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Sample records for acutely acl injured

  1. The acutely ACL injured knee assessed by MRI

    DEFF Research Database (Denmark)

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

    2008-01-01

    OBJECTIVES: To map by magnetic resonance imaging (MRI) and quantitative MRI (qMRI) concomitant fractures and meniscal injuries, and location and volume of traumatic bone marrow lesions (BMLs) in the acutely anterior cruciate ligament (ACL) injured knee. To relate BML location and volume to cortical...... depression fractures, meniscal injuries and patient characteristics. METHODS: One hundred and twenty-one subjects (26% women, mean age 26 years) with an ACL rupture to a previously un-injured knee were studied using a 1.5T MR imager within 3 weeks from trauma. Meniscal injuries and fractures were classified...... depression fracture, but no associations were found between meniscal tears and BML volume or fractures. Older age at injury was associated with smaller BML volumes (PACL injured knees had a cortical depression fracture, which was associated with larger BML volumes...

  2. Healing of the Acutely Injured Anterior Cruciate Ligament: Functional Treatment with the ACL-Jack, a Dynamic Posterior Drawer Brace

    Science.gov (United States)

    Reischl, Nikolaus; Rönn, Karolin; Magnusson, Robert A.; Gautier, Emanuel; Jakob, Roland P.

    2016-01-01

    Background. The injured anterior cruciate ligament (ACL) has a limited healing capacity leading to persisting instability. Hypothesis/Purpose. To study if the application of a brace, producing a dynamic posterior drawer force, after acute ACL injury reduces initial instability. Study Design. Cohort study. Methods. Patients treated with the ACL-Jack brace were compared to controls treated with primary ACL reconstruction und controls treated nonsurgically with functional rehabilitation. Measurements included anterior laxity (Rolimeter), clinical scores (Lysholm, Tegner, and IKDC), and MRI evaluation. Patients were followed up to 24 months. Results. Patients treated with the ACL-Jack brace showed a significant improvement of anterior knee laxity comparable to patients treated with ACL reconstruction, whereas laxity persisted after nonsurgical functional rehabilitation. The failure risk (secondary reconstruction necessary) of the ACL-Jack group was however 21% (18 of 86) within 24 months. Clinical scores were similar in all treatment groups. Conclusion. Treatment of acute ACL tears with the ACL-Jack brace leads to improved anterior knee laxity compared to nonsurgical treatment with functional rehabilitation. PMID:28053787

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

    DEFF Research Database (Denmark)

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

    2008-01-01

    OBJECTIVES: To investigate changes in the knee during the first year after acute rupture of the anterior cruciate ligament (ACL) of volumes of joint fluid (JF), bone marrow lesions (BMLs), and cartilage volume (VC), and cartilage thickness (ThCcAB) and cartilage surface area (AC). To identify...... factors associated with these changes. METHODS: Fifty-eight subjects (mean age 26 years, 16 women) with an ACL rupture to a previously un-injured knee were followed prospectively using a 1.5T MR imager at baseline (within 5 weeks from injury), 3 months, 6 months, and 1 year. Thirty-four subjects were...... treated with ACL reconstruction followed by a structured rehabilitation program and 24 subjects were treated with structured rehabilitation only. Morphometric data were acquired from computer-assisted segmentation of MR images. Morphometric cartilage change was reported as mean change divided...

  4. Effect of Timing of Surgery in Partially Injured ACLs.

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    Li, Bin; Bai, Lunhao; Fu, Yonghui; Wang, Guangbin; He, Ming; Wang, Jiashi

    2012-05-01

    The purpose of this study was to explore the optimal timing for surgical intervention of partially injured anterior cruciate ligaments (ACL). Thirty-eight patients were divided into early (n=17) or delayed (n=21) surgery groups based on the interval between injury and surgery. Minimum follow-up was 2 years. The outcome measures used were the International Knee Documentation Committee score, Lysholm knee score, Tegner activity rating, range of motion, and arthrometer measurements. The findings of this study indicate that early surgical reconstruction of partially ruptured ACLs did not result in arthrofibrosis but may prevent secondary loosening of the intact bundles and further meniscal and chondral injury.

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

    DEFF Research Database (Denmark)

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

    2008-01-01

    during five functional tests in subjects with an anterior cruciate ligament (ACL) injury. METHOD: Twelve ACL-injured men, mean age 40 years, were video filmed before and after 12 weeks of knee-specific training when performing five different functional tests: walking, knee bending, step activity......, crossover hop on one leg and one-leg hop. The videos were observed by four physiotherapists, and the knee movement pattern quality, a feature of the loading strategy of the lower extremity, was scored on an 11-point rating scale. To assess the criterion validity, the observational rating was correlated...

  6. Acute Vs Delayed ACL Reconstruction. Early Differences and Preliminary Two Year Results

    Science.gov (United States)

    Eriksson, Karl; Barenius, Björn

    2016-01-01

    Objectives: Historically acute ACL reconstruction has been avoided due to reports of early rehabilitation problems with stiffness. Are these reports still valid today with modern arthroscopic techniques? Methods: 70 patients with a high recreational activity level (Tegner ≥6) who presented with a acute ACL injury were randomized to an acute reconstruction within 8 days from the injury or delayed reconstruction after 6-10 weeks. Four surgeons performed the ACL reconstructions with quadrupled semitendinosus tendon grafts and endobutton and metallic interference screw fixation. The rehabilitation training was performed at the same physiotherapy center for all patients. The follow up at 6 and 24 months included ROM, Lachman, Rolimeter, pivot shift, one leg hop, IKDC, KOOS, Lysholm and Tegner activity level. Results: There were no differences between the groups in ROM, IKDC, activity level or laxity at 6 months. Four patients had a combined extension and flexion deficit of more than 15 degrees, two from each group. In the acute group 79% had an objective IKDC grade A or B compared with 73% in the delayed group. The one leg hop index above 90% was found in 50% in the acute group and 24% in the delayed group (p=0.04). Functional data for the 2-year follow up are not available at the time of abstract writing. The median activity level according to Tegner was restored to pre-injury levels in both groups after one year, and was stationary at 2 years. The visual analogue scale (VAS) response to the question “How is your knee working on a scale from 0-100? (100 = best)” revealed 81 in the acute and 71 in the delayed group (p=0.1). To the question “How does your knee affect your activity level on a scale from 0-100? (100 = no affection)” the mean score was 75 in the acute group and 67 in the delayed group (p=0.3). At one and two years the KOOS was statistically similar between the groups but with slightly higher subscale “Sport and recreation” scores, 85 in the

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

    Science.gov (United States)

    Roberts, D; Ageberg, E; Andersson, G; Fridén, T

    2007-01-01

    A knee injury with anterior cruciate ligament (ACL) rupture may cause deficits in proprioception, increased laxity and decreased muscle strength. Although it may be common knowledge that these factors affect knee function, only a few studies have been performed where this has been investigated in the clinical situation, and the results are not conclusive. The purpose of this study was therefore to investigate how and to what extent proprioception, laxity and strength affect knee joint function and evaluate if the methods commonly used for estimating these factors clinically seem to be relevant. The study encompassed 36 patients with ACL deficiency. A single-leg hop test for distance and subjective rating of knee function were defined as dependent variables and analyzed separately in stepwise linear regression models where proprioception, knee joint laxity, hamstrings and quadriceps strength, age and sex were defined as independent variables. Higher threshold values (poorer proprioception), increased side-to-side difference of anterior laxity and poorer strength significantly predicted shorter length of the hop test. Higher rating of subjective function corresponded to female gender, lesser side-to-side difference of anterior laxity and better proprioception.

  8. Acute lung injury and the acute respiratory distress syndrome in the injured patient

    Directory of Open Access Journals (Sweden)

    Bakowitz Magdalena

    2012-08-01

    Full Text Available Abstract Acute lung injury and acute respiratory distress syndrome are clinical entities of multi-factorial origin frequently seen in traumatically injured patients requiring intensive care. We performed an unsystematic search using PubMed and the Cochrane Database of Systematic Reviews up to January 2012. The purpose of this article is to review recent evidence for the pathophysiology and the management of acute lung injury/acute respiratory distress syndrome in the critically injured patient. Lung protective ventilation remains the most beneficial therapy. Future trials should compare intervention groups to controls receiving lung protective ventilation, and focus on relevant outcome measures such as duration of mechanical ventilation, length of intensive care unit stay, and mortality.

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

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

    2004-05-01

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

  10. Anterior crucate ligament (ACL) injury

    Science.gov (United States)

    ... An anterior cruciate ligament injury is the over-stretching or tearing of the anterior cruciate ligament (ACL) ... may be injured. This is a medical emergency. Prevention Use proper techniques when playing sports or exercising. ...

  11. ACL reconstruction

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    ... this page: //medlineplus.gov/ency/article/007208.htm ACL reconstruction To use the sharing features on this page, please enable JavaScript. ACL reconstruction is surgery to reconstruct the ligament in ...

  12. Correlation study of podocyte injur y and kidney function in patients with acute kidney injur y

    Directory of Open Access Journals (Sweden)

    You-Gang Feng

    2016-11-01

    Full Text Available Objective: To investigate the correlation between the podocyte injury indexes in urine such as nephrin, desmin, P-cadherin, podocin, podocalyxin and CD2-associated protein (CD2AP and the kidney function in patients with acute kidney injury (AKI. Methods: A total of 120 severe postsurgical patients treated in the Intensive Care Unit of our hospital from May 2012 to October 2015 were selected and divided into AKI group (n = 38 and non-AKI group (n = 82 according to the diagnostic criteria of AKI. After admission to the Intensive Care Unit for 24 h, their blood samples were collected to detect the contents of serum creatinine (Scr, serum urea (SUrea, b2-microglobulin (b2-MG and cystatin C (Cys-C, and urine samples were collected to detect the contents of kidney injury molecule-1 (KIM-1, liver-type fatty acid binding protein (L-FABP, Netrin-1, nephrin, desmin, P-cadherin, podocin, podocalyxin and CD2AP. Results: For patients in AKI group, the contents of Scr, SUrea, b2-MG and Cys-C in their blood samples and the contents of KIM-1, L-FABP, Netrin-1, nephrin, desmin, Pcadherin, podocin, podocalyxin and CD2AP in their urine samples were both significantly higher than those in non-AKI group. The contents of nephrin, desmin, P-cadherin, podocin, podocalyxin and CD2AP in urine samples and contents of Scr, SUrea, b2-MG, Cys-C and neutrophil gelatinase associated lipocalin in blood samples were positively correlated with the contents of KIM-1, L-FABP, and Netrin-1 in urine. Conclusions: Contents of podocyte injury molecules in urine of patients with acute kidney injury such as nephrin, desmin, P-cadherin, podocin, podocalyxin and CD2AP raised remarkably and the changes were consistent with the changes of kidney function indexes in the blood and urine samples.

  13. Predicting Child Ptsd: The Relationship between Acute Stress Disorder and PTSD in Injured Children

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    Kassam-Adams, Nancy; Winston, Flaura Koplin

    2004-01-01

    Objective: To examine the prevalence of acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) in injured children and to evaluate the utility of ASD as a predictor of PTSD. Method: Children hospitalized for injuries sustained in a traffic crash were enrolled in a prospective study. ASD was assessed in 243 children within 1 month…

  14. Gait adaptation in ACL deficient patients before and after anterior cruciate ligament reconstruction surgery.

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    Knoll, Zsolt; Kiss, Rita M; Kocsis, László

    2004-06-01

    The objective of this study is to determine how kinematical parameters and electromyography data of selected muscles may change as a result of anterior cruciate ligament (ACL) deficiency and following ACL reconstruction. The study was conducted on 25 anterior cruciate ligament deficient subjects prior to and 6 weeks, 4 months, 8 months and 12 months following ACL reconstructive surgery using the bone-patellar tendon-bone technique. Gait analysis was performed by applying the zebris three-dimensional ultrasound-based system with surface electromyograph (zebris). Kinematic data were recorded for the lower limb. The muscles surveyed include vastus lateralis and medialis, biceps femoris and adductor longus. The results obtained from the injured subjects were compared with those of 51 individuals without any ACL damage whatsoever. Acute ACL deficient patients exhibited a quadriceps avoidance pattern prior to and 6 weeks following surgery. No quadriceps avoidance phenomenon develops in chronic ACL deficient patients. In operated individuals, tempo-spatial parameters and the knee angle regained a normal pattern for the ACL-deficient limb during gait as early as 4 months following surgery. However, the relative ACL movement parameter, which describes the tibial translation into the direction of ACL, and the EMG traces show no significant statistical difference compared with the same values of the healthy control group just 8 months following surgery. The analysis of spatial-temporal parameters and EMG traces show that the development of a quadriceps avoidance pattern is less common than previously reported. These data suggest that anterior cruciate ligament deficiency and reconstruction produce considerable changes in the lower extremity gait pattern. The results suggest that gait parameters tend to shift towards a normal value pattern; and the re-establishment of pre-injury gait patterns-including the normal biphase of muscles-takes at least 8 months to occur.

  15. ACL Revision

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    Costa-Paz, Matias; Dubois, Julieta Puig; Zicaro, Juan Pablo; Rasumoff, Alejandro; Yacuzzi, Carlos

    2017-01-01

    Objectives: The purpose of this study was to evaluate a series of patients one year after an ACL revision with clinical evaluation and MRI, to consider their condition before returning to sports activities. Methods: A descriptive, prospective and longitudinal study was performed. A series of patients who underwent an ACL revision between March 2014 and March 2015 were evaluated after one year post surgery. They were evaluated using the Lysholm score, IKDC, Tegner, artrometry and MRI (3.0 t). A signal pattern and osteointegration was determined in the MRI. Graft signal intensity of the ACL graft using the signal/noise quotient value (SNQ) was also determined to evaluate the ligamentatization process state. Results: A total of 18 male patients were evaluated with a mean age of 31 years old.Average scores were: Lysholm 88 points, IKDC 80 points, Pre-surgical Tegner 9 points and postoperative 4 points. Artrhometry (KT1000) at 20 newtons showed a side to side difference of less than 3 mm in 88%. Only 44% of patients returned to their previous sport activity one year after revision.The MRI showed a heterogeneous signal in neoligaments in 34% of patients. SNQ showed graft integration in only 28%. Synovial fluid was found in bone-graft interphase in 44% of tunnels, inferring partial osteointegration. The heterogeneous signal was present in 50% of patients who did not return to the previous sport level activity. (Fisher statistics: p = 0.043) There were no meaningful differences in patients with auto or allografts. Conclusion: Although the clinical evaluation was satisfactory, only 44% of patients returned to the previous level of sport activity one year after the ACL surgery. The ligamentatization process was found in 28% of knees evaluated with MRI one year later. Partial osteointegration is inferred in 44%. Results showed a meaningful relation between the signal of neoligaments in the MRI and the return to sport activity in said series of patients. MRI is a useful tool

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

    Institute of Scientific and Technical Information of China (English)

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

    2007-01-01

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

  17. ACL reconstruction - discharge

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    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 ...

  18. ACL Revision in Synthetic ACL graft failure

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    Etcheto, H. Rivarola; Zordán, J.; Escobar, G.; Collazo, C.; Palanconi, M.; Autorino, C.; Salinas, E. Alvarez

    2017-01-01

    The development of synthetic grafts as an alternative to biological grafts for reconstruction of the anterior cruciate ligament dates from 1980. The interest is awakened due to the potential advantages of: The absence of morbidity associated with donor site, and early return to sport. However, this surgical technique has had multiple complications associated with graft: mechanical failures (synthetic graft failure, loss of fixation), synovial foreign body reaction, recurrent stroke, recurrent instability and ultimately, early osteoarthritis. Objectives: We describe the synthetic graft failure LCA, intraoperative findings and details of surgical technique. Methods: Patient 35 years old, with a history of ACL reconstruction four years of evolution in another health center, consultation with the Service knee arthroscopy for acute knee pain left knee during secondary sporting event to a rotation mechanism with fixed foot. On physical examination, presents and positive Lachman maneuver Pivot. Radiografia in a widening of the tibial tunnel is observed. NMR shows a discontinuity of fibers of synthetic graft. Results: First time arthroscopic revision where synthetic plastic LCA identifies with Disruption fiber pattern. Intraoperatively, hypertrophic chronic synovitis localized predominantly in intercóndilo is observed. debridement thereof is performed, and proceeds to the extraction of the synthetic ligament. Then he was made prior cruentado and revival of the edges of the tunnel, filling them with non-irradiated structural bone allograft. At four months as planned and after confirmation by studies incorporating bone graft was performed the second time with the new plastic ACL. It was planned like a primary graft surgery with autologous hamstring prepared in fourfold form, and fixation with modified transtibial technique Biotransfix system proximal and distal screw Biocomposite (arthrex®). A quadruple graft 9 mm was obtained, making good positioning of tunnels and stable

  19. Anterior Cruciate Ligament (ACL) Injuries

    Science.gov (United States)

    ... Week of Healthy Breakfasts Shyness Anterior Cruciate Ligament (ACL) Injuries KidsHealth > For Teens > Anterior Cruciate Ligament (ACL) ... and Recovery Coping With an ACL Injury About ACL Injuries A torn anterior cruciate ligament (ACL) is ...

  20. The fibrotic role of phosphatidylinositol-3-kinase/Akt pathway in injured skeletal muscle after acute contusion.

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    Li, H-Y; Zhang, Q-G; Chen, J-W; Chen, S-Q; Chen, S-Y

    2013-09-01

    Transforming growth factor β (TGF-β) is a multifunctional cytokine with fibrogenic properties. Previous studies demonstrated that Phosphatidylinositol 3-Kinase (PI3K)/Akt/ mammalian target of Ramycin (mTOR), a non-Smad TGF-β pathway, plays an important role in the fibrotic pathogenesis of different organs such as the lung, kidney, skin and liver. However, the role of PI3k-Akt pathway in fibrosis in injured skeletal muscle is still unclear. In this study, we determined the fibrotic role of PI3K-Akt pathway in injured skeletal muscle. We established a mouse model for acute muscle contusion. Western blotting analysis showed that TGF-β, phosphorylated Akt and phosphorylated mTOR were increased in muscles after acute contusion, which indicated that the PI3K-Akt- mTOR pathway was activated in skeletal muscle after acute contusion. The pathway was inhibited by a PI3K inhibitor, LY294002. Moreover, the expression of fibrosis markers vimentin, α SMA and collagen I and the area of scar decreased in injured skeletal muscle after PI3K pathway was blocked. The muscle function improved in terms of both fast-twitch and tetanic strength after PI3K/Akt pathway was inhibited in injured skeletal muscle. In conclusion, activation of PI3K-Akt-mTOR pathway might promote collagen production and scar formation in the acute contused skeletal muscle. Blocking of PI3K-Akt-mTOR pathway could improve the function of injured skeletal muscle.

  1. Multiple-ligament injured knee

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

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

  2. The relationship between acute stress disorder and posttraumatic stress disorder in severely injured trauma survivors.

    Science.gov (United States)

    Creamer, Mark; O'Donnell, Meaghan L; Pattison, Phillipa

    2004-03-01

    This prospective longitudinal study was designed to investigate the relationship between acute stress disorder (ASD) and the subsequent development of posttraumatic stress disorder (PTSD) in a population of severely injured hospitalised trauma survivors. Symptoms of ASD were assessed just prior to discharge in 307 consecutive admissions to a Level 1 Trauma Centre, with PTSD assessments completed at 3 and 12 months post-injury. A well-established structured clinical interview was adopted for both assessments. Only 1% of the sample met criteria for an ASD diagnosis (at a mean of 8 days post-injury), while the incidence of PTSD was 9% at 3 months and 10% at 12 months. Although all ASD symptom clusters contributed to the prediction of subsequent PTSD severity, logistic regression indicated that only re-experiencing and arousal predicted a categorical PTSD diagnosis. The dissociative symptoms that form the core of ASD were rarely endorsed and showed high specificity but low sensitivity, resulting in a high proportion of false negative diagnoses. Reducing the number of dissociative symptoms required for a diagnosis ameliorated, but did not resolve, the problem. In this particular population, the low sensitivity of the ASD diagnosis renders it a poor screening test for use in identifying high risk individuals for early intervention and prevention strategies.

  3. (-)-Epigallocatechin-3-gallate (EGCG) modulates neurological function when intravenously infused in acute and, chronically injured spinal cord of adult rats.

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    Renno, Waleed M; Al-Khaledi, Ghanim; Mousa, Alyaa; Karam, Shaima M; Abul, Habib; Asfar, Sami

    2014-02-01

    Spinal cord injury (SCI) causes severe and long lasting motor and sensory deficits, chronic pain, and autonomic dysreflexia. (-)-epigallocatechin-3-gallate (EGCG) has shown to produce neuroprotective effect in a broad range of neurodegenerative disease animal models. This study designed to test the efficacy of intravenous infusion of EGCG for 36 h, in acutely injured rats' spinal cord: within first 4 h post-injury and, in chronically SC injured rats: after one year of injury. Functional outcomes measured using standard BBB scale, The Louisville Swim Scale (LSS) and, pain behavior assessment tests. 72 Female adult rats subjected to moderate thoracic SCI using MASCIS Impactor, blindly randomized as the following: (I) Acute SCI + EGCG (II) Acute SCI + saline. (III) Chronic SCI + EGCG. (IV) Chronic SCI + saline and, sham SCI animals. EGCG i.v. treatment of acute and, chronic SCI animals resulted in significantly better recovery of motor and sensory functions, BBB and LSS (P spinal cord increased (P < 0.001). Percent areas of GAP-43 and GFAP immunohistochemistry showed significant (P < 0.05) increase. We conclude that the therapeutic window of opportunity for EGCG to depict neurological recovery in SCI animals, is viable up to one year post SCI when intravenously infused for 36 h.

  4. Total Flavonoids from Mimosa Pudica Protects Carbon Tetrachloride-Induced Acute Liver Injur y in Mice

    Institute of Scientific and Technical Information of China (English)

    QIU Zhen-qin; CAI Lei; CHEN Da-shuai

    2015-01-01

    Objective:To observe the protective effect of total lfavonoids from Mimosa pudica on carbon tetrachloride (CCl4)-induced acute liver injury in mice. Methods:CCl4-induced acute liver injury model in mice was established. The activity of ALT and AST, the content of serum albumin (Alb) and total antioxidant capacity (T-AOC) were determined. The content of malondiadehyde (MDA) was measured and the activity of superoxide dismutase (SOD) was determined. The histopathological changes of liver were observed. Results:Compared with CCl4 model group, each dose group of total lfavonouida from Mimosa pudica could reduced the activity of ALT and AST in mice obviously (P<0.01), indicating they had remarkably protective effect on CCl4-induced acute liver injury in mice. High and middle dose groups of total lfavonouida from Mimosa pudica could increase the content of Alb in mice (P<0.01). Each dose group of total lfavonouida from Mimosa pudica could enhance the level of T-AOC (P<0.01), and lower the content of liver homogenate MDA, but enhance the activity of SOD in a dose-depended manner (P<0.01).

  5. Therapeutic exper ience of the application of anisodamine on acute lung injur y

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    Nan-Bin Yu

    2016-09-01

    Full Text Available Objective: To investigate the effect of anisodamine combining with conventional therapy on the degree of lung injury and inflammatory reaction of patients with acute pulmonary contusion. Methods: A total of 48 patients with acute pulmonary contusion treated in our hospital emergency department from April 2011 to October 2015 were enrolled as the research object and were divided into experimental group and control group by using a method of random number table. Experimental group received anisodamine combining with conventional therapy and control group received conventional therapy. In the process of the treatment, the mechanical ventilation time, hospital stays in intensive care unit and the number of cases developed into acute respiratory distress syndrome and multiple organ dysfunction syndromes of patients in two groups were observed. Oxygenation indexes of patients were respectively calculated on Days 1, 2 and 3 after treatment. The contents of inflammatory mediators in serum were detected on Day 3 after treatment. Results: The mechanical ventilation time and hospital stays in intensive care unit [(9.52 ± 1.41 vs. (14.57 ± 2.51 days] of patients in experimental group were signifi- cantly shorter than those in control group, and the number of cases developed into acute respiratory distress syndrome [1 (4.17% vs. 9 (37.50%] and multiple organ dysfunction syndrome [1 (4.17% vs. 7 (29.17%] was significantly less than those in control group. Oxygenation indexes (294.52 ± 41.26 vs. 257.63 ± 38.52; 357.74 ± 47.74 vs. 279.87 ± 31.46; 396.71 ± 55.12 vs. 279.87 ± 31.46 of patients were respectively calculated on Days 1, 2 and 3 after treatment, which were significantly higher than those in the control group. On Day 3 after treatment, the contents of serum C-reactive protein [(7.94 ± 1.05 vs. (14.49 ± 2.97 mg/L], tumor necrosis factor a [(264.69 ± 41.58 vs. (417.87 ± 64.51 ng/L], interleukin-6 (IL-6 [(147.72 ± 21.36 vs. (257.68 ± 41

  6. Analysis of clinical risk factors associated with mortality of severely injured multiple trauma patients with acute lung injury

    Institute of Scientific and Technical Information of China (English)

    MA Yue-feng; SHENG Lei; GU Jun; ZHANG Mao; JIANG Guan-yu

    2009-01-01

    Background It is important to study the factors affecting the clinical mortality of the severe multiple trauma population. The present study was aimed to identify the potential risk factors that could affect mortality rate of acute lung injury (ALI) in severely injured multiple trauma population and to investigate the effects of certain risk factors on the prognosis of different patient subpopulations.Methods This is a follow-up study treating trauma as a single cause for emergency department (ED) and emergency intensive care unit (EICU) admissions. Patients identified with severe multiple trauma with early onset of ALI were enrolled from five trauma centers. Nineteen potential risk factors affecting the prognosis of ALI were examined by univariate and multivariate Logistic regression analyses to identify the ones that affected the mortality of these severe multiple trauma patients.Results There were 687 multiple trauma patients with post-traumatic ALl admitted to ED and EICU during the study period. The six risk factors that affected the mortality with unadjusted odd ratios (ORs) and 95% confidence intervals (Cls)were Acute Physiology Score and Chronic Health Evaluation Score (APACHE) II score, Injury Severity Score (ISS), duration of trauma, age, aspiration of gastric contents, and disseminated intravascular coagulation (DIC). Specific risk factors also affected different patient subpopulations at different degrees (surviving beyond 24 hours, 72 hours, 28 days and with multiple blood transfusions and higher injury scores).Conclusions Factors of APACHE Ⅱ score, ISS and aspiration of gastric contents that could predict the mortality of ALI may exist in the early stage of trauma. Duration of trauma and DIC that greatly affected and predicted the short- and long-term development and mortality of ALI deserve special attention. Elderly patients (aged beyond 65 years) were the independent risk factor for the secondary sepsis and deterioration of pulmonary function

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

    Science.gov (United States)

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

    2016-01-01

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

  8. Ligustrazine alleviates gastric mucosal injur y in a rat model of acute necrotizing pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Sheng-Chun Dang; Jian-Xin Zhang; Jian-Guo Qu; Xue-Qing Wang; Xin Fan

    2007-01-01

    BACKGROUND: Acute necrotizing pancreatitis (ANP) leads to a systemic inlfammatory response characterized by widespread leukocyte activation and, as a consequence, distant organ injury. The aim of this study was to explore the relationship between gastric microcirculatory impairment and inlfammatory mediators released in rats and to evaluate the therapeutic effect of ligustrazine extracted from Rhizoma ligusticum wallichii on gastric mucosa injury in a rat model of ANP. METHODS: Ninety-six Sprague-Dawley rats were randomly divided into three groups: normal control (group C);ANP without treatment (group P); and ANP treated with ligustrazine (group T). The ANP model was induced by injection of 50 g/L sodium taurocholate under the pancreatic membrane (4 ml/kg). Group C was given isovolumetric injection of 9 g/L physiological saline by the same route. Group T was injected with ligustrazine (10 ml/kg) via the portal vein. The radioactive biomicrosphere technique was used to measure the blood lfow 2 and 12 hours after the induction of ANP. Samples of the pancreas and stomach were taken to assess pathological changes by a validated histology score;meanwhile, the levels of serum interleukin-1β(IL-1β) were determined. Gastric tissues were also used to measure the level of myeloperoxidase (MPO), which is expressed intracellularly in the azurophilic granules of neutrophils. RESULTS: Blood lfow in group P was signiifcantly lower than that in group C (P CONCLUSIONS: Decreased gastric blood lfow and increased inlfammatory mediators can be seen early in ANP, and both are important factors for gastric and mucosal injury. Ligustrazine can ameliorate microcirculatory disorder and alleviate the damage to the pancreas and stomach.

  9. An anterior cruciate ligament injury does not affect the neuromuscular function of the non-injured leg except for dynamic balance and voluntary quadriceps activation

    NARCIS (Netherlands)

    Zult, Tjerk; Gokeler, Alli; van Raay, Jos J A M; Brouwer, Reinoud W; Zijdewind, Inge; Hortobágyi, Tibor

    2016-01-01

    PURPOSE: The function of the anterior cruciate ligament (ACL) patients' non-injured leg is relevant in light of the high incidence of secondary ACL injuries on the contralateral side. However, the non-injured leg's function has only been examined for a selected number of neuromuscular outcomes and o

  10. CURRENT CONCEPTS IN ACL RECONSTRUCTION

    Directory of Open Access Journals (Sweden)

    Freddie H. Fu

    2008-09-01

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

  11. A QUANTITATIVE ASSESSMENT OF PROPRIOCEPTIVE FUNCTION IMPROVEMENT AFTER ARTHROSCOPIC ACL RECONSTRUCTION SURGERY

    Directory of Open Access Journals (Sweden)

    Dobson

    2015-05-01

    Full Text Available OBJECTIVE: To quantify the deficit in proprioceptive function in Anterior Cruciate Ligament (ACL deficiency and to quantify the improvement after Arthroscopic ACL Reconstruction . Type of Study : Prospective cohort study . METHOD S : The study included 73 patients (49 men , 24 women ; mean age 26 . 8 years ; range 21 to 40 years who underwent Arthroscopic ACL reconstruction . Arthroscopic ACL reconstruction was performed using either a patellar tendon or a hamstring auto graft . All patients followed a standard rehabilitation program . Proprioceptive function in the form of (B . I Balance Index Score was tested using Kinesthetic Ability Trainer (SPORT KAT 1750 preoperatively and at the end of third and sixth months after su rgery . Their contralateral knees served as control . Results were statistically analyzed by Paired t - test using SPSS 16 . 0 . RESULTS: Mean B . I Score in ACL insufficient limb was 2203 . 19 and of normal contralateral limb was1573 . 01 at the time of presentation , with a mean deficit of 630 . 18 (p<0 . 001 . The injured limb showed significant improvement in proprioception from preoperative B . I Score of 2203 . 19 to B . I Score of 1221 . 95 at the end of 6 months after Arthroscopic ACL Reconstruction (p<0 . 001 . CONCLUSION: There is a significant deficit in proprioceptive function in the ACL insufficient limb compared to the normal contralateral limb . Proprioceptive function improves significantly after Arthroscopic ACL Reconstruction .

  12. Association Between Lateral Posterior Tibial Slope, Body Mass Index, and ACL Injury Risk

    Science.gov (United States)

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

    2017-01-01

    Background: While body mass index (BMI), a modifiable parameter, and knee morphology, a nonmodifiable parameter, have been identified as risk factors for anterior cruciate ligament (ACL) rupture, the interaction between them remains unknown. An understanding of this interaction is important because greater compressive axial force (perhaps due to greater BMI) applied to a knee that is already at an increased risk because of its geometry, such as a steep lateral posterior tibial slope, could further increase the probability of ACL injury. Purpose: To quantify the relationship between BMI and select knee morphological parameters as potential risk factors for ACL injury. Study Design: Case-control study; Level of evidence, 3. Methods: Sagittal knee magnetic resonance imaging (MRI) files from 76 ACL-injured and 42 uninjured subjects were gathered from the University of Michigan Health System’s archive. The posterior tibial slope (PTS), middle cartilage slope (MCS), posterior meniscus height (PMH), and posterior meniscus bone angle (MBA) in the lateral compartment were measured using MRI. BMI was calculated from demographic data. The association between the knee structural factors, BMI, and ACL injury risk was explored using univariate and multivariate logistic regression. Results: PTS (P = .043) and MCS (P = .037) significantly predicted ACL injury risk. As PTS and MCS increased by 1°, odds of sustaining an ACL injury increased by 12% and 13%, respectively. The multivariate logistic regression analysis, which included PTS, BMI centered around the mean (cBMI), and their interaction, showed that this interaction predicted the odds of ACL rupture (P = .050; odds ratio, 1.03). For every 1-unit increase in BMI from the average that is combined with a 1° increase in PTS, the odds of an ACL tear increased by 15%. Conclusion: An increase in BMI was associated with increased risk of ACL tear in the presence of increased lateral posterior tibial slope. Larger values of PTS or

  13. Acute effects of static stretching of hamstring on performance and ACL injury risk during stop-jump and cutting tasks in female athletes.

    Science.gov (United States)

    Ruan, Mianfang; Zhang, Qiang; Wu, Xie

    2017-01-11

    There is limited research investigating antagonist stretch. The purpose of this study was to evaluate the influence of SSH on performance and ACL injury risk during stop-jump and 180° cutting tasks. Twelve female college athletes (age 20.8 ± 0.7 years; height 1.61 ± 0.05 m; mass 54.25 ± 4.22 kg) participated in this study. Subjects performed stop-jump and 180° cutting tasks under two conditions: after warm-up with 4×30 s SSH or after warm-up without SSH. Three-dimensional kinematic and kinetic data as well as EMG of biceps femoris (BF), rectus femoris (RF), vastus medialis (VM), and gastrocnemius medialis (GM) were collected during testing. SSH significantly enhanced jump height by 5.1% (P = 0.009), but did not change the takeoff speed of cutting. No significant changes in peak knee adduction moment or peak anterior tibia shear force were observed with SSH regardless of the task. The peak lateral tibia shear force during cutting was significantly (P = 0.036) reduced with SSH. The co-contraction of hamstring and quadriceps during the preactivation (stop-jump: P = 0.04; cutting: P = 0.05) and downward phases (stop-jump: P = 0.04; cutting: P = 0.05) was significantly reduced after SSH regardless of the task. The results suggest that SSH enhanced the performance of stop-jump due to decreased co-contraction of hamstring and quadriceps, but did not change the performance of cutting. In addition, SSH did not increase ACL injury risk during stop-jump and cutting tasks and even reduced medial-lateral knee loading during cutting.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

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

    Directory of Open Access Journals (Sweden)

    Nathan C Manley

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

  15. Responses of the Acutely Injured Spinal Cord to Vibration that Simulates Transport in Helicopters or Mine-Resistant Ambush-Protected Vehicles.

    Science.gov (United States)

    Streijger, Femke; Lee, Jae H T; Manouchehri, Neda; Melnyk, Angela D; Chak, Jason; Tigchelaar, Seth; So, Kitty; Okon, Elena B; Jiang, Shudong; Kinsler, Rachel; Barazanji, Khalid; Cripton, Peter A; Kwon, Brian K

    2016-12-15

    In the military environment, injured soldiers undergoing medical evacuation via helicopter or mine-resistant ambush-protected vehicle (MRAP) are subjected to vibration and shock inherent to the transport vehicle. We conducted the present study to assess the consequences of such vibration on the acutely injured spinal cord. We used a porcine model of spinal cord injury (SCI). After a T10 contusion-compression injury, animals were subjected to 1) no vibration (n = 7-8), 2) whole body vibration at frequencies and amplitudes simulating helicopter transport (n = 8), or 3) whole body vibration simulating ground transportation in an MRAP ambulance (n = 7). Hindlimb locomotor function (using Porcine Thoracic Injury Behavior Scale [PTIBS]), Eriochrome Cyanine histochemistry and biochemical analysis of inflammatory and neural damage markers were analyzed. Cerebrospinal fluid (CSF) expression levels for monocyte chemoattractant protein-1 (MCP-1), interleukin (IL)-6, IL-8, and glial fibrillary acidic protein (GFAP) were similar between the helicopter or MRAP group and the unvibrated controls. Spared white/gray matter tended to be lower in the MRAP-vibrated animals than in the unvibrated controls, especially rostral to the epicenter. However, spared white/gray matter in the helicopter-vibrated group appeared normal. Although there was a relationship between the extent of sparing and the extent of locomotor recovery, no significant differences were found in PTIBS scores between the groups. In summary, exposures to vibration in the context of ground (MRAP) or aeromedical (helicopter) transportation did not significantly impair functional outcome in our large animal model of SCI. However, MRAP vibration was associated with increased tissue damage around the injury site, warranting caution around exposure to vehicle vibration acutely after SCI.

  16. The female ACL: why is it more prone to injury?

    Science.gov (United States)

    Ireland, Mary Lloyd

    2002-10-01

    Multiple factors are responsible for ACL tears. The key factor in the gender discrepancy appears to be dynamic, not static, and proximal, not distal. The factors involved in evaluating the female ACL are multiple. However, it is the dynamic movement patterns ot hip and knee position with increased flexion and a coordinated proximal muscle firing pattern to keep the body in a safe landing position that are the most critical factors. An ACL injury at an early age is a life-changing event. We can very successfully reconstruct and rehabilitate an ACL, but we cannot stop there. We must now go into the prevention arena. In the United States there is tremendous variation in the exposure and acquisition of skills of physical activities in our youth. Today, children are often playing inside, using computers and watching television-missing out on the opportunity to learn safe movement patterns. Therefore, physical movement classes should occur very early in life, teaching children to land safely and in control, similar to the cry of "get down, stay down" routinely heard during youth soccer. Similarly, specific strength training programs can address landing as well as foot movements during cutting in basketball. Coaches should issue stern warnings when athletes demonstrate a high-risk movement patterns such as one-leg landings, out-of-control baseline landings, or straight-leg landings. The warnings may serve to keep the athlete from "touching the hot stove again" for fear of getting burned. No athlete feels she will be the one to get injured. Therefore, prospective analysis is likely to be received more warmly by the athletes if the program is presented with an emphasis on performance improvement rather than injury prevention. With increased participation in these programs, multiple-center analysis will have the power necessary to determine which factors significantly predispose athletes to ACL injury. The future for injury prevention is bright. We must rise to the challenge.

  17. An Athlete's Nightmare: Tearing the ACL

    Science.gov (United States)

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

  18. Comparison of hamstring muscle behavior for anterior cruciate ligament (ACL) patient and normal subject during local marching

    Science.gov (United States)

    Amineldin@Aminudin, Nurul Izzaty Bt.; Rambely, A. S.

    2014-09-01

    This study aims to investigate the hamstring muscle activity after the surgery by carrying out an electromyography experiment on the hamstring and to compare the behavior of the ACL muscle activity between ACL patient and control subject. Electromyography (EMG) is used to study the behavior of muscles during walking activity. Two hamstring muscles involved which are semitendinosus and bicep femoris. The EMG data for both muscles were recorded while the subject did maximum voluntary contraction (MVC) and marching. The study concluded that there were similarities between bicep femoris of the ACL and control subjects. The analysis showed that the biceps femoris muscle of the ACL subject had no abnormality and the pattern is as normal as the control subject. However, ACL patient has poor semitendinosus muscle strength compared to that of control subject because the differences of the forces produced. The force of semitendinosus value for control subject was two times greater than that of the ACL subject as the right semitendinosus muscle of ACL subject was used to replace the anterior cruciate ligament (ACL) that was injured.

  19. Mechanisms of electroacupuncture effects on acute cerebral ischemia/reperfusion injur y:possible association with upregulation of transforming growth factor beta 1

    Institute of Scientific and Technical Information of China (English)

    Wen-biao Wang; Lai-fu Yang; Qing-song He; Tong Li; Yi-yong Ma; Ping Zhang; Yi-sheng Cao

    2016-01-01

    Electroacupuncture at the head acupoints Baihui (GV20) and Shuigou (GV26) improves recovery of neurological function following isch-emic cerebrovascular events, but its mechanism remains incompletely understood. We hypothesized that the action of electroacupuncture at these acupoints is associated with elevated serum levels of transforming growth factor beta 1 (TGF-β1). To test this, we established a rat model of cerebral ischemia by middle cerebral artery occlusion. Electroacupuncture was performed at Baihui and Shuigou with a“disperse-dense”wave at an alternating frequency of 2 and 150 Hz, and at a constant intensity of 3 mA. Each electroacupuncture session lasted 30 minutes and was performed every 12 hours for 3 days. Neurological severity scores were lower in injured rats after acupuncture than in those not subjected to treatment. Furthermore, serum level of TGF-β1 was greater after electroacupuncture than after no treatment. Our results indicate that electroacupuncture at Baihui and Shuigou increases the serum level of TGF-β1 in rats with acute cerebral ischemia/reperfusion injury, and exerts neuroprotective effects.

  20. Cerebral Blood Flow and Transcranial Doppler Sonography Measurements of CO(2)-Reactivity in Acute Traumatic Brain Injured Patients

    DEFF Research Database (Denmark)

    Reinstrup, Peter; Ryding, Erik Hilmer; Asgeirsson, Bogi;

    2013-01-01

    BACKGROUND: Cerebral blood flow (CBF) measurements are helpful in managing patients with traumatic brain injury (TBI), and testing the cerebrovascular reactivity to CO(2) provides information about injury severity and outcome. The complexity and potential hazard of performing CBF measurements...... limits routine clinical use. An alternative approach is to measure the CBF velocity using bedside, non-invasive, and transcranial Doppler (TCD) sonography. This study was performed to investigate if TCD is a useful alternative to CBF in patients with severe TBI. METHOD: CBF and TCD flow velocity...... measurements and cerebrovascular reactivity to hypocapnia were simultaneously evaluated in 27 patients with acute TBI. Measurements were performed preoperatively during controlled normocapnia and hypocapnia in patients scheduled for hematoma evacuation under general anesthesia. MAIN FINDING AND CONCLUSION...

  1. Evidence-Based ACL Reconstruction

    Directory of Open Access Journals (Sweden)

    E. Carlos RODRIGUEZ-MERCHAN

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    Hong Yu; Shuo-Dong Wu

    2008-01-01

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

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

    DEFF Research Database (Denmark)

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

    2006-01-01

    was therefore to investigate if nutrient supplementation during 12 weeks of conservative rehabilitation strength training could enhance hypertrophy and strength of the quadriceps muscle in ACL-injured patients. Twenty-six ACL-injured men and women were included and randomly distributed into three...... supplementation groups: Protein+Carbohydrate (PC), Isocaloric-Carbohydrate (IC), or Placebo (PL), ingesting the supplementation immediately after each of 36 training sessions. Determined from images of thigh cross-sections (magnetic resonance imaging) the hypertrophy of the quadriceps muscle differed....... The results from this study demonstrate that restoration of the distal vasti muscle mass and knee extension muscle strength with resistance training is promoted further by protein-containing nutrient supplementation immediately after single exercise sessions. Thus, exercise-related protein supplementation may...

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

    Directory of Open Access Journals (Sweden)

    Fu Freddie H

    2011-06-01

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

  6. Review of NASA ACLS research

    Science.gov (United States)

    Daugherty, R. H.

    1983-01-01

    An experimental investigation was conducted to evaluate a method of maintaining stability of an air cushion vehicle and also to evaluate several concepts to brake and steer an ACLS-equipped vehicle. The investigation used a modified airboat equipped with an air cushion landing system. The pressure relief door stability concept was characterized by the ACLS pressure time histories. The pressure relief doors vented excess cavity and lobe pressures and consistently maintained vehicle heave and pitch stability. Braking concepts were characterized by the average deceleration of the vehicle. Reduced lobe flow and cavity venting braking concepts were evaluated in this program. The cavity venting concept demonstrated the best performance, producing decelerations on the test vehicle on the same order as moderate braking with conventional wheel brakes. Steering concepts were evaluated by recording the path taken while attempting to follow a prescribed maneuver. The steering concepts evaluated included using rudders only, using differential lobe flow, and using rudders combined with a lightly loaded, nonsteering center wheel. The latter concept proved to be the most accurate means of steering the vehicle on the ACLS, producing translational deviations which, while two to three times higher than those from conventional nose gear steering, were still felt to provide reasonably precise steering control for this type vehicle.

  7. Treatment for acute anterior cruciate ligament tear

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  8. Treatment for acute anterior cruciate ligament tear

    DEFF Research Database (Denmark)

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

    2015-01-01

    STUDY QUESTION: In young active adults with an acute anterior cruciate ligament (ACL) rupture, do patient reported or radiographic outcomes after five years differ between those treated with rehabilitation plus early ACL reconstruction and those treated with rehabilitation and optional delayed ACL...

  9. Mobilization of bone marrow-derived mesenchymal stem cells into the injured tissues after intraarticular injection and their contribution to tissue regeneration.

    Science.gov (United States)

    Agung, Muhammad; Ochi, Mitsuo; Yanada, Shinobu; Adachi, Nobuo; Izuta, Yasunori; Yamasaki, Takuma; Toda, Katsuhiro

    2006-12-01

    The purpose of present study was to evaluate active mobilization effect of mesenchymal stem cells (MSCs) into injured tissues after intraarticular injection of MSCs, and to evaluate their contribution to tissue regeneration. MSCs, which were obtained from green fluorescent protein (GFP) transgenic Sprague-Dawley (SD) rat and cultivated, were injected into normal SD rats in which multiple tissues had been injured including anterior cruciate ligament (ACL), medial meniscus, and articular cartilage of the femoral condyles. At 4 weeks after injection of MSCs, fluorescent microscopic observation, immunohistochemical or histological examinations were performed to evaluate mobilization of MSCs into injured tissue and their contribution to tissue regeneration. In the group of 1 x 10(6) MSCs injection, GFP positive cells could mobilize into the injured ACL alone in all 8 knees. In the group of 1 x 10(7) MSCs injection, GFP positive cells were observed in the injured site of ACL in all 8 knees and in the injured site of medial meniscus and cartilage of femoral condyles in 6 of 8 knees. More interestingly, extracellular matrix stained by toluidine blue was present around GFP positive cells in the injured femoral condyles cartilage and medial meniscus, indicating tissue regeneration. Intraarticularly injected MSCs could mobilize into the injured tissues, and probably contributed to tissue regeneration. This study demonstrated the possibility of intraarticular injection of MSCs for the treatment of intraarticular tissue injuries including ACL, meniscus, or cartilage. If this treatment option is established, it can be minimally invasive compared to conventional surgeries for these tissues.

  10. Anatomic Double-bundle ACL Reconstruction

    NARCIS (Netherlands)

    V.M. Schreiber; C.F. van Eck; F.H. Fu

    2010-01-01

    Rupture of the anterior cruciate ligament (ACL) is one of the most frequent forms of knee trauma. The traditional surgical treatment for ACL rupture is single-bundle reconstruction. However, during the past few years there has been a shift in interest toward double-bundle reconstruction to closely r

  11. Motor learning in ACL injury prevention

    NARCIS (Netherlands)

    Benjaminse, Anne

    2015-01-01

    Motor learning in ACL injury prevention
Anne Benjaminse

The physical and psychosocial consequences of an anterior cruciate ligament (ACL) injury are large, for example limitations in daily life, reduction of sports participation, development of osteoarthritis in the knee and increased risk for re-r

  12. ACLS.

    Science.gov (United States)

    Handley, A J

    2001-09-01

    It must be emphasised that the published International Guidelines 2000 contain an in-depth presentation of the scientific evidence behind advanced life support. The exact interpretation of this evidence, and the algorithms adopted by a national resuscitation council will depend upon various factors such as local interpretation of the evidence, local practice and availability of drugs. The ERC is publishing its own summaries of the guideline changes and the sequences of action for both BLS and ALS and these papers are recommended for further reading.

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

    Directory of Open Access Journals (Sweden)

    Marco Bigoni

    2016-01-01

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

  14. ACLS 2000: overview of changes to the guidelines.

    Science.gov (United States)

    Cleland, Michelle A; Hynes-Gay, Patricia

    2002-01-01

    Emergency treatment measures in the setting of a cardiopulmonary arrest have recently been reclassified according to the strength of evidence in support of their use. As a result, there are new recommendations that must be incorporated, both in the management of patients in cardiac arrest and those with clinical findings that have the potential to deteriorate and become life-threatening. This article provides an overview of the 2000 ACLS guidelines, with particular emphasis on new developments in the management of patients with acute coronary syndromes, changes in the tachycardia algorithms, and recommendations pertaining to endotracheal intubation.

  15. Amiodarone supplants lidocaine in ACLS and CPR protocols.

    Science.gov (United States)

    Mizzi, Anna; Tran, Thanh; Mangar, Devanand; Camporesi, Enrico M

    2011-09-01

    Amiodarone is an antiarrhythmic medication used to treat and prevent certain types of serious, life-threatening ventricular arrhythmias. Amiodarone gained slow acceptance outside the specialized field of cardiac antiarrhythmic surgery because the side-effects are significant. Recent adoption of amiodarone in the ACLS (Advanced Cardiac Life Support) protocol has somewhat popularized this class of antiarrhythmics. Its use is slowly expanding in the acute medicine setting of anesthetics. This article summarizes the use of Amiodarone by anesthesiologists in the operating room and during cardiopulmonary resuscitation.

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

    NARCIS (Netherlands)

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

    2012-01-01

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

  17. Three-dimensional kinematic and kinetic analysis of knee rotational stability in ACL-deficient patients during walking, running and pivoting

    DEFF Research Database (Denmark)

    Bohn, Marie Bagger; Petersen, Annemette Krintel; Nielsen, Dennis Brandborg;

    2016-01-01

    BACKGROUND: Anterior cruciate ligament (ACL) deficiency leads to altered stability of the knee. The purpose of this study was to compare the dynamic, rotational stability of the knee, expressed as rotational stiffness, between anterior cruciate ligament-deficient (ACLD) knees, their contralateral......: The tibial internal rotation of the ACLD knee was not significantly different from the ACLI knee during all three tasks. During walking and running, the tibial rotation of the control group was significantly different from both legs of the ACL-injured patient. For pivoting, no difference in tibial rotation...... group. During running, the ACLI knee displayed a higher external moment than the ACLD and the healthy control group. This could indicate some type of protective strategy or muscular adaptation in the ACL-injured patients....

  18. The analysis of acute intraoperative encephalocele insevere head-injured patients%重型颅脑损伤术中急性脑膨出的临床分析

    Institute of Scientific and Technical Information of China (English)

    陈清坤

    2010-01-01

    Objective To summarize the causes and prophylactic theyapeutic methods of acute intraoperative encephalocele in severe head-injured patient.Methods Thirty-one severe head injured patients with acute intraoperative encephalocele were analysed retrospectively and the preventive and treating methods were implemented.Results Acute diffuse brain swelling,delayed intracranial heamatomas,larcerationwere,long-term brain herniation and cerebral anoxia were the main causes of intraoperative encephalocele.Conclusion According todifferent causes,the methods of treatment should be removes heamatomas completely,decreasing intracranial pressure gradually,intraoperative hyperventilation,large dose of mannitol and maintain of systolic blood pressure respectively,the acute intraoperative encephalocele in head injured patients could be prevented and treated effectively.%目的 探讨重型颅脑损伤手术中急性脑膨出的原因及有效的防治措施.方法 对31例重型颅脑损伤患者手术中出现急性脑膨出进行回顾性分析,总结其形成原因,比较各种防治措施的疗效.结果 急性弥漫性脑肿胀、迟发性颅内血肿、严重脑挫裂伤、脑疝时间长、脑组织缺血和缺氧等是造成重型颅脑损伤手术中急性脑膨出的主要原因.结论 针对不同病因采取相应措施如彻底清除颅内血肿、适当控制血压、使用脱水剂和激素、过度通气、缓慢降低颅内压等是防治术中出现急性脑膨出的有效措施,提高临床疗效.

  19. Improving the sensitivity of the hop index in patients with an ACL deficient knee by transforming the hop distance scores

    Directory of Open Access Journals (Sweden)

    Thomas Scott G

    2006-02-01

    Full Text Available Abstract Background The one leg hop for distance is one of the most commonly employed functional tests utilized in the evaluation of the ACL deficient and reconstructed patient. While the reliability of the hop test scores has been well established, validity studies have revealed low sensitivity rates in detecting functional limitations using the hop index (the ratio or percentage of limb performance. However, the impact of the inherent limitations associated with the hop index have not been investigated to date. One specific limitation relates to the impact of the differences in the underlying hop distance scores. Therefore, this pilot study set out to determine: 1 the impact that between limb differences in hop distance has on the sensitivity of the hop index in detecting functional limitations and; 2 whether a logarithmic transformation of the underlying hop distance scores improves the sensitivity of the hop index. Methods A cross sectional design involving the evaluation of one leg hop for distance performance in a consecutive sample of 10 ACL deficient males with an isolated ACL tear awaiting reconstructive surgery and nine gender, age-matched controls. Results In the ACL deficient, the hop index was associated with the distance hopped on the non-injured limb (r = -0.66, p = 0.04 but not on the injured limb. Transformation (logarithmic of the hop distance scores and re-calculation of the hop index using the transformed scores increased the sensitivity of the hop index in the detection of functional limitations from 20 to 60% and 50 to 70% using the normal limb symmetry reference norms of ≥ 85% and 90% respectively. Conclusion The distance hopped on the non-injured limb is a critical factor in detecting functional limitations using the hop index in patients with an ACL deficient knee. Logarithmic transformation of the hop distance scores minimizes the effect of the arithmetic differences between limbs however; the sensitivity of the hop

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

    OpenAIRE

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

    2013-01-01

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

  1. Anterolateral ligament abnormalities in patients with acute anterior cruciate ligament rupture are associated with lateral meniscal and osseous injuries

    Energy Technology Data Exchange (ETDEWEB)

    Dyck, Pieter van; Smet, Eline de; Gielen, Jan L.; Parizel, Paul M. [Antwerp University Hospital and University of Antwerp, Department of Radiology, Antwerp (Belgium); Clockaerts, Stefan [University College Hospitals, Department of Orthopaedics, London (United Kingdom); Vanhoenacker, Filip M. [Antwerp University Hospital and University of Antwerp, Department of Radiology, Antwerp (Belgium); Ghent University Hospital and University of Ghent, Department of Radiology, Ghent (Belgium); AZ St-Maarten, Department of Radiology, Antwerp (Belgium); Lambrecht, Valerie [Ghent University Hospital and University of Ghent, Department of Radiology, Ghent (Belgium); Wouters, Kristien [Antwerp University Hospital and University of Antwerp, Department of Biostatistics, Antwerp (Belgium)

    2016-10-15

    To determine the frequency of anterolateral ligament (ALL) injury in patients with acute anterior cruciate ligament (ACL) rupture and to analyse its associated injury patterns. Ninety patients with acute ACL rupture for which MRI was obtained within 8 weeks after the initial trauma were retrospectively identified. Two radiologists assessed the status of the ALL on MRI by consensus. The presence or absence of an ALL abnormality was compared with the existence of medial and lateral meniscal tears diagnosed during arthroscopy. Associated collateral ligament and osseous injuries were documented with MRI. Forty-one of 90 knees (46 %) demonstrated ALL abnormalities on MRI. Of 49 knees with intact ALL, 15 (31 %) had a torn lateral meniscus as compared to 25 torn lateral menisci in 41 knees (61 %) with abnormal ALL (p = 0.008). Collateral ligament (p ≤ 0.05) and osseous injuries (p = 0.0037) were more frequent and severe in ALL-injured as compared with ALL-intact knees. ALL injuries are fairly common in patients with acute ACL rupture and are statistically significantly associated with lateral meniscal, collateral ligament and osseous injuries. (orig.)

  2. ACL repair might induce further abnormality of gamma loop in the intact side of the quadriceps femoris.

    Science.gov (United States)

    Konishi, Y U

    2011-04-01

    The purpose of this study was to investigate the effect of surgery on the gamma-loop in the quadriceps of patients with ACL injuries. We compared the response to vibration stimulation in subjects with ACL repair, subjects with ACL rupture, and normal subjects, by measuring the maximal strength and integrated electromyography (I-EMG) of the quadriceps. Pre-vibration data were obtained from each subject by measuring the MVC of the knee extension and the I-EMG from the vastus medialis, vastus lateralis, and rectus femoris. Vibration stimulation was applied to the infrapatellar tendon, followed immediately by repeating maximal strength and I-EMG recording. The results of this study indicated that alpha motor neuron activity of the intact side of the vastus lateralis in response to prolonged vibration stimulation was altered by surgery, but no effect was detected in the injured side. The results could suggest that abnormality of the gamma-loop existed even in the quadriceps of patients with ACL rupture since the vibration stimulus failed to elicit changes in ACL-rupture group as compared with those of normal subjects. In comparison, abnormality of the gamma-loop in the intact side of the QF was probably induced by the rupture, and further abnormality of gamma-loop was induced by surgery.

  3. Reducing the Risk of ACL Injury in Female Athletes

    Science.gov (United States)

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

    2010-01-01

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

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

    CERN Document Server

    Kaufmann, Matt; 10.4204/EPTCS.70.4

    2011-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

    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

  6. Anterior cruciate ligament (ACL) injury -- aftercare

    Science.gov (United States)

    ... Activity After your injury, you should not play sports or other activities until you and your doctor decide what treatment is best for you. If you have surgery to repair your ACL: You will need physical therapy to regain the full use of your knee. ...

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

    Institute of Scientific and Technical Information of China (English)

    David S. Kushner

    2015-01-01

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

  8. Prehospital ACLS--does it work?

    Science.gov (United States)

    Maheshwari, Alok; Mehrotra, Avanti; Gupta, Anoop K; Thakur, Ranjan K

    2002-11-01

    Cardiac disease is the most common cause of death in the United States, and sudden cardiac arrest frequently claims the lives of men and women during their most productive years. It is believed that much better survival rates can be achieved for victims of cardiac arrest through optimizing the "chain of survival" as described by the American Heart Association. The relative and incremental benefit of full prehospital ACLS over basic life support and defibrillation is unproven, however. This is an important issue in this era of cost containment. Some of the ongoing studies including the OPALS study may clarify the cost effectiveness and relative efficacy of rapid defibrillation and full ACLS programs for victims of prehospital cardiac arrest [6].

  9. TIBIAL LANDMARKS IN ACL ANATOMIC REPAIR

    Directory of Open Access Journals (Sweden)

    M. V. Demesсhenko

    2016-01-01

    Full Text Available Purpose: to identify anatomical landmarks on tibial articular surface to serve as reference in preparing tibial canal with respect to the center of ACL footprint during single bundle arthroscopic repair.Materials and methods. Twelve frozen knee joint specimens and 68 unpaired macerated human tibia were studied using anatomical, morphometric, statistical methods as well as graphic simulation.Results. Center of the tibial ACL footprint was located 13,1±1,7 mm anteriorly from posterior border of intercondylar eminence, at 1/3 of the distance along the line connecting apexes of internal and external tubercles and 6,1±0,5 mm anteriorly along the perpendicular raised to this point.Conclusion. Internal and external tubercles, as well as posterior border of intercondylar eminence can be considered as anatomical references to determine the center of the tibial ACL footprint and to prepare bone canals for anatomic ligament repair.

  10. Fourier Series Formalization in ACL2(r

    Directory of Open Access Journals (Sweden)

    Cuong K. Chau

    2015-09-01

    Full Text Available We formalize some basic properties of Fourier series in the logic of ACL2(r, which is a variant of ACL2 that supports reasoning about the real and complex numbers by way of non-standard analysis. More specifically, we extend a framework for formally evaluating definite integrals of real-valued, continuous functions using the Second Fundamental Theorem of Calculus. Our extended framework is also applied to functions containing free arguments. Using this framework, we are able to prove the orthogonality relationships between trigonometric functions, which are the essential properties in Fourier series analysis. The sum rule for definite integrals of indexed sums is also formalized by applying the extended framework along with the First Fundamental Theorem of Calculus and the sum rule for differentiation. The Fourier coefficient formulas of periodic functions are then formalized from the orthogonality relations and the sum rule for integration. Consequently, the uniqueness of Fourier sums is a straightforward corollary. We also present our formalization of the sum rule for definite integrals of infinite series in ACL2(r. Part of this task is to prove the Dini Uniform Convergence Theorem and the continuity of a limit function under certain conditions. A key technique in our proofs of these theorems is to apply the overspill principle from non-standard analysis.

  11. Should critical care nurses be ACLS-trained?

    Science.gov (United States)

    Hagyard-Wiebe, Tammy

    2007-01-01

    The aim of resuscitation is to sustain life with intact neurological functioning and the same quality of life previously experienced by the patient. Advanced cardiac life support (ACLS) was designed to achieve this aim. However the requirement for ACLS training for critical care nurses working in Canadian critical care units is inconsistent across the country. The purposes of this article are to explore the evidence surrounding ACLS training for critical care nurses and its impact on resuscitation outcomes, and to review the evidence surrounding ACLS knowledge and skill degradation with strategies to support code blue team efficiency for an effective resuscitation. Using the search terms ACLS training, resuscitation, critical care, and nursing, two databases, CINAHL and MEDLINE, were used. The evidence supports the need for ACLS training for critical care nurses. The evidence also supports organized ongoing refresher courses, multidisciplinary mock code blue practice using technologically advanced simulator mannequins, and videotaped reviews to prevent knowledge and skill degradation for effective resuscitation efforts.

  12. Influence of intravascular low level He-Ne laser irradiation on iNOS, total-NOS, and ET-1 in acute spinal cord-injured rabbits

    Science.gov (United States)

    Yin, Zhenchun; Dong, Yinghai; Zhu, Jing

    2005-07-01

    Objective To research the influence of intravascular low level Laser irradiation (ILLLI) on total NOS, iNOS, and ET-1 in spinal cord following acute spinal cord injury (ASCI), and discuss the protective effects of ILLLI on neurons .Methods 72 rabbits were randomly divided into 3 groups: treatment group, injury group and control group. In treatment group and injury group, after laminectomy at the level of T-13, ASCI was performed by using Allen"s method with slight modification (6g×10cm) on rabbits. After injury, rabbits were treated immediately with He-Ne laser (power 5 mW, 1 hour per day for 10 days). At the day of 10th after treatment, total-NOS, iNOS, and ET-1 in spinal cord tissues were measured. Results The expression level of total-NOS, iNOS, and ET-1 in spinal cord in injury group were significantly higher than those in control group (Pspinal cord. It indicates that ILLLI can relieve the overexpression of total-NOS, iNOS, and ET-1 ,and thus can perform protective effects on neurons in the course of secondary spinal cord injury (SSCI) following ASCI

  13. Five-year follow-up of knee joint cartilage thickness changes after acute anterior cruciate ligament rupture

    DEFF Research Database (Denmark)

    Eckstein, F; Wirth, W; Lohmander, Stefan

    2015-01-01

    Objective: Anterior cruciate ligament (ACL) rupture involves increased risk of osteoarthritis. We explored cartilage thickness changes over five years after ACL rupture. Methods: 121 young active adults (26% women, age 18-35 years) with acute traumatic ACL rupture were studied (the KANON-trial). ...

  14. Proof Pad: A New Development Environment for ACL2

    Directory of Open Access Journals (Sweden)

    Caleb Eggensperger

    2013-04-01

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

  15. The characteristics of EEG power spectra changes after ACL rupture

    Science.gov (United States)

    Miao, Xin; Huang, Hongshi; Hu, Xiaoqing; Li, Dai; Yu, Yuanyuan; Ao, Yingfang

    2017-01-01

    Background Reestablishing knee stability is the core of the treatment of ACL (Anterior Cruciate Ligament) injury. Some patients still have a feeling of instability of the knee after ACL injury treatment. This unstable feeling may be caused by central nervous system changes after ACL rupture. Methods To identify the central changes after ACL rupture, EEG spectra were recorded to compare ACL patients and healthy controls when they were walking, jogging, and landing. Results There was a significant increase in delta, theta, alpha and beta band power during walking, jogging and landing in ACL patients. We also found an asymmetry phenomenon of EEG only in the ACL patients, mainly in the frontal area and central-parietal area. The asymmetry of beta band power extended to the frontal and the central area during jogging and landing task. Conclusions There were significant differences in EEG power spectra between the ACL patients and healthy people. ACL patients showed high EEG band power activities and an asymmetry phenomenon. EEG power changes were affected by movements, the asymmetry extended when performing more complicated movements. PMID:28182627

  16. Psychopathological responses of physically injured persons

    Directory of Open Access Journals (Sweden)

    Lešić Aleksandar

    2003-01-01

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

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

    Science.gov (United States)

    Nawasreh, Zakariya Hussein

    perturbation training using mechanical device provides effects similar to manual perturbation training on knee mechanics, knee functional performance, and neuromuscular activation pattern in patients with ACL rupture. The second aim of this study was to measure whether the mechanical perturbation training provides an effect similar to that of manual perturbation training on gait mechanics, knee functional performance, muscle co-contraction, and neuromuscular activation pattern in athletes with an acute ACL rupture who are managed non-surgically. The findings of this work revealed that mechanical perturbation training provides effects similar to the manual perturbation training on knee kinematics and kinetics during walking and performance-based and patient-reported measures. Gait limb-to-limb asymmetries continue persist after the training regardless of the treatment group which may indicate that patients require participating in an extended rehabilitation program. Additionally, Perturbation training attempts to resolve the neuromuscular deficits and restore a balance in muscle activation and strength between knee flexors and extensors to enhance the dynamic stability of the knee joint. There are moderate to strong relationships between time duration of muscles' activities and the muscle co-contraction that may reflect neuromuscular adaptations to provide dynamic knee stability.

  18. Bit-Blasting ACL2 Theorems

    Directory of Open Access Journals (Sweden)

    Sol Swords

    2011-10-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-10-15

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

  20. Knee extension torque variability after exercise in ACL reconstructed knees.

    Science.gov (United States)

    Goetschius, John; Kuenze, Christopher M; Hart, Joseph M

    2015-08-01

    The purpose of this study was to compare knee extension torque variability in patients with ACL reconstructed knees before and after exercise. Thirty two patients with an ACL reconstructed knee (ACL-R group) and 32 healthy controls (control group) completed measures of maximal isometric knee extension torque (90° flexion) at baseline and following a 30-min exercise protocol (post-exercise). Exercise included 30-min of repeated cycles of inclined treadmill walking and hopping tasks. Dependent variables were the coefficient of variation (CV) and raw-change in CV (ΔCV): CV = (torque standard deviation/torque mean x 100), ΔCV = (post-exercise - baseline). There was a group-by-time interaction (p = 0.03) on CV. The ACL-R group demonstrated greater CV than the control group at baseline (ACL-R = 1.07 ± 0.55, control = 0.79 ± 0.42, p = 0.03) and post-exercise (ACL-R = 1.60 ± 0.91, control = 0.94 ± 0.41, p = 0.001). ΔCV was greater (p = 0.03) in the ACL-R group (0.52 ± 0.82) than control group (0.15 ± 0.46). CV significantly increased from baseline to post-exercise (p = 0.001) in the ACL-R group, while the control group did not (p = 0.06). The ACL-R group demonstrated greater knee extension torque variability than the control group. Exercise increased torque variability more in the ACL-R group than control group.

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

    Institute of Scientific and Technical Information of China (English)

    Paul; Kuo-Li; SUNG

    2005-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Dhanda Sunita

    2010-01-01

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

  3. KIM-1、CC16在急性肾/肺损伤临床诊断中的意义%The significance of KIM-1 、CC16 in acute kidney injury and acute lung injure

    Institute of Scientific and Technical Information of China (English)

    申晓丽; 周巧玲; 王祺

    2014-01-01

    目的 观察肾损伤分子-1(kidney injury molecule 1,KIM-1)与Clara细胞分泌蛋白(Clara cell secretionprotein,CCSP/CC16)在急性肾损伤(Acute Kidney Injury,AKI)合并急性肺损伤(Acute Lung Injury,ALI)患者体内的变化,探讨其在急性肾/肺损伤临床诊断中的意义.方法 入选本院确诊为AKI的患者纳入AKI组(25例),确诊为ALI的患者纳入ALI组(15例),确诊为AKI合并ALI的患者纳入AKI+ALI组(25例),与之年龄、性别、民族相匹配的非吸烟健康志愿者作为正常对照组(23例),采用酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA)检测尿液KIM-1、尿液CC16和血浆KIM-1、血浆CC16的水平,用比色法检测尿N-乙酰-β-D-氨基葡萄糖苷酶(N-acetyl-beta-D-glucosaminidase,NAG),整理四组所有研究资料利用统计学方法进行综合分析.结果 与正常非吸烟对照组相比,AKI组的尿NAG酶、尿KIM-1、血浆KIM-1和血浆CC16水平均显著升高,差异有统计学意义(P<0.05);ALI组的尿CC16和血浆CC16水平均显著升高,差异有统计学意义(P <0.05);AKI+ALI组的尿NAG酶、尿KIM-1、血浆KIM-1、尿CC16和血浆CC16水平均显著升高,差异有统计学意义(P<0.05).直线相关分析显示:AKI患者的尿KIM-1水平与尿NAG呈显著正相关关系(r=0.493,P<0.01),血浆KIM-1水平与尿NAG无直线相关关系(r =0.276,P>0.05).ALI患者的尿CC16、血浆CC16与氧合指数均呈显著负相关关系(r=0.460,P<0.01;r=0.468,P<0.01).AKI合并ALI患者的尿KIM-1、血浆KIM-1与尿CC16、血浆CC16均呈显著正相关关系(P<0.05).ROC曲线分析提示:在AKI诊断中,尿KIM-1曲线下面积为0.781(95% CI:0.688 ~0.875,P<0.01);血浆KIM-1曲线下面积为0.988(95% CI:0.000~1.000,P<0.01);尿NAG酶曲线下面积为0.798 (95%CI:0.708~0.888,P<0.01).在ALI诊断中,尿CC16曲线下面积为1.000(95% CI:1.000 ~1.000,P<0.01);血浆CC16曲线面积为0.849(95% CI:0.764~0.935,P<0.01).结论 AKI

  4. Stability Outcomes following Computer-Assisted ACL Reconstruction

    Directory of Open Access Journals (Sweden)

    Melissa A. Christino

    2015-01-01

    Full Text Available Purpose. The purpose of this study was to determine whether intraoperative prereconstruction stability measurements and/or patient characteristics were associated with final knee stability after computer-assisted ACL reconstruction. Methods. This was a retrospective review of all patients who underwent computer-assisted single-bundle ACL reconstruction by a single surgeon. Prereconstruction intraoperative stability measurements were correlated with patient characteristics and postreconstruction stability measurements. 143 patients were included (87 male and 56 female. Average age was 29.8 years (SD ± 11.8. Results. Females were found to have significantly more pre- and postreconstruction internal rotation than males (P < 0.001 and P = 0.001, resp.. Patients with additional intra-articular injuries demonstrated more prereconstruction anterior instability than patients with isolated ACL tears (P < 0.001. After reconstruction, these patients also had higher residual anterior translation (P = 0.01. Among all patients with ACL reconstructions, the percent of correction of anterior translation was found to be significantly higher than the percent of correction for internal or external rotation (P < 0.001. Conclusion. Anterior translation was corrected the most using a single-bundle ACL reconstruction. Females had higher pre- and postoperative internal rotation. Patients with additional injuries had greater original anterior translation and less operative correction of anterior translation compared to patients with isolated ACL tears.

  5. Amiodarone for ACLS: a critical evaluation.

    Science.gov (United States)

    Stewart, C E

    2001-09-01

    Years ago, William Osler taught physicians, "Be not the first nor the last to adopt a therapy." This continues to be sage advice. Clinicians should be cautious in considering the use of amiodarone in a field setting for cardiac arrest until studies clearly show a benefit over drugs currently in use. The endpoint of the only cardiac arrest study available shows improved survival when amiodarone is combined with other drugs over placebo until the patient gets to the emergency department, but is not a comparison with other current drugs nor had any effect on long-term survival or functioning neurologic status. As previously cited, amiodarone was comparable with bretylium in treating recurrent VT/VF in one controlled study. Further study of this and other ACLS drugs is imperative. In summary, amiodarone should be reclassified as either a class indeterminate agent when used alone ("no harm but no benefit ... evidence insufficient to support final class decision") or a class IIb agent ("acceptable and useful ... supported by fair to good evidence") when used in addition to other therapies in the treatment of ventricular fibrillation and pulseless ventricular tachycardia. There is not sufficient evidence to move amiodarone to first-line therapy in the "out-of-hospital" cardiac arrest. This evidence may be available in the future and would then change this recommendation.

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

    NARCIS (Netherlands)

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

    2016-01-01

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

  7. ACL ideal graft: MRI correlation between ACL and humstrings, PT and QT

    Directory of Open Access Journals (Sweden)

    Fabiano Kupczik

    2013-09-01

    Full Text Available OBJECTIVE: The objective of this study was to measure in MRI scans, the size of the origin, insertion and length of the anterior cruciate ligament and possible graft for reconstruction surgery in case of injury. Besides this, there was a cross between statistical data to test the hypothesis of proportional relationship between these anatomical extent. MATERIALS AND METHODS: 52 MRI examinations performed between 2008 and 2011 were valued at random in a longitudinal retrospective epidemiological study. To measure the width of the ACL was used coronal oblique to the length of the sagittal section, for inserting the tibial coronal femoral insertion and was also used oblique coronal section. RESULTS: The average diameter of the ACL was 4.80 mm (3.1-8.3 mm, with a length of 3.8 cm (2.85-4.5 cm. The origin ranged from 9.7 mm to 15.4 mm. The average insertion on the tibia was 13.3 mm. The average diameter of the semi-tendinous was 4.38 mm and the average diameter was 3.42 mm gracilis. The quadriceps presented diameter of 7.67 mm, a length of 35.34 mm and 4.54 mm patellar tendon diameter and 26.62 mm in average length. CONCLUSION: These data provide important information for the pre-operative surgeon, facilitating preoperative planning and providing viable alternatives and avoiding inadequate grafts.

  8. Isokinetic Testing in Evaluation Rehabilitation Outcome After ACL Reconstruction

    Science.gov (United States)

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

    2015-01-01

    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

  9. Navigation in ACL reconstruction - comparison with conventional measurement tools.

    Science.gov (United States)

    Kendoff, D; Meller, R; Citak, M; Pearle, A; Marquardt, S; Krettek, C; Hüfner, T

    2007-01-01

    Restoration of rotational and translational stability is a goal of ACL reconstruction. Intraoperative instability measurements of AP translation and rotation are not well established clinically. We compared navigated measurements of tibial AP translation and rotation with mechanical measuring devices: the KT 1000 and a modified goniometer tool. Tests were repeated with intact and dissected ACLs, and measures of translation and rotation statistically compared. There was no significant difference in AP translation between navigation, 3.2 mm (range 1-6 mm) and the KT 1000, 4.8 mm (range, 4-7 mm) in our experimental set up (p>0.05). Tibial rotation revealed no significant difference, 0.12 degrees (range, 0 degrees -1 degrees ) between navigation and goniometer (p>0.05). Total range of rotation was 4.2 degrees (range, 2 degrees -6 degrees ) in intact and 7.05 degrees (range, 4 degrees -9 degrees ) in dissected ACLs (pmechanical testing devices.

  10. ACL graft failure location differs between allografts and autografts

    Directory of Open Access Journals (Sweden)

    Magnussen Robert A

    2012-06-01

    Full Text Available Abstract Background Between 5 and 20% of patients undergoing ACL reconstruction fail and require revision. Animal studies have demonstrated slower incorporation of allograft tissue, which may affect the mechanism of graft failure. The purpose of this study is to determine the location of traumatic graft failure following ACL reconstruction and investigate differences in failure patterns between autografts and allografts. Methods The medical records of 34 consecutive patients at our center undergoing revision ACL reconstruction following a documented traumatic re-injury were reviewed. Graft utilized in the primary reconstruction, time from initial reconstruction to re-injury, activity at re-injury, time to revision reconstruction, and location of ACL graft tear were recorded. Results Median patient age at primary ACL reconstruction was 18.5 years (range, 13–39 years. The primary reconstructions included 20 autografts (13 hamstrings, 6 patellar tendons, 1 iliotibial band, 12 allografts (5 patellar tendon, 5 tibialis anterior tendons, 2 achilles tendons, and 2 unknown. The median time from primary reconstruction to re-injury was 1.2 years (range, 0.4 – 17.6 years. The median time from re-injury to revision reconstruction was 10.4 weeks (range, 1 to 241 weeks. Failure location could be determined in 30 patients. In the autograft group 14 of 19 grafts failed near their femoral attachment, while in the allograft group 2 of 11 grafts failed near their femoral attachment (p  Conclusions When ACL autografts fail traumatically, they frequently fail near their femoral origin, while allograft reconstructions that fail are more likely to fail in other locations or stretch. Level of evidence Level III - Retrospective cohort study

  11. Radiographic findings in restrained hip joints associated with ACL rupture.

    Science.gov (United States)

    Ellera Gomes, João L; Palma, Humberto Moreira; Becker, Ricardo

    2010-11-01

    Although decreased hip range of motion has been detected in many soccer players with noncontact anterior cruciate ligament (ACL), it is not clear whether it is associated with bone spurs, capsular soft tissue stiffness or both. Our aim was to investigate abnormal radiographic findings in soccer players with limited hip range of motion and noncontact ACL injury. Fifty consecutive male soccer players with restricted hip range of motion and noncontact ACL injury were subjected to radiographic examination to identify bone changes that could be associated with decreased hip range of motion. Of 50 patients, 56% revealed abnormal radiographic findings: pericapsular calcifications or acetabular rim osteophytes (24%), femoral neck deformity (10%), femoral neck and acetabular rim disorders (18%), neck groove caused by impingement (4%). Radiographic evaluation of those individuals showed a high number of bone abnormalities around the hip joint. This was considered to be an important finding to guide a decision-making process between three different approaches: changing the type of sports practiced, undergoing a more restrictive surgery (such as a double-bundle intra-articular reconstruction or an intra plus extra technique) or the onset of a hip-stretching program in addition to the conventional ACL rehabilitation protocol. In this last option, ACL-operated patients without radiographic hip abnormalities may have better outcomes for their decreased hip range of motion when submitted to a stretching program targeting the prevention of rotational overload on the reconstructed intra-articular grafts. The decision-making process concerning soccer players with ACL ruptures should take into consideration the amount of motion-limiting abnormalities around the hip joint.

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

    Science.gov (United States)

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

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

    OpenAIRE

    2008-01-01

    The incidence of anterior cruciate ligament (ACL) injury remains high in young athletes. Because female athletes have a much higher incidence of ACL injuries in sports such as basketball and team handball than male athletes, the IOC Medical Commission invited a multidisciplinary group of ACL expert clinicians and scientists to (1) review current evidence including data from the new Scandinavian ACL registries; (2) critically evaluate high-quality studies of injury mechanics; (3) consider the ...

  14. CURBSIDE CONSULTATION OF THE ACL: 49 CLINICAL QUESTIONS

    Directory of Open Access Journals (Sweden)

    Bernard R. Bach

    2008-09-01

    Full Text Available DESCRIPTION A unique reference that offers opinions, preferences and expert advice associated with management of ACL injuries in the questions and answers format which enhanced by images, diagrams and references. PURPOSE "Curbside Consultation of the ACL" aims to provide some knowledge more than the basic information in the evaluation and the management of ACL injuries. This information is based on the opinion or the advice of an expert. Quick access of audience to these pearl and pit-falls and evidence-based expert advice for complicated cases in ACL reconstruction in the form of brief answers including current concepts is targeted by the authors. FEATURES 49 Clinical questions are outlined in 5 sections. In the first section is about preoperative questions including indications, diagnostic measures, combined ligament injuries, graft choice, preparation before surgery, avulsion of the eminence, examination in posterolateral corner injury. In the second section is preoperative questions are subjected including dropping the graft to the floor, posterior wall blowout, knees without hamstring tendon, graft amputation by interference screw, to avoid vertical tunnel in tibia, fixation methods of graft, femoral and tibial tunnel positioning. Third section is about postoperative questions including postoperative management, differences in postoperative rehabilitation protocols in different type of grafts, postoperative man-agement of meniscal repair, management in difficulties in gaining extension, infection, patellar pain, timing of reop-eration in motion problems, criteria returning to sports, outcome measures, outcome in using different grafts, role of bracing. The fourth section is about failed ACL recon-struction including causes, indications for revision, ex-panded tunnels, graft choice in revision surgery, contro-lateral patellar tendon graft for revision, rehab protocol after revision surgery, hardware removal, early degenera-tive joint disease

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

    Directory of Open Access Journals (Sweden)

    David S. Hardin

    2013-04-01

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

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

    Science.gov (United States)

    Toscano, Lisa; Carroll, Brianne

    2015-01-01

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

  17. Outcome of ACL Reconstruction for Chronic ACL Injury in Knees without the Posterior Horn of the Medial Meniscus: Comparison with ACL Reconstructed Knees with An Intact Medial Meniscus

    Science.gov (United States)

    Syam, Kevin; Chouhan, Devendra K.; Dhillon, Mandeep Singh

    2017-01-01

    Purpose Cadaveric studies have shown that deficiency of the posterior horn of the medial meniscus (PHMM) increases strain on the anterior cruciate ligament (ACL) graft. However, its influence on the clinical and radiological outcome after ACL reconstruction is less discussed and hence evaluated in this study. Materials and Methods This study included 77 cases of ACL reconstruction with a minimum 18-month follow-up. Of the 77 cases, 41 patients with intact menisci were compared clinically and radiologically with 36 patients with an injury to the PHMM that required various grades of meniscectomy. The knees were evaluated using subjective International Knee Documentation Committee (IKDC) score and Orthopadische Arbeitsgruppe Knie (OAK) score. Results Cases with intact menisci showed better stability (p=0.004) at an average of 44.51 months after surgery. No significant differences were noted in the overall OAK score, subjective IKDC score, and functional OAK score (p=0.082, p=0.526, and p=0.363, respectively). The incidence of radiological osteoarthrosis was significantly higher in the posterior horn deficient knees (p=0.022). Conclusions The tendency toward relatively higher objective instability and increased incidence of osteoarthrosis in the group with absent posterior horn reinforces its importance as a secondary stabiliser of the knee. PMID:28231647

  18. The ACLS Survey of Scholars: Views on Publications, Computers, Libraries.

    Science.gov (United States)

    Morton, Herbert C.; Price, Anne Jamieson

    1986-01-01

    Reviews results of a survey by the American Council of Learned Societies (ACLS) of 3,835 scholars in the humanities and social sciences who are working both in colleges and universities and outside the academic community. Areas highlighted include professional reading, authorship patterns, computer use, and library use. (LRW)

  19. The Humanities in the Schools. ACLS Occasion Paper, No. 20.

    Science.gov (United States)

    American Council of Learned Societies, New York, NY.

    Designed to serve as a record of the initial public activity of the American Council of Learned Societies (ACLS) Program in Humanities Curriculum Development, this collection of three articles offers different perspectives on the humanities in the schools. In the first article, "The Humanities and Public Education," Stanley N. Katz discusses the…

  20. Twist and its effect on ACL graft forces

    NARCIS (Netherlands)

    Arnold, MP; Blankevoort, L; ten Ham, A; Verdonschot, N; van Kampen, A

    2004-01-01

    Graft tension is a controversial topic in anterior cruciate ligament (ACL) surgery. Evidence suggests a narrow range of graft tensions, which allow the graft to remodel to a stable and mature neoligament. In previous cadaver experiments, we showed that twisting the graft could modulate the graft for

  1. Individuality of Item Interpretation in Interchangeable ACL Scales

    Science.gov (United States)

    Fiske, Donald W.; Barack, Leonard I.

    1976-01-01

    The diversity among interpretations of single items in personality questionnaires has been noted previously. Using adjectives from the Adjective Check List (ACL), the study sought evidence bearing on these questions: Does such diversity make the responses to an item not comparable across subjects? If so, what are the implications for scores based…

  2. ACL Tears on The Rise Among Kids, Especially Girls

    Science.gov (United States)

    ... Feb. 22, 2017 (HealthDay News) -- As kids play sports like soccer and football with more frequency and force, many ... orthopedic surgery resident at the University of Minnesota. Sports that involve cutting or pivoting -- such as soccer and basketball -- are the riskiest for ACL tears. ...

  3. Twist and its effect on ACL graft forces.

    NARCIS (Netherlands)

    Arnold, M.P.; Blankevoort, L.; Ham, A. ten; Verdonschot, N.J.J.; Kampen, A. van

    2004-01-01

    Graft tension is a controversial topic in anterior cruciate ligament (ACL) surgery. Evidence suggests a narrow range of graft tensions, which allow the graft to remodel to a stable and mature neoligament. In previous cadaver experiments, we showed that twisting the graft could modulate the graft for

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

    Science.gov (United States)

    Levine, Jonathan M; Cohen, Noah D; Heller, Michael; Fajt, Virginia R; Levine, Gwendolyn J; Kerwin, Sharon C; Trivedi, Alpa A; Fandel, Thomas M; Werb, Zena; Modestino, Augusta; Noble-Haeusslein, Linda J

    2014-01-01

    Matrix metalloproteinase-9 is elevated within the acutely injured murine spinal cord and blockade of this early proteolytic activity with GM6001, a broad-spectrum matrix metalloproteinase inhibitor, results in improved recovery after spinal cord injury. As matrix metalloproteinase-9 is likewise acutely elevated in dogs with naturally occurring spinal cord injuries, we evaluated efficacy of GM6001 solubilized in dimethyl sulfoxide in this second species. Safety and pharmacokinetic studies were conducted in naïve dogs. After confirming safety, subsequent pharmacokinetic analyses demonstrated that a 100 mg/kg subcutaneous dose of GM6001 resulted in plasma concentrations that peaked shortly after administration and were sustained for at least 4 days at levels that produced robust in vitro inhibition of matrix metalloproteinase-9. A randomized, blinded, placebo-controlled study was then conducted to assess efficacy of GM6001 given within 48 hours of spinal cord injury. Dogs were enrolled in 3 groups: GM6001 dissolved in dimethyl sulfoxide (n = 35), dimethyl sulfoxide (n = 37), or saline (n = 41). Matrix metalloproteinase activity was increased in the serum of injured dogs and GM6001 reduced this serum protease activity compared to the other two groups. To assess recovery, dogs were a priori stratified into a severely injured group and a mild-to-moderate injured group, using a Modified Frankel Scale. The Texas Spinal Cord Injury Score was then used to assess long-term motor/sensory function. In dogs with severe spinal cord injuries, those treated with saline had a mean motor score of 2 (95% CI 0-4.0) that was significantly (Pinjured cord.

  5. DANCE in developing and injured lung.

    Science.gov (United States)

    Jean, Jyh-Chang; Eruchalu, Ifeanyi; Cao, Yu Xia; Joyce-Brady, Martin

    2002-01-01

    We identified rat developing arteries and neural crest derivatives with multiple epidermal growth factor-like domains (DANCE) as a developmentally regulated gene using suppression-subtractive hybridization. Northern analysis confirmed a fivefold induction of this mRNA transcript between fetal day 18 and 20 that persisted through postnatal day 17. The level was declining at postnatal day 21 and was similar in adult lung to that at fetal day 18. In adults DANCE mRNA abundance was highest in lung, kidney, and spleen, lower in heart, skeletal muscle, and brain, but absent from liver and thymus. It was abundant in pulmonary artery endothelium and a lung epithelial type 2 cell line, barely detectable in vascular smooth muscle, and absent in fibroblasts. In situ hybridization revealed a regulated pattern of expression in endothelial cells of fetal, postnatal, and adult lung. Because DANCE mRNA was inducible in systemic arteries during recovery from injury, we searched for induction in lung injured by hyperoxia. Mouse DANCE mRNA abundance was unchanged during an acute 3-day exposure period, induced threefold 5 days into the recovery phase, and returned to baseline at days 8, 11, and 14. In situ hybridization at day 5 suggested a diffuse pattern of induction. DANCE may play a role in lung endothelial cell biology during development repair after injury.

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

    Science.gov (United States)

    Garcia, Vanessa Lizeth

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

  7. Rehabilitation for Patients Following ACL Reconstruction: A Knee Symmetry Model

    OpenAIRE

    Biggs, Angie; Jenkins, Walter L.; Urch, Scott E.; Shelbourne, K. Donald

    2009-01-01

    This clinical commentary outlines a new clinical model for anterior cruciate ligament (ACL) rehabilitation, the Knee Symmetry Model. This model has been developed by clinical observation, patient interaction, and by analyzing outcome measures derived from prospective follow-up of patients. More specifically, the best outcome scores occurred in patients with symmetric range of motion and strength. A thorough discussion of the details involved in the development and implementation of this rehab...

  8. ACL reconstruction with BPTB autograft and irradiated fresh frozen allograft

    Institute of Scientific and Technical Information of China (English)

    Kang SUN; Shao-qi TIAN; Ji-hua ZHANG; Chang-suo XIA; Cai-long ZHANG; Teng-bo YU

    2009-01-01

    Objective: To analyze the clinical outcomes of arthroscopic anterior cruciate ligament (ACL) reconstruction with irradiated bone-patellar tendon-bone (BPTB) allograft compared with non-irradiated allograft and autograft. Methods: All BPTB allografts were obtained from a single tissue bank and the irradiated allografts were sterilized with 2.5 mrad of irradiation prior to distribution. A total of 68 patients undergoing arthroscopic ACL reconstruction were prospectively randomized consecutively into one of the two groups (autograft and irradiated allograft groups). The same surgical technique was used in all operations done by the same senior surgeon. Before surgery and at the average of 31 months of follow-up (ranging from 24 to 47 months), patients were evaluated by the same observer according to objective and subjective clinical evaluations. Results: Of these patients, 65 (autograft 33, irradiated allograft 32) were available for full evaluation. When the irradiated allograft group was compared to the autografi group at the 31-month follow-up by the Lachman test, the anterior drawer test (ADT), the pivot shift test, and KT-2000 arthrometer test, statistically significant differences were found. Most importantly, 87.8% of patients in the autograft group and just only 31.3% in the irradiated allograft group had a side-to-side difference of less than 3 mm according to KT-2000. The failure rate of the ACL reconstruction with irradiated allograft (34.4%) was higher than that with autograft (6.1%). The anterior and rotational stabilities decreased significantly in the irradiated allograft group. According to the overall International Knee Docu-mentation Committee (IKDC), functional and subjective evaluations, and activity level testing, no statistically significant dif-ferences were found between the two groups. Besides, patients in the irradiated allograft group had a shorter operation time and a longer duration of postoperative fever. When the patients had a fever

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

    Directory of Open Access Journals (Sweden)

    Holmström Eva

    2007-04-01

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

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

    Directory of Open Access Journals (Sweden)

    T Brune

    2007-12-01

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

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    The benefit of anterior cruciate ligament (ACL) reconstruction has been questioned based on patient-reported outcome measures (PROMs). Valid interpretation of such results requires confirmation of the psychometric properties of the PROM. Rasch analysis is the gold standard for validation of PROMs......, yet PROMs used for ACL reconstruction have not been validated using Rasch analysis. We used Rasch analysis to investigate the psychometric properties of the Knee Numeric-Entity Evaluation Score (KNEES-ACL), a newly developed PROM for patients treated for ACL deficiency. Two-hundred forty-two patients...

  12. Can PRP effectively treat injured tendons?

    Science.gov (United States)

    Wang, James H-C

    2014-01-01

    PRP is widely used to treat tendon and other tissue injuries in orthopaedics and sports medicine; however, the efficacy of PRP treatment on injured tendons is highly controversial. In this commentary, I reason that there are many PRP- and patient-related factors that influence the outcomes of PRP treatment on injured tendons. Therefore, more basic science studies are needed to understand the mechanism of PRP on injured tendons. Finally, I suggest that better understanding of the PRP action mechanism will lead to better use of PRP for the effective treatment of tendon injuries in clinics.

  13. Liberal Arts Colleges in American Higher Education: Challenges and Opportunities. ACLS Occasional Paper, No. 59

    Science.gov (United States)

    American Council of Learned Societies, 2005

    2005-01-01

    This American Council of Learned Societies (ACLS) Occasional Paper presents the proceedings of a conference on "Liberal Arts Colleges in American Higher Education: Challenges and Opportunities" convened by ACLS in November 2003 in Williamstown, Massachusetts with the support of the Oakley Center for the Humanities and Social Sciences at…

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

    Science.gov (United States)

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

    2007-01-01

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

  15. Perspectives on the Humanities and School-Based Curriculum Development. ACLS Occasional Paper No. 24.

    Science.gov (United States)

    Blackman, Sandra; Chodorow, Stanley; Ohmann, Richard; Okura, Sandra; Purrington, Sandra Sanchez; Stein, Robert

    This paper records three plenary sessions held at the American Council of Learned Societies (ACLS) National Education Conference, August 27-29, 1993. The conference built on what was learned in the first year of the project and reported in ACLS Occasional Paper 20. Sessions allowed participants to talk with colleagues who had been project…

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

    CERN Document Server

    Hardin, David; 10.4204/EPTCS.70

    2011-01-01

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

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

    DEFF Research Database (Denmark)

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

    2011-01-01

    Rupture of the anterior cruciate ligament (ACL) causes changes in the walking pattern. ACL deficient subjects classified as copers and non-copers have been observed to adopt different post-injury walking patterns. How these different patterns affect the knee compression and shear forces...

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  19. Quadriceps function following ACL reconstruction and rehabilitation : implications for optimisation of current practices

    NARCIS (Netherlands)

    Gokeler, Alli; Bisschop, Marsha; Benjaminse, Anne; Myer, Greg D.; Eppinga, Peter; Otten, Egbert

    2014-01-01

    To determine the most effective practices for quadriceps strengthening after ACL reconstruction. An electronic search has been performed for the literature appearing from January 1990 to January 2012. Inclusion criteria were articles written in English, German or Dutch with unilateral ACL-reconstruc

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-02-15

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

  1. Lower extremity muscle activation onset times during the transition from double-leg stance to single-leg stance in anterior cruciate ligament injured subjects.

    Science.gov (United States)

    Dingenen, Bart; Janssens, Luc; Luyckx, Thomas; Claes, Steven; Bellemans, Johan; Staes, Filip F

    2015-12-01

    The goal of this study was to evaluate muscle activation onset times (MAOT) of both legs during a transition task from double-leg stance (DLS) to single-leg stance (SLS) in anterior cruciate ligament injured (ACLI) (n=15) and non-injured control subjects (n=15) with eyes open and eyes closed. Significantly delayed MAOT were found in the ACLI group compared to the control group for vastus lateralis, vastus medialis obliquus, hamstrings medial, hamstrings lateral, tibialis anterior, peroneus longus and gastrocnemius in both vision conditions, for gluteus maximus and gluteus medius with eyes open and for tensor fascia latae with eyes closed. Within the ACLI group, delayed MAOT of tibialis anterior with eyes open and gastrocnemius with eyes closed were found in the injured leg compared to the non-injured leg. All other muscles were not significantly different between legs. In conclusion, the ACLI group showed delayed MAOT not only around the knee, but also at the hip and ankle muscles compared to the non-injured control group. No differences between both legs of the ACLI group were found, except for tibialis anterior and gastrocnemius. These findings indirectly support including central nervous system re-education training to target the underlying mechanisms of these altered MAOT after ACL injury.

  2. Development of a Translator from LLVM to ACL2

    Directory of Open Access Journals (Sweden)

    David S. Hardin

    2014-06-01

    Full Text Available In our current work a library of formally verified software components is to be created, and assembled, using the Low-Level Virtual Machine (LLVM intermediate form, into subsystems whose top-level assurance relies on the assurance of the individual components. We have thus undertaken a project to build a translator from LLVM to the applicative subset of Common Lisp accepted by the ACL2 theorem prover. Our translator produces executable ACL2 formal models, allowing us to both prove theorems about the translated models as well as validate those models by testing. The resulting models can be translated and certified without user intervention, even for code with loops, thanks to the use of the def::ung macro which allows us to defer the question of termination. Initial measurements of concrete execution for translated LLVM functions indicate that performance is nearly 2.4 million LLVM instructions per second on a typical laptop computer. In this paper we overview the translation process and illustrate the translator's capabilities by way of a concrete example, including both a functional correctness theorem as well as a validation test for that example.

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

    Directory of Open Access Journals (Sweden)

    Emilton Lima Júnior

    2002-12-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-10-15

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

  5. 78 FR 21071 - Fisheries of the Northeastern United States; Atlantic Herring Fishery; Sub-ACL (Annual Catch...

    Science.gov (United States)

    2013-04-09

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

  6. 76 FR 61061 - Fisheries of the Northeastern United States; Atlantic Herring Fishery; Sub-ACL (Annual Catch...

    Science.gov (United States)

    2011-10-03

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

  7. 77 FR 10668 - Fisheries of the Northeastern United States; Atlantic Herring Fishery; Sub-ACL (Annual Catch...

    Science.gov (United States)

    2012-02-23

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

  8. 76 FR 61059 - Fisheries of the Northeastern United States; Atlantic Herring Fishery; Sub-ACL (Annual Catch...

    Science.gov (United States)

    2011-10-03

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

  9. 76 FR 66654 - Fisheries of the Northeastern United States; Atlantic Herring Fishery; Sub-ACL (Annual Catch...

    Science.gov (United States)

    2011-10-27

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

  10. Strengthening care of injured children globally.

    Science.gov (United States)

    Mock, Charles; Abantanga, Francis; Goosen, Jacques; Joshipura, Manjul; Juillard, Catherine

    2009-05-01

    Part of the solution to the growing problem of child injury is to strengthen the care that injured children receive. This paper will point out the potential health gains to be made by doing this and will then review recent advances in the care of injured children in individual institutions and countries. It will discuss how these individual efforts have been aided by increased international attention to trauma care. Although there are no major, well-funded global programmes to improve trauma care, recent guidance documents developed by WHO and a broad network of collaborators have stimulated increased global attention to improving planning and resources for trauma care. This has in turn led to increased attention to strengthening trauma care capabilities in countries, including needs assessments and implementation of WHO recommendations in national policy. Most of these global efforts, however, have not yet specifically addressed children. Given the special needs of the injured child and the high burden of injury-related death and disability among children, clearly greater emphasis on childhood trauma care is needed. Trauma care needs assessments being conducted in a growing number of countries need to focus more on capabilities for care of injured children. Trauma care policy development needs to better encompass childhood trauma care. More broadly, the growing network of individuals and groups collaborating to strengthen trauma care globally needs to engage a broader range of stakeholders who will focus on and champion the improvement of care for injured children.

  11. 共培养下前交叉韧带成纤维细胞中LOXs与MMPs的基因表达情况%Gene Expressions of LOXs and MMPs of the ACL Fibroblasts Cells Co-cultured with Synovial Cells

    Institute of Scientific and Technical Information of China (English)

    王春莉; 梅虎; 谢静; 蒋稼欢; 陈荣富; 尹琳; 符纯锋; 陈诚; 宋国立

    2013-01-01

    The progress of research on the the anterior cruciate ligament (ACL) wound healing demonstrates that the synovial tissue in the knee joint plays a very important role in the healing process of injured ACL.Therefore,the molecular response mechanisms of lysyl oxidase (LOX) and matrix metalloproteina (MMP) in normal/injured ACL fibroblast cells could be considered to perform the major analysis function of injured ACL healing mechanism.The mRNA expressions of LOXs and MMPs and the activity expressions of MMP-2 in ACL fibroblasts co-cultured with synovial cells were analyzed by quantitative real-time PCR and zymography.The results showed that co-culture could regulate the mRNA expressions of LOXs and MMPs in the ACL fibroblasts cells.These results suggest that the differential expressions of LOXs and MMP-1,2,3 in co-cultured ACL indicate that interaction crosstalk do exist between ACL cells and synovial cells and provide a theoretical basis for subsequent exploration of the mechanisms and treatment of ACL injury and repair.%前交叉韧带(ACL)损伤修复的研究进展表明,膝关节内覆在ACL上的滑膜组织对ACL损伤修复起到非常重要的作用.为探讨滑膜细胞对ACL成纤维细胞中影响组织修复的关键酶即赖氨酰氧化酶(LOXs)与基质金属蛋白酶(MMPs)表达及活性的影响,本文通过建立体外ACL成纤维细胞与滑膜细胞共培养体系,采用RT-PCR与明胶酶谱(zemography)技术定量分析比较单培养与共培养ACL成纤维细胞中LOXs与MMP-1、2、3基因的表达情况及MMP-2蛋白酶的活性.结果显示:(1)共培养促进ACL成纤维细胞中的LOXs与MMP-2的基因表达,但降低MMP-1、MMP-3的基因表达.(2)与单培养组相比,在不同时间点,共培养组都促进ACL成纤维细胞中MMP-2蛋白酶的表达及其活化程度.以上结果表明:ACL细胞和滑膜细胞之间存在密切的交流影响了LOXs与MMP-1、2、3的基因表达,为后续探索ACL损伤修复的机制及治疗方法提供了理论依据.

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

    Science.gov (United States)

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

    2016-11-01

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

  13. ATP released by injured neurons activates Schwann cells

    Directory of Open Access Journals (Sweden)

    Samuele eNegro

    2016-05-01

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

  14. Rapid neuroinflammatory response localized to injured neurons after diffuse traumatic brain injury in swine.

    Science.gov (United States)

    Wofford, Kathryn L; Harris, James P; Browne, Kevin D; Brown, Daniel P; Grovola, Michael R; Mietus, Constance J; Wolf, John A; Duda, John E; Putt, Mary E; Spiller, Kara L; Cullen, D Kacy

    2017-04-01

    Despite increasing appreciation of the critical role that neuroinflammatory pathways play in brain injury and neurodegeneration, little is known about acute microglial reactivity following diffuse traumatic brain injury (TBI) - the most common clinical presentation that includes all concussions. Therefore, we investigated acute microglial reactivity using a porcine model of closed-head rotational velocity/acceleration-induced TBI that closely mimics the biomechanical etiology of inertial TBI in humans. We observed rapid microglial reactivity within 15min of both mild and severe TBI. Strikingly, microglial activation was restrained to regions proximal to individual injured neurons - as denoted by trauma-induced plasma membrane disruption - which served as epicenters of acute reactivity. Single-cell quantitative analysis showed that in areas free of traumatically permeabilized neurons, microglial density and morphology were similar between sham or following mild or severe TBI. However, microglia density increased and morphology shifted to become more reactive in proximity to injured neurons. Microglial reactivity around injured neurons was exacerbated following repetitive TBI, suggesting further amplification of acute neuroinflammatory responses. These results indicate that neuronal trauma rapidly activates microglia in a highly localized manner, and suggest that activated microglia may rapidly influence neuronal stability and/or pathophysiology after diffuse TBI.

  15. Nursing care of the thermally injured patient.

    Science.gov (United States)

    Elfving, U

    1980-01-01

    Team work is required in the treatment of the thermally injured patient--nursing staff being part of the team. The nurses are with the patient for 24 hours a day and they have to understand the objectives of all other members of the team involved in the treatment as well as thoroughly mastering their own work. For the nursing staff the care of the thermally injured patient is a challenge. The work demands strong motivation and interest--it includes at times painful treatment, isolation and also constant alertness. It is important that the nursing staff is given continuous training so that they are able to give the required care efficiently and to keep up active interest. Practical work is the best way of getting aquainted with the complex forms of treatment of the thermally injured patient. It also lessens the fear of a badly burned patient. Nursing care of the thermally injured patient consists of good basic care, local attention and active observation. The basic care consists of basic hygiene, diet, observation of the patient's psychological condition, giving emotional support, encouraging initiative physiotherapy and postural treatment.

  16. Thromboembolic Complications in Thermally Injured Patients,

    Science.gov (United States)

    1992-12-01

    utilisation systdmatique chez le brOld sauf chez les patients A bolism: A clinico -pathological study in injured and burned patients. thromoemblie.Br. J...fueron identificados como casos de tromboembolismo, complications in the surgical patient. Ann. Surg. 186:669, 1977 pulmonar significativo. En s6lo tres

  17. Prehospital care of head injured patients

    Directory of Open Access Journals (Sweden)

    Dash Hari

    2008-01-01

    Full Text Available Resuscitation of head injured patients at the accident site is paramount in minimizing morbidity and mortality. This can be achieved through prehospital care which is nonexistent in our country. This review is a step forward, so that we can formulate guidelines in this regard.

  18. Phosphor-in-glass for high-powered remote-type white AC-LED.

    Science.gov (United States)

    Lin, Hang; Wang, Bo; Xu, Ju; Zhang, Rui; Chen, Hui; Yu, Yunlong; Wang, Yuansheng

    2014-12-10

    The high-powered alternating current (AC) light-emitting diode (LED) (AC-LED), featuring low cost, high energy utilization efficiency, and long service life, will become a new economic growth point in the field of semiconductor lighting. However, flicker of AC-LED in the AC cycles is not healthy for human eyes, and therefore need to be restrained. Herein we report an innovation of persistent "phosphor-in-glass" (PiG) for the remote-type AC-LED, whose afterglow can be efficiently activated by the blue light. It is experimentally demonstrated that the afterglow decay of PiG in the microsecond range can partly compensate the AC time gap. Moreover, the substitution of inorganic glass for organic resins or silicones as the encapsulants would bring out several technological benefits to AC-LED, such as good heat-dissipation, low glare, and excellent physical/chemical stability.

  19. Evaluation of pediatric CPR course on knowledge of pediatric residents--before and after ACLS course.

    Science.gov (United States)

    Soltani, Alireza Ebrahim; Khan, Zahid Hussain; Arbabi, Shahriar; Hossini, Babak; Nahvi, Hedaiatollah; Agamohammadi, Asghar

    2009-02-01

    An evaluation was conducted on the knowledge gained by pediatric residents on CPR, before and after a PALS (Pediatric Advanced Cardiac Life Support) course. Following an examination of all pediatric residents at Tehran University of Medical Sciences, they were divided into two groups: non-trained (Group 1) and a group scheduled to undergone training (Group 2). A course on ACLS was conducted. Examination were performed before and after the ACLS course. The mean of the examination prior to the course in Group 1 and 2 was low, reflecting no significant differences between the Groups. Examination after the ACLS course showed a statistically significant improvement in Group 2 (P ACLS course and enhanced after the course.

  20. Relationship jump-landing technique and neuropsychological characteristics, implications for acl injury prevention

    NARCIS (Netherlands)

    Benjaminse, A.; Meijer, M.; Cortes, N.; Gokeler, A.

    2014-01-01

    BACKGROUND: Neuropsychological capabilities in athletes may be associated with a predisposition to anterior cruciate ligament (ACL) injuries. OBJECTIVE: Assess differences between male and female athletes in jump-landing technique in relation to their neuropsychological capabilities. DESIGN: Experim

  1. Muscle function is associated with future patient-reported outcomes in young adults with ACL injury

    DEFF Research Database (Denmark)

    Flosadottir, Vala; Roos, Ewa M; Ageberg, Eva

    2016-01-01

    BACKGROUND/AIM: Consequences of an anterior cruciate ligament (ACL) injury include worse patient-reported outcomes (PROs) and a decrease in activity level. Muscle function can be improved by targeted exercise. Our aims were to investigate cross-sectional and longitudinal associations among lower...... extremity muscle function and PROs after ACL injury. METHODS: Fifty-four participants (15 women, mean 30 years) with ACL injury or reconstruction, from the Knee Anterior Cruciate Ligament, Nonsurgical versus Surgical Treatment (KANON) trial (ISRCTN84752559), were assessed with hop performance, muscle power...... and postural orientation 3 years (SD 0.85) after ACL injury. PROs at 3 and 5 years after injury included Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales Function in sport and recreation (KOOS Sport/rec) and Knee-related Quality of life (KOOS QoL), KOOS item Q3 (KOOS Q3), Tegner Activity Scale...

  2. Influence of thermofixation on artificial ACL ligament dimensional and mechanical properties

    Science.gov (United States)

    Ben Abdessalem, S.; Jedda, H.; Skhiri, S.; Karray, S.; Dahmen, J.; Boughamoura, H.

    2005-11-01

    The anterior cruciate ligament (ACL) is the major articular ligamentous structure of the knee, it functions as a joint stabilizer. When ruptured, the natural ACL ligament can be replaced by a textile synthetic ligament such as a braid, knitted cord, or woven cord. Theses structures are composed of biocompatible materials such as polyester or Gore-Tex filaments. The success of an ACL replacement is widely linked to its mechanical and dimensional properties such as tensile strength, dimensional stability and resistance to abrasion. We introduced an additional treatment in the manufacturing of textile ACL ligaments based on the thermofixation of the textile structure by using textile industry stabilization techniques. Boiling water, saturated vapor and dry heat have been tested to stabilize a braided ligament made of Dacron polyester. The application of these three techniques led to shrinkage and an increase of breaking strength of the textile structure.

  3. Practical screening and intervention to reduce risk of ACL injury in young women

    OpenAIRE

    2016-01-01

    Injury of the anterior cruciate ligament (ACL) is a relatively common knee injury amongst participants of competitive sports such as soccer, basketball, gymnastics, volleyball and handball. Its incidence amongst young females is two to six times higher than males participating in the same sports due to a number of factors including biomechanical and neuromuscular differences. ACL injury has serious consequences for affected individuals including costly rehabilitation, long recovery time and a...

  4. Treatment of persistent extraarticular infection using a temporary cement spacer on the tibia after ACL reconstruction.

    Science.gov (United States)

    Jung, Kwang Am; Lee, Soo Chan; Song, Moon Bok; Lee, Choon Key

    2008-01-01

    Postoperative infection after anterior cruciate ligament (ACL) reconstruction is an uncommon but serious complication. Although several treatments for intraarticular infection have been reported, no report has been recorded on the treatment of persistent extraarticular infections. The authors experienced reconstructed graft removal due to a refractory extraarticular infection on tibia. Early ACL reimplantation was performed using a temporary cement spacer containing antibiotics and a irradiated bone patellar tendon bone allograft.

  5. TRANSTIBIAL VERSUS ANTEROMEDIAL PORTAL TECHNIQUES IN ACL RECONSTRUCTION

    Directory of Open Access Journals (Sweden)

    Luiz Gabriel Betoni Guglielmetti

    Full Text Available Abstract Introduction: Although the results of anterior cruciate ligament (ACL reconstruction are well documented in many studies, with good to excellent outcomes in most cases, some issues like tunnel positioning are still discussed and studied. Objective: To compare the objective and subjective clinical outcomes of ACL reconstruction using the transtibial and anteromedial portal techniques. Methods: Prospective randomized study of 80 patients undergoing anterior cruciate ligament reconstruction by the same surgeon, with 40 patients operated by the transtibial technique and 40 by anteromedial portal technique. The patients, 34 in the transtibial group and 37 in the anteromedial portal group (nine dropouts, were reassessed during a 2-year follow-up period. The clinical assessment consisted of physical examination, KT-1000TM evaluation, Lysholm score, and objective and subjective International Knee Documentation Committee - IKDC scores. Results: Regarding the Lachman and pivot shift tests, we observed more cases of instability in the transtibial group, but with no statistical significance (p=0.300 and p=0.634, respectively. Regarding the anterior drawer test, the groups presented similar results (p=0.977. Regarding KT-1000TM evaluation, the mean results were 1.44 for the transtibial group and 1.23 for the anteromedial portal group, with no statistical significance (p=0.548. We separated the objective IKDC scores into two groups: Group 1, IKDC A, and Group 2, IKDC B, C, or D, with no statistical significance (p=0.208. Concerning the Lysholm score, the transtibial group had a mean score of 91.32, and the anteromedial portal group had a mean score of 92.81. The mean subjective IKDC scores were 90.65 for the transtibial group and 92.65 for the anteromedial portal group. Three re-ruptures were encountered in the transtibial group and three in the anteromedial portal group. Conclusions: There were no significant differences in the subjective and

  6. Timing of surgery in anterior cruciate ligament-injured knees.

    Science.gov (United States)

    Shelbourne, K D; Patel, D V

    1995-01-01

    Despite recent advances in the surgical techniques of anterior cruciate ligament (ACL) reconstruction in the past two decades, there is no consensus of opinion as to the ideal timing for ACL surgery. Based on the evolution of management of patients with ACL injuries over the period 1982-1994, we have found that various factors need to be considered in order to provide the best possible long-term result to the patient with minimal or no complications. In this review, we discuss the perioperative factors that one must consider to determine optimum timing for ACL surgery. Factors such as mental preparation of the patient; school, work, family, and social schedules; preoperative condition of the knee [i.e., minimal or no swelling, good strength, good leg control, and full range of motion (ROM) including full hyperextension]; and associated ligamentous and/or meniscal injuries must be considered before undertaking ACL surgery. With careful consideration of the above-mentioned factors and with our preoperative and postoperative rehabilitation program, we have been able to obtain predictable, successful, long-term results following ACL reconstruction in our athletic population. We emphasize that every patient should be treated on his or her own merit, and treatment decisions must be individualized.

  7. Torn ACL: A New Bioengineered Substitute Brought from the Laboratory to the Knee Joint

    Directory of Open Access Journals (Sweden)

    Francine Goulet

    2004-01-01

    Full Text Available Anterior cruciate ligament (ACL injuries occur at an annual rate of 120 000 in the USA, and many need reconstructive surgery. We report successful results at 1–13 months following implantation of bioengineered ACL (bACL in goats. A bACL has been developed using autologous ACL cells, a collagen matrix and bone plugs. The extremities of the bACL were fully integrated into the femur and tibia of the host. Vascularisation of the grafts was extensive 1 month post-surgery and improved with time. At 6 months post-grafting, histological and ultrastructural observations demonstrated a highly organised ligamentous structure, rich in type I collagen fibres and fibroblasts. At the implants' insertion sites, characteristic fibrocartilage was observed having well aligned chondrocytes and collagen fibrils. After a year, mechanical rupture of the grafts demonstrated a major gain in strength. Eventual applications of this new technology in humans include multiple uses in orthopaedic, dental and reconstructive surgeries.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    (ACL-R). METHODS: Uninjured (n=13 males; n=8 females) and ACL-R (n=3 males; n=5 females; 25.0±11.3 months post-op) elite ski racers performed maximal voluntary isometric HAM and QUAD contractions to obtain maximal torque (MVC) and rate of torque development (RTD) at 0-50, 0-100, 0-150 and 0-200 ms. MVC...... and RTD (per kg body mass) were calculated for the uninjured group to compare between sexes, and to compare the control group with the ACL-R limb and unaffected limb of the ACL-R skiers. H/Q MVC and RTD strength ratios were also compared RESULTS: The ACL-R limb demonstrated significant HAM and QUAD...... deficits compared to the contralateral limb for MVC and late-phase RTD (PMVC and RTD at 150 ms (PMVC and RTD deficits were observed in the affected limb of ACL-R skiers, which led to an inflated H/Q Ratio (50 ms) compared...

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    Studies suggest that the anterolateral ligament (ALL) is important for knee stability. The purpose was to clarify ALL's effect on rotatory and anterior-posterior stability in the anterior cruciate ligament (ACL)-insufficient and reconstructed knees and the effect of reconstruction of an insuffici......Studies suggest that the anterolateral ligament (ALL) is important for knee stability. The purpose was to clarify ALL's effect on rotatory and anterior-posterior stability in the anterior cruciate ligament (ACL)-insufficient and reconstructed knees and the effect of reconstruction...... of an insufficient ALL. Eighteen cadaveric knees were included. Stability was tested for intact (+ALL), detached (-ALL) and reconstructed (+ reALL) ALL, with ACL removed (-ACL) and reconstructed (+ACL) in six combinations. All were tested in 0, 30, 60, and 90 °C flexion. Anterior-posterior stability was measured...... with a rolimeter. Rotation with a torque of 8.85 Nm was measured photographically. The ALL was well defined in 78% of knees. ACL reconstruction had a significant effect on anterior-posterior stability. Detaching the ALL had a significant effect on internal rotatory stability and on anterior-posterior stability...

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

    Science.gov (United States)

    Renstrom, P; Ljungqvist, A; Arendt, E; Beynnon, B; Fukubayashi, T; Garrett, W; Georgoulis, T; Hewett, T E; Johnson, R; Krosshaug, T; Mandelbaum, B; Micheli, L; Myklebust, G; Roos, E; Roos, H; Schamasch, P; Shultz, S; Werner, S; Wojtys, E; Engebretsen, L

    2008-06-01

    The incidence of anterior cruciate ligament (ACL) injury remains high in young athletes. Because female athletes have a much higher incidence of ACL injuries in sports such as basketball and team handball than male athletes, the IOC Medical Commission invited a multidisciplinary group of ACL expert clinicians and scientists to (1) review current evidence including data from the new Scandinavian ACL registries; (2) critically evaluate high-quality studies of injury mechanics; (3) consider the key elements of successful prevention programmes; (4) summarise clinical management including surgery and conservative management; and (5) identify areas for further research. Risk factors for female athletes suffering ACL injury include: (1) being in the preovulatory phase of the menstrual cycle compared with the postovulatory phase; (2) having decreased intercondylar notch width on plain radiography; and (3) developing increased knee abduction moment (a valgus intersegmental torque) during impact on landing. Well-designed injury prevention programmes reduce the risk of ACL for athletes, particularly women. These programmes attempt to alter dynamic loading of the tibiofemoral joint through neuromuscular and proprioceptive training. They emphasise proper landing and cutting techniques. This includes landing softly on the forefoot and rolling back to the rearfoot, engaging knee and hip flexion and, where possible, landing on two feet. Players are trained to avoid excessive dynamic valgus of the knee and to focus on the "knee over toe position" when cutting.

  11. Relationship of ACL Injury and Posterior Tibial Slope With Patient Age, Sex, and Race

    Science.gov (United States)

    Waiwaiole, Alana; Gurbani, Ajay; Motamedi, Kambiz; Seeger, Leanne; Sim, Myung Shin; Nwajuaku, Patricia; Hame, Sharon L.

    2016-01-01

    Background: Posterior tibial slope (PTS) has been proposed as a potential risk factor for anterior cruciate ligament (ACL) injury; however, studies that have examined this relationship have provided inconclusive and sometimes contradictory results. Further characterization of this relationship may enable the medical community to identify individuals at greater risk for ACL injury and possibly characterize an anatomic target during surgical reconstruction. Purpose: The primary goal was to investigate the relationship between PTS and ACL injury. The secondary goal was to determine whether there are any patient factors, such as age, race, or sex, that correlate with ACL injury and PTS. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Medical records of 221 patients who underwent magnetic resonance imaging (MRI) of the knee between January 2003 and December 2009 were reviewed. Patients were separated into 2 groups: a study group of those subjects who had undergone surgery for ACL injury (n = 107) and a control group of patients diagnosed with patellofemoral syndrome (n = 114). Demographic data were collected, and MRI images from both groups were analyzed using imaging software to obtain medial and lateral tibial slope measurements. Data were then analyzed using analysis of variance (ANOVA) comparison and a multivariable regression model to determine which, if any, patient factors were related to probability of having an ACL injury. Results: ANOVA comparison demonstrated that the study group had significantly greater values for lateral PTS (6° ± 4°; P < .001) and medial PTS (7° ± 4°; P = .002) compared with controls (5° ± 3° and 5° ± 4°, respectively). After stepwise elimination of nonsignificant variables, the final multivariable logistic regression model determined that age (odds ratio [OR], 0.94; P < .001) and lateral PTS (OR, 1.12; P = .002) had statistically significant relationships with ACL injury. Medial PTS, race, and sex were not

  12. Accident characteristics of injured motorcyclists in Malaysia.

    Science.gov (United States)

    Pang, T Y; Umar, R S; Azhar, A A; Ahmad, M M; Nasir, M T; Harwant, S

    2000-03-01

    This study examines the accident characteristics of injured motorcyclists in Malaysia. The aim of this study is to identify the characteristics of motorcyclists who are at higher fatality risk and subsequently be the targeted group for the fatality-reduction countermeasures. A total of 412 motorcycle crash victims with serious or fatal injuries were analysed. The results showed that the injured motorcyclists were predominant young, novice riders of less than 3 years licensure and male. A fatal outcome was more likely to be associated with a larger engine capacity motorcycle, collision with a heavy vehicle, head on collision, and collision at a non-junction road. In contrast, a non-fatal outcome was more likely to be associated with a small engine capacity motorcycle, collision with another motorcycle or passenger car, junction accidents, and side or rear collisions.

  13. Randomized Trial of a Novel ACLS Teaching Tool: Does it Improve Student Performance?

    Directory of Open Access Journals (Sweden)

    Nicholas Nacca

    2014-11-01

    Full Text Available Introduction: Mounting evidence suggests that high-fidelity mannequin-based (HFMBS and computer-based simulation are useful adjunctive educational tools for advanced cardiac life support (ACLS instruction. We sought to determine whether access to a supplemental, online computer-based ACLS simulator would improve students’ performance on a standardized Mega Code using high-fidelity mannequin based simulation (HFMBS. Methods: Sixty-five third-year medical students were randomized. Intervention group subjects (n = 29 each received a two-week access code to the online ACLS simulator, whereas the control group subjects (n = 36 did not. Primary outcome measures included students’ time to initiate chest compressions, defibrillate ventricular fibrillation, and pace symptomatic bradycardia. Secondary outcome measures included students’ subjective self-assessment of ACLS knowledge and confidence. Results: Students with access to the online simulator on average defibrillated ventricular fibrillation in 112 seconds, whereas those without defibrillated in 149.9 seconds, an average of 38 seconds faster [p<.05]. Similarly, those with access to the simulator paced symptomatic bradycardia on average in 95.14 seconds whereas those without access paced on average 154.9 seconds a difference of 59.81 seconds [p<.05]. On a subjective 5-point scale, there was no difference in self-assessment of ACLS knowledge between the control (mean 3.3 versus intervention (mean 3.1 [p-value =.21]. Despite having outperformed the control group subjects in the standardized Mega Code test scenario, the intervention group felt less confident on a 5-point scale (mean 2.5 than the control group. (mean 3.2 [p<.05] Conclusion: The reduction in time to defibrillate ventricular fibrillation and to pace symptomatic bradycardia among the intervention group subjects suggests that the online computer-based ACLS simulator is an effective adjunctive ACLS instructional tool. [West J Emerg Med

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1994-08-01

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

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

    Science.gov (United States)

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

    2014-10-01

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

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

    Science.gov (United States)

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

    2015-08-01

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

  17. Biomechanical regulation of type I collagen gene expression in ACLs in organ culture.

    Science.gov (United States)

    Hsieh, Adam H; Sah, Robert L; Paul Sung, K L

    2002-03-01

    In this study, an ex vivo organ culture system that allows the application of controlled loads to the anterior cruciate ligament (ACL) was designed and used to characterize the influence of a step input in mechanical load on gene expression. A procedure for isolating bone-ACL-bone (B-ACL-B) complexes from rat knees was developed. After harvest and 24 hour culture, B-ACL-B complexes exhibited percentages of viability similar to that in intact ACLs (approximately 90%). Application of a physiologically relevant load of 5 N (superimposed on a I N tare load) resulted in changes in levels of mRNA encoding type I collagen. While levels of type I collagen mRNA significantly increased 32+/-13% (mean +/- standard errors of the mean (SEM)) over controls within the first hour of loading, levels decreased significantly to 44+/-9% of control after 2 h. Displacements induced by the 5 N load were measured by video dimensional analysis. Calculated axial strains of 0.141+/-0.034 were achieved rapidly during the first hour and remained essentially unchanged thereafter. These results demonstrate the feasibility of maintaining ligaments in organ culture and illustrate the time course expression of type I collagen following the application of a mechanical load.

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

    Science.gov (United States)

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

    2016-01-01

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

  19. Negative feedback regulation of auxin signaling by ATHB8/ACL5-BUD2 transcription module.

    Science.gov (United States)

    Baima, Simona; Forte, Valentina; Possenti, Marco; Peñalosa, Andrés; Leoni, Guido; Salvi, Sergio; Felici, Barbara; Ruberti, Ida; Morelli, Giorgio

    2014-06-01

    The role of auxin as main regulator of vascular differentiation is well established, and a direct correlation between the rate of xylem differentiation and the amount of auxin reaching the (pro)cambial cells has been proposed. It has been suggested that thermospermine produced by ACAULIS5 (ACL5) and bushy and dwarf2 (BUD2) is one of the factors downstream to auxin contributing to the regulation of this process in Arabidopsis. Here, we provide an in-depth characterization of the mechanism through which ACL5 modulates xylem differentiation. We show that an increased level of ACL5 slows down xylem differentiation by negatively affecting the expression of homeodomain-leucine zipper (HD-ZIP) III and key auxin signaling genes. This mechanism involves the positive regulation of thermospermine biosynthesis by the HD-ZIP III protein Arabidopsis thaliana homeobox8 tightly controlling the expression of ACL5 and BUD2. In addition, we show that the HD-ZIP III protein REVOLUTA contributes to the increased leaf vascularization and long hypocotyl phenotype of acl5 likely by a direct regulation of auxin signaling genes such as like auxin resistant2 (LAX2) and LAX3. We propose that proper formation and differentiation of xylem depend on a balance between positive and negative feedback loops operating through HD-ZIP III genes.

  20. Inhibition of inflammatory injure by polysaccharides from Bupleurum chinense through antagonizing P-selectin.

    Science.gov (United States)

    Tong, Haibin; Tian, Dan; Li, Tianbao; Wang, Bo; Jiang, Guiquan; Sun, Xin

    2014-05-25

    P-selectin-mediated adhesion between endothelium and neutrophils is a crucial process leading to acute inflammatory injure. Thus, P-selectin has been considered as promising target for therapeutics of acute inflammatory-related diseases. In the present study, the water-soluble polysaccharides (BCPs) were isolated from Bupleurum chinense, and we evaluated their therapeutical effects on acute inflammatory injure and antagonistic function against P-selectin-mediated neutrophil adhesion. Our results showed that BCPs significantly impaired the leukocyte infiltration and relieve lung injury in LPS-induced acute pneumonia model. BCPs significantly blocked the binding of P-selectin to neutrophils and inhibited P-selectin-mediated neutrophils rolling along CHO-P cell monolayer. The result from in vitro protein binding assay showed a direct evidence indicating that BCPs-treatment significantly eliminated the interaction between rhP-Fc and its physiological ligand PSGL-1 at protein level. Together, these results provide a novel therapeutical strategy for amelioration of inflammation-related disease processes by polysaccharides from B. chinense.

  1. ACL reconstruction with unicondylar replacement in knee with functional instability and osteoarthritis

    Directory of Open Access Journals (Sweden)

    Randle Ray

    2009-12-01

    Full Text Available Abstract Severe symptomatic osteoarthritis in young and active patients with pre-existing deficiency of the anterior cruciate ligament and severe functionally instability is a difficult subgroup to manage. There is considerable debate regarding management of young patients with isolated unicompartment osteoarthritis and concomitant ACL deficiency. A retrospective analysis of was done in 9 patients with symptomatic osteoarthritis with ACL deficiencies and functional instability that were treated with unicompartment knee arthroplasty and ACL reconstruction between April 2002 and June 2005. The average arc of flexion was 119° (range 85° to 135° preoperatively and 125° (range 105° to 140°. There were no signs of instability during the follow up of patients. No patients in this group were reoperated. In this small series we have shown that instability can be corrected and pain relieved by this combined procedure.

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

    DEFF Research Database (Denmark)

    Alkjær, Tine; Simonsen, Erik B; Magnusson, S Peter;

    2012-01-01

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

  3. Transverse femoral implant prominence: four cases demonstrating a preventable complication for ACL reconstruction.

    Science.gov (United States)

    Argintar, Evan; Scherer, Benjamin; Jordan, Tom; Klimkiewicz, John

    2010-12-01

    Anterior cruciate ligament (ACL) tear is a commonly occurring injury that often demands surgical reconstruction. Although the utility of this operation is widely accepted, many specific components, including graft fixation technique, remain controversial. Many clinicians favor transverse femoral implant fixation for soft tissue ACL grafts. This technique can be accomplished successfully; however, in a minority of the cases, the femoral implant can be excessively prominent, leading to iatrogenic postoperative iliotibial band syndrome. This article presents 4 patients that developed postoperative iliotibial band syndrome resulting from transverse femoral implant prominence. Despite achievement of knee ligamentous stability, implant prominence compromised final clinical results following ACL reconstruction. Through change in Lysholm value, we reviewed the clinical outcomes of these patients following femoral implant hardware removal for treatment of iliotibial band syndrome. On hardware removal, all patients demonstrated complete symptomatic improvement, mirroring an average Lysholm value increase of 38. We believe transverse femoral implant prominence is avoidable, and subsequent iliotibial band syndrome is a preventable postoperative complication.

  4. Combining peripheral nerve grafts and chondroitinase promotes functional axonal regeneration in the chronically injured spinal cord.

    Science.gov (United States)

    Tom, Veronica J; Sandrow-Feinberg, Harra R; Miller, Kassi; Santi, Lauren; Connors, Theresa; Lemay, Michel A; Houlé, John D

    2009-11-25

    Because there currently is no treatment for spinal cord injury, most patients are living with long-standing injuries. Therefore, strategies aimed at promoting restoration of function to the chronically injured spinal cord have high therapeutic value. For successful regeneration, long-injured axons must overcome their poor intrinsic growth potential as well as the inhibitory environment of the glial scar established around the lesion site. Acutely injured axons that regenerate into growth-permissive peripheral nerve grafts (PNGs) reenter host tissue to mediate functional recovery if the distal graft-host interface is treated with chondroitinase ABC (ChABC) to cleave inhibitory chondroitin sulfate proteoglycans in the scar matrix. To determine whether a similar strategy is effective for a chronic injury, we combined grafting of a peripheral nerve into a highly relevant, chronic, cervical contusion site with ChABC treatment of the glial scar and glial cell line-derived neurotrophic factor (GDNF) stimulation of long-injured axons. We tested this combination in two grafting paradigms: (1) a peripheral nerve that was grafted to span a chronic injury site or (2) a PNG that bridged a chronic contusion site with a second, more distal injury site. Unlike GDNF-PBS treatment, GDNF-ChABC treatment facilitated axons to exit the PNG into host tissue and promoted some functional recovery. Electrical stimulation of axons in the peripheral nerve bridge induced c-Fos expression in host neurons, indicative of synaptic contact by regenerating fibers. Thus, our data demonstrate, for the first time, that administering ChABC to a distal graft interface allows for functional axonal regeneration by chronically injured neurons.

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

    Directory of Open Access Journals (Sweden)

    Yan-Sheng Liu

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

  6. Advanced Cardiac Life Support (ACLS) utilizing Man-Tended Capability (MTC) hardware onboard Space Station Freedom

    Science.gov (United States)

    Smith, M.; Barratt, M.; Lloyd, C.

    1992-01-01

    Because of the time and distance involved in returning a patient from space to a definitive medical care facility, the capability for Advanced Cardiac Life Support (ACLS) exists onboard Space Station Freedom. Methods: In order to evaluate the effectiveness of terrestrial ACLS protocols in microgravity, a medical team conducted simulations during parabolic flights onboard the KC-135 aircraft. The hardware planned for use during the MTC phase of the space station was utilized to increase the fidelity of the scenario and to evaluate the prototype equipment. Based on initial KC-135 testing of CPR and ACLS, changes were made to the ventricular fibrillation algorithm in order to accommodate the space environment. Other constraints to delivery of ACLS onboard the space station include crew size, minimum training, crew deconditioning, and limited supplies and equipment. Results: The delivery of ACLS in microgravity is hindered by the environment, but should be adequate. Factors specific to microgravity were identified for inclusion in the protocol including immediate restraint of the patient and early intubation to insure airway. External cardiac compressions of adequate force and frequency were administered using various methods. The more significant limiting factors appear to be crew training, crew size, and limited supplies. Conclusions: Although ACLS is possible in the microgravity environment, future evaluations are necessary to further refine the protocols. Proper patient and medical officer restraint is crucial prior to advanced procedures. Also emphasis should be placed on early intubation for airway management and drug administration. Preliminary results and further testing will be utilized in the design of medical hardware, determination of crew training, and medical operations for space station and beyond.

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

    Science.gov (United States)

    Padua, Darin A.; DiStefano, Lindsay J.

    2009-01-01

    Context: Injuries to the anterior cruciate ligament (ACL) occur because of excessive loading on the knee. ACL injury prevention programs can influence sagittal plane ACL loading factors and vertical ground reaction force (VGRF). Objective: To determine the influence of ACL injury prevention programs on sagittal plane knee biomechanics (anterior tibial shear force, knee flexion angle/moments) and VGRF. Data Sources: The PubMed database was searched for studies published between January 1988 and June 2008. Reference lists of selected articles were also reviewed. Study Selection: Studies were included that evaluated healthy participants for knee flexion angle, sagittal plane knee kinetics, or VGRF after performing a multisession training program. Two individuals reviewed all articles and determined which articles met the selection criteria. Approximately 4% of the articles fulfilled the selection criteria. Data Extraction: Data were extracted regarding each program’s duration, frequency, exercise type, population, supervision, and testing procedures. Means and variability measures were recorded to calculate effect sizes. One reviewer extracted all data and assessed study quality using PEDro (Physiotherapy Evidence Database). A second reviewer (blinded) verified all information. Results: There is moderate evidence to indicate that knee flexion angle, external knee flexion moment, and VGRF can be successfully modified by an ACL injury prevention program. Programs utilizing multiple exercises (ie, integrated training) appear to produce the most improvement, in comparison to that of single-exercise programs. Knee flexion angle was improved following integrated training (combined balance and strength exercises or combined plyometric and strength exercises). Similarly, external knee flexion moment was improved following integrated training consisting of balance, plyometric, and strength exercises. VGRF was improved when incorporating supervision with instruction and

  8. 77 FR 66746 - Fisheries of the Northeastern United States; Atlantic Herring Fishery; Sub-ACL (Annual Catch...

    Science.gov (United States)

    2012-11-07

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

  9. 77 FR 61299 - Fisheries of the Northeastern United States; Atlantic Herring Fishery; Sub-ACL (Annual Catch...

    Science.gov (United States)

    2012-10-09

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

  10. Enhancing Linux Security with ACL Embedded in it's Kernel%用内核ACL增强LINUX的安全性

    Institute of Scientific and Technical Information of China (English)

    张志文; 周明天

    2002-01-01

    As data sharing is growing continuously,this is constantly increasing the vulnerability of the operating systems.So the need for secure operating system is urgent.ACL is one of the basic characters of secure operating system.This paper describes how to enhance the Linux security with POSIX ACL embedded in it''''''''s kernel.

  11. Dimensionality of the Knee Numeric-Entity Evaluation Score (KNEES-ACL): a condition-specific questionnaire.

    Science.gov (United States)

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

    2013-10-01

    The benefit of anterior cruciate ligament (ACL) reconstruction has been questioned based on patient-reported outcome measures (PROMs). Valid interpretation of such results requires confirmation of the psychometric properties of the PROM. Rasch analysis is the gold standard for validation of PROMs, yet PROMs used for ACL reconstruction have not been validated using Rasch analysis. We used Rasch analysis to investigate the psychometric properties of the Knee Numeric-Entity Evaluation Score (KNEES-ACL), a newly developed PROM for patients treated for ACL deficiency. Two-hundred forty-two patients pre- and post-ACL reconstruction completed the pilot PROM. Rasch models were used to assess the psychometric properties (e.g., unidimensionality, local response dependency, and differential item functioning). Forty-one items distributed across seven unidimensional constructs measuring impairment, functional limitations, and psychosocial consequences were confirmed to fit Rasch models. Fourteen items were removed because of statistical lack of fit and inadequate face validity. Local response dependency and differential item functioning were identified and adjusted. The KNEES-ACL is the first Rasch-validated condition-specific PROM constructed for patients with ACL deficiency and patients with ACL reconstruction. Thus, this instrument can be used for within- and between-group comparisons.

  12. The effect of anterior cruciate ligament injury on bone curvature

    DEFF Research Database (Denmark)

    Hunter, D J; Lohmander, Stefan; Makovey, J;

    2014-01-01

    OBJECTIVE: Investigate the 5-year longitudinal changes in bone curvature after acute anterior cruciate ligament (ACL) injury, and identify predictors of such changes. METHODS: In the KANON-trial (ISRCTN 84752559), 111/121 young active adults with an acute ACL tear to a previously un-injured knee...

  13. The ACL Analyses on Cisco Routers%Cisco路由器ACL剖析

    Institute of Scientific and Technical Information of China (English)

    吴刚

    2010-01-01

    访问控制列表是Cisco IOS防火墙的核心技术,它包括标准ACL、扩展ACL、命名ACL、基于时间的ACL,动态ACL,自反ACL、基于上下文的访问控制(CBAC)等,这些ACL技术从简到繁、从网络层到应用层,为网络的边界安全提供了灵活的解决方案.

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

    DEFF Research Database (Denmark)

    Alkjaer, Tine; Henriksen, Marius; Dyhre-Poulsen, Poul;

    2009-01-01

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

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

    DEFF Research Database (Denmark)

    Renstrom, P; Ljungqvist, A; Arendt, E

    2008-01-01

    clinicians and scientists to (1) review current evidence including data from the new Scandinavian ACL registries; (2) critically evaluate high-quality studies of injury mechanics; (3) consider the key elements of successful prevention programmes; (4) summarise clinical management including surgery...... and conservative management; and (5) identify areas for further research. Risk factors for female athletes suffering ACL injury include: (1) being in the preovulatory phase of the menstrual cycle compared with the postovulatory phase; (2) having decreased intercondylar notch width on plain radiography; and (3...

  16. Therapeutic activities of engrafted neural stem/precursor cells are not dormant in the chronically injured spinal cord.

    Science.gov (United States)

    Kumamaru, Hiromi; Saiwai, Hirokazu; Kubota, Kensuke; Kobayakawa, Kazu; Yokota, Kazuya; Ohkawa, Yasuyuki; Shiba, Keiichiro; Iwamoto, Yukihide; Okada, Seiji

    2013-08-01

    The transplantation of neural stem/precursor cells (NSPCs) is a promising therapeutic strategy for many neurodegenerative disorders including spinal cord injury (SCI) because it provides for neural replacement or trophic support. This strategy is now being extended to the treatment of chronic SCI patients. However, understanding of biological properties of chronically transplanted NSPCs and their surrounding environments is limited. Here, we performed temporal analysis of injured spinal cords and demonstrated their multiphasic cellular and molecular responses. In particular, chronically injured spinal cords were growth factor-enriched environments, whereas acutely injured spinal cords were enriched by neurotrophic and inflammatory factors. To determine how these environmental differences affect engrafted cells, NSPCs transplanted into acutely, subacutely, and chronically injured spinal cords were selectively isolated by flow cytometry, and their whole transcriptomes were compared by RNA sequencing. This analysis revealed that NSPCs produced many regenerative/neurotrophic molecules irrespective of transplantation timing, and these activities were prominent in chronically transplanted NSPCs. Furthermore, chronically injured spinal cords permitted engrafted NSPCs to differentiate into neurons/oligodendrocytes and provided more neurogenic environment for NSPCs than other environments. Despite these results demonstrate that transplanted NSPCs have adequate capacity in generating neurons/oligodendrocytes and producing therapeutic molecules in chronic SCI microenvironments, they did not improve locomotor function. Our results indicate that failure in chronic transplantation is not due to the lack of therapeutic activities of engrafted NSPCs but the refractory state of chronically injured spinal cords. Environmental modulation, rather modification of transplanting cells, will be significant for successful translation of stem cell-based therapies into chronic SCI patients.

  17. Thermography based diagnosis of ruptured anterior cruciate ligament (ACL) in canines

    Science.gov (United States)

    Lama, Norsang; Umbaugh, Scott E.; Mishra, Deependra; Dahal, Rohini; Marino, Dominic J.; Sackman, Joseph

    2016-09-01

    Anterior cruciate ligament (ACL) rupture in canines is a common orthopedic injury in veterinary medicine. Veterinarians use both imaging and non-imaging methods to diagnose the disease. Common imaging methods such as radiography, computed tomography (CT scan) and magnetic resonance imaging (MRI) have some disadvantages: expensive setup, high dose of radiation, and time-consuming. In this paper, we present an alternative diagnostic method based on feature extraction and pattern classification (FEPC) to diagnose abnormal patterns in ACL thermograms. The proposed method was experimented with a total of 30 thermograms for each camera view (anterior, lateral and posterior) including 14 disease and 16 non-disease cases provided from Long Island Veterinary Specialists. The normal and abnormal patterns in thermograms are analyzed in two steps: feature extraction and pattern classification. Texture features based on gray level co-occurrence matrices (GLCM), histogram features and spectral features are extracted from the color normalized thermograms and the computed feature vectors are applied to Nearest Neighbor (NN) classifier, K-Nearest Neighbor (KNN) classifier and Support Vector Machine (SVM) classifier with leave-one-out validation method. The algorithm gives the best classification success rate of 86.67% with a sensitivity of 85.71% and a specificity of 87.5% in ACL rupture detection using NN classifier for the lateral view and Norm-RGB-Lum color normalization method. Our results show that the proposed method has the potential to detect ACL rupture in canines.

  18. Crises and Opportunities: The Futures of Scholarly Publishing. ACLS Occasional Paper, No. 57

    Science.gov (United States)

    Alonso, Carlos J.; Davidson, Cathy N.; Unsworth, John M.; Withey, Lynne

    2003-01-01

    Presented herein are papers presented at a session entitled "Crises and Opportunities: The Future of Scholarly Publishing," from the American Council of Learned Societies (ACLS) Annual Meeting, May 10, 2003. Four speakers approached this topic from different standpoints: as leaders of learned societies, as senior university officials, from the…

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

    Science.gov (United States)

    Lawall, Gilbert

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

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

    Directory of Open Access Journals (Sweden)

    Navin Kumar Karn

    2015-12-01

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

  1. Novel methods of instruction in ACL injury prevention programs, a systematic review

    NARCIS (Netherlands)

    Benjaminse, Anne; Welling, Wouter; Otten, Bert; Gokeler, Alli

    2015-01-01

    Anterior cruciate ligament (ACL) injury prevention programs have been successful in the short term. Motor learning strategies with an internal focus (IF) to body movements have traditionally been utilized, but may be less suitable than an external focus (EF) for the acquisition and control of comple

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

    Science.gov (United States)

    Lawall, Gilbert

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

  3. Effects of short-term cycling on knee joint proprioception in ACL-deficient patients.

    Science.gov (United States)

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

    2004-09-01

    It has previously been shown that knee injuries with ACL ruptures may lead to decreased proprioception and that exercise in a normal population, uninjured individuals, may reduce the proprioceptive ability. How proprioception is affected by exercise in patients with ACL deficiency has, to our knowledge, not been studied before. Knee joint proprioception was estimated in 36 patients, 18 males and 18 females, with ACL deficiency by measuring thresholds for detection of slow passive motion before and after a short period of exercise on an ergometer bicycle. In addition, the results were compared with a control group of 24 individuals of the same age. We found trends of enhanced proprioception towards extension in the patient group after cycling, but not in the control group. Towards flexion, both groups showed poorer proprioception after cycling. When difference scores of proprioceptive change in each group were compared, a trend towards different reaction upon cycling between the groups was seen in measurement towards extension from 20 degrees where the patients seemed to improve proprioception, which the controls did not. The results are not conclusive in this pilot study, but the possibility that ACL-deficient patients and controls may not react likewise to cycling, as regards their proprioceptive ability, is discussed.

  4. Effect of an internally versus externally focused acl injury prevention program on injury risk

    NARCIS (Netherlands)

    Dallinga, J.; Benjaminse, A.; Gokeler, A.; Otten, Egbert; Lemmink, K.

    2014-01-01

    BACKGROUND: Anterior cruciate ligament (ACL) injury prevention programs have shown mixed results, which may be in part due to suboptimal training components. OBJECTIVE: Determine effects of a prevention program with external and internal focus of attention on (potential) biomechanical risk factors f

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    Patient-related outcome measures (PROMs) are commonly used to gauge treatment effects in patients with anterior cruciate ligament (ACL) deficiency. Valid measures of specific conditions depend on relevant item content. While item content can be derived either from clinicians (face validity) or from...

  6. Muscle function is associated with future patient-reported outcomes in young adults with ACL injury

    DEFF Research Database (Denmark)

    Flosadottir, Vala; Roos, Ewa M; Ageberg, Eva

    2016-01-01

    BACKGROUND/AIM: Consequences of an anterior cruciate ligament (ACL) injury include worse patient-reported outcomes (PROs) and a decrease in activity level. Muscle function can be improved by targeted exercise. Our aims were to investigate cross-sectional and longitudinal associations among lower ...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-08-15

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

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

    DEFF Research Database (Denmark)

    Stensbirk, Frederik; Thorborg, Kristian; Konradsen, Lars;

    2014-01-01

    PURPOSE: The long-term results after using the iliotibial band autograft (ITB) in anterior cruciate ligament (ACL) reconstruction are not fully known. If equal in quality to conventional methods, the ITB graft could be a useful alternative as a primary graft, in revision surgery or multi-ligament......PURPOSE: The long-term results after using the iliotibial band autograft (ITB) in anterior cruciate ligament (ACL) reconstruction are not fully known. If equal in quality to conventional methods, the ITB graft could be a useful alternative as a primary graft, in revision surgery or multi......-ligament reconstruction. The purpose is to assess whether the ITB autograft is a long-term reliable alternative to the bone-patella-tendon-bone (BPTB) autograft, using a prospective randomized controlled trial design. METHODS: From 1995 to 1996, sixty patients scheduled for primary ACL reconstruction were included...... compared to the BPTB graft and is recommended as a reliable alternative autograft for ACL reconstruction. LEVEL OF EVIDENCE: Therapeutic studies, Level I....

  9. Measurement of movement patterns to enhance ACL injury prevention – A dead end?

    Directory of Open Access Journals (Sweden)

    Kam-Ming Mok

    2016-07-01

    Full Text Available Vertical drop jump has been suggested to be an effective movement screening task for ACL injury risk, but recent studies have questioned the ability of such tasks to accurately identify players with increased risk of injury. In this paper, we discuss the usefulness of movement screening tests from an injury prevention perspective.

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

    Directory of Open Access Journals (Sweden)

    Yamamoto Yuji

    2010-11-01

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

  11. THE EFFECT OF CONSERVATIVELY TREATED ACL INJURY ON KNEE JOINT POSITION Sense

    Science.gov (United States)

    Herrington, Lee

    2016-01-01

    ABSTRACT Background Proprioception is critical for effective movement patterns. However, methods of proprioceptive measurement in previous research have been inconsistent and lacking in reliability statistics making it applications to clinical practice difficult. Researchers have suggested that damage to the anterior cruciate ligament (ACL) can alter proprioceptive ability due to a loss of functioning mechanoreceptors. The majority of patients opt for reconstructive surgery following this injury. However, some patients chose conservative rehabilitation options rather than surgical intervention. Purpose The purpose of this study was to determine the effect of ACL deficiency on knee joint position sense following conservative, non-operative treatment and return to physical activity. A secondary purpose was to report the reliability and measurement error of the technique used to measure joint position sense, (JPS) and comment on the clinical utility of this measurement. Study Design Observational study design using a cross-section of ACL deficient patients and matched uninjured controls. Methods Twenty active conservatively treated ACL deficient patients who had returned to physical activity and twenty active matched controls were included in the study. Knee joint position sense was measured using a seated passive-active reproductive angle technique. The average absolute angle of error score, between 10 °-30 ° of knee flexion was determined. This error score was derived from the difference between the target and repositioning angle. Results The ACL deficient patients had a greater error score (7.9 °±3.6) and hence poorer static proprioception ability that both the contra-lateral leg (2.0 °±1.6; p = 0.0001) and the control group (2.6 °±0.9; p = 0.0001). The standard error of the mean (SEM) of this JPS technique was 0.5 ° and 0.2 ° and the minimum detectable change (MDC) was 1.3 ° and 0.4 ° on asymptomatic and symptomatic subjects

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

    Directory of Open Access Journals (Sweden)

    Jalali

    2015-07-01

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

  13. Spinal Cord Injured College Students: Counseling and Guidance Approaches.

    Science.gov (United States)

    Dailey, Anne Louise

    1979-01-01

    Physical, psychological, academic, and career problems of spinal cord injured college students plus counselor knowledge, attitudes, and skills that help in solving these problems are cited. Community and commercial resources are identified. Programs that enhance faculty and employer sensitivity and cord injured student development are described.…

  14. Effect of human neural progenitor cells on injured spinal cord

    Institute of Scientific and Technical Information of China (English)

    XU Guang-hui; BAI Jin-zhu; CAI Qin-lin; LI Xiao-xia; LI Ling-song; SHEN Li

    2005-01-01

    Objective: To study whether human neural progenitor cells can differentiate into neural cells in vivo and improve the recovery of injured spinal cord in rats.Methods: Human neural progenitor cells were transplanted into the injured spinal cord and the functional recovery of the rats with spinal cord contusion injury was evaluated with Basso-Beattie-Bresnahan (BBB) locomotor scale and motor evoked potentials. Additionally, the differentiation of human neural progenitor cells was shown by immunocytochemistry.Results: Human neural progenitor cells developed into functional cells in the injured spinal cord and improved the recovery of injured spinal cord in both locomotor scores and electrophysiological parameters in rats.Conclusions: Human neural progenitor cells can treat injured spinal cord, which may provide a new cell source for research of clinical application.

  15. Eight clinical conundrums relating to anterior cruciate ligament (ACL) injury in sport: recent evidence and a personal reflection.

    Science.gov (United States)

    Renström, Per A

    2013-04-01

    Over two million anterior cruciate ligament (ACL) injuries occur worldwide annually, and the greater prevalence for ACL injury in young female athletes is one of the major problems in sports medicine. Optimal treatment of ACL injury requires individualised management. Patient selection is of utmost importance, and so is respect for the patient's functional demands and interests. All patients with an ACL tear may not need surgery, however athletes and persons with an active lifestyle with high knee functional demands including cutting motions need and should be offered surgery. In many cases it may not be the choice of graft or technique that is the key for success, but the choice of surgeon. The surgeon should be experienced and use a reconstructive procedure he/she knows very well and is comfortable with. The development of osteoarthritis after an ACL injury depends very much on the injury mechanism and concurrent meniscal injury, as knee articular cartilage continues to heal for 1-2 years after an ACL injury. Therefore the surgeon and rehabilitation team must pay attention to the rehabilitation process and to the decision when to return to sport. Return to sport must be carefully considered, as top-level sport in itself is one main risk factor for osteoarthritis after ACL injury. The present criteria for return to sport need to be revisited, also due to the fact that recurrent injury seems to be an increasing problem. ACL injury prevention programmes are now available in some sports. The key issue for a prevention programme to be successful is proper implementation. Vital factors for success include the individual coaching of the player and well controlled compliance with the training programme. Preventive activities should be more actively supported by the involved athletic community. Despite substantial advances in the field of ACL injury over the past 40 years, substantial management challenges remain.

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

    Directory of Open Access Journals (Sweden)

    Joanne Mouthaan

    2011-11-01

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

  17. 女性运动员 ACL 损伤危险因素研究进展

    Institute of Scientific and Technical Information of China (English)

    蒋飘

    2015-01-01

    随着女性参与竞技体育活动的人数的增加,女性运动员 ACL 损伤也呈上升趋势,特别在足球、曲棍球等项目中,与男性运动员相比,女性运动员 ACL 损伤更是呈高发态势。本文就女性运动员 ACL 损伤危险因素的研究作一综述。

  18. Haemorrhage control in severely injured patients.

    Science.gov (United States)

    Gruen, Russell L; Brohi, Karim; Schreiber, Martin; Balogh, Zsolt J; Pitt, Veronica; Narayan, Mayur; Maier, Ronald V

    2012-09-22

    Most surgeons have adopted damage control surgery for severely injured patients, in which the initial operation is abbreviated after control of bleeding and contamination to allow ongoing resuscitation in the intensive-care unit. Developments in early resuscitation that emphasise rapid control of bleeding, restrictive volume replacement, and prevention or early management of coagulopathy are making definitive surgery during the first operation possible for many patients. Improved topical haemostatic agents and interventional radiology are becoming increasingly useful adjuncts to surgical control of bleeding. Better understanding of trauma-induced coagulopathy is paving the way for the replacement of blind, unguided protocols for blood component therapy with systemic treatments targeting specific deficiencies in coagulation. Similarly, treatments targeting dysregulated inflammatory responses to severe injury are under investigation. As point-of-care diagnostics become more suited to emergency environments, timely targeted intervention for haemorrhage control will result in better patient outcomes and reduced demand for blood products. Our Series paper describes how our understanding of the roles of the microcirculation, inflammation, and coagulation has shaped new and emerging treatment strategies.

  19. Metabolic profile of injured human spinal cord determined using surface microdialysis.

    Science.gov (United States)

    Chen, Suliang; Phang, Isaac; Zoumprouli, Argyro; Papadopoulos, Marios C; Saadoun, Samira

    2016-12-01

    The management of patients having traumatic spinal cord injury would benefit from understanding and monitoring of spinal cord metabolic states. We hypothesized that the metabolism of the injured spinal cord could be visualized using Kohonen self-organizing maps. Sixteen patients with acute, severe spinal cord injuries were studied. Starting within 72 h of the injury, and for up to a week, we monitored the injury site hourly for tissue glucose, lactate, pyruvate, glutamate, and glycerol using microdialysis as well as intraspinal pressure and spinal cord perfusion pressure. A Kohonen map, which is an unsupervised, self-organizing topology-preserving neural network, was used to analyze 3366 h of monitoring data. We first visualized the different spinal cord metabolic states. Our data show that the injured cord assumes one or more of four metabolic states. On the basis of their metabolite profiles, we termed these states near-normal, ischemic, hypermetabolic, and distal. We then visualized how patients' intraspinal pressure and spinal cord perfusion pressure affect spinal cord metabolism. This revealed that for more than 60% of the time, spinal cord metabolism is patient-specific; periods of high intraspinal pressure or low perfusion pressure are not associated with specific spinal cord metabolic patterns. Finally, we determined relationships between spinal cord metabolism and neurological status. Patients with complete deficits have shorter periods of near-normal spinal cord metabolic states (7 ± 4% vs. 58 ± 12%, p injured spinal cord and may thus aid us in treating patients with acute spinal cord injuries.

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

    Institute of Scientific and Technical Information of China (English)

    李欢; 王珂杰; 严伟洪

    2013-01-01

    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。

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

    DEFF Research Database (Denmark)

    Brekke, Anders Falk

    2014-01-01

    between the ACL-reconstructed and contralateral knee during bilateral and unilateral vertical counter movement jumping, and to investigate potential associations between self-reported knee function and kinetics. Material and method: 23 ACL-reconstructed men 27.2±7.5 years, all hamstring autografts, 27......Relationship between knee kinetic outcome measures in counter movement jumps and self-reported function in ACL reconstructed subjects Brekke AF1,2, Nielsen DB2, Holsgaard-Larsen A2 1School of physiotherapy, University College Zealand, Denmark 2Orthopaedic Research Unit, Department of Orthopaedics...... with early-onset OA with associated pain, functional limitations, and decreased quality of life. However, specific knee loading pattern of the medial aspect has not been investigated during different jump-tasks in ACL-reconstructed patients. The purpose was to investigate potential kinetic differences...

  2. Nerve growth factor and injured peripheral nerve regeneration

    Institute of Scientific and Technical Information of China (English)

    Endong Shi; Bingchen Wang; Qingshan Sun

    2008-01-01

    Nerve growth factor (NGF) exhibits many biological activities, such as supply of nutrients, neuroprotection, and the generation and rehabilitation of injured nerves. The neuroprotective and neurotrophic qualities of NGF are generally recognized. NGF may enhance axonal regeneration and myelination of peripheral nerves, as well as cooperatively promote functional recovery of injured nerves and limbs. The clinical efficacy of NGF and its therapeutic potentials are reviewed here. This paper also reviews the latest NGF research developments for repairing injured peripheral nerve, thereby providing scientific evidence for the appropriate clinical application of NGF.

  3. Adapting the Advanced Cardiac Life Support for the Experienced Provider (ACLS-EP course for emergency care education in Rwanda

    Directory of Open Access Journals (Sweden)

    William E. Cayley Jr

    2011-02-01

    Full Text Available The Advanced Cardiac Life Support for the Experienced Provider (ACLS-EP course uses a case-based curriculum to teach emergency resuscitation principles to experienced health care professionals. This article describes the adaptation of the ACLS-EP curriculum to be used in a family medicine training programme in Rwanda, including lessons learned and recommendations for future use of this material for emergency care education in the African setting.

  4. Adapting the Advanced Cardiac Life Support for the Experienced Provider (ACLS-EP) course for emergency care education in Rwanda

    OpenAIRE

    Cayley Jr, William E

    2011-01-01

    The Advanced Cardiac Life Support for the Experienced Provider (ACLS-EP) course uses a case-based curriculum to teach emergency resuscitation principles to experienced health care professionals. This article describes the adaptation of the ACLS-EP curriculum to be used in a family medicine training programme in Rwanda, including lessons learned and recommendations for future use of this material for emergency care education in the African setting.

  5. THE ROLE AND IMPLEMENTATION OF ECCENTRIC TRAINING IN ATHLETIC REHABILITATION: TENDINOPATHY, HAMSTRING STRAINS, AND ACL RECONSTRUCTION

    Science.gov (United States)

    Reiman, Michael

    2011-01-01

    The benefits and proposed physiological mechanisms of eccentric exercise have previously been elucidated and eccentric exercise has been used for well over seventy years. Traditionally, eccentric exercise has been used as a regular component of strength training. However, in recent years, eccentric exercise has been used in rehabilitation to manage a host of conditions. Of note, there is evidence in the literature supporting eccentric exercise for the rehabilitation of tendinopathies, muscle strains, and in anterior cruciate ligament (ACL) rehabilitation. The purpose of this Clinical Commentary is to discuss the physiologic mechanism of eccentric exercise as well as to review the literature regarding the utilization of eccentric training during rehabilitation. A secondary purpose of this commentary is to provide the reader with a framework for the implementation of eccentric training during rehabilitation of tendinopathies, muscle strains, and after ACL reconstruction. PMID:21655455

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

    Science.gov (United States)

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

    2016-05-06

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

  7. Can course format influence the performance of students in an advanced cardiac life support (ACLS program?

    Directory of Open Access Journals (Sweden)

    F.D. Garrido

    2011-01-01

    Full Text Available Advanced cardiac life support (ACLS is a problem-based course that employs simulation techniques to teach the standard management techniques of cardiovascular emergencies. Its structure is periodically revised according to new versions of the American Heart Association guidelines. Since it was introduced in Brazil in 1996, the ACLS has been through two conceptual and structural changes. Detailed documented reports on the effect of these changes on student performance are limited. The objective of the present study was to evaluate the effect of conceptual and structural changes of the course on student ACLS performance at a Brazilian training center. This was a retrospective study of 3266 students divided into two groups according to the teaching model: Model 1 (N = 1181; 1999-2003 and Model 2 (N = 2085; 2003-2007. Model 2 increased practical skill activities to 75% of the total versus 60% in Model 1. Furthermore, the teaching material provided to the students before the course was more objective than that used for Model 1. Scores greater than 85% in the theoretical evaluation and approval in the evaluation of practice by the instructor were considered to be a positive outcome. Multiple logistic regression was used to adjust for potential confounders (specialty, residency, study time, opportunity to enhance practical skills during the course and location where the course was given. Compared to Model 1, Model 2 presented odds ratios (OR indicating better performance in the theoretical (OR = 1.34; 95%CI = 1.10-1.64, practical (OR = 1.19; 95%CI = 0.90-1.57, and combined (OR = 1.38; 95%CI = 1.13-1.68 outcomes. Increasing the time devoted to practical skills did not improve the performance of ACLS students.

  8. Can course format influence the performance of students in an advanced cardiac life support (ACLS) program?

    Science.gov (United States)

    Garrido, F D; Romano, M M D; Schmidt, A; Pazin-Filho, A

    2011-01-01

    Advanced cardiac life support (ACLS) is a problem-based course that employs simulation techniques to teach the standard management techniques of cardiovascular emergencies. Its structure is periodically revised according to new versions of the American Heart Association guidelines. Since it was introduced in Brazil in 1996, the ACLS has been through two conceptual and structural changes. Detailed documented reports on the effect of these changes on student performance are limited. The objective of the present study was to evaluate the effect of conceptual and structural changes of the course on student ACLS performance at a Brazilian training center. This was a retrospective study of 3266 students divided into two groups according to the teaching model: Model 1 (N = 1181; 1999-2003) and Model 2 (N = 2085; 2003-2007). Model 2 increased practical skill activities to 75% of the total versus 60% in Model 1. Furthermore, the teaching material provided to the students before the course was more objective than that used for Model 1. Scores greater than 85% in the theoretical evaluation and approval in the evaluation of practice by the instructor were considered to be a positive outcome. Multiple logistic regression was used to adjust for potential confounders (specialty, residency, study time, opportunity to enhance practical skills during the course and location where the course was given). Compared to Model 1, Model 2 presented odds ratios (OR) indicating better performance in the theoretical (OR = 1.34; 95%CI = 1.10-1.64), practical (OR = 1.19; 95%CI = 0.90-1.57), and combined (OR = 1.38; 95%CI = 1.13-1.68) outcomes. Increasing the time devoted to practical skills did not improve the performance of ACLS students.

  9. Functional and morphological changes in the quadriceps muscle induced by eccentric training after ACL reconstruction

    OpenAIRE

    Brasileiro,Jamilson S.; Pinto,Olga M. S. F.; Mariana A. Ávila; Tania F. Salvini

    2011-01-01

    OBJECTIVES: The purpose of this study was to investigate the contributions of functional and morphological factors in the recovery of the quadriceps muscle after anterior cruciate ligament (ACL) reconstruction. METHODS: Nine subjects (31.3±5.8 years) underwent eccentric exercise sessions twice a week for 12 weeks. Quadriceps muscle function was evaluated using an isokinetic dynamometer (isometric and eccentric peak torque) and electromyography (RMS). Morphological changes were measured using ...

  10. Neural stimulation does not mediate attenuated vascular response in ACL-deficient knees: potential role of local inflammatory mediators.

    Science.gov (United States)

    Miller, Daniel; Salo, Paul; Hart, David A; Leonard, Catherine; Mammoto, Takeo; Bray, Robert C

    2010-01-01

    Chronic inflammation associated with osteoarthritis (OA) alters normal responses and modifies the functionality of the articular vasculature. Altered responsiveness of the vasculature may be due to excessive neural activity associated with chronic pain and inflammation, or from the production of inflammatory mediators which induce vasodilation. Using laser speckle perfusion imaging (LSPI), blood flow to the medial collateral ligament (MCL) of adult rabbits was measured in denervated ACL transected knees (n = 6) and compared to unoperated control (n = 6) and 6-week anterial cruciate ligament (ACL)-transected knees (n = 6). Phenylephrine and neuropeptide Y were applied to the MCL vasculature in topical boluses of 100 microL (dose range 10(-14) to 10(-8) mol and 10(-14) to 10(-9) mol, respectively). Denervation diminished vasoconstrictive responsiveness to phenylephrine compared to both control and ACL-transected knees. Denervation minimally enhanced vascular responses to neuropeptide Y (NPY) compared to ACL deficiency alone, which nevertheless remained significantly diminished from control responses. To evaluate the potential role of inflammatory dilators in the diminished contractile responses, phenylephrine was coadministered with histamine, substance P, and prostaglandin E(2). High-dose histamine, and low-dose substance P and PGE(2) were able to inhibit contractile responses in the MCL of control knees. Excessive neural input does not mediate diminished vasoconstrictive responses in the ACL transected knee; inflammatory mediators may play a role in the deficient vascular responsiveness of the ACL transected knee.

  11. Analytical performances of Hemoclot Protein C Reagent on ACL TOP analyzer.

    Science.gov (United States)

    Calmette, Leyla; Charpentier, Nicole; Tircot, Caroline; Bigot, Delphine; Dunois, Claire; Amiral, Jean; Tetegan, Marcelle; Sep Hieng, Sonnthida; Peltier, Jean-Yves

    2016-12-01

    Our study aimed to evaluate and validate according to standard NF EN ISO 15189 the original protocol ajustement of Hemoclot Protein C (PC) (Hyphen BioMed), clotting-based assay of PC on ACL TOP analyzer (Werfen/Instrumentation Laboratory). We evaluated the performance in terms of imprecision and we validate additional parameters in range B required by the SH GTA 04 (COFRAC): repeatability, reproducibility, detection and quantification limits, limits of linearity, stability, inter-samples and inter-reagents contamination, inaccuracy, evaluation of interferences (hemolysis, bilirubinemia and chyles). A comparison with Hemoclot PC on STA Compact analyzer (Stago) was performed. Coefficients of variation were lower than 5 %. Detection and quantification limits were respectively 8.3 % and 9.3 %. Superior limit of linearity was 140 %. The test didn't diplay any inter-samples and inter-reagents contamination. Reagent after reconstitution was stable 6 hours on ACL TOP. No interferences were observed for hemoglobin lower than 500 mg/dL, for bilirubin lower than and for chyles lower than 300 mg/dL. Comparison with Hemoclot PC on STA analyzer (Stago) was satisfactory. Hemoclot PC adjusted on ACL TOP analyzer showed satisfactory analytical performances with criteria chosen in our study. These data allow a better knowledge of the performances of this test and were useful to make a validation file in range B as recommended by SH GTA 04.

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

    Directory of Open Access Journals (Sweden)

    Kaseb Mohammad Hasan

    2009-05-01

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

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

    Science.gov (United States)

    Kona, Soujanya

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  16. Glucose metabolism in injured tissue: A longitudinal study

    Energy Technology Data Exchange (ETDEWEB)

    Daley, J.M.; Shearer, J.D.; Mastrofrancesco, B.; Caldwell, M.D. (Brown Univ., Providence, RI (USA))

    1990-02-01

    Injured tissue is characterized by increased glucose uptake and increased lactate production as compared to normal tissue. These metabolic changes have been attributed to the presence of inflammatory cells in injured tissues. To correlate these metabolic changes with changes in the inflammatory cell population at various times after injury, we studied the lambda-carrageenan hindlimb wound model in anesthetized rats. Perfusion studies demonstrated that at 3 and 5 days after injury glucose uptake was increased in injured hindlimbs, compared with hindlimbs from pair-fed control animals. At 3, 5, and 10 days after injury, lactate production from glucose was increased in injured hindlimbs, compared with hindlimbs from pair-fed control animals. These metabolic changes were not related to differences in body weight or food intake. There was no difference in glucose oxidation or in oxygen consumption in injured hindlimbs, compared with hindlimbs from pair-fed control animals. The increased glucose uptake and increased lactate production from glucose was coincident with the presence of inflammatory cells--predominantly macrophages--at the site of injury. It is suggested that the glucose metabolism in injured tissue reflects the metabolism of the inflammatory cells at the site of injury.

  17. 冷冻保存同种异体骨-前交叉韧带(ACL)-骨移植实验研究%An experiment on transplantation of cryopreserved bone-anterior cruciate ligament(ACL)-bone allograft

    Institute of Scientific and Technical Information of China (English)

    周建生; 张长春; 潘功平; 胡汝麒

    2004-01-01

    目的探讨自体骨-ACL-骨和二步冷冻保存同种异体骨-ACL-骨移植的组织学、形态学及生物力学的变化特点.方法将60只日本大耳兔和60只新西兰兔随机分成自体骨-ACL-骨移植组和二步冷冻保存骨-ACL-骨同种异体移植组.术中及术后不用免疫抑制剂.术后4、8、12周切取移植膝关节及健侧膝关节,行ACL生物力学测试.术后4、12周切取ACL分别作组织学检查和电镜检查.结果自体移植组和二步冷冻保存同种异体骨-ACL-骨移植组的ACL所测最大拉伸强度和拉伸刚度与同期正常对照ACL相比显著下降(P<0.01)两组之间同期相比其最大拉伸强度和拉伸刚度差异无显著(P>0.05).结论自体骨-ACL-骨移植和二步冷冻保存同种异体骨-ACL-骨移植后具有相同的生物力学性能和组织学愈合过程.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    reconstruction and structured rehabilitation with the option of later ACL reconstruction if needed. The primary outcome was the change from baseline to 2 years in the average score on four subscales of the Knee Injury and Osteoarthritis Outcome Score (KOOS) - pain, symptoms, function in sports and recreation...... no significant differences between the two treatment groups with respect to secondary outcomes. Adverse events were common in both groups. The results were similar when the data were analyzed according to the treatment actually received. CONCLUSIONS: In young, active adults with acute ACL tears, a strategy...

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

    Science.gov (United States)

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

    2016-01-01

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

  20. ACL deficiency impairs the vasoconstrictive efficacy of neuropeptide Y and phenylephrine in articular tissues: a laser speckle perfusion imaging study.

    Science.gov (United States)

    Miller, Daniel; Forrester, Kevin; Leonard, Catherine; Salo, Paul; Bray, Robert C

    2005-01-01

    Sympathetic-derived neuropeptide Y (NPY) helps regulate inflammatory responses in injury and disease, is a vasoconstrictor, and stimulates angiogenesis. Rupture of the anterior cruciate ligament (ACL) is a common clinical presentation that results in tissue inflammation, hyperemia, and angiogenesis in the intact medial collateral ligament (MCL). This study is the first to examine the vasoregulatory role of NPY in ACL-deficient knee joints by using the newly developed technique of laser speckle perfusion imaging (LSPI). MCL blood flow was measured in two groups of adult rabbits: unoperated control (n = 6), and 6-wk ACL transected (n = 5). Under anesthesia, the MCL was surgically exposed and tissue blood flow was imaged at high resolution using LSPI. NPY was applied to the MCL vasculature in topical boluses of 100 mul (dose range 10(-14) to 10(-9) mol), and the alpha-adrenoceptor agonist phenylephrine was applied in doses of 10(-14), 10(-10), and 10(-7) mol. In control rabbits, topical administration of NPY or phenylephrine produced dose-dependent vasopressor responses (maximal effect at 10(-9) mol NPY and 10(-7) mol phenylephrine). In ACL-transected knees, there was little or no vasoconstrictive response to NPY at any dose. The response to phenylephrine was significantly reduced compared with control ligaments. Possible causes of the reduced vasoconstrictive response to NPY in the MCL after 6 wk of ACL deficiency include development of tolerance to the peptide due to a prolonged increase in sympathetic nerve activity or change in the distribution or functionality of the NPY Y(1) receptors. Chronic ACL deficiency leads to profound and protracted hyperemia in associated articular tissues. Abrogation of a vasoconstrictor response to both NPY and phenylephrine in the MCL indicates that ACL deficiency induces major changes in the vascular physiological homeostasis.

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

    Directory of Open Access Journals (Sweden)

    Hirschmann Michael T

    2010-09-01

    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.

  2. Return to Sports after Acute Simultaneous Reconstruction of Anterior Cruciate Ligament Injury and Grade III Medial Collateral Ligament Injury

    Science.gov (United States)

    Bertona, Agustin; Zicaro, Juan Pablo; Viescas, Juan Manuel Gonzalez; Atala, Nicolas; Yacuzzi, Carlos; Costa-Paz, Matias

    2017-01-01

    Objectives: Combined Anterior Cruciate Ligament (ACL) injury and Medial Collateral Ligament (MCL) injury account for 20% of knee ligament lesions. Conservative treatment of MCL and surgical ACL reconstruction are generally recommended. Significant medial instability after non-surgical management of MCL can lead to ACL reconstruction failure. The optimal management for athletes with combined ACL-MCL injuries remains controversial. The purpose of this study was to analyze the functional and clinical evolution of patients who underwent combined ACL-MCL surgery and their return-to-sport level with minimum 2-years follow-up. Methods: A total of 20 athletes with acute simultaneous ACL/Grade III MCL reconstructions were treated between March 2006 and January 2014. The minimum follow-up time was 24 months. Subjective functional results (IKDC, Lysholm), range of motion, anterior-medial and rotational stability (Lachmann, Pivot Shift, valgus stress) were evaluated. The ability to return to sport (Tegner) and the level achieved was recorded. Results: All patients significantly improved functional scores and stability tests. The mean subjective IKDC score improved from 37.7 ± 12.9 (range 21-69) preoperatively to 88.21 ± 4.47 (range 80-96) postoperatively (P sports; 90% reached the level they had prior to the ligamentous injury. Of all competitive athletes, 66% achieved the same level of sport. Conclusion: In athletes with acute ACL-Grade III MCL lesions, an early simultaneous reconstruction can significantly improve the medial and sagittal stability of the knee. This procedure resulted in excellent functional outcomes, with return to the same level of sports in the majority of patients at short-term follow-up.

  3. The role of the anterolateral ligament in ACL insufficient and reconstructed knees on rotatory stability: A biomechanical study on human cadavers.

    Science.gov (United States)

    Tavlo, M; Eljaja, S; Jensen, J T; Siersma, V D; Krogsgaard, M R

    2016-08-01

    Studies suggest that the anterolateral ligament (ALL) is important for knee stability. The purpose was to clarify ALL's effect on rotatory and anterior-posterior stability in the anterior cruciate ligament (ACL)-insufficient and reconstructed knees and the effect of reconstruction of an insufficient ALL. Eighteen cadaveric knees were included. Stability was tested for intact (+ALL), detached (-ALL) and reconstructed (+ reALL) ALL, with ACL removed (-ACL) and reconstructed (+ACL) in six combinations. All were tested in 0, 30, 60, and 90 °C flexion. Anterior-posterior stability was measured with a rolimeter. Rotation with a torque of 8.85 Nm was measured photographically. The ALL was well defined in 78% of knees. ACL reconstruction had a significant effect on anterior-posterior stability. Detaching the ALL had a significant effect on internal rotatory stability and on anterior-posterior stability in ACL-insufficient knees. Reconstruction of ACL and ALL reestablished knee stability. The appearance of the ALL was not uniform. The ALL was an internal rotational stabilizer. Anatomical ALL reconstruction in combination with ACL reconstruction could reestablish stability. ALL reconstruction might be considered in patients with combined ACL and ALL tears, but the clinical effect should be established in a controlled clinical study.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-04-15

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

  5. 确定前交叉韧带损伤概率及危险因素的随机生物力学模型与模拟%Stochastic Biomechanical Model and Simulation for the Injury Rate and Risk Factors of the Non-contact ACL Injury

    Institute of Scientific and Technical Information of China (English)

    李翰君; 刘卉; 张美珍; 于冰

    2014-01-01

    确定损伤风险因素是有效预防非接触性前交叉韧带损伤的关键。目的:建立前交叉韧带损伤随机生物力学模型,确定与损伤率有因果关系的风险因素。方法:在前交叉韧带负荷的生物力学模型基础上建立前交叉韧带损伤的随机生物力学模型,采用蒙特卡洛模拟方法预测急停起跳落地动作时前交叉韧带损伤概率,并判断影响损伤概率的风险因素。随机模型所需要的各独立变量的分布来自于19名男性和18名女性运动员的实测数据。结果:女性损伤概率是男性的4.91±0.25倍。模拟的损伤组比非损伤组的膝屈角更小、向后地面反力峰值更大。结论:模型预测的男、女损伤概率比、损伤膝角均与文献研究结果一致,证明了模型预测前交叉韧带负荷的有效性。着地瞬间的向后地面反作用力第一峰值和膝关节屈角是 ACL损伤的风险因素。%It is important to understand the biomechanical risk factors of the non‐contact ACL injury to develop effective prevention programs .The purpose of this study was to validate a stochastic biomechanical model for non‐contact ACL injuries ,which can determine the cause‐and‐effect relationship and risk factors .Methods :A stochastic biomechanical model for non‐contact ACL injuries was developed and instrumented to a Monte Carlo simulation to estimate the ACL injury rate and risk factors during landing of the stop‐jump task .The distributions of independent variables were determined from vivo data of 19 male and 18 female athletes .Re‐sults :The female‐to‐male non‐contact ACL injury rate ratio was 4 .91 ± 0 .25 .In the simula‐ted injured trials ,there are smaller knee flexion angle ,greater posterior GRF ,and greater prox‐imal tibia anterior shear force in comparison to the simulated uninjured trials .Conclusion :The estimated female‐to‐male non‐contact ACL injury rate ratio and knee flexion

  6. A comparison of the outcome of CPR according to AHA 2005 ACLS and AHA 2010 ACLS guidelines in cardiac arrest: multicenter study.

    Science.gov (United States)

    Ocal, Oktay; Ozucelik, Dogac Niyazi; Avci, Akkan; Yazicioglu, Mustafa; Aydin, Yilmaz; Ayvaci, Baris Murat; Dogan, Halil; Aciksari, Kurtulus; Cukurova, Zafer

    2015-01-01

    The aim of this study was to evaluate whether there is a difference in the return of spontaneous circulation (ROSC) and survival with sequel-free recovery rates between the patients who underwent cardiopulmonary resuscitation (CPR) according to 2005 and 2010 guidelines. This study was conducted in the Bakırköy Dr. Sadi Konuk and Kartal Lütfi Kırdar Training and Research Hospital between dates of October 2010 and 28 February 2011 after approval of Ethics Committee. In the first months of the study, CPR was performed according to AHA 2005 ACLS guidelines (Group-1), while CPR was performed according to AHA 2010 ACLS guidelines after November 2010 (Group-2). Patients were assessed for neurological deficit with Cerebral Performance Categories Scale. Mean age was found as 69.01±13.05 (minimum: 21, maximum: 92) in 86 patients included. Of the 33 patients underwent CPR in the Group 1, ROSC was achieved in 51.5%; and 6.1% of these patients were discharged. Of the 53 patients underwent CPR in the Group 2, ROSC was achieved in 37.7%; and 9.4% of these patients were discharged. Although the number of living patients in Group 2 was higher than Group 1, the difference was not found statistically significant (5 versus 2), (P>0.05). But, neurological outcomes were found better with 2010 compared to 2005 guidelines (3/7 versus 0/2 good cerebral performance). It was found that the 2005 CPR guidelines practices in ED were more successful than the 2010 CPR guidelines practices in ROSC, but less successful in the rate of discharge from hospital and neurological sequel-free discharge rate.

  7. Relationship between jump landing kinematics and peak ACL force during a jump in downhill skiing: a simulation study.

    Science.gov (United States)

    Heinrich, D; van den Bogert, A J; Nachbauer, W

    2014-06-01

    Recent data highlight that competitive skiers face a high risk of injuries especially during off-balance jump landing maneuvers in downhill skiing. The purpose of the present study was to develop a musculo-skeletal modeling and simulation approach to investigate the cause-and-effect relationship between a perturbed landing position, i.e., joint angles and trunk orientation, and the peak force in the anterior cruciate ligament (ACL) during jump landing. A two-dimensional musculo-skeletal model was developed and a baseline simulation was obtained reproducing measurement data of a reference landing movement. Based on the baseline simulation, a series of perturbed landing simulations (n = 1000) was generated. Multiple linear regression was performed to determine a relationship between peak ACL force and the perturbed landing posture. Increased backward lean, hip flexion, knee extension, and ankle dorsiflexion as well as an asymmetric position were related to higher peak ACL forces during jump landing. The orientation of the trunk of the skier was identified as the most important predictor accounting for 60% of the variance of the peak ACL force in the simulations. Teaching of tactical decisions and the inclusion of exercise regimens in ACL injury prevention programs to improve trunk control during landing motions in downhill skiing was concluded.

  8. The effects of gender on quadriceps muscle activation strategies during a maneuver that mimics a high ACL injury risk position.

    Science.gov (United States)

    Myer, Gregory D; Ford, Kevin R; Hewett, Timothy E

    2005-04-01

    While the increased incidence of serious knee injuries in female athletes is well established, the underlying neuromuscular mechanisms related to the elevated ACL injury rate has yet to be delineated. Video analysis of ACL injury during competitive sports play indicates a common body position associated with non-contact ACL injury; the tibia is externally rotated, the knee is close to full extension, the foot is planted and as the limb is decelerated it collapses into valgus. The purpose of the current prospective study was to evaluate gender differences in quadriceps muscle activation strategies when performing a physically challenging, but reproducible maneuver that mimics the high ACL injury risk position (in the absence of high velocity and high loads). Twenty physically active college-aged subjects (10 male and 10 female) performed multiple sets of the prescribed exercise. EMG recordings were employed to measure the ratio of activation between the medial and lateral quadriceps during the 4, 8, 12, 16, and 20th sets of exercise. Females demonstrated decreased RMS medial-to-lateral quadriceps ratios compared to males (F(1,18)=5.88, p=0.026). There was no main effect of set number on RMS quadriceps ratio (p>0.05). The results of this study suggest that females utilize neuromuscular activation strategies which may contribute to "dynamic valgus" and ACL rupture when performing high-risk maneuvers.

  9. Postinfectious ankylosis of the knee after bacterial arthritis following routine anterior cruciate ligament (ACL) reconstruction

    Science.gov (United States)

    Mester, Bastian; Schoepp, Christian; Glombitza, Martin; Rixen, Dieter

    2016-01-01

    Aims and Objectives: Knee arthroscopy is a very common surgical procedure. It belongs to the most frequently performed procedures in orthopedics and traumatology and is considered to have a low complication rate. The risk of postoperative knee infection following ACL reconstrucion is estimated 1-2 %. Thereby the ACL reconstruction cannot always be preserved. Persistent defects after healing and postinfectios osteoarthritis are observed. We present the case of an adolescent patient suffering from postoperative knee infection following routine ACL reconstruction, who is developing - while infection is decreasing - a complete bony ankylosis of the knee, clinically meaning a severe constraint to joint function with complete stiffness of the knee. Materials and Methods: The 13-year-old male patient sustained a distorsion of the right knee during sports at school, after clinical examination magnetic resonance tomography showed a complete tear of the ACL. Single bundle ACL reconstruction was done using autologous hamstrings in Transfix technique. After 5 days at hospital the patient was discharged without any complications. Shortly afterwards the patient was admitted to hospital again presenting a postoperative knee infection. After primary operative revision the patient was shifted to our intensive care unit in a septic condition for stabilization. During 4 month of stay at our hospital multiple operative revisions were performed as arthrotomy, debridement, insertion of antibiotic carriers, complete removal of the autograft and total synovectomy. We found a severe bacterial infection (staphylococcus aureus) of the knee joint, classified Gaechter IV, histopathologically mostly avital cartilage tissue and chronic synovialitis. After decrease of the infection we could discharge the patient from hospital. Results: During the following 8 month under ongoing physiotherapy the patient was developing an increasing stiffness of the knee, finally fixed at 30 degrees of flexion and

  10. Prevention of Cartilage Degeneration and Gait Asymmetry by Lubricin Tribosupplementation in the Rat Following ACL Transection

    Science.gov (United States)

    Jay, Gregory D.; Elsaid, Khaled A.; Kelly, Karen A.; Anderson, Scott C.; Zhang, Ling; Teeple, Erin; Waller, Kimberly; Fleming, Braden C.

    2011-01-01

    Objective To investigate whether cartilage degeneration is prevented or minimized in an anterior cruciate ligament (ACL) injury rat model following a single dose-escalated intra-articular injection of lubricin derived from human synoviocytes in culture (HSL). Methods Unilateral ACL transection (ACLT) of the right hindlimb was performed in Lewis rats (N = 56). Control animals underwent a capsulotomy alone leaving the ACL intact (N = 11). Intra-articular injections (50μl/injection) of PBS (N = 14) and HSL (N = 14; 1600μg/ml) were performed on day 7 post-surgery. Animals were euthanized on day 70 post-surgery. Histological specimens were immunoprobed for lubricin, and sulfated glycosaminoglycans. Urinary CTX-II (uCTX-II) levels were measured on day 35 and 70 post-surgery. Hindlimb maximum applied force was determined using a variable resistor walkway to monitor quadruped gait asymmetries. Results Increased immunostaining for lubricin in the superficial zone and on the surface of cartilage was observed in lubricin-treated and control animals but not the PBS-treated nor the untreated ACLT animals. On post-operative day 35 and 70, uCTXII levels of HSL-treated animals were lower than corresponding untreated and PBS-treated (p=0.005; p<0.001 respectively) animals. ACLT animals treated with HSL and control animals distributed their weight equally between hindlimbs compared to PBS treated or untreated animals (p<0.01). Conclusion A single intra-articular injection of concentrated lubricin, following ACLT, reduced collagen type II degradation and improved weight bearing in the affected joint. This study supports the practice of tribosupplementation with lubricin in retarding cartilage degeneration and possibly the development of post-traumatic OA. PMID:22127873

  11. Quantifying Quadriceps Muscle Strength in Patients With ACL Injury, Focal Cartilage Lesions, and Degenerative Meniscus Tears

    Science.gov (United States)

    Eitzen, Ingrid; Grindem, Hege; Nilstad, Agnethe; Moksnes, Håvard; Risberg, May Arna

    2016-01-01

    Background: Reduced quadriceps strength influences knee function and increases the risk of knee osteoarthritis. Thus, it is of significant clinical relevance to precisely quantify strength deficits in patients with knee injuries. Purpose: To evaluate isokinetic concentric quadriceps muscle strength torque values, assessed both from peak torque and at specific knee flexion joint angles, in patients with anterior cruciate ligament (ACL) injury, focal cartilage lesions, and degenerative meniscus tears. Study Design: Cohort study; Level of evidence, 3. Methods: Data were synthesized from patients included in 3 previously conducted research projects: 2 prospective cohort studies and 1 randomized controlled trial. At the time of inclusion, all patients were candidates for surgery. Isokinetic concentric quadriceps muscle strength measurements (60 deg/s) were performed at baseline (preoperative status) and after a period of progressive supervised exercise therapy (length of rehabilitation period: 5 weeks for ACL injury, 12 weeks for cartilage lesions and degenerative meniscus). Outcome measures were peak torque and torque at specific knee flexion joint angles from 20° to 70°. All patients had unilateral injuries, and side-to-side deficits were calculated. For comparisons between and within groups, we utilized 1-way analysis of variance and paired t tests, respectively. Results: In total, 250 patients were included. At baseline, cartilage patients had the most severe deficit (39.7% ± 24.3%; P torque was consistently measured at 60° of knee flexion, whereas the largest mean deficits were measured at 30° at baseline and 70° at retest for the ACL group, at 70° at baseline and retest for the degenerative meniscus group, and at 60° at baseline and at 50° at retest for the cartilage group. Conclusion: This study underlines the importance of including torque at specific knee flexion joint angles from isokinetic assessments to identify the most severe quadriceps muscle

  12. Effect of amiloride on endoplasmic reticulum stress response in the injured spinal cord of rats.

    Science.gov (United States)

    Kuroiwa, Masahiro; Watanabe, Masahiko; Katoh, Hiroyuki; Suyama, Kaori; Matsuyama, Daisuke; Imai, Takeshi; Mochida, Joji

    2014-10-01

    After traumatic spinal cord injury (SCI), endoplasmic reticulum (ER) stress exacerbates secondary injury, leading to expansion of demyelination and reduced remyelination due to oligodendrocyte precursor cell (OPC) apoptosis. Although recent studies have revealed that amiloride controls ER stress and leads to improvement in several neurological disorders including SCI, its mechanism is not completely understood. Here, we used a rat SCI model to assess the effects of amiloride on functional recovery, secondary damage expansion, ER stress-induced cell death and OPC survival. Hindlimb function in rats with spinal cord contusion significantly improved after amiloride administration. Amiloride significantly decreased the expression of the pro-apoptotic transcription factor CHOP in the injured spinal cord and significantly increased the expression of the ER chaperone GRP78, which protects cells against ER stress. In addition, amiloride treatment led to a significant decrease in ER stress-induced apoptosis and a significant increase of NG2-positive OPCs in the injured spinal cord. Furthermore, in vitro experiments performed to investigate the direct effect of amiloride on OPCs revealed that amiloride reduced CHOP expression in OPCs cultured under ER stress. These results suggest that amiloride controls ER stress in SCI and inhibits cellular apoptosis, contributing to OPC survival. The present study suggests that amiloride may be an effective treatment to reduce ER stress-induced cell death in the acute phase of SCI.

  13. Sustained delivery of bioactive neurotrophin-3 to the injured spinal cord.

    Science.gov (United States)

    Elliott Donaghue, Irja; Tator, Charles H; Shoichet, Molly S

    2015-01-01

    Spinal cord injury is a debilitating condition that currently lacks effective clinical treatment. Neurotrophin-3 (NT-3) has been demonstrated in experimental animal models to induce axonal regeneration and functional improvements, yet its local delivery remains challenging. For ultimate clinical translation, a drug delivery system is required for localized, sustained, and minimally invasive release. Here, an injectable composite drug delivery system (DDS) composed of biodegradable polymeric nanoparticles dispersed in a hyaluronan/methyl cellulose hydrogel was injected into the intrathecal space to achieve acute local delivery to the spinal cord after a thoracic clip compression injury. NT-3 was encapsulated in the DDS and released in vitro for up to 50 d. With a single injection of the DDS into the intrathecal space of the injured spinal cord, NT-3 diffused ventrally through the cord and was detectable in the spinal cord for at least 28 d therein. Delivery of NT-3 resulted in significant axon growth with no effect on the astroglial response to injury in comparison with vehicle and injury controls. NT-3 treatment promoted functional improvements at 21 d according to the Basso Beattie Bresnahan locomotor scale in comparison with the DDS alone. The sustained delivery of bioactive NT-3 to the injured spinal cord achieved in this study demonstrates the promise of this DDS for central nervous system repair.

  14. Multivariable robust controller design of ACLS using loop-shaping approach

    Science.gov (United States)

    Dong, Chaoyang; Cui, Haihua; Wang, Qing

    2008-10-01

    In this paper a multivariable robust controller design approach of the ACLS is accomplished by using robust loop-shaping techniques. In order to avoid the inefficient way of choosing the weight functions by trial-and-error method, the structured genetic algorithm (SGA) approach is introduced, which is capable of simultaneously searching the orders and coefficients of the pre- and post-compensator for weight matrices. According to this approach, engineers can achieve an ideal loop-shape which lies in an appropriate region relating to the desired performance specifications. The effectiveness of this approach is illustrated by the longitudinal equations of a carrier-based aircraft's motion design example.

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

    Directory of Open Access Journals (Sweden)

    Marília S. Andrade

    2014-05-01

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

  16. Thermodynamic Optimization of TmCl3-ACl (A=Na, K, Rb, Cs) Phase Diagrams

    Institute of Scientific and Technical Information of China (English)

    Ye Xinyu; Zhang Jing; Sun Yimin; Wang Yu; Tan Junjun

    2005-01-01

    From the measured phase equilibria data and experimental thermochemical properties, the TmCl3-ACl (A=Na, K, Rb, Cs) phase diagrams were optimized and calculated using the CALPHAD technique. For describing the Gibbs energies of the liquid phase in these systems, the new modified quasichemical model in the pair-approximation for short-range ordering was used. A set of thermodynamic functions was optimized and gotten based on an interactive computer-assisted analysis. The calculated phase diagrams and thermodynamic data are self-consistent.

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

    Science.gov (United States)

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

    2014-01-01

    Objectives: Graft survivorship, reinjury rates, and career length are poorly understood after ACL reconstruction in the elite, NCAA Division-I athlete. The purpose of this study was to examine the outcomes of ACL reconstruction in a Division-I athlete cohort. Methods: Retrospective chart review was performed of all Division-I athletes at a single, public university from 2000 to 2009 until completion of eligibility. Athletes with a Pre-collegiate (PC) and Intra-collegiate (IC) ACL reconstruction were separated into two cohorts. Graft survivorship, reoperation rates, and career length information was collected. Results: 35 athletes were identified with a pre-collegiate (PC) ACL reconstruction; 60 with an intra-collegiate (IC) reconstruction. The PC group had a 17.1% injury rate to the original graft, with a 20.0% rate of contralateral ACL injury. For the IC group, the reinjury rates were 1.9% to the ACL graft, with a 9.2% rate of contralateral ACL injury after an IntraCollegiate ACL reconstruction. The PC group used 78% of their total eligibility (avg 3.11 yrs). Athletes in the IC group used an average of 77% of their remaining NCAA eligibility. 88.3% of the IC group played an additional non-redshirt year after their injury. Reoperation rate for the PC group was 51.4% and 20.3% for the IC group. Conclusion: Reoperation and reinjury rates are high after ACL reconstruction in the Division-I athlete. Pre-collegiate ACL reconstruction is associated with a very high rate of repeat ACL reinjury to the graft or opposite knee (37.1%). The majority of athletes are able to return to play after successful reconstruction.

  18. Psychoactive substances in seriously injured drivers in Denmark

    DEFF Research Database (Denmark)

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

    2013-01-01

    found to be above the Danish legal limit in 4.9% of injured drivers. Young men (median age 31 years) were over-represented among injured drivers who violated Danish law for alcohol and drugs. Diazepam (4.4%), tramadol (3.2%), and clonazepam (3.0%) were the medicinal drugs most frequently detected......This study assesses the presence of a number of psychoactive substances, including alcohol, based on blood samples from 840 seriously injured drivers admitted to five selected hospitals located in five different regions of Denmark. The study was a part of the EU 6th framework program DRUID (Driving...... Under the Influence of Drugs, Alcohol and Medicines). Blood samples were screened for 30 illegal and legal psychoactive substances and metabolites as well as ethanol. Danish legal limits were used to evaluate the frequency of drivers violating the Danish legislation while limit of quantification (LOQ...

  19. Pain and knee function in relation to degree of bone bruise after acute anterior cruciate ligament rupture

    DEFF Research Database (Denmark)

    Szkopek, K; Warming, Torsten; Neergaard, K;

    2012-01-01

    and the bone bruise volume of the lateral femoral condyle. Patients with bone bruise of the medial tibia and patients with meniscal lesions had more pain. It is suggested that pain and decreased function after acute ACL injury most likely is related to soft tissue and cartilage injury and not to bone bruise....

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

    Science.gov (United States)

    Zierold, Kristina M

    2016-04-01

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

  1. Rescue and treatment of severely injured lower extremities

    Institute of Scientific and Technical Information of China (English)

    GUO Qi-feng; XU Zhong-he

    2005-01-01

    Objective: To explore a treatment approach for severely injured lower extremities. Methods: The data of 42 patients with severely traumatic lower extremities from 1989 to 1999 were retrospectively reviewed. According to MESS(mangled extremity severity score) the mean score of all the limbs was 6.24±1.45, 34 cases had MESS score<7 and 8 cases had MESS score≥7. Treatment approaches included microvascular anastomosis technique, compound tissue flap transplantation technique and compound bone tissue flap transplantation. Conclusions: Successful emergency treatment of severely injured lower extremities could be achieved by using microsurgery techniques and strict controlling of lower extremity salvagel indications.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-05-15

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

  3. Coil embolization of internal mammary artery injured during central vein catheter and cardiac pacemaker lead insertion

    Energy Technology Data Exchange (ETDEWEB)

    Chemelli, A.P. [Department of Radiology, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck (Austria)], E-mail: Andreas.Chemelli@i-med.ac.at; Chemelli-Steingruber, I.E. [Department of Radiology, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck (Austria); Bonaros, N. [Department of Cardiovascular Surgery, Innsbruck Medical University (Austria); Luckner, G. [Department of Anaesthesiology and Critical Care Medicine, Innsbruck Medical University (Austria); Millonig, G. [Department of Gastroenterology and Hepatology, Innsbruck Medical University (Austria); Seppi, K. [Department of Neurology, Innsbruck Medical University (Austria); Lottersberger, C.; Jaschke, W. [Department of Radiology, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck (Austria)

    2009-08-15

    Purpose: This study describes several cases of endovascular coil embolization of the proximal internal mammary artery injured by blind approach to the subclavian vein for central venous catheter or pacemaker lead insertion. Materials and methods: We conducted a retrospective analysis of five patients with iatrogenic arterial lesions of the internal mammary artery (IMA). The lesions occurred in three patients from a puncture of the subclavian vein during insertion of a central venous catheter and in two patients from a puncture of the subclavian vein for insertion of a pacemaker lead. Four patients had acute symptoms of bleeding with mediastinal hematoma and hematothorax and one patient was investigated in a chronic stage. A pseudoaneurysm was detected in all five patients. All four acute and hemodynamic unstable patients required hemodynamic support. Results: In all patients, embolization was performed using a coaxial catheter technique, and a long segment of the IMA adjacent distally and proximally to the source of bleeding was occluded with pushable microcoils. In one patient, additional mechanically detachable microcoils were used at the very proximal part of the IMA. Microcoil embolization of the IMA was successful in all patients, and the source of bleeding was eliminated in all patients. Conclusion: Transarterial coil embolization is a feasible and efficient method in treating acute bleeding and pseudoaneurysm of the IMA and should be considered if mediastinal hematoma or hemathorax occurs after blind puncture of the subclavian vein.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  5. Joint loads resulting in ACL rupture: Effects of age, sex, and body mass on injury load and mode of failure in a mouse model.

    Science.gov (United States)

    Blaker, Carina L; Little, Christopher B; Clarke, Elizabeth C

    2016-09-07

    Anterior cruciate ligament (ACL) tears are a common knee injury with a known but poorly understood association with secondary joint injuries and post-traumatic osteoarthritis (OA). Female sex and age are known risk factors for ACL injury but these variables are rarely explored in mouse models of injury. This study aimed to further characterize a non-surgical ACL injury model to determine its clinical relevance across a wider range of mouse specifications. Cadaveric and anesthetized C57BL/6 mice (9-52 weeks of age) underwent joint loading to investigate the effects of age, sex, and body mass on ACL injury mechanisms. The ACL injury load (whole joint load required to rupture the ACL) was measured from force-displacement data, and mode of failure was assessed using micro-dissection and histology. ACL injury load was found to increase with body mass and age (p mode of ACL failure varied with both age and sex groups. Avulsion fractures (complete or mixed with mid-substance tears) were common in all age groups but the proportion of mixed and mid-substance failures increased with age. Females were more likely than males to have a major avulsion relative to a mid-substance tear (p model. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.

  6. Using Reflexive ACL to Unilaterally Access a Network%用Reflexive ACL实现网络单向访问

    Institute of Scientific and Technical Information of China (English)

    张昆朋

    2006-01-01

    通过建立路由器访问控制列表,可以控制任何IP地址对网络的访问,但要实现网络的单向访问,一般的访问列表是无法做到的.本文从实际应用的角度出发,利用一种特殊的ACL-Reflexive ACL,即自反访问控制列表,来实现网络的单向访问,并分析、阐述了它的配置过程.

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

    Institute of Scientific and Technical Information of China (English)

    Sun Yimin; Zhang Jing; Guan Mingyun; Qiao Zhiyu

    2005-01-01

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

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    BACKGROUND: Adolescent female football and handball players are among the athletes with the highest risk of sustaining anterior cruciate ligament (ACL) injuries. AIM: This study evaluated the effects of evidence-based lower extremity injury prevention training on neuromuscular and biomechanical...... risk factors for non-contact ACL injury. METHODS: 40 adolescent female football and handball players (15-16 years) were randomly allocated to a control group (CON, n=20) or neuromuscular training group (NMT, n=20). The NMT group performed an injury prevention programme as a warm-up before their usual...

  9. Differential expression of fatty acid synthase genes, Acl, Fat and Kas, in Capsicum fruit.

    Science.gov (United States)

    Aluru, Maneesha R; Mazourek, Michael; Landry, Laurie G; Curry, Jeanne; Jahn, Molly; O'Connell, Mary A

    2003-07-01

    The biosynthesis of capsaicinoids in the placenta of chilli fruit is modelled to require components of the fatty acid synthase (FAS) complex. Three candidate genes for subunits in this complex, Kas, Acl, and Fat, isolated based on differential expression, were characterized. Transcription of these three genes was placental-specific and RNA abundance was positively correlated with degree of pungency. Kas and Acl were mapped to linkage group 1 and Fat to linkage group 6. None of the genes is linked to the pungency locus, C, on linkage group 2. KAS accumulation was positively correlated with pungency. Western blots of placental extracts and histological sections both demonstrated that the accumulation of this enzyme was correlated with fruit pungency and KAS was immunolocalized to the expected cell layer, the placental epidermis. Enzyme activity of the recombinant form of the placental-specific KAS was confirmed using crude cell extracts. These FAS components are fruit-specific members of their respective gene families. These genes are predicted to be associated with Capsicum fruit traits, for example, capsaicinoid biosynthesis or fatty acid biosynthesis necessary for placental development.

  10. Comparison of grafts for anatomical reconstruction of the ACL: patellar versus semitendinosus/gracilis

    Directory of Open Access Journals (Sweden)

    Patrícia Barros Bitun

    2015-02-01

    Full Text Available OBJECTIVE: To compare the functional results from surgical treatment for anatomical reconstruction of the anterior cruciate ligament (ACL with a single band, using two types of autologous grafts.METHODS: Twenty-seven patients who underwent anatomical reconstruction of the ACL by means of the Chambat technique were evaluated prospectively. They were divided into two groups: A, with 14 patients, using grafts from flexor tendons; and B, with 13 patients, using grafts from the patellar tendon. In both groups, fixation was performed using an absorbable interference screw.RESULTS: Based on the Lysholm score, group A presented a mean score of 71.6 in the first month, while B presented 75. At the end of the sixth month, both groups presented 96.6. Evaluation of the total IKDC showed that in the first month, the majority of the patients, both in group A (85.7% and in group B (76.9%, presented a knee assessment that was close to normal. In the sixth month, 92.9% of group A had normal presentations, and 100% of group B.CONCLUSION: According to the Lysholm functional evaluation and the IKDC subjective assessment, there was no statistically significant difference in the results between the groups, and the results were better in the sixth month.

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

    Science.gov (United States)

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

    2008-11-01

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

  12. Identification of types of landings after blocking in volleyball associated with risk of ACL injury.

    Science.gov (United States)

    Zahradnik, David; Jandacka, Daniel; Farana, Roman; Uchytil, Jaroslav; Hamill, Joseph

    2017-03-01

    Landing with a low knee flexion angle after volleyball block jumps may be associated with an increased risk of anterior cruciate ligament (ACL) injury. The aim of the present study was to identify the types of volleyball landings after blocks where the knee flexion angle is found to be under a critical knee flexion angle value of 30° at the instant of the first peak of the ground reaction force (GRF). Synchronized kinematic and kinetic data were collected for each trial. T-tests were used to determine if each knee flexion angle at the instant of the peak GRF was significantly different from the critical value of 30°. A repeated measures ANOVA was used to compare knee flexion angle, time to first peak and the magnitude of the first peak of the resultant GRF and knee stiffness. Significantly lower knee flexion angles were found in the "go" landing (p = .01, ES = 0.6) and the "reverse" landing (p = .02, ES = 0.6) only. The results for knee flexion angle and GRF parameters indicated a significant difference between a "reverse" and "go" and other types of landings, except the "side stick" landing for GRF. The "reverse" and "go" landings may present a risk for ACL injury due to the single-leg landing of these activities that have an associated mediolateral movement.

  13. Validation of GAITRite and PROMIS as high-throughput physical function outcome measures following ACL reconstruction.

    Science.gov (United States)

    Papuga, M Owen; Beck, Christopher A; Kates, Stephen L; Schwarz, Edward M; Maloney, Michael D

    2014-06-01

    New healthcare demands for quality measures of elective procedures, such as anterior cruciate ligament (ACL) reconstructive surgery, warrant the establishment of high throughput outcomes for high volume clinics. To this end, we evaluated the PROMIS and GAITRite as physical function outcome measures to quantify early healing and post-operative complications in 106 patients at pre-operative and 3, 10, 20 and 52 weeks post-ACL reconstruction with bone-tendon-bone autograft, and compared the results to the current IKDC validated outcome measure. The results showed that both PROMIS and GAITRite were significantly quicker to administer versus IKDC (pPROMIS and GAITRite detected a significant decrease in physical function at 3 weeks post-operative, and a significant improvement at 10 weeks post-operative versus pre-operative (pPROMIS and IKDC detected significant improvement out to 52 weeks post-operative (pPROMIS, with a combined correlation value of 0.8954 (pPROMIS is a diagnostic test for poor outcomes.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-07-15

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

  15. Systematic review: Annual incidence of ACL injury and surgery in various populations.

    Science.gov (United States)

    Moses, Bassam; Orchard, John; Orchard, Jessica

    2012-07-01

    Accurate documentation of injury incidence is critical for study of injury risk factors and prevention. Comparisons of published incidences of anterior cruciate ligament (ACL) injuries and surgical reconstructions are difficult, however, because of the variations in units. Some studies report absolute time-based denominators (such as annual incidence or incidence per 100,000 person years), whereas others report exposure-based denominators (such as incidence per 1,000 player hours or athlete exposures). We converted exposure-based units into annual incidences to compare various studies. National population studies show annual incidence rates of up to 0.05% per person per year in Australia. Professional athletes in basketball, soccer, and the other football codes report an annual incidence of 0.15%-3.7% in studies with at least a moderate sample size. Annual ACL incidence in amateur sporting groups was generally higher than the entire population but lower than among professional athletes. Converting incidence rates to annual units allowed better comparisons to be made between population rates across different studies.

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

    Science.gov (United States)

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

    2008-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Jung Ho-Joong

    2009-05-01

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

  18. Psychoactive substances in seriously injured drivers in Denmark

    DEFF Research Database (Denmark)

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

    2013-01-01

    This study assesses the presence of a number of psychoactive substances, including alcohol, based on blood samples from 840 seriously injured drivers admitted to five selected hospitals located in five different regions of Denmark. The study was a part of the EU 6th framework program DRUID (Drivi...

  19. Recovery of Sublethally Injured Bacteria Using Selective Agar Overlays.

    Science.gov (United States)

    McKillip, John L.

    2001-01-01

    This experiment subjects bacteria in a food sample and an environmental sample to conditions of sublethal stress in order to assess the effectiveness of the agar overlay method to recover sublethally injured cells compared to direct plating onto the appropriate selective medium. (SAH)

  20. Personal Adjustment Training for the Spinal Cord Injured

    Science.gov (United States)

    Roessler, Richard; And Others

    1976-01-01

    This article describes experiences with Personal Achievement Skills (PAS), a group counseling process in a spinal cord injury project, emphasizing training in communication and goal setting in the context of group process. Issues in conducting such training and providing comprehensive service to the spinal cord injured are discussed in detail.…

  1. The Rehabilitation of the Spinal Cord-Injured Street Person.

    Science.gov (United States)

    Coven, Arnold B.; Glazeroff, Herbert

    1978-01-01

    The spinal cord-injured street person is especially resistant to rehabilitation. His life style is characterized by the use of physical power and mobility to survive and gain respect. He loses this main form of control and attempts to manipulate the treatment environment to care for him while he avoids confronting his disability. (Author)

  2. Sexual Counseling with Spinal Cord-Injured Clients

    Science.gov (United States)

    Miller, Donald K.

    1975-01-01

    Spinal cord-injured clients have many fears and misapprehensions about their sexual functioning. Such misapprehensions can be helped by the counselor's willingness to discuss sexual issues openly. Clients need a clear and accurate picture of the facts, as well as encouragement and support to help them rediscover their sexuality. (Author)

  3. Long-term functional health status of severely injured patients

    NARCIS (Netherlands)

    Holtslag, H. R.; Post, M. W.; Lindeman, E.; Van der Werken, Chr.

    2007-01-01

    Background: Studies of the consequences of major trauma have traditionally focused on mortality rates. The aims of this study were, firstly, to investigate the long-term functional health status in a large, unselected group of severely injured patients and to compare this with normative data, and se

  4. Interleukin 6 in intact and injured mouse peripheral nerves.

    Science.gov (United States)

    Reichert, F; Levitzky, R; Rotshenker, S

    1996-03-01

    The multifunctional cytokine interleukin 6 (IL-6) has direct growth, survival and differentiation effects on peripheral and central neurons. Furthermore, it can modulate the production by non-neuronal cells of other cytokines and growth factors, and thereby affect nerve cells indirectly. We have studied IL-6 expression and production in intact and injured peripheral nerves of C57/BL/6NHSD mice, which display the normal rapid progression of Wallerian degeneration. The IL-6 mRNA was detected in nerves degenerating in vitro or in vivo, but not in intact nerves. In vitro- and in vivo-degenerating nerve segments and neuroma nerve segments synthesized and secreted IL-6. The onset of IL-6 production was rapid and prolonged. It was detected as early as 2 h after injury and persisted for the entire period of 21 days tested after the injury. Of the non-neuronal cells that reside in intact and injured nerves, macrophages and fibroblasts were the major contributors to IL-6 production. We also studied IL-6 production in intact and injured nerves of mutant C57BL/6-WLD/OLA/NHSD mice, which display very slow progression of Wallerian degeneration. Injured nerves of C57BL/6-WLD/OLA/NHSD mice produced significantly lower amounts of IL-6 than did rapidly degenerating nerves of C57/BL/6NHSD mice.

  5. Characteristics of injured children attending the emergency department : patients potentially in need of rehabilitation

    NARCIS (Netherlands)

    Sturms, L.M.; van der Sluis, C.K.; Groothoff, J.W.; Ten Duis, H.J.; Eisma, W.H.

    2002-01-01

    Objective: To provide an epidemiological overview of the characteristics of injured children and to compare hospitalized and nonhospitalized injured children to identify predictors of hospitalization and, with that, possible predictors of disablement. Design: Retrospective analysis of data obtained

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

    Science.gov (United States)

    American Council of Learned Societies, 2010

    2010-01-01

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

  7. Combined lipid emulsion and ACLS resuscitation following bupivacaine- and hypoxia-induced cardiovascular collapse in unanesthetized swine.

    Science.gov (United States)

    Bushey, Brent A; Auld, Victor H; Volk, John E; Vacchiano, Charles A

    2011-04-01

    This study examined whether combining lipid emulsion and advanced cardiac life support (ACLS) improves survival in an unanesthetized swine model of bupivacaine- and hypoxia-induced cardiovascular collapse. Arterial and venous catheters and a tracheostomy were surgically placed in 26 swine receiving inhalation anesthesia. After a 1-hour recovery period, bupivacaine (5 mg/kg) was administered intravenously over 15 seconds. Following 1 minute of observation and 3 minutes of mechanical airway obstruction, during which all animals exhibited complete cardiovascular collapse, ACLS was initiated. Animals were randomized to receive either intravenous saline or 20% lipid emulsion commencing with the initiation ofACLS. Survival was defined as a return of spontaneous circulation (ROSC) with unsupported blood pressure greater than 60 mm Hg for 10 minutes after 25 minutes of resuscitation effort. Data collection included electrocardiogram, arterial blood pressure, and arterial and mixed venous oxygen saturations. There was no significant difference in survival between the saline group (4/12, 33%) and lipid emulsion group (6/12, 50%; P > .05). Additionally, there was no significant difference between groups of surviving animals in the time to ROSC (P > .05). The combination of lipid emulsion and ACLS did not improve survival from bupivacaine- and hypoxia-induced cardiovascular collapse in unanesthetized swine.

  8. Handheld E-Book Readers and Scholarship Report and Reader Survey: ACLS Humanities E-Book. White Paper No. 3

    Science.gov (United States)

    Gielen, Nina

    2010-01-01

    This report describes a conversion experiment and subsequent reader survey conducted by the American Council of Learned Societies (ACLS) Humanities E-Book (HEB) in late 2009 and early 2010 to assess the viability of using scholarly monographs with handheld e-readers. As sample content, HEB selected six titles from its own online collection, three…

  9. Changing epidemiology of American cutaneous leishmaniasis (ACL) in Brazil: a disease of the urban-rural interface.

    Science.gov (United States)

    Oliveira, Carlos C G; Lacerda, Henio G; Martins, Daniella R M; Barbosa, James D A; Monteiro, Gloria R; Queiroz, Jose W; Sousa, Jacira M A; Ximenes, Maria F F M; Jeronimo, Selma M B

    2004-04-01

    American cutaneous leishmaniasis (ACL) was first reported from the south-western region of the state of Rio Grande do Norte in 1987. São Miguel municipality and adjacent areas have accounted for 90% of the American cutaneous leishmaniasis cases in the region since then. A population survey conducted in São Miguel and adjacent areas was undertaken to identify individuals with a history of ACL. The incidence of ACL, distribution by age and gender, clinical characteristics, family clustering, relationship to animals, association with skin test responses, and development of mucosal lesions were determined. Males and females were equally likely to be infected by Leishmania. Thirty-eight percent of the individuals tested were found to be Montenegro skin test positive. No difference in the Montenegro skin test was observed with gender, but the response increased with age. Among the 140 ACL cases treated in a 4-year period in São Miguel, five (3.6%) developed mucosal involvement. Sandflies capable of transmitting Leishmania were captured inside households and in the areas surrounding them. The high density of sandfly species potentially able to transmit Leishmania species and the age distribution of cases of cutaneous leishmaniasis suggest that transmission of the parasite occurred inside or in close proximity to houses.

  10. An intelligent recovery progress evaluation system for ACL reconstructed subjects using integrated 3-D kinematics and EMG features.

    Science.gov (United States)

    Malik, Owais A; Senanayake, S M N Arosha; Zaheer, Dansih

    2015-03-01

    An intelligent recovery evaluation system is presented for objective assessment and performance monitoring of anterior cruciate ligament reconstructed (ACL-R) subjects. The system acquires 3-D kinematics of tibiofemoral joint and electromyography (EMG) data from surrounding muscles during various ambulatory and balance testing activities through wireless body-mounted inertial and EMG sensors, respectively. An integrated feature set is generated based on different features extracted from data collected for each activity. The fuzzy clustering and adaptive neuro-fuzzy inference techniques are applied to these integrated feature sets in order to provide different recovery progress assessment indicators (e.g., current stage of recovery, percentage of recovery progress as compared to healthy group, etc.) for ACL-R subjects. The system was trained and tested on data collected from a group of healthy and ACL-R subjects. For recovery stage identification, the average testing accuracy of the system was found above 95% (95-99%) for ambulatory activities and above 80% (80-84%) for balance testing activities. The overall recovery evaluation performed by the proposed system was found consistent with the assessment made by the physiotherapists using standard subjective/objective scores. The validated system can potentially be used as a decision supporting tool by physiatrists, physiotherapists, and clinicians for quantitative rehabilitation analysis of ACL-R subjects in conjunction with the existing recovery monitoring systems.

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

    NARCIS (Netherlands)

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

    2015-01-01

    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

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

    NARCIS (Netherlands)

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

    2015-01-01

    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

  13. Combined sciatic femoral nerve block in a case of restrictive cardiomyopathy for arthroscopy and anterior cruciate ligament (ACL reconstruction

    Directory of Open Access Journals (Sweden)

    Gaurab Maitra

    2007-01-01

    Full Text Available Restrictive cardiomyopathy is a rare heart muscle disease resulting in impaired ventricular filling, low cardiac output and a propensity for development of heart failure with minimal fluid overload. Here, we present the management of a case of restrictive cardiomyopathy undergoing arthroscopy and anterior cruciate liga-ment (ACL reconstruction.

  14. MRI evaluation of the knee post double bundle ACL reconstruction: Association of graft findings and comparison with arthroscopy

    Directory of Open Access Journals (Sweden)

    Mohammed Farghally Amin

    2016-06-01

    Conclusion: Increased signal intensity within the anteromedial or posterolateral bundles of a double bundle ACL reconstruction is frequently associated with a partial tear. Impingement of the anteromedial graft is frequently associated with partial tear and increased signal intensity which is proved by arthroscopy/surgery. A low incidence of other complications is seen.

  15. Motor learning strategies in basketball players and its implications for ACL injury prevention: a randomized controlled trial

    NARCIS (Netherlands)

    Benjaminse, Anne; Otten, Bert; Gokeler, Alli; Lemmink, K.A.P.M.

    2015-01-01

    Purpose Adding external focus of attention (EF, focus on the movement effect) may optimize current anterior cruci- ate ligament (ACL) injury prevention programmes. The purpose of the current study was to investigate the effects of an EF, by a visual stimulus and an internal focus, by a verbal stimul

  16. Motor learning strategies in basketball players and its implications for ACL injury prevention : a randomized controlled trial

    NARCIS (Netherlands)

    Benjaminse, Anne; Otten, Bert; Gokeler, Alli; Diercks, Ron L; Lemmink, Koen A P M

    2015-01-01

    PURPOSE: Adding external focus of attention (EF, focus on the movement effect) may optimize current anterior cruciate ligament (ACL) injury prevention programmes. The purpose of the current study was to investigate the effects of an EF, by a visual stimulus and an internal focus, by a verbal stimulu

  17. Quantitative assessment of immune cells in the injured spinal cord tissue by flow cytometry: a novel use for a cell purification method.

    Science.gov (United States)

    Nguyen, Hal X; Beck, Kevin D; Anderson, Aileen J

    2011-04-09

    Detection of immune cells in the injured central nervous system (CNS) using morphological or histological techniques has not always provided true quantitative analysis of cellular inflammation. Flow cytometry is a quick alternative method to quantify immune cells in the injured brain or spinal cord tissue. Historically, flow cytometry has been used to quantify immune cells collected from blood or dissociated spleen or thymus, and only a few studies have attempted to quantify immune cells in the injured spinal cord by flow cytometry using fresh dissociated cord tissue. However, the dissociated spinal cord tissue is concentrated with myelin debris that can be mistaken for cells and reduce cell count reliability obtained by the flow cytometer. We have advanced a cell preparation method using the OptiPrep gradient system to effectively separate lipid/myelin debris from cells, providing sensitive and reliable quantifications of cellular inflammation in the injured spinal cord by flow cytometry. As described in our recent study (Beck & Nguyen et al., Brain. 2010 Feb; 133 (Pt 2): 433-47), the OptiPrep cell preparation had increased sensitivity to detect cellular inflammation in the injured spinal cord, with counts of specific cell types correlating with injury severity. Critically, novel usage of this method provided the first characterization of acute and chronic cellular inflammation after SCI to include a complete time course for polymorphonuclear leukocytes (PMNs, neutrophils), macrophages/microglia, and T-cells over a period ranging from 2 hours to 180 days post-injury (dpi), identifying a surprising novel second phase of cellular inflammation. Thorough characterization of cellular inflammation using this method may provide a better understanding of neuroinflammation in the injured CNS, and reveal an important multiphasic component of neuroinflammation that may be critical for the design and implementation of rational therapeutic treatment strategies, including both

  18. Echocardiography integrated ACLS protocol versus con-ventional cardiopulmonary resuscitation in patients with

    Directory of Open Access Journals (Sweden)

    Chardoli Mojtaba

    2012-11-01

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

  19. Predictive mathematical modeling of knee static laxity after ACL reconstruction: in vivo analysis.

    Science.gov (United States)

    Signorelli, C; Bonanzinga, T; Grassi, A; Lopomo, N; Zaffagnini, S; Marcacci, M

    2016-11-01

    Previous studies did not take into consideration such large variety of surgery variables which describe the performed anterior cruciate ligament (ACL) reconstruction and the interaction among them in the definition of postoperative outcome. Seventeen patients who underwent navigated Single Bundle plus Lateral Plasty ACL reconstruction were enrolled in the study. Static laxity was evaluated as the value of anterior/posterior displacement at 30° and at 90° of flexion, internal/external rotation at 30° and 90° of knee flexion, varus/valgus test at 0° and 30° of flexion. The evaluated surgical variables were analyzed through a multivariate analysis defining the following models: AP30estimate, AP90estimate, IE30estimate, IE90estimate, VV0estimate, VV30estimate. Surgical variables has been defined as the angles between the tibial tunnel and the three planes, the lengths of the tunnel and the relationship between native footprints and tunnels. An analogous characterization was performed for the femoral side. Performance and significance of the defined models have been quantified by the correlation ratio (η(2)) and the corresponding p-value (*p static laxity values. The only exception was the AP90estimate model. The η(2) ranged from 0.568 (IE90estimate) to 0.995 (IE30estimate). The orientation of the tibial tunnel resulted to be the most important surgical variable for the performed laxity estimation. Mathematical models for postoperative knee laxity is a useful tool to evaluate the effects of different surgical variables on the postoperative outcome.

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

  1. Macrophage and microglial plasticity in the injured spinal cord.

    Science.gov (United States)

    David, S; Greenhalgh, A D; Kroner, A

    2015-10-29

    Macrophages in the injured spinal cord arise from resident microglia and from infiltrating peripheral myeloid cells. Microglia respond within minutes after central nervous system (CNS) injury and along with other CNS cells signal the influx of their peripheral counterpart. Although some of the functions they carry out are similar, they appear to be specialized to perform particular roles after CNS injury. Microglia and macrophages are very plastic cells that can change their phenotype drastically in response to in vitro and in vivo conditions. They can change from pro-inflammatory, cytotoxic cells to anti-inflammatory, pro-repair phenotypes. The microenvironment of the injured CNS importantly influences macrophage plasticity. This review discusses the phagocytosis and cytokine-mediated effects on macrophage plasticity in the context of spinal cord injury.

  2. Les jeux de l’injure dans Henry IV

    OpenAIRE

    Vienne-Guerrin, Nathalie

    2006-01-01

    International audience; Il s’agit d’analyser les mécanismes ludiques qui président aux « joutes de jactance » qui sont si caractéristiques d’Henry iv et à l’aune desquelles on peut mesurer l’ambiguïté et l’évolution de la relation entre Falstaff et Hal / Henry. Nous examinons comment ces tournois d’injures se manifestent sur la scène shakespearienne. Il ne s’agit pas d’une étude rhétorique et lexicale de l’injure mais de l’examen d’un rituel verbal paradoxal au cours duquel on s’insulte sans ...

  3. Impact of Beta-Blockers on Nonhead Injured Trauma Patients.

    Science.gov (United States)

    Hendrick, Leah E; Schroeppel, Thomas J; Sharpe, John P; Alsbrook, Diana; Magnotti, Louis J; Weinberg, Jordan A; Johnson, Benjamin P; Lewis, Richard H; Clement, L Paige; Croce, Martin A; Fabian, Timothy C

    2016-07-01

    Catecholamine surge after traumatic injury may lead to dysautonomia with increased morbidity. Small retrospective studies have shown potential benefit of beta-blockers (BB) in trauma patients with and without traumatic brain injury (TBI). This study evaluates a large multiply injured cohort without TBI that received BB. Patients were identified from the trauma registry from January 1, 2003 to December 31, 2011. Patients who received >1 dose of BB were compared to controls. Patients with TBI, length of stay (LOS) ratio (OR) 0.952; confidence interval (CI) 0.620-1.461]. In conclusion, in this largest study to date, patients receiving BB were older, more severely injured, and had a higher mortality. Unlike TBI patients, multivariable regression showed no benefit from BB in this population.

  4. Development of a CPM Machine for Injured Fingers.

    Science.gov (United States)

    Fu, Yili; Zhang, Fuxiang; Ma, Xin; Meng, Qinggang

    2005-01-01

    Human fingers are easy to be injured. A CPM machine is a mechanism based on the rehabilitation theory of continuous passive motion (CPM). To develop a CPM machine for the clinic application in the rehabilitation of injured fingers is a significant task. Therefore, based on the theories of evidence based medicine (EBM) and CPM, we've developed a set of biomimetic mechanism after modeling the motions of fingers and analyzing its kinematics and dynamics analysis. We also design an embedded operating system based on ARM (a kind of 32-bit RISC microprocessor). The equipment can achieve the precise control of moving scope of fingers, finger's force and speed. It can serves as a rational checking method and a way of assessment for functional rehabilitation of human hands. Now, the first prototype has been finished and will start the clinical testing in Harbin Medical University shortly.

  5. Posterior Chamber IOL Implantation in Traumatic Cataract with Injured Complications

    Institute of Scientific and Technical Information of China (English)

    1992-01-01

    Twenty-five cases of posterior chamber IOL implantation intraumatic cataract with complications associated with primary injury werereported.The operating methods were described and the post-operative com-plications were discussed.Seventy-two percent of patients have the correctvision over 20/40.It is suggested that the posterior chamber IOL can be im-planted in traumatic cataract with some injured complications.EYE SCIENCE1992;8:111-112.

  6. Identifying contextual influences of community reintegration among injured servicemembers.

    Science.gov (United States)

    Hawkins, Brent L; McGuire, Francis A; Britt, Thomas W; Linder, Sandra M

    2015-01-01

    Research suggests that community reintegration (CR) after injury and rehabilitation is difficult for many injured servicemembers. However, little is known about the influence of the contextual factors, both personal and environmental, that influence CR. Framed within the International Classification of Functioning, Disability and Health and Social Cognitive Theory, the quantitative portion of a larger mixed-methods study of 51 injured, community-dwelling servicemembers compared the relative contribution of contextual factors between groups of servicemembers with different levels of CR. Cluster analysis indicated three groups of servicemembers showing low, moderate, and high levels of CR. Statistical analyses identified contextual factors (e.g., personal and environmental factors) that significantly discriminated between CR clusters. Multivariate analysis of variance and discriminant analysis indicated significant contributions of general self-efficacy, services and assistance barriers, physical and structural barriers, attitudes and support barriers, perceived level of disability and/or handicap, work and school barriers, and policy barriers on CR scores. Overall, analyses indicated that injured servicemembers with lower CR scores had lower general self-efficacy scores, reported more difficulty with environmental barriers, and reported their injuries as more disabling.

  7. Understanding contextual influences of community reintegration among injured servicemembers.

    Science.gov (United States)

    Hawkins, Brent L; McGuire, Francis A; Linder, Sandra M; Britt, Thomas W

    2015-01-01

    As part of a larger mixed-methods research project investigating the influence of contextual factors on community reintegration (CR), this qualitative study sought to understand the subjective experiences of injured servicemembers and their perception of how contextual factors influenced their CR. More specifically, this article addresses how the influences of contextual factors differ between injured servicemembers with different levels of CR. Using a phenomenological framework, semistructured interviews were conducted with nine injured, community-dwelling servicemembers with low, moderate, and high levels of CR (three per category). Participants provided in-depth descriptions of the contextual barriers and facilitators of CR. Thematic analysis indicated the importance of social support and personal factors (e.g., self-efficacy, personal motivation) as the primary means for being reintegrated into their homes and communities. Other themes indicated factors that had an indirect but important influence on CR, including adapted sports, recreation, and other social programs; rehabilitation programs and therapists; school, work, and volunteering; and organizations and policies in developing social supports and personal factors. Comparisons between servicemembers indicated participants with low CR described many more contextual barriers and far fewer contextual facilitators to reintegration than those with high CR. Those with moderate CR were unique in that they described many facilitators and barriers to reintegration.

  8. Repair and enumeration of injured coliforms in frozen foods.

    Science.gov (United States)

    Warseck, M; Ray, B; Speck, M L

    1973-12-01

    Two strains of Escherichia coli manifested death and repairable injury after being frozen in water or sterile foods at -20 C. The injured survivors were inhibited from forming colonies on violet red bile agar (VRBA) or deoxycholate lactose agar; this inhibition was greater when enumeration was done by the pour plate method instead of the surface or surface-overlay method. Injured cells repaired rapidly in Trypticase soy broth (TSB), and the repair was about maximum after 1 h at 25 C. When the injured cells were added to different foods and incubated at 25 C, repair also occurred; however, recovery was better and more uniform when the samples were mixed with TSB and incubated 1 h at 25 C. Cell multiplication was not evident until after 90 to 120 min at 25 C. The enumeration of coliforms from commercially frozen foods was increased when the thawed samples were mixed with TSB and the cells were allowed to repair 1 h at 25 C. In some samples, the repair permitted at least a 20-fold increase in the coliform count. The associated flora in the commercially frozen foods gave no evidence of impairing the repair of coliforms, nor did they start multiplication prior to 90 min after being incubated in TSB at 25 C. Generally, the plating gave more reproducible recovery of coliforms than did the most probable number method. Also, a higher number of coliforms were obtained by the surface-overlay method of plating using VRBA.

  9. Management of ventricular fibrillation or unstable ventricular tachycardia in patients with congenital long-QT syndrome: a suggested modification to ACLS guidelines.

    Science.gov (United States)

    Homme, Jason H; White, Roger D; Ackerman, Michael J

    2003-10-01

    Prolongation of the QT interval is a known risk factor for syncope, seizures and sudden cardiac death. Most patients with QT prolongation have an acquired cause, but congenital forms of QT prolongation are being increasingly recognized. However, existing advanced cardiac life support (ACLS) treatment algorithms for prolonged QT mediated ventricular fibrillation pertains to acquired long-QT syndrome (LQTS). Here, a young patient with out-of-hospital cardiac arrest secondary to congenital LQTS illustrates critical exceptions to the current ACLS treatment algorithms for ventricular fibrillation and unstable ventricular tachycardia when QT prolongation is congenital in origin. A clarified ACLS algorithm is proposed.

  10. 聚腺苷二磷酸核糖聚合酶抑制剂3-氨基苯甲酰胺对重症急性胰腺炎大鼠腺垂体损伤的保护作用%The protection of 3-AB, a PARP Inhibitor, on injures of adenohypophysis in rats with severe acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    邓文宏; 赵凯亮; 杨波; 石乔; 周星; 王卫星

    2013-01-01

    Objective To evaluate the protection of 3-aminobenzamide (3-AB),an inhibitor of Poly (ADP-ribose) polymerase (PARP),on severe acute pancreatitis associated adenohypophysis injury in rats.Method Forty Wistar rats were randomly divided into 4 groups:sham operation group (SO group,n=8),SAP group (n=12),3-AB pretreatment group (n =12),drug control group (n =8).The bilepancreatic duct was cannulated through the duodenum and SAP model was induced by a standardized pressure-controlled retrograde infusion of 5% sodium taurocholate (0.1 ml/100 g) into the bile-pancreatic duct.In 3-AB group,3-AB (20 mg/kg) was administered via femoral vein 30 min prior to the operation;other procedures were identical to SAP group.In SO group,pancreas was flipped several times only.In drug control group,3-AB (20 mg/kg) was administered via femoral vein 30 min prior to the operation.Serum amylase,lipase were measured.Pancreas and pituitary tissue were taken for pathological examination under light microscope.PARP and NF-κB antibodies for adenohypophysis immunohistochemical stains.Adenohypophysis cell was observed under electronic microscope.Result Serum amylase,lipase and pancreas pathological scores were significantly higher in 3-AB group compared with SO group (P < 0.05),but lower than that in SAP group (P < 0.05).Adenohypophysis pathological injury was less severe in 3-AB group.Expressions of PARP and NF-κB in adenohypophysis cells were significantly higher in 3-AB group compared with SO group,but lower than that in SAP group (P < 0.05).Ultrastructural change of thyrotroph cell was relieved in 3-AB group.No significant difference was observed between SO group and drug control group in PARP and NF-κB expression nor adenohypophysis pathological injury.Conclusions 3-AB exerts the protective effect against acute pancreatitis associated adenohypophysis injury by inhibition of PARP and NF-κB.%目的 探讨聚腺苷二磷酸核糖聚合酶抑制剂3-氨基苯甲酰胺(3-AB)对SAP大

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

    Institute of Scientific and Technical Information of China (English)

    J. Jordan Hamson-Utley

    2010-01-01

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

  12. Matrine Inhibits Infiltration of the Inflammatory Gr1hi Monocyte Subset in Injured Mouse Liver through Inhibition of Monocyte Chemoattractant Protein-1

    Directory of Open Access Journals (Sweden)

    Duo Shi

    2013-01-01

    Full Text Available Matrine (Mat is a major alkaloid extracted from Sophora flavescens Ait, an herb which is used in the traditional Chinese medicine for treatment of inflammation, cancer, and other diseases. The present study examined the impact of Mat on the CCl4-induced hepatic infiltration of Gr1hi monocytes to explore the possible mechanisms underlying its anti-inflammatory and antifibrotic effects. The results indicated that Mat protected mice from acute liver injury induced by single intraperitoneal injection of CCl4 and attenuated liver fibrosis induced by repeated CCl4 injection. Meanwhile, the infiltrations of Gr1hi monocytes in both acute and chronic injured livers were all inhibited, and the enhanced hepatic expression of MCP-1 was suppressed. Cellular experiments demonstrated that Mat directly inhibited MCP-1 production in both nonparenchymal cells and hepatic stellate cells derived from CCl4-injured livers. Transwell chemotaxis assays showed that Mat significantly inhibited the chemotactic activity of MCP-1. These results suggest that the anti-inflammatory and antifibrotic effects of Mat could be contributed, at least in part, to its prevention of Gr1hi monocyte infiltration into the injured livers and inhibition of MCP-1 production and activity. These findings extend our understanding of the mechanisms underlying the anti-inflammatory and antifibrotic effects of Mat.

  13. Comparison of traditional advanced cardiac life support (ACLS) course instruction vs. a scenario-based, performance oriented team instruction (SPOTI) method for Korean paramedic students.

    Science.gov (United States)

    Lee, Christopher C; Im, Mark; Kim, Tae Min; Stapleton, Edward R; Kim, Kyuseok; Suh, Gil Joon; Singer, Adam J; Henry, Mark C

    2010-01-01

    Current Advanced Cardiac Life Support (ACLS) course instruction involves a 2-day course with traditional lectures and limited team interaction. We wish to explore the advantages of a scenario-based performance-oriented team instruction (SPOTI) method to implement core ACLS skills for non-English-speaking international paramedic students. The objective of this study was to determine if scenario-based, performance-oriented team instruction (SPOTI) improves educational outcomes for the ACLS instruction of Korean paramedic students. Thirty Korean paramedic students were randomly selected into two groups. One group of 15 students was taught the traditional ACLS course. The other 15 students were instructed using a SPOTI method. Each group was tested using ACLS megacode examinations endorsed by the American Heart Association. All 30 students passed the ACLS megacode examination. In the traditional ACLS study group an average of 85% of the core skills were met. In the SPOTI study group an average of 93% of the core skills were met. In particular, the SPOTI study group excelled at physical examination skills such as airway opening, assessment of breathing, signs of circulation, and compression rates. In addition, the SPOTI group performed with higher marks on rhythm recognition compared to the traditional group. The traditional group performed with higher marks at providing proper drug dosages compared to the SPOTI students. However, the students enrolled in the SPOTI method resulted in higher megacode core compliance scores compared to students trained in traditional ACLS course instruction. These differences did not achieve statistical significance due to the small sample size.

  14. POTENTIAL FOR NON-CONTACT ACL INJURY BETWEEN STEP-CLOSE-JUMP AND HOP-JUMP TASKS

    Directory of Open Access Journals (Sweden)

    Li-I Wang

    2010-03-01

    Full Text Available This study aimed to compare the kinematics and kinetics during the landing of hop-jump and step-close-jump movements in order to provide further inferring that the potential risk of ACL injuries. Eleven elite male volleyball players were recruited to perform hop-jump and step-close-jump tasks. Lower extremity kinematics and ground reaction forces during landing in stop-jump tasks were recorded. Lower extremity kinetics was calculated by using an inverse dynamic process. Step-close-jump tasks demonstrated smaller peak proximal tibia anterior shear forces during the landing phase. In step-close-jump tasks, increasing hip joint angular velocity during initial foot-ground contact decreased peak posterior ground reaction force during the landing phase, which theoretically could reduce the risk of ACL injury

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

    Directory of Open Access Journals (Sweden)

    Kenji Shirakura

    1995-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    Chen-xu Li; Guo-ying Ma; Min-fang Guo; Ying Liu

    2015-01-01

    Peripheral nerve injury has been shown to result in ectopic spontaneous discharges on soma and injured sites of sensory neurons, thereby inducing neuropathic pain. With the increase of membrane proteins on soma and injured site neurons, the negatively charged sialic acids bind to the external domains of membrane proteins, resulting in an increase of this charge. We therefore speculate that the electrophoretic velocity of injured neurons may be faster than non-injured neurons. The present study established rat models of neuropathic pain via chronic constriction injury. Results of the cell electrophoresis test revealed that the electrophoretic velocity of injured neuronal cells was faster than that of non-injured (control) cells. We then treated cells with di-valent cations of Ca2+and organic compounds with positive charges, polylysine to counteract the negatively charged sialic acids, or neuraminidase to speciifcally remove sialic acids from the membrane surface of injured neurons. All three treatments significantly reduced the electro-phoretic velocity of injured neuronal cells. These ifndings suggest that enhanced sialic acids on injured neurons may accelerate the electrophoretic velocity of injured neurons.

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

    Directory of Open Access Journals (Sweden)

    Chen-xu Li

    2015-01-01

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

  18. 高级心血管生命支持(ACLS)实施者课程介绍

    Institute of Scientific and Technical Information of China (English)

    徐惠梁

    2006-01-01

    @@ 1 ACLS实施者课程预期效果 在本课程中你将通过观察、讨论和操作学习高级心血管生命支持(ACLS)的具体内容.ACLS指导老师会帮助你运用下列方法达到课程的目的.

  19. 同种异体骨-ACL-骨移植重建ACL的研究现状

    Institute of Scientific and Technical Information of China (English)

    李相伟

    2011-01-01

    @@ 前交叉韧带(ACL)是稳定膝关节的重要组织结构,具有控制膝关节伸直和内旋,以及限制胫骨前移和过度伸展的作用.随着我国体育事业发展和交通事故的增多,ACL的急性损伤非常常见.

  20. 巧用2.6内核新功能配置文件ACL

    Institute of Scientific and Technical Information of China (English)

    马路遥

    2004-01-01

    如果使用过Unix.就不会对ACL(Access Control List,访问控制列表)感到陌生。在Linux 2.4内核中。ACL作为补丁存在.而在2.6新内棱中,它已经是标准内核的一部分了。

  1. Motor learning strategies in basketball players and its implications for ACL injury prevention: a randomized controlled trial

    OpenAIRE

    2015-01-01

    Purpose Adding external focus of attention (EF, focus on the movement effect) may optimize current anterior cruci- ate ligament (ACL) injury prevention programmes. The purpose of the current study was to investigate the effects of an EF, by a visual stimulus and an internal focus, by a verbal stimulus during unexpected sidestep cutting in female and male athletes and how these effects remained over time. Methods Ninety experienced basketball athletes per- formed sidestep cutting manoeuvres in...

  2. Effect of Calcium Phosphate–Hybridized Tendon Graft in Anatomic Single-Bundle ACL Reconstruction in Goats

    Science.gov (United States)

    Mutsuzaki, Hirotaka; Fujie, Hiromichi; Nakajima, Hiromi; Fukagawa, Makoto; Nomura, Shunsuke; Sakane, Masataka

    2016-01-01

    Background: We previously developed a novel technique using an alternate soaking process that improves tendon-bone healing by hybridizing the tendon graft with calcium phosphate (CaP). However, the effects of the CaP-hybridized tendon graft on anatomic single-bundle anterior cruciate ligament (ACL) reconstruction remain unclear. Purpose: To determine the effects of CaP-hybridized tendon grafts compared with untreated tendon grafts 6 months after anatomic single-bundle ACL reconstruction using a goat model. Study Design: Controlled laboratory study. Methods: Animals were divided into a CaP group (n = 5 goats) and a control group (n = 5 goats), and we analyzed (1) knee kinematics and in situ forces under applied anterior tibial loads of 50 N and internal tibial torque of 2.0 N·m in the grafts at full extension and at 60° and 90° of knee flexion, (2) the mean percentage of bone tunnel enlargement using computed tomography (CT), and (3) the histology of the tendon-bone interface. Results: The in situ forces under applied anterior tibial loads of 50 N at 60° and 90° of knee flexion in the CaP group were greater than those in the control group (P joint aperture sites of the anterior femoral and posterior tibial bone tunnel, was greater in the CaP group than that in the control group (P joint aperture site in both anterior femoral and posterior tibial tunnels 6 months after anatomic single-bundle ACL reconstruction in goats. The in situ forces under applied anterior tibial loads at greater flexion angles in the CaP group increased compared with controls. Clinical Relevance: Anatomic single-bundle ACL reconstruction using CaP-hybridized tendon grafts may lead to better postoperative knee function. PMID:27660798

  3. Treating work-injured patients in Europe. The Italian experience.

    Science.gov (United States)

    Giannini, Sandro; Ceccarelli, Francesco

    2002-06-01

    According with to International Labor Office, the European Union gave the directions to improve the life of workers not only by regulating care, but also safety and return to work. Each European country is conforming to this. In Italy, INAIL, an independent body under the control of the Department of Labor and the Ministry of Health, covers the workers for occupational accidents and is funded by an insurance premium, obligatory paid by the employer. INAIL has the medicolegal task of assessment of injuries, supply of prostheses, physical therapy, and various compensation according to the degree of disability and the type of work. The specific treatment of the injured workers is carried out by the SSN, which is in charge of the outpatient treatment and hospitalization; however, INAIL contributes to the costs according to agreements made with each region. Although on one hand the injured worker is fully protected by the regulations, on the other hand, he or she is obliged to abide to the laws of security and to undergo treatment offered. In returning to work, certain factors are taken into account, such as percentage of disability, type of work, and discomfort that disability produces in carrying out work. Should the type or severity of the disability not allow complete return to work, support is given to assess and integrate the reduced working ability of the injured worker with regards to the workplace, even by adapting the latter to solve structural and environmental problems. INAIL, in accordance with the European Council, is committed to the total care of the worker and not only worker meaning "work force." In fact, health care and economic aid are integrated with the safety and rehabilitation of the worker and his or her return to family, social, and working life.

  4. Neuromuscular Coordination Deficit Persists 12 Months after ACL Reconstruction But Can Be Modulated by 6 Weeks of Kettlebell Training: A Case Study in Women’s Elite Soccer

    Directory of Open Access Journals (Sweden)

    Mette K. Zebis

    2017-01-01

    Full Text Available The aim of the present single-case study was to investigate the effect of 6 weeks’ kettlebell training on the neuromuscular risk profile for ACL injury in a high-risk athlete returning to sport after ACL reconstruction. A female elite soccer player (age 21 years with no previous history of ACL injury went through neuromuscular screening as measured by EMG preactivity of vastus lateralis and semitendinosus during a standardized sidecutting maneuver. Subsequently, the player experienced a noncontact ACL injury. The player was screened again following postreconstruction rehabilitation, then underwent 6-week kettlebell training, and was subsequently screened again at 6-week follow-up. Prior to and after postreconstruction rehabilitation the player demonstrated a neuromuscular profile during sidecutting known to increase the risk for noncontact ACL injury, that is, reduced EMG preactivity for semitendinosus and elevated EMG preactivity for vastus lateralis. Subsequently, the 6-week kettlebell training increased semitendinosus muscle preactivity during sidecutting by 38 percentage points to a level equivalent to a neuromuscular low-risk profile. An ACL rehabilitated female athlete with a high-risk neuromuscular profile changed to low-risk in response to 6 weeks of kettlebell training. Thus, short-term kettlebell exercise with documented high levels of medial hamstring activation was found to transfer into high medial hamstring preactivation during a sidecutting maneuver.

  5. The effects of high-intensity versus low-intensity resistance training on leg extensor power and recovery of knee function after ACL-reconstruction

    DEFF Research Database (Denmark)

    Bieler, Theresa; Aue Sobol, Nanna; Andersen, Lars L;

    2014-01-01

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

  6. Neuromuscular Coordination Deficit Persists 12 Months after ACL Reconstruction But Can Be Modulated by 6 Weeks of Kettlebell Training: A Case Study in Women's Elite Soccer

    Science.gov (United States)

    Andersen, Christoffer H.; Bencke, Jesper; Ørntoft, Christina; Linnebjerg, Connie; Hölmich, Per

    2017-01-01

    The aim of the present single-case study was to investigate the effect of 6 weeks' kettlebell training on the neuromuscular risk profile for ACL injury in a high-risk athlete returning to sport after ACL reconstruction. A female elite soccer player (age 21 years) with no previous history of ACL injury went through neuromuscular screening as measured by EMG preactivity of vastus lateralis and semitendinosus during a standardized sidecutting maneuver. Subsequently, the player experienced a noncontact ACL injury. The player was screened again following postreconstruction rehabilitation, then underwent 6-week kettlebell training, and was subsequently screened again at 6-week follow-up. Prior to and after postreconstruction rehabilitation the player demonstrated a neuromuscular profile during sidecutting known to increase the risk for noncontact ACL injury, that is, reduced EMG preactivity for semitendinosus and elevated EMG preactivity for vastus lateralis. Subsequently, the 6-week kettlebell training increased semitendinosus muscle preactivity during sidecutting by 38 percentage points to a level equivalent to a neuromuscular low-risk profile. An ACL rehabilitated female athlete with a high-risk neuromuscular profile changed to low-risk in response to 6 weeks of kettlebell training. Thus, short-term kettlebell exercise with documented high levels of medial hamstring activation was found to transfer into high medial hamstring preactivation during a sidecutting maneuver. PMID:28197354

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

    Institute of Scientific and Technical Information of China (English)

    刘学民; 刘青光; 潘承恩

    2002-01-01

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

  8. In-hospital mortality pattern of severely injured children

    DEFF Research Database (Denmark)

    Do, Hien Quoc; Steinmetz, Jacob; Rasmussen, Lars S

    2012-01-01

    BACKGROUND: Although trauma remains a major cause of morbidity and mortality in children, less attention has been directed to this group of patients. Whilst there is considerable literature on trauma in adults, only few studies describe paediatric trauma. The aim of this study was to describe...... the mortality pattern of severely injured children admitted to a Danish level I trauma centre. METHODS: We included trauma patients aged 15 years or less, who subsequent a trauma team activation were admitted during the 9-year period 1999-2007. Data were collected prospectively for subjects who had a length...

  9. [Rehabilitation and reintegration of soldiers injured on deployment].

    Science.gov (United States)

    de Montleau, Franck; Boussaud, Marie; Dascalescu, Délia; Granier, Claire; Allagil, Constance; Daudin, Marianne

    2015-01-01

    The participation of the French army in the Afghan conflict has highlighted the need for discussion and action regarding the pathway, rehabilitation and reintegration of soldiers who have been physically or psychologically injured. Clinical experience demonstrates that difficulties are less likely to appear during the initial treatment phase than later on, when there is less group support and there are fewer visible effects of the recognition on the part of the institution. It is important to strengthen the links between healthcare personnel and institutional players, in order to optimise the medical and social care of these war casualties.

  10. ACL控制的配置方法及实例%The ACL control configuration method and examples

    Institute of Scientific and Technical Information of China (English)

    张玲丽

    2014-01-01

    访问控制列表ACL有多种,不同场合应用不同种类的ACL。本文以实际场景为例,为实现不同的网络连接目的,而做的相应的配置,并分析了各种配置的适用范围和优劣。这些ACL技术从简到繁、从网络层到应用层,为网络的边界安全提供了灵活的解决方案。%There are many types of access control lists(ACL).Different kinds of ACL were suitable for different occasions.According to the different purpose of network connection,the corresponding configurations were completed.Also,this text analyzed the applicable range and advantages and disadvantages of various kinds of configuration.The ACL technology from simple to complex,during the network layer to application layer,provided a flexible solution for the boundary of the network security.

  11. Hydrogel fibers for ACL prosthesis: design and mechanical evaluation of PVA and PVA/UHMWPE fiber constructs.

    Science.gov (United States)

    Bach, Jason S; Detrez, Fabrice; Cherkaoui, Mohammed; Cantournet, Sabine; Ku, David N; Corté, Laurent

    2013-05-31

    Prosthetic devices for anterior cruciate ligament (ACL) reconstruction have been unsuccessful due to mechanical failure or chronic inflammation. Polymer hydrogels combine biocompatibility and unique low friction properties; however, their prior use for ligament reconstruction has been restricted to coatings due to insufficient tensile mechanics. Here, we investigate new constructs of polyvinyl alcohol (PVA) hydrogel fibers. In water, these fibers swell to an equilibrium water content of 50% by weight, retaining a tensile modulus greater than 40 MPa along the fiber axis at low strain. Rope constructs were assembled for ACL replacement and mechanical properties were compared with data from the literature. Pure PVA hydrogel constructs closely reproduce the non-linear tensile stiffness of the native ACL with an ultimate strength of about 2000 N. An additional safety factor in tensile strength was achieved with composite braids by adding ultrahigh molecular weight polyethylene (UHMWPE) fibers around a core of PVA cords. Composition and braiding angle are adjusted to produce a non-linear tensile behavior within the range of the native ligament that can be predicted by a simple rope model. This design was found to sustain over one million cycles between 50 and 450 N with limited damage and less than 20% creep. The promising mechanical performances of these systems provide justification for more extensive in vivo evaluation.

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

    Science.gov (United States)

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

    2013-12-01

    [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.

  13. Double-band reconstruction of the ACL using a synthetic implant: a cadaveric study of knee laxity.

    Science.gov (United States)

    Guardamagna, Luca; Seedhom, Bahaa B; Ostell, Alistair E

    2004-01-01

    In this study, the anterior laxity and internal rotation of five cadaveric knee joints were compared when the anterior cruciate ligament (ACL) was intact, after its reconstruction with the anteromedial band (AMB) only, then after its reconstruction with the double band, with the posterolateral band (PLB) tensioned first at 20 degrees and then at 90 degrees, and finally with the ACL resected. The tests were performed using a mechanical apparatus that allowed the joint 6 degrees of freedom and also the application of external loads and torques on the tibia. The loads used were 50, 90, and 130 N for the anterior laxity test, and a torque of 2, 3, and 4 Nm in the internal rotation test. In all cases, laxity with double-band reconstruction was closer to the natural value than when it was constructed with the AMB only. In some cases, double-band reconstruction imposed a higher constraint on the joint than did the natural ACL. Measurement of the residual tension on the PLB after its final anchoring was also performed during passive flexion. This test revealed a high tension on this band with the knee in hyperextension, followed by a decrease in value through to 45 degrees and a slight increase at 90 degrees, thus following a similar trend to that of the natural PLB.

  14. 校园网安全之ACL技术%ACL Technology of Campus Network Security

    Institute of Scientific and Technical Information of China (English)

    高琳

    2013-01-01

    With the development of large-scale open campus network, campus network is facing more and more threat. On the one hand, in order to develop the foreign exchange in college and universities, we must allow access to network resources development, on the other hand, we must ensure the safety of the campus network data and resources. Network security adopts a lot of technology, and through the access control list (ACL), it can filter the data flow, is a basic one of the campus network security means.%随着大规模开放式校园网络的开发,校园网面临的威胁也越来越多。一方面为了高校对外交流的开展,必须允许对网络资源的开发访问,另一方面,又必须确保校园网数据和资源的尽可能安全。网络安全采用的技术很多,而通过访问控制列表(ACL)可以对数据流进行过滤,是实现基本的校园网安全手段之一。

  15. Injury Risk Estimation Expertise: Cognitive-Perceptual Mechanisms of ACL-IQ.

    Science.gov (United States)

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

    2015-06-01

    Instrument-based biomechanical movement analysis is an effective injury screening method but relies on expensive equipment and time-consuming analysis. Screening methods that rely on visual inspection and perceptual skill for prognosticating injury risk provide an alternative approach that can significantly reduce cost and time. However, substantial individual differences exist in skill when estimating injury risk performance via observation. The underlying perceptual-cognitive mechanisms of injury risk identification were explored to better understand the nature of this skill and provide a foundation for improving performance. Quantitative structural and process modeling of risk estimation indicated that superior performance was largely mediated by specific strategies and skills (e.g., irrelevant information reduction), and independent of domain-general cognitive abilities (e.g., mental rotation, general decision skill). These cognitive models suggest that injury prediction expertise (i.e., ACL-IQ) is a trainable skill, and provide a foundation for future research and applications in training, decision support, and ultimately clinical screening investigations.

  16. TGF-β1刺激下损伤的前交叉韧带和内侧副韧带中BMP-1基因的表达%Differential BMP-1 expression in injured anterior cruciate ligament and medial collateral ligament fibroblasts induced by TGF-β1

    Institute of Scientific and Technical Information of China (English)

    尹琳; 谢静; 蒋稼欢; 王春莉; 张艳君; 许春明; KL Paul Sung

    2012-01-01

    Objective To investigate the differential expression of bone morphogenetic protein-1 (BMP-1) in injured anterior cruciate ligament ( ACL) and medial collateral ligament ( MCL) fibroblasts induced by TGF-p,, and to find out the differences between the poorly self-healing ACL and well functionally self-healing MCL fibroblasts. Methods Fibroblasts were primarily cultured from clinical ACL and MCL samples, and then given 12% mechanical stretch injury and treated by 1, 5 and 50 ng/ml TGF-β1 for 2 h, or by 5 ng/ml TGF-β,1 for 2, 6, 12 and 24 h respectively at the same time. The expression of BMP-1 in the above treated and untreated fibroblasts were detected by reversed-transcript PCR and real-time quantitative PCR. Western blotting was used to detect the expression of BMP-1 in the injured fibroblasts induced by 5 ng/ml TGF-p, for 48 h. Results TGF-p, treatment resulted in an increased mRNA expression of BMP-1 in the injured fibroblasts in a dose-depended manner, especially in the cells from MCL than in those from ACL (about 1 times higher, P <0. 05). Compared with the fibroblasts without TGF-p, treatment, 5 ng/ml TGF-p, treatment for 24 h made the expression of BMP-1 reach the summit in ACL (6.1 folds higher, P <0.05) and in MCL (9.84 folds higher, P <0.05). Compared with the control, the protein expression of BMP-1 were elevated to 2. 32 and 3. 84 folds higher in ACL and MCL respectively after 5 ng/ml TGF-p, treatment for 48 h (P <0.01). Conclusion TGF-p, affects the expression of BMP-1 in the injured fibroblasts, and then directly affects activities of lysyl oxiadse in the extracellular matrix, implying its potential significant value and clinical usage in repair of injured ACL.%目的 观察在转化生长因子-β1(transforming growth factor betal,TGF-β1)作用下,损伤的前交叉韧带(anterior cruciate ligament,ACL)和内侧副韧带(medial collateral ligament,MCL)中骨形态发生蛋白-1(bone morphogenetic protein-1,BMP-1)基因的表达,找出TGF-31

  17. Reconstruction of Injured Carotid Artery in a Comatose Patient

    Directory of Open Access Journals (Sweden)

    Arben Zenelaj

    2014-06-01

    Full Text Available A man 30 years old,was brought to the emergency department after being injured on the left side of the neck area.Massive bleeding from the wound caused by glass was observed.The patient was in cerebral coma and hemorrahagic shock.The eye pupils remained isochoric during and after the operation.He was taken immediately at the surgery room.The bleeding was stopped by using external compression.Exposure of the left neck blood vessels was carried out.The left common carotid artery and internal jugular vein was revealed.A provisory Pruitt-Inahara shunt was put in the common carotid artery,while teh injured vein was ligated.The suture of the left common carotid artery using Prolen 6-0 completed the procedure.After the surgery the patient was transferred to the intensive care unit.About two hours later he woke up,conscious.The left thoracic drainage because of the hemothorax was applied in the second postoperative day.The patient was lively and discharged from the hospitall in the 14-th postoperative day.The right facial paresis and mild left side hemiparesis persisted.Two months after the event no residual neurologic deficits were observed. [Cukurova Med J 2014; 39(3.000: 598-601

  18. Fetal hippocampal CA3 cell grafts enriched with FGF-2 and BDNF exhibit robust long-term survival and integration and suppress aberrant mossy fiber sprouting in the injured middle-aged hippocampus.

    Science.gov (United States)

    Rao, Muddanna S; Hattiangady, Bharathi; Shetty, Ashok K

    2006-02-01

    Cell transplants that successfully replace the lost neurons and facilitate the reconstruction of the disrupted circuitry in the injured aging hippocampus are invaluable for treating acute head injury, stroke and status epilepticus in the elderly. This is because apt graft integration has the potential to prevent the progression of the acute injury into chronic epilepsy in the elderly. However, neural transplants into the injured middle-aged or aged hippocampus exhibit poor cell survival, suggesting that apt graft augmentation strategies are critical for robust integration of grafted cells into the injured aging hippocampus. We examined the efficacy of pre-treatment and grafting of donor fetal CA3 cells with a blend of fibroblast growth factor-2 (FGF-2) and brain-derived neurotrophic factor (BDNF) for lasting survival and integration of grafted cells in the injured middle-aged (12 months old) hippocampus of F344 rats. Grafts were placed at 4 days after the kainic-acid-induced hippocampal injury and were analyzed at 6 months post-grafting. We demonstrate that 80% of grafted cells exhibit prolonged survival and 71% of grafted cells differentiate into CA3 pyramidal neurons. Grafts also receive a robust afferent input from the host mossy fibers and project efferent axons into the denervated zones of the dentate gyrus and the CA1 subfield. Consequently, the aberrant sprouting of the dentate mossy fibers, an epileptogenic change that typically ensues after the hippocampal injury, was suppressed. Thus, grafts of fetal CA3 cells enriched with FGF-2 and BDNF exhibit robust integration and dampen the abnormal mossy fiber sprouting in the injured middle-aged hippocampus. Because the aberrantly sprouted mossy fibers contribute to the generation of seizures, the results suggest that the grafting intervention using FGF-2 and BDNF is efficacious for suppressing epileptogenesis in the injured middle-aged hippocampus.

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

    Directory of Open Access Journals (Sweden)

    Abel Torres-Espín

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

  20. Fast-conducting mechanoreceptors contribute to withdrawal behavior in normal and nerve injured rats.

    Science.gov (United States)

    Boada, M Danilo; Martin, Thomas J; Peters, Christopher M; Hayashida, Kenichiro; Harris, Michael H; Houle, Timothy T; Boyden, Edward S; Eisenach, James C; Ririe, Douglas G

    2014-12-01

    Fast-conducting myelinated high-threshold mechanoreceptors (AHTMR) are largely thought to transmit acute nociception from the periphery. However, their roles in normal withdrawal and in nerve injury-induced hyperalgesia are less well accepted. Modulation of this subpopulation of peripheral neurons would help define their roles in withdrawal behaviors. The optically active proton pump, ArchT, was placed in an adeno-associated virus-type 8 viral vector with the CAG promoter and was administered by intrathecal injection resulting in expression in myelinated neurons. Optical inhibition of peripheral neurons at the soma and transcutaneously was possible in the neurons expressing ArchT, but not in neurons from control animals. Receptive field characteristics and electrophysiology determined that inhibition was neuronal subtype-specific with only AHTMR neurons being inhibited. One week after nerve injury the AHTMR are hyperexcitable, but can still be inhibited at the soma and transcutaneously. Withdrawal thresholds to mechanical stimuli in normal and in hyperalgesic nerve-injured animals also were increased by transcutaneous light to the affected hindpaw. This suggests that AHTMR neurons play a role not only in threshold-related withdrawal behavior in the normal animal, but also in sensitized states after nerve injury. This is the first time this subpopulation of neurons has been reversibly modulated to test their contribution to withdrawal-related behaviors before and after nerve injury. This technique may prove useful to define the role of selective neuronal populations in different pain states.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-09-15

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

  2. Study on radioprotection effects of clinoptilolite on sub-acute radiation-injured mice

    Directory of Open Access Journals (Sweden)

    Na LI

    2016-03-01

    Full Text Available Objective  To study the protection effect of clinoptilolite (Cp against radiation injury. Methods  Fortyeight male BALB/c mice were randomly divided into 6 groups, namely normal control group (distilled water + sham irradiation, radiation control group (distilled water + irradiation, 300mg/kg 523 group (200mg/kg nilestriol 24h before irradiation and 100mg/ kg nilestriol 4h after irradiation, 56mg/kg Cp group (56mg/kg Cp + irradiation, 167mg/kg Cp group (167mg/kg Cp + irradiation and 500mg/kg Cp group (500mg/kg Cp + irradiation. Seven days after the administration of the drug, all the mice but those from the normal control group were irradiated with γ-ray irradiation of 137Cs in the dose of 4.0Gy, at the rate of 0.75Gy/min. All the mice were given the drug for 14 days after irradiation. RBC, WBC and PLT counts in peripheral blood, superoxide dismutases (SOD activity, malondialdehyde (MDA level, glutathione peroxidase (GSH-Px level in blood serum, the content of deoxyribonucleic acid (DNA and hematopoietic stem cells in bone marrow were determined. Results  Compared with radiation control group, on 10th day after irradiation, RBC counts in peripheral blood of 56mg/kg Cp group and 167mg/kg Cp group were significantly higher (P<0.05, P<0.01, and WBC counts in peripheral blood of 56mg/kg Cp group and 500mg/kg Cp group were significantly higher (P<0.01. On 14th day after irradiation, compared with radiation control group, the SOD activities in blood serum of three Cp groups were elevated (P<0.05, P<0.01, the GSH-Px levels were elevated in blood serum of 167mg/kg Cp group and 500mg/kg Cp group (P<0.01, the DNA contents were significantly higher in 56mg/kg Cp group and 500mg/kg Cp group (P<0.05, P<0.01, the hematopoietic stem cells were significantly increased in number in bone marrow of three Cp groups (P<0.01. Conclusion  The clinoptilolite possesses protective effect against injury induced by 137Cs γ-irradiation in mice. DOI: 10.11855/j.issn.0577-7402.2016.01.15

  3. Acute Lung Injury: Making Injured Lungs Perform Better and Rebuilding Healthy Lungs

    Science.gov (United States)

    2010-07-01

    infiltrates AND 4c. PaO2 /FiO2 ratio less than 300 for ALI, less than 200 for ARDS; or if no arterial blood gas has been drawn by the primary team, a...the study powered to detect an increase in oxygenation ( PaO2 in mmHg) from the "Conventional Ventilation" to the "Variable Ventilation" phase. Other...and Time 2. Specifically, these measurements are: 4. Oxygenation: PaO2 in mmHg (from blood gas) and O2 saturation (from oximetry) 5. Ventilation

  4. Not a NICE CT protocol for the acutely head injured child

    Energy Technology Data Exchange (ETDEWEB)

    Willis, A.P.; Latif, S.A.A.; Chandratre, S.; Stanhope, B. [Birmingham Children' s Hospital, Steelhouse Lane, Birmingham, B4 6NH (United Kingdom); Johnson, K. [Birmingham Children' s Hospital, Steelhouse Lane, Birmingham, B4 6NH (United Kingdom)], E-mail: karl.johnson@bch.nhs.uk

    2008-02-15

    Aim: To assess the impact of the introduction of the Birmingham Children's Hospital (BCH) head injury computed tomography (CT) guidelines, when compared with the National Institute of Health and Clinical Excellence (NICE) guidelines, on the number of children with head injuries referred from the Emergency Department (ED) undergoing a CT examination of the head. Material and methods: All children attending BCH ED over a 6-month period with any severity of head injury were included in the study. ED case notes were reviewed and data were collected on a specifically designed proforma. Indications for a CT examination according to both NICE and BCH head injury guidelines and whether or not CT examinations were performed were recorded. Results: A total of 1428 children attended the BCH ED following a head injury in the 6-month period. The median age was 4 years (range 6 days to 15 years) and 65% were boys. Four percent of children were referred for a CT using BCH guidelines and were appropriately examined. If the NICE guidelines had been strictly adhered to a further 8% of children would have undergone a CT examination of the head. All of these children were discharged without complication. The remaining 88% had no indication for CT examination by either BCH or NICE and appropriately did not undergo CT. Conclusions: Adherence to the NICE head injury guidelines would have resulted in a three-fold increase in the total number of CT examinations of the head. The BCH head injury guidelines are both safe and appropriate in the setting of a large children's hospital experienced in the management of children with head injuries.

  5. Acute Lung Injury: Making the Injured Lung Perform Better and Rebuilding Healthy Lungs

    Science.gov (United States)

    2014-04-01

    of the Nkx2-1GFP ESC reporter line in vitro, we first derived embryoid bodies (EBs) using published serum-free culture conditions supplemented with...ously described (14). Briefly, ES or iPS cells were plated under nonadherent  conditions and allowed to spontaneously differentiate and form  embryoid

  6. Employment Effects of educational measures for work-injured people

    DEFF Research Database (Denmark)

    Bach, Henning Bjerregaard; Datta Gupta, Nabanita; Høgelund, Jan

    Vocational rehabilitation in the form of education is the cornerstone of governmental rehabilitation programs for the work-disabled in many countries. Merging a 2004 Danish survey to register information from the Danish National Board of Industrial Injuries, we assess the employment effects...... of educational measures for the work-injured, by simultaneously estimating the hazard rate to education and the return to work, controlling for unobserved heterogeneity and the endogeneity of education. In addition, we allow for any enhanced employment effects of a unique wage subsidy program in Denmark, giving...... employers a partial wage subsidy for disabled workers’ wages, by distinguishing between education effects of a return to wage-subsidized work versus a return to ordinary work. Unlike previous studies, we find a positive impact of educational measures on the probability of returning to work for the work...

  7. FES-cycling training in spinal cord injured patients.

    Science.gov (United States)

    Mazzoleni, S; Stampacchia, G; Gerini, A; Tombini, T; Carrozza, M C

    2013-01-01

    Among the objectives of spinal cord injury (SCI) rehabilitation, (i) prevention of bony, muscular and joint trophism and (ii) limitation of spastic hypertone represent important goals to be achieved. The aim of this study is to use functional electrical stimulation (FES) to activate pedaling on cycle-ergometer and analyse effects of this technique for a rehabilitation training in SCI persons. Five spinal cord injured subjects were recruited and underwent a two months FES-cycling training. Our results show an increase of thigh muscular area and endurance after the FES-cycling training, without any increase of spasticity. This approach, which is being validated on a larger pool of patients, represents a potential tool for improving the rehabilitation outcome of complete and incomplete SCI persons.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-10-15

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

  9. Differentiation of different mixed Listeria strains and also acid-injured, heat-injured, and repaired cells of Listeria monocytogenes using fourier transform infrared spectroscopy.

    Science.gov (United States)

    Nyarko, Esmond; Donnelly, Catherine

    2015-03-01

    Fourier transform infrared (FT-IR) spectroscopy was used to differentiate mixed strains of Listeria monocytogenes and mixed strains of L. monocytogenes and Listeria innocua. FT-IR spectroscopy was also applied to investigate the hypothesis that heat-injured and acid-injured cells would return to their original physiological integrity following repair. Thin smears of cells on infrared slides were prepared from cultures for mixed strains of L. monocytogenes, mixed strains of L. monocytogenes and L. innocua, and each individual strain. Heat-injured and acid-injured cells were prepared by exposing harvested cells of L. monocytogenes strain R2-764 to a temperature of 56 ± 0.2°C for 10 min or lactic acid at pH 3 for 60 min, respectively. Cellular repair involved incubating aliquots of acid-injured and heat-injured cells separately in Trypticase soy broth supplemented with 0.6% yeast extract for 22 to 24 h; bacterial thin smears on infrared slides were prepared for each treatment. Spectral collection was done using 250 scans at a resolution of 4 cm(-1) in the mid-infrared wavelength region. Application of multivariate discriminant analysis to the wavelength region from 1,800 to 900 cm(-1) separated the individual L. monocytogenes strains. Mixed strains of L. monocytogenes and L. monocytogenes cocultured with L. innocua were successfully differentiated from the individual strains when the discriminant analysis was applied. Different mixed strains of L. monocytogenes were also successfully separated when the discriminant analysis was applied. A data set for injury and repair analysis resulted in the separation of acid-injured, heat-injured, and intact cells; repaired cells clustered closer to intact cells when the discriminant analysis (1,800 to 600 cm(-1)) was applied. FT-IR spectroscopy can be used for the rapid source tracking of L. monocytogenes strains because it can differentiate between different mixed strains and individual strains of the pathogen.

  10. Acute pancreatitis

    Science.gov (United States)

    ... its blood vessels. This problem is called acute pancreatitis. Acute pancreatitis affects men more often than women. Certain ... pancreatitis; Pancreas - inflammation Images Digestive system Endocrine glands Pancreatitis, acute - CT scan Pancreatitis - series References Forsmark CE. Pancreatitis. ...

  11. Cystitis - acute

    Science.gov (United States)

    Uncomplicated urinary tract infection; UTI - acute cystitis; Acute bladder infection; Acute bacterial cystitis ... cause. Menopause also increases the risk for a urinary tract infection. The following also increase your chances of having ...

  12. Prevalence of alcohol and other psychoactive substances in injured drivers : comparison between Belgium and The Netherlands.

    NARCIS (Netherlands)

    Legrand, S.-A. Houwing, S. Hagenzieker, M. & Verstraete, A.G.

    2013-01-01

    The study objective was to compare the prevalence of alcohol and (il)licit drugs in seriously injured drivers in Belgium (BE) and the Netherlands (NL). Injured car and van drivers admitted to the emergency departments of five hospitals in Belgium and three in the Netherlands from January 2008 to May

  13. URINARY-TRACT INJURIES IN MULTIPLY-INJURED PATIENTS - A RATIONAL GUIDELINE FOR THE INITIAL ASSESSMENT

    NARCIS (Netherlands)

    WERKMAN, HA; JANSEN, C; KLEIN, JP; TENDUIS, HJ

    1991-01-01

    In a retrospective study involving 866 multiply-injured patients we demonstrated urinary tract injuries in 72 patients (8.3 per cent), 17 (2 per cent) of which were serious. Haematuria was a frequent finding in multiply-injured patients. In patients with serious lesions of the urinary tract, more th

  14. Collaborative Strengths-Based Brief Therapy with Self-Injuring Adolescents and Their Families

    Science.gov (United States)

    Selekman, Matthew D.

    2010-01-01

    This article presents a family competency-based treatment approach that capitalizes on the strengths and resources of self-injuring adolescents and their families. Throughout the article, the author provides therapeutic tools and strategies that he has found effective in his clinical practice of working with self-injuring youth and their families…

  15. Employment among Spinal Cord Injured Patients Living in Turkey: A Cross-Sectional Study

    Science.gov (United States)

    Gunduz, Berrin; Erhan, Belgin; Bardak, Ayse Nur

    2010-01-01

    The aim of this study was to determine the rate of employment and to establish the factors affecting vocational status in spinal cord injured patients living in Turkey. One hundred and fifty-two traumatic spinal cord injured patients older than 18 years with injury duration of at least 1 year and living in the community were included in the study;…

  16. Prevention of Cartilage Degeneration and Restoration of Chondroprotection by Lubricin Tribosupplementation in the Rat Following ACL Transection

    Science.gov (United States)

    Jay, Gregory D.; Fleming, Braden C.; Watkins, Bryn A.; McHugh, Karen A.; Anderson, Scott C.; Zhang, Ling X.; Teeple, Erin; Waller, Kimberly A.; Elsaid, Khaled A.

    2010-01-01

    Objective To investigate whether cartilage degeneration is prevented or minimized in an anterior cruciate ligament (ACL) injury rat model following intra-articular injections of lubricin derived from human synoviocytes in culture (HSL), recombinant protein (rhPRG4), or from human synovial fluids (HSFL). Methods Unilateral ACL transection (ACLT) was performed in Lewis rats (n=45). Intra-articular injections (50μl/injection) of PBS (n=9), HSL (n=9; 200μg/ml), rhPRG4 (n=9; 200μg/ml) and HSFL (n=9; 200μg/ml) started on day 7 post-injury and continued twice weekly. Animals were harvested on day 32 post-injury. Histological analysis was performed using Safranin O/Fast green stain and blinded investigators graded articular cartilage degeneration using OARSI modified Mankin criteria. Histological specimens were immunoprobed for lubricin and sulphated glycosaminoglycans. 24 hour urine collection was performed on days 17 and 29 post-injury and urinary CTXII (uCTXII) levels were measured. Results Treatment with HSL resulted in significantly (p<0.05) lower OARSI scores for cartilage degeneration compared to no treatment or PBS treatment. Increased immunostaining for lubricin in the superficial zone chondrocytes and on the surface of cartilage was observed in lubricins-treated but not untreated or PBS-treated joints. On day 17, uCTXII levels of HSL and HSFL-treated animals were significantly lower than untreated (p=0.005; p=0.002) and PBS-treated (p=0.002; p<0.001) animals, respectively. Conclusion Across all types of lubricin evaluated in this study, a reduction in cartilage damage following ACLT was evident, combined with a reduction in collagen type II degradation. Intraarticular lubricin injection following an ACL injury may be beneficial in retarding cartilage degeneration and development of post-traumatic OA. PMID:20506144

  17. Assessing 3D tunnel position in ACL reconstruction using a novel single image 3D-2D registration

    Science.gov (United States)

    Kang, X.; Yau, W. P.; Otake, Y.; Cheung, P. Y. S.; Hu, Y.; Taylor, R. H.

    2012-02-01

    The routinely used procedure for evaluating tunnel positions following anterior cruciate ligament (ACL) reconstructions based on standard X-ray images is known to pose difficulties in terms of obtaining accurate measures, especially in providing three-dimensional tunnel positions. This is largely due to the variability in individual knee joint pose relative to X-ray plates. Accurate results were reported using postoperative CT. However, its extensive usage in clinical routine is hampered by its major requirement of having CT scans of individual patients, which is not available for most ACL reconstructions. These difficulties are addressed through the proposed method, which aligns a knee model to X-ray images using our novel single-image 3D-2D registration method and then estimates the 3D tunnel position. In the proposed method, the alignment is achieved by using a novel contour-based 3D-2D registration method wherein image contours are treated as a set of oriented points. However, instead of using some form of orientation weighting function and multiplying it with a distance function, we formulate the 3D-2D registration as a probability density estimation using a mixture of von Mises-Fisher-Gaussian (vMFG) distributions and solve it through an expectation maximization (EM) algorithm. Compared with the ground-truth established from postoperative CT, our registration method in an experiment using a plastic phantom showed accurate results with errors of (-0.43°+/-1.19°, 0.45°+/-2.17°, 0.23°+/-1.05°) and (0.03+/-0.55, -0.03+/-0.54, -2.73+/-1.64) mm. As for the entry point of the ACL tunnel, one of the key measurements, it was obtained with high accuracy of 0.53+/-0.30 mm distance errors.

  18. Identification of nutritional components in trypticase responsible for recovery of Escherichia coli injured by freezing.

    Science.gov (United States)

    Moss, C W; Speck, M L

    1966-03-01

    Moss, C. Wayne (North Carolina State University, Raleigh), and M. L. Speck. Identification of nutritional components in Trypticase responsible for recovery of Escherichia coli injured by freezing. J. Bacteriol. 91:1098-1104. 1966.-Freezing and storage of Escherichia coli at -20 C resulted in nonlethal or "metabolic" injury to a proportion of the surviving population. The injury was manifested as an increased nutritional requirement after freezing. Injured cells could not grow on a minimal agar medium, but could develop on Trypticase Soy Agar. The percentage of injured survivors varied among strains, but was little affected by altering the freezing menstruum. Trypticase was found to be the component in Trypticase Soy Agar responsible for the recovery of injured cells, and contained five closely related peptides that possessed most of the biological activity. Isolation of the peptides was accomplished by Sephadex gel chromatography, paper chromatography, and high-voltage paper electrophoresis. Hydrolysis of the peptides destroyed the ability to restore injured cells.

  19. Do Newer-Generation Bioabsorbable Screws Become Incorporated into Bone at Two Years After ACL Reconstruction with Patellar Tendon Graft?

    Science.gov (United States)

    Cox, Charles L.; Spindler, Kurt P.; Leonard, James P.; Morris, Brent J.; Dunn, Warren R.; Reinke, Emily K.

    2014-01-01

    Background: Bioabsorbable interference screws are used frequently for graft fixation in ACL (anterior cruciate ligament) reconstruction. The resorption properties of many available screws that are marketed as bioabsorbable are not well defined. The CALAXO (Smith & Nephew Endoscopy) and MILAGRO (DePuy Synthes) bioabsorbable screws contain polymers of poly(lactic-co-glycolic acid) (PLGA) plus additives to encourage osseointegration over time. The purpose of this study was to evaluate radiographic and magnetic resonance imaging (MRI) properties and compare patient-reported outcomes at a minimum of two years of follow-up after ACL reconstruction using CALAXO or MILAGRO bioabsorbable interference screws. Methods: A cohort of patients who underwent ACL reconstruction in which the fixation used was either CALAXO or MILAGRO screws returned for repeat radiographs for evaluation of tunnel widening, repeat MRI for evaluation of graft integrity and screw breakdown, and completion of the pain and symptom items of the KOOS (Knee injury and Osteoarthritis Outcome Score) questionnaire. Results: At a mean of three years (range, 2.5 to 4.0 years) after surgery, thirty-one patients with sixty-two CALAXO screws and thirty-six patients with seventy-two MILAGRO screws returned for repeat evaluation. Two blinded, independent reviewers found no significant differences between the two screw types when comparing radiographs for tibial or femoral tunnel widening or MRIs for graft integrity, tibial and femoral foreign body reactions, or femoral screw degradation. Both reviewers found a significant difference between the two screw types when comparing tibial screw degradation properties (p MILAGRO screws were more likely to be rated as intact. No significant differences were noted between the two screw types when comparing the two KOOS subscales. Conclusions: CALAXO screws in the tibial tunnel were more likely to be rated as degraded or partially degraded compared with MILAGRO screws at a mean

  20. Research on System Access Control Based on Spring Security ACL%基于Spring Security ACL的系统访问控制研究

    Institute of Scientific and Technical Information of China (English)

    张朝日

    2011-01-01

    Spring Security ACL is an access control security framework, it can control all kinds of resource authority. This article introduces the concept and mechanism of Spring Security ACL, at the same time describes the implementation and process of Spring Security ACL security framework by example.%Spring Security ACL是一个权限访问控制框架,主要用采控制各种资源的访问权限.本文讲述Spring Security ACL的机制原理和理论研究,同时也通过一个简单的权限控制实现的例子演示Spring Security ACL的安全框架的实现方法和过程.

  1. 后外侧旋转不稳定对ACL重建的影响单独ACL重建与ACL联合后外侧角重建的比较%The Influence of Posterolateral Rotatory Instability on ACL Reconstruction Comparison Betwwen Isolated ACL Reconstruction and ACL Reconstruction Combined with Posterolateral Corner ACL Reconstruction

    Institute of Scientific and Technical Information of China (English)

    Sung-Jae Kim; Duck-Hyun Choi; Byoung-Yoon Hwang; 冯万文; 刘玉杰

    2013-01-01

    背景:本文回顾性研究的目的是评价后外侧角重建对前十字韧带(ACL)重建在前方松弛和临床效果方面的影响.我们建立的假设是ACL联合后外侧角重建比单独ACL重建在前方松弛和临床结果方面更不满意.方法:我们对自2001年2月至2005年12月期间行ACL重建的69倒患者进行了回顾性研究.单独ACL重建46例(Ⅰ组),ACL联合后外侧角重建23例(Ⅱ组).由术前和经24个月随访检查获取的数据确定临床结果.结果:用KT2000关节测量仪测量胫骨前移,术后平均移位值与健侧对照(标准误),Ⅰ组(2.2±1.0 mm)比Ⅱ组(1.6±0.8mm)大(p=0.031),1级前移Ⅰ组7膝(15.2%),Ⅱ组2膝(8.7%).平均Lysholm评分Ⅰ组93.2分,Ⅱ组90.1分(p=0.392).根据国际膝关节评分系统,Ⅰ组38膝(82.6%)和Ⅱ组20膝(87.0%)为正常或接近正常(p=0.882).结论:根据应用KT2000关节测量仪测量评价韧带松弛,观察到ACL联合后外侧角重建比单独ACL重建前移小.然而,不能确定两组间在功能方面的统计学差异.

  2. Relationship between mucoid hypertrophy of the anterior cruciate ligament (ACL) and morphologic change of the intercondylar notch: MRI and arthroscopy correlation

    Energy Technology Data Exchange (ETDEWEB)

    Cha, Ji Hyeon; Shin, Myung Jin; Choi, Byeong Kyoo [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul (Korea); Lee, Sang Hoon [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul (Korea); University of Ulsan College of Medicine, Department of Radiology, Asan Medical Center, Seoul (Korea); Bin, Sung Il [University of Ulsan College of Medicine, Department of Orthopedic Surgery, Asan Medical Center, Seoul (Korea)

    2008-09-15

    The purpose of this study was to evaluate the relationship between mucoid hypertrophy of the anterior cruciate ligament (ACL) and morphologic change of the intercondylar notch. We retrospectively reviewed the 105 patients with knee magnetic resonance imaging (MRI) with or without knee arthroscopy [group 1: patients with arthroscopic notchplasty (N = 47), group 2: knee arthroscopy demonstrating intact ACL (N = 33), and group 3: patients with normal knee MRI but no arthroscopy (N = 25)]. Groups 2 and 3 served as an arthroscopic and MR control group, respectively. Two musculoskeletal radiologists reviewed all MR examinations. The intercondylar notch width, notch index (width of intercondylar notch/width of femoral condyle), transverse notch angle (TNA), sagittal notch angle (SNA), and notch area were recorded on axial and sagittal MR images at the midpoint of Blumensaat's line which was identified on sagittal images. The diameter of the ACL was recorded on coronal MR images at the posterior end of Blumensaat's line. The mean values of the intercondylar notch width, notch index, TNA, SNA, notch area, and ACL diameter for the three groups were 16.0 mm/0.2/50.3 /36.5 /249.0 mm{sup 2}/7.7 mm (group 1); 19.3 mm/0.3/52.9 /40.2 /323.4 mm{sup 2}/4.8 mm (group 2); and 20.3 mm/0.3/51.4 /39.1 /350.8 mm{sup 2}/4.5 mm (group 3). The intercondylar notch width, notch index, SNA, and notch area were smaller, and ACL diameter was thicker in group 1 compared with the other groups (p < 0.05). Patients with mucoid ACL hypertrophy show a narrower notch, a steeper notch angle, and a smaller notch area than control groups. (orig.)

  3. Acute Bronchitis

    Science.gov (United States)

    ... Smoking also slows down the healing process. Acute bronchitis treatment Most cases of acute bronchitis can be treated at home.Drink fluids, but ... bronchial tree. Your doctor will decide if this treatment is right for you. Living with acute bronchitis Most cases of acute bronchitis go away on ...

  4. Assessing the progress of rehabilitation in patients with ACL reconstruction using the International Knee Documentation Committee Subjective Knee Form

    Science.gov (United States)

    Leguizamon, J. H.; Braidot, A.; Catalfamo Formento, P.

    2011-12-01

    There are numerous assessment tools designed to provide information on the results of reconstructive surgery of anterior cruciate ligament (ACL). They are also used for monitoring progress and facilitating clinical decision-making during the rehabilitation process. A brief summary of some existing tools specifically designed to evaluate knee ligament injuries is presented in this article. Then, one of those outcome measures, the International Knee Documentation Committee Subjective Knee Form (IKDC) was applied to a group of patients (N = 10) who had undergone surgery for ACL reconstruction. The patients attended the same physiotherapy service and followed a unified rehabilitation protocol. The assessment was performed twice: four and six months after surgery. The results showed an improvement in the rehabilitation of most patients tested (verified by a difference equal to or greater than 9 points on the IKDC outcome between measurements 1 and 2). The IKDC probed to be an instrument of quick and easy application. It provided quantitative data about the progress of rehabilitation and could be applied in everyday clinical physiotherapy practice. However, the results suggested considering the IKDC as one component of an evaluation kit to make decisions regarding the progress of the rehabilitation treatment.

  5. Wound healing process of injured pulp tissues with emdogain gel.

    Science.gov (United States)

    Kaida, Hikaru; Hamachi, Takafumi; Anan, Hisashi; Maeda, Katsumasa

    2008-01-01

    This study aimed to investigate the wound healing process of injured pulp tissues with Emdogain gel (EMD). Pulpotomy was performed for the first molars of the mandibles in rats. EMD or Vitapex (VIT)-containing calcium hydroxide was applied to the exposed pulp tissues. The treated teeth were extracted after 7, 14, and 28 days and prepared for histologic examination. In the VIT-treated group, the number of interleukin-1 beta (IL-1 beta)-expressing macrophages initially increased, followed by that of transforming growth factor-beta1 (TGF-beta1)-expressing macrophages. The number of cells expressing bone morphogenetic proteins (BMPs) gradually increased with reparative dentin formation. Meanwhile, in the EMD-treated group, cells expressing IL-1 beta or TGF-beta1 were few. However, the number of BMP-expressing cells, partly macrophages, increased in the early phase, and large amounts of reparative dentin were observed. This study demonstrated that different healing processes existed for EMD and VIT. BMP-expressing macrophages might play important roles in reparative dentin formation.

  6. Corps de ballet: the case of the injured ballet dancer.

    Science.gov (United States)

    Turner, Bryan S; Wainwright, Steven P

    2003-05-01

    This paper contributes to debate on social constructionism in the sociology of health and illness through a study of injury among ballet dancers. In this empirical study of classical ballet dancers, we outline a phenomenology of the injured and ageing body in terms of a critical commentary on constructionism. We explore dancers' experiences of embodiment to illustrate our critique of recent interpretations of dance as a textual practice. Those forms of social constructionism that define the body as a text provide a forceful attack on discourses of authority and legitimation, but we argue that they are problematic as epistemologies and ontologies of embodiment. Through a phenomenological understanding of the experiences of embodiment, we observe how injury and ageing disrupt the practical accomplishments that underpin the ballet habitus and the dancer's identity. Although ballet injuries can terminate a dancing career, they are accepted as an inevitable part of the vocation of ballet. Our aim is to understand the interaction between injuries, dancers' experiences of discomfort and the social support that emerges from the ballet dancers as a social group. We draw on the concepts of social solidarity and collective consciousness in Emile Durkheim to show that injury is mediated through the social bonding of dancers into a professional ballet company, where injury is accepted as a sign of vocational commitment, and suggest that this 'collective effervescence' gives a novel meaning to the idea of a corps de ballet.

  7. Interplay between thyroxin, BDNF and GABA in injured neurons.

    Science.gov (United States)

    Shulga, A; Rivera, C

    2013-06-03

    Accumulating experimental evidence suggests that groups of neurons in the CNS might react to pathological insults by activating developmental-like programs for survival, regeneration and re-establishment of lost connections. For instance, in cell and animal models it was shown that after trauma mature central neurons become dependent on brain-derived neurotrophic factor (BDNF) trophic support for survival. This event is preceded by a shift of postsynaptic GABAA receptor-mediated responses from hyperpolarization to developmental-like depolarization. These profound functional changes in GABAA receptor-mediated transmission and the requirement of injured neurons for BDNF trophic support are interdependent. Thyroid hormones (THs) play a crucial role in the development of the nervous system, having significant effects on dendritic branching, synaptogenesis and axonal growth to name a few. In the adult nervous system TH thyroxin has been shown to have a neuroprotective effect and to promote regeneration in experimental trauma models. Interestingly, after trauma there is a qualitative change in the regulatory effect of thyroxin on BDNF expression as well as on GABAergic transmission. In this review we provide an overview of the post-traumatic changes in these signaling systems and discuss the potential significance of their interactions for the development of novel therapeutic strategies.

  8. Maladaptation of cerebral perfusion in the spinal cord injured individuals

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Ihn Ho; Chun, Kyung A.; Lee, Hyoung Woo; Ahn, Sang Ho; Hayashida, Kohei [National Cardiovascular Center, Osaka (Korea, Republic of)

    2001-07-01

    The aim of this study was to evaluate the tilt-induced alteration of cerebral perfusion of spinal cord injured individuals. Supine and upright sitting brain SPECT was performed using a 1-day protocol with {sup 99m}Tc-ethylcysteinate dimer (ECD) in 11 SCI individuals (mean age, 32.6 y), with lesions between C3 and T4, ad 5 AB individuals (mean age, 31.4 y). The patients rested on a wheelchair in the supine position. Then, they sat up and, at the same time 555MBq of ECD was injected. The upright SPECT was done. Finally, 740MBq of ECD was injected and supine SPECT was performed again. The SPECT data were acquired with dual head gamma camera (E-cam, Siemens). For semiquantitative analysis, 14 ROIs were drawn on the brain. In the SCI individuals, the radiotracer uptake in the frontal, temporal and parietal areas were significantly decreased in the upright SPECT. No postural changes was evident in the occipital lobe, basal ganglia and thalamus in the SCI individuals. In the AB individuals, there were no such changes on the upright SPECT. Postural cerebral hypoperfusion in the frontal, temporal and parietal areas in the SCI individuals might relate to maladaptation of the vascular response during the upright position.

  9. Management of Sexual Disorders in Spinal Cord Injured Patients

    Directory of Open Access Journals (Sweden)

    Alexander R Vaccaro

    2012-05-01

    Full Text Available Spinal cord injured (SCI patients have sexual disorders including erectile dysfunction (ED, impotence, priapism, ejaculatory dysfunction and infertility. Treatments for erectile dysfunction include four steps. Step 1 involves smoking cessation, weight loss, and increasing physical activity. Step 2 is phosphodiesterase type 5 inhibitors (PDE5I such as Sildenafil (Viagra, intracavernous injections of Papaverine or prostaglandins, and vacuum constriction devices. Step 3 is a penile prosthesis, and Step 4 is sacral neuromodulation (SNM. Priapism can be resolved spontaneously if there is no ischemia found on blood gas measurement or by Phenylephrine. For anejaculatory dysfunction, massage, vibrator, electrical stimulation and direct surgical biopsy can be used to obtain sperm which can then be used for intra-uterine or in-vitro fertilization. Infertility treatment in male SCI patients involves a combination of the above treatments for erectile and anejaculatory dysfunctions. The basic approach to and management of sexual dysfunction in female SCI patients are similar as for men but do not require treatment for erectile or ejaculatory problems.

  10. Sodium hydrosulfide relieves neuropathic pain in chronic constriction injured rats.

    Science.gov (United States)

    Lin, Jian-Qing; Luo, Hui-Qin; Lin, Cai-Zhu; Chen, Jin-Zhuan; Lin, Xian-Zhong

    2014-01-01

    Aberrant neuronal activity in injured peripheral nerves is believed to be an important factor in the development of neuropathic pain (NPP). Channel protein pCREB of that activity has been shown to mitigate the onset of associated molecular events in the nervous system, and sodium hydrosulfide (NaHS) could inhibit the expression of pCREB. However, whether NaHS could relieve the pain, it needs further experimental research. Furthermore, the clinical potential that NaHS was used to relieve pain was limited so it would be required. To address these issues, the rats of sciatic nerve chronic constriction injury (CCI) were given intraperitoneal injection of NaHS containing hydrogen sulfide (H2S). The experimental results showed that NaHS inhibited the reduction of paw withdrawal thermal latency (PWTL), mechanical withdrawal threshold (MWT), and the level of pCREB in CCI rats in a dose-dependent manner and they were greatly decreased in NaHSM group (P < 0.05). NaHS alleviates chronic neuropathic pain by inhibiting expression of pCREB in the spinal cord of Sprague-Dawley rats.

  11. Sodium Hydrosulfide Relieves Neuropathic Pain in Chronic Constriction Injured Rats

    Directory of Open Access Journals (Sweden)

    Jian-qing Lin

    2014-01-01

    Full Text Available Aberrant neuronal activity in injured peripheral nerves is believed to be an important factor in the development of neuropathic pain (NPP. Channel protein pCREB of that activity has been shown to mitigate the onset of associated molecular events in the nervous system, and sodium hydrosulfide (NaHS could inhibit the expression of pCREB. However, whether NaHS could relieve the pain, it needs further experimental research. Furthermore, the clinical potential that NaHS was used to relieve pain was limited so it would be required. To address these issues, the rats of sciatic nerve chronic constriction injury (CCI were given intraperitoneal injection of NaHS containing hydrogen sulfide (H2S. The experimental results showed that NaHS inhibited the reduction of paw withdrawal thermal latency (PWTL, mechanical withdrawal threshold (MWT, and the level of pCREB in CCI rats in a dose-dependent manner and they were greatly decreased in NaHSM group (P < 0.05. NaHS alleviates chronic neuropathic pain by inhibiting expression of pCREB in the spinal cord of Sprague-Dawley rats.

  12. Social reintegration of traumatic brain-injured: the French experience.

    Science.gov (United States)

    Truelle, J-L; Wild, K Von; Onillon, M; Montreuil, M

    2010-01-01

    Traumatic Brain Injury (TBI) may lead to specific handicap, often hidden, mainly due to cognitive and behavioural sequelae. Social re-entry is a long-term, fluctuant and precarious process. The French experience will be illustrated by 6 initiatives answering to 6 challenges to do with TBI specificities:1. bridging the gap, between initial rehabilitation and community re-entry, via transitional units dealing with assessment, retraining, social/vocational orientation and follow-up. Today, there are 30 such units based on multidisciplinary teams.2. assessing recovery by TBI-specific and validated evaluation tools: EBIS holistic document, BNI Screening of higher cerebral functions, Glasgow outcome extended, and QOLIBRI, a TBI-specific quality of life tool.3. promoting specific re-entry programmes founded on limited medication, ecological neuro-psychological rehabilitation, exchange groups and workshops, violence prevention, continuity of care, environmental structuration, and "resocialisation".4. taking into account the "head injured family"5. facilitating recovery after sports-related concussion6. facing medico-legal consequences and compensation: In that perspective, we developed guidelines for TBI-specific expert appraisal, including mandatory neuro-psychological assessment, family interview and an annual forum gathering lawyers and health professionals.

  13. Management of Abdominal Wounds in Thermally Injured Patients

    Science.gov (United States)

    1982-01-01

    Acute inflammatory disease 5 Superior mesenteric artery syndrome 4 Biliary tract disease 4 surface in the patients with abdominal burns, and only...ity of these critically ill patients were equally affected by polypropylene was used for fascial closure, the wound ileus , sepsis, abdominal distention

  14. Regenerative Responses and Axon Pathfinding of Retinal Ganglion Cells in Chronically Injured Mice

    Science.gov (United States)

    Yungher, Benjamin J.; Ribeiro, Márcio; Park, Kevin K.

    2017-01-01

    Purpose Enhanced regeneration of retinal ganglion cell (RGC) axons can be achieved by modification of numerous neuronal-intrinsic factors. However, axon growth initiation and the pathfinding behavior of these axons after traumatic injury remain poorly understood outside of acute injury paradigms, despite the clinical relevance of more chronic settings. We therefore examined RGC axon regeneration following therapeutic delivery that is postponed until 2 months after optic nerve crush injury. Methods Optic nerve regeneration was induced by virally mediated (adeno-associated virus) ciliary neurotrophic factor (AAV-CNTF) administered either immediately or 56 days after optic nerve crush in wild-type or Bax knockout (KO) mice. Retinal ganglion nerve axon regeneration was assessed 21 and 56 days after viral injection. Immunohistochemical analysis of RGC injury signals and extrinsic factors in the optic nerve were also examined at 5 and 56 days post crush. Results In addition to sustained expression of injury response proteins in surviving RGCs, we observe axon regrowth in wild-type and apoptosis-deficient Bax KO mice following AAV-CNTF treatment. Fewer instances of aberrant axon growth are seen, at least in the area near the lesion site, in animals given treatment 56 days after crush injury compared to the animals given treatment immediately after injury. We also find evidence of long distance growth into a visual target in Bax KO mice despite postponed initiation of this regenerative program. Conclusions These studies provide evidence against an intrinsic critical period for RGC axon regeneration or degradation of injury signals. Regeneration results from Bax KO mice imply highly sustained regenerative capacity in RGCs, highlighting the importance of long-lasting neuroprotective strategies as well as of RGC axon guidance research in chronically injured animals. PMID:28324115

  15. Human astrocytes derived from glial restricted progenitors support regeneration of the injured spinal cord.

    Science.gov (United States)

    Haas, Christopher; Fischer, Itzhak

    2013-06-15

    Cellular transplantation using neural stem cells and progenitors is a promising therapeutic strategy that has the potential to replace lost cells, modulate the injury environment, and create a permissive environment for the regeneration of injured host axons. Our research has focused on the use of human glial restricted progenitors (hGRP) and derived astrocytes. In the current study, we examined the morphological and phenotypic properties of hGRP prepared from the fetal central nervous system by clinically-approved protocols, compared with astrocytes derived from hGRP prepared by treatment with ciliary neurotrophic factor or bone morphogenetic protein 4. These differentiation protocols generated astrocytes that showed morphological differences and could be classified along an immature to mature spectrum, respectively. Despite these differences, the cells retained morphological and phenotypic plasticity upon a challenge with an alternate differentiation protocol. Importantly, when hGRP and derived astrocytes were transplanted acutely into a cervical dorsal column lesion, they survived and promoted regeneration of long ascending host sensory axons into the graft/lesion site, with no differences among the groups. Further, hGRP taken directly from frozen stocks behaved similarly and also supported regeneration of host axons into the lesion. Our results underscore the dynamic and permissive properties of human fetal astrocytes to promote axonal regeneration. They also suggest that a time-consuming process of pre-differentiation may not be necessary for therapeutic efficacy, and that the banking of large quantities of readily available hGRP can be an appropriate source of permissive cells for transplantation.

  16. ACL TOP血凝仪在儿科实验室的应用评价%Evaluation of ACL TOP coagulation analytical system in the laboratory of children′s hospital

    Institute of Scientific and Technical Information of China (English)

    吴跃平; 肖丽霞; 杨庆斌; 蔡德丰; 马东礼

    2014-01-01

    目的:评价 ACL TOP 血凝仪在儿科实验室的性能及应用。方法:参照 CLSI 的要求,评价 ACL TOP血凝仪的精密度、正确度、线性、抗生物干扰能力、样本携带污染率;建立 ACL TOP 血凝仪在本地区儿童的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)的参考区间。结果:凝固法及免疫比浊法两种方法的精密度均符合厂家规定的要求;正确度实验PT、APTT、FIB的偏倚均未超出二分之一 CLIA′88规定的允许误差范围;FIB 线性测定的直线回归方程为 Y =1.0021X-0.122,R2为0.9982,符合厂家要求(r≥0.975);胆红素20 mg/dL、甘油三脂900 mg/dL、血红蛋白5 g/L 时,对 PT、APTT、TT 和 FIB 测定的影响度均小于二分之一 CLIA′88规定的允许误差范围;样本携带污染率最高为1.81%,符合厂家性能要求;本地区儿童生物参考区间:PT(9.1~13.1 s)、APTT(24.9~42.1 s)、TT(12.6~21.1 s)、FIB(1.924~4.011 g/L)。结论:ACL TOP血凝仪具有良好的精密度、正确度、线性和较低的样本携带污染率,并具较强的抗生物干扰能力,适合本实验室使用。%Objective To evaluate the performance of ACL TOP coagulation analyzer system in the laboratory of children′s hospital. Methods According to the documents of CLSI, the analytic characteristics including precision, accuracy, linearity, interference and carryover rate were examined; specimens from healthy children were collected and assayed to determine the reference range of Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT), Thrombin Time (TT), Fibrinogen (FIB) and D-Dimer (D-D) from children on ACL TOP. Results The within-run and between-day coefficient of variability (CV) were within an acceptable range; The accuracy deviation of PT , APTT and FIB were less than 1/2 allowed total errors

  17. Causes of the Injured Prisoners Degradation in the Reality of Polish Penal Institutions

    Directory of Open Access Journals (Sweden)

    Mariusz Snopek

    2013-12-01

    Full Text Available The injured prisoners – in terms of functioning in penal institution – represent a specific group of embedded. This article includes current research, which enabled specification determining injured reasons and their detailed characterization. Specified causes are determining the way of treating prisoners, therefore good recognizing the prison’s environment by the staff is very important. Only it can be a base for preventive and rehabilitative action. Researches aimed to showing modern, i.e. after the transformation occurring in penitentiary system, the image of injured prisoners.

  18. Can molecular motors drive distance measurements in injured neurons?

    Directory of Open Access Journals (Sweden)

    Naaman Kam

    2009-08-01

    Full Text Available Injury to nerve axons induces diverse responses in neuronal cell bodies, some of which are influenced by the distance from the site of injury. This suggests that neurons have the capacity to estimate the distance of the injury site from their cell body. Recent work has shown that the molecular motor dynein transports importin-mediated retrograde signaling complexes from axonal lesion sites to cell bodies, raising the question whether dynein-based mechanisms enable axonal distance estimations in injured neurons? We used computer simulations to examine mechanisms that may provide nerve cells with dynein-dependent distance assessment capabilities. A multiple-signals model was postulated based on the time delay between the arrival of two or more signals produced at the site of injury-a rapid signal carried by action potentials or similar mechanisms and slower signals carried by dynein. The time delay between the arrivals of these two types of signals should reflect the distance traversed, and simulations of this model show that it can indeed provide a basis for distance measurements in the context of nerve injuries. The analyses indicate that the suggested mechanism can allow nerve cells to discriminate between distances differing by 10% or more of their total axon length, and suggest that dynein-based retrograde signaling in neurons can be utilized for this purpose over different scales of nerves and organisms. Moreover, such a mechanism might also function in synapse to nucleus signaling in uninjured neurons. This could potentially allow a neuron to dynamically sense the relative lengths of its processes on an ongoing basis, enabling appropriate metabolic output from cell body to processes.

  19. Histological study of soybeans injured by exposure to sulfur dioxide

    Energy Technology Data Exchange (ETDEWEB)

    Irving, P. M.; Martinson, D. J.; Miller, J. E.

    1979-01-15

    Since it is now known that crop yields may be reduced by exposure to sulfur dioxide without accompanying visible damage, a technique for quantifying both visible and hidden damage to crop plants after exposure to SO/sub 2/ would be extremely useful. A preliminary histological study of soybean leaves exposed to SO/sub 2/ gas was undertaken to examine the possibility that a microscopic determination of cell death is related to SO/sub 2/ exposure and crop yield. Soybean leaf tissue samples were collected from two field plots which had been exposed to a gradient of acute SO/sub 2/ concentrations. The results from this preliminary investigation suggest that yield decreases will occur in soybeans when approximately 3.5 to 4% of the leaf cells are killed by SO/sub 2/ exposure during an acute episode and that cell death also results from chronic SO/sub 2/ exposures, even though visible damage is not observed. (JGB)

  20. Oxygen Flow Rate Requirements of Critically Injured Patients

    Science.gov (United States)

    2015-04-08

    Military Med. 2013; 178(10):1121-1125. 4. Cabello JB, Burls A, Emparanza JI, Bayliss S, Quinn T. Oxygen therapy for acute myocardial infarction ...Simmonds M, Weatherall M, Beasley R. Routine use of oxygen in the treatment of myocardial infarction : systematic review. Heart. 2009; 95(3):198-202...18. Rønning OM , Guldvog B. Should stroke victims routinely receive supplemental oxygen? A quasi-randomized controlled trial. Stroke. 1999; 30(10

  1. Effective repair of traumatically injured spinal cord by nanoscale block copolymer micelles.

    Science.gov (United States)

    Shi, Yunzhou; Kim, Sungwon; Huff, Terry B; Borgens, Richard B; Park, Kinam; Shi, Riyi; Cheng, Ji-Xin

    2010-01-01

    Spinal cord injury results in immediate disruption of neuronal membranes, followed by extensive secondary neurodegenerative processes. A key approach for repairing injured spinal cord is to seal the damaged membranes at an early stage. Here, we show that axonal membranes injured by compression can be effectively repaired using self-assembled monomethoxy poly(ethylene glycol)-poly(d,l-lactic acid) di-block copolymer micelles. Injured spinal tissue incubated with micelles (60 nm diameter) showed rapid restoration of compound action potential and reduced calcium influx into axons for micelle concentrations much lower than the concentrations of polyethylene glycol, a known sealing agent for early-stage spinal cord injury. Intravenously injected micelles effectively recovered locomotor function and reduced the volume and inflammatory response of the lesion in injured rats, without any adverse effects. Our results show that copolymer micelles can interrupt the spread of primary spinal cord injury damage with minimal toxicity.

  2. Effective repair of traumatically injured spinal cord by nanoscale block copolymer micelles

    Science.gov (United States)

    Shi, Yunzhou; Kim, Sungwon; Huff, Terry B.; Borgens, Richard B.; Park, Kinam; Shi, Riyi; Cheng, Ji-Xin

    2010-01-01

    Spinal cord injury results in immediate disruption of neuronal membranes, followed by extensive secondary neurodegenerative processes. A key approach for repairing injured spinal cord is to seal the damaged membranes at an early stage. Here, we show that axonal membranes injured by compression can be effectively repaired using self-assembled monomethoxy poly(ethylene glycol)-poly(D,L-lactic acid) di-block copolymer micelles. Injured spinal tissue incubated with micelles (60 nm diameter) showed rapid restoration of compound action potential and reduced calcium influx into axons for micelle concentrations much lower than the concentrations of polyethylene glycol, a known sealing agent for early-stage spinal cord injury. Intravenously injected micelles effectively recovered locomotor function and reduced the volume and inflammatory response of the lesion in injured rats, without any adverse effects. Our results show that copolymer micelles can interrupt the spread of primary spinal cord injury damage with minimal toxicity.

  3. The Idea and Ideals of the University: A Panel Session of the 2004 Annual Meeting of the American Council of Learned Societies. ACLS Occasional Paper No. 63

    Science.gov (United States)

    American Council of Learned Societies, 2007

    2007-01-01

    In 1918, just one year before the founding of American Council of Learned Societies (ACLS), Thorstein Veblin wrote, "In one shape or another, this problem of adjustment, reconciliation or compromise between the needs of higher learning and the demands of the business enterprise is forever present in the deliberations of the university…

  4. ACL-based Campus Network Security Management of Colleges and Universities%基于ACL的高校校园网络安全管理探析

    Institute of Scientific and Technical Information of China (English)

    刘小园; 衣扬

    2013-01-01

    With the extensive application of the campus network, network security problems increasingly apparent. The concept of access control list (ACL),grammatical structure and working principle are discussed,and the specific ACL in the campus network security equipment set is cited. The combined configuration instance,ACL is to limit network traffic and improve network performance,an important technical means to build a network security system.%  随着校园网的广泛应用,其网络安全问题日益显现出来。探讨了访问控制列表(ACL)的概念、语法结构及工作原理,并列举了ACL在校园网络安全方面的具体备置。结合配置实例,ACL是限制网络流量和提高网络性能,构建网络安全体系的一种重要技术手段。

  5. Immersive virtual reality improves movement patterns in patients after ACL reconstruction : implications for enhanced criteria-based return-to-sport rehabilitation

    NARCIS (Netherlands)

    Gokeler, Alli; Bisschop, Marsha; Myer, Gregory D.; Benjaminse, Anne; Dijkstra, Pieter U.; van Keeken, Helco G.; van Raay, Jos J. A. M.; Burgerhof, Johannes G. M.; Otten, Egbert

    2016-01-01

    The purpose of this study was to evaluate the influence of immersion in a virtual reality environment on knee biomechanics in patients after ACL reconstruction (ACLR). It was hypothesized that virtual reality techniques aimed to change attentional focus would influence altered knee flexion angle, kn

  6. Immersive virtual reality improves movement patterns in patients after ACL reconstruction : implications for enhanced criteria-based return-to-sport rehabilitation

    NARCIS (Netherlands)

    Gokeler, Alli; Bisschop, Marsha; Myer, Gregory D.; Benjaminse, Anne; Dijkstra, Pieter U.; van Keeken, Helco G.; van Raay, Jos J. A. M.; Burgerhof, Johannes G. M.; Otten, Egbert

    2016-01-01

    PURPOSE: The purpose of this study was to evaluate the influence of immersion in a virtual reality environment on knee biomechanics in patients after ACL reconstruction (ACLR). It was hypothesized that virtual reality techniques aimed to change attentional focus would influence altered knee flexion

  7. Immersive virtual reality improves movement patterns in patients after ACL reconstruction : implications for enhanced criteria-based return-to-sport rehabilitation

    NARCIS (Netherlands)

    Gokeler, Alli; Bisschop, Marsha; Myer, Gregory D; Benjaminse, Anne; Dijkstra, Pieter U.; van Keeken, Helco G; van Raay, Jos J A M; Burgerhof, Johannes G M; Otten, Egbert

    2014-01-01

    PURPOSE: The purpose of this study was to evaluate the influence of immersion in a virtual reality environment on knee biomechanics in patients after ACL reconstruction (ACLR). It was hypothesized that virtual reality techniques aimed to change attentional focus would influence altered knee flexion

  8. Constitutive modeling of the human Anterior Cruciate Ligament (ACL) under uniaxial loading using viscoelastic prony series and hyperelastic five parameter Mooney-Rivlin model

    Science.gov (United States)

    Chakraborty, Souvik; Mondal, Debabrata; Motalab, Mohammad

    2016-07-01

    In this present study, the stress-strain behavior of the Human Anterior Cruciate Ligament (ACL) is studied under uniaxial loads applied with various strain rates. Tensile testing of the human ACL samples requires state of the art test facilities. Furthermore, difficulty in finding human ligament for testing purpose results in very limited archival data. Nominal Stress vs. deformation gradient plots for different strain rates, as found in literature, is used to model the material behavior either as a hyperelastic or as a viscoelastic material. The well-known five parameter Mooney-Rivlin constitutivemodel for hyperelastic material and the Prony Series model for viscoelastic material are used and the objective of the analyses comprises of determining the model constants and their variation-trend with strain rates for the Human Anterior Cruciate Ligament (ACL) material using the non-linear curve fitting tool. The relationship between the model constants and strain rate, using the Hyperelastic Mooney-Rivlin model, has been obtained. The variation of the values of each coefficient with strain rates, obtained using Hyperelastic Mooney-Rivlin model are then plotted and variation of the values with strain rates are obtained for all the model constants. These plots are again fitted using the software package MATLAB and a power law relationship between the model constants and strain rates is obtained for each constant. The obtained material model for Human Anterior Cruciate Ligament (ACL) material can be implemented in any commercial finite element software package for stress analysis.

  9. Psychological approach to the rehabilitation of the spinal cord injured: the contribution of relaxation techniques.

    Science.gov (United States)

    Curcoll, M L

    1992-06-01

    We analyse the benefit of learning relaxation techniques as an essential coping strategy in the behavioural medicine field. This has proved useful as a part of the newly spinal cord injured rehabilitation treatment or concerning later problems if there is readmission. We report the changes we have made in the relaxation standard methods to be used in spinal cord injured patients as well as the timing in the rehabilitation process when these techniques were applied.

  10. Single Wake Meandering, Advection and Expansion - An analysis using an adapted Pulsed Lidar and CFD LES-ACL simulations

    DEFF Research Database (Denmark)

    In this paper, single wake characteristics have been studied both experimentally and numerically. Firstly, the wake is studied experimentally using full-scale measurements from an adapted focused pulsed lidar system, which potentially gives more insight into the wake dynamics as compared to class...... using the EllipSys3D flow solver using Large Eddy Simulation (LES) and Actuator Line Technique (ACL) to model the rotor. Discrepancies due to the uncertainties on the wake advection velocity are observed and discussed....... of the wake, and it is compared to the predictions from the Dynamic Wake Meandering model, for a selected 10 minutes dataset. Secondly, the average wake expansion in the fixed frame of reference is determined from measurements and compared to results from CFD simulations. The CFD simulations were conducted...

  11. Single Wake Meandering, Advection and Expansion - An analysis using an adapted Pulsed Lidar and CFD LES-ACL simulations

    DEFF Research Database (Denmark)

    Machefaux, Ewan; Larsen, Gunner Chr.; Troldborg, Niels;

    2013-01-01

    In this paper, single wake characteristics have been studied both experimentally and numerically. Firstly, the wake is studied experimentally using full-scale measurements from an adapted focused pulsed lidar system, which potentially gives more insight into the wake dynamics as compared to class...... using the EllipSys3D flow solver using Large Eddy Simulation (LES) and Actuator Line Technique (ACL) to model the rotor. Discrepancies due to the uncertainties on the wake advection velocity are observed and discussed....... of the wake, and it is compared to the predictions from the Dynamic Wake Meandering model, for a selected 10 minutes dataset. Secondly, the average wake expansion in the fixed frame of reference is determined from measurements and compared to results from CFD simulations. The CFD simulations were conducted...

  12. Acute pancreatitis

    Directory of Open Access Journals (Sweden)

    Bo-Guang Fan

    2010-01-01

    Full Text Available Background : Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims : The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods : We reviewed the English-language literature (Medline addressing pancreatitis. Results : Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion. There are a number of important issues regarding clinical highlights in the classification, treatment and prognosis of acute pancreatitis, and treatment options for complications of acute pancreatitis including pancreatic pseudocysts. Conclusions : Multidisciplinary approach should be used for the management of the patient with acute pancreatitis.

  13. Acute pancreatitis

    Directory of Open Access Journals (Sweden)

    Bo-Guang Fan

    2010-05-01

    Full Text Available Background: Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims: The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods: We reviewed the English-language literature (Medline addressing pancreatitis. Results: Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion. There are a number of important issues regarding clinical highlights in the classification, treatment and prognosis of acute pancreatitis, and treatment options for complications of acute pancreatitis including pancreatic pseudocysts. Conclusions: Multidisciplinary approach should be used for the management of the patient with acute pancreatitis.

  14. Low-intensity ultrasound for regeneration of injured peripheral nerve

    Institute of Scientific and Technical Information of China (English)

    Wei Zhou; Wenzhi Chen; Kun Zhou; Zhibiao Wang

    2006-01-01

    BACKGROUND: Ultrasound is a kind of mechanical wave and characterized by mechanical effect,heat affect and physical and chemical effect.Ultrasound can promote regeneration of peripheral nerves after a slight injury based on its mechanical effect.However,whether it can promote regeneration of peripheral nerves after a severe injury or not is still unclear.OBJECTIVE: To study the effect of low-intensity ultrasound(LIU)on regeneration of injured peripheral nerve,throgh examining sciatic nerve function index,the sensory nerve conduction velocity and the thickness of myelin sheath.DESIGN: Single factor design of contrast observation.SETTING: Institute of Ultrasound Engineering,Chongqing Medical University.MATERIALS:A total of 64 female Wistar rats,of clean grade,age 3 moths,weighing 200-250g ,were provided by Experimental Animal Center of Chongqing Medical University. All rats were randomly divided into treatment group and control group with 32 in each group. In addition rats were observed at 4 time points, including 2,4,6 and 8 weeks,with 8 at each time point.The main equipments were detailed as follows:forceps (Medical Treatment Apparatus Company,Chongqing),low-intensity ultrasound treatment instrument(Institute of Ulrasound Engineering in Medicine),the analysis instrument of diagram resembles and arithmetic figure(the United States Bio-RAD Company),ultrasound coupling agent(Xunde Image material factory,Hangzhou),Osmium Tetraoxide(Next Chimicam,South Africa).METHODS:The experiment was carried out in Institute of Ultrasound Engineering of Chongqing Medical University from December 2003 to May 2004.The right sciatic nerves of 64 rats were crushed with forceps for 30 s to form the experimental animal models.Then they were treated at 3 days after operation.Rats in the treatment group received the LIU exposure.LIU was applied every other day to the crush site of rats,which had a spatial peak,time-averaged intensity of 0.25 W/cm2 operated at 1 MHz for 1 minute per

  15. Acute ischemic injury to the renal microvasculature in human kidney transplantation.

    NARCIS (Netherlands)

    Snoeijs, M.G.; Vink, H.; Voesten, N.; Christiaans, M.H.; Daemen, J.W.; Peppelenbosch, A.G.; Tordoir, J.H.; Peutz-Kootstra, C.J.; Buurman, W.A.; Schurink, G.W.; Heurn, L.W.E. van

    2010-01-01

    Increased understanding of the pathophysiology of ischemic acute kidney injury in renal transplantation may lead to novel therapies that improve early graft function. Therefore, we studied the renal microcirculation in ischemically injured kidneys from donors after cardiac death (DCD) and in living

  16. Effects of Early Acute Care on Autonomic Outcomes in SCI: Bedside to Bench and Back

    Science.gov (United States)

    2015-10-01

    Additional locally defined elements pertinent to the SCIC project aims • Rules and error flags for data field ranges, relational consistency and...acutely injured spinal cord in Switzerland . J Trauma. 17, 931–936. 38. Gschaedler, R., Dollfus, P., Mole, J.P., Mole, L., and Loeb, J.P. (1979

  17. Responses of intact and injured sural nerve fibers to cooling and menthol.

    Science.gov (United States)

    Teliban, Alina; Bartsch, Fabian; Struck, Marek; Baron, Ralf; Jänig, Wilfrid

    2014-05-01

    Intact and injured cutaneous C-fibers in the rat sural nerve are cold sensitive, heat sensitive, and/or mechanosensitive. Cold-sensitive fibers are either low-threshold type 1 cold sensitive or high-threshold type 2 cold sensitive. The hypothesis was tested, in intact and injured afferent nerve fibers, that low-threshold cold-sensitive afferent nerve fibers are activated by the transient receptor potential melastatin 8 (TRPM8) agonist menthol, whereas high-threshold cold-sensitive C-fibers and cold-insensitive afferent nerve fibers are menthol insensitive. In anesthetized rats, activity was recorded from afferent nerve fibers in strands isolated from the sural nerve, which was either intact or crushed 6-12 days before the experiment distal to the recording site. In all, 77 functionally identified afferent C-fibers (30 intact fibers, 47 injured fibers) and 34 functionally characterized A-fibers (11 intact fibers, 23 injured fibers) were tested for their responses to menthol applied to their receptive fields either in the skin (10 or 20%) or in the nerve (4 or 8 mM). Menthol activated all intact (n = 12) and 90% of injured (n = 20/22) type 1 cold-sensitive C-fibers; it activated no intact type 2 cold-sensitive C-fibers (n = 7) and 1/11 injured type 2 cold-sensitive C-fibers. Neither intact nor injured heat- and/or mechanosensitive cold-insensitive C-fibers (n = 25) and almost no A-fibers (n = 2/34) were activated by menthol. These results strongly argue that cutaneous type 1 cold-sensitive afferent fibers are nonnociceptive cold fibers that use the TRPM8 transduction channel.

  18. Monitoring the injured brain in the intensive care unit.

    Directory of Open Access Journals (Sweden)

    Gupta A

    2002-07-01

    Full Text Available The primary aim of managing patients with acute brain injury in the intensive care unit is to minimise secondary injury by maintaining cerebral perfusion and oxygenation. The mechanisms of secondary injury are frequently triggered by secondary insults, which may be subtle and remain undetected by the usual systemic physiological monitoring. Continuous monitoring of the central nervous system in the intensive care unit can serve two functions. Firstly it will help early detection of these secondary cerebral insults so that appropriate interventions can be instituted. Secondly, it can help to monitor therapeutic interventions and provide online feedback. This review focuses on the monitoring of intracranial pressure, blood flow to the brain (Transcranial Doppler, cerebral oxygenation using the methods of jugular bulb oximetry, near infrared spectroscopy and implantable sensors, and the monitoring of function using electrophysiological techniques.

  19. An evaluation of the clinical utility of mangled extremity severity score in severely injured lower limbs

    Directory of Open Access Journals (Sweden)

    Vipul Agarwal

    2016-05-01

    Results: Crush injury of leg with fracture of tibia and fibula was observed in 78% of injured limbs. The most common mechanism of injury was high-energy trauma. Road traffic accidents accounted for 72% of patients. Mean hospitalization for primary amputation was 19.3 (8-26 days and for delayed amputation limbs was 36.6 (15-62 days and for salvaged limbs was 45.5 (14-128 days. In the prospective study, out of 7 injured limbs with a MESS score of equal or more than 7, 6 limbs were amputated and 1 limb was salvaged. Out of the remaining 18 injured limbs with a MESS score of less than 7, 17 limbs were successfully salvaged and one limb was amputated. In the retrospective study, 10 injured limbs with a MESS score of equal or more than 7 were amputated (mean score 8.4 with range of 10-8 and the remaining 15 injured limbs with a MESS score of less than 7 were salvaged (mean score 4.57 with range of (4-6; suggesting a significant difference in the mean scores. Conclusions: MESS is a cost-effective, relatively simple and readily available scoring system, which assists the surgeon to identify variables that may ultimately influence the outcome of a severely traumatized extremity with arterial compromise due to high-energy injury. [Int J Res Med Sci 2016; 4(5.000: 1661-1665

  20. A prospective study on time to recovery in 254 injured novice runners.

    Directory of Open Access Journals (Sweden)

    Rasmus Oestergaard Nielsen

    Full Text Available Describe the diagnoses and the time to recovery of running-related injuries in novice runners.Prospective cohort study on injured runners.This paper is a secondary data analysis of a 933-person cohort study (DANO-RUN aimed at characterizing risk factors for injury in novice runners. Among those sustaining running-related injuries, the types of injuries and time to recovery is described in the present paper. All injured runners were diagnosed after a thorough clinical examination and then followed prospectively during their recovery. If they recovered completely from injury, time to recovery of each injury was registered.A total of 254 runners were injured. The proportion of runners diagnosed with medial tibial stress syndrome was 15%, 10% for patellofemoral pain, 9% for medial meniscal injury, 7% for Achilles tendinopathy and 5% for plantar fasciitis. Among the 220 runners (87% recovering from their injury, the median time to recovery was 71 days (minimum  = 9 days, maximum  = 617 days.Medial tibial stress syndrome was the most common injury followed by patellofemoral pain, medial meniscal injury and Achilles tendinopathy. Half of the injured runners were unable to run 2×500 meters without pain after 10 weeks. Almost 5% of the injured runners received surgical treatment.

  1. Tropism mechanism of stem cells targeting injured brain tissues by stromal cell-derived factor-1

    Institute of Scientific and Technical Information of China (English)

    ZHANG Sai; LIU Xiao-zhi; LIU Zhen-lin; SHANG Chong-zhi; HU Qun-liang

    2009-01-01

    Objective: To explore the role and function of stromal cell-derived factor- 1 (SDF- 1) in stem cells migrating into injured brain area.Methods: Rat-derived nerve stem cells (NSCs) were isolated and cultured routinely. Transwell system was used to observe the migration ability of NSCs into injured nerve cells. Immunocytochemistry was used to explore the expression of chemotactic factor receptor-4 (CXCR-4) in NSCs. In vivo, we applied immunofluorescence technique to observe the migration of NSCs into injured brain area. Immunofluorescence technique and Western blotting were used to test expression level of SDF- 1. After AMD3100 (a special chemical blocker) blocking CXCR-4, the migration ability of NSCs was tested in vivo and in vitro, respectively.Results: NSCs displayed specific tropism for injured nerve cells or traumatic brain area in vivo and in vitro. The expression level of SDF-1 in traumatic brain area increased remarkably and the expression level of CXCR-4 in the NSCs increased simultaneously. After AMD3100 blocking the expression of CXCR-4, the migration ability of NSCs decreased significantly both in vivo and in vitro.Conclusions: SDF-1 may play a key role in stem cells migrating into injured brain area through specially combining with CXCR-4.

  2. pSVPoMcat modifying Schwann cell to protect injured spinal neurons in rats

    Institute of Scientific and Technical Information of China (English)

    陈礼刚; 高立达; 朴永旭; 毛伯镛; 曾凡俊

    2002-01-01

    Objective: To investigate the protective effect of pSVPoMcat (myelin basic protein microgene)modifying Schwann cell on injured spinal neurons.Methods: A model of rat spinal cord injured by hemisection was used. One hundred and twenty healthy SD rats of both sexes weighing 250-300 g were divided into three groups: Group A (n=40, treated with implantation of pSVPoMcat modifying Schwann cell), Group B (n= 40, treated with implantation of Schwann cell only) and Group C (n=400, treated with sham operation as the control). One week after operation the rat functional recovery was observed dynamically by using combined behavioral score (CBS) and cortical somatasensory evoked potentials, the spinal cord sections were stained by Nissl, acid phosphatase enzyme histochemistry and cell apoptosis was examined by methye green, terminal deoxynucleotidyl and the dUTP Nick end labeling technique. Quantitative analysis was done by computer image analysis system.Results: In Group A the injured neurons recovered well morphologically. The imaging analysis showed a result of Group A>Group B>Group C in the size of the neurons (P<0.01). The percentage of ACP (acid phosphatase) stained area and the rate of apoptosis sequence were groups Ainjured spinal neurons and promotes recovery of injured spinal cord function in rats.

  3. Mechanical characterization of the injured spinal cord after lateral spinal hemisection injury in the rat.

    Science.gov (United States)

    Saxena, Tarun; Gilbert, Jeremy; Stelzner, Dennis; Hasenwinkel, Julie

    2012-06-10

    The glial scar formed at the site of traumatic spinal cord injury (SCI) has been classically hypothesized to be a potent physical and biochemical barrier to nerve regeneration. One longstanding hypothesis is that the scar acts as a physical barrier due to its increased stiffness in comparison to uninjured spinal cord tissue. However, the information regarding the mechanical properties of the glial scar in the current literature is mostly anecdotal and not well quantified. We monitored the mechanical relaxation behavior of injured rat spinal cord tissue at the site of mid-thoracic spinal hemisection 2 weeks and 8 weeks post-injury using a microindentation test method. Elastic moduli were calculated and a modified standard linear model (mSLM) was fit to the data to estimate the relaxation time constant and viscosity. The SLM was modified to account for a spectrum of relaxation times, a phenomenon common to biological tissues, by incorporating a stretched exponential term. Injured tissue exhibited significantly lower stiffness and elastic modulus in comparison to uninjured control tissue, and the results from the model parameters indicated that the relaxation time constant and viscosity of injured tissue were significantly higher than controls. This study presents direct micromechanical measurements of injured spinal cord tissue post-injury. The results of this study show that the injured spinal tissue displays complex viscoelastic behavior, likely indicating changes in tissue permeability and diffusivity.

  4. In need of remedy: US policy for compensating injured research participants.

    Science.gov (United States)

    Pike, Elizabeth R

    2014-03-01

    There is an emerging ethical consensus that injured research participants should receive medical care and compensation for their research-related injuries. This consensus is premised on notions of beneficence, distributive justice, compensatory justice and reciprocity. In response, countries around the world have implemented no-fault compensation systems to ensure that research participants are adequately protected in the event of injury. The United States, the world's leading sponsor of research, has chosen instead to rely on its legal system to provide injured research participants with medical care and compensation. This article argues that US reliance on its legal system leaves injured research participants unprotected in the event of injury. Nearly every injured research participant will have difficulty receiving compensation in court, and certain classes of research participants will be barred from receiving compensation altogether. The United States' outlier status also threatens to impede US-sponsored multinational research, potentially delaying important biomedical advances. To rectify this injustice, researchers, Institutional Review Boards, sponsors and research institutions should advocate systematic no-fault compensation in the United States to bring US law into accord with global ethical norms and ensure that injured research participants are adequately protected.

  5. Acute cholecystitis

    OpenAIRE

    Halpin, Valerie

    2014-01-01

    Acute cholecystitis causes unremitting right upper quadrant pain, anorexia, nausea, vomiting, and fever, and if untreated can lead to perforations, abscess formation, or fistulae. About 95% of people with acute cholecystitis have gallstones.It is thought that blockage of the cystic duct by a gallstone or local inflammation can lead to acute cholecystitis, but we don't know whether bacterial infection is also necessary.

  6. Expansion duroplasty improves intraspinal pressure, spinal cord perfusion pressure, and vascular pressure reactivity index in patients with traumatic spinal cord injury: injured spinal cord pressure evaluation study.

    Science.gov (United States)

    Phang, Isaac; Werndle, Melissa C; Saadoun, Samira; Varsos, Georgios; Czosnyka, Marek; Zoumprouli, Argyro; Papadopoulos, Marios C

    2015-06-15

    We recently showed that, after traumatic spinal cord injury (TSCI), laminectomy does not improve intraspinal pressure (ISP), spinal cord perfusion pressure (SCPP), or the vascular pressure reactivity index (sPRx) at the injury site sufficiently because of dural compression. This is an open label, prospective trial comparing combined bony and dural decompression versus laminectomy. Twenty-one patients with acute severe TSCI had re-alignment of the fracture and surgical fixation; 11 had laminectomy alone (laminectomy group) and 10 had laminectomy and duroplasty (laminectomy+duroplasty group). Primary outcomes were magnetic resonance imaging evidence of spinal cord decompression (increase in intradural space, cerebrospinal fluid around the injured cord) and spinal cord physiology (ISP, SCPP, sPRx). The laminectomy and laminectomy+duroplasty groups were well matched. Compared with the laminectomy group, the laminectomy+duroplasty group had greater increase in intradural space at the injury site and more effective decompression of the injured cord. In the laminectomy+duroplasty group, ISP was lower, SCPP higher, and sPRx lower, (i.e., improved vascular pressure reactivity), compared with the laminectomy group. Laminectomy+duroplasty caused cerebrospinal fluid leak that settled with lumbar drain in one patient and pseudomeningocele that resolved completely in five patients. We conclude that, after TSCI, laminectomy+duroplasty improves spinal cord radiological and physiological parameters more effectively than laminectomy alone.

  7. First clinical experience with intranasal cooling for hyperthermia in brain-injured patients

    DEFF Research Database (Denmark)

    Springborg, Jacob Bertram; Springborg, Karoline Kanstrup; Romner, Bertil

    2013-01-01

    Hyperthermia is common in brain-injured patients and associated with a worse outcome. As brain rather than body temperature reduction, theoretically, is the most important in cerebral protection, there is logic in targeting cooling at the brain. Selective brain cooling can, in theory, be obtained...... by cooling the skull or by heat loss from the upper airways. In this preliminary safety and efficacy study, we report clinical data from brain-injured patients who because of hyperthermia were treated with intranasal cooling.......Hyperthermia is common in brain-injured patients and associated with a worse outcome. As brain rather than body temperature reduction, theoretically, is the most important in cerebral protection, there is logic in targeting cooling at the brain. Selective brain cooling can, in theory, be obtained...

  8. Adherence of Pseudomonas aeruginosa to tracheal cells injured by influenza infection or by endotracheal intubation.

    Science.gov (United States)

    Ramphal, R; Small, P M; Shands, J W; Fischlschweiger, W; Small, P A

    1980-02-01

    Adherence of Pseudomonas aeruginosa to normal, injured, and regenerating tracheal mucosa was examined by scanning electron microscopy. Uninfected and influenza-infected murine tracheas were exposed to six strains of P. aeruginosa isolated from human sources and one strain of platn origin. All of the strains tested adhered to desquamating cells of the infected tracheas, but not to normal mucosa, the basal cell layer, or the regenerating epithelium. Adherence increased when the incubation time of the bacteria with the trachea was prolonged. Strains isolated from human tracheas appeared to adhere better than strains derived from the urinary tract. After endotracheal intubation of ferrets, P. aeruginosa adhered only to the injured cells and to areas of exposed basement membrane. We call this phenomenon "opportunistic adherence" and propose that alteration of the cell surfaces or cell injury facilitates the adherence of this bacterium and that adherence to injured cells may be a key to the pathogenesis of opportunistic Pseudomonas infections.

  9. Migration and distribution of bone marrow stromal cells in injured spinal cord with different transplantation techniques

    Institute of Scientific and Technical Information of China (English)

    FAN Li; DU Fei; CHENG Bang-chang; PENG Hao; LIU Shi-qing

    2008-01-01

    To study the regularity of migration and distribution of bone marrow stromal cells (BMSCs)in iniured spinal cord with intradural space transplantation.Methods:Forty Wistar rats were randomly assigned into 4 groups. The spinal cord injury,model was prepared according to the modified Allen method. BMSCs were labeled by CM-Dil. And 5.0×10 6 cells were transplanted by different channels including intraventricular injection(Group A),injured spinal cord intrathecally injection(Group B),remote intrathecally injection at the L3-L4 level(Group C),and intravenous injection(Group D). Spinal cord was dissected at 24 hours,1,2,3 and 4 weeks after transplantation.Sections of 4 μm were cut on a cryostat and observed under fluorescence microscopy.Results:No fluorescence was observed 24 hours after transplantation in spinal cord injury parenchyma except Group B. One week later,BMSCs in Groups A and C began to migrate to the injured parenchyma;2-4 weeks later,BMSCs penetrated into the injured parenchyma except Group D.The number of BMSCS decreased at 3-4 weeks after transplantation. The number of cells in Group B decreased faster than that of Groups A and C.Conclusions:BMSCs transplanted through intraventricular injection,injured spinal cord intrathecally injection and remote intrathecal injection could migrate to the injured parenchyma of spinal cord effectively. The number of BMSCs migrated into injured spinal cord parenchyma is rare by intravenous injection.

  10. 利用ACL在校园网内实现安全管理%Use ACL to Realize Security Management in Campus Network

    Institute of Scientific and Technical Information of China (English)

    杨丕仁

    2007-01-01

    阐述了ACL(Access Control List)基本原理、分类及简单配置方法,并结合实际案例进行了分析并配置,说明如何在校园网中使用ACL进行网络层访问权限控制,提高网络整体性能和安全.

  11. Arterial injures in open fractures of the leg; Uszkodzenia ukladu tetniczego w otwartych zlamaniach goleni

    Energy Technology Data Exchange (ETDEWEB)

    Konarski, K. [Szpital im. J. Jonstona, Lublin (Poland)

    1993-12-31

    Patterns of arterial injures in open fractures of the leg are presented. It was noted, that union disorders and infection result from changes in both primarily pathological and only recently injured (compression or contusion) arteries. In 23 cases of 3 and 4 degree open fracture femoral arteriography has been performed. In 19 cases (84%) vascular injuries were detected. Most of the arteriographies carried out immediately after injury revealed compression and transposition of the leg arteries. Those cases are prone to develop subsequent arterial occlusion. (author). 19 refs, 6 figs.

  12. Alcohol and drugs in seriously injured drivers in 6 European countries

    DEFF Research Database (Denmark)

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

    2012-01-01

    Objective: To determine the presence of alcohol and drugs in drivers severely injured in traffic crashes in 6 European countries. Methods: Data were collected from 2492 seriously injured drivers of cars and vans in Belgium, Denmark, Finland, Italy, Lithuania and The Netherlands, between 2007...... drivers, but we observed large differences between the participating countries. Alcohol was the most common finding, followed by cannabis and benzodiazepines. Notable are the many drivers having a BAC ≥ 1.3 g/L. The majority of the substances were found in combination with another psychoactive substance...

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    The objective of this study was to determine the presence of alcohol and drugs in drivers severely injured in traffic crashes in six European countries. Data were collected from 2492 seriously injured drivers of cars and vans in Belgium, Denmark, Finland, Italy, Lithuania, and the Netherlands...... differences between the participating countries. Alcohol was the most common finding, followed by cannabis and benzodiazepines. Notable are the many drivers having a BAC = 1.3 g/L. The majority of the substances were found in combination with another psychoactive substance, mostly alcohol. The high prevalence...

  14. Protective effects of gastrodine on dendritic spines in kainic acid-injured neurons

    Institute of Scientific and Technical Information of China (English)

    Yangfei Ji; Boai Zhang; Yanjie Jia; Guifang Sun; Yu Liu; Tao Peng; Yanru Liu; Xingrong Ma

    2011-01-01

    EphB2 affects neuronal cells by altering the dendritic spines. The present study analyzed the neuroprotective effects of gastrodine by measuring EphB2 expression in rat neural cells cultured in vitro and injured by kainic acid. Gastrodine (12.5, 25, and 50 mg/L) improved morphology in kainic acid-injured neurons, reduced lactate dehydrogenase leakage, decreased neuronal apoptosis, and increased EphB2 expression in neuronal cells. A moderate dose of 25 mg/L gastrodine resulted in the most significant effects. These results suggested that gastrodine suppressed the neurotoxic effects of excitatory amino acids and provided neuroprotection by remodeling neuronal dendritic spines.

  15. Whole Body Vibration Exercise Protocol versus a Standard Exercise Protocol after ACL Reconstruction: A Clinical Randomized Controlled Trial with Short Term Follow-Up

    Directory of Open Access Journals (Sweden)

    Gereon Berschin

    2014-09-01

    Full Text Available The suitability and effectiveness of whole body vibration (WBV exercise in rehabilitation after injury of the anterior cruciate ligament (ACL was studied using a specially designed WBV protocol. We wanted to test the hypothesis if WBV leads to superior short term results regarding neuromuscular performance (strength and coordination and would be less time consuming than a current standard muscle strengthening protocol. In this prospective randomized controlled clinical trial, forty patients who tore their ACL and underwent subsequent ligament reconstruction were enrolled. Patients were randomized to the whole body vibration (n=20 or standard rehabilitation exercise protocol (n=20. Both protocols started in the 2nd week after surgery. Isometric and isokinetic strength measurements, clinical assessment, Lysholm score, neuromuscular performance were conducted weeks 2, 5, 8 and 11 after surgery. Time spent for rehabilitation exercise was reduced to less than a half in the WBV group. There were no statistically significant differences in terms of clinical assessment, Lysholm score, isokinetic and isometric strength. The WBV group displayed significant better results in the stability test. In conclusion, preliminary data indicate that our whole body vibration muscle exercise protocol seems to be a good alternative to a standard exercise program in ACL-rehabilitation. Despite of its significant reduced time requirement it is at least equally effective compared to a standard rehabilitation protocol.

  16. The Impact of Surgical Timing in Acute Traumatic Spinal Cord Injury

    Science.gov (United States)

    2014-10-01

    quality of life) in patients with a traumatic SCI. For the first reporting period, we have completed recruitment of traumatic spinal cord injured ...the  major  goals  were  to  complete  recruitment  of  our  sample  of   136  traumatic   spinal   cord   injured ...TYPE Annual 3. DATES COVERED 30 Sep 2013 – 29 Sep 2014 4. TITLE AND SUBTITLE The impact of surgical timing in acute traumatic spinal cord

  17. A peptide for targeted, systemic delivery of imaging and therapeutic compounds into acute brain injuries

    Science.gov (United States)

    Mann, Aman P.; Scodeller, Pablo; Hussain, Sazid; Joo, Jinmyoung; Kwon, Ester; Braun, Gary B.; Mölder, Tarmo; She, Zhi-Gang; Kotamraju, Venkata Ramana; Ranscht, Barbara; Krajewski, Stan; Teesalu, Tambet; Bhatia, Sangeeta; Sailor, Michael J.; Ruoslahti, Erkki

    2016-01-01

    Traumatic brain injury (TBI) is a major health and socio-economic problem, but no pharmacological agent is currently approved for the treatment of acute TBI. Thus, there is a great need for advances in this field. Here, we describe a short peptide (sequence CAQK) identified by in vivo phage display screening in mice with acute brain injury. The CAQK peptide selectively binds to injured mouse and human brain, and systemically injected CAQK specifically homes to sites of brain injury in mouse models. The CAQK target is a proteoglycan complex upregulated in brain injuries. Coupling to CAQK increased injury site accumulation of systemically administered molecules ranging from a drug-sized molecule to nanoparticles. CAQK-coated nanoparticles containing silencing oligonucleotides provided the first evidence of gene silencing in injured brain parenchyma by systemically administered siRNA. These findings present an effective targeting strategy for the delivery of therapeutics in clinical management of acute brain injuries. PMID:27351915

  18. A peptide for targeted, systemic delivery of imaging and therapeutic compounds into acute brain injuries

    Science.gov (United States)

    Mann, Aman P.; Scodeller, Pablo; Hussain, Sazid; Joo, Jinmyoung; Kwon, Ester; Braun, Gary B.; Mölder, Tarmo; She, Zhi-Gang; Kotamraju, Venkata Ramana; Ranscht, Barbara; Krajewski, Stan; Teesalu, Tambet; Bhatia, Sangeeta; Sailor, Michael J.; Ruoslahti, Erkki

    2016-06-01

    Traumatic brain injury (TBI) is a major health and socio-economic problem, but no pharmacological agent is currently approved for the treatment of acute TBI. Thus, there is a great need for advances in this field. Here, we describe a short peptide (sequence CAQK) identified by in vivo phage display screening in mice with acute brain injury. The CAQK peptide selectively binds to injured mouse and human brain, and systemically injected CAQK specifically homes to sites of brain injury in mouse models. The CAQK target is a proteoglycan complex upregulated in brain injuries. Coupling to CAQK increased injury site accumulation of systemically administered molecules ranging from a drug-sized molecule to nanoparticles. CAQK-coated nanoparticles containing silencing oligonucleotides provided the first evidence of gene silencing in injured brain parenchyma by systemically administered siRNA. These findings present an effective targeting strategy for the delivery of therapeutics in clinical management of acute brain injuries.

  19. Acute Kidney Failure

    Science.gov (United States)

    ... out of balance. Acute kidney failure — also called acute renal failure or acute kidney injury — develops rapidly over ... 2015. Palevsky PM. Definition of acute kidney injury (acute renal failure). http://www.uptodate.com/home. Accessed April ...

  20. Acute Pancreatitis and Pregnancy

    Science.gov (United States)

    ... Pancreatitis Acute Pancreatitis and Pregnancy Acute Pancreatitis and Pregnancy Timothy Gardner, MD Acute pancreatitis is defined as ... pancreatitis in pregnancy. Reasons for Acute Pancreatitis and Pregnancy While acute pancreatitis is responsible for almost 1 ...

  1. 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?

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-12-15

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

  2. 20 CFR 10.730 - What are the conditions of coverage for Peace Corps volunteers and volunteer leaders injured...

    Science.gov (United States)

    2010-04-01

    ... Corps volunteers and volunteer leaders injured while serving outside the United States? 10.730 Section... Corps volunteers and volunteer leaders injured while serving outside the United States? (a) Any injury sustained by a volunteer or volunteer leader while he or she is located abroad shall be presumed to...

  3. Development and Validation of a Predictive Model of Return-to-Work Outcomes of Injured Employees in Minnesota

    Science.gov (United States)

    Hankins, Adrian Bentley

    2013-01-01

    In Minnesota's workers' compensation system, injured employees at risk for sustaining permanent disability may be eligible for receipt of vocational rehabilitation (VR) services if they are determined to be capable of benefitting from such services. VR services can be a valuable resource to injured employees who need assistance minimizing their…

  4. Injury, imagery, and self-esteem in dance healthy minds in injured bodies?

    Science.gov (United States)

    Nordin-Bates, Sanna M; Walker, Imogen J; Baker, Jo; Garner, Jocelyn; Hardy, Cinzia; Irvine, Sarah; Jola, Corinne; Laws, Helen; Blevins, Peta

    2011-06-01

    The purpose of this study was to investigate a selection of psychological variables (help-seeking behaviors, mental imagery, self-esteem) in relation to injury among UK dancers. We recruited 216 participants from eight dance styles and six levels of involvement. It was found that 83.5% of the participants had experienced at least one injury in the past year. The most common response to injury was to inform someone, and most continued to dance when injured, albeit carefully. Physical therapy was the most common treatment sought when an injury occurred (38.1%), and dancers seemed to follow recommendations offered. Injured and non-injured dancers did not differ in their imagery frequencies (facilitative, debilitative, or injury-related) and scored similarly (and relatively high) in self-esteem. Neither facilitative nor debilitative imagery was correlated with self-esteem, but dancers who engaged in more facilitative imagery in general also reported doing so when injured. Altogether, it appears that injury is not related to dancers' self-esteem or imagery, at least not when injuries are mild or moderate. Even so, such conclusions should be made with caution, given that most dancers do sustain at least one injury each year.

  5. 43 CFR 11.22 - Sampling of potentially injured natural resources.

    Science.gov (United States)

    2010-10-01

    ... resources. 11.22 Section 11.22 Public Lands: Interior Office of the Secretary of the Interior NATURAL RESOURCE DAMAGE ASSESSMENTS Preassessment Phase § 11.22 Sampling of potentially injured natural resources... of this part to proceed with an assessment, field sampling of natural resources should be limited...

  6. Preserved alpha-adrenergic tone in the leg vascular bed of spinal cord-injured individuals.

    NARCIS (Netherlands)

    Kooijman, H.M.; Rongen, G.A.P.J.M.; Smits, P.; Hopman, M.T.E.

    2003-01-01

    BACKGROUND: Supraspinal sympathetic control of leg vascular tone is lost in spinal cord-injured individuals, but this does not result in a reduced leg vascular tone: Leg vascular resistance is even increased. The aim of this study was to assess the alpha-adrenergic contribution to the increased vasc

  7. Imaging corticospinal tract connectivity in injured rat spinal cord using manganese-enhanced MRI

    Directory of Open Access Journals (Sweden)

    Bilgen Mehmet

    2006-11-01

    Full Text Available Abstract Background Manganese-enhanced MRI (MEI offers a novel neuroimaging modality to trace corticospinal tract (CST in live animals. This paper expands this capability further and tests the utility of MEI to image axonal fiber connectivity in CST of injured spinal cord (SC. Methods A rat was injured at the thoracic T4 level of the SC. The CST was labeled with manganese (Mn injected intracortically at two weeks post injury. Next day, the injured SC was imaged using MEI and diffusion tensor imaging (DTI modalities. Results In vivo MEI data obtained from cervical SC confirmed that CST was successfully labeled with Mn. Ex vivo MEI data obtained from excised SC depicted Mn labeling of the CST in SC sections caudal to the lesion, which meant that Mn was transported through the injury, possibly mediated by viable CST fibers present at the injury site. Examining the ex vivo data from the injury epicenter closely revealed a thin strip of signal enhancement located ventrally between the dorsal horns. This enhancement was presumably associated with the Mn accumulation in these intact fibers projecting caudally as part of the CST. Additional measurements with DTI supported this view. Conclusion Combining these preliminary results collectively demonstrated the feasibility of imaging fiber connectivity in experimentally injured SC using MEI. This approach may play important role in future investigations aimed at understanding the neuroplasticity in experimental SCI research.

  8. Differences in kinetic variables between injured and noninjured novice runners : A prospective cohort study

    NARCIS (Netherlands)

    Bredeweg, Steef W.; Kluitenberg, Bas; Bessem, Bram; Buist, Ida

    2013-01-01

    Objectives: This prospective study examined differences in kinetic variables between injured and noninjured novice female and male runners and their potential contribution to RRIs. Design: A prospective cohort study. Methods: At baseline vertical ground reaction forces were assessed with an instrume

  9. Sympathetic nonadrenergic transmission contributes to autonomic dysreflexia in spinal cord-injured individuals.

    NARCIS (Netherlands)

    Groothuis, J.T.; Rongen, G.A.P.J.M.; Deinum, J.; Pickkers, P.; Danser, A.H.; Geurts, A.C.H.; Smits, P.; Hopman, M.T.E.

    2010-01-01

    Autonomic dysreflexia is a hypertensive episode in spinal cord-injured individuals induced by exaggerated sympathetic activity and thought to be alpha-adrenergic mediated. alpha-Adrenoceptor antagonists have been a rational first choice; nevertheless, calcium channel blockers are primarily used in a

  10. Postservice Psychosocial Adjustment of Former Spinal Cord Injured Rehabilitation Clients. Research Report.

    Science.gov (United States)

    Cook, Daniel W.

    A study examined the long-term adjustment of spinal cord-injured vocational rehabilitation clients by isolating major dimensions of postservice adjustment, correlating preservice status with adjustment followup, and by measuring client pre- to postservice psychological change. Three self-report instruments (a needs satisfaction inventory, a goal…

  11. FUNCTIONAL AND STRUCTURAL RECOVERY OF INJURED SPINAL CORD FOLLOWING DELAYED X-IRRADIATION IN RATS

    Institute of Scientific and Technical Information of China (English)

    Xin-gang Li; De-ze Jia; Dong-hai Wang; Yu-hang Su; Qing-lin Zhang

    2007-01-01

    Objective To test the hypothesis that delayed X-irradiation can enhance the functional and structural recovery of the injured spinal cord in rats,Methods Seventy Sprague-Dawley rats were randomly divided into two groups, 35 rats in each. The control group sustained a one-minute clip compression (force of clip was 30 g) injury of the spinal cord at the T2 level, without X-irradiation. The experimental group received X-irradiation 14 days after injury. Neurological function was assessed by the modified Tarlov method, including hind limbs movement, inclined plane, and pain withdrawal. These tests were performed in a blinded fashion at 3, 7, 14, 21, 28, 35 , and 42 days after injury. At 43 days after injury, histological examination of the injured spinal cord was performed following decapitation of the rats.Results Sixty-two rats met the experimental requirements (spinal cord injury was similar), 32 rats in experimental group and 30 rats in control group. Statistically significant difference was observed between the two groups in hind limbs movement and inclined plane (P <0.01), but not in the pain withdrawal test The edema and necrosis areas of injured spinal cords in experimental group were less than those in control group, and axons in experimental group were significantly more than those in control group (P < 0.01).Conclusion Delayed X-irradiation following spinal cord injury may enhance functional recovery by improving and restoring structural integrity of the injured spinal cord in rats.

  12. Demographic Profile and Athletic Identity of Traumatic Spinal Cord Injured Wheelchair Basketball Athletes in Greece

    Science.gov (United States)

    Vasiliadis, Angelo; Evaggelinou, Christina; Avourdiadou, Sevastia; Grekinis, Petros

    2010-01-01

    An epidemiological study conducted across the country of Greece was conducted in order to determine the profile and the athletic identity of spinal cord injured (SCI) wheelchair basketball athletes who participated to the 13th Greek Wheelchair Basketball Championship and Cup. The Disability Sport Participation questionnaire was used for data…

  13. Multi-drug resistant Acinetobacter infections in critically injured Canadian forces soldiers

    Directory of Open Access Journals (Sweden)

    Brisebois Ronald

    2007-08-01

    Full Text Available Abstract Background Military members, injured in Afghanistan or Iraq, have returned home with multi-drug resistant Acinetobacter baumannii infections. The source of these infections is unknown. Methods Retrospective study of all Canadian soldiers who were injured in Afghanistan and who required mechanical ventilation from January 1 2006 to September 1 2006. Patients who developed A. baumannii ventilator associated pneumonia (VAP were identified. All A. baumannii isolates were retrieved for study patients and compared with A. baumannii isolates from environmental sources from the Kandahar military hospital using pulsed-field gel electrophoresis (PFGE. Results During the study period, six Canadian Forces (CF soldiers were injured in Afghanistan, required mechanical ventilation and were repatriated to Canadian hospitals. Four of these patients developed A. baumannii VAP. A. baumannii was also isolated from one environmental source in Kandahar – a ventilator air intake filter. Patient isolates were genetically indistinguishable from each other and from the isolates cultured from the ventilator filter. These isolates were resistant to numerous classes of antimicrobials including the carbapenems. Conclusion These results suggest that the source of A. baumannii infection for these four patients was an environmental source in the military field hospital in Kandahar. A causal linkage, however, was not established with the ventilator. This study suggests that infection control efforts and further research should be focused on the military field hospital environment to prevent further multi-drug resistant A. baumannii infections in injured soldiers.

  14. Sites of inhibition of mitochondrial electron transport in macrophage-injured neoplastic cells.

    Science.gov (United States)

    Granger, D L; Lehninger, A L

    1982-11-01

    Previous work has shown that injury of neoplastic cells by cytotoxic macrophages (CM) in cell culture is accompanied by inhibition of mitochondrial respiration. We have investigated the nature of this inhibition by studying mitochondrial respiration in CM-injured leukemia L1210 cells permeabilized with digitonin. CM-induced injury affects the mitochondrial respiratory chain proper. Complex I (NADH-coenzyme Q reductase) and complex II (succinate-coenzyme Q reductase) are markedly inhibited. In addition a minor inhibition of cytochrome oxidase was found. Electron transport from alpha-glycerophosphate through the respiratory chain to oxygen is unaffected and permeabilized CM-injured L1210 cells oxidizing this substrate exhibit acceptor control. However, glycerophosphate shuttle activity was found not to occur within CM-injured or uninjured L1210 cells in culture hence, alpha-glycerophosphate is apparently unavailable for mitochondrial oxidation in the intact cell. It is concluded that the failure of respiration of intact neoplastic cells injured by CM is caused by the nearly complete inhibition of complexes I and II of the mitochondrial electron transport chain. The time courses of CM-induced electron transport inhibition and arrest of L1210 cell division are examined and the possible relationship between these phenomena is discussed.

  15. Efficient delivery of small interfering RNA into injured spinal cords in rats by photomechanical waves

    Science.gov (United States)

    Ando, Takahiro; Sato, Shunichi; Toyooka, Terushige; Kobayashi, Hiroaki; Nawashiro, Hiroshi; Ashida, Hiroshi; Obara, Minoru

    2011-03-01

    In the central nervous system, lack of axonal regeneration leads to permanent functional disabilities. In spinal cord injury (SCI), the over-expressions of intermediate filament (IF) proteins, such as glial fibrillary acidic protein (GFAP) and vimentin, are mainly involved in glial scar formation; these proteins work as both physical and biochemical barriers to axonal regeneration. Thus, silencing of these IF proteins would be an attractive strategy to treat SCI. In this study, we first attempted to deliver fluorescent probe-labeled siRNAs into injured spinal cords in rats by applying photomechanical waves (PMWs) to examine the capability of PMWs as a tool for siRNA delivery. Intense fluorescence from siRNAs was observed in much broader regions in the spinal cords with PMW application when compared with those with siRNA injection alone. Based on this result, we delivered siRNAs for GFAP and vimentin into injured spinal tissues in rats by applying PMWs. The treatment resulted in efficient silencing of the proteins at five days after SCI and a decrease of the cavity area in the injured tissue at three weeks after SCI when compared with those with siRNA injection alone. These results demonstrate the capability of PMWs for efficient delivery of siRNAs into injured spinal cords and treatment of SCIs.

  16. Do workers' compensation laws protect industrial hygienists from lawsuits by injured workers?

    Science.gov (United States)

    Stout, N C

    1993-11-01

    Workers' compensation laws provide injured employees with a swifter, more certain, and less litigious system of compensation than existed under the common law. Although workers' compensation is almost always an injured employee's exclusive remedy against the employer, the employee may bring a common-law tort action against a "third party" who may be liable in whole or in part for the employee's injury. This article investigates whether industrial hygienists are "third parties" and therefore subject to suit by injured employees who claim that industrial hygienists negligently caused their injuries. The author concludes that in most states, where the industrial hygienist and the injured worker are fellow employees, the industrial hygienist shares the employer's immunity from suit. As to the consultant who performs industrial hygiene services as an independent contractor, the author concludes that the employer's nondelegable duty to provide a safe workplace offers industrial hygiene consultants an argument that they share the employer's immunity from suit. Countervailing arguments, however, leave the industrial hygiene consultant vulnerable to negligence claims in many jurisdictions. There is a trend among the states to extend the employer's immunity to those who provide safety and health services to the employer.

  17. Protective effects of paroxetine on the lipopolysaccharide injured hippocampal-derived neural stem cell

    Institute of Scientific and Technical Information of China (English)

    彭正午

    2013-01-01

    Objective To investigate the effects of paroxetine on the cell viability and expression of the phosphorylated ERK1/2 in lipopolysaccharide LPS injured hippocampalderived neural stem cells (NSCs) .Methods The NSCs were derived from hippocampus of fetal rats,after the

  18. Body temperature responses in spinal cord injured individuals during exercise in the cold and heat.

    NARCIS (Netherlands)

    Boot, C.R.L.; Binkhorst, R.A.; Hopman, M.T.E.

    2006-01-01

    The aim of this study was to assess the effect of arm exercise on the heat balance in spinal cord-injured (SCI) individuals with complete lesions at ambient temperatures of 10 and 35 degrees C. Four SCI with a high lesion (> or = T6) (SCI-H), seven with a low lesion (< T6) (SCI-L), and ten abl

  19. Optimising diagnosis and treatment of coagulopathy in severely injured trauma patients

    NARCIS (Netherlands)

    Balvers, K.

    2016-01-01

    Trauma has a profound impact on public health around the world. Yearly approximately 5 million people die due to traumatic injury, which is 1 out of every 3 severely injured patients. Therefore, improving survival after trauma is a major challenge in which timely therapy is of great importance. In t

  20. Survival benefit of physician-staffed Helicopter Emergency Medical Services (HEMS) assistance for severely injured patients

    NARCIS (Netherlands)

    D. den Hartog (Dennis); J. Romeo (Jamie); A.N. Ringburg (Akkie); M.H.J. Verhofstad (Michiel); E.M.M. van Lieshout (Esther)

    2015-01-01

    markdownabstractBackground: Physician-staffed Helicopter Emergency Medical Services (HEMS) provide specialist medical care to the accident scene and aim to improve survival of severely injured patients. Previous studies were often underpowered and showed heterogeneous results, leaving the subject at

  1. Health status, work limitations, and return-to-work trajectories in injured workers with musculoskeletal disorders

    NARCIS (Netherlands)

    Bultmann, U.; Franche, R.L.; Hogg-Johnson, S.; Cote, P.; Lee, H.; Severin, C.; Vidmar, M.; Carnide, N.

    2007-01-01

    Background The purpose of this study was to describe the health status and work limitations in injured workers with musculoskeletal disorders at 1 month post-injury, stratified by return-to-work status, and to document their return-to-work trajectories 6 months post-injury. Methods A sample of 632 w

  2. E-Message Boards for Those Who Self-Injure: Implications for E-Health

    Science.gov (United States)

    Johnson, Genevieve Marie; Zastawny, Sylvia; Kulpa, Anastasia

    2010-01-01

    Virtual communities for those who self-injure (SI) are increasingly popular and involve Internet communication technologies including e-message boards. The social and emotional support of an accepting virtual community may facilitate individual recovery from SI. Via self-report data, this study describes individuals who participate in virtual…

  3. The Impact of Different Degrees of Injured C7 Nerve Transfer: An Experimental Rat Study

    Directory of Open Access Journals (Sweden)

    Chieh-Han John Tzou, MD, PhD

    2014-10-01

    Conclusions: An injured but grossly normal-looking ipsilateral C7 can be used as a motor source but with variable results. The result is directly proportional to the severity of injury, potentially implying that better results will be achieved when longer regeneration time is allowed.

  4. Recovering from research: a no-fault proposal to compensate injured research participants.

    Science.gov (United States)

    Pike, Elizabeth R

    2012-01-01

    National advisory committees have considered the obligations owed to research participants in the event of research-related injuries. These committees have repeatedly concluded that injured research participants are entitled to compensation for their injuries, that the tort system provides inadequate remedies, and that the United States should adopt no-fault compensation. But because the advisory committees have made no concrete proposals and have taken no steps toward implementing no-fault compensation, the United States continues to rely on the tort system to compensate injured research participants. This Article argues that recent legal developments and a transformation in the global research landscape make maintaining the status quo morally indefensible and practically unsustainable. Recent legal developments exacerbate the longstanding difficulties associated with the tort system as a method of compensation; nearly every injured research participant will have difficulty recovering damages, and certain classes of injured research participants--those in federal research and those abroad--are prevented from recovering altogether, resulting in substantial unfairness. In the past ten years, many of the countries substantially involved in research have mandated systematic compensation. By not mandating compensation, the United States has become a moral outlier and risks having its noncompliant research embargoed by foreign ethics committees, thereby delaying important biomedical advances. This Article examines alternative compensation mechanisms and offers a concrete no-fault compensation proposal built on systems already in place. The proposed system can be implemented in the United States and countries around the world to help harmonize various national compensation systems and to more equitably and effectively make those injured by research whole.

  5. pSVPoMcat modifying Schwann cell to protect injured spinal neurons in rats

    Institute of Scientific and Technical Information of China (English)

    陈礼刚; 高立达; 等

    2002-01-01

    Objective:To investigate the protective effect of pSVPoMcat(myelin basic protein microgene)modifying Schwann cell on injured spinal neurons.Methods;A model of rat spinal cord injured by hemisection was used.One hundred and twenty healthy SD rats of both sexes weighing 250-300g were divided into three groups:GroupA(n=40,treated with implantation of pSPVoMcat modifying Schwann cell),GroupB(n=40,treated with implantation of Schwann cell only)and GroupC(n=400,treated with sham operation as the control).One week after operation the rat functional recovery was observed dynamically by using combined behavioral score(CBS)and cortical somatasensory evoked potentials,the spinal cord sections were stained by Nissl,acid phosphatase enzyme histochemistry and cell apoptosis was examined by metye green,terminal deoxynucleotidyl and the dUTP Nick end labeling technique.Quantitative analysis was done by computer image analysis system.Results:In Group A the injured neurons recovered well morphologically.The imaging analysis showed a result of GroupA>GroupB>Group Cin the size of the neurons (P<0.01),The percentage of ACP(acid phosphatase) stained area and the rate of apoptosis sequence were groupsAinjured spinal neurons and promotes recovery of injured spinal cord function in rats.

  6. Imaging of injured and atherosclerotic arteries in mice using fluorescence-labeled glycoprotein VI-Fc

    Energy Technology Data Exchange (ETDEWEB)

    Bigalke, Boris, E-mail: boris.bigalke@med.uni-tuebingen.de [Medizinische Klinik III, Kardiologie und Kreislauferkrankungen, Eberhard-Karls-Universitaet Tuebingen (Germany); Division of Imaging Sciences, St Thomas' Hospital, King' s College London (United Kingdom); Pohlmeyer, Ilka; Schoenberger, Tanja [Medizinische Klinik III, Kardiologie und Kreislauferkrankungen, Eberhard-Karls-Universitaet Tuebingen (Germany); Griessinger, Christoph M. [Labor fuer Praeklinische Bildgebung und Bildgebungstechnologie der Werner-Siemens-Stiftung, Radiologische Klinik, Eberhard-Karls-Universitaet Tuebingen (Germany); Ungerer, Martin [Corimmun GmbH, Martinsried (Germany); Botnar, Rene M. [Division of Imaging Sciences, St Thomas' Hospital, King' s College London (United Kingdom); Pichler, Bernd J. [Labor fuer Praeklinische Bildgebung und Bildgebungstechnologie der Werner-Siemens-Stiftung, Radiologische Klinik, Eberhard-Karls-Universitaet Tuebingen (Germany); Gawaz, Meinrad [Medizinische Klinik III, Kardiologie und Kreislauferkrankungen, Eberhard-Karls-Universitaet Tuebingen (Germany)

    2011-08-15

    Purpose: To assess endothelial injury and repair using fluorescence-labeled glycoprotein VI (GPVI)-Fc in a murine model. Materials and methods: Three 4-week-old male ApoE-deficient (ApoE{sup -/-})-mice were fed with a 1.25% cholesterol diet over 16 weeks and compared to three wild type (WT) C57BL/6J-mice in a wire-induced vascular injury model. Another group of WT mice (n = 10) were mechanically injured by carotid ligation. Fluorescence-labeled GPVI-Fc (150 {mu}g/mouse) was administered and assessed by optical imaging 24 h after injury and compared to another group (n = 3) which was injected two days after injury and sacrificed another day later. Results: After denudation, all injured carotids of WT mice showed a higher mean fluorescence signal than the corresponding intact carotids of the same animals (48.4 {+-} 18.9 vs. 10.4 {+-} 1.0; P = 0.028). Injection of unlabeled GPVI-Fc 20 h and 3 h before injecting GPVI-Fc-FITC significantly reduced the fluorescence signal in injured carotids to 14.6 {+-} 4.6, while intact carotids showed a signal of 9.2 {+-} 1.1; P = 0.046. Ligation injury resulted with an increased GPVI-Fc-binding to injured carotids compared to intact carotids (31.53 {+-} 6.18 vs. 16.48 {+-} 5.15; P = 0.039). Three days after injury and 24 h after GPVI-Fc-FITC injection, differences between intact and injured carotids have vanished (12.51 {+-} 2.76 vs. 14.76 {+-} 1.59; P = 0.519). Conclusions: A GPVI-based plaque imaging system could help to identify vascular lesions and to take a precautionary measure as necessary.

  7. Oral everolimus inhibits intimal proliferation in injured carotid artery in rats

    Institute of Scientific and Technical Information of China (English)

    WANG Xiao-fang; SHEN De-liang; ZHAO Xiao-yan; NING Hong-jie; FENG Ri-sheng; ZHANG Jin-ying

    2013-01-01

    Background Everolimus,a derivative of sirolimus,is a potent immunosuppressant that has important anti-proliferative properties.In the present study,we demonstrated the inhibiting neointimal hyperplasia in injured carotid arteries in rats by using two different doses of everolimus administrated via the oral route for a long time.Methods A rat model of carotid artery injury was established by balloon inflation.Eighty rats were randomly divided into the sham-operated group (n=20),injury group (n=20),low dosage of everolimus group (n=20),and high dosage of everolimus group (n=20).The low dose of everolimus (1.5 mg/kg) was given one day before injuring the carotid artery by balloon,followed by 0.75 mg/kg per day for 28 days via intragastric gavage.High dose everolimus (2.5 mg/kg) was given one day before injuring the carotid artery by balloon,followed by 1 mg/kg per day for 28 days.Expression of eukaryotic translation initiation factor 4E (elF-4E) and phosphorylation of ribosomal protein S6 kinase 1 (P70S6K) were determined by reverse transcription-polymerase chain reaction and Western blotting analysis.Results In the injured carotid artery,neointimal hyperplasia was normally observed four weeks after injury.Everolimus inhibited neointimal hyperplasia after balloon injury in a dose dependent manner.At the same time,the study demonstrated that everolimus reduced the expression of P-P70S6K,elF-4E,transforming growth factor (TGF)-β1 and of proliferating cell nuclear antigen (PCNA).Conclusions Everolimus significantly inhibited neointimal hyperplasia of the injured carotid artery.The effect depended on dosage and was associated with the reduction of phosphorylation of P70S6K and the elF-4E expression level.

  8. Magnetic resonance imaging of acute spinal-cord injury

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Hideki; Nakagawa, Hiroshi; Yamada, Takahisa; Iwata, Kinjiro (Aichi Medical Univ., Nagakute (Japan)); Okumura, Terufumi; Hoshino, Daisaku

    1992-04-01

    Magnetic resonance imaging (MRI) provides a noninvasive and very important method of investigating spinal-cord injuries. By means of MRI we examined 36 patients with spinal injuries, 34 of them in the acute stage. 19 cases had complete spinal-cord injury with paraplegia, while 17 cases had incomplete spinal-cord injury. MRI showed the injured spinal-cord in the acute stage to be partially swollen, with a high signal intensity in the T[sub 2]-weighted images. In the chronic stage, the injured cord may show atrophic changes with a post-traumatic cavity or myelomalacia, which appears as a high-signal-intensity lesion in the T[sub 2]-weighted images and as a low-signal intensity in the T[sub 1]-weighted images. The cases with complete spinal injuries showed a high signal intensity at the wide level, and these prognoses were poor. The cases with incomplete injuries showed normal findings or a high-signal-intensity spot. In the Gd-DTPA enhanced images, the injured cords were enhanced very well in the subchronic stage. MRI is thus found to be useful in the diagnosis of spinal injuries; it also demonstrates a potential for predicting the neurological prognosis. (author).

  9. Acute phase phospholipids related to the cardiolipin of mitochondria in the sera of patients with chronic fatigue syndrome (CFS), chronic Ciguatera fish poisoning (CCFP), and other diseases attributed to chemicals, Gulf War, and marine toxins.

    Science.gov (United States)

    Hokama, Yoshitsugi; Empey-Campora, Cara; Hara, Cynthia; Higa, Nicole; Siu, Nathaniel; Lau, Rachael; Kuribayashi, Tina; Yabusaki, Kenichi

    2008-01-01

    This study examined 328 CFS sera in a study with 17 CCFP, 8 Gulf War Veterans (GWV), 24 Prostate Cancer (PC), and 52 normal sera in the modified Membrane Immunobead Assay (MIA) procedure for CTX. Three hundred and twenty-eight CFS patients' sera were examined by the modified MIA with purified MAb-CTX and 91.2% gave a titre > or =1:40. 76% of the 17 CCFP sera samples and 100% of the 8 GWV sera samples also had a titre > or =1:40. 92.3% of 52 normal sera showed titres of 1:20 or less, while 4 gave titres of > or =1:40. In addition, 41 sera were examined for Anti-Cardiolipin (aCL) by a commercial ELISA procedure with 87.8% demonstrating IgM, IgM+IgA, or IgM+IgG aCL antibodies. These results showed mostly the IgM aCL antibody alone in the sera samples. In addition, 41 serum samples were examined for aCL, with 37 showing positive for aCL, representing 90.2% positive for the three disease categories examined: CFS, CCFP and GWV. Examination for antiMitochondrial-M2 autoantibody (aM-M2) in 28 patients (CFS (18), CCFP (5), and GWV (5)) was negative for aM-M2. Inhibition analysis with antigens, CTX, CFS "Acute Phase Lipids", commercial Cardiolipin (CL) and 1,2-Dipalmitoyl-sn-Glycero-3-[Phospho-L-Serine] (PS) and antibodies, MAb-CTX and aCL from patients' serum show that the phospholipids in CL and CTX are antigenically indistinguishable with antibodies MAb-CTX and CFS-aCL. Preliminary chemical analyses have shown the lipids to be phospholipids associated with CL of the mitochondria. We designate this "Acute Phase Lipid" comparable to "Acute Phase Proteins" (C-reactive protein (CRP) and Serum Amyloid A (SAA)) in inflammatory conditions.

  10. COMPARISON OF IZOKINETIC KNEE STRENGTHS BETWEEN ATHLETE AND SEDANTER MALES WHO HAD ANTERIOR CRUCIATE LIGAMENT (ACL OPERATION

    Directory of Open Access Journals (Sweden)

    Alparslan İNCE

    2009-08-01

    Full Text Available In this study, it is aimed to examine the isokinetic force development of the sportsmen who had an anterior cruciate ligament operation. This research was executed on 19 person, 10 of them were sportsmen and 9 of them were not, who attended to the department of Physical Medicine and Rehabilitation Center of Selcuk University between the years of 2004–2005 for this purpose, the isokinetic muscle forces of patients (820–130 type Biodex system isokinetic exercise measurement device attended to the research was examined by determining their preliminary preparation. Statistical analysis of the obtaining parameters were performed on SPSS 15.0 (19 program. Diversities between control and informant group were determined by t-test and also the diversity of each group among weeks were stated by paired t-test. There was no difference on the body heights and body weights of the control and informant groups, but is was determined that the control group was older than the informant group. There was an increase in the PT (Peak torque measurement of isokinetic force development (flexion and extansion within the control and informant groups according to the weeks . During the statistical research on the extansion 60°/sec, 120°/sec and flexion 60°/sec, 120°/sec it was observed that the isokinetic measurement value of the informant group was higher than the control group. Although there was no difference between the flexion 60°/sec and 120°/sec PT isokinetic measurement values during the first four weeks, a difference was detected during the 8. and 12th weeks.Consequently according to the obtained findings, it was determined that after the ACL operation the isokinetic exercise and the treatment method is crucial for the sportsmen.

  11. Effect of graft choice on the outcome of revision anterior cruciate ligament reconstruction in the Multicenter ACL Revision Study (MARS) Cohort

    Science.gov (United States)

    Wright, Rick W.; Huston, Laura J.; Haas, Amanda K.; Spindler, Kurt P.; Nwosu, Sam K.; Allen, Christina R.; Anderson, Allen F.; Cooper, Daniel E.; DeBerardino, Thomas M.; Dunn, Warren R.; Lantz, Brett (Brick) A.; Stuart, Michael J.; Garofoli, Elizabeth A.; Albright, John P.; Amendola, Annunziato (Ned); Andrish, Jack T.; Annunziata, Christopher C.; Arciero, Robert A.; Bach, Bernard R.; Baker, Champ L.; Bartolozzi, Arthur R.; Baumgarten, Keith M.; Bechler, Jeffery R.; Berg, Jeffrey H.; Bernas, Geoffrey A.; Brockmeier, Stephen F.; Brophy, Robert H.; Bush-Joseph, Charles A.; Butler, J. Brad; Campbell, John D.; Carey, James L.; Carpenter, James E.; Cole, Brian J.; Cooper, Jonathan M.; Cox, Charles L.; Creighton, R. Alexander; Dahm, Diane L.; David, Tal S.; Flanigan, David C.; Frederick, Robert W.; Ganley, Theodore J.; Gatt, Charles J.; Gecha, Steven R.; Giffin, James Robert; Hame, Sharon L.; Hannafin, Jo A.; Harner, Christopher D.; Harris, Norman Lindsay; Hechtman, Keith S.; Hershman, Elliott B.; Hoellrich, Rudolf G.; Hosea, Timothy M.; Johnson, David C.; Johnson, Timothy S.; Jones, Morgan H.; Kaeding, Christopher C.; Kamath, Ganesh V.; Klootwyk, Thomas E.; Levy, Bruce A.; Ma, C. Benjamin; Maiers, G. Peter; Marx, Robert G.; Matava, Matthew J.; Mathien, Gregory M.; McAllister, David R.; McCarty, Eric C.; McCormack, Robert G.; Miller, Bruce S.; Nissen, Carl W.; O'Neill, Daniel F.; Owens, Brett D.; Parker, Richard D.; Purnell, Mark L.; Ramappa, Arun J.; Rauh, Michael A.; Rettig, Arthur C.; Sekiya, Jon K.; Shea, Kevin G.; Sherman, Orrin H.; Slauterbeck, James R.; Smith, Matthew V.; Spang, Jeffrey T.; Svoboda, Steven J.; Taft, Timothy N.; Tenuta, Joachim J.; Tingstad, Edwin M.; Vidal, Armando F.; Viskontas, Darius G.; White, Richard A.; Williams, James S.; Wolcott, Michelle L.; Wolf, Brian R.; York, James J.

    2015-01-01

    Background Most surgeons believe that graft choice for ACL reconstruction is an important factor related to outcome. Although graft choice may be limited in the revision setting based on previously used grafts, it is still felt to be important. Hypothesis The purpose of this study was to determine if revision ACL graft choice predicts outcomes related to sports function, activity level, OA symptoms, graft re-rupture, and reoperation at two years following revision reconstruction. We hypothesized that autograft use would result in increased sports function, increased activity level, and decreased OA symptoms (as measured by validated patient reported outcome instruments). Additionally, we hypothesized that autograft use would result in decreased graft failure and reoperation rate 2 years following revision ACL reconstruction. Study Design Prospective cohort study; Level of evidence, 2. Methods Revision ACL reconstruction patients were identified and prospectively enrolled by 83 surgeons over 52 sites. Data collected included baseline demographics, surgical technique and pathology, and a series of validated patient reported outcome instruments (IKDC, KOOS, WOMAC, and Marx activity rating score). Patients were followed up at 2 years, and asked to complete the identical set of outcome instruments. Incidence of additional surgery and reoperation due to graft failure were also recorded. Multivariate regression models were used to determine the predictors (risk factors) of IKDC, KOOS, WOMAC, Marx scores, graft re-rupture, and reoperation rate at 2 years following revision surgery. Results 1205 patients were successfully enrolled with 697 (58%) males. Median age was 26. In 88% this was their first revision. 341 (28%) were undergoing revision by the surgeon that had performed the previous reconstruction. 583 (48%) underwent revision reconstruction utilizing an autograft, 590 (49%) allograft, and 32 (3%) both autograft and allograft. Median time since their last ACL

  12. Reconstrução anatômica do LCA com duplo feixe: primeiros 40 casos Anatomical ACL reconstruction with double bundle: first 40 cases

    Directory of Open Access Journals (Sweden)

    Ari Zekcer

    2011-01-01

    Full Text Available OBJETIVO: Discutir a técnica de reconstrução anatômica do ligamento cruzado anterior (LCA com duplo feixe, a curva de aprendizado e os resultados preliminares. MÉTODOS: Quarenta pacientes com lesão do LCA foram submetidos à reconstrução anatômica com duplo feixe, utilizando-se do tendão semitendinoso para refazer a banda anteromedial (AM e gracilis para refazer a banda posterolateral (PL do joelho. RESULTADOS: Tivemos dois casos de limitação de extensão, sendo que em um deles foi necessária a realização de artrólise artroscópica, e um caso de trombose venosa profunda. CONCLUSÃO: A reconstrução do LCA com duplo feixe se mostrou factível, apesar de apresentar uma maior curva de aprendizado; e as vantagens da técnica proposta ainda deverão ser comprovadas se comparada com a técnica de feixe único.OBJECTIVE: To discuss the technique of anatomical reconstruction of the anterior cruciate ligament (ACL with double beam, the learning curve and preliminary results. METHODS: Forty patients with ACL injury underwent reconstruction with anatomical double-bundle, using the semitendinosus tendon to remake the band anterior medial (AM and gracile to remake the band posterior lateral (PL of the knee. RESULTS: We had two cases of limitation of extension, and in one of them were necessary to perform arthroscopic artrolise, and one case of deep vein thrombosis. CONCLUSION: ACL reconstruction with double bundle proved feasible, despite having a higher learning curve, and the advantages of the proposed technique still must be proven compared to the single-beam technique.

  13. Effects of isokinetic eccentric training on knee extensor and flexor torque and on gait of individuals with long term ACL reconstruction: A controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Heleodório Honorato dos Santos

    2014-12-01

    Full Text Available This study investigated the effects of the isokinetic eccentric training (IET on the knee extensor and flexor torque and kinematic gait parameters in individuals with ACL reconstruction. Sixteen men with ACL reconstructed (ACLr whose torque and the gait were evaluated, before and after 12 weeks of IET, was compared to a control group (14 individuals. Student t, MANOVA and ANOVA tests were performed with 5% of significance. The training increased the isometric, concentric at 30 and 120º/s (p < .05 and eccentric at 30º/s (p < .01 extensor torque on the affected limb (AL, and eccentric at 30 and 120º/s (p < .01, on the non-affected limb (NAL. In the flexors, there was an increase on the torque: isometric, concentric at 30º/s and eccentric at 30 and 120º/s (p < .01 in AL and in eccentric at 30 (p < .05 and 120º/s (p< .01 in NAL. With respect to the angular and spatio-temporal variables gait, there was no difference between pre-and post-training in LCAr group. Compared to control group, the cycle time, in two members, was lower in LCAr group, and stride length and cadence were higher in the AL of the LCAr (p < .05. Moreover, the knee flexion-extension angles (minimum and maximum remained lower in LCAr, pre- and post-training (p < .01. The torque gain associated with eccentric isokinetic training did not affect the kinematic parameters of gait in patients undergoing ACL reconstruction.

  14. Sterilization with electron beam irradiation influences the biomechanical properties and the early remodeling of tendon allografts for reconstruction of the anterior cruciate ligament (ACL).

    Science.gov (United States)

    Schmidt, Tanja; Hoburg, Arnd; Broziat, Christine; Smith, Mark D; Gohs, Uwe; Pruss, Axel; Scheffler, Sven

    2012-08-01

    Although allografts for anterior cruciate ligament (ACL) replacement have shown advantages compared to autografts, their use is limited due to the risk of disease transmission and the limitations of available sterilization methods. Gamma sterilization has shown detrimental effects on graft properties at the high doses required for sufficient pathogen inactivation. In our previous in vitro study on human patellar tendon allografts, Electron beam (Ebeam) irradiation showed less detrimental effects compared to gamma sterilization (Hoburg et al. in Am J Sports Med 38(6):1134-1140, 2010). To investigate the biological healing and restoration of the mechanical properties of a 34 kGy Ebeam treated tendon allograft twenty-four sheep underwent ACL replacement with either a 34 kGy Ebeam treated allograft or a non-sterilized fresh frozen allograft. Biomechanical testing of stiffness, ultimate failure load and AP-laxity as well as histological analysis to investigate cell, vessel and myofibroblast-density were performed after 6 and 12 weeks. Native sheep ACL and hamstring tendons (HAT, each n = 9) served as controls. The results of a previous study analyzing the remodeling of fresh frozen allografts (n = 12) and autografts (Auto, n = 18) with the same study design were also included in the analysis. Statistics were performed using Mann-Whitney U test followed by Bonferroni-Holm correction. Results showed significantly decreased biomechanical properties during the early remodeling period in Ebeam treated grafts and this was accompanied with an increased remodeling activity. There was no recovery of biomechanical function from 6 to 12 weeks in this group in contrast to the results observed in fresh frozen allografts and autografts. Therefore, high dose Ebeam irradiation investigated in this paper cannot be recommended for soft tissue allograft sterilization.

  15. Fixation strength of biocomposite wedge interference screw in ACL reconstruction: effect of screw length and tunnel/screw ratio. A controlled laboratory study

    Directory of Open Access Journals (Sweden)

    Herrera Antonio

    2010-06-01

    Full Text Available Abstract Background Primary stability of the graft is essential in anterior cruciate ligament surgery. An optimal method of fixation should be easy to insert and provide great resistance against pull-out forces. A controlled laboratory study was designed to test the primary stability of ACL tendinous grafts in the tibial tunnel. The correlation between resistance to traction forces and the cross-section and length of the screw was studied. Methods The tibial phase of ACL reconstruction was performed in forty porcine tibias using digital flexor tendons of the same animal. An 8 mm tunnel was drilled in each specimen and two looped tendons placed as graft. Specimens were divided in five groups according to the diameter and length of the screw used for fixation. Wedge interference screws were used. Longitudinal traction was applied to the graft with a Servohydraulic Fatigue System. Load and displacement were controlled and analyzed. Results The mean loads to failure for each group were 295,44 N (Group 1; 9 × 23 screw, 564,05 N (Group 2; 9 × 28, 614,95 N (Group 3; 9 × 35, 651,14 N (Group 4; 10 × 28 and 664,99 (Group 5; 10 × 35. No slippage of the graft was observed in groups 3, 4 and 5. There were significant differences in the load to failure among groups (ANOVA/P Conclusions Longer and wider interference screws provide better fixation in tibial ACL graft fixation. Short screws (23 mm do not achieve optimal fixation and should be implanted only with special requirements.

  16. Australian Institute of Sport and the Australian Paralympic Committee position statement: urinary tract infection in spinal cord injured athletes.

    Science.gov (United States)

    Compton, Stacey; Trease, Larissa; Cunningham, Corey; Hughes, David

    2015-10-01

    Patients with spinal cord injuries are at increased risk of developing symptomatic urinary tract infections. Current evidence-based knowledge regarding prevention and treatment of urinary tract infection in the spinal cord injured population is limited. There are currently no urinary tract infection prevention and management guidelines specifically targeted towards elite spinal cord injured athletes. This position statement represents a set of recommendations intended to provide clinical guidelines for sport and exercise medicine physicians and other healthcare providers for the prevention and treatment of urinary tract infection in spinal cord injured athletes. It has been endorsed by the Australian Institute of Sport (AIS) and the Australian Paralympic Committee (APC).

  17. USING ACL TO REALIZE THE SYSTEM'S SAFE ACCESS CONTROL%用ACL实现系统的安全访问控制

    Institute of Scientific and Technical Information of China (English)

    诸晔

    2005-01-01

    ACL作为Windows各主流操作系统的基础部分,是对机器资源进行保护的最后一道屏障,其重要性不言而喻.本文着重介绍了ACL内涵,并通过具体实例说明如何合理地创建和使用ACL,最终实现系统的安全访问控制,达到资源不被恶意攻击的目的.

  18. 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

    Institute of Scientific and Technical Information of China (English)

    区永亮(综述); 黄华扬(审校)

    2015-01-01

    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。

  19. Co-culture of astrocytes with neurons from injured brain A time-dependent dichotomy

    Institute of Scientific and Technical Information of China (English)

    Xiaojing Xu; Min Wang; Jing Liu; Jingya Lv; Yanan Hu; Huanxiang Zhang

    2011-01-01

    As supportive cells for neuronal growth and development, much effort has been devoted to the role of astrocytes in the normal state. However, the effect of the astrocytes after injury remains elusive. In the present study, neurons isolated from the subventricular zone of injured neonatal rat brains were co-cultured with astrocytes. After 6 days, these astrocytes showed a mature neuron-like appearance and the number of survivingneurons, primary dendrites and total branches was significantly higher than those at 3 days. The neurons began to shrink at 9 days after co-culture with shorter and thinner processes and the number of primary dendrites and total branches was significantly reduced. These experimental findings indicate that astrocytes in the injured brain promote the development of neurons in the early stages of co-culture while these cells reversely inhibit neuronal growth and development at the later states.

  20. Neurodevelopment. Live imaging of adult neural stem cell behavior in the intact and injured zebrafish brain.

    Science.gov (United States)

    Barbosa, Joana S; Sanchez-Gonzalez, Rosario; Di Giaimo, Rossella; Baumgart, Emily Violette; Theis, Fabian J; Götz, Magdalena; Ninkovic, Jovica

    2015-05-15

    Adult neural stem cells are the source for restoring injured brain tissue. We used repetitive imaging to follow single stem cells in the intact and injured adult zebrafish telencephalon in vivo and found that neurons are generated by both direct conversions of stem cells into postmitotic neurons and via intermediate progenitors amplifying the neuronal output. We observed an imbalance of direct conversion consuming the stem cells and asymmetric and symmetric self-renewing divisions, leading to depletion of stem cells over time. After brain injury, neuronal progenitors are recruited to the injury site. These progenitors are generated by symmetric divisions that deplete the pool of stem cells, a mode of neurogenesis absent in the intact telencephalon. Our analysis revealed changes in the behavior of stem cells underlying generation of additional neurons during regeneration.

  1. Biodegradable biomatrices and bridging the injured spinal cord: the corticospinal tract as a proof of principle.

    Science.gov (United States)

    Joosten, Elbert A J

    2012-07-01

    Important advances in the development of smart biodegradable implants for axonal regeneration after spinal cord injury have recently been reported. These advances are evaluated in this review with special emphasis on the regeneration of the corticospinal tract. The corticospinal tract is often considered the ultimate challenge in demonstrating whether a repair strategy has been successful in the regeneration of the injured mammalian spinal cord. The extensive know-how of factors and cells involved in the development of the corticospinal tract, and the advances made in material science and tissue engineering technology, have provided the foundations for the optimization of the biomatrices needed for repair. Based on the findings summarized in this review, the future development of smart biodegradable bridges for CST regrowth and regeneration in the injured spinal cord is discussed.

  2. Effects of low-intensity pulsed ultrasound in repairing injured articular cartilage

    Institute of Scientific and Technical Information of China (English)

    JIA Xiao-lin; CHEN Wen-zhi; ZHOU Kun; WANG Zhi-biao

    2005-01-01

    Objective: To investigate the effects of low-intensity pulsed ultrasound in repairing injured articular cartilage. Methods: Ten adult New Zealand rabbits with bilateral full-thickness osteochondral defects on the cartilage surface of intercondylar fossas were used in this study. The wounds in the left knees were treated with low-intensity pulsed ultrasound as the experimental group. The right knees received no treatment as the control group. All the animals were killed at 8 weeks after injury and the tissues in the wounds were collected for gross appearance grading, histological grading and proteoglycan quantity. Results: The scores of the gross appearance grades, histological grades and the optical density of toluidine blue of the tissues in the experimental group were significantly higher than those of the controls at 8 weeks after injury (P<0.05). Conclusions: Low-intensity pulsed ultrasound can accelerate the repair of injured articular cartilage.

  3. Semaphorin 3A expression in spinal cord injured rats after olfactory ensheathing cell transplantation

    Institute of Scientific and Technical Information of China (English)

    Guoyu Wang; Xijing He; Puwei Yuan; Haopeng Li; Rui Chang

    2011-01-01

    Semaphorin 3A expression is thought to increase following spinal cord injury. The impact of olfactory ensheathing cell transplantation remains unclear. The current study demonstrated that spinal cord hemorrhage, edema, degeneration, necrosis, cyst formation, proliferation of glial cells, regeneration of nerve fibers and various pathological reactions occurred following a simple cross-section of spinal cord injury. Transplantation of olfactory ensheathing cells was found to significantly relieve the pathological reactions in the spinal cord described above, decrease the extent of necrosis in damaged neurons and nerve fibers, and downregulate semaphorin 3A expression in the injured zone. The results confirmed that olfactory ensheathing cell transplantation plays a protective role on the injured spinal cord by reducing the expression of semaphorin 3A.

  4. Les jeux de l’injure dans Henry IV

    OpenAIRE

    Vienne-Guerrin, Nathalie

    2007-01-01

    Il s’agit d’analyser les mécanismes ludiques qui président aux « joutes de jactance » qui sont si caractéristiques d’Henry iv et à l’aune desquelles on peut mesurer l’ambiguïté et l’évolution de la relation entre Falstaff et Hal / Henry. Nous examinons comment ces tournois d’injures se manifestent sur la scène shakespearienne. Il ne s’agit pas d’une étude rhétorique et lexicale de l’injure mais de l’examen d’un rituel verbal paradoxal au cours duquel on s’insulte sans s’injurier, au cours duq...

  5. Physiological arousal, distress tolerance, and social problem-solving deficits among adolescent self-injurers.

    Science.gov (United States)

    Nock, Matthew K; Mendes, Wendy Berry

    2008-02-01

    It has been suggested that people engage in nonsuicidal self-injury (NSSI) because they (a) experience heightened physiological arousal following stressful events and use NSSI to regulate experienced distress and (b) have deficits in their social problem-solving skills that interfere with the performance of more adaptive social responses. However, objective physiological and behavioral data supporting this model are lacking. The authors compared adolescent self-injurers (n = 62) with noninjurers (n = 30) and found that self-injurers showed higher physiological reactivity (skin conductance) during a distressing task, a poorer ability to tolerate this distress, and deficits in several social problem-solving abilities. These findings highlight the importance of attending to increased arousal, distress tolerance, and problem-solving skills in the assessment and treatment of NSSI.

  6. Music for the injured soldier: a contribution of American women's military bands during World War II.

    Science.gov (United States)

    Sullivan, Jill M

    2007-01-01

    This study is an investigation of the contributions of women's military bands in the United States to the reconditioning of the injured American troops during World War II. Primary and secondary sources revealed that these bands welcomed home hospital ships, performed for convalescing soldiers in hospitals, and provided music for hospital dances. While each of the bands investigated served in similar capacities, only one, the 403rd Women's Army Corps (WAC) Band, was stationed at a hospital. While entertainment by women's bands was an important part of the Army Reconditioning Program for the injured, the study also revealed a working partnership that developed between these musicians and the medical community. Sixty years after the war, band members believe their performances in hospitals were the most important contribution of their service. Some historians have concluded that music used in military hospitals during the war was the impetus for the music therapy profession.

  7. Salvage versus amputation: Utility of mangled extremity severity score in severely injured lower limbs

    OpenAIRE

    Kumar M; Badole C; Patond K

    2007-01-01

    Background: The purpose of the present study was to evaluate the clinical utility of Mangled extremity severity score (MESS) in severely injured lower limbs. Materials and Methods: Retrospectively 25 and prospectively 36 lower limbs in 58 patients with high-energy injuries were evaluated with the use of MESS, to assist in the decision-making process for the care of patients with such injuries. Difference between the mean MESS scores for amputated and salvaged limbs was analyzed. Results: ...

  8. Alcohol in Head-Injured Aircrew Evaluated by the Aeromedical Consult Service, 1982-2002

    Science.gov (United States)

    2012-02-23

    problem drinking and the results were compared to the "gold standard", the Psychoactive Substance Use Disorder tool. These two questions were: 1...McDuff DR, Hebel JR, Gorelick DA, Kerns TJ, Ho SM, Read KM. Psychoactive substance abuse among seriously injured trauma center patients. JAMA 1997;277... CONSUMPTION 38 ALCOHOL USE AT THE TIME OF HEAD INJURY 39 ALCOHOL CONTRIBUTION TO THE HEAD INJURY 40 Alcohol as a Contributing Factor 40 Alcohol

  9. Tracking of CFSE-labeled endothelial progenitor cells in laser-injured mouse retina

    Institute of Scientific and Technical Information of China (English)

    SHI Hui; YANG Wei; CUI Zhi-hua; LU Cheng-wei; LI Xiao-hong; LIANG Ling-ling; SONG E

    2011-01-01

    Background Endothelial progenitor cells (EPCs) transplantation is a promising therapeutic strategy for ischemic retinopathy. The current study aimed to establish a simple, reliable and fluorescent labeling method for tracking EPCs with 5-(and-6)-carboxyfluorescein diacetate succinimidyl ester (CFSE) in laser-injured mouse retina.Methods EPCs were isolated from human umbilical cord blood mononuclear cells, cultivated, and labeled with various concentrations of CFSE. Based on fluorescence intensity and cell morphology, a 15 minutes incubation with 5 μmol/L CFSE at 37℃ was selected as the optimal labeling condition. The survival capability and the apoptosis rate of CFSE-labeled EPCs were measured by Trypan blue staining and Annexin V/PI staining assay respectively. Fluorescence microscopy was used to observe the label stability during the extended culture period. Labeled EPCs were transplanted into the vitreous cavity of pigmented mice injured by retinal laser photocoagulation. Evans Blue angiography and flat mounted retinas were examined to track the labeled cells.Results EPCs labeled with 5 μmol/L CFSE presented an intense green fluorescence and maintained normal morphology, with no significant changes in the survival capability or apoptosis rate after being labeled for 2 days, 1 and 4 weeks. The fluorescence intensity gradually decreased in the cells at the end of 4 weeks. Evans Blue angiography of the retina displayed the retinal capillarity network clearly and fluorescence leakage was observed around photocoagulated spots in the laser-injured mouse model. One week after transplantation of labeled EPCs, the fluorescent cells were identified around the photocoagulated lesions. Four weeks after transplantation, fluorescent tube-like structures were observed in the retinal vascular networks.Conclusion EPCs could be labeled by CFSE in vitro and monitored in vivo for at least 4 weeks, and participate in the repair of injured retinal vessels.

  10. Crash Culpability Relative to Age and Sex for Injured Drivers Using Alcohol, Marijuana or Cocaine

    OpenAIRE

    Soderstrom, Carl A.; Dischinger, Patricia C; Kufera, Joseph A.; Ho, Shiu M.; Shepard, Angela

    2005-01-01

    While there is a great deal of data documenting the etiologic role alcohol use plays in crash culpability, there is a dearth of data for other drugs. The purpose of this study was to assess crash culpability for single drug use among injured drivers admitted to a regional trauma center. This study is the largest of its kind involving trauma center patients. Clinical toxicology results obtained for patient care were linked to police crash reports containing a field attributing crash culpabilit...

  11. BDNF promotes connections of corticospinal neurons onto spared descending interneurons in spinal cord injured rats.

    Science.gov (United States)

    Vavrek, R; Girgis, J; Tetzlaff, W; Hiebert, G W; Fouad, K

    2006-06-01

    Although regeneration of injured axons is inhibited within the adult CNS, moderate recovery can be found in patients and animals with incomplete spinal cord injury (SCI). This can be partly attributed to sprouting of spared and injured axons, rostral and caudal to the lesion, respectively. Recently, it has been reported that following a thoracic SCI such sprouting can result in indirect reconnections of the lesioned axons to caudal targets via propriospinal interneurons (PrI). Here, we attempted to further promote this spontaneous repair mechanism by applying the neurotrophic factor BDNF (brain-derived neurotrophic factor), in the vicinity of the cell bodies of lesioned corticospinal neurons or NT-3, intrathecally to the cervical spinal cord. We performed a dorsal over-hemisection at the thoracic spinal cord sparing only the left ventrolateral quadrant. This type of lesion did not promote sprouting of injured corticospinal axons or re-routing via commissural PrI. Also, in rats that received NT-3 at the cervical enlargement, no increase in sprouting was found. However, animals receiving BDNF at the cell bodies of lesioned corticospinal neurons showed a significant increase in collateral sprouting and in the number of contacts with PrI. This was not observed when BDNF was administered to unlesioned animals. Although no statistical difference in the horizontal ladder walking was found between the groups, the increase in collateral sprouting and in the number of contacts correlated with the functional recovery. Hence, cell body treatment can promote plasticity of the injured CNS and may be a valuable treatment approach in conjunction with local regeneration promoting strategies.

  12. Injured workers’ perception of loss and gain in the return to work process

    Science.gov (United States)

    Lai, Hon Sun; Szeto, Grace PY; Chan, Chetwyn CH

    2017-01-01

    When a worker is injured at work, he has to face a tough decision-making process about when and how to return to work (RTW). This study tests how the prospect theory can be applied to influence the injured workers’ perceptions about this important choice. One hundred forty-one injured workers were presented with wage- and pain-related information in four different message framing (negatively or positively) and precision (smaller or larger number) conditions. After exposure to the specific combination of this wage and pain information, the participants were asked to express intentions to RTW in terms of perceived chance, confidence, and anticipated sick leave duration. When asked to predict their RTW outcome, 101 participants (72.3%) responded favorably, whereas only 40 (27.7%) indicated an expectation for staying on sick leave. The present results did not show significant differences in the participants’ responses to the positively and negatively framed information about wage and pain. However, it was noted that the control group that was presented with positive framing for both “wage” and “pain” information showed higher scores in expectation and confidence for RTW, whereas the Ambivalent Group that had both negative messages showed lower scores. Seventy-nine participants who had ≥60% perceived improvement in condition were selected for further analysis, and those who were presented with “wage loss” information rated significantly higher perceived chance of RTW than those in the “pain gain” group. More in-depth investigation is warranted on this topic, with a larger sample of injured workers to investigate the effects of message framing on the decision-making process about RTW. PMID:28223852

  13. Cross-Sectional Nakagami Images in Passive Stretches Reveal Damage of Injured Muscles.

    Science.gov (United States)

    Lin, Shih-Ping; Lin, Yi-Hsun; Fan, Shih-Chen; Huang, Bu-Miin; Lin, Wei-Yin; Wang, Shyh-Hau; Shung, K Kirk; Su, Fong-Chin; Wu, Chia-Ching

    2016-01-01

    Muscle strain is still awanting a noninvasive quantitatively diagnosis tool. High frequency ultrasound (HFU) improves image resolution for monitoring changes of tissue structures, but the biomechanical factors may influence ultrasonography during injury detection. We aim to illustrate the ultrasonic parameters to present the histological damage of overstretched muscle with the consideration of biomechanical factors. Gastrocnemius muscles from mice were assembled and ex vivo passive stretching was performed before or after injury. After injury, the muscle significantly decreased mechanical strength. Ultrasonic images were obtained by HFU at different deformations to scan in cross and longitudinal orientations of muscle. The ultrasonography was quantified by echogenicity and Nakagami parameters (NP) for structural evaluation and correlated with histological results. The injured muscle at its original length exhibited decreased echogenicity and NP from HFU images. Cross-sectional ultrasonography revealed a loss of correlation between NP and passive muscle stretching that suggested a special scatterer pattern in the cross section of injured muscle. The independence of NP during passive stretching of injured muscle was confirmed by histological findings in ruptured collagen fibers, decreased muscle density, and increased intermuscular fiber space. Thus, HFU analysis of NP in cross section represents muscle injury that may benefit the clinical diagnosis.

  14. Cross-Sectional Nakagami Images in Passive Stretches Reveal Damage of Injured Muscles

    Directory of Open Access Journals (Sweden)

    Shih-Ping Lin

    2016-01-01

    Full Text Available Muscle strain is still awanting a noninvasive quantitatively diagnosis tool. High frequency ultrasound (HFU improves image resolution for monitoring changes of tissue structures, but the biomechanical factors may influence ultrasonography during injury detection. We aim to illustrate the ultrasonic parameters to present the histological damage of overstretched muscle with the consideration of biomechanical factors. Gastrocnemius muscles from mice were assembled and ex vivo passive stretching was performed before or after injury. After injury, the muscle significantly decreased mechanical strength. Ultrasonic images were obtained by HFU at different deformations to scan in cross and longitudinal orientations of muscle. The ultrasonography was quantified by echogenicity and Nakagami parameters (NP for structural evaluation and correlated with histological results. The injured muscle at its original length exhibited decreased echogenicity and NP from HFU images. Cross-sectional ultrasonography revealed a loss of correlation between NP and passive muscle stretching that suggested a special scatterer pattern in the cross section of injured muscle. The independence of NP during passive stretching of injured muscle was confirmed by histological findings in ruptured collagen fibers, decreased muscle density, and increased intermuscular fiber space. Thus, HFU analysis of NP in cross section represents muscle injury that may benefit the clinical diagnosis.

  15. Histological and functional benefit following transplantation of motor neuron progenitors to the injured rat spinal cord.

    Directory of Open Access Journals (Sweden)

    Sharyn L Rossi

    Full Text Available BACKGROUND: Motor neuron loss is characteristic of cervical spinal cord injury (SCI and contributes to functional deficit. METHODOLOGY/PRINCIPAL FINDINGS: In order to investigate the amenability of the injured adult spinal cord to motor neuron differentiation, we transplanted spinal cord injured animals with a high purity population of human motor neuron progenitors (hMNP derived from human embryonic stem cells (hESCs. In vitro, hMNPs displayed characteristic motor neuron-specific markers, a typical electrophysiological profile, functionally innervated human or rodent muscle, and secreted physiologically active growth factors that caused neurite branching and neuronal survival. hMNP transplantation into cervical SCI sites in adult rats resulted in suppression of intracellular signaling pathways associated with SCI pathogenesis, which correlated with greater endogenous neuronal survival and neurite branching. These neurotrophic effects were accompanied by significantly enhanced performance on all parameters of the balance beam task, as compared to controls. Interestingly, hMNP transplantation resulted in survival, differentiation, and site-specific integration of hMNPs distal to the SCI site within ventral horns, but hMNPs near the SCI site reverted to a neuronal progenitor state, suggesting an environmental deficiency for neuronal maturation associated with SCI. CONCLUSIONS/SIGNIFICANCE: These findings underscore the barriers imposed on neuronal differentiation of transplanted cells by the gliogenic nature of the injured spinal cord, and the physiological relevance of transplant-derived neurotrophic support to functional recovery.

  16. Buyang Huanwu decoction up-regulates Notch1 gene expression in injured spinal cord.

    Science.gov (United States)

    Guo, Zhan-Peng; Huang, Mi-Na; Liu, An-Qi; Yuan, Ya-Jiang; Zhao, Jian-Bo; Mei, Xi-Fan

    2015-08-01

    Expression of genes in the Notch signaling pathway is altered in the injured spinal cord, which indicates that Notch participates in repair after spinal cord injury. Buyang Huanwu decoction, a traditional Chinese herbal preparation, can promote the growth of nerve cells and nerve fibers; however, it is unclear whether Buyang Huanwu decoction affects the Notch signaling pathway in injured spinal cord. In this study, a rat model was established by injuring the T10 spinal cord. At 2 days after injury, rats were intragastrically administered 2 mL of 0.8 g/mL Buyang Huanwu decoction daily until sacrifice. Real-time reverse transcription polymerase chain reaction analysis demonstrated that at 7, 14 and 28 days after injury, the expression of Notch1 was increased in the Buyang Huanwu decoction group compared with controls. These findings confirm that Buyang Huanwu decoction can promote the expression of Notch1 in rats with incomplete spinal cord injury, and may indicate a mechanism to promote the repair of spinal cord injury.

  17. Expression of PirB in normal and injured spinal cord of rats.

    Science.gov (United States)

    Zhou, Yingchun; Qian, Rongjun; Rao, Jing; Weng, Mixia; Yi, Xuxia

    2010-08-01

    The expression of paired immunoglobulin-like receptor B (PirB) in normal and injured spinal cord of rats was investigated. The SD rat hemi-sectioned spinal cord injury (SCI) model was established. Before and 1, 3, 7, 10 days after SCI, the spinal cord tissues were harvested, and Western blot and immunohistochemistry were used to examine the expression and location of PirB. The results showed that the expression level of PirB in the normal spinal cord of SD rats was low. At the first day after SCI, the expression of PirB was obviously increased, and that in the injured spinal cord from the first day to the 10th day was significantly higher than in the normal spinal cord. The positive expression of PirB in neurons from different regions of gray matter of the injured spinal cord was seen. It was concluded that the expression of PirB in the normal spinal cord of rats was low. The expression of PirB in SCI was significantly increased till at least the 10th day.

  18. Buyang Huanwu decoction up-regulatesNotch1 gene expression in injured spinal cord

    Institute of Scientific and Technical Information of China (English)

    Zhan-peng Guo; Mi-na Huang; An-qi Liu; Ya-jiang Yuan; Jian-bo Zhao; Xi-fan Mei

    2015-01-01

    Expression of genes in the Notch signaling pathway is altered in the injured spinal cord, which indicates thatNotch participates in repair after spinal cord injury.Buyang Huanwu decoction, a traditional Chinese herbal preparation, can promote the growth of nerve cells and nerve ifbers;however, it is unclear whetherBuyang Huanwu decoction affects the Notch signaling pathway in injured spinal cord. In this study, a rat model was established by injuring the T10 spinal cord. At 2 days after injury, rats were intragastrically administered 2 mL of 0.8 g/mLBuyang Huanwu decoction daily until sacriifce. Real-time reverse transcription polymerase chain reaction analysis demonstrated that at 7, 14 and 28 days after injury, the expression ofNotch1 was increased in the Buyang Huanwu decoction group compared with controls. These ifndings conifrm thatBuyang Huanwu decoction can promote the expression of Notch1 in rats with incomplete spinal cord injury, and may indicate a mechanism to promote the repair of spinal cord injury.

  19. The effects of cyclo-oxygenase inhibitors on bile-injured and normal equine colon.

    Science.gov (United States)

    Campbell, N B; Jones, S L; Blikslager, A T

    2002-07-01

    A potential adverse effect of cyclo-oxygenase (COX) inhibitors (nonsteroidal anti-inflammatory drugs [NSAIDs]) in horses is colitis. In addition, we have previously shown an important role for COX-produced prostanoids in recovery of ischaemic-injured equine jejunum. It was hypothesised that the nonselective COX inhibitor flunixin would retard repair of bile-injured colon by preventing production of reparative prostaglandins, whereas the selective COX-2 inhibitor, etodolac would not inhibit repair as a result of continued COX-1 activity. Segments of the pelvic flexure were exposed to 1.5 mmol/l deoxycholate for 30 min, after which they were recovered for 4 h in Ussing chambers. Contrary to the proposed hypothesis, recovery of bile-injured colonic mucosa was not affected by flunixin or etodolac, despite significantly depressed prostanoid production. However, treatment of control tissue with flunixin led to increases in mucosal permeability, whereas treatment with etodolac had no significant effect. Therefore, although recovery from bile-induced colonic injury maybe independent of COX-elaborated prostanoids, treatment of control tissues with nonselective COX inhibitors may lead to marked increases in permeability. Alternatively, selective inhibition of COX-2 may reduce the incidence of adverse effects in horses requiring NSAID therapy.

  20. Repair of injured spinal cord using biomaterial scaffolds and stem cells.

    Science.gov (United States)

    Shrestha, Bikesh; Coykendall, Katherine; Li, Yongchao; Moon, Alex; Priyadarshani, Priyanka; Yao, Li

    2014-08-01

    The loss of neurons and degeneration of axons after spinal cord injury result in the loss of sensory and motor functions. A bridging biomaterial construct that allows the axons to grow through has been investigated for the repair of injured spinal cord. Due to the hostility of the microenvironment in the lesion, multiple conditions need to be fulfilled to achieve improved functional recovery. A scaffold has been applied to bridge the gap of the lesion as contact guidance for axonal growth and to act as a vehicle to deliver stem cells in order to modify the microenvironment. Stem cells may improve functional recovery of the injured spinal cord by providing trophic support or directly replacing neurons and their support cells. Neural stem cells and mesenchymal stem cells have been seeded into biomaterial scaffolds and investigated for spinal cord regeneration. Both natural and synthetic biomaterials have increased stem cell survival in vivo by providing the cells with a controlled microenvironment in which cell growth and differentiation are facilitated. This optimal multi‒disciplinary approach of combining biomaterials, stem cells, and biomolecules offers a promising treatment for the injured spinal cord.

  1. Induction of regenerative responses of injured sciatic nerve by pharmacopuncture therapy in rats.

    Science.gov (United States)

    Chang, In Ae; Namgung, Uk

    2013-04-01

    Although recent studies report that combined treatment of herbal drugs with acupuncture can improve clinical efficacy in traditional oriental medicine, experimental evidence that supports this pharmacopuncture therapy is rare thus far. Here, we investigated the effects of the herbal drug recipe Sciatica 5 (SCTA5) and acupuncture stimulation on gall bladder 30 (GB30) on regenerative responses of injured sciatic nerve in rats. Treatment of cultured dorsal root ganglion (DRG) neurons with SCTA5 improved neurite outgrowth. In vivo regenerative responses, in terms of distal extension of regenerating axons and retrogradely-labeled DRG neurons, were improved by either injury site application of SCTA5 or GB30 acupuncture stimulation and further increased by SCTA5 pharmacopuncture on GB30 acupoint. Moreover, combined treatment of SCTA5 and GB30 was more effective than singular treatments in inducing Cdc2 kinase and accompanying vimentin phosphorylation in Schwann cells of the injured nerve. These results suggest that SCTA5 and GB30 therapies may be cooperative in facilitating axonal regeneration in the injured peripheral nerves.

  2. The suffering is similar--is the treatment equal? An intervention with Arab Terror injured.

    Science.gov (United States)

    Gagin, Roni; Unger-Arnov, Yael; Shinan-Altman, Shiri; Tessler, Aviva

    2011-01-01

    In the course of the last Intifada and during the Second Lebanon War, all citizens of Israel were exposed to waves of terrorism that claimed many people wounded and killed, unrelated to religious differences, age, gender, or nationality: Jews and Arabs suffered alike. The acts of terror exposed all inhabitants equally to injury, suffering, and the need to adjust. The professional literature attests that minority groups are at a higher risk of experiencing post-traumatic symptoms as a result of exposure to acts of terror. This article describes the treatment with terror injured, Jews and Arabs, in the frame of the project for terror victims at Rambam Medical Center, in cooperation with Operation Embrace. It also covers the project intervention with casualties of the shooting incident in the Arab town of Shefaram, with the cooperation of Shefaram Social Welfare department. The psycho-social work conducted with the injured, Jews and Arabs, emphasized their similarities, their common fate, and the fact that any of us could be injured in a terror act or a war. The suffering, the loss, and the hurt are common to us all. At the same time, the interventions referred to cultural differences and the diverse ways of coping with the aftermath of the events, based on values, faith, and outlook on life arising from cultural background.

  3. R2* and R2 mapping for quantifying recruitment of superparamagnetic iron oxide-tagged endothelial progenitor cells to injured liver: tracking in vitro and in vivo

    Directory of Open Access Journals (Sweden)

    Wang Q

    2014-04-01

    Full Text Available Qingguo Wang, Kangan Li, Qimeng Quan, Guixiang ZhangDepartment of Radiology, Shanghai Jiaotong University Affiliated First People’s Hospital, Hongkou District, Shanghai, People’s Republic of ChinaObjective: To evaluate clinical 3.0T magnetic resonance for tracking and quantifying superparamagnetic iron oxide (SPIO–labeled endothelial progenitor cells (EPCs in vitro and homing to liver with acute injury in vivo.Methods: The bone marrow-derived EPCs were isolated and cultured for 4 days and examined in vitro for lineage markers. Then the cultured cells were labeled with a ferumoxides-protamine sulfate complex. Iron uptake was analyzed with an electron microscope and Prussian blue staining. Agarose gel phantoms containing different amounts of EPCs (0–2.5 × 106 cells per milliliter of 1.0% agarose gel were analyzed with 3.0T R2 and R2* relaxometry. For in vivo tracking, liver injury was induced in healthy C57 mice (female, 6 weeks old, weight 19–20 g by administration of carbon tetrachloride by single intraperitoneal injection. The R2* and R2 mapping of injured and normal livers of C57 mice were conducted by using 3.0T magnetic resonance on Days 0, 1, 4, and 8 after intravenous SPIO-tagged cells transplantation.Results: Electron microscope and Perls Prussian blue stain revealed the efficiency of SPIO particles uptake was more than 95% and no structural changes of labeled cells were found compared with control group. R2 and R2* values were linearly correlated with the number of iron-loaded cells in the agarose gel phantoms, and R2* values were significantly greater than R2 (P<0.01. R2* values in all groups were obviously greater than R2 (P<0.01. The R2* values of the injured livers were greater than normal on Days 1 and 4 (P<0.01. No significant difference of R2 values could be found among the three groups.Conclusion: Quantitative R2* mapping provides a useful method for quantifying intravascular administered SPIO-tagged EPCs homing to

  4. Biology of anterior cruciate ligament injury and repair: Kappa delta ann doner vaughn award paper 2013.

    Science.gov (United States)

    Murray, Martha Meaney; Fleming, Braden C

    2013-10-01

    Anterior cruciate ligament (ACL) injuries are currently treated by removing the injured ligament and replacing it with a tendon graft. Recent studies have examined alternative treatment methods, including repair and regeneration of the injured ligament. In order to make such an approach feasible, a basic understanding of ACL biology and its response to injury is needed. Identification of obstacles to native ACL healing can then be identified and potentially resolved using tissue engineering strategies-first, with in vitro screening assays, and then with in vivo models of efficacy and safety. This Perspectives paper outlines this path of discovery for optimizing ACL healing using a bio-enhanced repair technique. This journey required constructing indices of the functional tissue response, pioneering physiologically based methods of biomechanical testing, developing, and validating clinically relevant animal models, and creating and optimizing translationally feasible scaffolds, surgical techniques, and biologic additives. Using this systematic translational approach, "bio-enhanced" ACL repair has been advanced to the point where it may become an option for future treatment of acute ACL injuries and the prevention of subsequent post-traumatic osteoarthritis associated with this injury.

  5. Gamma knife irradiation of injured sciatic nerve induces histological and behavioral improvement in the rat neuropathic pain model.

    Directory of Open Access Journals (Sweden)

    Yuki Yagasaki

    Full Text Available We examined the effects of gamma knife (GK irradiation on injured nerves using a rat partial sciatic nerve ligation (PSL model. GK irradiation was performed at one week after ligation and nerve preparations were made three weeks after ligation. GK irradiation is known to induce immune responses such as glial cell activation in the central nervous system. Thus, we determined the effects of GK irradiation on macrophages using immunoblot and histochemical analyses. Expression of Iba-1 protein, a macrophage marker, was further increased in GK-treated injured nerves as compared with non-irradiated injured nerves. Immunohistochemical study of Iba-1 in GK-irradiated injured sciatic nerves demonstrated Iba-1 positive macrophage accumulation to be enhanced in areas distal to the ligation point. In the same area, myelin debris was also more efficiently removed by GK-irradiation. Myelin debris clearance by macrophages is thought to contribute to a permissive environment for axon growth. In the immunoblot study, GK irradiation significantly increased expressions of βIII-tubulin protein and myelin protein zero, which are markers of axon regeneration and re-myelination, respectively. Toluidine blue staining revealed the re-myelinated fiber diameter to be larger at proximal sites and that the re-myelinated fiber number was increased at distal sites in GK-irradiated injured nerves as compared with non-irradiated injured nerves. These results suggest that GK irradiation of injured nerves facilitates regeneration and re-myelination. In a behavior study, early alleviation of allodynia was observed with GK irradiation in PSL rats. When GK-induced alleviation of allodynia was initially detected, the expression of glial cell line-derived neurotrophic factor (GDNF, a potent analgesic factor, was significantly increased by GK irradiation. These results suggested that GK irradiation alleviates allodynia via increased GDNF. This study provides novel evidence that GK

  6. Procedural and legal status of the injured party according to the new criminal procedure code of the Republic of Serbia

    Directory of Open Access Journals (Sweden)

    Grubač Momčilo

    2012-01-01

    Full Text Available In this article the author is critically analyzing certain solutions of the new Criminal Procedure Code of the Republic of Serbia from 2011 which consider the injured party and their rights in the criminal proceeding. He states that unlike the previous ones, this Code does not improve the status of the injured party but makes it even worse. The author particularly claims that the legislator yet again failed to establish the right of the injured party to be efficiently compensated in the event of a serious offense from a special fund and immediately after the crime has been committed, but prior to the end of the criminal proceeding. In the provision of the Code which states that the injured party may take over the prosecution and become a prosecutor replacing the Public Prosecutor (subsidiary prosecutor only if the Public Prosecutor withdraws after having confirmed the indictment, however not in the cases of rejection of criminal charges or withdrawal from the prosecution in the previous proceeding, the author sees not only the limitation of the rights of the injured party, but also jeopardy of the public interest. This is due to the fact that, freed from a threat of the subsidiary accusation by the injured party, the Public Prosecutor has gained an absolute and uncontrolled monopoly over the initiation of criminal proceeding. According to the author, the subject of the proceedings will not have any substantial use from some rights which the new Code assigns to the injured party (for example the right to appeal against the judgment on the adjudicated property claim. In conclusion, the author stresses out that in spite of his objections against certain provisions in the Code, the legal status of the injured party is more favorable in the criminal law of Serbia then in many other countries.

  7. Increased TNFR1 expression and signaling in injured peripheral nerves of mice with reduced BACE1 activity.

    Science.gov (United States)

    Liu, Lijuan; Fissel, John A; Tasnim, Aniqa; Borzan, Jasenka; Gocke, Anne; Calabresi, Peter A; Farah, Mohamed H

    2016-09-01

    Hematogenous macrophages remove myelin debris from injured peripheral nerves to provide a micro-environment conducive to axonal regeneration. Previously, we observed that injured peripheral nerves from Beta-site APP Cleaving Enzyme 1 (BACE1) knockout (KO) mice displayed earlier influx of and enhanced phagocytosis by macrophages when compared to wild-type (WT) mice. These observations suggest that BACE1 might regulate macrophage influx into distal stumps of injured nerves. To determine through which pathway BACE1 influences macrophage influx, we used a mouse inflammation antibody array to assay the expression of inflammation-related proteins in injured nerves of BACE1 KO and WT mice. The most significant change was in expression of tumor necrosis factor receptor 1 (TNFR1) in the distal stump of injured BACE1 KO nerves. Western blotting of protein extracts confirmed increased expression of TNFR1 and its downstream transcriptional factor NFκB in the BACE1 KO distal stumps. Additionally, treatment of WT mice with a BACE1 inhibitor resulted in increased TNFR1 expression and signaling in the distal stump of injured nerves. Exogenous TNFα increased nuclear translocation of p65 NFκB in BACE1 KO tissue and cultured fibroblasts compared with control WT. BACE1 regulates TNFR1 expression at the level of gene expression and not through proteolytic processing. The accelerated macrophage influx in injured nerves of BACE1 KO mice correlates with increased expression and signaling via TNFR1, indicating a link between BACE1 activity and TNFR1 expression/signaling that might contribute to repair of the injured nervous system.

  8. Modeling and stabilization results for a charge or current-actuated active constrained layer (ACL) beam model with the electrostatic assumption

    Science.gov (United States)

    Özer, Ahmet Özkan

    2016-04-01

    An infinite dimensional model for a three-layer active constrained layer (ACL) beam model, consisting of a piezoelectric elastic layer at the top and an elastic host layer at the bottom constraining a viscoelastic layer in the middle, is obtained for clamped-free boundary conditions by using a thorough variational approach. The Rao-Nakra thin compliant layer approximation is adopted to model the sandwich structure, and the electrostatic approach (magnetic effects are ignored) is assumed for the piezoelectric layer. Instead of the voltage actuation of the piezoelectric layer, the piezoelectric layer is proposed to be activated by a charge (or current) source. We show that, the closed-loop system with all mechanical feedback is shown to be uniformly exponentially stable. Our result is the outcome of the compact perturbation argument and a unique continuation result for the spectral problem which relies on the multipliers method. Finally, the modeling methodology of the paper is generalized to the multilayer ACL beams, and the uniform exponential stabilizability result is established analogously.

  9. 基于EPON系统的ACL模块设计与实现%The design and implementation of ACL module based on EPON system

    Institute of Scientific and Technical Information of China (English)

    胡曦; 张劲松

    2011-01-01

    Compared to the great development of the backbone network technology,the access network still have a long way to go to enhance the further improvement of the intemet. The Ethernet Passive Optical Network (EPON) comes birth in this situation. This thesis analyses proceeding from defmition of EPON system,we introduce the structure of the EPON system and operation princle,forcing on decreasing the problems of the security risks of the EPON system in network ,through introducing the configuration access control list(ACL).%接入网技术与骨干网技术发展的巨大差异制约了互联网进一步发展.以太无源光网络(Ethernet Passive Optical Network,EPON)技术正是在这种形势下诞生的.从EPON系统定义出发,介绍EPON系统的结构和工作原理,重点介绍了通过访问控制列表(ACL)技术的配置来减小EPON系统在网络中存在的安全隐患问题.

  10. Changes of Apoptosis in Rats of Acute Ischemic Renal Injury under Treatment of Tetrandrine

    Institute of Scientific and Technical Information of China (English)

    钱玲梅; 王笑云; 冷静

    2002-01-01

    ObjectiveTo elucidate the effect of tetrandrine on acute ischemic renal injury and its relation with apoptosis.MethodsA model for bilateral post-ischemic renal injury in rats was developed by clamping renal pedicles for 45 min.Renal tissular DNA fragmentation analysis and renal tissular HE staining were used.Also quantitative analysis of apoptosis in injured renal tubular epithelium was carried out by using TdT-mediated dUTP nick and labeling (TUNEL).ResultsApoptosis of renal tubular epithelium increased in acute ischemic renal injury.Tetrandrine could remarkably decrease the level of apoptosis in injured renal tubule while protecting renal tissue against the ischemic injuries.ConclusionTetrandrine could adjust the level of apoptosis in renal tubular epithelium and alleviate renal tissular injury.``

  11. Changes of Apoptosis in Rats of Acute Ischemic Renal Injury under Treatment of Tetrandrine

    Institute of Scientific and Technical Information of China (English)

    钱玲梅; 王笑云; 等

    2002-01-01

    Objective To elucidate the effect of tetrandrine on acute ischemic renal injury and its relation with apoptosis.Methods A model for bilateral post-ischemic renal injury in rats was developed by clamping renal pedicles for 45 min.Renal tissular DNA fragmentation analysis and renal tissular HE staining were used.Also quantitative analysis of apoptosis in injured renal tubular epithelium was carried out by using TdT-mediated dUTP nick and labeling(TUNEL).Results Apoptosis of renal tubular epithelium increased in acute ischemic renal injury.Tetrandrine could remarkably decrease the level of apoptosis in injured renal tubule while protecting renal tissue against the ischemic injuries.Conclusion Tetrandrine could adjust the level of apoptosis in renal tubular epithelium and alleviate renal tissular injury.

  12. ACL on Linux

    Institute of Scientific and Technical Information of China (English)

    Whitebe&r@Freebear Developer Group

    2009-01-01

    很多用户抱怨Linux的UGO权限模式过于粗糙.难以满足管理需要。同时,Windows因为具有灵活强大的ACL机制,吸引了相当多系统管理员的注意。随着IEEE POSIX 1003.1e标准草案的出现,ACL开始在FreeBSD等类UNfX操作系统上实现。

  13. Differentiation potential of bone marrow mesenchymal stem cells into retina in normal and laser-injured rat eye

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jie; SHAN Qing; MA Ping; JIANG Yanming; CHEN Peng; WEN Jingxia; ZHOU You; QIAN Huanwen; PEI Xuetao

    2004-01-01

    Bone marrow mesenchymal stem cells (MSCs) can develop into hematopoietic and mesenchymal lineages but have not been known to participate in the production of retina. Here we report that bone marrow mesenchymal stem cells, after being subretinally transplanted into normal or Nd: YAG laser-injured rat eye, can integrate into RPE layer, photoreceptor layer, bipolar cell layer and ganglion layer. DAPI-labeling detection was used to trace the origin of the repopulating cells. DAPI fluorescence was used to identify retina cells of bone marrow origin 10, 20, 35 and 50 days after transplantation. No formation of rosettes was found but some random cells were found at the end of the observation. MSCs-originated cells spread more widely in the injured retinas than in the normal ones. Immunohistochemical detection showed that though the cells could express neuronal nuclei (NeuN), neuron specific enolase (NSE), glial fibrillary acidic protein (GFAP) and cytokeratin (CK), the proteins expression in the injured transplantation group was abnormal in some region compared with that in the normal transplantation group. Electroretinogram (ERG) showed that ERG-b wave of the injured transplantation group is significantly higher than that of the two laser-injured control groups. These results suggest that a proportion of MSCs can differentiate into retina-like structure in vivo and the differentiation differs in normal and laser-injured retinas.

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

    Institute of Scientific and Technical Information of China (English)

    LUH Shi-ping; CHIANG Chi-huei

    2007-01-01

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

  15. Bone bruises in anterior cruciate ligament injured knee and long-term outcomes. A review of the evidence

    Directory of Open Access Journals (Sweden)

    Papalia R

    2015-02-01

    Full Text Available Rocco Papalia,1 Guglielmo Torre,1 Sebastiano Vasta,1 Biagio Zampogna,1 Douglas R Pedersen,2,3 Vincenzo Denaro,1 Annunziato Amendola3 1Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy; 2Department of Biomedical Engineering, 3Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA, USA Background: Bone bruises are frequently associated with anterior cruciate ligament (ACL tears as a result of trauma or direct shear stress of the bone. Purpose: To review the evidence regarding the characteristics of the bone bruise associated with ACL tears, its relevance on clinical outcomes, and its progression over time. In particular, the long-term effects of the bone bruise on the knee osteochondral architecture and joint function were evaluated. Study design: Review; level of evidence: 4. Methods: An electronic search was performed on PubMed. Combinations of keywords included: “bone bruise AND knee”; “bone bruise AND anterior cruciate ligament”; “bone bruise AND osteo-chondral defects”. Any level of evidence studies concerning bone bruises in patients with partial or complete ACL tears were retrieved. Results: A total of 25 studies were included; three of them investigated biomechanical parameters, seven were concerned with clinical outcomes, and 15 were radiological studies. Evaluation of the bone bruise is best performed using a fat-saturated T2-weighted fast spin echo exam or a short tau inversion recovery sequence where fat saturation is challenging. The location of the injury has been demonstrated to be more frequent in the lateral compartment of the joint (lateral femoral condyle and lateral tibial plateau. It is associated with ACL tears in approximately 70% of cases, often with collateral ligament or meniscal tears. Mid- and long-term outcomes demonstrated a complete healing of the marrow lesions at magnetic ρresonance imaging, but chondral defects detected with T1

  16. A noninvasive biomechanical treatment as an additional tool in the rehabilitation of an acute anterior cruciate ligament tear: A case report

    Directory of Open Access Journals (Sweden)

    Avi Elbaz

    2014-01-01

    Full Text Available Objectives: Conservative treatments for anterior cruciate ligament (ACL tears may have just as good an outcome as invasive treatments. These include muscle strengthening and neuromuscular proprioceptive exercises to improve joint stability and restore motion to the knee. The Purpose of the current work presents was to examine the feasibility of a novel non-invasive biomechanical treatment to improve the rehabilitation process following an ACL tear. This is a single case report that presents the effect of this therapy in a patient with a complete ACL rupture who chose not to undergo reconstructive surgery. Methods: A 29-year old female athlete with an acute indirect injury to the knee who chose not to undergo surgery was monitored. Two days after injury the patient began AposTherapy. A unique biomechanical device was specially calibrated to the patient’s feet. The therapy program was initiated, which included carrying out her daily routine while wearing the device. The subject underwent a gait analysis at baseline and follow-up gait analyses at weeks 1, 2, 4, 8, 12 and 26. Results: A severe abnormal gait was seen immediately after injury, including a substantial decrease in gait velocity, step length and single limb support. In addition, limb symmetry was substantially compromised following the injury. After 4 weeks of treatment, patient had returned to normal gait values and limbs asymmetry reached the normal range. Conclusions: The results of this case report suggest that this conservative biomechanical therapy may have helped this patient in her rehabilitation process. Further research is needed in order to determine the effect of this therapy for patients post ACL injuries.

  17. Acute abdomen

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    Wig J

    1978-01-01

    Full Text Available 550 cases of acute abdomen have been analysed in detail includ-ing their clinical presentation and operative findings. Males are more frequently affected than females in a ratio of 3: 1. More than 45% of patients presented after 48 hours of onset of symptoms. Intestinal obstruction was the commonest cause of acute abdomen (47.6%. External hernia was responsible for 26% of cases of intestinal obstruction. Perforated peptic ulcer was the commonest cause of peritonitis in the present series (31.7% while incidence of biliary peritonitis was only 2.4%.. The clinical accuracy rate was 87%. The mortality in operated cases was high (10% while the over-all mortality rate was 7.5%.

  18. Protective effect of ghrelin against paraquatinduced acute lung injury in mice

    Institute of Scientific and Technical Information of China (English)

    刘瑶

    2014-01-01

    Objective To measure the levels of ghrelin-induced expression or activation of nuclear factor erythroid 2-re-lated factor 2(Nrf2),heme oxygenase-1(HO-1),and NAD(P)H:quinone oxidoreductase 1(NQO1)in the PQ-injured lungs of mice and to evaluate the protective effect of ghrelin against paraquat(PQ)-induced acute lung injury in mice.Methods According to the random number table method,50 ICR mice of clean grade were

  19. Acute Pancreatitis Concomitant Acute Coronary Syndrome

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    Okay Abacı

    2013-03-01

    Full Text Available Acute pancreatitis is an inflammatory syndrome with unpredictable progression to systemic inflammation and multi-organ dysfunction. As in our case rarely, acute pancreatitis can be presented with the coexistance of acute coronary syndrome. To prevent a misdiagnosis of acute situation presented with chest or abdominal pain, physicians must be aware for coexisting pathophysiologies and take into account the differential diagnosis of all life-threatening causes such as cardiac ischemia or acute abdominal situations.

  20. Abundant expression of guidance and synaptogenic molecules in the injured spinal cord.

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    Anne Jacobi

    Full Text Available BACKGROUND: Spinal interneurons have emerged as crucial targets of supraspinal input during post-injury axonal remodelling. For example, lesioned corticospinal projections use propriospinal neurons as relay stations to form intraspinal detour circuits that circumvent the lesion site and contribute to functional recovery. While a number of the molecules that determine the formation of neuronal circuits in the developing nervous system have been identified, it is much less understood which of these cues are also expressed in the injured spinal cord and can thus guide growing collaterals and initiate synaptogenesis during circuit remodelling. METHODOLOGY/PRINCIPAL FINDINGS: To address this question we characterized the expression profile of a number of guidance and synaptogenic molecules in the cervical spinal cord of healthy and spinal cord-injured mice by in situ hybridization. To assign the expression of these molecules to distinct populations of interneurons we labeled short and long propriospinal neurons by retrograde tracing and glycinergic neurons using a transgenically expressed fluorescent protein. Interestingly, we found that most of the molecules studied including members of slit-, semaphorin-, synCAM-, neuroligin- and ephrin- families as well as their receptors are also present in the adult CNS. While many of these molecules were abundantly expressed in all interneurons examined, some molecules including slits, semaphorin 7a, synCAM4 and neuroligin 1 showed preferential expression in propriospinal interneurons. Overall the expression pattern of guidance and synaptogenic molecules in the cervical spinal cord appeared to be stable over time and was not substantially altered following a midthoracic spinal cord injury. CONCLUSIONS: Taken together, our study indicates that many of the guidance and synaptogenic cues that regulate neuronal circuit formation in development are also present in the adult CNS and therefore likely contribute to the

  1. Interleukin (IL)-8 immunoreactivity of injured axons and surrounding oligodendrocytes in traumatic head injury.

    Science.gov (United States)

    Hayashi, Takahito; Ago, Kazutoshi; Nakamae, Takuma; Higo, Eri; Ogata, Mamoru

    2016-06-01

    Interleukin (IL)-8 has been suggested to be a positive regulator of myelination in the central nervous system, in addition to its principal role as a chemokine for neutrophils. Immunostaining for beta-amyloid precursor protein (AβPP) is an effective tool for detecting traumatic axonal injury, although AβPP immunoreactivity can also indicate axonal injury due to hypoxic causes. In this study, we examined IL-8 and AβPP immunoreactivity in sections of corpus callosum obtained from deceased patients with blunt head injury and from equivalent control tissue. AβPP immunoreactivity was detected in injured axons, such as axonal bulbs and varicose axons, in 24 of 44 head injury cases. These AβPP immunoreactive cases had survived for more than 3h. The AβPP immunostaining pattern can be classified into two types: traumatic (Pattern 1) and non-traumatic (Pattern 2) axonal injuries, which we described previously [Hayashi et al. Int. J. Legal Med. 129 (2015) 1085-1090]. Three of 44 control cases also showed AβPP immunoreactive injured axons as Pattern 2. In contrast, IL-8 immunoreactivity was detected in 7 AβPP immunoreactive and in 2 non-AβPP immunoreactive head injury cases, but was not detected in any of the 44 control cases, including the 3 AβPP immunoreactive control cases. The IL-8 immunoreactive cases had survived from 3 to 24 days, whereas those cases who survived less than 3 days (n=29) and who survived 90 days (n=1) were not IL-8 immunoreactive. Moreover, IL-8 was detected as Pattern 1 axons only. In addition, double immunofluorescence analysis showed that IL-8 is expressed by oligodendrocytes surrounding injured axons. In conclusion, our results suggest that immunohistochemical detection of IL-8 may be useful as a complementary diagnostic marker of traumatic axonal injury.

  2. Cytoskeleton, L-type Ca2+ and stretch activated channels in injured skeletal muscle

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    Fabio Francini

    2013-07-01

    Full Text Available The extra-sarcomeric cytoskeleton (actin microfilaments and anchoring proteins is involved in maintaining the sarco-membrane stiffness and integrity and in turn the mechanical stability and function of the intra- and sub-sarcoplasmic proteins. Accordingly, it regulates Ca2+ entry through the L-type Ca2+ channels and the mechano-sensitivity of the stretch activated channels (SACs. Moreover, being intra-sarcomeric cytoskeleton bound to costameric proteins and other proteins of the sarcoplasma by intermediate filaments, as desmin, it integrates the properties of the sarcolemma with the skeletal muscle fibres contraction. The aim of this research was to compare the cytoskeleton, SACs and the ECC alterations in two different types of injured skeletal muscle fibres: by muscle denervation and mechanical overload (eccentric contraction. Experiments on denervation were made in isolated Soleus muscle of male Wistar rats; forced eccentric-contraction (EC injury was achieved in Extensor Digitorum Longus muscles of Swiss mice. The method employed conventional intracellular recording with microelectrodes inserted in a single fibre of an isolated skeletal muscle bundle. The state of cytoskeleton was evaluated by recording SAC currents and by evaluating the resting membrane potential (RMP value determined in current-clamp mode. The results demonstrated that in both injured skeletal muscle conditions the functionality of L-type Ca2+ current, ICa, was affected. In parallel, muscle fibres showed an increase of the resting membrane permeability and of the SAC current. These issues, together with a more depolarized RMP are an index of altered cytoskeleton. In conclusion, we found a symilar alteration of ICa, SAC and cytoskeleton in both injured skeletal muscle conditions.

  3. Biliverdin Reductase A (BVRA) Mediates Macrophage Expression of Interleukin-10 in Injured Kidney.

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    Hu, Zhizhi; Pei, Guangchang; Wang, Pengge; Yang, Juan; Zhu, Fengmin; Guo, Yujiao; Wang, Meng; Yao, Ying; Zeng, Rui; Liao, Wenhui; Xu, Gang

    2015-09-18

    Biliverdin reductase A is an enzyme, with serine/threonine/tyrosine kinase activation, converting biliverdin (BV) to bilirubin (BR) in heme degradation pathway. It has been reported to have anti-inflammatory and antioxidant effect in monocytes and human glioblastoma. However, the function of BVRA in polarized macrophage was unknown. This study aimed to investigate the effect of BVRA on macrophage activation and polarization in injured renal microenvironment. Classically activated macrophages (M1macrophages) and alternative activation of macrophages (M2 macrophages) polarization of murine bone marrow derived macrophage was induced by GM-CSF and M-CSF. M1 polarization was associated with a significant down-regulation of BVRA and Interleukin-10 (IL-10), and increased secretion of TNF-α. We also found IL-10 expression was increased in BVRA over-expressed macrophages, while it decreased in BVRA knockdown macrophages. In contrast, BVRA over-expressed or knockdown macrophages had no effect on TNF-α expression level, indicating BVRA mediated IL-10 expression in macrophages. Furthermore, we observed in macrophages infected with recombinant adenoviruses BVRA gene, which BVRA over-expressed enhanced both INOS and ARG-1 mRNA expression, resulting in a specific macrophage phenotype. Through in vivo study, we found BVRA positive macrophages largely existed in mice renal ischemia perfusion injury. With the treatment of the regular cytokines GM-CSF, M-CSF or LPS, excreted in the injured renal microenvironment, IL-10 secretion was significantly increased in BVRA over-expressed macrophages. In conclusion, the BVRA positive macrophage is a source of anti-inflammatory cytokine IL-10 in injured kidney, which may provide a potential target for treatment of kidney disease.

  4. Wood anatomical analysis of Alnus incana and Betula pendula injured by a debris-flow event.

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    Arbellay, Estelle; Stoffel, Markus; Bollschweiler, Michelle

    2010-10-01

    Vessel chronologies in ring-porous species have been successfully employed in the past to extract the climate signal from tree rings. Environmental signals recorded in vessels of ring-porous species have also been used in previous studies to reconstruct discrete events of drought, flooding and insect defoliation. However, very little is known about the ability of diffuse-porous species to record environmental signals in their xylem cells. Moreover, time series of wood anatomical features have only rarely been used to reconstruct former geomorphic events. This study was therefore undertaken to characterize the wood anatomical response of diffuse-porous Alnus incana (L.) Moench and Betula pendula Roth to debris-flow-induced wounding. Tree microscopic response to wounding was assessed through the analysis of wood anatomical differences between injured rings formed in the debris-flow event year and uninjured rings formed in the previous year. The two ring types were examined close and opposite to the injury in order to determine whether wound effects on xylem cells decrease with increasing tangential distance from the injury. Image analysis was used to measure vessel parameters as well as fiber and parenchyma cell (FPC) parameters. The results of this study indicate that injured rings are characterized by smaller vessels as compared with uninjured rings. By contrast, FPC parameters were not found to significantly differ between injured and uninjured rings. Vessel and FPC parameters mainly remained constant with increasing tangential distance from the injury, except for a higher proportion of vessel lumen area opposite to the injury within A. incana. This study highlights the existence of anatomical tree-ring signatures-in the form of smaller vessels-related to past debris-flow activity and addresses a new methodological approach to date injuries inflicted on trees by geomorphic processes.

  5. What World Health Assembly Resolution 60.22 means to those who care for the injured.

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    Mock, Charles; Arafat, Raed; Chadbunchachai, Witaya; Joshipura, Manjul; Goosen, Jacques

    2008-08-01

    On May 23, 2007, the World Health Assembly (WHA) adopted WHA Resolution 60.22, "Health Systems: Emergency Care Systems," which called on the World Health Organization (WHO) and governments to adopt a variety of measures to strengthen trauma and emergency care services worldwide. This resolution constituted some of the highest level attention ever devoted to trauma care worldwide. This article reviews the background of this resolution and discusses how it can be of use to surgeons, emergency physicians, and others who care for the injured, especially in low- and middle-income countries.

  6. Vibratory ejaculation in 140 spinal cord injured men and home insemination of their partners

    DEFF Research Database (Denmark)

    Sønksen, J; Fode, Mikkel; Löchner-Ernst, D

    2012-01-01

    Study design:Retrospective cohort study.Objectives:Anejaculation is commonly found in spinal cord injured (SCI) men. Clinical treatments and assisted reproductive techniques allow SCI men to father children but few home pregnancies have been reported. The objective of this paper is to evaluate...... in live births with the delivery of 73 healthy babies. Median time to first pregnancy was 22.8 months (6.0-98.4). No complications were reported.Conclusion:PVS combined with vaginal self-insemination may be performed as a viable, inexpensive option for assisted conception in couples in whom the SCI male...

  7. Injured workers’ perception of loss and gain in the return to work process

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    Lai HS

    2017-02-01

    Full Text Available Hon Sun Lai,1,2 Grace PY Szeto,1 Chetwyn CH Chan3 1Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 2Total Rehabilitation Management (Hong Kong Limited, 3Applied Cognitive Neuroscience Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong Abstract: When a worker is injured at work, he has to face a tough decision-making process about when and how to return to work (RTW. This study tests how the prospect theory can be applied to influence the injured workers’ perceptions about this important choice. One hundred forty-one injured workers were presented with wage- and pain-related information in four different message framing (negatively or positively and precision (smaller or larger number conditions. After exposure to the specific combination of this wage and pain information, the participants were asked to express intentions to RTW in terms of perceived chance, confidence, and anticipated sick leave duration. When asked to predict their RTW outcome, 101 participants (72.3% responded favorably, whereas only 40 (27.7% indicated an expectation for staying on sick leave. The present results did not show significant differences in the participants’ responses to the positively and negatively framed information about wage and pain. However, it was noted that the control group that was presented with positive framing for both “wage” and “pain” information showed higher scores in expectation and confidence for RTW, whereas the Ambivalent Group that had both negative messages showed lower scores. Seventy-nine participants who had ≥60% perceived improvement in condition were selected for further analysis, and those who were presented with “wage loss” information rated significantly higher perceived chance of RTW than those in the “pain gain” group. More in-depth investigation is warranted on this topic, with a larger sample of injured workers to investigate the

  8. Expression of PirB in Normal and Injured Spinal Cord of Rats

    Institute of Scientific and Technical Information of China (English)

    周迎春; 迁荣军; 饶竞; 翁密霞; 易序霞

    2010-01-01

    The expression of paired immunoglobulin-like receptor B (PirB) in normal and injured spinal cord of rats was investigated. The SD rat hemi-sectioned spinal cord injury (SCI) model was established. Before and 1, 3, 7, 10 days after SCI, the spinal cord tissues were harvested, and Western blot and immunohistochemistry were used to examine the expression and location of PirB. The results showed that the expression level of PirB in the normal spinal cord of SD rats was low. At the first day after SCI, the expre...

  9. Extract of Cornus officinalis SIEB ameliorates osteoporosis in Spinal Cord-Injured Rats

    Institute of Scientific and Technical Information of China (English)

    Qingxi Meng; Baolong Wang; Peng Yu; Qunqun Shan; Zhaohu Mao; Fan Zhang; Jian Li; Tinbao Zhao

    2015-01-01

    目的:观察山茱萸的提取物对脊髓损伤大鼠的骨质疏松的治疗作用。方法40只Wistar雄性大鼠分成四组:标准对照组、脊髓损伤组、脊髓损伤高剂量提取物治疗组、脊髓损伤低剂量提取物治疗组。除标准对照组外,建立脊髓损伤引起的骨质疏松大鼠模型,然后进行相关生物化学、骨密度及形态的分析和比较。结果与标准对照组相比,脊髓损伤组的大鼠显示骨量、生物化学指标和形态学参数的显著下降。山茱萸提取物高剂量组治疗大鼠胫骨骨干内、外部区域骨质疏松显示剂量依赖性。结论山茱萸提取物治疗可能通过刺激成骨细胞引骨组织反应,从而导致形态学的变化。%This study investigated the effects of extract of Cornus officinalis CO) on bone loss in spinal cord-injured rats.Forty male Wistar rats were used to establish osteoporosis induced by spinal cord injury, subsequently divided into four groups: standard control group (CG);spinal cord-injured control (SC); spinal cord-injured treated with low-dose extract (L group); and spinal cord-injured treated with high-dose extract ( H group) .Biomechanical, densitometric, and morphometric analyses were performed. SC rats showed a significant decrease in bone mass, biomechanical properties, and morphometric parameters (versus CG).CO-treated rats showed significantly higher values of inner diameter and internal and external areas of tibia diaphysis in a dose-dependent manner.We conclude that the extract of Cornus officinalis SIEB et.ZUCC treatment was able to initiate a positive bone-tissue response, might through stimulation of osteoblasts, which was able to determine the observed morphometric modifications.

  10. Treatments of the injured tendon in Veterinary Medicine: from scaffolds to adult stem cells.

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    Patruno, Marco; Martinello, Tiziana

    2014-04-01

    In order to treat frequently occurring conditions such as traumatic rupture or over-strain tendinopathies, the techniques of tissue engineering and cell-based therapies have become an accepted modus operandi since other available remedies appear to be ineffective in restoring the original structure and function of the injured tissue. However, the mechanisms accounting for the effectiveness of novel regenerative approaches in treating equine tendon and ligament injuries remain poorly characterised. In this review we summarize and discuss the most significant results of our research regarding bioscaffold technology for treating complete tendon tears and the use of adult stem cells for treating tendon lesions induced by over-strain.

  11. Endothelial glycocalyx shedding and vascular permeability in severely injured trauma patients

    DEFF Research Database (Denmark)

    Rahbar, Elaheh; Cardenas, Jessica C; Baimukanova, Gyulnar;

    2015-01-01

    of syndecan-1 during hemorrhagic shock, little is known about the shedding of other EGL components, and their effects on altered permeability and coagulation. We characterized shedding of all four primary components of the EGL, as well as the plasma's effect on permeability and thrombin generation in a cohort...... of trauma patients. METHODS: Plasma samples were collected from 5 healthy consented volunteers and 22 severely injured trauma patients upon admission to the emergency department. ELISA assays were performed to quantify shed HA, HS, CS and syndecan-1 in plasma. A colloid osmometer and Electric Cell...

  12. Biomaterial-engineering and neurobiological approaches for regenerating the injured cerebral cortex

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    Itsuki Ajioka

    2016-03-01

    Full Text Available The cerebral cortex is responsible for higher functions of the central nervous system (CNS, such as movement, sensation, and cognition. When the cerebral cortex is severely injured, these functions are irreversibly impaired. Although recent neurobiological studies reveal that the cortex has the potential for regeneration, therapies for functional recovery face some technological obstacles. Biomaterials have been used to evoke regenerative potential and promote regeneration in several tissues, including the CNS. This review presents a brief overview of new therapeutic strategies for cortical regeneration from the perspectives of neurobiology and biomaterial engineering, and discusses a promising technology for evoking the regenerative potential of the cerebral cortex.

  13. Tendon progenitor cells in injured tendons have strong chondrogenic potential: the CD105-negative subpopulation induces chondrogenic degeneration.

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    Asai, Shuji; Otsuru, Satoru; Candela, Maria Elena; Cantley, Leslie; Uchibe, Kenta; Hofmann, Ted J; Zhang, Kairui; Wapner, Keith L; Soslowsky, Louis J; Horwitz, Edwin M; Enomoto-Iwamoto, Motomi

    2014-12-01

    To study the cellular mechanism of the tendon repair process, we used a mouse Achilles tendon injury model to focus on the cells recruited to the injured site. The cells isolated from injured tendon 1 week after the surgery and uninjured tendons contained the connective tissue progenitor populations as determined by colony-forming capacity, cell surface markers, and multipotency. When the injured tendon-derived progenitor cells (inTPCs) were transplanted into injured Achilles tendons, they were not only integrated in the regenerating area expressing tenogenic phenotype but also trans-differentiated into chondrogenic cells in the degenerative lesion that underwent ectopic endochondral ossification. Surprisingly, the micromass culture of the inTPCs rapidly underwent chondrogenic differentiation even in the absence of exogenous bone morphogenetic proteins or TGFβs. The cells isolated from human ruptured tendon tissues also showed connective tissue progenitor properties and exhibited stronger chondrogenic ability than bone marrow stromal cells. The mouse inTPCs contained two subpopulations one positive and one negative for CD105, a coreceptor of the TGFβ superfamily. The CD105-negative cells showed superior chondrogenic potential in vitro and induced larger chondroid degenerative lesions in mice as compared to the CD105-positive cells. These findings indicate that tendon progenitor cells are recruited to the injured site of tendons and have a strong chondrogenic potential and that the CD105-negative population of these cells would be the cause for chondroid degeneration in injured tendons. The newly identified cells recruited to the injured tendon may provide novel targets to develop therapeutic strategies to facilitate tendon repair.

  14. [Injured players candidates for professional volleyball team: sign them up or not?].

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    Tsur, Atzmon

    2012-02-01

    Competitive volleyball teams master six basic skills: serve, pass, set, attack, block and dig. Each of these skills comprises a number of specific techniques, considered standard practice in high-level volleyball. Five professional volleyball players were candidates to join a first division team in Israel. Their medical dossier presented previous injuries that occurred during their sport's activity. Two of the players had a suprascapular nerve injury, one had a lesion in the hamstrings, another one had an operated ankle sprain and the fifth one had an operated anterior cruciate ligament (ACL) tear in both knees and a mallet fifth finger. The team physician had to make the decision as to whether they are able to continue playing volleyball at a high level, taking into consideration the different skills necessary in this sport. Players having suprascapular nerve injury might have difficulties to hit the serve, to hit and to block the ball. Those with unstable knee or ankle take a risk white landing. Lesions in the hamstrings cause local pain during jumping to attack or to block the ball and a mallet finger will disturb the player when attempting to set the ball, to handle it in attack or to block.

  15. A prospective study of the 1-year incidence of fibromyalgia after acute whiplash injury

    OpenAIRE

    Ferrari, Robert

    2015-01-01

    Objective To measure the 1-year incidence of fibromyalgia in a cohort of acute whiplash-injured participants. Methods Consecutive acute patients with whiplash were assessed via the 2010 Modified American College of Rheumatology (ACR) criteria for fibromyalgia at 3 months, 6 months and 1 year postinjury. At each of these follow-up points, participants were also examined for recovery from whiplash injury. Results Of an initial 268 participants, data on recovery was available for 264 participant...

  16. In vivo transplantation of bone marrow mesenchymal stem cells accelerates repair of injured gastric mucosa in rats

    Institute of Scientific and Technical Information of China (English)

    CHANG Qing; YAN Li; WANG Chang-zheng; ZHANG Wen-hui; HU Ya-zhuo; WU Ben-yan

    2012-01-01

    Background Adult stem cells provide a promising alternative for the treatment of injured tissues.We aimed to investigate the effect of in vivo transplantation of bone marrow mesenchymal stem cells (BMMSCs) on injured gastric mucosa in rats.Methods The gastric ulcer in rats was induced by indomethacin.BMMSCs from male rats,labeled with the fluorescent cell linker 5,6-carboxyfluorescein diacetate succinimidyl ester (CFDA SE),were transplanted into the female rats via tail vein injection.The healing process of gastric ulcers was monitored by HE staining.The protein levels of vascular endothelial growth factor (VEGF) and the epidermal growth factor receptor (EGFR) in the injured gastric mucosa were determined by immunohistochemistry.Results At 48 and 72 hours after BMMSCs transplantation,the CFDA SE labeled cells were found scattered in the injured gastric mucosa,but not in the gastric mucosa of control rats.At 72 hours after BMMSCs transplantation,the mean ulcer index was 12.67±2.16 in the BMMSCs transplanted group and 17.33±1.97 in vehicle-treated controls (P <0.01).Both VEGF and EGFR protein expression levels were significantly higher in the gastric section from the rats that received BMMSCs transplantation as compared to rats without BMMSCs transplantation.Conclusion Autologous BMMSCs transplantation can accelerate gastric ulcer healing in injured gastric mucosa in a rodent model.

  17. The effects of low level laser therapy on injured skeletal muscle

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    Ana Claudia Muniz Renno

    2014-02-01

    Full Text Available The main purpose of the present study was to investigate the effects of low-level laser therapy (LLLT used in two different fluencies on injured skeletal muscle after cryolesion by means of histopathological analysis and immunohistochemistry for COX-2. A total of sixty male Wistar rats were randomly distributed into three groups: injured animals without any treatment; 808 nm laser treated group, at 10 J/cm² and 808 nm laser treated group, at 50 J/cm². Each group was divided into two different subgroups (n=10 on days 6 and 13 post-injury. The results showed that the animals irradiated with laser at 10 J/cm² or 50 J/cm² presented the areas with cell infiltrate and pointed out to minor and mild areas with destroyed zones compared with the control group. Also, a COX-2 downregulation was noticed in the groups exposed to laser at two fluences evaluated in this study. Significant statistically differences (p<0.05 were noticed to collagen deposition in the laser treated animals, with the fluence of 50 J/cm² when compared to the other groups on day 13 post-surgery. Taken together, these results suggested that laser therapy could have positive effects on muscle repair in the rats after cryolesion.

  18. Recruitment for Occupational Research: Using Injured Workers as the Point of Entry into Workplaces.

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    Mieke Koehoorn

    Full Text Available To investigate the feasibility, costs and sample representativeness of a recruitment method that used workers with back injuries as the point of entry into diverse working environments.Workers' compensation claims were used to randomly sample workers from five heavy industries and to recruit their employers for ergonomic assessments of the injured worker and up to 2 co-workers.The final study sample included 54 workers from the workers' compensation registry and 72 co-workers. This sample of 126 workers was based on an initial random sample of 822 workers with a compensation claim, or a ratio of 1 recruited worker to approximately 7 sampled workers. The average recruitment cost was CND$262/injured worker and CND$240/participating worksite including co-workers. The sample was representative of the heavy industry workforce, and was successful in recruiting the self-employed (8.2%, workers from small employers (<20 workers, 38.7%, and workers from diverse working environments (49 worksites, 29 worksite types, and 51 occupations.The recruitment rate was low but the cost per participant reasonable and the sample representative of workers in small worksites. Small worksites represent a significant portion of the workforce but are typically underrepresented in occupational research despite having distinct working conditions, exposures and health risks worthy of investigation.

  19. Combination of edaravone and neural stem cell transplantation repairs injured spinal cord in rats.

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    Song, Y Y; Peng, C G; Ye, X B

    2015-12-29

    This study sought to observe the effect of the combination of edaravone and neural stem cell (NSC) transplantation on the repair of complete spinal cord transection in rats. Eighty adult female Sprague-Dawley (SD) rats were used to establish the injury model of complete spinal cord transection at T9. Animals were divided randomly into four groups (N = 20 each): control, edaravone, transplantation, and edaravone + transplantation. The recovery of spinal function was evaluated with the Basso, Beattie, Bresnahan (BBB) rating scale on days 1, 3, and 7 each week after the surgery. After 8 weeks, the BBB scores of the control, edaravone, transplantation, and combination groups were 4.21 ± 0.11, 8.46 ± 0.1, 8.54 ± 0.13, and 11.21 ± 0.14, respectively. At 8 weeks after surgery, the spinal cord was collected; the survival and transportation of transplanted cells were observed with PKH-26 labeling, and the regeneration and distribution of spinal nerve fibers with fluorescent-gold (FG) retrograde tracing. Five rats died due to the injury. PKH-26-labeled NSCs had migrated into the spinal cord. A few intact nerve fibers and pyramidal neurons passed the injured area in the transplantation and combination groups. The numbers of PKH-26-labeled cells and FG-labeled nerve fibers were in the order: combination group > edaravone group and transplantation group > control group (P injured areas; edaravone with NSC transplantation can improve the effectiveness of spinal cord injury repair in rats.

  20. Extracellular matrix regulation of inflammation in the healthy and injured spinal cord.

    Science.gov (United States)

    Gaudet, Andrew D; Popovich, Phillip G

    2014-08-01

    Throughout the body, the extracellular matrix (ECM) provides structure and organization to tissues and also helps regulate cell migration and intercellular communication. In the injured spinal cord (or brain), changes in the composition and structure of the ECM undoubtedly contribute to regeneration failure. Less appreciated is how the native and injured ECM influences intraspinal inflammation and, conversely, how neuroinflammation affects the synthesis and deposition of ECM after CNS injury. In all tissues, inflammation can be initiated and propagated by ECM disruption. Molecules of ECM newly liberated by injury or inflammation include hyaluronan fragments, tenascins, and sulfated proteoglycans. These act as "damage-associated molecular patterns" or "alarmins", i.e., endogenous proteins that trigger and subsequently amplify inflammation. Activated inflammatory cells, in turn, further damage the ECM by releasing degradative enzymes including matrix metalloproteinases (MMPs). After spinal cord injury (SCI), destabilization or alteration of the structural and chemical compositions of the ECM affects migration, communication, and survival of all cells - neural and non-neural - that are critical for spinal cord repair. By stabilizing ECM structure or modifying their ability to trigger the degradative effects of inflammation, it may be possible to create an environment that is more conducive to tissue repair and axon plasticity after SCI.