degraded and under palpation and pressure a grey fluid-like substance drained into the joint. The interference screws and the ACL graft were removed and an arthrolysis performed. In the case presented it was most likely a combination of improper graft placement, delayed degradation of the interference screws and unknown biological factors. The too shallow and high ACL graft placement might have led to roof impingement, chronic intraarticular inflammation and hence the delayed degradation of the screws. SPECT/CT has facilitated the establishment of diagnosis, process of decision making and further treatment in patients with knee pain after ACL reconstruction. From the combination of structural (tunnel position in 3D-CT and metabolic information (tracer uptake in SPECT/CT the patient's cause of the pain was established.

  10. Improvement of the size estimation of 3D tracked droplets using digital in-line holography with joint estimation reconstruction

    Verrier, N.; Grosjean, N.; Dib, E.; Méès, L.; Fournier, C.; Marié, J.-L.


    Digital holography is a valuable tool for three-dimensional information extraction. Among existing configurations, the originally proposed set-up (i.e. Gabor, or in-line holography), is reasonably immune to variations in the experimental environment making it a method of choice for studies of fluid dynamics. Nevertheless, standard hologram reconstruction techniques, based on numerical light back-propagation are prone to artifacts such as twin images or aliases that limit both the quality and quantity of information extracted from the acquired holograms. To get round this issue, the hologram reconstruction as a parametric inverse problem has been shown to accurately estimate 3D positions and the size of seeding particles directly from the hologram. To push the bounds of accuracy on size estimation still further, we propose to fully exploit the information redundancy of a hologram video sequence using joint estimation reconstruction. Applying this approach in a bench-top experiment, we show that it led to a relative precision of 0.13% (for a 60 μm diameter droplet) for droplet size estimation, and a tracking precision of {σx}× {σy}× {σz}=0.15× 0.15× 1~\\text{pixels} .

  11. A quantitative assessment of the insertional footprints of the hip joint capsular ligaments and their spanning fibers for reconstruction.

    Telleria, Jessica J M; Lindsey, Derek P; Giori, Nicholas J; Safran, Marc R


    Quantitative descriptions of the hip joint capsular ligament insertional footprints have been reported. Using a three-dimensional digitizing system, and computer modeling, the area, and dimensions of the three main hip capsular ligaments and their insertional footprints were quantified in eight cadaveric hips. The iliofemoral ligament (ILFL) attaches proximally to the anterolateral supra-acetabular region (mean area = 4.2 cm(2)). The mean areas of the ILFL lateral and medial arm insertional footprints are 4.8 and 3.1 cm(2), respectively. The pubofemoral ligament (proximal footprint mean area = 1.4 cm(2)) blends with the medial ILFL anteriorly and the proximal ischiofemoral ligament (ISFL) distally without a distal bony insertion. The proximal and distal ISFL footprint mean areas are 6.4 and 1.2 cm(2), respectively. The hip joint capsular ligaments have consistent anatomic and insertional patterns. Quantification of the ligaments and their attachment sites may aid in improving anatomic repairs and reconstructions of the hip joint capsule using open and/or arthroscopic techniques.

  12. Joint Reconstruction of Multi-channel, Spectral CT Data via Constrained Total Nuclear Variation Minimization

    Rigie, David


    We explore the use of the recently proposed "total nuclear variation" (TNV) \\cite{Rigie2014,Holt2014} as a regularizer for reconstructing multi-channel, spectral CT images. This convex penalty is a natural extension of the total variation (TV) to vector-valued images and has the advantage of encouraging common edge locations and a shared gradient direction among image channels. We show how it can be incorporated into a general, data-constrained reconstruction framework and derive update equations based on the first-order, primal-dual algorithm of Chambolle and Pock. Early simulation studies based on the numerical XCAT phantom indicate that the inter-channel coupling introduced by the TNV leads to better preservation of image features at high levels of regularization, compared to independent, channel-by-channel TV reconstructions.

  13. Reconstruction of the joint state of a two-mode Bose-Einstein condensate

    Bolda, E L; Walls, D F; Bolda, Eric L.; Tan, Sze M.; Walls, Dan F.


    We propose a scheme to reconstruct the state of a two-mode Bose-Einstein condensate, with a given total number of atoms, using an atom interferometer that requires beam splitter, phase shift and non-ideal atom counting operations. The density matrix in the number-state basis can be computed directly from the probabilities of different counts for various phase shifts between the original modes, unless the beamsplitter is exactly balanced. Simulated noisy data from a two-mode coherent state is produced and the state is reconstructed, for 49 atoms. The error can be estimated from the singular values of the transformation matrix between state and probability data.

  14. Acromioclavicular dislocation: postoperative evaluation of the coracoclavicular ligaments using magnetic resonance

    Rafael Salomon Silva Faria


    Full Text Available OBJECTIVE: To radiologically evaluate the healing of the coracoclavicular ligaments after surgical treatment for acromioclavicular dislocation.METHODS: Ten patients who had undergone surgical treatment for acromioclavicular dislocation via a posterosuperior route at least one year earlier were invited to return for radiological assessment using magnetic resonance. This evaluation was done by means of analogy with the scale described in the literature for studying the healing of the anterior cruciate ligament of the knee and for measuring the healed coracoclavicular ligaments.RESULTS: A scar structure of fibrous appearance had formed in 100% of the cases. In 50% of the cases, the images of this structure had a good appearance, while the other 50% were deficient.CONCLUSION: Late postoperative evaluation using magnetic resonance, on patients who had been treated for acute acromioclavicular dislocation using a posterosuperior route in the shoulder, showed that the coracoclavicular ligaments had healed in 100% of the cases, but that this healing was deficient in 50%.

  15. Reconstruction

    Stefano Zurrida


    Full Text Available Breast cancer is the most common cancer in women. Primary treatment is surgery, with mastectomy as the main treatment for most of the twentieth century. However, over that time, the extent of the procedure varied, and less extensive mastectomies are employed today compared to those used in the past, as excessively mutilating procedures did not improve survival. Today, many women receive breast-conserving surgery, usually with radiotherapy to the residual breast, instead of mastectomy, as it has been shown to be as effective as mastectomy in early disease. The relatively new skin-sparing mastectomy, often with immediate breast reconstruction, improves aesthetic outcomes and is oncologically safe. Nipple-sparing mastectomy is newer and used increasingly, with better acceptance by patients, and again appears to be oncologically safe. Breast reconstruction is an important adjunct to mastectomy, as it has a positive psychological impact on the patient, contributing to improved quality of life.

  16. Combined composite osteofasciocutaneous fibular free flap and radial head arthroplasty for reconstruction of the elbow joint.

    van Alphen, Nick A; Houdek, Matthew T; Steinmann, Scott S; Moran, Steven L


    Reconstruction of the radial head can be complicated in cases of wide resection, particularly in those cases including the proximal radial shaft. In such cases, radial head replacement may not be possible because of lack of adequate bone stock. Here, we report the use of a radial head prosthesis incorporated with a vascularized fibula for immediate anatomic restoration of the forearm and elbow. We present a case of a pathologic fracture non-union in the proximal radius in a 57-year-old female with a history of multiple myeloma. Non-operative management of the fracture was unsuccessful after chemotherapy and radiation. The proximal radius and radial head were resected and reconstructed with vascularized fibula graft in conjunction with immediate radial head prosthesis. The osteotomy site healed at 6-weeks and follow-up at 1 year showed good functional outcome. We feel that the use of this construct has definite promise and may be considered for reconstruction following resection of the proximal radius.

  17. [Diagnosis of the temporomandibular joint dysfunction by graphic reconstruction of mandibular movements].

    Arutiunov, S D; Khvatov, I L; Arutiunov, D S; Nabiev, N V; Tuturov, N S


    A total of 974 patients with suspected abnormalities of the temporomandibular joint (TMJ) were examined; diseases were detected in 371 patients. The test group consisted of 40 patients, control group of 18 patients. Analysis of the results of graphic recording of mandibular movements and clinical x-ray data in patients of the main and control groups helped develop the strategy for the diagnosis of TMJ dysfunction, based on the functional methods of examination (oral functionography and non-oral axiography).

  18. Influence of plasma diagnostics and constraints on the quality of equilibrium reconstructions on Joint European Torus

    Gelfusa, M.; Gaudio, P.; Peluso, E. [Associazione EURATOM-ENEA, University of Rome “Tor Vergata”, Roma (Italy); Murari, A.; Baruzzo, M. [Consorzio RFX-Associazione EURATOM ENEA per la Fusione, I-35127 Padova (Italy); Lupelli, I.; Hawkes, N.; Brix, M.; Drozdov, V.; Meigs, A.; Romanelli, M. [EURATOM/CCFE Fusion Association, Culham Science Centre, Abingdon, Oxon OX14 3DB (United Kingdom); Craciunescu, T. [EURATOM-MEdC Association, NILPRP, Bucharest (Romania); Schmuck, S.; Sieglin, B. [Max-Planck-Institut für Plasmaphysik, Teilinstitut Greifswald, EURATOM Association, Wendelsteinstr.1, 17491 Greifswald (Germany); Collaboration: JET-EFDA Contributors


    One of the main approaches to thermonuclear fusion relies on confining high temperature plasmas with properly shaped magnetic fields. The determination of the magnetic topology is, therefore, essential for controlling the experiments and for achieving the required performance. In Tokamaks, the reconstruction of the fields is typically formulated as a free boundary equilibrium problem, described by the Grad-Shafranov equation in toroidal geometry and axisymmetric configurations. Unfortunately, this results in mathematically very ill posed problems and, therefore, the quality of the equilibrium reconstructions depends sensitively on the measurements used as inputs and on the imposed constraints. In this paper, it is shown how the different diagnostics (Magnetics Measurements, Polarimetry and Motional Stark Effect), together with the edge current density and plasma pressure constraints, can have a significant impact on the quality of the equilibrium on JET. Results show that both the Polarimetry and Motional Stark Effect internal diagnostics are crucial in order to obtain reasonable safety factor profiles. The impact of the edge current density constraint is significant when the plasma is in the H-mode of confinement. In this plasma scenario the strike point positions and the plasma last closed flux surface can change even by centimetres, depending on the edge constraints, with a significant impact on the remapping of the equilibrium-dependent diagnostics and of pedestal physics studies. On the other hand and quite counter intuitively, the pressure constraint can severely affect the quality of the magnetic reconstructions in the core. These trends have been verified with several JET discharges and consistent results have been found. An interpretation of these results, as interplay between degrees of freedom and available measurements, is provided. The systematic analysis described in the paper emphasizes the importance of having sufficient diagnostic inputs and of




    Full Text Available BACKGROUND: Chronic isolated distal radioulnar joint instability is a relatively rare entity. Several methods of reconstruction were available to stabilize the joint and each method has some advantage over others. We proposed to assess the functional outcome following reconstruction of chronic dorsal distal radio ulnar instability using extra articular reconstruction by Fulkerson – Watson method. AIM: To assess the functional outcome following reconstruction for chronic isolated dorsal distal radio ulnar instability using Fulkerson –Watson method. METHODS: We conducted a prospective study in five patients over three years from 2010 to 2013 with chronic isolated dorsal distal radio ulnar instability who were treated by Fulkerson-Watson method of reconstruction. All patients underwent MRI evaluation before surgery to assess ligament pathology and for adequacy of sigmoid notch. Arthroscopy performed in all patients. Functional outcomes were assessed using VAS score, quick-DASH score and Mayo wrist score at every 6 months follow-up. Radiological assessment done using plain x-rays at each follow up. RESULTS: Three patients required Arthroscopic debridement for TFCC. All five patients had achieved stability at distal radio ulnar joint after surgery and remained so till their last follow up. One patient had persistent pain near ulnar styloid. The average loss of motion for pronation was 10 degrees and supination was 3 degrees in reference to the normal side. All except one patient achieved ulnar grip strength of >90 % compared to normal side. The mean pre and postoperative VAS score, quick-DASH score, Mayo wrist score were 76.6 and 17.2, 37.3 and 11.3, 45 and 77 respectively. CONCLUSION: Though extra articular reconstruction for DRUJ by Fulkerson-Watson method is non-anatomical, the procedure is simple than intra articular reconstruction and gives similar functional outcome like intra articular reconstructions as shown by our results.

  20. Topical diagnostics of traumatic condylar injuries and alloplastic reconstruction of temporomandibular joint heads.

    Gvenetadze, Z; Danelia, T; Nemsadze, G; Gvenetadze, G


    Condylar fractures have an important place in facial traumatic injuries. Classification of condylar fractures according to clinical-anatomic picture is common in clinical practice. According to this classification there are: 1) fractures of mandibular joint head, aka intraarticular fractures, 2) condylar neck fractures or high extra articular fractures, 3) condylar base fractures. Radiographic imaging plays important role in diagnosing condylar fractures along with knowledge of clinical symptoms. We used computer tomography imaging in our clinical practice. Three-dimensional imaging of computer tomography gives exact information about location of condylar fractures, impact of fractured fragments, displacement of condylar head from articular fossa. This method is mostly important for the cases which are hard to diagnose (fractures of mandibular joint head, aka intraarticular fractures). For this group of patients surgical treatment is necessary with the method of arthroplasty. We have observed 5 patients with bilateral, fragmented, high condylar fractures. In all cases the surgery was performed on both sides with bone cement and titanium mini-plates. Long-term effects of the treatment included observation from 6 months to 2 years. In all cases anatomic and functional results were good. Shape of the mandible is restored, opening of mouth 3-3.5 cm, absence of malocclusion.

  1. Model-Based Iterative Reconstruction for Dual-Energy X-Ray CT Using a Joint Quadratic Likelihood Model.

    Zhang, Ruoqiao; Thibault, Jean-Baptiste; Bouman, Charles A; Sauer, Ken D; Hsieh, Jiang


    Dual-energy X-ray CT (DECT) has the potential to improve contrast and reduce artifacts as compared to traditional CT. Moreover, by applying model-based iterative reconstruction (MBIR) to dual-energy data, one might also expect to reduce noise and improve resolution. However, the direct implementation of dual-energy MBIR requires the use of a nonlinear forward model, which increases both complexity and computation. Alternatively, simplified forward models have been used which treat the material-decomposed channels separately, but these approaches do not fully account for the statistical dependencies in the channels. In this paper, we present a method for joint dual-energy MBIR (JDE-MBIR), which simplifies the forward model while still accounting for the complete statistical dependency in the material-decomposed sinogram components. The JDE-MBIR approach works by using a quadratic approximation to the polychromatic log-likelihood and a simple but exact nonnegativity constraint in the image domain. We demonstrate that our method is particularly effective when the DECT system uses fast kVp switching, since in this case the model accounts for the inaccuracy of interpolated sinogram entries. Both phantom and clinical results show that the proposed model produces images that compare favorably in quality to previous decomposition-based methods, including FBP and other statistical iterative approaches.

  2. 全髋置换是否重建偏心距对髋关节功能的影响%Effects of femoral offset reconstruction or non-reconstruction on hip joint function in total hip arthroplasty

    李永旺; 何荣丽; 白晓亮; 安明; 张谦; 马文海; 宋兴建; 孙俊英


    背景:股骨偏心距的重建对于恢复外展肌力和髋关节周围软组织张力平衡,维持关节稳定,恢复关节功能,减少置换后跛行,降低假体磨损、人工关节脱位等并发症的发生率具有重要意义。  目的:探讨全髋置换的重建偏心距对髋关节功能恢复的影响。  方法:对比分析采用组配式假体(S-ROM)行全髋置换20例20髋患者及采用普通假体(Corail)行全髋置换19例20髋患者的相关资料,通过临床(Harris评分)和X射线测量,对两组患者置换后髋关节功能和偏心距重建率进行对比研究。  结果与结论:纳入患者均无感染、骨折、脱位,无深静脉血栓及神经损伤等并发症。临床随访:在组配式假体和普通假体两组中,股骨偏心距重建组与未重建组置换前Harris评分差异无显著性意义(P>0.05);置换后12个月及末次随访偏心距重建患者Harris评分高于未重建者(P 0.05)。说明组配式假体和普通假体两组中股骨偏心距得到重建患者的髋关节功能和髋关节外展活动度优于未得到重建者,组配式假体偏心距重建率高。%BACKGROUND:Femoral offset reconstruction is significant for recovering strength of abductor and the balance of soft tissue tension surrounding hip joint, maintaining joint stabilization, restoring joint function, reducing limping after replacement, decreasing prosthetic abrasion, and the incidence of joint prosthesis dislocation. OBJECTIVE:To discuss effect of femoral offset reconstruction on hip joint function in total hip arthroplasty. METHODS:We comparatively analyzed 20 patients (20 hips) undergoing the modular prosthesis (S-ROM) total hip arthroplasty and 19 patients (20 hips) undergoing the one modular prosthesis (Corail) total hip arthroplasty at the same time. According to Harris hip score and radiography results, hip joint function and femoral offset reconstruction rate were comparatively studied

  3. Quadruple-component superficial circumflex iliac artery perforator (SCIP) flap: A chimeric SCIP flap for complex ankle reconstruction of an exposed artificial joint after total ankle arthroplasty.

    Yamamoto, Takumi; Saito, Takafumi; Ishiura, Ryohei; Iida, Takuya


    Total ankle arthroplasty (TAA) is becoming popular in patients with rheumatoid arthritis (RA)-associated ankle joint degeneration. However, ankle wound complications can occur after TAA, which sometimes requires challenging reconstruction due to anatomical complexity of the ankle. Superficial circumflex iliac artery (SCIA) perforator (SCIP) flap has been reported to be useful for various reconstructions, but no case has been reported regarding a chimeric SCIP flap for complex ankle reconstruction. We report a case of complex ankle defect successfully reconstructed with a free quadruple-component chimeric SCIP flap. A 73-year-old female patient with RA underwent TAA, and suffered from an extensive ankle soft tissue defect (13 × 5 cm) with exposure of the implanted artificial joint and the extensor tendons. A chimeric SCIP flap was raised based on the deep branch and the superficial branch of the SCIA, which included chimeric portions of the sartorius muscle, the deep fascia, the inguinal lymph node (ILN), and the skin/fat. The flap was transferred to the recipient ankle. The sartorius muscle was used to cover the artificial joint, the deep fascia to reconstruct the extensor retinaculum, the ILN to prevent postoperative lymphedema, and the adiposal tissue to put around the extensor tendons for prevention of postoperative adhesion. Postoperatively, the patient could walk by herself without persistent leg edema or bowstringing of the extensor tendons, and was satisfied with the concealable donor scar. Although further studies are required to confirm efficacy, multicomponent chimeric SCIP has a potential to be a useful option for complex defects of the ankle.

  4. A Three-Dimensional Skeletal Reconstruction of the Stem Amniote Orobates pabsti (Diadectidae): Analyses of Body Mass, Centre of Mass Position, and Joint Mobility

    Nyakatura, John A.; Allen, Vivian R.; Lauströer, Jonas; Andikfar, Amir; Danczak, Marek; Ullrich, Hans-Jürgen; Hufenbach, Werner; Martens, Thomas; Fischer, Martin S.


    Orobates pabsti, a basal diadectid from the lower Permian, is a key fossil for the understanding of early amniote evolution. Quantitative analysis of anatomical information suffers from fragmentation of fossil bones, plastic deformation due to diagenetic processes and fragile preservation within surrounding rock matrix, preventing further biomechanical investigation. Here we describe the steps taken to digitally reconstruct MNG 10181, the holotype specimen of Orobates pabsti, and subsequently use the digital reconstruction to assess body mass, position of the centre of mass in individual segments as well as the whole animal, and study joint mobility in the shoulder and hip joints. The shape of most fossil bone fragments could be recovered from micro-focus computed tomography scans. This also revealed structures that were hitherto hidden within the rock matrix. However, parts of the axial skeleton had to be modelled using relevant isolated bones from the same locality as templates. Based on the digital fossil, mass of MNG 10181 was estimated using a model of body shape that was varied within a plausible range to account for uncertainties of the dimension. In the mean estimate model the specimen had an estimated mass of circa 4 kg. Varying of the mass distribution amongst body segments further revealed that Orobates carried most of its weight on the hind limbs. Mostly unrestricted joint morphology further suggested that MNG 10181 was able to effectively generate propulsion with the pelvic limbs. The digital reconstruction is made available for future biomechanical studies. PMID:26355297

  5. Temporomandibular joint, skull base and mandibular ramus functional reconstruction with homologous bank tissue and free flap: a case report with 30 months follow-up.

    Maranzano, Massimo; Rizzo, Roberto; Cicognini, Alessandro; Sorato, Renzo; Recchia, Guglielmo; De Grazia, Raffaella; Di Paola, Francesco; Paolin, Adolfo; Mazzoleni, Giovanni


    Big craniofacial resections for highly invasive malignant neoplasm, including skull base and maxillary bones, always represent a difficult chance for the reconstructive surgeon. In these cases it is not easy to restore anatomy and function simultaneously even adopting complex microsurgical techniques. In maxillofacial and oral surgery, simple bone homotransplantation for small bone segments reconstruction has been developing as popular technique and tissue banks offer not only bone segments but also many different tissues including complex body parts. In this paper we present, a case report of a homotransplantation of a complete temporomandibular joint (TMJ) together with a portion of the medial skull base and mandibular ramus folded with an ante-brachial fascio-periosteal free flap as secondary reconstruction after nearly 5 years from the removal of a sarcoma of the TMJ involving the skull base and a follow up of more than 30 months.

  6. Safety screw fixation technique in a case of coracoid base fracture with acromioclavicular dislocation and coracoid base cross-sectional size data from a computed axial tomography study.

    Kawasaki, Yoshiteru; Hirano, Tetsuya; Miyatake, Katsutoshi; Fujii, Koji; Takeda, Yoshitsugu


    Coracoid base fracture accompanied by acromioclavicular joint dislocation with intact coracoclavicular ligaments is a rare injury. Generally, an open reduction with screw fixation is the first treatment choice, as it protects the important structures around the coracoid process. This report presents a new technique of screw fixation for coracoid base fracture and provides anatomic information on cross-sectional size of the coracoid base obtained by computed tomography (CT). An axial image of the coracoid base was visualized over the neck of the scapula, and a guidewire was inserted into this circle under fluoroscopic guidance. The wire was inserted easily into the neck of scapula across the coracoid base fracture with imaging in only 1 plane. In addition, 25 measurements of the coracoid base were made in 25 subjects on axial CT images. Average length of the long and short axes at the thinnest part of the coracoid base was 13.9 ± 2.0 mm (range 10.6-17.0) and 10.5 ± 2.2 mm (6.6-15.1), respectively. This new screw fixation technique and measurement data on the coracoid base may be beneficial for safety screw fixation of coracoid base fracture.

  7. 关节镜下ACL重建术后关节感染诊疗进展%Diagnosis and treatment progress of joint infection after arthroscopic ACL reconstruction

    区永亮(综述); 黄华扬(审校)


    Nowadays arthroscopic anterior cruciate ligament (ACL) reconstruction has been used widely due to its good therapeutic efficacy, but the following joint infection after ACL reconstruction often causes destructive outcomes such as articular cartilage destruction, joint stiff and chronic osteomyelitis, which should be paid much attention for clinician. There existed varied of factors resulted in joint infection after arthroscopic ACL reconstruction with non-unified diagnosis standards. Early diagnosis and reasonable choice of therapeutic protocol are of important significance for enhancing ligament reservation rate and joint stability. Once given incorrect or delayed treatment, the rehabilitation of joint function would not be very ideal. Current situation and research hot spots of epidemiology, etiology, diagnosis, treatment and prognosis of joint infection after arthroscopic ACL reconstruction were reviewed in this paper.%关节镜下前交叉韧带(ACL)重建术临床应用广泛,疗效良好,但术后关节感染往往导致关节软骨破坏、关节强直、慢性骨髓炎等破坏性结局,临床医师需高度重视。导致关节镜下ACL重建术后关节感染的因素多种多样,诊断标准仍未统一,早期诊断及治疗方案的合理选择对于提高韧带保留率和关节稳定性具有重要意义,如处理不当或延误治疗,往往导致关节功能恢复不佳。该文围绕关节镜下ACL重建术后关节感染的流行病学、病因、诊断、治疗及预后等方面的现状和研究热点进行综述。

  8. Surgical treatment for unstable distal clavicle fracture with micromovable and anatomical acromioclavicular plate.

    Liu, Qingjun; Miao, Jianyun; Lin, Bin; Lian, Kejian


    Between 2006 and 2009, 18 patients of distal clavicle fracture were treated with micro-movable and anatomical acromioclavicular plate (MAAP) in our department. According to the Neer's classification, all cases were unstable with type IIA (12 cases) and type IIB (6 cases). Functional outcome was evaluated using the Karlsson's criteria. The mean follow-up was 18 months (range, 12-36months). No postoperative plate screws complication was observed. Osseous union could be achieved at a mean time of 12 weeks after operation in 18 patients (range, 8 -16 weeks). According to Karlsson's criteria, radiographic appearances and postoperative shoulder functional recovery revealed a good and excellent rate in these cases. We conclude that surgical treatment using MAAP seems to be a good option for unstable type II fractures of the distal clavicle. This technique allows for reliable fixation with early functional exercises and functional recovery.

  9. Surgical Treatment for Unstable Distal Clavicle Fracture with Micromovable and Anatomical Acromioclavicular Plate

    Qingjun Liu, Jianyun Miao, Bin Lin, Kejian Lian


    Full Text Available Between 2006 and 2009, 18 patients of distal clavicle fracture were treated with micro-movable and anatomical acromioclavicular plate (MAAP in our department. According to the Neer's classification, all cases were unstable with type IIA (12 cases and type IIB (6 cases. Functional outcome was evaluated using the Karlsson's criteria. The mean follow-up was 18 months (range, 12-36months. No postoperative plate screws complication was observed. Osseous union could be achieved at a mean time of 12 weeks after operation in 18 patients (range, 8 -16 weeks. According to Karlsson's criteria, radiographic appearances and postoperative shoulder functional recovery revealed a good and excellent rate in these cases. We conclude that surgical treatment using MAAP seems to be a good option for unstable type II fractures of the distal clavicle. This technique allows for reliable fixation with early functional exercises and functional recovery.

  10. The Possibilities of Full-Color Three-Dimensional Reconstruction of Biological Objects by the Method of Layer-By-Layer Overlapping: Knee Joint of a Rat

    Terpilovskiy A.A.


    Full Text Available The article has a goal to demonstrate capabilities of layer-by-layer overlapping method for 3D-reconstruction of knee joint. The model object was chosen for this research to provide the base for new methods in diagnostics and treatment of human orthopedic diseases. We used the original technology of high-precision grinding and compared the ability of quantitative analysis of bone and cartilage tissue on 3D models to the capabilities of classical morphometry of histological slices. Obtained digitized images of thin sections (1200-2600 on each of the 8 joints had a pixel size of 8 x 8 μm, with a vertical step grinding 8 μm. Its software processing allows for the construction of a virtual slice with an offset and slope, required for the adequate visualization of the biological structures. The developed method of high-precision grinding allows obtaining series of digitized cross-sectional images of biological objects, so the virtual object created on its base, is almost devoid of spatial deformations and distortions of color. Morphometric analysis of these 3D reconstructions in terms of precision and informativeness is not inferior, and according to some indicators it exceeds the quantitative study of serial histological sections. The reconstruction, obtained using the high-precision grinding, can be used to create virtual museum exhibits, atlases and manuals in various biological sciences, based on morphological approach to the cognition of its objects. Another application of reconstruction is to convert them into virtual simulators on the principles of augmented reality or into the models for 3D printing of physical simulators and working prototypes for medicine, veterinary, animal science and related areas. This will be of most value where an MRI or histological reconstruction did not provide full three-dimensional picture.

  11. Ligament reconstruction.

    Glickel, Steven Z; Gupta, Salil


    Volar ligament reconstruction is an effective technique for treating symptomatic laxity of the CMC joint of the thumb. The laxity may bea manifestation of generalized ligament laxity,post-traumatic, or metabolic (Ehler-Danlos). There construction reduces the shear forces on the joint that contribute to the development and persistence of inflammation. Although there have been only a few reports of the results of volar ligament reconstruction, the use of the procedure to treat Stage I and Stage II disease gives good to excellent results consistently. More advanced stages of disease are best treated by trapeziectomy, with or without ligament reconstruction.

  12. Reconstrucción de la articulación temporomandibular: injertos autólogos Reconstruction of the temporomandibular joint: autogenous grafts

    A. García-Rozado González


    Full Text Available Las indicaciones para la reconstrucción de la articulación temporomandibular (ATM están bien establecidas en la literatura médica y en la práctica clínica de la Cirugía Oral y Maxilofacial. Sin embargo, la técnica reconstructiva más adecuada para cada caso permanece controvertida. El desarrollo de nuevos materiales para la confección de prótesis de ATM no ha conseguido desplazar a los injertos autólogos, que conservan numerosas indicaciones reconstructivas merced a las indudables ventajas que supone el empleo de tejidos del propio paciente.The indications for surgical reconstruction of the temporomandibular joint (TMJ are well-established in medical literature and even in clinical practice of Oral and Maxillofacial Surgery. The optimal reconstructive method for each case, however, is still controversial. The progressive developing of new materials to obtain better TMJ prostheses has not been enough to replace autogenous tissue reconstruction. It still maintains a great number of indications in TMJ reconstruction due to the remarkable advantages that undoubtedly provides the use of tissue harvested from the same patient.

  13. Outcome analysis of conservative treatment for acute Rockwood grade Ⅰ and grade Ⅱ acromioclavicular dislocation%急性Rockwood Ⅰ、Ⅱ型肩锁关节脱位非手术治疗疗效分析

    刘燕洁; 何鸿陶; 陈云丰; 王磊; 魏海峰


    目的 评估急性Rockwood Ⅰ、Ⅱ型肩锁关节脱位非手术治疗的疗效.方法 对自2009年1月~2010年10月收治的急性Rockwood Ⅰ、Ⅱ型肩锁关节脱位38例采用非手术治疗.结果 30例平均随访19个月(8~28个月).最后一次随访平均VAS由(4.4±1.5)分降低到(0.8±0.1)分,Constant评分由(64.9±27.9)分上升到(91.6±14.8)分,按Constant评分优良率为89%.最后随访时9例(30%)有肩锁关节疼痛,3例(10%)有活动受限;影像学上8例(27%)显示肩锁关节半脱位;10例(33%)有肩锁关节退化性改变.结论 Ⅰ、Ⅱ型肩锁关节不完全脱位采用非手术治疗可获得满意的临床结果.但同时也有较高的并发症发生率,有必要对影响治疗效果的相关因素进行探索,以取得更好的临床疗效.%Objective To analyze the outcome of non -operation treatment for acute Rockwood grade I and grade U acromioclavicular dislocation. Methods Between Jan. 2009 and Oct. 2010, 38 patients with acute Rockwood grade I and grade II acromioclavicular dislocation were treated with non -operation methods. Results Thirty patients were averagely followed up for 19 months (range 8 to 28 months). The mean VAS score was decreased from (4.4±1.5) to (0.8±0.1) (P <0.05) at final follow-up, and the mean Constant score was increased from (64.9±27.9) to (91.6±14.8) (P <0.05), respectively. The good and excellent rate was 89% according to Constant score. At final follow -up, 9 (30% ) patients had pain at acromioclavicular joint,3(10%) had restriction of shoulder motion, 8(27%) showed partial dislocation in radiography,and 10 (33%) showed degenerative change. Conclusion The non-operation treatment for acute Rockwood grade I and grade II acromioclavicular dislocation can always have a good outcome, however, it has a relatively high complications rate. It is necessary to study the factors which affect the outcome of conservative treatment, so as to acquire more appropriate outcome.

  14. Upper extremity biomechanical model for evaluation of pediatric joint demands during wheelchair mobility.

    Paul, Alyssa J; Slavens, Brooke A; Graf, Adam; Krzak, Joseph; Vogel, Lawrence; Harris, Gerald F


    Current methods for evaluating upper extremity (UE) dynamics during pediatric wheelchair use are limited. We propose a new model to characterize UE joint kinematics and kinetics during pediatric wheelchair mobility. The bilateral model is comprised of the thorax, clavicle, scapula, upper arm, forearm, and hand segments. The modeled joints include: sternoclavicular, acromioclavicular, glenohumeral, elbow and wrist. The model is complete and is currently undergoing pilot studies for clinical application. Results may provide considerable quantitative insight into pediatric UE joint dynamics to improve wheelchair prescription, training and long term care of children with orthopaedic disabilities.

  15. Implants composed of carbon fiber mesh and bone-marrow-derived, chondrocyte-enriched cultures for joint surface reconstruction.

    Robinson, D; Efrat, M; Mendes, D G; Halperin, N; Nevo, Z


    The current study integrates two distinct approaches in joint resurfacing into a combined type of implant, composed of carbon fiber mesh impregnated and coated with a hyaluronic-acid-based delivery substance containing cultured cells. Rabbit autogeneic chondrocyte-enriched cultures obtained from mesenchymal stem cells (chondroprogenitor cells) derived from adult rabbit bone marrow were grown in vitro under conditions favoring chondrogenesis. The improvement in quality of repair when a combined implant containing both cells and a carbon scaffold was used, in comparison to the utilization of carbon fiber mesh alone, was clearly demonstrated using clinical, histological, biochemical, and biomechanical examinations. Evaluations of the joints were performed at 6 weeks and 6 months after implantation. The repair tissue in the cell-implanted joints consisted of a typical hyaline cartilage, which was more cellular and thicker than the repair tissue in the hyaluronic-acid-impregnated carbon-fiber-implanted control joints. The hyaline cartilage in the experimental group formed a superficial layer above the carbon fibers, flush with the joint surface. In the controls, in which carbon fiber and the delivery substance alone were implanted, a histologically and biochemically fibrous tissue that was inferior biomechanically to the new cartilage was formed by the cells containing implants.

  16. The effects of attentional focus on jump performance and knee joint kinematics in patients after ACL reconstruction

    Gokeler, Alli; Benjaminse, Anne; Welling, Wouter; Alferink, Malou; Eppinga, Peter; Otten, Bert


    Objectives: The purpose of this study was to determine the effect of an internal and external attentional focus on single leg hop jump distance and knee kinematics in patients after ACL reconstruction (ACLR). Design: Experimental. Setting: Outpatient physical therapy facility. Participants: Sixteen

  17. The effects of attentional focus on jump performance and knee joint kinematics in patients after ACL reconstruction

    Gokeler, Alli; Benjaminse, Anne; Welling, Wouter; Alferink, Malou; Eppinga, Peter; Otten, Bert


    OBJECTIVES: The purpose of this study was to determine the effect of an internal and external attentional focus on single leg hop jump distance and knee kinematics in patients after ACL reconstruction (ACLR). DESIGN: Experimental. SETTING: Outpatient physical therapy facility. PARTICIPANTS: Sixteen

  18. Biomechanical model for evaluation of pediatric upper extremity joint dynamics during wheelchair mobility.

    Schnorenberg, Alyssa J; Slavens, Brooke A; Wang, Mei; Vogel, Lawrence C; Smith, Peter A; Harris, Gerald F


    Pediatric manual wheelchair users (MWU) require high joint demands on their upper extremity (UE) during wheelchair mobility, leading them to be at risk of developing pain and pathology. Studies have examined UE biomechanics during wheelchair mobility in the adult population; however, current methods for evaluating UE joint dynamics of pediatric MWU are limited. An inverse dynamics model is proposed to characterize three-dimensional UE joint kinematics and kinetics during pediatric wheelchair mobility using a SmartWheel instrumented handrim system. The bilateral model comprises thorax, clavicle, scapula, upper arm, forearm, and hand segments and includes the sternoclavicular, acromioclavicular, glenohumeral, elbow and wrist joints. A single 17 year-old male with a C7 spinal cord injury (SCI) was evaluated while propelling his wheelchair across a 15-meter walkway. The subject exhibited wrist extension angles up to 60°, large elbow ranges of motion and peak glenohumeral joint forces up to 10% body weight. Statistically significant asymmetry of the wrist, elbow, glenohumeral and acromioclavicular joints was detected by the model. As demonstrated, the custom bilateral UE pediatric model may provide considerable quantitative insight into UE joint dynamics to improve wheelchair prescription, training, rehabilitation and long-term care of children with orthopedic disabilities. Further research is warranted to evaluate pediatric wheelchair mobility in a larger population of children with SCI to investigate correlations to pain, function and transitional changes to adulthood.

  19. Luxación acromioclavicular: resultados del tratamiento con cerclaje alámbrico sobre agujas de Kirschner

    Segura Mata, J.; Laclériga Giménez, A.F.; Albareda, J.; Seral Iñigo, Fernando


    Hemos revisado retrospectivamente 44 pacientes (38 años de edad media) de un total de 57 con luxación acromioclavicular tipo III de Allman intervenidos con la técnica de Phemister modificada desde 1975 hasta 1992. Han sido evaluados desde el punto de vista funcional (escala de Imatani), radiológico, resultado estético, valoración subjetiva del paciente, así como sus complicaciones. La media de seguimiento es de 6 años y medio (rango: 2-17 años). El resultado ha sido excelente e...

  20. Lesión de la articulación acromio-clavicular en jugadores de rugby

    Olaizola, Joaquín


    El rugby es un deporte de contacto que se realiza al aire libre en un campo de juego con una pelota. El objetivo del presente trabajo fue conocer la incidencia de la lesión en la articulación Acromio-Clavicular. Para ello deberemos conocer cuáles son los músculos de la articulación del hombro que participan en el gesto deportivo. Con los resultados obtenidos lograremos que estos deportistas sepan qué músculos deben fortalecer y mantener a través de actividades complementarias evitando futuras...

  1. A novel technique for the reconstruction of resected sternoclavicular joints: A case report with a review of the literature

    Waseem M Hajjar


    Full Text Available Sternal metastasis in thyroid cancer is an uncommon occurrence with only a handful of cases of chest wall resections being done. Sternal reconstruction for both primary and secondary tumors has been performed using various techniques and materials such as the mesh, methyl acrylate resin, and steel plates; however, this is a case of papillary thyroid cancer involving the sternum in a 50-year-old woman who had resection of the sternum with reconstruction using titanium bars and clips (STRATOS system fixed to the clavicles with an underlying Proceed mesh. STRATOS system showed good recovery postoperatively. The functional results were excellent with the patient being able to perform all daily activities unassisted after 1 month and almost complete range of motion with acceptable limitations in power of the shoulder muscles after 2 months. We have reviewed all the English language publications of the subject by doing Medline search for the last 25 years and we present here the surgical management of this pathology with our novel approach by using the titanium steel bars to stabilize both medial aspects of the resected clavicles as a promising therapy for manubrial reconstruction and clavicular fixation.

  2. Enhanced knee joint function due to accelerated rehabilitation exercise after anterior cruciate ligament reconstruction surgery in Korean male high school soccer players.

    Lee, Myungchun; Sung, Dong Jun; Lee, Joohyung; Oh, Inyoung; Kim, Sojung; Kim, Seungho; Kim, Jooyoung


    This study was conducted on Korean male high school soccer players who underwent anterior cruciate ligament reconstruction (ACLR) to identify the effects of an accelerated rehabilitation exercise (ARE) program on knee joint isometric strength, thigh circumference, Lysholm score, and active balance agility. We assigned eight test participants each to a physical therapy group (PTG) and an accelerated rehabilitation exercise group (AREG), and compared differences between the groups. Both the PTG and AREG showed significant increases in 30° away and 60° toward isometric strength after treatment. In addition, significant differences were observed in these strength tests between the two groups. Both groups also showed significant increases in thigh circumference, Lysholm score, and active balance agility after treatment, but no significant differences were observed between the two groups. We conclude that the ARE treatment was more effective for improving isometric strength of the knee joint than that of physical therapy, and that an active rehabilitation exercise program after ACLR had positive effects on recovery performance of patients with an ACL injury and their return to the playing field.

  3. Chondromyxoid fibroma of the clavicle extending to the adjacent joint: a case report.

    Aggarwal, Aditya; Bachhal, Vikas; Soni, Ashwani; Rangdal, Sushil


    Chondromyxoid fibroma is a rare benign bone tumour usually involving bones of the lower extremity in young adults. We present a case of chondromyxoid fibroma of the left clavicle extending to the adjacent joint in a 84-year-old man. The tumour had breached the hyaline cartilage of acromioclavicular joint. The tumour was excised en bloc, and the humeral head was curetted and grafted with autogenous cancellous bone. Postoperatively, the patient had an uneventful recovery and regained excellent function of the left shoulder without any pain or stiffness. At the 18-month follow-up, there was no sign of recurrence.

  4. 肩锁关节脱位的诊断与治疗%Diagnosis and treatment of acromioclavicular dislocation

    黄高; 王金华; 孔建中


    The acromioclavicular dislocation is a type of common shoulder athletic injury in clinic , and its incidence accounted for 12% of the local sites injuries. At present,The acute dislocation of Rockwood type I , II was recommended to be managed non -operatively, while acute dislocation of type IV, V and VI operatively. But there still exist controversial in the treatment of acute dislocation of type III. In this peper, the authors have reviewed the current status of treatment of acromioclavicular dislocation .%肩锁关节脱位是临床常见的肩部运动损伤.目前,临床认为Rockwood Ⅰ、Ⅱ型急性脱位应行非手术治疗,Ⅳ、V及Ⅵ型急性脱位应行手术治疗,但对Ⅲ型急性脱位是采取非手术治疗还是手术治疗仍存在争议.本文对肩锁关节脱位的治疗现状进行综述.

  5. 膝关节ACL重建术研究进展%Current research on ACL reconstruction for knee joint

    李欢; 王珂杰; 严伟洪


    As an effective treatment for anterior cruciate ligament (ACL) injuries, technique of ACL reconstruction has been developed in recent years. Focus on treatment for ACL injuries, graft choice, bone tunnel preparation and selection, graft fixation, and improvement methods for tendon-bone healing, the latest research development of ACL construction were reviewed in this paper.%前交叉韧带(ACL)重建术作为治疗ACL损伤的有效治疗手段,近年来发展快速。该文围绕ACL损伤治疗方法,ACL重建术移植物选择、骨隧道制备和选择、移植物固定方式以及促进腱骨愈合方法等方面,综述膝关节ACL重建术的最新研究进展。

  6. Dose reconstruction for the Urals population: Joint Coordinating Committee on Radiation Effects Research Project 1.1. Final report

    Degteva, M.O.; Drozhko, E.; Anspaugh, L.R.; Napier, B.A.; Bouville, A.C.; Miller, C.W. [US-Russia Joint Coordinating Committee on Radiation Effects Research (International organizations without location)


    Population exposure in the Urals occurred as a result of failures in the technological processes at the Mayak plutonium facility in the 1950s. Construction of the Mayak facility began in 1945 and was completed in 1948. Initially this complex consisted of three main parts: Reactor plant, radiochemical facility, and waste-management facilities. The major sources of radioactive contamination were the discharges of 2.7 x 10{sup 6}Ci of liquid wastes into the Techa River (1949-1956); an explosion in the radioactive waste storage facility in 1957 (the so-called Kyshtym Accident) that formed the East Urals Radioactive Trace (EURT) due to dispersion. of 2 x 10{sup 6}Ci into the atmosphere; and gaseous aerosol releases (about 560,000 Ci of {sup 131}I in total) within the first decades of the facility`s operation. The significant portion of activity for the Techa River and EURT consists of long-lived radionuclides, mainly {sup 9O}Sr. These releases resulted in the long-lived contamination of surrounding territories. The predominant radionuclide for operating gaseous aerosol releases was short-lived {sup 131}I resulting from reprocessing of nuclear fuel. The maximal annual rates, which occurred in 1952-1953, were reconstructed on the basis of technological records by the Mayak team.

  7. Dose reconstruction for the Urals population. Joint Coordinating Committee on Radiation Effects Research, Project 1.1 -- Final report

    Degteva, M.O. [Urals Research Center for Radiation Medicine, Chelyabinsk (Russian Federation); Drozhko, E. [Branch 1 of Moscow Biophysics Inst., Ozersk (Russian Federation); Anspaugh, L.R. [Lawrence Livermore National Lab., CA (United States); Napier, B.A. [Pacific Northwest National Lab., Richland, WA (United States); Bouville, A.C. [National Cancer Inst., Bethesda, MD (United States); Miller, C.W. [Centers for Disease Control and Prevention, Atlanta, GA (United States)


    This work is being carried out as a feasibility study to determine if a long-term course of work can be implemented to assess the long-term risks of radiation exposure delivered at low to moderate dose rates to the populations living in the vicinity of the Mayak Industrial Association (MIA). This work was authorized and conducted under the auspices of the US-Russian Joint Coordinating Committee on Radiation Effects Research (JCCRER) and its Executive Committee (EC). The MIA was the first Russian site for the production and separation of plutonium. This plant began operation in 1948, and during its early days there were technological failures that resulted in the release of large amounts of waste into the rather small Techa River. There were also gaseous releases of radioiodines and other radionuclides during the early days of operation. In addition, there was an accidental explosion in a waste storage tank in 1957 that resulted in a significant release. The Techa River Cohort has been studied for several years by scientists from the Urals Research Centre for Radiation Medicine and an increase in both leukemia and solid tumors has been noted.

  8. Treatment of patients with acromioclavicular joint injuries(Rockwood II-VI) with modeled Kirschner wire and cortical screw

    Ivan; Viktorovich; Borozda; Mikhail; Anatolievich; Danilov; Kirill; Sergeevich; Golokhvast


    Objective: To propose an original method of surgical treatment for the acromial extremity of the clavicle rupture(Rockwood II-VI) with modeled Kirschner wire and cortical screw. Methods: Anatomical study and a test method were applied to 43 cadavers of both sexes. During the period between 2000 and 2013, 34 patients of both sexes were operated upon using the new method. In the comparison group(n = 120), the fixation of the acromial extremity of the clavicle rupture was performed with hamate plate, Lee hook and Kirschner wires.Results: Its application allows, according to the evaluation scale of Constant and Murley(1987), 10% more preservation of the function of the shoulder compared with traditional methods of surgical treatment, and shortens the required hospital treatment and temporary disability periods.Conclusions: It is shown that the proposed author’s method combines low invasiveness, minimum dimensions of the construction and low-cost treatment.

  9. Treatment of patients with acromioclavicular joint injuries (Rockwood II-VI) with modeled Kirschner wire and cortical screw

    Ivan Viktorovich Borozda; Mikhail Anatolievich Danilov; Kirill Sergeevich Golokhvast


    Objective:To propose an original method of surgical treatment for the acromial extremity of the clavicle rupture (Rockwood II-VI) with modeled Kirschner wire and cortical screw. Methods:Anatomical study and a test method were applied to 43 cadavers of both sexes. During the period between 2000 and 2013, 34 patients of both sexes were operated upon using the new method. In the comparison group (n=120), the fixation of the acromial extremity of the clavicle rupture was performed with hamate plate, Lee hook and Kirschner wires. Results:Its application allows, according to the evaluation scale of Constant and Murley (1987), 10%more preservation of the function of the shoulder compared with traditional methods of surgical treatment, and shortens the required hospital treatment and temporary disability periods. Conclusions: It is shown that the proposed author’s method combines low invasiveness, minimum dimensions of the construction and low-cost treatment.

  10. ISAKOS upper extremity committee consensus statement on the need for diversification of the Rockwood classification for acromioclavicular joint injuries

    Beitzel, Knut; Mazzocca, Augustus D; Bak, Klaus;


    the coracoclavicular and AC ligaments. The ISAKOS Upper Extremity Committee has provided a more specific classification of shoulder pathologies to enhance the knowledge on and clinical approach to these injuries. We suggest the addition of grade IIIA and grade IIIB injuries to a modified Rockwood classification. Grade...

  11. Reconstruction of temporomandibular joint disk cartilage with tissue engineering in rabbits%组织工程重建兔颞下颌关节盘软骨

    焦岩涛; 马绪臣; 张震康; 于世凤; 武登诚


    目的 应用组织工程学方法重建颞下颌关节盘软骨。 方法 分离6只日本大耳白兔髁状突软骨细胞,进行细胞的微载体大规模扩增,将扩增后的软骨细胞接种于组织引导再生胶原膜,体外适当培养后植入4只同种成年兔皮下。植入后12周,对所获组织进行组织形态学观察。 结果 髁状突软骨细胞在胶原膜内生长良好,植入动物体内12周后可形成乳白色类软骨样组织,其表面光滑,有弹性。甲苯胺蓝染色,细胞周围基质呈异染性。  结论 应用胶原膜结合软骨细胞共同培养,可形成软骨样组织。该方法将有可能成为软骨缺损及关节盘破损修复的有途径。%Objective To reconstruct the temporomandibular joint disk cartilage with tissue engineering in rabbits.   Methods The mandibular condylar cartilage (MCC) cells were harvested from 6 Japan white rabbits with enzymatic method. They were augmented extensively in a micro-carrier culture system. The augmented MCC cells were inoculated into collagen films of guided tissue regeneration, and they grew in vitro for a week. After that, the cell-collagen complex was transplanted subcutaneously into the backs of 4 Japan adult white rabbits. After 12 weeks of the transplantation, the rabbits were sacrificed and the newly fabricated cartilaginous tissues were extracted. The samples were assessed histomorphologically.   Results The MCC cells could attach and grow well into the collagen films in vitro, and ivory cartilage-like tissues with smooth surface and elasticity formed after 12 weeks of the transplantation. Stained with toluidine blue, the stroma around the cells showed metachromia.  Conclusions Cartilage-like tissues can be formed with the coculture of collagen films and cartilage cells, which will be an effective way for repairing cartilage defects and temporomandibular joint disk damage.


    黄荣瑛; 徐强; 许勇刚; 郑红光


    该文基于正常膝关节的MRI图像数据,构建正常/单束/双束韧带重建胫股关节整体模型,通过对这3个关节整体模型分别加载单一负荷(轴向力)及组合负荷(轴向力和扭矩)进行有限元仿真,得到3个整体模型在两类负荷作用下的应力分布;通过从整体模型的应力云图中提取股骨、胫骨、关节软骨、半月板及后交叉/内侧/外侧韧带的表面应力等进行对比分析,得到ACL单束/双柬重建对胫股关节各组织应力分布的影响。结果表明:1)股骨,胫骨的高应力区位于股骨/胫骨与韧带的连接部位及胫骨与腓骨的接触部位,除单束重建在组合载荷作用下股骨与内侧韧带%Based on MRI images of the normal human knee, the normal, single-bundle and double-bundle ligaments reconstruction models of tibio-femoral joint were built. In the experiment, single load (axial force) and combined loads (axial force and torque) were applied to these models for the finite element simulation to obtain the stress distribution. Then we acquired stress distributions of the femur, tibia, articular cartilage, meniscus, posterior cruciate, medial collateral and the lateral collateral ligament to make a comparison between the stress distributions before and after the ACL reconstruction. The results show that: 1) The high-stress areas of the femur/tibia are located in the connection parts of the femur/tibia and ligament and the contact area between tibia and fibular. Meanwhile, the stresses on the tibia/femur after the reconstruction are close to those on the normal joint except for that the maximum stress in the junction between the femur and the MCL after singie-bundle reconstruction under the combined loads exceeds that on the normal joint; 2) Single-bundle reconstruction can lead to the increment of the equivalent stress on femoral/tibial cartilages and the medial meniscus while double

  13. Reconstrucción de la articulación temporomandibular (ATM: prótesis aloplástica Reconstruction of the temporomandibular joint (TMJ: alloplastic prostheses

    C. Goizueta Adame


    Full Text Available La incapacidad de desarrollar sistemas inertes eficaces para la sustitución completa de la articulación temporo-mandibular durante décadas ha generado una variedad de soluciones biológicas para un problema biomecánico. Los injertos autólogos no ofrecen garantías en funcionalidad, simetría, o estabilidad oclusal; resultan técnicamente más complejos y tienen mayor potencial morbilidad. El paciente candidato a reconstrucción completa de la ATM debe contar con la posibilidad de una prótesis si otras opciones fracasan. La reconstrucción aloplástica garantiza estabilidad oclusal, técnica sencilla y reproducible, estancia hospitalaria predecible y baja tasa de complicaciones con los sistemas protésicos actuales. Siempre van a existir pacientes en los que ésta sea la única opción, por lo tanto es primordial la medición de la magnitud de las fuerzas implicadas en la mecánica de la ATM para poder diseñar prótesis en base a modelos fiables como en otras articulaciones en las que ya han resuelto el problema.Incapabability to develop effective inert systems to total temporomandibular joint substitution during decades has genered several biologic solutions for a biomecanic question. Autologous grafts don´t offer security in functioning, simmetry, or oclusal estability; its have more coplex technique and more potencial morbility. Alloplastic reconstruction guarantees oclusal stability, single and reproducible technique, predictable time in hospital, and low morbility with actual prosthetic systems. Patients whos prostheses is only one option are going to exist always, so that it is primordial measures of magnitude of implicated strenghts in TMJ mecanic to can design prosthesis based on reliable models like others articulations which have just resolved the question.

  14. 数字医学在膝关节三维重建中的应用%Application of digital medicine in the three-dimensional reconstruction of the knee joint

    徐伟; 周庭永; 钱学华; 刘本菊; 李林宏; 张慧; 吕发金


    Objective:To explore the methods for reconstruction and visualization of three-dimensional (3D) models of knee joint.Methods: The MRI thin layer scanning data set of a donor' s right knee joint were used; two-dimensional image data were collected. The 3D models of knee joint including the bones, meniscus, cruciate ligaments and collateral ligaments were reconstructed by using Mimics software. The meniscus and ligaments were measured cross sectionally and tridimensionally. Results: The 3D models of knee joint were reconstructed successfully based on the MRI images by using Mimics. The model' s morph of the bones and soft tissues were vivid and the anatomy signal was limpid. The models reconstructed could be isplayed by different colors and combined randomly. The models could also be viewed in any direction by zooming in,zooming out,rotating and so on. The measured data of knee joint revealed that the sectioned information was the same as the spatial ones. Conclusion:The 3D models of knee joint which look veridical and accurate can not only be reconstructed explicitly by using MRI lamellate images, but also be measured. The reconstructed 3D models of the knee joint are helpful for anatomy teaching and study, and it can also establish the basis for the finite element analysis and virtual reality surgery.%目的:探索膝关节三维数字化模型的重建及可视化方法.方法:利用1例志愿者的右侧膝关节核磁共振成像(Magnetic resonallce imaging,MRI)薄层扫描数据,采集二维图像数据,应用Materialise公司的交互式医学图像控制系统(Materialises interactive medical image control system,Mimics)软件重建膝关节骨性结构及半月板、交叉韧带、侧副韧带等软组织的三维数字化模型,并对半月板和韧带进行断面测量和模型立体测量.结果:利用MRI数据,应用Mimics软件成功建立膝关节三维可视化模型,重建的膝关节骨性结构及相关软组织形态逼真,解剖学标志清晰,

  15. Shouldering the burdens of locomotion and posture: glenohumeral joint structure in prosimians.

    Wright-Fitzgerald, Adrian S; Balceniuk, Mark D; Burrows, Anne M


    Despite its importance in movement of the upper limb, the soft-tissue morphology of the shoulder joint complex (the acromioclavicular, coracoclavicular, and glenohumeral joints) across primates is poorly understood. This study compares soft-tissue morphology of these three shoulder joint components among broad phylogenetic, locomotor, and postural behavior ranges in prosimian primates. Two adult specimens of Galago moholi (a vertical clinger and leaper) were dissected for study, along with one adult each of Cheirogaleus medius (an arboreal quadruped), Eulemur macaco (an arboreal quadruped that also frequently engages in suspensory behavior), and Tarsius syrichta (a vertical clinger and leaper). Because of their role in glenohumeral joint movement and stabilization, the rotator cuff muscles were also dissected and weighed among the species. Results showed that muscle mass of individual components of the rotator cuff musculature may be adaptive to locomotor and postural behaviors of the taxa in this study. Two soft-tissue components of the glenohumeral joint, but not the acromioclavicular and coracoclavicular joints, were also considered adaptive. The quadrupedal species, C. medius and E. macaco, both had glenohumeral ligaments and E. macaco had a relatively deeper glenoid articular surface for the humerus because of the shape of the glenoid labrum. Additionally, this study noted a lack of a teres minor muscle in G. moholi, C. medius, and E. macaco despite previous studies describing them. A relatively robust teres minor muscle was found in T. syrichta. Even with the limited sample dissected here, these results suggest that soft-tissue joint morphology itself may be as adaptive to locomotory and postural styles as osseous morphology.

  16. Mycobacterium avium-intracellulare cellulitis occurring with septic arthritis after joint injection: a case report

    Murdoch David M


    Full Text Available Abstract Background Cellulitis caused by Mycobacterium avium-intracellulare has rarely been described. Mycobacterium avium-intracellulare is a rare cause of septic arthritis after intra-articular injection, though the causative role of injection is difficult to ascertain in such cases. Case presentation A 57-year-old with rheumatoid arthritis treated with prednisone and azathioprine developed bilateral painful degenerative shoulder arthritis. After corticosteroid injections into both acromioclavicular joints, he developed bilateral cellulitis centered over the injection sites. Skin biopsy showed non-caseating granulomas, and culture grew Mycobacterium avium-intracellulare. Joint aspiration also revealed Mycobacterium avium-intracellulare infection. Conclusion Although rare, skin and joint infections caused by Mycobacterium avium-intracellulare should be considered in any immunocompromised host, particularly after intra-articular injection. Stains for acid-fast bacilli may be negative in pathologic samples even in the presence of infection; cultures of tissue specimens should always be obtained.

  17. [Biomechanics of the ankle joint].

    Zwipp, H


    According to Fick, the tree-dimensional patterns of foot motion are best characterized as jawlike movement. Anatomically and biomechanically, this process represents conjoined, synchronous motion within the three mobile segments of the hindfoot: the ankle joint, the posterior subtalar joint, and the anterior subtalar joint. Foot kinematics can be described more completely if the anterior subtalar joint is defined not only as the talocalcaneal navicular joint, but as including the calcaneocuboid joint, thus representing the transverse joint of the tarsus, i.e., the Chopart joint. The axes of these three joints can be defined precisely. In some parts they represent a screwlike motion, clockwise or counter-clockwise, around the central ligamentous structures (fibulotibial ligament, talocalcaneal interosseous ligament, bifurcate ligament). The individual anatomy and structure of these ligaments provide variations in the degree and direction of foot motion. A precise knowledge of foot kinematics is important in surgical ligament and joint reconstruction and in selective foot arthrodeses.

  18. H 形钢板固定骶髂关节分离的生物力学评价%Biomechanical assessment on internal fixation with H-shaped reconstruc-tion plate for sacroiliac joint dislocation

    廖文胜; 丁强; 王利民


    目的:设计针对骶髂关节脱位内固定治疗的H形钢板,并行生物力学评价。方法:根据解剖特点,设计并制作适用于骶髂关节脱位的H形钢板。收集12个成年防腐骨盆标本,切断骶髂前韧带、骶髂后韧带和骶髂骨间韧带,制作成12对骶髂关节分离模型并随机分为两组,分别使用H形钢板固定和传统的双钢板固定。应用万能生物力学试验机,分别测量侧方和垂直方向上骶髂关节间位移1、2和3 mm时所需要的载荷。结果:在侧方位移1、2和3 mm和垂直位移1 mm时,H形钢板固定组所需载荷均大于传统双钢板固定组(t=4.774,4.202,5.561和2.793,P<0.05)。垂直位移2和3 mm时,两组间所需载荷差异无统计学意义(t=1.362,0.775,P>0.05)。结论:H形钢板应用于骶髂关节分离的固定时,对抗旋转和垂直方向上的初始移位的能力更强,具有更好的力学稳定性。%Aim:To design H-shaped reconstruction plate for the fixation of sacroiliac joint dislocation and to observe its biomechanical characteristics .Methods:H-shaped reconstruction plate was designed based on anatomical features of sacroiliac joint .A total of 12 pelvises of cadaver were achieved ,and dissected sagittally through the midline of the sacrum and the pubic symphysis .All ligaments surrounding the sacroiliac joints were removed .12 pairs of sacroiliac joint disloca-tion model were obtained and divided into two groups randomly .Six samples(Group A)were fixed with H-shaped plates and 4 screws,another 6 samples(Group B)were fixed with two traditional reconstruction plates and 4 screws.Then biomechani-cal tests were performed to measure the loading force at the different displacement (1, 2, and 3 mm) in the lateral and ver-tical direction, respectively.Results:The loading force of Group A was larger than that of Group B at 1,2 and 3 mm dis-placement in lateral direction and 1 mm

  19. CT三维重建技术对骶髂关节理想螺钉选择的意义%Significance of Three-dimensional Computed Tomography Reconstruction on Choice of Ideal Screw of the Sacroiliac Joint

    刘新园; 黄继锋; 付强; 刘忠; 赵卫东


    目的 应用CT三维重建技术测量骶髂关节理想螺钉的形态,并验证其准确性与探讨其临床意义.方法 应用CT三维重建技术,对11例冰冻正常成人骨盆标本左右侧骶髂关节进行模拟骶髂螺钉内固定术,并测量骶髂关节理想螺钉的形态;根据CT测量结果,在11例骨盆标本(22个骶髂关节)上进行个体化置钉验证.结果 理想螺钉的长度与最大直径分别为(87.62±1.68) mm与(20.26±1.20) mm,理想螺钉与冠状面、水平面的夹角分别是(25.85±1.06)°与(19.79±1.60)°,进针点与髂后上、下棘的距离分别为(37.02±1.67) mm与(38.30±1.14) mm;左右侧骶髂关节所置螺钉均安全、准确到达预定位置.结论 应用CT三维重建技术模拟骶髂螺钉内固定术,可准确测量骶髂关节理想螺钉的形态并进行评估,对术中置入螺钉的进针点、角度和形态的选择有指导意义;同一个体左右侧骶髂关节理想螺钉的形态无明显差别.%Objective To study the application of three-dimensional computed tomography (CT) reconstruction in measuring the morphometry of ideal screw of the sacroiliac joint, validate the accuracy and explore the clinical significance. Methods The left and right sacroiliac joints of 11 frozen pelvic specimens of normal adults underwent internal fixation using sacroiliac screw by three-dimensional CT reconstruction, and the ideal shapes of the sacroiliac screw were measured. According to the measurement results, 11 pelvic specimens (22 sacroiliac joints) were individually validated by the iliosacral screws. Results The diameter of the deal screw was (20. 26 ± 1. 20) mm, and the length was (87.62 ± 1. 68) mm. The direction of the ideal screw was (25. 85 ± 1. 06)° to the coronal plane, and (19. 79 ± 1. 60)° to the horizontal plane. The distance from the entry point to the posterior superior iliac spine was (37. 02 ± 1. 67) mm, and to the posterior inferior iliac spine (38.30 ± 1. 14) mm. All the

  20. Reconstruction of the distal radio-ulnar joint with a prosthesis of the distal ulna in the treatment of a recurrent giant cell tumour.

    Kotrych, Daniel; Zyluk, Andrzej; Walaszek, Ireneusz; Bohatryrewicz, Andrzej


    We present a case of 35-year old left-handed woman with recurrent giant-cell tumour affecting 1/4 of the distal part of the left ulna, with associated ulnar nerve involvement. After resection of the tumour and 1 cm of the ulnar nerve, the distal ulna was reconstructed with an individually designed and matched prosthesis, followed by ulnar nerve reconstruction. At 12 months follow-up the patients was free of pain, had excellent recovery of ulnar nerve function, satisfactory wrist range of motion and moderately impaired function of the left hand (DASH score 42). She returned to her original work in the office. We believe that restoration of the anatomy of the distal forearm after en block resection of the distal ulna is desirable in young, active patients, and that the prosthesis we used provides a good anatomical framework for the recovery of the function of the wrist.

  1. Joint expansion of double fascia flaps for fall-ear mastoid reconstruction%扩张耳后乳突区联合双层筋膜皮瓣耳廓再造的临床效果

    张本寿; 杨积顺; 水祥兵; 储辉; 徐志久; 林子豪; 赵耀忠


    目的 探讨扩张耳后联合双层筋膜皮瓣覆盖多孔高密度聚乙烯(Medpor)支架行先天性小耳畸形耳廓再造术的临床效果.方法 选取60例先天性小耳畸形患者,左侧22例,右侧38例.临床表现大部分耳廓缺如,或仅有部分耳垂.Ⅰ期手术将颞顶筋膜瓣转移于残耳乳突区筋膜层下,与耳后筋膜皮瓣进行同步扩张;Ⅱ期手术将扩张的耳后联合双层筋膜皮瓣包裹整个Medpor支架行耳廓再造术.结果 60例患者外耳廓再造术后皮瓣均成活,均Ⅰ期愈合,无并发症发生.术后随访3个月至3年再造耳廓形态良好,微细解剖结构清晰,颅耳角位置大小均与健耳基本一致.无1例支架外露及瘢痕挛缩,三维立体外形逼真,再造耳形态满意.结论 采用扩张耳后联合双层筋膜皮瓣覆盖Med-por支架行耳廓再造术,能有效地避免传统术胸壁畸形及支架外露弊端,再造耳微细形态结构满意.%Objective To study the methods and clinical effects of joint expansion of double fascia flaps wrapping the Medpor to perform full-ear reconstruction on congenital microtia deformity.Methods 60 patients with congenital microtia deformity were selected.including 22 left ears and 38 right ears.Majority had loss of ear auricle or only partial earlobe.Phase Ⅰ procedures included:temporal-parietal branch was used for the vascular pedicle,and mastoid area behind the ear was moved and expanded for fascia flap.Phase Ⅱ included:the joint expansion of double fascia flap wrapped Medpor to do full-ear reconstruction.Results Flaps survived and no complications for all 60 patients.Reconstructed ears had lifelike appearance and clear anatomical structures.Auriculocephalic angulars positions and sizes were consistent with the healthy ears.None of them had exposed prosthesis and scar contraction.Three-dimensional shapes were good.Conclusions Joint expansion of double fascia flap wrapping Medpor could avoid the chest wall deformity and exposed

  2. ACL reconstruction

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  3. [Joint reconstruction with autologous bone cylinder and locked intramedullary nail: proximal humeral shaft fracture with ipsilateral reverse Hill-Sachs lesion].

    Osterhoff, G; Hepp, P; Engel, T; Josten, C


    The case of a 51-year-old patient is presented, with a humeral shaft fracture in combination with an ipsilateral reverse Hill-Sachs lesion, presumably after posterior shoulder dislocation as a result of an electrical accident followed by a fall from a ladder. After corresponding diagnostics, osteosynthesis of the shaft fracture was performed with a locked antegrade intramedullary nail. Simultaneously the reverse Hill-Sachs lesion was elevated und supplemented with the bone core that accrues during drilling of the nail entrance. In the follow-up period good fragment alignment, persistent joint stability and freedom of pain could be observed. On the basis of this case and the current literature the injury mechanism and potential therapy alternatives are discussed.

  4. 带襻钢板结合自体肌腱移植重建喙锁韧带治疗陈旧性肩锁关节脱位的近期临床疗效%Double endobuttons combined with autogenic tendon transplantation for chronic acromioclavicular dislocation

    李剑; 赵阳; 王微; 李红川; 康汇


    patients were caused by direct violence. There were 7 cases of Rockwood type III, 4 of type IV and 1 of type V. Seven cases were in the left, and 5 in the right. The duration from the injury to surgery was averagely 7 months ( range:2-17 months ). The Constant-Murley score was used to assess shoulder functions before and after the surgery. And visual analogue scale was used for pain grading. Range of motion ( lfexion, extension, abduction, adduction, external rotation, internal rotation ) was also measured. Results All patients have been followed up, with the mean time of 12 months ( range:6-18 months ). After the surgery, all dislocations got reduction and all wounds got one-stage healing. There were no cases of nerve or vessel complications. Till the end of the follow-up, there were no cases of re-dislocation. The Constant-Murley score increased signiifcantly from ( 52.3 ± 10.3 ) points before the surgery to ( 89.4 ± 5.8 ) points after the surgery ( P=0.003 ). And the VAS pain score declined signiifcantly from ( 2.4 ± 0.6 ) points before the surgery to ( 0.4 ± 0.2 ) points after the surgery ( P<0.001 ). However, there were no signiifcant differences in range of motion in any direction after the surgery. Conclusions Our operation method provides similar biological activity like the original ligament and complies with the biomechanics of the acromioclavicular joint. At the same time, it has advantages of small trauma, simple operation, reliable ifxation and earlier beginning of functional exercises. It is an ideal method for the treatment of chronic acromioclavicular joint dislocation.

  5. Estudo transversal sobre o tratamento das lesões acrômioclaviculares agudas Transversal study about acute acromioclavicular lesions

    Marcel Jun Sugawara Tamaoki


    Full Text Available OBJETIVO: O objetivo do presente estudo transversal é verificar como o ortopedista brasileiro interpreta as lesões acromioclaviculares quanto aos critérios para a indicação do tratamento cirúrgico ou não, seus métodos preferidos, as complicações mais frequentes e os resultados obtidos. MÉTODOS: Durante o 6º Congresso Brasileiro de Cirurgia do Ombro e Cotovelo (CBOC e o 38º Congresso Brasileiro de Ortopedia e Traumatologia (CBOT foram distribuídos 507 questionários, sendo considerados 478 para análise. RESULTADOS: Em relação ao tratamento das LAC tipo I e II, a maioria dos entrevistados utilizam métodos não cirúrgicos. Em contraposição nas LAC IV, V e VI 475 (99,4% dos entrevistados tratam essas lesões cirurgicamente. Nas LAC tipo III não existe uma definição na escolha do tratamento cirúrgico ou não cirúrgico para 386 (80,7% entrevistados, sendo que o fator mais importante para tomada de decisão para a maioria dos entrevistados é a atividade esportiva do paciente e a idade. CONCLUSÃO: Nas LAC tipo III não há consenso, sendo o tratamento determinado conforme as características do paciente, contudo na literatura atual há uma tendência para o tratamento não cirúrgico destas lesões.The objective of the present transversal study is to check how Brazilian orthopedists treat these injuries, their criteria for choosing the treatment, results and complications. METHODS: During the 6th Brazilian Congress of Shoulder and Elbow Surgery (CBOC and the 38th Brazilian Congress of Orthopaedics and Traumatology (CBOT 507 questionnaires were distributed (148 CBOC and 359 CBOT, with 478 being considered for analysis. RESULTS: Regarding type-I and -II ACIs, most of the respondents use traditional non-surgical methods. On the other hand, for type-IV, V and VI injuries, 475 (99.4% of the respondents indicate surgical methods. Concerning type-III injuries, there is no consensus in the selection between traditional and surgical

  6. Transport distraction osteogenesis as a method of reconstruction of the temporomandibular joint following gap arthroplasty for post-traumatic ankylosis in children: a clinical and radiological prospective assessment of outcome.

    Bansal, V; Singh, S; Garg, N; Dubey, P


    This clinical and radiographic study investigated the use of transport distraction osteogenesis in unilateral temporomandibular joint (TMJ) ankylosis patients. Six patients aged between 4 and 8 years were selected for the study; the mean preoperative maximal inter-incisal opening (MIO) was 3.5mm without lateral and protrusive mandibular movements. The ankylotic mass along with the posterior border of the ascending ramus was exposed via 'lazy-S' incision. A gap arthroplasty was performed, followed by a 'reverse L' osteotomy on the posterior border of the ramus. In-house manufactured extraoral distraction devices were used for this prospective study. Follow-up clinical and radiographic evaluation was carried out for 13-27 months after completion of the activation period. After a mean follow-up of 19 months, the mean MIO was 29.1mm and the lateral and protrusive movements changed from none to slight. Cone beam computed tomography images of all patients showed remodelled neocondyle created by transport distraction osteogenesis with no statistically significant differences observed for average cancellous bone density, trabecular number, and trabecular spacing between the neocondyle of the operated side (test) and the condyle of the non-operated side (control). Neocondyle formation by transport distraction osteogenesis using the in-house distraction device is a promising treatment option for TMJ reconstruction in ankylosis patients.


    蒋欣; 唐学阳; 王道喜; 陈小亮; 刘芳; 谢晓丽; 刘利君; 彭明惺


    目的 总结髋臼重建手术在儿童髋关节病理性脱位中的应用及临床疗效.方法 2006年1月-2011年1月,共收治59例(59髋)儿童髋关节病理性脱位,采用髋关节切开复位联合髋臼重建手术治疗.男22例,女37例;年龄1~15岁,平均4.9岁.化脓性髋关节炎后遗病理性脱位33例,髋关节结核26例;病程1个月~10年.髋关节半脱位9例,髋关节全脱位50例.术前Harris髋关节功能评分为43~78分,平均61分.14例髋臼指数基本正常,32例轻度增大,13例明显增大.合并髋臼破坏28例;股骨头缺血性坏死25例,股骨头部分缺失12例,股骨头完全缺失6例,股骨头颈同时缺失3例;前倾角增大25例;髋内翻畸形9例.结果 术后即刻摄X线片示所有髋关节均达中心性复位.55例切口 Ⅰ期愈合,4例切口延期愈合.53例获随访,随访时间2~5年,平均3年.随访期间无髋关节再脱位.38例髋臼指数基本正常,15例轻度增大.前倾角15~25°,平均20°;颈干角110~140°,平均125°,头颈解剖关系基本恢复正常.术后2年髋关节活动度完全恢复正常18例,屈曲及旋转轻度受限30例,纤维强直5例;Harris髋关节功能评分为62~95分,平均87分.结论 儿童髋关节病理性脱位常合并严重的髋臼及股骨头颈部骨质破坏及后遗畸形,治疗上应严格遵循个体化原则,根据患髋主要病理改变选择适当的髋臼重建术式,并结合股骨头颈重建处理,可获得满意疗效.%Objective To investigate the effectiveness of the acetabular reconstruction surgery in children pathological dislocation of the hip joint. Methods Between January 2006 and January 2011, 59 patients (59 hips) with pathological dislocation were treated by open reduction combined with acetabular reconstruction surgery. There were 22 boys and 37 girls, aged from 1 to 15 years (mean, 4.9 years). There were 9 cases of hip subluxation and 50 cases of hip joint dislocation, which were caused by suppurative

  8. Reconstruction of anterior cruciate ligament of knee joint with single bundle allograft under arthroscopic%关节镜下应用单束同种异体肌腱重建膝关节前交叉韧带

    罗绍伟; 张平; 李文胜; 郑创义; 邱开封


    目的 探讨关节镜下采用同种异体肌腱解剖单束重建膝关节前交叉韧带(ACL)损伤的治疗效果.方法 对62例ACL断裂患者在关节镜下进行重建,采用同种异体肌腱作为移植物,在胫骨近端及股骨远端建立骨隧道,利用挤压钉对移植物进行固定.术后应用支具固定膝关节12周,按照Lysholm和Larson膝关节评分标准进行主观评估;对患者行Lachman试验进行客观评估,了解重建韧带的稳定性和膝关节的功能恢复情况.结果 Lysholm术前评分平均(43.1±2.1)分,术后韧带重建后随访时评分平均(91.0±2.3)分,术前与术后对比,差异有统计学意义(t=3.460,P=0.001).Larson术前评分平均(41.0±2.9)分,韧带重建后最终评分平均(90.1±3.5)分,术前与术后对比,差异有统计学意义(t=3.232,P=0.001).62例患者在最后复查时Lachman试验结果均为阴性.所有患者术后无膝关节感染、深静脉血栓及僵硬.在术后1年均能完全伸直,屈膝达到120度.随访期间未发生韧带再断裂.结论 关节镜下采用同种异体单束解剖重建前交叉韧带可以获得满意的临床疗效.%Objective To introduce the treatment efficacy of using allograft muscle ligament anatomical to rebuild anterior cruciate ligament (ACL) of knee joint under the arthroscopy.Methods Sixty-two cases patients with ACL rupture in anterior cruciate ligament reconstruction under arthroscopy.Allograft ligaments were used as graft,a bone tunnel was established in the proximal tibia and distal femur,and the graft was fixed by the extrusion screw.After the operation,the knee joint was fixed for 12 weeks,and the subjective evaluation was carried out according to the Lysholm and Larson knee score standards;in order to assess the stability of the ligament and the functional recovery of the knee joint,objective evaluation was carried out according to Lachman test in patients.Results The preoperative average Lysholm scale was (43.1±2.1) points,the final

  9. Helical CT three-dimensional reconstruction for inferior cervical zygapophyseal joint and its clinic meaning%下颈椎关节突关节的影像学观测及其临床意义

    曾辉; 邹德威; 吴继功; 马华松; 姬勇; 张乐乐


    目的:观测下颈椎关节突关节面的形态及其三维空间角度,探讨其临床意义.方法:选取60例正常人行颈椎CT检查,螺旋CT三维重建后在横轴面、矢状面、冠状面上观察颈椎关节突关节面形态特点,并测量关节面的曲度、关节突关节角.结果:横轴面,C3上关节面及C7的下关节面直面形多见.C3、C4、C5Ⅱ型关节面曲度比较无显著差异,C5~C7关节突关节面曲度逐渐变小(P<0.05).C3-C4、C4-C5、C5-C6、C6-C7、C7-T1关节突关节面与矢状面的夹角分别为91.98°±9.92°、96.64°±9.01°、99.46°±7.66°、94.20°±8.72°、94.83°±10.88°,C4-C5、C5-C6夹角较大(P<0.05).冠状面,C6/7节段椭圆形多见,C2/3、C3/4节段圆形多见.矢状面,下颈椎C3~C7关节突关节倾角分别为52.09°±6.28°、48.14°±4.75°、45.81°±4.07°、55.65°±4.15°、58.32°±5.77°,C3、C6、C7与C5关节突关节倾角之间差异显著(P<0.05).结论:正常人下颈椎关节突关节形态在诸节段及横轴面、冠状面不尽相同.横轴面上,C3~C7的上关节面的方向逐渐从朝向正中矢状面转向外侧,渐渐与胸椎的小关节相适应,矢状面上,C3~C7的关节倾角均为锐角,且以C5为中心分布.%Objective:To study the three-dimensional quantitative morphology as well as the orientation of cervical zygapophyseal joint and their clinical significances.Method:The cervical zygapophyseal joints of 60 normal volunteers were scanned using spiral CT and reconstructed three-dimensionally .The shapes,curvatures and angulations of these joints were observed and measured in the cross-sectional,sagittal and coronal planes respectively.Result:At the cross-sectional plane,the superior facet joint of C3 and the inferior facet joint of C7 presented with face-type frequently .The C-shape articular surfaces in C3,C4,C5 showed no statistic sig-nificance.The angles of the articular facet orientation at C3/4, C4/5, C5/6, C6/7 and C7/T1 were 91.98°±9

  10. 改良人工全颞下颌关节置换术及效果评价%Modified total alloplastic temporomandibular joint reconstruction and evaluation of efficiency

    刘欢; 张晓虎; 杨驰; 张善勇; 陈敏洁; 何冬梅; 邱亚汀


    目的:介绍一种人工全颞下颌关节(temporomandibular joint,TMJ)置换的改良术式并评价其临床应用效果.方法:自2006年9月,我院开始引进Biomet-Lorenz公司(Jacksonville,FL)标准型假体系统进行人工全TMJ置换术,对手术方法进行改良,包括①切取关节结节/髁突骨块填充关节窝,增加关节窝假体固定的稳定性;②保留关节盘,作为髁突假体的内侧充填物,防止发生异位骨化;③经下颌下切口切取皮下游离脂肪瓣,避免腹部切口.拍摄全口曲面体层片(panoramic radiographs,PR)或CT,分别于术后即刻、6个月、1年观察假体位置及其周围骨结构.采用SAS 9.13软件包对数据进行统计学处理.结果:随访12例(14侧)患者,平均随访期26.08个月(4~48个月).11例(13侧)采用自体骨转移,辅助关节窝假体固位,其中采用关节结节骨块7例(10侧),髁突骨块2例(2侧),下颌支残端骨块1例(2侧);5例(5侧)保留关节盘作为髁突假体内侧充填物;10例(10侧)从下颌下切口切取皮下游离脂肪瓣.术后即刻、6个月、1年影像学(PR或CT)检查均显示关节窝及下颌假体位置良好,患者假体周围骨结构均未见异常.术后所有患者咬合关系稳定,未见假体松动现象.结论:人工全TMJ置换改良术式有助于提高假体的稳定性,减少术后异位成骨的发生,避免额外手术切口,值得推广应用.

  11. [Fractures of the elbow joint].

    Nowak, T E; Dietz, S O; Burkhart, K J; Müller, L P; Rommens, P M


    Fractures around the elbow joint comprise fractures of the distal humerus, the radial head, the olecranon and the coronoid process. Combined lesions are particularly demanding for the surgeon. Accurate knowledge of the anatomy and of the biomechanics is an essential requirement for a specific diagnosis and therapy. A stable and painless movable elbow joint is essential for most of the activities of daily living. Risk factors for the development of posttraumatic elbow joint arthrosis are non-anatomically reconstructed joint surfaces, axial malalignment of the joint axis and untreated concomitant injuries. Modern angular stable and anatomically preshaped implants facilitate a biomechanically adequate osteosynthesis and avoid or decrease functional impairment. In consideration of an increasing number of osteoporotic elbow joint fractures, endoprosthetic replacement has gained significance.

  12. Metatarsophalangeal joint medial collateral ligament reconstruction in the treatment of hallux valgus%跖趾关节内侧副韧带重建术治疗外翻

    赵鸿声; 靖光武; 张建军; 黄吉利


    目的 探讨跖趾关节内侧副韧带重建加跖趾关节成形术治疗外翻疗效.方法 采用改良跖趾关节成形术治疗外翻23例(38足),并对趾畸形的矫正程度、疼痛症状的改善及行走功能的恢复等进行充分评估.结果 本组患者外翻角(HAV)及第一、二跖骨间夹角(IMA)术前、后比较,差异有统计学意义(P<0.05).术后随访(13.6±2.3)个月,疗效优28足,良8足,可1足,差1足,总优良率达94.7%.结论 跖趾关节内侧副韧带重建加跖趾关节成形术能够治疗多种中、重度外翻及合并趾跖关节炎患者,能有效改善足部外形及症状,恢复行走功能,并发症少.%Objective To investigate clinical effect of medial collateral ligament reconstruction and arthroplasty of metatarsophalangeal joint for the treatment of hallux valgus. Methods From 2006 to 2011,38 feet of 23 patients were treated with the modified operation. All patients were followed up and the degree of deformity correction, the improvement of pain and the recovery of walking function were fully e-valuated. Results After the surgery, there were significant differences in hallux valgus angle( HVA )and intermetatarsal angle( IMA )( P <0. 05 ). All the cases were followed up for( 13. 6 ± 2. 3 )months and an excellent outcome was found in 28 feet, good in 8, fair in 1 and poor in 1, the excellent and good rate was 94.7%. Conclusion The modified metatarsophalangeal joint arthroplasty is an effective method for patients with hallux valgus and extensor digitorum communis arthritis. It can markedly improve the appearance, release the symptoms, restore the function and reduce the complications.

  13. Motion of the shoulder complex in individuals with isolated acromioclavicular osteoarthritis and associated with rotator cuff dysfunction: part 2 - muscle activity.

    Sousa, Catarina de Oliveira; Michener, Lori Ann; Ribeiro, Ivana Leão; Reiff, Rodrigo Bezerra de Menezes; Camargo, Paula Rezende; Salvini, Tania Fátima


    This study aimed to compare muscle activity in individuals with isolated acromioclavicular osteoarthritis (ACO), ACO associated with rotator cuff disease (ACO+RCD), and controls. Seventy-four participants (23 isolated ACO, 25 ACO+RCD, 26 controls) took part in this study. Disability was assessed with the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Muscle activity of the upper trapezius (UT), lower trapezius (LT), serratus anterior (SA), and anterior deltoid (AD) was collected during arm elevation in the sagittal and scapular planes. Pain during motion was assessed with the numerical pain rating scale. Analysis of the DASH, pain and kinematics were reported in part 1 of this study. For each muscle, separate 2-way linear mixed-model ANOVAs were performed to compare groups. ACO+RCD group had more UT and AD activity than the the isolated ACO and control other groups, more AD activity than the isolated ACO group during the ascending phase, and more AD activity than the ACO and control groups during the descending phase in both planes. Isolated ACO group had less SA activity than the control group only in the sagittal plane. Alterations in shoulder muscle activity are present in individuals with isolated ACO and with ACO+RCD and should be considered in rehabilitation.

  14. Joint ventures

    Sørensen, Karsten Engsig

    Afhandlingen analysere de konkurrenceretlige og selskabsretlige regler som er bestemmende for hvordan et joint venture samarbejde er struktureret......Afhandlingen analysere de konkurrenceretlige og selskabsretlige regler som er bestemmende for hvordan et joint venture samarbejde er struktureret...

  15. Joint swelling

    ... chap 275. Raftery AT, Lim E, Ostor AJK. Joint disorders. In: Raftery AT, Lim E, Ostor AJK, eds. ... A.M. Editorial team. Related MedlinePlus Health Topics Joint Disorders Browse the Encyclopedia A.D.A.M., Inc. ...

  16. Late reconstruction of condylar neck and head fractures.

    Davis, Ben


    Condyle fractures are a common injury, but only a few of these injuries require immediate or late reconstruction. The complications that most frequently necessitate condylar reconstruction include proximal segment degeneration, malunion, and ankylosis. Costochondral grafts and total joint prostheses, both stock and custom, remain the most common methods of reconstruction. Reconstruction plates with condylar extensions should only be used temporarily as an unacceptable number cause serious complications. Distraction osteogenesis may have an occasional role in reconstructing the posttraumatic condyle.

  17. Joint ventures

    M.N. Hoogendoorn (Martin)


    textabstractEen veel voorkomende wijze van samenwerking tussen ondernemingen is het uitvoeren van activiteiten in de vorm van een joint venture. Een joint venture is bijna altijd een afzonderlijke juridische entiteit. De partners in de joint venture voeren gezamenlijk de zeggenschap uit. In internat

  18. Wide resection and knee joint reconstruction for malignant tumors of the proximal tibia%胫骨上端恶性骨肿瘤广泛切除与重建

    杨志平; 杨强; 李昕; 李振峰; 李建民


    bone tumors of proximal tibia,27 males and 18 females,28 years in average (range, 12 -62 years). The tumors,including 25 osteosarcomas,7 malignant giant cell tumors,6 chondrosarcomas,3 malignant fibrous histiocytomas,3 fibrosarcomas and 1 lymphoma were treated with wide resection which performed through anteromedial incision in 30 cases and anterolateral incision in 15. The superior tibiofibuiar joints were involved and the proximal tibia resected en bloc in 13. Two knee joints were involved and extraarticuler resection were performed. Partial tumorous bone was devitalized and replanted in 5 cases and the anterior tibial vessels were ligated in 28. The involved knee joints were reconstructed with domestic-made prostheses and soft tissue coverage was improved by medial or lateral gastrocnemius flap and sagittal split anterior tibial muscle flap in some patients which tibia was removed longer. Neoadjuvant chemotherapy were performed to the patients with osteosarcoma and malignant fibrous histiocytoma. [ Result] With an average follow-up of 4.6 years ( range,8 months -9 years ),local recurrences occurred in four cases and lung metastases in six cases. One patients with malignant fibrous histiocytoma of proximal tibia had metastasis to L* after 6 years postoperatively and was treated with total en bloc spondylectomy. The complications related to the prostheses included peri-prosthetic infection in 3, prosthetic dis-location in 3, prosthesis loosening in 2, peri-prosthesis fracturein 1 and prosthetic fracture in 1. The average range of motion were 92 degrees (50 - 120 degrees) with the 4.4 degrees (0 - 20 degrees) of average extension lag. According to the Musculoskeletal Tumor Society ( MSTS ) Scoring system, the average functional score was 76.7%. [ Conclusion ] Wide resection and reconstruction for malignant tumor of proximal tib-la I- highly demanding. To achieve the goal of Limb salvage and _■■?." function, il is necessary to employ standard reseolion lech

  19. Distal radioulnar joint injuries

    Binu P Thomas


    Full Text Available Distal radioulnar joint is a trochoid joint relatively new in evolution. Along with proximal radioulnar joint , forearm bones and interosseous membrane, it allows pronosupination and load transmission across the wrist. Injuries around distal radioulnar joint are not uncommon, and are usually associated with distal radius fractures,fractures of the ulnar styloid and with the eponymous Galeazzi or Essex_Lopresti fractures. The injury can be purely involving the soft tissue especially the triangular fibrocartilage or the radioulnar ligaments.The patients usually present with ulnar sided wrist pain, features of instability, or restriction of rotation. Difficulty in carrying loads in the hand is a major constraint for these patients. Thorough clinical examination to localize point of tenderness and appropriate provocative tests help in diagnosis. Radiology and MRI are extremely useful, while arthroscopy is the gold standard for evaluation. The treatment protocols are continuously evolving and range from conservative, arthroscopic to open surgical methods. Isolated dislocation are uncommon. Basal fractures of the ulnar styloid tend to make the joint unstable and may require operative intervention. Chronic instability requires reconstruction of the stabilizing ligaments to avoid onset of arthritis. Prosthetic replacement in arthritis is gaining acceptance in the management of arthritis.

  20. Analysis of therapeutic effect of rehabilitation treatment improving function of knee joint following reconstruction anterior crucial ligament with allogenic achilles tendon under arthroscopy%跟腱重建前十字韧带术后康复治疗恢复膝关节功能的疗效分析

    常青; 黄迅悟; 张晓鸥; 郑光新


    Objective Combining the reconstruction of anterior crucial ligament(ACL) with functional rehabilitation,we recover the injured knee as possible as can.Methods 38 patients received ACL reconstruction with allogenci Achilles tendon under arthroscopy.We reconstructed the injured ACL and the injured medial crucial ligament(MCL) by utilization of length of achiles tendon.Then we carried out different rehabilitations in accordance with special needs of the patients.Results The follow up was performed for more than 7 months in 34 cases.Lysholm method was used to evaluate patients' function before and after operation.Results showed average score was 53.8 preoperatively, and 84.2 postoperatively,the good rate was 84.4% .In the objective examination,anterior drawer test(ADT),31 cases were positive preoperatively,1 was positive postoperatively;lachman test:34 were positive preoperatively,1 was positive postoperatively;4 were weak positive postoperatively.There were 3 cases with pain of knee joints and 4 cases with limitation of activity of knee joints(5~ 20 degree) postopratively.Conclusion Combination of reconsgruction of ACL with allogenic achilles tendon and the functional rehabilitation can gain remarkable curative effect.

  1. Finite Element Analysis of Reconstructed Sacro-iliac Joint with Galveston Technique after Subtotal Sacrum Resection%骶骨次全切除术后骶髂关节重建的有限元分析

    张东华; 李诚; 王志伟; 王翠珠; 李全


    Objective To evaluate the number of screws on the biomechanics of the sacral joint in the modified Galveston technology. Methods Based on the finite element postoperative pelvic model with subtotal sacrectomy previously established, two finite element models of modified Galveston technique were built,with 4 screws and 6 screws respectively. The same pres-sure load was applied on the two models,and the validity of the model was verified,the displacement of model and the stress distribution on screws and rods were compared. Results The model was validated to be effective according to the result of the experimental results of the cadaver model in the literature. Number of lumbar screws had little impact on the lumbosacral stiff-ness and equipment total stress. However,L5 pedicle screw stress of 4 screws reconstruction methods were higher than that of 6 screws reconstruction methods. Conclusion The less the number of screws,the greater stress on L5 pedicle screw. And the risk of screw breaking or loosening also increases with less screws. More pedicle screws should be used on osteoporosis pa-tients.%目的:评价改良 Galveston 技术固定骶髂关节时,不同螺钉数量对腰骶部生物力学的影响。方法建立骶骨次全切除术后的骨盆有限元模型,在此模型基础上行改良 Galveston 技术双侧固定腰骶部,分别建立4枚螺钉和6枚螺钉两种内固定方式。施加相同的压力载荷,经计算后对模型的有效性进行验证,进而比较不同螺钉内固定的模型位移以及内固定器械上的应力分布差异。结果模型经验证与文献中尸体模型实验结果近似,可以认为有效。尽管腰椎固定节段的数目对于腰骶部的刚度和器械整体应力的影响较小,但比较两种重建方式下 L5椎弓根螺钉上的应力发现,螺钉数目越少,螺钉上的应力越大,从而也增加了断钉或松动的风险。结论改良 Galveston 技术腰椎螺钉的数目与螺

  2. Penile reconstruction

    Giulio Garaffa; Salvatore Sansalone; David J Ralph


    During the most recent years,a variety of new techniques of penile reconstruction have been described in the literature.This paper focuses on the most recent advances in male genital reconstruction after trauma,excision of benign and malignant disease,in gender reassignment surgery and aphallia with emphasis on surgical technique,cosmetic and functional outcome.

  3. 关节镜下重建膝关节新鲜与陈旧前交叉韧带训练伤疗效对比分析%Comparison of the clinical outcome of knee joint reconstruction between fresh and old military training injury of ACL with arthroscopy

    王兵; 王善超; 孙卫平; 董桂芝


    Objective To compare the clinical outcome of knee joint reconstruction of different operative period in treatment of military training injury of ACL. Methods ACL injuries were treated with knee joint reconstruction with semitendinosus tendon and gra-cilis tendon. 27 patients in the fresh group were treated in (5 ±0. 8) weeks and 19 patients in the old group were done in (76 ± 10.5) weeks. Results According to Lysholm knee function score, the excellent and good rates were 92. 5% in the fresh group and 78. 9% in the old group. The difference showed statistical significance (P < 0. 01). Conclusion Reconstruction of knee joint in military training with anthroscope can play better clinical effect in the early time than in the late time.%目的 比较部队官兵体能训练所致膝关节前交叉韧带(ACL)损伤手术时机对疗效的影响.方法 关节镜下对平均病程(5±0.8)周27例新鲜组和平均病程(76±10.5)周19例陈旧组ACL损伤,均以半腱肌和股薄肌为替代物进行手术重建.结果 按Lysholm评分,新鲜组和陈旧组ACL损伤的优良率分别为92.5%和78.9%,两组比较差异有显著统计学意义(P<0.01).结论 体能训练所致膝关节交叉韧带损伤早期关节镜手术重建的疗效优于晚期重建.

  4. 关节镜辅助下一期修复重建膝关节三联损伤疗效观察%Clinical effect of one-stage arthroscopically assisted repair and reconstruction on Triplicate injuries of knee joint

    何建华; 谢水华; 王小鹏; 丁浩


    目的:探讨关节镜下一期修复重建膝关节三联损伤(前交叉韧带,内侧副韧带和内侧半月板损伤)的方法及效果。方法2009年10月-2014年6月,对21例膝关节三联损伤患者采用一期关节镜下手术,取腘绳肌腱(或同种异体肌腱)重建前交叉韧带,止点重建或缝合修复治疗内侧副韧带损伤,一期缝合或修整损伤的内侧半月板。结果术后均获随访6-30个月,平均16个月,术前Lysholm膝关节功能评分为(40.4±15.8)术后末次随访为(84.5±12.8),有显著改善。患者在0°和20°应力测试时稳定性均完全恢复。结论膝关节三联损伤可以一期在关节镜下完成重建及修复,早期有效恢复膝关节稳定性。%Objective To investigate one-stage arthroscopic repair and reconstruction of the triplicate Injuries of knee joint (anterior cruciate ligament,medial collateral ligament and medial meniscus). Methods From October 2009- June 2014,21 cases of knee joint injury were treated as taking arthroscopic operation with one stage ,The ACL was reconstructed using the hamstring tendon autograft (or tendon allograft),medial collateral ligament was repaired and reconstruction of the interdictory point,One-stage suture or trimmed medial meniscus injury. Results All cases were followed up for 6-30 months,average 16 months,Accord-ing to the Lysholm scale of knee function,preoperative was (40.4+15.8),the last follow-up was (84.5+12.8) after operation,has im-proved significantly. Patients with stress test stability were recovered in 0 degree and 20 degree. Conclusion The triplicate In-juries of knee joint can be reconstructed and repaired for one stage under the arthroscope ,early and effective recovery of knee joint stability.

  5. 基于分布式压缩感知的可穿戴多传感数据联合重构新方法%A Novel Distributed Compressed Sensing-Based Joint Reconstruction Method for Multiple Sensor Data from Wearable Device

    徐海东; 吴建宁; 王珏


    In order to improve the performance of joint reconstruction of multi-sensor acceleration data from different wearable devices, a novel approach to jointly reconstruct based on distributed compressed sensing (DCS) algorithm was proposed. The basic idea was that the raw data was ifrstly compressed through encoding, and the encoded data was sent to remote terminal. Then, with the spatiotemporal correlation of data from sensors, the joint reconstruction method based on Block Sparse Bayesian Learning (BSBL) was applied to decode the compressed data at remote terminal. At last, the wearable data from University of California-Berkeley database was analized. Experiments show that the proposed approach can gain better performance than the traditional joint reconstruction algorithms such as TMSBL and tMFOCUSS, and decode the compressed data accurately. The proposed technique may be helpful for telemedicine application.%为提高可穿戴多传感数据远程联合重构性能,提出了一种基于分布式压缩感知的可穿戴多传感加速度数据联合重构新方法。该方法首先对可穿戴多传感原始数据压缩编码,将数据融合传送至远端服务器;然后,基于可穿戴传感数据的时空相关性,构建块稀疏贝叶斯学习联合重构算法,实现压缩数据解码,准确重构各传感原始数据;最后,新方法对美国加州伯克利大学可穿戴多传感运动数据进行分析。实验结果表明,对不同编码采样率,文章所提方法重构性能明显优于传统的算法,并且能够准确解码压缩数据,有望在远程医疗环境下推广应用。

  6. Labral reconstruction: when to perform and how

    Brian J White


    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.

  7. Climate Reconstructions

    National Oceanic and Atmospheric Administration, Department of Commerce — The NOAA Paleoclimatology Program archives reconstructions of past climatic conditions derived from paleoclimate proxies, in addition to the Program's large holdings...

  8. Breast Reconstruction

    ... senos Preguntas Para el Médico Datos Para la Vida Komen El cuidado de sus senos:Consejos útiles ... that can help . Federal law requires most insurance plans cover the cost of breast reconstruction. Learn more ...

  9. Studies of welded joints

    J. M. Krupa


    Full Text Available Studies of a welded joint were described. The joint was made as a result of the reconstruction of a truss and one of the possible means to make a repair. The studies were of a simulation character and were targeted at the detection of welding defects and imperfections thatshould be eliminated in a real structure. A model was designed and on this model the tests and examinations were carried out. The modelwas made under the same conditions as the conditions adopted for repair. It corresponded to the real object in shape and dimensions, and in the proposed technique of welding and welding parameters. The model was composed of five plates joined together with twelve beads.The destructive and non-destructive tests were carried out; the whole structure and the respective welds were also examined visually. Thedefects and imperfections in welds were detected by surface methods of inspection, penetration tests and magnetic particle flaw detection.The model of the welded joint was prepared by destructive methods, a technique that would never be permitted in the case of a realstructure. For the investigations it was necessary to cut out the specimens from the welded joint in direction transverse to the weld run. The specimens were subjected to metallographic examinations and hardness measurements. Additionally, the joint cross-section was examined by destructive testing methods to enable precise determination of the internal defects and imperfections. The surface methods were applied again, this time to determine the severity of welding defects. The analysis has proved that, fabricated under proper conditions and with parameters of the welding process duly observed, the welded joint has good properties and repairs of this type are possible in practice.

  10. Joint Interdiction


    exercise of authority by combatant commanders and other joint force commanders (JFCs), and prescribes joint doctrine for operations and training. It...interdiction requirements and dependable, interoperable, and secure communications architecture to exercise control. The JFC exercises C2 through...moving across open desert terrain were more vulnerable to interdiction by coalition airpower than dispersed Serbian forces that benefited from trees

  11. Diagnostic Value of the Application of High-Resolution CT and Curve Reconstruction in Ankylosing Spondylitis of Sacroiliac Joint Disease%强直性脊柱炎骶髂病变的HRCT及曲面重建诊断价值分析

    刘秀华; 赵汗青; 胡敬宏


    目的 分析HRCT结合曲面重建在诊断强直性脊柱炎(AS)骶髂关节病变的诊断价值.方法 对96例临床明确诊断AS患者的骶髂关节行高分辨CT扫描及曲面重建,分析其影像表现.结果 骶髂关节炎可以双侧或单侧.早期(CT Ⅰ~Ⅱ级)48例,多累及髂骨侧,表现为骶髂关节髂骨面下小虫蚀样破坏或微小囊变,关节面下轻微硬化,关节面皮质白线中断,略毛糙.中期(CTⅢ级)34例,双侧受累,关节面及关节面下骨侵蚀破坏,呈锯齿样或毛刷样改变,周围骨增生硬化明显,关节面模糊毛糙,可见软骨或韧带钙化,关节间隙不规则狭窄,少数可见真空现象.晚期(CTⅣ级)14例,多双侧受累,关节间隙消失,关节强直,周围骨质疏松.结论 HRCT可显示骶髂关节的细微结构,结合曲面重建在影像表现上提供更全面的范围,因此HRCT具有较高的敏感性和特异性,可做出更早期诊断及明确的分级及分期,为临床治疗提供客观依据.%Objective To explore the application value of high-resolution CT,curve reconstruction in the diagnosis of ankylosing spondylitis (AS) sacroiliac joint. Methods High-resolution CT scan and curve reconstruction were conducted in % cases of patients with sacroiliac joint AS,the imaging manifestations were analyzed. Results Sacroiliitis may be unilateral or bilateral. 48 cases were at early stage( I -D grade),imaging characteristics of sacroiliitis were:iliac side of synovia! section mostly involved, slightly insect-bite, subcortical microcysts and mild sclerosis of iliac surface of joint, most cases with symmetric involvement of the joints showed coarse articular surface,interruption or disappearance of the joint cortex. 34 cases were at the intermediate stage( Ⅲ grade) .most cases showed bilateral articular surface and subcortical destruction,serrated or brush appearance with vague and irregularity of sacroiliac articular surface, sclerosis or hypertrophic changes around the

  12. Reconstrucción de la articulación temporomandibular postraumática con prótesis a medida: Planificación quirúrgica virtual Post-traumatic reconstruction with custom prosthesis of the temporomandibular joint: Computerized surgical planning

    Aitor García Sánchez


    Full Text Available Introducción: Las nuevas técnicas de planificación quirúrgica virtual, como la tecnología CAD/CAM, así como los avances en biomateriales, permiten abordar casos cada vez más complejos de reconstrucción de la articulación temporomandibular. La planificación y la fabricación de dispositivos aloplásticos a medida permiten una adaptación excelente a las estructuras anatómicas. Las deformidades dentofaciales coexisten en muchas ocasiones con la afección articular. Con estos métodos de planificación es posible asociar procedimientos de cirugía ortognática, a la vez que reconstruimos la articulación temporomandibular en un solo tiempo quirúrgico. Material y métodos: En este artículo presentamos nuestra experiencia en la planificación virtual y posterior cirugía de 3 casos de anquilosis articular bilateral (6 articulaciones, con simulación de osteotomías, movimientos maxilomandibulares y diseño de prótesis totales aloplásticas a medida de la articulación temporomandibular. Conclusiones: El abordaje integral de la biomecánica articular, la relación intermaxilar y la oclusión dental es imprescindible para obtener resultados predecibles y satisfactorios. La planificación virtual y la utilización de dispositivos aloplásticos a medida permiten la reconstrucción total articular de una forma precisa y segura.Introduction: New virtual surgery planning techniques like CAD/CAM and advances in biomaterials have made it possible to undertake increasingly complex cases of temporomandibular joint reconstruction. The planning and preparation of custom alloplastic devices makes it possible to accurately accommodate anatomic structures. Dental and facial deformities often coexist with articular pathology. Using computerized planning methods, orthognathic surgery procedures can be combined with temporomandibular joint reconstruction in a single procedure. Material and methods: The authors' experience with computerized planning and

  13. Improve reconstructed metacarpophalangeal joint function with second toe transplantation after curved osteotomy under the metatarsal head cartilage%跖骨头软骨面下弧形截骨改善第二跖趾关节屈曲方向的临床研究

    丁小珩; 方光荣; 张宏勋; 刘育杰; 屈志刚; 姜凯; 焦鸿生; 潘达德


    目的 探讨带跖趾关节的第二趾移植再造拇手指过程中,利用跖骨头软骨面下选择性截骨来改善跖趾关节屈曲方向的手术方法和临床疗效. 方法 对21例21指带跖趾关节的第二趾移植再造拇、手指病例,术中在第二跖骨头底部关节囊近侧做截骨口,距跖趾关节面5.0 mm处进入跖骨,弧形截除松质骨,使跖趾关节可以屈曲到90°为止,纵贯或交叉克氏针固定关节,再按常规的再造方法重建动力、神经及血液循环. 结果 本组所有再造指均成活.随访时间6~24个月,其中6例得到长期随访(12 ~ 24个月).再造指的掌指关节被动活动范围65°~85°,平均75°.主动活动范围45°~80°,平均65°.X线片复查显示骨质愈合良好,无关节退性行变表现. 结论 在带跖趾关节的第二趾移植再造拇、手指过程中,采用跖骨头软骨面下选择性截骨的方法能明显增加再造掌指关节主、被动屈伸活动度,是提高再造指掌指关节活动度的较佳方法.%Objective To investigate the technique and clinical results of curved osteotomy under the metatarsal head's cartilage for improving reconstructed metacarpophalangeal joint function of fingers with second toe transplantation. Methods There were total 21 cases with 21 digits. During second toe transplantation with the metatarsophalangeal joint, the bottom of the second metatarsal head was incised. Then a curved osteotomy were carried out on about 5.0 mm under the metatarsal head's cartilage until the passive range of motion could be 90°.Longitudinal or cross-Kirschner wires were used to fix the joint.Finally,the conventional methods were used to reconstruct the blood supply, movement and nerves. Results All 21 digits of the 21 cases survived uneventfully.The follow-up time was ranged from 6 to 24 months.Their average passive range of motion of the reconstructed metacarpophalangeal joint was 75°,ranging from 65° to 85°.The average active range

  14. Nonlinear Reconstruction

    Zhu, Hong-Ming; Pen, Ue-Li; Chen, Xuelei; Yu, Hao-Ran


    We present a direct approach to non-parametrically reconstruct the linear density field from an observed non-linear map. We solve for the unique displacement potential consistent with the non-linear density and positive definite coordinate transformation using a multigrid algorithm. We show that we recover the linear initial conditions up to $k\\sim 1\\ h/\\mathrm{Mpc}$ with minimal computational cost. This reconstruction approach generalizes the linear displacement theory to fully non-linear fields, potentially substantially expanding the BAO and RSD information content of dense large scale structure surveys, including for example SDSS main sample and 21cm intensity mapping.

  15. Deterministic joint remote state preparation

    An, Nguyen Ba, E-mail: [Center for Theoretical Physics, Institute of Physics, 10 Dao Tan, Ba Dinh, Hanoi (Viet Nam); Bich, Cao Thi [Center for Theoretical Physics, Institute of Physics, 10 Dao Tan, Ba Dinh, Hanoi (Viet Nam); Physics Department, University of Education No. 1, 136 Xuan Thuy, Cau Giay, Hanoi (Viet Nam); Don, Nung Van [Center for Theoretical Physics, Institute of Physics, 10 Dao Tan, Ba Dinh, Hanoi (Viet Nam); Physics Department, Hanoi National University, 334 Nguyen Trai, Thanh Xuan, Hanoi (Viet Nam)


    We put forward a new nontrivial three-step strategy to execute joint remote state preparation via Einstein-Podolsky-Rosen pairs deterministically. At variance with all existing protocols, in ours the receiver contributes actively in both preparation and reconstruction steps, although he knows nothing about the quantum state to be prepared. -- Highlights: → Deterministic joint remote state preparation via EPR pairs is proposed. → Both general single- and two-qubit states are studied. → Differently from all existing protocols, in ours the receiver participates actively. → This is for the first time such a strategy is adopted.

  16. MRI based volumetric assessment of knee cartilage after ACL-reconstruction, correlated with qualitative morphologic changes in the joint and with clinical outcome. Is there evidence for early posttraumatic degeneration?; MRT-basierte Knorpelvolumetrie nach Kreuzbandersatzplastik in Korrelation mit qualitativen Gelenkveraenderungen und dem klinischen Outcome. Gibt es Hinweise auf fruehzeitige posttraumatische degenerative Veraenderungen?

    Arnoldi, A.P.; Weckbach, S.; Horng, A.; Reiser, M. [Ludwig-Maximilians-Univ. Muenchen (Germany). Dept. of Clinical Radiology; Nussbickel, C. [Klinikum Garmisch-Partenkirchen (Germany). Dept. of Internal Medicine; Noebauer, I. [Medizinische Universitaet Wien (Austria). Klinik fuer Radiodiagnostik; Zysk, S. [Orthopaedie Zentrum Groebenzell (Germany). Center of Orthopaedics; Glaser, C. [NYU Medical Center, New York, NY (United States). Dept. of Radiology


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


    徐强; 黄荣瑛; 许勇刚; 郭云飞; 郑红光


    flexion angle of 0° for the models A and B, the accuracy and validity of the pairs of models for healthy adult A were proved. After that, MRI images of the normal human knee at different flexion angles of 0°/25°/60°/80° were obtained through SONATA MAESTRO 1.5 T Scanning. Then, the corresponding 3D tibio-femoral joint models of normal/ACL single bundle/double bundle reconstruction were established. In the experiment, axial force and combined loads (axial force and torque) were applied to these models to analyze and compare the changes of the stress distribution of cartilages/meniscus/ligaments and the tension characteristic of ligaments before and after the ACL reconstruction. The results show that: (1) The stresses on cartilages and meniscus after ACL single bundle/double bundle reconstruction change with the flexion angles, and especially the stress distributions on the cartilages change significantly at some angle. (2) Single-bundle reconstruction can lead to the obvious increment of the equivalent stresses on cartilages and meniscus, and the maximum increment is to 40%. However, the corresponding values after double bundle reconstruction at different flexion angles are closer than that after single-bundle reconstruction. (3) Although ACL single-bundle reconstruction will reduce the equivalent stress on PCL, stress on medial/lateral collateral ligament will significantly increase at high-flexion angle. The maximum stress on MCL changes obviously with the flexion angles after double-bundle reconstruction, but the maximum stress on LCL and PCL show the corresponding trend to normal joint. (4) The average tension of MCL is higher than that of the other two after single or double bundle reconstruction. Besides, the tension characteristic of ligaments after the double-bundle reconstruction is closer to the normal joint than that after single-bundle. In short, considering the stress and tension of cartilages, meniscus and ligaments after ACL

  18. ACL reconstruction - discharge

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

  19. Evidence-based radiology (part 2): Is there sufficient research to support the use of therapeutic injections into the peripheral joints?

    Peterson, Cynthia; Hodler, Juerg [Orthopaedic University Hospital of Balgrist, Radiology, Zuerich (Switzerland)


    This review article addresses the best evidence currently available for the effectiveness of injection therapy for musculoskeletal conditions involving the peripheral joints. The research is presented by anatomical region and areas of controversy and the need for additional research are identified. Randomized controlled trials, meta-analyses and systematic reviews are lacking that address the effectiveness of therapeutic injections to the sternoclavicular, acromioclavicular, ankle and foot joints. No research studies of any kind have been reported for therapeutic injections of the sternoclavicular joint. With the exception of the knee, possibly the hip and patients with inflammatory arthropathies, research does not unequivocally support the use of therapeutic joint injections for most of the peripheral joints, including the shoulder. Additionally, controversy exists in some areas as to whether or not corticosteroids provide better outcomes compared to local anesthetic injections alone. When viscosupplementation injections are compared to corticosteroids in patients with osteoarthritis of the knee, the evidence supports the use of viscosupplementation for more prolonged improvement in outcomes, with corticosteroids being good for short-term relief. (orig.)

  20. Observation of the clinical effect of the occlusal reconstruction treatment on patients with temporomandibular joint disorder as well as severe dental abrasion%牙列重度磨耗伴颞下颌关节紊乱病咬合重建序列治疗临床疗效观察

    黄静莲; 曹云娟


    目的 观察分析牙列重度磨耗伴颞下颌关节紊乱病(TMD)患者咬合重建序列治疗的疗效.方法 选取牙列重度磨耗伴TMD患者11例,检查记录TMD及其相关症状,然后进行咬合重建序列治疗,治疗完成3个月、6个月及12个月后,将治疗后的TMD及其相关症状与治疗前相比较,对相关数据进行统计分析.结果 治疗后11例患者均感满意且咀嚼有力,关节弹响、关节疼痛及咬合干扰治疗前后的比较存在统计学意义(P<0.05).结论 咬合重建后,患者满意度较高,其TMD症状有明显改善,髁突位置在短期内无明显改善.%Objective Observe and analyse the clinical effect of the occlusal reconstruction treatment on patients with temporomandibular joint disorder(TMD) as well as severe dental abrasion. Methods 11 patients with TMD and severe abrasion were given occlusal reconstruction treatment after records of their situation of TMD and related symptoms. 3,6,12 months after operation,compare TMD and related symptorms with those before operation. Data were analysed statistically. Kelusts 11 patients given the treatment were all satisfied with the correct and effective occlusion. There were significantly statistical differences (P <0.05) in the comparison before and after the treatment in joint-snapping,joint-paining and occlusal interference. Conclusions Patients are highly satisfied after occlusal reconstruction , and their symptoms about TMD improve obviously. There was no variation of the mandibular condyle position in short time.

  1. Breast Reconstruction Alternatives

    ... Breast Reconstruction Surgery Breast Cancer Breast Reconstruction Surgery Breast Reconstruction Alternatives Some women who have had a ... chest. What if I choose not to get breast reconstruction? Some women decide not to have any ...

  2. Smooth Reconstruction


    Eighty percent of the reconstruction projects in Sichuan Province will be completed by the end of the year Despite ruins still seen everywhere in the earthquake-hit areas in Sichuan (Province, new buildings have been completed, and many people have moved into new houses. Through cameras of the media, the faces, once painful and melancholy after last year’s earthquake, now look confident and firm, gratifying people all over the

  3. Maxillary reconstruction

    Brown James


    Full Text Available This article aims to discuss the various defects that occur with maxillectomy with a full review of the literature and discussion of the advantages and disadvantages of the various techniques described. Reconstruction of the maxilla can be relatively simple for the standard low maxillectomy that does not involve the orbital floor (Class 2. In this situation the structure of the face is less damaged and the there are multiple reconstructive options for the restoration of the maxilla and dental alveolus. If the maxillectomy includes the orbit (Class 4 then problems involving the eye (enopthalmos, orbital dystopia, ectropion and diplopia are avoided which simplifies the reconstruction. Most controversy is associated with the maxillectomy that involves the orbital floor and dental alveolus (Class 3. A case is made for the use of the iliac crest with internal oblique as an ideal option but there are other methods, which may provide a similar result. A multidisciplinary approach to these patients is emphasised which should include a prosthodontist with a special expertise for these defects.

  4. Joint Assessment Mission provides road-map for peace

    Jon Bennett


    The Joint Assessment Mission (JAM) for Sudan has broken new ground in post-conflict planning by working with key local and international actors to develop a strategic vision for reconstruction and recovery.

  5. Joint purpose?

    Pristed Nielsen, Helene


    Starting from Crenshaw´s point that antiracism often fails to interrogate patriarchy and that feminism often reproduces racist practices (1991: 1252), this paper asks: What are the theoretical reasons for believing that feminism and anti-racism can be regarded as fighting for the joint purpose of...

  6. Afghanistan Reconstruction

    Fu Xiaoqiang


    @@ The Karzai regime has made some progress over the past four years and a half in the post-war reconstruction.However, Taliban's destruction and drug economy are still having serious impacts on the security and stability of Afghanistan.Hence the settlement of the two problems has become a crux of affecting the country' s future.Moreover, the Karzai regime is yet to handle a series of hot potatoes in the fields of central government' s authority, military and police building-up and foreign relations as well.



    A new method is put forward combining computer vision with computer aided geometric design (CAGD) to resolve the problem of free-form surface reconstruction. The surface is first subdivided into N-sided Gregory patches, and a stereo algorithm is used to reconstruct the boundary curves. Then, the cross boundary tangent vectors are computed through reflectance analysis. At last, the whole surface can be reconstructed jointing these patches with G1 continuity(tangent continuity). Examples on synthetic images are given.

  8. Estudio e intervencionismo ecoguiado de la articulación del hombro Ultrasound-assisted and interventionism study of shoulder joint

    D. Benítez Pareja


    Full Text Available El hombro doloroso es una entidad que encontramos en nuestra práctica diaria con relativa frecuencia. Con la introducción de la ultrasonografía, se abre un campo novedoso ya que podemos explorar, localizar e infiltrar exactamente la zona lesionada. La ecografía permite una exploración en la misma consulta, así como la capacidad de realizar una exploración dinámica. El hombro se compone de 5 articulaciones: 3 verdaderas (esternoclavicular, acromioclavicular y glenohumeral y 2 denominadas falsas (subacromial y escapulotorácica. Siempre que sea posible, intentaremos realizar la punción en plano, intentando visualizar el trayecto completo de la aguja y la punta de la misma. En el intervencionismo del hombro esto es bastante fácil de conseguir puesto que se trata de estructuras muy superficiales. Es muy poco probable que se produzcan daños graves durante la infiltración del hombro. Tendremos especial cuidado de no puncionar estructuras vasculares.Painful shoulder is an entity that we find in our daily practice with relative frequency. With the introduction of ultrasound, opens a new field that we can explore, locate and exactly infiltrate the injured area. Ultrasound allows an exploration in the same act, as well as the ability to make a dynamic scanning. The shoulder is made up of 5 joint: true 3 (sternoclavicular, acromioclavicular and glenohumeral and 2 known as false (subacromial and thoracic scapula. Wherever possible, we will try to puncture in plane, trying to display the full path of the needle and the tip of it. In the interventionism of the shoulder, this is quite easy to get since it's very superficial structures. It is highly unlikely any serious damage during the infiltration of the shoulder. Take special care of non piercing vascular structures.

  9. 累及骶髂关节原始神经外胚瘤的整块切除与骨盆环重建术一例报道并文献复习%En bloc resection of primitive neuroectodermal tumor involving the sacroiliac joint and reconstruction of the pelvic ring: a case report and literature review

    于秀淳; 徐明; 许宋锋; 付志厚; 袁冶


    Objective To investigate the possibility of clinical application of en bloc resection of primitive neuroectodermal tumor (PNET) involving the sacroiliac joint and reconstruction of the pelvic ring. Methods 1 female patient with PNET involving the sacroiliac joint was treated in our hospital in February 2009. She underwent 2 cycles of preoperative chemotherapy and 1 cycle of radiotherapy as the diagnosis was made by preoperative puncture. And then she received en bloc resection and reconstruction of the pelvic ring under general anesthesia. Postoperatively she accepted 10 cycles of chemotherapy. Results No recurrence and metastasis was found during the postoperative follow-up of 36 months, and she recovered to normal now. Conclusions It is particularly challenging to treat the patients with malignant bone tumors involving the sacroiliac joint because of the complicated anatomy of tumors and some other problems. However, it is possible to perform en bloc resection of tumors as long as the comprehensive methods such as preoperative chemotherapy, radiotherapy and so on are used and the therapy procedure of malignant bone tumors is strictly followed.%@@ 骶骨和骨盆环处恶性肿瘤的保肢治疗具有相当高起,局部皮温升高.L5~S3棘突左侧压痛、叩击痛的挑战性,该部位解剖毗邻关系复杂、存在重要脏阳性,无放射痛,鞍区及双下肢感觉无异常,双下器和神经血管等常使手术难以达到恶性骨肿瘤的外肢肌力V级.肛门收缩正常.左侧"4字"试验阳科边界[1] .恶性肿瘤一旦侵及骶髂关节,手术过程性,双侧膝腱、右跟腱反射正常,左侧跟腱反射消中需要将肿瘤组织包括骶髂关节一并切除,同时重失.

  10. Transverse morphology of the sacroiliac joint: effect of angulation and implications for fluoroscopically guided sacroiliac joint injection

    Ling, B.C.; Lee, J.W.; Man, H.S.J.; Grace, M.G.A.; Lambert, R.G.W. [Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, Edmonton (Canada); Jhangri, G.S. [Department of Public Health Sciences, University of Alberta Hospital, Edmonton (Canada)


    Effects of angulation of computed tomography (CT) reconstruction plane on sacroiliac (SI) joint morphology were studied, and factors influencing the approach to fluoroscopically guided SI joint injection were assessed. CT scans of pelvises were reformatted on 41 subjects, aged 51.7 ({+-}15.1) years. Transverse images were reconstructed at the caudal 3 cm of the SI joint tilting plane of reconstruction from -30 to +30 at 15 increments. Anteroposterior diameter of joint (depth), angle from sagittal plane (orientation angle), and distance from skin were measured. Joint contour was classified, and presence of bone blocking access to the joint was recorded. Comparison between angles were analysed by t-test. Relationships between variables were assessed by a Pearson correlation test. Depth was shorter with angulation in the inferior direction (P<0.01). Orientation angle increased with superior angulation (P<0.01). Distance from skin increased (P<0.01) with angulation in either direction. Joint contour was significantly different from baseline at each angle (P<0.001) but highly variable. Inferior angulation resulted in interposition of ilium between skin and SI joint, and superior angulation caused bone block due to the lower sacrum. None of these features was identified without tilting of the reconstruction plane, and effects were more pronounced with steeper angulation.

  11. Temporomandibular joint: true sagittal computed tomography with meniscus visualization

    Sartorix, D.J.; Neumann, C.H.; Riley, R.W.


    Accessory patient support equipment was constructed that allows patient positioning for true sagittal projection of the temporomandibular joint using a GE 8800 CT/T scanner. Range of motion abnormalities, osseous alterations of the mandibular condyle and temporal bone, joint-space narrowing, and meniscal configuration may be demonstrated. The technique has potential advantages over other CT projections and sagittal reconstruction for evaluation of temporomandibular joint dysfunction.

  12. Motor evoked potentials and spontaneous electromyography in reconstruction of pelvic fracture combined with sacroiliac joint dislocation%骨盆骨折合并骶髂关节脱位术中电生理监测技术的应用

    陈艺; 林志雄; 黎文; 刘琦; 严广斌; 张姝江; 余楠生


    目的 探讨骨盆骨折合并骶髂关节脱位手术中应用电生理监测技术预防神经损伤的效果.方法 对需要手术治疗的骨盆骨折合并骶髂关节脱位患者,术中对术侧采用经颅电刺激运动诱发电位(TES-MEP)和自由肌电图(EMG)进行实时监测,观察其对坐骨神经和腰5神经根医源性损伤的预防效果.结果 骶髂关节复位固定时,术侧股二头肌、胫前肌、胫后肌MEP波幅下降,但波形均能引出.耻骨复位时,MEP波形稳定.因手术操作引发趾短伸肌、胫后肌短暂、高幅EMG反应,即刻提醒术者,避免频繁,粗暴骚扰神经组织.术后骶髂关节、耻骨复位良好,且未出现医源性神经损伤.结论 联合运用MEP和自由EMG实时监测能及时反映骨盆骨折合并骶髂关节脱位切开复位内固定术中坐骨神经及L5神经根受激惹情况和运动功能状态,提高手术精确性,值得在临床推广应用.%Objective To investigate the efficacy of nerve damage prevention using electrophysiological monitoring techniques during reconstruction of pelvic fracture combined with sacroiliac joint dislocation. Methods Intraoperative real-time monitoring by motor evoked potentials with trans-cranial electrical stimulation (TES-MEP) and spontaneous electromyogram (EMG) were performed during surgical treatment for the patient of pelvic fracture combined with sacroiliac joint dislocation. The preventive effects on iatrogenic injury of sciatic nerve and L5 nerve root were observed. Results The TES-MEP volatility of biceps femoris, tibialis anterior muscle and posterior tibial muscle dropped on the surgical side when resetting sacroiliac joint, but the waveform could be elicited. The TES-MEP waveform was stable when resetting pubis. Some short, high-amplitude EMG response appeared in extensor digitorum brevis and posterior tibial muscle due to surgical operation, so that the surgeons could be immediately aware of avoiding irritation for nerve tissues

  13. 基于美学修复目的咬合重建对颞下颌关节的影响%The effects of occlusal reconstruction of esthetic prosthetic to TemporoMandibular Joint

    曹利; 越涑霞


    目的:探讨以美容为目的的固定修复治疗所形成的咬合重建对颞下颌关节可能产生的影响.方法:通过固定修复、咬合重建的方法对牙列不齐、面下1/3垂直距离较短的患者,按下颌息止颌位时的面下1/3垂直距离减去2- 3mm确定下颌位置并以此为标准进行修复治疗,使患者实现正常的面容及咬合形态,同时观察颞下颌关节(TMJ)的结构和功能的变化.结果:3例前牙超覆(牙合)、超覆盖,面下1/3垂直距离偏短的患者进行咬合重建,均恢复了正常的咬合形态,改善了咀嚼功能和容貌,同时1例伴有TMJ症状的患者TMJ症状消失.结论:对面下1/3垂直距离不足的咬合畸形患者恢复正常的咬合形态及面下1/3垂直距离,在改善容貌和咬合功能的同时,也去除了TMD的易感(occlusion)因素,对于缓解或解除TMD症状有良好的效果.%Objective To investigate the effects to the TMJ of patients who had malocclusion were treated occlusal reconstruction of esthetic prosthodontics. Methods Three patients, were crowded malalinment, Ⅱ were whole dental cross bite, Ⅲ were Angle Ⅱ malocclusion who had deep over bite,deep over jet.maxillary forward,mandibular retraction, decrease of vertical dimension and symptoms of TMD.Patients I and Ⅱ were alined teeth by fixed ceramic crowns,not changed mandibular position. Patient III were mowed mandible forward and downward according to the mandibular postural position and got occlusal reconstruction by fixed ceramic crowns. Results Three patients who had esthetic occlusal reconstruction rehabilitated normal articulation and improved masticatory movement and face.Symptoms of TMD of patient Ⅲ disappeared. Conclusion When patients of malocclusion were treated occlusal reconstruction of esthetic prosthodontics,the occlusal factors of TMD were removed and symptoms TMD eliminated.

  14. Reconstructive Urology

    Fikret Fatih Önol


    Full Text Available In the treatment of urethral stricture, Buccal Mucosa Graft (BMG and reconstruction is applied with different patch techniques. Recently often prefered, this approach is, in bulber urethra strictures of BMG’s; by “ventral onley”, in pendulous urethra because of thinner spingiosis body, which provides support and nutrition of graft; by means of “dorsal inley” being anastomosis. In the research that Cordon et al. did, they compared conventional BMJ “onley” urethroplast and “pseudo-spongioplasty” which base on periurethral vascular tissues to be nourished by closing onto graft. In repairment of front urethras that spongiosis supportive tissue is insufficient, this method is defined as peripheral dartos [çevre dartos?] and buck’s fascia being mobilized and being combined on BMG patch. Between the years 2007 and 2012, assessment of 56 patients with conventional “ventral onley” BMG urethroplast and 46 patients with “pseudo-spongioplasty” were reported to have similar success rates (80% to 84% in 3.5 year follow-up on average. While 74% of the patients that were applied pseudo-spongioplasty had disease present at distal urethra (pendulous, bulbopendulous, 82% of the patients which were applied conventional onley urethroplast had stricture at proximal (bulber urethra yet. Also lenght of the stricture at the pseudo-spongioplasty group was longer in a statistically significant way (5.8 cm to 4.7 cm on average, p=0.028. This study which Cordon et al. did, shows that conditions in which conventional sponjiyoplasti is not possible, periurethral vascular tissues are adequate to nourish BMG. Even it is an important technique in terms of bringing a new point of view to today’s practice, data especially about complications that may show up after pseudo-spongioplasty usage on long distal strictures (e.g. appearance of urethral diverticulum is not reported. Along with this we think that, providing an oppurtinity to patch directly

  15. Simultaneous Reconstruction and Segmentation with Class-Specific Priors

    Romanov, Mikhail

    for regularizing the reconstruction process. The thesis provides models and algorithms for simultaneous reconstruction and segmentation and their performance is empirically validated. Two method of simultaneous reconstruction and segmentation are described in the thesis. Also, a method for parameter selection......Studying the interior of objects using tomography often require an image segmentation, such that different material properties can be quantified. This can for example be volume or surface area. Segmentation is typically done as an image analysis step after the image has been reconstructed....... This thesis investigates computing the reconstruction and segmentation simultaneously. The advantage of this is that because the reconstruction and segmentation are computed jointly, reconstruction errors are not propagated to the segmentation step. Furthermore the segmentation procedure can be used...

  16. Maximum entropy reconstruction of joint {phi}, {psi}-distribution with a coil-library prior: the backbone conformation of the peptide hormone motilin in aqueous solution from {phi} and {psi}-dependent J-couplings

    Massad, Tariq; Jarvet, Jueri [Stockholm University, Department of Biochemistry and Biophysics (Sweden); Tanner, Risto [National Institute of Chemical Physics and Biophysics (Estonia); Tomson, Katrin; Smirnova, Julia; Palumaa, Peep [Tallinn Technical University, Inst. of Gene Technology (Estonia); Sugai, Mariko; Kohno, Toshiyuki [Mitsubishi Kagaku Institute of Life Sciences (MITILS) (Japan); Vanatalu, Kalju [Tallinn Technical University, Inst. of Gene Technology (Estonia); Damberg, Peter [Stockholm University, Department of Biochemistry and Biophysics (Sweden)], E-mail:


    In this paper, we present a new method for structure determination of flexible 'random-coil' peptides. A numerical method is described, where the experimentally measured {sup 3}J{sup H{sup N}}{sup H{sup {alpha}}} and {sup 3}J{sup H{sup {alpha}}}{sup N{sup I}+1} couplings, which depend on the {phi} and {psi} dihedral angles, are analyzed jointly with the information from a coil-library through a maximum entropy approach. The coil-library is the distribution of dihedral angles found outside the elements of the secondary structure in the high-resolution protein structures. The method results in residue specific joint {phi},{psi}-distribution functions, which are in agreement with the experimental J-couplings and minimally committal to the information in the coil-library. The 22-residue human peptide hormone motilin, uniformly {sup 15}N-labeled was studied. The {sup 3}J{sup H{sup {alpha}}}{sup N{sup I}+1} were measured from the E.COSY pattern in the sequential NOESY cross-peaks. By employing homodecoupling and an in-phase/anti-phase filter, sharp H{sup {alpha}}-resonances (about 5 Hz) were obtained enabling accurate determination of the coupling with minimal spectral overlap. Clear trends in the resulting {phi},{psi}-distribution functions along the sequence are observed, with a nascent helical structure in the central part of the peptide and more extended conformations of the receptor binding N-terminus as the most prominent characteristics. From the {phi},{psi}-distribution functions, the contribution from each residue to the thermodynamic entropy, i.e., the segmental entropies, are calculated and compared to segmental entropies estimated from {sup 15}N-relaxation data. Remarkable agreement between the relaxation and J-couplings based methods is found. Residues belonging to the nascent helix and the C-terminus show segmental entropies, of approximately -20 J K{sup -1} mol{sup -1} and -12 J K{sup -1} mol{sup -1}, respectively, in both series. The agreement

  17. Maximum entropy reconstruction of joint phi, psi-distribution with a coil-library prior: the backbone conformation of the peptide hormone motilin in aqueous solution from phi and psi-dependent J-couplings.

    Massad, Tariq; Jarvet, Jüri; Tanner, Risto; Tomson, Katrin; Smirnova, Julia; Palumaa, Peep; Sugai, Mariko; Kohno, Toshiyuki; Vanatalu, Kalju; Damberg, Peter


    In this paper, we present a new method for structure determination of flexible "random-coil" peptides. A numerical method is described, where the experimentally measured 3J(H(alpha)Nalpha) and [3J(H(alpha)Nalpha+1 couplings, which depend on the phi and psi dihedral angles, are analyzed jointly with the information from a coil-library through a maximum entropy approach. The coil-library is the distribution of dihedral angles found outside the elements of the secondary structure in the high-resolution protein structures. The method results in residue specific joint phi,psi-distribution functions, which are in agreement with the experimental J-couplings and minimally committal to the information in the coil-library. The 22-residue human peptide hormone motilin, uniformly 15N-labeled was studied. The 3J(H(alpha)-N(i+1)) were measured from the E.COSY pattern in the sequential NOESY cross-peaks. By employing homodecoupling and an in-phase/anti-phase filter, sharp H(alpha)-resonances (about 5 Hz) were obtained enabling accurate determination of the coupling with minimal spectral overlap. Clear trends in the resulting phi,psi-distribution functions along the sequence are observed, with a nascent helical structure in the central part of the peptide and more extended conformations of the receptor binding N-terminus as the most prominent characteristics. From the phi,psi-distribution functions, the contribution from each residue to the thermodynamic entropy, i.e., the segmental entropies, are calculated and compared to segmental entropies estimated from 15N-relaxation data. Remarkable agreement between the relaxation and J-couplings based methods is found. Residues belonging to the nascent helix and the C-terminus show segmental entropies, of approximately -20 J K(-1) mol(-1) and -12 J K(-1) mol(-1), respectively, in both series. The agreement between the two estimates of the segmental entropy, the agreement with the observed J-couplings, the agreement with the CD experiments

  18. Arthrodesis for osteoarthritis of the manubriosternal joint.

    Al-Dahiri, Ahmed; Pallister, Ian


    Osteoarthritis of the manubriosternal joint is rare. The diagnosis is not easy to make, and more serious causes of chest pain have to be ruled out first. We report one case that was treated with arthrodesis of the manubriosternal joint using double locking screw compression plating (LCP) with excellent results. Pre-operative CT-scan images with 3D reconstruction were used to measure the screw length and the drill stop depth. In this case report, we have shown that arthrodesis can be an effective way of treating osteoarthritis of the manubriosternal joint, when other measures fail. Furthermore, the use of a locking compression plate with appropriate and careful pre-operative planning affords a safe surgical technique, rapid pain relief and ultimately sound and asymptomatic union of the joint.

  19. Reliability of Tubular Joints

    Sørensen, John Dalsgaard; Thoft-Christensen, Palle

    In this paper the preliminary results obtained by tests on tubular joints are presented. The joints are T-joints and the loading is static. It is the intention in continuation of these tests to perform tests on other types of joints (e.g. Y-joints) and also with dynamic loading. The purpose...... of the test is partly to obtain empirical data for the ultimate load-carrying capacity of tubular T-joints and partly to obtain some experience in performing tests with tubular joints. It is well known that tubular joints are usually designed in offshore engineering on the basis of empirical formulas obtained...

  20. Spacesuit mobility knee joints

    Vykukal, H. C. (Inventor)


    Pressure suit mobility joints are for use in interconnecting adjacent segments of an hermetically sealed spacesuit in which low torques, low leakage and a high degree of reliability are required. Each of the joints is a special purpose joint characterized by substantially constant volume and low torque characteristics and includes linkages which restrain the joint from longitudinal distension and includes a flexible, substantially impermeable diaphragm of tubular configuration spanning the distance between pivotally supported annuli. The diaphragms of selected joints include rolling convolutions for balancing the joints, while various joints include wedge-shaped sections which enhance the range of motion for the joints.

  1. Neuromagnetic source reconstruction

    Lewis, P.S.; Mosher, J.C. [Los Alamos National Lab., NM (United States); Leahy, R.M. [University of Southern California, Los Angeles, CA (United States)


    In neuromagnetic source reconstruction, a functional map of neural activity is constructed from noninvasive magnetoencephalographic (MEG) measurements. The overall reconstruction problem is under-determined, so some form of source modeling must be applied. We review the two main classes of reconstruction techniques-parametric current dipole models and nonparametric distributed source reconstructions. Current dipole reconstructions use a physically plausible source model, but are limited to cases in which the neural currents are expected to be highly sparse and localized. Distributed source reconstructions can be applied to a wider variety of cases, but must incorporate an implicit source, model in order to arrive at a single reconstruction. We examine distributed source reconstruction in a Bayesian framework to highlight the implicit nonphysical Gaussian assumptions of minimum norm based reconstruction algorithms. We conclude with a brief discussion of alternative non-Gaussian approachs.

  2. International joint ventures

    Sørensen, Karsten Engsig


    The article analysis problems connected with corporate joint ventures. Among others the possible conflicts between the joint venture agreement and the statutes of the companies is examined, as well as certain problems connected to the fact that the joint venture partners have created commen control...... over their joint company....

  3. Motion Estimated-Compensated Reconstruction with Preserved-Features in Free-Breathing Cardiac MRI

    Bustin, Aurelien; Janich, Martin A; Burschka, Darius; Felblinger, Jacques; Brau, Anja C S; Odille, Freddy


    To develop an efficient motion-compensated reconstruction technique for free-breathing cardiac magnetic resonance imaging (MRI) that allows high-quality images to be reconstructed from multiple undersampled single-shot acquisitions. The proposed method is a joint image reconstruction and motion correction method consisting of several steps, including a non-rigid motion extraction and a motion-compensated reconstruction. The reconstruction includes a denoising with the Beltrami regularization, which offers an ideal compromise between feature preservation and staircasing reduction. Results were assessed in simulation, phantom and volunteer experiments. The proposed joint image reconstruction and motion correction method exhibits visible quality improvement over previous methods while reconstructing sharper edges. Moreover, when the acceleration factor increases, standard methods show blurry results while the proposed method preserves image quality. The method was applied to free-breathing single-shot cardiac MR...

  4. 膝关节交叉韧带修复重建治疗中的康复干预%Rehabilitative intervention in the reconstruction of knee joint cruciate ligament

    李棋; 李箭


    目的:随着关节镜在膝关节交叉韧带修复重建治疗中的运用,术后效果有了显著的提高.但是,重建术后膝关节完全固定或者是限制其活动和肌肉收缩,会导致关节囊和关节周围韧带的挛缩,肌肉萎缩,以及关节软骨的退行性变化,影响术后功能的恢复.资料来源:应用计算机检索Medline 1980-01/2004-03文章,检索词为 "anterior cruciate ligament, posterior cruciate ligament, reconstruction, re-habilitation",限定文章语言种类为English;同时检索 1994-01/2004-03文章,检索词为"前交叉韧带,后交叉韧带,重建,康复",限定文章语言种类为中文.资料选择:对资料进行初审,选取包括膝关节交叉韧带重建术前、术后康复训练有关的文献.纳入条件:①随机或自身对照的临床研究.②调查研究.③有明确的康复程序.④结论明确.排除条件:①重复的统一研究.②综述文献.资料提炼:共收集到42篇关于膝关节交叉韧带修复重建术康复干预的文章,选择其中符合标准的23篇进行综述.资料综合:分别对交叉韧带愈合的生物力学、不同移植物术前、术后的不同康复程序对康复结果的影响等方面作了讨论.①采用髌腱骨-髌腱中1/3-骨重建前交叉韧带术后的康复:有研究分别采用开链运动和闭链运动的康复程序比较其效果,随访1年后,使用KT-1000关节测量仪测量结果显示:与开链运动组相比,闭链运动组的膝关节前后向松弛度更接近正常.②采用腘绳肌肌腱重建前交叉韧带术后的康复:将62例术后患者随机分成两组,分别采取保守和激进的康复程序进行康复.结果激进的康复能使肌力得到较快的恢复,但存在着增加滑膜炎的发病率的问题;9个月以后两组肌力评定没有显著差异.③后交叉韧带重建术后的康复:对21名采用腘绳肌肌腱重建后交叉韧带的患者进行

  5. Breast reconstruction after mastectomy

    Daniel eSchmauss


    Full Text Available Breast cancer is the leading cause of cancer death in women worldwide. Its surgical approach has become less and less mutilating in the last decades. However, the overall number of breast reconstructions has significantly increased lately. Nowadays breast reconstruction should be individualized at its best, first of all taking into consideration oncological aspects of the tumor, neo-/adjuvant treatment and genetic predisposition, but also its timing (immediate versus delayed breast reconstruction, as well as the patient’s condition and wish. This article gives an overview over the various possibilities of breast reconstruction, including implant- and expander-based reconstruction, flap-based reconstruction (vascularized autologous tissue, the combination of implant and flap, reconstruction using non-vascularized autologous fat, as well as refinement surgery after breast reconstruction.

  6. Core Stabilization Training After Anterior Cruciate Ligament Reconstruction

    Medeni, Özge Çınar; Bayramlar, Kezban; Baltacı, Gül; Yanmış, İbrahim


    Objectives: The aim of this study was to compare the effects of core stabilization exercises and conventional rehabilitation exercises after anterior cruciate ligament reconstruction in terms of knee joint laxity, knee muscle strength, postural stability and functional tests. Methods: Twenty eight patients reconstructed with hamstring tendon were included. Thirteen patients evaluated after a conventional rehabilitation and fifteen after a core stabilization programme. Single-limb postural sta...

  7. Reoperative midface reconstruction.

    Acero, Julio; García, Eloy


    Reoperative reconstruction of the midface is a challenging issue because of the complexity of this region and the severity of the aesthetic and functional sequela related to the absence or failure of a primary reconstruction. The different situations that can lead to the indication of a reoperative reconstructive procedure after previous oncologic ablative procedures in the midface are reviewed. Surgical techniques, anatomic problems, and limitations affecting the reoperative reconstruction in this region of the head and neck are discussed.

  8. Clinical observation on reconstructing the anterior and posterior cruciate ligaments of knee joint with allograft-tendon by arthroscopy%关节镜下同种异体肌腱重建膝关节前后交叉韧带的临床观察

    阳波; 谭雄进


    目的:比较关节镜下同种异体肌腱移植和自体肌腱移植重建膝关节前后交叉韧带的临床效果。方法将130例膝关节前后交叉韧带断裂的患者按手术方式的不同分为2组,观察组采用同种异体肌腱移植,对照组采用自体肌腱移植,观察患者临床疗效。结果观察组手术时间明显少于对照组(P0.05);2组患者术后Lysholm及Tengner评分均明显高于术前,2组差异有统计学意义(P0.05)。结论同种异体与自体肌腱重建ACL及PCL的疗效相近,是重建ACL及PCL良好的移植物。%Objective To compare the clinical effect of reconstructing the anterior and posterior cruciate ligaments of knee joint with al-lografttendon and autogenous tendon transplantation. Methods 130 patients with anterior and posterior cruciate ligaments of knee fractured were randomly divided into two groups:the observation group were given allogeneic tendon transplantation while the control group were autol-ogous tendon transplantation. Observed the clinical efficacy of the two groups. Results The operation time of the observation group was ob-viously less than control group(P0. 05);the Lysholm and Tengner score of the two groups were significantly higher compared with the preoperative scores with a statistically significant difference (P0. 05). Conclusion Allogeneic tendon transplantation has similar curative effect with autologous tendon transplantation, both of them are good transplantation material for anterior and posterior cruciate ligaments reconstruction.

  9. Surfaces, Digitisations and Reconstructions


    We present a new digital reconstruction of r-regular sets in three-dimensional Euclidean space. We introduce a vector field and analyse the relation between the topologies of the boundaries of the r-regular set and its reconstruction. This reconstruction can be carried out faster than prior models...

  10. Concomitant treatment of mandibular ameloblastoma and bilateral temporomandibular joint osteoarthritis with bone graft and total joint prostheses.

    Rodrigues, Daniel B; Wolford, Larry M; Malaquias, Pietry; Campos, Paulo S F


    Temporomandibular joint (TMJ) osteoarthritis is a degenerative disease that can create clinical problems in the masticatory musculature, jaws, occlusion, and other associated structures and is commonly accompanied by inflammatory changes and pain. Many cases of TMJ dysfunction can be managed with nonsurgical therapies, but patients with irreversible TMJ damage may require surgical intervention for repair or reconstruction. Despite various methods of TMJ reconstruction, the patient-fitted total joint prostheses may be the best option to achieve good outcomes. Multicystic ameloblastoma is a benign odontogenic neoplasm of the jaws that is found most often in the mandible, in the region of the molars, and the ramus. Ameloblastomas usually progress slowly, but are locally invasive and may cause significant morbidity and sometimes death. This report describes a case of concomitant treatment of recurrent mandibular ameloblastoma and severe bilateral TMJ osteoarthritis treated by resection of the tumor, reconstruction with bone grafting, and bilateral TMJ reconstruction in a 63-year-old woman.

  11. Should I Have Breast Reconstruction?

    ... Reconstruction Surgery Breast Cancer Breast Reconstruction Surgery Should I Get Breast Reconstruction Surgery? Women who have surgery ... It usually responds well to treatment. What if I choose not to have breast reconstruction? Many women ...

  12. Parametric modelling of a knee joint prosthesis.

    Khoo, L P; Goh, J C; Chow, S L


    This paper presents an approach for the establishment of a parametric model of knee joint prosthesis. Four different sizes of a commercial prosthesis are used as an example in the study. A reverse engineering technique was employed to reconstruct the prosthesis on CATIA, a CAD (computer aided design) system. Parametric models were established as a result of the analysis. Using the parametric model established and the knee data obtained from a clinical study on 21 pairs of cadaveric Asian knees, the development of a prototype prosthesis that suits a patient with a very small knee joint is presented. However, it was found that modification to certain parameters may be inevitable due to the uniqueness of the Asian knee. An avenue for rapid modelling and eventually economical production of a customized knee joint prosthesis for patients is proposed and discussed.

  13. Modeling of Human Joint Structures.


    Radial Lateral " epicondyle Olecranon Radius Ulna Figure 3. Lateral aspect of the right elbow joint. -17- Annular Ligament This strong band encircles... elbow joint, knee joint, human joints, shoulder joint, ankle joint, joint models, hip joint, ligaments. 20. ABSTRACT (Continue on reverse side If...ligaments. -A rather extended discussion of the articulations and anatomical descriptions of the elbow , shoulder, hip, knee and ankle joints are

  14. [Breast reconstruction after mastectomy].

    Ho Quoc, C; Delay, E


    The mutilating surgery for breast cancer causes deep somatic and psychological sequelae. Breast reconstruction can mitigate these effects and permit the patient to help rebuild their lives. The purpose of this paper is to focus on breast reconstruction techniques and on factors involved in breast reconstruction. The methods of breast reconstruction are presented: objectives, indications, different techniques, operative risks, and long-term monitoring. Many different techniques can now allow breast reconstruction in most patients. Clinical cases are also presented in order to understand the results we expect from a breast reconstruction. Breast reconstruction provides many benefits for patients in terms of rehabilitation, wellness, and quality of life. In our mind, breast reconstruction should be considered more as an opportunity and a positive choice (the patient can decide to do it), than as an obligation (that the patient would suffer). The consultation with the surgeon who will perform the reconstruction is an important step to give all necessary informations. It is really important that the patient could speak again with him before undergoing reconstruction, if she has any doubt. The quality of information given by medical doctors is essential to the success of psychological intervention. This article was written in a simple, and understandable way to help gynecologists giving the best information to their patients. It is maybe also possible to let them a copy of this article, which would enable them to have a written support and would facilitate future consultation with the surgeon who will perform the reconstruction.

  15. Clinical effect of reconstruction of posterolateral hip joint capsule and external rotator muscles in total hip arthroplasty%全髋关节置换术中重建关节囊及外旋肌群的临床疗效

    刘子璇; 张欣; 章云童; 王攀峰; 汤洋; 张春才


    Objective To study the efficacy and complications of total hip arthroplasty (THA) with rivet system for reconstruction of joint capsule and external rotator muscles.Methods Data of 170 patients managed with THA of femoral neck fracture between January 2009 and January 2012 were reviewed retrospectively.Hip fracture was the result of a fall and all were subcapital fractures.The fracture patterns were classified as Garden Ⅳ in 139 patients and Garden Ⅱ in 31 patients according to the degree of displacement.In all,85 patients (37 males and 48 females;age between 61 and 84 years,mean 73 years) underwent joint capsule as well as external rotator muscle reconstruction by rivet system (study group).The remaining 85 patients (36 males and 49 females;age between 64-87 years,mean 74 years) were served as control group.The MOS 36-item short form health survey (SF-36),dislocation rate and complications were evaluated at postoperative follow-up.Results Duration of follow-up was 36 to 60 months (mean,46 months).SF-36 questionnaire scale was (45.95 ±4.27)points in study group and (45.38 ± 4.67) points in control group before operation (P > 0.05),while (83.67 ± 3.93) points in study group and (82.16 ± 3.21) points in control group at postoperative follow-up (P < 0.05).Six patients in control group suffered from early prosthetic dislocation,but none in study control.Perioperative incidence of complications was comparable between the two groups (P >0.05).Conclusions Application of rivet system for reconstruction of joint capsule and external rotator muscles in THA of patients with femoral neck fracture can reduce incidence of prosthetic dislocation after operation.The operation is simple and will not increase the rate of perioperative complications.%目的 探讨全髋关节置换术(THA)中应用铆钉重建关节囊及外旋肌群的临床疗效及并发症. 方法 回顾性分析2009年1月—2012年1月因股骨颈骨折接受THA的患者170例,致伤原因均为

  16. Culture - joint fluid

    Joint fluid culture ... fungi, or viruses grow. This is called a culture. If these germs are detected, other tests may ... is no special preparation needed for the lab culture. How to prepare for the removal of joint ...

  17. Sacroiliac joint pain - aftercare

    ... this page: // Sacroiliac joint pain - aftercare To use the sharing features on this page, please enable JavaScript. The sacroiliac joint (SIJ) is a term used to describe the ...

  18. Knee joint replacement - slideshow

    ... this page: // Knee joint replacement - series—Normal anatomy To use the ... to slide 4 out of 4 Overview The knee is a complex joint. It contains the distal ...

  19. 关节镜辅助下大收肌肌腱转位重建内侧髌股韧带在年龄18岁以下青少年髌股关节不稳治疗中的应用%Application of adductor magnus tendon transposition with arthroscopic in reconstruction medial patellofemoral ligament for the treatment of patellofemoral joint instability of adolescents age less than 18 years old

    杨红梅; 公伟; 邵川强; 陈长春; 张锦


    Objective To investigate the clinical effect of adductor magnus tendon transposition with arthroscopic in reconstruction medial patellofemoral ligament (MPFL) for the treatment of patellofemoral joint instability of adolescents. Methods Eighteen juvenile patients (21 knees) with patellofemoral joint instability (including chronic patellar dislocation and recurrent patellar dislocation) were treated with adductor magnus tendon transposition for MPFL reconstruction, combined with lateral patellofemoral ligament release. They were followed up for 12- 30 months. The complications, patellofemoral angles and Lysholm scores before and after operation were recorded and compared. Results There was no complications such as wound infection, redislocation, patellofemoral joint instability and epiphyses injured. All patients got excellent knee flexion and extension function. Patella fear tests were all negative. The patellofemoral angles and Lysholm scores after operation were improved significantly than those before operation:(10.3 ± 4.1)° vs. (-3.8 ± 4.9)°, (92.7 ± 3.6) scores vs. (61.5 ±2.4) scores, P<0.01. Conclusions Adductor magnus tendon transposition with arthroscopic in reconstruction MPFL can significantly improve the stability of patellofemoral joints. This is one of the effective methods for the treatment of patellofemoral joint instability of adolescents.%目的:探讨大收肌肌腱转位重建内侧髌股韧带(MPFL)治疗青少年髌股关节不稳的临床效果。方法18例(21膝)青少年髌股关节不稳(包括习惯性髌骨脱位和复发性髌骨脱位)患者,在关节镜辅助下行外侧支持带松解,保留股骨大收肌止点的大收肌肌腱转位重建MPFL。随访12~30个月,记录并发症,比较术前、术后髌股外侧角、Lysholm膝关节功能综合评分。结果18例术后均无切口感染,无再脱位,髌骨稳定性良好,无骨骺损伤,膝关节屈伸功能良好。髌骨恐惧试验均阴

  20. Towards joint reconstruction of noise and losses in quantum channels

    Piacentini, F; Traina, P; Lolli, L; Taralli, E; Monticone, E; Rajteri, M; Fukuda, D; Degiovanni, I P; Brida, G


    The calibration of a quantum channel, i.e. the determination of the transmission losses affecting it, is definitely one of the principal objectives in both the quantum communication and quantum metrology frameworks. Another task of the utmost relevance is the identification, e.g. by extracting its photon number distribution, of the noise potentially present in the channel. Here we present a protocol, based on the response of a photon-number-resolving detector at different quantum efficiencies, able to accomplish both of these tasks at once, providing with a single measurement an estimate of the transmission losses as well as the photon statistics of the noise present in the exploited quantum channel. We show and discuss the experimental results obtained in the practical implementation of such protocol, with different kinds and levels of noise.

  1. Cosmic Tidal Reconstruction

    Zhu, Hong-Ming; Yu, Yu; Er, Xinzhong; Chen, Xuelei


    The gravitational coupling of a long wavelength tidal field with small scale density fluctuations leads to anisotropic distortions of the locally measured small scale matter correlation function. Since the local correlation function is statistically isotropic in the absence of such tidal interactions, the tidal distortions can be used to reconstruct the long wavelength tidal field and large scale density field in analogy with the cosmic microwave background lensing reconstruction. In this paper we present in detail a formalism for the cosmic tidal reconstruction and test the reconstruction in numerical simulations. We find that the density field on large scales can be reconstructed with good accuracy and the cross correlation coefficient between the reconstructed density field and the original density field is greater than 0.9 on large scales ($k\\lesssim0.1h/\\mathrm{Mpc}$). This is useful in the 21cm intensity mapping survey, where the long wavelength radial modes are lost due to foreground subtraction proces...

  2. Ptychographic ultrafast pulse reconstruction

    Spangenberg, D; Brügmann, M H; Feurer, T


    We demonstrate a new ultrafast pulse reconstruction modality which is somewhat reminiscent of frequency resolved optical gating but uses a modified setup and a conceptually different reconstruction algorithm that is derived from ptychography. Even though it is a second order correlation scheme it shows no time ambiguity. Moreover, the number of spectra to record is considerably smaller than in most other related schemes which, together with a robust algorithm, leads to extremely fast convergence of the reconstruction.

  3. Application of CT 3D reconstruction in diagnosing atlantoaxial subluxation

    段少银; 林清池; 庞瑞麟


    Objective:To evaluate and compare the diagnostic value in atlantoaxial subluxation by CT three-dimensional (3D) reconstruction.Methods:3D reconstruction fimdings of 41 patients with atlantoaxiai subluxation were retrospectively analyzed, and comparisons were made among images of transverse section, multiplanar reformorting (MPR), surface shade display (SSD), maximum intensity project (MIP), and volume rendering (VR). Results:Of 41 patients with atlantoaxial subluxation, 31 belonged to rotary dislocation, 5 antedislocation, and 5 hind dislocation. All the cases showed the dislocated joint panel of atlantoaxial articulation.Fifteen cases showed deviation of the odontoid process and 8 cases widened distance between the dens and anterior arch of the atlas. The dislocated joint panel of atlantoaxial articulation was more clearly seen with SSD-3D imaging than any other methods. Conclusions:Atlantoaxial subluxation can well be diagnosed by CT 3D reconstruction, in which SSD-3D imaging is optimal.

  4. Recent Advances in Computational Mechanics of the Human Knee Joint

    M. Kazemi


    Full Text Available Computational mechanics has been advanced in every area of orthopedic biomechanics. The objective of this paper is to provide a general review of the computational models used in the analysis of the mechanical function of the knee joint in different loading and pathological conditions. Major review articles published in related areas are summarized first. The constitutive models for soft tissues of the knee are briefly discussed to facilitate understanding the joint modeling. A detailed review of the tibiofemoral joint models is presented thereafter. The geometry reconstruction procedures as well as some critical issues in finite element modeling are also discussed. Computational modeling can be a reliable and effective method for the study of mechanical behavior of the knee joint, if the model is constructed correctly. Single-phase material models have been used to predict the instantaneous load response for the healthy knees and repaired joints, such as total and partial meniscectomies, ACL and PCL reconstructions, and joint replacements. Recently, poromechanical models accounting for fluid pressurization in soft tissues have been proposed to study the viscoelastic response of the healthy and impaired knee joints. While the constitutive modeling has been considerably advanced at the tissue level, many challenges still exist in applying a good material model to three-dimensional joint simulations. A complete model validation at the joint level seems impossible presently, because only simple data can be obtained experimentally. Therefore, model validation may be concentrated on the constitutive laws using multiple mechanical tests of the tissues. Extensive model verifications at the joint level are still crucial for the accuracy of the modeling.

  5. Recent advances in computational mechanics of the human knee joint.

    Kazemi, M; Dabiri, Y; Li, L P


    Computational mechanics has been advanced in every area of orthopedic biomechanics. The objective of this paper is to provide a general review of the computational models used in the analysis of the mechanical function of the knee joint in different loading and pathological conditions. Major review articles published in related areas are summarized first. The constitutive models for soft tissues of the knee are briefly discussed to facilitate understanding the joint modeling. A detailed review of the tibiofemoral joint models is presented thereafter. The geometry reconstruction procedures as well as some critical issues in finite element modeling are also discussed. Computational modeling can be a reliable and effective method for the study of mechanical behavior of the knee joint, if the model is constructed correctly. Single-phase material models have been used to predict the instantaneous load response for the healthy knees and repaired joints, such as total and partial meniscectomies, ACL and PCL reconstructions, and joint replacements. Recently, poromechanical models accounting for fluid pressurization in soft tissues have been proposed to study the viscoelastic response of the healthy and impaired knee joints. While the constitutive modeling has been considerably advanced at the tissue level, many challenges still exist in applying a good material model to three-dimensional joint simulations. A complete model validation at the joint level seems impossible presently, because only simple data can be obtained experimentally. Therefore, model validation may be concentrated on the constitutive laws using multiple mechanical tests of the tissues. Extensive model verifications at the joint level are still crucial for the accuracy of the modeling.




    Full Text Available BACKGROUND The knee joint is the most commonly injured of all joints and the ACL is the most commonly injured ligament. Arthroscopic reconstruction of ACL has become gold standard in treating these injuries. AIM 1. To compare the short-term results of ACL reconstruction using single bundle (one Tibial + one Femoral tunnel and non-anatomical double-bundle (one Tibial + two Femoral tunnels techniques using Hamstrings (Semitendinosus ± Gracilis graft. 2. To evaluate ACL graft reconstruction stability measured by laxometry and to find out an association with clinical findings. MATERIAL & METHODS We performed a prospective study between 2014-2015 of 20 case of ACL injuries & compared single bundle reconstruction with Non – anatomical double Bundle reconstruction with semitendinosus ± Gracilis, Autograft using laxometry. CONCLUSION Arthroscopic Non-anatomical double ACL Reconstruction is Bio-mechanically stable reconstruction resembling anatomy of the ACL.

  7. Delayed breast implant reconstruction

    Hvilsom, Gitte B.; Hölmich, Lisbet R.; Steding-Jessen, Marianne;


    We evaluated the association between radiation therapy and severe capsular contracture or reoperation after 717 delayed breast implant reconstruction procedures (288 1- and 429 2-stage procedures) identified in the prospective database of the Danish Registry for Plastic Surgery of the Breast during...... reconstruction approaches other than implants should be seriously considered among women who have received radiation therapy....

  8. Managing Joint Production Motivation

    Lindenberg, Siegwart; Foss, Nicolai Juul


    We contribute to the microfoundations of organizational performance by proffering the construct of joint production motivation. Under such motivational conditions individuals see themselves as part of a joint endeavor, each with his or her own roles and responsibilities; generate shared represent...... representations of actions and tasks; cognitively coordinate cooperation; and choose their own behaviors in terms of joint goals. Using goal-framing theory, we explain how motivation for joint production can be managed by cognitive/symbolic management and organizational design.......We contribute to the microfoundations of organizational performance by proffering the construct of joint production motivation. Under such motivational conditions individuals see themselves as part of a joint endeavor, each with his or her own roles and responsibilities; generate shared...

  9. Vascularized composite tissue part transfer for central hand defect reconstruction. Case report

    Billig, Jessica; Johnson, Shepard P.; Ogawa, Takeshi; Chung, Kevin C.


    Injuries to the hand with loss of joints, tendons, nerves, and soft tissue may require complex, innovative reconstructive techniques to achieve a favorable functional and aesthetic outcome. We present a case of a manual laborer who sustained a multifaceted injury from a metal press machine with loss of composite structures including the long and ring finger metacarpophalangeal joints, flexor and extensor tendons, digital nerves, and dorsal/volar soft tissues. Reconstruction included using the spare parts technique for transferring his ring finger proximal interphalangeal joint as a pedicle to reconstitute the missing metacarpophalangeal joint of his long finger. The soft tissue from the ring finger was rearranged to provide aesthetic coverage of the hand with like-to-like reconstruction of the glabrous and non-glabrous skin. PMID:26710738

  10. Anterior cruciate ligament reconstruction with allograft tendons.

    Strickland, Sabrina M; MacGillivray, John D; Warren, Russell F


    Allograft tissue allows reconstruction of the ACL without the donor site morbidity that can be caused by autograft harvesting. Patients who must kneel as a part of their occupation or chosen sport are particularly good candidates for allograft reconstruction. Patients over 45 years of age and those requiring revision ACL surgery can also benefit from the use and availability of allograft tendons. In some cases, patients or surgeons may opt for allograft tendons to maximize the result or morbidity ratio. Despite advances in cadaver screening and graft preparation, there remain risks of disease transmission and joint infection after allograft implantation. Detailed explanation and informed consent is vitally important in cases in which allograft tissue is used.

  11. Medial plica after reconstruction of anterior cruciate ligament

    YIN Yu; WANG Jian-quan; HE Zhen-ming


    Background The medial plica may be caused by direct trauma or joint degeneration,which also could be iatrogenic.There have been few reports in the literature discussing incidence of the medial plica caused by an operation on the knee joint,specifically after the reconstruction of anterior cruciate ligament (ACL).In this study,we aimed to evaluate and analyze the relationship between the incidence of the medial plica and reconstruction of the ACL.Methods A retrospective case series study was conducted to review the findings of 1085 patients between 2003 and 2007,who underwent second-look arthroscopy after reconstruction of the ACL (between 2002 and 2006).The correlation of the incidence of medial plica with the stability of the knee joint,the time from onset of injury to reconstruction surgery,the associated injuries,and the rate of progress during postoperative rehabilitation were analyzed.Results We found that 722 patients had the structure of a medial plica.The incidence after reconstruction of the anterior cruciate ligament (66.5%) was significantly higher than usually reported.All these medial plica had avascular fibrotic and thickened edges.An excision of pathologic medial plica and fat pad synovial fringes were done.The incidences were significantly different between the two groups with their reconstruction operation time,from onset of injury to surgery (less than one month or over 2 years),and the progress rate of postoperative rehabilitation (knee flexion could not be over 90° in four weeks).The incidence was not different between the groups with knee stable conditions.Conclusions Medial plica is more common in patients after reconstruction of ACL.More associated injuries and more rehabilitation difficulties can increase the medial plica incidence.

  12. Jointly Poisson processes

    Johnson, D H


    What constitutes jointly Poisson processes remains an unresolved issue. This report reviews the current state of the theory and indicates how the accepted but unproven model equals that resulting from the small time-interval limit of jointly Bernoulli processes. One intriguing consequence of these models is that jointly Poisson processes can only be positively correlated as measured by the correlation coefficient defined by cumulants of the probability generating functional.

  13. Joint Program Management Handbook


    the Engieermg and Manufacuring Devopment Phase. Nfilestoae HI- Develommen Annros Devopment approval marks a significant step for any program, but it review concept formulaton. Systems Engilneertn As with service programs, systems engineering in joint program management is an essential tool . I...MANAGEMENT HANDBOOK On=e wd Umawtaiutt As discussed in Chapter 7, systems analysis of relationships is a usef tool for joint program managers. The joint

  14. 局部修复和(或)异体肌腱重建治疗急性膝关节后外侧复合结构损伤%Local suture repair and(or)allograft tendon reconstruction for acute posterolateral complex injuries of the knee joint

    高石军; 李彤; 陆博; 邵德成; 陈竞青; 王建朝


    Objective To evaluate the surgical treatment of the acute posterolateral complex(PLC)injuries of knee joint and then observe the clinical outcome.Methods Twelve cases(12 knees)of acute PLC injuries were treated from May 2006 to October 2008.Patients' age ranged from 23 to 47 years old,average 31 years.There were 9 males and 3 females.Rebuild the anterior cruciate ligament(ACL)and posterior cruciate ligament(PCL)under arthroscope and then,locally suture the PLC injuries sites on those patients with PLC avulsion fraction.If there is PLC rupture,then locally suture the injury sites plus PLC reconstruction.Knee functions were evaluated by IKDC and Lysholm score.Results All patients were followed up for 12-18 months(mean,13.3 months).The preoperative range of motion was 118.00°±6.77°,which was 130.75°±3.05° after surgery.KT-1000 arthrometer measurement showed that the average posterior translation improved from(14.85+1.83)mm preoperatively to(4.18±1.88)mm postoperatively.Seven cases were normal(A grade),3 cases were nearly normal(B grade),1 abnormal(C grade),and 1 severely abnormal(D grade)according to IKDC standard.The preoperative Lysholm joint function score was 35-44,average 38.83 ±3.16,which was 79-91,average 84.92±3.73 after surgery.Conclusion To those acute PLC injuries with avulsion at the ligament extremities,locally suture should be taken.But for those with PLC rupture at the mid part of ligament,locally suture the injury sites plus PLC reconstruction helps get satisfactory outcome.%目的 探讨采用局部修复和(或)异体肌腱重建治疗急性膝关节后外侧复合结构(posterolateral complex,PLC)损伤的方法及疗效.方法 2006年5月至2008年10月,收治急性PLC损伤患者12例,男9例,女3例;年龄23~47岁,平均31岁;合并后十字韧带损伤9例,合并前、后十字韧带同时损伤3例.首先在关节镜下采用异体肌腱解剖重建前、后十字韧带,然后对于PLC两端附着点撕脱损伤的患者采用铆钉

  15. Mechanics of Sheeting Joints

    Martel, S. J.


    Physical breakdown of rock across a broad scale spectrum involves fracturing. In many areas large fractures develop near the topographic surface, with sheeting joints being among the most impressive. Sheeting joints share many geometric, textural, and kinematic features with other joints (opening-mode fractures) but differ in that they are (a) discernibly curved, (b) open near the topographic surface, and (c) form subparallel to the topographic surface. Where sheeting joints are geologically young, the surface-parallel compressive stresses are typically several MPa or greater. Sheeting joints are best developed beneath domes, ridges, and saddles; they also are reported, albeit rarely, beneath valleys or bowls. A mechanism that accounts for all these associations has been sought for more than a century: neither erosion of overburden nor high lateral compressive stresses alone suffices. Sheeting joints are not accounted for by Mohr-Coulomb shear failure criteria. Principles of linear elastic fracture mechanics, together with the mechanical effect of a curved topographic surface, do provide a basis for understanding sheeting joint growth and the pattern sheeting joints form. Compressive stresses parallel to a singly or doubly convex topographic surface induce a tensile stress perpendicular to the surface at shallow depths; in some cases this alone could overcome the weight of overburden to open sheeting joints. If regional horizontal compressive stresses, augmented by thermal stresses, are an order of magnitude or so greater than a characteristic vertical stress that scales with topographic amplitude, then topographic stress perturbations can cause sheeting joints to open near the top of a ridge. This topographic effect can be augmented by pressure within sheeting joints arising from water, ice, or salt. Water pressure could be particularly important in helping drive sheeting joints downslope beneath valleys. Once sheeting joints have formed, the rock sheets between

  16. Computer-assisted anterior cruciate ligament reconstruction. Four generations of development and usage.

    Klos, Tiburtius V S


    The purpose of this paper is to review the literature about the contribution of navigation in anterior cruciate ligament (ACL) reconstruction. The evolution of computer-assisted surgery (CAS) for ACL reconstruction has undergone several steps. These steps were divided into 4 subsequent developments: (1) positioning of ACL graft placement; (2) laxity measurement of ACL reconstruction (quality control); (3) kinematic evaluation during ACL reconstruction (navigated pivot shift); (4) case-specific individual ACL reconstruction with adjustments and additional reconstruction options. CAS has shown to improve femoral tunnel positioning, even if clinical outcomes do not improve results of manual techniques. CAS technology has helped researchers better understand the effects of different ACL reconstruction techniques and bundles replacements on joint laxity and to describe tunnel positioning in relation to native ACL insertion. CAS in ACL surgery can improve results at time zero and can improve knowledge in this field.

  17. Reconstructing Step by Step


    On May 22,10 days after the Wenchuan earthquake in Sichuan Province,the State Council formed the Post-earthquake Reconstruction Planning Group,deciding to work out a general recon- struction plan within a period of three months. Sichuan was the worst-hit area of China,so reconstruction work there will have a direct influence on how plans proceed in other areas.On July 18,Beijing Review reporter Feng Jianhua interviewed Wang Guangsi,Vice Director of the Sichuan Development and Reform Commission,about Sichuan’s reconstruction plan.

  18. MR diagnosis of temporomandibular joint. A study of joint effusion

    Kaneda, Takashi; Yamashiro, Mitsuaki; Ozawa, Kaoru; Suzuki, Hiromi; Okada, Hiroyuki; Yamamoto, Hirotsugu [Nihon Univ., Matsudo, Chiba (Japan). School of Dentistry


    The purposes of this study were to evaluate the relationship between correlation of MR joint effusion of the temporomandibular joint and disk position, to evaluate the relationship between joint effusion and aging, and to assess the frequency of MR joint effusion of bilateral temporomandibular joints. The temporomandibular joints of 192 patients with clinical symptoms of temporomandibular joint disorders were imaged bilaterally using high field, surface-coil MR imaging. Oblique sagittal and coronal proton density-weighted and T2-weighted images were obtained. Imaging findings of joint effusion were correlated with disk position, aging, and bilateral temporomandibular joints. MR showed effusion in 4% of the joints with normal superior disk position, 36% of the joints with disk displacement with reduction, and 45% of the joints with disk displacement without reduction. There were significant differences in the incidence of joint effusion between normal disk position and anterior disk displacement with or without reduction. Younger patients less than 40 years were significant higher the incidence of joint effusion than those of older patients. A significant association was seen between joint effusion and aging. MR showed effusion in 17% of the unilateral temporomandibular joint, 24% of the bilateral temporomandibular joints. There was no significant difference between unilateral and bilateral case. These results indicated that joint effusion using MR imaging was associated with varied temporomandibular joint pathologic states. (author)

  19. Image Magnification Method Using Joint Diffusion

    Zhong-Xuan Liu; Hong-Jian Wang; Si-Long Peng


    In this paper a new algorithm for image magnification is presented. Because linear magnification/interpolation techniques diminish the contrast and produce sawtooth effects, in recent years, many nonlinear interpolation methods, especially nonlinear diffusion based approaches, have been proposed to solve these problems. Two recently proposed techniques for interpolation by diffusion, forward and backward diffusion (FAB) and level-set reconstruction (LSR), cannot enhance the contrast and smooth edges simultaneously. In this article, a novel Partial Differential Equations (PDE) based approach is presented. The contributions of the paper include:firstly, a unified form of diffusion joining FAB and LSR is constructed to have all of their virtues; secondly, to eliminate artifacts of the joint diffusion, soft constraint takes the place of hard constraint presented by LSR;thirdly, the determination of joint coefficients, criterion for stopping time and color image processing are also discussed. The results demonstrate that the method is visually and quantitatively better than Bicubic, FAB and LSR.

  20. Prairie Reconstruction Initiative Project

    US Fish and Wildlife Service, Department of the Interior — The purpose of the Prairie Reconstruction Initiative Advisory Team (PRIAT) is to identify and take steps to resolve uncertainties in the process of prairie...

  1. On TPC cluster reconstruction

    Dydak, F; Nefedov, Y; Wotschack, J; Zhemchugov, A


    For a bias-free momentum measurement of TPC tracks, the correct determination of cluster positions is mandatory. We argue in particular that (i) the reconstruction of the entire longitudinal signal shape in view of longitudinal diffusion, electronic pulse shaping, and track inclination is important both for the polar angle reconstruction and for optimum r phi resolution; and that (ii) self-crosstalk of pad signals calls for special measures for the reconstruction of the z coordinate. The problem of 'shadow clusters' is resolved. Algorithms are presented for accepting clusters as 'good' clusters, and for the reconstruction of the r phi and z cluster coordinates, including provisions for 'bad' pads and pads next to sector boundaries, respectively.

  2. Permutationally invariant state reconstruction

    Moroder, Tobias; Hyllus, Philipp; Tóth, Géza;


    Feasible tomography schemes for large particle numbers must possess, besides an appropriate data acquisition protocol, an efficient way to reconstruct the density operator from the observed finite data set. Since state reconstruction typically requires the solution of a nonlinear large-scale opti......Feasible tomography schemes for large particle numbers must possess, besides an appropriate data acquisition protocol, an efficient way to reconstruct the density operator from the observed finite data set. Since state reconstruction typically requires the solution of a nonlinear large...... likelihood and least squares methods, which are the preferred choices in today's experiments. This high efficiency is achieved by greatly reducing the dimensionality of the problem employing a particular representation of permutationally invariant states known from spin coupling combined with convex...

  3. Permutationally invariant state reconstruction

    Moroder, Tobias; Toth, Geza; Schwemmer, Christian; Niggebaum, Alexander; Gaile, Stefanie; Gühne, Otfried; Weinfurter, Harald


    Feasible tomography schemes for large particle numbers must possess, besides an appropriate data acquisition protocol, also an efficient way to reconstruct the density operator from the observed finite data set. Since state reconstruction typically requires the solution of a non-linear large-scale optimization problem, this is a major challenge in the design of scalable tomography schemes. Here we present an efficient state reconstruction scheme for permutationally invariant quantum state tomography. It works for all common state-of-the-art reconstruction principles, including, in particular, maximum likelihood and least squares methods, which are the preferred choices in today's experiments. This high efficiency is achieved by greatly reducing the dimensionality of the problem employing a particular representation of permutationally invariant states known from spin coupling combined with convex optimization, which has clear advantages regarding speed, control and accuracy in comparison to commonly employed n...

  4. Reconstructions of eyelid defects

    Nirmala Subramanian


    Full Text Available Eyelids are the protective mechanism of the eyes. The upper and lower eyelids have been formed for their specific functions by Nature. The eyelid defects are encountered in congenital anomalies, trauma, and postexcision for neoplasm. The reconstructions should be based on both functional and cosmetic aspects. The knowledge of the basic anatomy of the lids is a must. There are different techniques for reconstructing the upper eyelid, lower eyelid, and medial and lateral canthal areas. Many a times, the defects involve more than one area. For the reconstruction of the lid, the lining should be similar to the conjunctiva, a cover by skin and the middle layer to give firmness and support. It is important to understand the availability of various tissues for reconstruction. One layer should have the vascularity to support the other layer which can be a graft. A proper plan and execution of it is very important.

  5. Prairie Reconstruction Initiative

    US Fish and Wildlife Service, Department of the Interior — The purpose of the Prairie Reconstruction Initiative Advisory Team (PRIAT) is to identify and take steps to resolve uncertainties in the process of prairie...

  6. Breast Reconstruction After Mastectomy

    ... It also does not involve cutting of the abdominal muscle and is a free flap. This type of ... NCI fact sheet Mammograms . What are some new developments in breast reconstruction after mastectomy? Oncoplastic surgery. In ...

  7. Head and face reconstruction

    ... work together. Head and neck surgeons also perform craniofacial reconstruction operations. The surgery is done while you are deep asleep and pain-free (under general anesthesia ). The surgery may take ...

  8. Jointness for the Rest of Us: Reforming Joint Professional Development


    service members for joint employment . Similar to their enlisted counterparts, the training, education and professional development of DOD civilian...the U.S. Armed forces sought by Congressional legislators and Defense leaders is not possible as long as joint education and training are limited to a...SUBJECT TERMS joint training, joint education , Goldwater Nichols Act, jointness, joint development reform analytics 16. SECURITY CLASSIFICATION OF

  9. Reconstruction Setting Out


    The earthquake-hit Yushu shifts its focus from rescuing survivors to post-quake reconstruction The first phase of earthquake relief, in which rescuing lives was the priority, finished 12 days after a 7.1-magnitude earthquake struck the Tibetan Autonomous Prefecture of Yushu in northwest China’s Qinghai Province on April 14, and reconstruction of the area is now ready to begin.

  10. Rotationplasty for patients with osteosarcoma around the knee joint.



    Full Text Available The results of rotationplasty for patients with osteosarcoma around the knee joint are presented. After an average observation period of 13.3 months, there has been no local recurrence or metastasis. The ankle joints (the new knee joints of the patients were able to support their body weight with an average range of motion of 75 degrees. All patients could walk well without crutches and without risk of the giving way phenomenon. The average rate of the functional evaluation according to the re-modified system by Enneking was 84.5% (range, 80.0-86.7%. No patient had psychological trouble in accepting the shortened and rotated extremity. The results show that rotationplasty is a useful reconstructive method for the treatment of osteosarcoma around the knee joint.

  11. Total ankle joint replacement.


    Ankle arthritis results in a stiff and painful ankle and can be a major cause of disability. For people with end-stage ankle arthritis, arthrodesis (ankle fusion) is effective at reducing pain in the shorter term, but results in a fixed joint, and over time the loss of mobility places stress on other joints in the foot that may lead to arthritis, pain and dysfunction. Another option is to perform a total ankle joint replacement, with the aim of giving the patient a mobile and pain-free ankle. In this article we review the efficacy of this procedure, including how it compares to ankle arthrodesis, and consider the indications and complications.

  12. Joint Robotics Program


    Åèìáëáíáçå= oÉëÉ~êÅÜ=póãéçëáìã= JOINT ROBOTICS PROGRAM Published: 23 April 2008 by Joel Brown and Paul Varian 5th Annual Acquisition Research...3. DATES COVERED 00-00-2008 to 00-00-2008 4. TITLE AND SUBTITLE Joint Robotics Program 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM...ëóåÉêÖó=Ñçê=áåÑçêãÉÇ=ÅÜ~åÖÉ=======- 464 - = = Joint Robotics Program Presenter: Joel Brown, Defense Acquisition University Author: Paul Varian

  13. Joints in steel buildings

    Gabriel F. Valencia Clement


    Full Text Available Masonry and steel components used in constructing buildings are in a constant state of motion. Volumetric changes are produced by temperature variation and deformation resulting from static or dynamic loading and in some materials, such as masonry, due to moisture content. This article addresses means of determining when expansion and seismic joints are required and how to proportion and design appropriate joints, specifically in steel buildings. It does not cover the study of expansion joints in concrete structures, in masonry construction or in non-structural (architectural elements.

  14. Primordial density and BAO reconstruction

    Zhu, Hong-Ming; Chen, Xuelei


    We present a new method to reconstruct the primordial (linear) density field using the estimated nonlinear displacement field. The divergence of the displacement field gives the reconstructed density field. We solve the nonlinear displacement field in the 1D cosmology and show the reconstruction results. The new reconstruction algorithm recovers a lot of linear modes and reduces the nonlinear damping scale significantly. The successful 1D reconstruction results imply the new algorithm should also be a promising technique in the 3D case.

  15. TKA 术中螺钉附加骨水泥结合髓内延长杆修复胫骨平台骨缺损重建关节稳定性%Supporing Screws and Bbone Cement Filling Combined with Intramedullary Stem for Reconstruc-ting Tibial Bone Defect and Joint Stability in Total Knee Arthroplasty

    潘文杰; 贺艳; 马建兵; 肖琳; 卿忠; 王曦; 姚舒馨; 武淑芳


    Objective To observe the early clinical effect of Supporing screws and bone cement filling combined with intr-amedullary stem for reconstructing tibial noncontained bone defect and joint stability in primary total knee arthroplasty. Meth-ods From May 2012 to October 2015,16 patients(21 knees)with tibial plateau noncontained bone defects including 4 men (5knees)and12 women(16 knees)underwent primary total knee arthmplasty. The average age of the patients was 70. 5 years old ranging from 65 to 76 years. The average weight was 75. 6 kg ranging from 68. 5 kg to 92 kg,and the average body height was 171. 1 cm ranging from 155 cm to 180 cm. The diagnoses of the patients were osteoarthritis in 13 cases(16 knees)and rheumatoid arthritis in 2 cases(4 knees),Kashin-Bek syndrome in 1 case(1 knee). The preoperative range of movement (ROM)was(69. 8 ± 9. 8)°. According to Knee Society score(KSS)criterion,the clinical score of preoperation was(31. 9 ± 8. 8)and functional score was(33. 1 ± 9. 1)During operation,the average depth of tibial plateau defect was 19. 8 mm before tibial osteotomy. The conventional tibial osteotomy of 10. 0 mm was performed,the average depth of the residual bone defect was10. 5 mm. Sclerotic bone was thoroughly removed,2 or 3 pieces of supporting screws were inserted according to bone defect area and morphology,and bone cement was pressurely filled,and then the tibial prosthesis with stem was installed. Results All the cases were followed up of 26. 5 months(range,3 to 36months). All the patients can walk without crutch and self-care 1 month after operation,The enstrophy or ecstrophy or contraction anisotrophy were completely rectified right after operation,and the pain of knee was totally reliefed,At the latest follow-up,the KSS clinical score was knee score(90. 3 ± 9. 0)and functional score was(91. 4 ± 8. 3). The ROM of the knee joint was(115 ± 8. 8)°. In the final follow-up through the X-ray measurement, the position of the prosthesis was good

  16. Augmented Likelihood Image Reconstruction.

    Stille, Maik; Kleine, Matthias; Hägele, Julian; Barkhausen, Jörg; Buzug, Thorsten M


    The presence of high-density objects remains an open problem in medical CT imaging. Data of projections passing through objects of high density, such as metal implants, are dominated by noise and are highly affected by beam hardening and scatter. Reconstructed images become less diagnostically conclusive because of pronounced artifacts that manifest as dark and bright streaks. A new reconstruction algorithm is proposed with the aim to reduce these artifacts by incorporating information about shape and known attenuation coefficients of a metal implant. Image reconstruction is considered as a variational optimization problem. The afore-mentioned prior knowledge is introduced in terms of equality constraints. An augmented Lagrangian approach is adapted in order to minimize the associated log-likelihood function for transmission CT. During iterations, temporally appearing artifacts are reduced with a bilateral filter and new projection values are calculated, which are used later on for the reconstruction. A detailed evaluation in cooperation with radiologists is performed on software and hardware phantoms, as well as on clinically relevant patient data of subjects with various metal implants. Results show that the proposed reconstruction algorithm is able to outperform contemporary metal artifact reduction methods such as normalized metal artifact reduction.

  17. Joint Quantum Institute

    Federal Laboratory Consortium — The Joint Quantum Institute (JQI) is pursuing that goal through the work of leading quantum scientists from the Department of Physics of the University of Maryland...

  18. Healthy Joints Matter

    ... my joints more healthy? Definitions What can go wrong? Although you might think arthritis affects only older ... Discovery Into Health ® Home | Health Information | Research | Funding | News & Events | About Us | Portal en español | Asian-Language ...

  19. Improved orthopedic arm joint

    Dane, D. H.


    Joint permits smooth and easy movement of disabled arm and is smaller, lighter and less expensive than previous models. Device is interchangeable and may be used on either arm at the shoulder or at the elbow.

  20. Concrete Pavement Joint Deterioration


    Concrete pavements are an important part of our national infrastructure. In recent years the relatively small number of reported joints deteriorating prematurely in concrete pavements around Indiana has increased. Changes over the past 45 years in INDOT specification, pavement materials, designs and construction practices, and current de-icing materials were examined and related to the durability of concrete at the joints of existing pavements. A survey of concrete pavements across the state ...

  1. High pressure ceramic joint

    Ward, Michael E.; Harkins, Bruce D.


    Many recuperators have components which react to corrosive gases and are used in applications where the donor fluid includes highly corrosive gases. These recuperators have suffered reduced life, increased service or maintenance, and resulted in increased cost. The present joint when used with recuperators increases the use of ceramic components which do not react to highly corrosive gases. Thus, the present joint used with the present recuperator increases the life, reduces the service and maintenance, and reduces the increased cost associated with corrosive action of components used to manufacture recuperators. The present joint is comprised of a first ceramic member, a second ceramic member, a mechanical locking device having a groove defined in one of the first ceramic member and the second ceramic member. The joint and the mechanical locking device is further comprised of a refractory material disposed in the groove and contacting the first ceramic member and the second ceramic member. The present joint mechanically provides a high strength load bearing joint having good thermal cycling characteristics, good resistance to a corrosive environment and good steady state strength at elevated temperatures.

  2. Reconstruction of inflation models

    Myrzakulov, Ratbay; Sebastiani, Lorenzo [Eurasian National University, Department of General and Theoretical Physics and Eurasian Center for Theoretical Physics, Astana (Kazakhstan); Zerbini, Sergio [Universita di Trento, Dipartimento di Fisica, Trento (Italy); TIFPA, Istituto Nazionale di Fisica Nucleare, Trento (Italy)


    In this paper, we reconstruct viable inflationary models by starting from spectral index and tensor-to-scalar ratio from Planck observations. We analyze three different kinds of models: scalar field theories, fluid cosmology, and f(R)-modified gravity. We recover the well-known R{sup 2} inflation in Jordan-frame and Einstein-frame representation, the massive scalar inflaton models and two models of inhomogeneous fluid. A model of R{sup 2} correction to Einstein's gravity plus a ''cosmological constant'' with an exact solution for early-time acceleration is reconstructed. (orig.)

  3. The evolving breast reconstruction

    Thomsen, Jørn Bo; Gunnarsson, Gudjon Leifur


    The aim of this editorial is to give an update on the use of the propeller thoracodorsal artery perforator flap (TAP/TDAP-flap) within the field of breast reconstruction. The TAP-flap can be dissected by a combined use of a monopolar cautery and a scalpel. Microsurgical instruments are generally...... not needed. The propeller TAP-flap can be designed in different ways, three of these have been published: (I) an oblique upwards design; (II) a horizontal design; (III) an oblique downward design. The latissimus dorsi-flap is a good and reliable option for breast reconstruction, but has been criticized...

  4. Vertex Reconstruction in CMS

    Chabanat, E; D'Hondt, J; Vanlaer, P; Prokofiev, K; Speer, T; Frühwirth, R; Waltenberger, W


    Because of the high track multiplicity in the final states expected in proton collisions at the LHC experiments, novel vertex reconstruction algorithms are required. The vertex reconstruction problem can be decomposed into a pattern recognition problem ("vertex finding") and an estimation problem ("vertex fitting"). Starting from least-square methods, ways to render the classical algorithms more robust are discussed and the statistical properties of the novel methods are shown. A whole set of different approaches for the vertex finding problem is presented and compared in relevant physics channels.

  5. Upper Eyelid Reconstruction.

    Espinoza, Gabriela Mabel; Prost, Angela Michelle


    Reconstruction of the upper eyelid is complicated because the eyelid must retain mobility, flexibility, function, and a suitable mucosal surface over the delicate cornea. Defects of the upper eyelid may be due to congenital defects or traumatic injury or follow oncologic resection. This article focuses on reconstruction due to loss of tissue. Multiple surgeries may be needed to reach the desired results, addressing loss of tissue and then loss of function. Each defect is unique and the laxity and availability of surrounding tissue vary. Knowing the most common techniques for repair assists surgeons in the multifaceted planning that takes place.

  6. Proximal Tibiofibular Joint: An overview

    Tze Wang Chan


    Full Text Available Proximal tibiofibular joint is a frequently neglected joint which can be a source of lateral knee pain. Open surgery is the current mainstay of surgical management of proximal tibiofibular joint disorders. The proximal tibiofibular arthroscopy allows access to the joint and adjacent important ligamentous structures. This forms the basis of further development of arthroscopic procedures for a variety of pathologies.

  7. Joint ventures in medical services.

    Rublee, D A


    This paper is an overview of joint-venture activity in healthcare, describing trends in joint ventures and raising issues for physicians. The purposes are to discuss the major current facets of joint-venture alliances in healthcare and to identify policy issues that arise from the trend to use joint ventures as an organizational tool. Speculation is made about the future role of joint ventures in the organization of healthcare.

  8. Management of Temporomandibular Joint Reankylosis in Syndromic Patients Corrected with Joint Prostheses: Surgical and Rehabilitation Protocols

    Clauser, Luigi C.; Consorti, Giuseppe; Elia, Giovanni; Tieghi, Riccardo; Galiè, Manlio


    Temporomandibular joint ankylosis (TMJA) is a severe disorder described as an intracapsular union of the disc-condyle complex to the temporal articular surface with bony fusion. The management of this disability is challenging and rarely based on surgical and rehabilitation protocols. We describe the treatment in two young adults affected by Goldenhar syndrome and Pierre Robin sequence with reankylosis after previous surgical treatments. There are three main surgical procedures for the treatment of TMJA: gap arthroplasty, interpositional arthroplasty, and joint reconstruction. Various authors have described reankylosis as a frequent event after treatment. Treatment failure could be associated with surgical errors and/or inadequate intensive postoperative physiotherapy. Surgical treatment should be individually tailored and adequate postoperative physiotherapy protocol is mandatory for success. PMID:24624260

  9. Compressive optical image watermarking using joint Fresnel transform correlator architecture

    Li, Jun; Zhong, Ting; Dai, Xiaofang; Yang, Chanxia; Li, Rong; Tang, Zhilie


    A new optical image watermarking technique based on compressive sensing using joint Fresnel transform correlator architecture has been presented. A secret scene or image is first embedded into a host image to perform optical image watermarking by use of joint Fresnel transform correlator architecture. Then, the watermarked image is compressed to much smaller signal data using single-pixel compressive holographic imaging in optical domain. At the received terminal, the watermarked image is reconstructed well via compressive sensing theory and a specified holographic reconstruction algorithm. The preliminary numerical simulations show that it is effective and suitable for optical image security transmission in the coming absolutely optical network for the reason of the completely optical implementation and largely decreased holograms data volume.

  10. Reconstruction of the extensor mechanism after major knee resection.

    Mavrogenis, Andreas F; Angelini, Andrea; Pala, Elisa; Sakellariou, Vasileios I; Ruggieri, Pietro; Papagelopoulos, Panayiotis J


    In periarticular knee resections, the relative lack of soft tissue coverage and need to reattach the extensor mechanism after en bloc resection of the tibial tuberosity with the tumor specimen complicate reconstructions and decrease postoperative function and stability of the knee joint. Distal femoral reconstructions are less problematic; muscular attachments are relatively few, neurovascular structures are not immediately adjacent to bone, and the knee extensor mechanism is usually not compromised from bone tumors. In the proximal tibia, the close proximity of the neurovascular structures in the popliteal fossa and peroneal nerve at the lateral aspect of the leg make reconstruction more difficult. Poor function is mostly related to unreliable options for knee extensor mechanism reattachment and poor soft tissue coverage. Successful and reliable attachment of the soft tissues has been a significant advance that improved functional outcomes.This article describes techniques for the reconstruction of the extensor mechanism of the knee after proximal tibia resections. Combined reconstruction techniques using direct reattachment of the patellar tendon with synthetic materials to megaprosthetic or allograft reconstructions for immediate stability, augmentation with autologous bone graft or substitutes at the attachment site, and coverage with the medial gastrocnemius muscle flap and supplementary flaps for long-term stability of the reattachment are currently considered the gold standard.

  11. Colored 3D surface reconstruction using Kinect sensor

    Guo, Lian-peng; Chen, Xiang-ning; Chen, Ying; Liu, Bin


    A colored 3D surface reconstruction method which effectively fuses the information of both depth and color image using Microsoft Kinect is proposed and demonstrated by experiment. Kinect depth images are processed with the improved joint-bilateral filter based on region segmentation which efficiently combines the depth and color data to improve its quality. The registered depth data are integrated to achieve a surface reconstruction through the colored truncated signed distance fields presented in this paper. Finally, the improved ray casting for rendering full colored surface is implemented to estimate color texture of the reconstruction object. Capturing the depth and color images of a toy car, the improved joint-bilateral filter based on region segmentation is used to improve the quality of depth images and the peak signal-to-noise ratio (PSNR) is approximately 4.57 dB, which is better than 1.16 dB of the joint-bilateral filter. The colored construction results of toy car demonstrate the suitability and ability of the proposed method.

  12. Reconstruction Setting Out



    @@ The first phase of earthquake relief,in which rescuing lives was the priority,finished 12 days after a 7.1-magnitude earthquake struck the Tibetan Autonomous Prefecture of Yushu in northwest China's Qinghai Province on April 14,and reconstruction of the area is now ready to begin.

  13. Urogenital Reconstructive Surgery

    Jakobsen, Lotte Kaasgaard

    Urogenital reconstructive surgery Lotte Kaasgaard Jakobsen1 Professor Henning Olsen1 Overlæge Gitte Hvistendahl1 Professor Karl-Erik Andersson2 1 – Dept. of Urology, Aarhus University Hospital 2 – Dept. of Gynecology and Obstetrics, Aarhus University hospital Background: Congenital obstruction...

  14. Contact areas of the tibiotalar joint.

    Windisch, Gunther; Odehnal, Boris; Reimann, Reinhold; Anderhuber, Friedrich; Stachel, Hellmuth


    The contact areas between the articular surfaces of the talus and tibia are essential for understanding the mobility of the ankle joint. The purpose of our study was to reveal the contact area among the superior articular surface of the trochlea tali (target surface T) and the inferior articular surface of the tibia (query surface Q) under non-weight-bearing conditions in plantar flexion and dorsiflexion. Twenty cadaveric foot specimens were dissected and scanned by a three-dimensional (3D) laser scanner to obtain data point sets. These point sets were triangulated and a registration procedure performed to avoid any intersection of the two joint surfaces. For all points of the query surface Q, the closest distance to T was measured. In 11 of the 20 ankle joints, the contact area was larger in plantar flexion, in 5 it was nearly of equal size, and in 4 the two surfaces were found in a better congruence in dorsiflexion. The two articular surfaces can be in point or line contact and cause different motions while T is gliding on Q, so the original geometry of ligaments must be carefully reconstructed after injury or during total ankle replacement.

  15. Temporomandibular joint examination reviewed

    L. Guarda Nardini


    Full Text Available The temporo-mandibular joint (TMJ it’s a joint closely related to the skull base, the spine, and the jaws; all these anatomical structures must be taken in consideration when evaluating pain involving the tmj. In order to detect patients affected by pathology or dysfunctions of the tmj, physical examination is of great value in orienting the diagnosis. Inspection must consider the symmetry of the body, the dental status and the type of occlusion. Palpation is a way to assess contractiont involving the muscles of the masticatory system and of the neck. Auscultation, based on articular noise provides means to determine whether we are dealing with degeneration of the joint or a dislocation of the intrarticular disc. In order to confirm the diagnosis obtained with the clinical evaluation, it’s useful to perform imaging techniques as opt, tomography and TC of the tmj and electromyokineosiography – index of the mandibular functionality and of the muscles status. MRI and dynamic MRI are among the non invasive exams which give the greatest amount of information, regarding the disc position and the joint degeneration. Arthroscopy is an invasive technique that allows early diagnosis of degeneration and is helpful to reveal early inflammatory processes of the joint.

  16. Temporomandibular joint disorders.

    Buescher, Jennifer J


    Temporomandibular joint disorders are common in adults; as many as one third of adults report having one or more symptoms, which include jaw or neck pain, headache, and clicking or grating within the joint. Most symptoms improve without treatment, but various noninvasive therapies may reduce pain for patients who have not experienced relief from self-care therapies. Physical therapy modalities (e.g., iontophoresis, phonophoresis), psychological therapies (e.g., cognitive behavior therapy), relaxation techniques, and complementary therapies (e.g., acupuncture, hypnosis) are all used for the treatment of temporomandibular joint disorders; however, no therapies have been shown to be uniformly superior for the treatment of pain or oral dysfunction. Noninvasive therapies should be attempted before pursuing invasive, permanent, or semi-permanent treatments that have the potential to cause irreparable harm. Dental occlusion therapy (e.g., oral splinting) is a common treatment for temporomandibular joint disorders, but a recent systematic review found insufficient evidence for or against its use. Some patients with intractable temporomandibular joint disorders develop chronic pain syndrome and may benefit from treatment, including antidepressants or cognitive behavior therapy.


    Zhuo Li; Shen Lansun; Zhu Qing


    An improved FGS (Fine Granular Scalability) coding method is proposed in this letter, which is based on human visual characteristics. This method adjusts FGS coding frame rate according to the evaluation of video sequences so as to improve the coding efficiency and subject perceived quality of reconstructed images. Finally, a fine granular joint source channel coding is proposed based on the source coding method, which not only utilizes the network resources efficiently, but guarantees the reliable transmission of video information.


    Thimma Reddy


    Full Text Available BACKGROUND: Anterior knee instability associated with rupture of the ACL (Anterior Cruciate Ligament is a disabling clinical problem. The ACL has a poor capacity for intrinsic repair. Thus for patients who have knee symptoms related to ACL deficiency, one may consider ligament reconstruction as a means of stabilizing the T ibio - F emoral articulation and restoring high level function of the knee joint. Arthroscopically assisted ACLR ( ACL Reconstruction has the advantage of being minimally invasive, accurate graft placement, less disturbance of normal tissue resulting in quicker recovery and rehabilitation, minimal hospital stay and very less infection rate. MATERIAL AND METHODS: Between April 2012 to May 2013, 30 patients who underwent arthroscopic assisted ACL reconstructions using either bone - patellar tendon - bone auto graft ( BTB or Quadrupled hamstring auto graft ( QHG or Quadriceps tendon graft ( QTG in the Department of Orthopaedics and Traumatology, Osmania Medical College, Hyderabad, Andhra Pradesh is the material in our study. CONCLUSIONS : Arthroscopic reconstruction of Anterior Cruciate Ligament is a reliable, safe procedure. It helps in the early restoration of function and stability of the Knee joint and helps the patient to get back to his normal activity much earlier than with the traditional open surgical methods. The choice of the graft does not play a major role in the function of the knee in the long run.

  19. Anterior cruciate ligament reconstruction failure after tibial shaft malunion.

    LaFrance, Russell M; Gorczyca, John T; Maloney, Michael D


    Anterior cruciate ligament (ACL) reconstruction is common, with >100,000 procedures performed each year in the United States. Several factors are associated with failure, including poor surgical technique, graft incorporation failure, overly aggressive rehabilitation, and trauma. Tibial shaft fracture is also common and frequently requires operative intervention. Failure to reestablish the anatomic alignment of the tibia may cause abnormal forces across adjacent joints, which can cause degenerative joint disease or attritional failure of the surrounding soft tissues. This article describes a case of ACL reconstruction failure after a tibial fracture that resulted in malunion. Excessive force across the graft from lower-extremity malalignment and improper tunnel placement likely contributed to the attritional failure of the graft. This patient required a staged procedure for corrective tibial osteotomy followed by revision ACL reconstruction. This article describes ACL reconstruction failure, tibial shaft malunions, their respective treatments, the technical details of each procedure, and the technical aspects that must be considered when these procedures are done in a staged manner by 2 surgeons.

  20. Preparing for Breast Reconstruction Surgery

    ... Cancer Breast Reconstruction Surgery Preparing for Breast Reconstruction Surgery Your surgeon can help you know what to ... The plan for follow-up Costs Understanding your surgery costs Health insurance policies often cover most or ...

  1. 8th International Workshop on Boosted Object Phenomenology, Reconstruction and Searches in HEP


    BOOST2016 is the eighth of a series of successful joint theory/experiment workshops that bring together the world's leading experts from theory and LHC experiments to discuss the latest progress and develop new approaches on the reconstruction of and use of boosted decay topologies in order to search for new physics. This year, the workshop is jointly hosted by the University of Zurich and ETH Zurich.

  2. 3D打印技术在复杂肿瘤膝关节股骨假体周围骨折翻修术中的应用%Application of 3D printing technology in reconstruction of an complex periprosthetic femoral fracture of tumor knee joint

    李忱; 邹运; 王晓楠; 赵洪宇; 韩青; 王金成


    Objective:To perform the preoperative design and operative simulation for periprosthetic femoral fractures (PFF)in one patient with complex tumor knee replacement under assistance of three-dimensional (3D) printing technology,and to explore a more accurate and feasible way to restore the normal anatomy and function of this kind of patients.Methods:The female patient aged 32 years old diagnosed with PFF after an complex tumor knee replacement was selected.The CT images of the patient’s bilateral legs were collected and reconstructed.The bilateral femurs were virtually sliced and the important parameters at each location of both sides were recorded respectively.Novel femoral stem and nail paths were specially designed on the basis of original prosthesis according to these parameters. Then vitual assemble was made with the residual femur. The prosthetic femoral stem components and navigator were customized based on the 3D simulation results when no more errors were found.The residual femoral resin model,customized components and navigator were printed with an SLA 3D printer.The bone cement was taken out and newly designed femoral stem was implanted successfully according to the steps designed preoperatively.The preconcerted allograft bone plates were applied for patch of the bone defect.The pathological results,X-ray and functional scores were included in the observation indexes. Results: With the help of successfully preoperative computer matching,successfully printed bone model-prosthesis assemble and re-customized navigator,the operation was successfully performed.The postoperative alignment shown in the X-ray image was good.The patient was able to normally walk and squat one month after operation with a crutch.MSTS93 score was improved from 0 before operation to 14 only one month after operation.Conclusion:As for PFF of complex tumor knee joint,preoperative design and simulation with 3D printing technology may provide a more accurately and effectively operative

  3. Transversely Compressed Bonded Joints

    Hansen, Christian Skodborg; Schmidt, Jacob Wittrup; Stang, Henrik


    The load capacity of bonded joints can be increased if transverse pressure is applied at the interface. The transverse pressure is assumed to introduce a Coulomb-friction contribution to the cohesive law for the interface. Response and load capacity for a bonded single-lap joint was derived using...... non-linear fracture mechanics. The results indicated a good correlation between theory and tests. Furthermore, the model is suggested as theoretical base for determining load capacity of bonded anchorages with transverse pressure, in externally reinforced concrete structures....

  4. Joint for deployable structures

    Craighead, N. D., II; Preliasco, R. J.; Hult, T. D. (Inventor)


    A joint is described for connecting a pair of beams to pivot them between positions in alignment or beside one another, which is of light weight and which operates in a controlled manner. The joint includes a pair of fittings and at least one center link having opposite ends pivotally connected to opposite fittings and having axes that pass through centerplates of the fittings. A control link having opposite ends pivotally connected to the different fittings controls their relative orientations, and a toggle assemly holds the fittings in the deployed configuration wherein they are aligned. The fittings have stops that lie on one side of the centerplane opposite the toggle assembly.

  5. Tibiofemoral cartilage contact biomechanics in patients after reconstruction of a ruptured anterior cruciate ligament.

    Hosseini, Ali; Van de Velde, Samuel; Gill, Thomas J; Li, Guoan


    We investigated the in vivo cartilage contact biomechanics of the tibiofemoral joint in patients after reconstruction of a ruptured anterior cruciate ligament (ACL). A dual fluoroscopic and MR imaging technique was used to investigate the cartilage contact biomechanics of the tibiofemoral joint during in vivo weight-bearing flexion of the knee in eight patients 6 months following clinically successful reconstruction of an acute isolated ACL rupture. The location of tibiofemoral cartilage contact, size of the contact area, cartilage thickness at the contact area, and magnitude of the cartilage contact deformation of the ACL-reconstructed knees were compared with those previously measured in intact (contralateral) knees and ACL-deficient knees of the same subjects. Contact biomechanics of the tibiofemoral cartilage after ACL reconstruction were similar to those measured in intact knees. However, at lower flexion, the abnormal posterior and lateral shift of cartilage contact location to smaller regions of thinner tibial cartilage that has been described in ACL-deficient knees persisted in ACL-reconstructed knees, resulting in an increase of the magnitude of cartilage contact deformation at those flexion angles. Reconstruction of the ACL restored some of the in vivo cartilage contact biomechanics of the tibiofemoral joint to normal. Clinically, recovering anterior knee stability might be insufficient to prevent post-operative cartilage degeneration due to lack of restoration of in vivo cartilage contact biomechanics.

  6. Kinematic analysis of the knee joint by cine MRI

    Niitsu, Mamoru; Akisada, Masayoshi; Anno, Izumi; Matsumoto, Kunihiko; Kuno, Shin-ya; Miyakawa, Shunpei (Tsukuba Univ., Ibaraki (Japan). Inst. of Clinical Medicine); Inouye, Tamon; Kose, Katsumi


    In order to obtain the MR imaging of a moving knee joint, we developed a drive system of the knee. A reciprocating reversible motor with a rope and pulleys drove a knee brace with the knee bending and extending every two seconds. Using photo sensor probe for gating cine acquisition, we got 16-time frames/cycle MR images. Such as articular cartilage, ligaments and synovial fluid, the fine components of a moving knee joint were clearly seen. In a dynamic display, these cine images demonstrated 'actual' movement of the knee joint. Moving joint fluid and defect of anterior cruciate ligament were demonstrated in the case of knee injury. These findings were not seen on static images. Cine MR imaging was also helpful for evaluating the chronic joint disease and ligament reconstruction. Through the use of the present drive system and cine acquisition, dynamic MR imaging of a moving knee joint is clearly demonstrated and it may provide useful information in the kinematic analysis of the normal and pathologic knee. (author).

  7. Arctic Sea Level Reconstruction

    Svendsen, Peter Limkilde

    method.For oceanographic purposes, the altimetric record over the Arctic Ocean is inferiorin quality to that of moderate latitudes, but nonetheless an invaluable set of observations. During this project, newly processed Arctic altimetry from the ERS-1/-2 and Envisat missions has become available......Reconstruction of historical Arctic sea level is very difficult due to the limited coverage and quality of tide gauge and altimetry data in the area. This thesis addresses many of these issues, and discusses strategies to help achieve a stable and plausible reconstruction of Arctic sea level from...... 1950 to today.The primary record of historical sea level, on the order of several decades to a few centuries, is tide gauges. Tide gauge records from around the world are collected in the Permanent Service for Mean Sea Level (PSMSL) database, and includes data along the Arctic coasts. A reasonable...

  8. Autologous Costochondral Microtia Reconstruction.

    Patel, Sapna A; Bhrany, Amit D; Murakami, Craig S; Sie, Kathleen C Y


    Reconstruction with autologous costochondral cartilage is one of the mainstays of surgical management of congenital microtia. We review the literature, present our current technique for microtia reconstruction with autologous costochondral graft, and discuss the evolution of our technique over the past 20 years. We aim to minimize donor site morbidity and create the most durable and natural appearing ear possible using a stacked framework to augment the antihelical fold and antitragal-tragal complex. Assessment of outcomes is challenging due to the paucity of available objective measures with which to evaluate aesthetic outcomes. Various instruments are used to assess outcomes, but none is universally accepted as the standard. The challenges we continue to face are humbling, but ongoing work on tissue engineering, application of 3D models, and use of validated questionnaires can help us get closer to achieving a maximal aesthetic outcome.

  9. Stochastic reconstruction of sandstones

    Manwart; Torquato; Hilfer


    A simulated annealing algorithm is employed to generate a stochastic model for a Berea sandstone and a Fontainebleau sandstone, with each a prescribed two-point probability function, lineal-path function, and "pore size" distribution function, respectively. We find that the temperature decrease of the annealing has to be rather quick to yield isotropic and percolating configurations. A comparison of simple morphological quantities indicates good agreement between the reconstructions and the original sandstones. Also, the mean survival time of a random walker in the pore space is reproduced with good accuracy. However, a more detailed investigation by means of local porosity theory shows that there may be significant differences of the geometrical connectivity between the reconstructed and the experimental samples.

  10. Reconstructing the Tengger calendar

    Ian Proudfoot


    Full Text Available The survival of an Indic calendar among the Tengger people of the Brama highlands in east Java opens a window on Java’s calendar history. Its hybrid form reflects accommodations between this non-Muslim Javanese group and the increasingly dominant Muslim Javanese culture. Reconstruction is challenging because of this hybridity, because of inconsistencies in practice, and because the historical evidence is sketchy and often difficult to interpret.

  11. CT图像后处理重建膝关节三维模型:3D-CT评估前交叉韧带重建后的骨道差异%Reconstruction of three-dimensional models of knee joint using CT image post-processing technique:evaluation of bone tunnel difference after anterior cruciate ligament reconstruction using three-dimensional computed tomography

    高冠奇; 张克远


    背景:有研究表明影响前交叉韧带重建手术效果的因素主要取决于骨道的位置,而目前对骨道位置的研究仍存在一定争议。目的:探讨3D-CT对关节镜辅助下前交叉韧带重建后骨道评估的临床价值。方法:对2014年1月至8月收治的58例前交叉韧带损伤患者行关节镜下前交叉韧带重建。股骨端采用Endobutton固定,胫骨端使用可吸收界面钉固定。分别对58个膝关节进行双源CT扫描,使用CT图像后处理工作站重建膝关节三维模型,再现股骨外髁内侧壁及重建后单束骨道,胫骨平台及骨道。根据Lysholm评分分级办法,将随访时Lysholm评分≥80分病例作为优良组,80分以下为不良组,标记、测量股骨及胫骨骨道中心点的相对位置,比较两者的位置关系。结果与结论:3D-CT 三维重建法清晰地反映了膝关节前交叉韧带重建后的骨道及其出入口的位置、固定物及移植物等情况。膝关节功能优良组与不良组患者的术侧膝关节的股骨骨道中心位置之间差异有显著性意义(P 0.05)。结果证实,3D-CT能够清晰重建骨隧道及前交叉韧带移植物的图像,临床上可用于评估骨隧道定位与移植物走形的关系。%BACKGROUND:Studies have shown that factors affecting the outcomes of anterior cruciate ligament reconstruction mainly depend on the position of bone tunnels. However, there stil exists certain controversy over the researches on the position of bone tunnels. OBJECTIVE:To investigate the clinical value of three-dimensional computed tomography on postoperative evaluation of bone tunnel after anterior cruciate ligament reconstruction under arthroscopic assistance. METHODS:Fifty-eight patients with anterior cruciate ligament injury who received the treatment from January 2014 to August 2014 underwent anterior cruciate ligament reconstruction under arthroscopic assistance. The femoral end was fixed using an

  12. Joint Custody and Coparenting.

    Sell, Kenneth D.

    Results are presented of an intensive search of U.S. newspapers and periodicals on the joint custody of children after divorce, where both parents have continued responsibility for parenting and where the children spend part of each week, month, or year with both of the parents. Areas of concern addressed by these materials include the following:…

  13. Jointness: A Selected Bibliography


    Leavenworth: U.S. Army Combined Arms Center, Combat Studies Institute, 2008. 428pp. (UA25 .C55 2008) carl /download/csipubs...SMARTbook: Guide to Joint, Multinational & Interagency Operations. 2nd ed., rev. Lakeland, FL: Lightning Press, 2009. 302pp. (U260 .W33 2009) Whittaker

  14. Keyed shear joints

    Hansen, Klaus

    This report gives a summary of the present information on the behaviour of vertical keyed shear joints in large panel structures. An attemp is made to outline the implications which this information might have on the analysis and design of a complete wall. The publications also gives a short...

  15. Jointness, A Selected Bibliography.


    The Services’ Judge Advocates and Lawyers Move Toward the Next Century. Study Project. Car- lisle Barracks: US Army War College, 5 April 1993. 57pp...Shaping America’s Future Mili- tary." Parameters 24 (Winter 1994-1995): 19-29. Barlow, Jason B. "Interservice Rivalry in the Pacific." Joint Force

  16. Canal Wall Reconstruction Mastoidectomy


    Objective To investigate the advantages of canal wall reconstruction (CWR) mastoidectomy, a single-stage technique for cholesteatoma removal and posterior external canal wall reconstruction, over the open and closed procedures in terms of cholesteatoma recurrence. Methods: Between June 2002 and December 2005, 38 patients (40 ears) with cholesteatoma were admited to Sun Yat-Sen Memorial Hospital and received surgical treatments. Of these patients, 25 were male with ages ranging between 11 and 60 years (mean = 31.6 years) and 13 were female with ages ranging between 20 and 65 years (mean = 38.8 years). Canal wall reconstruction (CWR)mastoidectomy was performed in 31 ears and canal wall down (CWD) mastoidectomy in 9 ears. Concha cartilage was used for ear canal wall reconstruction in 22 of the 31 CWR procedures and cortical mastoid bone was used in the remaining 9 cases. Results At 0.5 to 4 years follow up, all but one patients remained free of signs of cholesteatoma recurrence, i.e., no retraction pocket or cholesteatoma matrix. One patient, a smoker, needed revision surgery due to cholesteatoma recurrence 1.5 year after the initial operation. The recurrence rate was therefore 3.2% (1/31). Cholesteatoma recurrence was monitored using postoperative CT scans whenever possible. In the case that needed a revision procedure, a retraction pocket was identified by otoendoscopy in the pars flacida area that eventually evolved into a cholesteatoma. A pocket extending to the epitympanum filled with cholesteatoma matrix was confirmed during the revision operation, A decision to perform a modified mastoidectomy was made as the patient refused to quit smoking. The mean air-bone gap in pure tone threshold was 45 dB before surgery and 25 dB after (p < 0.05). There was no difference between using concha cartilage and cortical mastoid bone for the reconstruction regarding air-bone gap improvement, CT findings and otoendoscopic results. Conclusion CWR mastoidectomy can be used for

  17. Posteromedial Corner Reconstruction

    Ferrer, Gonzalo; Leon, Agustín; Wirth, Hans; Mena, Adolfo; Tuca, María José; Espinoza, Gonzalo


    Objective: Report the experience, after 1-year follow-up, of 30 patients who underwent anatomical knee reconstruction of posteromedial corner (PMC) injuries, using La Prade´s Technique. Methods: Retrospective cohort study of 30 consecutive patients with PMC injuries operated between November 2010 and May 2014 by the same surgical team. Inclusion criteria: patients with clinical presentation and images (stress radiographs and MRI) compatible with PMC injury, who maintained a grade III chronic instability in spite of at least 3 months of orthopedic treatment, who were reconstructed using La Prade’s anatomical technique, and completed at least 12 months of follow-up. Exclusion criteria: discordance between clinical and image studies, grade I or II medial instability, and surgery performed through a different technique. Data was collected by reviewing the electronic files and images. Functional scores (IKDC and Lysholm) were applied and registered in the preoperative evaluation, and then 6 and 12 months after surgery. Results: Thirty patients (28 men and 2 women) met the inclusion criteria. Mean age was 43 years (24-69). The vast majority (28 patients) had a high-energy mechanism of injury. Twenty patients were diagnosed in the acute setting, while 10 had a delayed diagnosis after poor results of concomitant ligament reconstructions. With the exception of 2 patients, who presented with isolated PMC injury, the majority had associated injuries as detailed: 11 cases had PMC + anterior cruciate ligament (ACL) injury, 3 patients had PMC + posterior cruciate ligament (PCL) injury, 3 patients had PMC + meniscal tears, 9 patients had PMC + ACL + PCL injuries, and there were 2 cases of PMC + ACL + PCL + lateral collateral ligament injuries. Mean time for PMC reconstruction surgery was 5 months (range 2-32). Lysholm and IKDC scores were 18,2 (2-69) and 24,3 (9,2-52,9) respectively in the preoperative setting, improving to 76,7 (44-94) and 70,7 (36,8-95,4) after 1-year follow

  18. A Computer Vision Method for 3D Reconstruction of Curves-Marked Free-Form Surfaces

    Xiong Hanwei; Zhang Xiangwei


    Visual method is now broadly used in reverse engineering for 3D reconstruction. Thetraditional computer vision methods are feature-based, i.e., they require that the objects must revealfeatures owing to geometry or textures. For textureless free-form surfaces, dense feature points areadded artificially. In this paper, a new method is put forward combining computer vision with CAGD.The surface is subdivided into N-side Gregory patches using marked curves, and a stereo algorithm isused to reconstruct the curves. Then, the cross boundary tangent vector is computed throughreflectance analysis. At last, the whole surface can be reconstructed by jointing these patches withG1 continuity.

  19. Isokinetic Testing in Evaluation Rehabilitation Outcome After ACL Reconstruction

    Cvjetkovic, Dragana Dragicevic; Bijeljac, Sinisa; Palija, Stanislav; Talic, Goran; Radulovic, Tatjana Nozica; Kosanovic, Milkica Glogovac; Manojlovic, Slavko


    Introduction: Numerous rehab protocols have been used in rehabilitation after ACL reconstruction. Isokinetic testing is an objective way to evaluate dynamic stability of the knee joint that estimates the quality of rehabilitation outcome after ACL reconstruction. Our investigation goal was to show importance of isokinetic testing in evaluation thigh muscle strength in patients which underwent ACL reconstruction and rehabilitation protocol. Subjects and methods: In prospective study, we evaluated 40 subjects which were divided into two groups. Experimental group consisted of 20 recreational males which underwent ACL reconstruction with hamstring tendon and rehabilitation protocol 6 months before isokinetic testing. Control group (20 subjects) consisted of healthy recreational males. In all subjects knee muscle testing was performed on a Biodex System 4 Pro isokinetic dynamo-meter et velocities of 60°/s and 180°/s. We followed average peak torque to body weight (PT/BW) and classic H/Q ratio. In statistical analysis Student’s T test was used. Results: There were statistically significant differences between groups in all evaluated parameters except of the mean value of PT/BW of the quadriceps et velocity of 60°/s (p>0.05). Conclusion: Isokinetic testing of dynamic stabilizers of the knee is need in diagnostic and treatment thigh muscle imbalance. We believe that isokinetic testing is an objective parameter for return to sport activities after ACL reconstruction. PMID:25870471

  20. Surgical reconstruction in diabetic foot syndrome

    Umid Shoyusupov


    Full Text Available Considerable morbidity upon spontaneous wound healing (phlegmons, osteomyelitis, and purulent osteoarthritis of metatarsophalangeal joint as well as loss of the diseased foot’s walking ability are among the reasons for transition to plastic surgery in management tactics. The longer foot lesion persists, the higher probability of amputation. Improvement of treatment of both wound and ulcer lesions by means of reconstructive surgery in patients with diabetic foot syndrome was the main aim of the study. Outcomes of treatment of 460 patients managed at the Center for the Scientific and Clinical Study of Endocrinology, within the period from 2001 to 2009 were analyzed. Size, form, depth and localization of a wound, tissue composition of the wound bed as well as circulation in skin flaps caused the choice of specific operation: autodermoplasty by Parin (with the split-thickness skin flap, local tissue plastic operation (with the sliding or inter-advancing skin flaps, flaps from previously amputated toe or Indian flaps, plastic operation with the controlled tissue tension or combined plastic operation. Reconstructive foot wound surgery allows restoring load-bearing function of the extremity much earlier in contrast to spontaneous healing, reducing incidence of post-operative and long-term complications, amputations and re-amputations, decreasing period of treatment.

  1. Finite element analysis of human joints

    Bossart, P.L.; Hollerbach, K.


    Our work focuses on the development of finite element models (FEMs) that describe the biomechanics of human joints. Finite element modeling is becoming a standard tool in industrial applications. In highly complex problems such as those found in biomechanics research, however, the full potential of FEMs is just beginning to be explored, due to the absence of precise, high resolution medical data and the difficulties encountered in converting these enormous datasets into a form that is usable in FEMs. With increasing computing speed and memory available, it is now feasible to address these challenges. We address the first by acquiring data with a high resolution C-ray CT scanner and the latter by developing semi-automated method for generating the volumetric meshes used in the FEM. Issues related to tomographic reconstruction, volume segmentation, the use of extracted surfaces to generate volumetric hexahedral meshes, and applications of the FEM are described.

  2. Achieving joint benefits from joint implementation

    Moomaw, W.R. [Tufts Univ., Medford, MA (United States)


    Joint Implementation (JI) appears to have been born with Applied Energy Services Guatemala project in 1988. That project, to plant 52 million trees, protect existing forests from cutting and fire, and enhance rural development, is being implemented by CARE Guatemala to offset 120 per cent of the emissions of a small coal burning power plant that has been built in Connecticut. Since that time, several utilities and governments have initiated additional projects. Not all of these necessarily consist of tree planting in other countries, but may consist of energy efficiency or energy conservation programs designed to reduce carbon emissions by at least as much as the additional releases from a new facility. All JI projects share the characteristic of linking the release of greenhouse gases in an industrial country with an offset that reduces or absorbs a comparable amount in another country. The emitter in the industrial country is willing to pay for the reduction elsewhere because costs are less than they would be at home.

  3. A dynamic 3D foot reconstruction system.

    Thabet, Ali K; Trucco, Emanuele; Salvi, Joaquim; Wang, Weijie; Abboud, Rami J


    Foot problems are varied and range from simple disorders through to complex diseases and joint deformities. Wherever possible, the use of insoles, or orthoses, is preferred over surgery. Current insole design techniques are based on static measurements of the foot, despite the fact that orthoses are prevalently used in dynamic conditions while walking or running. This paper presents the design and implementation of a structured-light prototype system providing dense three dimensional (3D) measurements of the foot in motion, and its use to show that foot measurements in dynamic conditions differ significantly from their static counterparts. The input to the system is a video sequence of a foot during a single step; the output is a 3D reconstruction of the plantar surface of the foot for each frame of the input. Engineering and clinical tests were carried out for the validation of the system. The accuracy of the system was found to be 0.34 mm with planar test objects. In tests with real feet, the system proved repeatable, with reconstruction differences between trials one week apart averaging 2.44 mm (static case) and 2.81 mm (dynamic case). Furthermore, a study was performed to compare the effective length of the foot between static and dynamic reconstructions using the 4D system. Results showed an average increase of 9 mm for the dynamic case. This increase is substantial for orthotics design, cannot be captured by a static system, and its subject-specific measurement is crucial for the design of effective foot orthoses.

  4. Infections after reconstructions of anterior cruciate ligament

    Ristić Vladimir


    Full Text Available Introduction. Infections after anterior cruciate ligament reconstructions are rare, but, on the other hand, they are difficult to be treated. The aim of this study was to analyze causes of infections, risk factors, diagnostics, and possibilities of their prevention. Material and Methods. Seventeen deep infections (1.2% were found in 1425 patients who had undergone anterior cruciate ligament reconstructions. Fifteen patients were males and two were females. Out of 475 professional athletes nine (1.9% had this postoperative complication. Eleven patients with septic arthritis were allergic to penicillin. Three of them had immunosuppressive diseases. Results. Staphylococcus aureus was isolated in eleven cases (65%, other Staphylococcus and Streptococcus groups were found in four and three patients, respectively; while one patient had infection although the punctate was negative. Out of 965 patients with the patellar tendon grafts, ten (1.03% had this complication, while the incidence was 1.52% (7/460 in those with the hamstring grafts. Fifteen infections were acute with obvious symptoms within 14 days after surgery. Severe pain, limited range of motion, swelling of the knee joint and fever were the most common symptoms, while rubor and pus developed rarely. The infection was three times more frequent in the patients who had undergone surgery lasting more than 1.5 hour. Discussion and Conclusion. The following population groups are at risk of developing septic arthritis after anterior cruciate ligament reconstructions: professional athletes, those who are allergic to penicillin, and those with immunosuppressive diseases. Staphyllococus aureus is the most common cause of infection. The patients with the hamstring autografts have a higher risk than those with the patellar tendon grafts. Preventive measures that should be performed include aseptic conditions in operative rooms, irrigation of the graft before its placement into the bone tunnels

  5. Laundry joint venture.

    Giancola, D; Voyvodich, M


    Many hospitals are concerned about the loss of control which is associated with contracting for linen service. On the the hand, many laundries do not have the resources or experience to serve hospitals in a comprehensive and trouble-free manner. In many communities a joint venture, such as the one described here, can successfully combine the interests of the hospital and laundry communities without causing the hospitals to lose control of the service and without requiring the laundry operator to have detailed knowledge of hospital operations. As more hospitals opt for contract service, and if this service is to be provided at the lowest total cost, the hospitals and the laundries must come to grips with the problems surrounding the laundry-hospital interface. A joint venture, such as that described here, is one way to accomplish this.

  6. Joint International Accelerator School

    CERN Accelerator School


    The CERN and US Particle Accelerator Schools recently organised a Joint International Accelerator School on Beam Loss and Accelerator Protection, held at the Hyatt Regency Hotel, Newport Beach, California, USA from 5-14 November 2014. This Joint School was the 13th in a series of such schools, which started in 1985 and also involves the accelerator communities in Japan and Russia.   Photo courtesy of Alfonse Pham, Michigan State University.   The school attracted 58 participants representing 22 different nationalities, with around half from Europe and the other half from Asia and the Americas. The programme comprised 26 lectures, each of 90 minutes, and 13 hours of case study. The students were given homework each day and had an opportunity to sit a final exam, which counted towards university credit. Feedback from the participants was extremely positive, praising the expertise and enthusiasm of the lecturers, as well as the high standard and quality of their lectures. Initial dis...

  7. Joint Forces Capabilities


    for countering the proliferation of weapons of mass destruction (WMD) in space. The Space Operations Center ( SPOC ), USSPACECOM is the single point...of contact for assessing space capabilities. Combatant commanders, subordinate JFCs, and Services can access this information from the SPOC via the...special operations forces SPOC Space Operations Center SSBN fleet ballistic missile submarine SST space support team UJTL Universal Joint Task List UN

  8. Australias Joint Approach


    the early nineties as well. 219 Systems Thinking and Systems Engineering for Defence Strategic Planning, Richard Hodge , Kym Hendrickson and Geoff...Head Capability Systems, dated 9 December 2013. 272 Private communications with LTCOL Nick Floyd, Deputy Director Joint Concepts, JCC, March...with LTCOL Nick Floyd, 29 October 2014. 307 Pathway to Change: Evolving Defence Culture, 2012, p1. 308 Ibid, p3. 309 Communication with Dr Irena Ali

  9. Nonarthritic hip joint pain.

    Enseki, Keelan; Harris-Hayes, Marcie; White, Douglas M; Cibulka, Michael T; Woehrle, Judith; Fagerson, Timothy L; Clohisy, John C


    The Orthopaedic Section of the American Physical Therapy Association (APTA) has an ongoing effort to create evidence-based practice guidelines for orthopaedic physical therapy management of patients with musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability, and Health (ICF). The purpose of these clinical practice guidelines is to describe the peer-reviewed literature and make recommendations related to nonarthritic hip joint pain.

  10. The international joint commission

    Clamens, Murray


    For over 92 years the International Joint Commission (IJC), United States and Canada, has effectively served the two nations in approving and providing continuous oversight of water resource projects along the 5000-mile common border, in assisting the governments in preventing and resolving issues and disagreements regarding the use of these waters, and in addressing other environmental issues affecting or potentially affecting one or both of the countries. During the first years of the 20th...

  11. Joint Urban Operations


    in Kosovo , the Red Cross provided the most accurate figures on the number of Kosovo refugees, helping US and other coalition services to estimate the...Port-au-Prince, Ramadi, Fallujah, and cities in Bosnia, Serbia, and Kosovo ). This clearly indicates an increase in the frequency of US joint...areas perhaps including shantytowns, and military areas. Buildings may range from single-story wooden or mud dwellings to high-rise apartments and

  12. Successfully Developing Joint Leaders


    officer’s pyramid representing his career, there is merely the word “joint”. Therefore, unless the officer adamantly pursues a joint assignment it...had the chance to participate in Bosnia stability operations. It is how we were taught to work with locals and the experiences I took with me that...Drug Ops, OAF, OEF, OIF, Bosnia , Unconventional) - When you participated in an operation was there any “joint” involvement? If “yes”, did you feel

  13. Implementation of Open and Closed Kinetic Chain Quadriceps Strengthening Exercises after Anterior Cruciate Ligament Reconstruction.

    Ross, Michael D.; Denegar, Craig R.; Winzenried, Jay A.


    Reviews the effects of open kinetic chain (OKC) and closed kinetic chain (CKC) exercise on anterior cruciate ligament (ACL) strain and patellofemoral joint stress, suggesting a combination of the two for quadriceps strengthening after ACL reconstruction. Both OKC and CKC exercises may be modified and implemented for quadriceps strengthening after…

  14. Laboratory characterization of rock joints

    Hsiung, S.M.; Kana, D.D.; Ahola, M.P.; Chowdhury, A.H.; Ghosh, A. [Southwest Research Inst., San Antonio, TX (United States). Center for Nuclear Waste Regulatory Analyses


    A laboratory characterization of the Apache Leap tuff joints under cyclic pseudostatic and dynamic loads has been undertaken to obtain a better understanding of dynamic joint shear behavior and to generate a complete data set that can be used for validation of existing rock-joint models. Study has indicated that available methods for determining joint roughness coefficient (JRC) significantly underestimate the roughness coefficient of the Apache Leap tuff joints, that will lead to an underestimation of the joint shear strength. The results of the direct shear tests have indicated that both under cyclic pseudostatic and dynamic loadings the joint resistance upon reverse shearing is smaller than that of forward shearing and the joint dilation resulting from forward shearing recovers during reverse shearing. Within the range of variation of shearing velocity used in these tests, the shearing velocity effect on rock-joint behavior seems to be minor, and no noticeable effect on the peak joint shear strength and the joint shear strength for the reverse shearing is observed.

  15. Reconstruction in Fourier space

    Burden, A.; Percival, W. J.; Howlett, C.


    We present a fast iterative fast Fourier transform (FFT) based reconstruction algorithm that allows for non-parallel redshift-space distortions (RSDs). We test our algorithm on both N-body dark matter simulations and mock distributions of galaxies designed to replicate galaxy survey conditions. We compare solenoidal and irrotational components of the redshift distortion and show that an approximation of this distortion leads to a better estimate of the real-space potential (and therefore faster convergence) than ignoring the RSD when estimating the displacement field. Our iterative reconstruction scheme converges in two iterations for the mock samples corresponding to Baryon Oscillation Spectroscopic Survey CMASS Data Release 11 when we start with an approximation of the RSD. The scheme takes six iterations when the initial estimate, measured from the redshift-space overdensity, has no RSD correction. Slower convergence would be expected for surveys covering a larger angle on the sky. We show that this FFT based method provides a better estimate of the real-space displacement field than a configuration space method that uses finite difference routines to compute the potential for the same grid resolution. Finally, we show that a lognormal transform of the overdensity, used as a proxy for the linear overdensity, is beneficial in estimating the full displacement field from a dense sample of tracers. However, the lognormal transform of the overdensity does not perform well when estimating the displacements from sparser simulations with a more realistic galaxy density.

  16. LHCb; LHCb Jet Reconstruction

    Augusto, O


    The Large Hadron Collider (LHC) is the most powerful particle accelerator in the world. It has been designed to collide proton beams at an energy up to 14 TeV in the center of mass. In 2011, the data taking was done with a center of mass energy of 7 TeV, the instant luminosity has reached values greater than $4 \\times 10^{32} cm^{-2} s^{-1}$ and the integrated luminosity reached the value of 1.02 $fb^{-1}$ on the LHCb. The jet reconstruction is fundamental to observe events that can be used to test pertubative QCD (pQCD). It also provides a way to observe standard model channels and searches for new physics like SUSY. The anti-kt algorithm is a jet reconstruction algorithm that is based on the distance of the particles on the space $\\eta \\times \\phi$ and on the transverse momentum of particles. To maximize the energy resolution all information about the trackers and the calo...

  17. Reconstructing Experiences through Sketching

    Karapanos, Evangelos; Hassenzahl, Marc


    This paper presents iScale, a survey tool that aims at eliciting users' experiences with a product from memory. iScale employs sketching in imposing a process in the reconstruction of one's experiences. Two versions of iScale, the Constructive and the Value-Account iScale, were motivated by two distinct theories on how people reconstruct emotional experiences from memory. These two versions were tested in two separate studies. Study 1 aimed at providing qualitative insight into the use of iScale and compared its performance to that of free-hand sketching. Study 2 compared the two iScale versions to a control condition: that of reporting one's experiences without employing any form of sketching. Significant differences between iScale and the "no-sketching" tool were found. Overall, iScale resulted in a) an increase in the number of experience reports that subjects provided, b) an increase in the amount of contextual information for the reported experiences, and c) an increase in subjects' accuracy in recalling...

  18. Biomaterials for craniofacial reconstruction

    Neumann, Andreas


    Full Text Available Biomaterials for reconstruction of bony defects of the skull comprise of osteosynthetic materials applied after osteotomies or traumatic fractures and materials to fill bony defects which result from malformation, trauma or tumor resections. Other applications concern functional augmentations for dental implants or aesthetic augmentations in the facial region.For ostheosynthesis, mini- and microplates made from titanium alloys provide major advantages concerning biocompatibility, stability and individual fitting to the implant bed. The necessity of removing asymptomatic plates and screws after fracture healing is still a controversial issue. Risks and costs of secondary surgery for removal face a low rate of complications (due to corrosion products when the material remains in situ. Resorbable osteosynthesis systems have similar mechanical stability and are especially useful in the growing skull.The huge variety of biomaterials for the reconstruction of bony defects makes it difficult to decide which material is adequate for which indication and for which site. The optimal biomaterial that meets every requirement (e.g. biocompatibility, stability, intraoperative fitting, product safety, low costs etc. does not exist. The different material types are (autogenic bone and many alloplastics such as metals (mainly titanium, ceramics, plastics and composites. Future developments aim to improve physical and biological properties, especially regarding surface interactions. To date, tissue engineered bone is far from routine clinical application.

  19. Optical tomographic imaging of vascular and metabolic reactivity in rheumatoid joints

    Lasker, Joseph M.; Dwyer, Edward; Hielscher, Andreas H.


    Our group has recently established that joints affected by Rheumatoid Arthritis (RA) can be distinguished from healthy joints through measurements of the scattering coefficient. We showed that a high scattering coefficient in the center of the joint is indicative of a joint with RA. While these results were encouraging, data to date still suffers from low sensitivity and specificity. Possibly higher specificities and sensitivities can be achieved if dynamic measurements of hemodynamic and metabolic processes in the synovium are considered. Using our dual-wavelength imaging system together with previously implemented model-based iterative image reconstruction schemes, we have performed initial dynamic imaging studies involving healthy human volunteers and patients affected by RA. These case studies seem to confirm our hypothesis that differences in the vascular reactivity exist between affected and unaffected joints.

  20. Virtual 3-D Facial Reconstruction

    Martin Paul Evison


    Full Text Available Facial reconstructions in archaeology allow empathy with people who lived in the past and enjoy considerable popularity with the public. It is a common misconception that facial reconstruction will produce an exact likeness; a resemblance is the best that can be hoped for. Research at Sheffield University is aimed at the development of a computer system for facial reconstruction that will be accurate, rapid, repeatable, accessible and flexible. This research is described and prototypical 3-D facial reconstructions are presented. Interpolation models simulating obesity, ageing and ethnic affiliation are also described. Some strengths and weaknesses in the models, and their potential for application in archaeology are discussed.

  1. Exercises in PET Image Reconstruction

    Nix, Oliver

    These exercises are complementary to the theoretical lectures about positron emission tomography (PET) image reconstruction. They aim at providing some hands on experience in PET image reconstruction and focus on demonstrating the different data preprocessing steps and reconstruction algorithms needed to obtain high quality PET images. Normalisation, geometric-, attenuation- and scatter correction are introduced. To explain the necessity of those some basics about PET scanner hardware, data acquisition and organisation are reviewed. During the course the students use a software application based on the STIR (software for tomographic image reconstruction) library 1,2 which allows them to dynamically select or deselect corrections and reconstruction methods as well as to modify their most important parameters. Following the guided tutorial, the students get an impression on the effect the individual data precorrections have on image quality and what happens if they are forgotten. Several data sets in sinogram format are provided, such as line source data, Jaszczak phantom data sets with high and low statistics and NEMA whole body phantom data. The two most frequently used reconstruction algorithms in PET image reconstruction, filtered back projection (FBP) and the iterative OSEM (ordered subset expectation maximation) approach are used to reconstruct images. The exercise should help the students gaining an understanding what the reasons for inferior image quality and artefacts are and how to improve quality by a clever choice of reconstruction parameters.

  2. Srebrenica: on joint criminal enterprise, aiding and abetting and command responsibility

    van der Wilt, H.


    The objective of this article is to find out how the atrocities in Srebrenica have been reconstructed by the ICTY by the choice of concepts of criminal responsibility that reflect the positions, contributions and relative guilt of the participants. The concepts of joint criminal enterprise, aiding a

  3. Biomatrices for bladder reconstruction.

    Lin, Hsueh-Kung; Madihally, Sundar V; Palmer, Blake; Frimberger, Dominic; Fung, Kar-Ming; Kropp, Bradley P


    There is a demand for tissue engineering of the bladder needed by patients who experience a neurogenic bladder or idiopathic detrusor overactivity. To avoid complications from augmentation cystoplasty, the field of tissue engineering seeks optimal scaffolds for bladder reconstruction. Naturally derived biomaterials as well as synthetic and natural polymers have been explored as bladder substitutes. To improve regenerative properties, these biomaterials have been conjugated with functional molecules, combined with nanotechology, or seeded with exogenous cells. Although most studies reported complete and functional bladder regeneration in small-animal models, results from large-animal models and human clinical trials varied. For functional bladder regeneration, procedures for biomaterial fabrication, incorporation of biologically active agents, introduction of nanotechnology, and application of stem-cell technology need to be standardized. Advanced molecular and medical technologies such as next generation sequencing and magnetic resonance imaging can be introduced for mechanistic understanding and non-invasive monitoring of regeneration processes, respectively.

  4. Reconstructability analysis of epistasis.

    Zwick, Martin


    The literature on epistasis describes various methods to detect epistatic interactions and to classify different types of epistasis. Reconstructability analysis (RA) has recently been used to detect epistasis in genomic data. This paper shows that RA offers a classification of types of epistasis at three levels of resolution (variable-based models without loops, variable-based models with loops, state-based models). These types can be defined by the simplest RA structures that model the data without information loss; a more detailed classification can be defined by the information content of multiple candidate structures. The RA classification can be augmented with structures from related graphical modeling approaches. RA can analyze epistatic interactions involving an arbitrary number of genes or SNPs and constitutes a flexible and effective methodology for genomic analysis.


    Human Resources Division


    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Serge Peraire with regard to exceptional advancement. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 17 to 31 May 2002. Human Resources Division Tel. 74128

  6. Joint Advisory Appeals Board


    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mrs Judith Igo-Kemenes concerning the application of procedures foreseen by Administrative Circular N§ 26 (Rev. 3). As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 6 to 20 June 2003. Human Resources Division Tel. 74128

  7. Joint Advisory Appeals Board


    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mrs Maria DIMOU with regard to a periodic one-step increase. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 30 April to 14 May 2004. Human Resources Department Tel. 74128

  8. Joint Advisory Appeals Board


    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Aloïs Girardoz with regard to classification and advancement. As the appellant has not objected, the Board's report and the Director-General's decision will be brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 15 to 29 August 2003. Human Resources Division Tel. 74128


    Human Resources Division


    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Bertrand Nicquevert with regard to the non-resident allowance. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 29 November to 13 December 2002. Human Resources Division Tel. 74128


    Human Resources Division


    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Jack Blanchard with regard to 'non recognition of specific functions'. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 12th to 26th April 2002. Human Resources Division Tel. 74128


    Human Resources Division


    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Antonio Millich with regard to advancement. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 27 September to 11 October 2002. Human Resources Division Tel. 74128

  12. Joint Advisory Appeals Board


    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Poul Frandsen concerning his assimilation into the new career structure. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 13 to 24 January 2003. Human Resources Division Tel. 74128


    Human Resources Division


    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Luc Vos with regard to advancement. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 14 to 28 June 2002. Human Resources Division Tel. 74128

  14. Surgery center joint ventures.

    Zasa, R J


    Surgery centers have been accepted as a cost effective, patient friendly vehicle for delivery of quality ambulatory care. Hospitals and physician groups also have made them the vehicles for coming together. Surgery centers allow hospitals and physicians to align incentives and share benefits. It is one of the few types of health care businesses physicians can own without anti-fraud and abuse violation. As a result, many surgery center ventures are now jointly owned by hospitals and physician groups. This article outlines common structures that have been used successfully to allow both to own and govern surgery centers.


    Personnel Division


    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Joào Bento with regard to residential category. As the appellant has not objected, the recommendations of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article RÊVIÊ1.20 of the Staff Regulations.The relevant documents will therefore be posted on the notice boards of the Administration Building (N¡ 60) from 29 October to 12 November 1999.Personnel DivisionTel. 74128

  16. Joint Advisory Appeals Board

    HR Department


    The Joint Advisory Appeals Board was convened to examine an appeal lodged by a member of the personnel with regard to advancement. The person concerned has requested that the report of the Board and the final decision of the Director-General be brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (No. 60) from 24 March to 10 April 2006. Human Resources Department Tel. 74128

  17. Bones and joints

    Runge, M.


    This exercise book guides the student and the radiologist wishing to review his knowledge to rapid and correct analysis and interpretation of radiologic findings in bone and joint disorders. The first part of the volume demonstrates the radiologic findings without going into the clinical and pathological aspects. In the second part, the reader then learns to analyse and diagnose systematically the case examples by means of a complete description of the X-ray images. Contents: Introduction; iconography; commentary with corresponding schemata; references and subject index.

  18. Joint Advisory Appeals Board

    HR Department


    The Joint Advisory Appeals Board has examined the internal appeal lodged by a member of the personnel with regard to the decision not to award him a periodic one-step advancement for the 2006 reference year. The person concerned has not objected to the report of the Board and the final decision of the Director-General being brought to the notice of the members of the personnel. In application of Article R VI 1.18 of the Staff Regulations, these documents will therefore be posted on the notice board of the Main building (Bldg. 500) from 17 March to 30 March 2008. Human Resources Department Tel. 73911

  19. Joint Advisory Appeals Board


    The Joint Advisory Appeals Board has examined the internal appeal lodged by a former member of the personnel, a beneficiary of the CERN Pension Fund, against the calculation of his pension in the framework of the Progressive Retirement Programme.   The person concerned has not objected to the report of the Board and the final decision of the Director-General being brought to the attention of the members of the personnel. In application of Article R VI 1.18 of the Staff Regulations, these documents will therefore be available from 26 July to 11 August 2013 at the following link. HR Department Head Office

  20. Joint Advisory Appeals Board

    HR Department


    The Joint Advisory Appeals Board has examined the internal appeal lodged by a member of the personnel against the decision to grant him only a periodic one-step advancement for the 2006 reference year. The person concerned has not objected to the report of the Board and the final decision of the Director-General being brought to the attention of the members of the personnel. In application of Article R VI 1.18 of the Staff Regulations, these documents will therefore be posted on the notice board of the Main Building (Bldg. 500) from 1 September to 14 September 2008. Human Resources Department (73911)

  1. Joint Advisory Appeals Board

    HR Department


    The Joint Advisory Appeals Board has examined the internal appeal lodged by a member of the personnel with regard to the decision not to grant him an indefinite contract. The person concerned has not objected to the report of the Board and the final decision of the Director-General being brought to the notice of the members of the personnel. In application of Article R VI 1.18 of the Staff Regulations, these documents will therefore be posted on the notice board of the Main Building (Bldg. 500) from 26 May to 6 June 2008. Human Resources Department (73911)

  2. Joint Advisory Appeals Board

    HR Department


    The Joint Advisory Appeals Board was convened to examine an internal appeal lodged by a member of the personnel with regard to the decision not to grant him an indefinite contract. The person concerned has requested that the report of the Board and the final decision of the Director-General be brought to the notice of the members of the personnel, in accordance with Article R VI 1.18 of the Staff Regulations. The relevant documents will therefore be posted on the notice board of the Main building (Bldg. 60) from 24 September to 7 October 2007. Human Resources Department

  3. Joint Advisory Appeals Board

    HR Department


    The Joint Advisory Appeals Board was convened to examine an internal appeal lodged by a member of the personnel with regard to the decision not to grant him an indefinite contract. The person concerned has not objected to the report of the Board and the final decision of the Director-General being brought to the notice of the members of the personnel, in accordance with Article R VI 1.18 of the Staff Regulations. These documents will therefore be posted on the notice board of the Main Building (Bldg. 60) from 21 January to 3 February 2008. Human Resources Department (73911)

  4. Joint Advisory Appeals Board

    HR Department


    The Joint Advisory Appeals Board has examined the internal appeal lodged by a member of the personnel against the decision to grant him only a periodic one-step advancement for the 2006 reference year. The person concerned has not objected to the report of the Board and the final decision of the Director-General being brought to the attention of the members of the personnel. In application of Article R VI 1.18 of the Staff Regulations, these documents will therefore be posted on the notice board of the Main building (bldg. 500) from 1 September to 14 September 2008. Human Resources Department (73911)

  5. Lisfranc Joint Injuries

    Lisa Chinn


    @@ The ankle and foot are the most common sites for athletic injuries.[1]Midfoot,or Lisfranc,injuries are the second most common foot injury and have a high in cidence in particular sports.They account for 4% of all football injuries per year,occurring frequently in linemen.[2]They are also common in equestrians,surfers,and windsurfers.[2]Lisfranc injuries are often misdiagnosed and if not treated properly can have lingering symptoms.It is estimated that Lisfranc joint injuries occur in 1 in every 55,000 persons every year.[3,4


    A. V. Korolev


    Full Text Available Purpose: To evaluate long-term results of meniscal repair during arthroscopic ACL reconstruction.Materials and methods: 45 patients who underwent meniscal repair during arthroscopic ACL reconstruction between 2007 and 2013 by the same surgeon were included in the study. In total, fifty meniscus were repaired (26 medial and 24 lateral. Procedures included use of one up to four Fast-Fix implants (Smith & Nephew. In five cases both medial and lateral meniscus were repaired. Cincinnati, IKDC and Lysholm scales were used for long-term outcome analysis.Results: 19 male and 26 female patients were included in the study aging from 15 to 59 years (mean age 33,2±1,5. Median time from injury to surgical procedure was zero months (ranging zero to one. Mean time from surgery to scale analysis was 55,9±3 months (ranged 20-102. Median Cincinnati score was 97 (ranged 90-100, with excellent results in 93% of cases (43 patients and good results in 7% (3 patients. Median IKDC score was 90,8 (ranged 86,2-95,4, with excellent outcomes in 51% of cases (23 patients, good in 33% (15 patients and satisfactory in 16% (7 patients. Median Lysholm score was 95 (ranged 90-100, with excellent outcomes in 76% of cases (34 patients and good in 24% (11 patients. Authors identified no statistical differences when comparing survey results in age, sex and time from trauma to surgery.Conclusions: Results of the present study match the data from orthopedic literature that prove meniscal repair as a safe and efficient procedure with good and excellent outcomes. All-inside meniscal repair can be used irrespectively of patients' age and is efficient even in case of delayed procedures.

  7. Closed rupture of the flexor tendons caused by carpal bone and joint disorders.

    Yamazaki, H; Kato, H; Hata, Y; Nakatsuchi, Y; Tsuchikane, A


    We analysed 21 patients with closed rupture of the flexor tendons caused by carpal bone and joint disorders. The tendon that ruptured depended on the location of the bone perforation into the carpal tunnel. Radiocarpal arthrography was performed in 13 patients and capsular perforation was demonstrated by contrast medium leakage into the carpal canal in 11 patients. This proved a useful diagnostic test. The flexor tendon(s) were reconstructed with free tendon graft in 17 patients, cross-over transfer of flexor tendons from adjacent digits in two and buddying to an adjacent flexor tendon in one patient. Postoperative total active range of motion in the fingers after 13 free tendon graft reconstructions averaged 213 degrees (range 170-265 degrees ). The active range of motion of the thumb-interphalangeal joint after free tendon graft reconstruction in three cases improved from 0 degrees to 33 degrees on average (range 10 degrees -40 degrees ).

  8. In vitro study of knee stability after two-band two-tunnel posterior cruciate ligament reconstruction

    MAO Yuan-qing; CHEN Bai-cheng; ZHU Zhen-an


    Objective: To compare the ability of three different reconstruction procedures in restoring the posterior displacement of tibia and the posterior stability of the knee joint from 0° to 120° flexion.Methods: Three posterior cruciate ligaments (PCL)reconstruction procedures were performed, namely twoband two-tunnel reconstruction, one-band anterior tunnel reconstruction and one-band posterior tunnel reconstruction. The posterior displacement of the tibia in relation to the femur was measured when a 200N posterior force was applied.Results: Within the flexion range of 0° to 30°, the displacement in the one-band posterior tunnel reconstruction showed little difference from that of an intact knee (P>0.05). But when the flexion exceeded 30°,especially when it exceeded 60°, the displacement in oneband posterior tunnel reconstruction was much greater than that of an intact knee (P < 0.01 ). In two-band two-tunnel reconstruction and one-band anterior tunnel reconstruction,the displacement was approximately the same as that of an intact knee ranging from 0° to 120° (P > 0.05), while a slight over-restriction might be found at some angles.Conclusions: Two-band reconstruction could effectively restrict the posterior displacement of the tibia and restore anterior, posterior stability of the knee joint within its full range of flexion. One-band anterior tunnel reconstruction also could maintain the posterior stability of the knee, while the result of one-band posterior tunnel reconstruction is the most unsatisfactory.

  9. Ptychographic reconstruction of attosecond pulses

    Lucchini, M; Ludwig, A; Gallmann, L; Keller, U; Feurer, T


    We demonstrate a new attosecond pulse reconstruction modality which uses an algorithm that is derived from ptychography. In contrast to other methods, energy and delay sampling are not correlated, and as a result, the number of electron spectra to record is considerably smaller. Together with the robust algorithm, this leads to a more precise and fast convergence of the reconstruction.

  10. Are temperature reconstructions regionally biased?

    Bothe, O


    Are temperature reconstructions possibly biased due to regionally differing density of utilized proxy-networks? This question is assessed utilizing a simple process-based forward model of tree growth in the virtual reality of two simulations of the climate of the last millennium with different amplitude of solar forcing variations. The pseudo-tree ring series cluster in high latitudes of the northern hemisphere and east Asia. Only weak biases are found for the full network. However, for a strong solar forcing amplitude the high latitudes indicate a warmer first half of the last millennium while mid-latitudes and Asia were slightly colder than the extratropical hemispheric average. Reconstruction skill is weak or non-existent for two simple reconstruction schemes, and comparison of virtual reality target and reconstructions reveals strong deficiencies. The temporal resolution of the proxies has an influence on the reconstruction task and results are sensitive to the construction of the proxy-network. Existing ...

  11. Fast Hadamard transforms for compressive sensing of joint systems: measurement of a 3.2 million-dimensional bi-photon probability distribution.

    Lum, Daniel J; Knarr, Samuel H; Howell, John C


    We demonstrate how to efficiently implement extremely high-dimensional compressive imaging of a bi-photon probability distribution. Our method uses fast-Hadamard-transform Kronecker-based compressive sensing to acquire the joint space distribution. We list, in detail, the operations necessary to enable fast-transform-based matrix-vector operations in the joint space to reconstruct a 16.8 million-dimensional image in less than 10 minutes. Within a subspace of that image exists a 3.2 million-dimensional bi-photon probability distribution. In addition, we demonstrate how the marginal distributions can aid in the accuracy of joint space distribution reconstructions.

  12. New concepts of rehabilitation following anterior cruciate reconstruction.

    Stanish, W D; Lai, A


    Can a knee joint with a torn ACL of 2 years' duration ever be able to return to high performance? Very unlikely indeed. Some realistic expectations follow: 1. The knee joint can never be normal after an ACL reconstruction. 2. Surgery must take place as early after the injury as possible, before secondary joint degeneration takes place. 3. The surgery must employ a tissue that best matches the normal ACL in strength and structure. 4. The surgery must involve as little trauma as possible while restoring knee joint mechanics. 5. Stress, although guarded, must be faced by the knee joint as soon as possible after surgery. 6. Progressive weight bearing starts immediately, combined with quadriceps isometrics. ROM of the knee joint, particularly full extension, is conserved and protected. 7. Progressive active ROM without formal resistance continues for 4 weeks. 8. Progressive formal resistance exercises continue for at least 1 year. 9. Sport-specific tasks commence at 16 weeks, depending on the requirement of the sport and the response of the individual athlete. 10. Recovery will plateau at several stages, with the final plateau at approximately 18 months. Knee instability is an exciting but perplexing problem. Although we have advanced profoundly from the era of Jones, Smiley, and others, we still face many of the same challenges as our predecessors. New technology should not fool us. We are still addressing a major structural failure within the knee joint. Our attempts have been non-surgical and surgical, with repair, reconstruction, and replacement. However, fundamental to all of these hopes has been the reconditioning of the extremity after ACL surgery. Can we do better than our forefathers like Licht and others? No one is certain. This article offers an approach, in some areas our approach, but should not be perceived as a cookbook. Individual responses by our patients, athletes, dictate whether any protocol is too hasty or tardy. It is fundamental that we listen to

  13. Joint collaborative technology experiment

    Wills, Michael; Ciccimaro, Donny; Yee, See; Denewiler, Thomas; Stroumtsos, Nicholas; Messamore, John; Brown, Rodney; Skibba, Brian; Clapp, Daniel; Wit, Jeff; Shirts, Randy J.; Dion, Gary N.; Anselmo, Gary S.


    Use of unmanned systems is rapidly growing within the military and civilian sectors in a variety of roles including reconnaissance, surveillance, explosive ordinance disposal (EOD), and force-protection and perimeter security. As utilization of these systems grows at an ever increasing rate, the need for unmanned systems teaming and inter-system collaboration becomes apparent. Collaboration provides a means of enhancing individual system capabilities through relevant data exchange that contributes to cooperative behaviors between systems and enables new capabilities not possible if the systems operate independently. A collaborative networked approach to development holds the promise of adding mission capability while simultaneously reducing the workload of system operators. The Joint Collaborative Technology Experiment (JCTE) joins individual technology development efforts within the Air Force, Navy, and Army to demonstrate the potential benefits of interoperable multiple system collaboration in a force-protection application. JCTE participants are the Air Force Research Laboratory, Materials and Manufacturing Directorate, Airbase Technologies Division, Force Protection Branch (AFRL/RXQF); the Army Aviation and Missile Research, Development, and Engineering Center Software Engineering Directorate (AMRDEC SED); and the Space and Naval Warfare Systems Center - Pacific (SSC Pacific) Unmanned Systems Branch operating with funding provided by the Joint Ground Robotics Enterprise (JGRE). This paper will describe the efforts to date in system development by the three partner organizations, development of collaborative behaviors and experimentation in the force-protection application, results and lessons learned at a technical demonstration, simulation results, and a path forward for future work.

  14. Phytomedicine in Joint Disorders

    Dorin Dragos


    Full Text Available Chronic joint inflammatory disorders such as osteoarthritis and rheumatoid arthritis have in common an upsurge of inflammation, and oxidative stress, resulting in progressive histological alterations and disabling symptoms. Currently used conventional medication (ranging from pain-killers to biological agents is potent, but frequently associated with serious, even life-threatening side effects. Used for millennia in traditional herbalism, medicinal plants are a promising alternative, with lower rate of adverse events and efficiency frequently comparable with that of conventional drugs. Nevertheless, their mechanism of action is in many cases elusive and/or uncertain. Even though many of them have been proven effective in studies done in vitro or on animal models, there is a scarcity of human clinical evidence. The purpose of this review is to summarize the available scientific information on the following joint-friendly medicinal plants, which have been tested in human studies: Arnica montana, Boswellia spp., Curcuma spp., Equisetum arvense, Harpagophytum procumbens, Salix spp., Sesamum indicum, Symphytum officinalis, Zingiber officinalis, Panax notoginseng, and Whitania somnifera.

  15. Phytomedicine in Joint Disorders

    Dragos, Dorin; Gilca, Marilena; Gaman, Laura; Vlad, Adelina; Iosif, Liviu; Stoian, Irina; Lupescu, Olivera


    Chronic joint inflammatory disorders such as osteoarthritis and rheumatoid arthritis have in common an upsurge of inflammation, and oxidative stress, resulting in progressive histological alterations and disabling symptoms. Currently used conventional medication (ranging from pain-killers to biological agents) is potent, but frequently associated with serious, even life-threatening side effects. Used for millennia in traditional herbalism, medicinal plants are a promising alternative, with lower rate of adverse events and efficiency frequently comparable with that of conventional drugs. Nevertheless, their mechanism of action is in many cases elusive and/or uncertain. Even though many of them have been proven effective in studies done in vitro or on animal models, there is a scarcity of human clinical evidence. The purpose of this review is to summarize the available scientific information on the following joint-friendly medicinal plants, which have been tested in human studies: Arnica montana, Boswellia spp., Curcuma spp., Equisetum arvense, Harpagophytum procumbens, Salix spp., Sesamum indicum, Symphytum officinalis, Zingiber officinalis, Panax notoginseng, and Whitania somnifera.

  16. Jointly Sponsored Research Program

    Everett A. Sondreal; John G. Hendrikson; Thomas A. Erickson


    U.S. Department of Energy (DOE) Cooperative Agreement DE-FC26-98FT40321 funded through the Office of Fossil Energy and administered at the National Energy Technology Laboratory (NETL) supported the performance of a Jointly Sponsored Research Program (JSRP) at the Energy & Environmental Research Center (EERC) with a minimum 50% nonfederal cost share to assist industry in commercializing and effectively applying highly efficient, nonpolluting energy systems that meet the nation's requirements for clean fuels, chemicals, and electricity in the 21st century. The EERC in partnership with its nonfederal partners jointly performed 131 JSRP projects for which the total DOE cost share was $22,716,634 (38%) and the nonfederal share was $36,776,573 (62%). Summaries of these projects are presented in this report for six program areas: (1) resource characterization and waste management, (2) air quality assessment and control, (3) advanced power systems, (4) advanced fuel forms, (5) value-added coproducts, and (6) advanced materials. The work performed under this agreement addressed DOE goals for reductions in CO{sub 2} emissions through efficiency, capture, and sequestration; near-zero emissions from highly efficient coal-fired power plants; environmental control capabilities for SO{sub 2}, NO{sub x}, fine respirable particulate (PM{sub 2.5}), and mercury; alternative transportation fuels including liquid synfuels and hydrogen; and synergistic integration of fossil and renewable resources.

  17. Arthrography of the knee joint

    Keyl, W.; Jaeger, M.


    The standardized examination technique and the clinical problems of the arthrographic mehtod applied on the knee joint is explained by the results obtained in 3000 examinations. Whereas the accuracy of the knee-joint arthrography provides a high degree in cases of meniscus lesions, computer tomography presents in chondral and capsular ligament lesions, and sonography in popliteal cysts better diagnostic information; but in any case arthroscopy gains more and more importance in knee-joint diagnostics.

  18. OIG targets contractual joint ventures.

    O'Hare, Patrick K


    A recent OIG Special Advisory Bulletin raises questions for providers involved in joint ventures. The Bulletin describes several characteristics that the OIG views as potentially suspect, including a referral stream controlled by the provider initiating the joint venture and the use of a wholly owned subsidiary of the provider to bill and collect for services. According to the OIG, profits paid by the subsidiary to the provider owner in such "suspect contractual joint ventures" could constitute illegal remuneration for referrals.

  19. Blob-enhanced reconstruction technique

    Castrillo, Giusy; Cafiero, Gioacchino; Discetti, Stefano; Astarita, Tommaso


    A method to enhance the quality of the tomographic reconstruction and, consequently, the 3D velocity measurement accuracy, is presented. The technique is based on integrating information on the objects to be reconstructed within the algebraic reconstruction process. A first guess intensity distribution is produced with a standard algebraic method, then the distribution is rebuilt as a sum of Gaussian blobs, based on location, intensity and size of agglomerates of light intensity surrounding local maxima. The blobs substitution regularizes the particle shape allowing a reduction of the particles discretization errors and of their elongation in the depth direction. The performances of the blob-enhanced reconstruction technique (BERT) are assessed with a 3D synthetic experiment. The results have been compared with those obtained by applying the standard camera simultaneous multiplicative reconstruction technique (CSMART) to the same volume. Several blob-enhanced reconstruction processes, both substituting the blobs at the end of the CSMART algorithm and during the iterations (i.e. using the blob-enhanced reconstruction as predictor for the following iterations), have been tested. The results confirm the enhancement in the velocity measurements accuracy, demonstrating a reduction of the bias error due to the ghost particles. The improvement is more remarkable at the largest tested seeding densities. Additionally, using the blobs distributions as a predictor enables further improvement of the convergence of the reconstruction algorithm, with the improvement being more considerable when substituting the blobs more than once during the process. The BERT process is also applied to multi resolution (MR) CSMART reconstructions, permitting simultaneously to achieve remarkable improvements in the flow field measurements and to benefit from the reduction in computational time due to the MR approach. Finally, BERT is also tested on experimental data, obtaining an increase of the

  20. Porcelain three-dimensional shape reconstruction and its color reconstruction

    Yu, Xiaoyang; Wu, Haibin; Yang, Xue; Yu, Shuang; Wang, Beiyi; Chen, Deyun


    In this paper, structured light three-dimensional measurement technology was used to reconstruct the porcelain shape, and further more the porcelain color was reconstructed. So the accurate reconstruction of the shape and color of porcelain was realized. Our shape measurement installation drawing is given. Because the porcelain surface is color complex and highly reflective, the binary Gray code encoding is used to reduce the influence of the porcelain surface. The color camera was employed to obtain the color of the porcelain surface. Then, the comprehensive reconstruction of the shape and color was realized in Java3D runtime environment. In the reconstruction process, the space point by point coloration method is proposed and achieved. Our coloration method ensures the pixel corresponding accuracy in both of shape and color aspects. The porcelain surface shape and color reconstruction experimental results completed by proposed method and our installation, show that: the depth range is 860 ˜ 980mm, the relative error of the shape measurement is less than 0.1%, the reconstructed color of the porcelain surface is real, refined and subtle, and has the same visual effect as the measured surface.

  1. Arthroscopic capsule reconstruction in the hip using iliotibial band allograft.

    Trindade, Christiano A C; Sawyer, Gregory A; Fukui, Kiyokazu; Briggs, Karen K; Philippon, Marc J


    The hip capsule has been identified as an important static stabilizer of the hip joint. Despite the intrinsic bony stability of the hip socket, the capsule plays a key role in hip stability, particularly at the extremes of motion, and the iliofemoral ligament is the most important stabilizer in extension and external rotation. Patients who do not undergo capsular closure or plication may continue to complain of hip pain and dysfunction postoperatively, likely because of microinstability or muscle invagination into the capsular defect, and high-resolution magnetic resonance imaging or magnetic resonance arthrography will identify the capsular defect. Seen primarily in the revision setting, capsular defects can cause recurrent stress at the chondrolabral junction. An attempt at secondary closure can be challenging because of capsular limb adherence to the surrounding soft tissues. Therefore reconstruction may be the only possible surgical solution for this problem. We describe our new surgical technique for arthroscopic hip capsular reconstruction using iliotibial band allograft.

  2. Joint audits - benefit or burden?

    Holm, Claus; Thinggaard, Frank

    In this paper we examine whether there are perceived and observed benefits or burdens from using two audit firms instead of one. In 2005 the mandatory joint audit requirement was abolished in Denmark. This provides a unique setting for studying the consequences and implications of going from...... a joint audit regime to a single auditor/voluntary joint audit regime. The dataset used in this paper has been collected for the full population of non-financial Danish companies listed on the Copenhagen Stock Exchange (CSE) in the years 2004 and 2005. We find that a majority of firms perceive joint...

  3. Sacroiliac joint dysfunction in athletes.

    Brolinson, P Gunnar; Kozar, Albert J; Cibor, Greg


    The sacroiliac (SI) joint is a common source of low back pain in the general population. Because it is the link between the lower extremities and the spine, it sustains even higher loads during athletic activity, predisposing athletes to a greater probability of joint dysfunction and pain. The diagnosis and treatment of SI joint dysfunction remains controversial, due to complex anatomy and biomechanics, and a lack of universally accepted nomenclature and terminology, consistently reliable clinical tests and imaging studies, and consistently effective treatments. This article clarifies these issues by presenting a model of SI joint anatomy and function, a systematic approach to the diagnosis of dysfunction, and a comprehensive treatment plan.

  4. Induction brazing of complex joints

    Henningsen, Poul; Zhang, Wenqi; Bay, Niels


    Induction brazing is a fast and appropriate method for industrial joining of complex geometries and metal combinations. In all types of brazing processes it is important to heat the joint interface of the two materials to the same, high temperature. If one of the specimens is warmer than the other......, or if the hottest area is located outside the joint interface, a number of defects may appear: the braze metal may flow away from the joint, the flux may burn off, poor binding of the braze metal may appear or the braze metal may be overheated. Joint geometry as well as electro-magnetic properties of the work piece...

  5. Variable Joint Elasticities in Running

    Peter, Stephan; Grimmer, Sten; Lipfert, Susanne W.; Seyfarth, Andre

    In this paper we investigate how spring-like leg behavior in human running is represented at joint level. We assume linear torsion springs in the joints and between the knee and the ankle joint. Using experimental data of the leg dynamics we compute how the spring parameters (stiffness and rest angles) change during gait cycle. We found that during contact the joints reveal elasticity with strongly changing parameters and compare the changes of different parameters for different spring arrangements. The results may help to design and improve biologically inspired spring mechanisms with adjustable parameters.

  6. Errors and Uncertainties in Dose Reconstruction for Radiation Effects Research

    Strom, Daniel J.


    Dose reconstruction for studies of the health effects of ionizing radiation have been carried out for many decades. Major studies have included Japanese bomb survivors, atomic veterans, downwinders of the Nevada Test Site and Hanford, underground uranium miners, and populations of nuclear workers. For such studies to be credible, significant effort must be put into applying the best science to reconstructing unbiased absorbed doses to tissues and organs as a function of time. In many cases, more and more sophisticated dose reconstruction methods have been developed as studies progressed. For the example of the Japanese bomb survivors, the dose surrogate “distance from the hypocenter” was replaced by slant range, and then by TD65 doses, DS86 doses, and more recently DS02 doses. Over the years, it has become increasingly clear that an equal level of effort must be expended on the quantitative assessment of uncertainty in such doses, and to reducing and managing uncertainty. In this context, this paper reviews difficulties in terminology, explores the nature of Berkson and classical uncertainties in dose reconstruction through examples, and proposes a path forward for Joint Coordinating Committee for Radiation Effects Research (JCCRER) Project 2.4 that requires a reasonably small level of effort for DOSES-2008.

  7. Analysis of limb function after various reconstruction methods according to tumor location following resection of pediatric malignant bone tumors

    Tokuhashi Yasuaki


    Full Text Available Abstract Background In the reconstruction of the affected limb in pediatric malignant bone tumors, since the loss of joint function affects limb-length discrepancy expected in the future, reconstruction methods that not only maximally preserve the joint function but also maintain good limb function are necessary. We analysis limb function of reconstruction methods by tumor location following resection of pediatric malignant bone tumors. Patients and methods We classified the tumors according to their location into 3 types by preoperative MRI, and evaluated reconstruction methods after wide resection, paying attention to whether the joint function could be preserved. The mean age of the patients was 10.6 years, Osteosarcoma was observed in 26 patients, Ewing's sarcoma in 3, and PNET(primitive neuroectodermal tumor and chondrosarcoma (grade 1 in 1 each. Results Type I were those located in the diaphysis, and reconstruction was performed using a vascularized fibular graft(vascularized fibular graft. Type 2 were those located in contact with the epiphyseal line or within 1 cm from this line, and VFG was performed in 1, and distraction osteogenesis in 1. Type III were those extending from the diaphysis to the epiphysis beyond the epiphyseal line, and a Growing Kotz was mainly used in 10 patients. The mean functional assessment score was the highest for Type I (96%: n = 4 according to the type and for VFG (99% according to the reconstruction method. Conclusion The final functional results were the most satisfactory for Types I and II according to tumor location. Biological reconstruction such as VFG and distraction osteogenesis without a prosthesis are so high score in the MSTS rating system. Therefore, considering the function of the affected limb, a limb reconstruction method allowing the maximal preservation of joint function should be selected after careful evaluation of the effects of chemotherapy and the location of the tumor.

  8. Multiview specular stereo reconstruction of large mirror surfaces

    Balzer, Jonathan


    In deflectometry, the shape of mirror objects is recovered from distorted images of a calibrated scene. While remarkably high accuracies are achievable, state-of-the-art methods suffer from two distinct weaknesses: First, for mainly constructive reasons, these can only capture a few square centimeters of surface area at once. Second, reconstructions are ambiguous i.e. infinitely many surfaces lead to the same visual impression. We resolve both of these problems by introducing the first multiview specular stereo approach, which jointly evaluates a series of overlapping deflectometric images. Two publicly available benchmarks accompany this paper, enabling us to numerically demonstrate viability and practicability of our approach. © 2011 IEEE.




    Peripheral joint mobility of temporomandibular joint (TMJ) osteoarthrosis and internal derangement patients (n = 25) and of a control group (n = 29) was measured according to a rigidly standardized protocol, in order to study the relationships between TMJ osteoarthrosis and internal derangement and

  10. Index of Joint Condition for PVC push-fit joints

    Arsenio, A.M.; Vreeburg, J.H.G.; Rietveld, L.


    The Index of Joint Condition (IJC) for polyvinyl chloride (PVC) push-fit joints, discussed in this article, was derived from installation guidelines and from destructive laboratory tests. The IJC is presented in a graphical framework and is a powerful tool to employ in order to visualize and compare

  11. Traumatic Posterior Urethral Fistula to the Hip Joint Following Gunshot Injury: A Case Report

    Mohammad Ghasemi-Rad


    Full Text Available Introduction: Fistula of the Urinary system to the hip joint is a rare complication. We report a case of delayed posterior urethral fistula to the hip joint following penetrating gunshot wound injury."nCase Presentation: A 37-year-old man was shot with firearm to the superior part of the right pelvis. He underwent delayed reconstruction surgery for urethral rupture. After 10 months of initial injury, he presented with inability to urinate, and history of progressive pain in the right hip joint accompanied by low-grade fever, which started two months after the initial injury. In retrograde urethrography and antegrade cystography, a 5 cm-long stricture and a fistula tract to the right hip joint were detected. Hip x-ray showed evidence of acetabular cavity and femoral head destruction diagnostic of complicated septic arthritis. The patient subsequently underwent reconstructive surgery for the urethral stricture and urethral fistula via a transperineal approach followed by total hip arthroplasty."nConclusion: Hip joint contamination with urine following urethro-acetabular fistula may lead to severe and disabling complications such as septic arthritis. We recommend that every clinician should have these fistulas in mind as a complication of penetrating urethral injury; every attempt should be made for their early diagnosis and prompt treatment should be performed to prevent further complications."nKeywords: Urethral Fistula, Hip Joint, Gunshot Injury, Urethro-Acetabular Fistula, Trauma    

  12. Dynamic stereometry of the temporomandibular joint.

    Palla, S; Gallo, L M; Gössi, D


    Studies on jaw kinematics have provided a good understanding of the motion of the mandible in space, but are of little biomechanical relevance because they could not relate the movements to anatomic structures. This is possible by the combination of three-dimensional reconstructions of the temporomandibular joint (TMJ) anatomy with jaw motion recordings. This technique allows us to analyze the variation of the relationship between the articular surfaces, providing indirect insight into disk deformation during function and parafunction as well as TMJ loading. As far as the variation of the condyle-fossa distance is concerned, data indicated that during chewing the distance was smaller 1) on closing than on opening; 2) on the balancing than on the working side; and 3) during chewing of hard than soft food. Moreover, during a forceful static biting, the condyle-fossa distance decreased more on the contralateral, i.e. on the balancing side than on the working side. The decrease was related to the degree of clenching force. These results support the content that both condyles are loaded during chewing and the balancing side joint more than the working one. Biomechanically, the development of osteoarthrosis is more likely related to the magnitude and frequency of stresses applied on the cartilage. Joint movements produce tractional forces that may cause shear stresses contributing to cartilage wear and fatigue. Tractional forces are the result of frictional forces caused by the cartilage surface rubbing and of plowing forces caused by the translation of a stress-field through the cartilage matrix, as the intra-articular space changes during motion. Translation of the stress-field in mediolateral direction seems to be particularly important for the integrity of the TMJ disk because of its anisotropic properties. Dynamic stereometry showed that stress-fields translate in mediolateral direction during opening/closing, protrusion and laterotrusion, and that their translatory

  13. Comparison of clinical outcomes of double Endobutton plate versus clavicular hook plate for TossyⅢacromioclavicular dislocation:A systematic review and metaanalysis%双Endobutton钢板与锁骨钩钢板治疗TossyⅢ型肩锁关节脱位疗效比较Meta分析

    任士友; 江长青; 张文涛; 李伟


    目的:采用Meta分析法对双Endobutton钢板与锁骨钩钢板治疗TossyⅢ型肩锁关节脱位的疗效进行对比,为其广泛的应用提供循证证据。方法检索Medline,EMbase,Cochrane Library,Springerlink、中国知识资源总库、万方数据库、维普数据库。检索时间为2006年1月—2014年5月。收集双Endobutton钢板与锁骨钩钢板治疗TossyⅢ型肩锁关节脱位的相关文献,按纳入与排除标准筛选文献并对纳入文献进行质量评价,采用RevMan5.2软件进行分析。结果共纳入31篇文献,病例数合计为1346例,其中双Endobutton钢板组618例,锁骨钩钢板组728例。结果显示在主要观察指标中,双Endobutton钢板组在术后疗效、术后关节活动正常概率均优于锁骨钩钢板组(P<0.0001);在次要观察指标分析中,双Endobutton钢板组切口长度、术后肌力正常概率、Constant-Murley评分优于锁骨钩钢板组(P<0.05),其余两项指标锁骨钩钢板组优于双Endobutton钢板组(P<0.05)。结论双Endobutton钢板治疗TossyⅢ型肩锁关节脱位在疗效、术后疼痛风险、术后关节活动正常概率、切口长度、术后肌力正常概率方面优于锁骨钩钢板,而在手术时间、术中出血量方面劣于锁骨钩钢板。%Objective To evaluate the effects of double Endobutton plate versus clavicular hook plate in the treatment of Tossy Ⅲ acromioclavicular dislocation. Methods Eligible studies were identified from electronic databases including Medline、EMbase、Cochrane Library、Springerlink, CNKI, WanFang Data and VIP. We screened the retrieved literature according to the inclusion and exclusion criteria and performed a Metaanalysis with the software RevMan 5.2 after identification of the relevant data. Results A total of 1246 patients from 29 studies were included for the analysis, including 570 patients who underwent double Endobutton plate surgeries and 676 patients who underwent

  14. Evidence-Based ACL Reconstruction



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


    Human Resources Division


    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Neil Calder, Mrs Sudeshna Datta Cockerill, Mrs Andrée Fontbonne, Mrs Moniek Laurent and Mr Ulrich Liptow with regard to membership in the Pension Fund under the period with a Paid Associate contract, appeals dealt with on a collective basis. As the appellants have not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 10 to 31 August 2001.

  16. Reconstruction of B mesons

    Albrecht, H.; Binder, U.; Böckmann, P.; Gläser, R.; Harder, G.; Lembke-Koppitz, I.; Schmidt-Parzefall, W.; Schröder, H.; Schulz, H. D.; Wurth, R.; Yagil, A.; Donker, J. P.; Drescher, A.; Kamp, D.; Matthiesen, U.; Scheck, H.; Spaan, B.; Spengler, J.; Wegener, D.; Gabriel, J. C.; Schubert, K. R.; Stiewe, J.; Strahl, K.; Waldi, R.; Weseler, S.; Edwards, K. W.; Frisken, W. R.; Gilkinson, D. J.; Gingrich, D. M.; Kapitza, H.; Kim, P. C. H.; Kutschke, R.; Macfarlane, D. B.; McKenna, J. A.; McLean, K. W.; Nilsson, A. W.; Orr, R. S.; Padley, P.; Parsons, J. A.; Patel, P. M.; Prentice, J. D.; Seywerd, H. C. J.; Swain, J. D.; Tsipolitis, G.; Yoon, T.-S.; Yun, J. C.; Ammar, R.; Coppage, D.; Davis, R.; Kanekal, S.; Kwak, N.; Boštjančič, B.; Kernel, G.; Pleško, M.; Jönsson, L.; Babaev, A.; Danilov, M.; Golutvin, A.; Gorelov, I.; Lubimov, V.; Matveev, V.; Nagovitsin, V.; Ryltsov, V.; Semenov, A.; Shevchenko, V.; Soloshenko, V.; Tchistilin, V.; Tichomirov, I.; Zaitzev, Yu.; Childers, R.; Darden, C. W.; Oku, Y.; Gennow, H.; Argus Collaboration


    B mesons have been reconstructed in five decay channels of the type B→D ∗±nπ(n=1,2,3) using data accumulated by the ARGUS experiment at the e +e - storage ring DORIS II at DESY. In total, we find 40 neutral B mesons above a background of 15±6 events with a mass of (5278.2±1.0±3.0) MeV/ c2 and 32 charged B mesons above a background of 17±6 events with a mass of (5275.8±1.3±3.0) MeV/ c2. The decays overlineB0D∗+π -π 0, overlineB0D∗+π -π -π +, and B-→ D∗+π -π -π 0 have been observed for the first time. We find substantially smaller branching ratios for the decay modes overlineB0→ D∗+π - and B-→ D∗+π -π - than previously published by the CLEO collaboration.

  17. Reconstructing human evolution

    Cavalli-Sforza, M


    One can reconstruct human evolution using modern genetic data and models based on the mathematical theory of evolution and its four major factors : mutation, natural selection, statistical fluctuations in finite populations (random genetic drift), and migration. Archaeology gives some help on the major dates and events of the process. Chances of studying ancient DNA are very limited but there have been a few successful results. Studying DNA instead of proteins, as was done until a few years ago, and in particular the DNA of mitochondria and of the Y chromosome which are transmitted, respectively, by the maternal line and the paternal line, has greatly simplified the analysis. It is now possible to carry the analysis on individuals, while earlier studies were of necessity based on populations. Also the evolution of ÒcultureÓ (i.e. what we learn from others), in particular that of languages, gives some help and can be greatly enlightened by genetic studies. Even though it is largely based on mechanisms of mut...

  18. Facial Reconstruction and Rehabilitation.

    Guntinas-Lichius, Orlando; Genther, Dane J; Byrne, Patrick J


    Extracranial infiltration of the facial nerve by salivary gland tumors is the most frequent cause of facial palsy secondary to malignancy. Nevertheless, facial palsy related to salivary gland cancer is uncommon. Therefore, reconstructive facial reanimation surgery is not a routine undertaking for most head and neck surgeons. The primary aims of facial reanimation are to restore tone, symmetry, and movement to the paralyzed face. Such restoration should improve the patient's objective motor function and subjective quality of life. The surgical procedures for facial reanimation rely heavily on long-established techniques, but many advances and improvements have been made in recent years. In the past, published experiences on strategies for optimizing functional outcomes in facial paralysis patients were primarily based on small case series and described a wide variety of surgical techniques. However, in the recent years, larger series have been published from high-volume centers with significant and specialized experience in surgical and nonsurgical reanimation of the paralyzed face that have informed modern treatment. This chapter reviews the most important diagnostic methods used for the evaluation of facial paralysis to optimize the planning of each individual's treatment and discusses surgical and nonsurgical techniques for facial rehabilitation based on the contemporary literature.

  19. Hierarchical Bayesian Model for Simultaneous EEG Source and Forward Model Reconstruction (SOFOMORE)

    Stahlhut, Carsten; Mørup, Morten; Winther, Ole;


    In this paper we propose an approach to handle forward model uncertainty for EEG source reconstruction. A stochastic forward model is motivated by the many uncertain contributions that form the forward propagation model including the tissue conductivity distribution, the cortical surface, and ele......In this paper we propose an approach to handle forward model uncertainty for EEG source reconstruction. A stochastic forward model is motivated by the many uncertain contributions that form the forward propagation model including the tissue conductivity distribution, the cortical surface......, and electrode positions. We first present a hierarchical Bayesian framework for EEG source localization that jointly performs source and forward model reconstruction (SOFOMORE). Secondly, we evaluate the SOFOMORE model by comparison with source reconstruction methods that use fixed forward models. Simulated...... and real EEG data demonstrate that invoking a stochastic forward model leads to improved source estimates....

  20. Extraction and Reconstruction of Zebra Crossings from High Resolution Aerial Images

    Yanbiao Sun


    Full Text Available In this paper, an automatic approach for zebra crossing extraction and reconstruction from high-resolution aerial images is proposed. In the extraction procedure, zebra crossings are extracted by the JointBoost classifier based on GLCM (Gray Level Co-occurrence Matrix features and 2D Gabor Features. In the reconstruction procedure, a geometric parameter model based on spatial repeatability relationships is globally fitted to reconstruct the geometric shape of zebra crossings. Additionally, a group of representative experiments is conducted to test the proposed method under interfered conditions, such as zebra crossings covered by pedestrians, shadows and color fading. Furthermore, the performance of the proposed extraction method is compared with the template matching method. Finally, the results show the validation of our proposed method, both in the extraction and reconstruction of zebra crossings.

  1. A constrained variable projection reconstruction method for photoacoustic computed tomography without accurate knowledge of transducer responses

    Sheng, Qiwei; Matthews, Thomas P; Xia, Jun; Zhu, Liren; Wang, Lihong V; Anastasio, Mark A


    Photoacoustic computed tomography (PACT) is an emerging computed imaging modality that exploits optical contrast and ultrasonic detection principles to form images of the absorbed optical energy density within tissue. When the imaging system employs conventional piezoelectric ultrasonic transducers, the ideal photoacoustic (PA) signals are degraded by the transducers' acousto-electric impulse responses (EIRs) during the measurement process. If unaccounted for, this can degrade the accuracy of the reconstructed image. In principle, the effect of the EIRs on the measured PA signals can be ameliorated via deconvolution; images can be reconstructed subsequently by application of a reconstruction method that assumes an idealized EIR. Alternatively, the effect of the EIR can be incorporated into an imaging model and implicitly compensated for during reconstruction. In either case, the efficacy of the correction can be limited by errors in the assumed EIRs. In this work, a joint optimization approach to PACT image r...

  2. First experiences with simultaneous skeletal and soft tissue reconstruction of noma-related facial defects.

    Giessler, Goetz A; Borsche, André; Lim, Paul K; Schmidt, Andreas B; Cornelius, C-Peter


    Noma victims suffer from a three-dimensional facial soft-tissue loss. Some may also develop complex viscerocranial defects, due to acute osteitis, chronic exposure, or arrested skeletal growth. Reconstruction has mainly focused on soft tissue so far, whereas skeletal restoration was mostly avoided. After successful microvascular soft tissue free flap reconstruction, we now included skeletal restoration and mandibular ankylosis release into the initial step of complex noma surgery. One free rib graft and parascapular flap, one microvascular osteomyocutaneous flap from the subscapular system, and two sequential chimeric free flaps including vascularized bone were used as the initial steps for facial reconstruction. Ankylosis release could spare the temporomandibular joint. Complex noma reconstruction should include skeletal restoration. Avascular bone is acceptable in cases with complete vascularized graft coverage. Microsurgical chimeric flaps are preferable as they can reduce the number and complexity of secondary operations and provide viable, infection-resistant bone supporting facial growth.

  3. Image Interpolation Through Surface Reconstruction

    ZHANG Ling; LI Xue-mei


    Reconstructing an HR (high-resolution) image which preserves the image intrinsic structures from its LR ( low-resolution) counterpart is highly challenging. This paper proposes a new surface reconstruction algorithm applied to image interpolation. The interpolation surface for the whole image is generated by putting all the quadratic polynomial patches together. In order to eliminate the jaggies of the edge, a new weight function containing edge information is incorporated into the patch reconstruction procedure as a constraint. Extensive experimental results demonstrate that our method produces better results across a wide range of scenes in terms of both quantitative evaluation and subjective visual quality.

  4. 37 CFR 1.45 - Joint inventors.


    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Joint inventors. 1.45 Section... Patent § 1.45 Joint inventors. (a) Joint inventors must apply for a patent jointly and each must make the... patent for an invention invented by them jointly, except as provided in § 1.47. (b) Inventors may...

  5. 38 CFR 4.45 - The joints.


    ..., ratable on a parity with major joints. The lumbosacral articulation and both sacroiliac joints are... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false The joints. 4.45 Section... DISABILITIES Disability Ratings The Musculoskeletal System § 4.45 The joints. As regards the joints the...

  6. Sagittal laser optical tomography for imaging of rheumatoid finger joints

    Hielscher, Andreas H [Departments of Biomedical Engineering and Radiology, Columbia University, New York, NY 10027 (United States); Klose, Alexander D [Departments of Biomedical Engineering and Radiology, Columbia University, New York, NY 10027 (United States); Scheel, Alexander K [Department of Nephrology and Rheumatology, Georg-August University, Goettingen (Germany); Moa-Anderson, Bryte [Departments of Biomedical Engineering and Radiology, Columbia University, New York, NY 10027 (United States); Backhaus, Marina [Department of Rheumatology and Clinical Immunology, Charite University Hospital, Berlin (Germany); Netz, Uwe [Institute for Medical Physics and Laser Medicine, Free University of Berlin, Berlin (Germany); Beuthan, Juergen [Institute for Medical Physics and Laser Medicine, Free University of Berlin, Berlin (Germany)


    We present a novel optical tomographic imaging system that was designed to determine two-dimensional spatial distribution of optical properties in a sagittal plane through finger joints. The system incorporates a single laser diode and a single silicon photodetector into a scanning device that records spatially resolved light intensities as they are transmitted through a finger. These data are input to a model-based iterative image reconstruction (MOBIIR) scheme, which uses the equation of radiative transfer (ERT) as a forward model for light propagation through tissue. We have used this system to obtain tomographic images of six proximal interphalangeal finger joints from two patients with rheumatoid arthritis. The optical images were compared to clinical symptoms and ultrasound images.

  7. Structuring managed care joint ventures.

    Williams, L


    Providers that undertake joint ventures to secure managed care contracts must understand the important governance, operational, legal, and political issues involved. Careful planning in all these areas can help ensure that the joint venture will meet its goals and avoid problems such as inappropriately negotiated contracts and legal violations.

  8. Steroid injections - tendon, bursa, joint

    ... PA: Elsevier Mosby; 2014:chap 71. Schrank KS. Joint disorders. In: Adams JG, ed. Emergency Medicine. 2nd ed. ... A.M. Editorial team. Related MedlinePlus Health Topics Joint Disorders Steroids Browse the Encyclopedia A.D.A.M., ...


    ZhuoLi; ShenLanusun


    An improved FGS (Fine Granular Scalability) coding method is proposed in this letter,which is based on human visual characteristics.This method adjusts FGS coding frame rate according to the evaluation of video sequences so as to improve the coding efficiency and subject perceived quality of reconstructed images.Finally,a fine granular joint source channel coding is proposed based on the source coding method,which not only utilizes the network resources efficiently,but guarantees the reliable transmission of video information.

  10. System for three-dimensional biomechanical analysis of joints

    Siebert, Markus; Englmeier, Karl-Hans; von Eisenhart-Rothe, Ruediger; Bringmann, Christoph; Eckstein, Felix; Bonel, H.; Reiser, Maximilian; Graichen, Heiko


    We developed 3D MR based image processing methods for biomechanical analysis of joints. These methods provide quantitative data on the morphological distribution of the joint cartilage as well as biomechanical analysis of relative translation and rotation of joints. After image data acquisition in an open MR system, the segmentation of the different joint structures was performed by a semi automatic technique based on a gray value oriented region growing algorithm. After segmentation 3D reconstructions of cartilage and bone surfaces were performed. Principal axis decomposition is used to calculate a reproducible tibia plateau based coordinate system that allows the determination of relative rotation and translation of the condyles and menisci in relation to the tibia plateau. The analysis of the femoral movement is based on a reproducible, semi automatic calculated epicondylar axis. The analysis showed a posterior translation of the meniscus and even more of the femur condyles in healthy knees and in knees with an insufficiency of the anterior cruciate ligament (ACL).

  11. [Treatment Strategies for Septic Arthritis of the Sternoclavicular Joint].

    Kuhtin, O; Schmidt-Rohlfing, B; Dittrich, M; Lampl, L; Hohls, M; Haas, V


    Septic arthritis of the sternoclavicular joint (SCJ) is a relatively rare disease. Due to serious complications including mediastinitis and generalised sepsis early diagnosis and rapid onset of treatment are mandatory. The disease often affects immunocompromised patients, diabetics, or patients with other infectious diseases. The therapeutic options range from administration of antibiotics to extended surgery including reconstructive procedures. Apart from rare situations where conservative treatment with antibiotics is sufficient, joint resection followed by plastic surgical procedures are required. We present a retrospective analysis with data from two hospitals. From January 2008 to December 2012 23 patients with radiographically confirmed septic arthritis of various aetiology were included. Fourteen (60.8 %) male, nine (39.2 %) female patients with an average age of 60.3 ± 14.2 years (range: 23-88 years) with septic arthritis of the SCJ were treated. Seven (30.4 %) patients suffered from Diabetes mellitus, nine (39.1 %) had underlying diseases with a compromised immune system. In 14 (60.8 %) out of 23 patients a bacterial focus was detected. Only six (26 %) patients suffered from confined septic arthritis of the SCG, in 17 (73,9 %) patients osteomyelitis of the adjacent sternum, and the clavicle was present. In addition, 15 (65.2 %) patients already suffered from mediastinitis at the time of diagnosis, eight (35 %) patients even from septicaemia. In conclusion, septic arthritis requires an active surgical treatment. Limited incision of the joint and debridement alone is only successful at early stages of the disease. The treatment concept has to include the local joint and bone resection as well as complications like mediastinitis. After successful treatment of the infection, the defect of the chest wall requires secondary reconstructive surgery using a pedicled pectoralis muscle flap.

  12. Osteoarthritis of the Wrist STT Joint and Radiocarpal Joint

    Ronit Wollstein


    Full Text Available Our understanding of wrist osteoarthritis (OA lags behind that of other joints, possibly due to the complexity of wrist biomechanics and the importance of ligamentous forces in the function of the wrist. Scaphotrapeziotrapezoidal (STT OA is common, but its role in wrist clinical pathology and biomechanics is unclear. We identified the prevalence of radiographic STT joint OA in our hand clinic population and defined the relationship between STT and radiocarpal OA in wrist radiographs. One hundred consecutive wrist clinical and radiographic exams were retrospectively reviewed. Radiographs were evaluated for the presence and stage of OA. The mean age was 61.3 (±14.5 years. The radiographic occurrence of STT joint OA was 59% and of radiocarpal (RC OA was 29%. Radiographic STT and RC joint OA were inversely related. Tenderness over the STT joint in physical exam was not associated with OA in the STT or other joints. STT OA in our series was not related to wrist pain. These findings support the discrepancy between radiographic and cadaver findings and clinically significant OA in this joint. The inverse relationship between STT and RC OA, as seen in scapholunate advanced collapse (SLAC wrist, requires further biomechanical study.

  13. Osteoarthritis of the Wrist STT Joint and Radiocarpal Joint.

    Wollstein, Ronit; Clavijo, Julio; Gilula, Louis A


    Our understanding of wrist osteoarthritis (OA) lags behind that of other joints, possibly due to the complexity of wrist biomechanics and the importance of ligamentous forces in the function of the wrist. Scaphotrapeziotrapezoidal (STT) OA is common, but its role in wrist clinical pathology and biomechanics is unclear. We identified the prevalence of radiographic STT joint OA in our hand clinic population and defined the relationship between STT and radiocarpal OA in wrist radiographs. One hundred consecutive wrist clinical and radiographic exams were retrospectively reviewed. Radiographs were evaluated for the presence and stage of OA. The mean age was 61.3 (±14.5) years. The radiographic occurrence of STT joint OA was 59% and of radiocarpal (RC) OA was 29%. Radiographic STT and RC joint OA were inversely related. Tenderness over the STT joint in physical exam was not associated with OA in the STT or other joints. STT OA in our series was not related to wrist pain. These findings support the discrepancy between radiographic and cadaver findings and clinically significant OA in this joint. The inverse relationship between STT and RC OA, as seen in scapholunate advanced collapse (SLAC) wrist, requires further biomechanical study.

  14. Hologram-reconstruction signal enhancement

    Mezrich, R. S.


    Principle of heterodyne detection is used to combine object beam and reconstructed virtual image beam. All light valves in page composer are opened, and virtual-image beam is allowed to interfere with light from valves.

  15. Arapahoe NWR diversion reconstruction : Preliminary

    US Fish and Wildlife Service, Department of the Interior — This is a preliminary plan for a diversion reconstruction for Hubbard #2. Oklahoma #1, Dryer, Hill and Crowder sites on the Arapahoe National Wildlife Refuge.

  16. Rational reconstructions of modern physics

    Mittelstaedt, Peter


    Newton’s classical physics and its underlying ontology are loaded with several metaphysical hypotheses that cannot be justified by rational reasoning nor by experimental evidence. Furthermore, it is well known that some of these hypotheses are not contained in the great theories of Modern Physics, such as the theory of Special Relativity and Quantum Mechanics. This book shows that, on the basis of Newton’s classical physics and by rational reconstruction, the theory of Special Relativity as well as Quantum Mechanics can be obtained by partly eliminating or attenuating the metaphysical hypotheses. Moreover, it is shown that these reconstructions do not require additional hypotheses or new experimental results. In the second edition the rational reconstructions are completed with respect to General Relativity and Cosmology. In addition, the statistics of quantum objects is elaborated in more detail with respect to the rational reconstruction of quantum mechanics. The new material completes the approach of t...

  17. Comparison of curative effects of traditional reconstruction plate and sacroiliac anterior cervical butterfly plate in treatment of sacroiliac joint injury%传统重建钢板与骶髂前路蝶形钢板治疗骶髂关节损伤的疗效比较

    赵亮; 邢宏; 王劲松; 李雪松


    目的::对比传统重建钢板与骶髂前路蝶形钢板治疗骶髂关节损伤的疗效。方法:将64例患者分为观察组和对照组,每组各32例。观察组患者行骶髂前路蝶形钢板治疗,对照组患者行传统重建钢板治疗。结果:两组患者的损伤恢复优良率对比,观察组患者优于对照组(P>0.05);功能恢复、手术时间、盆骨稳定时间对比,观察组患者也好于对照组(P0. 05), and the time of function recovery, operation time, pelvic stability time were also better than those of control group (P<0. 05) with no severe complications. Conclusions:The sacroiliac anterior cervical butterfly plate in the treatment of sacroiliac joint injury has signifi-cant curative effects.

  18. 膝关节周围皮肤软组织缺损的修复%Repair of skin and soft tissue defects around the knee joints

    谭谦; 许澎


    Skin and soft tissue defects around the knee joints are often accompanied by popliteal artery injury, patellar ligament injury, patellar fracture, and other deep tissue damage or exposure, making them challenging to repair.The principle is to repair the wound, reconstruct anatomical structure of the knee joint, and recover the knee joint function.At present the reconstruction with skin flap or myocutaneous flap is our priority.Local flap or myocutaneous flap can be used for repairing minor defects around the knee joints.Repairing with perforator flap, fascia flap, and free flap are main alternatives for covering larger and complex defects around the knee joints.During the treatment, a joint effort is mandatory, not only to repair the wound, but also to reconstruct vasculature, fix fracture, repair ligament, and finally recover the knee joint function.Therefore, the importance of multidisciplinary cooperation must be emphasized.Moreover, along with the development of new technologies, new methods, and new materials, perforator flap plays an important role in repairing skin and soft tissue defects around the knee joints.

  19. Analytical and semi-analytical inverse kinematics of SSRMS-type manipulators with single joint locked failure

    Xu, Wenfu; She, Yu; Xu, Yangsheng


    Redundant space manipulators, including Space Station Remote Manipulator System (SSRMS), Special Purpose Dexterous Manipulator (SPDM) and European Robotic Arm (ERA), have been playing important roles in the construction and maintenance of International Space Station (ISS). They all have 7 revolute joints arranged in similar configurations, and are referred to as SSRMS-type manipulators. When a joint is locked in an arbitrary position due to some failures, a 7R manipulator degrades to a 6R manipulator. Without a spherical wrist or three consecutive parallel joints, the inverse kinematics of the 6R manipulator is very complex. In this paper, we propose effective methods to resolve the inverse kinematics for different cases of any joint locked in an arbitrary position. Firstly, configuration characteristics of the SSRMS-type redundant manipulators are analyzed. Then, an existing of closed-form inverse kinematics is discussed for locking different joints. Secondly, D-H frames and corresponding D-H parameters of the new 6-DOF manipulator formed by locking a joint in an arbitrary position are re-constructed. A unified table is then created to describe the kinematics for all possible cases of single joint locking failure. Thirdly, completely analytical and semi-analytical methods are presented to solve the inverse kinematics equations, and the former is used for locking joint 1, 2, 6 or 7 while the latter for locking joint 3, 4 or 5. Finally, typical cases for single joint locking are studied. The results verify the proposed methods.

  20. Nondestructive Evaluation of Double Bevel T-Joint by Tandem Array Ultrasonic Transducer

    Shirahata, H.; Miki, C.; Yamaguchi, R.


    The double bevel T-joint is one of the most fundamental joints of steel bridges. Double bevel T-joint can be seen at beam-column connection of bridge pier. In the Japanese specifications, the welding should be full penetration. However, weld defect of incomplete penetration could be left in the joint due to the lack of quality control in welding. Fatigue cracks can be propagated from the weld defects. The authors developed a tandem array transducer. The tandem array transducer consists of 10 elements aligned in the same direction. Tandem scanning can be simulated by the transducer. Image reconstruction of incomplete penetration by synthetic aperture focusing technique was carried out. The test results showed sufficient detectability of incomplete penetration by the tandem array transducer. Height of incomplete of penetration could be estimated.

  1. MR-guided dynamic PET reconstruction with the kernel method and spectral temporal basis functions

    Novosad, Philip; Reader, Andrew J.


    Recent advances in dynamic positron emission tomography (PET) reconstruction have demonstrated that it is possible to achieve markedly improved end-point kinetic parameter maps by incorporating a temporal model of the radiotracer directly into the reconstruction algorithm. In this work we have developed a highly constrained, fully dynamic PET reconstruction algorithm incorporating both spectral analysis temporal basis functions and spatial basis functions derived from the kernel method applied to a co-registered T1-weighted magnetic resonance (MR) image. The dynamic PET image is modelled as a linear combination of spatial and temporal basis functions, and a maximum likelihood estimate for the coefficients can be found using the expectation-maximization (EM) algorithm. Following reconstruction, kinetic fitting using any temporal model of interest can be applied. Based on a BrainWeb T1-weighted MR phantom, we performed a realistic dynamic [18F]FDG simulation study with two noise levels, and investigated the quantitative performance of the proposed reconstruction algorithm, comparing it with reconstructions incorporating either spectral analysis temporal basis functions alone or kernel spatial basis functions alone, as well as with conventional frame-independent reconstruction. Compared to the other reconstruction algorithms, the proposed algorithm achieved superior performance, offering a decrease in spatially averaged pixel-level root-mean-square-error on post-reconstruction kinetic parametric maps in the grey/white matter, as well as in the tumours when they were present on the co-registered MR image. When the tumours were not visible in the MR image, reconstruction with the proposed algorithm performed similarly to reconstruction with spectral temporal basis functions and was superior to both conventional frame-independent reconstruction and frame-independent reconstruction with kernel spatial basis functions. Furthermore, we demonstrate that a joint spectral

  2. MR-guided dynamic PET reconstruction with the kernel method and spectral temporal basis functions.

    Novosad, Philip; Reader, Andrew J


    Recent advances in dynamic positron emission tomography (PET) reconstruction have demonstrated that it is possible to achieve markedly improved end-point kinetic parameter maps by incorporating a temporal model of the radiotracer directly into the reconstruction algorithm. In this work we have developed a highly constrained, fully dynamic PET reconstruction algorithm incorporating both spectral analysis temporal basis functions and spatial basis functions derived from the kernel method applied to a co-registered T1-weighted magnetic resonance (MR) image. The dynamic PET image is modelled as a linear combination of spatial and temporal basis functions, and a maximum likelihood estimate for the coefficients can be found using the expectation-maximization (EM) algorithm. Following reconstruction, kinetic fitting using any temporal model of interest can be applied. Based on a BrainWeb T1-weighted MR phantom, we performed a realistic dynamic [(18)F]FDG simulation study with two noise levels, and investigated the quantitative performance of the proposed reconstruction algorithm, comparing it with reconstructions incorporating either spectral analysis temporal basis functions alone or kernel spatial basis functions alone, as well as with conventional frame-independent reconstruction. Compared to the other reconstruction algorithms, the proposed algorithm achieved superior performance, offering a decrease in spatially averaged pixel-level root-mean-square-error on post-reconstruction kinetic parametric maps in the grey/white matter, as well as in the tumours when they were present on the co-registered MR image. When the tumours were not visible in the MR image, reconstruction with the proposed algorithm performed similarly to reconstruction with spectral temporal basis functions and was superior to both conventional frame-independent reconstruction and frame-independent reconstruction with kernel spatial basis functions. Furthermore, we demonstrate that a joint spectral

  3. Evaluation of reconstruction errors and identification of artefacts for JET gamma and neutron tomography

    Craciunescu, Teddy, E-mail:; Tiseanu, Ion; Zoita, Vasile [National Institute for Laser, Plasma and Radiation Physics, Magurele-Bucharest (Romania); Murari, Andrea [Consorzio RFX, Padova (Italy); Kiptily, Vasily; Sharapov, Sergei [CCFE Culham Science Centre, Abingdon, Oxon OX14 3DB (United Kingdom); Lupelli, Ivan [CCFE Culham Science Centre, Abingdon, Oxon OX14 3DB (United Kingdom); University of Rome “Tor Vergata,” Roma (Italy); Fernandes, Ana [Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, Universidade de Lisboa, Lisboa (Portugal); Collaboration: EUROfusion Consortium, JET, Culham Science Centre, Abingdon OX14 3DB (United Kingdom)


    The Joint European Torus (JET) neutron profile monitor ensures 2D coverage of the gamma and neutron emissive region that enables tomographic reconstruction. Due to the availability of only two projection angles and to the coarse sampling, tomographic inversion is a limited data set problem. Several techniques have been developed for tomographic reconstruction of the 2-D gamma and neutron emissivity on JET, but the problem of evaluating the errors associated with the reconstructed emissivity profile is still open. The reconstruction technique based on the maximum likelihood principle, that proved already to be a powerful tool for JET tomography, has been used to develop a method for the numerical evaluation of the statistical properties of the uncertainties in gamma and neutron emissivity reconstructions. The image covariance calculation takes into account the additional techniques introduced in the reconstruction process for tackling with the limited data set (projection resampling, smoothness regularization depending on magnetic field). The method has been validated by numerically simulations and applied to JET data. Different sources of artefacts that may significantly influence the quality of reconstructions and the accuracy of variance calculation have been identified.

  4. Fibular free flap reconstruction for the management of advanced bilateral mandibular osteoradionecrosis.

    Shan, Xiao-Feng; Li, Ru-Huang; Lu, Xu-Guang; Cai, Zhi-Gang; Zhang, Jie; Zhang, Jian-Guo


    Fibular osteoseptocutaneous flap has been widely used for unilateral mandibular reconstruction. However, reports about the effects of fibular osteoseptocutaneous flap for the reconstruction of bilateral mandibular defects are limited. In this study, we used free vascularized fibular flaps to successfully manage bilateral mandibular osteoradionecrosis(ORN) in 5 patients. Functional aspects were evaluated during the reconstruction process. All 5 patients had bilateral refractory ORN of the mandible and underwent radical resection between 2003 and 2011. The reconstruction surgery was performed in 2 stages using 2 free fibular flaps in 3 patients. In the other 2 patients, reconstruction was performed in a single stage using 2 separate flaps prepared from a single fibula. All patients had a healthy mandibular symphysis and meniscus of the temporomandibular joint, and these structures were preserved during the reconstruction.Of the 10 defects involving the mandible sides, 9 were successfully reconstructed. One microvascular composite flap failed because of radiation injury to the arterial endothelium at the recipient site. After the treatments, all patients had good esthetic and functional outcomes. Preoperative clinical features such as trismus and dysphagia were also markedly improved. Our surgical method may be an effective alternative for the clinical management of advanced bilateral mandibular ORN.

  5. Improving outcomes in aesthetic facial reconstruction.

    Hofer, Stefan O P; Mureau, Marc A M


    Aesthetic facial reconstruction is a challenging art. Improving outcomes in aesthetic facial reconstruction requires a thorough understanding of the basic principles of the functional and aesthetic requirements for facial reconstruction. From there, further refinement and attention to detail can be provided. This paper discusses basic principles of aesthetic facial reconstruction.

  6. On $\\mathfrak{I}$-reconstruction Property

    L. K. Vashisht; Khattar, Geetika


    Reconstruction property in Banach spaces introduced and studied by Casazza and Christensen in [1]. In this paper we introduce reconstruction property in Banach spaces which satisfy $\\mathfrak{I}$-property. A characterization of reconstruction property in Banach spaces which satisfy $\\mathfrak{I}$-property in terms of frames in Banach spaces is obtained. Banach frames associated with reconstruction property are discussed.

  7. An Isolated Medial Patellofemoral Ligament Reconstruction with Patellar Tendon Autograft

    Dariusz Witoński


    Full Text Available The aim of the study was to evaluate the results of the medial patellofemoral ligament reconstruction with a medial strip of patellar tendon autograft after a minimum 2-year followup. Ten patients (10 knees were operated on by one surgeon, according to the modified technique, described by Camanho, without any bone plug at free graft end. The mean age of the patients was 27.2 years (ranging from 18 to 42 years. The mean follow-up period was 3 years and 7 months. All patients were reviewed prospectively. At the last follow-up visit, all the patients demonstrated a significant improvement in terms of patellofemoral joint stability, all aspects of the KOOS questionnaire, and Kujala et al.’s score (59.7 points preoperatively and 84.4 points at the last followup. No patient revealed recurrent dislocation. The SF-36 score revealed a significant improvement in bodily pain, general health, physical role functioning, social role functioning, and physical functioning domains. The described MPFL reconstruction with the use of the medial 1/3rd of patella tendon is an effective procedure that gives satisfactorily patellofemoral joint functions, improves the quality of life, and provides much pain relief. It is relatively simple, surgically not extensive, and economically cost-effective procedure.




    For studying the relationship between condylar hypermobility of the temporomandibular joint (TMJ) and osteoarthrosis (OA), 13 patients with bilateral condylar hypermobility were evaluated clinically and radiographically, 30 years after non-surgical treatment. The evaluation included range of motion,

  9. Joint ventures in health care.

    Pelfrey, S; Theisen, B A


    To remain competitive, many not-for-profit hospitals have turned to joint ventures with for-profit and other not-for-profit entities. The authors examine the organizational structures that are used most often to form joint ventures (contractual agreements, subsidiary corporations, partnerships, and not-for-profit title-holding corporations), as well as the advantages and disadvantages associated with each form. Nurse executives must be aware of the opportunities that joint ventures provide their institutions. These arrangements can help improve and expand services and profitability.

  10. [Rehabilitation after arthroscopic anterior cruciate ligament reconstruction].

    Smékal, D; Kalina, R; Urban, J


    Rehabilitation is an important part of therapy in patients who have had arthroscopic anterior cruciate ligament reconstruction. A well-designed rehabilitation program avoids potential graft damage and speeds up patients' return to their full function level. The course of rehabilitation depends on the type of surgery, mode of fixation and possible co-existing injury to the knee's soft tissues. The rehabilitation program presented here is based on the present-day knowledge of neurophysiological and biomechanical principles and is divided into five phases. In the pre-operative phase (I), the main objective is to prepare patients for surgery in terms of maximum muscle strength and range of motion. It also includes providing full information on the procedure. In the early post-operative phase (II) we are concerned with pain alleviation and reduction of knee edema. After suture removal we begin with soft techniques for the patella and post-operative physical therapy to reduce scarring. In the next post-operative phase (III) patients are able to walk with their full weight on the extremity operated on, and we continue doing exercises that improve flexor/extensor co-contraction. In this phase we also begin with exercises improving the patient's proprioceptive and sensorimotor functions. In the late post-operative phase (IV) we go on with exercises promoting proprioception of both lower extremities with the aim of increasing muscle control of the knee joints. In the convalescent phase (V) patients gradually return to their sports activities.

  11. Jointness for the Rest of Us: Reforming Joint Professional Development


    since the law’s enactment, its stated goals are not yet fully realized . This thesis argues that the interdependence sought by Congressional legislators...knowledge, skills, values , and understanding that are not simply related to a narrow field of activity, but instead contribute to defining, analyzing...The authors of the legislation felt that “something had to be done to instill a joint culture (e.g., attitudes, values , and beliefs about joint

  12. Reliable Gait Recognition Using 3D Reconstructions and Random Forests - An Anthropometric Approach

    Sandau, Martin; Heimbürger, Rikke V.; Jensen, Karl E.


    Photogrammetric measurements of bodily dimensions and analysis of gait patterns in CCTV are important tools in forensic investigations but accurate extraction of the measurements are challenging. This study tested whether manual annotation of the joint centers on 3D reconstructions could provide...... expert annotated the data. Recognition based on data annotated by different experts was less reliable achieving 72.6% correct recognitions as some parameters were heavily affected by interobserver variability. This study verified that 3D reconstructions are feasible for forensic gait analysis...

  13. Reconstruction of anterior cruciate ligament and anterolateral ligament using interlinked hamstrings - technical note.

    Ferreira, Marcio de Castro; Zidan, Flavio Ferreira; Miduati, Francini Belluci; Fortuna, Caio Cesar; Mizutani, Bruno Moreira; Abdalla, Rene Jorge


    Recent anatomical and biomechanical studies on the anterolateral ligament (ALL) of the knee have shown that this structure has an important function in relation to joint stability, especially when associated with anterior cruciate ligament (ACL) injury. However, the criteria for its reconstruction have not yet been fully established and the surgical techniques that have been described present variations regarding anatomical points and fixation materials. This study presents a reproducible technique for ALL and ACL reconstruction using hamstring tendons, in which three interference screws are used for fixation.

  14. Desmoplastic fibroma of ulna: Excision and reconstruction of olecranon with a fibular graft

    Tarun Goyal


    Full Text Available Desmoplastic fibroma is a rare, well differentiated, locally aggressive fibrous tumor usually arising from soft tissues, and rarely from bones. Involvement of forearm bones is extremely unusual. We present a large desmoplastic fibroma of right ulna in a 15-year-old male. The tumor was excised with a wide margin, and the bony defect was reconstructed with nonvascular autologous fibular graft. Reconstruction of the olecranon process was attempted using the fibular head and the remaining olecranon. At 2-years followup, there was no recurrence, flexion extension arc of the elbow joint was 40°-130° and there was no restriction of activities of daily living.

  15. Lossy Broadcasting in Two-Way Relay Networks with Common Reconstructions

    Timo, Roy; Kramer, Gerhard


    The broadcast phase (downlink transmission) of the two-way relay network is studied in the source coding and joint source-channel coding settings. The rates needed for reliable communication are characterised for a number of special cases including: small distortions, deterministic distortion measures, and jointly Gaussian sources with quadratic distortion measures. The broadcast problem is also studied with common-reconstruction decoding constraints, and the rates needed for reliable communication are characterised for all discrete memoryless sources and per-letter distortion measures.

  16. Measurement of functional recovery after an anterior cruciate ligament reconstruction in competitive athletes; development of a measuring method

    Reininga, I.HF; Lemmink, K.A.P.M.; Krijt, D.I.; Waninge, H.; Diercks, Ron; Stevens, M.


    Many athletes with an anterior cruciate ligament tear do not return to their original sport level after reconstruction, in spite of good results on clinical tests. After an anterior cruciate ligament tear, knee joint proprioception is shown to be decreased. This leads to the use of compensatory mech

  17. 计算机辅助导航下膝关节后交叉韧带重建的现状和展望%Current status and prospect of knee joint posterior cruciate ligament reconstruction under computer-assisted navigation

    熊健斌; 韦庆军; 赵劲民


    背景:随着现代膝关节镜技术的发展与完善,镜下后交叉韧带重建技术已是目前学术界所公认的手术方法.计算机导航系统辅助下的重建定位精确、稳定性和町重复性高.通过对计算机辅助系统的进一步完善,计算机导航辅助下的关节镜手术将会成为后交叉韧带重建的又一个里程碑.目的:阐述近年来后交叉韧带重建的治疗进展,探讨计算机导航系统在后交叉韧带重建中的应用.方法;第一作者应用计算机检索1989-11/2009-06 PubMed数据库(网址相关文章,检索词为"computer navigation,posterior cruciate ligament,reconstruction",并限定文章语言种类为English.同时计算机检索1989-11/2009-06中国期刊全文数据库(网址相关文章,检索词为"计算机导航,后交叉韧带,重建",并限定文章语言种类为中文.共检索到文献112篇.结果与结论:后交叉韧带由于解剖位置特殊,功能重要,在损伤后如何精确的重建后交叉韧带一直是关节镜医生致力解决的难题.随着20世纪计算机科技的迅猛发展,计算机辅助的手术导航系统进入外科领域.计算机辅助的后交叉韧带重建导航系统能更好地评估手术的精确度和可行性,满足了术者手术优化的要求,改善了重建的临床效果.

  18. Finishing touch to joint venture


    "A new process for polishing titanium and its alloys has been announced following an agreement between Bripol (an Anopol/Delmet joint venture) of Birmingham and the European Organisation for Nuclear Reseach (CERN) in Geneva" (1 paragraph).

  19. Torsion testing of bed joints

    Hansen, Klavs Feilberg; Pedersen, Carsten Mørk


    This paper describes a simple test method for determining the torsion strength of a single bed joint between two bricks and presents results from testing using this test method. The setup for the torsion test is well defined, require minimal preparation of the test specimen and the test can...... be carried out directly in a normal testing machine. The torsion strength is believed to be the most important parameter in out-of-plane resistance of masonry walls subjected to bending about an axis perpendicular to the bed joints. The paper also contains a few test results from bending of small walls about...... an axis perpendicular to the bed joints, which indicate the close connection between these results and results from torsion tests. These characteristics make the torsion strength well suited to act as substitute parameter for the bending strength of masonry about an axis perpendicular to the bed joints....

  20. Entanglement swapping without joint Measurement

    Yang, M; Cao, Z L; Yang, Ming; Song, Wei; Cao, Zhuo-Liang


    We propose an entanglement swapping scheme in cavity QED. In the scheme, the previously used joint measurement is not needed. Only single measurement on cavity can realize the swapping process, which avoids the difficulty of measurement on atomic state.

  1. Joint Performance and Planning System

    US Agency for International Development — A joint State/USAID system hosted by State that integrates resource and performance information at the program level and enables more flexible and frequent entry of...

  2. US Joint Ventures 2014 revision

    US Fish and Wildlife Service, Department of the Interior — A joint venture is a self-directed partnership of agencies, organizations, corporations, tribes, or individuals that has formally accepted the responsibility of...

  3. Campus/Industry Joint Ventures.

    McDonald, Eugene J.


    Opportunities for joint economic ventures of colleges and industry are discussed, and a variety of ventures undertaken by Duke University are outlined, including a health club, hotel, and office building. Tax and financing considerations are noted. (MSE)

  4. [Fractures of the acetabulum: complications and joint replacement].

    Herath, S C; Holstein, J H; Pizanis, A; Pohlemann, T


    Acetabular fractures assume a special role amongst the fractures of the pelvis, because they involve a major weight-bearing joint. As those fractures mostly result from exposure to great force, and because of their location in an anatomically complex region, a high rate of complications has to be anticipated. Besides general and perioperative complications long-term consequences, especially post-traumatic arthrosis, are relevant problems when it comes to treating fractures of the acetabulum. The primary reconstruction of the acetabulum, as well as a possibly necessary prosthetic replacement of the hip joint, makes high demands on the diagnostic and operative capabilities of the attending physician. Exact knowledge of the specific risks and pitfalls for each type of fracture and for the specific surgical techniques is crucial for a successful treatment. Due to the much worse long-term outcome when compared to primary total hip replacement in patients with osteoarthritis, acetabular fractures should, regardless of the patient's age, whenever possible be treated by operative reconstruction.

  5. The Joint Master Operational Planner


    Staff College , College of Naval Command and Staff, or Marine Corps Command and Staff College . Next, students must apply, and the services competitively...ELEMENT NUMBER 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 6. AUTHOR(S) 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8...Daniel H. Hibner, United States Army Joint Forces Staff College Joint Advanced Warfighting School 7800 Hampton Blvd. Norfolk, VA 23511-1702 Approved

  6. "Fraud alert": joint venture arrangements.

    Vipperman, R M


    The Office of Inspector General of the Department of Health and Human Services recently issued a special "Fraud Alert" identifying those characteristics of joint venture arrangements that it views as indicators of potentially unlawful activity. As discussed in this article, participants in joint ventures should examine their arrangements to see if one or more of the questionable features are present, and, if so, should take steps to eliminate them, to the extent possible.

  7. IRS memorandum limits joint ventures.

    Herman, A W


    Based on a new memorandum, the Internal Revenue Service (IRS) will be looking at joint hospital/physician activities with greater attention to the nuances of public versus private benefit. As a result, hospitals face greater risk of losing their tax-exempt status in the maze of joint ventures, physician recruitment, and practice acquisition. To be successful, ventures will have to be backed by sound reasoning and thorough documentation.

  8. Joint Center for Robotics (JCR)


    Unclassified 1 Joint Center for Robotics (JCR) Dr. Jim Overholt 15 April 2008 DISTRIBUTION STATEMENT A. Approved for public release; distribution is...REPORT DATE APR 2008 2. REPORT TYPE N/A 3. DATES COVERED - 4. TITLE AND SUBTITLE Joint Center for Robotics (JCR) 5a. CONTRACT NUMBER 5b. GRANT...ANSI Std Z39-18 Unclassified 2 TARDEC JCR Robotics CAST Projects & Cells “White Hat” Organization - Understand the needs of the user and create

  9. Joint probabilities and quantum cognition

    de Barros, J Acacio


    In this paper we discuss the existence of joint probability distributions for quantum-like response computations in the brain. We do so by focusing on a contextual neural-oscillator model shown to reproduce the main features of behavioral stimulus-response theory. We then exhibit a simple example of contextual random variables not having a joint probability distribution, and describe how such variables can be obtained from neural oscillators, but not from a quantum observable algebra.

  10. Ankylosis of the temporomandibular joint. Follow-up of thirteen patients.

    Schobel, G; Millesi, W; Watzke, I M; Hollmann, K


    We undertook a postoperative clinical study of 13 patients with ankylosis of the temporomandibular joints. The study consisted of an evaluation of the surgical concepts of resection and subsequent surgical reconstruction by osteotomy in previous height of the joint space and lining of the glenoid fossa with lyophilized dura. Early mobilization and aggressive physiotherapy are mandatory postoperative measures. According to the theory of mandibular growth as a result of functional matrix, early surgical intervention to correct ankylosis should be performed, regardless of the age of the patient, to prevent recurrence and later asymmetry or distoclusion.

  11. Optimal Joint Remote State Preparation of Arbitrary Equatorial Multi-qudit States

    Cai, Tao; Jiang, Min


    As an important communication technology, quantum information transmission plays an important role in the future network communication. It involves two kinds of transmission ways: quantum teleportation and remote state preparation. In this paper, we put forward a new scheme for optimal joint remote state preparation (JRSP) of an arbitrary equatorial two-qudit state with hybrid dimensions. Moreover, the receiver can reconstruct the target state with 100 % success probability in a deterministic manner via two spatially separated senders. Based on it, we can extend it to joint remote preparation of arbitrary equatorial multi-qudit states with hybrid dimensions using the same strategy.

  12. Optimal Joint Remote State Preparation of Arbitrary Equatorial Multi-qudit States

    Cai, Tao; Jiang, Min


    As an important communication technology, quantum information transmission plays an important role in the future network communication. It involves two kinds of transmission ways: quantum teleportation and remote state preparation. In this paper, we put forward a new scheme for optimal joint remote state preparation (JRSP) of an arbitrary equatorial two-qudit state with hybrid dimensions. Moreover, the receiver can reconstruct the target state with 100 % success probability in a deterministic manner via two spatially separated senders. Based on it, we can extend it to joint remote preparation of arbitrary equatorial multi-qudit states with hybrid dimensions using the same strategy.

  13. A reconstruction of the Vienna skull of Hadropithecus stenognathus

    Ryan, T. M.; Burney, D. A.; Godfrey, L. R.; Göhlich, U. B.; Jungers, W. L.; Vasey, N.; Ramilisonina; Walker, A.; Weber, G. W.


    Franz Sikora found the first specimen and type of the recently extinct Hadropithecus stenognathus in Madagascar in 1899 and sent it to Ludwig Lorenz von Liburnau of the Austrian Imperial Academy of Sciences. Later, he sent several more specimens including a subadult skull that was described by Lorenz von Liburnau in 1902. In 2003, some of us excavated at the locality and found more specimens belonging to this species, including much of a subadult skeleton. Two frontal fragments were found, and these, together with most of the postcranial bones, belong to the skull. CT scans of the skull and other jaw fragments were made in Vienna and those of the frontal fragments at Penn State University. The two fragments have been reunited with the skull in silico, and broken parts from one side of the skull have been replaced virtually by mirror-imaged complete parts from the other side. The parts of the jaw of another individual of a slightly younger dental age have also been reconstructed virtually from CT scans with mirror imaging and by using the maxillary teeth and temporomandibular joints as a guide to finish the reconstruction. Apart from forming a virtual skull for biomechanical and systematic analysis, we were also able to make a virtual endocast. Missing anterior pieces were reconstructed by using part of an endocast of the related Archaeolemur majori. The volume is 115 ml. Hadropithecus and Archaeolemur seem to have had relatively large brains compared with the other large-bodied subfossil lemurs. PMID:18663217

  14. Reconstructive foot and ankle surgeries in diabetic patients

    Ajit Kumar Varma


    Full Text Available Diabetic foot and ankle deformities are secondary to long-standing diabetes and neglected foot care. The concept of surgical correction for these deformities is quite recent. The primary objective of reconstructive foot and ankle surgery is the reduction of increased plantar pressures, reduction of pain and the restoration of function, stability and proper appearance. Foot and ankle deformities can result in significant disability, loss of life style, employment and even the loss of the lower limb. Therefore, restoration of normal, problem free foot function and activities will have a significant impact on peoples′ lives. Reconstructive surgical procedures are complex and during reconstruction, internal and external fixation devices, including pins, compression screws, staples, and wires, may be used for repair and stabilization. The surgeries performed depend on the type and severity of the condition. Surgery can involve any part of the foot and ankle, and may involve tendon, bone, joint, tissue or skin repair. Corrective surgeries can at times be performed on an outpatient basis with minimally invasive techniques. Recovery time depends on the type of condition being treated.

  15. Two-Dimensional Impact Reconstruction Method for Rail Defect Inspection

    Jie Zhao


    Full Text Available The safety of train operating is seriously menaced by the rail defects, so it is of great significance to inspect rail defects dynamically while the train is operating. This paper presents a two-dimensional impact reconstruction method to realize the on-line inspection of rail defects. The proposed method utilizes preprocessing technology to convert time domain vertical vibration signals acquired by wireless sensor network to space signals. The modern time-frequency analysis method is improved to reconstruct the obtained multisensor information. Then, the image fusion processing technology based on spectrum threshold processing and node color labeling is proposed to reduce the noise, and blank the periodic impact signal caused by rail joints and locomotive running gear. This method can convert the aperiodic impact signals caused by rail defects to partial periodic impact signals, and locate the rail defects. An application indicates that the two-dimensional impact reconstruction method could display the impact caused by rail defects obviously, and is an effective on-line rail defects inspection method.

  16. Total allograft transplantation of the elbow joint after wide resection of synovial cell sarcoma: a case series.

    Hossein, E M; Ashraf, H; Peivandi, L


    Total elbow allograft transplantation is an option for patients who have extensive joint defects secondary to tumor surgery, trauma, or failed total elbow arthroplasty. This salvage procedure provides patients with a useful, painless range of motion of the elbow. We report our experience with two complete elbow allograft reconstructions after tumor resection surgery with 5 and 6 years of follow-up.

  17. Network reconstruction from infection cascades

    Braunstein, Alfredo


    Reconstructing propagation networks from observations is a fundamental inverse problem, and it's crucial to understand and control dynamics in complex systems. Here we show that it is possible to reconstruct the whole structure of an interaction network and to simultaneously infer the complete time course of activation spreading, relying just on single snapshots of a small number of activity cascades. The method, that we called Inverse Dynamics Network Reconstruction (IDNR), is shown to work successfully on several synthetic and real networks, inferring the networks and the sources of infection based on sparse observations, including single snapshots. IDNR is built on a Belief Propagation approximation, that has an impressive performance in a wide variety of topological structures. The method can be applied in absence of complete time-series data by providing a detailed modeling of the posterior distribution of trajectories conditioned to the observations. Furthermore, we show by experiments that the informat...

  18. Track Reconstruction Performance in CMS

    Azzurri, Paolo


    The expected performance of track reconstruction with LHC events using the CMS silicon tracker is presented. Track finding and fitting is accomplished with Kalman Filter techniques that achieve efficiencies above 99\\% on single muons with $p_T >$1~GeV/c. Difficulties arise in the context of standard LHC events with a high density of charged particles, where the rate of fake combinatorial tracks is very large for low $p_T$ tracks, and nuclear interactions in the tracker material reduce the tracking efficiency for charged hadrons. Recent improvements with the CMS track reconstruction now allow to efficiently reconstruct charged tracks with $p_T$ down to few hundred MeV/c and as few as three crossed layers, with a very small fake fraction, by making use of an optimal rejection of fake tracks in conjunction with an iterative tracking procedure.


    Freddie H. Fu


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

  20. Clinical applications of iterative reconstruction

    Eberl, S. [Royal Prince Alfred Hospital, Camperdown, NSW (Australia). Department of PET and Nuclear Medicine


    Expectation maximisation (EM) reconstruction largely eliminates the hot and cold streaking artifacts characteristic of filtered-back projection (FBP) reconstruction around localised hot areas, such as the bladder. It also substantially reduces the problem of decreased inferior wall counts in MIBI myocardial perfusion studies due to ``streaking`` from high liver uptake. Non-uniform attenuation and scatter correction, resolution recovery, anatomical information, e.g. from MRI or CT tracer kinetic modelling, can all be built into the EM reconstruction imaging model. The properties of ordered subset EM (OSEM) have also been used to correct for known patient motion as part of the reconstruction process. These uses of EM are elaborated more fully in some of the other abstracts of this meeting. Currently we use OSEM routinely for: (i) studies where streaking is a problem, including all MIBI myocardial perfusion studies, to avoid hot liver inferior wall artifact, (ii) all whole body FDG PET, all lung V/Q SPECT (which have a short acquisition time) and all gated {sup 201}TI myocardial perfusion studies due to improved noise characteristics of OSEM in these studies; (iii) studies with measured, non-uniform attenuation correction. With the accelerated OSEM algorithm, iterative reconstruction is practical for routine clinical applications and we have found OSEM to provide clearly superior reconstructions for the areas listed above and are investigating its application to other studies. In clinical use, we have not found OSEM to introduce artifacts which would not also occur with FBP, e.g. uncorrected patient motion will cause artifacts with both OSEM and FBP.

  1. 12 CFR 347.107 - Joint ventures.


    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Joint ventures. 347.107 Section 347.107 Banks... INTERNATIONAL BANKING § 347.107 Joint ventures. (a) Joint ventures. If a bank, directly or indirectly, acquires or holds an equity interest in a foreign organization that is a joint venture, and the bank or...

  2. Markov Random Field Surface Reconstruction

    Paulsen, Rasmus Reinhold; Bærentzen, Jakob Andreas; Larsen, Rasmus


    ) and knowledge about data (the observation model) in an orthogonal fashion. Local models that account for both scene-specific knowledge and physical properties of the scanning device are described. Furthermore, how the optimal distance field can be computed is demonstrated using conjugate gradients, sparse......A method for implicit surface reconstruction is proposed. The novelty in this paper is the adaption of Markov Random Field regularization of a distance field. The Markov Random Field formulation allows us to integrate both knowledge about the type of surface we wish to reconstruct (the prior...

  3. Tragal reconstruction after tumor excision.

    Coombs, Christopher J; Lin, Frank


    The tragus forms a distinct and important landmark in the overall artistic and anatomical landscape of the ear. Despite its small size, it functions to cover and prevent direct access to the ear canal. Aesthetically, it has an important role in defining the morphology of the auricle in 3 dimensions, not only covering the meatus but also casting a shadow into the conchal bowl that gives the impression of depth. Most of the techniques for tragal reconstruction are associated with creation of a tragus in patients with microtia. We present here a new technique for tragal reconstruction in the setting of tumor ablation.

  4. Vascular Reconstruction in Hepatic Malignancy.

    Berumen, Jennifer; Hemming, Alan


    With surgery for hepatic malignancy, there are poor options for chemotherapy; many patients are deemed unresectable because of vascular involvement or location of tumors. Over the past few decades, advances in surgical technique have allowed resection of these tumors with vascular reconstruction to achieve negative margins and improve chances for survival. This article reviews those reconstruction techniques and outcomes in detail, including in situ perfusion and ex vivo liver surgery, and provides a discussion of implications and operative planning for patients with hepatic malignancy in order to provide surgeons with better understanding of these complicated operations.

  5. Rational Reconstructions of Modern Physics

    Mittelstaedt, Peter


    Newton’s classical physics and its underlying ontology are loaded with several metaphysical hypotheses that cannot be justified by rational reasoning nor by experimental evidence. Furthermore, it is well known that some of these hypotheses are not contained in the great theories of modern physics, such as the theory of relativity and quantum mechanics. This book shows that, on the basis of Newton’s classical physics and by rational reconstruction, the theory of relativity as well as quantum mechanics can be obtained by partly eliminating or attenuating the metaphysical hypotheses. Moreover, it is shown that these reconstructions do not require additional hypotheses or new experimental results.

  6. Reconstruction of gyrotropic phase-space distributions from one-dimensional projections

    Egedal, J.; Bindslev, H.


    This paper describes mathematical tools applicable to the reconstruction of anisotropic velocity distributions through the unfolding of data coming from techniques like collective Thomson scattering or laser induced fluorescence, where one-dimensional projections of the velocity space along....... An example is given based on alpha particle distribution in the Joint European Torus tokamak [P. H. Rebut and B. E. Keen, Fusion Technol. 11, 13 (1987)]. (C) 2004 American Institute of Physics....

  7. Differential Effects of Two Rehabilitation Programs Following Anterior Cruciate Ligament Reconstruction

    Setuain, Igor; Izquierdo, Mikel; Idoate, Fernando


    Context- The muscular function restoration related to the type of physical rehabilitation followed after anterior cruciate ligament reconstruction (ACLR) using autologous hamstring tendon graft in terms of strength and cross sectional area (CSA) remain controversial. Objective- To analyze the CSA...... to persist in both rehabilitation groups. However, OCBR after ACLR lead to substantial gains on maximal knee flexor strength and ensured more symmetrical anterior-posterior laxity levels at the knee joint....


    M. A. Shevtsov


    Full Text Available Method of intraosseous prosthesis based on the principle of osseointegration that was introduced by Prof. Per-Ingvar Branemark is one of the most perspective approaches in contemporary reconstructive surgery This method helps to achieve increased functional activity and to improve patients quality of life in comparison to conventional treatment. In presented article the results of prosthetic treatment of amputees of different localizations, application of this technology in cranio-fascial surgery, finger joint prostheses are discussed.

  9. A protocol for management of temporomandibular joint ankylosis in children.

    Kaban, Leonard B; Bouchard, Carl; Troulis, Maria J


    Temporomandibular joint (TMJ) ankylosis in children is a challenging problem. Surgical correction is technically difficult and the incidence of recurrence after treatment is high. The purpose of the present report is to describe the protocol currently used at the Massachusetts General Hospital for the management of TMJ ankylosis in children. It has been our observation that the most common cause of treatment failure is inadequate resection of the ankylotic mass and failure to achieve adequate passive maximal opening in the operating room. The 7-step protocol consists of 1) aggressive excision of the fibrous and/or bony ankylotic mass, 2) coronoidectomy on the affected side, 3) coronoidectomy on the contralateral side, if steps 1 and 2 do not result in a maximal incisal opening greater than 35 mm or to the point of dislocation of the unaffected TMJ, 4) lining of the TMJ with a temporalis myofascial flap or the native disc, if it can be salvaged, 5) reconstruction of the ramus condyle unit with either distraction osteogenesis or costochondral graft and rigid fixation, and 6) early mobilization of the jaw. If distraction osteogenesis is used to reconstruct the ramus condyle unit, mobilization begins the day of the operation. In patients who undergo costochondral graft reconstruction, mobilization begins after 10 days of maxillomandibular fixation. Finally (step 7), all patients receive aggressive physiotherapy. A case series of children with ankylosis treated using this protocol is presented.

  10. Joint venture instability: a life cycle approach

    Roy Chowdhury, Prabal; Roy Chowdhury, Indrani


    Joint ventures represent one of the most fascinating developments in international business. In the last few decades, the rate of joint venture formation has accelerated dramatically. Nowadays joint ventures are much more widespread and occur in industries like telecommunications, biotechnology etc. At the same time, however, it must be noted that joint ventures are very unstable. In this paper we survey the phenomenon of joint venture instability. We draw on the relative recent theoretical l...

  11. Adaptation of DICOM 3.0 to jaw joint movement images

    Negishi, Tohru; Katoh, Tsuguhisa; Fukushi, Masahiro; Senoo, Atsushi; Nomura, Yukihiro; Shimanishi, Satoshi


    Kinetic MRI images has been developed and often applied to the diagnosis of soft tissues. The diagnosis of the temporomandibular joint seemed to be one of the typical application fields and has been already clinically performed in some hospitals. Kinetic MRI images cannot be dealt with by DICOM systems, since the information elements and transfer syntax has not been defined yet. We tried to define them and examined its performances. Several objects of temporomandibular joint kinetic MRI images in Quick TIME format were created using the newly defined information elements. The objects were transferred and stored to a DICOM image server using CTN software. The stored images were successfully reconstructed and replayed. The outline of the newly defined information elements, the procedures for making and reconstruction of the objects were discussed in this paper.

  12. A survey of urban reconstruction

    Musialski, Przemyslaw


    This paper provides a comprehensive overview of urban reconstruction. While there exists a considerable body of literature, this topic is still under active research. The work reviewed in this survey stems from the following three research communities: computer graphics, computer vision and photogrammetry and remote sensing. Our goal is to provide a survey that will help researchers to better position their own work in the context of existing solutions, and to help newcomers and practitioners in computer graphics to quickly gain an overview of this vast field. Further, we would like to bring the mentioned research communities to even more interdisciplinary work, since the reconstruction problem itself is by far not solved. This paper provides a comprehensive overview of urban reconstruction. While there exists a considerable body of literature, this topic is still under active research. The work reviewed in this survey stems from the following three research communities: computer graphics, computer vision and photogrammetry and remote sensing. Our goal is to provide a survey that will help researchers to better position their own work in the context of existing solutions, and to help newcomers and practitioners in computer graphics to quickly gain an overview of this vast field. Further, we would like to bring the mentioned research communities to even more interdisciplinary work, since the reconstruction problem itself is by far not solved. © 2013 The Eurographics Association and John Wiley & Sons Ltd.

  13. Reconstructing Death in Postmodern Society.

    Kastenbaum, Robert


    Examines interaction between emerging thanatological movement and its sociohistorical context. Notes that thanatology will take on new shape as individuals and society attempt to cope with postmodernistic forces and deconstructive mentality. Considers prospect for authentic solidarity against distress in reconstructed death system. (Author/NB)

  14. Uncertainty of knee joint muscle activity during knee joint torque exertion: the significance of controlling adjacent joint torque.

    Nozaki, Daichi; Nakazawa, Kimitaka; Akai, Masami


    In the single-joint torque exertion task, which has been widely used to control muscle activity, only the relevant joint torque is specified. However, the neglect of the neighboring joint could make the procedure unreliable, considering our previous result that even monoarticular muscle activity level is indefinite without specifying the adjacent joint torque. Here we examined the amount of hip joint torque generated with knee joint torque and its influence on the activity of the knee joint muscles. Twelve healthy subjects were requested to exert various levels of isometric knee joint torque. The knee and hip joint torques were obtained by using a custom-made device. Because no information about hip joint torque was provided to the subjects, the hip joint torque measured here was a secondary one associated with the task. The amount of hip joint torque varied among subjects, indicating that they adopted various strategies to achieve the task. In some subjects, there was a considerable internal variability in the hip joint torque. Such variability was not negligible, because the knee joint muscle activity level with respect to the knee joint torque, as quantified by surface electromyography (EMG), changed significantly when the subjects were requested to change the strategy. This change occurred in a very systematic manner: in the case of the knee extension, as the hip flexion torque was larger, the activity of mono- and biarticular knee extensors decreased and increased, respectively. These results indicate that the conventional single knee joint torque exertion has the drawback that the intersubject and/or intertrial variability is inevitable in the relative contribution among mono- and biarticular muscles because of the uncertainty of the hip joint torque. We discuss that the viewpoint that both joint torques need to be considered will bring insights into various controversial problems such as the shape of the EMG-force relationship, neural factors that help

  15. Transplantation of autogenous palmaris longus tendon combined with suture anchor fixation in the treatment of aromioclavicular dislocations%自体掌长肌移植重建喙锁韧带结合带线锚钉固定治疗肩锁关节脱位的疗效

    罗吉伟; 余斌; 魏宽海; 覃承诃; 胡岩君


    Background Clinically,acromioclavicular dislocation is a common disease.Whether surgical treatment should be taken or not depends on the type and degree of the inj ury,as well as the symptoms,ages,occupation,exercise requirements,and other factors of patients.Acromioclavicular dislocation can be classified as six types (degrees)according to Rockwood.The injury with obvious symptoms above Ⅲ degree is generally considered as an important operation indication.The key point in the surgical treatment of acromioclavicular dislocation is to select appropriate methods for the acromioclavicular joint fixation after reduction.There are many choices of the internal fixation to fix the acromioclavicular joint,such as the Kirschner wire and tension band,the clavicular hook plate or anatomical plate for the coracoclavicular joint fixation,and the cannulated screws,steel wires or suture anchors for the coracoclavicular fixation.The selection of these fixations can be combined with debridement of the acromioclavicular joint,the distal clavicle resection,or stitching and reconstruction of the coracoclavicular ligament.Most of these surgical procedures have obtained better results. However,the internal fixation failure,displacement or dislocation after the fixation removal sometimes happened.Considering that the coracoclavicular ligament plays an important role for the acromioclavicular joint stability,researchers has gradually paid more attentions to the reconstruction of the coracoclavicular ligament recently.The repair methods include the direct suture,the partial ligament displacement,the autologous tendon graft,and the tendon graft transplantation.We chose a simple,less traumatic method for the acromioclavicular dislocations,which is autogenous palmaris longus muscle transplant combined with the suture anchor fixation,and achieved satisfactory results. Methods (1)General information:A total of 30 cases aged from 17 to 55 years (mean 31 years)with acromioclavicular

  16. Reliable Gait Recognition Using 3D Reconstructions and Random Forests - An Anthropometric Approach.

    Sandau, Martin; Heimbürger, Rikke V; Jensen, Karl E; Moeslund, Thomas B; Aanaes, Henrik; Alkjaer, Tine; Simonsen, Erik B


    Photogrammetric measurements of bodily dimensions and analysis of gait patterns in CCTV are important tools in forensic investigations but accurate extraction of the measurements are challenging. This study tested whether manual annotation of the joint centers on 3D reconstructions could provide reliable recognition. Sixteen participants performed normal walking where 3D reconstructions were obtained continually. Segment lengths and kinematics from the extremities were manually extracted by eight expert observers. The results showed that all the participants were recognized, assuming the same expert annotated the data. Recognition based on data annotated by different experts was less reliable achieving 72.6% correct recognitions as some parameters were heavily affected by interobserver variability. This study verified that 3D reconstructions are feasible for forensic gait analysis as an improved alternative to conventional CCTV. However, further studies are needed to account for the use of different clothing, field conditions, etc.

  17. Total variation regularization in measurement and image space for PET reconstruction

    Burger, M


    © 2014 IOP Publishing Ltd. The aim of this paper is to test and analyse a novel technique for image reconstruction in positron emission tomography, which is based on (total variation) regularization on both the image space and the projection space. We formulate our variational problem considering both total variation penalty terms on the image and on an idealized sinogram to be reconstructed from a given Poisson distributed noisy sinogram. We prove existence, uniqueness and stability results for the proposed model and provide some analytical insight into the structures favoured by joint regularization. For the numerical solution of the corresponding discretized problem we employ the split Bregman algorithm and extensively test the approach in comparison to standard total variation regularization on the image. The numerical results show that an additional penalty on the sinogram performs better on reconstructing images with thin structures.

  18. Speed-dependent reference joint trajectory generation for robotic gait support.

    Koopman, B; van Asseldonk, E H F; van der Kooij, H


    For the control of actuated orthoses, or gait rehabilitation robotics, kinematic reference trajectories are often required. These trajectories, consisting of joint angles, angular velocities and accelerations, are highly dependent on walking-speed. We present and evaluate a novel method to reconstruct body-height and speed-dependent joint trajectories. First, we collected gait kinematics in fifteen healthy (middle) aged subjects (47-68), at a wide range of walking-speeds (0.5-5 kph). For each joint trajectory multiple key-events were selected (among which its extremes). Second, we derived regression-models that predict the timing, angle, angular velocity and acceleration for each key-event, based on walking-speed and the subject׳s body-height. Finally, quintic splines were fitted between the predicted key-events to reconstruct a full gait cycle. Regression-models were obtained for hip ab-/adduction, hip flexion/extension, knee flexion/extension and ankle plantar-/dorsiflexion. Results showed that the majority of the key-events were dependent on walking-speed, both in terms of timing and amplitude, whereas the body-height had less effect. The reconstructed trajectories matched the measured trajectories very well, in terms of angle, angular velocity and acceleration. For the angles the RMSE between the reconstructed and measured trajectories was 2.6°. The mean correlation coefficient between the reconstructed and measured angular trajectories was 0.91. The method and the data presented in this paper can be used to generate speed-dependent gait patterns. These patterns can be used for the control of several robotic gait applications. Alternatively they can assist the assessment of pathological gait, where they can serve as a reference for "normal" gait.

  19. Rheumatoid arthritis affecting temporomandibular joint.

    Sodhi, Amandeep; Naik, Shobha; Pai, Anuradha; Anuradha, Ardra


    Rheumatoid arthritis (RA) is a chronic, systemic, autoimmune inflammatory disorder that is characterized by joint inflammation, erosive properties and symmetric multiple joint involvement. Temporomandibular joint (TMJ) is very rare to be affected in the early phase of the disease, thus posing diagnostic challenges for the dentist. Conventional radiographs fail to show the early lesions due to its limitations. More recently cone-beam computed tomography (CBCT) has been found to diagnose the early degenerative changes of TMJ and hence aid in the diagnosis of the lesions more accurately. Our case highlights the involvement of TMJ in RA and the role of advanced imaging (CBCT) in diagnosing the bony changes in the early phase of the disease.

  20. Joint US/German Conference

    Gulledge, Thomas; Jones, Albert


    This proceedings volume contains selected and refereed contributions that were presented at the conference on "Recent Developments and New Perspectives of Operations Research in the Area of Production Planning and Control" in Hagen/Germany, 25. - 26. June 1992. This conference was organized with the cooperation of the FernuniversiHit Hagen and was jointly hosted by the "Deutsche Gesellschaft fur Operations Research (DGOR)" and the "Manufacturing Special Interest Group of the Operations Research Society of America (ORSA-SIGMA)". For the organization of the conference we received generous financial support from the sponsors listed at the end of this volume. We wish to express our appreciation to all supporters for their contributions. This conference was the successor of the JOInt ORSA/DGOR-conference in Gaithersburg/Maryland, USA, on the 30. and 31. July 1991. Both OR-societies committed themselves in 1989 to host joint conferences on special topics of interest from the field of operations research. This goal ...

  1. Rheumatoid arthritis affecting temporomandibular joint

    Amandeep Sodhi


    Full Text Available Rheumatoid arthritis (RA is a chronic, systemic, autoimmune inflammatory disorder that is characterized by joint inflammation, erosive properties and symmetric multiple joint involvement. Temporomandibular joint (TMJ is very rare to be affected in the early phase of the disease, thus posing diagnostic challenges for the dentist. Conventional radiographs fail to show the early lesions due to its limitations. More recently cone-beam computed tomography (CBCT has been found to diagnose the early degenerative changes of TMJ and hence aid in the diagnosis of the lesions more accurately. Our case highlights the involvement of TMJ in RA and the role of advanced imaging (CBCT in diagnosing the bony changes in the early phase of the disease.

  2. Mandibular reconstruction in adults: a review.

    Goh, B.T.; Lee, S.; Tideman, H.; Stoelinga, P.J.W.


    Mandibular defects may result from trauma, inflammatory disease and benign or malignant tumours. Mastication, speech and facial aesthetics are often severely compromised without reconstruction. The goal of mandibular reconstruction is to restore facial form and function, implying repair of mandibula

  3. 3D volume assessment techniques and computer-aided design and manufacturing for preoperative fabrication of implants in head and neck reconstruction.

    Patel, Ashish; Otterburn, David; Saadeh, Pierre; Levine, Jamie; Hirsch, David L


    Cases in subdisciplines of craniomaxillofacial surgery--corrective jaw surgery, maxillofacial trauma, temporomandibular joint/skull base, jaw reconstruction, and postablative reconstruction-illustrate the ease of use, cost effectiveness, and superior results that can be achieved when using computer-assisted design and 3D volumetric analysis in preoperative surgical planning. This article discusses the materials and methods needed to plan cases, illustrates implementation of guides and implants, and describes postoperative analysis in relation to the virtually planned surgery.

  4. Soft tissue influence on ex vivo mobility in the hip of Iguana: comparison with in vivo movement and its bearing on joint motion of fossil sprawling tetrapods.

    Arnold, Patrick; Fischer, Martin S; Nyakatura, John A


    The reconstruction of a joint's maximum range of mobility (ROM) often is a first step when trying to understand the locomotion of fossil tetrapods. But previous studies suggest that the ROM of a joint is restricted by soft tissues surrounding the joint. To expand the limited informative value of ROM studies for the reconstruction of a fossil species' locomotor characteristics, it is moreover necessary to better understand the relationship of ex vivo ROM with the actual in vivo joint movement. To gain insight into the relationship between ex vivo mobility and in vivo movement, we systematically tested for the influence of soft tissues on joint ROM in the hip of the modern lizard Iguana iguana. Then, we compared the ex vivo mobility to in vivo kinematics of the hip joint in the same specimens using X-ray sequences of steady-state treadmill locomotion previously recorded. With stepwise removal of soft tissues and a repeated-measurement protocol, we show that soft tissues surrounding the hip joint considerably limit ROM, highlighting the problems when joint ROM is deduced from bare bones only. We found the integument to have the largest effect on the range of long-axis rotation, pro- and retraction. Importantly, during locomotion the iguana used only a fragment of the ROM that was measured in our least restrictive dissection situation (i.e. pelvis and femur only conjoined by ligaments), demonstrating the discrepancy between hip joint ROM and actual in vivo movement. Our study emphasizes the necessity for caution when attempting to reconstruct joint ROM or even locomotor kinematics from fossil bones only, as actual in vivo movement cannot be deduced directly from any condition of cadaver mobility in Iguana and likely in other tetrapods.

  5. Post-traumatic instability of the metacarpophalangeal joint of the thumb.

    Smith, R J


    Of eithty-six patients with collateral ligament instability of the metacarpophalangeal joint of the thumb, sixty-six (77 per cent) had ulnar and twenty (23 per cent) had radial instability, while in addition twenty-four had fractures and twenty-nine had volar subluxation of the proximal phalanx. Of the sixty-nine patients operated on, sixty-five had an abnormality of the ulnar or radial collateral ligament proper or of its attachment; two, subluxation of the extensor pollicis longus; and two, stretching of the adductor expansion. Stability was restored by collateral ligament repair or reconstruction, by fixation of a fracture fragment with a Kirschner wire, or by arthrodesis in all but five thumbs. Of the five patients who did not have stability of the metacarpophalangeal joint following surgery, three had had the collateral ligament sutured more than three weeks after injury and two had had reconstruction of the collateral ligament using a tendon graft. Early surgical treatment is recommended for all patients with post-traumatic instability of the metacarpophalangeal joint greater than 45 degrees and for those with volar subluxation of the proximal phalanx or a displaced fracture of the base of the proximal phalanx. Collateral ligament repair is indicated for patients operated on within three weeks of injury, and reconstruction of the ligament by means of a tendon graft is recommended for those treated more than three weeks after injury.

  6. 3D Reconstruction Technique for Tomographic PIV

    姜楠; 包全; 杨绍琼


    Tomographic particle image velocimetry(Tomo-PIV) is a state-of-the-art experimental technique based on a method of optical tomography to achieve the three-dimensional(3D) reconstruction for three-dimensional three-component(3D-3C) flow velocity measurements. 3D reconstruction for Tomo-PIV is carried out herein. Meanwhile, a 3D simplified tomographic reconstruction model reduced from a 3D volume light inten-sity field with 2D projection images into a 2D Tomo-slice plane with 1D projecting lines, i.e., simplifying this 3D reconstruction into a problem of 2D Tomo-slice plane reconstruction, is applied thereafter. Two kinds of the most well-known algebraic reconstruction techniques, algebraic reconstruction technique(ART) and multiple algebraic reconstruction technique(MART), are compared as well. The principles of the two reconstruction algorithms are discussed in detail, which has been performed by a series of simulation images, yielding the corresponding recon-struction images that show different features between the ART and MART algorithm, and then their advantages and disadvantages are discussed. Further discussions are made for the standard particle image reconstruction when the background noise of the pre-initial particle image has been removed. Results show that the particle image recon-struction has been greatly improved. The MART algorithm is much better than the ART. Furthermore, the computa-tional analyses of two parameters(the particle density and the number of cameras), are performed to study their effects on the reconstruction. Lastly, the 3D volume particle field is reconstructed by using the improved algorithm based on the simplified 3D tomographic reconstruction model, which proves that the algorithm simplification is feasible and it can be applied to the reconstruction of 3D volume particle field in a Tomo-PIV system.

  7. Top reconstruction and boosted top experimental overview

    Skinnari, Louise


    An overview of techniques used to reconstruct resolved and boosted top quarks is presented. Techniques for resolved top quark reconstruction include kinematic likelihood fitters and pseudo- top reconstruction. Many tools and methods are available for the reconstruction of boosted top quarks, such as jet grooming techniques, jet substructure variables, and dedicated top taggers. Different techniques as used by ATLAS and CMS analyses are described and the performance of different variables and top taggers are shown.

  8. Thermographic image reconstruction using ultrasound reconstruction from virtual waves

    Burgholzer, Peter; Gruber, Jürgen; Mayr, Günther


    Reconstruction of subsurface features from ultrasound signals measured on the surface is widely used in medicine and non-destructive testing. In this work, we introduce a concept how to use image reconstruction methods known from ultrasonic imaging for thermographic signals, i.e. on the measured temperature evolution on a sample surface. Before using these imaging methods a virtual signal is calculated by applying a transformation to the measured temperature evolution. The virtual signal is calculated locally for every detection point and has the same initial temperature distribution as the measured signal, but is a solution of the wave equation. The introduced transformation can be used for every shape of the detection surface and in every dimension. It describes all the irreversibility of the heat diffusion, which is responsible that the spatial resolution gets worse with increasing depth. Up to now, for thermographic imaging mostly one-dimensional methods, e.g., for depth-profiling were used, which are sui...

  9. Solder Joint Health Monitoring Testbed

    Delaney, Michael M.; Flynn, James G.; Browder, Mark E.


    A method of monitoring the health of selected solder joints, called SJ-BIST, has been developed by Ridgetop Group Inc. under a Small Business Innovative Research (SBIR) contract. The primary goal of this research program is to test and validate this method in a flight environment using realistically seeded faults in selected solder joints. An additional objective is to gather environmental data for future development of physics-based and data-driven prognostics algorithms. A test board is being designed using a Xilinx FPGA. These boards will be tested both in flight and on the ground using a shaker table and an altitude chamber.

  10. Joint Measurability and Temporal Steering

    Karthik, H. S.; Tej, J Prabhu; Devi, A. R. Usha; Rajagopal, A. K.


    Quintino et. al. (Phys. Rev. Lett. 113, 160402 (2014)) and Uola et. al. (Phys. Rev. Lett. 113, 160403 (2014)) have recently established an intrinsic relation between non-joint measurability and Einstein-Podolsky- Rosen steering. They showed that a set of measurements is incompatible (i.e., not jointly measurable) if and only if it can be used for the demonstration of steering. In this paper, we prove the temporal analog of this result viz., a set of measurements are incompatible if and only i...

  11. Temporomandibular joint disorders in children.

    Howard, James A


    A child's difficulty in verbalizing the precise location and nature of facial pain and jaw dysfunction often results in a nondefinitive history, increasing the importance of the dentist's awareness of the early signs and symptoms of temporomandibular joint disorders (TMD). A focused examination of the masticatory musculature, the temporomandibular joints, and associated capsular and ligamentous structures can reveal if a patient's symptoms are TMD in origin. An accurate differential diagnosis enables timely referral to appropriate health care providers and minimizes the use of diagnostic imaging.

  12. [Divorce and joint physical custody].

    Golse, B


    This work first recalls the definition of joint physical custody, as well as the current legal procedure for obtaining it, its practical implementation, the financial implications for parents, and finally some statistics. Some psychological and psychopathological reflections on the impact of divorce on children are then presented before considering the question of joint physically custody with regard to attachment theory and depending on the age of the child (a great caution seems to be required before three years). The article concludes with a brief discussion of parental alienation syndrome.

  13. Dual joint space arthrography in temporomandibular joint disorders: Comparison with single inferior joint space arthrography

    Choi, Hyung Sik; Chang, Duk Soo; Lee, Kyung Soo; Kim, Woo Sun; Sung, Jung Ho; Jun, Young Hwan [Capital Armed Forces General Hospital, Seoul (Korea, Republic of)


    The temporomandibular joint(TMJ) is really a complex of two synovial space separated by fibrocartilaginous disc. Single inferior joint space arthrography is commonly performed for evaluation of TMJ disorders, which is known to be superior in demonstrating joint dynamics. But it reveals only the inferior surface of the disc. Therefore, dual space arthrography is superior to demonstrate the soft tissue anatomic feature of the joint such as disc position and shape. Authors performed 83 TMJ arthrograms in TMJ problems. Initially, the inferior joint space was done and then the superior space was sequentially contrasted. The follow results were noted: 1. In all cases, dual space arthrography revealed accurate disc shape and positions. 2. Concordant findings between the two techniques: 68 cases (82%). Discordance between the two techniques: 15 cases (18%) 3. Possible causes of discordance between inferior and dual space arthrography. a) Normal varians of anterior recess: 3 cases b) Posterior disc displacement: 4 cases c) Influence of the patient's head position change :4 cases d) False perforation: 2 cases e) Reduction change: 2 cases 4. In 5 cases with anterior displacement, dual space arthrography gave additional findings such as adhesion within the superior space, which could not be evaluated by single inferior space.

  14. Focused Logistics, Joint Vision 2010: A Joint Logistics Roadmap


    such best commercial business practices as Activity Based Costing ( ABC ), Activity Based Man- agement ( ABM ), and other total quality initiatives, will...Joint Warfighting Center, Fort Monroe, Virginia C-1 APPENDIX C Acronyms ABC Activity Based Costing ABM Activity Based Management ACSA Acquisition and

  15. Joint Service Aircrew Mask (JSAM) - Joint Strike Fighter (JSF): Speech Intelligibility Performance


    AFRL-RH-WP-TP-2015-0028 Joint Service Aircrew Mask (JSAM) – Joint Strike Fighter (JSF): Speech Intelligibility Performance...COVERED (From - To) June 2014 – April 2015 4. TITLE AND SUBTITLE Joint Service Aircrew Mask (JSAM) – Joint Strike Fighter (JSF): Speech Intelligibility...Method for Measuring the Intelligibility of Speech over Communication Systems on the Joint Service Aircrew Mask (JSAM) – Joint Strike Fighter (JSF) with

  16. Vertex Reconstruction in ATLAS Run II

    Zhang, Matt; The ATLAS collaboration


    Vertex reconstruction is the process of taking reconstructed tracks and using them to determine the locations of proton collisions. In this poster we present the performance of our current vertex reconstruction algorithm, and look at investigations into potential improvements from a new seed finding method.

  17. First ray reconstruction with distraction osteogenesis.

    Kömürcü, Mahmut; Kürklü, Mustafa; Demiralp, Bahtiyar; Atesalp, Ali Sabri; Alsancak, Serap; Basbozkurt, Mustafa


    Disarticulation of the thumb at the metacarpophalangeal joint level is not beneficial either aesthetically or functionally without additional surgery because it requires a bulky and an unacceptable prosthesis to be made for this amputation level. In this study, the authors have presented our experience of 12 metacarpal distractions in thumb amputated patients. Twelve male patients who had thumb amputation due to gunshot wounds were included in the study. Before the operation, aesthetic hand prostheses were made for 5 of the 12 patients. Callus distraction was performed with the use of a mini Ilizarov type external fixator in 7 cases and uniplanar dynamic mini external fixator in 5 cases too. External fixators were removed after the completion of the radiographic consolidation. Five patients whose prosthesis had been made before the operation wore their prosthesis for an average 6.8 months (5 - 14) due to poor appearance and poor construction. Union of the lengthened segment was observed in all cases. Average lengthening was 28.9 mm (range from 25 - 37). Average healing time was 2.1 months (range from 1.8 - 2.5). Average healing index was 0.73 month/cm (range from 0.65 - 0.88). Pin tract infection was seen in 7 cases (58.3%). Volar angulation developed after removing the external fixator in 1 case. Webplasty was performed in all cases. Patients were evaluated by means of Disability of the Arm, Shoulder and Hand (DASH) score and pick-up test. It was concluded that the metacarpus lengthening by callus distraction technique may be a functionally and cosmetically effective reconstruction method for traumatic thumb amputations. It is believed that the possibility for a functionally and aesthetically acceptable fabrication of a thumb prosthesis, by providing a suction suspension with distraction and/or webplasty procedures.

  18. Implant fixationversus conservative treatment for Rockwood type III acromioclavicular dislocation:a systematic review%植入物内固定与保守疗法修复Rockwood Ⅲ型肩锁关节脱位的系统评价

    孙根文; 帕拉提•阿巴伯艾力; 李涛; 苏来曼; 阿布都萨拉木; 塔依尔•阿不都哈德尔


    BACKGROUND:Although there is a general consensus with regard to the treatment of Rockwood types I, II, IV, V and VI injuries, the treatment of type III injury is inconsistent. OBJECTIVE: The aim of this systematic review was to evaluate the efficacy and safety of implant fixation and conservative treatment for Rockwood type III acromioclavicular dislocation. METHODS:Studies were identified from databases (PubMed, Embase, Cochrane Library, China Biological Medicine, VIP, CNKI and Wanfang Database) up to May 2015. Eligible studies that investigated and compared the effectiveness and/or complications of implant fixation and conservative treatment for Rockwood type III acromioclavicular dislocation and provided sufficient data were included. RESULTS AND CONCLUSION:In total, eight studies were included. Implant fixation (n=207) included the Bosworth technique, Clavicle Hook Plate technique, the TightRopeTM system (titanium plate and Arthrex fiber suture), Weaver-Dunn technique (coracoacromial ligament displacement, instead of coracoclavicular ligament fixation), Phemister technique (Kirschner wire fixation) and the use of a poly dioxanone sutures cord. The conservative treatments (n=137) consisted of immobilisation management with a sling, Kenny-Howard brace, or with a sling and clavicle fastening taping tape or a simple brake, or with a sling or tape. There were no significant differences in the Constant score (P=0.90) and infection rate (P=0.07) between the two groups. The rate of satisfaction with aesthetic outcomes was higher in the implant fixation group (P < 0.000 01), although the incidence of coracoclavicular ligament calcification was also higher (P=0.03) in this group. The time to resumption of normal work and normal activities was shorter after conservative treatment than that after implant fixation treatment. However, implant fixation could return to the game faster. These results indicate that both implant fixation and conservative treatments can result in

  19. Sagittal alignment of the first metatarsophalangeal joint after arthrodesis for rheumatoid forefoot deformity.

    Tanabe, Akihiko; Majima, Tokifumi; Onodera, Tomohiro; Sawaguchi, Naohiro; Watanabe, Takuya; Kasahara, Yasuhiko; Takahashi, Daisuke


    The present study assessed the midterm results of reconstruction for rheumatoid forefoot deformity with arthrodesis of the first metatarsophalangeal (MTP) joint, scarf osteotomy, resection arthroplasty of the metatarsal head of the lesser toes, and surgical repair of hammertoe deformity (arthrodesis of the proximal interphalangeal joint). Special focus was placed on the sagittal alignment of the first metatarsophalangeal joint after arthrodesis. We retrospectively evaluated the postoperative clinical outcomes and radiographic findings for 16 consecutive female patients (20 feet) with symptomatic rheumatoid forefoot deformities. The mean duration of follow-up was 7.9 (range 4 to 13) years. All first MTP joints and first metatarsal bones were fused successfully. The mean value of the American Orthopaedic Foot and Ankle Society and Japanese Society for Foot Surgery clinical scores significantly improved overall, except for 2 patients (10%), who complained of first toe pain at the final follow-up visit owing to sagittal misalignment of the fused first MTP joint. Sagittal alignment of the first metatarsal varies greatly because of the rheumatoid midfoot and hindfoot deformities. Therefore, inclination of the first metatarsal should be considered when determining the first MTP joint sagittal fusion angle.

  20. Assessing performance and seasonal bias of pollen-based climate reconstructions in a perfect model world

    Rehfeld, Kira; Trachsel, Mathias; Telford, Richard J.; Laepple, Thomas


    Reconstructions of summer, winter or annual mean temperatures based on the species composition of bio-indicators such as pollen, foraminifera or chironomids are routinely used in climate model-proxy data comparison studies. Most reconstruction algorithms exploit the joint distribution of modern spatial climate and species distribution for the development of the reconstructions. They rely on the space-for-time substitution and the specific assumption that environmental variables other than those reconstructed are not important or that their relationship with the reconstructed variable(s) should be the same in the past as in the modern spatial calibration dataset. Here we test the implications of this "correlative uniformitarianism" assumption on climate reconstructions in an ideal model world, in which climate and vegetation are known at all times. The alternate reality is a climate simulation of the last 6000 years with dynamic vegetation. Transient changes of plant functional types are considered as surrogate pollen counts and allow us to establish, apply and evaluate transfer functions in the modeled world. We find that in our model experiments the transfer function cross validation r2 is of limited use to identify reconstructible climate variables, as it only relies on the modern spatial climate-vegetation relationship. However, ordination approaches that assess the amount of fossil vegetation variance explained by the reconstructions are promising. We furthermore show that correlations between climate variables in the modern climate-vegetation relationship are systematically extended into the reconstructions. Summer temperatures, the most prominent driving variable for modeled vegetation change in the Northern Hemisphere, are accurately reconstructed. However, the amplitude of the model winter and mean annual temperature cooling between the mid-Holocene and present day is overestimated and similar to the summer trend in magnitude. This effect occurs because