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Sample records for anterior distal basado

  1. [Large distal anterior cerebral artery aneurysm associated with azygos anterior cerebral artery: case report].

    Science.gov (United States)

    Suzuki, Y; Kawamata, T; Matsumoto, H; Kunii, N; Matsumoto, K

    1998-10-01

    A 51-year-old woman presented with a distal anterior cerebral artery aneurysm (DACAA) manifesting as severe headache and monoparesis of the left lower limb. Computed tomography revealed subarachnoid hemorrhage in the interhemispheric fissure, bilateral sylvian fissures, and basal cistern, and a hematoma in the supracallosal region. Angiography showed a large aneurysm (23 x 18 mm) located on the distal end of the azygos anterior cerebral artery (azygos ACA) at the supracallosal portion. T2-weighted magnetic resonance imaging demonstrated the hematoma as a mixed intensity mass, compressing the corpus callosum downward, and the aneurysm as a flow void anterior to the hematoma. Unilateral frontoparietal parasagittal craniotomy was performed with a horse-shoe shaped incision. The aneurysm was clipped via the interhemispheric approach, and the hematoma was aspirated. Postoperative angiography showed disappearance of the aneurysm and intact azygos ACA. The patient was discharged with mild monoparesis, paresthesia of the left lower limb and diagnostic dyspraxia. DACAA almost always arises at or near the genu of the corpus callosum and is often associated with vascular anomaly. In the literature, 22 of 26 cases of large and giant DACAA were located at or near the genu, but only 3 cases, including ours, in the supracallosal area. 11 cases were associated with azygos ACA. Therefore, hemodynamic stress caused by vascular anomaly may be involved in the formation of large or giant DACAA in contrast with cases of normal DACAA. PMID:9789300

  2. A case of angiographically occult, distal small anterior inferior cerebellar artery aneurysm

    OpenAIRE

    Hisashi Kubota; Yasuhiro Sanada; Kazuhiro Nagatsuka; Amami Kato

    2015-01-01

    Background: A small aneurysm at an unusual location, such as a distal anterior inferior cerebellar artery (AICA) aneurysm, may conceal as a computed tomography angiography (CTA) and digital subtraction angiography (DSA)-occult aneurysm. Case Description: We herein present the case of a patient suffering from a subarachnoid hemorrhage (SAH) with two aneurysms in which the AICA aneurysm was negative by CTA and DSA. CTA demonstrated a right anterior choroidal artery aneurysm, which was revea...

  3. [Ruptured distal anterior cerebral artery aneurysm and diagnostic dyspraxia: a case report].

    Science.gov (United States)

    Wada, M; Kajikawa, H; Fujii, S; Yamamura, K; Kajikawa, M

    1995-04-01

    A case of ruptured distal anterior cerebral artery aneurysm presenting with diagnostic dyspraxia is presented. A 54-year-old female was referred to our hospital with the complaint of sudden onset of headache followed by disturbance of consciousness. CT and MRI revealed subarachnoid hemorrhage with hematomas in the interhemispheric fissure and the supracallosal area, and CAG revealed a left-sided callosomarginal artery aneurysm. During and after hospitalization, she showed diagnostic dyspraxia characterized by behavior of both her hands opposite to what might be expected e.g. when she tried to pick up a bowl, both her hands moved forward and held it at once; she wiped her head and face with toilet paper after urination. At times her hands behaved in opposite ways. For example, while folding cloths, her right hand tended to fold them while the left hand tended to unfold them; when she put on a sweater, as the right hand put it on, the left hand took it off; when she put her shirt into her trousers, one hand pushed it in while the other hand pulled it out. This unusual behavior was considered to be caused by the impairment of the corpus callosum due to compression by the hematoma. It disappeared gradually over a period of one year. Involuntary motor behavior of the left hand while the right hand is in voluntary action is known as diagnostic dyspraxia. Although this symptom has rarely been reported so far in cases of ruptured distal anterior cerebral artery, it may become noticed more frequently through careful observation. PMID:7739777

  4. Simultaneous laparoscopy-assisted low anterior resection and distal gastrectomy for synchronous carcinoma of rectum and stomach

    Institute of Scientific and Technical Information of China (English)

    Qian-Lin Zhu; Feng Dong; Jun-Jun Ma; Ya-Ping Zong; Min-Hua Zheng; Bo Feng; Ai-Guo Lu; Min-Liang Wang; Jian-Wen Li; Wei-Guo Hu; Lu Zang; Zhi-Hai Mao

    2008-01-01

    Laparoscopic resection of rectal cancer or gastric cancer has been advocated for the benefits of a reduced morbidity,a shorter treatment time,and similar outcomes.However,simultaneous laparoscopy-assisted low anterior resection and distal gastrectomy for synchronous carcinoma of rectum and stomach are rarely documented in literature.Endoscopic examination revealed a synchronous carcinoma of rectum and stomach in a 55-year-old male patient with rectal bleeding and epigastric discomfort.He underwent a simultaneous laparoscopy-assisted low anterior resection and distal gastrectomy with regional lymph nodes dissected.The operation time was 270min and the estimated blood loss was 120mL.The patient required parenteral analgesia for less than 24h.Flatus was passed on postoperative day 3,and a solid diet was resumed on postoperative day 7.He was discharged on postoperative day 13.With the advances in laparoscopic technology and experience,simultaneous resection is an attractive alternative to a synchronous gastrointestinal cancer.

  5. The additional value of an oblique image plane for MRI of the anterior and posterior distal tibiofibular syndesmosis

    International Nuclear Information System (INIS)

    The optimal MRI scan planes of collateral ligaments of the ankle have been described extensively, with the exception of the syndesmotic ligaments. We assessed the optimal scan plane for depicting the distal tibiofibular syndesmosis. In order to determine the optimal oblique caudal-cranial and lateral-medial MRI scan plane, two fresh frozen cadaveric ankles were used. The angle of the scan plane that demonstrated the anterior and posterior distal tibiofibular ligament uninterrupted in their full length was determined. In a prospective study this oblique scan plane was then used in addition to the axial and coronal planes, for MRI scans of both ankles in 21 healthy volunteers. Two observers independently evaluated the anterior tibiofibular ligament (ATIFL) and posterior tibiofibular ligament (PTIFL) regarding the continuity of the individual fascicles, thickness and wavy contour of the ligaments in both the axial and the oblique plane. Kappa was calculated to determine the interobserver agreement. McNemar's test was used to statistically quantify the significance of the two scan planes. In the axial plane the ATIFL was in 31% (13/42) partly and in 69% (29/42) completely discontinuous; in the oblique plane the ATIFL was continuous in 88% (37/42) and partly discontinuous in 12% (5/42). Compared with the axial plane, the oblique plane demonstrated significantly less discontinuity (p < 0.001), but not significantly less thickening (p = 1.00) or less wavy contour (p = 0.06) of the ATIFL. In the axial scan plane the PTIFL was continuous in 76% (32/42), partially discontinuous in 19% (8/42) and completely discontinuous in 5% (2/42); in the oblique plane the PTIFL was continuous in 100% (42/42). Compared with the axial plane, the oblique plane demonstrated significantly less discontinuity (p = 0.002), but not significantly less thickening (p = 1.00) or less wavy contour (p = 0.50) of the PTIFL. The interobserver agreement score and kappa (κ) regarding the continuity for the

  6. The additional value of an oblique image plane for MRI of the anterior and posterior distal tibiofibular syndesmosis

    Energy Technology Data Exchange (ETDEWEB)

    Hermans, John J.; Ginai, Abida Z.; Wentink, Noortje [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Hop, Wim C.J. [Erasmus University Medical Center, Department of Epidemiology and Biostatistics, Rotterdam (Netherlands); Beumer, Annechien [Amphia Ziekenhuis, Department of Orthopaedics, Upper Limb Unit, Breda (Netherlands)

    2011-01-15

    The optimal MRI scan planes of collateral ligaments of the ankle have been described extensively, with the exception of the syndesmotic ligaments. We assessed the optimal scan plane for depicting the distal tibiofibular syndesmosis. In order to determine the optimal oblique caudal-cranial and lateral-medial MRI scan plane, two fresh frozen cadaveric ankles were used. The angle of the scan plane that demonstrated the anterior and posterior distal tibiofibular ligament uninterrupted in their full length was determined. In a prospective study this oblique scan plane was then used in addition to the axial and coronal planes, for MRI scans of both ankles in 21 healthy volunteers. Two observers independently evaluated the anterior tibiofibular ligament (ATIFL) and posterior tibiofibular ligament (PTIFL) regarding the continuity of the individual fascicles, thickness and wavy contour of the ligaments in both the axial and the oblique plane. Kappa was calculated to determine the interobserver agreement. McNemar's test was used to statistically quantify the significance of the two scan planes. In the axial plane the ATIFL was in 31% (13/42) partly and in 69% (29/42) completely discontinuous; in the oblique plane the ATIFL was continuous in 88% (37/42) and partly discontinuous in 12% (5/42). Compared with the axial plane, the oblique plane demonstrated significantly less discontinuity (p < 0.001), but not significantly less thickening (p = 1.00) or less wavy contour (p = 0.06) of the ATIFL. In the axial scan plane the PTIFL was continuous in 76% (32/42), partially discontinuous in 19% (8/42) and completely discontinuous in 5% (2/42); in the oblique plane the PTIFL was continuous in 100% (42/42). Compared with the axial plane, the oblique plane demonstrated significantly less discontinuity (p = 0.002), but not significantly less thickening (p = 1.00) or less wavy contour (p = 0.50) of the PTIFL. The interobserver agreement score and kappa ({kappa}) regarding the

  7. What is the best choice for repair of distal penile hypospadias: The tubularized incised plate urethroplasty or anterior urethral advancement technique?

    Directory of Open Access Journals (Sweden)

    Awad Mohamed

    2007-01-01

    Full Text Available Background and Aim: Numerous ingenious methods have been introduced to repair hypospadias with variable results. We tried to evaluate the two techniques, tubularized incised plate urethroplasty (TIP and anterior urethral advancement (AUA for repair of distal hypospadias and choose the best method to treat the distal type of penile hypospadias with the least complications. Materials and Methods : A total of 140 boys with distal penile hypospadias were divided into two groups. Group A (68 patients was treated with TIP and Group B (72 patients was treated with AUA. All the patients had an average age of three years (2-19 with variable meatal sites coronal (44 sub coronal (53 and anterior penile hypospadias (43. There was no significant difference between both groups with respect to the age and meatal sites. Results: The fistula rate in Group A was 8.8% versus 1.3% in Group B. There was no urethral stricture in both procedures. Wound dehiscence did not occur in Group A versus one case in Group B (1.3%. In Group A, 26 cases (38.3% had mild glanular torsion and five (7.3% had moderate glanular torsion versus none in Group B postoperatively. No postoperative chordee or binding in Group A, versus four patients (5.5% in Group B. No significant difference was observed in both groups with respect to meatal stenosis (7.3% versus 5.5% respectively. There was a significant difference between both groups with regard to the operative time in favour of Group B. Good cosmetic appearance of the glans was achieved in both techniques. Conclusion: Both techniques can treat this anomaly with a high success rate but the modified AUA technique appears to be a good choice due to its simplicity, short operative time and less fistula rate with good cosmetic results.

  8. Distal anterior interosseous nerve transfer to the deep ulnar nerve and end-to-side suture of the superficial ulnar nerve to the third common palmar digital nerve for treatment of high ulnar nerve injuries: experience in five cases

    OpenAIRE

    Leandro Pretto Flores

    2011-01-01

    OBJECTIVE: To demonstrate the results of a double nerve transfer at the level of the hand for recovery of the motor and sensory function of the hand in cases of high ulnar nerve injuries. METHOD: Five patients underwent a transfer of the distal branch of the anterior interosseous nerve to the deep ulnar nerve, and an end-to-side suture of the superficial ulnar nerve to the third common palmar digital nerve. RESULTS: Two patients recovered strength M3 and three cases were graded as M4; recover...

  9. Resultados e técnica da reparação do tendão bicipital distal através de duas mini-incisões anteriores Technique and results after distal braquial biceps tendon reparation, through two anterior mini-incisions

    Directory of Open Access Journals (Sweden)

    Luciano Pascarelli

    2013-04-01

    Full Text Available OBJETIVO: Avaliação do resultado pós-operatório da ruptura do bíceps distal após emprego da técnica cirúrgica através de duas mini-incisões anteriores. MÉTODOS: Foram operados, através de uma técnica cirúrgica de duas mini-incisões, nove pacientes com diagnóstico clínico e por imagem (ressonância nuclear magnética de lesão total do bíceps braquial na região insercional entre 2008 e 2011. Os pacientes foram avaliados com três meses de evolução e todos recuperaram a flexão e extensão totalmente. RESULTADOS: Em dois pacientes (22,2% houve uma limitação da supinação em 20 graus. Em um paciente (11,1% houve praxia do nervo radial que durou por um período de cinco meses, porém com recuperação total. Houve uma diminuição da força em todos os pacientes. Em um paciente (11,1% o músculo do bíceps se manteve retraído, mas a inserção estava refeita. Em três pacientes (33,3% foi observada aderência sobre a cicatriz proximal. Não houve evidência clínica ou radiográfica de sinostose radioulnar após seis meses de evolução. Todos os pacientes referiram satisfação com o tratamento. CONCLUSÃO: Concluímos que o método apresentado apresenta bom resultados assim como as demais técnicas, diminuido o risco de aderência sobre a prega flexora do cotovelo. Nível de evidência IV, Série de Casos.OBJECTIVE: Evaluation of postoperative results of repair of distal biceps brachii ruptures through a two anterior mini-incisions. METHODS: Nine patients with clinical and imaging (mRi diagnosis of total lesion of the biceps brachii at its insertion were operated with a surgical technique with two mini-incisions between 2008 and 2011. the patients were evaluated after three months of evolution and all of them recovered the fully flexion-extension arch. RESULTS: Two patients (22.2% presented a limitation of 20 degrees of supination. one patient (11.1% had radial nerve palsy, but was totally recovered after five months. in

  10. Aprendizaje basado en juegos

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    Marco A. Gómez-Martín

    2012-04-01

    Full Text Available Gracias al incremento de potencia de los ordenadores, gran cantidad de personas dedican horas y horas a aprovechar su aspecto más lúdico, los videojuegos. Por otro lado, existen programas educativos que aprovechan la infinita paciencia de los ordenadores que les hacen capaces de explicar conceptos una y otra vez hasta que los alumnos lo entiendan. En este artículo mostramos qué cosas pueden aportar las aplicaciones de enseñanza a los videojuegos y viceversa. Terminamos describiendo JV2M, como un ejemplo de sistema de aprendizaje basado en juegos.

  11. Update on anterior ankle impingement

    OpenAIRE

    Vaseenon, Tanawat; Amendola, Annunziato

    2012-01-01

    Anterior ankle impingement results from an impingement of the ankle joint by a soft tissue or osteophyte formation at the anterior aspect of the distal tibia and talar neck. It often occurs secondary to direct trauma (impaction force) or repetitive ankle dorsiflexion (repetitive impaction and traction force). Chronic ankle pain, swelling, and limitation of ankle dorsiflexion are common complaints. Imaging is valuable for diagnosis of the bony impingement but not for the soft tissue impingemen...

  12. Computed tomography of normal distal tibiofibular syndesmosis

    International Nuclear Information System (INIS)

    The purpose of this study was to determine the shape and measurements of the normal distal tibiofibular syndesmosis on computed tomographic scans and to identify features that could aid in the diagnosis of syndesmotic diastasis using computed tomography (CT). CT scans of 100 patients with normal distal tibiofibular syndesmoses were reviewed retrospectively. In 67% the incisura fibularis was deep, giving the syndesmosis a crescent shape. In 33% the incisura fibularis was shallow, giving the syndesmosis a rectangular shape. The measurements of both types were taken using the same reference points. The mean age of the patients was 40 years, and there were 53 men and 47 women. The mean width of the distal tibiofibular syndesmosis anteriorly between the tip of the anterior tibial tubercle and the nearest point of the fibula was 2 mm. The mean width of the distal tibiofibular syndesmosis posteriorly between the medial border of the fibula and the nearest point of the lateral border of the posterior tibial tubercle was 4 mm. In men the mean width of the distal tibiofibular syndesmosis, anterior and posterior, was 2 mm and 5 mm, respectively, and in women it was 2 mm and 4 mm, respectively. This study provides measurements of the normal tibiofibular syndesmosis to aid in the diagnosis of occult diastasis. (orig.)

  13. Computed tomography of normal distal tibiofibular syndesmosis

    Energy Technology Data Exchange (ETDEWEB)

    Elgafy, Hossein; Semaan, Hassan B.; Blessinger, Brian; Wassef, Andrew; Ebraheim, Nabil A. [University of Toledo Medical Center, Departments of Orthopaedic Surgery and Radiology, Toledo, OH (United States)

    2010-06-15

    The purpose of this study was to determine the shape and measurements of the normal distal tibiofibular syndesmosis on computed tomographic scans and to identify features that could aid in the diagnosis of syndesmotic diastasis using computed tomography (CT). CT scans of 100 patients with normal distal tibiofibular syndesmoses were reviewed retrospectively. In 67% the incisura fibularis was deep, giving the syndesmosis a crescent shape. In 33% the incisura fibularis was shallow, giving the syndesmosis a rectangular shape. The measurements of both types were taken using the same reference points. The mean age of the patients was 40 years, and there were 53 men and 47 women. The mean width of the distal tibiofibular syndesmosis anteriorly between the tip of the anterior tibial tubercle and the nearest point of the fibula was 2 mm. The mean width of the distal tibiofibular syndesmosis posteriorly between the medial border of the fibula and the nearest point of the lateral border of the posterior tibial tubercle was 4 mm. In men the mean width of the distal tibiofibular syndesmosis, anterior and posterior, was 2 mm and 5 mm, respectively, and in women it was 2 mm and 4 mm, respectively. This study provides measurements of the normal tibiofibular syndesmosis to aid in the diagnosis of occult diastasis. (orig.)

  14. Cervicoplastia anterior Anterior cervicoplasty

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    Lucas Gomes Patrocínio

    2004-10-01

    Full Text Available Muitos pacientes buscam correção estética da frouxidão da pele do pescoço, depósito de gordura na região submentoneana ou bandas de platisma. Em grande parte dos casos a ação medial, via cervicoplastia anterior é necessária. OBJETIVO: Demonstrar a casuística e avaliar os resultados e complicações com a técnica de cervicoplastia anterior no Serviço de Otorrinolaringologia da Universidade Federal de Uberlândia. FORMA DE ESTUDO: Relato de série. PACIENTES E MÉTODOS: Quarenta e dois pacientes, entre 39 e 65 anos de idade, sendo 40 (95,2% do sexo feminino e 2 (4,8% do masculino, foram submetidos a cervicoplastia anterior. Retrospectivamente foram avaliados resultados e complicações. RESULTADOS: Destes, 34 apresentaram resultados satisfatórios, 4 apresentaram déficit estético notado somente pelo cirurgião, 3 apresentaram déficit estético notado somente pelo paciente e 1 apresentou déficit estético necessitando cirurgia revisional. Ao estudo fotográfico, todos os pacientes apresentaram melhora do perfil cervical, redução das bandas de platisma e da frouxidão da pele, estabilização da musculatura cervical e acentuação do ângulo cervicomental, em graus variados. Houve complicação em 2 casos (discreto serohematoma e cicatriz um pouco alargada. CONCLUSÃO: A cervicoplastia, associada ou não à tração lateral pela ritidoplastia, é uma técnica que produz resultados satisfatórios na grande maioria dos casos.Many patients look for aesthetic correction of the laxity of neck skin, submandibular fat deposit or platisma bands. In a large part of the cases, medial action, through anterior cervicoplasty is necessary. AIM: To demonstrate the casuistic and to evaluate the results and complications with anterior cervicoplasty technique in the Otorhinolaryngology Service of the Federal University of Uberlândia. STUDY DESIGN: Serie report. PATIENTS AND METHODS: Forty-two patients, between 39 and 65 years of age, being 40 (95

  15. Distal radius triplane fracture

    OpenAIRE

    Parkar, AAH; Marya, S.; Auplish, S

    2014-01-01

    A triplane fracture is so named because of the three planes traversed by the fracture line. These are physeal fractures that result from injury during the final phase of maturation and cessation of growth. This fracture pattern typically involves the distal tibia. We present a rare case of a triplane fracture involving the distal radius.

  16. Surgical Tutorial of a Robotic-Assisted Anterior Pelvic Exenteration

    Medline Plus

    Full Text Available ... a second wick down distally to prevent transitional cell carcinoma spillage. In this case it's probably not ... pulled the bladder off of the anterior abdominal wall and off of the pubic bone, the pubic ...

  17. The study of the distal femur anterior posterior line and rotational alignment in Chinese Han population and its clinical significance%汉族人群正常股骨远端髁间前后轴线与旋转轴线的对位关系及其临床意义

    Institute of Scientific and Technical Information of China (English)

    马德思; 曲铁兵; 温亮; 潘江; 林源; 张博; 辛星; 赵潇雄; 王志为

    2014-01-01

    Objective To explore the distal femur anterior posterior line and rotational alignment in normal Chinese Han population and discuss its clinical application.Methods From October 2012 to July 2013,288 volunteers (148 males and 140 females) from Beijing,Hebei,Xinjiang and Chongqing,aged from 17 to 65(36.3 in average)had undergone CT scan of their lower limbs.The CT scan images of 575 normal knees (288 left and 287 right knees) were obtained.With computer-assisted image processing and reconstruction,the correlative parameters,including anterior posterior line with surgical transepicongdylar axis angle (ASA),anterior posterior line with clinical transepicondylar axis angle (ACA) and anterior posterior line with anterior posterior line angle(APA) were measured.The parameters of two groups between males and females,left and right sides were analyzed.Results ASA:87.19° ± 1.92° in average,87.03° ± 1.95° in males,87.35° ± 1.87° in females,87.33° ± 1.88° in left knees and 87.05° ± 1.95° in right knees; ACA:90.93° ±2.03° in average,90.68° ± 2.01° in males,91.19° ± 2.03° in females,91.05° ±1.93° in left knees and 90.81° ± 2.13° in right knees; APA:83.99° ± 2.16° in average,83.86° ± 2.20° in males,84.12° ± 2.12° in females,84.05° ± 2.09° in left knees and 83.92° ± 2.23° in right knees.There was significant difference between males and females in terms of ACA (t =3.000,P =0.003) and ACA in females was 0.51° larger than that in males.There was no significant difference both in gender and sides in terms of other parameters (all P values > 0.05).Conclusions The relatively accurate relationship between distal femur anterior posterior line and rotational alignment was obtained by investigating larger samples in Chinese Han population,and it can guide the osteotomy of distal femur to get the appropriate rotational alignment.%目的 探讨中国汉族人群正常股骨远端髁间前后轴线与旋转轴线的对位关系及在全膝关

  18. Distal splenorenal shunt

    Science.gov (United States)

    ... Surg. 2006 Apr;141(4):385-8. J. Michael Henderson JM, Boyer TD, Kutner MH, et al. Distal splenorenal shunt versus transjugular intrahepatic portal systematic shunt for variceal bleeding: a randomized trial. ...

  19. Anterior tarsaltunnelsyndrom

    DEFF Research Database (Denmark)

    Miliam, Palle B; Basse, Peter N

    2009-01-01

    Anterior tarsal tunnel syndrome is a rare entrapment neuropathy of the deep peroneal nerve beneath the extensor retinaculum of the ankle. It may be rare because it is underrecognized clinically.We present a case regarding a 29-year-old man, drummer, who for one and a half year experienced clinical...

  20. Microanatomy of the perforators of the anterior communicating artery complex.

    Science.gov (United States)

    Camuscu, H; Dujovny, M; Abd el-Bary, T; Beristain, X; Viñas, F C

    1997-12-01

    We describe the microanatomy of the perforating arteries arising from the anterior communicating artery complex (5 mm distal of the anterior cerebral artery, the anterior communicating artery, and 5 mm proximal of the distal anterior cerebral artery). Thirteen unfixed human brains were used in this study. The origin and number of perforators are described, as is the site of brain penetration, and results are correlated with previous studies. The hemodynamics of blood flow in relation to the formation of an anterior communicating artery aneurysm and different surgical approaches are mentioned. The neuropsychological outcome after aneurysm clipping with regards to the pattern of blood supply from the anterior cerebral artery complex is also discussed. PMID:9427956

  1. 胫骨前侧单切口手术入路治疗胫骨下1/3螺旋形骨折合并显性后踝骨折%Tibial Anterior Single Incision Surgical Approach in the Treatment of Distal 1/3 Spiral Tibial Fracture Associated with Posterior Malleolus Fracture

    Institute of Scientific and Technical Information of China (English)

    王刚; 金冶华; 智春升; 付东宁; 孙禹

    2016-01-01

    目的:探讨胫骨下1/3螺旋形骨折合并显性后踝骨折的发生原因、受伤机制和治疗方案。方法:选择本院2008年2月-2014年4月收治的胫骨下1/3螺旋形骨折合并显性后踝骨折的43例患者作为研究对象。所选患者均采用胫骨前侧手术入路行前外侧钢板联合空心拉力螺钉固定;对无明显移位后踝骨折先固定后踝骨折再复位固定胫骨,对后踝骨折移位明显者予先复位固定胫骨,然后手法复位后踝骨折,再进行空心拉力螺钉固定,所选患者中腓骨骨折均为中段及近端骨折,均未予固定。结果:两组随访时间、踝关节功能优良率、胫骨下1/3螺旋骨折愈合时间及总并发症率比较,差异均无统计学意义(P>0.05);Ⅵ型损伤组后踝骨折愈合时间明显长于Ⅲ型损伤组,比较差异有统计学意义(P0.05).The healing time of posterior malleolus fracture in the type Ⅵ group was longer than that in the type Ⅲ group,the difference was statistically significant(P<0.05). Conclusion:Tibia anterior lateral plate associated with cannulated screw through tibial anterior single incision surgical approach in the treatment of type Ⅲ and Ⅵ fractures has better treatment effect,it is an effective measure for the treatment of distal 1/3 spiral tibial fracture associated with obvious posterior malleolus fracture.

  2. Videojuego basado en la generación procedimental de mundos o niveles

    OpenAIRE

    Martínez Vilar, Rubén

    2015-01-01

    Desde el lanzamiento de Minecraft los videojuegos basados en la generación de niveles o mundos de manera procedimental ha explotado en popularidad, creando incluso una nueva generación de este tipo de juegos como vemos en el prometedor No Man's Sky. Este tipo de generación de niveles permite agregar una jugabilidad prácticamente infinita, donde en cada partida nueva se generan situaciones o configuraciones de objetos diferentes a las anteriores. En este trabajo propongo un estudio de técnicas...

  3. La escuela distal

    OpenAIRE

    Echevarría, Javier

    1998-01-01

    Las tecnologías telemáticas están haciendo surgir un nuevo entorno para las interrelaciones humanas, que comienza a estar presente en la escuela. El entorno telemático es representacional, distal, asincrónico y reticular, y genera nuevas puertas y ventanas en la escuela, que conectan el aula con Telépolis, la ciudad global. Además de alfabetizar para el entorno proximal clásico, la escuela distal ha de alfanumerizar a niños y niñas, adaptándolos al nuevo espacio de interrelación a distancia. ...

  4. Miastenia grave distal: relato de caso

    Directory of Open Access Journals (Sweden)

    Scola Rosana Herminia

    2003-01-01

    Full Text Available Relatamos o caso de uma mulher de 30 anos com quadro de fraqueza muscular nos membros inferiores com predomínio distal com início há 7 anos. Na evolução apresentou fraqueza muscular nos membros superiores. O exame físico mostrava nervos cranianos sem alterações, hipotrofia bilateral de quadriceps e interósseos dos pés, redução da força muscular mais intensa em tibiais anteriores e interósseos dorsais dos pés e reflexos tendinosos globalmente hipoativos. Foi realizado teste de estimulação repetitiva que mostrou decremento maior que 10% no nervo fibular e ulnar. A dosagem de anticorpos anti-receptor de acetilcolina foi positiva. Tomografia computadorizada de tórax foi normal. Dosagem de hormônios tireoidianos mostrou evidências laboratoriais de hipertireoidismo, porém sem manifestações clínicas. Foi iniciado tratamento com piridostigmina havendo melhora importante do quadro clínico. A fraqueza distal é um sintoma inicial raro na miastenia grave (MG. Contudo, a MG deve entrar no diagnóstico diferencial de doenças que cursam com fraqueza muscular distal de membros superiores ou inferiores.

  5. Familial distal dysautonomia.

    OpenAIRE

    Robinson, B; Johnson, R.; Abernethy, D; Holloway, L

    1989-01-01

    A patient is described who presented with painful feet on exercise. He had no evidence of peripheral vascular disease but did have anhidrosis and failure of vasodilatation in the hands and feet suggesting peripheral dysautonomia. Examination of his mother and a cousin and clinical histories of blood relatives suggested that his problem was a severe presentation of a familial distal dysautonomia. In other family members this was represented by dry hands and feet and variable vasomotor symptoms...

  6. Distal radioulnar joint injuries.

    Science.gov (United States)

    Thomas, Binu P; Sreekanth, Raveendran

    2012-09-01

    Distal radioulnar joint is a trochoid joint relatively new in evolution. Along with proximal radioulnar joint, forearm bones and interosseous membrane, it allows pronosupination and load transmission across the wrist. Injuries around distal radioulnar joint are not uncommon, and are usually associated with distal radius fractures,fractures of the ulnar styloid and with the eponymous Galeazzi or Essex_Lopresti fractures. The injury can be purely involving the soft tissue especially the triangular fibrocartilage or the radioulnar ligaments. The patients usually present with ulnar sided wrist pain, features of instability, or restriction of rotation. Difficulty in carrying loads in the hand is a major constraint for these patients. Thorough clinical examination to localize point of tenderness and appropriate provocative tests help in diagnosis. Radiology and MRI are extremely useful, while arthroscopy is the gold standard for evaluation. The treatment protocols are continuously evolving and range from conservative, arthroscopic to open surgical methods. Isolated dislocation are uncommon. Basal fractures of the ulnar styloid tend to make the joint unstable and may require operative intervention. Chronic instability requires reconstruction of the stabilizing ligaments to avoid onset of arthritis. Prosthetic replacement in arthritis is gaining acceptance in the management of arthritis. PMID:23162140

  7. Distal radioulnar joint injuries

    Directory of Open Access Journals (Sweden)

    Binu P Thomas

    2012-01-01

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

  8. RETOS DEL APRENDIZAJE BASADO EN PROBLEMAS

    OpenAIRE

    Carlos Antonio Poot-Delgado

    2013-01-01

    Se realiza una breve descripción de la viabilidad y retos de llevar a la práctica docente el aprendizaje basado en problemas, con una estructura organizada, donde se plasman ideas bien fundamentadas con claridad y precisión. Asimismo, se plantean reflexiones pertinentes, mediante ejercicios alusivos y ubicados en la práctica docente. Es decir, una forma de trabajo que puede ser usada por el edu- cador en una parte de su curso, combinado con otras técnicas didácticas y de- limitando los objeti...

  9. Sistemas basados en conocimiento usando Prolog

    OpenAIRE

    Zenaida García Valdivia; Isis Bonet Cruz; Maikel León Espinosa; Pedro Y. Piñero Pérez

    2011-01-01

    Se exponen algunos de los resultados alcanzados en la Universidad Central "Marta Abreu" de Las Villas en cuanto al uso de un lenguaje de Programación Lógica (Prolog) en la elaboración de Sistemas Basados en Conocimiento para diferentes áreas del saber como son la medicina, soldadura, educación, sistemas eléctricos de potencia, entre otros. Todos los sistemas elaborados utilizan el paradigma de la programación lógica para la representación del conocimiento de los expertos en los temas en cuest...

  10. Metatarsalgia: distal metatarsal osteotomies.

    Science.gov (United States)

    Schuh, Reinhard; Trnka, Hans Joerg

    2011-12-01

    Metatarsalgia is a common pathologic entity. It refers to pain at the MTP joints. Pain in the foot unrelated to the MTP joints (such as Morton’s neuroma) must be distinguished from those disorders, which lead to abnormal pressure distribution, reactive calluses, and pain. Initial treatment options for metatarsalgia include modifications of shoe wear, metatarsal pads, and custom-made orthoses. If conservative treatment fails, operative reconstructive procedures in terms of metatarsal osteotomies should be considered. Lesser metatarsal osteotomy is an effective and well-accepted method for the management of metatarsalgia. The main purpose of these osteotomies is to decrease prominence of the symptomatic metatarsal head. The distal metatarsal oblique osteotomy (Weil osteotomy) with its modification represents the best evaluated distal metatarsal osteotomy in terms of outcome studies and biomechanical analysis. The role of the Weil osteotomy in metatarsalgia owing to a subluxed or dislocated MTP joint is to bring the metatarsal head proximal to the callus and to provide axial decompression of the toe to correct the deformity contributing to metatarsalgia. PMID:22118231

  11. RETOS DEL APRENDIZAJE BASADO EN PROBLEMAS

    Directory of Open Access Journals (Sweden)

    Carlos Antonio Poot-Delgado

    2013-01-01

    Full Text Available Se realiza una breve descripción de la viabilidad y retos de llevar a la práctica docente el aprendizaje basado en problemas, con una estructura organizada, donde se plasman ideas bien fundamentadas con claridad y precisión. Asimismo, se plantean reflexiones pertinentes, mediante ejercicios alusivos y ubicados en la práctica docente. Es decir, una forma de trabajo que puede ser usada por el edu- cador en una parte de su curso, combinado con otras técnicas didácticas y de- limitando los objetivos de aprendizaje que desea cubrir. Este tipo de aprendizaje estimula ciertas habilidades cognitivas que son incitadas en menor grado me- diante métodos tradicionales, permitiendo promover aprendizajes, tales como pensamiento crítico, creatividad, toma de decisiones en situaciones nuevas y habilidades comunicativas.

  12. Sistemas basados en conocimiento usando Prolog

    Directory of Open Access Journals (Sweden)

    Zenaida García Valdivia

    2011-10-01

    Full Text Available Se exponen algunos de los resultados alcanzados en la Universidad Central "Marta Abreu" de Las Villas en cuanto al uso de un lenguaje de Programación Lógica (Prolog en la elaboración de Sistemas Basados en Conocimiento para diferentes áreas del saber como son la medicina, soldadura, educación, sistemas eléctricos de potencia, entre otros. Todos los sistemas elaborados utilizan el paradigma de la programación lógica para la representación del conocimiento de los expertos en los temas en cuestión y además hacen uso de entornos agradables a los usuarios a través interfaces visuales elaboradas en ambientes de programación para súper lenguajes ó utilizan un conjunto de herramientas para la elaboración de sistemas sobre la Web

  13. Distal arthrogryposis syndrome

    Directory of Open Access Journals (Sweden)

    Kulkarni K

    2008-01-01

    Full Text Available A 5-month-old male infant presented with weak cry, decreased body movements, tightness of whole body since birth, and one episode of generalized seizure on day 4 of life. He was born at term by elective caesarian section performed for breech presentation. The child had failure to thrive, contractures at elbow and knee joints, hypertonia, microcephaly, small mouth, retrognathia, and camptodactyly. There was global developmental delay. Abdominal examination revealed umbilical and bilateral inguinal hernia. Visual evoked response and brainstem evoked response audiometry were abnormal. Nerve conduction velocity was normal. Magnetic resonance imaging of brain revealed paucity of white matter in bilateral cerebral hemispheres with cerebellar and brain stem atrophy. The differential diagnoses considered in the index patient were distal arthrogryposis (DA syndrome, cerebroculofacioskeletal syndrome, and Pena Shokier syndrome. The index patient most likely represents a variant of DA: Sheldon Hall syndrome.

  14. Miastenia grave distal: relato de caso

    OpenAIRE

    Scola Rosana Herminia; Iwamoto Fábio Massaiti; Mainardi Maraya Annaai Michels; Della-Coletta Marcus Vinicius; Carvalho Gisah; Zavala Jorge Augusto; Werneck Lineu Cesar

    2003-01-01

    Relatamos o caso de uma mulher de 30 anos com quadro de fraqueza muscular nos membros inferiores com predomínio distal com início há 7 anos. Na evolução apresentou fraqueza muscular nos membros superiores. O exame físico mostrava nervos cranianos sem alterações, hipotrofia bilateral de quadriceps e interósseos dos pés, redução da força muscular mais intensa em tibiais anteriores e interósseos dorsais dos pés e reflexos tendinosos globalmente hipoativos. Foi realizado teste de estimulação repe...

  15. Phacoemulsification in anterior megalophthalmos.

    Science.gov (United States)

    Lee, Graham A; Hann, Joshua V; Braga-Mele, Rosa

    2006-07-01

    This case outlines the phacoemulsification technique used to overcome the challenge of the hyperdeep anterior chamber, weak zonules, abnormal anterior capsule, and large capsular bag. Key steps included trypan blue staining of the anterior capsule, a large capsulorhexis, prolapse of the nucleus into the anterior chamber with phacoemulsification anterior to the capsulorhexis, and a posterior chamber-placed iris-clip intraocular lens. Successful visual rehabilitation is achievable in these anatomically challenging eyes. PMID:16857490

  16. The Changed Route of Anterior Tibial Artery due to Healed Fracture

    OpenAIRE

    Kemal Gökkuş; Ergin Sagtas; Nuri Comert; Mehmet Bekir Unal; Murat Baloglu

    2016-01-01

    We would like to highlight unusual sequelae of healed distal third diaphyseal tibia fracture that was treated conservatively 36 years ago, in which we incidentally detected peripheral CT angiography. The anterior tibial artery was enveloped three-quarterly by the healing callus of the bone (distal tibia).

  17. The Changed Route of Anterior Tibial Artery due to Healed Fracture

    Science.gov (United States)

    Gökkuş, Kemal; Sagtas, Ergin; Comert, Nuri; Unal, Mehmet Bekir; Baloglu, Murat

    2016-01-01

    We would like to highlight unusual sequelae of healed distal third diaphyseal tibia fracture that was treated conservatively 36 years ago, in which we incidentally detected peripheral CT angiography. The anterior tibial artery was enveloped three-quarterly by the healing callus of the bone (distal tibia). PMID:27019760

  18. The Changed Route of Anterior Tibial Artery due to Healed Fracture

    Directory of Open Access Journals (Sweden)

    Kemal Gökkuş

    2016-01-01

    Full Text Available We would like to highlight unusual sequelae of healed distal third diaphyseal tibia fracture that was treated conservatively 36 years ago, in which we incidentally detected peripheral CT angiography. The anterior tibial artery was enveloped three-quarterly by the healing callus of the bone (distal tibia.

  19. Simultaneous bilateral distal biceps tendon ruptures repaired using an endobutton technique: a case report

    OpenAIRE

    DaCambra, Mark P; Walker, Richard EA; Hildebrand, Kevin A.

    2013-01-01

    Introduction The simultaneous rupture of both distal biceps tendons is a rare clinical entity that is difficult to treat and can have poor outcomes. A variety of treatment and rehabilitation options exist and have been reported for single sided and staged bilateral repairs, but none have described an approach for acute bilateral ruptures. Repairing distal biceps tendon ruptures using a single anterior incision and a cortical suspensory button technique has become increasingly popular in recen...

  20. Tratamento cirúrgico da tendinite distal da patela Surgical treatment of the distal patellar tendinitis

    Directory of Open Access Journals (Sweden)

    Marco Martins Amatuzzi

    2005-01-01

    Full Text Available A tendinite distal da patela é uma doença que acomete principalmente jovens esportistas e caracteriza-se por dor referida na extremidade distal da patela junto à inserção do ligamento patelar. O tratamento inicial preconizado é sempre conservador com fisioterapia. A grande maioria tem boa resposta a este tipo de conduta, mas em alguns raros casos os sintomas não regridem exigindo uma mudança de conduta. Para este grupo usamos o tratamento cirúrgico com técnica derivada de Trillat que se baseia na utilização de um enxerto de parte do tendão do músculo Grácil implantado dentro do ligamento patelar, inserido intra-ósseo na patela e fixado na tuberosidade anterior da tíbia. Foram operados seis pacientes, sendo que em dois casos a operação foi bilateral, totalizando oito joelhos. O seguimento mínimo foi de três anos, com avaliação final dentro do índice considerado como EXCELENTE, conforme a cotação ARPÉGE, para todos os joelhos.Distal patellar tendinitis is a young athlete's disease characterized by pain at the distal patellar pole, near the patellar ligament insertion. Early treatment recommended is generally conservative, with physical therapy. The great majority of patients present favorable responses to this approach, but, in some cases, the remission of symptoms does not occur, requiring a different approach. For this group, surgical treatment with a technique derived from that of Trillat was used, which is based on the use of a graft removed from a portion of gracillis muscle tendon into patellar ligament, intraosseously inserted in the patella and fixed at the tibial anterior tuberosity. Six patients were operated, bilaterally in two cases, totaling eight knees. The minimum follow-up time was three years, with all knees presenting an EXCELLENT score, according to ARPÉGE evaluation.

  1. Chronic instability of the anterior syndesmosis of the ankle: Biomechanical, kinematical, radiological and clinical aspects

    OpenAIRE

    Beumer, Annechien

    2007-01-01

    textabstractThis thesis is concerned with chronic anterior instability of the tibiofibular syndesmosis of the ankle. The ankle plays a fundamental role in locomotion. It consists of the talocrural and distal tibiofibular joint. The latter is a syndesmosis, a fibrous joint with ample intervening fibrous connective tissue. The syndesmosis consists of the anterior inferior tibiofibular ligament (ATiFL, also known as the anterior syndesmosis), the interosseous ligament (IL), and the posterior inf...

  2. Non-compliance Appliances for Upper Molar Distalization: An Overview.

    Science.gov (United States)

    Noorollahian, Saeed; Alavi, Shiva; Shirban, Farinaz

    2015-01-01

    Tooth Size Arch-length Discrepancy (TSALD) is a common problem in orthodontics. Its clinical signs are tooth crowding, impaction and incisor proclination. The treatment options are dental arch expansion or tooth mass reduction (stripping or extraction). The "extraction versus non-extraction" controversy has been widely debated in the orthodontic literature. Distalization is a kind of arch expansion in anetro-posterior dimension. Several studies have evaluated both the therapeutic effectiveness and the side effects of the appliances for this method of space gaining. In some cases molar distalization is preferred, e.g., a patient with acceptable profile and skeletal pattern and half cusp Class II molar malocclusion or even less. In some cases molar distalization is the only way, e.g., the patient with previous upper premolar extraction and excessive overijet, or a skeletal Class III patient with previous upper premolar extraction needed upper anterior teeth retraction to create reverse overjet aspre surgical orthodontic decompensation. In this review article, we described non-compliance upper molar distalizing appliances. PMID:26720949

  3. Simultaneous dislocation of radiocapitellar and distal radioulnar joint.

    Science.gov (United States)

    Nishi, Tomio; Suzuki, Noriyuki; Tani, Takayuki; Aonuma, Hiroshi

    2013-01-01

    A 45-year-old male presented to the emergency room of our institution complaining of severe pain around the left elbow. While playing volleyball, he slipped down with his left arm hit between the floor and his body. He complaind of strong pain from left elbow to hand, and active motion of elbow and wrist joint was impossible. His forearm was held in supinated position. On X-ray examination, radius head was deviated to anterior lateral side, and distal end of radius was dislocated to dorsal side. Tenderness was prominent at the site of radial head and distal radioulnar joint. Surgical treatment was performed using triceps tendon strip. Good functional recovery was gained. PMID:24194995

  4. Simultaneous Dislocation of Radiocapitellar and Distal Radioulnar Joint

    Directory of Open Access Journals (Sweden)

    Tomio Nishi

    2013-01-01

    Full Text Available A 45-year-old male presented to the emergency room of our institution complaining of severe pain around the left elbow. While playing volleyball, he slipped down with his left arm hit between the floor and his body. He complaind of strong pain from left elbow to hand, and active motion of elbow and wrist joint was impossible. His forearm was held in supinated position. On X-ray examination, radius head was deviated to anterior lateral side, and distal end of radius was dislocated to dorsal side. Tenderness was prominent at the site of radial head and distal radioulnar joint. Surgical treatment was performed using triceps tendon strip. Good functional recovery was gained.

  5. Anatomic variations of anterior cerebral artery cortical branches.

    Science.gov (United States)

    Stefani, M A; Schneider, F L; Marrone, A C; Severino, A G; Jackowski, A P; Wallace, M C

    2000-01-01

    The anterior cerebral artery (ACA) is a major vessel responsible for the blood supply to the interhemispheric region. The ACA segment after the anterior communicating artery (AComA) origin is called the distal ACA and has central and cortical branches. The cortical branches are distributed in the different regions of the orbital and medial part of the brain. The objects of this study are the anatomical variations found in the distal ACA. In 76 hemispheres the ACA distal branches were injected with latex and dissected under microscope magnification. Vessel diameters and distances between vessel origins and anterior communicating artery were recorded and analyzed. Microsurgical dissection was carried out to demonstrate anatomic variations of these vessels. Average diameter of ACA at origin was 2.61 +/- 0.34 mm and average diameter of cortical branches diameter ranged from 0.79 +/- 0.27 mm to 1.84 +/- 0.3 mm. Distances between vessel origin and AComA ranged from 7.68 +/- 3.91 mm (orbitofrontal) to 112.6 +/- 11.63 mm (inferior internal parietal). This study found anatomical variations: a single (azygos) ACA was present in one case and three in three cases. Crossing branches of the distal ACA to the contralateral hemisphere were present in 26% of the cases. In some cases a single ACA may supply the posterior hemispheric region through crossing branches. This calls attention to potential bilateral brain infarcts due to a single unilateral ACA occlusion. PMID:10873213

  6. Simultaneous Dislocation of Radiocapitellar and Distal Radioulnar Joint

    OpenAIRE

    Tomio Nishi; Noriyuki Suzuki; Takayuki Tani; Hiroshi Aonuma

    2013-01-01

    A 45-year-old male presented to the emergency room of our institution complaining of severe pain around the left elbow. While playing volleyball, he slipped down with his left arm hit between the floor and his body. He complaind of strong pain from left elbow to hand, and active motion of elbow and wrist joint was impossible. His forearm was held in supinated position. On X-ray examination, radius head was deviated to anterior lateral side, and distal end of radius was dislocated to dorsal si...

  7. Bilateral anterior shoulder dislocation

    OpenAIRE

    Meena, Sanjay; Saini, Pramod; Singh, Vivek; Kumar, Ramakant; Trikha, Vivek

    2013-01-01

    Shoulder dislocations are the most common major joint dislocations encountered in the emergency departments. Bilateral shoulder dislocations are rare and of these, bilateral posterior shoulder dislocations are more prevalent than bilateral anterior shoulder dislocations. Bilateral anterior shoulder dislocation is very rare. We present a case of 24-year-old male who sustained bilateral anterior shoulder dislocation following minor trauma, with associated greater tuberosity fracture on one side...

  8. Distal insertions of the semimembranosus tendon: MR imaging with anatomic correlation

    International Nuclear Information System (INIS)

    The purpose of this study is to investigate the distal insertions of the semimembranosus tendon with MR imaging, correlated with findings in cadavers. Four fresh cadaveric specimens were studied with 3-T MR imaging. Sequences included proton density (PD) sequences (TE, 13; TR, 4957; FOV, 170 x 170; matrix, 424 x 413; NA, 2; slice thickness, 2.5 mm) in the axial, coronal, and sagittal planes and 3D fast field echo (FFE) sequences (TR 9.4; TE 6.9; FOV, 159 x 105; matrix, 200 x 211; NA, 2; slice thickness, 0.57 mm). One specimen was dissected and three specimens were sectioned with a bandsaw in the axial, coronal, and sagittal plane. The sections were photographed and correlated with MR images. To standardize the analysis, the semimembranosus muscle and tendon were assessed at seven levels for the axial sections, and at three levels for the coronal and sagittal sections. Anatomic dissection revealed six insertions of the distal semimembranosus tendon: direct arm, anterior arm, posterior oblique ligament extension, oblique popliteal ligament extension, distal tibial expansion (popliteus aponeurosis), and meniscal arm. Axial MR images showed five of six insertions: direct arm, anterior arm, oblique popliteal ligament extension, posterior oblique ligament extension, and distal tibial expansion. Sagittal MR images showed four of six insertions: direct arm, anterior arm, oblique popliteal ligament arm, and distal tibial expansion. Sagittal MR images were ideal for showing the direct arm insertion, but were less optimal than the axial images for showing the other insertions. The anterior arm was seen but volume averaging was present with the gracilis tendon. Coronal MR images optimally revealed the anterior arm, although magic angle artifact was present at its posterior aspect. The common semimembranosus tendon and meniscal arm were also well depicted. The division in anterior arm, direct arm, and oblique popliteal ligament arm was poorly seen on coronal images due to

  9. Distal insertions of the semimembranosus tendon: MR imaging with anatomic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Maeseneer, Michel de [Universitair Ziekenhuis Brussel, Department of Radiology, Jette, Brussels (Belgium); Vrije Universiteit Brussel, Department of Experimental Anatomy, Brussels (Belgium); Shahabpour, Maryam; Milants, Annemieke; Ridder, Filip de; Mey, Johan de [Universitair Ziekenhuis Brussel, Department of Radiology, Jette, Brussels (Belgium); Lenchik, Leon [Wake Forest University, Department of Radiology, Winston-Salem, NC (United States); Cattrysse, Erik [Vrije Universiteit Brussel, Department of Experimental Anatomy, Brussels (Belgium)

    2014-06-15

    The purpose of this study is to investigate the distal insertions of the semimembranosus tendon with MR imaging, correlated with findings in cadavers. Four fresh cadaveric specimens were studied with 3-T MR imaging. Sequences included proton density (PD) sequences (TE, 13; TR, 4957; FOV, 170 x 170; matrix, 424 x 413; NA, 2; slice thickness, 2.5 mm) in the axial, coronal, and sagittal planes and 3D fast field echo (FFE) sequences (TR 9.4; TE 6.9; FOV, 159 x 105; matrix, 200 x 211; NA, 2; slice thickness, 0.57 mm). One specimen was dissected and three specimens were sectioned with a bandsaw in the axial, coronal, and sagittal plane. The sections were photographed and correlated with MR images. To standardize the analysis, the semimembranosus muscle and tendon were assessed at seven levels for the axial sections, and at three levels for the coronal and sagittal sections. Anatomic dissection revealed six insertions of the distal semimembranosus tendon: direct arm, anterior arm, posterior oblique ligament extension, oblique popliteal ligament extension, distal tibial expansion (popliteus aponeurosis), and meniscal arm. Axial MR images showed five of six insertions: direct arm, anterior arm, oblique popliteal ligament extension, posterior oblique ligament extension, and distal tibial expansion. Sagittal MR images showed four of six insertions: direct arm, anterior arm, oblique popliteal ligament arm, and distal tibial expansion. Sagittal MR images were ideal for showing the direct arm insertion, but were less optimal than the axial images for showing the other insertions. The anterior arm was seen but volume averaging was present with the gracilis tendon. Coronal MR images optimally revealed the anterior arm, although magic angle artifact was present at its posterior aspect. The common semimembranosus tendon and meniscal arm were also well depicted. The division in anterior arm, direct arm, and oblique popliteal ligament arm was poorly seen on coronal images due to

  10. Anterior Cruciate Ligament (ACL) Injuries

    Science.gov (United States)

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

  11. OASEARCH: Modelo de aplicación basado en web semántica para la búsqueda de objetos de aprendizaje mediante perfilado de consultas

    OpenAIRE

    Gómez Álvarez, Diego Fernando

    2014-01-01

    Uno de los aspectos que determina la calidad de un Sistema Educativo Basado en la Web es la manera en que este proporciona a los estudiantes los objetos de aprendizaje que mejor se adaptan a sus condiciones específicas -- Es por lo anterior que se hace necesario contar con mecanismos de búsqueda para estos objetos que puedan ser usados fácilmente por la aplicación o por los usuarios de la misma y que entreguen los resultados más relevantes posibles en un contexto determinado -- Múltiples meca...

  12. Management of distal humerus fractures.

    Science.gov (United States)

    McCarty, L Pearce; Ring, David; Jupiter, Jesse B

    2005-09-01

    Fractures of the distal humerus are complex injuries that can be effectively treated with open reduction and internal fixation (ORiF). Exposure of a complex intra-articular fracture may best be achieved through a posterior approach with osteotomy of the olecranon process. The ulnar nerve must be identified and protected, the articular surface must be reduced anatomically, and rigid fixation must be applied to both the medial and lateral columns of the distal humerus. Range of motion should be initiated as soon as possible postoperatively. Complications such as ulnar neuropathy, elbow stiffness, heterotopic ossification, and nonunion should be treated aggressively. Total elbow arthroplasty represents an effective option for fractures that cannot be treated with ORIF. PMID:16250484

  13. Distal clavicle fractures in children☆

    Science.gov (United States)

    Labronici, Pedro José; da Silva, Ricardo Rodrigues; Franco, Marcos Vinícius Viana; Labronici, Gustavo José; Pires, Robinson Esteves Santos; Franco, José Sergio

    2015-01-01

    Objective To analyze fractures of the distal clavicle region in pediatric patients. Methods Ten patients between the ages of five to eleven years (mean of 7.3 years) were observed. Nine patients were treated conservatively and one surgically. All the fractures were classified using the Nenopoulos classification system. Results All the fractures consolidated without complications. Conservative treatment was used for nine patients, of whom three were in group IIIB, three IIb, two IIa and one IV. The only patient who was treated surgically was a female patient of eleven years of age with a group IV fracture. Conclusion The treatment indication for distal fractures of the clavicle in children should be based on the patient's age and the displacement of the fragments. PMID:26962489

  14. Triplane fracture of the distal radius

    OpenAIRE

    Christopher Pearce; Raymond Chung

    2011-01-01

    We report the case of a 14-year-old boy who sustained a displaced triplane fracture of the distal radius. This was treated with closed reduction and application of a cast with good clinical and radiological results. We discuss (for the first time) the reasons for the rarity of this fracture at the distal radius compared to the distal tibia.

  15. Proximal to distal cell communication in the Drosophila leg provides a basis for an intercalary mechanism of limb patterning.

    Science.gov (United States)

    Goto, S; Hayashi, S

    1999-08-01

    Proximodistal patterning in the Drosophila leg is elaborated from the circular arrangement of the proximal domain expressing escargot and homothorax, and the distal domain expressing Distal-less that are allocated during embryogenesis. The distal domain differentiates multiply segmented distal appendages by activating additional genes such as dachshund. Secreted signaling molecules Wingless and Decapentaplegic, expressed along the anterior-posterior compartment boundary, are required for activation of Distal-less and dachshund and repression of homothorax in the distal domain. However, whether Wingless and Decapentaplegic are sufficient for the circular pattern of gene expression is not known. Here we show that a proximal gene escargot and its activator homothorax regulate proximodistal patterning in the distal domain. Clones of cells expressing escargot or homothorax placed in the distal domain induce intercalary expression of dachshund in surrounding cells and reorient planar cell polarity of those cells. Escargot and homothorax-expressing cells also sort out from other cells in the distal domain. We suggest that inductive cell communication between the proximodistal domains, which is maintained in part by a cell-sorting mechanism, is the cellular basis for an intercalary mechanism of the proximodistal axis patterning of the limb. PMID:10393119

  16. Reasoning based in cases applied to diagnosis of electric generators; Razonamiento basado en casos aplicado al diagnostico de generadores electricos

    Energy Technology Data Exchange (ETDEWEB)

    De la Torre Vega, H. Octavio; Garcia Tevillo, Arturo; Campuzano Martinez, Roberto [Instituto de Investigaciones Electricas, Temixco, Morelos (Mexico); Lopez Azamar, Ernesto [Comision Federal de Electricidad (Mexico)

    2000-07-01

    The development of a system for the diagnosis of electrical generators that apply techniques of artificial intelligence, is presented, as it is the reasoning based on cases, to support the work of the diagnosis engineer. This system is part of a system called CADIS, dedicated to the diagnosis of electrical generators out of line and reason of previous articles. In this occasion the characteristics of the reasoning module based on experiences (SirBE) are emphasized, indicating how to make a diagnosis using similar cases and how to edit the system base of experience, using the interactive editor of cases. It is included, in addition, a summarized example which represents a case for SirBE and how the system helps to make a diagnosis. [Spanish] Se presenta el desarrollo de un sistema de diagnostico de generadores electricos que aplica tecnicas de inteligencia artificial, como es el razonamiento basado en casos, para apoyar la labor del ingeniero de diagnostico. Este sistema es parte de un sistema denominado CADIS, dedicado al diagnostico de generadores electricos fuera de linea y motivo de articulos anteriores. En esta ocasion se resaltan las caracteristicas del modulo de razonamiento basado en experiencias (SirBE), indicando como realizar un diagnostico utilizando casos similares y como editar la base de experiencia del sistema utilizando el editor interactivo de casos. Se incluye, ademas, un ejemplo resumido de lo que representa un caso para SiRBE y como el sistema ayuda a realizar un diagnostico.

  17. Anterior cervical plating

    Directory of Open Access Journals (Sweden)

    Gonugunta V

    2005-01-01

    Full Text Available Although anterior cervical instrumentation was initially used in cervical trauma, because of obvious benefits, indications for its use have been expanded over time to degenerative cases as well as tumor and infection of the cervical spine. Along with a threefold increase in incidence of cervical fusion surgery, implant designs have evolved over the last three decades. Observation of graft subsidence and phenomenon of stress shielding led to the development of the new generation dynamic anterior cervical plating systems. Anterior cervical plating does not conclusively improve clinical outcome of the patients, but certainly enhances the efficacy of autograft and allograft fusion and lessens the rate of pseudoarthrosis and kyphosis after multilevel discectomy and fusions. A review of biomechanics, surgical technique, indications, complications and results of various anterior cervical plating systems is presented here to enable clinicians to select the appropriate construct design.

  18. Anterior knee pain

    Science.gov (United States)

    Patellofemoral syndrome; Chondromalacia patella; Runner's knee; Patellar tendinitis; Jumper's knee ... or playing soccer). You have flat feet. Anterior knee pain is more ... skiers, bicyclists, and soccer players who exercise often ...

  19. Anterior knee pain

    Science.gov (United States)

    ... or playing soccer). You have flat feet. Anterior knee pain is more common in: People who are overweight People who have had a dislocation, fracture, or other injury to the kneecap Runners, jumpers, ...

  20. MAPA CONCEPTUAL PARA EL APRENDIZAJE BASADO EN PROBLEMAS

    Directory of Open Access Journals (Sweden)

    YURI GORBANEFF

    2009-01-01

    Full Text Available Se presentan los resultados del experimento sobre el uso de mapas conceptuales en el contexto del aprendizaje basado en problemas (ABP. El experimento fue realizado en la Universidad Javeriana (Bogotá, Colombia en el pregrado de administración. Se encontró que el mapa conceptual mejora el aprendizaje pero no afecta la percepción de los alumnos del método de ABP. Se recomienda incluir mapas conceptuales en los ejercicios de ABP.

  1. Anatomic distribution of nerves and microvascular density in the human anterior vaginal wall: prospective study.

    Directory of Open Access Journals (Sweden)

    Ting Li

    Full Text Available BACKGROUND: The presence of the G-spot (an assumed erotic sensitive area in the anterior wall of the vagina remains controversial. We explored the histomorphological basis of the G-spot. METHODS: Biopsies were drawn from a 12 o'clock direction in the distal- and proximal-third areas of the anterior vagina of 32 Chinese subjects. The total number of protein gene product 9.5-immunoreactive nerves and smooth muscle actin-immunoreactive blood vessels in each specimen was quantified using the avidin-biotin-peroxidase assay. RESULTS: Vaginal innervation was observed in the lamina propria and muscle layer of the anterior vaginal wall. The distal-third of the anterior vaginal wall had significantly richer small-nerve-fiber innervation in the lamina propria than the proximal-third (p = 0.000 and in the vaginal muscle layer (p = 0.006. There were abundant microvessels in the lamina propria and muscle layer, but no small vessels in the lamina propria and few in the muscle layer. Significant differences were noted in the number of microvessels when comparing the distal- with proximal-third parts in the lamina propria (p = 0.046 and muscle layer (p = 0.002. CONCLUSIONS: Significantly increased density of nerves and microvessels in the distal-third of the anterior vaginal wall could be the histomorphological basis of the G-spot. Distal anterior vaginal repair could disrupt the normal anatomy, neurovascular supply and function of the G-spot, and cause sexual dysfunction.

  2. Congenital anterior urethral diverticulum.

    Science.gov (United States)

    Singh, Sanjeet Kumar; Ansari, Ms

    2014-09-01

    Congenital anterior urethral diverticulum (CAUD) may be found all along the anterior urethra and may present itself at any age, from infant to adult. Most children with this condition present with difficulty in initiating micturition, dribbling of urine, poor urinary stream, or urinary tract infection. A careful history will reveal that these children never had a good urinary stream since birth, and the telltale sign is a cystic swelling of the penile urethra. In this paper, we present two cases of CAUD that were managed by excision of the diverticulum with primary repair. PMID:26328174

  3. Ruptured distal AICA pseudoaneurysm presenting years after vestibular schwannoma resection and radiation.

    Science.gov (United States)

    Mascitelli, Justin R; McNeill, Ian T; Mocco, J; Berenstein, Alejandro; DeMattia, Joseph; Fifi, Johanna T

    2016-05-01

    Distal anterior inferior cerebellar artery (AICA) pseudoaneurysms are very rare lesions. Although cases have been previously reported, only a few have been reported as a result of vestibular schwannoma (VS) radiation, none have been reported as a result of VS resection, and only one has been reported as treated with parent vessel occlusion (PVO) with n-butyl cyanoacrylate (nBCA). We report a case of a 65-year-old man with a history of right-sided VS surgery and radiation who presented years later with a ruptured pseudoaneurysm of the distal right AICA and was treated with endovascular PVO using nBCA. The aneurysm was completely obliterated and the patient had no worsening of symptoms or neurological exam. The case illustrates a very rare complication of VS surgery and radiation as well as an effective treatment for distal AICA aneurysms. PMID:25964373

  4. Miniscrew-assisted mandibular molar distalization in a patient with skeletal class-III malocclusion: A clinical case report

    Directory of Open Access Journals (Sweden)

    Seyed Mohammadreza Safavi

    2013-01-01

    Full Text Available In nongrowing patients with mild skeletal Class-III malocclusion, premolar extraction or molar distalization in the lower arch can be done as a part of camouflage treatment. Temporary anchorage devices are widely used for this purpose because they do not produce undesirable reciprocal effects and do not depend on the patient′s cooperation. However, most reported cases in this regard have used interradicular miniscrews in the mandibular arch and these have a risk of failure as they can loosen due to collision with adjacent roots. This article showcases mandibular molar distalization utilizing miniscrews, inserted at the retromolar area to correct a Class-III problem. A 24-year-old girl with a mild skeletal Class-III malocclusion and dental Class-III molar and canine relationship bilaterally was referred for orthodontic treatment. The treatment plan included distalization of the lower molars bilaterally followed by full fixed appliance therapy, after third molar extractions. For the lower molar distalization, the miniscrews were inserted at the retromolar pad. At the end of 21 months, a Class-I molar and canine relationship, normal overjet and overbite were obtained. The average amount of distalization of mandibular first molar was 3.2 mm at the crown level. In conclusion, placing miniscrews at the retromolar pad area for lower molar distalization was found to be a simple and effective method for correcting anterior cross bite and mandibular anterior crowding or protrusion, without the need for patient compliance.

  5. Computed tomography after distal radius fractures

    Energy Technology Data Exchange (ETDEWEB)

    Frahm, R.; Saul, O.; Drescher, E.

    1989-02-01

    Examination of 29 cases of fracture of the distal radius with restricted motion or persistent pain in 22 patients showed that most had been caused by incongruity of the distal radioulnar joint or by rotational malalignment in supination or pronation. Imaging of the distal radioulnar joint without superimposition enables us to detect whether disorders of the joint facets are impeding movement. Exact knowledge of the malalignment aids in the planning of osteoplastic surgery.

  6. Mandibular first molar with three distal canals

    OpenAIRE

    Shweta Jain

    2011-01-01

    With the increasing number of reports of aberrant root canal morphology, the clinician needs to be aware of the variable anatomy. Various case reports have been published with the finding of middle mesial canal in mandibular first molar, however finding of middle distal canal in distal root of mandibular first molar is rare. This case report describes root canal treatment of two rooted mandibular first molar with five root canals (three in distal and two in mesial root), and Sert and Bayirli ...

  7. Anterior vaginal wall repair

    Science.gov (United States)

    ... symptoms will go away. This improvement will often last for years. Alternative Names A/P repair; Vaginal wall repair; Anterior and/ ... writing by ADAM Health Solutions. About MedlinePlus Site Map FAQs Contact ... Institutes of Health Page last updated: 23 August 2016

  8. [Toxic anterior segment syndrome].

    Science.gov (United States)

    Cornut, P-L; Chiquet, C

    2011-01-01

    Toxic anterior segment syndrome (TASS) is a general term used to describe acute, sterile postoperative inflammation due to a non-infectious substance that accidentally enters the anterior segment at the time of surgery and mimics infectious endophthalmitis. TASS most commonly occurs acutely following anterior segment surgery, typically 12-72h after cataract extraction. Anterior segment inflammation is usually quite severe with hypopyon. Endothelial cell damage is common, resulting in diffuse corneal edema. No bacterium is isolated from ocular samples. The causes of TASS are numerous and difficult to isolate. Any device or substance used during the surgery or in the immediate postoperative period may be implicated. The major known causes include: preservatives in ophthalmic solutions, denatured ophthalmic viscosurgical devices, bacterial endotoxin, and intraocular lens-induced inflammation. Clinical features of infectious and non-infectious inflammation are initially indistinguishable and TASS is usually diagnosed and treated as acute endophthalmitis. It usually improves with local steroid treatment but may result in chronic elevation of intraocular pressure or irreversible corneal edema due to permanent damage of trabecular meshwork or endothelial cells. PMID:21176994

  9. Distal femoral fractures: current concepts.

    Science.gov (United States)

    Gwathmey, F Winston; Jones-Quaidoo, Sean M; Kahler, David; Hurwitz, Shepard; Cui, Quanjun

    2010-10-01

    The diversity of surgical options for the management of distal femoral fractures reflects the challenges inherent in these injuries. These fractures are frequently comminuted and intra-articular, and they often involve osteoporotic bone, which makes it difficult to reduce and hold them while maintaining joint function and overall limb alignment. Surgery has become the standard of care for displaced fractures and for patients who must obtain rapid return of knee function. The goal of surgical management is to promote early knee motion while restoring the articular surface, maintaining limb length and alignment, and preserving the soft-tissue envelope with a durable fixation that allows functional recovery during bone healing. A variety of surgical exposures, techniques, and implants has been developed to meet these objectives, including intramedullary nailing, screw fixation, and periarticular locked plating, possibly augmented with bone fillers. Recognition of the indications and applications of the principles of modern implants and techniques is fundamental in achieving optimal outcomes. PMID:20889949

  10. Chronic instability of the anterior syndesmosis of the ankle: Biomechanical, kinematical, radiological and clinical aspects

    NARCIS (Netherlands)

    A. Beumer (Annechien)

    2007-01-01

    textabstractThis thesis is concerned with chronic anterior instability of the tibiofibular syndesmosis of the ankle. The ankle plays a fundamental role in locomotion. It consists of the talocrural and distal tibiofibular joint. The latter is a syndesmosis, a fibrous joint with ample intervening fibr

  11. Evolutopia: aprendizaje basado en problemas en Zoología

    OpenAIRE

    Beltrán Gala, Juan Francisco; Conradi Barrena, Mercedes; Gálvez, Francisco

    2012-01-01

    Zoología es una asignatura troncal del Grado de Biología, con 12 créditos ECTS. Durante el curso 2011-12, ensayamos el aprendizaje basado en problemas (ABP) como una metodología activa de enseñanza-aprendizaje. Al comienzo del curso se presentó el proyecto a los alumnos. La participación era voluntaria y sin recompensa académica (sólo por el deseo de aprender y formarse). Se apuntaron 45 alumnos (de los 371 matriculados). Los alumnos trabajaron a lo largo del curso y sucesiv...

  12. Sistemas de Inteligencia Web basados en redes sociales

    OpenAIRE

    de la Rosa Troyano, Fco. Fernando; Martínez Gasca, Rafael

    2007-01-01

    El Análisis de las Redes Sociales (ARS) es un área que está emergiendo como imprescindible en los procesos de toma de decisiones. Su capacidad para analizar e intervenir una red social puede ser aprovechada para implantar tareas de vigilancia en los sistemas de inteligencia de un centro de investigación o una empresa de base tecnológica. El objetivo de este trabajo es realizar una propuesta para diseñar sistemas de inteligencia web basados en redes sociales. El primer obstáculo para implantar...

  13. Materiales funcionales y estructurales basados en hexaluminato de calcio

    OpenAIRE

    Gómez de la Iglesia, Patricia

    2013-01-01

    En este trabajo se estudia la obtención de materiales basados en hexaluminato de calcio (CA6) empleando diferentes métodos de procesamiento y de síntesis y sinterización. El hexaluminato de calcio es un material muy versátil utilizado para gran variedad de aplicaciones como son la siderurgia, en balística, armamento, etc. Por ello, se han explorado diferentes métodos de síntesis y sinterización de manera que se pueda controlar su formación y propiedades. Los métodos de síntesis convencion...

  14. Control basado en emociones. una revisión

    OpenAIRE

    Rairán Antolines, Jose Danilo

    2011-01-01

    En este artículo se presenta el estado del arte con respecto a modelos computacionales de emociones humanas, así como los desarrollos actuales de controladores emocionales y se propone un esquema de control nuevo basado en las emociones. La introducción la utilidad de las emociones humanas en máquinas y sus aplicaciones. Los trabajos referenciados son clasificados en cuatro grupos. En el primero se muestra por qué la lógica difusa ha sido útil en la emulación de las emociones humanas. En...

  15. MODELO DE TOMA DE DECISIONES BASADO EN MICROSOFT SOLVER

    OpenAIRE

    Felipe García López; Antonio Trejo Romo

    2008-01-01

    En esta investigación se presenta un Modelo de toma de decisiones basado en Microsoft© Excel Solver©. En las ciencias administrativas se busca siempre llegar a la eficiencia, pero sólo la investigación de operaciones enseña cómo obtener el número de unidades que han de producirse y venderse para que los ingresos sean los máximos que una empresa puede alcanzar, con esto habrá mayor reinversión, empleos, impuestos y bienestar. Se propone a Microsoft© Excel Solver© como un programa adecuado y al...

  16. Motor para videojuegos en HTML5, basados en tiles

    OpenAIRE

    Nuñez Del Rio, Rodolfo

    2014-01-01

    Projecte realitzat en dues parts: 1)editor desenvolupada per Rodolfo Núñez del Río; 2) conjunt de rutines que controlen la física i la intel·ligència del joc desenvolupada per Víctor Manuel Agüero En este proyecto se presenta el desarrollo de un game engine utilizando el lenguaje de etiquetas HTML5 y basado en tiles, dando prioridad a la facilidad de uso por parte de creadores no relacionados con el desarrollo de videojuegos.Actualmente las grandes desarrolladoras de videojuegos crean sus...

  17. Anterior cruciate ligament (ACL) injury

    Science.gov (United States)

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

  18. Transabdominal sonographic findings of the distal esophagus in esophageal varices

    International Nuclear Information System (INIS)

    To assess transabdominal sonographic findings of the distal esophagus in the patients with esophageal varices. Transabdominal sonography was performed on two groups which considered of 42 normal subjects (25 males and 17 female, age: 20-65) and 45 cirrhotic patients (34 males and 11 females, age: 30-70) with esophageal varices. The thickness of the anterior wall of the distal esophagus (AWDE) was measured and the shape of its surface was observed. Then these findings were compared between the two groups. The mean thickness of the AWDE in the 42 normal subjects was 2.4 ± 0.62 mm (2-4 mm), while that of the 45 cirrhotic patients was 6.0 ± 1.27 mm (3-10 mm). Whereas the irregular surface of the AWDE was observed in 4 of the 42 normal subjects (9.5%), it was seen in 30 of the 45 cirrhotic patients with esophageal varices (66.7%). When as AWDE having more than 5 mm in thickness was used as a diagnostic criterion for the esophageal varices, the sensitivity, specificity, and accuracy was 89%, 100% and 94% respectively. When an irregular wall surface was used as a diagnostic standard, the results were 67%, 90% and 70% respectively. In the cirrhotic patients, esophageal varix can be presumed with reasons of the thickening AWDE (more than 5 mm) and irregularity of its surface in the transabdominal sonography.

  19. [Proximal and distal ruptures of the biceps brachii tendon].

    Science.gov (United States)

    Klonz, A; Loitz, D; Reilmann, H

    2003-09-01

    Proximal ruptures. Ruptures of the long head of the M. biceps humeri are commonly caused by degenerative changes within the tendon. Non-operative treatment gives good results, the loss of power regarding elbow flexion and supination amounts to only 8-21%. Refixation may be indicated for cosmetic reasons and offers a small but evident improvement of flexion and supination power. Deformity of the slipped muscle can be corrected effectively. Residual complaints after conservative treatment often result from associated subacromial problems. Distal ruptures. Ruptures of the distal tendon should be treated operatively. The loss of power after conservative treatment is evident (30-40% for flexion, >50% for supination). Extra-anatomical tenodesis to the brachialis muscle or anatomical fixation to the radial tuberosity can be applied. Flexion power and cosmesis can be addressed by both techniques. If supination strength is to be restored, the tendon has to be fixed anatomically. Preparation of the tuberosity bears the risk of heterotopic ossification or nerve damage. Mini-open techniques, using only a limited anterior approach, may decrease risks. PMID:14959750

  20. Genetics Home Reference: distal myopathy 2

    Science.gov (United States)

    ... Muscular Dystrophy Health Topic: Muscle Disorders Health Topic: Muscular Dystrophy Genetic and Rare Diseases Information Center (1 link) Distal ... MPD2) Patient Support and Advocacy Resources (2 links) Muscular Dystrophy ... Genetic Testing Registry (1 link) Myopathy, distal, 2 ClinicalTrials. ...

  1. Robotic distal pancreatectomy: a valid option?

    Science.gov (United States)

    Jung, M K; Buchs, N C; Azagury, D E; Hagen, M E; Morel, P

    2013-10-01

    Although reported in the literature, conventional laparoscopic approach for distal pancreatectomy is still lacking widespread acceptance. This might be due to two-dimensional vision and decreased range of motion to reach and safely dissect this highly vascularized retroperitoneal organ by laparoscopy. However, interest in minimally invasive access is growing ever since and the robotic system could certainly help overcome limitations of the laparoscopic approach in the challenging domain of pancreatic resection, notably in distal pancreatectomy. Robotic distal pancreatectomy with and without spleen preservation has been reported with encouraging outcomes for benign and borderline malignant disease. As a result of upgraded endowristed manipulation and three-dimensional visualization, improved outcome might be expected with the launch of the robotic system in the procedure of distal pancreatectomy. Our aim was thus to extensively review the current literature of robot-assisted surgery for distal pancreatectomy and to evaluate advantages and possible limitations of the robotic approach. PMID:24101006

  2. Ophthalmohelioses and peripheral light focusing by the anterior eye

    Science.gov (United States)

    Coroneo, Minas T.

    1994-07-01

    A coincidence of the locations of foci of scattered light in the anterior eye with the usual locations of common sun-related eye conditions has been observed. These phenomena may explain the pathogenesis of pterygium and the initial location of certain cortical lens opacities and eyelid malignancies. Human and bovine eyes were used to demonstrate that the anterior eye acts as a side-on lens system. Light incident at the temporal limbus can be concentrated at the nasal limbus or beyond or at the nasal crystalline lens equator. The main pathways of light are transcameral and this is demonstrated by the use of baffles. Although this phenomenon is obvious with visible light, focusing of light at 308nm can be demonstrated. Computer-assisted optical ray tracing in a standard human anterior segment model showed that the peak intensity at the distal limbus is approximately twenty times that of the incident light intensity. The degree of limbal focusing is determined by corneal shape and anterior chamber depth. Such light focusing may be particularly injurious to corneal and lenticular epithelial stem cells. These observations provide circumstantial evidence that peripheral refraction phenomena are involved in the pathogenesis of the anterior ophthalmohelioses. Adequate lateral protection of the eye from increasing ultraviolet insolation may be prudent.

  3. Itinerarios de aprendizaje flexibles basados en mapas conceptuales

    Directory of Open Access Journals (Sweden)

    Olga Lucía Agudelo

    2015-07-01

    Full Text Available Se estudia el uso de itinerarios de aprendizaje  basados en mapas conceptuales como una propuesta para un diseño instruccional más flexible que potencie el aprendizaje y se centre en el estudiante, generando procesos no lineales, caracterizando sus elementos, estableciendo relaciones entre ellos y configurando un modelo general con especificaciones para  cada nivel de educación. Mediante una metodología construida sobre el modelo SAM (Successive Aproximation Model, se ha estudiado el proceso de diseño, implementación y evaluación de itinerarios de aprendizaje, en los que se representan en mapas conceptuales y de manera organizada y no lineal, conjuntos de actividades  que permiten el desarrollo de las competencias que deben comprenderse, dominarse y demostrarse. Los resultados obtenidos muestran la adecuación del itinerario de aprendizaje basado en mapas conceptuales a las características de los sujetos, resolviendo situaciones de la realidad mediante la construcción y creación de nuevos esquemas y formas de gestión del conocimiento, al mismo tiempo que aporta reflexión sobre los principios del diseño curricular utilizando TIC y genera autonomía en el proceso de aprendizaje.

  4. El Aprendizaje Basado en Problemas en Ciencias de la Salud

    Directory of Open Access Journals (Sweden)

    Francisco A. Vega Ramírez, Remedios López Liria

    2010-01-01

    Full Text Available El Aprendizaje Basado en Problemas es una innovación metodológicaque ha proliferado en la producción bibliográfica de los últimos años, lo que está manifestando su mayor utilización dentro del contexto del Espacio Europeo de Educación Superior. Este artículo contiene una revisión bibliográfica exhaustiva en las bases de datos españolas (CUIDEN Plus, ENFISPO e IME biomedicina sobre experiencias con Aprendizaje Basado en Problemas que se han realizado en distintas titulaciones relacionadas con las Ciencias de la Salud ofreciendo los datos, que puedan aportar evidencia sobre su eficiencia y la satisfacción del alumnado. Como conclusiones principales se destaca sucarácter eminentemente profesionalizante, que genera aprendizajes de mayor calidad (resolución de problemas, pensamiento crítico, búsqueda de información relevante, expresión escrita y oral, habilidades de autorreflexión y autoevaluación y permite incorporar contenidos transversales, aunque este tipo de experiencias se restringen normalmente a iniciativas de pequeños grupos de profesores embarcados en proyectos de coordinación interdisciplicar.

  5. Anterior Cruciate Ligament Injury

    OpenAIRE

    Vilaseca, Tomas; Chahla, Jorge; Rodriguez, Gustavo Gomez; Arroquy, Damián; Herrera, Gonzalo Perez; Orlowski, Belen; Carboni, Martín

    2015-01-01

    Objectives: The objective of this study was to analyze whether it is more frequent the presence of a decreased range of motion in the hips of recreational athletes with primary injury of the anterior cruciate ligament (ACL) than in a control group of volunteers without knee pathology. Methods: We included prospectively recreational athletes between 18 and 40 years with an acute ACL injury between January 2011 and January 2013. They were compared with a control group of volunteers recreational...

  6. Posterior implants for distal extension removable prostheses: a retrospective study.

    Science.gov (United States)

    Mitrani, Ricardo; Brudvik, James S; Phillips, Keith M

    2003-08-01

    Common complaints associated with the Kennedy Class I (bilateral free end) and Class II (unilateral free end) removable partial denture situations are lack of stability, minimal retention, and unesthetic retentive clasping. Some of the same complaints have been reported for implant overdentures with only anterior implants. Starting in 1995, 10 of these patients were treated at the University of Washington with posterior osseointegrated implants to provide stability and/or retention of the removable prostheses, eliminating the need for clasps when possible. This article describes implant alternatives and prosthesis designs and presents a follow-up clinical evaluation of at least 1 year consisting of patient satisfaction, radiographic examination, and soft tissue health. Two groups were evaluated. Group 1 included patients whose implants were used as vertical stops for mandibular distal extension prostheses. Care was taken to ensure that the implants were not loaded laterally by creating a single-point contact at the center of a modified healing abutment. In these cases, sufficient retention was available from the anterior teeth and/or implant abutments. Group 2 included patients whose implants required retention because of lack of adequate tooth abutments. In those cases, a resilient type of attachment was used, which allowed for a small divergence from the path of insertion. Results indicated consistent increased satisfaction in all patients, minimal component wear, no radiographic evidence of excessive bone loss, and stable peri-implant soft tissues. PMID:12956479

  7. MRI anatomy of anteriorly displaced anus: what obstructs defecation?

    Energy Technology Data Exchange (ETDEWEB)

    AbouZeid, Amr Abdelhamid [Ain-Shams University, Department of Pediatric Surgery, Cairo (Egypt); Mohammad, Shaimaa Abdelsattar; Khairy, Khaled Talaat [Ain-Shams University, Department of Radiodiagnosis, Cairo (Egypt)

    2014-07-15

    Anteriorly displaced anus is an anomaly that is debated with regard to its nomenclature, diagnosis and management. To describe MRI anatomy of the anal canal in children with anteriorly displaced anus and its impact on the process of defecation. We prospectively examined ten children (7 girls, 3 boys; age range 7 months to 8 years, mean 3 years) with anteriorly displaced anus between August 2009 and April 2012. Noncontrast MRI examinations were performed on a 1.5-T magnet. T1- and T2-weighted turbo spin-echo images were acquired in axial, sagittal and coronal planes of the pelvis. The anorectal angle and the relative hiatal distance were measured in mid-sagittal images, and compared with those of a control group using the Mann-Whitney test. In children with anteriorly displaced anus, no anatomical abnormality was depicted at the level of the proximal anal canal. However, the distal anal canal was displaced anteriorly, running out its external muscle cuff, which remained un-displaced at the usual site of the anus. This changes the orientation of the central axis of the anal canal by passing across instead of along the fibers of the longitudinal muscle coat. Children with anteriorly displaced anus had a more obtuse anorectal angle (mean 112.1 ), which was significantly greater than that of the control group (mean 86.2 ). MRI is a valuable tool in studying the anatomy of the anal canal in children with anteriorly displaced anus. The abnormal orientation of the longitudinal muscle across the anal canal can explain the obstructed defecation in these children. Based on this study, it might be of interest to use MRI in studying equivocal cases and children with unexplained constipation. (orig.)

  8. Diagnostic accuracy of computed tomographic angiography for the detection of stenotic lesion of the distal segments of main coronary arteries

    International Nuclear Information System (INIS)

    Objective: It was to find out the diagnostic accuracy of CT angiography for the detection of stenotic atherosclerotic lesions in the distal segments of 4 main coronary arteries using invasive angiography as gold standard. Methodology: This observational study was carried out at Department of Cardiology, Hayatabad Medical Complex, Peshawar. It included 50 patients from June to September 2011. CT and invasive angiography was performed for each patient and data was analyzed in SPSS software version 10.0 to analyze the findings of distal segments of the 4 main arteries. Results: The sensitivity for detection of stenotic atherosclerotic lesions in left main stem, left anterior descending, circumflex and right coronary arteries was 87.5%, 100%, 66.67% and 50% respectively. Specificity for detection of stenotic atherosclerotic lesions in left main stem, left anterior descending, circumflex and right coronary artery was 100% for all. Positive predictive value for detection of stenotic atherosclerotic lesions in left main stem, left anterior descending, circumflex and right coronary arteries was also 100% for all and negative predictive value was 97.6%, 100%, 97.91% and 95.83% for the left main stem, left anterior descending, circumflex and right coronary arteries respectively. Conclusion: Invasive angiography is more sensitive than CT angiography but has equal specificity to invasive angiography for the detection of stenotic lesions in the distal segments of 4 main coronary arteries. (author)

  9. Unilateral Molar Distalization: A Nonextraction Therapy

    Directory of Open Access Journals (Sweden)

    M. Bhanu Prasad

    2012-01-01

    Full Text Available In the recent years, nonextraction treatment approaches and noncompliance therapies have become more popular in the correction of space discrepancies. One of the conventional approaches for space gaining in the arches without patient compliance is done by using certain extra oral appliances or intraoral appliance. The greatest advantage of certain appliances like fixed functional and molar distalization appliances is that they minimize the dependence on patient cooperation. Molar distalization appliances like pendulum appliance which distalizes the molar rapidly without the need of head gear can be used in patients as a unilateral space gaining procedure due to buccal segment crowding.

  10. Anterior knee pain

    International Nuclear Information System (INIS)

    Anterior knee pain is a common complain in all ages athletes. It may be caused by a large variety of injuries. There is a continuum of diagnoses and most of the disorders are closely related. Repeated minor trauma and overuse play an important role for the development of lesions in Hoffa's pad, extensor mechanism, lateral and medial restrain structures or cartilage surface, however usually an increase or change of activity is referred. Although the direct relation of cartilage lesions, especially chondral, and pain is a subject of debate these lesions may be responsible of early osteoarthrosis and can determine athlete's prognosis. The anatomy and biomechanics of patellofemoral joint is complex and symptoms are often unspecific. Transient patellar dislocation has MR distinct features that provide evidence of prior dislocation and rules our complication. However, anterior knee pain more often is related to overuse and repeated minor trauma. Patella and quadriceps tendon have been also implicated in anterior knee pain, as well as lateral or medial restraint structures and Hoffa's pad. US and MR are excellent tools for the diagnosis of superficial tendons, the advantage of MR is that permits to rule out other sources of intraarticular derangements. Due to the complex anatomy and biomechanic of patellofemoral joint maltracking is not fully understood; plain films and CT allow the study of malalignment, new CT and MR kinematic studies have promising results but further studies are needed. Our purpose here is to describe how imaging techniques can be helpful in precisely defining the origin of the patient's complaint and thus improve understanding and management of these injuries

  11. The anterior cingulate cortex

    Directory of Open Access Journals (Sweden)

    Pavlović D.M.

    2009-01-01

    Full Text Available The anterior cingulate cortex (ACC has a role in attention, analysis of sensory information, error recognition, problem solving, detection of novelty, behavior, emotions, social relations, cognitive control, and regulation of visceral functions. This area is active whenever the individual feels some emotions, solves a problem, or analyzes the pros and cons of an action (if it is a right decision. Analogous areas are also found in higher mammals, especially whales, and they contain spindle neurons that enable complex social interactions. Disturbance of ACC activity is found in dementias, schizophrenia, depression, the obsessive-compulsive syndrome, and other neuropsychiatric diseases.

  12. Anatomical reconstruction of the anterior cruciate ligament: a logical approach

    Directory of Open Access Journals (Sweden)

    Julio Cesar Gali

    2015-08-01

    Full Text Available ABSTRACT We describe the surgical approach that we have used over the last years for anterior cruciate ligament (ACL reconstruction, highlighting the importance of arthroscopic viewing through the anteromedial portal (AMP and femoral tunnel drilling through an accessory anteromedial portal (AMP. The AMP allows direct view of the ACL femoral insertion site on the medial aspect of the lateral femoral condyle, does not require guides for anatomic femoral tunnel reaming, prevents an additional lateral incision in the distal third of the thigh (as would be unavoidable when the outside-intechnique is used and also can be used for double-bundle ACL reconstruction.

  13. Cobertura do terço distal da perna com retalhos de perfurantes pediculados Covering the distal third of the leg with pedicled perforating vessels patches

    Directory of Open Access Journals (Sweden)

    Marcelo Rosa de Rezende

    2008-01-01

    Full Text Available Os retalhos de vasos perfurantes representam um avanço no tratamento das perdas cutâneas. No terço distal da perna as opções para a cobertura cutânea são poucas e muitas vezes devemos recorrer a microcirurgia. Neste trabalho realizou-se uma avaliação prospectiva de 20 pacientes submetidos ao tratamento de áreas cruentas no terço distal da perna através de retalhos pediculados em artéria perfurante. A localização das artéria perfurantes foi feita , no pré-operatório , através do exame de eco-doppler. Os retalhos foram planejados de forma a permitir sua rotação junto à área cruenta em até 180 graus. Em 6 casos os vasos perfurantes tinham como origem a artéria fibular, em 10 a artéria tibial posterior e 4 a artéria tibial anterior. O índice de acerto do eco-doppler foi de 88,2%. Em pacientes jovens com lesões traumáticas houve 15,4% de falha do procedimento e 33,3% em pacientes com morbidades associadas. Baseado em nossos resultados concluímos ser o retalho de perfurante uma boa opção de tratamento das perdas cutâneas no segmento distal da perna.Perforating vessels patches represent an advancement in terms of skin failures treatment. On the distal third of the leg, the alternatives for skin covering are scarce, often requiring microsurgery. In this study, we aimed to make a prospective assessment of 20 patients submitted to treatment of bloody areas of leg's distal third by means of pedicled patches in perforating arteries. The location of the perforating arteries was preoperatively found using the ecodoppler test. The patches were planned to allow up to 180-degree rotation in the bloody area. In 6 cases, perforating vessels had the fibular artery as source; in 10, the posterior tibial artery, and; in 4, the anterior tibial artery. The accuracy rate of the ecodoppler was 88.2%. For young patients presenting injuries caused by trauma, procedure failures were found in 15.4%, and for those with associated

  14. Ovarian Dermoid Cyst Causing Distal Ureteral Obstruction

    OpenAIRE

    Aiken, WD; Mayhew, RG; Mitchell, S; Stennett, M; Johnson, P.

    2015-01-01

    A case of a 45-year old woman with an ovarian dermoid cyst causing ureteric colic secondary to distal ureteral obstruction is reported. The dermoid cyst was observed on computed tomography to be adjacent to and compressing the distal left ureter and this was confirmed at surgical exploration. Following oophorectomy, the patient's symptoms completely resolved and the excised ovarian cyst was confirmed on pathological evaluation to be a dermoid cyst. This appears to be the first reported case o...

  15. Clinical profile of distal renal tubular acidosis

    OpenAIRE

    Ratan Jha; Muthukrishnan, J.; Shekhar Shiradhonkar; Kiran Patro; Harikumar KVS; Modi, K.D.

    2011-01-01

    To determine the clinical profile and progression of renal dysfunction in distal renal tubular acidosis (dRTA), we retrospectively studied 96 consecutive cases of dRTA diagnosed at our center. Patients with unexplained metabolic bone disease, short stature, hypokalemia, re-current renal stones, chronic obstructive uropathy or any primary autoimmune condition known to cause dRTA were screened. Distal RTA was diagnosed on the basis of systemic metabolic acidosis with urine pH >5.5 and positive ...

  16. Aerotactile Integration from Distal Skin Stimuli

    OpenAIRE

    Derrick, Donald; Gick, Bryan

    2013-01-01

    Tactile sensations at extreme distal body locations can integrate with auditory information to alter speech perception among uninformed and untrained listeners. Inaudible air puffs were applied to participants' ankles, simultaneously with audible syllables having aspirated and unaspirated stop onsets. Syllables heard simultaneously with air puffs were more likely to be heard as aspirated. These results demonstrate that event-appropriate information from distal parts of the body integrates in ...

  17. Arthroscopic management of distal radius fractures.

    Science.gov (United States)

    Wiesler, Ethan R; Chloros, George D; Mahirogullari, Mahir; Kuzma, Gary R

    2006-11-01

    Arthroscopy has the advantage of providing a direct and accurate assessment of the articular surfaces and detecting the presence of injuries associated with distal radius fractures. Current indications, although numerous and potentially expanding, also are controversial. This report presents a global view of the current status of arthroscopy in the management of distal radius fractures. The rationale of arthroscopic treatment, the available evidence, and finally the diagnosis and treatment are discussed. PMID:17095385

  18. Fabrication and Evaluation of a Noncompliant Molar Distalizing Appliance: Bonded Molar Distalizer

    OpenAIRE

    Arab, S.; Rafighii, A.; M. S. Ahmad Akhoundi; Sodagar, A.

    2011-01-01

    Objective Attempts to treat class II malocclusions without extraction in non-compliant patients have led to utilization of intraoral molar distalizing appliances. The purpose of this study was to investigate dental and skeletal effects of Bonded Molar Distalizer (BMD) which is a simple molar distalizing appliance. Materials and Methods Sixteen patients (12 girls, four boys) with bilateral half-cusp class II molar relationship, erupted permanent second molars and normal or vertical growth patt...

  19. Desarrollo basado en conocimiento siguiendo prácticas ágiles

    OpenAIRE

    Gil, Gustavo Daniel; Gimson Saravia, Loraine Elizabeth; Silvera, Jorge Alberto

    2015-01-01

    En este proyecto de investigación hemos planteado realizar una investigación tendiente a exponer los fundamentos del desarrollo basado en conocimiento y de diferentes metodologías ágiles propuestas para el desarrollo de sistemas. A su vez, hemos pretendido esbozar relaciones que pudieran permitir trabajar con metodologías ágiles y desarrollo basado en conocimiento al mismo tiempo, buscando definir una propuesta de uso de prácticas ágiles en el Desarrollo Basado en Conocimiento (DBC). En WICC ...

  20. Multidisciplinary management of anterior diastemata

    DEFF Research Database (Denmark)

    Furuse, Adilson Yoshio; Herkrath, Fernando José; Franco, Eduardo Jacomino;

    2007-01-01

    Anterior diastemata may compromise the harmony of a patient's smile. Consideration of etiologic factors, previous gingival conditioning, and individual treatment planning are essential in the proper management of anterior diastemata. An integrated orthodontic-restorative approach may enhance the...... aesthetic results when orthodontic therapy itself is not feasible. This article presents integrated orthodonticrestorative solutions of anterior diastemata, associated with the conditioning of the gingival tissue with composite resin, and discusses the most relevant aspects related to their etiology and...

  1. Endoscopic fetal urethrotomy for anterior urethral valves: a preliminary report.

    Science.gov (United States)

    Sago, Haruhiko; Hayashi, Satoshi; Chiba, Toshio; Ueoka, Katsuhiko; Matsuoka, Kentaro; Nakagawa, Atsuko; Kitagawa, Michihiro

    2008-01-01

    Anterior urethral valves are a rare congenital anomaly associated with distal urethral obstruction, which can result in a poor prognosis. We report on the endoscopic creation of a fetal urethrotomy for obstructive uropathy resulting from anterior urethral valves. A 33-year-old woman was evaluated at 17 weeks gestation due to fetal megacystis. The diagnosis of anterior urethral valves was confirmed by the characteristic sonographic feature of a dilated membranous penile urethra. Oligohydramnios with normal-appearing kidneys and favorable urinary electrolytes led to fetal intervention. Ablation on the ventral site of the fetal penis for a cutaneous urethrotomy was performed using a YAG laser under a 1-mm fetoscope at 19 weeks gestation. Urine was drained from the incision and the dilated penis and the distended bladder shrunk with an increase in amniotic fluid. However, the fetus died unexpectedly on postoperative day 3, and chorioamnionitis was suspected as the etiology. While the outcome was unfavorable, our preliminary experience shows that fetal urethrotomy for obstructive uropathy can be achieved in utero using an endoscopic laser approach. Further experience will be required to evaluate the therapeutic value of this new procedure in the management of fetal anterior urethral valves. PMID:18648205

  2. Anterior cruciate ligament reconstruction

    International Nuclear Information System (INIS)

    This paper determines the efficacy of MR imaging in evaluation of the anterior cruciate ligament (ACL) following reconstructive surgery. Forty-three MR examinations were performed in 33 patients who had undergone previous arthroscopic ACL reconstruction with patellar bone-tendon- bone autografts (postoperative period, 1-24 months; mean, 5.2 months). Of the 40 studies performed in clinically stable knees (30 patients), MR demonstrated a well-defined, signal void ACL graft in 36. Of the three studies performed in three patients with clinical ACL laxity or suspected tear, the neoligament was of intermediate definition in one and nondiscernible in the other two. As in the native knee, buckling of the PCL was suggestive of ACL insufficiency. Bone tunnel placement, patellar tendon changes, and joint effusions were also evaluated

  3. Anterior hip pain.

    Science.gov (United States)

    O'Kane, J W

    1999-10-15

    Anterior hip pain is a common complaint with many possible causes. Apophyseal avulsion and slipped capital femoral epiphysis should not be overlooked in adolescents. Muscle and tendon strains are common in adults. Subsequent to accurate diagnosis, strains should improve with rest and directed conservative treatment. Osteoarthritis, which is diagnosed radiographically, generally occurs in middle-aged and older adults. Arthritis in younger adults should prompt consideration of an inflammatory cause. A possible femoral neck stress fracture should be evaluated urgently to prevent the potentially significant complications associated with displacement. Patients with osteitis pubis should be educated about the natural history of the condition and should undergo physical therapy to correct abnormal pelvic mechanics. "Sports hernias," nerve entrapments and labral pathologic conditions should be considered in athletic adults with characteristic presentations and chronic symptoms. Surgical intervention may allow resumption of pain-free athletic activity. PMID:10537384

  4. Archaic and modern human distal humeral morphology.

    Science.gov (United States)

    Yokley, Todd R; Churchill, Steven E

    2006-12-01

    The morphology of the proximal ulna has been shown to effectively differentiate archaic or premodern humans (such as Homo heidelbergensis and H. neanderthalensis) from modern humans (H. sapiens). Accordingly, the morphology of adjacent, articulating elements should be able to distinguish these two broad groups as well. Here we test the taxonomic utility of another portion of the elbow, the distal humerus, as a discriminator of archaic and modern humans. Principal components analysis was employed on a suite of log-raw and log-shape distal humeral measures to examine differences between Neandertal and modern human distal humeri. In addition, the morphological affinities of Broken Hill (Kabwe) E.898, an archaic human distal humeral fragment from the middle Pleistocene of Zambia, and five Pliocene and early Pleistocene australopith humeri were assessed. The morphometric analyses effectively differentiated the Neandertals from the other groups, while the Broken Hill humerus appears morphologically similar to modern human distal humeri. Thus, an archaic/modern human dichotomy-as previously reported for proximal ulnar morphology-is not supported with respect to distal humeral morphology. Relative to australopiths and modern humans, Neandertal humeri are characterized by large olecranon fossae and small distodorsal medial and lateral pillars. The seeming disparity in morphological affinities of proximal ulnae (in which all archaic human groups appear distinct from modern humans) and distal humeri (in which Neandertals appear distinct from modern humans, but other archaic humans do not) is probably indicative of a highly variable, possibly transitional population of which our knowledge is hampered by sample-size limitations imposed by the scarcity of middle-to-late Pleistocene premodern human fossils outside of Europe. PMID:16959299

  5. Idiopathic aneurysms of distal cerebellar arteries: endovascular treatment after rupture

    International Nuclear Information System (INIS)

    Idiopathic ruptured aneurysms of distal cerebellar arteries (DCAAs) are rare, and their endovascular therapy (EVT) has as yet not been extensively reported. They are usually assumed to result from local arterial wall disruption rather than infection, unlike distal supratentorial artery aneurysms. This study was performed to audit their frequency, potential aetiology and results of EVT. Using strict inclusion criteria and a database of 1715 EVT patients, we identified ten idiopathic ruptured DCAAs (0.6%) over a 13-year period (1993-2006). The series comprised six males and four females with mean age of 64 years and solitary aneurysms located on posterior inferior cerebellar artery (five patients), anterior inferior cerebellar artery (three patients) and superior cerebellar artery (two patients). Nine aneurysms were fusiform and were treated by endovascular parent artery occlusion, and one was saccular and treated by endosaccular packing. Endovascular therapy was performed with coils in seven cases, n-butyl-2-cyanoacrylate (NBCA) in two cases and with both in one case. Primary EVT was successful in eight patients. One patient died following a procedure-related re-bleeding and one patient required re-treatment after failed endosaccular packing. Nine patients made good or excellent clinical recoveries (modified Rankin Scale 2 or less). Focal cerebellar infarctions were seen on computed tomography images after EVT in three patients, only one of whom was symptomatic with transient dysmetria, which resolved completely during follow up. No aneurysm recanalisation was detected on late follow-up imaging up to 24 months. Ruptured DCAAs are rare. The majority are fusiform in shape and their aetiology remains uncertain. Endovascular treatment is feasible and effective. It usually requires parent artery occlusion. (orig.)

  6. The distal semimembranosus complex: normal MR anatomy, variants, biomechanics and pathology

    Energy Technology Data Exchange (ETDEWEB)

    Beltran, Javier; Jbara, Marlena; Maimon, Ron [Department of Radiology, Maimonides Medical Center, 4802 Tenth Avenue, NY 11219, Brooklyn (United States); Matityahu, Amir; Hwang, Ki [Department of Orthopedic Surgery, Maimonides Medical Center, Brooklyn, NY (United States); Padron, Mario [Department of Radiology, Clinica CEMTRO, Madrid (Spain); Mota, Javier [Department of Radiology, Instituto Clinica Corachan, Barcelona (Spain); Beltran, Luis [New York Medical College, Valhalla, NY (United States); Sundaram, Murali [Department of Radiology, Mayo Clinic, Rochester, MN (United States)

    2003-08-01

    To describe the normal MR anatomy and variations of the distal semimembranosus tendinous arms and the posterior oblique ligament as seen in the three orthogonal planes, to review the biomechanics of this complex and to illustrate pathologic examples. The distal semimembranosus tendon divides into five tendinous arms named the anterior, direct, capsular, inferior and the oblique popliteal ligament. These arms intertwine with the branches of the posterior oblique ligament in the posterior medial aspect of the knee, providing stability. This tendon-ligamentous complex also acts synergistically with the popliteus muscle and actively pulls the posterior horn of the medial meniscus during knee flexion. Pathologic conditions involving this complex include complete and partial tears, insertional tendinosis, avulsion fractures and bursitis. (orig.)

  7. The distal semimembranosus complex: normal MR anatomy, variants, biomechanics and pathology

    International Nuclear Information System (INIS)

    To describe the normal MR anatomy and variations of the distal semimembranosus tendinous arms and the posterior oblique ligament as seen in the three orthogonal planes, to review the biomechanics of this complex and to illustrate pathologic examples. The distal semimembranosus tendon divides into five tendinous arms named the anterior, direct, capsular, inferior and the oblique popliteal ligament. These arms intertwine with the branches of the posterior oblique ligament in the posterior medial aspect of the knee, providing stability. This tendon-ligamentous complex also acts synergistically with the popliteus muscle and actively pulls the posterior horn of the medial meniscus during knee flexion. Pathologic conditions involving this complex include complete and partial tears, insertional tendinosis, avulsion fractures and bursitis. (orig.)

  8. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... and E-poly antioxidant-infused technology during a hip replacement through the anterior supine intramuscular approach. “OR- ... Dr. Keith Berend perform an anterior approach total hip replacement with the patient on a regular OR ...

  9. RESULT OF PRE-CONTOURED DISTAL RADIUS INDIAN LOCKING PLATES IN DISTAL RADIUS FRACTURE

    Directory of Open Access Journals (Sweden)

    Shaleen

    2014-11-01

    Full Text Available BACKGROUND: Fractures of the distal radius are common, open reduction and internal fixation using an interlocking plate system has gained popularity for the treatment of dorsally displaced distal radius fractures. The aim of the study was to assess how adequately distal radial fracture reduction was reproduced and maintained with the pre-contoured distal radius Indian locking plates and to evaluate the functional and radiological results of treating unstable distal radius fractures with the volar locking plate. PATIENTS AND METHODS: It was conducted on 20 patients with distal radius fractures who underwent open reduction, internal fixation using the pre-contoured distal radius Indian locking plates between May 2012 and September 2013 at the our Hospital. The preoperative, intra-operative, and postoperative films were reviewed. The AO classification was recorded. The volar angulation, radial tilt, radial height and step-off in joint incongruity were measured on intra-operative X-rays and compared with final follow-up X-rays. The last recorded range of motion at follow-up and a functional assessment using Gartland and Werley criteria. RESULTS: Radiological review showed bone healing in 20 patients and good articular congruity for all intrarticular fractures with less than 1 mm step-off. Complications were few with two wound infection and one neuropraxia of the superficial radial nerve. Wrist function was excellent in seven (35% patients, good in 10 (50% and fair in three (15%. CONCLUSION: The pre-contoured distal radius Indian locking plates with its distal buttressing ability are an effective treatment method in patients with distal radius fractures.

  10. Treatment Options for Distal Femur Fractures.

    Science.gov (United States)

    von Keudell, Arvind; Shoji, Kristin; Nasr, Michael; Lucas, Robert; Dolan, Robert; Weaver, Michael J

    2016-08-01

    Despite advances in implant design, the management of distal femur fractures remains challenging. Fracture comminution and intra-articular extension can make it difficult to obtain an adequate reduction while preserving the soft tissue attachments to bone fragments to allow for bone healing. Many implant manufacturers have developed optimal anatomically contoured, distal femoral locking plates with percutaneous guides. This environment allows for the application of lateral locked plates in a biologically friendly manner. Although initial reports had high success rates, more recently a high rate of nonunion has been found, particularly in elderly patients. Limited literature is available for the treatment of patients with osteoporotic bone and associated ipsilateral total knee replacement and hip replacement. We present a patient with a distal femur fracture with significant comminution in the setting of an ipsilateral total hip replacement. PMID:27441931

  11. Esquema basado en Wavelet para la reducción de ruido online en señales industriales

    Directory of Open Access Journals (Sweden)

    Antonio Cedeño Pozo

    2014-07-01

    Full Text Available En este trabajo se propone un esquema para la reducción de ruido gaussiano online basado en wavelet con ventanas deslizantes para ser utilizado en señales industriales. Este tipo de técnicas se utilizan cuando la señal debe ser tratada a medida que se obtienen las muestras, funcionalidad necesaria en aplicaciones con requerimientos de tiempo real, por ejemplo en sistemas SCADA. El algoritmo introducido en el presente trabajo se diferencia de algoritmos similares en que: en primer término utiliza una selección adaptativa del umbral basada en NeighShrink; adicionalmente reutiliza en lo posible los coeficientes wavelet calculados en pasos anteriores para el procesamiento de cada punto; finalmente utiliza la wavelet Haar en lugar de otros filtros de mayor complejidad computacional. Para la comprobación experimental del nuevo esquema se utilizó un conjunto de señales sintéticas introducido por Donoho y Marron, complementadas por señales adquiridas en procesos reales de plantas industriales. Las pruebas realizadas revelan que el algoritmo propuesto mejora la reducción de ruido online respecto a esquemas similares reportados anteriormente y es computacionalmente menos complejo.

  12. hipermedia adaptativos educativos basados en estilos de aprendizaje

    Directory of Open Access Journals (Sweden)

    Helmut Leighton Álvarez

    2005-01-01

    Full Text Available Este trabajo es una propuesta metodológica para determinar atributos y métricas de calidad en sistemas hipermedia adaptativos educativos basados en estilos de aprendizaje, específicamente en los estilos activo, reflexivo, teórico y pragmático. Estos atributos y métricas están referidos únicamente a la interacción del usuario-estudiante con el sistema, es decir, desde la óptica puramente educativa y no desde el punto de vista de la herramienta informática como tal. Para ello comienza su análisis desde las características del estilo de aprendizaje y a partir de ellas se procede al establecimiento de los atributos de acuerdo a las estrategias instruccionales que le correspondan. Finalmente, se definen las métricas necesarias para cada uno de los atributos, estableciendo el o los tipos de variables que involucran, sus unidades de medida y escalas. De esta manera se desarrolla una metodología de cascada de determinación de atributos y métricas

  13. Distal axonopathy in streptozotocin diabetes in rats.

    Science.gov (United States)

    Chokroverty, S; Seiden, D; Navidad, P; Cody, R

    1988-05-15

    We noted the earliest morphological changes in the motor endplates 8 weeks after the induction of streptozotocin diabetes in rats. Morphometric measurements showed reduced axonal areas of the lateral plantar and the sciatic nerves in the diabetic rats 28 but not 2 and 8 weeks after the experiment. These findings suggested distal axonopathy. PMID:3371449

  14. Genetics Home Reference: Laing distal myopathy

    Science.gov (United States)

    ... Additional Information & Resources MedlinePlus (1 link) Health Topic: Muscular Dystrophy Genetic and Rare Diseases Information Center (1 link) Laing ... list from the University of Kansas Medical Center: Muscular Dystrophy/Atrophy GeneReviews (1 ... Genetic Testing Registry (1 link) Myopathy, distal, 1 ClinicalTrials. ...

  15. Intraosseous keratin cyst of the distal phalanx

    Directory of Open Access Journals (Sweden)

    Rohini Prasad

    2015-01-01

    Full Text Available Keratin or epidermoid cysts of the phalanges are rare lesions mimicking osteolytic lesions such as infection, malignancy and other tumours. Definitive diagnosis can be made by histopathology only and treatment is by simple excision and curettage. We present a case of intraosseous keratin cyst of the distal phalanx and review of literature.

  16. External mechanical cues trigger the establishment of the anterior-posterior axis in early mouse embryos.

    Science.gov (United States)

    Hiramatsu, Ryuji; Matsuoka, Toshiki; Kimura-Yoshida, Chiharu; Han, Sung-Woong; Mochida, Kyoko; Adachi, Taiji; Takayama, Shuichi; Matsuo, Isao

    2013-10-28

    Mouse anterior-posterior axis polarization is preceded by formation of the distal visceral endoderm (DVE) by unknown mechanisms. Here, we show by in vitro culturing of embryos immediately after implantation in microfabricated cavities that the external mechanical cues exerted on the embryo are crucial for DVE formation, as well as the elongated egg cylinder shape, without affecting embryo-intrinsic transcriptional programs except those involving DVE-specific genes. This implies that these developmental events immediately after implantation are not simply embryo-autonomous processes but require extrinsic factors from maternal tissues. Moreover, the mechanical forces induce a breach of the basement membrane barrier at the distal portion locally, and thereby the transmigrated epiblast cells emerge as the DVE cells. Thus, we propose that external mechanical forces exerted by the interaction between embryo and maternal uterine tissues directly control the location of DVE formation at the distal tip and consequently establish the mammalian primary body axis. PMID:24176640

  17. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... Taperloc Microplasty stem and E-poly antioxidant-infused technology during a hip replacement through the anterior supine ... renewed interest at this time due to several advantages that it brings. The approach that is performed ...

  18. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... an anterior approach total hip replacement with the patient on a regular OR table supine. My name ... less invasive without being small incision surgery. Obese patients can be easier due to less distribution of ...

  19. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... it to have any real negative or deleterious effect by removing the anterior capsule. Now I would ... is what happens with one of the competitive designs. Like I told you, I just take a ...

  20. Anterior approach for knee arthrography

    International Nuclear Information System (INIS)

    Objective. To develop a new method of magnetic resonance arthrography (MRA) of the knee using an anterior approach analogous to the portals used for knee arthroscopy.Design. An anterior approach to the knee joint was devised mimicking anterior portals used for knee arthroscopy. Seven patients scheduled for routine knee MRA were placed in a decubitus position and under fluoroscopic guidance a needle was advanced from a position adjacent to the patellar tendon into the knee joint. After confirmation of the needle tip location, a dilute gadolinium solution was injected.Results and conclusion. All the arthrograms were technically successful. The anterior approach to knee MRA has greater technical ease than the traditional approach with little patient discomfort. (orig.)

  1. Locked volar distal radioulnar joint dislocation

    Science.gov (United States)

    Bouri, Fadi; Fuad, Mazhar; Elsayed Abdolenour, Ayman

    2016-01-01

    Introduction Volar dislocation of the distal radioulnar joint is a rare injury which is commonly missed in the emergency departments. A thorough review of literature showed very few reported cases and the cause for irreducibility varied in different cases, Lack of suspicion and improper X-ray can delay the diagnosis. Case presentation Our article discusses a case 40 year old construction worker, who presented to the Emergency with work-related injury, complaining of left wrist pain, deformity and inability to rotate his forearm. X-rays revealed a volar dislocation of distal ulna which was reducible after manipulation under General Anesthesia (GA). The joint was stable after the reduction. Discussion Isolated dislocation of the distal radioulnar joint can be either volar or dorsal, although dorsal dislocation is more common. The distal radioulnar articulation plays an important role in the rotational movement of the forearm. It allows pronation and supination which are essential for the function of the upper limb. Pronator Quadratus muscle spasm is an important blockade to reduction and was preventing reduction in this case. Methods The work has been reported in line with the CARE criteria [9]. Conclusion Volar locked dislocation of Distal Radio ulnar joint is a rare injury. High degree of clinical suspicion and proper X-ray is required for prompt detection. The importance of this case is to raise the awareness among physicians in treating these kind of injuries by careful assessment of the patient and radiographs, and to consider pronator quadratus as an important cause for the blockade to reduction. PMID:27016647

  2. Travoprost Induced Granulomatous Anterior Uveitis

    OpenAIRE

    Patrick Chiam

    2011-01-01

    Purpose. To report a case of granulomatous anterior uveitis caused by travoprost. Methods. Single observational case report. Results. A 71-year-old who was fit and healthy presented with bilateral granulomatous anterior uveitis 2 months after he was started on travoprost in both eyes. There was no past history of uveitis. Blood test and radiological investigation were unremarkable. Travoprost was stopped. The uveitis resolved on topical steroid treatment. A rechallenge with travoprost was att...

  3. Anterior chamber depth during hemodialysis

    Directory of Open Access Journals (Sweden)

    Gracitelli CPB

    2013-08-01

    Full Text Available Carolina Pelegrini Barbosa Gracitelli,1 Francisco Rosa Stefanini,1 Fernando Penha,1 Miguel Ângelo Góes,2 Sérgio Antonio Draibe,2 Maria Eugênia Canziani,2 Augusto Paranhos Junior1 1Ophthalmology Department, 2Division of Nephrology, Federal University of São Paulo – UNIFESP, São Paulo, Brazil Background: Exacerbation of chronic glaucoma or acute glaucoma is occasionally observed in patients undergoing hemodialysis (HD because of anterior chamber depth changes during this therapy. Purpose: To evaluate anterior chamber depth and axial length in patients during HD sessions. Methods: A total of 67 eyes of 35 patients were prospectively enrolled. Axial length and anterior chamber depth were measured using ultrasonic biometry, and these measures were evaluated at three different times during HD sessions. Body weight and blood pressure pre- and post-HD were also measured. Results: There was no difference in the axial length between the three measurements (P = 0.241. We observed a significantly decreased anterior chamber depth (P = 0.002 during HD sessions. Conclusion: Our results support the idea that there is a change in anterior chamber depth in HD sessions. Keywords: anterior chamber, hemodialysis, axial length, acute angle-closure glaucoma

  4. Occlusion and Temporomandibular Function among Subjects with Mandibular Distal Extension Removable Partial Dentures

    Directory of Open Access Journals (Sweden)

    N. H. J. Creugers

    2010-01-01

    Full Text Available Objective. To quantify effects on occlusion and temporomandibular function of mandibular distal extension removable partial dentures in shortened dental arches. Methods. Subjects wearing mandibular extension removable partial dentures (n=25 were compared with subjects with shortened dental arches without extension (n=74 and with subjects who had worn a mandibular extension removable partial denture in the past (n=19. Subjects with complete dentitions (n=72 were controls. Data were collected at baseline and at 3-, 6-, and 9-year observations. Results. Occlusal activity in terms of reported awareness of bruxism and occlusal tooth wear of lower anterior teeth did not differ significantly between the groups. In contrast, occlusal tooth wear of premolars in shortened dental arches with or without extension dentures was significantly higher than in the controls. Differences amongst groups with respect to signs and symptoms related to temporomandibular disorders were not found. Occlusal support of the dentures did not influence anterior spatial relationship. Occlusal contacts of the denture teeth decreased from 70% for second premolars via 50% for first molars, to 30% for second molars. Conclusions. Mandibular distal extension removable partial dentures in moderate shortened dental arches had no effects on occlusion and temporomandibular function.

  5. Genetics Home Reference: distal hereditary motor neuropathy, type V

    Science.gov (United States)

    ... neuropathy, type V distal hereditary motor neuropathy, type V Enable Javascript to view the expand/collapse boxes. ... Close All Description Distal hereditary motor neuropathy, type V is a progressive disorder that affects nerve cells ...

  6. Lateral supporting ligament of the distal phalanx.

    Science.gov (United States)

    Winter, W G; Iwersen, L J; Johnson, E D

    1989-06-01

    A 49-year-old woman complained of 3 months of constant aching pain deep to the ingrown medial nail margin of her right hallux that was unaffected by shoe wear. Physical examination disclosed no purulence, discoloration, or obvious acute inflammation; an incurved medial nail plate was seen. There was mild chronic thickening of the medial nail fold. Tenderness was maximal 2 to 3 mm plantar to the medial edge of the nail. By roentgenogram, bony projections were seen arcing from the distal phalangeal tuft and the proximal metaphyseal flare toward each other. This was considered to be a "normal" radiological variant. A partial medial onychectomy and matricectomy (Winograd procedure) was performed. Further dissection 1 to 2 mm deeper along the medial phalangeal border revealed a 1-mm wide longitudinal ligament extending from the phalangeal distal tuft to the proximal metaphyseal flare. Bony projections and ligament were excised. The wound healed satisfactorily, and symptoms ceased. PMID:2744674

  7. Urothelial carcinoma involving the distal penis

    OpenAIRE

    Dason, Shawn; Sheikh, Adeel; Wang, Jing Gennie; Tauqir, Syeda; Davies, Timothy O.; Shayegan, Bobby

    2012-01-01

    Urothelial carcinoma (UC) rarely metastasizes to the penis and skin. We report the case of a 73-year-old man with UC metastases to the corpus spongiosum and dermis of the distal penis. We also review the clinicopathologic characteristics and management options for UC metastasizing to the penis. The patient presented with priapism and edema of the genital region. This follows a 5-year history of urothelial carcinoma in situ that progressed to invasive cancer despite intravesical immunotherapy....

  8. Fractures of distal radius: an overview.

    Science.gov (United States)

    Meena, Sanjay; Sharma, Pankaj; Sambharia, Abhishek Kumar; Dawar, Ashok

    2014-01-01

    Fractures of distal radius account for up to 20% of all fractures treated in emergency department. Initial assessment includes a history of mechanism of injury, associated injury and appropriate radiological evaluation. Treatment options include conservative management, internal fixation with pins, bridging and non-bridging external fixation, dorsal or volar plating with/without arthroscopy assistance. However, many questions regarding these fractures remain unanswered and good prospective randomized trials are needed. PMID:25657938

  9. Fractures of the distal phalanx in the horse

    International Nuclear Information System (INIS)

    Fractures of the distal phalanx are an important cause of lameness referable to the foot. Depending on the fracture configuration and articular involvement, conservative or surgical treatment may be required. Fractures of the distal phalanx have been divided into six categories based on fracture configuration. Discussion of clinical features, management, and prognosis for horses with distal phalangeal fractures is presented for each fracture type

  10. DISTAL TRICEPS AVULSION: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Ramkumar Reddy

    2015-05-01

    Full Text Available Triceps rupture is an uncommon injury. Fracture of olecranon or a dislocation / fracture is most often common injury for similar mechanism of fall. It is commonly associated with anabolic steroid use, weight lifting, and direct laceration. Risk factors include local steroid injection, olecranon bursitis, and hyperparathyroidism. Distal triceps rupture is usually caused by a fall on an outstretched hand. Eccentric loading of a contracting triceps has been implicated. Initial diagnosis may be difficult because a palpable defect is not always present. Pain and swelling may limit the ability to evaluate strength and elbow range of motion. Although plain radiographs are helpful in ruling out other elbow pathology, MRI is used to confirm the diagnosis, classify the injury, and plan management. Incomplete tears with active elbow extension against resistance are managed non - surgically. Surgical repair is indicated in active persons with complete tears and for incomplete tears with concomitant loss of strength. Good to excellent results have been reported with surgical repair in triceps, even for chronic tears. BACKGROUND: Distal triceps tendon avulsions occur very infrequently, and the diagnosis is often missed when the injury is acute. The literature provides little guidance regarding treatment or the outcome of these injuries. The goal of this report was to report our experience with the diagnosis, timing and technique of surgical treatment, and outcome of treatment of distal triceps tendon rupture.

  11. Management and treatment of distal ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Andrea Calafiore

    2013-12-01

    Full Text Available Ulcerative colitis (UC is a chronic inflammatory condition that is confined to the colonic mucosa. Its main symptoms include diarrhea, rectal bleeding and abdominal pain. Approximately two-thirds of UC patients have disease confined distal to the splenic flexure, which can be treated effectively with topical therapy. This means the active drug can be delivered directly to the site of inflammation, limiting the systemic absorption and potential side effects. Topical treatment with aminosalicylates is the most effective approach in the treatment of these forms, provided that the formulation reaches the upper margin of the disease. Given this, the suppository formulation is the treatment of choice for proctitis and distal sigmoiditis. Thanks to their proximal spread, enemas, foams and gels represent the treatment of choice for proctosigmoiditis and for distal ulcerative colitis. Oral aminosalicylates are less effective than topical therapies in patients with active disease, while the combination of topical and oral treatment is more effective in patients refractory to topical or oral mono-therapy. Topically administered aminosalicylates play an important role in the maintenance of remission, but the long-term adhesion to therapy is poor. For this reason, the oral formulation is the first-line therapy in the maintenance of remission. Refractory patients can be treated with topical steroids or systemic steroids and TNF-alpha inhibitors in severe forms.

  12. The spinal nail: a new implant for short-segment anterior instrumentation of the thoracolumbar spine.

    Science.gov (United States)

    Dawson, J M; DeBoer, D K; Spengler, D M; Schwartz, H S

    1996-08-01

    The biomechanics of a new spinal implant were evaluated and its dependence on an anterior strut graft was determined. Six fresh-frozen adult porcine spines were used. An L3 corpectomy was created. The spinal nail was inserted intraosseously into the middle column of the L2-L4 vertebral bodies in a trough. Implant drill holes were made for proximal and distal locking bolts in L2 and L4. A locking plate bridged the L2 and L4 trough and anchored the exposed ends of the locking bolts. Testing was performed in axial compression, torsion, and flexion. The axial and torsional stability of the spine instrumented with the spinal nail are similar to results with other devices when used with anterior strut grafting. The axial and flexural stiffnesses of the instrumented spine are independent of strut grafting. This study suggests that this device may be useful for reconstruction of the anterior spine because of instability. PMID:8877956

  13. Sistema bio - inspirado basado en AER aplicado a automoción

    OpenAIRE

    González Blanco, Manuel

    2012-01-01

    VULCANO (Ref: TEC2009-10639-C04-04) En este proyecto se ha trabajado en el diseño e implementación de un sistema bio-inspirado basado en eventos y su adaptación a cámaras comerciales, evitando unos de los principales problemas de este tipo de sistemas. Por otro lado, se ha aplicado el sistema a un entorno de automoción mediante la utilización de un simulador altamente inmersivo. De este modo se ha evaluado el rendimiento y adecuación de los sistemas basados en AER para la medición de la...

  14. Sistema Solar Autónomo basado en Convertidores Multicelda Apilables

    OpenAIRE

    Labastida Alcalá, Miguel Alberto

    2005-01-01

    En esta tesis se presenta el diseño, desarrollo e implementación de un sistema solar autónomo basado en convertidores multicelda apilables el cual, como su nombre lo indica, utiliza la energía solar y se encuentra independiente de la energía eléctrica proveniente de Comisión Federal de Electricidad. Un sistema solar autónomo está formado por: paneles solares, baterías, un control y la carga [1]. El sistema solar autónomo basado en convertidores multicelda apilables propu...

  15. Metodologías ágiles y desarrollo basado en conocimiento

    OpenAIRE

    Gil, Gustavo Daniel; Gimson Saravia, Loraine Elizabeth; Ramírez, Jorge; Aballay, Patricia; Ortega, V.; Torres, M.

    2011-01-01

    En este proyecto de investigación se ha planteado realizar una investigación tendiente a exponer los fundamentos de diferentes metodologías ágiles propuestas para el desarrollo de sistemas y sobre el desarrollo basado en conocimiento. A su vez, se ha pretendido realizar un intento por esbozar relaciones que pudieran hacer posible trabajar con metodologías ágiles y desarrollo basado en conocimiento al mismo tiempo. En función de los objetivos a alcanzar, se está realizando una investigación bi...

  16. Leiomyosarcoma of the distal femur in a patient with a history of bilateral retinoblastoma: a case report and review of the literature

    International Nuclear Information System (INIS)

    We report a case of primary leiomyosarcoma of the distal femoral shaft arising in a patient who had undergone bilateral orbital enucleation for bilateral retinoblastoma several years previously. Radiography demonstrated an osteolytic, expansive lesion with cortical destruction anteriorly in the distal femoral shaft, and these findings were confirmed on CT. MR imaging revealed an expansive intramedullary lesion with cortical breakthrough and soft tissue extension. The occurrence of a second malignancy in patients with a history of bilateral retinoblastoma is well documented. Many different histological types have been described, with osteosarcoma and leiomyosarcoma occurring with the greatest frequency. (orig.)

  17. Travoprost Induced Granulomatous Anterior Uveitis

    Science.gov (United States)

    Chiam, Patrick

    2011-01-01

    Purpose. To report a case of granulomatous anterior uveitis caused by travoprost. Methods. Single observational case report. Results. A 71-year-old who was fit and healthy presented with bilateral granulomatous anterior uveitis 2 months after he was started on travoprost in both eyes. There was no past history of uveitis. Blood test and radiological investigation were unremarkable. Travoprost was stopped. The uveitis resolved on topical steroid treatment. A rechallenge with travoprost was attempted in one eye. The inflammation recurred in this eye only. This subsided with the cessation of travoprost alone without topical steroid. Conclusion. This is the first case report of travoprost causing granulomatous anterior uveitis. The uveitis recurred with a rechallenge. Changing the prostaglandin analogue to another topical treatment may be adequate to cease the inflammation. PMID:22606464

  18. An innovative technique to distalize maxillary molar using microimplant supported rapid molar distalizer

    Directory of Open Access Journals (Sweden)

    Meenu Goel

    2013-01-01

    Full Text Available Introduction: In recent years, enhancements in implants have made their use possible as a mode of absolute anchorage in orthodontic patients. In this paper, the authors have introduced an innovative technique to unilaterally distalize the upper left 1 st molar to obtain an ideal Class I molar relationship from a Class II existing molar relationship with an indigenous designed distalizer. Clinical Innovation: For effective unilateral diatalization of molar, a novel cantilever sliding jig assembly was utilized with coil spring supported by a buccally placed single micro implant. The results showed 3 mm of bodily distalization with 1 mm of intrusion and 2° of distal tipping of upper left 1 st molar in 1.5 months. Discussion: This appliance is relatively easy to insert, well-tolerated, and requires minimal patient cooperation compared to other present techniques of molar distalization. Moreover, it is particularly useful in cases that are Class II on one side and Class I on the other, with a minor midline discrepancy and nominal overjet. Patient acceptance level was reported to be within patients physiological and comfort limits.

  19. Distal renal tubular acidosis in recurrent renal stone formers

    DEFF Research Database (Denmark)

    Osther, P J; Hansen, A B; Røhl, H F

    1989-01-01

    metabolic disturbances in renal stone formers. Distal renal tubular acidosis (dRTA) was relatively more common in female stone formers and most often found in patients with bilateral stone disease (36%). Since prophylactic treatment in renal stone formers with renal acidification defects is available, this...... (1.1%) had complete distal renal tubular acidosis and 14 (15.5%) incomplete distal renal tubular acidosis. Our results confirm that distal renal tubular acidification defects are associated with a more severe form of stone disease and make distal renal tubular acidosis one of the most frequent...

  20. Graft Flow Unaffected by Full Occlusion of Left Anterior Descending Artery during Coronary Artery Bypass Grafting in a Porcine Model

    DEFF Research Database (Denmark)

    Torstensson, Gustav Nils Johannes; Torp, Thomas Lee; Rasuli-Oskuii, Nader;

    2013-01-01

    Background: We investigated in a porcine model whether measuring both the flow distal to an anastomosis and the graft transit time flow (TTF) gives a more accurate picture of the true blood flow in the left anterior descending artery (LAD) than graft TTF measurement alone.Methods: We performed off-pump...... anastomosis, despite a fully occluded LAD. This result suggests that graft TTF measurement alone is not sufficient when performing CABG, and measurement of flow distal to the anastomosis is also necessary to determine the true blood flow in the LAD....

  1. Experience with peroneus brevis muscle flaps for reconstruction of distal leg and ankle defects

    Directory of Open Access Journals (Sweden)

    Babu Bajantri

    2013-01-01

    Full Text Available Objective: Peroneus brevis is a muscle in the leg which is expendable without much functional deficit. The objective of this study was to find out its usefulness in coverage of the defects of the lower leg and ankle. Patients and Methods: A retrospective analysis of the use of 39 pedicled peroneus brevis muscle flaps used for coverage of defects of the lower leg and ankle between November 2010 and December 2012 was carried out. The flaps were proximally based for defects of the lower third of the leg in 12 patients and distally based for reconstruction of defects of the ankle in 26 patients, with one patient having flaps on both ankles. Results: Partial flap loss in critical areas was found in four patients requiring further flap cover and in non-critical areas in two patients, which were managed with a skin graft. Three of the four critical losses occurred when we used it for covering defects over the medial malleolus. There was no complete flap loss in any of the patients. Conclusion: This flap has a unique vascular pattern and fails to fit into the classification of the vasculature of muscles by Mathes and Nahai. The unusual feature is an axial vessel system running down the deep aspect of the muscle and linking the perforators from the peroneal artery and anterior tibial artery, which allows it to be raised proximally or distally on a single perforator. The flap is simple to raise and safe for the reconstruction of small-to moderate-sized skin defects of the distal third of the tibia and all parts of the ankle except the medial malleolus, which is too far from the pedicle of the distally based flap. The donor site can be closed primarily to provide a linear scar. The muscle flap thins with time to provide a good result aesthetically at the primary defect.

  2. Urethral advancement technique for repair of distal penile hypospadias: A revisit

    Directory of Open Access Journals (Sweden)

    Awad Mohamed

    2006-01-01

    Full Text Available Background: Numerous ingenious methods have been described to repair hypospadias with variable results. The anterior urethral advancement technique reported by Chang[1] to repair distal hypospadias has shown encouraging results. We have reevaluated this technique with some modifications to improve its results. Materials and Methods: This study was done on 72 patients, 19 cases with glanular hypospadias, 20 cases with coronal hypospadias, 22 cases of subcoronal hypospadias,and 11 cases with anterior penile hypospadias in the period between September 1999 and October 2003. The patients′ age ranged from two years to twenty five years (median age 5.6 years. All the patients were operated using Chang′s technique with our modifications. Results: There were no major complications in any of our patients, no postoperative fistulae or urethral stricture. Three patients had meatal stenosis and preputial edema occurred in 83.3% in non-circumcised patients. Conclusion: Modifications of the anterior advancement technique has produced excellent Results. It is easy to do and learn and also offers good cosmetic and functional results.

  3. Tratamento cirúrgico da tendinite distal da patela Surgical treatment of the distal patellar tendinitis

    OpenAIRE

    Marco Martins Amatuzzi; Luiz Antonio Pupo Delgado; Roberto Freire da Mota e Albuquerque; Sandra Umeda Sasaki

    2005-01-01

    A tendinite distal da patela é uma doença que acomete principalmente jovens esportistas e caracteriza-se por dor referida na extremidade distal da patela junto à inserção do ligamento patelar. O tratamento inicial preconizado é sempre conservador com fisioterapia. A grande maioria tem boa resposta a este tipo de conduta, mas em alguns raros casos os sintomas não regridem exigindo uma mudança de conduta. Para este grupo usamos o tratamento cirúrgico com técnica derivada de Trillat que se basei...

  4. DISTAL FEMORAL LOCKING COMPRESSION PLATE FIXATION IN DISTAL FEMORAL FRACTURES: ONE YEAR HOSPITAL BASED STUDY

    Directory of Open Access Journals (Sweden)

    Kiran

    2014-07-01

    Full Text Available : A prospective study on eleven patients who were treated for Type A and C distal femoral fractures (based on AO classification between January 2012 and December2012. All fractures were fixed with titanium distal femoral locking compression plate. The patient’s ages ranged from 15to 85 with a mean of 44. Clinical assessment was conducted at least 6 months post-operatively using the Sanders 40 point functional score. Results showed that four patients had excellent results, four good, two fair and one failure

  5. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... during a hip replacement through the anterior supine intramuscular approach. “OR-Live,” the vision of improving health. ... the approach are operating through an internervous and intramuscular anatomic interval. It’s not necessary to detach any ...

  6. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... got coming out in “JBJS,” the early six-week recovery is dramatically different between a direct lateral abductor splitting approach and this anterior supine approach. Let me get this head on. My experience, these patients have full leg control in about 24 hours. Yeah. They can get out of bed and ...

  7. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... the anterior supine intramuscular approach. “OR-Live,” the vision of improving health. Good evening and welcome to ... should know that this is done under direct vision. Yeah. You are seeing everything you’re doing. ...

  8. Creation of distal canine limb lymphedema

    Energy Technology Data Exchange (ETDEWEB)

    Chen, H.C.; Pribaz, J.J.; O' Brien, B.M.; Knight, K.R.; Morrison, W.A.

    1989-06-01

    A canine model of distal limb lymphedema was established in order to study the treatment of this condition by lymph node transfer. This model was more difficult to establish than whole-limb lymphedema. Significant edema was achieved by a combination of preoperative irradiation and circumferential removal of skin from the irradiated areas followed by removal of the contents of the popliteal fossa. Despite these measures, it was not possible to produce lymphedema in every case, possibly because of the presence of lymphaticovenous shunts and panvascular compensation mechanisms.

  9. Distal Renal Tubular Acidosis and Calcium Nephrolithiasis

    Science.gov (United States)

    Moe, Orson W.; Fuster, Daniel G.; Xie, Xiao-Song

    2008-09-01

    Calcium stones are commonly encountered in patients with congenital distal renal tubular acidosis, a disease of renal acidification caused by mutations in either the vacuolar H+-ATPase (B1 or a4 subunit), anion exchanger-1, or carbonic anhydrase II. Based on the existing database, we present two hypotheses. First, heterozygotes with mutations in B1 subunit of H+-ATPase are not normal but may harbor biochemical abnormalities such as renal acidification defects, hypercalciuria, and hypocitraturia which can predispose them to kidney stone formation. Second, we propose at least two mechanisms by which mutant B1 subunit can impair H+-ATPase: defective pump assembly and defective pump activity.

  10. Distal amputations for the diabetic foot

    Directory of Open Access Journals (Sweden)

    Aziz Nather

    2013-07-01

    Full Text Available Minor amputations in diabetic patients with foot complications have been well studied in the literature but controversy still remains as to what constitutes successful or non-successful limb salvage. In addition, there is a lack of consensus on the definition of a minor or distal amputation and a major or proximal amputation for the diabetic population. In this article, the authors review the existing literature to evaluate the efficacy of minor amputations in this selected group of patients in terms of diabetic limb salvage and also propose several definitions regarding diabetic foot amputations.

  11. Factores que influyen en el uso recurrente del Costeo basado en actividades

    Directory of Open Access Journals (Sweden)

    Angels Fitó Bertran

    2012-01-01

    Full Text Available El modelo de costos basados en actividades o costeo basado en actividades ha sido aceptado y ampliamente estudiado en la literatura tanto desde un enfoque teórico como práctico. No obstante, en la práctica, muchas empresas que desarrollan este modelo no lo utilizan de forma regular. En tal sentido, este trabajo se centra en determinar y analizar los factores que influyen positiva o negativamente en la utilización recurrente o rutinaria del modelo. Para ello, se ha revisado la literatura existente sobre el proceso de implementación del costeo basado en actividades, concentrando la atención, específicamente en el paso de la aceptación de un costeo basado en actividades a su uso rutinario. Se describen seis factores clave (estratégicos, individuales, organizativos, tecnológicos, operativos y externos que tienen una incidencia específica en la fase de normalización del costeo basado en actividades como herramienta de gestión operativa y estratégica, y se analiza mediante la metodología del estudio de casos la experiencia de cuatro empresas (dos industriales y dos de servicios que ilustran dos casos de éxito y dos de fracaso. Entre las conclusiones obtenidas, cabe resaltar que los factores estratégicos influyen en la utilización del sistema de manera recurrente, no teniendo esta misma influencia los factores individuales, operativos y externos

  12. Clinical profile of distal renal tubular acidosis

    Directory of Open Access Journals (Sweden)

    Ratan Jha

    2011-01-01

    Full Text Available To determine the clinical profile and progression of renal dysfunction in distal renal tubular acidosis (dRTA, we retrospectively studied 96 consecutive cases of dRTA diagnosed at our center. Patients with unexplained metabolic bone disease, short stature, hypokalemia, re-current renal stones, chronic obstructive uropathy or any primary autoimmune condition known to cause dRTA were screened. Distal RTA was diagnosed on the basis of systemic metabolic acidosis with urine pH >5.5 and positive urine anion gap. In those patients who had fasting urine pH >5.5 with normal baseline systemic pH and bicarbonate levels (incomplete RTA, acid load test with ammonium chloride was done. A cause of dRTA could be established in 53 (54% patients. Urological defect in children (22/44 and autoimmune disease in adults (11/52 were the commonest causes. Hypokalemic paralysis, proximal muscle weakness and voiding difficulty were the common modes of presentation. Doubling of serum creatinine during the study period was noted in 13 out of 27 patients who had GFR 60 mL/min (P <0.005. In conclusion, urological disorders were the commonest cause of dRTA in children while autoimmune disorders were the commonest asso-ciation in adults. Worse baseline renal function, longer duration of disease and greater frequency of nephrolithiasis/nephrocalcinosis and urological disorders were noted in those who had wor-sening of renal dysfunction during the study period.

  13. Clinical profile of distal renal tubular acidosis.

    Science.gov (United States)

    Jha, Ratan; Muthukrishnan, J; Shiradhonkar, Shekhar; Patro, Kiran; Harikumar, Kvs; Modi, K D

    2011-03-01

    To determine the clinical profile and progression of renal dysfunction in distal renal tubular acidosis (dRTA), we retrospectively studied 96 consecutive cases of dRTA diagnosed at our center. Patients with unexplained metabolic bone disease, short stature, hypokalemia, re-current renal stones, chronic obstructive uropathy or any primary autoimmune condition known to cause dRTA were screened. Distal RTA was diagnosed on the basis of systemic metabolic acidosis with urine pH >5.5 and positive urine anion gap. In those patients who had fasting urine pH >5.5 with normal baseline systemic pH and bicarbonate levels (incomplete RTA), acid load test with ammonium chloride was done. A cause of dRTA could be established in 53 (54%) patients. Urological defect in children (22/44) and autoimmune disease in adults (11/52) were the commonest causes. Hypokalemic paralysis, proximal muscle weakness and voiding difficulty were the common modes of presentation. Doubling of serum creatinine during the study period was noted in 13 out of 27 patients who had GFR 60 mL/min (P <0.005). In conclusion, urological disorders were the commonest cause of dRTA in children while autoimmune disorders were the commonest asso-ciation in adults. Worse baseline renal function, longer duration of disease and greater frequency of nephrolithiasis/nephrocalcinosis and urological disorders were noted in those who had wor-sening of renal dysfunction during the study period. PMID:21422623

  14. [Arthroscopic treatment of distal radius fracture].

    Science.gov (United States)

    Lindau, T

    2006-11-01

    The orthopaedic surgeons cannot predict the functional results after a distal intra articular radius fracture. The intra-articular incongruity of more than 1 mm is associated with the development of secondary osteoarthrosis. The wrist arthroscopy became an essential help for the reduction of these fractures. The hand is normally in an upright position with a traction of approximately 4-5 kg which facilitates the reduction of the extra-articular fracture component. It is possible to use a technique of horizontal traction. The arthroscopy allows the reduction and control of the fixing of the various fragments, but also the treatment associated lesions associated. One randomized study, which compared 34 arthroscopically treated fractures with 48 openly treated, concluded that the arthroscopy-treated group had better outcome, better reduction, better grip strength and better range of motion than the openly treated group. The treatment of intra articular distal radius fractures with arthroscopic assistance is thus the guaranteeing of the most anatomical reduction of articular surface. It allows the diagnosis and the treatment of the associated lesions, decreases the peripheral fibrous scars of soft tissues by avoiding initially extensive approaches and finally gives better functional results. PMID:17361885

  15. Biotin absorption by distal rat intestine

    International Nuclear Information System (INIS)

    We used the in vivo intestinal loop approach, with short (10-min) and long (3-h) incubations, to examine biotin absorption in proximal jejunum, distal ileum, cecum and proximal colon. In short-term studies, luminal biotin disappearance from rat ileum was about half that observed in the jejunum, whereas absorption by proximal colon was about 12% of that in the jejunum. In 3-h closed-loop studies, the absorption of 1.0 microM biotin varied regionally. Biotin absorption was nearly complete in the small intestine after 3 h; however, only about 15% of the dose had been absorbed in the cecum and 27% in the proximal colon after 3 h. Independent of site of administration, the major fraction of absorbed biotin was recovered in the liver; measurable amounts of radioactive biotin were also present in kidney and plasma. The results support the potential nutritional significance for the rat of biotin synthesized by bacteria in the distal intestine, by demonstrating directly an absorptive capability of mammalian large bowel for this vitamin

  16. Single-incision technique for the internal fixation of distal fractures of the tibia and fibula: a combined anatomic and clinical study

    OpenAIRE

    Yu, Baoqing; Huang, Gan; George, Josiah T.; Li, Wenrui; Pan, Sihua; Zhou, Haiyan

    2013-01-01

    Objectives To present a novel single anterior-lateral approach for the treatment of distal tibia and fibula fracture via anatomical study and primary clinical application in order to minimize soft tissue complications. Design Both a gross anatomic cadaver and retrospective studies of the single-incision technique in patients recruited between June 2004 and January 2010. Setting Level I trauma center. Patients/participants Twenty-six legs of 14 adult human cadavers and clinical recruitment of ...

  17. 38 CFR 3.379 - Anterior poliomyelitis.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Anterior poliomyelitis. 3... Specific Diseases § 3.379 Anterior poliomyelitis. If the first manifestations of acute anterior poliomyelitis present themselves in a veteran within 35 days of termination of active military service, it...

  18. Surgical techniques of anterior decompression and fusion for spinal cord injuries.

    Science.gov (United States)

    Bohlman, H H; Eismont, F J

    1981-01-01

    Many patients who have static or only slowly improving neurologic deficits and significant compression of the spinal cord and nerve roots can benefit from anterior decompression. The improvement ranges from partial root recovery to very dramatic improvement in upper as well as lower extremities in the patient with quadriparesis. Intrinsic damage or contusion of the spinal cord cannot be reversed by decompression. Patients with motor sparing preoperatively attain a better functional improvement than those patients who have only slight distal sensory function initially. The same can be said of patients with spinal cord injuries treated with surgery, but we believe the ultimate degree of functional recovery of incomplete cord injuries is greater following anterior than posterior decompression when the operation is indicated. An early accurate diagnosis must be made concerning whether a patient has a complete or an incomplete spinal cord injury. The mechanical compressive lesion must be well documented by myelography, laminography, or CAT scan. The patient should not be neurologically harmed by a posterior laminectomy approach to anterior pathology which additionally removes all posterior stability. An anterior compressive block is best removed through an anterior approach. PMID:7471590

  19. Targeted Anterior Gland Focal Therapy-a Novel Treatment Option for a Better Defined Disease.

    Science.gov (United States)

    Tay, Kae Jack; Villers, Arnauld; Polascik, Thomas J

    2016-10-01

    The goal of focal therapy is to achieve long-term oncological control by eradicating only the clinically significant focus/foci of cancer within the prostate, while preserving erectile function and continence. Anterior prostate cancers may have a PZ or TZ origin and share commonalities in location and biology. While anterior prostate cancers previously constituted a diagnostic blind spot in the prostate and were often not detected or discovered late, with the rapid dissemination of advanced imaging and biopsy techniques, they can now be identified at an earlier, organ-confined stage due to MR imaging and targeted biopsies. Due to their anterior location, they represent a therapeutic target that allows for thorough ablation of the cancer focus/foci with an adequate margin while remaining far from the neurovascular bundles bilaterally. However, the TZ origin cancers are mostly anterior to the distal urethra close to the apex and the striated sphincter. Men having early stage anterior cancers may represent good candidates to achieve a balance between oncological control and functional preservation with focal therapy. Thus, this class of tumor based on location, along with the proposed treatment, represents a novel form of targeted image-guided therapy. PMID:27502428

  20. Application of cone-beam CT in root morphology observation of human maxillary anterior teeth

    International Nuclear Information System (INIS)

    Objective: To detect the root curvature and diameter in human maxillary anterior teeth by cone-beam computed tomography (CBCT) and to provide some anatomical parameters related to post-core design. Methods: A total of 129 human maxillary anterior teeth were selected and analyzed. The three-dimensional images of these teeth were obtained by multiplanar reconstructions (MPR) technique of CBCT, and the root curvature and diameter were observed and measured by dedicated software. Results: The mean labio-lingual root curvature degree of maxillary central incisors was significantly smaller than those of maxillary lateral incisors and canines (χ2=6.592, P=0.037), while the labio-lingual root curvature radius was significantly larger than those of other groups (χ2=8.504, P=0.014). There were significant differences in the root length distribution of the mesio-distal curved part between the three different maxillary anterior teeth groups (χ2=13.910, P=0.008). The mean diameter measured labio-lingually was significantly different from that measured mesiodistally in various groups (P=0.000). Conclusion: There are differences in root morphology of 129 human maxillary anterior teeth, and the root curvatures and diameters of human maxillary anterior teeth present differently in CBCT. (authors)

  1. Pediatric anterior cruciate ligament reconstruction

    OpenAIRE

    McConkey, Mark O.; Bonasia, Davide Edoardo; Amendola, Annunziato

    2011-01-01

    An increasing number of anterior cruciate ligament (ACL) injuries are seen in children now than in the past due to increased sports participation. The natural history of ACL deficient knees in active individuals, particularly in children is poor. Surgical management of ACL deficiency in children is complex due to the potential risk of injury to the physis and growth disturbance. Delaying ACL reconstruction until maturity is possible but risks instability episodes and intra-articular damage. S...

  2. Anterior impingement syndrome in dancers

    OpenAIRE

    O’Kane, John William; Kadel, Nancy

    2007-01-01

    Anterior impingement is a common problem in dancers occurring primarily secondary to the repetitive forced ankle dorsiflexion inherent in ballet. Symptoms generally occur progressively and may respond to conservative treatment including addressing biomechanical faults that contribute to the problem. As impingement progresses, movements essential to ballet may become impossible and arthroscopic ankle surgery is often effective for both diagnosis and treatment, allowing athletes to return to da...

  3. Superficial peroneal neurocutaneous flap based on an anterior tibial artery perforator for forefoot reconstruction.

    Science.gov (United States)

    Wang, Chun-Yang; Chai, Yi-Min; Wen, Gen; Han, Pei; Cheng, Liang

    2015-06-01

    The distally based superficial peroneal neurocutaneous (SPNC) island flap has been widely used for foot reconstruction. It is based on the descending branch of the peroneal artery perforator. However, damage to the perimalleolar vascularization or anatomic variations of the descending branch often causes flap necrosis. Because septocutaneous perforators from the anterior tibial artery participate in the vascular network of superficial peroneal nerve in the distal lower leg, a modified SPNC flap is designed based on the anterior tibial artery perforator. Seven patients with soft tissue defect over the forefoot were treated by this modified technique. Six patients had accompanied injuries at the lateral perimalleolar region, and 1 patient had an anatomic variation of the descending branch of the peroneal artery perforator. The size of defect ranged from 12 × 5 to 15 × 9 cm. All 7 flaps survived completely without complications. The size of the flaps ranged from 13 × 6 to 16 × 10 cm. No severe venous congestion occurred. The mean follow-up was 9.4 months (range, 6-14 months). All patients were satisfied with the texture and color of the flaps. Two patients complained about the thickness of the flaps, but did not want further operation. The donor sites healed uneventfully and no painful neuroma occurred. In conclusion, the modified SPNC flap based on an anterior tibial artery perforator is a feasible salvage procedure when the traditional design is unreliable. It can provide sufficient and superior coverage for large forefoot defect. PMID:25969973

  4. Distal Xq duplication and functional Xq disomy

    Directory of Open Access Journals (Sweden)

    Schluth-Bolard Caroline

    2009-02-01

    Full Text Available Abstract Distal Xq duplications refer to chromosomal disorders resulting from involvement of the long arm of the X chromosome (Xq. Clinical manifestations widely vary depending on the gender of the patient and on the gene content of the duplicated segment. Prevalence of Xq duplications remains unknown. About 40 cases of Xq28 functional disomy due to cytogenetically visible rearrangements, and about 50 cases of cryptic duplications encompassing the MECP2 gene have been reported. The most frequently reported distal duplications involve the Xq28 segment and yield a recognisable phenotype including distinctive facial features (premature closure of the fontanels or ridged metopic suture, broad face with full cheeks, epicanthal folds, large ears, small and open mouth, ear anomalies, pointed nose, abnormal palate and facial hypotonia, major axial hypotonia, severe developmental delay, severe feeding difficulties, abnormal genitalia and proneness to infections. Xq duplications may be caused either by an intrachromosomal duplication or an unbalanced X/Y or X/autosome translocation. In XY males, structural X disomy always results in functional disomy. In females, failure of X chromosome dosage compensation could result from a variety of mechanisms, including an unfavourable pattern of inactivation, a breakpoint separating an X segment from the X-inactivation centre in cis, or a small ring chromosome. The MECP2 gene in Xq28 is the most important dosage-sensitive gene responsible for the abnormal phenotype in duplications of distal Xq. Diagnosis is based on clinical features and is confirmed by CGH array techniques. Differential diagnoses include Prader-Willi syndrome and Alpha thalassaemia-mental retardation, X linked (ATR-X. The recurrence risk is significant if a structural rearrangement is present in one of the parent, the most frequent situation being that of an intrachromosomal duplication inherited from the mother. Prenatal diagnosis is performed by

  5. Early experiences with magnetic rings in resection of the distal colon.

    Science.gov (United States)

    Jansen, A; Keeman, J N; Davies, G A; Klopper, P J

    1980-01-01

    We have developed an anastomosis technique for resection of the distal colon based on the principle of submucosal layer apposition. The anastomosis apparatus consists of two rings of Ertalyte (polyester-polyethyleneterephtalate) containing two magnetic rings of polymer bonded rare earth cobalt. For low anastomoses we developed a magnetic ring holder, protecting cap and hexagonal connecting rod. The working principle is based on progressive compression leading to necrosis of the intermediate mucosal and submucosal layers by increasing magnetic force while bowel healing takes place. After 7 to 17 days the magnets cut through and are propelled by peristalis out of the anastomotic region. From our initial series of five patients we performed three sigmoid resections and two low anterior resections. There were no postoperative complications. Sigmoidoscopic and radiological investigations two weeks postoperatively, showed no evidence of leakage or anastomotic narrowing. The technique and the special advantages of the apparatus are discussed. PMID:7366876

  6. Modelo de Sistema Basado en Conocimiento en el Dominio de la Seguridad de Aplicaciones

    Directory of Open Access Journals (Sweden)

    María Victoria Bajarlía

    2013-12-01

    Full Text Available El objetivo es proponer un modelo de un sistema basado en conocimiento (SBC aplicado al análisis de seguridad de aplicaciones de gestión. El modelo se fundamenta en un sistema basado en conocimiento (SBC que cuenta con un componente cognitivo que le permite incorporar conocimiento. En virtud de que las amenazas y los ataques informáticos representan un problema constante y creciente se puede suponer que el SBC, a través del aprendizaje dinámico que lo mantendrá actualizado, podrá asistir a los especialistas en Seguridad de la Información, en el área de competencia, a la elaboración de Especificación de Requerimientos.

  7. Incidence of distal femoral and distal tibial deformities in infantile and adolescent blount disease.

    Science.gov (United States)

    Myers, Thomas G; Fishman, Michael K; McCarthy, James J; Davidson, Richard S; Gaughan, John

    2005-01-01

    The purpose of this study was to assess distal femoral and tibial deformity in patients with infantile and adolescent Blount disease. This was a retrospective review of patients at the authors' institution diagnosed with Blount disease. Thirty-eight patients (21 in the infantile group and 17 in the adolescent group) met the study criteria. Measurements of the anatomic lateral distal femoral angle (aLDFA), anatomic lateral distal tibial angle (aLDTA), and tibiofemoral angle (TFA) were made from long-leg radiographs. The results of the infantile and adolescent measurements were compared with each other and to a normal database. Intraobserver and interobserver error was determined. The adolescent aLDFA measurements were significantly greater (more varus) than for the infantile group and normal database. The aLDTA (ankle) measurements were not statistically different between the two groups, or from the normal database. Analysis of both intraobserver and interobserver error for the aLDFA and aLDTA showed good reliability. PMID:15718905

  8. Dynamic Finite Element Analysis of Impulsive Stress Waves Propagating from Distal End of Femur

    Directory of Open Access Journals (Sweden)

    Sarai,Takaaki

    2012-10-01

    Full Text Available The human femur is subjected to an impulsive load at its distal end during daily life. Femoral bone fracture caused by impact loading is common in elderly women. It is important to clarify the dynamic response of the femur and to evaluate the change in its stress state during impact loading. A 3-dimensional model of the femur was prepared in the present study, and the impulsive stress waves propagating from the distal end of the femur were analyzed by the dynamic finite element method. This model showed that the von Mises equivalent stress is large on the anterior and posterior sides of the mid-diaphysis when the impact direction is different from that of the bone axis. As for the femoral neck, the absolute value of minimum principal stress initially increases on the medial side;slightly later the maximum principal stress increases on the lateral side. In this case, the absolute value of the maximum principal stress was found to be larger than that of the minimum principal stress, and the absolute value of the principal stress decreased as the impact angle increased. Further, the femoral neck and the trochanter were shown to have a higher risk of bone fracture when the impact direction is coincident with the bone axis.

  9. Results of distal revascularization in elderly patients for critical ischemia of the lower limbs.

    Science.gov (United States)

    Illuminati, G; Calio, F G; Bertagni, A; Piermattei, A; Vietri, F; Martinelli, V

    1999-04-01

    Thirty eight patients over 75 years of age were operated upon of 40 distal arterial revascularizations for critical ischaemia of the lower limbs. Arterial reconstruction was proposed to ambulatory, self sufficient patients, with a patent artery of the leg or the foot in continuity with pedal arch, at arteriography. The revascularized artery was the peroneal in 14 cases, the anterior tibial in 11, the posterior tibial in 9, the dorsalis pedis in 5, and the external plantar artery in 1 case. Postoperative mortality was 2.6%. No postoperative arterial occlusion occurred and no postoperative amputation needed to be performed. The mean follow-up of 37 patients surviving operation was 21 months (ext. 2-52 months). At 36 months interval, patients' survival was 43%, primary patency rate was 57%, and limb salvage rate was 76%, at life-table analysis. Distal revascularization enables a good number of elderly patients in critical ischaemia of the lower limb, to enjoy an active, independent life, with a viable limb. PMID:10352735

  10. Plan de implementación del SGSI basado en la norma ISO 27001:2013

    OpenAIRE

    Salcedo Buelvas, Robin J.

    2014-01-01

    El trabajo final del máster describe los objetivos, el alcance, la expectativa del SGSI y la metodología asociada a la definición, planeación, identificación y creación del modelo de seguridad de la información para la organización ISAGXXX, basado en la norma ISO 27001:2013.

  11. Desarrollo de entorno para videojuegos en HTML5, basado en tiles

    OpenAIRE

    Agüero Requena, Victor Manuel

    2014-01-01

    Projecte realitzat en dues parts: 1) part de l'editor desenvolupada per Rodolfo Núñez del Río, i 2) conjunt de rutines que controlen la física i la intel·ligència del joc desenvolupada per Víctor Manuel Agüero Requena. Desarrollo de un game engine en HTML5 para desarrollar videojuegos basados en tiles para ejecutar en un navegador web

  12. [Proximal and distal biceps tendon rupture--an indication for surgery?].

    Science.gov (United States)

    Klonz, A; Eggers, C; Reilmann, H

    1998-09-01

    We reviewed 77 conservatively and 164 operatively treated cases of rupture of the long head of the biceps documented in the literature. Refixation offers a small but relatively constant improvement of flexion and supination power and thus reduces the number of cases with remaining light or marked weakness by one third. Deformity by the slipped muscle can be corrected effectively. As complications are uncommon surgery should be recommended to young and active patients and should at least be offered to less active patients. Thirteen patients were re-examined after operative repair for distal biceps tendon avulsion and 277 reported cases were reviewed. After conservative management (n = 20) the power of flexion remains reduced by 30%-40%, that of supination by more than 50%. The loss of flexion power, as well as the deformity can be nicely diminished by attachment of the distal biceps to the brachialis muscle (n = 22). There are no complications documented regarding this procedure. The anatomic reinsertion (n = 248) additionally reduces the loss of supination power to 0%-25%, but bears a higher risk of complications. The double-incision technique (n = 105 of 248) does not necessarily decrease this risk. There are as many nerve injuries reported as with the single-anterior approach. Additionally we are faced with the problem of radioulnar synostosis. The use of suture anchors provides a nice way of fixation of the tendon but does not facilitate the approach to the tuberosity. The distal biceps tendon rupture should be treated operatively. The adequate method of repair is to be determined individually. PMID:9816985

  13. Absence of scalenus anterior muscle.

    OpenAIRE

    Murakami S; Horiuchi K; Yamamoto C; Ohtsuka A; Murakami T.

    2003-01-01

    A rare anomaly of the scalenus muscles is described. In this case, the right scalenus anterior muscle was absent. As a substitute for this muscle, some aberrant muscle slips arose from the lower vertebrae and descended in front of the ventral rami of the lower cervical nerves. These aberrant slips then ran between the ventral rami of the the eighth cervical and first thoracic nerves, and were fused with the right scalenus medius muscle. Thus, the subclavian artery and vein ran in front of the...

  14. Lesiones del ligamento cruzado anterior

    OpenAIRE

    Alejandro Álvarez López; Yenima García Lorenzo

    2015-01-01

    Fundamento: el ligamento cruzado anterior desempeña un papel muy importante en la estabili-dad de la rodilla. La incidencia de esta afección es alta en pacientes que practican deportes de contacto y de no ser tratados de forma adecuada, los resultados son desfavorables. Objetivo: profundizar en los factores necesarios para el tratamiento adecuado de enfermos con esta lesión y evitar las complicaciones. Método: se realizó una revisión bibliográfica de un total de 300 artículos publicados en Pu...

  15. Screening renal stone formers for distal renal tubular acidosis

    DEFF Research Database (Denmark)

    Osther, P J; Hansen, A B; Røhl, H F

    1989-01-01

    A group of 110 consecutive renal stone formers were screened for distal renal tubular acidosis (RTA) using morning fasting urinary pH (mfUpH) levels followed by a short ammonium chloride loading test in patients with levels above 6.0. In 14 patients (12.7%) a renal acidification defect was noted......; 13 had incomplete and 1 had complete distal RTA. Distal RTA was found particularly in recurrent stone formers (17%), and especially in those with bilateral stone disease, where a distal renal tubular acidification defect was found in 50%. We have been unable to differentiate primary from secondary...... RTA in renal stone formers. Regardless of whether the acidification defect is primary or secondary to stone formation, however, all renal stone formers with distal RTA can expect to benefit from prophylactic alkaline therapy and it is recommended that the screening procedure, which is easy to use in...

  16. Posterior high sacral segmental disconnection prior to anterior en bloc exenteration for recurrent rectal cancer.

    Science.gov (United States)

    Brown, K G M; Solomon, M J; Austin, K K S; Lee, P J; Stalley, P

    2016-06-01

    This article describes a novel technique for en bloc resection of locally recurrent rectal cancer that invades the high sacral bone (above S3). The involved segment of the sacrum is mobilised with osteotomes during an initial posterior approach before an anterior abdominal phase where the segment of sacral bone is delivered with the specimen. This allows en bloc resection of the involved sacrum while preserving uninvolved distal and contralateral sacral bone and nerve roots. The goal is to obtain a clear bony margin and offer a chance of cure while improving functional outcomes by maintaining pelvic stability and minimising neurological deficit. PMID:27000857

  17. The Role of Diverting Stoma After an Ultra-low Anterior Resection for Rectal Cancer

    OpenAIRE

    Seo, Seok In; Yu, Chang Sik; Kim, Gwon Sik; Lee, Jong Lyul; Yoon, Yong Sik; Kim, Chan Wook; Lim, Seok-Byung; Kim, Jin Cheon

    2013-01-01

    Purpose A diverting stoma is known to reduce the consequences of distal anastomotic failure following colorectal surgery. The aim of this study was to evaluate the efficacy of a diverting stoma after an ultra-low anterior resection (uLAR) for rectal cancer. Methods Between 2000 and 2007, 836 patients who underwent an uLAR were divided into two groups, depending on the fecal diversion: 246 received fecal diversion, and 590 had no diversion. Patient- and disease-related variables were compared ...

  18. Procedimiento para mejorar la satisfacción del cliente basado en la lógica difusa. Aplicación en el hotel Miraflores

    Directory of Open Access Journals (Sweden)

    Javier Fernando Almaguer-Pratts

    2014-01-01

    Full Text Available El turismo en Cuba en los últimos años se ha desarrollado aceleradamente, desenvolviéndose en mercados competitivos con clientes cada día más exigentes, por eso se hace necesario introducir elementos de calidad a través de métodos flexibles y seguros, capaces de brindar productos y servicios diferenciados, donde el cliente perciba la excelencia y profesionalidad de las entidades prestadoras de servicios. De ahí la necesidad de continuar la investigación científica sobre los niveles de satisfacción experimentada por los clientes externos en instalaciones hoteleras. En correspondencia con lo anterior, la presente investigación muestra la aplicación de un procedimiento para la mejora de la satisfacción de los clientes en el hotel Miraflores de la cadena Islazul basado en los postulados de la lógica difusa. Su aplicación parcial permitió una evaluación más acorde a la naturaleza del proceso, así como conocer los niveles de satisfacción de los clientes y la causa que inciden desfavorablemente en estos, a partir de las cuales se diseñaron un conjunto de acciones de mejora.

  19. Anterior chest wall examination reviewed

    Directory of Open Access Journals (Sweden)

    F. Trotta

    2011-09-01

    Full Text Available Anterior chest wall involvement is not infrequently observed within inflammatory arthropaties, particularly if one considers seronegative spondiloarthritides and SAPHO syndrome. Physical examination is unreliable and conventional X-rays analysis is an unsatisfactory tool during diagnostic work-up of this region. Scintigraphic techniques yield informations both on the activity and on the anatomical extent of the disease while computerized tomography visualize the elementary lesions, such as erosions, which characterize the process. Moreover, when available, magnetic resonance imaging couple the ability to finely visualize such lesions with the possibility to show early alterations and to characterize the “activity” of the disease, presenting itself as a powerful tool both for diagnosis and follow-up. This review briefly shows the applications of imaging techniques for the evaluation of the anterior chest wall focusing on what has been done in the SAPHO syndrome which can be considered prototypical for this regional involvement since it is the osteo-articular target mainly affected by the disease.

  20. Dolor anterior de la rodilla

    Directory of Open Access Journals (Sweden)

    Alejandro Álvarez López

    2010-01-01

    Full Text Available Introducción:el dolor anterior de la rodilla constituye una importante causa de consulta en la especialidad de Ortopedia y Traumatología. La incidencia de otras enfermedades relacionadas con este síntoma es cada vez mayor, ejemplo de ello es la condromalacia de rótula, tendinitis patelar, osteoartritis patelofemoral entre otras, el diagnóstico de estas enfermedades se debe al cúmulo de experiencia y a la introducción de técnicas y equipos imagenológicos de avanzada. Desarrollo: se realizó una revisión bibliográfica sobre el dolor anterior de la rodilla, con especial énfasis en las teorías involucradas en su fisiopatología, entre las que se encuentran la mala-alineación patelo-femoral, equilibrio de la homeostasis tisular y aumento de la presión intra-ósea, además de brindar brevemente el cuadro clínico de la enfermedad. Para finalizar se expone el enfoque terapéutico que se basa fundamentalmente en el tratamiento conservador, se mencionan además las modalidades de tratamiento quirúrgico.

  1. Distal Stressors and Depression among Homeless Men.

    Science.gov (United States)

    Coohey, Carol; Easton, Scott D

    2016-05-01

    Depression is a common problem among homeless men that may interfere with functional tasks, such as securing stable housing, obtaining employment, and accessing health services. Previous research on depression among homeless men has largely focused on current psychosocial resources, substance abuse, and past victimization. Guided by Ensel and Lin's life course stress process model, the authors examined whether distal stressors, including victimization and exposure to parent problems in childhood, contributed to men's depression above and beyond current (or proximal) stressors, such as substance abuse and health problems, and social resources. The sample consisted of 309 homeless men who had entered a federally funded emergency shelter. Using the Burns Depression Checklist, the authors found that one out of three men met the threshold for moderate to severe depression during the past week. The logistic regression showed that past exposure to parent problems was related to depression after accounting for current stressors and social resources (number of close adult relationships and whether their emotional support needs were met). Past victimization was not related to depression. To address men's depression, workers should concurrently provide services that meet men's basic needs (for example, housing) and address their relationship needs, including their need for emotional support. PMID:27263201

  2. Mitotoxicity in distal symmetrical sensory peripheral neuropathies

    Science.gov (United States)

    Bennett, Gary J.; Doyle, Timothy; Salvemini, Daniela

    2016-01-01

    Chronic distal symmetrical sensory peripheral neuropathy is a common neurological complication of cancer chemotherapy, HIV treatment and diabetes. Although aetiology-specific differences in presentation are evident, the clinical signs and symptoms of these neuropathies are clearly similar. Data from animal models of neuropathic pain suggest that the similarities have a common cause: mitochondrial dysfunction in primary afferent sensory neurons. Mitochondrial dysfunction is caused by mitotoxic effects of cancer chemotherapeutic drugs of several chemical classes, HIV-associated viral proteins, and nucleoside reverse transcriptase inhibitor treatment, as well as the (possibly both direct and indirect) effects of excess glucose. The mitochondrial injury results in a chronic neuronal energy deficit, which gives rise to spontaneous nerve impulses and a compartmental neuronal degeneration that is first apparent in the terminal receptor arbor—that is, intraepidermal nerve fibres—of cutaneous afferent neurons. Preliminary data suggest that drugs that prevent mitochondrial injury or improve mitochondrial function could be useful in the treatment of these conditions. PMID:24840972

  3. Positioning of anterior teeth in removable dentures

    Directory of Open Access Journals (Sweden)

    Strajnić Ljiljana

    2002-01-01

    Full Text Available Introduction The aim of this paper was to present methods of placement of artificial anterior teeth in edentulous individuals. The following review takes account of the majority of papers published during the last 100 years. The review has been divided into sections regarding the method used to determine the position of artificial anterior teeth. Geometric aspect Gysi (1895-1920 produced the first scientific theory about the position of artificial anterior teeth. Physiognomic theory The aim of this theory is to find the most natural position for artificial anterior teeth for each individual. Camper's "face angle" as a physiognomic criterion, has been introduced in papers of Wehrli (1961, Marxhors (1966, Tanzer (1968, Lombardi (1973. Esthetic aspect Important names in the field of dental esthetics are: Schön and Singer (1961, Arnheim (1965, Krajiček (1969, Tanzer (1968, Lombardi (1973, Goldstein (1976. They have introduced principles of visual aspects for selection of contours, dimension and position of artificial anterior teeth. Constitution aspect Flagg (1880, Williams (1913 and Hrauf (1957, 1958, have considered body constitution and individual characteristics regarding position of artificial anterior teeth. Physiological theory In 1971, Marxhors pointed to the fact that the position of artificial teeth corresponds with the function of the surrounding soft tissue and from the aspect of physiognomy as well. Phonetic aspect According to Silverman (1962 artificial anterior teeth are nearest when we pronounce the sound "S". Cephalometrical research Rayson (1970, Watson (1989, Strajnić Lj. (1999, Bassi F. (2001 have presented cephalometric radiographic analyses of natural anterior teeth compared with cephalometric radiographic analyses of artificial anterior teeth. A review of dental literature shows several factors suggesting modalities which should determine the position of artificial anterior teeth. Numerous methods have been designed for

  4. Pharyngocutaneous fistula after anterior cervical spine surgery

    OpenAIRE

    Sansur, Charles A.; Early, Stephen; Reibel, James; Arlet, Vincent

    2009-01-01

    Pharyngocutaneous fistulae are rare complications of anterior spine surgery occurring in less than 0.1% of all anterior surgery cases. We report a case of a 19 year old female who sustained a C6 burst fracture with complete quadriplegia. She was treated urgently with a C6 corpectomy with anterior cage and plating followed by posterior cervical stabilization at another institution. Post operatively she developed a pharyngocutaneous fistula that failed to heal despite several attempts of closu...

  5. Distal radius fixation through a mini-invasive approach of 15 mm. PART 1: a series of 144 cases.

    Science.gov (United States)

    Lebailly, Frédéric; Zemirline, Ahmed; Facca, Sybille; Gouzou, Stéphanie; Liverneaux, Philippe

    2014-08-01

    The volar Henry approach is becoming the gold standard for distal radius fracture fixation. It decreases the incidence of nonunion, limits complications especially complex regional pain syndrome (CRPS) type I, and allows early mobilization of the wrist. Nonetheless, it has some disadvantages such as the size of the incision, which is not esthetically pleasing, and the loss of ligamentotaxis. This is why some authors have developed a mini-invasive approach. The aim of this work was to evaluate the feasibility of the anterior mini-invasive approach of 15 mm in a clinical series of 144 cases of distal radius fracture. All patients were operated under regional anesthesia using the same techniques by five surgeons of the same team. According to the AO classification, there were 83 type A fractures, 2 type B, and 59 type C. A volar plate (Step One(®), Newclip Technics™, Haute-Goulaine, France) was used in all cases. The 2 proximal metaphyseal screws and the 2 distal central epiphyseal screws were monoaxial locking. The 2 distal ulnar and radial epiphyseal screws were placed in polyaxial locking at 20° angulation maximum. Skin closure without drainage was performed. No postoperative immobilization was prescribed, and patients were encouraged to use their upper limb immediately postoperative. No postoperative physiotherapy was prescribed. The mean follow-up was 4.1 months. The final size of the incision was on average 16.1 mm. Mean pain score was 1.8. The Quick DASH score was average 25. Average range of motion was more than 85 %, and global force of the hand was 67 % compared with contralateral side. On X-ray, the mean radial slope was 22°, the mean radial tilt was 8.3°, and the mean radioulnar variance/index was -0.4 mm. There were nine cases of CRPS type I, which all resolved. Specific complications included two secondary displacements and nine tenosynovitis cases. No tendon rupture was noted. Two intra-articular distal radioulnar joint screws had to be removed at

  6. Median nerve neuropathy in the forearm due to recurrence of anterior wrist ganglion that originates from the scaphotrapezial joint: Case Report

    Directory of Open Access Journals (Sweden)

    Okada Kiyoshi

    2012-01-01

    Full Text Available Abstract Background Median nerve neuropathy caused by compression from a tumor in the forearm is rare. Cases with anterior wrist ganglion have high recurrence rates despite surgical treatment. Here, we report the recurrence of an anterior wrist ganglion that originated from the Scaphotrapezial joint due to incomplete resection and that caused median nerve neuropathy in the distal forearm. Case presentation A 47-year-old right-handed housewife noted the appearance of soft swelling on the volar aspect of her left distal forearm, and local resection surgery was performed twice at another hospital. One year after the last surgery, the swelling reappeared and was associated with numbness and pain in the radial volar aspect of the hand. Magnetic resonance imaging revealed that the multicystic lesion originated from the Scaphotrapezial joint and had expanded beyond the wrist. Exploration of the left median nerve showed that it was compressed by a large ovoid cystic lesion at the distal forearm near the proximal end of the carpal tunnel. We resected the cystic lesion to the Scaphotrapezial joint. Her symptoms disappeared 1 week after surgery, and complications or recurrent symptoms were absent 13 months after surgery. Conclusions A typical median nerve compression was caused by incomplete resection of an anterior wrist ganglion, which may have induced widening of the cyst. Cases with anterior wrist ganglion have high recurrence rates and require extra attention in their treatment.

  7. Herniation of the anterior lens capsule

    Directory of Open Access Journals (Sweden)

    Pereira Nolette

    2007-01-01

    Full Text Available Herniation of the anterior lens capsule is a rare abnormality in which the capsule bulges forward in the pupillary area. This herniation can be mistaken for an anterior lenticonus where both the capsule and the cortex bulge forward. The exact pathology behind this finding is still unclear. We report the clinical, ultrasound biomicroscopy (UBM and histopathological findings of a case of herniation of the anterior lens capsule. UBM helped to differentiate this entity from anterior lenticonus. Light microscopy revealed capsular splitting suggestive of capsular delamination and collection of fluid (aqueous in the area of herniation giving it a characteristic appearance.

  8. Correlation between some facial indexes and mesiodistal width of maxillary anterior teeth

    Directory of Open Access Journals (Sweden)

    Leila Ahmadian

    2012-01-01

    Full Text Available Background: Both tooth size and shape of the anterior maxilla play important role in complete denture and facial esthetics. Tooth selection for an edentulous patient with no pre-extraction is very difficult. The purpose of this study was to analyze mesio-distal width of maxillary anterior teeth and to determine the presence of any relationship between them and other facial measurements.Materials and Method: In this cross-sectional study, after enrolment of 100 high school students, full-face standardized digital images of them were taken in frontal view. Bizaygomatic, interpupilary and interalar distance were measured by images. Width of teeth was determined on the casts. T-test and pearson correlation coefficient were performed to analyze the data.Results: Maxillary central incisor is the widest anterior tooth in both male and female. Correlation between bizaygomatic and interpupillay distances and central incisor width were not significant but between interalar and intercanine were significant.Conclusion: Based on this study, interalar distance is a better index to estimate the width of anterior teeth of maxilla in an edentulous patient

  9. Perawatan Gigitan Terbalik Anterior Dengan Menggunakan Inclined Plane

    OpenAIRE

    Siregar, Wilda A.

    2008-01-01

    Gigitan terbalik anterior adalah suatu anomali posisi gigi anterior atas yang lebih ke lingual dibandingkan gigi anterior bawah. Anomali gigitan terbalik anterior dapat ditemui pada periode gigi sulung, gigi bercampur, dan gigi permanen. Faktor etiologi gigitan terbalik anterior dibedakan atas dental, fungsional atau skeletal. Untuk menentukan etiologi dari anomali gigitan terbalik anterior perlu dilakukan diagnosa yang tepat. Perawatan gigitan terbalik anterior ini dapat dilakukan de...

  10. Two-wave propagation in in vitro swine distal ulna

    Science.gov (United States)

    Mano, Isao; Horii, Kaoru; Matsukawa, Mami; Otani, Takahiko

    2015-07-01

    Ultrasonic transmitted waves were obtained in an in vitro swine distal ulna specimen, which mimics a human distal radius, that consists of interconnected cortical bone and cancellous bone. The transmitted waveforms appeared similar to the fast waves, slow waves, and overlapping fast and slow waves measured in the specimen after removing the surface cortical bone (only cancellous bone). In addition, the circumferential waves in the cortical bone and water did not affect the fast and slow waves. This suggests that the fast-and-slow-wave phenomenon can be observed in an in vivo human distal radius.

  11. Distal humerus fractures: a review of current therapy concepts.

    Science.gov (United States)

    Amir, Steinitz; Jannis, Sailer; Daniel, Rikli

    2016-06-01

    Fractures of the distal humerus in the adult comprise approximately one third of all humeral fractures. Successful management of distal humerus fractures depends on correct reduction of the fracture, reconstruction of the articular surface if needed, stability and rigidity of the fixation, and appropriate rehabilitation. In this review, we evaluated the available literature and highlighted current therapy concepts. We assessed the evolution of internal fixation and elbow arthroplasty focusing on the established surgical approaches against the background of a growing incidence of distal humeral fractures in an aging patient population. Therefore evaluating the aspect and influence of age-dependent comorbidities like osteoporosis on successful treatment. PMID:27039395

  12. Adenoma of the distal common bile duct -a case report-

    Energy Technology Data Exchange (ETDEWEB)

    Do, Young Soo; Lee, Hyun Gon; Han, Ho Seong; Ko, Gyung Hyuck; Kim, Jae Hyoung; Kim, Hyung Jin; Chung, Sung Hoon [College of Medicine, Gyeongsang National University, Jinju (Korea, Republic of)

    1991-05-15

    On rare occasions, Obstructive Jaundice may be caused by a benign tumor of the biliary tract. We describe a patient in whom the diagnosis of an adenoma of the distal common bile duct (CBD) was established. The CT showed a soft tissue density mass in the distal CBD and diffuse dilatation of the intrahepatic duct, gall the bladder, and CBD. Endoscopic retrograde cholangiopnacreatography showed an irregularly marginated polypoid mass in the distal CBD. The clinical, radiological, and histological features of this neoplasm are reviewed. The clinical, radiological and histological features of this neoplasm are reviewed.

  13. Absence of scalenus anterior muscle.

    Directory of Open Access Journals (Sweden)

    Murakami S

    2003-06-01

    Full Text Available A rare anomaly of the scalenus muscles is described. In this case, the right scalenus anterior muscle was absent. As a substitute for this muscle, some aberrant muscle slips arose from the lower vertebrae and descended in front of the ventral rami of the lower cervical nerves. These aberrant slips then ran between the ventral rami of the the eighth cervical and first thoracic nerves, and were fused with the right scalenus medius muscle. Thus, the subclavian artery and vein ran in front of the aberrant slips, together with the ventral ramus of the first thoracic nerve. The aberrant muscle slips issued 2 accessory bundles. One bundle ran between the ventral rami of the fourth and fifth cervical nerves and was fused with the scalenus medius muscle; the other bundle ran between the ventral rami of the fifth and sixth cervical nerves and was fused with the scalenus medius muscle.

  14. Toxic Anterior Segment Syndrome (TASS

    Directory of Open Access Journals (Sweden)

    Özlem Öner

    2011-12-01

    Full Text Available Toxic anterior segment syndrome (TASS is a sterile intraocular inflammation caused by noninfectious substances, resulting in extensive toxic damage to the intraocular tissues. Possible etiologic factors of TASS include surgical trauma, bacterial endotoxin, intraocular solutions with inappropriate pH and osmolality, preservatives, denatured ophthalmic viscosurgical devices (OVD, inadequate sterilization, cleaning and rinsing of surgical devices, intraocular lenses, polishing and sterilizing compounds which are related to intraocular lenses. The characteristic signs and symptoms such as blurred vision, corneal edema, hypopyon and nonreactive pupil usually occur 24 hours after the cataract surgery. The differential diagnosis of TASS from infectious endophthalmitis is important. The main treatment for TASS formation is prevention. TASS is a cataract surgery complication that is more commonly seen nowadays. In this article, the possible underlying causes as well as treatment and prevention methods of TASS are summarized. (Turk J Oph thal mol 2011; 41: 407-13

  15. Mild toxic anterior segment syndrome mimicking delayed onset toxic anterior segment syndrome after cataract surgery

    Directory of Open Access Journals (Sweden)

    Su-Na Lee

    2014-01-01

    Full Text Available Toxic anterior segment syndrome (TASS is an acute sterile postoperative anterior segment inflammation that may occur after anterior segment surgery. I report herein a case that developed mild TASS in one eye after bilateral uneventful cataract surgery, which was masked during early postoperative period under steroid eye drop and mimicking delayed onset TASS after switching to weaker steroid eye drop.

  16. Robotic anterior resection of rectal cancer: technique and early outcome

    Institute of Scientific and Technical Information of China (English)

    DU Xiao-hui; SHEN Di; LI Rong; LI Song-yan; NING Ning; ZHAO Yun-shan; ZOU Zhen-yu

    2013-01-01

    Background The Da Vinci system is a newly developed device for colorectal surgery.With advanced stereoscopic vision,lack of tremor,and the ability to rotate the instruments surgeons find that robotic systems are ideal laparoscopic tools.Since conventional laparoscopic total mesorectal excision is a challenging procedure,we have sought to assess the utility of the Da Vinci robotic system in anterior resections for rectal cancer.Methods Between November 2010 and December 2011,a total of 22 patients affected by rectal cancer were operated on with robotic technique,using the Da Vinci robot.Data regarding the outcome and pathology reports were prospectively collected in a dedicated database.Results There were no conversions to open surgery and no postoperative mortality of any patient.Mean operative time was (220±46) minutes (range,152-286 minutes).The median number of lymph nodes harvested was (14.6±6.5) (range,8-32),and the circumferential margin was negative in all cases.The distal margin was (2.6±1.2) cm (range,1.0-5.5 cm).The mean length of hospital stay was (7.8+2.6) days (range,7.0-13.0 days).Macroscopic grading of the specimen was complete in 19 cases and neady complete in three patients.Conclusions Robotic anterior resection for rectal surgery is safe and feasible in experienced hands.Outcome and pathology findings are comparable with those observed in open and laparoscopy procedures.This technique may facilitate minimally invasive radical rectal surgery.

  17. Totally thrombosed giant anterior communicating artery aneurysm

    Directory of Open Access Journals (Sweden)

    V R Roopesh Kumar

    2015-01-01

    Full Text Available Giant anterior communicating artery aneurysmsarerare. Apatient presented with visual dysfunction, gait ataxia and urinary incontinence. MRI showed a giant suprasellar mass.At surgery, the lesion was identified as being an aneurysm arising from the anterior communicating artery.The difficulty in preoperative diagnosis and relevant literature are reviewed.

  18. Anterior capsular rupture following blunt ocular injury

    OpenAIRE

    Gremida, Anas; Kassem, Iris; Traish, Aisha

    2011-01-01

    A 10-year-old boy suffered a large, oblique anterior capsular tear following blunt injury to his right eye. The boy was followed daily for hyphema resolution and progressive traumatic cataract formation. After the hyphema had resolved, the lens was removed using an anterior approach and an intraocular lens was placed with excellent visual outcome.

  19. Dentulous Appliance for Upper Anterior Edentulous Span

    OpenAIRE

    Chalakkal, Paul; Devi, Ramisetty Sabitha; Srinivas, G Vijay; Venkataramana, Pammi

    2013-01-01

    This article discusses about a fixed dentulous appliance that was constructed to replace the primary upper anterior edentulous span in a four year old girl. It constituted a design, whereby the maxillary primary second molars were used to support the appliance through bands and a wire that contained an acrylic flange bearing trimmed acrylic teeth, anteriorly. The appliance was functionally and aesthetically compliant.

  20. Anterior cervical hypertrichosis: a sporadic case.

    Science.gov (United States)

    Bostan, Sezen; Yaşar, Şirin; Serdar, Zehra Aşiran; Gizlenti, Sevda

    2016-03-01

    Anterior cervical hypertrichosis is a very rare form of primary localized hypertrichosis. It consists of a tuft of terminal hair on the anterior neck just above the laryngeal prominence. The etiology is still unknown. In this article, we reported a 15-year-old female patient who presented to our clinic with a complaint of hypertrichosis on the anterior aspect of the neck for the last five years. Her past medical history revealed no pathology except for vesicoureteral reflux. On the basis of clinical presentation, our patient was diagnosed with anterior cervical hypertrichosis and she was considered to be a sporadic case due to lack of other similar cases in familial history. To date, 33 patients with anterior cervical hypertrichosis have been reported. Anterior cervical hypertrichosis can be associated with other abnormalities, but it frequently presents as an isolated defect (70%). The association of vesicoureteral reflux and anterior cervical hypertrichosis which was observed in our patient might be coincidental. So far, no case of anterior cervical hypertrichosis associated with vesicoureteral reflux has been reported in the literature. PMID:27103865

  1. Distal Humeral Fixation of an Intramedullary Nail Periprosthetic Fracture

    Directory of Open Access Journals (Sweden)

    Hiren M. Divecha

    2013-01-01

    Full Text Available Distal humeral periprosthetic fractures below intramedullary nail devices are complex and challenging to treat, in particular due to the osteopenic/porotic nature of bone found in these patients. Fixation is often difficult to satisfactorily achieve around the intramedullary device, whilst minimising soft tissue disruption. Descriptions of such cases in the current literature are very rare. We present the case of a midshaft humeral fracture treated with a locking compression plate that developed a nonunion, in a 60-year old female. This went on to successful union after exchange for an intramedullary humeral nail. Unfortunately, the patient developed a distal 1/5th humeral periprosthetic fracture, which was then successfully addressed with a single-contoured, extra-articular, distal humeral locking compression plate (Synthes with unicortical locking screws and cerclage cables proximally around the distal nail tip region. An excellent postoperative range of motion was achieved.

  2. Intraosseous epidermoid cysts in the distal phalanx of two dogs

    International Nuclear Information System (INIS)

    Two dogs were presented with a history of lameness associated with swelling of one of the digits. Radiographs of the affected digits revealed an irregularly mineralized, smoothly marginated proliferative bone lesion in the distal phalanx of one dog and a destructive bony lesion in the distal phalanx of the second dog. The differential diagnosis included nail bed carcinoma, malignant melanoma, osteomyelitis, and subungual keratoacanthoma. Radiographic findings and no response to medical treatment resulted in amputation and submission of the digits for a histopathologic diagnosis. Histologic examination of the distal phalanx of the digits revealed benign epidermoid cysts associated with either bony proliferation or osteolysis. Excision of the lesions was curative. This report presents the clinical, radiographic, and histopathologic findings associated with intraosseous epidermoid cysts in the distal phalanx of two dogs

  3. Distal clavicle osteolysis following fixation with a synthetic ligament

    Directory of Open Access Journals (Sweden)

    Paul M.C Dearden

    2011-01-01

    Full Text Available We present a case of distal clavicle osteolysis following treatment of a chronic acromioclavicular joint dislocation with a synthetic ligament. The relevant literature is reviewed and discussed.

  4. Minimally invasive percutaneous plate fixation of distal tibia fractures.

    LENUS (Irish Health Repository)

    Bahari, Syah

    2007-10-01

    We report a series of 42 patients reviewed at a mean of 19.6 months after treatment of distal tibial and pilon fractures using the AO distal tibia locking plate with a minimally invasive percutaneous plate osteosynthesis (MIPPO) technique. Mean time to union was 22.4 weeks. All fractures united with acceptable alignment and angulation. Two cases of superficial infection were noted, with one case of deep infection. Mean SF36 score was 85 and mean AOFAS score was 90 at a mean of 19 months follow-up. We report satisfactory outcomes with the use of the AO distal tibia locking plate in treatment of unstable distal tibial fractures. Eighty-nine percent of the patients felt that they were back to their pre injury status and 95% back to their previous employment.

  5. Symptomatic venous thromboembolism following fractures distal to the knee

    DEFF Research Database (Denmark)

    Wahlsten, L. R.; Eckardt, H.; Lyngbæk, S.;

    2015-01-01

    the knee. METHODS: Using individual linkage of nationwide registries, we included all Danish patients who had undergone surgery for a fracture distal to the knee between 1999 and 2011. Patients were followed for 180 days from discharge. Event rates of DVT/PE were calculated, and significant risk...... of DVT/PE was low following surgery for fractures distal to the knee; however, the risk was increased in the presence of a number of risk factors. This study suggests that specific groups of patients undergoing surgery for a fracture distal to the knee might benefit from postdischarge antithrombotic......BACKGROUND: Our aims were to determine the incidence of symptomatic deep venous thrombosis (DVT) and pulmonary embolism (PE) that required inpatient or outpatient treatment, and to identify specific risk factors associated with DVT/PE in patients who had undergone surgery for a fracture distal to...

  6. Fixed Lunate Flexion Deformity in Distal Radius Fractures.

    Science.gov (United States)

    Lee, Sanglim; Yu, Jae-Ha; Jeon, Suk Ha

    2016-06-01

    Carpal malalignments in malunion of distal radius fracture are considered as an adaptive response of the carpus to loss of normal architecture of the distal radius. This condition leads to mechanical overload, ligament attenuation and progressive dynamic instability around the wrist joint. Radial corrective osteotomy is suggested as a treatment option of carpal malalignment after distal radius malunion. In radiocarpal malalignment, the lunate is usually observed in flexion in contrast to its extension posture in the more common midcarpal malalignment. We report two cases of fixed lunate flexion deformity after a distal radius fracture, in which reduction and fixation of fresh fracture or corrective osteotomy of malunion were not successful. Arthritic changes were observed in the radiolunate joint on arthroscopy. Thus, fixed flexion deformity of the lunate might be associated with posttraumatic arthritic change in the radiolunate joint. PMID:27247752

  7. Outflow distribution at the distal anastomosis of infrainguinal bypass grafts.

    Science.gov (United States)

    Fisher, R K; How, T V; Bakran, A; Brennan, J A; Harris, P L

    2004-03-01

    Outflow distribution at the distal anastomosis of infrainguinal bypass grafts remains unquantified in vivo, but is likely to influence flow patterns and haemodynamics, thereby impacting upon graft patency. This study measured the ratio of distal to proximal outflow in 30 patients undergoing infrainguinal bypass for lower limb ischaemia, using a flow probe and a transit-time ultrasonic flow meter. The mean outflow distribution was approximately 75% distal to 25% proximal, with above knee anastomoses having a greater proportion of distal flow (84%) compared to below knee grafts (73%). These in vivo flow characteristics differ significantly from those used in theoretical models studying flow phenomena (50:50 and/or 100:0), and should be incorporated into future research. PMID:14757463

  8. Distal posterior tibial artery pseudoaneurysm after fracture calcaneous

    OpenAIRE

    Dey, Subhajeet; Das, Anjan K.; Dey, Rubi

    2008-01-01

    Here we report a case of pseudoaneurysm of distal posterior tibial artery following closed fracture of calcaneous. Association of pseudoaneurysm of posterior tibial artery with fracture of calcaneous is extremely uncommon. It is always suggested that pseudoaneurysm be treated by reconstruction, but here we present the case treated by ligation, obliteration and excision as it was situated distally and the plantar arch circulation was maintained. The purpose of this case report is to bring atte...

  9. Potassium excretion during antinatriuresis: perspective from a distal nephron model

    OpenAIRE

    Weinstein, Alan M.

    2011-01-01

    Renal excretion of Na+ and K+ must be regulated independently within the distal nephron, but is complicated by the fact that changing excretion of one solute requires adjustments in the transport of both. It is long known that hypovolemia increases Na+ reabsorption while impairing K+ excretion, even when distal Na+ delivery is little changed. Renewed interest in this micropuncture observation came with identification of the molecular defects underlying familial hyperkalemic hypertension (FHH)...

  10. Distal posterior inferior cerebellar artery aneurysm in a child

    OpenAIRE

    J. FRANCISCO SALOMÃO; René D. Leibinger; Yara M. S. Lima Ciro de A. Cunha; Ilton G. Shinzato; Paulo de T. L. Dantas

    1992-01-01

    The case of a 7-year-old boy presenting with recurrent episodes of subarachnoid hemorrhage due to a distal posterior inferior cerebellar artery aneurysm (PICA), successfully operated, is reported.' The low incidence of intracranial aneurysms in the first decade of life and the rare occurrence of distal PICA aneurysms are unusual features of this case. The theories regarding the origin of intracranial berry aneurysms are discussed.

  11. Distal renal tubular acidosis and amelogenesis imperfecta: A rare association

    OpenAIRE

    Ravi, P.; Ekambaranath, T. S.; Arasi, S. Ellil; Fernando, E.

    2013-01-01

    Renal tubular acidosis (RTA) is characterized by a normal anion gap with hyperchloremic metabolic acidosis. Primary distal RTA (type I) is the most common RTA in children. Childhood presentation of distal RTA includes vomiting, failure to thrive, metabolic acidosis, and hypokalemia. Amelogenesis imperfecta (AI) represents a condition where the dental enamel and oral tissues are affected in an equal manner resulting in the hypoplastic or hypopigmented teeth. We report a 10-year-old girl, previ...

  12. Distal humerus fractures: a review of current therapy concepts

    OpenAIRE

    Amir, Steinitz; Jannis, Sailer; Daniel, Rikli

    2016-01-01

    Fractures of the distal humerus in the adult comprise approximately one third of all humeral fractures. Successful management of distal humerus fractures depends on correct reduction of the fracture, reconstruction of the articular surface if needed, stability and rigidity of the fixation, and appropriate rehabilitation. In this review, we evaluated the available literature and highlighted current therapy concepts. We assessed the evolution of internal fixation and elbow arthroplasty focusing...

  13. Distal tibia fractures: management and complications of 101 cases

    OpenAIRE

    Joveniaux, Pierre; Ohl, Xavier; Harisboure, Alain; Berrichi, Aboubekr; Labatut, Ludovic; Simon, Patrick; Mainard, Didier; Vix, Nicolas; Dehoux, Emile

    2009-01-01

    Distal tibia fractures are complex injuries with a high complication rate. In this retrospective and multicentre study we attempted to detail complications and outcomes of this type of injury in order to determine predictive factors of poor results. Between 2002 and 2004, 104 patients were admitted for 105 distal tibia fractures. One hundred patients (101 fractures) were reviewed with an average follow-up of 19 months (range, 12–46). Internal fixation, external fixation, limited internal fixa...

  14. Anterior Shoulder Instability with Concomitant Superior Labrum from Anterior to Posterior (SLAP) Lesion Compared to Anterior Instability without SLAP Lesion

    Science.gov (United States)

    Durban, Claire Marie C.; Kim, Je Kyun; Kim, Sae Hoon

    2016-01-01

    Background The aims of this study were to investigate the clinical characteristics of patients with combined anterior instability and superior labrum from anterior to posterior (SLAP) lesions, and to analyze the effect of concomitant SLAP repair on surgical outcomes. Methods We retrospectively reviewed patients who underwent arthroscopic stabilization for anterior shoulder instability between January 2004 and March 2013. A total of 120 patients were available for at least 1-year follow-up. Forty-four patients with reparable concomitant detached SLAP lesions (group I) underwent combined SLAP and anterior stabilization, and 76 patients without SLAP lesions (group II) underwent anterior stabilization alone. Patient characteristics, preoperative and postoperative pain scores, Rowe scores, and shoulder ranges of motion were compared between the 2 groups. Results Patients in group I had higher incidences of high-energy trauma (p = 0.03), worse preoperative pain visual analogue scale (VAS) (p = 0.02), and Rowe scores (p = 0.04). The postoperative pain VAS and Rowe scores improved equally in both groups without significant differences. Limitation in postoperative range of motion was similar between the groups (all p-value > 0.05). Conclusions Anterior instability with SLAP lesion may not be related to frequent episodes of dislocation but rather to a high-energy trauma. SLAP fixation with anterior stabilization procedures did not lead to poor functional outcomes if appropriate surgical techniques were followed. PMID:27247742

  15. Update on the roles of distal airways in COPD

    Directory of Open Access Journals (Sweden)

    N. Roche

    2011-03-01

    Full Text Available This review is the summary of a workshop on the role of distal airways in chronic obstructive pulmonary disease (COPD, which took place in 2009 in Vence, France. The evidence showing inflammation and remodelling in distal airways and the possible involvement of these in the pathobiology, physiology, clinical manifestations and natural history of COPD were examined. The usefulness and limitations of physiological tests and imaging techniques for assessing distal airways abnormalities were evaluated. Ex vivo studies in isolated lungs and invasive measurements of airway resistance in living individuals have revealed that distal airways represent the main site of airflow limitation in COPD. Structural changes in small conducting airways, including increased wall thickness and obstruction by muco-inflammatory exudates, and emphysema (resulting in premature airway closure, were important determinants of airflow limitation. Infiltration of small conducting airways by phagocytes (macrophages and neutrophils, dendritic cells and T and B lymphocytes increased with airflow limitation. Distal airways abnormalities were associated with patient-related outcomes (e.g. dyspnoea and reduced health-related quality of life and with the natural history of the disease, as reflected by lung function decline and mortality. These data provide a clear rationale for targeting distal airways in COPD.

  16. Distal Locking Screws for Intramedullary Nailing of Tibial Fractures.

    Science.gov (United States)

    Agathangelidis, Filon; Petsatodis, Georgios; Kirkos, John; Papadopoulos, Pericles; Karataglis, Dimitrios; Christodoulou, Anastasios

    2016-01-01

    Recently introduced tibial intramedullary nails allow a number of distal screws to be used to reduce the incidence of malalignment and loss of fixation of distal metaphyseal fractures. However, the number of screws and the type of screw configuration to be used remains obscure. This biomechanical study was performed to address this question. Thirty-six Expert tibial nails (Synthes, Oberdorf, Switzerland) were introduced in composite bone models. The models were divided into 4 groups with different distal locking configurations ranging from 2 to 4 screws. A 7-mm gap osteotomy was performed 72 mm from the tibial plafond to simulate a 42-C3 unstable distal tibial fracture. Each group was divided in 3 subgroups and underwent nondestructive biomechanical testing in axial compression, coronal bending, and axial torsion. The passive construct stiffness was measured and statistically analyzed with one-way analysis of variance. Although some differences were noted between the stiffness of each group, these were not statistically significant in compression (P=.105), bending (P=.801), external rotation (P=.246), and internal rotation (P=.370). This in vitro study showed that, when using the Expert tibial nail for unstable distal tibial fractures, the classic configuration of 2 parallel distal screws could provide the necessary stability under partial weight-bearing conditions. PMID:26840700

  17. Primary ciliogenesis requires the distal appendage component Cep123

    Directory of Open Access Journals (Sweden)

    James E. Sillibourne

    2013-04-01

    Primary cilium formation is initiated at the distal end of the mother centriole in a highly co-ordinated manner. This requires the capping of the distal end of the mother centriole with a ciliary vesicle and the anchoring of the basal body (mother centriole to the cell cortex, both of which are mediated by the distal appendages. Here, we show that the distal appendage protein Cep123 (Cep89/CCDC123 is required for the assembly, but not the maintenance, of a primary cilium. In the absence of Cep123 ciliary vesicle formation fails, suggesting that it functions in the early stages of primary ciliogenesis. Consistent with such a role, Cep123 interacts with the centriolar satellite proteins PCM-1, Cep290 and OFD1, all of which play a role in primary ciliogenesis. These interactions are mediated by a domain in the C-terminus of Cep123 (400–783 that overlaps the distal appendage-targeting domain (500–600. Together, the data implicate Cep123 as a new player in the primary ciliogenesis pathway and expand upon the role of the distal appendages in this process.

  18. Propuesta de aplicación en el aula sobre: aprendizaje basado en proyectos

    OpenAIRE

    Casado Ruiz, Soledad

    2014-01-01

    La finalidad de este trabajo fin de grado es demostrar la posibilidad de obtener mayor rendimiento en el proceso de enseñanza-aprendizaje de nuestros alumnos/as poniendo en práctica un aprendizaje basado en proyectos. Para ello se ha dividido el trabajo en dos partes que a continuación se exponen: En la primera parte, se analiza una fundamentación teórica sobre lo que es el aprendizaje por proyectos como opción didáctica, la cual se complementa con la opinión acerca del tema...

  19. Aprendizaje basado en problemas: experiencia de negociación transversal

    OpenAIRE

    Alzueta Goyeneche, Loretto; Bejarano Encinas, Virginia

    2012-01-01

    Esta actividad que se describe es un método activo de enseñanza como mecanismo de aprendizaje integral y transversal. Se llevó a cabo con alumnos de derecho y empresa, utilizando el método del aprendizaje basado en problemas. Esta metodología de aprendizaje se proyecta sobre la negociación de un convenio colectivo de empresa, en el que la mitad de los alumnos del aula adoptarán el rol de representantes de los trabajadores y la otra mitad el rol de empresario. Para su correcto desarrollo, los ...

  20. Sensores potenciométricos basados en clusters de boro aniónicos

    OpenAIRE

    Stoica, Anca Lulia; Viñas, Clara; Teixidor, Francesc

    2010-01-01

    Sensores potenciométricos basados en clusters de boro aniónicos. Sensor potenciométrico que comprende un electrodo selectivo a iones y este a su vez una membrana caracterizada porque comprende: un material termoplástico; una sustancia electroactiva basada en una sal en la que el catión es la forma protonada del analito a determinar y el anión es un cluster que comprende átomos de boro; y un agente plastificante. Además, la invención también se refiere al uso de dich...

  1. Compuestos cruciformes y polímeros dendronizados basados en bitiofeno y fenilenvinileno

    OpenAIRE

    García Rodríguez, Eva Amaranda

    2013-01-01

    En esta Tesis Doctoral se presenta la síntesis y caracterización de compuestos cruciformes (primera parte) y polímeros dendronizados (segunda parte), basados en bitiofeno y fenilenvinileno, así como el estudio de las propiedades optoelectrónicas de algunos de ellos. Dentro de los compuestos orgánicos con un alto grado de conjugación destacan los compuestos con estructura cruciforme, los cuales ofrecen la posibilidad de situar sus orbitales frontera HOMO y LUMO en distintas zonas de la mol...

  2. Materiales cerámicos basados en titanatos de estroncio como ánodos SOFC

    OpenAIRE

    Gálvez Sánchez, María

    2015-01-01

    En los últimos años, los cerámicos basados en titanatos de estroncio (Sr) sustituido por lantano (La), ((Sr,La)TiO₃±δ), han despertado un gran interés para aplicaciones prácticas como componente en pilas de combustible de óxido sólido (SOFC, “Solid Oxide Fuel Cell”), debido a la elevada conductividad electrónica en atmósferas reductoras y a la resistencia al desgaste (o contaminación) por las impurezas contenidas en el combustible (por ejemplo el sulfuro de hidrógeno (H₂S) presente en los hid...

  3. PEM - Modelo de Ejecución Paralela basado en redes de Petri

    OpenAIRE

    Wolfmann, Aaron Gustavo Horacio

    2015-01-01

    El objetivo de la tesis es la definición de un modelo de ejecución paralelo, que basado en la representación de un algoritmo paralelo con Redes de Petri, permita a un conjunto flexible de procesadores independientes entre sí, ejecutar el algoritmo en forma asíncrona con altos rendimientos y que el programador tenga capacidad de ajustar los parámetros de ejecución en vista de mejoras de rendimiento. Los fundamentos son claros: se desea contar con una herramienta de ejecución de programas paral...

  4. Vectores recombinantes basados en el virus Vaccinia modificado de Ankara (MVA) como vacunas contra la leishmaniasis

    OpenAIRE

    Pérez Jiménez, Eva; Larraga, Vicente; Esteban, Mariano

    2005-01-01

    Vectores recombinantes basados en el virus vaccinia modificado de Ankara (MVA) como vacunas contra la leishmaniasis. Los vectores de la invención contienen secuencias codificantes de la proteína LACK, preferentemente insertadas en el locus de hemaglutinina del virus y bajo el control de un promotor que permite su expresión a lo largo del ciclo de infección del virus. Son vectores seguros, estables, que dan lugar a una potente respuesta inmune que confiere protección frente a la leishmaniasis,...

  5. Servicios y Seguridad, un enfoque basado en estrategias de ataque y defensa

    OpenAIRE

    Castro-Le??n, Marcela; Boixader, Francesc; Taboada, Manel; Rexachs, Dolores; Luque, Emilio

    2015-01-01

    En este art??culo se presenta el enfoque metodol??gico de la asignatura Servicios y Seguridad del Grado de Inform??tica y Servicios, t??tulo oficial de la Universidad Aut??noma de Barcelona que se imparte en la Escuela Universitaria de Inform??tica Tom??s Cerd??. Proponemos un enfoque basado en estrategias de ataque y defensa utilizadas en sistemas inform??ticos. Los modelos de estrategia constituyen el hilo conductor que permite relacionar c??mo contribuyen el resto de temas, como criptograf...

  6. Sistema de riego autónomo basado en la Internet de las Cosas

    OpenAIRE

    Castro-Silva, Juan Antonio

    2016-01-01

    Las necesidades de agua para la producción de alimentos seguirán en aumento debido al crecimiento de la población mundial. En este trabajo de investigación se ha construido un sistema de riego autónomo basado en la Internet de las Cosas (IoT). Se emplean elementos de bajo costo y hardware - software libre (Raspberry Pi, Arduino, Linux, Java, Wildfly, Python, etc.) para implementar Redes de Sensores Inalámbricos (WSN) que permiten obtener la información de las variables agroclimáticas (Humedad...

  7. Bases de la resistencia a preparados bioinsecticidas basados en "Bacillus thuringiensis" en diferentes especies de insectos

    OpenAIRE

    Ibiza Palacios, María de Sales

    2015-01-01

    El empleo de insecticidas en la agricultura moderna resulta fundamental para obtener unos niveles óptimos de productividad. Actualmente se tiende al empleo de bioinsecticidas dados los efectos perniciosos de la mayor parte de los insecticidas convencionales. Los preparados bioinsecticidas basados en las proteínas cristalinas insecticidas (toxinas Cry) de “Bacillus thuringiensis” (Bt) son los de mayor venta del mercado y las plantas transgénicas protegidas por estas proteínas, están siendo cul...

  8. agcc: un generador de procesadores de lenguajes basado en gramáticas de atributos

    OpenAIRE

    Arroyo, Marcelo; Aguirre, Jorge; Alarcón, Román

    2005-01-01

    Este trabajo describe una herramienta de generación procesadores de lenguaje basados en gramáticas de atributos para la familia de bien definidas (well defined atribute gramars) las cuales imposibilitan la derivación de árboles sintácticos con dependencias circulares entre las instancias de sus atributos. La herramienta desarrollada, denominada agcc, genera todos los componentes necesarios de un procesador de lenguajes análisis léxico, sintáctico y evaluación de atributos a partir de una e...

  9. Un sistema de enseñanza adaptativa a distancia basado en tareas y reglas docentes

    OpenAIRE

    Carro, Rosa M.; Pulido, Estrella; Rodríguez Marín, Pilar

    2000-01-01

    Este artículo describe cómo construir y ejecutar cursos adaptativos accesibles a través de Internet. Para ambas tareas se utiliza el sistema TANGOW (Task-based Adaptive learNer Guidance Qn the Web), un sistema de enseñanza adaptativa basado en la Web que guía a los estudiantes durante la realización de esos cursos. El procedimiento de guía permite que tanto los itinerarios propuestos a los estudiantes como los contenidos mostrados durante la realización de un curso se adapten al perfil del es...

  10. Sistemas basados en conocimiento: Una alternativa poco explorada en psicología

    OpenAIRE

    Óscar García-Leal; Francisco Pedroza-Cabrera

    2011-01-01

    Desde la aparición de los primeros Sistemas Expertos o Sistemas Basados en Conocimiento, aproximadamente en la década de 1960, el uso de estas herramientas se ha extendido de manera extraordinaria. Más allá de las aplicaciones que estas herramientas, derivadas de la Inteligencia Artificial presentan, el análisis del conocimiento disponible acerca del tema sobre las que las mismas son expertas resulta altamente interesante. Su utilidad para la formación de nuevos profesionales es también uno d...

  11. Aprendizaje basado en problemas(ABP) en los alumnos de carreras técnicas

    OpenAIRE

    Minnaard, Claudia; Minnaard, Viviana

    2013-01-01

    El Aprendizaje Basado en Problemas (ABP) es uno de los métodos de enseñanza - aprendizaje que ha tomado más arraigo en las instituciones de educación superior en los últimos años. El camino que toma el proceso de aprendizaje convencional se invierte al trabajar en el ABP. Mientras tradicionalmente primero se expone la información y posteriormente se busca su aplicación en la resolución de un problema, en el caso del ABP primero se presenta el problema, se identifican las necesidades de aprend...

  12. Test basado en sensores de corriente internos para circuitos integrados mixtos (analógicos-digitales)

    OpenAIRE

    Mozuelos García, Román

    2009-01-01

    RESUMEN: En esta tesis se propone un método de diseño para test orientado hacia circuitos mixtos empotrados. El método de test está basado en el análisis del consumo de corriente dinámica (IDDX) tanto estacionaria como transitoria. Con objeto de procesar adecuadamente la información de los transitorios de corriente, la medida se efectúa internamente integrando dentro del chip un bloque sensor de corriente (BICS) junto al circuito bajo test (CUT). Se ha desarrollado una estructura del módul...

  13. Europea Party Run: el aprendizaje basado en proyectos llevado a la vida real

    OpenAIRE

    Mattera, Marina; Lacalle Muñoz de Cuerva, Luis; Campo Cabal, Juan Manuel

    2014-01-01

    El presente trabajo se establece en el marco de la Teoría del Aprendizaje Experimental, y tiene su base en la implantación de un proyecto colaborativo. Concretamente, el aprendizaje basado en proyectos en este caso se erige en torno a la organización de una carrera con fines lúdicos dentro del campus universitario de la Universidad Europea de Madrid. En este contexto, los alumnos han tenido que realizar una previa investigación de mercado, un análisis de recursos, un estudio de...

  14. Experiencia docente mediante la Metodología de Aprendizaje Basado en Problemas

    OpenAIRE

    José Manuel López-Guede

    2015-01-01

    En este artículo se describe una experiencia docente de implantación de Aprendizaje Basado en Problemas (ABP) llevada a cabo en la Escuela Universitaria de Ingeniería de Vitoria-Gasteiz, de la Universidad del País Vasco (UPV/EHU). La asignatura objeto de la implantación ha sido Arquitectura de Computadores, del Grado en Ingeniería Informática de Gestión y Sistemas de Información. En el artículo se recogen los elementos principales a considerar en toda implantación como son las competencias es...

  15. El enfoque educativo basado en competencias, un reto que enfrenta la Universidad Veracruzana

    OpenAIRE

    Adoración Barrales Villegas

    2012-01-01

    Este artículo tiene como propósito compartir la experiencia que ha tenido la Universidad Veracruzana en la promoción e implementación del enfoque educativo basado en competencias. La incorporación obedece a la demanda internacional de formar profesionistas competentes en los ámbitos profesional, personal y social.Una de las acciones relevantes ha sido la capacitación de su personal docente y la implementación de una estrategia denominada Proyecto Aula. Este proyecto va dirigido a sistematizar...

  16. Modelo de Comportamiento de Conductores de Automóviles Usando Razonamiento Basado en Contextos Modelo de Comportamiento de Conductores de Automóviles Usando Razonamiento Basado en Contextos

    Directory of Open Access Journals (Sweden)

    Maureen Murillo

    2003-12-01

    Full Text Available This article shows the results of a research project in the area of Artificial intelligence, specifically in the field of the representation of the human knowledge. It presents a conceptual or theoretical model of the behavior of automobile drivers, whose development is based on the representation paradigm called Context-based Reasoning (CxBR. The model is based on the profile of a Costa Rican automobile driver with certain characteristics, constituting itself thus in a model example to develop future simulations of vehicular traffic in other countries. The article presents a description of the paradigm Context-base Reasoning and then it exposes the conceptual model of automobile drivers’ behavior. En este artículo se exponen los resultados de un proyecto de investigación en el área de Inteligencia Artificial, específicamente en el campo de la representación del conocimiento humano. Se presenta un modelo conceptual o teórico del comportamiento de conductores de automóviles, cuyo desarrollo está basado en el paradigma de representación llamado Razonamiento Basado en Contextos (CxBR – Context-Based Reasoning. El modelo está basado en el perfil de un conductor de Costa Rica con ciertas características, constituyéndose así en un modelo ejemplo para desarrollar futuras simulaciones de tráfico vehicular en otros países. El artículo presenta una descripción del paradigma de Razonamiento Basado en Contextos y luego expone el modelo conceptual del comportamiento de un conductor. En este artículo se exponen los resultados de un proyecto de investigación en el área de Inteligencia Artificial, específicamente en el campo de la representación del conocimiento humano. Se presenta un modelo conceptual o teórico del comportamiento de conductores de automóviles, cuyo desarrollo está basado en el paradigma de representación llamado Razonamiento Basado en Contextos (CxBR – Context-Based Reasoning. El modelo está basado en el perfil

  17. Generación de sistemas basados en reglas mediante programación genética

    OpenAIRE

    Font Fernández, José María

    2008-01-01

    El objetivo fundamental de esta tesis de fin de máster es la construcción de un algoritmo de generación automática de sistemas basados en reglas mediante técnicas evolutivas, y su aplicación a la resolución del problema de detección de lesiones de rodilla a partir de curvas isocinéticas. Se presentan dos técnicas diferentes de generación de sistemas basados en reglas a través de programación genética guiada por gramáticas: la primera genera directamente sistemas basados en reglas y la seg...

  18. Coil embolization in precommunicating (A1) segment aneurysms of anterior cerebral artery

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Young Dae; Ahn, Jun Hyong; Jung, Seung Chai; Kim, Chang Hun [Seoul National University Hospital, Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Kang, Hyun-Seung; Kim, Jeong Eun [Seoul National University Hospital, Seoul National University College of Medicine, Department of Neurosurgery, 28 Yongon-dong, Jongno-gu, Seoul (Korea, Republic of); Son, Young Je [Seoul National University Boramae Hospital, Seoul National University College of Medicine, Department of Neurosurgery, Seoul (Korea, Republic of); Han, Moon Hee [Seoul National University Hospital, Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Hospital, Seoul National University College of Medicine, Department of Neurosurgery, 28 Yongon-dong, Jongno-gu, Seoul (Korea, Republic of)

    2014-03-15

    Precommunicating (A1) segment aneurysms of the anterior cerebral artery are rare and often pose technical challenges for coil embolization due to their distinctive configurations. Clinical and radiologic outcomes of treating such aneurysms through endovascular coil embolization are presented herein. Data accruing prospectively from May 2002 to August 2013 yielded 48 patients harboring 50 A1 segment aneurysms, each classified as proximal, middle, or distal by location. Clinical outcome of the patients and morphological outcome of the aneurysms were assessed, with emphasis on technical aspects of treatment. The aneurysms studied occupied either proximal (n = 39), middle (n = 6), or distal (n = 5). Proximal aneurysms were largely directed posteriorly (80 %), and most (97 %) were devoid of branches. Middle and distal aneurysms were associated with the medial lenticulostriate artery, cortical branches, or fenestrations. The preshaped ''S'' and steam-shaped ''S'' microcatheters facilitated aneurysm selection in 60 % of lesions. Single-microcatheter technique was most commonly applied for coil embolization (62 %), followed by balloon protection (16 %). Successful aneurysmal occlusion could be achieved in 76 % of the patients, with no procedure-related morbidity and mortality. At final follow-up (mean interval, 29.9 months), stable aneurysmal occlusion was sustained in 93 % of the patients (40/43). A1 segment aneurysms are amenable to safe and efficacious endovascular coil embolization by adjusting procedural strategy to accommodate distinctive anatomic configurations. (orig.)

  19. Elastic Knee Sleeves Limit Anterior Tibial Translation in Healthy Females

    Directory of Open Access Journals (Sweden)

    Robert Csapo, Simona Hosp, Ramona Folie, Robert Eberle, Michael Hasler, Werner Nachbauer

    2016-03-01

    aspect of the shank, just distal of the patella, recorded the anterior displacement of the tibia. Displacements were continuously recorded but only the discrete values coinciding with 50, 100, 150, 200 and 250 N were extracted for statistical analyses. The GNRB® system features a measurement accuracy of 0.1 mm and has been shown to be a valid tool for measurements of anterior knee laxity (Jenny et al., 2013. To control inadvertent coactivation of hamstring muscles, which may bias the results of arthrometry measurements (Steele et al., 1994, the integrated electromyographic (EMG activity of the biceps femoris and semitendinosus muscle was simultaneously recorded and normalized to additional recordings obtained during maximal voluntary contraction (MVC. These tests confirmed that, during arthrometry measurements, the EMG activities of biceps femoris and semitendinosus muscle were negligible and remained below 3% of MVC levels at all times. To assess measurement reliability, tests were repeated twice under both experimental conditions: first without and then after application of a light elastic knee sleeve (Cellacare Genu, Lohmann & Rauscher, Rengsdorf, Germany. According to the manufacturer’s information, this sleeve can be used for a variety of indications including injury prevention. Test-retest reliability of arthrometry measurements was excellent, as reflected by low typical measurement errors (0.08 mm and high correlation coefficients (r = 0.99, p < 0.001. Analysis of results (Figure 1 by factorial ANOVA revealed that the elastic sleeve tested in this study reduced the anterior displacement of the tibia by a small (max. 0.7 mm on average yet statistically significant amount (F(1,9 = 22.88, p = 0.001, r = 0.98. In an attempt to better understand the degree of protection provided by the sleeve, we determined its material properties by appending weight discs (2.5-15 kg, in steps of 2.5 kg to its dorsal aspect and measuring the resulting elongation. The resulting force

  20. AO distal radius volar plate fixation for AO type C distal radius fracture

    International Nuclear Information System (INIS)

    We applied a volar AO distal radius plate for AO type C fractures of the distal radius. The subjects included 1 man and 12 women, and their mean age at the time of surgery was 62 years. The mean follow-up period was 10 months. According to the AO classification, 3 cases were C2, 7 cases were C3-1, and 3 cases were C3-2. Union was achieved in all cases. Wrist function was evaluated using the modified Mayo wrist scoring system. The functional results were excellent in 7 cases, good in 4 cases, and fair in 2 cases. To evaluate the strength of the initial fixation and the accuracy of joint surface reduction after surgery, palmar tilt, ulnar variance, and radial inclination were measured from radiographs that were taken before surgery, immediately after surgery, and at the final follow-up examination, and from CT scan images taken at the final follow-up examination. In 3 cases, correction losses included poor initial fixation and joint surface reduction, and all 3 were AO C3-2 fractures. These cases had comminuted fragments, both volar and dorsal metaphysic, and lunate fossa fragments. A volar locking plate fixation that can support the articular surface should be applied to AO C2 and C3-1 fractures. However, in the absence of bone grafting, it should not be applied to AO C3-2 fractures because it is very difficult not only to reduce the concave lunate fossa fragments but also to fix the fragments to the volar metaphysis. (author)

  1. Comparative studies of locking volar plates for distal radius fracture. Concerning the site of insertion of distal screw

    International Nuclear Information System (INIS)

    Studies in the title were performed with 5 products of the locking volar plate (LVP) for the fracture of which frequency having been raised along with the elderly population increase, by evaluation through multi-slice CT images. Plates employed were ACU-LOC DISTAL RADIUS SYSTEM standard (I) or narrow (II) (KOBAYASHI pharmaceutical), Locking Voral Plate System (III) (Nakashima Medical), Matrix SmartLock (IV) (Stryker) and Locking Distal Radius System 2.4 (V) (Synthes), which were fixed with the artificial left distal radial bone (SAWBONES) at the optimal position (the distal screws were positioned as close as possible to the joint surface) through discussion by 3 orthopedists and a manufacturer in charge. CT was conducted with Toshiba Aquilion 16 and by the workstation M900 QUADRA (ZIOSOFT), multi-planar images were reconstructed along the parallel axis to the distal screw. Plates were compared for their thickness, width, anatomical feature, water shed line, angle between plate and distal screw, number of screws, diameter, and surgical feature. The lateral view of joint supporting portion gave the position of I and II plates to be near the center, III and IV, slightly dorsal and V, slightly palmar. Understanding these features of plate, and its most appropriate choice and insertion were concluded important for improved outcome and prevention of complication. (K.T.)

  2. The in vivo assessment of tibial motion in the transverse plane in anterior cruciate ligament-reconstructed knees.

    Science.gov (United States)

    Nordt, W E; Lotfi, P; Plotkin, E; Williamson, B

    1999-01-01

    Twenty-one knees with acutely injured anterior cruciate ligaments were reconstructed with patellar tendon autografts. Eight of the knees had concomitant medial ligament injuries that were not addressed surgically. Follow-up evaluation (average, 25 months) included computed tomography measurements to analyze transverse-plane laxity in both translation and rotation. These measurements were performed with the patient's leg in a load cell device that stabilizes the distal femur and applies known anterior translational force to the proximal tibia at approximately 20 degrees of flexion. A torque apparatus was used to apply internal and external rotational torque to the leg. Images of the tibial plateau in neutral, internal, and external rotation were performed, with and without an anterior translational force. Both knees of each patient were tested and categorized as group I (anterior cruciate ligament-reconstructed) or group II (uninjured). Translation as measured by computed tomography averaged 1 mm side-to-side difference. Internal rotation averaged 8.7 degrees in group I knees and 10.8 degrees in group II knees. External rotation averaged 9.1 degrees in group I knees and 7.4 degrees in group II knees. The eight knees with concomitant medial ligament injuries were analyzed separately; external rotation without anterior load in group I was 9.5 degrees, compared with 5 degrees in group II. This difference was significant (P < 0.01). PMID:10496578

  3. Juegos Educativos Móviles basados en posicionamiento: una guía para su conceptualización

    OpenAIRE

    Lliteras, Alejandra Beatriz; Challiol, Cecilia; Gordillo, Silvia Ethel

    2012-01-01

    Los Juegos Educativos Móviles basados en posicionamiento constituyen un tipo particular de Aplicación Móvil y cuentan con características propias que los identifican. Son creados con objetivos educativos y se emplean como una herramienta en el proceso de aprendizaje por considerarse un elemento motivador para el alumno en dicho proceso. En este trabajo se propone una Guía para la Conceptualización de Juegos Educativos Móviles basados en posicionamiento. Esta conceptualización contempla dos ca...

  4. Hidrogeles basados en poloxámeros con estructura de estrella para liberación controlada de sustancias activas

    OpenAIRE

    Parra Ruiz, Jesús; San Román, Julio; Rodríguez Alonso, Lucena; Herrero Vanrell, María del Rocio; Vázquez Lasa, Blanca

    2009-01-01

    Hidrogeles basados en poloxámeros con estructura de estrella para liberación controlada de sustancias activas. La presente invención describe un compuesto basado en poloxámeros y un hidrogel que comprende estos compuestos, así como el uso de estos hidrogeles como vehículos para la administración de sustancias activas o como adyuvantes en composiciones farmacéuticas, especialmente en las que se administran por vía tópica ocular

  5. Anterior retropharyngeal approach to the cervical spine.

    OpenAIRE

    Behari S; Banerji D; Trivedi P; Jain V; Chhabra D

    2001-01-01

    The anterior retropharyngeal approach (ARPA) accesses anteriorly situated lesions from the clivus to C3, in patients with a short neck, Klippel Feil anomaly or those in whom the C2-3 and C3-4 disc spaces are situated higher in relation to the hyoid bone and the angle of mandible where it is difficult to approach this region using the conventional anterior approach, due to the superomedial obliquity of the trajectory. The ARPA avoids the potentially contaminated oropharyngeal cavity providing ...

  6. Mini-open anterior lumbar interbody fusion.

    Science.gov (United States)

    Gandhoke, Gurpreet S; Ricks, Christian; Tempel, Zachary; Zuckerbraun, Brian; Hamilton, D Kojo; Okonkwo, David O; Kanter, Adam S

    2016-07-01

    In deformity surgery, anterior lumbar interbody fusion provides excellent biomechanical support, creates a broad surface area for arthrodesis, and induces lordosis in the lower lumbar spine. Preoperative MRI, plain radiographs, and, when available, CT scan should be carefully assessed for sacral slope as it relates to pubic symphysis, position of the great vessels (especially at L4/5), disc space height, or contraindication to an anterior approach. This video demonstrates the steps in an anterior surgical procedure with minimal open exposure. The video can be found here: https://youtu.be/r3bC4_vu1hQ . PMID:27364424

  7. Distal Ulna Reconstruction using the Second Metatarsal: Anatomical Study.

    Science.gov (United States)

    Cavadas, Pedro C; Thione, Alessandro; Martinez, Isabel Elía

    2016-05-01

    Background The ulnar head is a key stabilizer of the wrist and forearm. The authors investigated the possibility of using the second metatarsal bone to replace the distal ulna in an anatomical study. Methods The morphology of the distal ulna and the head of the second metatarsal (MT2) were studied using three-dimensional computerized tomographic (CT) scans of the wrist and foot in 52 patients without pathology related to these two areas, and 11 cadaveric specimens. The radius and height of the best-fit cylinder for both epiphyses were measured in the CT scans and compared. In the cadaveric specimens an osteotomy of the metatarsal neck was performed to rotate 90 degrees the head of the MT2 to match the shape of the distal ulna. Results The osseous morphology of the distal ulna and the head of the MT2 are roughly cylindrical, but differently oriented relative to the diaphyseal axes. In the osteotomized cadaveric MT2specimens, the overall morphology was relatively similar that of the distal ulna. The mean length of the MT2 after the osteotomy was 65 mm. Conclusion The head of the MT2 was found to have a similar cylindrical morphology to that of the ulnar head, with a different orientation. The radius of the cylinder was similar, although the height was bigger for the MT2. After a rotation osteotomy of the neck of the MT2 the overall shape and orientation of the epiphysis was more similar to the distal ulna. A vascularized transfer of an osteotomized MT2 would be an option for autologous reconstruction of the distal ulna in selected patients, but further study is needed in terms of the vascular supply, ligamentous reconstruction, and reconstruction of the sigmoid notch. Level of Evidence Therapeutic, level IV. PMID:27104084

  8. Objective measurement of the distal resection margin by MRI of the fresh and fixed specimen after partial mesorectal excision for rectal cancer

    DEFF Research Database (Denmark)

    Bondeven, Peter; Hagemann-Madsen, Rikke H; Bro, Lise;

    2015-01-01

    measure the length of the distal resection margin in the fresh and fixed specimen following partial mesorectal excision for rectal cancer using magnetic resonance imaging (MRI) to document tissue shrinkage after surgical removal and fixation. MATERIAL AND METHODS: The length of the distal resection margin...... was measured by MRI of the fresh and fixed specimen and at histopathological examination of the fixed specimen in 10 patients who underwent surgery for upper rectal cancer. In addition, tissue shrinkage was estimated by measuring the total length of the fresh and fixed specimen and distance from the...... peritoneal reflection anteriorly to the distal cut edge of the specimen. RESULTS: Measured by MRI, the distal resection margin was in the range of 0.6-10.2 cm (mean, 4.6 cm) in the fresh specimen, and 0.5-6.2 cm (mean, 3.2 cm) in the fixed specimen. The tissue shrinkage ratio was a mean of 69% (interquartile...

  9. Influence of Implant Position on Stress Distribution in Implant-Assisted Distal Extension Removable Partial Dentures: A 3D Finite Element Analysis.

    Directory of Open Access Journals (Sweden)

    Yeganeh Memari

    2014-10-01

    Full Text Available Distal extension removable partial denture is a prosthesis with lack of distal dental support with a 13-fold difference in resiliency between the mucosa and the periodontal ligament, resulting in leverage during compression forces. It may be potentially destructive to the abutments and the surrounding tissues. The aim of this study was to assess the effect of implant location on stress distribution, in distal extension implant assisted removable partial dentures.Three-dimensional models of a bilateral distal extension partially edentulous mandible containing anterior teeth and first premolar in both sides of the arch, a partial removable denture and an implant (4×10mm were designed. With the aid of the finite element program ANSYS 8.0, the models were meshed and strictly vertical forces of 10 N were applied to each cusp tip. Displacement and von Mises Maps were plotted for visualization of results.When an implant was placed in the second premolar region, the highest stress on implant, abutment tooth and cancellous bone was shown. The lowest stress was shown on implant and bone in the 1(st molar area.Implants located in the first molar area showed the least distribution of stresses in the analyzed models.

  10. Impact of posterior tibial nail malpositioning on iatrogenic injuries by distal medio-lateral interlocking screws. A cadaveric study on plastinated specimens.

    Science.gov (United States)

    Wegmann, Kilian; Burkhart, Klaus Josef; Buhl, Jörg; Gausepohl, Thomas; Koebke, Jürgen; Müller, Lars Peter

    2012-12-01

    In intramedullary tibial nailing, multi-planar locking makes stabilization of proximal and distal metaphyseal fractures possible. A known complication in intramedullary nailing of the tibia is iatrogenic injury to neuro-vascular structures caused by the insertion of locking screws. As shown in previous studies, the distal positioning of the nail is important, as it determines the course of the locking bolts. The goal of the present study was to display the consequences of posterior nail malpositioning with respect to the safety of the distal medio-lateral locking screws and the available options. Human cadaveric legs were plastinated according to the sequential plastination technique after intramedullary nailing of the tibia and were then cut transversely. The tibial nails were placed centrally or posteriorly. Macroscopic analysis showed a distinct drawback of posterior nail positioning, with diminished options for the placement of the locking screws and thereby a risk of damaging the anterior and posterior neuro-vascular bundles by distal medio-lateral locking screws. PMID:23409576

  11. Age Related Normal Variants of Growth Plates at Distal Femur and Proximal Tibia: Scintigraphic Patterns

    International Nuclear Information System (INIS)

    The skeleton is a dynamic structure that changes during the normal physiological processes of growth and remodeling as well as in response to pathological insult. In infants and children, it is well recognized that bone-seeking tracer accumulates in greater amounts in the growth plates of immature skeleton. Scintigraphic appearance of the normal growth plate changes with age. Full investigation of age-related patterns of growth plate's uptake on bone scintigraphy has not been reported. The objective of this study is to evaluate age related pattern of distal femur and proximal tibia growth plates in children on bone scintigraphy. A retrospective analysis of bone scans for pediatric age group. Anterior and posterior views of the whole-body scan were visually reviewed by two nuclear medicine physicians to establish characteristics of the growth plates in the distal femur and proximal tibia. Of particular interest was the shape of the plate, segmental pattern of radiotracer uptake through the plate. Quantitative assessment was done to support visual assessment findings. Eighty-nine patients were found during the specified period. Various patterns of growth plate's uptake were recognized in different age groups. In the infant and children below age of five, the plate appears oval shaped with uniform uptake. Later it becomes linear with specific pattern of nonuniform uptake till the age of ten. In adolescence, additionally the majority of cases show a specific pattern of biconcave and nonuniform uptake. After the age of fifteen, the plates show progressive fading of activity with gender difference. Excellent agreement was obtained between visual and quantitative assessment regarding the segmental uptake of the plate. Conclusion: Age-related patterns of growth plate's uptake on bone scintigraphy have been identified. Awareness of these appearances is important since lack of knowledge of these normal variants may lead to misinterpretation of growth plate abnormalities

  12. Translabial ultrasound assessment of the anal sphincter complex: normal measurements of the internal and external anal sphincters at the proximal, mid-, and distal levels.

    Science.gov (United States)

    Hall, Rebecca J; Rogers, Rebecca G; Saiz, Lori; Qualls, C

    2007-08-01

    The purpose of this study was to measure the internal and external anal sphincters using translabial ultrasound (TLU) at the proximal, mid, and distal levels of the anal sphincter complex. The human review committee approval was obtained and all women gave written informed consent. Sixty women presenting for gynecologic ultrasound for symptoms other than pelvic organ prolapse or urinary or anal incontinence underwent TLU. Thirty-six (60%) were asymptomatic and intact, 13 symptomatic and intact, and 11 disrupted. Anterior-posterior diameters of the internal anal sphincter at all levels and the external anal sphincter at the distal level were measured in four quadrants. Mean sphincter measurements are given for symptomatic and asymptomatic intact women and are comparable to previously reported endoanal MRI and ultrasound measurements. PMID:17221149

  13. Secondary anterior crocodile shagreen of Vogt.

    Science.gov (United States)

    Tripathi, R C; Bron, A J

    1975-01-01

    The clincopathological features and pathogenesis of secondary mosaic degeneration of the cornea (anterior crocodile shagreen of Vogt) are described. The structural basis for the normal anterior corneal mosaic pattern seems to lie in the particular arrangement of many prominent collagen lamellae of the anterior stroma that thake an oblique course to gain insertion into Bowman's layer. Since, at normal intraocular pressure, Bowman's layer is under tension, when viewed from the anterior surface the cornea appears smooth. By releasing the tension, however, a reproducible polygonal ridge pattern becomes manifest. It is suggested that a prolonged phthisical state of the eye is one condition wherein the mosaic pattern may become permanent and that, as a secondary event, this is followed by irregular calcification of Bowman's layer which particularly involves the ridges projecting into the epithelium. Biomicroscopically these ridges corresponded to the branching reticular arrangement of the mosaic opacities. Images PMID:1079137

  14. Anterior Cervical Discectomy and Fusion with Plating

    Medline Plus

    Full Text Available Anterior Cervical Discectomy and Fusion with Plating Broward Health Medical Center Fort Lauderdale, FL November 17, 2011 I'm Dr. Matthew Moore, head of the Spine Care Center here at North Broward Medical Center. And ...

  15. Geometric morphometric analysis reveals sexual dimorphism in the distal femur.

    Science.gov (United States)

    Cavaignac, Etienne; Savall, Frederic; Faruch, Marie; Reina, Nicolas; Chiron, Philippe; Telmon, Norbert

    2016-02-01

    An individual's sex can be determined by the shape of their distal femur. The goal of this study was to show that differences in distal femur shape related to sexual dimorphism could be identified, visualized, and quantified using 3D geometric morphometric analysis. Geometric morphometric analysis was carried out on CT scans of the distal femur of 256 subjects living in the south of France. Ten landmarks were defined on 3D reconstructions of the distal femur. Both traditional metric and geometric morphometric analyses were carried out on these bone reconstructions; these analyses identified trends in bone shape in sex-based subgroups. Sex-related differences in shape were statistically significant. The subject's sex was correctly assigned in 77.3% of cases using geometric morphometric analysis. This study has shown that geometric morphometric analysis of the distal femur is feasible and has revealed sexual dimorphism differences in this bone segment. This reliable, accurate method could be used for virtual autopsy and be used to perform diachronic and interethnic comparisons. Moreover, this study provides updated morphometric data for a modern population in the south of France. PMID:26743712

  16. Trypan blue dye for anterior segment surgeries

    OpenAIRE

    Jhanji, V; Chan, E.; Das, S.; Zhang, H; Vajpayee, R B

    2011-01-01

    Use of vital dyes in ophthalmic surgery has gained increased importance in the past few years. Trypan blue (TB) has been a popular choice among anterior segment surgeons mainly due to its safety, ease of availability, and remarkable ability to enable an easy surgery in difficult situations mostly related to visibility of the targeted tissue. It is being used in cataract surgery since nearly a decade and its utilization has been extended to other anterior segment surgeries like trabeculectomy ...

  17. Ejecta emplacement: from distal to proximal

    Science.gov (United States)

    Artemieva, N.

    2008-09-01

    Introduction Most part of impact ejecta is deposited ballistically at some distance from a crater, defined by ejection velocity V and ejection angle α: d=v2sinα/g. In case of giant impacts, planetary curvature should be taken into account [1]. Combined with ejecta scaling [2], these relations allow to define ejecta thickness as a function of distance. Ejecta from large craters are deposited at velocity high enough to mobilize substrate material and to thicken ejecta deposits [3]. Ballistic approximation is valid for airless bodies (if impact vaporization is not vast) or for proximal ejecta of large impact craters, where ejecta mass per unit area is substantially greater than the mass of involved vapor/atmosphere (M-ratio). Deposition of distal ejecta, in which ejecta mass is negligible compared to the atmosphere, may be also treated in a simplified manner, i.e. as 1) passive motion of ejected particles within an impact plume and 2) later, as sedimentation of particles in undisturbed atmosphere (equilibrium between gravity and drag). In all intermediate M-ratio values, impact ejecta move like a surge, i.e. dilute suspension current in which particles are carried in turbulent flows under the influence of gravity. Surges are well-known for near-surface explosive tests, described in detail for volcanic explosions (Plinian column collapse, phreato-magmatic eruption, lateral blast), and found in ejecta from the Chicxulub [4] and the Ries [5]. Important aspects of surge transport include its ability to deposit ejecta over a larger area than that typical of continuous ballistic ejecta and to create multiple ejecta layers. Numerical model Two-phase hydrodynamics. Surges should be modeled in the frame of two-phase hydrodynamics, i.e. interaction between solid/molten particles and atmospheric gas/impact vapor should be taken into account. There are two techniques of solving equations for dust particle motion in a gas flow. The first one describes solid/molten particles as a

  18. Functional Outcomes of Primary Anterior Cruciate Ligament Reconstruction with Tibialis Anterior Allograft

    OpenAIRE

    Başar, Selda; Büyükafşar, Enes; Hazar, Zeynep; Ataoğlu, Baybars; Kanatlı, Ulunay

    2014-01-01

    Objectives: Allografts have potential advantages in primary anterior cruciate ligament reconstruction (ACLR), including the absence of donor site morbidity, shorter operative times, improved cosmesis, and easier rehabilitation. There is limited and conflicting outcome data for ACLR with tibialis anterior allograft. The purpose of this study was to evaluate the functional outcomes of ACLR with tibialis anterior allograft. Methods: We retrospectively evaluated patients underwent ACLR using with...

  19. Anterior Eye Imaging with Optical Coherence Tomography

    Science.gov (United States)

    Huang, David; Li, Yan; Tang, Maolong

    The development of corneal and anterior segment optical coherence tomography (OCT) technology has advanced rapidly in recently years. The scan geometry and imaging wavelength are both important choices to make in designing anterior segment OCT systems. Rectangular scan geometry offers the least image distortion and is now used in most anterior OCT systems. The wavelength of OCT light source affects resolution and penetration. An optimal choice of the OCT imaging wavelength (840, 1,050, or 1,310 nm) depends on the application of interest. Newer generation Fourier-domain OCT technology can provide scan speed 100-1000 times faster than the time-domain technology. Various commercial anterior OCT systems are available on the market. A wide spectrum of diagnostic and surgical applications using anterior segment OCT had been investigated, including mapping of corneal and epithelial thicknesses, keratoconus screening, measuring corneal refractive power, corneal surgery planning and evaluation in LASIK, intracorneal ring implantation, assessment of angle closure glaucoma, anterior chamber biometry and intraocular lens implants, intraocular lens power calculation, and eye bank donor cornea screening.

  20. A STUDY ON TUBERCLE S AT THE ANTERIOR MARGIN OF THE FORAMEN MAGNUM

    Directory of Open Access Journals (Sweden)

    Md. Khaleel

    2014-12-01

    Full Text Available The basilar process of occipital bone is formed by fusion of the first three primitive vertebrae (or occipitoblasts, the most caudal of which is so - called occipital vertebra or pro - atlas. The failure of distal occipitoblasts to fuse with others gives rise to abnormal bone formations on the external surface of skull around foramen magnum, phenomenon called as “ manifestation of occipital vertebra”. Bone anomalies related to failure of segmentation of the most caudal occipital sclerotomes are rare, but have been identified. The anomaly leads to abnormal bone formation in the region of anterior rim of foramen magnum, either in the midline and or laterally. The anomaly has been occasionally referred to as third condyle, remanants of occipital vertebra, un - formed bon e masses on the anterior rim of foramen magnum and prebasi - occipital arch in combination with an odontoid bone. The basiocciput of 100 Indian adult human skulls were examined for the presence of precondylar tubercles, which are single or paired osseous formations anterior to the occipital condyles and foramen magnum. Out of these 100 skulls , one skull displayed unilateral tubercle and the other bilateral tubercles.

  1. Distal myopathy with rimmed vacuoles: Report on clinical characteristics in 23 cases

    Directory of Open Access Journals (Sweden)

    Nalini A

    2010-01-01

    Full Text Available Background: Distal myopathy with rimmed vacuoles (DMRV is an autosomal recessive (AR myopathy characterized clinically by the preferential involvement of the tibialis anterior and has been reported predominantly in the Japanese population. Materials and Methods: A case series of DMRV patients seen over a period of 3 years at a tertiary national referral center for neurological disorders in south India. Results: We describe the clinical characteristics, muscle magnetic resonance imaging (MRI findings and classical histopathological feature in 23 patients. There were 12 men and 11 women. Mean age of onset was 27.04 ± 6.35 years (10-39 years. Onset was in the second or third decade in a majority. Mean age at presentation was 33.95 ± 6.35 years (25-48 years. Mean duration of illness was 6.74 ± 4.8 years (1-18 years. Consanguinity was reported in eight (34.8% patients. The predominant and initial manifestation was bilateral foot drop in all patients. Muscle MRI demonstrated classical involvement of the anterior compartment muscles of the lower legs and the posterior compartment muscles of the thighs and the quadriceps was normal in all. Muscle histopathology showed numerous fibers containing rimmed vacuoles. Necrotic fibers or phagocytosis or regenerating fibers were rarely noted or were absent. Conclusions: DMRV is a rare AR myopathy. The disorder presents as progressive foot drop and hence has many differential diagnoses. It is easily mistaken as neuropathy of hereditary nature and hence it is extremely important to recognize the preferential muscle involvement and characterize the phenotype. This is the first report from India with patients having characteristic phenotype of Nonaka′s/AR hereditary inclusion body myopathy with quadriceps sparing, and all were confirmed by histopathology.

  2. Management of radionecrosis of the vulva and distal vagina

    International Nuclear Information System (INIS)

    Twelve patients were seen between January 1983 and June 1989 with the clinical diagnosis of radionecrosis of the vulva or distal vagina. Seven patients received radiation for vulvar cancer, three for distal vaginal cancer, and two for recurrent endometrial cancer. No patient healed spontaneously and the mean delay in surgical therapy was 8.5 months. The radionecrotic site was treated with local therapy, radical local excision (with or without colostomy), or exenteration. The operative defect was closed primarily in three patients and covered with local flaps or myocutaneous flaps in seven patients. The two patients with local care still have radionecrotic ulcers. One of three patients who were closed primarily continues to have an ulcer. All other patients have healed satisfactorily except one who died after two attempts to correct the problem. Radionecrosis of the vulva and distal vagina should generally be treated surgically

  3. Management of radionecrosis of the vulva and distal vagina

    Energy Technology Data Exchange (ETDEWEB)

    Roberts, W.S.; Hoffman, M.S.; LaPolla, J.P.; Ruas, E.; Fiorica, J.V.; Cavanagh, D. (Univ. of South Florida, Tampa (USA))

    1991-05-01

    Twelve patients were seen between January 1983 and June 1989 with the clinical diagnosis of radionecrosis of the vulva or distal vagina. Seven patients received radiation for vulvar cancer, three for distal vaginal cancer, and two for recurrent endometrial cancer. No patient healed spontaneously and the mean delay in surgical therapy was 8.5 months. The radionecrotic site was treated with local therapy, radical local excision (with or without colostomy), or exenteration. The operative defect was closed primarily in three patients and covered with local flaps or myocutaneous flaps in seven patients. The two patients with local care still have radionecrotic ulcers. One of three patients who were closed primarily continues to have an ulcer. All other patients have healed satisfactorily except one who died after two attempts to correct the problem. Radionecrosis of the vulva and distal vagina should generally be treated surgically.

  4. Hemangioma of the distal phalanx in a colt

    International Nuclear Information System (INIS)

    A yearling Thoroughbred colt was admitted to the University of Florida College of Veterinary Medicine with severe, progressive lameness of the left forelimb. A centrally located expansile lytic lesion involving approximately 40% of the distal phalanx with a large associated vascular channel was identified by radiography. Increased vascular phase pooling, increased soft tissue phase uptake, and a photopenic area on bone phase images corresponding to the lytic lesion within the left distal phalanx were identified by vascular, soft tissue, and bone phases of a three phase bone scan, respectively. Contrast medium accumulation and disappearance in dilated vessels within the lesion was apparent angiographically. The colt was euthanized and the histologic diagnosis was hemangioma of the distal phalanx with a pathologic fracture

  5. Lesiones del ligamento cruzado anterior

    Directory of Open Access Journals (Sweden)

    Alejandro Álvarez López

    2015-01-01

    Full Text Available Fundamento: el ligamento cruzado anterior desempeña un papel muy importante en la estabili-dad de la rodilla. La incidencia de esta afección es alta en pacientes que practican deportes de contacto y de no ser tratados de forma adecuada, los resultados son desfavorables. Objetivo: profundizar en los factores necesarios para el tratamiento adecuado de enfermos con esta lesión y evitar las complicaciones. Método: se realizó una revisión bibliográfica de un total de 300 artículos publicados en Pubmed, Hinari y Medline mediante el localizador de información Endnote, de ellos se utilizaron 52 citas selecciona-das para realizar la revisión, 48 de ellas de los últimos cinco años donde se incluyeron seis libros. Desarrollo: se discuten los aspectos relacionados con el diagnóstico clínico e imaginológico. Se aborda la clasificación de esta lesión en cuanto a varios aspectos como: tiempo, lesión de ligamentos u ósea, aislada o combinada y parcial o total. Se mencionan los parámetros para obtener resultados satisfac-torios al considerar factores como la edad del enfermo, lesiones asociadas y tiempo de la lesión. Se relacio-nan los requisitos para la selección del implante y se mostró las ventajas y desventajas de cada tipo de in-jerto. Las complicaciones de esta cirugía están relacionadas con la técnica quirúrgica y médicas. Conclusiones: las lesiones del ligamento son entidades traumáticas que afectan por lo general a pacientes jóvenes. Para lograr un resultado satisfactorio en el tratamiento es necesario el conocimiento de su anatomía, clasificación, tipo de injerto a emplear según sus ventajas y desventajas.

  6. Videojuego de rol táctico de estética retro basado en combates por turnos

    OpenAIRE

    García García, Juan de la Cruz

    2010-01-01

    Videojuego de rol basado en combates por turnos con estética retro, de nombre comercial TierraCuadrada, donde el jugador podrá llevar a cabo partidas en modo historia, involucrando combates con la Inteligencia Artificial, y partidas contra rivales humanos.

  7. Introducción al aprendizaje basado en problemas: Una guía para el alumnado

    OpenAIRE

    Vera Giménez, Jesús Manuel

    2012-01-01

    Manual para uso del alumnado que les permite familiarizarse con los procedimientos utilizados en las asignaturas impartidas por el profesor autor del manual y que se centra en el enfoque conocido como Aprendizaje Basado en Problemas. Se describen los pasos a seguir, los procedimientos y los aspectos de habilidades personales a poner en marcha y/o adquirir por el alumnado.

  8. Management of distal femoral periprosthetic fractures by distal femoral locking plate: A retrospective study.

    Directory of Open Access Journals (Sweden)

    Rajiv Thukral

    2015-01-01

    Full Text Available Background: Management of periprosthetic supracondylar femoral fractures is difficult. Osteoporosis, comminution and bone loss, compromise stability with delayed mobility and poor functional outcomes. Open reduction and internal fixation (ORIF with anatomic distal femoral (DF locking plate permits early mobilization. However, this usually necessitates bone grafting (BG. Biological fixation using minimally invasive techniques minimizes periosteal stripping and morbidity. Materials and Methods: 31 patients with comminuted periprosthetic DF fractures were reviewed retrospectively from October 2006 to September 2012. All patients underwent fixation using a DF locking compression plate (Synthes. 17 patients underwent ORIF with primary BG, whereas 14 were treated by closed reduction (CR and internal fixation using biological minimally invasive techniques. Clinical and radiological followup were recorded for an average 36 months. Results: Mean time to union for the entire group was 5.6 months (range 3-9 months. Patients of ORIF group took longer (Mean 6.4 months, range 4.5-9 months than the CR group (mean 4.6 months, range 3-7 months. Three patients of ORIF and one in CR group had poor results. Mean knee society scores were higher for CR group at 6 months, but nearly identical at 12 months, with similar eventual range of motion. Discussion: Locked plating of comminuted periprosthetic DF fractures permits stable rigid fixation and early mobilization. Fixation using minimally invasive biological techniques minimizes morbidity and may obviate the need for primary BG.

  9. Locking plates in distal humerus fractures: study of 43 patients

    Directory of Open Access Journals (Sweden)

    Gupta Rakesh Kumar

    2013-08-01

    Full Text Available 【Abstract】Objective: The treatment of multi-fragmentary, intraarticular fractures of the distal humerus is difficult, even in young patients with bone of good quality. Small distal fragment, diminished bone mineral quality and increased trauma-associated joint destruction make stable joint reconstruction more problematic. The anatomically preshaped locking plates allow angular stable fixation for these complex fractures. We evaluated functional results of patients treated with open reduction and internal fixation with distal humerus locking plates for complex distal hu-merus fractures. Methods: Forty-three consecutive patients with ar-ticular fractures of the distal humerus were treated by open reduction and internal fixation with AO distal humerus plate system and locking reconstruction plates. Forty patients were available for the final outcome analysis. According to AO/ASIF classification, there were 2 cases of type A2, 4 cases of type A3, 1 case of type B1, 1 case of type B2, 14 cases of type C1, 7 cases of type C2 and 11 cases of type C3. Open reduction with triceps splitting technique was used in all patients. The clinical and radiographic follow-up was performed and outcome measures included pain assessment, range of motion, and Mayo elbow performance score. Results: Forty patients were available for the final outcome analysis. There were 29 males and 11 females with an average age of 38.4 years (18-73 years. Clinical and ra-diological consolidation of the fracture was observed in all cases at an average of 11.6 weeks (9-14 weeks. The average follow-up was 12 months (10-18 months. Using the Mayo elbow performance score the results obtained were graded as excellent or good results in 33 patients (82.5%. One pa-tient had superficial infection, and 4 had myositis ossificans. There were no cases of primary malposition or secondary displacement, implant failure or ulnar neuropathy. Conclusion: Anatomically preshaped distal humerus locking

  10. Distal renal tubular acidosis and amelogenesis imperfecta: A rare association.

    Science.gov (United States)

    Ravi, P; Ekambaranath, T S; Arasi, S Ellil; Fernando, E

    2013-11-01

    Renal tubular acidosis (RTA) is characterized by a normal anion gap with hyperchloremic metabolic acidosis. Primary distal RTA (type I) is the most common RTA in children. Childhood presentation of distal RTA includes vomiting, failure to thrive, metabolic acidosis, and hypokalemia. Amelogenesis imperfecta (AI) represents a condition where the dental enamel and oral tissues are affected in an equal manner resulting in the hypoplastic or hypopigmented teeth. We report a 10-year-old girl, previously asymptomatic presented with the hypokalemic paralysis and on work-up found out to have type I RTA. The discoloration of teeth and enamel was diagnosed as AI. PMID:24339526

  11. Lower leg electrical impedance after distal bypass surgery

    DEFF Research Database (Denmark)

    Belanger, G K; Bolbjerg, M L; Heegaard, N H; Wiik, A; Schroeder, T V; Secher, N H

    1998-01-01

    Electrical impedance was determined in 13 patients following distal bypass surgery to evaluate lower leg oedema as reflected by its circumference. Tissue injury was assessed by the plasma concentration of muscle enzymes. After surgery, the volume of the control lower leg increased from 1250 (816...... concentration of troponin I (n = 8). In conclusion, tissue injury was reflected by increases in muscle enzymes in plasma. We found an inverse correlation between lower leg electrical impedance and volume, but the deviation in electrical impedance was approximately twice that of the leg volume. Electrical...... impedance appears to be a useful method for the evaluation of lower leg oedema after distal bypass surgery....

  12. Neglected Distal Humeral Epiphyseal Injury - Two Case Reports

    Directory of Open Access Journals (Sweden)

    Dr. Pankaj Kumar

    2008-07-01

    Full Text Available Distal humeral epiphyseal separation is an uncommon injury in children, which can be missed or misdiagnosed at initial presentation. Awareness of this injury and appropriate radiological assessment helps in proper management. Neglected cases because of inappropriate diagnosis can result in cubitus varus deformity. Full range of movements of elbow can be achieved if properly diagnosed and managed. We present two cases of neglected distal humeral epiphyseal injury in children that resulted in cubitus varus deformity in one case. Full range of movements was achieved in both cases after proper management.

  13. Distally based superficial sural artery flap for soft tissue coverage in the distal 2/3 of leg and foot

    Directory of Open Access Journals (Sweden)

    Kamath B

    2005-01-01

    Full Text Available Background: Skin coverage for defects in the lower 2/3 of leg, ankle region and posterior heel has always been a difficult challenge for reconstructive surgeon. Methods: We describe our experience with the distally based superficial sural artery flap coverage in 48 patients with moderate sized defects in these difficult areas. Results: One out of 48 flaps (in 48 patients was lost totally and 3 suffered marginal necrosis which did not require any secondary procedure. These complications could have been avoided by proper selection of cases and refining technical skills. Conclusion: This simple procedure could be an important and versatile tool for any reconstructive surgeon in providing skin coverage in the distal leg and proximal foot. Preservation of major arteries of the lower limb, minimal donor defect, relatively uninjured donor area in compound fracture or poly trauma involving distal leg are some of the advantages of the flap.

  14. Reparación del ligamento cruzado anterior en rodillas con alto potencial de crecimiento. Estudio experimental

    OpenAIRE

    Calvente Nomdedeu, Alejandro

    2005-01-01

    RESUMEN INTRODUCCIÓN La rotura del ligamento cruzado anterior en individuos con fisis abiertas, aparece en edades cada vez más tempranas, con frecuencia creciente. Una reparación anatómica, con un riesgo mínimo de lesión fisaria, sería la técnica ideal. OBJETIVOS Principal: 1ª Parte: estudiar el efecto de la perforación transfisaria femoral distal en individuos con alto potencial de crecimiento y el posible efecto protector del injerto tendinoso. 2ª Parte: investigar las variacion...

  15. Perfiles de cargos basados en competencias para la empresa Fabega S.A.S.

    OpenAIRE

    Pérez Bolaños, Gretty Yohanna; Marulanda Vélez, Milena

    2012-01-01

    El presente trabajo está orientado a la estructuración de los perfiles de cargos administrativos y operativos basados en competencias, para la empresa FABEGA S.A.S – Planeta Sport, a través de métodos de investigación que permitan evaluar el estado actual e intervenir en los procesos, los cuales darán lugar a la implementación de los perfiles por competencias. Esta investigación se cimentará a partir del análisis y descripción de la problemática a resolver, la cual definirá los métodos, técn...

  16. LA EPISTEMOLOGÍA Y LOS SISTEMAS DE INFORMACIÓN BASADOS EN INTELIGENCIA ARTIFICIAL

    Directory of Open Access Journals (Sweden)

    Miguel Rendueles Mata

    2007-09-01

    Full Text Available La Epistemología ha sido una disciplina Filosófica que toma su autonomía en particular desde distintas corrientes del siglo XVII. El campo de acción de esta disciplina ha versado esencialmente sobre la posibilidad de representación de la inteligencia humana. Ante el surgimiento de los Sistemas de Información basados en la Inteligencia Artificial, la Epistemología se enfrenta a un reto, pues se muestra que aun falta mucho por aclarar acerca de los avances en esta área. Este artículo presenta el problema y sugiere la idea de conjugar los aportes de la tradición epistemológica con el desarrollo de la Inteligencia Artificial.

  17. Modelos de Requisitos Basados en I* para Detectar Proactividad en Dashboards

    Directory of Open Access Journals (Sweden)

    Alain Pérez-Acosta

    2014-06-01

    Full Text Available El objetivo del trabajo es presentar modelos para la captura de los requisitos de un dashboard para detectar un comportamiento proactivo. Estos modelos siguen un enfoque orientado hacia metas y fueron creados con el marco de trabajo i*, que toma como base las premisas del modelado social. Para detectar el comportamiento proactivo se usaron patrones basados en modelos de i* para detectar proactividad en la etapa de requisitos de un sistema de software. Los modelos que se obtienen como resultado del trabajo tienen representados los actores, metas, intenciones, tareas y recursos que se necesitan para modelar los requisitos de un dashboard con un comportamiento proactivo y pueden, además, ser utilizados en distintos contextos de negocio.

  18. Origen del sistema de gestión y costos basado en actividades (ABC/ABM

    Directory of Open Access Journals (Sweden)

    Osmany Pérez Barral

    2011-03-01

    Full Text Available El desafío que supone trabajar con eficiencia y lograr la excelencia empresarial en las condiciones actuales, exige a nuestras empresas utilizar las herramientas necesarias para enfrentar con éxito la inestabilidad de un entorno cada vez más turbulento. En el presente trabajo se propone el procedimiento ABC/ABM, que proporciona mayor exactitud y facilita la toma de decisiones, asimismo, plantea que las diversas actividades desarrolladas en la empresa generan costos y que los diferentes productos consumen y utilizan estas actividades. En el procedimiento se procura establecer la relación que existe entre actividades y productos, utilizándose el concepto de generador de costo. Como resultado general se puede plantear que el procedimiento de costeo basado en actividades forma parte de las herramientas más novedosas de la gestión empresarial y está encaminado a elevar los niveles de eficiencia.

  19. Sistema de seguridad basado en la clasificación de eventos sonoros

    OpenAIRE

    Hernández Martín, Álvaro

    2015-01-01

    La teoría de reconocimiento y clasificación de patrones y el aprendizaje automático son actualmente áreas de conocimiento en constante desarrollo y con aplicaciones prácticas en múltiples ámbitos de la industria. El propósito de este Proyecto de Fin de Grado es el estudio de las mismas así como la implementación de un sistema software que dé solución a un problema de clasificación de ruido impulsivo, concretamente mediante el desarrollo de un sistema de seguridad basado en la clasificación de...

  20. Mantenimiento Correctivo Aplicado a un Sitio Basado en Joomla. Una Propuesta Centrada en la Accesibilidad

    Directory of Open Access Journals (Sweden)

    Daiana E. Casaro Pedro L. Alfonzo

    2015-05-01

    Full Text Available Se presenta una experiencia de personalización de un sitio basado en un sistema gestor de contenidos de libre distribución o CMS, atendiendo su amplia aplicabilidad en la Industria del Software y el Sector de Servicios Informáticos. Dado que un CMS puede ser mejorado por la comunidad de desarrolladores, se considera al mantenimiento correctivo como parte integral del ciclo de vida de desarrollo del software. En este trabajo, se abordan los estándares propuestos por el Consorcio W3C que permiten el acceso a los contenidos web y la verificación del cumplimiento de las pautas WCAG 2.0, durante el proceso de desarrollo del sitio web.

  1. Valoración del profesorado de magisterio sobre el aprendizaje basado en competencias implantado

    Directory of Open Access Journals (Sweden)

    Aurelio Villa

    2013-01-01

    Full Text Available A partir del curso académico 2010 - 11 se ha iniciado en Europa de modo oficial el Espacio Europeo de Educación Superior (EEES, y con él la puesta en marcha de las denominadas titulaciones Bolonia bajo la etiqueta del crédito europeo (European Credit Transf er System, ECTS. Este artículo trata de presentar el nivel de desarrollo del aprendizaje basado en competencias de las titulaciones de magisterio en España. A través de una metodología denominada Análisis Importancia - Realización (AIR (Martilla, J.A. y J ames, J.L., 1977 con la que se pretende dibujar la valoración que el profesorado y responsables académicos de magisterio realizan sobre el aprendizaje basado en competencias (ABC, y extraer las principales conclusiones del estudio empírico llevado a cabo en una muestra de 145 personas (profesores y gestores. Se presentan los resultados de un análisis factorial con cinco factores que describen el proceso de enseñanza - aprendizaje: planificación de competencias, gestión pedagógica, coordinación docente, tut oría y evaluación, y finalmente, revisión y mejora. Estos factores se correlacionaron con la formación recibida para iniciar el EEES y con el uso de la lección magistral. Obteniendo ambas variables correlaciones significativas. Este artículo se enriquece con otro artículo complementario que recoge la perspectiva cualitativa del profesorado sobre su visión de la implementación del proceso europeo y sus dificultades.

  2. SELECCIÓN DE NUEVOS GENOTIPOS DE ARROZ BASADOS EN LA PROBABILIDAD DE SUPERAR AL TESTIGO

    Directory of Open Access Journals (Sweden)

    Ismael Camargo-Buitrago

    2014-01-01

    Full Text Available El objetivo de este trabajo fue validar una metodología estadística para estimar la confiabilidad o respuesta normalizada (RN i y la esta - bilidad de cuatro genotipos elite de arroz, en comparación con el testigo IDIAP 145-05. Se utilizó la base de datos del proyecto de mejoramiento genético de arroz del IDIAP, proveniente de los experimentos realizados entre el 2009 y 2011, en 31 ambientes bajo condiciones de secano. Los resultados del estudio permitieron verificar que los nuevos genotipos superaron significativamente (P<0,05 en rendi - miento al testigo. Los cuatro genotipos IDIAP FL 106-11, IDIAP FL 137-11, IDIAP FL 155, e IDIAP FL 156 presen - taron una confiablidad promedio de 0,79; 0,75; 0,75 y 0,74, respectivamente. La probabilidad normalizada del IDIAP FL 106-11 representó una respuesta diferencial en rendimiento mayor que cero con respecto al IDIAP 145-05, en ocho de cada diez casos. La confiabilidad estuvo relacionada con los parámetros de estabilidad basados en modelos de regresión (b i y S 2 di . El modelo multivariado AMMI, considerando el PCA1, identificó el genotipo IDIAP FL 156, como el más estable. El modelo Biplot GGE, basado en el PCA2, indicó que el genotipo IDIAP FL 155, tuvo mayor estabilidad. La confiabilidad o respuesta normalizada, puede ser útil para hacer recomendaciones más precisas para la utilización de los nuevos genotipos a nivel comercial

  3. Floating anterior lens capsule: an unusual case of true exfoliation

    OpenAIRE

    Riffle, John

    2010-01-01

    A rare case of delamination and replication of the anterior lens capsule into prominent floating folds in the anterior chamber approximately 55 years after a penetrating injury to the eye and anterior lens capsule is reported. Classically, true exfoliation of the anterior lens capsule has been reported in individuals who have been exposed to intense heat over a prolonged period. However, more recently cases of true exfoliation of the anterior lens capsule have been reported in patients who ha...

  4. The distal hindlimb musculature of the cat. Patterns of normal use.

    Science.gov (United States)

    Abraham, L D; Loeb, G E

    1985-01-01

    Chronic recordings were made of electromyographic (EMG) activity, tension, and length of distal hindlimb muscles in six cats performing a variety of normal motor tasks. Muscles studied thoroughly or in part were medial gastrocnemius, lateral gastrocnemius, plantaris, soleus, flexor digitorum brevis, flexor digitorum longus, flexor hallucis longus, tibialis posterior, tibialis anterior, extensor digitorum longus, peroneus longus, and peroneus brevis. Postural and locomotor activities were examined, as well as jumping, landing, scratching, and paw shaking. In general, muscles could be assigned to traditional groupings (e.g. extensor, flexor) related to the demands of the motor task. Patterns of muscle activity were most often consistent with current understanding of muscle mechanics and neural coordination. However, purely functional distinctions between flexor digitorum longus and flexor hallucis longus ("anatomical synergists") were made on the basis of activity patterns. Likewise, the activity of plantaris and flexor digitorum brevis, which are attached in series, was differentiated in certain tasks. The rhythmical oscillatory patterns of scratching and paw shaking were found to differ temporally in a manner consistent with the limb mechanics. In several cases, mechanical explanations of specific muscle activity required length and force records, as well as EMG patterns. Future efforts to study motor patterns should incorporate information about the relationships between muscle activation, tension, length and velocity. PMID:4007096

  5. Aphasia following anterior cerebral artery occlusion

    International Nuclear Information System (INIS)

    We have report two cases of aphasia that had infarcts in the distribution of the left or right anterior cerebral artery, as confirmed by computed tomography. Case 1 is a right-handed, 65-year-old man in whom computerized tomographic scanning revealed an infarction of the territory of the left anterior cerebral artery after the clipping of the anterior communicating artery aneurysm. The standard language test of aphasia (SLTA) revealed non-fluent aphasia with dysarthria, good comprehension, almost normal repetition with good articulation, and a defectiveness in writing. This syndrome was considered an instance of transcortical motor aphasia. Although three years had passed from the onset, his aphasia did not show any improvement. Case 2 is a 37-year-old man who is right-handed but who can use his left hand as well. He was admitted because of subarachnoid hemorrhage from an anterior communicating aneurysm. Because of postoperative spasm, an infarction in the distribution of the right anterior cerebral artery developed. He was totally unable to express himself vocally, but he could use written language quite well to express his ideas and had a good comprehension of spoken language. This clinical picture was considered that of an aphemia. After several weeks, his vocalization returned, but the initial output was still hypophonic. (J.P.N.)

  6. MANAGEMENT OF FRACTURE DISTAL TIBIA WITH LOCKING MEDIAL METAPHYSEAL PLATE

    OpenAIRE

    Banikanta Sharma; Sanjib

    2015-01-01

    Distal 1/3 rd of tibia being a region with precarious blood supply is known for delayed union or non - union when a fracture occurs in this part. Conservative treatment with POP cast after manipulation and reduction, Interlocking nail, Plate osteosynthesis, Ring fixators etc . are the usual treatment modalities employed for the manageme...

  7. Outcome Assessment after Aptis Distal Radioulnar Joint (DRUJ Implant Arthroplasty

    Directory of Open Access Journals (Sweden)

    Amir Reza Kachooei

    2014-09-01

    Distal radioulnar joint injuries are disabling and patients usually undergo one or more salvage surgeries prior to receiving an arthroplasty. The Scheker prosthesis has shown satisfactory results with 100% survival rate in all reports. The constrained design of this prosthesis gives enough stability to prevent painful subluxation.

  8. Surgical treatment of distal intraarticular humeral fractures in adults

    OpenAIRE

    Eralp, L.; Kocaoglu, M; Sar, C.; Atalar, A.C.

    2001-01-01

    We reviewed 17 patients with distal intraarticular humeral type C fractures, treated by open reduction and internal fixation, followed by an early rehabilitation programme. The results, as judged by the criteria of Jupiter, were excellent in ten, good in five and fair in two. Non-union of the olecranon osteotomy occurred in one patient.

  9. Traumatisk distal humerus-epifysiolyse hos nyfødt

    DEFF Research Database (Denmark)

    Al-Aubaidi, Zaid; Nielsen, Keld Daubjerg

    2010-01-01

    Traumatic distal humerus epiphysiolysis (TDHE) is a rare injury in infants with an incidence of about 1:35,000 births. It is primarily a birth injury, but it is also seen in cases of battered child syndrome. Because of its rare occurrence and the diagnostic difficulties, the lesion may be overloo...

  10. Arthroscopic assisted fixation for the distal radius fractures

    International Nuclear Information System (INIS)

    Anatomic reduction of the articular surface of the distal radius is still the main goal when treating fractures in the young population. Appropriate assessment of intra-articular reduction is difficult when performing open reduction and internal fixation without having to open the joint capsule. This preliminary report focuses on the description of the surgical technique, philosophy, indications and advantages of using wrist arthroscopy to assist fixation of distal radius fractures. Twenty-seven patients (16 males and 11 females) underwent arthroscopic assisted fixation for intra-articular distal radius fractures between March of 1999 and august of 2002. According to the AO classification there were 9 C1, 12 C2, 2 C3, 3 B1 and 1 B2. Average age was 41 years old (range: 18-48). Average follow up was 6 months. Patients were evaluated at final follow-up for wrist motion, pain and grip strength. Radiographic studies were also obtained to evaluate final position of the distal radius

  11. SOLITARY INTEROSSEOUS NEUROFIBROMA OF DISTAL FOREARM : AN UNUSUAL PRESENTATION

    Directory of Open Access Journals (Sweden)

    Ashok Kumar

    2015-01-01

    Full Text Available Solitary Neurofibromas are uncommon nerve tumors and are still rarer in interosseous locations. They are not detected until they cause a significant damage to the neighbouring tissues . 1 We present a case of a solitary interosseousneurofibroma of the right distal forearm, without neurological deficit. It was diagnosed by Radiology and histopathology and was excised.

  12. SOLITARY INTEROSSEOUS NEUROFIBROMA OF DISTAL FOREARM : AN UNUSUAL PRESENTATION

    OpenAIRE

    Ashok Kumar; Ch. V. Murali; Srinivas Rao; Rambabu; Krishnaswamy, MR

    2015-01-01

    Solitary Neurofibromas are uncommon nerve tumors and are still rarer in interosseous locations. They are not detected until they cause a significant damage to the neighbouring tissues . 1 We present a case of a solitary interosseousneurofibroma of the right distal forearm, without neurological deficit. It was diagnosed by Radiology and histopathology and was excised.

  13. Genetics Home Reference: CAV3-related distal myopathy

    Science.gov (United States)

    ... gene causes a peculiar form of distal myopathy. Neurology. 2002 Jan 22;58(2):323-5. Erratum in: Neurology 2002 Mar 12;58(5):839. Itoyoma Y [ ... 3 cause four distinct autosomal dominant muscle diseases. Neurology. 2004 Feb 24;62(4):538-43. Review. ...

  14. Retention mucocele of distal viable remnant tip of appendix: An unusually rare late surgical complication following incomplete appendectomy

    Institute of Scientific and Technical Information of China (English)

    Maria Antony Johnson; Damodaran Jyotibasu; Palaniappan Ravichandran; Satyanesan Jeswanth; Devy Gounder Kannan; Rajagopal Surendran

    2006-01-01

    A 67-year old man was presented with e 6-mo history of recurrent right lower quadrant abdominal pain. On physical examination, a vague mass was palpable in the right lumbar region. His routine laboratory tests were normal. Ultrasonography showed a hypoechoic lesion in the right lumbar region anterior to the right kidney with internal echoes and fluid components.Abdominal contrast-enhanced computed tomography(CECT) showed a well-defined hypodense cystic mass lesion lateral to the ascending colon/caecum, not communicating with the lumen of colon/caecum. After complete open excision of the cystic mass lesion, gross pathologic examination revealed a turgid cystic dilatation of appendiceal remnant filled with the mucinous material. On histopathological examination, mucinous cyst adenoma of appendix was confirmed. We report this rare unusual late complication of mucocele formation in the distal viable appendiceal remnant, which was leftover following incomplete retrograde appendectomy. This unusual complication is not described in the literature and we report it in order to highlight the fact that a high index of clinical and radiological suspicion is essential for the diagnosis of mucocele arising from a distal viable appendiceal remnant in a patient who has already undergone appendectomy presenting with recurrent abdominal pain.

  15. The contribution of the nonporous distal stem to the stability of proximally porous-coated canine femoral components.

    Science.gov (United States)

    Jasty, M; Krushell, R; Zalenski, E; O'Connor, D; Sedlacek, R; Harris, W

    1993-02-01

    The contribution of the distal nonporous-coated stem to the stability of the uncemented femoral components, which were porous coated only proximally, was investigated under two conditions: (1) immediately after insertion and (2) at 6 months, 1 year, and 2 years after surgery in a canine model. The relative motion of the femoral components at the bone porous-coating interface under loads simulating the canine midstance was measured at these time periods using displacement transducers. The measurements were repeated after severing the connection between the porous-coated proximal body and the nonporous-coated distal stem through a small hole in the anterior cortex. The results showed that while the distal nonporous-coated stem enhanced the immediate stability of the proximally porous-coated uncemented femoral components, it contributed little to the long-term stability of the femoral components after bony ingrowth had occurred in vivo. The mean relative motion between the body of the prosthesis and the cortical bone increased from 12 microns (+/- 7 microns) to 31 microns (+/- 34 microns) in the posterior transverse direction when the stem was immediately severed after the surgery. However, at 6 months, 1 year, and 2 years after surgery, extensive bone ingrowth had occurred into the proximal porous-coated regions of the body and provided excellent stability to the femoral components. With bone ingrowth, the mean relative motion was less than 5 microns at any site. Under these conditions, severing the stem did not increase the relative motion of the prostheses significantly.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8436987

  16. Biomechanical analysis of the anterior displacement of Tibial tuberosity (Maquet operation: A computer model study

    Directory of Open Access Journals (Sweden)

    Farahmand F

    2000-08-01

    Full Text Available Computer model of the patellofemoral joint was developed and the effects on the anterior displacement of the tibial tuberosity were investigated. The input geometrical and verification data for the model were obtained form an experimental study on a cadaver knee, mounted in an instron machine. The computer program found the configuration of the patellofemoral joint which satified both the geometrical and force equilibrium conditions, simultaneously, using a trial graphical approach.verification of the model was achieved by determining the patellar sagittal plane motion and patellofemoral contact locations and comparing the results with the experimental results of the same specimen and published data. Simulation of the anterior displacement of the tibial tuberosity by the model showed that the location of contact area migrates distally on the femur and proximally on the patella following operation. The contact force of the patellofemoral joint decreased significantly by 70% at full extension, 30% at 30 degrees flexion and around 15% at higher flexion angles for a 1 cm anterior displacement of the tibial tuberosity and nearly doubled for a 2cm anterior displacement. The change of the effective moment are of the quadriceps was not considerable. The results suggest that the major effect of the Maquet operation on the contact force appears in extension and mid-flexion rather than deep flexion amgles. Further displacement of the tuberosity enhances the reduction of the contact force, however, the total reduction is less than what was predicted by Maquet. The change of the contact location relieves pain in short term but causes hyperpressure in the proximal retropatellar surface which might be detrimental in long term

  17. Estimación de un Sistema de Demanda: Análisis Basado en la Encuesta de Presupuestos Familiares de 1988 Estimación de un Sistema de Demanda: Análisis Basado en la Encuesta de Presupuestos Familiares de 1988

    Directory of Open Access Journals (Sweden)

    Cristián Aedo

    1996-03-01

    Full Text Available Estimación de un Sistema de Demanda: Análisis Basado en la Encuesta de Presupuestos Familiares de 1988 Estimación de un Sistema de Demanda: Análisis Basado en la Encuesta de Presupuestos Familiares de 1988

  18. Estimación de un Sistema de Demanda: Análisis Basado en la Encuesta de Presupuestos Familiares de 1988 Estimación de un Sistema de Demanda: Análisis Basado en la Encuesta de Presupuestos Familiares de 1988

    OpenAIRE

    Cristián Aedo

    1996-01-01

    Estimación de un Sistema de Demanda: Análisis Basado en la Encuesta de Presupuestos Familiares de 1988 Estimación de un Sistema de Demanda: Análisis Basado en la Encuesta de Presupuestos Familiares de 1988

  19. Indolent infection in nonunion of the distal femur.

    Science.gov (United States)

    Kim, Ji Wan; Byun, Seong-Eun; Oh, Hyoung Keun; Kim, Jung Jae

    2015-04-01

    In the treatment of nonunions of the distal femur, infection should be excluded. However, it is difficult to determine whether the nonunion is infected or not with negative history and signs of infection. The purpose of this study was to investigate indolent infection as a cause of presumptive aseptic distal femur nonunion. All presumptive aseptic distal femur nonunions treated from 1998 to 2008 were retrospectively reviewed. Any patient with suspected of having an infection clinically was excluded. Multiple tissue cultures were performed at the nonunion site. The main outcomes were to analyze the rate of positive cultures in presumptive aseptic distal femur nonunion and to compare the rate of secondary surgery in positive and negative culture groups. Of the 22 patients, 3 (13.6%) had positive culture results. The organisms cultured were Staphylococcus aureus, Staphylococcus epidermidis, and Enterobacter cloacae. The overall rate of infection was 9.1% (2/22), and one patient underwent a secondary procedure. In the open fracture group, 2 of 10 patients (20%) had positive cultures; all developed infection. In the closed fracture group, 1 of 12 patients (8.3%) had positive culture results, but Infection did not occur in the patient with a 3-week intravenous antibiotic treatment. The postoperative infection rate was 67% (2/3) in patients with positive intraoperative cultures, while 0% (0/18) in the group with negative intraoperative cultures (pinfection can be verified in patients with presumptive aseptic nonunion of distal femoral fractures by obtaining intraoperative biopsy tissue cultures. Positive intraoperative culture results were related with postoperative infection. PMID:25189289

  20. Successful Return to Sport Following Distal Femoral Varus Osteotomy

    Science.gov (United States)

    Voleti, Pramod Babu; Degen, Ryan; Tetreault, Danielle; Krych, Aaron John; Williams, Riley J.

    2016-01-01

    Objectives: Distal femoral varus osteotomy is an effective treatment for unloading valgus knee malalignment; however, there is limited evidence on the ability for patients to return to athletics following this procedure. The purpose of this study is to report the functional outcomes and return to sport for athletic patients that underwent distal femoral varus osteotomy. Methods: A consecutive series of athletic patients that had undergone distal femoral varus osteotomy for symptomatic lateral compartment overload and valgus knee malalignment were prospectively reviewed. All patients had a minimum of 2-year follow-up. Radiographs were assessed to determine pre-operative and post-operative alignment. Details regarding sport of interest, ability to return to sport, and timing of return were obtained from the patients. Prospective institutional registries were utilized to collect pre-operative and post-operative Marx Activity Scale and International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC) scores; these values were compared using paired t-tests with p soccer, 2 softball, 2 running, 1 football, 1 basketball, 1 ice hockey, 1 volleyball, 1 rowing) at a mean of 11 months (range: 9-13). Furthermore, all 13 patients demonstrated an improvement in both Marx Activity Scale and IKDC scores after surgery. The mean improvement in Marx Activity Scale was 7 (mean pre-op: 4, mean post-op: 11, p < 0.01), and the mean improvement in IKDC score was 36 (mean pre-op: 53, mean post-op: 89, p < 0.01). Conclusion: Valgus knee malalignment results in overload of the lateral compartment and can severely limit one’s ability to participate in athletic activities. Correction of valgus knee malalignment through distal femoral varus osteotomy - either medial closing wedge or lateral opening wedge - can reliably result in improvement in function and return to sport, provided that concomitant chondral, meniscal, and ligamentous pathology is addressed. Therefore, distal

  1. THYMOLIPOMA: A RARE, LARGE ANTERIOR MEDIASTINAL MASS

    Directory of Open Access Journals (Sweden)

    Premananth

    2015-07-01

    Full Text Available Thymolipoma is a rare benign tumor of anterior mediastinum, described by Lange in 1916. 1 Less than 200 cases have been reported worldwide. 2 It accounts for 2% to 9% of thymic tumours. 3 We report a case of thymolipoma in a 37 year s old male patient, who pre sented with cough, dys p nea, chest pain for 2 months. CT THORAX revealed a large anterior mediastinal mass extending in to right hemithorax arising from thymus gland, with multiple areas of fat density, no significant mediastinal adenopathy, complete collap se of right middle and lower lobe suggestive of thymolipoma. CT guided biopsy suggestive of thymic neoplasm. The tumour was removed enbloc through surgery. Histopathological examination of large mass lesion confirmed thymolipoma. We report this case to emp hasize the importance of considering thymolipoma as a differential diagnosis of anterior mediastinal mass, although rare.

  2. The anterior tilt angle of the proximal tibia epiphyseal plate: A significant radiological finding in young children with trampoline fractures

    International Nuclear Information System (INIS)

    Objective: Evaluation of the anterior tilt angle of the proximal tibia epiphyseal plate in young children, which suffered a trampoline fracture in comparison with a normal population. Materials and methods: 62 children (31 females, 31 males) between 2 and 5 years of age (average 2 years 11 months, standard deviation 11 months) with radiographs in two views of the tibia were included in this retrospective study. 25 children with proximal tibia fractures were injured with a history of jumping on a trampoline. All other causes for tibia fractures were excluded. A normal age-mapped control cohort of 37 children was compared. These children had neither evidence of a trampoline related injury nor a fracture of the tibia. The anterior tilt angle of the epiphyseal plate of the tibia was defined as an angle between the proximal tibia physis and the distal tibia physis on a lateral view. Two radiologists evaluated all radiographs for fractures and measured the anterior tilt angle in consensus. An unpaired Student's t-test was used for statistical analysis (SPSS). Original reports were reviewed and compared with the radiological findings and follow-up radiographs. Results: In the normal control group, the average anterior tilt angle measured −3.2°, SD ± 2.8°. The children with trampoline fractures showed an anterior tilt of +4.4°, SD ± 2.9°. The difference was statistically significant, P < 0.0001. In 6 patients (24% of all patients with confirmed fractures) the original report missed to diagnose the proximal tibial fracture. Conclusion: Young children between 2 and 5 years of age are at risk for proximal tibia fractures while jumping on a trampoline. These fractures may be very subtle and difficult to detect on initial radiographs. Measurement of the anterior tilt angle of the proximal tibia epiphyseal plate on lateral radiographs is supportive for interpreting correctly trampoline fractures

  3. The anterior tilt angle of the proximal tibia epiphyseal plate: A significant radiological finding in young children with trampoline fractures

    Energy Technology Data Exchange (ETDEWEB)

    Stranzinger, Enno, E-mail: enno.stranzinger@insel.ch [University Hospital Bern, Inselspital, Department of Diagnostic, Interventional and Pediatric Radiology, CH-3010 Bern (Switzerland); Leidolt, Lars, E-mail: lars.leidolt@insel.ch [University Hospital Bern, Inselspital, Department of Diagnostic, Interventional and Pediatric Radiology, CH-3010 Bern (Switzerland); Eich, Georg, E-mail: georg.eich@ksa.ch [Cantonal Hospital Aarau, Pediatric Radiology, Tellstrasse, CH-5001 Aarau (Switzerland); Klimek, Peter Michael, E-mail: peter.klimek@ksa.ch [Cantonal Hospital Aarau, Pediatric Surgery, Tellstrasse, CH-5001 Aarau (Switzerland)

    2014-08-15

    Objective: Evaluation of the anterior tilt angle of the proximal tibia epiphyseal plate in young children, which suffered a trampoline fracture in comparison with a normal population. Materials and methods: 62 children (31 females, 31 males) between 2 and 5 years of age (average 2 years 11 months, standard deviation 11 months) with radiographs in two views of the tibia were included in this retrospective study. 25 children with proximal tibia fractures were injured with a history of jumping on a trampoline. All other causes for tibia fractures were excluded. A normal age-mapped control cohort of 37 children was compared. These children had neither evidence of a trampoline related injury nor a fracture of the tibia. The anterior tilt angle of the epiphyseal plate of the tibia was defined as an angle between the proximal tibia physis and the distal tibia physis on a lateral view. Two radiologists evaluated all radiographs for fractures and measured the anterior tilt angle in consensus. An unpaired Student's t-test was used for statistical analysis (SPSS). Original reports were reviewed and compared with the radiological findings and follow-up radiographs. Results: In the normal control group, the average anterior tilt angle measured −3.2°, SD ± 2.8°. The children with trampoline fractures showed an anterior tilt of +4.4°, SD ± 2.9°. The difference was statistically significant, P < 0.0001. In 6 patients (24% of all patients with confirmed fractures) the original report missed to diagnose the proximal tibial fracture. Conclusion: Young children between 2 and 5 years of age are at risk for proximal tibia fractures while jumping on a trampoline. These fractures may be very subtle and difficult to detect on initial radiographs. Measurement of the anterior tilt angle of the proximal tibia epiphyseal plate on lateral radiographs is supportive for interpreting correctly trampoline fractures.

  4. Anterior tooth relations in Kenyan Africans.

    Science.gov (United States)

    Hassanali, J; Pokhariyal, G P

    1993-04-01

    Dental plaster casts of 235 Maasai, 116 Kikuyu and 61 Kalenjin children aged 3-16 yr were studied to determine the incidence and magnitude of diastemas, overbite, overjet and anterior open bite. The highest prevalence of diastema was amongst the Maasai (61.3%), of overbite (84%) and overjet (99%) amongst the Kikuyu, and of anterior open bite amongst Kalenjin (24%), with values greater than 0.4 mm up to 11.5 mm. Comparison of the mean values showed that diastema (1.77 mm) and overjet (4.4 mm) were greatest in Maasai, overbite (3.53 mm) in Kalenjin, and anterior open bite (3.50 mm) in Kikuyu. In the total sample, the prevalence and mean of diastema were 49%, 1.68 mm; of overbite 77.4%, 2.96 mm; of overjet 88.6%, 3.83 mm; and of anterior open bite 16.5%, 2.69 mm (with values between 0.4-11.5 mm), while 5.5% had an edge-to-edge bite (-0.5-0.5 mm). The prevalence of diastema decreased whilst its magnitude increased with age. The mean values of overbite and overjet increased, while those for anterior open bite decreased with age. The mean values of diastema, overbite and overjet were greater amongst the females, but the difference was significant only for overjet. The high prevalence and greater values of measurements of anterior tooth relations may be related to variable growth of the bimaxillary dentoalveolar complex and soft tissue influences. This may be important in orthodontic treatment planning, dental prostheses and other clinical dental treatments in Kenyan populations. PMID:8517805

  5. ANTERIOR OSTEOPHYTE IDENTIFICATION IN CERVICAL VERTEBRAE

    Directory of Open Access Journals (Sweden)

    A. T. Chougale

    2011-06-01

    Full Text Available Radiologist always examines X-ray to determine abnormal changes in cervical, lumbar & thoracic vertebrae. Osteophyte (bony growth may appear at the corners of vertebrae so that vertebral shape becomes abnormal. This paper presents the idea from Image processing techniques such as customised Hough transform which will be used for segmentation which should be independent of rotation, scale, noise & shape. This segmented image will be then used for computing size invariant, convex hull based features to differentiate normal cervical vertebrae from cervical vertebrae containing anterior osteophyte. This approach effectively finds anterior osteophytes in cervical vertebrae.

  6. Roentgenographic findings following anterior cervical fusion

    International Nuclear Information System (INIS)

    We reviewed the pre- and postoperative lateral cervical roentgenograms in 90 patients who had anterior fusions and compared their findings with age and sex-matched people without neck problems. The average interval from surgery to review was 5 years. Preoperatively, all patients had a higher incidence of degenerative spondylosis at the levels to be fused than their asymptomatic counterparts. Postoperatively, there was no difference in the incidence of degenerative change between the operated and the control group at the levels above and below the fusion with the exception of anterior osteophyte formation which was more frequent in those with fusions. (orig.)

  7. The costae presenting in high-temperature-induced vestigial wings of Drosophila: implications for anterior wing margin formation

    Indian Academy of Sciences (India)

    Daxiang Yang

    2007-01-01

    It has long been noted that high temperature produces great variation in wing forms of the vestigial mutant of Drosophila. Most of the wings have defects in the wing blade and partially formed wing margin, which are the result of autonomous cell death in the presumptive wing blade or costal region of the wing disc. The vestigial gene ($vg$) and the interaction of Vg protein with other gene products are well understood. With this biochemical knowledge, reinvestigations of the high-temperature-induced vestigial wings and the elucidation of the molecular mechanism underlying the large-scale variation of the wing forms may provide insight into further understanding of development of the wing of Drosophila. As a first step of such explorations, I examined high-temperature-induced (29°C) vestigial wings. In the first part of this paper, I provide evidences to show that the proximal and distal costae in these wings exhibit regular and continuous variation, which suggests different developmental processes for the proximal and distal costal sections. Judging by the costae presenting in the anterior wing margin, I propose that the proximal and distal costal sections are independent growth units. The genes that regulate formation of the distal costal section also strongly affect proliferation of cells nearby; however, the same phenomenon has not been found in the proximal costal section. The distal costal section seems to be an extension of the radius vein. vestigial, one of the most intensely researched temperature-sensitive mutations, is a good candidate for the study of marginal vein formation. In the second part of the paper, I regroup the wing forms of these wings, chiefly by comparison of venation among these wings, and try to elucidate the variation of the wing forms according to the results of previous work and the conclusions reached in the first part of this paper, and provide clues for further researches.

  8. [Anterior dislocation of the fibula resulting from surgical malreduction: a case report].

    Science.gov (United States)

    Wang, Z Y; Wu, X B

    2016-04-18

    Ankle joint fracture is one of the most common types of fracture. There are many researches on the injury mechanism, treatment principles and surgical techniques. A type of injury which combines posterior dislocation of fibula, known as the Bosworth injury, is relatively rare. In 1947, Bosworth first described this type of injury as an unusual ankle fracture dislocation with fixed posterior fracture dislocation of the distal part of the fibula. In this type of fracture, the proximal fibular shaft fragment locks behind the tibialis posterior tubercle. This rare ankle fracture variant is often not recognized in initial radiographs and requires a computed tomographic (CT) scan for verification. But there are already many reports, discussing the injury mechanism, treatment principles and surgical techniques. However, there are few reports of anterior dislocation of the fibula, caused by either injury or surgery. The mechanism of the injury is still not clear. This article reports a case of anterior dislocation of the fibula. We report a patient with left ankle open fracture (Lauge-Hansen pronation-external rotation stage III, Gustilo IIIA). Open reduction and internal fixation was done in the initial surgery, but ended up with poor reduction, resulting in fibula anterior dislocation, anterior dislocation of talus and tibia fibular dislocation. The fibula was dislocated anteriorly of the tibia, which rarely happened. The patient suffered severe ankle joint dysfunction. The second operation took out the original internal fixation, reduced the fracture, and reset the internal fixation. The function of ankle joint was improved obviously after operation. But because of the initial injury and the two operations, the soft tissue around the fracture was greatly damaged. 6 months after the second operation, and the fracture still not healed, so the bone graft was carried out in the third surgery. Two months after the third surgery, the function of the ankle was significantly

  9. TIBIALIS ANTERIOR VASCULARIZED TRIPLE FLAPS IN ONE STAGE RECONSTRUCTION OF MUTILATED HAND WITH LOSS OF THUMB

    Institute of Scientific and Technical Information of China (English)

    钱云良; 章一新; 张余光; 王丹茹; 关文祥

    2004-01-01

    Objective To introduce a one stage technique in the reconstruction of mutilated hand with loss of thumb and eventual digits. Methods Tibialis anterior pediculated triple flaps (TAPTF) including distal lateral leg, dorsalis pedis flaps for skin defect covering and trimmed hallux for thumb reconstruction were presented.Results Mutilated hands in five patients were repaired by the technique with acceptable cosmetic and functional success. A three to twelve months follow-up in three patients resulted in the recovery of protective thermal sensation and pinch action of the reconstructed thumb. The donor sites were free from major disability. Conclusion TAPTF is ideal for one stage reconstruction of the mutilated hand with loss of digits.

  10. Posttraumatic incarceration of medial collateral ligament into knee joint with anterior cruciate ligament injury

    Institute of Scientific and Technical Information of China (English)

    Sunil Gurpur Kini; Karel du Pre; Warwick Bruce

    2015-01-01

    Medial collateral ligament of the knee is an important coronal stabiliser and often injured in isolation or as combination of injuries.The article reports a case of incarcerated medial collateral ligament (MCL) injury in combination with anterior cruciate ligament (ACL) injury in 20 year old male who presented to us 4 weeks after injury.Clinical examination and MRI was correlated to complete ACL tear with torn distal MCL and incarceration into the joint.Patient was taken up for ACL hamstring graft reconstruction with mini-arthrotomy and repair of the torn MCL.Patient was followed up with dedicated rehabilitation protocol with good functional results.At one year follow-up, patient exhibited full range of motion with negative Lachman, Pivot shift and valgus stress tests.This article highlights the rare pattern of MCL tear and also reviews the literature on this pattern of injury.

  11. Anterior-posterior dissociative slide facilitates the second stage of 3-stage forehead flap nasal reconstruction.

    Science.gov (United States)

    Weinfeld, Adam Bryce; DeLeon, Ashley Nicole

    2015-03-01

    Pedicle-lining skin grafts contract between the first and second stage in a 3-stage forehead flap nasal reconstruction. The second stage involves an inherent reduction in vascularity due to the soft tissue thinning performed. The Anterior-Posterior Dissociative Slide restores first-stage pedicle length at the second stage. Incisions are made at the distal seam between the contracted graft and the pedicle tissue. The flap is then slid caudally relative to the fixed graft, thus relengthening the pedicle. This technique has been performed in 16 patients achieving an average length gain of 0.7 (+0.2) cm. The additional length created with the dissociative slide translates into reduced tension with flap reinset, thus increasing flap workability and overall artistry in the second stage. PMID:24051472

  12. Multicentre prospective evaluation of implant-assisted mandibular bilateral distal extension removable partial dentures: patient satisfaction

    NARCIS (Netherlands)

    D. Wismeijer; A. Tawse-Smith; A.G.T. Payne

    2013-01-01

    Objective To compare the levels of patient satisfaction with either conventional mandibular bilateral distal extension partial dentures or those assisted by bilateral distal implants. Materials and methods Forty-eight participants who were dissatisfied with their existing conventional mandibular dis

  13. Perawatan Ortodontik Gigi Anterior Berjejal dengan Tulang Alveolar yang Tipis

    Directory of Open Access Journals (Sweden)

    Miesje K. Purwanegara

    2015-09-01

    Full Text Available Anterior teeth movement in orthodontic treatment is limited to labiolingual direction by very thin alveolar bone. An uncontrolled anterior tooth movement to labiolingual direction can cause alveolar bone perforation at its root segment. This case report is to remind us that alveolar bone thickness limits orthodontc tooth movement. A case of crowded anterior teeth with thin alveolar bone in malocclusion I is reported. This case is treated using adgewise orthodontic appliance. Protraction of anterior teeth is anticipated due to thin alveolar bone on the anterior surface. The conclusion is although the alveolar bone surrounding the crowded anterior teeth is thin, by controlling the movement the teeth reposition is allowed.

  14. Anterior retropharyngeal approach to the cervical spine.

    Directory of Open Access Journals (Sweden)

    Behari S

    2001-10-01

    Full Text Available The anterior retropharyngeal approach (ARPA accesses anteriorly situated lesions from the clivus to C3, in patients with a short neck, Klippel Feil anomaly or those in whom the C2-3 and C3-4 disc spaces are situated higher in relation to the hyoid bone and the angle of mandible where it is difficult to approach this region using the conventional anterior approach, due to the superomedial obliquity of the trajectory. The ARPA avoids the potentially contaminated oropharyngeal cavity providing for a simultaneous arthrodesis and instrumentation during the primary surgical procedure. Experience of five patients with high cervical extradural compression, who underwent surgery using this approach between 1994 and 1999, is presented. The surgical procedures included excision of ossified posterior longitudinal ligament (n=2; excision of prolapsed disc and osteophytes (n=2; and excision of a vertebral body neoplasm (n=1. Following the procedure, vertebral arthrodesis was achieved using an iliac graft in all the patients. Only one patient with vertebral body neoplasm required an additional anterior cervical plating procedure for stabilisation the construct. The complications included transient respiratory insufficiency and neurological deterioration in two patients; and, pharyngeal fistula and donor site infection in one patient.

  15. Treatment for acute anterior cruciate ligament tear

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  16. Anterior Chamber Live Loa loa: Case Report.

    Science.gov (United States)

    Kagmeni, G; Cheuteu, R; Bilong, Y; Wiedemann, P

    2016-01-01

    We reported a case of unusual intraocular Loa loa in a 27-year-old patient who presented with painful red eye. Biomicroscopy revealed a living and active adult worm in the anterior chamber of the right eye. After surgical extraction under local anesthesia, parasitological identification confirmed L. loa filariasis. PMID:27441005

  17. Anterior Chamber Live Loa loa: Case Report

    Science.gov (United States)

    Kagmeni, G.; Cheuteu, R.; Bilong, Y.; Wiedemann, P.

    2016-01-01

    We reported a case of unusual intraocular Loa loa in a 27-year-old patient who presented with painful red eye. Biomicroscopy revealed a living and active adult worm in the anterior chamber of the right eye. After surgical extraction under local anesthesia, parasitological identification confirmed L. loa filariasis. PMID:27441005

  18. Novel Insights into Anterior Cruciate Ligament Injury

    NARCIS (Netherlands)

    D.E. Meuffels (Duncan)

    2011-01-01

    textabstractAnterior cruciate ligament (ACL) injury is one of the most common sports injuries of the knee. ACL reconstruction has become, standard orthopaedic practice worldwide with an estimated 175,000 reconstructions per year in the United States.6 The ACL remains the most frequently studied liga

  19. Anorgasmia in anterior spinal cord syndrome.

    OpenAIRE

    Berić, A; Light, J K

    1993-01-01

    Three male and two female patients with anorgasmia and dissociated sensory loss due to an anterior spinal cord syndrome are described. Clinical, neurophysiological and quantitative sensory evaluation revealed preservation of the large fibre dorsal column functions from the lumbosacral segments with concomitant severe dysfunction or absence of the small fibre neospinothalamic mediated functions. These findings indicate a role for the spinothalamic system in orgasm.

  20. Anterior process fractures of the calcaneus

    Energy Technology Data Exchange (ETDEWEB)

    Renfrew, D.L.; El-Khoury, G.Y.

    1985-07-01

    Fractures of the anterior process of the calcaneus are often missed. This error follows from the tendency to focus exclusively on the mortise and malleoli when a history of ankle trauma is supplied. Seven patients with this fracture are presented. The anatomy, mechanism of injury, clinical presentation, and the radiographic features of this injury are discussed.

  1. Causes of anterior cruciate ligament injuries

    Directory of Open Access Journals (Sweden)

    Ristić Vladimir

    2010-01-01

    Full Text Available In order to prevent anterior cruciate ligament injuries it is necessary to define risk factors and to analyze the most frequent causes of injuries - that being the aim of this study. The study sample consisted of 451 surgically treated patients, including 400 sportsmen (65% of them being active and 35% recreational sportsmen, 29% female and 71% male; of whom 90% were younger than 35. Sports injuries, as the most frequent cause of anterior cruciate ligament injuries, were recorded in 88% of patients (non-contact ones in 78% and contact ones in 22%, injuries occurring in everyday activities in 11% and in traffic in 1%. Among sportsmen, reconstruction of the anterior cruciate ligament was most frequently performed in football players (48%, then in handball players (22%, basketball players (13%, volleyball players (8%, martial arts fighters (4%. However, the injury incidence was the highest among the active basketball players (1 injured among 91 active players. Type of footwear, warming up before the activity, genetic predisposition and everyday therapy did not have a significant influence on getting injured. Anterior cruciate ligament injuries happened three times more often during matches, in the middle and at the end of a match and training session (79%, at landing after the jump or when changing direction of movement (75% without a contact with other competitors, on dry surfaces (79%, among not so well prepared sportsmen.

  2. Integración sostenible de áreas industriales y urbanas mediante modelado basado en agentes

    OpenAIRE

    Ruiz Puente, María del Carmen; Romero Arozamena, Elena

    2014-01-01

    El modelado basado en agentes es una técnica empleada en la representación de sistemas complejos. El sistema se define en función de las entidades -agentes- que lo componen y sus reglas de comportamiento. Ampliamente utilizada en el área de la computación, la aplicación de esta técnica está cada día más extendida en diversos campos de conocimiento como las ciencias ambientales, ingeniería o ciencias sociales. Esta contribución se apoya en un modelo basado en agentes diseñado para la regenerac...

  3. Pendulum Therapy of Molar Distalization in Mixed Dentition

    Science.gov (United States)

    Prakash, Amit; Agarwal, Anshu

    2016-01-01

    ABSTRACT Early and timely pedo-orthodontic treatment is aimed at eliminating the disturbances of skeletal or dentoalveolar development, to harmonize the stomatognathic system before the full eruption of all permanent teeth. The advantages of pendulum appliance are its minimal dependence on patient’s compliance (child cooperation), ease of fabrication, onetime activation and adjustment of the springs if necessary to correct minor transverse and vertical molar positions. This article reports a successful treatment method of class II malocclusion with pendulum appliance in mixed dentition phase. Distalization of maxillary molar was done, followed by guidance of canine impaction orthodontically and other dental correction using 0.022 MBT appliances. Posttreatment results were stable and remarkable. How to cite this article: Patil RU, Prakash A, Agarwal A. Pendulum Therapy of Molar Distalization in Mixed Dentition. Int J Clin Pediatr Dent 2016;9(1):67-73. PMID:27274159

  4. Giant cell tumor of the distal ulna: a case report

    Directory of Open Access Journals (Sweden)

    Vanni Daniele

    2012-06-01

    Full Text Available Abstract Introduction Several cases of long bone giant cell tumor have been reported in the literature. We report the case of a patient with a giant cell tumor in the distal ulna. This is very unusual, with a reported incidence of 0.45 to 6%. Case presentation A 17-year-old Colombian man presented with a painful swelling of the left wrist. After performing an instrumental examination, a diagnosis of distal ulna giant cell tumor was made. The tumor was treated with an intralesional curettage, phenol application and bone grafting. Conclusions This tumor may have a good prognosis if it is diagnosed early and radically treated. It is important to be aware of atypical cancer localizations in order to perform a proper diagnosis.

  5. [Primary distal renal tubular acidosis: a case report].

    Science.gov (United States)

    Abdallah, Jihene Ben; Charfeddine, Bassem; Braham, Imen; Neffati, Souhir; Othmen, Leila Ben; Letaief, Affef; Smach, Mohamed Ali; Bourfifa, Zoheier; Dridi, Hedi; Limem, Khalifa

    2011-01-01

    The primary distal renal tubular acidosis is characterized biochemically by the inability of the kidney to produce appropriately acid urine in the presence of systemic metabolic acidosis or after acid loading (e.g. ammonium chloride). It is secondary to defective excretion of H(+) by the cells of the collecting duct. We report the observation of the child MC, 4-year-old, for whom the association of polyuria-polydipsia syndrome, a failure to thrive, nephrolithiasis, hypercalciuria, and especially a high urine pH in the presence of metabolic acidosis did evoke diagnosis of distal renal tubular acidosis. An urine acidification test with ammonium chloride was performed, the urinary pH was always higher than 5.5, thus confirming the diagnosis. PMID:21464016

  6. [Results following percutaneous intramedullary pin fixation in distal radius fractures].

    Science.gov (United States)

    Kirchner, R; Hüttl, T; Krüger-Franke, M; Rosemeyer, B

    1994-01-01

    42 distal radius fractures have been submitted to further examination after percutaneous intramedullary pin fixation. The outcome were 95.3% of very good to good anatomic results and 90.5% of satisfying functional results. This showed the close link between the radiological-anatomical and functional results. The success of the treatment was very acceptable, although the Morbus Sudeck as the major complication--with 7.2%--was still relatively frequently observed. It could be seen that particularly fractures at the risk of dislocation with smash zone constituted an indication for the percutaneous intramedullary pin fixation, that is to say all fractures for which a retention is primarily difficult. It constitutes a supplement, as well as an extension to the therapy of the distal radius fractures. PMID:7516105

  7. Atypical presentation of distal renal tubular acidosis in two siblings.

    Science.gov (United States)

    Tasic, Velibor; Korneti, Petar; Gucev, Zoran; Hoppe, Bernd; Blau, Nenad; Cheong, Hae Il

    2008-07-01

    Primary distal renal tubular acidosis (dRTA) is an inherited disease characterized by the inability of the distal tubule to lower urine pH hypokalemic paralysis. Laboratory investigations revealed proximal tubular dysfunction (low molecular weight proteinuria, generalized hyperaminoaciduria, hypophosphatemia with hyperphosphaturia, and hypouricemia with hyperuricosuria). There was significant hyperoxaluria and laboratory evidence for mild rhabdomyolysis. Under potassium and alkali therapy, proximal tubular abnormalities, muscular enzymes, and oxaluria normalized. A homozygous mutation in the ATP6V1B1 gene, which is responsible for dRTA with early hearing loss, was detected in both siblings. In conclusion, proximal tubular dysfunction and hyperoxaluria may be found in children with dRTA and are reversible under appropriate therapy. PMID:18386070

  8. External Fixation of Unstable Distal Radius Fracture. A Case Report

    Directory of Open Access Journals (Sweden)

    Yaniel Truffin Rodríguez

    2014-12-01

    Full Text Available Unstable fracture of the distal radius is a common injury. If not properly treated, it can cause major disturbance in the radiocarpal joint and impaired hand function. A case of a 42-year-old patient of rural origin without a history of previous conditions treated at the Gustavo Aldereguía Lima Hospital in Cienfuegos is presented. He suffered a fall on the outstretched hand, which led to an unstable fracture of the left distal radius. Emergency surgery consisting of manual fracture reduction under general anesthesia and fixation with RALCA minifixator plus a percutaneously placed Kirschner wire was performed. Since this fracture is often inadequately treated, the presentation of this case can be helpful to many orthopedic surgeons.

  9. Posttraumatic osteonecrosis and nonunion of distal pole of scaphoid

    Directory of Open Access Journals (Sweden)

    Saurabh Kapoor

    2013-01-01

    Full Text Available Posttraumatic osteonecrosis of distal pole of scaphoid is an extremely rare with only two reported cases so far. We present a case of a 30-year-old male with a 2-year-old posttraumatic osteonecrosis and nonunion of distal pole of scaphoid left wrist. He presented with complaints of pain and restriction of movements. There was no evidence of radiocarpal arthritis. He was managed with open reduction and internal fixation with k-wires, supplemented by a pronator quadratus based muscle pedicle bone graft. The fracture union was achieved at 6 months. After 2 years, he had almost complete range of wrist motion and had returned to his preinjury level of functional activity. His MRI (magnetic resonance imaging scans showed evidence of revascularization suggesting successful incorporation of bone graft.

  10. Retrograde nailing for distal femur fractures in the elderly

    Directory of Open Access Journals (Sweden)

    Giddie Jasdeep

    2015-01-01

    Full Text Available Introduction: We report the results of treating a series of 56 fractures in 54 elderly patients with a distal femur fracture with a retrograde femoral nail. Methods: Fifty-four of the nails were inserted percutaneously with a closed reduction. After surgery all patients were allowed to weight bear as tolerated. Four fractures were supported in a temporary external splint. Results: The mean age of patients was 80.6 years (range 51–103 years, 52/54 (96% were females. There were no cases of nail related complications and no re-operations were required. One patient was lost to follow up. The 30-day mortality was 5/54 (9.3% and the one year mortality was 17/54 (31.5%. Conclusions: Distal femoral nail fixation provides a good method of fixation allowing immediate mobilisation for this group of patients.

  11. Pendulum Therapy of Molar Distalization in Mixed Dentition.

    Science.gov (United States)

    Patil, Raju Umaji; Prakash, Amit; Agarwal, Anshu

    2016-01-01

    Early and timely pedo-orthodontic treatment is aimed at eliminating the disturbances of skeletal or dentoalveolar development, to harmonize the stomatognathic system before the full eruption of all permanent teeth. The advantages of pendulum appliance are its minimal dependence on patient's compliance (child cooperation), ease of fabrication, onetime activation and adjustment of the springs if necessary to correct minor transverse and vertical molar positions. This article reports a successful treatment method of class II malocclusion with pendulum appliance in mixed dentition phase. Distalization of maxillary molar was done, followed by guidance of canine impaction orthodontically and other dental correction using 0.022 MBT appliances. Posttreatment results were stable and remarkable. How to cite this article: Patil RU, Prakash A, Agarwal A. Pendulum Therapy of Molar Distalization in Mixed Dentition. Int J Clin Pediatr Dent 2016;9(1):67-73. PMID:27274159

  12. Aprendizaje basado en programación. Alimento transdisciplinar para el pensamiento creativo

    Directory of Open Access Journals (Sweden)

    Alberto Domingo Galán

    2013-11-01

    Full Text Available Este trabajo describe una actividad de aprendizaje transdisciplinar destinado a impulsar la creatividad y fomentar actitudes innovadoras. Combina biología molecular con programación de computadoras, pero más que el caso concreto, es un ejemplo de abordaje dirigido a impulsar la capacidad de innovación en el proceso educativo. Se basa en la convicción de que un conocimiento amplio y multidisciplinar es el sustrato más eficiente para transformar la creatividad individual en innovación práctica. Esta actividad, ya aplicada en más de seis cursos, utiliza una metodología de aprendizaje activo inscrita en el marco del Aprendizaje Basado en Proyectos y se diseñó inicialmente para las clases prácticas de laboratorio de una asignatura de Biología Molecular. Los participantes tienen que desarrollar una herramienta de software real, capaz de realizar un análisis de secuencias de ácidos nucleicos, incluyendo una interfaz de usuario interactiva. Comienzan a escribir el código real y a aprender los rudimentos de un la programación directamente aplicándolos a resolver un problema. Se trata de un “aprendizaje basado en programación” ya que la escritura del programa no es la finalidad, sino el medio para crear un entorno en el que los alumnos tienen que repensar y entender realmente la lógica detrás de muchos conceptos biológicos fundamentales ya aprendidos, pero que en esta actividad tienen que enfrentar en un contexto diferente y con un nuevo lenguaje y objetivos prácticos. En lugar de descripciones teóricas, el proceso de aprendizaje involucra a los participantes en un reto divertido y motivador, una meta exigente pero estimulante de crear su propia solución para un problema auténtico, que se reconoce como difícil, pero también como comprensible y realizable. Es una actividad realmente transdisciplinar que también trata de dar a los estudiantes una visión de un nuevo campo, ampliando su mente y motivándoles a explorar y

  13. 不稳定性下胫腓联合损伤的诊治研究进展%Recent advances in the diagnosis and treatment of instable distal tibiofibular syndesmosis injuries

    Institute of Scientific and Technical Information of China (English)

    邢丹; 宋东辉; 马信龙; 马剑雄

    2013-01-01

    Syndesmosis is a kind of fibrous articulation in which the opposing joint surfaces are united by ligaments. The distal tibiofibular syndesmosis consists of a complex of ligaments that provide stability to the joints. The anterior, posterior and transverse tibiofibular ligaments together with the interosseous ligament form the distal tibiofibular syndesmosis. Syndesmosis injuries are rare, but very debilitating and frequently misdiagnosed. It is estimated that 10% of all ankle fractures and 20% of operatively treated ankle fractures are accompanied by syndesmotic injury. Distal tibiofibular syndesmotic ligament injury can also occur in isolation mostly due to an extorsion or in association with damage to the lateral ankle ligaments. Syndesmotic injury leads to subsequent mortise instability and should be treated with syndesmotic stabilization to prevent long-term complications of ankle joint. Immediate reconstruction of the unstable syndesmosis is indicated, because a delay could expedite the development of degenerative arthritis. However, the precise diagnosis of distal tibiofibular syndesmotic ligament injury is critically difficult. The distinction should be made between syndesmotic ligament disruption and real syndesmotic instability. Radiographic measures including tibiofibular overlap, tibiofibular space, medial and superior space are of little value in detecting distal tibiofibular syndesmosis, because all these parameters depend on the rotation of the ankle joint. CT and MRI could also be used in detecting syndesmotic disruption in patients with distal tibiofibular syndesmotic ligament injuries. Intra-operative stress testing is essential in the diagnosis for syndesmotic injuries. Although ankle arthroscopy is a more sensitive method than radiography, it is more invasive and not all surgeons have the expertise to perform ankle arthroscopy. Therefore, there has no“gold standard”diagnostic measure in testing the instability of distal tibiofibular

  14. Work related distal airway obstruction in an agricultural population.

    OpenAIRE

    Vergnenegre, A.; D'arco, X; Melloni, B.; Antonini, M T; Courat, C; Dupont-Cuisinier, M; Bonnaud, F.

    1995-01-01

    OBJECTIVE--To assess the prevalence of distal airway obstruction and its risk factors in agricultural areas. METHODS--A cross sectional study of respiratory symptoms and lung function was performed among French farmers and their spouses (1122 subjects) who came for preventive medicine examinations. They answered a respiratory questionnaire and performed pulmonary function tests on a portable spirometer. Diagnoses of chronic bronchitis were made on the basis of reported chronic respiratory sym...

  15. Auxin regulates distal stem cell differentiation in Arabidopsis roots

    OpenAIRE

    Ding, Zhaojun; Friml, Jiří

    2010-01-01

    The stem cell niche in the root meristem is critical for the development of the plant root system. The plant hormone auxin acts as a versatile trigger in many developmental processes, including the regulation of root growth, but its role in the control of the stem cell activity remains largely unclear. Here we show that local auxin levels, determined by biosynthesis and intercellular transport, mediate maintenance or differentiation of distal stem cells in the Arabidopsis thaliana roots. Gene...

  16. A new distal myopathy with mutation in anoctamin 5

    OpenAIRE

    Mahjneh, Ibrahim; Jaiswal, Jyoti; Lamminen, Antti; Somer, Mirja; Marlow, Gareth; Kiuru-Enari, Sari; Bashir, Rumaisa

    2010-01-01

    We have been following clinically and with muscle MRI for the past 3-decades a Finnish family with two patients with distal muscular dystrophy. Previously we demonstrated the cellular defect in these patients to be defective membrane repair and more recently have identified the causative gene to be anoctamin 5 (ANO5). The disorder seen in these patients is characterized by onset in the third decade. First symptoms were burning sensation on the calves and later on calf tightness during running...

  17. Characterisation of osseous bodies of the distal phalanx of foals

    International Nuclear Information System (INIS)

    The distal phalanx and metacarpal physis of both forelimbs of 32 Thoroughbred foals 3-32 weeks of age were radiographed to identify those limbs with osseous bodies at a palmar process (PP) of the distal phalanx. Osseous bodies (ossicles) were identified radiographically in 19% of the foals. Sixteen of the 32 foals were selected for microradiographic and histological evaluation: 6 foals with radiographic evidence of ossicles and 10 foals without. Fourteen ossicles of the PP were observed radiographically. Ossicles were either a triangular bone fragment at the palmar aspect of the distal angle of the PP, or an oblong bone fragment separated from P3 by a radiolucent line extending 1-3 cm from the incisure of the PP to the solar margin. One foal had radiographic evidence of bilateral distal metacarpal physitis. Seventeen of 35 PPs examined microradiographically were considered normal, in that the dorsal and solar cortices were thin with trabecular bone orientated parallel to the cortical surfaces, and there was a depression in the dorsal cortical surface (i.e. parietal sulcus). Abnormal microradiographic findings in the other 18 PPs included a fracture line extending from the dorsal cortical surfaces and trabecular bridging of the fracture gap. The fracture line was often continuous with the parietal sulcus. Microradiographic evidence of a fracture was found in 75% of foals evaluated. Normal histological findings in 16 PPs included thin dorsal and solar cortices with trabeculae orientated parallel to the cortical surfaces, parallel-fibred dense connective tissue attachments of the deep digital flexor tendon to the solar cortical surfaces, and a neurovascular bundle associated with the parietal sulcus

  18. [Arthroscopic distal ulna resection after post traumatic ulno carpal abutment].

    Science.gov (United States)

    Mathoulin, C; Pagnotta, A

    2006-11-01

    Ulno carpal abutments secondary to the sequels of a fracture of the radius are often due to the inversion of the distal radio ulnar index by shortening relative to the radius. This positive ulnar variance eventually leads to an abutment between the head of the ulnar and the proximal articular face of the lunate with alteration of the cartilaginous carpal surfaces. The wrist arthroscopy makes diagnosis and treatment possible in a less invasive way. The patients are operated on as outpatients under local regional anaesthetic using a pneumatic tourniquet. The arthroscope is positioned using the 3-4 radio carpal opening permitting exploration of the joint. The surgical treatment is performed by arthroscopy using a burr and going in through the 6R radio carpal opening. In this way we use the technique of partial resection of the distal ulna. We have a series of 62 patients who have benefited from the technique of partial resection of the ulnar head by arthroscopy. There were 30 men and 32 women. The average age was 66 years old (between 45 and 82). Our average follow-up is 32 months (between 12 and 60 months). Recovery of mobility was immediate in all cases with persistent pain in the radio ulnar joint in 8 cases. Arthroscopic treatment of ulno carpal abutment has proved itself effective and innocuous. It should nevertheless be reserved for operations on small sized inversions of the distal radio ulnar index (less than 5 mm). In the event of larger ulnar variances we prefer ulnar shortening osteotomy. The other techniques will be restricted to cases where the distal radio ulnar joint has been impaired. PMID:17361890

  19. DISTAL SPLENORENAL VENOUS ANASTOMOSIS IN TREATMENT OF DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    T. I. Shraer

    2010-06-01

    Full Text Available We studied the outcomes of the operations for distal splenorenal venous anastomosis of 134 patients with type 1 diabetes mellitus. We have noticed the significant improvement of patient’s general condition due to spasmolytic effect of glucagon, bypassed to blood circulation without coming through liver and also a stabilization of glyce- mia because of a restoration of insulin-glucagon ratio in systemic circulation. The effect of a surgery depends on a stage of microangiopathy and nephrosclerosis. 

  20. Recurrent synovial chondromatosis of the distal interphalangeal joint: case report.

    Science.gov (United States)

    Craft, Randall O; Smith, Anthony A; Duncan, Scott F M

    2009-02-01

    A 59-year-old woman presented with recurrent synovial chondromatosis of the distal interphalangeal joint at the site of removal of what was thought to be a ganglion cyst in 2003 and the subsequent excision of a recurrent synovial chondromatosis in 2005. Although synovial chondromatosis is typically described as a benign, self-limiting process, recurrent disease and local erosion of the joint of this patient required wide excision with bone grafting and arthrodesis for definitive treatment. PMID:19181231

  1. Minimally invasive plate osteosynthesis for distal radius fractures

    Directory of Open Access Journals (Sweden)

    Xu-ming Wei

    2014-01-01

    Full Text Available Background: Fractures of distal radius are common injury in all age groups. Cast treatment with or without close reduction is a viable option. However, the results are often unsatisfactory with restricted function. The open reduction and internal fixation often results in extensive soft tissue dissection and associated high rates of infection and delayed/nonunion. The distractor/external fixator have reported good functional and anatomical results but the incidence of pin traction infection nerve injury and cosmedic deformity are high. We introduced a modified operative technique for minimally invasive plate osteosynthesis (MIPO for distal radial fracture and evaluated the functional outcomes and complications. Materials and Methods: 22 distal radial fractures (10 left, 12 right were treated using the MIPO technique and two small incisions with a palmar locking plate from August 2009 to August 2010. The wrist function was assessed according to Dienst wrist rating system, and postoperative complications were recorded. Results: According to Dienst wrist rating system, 13 patients showed excellent results, 6 cases showed good results and 3 patients had moderate results. No patient had poor results. Thus, the excellent and good rate was 86.4%. One patient had anesthesia in the thenar eminence and this symptom disappeared after 3 months. One patient had delayed healing in the proximal wrist crease. Two patients had mild pain on the ulnar side of the wrist and two patients had limited wrist joint function. Conclusion: The MIPO technique by using two small palmar incisions is safe and effective for treatment of distal radial fractures.

  2. TREATMENT WITH TAMSULOSIN IN PATIENTS WITH DISTAL URETERAL CALCULI

    OpenAIRE

    Jagodic, K.; Bizjak, I.(J. Stefan Institute, 1000, Ljubljana, Slovenia); Erklavec, M.; Poteko, S.; Korosec-Jagodic, H.

    2008-01-01

    Background: Symptomatic ureteral calculi are one of the most important issues in urologist emergency clinical settings. Spontaneous passage of distal ureteral calculi is usually achieved with good hydration and spasmoanalgetic drugs. alpha-blocker therapy may facilitate and accelerate the spontaneous passage of ureteral stones.Patients and methodsIn retrospective study we analyzed patients with renal colic admitted to our department in 2006. All of them had clinical examination, urine and blo...

  3. A distal renal tubular acidosis showing hyperammonemia and hyperlactacidemia

    OpenAIRE

    C. Ripoli; Pinna, A.; Marras, S.; M.L. Fenu; Nurchi, A M

    2012-01-01

    Introduction: distal renal tubular acidosis (dRTA) presents itself with variable clinical manifestations and often with late expressions that impact on prognosis. Case report: A 45-day-old male infant was admitted with stopping growth, difficult feeding and vomiting after meals. Clinical tests and labs revealed a type 1 renal tubular acidosis, even if the first blood tests showed ammonium and lactate increase. We had to exclude metabolic diseases before having a certain diagnosis. Conclusions...

  4. Factors Associated with Infection Following Open Distal Radius Fractures

    OpenAIRE

    Glueck, Dane A.; Charoglu, Constantine P.; Lawton, Jeffrey N.

    2009-01-01

    Open fractures are often classified according to a system described by Gustilo and Anderson. However, this system was applied to open long bone factures, which may not predict the incidence of infection in open metaphyseal fractures of the upper extremity. Other studies have found that wound contamination and systemic illness were the best predictors of infections in open hand fractures. Our study assessed infection in open distal radius fractures and identifies factors that are associated wi...

  5. Semi-rigid ureteroscopy: Proximal versus distal ureteral stones

    Directory of Open Access Journals (Sweden)

    Mahmoud Alameddine

    2016-01-01

    Conclusion: Although there is a clinical difference between proximal and distal calculi groups in terms of complication and stone-free rates, this difference remained statistically insignificant (P = 0.06. Using a smaller caliber semi-rigid ureteroscopy combined with Holmium-YAG laser can be carried out as a day care procedure and showed a slightly higher risk in patients with proximal ureteral calculi which should be explained to the patient

  6. UN SISTEMA EXPERTO PARA ASISTIR DECISIONES TURÍSTICAS. DISEÑO DE UN PROTOTIPO BASADO EN WEB

    OpenAIRE

    Carlos R. Primorac; Sonia I. Mariño

    2011-01-01

    El estudio del comportamiento del consumidor del turismo es una actividad compleja en el cual intervienen numerosas variables. Los sistemas expertos actúan como asistentes y auxiliares complejos de gran utilidad, brindando ayuda efectiva en aquellos trabajos que requieren responsabilidad, competencia e intuición. Se presenta un prototipo de Sistema Experto, basado en plataforma Web, para asistir a los potenciales turistas en sus decisiones. El sistema recomienda un destino de acuerdo a las pr...

  7. Análisis de métricas de similitud en razonamiento basado en casos para administrar proyectos

    OpenAIRE

    Rodríguez, Guillermo Horacio; Berdun, Luis S.; Soria, Alvaro; Amandi, Analía; Campo, Marcelo

    2015-01-01

    La administración de proyectos de software es crucial para el desarrollo controlado de los productos de software. Sin embargo, cuando un administrador de proyectos experimentado abandona el proyecto y es reemplazado por alguien con menor experiencia y sin conocimiento del entorno del proyecto, aparece la Amnesia Organizacional. En efecto, administrar un proyecto de software se convierte en una tarea costosa, con incertidumbre y escasa garantía de éxito. En este contexto, Razonamiento Basado e...

  8. Distal Goal and Proximal Goal Transfer of Training Interventions in an Executive Education Program

    Science.gov (United States)

    Brown, Travor C.; Warren, Amy M.

    2009-01-01

    This study assessed transfer from a customized executive training program involving 89 public sector employees. Participants who set a distal goal had higher self-efficacy than those in both the "do your best" (DYB) and the proximal plus distal goal conditions. Participants who set proximal plus distal goals had higher maintenance than those who…

  9. Pulmonary Vascular Congestion: A Mechanism for Distal Lung Unit Dysfunction in Obesity

    OpenAIRE

    Beno W Oppenheimer; Berger, Kenneth I.; Ali, Saleem; Segal, Leopoldo N.; Donnino, Robert; Katz, Stuart; Parikh, Manish; Goldring, Roberta M.

    2016-01-01

    Rationale Obesity is characterized by increased systemic and pulmonary blood volumes (pulmonary vascular congestion). Concomitant abnormal alveolar membrane diffusion suggests subclinical interstitial edema. In this setting, functional abnormalities should encompass the entire distal lung including the airways. Objectives We hypothesize that in obesity: 1) pulmonary vascular congestion will affect the distal lung unit with concordant alveolar membrane and distal airway abnormalities; and 2) t...

  10. Distal antebrachial fractures in toy-breed dogs

    International Nuclear Information System (INIS)

    Antebrachial fractures account for approximately 17% of all canine fractures, with motor vehicle trauma cited as one of the primary causes. However, antebrachial fractures in toy-breed dogs are often sustained after apparently minimal trauma, such as jumping or falling, and are usually distal. The cause of antebrachial fractures in toy breeds is not well understood. Complications after treatment of distal antebrachial fractures in toy-breed dogs, including delayed union, nonunion, and malunion, are common and are potentially serious because they may necessitate limb amputation. This article reports on distal antebrachial fractures in 26 toy-breed dogs that wee presented to the University of California, Davis, Veterinary Medical Teaching Hospital from April 1987 to March 1996. The author found that (1) these fractures typically occur in growing or adolescent dogs; (2) the presence of complications of union is typically associated with prior treatment using intramedullary pinning or external coaptation; and (3) successful healing of this type of fracture is obtained via rigid stabilization with bone plating in combination with cancellous bone autograft

  11. Distal histidine conformational flexibility in dehaloperoxidase from Amphitrite ornata

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Zuxu; de Serrano, Vesna; Betts, Laurie; Franzen, Stefan; (NCSU); (UNC)

    2009-01-28

    The enzyme dehaloperoxidase (DHP) from the terebellid polychaete Amphitrite ornata is a heme protein which has a globin fold but can function as both a hemoglobin and a peroxidase. As a peroxidase, DHP is capable of converting 2,4,6-trihalophenols to the corresponding 2,6-dihaloquinones in the presence of hydrogen peroxide. As a hemoglobin, DHP cycles between the oxy and deoxy states as it reversibly binds oxygen for storage. Here, it is reported that the distal histidine, His55, exhibits conformational flexibility in the deoxy form and is consequently observed in two solvent-exposed conformations more than 9.5 {angstrom} away from the heme. These conformations are analogous to the open conformation of sperm whale myoglobin. The heme iron in deoxy ferrous DHP is five-coordinate and has an out-of-plane displacement of 0.25 {angstrom} from the heme plane. The observation of five-coordinate heme iron with His55 in a remote solvent-exposed conformation is consistent with the hypothesis that His55 interacts with heme iron ligands through hydrogen bonding in the closed conformation. Since His55 is also displaced by the binding of 4-iodophenol in an internal pocket, these results provide new insight into the correlation between heme iron ligation, molecular binding in the distal pocket and the conformation of the distal histidine in DHP.

  12. Ionotropic GABA Receptors and Distal Retinal ON and OFF Responses

    Directory of Open Access Journals (Sweden)

    E. Popova

    2014-01-01

    Full Text Available In the vertebrate retina, visual signals are segregated into parallel ON and OFF pathways, which provide information for light increments and decrements. The segregation is first evident at the level of the ON and OFF bipolar cells in distal retina. The activity of large populations of ON and OFF bipolar cells is reflected in the b- and d-waves of the diffuse electroretinogram (ERG. The role of gamma-aminobutyric acid (GABA, acting through ionotropic GABA receptors in shaping the ON and OFF responses in distal retina, is a matter of debate. This review summarized current knowledge about the types of the GABAergic neurons and ionotropic GABA receptors in the retina as well as the effects of GABA and specific GABAA and GABAC receptor antagonists on the activity of the ON and OFF bipolar cells in both nonmammalian and mammalian retina. Special emphasis is put on the effects on b- and d-waves of the ERG as a useful tool for assessment of the overall function of distal retinal ON and OFF channels. The role of GABAergic system in establishing the ON-OFF asymmetry concerning the time course and absolute and relative sensitivity of the ERG responses under different conditions of light adaptation in amphibian retina is also discussed.

  13. Plate presetting arthroscopic reduction technique for the distal radius fractures.

    Science.gov (United States)

    Abe, Yukio; Tsubone, Tetsu; Tominaga, Yasuhiro

    2008-09-01

    Wrist arthroscopy for the distal radius fractures is an effective adjunct to evaluate the reduction of intraarticular fragments and soft tissue injuries. In recent years, volar locking plate fixation has become popular, and arthroscopic procedures for distal radius fracture reduction have become problematic because vertical traction has to be both on and off during surgery. We developed a plate presetting arthroscopic reduction technique to simplify the combination of plating and arthroscopy. The fracture was reduced, and anatomic alignment was regained under an image intensifier, and then the volar locking plate was preset. Wrist arthroscopy was introduced under vertical traction, and the intraarticular condition was assessed. If dislocations of the intraarticular fragments were residual, they were reduced arthroscopically, and soft tissue injuries were treated subsequently. Finally, the traction was removed, and the plate was securely fixed. Since May 2005, the authors have used this technique in more than 50 patients. This article will review the history, indications, contraindications, technique, rehabilitation, and complications for the plate presetting arthroscopic reduction technique for distal radius fractures. PMID:18776773

  14. Multipurpose external fixator for intraarticular fracture of distal radius.

    Science.gov (United States)

    Siripakarn, Yongyuth; Siripakarn, Zongyuti

    2010-12-01

    Fracture of distal radius is one of a complicated injury which can be difficult in reduction and maintaining its alignment and may result in malunion and shortening following a variety of fixation. Since Anderson's and O'neil described the use of sustain traction by extraskeletal device anchored to the radius and the first metacarpal of the hand. Vidal et al [1979] demonstrated that the ligamentotaxis could be used to reduce the fracture around the wrist, ankle, hip and knee. The external fixation frame can maintain radial length and inclination by the pullout force from the radial styloid. External fixation is useful for management of complex intraarticular fracture of distal radius. There are few types of commercially available fixator. It is important to use one that allow versatility and follow biomechanic principles of ligamentotaxis, which can be used to reduce the severe comminution and the most difficult fracture by distraction and stabilization effectively. The ideal characteristic of the external fixation are: Telescoping connecting frame fixed externally compose of two joints which can be easily adjust in any direction, two pins clamp connected to the external connecting rod. Our TU Multipurpose external fixator can be designed as a multiplana, can be used as a bridge or non bridge fixation, and can be adjusted to any direction which require for the treatment of distal radius fracture. It is differed to other commercially available devices. PMID:21294433

  15. Anterior ethmoidal artery emerging anterior to bulla ethmoidalis: An abnormal anatomical variation in Waardenburg's syndrome

    OpenAIRE

    Wong, Danny K. C.; Shao, Angus; Campbell, Raewyn; Douglas, Richard

    2014-01-01

    In endoscopic sinus surgery, the anterior ethmoidal artery (AEA) is usually identified as it traverses obliquely across the fovea ethmoidalis, posterior to the bulla ethmoidalis and anterior to or within the ground lamella's attachment to the skull base. Injury to the AEA may result in hemorrhage, retraction of the AEA into the orbit, and a retrobulbar hematoma. The resulting increase in intraorbital pressure may threaten vision. Waardenburg's syndrome (WS) is a rare congenital, autosomal dom...

  16. Accuracy of Lachman and Anterior Drawer Tests for Anterior Cruciate Ligament Injuries

    OpenAIRE

    Hadi Makhmalbaf; Ali Moradi; Saeid Ganji; Farzad Omidi-Kashani

    2013-01-01

      Background: The knee joint is prone to injury because of its complexity and weight-bearing function. Anterior cruciate ligament (ACL) ruptures happen in young and physically active population and can result in instability, meniscal tears, and articular cartilage damage. The aim of this study is to evaluate the accuracy of Lachman and anterior drawer test in ACL injury in compare with arthroscopy.   Methods: In a descriptive, analytical study from 2009 to 2013, 653 patients who were suspecte...

  17. The anterior insular and anterior cingulate cortices in emotional processing for self-face recognition

    OpenAIRE

    Morita, Tomoyo; Tanabe, Hiroki C.; Akihiro T Sasaki; Shimada, Koji; Kakigi, Ryusuke; Sadato, Norihiro

    2013-01-01

    Individuals can experience embarrassment when exposed to self-feedback images, depending on the extent of the divergence from the internal representation of the standard self. Our previous work implicated the anterior insular cortex (AI) and the anterior cingulate cortex (ACC) in the processing of embarrassment; however, their exact functional contributions have remained uncertain. Here, we explored the effects of being observed by others while viewing self-face images on the extent of embarr...

  18. Distal tibial interosseous osteochondroma with impending fracture of fibula – a case report and review of literature

    OpenAIRE

    Wani, Iftikhar H.; Sharma, Siddhartha; Malik, Farid H; Singh, Manjeet; Shiekh, Irfan; Salaria, Abdul Q.

    2009-01-01

    Osteochondromas arising from the interosseous border of the distal tibia and involving distal fibula are uncommon. We present a 16 year old young boy with an impending fracture, erosion and weakness of the distal fibula, secondary to an osteochondroma arising from the distal tibia. Early excision of this deforming distal tibial osteochondroma avoided the future risk of pathological fracture of the distal fibula, ankle deformities and syndesmotic complications.

  19. Endocavitary radiation for treatment of distal rectal carcinoma and twenty years experience

    International Nuclear Information System (INIS)

    Purpose/Objective: Sphincter preservation in the treatment of rectal cancer. Materials/Methods: The majority of patients with adenocarcinoma of the rectum are treated with radical surgical procedures. Lesions located in the distal rectum by abdominal perineal resection and those situated in the proximal portion of the rectum are treated by low anterior resection. Since the inception of endocavitary radiation therapy at Highland Hospital in July of 1973 to June of 1993, 227 patients were selected for curative endocavitary radiation. Stringent patient selection criteria was applied, (1) Well to moderately differentiated adenocarcinoma which is mobile on rectal examination and not larger than 5 cm in diameter, (2) The lesion must be no further than 11-12 cm from the anal verge, without any lymph node metastasis. The patients were staged by digital rectal examination, transrectal ultrasound, high resolution CT scan of the pelvis and abdomen and chest x-ray and received 10,000-12,000 cGy in approximately 4 fractions over a period of about 60 days. The treatments are separated by an interval of two or three weeks. Results: Local control has been achieved in 216 (95%) of patients. This is defined as no evidence of local disease on clinical examination or on laboratory or imaging studies. 35 patients failed from treatment (16 failed only distally). 9 patients died of disease. 59 patients died of intercurrent disease. The minimal follow up was 30 months. During the same period of time, 169 patients were treated with palliative intent only because they were not eligible for curative therapy due to more extensive disease and poor medical condition. Local control was achieved in 77 patients (45%) and good palliation was achieved in 76 patients (44%). 18 patients (11%) did not respond to treatment. Endocavitary radiation therapy has been utilized for treatment of villous adenomas from July 1973 to June of 1993. A total of 39 patients were treated for villous adenomas, 33 (85

  20. Volar, Intramedullary, and Percutaneous Fixation of Distal Radius Fractures.

    Science.gov (United States)

    Alluri, Ram; Longacre, Matthew; Pannell, William; Stevanovic, Milan; Ghiassi, Alidad

    2015-11-01

    Background The management of extra-articular distal radius fractures is highly variable, with no clear consensus regarding their optimal management. Purpose To assess comparatively the biomechanical stability of Kirschner wire (K-wire) fixation, volar plating, and intramedullary nailing for unstable, extra-articular distal radius fractures with both (1) constant and (2) cyclical axial compression, simulating forces experienced during early postoperative rehabilitation. Methods Twenty-six volar locking plate, intramedullary nail, and K-wire bone-implant constructs were biomechanically assessed using an unstable extra-articular distal radius bone model. Bone implant models were created for each type of construct. Three samples from each construct underwent compressive axial loading until fixation failure. The remaining samples from each construct underwent fatigue testing with a 50-N force for 2,000 cycles followed by repeat compressive axial loading until fixation failure. Results Axial loading revealed the volar plate was significantly stiffer than the intramedullary nail and K-wire constructs. Both the volar plate and intramedullary nail required greater than 300 N of force for fixation failure, while the K-wire construct failed at less than 150 N. Both the volar plate and intramedullary nail demonstrated less than 1 mm of displacement during cyclic loading, while the K-wire construct displaced greater than 3 mm. Postfatigue testing demonstrated the volar plate was stiffer than the intramedullary nail and K-wire constructs, and both the volar plate and intramedullary nail required greater than 300 N of force for fixation failure while the K-wire construct failed at less than 150 N. Conclusions Volar plating of unstable extra-articular distal radius fractures is biomechanically stiffer than K-wire and intramedullary fixation. Both the volar plate and intramedullary nail demonstrated the necessary stability and stiffness to maintain anatomic

  1. USO DEL RAZONAMIENTO BASADO EN CASOS PARA LA ENSEÑANZA DE TEMAS MÉDICOS

    Directory of Open Access Journals (Sweden)

    Vivian Estrada Sentí

    2002-05-01

    Full Text Available

    Dentro de las técnicas de inteligencia artificial, el Razonamiento Basado en Casos (RBC ocupa un importante lugar ya que facilita el uso de la experiencia acumulada para la toma de decisiones sobre las nuevas situaciones que se presenten. Los autores afirman que el RBC es una importante herramienta de apoyo a la enseñanza de temas médicos, basándose en los resultados de las investigaciones realizadas, y exponen una de las bases de casos utilizadas con estos fines, por su eficiencia para el diagnostico, el pronóstico y la conducta médica.

    Abstract

    In particular, the introduction of artificial intelligence methods and its application in medicine constitute an interesting and perspective scientific field. Specially, Case Based Reasoning (CBR plays an important role in medical science. CBR methods and techniques have been used with success in complex medical decision making. Paper's authors argued CBR represents a very important tool in medical learning and teaching.

  2. Experiencia docente mediante la Metodología de Aprendizaje Basado en Problemas

    Directory of Open Access Journals (Sweden)

    José Manuel López-Guede

    2015-07-01

    Full Text Available En este artículo se describe una experiencia docente de implantación de Aprendizaje Basado en Problemas (ABP llevada a cabo en la Escuela Universitaria de Ingeniería de Vitoria-Gasteiz, de la Universidad del País Vasco (UPV/EHU. La asignatura objeto de la implantación ha sido Arquitectura de Computadores, del Grado en Ingeniería Informática de Gestión y Sistemas de Información. En el artículo se recogen los elementos principales a considerar en toda implantación como son las competencias específicas y transversales a adquirir por el alumnado, por lo que se recoge el temario y los resultados del aprendizaje a lograr y evaluar. Se detalla el problema estructurante diseñado y su división en subproblemas, así como los logros alcanzados, siendo estos altamente satisfactorios tanto para el alumnado en general como para el profesorado.

  3. El enfoque educativo basado en competencias, un reto que enfrenta la Universidad Veracruzana

    Directory of Open Access Journals (Sweden)

    Adoración Barrales Villegas

    2012-12-01

    Full Text Available Este artículo tiene como propósito compartir la experiencia que ha tenido la Universidad Veracruzana en la promoción e implementación del enfoque educativo basado en competencias. La incorporación obedece a la demanda internacional de formar profesionistas competentes en los ámbitos profesional, personal y social.Una de las acciones relevantes ha sido la capacitación de su personal docente y la implementación de una estrategia denominada Proyecto Aula. Este proyecto va dirigido a sistematizar la práctica docente a partir de la elaboración, aplicación y evaluación de un diseño instruccional para cada una de las experiencias educativas (asignaturas que se imparten al interior de sus programas educativos. Esta es la razón de que se revisen conceptos como competencia, tipos, enfoques, metodología y evaluación por competencias enfatizando los retos y aciertos de nuestra institución.

  4. Anterior capsule tear after laser iridotomy complicating phacoemulsification

    OpenAIRE

    Vivien Cherng Hui, Yip; Sanjay, Srinivasan; Benjamin Chong-Ming, Chang

    2011-01-01

    A 70-year-old Indian lady had a history of bilateral laser peripheral iridotomy (LPI) for primary angle closure. Subsequently she developed cataract in both the eyes. Right eye cataract surgery was complicated by an anterior capsule rupture, which was discovered intra-operatively at the site of the LPI. Trypan blue was used to stain the anterior capsule to delineate the anterior capsule defect. An attempt at continuous curvilinear capsulorhexis was unsuccessful, and the anterior capsulotomy w...

  5. Importance of anatomically locating the infrapatellar branch of the saphenous nerve in reconstructing the anterior cruciate ligament using flexor tendons,

    Directory of Open Access Journals (Sweden)

    Julio Cesar Gali

    2014-12-01

    Full Text Available Objective:To describe the path of the infrapatellar branch of the saphenous nerve (IBSN using the medial joint line, anterior tibial tuberosity (ATT, tibial collateral ligament and a horizontal line parallel to the medial joint line that passes over the ATT, as reference points, in order to help surgeons to diminish the likelihood of injuring this nerve branch during reconstruction of the anterior cruciate ligament (ACL using flexor tendons.Methods:Ten frozen knees that originated from amputations were examined. Through anatomical dissection performed with the specimens flexed, we sought to find the IBSN, from its most medial and proximal portion to its most lateral and distal portion. Following this, the anatomical specimens were photographed and, using the ImageJ software, we determined the distance from the IBSN to the medial joint line and to a lower horizontal line going through the ATT and parallel to the first line. We also measured the angle of the direction of the path of the nerve branch in relation to this lower line.Results:The mean angle of the path of the nerve branch in relation to the lower horizontal line was 17.50 ±6.17°. The mean distance from the IBSN to the medial joint line was 2.61 ± 0.59 cm and from the IBSN to the lower horizontal line, 1.44 ±0.51 cm.Conclusion:The IBSN was found in all the knees studied. In three knees, we found a second branch proximal to the first one. The direction of its path was always from proximal and medial to distal and lateral. The IBSN was always proximal and medial to the ATT and distal to the medial joint line. The medial angle between its direction and a horizontal line going through the ATT was 17.50 ± 6.17°.

  6. Nutrition of the anterior cruciate ligament. Effects of continuous passive motion

    International Nuclear Information System (INIS)

    Twelve freshly killed mature male rabbits were used to study the effects of continuous passive motion (CPM) on regional and overall nonvascular nutritional pathways of the anterior cruciate ligament (ACL). One hundred fifty microcuries of 35S-sulfate was injected intraarticularly into each knee joint. The right knee underwent CPM for 1 hour, while the left knee remained immobilized. Both knee joints were then isolated and immediately frozen. The ACLs were removed while still mostly frozen, and sectioned into anterior, middle, and posterior thirds for the six rabbits in Group 1, and proximal, middle, and distal thirds for the six rabbits in Group 2. In addition, quadriceps tendon samples were harvested from each limb of three rabbits. After appropriate processing, all samples were counted in a scintillation counter, and counts per minute per milligram of tissue were calculated. There was significantly higher uptake in rest extremity ACLs compared to CPM extremity ACLs (P = 0.0001). No significant difference was demonstrated in regional uptake comparing respective thirds of the ACL in either Group 1 or Group 2. Quadriceps tendon uptake trended higher in the limbs exposed to CPM compared to those maintained at rest (P = 0.14). The ACL uses diffusion as a primary nutrient pathway. CPM does not increase nutrient uptake by the ACL in this avascular model, but CPM may facilitate transport of metabolites out of the joint. No regional differences in uptake within the ACL occurred in either group

  7. Magnetic resonance imaging of juvenile-type distal and segmental muscular atrophy of upper extremities

    International Nuclear Information System (INIS)

    Juvenile-type distal and segmental muscular atrophy of the upper extremities is a disorder characterized by juvenile onset, muscular atrophy localized in the hand and forearm, lack of definite sensory disturbances and non or very slow progressive course. A magnetic resonance imaging study was made of 19 patients with this disease. The subjects were all males. The age at onset ranged from 12 to 24 years, and the age at the time of study ranged from 17 to 45 years. A superconducting MRI unit operating at 0.5 tesla was employed. Spin-echo images (TR 1000 ms, TE 40 ms) showed a flattening and ventral shifting of the cord at C5 - C7 in the ventroflexed head position in 18 out of 19 cases. Cord atrophy was asymmetrical with dominance on the same side of muscular atrophy. In the prone flexed position, spin-echo images (TR 2000 ms, TE 80 ms) showed narrowing and anterior shift of the dural sac at C5 - C7 and a high signal intensity lesion in the posterior epidural space at C4 - C7 level in 15 out of 19 cases. With the inversion recovery images (TR 2000 ms, TI 500 ms) the intensity of the lesion in the posterior epidural space was much weaker than that of fatty tissue. Dynamic CT was carried out and the analysis of time-density curves showed that the lesion had venous compartment. The lesions of increased signal intensity were considered to represent congestion of the internal vertebral venous plexus. These findings suggest that the spinal cord is stretched with the fulculm at the fifth and sixth cervical vertebra when the neck is ventroflexed, producing traction, compression and circulatory cord damage. Moreover, compression of the spinal cord may arise due to an extreme narrowing of the dural sac. The most probable cause of the circulatory disorder is ischemia in the anterior spinal artery and the intraspinal arterioles due to compression of the spinal cord. (J.P.N.)

  8. Uveítes anteriores associadas a doenças sistêmicas Anterior uveitis associated to systemic diseases

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    Maria Angélica Pavão Dimantas

    2003-01-01

    Full Text Available As uveítes anteriores são caracterizadas pela inflamação preponderante do segmento anterior do olho. Hiperemia conjuntival, reação de câmara anterior com células e "flare", precipitados ceráticos e sinéquias posteriores são sinais que compõem o quadro inflamatório. Aspectos clínicos de algumas doenças sistêmicas envolvidas na etiologia das uveítes anteriores serão abordados neste artigo.Anterior uveitis describes a disease predominantly limited to the anterior segment of the eye. Conjunctival hyperemia, anterior chamber cell and flare, keratic precipitates, and iris abnormalities including posterior synechiae characterize the inflammation. This article discusses clinical aspects of the systemic diseases that cause anterior uveitis with review of the literature.

  9. A two-choice strategy through a medial tibial approach for the treatment of pilon fractures with posterior or anterior fragmentation

    Directory of Open Access Journals (Sweden)

    Di Giorgio Luigi

    2013-10-01

    Full Text Available 【Abstract】Objective: The anterolateral approach to the tibia has been popularized for the management of tibial pilon fractures. For complex fracture patterns a combined anterolateral/anteromedial approach is suitable buta high rate of complicat ion has been reported. In our retrospective study a two-choice strategy adopting a medial tibial approach was proposed for the treatment of pilon fractures with anterior or posterior fragmentation. Methods: Based on an anatomic study of tibial pilon fractures, we retrospectively analyzed the fractures with primary posterior, posterior-lateral or anterior, anterior-lateral (Tillaux-Chaput involvement of the distal tibia. This retrospective study consisted of 18 patients with a closed tibial plafond fracture. The inclusion criteria were: (1 presence of an anterior/anterolateral type fragment or a posterior (Volkmann type fragment involving >25% of the articular surface, (2 a minimum follow-upof 12 months, (3 a fibula f racture associated with a medial column fracture of the distaltibia, and (4 soft tissue conditions at the time of operation that did not compromise the choice of surgical access (Tscher ne classi fication for closed fr actures: grade 0 and grade 1. Tibial plafond fractures were classified into two groups: one presenting anterior and the other with posterior rim (Volkmann fragments. Resul ts: Most patients achieved a good clinical recovery in terms of range of motion and Olerud-Molander scale scores. Only three patient s presented a grade 2 osteoarthritis at the 12 month follow-up. Conclusion: Our two-choice strategy highlights concepts which have been previously debated and described in the literature. But a new extended protocol for surgical approach to the distal tibia, including more fracture patterns and their association should be further investigated. Key words: Tibial fractures; Fracture fixation; Surgical procedures, operative; Intraoperative complications

  10. In vitro evaluation of fracture resistance of Fiber-Reinforced Composite inlay bridges in upper anterior and lower posterior teeth

    Directory of Open Access Journals (Sweden)

    Jalalian E.

    2007-07-01

    Full Text Available Background and Aim: Considering flexural strength of fiber-reinforced composites (FRC and also the role of conservative cavities in protecting sound tissue of abutments, the aim of this study was to evaluate the fracture resistance of these bridges by handmade samples in vitro.Materials and Methods: In this experimental in vitro study, 44 sound newly extracted teeth were used to make 22 fixed inlay bridges including 11 three unit anterior upper inlay bridges substituting clinical model of upper central and 11 three unit posterior lower inlay bridges substituting clinical model of lower first molar. Specimens were prepared with FRC and mounted with artificial PDL in acryl. Cases were exposed to final load by using Universal Testing Machine (Instron 1195 with the speed of 1 mm/min. Statistical analysis was performed by Kolmogorov- Smirnov, independent sample T and Kaplan-Meier tests with p<0.05 as the level of significance.Results: Based on the statistical tests, the 95% confidence interval of mean was 450-562 N in anterior and  1473- 1761 N in posterior area. Fracture strength was high in the studied groups. Fractures in both groups occurred on composite facing, and the framework remained intact. The highest percentage of fracture in posterior teeth was in the middle of pontic towards the distal connector and in the anterior teeth in the lateral connector, between central pontic and lateral abutment. Using the independent sample T  test a significant statistical difference was observed between two groups (P<0.001. The fracture resistance of anterior samples was lower than the posterior ones.Conclusion: Based on the results of this study regarding the high fracture resistance in both areas FRC inlay bridges could be recommended for upper anterior and lower posterior teeth in clinical dentistry certainly more studies are needed to ascertain this treatment option.

  11. Displaced fracture through the anterior atlantal synchondrosis

    Energy Technology Data Exchange (ETDEWEB)

    Thakar, Chrishan; Allibone, James [Royal National Orthopaedic Hospital NHS Trust, Department of Spinal Deformity, Stanmore, Middlesex (United Kingdom); Harish, Srinivasan [Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, Stanmore, Middlesex (United Kingdom); Saifuddin, Asif [Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, Stanmore, Middlesex (United Kingdom); University College, The Institute of Orthopaedics and Musculoskeletal Sciences, London (United Kingdom)

    2005-09-01

    In the acute setting, accurate radiological interpretation of paediatric cervical spine trauma can be difficult due to a combination of normal variants and presence of multiple synchondroses. We present a rare case of a fracture through the anterior atlantal synchondrosis in a paediatric spine. A five-year-old boy, who fell backwards onto the top of his head while swinging across on a monkey bar frame, presented with neck pain, cervical muscle spasm and decreased right lateral rotation and extension of his neck. Computed tomography showed a displaced diastatic fracture through right anterior atlantal synchondrosis. There are only 12 cases of paediatric C1 fractures reported in the world literature. The importance of considering this diagnosis in the appropriate clinical setting, and the normal variants in the paediatric atlas that can cause diagnostic dilemma to the interpreting radiologist, are discussed in this case report. (orig.)

  12. Concave distal end of ulna metaphysis alone is not a sign of rickets

    International Nuclear Information System (INIS)

    Statements have been made in the literature and in legal testimony that misrepresent the radiographic finding of concave distal end of the ulnar metaphysis. To demonstrate that a concave distal end of the ossified ulna in infancy can be normal. Eighty distal wrists of randomly selected infants in the first year of life with radiographic evidence that ruled out rickets were reviewed. In 16 of the cases (20%), mild or moderate concavity of the distal end of the ulna was seen. An intact metaphyseal collar of distal radius or ulna confirmed the absence of radiographic rickets. The finding of 20% of concave distal ulnas in the first year of life confirms the widely acknowledged statements that concave distal end of the ulna alone is not indicative of rickets. Statements to the contrary are not justified. (orig.)

  13. Concave distal end of ulna metaphysis alone is not a sign of rickets

    Energy Technology Data Exchange (ETDEWEB)

    Oestreich, Alan E. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, 5031, Cincinnati, OH (United States)

    2015-07-15

    Statements have been made in the literature and in legal testimony that misrepresent the radiographic finding of concave distal end of the ulnar metaphysis. To demonstrate that a concave distal end of the ossified ulna in infancy can be normal. Eighty distal wrists of randomly selected infants in the first year of life with radiographic evidence that ruled out rickets were reviewed. In 16 of the cases (20%), mild or moderate concavity of the distal end of the ulna was seen. An intact metaphyseal collar of distal radius or ulna confirmed the absence of radiographic rickets. The finding of 20% of concave distal ulnas in the first year of life confirms the widely acknowledged statements that concave distal end of the ulna alone is not indicative of rickets. Statements to the contrary are not justified. (orig.)

  14. Anterior Cruciate Ligament Injuries in Growing Skeleton

    OpenAIRE

    AlHarby, Saleh W.

    2010-01-01

    Anterior cruciate ligament (ACL) injuries in the adult patients are thoroughly studied and published in orthopedic literature. Until recently, little was known about similar injuries in skeletally growing patients. The more frequent involvement of this age group in various athletic activities and the improved diagnostic modalities have increased the awareness and interest of ACL injuries in skeletally immature patients. ACL reconstruction in growing skeleton is controversial and carries some ...

  15. Biomechanics and anterior cruciate ligament reconstruction

    OpenAIRE

    Vercillo Fabio; Dede Ozgur; Wu Changfu; Woo Savio; Noorani Sabrina

    2006-01-01

    Abstract For years, bioengineers and orthopaedic surgeons have applied the principles of mechanics to gain valuable information about the complex function of the anterior cruciate ligament (ACL). The results of these investigations have provided scientific data for surgeons to improve methods of ACL reconstruction and postoperative rehabilitation. This review paper will present specific examples of how the field of biomechanics has impacted the evolution of ACL research. The anatomy and biome...

  16. Current Trends in Anterior Cruciate Ligament Reconstruction

    OpenAIRE

    Kim, Ha Sung; Seon, Jong Keun; Jo, Ah Reum

    2013-01-01

    The advances in the knowledge of anatomy, surgical techniques, and fixation devices have led to the improvement of anterior cruciate ligament (ACL) reconstruction over the past 10 years. Nowadays, double bundle and anatomical single bundle ACL reconstruction that more closely restores the normal anatomy of the ACL are becoming popular. Although there is still no definite conclusion whether double bundle ACL reconstruction provides better clinical results than single bundle reconstruction, the...

  17. Familial predisposition to anterior cruciate ligament injury

    OpenAIRE

    Kenichi Goshima; Katsuhiko Kitaoka; Junsuke Nakase; Hiroyuki Tsuchiya

    2014-01-01

    Although several risk factors for anterior cruciate ligament (ACL) injury have been evaluated in the literature, there are few reports on familial predisposition. This study investigated the familial predisposition to ACL injury. The study included 350 patients who underwent ACL reconstruction between January 2005 and September 2008. All patients were surveyed by telephone or a written questionnaire about family history (FH) of ACL injury, sports played by family members, and mechanisms of in...

  18. Foreign Body Embedded in Anterior Chamber Angle

    OpenAIRE

    Shmuel Graffi; Beatrice Tiosano; Ran Ben Cnaan; Jonathan Bahir; Modi Naftali

    2012-01-01

    Introduction. We present a case of a metallic foreign body embedded in the anterior chamber angle. After standing in close proximity to a construction worker breaking a tile, a 26-year-old woman using soft contact lens for the correction of mild myopia presented to emergency department for evaluation of a foreign body sensation of her right eye. Methods and Results. Diagnosis was confirmed by gonioscopic examination and a noncontrast CT scan of head and orbits. The foreign body was removed by...

  19. Anterior Cruciate Ligament Injuries in Wakeboarding

    OpenAIRE

    Starr, Harlan M.; Sanders, Brett

    2012-01-01

    Background: Wakeboarding is an increasingly popular sport that involves aggressive stunts with high risk for lower extremity injury, including anterior cruciate ligament (ACL) rupture. Little has been reported on prevalence or mechanism of ACL injury while wakeboarding. Hypothesis: The prevalence of ACL injury in wakeboarding approaches that of other high-risk sports. Analyzing the mechanism of ACL injury may aid in future efforts of prevention. Study Design: Descriptive epidemiology study. M...

  20. Risk Factors for Anterior Cruciate Ligament Injury

    OpenAIRE

    Smith, Helen C.; Vacek, Pamela; Johnson, Robert J.; Slauterbeck, James R.; Hashemi, Javad; Shultz, Sandra; Beynnon, Bruce D.

    2012-01-01

    Context: Injuries to the anterior cruciate ligament (ACL) are immediately disabling and are associated with long-term consequences, such as posttraumatic osteoarthritis. It is important to have a comprehensive understanding of all possible risk factors for ACL injury to identify individuals who are at risk for future injuries and to provide an appropriate level of counseling and programs for prevention. Objective: This review, part 2 of a 2-part series, highlights what is known and still unkn...

  1. Erlotinib-related bilateral anterior uveitis

    OpenAIRE

    Ali, Kashif; Kumar, Indu; Usman-Saeed, Muniba; Usman Saeed, Muhammad

    2011-01-01

    The authors report the case of a 68-year-old woman with secondary adenocarcinoma of the lungs from an unknown primary. Erlotinib was started which produced symptoms suggestive of uveitis. Erlotinib was stopped and restarted a month later at a lower dose, which resulted in severe bilateral anterior uveitis. The uveitis settled after stopping erlotinib and treatment with topical steroids and cycloplegics. To the best of the authors’ knowledge, this is the first case of erlotinib-related anterio...

  2. Anterior segment dysgenesis in mosaic Turner syndrome

    OpenAIRE

    Lloyd, I; Haigh, P; Clayton-Smith, J.; Clayton, P.; Price, D.; Ridgway, A; Donnai, D

    1997-01-01

    AIMS/BACKGROUND—Females with Turner syndrome commonly exhibit ophthalmological abnormalities, although there is little information in the literature documenting findings specific to Turner syndrome mosaics. Ophthalmic findings are described in four patients with mosaic Turner syndrome. All had anterior chamber abnormalities and all four had karyotypic abnormalities with a 45, X cell line. The possible relation between the karyotypic and the phenotypic findings in these patients is discussed.
...

  3. Anterior uveitis and its relation to stress

    OpenAIRE

    MULHOLLAND, B; Marks, M; Lightman, S

    2000-01-01

    BACKGROUND/AIMS—Idiopathic recurrent acute anterior uveitis (RAAU) is a common reason for attendance at ophthalmic casualty departments. Patients who suffer with this condition may have multiple recurrent episodes which are often debilitating and necessitate time off work. If recurrences are identified early and treatment initiated rapidly, the inflammation can be minimised and settles quickly on topical treatment with a speedy functional recovery by the patient. It has been our clinical impr...

  4. Bilateral anterior uveitis secondary to erlotinib

    OpenAIRE

    Lim, Lik Thai; Blum, Robert Alexander; Cheng, Chee Peng; Hanifudin, Abdul

    2010-01-01

    Bilateral anterior uveitis secondary to erlotinib phone: +44-784-3617788 (Lim, Lik Thai) (Lim, Lik Thai) Ophthalmology Department, Gartnavel General Hospital - Great Western Road - G12 0YN - Glasgow - UNITED KINGDOM (Lim, Lik Thai) Ophthalmology Department, Gartnavel General Hospital - Great Western Road - G12 0YN - Glasgow - UNITED KINGDOM (Blum, Robert Alexander) Ophthalmology Department, Gartnavel General Hospital - Great Western Road - G12 0YN - G...

  5. Multimodal emotion perception after anterior temporal lobectomy

    OpenAIRE

    Valérie Milesi; Chiara Cristinzio; Margitta Seeck

    2014-01-01

    In the context of emotion information processing, several studies have demonstrated the involvement of the amygdala in emotion perception, for unimodal and multimodal stimuli. However, it seems that not only the amygdala, but several regions around it, may also play a major role in multimodal emotional integration. In order to investigate the contribution of these regions to multimodal emotion perception, five patients who had undergone unilateral anterior temporal lobe resection were exposed...

  6. Guideline on anterior cruciate ligament injury

    OpenAIRE

    Meuffels, Duncan; Poldervaart, Michelle T.; Diercks, Ron L; Fievez, Alex W.F.M.; Patt, Thomas W; van der Hart, Cor P; Hammacher, Eric; Meer, Fred; Goedhart, Edwin A; Lenssen, Anton F; Muller-Ploeger, Sabrina B; Pols, Margreet; Saris, Daniel

    2012-01-01

    textabstractThe Dutch Orthopaedic Association has a long tradition of development of practical clinical guidelines. Here we present the recommendations from the multidisciplinary clinical guideline working group for anterior cruciate ligament injury. The following 8 clinical questions were formulated by a steering group of the Dutch Orthopaedic Association. • What is the role of physical examination and additional diagnostic tools? • Which patient-related outcome measures should be used? • Wh...

  7. Novel Insights into Anterior Cruciate Ligament Injury

    OpenAIRE

    Meuffels, Duncan

    2011-01-01

    textabstractAnterior cruciate ligament (ACL) injury is one of the most common sports injuries of the knee. ACL reconstruction has become, standard orthopaedic practice worldwide with an estimated 175,000 reconstructions per year in the United States.6 The ACL remains the most frequently studied ligament in orthopaedic research. Hundreds of papers are published each year related to the ACL. However, the treatment options and techniques are still developing and increasing, indicating the diffic...

  8. Psychological Aspects of Anterior Cruciate Ligament Injuries

    OpenAIRE

    Ardern, Clare; Kvist, Joanna; Webster, Kate E.

    2016-01-01

    Impairment-based evaluation has, until recently, been the mainstay of orthopaedic research in anterior cruciate ligament (ACL) reconstruction. However, participation-based outcomes, in particular returning to sport, have lately garnered increased research attention. This is important because returning to sport is typically a main concern of injured athletes. Recent metaanalyses have demonstrated that the return to sport rate after ACL reconstruction is disappointingly low, and that a range of...

  9. Anterior Tibial Artery Pseudoaneurysm: Case Report

    Directory of Open Access Journals (Sweden)

    Funda Tor

    2012-06-01

    Full Text Available The aneurysmsatic changes of the infrapopliteal arteries are rarely seen. They are pseudoaneurysms rather than true aneursyms. The most important cause of them is trauma. There is not a standart treatment for infrapopliteal aneursyms. In this study, we have evaluated a case operated for anterior tibial artery pseudoaneurysm developed after penetrant trauma and diagnosed two weeks later. [Cukurova Med J 2012; 37(3.000: 172-175

  10. Anterior approaches to the upper thoracic spine

    International Nuclear Information System (INIS)

    The upper thoracic spine region is difficult to access from an anterior approach because of the surrounding bones (ribs, sternum and scapulae) and organs (heart, lung and great vessels). The outcomes of 37 consecutive cases with lesions in the upper thoracic spine region (T1-4) were reviewed to study surgical approaches to the upper thoracic spine. We used anterior approaches in 13 cases. A full sternotomy was performed in 6 cases (5 cases ossification of posterior longitudinal ligament (OPLL), 1 case herniated disc), a high thoracotomy was performed in 6 cases (3 cases herniated disc, 2 cases spinal cord tumor, 1 case TB spine), and a partial resection of a unilateral sternoclavicular joint was performed in 1 case. A sternotomy is thought to be useful for OPLL in the T1-3 region, whereas a high thoracotomy is recommended for unilateral anterior lesions and lesions extending below the T3/4 level. Reconstructive CT sagittal images can supply useful anatomical informations for selecting a surgical approach. (author)

  11. Direct repair of chronic distal biceps tendon tears

    Directory of Open Access Journals (Sweden)

    Bernardo Barcellos Terra

    2016-06-01

    Full Text Available ABSTRACT OBJECTIVE: To present the results from direct tendon repair using EndoButton and interference screws in patients with lesions of the distal biceps that had evolved over a period of more than 28 days. METHODS: Between January 2012 and November 2013, eleven patients (all male with a torn distal biceps and a time interval between injury and surgery of more than 28 days were evaluated. The patients' mean age was 46 years and the most common mechanism of injury was eccentric loading with the elbow flexed and supinated. RESULTS: A subjective analysis on pain and function was conducted using a visual analog scale of pain (VAS and the Mayo Elbow Performance Score (MEPS, before and after surgery. The VAS showed a decrease of 5 points to 0.8 points on average. The MEPS improved from 69.3 points before the operation to 97.5 points afterwards. The mean flexion was 133.1° on the operated side, versus 134.3°. The mean extension was -2.5° and 0° (operated side versus non-operated. Supination was 88.2° versus 89.5° and pronation was 82.5° versus 84.1°, comparing the operated side versus the non-operated side. Flexion and supination strengths were evaluated with the aid of a dynamometer, and the mean flexion and supination strengths were found to be respectively 78.57% and 89.65% of the strength of the non-operated limb. CONCLUSION: Use of the technique of direct tendon repair using EndoButton and interference screws was shown to be a safe and effective alternative for repairing chronic lesions of the distal biceps.

  12. Outcome Assessment after Aptis Distal Radioulnar Joint (DRUJ Implant Arthroplasty

    Directory of Open Access Journals (Sweden)

    Amir Reza Kachooei

    2014-09-01

    Full Text Available Background:  Conventional treatments after complicated injuries of the distal radioulnar joint (DRUJ such as Darrach and Kapandji-Sauvé procedures have many drawbacks, which may eventually lead to a painful unstable distal ulna.  The development of DRUJ prosthesis has significantly evolved over the past years. In this study, we assessed the outcome results of patients after DRUJ implant arthroplasty using the Aptis (Scheker prosthesis. Methods: We identified 13 patients with 14 prosthesis during the past 10 years. Patients underwent DRUJ arthroplasty due to persistent symptoms of instability, chronic pain, and stiffness. Records and follow-up visits were reviewed to find the final post-operative symptoms, pain, range of motion, and grip strength with a mean follow-up of 12 months (range: 2-25 months. Also, patients were contacted prospectively by phone in order to  minister the disabilities of the armshoulder and hand (DASH, patient rated wrist evaluation (PRWE, and visual analogue scale (VAS, and to interview regarding satisfaction and progress in daily activities. Eleven patients out of 13 could be reached with a median followup time of 60 months (range: 2 to 102 months.  Results: No patient required removal of the prosthesis. Only two patients underwent secondary surgeries in which both required debridement of the screw tip over the radius. The median DASH score, PRWE score, VAS, and satisfaction were 1.3, 2.5, 0, and 10, respectively. The mean range of flexion, extension, supination, and pronation was 62, 54, 51, and 64, respectively. Conclusions: Distal radioulnar joint injuries are disabling and patients usually undergo one or more salvage surgeries prior to receiving an arthroplasty. The Scheker prosthesis has shown satisfactory results with 100% survival rate in all reports. The constrained design of this prosthesis gives enough stability to prevent painful subluxation.

  13. Distal bronchial tubes damage in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    M V Sheyanov

    2009-12-01

    Full Text Available Objective. To study prevalence and clinical picture of distal parts of bronchial tree(bronchiolitis in pts with rheumatoid arthritis (RA. Material and methods. 104 nonsmoking pts with RA and 100 pts without RA and chronic diseases of respiratory apparatus were included. General clinical examination, spirometry, bodyplethysmography, examination of lung diffusion capacity (LDC and multispiralcomputed tomography (MSCT of lungs were performed. Results. Direct and indirect bronchiolitis signs were revealed with MSCT in 36 (35% ptswith RA and 1 pt of control group (p<0,01. Pts with signs of bronchiolitis complained of shortness of breath (69% of pts, cough (56%, phlegm discharge (56%, heavy breathing (25%. Obstructive lung ventilation disturbances were revealed in 19 (53% RA pts with bronchiolitis. Restrictive disturbances and LDC decrease were present in 3 (8% pts. High frequency of oligosymptomatic bronchiolitis course was found in RA pts. Bronchiolitis symptoms in RA pts coincided with signs of proximal bronchial tubes damage forming picture of diffuse damage of bronchial tree. Conclusion. Bronchiolitis is a prevalent variant of respiratory apparatus damage in pts with RA. Pts with MSCT signs of bronchiolitis often have cough, phlegm discharge, shortness of breath, heavy breathing. Lung ventilation disturbances of obstructive type are common but part of pts has normal lung functional measures or restriction. Oligosymptomatic forms of distal bronchial tubes damage are prevalent in RA pts. Lung MSCT is the main method of bronchiolitis diagnostics because bronchiolitis induces nonspecific clinical signs and RA pts have multilevel respiratory apparatus damage. MSCT reveals signs of distal bronchial tubes damage in 35% of RA pts.

  14. Functional Outcomes of Primary Anterior Cruciate Ligament Reconstruction with Tibialis Anterior Allograft

    Science.gov (United States)

    Başar, Selda; Büyükafşar, Enes; Hazar, Zeynep; Ataoğlu, Baybars; Kanatlı, Ulunay

    2014-01-01

    Objectives: Allografts have potential advantages in primary anterior cruciate ligament reconstruction (ACLR), including the absence of donor site morbidity, shorter operative times, improved cosmesis, and easier rehabilitation. There is limited and conflicting outcome data for ACLR with tibialis anterior allograft. The purpose of this study was to evaluate the functional outcomes of ACLR with tibialis anterior allograft. Methods: We retrospectively evaluated patients underwent ACLR using with tibialis anterior allograft between 2005 and 2013. Totally 12 patients who were performed suspensory fixation technique were included in this study (range: 25-43 years). Exclusion criteria included double bundle, bone tendon bone technique and revision surgery. Clinical outcomes were measured by subject part of International Knee Documentation Committee (IKDC) and Lysholm scores. Results: A significant increase was reported in all the clinical scores. In particular, the IKDC-subjective score increased from a basal value of 45.5±12.7 to 84.3±5.50 at the 12 months' evaluation (p<0.05). The Lysholm score revealed a significant improvement from 49.7±14.2 to 83.5±20.5 at the 12 months' evaluation (p<0.05). Conclusion: ACLR with tibialis anterior allograft is an effective treatment for correcting loss of function and increasing quality of life.

  15. A Novel Technique for Anterior Vaginal Wall Prolapse Repair: Anterior Vaginal Wall Darn

    Directory of Open Access Journals (Sweden)

    Osman Köse

    2013-01-01

    Full Text Available Aim. The aim of this study is to introduce a new technique, anterior vaginal wall darn (AVWD, which has not been used before to repair the anterior vaginal wall prolapse, a common problem among women. Materials and Methods. Forty-five women suffering from anterior vaginal wall prolapse were operated on with a new technique. The anterior vaginal wall was detached by sharp and blunt dissection via an incision beginning from the 1 cm proximal aspect of the external meatus extending to the vaginal apex, and the space between the tissues that attach the lateral walls of the vagina to the arcus tendineus fascia pelvis (ATFP was then darned. Preoperation and early postoperation evaluations of the patients were conducted and summarized. Results. Data were collected six months after operation. Cough stress test (CST, Pelvic Organ Prolapse Quantification (POP-Q evaluation, Incontinence Impact Questionnaire (IIQ-7, and Urogenital Distress Inventory (UDI-6 scores indicated recovery. According to the early postoperation results, all patients were satisfied with the operation. No vaginal mucosal erosion or any other complications were detected. Conclusion. In this initial series, our short-term results suggested that patients with grade II-III anterior vaginal wall prolapsus might be treated successfully with the AVWD method.

  16. Giant cells tumor of radius distal end and bone reconstruction

    International Nuclear Information System (INIS)

    This is the case of a black women aged 40 presenting with a tumor of distal end of right radium with histological diagnosis of low-grade malignancy giant cells tumor and proposal of limb amputation. A conservative surgery was performed with a two-steps total exeresis of lesion sparing the oncologic margin. A fibular free-graft was used and wrist arthrodesis and internal fixation of graft using AO system. There was a good graft consolidation and an active incorporation of patient to social activities. The diagnosis, treatment, follow-up, rehabilitation and case prognosis are exposed

  17. ROLE OF SUPRACONDYLAR NAILING IN DISTAL FEMORAL FRACTURES

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    Abhishek

    2014-08-01

    Full Text Available : BACKGROUND: Fractures of distal femur are complex injuries that can be difficult to manage. Due to poor bone stock, less cortical bone in this region, wide medullary cavity and frequently associated severe soft tissue damage. METHODS: From June 2008 to April 2012, a prospective study of 46 patients, with distal femoral fractures, including supracondylar and inter condylar fractures, treated with intramedullary supracondylar nail, was done to evaluate its results and final functional outcome and its applicability in open as well as closed distal femoral fractures. Four cases were lost to follow up; six had followed up for less than six months. These ten cases were excluded from the study hence effectively the study included total thirty six cases. Average age of patients was 41.7 yrs. with Male: Female ratio of 2.6:1. Among 36 fractures 16.6% were of type A1, 44.4% were of type A2, 27.7% were of type A3 and 11.1% were of type C1. 27.7% fractures were open and associated injuries were present in 22.2% of cases. Second generation supracondylar nail was used for definitive fixation in all eighteen cases, through percutaneous patellar tendon splitting approach in 26 patients and medial parapatellar arthrotomy approach in ten patients. RESULTS: At an average follow up of 9 months, final functional outcome was evaluated as per Neer’s criteria (1967. Average time of union was 17.5 weeks, with an average range of movement being 101.38. Functional results were excellent in 20 (55.5% cases, satisfactory in 10 (27.7% cases, unsatisfactory in 2 (5.5% and poor in 4 (11.1% cases. No significant correlation was observed in this study between the age of the patient, fracture type and the final functional outcome achieved. Similarly no significant difference was observed between the final functional outcomes achieved in open versus closed fracture. However patients treated with medial parapatellar arthrotomy approach were found to be associated with increased

  18. Management of Intercarpal Ligament Injuries Associated with Distal Radius Fractures.

    Science.gov (United States)

    Desai, Mihir J; Kamal, Robin N; Richard, Marc J

    2015-08-01

    The prevalence of ligamentous injury associated with fractures of the distal radius is reported to be as high as 69% with injury to the scapholunate interosseous ligament and lunotriquetral interosseous ligament occurring in 16% to 40% and 8.5% to 15%, respectively. There is a lack of consensus on which patients should undergo advanced imaging, arthroscopy, and treatment and whether this changes their natural history. Overall, patients with high-grade intercarpal ligament injuries are shown to have longer-term disability and sequelae compared with those with lower-grade injuries. This article reviews the diagnosis and treatment options for these injuries. PMID:26205702

  19. Sistema basado en casos para apoyar el proceso de clasificación penitenciaria

    Directory of Open Access Journals (Sweden)

    Yadira Benavides Zaila

    2012-12-01

    Full Text Available Los sistemas de clasificación del régimen de severidad, se consideran el cerebro de la gestión de un Sistema Penitenciario ya que son esenciales para proyectar las necesidades de recursos en el futuro. Un correcto funcionamiento del sistema de clasificación permite la toma de decisiones en relación a la construcción de espacios para la reclusión, contratación y capacitación del personal, establecimiento de programas de educación y rehabilitación, de acuerdo a las necesidades de los internos. El presente trabajo tiene como objetivo el desarrollo de un sistema inteligente que permita insertarse en el proceso de calificación en los sistemas penitenciarios. El diseño del sistema estará enfocado en la técnica de Razonamiento Basado en Casos que permita utilizar la experiencia de expertos en el campo de la clasificación del nivel de severidad dadas las características de un sujeto. A partir del análisis de sistemas de clasificación utilizados en varios países, y la validación de expertos, se proponen los rasgos para conformar los casos de la Base de Casos del sistema y la relevancia de cada una de ellos. La utilización del sistema propuesto contribuirá a acelerar el proceso de clasificación y evitar o disminuir errores durante su ejecución.

  20. Propuesta de esquemas de tratamiento antituberculosis basados en la susceptibilidad A isoniacida y rifampicina

    Directory of Open Access Journals (Sweden)

    Alberto Mendoza-Ticona

    2013-04-01

    Full Text Available Objetivo. Elaborar esquemas de tratamiento para tuberculosis de acuerdo con sus perfiles de susceptibilidad a isoniacida (H y rifampicina (R. Materiales y métodos. Un total de 12 311 aislamientos de M. tuberculosis (Instituto Nacional de Salud, 2007-2009 se clasificaron en cuatro grupos de acuerdo con su susceptibilidad a H y R. En cada grupo se analizó la sensibilidad a etambutol (E, pirazinamida (Z, estreptomicina (S, kanamicina (Km, capreomicina (Cm, ciprofloxacina (Cfx, etionamida (Eto, cicloserina (Cs y ácido p-amino salicílico (PAS. En base a los perfiles de resistencia, principios de terapéutica de la Organización Mundial de la Salud y costos en el país, se elaboraron los esquemas más adecuados para cada grupo. Se definió la eficacia potencial (EP como la proporción de cepas sensibles a tres o cuatro drogas del esquema evaluado. Resultados. Los esquemas con el menor costo y la mayor EP a tres y cuatro drogas para tuberculosis sensible a H y R fueron: HRZ (EP=99,5%, HREZ (EP=99,1%; REZCfx (EP=98,9% y para tuberculosis resistente a H: REZCfxKm (EP=97,7%. Para tuberculosis resistente a R: HEZCfx (EP=96,8% y HEZCfxKm (EP=95,4%; el esquema con mejor eficacia potencial para tuberculosis multidrogorresistente fue EZCfxKmEtoCs (EP=82,9%. Conclusión. Basados en la resistencia a H y R se han elaborado y seleccionado esquemas de tratamiento con la más alta probabilidad de eficacia. Esta propuesta es una alternativa viable para hacer frente a la tuberculosis en Perú donde el acceso a pruebas de sensibilidad rápida a H y R se viene expandiendo.

  1. Propuesta de esquemas de tratamiento antituberculosis basados en la susceptibilidad A isoniacida y rifampicina

    Directory of Open Access Journals (Sweden)

    Alberto Mendoza-Ticona

    2013-06-01

    Full Text Available Objetivo. Elaborar esquemas de tratamiento para tuberculosis de acuerdo con sus perfiles de susceptibilidad a isoniacida (H y rifampicina (R. Materiales y métodos. Un total de 12 311 aislamientos de M. tuberculosis (Instituto Nacional de Salud, 2007-2009 se clasificaron en cuatro grupos de acuerdo con su susceptibilidad a H y R. En cada grupo se analizó la sensibilidad a etambutol (E, pirazinamida (Z, estreptomicina (S, kanamicina (Km, capreomicina (Cm, ciprofloxacina (Cfx, etionamida (Eto, cicloserina (Cs y ácido p-amino salicílico (PAS. En base a los perfiles de resistencia, principios de terapéutica de la Organización Mundial de la Salud y costos en el país, se elaboraron los esquemas más adecuados para cada grupo. Se definió la eficacia potencial (EP como la proporción de cepas sensibles a tres o cuatro drogas del esquema evaluado. Resultados. Los esquemas con el menor costo y la mayor EP a tres y cuatro drogas para tuberculosis sensible a H y R fueron: HRZ (EP=99,5%, HREZ (EP=99,1%; REZCfx (EP=98,9% y para tuberculosis resistente a H: REZCfxKm (EP=97,7%. Para tuberculosis resistente a R: HEZCfx (EP=96,8% y HEZCfxKm (EP=95,4%; el esquema con mejor eficacia potencial para tuberculosis multidrogorresistente fue EZCfxKmEtoCs (EP=82,9%. Conclusión. Basados en la resistencia a H y R se han elaborado y seleccionado esquemas de tratamiento con la más alta probabilidad de eficacia. Esta propuesta es una alternativa viable para hacer frente a la tuberculosis en Perú donde el acceso a pruebas de sensibilidad rápida a H y R se viene expandiendo.

  2. High prevalence of anterolateral ligament abnormalities in magnetic resonance images of anterior cruciate ligament-injured knees.

    Science.gov (United States)

    Claes, Steven; Bartholomeeusen, Stijn; Bellemans, Johan

    2014-03-01

    The purpose of this study was to identify the newly described anterolateral ligament of the human knee on magnetic resonance imaging and to describe its eventual radiological abnormalities in anterior cruciate ligament-injured subjects. A retrospective cohort study on a series of consecutive subjects undergoing anterior cruciate ligament reconstructive surgery was performed. The MR images of 206 included knees were studied and the status of the anterolateral ligament status was judged to be either "non-visualized", "normal" or "abnormal". Of all the visualized anterolateral ligaments, 44 (21.3%) were considered uninjured, while 162 (78.8%) knees demonstrated radiological ALL abnormalities. The majority of ALL abnormalities were situated in the distal part of the ligament (77.8%). In conclusion, the anterolateral ligament can be identified on classic knee magnetic resonance images. Although anterior cruciate ligament injured subjects often demonstrated associated anterolateral ligament lesions, further research is needed in order to establish the clinical relevance of these highly frequent radiological abnormalities. PMID:24873084

  3. MRI appearances of the anterior fibulocalcaneus muscle: a rare anterior compartment muscle

    Energy Technology Data Exchange (ETDEWEB)

    Upadhyay, Bhavin [Basildon and Thurrock University Hospitals NHS Foundation Trust, Imaging Department, Essex (United Kingdom); Amiras, Dimitri [Imperial College Health Care NHS Trust, Imaging Department, London (United Kingdom)

    2015-05-01

    MRI of a 62-year-old female presenting with ankle pain demonstrated an accessory muscle within the anterior compartment of the lower leg. The muscle originated from the fibula and anterior crural septum. The tendon passed anterior to the lateral malleolus and inserted at the critical angle of Gissane on the calcaneus. This muscle was initially described in the anatomic literature by Lambert and Atsas in 2010. To our knowledge, this is the first time the MRI appearances of this muscle has been described in the radiological literature. Awareness of the fibulocalcaneal muscle is important as it may represent a cause of ankle pain. In addition, the tendon could potentially be harvested for use in reconstructive procedures. (orig.)

  4. Anterior Decompression and Anterior Instrumentation of Tuberculosis of Cervicothoracic Spine by Cervicomanubrial Approach

    Directory of Open Access Journals (Sweden)

    Anant Kumar Garg

    2012-04-01

    Full Text Available Background: Evaluation of result of anterior cervical approach with manubriotomy and anterior instrumentation in tuberculosis of cervicothoracic spine in terms of the neurological recovery, reconstruction of spine and prevention of deformity along with relief of pain. Materials and Methods: All five patients with cervicothoracic caries spine had surgery through anterior cervical approach with manubriotomy in our hospital and underwent excision of the involved vertebrae and intervertebral discs followed by anterior spinal reconstruction with titanium spacer cage filled with cancellous iliac crest bone graft and Orion plate with locking screw. Antitubercular drugs were administered for 12 months. The follow-up period ranged from 12 to 36 months. Results: Analysis of result was done on the basis of clinical and radiological criteria. Clinical assessment based on Frankel grade and modified JOA score showed significant improvement from preoperative findings. Radiological assessment showed osteointegration, no spinal instability and no progression of the deformity. The pain control, based on visual analog scale changed from a pre-operative average of 7.5 to 2 at the last follow-up thereby indicating significant improvement and all patients returned to preoperative functional status. One patient had transient hoarseness of voice. No other complication had been encountered in the immediate post operative and during the follow-up period. Conclusions: Our study showed that anterior cervical approach with manubriotomy and anterior insertion of titanium cage, filled with autogenous bone graft, secured with locking plate instrumentation has a successful role in the eradication of infection, neurological recovery, segmental spinal reconstruction and it also reduces surgical time, blood loss, and surgical complications and approach related comorbidity in follow up period. Level of Evidence- Level 4, Case series

  5. Tendinopatia do compartimento anterior do tornozelo Tendinopathy of the anterior compartment of the ankle

    OpenAIRE

    Antonio Egydio de Carvalho Junior; Cíntia Kelly Bittar; Osny Salomão; João Batista de Miranda; André Ninomiya; Daniel Bento Silva

    2010-01-01

    OBJETIVO: Análise retrospectiva da etiopatogenia, diagnóstico e opções de tratamento nos casos de tendinopatias do compartimento anterior do tornozelo (TCAT). MÉTODO: No período de setembro de 1998 a fevereiro de 2009, 13 pacientes foram operados por tendinopatia do compartimento anterior do tornozelo. A casuística constou de 10 pacientes do sexo masculino e três do feminino. O lado direito foi acometido em 12 pés e um do esquerdo. A média de idade foi de 35 anos (15-67). A etiologia foi trau...

  6. Tireoide ectópica no mediastino anterior Ectopic thyroid in the anterior mediastinum

    OpenAIRE

    Maria José Araújo da Cunha Guimarães; Carla Manuela Silva Valente; Lèlita Santos; Manuel Fontes Baganha

    2009-01-01

    A ectopia de tireoide é rara, e a sua localização no mediastino anterior é excepcional, estando descritos apenas 5 casos nos últimos 30 anos. Os autores apresentam 2 casos clínicos, além de uma revisão da literatura abordando a etiologia, a embriologia e manifestações clínicas de ectopia de tireoide.Ectopic thyroid is a rare condition, and its location in the anterior mediastinum is even rarer, there having been only 5 reported cases in the past 30 years. Here, we describe 2 clinical cases an...

  7. Spinal irradiation does not inhibit distal axonal sprouting

    International Nuclear Information System (INIS)

    In an attempt to determine the relative importance of the nerve cell body and of the axon in initiating and controlling axonal regeneration, nerve cell bodies were irradiated and the ability of the distal axon to sprout was examined. Mice were subjected to either 25 or 50 Gray (Gy) of x-irradiation localized to the lumbar spinal cord. After times varying from 1 day to 6 months after irradiation, a sublethal dose of botulinum toxin (BoTx) was injected into the calf muscles of one leg. The soleus muscle was examined histologically after times varying from 1 week to 6 months after injection, and BoTx-induced ultraterminal axonal sprouting was assessed by the number of motor endplates showing sprouts, the length of the sprouts, and the long term endplate morphology. Apart from some irradiated subgroups having slightly shorter sprout lengths, no significant differences were found between irradiated and nonirradiated groups. The results suggest either that the processes in the nerve cell body responsible for initiating and supporting axonal growth are resistant to large doses of irradiation, or that growth regulatory mechanisms in the distal axon are under local control

  8. Concomitant physeal fractures of the distal femur and proximal tibia

    International Nuclear Information System (INIS)

    Concomitant physeal fractures of the distal femur and proximal tibia are very rare in children and adolescents. They are included in the classification of the ''floating knee'' injuries. Two cases with this combined injury are reported. They were closed injuries and in both patients the fracture of the proximal tibial epiphyseal plate was nondisplaced. In the first, a six-year-old girl, an early diagnosis was made radiographically. The intra-articular femoral fracture was operatively reduced and fixed. No growth abnormality was encountered 12 years later. The second patient, a 16-year-old boy, was conservatively treated for a displaced fracture-separation of the distal femoral epiphysis. Four weeks later there was physeal widening on both sides of the knee which indicated an associated fracture of the proximal tibial epiphyseal plate. One year after injury there was a varus deformity of the knee that was treated with a corrective osteotomy. Ten years later there is normal alignment of the leg. (orig.)

  9. Distal 10q monosomy: new evidence for a neurobehavioral condition?

    Science.gov (United States)

    Plaisancié, Julie; Bouneau, Laurence; Cances, Claude; Garnier, Christelle; Benesteau, Jacques; Leonard, Samantha; Bourrouillou, Georges; Calvas, Patrick; Vigouroux, Adeline; Julia, Sophie; Bieth, Eric

    2014-01-01

    Pure distal monosomy of the long arm of chromosome 10 is a rare cytogenetic abnormality. The location and size of the deletions described in this region are variable. Nevertheless, the patients share characteristic facial appearance, variable cognitive impairment and neurobehavioral manifestations. A Minimal Critical Region corresponding to a 600 kb Smallest Region of deletion Overlap (SRO) has been proposed. In this report, we describe four patients with a distal 10q26 deletion, who displayed attention-deficit/hyperactivity disorders (ADHD). One of them had a marked behavioral profile and relatively preserved cognitive functions. Interestingly, the SRO was not included in the deleted segment of this patient suggesting that this deletion could contain candidate genes involved in the control of neurobehavioral functions. One of these candidates was the CALY gene, known for its association with ADHD patients and whose expression level was shown to be correlated with neurobehavioral disturbances in varying animal models. This report emphasizes the importance of the behavioral problems as a cardinal feature of the 10q microdeletion syndrome. Haploinsufficiency of CALY could play a crucial role in the development of the behavioral troubles within these patients. PMID:24275544

  10. Artrite interfalangeana distal séptica em bovinos

    Directory of Open Access Journals (Sweden)

    Juliano Santos Gueretz

    2005-06-01

    Full Text Available Afecções podais são relativamente comuns em bovinos, principalmente em rebanhos leiteiros. São de difícil e oneroso tratamento. Causam claudicação, desconforto, dor e perdas econômicas. Podem ter origem exógena, por evolução de infecções nos dígitos e anexos e por traumas penetrantes.Fatores endógenos, pós mastites e afecções do útero, também podem evoluir para podopatias. Relata-se um caso de infecção na articulação interfalangeana distal numa fêmea bovina, raça charolesa, com três anos de idade, com histórico de claudicação crônica, atendida na Clínica Escola da Universidade Estadual do Centro-Oeste UNICENTRO, apresentando sinais clínicos de artrite interfalangeana distal séptica. As técnicas utilizadas no estabelecimento do diagnóstico e a terapêutica abordada são descritas. O caso serve de alerta para o estabelecimento de estratégias a fim de evitar podopatias em bovinos.

  11. Concomitant physeal fractures of the distal femur and proximal tibia

    Energy Technology Data Exchange (ETDEWEB)

    Sferopoulos, N.K. [Aristotle University of Thessaloniki, Department of Pediatric Orthopaedics, Thessaloniki (Greece)

    2005-07-01

    Concomitant physeal fractures of the distal femur and proximal tibia are very rare in children and adolescents. They are included in the classification of the ''floating knee'' injuries. Two cases with this combined injury are reported. They were closed injuries and in both patients the fracture of the proximal tibial epiphyseal plate was nondisplaced. In the first, a six-year-old girl, an early diagnosis was made radiographically. The intra-articular femoral fracture was operatively reduced and fixed. No growth abnormality was encountered 12 years later. The second patient, a 16-year-old boy, was conservatively treated for a displaced fracture-separation of the distal femoral epiphysis. Four weeks later there was physeal widening on both sides of the knee which indicated an associated fracture of the proximal tibial epiphyseal plate. One year after injury there was a varus deformity of the knee that was treated with a corrective osteotomy. Ten years later there is normal alignment of the leg. (orig.)

  12. Complicated distal femoral epiphyseolysis treated by Ilizarov method: Case report

    Directory of Open Access Journals (Sweden)

    Jovanović Vesna

    2010-01-01

    Full Text Available Introduction Injuries of the distal femur are rare in children; however, they are frequently associated with complications. They are almost always physeal, most frequently Salter-Harris type II epiphyseolysis. The treatment of such injuries is similar in all physeal injuries. It is intended to provide growth plate recovery by gentle reduction and stable fixation thus preventing secondary complications, and also to provide decompression of the segment to solve the compartment syndrome and recover the neurovascular structures. Case Outline A seven-year old boy presented with a right knee injury while sleigh riding. He was admitted three weeks following the injury with distal femoral epiphysiolysis associated with peroneal palsy. A day after admission to our Institute the reduction was performed using the Ilizarov device. Physical therapy was started immediately after surgery, as well as walking with weight bearing on the operated leg. Five months after surgery the patient was anatomically and functionally recovered. Conclusion The presented method is recommended in the treatment of such injuries because of several reasons; reposition is simple and complete, there is no need to open the fracture site, fixation is stable, the growth plate is preserved, there is no need for additional external immobilisation, and physical therapy involving walking with weight bearing on the operated leg may be started immediately after surgery. .

  13. Distal tibia fractures: management and complications of 101 cases.

    Science.gov (United States)

    Joveniaux, Pierre; Ohl, Xavier; Harisboure, Alain; Berrichi, Aboubekr; Labatut, Ludovic; Simon, Patrick; Mainard, Didier; Vix, Nicolas; Dehoux, Emile

    2010-04-01

    Distal tibia fractures are complex injuries with a high complication rate. In this retrospective and multicentre study we attempted to detail complications and outcomes of this type of injury in order to determine predictive factors of poor results. Between 2002 and 2004, 104 patients were admitted for 105 distal tibia fractures. One hundred patients (101 fractures) were reviewed with an average follow-up of 19 months (range, 12-46). Internal fixation, external fixation, limited internal fixation (K-wires or screws), intramedullary nailing and conservative treatment were used. Outcome parameters included occurrence of complications, radiographic analysis, evaluation of the American Orthopaedic Foot and Ankle Society (AOFAS) ankle score and measures of the ankle range of motion. The average functional score was 76 points (range, 30-100 points), and complications occurred in 30 patients. Predictive factors of poor results were fracture severity, complications, malunion and the use of external fixation. We believe that external fixation must be reserved for trauma with severe skin injury, as a temporary solution in a two-staged protocol. For other cases, we recommend ORIF with early mobilisation. PMID:19554328

  14. Infections after reconstructions of anterior cruciate ligament

    Directory of Open Access Journals (Sweden)

    Ristić Vladimir

    2014-01-01

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

  15. Toxic anterior-segment syndrome (TASS

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    Cetinkaya S

    2014-10-01

    Full Text Available Servet Cetinkaya,1 Zeynep Dadaci,2 Hüsamettin Aksoy,3 Nursen Oncel Acir,2 Halil Ibrahim Yener,4 Ekrem Kadioglu5 1Ophthalmology Clinics, Turkish Red Crescent Hospital, Konya, 2Department of Ophthalmology, Faculty of Medicine, Mevlana University, Konya, 3Ophthalmology Clinics, Karaman State Hospital, Karaman, 4Konya Eye Center Hospital, Konya, 5Ophthalmology Clinics, Beyhekim State Hospital, Konya, Turkey Purpose: To evaluate the clinical findings and courses of five patients who developed toxic anterior-segment syndrome (TASS after cataract surgery and investigate the cause.Materials and methods: In May 2010, on the same day, ten patients were operated on by the same surgeon. Five of these patients developed TASS postoperatively.Results: Patients had blurred-vision complaints on the first day after the operation, but no pain. They had different degrees of diffuse corneal edema, anterior-chamber reaction, fibrin, hypopyon, iris atrophies, and dilated pupils. Their vision decreased significantly, and their intraocular pressures increased. Both anti-inflammatory and antiglaucomatous therapies were commenced. Corneal edema and inflammation resolved in three cases; however, penetrating keratoplasty was needed for two cases and additional trabeculectomy was needed for one case. Although full investigations were undertaken at all steps, we could not find the causative agent.Conclusion: TASS is a preventable complication of anterior-segment surgery. Recognition of TASS, differentiating it from endophthalmitis, and starting treatment immediately is important. Controlling all steps in surgery, cleaning and sterilization of the instruments, and training nurses and other operation teams will help us in the prevention of TASS. Keywords: cataract, phacoemulsification, TASS, corneal edema, inflammation

  16. Selection of operative procedures for anterior plagiocephaly

    International Nuclear Information System (INIS)

    The purposes of this study were to evaluate long-term results after surgical treatment for anterior plagiocephaly and to identify factors that might influence these results. And according to these results selection of operative procedures for plagiocephaly was discussed. From April 1, 1985 to December 31, 2002, 12 children with anterior plagiocephaly were treated by craniofacial surgery (frontoorbital advancement) or distraction osteogenesis in Saitama Children's Medical Center. Distraction osteogenesis was applied in 3 patients with mild deformities. Preoperative severity of the craniofacial deformities, the time of operations, operative methods and long-term results were analyzed in these cases. Preoperative deformities were classified by the classification system developed by Di Rocco C et al (1988) and surgical results were graded according to the grading system reported by Wagner JD et al (1995) at the end of follow-up period. Follow-up ranged from 1 to 12 years (mean 6.2±4.9). Morphological long-term surgical results in 12 cases with plagiocephaly as follows; excellent in 8 cases, good in 3 cases and poor in 1 case. At the end of follow-up, excellent craniofacial configurations were obtained in 8 cases operated on in less than 1 year after birth or with mild craniofacial deformities (grade II) preoperatively. And also complete normalization of endocranial base asymmetries on 3D-CTs were recognized in cases operated on in less than 1 year after birth regardless of surgical procedures. These results suggest that early craniofacial surgery is necessary for an infant to attain complete normalization of the craniofacial dysmorphology of anterior plagiocephaly in spite of operative methods. (author)

  17. Biological fixation in anterior cruciate ligament surgery

    Directory of Open Access Journals (Sweden)

    Chih-Hwa Chen

    2014-04-01

    Full Text Available Successful anterior cruciate ligament (ACL reconstruction with tendon graft requires extensive tendon-to-bone healing in the bone tunnels and progressive graft ligamentization for biological, structural, and functional recovery of the ACL. Improvement in graft-to-bone healing is crucial for facilitating early, aggressive rehabilitation after surgery to ensure an early return to pre-injury activity levels. The use of various biomaterials for enhancing the healing of tendon grafts in bone tunnels has been developed. With the biological enhancement of tendon-to-bone healing, biological fixation of the tendon graft in the tunnel can be achieved in ACL reconstruction.

  18. Conceptos e implicaciones de la incorporación del Enfoque Basado en Derechos en organizaciones de desarrollo

    OpenAIRE

    PERIS BLANES, Jordi; Boni Aristizábal, Alejandra; Belda Miquel, Sergio

    2011-01-01

    La motivación del trabajo surge del hecho que el Enfoque Basado en Derechos (EBD) se está incorporando, de distintas maneras, en numerosas organizaciones que trabajan en el campo de la cooperación en el Estado español. El trabajo pretende ofrecer elementos que nos posibiliten acercarnos a estas prácticas, comprenderlas y obtener aprendizajes. En un primer momento, se ofrece una introducción que, sin voluntad de ser exhaustiva, pretende ofrecer un marco conceptual e histórico a los EBD....

  19. Análisis de los mecanismos de posicionamiento en interiores basados en huellas caso de estudio sobre Zigbee

    OpenAIRE

    Gómez Martín, José Antonio

    2014-01-01

    En estos tiempos se ha generado un creciente interés por los sistemas capaces de reconocer la ubicación del usuario y prestar servicios utilizando esta información, son los llamados LBS (Location Based Services Sistemas Basados en la Localizaciíon). La característica distintiva de estos sistemas es que la información de la aplicación y/o de la interfaz presentada al usuario está determinada, en general, por la ubicación física de éste.|

  20. Dispositivo de navegación para personas invidentes basado en la tecnología time of flight

    OpenAIRE

    Ismael Lengua; Larisa Dunai; Guillermo Peris Fajarnés; Beatriz Defez

    2013-01-01

    El artículo presenta un nuevo dispositivo de navegación y detección de obstáculos para las personas ciegas, basado en la tecnología Time-of-Flight y en sonidos acústicos. El dispositivo se ha desarrollado como un dispositivo de ayuda, complementario al bastón, para las personas invidentes. Su objetivo primordial es detectar los obstáculos e informar al usuario mediante sonidos acústicos de la locación de los mismos, tanto en distancia como en dirección. El dispositivo tiene un rango de trabaj...

  1. Aplicación del "aprendizaje basado en problemas" en los estudio de Grado en Enfermería

    OpenAIRE

    González Hernando, Carolina

    2013-01-01

    Con el fin de mejorar la calidad docente universitaria, en esta investigación, se propuso utilizar metodologías activas como el Aprendizaje Basado en Problemas en la formación de los estudiantes de Grado en Enfermería. Este trabajo constituye un nuevo paso, mi planteamiento abordó una innovación educativa desde un ángulo nuevo, realizando las prácticas de aula de los estudiantes para agregar conocimiento sobre su utilidad en el proceso de enseñanza y aprendizaje en Enfermería. Se utilizó una ...

  2. ALGORITMO PARA EL APRENDIZAJE DE REGLAS DE CLASIFICACION BASADO EN LA TEORÍA DE LOS CONJUNTOS APROXIMADOS EXTENDIDA

    Directory of Open Access Journals (Sweden)

    YAIMA FILIBERTO

    2011-01-01

    Full Text Available Los conjuntos aproximados han demostrado ser efectivos para desarrollar técnicas de aprendizaje automático, entre ellos métodos para el descubrimiento de reglas de clasificación. En este trabajo se presenta un algoritmo para generar reglas de clasificación basado en relaciones de similaridad, lo que permite que sea aplicable en casos donde los rasgos tienen dominio discreto o continuo. Los resultados experimentales muestran un desempeño satisfactorio en comparación con otros algoritmos conocidos como C4.5 y MODLEM.

  3. Material de banda intermedia basado en un compuesto semiconductor de tipo calcogenuro de estaño

    OpenAIRE

    Wahnón Benarroch, Perla; Palacios Clemente, Pablo; Sánchez Noriega, Kefrén; Aguilera Bonet, Irene; Seminovski Pérez, Yohanna; Conesa Cegarra, José Carlos; Lucena García, Raquel; Gamarra Sánchez, Daniel

    2009-01-01

    Material de banda intermedia basado en un compuesto semiconductor de tipo calcogenuro de estaño. La invención se refiere a compuestos formados mediante la introducción, dentro de un semiconductor de partida que es de tipo calcogenuro de estaño tetravalente octaédricamente coordinado, de un elemento de transición en posición octaédrica, para la fabricación de materiales o dispositivos para aplicaciones fotónicas. El elemento de transición genera una banda intermedia par...

  4. Material de banda intermedia basado en un compuesto semiconductor de tipo calcogenuro de estaño

    OpenAIRE

    Wahnón Benarroch, Perla; Palacios Clemente, Pablo; Sánchez Noriega, Kefrén; Aguilera Bonet, Irene; Seminovski Pérez, Yohanna; Conesa Cegarra, José Carlos

    2009-01-01

    Material de banda intermedia basado en un compuesto semiconductor de tipo calcogenuro de estaño. La invención se refiere a compuestos formados mediante la introducción, dentro de un semiconductor de partida que es de tipo calcogenuro de estaño tetravalente octaédricamente coordinado, de un elemento de transición en posición octaédrica, para la fabricación de materiales o dispositivos para aplicaciones fotónicas. El elemento de transición genera una banda intermedia parcialmente ocupada separa...

  5. Modelos flexibles de selección de personal basados en la valoración de competencias.

    Directory of Open Access Journals (Sweden)

    Liern Carrión, Vicente

    2008-01-01

    Full Text Available Las decisiones que toman los directivos respecto a la selección de personalcondicionan fuertemente el éxito de la empresa, pues si los empleados son elegidoscorrectamente suponen una fuente de ventaja competitiva. En este trabajo presentamosalgunos modelos fuzzy de selección de personal basados en la gestión por competencias.y la comparación con las valoraciones que la empresa considera óptimas en cadacompetencia (candidato ideal. Presentamos un algoritmo que permiten establecer unaordenación, incluso cuando el candidato ideal sólo ha sido valorado parcialmente.

  6. Aprendizaje Basado en Problemas y satisfacción de los estudiantes de Enfermería

    OpenAIRE

    González Hernando, Carolina; Carbonero Martín, Miguel Ángel; Lara Ortega, Fernando; Martín Villamor, Pedro

    2014-01-01

    ntroducción: El objetivo de esta investigación fue determinar el grado de satisfacción de los estudiantes de Enfermería después de utilizar la metodología Aprendizaje Basado en Problemas. Material y métodos: Estudio descriptivo y transversal. La muestra estuvo formada por 134 estudiantes de 2º de Grado de Enfermería de la Universidad de Valladolid. Después de la implementación de ABP se administró la escala de satisfacción de la Universidad de la Colima (México). Para el ...

  7. Empleo del aprendizaje basado en problemas (abp). Una propuesta para acercarse a la química verde

    OpenAIRE

    Marina Lucía Morales Galicia

    2013-01-01

    Los profesores han reflexionado acerca de que la educación ambiental deberá ser formativa, por lo que es importante participar para cambiar esta situación dentro del contexto en la enseñanza de las Ciencias Naturales como parte de incrementar el conocimiento acerca del deterioro del medio ambiente. Este trabajo tiene el propósito de presentar la estrategia Aprendizaje Basado en Problemas (ABP). Para demostrar esta metodología, se presentan los resultados que con esta se obtuvieron gracias a l...

  8. Diseño y análisis de un Oscilador 2-Push en banda X, basado en CSRRs

    OpenAIRE

    Flores Martin, José Luis

    2013-01-01

    RESUMEN: En el contexto de la aplicación de las técnicas de análisis no lineal a sistemas de osciladores acoplados, y aprovechando el potencial demostrado para obtener resonadores con un alto factor de calidad y reducidas dimensiones, de las estructuras de anillos resonantes utilizadas como partículas de base en el diseño de metamateriales; se ha decidido diseñar osciladores de tipo push-push (dos osciladores acoplados y sincronizados en oposición de fase) que incluyen resonadores basados en ...

  9. Efectividad de un programa de juego basado en realidad virtual para la mejora cognitiva en la esquizofrenia

    OpenAIRE

    Olga López-Martín; Antonio Segura Fragoso; Marta Rodríguez Hernández; Iris Dimbwadyo Terrer; Begoña Polonio-López

    2016-01-01

    Objetivo: Evaluar la efectividad de un programa de juego basado en la realidad virtual para la mejora de los dominios cognitivos en pacientes con esquizofrenia. Método: Ensayo clínico aleatorizado con 40 pacientes con esquizofrenia, 20 en el grupo experimental y 20 en el grupo control. El grupo experimental recibió 10 sesiones con Nintendo Wii® durante 5 semanas, 50 minutos/sesión, 2 días/semana, además del tratamiento convencional. El grupo control sólo recibió tratamiento convencional. ...

  10. Formación de un holograma en un fotopolímero basado en PVA/Acrilamida

    OpenAIRE

    Gallego Rico, Sergi; Ortuño Sánchez, Manuel; Márquez Ruiz, Andrés; Neipp López, Cristian; García Llopis, Celia; Beléndez Vázquez, Augusto; Pascual Villalobos, Inmaculada

    2004-01-01

    El interés por modelizar el comportamiento de los fotopolímeros se ha intensificado estos últimos añosdebido a su alta capacidad de almacenamiento de la modelización de la formación de una red de difracción holográfica en fotopolímeros. Se aplica en el estudio del comportamiento de un fotopolímero basado en PVA/acrilamida sin y con NN’,methylene-bis-acrylamide (BMAA) como entrecruzante. Por último también se valora la presencia de monómero residual predicha en el modelo.

  11. Sistema para la correlación de alertas de NIDS basados en anomalías

    OpenAIRE

    Maestre Vidal, Jorge

    2013-01-01

    El despliegue de un Sistema de Deteccion de Intrusiones basado en Redes (NIDS) en el perímetro de seguridad de un sistema ha de complementarse con la incorporación de herramientas que ayuden a mejorar su comportamiento. Los sistemas de correlación de alertas tienen como objetivo facilitar la gestión de las alertas emitidas, aportando información adicional, y permitiendo su agregación, agilizando de esta manera los procesos de prevención. A lo largo de los años, el area de investigación en ...

  12. Exploración dirigida por el objetivo en Aprendizaje por Refuerzo Basado en Modelo para ambientes no estacionarios

    OpenAIRE

    Errecalde, Marcelo Luis; Muchut, Alfredo

    2001-01-01

    El Aprendizaje por Refuerzo Basado en Modelo (ARBM) es una extensión al Aprendizaje por Refuerzo tradicional en la que el agente aprende una política (comportamiento), y en forma simultánea aprende un modelo de su ambiente. Distintos estudios han mostrado la superioridad de los métodos de ARBM sobre los métodos libres de Modelo en ambientes estacionarios. Sin embargo, existen serias dificultades para adaptar los métodos de ARBM a ambientes no estacionarios, existiendo actualmente un único mét...

  13. Sistema de toma de decisiones basado en emociones y autoaprendizaje para agentes sociales autónomos

    OpenAIRE

    Malfaz Vázquez, María de los Ángeles

    2007-01-01

    El objetivo de esta tesis es desarrollar un sistema de toma de decisiones para un robot personal social y autónomo. Este sistema consiste en varios módulos: el módulo motivacional, el módulo de los drives y el módulo de valoración y selección de comportamientos. Estos módulos están basados en motivaciones, drives y emociones, conceptos que son ampliamente desarrollados en esta tesis. Debido a las dificultades de trabajar con un robot real, como primer paso en esta investigac...

  14. Tranvía para mercancías basado en una plataforma convencional de transporte para viajeros

    OpenAIRE

    Regué, Robert; Astals Coma, Francesc

    2010-01-01

    El tranvía, que en España había sufrido un declive muy fuerte y prácticamente había desaparecido de nuestras ciudades, ha vuelto, en los últimos años, a experimentar un renacimiento. Ello se debe a múltiples motivos, entre otros, la mayor capacidad de transporte de los tranvías, el incremento del tráfico urbano y de las consiguientes emisiones de gases de efecto invernadero que aconsejan la sustitución progresiva de vehículos basados en motores de combustión interna por otros menos cont...

  15. Desarrollo de un sistema para minería de datos basado en los métodos Biplot

    OpenAIRE

    Vairinhos, Valter Martins

    2003-01-01

    [ES]Con esta tesis se buscó realizar dos objetivos: 1. Demostrar que tiene sentido la construcción de sistemas de minería gráfica de datos basados en el concepto de biplot, utilizando las característica únicas de interpretabilidad de estos gráficos que presentan, en un espacio métrico, conceptos expresos por conjuntos de observaciones, por conjuntos de variables y por conjuntos de variables y observaciones – lo que permite una fácil, útil e intuitiva interpretación de las proximidades ...

  16. Preparación de materiales electroluminiscentes basados en compuestos adsorbidos en el interior de sólidos porosos.

    OpenAIRE

    CABEZA MARTÍNEZ, JOSÉ FRANCISCO

    2008-01-01

    La electroluminiscencia es el fenómeno por el cual ciertos materiales emiten luz visible cuando se someten a un potencial eléctrico. En este contexto, en la presente tesis doctoral se desarrollaron dispositivos electroluminiscentes tipo OLED basados en sistemas supramoleculares huésped/hospedador, donde el grupo luminóforo se encontraba incorporado en el interior de los microporos de zeolitas, estabilizando este grupo frente a procesos químicos y agentes ambientales que originan su degradació...

  17. Proceso de evaluación basado en pruebas para la sustitución de componentes software.

    OpenAIRE

    Flores Mir, Andrés Pablo

    2009-01-01

    El Desarrollo de Software basado en Componentes ha emergido para facilitar el ensamblaje1 de sistemas. Sin embargo la modificación de un sistema mediante la snstit ución o actualización de componentes demanda un manejo cuidadoso debido a los riesgos de estabilidad en los sistemas ya desplegados. Los componentes de reemplazo deben sor apropiadamente evaluados para identificar si suministran el comportamiento esperado eme ha sido afectado por la sustitución. Para resolver este problema, en esta...

  18. Modelos flexibles de selección de personal basados en la valoración de competencias.

    OpenAIRE

    Liern Carrión, Vicente; Lara Mora, Tomás; Casasús Estellés, Trinidad; Canós Darós, Lourdes; Pérez Cantó, Juan Carlos;

    2008-01-01

    Las decisiones que toman los directivos respecto a la selección de personalcondicionan fuertemente el éxito de la empresa, pues si los empleados son elegidoscorrectamente suponen una fuente de ventaja competitiva. En este trabajo presentamosalgunos modelos fuzzy de selección de personal basados en la gestión por competencias.y la comparación con las valoraciones que la empresa considera óptimas en cadacompetencia (candidato ideal). Presentamos un algoritmo que permiten establecer unaordenació...

  19. CUESTIONARIO DE EJERCICIO BASADO EN EL MODELO TRANSTEÓRICO DE LA CONDUCTA EN UNA MUESTRA MEXICANA

    OpenAIRE

    Óscar Armando Esparza del Villar; Irene Concepción Carrillo Saucedo; Juan Quiñones Soto; Arturo del Castillo Arreola; Rebeca María Elena Guzmán Saldaña; Sergio Gabriel Ochoa Alcaraz; Gloria Margarita Gurrola Peña; Patricia Balcázar Nava; María Elena Villarreal González; Juan Carlos Sánchez Sosa

    2013-01-01

    Se elaboró un cuestionario de ejercicio basado en el modelo transteórico de cambio de la conducta propuesto por Prochaska y DiClemente. Este cuestionario fue diseñado para medir los cinco factores del modelo: precontemplación, contempla ción, preparación, acción y mantenimiento. Primero se elaboraron los reactivos para cada uno de los factores y después se llevó a cabo un análisis factorial exploratorio para analizar la estructura del cuestionario. La muestra fue de 951 participantes de cinco...

  20. Mejoras en sensores distribuidos basados en dispersión Brillouin estimulada en fibra óptica

    OpenAIRE

    Iribas Pardo, Haritz

    2015-01-01

    El presente trabajo fin de máster se ha llevado a cabo con el objetivo de desarrollar un sistema sensor de fibra óptica distribuido, capaz de monitorizar la deformación unitaria y variaciones de temperatura, basándose en el efecto de dispersión Brillouin estimulada en fibra óptica. Mejorando y solventando algunas de las limitaciones que manifiestan estos sensores hoy en día. Dado el auge actual en el que se encuentran los sensores Brillouin ópticos basados en el análisis del dominio del tiemp...

  1. Equipo compacto de medida de impedancia eléctrica multifrecuencia basado en señales multiseno

    OpenAIRE

    Sánchez Terrones, Benjamín; Bragós Bardia, Ramon

    2009-01-01

    A continuación se presenta el desarrollo e implementación de un sistema compacto de medida multifrecuencia de Espectroscopia de Impedancia Eléctrica (EIE). A diferencia de los equipos clásicos de medida de impedancia eléctrica basados en la técnica de barrido frecuencial, dicho sistema permite la caracterización instantánea del espectro de impedancia gracias a la realización simultánea de múltiples medidas espectrales mediante el uso de señales multiseno. Para disminuir el error en d...

  2. Modelos de estimación del software basados en técnicas de aprendizaje automático

    OpenAIRE

    Moreno García, María N.; Francisco José GARCÍA-PEÑALVO

    2007-01-01

    [ES]La realización de estimaciones fiables en las etapas iniciales del desarrollo de un proyecto es esencial para una efectiva toma de decisiones. Los métodos tradicionales de estimación son ampliamente conocidos y utilizados desde hace muchos años, sin embargo, actualmente están siendo reemplazados por modelos de predicción basados en técnicas de minería de datos cuya superioridad respecto a los primeros ha sido demostrada en numerosos estudios. En este capítulo se presenta una v...

  3. Un enfoque basado en competencias de sistemas multiagentes para la enseñanza de Inteligencia Artificial

    OpenAIRE

    Cecchi, Laura; Vaucheret, Claudio A.; Moya, Mario; Kogan, Pablo; Castillo, Rodolfo del; Torres, Guillermo

    2009-01-01

    En este trabajo se presenta un enfoque basado en competencias de sistemas multiagentes como fundamento de la enseñanza de tópicos avanzados en Inteligencia Artificial. La metodología fue implementada en la materia optativa Robótica Cognitiva con alumnos del 5to. año de la carrera Licenciatura en Ciencias de la Computación, de la Universidad Nacional del Comahue, en un dominio que es conocido y divertido: el fútbol. Los campeonatos que se realizan entre los diferentes equipos permiten que los ...

  4. El aprendizaje basado en competencias y el desarrollo de la dimensión social en las universidades

    OpenAIRE

    Villa Sánchez, Aurelio; Villa Leicea, Olga

    2007-01-01

    El presente artículo trata de dar a conocer las conclusiones obtenidas en un estudio realizado por la Universidad de Deusto sobre la percepción de competencias adquiridas por universitarios egresados, así como reflexionar sobre las posibilidades y los enfoques para desarrollar un aprendizaje basado en competencias con una orientación de formación integral. Este trabajo pretende responder a varias cuestiones. En primer lugar, identificar los ámbitos competenciales de una formación fundamentada...

  5. “Adquisición de competencias en mecatrónica mediante el aprendizaje basado en mini-proyectos”

    OpenAIRE

    Rengel Estévez, Raúl; García Vasallo, Beatriz; Martín Martínez, María Jesús

    2013-01-01

    [ES] El presente proyecto tenía como principal objetivo abordar, mediante el aprendizaje basado en mini-proyectos, la adquisición de competencias de mecatrónica (disciplina que aúna la Mecánica y la Electrónica) en la asignatura “Electrónica de los sistemas mecánicos”, del cuarto curso del grado en Ingeniería Mecánica impartido en la Escuela Politécnica Superior de Zamora. En el caso de las ingenierías, esta metodología parece particularmente interesante dada la propia naturale...

  6. A biomechanical approach to distal radius fractures for the emergency radiologist.

    Science.gov (United States)

    Bunch, Paul M; Sheehan, Scott E; Dyer, George S; Sodickson, Aaron; Khurana, Bharti

    2016-04-01

    Distal radius fractures are the most common upper extremity fracture and account for approximately one sixth of all fractures treated in US emergency departments. These fractures are associated with significant morbidity and have a major economic impact. Radiographic evaluation of distal radius fractures is frequently performed in the emergency department setting, has a profound impact on initial management, and is essential to assessing the quality and relative success of the initial reduction. While the most appropriate definitive management of distal radius fractures remains controversial, overarching treatment principles reflect distal radius injury mechanisms and biomechanics. An intuitive understanding of the biomechanics of the distal radius and of common mechanisms of injury informs and improves the emergency radiologist's ability to identify key imaging findings with important management implications and to communicate the critical information that emergency physicians and orthopedic surgeons need to best manage distal radius fractures. PMID:26564022

  7. Minimal Invasive Percutaneous Plate Osteosynthesis for Distal Tibial Fractures: A Prospective Study

    OpenAIRE

    Nitin Samal; Sanjay Deshpande; Vasant Gawande; Romil Rathi

    2014-01-01

    Background: Fractures of distal tibia and pilon fractures are one of the most common fractures and are difficult to treat on account of, absence of muscle tissue attachment on lower ¼ tibia and metaphyseal cancellous comminution. Most of them are compound fractures and result in poor blood supply to the distal tibia. The conventional technique of Open Reduction and Internal Fixation (ORIF) with plating of distal tibia fracture requires wide exposure, extensive soft tis...

  8. Associations of Red Meat, Fat, and Protein Intake With Distal Colorectal Cancer Risk

    OpenAIRE

    Williams, Christina Dawn; Satia, Jessie A.; Adair, Linda S.; Stevens, June; Galanko, Joseph; Keku, Temitope O.; Sandler, Robert S.

    2010-01-01

    Studies have suggested that red and processed meat consumption elevate the risk of colon cancer; however, the relationship between red meat, as well as fat and protein, and distal colorectal cancer (CRC) specifically is not clear. We determined the risk of distal CRC associated with red and processed meat, fat, and protein intakes in Whites and African Americans. There were 945 cases (720 White, 225 African American) of distal CRC and 959 controls (800 White, 159 African American). We assesse...

  9. Scaphoid fracture associated with distal radius fracture in children:a case report

    Institute of Scientific and Technical Information of China (English)

    Hamdi Med Faouzi

    2009-01-01

    @@ Te forearm distal bone fracture is the most com-mon fracture in children. Scaphoid frac-ture is rare because the scaphoid is largely car-tilaginous in children. Some cases associating both distal radius and scaphoid fractures were reported in the literature. Scaphoid fracture often occurs without displacement and can be easily overlooked. We re-ported a case of children wrist injury combining scaphoid fracture with ipsilateral distal fracture.

  10. Unusual peroxidase activity of a myoglobin mutant with two distal histidines

    Institute of Scientific and Technical Information of China (English)

    Wei Wei Guo; Dun Wan; Li Fu Liao; Ying Wu Lin

    2012-01-01

    By retaining the native distal His64 in sperm whale myoglobin (Mb),a second distal histidine was engineered in Mb by mutating Leu29 to His29.The resultant mutant of L29H Mb exhibits an unusual enhanced peroxidase activity with a positive cooperativity in comparison to that of wild type Mb.The new enzyme with two cooperative distal histidines has not been found in native peroxidase,which emphasizes a creation of the rational protein design.

  11. Accuracy of Lachman and Anterior Drawer Tests for Anterior Cruciate Ligament Injuries

    Directory of Open Access Journals (Sweden)

    Hadi Makhmalbaf

    2013-12-01

    Full Text Available   Background: The knee joint is prone to injury because of its complexity and weight-bearing function. Anterior cruciate ligament (ACL ruptures happen in young and physically active population and can result in instability, meniscal tears, and articular cartilage damage. The aim of this study is to evaluate the accuracy of Lachman and anterior drawer test in ACL injury in compare with arthroscopy.   Methods: In a descriptive, analytical study from 2009 to 2013, 653 patients who were suspected to ACL rapture were entered the study. Statistical analysis was performed by the usage of SPSS 19.0. Multiple comparison procedure was performed for comparing data between clinical examination and arthroscopic findings and their relation with age and sex. Results: Mean age of patients was 28.3±7.58 years (range from 16 to 68 years. From 428 patients, 41.2% (175 patients were between 26 and 35, 38.8% (165 ones between 15 and 25 and 20% (85 patients over 36 years. 414 patients were male (97.2% and 12 were female (2.8%. Sensitivity of anterior drawer test was 94.4% and sensitivity of Lachman test was 93.5%. Conclusion: The diagnosis and decision to reconstruct ACL injury can be reliably made regard to the anterior drawer and Lachman tests result. The tests did not have privilege to each other. These test accuracy increased considerably under anesthesia especially in women.

  12. Novas observações sôbre as fibras nervosas que repopulam o segmento distal de nervos com mais de seis meses de secção completa

    Directory of Open Access Journals (Sweden)

    Eros Abrantes Erhart

    1966-06-01

    Full Text Available Com base em dados experimentais, publicados em trabalhos anteriores, são apresentados e discutidos, aspectos histológicos que, analisados em seqüência (figs. 1 a 8, sugerem uma possível via de reorganização progressiva com conseqüente regeneração de fibras nervosas, nos segmentos intermédio e distal de nervos, completamente separados por transecção, entre si e do côto proximal, há mais de seis meses, mas mantidos em seus leitos conectivos naturais.

  13. [Differential treatment of fractures of the distal radius].

    Science.gov (United States)

    Oestern, H J; Hüls, E

    1994-01-01

    Treatment of distal fractures of the radius has undergone considerable change during recent years. The cause for this lies primarily in the poor results of conservative treatments. In addition to osseous instability, the fractures of the radius are frequently combined with ligamentary instability as well, thereby exceeding the ability of conservative treatment. Among the many classifications, the AO classification of these fractures has proven to be the best and most widely accepted. This classification allows the recommendation of suitable procedures of treatment. The problem with inadequately healed fractures of the radius lies in the inherent unphysiological loading of the joint in the characteristic dorsal tilted position. This leads to a pathological displacement of the radius of flexion and extension and thereby to an overloading of the dorsal joint cartilage. The shortening of the radius leads to a mechanical impingement of the triangular fibrocartilagenous complex. The Kirschner wire fixation is particularly indicated in type A and type C fractures when combined with an external fixator. Of great importance here is the crossing of the K-wires, best accomplished by inserting an additional wire in a proximal to distal direction to achieve maximal mechanical stability. Biodegradable fixation devices are not yet in widespread use, as high costs and possible foreign body reactions have prevented their acceptance. The plate osteosynthesis has its domain in the treatment of volar luxation fractures (B3) and the partially articular fractures of the radius (B2). The domain of the external fixator, on the other hand, lies in the C2 and C3 fractures in combination with the K-wire osteosynthesis. Changing the mode of treatment to a plate osteosynthesis after two to three weeks allows a functional postoperative treatment. By use of a differentiated treatment regimen, the complication rate can be significantly reduced whose cause frequently lies in repeatedly attempted

  14. MRI of anterior cruciate ligament autografts

    Energy Technology Data Exchange (ETDEWEB)

    Ogi, Shigeyuki; Ariizumi, Mitsuko; Yamagishi, Tsuneo [The Aoyama Tokyo Metropolitan office' s Hospital (Japan); Agata, Toshihiko; Tada, Shinpei; Fukuda, Kunihiko

    2000-09-01

    The purpose of this study was to assess the usefulness of MRI in the evaluation of autografts after anterior cruciate ligament reconstruction. The subjects were 110 patients with anterior cruciate ligament reconstruction using patellar tendon autografts who underwent clinical examination, MRI, and arthroscopy of the knee. T1- and T2-weighted MR images were obtained in sagittal plane. Clinical findings were categorized into three groups: normal, borderline, and abnormal. The MRI appearances of the autografts were categorized into three types: straight continuous band (type I), interrupted band (type II) and generalized increased intensity band (type III). The clinical findings and MRI findings were compared with arthroscopic findings. Ninety-six percent of the type I showed no autograft tear on arthroscopy. In comparison with the clinical findings, MRI was found to be well correlated with arthroscopic findings. In conclusion, if the clinical findings are normal, patients are to be followed-up without MRI and arthroscopy. However, if clinical findings are either borderline or abnormal, MRI should be performed prior to arthroscopy. (author)

  15. Approach-avoidance activation without anterior asymmetry

    Directory of Open Access Journals (Sweden)

    AnderoUusberg

    2014-03-01

    Full Text Available Occasionally, the expected effects of approach-avoidance motivation on anterior EEG alpha asymmetry fail to emerge, particularly in studies using affective picture stimuli. These null findings have been explained by insufficient motivational intensity of, and/or overshadowing interindividual variability within the responses to emotional pictures. These explanations were systematically tested using data from 70 students watching 5 types of affective pictures ranging from very pleasant to unpleasant. The stimulus categories reliably modulated self-reports as well as the amplitude of late positive potential, an ERP component reflecting orienting towards motivationally significant stimuli. The stimuli did not, however, induce expected asymmetry effects either for the sample or individual participants. Even while systematic stimulus-dependent individual differences emerged in self-reports as well as LPP amplitudes, the asymmetry variability was dominated by stimulus-independent interindividual variability. Taken together with previous findings, these results suggest that under some circumstances anterior asymmetry may not be an inevitable consequence of core affect. Instead, state asymmetry shifts may be overpowered by stable trait asymmetry differences and/or stimulus-independent yet situation-dependent interindividual variability, possibly caused by processes such as emotion regulation or anxious apprehension.

  16. Penghentian Karies Gigi Sulung Anterior (Laporan Penelitian

    Directory of Open Access Journals (Sweden)

    Titi Pratiwi Indra Yoga

    2015-10-01

    Full Text Available Salah satu cara menanggulangi karies pada gigi sulung anterior adalah dengan mengasah gigi menjadi bentuk self cleansing atau tapered dan kemudian mengolesnya dengan larutan SnF2 10%. Cara ini relatif mudah mengerjakannya serta murah biayanya. Keburukannya hanya pada masalah estetis, yaitu bentuk gigi menjadi lebih kecil, serta adanya staining kecoklatan karena pengendapan Sn. Penelitian ini dilakukan untuk mengetahui apakah cara ini dapat menghentikan karies pada gigi sulung anterior, serta sampai berapa lama pengaruh SnF2 10% dapat menghentikan karies. Sampel diambil dari murid TK yang berusia 2,5 sampai 5 tahun, gigi sulung anteriornya terkena karies email pada bagian proksimal satu atau dua sisi. Mengingat usia sampel yang masih muda, maka sampai akhir penelitian hanya didapat 20 orang anak yang memenuhi kriteria, dan hasil penelitian dihitung secara statistik dengan X2 – test. Hasil penelitian ternyata prosedur perawatan ini berhasil secara bermakna setelah 3-6 bulan (X2 = 0.056, df = 1, dan p < 0.05.

  17. TRANSFORMACIÓN DE ESQUEMAS RELACIONALES ORIENTADOS A OBJETOS: UN ENFOQUE BASADO EN EL OBJETO

    Directory of Open Access Journals (Sweden)

    Roberto Sepúlveda Lima

    2007-05-01

    Full Text Available

     

    Las innovaciones en la industria de las bases de datos son permanentes. Entre las más recientes , se tienen las bases de datos distribuidas, el paradigma orientado a objetos (OO, y la tecnología XML*. Todas tienen un objetivo común, mejorar la calidad de los servicios. Por otro lado se observa que la inmensa mayoría de los sistemas de bases de datos (BD actuales tienen una estructura relacional y aún siguen almacenando voluminosas informaciones de sumo valor para las organizaciones. La transformación de los esquemas de bases de datos permanecen siendo un campo de investigación de primordial importancia, ya que se observan numerosas aplicaciones sometidas hoy en día a procesos de reingeniería. Aunque la industria de software ya ofrece algunas herramientas para automatizar este proceso, aún queda mucho por hacer. Y en este contexto, la comprensión del formalismo matemático y de la orientación de los enfoques propuestos no solo podría permitir una mejor comprensión de estos, sino también apoyar a la realización de trabajos futuros en este campo. El presente artículo describe un enfoque de transformación basado en el objeto y en cómo refinarlo mediante traducción de consultas SQL en código C++.

  18. Influencia del Saniamiento en Projectos Basados en el Complimiento de Criterios de Desenpeño.

    Directory of Open Access Journals (Sweden)

    Ana Júlia Ferreira Rocha

    2005-01-01

    Full Text Available Este artículo destaca la necesidad de estudios de Saneamiento del Medio, específicamente, acerca de la cuestión que se refiere al suelo, debido a la emigración de substancias poluentes provenientes de residuos sólidos urbanos a través del mismo. El estudio del saneamiento ambiental pretende satisfacer tanto la definición aceptada por la OMS (Organización mundial de la Salud, que plantea: "Es el control de los factores del medio físico del hombre que ejercen o pueden ejercer un efecto nocivo sobre su bienestar físico, mental y social", cuando la definición expresada por la Fundación Internacional, que establece: "Modo de vivir, calidad de vida expresada en condiciones de salubridad, con casa limpia, hacienda limpia, comercio limpio, industria limpia. Siendo un modo de vida, por el bien del pueblo, ser alimentado por el saber y crecer en las relaciones humanas, no solo como ideal, sino como obligación". Los resultados obtenidos en este estudio pueden ser adicionados al desarrollo de proyectos basados en la atención a criterios de desempeño, ya que todo proyecto, donde se hace notar la presencia de obras de Ingeniaría de Suelos e cujo objetivo sea el destino final de residuos sólidos urbanos, han demostrado que: en la Ingeniaría Civil, en su curso de graduación, adquiere conocimientos de saneamiento básico, pero no de Saneamiento del Medio, por eso, surge la necesidad de conocimientos de otros profesionales, entre ellos, los microbiólogos, que no han sido capaces de trasmitir para los ingenieros lo necesario; e los ingenieros, por outro lado, han sido incapaces de interpretar la función de los microbiólogos en los proyectos prácticos. Es aqui que el proyecto cumplirá tanto las exigencias de la Ingeniería de Suelos cuanto las exigencias de Saneamiento del Medio, llevando en consideración que en la actualidad, para que un proyecto sea considerado completo, deberá satisfacer los estudios de viabilidad técnica, econ

  19. Aprendizaje basado en proyectos aplicados al entorno del laboratorio de inmunología

    Directory of Open Access Journals (Sweden)

    Javier Jiménez Jiménez

    2013-11-01

    Full Text Available En la aplicación de metodologías participativas en el entorno de laboratorio, son muchos los recursos educativos que han mostrado su utilidad para la adquisición de competencias, tanto genéricas (trabajo colaborativo, autoaprendizaje como específicas (razonamiento clínico, reconocimiento de mecanismos relacionados con fundamentos científicos. En este contexto, en la asignatura “Estructura y función de la sangre y del sistema inmunitario” de segundo curso del Grado en Medicina de la UIC se ha introducido una estrategia de aprendizaje basada en proyectos (ABP, que ha permitido dar sentido a la adquisición de conocimientos y habilidades con el fin específico de solucionar un caso clínico. Para ello, los estudiantes, en grupos de tres, se enfrentan al caso debiendo analizar, orientar y seleccionar una prueba de laboratorio que permita confirmar un diagnóstico. El alumno dispone de conexión a internet para la obtención de la base teórica del caso planteado y el apoyo de un tutor para orientar su investigación. Una vez decidida la prueba a realizar dispone de la muestra biológica del paciente, de los kits diagnósticos apropiados y de los protocolos necesarios para llevarlos a cabo. El alumno, con ayuda del tutor, realiza el test diagnóstico que ha seleccionado, obtiene los resultados, los interpreta y con la información obtenida emite un diagnóstico del caso clínico propuesto. Posteriormente los grupos de alumnos exponen cada caso clínico al resto de sus compañeros. En la presente comunicación se muestra con más detalle la realización de este tipo de “Aprendizaje Basado en Proyecto”, y se discute la aceptación que ha tenido por parte de los alumnos, los resultados académicos obtenidos y el grado de adquisición de las competencias trabajadas.

  20. Modelo del Costo Basado en la Actividad aplicado a consultas por trazadores de enfermedades cardiovasculares

    Directory of Open Access Journals (Sweden)

    Marteau Silvia A.

    2001-01-01

    Full Text Available OBJETIVO: Hacer un análisis de costos, de la atención médica en consultas externas, mediante la metodología del Costo Basado en la Actividad (ABC, por sus siglas en inglés y en relación con eventos trazadores de enfermedades cardiovasculares de origen isquémico en las instituciones del sector público. MATERIAL Y MÉTODOS: El estudio se basó en consultas por enfermedades o eventos trazadores (n=290 y no trazadores (n=1 710, de una muestra de 2 000 consultas de primera vez de un hospital zonal general de agudos (San Roque de Gonnet, de la provincia de Buenos Aires, Argentina, y se realizó de abril a octubre de 1998. El costo se evaluó con la metodología del ABC. RESULTADOS: El mejoramiento de las actividades de atención en el servicio de Clínica Médica conllevaría un ahorro sustancial en los costos indirectos, equivalente a un porcentaje promedio de 7.11 sobre los productos definidos como consultas por hipertensión arterial (HTA, dislipidemia y diabetes. El ahorro total en el costo unitario por producto que se produciría si se eliminaran las actividades mencionadas, estaría en el orden de 11.78% para el producto HTA, de 13.96% para dislipidemia, de 19.05% para diabetes y de 11.45% para las enfermedades no trazadores. Se asignó o se gastó ineficientemente 66.26% de los costos totales indirectos correspondientes al producto dislipidemia y 61.80% de los correspondientes a diabetes. El costo unitario total de las consultas en el servicio de Clínica Médica, según el método tradicional, es de $22.98, valor que en algunos casos está muy por debajo del costo obtenido a partir del método ABC aplicado en este estudio. CONCLUSIONES: Es necesario trabajar en el rediseño del proceso de atención para evaluar las actividades que no agreguen valor al mismo; éstas únicamente generan molestias y demoras al paciente y provocan ineficiencias en el sistema, dado que se asignan recursos a actividades que no optimizan la gestión y, como

  1. Aprendizaje basado en problemas: Metodología de aprendizaje centrada en el estudiante

    Directory of Open Access Journals (Sweden)

    V. Tórtora

    2013-11-01

    Full Text Available 8vas Jornadas de la Sociedad de Bioquímica y Biología Molecular. 12 y 13 de setiembre 2013. SIMPOSIO VI: “Educación en Ciencias” Coordinadores: María Noel Álvarez, Andrea MedeirosLa reforma del plan de estudios de la carrera de Doctor en Medicina implicó, entre outras modificaciones, la incorporación de nuevas metodologías de enseñanza y aprendizaje. Una de ellas es la de “aprendizaje basado en problemas” (ABP, que se caracteriza por colocar al estudiante en el centro del proceso de aprendizaje, promoviendo que este sea significativo, además de desarrollar habilidades y competencias indispensables en el ejercicio profesional. El ABP se realiza en grupos de aproximadamente 20 estudiantes, en dos instancias. El problema es diseñado por un equipo docente interdisciplinario, en función a los objetivos del curso. En la primera instancia se presenta el problema y los estudiantes discuten en función de sus conocimientos previos, identificando las áreas de saber y de no saber sobre el problema, e intentan plantear hipótesis explicativas sobre las dificultades identificadas. Lugo deben determinar qué competencias y nuevos conocimientos necesitan para comprobarlas. Este proceso es realizado de manera autónoma por los estudiantes, bajo la dirección de un docente tutor que actúa como facilitador del aprendizaje. Entre una instancia y otra buscan la información necesaria para lograr los objetivos de estudio definidos por el grupo, y regresan al problema en la segunda instancia. La información encontrada es compartida entre los integrantes del grupo, mediante discusión en foros en la plataforma de aprendizaje virtual (EVA y durante las clases presenciales, haciendo que el aprendizaje sea además cooperativo. En esta presentación se expondrá esta metodología de trabajo junto con un ejemplo de un problema específico con objetivos de bioquímica.En esta presentación se expondrá esta metodología de trabajo junto con un ejemplo

  2. Review of 31 cases of anterior thoracolumbar fixation with the anterior thoracolumbar locking plate system.

    Science.gov (United States)

    Wilson, J A; Bowen, S; Branch, C L; Meredith, J W

    1999-07-15

    Anterior fixation devices for the thoracolumbar spine have gained wide acceptance as viable alternatives to long-segment posterior fixation in cases of thoracolumbar spine trauma. This review was undertaken to evaluate the safety and efficacy of the Synthes anterior thoracolumbar locking plate (ATLP) system. Over a 3-year period, 31 patients with unstable traumatic fractures of the thoracolumbar spine underwent corpectomy, placement of a structural bone graft, and anterior fixation in which the Synthes ATLP system was used. Long-term follow-up data were obtained in 29 patients. Two patients were lost to follow up, one at 4 months and the other at 1 year. In the remaining patients, the average length of follow up was 20 months. In all patients radiographic evidence of solid bone fusion was demonstrated on follow-up plain x-ray films, and there were no signs or symptoms of pseudarthrosis. No patient suffered neurological deterioration as a result of surgery, and there was relatively little morbidity associated with this plating system. To date, none of the patients in this study has developed any delayed complications related to the fixation device. In one patient, who had sustained a severe flexion injury, loosening of the anterior fixation device occurred, and the patient developed progressive kyphosis, which required a posterior stabilization procedure. These results appear slightly better than those obtained in published studies in which other anterior plating systems were used, indicating that this system is safe and effective in the treatment of unstable fractures of the thoracolumbar spine. PMID:16918232

  3. Anterior Cervical Spinal Surgery for Multilevel Cervical Myelopathy.

    OpenAIRE

    Jung-Ju Huang; Lih-Huei Chen; Chi-Chien Niu; Tsai-Sheng Fu; Po-Liang Lai; Wen-Jer Chen

    2004-01-01

    Background: In multilevel spinal cord compression caused by cervical spondylosis, surgeonsface the choice of performing a posterior route as a laminectomy orlaminoplasty, or an anterior route as multiple adjacent interbody decompressionsor corpectomies. The anterior cervical operation is not considered bysome clinicians because of concerns about complications and the complexityof multilevel anterior cervical surgery.Methods: In this retrospective study, 14 patients with multilevel cervical sp...

  4. Complications of the anterior approach to the cervical spine

    OpenAIRE

    Marcelo Lemos Vieira da Cunha; Francisco Alves de Araújo Júnior; Cássio Czottis Grapiglia; Denildo César Amaral Veríssimo; Roberta Rehder; Samir Ale Bark; Luis Alencar Biurrum Borba

    2014-01-01

    OBJECTIVE: To evaluate the complications of anterior approach to the cervical spine in patients who underwent cervical arthrodesis with instrumentation. METHODS: Prospective and descriptive study was conducted from January 2009 to April 2010. All patients who underwent arthrodesis of the cervical spine by anterior approach were included, regardless the diagnosis. Access was made by the anterior approach on the right side. We evaluated the number of operated levels (1, 2 or 3 levels) and,...

  5. Current approach in diagnosis and management of anterior uveitis

    OpenAIRE

    Agrawal Rupesh; Murthy Somasheila; Sangwan Virender; Biswas Jyotirmay

    2010-01-01

    Uveitis is composed of a diverse group of disease entities, which in total has been estimated to cause approximately 10% of blindness. Uveitis is broadly classified into anterior, intermediate, posterior and panuveitis based on the anatomical involvement of the eye. Anterior uveitis is, however, the commonest form of uveitis with varying incidences reported in worldwide literature. Anterior uveitis can be very benign to present with but often can lead to severe morbidity if not treated...

  6. Double anterior chamber in a patient with glaucoma and microspherophakia

    Directory of Open Access Journals (Sweden)

    Hamid Khakshoor

    2011-01-01

    Full Text Available We report the case of a 16-year-old woman with microspherophakia and secondary open angle glaucoma. The patient presented with a membrane dividing the anterior chamber into two segments without edema or Descemet′s membrane detachment. Slit lamp biomicroscopy, Pentacam, and specular microscopy images were obtained. Double anterior chamber is primarily found in patients with anterior chamber anomalies when there is no history of surgery or trauma.

  7. No volumetric differences in the anterior cingulate of psychopathic individuals

    OpenAIRE

    Glenn, Andrea L.; Yang, Yaling; Raine, Adrian; Colletti, Patrick

    2010-01-01

    Functional imaging studies of psychopathy have demonstrated reduced activity in the anterior cingulate, yet it is unclear whether this region is structurally impaired. In this study, we used structural MRI to examine whether volumetric differences exist in the anterior cingulate between psychopathic (n=24) and control (n=24) male participants. We found no group differences in the volume of the anterior cingulate or its dorsal and ventral subregions. Our findings call into question whether the...

  8. Rehablitation of mandibular fracture with anterior teeth loss

    OpenAIRE

    Singh, Meenakshi; Singh, Ajay; Rajpal, Jaisika; K. K. Gupta; Singh, Vibha

    2011-01-01

    We report here on rehabilitating a case with mandibular fracture and lower anterior teeth loss. Three double-staged implants were placed in the lower anterior region; in an attempt to rehabilitate the condition of five missing lower teeth, two natural teeth were prepared to act as natural abutments. Teeth implant-supported prosthesis was fabricated. Patient with a right mandibular fracture and loss of lower anterior missing teeth was successfully rehabilitated with teeth implant-supported pro...

  9. Audit on necessity of radiographs in anterior shoulder dislocations

    OpenAIRE

    K. Ahmadi, M.D; M. Mofidi, M.D.

    2008-01-01

    AbstractBackground and Purpose: Anterior shoulder dislocation is the most common major joint dislocation. In most cases, this dislocation is being relocated in emergency departments. Routinely, pre and post reduction radiographs are performed. This study was done to determine the necessity of radiographs in the emergency department for management of patients with suspected anterior shoulder dislocation.Materials and Methods: In this case series study, 116 patients suspected of anterior should...

  10. Sarcoidosis: radiographic manifestations in the nails and distal phalanges

    International Nuclear Information System (INIS)

    Sarcoidosis is a granulomatous disease which can affect multiple organ systems. Clinical and radiologic manifestations depend on the organ system involved and the chronicity of disease. Nail involvement in sarcoidosis is rare, but is clinically relevant as it indicates chronic systemic disease. Nail abnormalities can be identified radiographically, and when seen in patients with known or suspected sarcoidosis, should prompt careful evaluation of the underlying bone for osseous involvement. We describe a case of sarcoidosis with radiographic findings in the nails and distal phalangeal tufts, which were indicative of nail and osseous sarcoid involvement and strongly supported the presence of chronic systemic disease. Although the nail findings resolved clinically and on radiographs after treatment, the osseous findings showed only minimal improvement. To our knowledge, the radiographic findings of nail sarcoidosis have not been previously addressed in the literature. (orig.)

  11. Criteria for diagnosing distal radioulnar joint subluxation by computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, Ryogo [Department of Orthopedic Surgery, Branch Hospital of Nagoya University, School of Medicine, 1-1-20 Daikominami, Higashiku, Nagoya 461 (Japan); Horii, Emiko [Department of Orthopedic Surgery, Branch Hospital of Nagoya University, School of Medicine, 1-1-20 Daikominami, Higashiku, Nagoya 461 (Japan); Imaeda, Toshihiko [Department of Orthopedic Surgery, Branch Hospital of Nagoya University, School of Medicine, 1-1-20 Daikominami, Higashiku, Nagoya 461 (Japan); Nakao, Etsuhiro [Department of Orthopedic Surgery, Branch Hospital of Nagoya University, School of Medicine, 1-1-20 Daikominami, Higashiku, Nagoya 461 (Japan)

    1996-10-01

    Bilateral wrist computed tomography (CT) was performed in 30 patients with suspected unilateral distal radioulnar joint (DRUJ) subluxation to evaluate dynamic DRUJ CT scanning with a straight elbow. Five CT criteria for diagnosing dorsovolar subluxation were examined. Maximum active supination and pronation on a conventional scanning table yielded satisfactory rotation (mean{+-}SD, 119 {+-}29 ) at the DRUJ, thus permitting a dynamic diagnosis of DRUJ subluxation. The radioulnar line method and the congruity method frequently yielded false positive results compared with bilateral diagnosis and were unreliable. Modifications of these two methods achieved sensitivity and specificity comparable to the epicenter method. We recommend the modified radioulnar line method for diagnosing dorsovolar subluxation using unilateral CT because of its excellent sensitivity and specificity combined with ease of technique. (orig.). With 4 figs., 2 tabs.

  12. Fernandez osteotomy of radio distal with mal united fracture

    International Nuclear Information System (INIS)

    We review prospectively our experience in the military hospital in Bogota, Colombia, with the opening-wedge osteotomy for the treatment of a mal united fracture of the distal end of the radius in fifty-six consecutive patients from 1990 to 2002. The indications for operation were pain predominantly in the radio-ulnar joint and functional limitation with grip strength loss. Preoperative radiographs revealed an average ulnar inclination of 14 degrees, an average ulnar variance of four millimeters, and increased dorsal tilt (colles deformity) that averaged 28 degrees. All patients had limited function. The average grip strength was a force of fifteen kilograms compared with a force of thirty-one kilograms in the contralateral hand. Postoperatively, all of the patients had substantial improvement in function, relief of pain and grip strength increased. The functional results were rated as very good in eleven patients, good in thirty-six, fair in nine

  13. New diagnostic tests for diabetic distal symmetric polyneuropathy.

    Science.gov (United States)

    Papanas, Nikolaos; Ziegler, Dan

    2011-01-01

    Neuropathy needs to be diagnosed early to prevent complications, such as neuropathic pain or the diabetic foot. It is obvious that diagnosis of neuropathy needs to be improved. New peripheral nerve function tests that appear to facilitate diagnosis are now emerging. This review outlines the new tests that have been proposed for the diagnosis of diabetic distal symmetric polyneuropathy, the commonest form of neuropathy in diabetes. New tests are classified into those mainly assessing large-fiber function (tactile circumferential discriminator, steel ball-bearing, and automated nerve conduction study) and those mainly assessing small-fiber function (NeuroQuick and Neuropad). Emerging tests are promising but must be evaluated in prospective studies. Moreover, their cost-effectiveness needs more careful appraisal. The clinician should, therefore, still rely on established modalities to diagnose neuropathy, but wider use of the new tests is expected in the near future. PMID:19896871

  14. A Peculiar Primary Paraganglioma of the Distal Thumb.

    Science.gov (United States)

    Lander, Sarah T; Coppola, Erin; Tyler, Wakenda; Elfar, John C

    2016-05-01

    A paraganglioma is a highly vascularized neuroendocrine tumor most commonly found within the adrenal gland as a pheochromocytoma. Extra-adrenal paragangliomas are frequently located in the head, neck, thorax, and abdomen. We report the first documented case of a primary paraganglioma found within the appendicular skeleton. Only 2 additional cases of paragangliomas in the extremities have been documented, one in the soft tissue of the forearm and other within the median nerve. Our patient underwent amputation of the distal phalanx, with no sign of recurrence at greater than 1 year of follow-up. Because of the geographic and clinical similarity to a benign enchondroma, radiographic imaging alone may not be sufficient to rule out malignancies inside bones. Thus paraganglioma should remain in the differential and immunohistochemistry is both vital and necessary to confirm the diagnosis. Vigilant and appropriate follow-up is necessary to detect metastases early in these patients. PMID:26971069

  15. Sarcoidosis: radiographic manifestations in the nails and distal phalanges

    Energy Technology Data Exchange (ETDEWEB)

    Albers, Brittany K.; Garner, Hillary W. [Mayo Clinic, Department of Radiology, Jacksonville, FL (United States); Sluzevich, Jason C. [Mayo Clinic, Department of Dermatology, Jacksonville, FL (United States)

    2016-05-15

    Sarcoidosis is a granulomatous disease which can affect multiple organ systems. Clinical and radiologic manifestations depend on the organ system involved and the chronicity of disease. Nail involvement in sarcoidosis is rare, but is clinically relevant as it indicates chronic systemic disease. Nail abnormalities can be identified radiographically, and when seen in patients with known or suspected sarcoidosis, should prompt careful evaluation of the underlying bone for osseous involvement. We describe a case of sarcoidosis with radiographic findings in the nails and distal phalangeal tufts, which were indicative of nail and osseous sarcoid involvement and strongly supported the presence of chronic systemic disease. Although the nail findings resolved clinically and on radiographs after treatment, the osseous findings showed only minimal improvement. To our knowledge, the radiographic findings of nail sarcoidosis have not been previously addressed in the literature. (orig.)

  16. A distal renal tubular acidosis showing hyperammonemia and hyperlactacidemia

    Directory of Open Access Journals (Sweden)

    C. Ripoli

    2012-08-01

    Full Text Available Introduction: distal renal tubular acidosis (dRTA presents itself with variable clinical manifestations and often with late expressions that impact on prognosis. Case report: A 45-day-old male infant was admitted with stopping growth, difficult feeding and vomiting after meals. Clinical tests and labs revealed a type 1 renal tubular acidosis, even if the first blood tests showed ammonium and lactate increase. We had to exclude metabolic diseases before having a certain diagnosis. Conclusions: blood and urine investigations and genetic tests are fundamental to formulate dRTA diagnosis and to plan follow-up, according to possible phenotypic expressions of recessive and dominant autosomal forms in patients with dRTA.

  17. Análisis del equilibrio entre precisión e interpretabilidad de los sistemas basados en reglas difusas lingüísticos y aproximativos

    OpenAIRE

    Galende Hernández, Marta

    2014-01-01

    La tesis doctoral se centra en los modelos difusos basados en sistemas basados en reglas difusas (sbrds) y su equilibrio en sus dos características básicas: precisión e interpretabilidad. el objetivo principal es alcanzar un adecuado equilibrio de estas prestaciones para lo cual se desarrollan metodologías y métricas que permitan generar sbrd con un equilibrio precisión-interpretabilidad adecuado. se diseñan e implementan dos nuevas métricas de interpretabilidad semántica a nivel de base de r...

  18. Método para la verificación de sistemas híbridos basado en la propagación de etiquetas

    OpenAIRE

    Ramírez Rodríguez, Jaime

    2002-01-01

    Esta tesis supone un paso hacia delante en el área de la Verificación de Sistemas Basados en el Conocimiento (SBCs). Así pues, se va a presentar un método, al que se ha llamado MECORI, capaz de detectar inconsistencias semánticas en SBCs Híbridos (basados en reglas de producción y jerarquías de marcos). Como parte del proceso de verificación, se construye una teoría ATMS simulando el proceso deductivo que sigue en el SBC para deducir una inconsistencia semántica. Posteriormente, es fácil obte...

  19. Síntesis de complejos metálicos basados en ligandos nitrogenados polianiónicos: aplicaciones como agentes antivirales

    OpenAIRE

    García Gallego, Sandra

    2013-01-01

    El VIH/SIDA es uno de los mayores problemas de salud mundial. Las terapias actuales no son capaces de erradicar los reservorios de este virus, lo que hace necesario la utilización de nuevas estrategias para su tratamiento. En la batalla frente a la infección por VIH, numerosos compuestos se han utilizado como agentes terapéuticos, principalmente basados en compuestos inorgánicos o sus complejos de coordinación u organometálicos, o sistemas profilácticos, especialmente aquellos basados en nano...

  20. El aprendizaje basado en problemas: aplicación y resultados en la asignatura de Métodos de Decisión

    OpenAIRE

    Martínez Rodríguez, Elena

    2008-01-01

    La adaptación de las enseñanzas universitarias a las directrices del Espacio Europeo de Educación Superior (EEES) impone la transformación de los sistemas educativos basados en la actividad docente del profesor, en un sistema basado en el aprendizaje del alumno. Este nuevo paradigma educativo exige a los docentes un esfuerzo innovador, adoptando metodologías de enseñanza-aprendizaje que confieran al alumno un papel activo, al tiempo que permiten el desarrollo de capacidades y h...

  1. Medical expulsive therapy for distal ureteric stones: tamsulosin versus silodosin

    Directory of Open Access Journals (Sweden)

    Vittorio Imperatore

    2014-06-01

    Full Text Available Objectives: To compare the efficacy and safety of tamsulosin and silodosin in the context of medical expulsive therapy (MET of distal ureteric stones. Patients and methods: Observational data were collected retrospectively from patients who received silodosin (N = 50 or tamsulosin (N = 50 as MET from January 2012 to January 2013. Inclusion criteria were: patients aged ≥ 18 years with a single, unilateral, symptomatic, radiopaque ureteric stone of 10 mm or smaller in the largest dimension located between the lower border of the sacroiliac joint and the vesico-ureteric junction. Stone expulsion rate, stone expulsion time, number of pain episodes, need for analgesics use, incidence of side effects were compared. Results: Stone-expulsion rate in the silodosin and in the tamsulosin groups were 88% and 82%, respectively (p not significant. Mean expulsion times were 6.7 and 6.5 days in the silodosin and tamsulosin group, respectively (p not significant. Mean number of pain episodes were 1.6 and 1.7 in the silodosin and tamsulosin group, respectively (p not significant. The mean number of analgesic requirement was 0.84 and 0.9 for the silodosin and tamsulosin group, respectively (p not significant. Overall, incidence of side effects was similar in both groups. Patients taking silodosin experienced an higher incidence of retrograde ejaculation but a lower incidence of side effects related to peripheral vasodilation when compared to patients taking tamsulosin. Subgroup analysis demonstrated significantly lower mean expulsion times and pain episodes in patients with stones ≤ 5 mm in both groups. Conclusions: Tamsulosin and silodosin are equally effective as MET for distal ureteric stones sized 10 mm or smaller. MET with silodosin is associatd with a lower incidence of side effects related to peripheral vasodilation but an higher incidence of retrograde ejaculation when compared to tamsulosin.

  2. Conservative Treatment of Distal Radius Fractures, Importance of Radial Height

    Directory of Open Access Journals (Sweden)

    Gokhan Keles

    2014-12-01

    Full Text Available Decision of conservative treatment or surgery still remains a debate for some particular types of radius distal fractures. We aimed to evaluate the clinical and radiological results of a patient group treated in our clinic with closed reduction and plaster cast fixation and tried to evaluate the prime factors affecting stability and prognosis of conservative treatment. The study comprised 51 patients (34 males, 17 females; mean age 39.8 ± 11.3 years treated with closed reduction and plaster cast fixation for radius distal end fracture at our clinic during the period January 2007 to September 2010. Obtained clinical results were scored according to the Gartland and Werley clinical evaluation system12 and the Disability Arm, Shoulder and Hand Surgery Questionnaire (DASH, for radiological examination; arthritic changes were evaluated according to the Knirk and Jupiter arthritis scoring system and angulation evaluation was made according to the Stewart%u2019s radiological evaluation criteria. Mean follow-up period time was 17.1 months (range, 6-48 months. According to the Gartland and Werley clinical evaluation system 23 patients had (45.1% 0-2 points (excellent, 19 (37.3% had 3-8 points (good and 9 (17.6% had 9-20 points (moderate. No poor results were determined. Loss of radial height had a negative effect on functional outcome, radial height is one of the prime factors affecting the prognosis of the treatment. Impairment of the radial inclination, radial shortening or loss of palmar inclination were not observed to negatively affect the prognosis.

  3. Distal Radius Quantitative Ultrasound Measurements and Related Factors

    Directory of Open Access Journals (Sweden)

    Özden Özyemiflçi Taflk›ran

    2011-04-01

    Full Text Available Aim: To investigate the quantitative ultrasound measurements and determine the related demographic, clinical and life style parameters. Material and Methods: A questionnaire including demographic features, systemic diseases, physical activity levels and other risk factors for osteoporosis was completed. Measurements of quantitative ultrasound (QUS were performed. Speed of sound (SOS (m/sec measurements were taken at the distal 1/3 radius of the nondominant extremity. Results: Among 2347 persons whom QUS measurements and questionnaires were completed, those aged 35 years and older and that were not taking antiosteoporotic treatment (N= 1867; 1654 women, 213 men were included for the analysis. Mean age of the participants were 52.1±10.7 years and mean SOS scores were 4142.8±185.8 m/sec. The variables that were statistically significant in either independent samples t test or analysis of variance were put in the linear regression analysis. In women, age, years since menopause and duration of lactation were independent predictors for SOS scores (constant= 4367.9 m/sec, age B: -3.8, ß: -0.197, p: 0.01; years since menopause: B: -3.9, ß: -0.211, p: 0.006; duration of lactation B: -0.4, ß: -0.086, p: 0.037. In men, age and level of education affected SOS scores independently (constant= 4271.3 m/sec, age B: -3.8, ß: -0.277, p: 0.001; level of education: B: 18.8, ß: 0.144, p: 0.036. Conclusion: Increasing age is associated with decrements in speed of sound measured by quantitative ultrasound at distal radius. It is important to give education about preventive measures on bone metabolism, especially during the lactation period. (Turkish Journal of Osteoporosis 2011;17:1-5

  4. Gastric partitioning gastrojejunostomy in unresectable distal gastric cancer patients.

    Science.gov (United States)

    Kwon, Sung Joon; Lee, Ha Gyoon

    2004-04-01

    The main purpose of bypass surgery in patients with unresectable distal gastric cancer is to improve their quality of life (QoL). However, the result of conventional gastroenterostomy is dismal including continuous bleeding due to the contact of food material on the tumor surface and early obstruction of the stoma by tumor growth. Developing more effective surgery is warranted to improve the QoL of these patients. Among the 1158 patients with gastric cancer who underwent surgery from March 1993 to July 2002 at Hanyang University Medical Center, 54 (4.7%) had unresectable cancers. Various types of gastrojejunostomy (G-Jstomy), including conventional G-Jstomy (CGJ) (n = 18), antral exclusion G-Jstomy (n = 7), and gastric partitioning G-Jstomy (GPGJ) (n = 17), as well as exploratory laparotomy only (n = 12) were performed in these unresectable cases. In this study, survival and postoperative QoL were compared for the CGJ and GPGJ groups. The median survivals were 120 and 209 days for the CGJ and GPGJ groups, respectively (p = 0.046). The rates of postoperative body weight loss compared to the preoperative weight were 9.3% and 3.1% in the CGJ and GPGJ groups, respectively; the difference showed borderline significance (p = 0.067). The volume of blood transfusion was much less during the postoperative period than during the preoperative period in the GPGJ group but not in the CGJ group. The GPGJ procedure minimized food contact on the tumor surface, which was confirmed by an upper gastrointestinal barium meal series. GPGJ can be recommended as the procedure of choice for bypass surgery in patients with unresectable distal gastric cancer considering their improved survival and postoperative QoL compared to those who underwent CGJ. PMID:14994143

  5. Repair of the torn distal biceps tendon by endobutton fixation

    Directory of Open Access Journals (Sweden)

    Ravi K Gupta

    2012-01-01

    Full Text Available Background: A number of techniques have been described to reattach the torn distal biceps tendon to the bicipital tuberosity. We report a retrospective analysis of single incision technique using an endobutton fixation in sports persons. Materials and Methods: The present series include nine torn distal biceps tendons in eight patients, fixed anatomically to the radial tuberosity with an endobutton by using a single incision surgical technique; seven patients had suffered the injuries during contact sports. The passage of the endobutton was facilitated by using a blunt tipped pin in order to avoid injury to the posterior interosseous nerve. The patients were evaluated by Disabilities of the Arm, Shoulder and Hand (DASH score and Mayo elbow score. Results: The average age of the patients was 27.35 years (range 21-42 years. Average follow-up was 41.5 months (range 24-102 months. The final average flexion extension arc was 0°-143°, while the average pronation and supination angles were 77° (range 70°-82° and 81° (range 78°-85°, respectively at the last followup. All the patients had a Disabilities of the Arm, Shoulder and Hand (DASH score of 0 and a Mayo elbow score of 100 each. All the seven active sports persons were able to get back to their respective game. There was no nerve injury or any other complication. Conclusions: The surgical procedure used by us is a simple, safe and reproducible technique giving minimal morbidity and better cosmetic results.

  6. Winging of scapula due to serratus anterior tear

    Directory of Open Access Journals (Sweden)

    Varun Singh Kumar

    2014-10-01

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

  7. Modelo de Awareness Basado en Topologías de Interacción para Espacios Virtuales de Trabajo Colaborativo

    Directory of Open Access Journals (Sweden)

    Edwin Alexander Herrera Saavedra

    2014-08-01

    Full Text Available En un sistema de trabajo colaborativo un grupo de usuarios puede realizar actividades combinando sus capacidades y trabajo para conseguir un determinado objetivo, para esto los miembros del grupo tienen que estar al tanto sobre el estado, cambios y las acciones que otros miembros del grupo están realizando, este tipo de información se conoce como “Información Awareness”. Estos procesos de colaboración han demostrado ser complejos de soportar y desarrollar. Dado esto se han creado varios tipos de awareness tratando de responder como soportar particularidades dentro de los sistemas, pero no existe un modelo general basado en la posibles formas grupales de interacción que sirva como guía en la construcción de awareness. En ese contexto esta investigación propone un modelo de awareness basado en interacciones grupales en los CSCW asociando la información de awareness adecuada para cada topología de interacción. Esto permitirá dar un mejor soporte a la información de tipo awareness en aplicaciones colaborativas.

  8. Modelo de gestión para el suministro de materiales e insumos basado en la demanda

    Directory of Open Access Journals (Sweden)

    Isabel Cristina Arango Palacio

    2014-12-01

    Full Text Available Este artículo hace referencia a la gestión de la cadena de abastecimiento, la cual requiere la sincronización de actividades que incluyen el flujo de información e inventarios. Una gestión exitosa depende de la óptima integración y sincronización de las actividades e inventarios requeridos para satisfacer la demanda. A partir de la investigación realizada en una empresa de cosméticos de venta directa, se analizan las estrategias para mejorar la gestión del suministro enfocado a la demanda, de modo que se pueda responder al mercado y, al mismo tiempo, controlar los inventarios y evitar los agotados. En esta investigación se toman en consideración que el suministro basado en el consumo diario, con entregas frecuentes y lotes pequeños flexibiliza el abastecimiento con los cambios de la demanda, y el stock de seguridad en cada empresa de la cadena de abastecimiento se convierte en un amortiguador para proteger la variabilidad. La metodología comienza con la identificación del problema, las posibles causas y las relaciones con los efectos encontrados con el fin de obtener un modelo de gestión del abastecimiento basado en la demanda, para responder rápidamente a la sobredemanda sin generar agotados y, a la vez, reaccionar a la subdemanda sin exceso de inventario.

  9. 复杂肱骨远端骨折手术治疗的临床探讨%Clinical evaluation of operative treatment of complicated distal humerus fractures

    Institute of Scientific and Technical Information of China (English)

    赵龙; 宋有鑫; 崔成喜; 张宇轩; 张宝琦; 龚平; 武云鹤; 尚瑞松; 陈宾

    2014-01-01

    Background Distal humeral fracture is a severe damage around the elbow joint,and is often seen in young adults.It accounts for 2% of all adult fractures and about 50% of all humerus fractures.It′s one of the fractures that is difficult to deal with.The types of distal humeral fracture are divergent. Distal humerus fractures are often comminuted which make operative reduction difficult.Secondary loss of reduction and elbow ankylosis are common postoperative complications. All these difficulties make the distal humerus fracture one of the unresolved problems in fracture treatment.This study is to evaluate the clinical outcome of complex distal humeral fractures treated by operation.Methods (1)General data:twenty-four cases of operative treated distal humerus fractures in author′s hospital from January 2004 to December 2013 were included in this study.There were 1 5 males and 9 females,aging from 1 7 to 73,averaged 41.AO/OTA Classification:A3:9 cases;B1, B2:6 cases;C3:9 cases.Two cases were combined with nerve injury.Two cases had histories of high blood pressure and diabetes.(2 ) Operative method:The patient was placed in the supine position,and the elbow to be operated on was positioned at 90°of abduction and supported on a lucent operating table.A pneumatic tourniquet was placed as proximally as possible on the arm.With the elbow flexed at about 60°,the first incision was made about 7 cm proximal to the tip of the medial epicondyle.In the initial cases,the ulnar nerve was isolated,released from the ulnar nerve groove, and protected carefully.In later cases,the nerve was only exposed.The medial and anteromedial side of the distal humerus was exposed through the opening between the brachial muscle and the medial intermuscular septum.The common origin of the flexor muscles was partially dissected and reflected distally,leaving a 5-mm strut to be re-sutured in situ at completion of surgery.The anterior capsule was incised.The articular surface of the trochlea was

  10. Will the untreated ulnar styloid fracture influence the outcome of unstable distal radial fracture treated with external fixation when the distal radioulnar joint is stable

    OpenAIRE

    Chen, Yi-Xin; Zheng, Xin; Shi, Hong-fei; Wangyang, Yu-fan; Yuan, Han; Xie, Xiao-xiao; Li, Dong-ya; Wang, Chang-jun; Qiu, Xu-sheng

    2013-01-01

    Background The ulnar styloid is an important supportive structure for the triangular fibrocartilage complex. However, it remains inconclusive whether or not a fractured ulnar styloid should be fixed in an unstable distal radius fracture (DRF) with a stable distal radioulnar joint (DRUJ). The purpose of this study is to evaluate the effect of an untreated ulnar styloid fracture on the outcome of unstable DRF treated with transarticular external fixation when the DRUJ is stable. Methods 106 pat...

  11. Síndrome tóxica do segmento anterior Toxic anterior segment syndrome

    Directory of Open Access Journals (Sweden)

    Luiz Filipe de Albuquerque Alves

    2013-02-01

    Full Text Available A síndrome tóxica do segmento anterior (STSA é uma severa reação inflamatória aguda causada por agente não infeccioso que entra no segmento anterior, resultando em lesão celular tóxica com necrose e apoptose mediado por resposta imunológica. Neste relato de caso de STSA são enfatizadas as causas mais comuns para o aparecimento da síndrome, apontam para os cuidados que devem ser tomados no processo de esterilização do material cirúrgico além de revisar a melhor conduta diante desses casos. Em conclusão notou-se que o foco principal deve ser a prevenção, pois o tratamento busca apenas suprimir a resposta inflamatória secundária. O tratamento nos casos de STSA consiste em intensa instilação de esteróides tópicos com seguimento rigoroso e controle de complicações tardias como o glaucoma.Toxic anterior segment syndrome is acute inflammatory reaction caused by a noninfectious substance that enters the anterior segment, resulting in extracellular damage with necrosis and apoptosis during an immune response. We have the report of a case of toxic anterior segment syndrome (TASS, in which the authors seek to emphasize the most common causes of the appearance of these syndrome. They point out the care that must be taken in the process of sterilization of surgical material, in addition to reviewing the best conduct when faced with these cases. In conclusion, it was noted that the main focus should be on prevention, as treatment only seeks to suppress the secondary inflammatory response. Treatment in cases of toxic anterior segment syndrome (TASS consists of intense instillation of topical steroids with strict follow-up and control of late complications such as glaucoma.

  12. WHAT IS THE BEST RADIOGRAPHIC VIEW FOR “DIE PUNCH” DISTAL RADIUS FRACTURES? A CADAVER MODEL STUDY

    Science.gov (United States)

    Falcochio, Diego Figueira; Crepaldi, Bruno Eiras; Trindade, Christiano Augusto; da Costa, Antonio Carlos; Chakkour, Ivan

    2015-01-01

    Objective: the aim of this study is try to show the best view for distal radius fractures so called die-punch fractures. Methods: There has been used a human cadaver radius bone from the Salvador Arena Tissue Bank. This bone was cleaned up after removing the soft tissues and osteotomies created displaced lunate fossa fractures of 0, 1, 2, 3 and 5 mm. We have fixed this fragment with adhesive tape. Then the joint deviation were significantly increased with step-offs of 1 mm. Radiographs were then taken into 5 different positions: postero-anterior view, lateral view, oblique views and tangencial view for each of the deviations. The resulting lunate fossa depression in each X-ray film was analyzed by the AutoCAD 2010® software. Results: The tangencial view was the best one to see the 1mm and 3mm bone degrees and the second one view to see the 2mm and 5 mm degrees. The pronated oblique view was the best to see the 2mm degrees and the oblique supinated view wasn't able to see the degrees between 1 and 2mm. Conclusion: The tangencial view was the best one to see the 1mm and 3mm bone degrees and the second one view to see the 2mm and 5 mm degrees. PMID:27027079

  13. Tunnel widening in anterior cruciate ligament reconstruction

    DEFF Research Database (Denmark)

    Clatworthy, M G; Annear, P; Bulow, J U;

    1999-01-01

    We report a prospective series evaluating the incidence and degree of tunnel widening in a well-matched series of patients receiving a hamstring or patella tendon graft for anterior cruciate ligament (ACL) deficiency. We correlated tunnel widening with clinical factors, knee scores, KT-1000 and...... similar endoscopic procedure and accelerated postoperative rehabilitation. Tunnel widening was determined using standardized anteroposterior (AP) and lateral X-rays adjusted for magnification. A limited series of MRIs was performed to validate these measurements. There was a significant difference in the...... degree of tunnel widening between the two groups. The mean increase in femoral tunnel area in the hamstring group was 100.4% compared with a decrease of 25% in the patella tendon group (P = <0.0001). In the tibial tunnel the mean increase in the hamstring group was 73.9% compared with a decrease of 2...

  14. Mechanisms of anterior cruciate ligament injury

    International Nuclear Information System (INIS)

    The anterior cruciate ligament (ACL) may be injured by various mechanisms. Each mechanism is know to produce specific combinations of ligamentous and meniscal abnormalities. This paper reports that this project was undertaken to evaluate the ability of MR imaging to characterize fully these different patterns of ACL injury. Two hundred fifty knee MR examinations in patients with suspected ACL injury were reviewed retrospectively. The presence of ACL injury and associated ligamentous, capsular, meniscal, and bone marrow abnormalities were correlated with the clinical history and mechanism of injury. Surgical or arthroscopic follow-up was available in all patients. As expected, ACL injuries were found to have a broad spectrum of associated abnormalities identified by MR imaging. Several mechanism-specific patterns of ligamentous and meniscal injury were observed; however, patterns of bone marrow edema and injury proved to be the most useful in predicting the mechanism of injury

  15. Concrescent triplets involving primary anterior teeth

    Directory of Open Access Journals (Sweden)

    Urvashi Sharma

    2013-01-01

    Full Text Available Odontogenesis is a complex process wherein more than 200 genes are known to play a significant role in tooth development. An imbalance can lead to an abnormality in the number, size, shape or structure of the developing tooth/teeth. The presence of an extra dental lamina forms a supernumerary tooth. The supernumerary teeth are of two types: A rudimentary tooth where the supernumerary tooth does not resemble any tooth in the normal series or a supplemental tooth in which this anomalous tooth resembles one in the normal series. It is also very rare to encounter triple teeth in primary dentition. The union of these teeth may be through fusion, gemination, concrescence or a combination of fusion and gemination. Presented is a rare case of concrescence involving maxillary deciduous incisors and a supplemental tooth in a 7-year-old boy. The differential diagnosis, etiology, and complications of primary anterior triple teeth are discussed.

  16. MR imaging of anterior cruciate ligament tears

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-09-01

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

  17. MR imaging of anterior cruciate ligament tears

    International Nuclear Information System (INIS)

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

  18. MR imaging evaluation of anterior cruciate ligaments

    International Nuclear Information System (INIS)

    On 546 knees, the authors have obtained MR images (0.5 T or 1.5 T). The protocol included 5-mm-thick contiguous sagittal and oblique coronal images (in the plane of the anterior cruciate ligament [ACL]) and T1-, proton-density-, and T2-weighted sequences. In 174 patients, correlations with arthroscopic or surgical findings were available. In these cases, sagittal and oblique coronal images were retrospectively and separately read by two radiologists, who were blinded to other results. The mean accuracy of sagittal MR images alone was 88% for the depiction of partial and complete ACL tears, intraligamental bleeding, and scarring; the accuracy of oblique coronal images alone was 96%. Use of sagittal and oblique coronal images together achieved 98% accuracy

  19. Patellotibial contusions in anterior cruciate ligament tears.

    Science.gov (United States)

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

    2014-02-01

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

  20. RETAINED STONE PIECE IN ANTERIOR CHAMBER

    Directory of Open Access Journals (Sweden)

    ZvornicaninJasmin, Nadarevic-VodencarevicAmra

    2015-04-01

    Full Text Available ABSTRACT We read with interest the article by Surekha et al. regarding the retained stone piece in anterior chamber. Similar to the results of previous studies, the authors found that delayed intraocular foreign body (IOFB management can result in good visual outcome without an apparent increased risk of endophthalmitis or other deleterious side effects. However, the authors failed to explain the exact reason for the diminution of vision in patients left eye. It is unclear what the uncorrected visual acuity was and what kind of correction was used, more precisely type and amount of cylinder, given the presence of the corneal opacity. Since the size of the IOFB is approximately 4x4x1mm, significant irido-corneal angle changes resulting in intraocular pressure raise and optic nerve head damage can be expected. Traumatic glaucoma following open globe injury can occur in 2.7 to 19% of cases, with several risk factors associated with glaucoma development (advanced age, poor visual acuity at presentation,perforating rather than penetrating ocular injury,lens injury, presence of vitreous hemorrhage and presence of an IOFB. Earlier reportsof latetraumaticoptic neuropathy onset, even after several years, indicate that this possibility cannot be completely ruled out too. Therefore, repeated intraocular pressure measurements, gonioscopy, pupillary reaction assessment, together with through posterior segment examination including visual field and optical coherence tomography examinations can be useful in determining the possible optic nerve damage as one of the possible reasons for visual acuity reduction. The authors did not suggest any operative treatment at this time. However, it should bear in mind that the inert anterior chamber IOFB could be a risk factor for non-infectious endophthalmitis development even after many years. Also, long term retained anterior chamber foreign body leads to permanent endothelial cell loss and can even result in a corneal