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Sample records for anterior opening wedge

  1. Variations in depth-dose data between open and wedge fields for 4-MV x-rays

    International Nuclear Information System (INIS)

    Sewchand, W.; Khan, F.M.; Williamson, J.

    1978-01-01

    Central-axis depth-dose data for 4-MV x rays, including tissue-maximum ratios, were measured for wedge fields. Comparison with corresponding open-field data revealed differences in magnitude which increased with depth, field size, and wedge thickness. However, phantom scatter correction factors for the wedge fields differed less than 1% from corresponding open-field factors. The differences in central-axis percent depth doses between the two types of fields indicate beam hardening by the wedge filter. This study also implies that the derivation of tissue-maximum ratios from central-axis percent depth is as valid for wedge as for open fields

  2. Variation in Depth Dose Data between Open and Wedge Fields for 6 MV X-Rays

    International Nuclear Information System (INIS)

    U, Hong; Ryu, M. S. Samuel; Park, In Kyu

    1989-01-01

    Central axis depth dose data for 6 MV X-rays, including tissue maximum ratios, were measured for wedge fields according to Tatcher equation. In wedge fields, the differences in magnitude which increased with depth, field size, and wedge thickness increased when compared with the corresponding open field data. However, phantom scatter correction factors for wedge fields differed less that 1% from the corresponding open field factors. The differences in central axis percent depth dose between two types of fields indicated beam hardening by the wedge filter. The deviation of percent depth doses and scatter correction factors between the effective wedge field and the nominal wedge field at same angle was negligible. The differences were less than 3.26% between the nominal or effective wedge fields and the open fields for percent depth doses to the depth 7cm in 6cm x 6cm field. For larger (10cm x 10cm) field size, however, the deviation of percent depth doses between the nominal or effective wedge fields and the open fields were greater-dosimetric errors were 3.56% at depth 7cm and nearly 5.30% at 12cm. We suggest that the percent depth doses of individual wedge and wedge transmission factors should be considered for the dose calculation or monitor setting in the treatment of deep seated tumor

  3. [Open-wedge osteotomy of the glenoid for treatment of posterior shoulder instability with increased glenoid retroversion].

    Science.gov (United States)

    Pogorzelski, J; Braun, S; Imhoff, A B; Beitzel, K

    2016-12-01

    Treatment of posterior shoulder instability with increased retroversion of the glenoid using open-wedge osteotomy of the glenoid neck stabilized with an autologous bone block. Symptomatic, atraumatic posterior shoulder instability with increased retroversion (>20°) of the glenoid and previously failed conservative or surgical treatment. General contraindications against surgery. Relative contraindications: osteoporosis, nicotine abuse, or suspected patient noncompliance. Posterior approach with a 7 cm long incision starting medial of the posterolateral corner of the acromion heading to the posterior axillary fold and subsequent preparation of the deltoid muscle and the infraspinatus muscle. The posterior glenohumeral capsule is incised by performing a capsular T‑shift. The osteotomy is performed intracapsulary medial to the genoid rim. The wedge bone graft, harvested from spina scapulae or iliac spine, is placed "press fit" in position. Additional fixation of the graft is not necessary if the anterior cortex is intact. For reinforcing the posterior capsule, a posterior capsule shift should be performed. Insertion of extracapsular wound drainage. Successive wound closure. Postoperative immobilization in a 0° shoulder orthesis for 6 weeks; avoidance of horizontal abduction for 8 weeks. After removing the wound drainage, start of limited active-assisted range of motion. Over-head sports after 6 months. From 2009-2015, 6 posterior open wedge glenoid osteotomies were performed. Postoperative retroversion of the glenoid was 11.2 ± 9.4° compared to 26.0 ± 8.6° before surgery. Of 6 shoulders, 2 showed postoperative signs of persistent posterior instability; the other 4 shoulders were free of complaints. No revision surgery was needed.

  4. Proximal Opening Wedge Osteotomy Provides Satisfactory Midterm Results With a Low Complication Rate.

    Science.gov (United States)

    Oravakangas, Rami; Leppilahti, Juhana; Laine, Vesa; Niinimäki, Tuukka

    2016-01-01

    Hallux valgus is one of the most common foot deformities. Proximal opening wedge osteotomy is used for the treatment of moderate and severe hallux valgus with metatarsus primus varus. However, hypermobility of the first tarsometatarsal joint can compromise the results of the operation, and a paucity of midterm results are available regarding proximal open wedge osteotomy surgery. The aim of the present study was to assess the midterm results of proximal open wedge osteotomy in a consecutive series of patients with severe hallux valgus. Thirty-one consecutive adult patients (35 feet) with severe hallux valgus underwent proximal open wedge osteotomy. Twenty patients (35.5%) and 23 feet (34.3%) were available for the final follow-up examination. The mean follow-up duration was 5.8 (range 4.6 to 7.0) years. The radiologic measurements and American Orthopaedic Foot and Ankle Society hallux-metatarsophalangeal-interphalangeal scores were recorded pre- and postoperatively, and subjective questionnaires were completed and foot scan analyses performed at the end of the follow-up period. The mean hallux valgus angle decreased from 38° to 23°, and the mean intermetatarsal angle correction decreased from 17° to 10°. The mean improvement in the American Orthopaedic Foot and Ankle Society hallux metatarsophalangeal-interphalangeal score increased from 52 to 84. Two feet (5.7%) required repeat surgery because of recurrent hallux valgus. No nonunions were identified. Proximal open wedge osteotomy provided satisfactory midterm results in the treatment of severe hallux valgus, with a low complication rate. The potential instability of the first tarsometatarsal joint does not seem to jeopardize the midterm results of the operation. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  5. Monoplanar versus biplanar medial open-wedge proximal tibial osteotomy for varus gonarthrosis: a comparison of clinical and radiological outcomes.

    Science.gov (United States)

    Elmalı, Nurzat; Esenkaya, Irfan; Can, Murat; Karakaplan, Mustafa

    2013-12-01

    We compared clinical and radiological results of two proximal tibial osteotomy (PTO) techniques: monoplanar medial open-wedge osteotomy and biplanar retrotubercle medial open-wedge osteotomy, stabilised by a wedged plate. We evaluated 88 knees in 78 patients. Monoplanar medial open-wedge PTO was performed on 56 knees in 50 patients with a mean age of 55 ± 9 years. Biplanar retrotubercle medial open-wedge PTO was performed on 32 knees in 28 patients with a mean age of 57 ± 7 years. Mean follow-up periods were 40.6 ± 7 months for the monoplanar PTO group and 38 ± 5 months for the biplanar retrotubercle PTO group. Clinical outcome was evaluated using the hospital for special surgery scoring system, and radiological outcome was evaluated by the measurements of femorotibial angle (FTA), patellar height and tibial slope changes. In both groups, post-operative HSS scores increased significantly. No significant difference was found between groups in FTA alteration, but the FTA decreased significantly in both groups. Patellar index ratios decreased significantly in the monoplanar PTO group (Insall-Salvati Index by 0.07, Blackburne-Peel Index by 0.07), but not in the biplanar retrotubercle PTO group. Tibial slopes were increased significantly in the monoplanar PTO group, but not in the retrotubercle PTO group. Biplanar retrotubercle medial open-wedge osteotomy and monoplanar medial open-wedge osteotomy are both clinically effective for the treatment for varus gonarthrosis. Retrotubercle osteotomy also prevents patella infera and tibial slope changes radiologically.

  6. Early weight bearing versus delayed weight bearing in medial opening wedge high tibial osteotomy: a randomized controlled trial.

    Science.gov (United States)

    Lansdaal, Joris Radboud; Mouton, Tanguy; Wascher, Daniel Charles; Demey, Guillaume; Lustig, Sebastien; Neyret, Philippe; Servien, Elvire

    2017-12-01

    The need for a period of non-weight bearing after medial opening wedge high tibial osteotomy remains controversial. It is hypothesized that immediate weight bearing after medial opening wedge high tibial osteotomy would have no difference in functional scores at one year compared to delayed weight bearing. Fifty patients, median age 54 years (range 40-65), with medial compartment osteoarthritis, underwent a medial opening wedge high tibial osteotomy utilizing a locking plate without bone grafting. Patients were randomized into an Immediate or a Delayed (2 months) weight bearing group. All patients were assessed at one-year follow-up and the two groups compared. The primary outcome measure was the IKS score. Secondary outcome measures included the IKDC score, the VAS pain score and rate of complications. The functional scores significantly improved in both groups. The IKS score increased from 142 ± 31 to 171 ± 26 in the Immediate group (p bearing after medial opening wedge high tibial osteotomy had no effect on functional scores at 1 year follow-up and did not significantly increase the complication rate. Immediate weight bearing after medial opening wedge high tibial osteotomy appears to be safe and can allow some patients a quicker return to activities of daily living and a decreased convalescence period. II.

  7. Changes in patellofemoral alignment do not cause clinical impact after open-wedge high tibial osteotomy.

    Science.gov (United States)

    Lee, Yong Seuk; Lee, Sang Bok; Oh, Won Seok; Kwon, Yong Eok; Lee, Beom Koo

    2016-01-01

    The objectives of this study were (1) to evaluate the clinical and radiologic outcomes of open-wedge high tibial osteotomy focusing on patellofemoral alignment and (2) to search for correlation between variables and patellofemoral malalignment. A total of 46 knees (46 patients) from 32 females and 14 males who underwent open-wedge high tibial osteotomy were included in this retrospective case series. Outcomes were evaluated using clinical scales and radiologic parameters at the last follow-up. Pre-operative and final follow-up values were compared for the outcome analysis. For the focused analysis of the patellofemoral joint, correlation analyses between patellofemoral variables and pre- and post-operative weight-bearing line (WBL), clinical score, posterior slope, Blackburn Peel ratio, lateral patellar tilt, lateral patellar shift, and congruence angle were performed. The minimum follow-up period was 2 years and median follow-up period was 44 months (range 24-88 months). The percentage of weight-bearing line was shifted from 17.2 ± 11.1 to 56.7 ± 12.7%, and it was statistically significant (p patellofemoral malalignment, the pre-operative weight-bearing line showed an association with the change in lateral patellar tilt and lateral patellar shift (correlation coefficient: 0.3). After open-wedge high tibial osteotomy, clinical results showed improvement, compared to pre-operative values. The patellar tilt and lateral patellar shift were not changed; however, descent of the patella was observed. Therefore, mild patellofemoral problems should not be a contraindication of the open-wedge high tibial osteotomy. Case series, Level IV.

  8. Three-level anterior cervical discectomy and fusion in elderly patients with wedge shaped tricortical autologous graft: A consecutive prospective series

    Directory of Open Access Journals (Sweden)

    Lee Suk

    2008-01-01

    Full Text Available Background: Treatment of multilevel cervical spondylotic myelopathy/radiculopathy is a matter of debate, more so in elderly patients due to compromised physiology. We evaluated the clinical and radiological results of cervical fusion, using wedge-shaped tricortical autologous iliac graft and Orion plate for three-level anterior cervical discectomy in elderly patients. Materials and Methods: Twelve elderly patients with mean age of 69.7 years (65-76 years were treated between April 2000 and March 2005, for three-level anterior cervical discectomy and fusion, using wedge-shaped tricortical autologous iliac graft and Orion plate. Outcome was recorded clinically according to Odom′s criteria and radiologically in terms of correction of lordosis angle and intervertebral disc height span at the time of bony union. The mean follow-up was 29.8 months (12-58 months. Results: All the patients had a complete recovery of clinical symptoms after surgery. Postoperative score according to Odom′s criteria was excellent in six patients and good in remaining six. Bony union was achieved in all the patients with average union time of 12 weeks (8-20 weeks. The mean of sum of three segment graft height collapse was 2.50 mm (SD = 2.47. The average angle of lordosis was corrected from 18.2° (SD = 2.59° preoperatively to 24.9° (SD = 4.54° at the final follow-up. This improvement in the radiological findings is statistically significant (P < 0.05. Conclusion: Cervical fusion with wedge-shaped tricortical autologous iliac graft and Orion plate for three-level anterior cervical discectomy is an acceptable technique in elderly patients. It gives satisfactory results in terms of clinical outcome, predictable early solid bony union, and maintenance of disc space height along with restoration of cervical lordosis.

  9. Factors associated with anterior open bite in children with developmental disabilities.

    Science.gov (United States)

    de Castilho, Lia Silva; Abreu, Mauro Henrique Nogueira Guimarães; Pires E Souza, Luiz Gustavo de Almeida; Romualdo, Leiliane Teresinha de Almeida; Souza E Silva, Maria Elisa; Resende, Vera Lúcia Silva

    2018-01-01

    To investigate factors associated with anterior open bite in individuals aged from 2 to 33 years with developmental disabilities. This is a cross-sectional study. A total of 271 dental records were examined. The anterior open bite analyzed was determined based on clinic exam. These variables were also analyzed: gender, age, education level of mother, International Code of Diseases (ICD), mouth breathing, use of anticonvulsant drugs, hyperkinesis, pacifier use, thumb sucking, seizure, and involuntary movements. For the purposes of analysis, the individuals were categorized as being with and without anterior open bite. Variables with a p-value of open bite than nasal breathers. Pacifier users are more likely to have an anterior open bite (3.32-fold, 95% CI: 1.62-6.77). Individuals with reported involuntary movements had a 2.66-fold (95% CI: 1.26-5.63) greater chance of exhibiting anterior open bite. Users of anticonvulsants drugs had a 3.05 (95% CI: 1.57-5.92) greater chance of showing anterior open bite. Involuntary movements, mouth breathing, using anticonvulsant drugs, and using pacifier are factors associated with anterior open bite in patients with developmental disabilities. © 2017 Special Care Dentistry Association and Wiley Periodicals, Inc.

  10. Beam profiles in the nonwedged direction for dynamic wedges

    International Nuclear Information System (INIS)

    Lydon, J.M.; Rykers, K.L.

    1996-01-01

    One feature of the dynamic wedge is the improved flatness of the beam profile in the nonwedged direction when compared to fixed wedges. Profiles in the nonwedged direction for fixed wedges show a fall-off in dose away from the central axis when compared to the open field profile. This study will show that there is no significant difference between open field profiles and nonwedged direction profiles for dynamically wedged beams. The implications are that the dynamic wedge offers an improved dose distribution in the nonwedged direction that can be modelled by approximating the dynamically wedged field to an open field. This is possible as both the profiles and depth doses of the dynamically wedged fields match those of the open fields, if normalized to d max of the same field size. For treatment planning purposes the effective wedge factor (EWF) provides a normalization factor for the open field depth dose data set. Data will be presented to demonstrate that the EWF shows relatively little variation with depth and can be treated as being independent of field size in the nonwedged direction. (author)

  11. Contralateral breast dose reduction using a virtual wedge

    International Nuclear Information System (INIS)

    Yeo, In Hwan; Kim, Dae Yong; Kim, Tae Hyun; Shin, Kyung Hwan; Chie, Eui Kyu; Park, Won; Lim, Do Hoon; Huh, Seung Jae; Ahn, Yong Chan

    2005-01-01

    To evaluate the contralateral breast dose using a virtual wedge compared with that using a physical wedge and an open beam in a Siemens linear accelerator. The contralateral breast dose was measured using diodes placed on a humanoid phantom. Diodes were placed at 5.5 cm (position 1), 9.5 cm (position 2), and 14 cm (position 3) along the medial-lateral line from the medial edge of the treatment field. A 6-MV photon beam was used with tangential irradiation technique at 50 and 230 degrees of gantry angle. Asymmetrically collimated 17 x 10 cm field was used. For the first set of experiment, four treatment set-ups were used, which were an open medial beam with a 30-degree wedged lateral beam (physical and virtual wedges, respectively) and a 15-degree wedge medial beam with a 15-degree wedged lateral beam (physical and virtual wedges, respectively). The second set of experiment consists of setting with medial beam without wedge, a 15-degree wedge, and a 60-degree wedge (physical and virtual wedges, respectively). Identical monitor units were delivered. Each set of experiment was repeated for three times. In the first set of experiment, the contralateral breast dose was the highest at the position 1 and decreased in order of the position 2 and 3. The contralateral breast dose was reduced with open beam on the medial side (2.70± 1.46%) compared to medial beam with a wedge (both physical and virtual) (3.25 ± 1.59%). The differences were larger with a physical wedge (0.99 ± 0.18%) than a virtual wedge (0.10 ± 0.01%) at all positions. The use of a virtual wedge reduced the contralateral breast dose by 0.12% to 1.20% of the prescribed dose compared to a physical wedge with same technique. In the second experiment, the contralateral breast dose decreased in order of the open beam, the virtual wedge, and the physical wedge at the position 1, and it decreased in order of a physical wedge, an open beam, and a virtual wedge at the position 2 and 3. The virtual wedge equipped

  12. Open wedge metatarsal osteotomy versus crescentic osteotomy to correct severe hallux valgus deformity

    DEFF Research Database (Denmark)

    Wester, Jens Ulrik; Hamborg-Petersen, Ellen; Herold, Niels

    2016-01-01

    BACKGROUND: Different techniques of proximal osteotomies have been introduced to correct severe hallux valgus. The open wedge osteotomy is a newly introduced method for proximal osteotomy. The aim of this prospective randomized study was to compare the radiological and clinical results after...... operation for severe hallux valgus, comparing the open wedge osteotomy to the crescentic osteotomy which is our traditional treatment. METHODS: Forty-five patients with severe hallux valgus (hallux valgus angle >35̊, and intermetatarsal angle >15̊) were included in this study. The treatment was proximal...... and 12 months after the operation. RESULTS: In group 1 the hallux valgus angle decreased from 39.0̊ to 24.1̊ after 4 months and 27.9̊ after 12 months. In group 2 the angle decreased from 38.3̊ to 21.4̊ after 4 months and 27.0̊ after 12 months. The intermetatarsal angle in group 1 was 19.0̊ preoperatively...

  13. Lamina cribrosa position and Bruch's membrane opening differences between anterior ischemic optic neuropathy and open-angle glaucoma.

    Science.gov (United States)

    Rebolleda, Gema; Pérez-Sarriegui, Ane; Díez-Álvarez, Laura; De Juan, Victoria; Muñoz-Negrete, Francisco J

    2018-06-01

    To compare the optic nerve head morphology among primary open-angle glaucoma, non-arteritic anterior ischemic optic neuropathy eyes, their fellow healthy eyes and control eyes, using spectral-domain optical coherence tomography with enhanced depth imaging. Observational cross-sectional study including 88 eyes of 68 patients. In this study, 23 non-arteritic anterior ischemic optic neuropathy eyes, 17 fellow unaffected eyes, 25 primary open-angle glaucoma eyes, and 23 age-matched control eyes were included. Peripapillary retinal nerve fiber layer thickness and optic disk area were evaluated. Bruch's membrane opening diameter, optic cup depth, anterior lamina cribrosa depth, and prelaminar tissue thickness were assessed. Non-arteritic anterior ischemic optic neuropathy and primary open-angle glaucoma eyes had similar visual field mean deviation and peripapillary retinal nerve fiber layer thickness (P = 0.6 and P = 0.56, respectively). Bruch's membrane opening diameter was significantly larger in primary open-angle glaucoma eyes than in control eyes (P = 0.02). Lamina cribrosa and disk cup were deeper in eyes with primary open-angle glaucoma than both control and non-arteritic anterior ischemic optic neuropathy eyes (P open-angle glaucoma eyes than in non-arteritic anterior ischemic optic neuropathy eyes (P opening diameter was found in primary open-angle glaucoma eyes compared with control eyes. This issue has clinical implications because Bruch's membrane opening has been considered a stable reference for disk-related measures.

  14. A practical method to calculate head scatter factors in wedged rectangular and irregular MLC shaped beams for external and internal wedges

    International Nuclear Information System (INIS)

    Georg, Dietmar; Olofsson, Joergen; Kuenzler, Thomas; Aiginger, Hannes; Karlsson, Mikael

    2004-01-01

    Factor based methods for absorbed dose or monitor unit calculations are often based on separate data sets for open and wedged beams. The determination of basic beam parameters can be rather time consuming, unless equivalent square methods are applied. When considering irregular wedged beams shaped with a multileaf collimator, parametrization methods for dosimetric quantities, e.g. output ratios or wedge factors as a function of field size and shape, become even more important. A practical method is presented to derive wedged output ratios in air (S c,w ) for any rectangular field and for any irregular MLC shaped beam. This method was based on open field output ratios in air (S c ) for a field with the same collimator setting, and a relation f w between S c,w and S c . The relation f w can be determined from measured output ratios in air for a few open and wedged fields including the maximum wedged field size. The function f w and its parametrization were dependent on wedge angle and treatment head design, i.e. they were different for internal and external wedges. The proposed method was tested for rectangular wedged fields on three accelerators with internal wedges (GE, Elekta, BBC) and two accelerators with external wedges (Varian). For symmetric regular beams the average deviation between calculated and measured S c,w /S c ratios was 0.3% for external wedges and about 0.6% for internal wedges. Maximum deviations of 1.8% were obtained for elongated rectangular fields on the GE and ELEKTA linacs with an internal wedge. The same accuracy was achieved for irregular MLC shaped wedged beams on the accelerators with MLC and internal wedges (GE and Elekta), with an average deviation <1% for the fields tested. The proposed method to determine output ratios in air for wedged beams from output ratios of open beams, combined with equivalent square approaches, can be easily integrated in empirical or semi-empirical methods for monitor unit calculations

  15. Open wedge high tibial osteotomy using three-dimensional printed models: Experimental analysis using porcine bone.

    Science.gov (United States)

    Kwun, Jun-Dae; Kim, Hee-June; Park, Jaeyoung; Park, Il-Hyung; Kyung, Hee-Soo

    2017-01-01

    The purpose of this study was to evaluate the usefulness of three-dimensional (3D) printed models for open wedge high tibial osteotomy (HTO) in porcine bone. Computed tomography (CT) images were obtained from 10 porcine knees and 3D imaging was planned using the 3D-Slicer program. The osteotomy line was drawn from the three centimeters below the medial tibial plateau to the proximal end of the fibular head. Then the osteotomy gap was opened until the mechanical axis line was 62.5% from the medial border along the width of the tibial plateau, maintaining the posterior tibial slope angle. The wedge-shaped 3D-printed model was designed with the measured angle and osteotomy section and was produced by the 3D printer. The open wedge HTO surgery was reproduced in porcine bone using the 3D-printed model and the osteotomy site was fixed with a plate. Accuracy of osteotomy and posterior tibial slope was evaluated after the osteotomy. The mean mechanical axis line on the tibial plateau was 61.8±1.5% from the medial tibia. There was no statistically significant difference (P=0.160). The planned and post-osteotomy correction wedge angles were 11.5±3.2° and 11.4±3.3°, and the posterior tibial slope angle was 11.2±2.2° pre-osteotomy and 11.4±2.5° post-osteotomy. There were no significant differences (P=0.854 and P=0.429, respectively). This study showed that good results could be obtained in high tibial osteotomy by using 3D printed models of porcine legs. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. The results of high tibial open wedge osteotomy in patients with varus deformity

    Directory of Open Access Journals (Sweden)

    Mahmood Jabalameli

    2013-07-01

    Full Text Available Background: High tibial open wedg osteotomy is one of the most important modality for treatment of varus deformity in order to correct deformity and improving signs and symptoms of patients with primary degenerative osteoarthritis. The aim of this study was to investigate the results of high tibial open wedge osteotomy in patients with varus deformities.Methods: This retrospective study conducted on twenty nine patients (36 knees undergone proximal tibial osteotomy operation in Shafa Yahyaian University Hospital from 2004 to 2010. Inclusion criteria were: age less than 60 years, high physical activity, varus deformity and involvement of medical compartment of knee. Patients with obesity, smoking, patelofemoral pain, lateral compartment lesion, deformity degree more than 20 degree, extension limitation and range of motion less than 90 degree were excluded. The clinical and radiologic characteristics were measured before and after operation.Results: Fourteen patients were females. All of them were younger than 50 years, with mean (±SD 27.64 (±10.88. The mean (±SD of follow up time was 4.33 (±1.7. All the patients were satisfied with the results of operation. Tenderness and pain decreased in all of them. In all patients autologus bone graft were used, in 15 cases (42.5% casting and in the rest T.Buttress plate were used for fixation of fractures. In both groups of primary and double varus the International knee documentation committee (IKDC and modified Larson indices were improved after operation, but there was no significant difference between two groups.Conclusion: High tibial open wedge osteotomy can have satisfying results in clinical signs and symptoms of patients with primary medial joint degenerative osteoarthritis. This procedure also may correct the deformity and improves the radiologic parameters of the patients.

  17. Clinical implementation of enhanced dynamic wedge

    International Nuclear Information System (INIS)

    Klein, Eric E.; Zhu Xiaorong; Low, Daniel A.; Drzymala, Robert E.; Harms, William B.; Purdy, James A.

    1996-01-01

    Purpose/Objective: Our clinic has been using dynamic wedge since 1993. We appreciate the customized wedge shaped distributions (independent of field size) and the positive aspects of replacing filters with dynamic jaw motion. Varian recently introduced enhanced dynamic wedge (EDW) software. The EDW can be delivered over; a 30 cm field, asymmetric fields (in both wedged and non-wedged directions), and additional wedge angles (10, 15, 20, 25, 30, 45, 60). The EDW software creates customized segmented treatment tables (STTs) for the desired wedge angle and field size. The STT is created from a 'golden' fluence profile of 60 deg. over 30 cm. The wedge STT is derived using ratio-of-tangents and the truncated field segment extracted from the 'golden' table. A review of our dosimetric studies will be presented as well as a discussion of clinical implementation issues including treatment planning and quality assurance. Methods and Materials: We tested a set of angle and field size combinations chosen to encompass clinical needs. The wedge factor (WF) was measured using an ionization chamber along central axis for symmetric fields ranging from 4 to 20 cm, and asymmetric fields to 30 cm. The non-wedged field dimension was found to be inconsequential. An algorithm was developed to predict the wedge factor for any angle and field dimension. Isodoses were measured with film and used for profile evaluation and treatment planning development. The 'golden' fluence table was used to create a universal 60 deg. 'physical' wedge for planning. The universal wedge is combined with an open field (to derive intermediate wedge angles) and blocked according to the treatment field segment. A quality assurance program was developed that relies on multi-point diode measurements. Results: We found the WF is a function of wedge angle and field settings of the final sweep position. There is a nearly linear dependence of WF vs. field size thus allowing a minimal WF table. This eliminates a

  18. Manual cross check of computed dose times for motorised wedged fields

    International Nuclear Information System (INIS)

    Porte, J.

    2001-01-01

    If a mass of tissue equivalent material is exposed in turn to wedged and open radiation fields of the same size, for equal times, it is incorrect to assume that the resultant isodose pattern will be effectively that of a wedge having half the angle of the wedged field. Computer programs have been written to address the problem of creating an intermediate wedge field, commonly known as a motorized wedge. The total exposure time is apportioned between the open and wedged fields, to produce a beam modification equivalent to that of a wedged field of a given wedge angle. (author)

  19. Numerical study on flow rate limitation of open capillary channel flow through a wedge

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    Ting-Ting Zhang

    2016-04-01

    Full Text Available The flow characteristics of slender-column flow in wedge-shaped channel under microgravity condition are investigated in this work. The one-dimensional theoretical model is applied to predict the critical flow rate and surface contour of stable flow. However, the one-dimensional model overestimates the critical flow rate for not considering the extra pressure loss. Then, we develop a three-dimensional simulation method with OpenFOAM, a computational fluid dynamics tool, to simulate various phenomena in wedge channels with different lengths. The numerical results are verified with the capillary channel flow experimental data on the International Space Station. We find that the three-dimensional simulation perfectly predicts the critical flow rates and surface contours under various flow conditions. Meanwhile, the general behaviors in subcritical, critical, and supercritical flow are studied in three-dimensional simulation considering variations of flow rate and open channel length. The numerical techniques for three-dimensional simulation is validated for a wide range of configurations and is hopeful to provide valuable guidance for capillary channel flow experiment and efficient liquid management in space.

  20. Prevalence and factors associated with anterior open bite in 2 to 5 ...

    African Journals Online (AJOL)

    Prevalence and factors associated with anterior open bite in 2 to 5 year old children in Benin city, Nigeria. ... Background: Anterior open bite is said to exist when there is an actual vertical gap between the upper and lower incisors with the teeth in centric occlusion. This could occur in the anterior or posterior region, and may ...

  1. Open wedge metatarsal osteotomy versus crescentic osteotomy to correct severe hallux valgus deformity - A prospective comparative study.

    Science.gov (United States)

    Wester, Jens Ulrik; Hamborg-Petersen, Ellen; Herold, Niels; Hansen, Palle Bo; Froekjaer, Johnny

    2016-03-01

    Different techniques of proximal osteotomies have been introduced to correct severe hallux valgus. The open wedge osteotomy is a newly introduced method for proximal osteotomy. The aim of this prospective randomized study was to compare the radiological and clinical results after operation for severe hallux valgus, comparing the open wedge osteotomy to the crescentic osteotomy which is our traditional treatment. Forty-five patients with severe hallux valgus (hallux valgus angle >35̊, and intermetatarsal angle >15̊) were included in this study. The treatment was proximal open wedge osteotomy and fixation with plate (Hemax), group 1, or operation with proximal crescentic osteotomy and fixation with a 3mm cannulated screw, group 2. The mean age was 52 years (19-71). Forty-one females and four males were included. Clinical and radiological follow-ups were performed 4 and 12 months after the operation. In group 1 the hallux valgus angle decreased from 39.0̊ to 24.1̊ after 4 months and 27.9̊ after 12 months. In group 2 the angle decreased from 38.3̊ to 21.4̊ after 4 months and 27.0̊ after 12 months. The intermetatarsal angle in group 1 was 19.0̊ preoperatively, 11.6̊ after 4 months and 12.6̊ after 12 months. In group 2 the mean intermetatarsal angle was 18.9̊ preoperatively, 12.0̊ after 4 months and 12.6̊ after 12 months. The AOFAS score improved from 59.3 to 81.5 in group 1 and from 61.8 to 84.8 in group 2 respectively measured 12 months postoperatively. The relative length of the 1 metatarsal compared to 2 metatarsal bone was 0.88 and 0.87 preoperatively and 0.88 and 0.86 for group 1 and 2 respectively measured after 12 months. Crescentic osteotomy and open wedge osteotomy improve AOFAS score and VAS scores on patients operated with severe hallux valgus. No significant difference was found in the two groups looking at the postoperative improvement of HVA and IMA measured 4 and 12 months postoperatively. The postoperative VAS score and AOFAS score were

  2. Dosimetry verifications of the physical parameters of virtual wedge on a Siemens accelerator

    International Nuclear Information System (INIS)

    Zhong Heli; Li Xiaodong; Li Longxing

    2002-01-01

    Objective: To verify the wedge angle of virtual wedge and the relation between wedge factor and beam energy, field size, wedge angle and to study the difference in percent depth dose (PDD) of virtual wedge field, hard wedge field and open field. Methods: Using wedge angle and wedge factor of 15 degree, 30 degree, 45 degree and 60 degree virtual wedge of Siemens Mevatron 6 MV and Primus 8 MV, 18 MV X rays were measured by RFA-plus 3D water phantom and RK finger chamber the PDD of the virtual wedge field, hard wedge field and open field were measured by Kodak XV-2 verifying film and FDM-300 film dosimeter. These PDDs were normalized to Dmax then compared. Results: There was good conformation between virtual wedge measured by four point method and set value. The virtual wedge was almost equal to 1, with a maximal variation of 0.031 no matter what the value of beam energy, field size or wedge angle was. Generally, for certain energy and field size, the wedge factor of larger wedge angle was slightly larger than smaller wedge angle. For certain energy and wedge angle, the wedge factor of larger field was also a little larger than smaller field. The PDD of virtual wedge field was similar to that of open field. Conclusions: The four point method measurement for virtual wedge angle is good for daily QA. Radiotherapy of virtual wedge field is not only simpler than hard wedge field, but also spares the beam output. The PDD conferment between virtual field and open field simplifies radiation treatment planning and increases the accuracy of wedge field therapy

  3. Dosimetry and clinical implementation of dynamic wedge

    International Nuclear Information System (INIS)

    Klein, Eric E.; Low, Daniel A.; Meigooni, Ali S.; Purdy, James A.

    1995-01-01

    Purpose: Wedge-shaped isodoses are desired in a number of clinical situations. Physical wedge filters have provided nominal angled isodoses with dosimetric consequences of beam hardening, increased peripheral dosing, nonidealized gradients at deep depths, along with the practical consequences of filter handling and placement problems. Dynamic wedging uses a combination of a moving jaw and changing dose rate to achieve angled isodoses. The clinical implementation of dynamic wedge and an accompanying quality assurance program are discussed in detail. Methods and Materials: The accelerator at our facility has two photon energies (6 MV and 18 MV), currently with dynamic wedge angles of 15 deg. , 30 deg. , 45 deg. , and 60 deg. . The segmented treatment tables (STT) that drive the jaw in concert with a changing dose rate are unique for field sizes ranging from 4.0 cm to 20.0 cm in 05 cm steps, resulting in 256 STTs. Transmission wedge factors were measured for each STT with an ion chamber. Isodose profiles were accumulated with film after dose conversion. For treatment-planning purposes, d max orthogonal dose profiles were measured for open and dynamic fields. Physical filters were assigned empirically via the ratio of open and wedge profiles. Results: A nonlinear relationship with wedge factor and field size was found. The factors were found to be independent of the stationary field setting or second order blocking. Dynamic wedging provided more consistent gradients across the field compared with physical filters. Percent depth doses were found to be closer to open field. The created physical filters provided planned isodoses that closely resembled measured isodoses. Comparative isodose plans show improvement with dynamic wedging. Conclusions: Dynamic weding has practical and dosimetric advantages over physical filters. Table collisions with physical filters are alleviated. Treatment planning has been solved with an empirical solution. Dynamic wedge is a positive

  4. Studying wedge factors and beam profiles for physical and enhanced dynamic wedges

    Directory of Open Access Journals (Sweden)

    Ahmad Misbah

    2010-01-01

    Full Text Available This study was designed to investigate variation in Varian′s Physical and Enhanced Dynamic Wedge Factors (WF as a function of depth and field size. The profiles for physical wedges (PWs and enhanced dynamic wedges (EDWs were also measured using LDA-99 array and compared for confirmation of EDW angles at different depths and field sizes. WF measurements were performed in water phantom using cylindrical 0.66 cc ionization chamber. WF was measured by taking the ratio of wedge and open field ionization data. A normalized wedge factor (NWF was introduced to circumvent large differences between wedge factors for different wedge angles. A strong linear dependence of PW Factor (PWF with depth was observed. Maximum variation of 8.9% and 4.1% was observed for 60° PW with depth at 6 and 15 MV beams respectively. The variation in EDW Factor (EDWF with depth was almost negligible and less than two per cent. The highest variation in PWF as a function of field size was 4.1% and 3.4% for thicker wedge (60° at 6 and 15 MV beams respectively and decreases with decreasing wedge angle. EDWF shows strong field size dependence and significant variation was observed for all wedges at both photon energies. Differences in profiles between PW and EDW were observed on toe and heel sides. These differences were dominant for larger fields, shallow depths, thicker wedges and low energy beam. The study indicated that ignoring depth and field size dependence of WF may result in under/over dose to the patient especially doing manual point dose calculation.

  5. ANTERIOR OPEN-BITE TREATMENT BY MEANS OF ZYGOMATIC MINIPLATES: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Kadir BEYCAN

    2017-01-01

    Full Text Available This case report presents the treatment of a patient with skeletal Cl II malocclusion and anterior open-bite who was treated with zygomatic miniplates through the intrusion of maxillary posterior teeth. A 16-year-old female patient with a chief complaint of anterior open-bite had a symmetric face, incompetent lips, convex profile, retrusive lower lip and chin. Intraoral examination showed that the buccal segments were in Class II relationship, and there was anterior open-bite (overbite -6.5 mm. The cephalometric analysis showed Class II skeletal relationship with increased lower facial height. The treatment plan included intrusion of the maxillary posterior teeth using zygomatic miniplates followed by fixed orthodontic treatment. At the end of treatment Class I canine and molar relationships were achieved, anterior open-bite was corrected and normal smile line was obtained. Skeletal anchorage using zygomatic miniplates is an effective method for open-bite treatment through the intrusion of maxillary posterior teeth.

  6. Tratamiento ortodóncico-quirúrgico de una adaquia anterior Orthodontic-surgical treatment of anterior open bite

    Directory of Open Access Journals (Sweden)

    Anselmo López Rodríguez

    2004-08-01

    Full Text Available En la práctica y desarrollo de la cirugía ortognática en el Hospital Universitario "Comandante Manuel Fajardo" a lo largo de los años, la morbilidad de diferentes anomalías del desarrollo maxilo-mandibulares ha mostrado que la adaquia o mordida abierta anterior es bastante frecuente. Desde tempranas edades se detectan y son tratadas por el especialista en Ortodoncia. El cerrar una adaquia en ocasiones se torna difícil y es cuando el análisis del paciente debe realizarse en el grupo multidisciplianrio integrado por cirujanos maxilofaciales, ortodoncistas y protesistas. Se han detectado diferentes causas que pueden producir una adaquia y en su mayor parte son hábitos nocivos que perduran en el paciente; por ejemplo, la interferencia con el centro de crecimiento condilar, la succión del pulgar, la deglución atípica o lengua protractil, la respiración bucal, entre otras. Este trabajo está encaminado en mostrar los diferentes tratamientos que en la actualidad se emplean para reducir una mordida abierta anterior y presenta el caso de una niña de 14 años de edad portadora de una adaquia de más de 18 mm.In the context of orthognathic surgery practice and development at "Comandante Manuel Fajardo" university hospital, morbidity from several anomalies in the maxillomandibular growth has shown that anterior open bite is pretty common. Such anomalies are detected and treated by the orthodontist at early childhood. To close an anterior open bite is difficult sometimes and requires the analysis of the patient by a multidisciplinary group made up of maxillofacial surgeons, orthodontists and denture specialists. A number of causes may be the origin of anterior open bite, mainly harmful habits that persist in the patient such as interference with the condylar growth center, dummy sucking, atypical deglutition or proctatile tongue, mouth breathing, among others. This paper is aimed at showing different therapies that presently reduce anterior open

  7. Open Approaches to the Anterior Skull Base in Children: Review of the Literature.

    Science.gov (United States)

    Wasserzug, Oshri; DeRowe, Ari; Ringel, Barak; Fishman, Gadi; Fliss, Dan M

    2018-02-01

    Introduction  Skull base lesions in children and adolescents are rare, and comprise only 5.6% of all skull base surgery. Anterior skull base lesions dominate, averaging slightly more than 50% of the cases. Until recently, surgery of the anterior skull base was dominated by open procedures and endoscopic skull base surgery was reserved for benign pathologies. Endoscopic skull base surgery is gradually gaining popularity. In spite of that, open skull base surgery is still considered the "gold standard" for the treatment of anterior skull base lesions, and it is the preferred approach in selected cases. Objective  This article reviews current concepts and open approaches to the anterior skull base in children in the era of endoscopic surgery. Materials and Methods  Comprehensive literature review. Results  Extensive intracranial-intradural invasion, extensive orbital invasion, encasement of the optic nerve or the internal carotid artery, lateral supraorbital dural involvement and involvement of the anterior table of the frontal sinus or lateral portion of the frontal sinus precludes endoscopic surgery, and mandates open skull base surgery. The open approaches which are used most frequently for surgical resection of anterior skull base tumors are the transfacial/transmaxillary, subcranial, and subfrontal approaches. Reconstruction of anterior skull base defects is discussed in a separate article in this supplement. Discussion  Although endoscopic skull base surgery in children is gaining popularity in developed countries, in many cases open surgery is still required. In addition, in developing countries, which accounts for more than 80% of the world's population, limited access to expensive equipment precludes the use of endoscopic surgery. Several open surgical approaches are still employed to resect anterior skull base lesions in the pediatric population. With this large armamentarium of surgical approaches, tailoring the most suitable approach to a

  8. Evaluation Of Open, Wedge Filtered And Half Block Profile For Single And Plan Parallel Field For 60Co Teletherapy Unit

    International Nuclear Information System (INIS)

    Heru-Prasetio; Nasukha; Soejoko, Djarwani S

    2003-01-01

    TPS shall be evaluated with experimental data before it is used for patient treatment. This experiment was performed using small water phantom, at the depth of 10 cm, SSD technique for single beam and 16 cm, SAD technique for plan parallel beam. Measuring device used in this experiment is Farmer 2571 detector. It was found differences between experiment and TPS iSis are not significant. Single field experiment and TPS differences of 0.6%, 3.6% and 0.1% for open, wedge filter and half-blocked field, for plan parallel experiment and TPS differences are 2.1%, 2% and 2.4% for open, wedge filter and half-blocked field. (author)

  9. Open-wedge osteotomy using an internal plate fixator in patients with medial-compartment gonarthritis and varus malalignment

    DEFF Research Database (Denmark)

    Niemeyer, Philipp; Schmal, Hagen; Hauschild, Oliver

    2010-01-01

    PURPOSE: Our purpose was to evaluate the 3-year clinical results of patients with medial-compartment osteoarthritis of the knee and varus malalignment who underwent open-wedge high tibial osteotomy (HTO) with an internal plate fixator (TomoFix; Synthes, Solothurn, Switzerland). Clinical results a...

  10. Correction of Anterior Open Bite and Facial Profile by Orthognathic Surgery– A Case Report

    Directory of Open Access Journals (Sweden)

    Quazi Billur Rahman

    2010-07-01

    Full Text Available This case report describes the treatment of a severe anterior open bite, Class III malocclusion with a history of digitsucking. An 18 years-old male presented with a significant anteroposterior and vertical discrepancy of face. The patient’sface was concave with procumbent lips. He had an anterior open bite of 11 mm, a reverse overjet of 8 mm, and atransverse maxillary deficiency on right side. The orthognathic surgery was elected as an option of treatment to correctthe anterior open bite with improvement of facial profile.Keywords: Anterior open bite; Transverse maxillary deficiency; Vertical excess; Orthognathic surgery.DOI: 10.3329/bsmmuj.v3i1.5512BSMMU J 2010; 3(1: 31-34

  11. Stability of anterior open-bite treatment with occlusal adjustment.

    Science.gov (United States)

    Janson, Guilherme; Crepaldi, Marcus Vinicius; Freitas, Karina Maria Salvatore; de Freitas, Marcos Roberto; Janson, Waldyr

    2010-07-01

    In this study, we aimed to evaluate the long-term stability of anterior open-bite treatment with occlusal adjustment and the dentinal sensitivity caused by this procedure in the long term. The sample comprised 17 open-bite patients who experienced relapse of the negative vertical overbite after orthodontic treatment and were retreated with occlusal adjustment. The cephalometric changes were evaluated on lateral cephalograms obtained before and after the occlusal adjustment and in the long term (mean, 3.4 years after occlusal adjustment). Dentinal sensitivity was also evaluated before the occlusal adjustment, and 1.35 months, 4.61 months, and 3.4 years later. The cephalometric statuses between the 3 evaluations were compared with analysis of variance (ANOVA) and Tukey tests. The percentages of clinically significant relapse were calculated. To compare dentinal sensitivity at the several stages, nonparametric Friedman and Wilcoxon tests were performed. Statistically significant relapse of anterior open bite occurred in 33.3% of the patients. Those who had the procedure before 21 years of age were most likely to experience relapse. Dentinal sensitivity remained within the normal range in the long term. Despite the statistically significant relapse of anterior open bite, clinically significant stability was found in 66.7% of the patients. Copyright (c) 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  12. Amelogenesis imperfecta and anterior open bite: Etiological, classification, clinical and management interrelationships.

    Science.gov (United States)

    Alachioti, Xanthippi Sofia; Dimopoulou, Eleni; Vlasakidou, Anatoli; Athanasiou, Athanasios E

    2014-01-01

    Although amelogenesis imperfecta is not a common dental pathological condition, its etiological, classification, clinical and management aspects have been addressed extensively in the scientific literature. Of special clinical consideration is the frequent co-existence of amelogenesis imperfecta with the anterior open bite. This paper provides an updated review on amelogenesis imperfecta as well as anterior open bite, in general, and documents the association of these two separate entities, in particular. Diagnosis and treatment of amelogenesis imperfecta patients presenting also with anterior open bite require a lengthy, comprehensive and multidisciplinary approach, which should aim to successfully address all dental, occlusal, developmental, skeletal and soft tissue problems associated with these two serious clinical conditions.

  13. Clinical Application of Wedge Factor

    International Nuclear Information System (INIS)

    Choi, Dong Rak; Ahn, Yong Chan; Huh, Sueng Jae

    1995-01-01

    Purpose : In general. The wedge factors which are used clinical practices are ignored of dependency on field sizes and depths. In this present, we investigated systematically the depth and field size dependency to determine the absorbed dose more accurately. Methods : The wedge factors for each wedge filter were measured at various depth (depth of Dmax, 5cm, 10cm, and 15cm) and field sizes (5 X 5cm, 10 X 10cm, 15 X 15cm, 20 X 20 cm) by using 4-,6-, and 10-MV X rays. By convention, wedge factors are determined by taking the ratio of the central axis ionization readings when the wedge filter is in place to those of the open field in same field size and measurement depth. In this present work, we determined the wedge factors for 4-, 6-, and 10-MV X rays from Clinac 600C and 2100C linear accelerators (manufactured by Varian Associates, Inc., Palo Alto, CA). To confirm that the wedge was centered., measurements were done with the two possible wedge position and various collimator orientations. Results : The standard deviations of measured values are within 0.3% and the depth dependence of wedge factor is greater for the lower energies. Especially, the variation of wedge factor is no less than 5% for 4- and 6- MV X rays with more than 45 .deg. wedge filter. But there seems to be a small dependence on field size. Conclusion : The results of this study show a dependence on the point of measurement. There also seems to be a small dependence on field size. And so, we should consider the depth and field size dependence in determining the wedge factors. If one wedge factor were to be used for each wedge filter, it seems that the measurement for a 10cm X 10cm field size at a depth of 10cm would be a reasonable choice

  14. Anterior open bite treatment with magnets.

    Science.gov (United States)

    Kiliaridis, S; Egermark, I; Thilander, B

    1990-11-01

    The aim of this study was to examine the effects of repelling magnets on the treatment of anterior open bite and compare them with the effects of acrylic posterior bite-blocks. Twenty patients, aged 9-16 years with skeletal anterior open bite, were randomly divided into two groups. In one group the patients wore posterior repelling magnet splints and in the other they wore acrylic posterior bite-blocks of the same thickness as the magnet splints. The patients were instructed to use their appliance as much as possible (the minimum accepted being 18 hours daily) during a 6-month period. Dental casts, intra-oral photos, and lateral cephalograms were taken before and after treatment, and the patients were also examined regularly to identify the development of any craniomandibular disorders. In the first group, the dental and skeletal vertical relation responded quickly to the magnet treatment. The open bite was generally closed in just under 4 months, especially in patients in early mixed dentition. Spacing in the labial segments decreased in some cases, while slight crowding was induced in others. Transverse problems, i.e. unilateral cross-bite, sometimes followed by scissor-bite on the opposite side, was observed in those patients who were in the early mixed dentition and had used the magnets intensively. The patients who wore acrylic posterior bite-blocks also showed improvement in the dental and skeletal vertical relationships, especially during the first months. This was followed by a 'plateau' period. No transverse problems were found in these patients.

  15. Filling Transitions in Acute and Open Wedges.

    Czech Academy of Sciences Publication Activity Database

    Malijevský, Alexandr; Parry, A.O.

    2015-01-01

    Roč. 91, č. 5 (2015), s. 052401 ISSN 1539-3755 R&D Projects: GA ČR GA13-09914S Grant - others:EPSRC(GB) EP/J009636/1; EPSRC(GB) EP/I019111/1 Institutional support: RVO:67985858 Keywords : wetting transitions * wedges * density functional theory Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 2.288, year: 2014

  16. Diffusion induced flow on a wedge-shaped obstacle

    International Nuclear Information System (INIS)

    Zagumennyi, Ia V; Dimitrieva, N F

    2016-01-01

    In this paper the problem of evolution of diffusion induced flow on a wedge-shaped obstacle is analyzed numerically. The governing set of fundamental equations is solved using original solvers from the open source OpenFOAM package on supercomputer facilities. Due to breaking of naturally existing diffusion flux of a stratifying agent by the impermeable surface of the wedge a complex multi-level vortex system of compensatory fluid motions is formed around the obstacle. Sharp edges of the obstacle generate extended high-gradient horizontal interfaces which are clearly observed in laboratory experiments by high-resolution Schlieren visualization. Formation of an intensive pressure depression zone in front of the leading vertex of the wedge is responsible for generation of propulsive force resulting in a self-displacement of the obstacle along the neutral buoyancy horizon in a stably stratified environment. The size of the pressure deficiency area near the sharp vertex of a concave wedge is about twice that for a convex one. This demonstrates a more intensive propulsion mechanism in case of the concave wedge and, accordingly, a higher velocity of its self-movement in a continuously stratified medium. (paper)

  17. Modelling the wedge shape for the virtual wedge

    International Nuclear Information System (INIS)

    Chang Liyun; Ho Shengyow; Chen, Helen H W

    2003-01-01

    We present a method to model the virtual wedge shape in a 3D treatment planning system as a physical wedge. The virtual wedge shape was determined using the measured dose profile of the virtual wedge at a chosen reference depth. The differences between the calculated and the measured dose profiles for the virtual wedge were within 0.5% at the reference depth, and within 2.5% at other depths. This method provides a fast and accurate way to implement the virtual wedge into our planning system for any wedge angles. This method is also applicable to model the physical wedge shapes with comparable good results

  18. Opening wedge trapezial osteotomy as possible treatment for early trapeziometacarpal osteoarthritis: a biomechanical investigation of radial subluxation, contact area, and contact pressure.

    Science.gov (United States)

    Cheema, Tahseen; Salas, Christina; Morrell, Nathan; Lansing, Letitia; Reda Taha, Mahmoud M; Mercer, Deana

    2012-04-01

    Radial subluxation and cartilage thinning have been associated with initiation and accelerated development of osteoarthritis of the trapeziometacarpal joint. Few investigators have reported on the benefits of opening wedge trapezial osteotomy for altering the contact mechanics of the trapeziometacarpal joint as a possible deterrent to the initiation or progression of osteoarthritis. We used cadaveric specimens to determine whether opening wedge osteotomy of the trapezium was successful in reducing radial subluxation of the metacarpal base and to quantify the contact area and pressure on the trapezial surface during simulated lateral pinch. We used 8 fresh-frozen specimens in this study. The flexor pollicis longus, abductor pollicis longus, adductor pollicis, abductor pollicis brevis, and flexor pollicis brevis/opponens pollicis tendons were each loaded to simulate the thumb in lateral pinch position. We measured radial subluxation from anteroposterior radiographs before and after placement of a 15° wedge. We used real-time sensors to analyze contact pressure and contact area distribution on the trapezium. Center of force in the normal joint under lateral pinch loading was primarily located in the dorsal region of the trapezium. After wedge placement, contact pressure increased in the ulnar-dorsal region by 76%. Mean contact area increased in the ulnar-dorsal region from 0.05 to 0.07 cm(2), and in the ulnar-volar region from 0.003 to 0.024 cm(2). The average reduction in joint subluxation was 64%. The 15° opening wedge osteotomy of the trapezium reduced radial subluxation of the metacarpal on the trapezium and increased contact pressure and contact area away from the diseased compartments of the trapezial surface. Trapezial osteotomy addresses the 2 preeminent theories about the initiation and progression of osteoarthritis. By reducing radial subluxation and altering contact pressure and contact area, trapezial osteotomy may prove an alternative to first

  19. Cephalometric evaluation of adult anterior open bite non-extraction treatment with Invisalign.

    Science.gov (United States)

    Moshiri, Shuka; Araújo, Eustáquio A; McCray, Julie F; Thiesen, Guilherme; Kim, Ki Beom

    2017-01-01

    The purpose of this study was to evaluate, by means of cephalometric appraisal, the vertical effects of non-extraction treatment of adult anterior open bite with clear aligners (Invisalign system, Align Technology, Santa Clara, CA, USA). Lateral cephalograms of 30 adult patients with anterior open bite treated using Invisalign (22 females, 8 males; mean age at start of treatment: 28 years and 10 months; mean anterior open bite at start of treatment: 1.8 mm) were analyzed. Pre- and post-treatment cephalograms were traced to compare the following vertical measurements: SN to maxillary occlusal plane (SN-MxOP), SN to mandibular occlusal plane (SN-MnOP), mandibular plane to mandibular occlusal plane (MP-MnOP), SN to mandibular plane (SN-MP), SN to palatal plane (SN-PP), SN to gonion-gnathion plane (SN-GoGn), upper 1 tip to palatal plane (U1-PP), lower 1 tip to mandibular plane (L1-MP), mesiobuccal cusp of upper 6 to palatal plane (U6-PP), mesiobuccal cusp of lower 6 to mandibular plane (L6-MP), lower anterior facial height (LAFH), and overbite (OB). Paired t-tests and descriptive statistics were utilized to analyze the data and assess any significant changes resulting from treatment. Statistically significant differences were found in overall treatment changes for SN-MxOP, SN-MnOP, MP-MnOP, SN-MP, SN-GoGn, L1-MP, L6-MP, LAFH, and OB. The Invisalign system is a viable therapeutic modality for non-extraction treatment of adult anterior mild open bites. Bite closure was mainly achieved by a combination of counterclockwise rotation of the mandibular plane, lower molar intrusion and lower incisor extrusion.

  20. Periodontal and gingival incisor findings in patients with anterior open bite in the mixed dentition.

    Science.gov (United States)

    Bechtold, Till Edward; Briegleb, Henning K

    2010-05-01

    The objective of this study was to investigate any association between anterior open bite and periodontal health of the front teeth during mixed dentition. We investigated the periodontal and gingival status of the teeth with dysfunctional and/or subfunctional loading in the open-bite area in 9- to 12-year-old children. We examined 36 subjects with anterior open bite between the ages of 9 and 12 years who had presented for the first time at the Department of Orthodontics, University of Tübingen. A control group of 36 children of the same age with a physiologic incisor relationship--vertical overbite and sagittal overjet were between 1 and 3 mm--were compared. In addition to overjet, the Silness-Löe plaque index, the modified Löe-Silness gingival index, pocket depth and attachment loss were measured and documented at each of the four surfaces (mesial, distal, oral and vestibular) of the upper and lower incisors. The subjects with anterior open bite exhibited significantly more plaque in the malocclusion area than children with a physiologic incisor relationship; the differences were statistically highly significant. The subjects with anterior open bite demonstrated slightly higher degrees of inflammation and a slight increase in periodontal pocket depths than the control group. Periodontal attachment loss was diagnosed in very few areas in both study groups, while attachment loss was slightly more frequent in those with anterior open bite. We observed a higher risk for caries in the malocclusion area in the late mixed dentition phase, as the subjects with anterior open bite presented significantly more plaque accumulation in the incisor area. However, no pathological periodontal anomalies have been detected so far.

  1. Ipsilateral open anterior hip dislocation and open posterior elbow dislocation in an adult

    Directory of Open Access Journals (Sweden)

    Kumar Sunil

    2014-02-01

    Full Text Available 【Abstract】Open anterior dislocation of the hip is a very rare injury, especially in adults. It is a hyperabduction, external rotation and extension injury. Its combination with open posterior dislocation of the elbow has not been described in English language-based medical literature. Primary resuscitation, debridement, urgent reduction of dislocation, and adequate antibiotic support resulted in good clinical outcome in our patient. At 18 months follow-up, no signs of avascular necrosis of the femoral head or infection were observed.

  2. Physical characteristics comparison of virtual wedge device with physical wedge

    International Nuclear Information System (INIS)

    Cho, Jung Keun; Choi, Kye Sook; Lim, Cheong Hwan; Kim, Jeong Koo; Jung, Hong Ryang; Lee, Jung Ok; Lee, Man Goo

    2001-01-01

    We compared the characteristics of Siemens virtual wedge device with physical wedges for clinical application. We investigated the characteristics of virtual and physical wedges for various wedge angles (15, 30, 45, and 60) using 6- and 15- MV photon beams. Wedge factors were measured in water using an ion chamber for various field sizes and depths. In case of virtual wedge device, as upper jaw moves during irradiation, wedge angles were estimated by accumulated doses. These measurements were performed at off-axis points perpendicular to the beam central axis in water for a 15 cm x 20 cm radiation field size at the depth of 10 cm. Surface does without and with virtual or physical wedges were measured using a parallel plate ion chamber at surface. Field size was 15 cm * 20 cm and a polystyrene phantom was used. For various field sizes, virtual and physical wedge factors were changed by maximum 2.1% and 3.9%, respectively. For various depths, virtual and physical wedge factors were changed by maximum 1.9% and 2.9%, respectively. No major difference was found between the virtual and physical wedge angles and the difference was within 0.5. Surface dose with physical wedge was reduced by maximum 20% (x-ray beam : 6 MV, wedge angle : 45, SSD : 80 cm) relative to one with virtual wedge or without wedge. Comparison of the characteristics of Siemens virtual wedge device with physical wedges was performed. Depth dependence of virtual wedge factor was smaller than that of physical wedge factor. Virtual and physical wedge factors were nearly independent of field sizes. The accuracy of virtual and physical wedge angles was excellent. Surface dose was found to be reduced using a physical wedge

  3. Physical characteristics comparison of virtual wedge device with physical wedge

    International Nuclear Information System (INIS)

    Choi, Dong Rak; Shin, Kyung Hwan; Lee, Kyu Chan; Kim, Dae Yong; Ahn, Yong Chan; Lim, Do Hoon; Kim, Moon Kyung; Huh, Seung Jae

    1999-01-01

    We have compared the characteristics of Siemens virtual wedge device with physical wedges for clinical application. We investigated the characteristics of virtual and physical wedges for various wedge angles (15, 30, 45, and 60 ) using 6- and 15MV photon beams. Wedge factors were measured in water using an ion chamber for various field sizes and depths. In case of virtual wedge device, as upper jaw moves during irradiation, wedge angles were estimated by accumulated doses. These measurements were performed at off-axis points perpendicular to the beam central axis in water for a 15 cm x 20 cm radiation field size at the depth of 10 cm. Surface doses without and with virtual or physical wedges were measured using a parallel plate ion chamber at surface. Field size was 15 cm x 20 cm and a polystyrene phantom was used. For various field sizes, virtual and physical wedge factors were changed by maximum 2.1% and 3.9%, respectively. For various depths, virtual and physical wedge factors were changed by maximum 1.9% and 2.9%, respectively. No major difference was found between the virtual and physical wedge angles and the difference was within 0.5 .deg. . Surface dose with physical wedge was reduced by maximum 20% (x-ray beam: 6 MV, wedge angle: 45 .deg. , SSD: 80cm) relative to one with virtual wedge or without wedge. Comparison of the characteristics of Siemens virtual wedge device with physical wedges was performed. Depth dependence of virtual wedge factor was smaller than that of physical wedge factor. Virtual and physical wedge factors were nearly independent of field sizes. The accuracy of virtual and physical wedge angles was excellent. Surface dose was found to be reduced using physical wedge

  4. Comparison of dosimetric methods for virtual wedge analysis

    International Nuclear Information System (INIS)

    Bailey, M.; Nelson, V.; Collins, O.; West, M.; Holloway, L.; Rajapaske, S.; Arts, J.; Varas, J.; Cho, G.; Hill, R.

    2004-01-01

    Full text: The Siemens Virtual Wedge (Concord, USA) creates wedged beam profile by moving a single collimator jaw across the specified field size whilst varying the dose rate and jaw speed for use in the delivery of radiotherapy treatments. The measurement of the dosimetric characteristics of the Siemens Virtual Wedge poses significant challenges to medical physicists. This study investigates several different methods for measuring and analysing the virtual wedge for data collection for treatment planning systems and ongoing quality assurance. The beam profiles of the Virtual Wedge (VW) were compared using several different dosimetric methods. Open field profiles were measured with Kodak X-Omat V (Rochester, NY, USA) radiographic film and compared with measurements made using the Sun Nuclear Profiler with a Motorized Drive Assembly (MDA) (Melbourne, FL, USA) and the Scanditronix Wellhofer CC13 ionisation chamber and 24 ion Chamber Array (CA24) (Schwarzenbruck, Germany). The resolution of each dosimetric method for open field profiles was determined. The Virtual Wedge profiles were measured with radiographic film the Profiler and the Scanditronix Wellhofer CA 24 ion Chamber Array at 5 different depths. The ease of setup, time taken, analysis and accuracy of measurement were all evaluated to determine the method that would be both appropriate and practical for routine quality assurance of the Virtual Wedge. The open field profiles agreed within ±2% or 2mm for all dosimetric methods. The accuracy of the Profiler and CA24 are limited to half of the step size selected for each of these detectors. For the VW measurements a step size of 2mm was selected for the Profiler and the CA24. The VW profiles for all dosimetric methods agreed within ±2% or 2mm for the main wedged section of the profile. The toe and heel ends of the wedges showed the significant discrepancies dependent upon the dosimetry method used, up to 7% for the toe end with the CA24. The dosimetry of the

  5. Cephalometric evaluation of adult anterior open bite non-extraction treatment with Invisalign

    Directory of Open Access Journals (Sweden)

    Shuka Moshiri

    Full Text Available ABSTRACT Objective: The purpose of this study was to evaluate, by means of cephalometric appraisal, the vertical effects of non-extraction treatment of adult anterior open bite with clear aligners (Invisalign system, Align Technology, Santa Clara, CA, USA. Methods: Lateral cephalograms of 30 adult patients with anterior open bite treated using Invisalign (22 females, 8 males; mean age at start of treatment: 28 years and 10 months; mean anterior open bite at start of treatment: 1.8 mm were analyzed. Pre- and post-treatment cephalograms were traced to compare the following vertical measurements: SN to maxillary occlusal plane (SN-MxOP, SN to mandibular occlusal plane (SN-MnOP, mandibular plane to mandibular occlusal plane (MP-MnOP, SN to mandibular plane (SN-MP, SN to palatal plane (SN-PP, SN to gonion-gnathion plane (SN-GoGn, upper 1 tip to palatal plane (U1-PP, lower 1 tip to mandibular plane (L1-MP, mesiobuccal cusp of upper 6 to palatal plane (U6-PP, mesiobuccal cusp of lower 6 to mandibular plane (L6-MP, lower anterior facial height (LAFH, and overbite (OB. Paired t-tests and descriptive statistics were utilized to analyze the data and assess any significant changes resulting from treatment. Results: Statistically significant differences were found in overall treatment changes for SN-MxOP, SN-MnOP, MP-MnOP, SN-MP, SN-GoGn, L1-MP, L6-MP, LAFH, and OB. Conclusions: The Invisalign system is a viable therapeutic modality for non-extraction treatment of adult anterior mild open bites. Bite closure was mainly achieved by a combination of counterclockwise rotation of the mandibular plane, lower molar intrusion and lower incisor extrusion.

  6. Cervical vertebral column morphology and head posture in preorthodontic patients with anterior open bite

    DEFF Research Database (Denmark)

    Kim, Phong; Sarauw, Martin Toft; Sonnesen, Liselotte

    2014-01-01

    INTRODUCTION: Cervical vertebral column morphology and head posture were examined and related to craniofacial morphology in preorthodontic children and adolescents with anterior open bite. METHODS: One hundred eleven patients (ages, 6-18 years) with an anterior open bite of more than 0 mm were...... posture were made on profile radiographs. RESULTS: Deviations in the cervical vertebral column morphology occurred in 23.7% of the subjects in the skeletal open-bite group and in 19.2% in the dentoalveolar open-bite group, but the difference was not significant. Head posture was significantly more...... extended in the skeletal open-bite group compared with the dentoalveolar open-bite group (craniovertical angle [Mx/VER], P posture was associated with craniofacial morphology: extended posture was associated with a large cranial base angle...

  7. Dosimetric parameters of enhanced dynamic wedge for treatment planning and verification

    International Nuclear Information System (INIS)

    Leavitt, Dennis D.; Lee, Wing Lok; Gaffney, David K.

    1996-01-01

    Purpose/Objective: Enhanced Dynamic Wedge (EDW) is an intensity-modulated radiotherapy technique in which one collimating jaw sweeps across the field to define a desired wedge dose distribution while dose rate is modified according to jaw position. This tool enables discrete or continuous wedge angles from zero to sixty degrees for field widths from three cm to 30 cm in the direction of the wedge, and up to 40 cm perpendicular to the wedge direction. Additionally, asymmetric wedge fields not centered on the line through isocenter can be created for applications such as tangential breast irradiation. The unique range of field shapes and wedge angles introduce a new set of dosimetric challenges to be resolved before routine clinical use of EDW, and especially require that a simple set of independent dose calculation and verification techniques be developed to check computerized treatment planning results. Using terminology in common use in treatment planning, this work defines the effective wedge factor vs. field width and wedge angle, evaluates the depth dose vs. open field values, defines primary intensity functions from which specific dynamic wedges can be calculated in treatment planning systems, and describes the technique for independent calculation of Monitor Units for EDW fields. Materials and Methods: Using 6- and 18-MV beams from a CI2100C, EDW beam profiles were measured in water phantom for depths from near-surface to 30 cm for the full range of field widths and wedge angles using a linear detector array of 25 energy-compensated diodes. Asymmetric wedge field profiles were likewise measured. Depth doses were measured in water phantom using an ionization chamber sequentially positioned to depths of 30 cm. Effective wedge factors for the full range of field widths and wedge angles were measured using an ionization chamber in water-equivalent plastic at a depth of 10 cm on central axis. Dose profiles were calculated by computer as the summation of a series

  8. Open-Wedge High Tibial Osteotomy: RCT 2 Years RSA Follow-Up.

    Science.gov (United States)

    Lind-Hansen, Thomas Bruno; Lind, Martin Carøe; Nielsen, Poul Torben; Laursen, Mogens Berg

    2016-11-01

    We investigated the influence of three different bone grafting materials on stability and clinical outcome of the healing open-wedge high tibial osteotomy (OW-HTO) with immediate partial weight bearing. A total of 45 (3 × 15) patients were randomized to injectable calcium phosphate cement (Calcibon; Biomet-Merck Biomaterials GmbH, Darmstadt, Germany), local bone autograft, or iliac crest autograft. Stability of the bony healing was evaluated with radiostereometric analysis (RSA) up to 24 months postoperatively. Clinical outcome was evaluated with the knee injury and osteoarthritis outcome score (KOOS). RSA revealed translations and rotations close to zero regardless of bone grafting material, with no statistically significant differences between the groups. Clinically, the Calcibon group had lower quality of life KOOS subscore at 2 years follow-up. We conclude that with a stable implant and 6 weeks of partial weight bearing, local autografting is sufficient to achieve solid bone consolidation following OW-HTO. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  9. Innovation in prediction planning for anterior open bite correction.

    Science.gov (United States)

    Almuzian, Mohammed; Almukhtar, Anas; O'Neil, Michael; Benington, Philip; Al Anezi, Thamer; Ayoub, Ashraf

    2015-05-01

    This study applies recent advances in 3D virtual imaging for application in the prediction planning of dentofacial deformities. Stereo-photogrammetry has been used to create virtual and physical models, which are creatively combined in planning the surgical correction of anterior open bite. The application of these novel methods is demonstrated through the surgical correction of a case.

  10. Patellofemoral Osteoarthritis Progression and Alignment Changes after Open-Wedge High Tibial Osteotomy Do Not Affect Clinical Outcomes at Mid-term Follow-up.

    Science.gov (United States)

    Goshima, Kenichi; Sawaguchi, Takeshi; Shigemoto, Kenji; Iwai, Shintaro; Nakanishi, Akira; Ueoka, Ken

    2017-10-01

    To evaluate the clinical and radiological outcomes of open-wedge high tibial osteotomy (OWHTO) with respect to the patellofemoral joint and to assess whether patellofemoral osteoarthritis (OA) progression and alignment changes after OWHTO affect clinical outcomes. Inclusion criteria were consecutive patients who underwent OWHTO from March 2005 to September 2013. Exclusion criteria were loss to follow-up within 2 years and absence of second-look arthroscopy findings at the time of plate removal. The clinical parameters, including anterior knee pain while climbing stairs, Japanese Orthopedic Association score, and Oxford Knee Score, were evaluated. Radiological outcomes, including weight-bearing line ratio, modified Blackburne-Peel ratio, posterior tibial slope, tilting angle, lateral shift ratio, and patellofemoral OA (Kellgren-Lawrence grade), were evaluated preoperatively and at the final follow-up. Cartilage status (International Cartilage Repair Society grade) was evaluated at the initial HTO and at plate removal. Fifty-three patients (60 knees) were included in this study. The mean follow-up was 58.2 ± 22.4 months. Two knees (3%) presented with mild anterior knee pain after OWHTO. The mean Japanese Orthopedic Association score (66.9 ± 11.2 to 91.2 ± 9.7) significantly improved (P patellofemoral OA had progressed in 15 knees (27%), and arthroscopically patellofemoral cartilage degeneration had progressed in 27 knees (45%). However, there was no significant correlation between changes in patellofemoral alignment and clinical outcomes. Changes in patellofemoral alignment and patellofemoral OA progression did not affect the clinical outcomes of OWHTO at mid-term follow-up. Level IV, therapeutic case series. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  11. Capsular phimosis with complete occlusion of the anterior capsular opening after intact continuous curvilinear capsulorrhexis

    International Nuclear Information System (INIS)

    Al-Kharashi, Soliman A.; Al-Obailan, Majed

    2009-01-01

    Shrinkage and whitening of the anterior capsule opening - capsular contraction syndrome - is a well-known complication after continuous curvilinear capsulorrhexis. A 72-year-old women underwent continuous curvilinear capsulorrhexis, phacoemulsification, and implantation of posterior chamber intraocular lens with polymethylmethacrylate haptics. Four months postoperatively, the patient reported deterioration in visual acuity that was resulted due to complete occlusion of anterior capsular opening by fibrotic tissue. The fibrous membrane was excised surgically in capsulorrhexis fashion. (author)

  12. Comparison of dosimetric characteristics of Siemens virtual and physical wedges for ONCOR linear accelerator

    Directory of Open Access Journals (Sweden)

    Attalla Ehab

    2010-01-01

    Full Text Available Dosimetric properties of virtual wedge (VW and physical wedge (PW in 6- and 10-MV photon beams from a Siemens ONCOR linear accelerator, including wedge factors, depth doses, dose profiles, peripheral doses, are compared. While there is a great difference in absolute values of wedge factors, VW factors (VWFs and PW factors (PWFs have a similar trend as a function of field size. PWFs have stronger depth dependence than VWF due to beam hardening in PW fields. VW dose profiles in the wedge direction, in general, match very well with those of PW, except in the toe area of large wedge angles with large field sizes. Dose profiles in the nonwedge direction show a significant reduction in PW fields due to off-axis beam softening and oblique filtration. PW fields have significantly higher peripheral doses than open and VW fields. VW fields have similar surface doses as the open fields, while PW fields have lower surface doses. Surface doses for both VW and PW increase with field size and slightly with wedge angle. For VW fields with wedge angles 45° and less, the initial gap up to 3 cm is dosimetrically acceptable when compared to dose profiles of PW. VW fields in general use less monitor units than PW fields.

  13. Radial wedge flange clamp

    Science.gov (United States)

    Smith, Karl H.

    2002-01-01

    A radial wedge flange clamp comprising a pair of flanges each comprising a plurality of peripheral flat wedge facets having flat wedge surfaces and opposed and mating flat surfaces attached to or otherwise engaged with two elements to be joined and including a series of generally U-shaped wedge clamps each having flat wedge interior surfaces and engaging one pair of said peripheral flat wedge facets. Each of said generally U-shaped wedge clamps has in its opposing extremities apertures for the tangential insertion of bolts to apply uniform radial force to said wedge clamps when assembled about said wedge segments.

  14. Utilization of an electronic portal imaging device for measurement of dynamic wedge data

    International Nuclear Information System (INIS)

    Elder, Eric S.; Miner, Marc S.; Butker, Elizabeth K.; Sutton, Danny S.; Davis, Lawrence W.

    1996-01-01

    Purpose/Objective: Due to the motion of the collimator during dynamic wedge treatments, the conventional method of collecting comprehensive wedge data with a water tank and a scanning ionization chamber is obsolete. It is the objective of this work to demonstrate the use of an electronic portal imaging device (EPID) and software to accomplish this task. Materials and Methods: A Varian Clinac[reg] 2300 C/D, equipped with a PortalVision TM EPID and Dosimetry Research Mode experimental software, was used to produce the radiation field. The Dosimetry Research Mode experimental software allows for a band of 10 of 256 high voltage electrodes to be continuously read and averaged by the 256 electrometer electrodes. The file that is produced contains data relating to the integrated ionization at each of the 256 points, essentially the cross plane beam profile. Software was developed using Microsoft C ++ to reformat the data for import into a Microsoft Excel spreadsheet allowing for easy mathematical manipulation and graphical display. Beam profiles were measured by the EPID with a 100 cm TSD for various field sizes. Each field size was measured open, steel wedged, and dynamically wedged. Scanning ionization chamber measurements performed in a water tank were compared to the open and steel wedged fields. Ionization chamber measurements taken in a water tank were compared with the dynamically wedged measurements. For the EPID measurements the depth was varied using Gammex RMI Solid Water TM placed directly above the EPID sensitive volume. Bolus material was placed between the Solid Water TM and the EPID to avoid an air gap. Results: Comparison of EPID measurements with those from an ion chamber in a water tank showed a discrepancy of ∼5%. Scans were successfully obtained for open, steel wedged and dynamically wedged beams. Software has been developed to allow for easy graphical display of beam profiles. Conclusions: Measurement of dynamic wedge data proves to be easily

  15. Mini-Open Latarjet Procedure for Recurrent Anterior Shoulder Instability

    Directory of Open Access Journals (Sweden)

    Numa Mercier

    2011-01-01

    Full Text Available Anterior shoulder instability is a common problem. The Latarjet procedure has been advocated as an option for the treatment of anteroinferior shoulder instability. The purpose of this paper is to explain our surgical procedure titled “Mini-open Latarjet Procedure.” We detailed patient positioning, skin incision, subscapularis approach, and coracoid fixation. Then, we reviewed the literature to evaluate the clinical outcomes of this procedure.

  16. Revision open Bankart surgery after arthroscopic repair for traumatic anterior shoulder instability.

    Science.gov (United States)

    Cho, Nam Su; Yi, Jin Woong; Lee, Bong Gun; Rhee, Yong Girl

    2009-11-01

    Only a few studies have provided homogeneous analysis of open revision surgery after a failed arthroscopic Bankart procedure. Open Bankart revision surgery will be effective in a failed arthroscopic anterior stabilization but inevitably results in a loss of range of motion, especially external rotation. Case series; Level of evidence, 4. Twenty-six shoulders that went through traditional open Bankart repair as revision surgery after a failed arthroscopic Bankart procedure for traumatic anterior shoulder instability were enrolled for this study. The mean patient age at the time of revision surgery was 24 years (range, 16-38 years), and the mean duration of follow-up was 42 months (range, 25-97 months). The preoperative mean range of motion was 173 degrees in forward flexion and 65 degrees in external rotation at the side. After revision surgery, the ranges measured 164 degrees and 55 degrees, respectively (P = .024 and .012, respectively). At the last follow-up, the mean Rowe score was 81 points, with 88.5% of the patients reporting good or excellent results. After revision surgery, redislocation developed in 3 shoulders (11.5%), all of which had an engaging Hill-Sachs lesion and associated hyperlaxity (2+ or greater laxity on the sulcus sign). Open revision Bankart surgery for a failed arthroscopic Bankart repair can provide a satisfactory outcome, including a low recurrence rate and reliable functional return. In open revision Bankart surgery after failed stabilization for traumatic anterior shoulder instability, the surgeon should keep in mind the possibility of a postoperative loss of range of motion and a thorough examination for not only a Bankart lesion but also other associated lesions, including a bone defect or hyperlaxity, to lower the risk of redislocation.

  17. Treatment of chronic anterior shoulder dislocation by open reduction and simultaneous Bankart lesion repair

    Directory of Open Access Journals (Sweden)

    Rouhani Alireza

    2010-06-01

    Full Text Available Abstract Background Untreated chronic shoulder dislocation eventually leads to functional disability and pain. Open reduction with different fixation methods have been introduced for most chronic shoulder dislocation. We hypothesized that open reduction and simultaneous Bankart lesion repair in chronic anterior shoulder dislocation obviates the need for joint fixation and leads to better results than previously reported methods. Methods Eight patients with chronic anterior dislocation of shoulder underwent open reduction and capsulolabral complex repair after an average delay of 10 weeks from injury. Early motion was allowed the day after surgery in the safe position and the clinical and radiographic results were analyzed at an average follow-up of one year. Results The average Rowe and Zarin's score was 86 points. Four out of eight shoulders were graded as excellent, three as good and one as fair (Rowe and Zarins system. All patients were able to perform their daily activities and they had either mild or no pain. Anterior active forward flexion loss averaged 18 degrees, external active rotation loss averaged 17.5 degrees and internal active rotation loss averaged 3 vertebral body levels. Mild degenerative joint changes were noted in one patient. Conclusion The results show that the overall prognosis for this method of operation is more favorable than the previously reported methods and we recommend concomitant open reduction and capsulolabral complex repair for the treatment of old anterior shoulder dislocation. Level of Evidence Therapeutic study, Level IV (case series [no, or historical, control group

  18. Correction of anterior open bite in a case of achondroplasia

    Directory of Open Access Journals (Sweden)

    Karpagam S

    2005-01-01

    Full Text Available Treatment planning for patients with skeletal deformities is often considered challenging. This article reports a female patient with achondroplasia who presented with severe maxillary retrognathism and vertical excess along with anterior open bite. The clinical and cephalometric findings of the patient are detailed here. The treatment plan consisted of modified anterior maxillary osteotomy for simultaneous vertical and sagittal augmentation along with orthodontic intervention. The course of surgical-orthodontic treatment and the results are presented. This treatment is to be followed by correction of vertical maxillary excess after completion of growth. This paper concludes that the dentoalveolar component of a skeletal deformity can be handled independent of the craniofacial management.

  19. Generalized monitor unit calculation for the Varian enhanced dynamic wedge field

    International Nuclear Information System (INIS)

    Liu Chihray; Kim, Siyong; Kahler, Darren L.; Palta, Jatinder R.

    2003-01-01

    The generalized monitor unit (MU) calculation equation for the Varian enhanced dynamic wedge (EDW) is derived. The assumption of this MU calculation method is that the wedge factor of the EDW at the center of the field is a function of field size, the position of the center of the field in the wedge direction, and the final position of the moving jaw. The wedge factors at the center of the field in both symmetric and asymmetric fields are examined. The difference between calculated and measured wedge factors is within 1.0%. The method developed here is easy to implement. The only datum required in addition to the standard set of conventional physical wedge implementation data is the off-axis output factor for the open field in the reference condition. The off-center point calculation is also examined. For the off-center point calculation, the dose profile in the wedge direction for the largest EDW field is used to obtain the relative off-center ratio in any smaller wedge field. The accuracy of the off-center point calculation decreases when the point of calculation is too close to the field edge

  20. Corticotomy assisted treatment of anterior open bite in an adult patient

    Directory of Open Access Journals (Sweden)

    Eshan Awasthi

    2016-01-01

    Full Text Available This case report discusses orthodontic treatment combined with the corticotomy technique to accelerate tooth movement and shorten the treatment time in a 34-year-old female patient with an anterior open bite and flared and spaced upper and lower incisors. Fixed orthodontic appliances (MBT 0.018″ edgewise brackets were bonded, and 4 months later, buccal and lingual corticotomy with alveolar augmentation procedure in the maxillary arch from canine to canine was performed. Orthodontic therapy proceeded with frequent activation of the appliances to retract the incisors every 2 weeks. The total treatment time was 10 months with an active period of 4 months and no adverse effects were observed at the end of active treatment. The addition of the decortication procedure to the conventional orthodontic therapy decreased the duration of treatment significantly. Successful closure of the anterior open bite with adequate overbite and interdigitation of the teeth was achieved.

  1. Anterior petroclinoid fold fenestration: an adjunct to clipping of postero-laterally projecting posterior communicating aneurysms.

    Science.gov (United States)

    Nossek, Erez; Setton, Avi; Dehdashti, Amir R; Chalif, David J

    2014-10-01

    Proximally located posterior communicating artery (PCoA) aneurysms, projecting postero-laterally in proximity to the tentorium, may pose a technical challenge for microsurgical clipping due to obscuration of the proximal aneurysmal neck by the anterior petroclinoid fold. We describe an efficacious technique utilizing fenestration of the anterior petroclinoid fold to facilitate visualization and clipping of PCoA aneurysms abutting this aspect of the tentorium. Of 86 cases of PCoA aneurysms treated between 2003 and 2013, the technique was used in nine (10.5 %) patients to allow for adequate clipping. A 3 mm fenestration in the anterior petroclinoid ligament is created adjacent and lateral to the anterior clinoid process. This fenestration is then widened into a small wedge corridor by bipolar coagulation. In all cases, the proximal aneurysm neck was visualized after the wedge fenestration. Additionally, an adequate corridor for placement of the proximal clip blade was uniformly established. All cases were adequately clipped, with complete occlusion of the aneurysm neck and fundus with preservation of the PCoA. There were two intraoperative ruptures not related to creation of the wedge fenestration. One patient experienced post-operative partial third nerve palsy, which resolved during follow-up. We describe a technique of fenestration of the anterior petroclinoid fold to establish a critical and safe corridor for both visualization and clipping of PCoA aneurysms.

  2. Wedges I

    International Nuclear Information System (INIS)

    DeWitt-Morette, C.; Low, S.G.; Schulman, L.S.; Shiekh, A.Y.

    1986-01-01

    The wedge problem, that is, the propagation of radiation or particles in the presence of a wedge, is examined in different contexts. Generally, the paper follows the historical order from Sommerfeld's early work to recent stochastic results - hindsights and new results being woven in as appropriate. In each context, identifying the relevant mathematical problem has been the key to the solution. Thus each section can be given both a physics and a mathematics title: Section 2: diffraction by reflecting wedge; boundary value problem of differential equations; solutions defined on multiply connected spaces. Section 3: geometrical theory of diffraction; identification of function spaces. Section 4: path integral solutions; path integration on multiply connected spaces; asymptotics on the boundaries of function spaces. Section 5: probing the shape of the wedge and the roughness of its surface; stochastic calculus. Several propagators and Green functions are given explicitly, some old ones and some new ones. They include the knife-edge propagator for Dirichlet and Neumann boundary conditions, the absorbing knife edge propagator, the wedge propagators, the propagator for a free particle on a /sigma phi/-sheeted Riemann surface, the Dirichlet and the Neumann wedge Green function

  3. Anterior open-bite orthodontic treatment in an adult patient: A clinical case report.

    Science.gov (United States)

    Gracco, Antonio; Siviero, Laura; de Stefani, Alberto; Bruno, Giovanni; Stellini, Edoardo

    2016-06-01

    A 45-year-old woman presented with an anterior open-bite complaining chiefly of her unpleasant smile esthetics and masticatory and speech problems. Treatment included speech therapy initiated immediately after bonding. Lingual spurs were positioned on the mandibular incisors in order to help tongue rehabilitation. During the working phase, temporary anchorage devices (TADs) were used at the mandibular anterior segment to intrude the lower left premolars. A splint was used to ensure retention in the upper and lower arches; an enveloppe linguale nocturne (ELN) was provided. Non-surgical open-bite treatment could offer a valid alternative to orthognanthic surgery when cephalometric evaluation shows no vertical growth pattern; patient compliance is essential to prevent relapse. Copyright © 2016 CEO. Published by Elsevier Masson SAS. All rights reserved.

  4. Perawatan Ortodontik Gigitan Terbuka Anterior

    Directory of Open Access Journals (Sweden)

    Yuniar Zen

    2014-06-01

    Full Text Available Perawatan gigitan terbuka anterior telah lama dianggap sebagai tantangan bagi ortodontis. Prevalensi gigitan terbuka anterior antara 3,5% hingga 11% terdapat pada berbagai usia dan kelompok etnis, serta ada sekitar 17% pasien ortodonti memiliki gigitan terbuka. Stabilitas hasil perawatan gigitan terbuka anterior sangat sulit, karena adanya kombinasi diskrepansi anteroposterior dengan gigitan terbuka skeletal sehingga dibutuhkan tingkat keterampilan diagnosis dan klinis yang tinggi. Etiologi gigitan terbuka anterior sangat kompleks karena dapat melibatkan skeletal, dental, dan faktor-faktor habitual. Eliminasi faktor etiologi merupakan hal yang penting dalam perawatan gigitan terbuka anterior. Berbagai cara perawatan untuk koreksi gigitan terbuka anterior diantaranya bedah ortognatik dan perawatan ortodontik kamuflase, seperti high-pull headgear, chincup, bite blocks, alatfungsional, pencabutan gigi, multi-loop edgewise archwires dan mini implan. Stabilitas hasil perawatan adalah kriteria yang paling penting dalam menentukan cara perawatan gigitan terbuka anterior. Orthodontic Treatment of Anterior Open Bite. An anterior open bite therapy has long been considered a challenge to orthodontist. The prevalence of anterior openbite range from 3,5 % to 11% among various age and ethnic groups and it has been shown that approximately 17% of orthodontic patients have open bite. Stability of treatment result of anterior open bite with well-maintained results is difficult, because the combination of anteroposteriorly discrepancy with skeletal open bite requires the highest degree of diagnostic and clinical skill. The etiology is complex, potentially involving skeletal, dental and habitual factors. The importance of an anterior open bite therapy is to eliminate the cause of the open bite. Various treatment modalities for the correction of an anterior open bite have been proposed, orthognatic surgery and orthodontic camouflage treatment such as high

  5. Reliability of the imaging software in the preoperative planning of the open-wedge high tibial osteotomy.

    Science.gov (United States)

    Lee, Yong Seuk; Kim, Min Kyu; Byun, Hae Won; Kim, Sang Bum; Kim, Jin Goo

    2015-03-01

    The purpose of this study was to verify a recently developed picture-archiving and communications system-photoshop method by comparing reliabilities between real-size paper template and the PACS-photoshop methods in preoperative planning of open-wedge high tibial osteotomy. A prospective case series was conducted, including patients with medial osteoarthritis undergoing open-wedge high tibial osteotomy. In the preoperative planning, the picture-archiving and communications system-photoshop method and real-size paper template method were used simultaneously in all patients. Preoperative hip-knee-ankle angle, height, and angle of the osteotomy were evaluated. The reliability of this newly devised method was evaluated, and the consistency between the two methods was also evaluated using intra-class correlation coefficient. Using the picture-archiving and communications system-photoshop method, the mean correction angle and height of osteotomy gap of rater-1 were 11.7° ± 3.6° and 10.7 ± 3.6 mm, respectively. The mean correction angle and height of osteotomy gap of rater-2 were 12.0 ± 2.6 and 10.8 ± 3.6, respectively. The inter- and intra-rater reliabilities of the correction angle were 0.956 ~ 0.979 and 0.980 ~ 0.992, respectively. The inter- and intra-rater reliabilities of the height of the osteotomy gap were 0.968 ~ 0.985 and 0.971 ~ 0.994, respectively (p photoshop method, mean values of the correction angle and height of the osteotomy gap were 11.9° ± 3.6° and 10.8 ± 3.6 mm, respectively. Consistency between the two methods by comparing the means of the correction angle and the height of the osteotomy gap were 0.985 and 0.985, respectively (p photoshop method enables direct measurement of the height of the osteotomy gap with high reliability.

  6. Effect of open wedge high tibial osteotomy on the lateral tibiofemoral compartment in sheep. Part III: analysis of the microstructure of the subchondral bone and correlations with the articular cartilage and meniscus.

    Science.gov (United States)

    Ziegler, Raphaela; Goebel, Lars; Seidel, Roland; Cucchiarini, Magali; Pape, Dietrich; Madry, Henning

    2015-09-01

    First, to evaluate whether medial open wedge high tibial osteotomy (HTO) induces alterations of the microstructure of the lateral tibial subchondral bone plate of sheep. Second, to test the hypothesis that specific correlations exist between topographical structural alterations of the subchondral bone, the cartilage and the lateral meniscus. Three experimental groups received biplanar osteotomies of the right proximal tibiae: (a) closing wedge HTO (4.5° of tibial varus), (b) opening wedge HTO (4.5° tibial valgus; standard correction) and (c) opening wedge HTO (9.5° of valgus; overcorrection), each of which was compared to the non-osteotomised contralateral proximal tibiae. After 6 months, subchondral bone structure indices were measured by computed tomography. Correlations between the subchondral bone, the articular cartilage and the lateral meniscus were determined. Increased loading by valgus overcorrection led to an enlarged specific bone surface (BS/BV) in the subarticular spongiosa compared with unloading by varisation. The subchondral bone plate was 3.9-fold thicker in the central region of the lateral tibial plateau than in the submeniscal periphery. Its thickness in the central region significantly correlated with the thickness of the articular cartilage. In the submeniscal region, such correlation did not exist. In general, a higher degree of osteoarthritis (OA) correlated with alterations of the subchondral bone plate microstructure. OA of the submeniscal articular cartilage also correlated with worse matrix staining of the lateral meniscus. Osteoarthritis changes are associated with alterations of the subchondral bone plate microstructure. Specific topographical relationships exist in the central region between the articular cartilage and subchondral bone plate thickness, and in the submeniscal periphery between and the articular cartilage and lateral meniscus. From a clinical perspective, the combined follow-up data from this and the previous two

  7. Stress analysis of the tibial plateau according to the difference of blade path entry in opening wedge high tibial osteotomy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jun Woo; Xin, YuanZhu; Yang, Seok Jo [Chungnam National University, Daejeon (Korea, Republic of); Ji, Jong Hun; Panchal, Karnav; Kwon, Oh Soo [The Catholic University of Korea, Daejeon (Korea, Republic of)

    2015-03-15

    High tibial osteotomy (HTO) has been used to successfully treat patients with genu varus deformities that can improve mechanical function and condition in the knee joint. Clinical studies have reported that bow legs often occur with a concentrated load on the varus of the tibia. This study aimed to analyze and verify the clinical test data result by utilizing the three-dimensional (3D) static finite element method (FEM). The 3D model of lower extremities, which include the femur, tibia, meniscus, and knee articular cartilage, was created using the images from a computer tomography scan and magnetic resonance imaging. In this report, we compared changes in stress distribution and force reaction on the tibial plateau because of critical problems caused by unexpected changes in the tibial posterior-slope angle because of HTO. The results showed that the 5 .deg. wedge-angle virtual opening wedge HTO without and with the posterior-slope angle shows has a load concentration of approximately 60% and 45% in the medial region, respectively.

  8. First Metatarsal Proximal Opening Wedge Osteotomy for Correction of Hallux Valgus Deformity: Comparison of Straight versus Oblique Osteotomy

    Science.gov (United States)

    Han, Seung Hwan; Park, Eui Hyun; Jo, Joon; Koh, Yong Gon; Lee, Jin Woo; Choi, Woo Jin

    2015-01-01

    Purpose The aim of this study was to compare clinical and radiographic outcomes of proximal opening wedge osteotomy using a straight versus oblique osteotomy. Materials and Methods We retrospectively reviewed 104 consecutive first metatarsal proximal opening wedge osteotomies performed in 95 patients with hallux valgus deformity. Twenty-six feet were treated using straight metatarsal osteotomy (group A), whereas 78 feet were treated using oblique metatarsal osteotomy (group B). The hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle, and distance from the first to the second metatarsal (distance) were measured for radiographic evaluation, whereas the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score was used for clinical evaluation. Results Significant corrections in the HVA, IMA, and distance from the first to the second metatarsal were obtained in both groups at the last follow-up (p<0.001). There was no difference in the mean IMA correction between the 2 groups (6.1±2.7° in group A and 6.0±2.1° in group B). However, a greater correction in the HVA and distance from the first to the second metatarsal were found in group B (HVA, 13.2±8.2°; distance, 25.1±0.2 mm) compared to group A (HVA, 20.9±7.7°; distance, 28.1±0.3 mm; p<0.001). AOFAS scores were improved in both groups. However, group B demonstrated a greater improvement relative to group A (p=0.005). Conclusion Compared with a straight first metatarsal osteotomy, an oblique first metatarsal osteotomy yielded better clinical and radiological outcomes. PMID:25837181

  9. Dose conformation to the spine during palliative treatments using dynamic wedges

    Energy Technology Data Exchange (ETDEWEB)

    Ormsby, Matthew A., E-mail: Matthew.Ormsby@usoncology.com [West Texas Cancer Center at Medical Center Hospital, Odessa, TX (United States); Herndon, R. Craig; Kaczor, Joseph G. [West Texas Cancer Center at Medical Center Hospital, Odessa, TX (United States)

    2013-07-01

    Radiation therapy is commonly used to alleviate pain associated with metastatic disease of the spine. Often, isodose lines are manipulated using dynamic or physical wedges to encompass the section of spine needing treatment while minimizing dose to normal tissue. We will compare 2 methods used to treat the entire thoracic spine. The first method treats the thoracic spine with a single, nonwedged posterior-anterior (PA) field. Dose is prescribed to include the entire spine. Isodose lines tightly conform to the top and bottom vertebrae, but vertebrae between these 2 received more than enough coverage. The second method uses a combination of wedges to create an isodose line that mimics the curvature of the thoracic spine. This “C”-shaped curvature is created by overlapping 2 fields with opposing dynamic wedges. Machine constraints limit the treatment length and therefore 2 isocenters are used. Each of the 2 PA fields contributes a portion of the total daily dose. This technique creates a “C”-shaped isodose line that tightly conforms to the thoracic spine, minimizing normal tissue dose. Spinal cord maximum dose is reduced, as well as mean dose to the liver, esophagus, and heart.

  10. Measurement of hepatic venous pressure gradient revisited: Catheter wedge vs balloon wedge techniques

    Directory of Open Access Journals (Sweden)

    S Timothy Chelliah

    2011-01-01

    Full Text Available Aims: To evaluate the accuracy of measurement of hepatic venous pressure gradient by catheter wedge as compared to balloon wedge (the gold standard. Materials and Methods: Forty-five patients having a clinical diagnosis of intrahepatic portal hypertension were subjected to the two different types of pressure measurements (catheter wedge and balloon wedge during transjugular liver biopsy under fluoroscopic guidance. Statistical Analysis: Spearman′s rank correlation coefficient, Bland-Altman plot for agreement, and single measure intraclass correlation were used for analysis of data. Results: There was a close correlation between the results obtained by both the techniques, with highly significant concordance (P < 0.0001. Hepatic venous pressure gradients as measured by the catheter wedge technique were either equal to or less than those obtained by the balloon wedge technique. Conclusions: The difference in hepatic venous pressure gradients measured by the two techniques is insignificant.

  11. A new skeletal retention system for retaining anterior open bites

    Directory of Open Access Journals (Sweden)

    Bodore Albaker

    2013-01-01

    Full Text Available Objectives: Relapse of anterior open bite after treatment poses a challenge to orthodontists and warrants finding new methods. We aimed to compare the effect of a skeletal retention (SR system to the conventional retention (CR commonly used. Materials and Methods: Twenty patients participated in this study. SR group ten patients (five females and five males with mean age of 16.2 years, CR group ten patients (five females and five males with mean age of 17.1 years in pretreatment stage. The SR system is comprised of four self-drilling miniscrews and vacuum retainers with interarch elastics where the CR group is comprised of removable or fixed retainers. Pretreatment (T1, posttreatment (T2, and 1-year follow up (T3 lateral cephalograms were taken and analyzed to compare the stability of both retention modalities. Results: The overbite in the CR group showed more relapse in the form of significant reduction when compared to the SR group (P < 0.001. The overbite was reduced only by 0.1 mm (±0.3 in the SR group compared to 1.4 mm (±0.9 in the CR group. In the CR group, the upper incisors and first molar showed a more significant relapse compared to the SR group (P < 0.05. Conclusion: Skeletal retention using miniscrews and vertical elastic is an effective method for retention of anterior open bite cases.

  12. Anterior lamina cribrosa insertion in primary open-angle glaucoma patients and healthy subjects.

    Directory of Open Access Journals (Sweden)

    Kyoung Min Lee

    Full Text Available To determine using swept-source optical coherence tomography (SS-OCT whether there are differences in the location of the anterior lamina cribrosa insertion (ALI in primary open-angle glaucoma (POAG patients and healthy subjects.Fifty three eyes from 53 patients with POAG, and 53 eyes from 53 age-matched healthy subjects were included prospectively in Seoul National University Bundang Hospital. Twelve radial line B-scans centered on the optic disc in every half-clock-hour meridian were acquired using SS-OCT. The ALI position was assessed by measuring two parameters: (1 ALI distance (ALID--the distance from the anterior scleral canal opening (ASCO to the ALI; and (2 marginal anterior lamina cribrosa surface depth (mALCSD--the perpendicular distance from the ASCO plane to the anterior lamina cribrosa surface. These parameters were compared between the two groups for each meridian.Both ALID (256 ± 54 vs. 209 ± 37 µm, mean ± SD, p < 0.001 and mALCSD (232 ± 63 vs. 187 ± 40 µm, p < 0.001 were significantly greater in the POAG group than in the normal group. The largest difference was observed at the 6.5 o'clock and 11.5 o'clock meridians for both ALID and mALCSD. Multiple regression analysis revealed a negative correlation between age and both ALID and mALCSD in the control group, and a negative correlation between mean deviation of the visual field test and both ALID and mALCSD in the POAG group.The ALI was displaced posteriorly in eyes with POAG compared to those of healthy controls. This finding suggests that the posteriorly located lamina cribrosa insertion is an important component of glaucomatous optic nerve excavation.

  13. Interdisciplinary treatment for an adult patient with anterior open bite, severe periodontitis, and intellectual disability.

    Science.gov (United States)

    Kang, Da-Young; Choi, Sung-Hwan; Jung, Young-Soo; Hwang, Chung-Ju

    2015-05-01

    This case report describes the beneficial effects of the interdisciplinary treatment of an adult patient with severe skeletal periodontal problems. A 30-year-old female patient presented with anterior open bite, gummy smile, and facial asymmetry. The patient had chronic generalized severe periodontitis with pathologic maxillary anterior teeth migration and mild intellectual disability. Treatment included 6 months of periodontal treatment, followed by presurgical orthodontic treatment, a Le Fort I osteotomy with anterior segmental osteotomy, a bilateral sagittal split ramus osteotomy, and postsurgical orthodontic treatment. After treatment completion, the patient exhibited functional and aesthetic improvements. Her periodontal condition improved and was maintained after the treatment. Here, we demonstrate a successful treatment outcome in a complicated case following a systematic interdisciplinary approach performed with the correct diagnosis and treatment planning.

  14. Observation of the dispersion of wedge waves propagating along cylinder wedge with different truncations by laser ultrasound technique

    Science.gov (United States)

    Jia, Jing; Zhang, Yu; Han, Qingbang; Jing, Xueping

    2017-10-01

    The research focuses on study the influence of truncations on the dispersion of wedge waves propagating along cylinder wedge with different truncations by using the laser ultrasound technique. The wedge waveguide models with different truncations were built by using finite element method (FEM). The dispersion curves were obtained by using 2D Fourier transformation method. Multiple mode wedge waves were observed, which was well agreed with the results estimated from Lagasse's empirical formula. We established cylinder wedge with radius of 3mm, 20° and 60°angle, with 0μm, 5μm, 10μm, 20μm, 30μm, 40μm, and 50μm truncations, respectively. It was found that non-ideal wedge tip caused abnormal dispersion of the mode of cylinder wedge, the modes of 20° cylinder wedge presents the characteristics of guide waves which propagating along hollow cylinder as the truncation increasing. Meanwhile, the modes of 60° cylinder wedge with truncations appears the characteristics of guide waves propagating along hollow cylinder, and its mode are observed clearly. The study can be used to evaluate and detect wedge structure.

  15. Partially wedged beams improve radiotherapy treatment of urinary bladder cancer

    International Nuclear Information System (INIS)

    Muren, Ludvig Paul; Hafslund, Rune; Gustafsson, Anders; Smaaland, Rune; Dahl, Olav

    2001-01-01

    Background and purpose: Partially wedged beams (PWBs) having wedge in one part of the field only, can be shaped using dynamic jaw intensity modulation. The possible clinical benefit of PWBs was tested in treatment plans for muscle-infiltrating bladder cancer. Material and methods: Three-dimensional treatment plans for 25 bladder cancer patients were analyzed. The originally prescribed standard conformal four-field box technique, which includes the use of lateral ordinary wedge beams, was compared to a modified conformal treatment using customized lateral PWBs. In these modified treatment plans, only the anterior parts of the two lateral beams had a wedge. To analyze the potential clinical benefit of treatment with PWBs, treatment plans were scored and compared using both physical parameters and biological dose response models. One tumour control probability model and two normal tissue complication probability (NTCP) models were applied. Different parameters for normal tissue radiation tolerance presented in the literature were used. Results: By PWBs the dose homogeneity throughout the target volume was improved for all patients, reducing the average relative standard deviation of the target dose distribution from 2.3 to 1.8%. A consistent reduction in the maximum doses to surrounding normal tissue volumes was also found. The most notable improvement was demonstrated in the rectum where the volume receiving more than the prescribed tumour dose was halved. Treatment with PWBs would permit a target dose escalation of 2-6 Gy in several of the patients analyzed, without increasing the overall risk for complications. The number of patients suitable for dose escalation ranged from 3 to 15, depending on whether support from all or only one of the five applied NTCP model/parameter combinations were required in each case to recommend dose escalation. Conclusion: PWBs represent a simple dose conformation tool that may allow radiation dose escalation in the treatment of muscle

  16. First Metatarsophalangeal Contact Properties Following Proximal Opening Wedge and Scarf Osteotomies for Hallux Valgus Correction: A Biomechanical Study.

    Science.gov (United States)

    Kia, Cameron; Yoshida, Ryu; Cote, Mark; DiVenere, Jessica; Geaney, Lauren E

    2017-04-01

    Proximal opening wedge osteotomy (POWO) is an established procedure for moderate to severe hallux valgus. A common concern of this procedure is that it results in lengthening of the first metatarsal, which could cause increased intra-articular pressure of the first metatarsophalangeal joint (MTP) and may ultimately lead to arthritis because of these altered mechanics. The purpose of this study was to use a cadaveric model to compare intra-articular pressures and articulating contact properties of the MTP joint following either scarf osteotomy or POWO. Fresh-frozen cadaveric below-knee specimens with pre-existing hallux valgus (n = 12) and specimens without hallux valgus (n = 6, control group) were used. The hallux valgus specimens were stratified into 2 groups (n = 6 each): POWO or scarf osteotomy. The groups were matched based on the degree of deformity. Peak intra-articular pressure, force, and area were measured in all normal, preoperative, and postoperative specimens with a simulated weightbearing model. These measurements were made with a pressure transducer placed within the first MTP joint. Postoperatively POWO group had slightly higher contact forces and pressures compared to the scarf group and lower contact forces and pressures than those of the normal group but were not statistically significant ( P > .05). Normal specimens had higher intra-articular force, pressure, and area than postoperative specimens but the difference was not found to be significant. First metatarsal lengthening was found in both the scarf and POWO specimens; however, neither increase was found to be significant ( P > .05). The results from this study show that after operative correction, contact properties of the fist MTP joint among normal, POWO, and scarf osteotomy groups revealed no significant differences. First MTP joints in those with hallux valgus had significantly lower contact force and pressure compared to those without hallux valgus. With little long-term outcomes of

  17. Rethinking wedges

    Science.gov (United States)

    Davis, Steven J.; Cao, Long; Caldeira, Ken; Hoffert, Martin I.

    2013-03-01

    Abstract Stabilizing CO2 emissions at current levels for fifty years is not consistent with either an atmospheric CO2 concentration below 500 ppm or global temperature increases below 2 °C. Accepting these targets, solving the climate problem requires that emissions peak and decline in the next few decades, and ultimately fall to near zero. Phasing out emissions over 50 years could be achieved by deploying on the order of 19 'wedges', each of which ramps up linearly over a period of 50 years to ultimately avoid 1 GtC y-1 of CO2 emissions. But this level of mitigation will require affordable carbon-free energy systems to be deployed at the scale of tens of terawatts. Any hope for such fundamental and disruptive transformation of the global energy system depends upon coordinated efforts to innovate, plan, and deploy new transportation and energy systems that can provide affordable energy at this scale without emitting CO2 to the atmosphere. 1. Introduction In 2004, Pacala and Socolow published a study in Science arguing that '[h]umanity can solve the carbon and climate problem in the first half of this century simply by scaling up what we already know how to do' [1]. Specifically, they presented 15 options for 'stabilization wedges' that would grow linearly from zero to 1 Gt of carbon emissions avoided per year (GtC y-1 1 Gt = 1012 kg) over 50 years. The solution to the carbon and climate problem, they asserted, was 'to deploy the technologies and/or lifestyle changes necessary to fill all seven wedges of the stabilization triangle'. They claimed this would offset the growth of emissions and put us on a trajectory to stabilize atmospheric CO2 concentration at 500 ppm if emissions decreased sharply in the second half of the 21st century. The wedge concept has proven popular as an analytical tool for considering the potential of different technologies to reduce CO2 emissions. In the years since the paper was published, it has been cited more than 400 times, and

  18. Capsulorhexis contraction after cataract surgery: Comparison of sharp anterior edge and modified anterior edge acrylic intraocular lenses

    DEFF Research Database (Denmark)

    Corydon, C.; Lindholt, M.; Knudsen, E.B.

    2007-01-01

    eyes) were included in a prospective randomized study. All had phacoemulsification followed by implantation of an IOL with a modified anterior edge (38 eyes) or a sharp anterior edge (46 eyes). One day (baseline) and 3 months postoperatively, the area of the anterior capsule opening was measured using...... retroillumination photographs. RESULTS: There was a significant reduction in the area of the anterior capsule opening from 1 day to 3 months postoperatively in both groups (Psharp...

  19. The effect of lower anterior high pull headgear on treatment of moderate open bite in adults

    Directory of Open Access Journals (Sweden)

    Rahman Showkatbakhsh

    2012-01-01

    Full Text Available Background and Aims: Various methods are used for treatment of open bite. The objective of this study was to investigate the effects of Lower Anterior High Pull Headgear (LAHPH appliance in Class I subjects with moderate open bite and high lower lip line.Materials and Methods: The study group was composed of 10 subjects with a mean age of 15.8±2.5 years and 3.05 ± 0.07 mm moderate open bite. All the patients rejected orthognathic surgery. The treatment included extraction of upper and lower second premolars followed by leveling, banding, bonding, posterior space closure, and anterior retraction. After these procedures, the open bite was reduced to 2.04±1.17 mm. Afterwards, LAHPH was applied for 18 hours per day for 8±2 months. LAHPH appliance was composed of High Pull Headgear and two hooks mounted on its inner bow. Two elastics (1.8, light, Dentaurum connected the upper hooks on the inner bow to the lower hooks on the mandibular canines vertically. The forces produced by the prescribed elastics were 10 and 60 g during mouth closing and opening, respectively. Paired T-test was used to evaluate pre-andpost-treatment outcomes.Results: The pre-and post-treatment cephalometric evaluations showed that the LAHPH reduced effectively the open bite of the patients to 0.15±1.7 mm (P<0.001.Conclusion: This appliance can be used as an acceptable method for closing the open bite in Class I subjects.

  20. Interdisciplinary management of an adult patient with class II div 1 Malocclusion, Anterior Open Bite and multiple missing molars

    Directory of Open Access Journals (Sweden)

    Rohit Mehrotra

    2014-01-01

    Full Text Available This case report describes the esthetic and functional rehabilitation of a female patient in her mid forties having Class II Div 1 malocclusion, anterior open bite and multiple missing molars, with orthodontics and implant prosthodontics. The patient had bilaterally missing upper first and third molars and lower first and second molars. Orthodontic treatment using skeletal anchorage was performed to retract and align the upper anteriors and correct the open bite. In the upper arch, first molar spaces were closed and no prosthesis was needed. In the lower arch, the anteriors and premolars were aligned and implants were placed bilaterally to replace the missing molars and provide proper occlusion with the upper posteriors. Significant improvement in the occlusion, smile and facial esthetics was achieved. This article highlights the importance of an interdisciplinary team approach for providing optimum treatment to many adult patients.

  1. Comparing virtual with physical wedge for the transmission factors

    International Nuclear Information System (INIS)

    Lin Kuei-Hua; Lin Jao-Perng; Chu Tieh-Chi; Liu Mu-Tai

    2000-01-01

    This paper investigates the discrepancies between virtual wedge and physical wedge at the standard wedge angles of 15, 30, 45, and 60 degrees. The dose distributions for virtual wedge and physics wedge were measured by using a commercial multichamber detector array. The transmission factors of each virtual wedge and physical wedge were measured for Siemens PRIMUS 3008 linear accelerator by single ion chamber. These factors were used to set-up the clinical treatment data tables for clinical dosimetry for virtual wedge utilization. The Wellhoefer IC15, 0.13cc chamber was installed on the chamber frame of Wellhoefer water phantom (48x48x40 cm 3 ). The surface of water was at 100 cm SSD. The output factor in water were measured on the central axis of each field at 5 cm depth for 6MV or 10 cm depth for 15MV X-ray on virtual wedge and physical wedge. Comparing virtual wedge with physical wedge for transmission factor as field size range from 4x4 to 25x25 cm 2 . We have measured the dose distributions using the chamber array for 25x25 cm 2 virtual wedge fields and physical wedge fields at wedge angles of 15deg to 60deg. The dose profiles at various depths were also measured using the chamber array. The transmission factors of each physical wedge were slowly increased as field sizes increase, and had different value for each wedge angle. The transmission factors of each virtual wedge were almost constant value as 1.0 for each wedge angle. The results show that the dose profiles including the penumbra dose measured by the chamber array for virtual wedge agree with those measured for the physical wedge. For transmission factors of virtual wedge were constant value as 1.0 for each angles, namely output without wedge is almost equal to output with wedge on the central axis. Virtual wedge has practical and dosimetric advantages over physical wedge. (author)

  2. Temporalis and masseter muscle activity in patients with anterior open bite and craniomandibular disorders

    DEFF Research Database (Denmark)

    Bakke, Merete; Michler, L

    1991-01-01

    values, particularly in subjects with muscular affection, but maximal activity increased significantly when biting on the splint. Maximal voluntary contraction was positively correlated to molar contact and negatively to anterior face height, mandibular inclination, vertical jaw relation and gonial angle......Activity in temporalis and masseter muscles, and traits of facial morphology and occlusal stability were studied in 22 patients (19 women, 3 men; 15-45 yr of age) with anterior open bite and symptoms and signs of craniomandibular disorders. Facial morphology was assessed by profile radiographs......, occlusal stability by tooth contacts, and craniomandibular function by clinical and radiological examination. Electromyographic activity was recorded by surface electrodes after primary treatment with a reflex-releasing, stabilizing splint. Maximal voluntary contraction was reduced compared to reference...

  3. Phase Space Exchange in Thick Wedge Absorbers

    Energy Technology Data Exchange (ETDEWEB)

    Neuffer, David [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States)

    2017-01-01

    The problem of phase space exchange in wedge absorbers with ionization cooling is discussed. The wedge absorber exchanges transverse and longitudinal phase space by introducing a position-dependent energy loss. In this paper we note that the wedges used with ionization cooling are relatively thick, so that single wedges cause relatively large changes in beam phase space. Calculation methods adapted to such “thick wedge” cases are presented, and beam phase-space transformations through such wedges are discussed.

  4. Optical dating of relict sand wedges and composite-wedge pseudomorphs in Flanders, Belgium

    DEFF Research Database (Denmark)

    Buylaert, Jan-Pieter; Ghysels, Günther; Murray, Andrew S.

    2009-01-01

    We report on quartz Optically Stimulated Luminescence (OSL) dating of the infill of 14 relict sand wedges and composite-wedge pseudomorphs at 5 different sites in Flanders, Belgium. A laboratory dose recovery test indicates that the single-aliquot regenerative-dose (SAR) procedure is suitable for...

  5. Stem thrust prediction model for W-K-M double wedge parallel expanding gate valves

    Energy Technology Data Exchange (ETDEWEB)

    Eldiwany, B.; Alvarez, P.D. [Kalsi Engineering Inc., Sugar Land, TX (United States); Wolfe, K. [Electric Power Research Institute, Palo Alto, CA (United States)

    1996-12-01

    An analytical model for determining the required valve stem thrust during opening and closing strokes of W-K-M parallel expanding gate valves was developed as part of the EPRI Motor-Operated Valve Performance Prediction Methodology (EPRI MOV PPM) Program. The model was validated against measured stem thrust data obtained from in-situ testing of three W-K-M valves. Model predictions show favorable, bounding agreement with the measured data for valves with Stellite 6 hardfacing on the disks and seat rings for water flow in the preferred flow direction (gate downstream). The maximum required thrust to open and to close the valve (excluding wedging and unwedging forces) occurs at a slightly open position and not at the fully closed position. In the nonpreferred flow direction, the model shows that premature wedging can occur during {Delta}P closure strokes even when the coefficients of friction at different sliding surfaces are within the typical range. This paper summarizes the model description and comparison against test data.

  6. Stem thrust prediction model for W-K-M double wedge parallel expanding gate valves

    International Nuclear Information System (INIS)

    Eldiwany, B.; Alvarez, P.D.; Wolfe, K.

    1996-01-01

    An analytical model for determining the required valve stem thrust during opening and closing strokes of W-K-M parallel expanding gate valves was developed as part of the EPRI Motor-Operated Valve Performance Prediction Methodology (EPRI MOV PPM) Program. The model was validated against measured stem thrust data obtained from in-situ testing of three W-K-M valves. Model predictions show favorable, bounding agreement with the measured data for valves with Stellite 6 hardfacing on the disks and seat rings for water flow in the preferred flow direction (gate downstream). The maximum required thrust to open and to close the valve (excluding wedging and unwedging forces) occurs at a slightly open position and not at the fully closed position. In the nonpreferred flow direction, the model shows that premature wedging can occur during ΔP closure strokes even when the coefficients of friction at different sliding surfaces are within the typical range. This paper summarizes the model description and comparison against test data

  7. Skeletal Class III and anterior open bite treatment with different retention protocols: a report of three cases.

    Science.gov (United States)

    Farret, Milton Meri Benitez; Farret, Marcel Marchiori; Farret, Alessandro Marchiori

    2012-09-01

    The treatment of skeletal class III and anterior open bite can be unstable and orthodontists frequently observe relapse. Here, we report on the management of three patients with skeletal class III profiles and open bites treated by orthodontic camouflage. Each received a retention protocol involving the use of two separate appliances during the night and day accompanied by myofunctional therapy. Long-term follow-up revealed a stable outcome.

  8. Inclined indentation of smooth wedge in rock mass

    Science.gov (United States)

    Chanyshev, AI; Podyminogin, GM; Lukyashko, OA

    2018-03-01

    The article focuses on the inclined rigid wedge indentation into a rigid-plastic half-plane of rocks with the Mohr–Coulomb-Mohr plasticity. The limiting loads on different sides of the wedge are determined versus the internal friction angle, cohesion and wedge angle. It is shown that when the force is applied along the symmetry axis of the wedge, the zone of plasticity is formed only on one wedge side. In order to form the plasticity zone on both sides of the wedge, it is necessary to apply the force asymmetrically relative to the wedge symmetry axis. An engineering solution for the asymmetrical case implementation is suggested.

  9. Checking the virtual treatment modality Wedge from Siemens; Verificacion de la modalidad de tratamiento virtual WEDGE de SIEMENS

    Energy Technology Data Exchange (ETDEWEB)

    Suero Rodrigo, M. A.; Marques Fraguela, E.

    2011-07-01

    The treatment modality Virtual Wedge (VW) or implemented by Siemens virtual wedge in electron linear accelerators achieved dose distributions are similar but not identical, to those obtained with physical wedges. Among the advantages against the latter is the greater ease of use, wedge factor close to one, and lower peripheral dose. However, these benefits are to be effective requires a through quality control dependence because a larger number of parameters that control the generation of the beam, the dose monitor system and the movement of the jaws of the collimator. We performed a study of the wedge taking into account different configurations that can affect their behavior from the dosimetric point of view.

  10. Effects of Lateral Heel Wedges and Lateral Forefoot Wedge on the Knee Adduction Moment in Healthy Male Students

    Directory of Open Access Journals (Sweden)

    Fatemeh Shamsi

    2012-01-01

    Full Text Available Objective: Lateral wedged insoles have been designed to decrease the force applied on the medial knee compartment. The aim of this study was to assess the effects of laterally wedged insoles regarding to the placement of the wedge under the sole (under the heel or under the forefoot on the knee adduction moment and the ground reaction forces. Material & Methods: In this pretest-posttest study, three-dimensional gait analysis was performed on 20 healthy men between 18-30 years old. Knee adduction moment and ground reaction forces were compared among following three types of insoles: a flat insole, a 6˚ laterally inclined heel wedged insole and a 6˚ laterally- inclined forefoot wedged insole. Results: there was no difference between three conditions (flat insole (9.72±1.501, lateral heel wedge (9.866±2.141 and lateral forefoot wedge (9.952±1.986 in peak knee adduction moment (P>0.05. Ground reaction forces and spatiotemporal parameters of gait were not affected by any types of these insoles (P>0.05. Conclusion: Based on the current finding, placement of the lateral wedge under the sole, that is, under the heel or under the forefoot has no effect on the efficacy of these insoles on the adduction moment of the knee and ground reaction forces.

  11. [Treatment of open tile type C pelvic fractures by open reduction and internal fixation through anterior and posterior approaches at early stage].

    Science.gov (United States)

    Li, Baichuan

    2014-05-01

    To explore the effectiveness of open reduction and internal fixation through anterior and posterior approaches in treatment of open Tile type C pelvic fractures at early stage. Between January 2009 and April 2012, 12 patients with open Tile C pelvic fractures were treated. There were 7 males and 5 females, aged 6-53 years (median, 31 years). Of 12 cases, 4 were classified as Tile type C1, 6 as Tile type C2, and 2 as Tile type C3; 5 were rated as Gustilo type II and 7 as Gustilo type III. The injury severity score was 18-57 (mean, 37.2). The interval of injury and admission ranged from 15 minutes to 3 days (median, 50 minutes). The debridement and external fixation were performed at first stage; then open reduction and internal fixation were used through anterior approach (reconstruction plate) and posterior approach (cannulated lag screws). The vacuum sealing drainage was performed during treatment until the wounds healed. Delayed healing of incison was obtained in 12 cases because of wound infection. Anatomical reduction or approximate anatomical reduction was achieved in all 12 cases. The patients were followed up 3-39 months (median, 18 months). No loosening of internal fixation or fracture displacement was observed during follow-up. The fracture healing time was 7-13 weeks (mean, 9.7 weeks). At last follow-up, according to the Matta standard, the outcome was excellent in 10 cases and good in 2 cases; according to Majeed score, the results were excellent in 9 cases, good in 1, and poor in 2. Early internal fixation operation of open Tile type C pelvic fractures can effectively restore the pelvic anatomical structure and stability, reduce the complication, and achieve satisfactory effectiveness.

  12. Rainfall induced groundwater mound in wedge-shaped promontories: The Strack-Chernyshov model revisited

    Science.gov (United States)

    Kacimov, A. R.; Kayumov, I. R.; Al-Maktoumi, A.

    2016-11-01

    An analytical solution to the Poisson equation governing Strack's discharge potential (squared thickness of a saturated zone in an unconfined aquifer) is obtained in a wedge-shaped domain with given head boundary conditions on the wedge sides (specified water level in an open water body around a porous promontory). The discharge vector components, maximum elevation of the water table in promontory vertical cross-sections, quantity of groundwater seeping through segments of the wedge sides, the volume of fresh groundwater in the mound are found. For acute angles, the solution to the problem is non-unique and specification of the behaviour at infinity is needed. A ;basic; solution is distinguished, which minimizes the water table height above a horizontal bedrock. MODFLOW simulations are carried out in a finite triangular island and compare solutions with a constant-head, no-flow and ;basic; boundary condition on one side of the triangle. Far from the tip of an infinite-size promontory one has to be cautious with truncation of the simulated flow domains and imposing corresponding boundary conditions. For a right and obtuse wedge angles, there are no positive solutions for the case of constant accretion on the water table. In a particular case of a confined rigid wedge-shaped aquifer and incompressible fluid, from an explicit solution to the Laplace equation for the hydraulic head with arbitrary time-space varying boundary conditions along the promontory rays, essentially 2-D transient Darcian flows within the wedge are computed. They illustrate that surface water waves on the promontory boundaries can generate strong Darcian waves inside the porous wedge. Evaporation from the water table and sea-water intruded interface (rather than a horizontal bed) are straightforward generalizations for the Poissonian Strack potential.

  13. [The mini-open Latarjet procedure for treatment of recurrent anterior instability of the shoulder].

    Science.gov (United States)

    Pogorzelski, J; Beitzel, K; Imhoff, A B; Braun, S

    2016-12-01

    Shoulder stabilization. Symptomatic recurrent anterior shoulder instability combined with glenoid bone loss of approximately 20-35 % of the glenoid surface, engaging Hill-Sachs lesion and/or previously failed arthroscopic Bankart repair. In patients with a high risk of redislocation (contact sports) or irreparable soft tissue injury the Latarjet procedure can be considered as a first-line treatment. Contraindicated if arthroscopic Bankart repair is possible. Irreparable damage of subscapularis tendon. Bony defect >35 % of the glenoid that cannot be filled with coracoid bone block. Arbitrary shoulder dislocation. Young patients with open growth plates (relative contraindication). Mini-open deltopectoral approach of approximately 6 cm. Preparation of the coracoid process and the conjoined tendons. Osteotomy of the coracoid process at its base using a 90° sawblade. Split of the subscapularis tendon. Preparation of the glenoid defect and implantation of 2-3 suture anchors where appropriate. Drilling of two parallel holes through the coracoid process. Fixation of the bone block with cannulated screws at the anterior glenoid rim and refixation of the joint capsula, if necessary with the help of the suture anchors. Wound drainage and closure in layers. Intermittent immobilization in a sling for 6 weeks with limited abduction, flexion and external rotation. Sport-specific training after 3 months, over-head sports after 6 months. Since 2009 64 mini-open Latarjet procedures (61 patients) performed. In all, 9.4 % of patients suffered from persistent instability (dislocations and subluxations); only 1 patient needed revision surgery due to instability.

  14. Diagnostic Laparoscopy as Decision Tool for Re-recurrent Inguinal Hernia Treatment Following Open Anterior and Laparo-Endoscopic Posterior Repair

    Directory of Open Access Journals (Sweden)

    Ferdinand Köckerling

    2017-05-01

    Full Text Available IntroductionThe guidelines of the international hernia societies recommend posterior repair in laparo-endoscopic technique for recurrent inguinal hernia after open anterior mesh repair and, conversely, open anterior repair for recurrence after laparo-endoscopic primary repair. Even when these guidelines are followed, already 1 year after repair a re-recurrence rate of 1–2% must be expected, with that rate rising further in the subsequent years. Accordingly, increasingly more patients with re-recurrence after anterior and posterior mesh implantation must be treated, which constitutes a problem that to date has been investigated in only very few studies. Hence, there are no well-founded recommendations. This paper now presents a number of case reports aimed at identifying the role of explorative laparoscopy as decision tool for re-recurrent inguinal hernia treatment.Patients and methodsBased on three case reports the role of explorative laparoscopy as decision tool for re-recurrent inguinal hernia treatment is presented below.ResultsIn all the three cases described explorative laparoscopy played a key role as decision tool when deciding how best to treat re-recurrence after anterior and posterior inguinal hernia repair. In one case severe adhesions after robotic prostatectomy and in another case correct placement of the mesh in the posterior plane, adhesions from the cecum to the groin region and no definitive finding of a re-recurrence resulted in an open repair. In the third case, an insufficient laparoscopic posterior mesh placement made the re-recurrent TAPP procedure relatively easy.ConclusionExplorative laparoscopy is an important decision tool for re-recurrent inguinal hernia treatment to minimize the risks of the procedure for the patients.

  15. Use of Wedge Absorbers in MICE

    Energy Technology Data Exchange (ETDEWEB)

    Neuffer, D. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Summers, D. [Univ. of Mississippi, Oxford, MS (United States); Mohayai, T. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); IIT, Chicago, IL (United States); Snopok, P. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); IIT, Chicago, IL (United States); Rogers, C. [Science and Technology Facilities Council (STFC), Oxford (United Kingdom). Rutherford Appleton Lab. (RAL)

    2017-03-01

    Wedge absorbers are needed to obtain longitudinal cooling in ionization cooling. They also can be used to obtain emittance exchanges between longitudinal and transverse phase space. There can be large exchanges in emittance, even with single wedges. In the present note we explore the use of wedge absorbers in the MICE experiment to obtain transverse–longitudinal emittance exchanges within present and future operational conditions. The same wedge can be used to explore “direct” and “reverse” emittance exchange dynamics, where direct indicates a configuration that reduces momentum spread and reverse is a configuration that increases momentum spread. Analytical estimated and ICOOL and G4BeamLine simulations of the exchanges at MICE parameters are presented. Large exchanges can be obtained in both reverse and direct configurations.

  16. Assessment of Neutron Contamination Originating from the Presence of Wedge and Block in Photon Beam Radiotherapy.

    Science.gov (United States)

    Bahreyni Toossi, M T; Khajetash, B; Ghorbani, M

    2018-03-01

    One of the main causes of induction of secondary cancer in radiation therapy is neutron contamination received by patients during treatment. Objective: In the present study the impact of wedge and block on neutron contamination production is investigated. The evaluations are conducted for a 15 MV Siemens Primus linear accelerator. Simulations were performed using MCNPX Monte Carlo code. 30˚, 45˚ and 60˚ wedges and a cerrobend block with dimensions of 1.5 × 1.5 × 7 cm 3 were simulated. The investigation were performed in the 10 × 10 cm 2 field size at source to surface distance of 100 cm for depth of 0.5, 2, 3 and 4 cm in a water phantom. Neutron dose was calculated using F4 tally with flux to dose conversion factors and F6 tally. Results showed that the presence of wedge increases the neutron contamination when the wedge factor was considered. In addition, 45˚ wedge produced the most amount of neutron contamination. If the block is in the center of the field, the cerrobend block caused less neutron contamination than the open field due to absorption of neutrons and photon attenuation. The results showed that neutron contamination is less in steeper depths. The results for two tallies showed practically equivalent results. Wedge causes neutron contamination hence should be considered in therapeutic protocols in which wedge is used. In terms of clinical aspects, the results of this study show that superficial tissues such as skin will tolerate more neutron contamination than the deep tissues.

  17. Recovery of shoulder strength and proprioception after open surgery for recurrent anterior instability: a comparison of two surgical techniques.

    Science.gov (United States)

    Rokito, Andrew S; Birdzell, Maureen Gallagher; Cuomo, Frances; Di Paola, Matthew J; Zuckerman, Joseph D

    2010-06-01

    Previous studies have documented a decrease in proprioceptive capacity in the unstable shoulder. The degree to which surgical approach affects recovery of strength and proprioception is unknown. The recovery of strength and proprioception after open surgery for recurrent anterior glenohumeral instability was compared for 2 surgical procedures. A prospective analysis of 55 consecutive patients with posttraumatic unilateral recurrent anterior glenohumeral instability was performed. Thirty patients (group 1) underwent an open inferior capsular shift with detachment of the subscapularis, and 25 (group 2) underwent an anterior capsulolabral reconstruction. Mean preoperative proprioception and strength values were significantly lower for the affected shoulders in both groups. At 6 months after surgery, there were no significant differences for mean strength and proprioception values between the unaffected and operative sides for group 2 patients. In group 1 patients, however, there were still significant deficits in mean position sense and strength values. Complete restoration of proprioception and strength, however, was evident by 12 months in group 1. This study demonstrates that there are significant deficits in both strength and proprioception in patients with posttraumatic, recurrent anterior glenohumeral instability. Although both are completely restored by 1 year after surgery, a subscapularis-splitting approach allows for complete recovery of strength and position sense as early as 6 months postoperatively. Detachment of the subscapularis delays recovery of strength and position sense for up to 12 months after surgery. Copyright 2010 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  18. Wedged multilayer Laue lens

    International Nuclear Information System (INIS)

    Conley, Ray; Liu Chian; Qian Jun; Kewish, Cameron M.; Macrander, Albert T.; Yan Hanfei; Maser, Joerg; Kang, Hyon Chol; Stephenson, G. Brian

    2008-01-01

    A multilayer Laue lens (MLL) is an x-ray focusing optic fabricated from a multilayer structure consisting of thousands of layers of two different materials produced by thin-film deposition. The sequence of layer thicknesses is controlled to satisfy the Fresnel zone plate law and the multilayer is sectioned to form the optic. An improved MLL geometry can be created by growing each layer with an in-plane thickness gradient to form a wedge, so that every interface makes the correct angle with the incident beam for symmetric Bragg diffraction. The ultimate hard x-ray focusing performance of a wedged MLL has been predicted to be significantly better than that of a nonwedged MLL, giving subnanometer resolution with high efficiency. Here, we describe a method to deposit the multilayer structure needed for an ideal wedged MLL and report our initial deposition results to produce these structures

  19. Anterior segment parameters as predictors of intraocular pressure reduction after phacoemulsification in eyes with open-angle glaucoma.

    Science.gov (United States)

    Hsia, Yen C; Moghimi, Sasan; Coh, Paul; Chen, Rebecca; Masis, Marisse; Lin, Shan C

    2017-07-01

    To evaluate intraocular pressure (IOP) change after cataract surgery in eyes with open-angle glaucoma (OAG) and its relationship to angle and anterior segment parameters measured by anterior segment optical coherence tomography (AS-OCT). University of California, San Francisco, California, USA. Prospective case series. Eyes were placed into a narrow-angle group or open-angle group based on gonioscopy grading. Biometric parameters were measured using AS-OCT (Visante) preoperatively, and IOP 4 months after surgery was obtained. The IOP change and its relationship to AS-OCT parameters were evaluated. Eighty-one eyes of 69 patients were enrolled. The mean age of the patients was 76.8 years. The preoperative IOP was 15.02 mm Hg on 1.89 glaucoma medications. The average mean deviation of preoperative visual field was -4.58 dB. The mean IOP reduction was 2.1 mm Hg (12.8%) from a preoperative mean of 15.0 mm Hg. The IOP reduction was significantly greater in eyes with narrow angles than in eyes with open angles (20.4% versus 8.0%) (P = .002). In multivariate analysis, preoperative IOP (β = -0.53, P < .001, R 2  = 0.40), angle-opening distance at 500 mm (β = 5.83, P = .02, R 2  = 0.45), angle-opening distance at 750 mm (β = 5.82, P = .001, R 2  = 0.52), and lens vault (β = -0.002, P = .009, R 2  = 0.47) were associated with IOP reduction postoperatively. In eyes with OAG, IOP reduction after cataract surgery was greater in eyes with narrower angles. Preoperative IOP, angle-opening distance, and lens vault were predictors for IOP reduction. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  20. Cytological organization of the alpha component of the anterior olfactory nucleus and olfactory limbus

    Directory of Open Access Journals (Sweden)

    Jorge A Larriva-Sahd

    2012-06-01

    Full Text Available This study describes the microscopic organization of a wedge-shaped area at the intersection of the main and accessory olfactory bulbs, or olfactory limbus , and an additional component of the anterior olfactory nucleus or alpha accessory olfactory bulb that lies underneath of the accessory olfactory bulb. The olfactory limbus consists of a modified bulbar cortex bounded anteriorly by the main olfactory bulb and posteriorly by the accessory olfactory bulb. In Nissl-stained specimens the olfactory limbus differs from the main olfactory bulb by a progressive, antero-posterior decrease in thickness or absence of the external plexiform, mitral/tufted cell, and granule cell layers. On cytoarchitectual grounds the olfactory limbus is divided from rostral to caudal into three distinct components: a stripe of glomerular-free cortex or preolfactory area, a second or necklace glomerular area, and a wedge-shaped or interstitial area crowned by the so-called modified glomeruli that appear to belong to the anterior accessory olfactory bulb. The strategic location and interactions with the main and accessory olfactory bulbs, together with the previously noted functional and connectional evidence, suggest that the olfactory limbus may be related to both sensory modalities. The alpha component of the anterior olfactory nucleus, a slender cellular cluster (i.e., 650 x 150 µm paralleling the base of the accessory olfactory bulb, contains two neuron types: a pyramidal-like neuron and an interneuron. Dendrites of pyramidal-like cells organize into a single bundle that ascends avoiding the accessory olfactory bulb to resolve in a trigone bounded by the edge of the olfactory limbus, the accessory olfactory bulb and the dorsal part of the anterior olfactory nucleus. Utrastructurally, the neuropil of the alpha component contains three types of synaptic terminals; one of them immunoreactive to the enzyme glutamate decarboxylase, isoform 67.

  1. Mantle wedge serpentinization effects on slab dips

    Directory of Open Access Journals (Sweden)

    Eh Tan

    2017-01-01

    Full Text Available The mechanical coupling between a subducting slab and the overlying mantle wedge is an important factor in controlling the subduction dip angle and the flow in mantel wedge. This paper investigates the role of the amount of mantle serpentinization on the subduction zone evolution. With numerical thermos-mechanical models with elasto-visco-plastic rheology, we vary the thickness and depth extent of mantle serpentinization in the mantle wedge to control the degree of coupling between the slab and mantle wedge. A thin serpentinized mantle layer is required for stable subduction. For models with stable subduction, we find that the slab dip is affected by the down-dip extent and the mantle serpentinization thickness. A critical down-dip extent exists in mantle serpentinization, determined by the thickness of the overriding lithosphere. If the down-dip extent does not exceed the critical depth, the slab is partially coupled to the overriding lithosphere and has a constant dip angle regardless of the mantle serpentinization thickness. However, if the down-dip extent exceeds the critical depth, the slab and the base of the overriding lithosphere would be separated and decoupled by a thick layer of serpentinized peridotite. This allows further slab bending and results in steeper slab dip. Increasing mantle serpentinization thickness will also result in larger slab dip. We also find that with weak mantle wedge, there is no material flowing from the asthenosphere into the serpentinized mantle wedge. All of these results indicate that serpentinization is an important ingredient when studying the subduction dynamics in the mantle wedge.

  2. Surgeons’ Volume-Outcome Relationship for Lobectomies and Wedge Resections for Cancer Using Video-Assisted Thoracoscopic Techniques

    Directory of Open Access Journals (Sweden)

    Guy David

    2012-01-01

    Full Text Available This study examined the effect of surgeons’ volume on outcomes in lung surgery: lobectomies and wedge resections. Additionally, the effect of video-assisted thoracoscopic surgery (VATS on cost, utilization, and adverse events was analyzed. The Premier Hospital Database was the data source for this analysis. Eligible patients were those of any age undergoing lobectomy or wedge resection using VATS for cancer treatment. Volume was represented by the aggregate experience level of the surgeon in a six-month window before each surgery. A positive volume-outcome relationship was found with some notable features. The relationship is stronger for cost and utilization outcomes than for adverse events; for thoracic surgeons as opposed to other surgeons; for VATS lobectomies rather than VATS wedge resections. While there was a reduction in cost and resource utilization with greater experience in VATS, these outcomes were not associated with greater experience in open procedures.

  3. 49 CFR 215.113 - Defective plain bearing wedge.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Defective plain bearing wedge. 215.113 Section 215... Suspension System § 215.113 Defective plain bearing wedge. A railroad may not place or continue in service a car, if a plain bearing wedge on that car is— (a) Missing; (b) Cracked; (c) Broken; or (d) Not located...

  4. Assessment of an amorphous silicon EPID for quality assurance of enhanced dynamic wedge

    International Nuclear Information System (INIS)

    Greer, P.

    2004-01-01

    Full text: Routine quality assurance (QA) of enhanced dynamic wedge (EDW) is usually performed weekly to monthly. Wedge factors are measured with ion-chamber, and profiles usually with diode-arrays such as the Profiler. The use of an electronic portal imaging device (EPID) for these measurements would combine these into a single rapid set-up and measurement. Currently the Varian EPID in standard imaging mode will not acquire integrated images during EDW treatments, and therefore has not been utilised for EDW dosimetry. Modification to image acquisition was made to enable imaging for EDW, and the performance of the EPID for suitability for quality assurance of EDW was investigated. The accuracy of EDW profiles measured with the EPID were assessed by comparison to Profiler measurements. The EPID was positioned at 105 cm to the detector surface, with 4 cm of additional solid water build-up to give total build-up including EPID inherent build-up of 5 cm. Images of EDW fields were acquired with continuous frame-averaging throughout the delivery. Field sizes of 10x10 cm, and 20x20 cm were used for 30 deg and 60 deg wedge angles for both 6 MV and 18 MV x-rays. Profiler measurements of the same fields were made with 5 cm of solid water build-up with 105 cm to the detector. Profiles in the wedged direction along the central axis of the beam were then compared. The reproducibility of the EPID measured profiles was assessed by three measurements made at weekly intervals. The accuracy of EPID measured wedge factors was investigated with the same experimental set-up. Three images of a 10x10 cm open field were acquired, and the mean pixel value in a 9x9 pixel region at the central axis was found. As the pixel value is the average of all acquired frames, this was multiplied by the number of frames to yield an integrated pixel value. This was repeated for three 10x10 cm 60 deg wedge irradiations. The wedge factor measured with the EPID was then compared to routine weekly

  5. Chevron closing base wedge bunionectomy.

    Science.gov (United States)

    Bruyn, J M

    1993-01-01

    The Chevron-base wedge Association for Osteosynthesis fixated bunionectomy provides a stable, aggressive correction of the severe hallux abducto valgus deformity. It is intended for the bunion requiring a double osteotomy in order to adequately reduce both intermetatarsal and proximal articular facet angle with minimal shortening and elevation. This article presents the rationale for the procedure, technique, and a 4-year follow-up of six patients with eight Chevron-base wedge bunionectomies.

  6. Diffraction by an immersed elastic wedge

    CERN Document Server

    Croisille, Jean-Pierre

    1999-01-01

    This monograph presents the mathematical description and numerical computation of the high-frequency diffracted wave by an immersed elastic wave with normal incidence. The mathematical analysis is based on the explicit description of the principal symbol of the pseudo-differential operator connected with the coupled linear problem elasticity/fluid by the wedge interface. This description is subsequently used to derive an accurate numerical computation of diffraction diagrams for different incoming waves in the fluid, and for different wedge angles. The method can be applied to any problem of coupled waves by a wedge interface. This work is of interest for any researcher concerned with high frequency wave scattering, especially mathematicians, acousticians, engineers.

  7. Convolution-wedge product of fields

    International Nuclear Information System (INIS)

    Diep, D.N.; Duc, D.V.; Tan, H.V.; Viet, N.A.

    2007-07-01

    In this paper we use the pair of electric-magnetic (or GNO, or Langlands) duality groups G = Sp(1) and L G = SO(3) and the T-transformation in mirror symmetry (or the S-duality, or the Fourier-Mukai transformation) to define the wedge product of fields: first by using gauge transformation, we reduce the fields with values in LieG = sp(1) to the fields with values in the Lie algebra of the maximal torus t subset of LieG = sp(1). Next we use the Fourier-Mukai transformation of fields to have the images as fields with values in the Lie algebra of the Langlands dual torus L t in Lie L G = so(3). The desired wedge product of two fields is defined as the pre-image of the ordinary wedge product of images with values in L t subset of so(3). (author)

  8. Field size dependence of wedge factor: miniphantom vs full phantom measurements

    International Nuclear Information System (INIS)

    Allen Li, X.; Szanto, J.; Soubra, M.; Gerig, L. H.

    1995-01-01

    It is empirically known that the transmission factor for wedge in a high-energy photon beam is dependent upon field size and depth of measurement. The field-size dependence of wedge factors may be attributed to changes in (i) head scatter, (ii) phantom scatter, and (iii) backscatter from the wedge into the linac monitor chamber. In this work we present the results of studies designed to examine each of these factors in isolation. The wedge factors for wedges with nominal wedge angles of 15 deg. , 30 deg. , 45 deg. and 60 deg. were measured with a 3-g/cm 2 -diameter narrow cylindrical phantom (miniphantom), a brass cap with 1.5-g/cm 2 side-wall thickness and a full water phantom for 6-, 10- and 18-MV photon beams. The measurements were performed with and without flattening filter in place. The wedge factors measured with the miniphantom and the brass cap exclude the phantom scatter contribution. It has been found that the field-size behaviour of wedge factor measured with full water phantom is similar to that measured with the miniphantom and cap. This indicates that the head scatter radiation is the major contributor to the field size dependence of wedge factors. Wedge factors measured with water phantom are up to 5.0% smaller than those measured with miniphantom. This difference increases with wedge angle. When Measured with the flattening filter removed, the field size dependence of the wedge factor is reduced. This justify that the flattening filter is one of the major contributors to head scatters. The measurement results made with the brass cap agree well with those made by using the miniphantom. By measuring the monitor chamber output, it is found that the backscatters from the wedge into the linac ion chamber have little effect on the field size dependence of the wedge factor

  9. Quench propagation across the copper wedges in SSC dipoles

    International Nuclear Information System (INIS)

    Ghosh, A.K.; Robins, K.E.; Sampson, W.B.

    1986-01-01

    The effect of copper wedges on quench propagation in SSC windings has been studied. The results indicate that the turn-to-turn quench transit time for conductors separated by an insulated copper wedge can be predicted with reasonable accuracy from the bulk quench properties and the mean wedge thickness

  10. Treatment of hyperdivergent growth pattern and anterior open bite with posterior metallic bite planes.

    Science.gov (United States)

    Ciavarella, Domenico; Lo Russo, Lucio; Nichelini, Jeffrey; Mastrovincenzo, Mario; Barbato, Ersilia; Laurenziello, Michele; Montaruli, Graziano; Lo Muzio, Lorenzo

    2017-12-01

    In the present paper, the authors analyze the effect of the "Swallowing Occlusal Contact Intercept Appliance" (SOCIA) in treatment of children with hyperdivergent Class II malocclusion. This functional appliance has no intra-oral anchorage, but induces a continuous periodontal, muscular, and articular stimulation. Twenty-six patients with hyperdivergent growth and class II malocclusion were selected and treated with SOCIA appliance. Cephalometric analysis was performed before treatment (T1) and immediately after the treatment (T2). After 24 months treatment authors observed a modification of maxillary growth with a reduction of the divergence with an increase of the posterior facial height, a modification of condylar inclination and forward position of the a hyoid. No modifications was observed about the ANB angle. After treatment the open bite was resolved with a reduction of the inclination of the upper incisors. SOCIA is a reliable functional appliance in growing age patients with a hyperdivergent pattern growth, anterior open bite and class II molar malocclusion.

  11. Establishing Age-Adjusted Reference Ranges for Iris-Related Parameters in Open Angle Eyes with Anterior Segment Optical Coherence Tomography.

    Directory of Open Access Journals (Sweden)

    Jeffrey R Peterson

    Full Text Available Define criteria for iris-related parameters in an adult open angle population as measured with swept source Fourier domain anterior segment optical coherence tomography (ASOCT.Ninety-eight eyes of 98 participants with open angles were included and stratified into 5 age groups (18-35, 36-45, 46-55, 56-65, and 66-79 years. ASOCT scans with 3D mode angle analysis were taken with the CASIA SS-1000 (Tomey Corporation, Nagoya, Japan and analyzed using the Anterior Chamber Analysis and Interpretation software. Anterior iris surface length (AISL, length of scleral spur landmark (SSL to pupillary margin (SSL-to-PM, iris contour ratio (ICR = AISL/SSL-to-PM, pupil radius, radius of iris centroid (RICe, and iris volume were measured. Outcome variables were summarized for all eyes and age groups, and mean values among age groups were compared using one-way analysis of variance. Stepwise regression analysis was used to investigate demographic and ocular characteristic factors that affected each iris-related parameter.Mean (±SD values were 2.24 mm (±0.46, 4.06 mm (±0.27, 3.65 mm (±0.48, 4.16 mm (±0.47, 1.14 (±0.04, 1.51 mm2 (±0.23, and 38.42 μL (±4.91 for pupillary radius, RICe, SSL-to-PM, AISL, ICR, iris cross-sectional area, and iris volume, respectively. Both pupillary radius (P = 0.002 and RICe (P = 0.027 decreased with age, while SSL-to-PM (P = 0.002 and AISL increased with age (P = 0.001. ICR (P = 0.54 and iris volume (P = 0.49 were not affected by age.This study establishes reference values for iris-related parameters in an adult open angle population, which will be useful for future studies examining the role of iris changes in pathologic states.

  12. Group sequential designs for stepped-wedge cluster randomised trials.

    Science.gov (United States)

    Grayling, Michael J; Wason, James Ms; Mander, Adrian P

    2017-10-01

    The stepped-wedge cluster randomised trial design has received substantial attention in recent years. Although various extensions to the original design have been proposed, no guidance is available on the design of stepped-wedge cluster randomised trials with interim analyses. In an individually randomised trial setting, group sequential methods can provide notable efficiency gains and ethical benefits. We address this by discussing how established group sequential methodology can be adapted for stepped-wedge designs. Utilising the error spending approach to group sequential trial design, we detail the assumptions required for the determination of stepped-wedge cluster randomised trials with interim analyses. We consider early stopping for efficacy, futility, or efficacy and futility. We describe first how this can be done for any specified linear mixed model for data analysis. We then focus on one particular commonly utilised model and, using a recently completed stepped-wedge cluster randomised trial, compare the performance of several designs with interim analyses to the classical stepped-wedge design. Finally, the performance of a quantile substitution procedure for dealing with the case of unknown variance is explored. We demonstrate that the incorporation of early stopping in stepped-wedge cluster randomised trial designs could reduce the expected sample size under the null and alternative hypotheses by up to 31% and 22%, respectively, with no cost to the trial's type-I and type-II error rates. The use of restricted error maximum likelihood estimation was found to be more important than quantile substitution for controlling the type-I error rate. The addition of interim analyses into stepped-wedge cluster randomised trials could help guard against time-consuming trials conducted on poor performing treatments and also help expedite the implementation of efficacious treatments. In future, trialists should consider incorporating early stopping of some kind into

  13. Transanal stent in anterior resection does not prevent anastomotic leakage

    DEFF Research Database (Denmark)

    Bülow, Steffen; Bulut, O; Christensen, Ib Jarle

    2006-01-01

    OBJECTIVE: A defunctioning transanal stent may theoretically reduce the leakage rate after anterior rectal resection. We present a randomized open study with the aim of comparing the leakage rate after anterior resection with a loop ileostomy, a transanal stent, both or neither. PATIENTS AND METH....... On this basis it was decided to discontinue the study prematurely for ethical reasons. CONCLUSION: Decompression of the anastomosis with a transanal stent does not reduce the risk of anastomotic leakage after anterior resection.......OBJECTIVE: A defunctioning transanal stent may theoretically reduce the leakage rate after anterior rectal resection. We present a randomized open study with the aim of comparing the leakage rate after anterior resection with a loop ileostomy, a transanal stent, both or neither. PATIENTS...... AND METHODS: Randomized open trial of 194 patients operated in 11 hospitals during September 2000 to September 2003 with anterior resection for a mobile rectal tumour, 115 men and 79 women, median age 68 years (range 37-90 years). The surgeon decided upon the use of a protective ileostomy, and after...

  14. Tax wedge in Croatia, Austria, Hungary, Poland and Greece

    Directory of Open Access Journals (Sweden)

    Marin Onorato

    2016-06-01

    Full Text Available The aim of this paper is to compare the tax burden on labour income in Croatia, Austria, Greece, Hungary and Poland in 2013. The Taxing Wages methodology has been applied to hypothetical units across a range of gross wages in order to calculate net average tax wedge, net average tax rate, as well as other relevant indicators. When it comes to single workers without children, the smallest tax wedge for workers earning less than the average gross wage was found in Croatia, while Poland had the smallest tax wedge for above-average wages. Due to a progressive PIT system, the tax wedge for a single worker in Croatia reaches 50% at 400% of the average gross wage, equalling that of Austria, Greece and Hungary. Tax wedges for couples with two children show a similar trend.

  15. Microtopographic control on the ground thermal regime in ice wedge polygons

    Science.gov (United States)

    Abolt, Charles J.; Young, Michael H.; Atchley, Adam L.; Harp, Dylan R.

    2018-06-01

    The goal of this research is to constrain the influence of ice wedge polygon microtopography on near-surface ground temperatures. Ice wedge polygon microtopography is prone to rapid deformation in a changing climate, and cracking in the ice wedge depends on thermal conditions at the top of the permafrost; therefore, feedbacks between microtopography and ground temperature can shed light on the potential for future ice wedge cracking in the Arctic. We first report on a year of sub-daily ground temperature observations at 5 depths and 9 locations throughout a cluster of low-centered polygons near Prudhoe Bay, Alaska, and demonstrate that the rims become the coldest zone of the polygon during winter, due to thinner snowpack. We then calibrate a polygon-scale numerical model of coupled thermal and hydrologic processes against this dataset, achieving an RMSE of less than 1.1 °C between observed and simulated ground temperature. Finally, we conduct a sensitivity analysis of the model by systematically manipulating the height of the rims and the depth of the troughs and tracking the effects on ice wedge temperature. The results indicate that winter temperatures in the ice wedge are sensitive to both rim height and trough depth, but more sensitive to rim height. Rims act as preferential outlets of subsurface heat; increasing rim size decreases winter temperatures in the ice wedge. Deeper troughs lead to increased snow entrapment, promoting insulation of the ice wedge. The potential for ice wedge cracking is therefore reduced if rims are destroyed or if troughs subside, due to warmer conditions in the ice wedge. These findings can help explain the origins of secondary ice wedges in modern and ancient polygons. The findings also imply that the potential for re-establishing rims in modern thermokarst-affected terrain will be limited by reduced cracking activity in the ice wedges, even if regional air temperatures stabilize.

  16. Experimental investigation of sound absorption of acoustic wedges for anechoic chambers

    Science.gov (United States)

    Belyaev, I. V.; Golubev, A. Yu.; Zverev, A. Ya.; Makashov, S. Yu.; Palchikovskiy, V. V.; Sobolev, A. F.; Chernykh, V. V.

    2015-09-01

    The results of measuring the sound absorption by acoustic wedges, which were performed in AC-3 and AC-11 reverberation chambers at the Central Aerohydrodynamic Institute (TsAGI), are presented. Wedges of different densities manufactured from superfine basaltic and thin mineral fibers were investigated. The results of tests of these wedges were compared to the sound absorption of wedges of the operating AC-2 anechoic facility at TsAGI. It is shown that basaltic-fiber wedges have better sound-absorption characteristics than the investigated analogs and can be recommended for facing anechoic facilities under construction.

  17. Physichal parameters for wedge filters used in radiotherapy

    International Nuclear Information System (INIS)

    Strunga, Emil

    1995-01-01

    Wedge filters using in radiotherapy up two important problems: attenuation of gamma rays introduced by the presence of wedge filters and spinning of isodoses curves plate. Depending of irradiation geometry, characterised by D w , - source filter distance, D c - source dose's estimate point distance, a - side of irradiation field; nature and size filter: α - wedge angle, μ - linear adsorption coefficient, ε - filter cover attenuation w - filter side, and nature of target volume characterised by μ' - linear absorption coefficient of medium has been estimated absorption factor of wedge filter (k w ) for two irradiation geometry: and spinning angle of isodose plate (Θ): 3) tg θ (μD w (μ'D c - 2 Calculated values has been compared with the experimental measured values, for a cobaltotherapy unit Rokus-M, and the result was that between the two series of dates it is a good concordance

  18. Restraint of fatigue crack growth by wedge effects of fine particles

    CERN Document Server

    Takahashi, I; Kotani, N

    2000-01-01

    Presents some experimental results which demonstrate restraint of fatigue crack growth in an Al-Mg alloy by wedge effects of fine particles. Fatigue test specimens were machined from a JIS A5083P-O Al-Mg alloy plate of 5 mm thickness and an EDM starter notch was introduced to each specimen. Three kinds of fine particles were prepared as the materials to be wedged into the fatigue cracks, i.e. magnetic particles and two kinds of alumina particles having different mean particle sizes of 47.3 mu m and 15.2 mu m. Particles of each kind were suspended in an oil to form a paste, which was applied on the specimen surface covering the notch zone prior to the fatigue tests. In order to make some fracture mechanics approaches, in situ observations of fatigue cracks were performed for the two cases using a CCD microscope, with a magnification of *1000. The crack length and the crack opening displacement (COD) at the notch root, delta , were measured. The crack retardation effect continues almost through the entire lifet...

  19. Isolating active orogenic wedge deformation in the southern Subandes of Bolivia

    Science.gov (United States)

    Weiss, Jonathan R.; Brooks, Benjamin A.; Foster, James H.; Bevis, Michael; Echalar, Arturo; Caccamise, Dana; Heck, Jacob; Kendrick, Eric; Ahlgren, Kevin; Raleigh, David; Smalley, Robert; Vergani, Gustavo

    2016-08-01

    A new GPS-derived surface velocity field for the central Andean backarc permits an assessment of orogenic wedge deformation across the southern Subandes of Bolivia, where recent studies suggest that great earthquakes (>Mw 8) are possible. We find that the backarc is not isolated from the main plate boundary seismic cycle. Rather, signals from subduction zone earthquakes contaminate the velocity field at distances greater than 800 km from the Chile trench. Two new wedge-crossing velocity profiles, corrected for seasonal and earthquake affects, reveal distinct regions that reflect (1) locking of the main plate boundary across the high Andes, (2) the location of and loading rate at the back of orogenic wedge, and (3) an east flank velocity gradient indicative of décollement locking beneath the Subandes. Modeling of the Subandean portions of the profiles indicates along-strike variations in the décollement locked width (WL) and wedge loading rate; the northern wedge décollement has a WL of ~100 km while accumulating slip at a rate of ~14 mm/yr, whereas the southern wedge has a WL of ~61 km and a slip rate of ~7 mm/yr. When compared to Quaternary estimates of geologic shortening and evidence for Holocene internal wedge deformation, the new GPS-derived wedge loading rates may indicate that the southern wedge is experiencing a phase of thickening via reactivation of preexisting internal structures. In contrast, we suspect that the northern wedge is undergoing an accretion or widening phase primarily via slip on relatively young thrust-front faults.

  20. A Wedge Absorber Experiment at MICE

    Energy Technology Data Exchange (ETDEWEB)

    Neuffer, David [Fermilab; Mohayai, Tanaz [IIT, Chicago; Rogers, Chris [Rutherford; Snopok, Pavel [IIT, Chicago; Summers, Don [Mississippi U.

    2017-05-01

    Emittance exchange mediated by wedge absorbers is required for longitudinal ionization cooling and for final transverse emittance minimization for a muon collider. A wedge absorber within the MICE beam line could serve as a demonstration of the type of emittance exchange needed for 6-D cooling, including the configurations needed for muon colliders, as well as configurations for low-energy muon sources. Parameters for this test are explored in simulation and possible experimental configurations with simulated results are presented.

  1. [Features of the new minimally invasive techniques facet fixation system «Facet Wedge» in the treatment of degenerative diseases of the lumbar spine in elderly patients.

    Science.gov (United States)

    Byvaltsev, V A; Kalinin, A A; Okoneshnikova, A K

    2017-01-01

    The aim of the study was a comparative analysis of the clinical and radiographic effectiveness of the use of interbody fusion and open pedicle screw stabilization of simultaneous and new minimally invasive techniques facet fixation system «Facet Wedge» in the treatment of degenerative diseases of the lumbar spine in elderly patients. The study included 39 elderly patients (older than 60), which carries out the transforaminal interbody fusion Cage «T-pal»: open transpedicaular stabilization was used in 1st group (n=23), ipsilateral open transpedicular stabilization with contralateral transfaset installing titanium Cage «facet Wedge» -in 2nd group (n=16). We used intraoperative interventions and specific post-operative patient management, clinical data and radiographic outcomes for a comparative analysis of the parameters. Dynamic assessment was made in a period of 8 to 36 months after surgery (median 24 mo.). As a result, it found that the use of the system «facet Wedge» allows you to achieve the best clinical outcomes and fewer postoperative complications compared with open transpedicular stabilization in similar radiographic findings of bone block formation. Low traumatic facet fixation makes it possible to use methods for the treatment of elderly patients with degenerative diseases of the lumbosacral spine.

  2. A Rare Case of Neglected Traumatic Anterior Dislocation of Hip in a Child.

    Science.gov (United States)

    Mootha, Aditya Krishna; Mogali, Kasi Viswanadam

    2016-01-01

    Post traumatic hip dislocations are very rare in children. Neglected anterior hip dislocations in children are not described in literature so far. Here, we present a case of 6 weeks old anterior hip dislocation successfully managed by open reduction. A 9-year-old male child presented with neglected anterior hip dislocation on left side. Open reduction carried out through direct anterior approach to hip. Congruent reduction is achieved. At final follow up of 1 year, the child had unrestricted activities of daily living and no radiological signs of osteonecrosis or any joint space reduction. There is paucity of literature over neglected post traumatic anterior hip dislocations in children. The treatment options vary from closed reduction after heavy traction to sub trochanteric osteotomy. However, we feel that open reduction through direct anterior approach is the preferred mode of management whenever considered possible.

  3. Irradiation of parametria by double-wedge

    International Nuclear Information System (INIS)

    Weisz, Csaba; Katona, Ernoe; Zarand, Pal; Polgar, Istvan; Nemeth, Gyoergy

    1984-01-01

    The dose distribution of a cobalt unit modified with a double-wedge as well as its combination with intracavitary radiotherapy was investigated. The measurements were made in both Alderson-Rando and wather phantom by using film densitometry, thermoluminescence dosimetry and ionization chambers. The dose distribution calculated on the basis of the Van de Geij program was in good agreement with the measurements. A homogeneous irradiation of the parametria can be obtained by using a combination of intracavitary and external double-wedge irradiation. (author)

  4. The Tax Wedge in Slovenia: International Comparison and Policy Recommendations

    Directory of Open Access Journals (Sweden)

    Primož Dolenc

    2005-09-01

    Full Text Available When taxes on labor are introduced, a “tax wedge” appears between the labor costs paid by the employer (gross wage and the net wage received by an employee. At a certain level of wage, a higher tax wedge increases unemployment and decreases employment, all other things being equal. The paper tackles three main questions: the characteristics of the tax wedge, unemployment and employment rates in OECD countries in the recent past, tax wedge policy in the EU15 and the new EU members and the tax system and its effects on the unemployment and employment rates in Slovenia. We found that the OECD countries can be classified into two groups of countries if the tax wedge, the unemployment rate and the employment rate are taken into consideration. The first group is the high tax wedge, high unemployment rate and low employment rate group of countries, whereas the other group has the opposite characteristics. European member states (old and new have on average a higher tax burden on labor than the OECD average, consequently suffering from higher unemployment rates. Slovenia has an unreasonably high tax wedge; in the EU only Belgium and Germany have a higher tax burden. According to previous and our empirical findings we suggest that Slovenia could benefit from a reduction in the tax wedge.

  5. Innovative wedge axe in making split firewood

    International Nuclear Information System (INIS)

    Mutikainen, A.

    1998-01-01

    Interteam Oy, a company located in Espoo, has developed a new method for making split firewood. The tools on which the patented System Logmatic are based are wedge axe and cylindrical splitting-carrying frame. The equipment costs about 495 FIM. The block of wood to be split is placed inside the upright carrying frame and split in a series of splitting actions using the innovative wedge axe. The finished split firewood remains in the carrying frame, which (as its name indicates) also serves as the means for carrying the firewood. This innovative wedge-axe method was compared with the conventional splitting of wood using an axe (Fiskars -handy 1400 splitting axe costing about 200 FIM) in a study conducted at TTS-Institute. There were eight test subjects involved in the study. In the case of the wedge-axe method, handling of the blocks to be split and of the finished firewood was a little quicker, but in actual splitting it was a little slower than the conventional axe method. The average productivity of splitting the wood and of the work stages related to it was about 0.4 m 3 per effective hour in both methods. The methods were also equivalent of one another in terms of the load imposed by the work when measured in terms of the heart rate. As regards work safety, the wedge-axe method was superior to the conventional method, but the continuous striking action and jolting transmitted to the arms were unpleasant (orig.)

  6. Three-dimensional wedge filling in ordered and disordered systems

    International Nuclear Information System (INIS)

    Greenall, M J; Parry, A O; Romero-Enrique, J M

    2004-01-01

    We investigate interfacial structural and fluctuation effects occurring at continuous filling transitions in 3D wedge geometries. We show that fluctuation-induced wedge covariance relations that have been reported recently for 2D filling and wetting have mean-field or classical analogues that apply to higher-dimensional systems. Classical wedge covariance emerges from analysis of filling in shallow wedges based on a simple interfacial Hamiltonian model and is supported by detailed numerical investigations of filling within a more microscopic Landau-like density functional theory. Evidence is presented that classical wedge covariance is also obeyed for filling in more acute wedges in the asymptotic critical regime. For sufficiently short-ranged forces mean-field predictions for the filling critical exponents and covariance are destroyed by pseudo-one-dimensional interfacial fluctuations. We argue that in this filling fluctuation regime the critical exponents describing the divergence of length scales are related to values of the interfacial wandering exponent ζ(d) defined for planar interfaces in (bulk) two-dimensional (d = 2) and three-dimensional (d = 3) systems. For the interfacial height l w ∼ θ-α) -β w , with θ the contact angle and α the wedge tilt angle, we find β w = ζ(2)/2(1-ζ(3)). For pure systems (thermal disorder) we recover the known result β w = 1/4 predicted by interfacial Hamiltonian studies whilst for random-bond disorder we predict the universal critical exponent β ∼ even in the presence of dispersion forces. We revisit the transfer matrix theory of three-dimensional filling based on an effective interfacial Hamiltonian model and discuss the interplay between breather, tilt and torsional interfacial fluctuations. We show that the coupling of the modes allows the problem to be mapped onto a quantum mechanical problem as conjectured by previous authors. The form of the interfacial height probability distribution function predicted by

  7. Prevalência de mordida aberta anterior e protrusão dentária em pré-escolares da cidade do Recife (PE, Brasil Prevalence of anterior open bite and overjet preschoolers in the city of Recife (PE, Brazil

    Directory of Open Access Journals (Sweden)

    Ana Flávia Granville-Garcia

    2010-10-01

    Full Text Available O objetivo deste trabalho foi verificar a prevalência de maloclusões (mordida aberta anterior, protrusão dentária e sua associação com idade, gênero e tipo de escola em 2.651 pré-escolares da cidade do Recife, PE, Brasil. As crianças foram sentadas em cadeiras escolares na sala da própria creche/escola para a execução do exame clínico; os menores de dois anos foram atendidos no sistema perna-perna ou joelho-joelho, por meio de iluminação natural e artificial. A protrusão dentária foi considerada quando sobressaliência maior que 3 mm, mensurada por meio de sonda periodontal milimetrada. A mordida aberta anterior foi registrada quando não houve contato com os dentes anteriores e os posteriores se mantiveram em oclusão. Foi registrada em ficha clínica a combinação dos dois tipos de maloclusão, ou seja, de mordida aberta e de protrusão dentária. Os dados foram avaliados estatisticamente pelo teste Qui-quadrado e a medida para avaliar a associação entre os eventos foi o odds ratio. A prevalência de protrusão dentária foi 66,1% e mordida aberta anterior, 19,8%; houve associação entre as maloclusões, idade e tipo de escola, porém não houve associação estatisticamente significante entre maloclusão e gênero. Conclui-se que a prevalência de maloclusões em pré-escolares foi elevada e esteve associada à idade e tipo de escola.The objective of this work was to verify the prevalence of malocclusions (anterior open bite, overjet and its association with age, gender and type of school with a sample of 2,651 preschool children in the city of Recife, PE, Brazil. The children were seated in school chairs in the room of the day care/school for the clinical exam, children aging two years or less were assisted in the system knee-knee, through natural and artificial illumination. The dental protrusion was verified when the overjet was larger than 3 mm through periodontal probe in millimeters. The presence of anterior open

  8. Clinical Experience Using a 3D-Printed Patient-Specific Instrument for Medial Opening Wedge High Tibial Osteotomy

    Directory of Open Access Journals (Sweden)

    Jesse Chieh-Szu Yang

    2018-01-01

    Full Text Available Purpose. High tibial osteotomy (HTO has been adopted as an effective surgery for medial degeneration of the osteoarthritis (OA knee. However, satisfactory outcomes necessitate the precise creation and distraction of osteotomized wedges and the use of intraoperative X-ray images to continually monitor the wedge-related manipulation. Thus HTO is highly technique-demanding and has a high radiation exposure. We report a patient-specific instrument (PSI guide for the precise creation and distraction of HTO wedge. Methods. This study first parameterized five HTO procedures to serve as a design rationale for an innovative PSI guide. Preoperative X-ray and computed tomography- (CT- scanning images were used to design and fabricate PSI guides for clinical use. The weight-bearing line (WBL of the ten patients was shifted to the Fujisawa’s point and instrumented using the TomoFix system. The radiological results of the PSI-guided HTO surgery were evaluated by the WBL percentage and tibial slope. Results. All patients consistently showed an increased range of motion and a decrease in pain and discomfort at about three-month follow-up. This study demonstrates the satisfactory accuracy of the WBL adjustment and tibial slope maintenance after HTO with PSI guide. For all patients, the average pre- and postoperative WBL are, respectively, 14.2% and 60.2%, while the tibial slopes are 9.9 and 10.1 degrees. The standard deviations are 2.78 and 0.36, respectively, in postoperative WBL and tibial slope. The relative errors of the pre- and postoperative WBL percentage and tibial slope averaged 4.9% and 4.1%, respectively. Conclusion. Instead of using navigator systems, this study integrated 2D and 3D preoperative planning to create a PSI guide that could most likely render the outcomes close to the planning. The PSI guide is a precise procedure that is time-saving, radiation-reducing, and relatively easy to use. Precise osteotomy and good short-term results were

  9. Optical wedge method for spatial reconstruction of particle trajectories

    International Nuclear Information System (INIS)

    Asatiani, T.L.; Alchudzhyan, S.V.; Gazaryan, K.A.; Zograbyan, D.Sh.; Kozliner, L.I.; Krishchyan, V.M.; Martirosyan, G.S.; Ter-Antonyan, S.V.

    1978-01-01

    A technique of optical wedges allowing the full reconstruction of pictures of events in space is considered. The technique is used for the detection of particle tracks in optical wide-gap spark chambers by photographing in one projection. The optical wedges are refracting right-angle plastic prisms positioned between the camera and the spark chamber so that through them both ends of the track are photographed. A method for calibrating measurements is given, and an estimate made of the accuracy of the determination of the second projection with the help of the optical wedges

  10. SOFTWARE FOR COMPUTER-AIDED DESIGN OF CROSS-WEDGE ROLLING

    OpenAIRE

    A. A. Abramov; S. V. Medvedev

    2013-01-01

    The issues of computer technology creation of 3D-design and engineering analysis of metal forming processes using cross wedge rolling methods (CWR) are considered. The developed software for computer-aided design and simulation of cross-wedge rolling is described.

  11. Three-dimensional vertebral wedging in mild and moderate adolescent idiopathic scoliosis.

    Directory of Open Access Journals (Sweden)

    Sophie-Anne Scherrer

    Full Text Available Vertebral wedging is associated with spinal deformity progression in adolescent idiopathic scoliosis. Reporting frontal and sagittal wedging separately could be misleading since these are projected values of a single three-dimensional deformation of the vertebral body. The objectives of this study were to determine if three-dimensional vertebral body wedging is present in mild scoliosis and if there are a preferential vertebral level, position and plane of deformation with increasing scoliotic severity.Twenty-seven adolescent idiopathic scoliotic girls with mild to moderate Cobb angles (10° to 50° participated in this study. All subjects had at least one set of bi-planar radiographs taken with the EOS® X-ray imaging system prior to any treatment. Subjects were divided into two groups, separating the mild (under 20° from the moderate (20° and over spinal scoliotic deformities. Wedging was calculated in three different geometric planes with respect to the smallest edge of the vertebral body.Factorial analyses of variance revealed a main effect for the scoliosis severity but no main effect of vertebral Levels (apex and each of the three vertebrae above and below it (F = 1.78, p = 0.101. Main effects of vertebral Positions (apex and above or below it (F = 4.20, p = 0.015 and wedging Planes (F = 34.36, p<0.001 were also noted. Post-hoc analysis demonstrated a greater wedging in the inferior group of vertebrae (3.6° than the superior group (2.9°, p = 0.019 and a significantly greater wedging (p≤0.03 along the sagittal plane (4.3°.Vertebral wedging was present in mild scoliosis and increased as the scoliosis progressed. The greater wedging of the inferior group of vertebrae could be important in estimating the most distal vertebral segment to be restrained by bracing or to be fused in surgery. Largest vertebral body wedging values obtained in the sagittal plane support the claim that scoliosis could be initiated

  12. Two brittle ductile transitions in subduction wedges, as revealed by topography

    Science.gov (United States)

    Thissen, C.; Brandon, M. T.

    2013-12-01

    Subduction wedges contain two brittle ductile transitions. One transition occurs within the wedge interior, and a second transition occurs along the decollement. The decollement typically has faster strain rates, which suggests that the brittle ductile transition along the decollement will be more rearward (deeper) than the transition within the interior. However, the presence of distinct rheologies or other factors such as pore fluid pressure along the decollement may reverse the order of the brittle-ductile transitions. We adopt a solution by Williams et al., (1994) to invert for these brittle ductile transitions using the wedge surface topography. At present, this model does not include an s point or sediment loading atop the wedge. The Hellenic wedge, however, as exposed in Crete presents an ideal setting to test these ideas. We find that the broad high of the Mediterranean ridge represents the coulomb frictional part of the Hellenic wedge. The rollover in topography north of the ridge results from curvature of the down going plate, creating a negative alpha depression in the vicinity of the Strabo, Pliny, and Ionian 'troughs' south of Crete. A steep topographic rise out of these troughs and subsequent flattening reflects the brittle ductile transition at depth in both the decollement and the wedge interior. Crete exposes the high-pressure viscous core of the wedge, and pressure solution textures provide additional evidence for viscous deformation in the rearward part of the wedge. The location of the decollement brittle ductile transition has been previously poorly constrained, and Crete has never experienced a subduction zone earthquake in recorded history. Williams, C. A., et al., (1994). Effect of the brittle ductile transition on the topography of compressive mountain belts on Earth and Venus. Journal of Geophysical Research Solid Earth

  13. On the practice of the clinical implementation of enhanced dynamic wedges

    International Nuclear Information System (INIS)

    Koken, Phil W.; Heukelom, Stan; Cuijpers, Johan P.

    2003-01-01

    Practical aspects of the clinical implementation of enhanced dynamic wedges (EDW) replacing manual wedges are presented and discussed extensively. A comparison between measured and calculated data is also presented. Relative dose distributions and wedge factors were calculated with a commercially available treatment planning system and measured in a water-phantom and with an ionization chamber. Wedge factor calculations and measurements were also compared with an independent method of wedge factor calculations available from the literature. Aspects of the clinical implementation, such as safety and quality assurance, were evaluated. Measurements and calculations agreed very well and were slightly better than results of previous studies. Profiles and percentage depth doses (PDDs) agreed within 1% to 1.5% and within 0.5%, respectively. Measured and calculated wedge factors ratios agreed within 0.5% to 1%. Calculated and measured EDW dose distributions showed excellent agreement, both relative and absolute. However, for safe and practical use, specific aspects need to be taken into consideration. Once the treatment planning system is commissioned properly, the clinical implementation of EDW is rather straightforward

  14. Glaucoma anterior chamber morphometry based on optical Scheimpflug images.

    Science.gov (United States)

    Alonso, Ruiz Simonato; Ambrósio Junior, Renato; Paranhos Junior, Augusto; Sakata, Lisandro Massanori; Ventura, Marcelo Palis

    2010-01-01

    To compare the performance of gonioscopy and noncontact morphometry with anterior chamber tomography (High Resolution Pentacam - HR) using optical Scheimpflug images in the evaluation of the anterior chamber angle (ACA). Transversal study. 112 eyes from 74 subjects evaluated at the Glaucoma Department, Fluminense Federal University, underwent gonioscopy and Pentacam HR. Using gonioscopy, the ACA was graded using the Shaffer Classification (SC) by a single experienced examiner masked to the Pentacam HR findings. Narrow angle was determined in eyes in which the posterior trabecular meshwork could not be seen in two or more quadrants on non-indentation gonioscopy (SC Grade 2 or less). Pentacam HR images of the nasal and temporal quadrants were evaluated by custom software to automatically obtain anterior chamber measurements, such as: anterior chamber angle (ACA), anterior chamber volume (ACV) and anterior chamber depth (ACD). Based on gonioscopy results, 74 (60.07%) eyes of patients classified as open-angle (SC 3 and 4) and 38 (33.93%) eyes of patients classified as narrow-angle (SC 1 and 2). Noncontact morphometry with Scheimpflug images revealed a mean ACA of 39.20 ± 5.31 degrees for open-angle and 21.18 ± 7.98 degrees for narrow-angle. The open-angle group showed significant greater ACV and ACD values when compared to narrow-angle group (ACV of 193 ± 36 mm³ vs. 90 ± 25 mm³, respectively, p<0.001; and ACD of 3,09 ± 0,42 mm vs. 1,55 ± 0,64 mm, respectively, p<0.0001.). In screening eyes with open-angle and narrow-angle with the Pentacam ACA of 20º (SC Grade 2) using the ROC curves, the analysis showed 52.6% of sensitivity and 100% of specificity. The Pentacam showed ability in detecting eyes at risk for angle closure analyzing ACV and ACD.

  15. Analysis of surface and build up region dose for motorized wedge and omni wedge

    International Nuclear Information System (INIS)

    Panta, Raj Kumar; Sundarum, T.

    2008-01-01

    Megavoltage x-ray beam exhibits the well known phenomenon of dose build-up within the first few millimeters of incident phantom surface or skin. The skin sparing effect of high energy gamma or x-ray photon may be reduced or even lost, if the beam is contaminated with electron or low energy photons. Since skin dose in the treatment of deeply seated tumor may be a limiting factor in the delivery of tumoricidal dose due to possible complications such as erythema, desquamation, fibrosis, necrosis and epilation, the dose distribution in the build up region should be known. The objective of this study was to measure and investigate the surface and build-up region dose for 6 MV and 15 MV photon beam for Motorized wedge and Omni wedge in Precise Digital Linear Accelerator (Elekta)

  16. Wedges of Anxiety

    DEFF Research Database (Denmark)

    Hellström, Maria; Brandt, Eva

    2005-01-01

    The Heraclitian notion of a reality in constant flux seems to have settled even in the public consciousness. We are, to an ever-increasing extent, on the move; in motion between different places of abode, between domiciles and places of residence, between temporary addresses and provisory settlem...... cones of light, as the cut their way into the unknown, like wedges of anxiety...

  17. Employment and productivity: The role of the tax wedge

    Directory of Open Access Journals (Sweden)

    Andrea FESTA

    2015-11-01

    Full Text Available After the economic crisis, many countries aim at reducing unemployment and foster productivity. To address these issues one of the most common policy indications recommends lowering the tax wedge on labour in order to increase employment and growth. As a consequence, a review of the empirical studies focused on the relation between tax wedge, employment and productivity is an useful and demanding exercise, especially in those European countries where the topic is on the front page of the domestic policy debate because the productivity growth is low and the tax wedge on labour is high.

  18. Casimir effect for a semitransparent wedge and an annular piston

    International Nuclear Information System (INIS)

    Milton, Kimball A.; Wagner, Jef; Kirsten, Klaus

    2009-01-01

    We consider the Casimir energy due to a massless scalar field in a geometry of an infinite wedge closed by a Dirichlet circular cylinder, where the wedge is formed by δ-function potentials, so-called semitransparent boundaries. A finite expression for the Casimir energy corresponding to the arc and the presence of both semitransparent potentials is obtained, from which the torque on the sidewalls can be derived. The most interesting part of the calculation is the nontrivial nature of the angular mode functions. Numerical results are obtained which are closely analogous to those recently found for a magnetodielectric wedge, with the same speed of light on both sides of the wedge boundaries. Alternative methods are developed for annular regions with radial semitransparent potentials, based on reduced Green's functions for the angular dependence, which allows calculations using the multiple-scattering formalism. Numerical results corresponding to the torque on the radial plates are likewise computed, which generalize those for the wedge geometry. Generally useful formulas for calculating Casimir energies in separable geometries are derived.

  19. Are Pericentric Inversions Reorganizing Wedge Shell Genomes?

    Directory of Open Access Journals (Sweden)

    Daniel García-Souto

    2017-12-01

    Full Text Available Wedge shells belonging to the Donacidae family are the dominant bivalves in exposed beaches in almost all areas of the world. Typically, two or more sympatric species of wedge shells differentially occupy intertidal, sublittoral, and offshore coastal waters in any given locality. A molecular cytogenetic analysis of two sympatric and closely related wedge shell species, Donax trunculus and Donax vittatus, was performed. Results showed that the karyotypes of these two species were both strikingly different and closely alike; whilst metacentric and submetacentric chromosome pairs were the main components of the karyotype of D. trunculus, 10–11 of the 19 chromosome pairs were telocentric in D. vittatus, most likely as a result of different pericentric inversions. GC-rich heterochromatic bands were present in both species. Furthermore, they showed coincidental 45S ribosomal RNA (rRNA, 5S rRNA and H3 histone gene clusters at conserved chromosomal locations, although D. trunculus had an additional 45S rDNA cluster. Intraspecific pericentric inversions were also detected in both D. trunculus and D. vittatus. The close genetic similarity of these two species together with the high degree of conservation of the 45S rRNA, 5S rRNA and H3 histone gene clusters, and GC-rich heterochromatic bands indicate that pericentric inversions contribute to the karyotype divergence in wedge shells.

  20. Ocorrência de mordida aberta anterior e hábitos bucais deletérios em crianças de 4 a 6 anos Occurrence of anterior open bite and harmful oral habits in children from 4 to 6-year old

    Directory of Open Access Journals (Sweden)

    Maritza Zapata

    2010-04-01

    Full Text Available OBJETIVO: verificar a ocorrência de mordida aberta anterior e de hábitos orais deletérios em crianças de quatro a seis anos de idade. MÉTODOS: foram avaliadas 266 crianças de quatro a seis anos incompletos, de ambos os gêneros, na cidade de Suzano - São Paulo. As avaliações constaram de aplicação de ficha de avaliação para detecção de ocorrência de hábitos bucais deletérios aos responsáveis e da realização de exame clínico constituído por avaliação da oclusão das crianças. RESULTADOS: verificou-se que 221 crianças (83,1% apresentaram pelo menos um hábito bucal deletério, sendo o mais frequente o uso de mamadeira 167 (75,6%. A ocorrência simultânea de hábitos deletérios e alterações de oclusão dentária foi observada em 119 crianças (44,1% da amostra e nestas, a maior prevalência foi a presença da mordida aberta anterior, presente em 89 (79,8%. CONCLUSÃO: a mordida aberta anterior (MAA foi a alteração oclusal mais prevalente nas crianças, havendo associação estatisticamente significante entre hábitos orais deletérios, como uso de mamadeira, chupeta e ocorrência de bruxismo e presença de mordida aberta anterior.PURPOSE: to determine the occurrence of anterior open bite and harmful oral habits in children from four to six-year old. METHODS: a total of 266 four-to-six-year-old male and female children in the city of Suzano (São Paulo, Brazil were evaluated. An assessment chart for detecting the occurrence of harmful oral habits was administered to the guardians and clinical exams were performed for assessing occlusion in the children. RESULTS: a total of 221 children (83.1% had at least one harmful oral habit, the most frequent of which was the use of a feeding bottle (n=167; 75.6%. The occurrence of simultaneous harmful habits and dental occlusion abnormalities was observed in 119 children (44.1% of the sample; among these children, the greatest prevalence was of anterior open bite (n=89; 79

  1. Multiple phases and vicious walkers in a wedge

    Directory of Open Access Journals (Sweden)

    Gesualdo Delfino

    2015-12-01

    Full Text Available We consider a statistical system in a planar wedge, for values of the bulk parameters corresponding to a first order phase transition and with boundary conditions inducing phase separation. Our previous exact field theoretical solution for the case of a single interface is extended to a class of systems, including the Blume–Capel model as the simplest representative, allowing for the appearance of an intermediate layer of a third phase. We show that the interfaces separating the different phases behave as trajectories of vicious walkers, and determine their passage probabilities. We also show how the theory leads to a remarkable form of wedge covariance, i.e. a relation between properties in the wedge and in the half plane, which involves the appearance of self-Fourier functions.

  2. Surface Geophysical Measurements for Locating and Mapping Ice-Wedges

    DEFF Research Database (Denmark)

    Ingeman-Nielsen, Thomas; Tomaskovicova, Sonia; Larsen, S.H.

    2012-01-01

    to test the applicability of DC electrical resistivity tomography (ERT) and Ground Penetrating Radar (GPR) to identifying and mapping ice-wedge occurrences. The site is located in Central West Greenland, and the ice-wedges are found in a permafrozen peat soil with an active layer of about 30 cm. ERT...

  3. Superior dislocation hip with anterior column acetabular fracture ...

    African Journals Online (AJOL)

    Superior variety of anterior dislocation of the hip is a rare injury. Its occurrence with acetabular fractures has been documented infrequently. We report a case of superior dislocation of the hip with anterior column acetabular fracture. Open reduction of the hip and internal fixation of the fracture was carried out using a twin ...

  4. Dissolved organic carbon loss from Yedoma permafrost amplified by ice wedge thaw

    International Nuclear Information System (INIS)

    Vonk, J E; Mann, P J; Spencer, R G M; Bulygina, E B; Holmes, R M; Dowdy, K L; Davydova, A; Davydov, S P; Zimov, N; Eglinton, T I

    2013-01-01

    Pleistocene Yedoma permafrost contains nearly a third of all organic matter (OM) stored in circum-arctic permafrost and is characterized by the presence of massive ice wedges. Due to its rapid formation by sediment accumulation and subsequent frozen storage, Yedoma OM is relatively well preserved and highly biologically available (biolabile) upon thaw. A better understanding of the processes regulating Yedoma degradation is important to improve estimates of the response and magnitude of permafrost carbon feedbacks to climate warming. In this study, we examine the composition of ice wedges and the influence of ice wedge thaw on the biolability of Yedoma OM. Incubation assays were used to assess OM biolability, fluorescence spectroscopy to characterize the OM composition, and potential enzyme activity rates to examine the controls and regulation of OM degradation. We show that increasing amounts of ice wedge melt water in Yedoma-leached incubations enhanced the loss of dissolved OM over time. This may be attributed to the presence of low-molecular weight compounds and low initial phenolic content in the OM of ice wedges, providing a readily available substrate that promotes the degradation of Yedoma OC. The physical vulnerability of ice wedges upon thaw (causing irreversible collapse), combined with the composition of ice wedge-engrained OM (co-metabolizing old OM), underlines the particularly strong potential of Yedoma to generate a positive feedback to climate warming relative to other forms of non-ice wedge permafrost. (letter)

  5. Changes in anterior segment morphology in response to illumination and after laser iridotomy in Asian eyes: an anterior segment OCT study

    Science.gov (United States)

    See, Jovina L S; Chew, Paul T K; Smith, Scott D; Nolan, Winifred P; Chan, Yiong‐Huak; Huang, David; Zheng, Ce; Foster, Paul J; Aung, Tin; Friedman, David S

    2007-01-01

    Aim Using the anterior segment optical coherence tomography (AS‐OCT) to quantify changes in anterior segment morphology going from light to dark and following laser iridotomy (LI). Methods Prospective observational study. 17 consecutive subjects without peripheral anterior synechiae undergoing LI were evaluated using gonioscopy and AS‐OCT. Angle configuration including angle opening distance (AOD) at 500 microns anterior to the scleral spur, AOD500, trabecular‐iris space area up to 750 microns from the scleral spur, TISA750 and the increase in angle opening going from dark to light conditions was determined. Results Both mean AOD500 and TISA750 increased nearly threefold going from dark to light. Both also significantly increased following LI (p<0.001) as did gonioscopic grading of the angle in all quadrants (p<0.001, McNemar's test). Angles were more than twice as wide on average in the dark after LI than before LI (p<0.05). Both the mean absolute change and the mean proportionate change in AOD500 and TISA750 when going from light to dark were greater after LI than before (p<0.05). Conclusion Increased illumination as well as LI resulted in significant widening of the anterior chamber angle. AS‐OCT (which does not require a water bath and can be performed with the patient at the slit lamp) identified similar magnitude changes as those previously reported using ultrasound biomicroscopy (UBM). Furthermore, the angle appears to open more both in absolute terms and and proportionate terms in response to illumination after LI. PMID:17504852

  6. Degradation and stabilization of ice wedges: Implications for assessing risk of thermokarst in northern Alaska

    Science.gov (United States)

    Kanevskiy, Mikhail; Shur, Yuri; Jorgenson, Torre; Brown, Dana R. N.; Moskalenko, Nataliya; Brown, Jerry; Walker, Donald A.; Raynolds, Martha K.; Buchhorn, Marcel

    2017-11-01

    Widespread degradation of ice wedges has been observed during the last decades in numerous areas within the continuous permafrost zone of Eurasia and North America. To study ice-wedge degradation, we performed field investigations at Prudhoe Bay and Barrow in northern Alaska during 2011-2016. In each study area, a 250-m transect was established with plots representing different stages of ice-wedge degradation/stabilization. Field work included surveying ground- and water-surface elevations, thaw-depth measurements, permafrost coring, vegetation sampling, and ground-based LiDAR scanning. We described cryostratigraphy of frozen soils and stable isotope composition, analyzed environmental characteristics associated with ice-wedge degradation and stabilization, evaluated the vulnerability and resilience of ice wedges to climate change and disturbances, and developed new conceptual models of ice-wedge dynamics that identify the main factors affecting ice-wedge degradation and stabilization and the main stages of this quasi-cyclic process. We found significant differences in the patterns of ice-wedge degradation and stabilization between the two areas, and the patterns were more complex than those previously described because of the interactions of changing topography, water redistribution, and vegetation/soil responses that can interrupt or reinforce degradation. Degradation of ice wedges is usually triggered by an increase in the active-layer thickness during exceptionally warm and wet summers or as a result of flooding or disturbance. Vulnerability of ice wedges to thermokarst is controlled by the thickness of the intermediate layer of the upper permafrost, which overlies ice wedges and protects them from thawing. In the continuous permafrost zone, degradation of ice wedges rarely leads to their complete melting; and in most cases wedges eventually stabilize and can then resume growing, indicating a somewhat cyclic and reversible process. Stabilization of ice wedges

  7. Graphene Plasmons in Triangular Wedges and Grooves

    DEFF Research Database (Denmark)

    Gonçalves, P. A. D.; Dias, E. J. C.; Xiao, Sanshui

    2016-01-01

    and tunability of graphene plasmons guided along the apex of a graphene-covered dielectric wedge or groove. In particular, we present a quasi-analytic model to describe the plasmonic eigenmodes in such a system, including the complete determination of their spectrum and corresponding induced potential...... and electric-field distributions. We have found that the dispersion of wedge/groove graphene plasmons follows the same functional dependence as their flat-graphene plasmon counterparts, but now scaled by a (purely) geometric factor in which all the information about the system’s geometry is contained. We...

  8. Natural orifice transgastric endoscopic wedge hepatic resection in an experimental model using an intuitively controlled master and slave transluminal endoscopic robot (MASTER).

    Science.gov (United States)

    Phee, S J; Ho, K Y; Lomanto, D; Low, S C; Huynh, V A; Kencana, A P; Yang, K; Sun, Z L; Chung, S C Sydney

    2010-09-01

    The lack of triangulation of standard endoscopic devices limits the degree of freedom for surgical maneuvers during natural orifice transluminal endoscopic surgery (NOTES). This study explored the feasibility of adapting an intuitively controlled master and slave transluminal endoscopic robot (MASTER) the authors developed to facilitate wedge hepatic resection in NOTES. The MASTER consists of a master controller, a telesurgical workstation, and a slave manipulator that holds two end-effectors: a grasper, and a monopolar electrocautery hook. The master controller is attached to the wrist and fingers of the operator and connected to the manipulator by electrical and wire cables. Movements of the operator are detected and converted into control signals driving the slave manipulator via a tendon-sheath power transmission mechanism allowing nine degrees of freedom. Using this system, wedge hepatic resection was performed through the transgastric route on two female pigs under general anesthesia. Entry into the peritoneal cavity was via a 10-mm incision made on the anterior wall of the stomach by the electrocautery hook. Wedge hepatic resection was performed using the robotic grasper and hook. Hemostasis was achieved with the electrocautery hook. After the procedure, the resected liver tissue was retrieved through the mouth using the grasper. Using the MASTER, transgastric wedge hepatic resection was successfully performed on two pigs with no laparoscopic assistance. The entire procedure took 9.4 min (range, 8.5-10.2 min), with 7.1 min (range, 6-8.2 min) spent on excision of the liver tissue. The robotics-controlled device was able to grasp, retract, and excise the liver specimen successfully in the desired plane. This study demonstrated for the first time that the MASTER could effectively mitigate the technical constraints normally encountered in NOTES procedures. With it, the triangulation of surgical tools and the manipulation of tissue became easy, and wedge hepatic

  9. Evaluation method of lead measurement accuracy of gears using a wedge artefact

    International Nuclear Information System (INIS)

    Komori, Masaharu; Takeoka, Fumi; Kubo, Aizoh; Okamoto, Kazuhiko; Osawa, Sonko; Sato, Osamu; Takatsuji, Toshiyuki

    2009-01-01

    The reduction of the vibration and noise of gears is an important issue in mechanical devices such as vehicles and wind turbines. The characteristics of the vibration and noise of gears are markedly affected by deviations of the tooth flank form of micrometre order; therefore, a strict quality control of the tooth flank form is required. The accuracy of the lead measurement for a gear-measuring instrument is usually evaluated using a master gear or a lead master. However, it is difficult to manufacture masters with high accuracy because the helix is a complicated geometrical form. In this paper, we propose a method of evaluating a gear-measuring instrument using a wedge artefact, which includes a highly precise plane surface. The concept of the wedge artefact is described and a mathematical model of the measuring condition of the wedge artefact is constructed. Theoretical measurement results for the wedge artefact are calculated. The wedge artefact is designed and produced on the basis of the theoretical measurement results. A measurement experiment using the wedge artefact is carried out and its effectiveness is verified

  10. Chemical risk factors responsible for the formation of wedge-shaped lesions

    Directory of Open Access Journals (Sweden)

    Perić Dejan

    2015-01-01

    Full Text Available Introduction: Non-carious tooth substances loss pose a major health problem of a modern man. The literature often collectively describes all non-carious lesions and is therefore difficult to compare results obtained by different authors. Chemical factors are one of the predisposing factors responsible for the formation of wedge-shaped erosions. Aim: Examination of chemical risk factors as one of the predisposing causes responsible for the formation of wedge-shaped lesions. Method: We examined 62 patients with wedge-shaped erosions (mean age 45.52 ± 12.03 years, 58.1% of men and 60 patients without erosions in the control group (mean age 34.40 ± 9.28 years, 60% men . The entire examination was completed by using a questionnaire at the Dental Clinic of the University of Pristina - Kosovska Mitrovica. salivary pH was measured by the pH meter. Results: The results show that the wedge-shaped lesions often occur equally in both men and women. Considerably often it might appear in older people but can also occur in teenagers. Patients with wedge-shaped erosion have increased acidity of saliva, a heightened sense of acid in the mouth and consume a lot more carbonated drinks compared to patients without erosions. Conclusion: Wedge-shaped lesions are more common in people older than 40 years. Taking into account the results obtained in this study it can be concluded that the chemical risk factors truly fall within the predisposing factors that may be responsible for the creation of wedge-shaped erosions.

  11. Galvanic vestibular stimulation may improve anterior bending posture in Parkinson's disease.

    Science.gov (United States)

    Okada, Yohei; Kita, Yorihiro; Nakamura, Junji; Kataoka, Hiroshi; Kiriyama, Takao; Ueno, Satoshi; Hiyamizu, Makoto; Morioka, Shu; Shomoto, Koji

    2015-05-06

    This study investigated the effects of binaural monopolar galvanic vestibular stimulation (GVS), which likely stimulates the bilateral vestibular system, on the anterior bending angle in patients with Parkinson's disease (PD) with anterior bending posture in a single-blind, randomized sham-controlled crossover trial. The seven PD patients completed two types of stimulation (binaural monopolar GVS and sham stimulation) applied in a random order 1 week apart. We measured each patient's anterior bending angles while he or she stood with eyes open and eyes closed before/after the stimulations. The anterior bending angles in both the eyes-open and the eyes-closed conditions were significantly reduced after the GVS. The amount of change in the eyes-closed condition post-GVS was significantly larger than that by sham stimulation. The amount of change in anterior bending angles in the GVS condition was not significantly correlated with Unified Parkinson's Disease Rating Scale motor score, disease duration, the duration of the postural deformities, and the anterior bending angles before the GVS. Binaural monopolar GVS might improve anterior bending posture in PD patients, irrespective of the duration and the severity of disease and postural deformities. Binaural monopolar GVS might be a novel treatment strategy to improve anterior bending posture in PD.

  12. Numerical Study on Critical Wedge Angle of Cellular Detonation Reflections

    International Nuclear Information System (INIS)

    Gang, Wang; Kai-Xin, Liu; De-Liang, Zhang

    2010-01-01

    The critical wedge angle (CWA) for the transition from regular reflection (RR) to Mach reflection (MR) of a cellular detonation wave is studied numerically by an improved space-time conservation element and solution element method together with a two-step chemical reaction model. The accuracy of that numerical way is verified by simulating cellular detonation reflections at a 19.3° wedge. The planar and cellular detonation reflections over 45°–55° wedges are also simulated. When the cellular detonation wave is over a 50° wedge, numerical results show a new phenomenon that RR and MR occur alternately. The transition process between RR and MR is investigated with the local pressure contours. Numerical analysis shows that the cellular structure is the essential reason for the new phenomenon and the CWA of detonation reflection is not a certain angle but an angle range. (fundamental areas of phenomenology(including applications))

  13. Localization of observables in the Rindler wedge

    Science.gov (United States)

    Asorey, M.; Balachandran, A. P.; Marmo, G.; de Queiroz, A. R.

    2017-11-01

    One of the striking features of QED is that charged particles create a coherent cloud of photons. The resultant coherent state vectors of photons generate a nontrivial representation of the localized algebra of observables that do not support a representation of the Lorentz group: Lorentz symmetry is spontaneously broken. We show in particular that Lorentz boost generators diverge in this representation, a result shown also by Balachandran et al. [Eur. Phys. J. C 75, 89 (2015), 10.1140/epjc/s10052-015-3305-0] (see also the work by Balachandran et al. [Mod. Phys. Lett. A 28, 1350028 (2013), 10.1142/S0217732313500284]. Localization of observables, for example in the Rindler wedge, uses Poincaré invariance in an essential way [Int. J. Geom. Methods Mod. Phys. 14, 1740008 (2017)., 10.1142/S0219887817400084]. Hence, in the presence of charged fields, the photon observables cannot be localized in the Rindler wedge. These observations may have a bearing on the black hole information loss paradox, as the physics in the exterior of the black hole has points of resemblance to that in the Rindler wedge.

  14. A predictive factor for acquiring an ideal lower limb realignment after opening-wedge high tibial osteotomy.

    Science.gov (United States)

    Bito, Haruhiko; Takeuchi, Ryohei; Kumagai, Ken; Aratake, Masato; Saito, Izumi; Hayashi, Riku; Sasaki, Yohei; Aota, Yoichi; Saito, Tomoyuki

    2009-04-01

    Obtaining a correct postoperative limb alignment is an important factor in achieving a successful clinical outcome after an opening-wedge high tibial osteotomy (OWHTO). To better predict some of the aspects that impact upon the clinical outcomes following this procedure, including postoperative correction loss and over correction, we examined the changes in the frontal plane of the lower limb in a cohort of patients who had undergone OWHTO using radiography. Forty-two knees from 33 patients (23 cases of osteoarthritis and 10 of osteonecrosis) underwent a valgus realignment OWHTO procedure and were radiographically assessed for changes that occurred pre- and post-surgery. The mean femorotibial angle (FTA) was found to be 182.1 +/- 2.0 degrees (12 +/- 2.0 anatomical varus angulation) preoperatively and 169.6 +/- 2.4 degrees (10.4 +/- 2.4 anatomical valgus angulation) postoperatively. These measurements thus revealed significant changes in the weight bearing line ratio (WBL), femoral axis angle (FA), tibial axis angle (TA), tibia plateau angle (TP), tibia vara angle (TV) and talar tilt angle (TT) following OWHTO. In contrast, no significant change was found in the weight bearing line angle (WBLA) after these treatments. To assess the relationship between the correction angle and these indexes, 42 knees were divided into the following three groups according to the postoperative FTA; a normal correction group (168 degrees FTA FTA FTA > 172 degrees ). There were significant differences in the delta angle [DA; calculated as (pre FTA - post FTA) - (pre TV - post TV)] among each group of patients. Our results thus indicate a negative correlation between the DA and preoperative TA (R(2) = 0.148, p < 0.05). Hence, given that the correction errors in our patients appear to negatively correlate with the preoperative TA, postoperative malalignments are likely to be predictable prior to surgery.

  15. Pilot production of the wedge filter for the TBI (total body irradiation)

    International Nuclear Information System (INIS)

    Ikezaki, Hiromi; Ikeda, Ikuo; Maruyama, Yasushi; Nako, Yasunobu; Tonari, Ayako; Kusuda, Junko; Takayama, Makoto

    2007-01-01

    Total body irradiation (TBI) is performed by various methods, such as a long SSD method and a translational couch method. For patient safety in carrying out TBI, the patient should be placed on the supine position and prone position near the floor. TBI is performed from 2 opposite ports (AP/PA) with a linear accelerator (10 MV X-ray). We experimented with a wedge filter for TBI created by us, which makes dose distribution to a floor uniform. The wedge filter, made of iron alloy, was attached to the linear accelerator. In designing the wedge filter, thickness of the lead-made wedge filter can be calculated numerically from the ratio of linear attenuation coefficient of iron alloy and lead. In measuring the dose profile for a phantom of 20 cm thick, dose homogeneity less than 10% was proved by the wedge filter for TBI. (author)

  16. Contemporary sand wedge development in seasonally frozen ground and paleoenvironmental implications

    Science.gov (United States)

    Wolfe, Stephen A.; Morse, Peter D.; Neudorf, Christina M.; Kokelj, Steven V.; Lian, Olav B.; O'Neill, H. Brendan

    2018-05-01

    Contemporary sand wedges and sand veins are active in seasonally frozen ground within the extensive discontinuous permafrost zone in Northwest Territories, Canada. The region has a subarctic continental climate with 291 mm a-1 precipitation, -4.1 °C mean annual air temperature, warm summers (July mean 17.0 °C), and cold winters (January mean -26.6 °C). Five years of continuous observations indicate that interannual variation of the ground thermal regime is dominantly controlled by winter air temperature and snow cover conditions. At sandy sites, thin snow cover and high thermal conductivity promote rapid freezing, high rates of ground cooling, and low near-surface ground temperatures (-15 to -25 °C), resulting in thermal contraction cracking to depths of 1.2 m. Cracking potentials are high in sandy soils when air temperatures are air temperatures are ≤-17 °C, and snow cover is conditions in peatlands maintain permafrost, but thermal contraction cracking does not occur because thicker snow cover and the thermal properties of peat prolong freezeback and maintain higher winter ground temperatures. A combination of radiocarbon dating, optical dating, and stratigraphic observations were used to differentiate sand wedge types and formation histories. Thermal contraction cracks that develop in the sandy terrain are filled by surface (allochthonous) and/or host (autochthonous) material during the thaw season. Epigenetic sand wedges infilled with allochthonous sand develop within former beach sediments beneath an active eolian sand sheet. Narrower and deeper syngenetic wedges developed within aggrading eolian sand sheets, whereas wider and shallower antisyngenetic wedges developed in areas of active erosion. Thermal contraction cracking beneath vegetation-stabilized surfaces leads to crack infilling by autochthonous host and overlying organic material, with resultant downturning and subsidence of adjacent strata. Sand wedge development in seasonally frozen ground

  17. The effect of shoe design and lateral wedging on knee loading

    DEFF Research Database (Denmark)

    Mølgaard, Carsten; Kersting, Uwe G.

    The increasing number of patients with developing osteoarthritis is accompanied by a growing scientific interest in non-operative early treatment strategies. It is generally believed that laterally wedged insoles can change the distribution of the knee loading, but the importance of footwear design...... shoe were revealed. Conclusion: Lateral wedging is effective regardless of shoe design. Differences between the four neutral walking conditions underline the importance of footwear choice in individuals. It is safe to apply lateral wedges without jeopardizing muscular control during walking regardless...

  18. Anterior eye protection with orbital neoplasia

    International Nuclear Information System (INIS)

    Hancock, S.L.

    1986-01-01

    The administration of adequate doses of radiation to tumors involving the orbit and surrounding facial structures and sinuses is often complicated by the need to protect the sensitive ocular components, the lens and cornea. A technique has been devised that uses four photon beam fields and an optional electron field to treat the contents of both orbits and adjacent sinuses with effective, reproducible protection of cornea and lens. Essential features include: alignment of the corneal surfaces with the central plane of rotation of the treatment machine, use of a narrow eye block across the entire beam to shield a strip equal to the width of the cornea, positioned symmetrically across the central plane of rotation, fine alignment of the eye block with both corneal surfaces by altering pedestal angle, treatment with paired, wedged, anterior oblique fields to encompass desired orbital and sinus volumes with additional blocking placed as needed, and complementary, lateral strip fields using collimators set to eye block thickness to equalize dose in the posterior orbit shielded by the strip eye block. A similar anterior electron beam strip field may be added to boost the medial orbit and ethmoid regions covered by the eye block. Bite block head immobilization and easy, direct daily visualization of block position assures eye protection for each treatment and provides substantial reduction in dose to the cornea, lens and iris. Additional blocking may be incorporated to provide partial lacrimal and parotid sparing

  19. Wedge gate valves selecting essentials in pipeline systems designing based on permissible operation parameters

    Science.gov (United States)

    Zakirnichnaya, M. M.; Kulsharipov, I. M.

    2017-10-01

    Wedge gate valves are widely used at the fuel and energy complex enterprises. The pipeline valves manufacturers indicate the safe operation resource according to the current regulatory and technical documentation. In this case, the resource value of the valve body strength calculation results is taken into consideration as the main structural part. However, it was determined that the wedge gate valves fail before the assigned resource due to the occurrence of conditions under which the wedge breaks in the hooks and, accordingly, the sealing integrity is not ensured. In this regard, it became necessary to assess the conditions under which the resource should be assigned not only to the valve body, but also to take into account the wedge durability. For this purpose, wedge resource calculations were made using the example of ZKL2 250-25 and ZKL2 300-25 valves using the ABAQUS software package FE-SAFE module under the technological parameters influence on the basis of their stressstrain state calculation results. Operating conditions, under which the wedge resource value is lower than the one set by the manufacturer, were determined. A technique for limiting the operating parameters for ensuring the wedge durability during the wedge gate valve assigned resource is proposed.

  20. Anterior vaginal wall repair (surgical treatment of urinary incontinence) - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100110.htm Anterior vaginal wall repair (surgical treatment of urinary incontinence) - series— ... to slide 4 out of 4 Overview The vaginal opening lies just below the urethral opening, and ...

  1. Modeling and Stability Analysis of Wedge Clutch System

    Directory of Open Access Journals (Sweden)

    Jian Yao

    2014-01-01

    Full Text Available A wedge clutch with unique features of self-reinforcement and small actuation force was designed. Its self-reinforcement feature, associated with different factors such as the wedge angle and friction coefficient, brings different dynamics and unstable problem with improper parameters. To analyze this system, a complete mathematical model of the actuation system is built, which includes the DC motor, the wedge mechanism, and the actuated clutch pack. By considering several nonlinear factors, such as the slip-stick friction and the contact or not of the clutch plates, the system is piecewise linear. Through the stability analysis of the linearized system in clutch slipping phase, the stable condition of the designed parameters is obtained as α>arctan⁡(μc. The mathematical model of the actuation system is validated by prototype testing. And with the validated model, the system dynamics in both stable and unstable conditions is investigated and discussed in engineering side.

  2. Investigation of turbulent wedges generated by different single surface roughness elements

    Science.gov (United States)

    Traphan, Dominik; Meinlschmidt, Peter; Lutz, Otto; Peinke, Joachim; Gülker, Gerd

    2013-11-01

    It is known that small faults on rotor blades of wind turbines can cause significant power loss. In order to better understand the governing physical effects, in this experimental study, the formation of a turbulent wedge over a flat plate induced by single surface roughness elements is under investigation. The experiments are performed at different ambient pressure gradients, thus allowing conclusions about the formation of a turbulent wedge over an airfoil. With respect to typical initial faults on operating airfoils, the roughness elements are modified in both size and shape (raised or recessed). None intrusive experimental methods, such as stereoscopic PIV and LDA, enable investigations based on temporally and spatially highly resolved velocity measurements. In this way, a spectral analysis of the turbulent boundary layer is performed and differences in coherent structures within the wedge are identified. These findings are correlated with global measurements of the wedge carried out by infrared thermography. This correlation aims to enable distinguishing the cause and main properties of a turbulent wedge by the easy applicable method of infrared thermography, which is of practical relevance in the field of condition monitoring of wind turbines.

  3. Porous Titanium Wedges in Lateral Column Lengthening for Adult-Acquired Flatfoot Deformity.

    Science.gov (United States)

    Moore, Spencer H; Carstensen, S Evan; Burrus, M Tyrrell; Cooper, Truitt; Park, Joseph S; Perumal, Venkat

    2017-10-01

    Lateral column lengthening (LCL) is a common procedure for reconstruction of stage II flexible adult-acquired flatfoot deformity (AAFD). The recent development of porous titanium wedges for this procedure provides an alternative to allograft and autograft. The purpose of this study was to report radiographic and clinical outcomes achieved with porous titanium wedges in LCL. A retrospective analysis of 34 feet in 30 patients with AAFD that received porous titanium wedges for LCL from January 2011 to October 2014. Deformity correction was assessed using both radiographic and clinical parameters. Radiographic correction was assessed using the lateral talo-first metatarsal angle, the talonavicular uncoverage percentage, and the first metatarsocuneiform height. The hindfoot valgus angle was measured. Patients were followed from a minimum of 6 months up to 4 years (mean 16.1 months). Postoperative radiographs demonstrated significant correction in all 3 radiographic criteria and the hindfoot valgus angle. We had no cases of nonunion, no wedge migration, and no wedges have been removed to date. The most common complication was calcaneocuboid joint pain (14.7%). Porous titanium wedges in LCL can achieve good radiographic and clinical correction of AAFD with a low rate of nonunion and other complications. Level IV: Case series.

  4. Capillary surfaces in a wedge: Differing contact angles

    Science.gov (United States)

    Concus, Paul; Finn, Robert

    1994-01-01

    The possible zero-gravity equilibrium configurations of capillary surfaces u(x, y) in cylindrical containers whose sections are (wedge) domains with corners are investigated mathematically, for the case in which the contact angles on the two sides of the wedge may differ. In such a situation the behavior can depart in significant qualitative ways from that for which the contact angles on the two sides are the same. Conditions are described under which such qualitative changes must occur. Numerically computed surfaces are depicted to indicate the behavior.

  5. Open bite in prematurely born children.

    Science.gov (United States)

    Harila, V; Heikkinen, T; Grön, M; Alvesalo, L

    2007-01-01

    The aims of this study were to: examine the expression of open bite in prematurely born children and discuss the etiological factors that may lead to bite it. The subjects were 328 prematurely born (cross-sectional study of the Collaborative Perinatal Project in the 1960s and 1970s. Dental documents, including casts and photographs, were taken once at the age of 6-12 years in the mixed dentition. The occlusion was recorded by examining and measuring the hard stone casts. Vertical open bite was recorded only for full erupted teeth. The statistical method used was chi-square analysis. Significant differences in the incidence of anterior open bite (from left to right canine) was found between the preterm and control groups and between gender and ethnic groups. The prevalence of anterior open bite was nearly 9% in the preterm group and almost 7% in the control group. African Americans (9%) had a significantly greater incidence of open bite than Caucasians (3%; Pbite than boys (8% vs 6%; Pbite was increased--especially in preterm African American boys compared to controls (11% vs 8%). The results show differences in the development of anterior open bite between ethnic and gender groups. Premature birth may also influence dental occlusal development. Of importance are the patient's: general health condition; respiratory infections; inadequate nasal- and mouth-breathing; oral habits; and other medical problems. Preterm children may be relatively more predisposed to etiological factors for the development of anterior open bite.

  6. Triangular metal wedges for subwavelength plasmon-polariton guiding at telecom wavelengths

    DEFF Research Database (Denmark)

    Boltasseva, Alexandra; Volkov, V.S.; Nielsen, Rasmus Bundgaard

    2008-01-01

    We report on subwavelength plasmon-polariton guiding by triangular metal wedges at telecom wavelengths. A high-quality fabrication procedure for making gold wedge waveguides, which is also mass- production compatible offering large-scale parallel fabrication of plasmonic components, is developed...

  7. Pilot Study: Foam Wedge Chin Support Static Tolerance Testing

    Science.gov (United States)

    2017-10-24

    AFRL-SA-WP-SR-2017-0026 Pilot Study: Foam Wedge Chin Support Static Tolerance Testing Austin M. Fischer, BS1; William W...COVERED (From – To) April – October 2017 4. TITLE AND SUBTITLE Pilot Study: Foam Wedge Chin Support Static Tolerance Testing 5a. CONTRACT NUMBER...PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) USAF School of Aerospace

  8. Late Holocene ice wedges near Fairbanks, Alaska, USA: Environmental setting and history of growth

    Science.gov (United States)

    Hamilton, T.D.; Ager, T.A.; Robinson, S.W.

    1983-01-01

    Test trenches excavated into muskeg near Fairbanks in 1969 exposed a polygonal network of active ice wedges. The wedges occur in peat that has accumulated since about 3500 yr BP and have grown episodically as the permafrost table fluctuated in response to fires, other local site conditions and perhaps regional climatic changes. Radiocarbon dates suggest one or two episodes of ice-wedge growth between about 3500 and 2000 yr BP as woody peat accumulated at the site. Subsequent wedge truncation evidently followed a fire that charred the peat. Younger peat exhibits facies changes between sedge-rich components that filled troughs over the ice wedges and woody bryophytic deposits that formed beyond the troughs. A final episode of wedge development took place within the past few hundred years. Pollen data from the site indicate that boreal forest was present throughout the past 6000 yr, but that it underwent a gradual transition from a predominantly deciduous to a spruce-dominated assemblage. This change may reflect either local site conditions or a more general climatic shift to cooler, moister summers in late Holocene time. The history of ice-wedge growth shows that wedges can form and grow to more than 1 m apparent width under mean annual temperatures that probably are close to those of the Fairbanks area today (-3.5°C) and under vegetation cover similar to that of the interior Alaskan boreal forest. The commonly held belief that ice wedges develop only below mean annual air temperatures of -6 to -8°C in the zone of continuous permafrost is invalid.

  9. Portal dosimetry in wedged beams

    NARCIS (Netherlands)

    Spreeuw, Hanno; Rozendaal, Roel; Camargo, Priscilla; Mans, Anton; Wendling, Markus; Olaciregui-Ruiz, Igor; Sonke, Jan-Jakob; van Herk, Marcel; Mijnheer, Ben

    2015-01-01

    Portal dosimetry using electronic portal imaging devices (EPIDs) is often applied to verify high-energy photon beam treatments. Due to the change in photon energy spectrum, the resulting dose values are, however, not very accurate in the case of wedged beams if the pixel-to-dose conversion for the

  10. Voluntary enhanced cocontraction of hamstring muscles during open kinetic chain leg extension exercise: its potential unloading effect on the anterior cruciate ligament.

    Science.gov (United States)

    Biscarini, Andrea; Benvenuti, Paolo; Botti, Fabio M; Brunetti, Antonella; Brunetti, Orazio; Pettorossi, Vito E

    2014-09-01

    A number of research studies provide evidence that hamstring cocontraction during open kinetic chain knee extension exercises enhances tibiofemoral (TF) stability and reduces the strain on the anterior cruciate ligament. To determine the possible increase in hamstring muscle coactivation caused by a voluntary cocontraction effort during open kinetic chain leg-extension exercises, and to assess whether an intentional hamstring cocontraction can completely suppress the anterior TF shear force during these exercises. Descriptive laboratory study. Knee kinematics as well as electromyographic activity in the semitendinosus (ST), semimembranosus (SM), biceps femoris (BF), and quadriceps femoris muscles were measured in 20 healthy men during isotonic leg extension exercises with resistance (R) ranging from 10% to 80% of the 1-repetition maximum (1RM). The same exercises were also performed while the participants attempted to enhance hamstring coactivation through a voluntary cocontraction effort. The data served as input parameters for a model to calculate the shear and compressive TF forces in leg extension exercises for any set of coactivation patterns of the different hamstring muscles. For R≤ 40% 1RM, the peak coactivation levels obtained with intentional cocontraction (l) were significantly higher (P hamstring muscle, maximum level l was reached at R = 30% 1RM, corresponding to 9.2%, 10.5%, and 24.5% maximum voluntary isometric contraction (MVIC) for the BF, ST, and SM, respectively, whereas the ratio l/l 0 reached its maximum at R = 20% 1RM and was approximately 2, 3, and 4 for the BF, SM, and ST, respectively. The voluntary enhanced coactivation level l obtained for R≤ 30% 1RM completely suppressed the anterior TF shear force developed by the quadriceps during the exercise. In leg extension exercises with resistance R≤ 40% 1RM, coactivation of the BF, SM, and ST can be significantly enhanced (up to 2, 3, and 4 times, respectively) by a voluntary hamstring

  11. Application of super-omni wedge concept to conformal radiotherapy treatment planning

    International Nuclear Information System (INIS)

    Dai Jianrong; Fu Weihua; Hu Yimin

    2004-01-01

    Objective: To describe a method which can optimize beam weight, wedge angle, and wedge orientation simultaneously by combining the super-omni wedge (SOW) concept with the function of beam weight optimization provided by a commercial treatment planning system. Methods: A five-step procedure including: Step 1. To set up four 60 degree nominal wedged beams for each beam direction with the wedge orientations of 'LEFT', 'IN', 'RIGHT', 'OUT', respectively; Step 2. To define an optimization request, including an optimization goal and constraints. Authors use CMS Focus treatment planning system which allows us to choose 'maximize target dose' or 'minimize critical structure dose' as the optimization goal, and to set minimum target dose, maximum target dose, and maximum average dose of critical structures as constraints. Then the optimization process was launched as step 3; Step 4. To evaluate the plan using isodose distributions and dose-volume histograms. If acceptable, go to Step 5. Otherwise, go back to Step 2 to modify optimization constraints; and Step 5. Transform the SOW beams into the beams of omni wedge so as to reduce the number of to-be-delivered beams. Results: This procedure was found being able to demonstrate successfully in two clinical cases: an esophageal carcinoma and a brain tumor. Compared with manually designed plan, the optimized plan showed better dose homogeneity in the targets and better sparing of the critical structures. Conclusions: This method described is able to optimize beam weights while working with a treatment planning system. Not only does it improve treatment plans' quality, but also shorten the treatment planning process

  12. Wedge cells during regeneration of juvenile and adult feathers and their role in carving out the branching pattern of barbs.

    Science.gov (United States)

    Alibardi, Lorenzo

    2007-01-01

    The present ultrastructural study on regenerating feathers emphasizes the role of supportive cells in determining the branching pattern of barbs. Supportive cells are localized among developing barb and barbule cells, in marginal plates, and underneath the feather sheath, and their differentiative fate, in general, is a form of lipid degeneration. The Latter process determines the carving out of barb branching in both downfeathers and pennaceous feathers. In the latter feathers, some supportive cells (barb vane cells and cylindrical cells of marginal plates) degenerate within each barb ridge leaving separate barbules. Other supportive cells, here termed wedge cells, form columns of cornified material that merge into elongated corneous scaffolds localized among barbs and the rachis. This previously undescribed form of cornification of supportive cells derives from the aggregation of periderm and dense granules present in wedge cells. The latter cells give origin to a corneous material different from feather keratin that may initially sustain the early and soft barbules. After barbules are cornified the supportive cells scaffolds are eventually sloughed as the sheath breaks allowing the new feather to open up and form a planar vane. The corneous material of wedge cells may also contribute to molding of the overlapped nodes of barbule cells that form lateral spines or hooklets in mature barbules. Eventually, the disappearance of wedge cell scaffolding determines the regular spacing of barbs attached to the rachis in order to form a close vane.

  13. Decarbonization Wedges. November 2015. Report

    International Nuclear Information System (INIS)

    Alazard-Toux, N.; Criqui, P.; Devezeaux de Lavergne, J.G.; Chevallet, L.; Gentier, S.; Hache, E.; Le Net, E.; Menanteau, Ph.; Thais, Fr.; Achard, JL.; Allard, Fr.; Authier, O.; Babarit, A.; Badin, Fr.; Bazile, F.; Bernard, O.; Birat, JP.; Brault, P.; Burnol, A.; Carre, Fr.; Delrue, F.; Dufour, A.; Duplan, JL.; Durand, P.; Duval, O.; Fabriol, H.; Ferrant, P.; Flamant, G.; Forti, L.; Garnier, J.; Gimenez, M.; Goyeneche, O.; Hadj Said, N.; Jasserand, Fr.; Kalaydjian, F.; Le Boulluec, M.; Legrand, J.; Lorne, D.; Lucchese, P.; Magand, S.; Malbranche, Ph.; Mermillod, N.; Monot, F.; Olivier, B.; Pacaud, P.; Papillon, Ph.; Ponsot-Jacquin, C.; Quenard, D.; Rachez, X.; Rapin, M.; Rocher, Ph.; Sanjuan, B.; Sauvant-Moynot, V.; Tilagone, R.; Vinot, S.; Berthomieu, R.; Vajnovszki, A.

    2015-01-01

    2015 is a particularly eventful year in the field of energy. From 30 November through 11 December, France will host the 21. Conference of the Parties on Climate Change (COP21) in Paris. The expectations for this international event are high. Its main goal is to obtain an agreement to keep global warming below 2 deg. C by securing a set of voluntary commitments from the various countries and regions of the world to reduce global greenhouse gas emissions and by mobilizing $100 billion per year from 2020 onwards to finance climate change policies, especially in developing countries. In France, the year 2015 was also marked by the adoption of the Energy Transition and Green Growth Act that set a course and defined a road-map, through a set of objectives, aimed at helping our country reduce its CO 2 emissions in the field of energy. In this context, ANCRE (French National Alliance for Energy Research Coordination) would like to reiterate the major role of energy research and innovation in reducing anthropogenic (i.e. human induced) greenhouse gas emissions through research conducted on decarbonization wedges, a key technology in the fight against climate change in the field of energy on a planetary scale. Limiting the temperature increase on the earth's surface to 2 deg. C by 2100 is a challenging target, but it could be achievable with the rapid, sustained development and wide dissemination of a broad set of technologies. However, to achieve this goal, it is indispensable to conduct research aimed at speeding up low carbon technologies deployment and at reducing their cost. Through this joint report to which numerous researchers and experts contributed, ANCRE wishes to continue its efforts to build a global strategic vision that an Alliance comprising nearly 19 different research institutions can provide. This study follows the work conducted on energy transition scenarios for France and the road-maps drawn up by the ten programmatic groups structuring the

  14. Monte Carlo simulation of the Varian Clinac 600C accelerator dynamic and physical wedges

    Energy Technology Data Exchange (ETDEWEB)

    Soares, S [Universidade da Beira Interior, Av. Marques d' Avila e Bolama, Covilha 6201-001 (Portugal); Chaves, A [Instituto Portugues de Oncologia Doutor Francisco Gentil (IPO), Av. Bissaya Barreto, Coimbra 3000-075 (Portugal); Peralta, L [Laboratorio de Instrumentacao e Fisica Experimental de PartIculas (LIP), Av. Elias Garcia no14 1o, Lisbon 1000-149 (Portugal); Lopes, Mc [Faculdade de Ciencias da Universidade de Lisboa, Campo Grande EdifIcio C5, Lisbon 1149-016 (Portugal)

    2007-06-15

    The present paper describes the study done on the dosimetric characteristics of the Varian Clinac 600C dynamic wedges (DW) and their comparison with the physical wedges (PW) in terms of the differences affecting the dose distributions, beam spectra, energy fluence and angular distributions. The geometry of the 4 MV photon beam and the dose distributions in a water phantom were simulated with GEANT3 and DPM Monte Carlo code systems. The DW was modelled through the constant movement of the upper jaws. The depth dose distributions and lateral profiles for the DW, PW and open fields were measured and compared with the Monte Carlo simulations and the global agreement was found to be within 3%. It was also found that the effects of a DW on beam spectral and angular distributions are much less significant than those produced by a PW. For example, in our study we found out that the 45{sup 0}PW, when compared with the corresponding open field, can introduce a 30% increase in the mean photon energy due to the beam hardening effect and that it can also introduce a 4.5% dose reduction in the build-up region because of the reduction of the contaminated electrons by the PW. For the DW neither this mean-energy increase nor such dose reduction was found. The PW, when compared to the DW, significantly alters the photon-beam spectrum and these dosimetric differences are significant and further investigation must be performed to quantify the impact in clinical use of these beams.

  15. Slamming pressures on the bottom of a free-falling vertical wedge

    Science.gov (United States)

    Ikeda, C. M.; Judge, C. Q.

    2013-11-01

    High-speed planing boats are subjected to repeat impacts due to slamming, which can cause structural damage and injury to passengers. A first step in understanding and predicting the physics of a craft re-entering the water after becoming partially airborne is an experimental vertical drop test of a prismastic wedge (deadrise angle, β =20° beam, B = 300 mm; and length, L = 600 mm). The acrylic wedge was mounted to a rig allowing it to free-fall into a deep-water tank (5.2m × 5.2m × 4.2m deep) from heights 0 camera (1000 fps, resolution of 1920 × 1200 pixels) is mounted above the wedge model to record the wetted surface as the wedge descended below the free surface. The pressure measurements taken with both conventional surface pressure transducers and the pressure mapping system agree within 10% of the peak pressure values (0.7 bar, typical). Supported by the Office of Naval Research.

  16. Wedge silicon detectors for the inner trackering system of CMS

    International Nuclear Information System (INIS)

    Catacchini, E.; Civinini, C.; D'Alessandro, R.; Focardi, E.; Meschini, M.; Parrini, G.; Pieri, M.; Wheadon, R.

    1997-01-01

    One ''wedge'' double sided silicon detector prototype for the CMS forward inner tracker has been tested both in laboratory and on a high energy particle beam. The results obtained indicate the most reliable solutions for the strip geometry of the junction side. Three different designs of ''wedge'' double sided detectors with different solutions for the ohmic side strip geometry are presented. (orig.)

  17. Analysis of Fault Spacing in Thrust-Belt Wedges Using Numerical Modeling

    Science.gov (United States)

    Regensburger, P. V.; Ito, G.

    2017-12-01

    Numerical modeling is invaluable in studying the mechanical processes governing the evolution of geologic features such as thrust-belt wedges. The mechanisms controlling thrust fault spacing in wedges is not well understood. Our numerical model treats the thrust belt as a visco-elastic-plastic continuum and uses a finite-difference, marker-in-cell method to solve for conservation of mass and momentum. From these conservation laws, stress is calculated and Byerlee's law is used to determine the shear stress required for a fault to form. Each model consists of a layer of crust, initially 3-km-thick, carried on top of a basal décollement, which moves at a constant speed towards a rigid backstop. A series of models were run with varied material properties, focusing on the angle of basal friction at the décollement, the angle of friction within the crust, and the cohesion of the crust. We investigate how these properties affected the spacing between thrusts that have the most time-integrated history of slip and therefore have the greatest effect on the large-scale undulations in surface topography. The surface position of these faults, which extend through most of the crustal layer, are identifiable as local maxima in positive curvature of surface topography. Tracking the temporal evolution of faults, we find that thrust blocks are widest when they first form at the front of the wedge and then they tend to contract over time as more crustal material is carried to the wedge. Within each model, thrust blocks form with similar initial widths, but individual thrust blocks develop differently and may approach an asymptotic width over time. The median of thrust block widths across the whole wedge tends to decrease with time. Median fault spacing shows a positive correlation with both wedge cohesion and internal friction. In contrast, median fault spacing exhibits a negative correlation at small angles of basal friction (laws that can be used to predict fault spacing in

  18. Modified protrusion arch for anterior crossbite correction - a case report.

    Science.gov (United States)

    Roy, Abhishek Singha; Singh, Gulshan Kr; Tandon, Pradeep; Chaudhary, Ramsukh

    2013-01-01

    Borderline and mild skeletal Class III relationships in adult patients are usually treated by orthodontic camouflage. Reasonably rood results have been achieved with nonsurgical teatment of anterior crossbite. Class III malocclusion may be associated with mandibular prognathism, maxillary retrognathism, or both. Class III maxillary retrognathism generally involves anterior crossbite, which must be opened if upper labial brackets are to be bonded. If multiple teeth are in crossbite, after opening the bite usual step is to ligate forward or advancement arch made of 0.018" or 0.020" stainless steel or NiTi wire main arch that must be kept separated 2 mm from the slot ofupper incisor braces. Two stops or omegas are made 1 mm mesial to the tubes of the molar bands that will impede main arch from slipping,and in this manner the arch will push the anterior teeth forward Here we have fabricated a modified multiple loop protrusion arch to correct an anterior crossbite with severe crowding that was not amenable to correct by advancement arches.

  19. North Aegean core complexes, the gravity spreading of a thrust wedge

    NARCIS (Netherlands)

    Kydonakis, Konstantinos; Brun, Jean Pierre; Sokoutis, Dimitrios

    2015-01-01

    The North Aegean core complexes developed in middle Eocene soon after the end of continental block convergence and piling up of the Hellenic Thrust Wedge. They formed during back-arc extension, driven by the Hellenic slab rollback, at the back of the thrust wedge. A series of scaled laboratory

  20. Magnetization study of interlayer exchange in semiconductor EuS-PbS ferromagnetic wedge multilayers

    International Nuclear Information System (INIS)

    Kowalczyk, L.; Osinniy, V.; Chernyshova, M.; Dziawa, P.; Boratynski, A.; Story, T.; Smits, C.J.P.; Swagten, H.J.M.; Sipatov, A.Yu.; Volobuev, V.V.

    2006-01-01

    Interlayer coupling was experimentally studied in semiconductor EuS-PbS ferromagnetic superlattice wedge structures grown on KCl (0 0 1) substrates with the wedges covering the semiconductor nonmagnetic PbS spacer layer thickness from 0.3 to 6 nm. Structural parameters of the wedges were examined by X-ray diffraction analysis of EuS-PbS superlattice period. Measurements of magnetic hysteresis loops of EuS-PbS structures were performed by both SQUID (for small terminal parts of the wedge) and MOKE (magneto-optical analysis along the wedge) magnetometry. A strong decrease of magnetic remanence and an increase of saturation field observed for EuS-PbS structures with the PbS spacer thickness decreasing below about 1.5 nm is discussed in terms of the influence of antiferromagnetic interlayer coupling

  1. Computer dosimetry for flattened and wedged fast-neutron beams

    International Nuclear Information System (INIS)

    Hogstrom, K.R.; Smith, A.R.; Almond, P.R.; Otte, V.A.; Smathers, J.B.

    1976-01-01

    Beam flattening by the use of polyethylene filters has been developed for the 50-MeV d→Be fast-neutron therapy beam at the Texas AandM Variable-Energy Cyclotron (TAMVEC) as a result of the need for a more uniform dose distribution at depth within the patient. A computer algorithm has been developed that allows the use of a modified decrement line method to calculate dose distributions; standard decrement line methods do not apply because of off-axis peaking. The dose distributions for measured flattened beams are transformed into distributions that are physically equivalent to an unflattened distribution. In the transformed space, standard decrement line theory yields a distribution for any field size which, by applying the inverse transformation, generates the flattened dose distribution, including the off-axis peaking. A semiempirical model has been constructed that allows the calculation of dose distributions for wedged beams from open-beam data

  2. Scattering of wedges and cones with impedance boundary conditions

    CERN Document Server

    Lyalinov, Mikhail

    2012-01-01

    This book is a systematic and detailed exposition of different analytical techniques used in studying two of the canonical problems, the wave scattering by wedges or cones with impedance boundary conditions. It is the first reference on novel, highly efficient analytical-numerical approaches for wave diffraction by impedance wedges or cones. The applicability of the reported solution procedures and formulae to existing software packages designed for real-world high-frequency problems encountered in antenna, wave propagation, and radar cross section.

  3. High Rate of Recurrence Following Proximal Medial Opening Wedge Osteotomy for Correction of Moderate Hallux Valgus.

    Science.gov (United States)

    Iyer, Sravisht; Demetracopoulos, Constantine A; Sofka, Carolyn M; Ellis, Scott J

    2015-07-01

    The proximal medial opening wedge (PMOW) osteotomy has become more popular to treat moderate to severe hallux valgus with the recent development of specifically designed, low-profile modular plates. Despite the promising results previously reported in the literature, we have noted a high incidence of recurrence in patients treated with a PMOW. The purpose of this study was to report the clinical and radiographic outcomes of an initial cohort of patients treated with a PMOW osteotomy for moderate hallux valgus. We retrospectively analyzed prospectively gathered data on a cohort of 17 consecutive patients who were treated by the senior author using a PMOW osteotomy for moderate hallux valgus deformity. Average time to follow-up was 2.4 years (range, 1.0-3.5 years). The intermetatarsal angle (IMA), the hallux valgus angle (HVA), and the distal metatarsal articular angle (DMAA) were assessed on standard weightbearing radiographs of the foot preoperatively and at all follow-up visits. The Foot and Ankle Outcome Score (FAOS) was collected on all patients preoperatively and at final follow-up. Despite demonstrating good correction of their deformity initially, 11 of the 17 patients (64.7%) had evidence of recurrence of their hallux valgus deformity at final follow-up. Patients who recurred had a greater preoperative HVA (P = .023) and DMAA (P = .049) than patients who maintained their correction. Improvement in the quality-of-life subscale of the FAOS was noted at final follow-up for all patients (P = .05). There was no significant improvement in any of the other FAOS subscales. There was a high rate of recurrence of the hallux valgus deformity in this cohort of patients. Recurrence was associated with greater preoperative deformity and an increased preoperative DMAA. The PMOW without a concomitant distal metatarsal osteotomy may be best reserved for patients with mild hallux valgus deformity without an increased DMAA. Level IV, retrospective case series. © The Author

  4. New Transition Wedge Design Composed by Prefabricated Reinforced Concrete Slabs

    Directory of Open Access Journals (Sweden)

    Julia Real-Herráiz

    Full Text Available Abstract Important track degradation occurs in structure-embankment transitions, in which an abrupt change in track vertical stiffness arises, leading to a reduction in passengers comfort and safety. Although granular wedges are suggested by different railroad administrations as a solution to avoid these problems, they present some disadvantages which may affect track long-term performance. In this paper, a new solution designed with prefabricated reinforced concrete slabs is proposed. The aim of this solution is to guarantee a continuous and gradual track vertical stiffness transition in the vicinity of structures, overcoming granular wedges disadvantages. The aim of this study is to assess the performance of the novel wedge design by means of a 3-D FEM model and to compare it with the current solution.

  5. Correction of moderate to severe hallux valgus with combined proximal opening wedge and distal chevron osteotomies: a reliable technique.

    Science.gov (United States)

    Jeyaseelan, L; Chandrashekar, S; Mulligan, A; Bosman, H A; Watson, A J S

    2016-09-01

    The mainstay of surgical correction of hallux valgus is first metatarsal osteotomy, either proximally or distally. We present a technique of combining a distal chevron osteotomy with a proximal opening wedge osteotomy, for the correction of moderate to severe hallux valgus. We reviewed 45 patients (49 feet) who had undergone double osteotomy. Outcome was assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) and the Short Form (SF) -36 Health Survey scores. Radiological measurements were undertaken to assess the correction. The mean age of the patients was 60.8 years (44.2 to 75.3). The mean follow-up was 35.4 months (24 to 51). The mean AOFAS score improved from 54.7 to 92.3 (p hallux valgus and intermetatarsal angles were improved from 41.6(o) to 12.8(o) (p < 0.001) and from 22.1(o) to 7.1(o), respectively (p < 0.001). The mean distal metatarsal articular angle improved from 23(o) to 9.7(o). The mean sesamoid position, as described by Hardy and Clapham, improved from 6.8 to 3.5. The mean length of the first metatarsal was unchanged. The overall rate of complications was 4.1% (two patients). These results suggest that a double osteotomy of the first metatarsal is a reliable, safe technique which, when compared with other metatarsal osteotomies, provides strong angular correction and excellent outcomes with a low rate of complications. Cite this article: Bone Joint J 2016;98-B:1202-7. ©2016 The British Editorial Society of Bone & Joint Surgery.

  6. Seismic characterization of a `compound tectonic wedge` beneath the Rocky Mountain foreland basin, Alberta

    Energy Technology Data Exchange (ETDEWEB)

    Lawton, D. C.; Sukaramongkol, C.; Spratt, D. A. [Calgary Univ., AB (Canada). Dept. of Geology and Geophysics

    1996-06-01

    The detailed internal geometry of a `compound tectonic wedge` beneath an eastward-dipping homocline in the Sundre area of southern Alberta was described. Data for the description was obtained by interpreting reflection seismic data. The wedge has been driven into the foreland succession beneath the gently dipping upper detachment which occurs within coal horizons of the Upper Brazeau Group. Shape of the upper detachment near its toe indicates that rocks in its hanging wall were decoupled from strain associated with forward emplacement of the wedge. Folding of the upper detachment occurs in the hinterland region of the wedge, with a new upper detachment developing above the fold. Emplacement of the wedge is suspected to be the result of excess pore fluid pressure, although proof of this happening awaits quantification of the mechanical model. 25 refs., 8 figs.

  7. Combined pars plana lensectomy-vitrectomy with open-loop flexible anterior chamber intraocular lens (AC IOL) implantation for subluxated lenses.

    Science.gov (United States)

    Kazemi, S; Wirostko, W J; Sinha, S; Mieler, W F; Koenig, S B; Sheth, B P

    2000-01-01

    To review our experience with combined pars plana lensectomy-vitrectomy and open-loop flexible anterior chamber intraocular lens (AC IOL) implantation for managing subluxated crystalline lenses. Retrospective review of 36 consecutive eyes (28 patients), all of which had subluxated crystalline lenses, managed by pars plana lensectomy-vitrectomy with insertion of an open-loop flexible AC IOL. The study was performed at the Medical College of Wisconsin, Milwaukee, over an 8-year period. An average preoperative visual acuity of 20/163 (range, 20/25 to hand motions) improved to 20/36 (range, 20/20 to 4/200) with surgery after a mean follow-up of 14 months (range, 1 to 59 months) (P IOL implantation appears to be an excellent technique for managing subluxated crystalline lenses. It is associated with a significant improvement in visual acuity (P subluxated lens through a limbal wound. Additionally, use of an AC IOL offers a simplified alternative to placement of a ciliary sulcus sutured posterior chamber intraocular lens (PC IOL).

  8. Tax wedge in Croatia, Belgium, Estonia, Germany and Slovakia

    Directory of Open Access Journals (Sweden)

    Ana Gabrilo

    2016-06-01

    Full Text Available The aim of this paper is to analyse the taxation of labour income in Croatia, Belgium,Estonia, Germany and Slovakia. Having presented an outline of tax system rules, the paper shows the decomposition of the net average tax wedge for different family types and different income levels based on the OECD methodology. The results show that all observed countries apply a progressive tax schedule, apart from Germany where taxation for higher gross wages is not progressive due to a  cap on the SIC base. When it comes to a taxpayer earning an average gross wage, a Croatian single worker without children has the lowest tax burden, followed by Estonia, Slovakia, Germany and Belgium. However, as regards taxpayers earning 400% of AGW, Estonia has the smallest tax wedge, followed by Slovakia, Germany, Croatia and Belgium. Similar results are obtained by analyzing the tax wedge for couples with two children where one spouse is out of work.

  9. Therapy by stationary photon fields from a 42 MeV betatron using wedge filters

    International Nuclear Information System (INIS)

    Wicke, L.; Kaercher, K.H.; Naesiger, H.; Prokosch, E.; Vienna Univ.

    1975-01-01

    The dose distribution in photon beams from a 42 MeV betatron using wedge filters of lead with different angles of slope is described. The wedge coefficient to be considered at a field size of 10 x 10 cm is given. The scope for isodoses modified by wedge filters is discussed with regard to stationary-field photon therapy. (orig.) [de

  10. Wedge geometry, frictional properties and interseismic coupling of the Java megathrust

    Science.gov (United States)

    Koulali, Achraf; McClusky, Simon; Cummins, Phil; Tregoning, Paul

    2018-06-01

    The mechanical interaction between rocks at fault zones is a key element for understanding how earthquakes nucleate and propagate. Therefore, estimating frictional properties along fault planes allows us to infer the degree of elastic strain accumulation throughout the seismic cycle. The Java subduction zone is an active plate boundary where high seismic activity has long been documented. However, very little is known about the seismogenic processes of the megathrust, especially its shallowest portion where onshore geodetic networks are insensitive to recover the pattern of elastic strain. Here, we use the geometry of the offshore accretionary prism to infer frictional properties along the Java subduction zone, using Coulomb critical taper theory. We show that large portions of the inner wedge in the eastern part of the Java subduction megathrust are in a critical state, where the wedge is on the verge of failure everywhere. We identify four clusters with an internal coefficient of friction μint of ∼ 0.8 and hydrostatic pore pressure within the wedge. The average effective coefficient of friction ranges between 0.3 and 0.4, reflecting a strong décollement. Our results also show that the aftershock sequence of the 1994 Mw 7.9 earthquake halted adjacent to a critical segment of the wedge, suggesting that critical taper wedge areas in the eastern Java subduction interface may behave as a permanent barrier to large earthquake rupture. In contrast, in western Java topographic slope and slab dip profiles suggest that the wedge is mechanically stable, i.e deformation is restricted to sliding along the décollement, and likely to coincide with a seismogenic portion of the megathrust. We discuss the seismic hazard implications and highlight the importance of considering the segmentation of the Java subduction zone when assessing the seismic hazard of this region.

  11. Three Years of High Resolution Year-Round Monitoring of Ice-Wedge Thermal Contraction Cracking in Svalbard

    Science.gov (United States)

    Christiansen, H. H.

    2006-12-01

    Most likely ice-wedges are the most widespread periglacial landform in lowlands with continuous permafrost. With a changing climate it is important to understand better the geomorphological processes controlling ice- wedge growth and decay, as they might cause large changes to the surface of the landscape, particularly if the active layer thickness increases causing melting of the most ice-rich permafrost top layer. As most settlements on permafrost are located in lowland areas, ice-wedge formation can also influence the infrastructure. Understanding the processes of ice-wedge growth and their thaw transformation into ice-wedge casts are essential when using contemporary ice wedges as analogues of Pleistocene thermal contraction cracking in palaeoenvironmental reconstructions. As ice-wedges are largely controlled by winter conditions, improved understanding of the factors controlling their growth will enable better palaeoclimatic reconstructions both directly from ice-wedges, but also from ice-wedge casts, than just mean winter temperatures. Detailed studies of ice-wedge dynamics, including quantification of movement, have only been done in very few places in the Arctic. In high arctic Svalbard at 78°N climate at sea level locates these islands close to the southern limit of the continuous permafrost zone, with MAAT of as much as -4 to -6°C. However, thermal contraction cracking is demonstrated to be widespread in the Adventdalen study area in Svalbard. The year-round field access from the University Centre in Svalbard, UNIS, has enabled the collection of different continuous or high frequency ice-wedge process monitoring data since 2002 to improve the understanding of the geomorphological activity of this landform. In all the winters the air temperature was below -30°C for shorter or longer periods. During all the winters, the temperature in the top permafrost was below -15°C both in the ice-wedge top for shorter or longer periods. The snow cover was

  12. Measured Hydrologic Storage Characteristics of Three Major Ice Wedge Polygon Types, Barrow, Alaska

    Science.gov (United States)

    Chamberlain, A. J.; Liljedahl, A.; Wilson, C. J.; Cable, W.; Romanovsky, V. E.

    2014-12-01

    Model simulations have suggested that the hydrologic fluxes and stores of Arctic wetlands are constrained by the micro-topographical features of ice wedge polygons, which are abundant in lowland tundra landscapes. Recently observed changes in ice wedge polygon landscapes - in particular, ice wedge degradation and trough formation - emphasize the need to better understand how differing ice wedge polygon morphologies affect the larger hydrologic system. Here we present three seasons of measured end-of-winter snow accumulation, continuous soil moisture and water table elevations, and repeated frost table mapping. Together, these describe the hydrologic characteristics of three main ice wedge polygon types: low centered polygons with limited trough development (representative of a ~500 year old vegetated drained thaw lake basin), and low- and high-centered polygons with well-defined troughs. Dramatic spatiotemporal variability exists both between polygon types and between the features of an individual polygon (e.g. troughs, centers, rims). Landscape-scale end-of-winter snow water equivalent is similar between polygon types, while the sub-polygon scale distribution of the surface water differs, both as snow and as ponded water. Some sub-polygon features appear buffered against large variations in water levels, while others display periods of prolonged recessions and large responses to rain events. Frost table elevations in general mimic the ground surface topography, but with spatiotemporal variability in thaw rate. The studied thaw seasons represented above long-term average rainfall, and in 2014, record high June precipitation. Differing ice wedge polygon types express dramatically different local hydrology, despite nearly identical climate forcing and landscape-scale snow accumulation, making ice wedge polygons an important component when describing the Arctic water, nutrient and energy system.

  13. Laser-based linear and nonlinear guided elastic waves at surfaces (2D) and wedges (1D).

    Science.gov (United States)

    Hess, Peter; Lomonosov, Alexey M; Mayer, Andreas P

    2014-01-01

    The characteristic features and applications of linear and nonlinear guided elastic waves propagating along surfaces (2D) and wedges (1D) are discussed. Laser-based excitation, detection, or contact-free analysis of these guided waves with pump-probe methods are reviewed. Determination of material parameters by broadband surface acoustic waves (SAWs) and other applications in nondestructive evaluation (NDE) are considered. The realization of nonlinear SAWs in the form of solitary waves and as shock waves, used for the determination of the fracture strength, is described. The unique properties of dispersion-free wedge waves (WWs) propagating along homogeneous wedges and of dispersive wedge waves observed in the presence of wedge modifications such as tip truncation or coatings are outlined. Theoretical and experimental results on nonlinear wedge waves in isotropic and anisotropic solids are presented. Copyright © 2013 Elsevier B.V. All rights reserved.

  14. Calibration of the Wedge Prism

    Science.gov (United States)

    Charles B. Briscoe

    1957-01-01

    Since the introduction of plotless cruising in this country by Grosenbaugh and the later suggestion of using a wedge prism as an angle gauge by Bruce this method of determining basal area has been widely adopted in the South. One of the factors contributing to the occasionally unsatisfactory results obtained is failure to calibrate the prism used. As noted by Bruce the...

  15. A possible mechanism for earthquakes found in the mantle wedge of the Nazca subduction zone

    Science.gov (United States)

    Warren, L. M.; Chang, Y.; Prieto, G. A.

    2017-12-01

    Beneath Colombia, the Cauca cluster of intermediate-depth earthquakes extends for 200 km along the trench (3.5°N-5.5°N, 77.0°W-75.3°W) and, with 58 earthquakes per year with local magnitude ML >= 2.5, has a higher rate of seismicity than the subduction zone immediately to the north or south. By precisely locating 433 cluster earthquakes from 1/2010-3/2014 with data from the Colombian National Seismic Network, we found that the earthquakes are located both in a continuous Nazca plate subducting at an angle of 33°-43° and in the overlying mantle wedge. The mantle wedge earthquakes (12% of the earthquakes) form two isolated 40-km-tall columns extending perpendicular to the subducting slab. Using waveform inversion, we computed focal mechanisms for 69 of the larger earthquakes. The focal mechanisms are variable, but the intraslab earthquakes are generally consistent with an in-slab extensional stress axis oriented 25° counterclockwise from the down-dip direction. We suggest that the observed mantle wedge earthquakes are the result of hydrofracture in a relatively cool mantle wedge. This segment of the Nazca Plate is currently subducting at a normal angle, but Wagner et al. (2017) suggested that a flat slab slowly developed in the region between 9-5.9 Ma and persisted until 4 Ma. During flat slab subduction, the overlying mantle wedge typically cools because it is cut off from mantle corner flow. After hydrous minerals in the slab dehydrate, the dehydrated fluid is expelled from the slab and migrates through the mantle wedge. If a cool mantle wedge remains today, fluid dehydrated from the slab may generate earthquakes by hydrofracture, with the mantle wedge earthquakes representing fluid migration pathways. Dahm's (2000) model of water-filled fracture propagation in the mantle wedge shows hydrofractures propagating normal to the subducting slab and extending tens of km into the mantle wedge, as we observe.

  16. A Novel Continuous Extrusion Process to Fabricate Wedge-Shaped Light Guide Plates

    Directory of Open Access Journals (Sweden)

    Wen-Tse Hsiao

    2013-01-01

    Full Text Available Backlight modules are key components in thin-film transistor liquid crystal displays (TFT-LCD. Among the components of a backlight module, the light guide plate (LGP plays the most important role controlling the light projected to the eyes of users. A wedge-shaped LGP, with its asymmetrical structure, is usually fabricated by an injection proces, but the fabrication time of this process is long. This study proposes a continuous extrusion process to fabricate wedge-shaped LGPs. This continuous process has advantages for mass production. Besides a T-die and rollers, this system also has an in situ monitor of the melt-bank that forms during the extrusion process, helping control the plate thickness. Results show that the melt bank has a close relationship with the plate thickness. The temperature of the bottom heater and roller was adjusted to reduce the surface deformation of the wedge-shaped plate. This continuous extrusion system can successfully manufacture wedge-shaped LGPs for mass production.

  17. Observations of Lower Mississippi River Estuarine Dynamics: Effects of the Salt Wedge on Sediment Deposition

    Science.gov (United States)

    Ramirez, M. T.; Allison, M. A.

    2017-12-01

    The lowermost Mississippi River is subject to salt-wedge estuarine conditions during seasonally low flow, when seaward flow is unable to overcome density stratification. Previous studies in the Mississippi River salt wedge have shown the deposition of a fine sediment layer accumulating several mm/day beneath the reach where the salt wedge is present. Field studies were conducted during low flow in 2012-2015 utilizing ADCP, CTD, LISST, and physical samples to observe the physics of the salt wedge reach and to calculate rates and character of sediment trapping beneath the salt wedge. The field observations were summarized using a two-layer box-model representation of the reach to calculate water and sediment budgets entering, exiting, and stored within the reach. The salt wedge reach was found to be net depositional at rates up to 1.8 mm/day. The mechanism for transferring sediment mass from the downstream-flowing fluvial layer to the upstream-flowing marine layer appears to be flocculation, evidenced in LISST data by a spike in sediment particle diameters at the halocline. Applying reach-averaged rates of sediment trapping to a time-integrated model of salt-wedge position, we calculated annual totals ranging from 0.025 to 2.2 million tons of sediment deposited beneath the salt wedge, depending on salt-wedge persistence and upstream extent. Most years this seasonal deposit is remobilized during spring flood following the low-flow estuarine season, which may affect the timing of sediment delivery to the Gulf of Mexico, as well as particulate organic carbon, whose transport trajectory mirrors that of mineral sediment. These results are also relevant to ongoing dredging efforts necessary to maintain the economically-important navigation pathway through the lower Mississippi River, as well as planned efforts to use Mississippi River sedimentary resources to build land in the degrading Louisiana deltaic coast.

  18. The synthesis and adsorption properties of some carbohydrate-terminated dendrimer wedges

    International Nuclear Information System (INIS)

    Ainsworth, Richard L.

    1997-01-01

    A range of dendritic molecules that are designed to bind to a cotton surface has been synthesised. The architecture of the molecules allows the location of various functional, property modifying units at the focus and the attachment of recognition groups at the periphery of a dendritic molecule with wedge topology. The synthesis and characterisation of dendrimer wedges up to the second generation using a divergent approach has been performed. These wedges are readily built up using a simple and efficient stepwise pathway from the central core, and surface recognising species are subsequently attached to the molecule utilising procedures developed in conjunction with Unilever Research Laboratories. Work has been carried out to assess their adsorption onto a cotton surface and the postulated adsorption mechanism is discussed. (author)

  19. [Compressive anterior thoracoplasty (modified Abramson's repair) for pectus carinatum repair].

    Science.gov (United States)

    Álvarez Muñoz, V; Prado Valle, M A; López López, A J; Martínez Suárez, M A; Oviedo Gutiérrez, M; Montalvo Ávalos, C; Fernández García, L

    2014-04-15

    For anterior protruding chest wall deformities treatment, mainly pectus carinatum, pediatric surgeons have been managing either orthotic methods or open surgical repairs. Anterior compressive thoracoplasty (Abramson's technique) has widened the therapeutic options. We describe herein a modification of this technique in the first reported Europen series. From 2010 to 2012, a total of five patients (four male and one female) underwent a modified Abramson's technique to correct pectus carinatum or combined protrusion of the chest at our center. We report the operative technique used for these reconstructions. In all five cases, the operation was completed uneventfully and with excellent results either for the surgical team or the patients. Mean operative time was 190 minutes and hospitalization lasted for three to six days, at the time of analgesic drugs withdrawal. We consider the anterior compresive thorocoplasty (modified Abramson's technique) a safe and feasible method to correct protruding chest deformities, particularly in those patients with stiff chest or lack of compliance, in order to avoid the agressive open procedures.

  20. Surgical quality of wedge resection affects overall survival in patients with early stage non-small cell lung cancer.

    Science.gov (United States)

    Ajmani, Gaurav S; Wang, Chi-Hsiung; Kim, Ki Wan; Howington, John A; Krantz, Seth B

    2018-07-01

    Very few studies have examined the quality of wedge resection in patients with non-small cell lung cancer. Using the National Cancer Database, we evaluated whether the quality of wedge resection affects overall survival in patients with early disease and how these outcomes compare with those of patients who receive stereotactic radiation. We identified 14,328 patients with cT1 to T2, N0, M0 disease treated with wedge resection (n = 10,032) or stereotactic radiation (n = 4296) from 2005 to 2013 and developed a subsample of propensity-matched wedge and radiation patients. Wedge quality was grouped as high (negative margins, >5 nodes), average (negative margins, ≤5 nodes), and poor (positive margins). Overall survival was compared between patients who received wedge resection of different quality and those who received radiation, adjusting for demographic and clinical variables. Among patients who underwent wedge resection, 94.6% had negative margins, 44.3% had 0 nodes examined, 17.1% had >5 examined, and 3.0% were nodally upstaged; 16.7% received a high-quality wedge, which was associated with a lower risk of death compared with average-quality resection (adjusted hazard ratio [aHR], 0.74; 95% confidence interval [CI], 0.67-0.82). Compared with stereotactic radiation, wedge patients with negative margins had significantly reduced hazard of death (>5 nodes: aHR, 0.50; 95% CI, 0.43-0.58; ≤5 nodes: aHR, 0.65; 95% CI, 0.60-0.70). There was no significant survival difference between margin-positive wedge and radiation. Lymph nodes examined and margins obtained are important quality metrics in wedge resection. A high-quality wedge appears to confer a significant survival advantage over lower-quality wedge and stereotactic radiation. A margin-positive wedge appears to offer no benefit compared with radiation. Copyright © 2018 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  1. Recurrent instability after revision anterior shoulder stabilization surgery.

    Science.gov (United States)

    Friedman, Lisa Genevra Mandeville; Griesser, Michael J; Miniaci, Anthony A; Jones, Morgan H

    2014-03-01

    The purpose of this study was to perform a systematic review of the literature to compare outcomes of revision anterior stabilization surgeries based on technique. This study also sought to compare the impact of bone defects on outcomes. A systematic review of the electronic databases PubMed, Cochrane Central Register of Controlled Trials, and Scopus was performed in July 2012 and March 2013. Of 345 articles identified in the search, 17 studies with Level I to IV Evidence satisfied the inclusion criteria and were analyzed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Recurrent instability was defined as redislocation, resubluxation, or a positive apprehensive test after revision surgery. Procedures were categorized as arthroscopic Bankart repair, open Bankart repair, Bristow-Latarjet procedure, and other open procedures. In total, 388 shoulders were studied. Male patients comprised 74.1% of patients, 66.7% of cases involved the dominant shoulder, the mean age was 28.2 years, and the mean follow-up period was 44.2 months. The surgical procedures classified as "other open procedures" had the highest rate of recurrent instability (42.7%), followed by arthroscopic Bankart repair (14.7%), the Bristow-Latarjet procedure (14.3%), and open Bankart repair (5.5%). Inconsistent reporting of bone defects precluded drawing significant conclusions. A number of different procedures are used to address recurrent instability after a primary operation for anterior shoulder instability has failed. There is significant variability in the rate of recurrent instability after revision anterior shoulder stabilization surgery. Level IV, systematic review of Level I to IV studies. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  2. The optimisation of wedge filters in radiotherapy of the prostate

    International Nuclear Information System (INIS)

    Oldham, Mark; Neal, Anthony J.; Webb, Steve

    1995-01-01

    A treatment plan optimisation algorithm has been applied to 12 patients with early prostate cancer in order to determine the optimum beam-weights and wedge angles for a standard conformal three-field treatment technique. The optimisation algorithm was based on fast-simulated-annealing using a cost function designed to achieve a uniform dose in the planning-target-volume (PTV) and to minimise the integral doses to the organs-at-risk. The algorithm has been applied to standard conformal three-field plans created by an experienced human planner, and run in three PLAN MODES: (1) where the wedge angles were fixed by the human planner and only the beam-weights were optimised; (2) where both the wedge angles and beam-weights were optimised; and (3) where both the wedge angles and beam-weights were optimised and a non-uniform dose was prescribed to the PTV. In the latter PLAN MODE, a uniform 100% dose was prescribed to all of the PTV except for that region that overlaps with the rectum where a lower (e.g., 90%) dose was prescribed. The resulting optimised plans have been compared with those of the human planner who found beam-weights by conventional forward planning techniques. Plans were compared on the basis of dose statistics, normal-tissue-complication-probability (NTCP) and tumour-control-probability (TCP). The results of the comparison showed that all three PLAN MODES produced plans with slightly higher TCP for the same rectal NTCP, than the human planner. The best results were observed for PLAN MODE 3, where an average increase in TCP of 0.73% (± 0.20, 95% confidence interval) was predicted by the biological models. This increase arises from a beneficial dose gradient which is produced across the tumour. Although the TCP gain is small it comes with no increase in treatment complexity, and could translate into increased cures given the large numbers of patients being referred. A study of the beam-weights and wedge angles chosen by the optimisation algorithm revealed

  3. Chronology and palaeoenvironmental implications of the ice-wedge pseudomorphs and composite-wedge casts on the Magdalen Islands (eastern Canada)

    DEFF Research Database (Denmark)

    Remillard, A.M.; Hetu, B.; Bernatchez, P.

    2015-01-01

    to the former presence of permafrost under periglacial conditions. These features truncate Carboniferous sandstone or Last Glacial Maximum (LGM) glacial and glaciomarine diamicts, both overlain by subtidal or coastal units. Six optically stimulated luminescence (OSL) and four radiocarbon ages were obtained from......The Magdalen Islands are a valuable terrestrial record, evidencing the complex glacial and periglacial history of the Gulf of St. Lawrence. Thirteen structures interpreted as ice-wedge pseudomorphs or composite-wedge casts were observed at four sites on the southern Magdalen Islands and testify...... both host and infilled sedimentary units. These ages provide the first absolute chronological data on these structures, shedding new light on the relationships between glacial and periglacial phases. Our chronostratigraphic data suggest that, after the deglaciation and the emersion of the archipelago...

  4. Pulmonary capillary wedge pressure, as inferred from lung areas in gated blood-pool scintigrams: concise communication

    International Nuclear Information System (INIS)

    Urbina, A.; Okada, R.D.; Palacios, I.; Osbakken, M.; Strauss, H.W.

    1981-01-01

    To determine whether the apex-to-base distribution of pulmonary blood volume, as obtained from gated cardiac blood-pool scans, could be used as a noninvasive method to estimate mean pulmonary capillary wedge pressure (PCWP), gated blood-pool scans were analyzed in 77 patients who also had PCWP measurements at cardiac catheterization. Ten of these patients had gated cardiac blood-pool scans and PCWP measurements both at rest and during exercise. The apex-to-base distribution of pulmonary blood volume was determined from the end-systolic frame of the left anterior oblique view by placing equal-sized regions of interest over the apex and base of the right lung. The ratio of apex counts over base counts (A/B ratio) was considered abnormal if greater than unity. The mean A/B ratio was 1.15 +/- 0.27 (1 s.d.) for the 32 studies associated with an abnormal mean PCWP (greater than 12 mm Hg). The mean A/B ratio was 0.85 +/- 0.23 for the 55 studies associated with a normal mean PCWP (p less than 0.01 comparing normal group with abnormal). The sensitivity of the A/B ratio for a mean PCWP greater than 12 mm Hg was 81%R (26/32). The specificity of the A/B ratio for a mean PCWP greater than or equal to 12 mm Hg was 89% (49/55). Thus, noninvasive determination of the pulmonary apex-to-base ratio from gated cardiac blood-pool scans appears to differentiate subjects with normal and abnormal mean pulmonary capillary wedge pressures

  5. Physical optics-based diffraction coefficient for a wedge with different face impedances.

    Science.gov (United States)

    Umul, Yusuf Ziya

    2018-03-20

    A new diffraction field expression is introduced with the aid of the modified theory of physical optics for a wedge with different face impedances. First, the scattered geometrical optics fields are determined when both faces of the wedge are illuminated by the incident wave. The geometrical optics waves are then expressed in terms of the sum of two different fields that occur for different impedance wedges. The diffracted fields are determined for the two cases separately, and the total diffracted field is obtained as a sum of these waves. Lastly, the uniform field expressions are obtained, and the resultant fields are numerically compared with the solution of Maliuzhinets.

  6. Má oclusão Classe I de Angle, com mordida aberta anterior, tratada com extração de dentes permanentes Angle Class I malocclusion, with anterior open bite, treated with extraction of permanent teeth

    Directory of Open Access Journals (Sweden)

    Mírian Aiko Nakane Matsumoto

    2011-02-01

    Full Text Available A mordida aberta é uma anomalia com características distintas que, além da complexidade dos múltiplos fatores etiológicos, traz consequências estéticas e funcionais. Muitas alternativas têm sido utilizadas em seu tratamento, entre elas a grade palatina, forças ortopédicas, ajuste oclusal, camuflagem com ou sem exodontias, mini-implantes ou miniplacas e cirurgia ortognática. O diagnóstico preciso e a determinação da etiologia permitem estabelecer os objetivos e o plano de tratamento ideal para essa má oclusão. O presente relato descreve o tratamento de uma má oclusão Classe I de Angle, com padrão esquelético de Classe II e mordida aberta anterior, realizado em duas fases e que foi apresentado à diretoria do Board Brasileiro de Ortodontia e Ortopedia Facial (BBO, representando a categoria 2, como parte dos requisitos para a obtenção do título de Diplomado pelo BBO.Open bite is an anomaly with distinct characteristics which, in addition to involving complex, multiple etiologic factors, entails aesthetic and functional consequences. Many alternative approaches have been employed to treat open bite, including palatal crib, orthopedic forces, occlusal adjustment, camouflage with or without extractions, mini-implants or mini-plates, and orthognathic surgery. By determining accurate diagnosis and etiology professionals can set the goals and ideal treatment plan for this malocclusion. This report, describing the two stages treatment of a Angle Class I malocclusion with Class II skeletal pattern and anterior open bite, was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO, representative of category 2, as partial fulfillment of the requirements for obtaining the title of BBO Diplomate.

  7. CarD uses a minor groove wedge mechanism to stabilize the RNA polymerase open promoter complex.

    Science.gov (United States)

    Bae, Brian; Chen, James; Davis, Elizabeth; Leon, Katherine; Darst, Seth A; Campbell, Elizabeth A

    2015-09-08

    A key point to regulate gene expression is at transcription initiation, and activators play a major role. CarD, an essential activator in Mycobacterium tuberculosis, is found in many bacteria, including Thermus species, but absent in Escherichia coli. To delineate the molecular mechanism of CarD, we determined crystal structures of Thermus transcription initiation complexes containing CarD. The structures show CarD interacts with the unique DNA topology presented by the upstream double-stranded/single-stranded DNA junction of the transcription bubble. We confirm that our structures correspond to functional activation complexes, and extend our understanding of the role of a conserved CarD Trp residue that serves as a minor groove wedge, preventing collapse of the transcription bubble to stabilize the transcription initiation complex. Unlike E. coli RNAP, many bacterial RNAPs form unstable promoter complexes, explaining the need for CarD.

  8. Improved field abutment-wedge design for 6-MV x-rays

    International Nuclear Information System (INIS)

    Nyerick, C.E.; Steadham, R.E.

    1989-01-01

    This paper presents an improved abutment wedge for matching large photon fields. The wedge is used with a 6-MV Linac accelerator and generates a 5-cm pseudopenumbra at the 50% relative dose juncture. The features allow treatment of fields up to 40 cm long in any fractional step of increment, simultaneous generation of two wide penumbrae or one wide and one sharp penumbra, and attachment of the device downstream of standard beam-shaping accessories in any 90 degrees angular orientation

  9. Tool life of ceramic wedges during precise turning of tungsten

    Directory of Open Access Journals (Sweden)

    Legutko Stanislaw

    2017-01-01

    Full Text Available Properties, application and machinability of tungsten and its alloys have been demonstrated. The comparison of the tool life and wear of the wedges made of SiAlON and whisker ceramics during the precise turning at different cutting parameters have been presented. The CNC lathe DMG CTX 310 Ecoline and tungsten of 99.7 % purity were used during the experiments. Only the wedge of whisker ceramics has proved to be sufficiently suitable and only for relatively low cutting speeds.

  10. Monte Carlo simulation of the Varian Clinac 600C accelerator using dynamic wedges

    International Nuclear Information System (INIS)

    Moreno, S.; Chaves, A.; Lopes, M.C.; Peralta, L.; Universidade de Lisboa

    2004-01-01

    The advent of linear accelerators (linac) with computer-controlled dynamic collimation systems and functional and anatomical imaging techniques allowed a more exact delimitation and localisation of the target volume. These advanced treatment techniques inevitably increase the complexity level of dose calculation because of the introduction of the temporal variable. On account of this, it is mandatory the usage of more accurate modelling techniques of the collimator components, as it is the case of Monte Carlo (MC) simulation, which has created an enormous interest in research and clinical practice. Because the patients bodies are not homogenous nor are their body surfaces plane and regular, the dose distribution may differ significantly from the standard distribution from the linac calibration. It is in the treatment planning systems, which include algorithms that are usually measured in homogeneous water phantoms specific for each correction that the dose distributions from each case are obtained. In a real treatment, exception made to superficial lesions, two or more radiation fields are used in order to obtain the recommended dose distributions. The simplest arrangement is made from two parallel and opposed fields that originate a homogeneous dose distribution in almost all the irradiated volume. The available resources are, for example, different types of energies and of radiation, the application of bolus, the protection of healthy structures, the usage of wedged filters and the application of dynamic wedges. A virtual or dynamic wedge, modelled through the movement of one of the jaws, when compared with a set of physical wedges offers an alternative calculation method of an arbitrary number of wedged fields, instead of the four traditional fields of 15 deg, 30 deg, 45 deg and 60 deg angle and obtained with physical wedges. The goal of this work consists in the study of the application of dynamic wedges in tailoring the radiation field by the Varian Clinac 600

  11. Geometric and Dosimetric Approach to Determine Probability of Late Cardiac Mortality in Left Tangential Breast Irradiation: Comparison Between Wedged Beams and Field-in-Field Technique

    International Nuclear Information System (INIS)

    Pili, Giorgio; Grimaldi, Luca; Fidanza, Christian; Florio, Elena T.; Petruzzelli, Maria F.; D'Errico, Maria P.; De Tommaso, Cristina; Tramacere, Francesco; Musaio, Francesca; Castagna, Roberta; Francavilla, Maria C.; Gianicolo, Emilio A.L.; Portaluri, Maurizio

    2011-01-01

    Purpose: To evaluate the probability of late cardiac mortality resulting from left breast irradiation planned with tangential fields and to compare this probability between the wedged beam and field-in-field (FIF) techniques and to investigate whether some geometric/dosimetric indicators can be determined to estimate the cardiac mortality probability before treatment begins. Methods and Materials: For 30 patients, differential dose-volume histograms were calculated for the wedged beam and FIF plans, and the corresponding cardiac mortality probabilities were determined using the relative seriality model. As a comparative index of the dose distribution uniformity, the planning target volume (PTV) percentages involved in 97-103% of prescribed dose were determined for the two techniques. Three geometric parameters were measured for each patient: the maximal length, indicates how much the heart contours were displaced toward the PTV, the angle subtended at the center of the computed tomography slice by the PTV contour, and the thorax width/thickness ratio. Results: Evaluating the differential dose-volume histograms showed that the gain in uniformity between the two techniques was about 1.5. With the FIF technique, the mean dose sparing for the heart, the left anterior descending coronary artery, and the lung was 15% (2.5 Gy vs. 2.2 Gy), 21% (11.3 Gy vs. 9.0 Gy), and 42% (8.0 Gy vs. 4.6 Gy) respectively, compared with the wedged beam technique. Also, the cardiac mortality probability decreased by 40% (from 0.9% to 0.5%). Three geometric parameters, the maximal length, angle subtended at the center of the computed tomography slice by the PTV contour, and thorax width/thickness ratio, were the determining factors (p = .06 for FIF, and p = .10 for wedged beam) for evaluating the cardiac mortality probability. Conclusion: The FIF technique seemed to yield a lower cardiac mortality probability than the conventional wedged beam technique. However, although our study

  12. The application of wedge type compensation filter for uniform density on the endoscopic retrograde pancreatography

    International Nuclear Information System (INIS)

    Son, Soon Yong; Lee, Hee Jeong; Lee, Won Hong; Cho, Cheong Chan; Ryu, Meung Sun; Jung, Hong Ryang

    2001-01-01

    Over-density of pancreatic duct tail part on the endoscopic retrograde pancreatogram results from patient's position and inserted air during the study. The aim of this paper is to decide the filter angle to obtain an uniform density. Endoscopic retrograde pancratography was performed to 234 patients, and angled wedge filter was used differently. They are 10 deg (47), 20 deg (45), 30 deg (50). We also did not use wedge filter to 42 patients. We decided reliance degree in 95%. The statistical difference was p<0.05. The patients' sex rate was 1.8:1 between 18 and 87 years old(average age 58 years). Their body girth was 18.71 cm on the average. Of total 234 patients, difference of right and left average density was 0.01 by 30 deg wedge filter, -0.08 40 deg wedge filter and 0.27 non-wedge filter. These average values of difference density were very significant statistically, and standard deviation also was close to regular distribution. In conclusion, there is a usefulness of angled wedge filter for increasing diagnostic value of pancreatic duct tail part on the endoscopic retrograde pancreatogram

  13. Wedge-shaped parenchymal enhancement peripheral to the hepatic hemangioma : two-phase spiral CT findings

    International Nuclear Information System (INIS)

    Kim, Kyoung Won; Kim, Tae Kyoung; Han, Joon Koo; Kim, Ah Young; Lee, Hyun Ju; Song, Chi Sung; Choi, Byung Ihn

    2000-01-01

    To determine the incidence of hepatic hemangiomas associated with wedge-shaped parenchymal enhancements adjacent to the tumors as seen on two-phase spiral CT images obtained during the hepatic arterial phase and to characterize the two-phase spiral CT findings of those hemangiomas. One hundred and eight consecutive hepatic hemangiomas in 63 patients who underwent two-phase spiral CT scanning during an 11-month period were included in this study. Two-phase spiral CT scans were obtained during the hepatic arterial phase (30-second delay) and portal venous phase (65-second delay) after injection of 120 mL of contrast material at a rate of 3 mL/sec. We evaluated the frequency with which wedge-shaped parenchymal enhancement was adjacent to the hemangiomas during the hepatic arterial phase and divided hemangiomas into two groups according to whether or not wedge-shaped parenchymal enhancement was noted (Group A and Group B). The presence of such enhancement in hemangiomas was correlated with tumor size and the grade of intratumoral enhancement. In 24 of 108 hemangiomas, wedge-shaped parenchymal enhancement adjacent to hepatic tumors was seen on two-phase CT images obtained during the hepatic arterial phase. Mean hemangioma size was 22mm in group A and 24mm in group B. There was no statistically significant relationship between lesion size and the presence of wedge-shaped parenchymal enhancement adjacent to a hemangioma. In 91.7% and 100% of tumors in Group A, and in 9.6% and 17.8% in Group B, hemangiomas showed more than 50% intratumoral enhancement during the arterial and portal venous phase, respectively. Wedge-shaped parenchymal enhancements peripheral to hepatic hemangiomas was more frequently found in tumors showing more than 50% intratumoral enhancement during these two phases (p less than 0.01). Wedge-shaped parenchymal enhancements is not uncommonly seen adjacent to hepatic hemangiomas on two-phase spiral CT images obtained during the hepatic arterial phase. A

  14. Cyclicity, episodicity, and continuity in accretionary wedge evolution: insights from geophysical imaging and physical analogue experiments

    Science.gov (United States)

    Kukowski, N.

    2009-04-01

    Geophysical profiles across active convergent margins reveal different styles and locations of sediment accretion, thrust slices dipping successively steeper towards the hinterland, splay faults, and blind thrusts as well as accumulation spaces e. g. thrust top basins and larger basins formed by regional subsidence, of very variable size and position. Morphologically, the continental slope at most margins can be sub-divided in a lower, middle, and upper slope, with often the middle slope being the most shallowly inclined, suggesting segmented wedges. Beneath the forearc, a subduction channel of a few hundred meters to a few km thickness marks a layer of material transport into greater depth that also hosts the plate interface and décollement zone. The petrographical composition of accretionary wedges and subduction channels as well as related pressures and temperatures are accessible through deep drilling or sampling fossil accretionary complexes now exhumed. The structure, lithology, and tectonic history of forearcs as identified from geophysical and geology field observations hint to parameters possibly controlling material transfer at convergent margins. Among them, sediment supply, which itself is largely controlled by climate, width of the subduction channel, and interplate frictional properties, which also exhibit control on plate coupling and therefore the seismic potential of a forearc, are suggested to be of major importance. These parameters further may undergo temporal fluctuation, e.g. when climate changes or when different material is entering the trench and therefore potentially also the subduction channel. High resolution monitoring of material flux and the evolution of fault zone kinematics of analogue experimental wedges made of granular materials exhibiting frictional behaviour equivalent to that of upper crustal rocks shows that accretionary cycles proceed as a chain of sub-processes, i.e. the development of a thrust slice from initial failure

  15. Anterior corpectomy via the mini-open, extreme lateral, transpsoas approach combined with short-segment posterior fixation for single-level traumatic lumbar burst fractures: analysis of health-related quality of life outcomes and patient satisfaction.

    Science.gov (United States)

    Theologis, Alexander A; Tabaraee, Ehsan; Toogood, Paul; Kennedy, Abbey; Birk, Harjus; McClellan, R Trigg; Pekmezci, Murat

    2016-01-01

    The authors present clinical outcome data and satisfaction of patients who underwent minimally invasive vertebral body corpectomy and cage placement via a mini-open, extreme lateral, transpsoas approach and posterior short-segment instrumentation for lumbar burst fractures. Patients with unstable lumbar burst fractures who underwent corpectomy and anterior column reconstruction via a mini-open, extreme lateral, transpsoas approach with short-segment posterior fixation were reviewed retrospectively. Demographic information, operative parameters, perioperative radiographic measurements, and complications were analyzed. Patient-reported outcome instruments (Oswestry Disability Index [ODI], 12-Item Short Form Health Survey [SF-12]) and an anterior scar-specific patient satisfaction questionnaire were recorded at the latest follow-up. Twelve patients (7 men, 5 women, average age 42 years, range 22-68 years) met the inclusion criteria. Lumbar corpectomies with anterior column support were performed (L-1, n = 8; L-2, n = 2; L-3, n = 2) and supplemented with short-segment posterior instrumentation (4 open, 8 percutaneous). Four patients had preoperative neurological deficits, all of which improved after surgery. No new neurological complications were noted. The anterior incision on average was 6.4 cm (range 5-8 cm) in length, caused mild pain and disability, and was aesthetically acceptable to the large majority of patients. Three patients required chest tube placement for pleural violation, and 1 patient required reoperation for cage subsidence/hardware failure. Average clinical follow-up was 38 months (range 16-68 months), and average radiographic follow-up was 37 months (range 6-68 months). Preoperative lumbar lordosis and focal lordosis were significantly improved/maintained after surgery. Patients were satisfied with their outcomes, had minimal/moderate disability (average ODI score 20, range 0-52), and had good physical (SF-12 physical component score 41.7% ± 10

  16. Radiographic evaluation of 19 patients with Paprosky 3A and 3B submitted to acetabular review with trabecular metal wedge

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo Benvindo Rosal da Fonseca Neto

    Full Text Available ABSTRACT Objective: This study is aimed at evaluating the fixation of trabecular metal wedges in patients who underwent revision of total hip arthroplasty with large acetabular bone defects. Methods: The radiographs of 19 patients (21 hips, who underwent revision of total hip arthroplasty using trabecular metal wedges from September 2010 to December 2014 were evaluated. This study included only cases of Paprosky 3A and 3B. Preoperative and postoperative images were analyzed. Non-fixation of the implant was defined by the presence of angular variation of the component higher 10 degrees or displacement greater than 6 mm. Patients with follow-up times of less than 24 months or who did not attend the last two appointments were excluded from the study. Results: The mean follow-up time was 39.4 months (25-61. Fixation was achieved in all cases despite its complexity. There was only one case of dislocation that was treated with open reduction. One case developed infection, and was surgically approached on two occasions, with extensive debridement and intravenous antibiotics following protocol, with good evolution. Conclusion: The implanted trabecular metal wedges showed excellent results in the short- and medium-term and may represent another option in the reconstruction of large acetabular defects, sometimes replacing bone reconstruction that uses bone tissue banks or autologous graft.

  17. Sonourethrography in the evaluation of anterior urethral strictures

    International Nuclear Information System (INIS)

    Kim, Jong Chul; Kwag, Jin Geun

    1994-01-01

    To determine the reliability of sonourethrography (SUG) in the evaluation of male anterior urethral strictures. Both SUG with retrograde saline infusion and retrograde urethrography (RUG) were performed in 5 young normal volunteers and 20 patients with symptoms of impaired urine flow. Those findings were compared with urethroscopic and operative findings in all patients. SUG was more accurate in the evaluation of the stricture length and degree than RUG in 7 patients with anterior urethral strictures, when compared with their subsequent open urethroplasty findings. Only SUG could classify the degree of spongiofibrosis surrounding the strictures in 15 patients. So, SUG was diagnostically as efficacious as or, superior to, RUG in all 20 patients. SUG can be used as one of complementary and reliable tools for diagnosis, evaluation and follow-up of anterior urethral strictures

  18. Transforaminal Anterior Release for the Treatment of Fixed Sagittal Imbalance and Segmental Kyphosis, Minimum 2-Year Follow-Up Study.

    Science.gov (United States)

    Sweet, Fred A; Sweet, Andrea

    2015-09-01

    Retrospective review of prospectively accrued patient cohort. To report minimum 2 years' follow-up after a single-surgeon series of 47 consecutive patients in whom fixed sagittal imbalance or segmental kyphosis was treated with a novel unilateral transforaminal annular release. Fixed sagittal imbalance has been treated most recently with pedicle subtraction osteotomy with great success but is associated with significant blood loss and neurologic risk. Forty-seven consecutive patients with fixed sagittal imbalance (n = 29) or segmental kyphosis (n = 18) were treated by a single surgeon with a single-level transforaminal anterior release (TFAR) to effect an opening wedge correction. Sagittal and coronal correction was performed with in situ rod contouring. An interbody cage was captured in the disc space with rod compression. Radiographic and clinical outcome analysis was performed with a minimum 2-year follow-up (range 2-7.8 years). The average increase in lordosis was 36° (range 24°-56°) in the fixed sagittal deformity group. Coronal corrections averaged 34° (range 18°-48°). The average improvement in plumb line was 13.6 cm. There were four pseudarthroses, one at the TFAR. Average blood loss was 578 mL (range 200-1,200). One patient had a transient grade 4/5 anterior tibialis weakness. There were no vascular injuries or permanent neurologic deficits. There were significant improvements in the Oswestry Disability Index (p imbalance with relatively low blood loss and was found to be neurologically safe in this single-surgeon series. Therapeutic study, Level IV (case series, no control group). Copyright © 2015 Scoliosis Research Society. Published by Elsevier Inc. All rights reserved.

  19. Development of Cone Wedge Ring Expansion Test to Evaluate Mechanical Properties of Clad Tubing Structure

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Jy-An John [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2016-10-01

    To determine the hoop tensile properties of irradiated fuel cladding in a hot cell, a cone wedge ring expansion test method was developed. A four-piece wedge insert was designed with tapered angles matched to the cone shape of a loading piston. The ring specimen was expanded in the radial direction by the lateral expansion of the wedges under the downward movement of the piston. The advantages of the proposed method are that implementation of the test setup in a hot cell is simple and easy, and that it enables a direct strain measurement of the test specimen from the piston’s vertical displacement soon after the wedge-clad contact resistance is initiated.

  20. Anterior Urethral Valves

    Directory of Open Access Journals (Sweden)

    Vidyadhar P. Mali

    2006-07-01

    Full Text Available We studied the clinical presentation and management of four patients with anterior urethral valves; a rare cause of urethral obstruction in male children. One patient presented antenatally with oligohydramnios, bilateral hydronephrosis and bladder thickening suggestive of an infravesical obstruction. Two other patients presented postnatally at 1 and 2 years of age, respectively, with poor stream of urine since birth. The fourth patient presented at 9 years with frequency and dysuria. Diagnosis was established on either micturating cystourethrogram (MCU (in 2 or on cystoscopy (in 2. All patients had cystoscopic ablation of the valves. One patient developed a postablation stricture that was resected with an end-to-end urethroplasty. He had an associated bilateral vesicoureteric junction (VUJ obstruction for which a bilateral ureteric reimplantation was done at the same time. On long-term follow-up, all patients demonstrated a good stream of urine. The renal function is normal. Patients are continent and free of urinary infections. Anterior urethral valves are rare obstructive lesions in male children. The degree of obstruction is variable, and so they may present with mild micturition difficulty or severe obstruction with hydroureteronephrosis and renal impairment. Hence, it is important to evaluate the anterior urethra in any male child with suspected infravesical obstruction. The diagnosis is established by MCU or cystoscopy and the treatment is always surgical, either a transurethral ablation or an open resection. The long-term prognosis is good.

  1. Role of tear location on outcomes of open primary repair of the anterior cruciate ligament: A systematic review of historical studies.

    Science.gov (United States)

    van der List, Jelle P; DiFelice, Gregory S

    2017-10-01

    The general opinion is that outcomes of open primary repair of the anterior cruciate ligament (ACL) in the historical literature were disappointing. Since good outcomes of primary repair of proximal tears have recently been reported, we aimed to assess the role of tear location on open primary repair outcomes in the historical literature. All studies reporting outcomes of open primary ACL repair published between the inception of PubMed, Embase and Cochrane and 2000 were identified. Studies were included if tear location was reported. Outcome scores, return to sports, stability examinations, failures and patient satisfaction were collected and reviewed in the total study cohort and in a subgroup of studies treating only proximal tears. Spearman correlation analysis was performed between the percentage of proximal tears in the studies and all outcomes. Twenty-nine studies were included reporting outcomes of open primary in 1457 patients of which 72% had proximal and 23% midsubstance tears. Mean age was 30years, 65% were males, and mean follow-up was 3.6years. Good outcomes were noted in the total cohort, and excellent outcomes were noted following repair of proximal tears. Positive correlation was found between the percentage proximal tears in the studies and percentage satisfied patients (p=0.010). Tear location seems to have played a role on the outcomes of open primary ACL repair. Outcomes of open primary repair in patients with proximal tears were excellent, which confirms there may be a potential role for primary repair as treatment for proximal ACL tears. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Pericardial effusion presenting as an anterior mediastinal mass

    International Nuclear Information System (INIS)

    Schlesinger, A.E.; Fernbach, S.K.; Northwestern Univ., Chicago, IL

    1986-01-01

    The authors present a case of pericardial effusion in a patient with previous cardiac surgery. Because the pericardium is opened and not reclosed during surgery, fluid can extend superior to the normal upper reflections of the pericardium and simulate an anterior mediastinal mass. (orig.)

  3. Intercomparison of wedge factor for symmetric field and asymmetric field used 6MV linac

    International Nuclear Information System (INIS)

    Ji, Youn Sang; Han, Jae Jin

    1999-01-01

    Therapy equipment have taken progress for Cancer make use of Radiation for the normal tissue system make much of important for shielding. In modern times independent jaw setting to used equipment as possible make use of asymmetric field. Therefore, the asymmetric field be leave out of consideration wedge factor because of with used wedge for the most of part. These experimentation find out have an effect on the dosimetry of out put compared with of the difference between the symmetric field and asymmetric field for the wedge factor

  4. Impingement of water droplets on wedges and diamond airfoils at supersonic speeds

    Science.gov (United States)

    Serafini, John S

    1953-01-01

    An analytical solution has been obtained for the equations of motion of water droplets impinging on a wedge in a two-dimensional supersonic flow field with a shock wave attached to the wedge. The closed-form solution yields analytical expressions for the equation of the droplet trajectory, the local rate of impingement and the impingement velocity at any point on the wedge surface, and the total rate of impingement. The analytical expressions are utilized to determine the impingement on the forward surfaces of diamond airfoils in supersonic flow fields with attached shock waves. The results presented include the following conditions: droplet diameters from 2 to 100 microns, pressure altitudes from sea level to 30,000 feet, free-stream static temperatures from 420 degrees to 460 degrees R. Also, free-stream Mach numbers from 1.1 to 2.0, semi-apex angles for the wedge from 1.14 degrees to 7.97 degrees, thickness-to-chord ratios for the diamond airfoil from 0.02 to 0.14, chord lengths from 1 to 20 feet, and angles of attack from zero to the inverse tangent of the airfoil thickness-to-chord ratio.

  5. The influence of wedge diffuser blade number and divergence angle on the performance of a high pressure ratio centrifugal compressor

    Science.gov (United States)

    Wang, Yi; Han, Ge; Lu, Xingen; Zhu, Junqiang

    2018-02-01

    Wedge diffuser is widely used in centrifugal compressors due to its high performance and compact size. This paper is aimed to research the influence of wedge diffuser blade number and divergence angle on centrifugal compressor performance. The impact of wedge diffuser blade number on compressor stage performance is investigated, and then the wedge diffusers with different divergence angle are studied by varying diffuser wedge angle and blade number simultaneously. It is found that wedge diffuser with 27 blades could have about 0.8% higher adiabatic efficiency and 0.14 higher total pressure ratio than the wedge diffuser with 19 blades and the best compressor performance is achieved when diffuser divergence angle is 8.3°.These results could give some advices on centrifugal compressor design.

  6. Dispersion analysis and measurement of circular cylindrical wedge-like acoustic waveguides.

    Science.gov (United States)

    Yu, Tai-Ho

    2015-09-01

    This study investigated the propagation of flexural waves along the outer edge of a circular cylindrical wedge, the phase velocities, and the corresponding mode displacements. Thus far, only approximate solutions have been derived because the corresponding boundary-value problems are complex. In this study, dispersion curves were determined using the bi-dimensional finite element method and derived through the separation of variables and the Hamilton principle. Modal displacement calculations clarified that the maximal deformations appeared at the outer edge of the wedge tip. Numerical examples indicated how distinct thin-film materials deposited on the outer surface of the circular cylindrical wedge influenced the dispersion curves. Additionally, dispersion curves were measured using a laser-induced guided wave, a knife-edge measurement scheme, and a two-dimensional fast Fourier transform method. Both the numerical and experimental results correlated closely, thus validating the numerical solution. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Evaluation of off-axis wedge correction factor using diode dosimeters for estimation of delivered dose in external radiotherapy

    International Nuclear Information System (INIS)

    Allahverdi, Mahmoud; Shirazi, Alireza; Geraily, Ghazale; Mohammadkarim, Alireza; Esfehani, Mahbod; Nedaie, Hasanali

    2012-01-01

    An in vivo dosimetry system, using p-type diode dosimeters, was characterized for clinical applications of treatment machines ranging in megavoltage energies. This paper investigates two different models of diodes for externally wedged beams and explains a new algorithm for the calculation of the target dose at various tissue depths in external radiotherapy. The values of off-axis wedge correction factors were determined at two different positions in the wedged (toward the thick and thin edges) and in the non-wedged directions on entrance and exit surfaces of a polystyrene phantom in 60 Co and 6 MV photon beams. Depth transmission was defined on the entrance and exit surfaces to obtain the off-axis wedge correction factor at any depth. As the sensitivity of the diodes depends on physical characteristics (field size, source-skin distance (SSD), thickness, backscatter), correction factors were applied to the diode reading when measuring conditions different from calibration situations. The results indicate that needful correction factors for 60 Co wedged photons are usually larger than those for 6 MV wedged photon beams. In vivo dosimetry performed with the proposed algorithms at externally wedged beams has negligible probable errors (less than 0.5%) and is a reliable method for patient dose control. (author)

  8. Evaluation of off-axis wedge correction factor using diode dosimeters for estimation of delivered dose in external radiotherapy

    Directory of Open Access Journals (Sweden)

    Mahmoud Allahverdi

    2012-01-01

    Full Text Available An in vivo dosimetry system, using p-type diode dosimeters, was characterized for clinical applications of treatment machines ranging in megavoltage energies. This paper investigates two different models of diodes for externally wedged beams and explains a new algorithm for the calculation of the target dose at various tissue depths in external radiotherapy. The values of off-axis wedge correction factors were determined at two different positions in the wedged (toward the thick and thin edges and in the non-wedged directions on entrance and exit surfaces of a polystyrene phantom in 60 Co and 6 MV photon beams. Depth transmission was defined on the entrance and exit surfaces to obtain the off-axis wedge correction factor at any depth. As the sensitivity of the diodes depends on physical characteristics [field size, source-skin distance (SSD, thickness, backscatter], correction factors were applied to the diode reading when measuring conditions different from calibration situations . The results indicate that needful correction factors for 60 Co wedged photons are usually larger than those for 6 MV wedged photon beams. In vivo dosimetry performed with the proposed algorithms at externally wedged beams has negligible probable errors (less than 0.5% and is a reliable method for patient dose control.

  9. Evaluation of wedge-shaped phantoms for assessment of scanner display as a part of quality control of scanner performance

    International Nuclear Information System (INIS)

    Bergmann, H.; Havlik, E.

    1981-01-01

    Image manipulation in modern rectilinear scanners comprises background subtraction and contrast enhancement facilities. It has been the aim of this investigation to develop simple quality assurance methods suitable for checking the function of these features on a routine basis. Several types of phantoms have been investigated: an absorption step wedge, an emission step wedge and an emission continuous wedge. The absorption step wedge when used with a usual gamma-camera checking source gave the least satisfactory results. The emission step wedge is best suited for test procedures for background subtraction of the colour printer display and for contrast enhancement of the photo display, whereas the emission continuous wedge gave best results in testing the contrast enhancement of the colour printer display. An evaluation of the relative merits of the phantoms indicates that the emission step wedge is best suited for quality assurance tests. (author)

  10. Medial versus anterior open reduction for developmental hip dislocation in age-matched patients.

    Science.gov (United States)

    Hoellwarth, Jason S; Kim, Young-Jo; Millis, Michael B; Kasser, James R; Zurakowski, David; Matheney, Travis H

    2015-01-01

    The difference between medial (MAOR) and anterior (AAOR) approaches for open reduction of developmental hip dysplasia in terms of risk for avascular necrosis (AVN) and need for further corrective surgery (FCS, femoral and/or acetabular osteotomy) is unclear. This study compared age-matched cohorts undergoing either MAOR or AAOR in terms of these 2 primary outcomes. Prognostic impact of presence of ossific nucleus at time of open reduction was also investigated. Institutional review board approval was obtained. Nineteen hips (14 patients) managed by MAOR were matched with 19 hips (18 patients) managed by AAOR based on age at operation (mean 6.0; range, 1.4 to 14.9 mo). Patients with neuromuscular conditions and known connective tissue disorders were excluded. Primary outcomes assessed at minimum 2 years' follow-up included radiographic evidence of AVN (Kalamchi and MacEwen) or requiring FCS. MAOR and AAOR cohorts were similar regarding age at open reduction, sex, laterality, and follow-up duration. One hip in each group had AVN before open reduction thus were excluded from AVN analysis. At minimum 2 years postoperatively (mean 6.2; range, 1.8 to 11.7 y), 4/18 (22%) MAOR and 5/18 (28%) AAOR met the same criteria for AVN (P=1.0). No predictors of AVN could be identified by regression analysis. Presence of an ossific nucleus preoperatively was not a protective factor from AVN (P=0.27). FCS was required in 4/19 (21%) MAOR and 7/19 (37%) AAOR hips (P=0.48). However, 7/12 (54%) hips failing closed reduction required FCS compared with 4/26 (16%) hips without prior failed closed reduction (P=0.024). Cox regression analysis showed that patients who failed closed reduction had an annual risk of requiring FCS approximately 6 times that of patients without a history of failed closed reduction (hazard ratio=6.1; 95% CI, 1.5-24.4; P=0.009), independent of surgical approach (P=0.55) or length of follow-up (P=0.78). In this study of age-matched patients undergoing either MAOR or

  11. Optical coherence tomography in anterior segment imaging

    Science.gov (United States)

    Kalev-Landoy, Maya; Day, Alexander C.; Cordeiro, M. Francesca; Migdal, Clive

    2008-01-01

    Purpose To evaluate the ability of optical coherence tomography (OCT), designed primarily to image the posterior segment, to visualize the anterior chamber angle (ACA) in patients with different angle configurations. Methods In a prospective observational study, the anterior segments of 26 eyes of 26 patients were imaged using the Zeiss Stratus OCT, model 3000. Imaging of the anterior segment was achieved by adjusting the focusing control on the Stratus OCT. A total of 16 patients had abnormal angle configurations including narrow or closed angles and plateau irides, and 10 had normal angle configurations as determined by prior full ophthalmic examination, including slit-lamp biomicroscopy and gonioscopy. Results In all cases, OCT provided high-resolution information regarding iris configuration. The ACA itself was clearly visualized in patients with narrow or closed angles, but not in patients with open angles. Conclusions Stratus OCT offers a non-contact, convenient and rapid method of assessing the configuration of the anterior chamber. Despite its limitations, it may be of help during the routine clinical assessment and treatment of patients with glaucoma, particularly when gonioscopy is not possible or difficult to interpret. PMID:17355288

  12. Esthetic correction in open bite

    Directory of Open Access Journals (Sweden)

    Swapnil Parlani

    2011-01-01

    Full Text Available Deleterious oral habits, which are persistent, can lead to poor esthetics of a beautiful face. Conventional treatment modalities for an open bite usually include orthodontic treatment and/or skeletal surgery. This article focuses on a different treatment modality for an anterior open bite.

  13. Wedge and subselective pulmonary angiography in pulmonary hypertension secondary to venous obstruction

    International Nuclear Information System (INIS)

    Bowen, J.S.; Bookstein, J.J.; Johnson, A.D.; Peterson, K.L.; Moser, K.M.

    1985-01-01

    Pulmonary wedge or subselective angiography provided key diagnostic information in two cases of pulmonary hypertension secondary to pulmonary venous obstruction. Whereas conventional pulmonary angiograms and ventilation-perfusion lung scans were interpreted as showing embolism, plain radiographs demonstrated Kerley B lines, suggesting venous obstruction. Subselective or wedge angiography of nonopacified arteries verified their anatomical patency and also revealed venous stenoses, collaterals, and atrophy indicative of obstruction

  14. Radiographic Outcomes Following Lateral Column Lengthening With a Porous Titanium Wedge.

    Science.gov (United States)

    Gross, Christopher E; Huh, Jeannie; Gray, Joni; Demetracopoulos, Constantine; Nunley, James A

    2015-08-01

    Lateral column lengthening (LCL) is commonly utilized in treating stage II posterior tibialis tendon dysfunction. This study aimed to analyze the outcomes of LCL with porous titanium wedges compared to historic controls of iliac crest autograft and allograft. We hypothesized that the use of a porous titanium wedge would have radiographic improvement and union rates similar to those with the use of autograft and allograft in LCL. Between May 2009 and May 2014, 28 feet in 26 patients were treated with LCL using a porous titanium wedge. Of the 26 patients, 9 were males (34.6%). The average age for males was 43 years (range, 17.9-58.7), 48.7 years (range, 21-72.3) for females. Mean follow-up was 14.6 months. Radiographs were examined for correction of the flatfoot deformity and forefoot abduction. All complications were noted. Radiographically, the patients had a significant deformity correction in the anteroposterior talo-first metatarsal angle, talonavicular coverage angle, lateral talo-first metatarsal angle, and calcaneal pitch. All but 1 patient (96%) had bony incorporation of the porous titanium wedge. The average preoperative visual analog scale pain score was 5; all patients but 3 (12%) had improvements in their pain score, with a mean change of 3.4. LCL with porous titanium had low nonunion rates, improved radiographic correction, and pain relief. Level IV, case series. © The Author(s) 2015.

  15. Clinical and radiographic outcomes of medial open-wedge high tibial osteotomy with Anthony-K plate: prospective minimum five year follow-up data.

    Science.gov (United States)

    Altay, Mehmet Akif; Ertürk, Cemil; Altay, Nuray; Mercan, Ahmet Şükrü; Sipahioğlu, Serkan; Kalender, Ali Murat; Işıkan, Uğur Erdem

    2016-07-01

    The purpose of this study was to prospectively evaluate the clinical and radiographic outcomes, and complication rates, after a minimum of five years of follow-up after medial open wedge high tibial osteotomy (MOWHTO) using an Anthony-K plate. MOWHTO was performed on 35 knees of 34 consecutive patients. A visual analogue scale (VAS), and Western Ontario and McMaster University Osteoarthritis (WOMAC) and Lysholm scores, were used in clinical evaluation. Upon radiographic assessment, alignment was expressed as the femorotibial angle (FTA). The posterior tibial slope (PTS) and the Insall-Salvati Index (ISI) were also measured. VAS, WOMAC, and Lysholm scores improved significantly upon follow-up (p FTA was 4.68 ± 4.39° varus pre-operatively; at the last post-operative follow-up, the value was 8.43 ± 2.02° valgus. The mean correction angle was 13.1 ± 2.7°. A significant increase in PTS was evident (p < 0.01), as was a significant decrease in the ISI (p < 0.01). The overall complication rate was 8.6 %. The Anthony-K plate affords accurate correction, initially stabilises the osteotomy after surgery, and maintains such stability until the osteotomy gap is completely healed, without correction loss. The plate survival rate was 97.2 % after a minimum of five years of follow-up. The plate increased the PTS, as do other medial osteotomy fixation plates.

  16. Checks for quality control of wedge dynamics in treatment units and the planning system

    International Nuclear Information System (INIS)

    Mateos Salvador, P.; Rodriguez Lopez, B.; Font Gelabert, J.; Hernandez Rodriguez, J.; Arino Gil, A.

    2013-01-01

    The objective of this study is to verify the implementation of enhanced dynamic wedge (EDW) vary in the Eclipse planning system and the experimental determination of the parameters that define the dosimetry characteristics of enhanced dynamic wedge of our treatment units. (Author)

  17. Nanoscale wedge polishing of superconducting thin films-an easy way to obtain depth dependent information by surface analysis techniques

    International Nuclear Information System (INIS)

    Shapoval, T; Engel, S; Gruendlich, M; Meier, D; Backen, E; Neu, V; Holzapfel, B; Schultz, L

    2008-01-01

    A mechanical wedge polishing procedure that offers a simple, cost-effective and rapid way to look into the depth of a thin film with different surface-sensitive scanning techniques has been developed. As an example of its wide applicability, this method was utilized for the investigation of two differently prepared superconducting YBa 2 Cu 3 O 7-δ thin films: an Hf-doped film prepared by chemical solution deposition and an undoped film grown by pulsed laser deposition. Upon polishing, the roughness of the samples was reduced to less than 5 nm (peak-to-valley) without influencing the superconducting properties of the films. Thus, nanoscale polishing opens up a unique possibility for microscopic studies with various surface-sensitive techniques. We demonstrate the successful imaging of flux lines by low temperature magnetic force microscopy after polishing a formerly rough as-prepared film. By applying the wedge polishing procedure to the Hf-doped sample, high resolution electron backscattering diffraction investigations reveal the homogeneous distribution of non-superconducting BaHfO 3 nanoparticles in the whole volume of the film

  18. Forces in Motzkin paths in a wedge

    International Nuclear Information System (INIS)

    Janse van Rensburg, E J

    2006-01-01

    Entropic forces in models of Motzkin paths in a wedge geometry are considered as models of forces in polymers in confined geometries. A Motzkin path in the square lattice is a path from the origin to a point in the line Y = X while it never visits sites below this line, and it is constrained to give unit length steps only in the north and east directions and steps of length √2 in the north-east direction. Motzkin path models may be generalized to ensembles of NE-oriented paths above the line Y = rX, where r > 0 is an irrational number. These are paths giving east, north and north-east steps from the origin in the square lattice, and confined to the r-wedge formed by the Y-axis and the line Y = rX. The generating function g r of these paths is not known, but if r > 1, then I determine its radius of convergence to be t r = min (r-1)/r≤y≤r/(r+1) [y y (1-r(1-y)) 1-r(1-y) (r(1-y)-y) r(1-y)-y ] and if r is an element of (0, 1), then t r = 1/3. The entropic force the path exerts on the line Y rX may be computed from this. An asymptotic expression for the force for large values of r is given by F(r) = log(2r)/r 2 - (1+2log(2r))/2r 3 + O (log(2r)/r 4 ). In terms of the vertex angle α of the r-wedge, the moment of the force about the origin has leading terms F(α) log(2/α) - (α/2)(1+2log(2/α)) + O(α 2 log(2/α)) as α → 0 + and F(α) = 0 if α is element of [π/4, π/2]. Moreover, numerical integration of the force shows that the total work done by closing the wedge is 1.085 07... lattice units. An alternative ensemble of NE-oriented paths may be defined by slightly changing the generating function g r . In this model, it is possible to determine closed-form expressions for the limiting free energy and the force. The leading term in an asymptotic expansions for this force agrees with the leading term in the asymptotic expansion of the above model, and the subleading term only differs by a factor of 2

  19. Analysis of the stress field in a wedge using the fast expansions with pointwise determined coefficients

    Science.gov (United States)

    Chernyshov, A. D.; Goryainov, V. V.; Danshin, A. A.

    2018-03-01

    The stress problem for the elastic wedge-shaped cutter of finite dimensions with mixed boundary conditions is considered. The differential problem is reduced to the system of linear algebraic equations by applying twice the fast expansions with respect to the angular and radial coordinate. In order to determine the unknown coefficients of fast expansions, the pointwise method is utilized. The problem solution derived has explicit analytical form and it’s valid for the entire domain including its boundary. The computed profiles of the displacements and stresses in a cross-section of the cutter are provided. The stress field is investigated for various values of opening angle and cusp’s radius.

  20. Comments related to infinite wedge representations

    OpenAIRE

    Grieve, Nathan

    2016-01-01

    We study the infinite wedge representation and show how it is related to the universal extension of $g[t,t^{-1}]$ the loop algebra of a complex semi-simple Lie algebra $g$. We also give an elementary proof of the boson-fermion correspondence. Our approach to proving this result is based on a combinatorial construction with partitions combined with an application of the Murnaghan-Nakayama rule.

  1. Anterior Interosseous Nerve Neuropraxia Secondary to Shoulder Arthroscopy and Open Subpectoral Long Head Biceps Tenodesis

    Directory of Open Access Journals (Sweden)

    Jeremiah T. Steed

    2017-01-01

    Full Text Available Arthroscopic rotator cuff tendon repair is a common elective procedure performed by trained orthopaedic surgeons with a relatively low complication rate. Specifically, isolated neuropraxia of the anterior interosseous nerve (AIN is a very rare complication of shoulder arthroscopy. An analysis of peer-reviewed published literature revealed only three articles reporting a total of seven cases that describe this specific complication following standard shoulder arthroscopic procedures. This article reports on three patients diagnosed with AIN neuropraxia following routine shoulder arthroscopy done by a single surgeon within a three-year period. All three patients also underwent open biceps tenodesis immediately following completion of the arthroscopic procedures. The exact causal mechanism of AIN neuropraxia following shoulder arthroscopy with biceps tenodesis is not known. This case report reviews possible mechanisms with emphasis on specific factors that make a traction injury the most likely etiology in these cases. We critically analyze our operating room setup and patient positioning practices in light of the existing biomechanical and cadaveric research to propose changes to our standard practices that may help to reduce the incidence of this specific postoperative complication in patients undergoing elective shoulder arthroscopy with biceps tenodesis.

  2. Climate adaptation wedges: a case study of premium wine in the western United States

    Energy Technology Data Exchange (ETDEWEB)

    Diffenbaugh, Noah [Stanford University; White, Michael A [Utah State University (USU); Jones, Gregory V [Southern Oregon University, Ashland, OR; Ashfaq, Moetasim [ORNL

    2011-01-01

    Design and implementation of effective climate change adaptation activities requires quantitative assessment of the impacts that are likely to occur without adaptation, as well as the fraction of impact that can be avoided through each activity. Here we present a quantitative framework inspired by the greenhouse gas stabilization wedges of Pacala and Socolow. In our proposed framework, the damage avoided by each adaptation activity creates an 'adaptation wedge' relative to the loss that would occur without that adaptation activity. We use premium winegrape suitability in the western United States as an illustrative case study, focusing on the near-term period that covers the years 2000 39. We find that the projected warming over this period results in the loss of suitable winegrape area throughout much of California, including most counties in the high-value North Coast and Central Coast regions. However, in quantifying adaptation wedges for individual high-value counties, we find that a large adaptation wedge can be captured by increasing the severe heat tolerance, including elimination of the 50% loss projected by the end of the 2030 9 period in the North Coast region, and reduction of the projected loss in the Central Coast region from 30% to less than 15%. Increased severe heat tolerance can capture an even larger adaptation wedge in the Pacific Northwest, including conversion of a projected loss of more than 30% in the Columbia Valley region of Washington to a projected gain of more than 150%. We also find that warming projected over the near-term decades has the potential to alter the quality of winegrapes produced in the western US, and we discuss potential actions that could create adaptation wedges given these potential changes in quality. While the present effort represents an initial exploration of one aspect of one industry, the climate adaptation wedge framework could be used to quantitatively evaluate the opportunities and limits of climate

  3. Climate adaptation wedges: a case study of premium wine in the western United States

    International Nuclear Information System (INIS)

    Diffenbaugh, Noah S; Ashfaq, Moetasim; White, Michael A; Jones, Gregory V

    2011-01-01

    Design and implementation of effective climate change adaptation activities requires quantitative assessment of the impacts that are likely to occur without adaptation, as well as the fraction of impact that can be avoided through each activity. Here we present a quantitative framework inspired by the greenhouse gas stabilization wedges of Pacala and Socolow. In our proposed framework, the damage avoided by each adaptation activity creates an 'adaptation wedge' relative to the loss that would occur without that adaptation activity. We use premium winegrape suitability in the western United States as an illustrative case study, focusing on the near-term period that covers the years 2000-39. We find that the projected warming over this period results in the loss of suitable winegrape area throughout much of California, including most counties in the high-value North Coast and Central Coast regions. However, in quantifying adaptation wedges for individual high-value counties, we find that a large adaptation wedge can be captured by increasing the severe heat tolerance, including elimination of the 50% loss projected by the end of the 2030-9 period in the North Coast region, and reduction of the projected loss in the Central Coast region from 30% to less than 15%. Increased severe heat tolerance can capture an even larger adaptation wedge in the Pacific Northwest, including conversion of a projected loss of more than 30% in the Columbia Valley region of Washington to a projected gain of more than 150%. We also find that warming projected over the near-term decades has the potential to alter the quality of winegrapes produced in the western US, and we discuss potential actions that could create adaptation wedges given these potential changes in quality. While the present effort represents an initial exploration of one aspect of one industry, the climate adaptation wedge framework could be used to quantitatively evaluate the opportunities and limits of climate adaptation

  4. Hong's grading for evaluating anterior chamber angle width.

    Science.gov (United States)

    Kim, Seok Hwan; Kang, Ja Heon; Park, Ki Ho; Hong, Chul

    2012-11-01

    To compare Hong's grading method with anterior segment optical coherence tomography (AS-OCT), gonioscopy, and the dark-room prone-position test (DRPT) for evaluating anterior chamber width. The anterior chamber angle was graded using Hong's grading method, and Hong's angle width was calculated from the arctangent of Hong's grades. The correlation between Hong's angle width and AS-OCT parameters was analyzed. The area under the receiver operating characteristic curve (AUC) for Hong's grading method when discriminating between narrow and open angles as determined by gonioscopy was calculated. Correlation analysis was performed between Hong's angle width and intraocular pressure (IOP) changes determined by DRPT. A total of 60 subjects were enrolled. Of these subjects, 53.5 % had a narrow angle. Hong's angle width correlated significantly with the AS-OCT parameters (r = 0.562-0.719, P < 0.01). A Bland-Altman plot showed relatively good agreement between Hong's angle width and the angle width obtained by AS-OCT. The ability of Hong's grading method to discriminate between open and narrow angles was good (AUC = 0.868, 95 % CI 0.756-0.942). A significant linear correlation was found between Hong's angle width and IOP change determined by DRPT (r = -0.761, P < 0.01). Hong's grading method is useful for detecting narrow angles. Hong's grading correlated well with AS-OCT parameters and DRPT.

  5. Radial head button holing: a cause of irreducible anterior radial head dislocation

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Su-Mi; Chai, Jee Won; You, Ja Yeon; Park, Jina [Seoul National University Seoul Metropolitan Government Boramae Medical Center, Department of Radiology, Seoul (Korea, Republic of); Bae, Kee Jeong [Seoul National University Seoul Metropolitan Government Boramae Medical Center, Department of Orthopedic Surgery, Seoul (Korea, Republic of)

    2016-10-15

    ''Buttonholing'' of the radial head through the anterior joint capsule is a known cause of irreducible anterior radial head dislocation associated with Monteggia injuries in pediatric patients. To the best of our knowledge, no report has described an injury consisting of buttonholing of the radial head through the annular ligament and a simultaneous radial head fracture in an adolescent. In the present case, the radiographic findings were a radial head fracture with anterior dislocation and lack of the anterior fat pad sign. Magnetic resonance imaging (MRI) clearly demonstrated anterior dislocation of the fractured radial head through the torn annular ligament. The anterior joint capsule and proximal portion of the annular ligament were interposed between the radial head and capitellum, preventing closed reduction of the radial head. Familiarity with this condition and imaging findings will aid clinicians to make a proper diagnosis and fast decision to perform an open reduction. (orig.)

  6. Recession wedge trochleoplasty as an additional procedure in the surgical treatment of patellar instability with major trochlear dysplasia: early results.

    Science.gov (United States)

    Thaunat, M; Bessiere, C; Pujol, N; Boisrenoult, P; Beaufils, P

    2011-12-01

    The importance of a dysplastic trochlea as a component of patellar instability has long been recognized. An original trochleoplasty technique consisting in retro-trochlear recession wedge osteotomy was described by Goutallier et al. The aim is not to fashion a groove but to reduce the bump without modifying patellofemoral congruence. This retrospective study reports the operative technique and short-term outcomes of a consecutive case series of 17 patients (19 knees) who underwent recession wedge trochleoplasty for patellofemoral instability associated with severe trochlear dysplasia. Other contributing factors of patellar instability were also corrected as part of the surgical procedure: tibial tuberosity transfer (n=18), MPFL reconstruction (n=8). Minimum follow-up was 12 months (mean, 34 months; range, 12 to 71 months). The trochlear prominence was reduced from a mean 4.8mm (range, 0 to 8mm) to -0.8mm (range, -8 to 6mm). Patellar tilt was reduced from a mean 14° (range, 6° to 26°) to 6° (range, -1° to 24°). Two cases showed recurrent patellofemoral instability. Mean Kujala, KOOS and IKDC score were respectively 80 (± 17), 70 (± 18) and 67 (± 17) at last follow-up. Three patients required further operations, apart from removal of metal screws: arthroscopic arthrolysis for stiffness (n=1), revision for tibial tuberosity non-union (n=1), and supratrochlear exostosectomy (n=1). Recession wedge trochleoplasty is a feasible additional procedure addressing bony trochlear abnormality in the surgical treatment of patellar instability. Our attitude is to perform it never in isolation but associated to realignment of the extensor apparatus according to the à la carte surgery concept. It seems to be effective in preventing future patellar dislocation and reducing anterior knee pain in case of painful patellofemoral instability with a major dysplastic trochlea, or in revision cases when other realignment procedures have failed. Copyright © 2011 Elsevier Masson SAS

  7. Spacing of Imbricated Thrust Faults and the Strength of Thrust-Belts and Accretionary Wedges

    Science.gov (United States)

    Ito, G.; Regensburger, P. V.; Moore, G. F.

    2017-12-01

    The pattern of imbricated thrust blocks is a prominent characteristic of the large-scale structure of thrust-belts and accretionary wedges around the world. Mechanical models of these systems have a rich history from laboratory analogs, and more recently from computational simulations, most of which, qualitatively reproduce the regular patterns of imbricated thrusts seen in nature. Despite the prevalence of these patterns in nature and in models, our knowledge of what controls the spacing of the thrusts remains immature at best. We tackle this problem using a finite difference, particle-in-cell method that simulates visco-elastic-plastic deformation with a Mohr-Coulomb brittle failure criterion. The model simulates a horizontal base that moves toward a rigid vertical backstop, carrying with it an overlying layer of crust. The crustal layer has a greater frictional strength than the base, is cohesive, and is initially uniform in thickness. As the layer contracts, a series of thrust blocks immerge sequentially and form a wedge having a mean taper consistent with that predicted by a noncohesive, critical Coulomb wedge. The widths of the thrust blocks (or spacing between adjacent thrusts) are greatest at the front of the wedge, tend to decrease with continued contraction, and then tend toward a pseudo-steady, minimum width. Numerous experiments show that the characteristic spacing of thrusts increases with the brittle strength of the wedge material (cohesion + friction) and decreases with increasing basal friction for low (laws that will illuminate the basic physical processes controlling systems, as well as allow researchers to use observations of thrust spacing as an independent constraint on the brittle strength of wedges as well as their bases.

  8. Reduced emissions of greenhouse gases 2050: Technological wedges - Input to the Commission on Low Emissions

    International Nuclear Information System (INIS)

    Rosenberg, Eva; Espegren, Kari Aamodt; Finden, Per; Hageman, Rolf; Stenersen, Dag

    2006-09-01

    The Commission on Low Emissions was established in March 2005 and has been charged with the task of describing how Norway can achieve a 50-80 percent reduction in emissions of greenhouse gases by 2050. The commission describes the desired total reduction in emissions to be a set of actions or 'wedges', meaning that the reduction in emissions are linked to an array of technological and behavioural changes. The technological wedges are described here, while the behavioural wedges are treated in a different report. The potentials described are based on the Low Emission's reference line. Possible changes in the reference line will result in changed potentials. The technological wedges studied comprise to a great extent a potential of 50-80 percent reduction in greenhouse gases by 2050. This depends on considerable effort from research and development, and a determination to change external conditions

  9. A quantum hybrid with a thin antenna at the vertex of a wedge

    Energy Technology Data Exchange (ETDEWEB)

    Carlone, Raffaele, E-mail: raffaele.carlone@unina.it [Università “Federico II” di Napoli, Dipartimento di Matematica e Applicazioni “R. Caccioppoli”, MSA, via Cinthia, I-80126, Napoli (Italy); Posilicano, Andrea, E-mail: andrea.posilicano@uninsubria.it [DiSAT, Università dell' Insubria, via Valleggio 11, I-22100, Como (Italy)

    2017-03-26

    We study the spectrum, resonances and scattering matrix of a quantum Hamiltonian on a “hybrid surface” consisting of a half-line attached by its endpoint to the vertex of a concave planar wedge. At the boundary of the wedge, outside the vertex, homogeneous Dirichlet conditions are imposed. The system is tunable by varying the measure of the angle at the vertex. - Highlights: • Spectral characterization of a quantum Hamiltonian on “hybrid surface” consisting of a halfline attached to the vertex of a concave planar wedge. • The system is tunable by varying the measure of the angle at the vertex. • Relation between the conduction properties inside the hybrid and formation of resonances. • Easy generalization of the results to more complicated structures.

  10. Interaction of Structure and Physical Properties in Accretionary Wedges: Examples from the Cascadia and Nankai Trough Subduction Zones

    Science.gov (United States)

    Webb, Susanna I.

    Subduction zones are capable of producing large, megathrust earthquakes that are sometimes tsunamigenic. Structure and physical properties in the accretionary wedge play a role in how far rupture can propagate and how the wedge deforms coseismically. In this dissertation, I use seismic reflection data and velocity models from the Cascadia subduction zone and logging data from the Nankai Trough, Japan, to interpret structure, link structure to the broader wedge deformation history, and investigate the material properties at depth. I present a full structural interpretation of newly acquired seismic reflection data in the central Cascadia margin, which is characterized by dominantly landward vergent faulting in the outer wedge, a very low wedge taper angle, and a broad, lightly deformed lower slope terrace. Two decollements are active: an upper decollement within the sedimentary section, and a basal decollement at the sediment-basement interface. These interpretations help delineate the spatial extent of decollements and suggest that supra-wedge sedimentation may influence the development of the wedge, including the formation of the lower slope terrace and out of sequence fault activity. I use velocity models from central Cascadia to estimate excess pore fluid pressure and overpressure ratio at depth, which do not exceed 5 MPa and 0.15, respectively. No excess pore pressure is documented in the underthrust sediment section, but modest overpressure is likely present in the incoming sediment section and the footwalls of thrust sheets. The analysis of pore pressure shows that (1) if the base of the wedge is weak, it is due to mechanical properties of the sediments or a relatively thin underthrust layer and (2) the Cascadia wedge is relatively well-drained, and thus potentially strong, which can lead to a low wedge taper angle. In the Nankai Trough, Japan, I reprocessed sonic log data to obtain P-wave and S-wave velocity values and estimate elastic moduli. The logs

  11. Elastic wave diffraction by infinite wedges

    Energy Technology Data Exchange (ETDEWEB)

    Fradkin, Larissa; Zernov, Victor [Sound Mathematics Ltd., Cambridge CB4 2AS (United Kingdom); Gautesen, Arthur [Mathematics Department, Iowa State University and Ames Laboratory (United States); Darmon, Michel, E-mail: l.fradkin@soundmathematics.com [CEA-LIST, CEA-Saclay, 91191 Gif-sur-Yvette (France)

    2011-01-01

    We compare two recently developed semi-analytical approaches to the classical problem of diffraction by an elastic two dimensional wedge, one based on the reciprocity principle and Fourier Transform and another, on the representations of the elastodynamic potentials in the form of Sommerfeld Integrals. At present, in their common region of validity, the approaches are complementary, one working better than the other at some isolated angles of incidence.

  12. Study and evaluation of the Siemens virtual wedge factor: dosimetric monitor system and variable field effects

    Energy Technology Data Exchange (ETDEWEB)

    Sendon Rio, J R Sendon; Martinez, C Otero; GarcIa, M Sanchez; Busto, R Lobato; Vega, V Luna; Sueiro, J Mosquera; Camean, M Pombar [Servizo de Radiofisica e Proteccion Radioloxica, Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), Santiago de Compostela (Spain)], E-mail: jose.ramon.sendon.del.rio@sergas.es

    2008-03-07

    In the year 1997 Siemens introduced the virtual wedge in its accelerators. The idea was that a dose profile similar to that of a physical wedge can be obtained by moving one of the accelerator jaws at a constant speed while the dose rate is changing. This work explores the observed behaviour of virtual wedge factors. A model is suggested which takes into account that at any point in time, when the jaw moves, the dose at a point of interest in the phantom is not only due to the direct beam. It also depends on the scattered radiation in the phantom, the head scatter and the behaviour of the monitoring system of the accelerator. Measurements are performed in a Siemens Primus accelerator and compared to the model predictions. It is shown that the model agrees reasonably well with measurements spanning a wide range of conditions. A strong dependence of virtual wedge factors on the dosimetric board has been confirmed and an explanation has been given on how the balance between different contributions is responsible for virtual wedge factors values.

  13. Fixed Points of Maps of a Nonaspherical Wedge

    Directory of Open Access Journals (Sweden)

    Merrill Keith

    2009-01-01

    Full Text Available Abstract Let be a finite polyhedron that has the homotopy type of the wedge of the projective plane and the circle. With the aid of techniques from combinatorial group theory, we obtain formulas for the Nielsen numbers of the selfmaps of .

  14. A multisatellite case study of the expansion of a substorm current wedge in the near-Earth magnetotail

    International Nuclear Information System (INIS)

    Lopez, R.E.; Lui, A.T.Y.

    1990-01-01

    This study presents observations made by four spacecraft (AMPTE CCE, AMPTE IRM, GOES 5, and GOES 6) and two ground stations (San Juan and Tucson) during a substorm that occurred at ∼0830 UT on April 19, 1985. The spacecraft were arrayed in a configuration that allows for the examination of the spatial evolution of the substorm current wedge, CCE was located between the GOES spacecraft in longitude, but at a radial distance of 8.0 R E . IRM was located west of the other three spacecraft in the same sector as Tucson, but at a radial distance of 11.6 R E . The relative times at which the signature of the substorm current wedge was first observed at the GOES spacecraft and the ground stations are consistent with a simple longitudinally expanding current wedge. However, the times at which IRM and CCE observed the current wedge are not consistent with a current wedge that expanded only longitudinally, IRM first observed the signature of the current wedge at about the same time the signature was observed by GOES 6 and Tucson, and CCE observed the current wedge only after both GOES satellites and the ground stations had done so. Moreover, both GOES spacecraft observed signatures consistent with entry into the central plasma sheet before CCE and IRM did, even though we estimate that CCE was slightly closer to the neutral sheet than the geosynchronous spacecraft. The sequence of events suggests that during this substorm the disruption of the cross-tail current sheet, the formation of the substorm current wedge, and the expansion of the plasma sheet began in the near-Earth region, and subsequently spread tailward as well as longitudinally

  15. Phakic iris-fixated intraocular lens placement in the anterior chamber: effects on aqueous flow.

    Science.gov (United States)

    Repetto, Rodolfo; Pralits, Jan O; Siggers, Jennifer H; Soleri, Paolo

    2015-05-01

    Phakic intraocular lenses (pIOLs) are used for correcting vision; in this paper we investigate the fluid dynamical effects of an iris-fixated lens in the anterior chamber. In particular, we focus on changes in the wall shear stress (WSS) on the cornea and iris, which could be responsible for endothelial and pigment cell loss, respectively, and also on the possible increase of the intraocular pressure, which is known to correlate with the incidence of secondary glaucoma. We use a mathematical model to study fluid flow in the anterior chamber in the presence of a pIOL. The governing equations are solved numerically using the open source software OpenFOAM. We use an idealized standard geometry for the anterior chamber and a realistic geometric description of the pIOL. We consider separately the main mechanisms that produce fluid flow in the anterior chamber. The numerical simulations allow us to obtain a detailed description of the velocity and pressure distribution in the anterior chamber, and indicated that implantation of the pIOL significantly modifies the fluid dynamics in the anterior chamber. However, lens implantation has negligible influence on the intraocular pressure and does not produce a significant increase of the shear stress on the cornea, while the shear stress on the iris, although increased, is not enough to cause detachment of cells. We conclude that alterations in the fluid dynamics in the anterior chamber as a result of lens implantation are unlikely to be the cause of medical complications associated with its use.

  16. Thermal regime of an ice-wedge polygon landscape near Barrow, Alaska

    Science.gov (United States)

    Daanen, R. P.; Liljedahl, A. K.

    2017-12-01

    Tundra landscapes are changing all over the circumpolar Arctic due to permafrost degradation. Soil cracking and infilling of meltwater repeated over thousands of years form ice wedges, which produce the characteristic surface pattern of ice-wedge polygon tundra. Rapid top-down thawing of massive ice leads to differential ground subsidence and sets in motion a series of short- and long-term hydrological and ecological changes. Subsequent responses in the soil thermal regime drive further permafrost degradation and/or stabilization. Here we explore the soil thermal regime of an ice-wedge polygon terrain near Utqiagvik (formerly Barrow) with the Water balance Simulation Model (WaSiM). WaSiM is a hydro-thermal model developed to simulate the water balance at the watershed scale and was recently refined to represent the hydrological processes unique to cold climates. WaSiM includes modules that represent surface runoff, evapotranspiration, groundwater, and soil moisture, while active layer freezing and thawing is based on a direct coupling of hydrological and thermal processes. A new snow module expands the vadose zone calculations into the snow pack, allowing the model to simulate the snow as a porous medium similar to soil. Together with a snow redistribution algorithm based on local topography, this latest addition to WaSiM makes simulation of the ground thermal regime much more accurate during winter months. Effective representation of ground temperatures during winter is crucial in the simulation of the permafrost thermal regime and allows for refined predictions of future ice-wedge degradation or stabilization.

  17. Extreme skeletal open bite correction with vertical elastics.

    Science.gov (United States)

    Cruz-Escalante, Marco Antonio; Aliaga-Del Castillo, Aron; Soldevilla, Luciano; Janson, Guilherme; Yatabe, Marilia; Zuazola, Ricardo Voss

    2017-11-01

    Severe skeletal open bites may be ideally treated with a combined surgical-orthodontic approach. Alternatively, compensations may be planned to camouflage the malocclusion with orthodontics alone. This case report describes the treatment of an 18-year-old man who presented with a severe open bite involving the anterior and posterior teeth up to the first molars, increased vertical dimension, bilateral Class III molar relationship, bilateral posterior crossbite, dental midline deviation, and absence of the maxillary right canine and the mandibular left first premolar. A treatment plan including the extraction of the mandibular right first premolar and based on uprighting and vertical control of the posterior teeth, combined with extrusion of the anterior teeth using multiloop edgewise archwire mechanics and elastics was chosen. After 6 months of alignment and 2 months of multiloop edgewise archwire mechanics, the open bite was significantly reduced. After 24 months of treatment, anterior teeth extrusion, posterior teeth intrusion, and counterclockwise mandibular rotation were accomplished. Satisfactory improvement of the overbite, overjet, sagittal malocclusion, and facial appearance were achieved. The mechanics used in this clinical case demonstrated good and stable results for open-bite correction at the 2-year posttreatment follow-up.

  18. Use of a wedge cuvette in thin layer photometry and its application to oximetry

    NARCIS (Netherlands)

    Spaan, J. A.; Garred, L. J.; van de Borne, P.

    1977-01-01

    A wedge cuvette was constructed by fixing 2 glass plates at a known angle with a spacer at one end. This resulted in a thin layer with thickness varying from 0 to 250 micrometer. By measuring the intensity of a beam of light through the thin layer as a function of distance along the wedge (and thus

  19. Direct FVM Simulation for Sound Propagation in an Ideal Wedge

    Directory of Open Access Journals (Sweden)

    Hongyu Ji

    2016-01-01

    Full Text Available The sound propagation in a wedge-shaped waveguide with perfectly reflecting boundaries is one of the few range-dependent problems with an analytical solution. This provides a benchmark for the theoretical and computational studies on the simulation of ocean acoustic applications. We present a direct finite volume method (FVM simulation for the ideal wedge problem, and both time and frequency domain results are analyzed. We also study the broadband problem with large-scale parallel simulations. The results presented in this paper validate the accuracy of the numerical techniques and show that the direct FVM simulation could be applied to large-scale complex acoustic applications with a high performance computing platform.

  20. The da Vinci robotic surgical assisted anterior lumbar interbody fusion: technical development and case report.

    Science.gov (United States)

    Beutler, William J; Peppelman, Walter C; DiMarco, Luciano A

    2013-02-15

    Technique development to use the da Vince Robotic Surgical System for anterior lumbar interbody fusion at L5-S1 is detailed. A case report is also presented. To evaluate and develop the da Vinci robotic assisted laparoscopic anterior lumbar stand-alone interbody fusion procedure. Anterior lumbar interbody fusion is a common procedure associated with potential morbidity related to the surgical approach. The da Vinci robot provides intra-abdominal dissection and visualization advantages compared with the traditional open and laparoscopic approach. The surgical techniques for approach to the anterior lumbar spine using the da Vinci robot were developed and modified progressively beginning with operative models followed by placement of an interbody fusion cage in the living porcine model. Development continued to progress with placement of fusion cage in a human cadaver, completed first in the laboratory setting and then in the operating room. Finally, the first patient with fusion completed using the da Vinci robot-assisted approach is presented. The anterior transperitoneal approach to the lumbar spine is accomplished with enhanced visualization and dissection capability, with maintenance of pneumoperitoneum using the da Vinci robot. Blood loss is minimal. The visualization inside the disc space and surrounding structures was considered better than current open and laparoscopic techniques. The da Vinci robot Surgical System technique continues to develop and is now described for the transperitoneal approach to the anterior lumbar spine. 4.

  1. Measurement of dynamic wedge angles and beam profiles by means of MRI ferrous sulphate gel dosimetry

    Science.gov (United States)

    Bengtsson, Magnus; Furre, Torbjørn; Rødal, Jan; Skretting, Arne; Olsen, Dag R.

    1996-02-01

    The purpose of this study is to examine the possible value of measuring the dose distribution in dynamic wedge photon beams using ferrous sulphate gel phantoms analysed by MRI. The wedge angles and dose profiles were measured for a field size of and for dynamic wedge angles of , , and using a 15 MV photon beam generated from a Clinac 2100 CD (Varian). The dose profiles obtained from MRI ferrous sulphate gel were in good agreement with the dose measurements performed with a diode detector array. Also, the wedge angles determined from the MRI ferrous sulphate gel agreed well with the values obtained by using film dosimetry and with calculations by use of TMS (treatment planning system) (Helax, Uppsala, Sweden). The study demonstrated that MRI ferrous sulphate gel dosimetry is an adequate tool for measurements of some beam characteristics of dynamic radiation fields.

  2. Anterior perineal hernia after anterior exenteration

    Directory of Open Access Journals (Sweden)

    Ka Wing Wong

    2017-10-01

    Full Text Available Perineal hernia is a rare complication of anterior exenteration. We reported this complication after an anterior exenteration for bladder cancer with bleeding complication requiring packing and second-look laparotomy. Perineal approach is a simple and effective method for repair of perineal hernia.

  3. Complications related to osteopenia in the thoracic spine on admission chest radiographs of substance abuse detoxification patients

    International Nuclear Information System (INIS)

    Haramati, L.B.; Alterman, D.D.; Israel, G.M.; Haramati, N.; Mallavurapu, R.

    1998-01-01

    Objective. To assess the prevalence of complications related to osteopenia in the thoracic spine (anterior wedging and fish vertebrae) of patients admitted for substance abuse detoxification. Design and patients. We retrospectively identified 150 sequential patients admitted to our drug and alcohol detoxification ward in whom posteroanterior and lateral admission chest radiographs and clinical charts were available for review. There were 116 men and 34 women with a mean age of 37 years (range 19-67 years). Thirty-eight patients were admitted for drug detoxification, 37 for alcohol detoxification, and 75 for drug and alcohol detoxification. These patients were compared with 66 age- and sex-matched controls from our hospital's employee health service. Two radiologists reviewed all chest radiographs for the presence of anterior wedging and fish vertebrae in the thoracic spine and other nonspinal fractures. Serum calcium and inorganic phosphorus levels were recorded for the substance abuse detoxification patients. Results. Forty-nine percent (n=73) of detoxification patients had complications of osteopenia in the thoracic spine including: anterior wedging (n=47), fish vertebrae (n=21), or both (n=5). Twenty-four percent (n=36) of patients had an elevated serum inorganic phosphorus level and one patient had an elevated serum calcium level. Patients with anterior wedging or fish vertebrae included: 45% (n=45) of patients below age 40 years, 35% (n=12) of women, 41% (n=15) of drug detoxification patients, 58% (n=22) of alcohol detoxification patients, 48% (n=36) of drug and alcohol detoxification patients, and 47% (n=17) of patients with elevated serum inorganic phosphorus (P=NS). Six percent (n=9) of our study population had nonspinal fractures on their chest radiographs. Twenty-one percent (n=14) of controls had complications of osteopenia in the thoracic spine (all anterior wedging). This prevalence differed significantly (P<0.05, chi-squared) from the study population

  4. Flow Analysis for the Falkner–Skan Wedge Flow

    DEFF Research Database (Denmark)

    Bararnia, H; Haghparast, N; Miansari, M

    2012-01-01

    In this article an analytical technique, namely the homotopy analysis method (HAM), is applied to solve the momentum and energy equations in the case of a two-dimensional incompressible flow passing over a wedge. The trail and error method and Padé approximation strategies have been used to obtai...

  5. Structure and tectonic evolution of the southwestern Trinidad dome, Escambray complex, Central Cuba: Insights into deformation in an accretionary wedge

    Science.gov (United States)

    Despaigne-Díaz, Ana Ibis; García Casco, Antonio; Cáceres Govea, Dámaso; Wilde, Simon A.; Millán Trujillo, Guillermo

    2017-10-01

    The Trinidad dome, Escambray complex, Cuba, forms part of an accretionary wedge built during intra-oceanic subduction in the Caribbean from the Late Cretaceous to Cenozoic. The structure reflects syn-subduction exhumation during thickening of the wedge, followed by extension. Field mapping, metamorphic and structural analysis constrain the tectonic evolution into five stages. Three ductile deformation events (D1, D2 and D3) are related to metamorphism in a compressional setting and formation of several nappes. D1 subduction fabrics are only preserved as relict S1 foliation and rootless isoclinal folds strongly overprinted by the main S2 foliation. The S2 foliation is parallel to sheared serpentinised lenses that define tectonic contacts, suggesting thrust stacks and underthrusting at mantle depths. Thrusting caused an inverted metamorphic structure with higher-grade on top of lower-grade nappes. Exhumation started during D2 when the units were incorporated into the growing accretionary wedge along NNE-directed thrust faults and was accompanied by substantial decompression and cooling. Folding and thrusting continued during D3 and marks the transition from ductile to brittle-ductile conditions at shallower crustal levels. The D4-5 events are related to extension and contributed to the final exhumation (likely as a core complex). D4 is associated with a regional spaced S4 cleavage, late open folds, and numerous extension veins, whereas D5 is recorded by normal and strike-slip faults affecting all nappes. The P-t path shows rapid exhumation during D2 and slower rates during D3 when the units were progressively incorporated into the accretionary prism. The domal shape formed in response to tectonic denudation assisted by normal faulting and erosion at the surface during the final stages of structural development. These results support tectonic models of SW subduction of the Proto-Caribbean crust under the Caribbean plate during the latest Cretaceous and provide

  6. A study on the stem friction coefficient with differential pressure conditions for the motor operated flexible wedge gate valve

    International Nuclear Information System (INIS)

    Kim, Dae Woong; Park, Sung Keun; Kim, Yang Seok; Lee, Do Hwan

    2008-01-01

    Stem friction coefficient is very important parameter for the evaluation of valve performance. In this study, the characteristics of stem friction coefficient is analyzed, and the bounding value is determined. The hydraulic testing is performed for flexible wedge gate valves in the plant and statistical method is applied to the determination of bounding value. According to the results of this study, stem friction coefficient is not effected in low differential pressure condition, but it is showed different distribution in medium and high differential pressure condition. And the bounding value of closing stroke is higher than that of opening stroke

  7. Sandbox Simulations of the Evolution of a Subduction Wedge following Subduction Initiation

    Science.gov (United States)

    Brandon, M. T.; Ma, K. F.; DeWolf, W.

    2012-12-01

    Subduction wedges at accreting subduction zones are bounded by a landward dipping pro-shear zone (= subduction thrust) and a seaward-dipping retro-shear zone in the overriding plate. For the Cascadia subduction zone, the surface trace of the retro-shear zone corresponds to the east side of the Coast Ranges of Oregon and Washington and the Insular Mountains of Vancouver Island. This coastal high or forearc high shows clear evidence of long-term uplift and erosion along its entire length, indicating that it is an active part of the Cascadia subduction wedge. The question addressed here is what controls the location of the retro-shear zone? In the popular double-sided wedge model of Willet et al (Geology 1993), the retro-shear zone remains pinned to the S point, which is interpreted to represent where the upper-plate Moho intersects the subduction zone. For this interpretation, the relatively strong mantle is considered to operate as a flat backstop. That model, however. is somewhat artificial in that the two plates collide in a symmetric fashion with equal crustal thicknesses on both sides. Using sandbox experiments, we explore a more realistic configuration where the upper and lower plate are separated by a gentle dipping (10 degree) pro-shear zone, to simulate the initial asymmetric geometry of the subduction thrust immediately after initiation of subduction. The entire lithosphere must fail along some plane for subduction to begin and this failure plane must dip in the direction of subduction. Thus, the initial geometry of the overriding plate is better approximated as a tapered wedge than as a layer of uniform thickness, as represented in the Willett et al models. We demonstrate this model using time-lapse movies of a sand wedge above a mylar subducting plate. We use particle image velocimetry (PIV) to show the evolution of strain and structure within the overriding plate. Material accreted to the tapered end of the overriding plate drives deformation and causes

  8. Three-dimensional semi-analytical solution to groundwater flow in confined and unconfined wedge-shaped aquifers

    Science.gov (United States)

    Sedghi, Mohammad Mahdi; Samani, Nozar; Sleep, Brent

    2009-06-01

    The Laplace domain solutions have been obtained for three-dimensional groundwater flow to a well in confined and unconfined wedge-shaped aquifers. The solutions take into account partial penetration effects, instantaneous drainage or delayed yield, vertical anisotropy and the water table boundary condition. As a basis, the Laplace domain solutions for drawdown created by a point source in uniform, anisotropic confined and unconfined wedge-shaped aquifers are first derived. Then, by the principle of superposition the point source solutions are extended to the cases of partially and fully penetrating wells. Unlike the previous solution for the confined aquifer that contains improper integrals arising from the Hankel transform [Yeh HD, Chang YC. New analytical solutions for groundwater flow in wedge-shaped aquifers with various topographic boundary conditions. Adv Water Resour 2006;26:471-80], numerical evaluation of our solution is relatively easy using well known numerical Laplace inversion methods. The effects of wedge angle, pumping well location and observation point location on drawdown and the effects of partial penetration, screen location and delay index on the wedge boundary hydraulic gradient in unconfined aquifers have also been investigated. The results are presented in the form of dimensionless drawdown-time and boundary gradient-time type curves. The curves are useful for parameter identification, calculation of stream depletion rates and the assessment of water budgets in river basins.

  9. Transmasseteric anterior parotid approach for condylar fractures: experience of 129 cases.

    Science.gov (United States)

    Narayanan, Vinod; Ramadorai, Ashok; Ravi, Poornima; Nirvikalpa, Natarajan

    2012-07-01

    We have evaluated the transmasseteric anterior parotid (TMAP) approach in the treatment of 163 condylar fractures in 129 patients. Ninety-five patients presented with unilateral, and 34 with bilateral, fractures. The inclusion criteria were patient's choice for open reduction and internal fixation, displaced unilateral condylar fractures with occlusal derangement, and displaced bilateral condylar fractures with anterior open bite. Mean (SD) maximum interincisal opening after 3 months was 44(5)mm. There were no differences in lateral movements during the reviews 6 weeks and 3 months postoperatively. Protrusive movement at the end of 3 months was 7(2)mm. All patients achieved functional occlusion identical to the pretraumatic occlusion and good reduction of the condyles. No patient developed temporary or permanent facial palsy, sialocele, salivary fistula, or Frey syndrome. The mean (SD) operating time was 46(11)min. The TMAP approach avoids the complications of incision of the parotid gland, minimises the risk of facial nerve palsy, and offers excellent access to the fractured condyle. Copyright © 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  10. Unrecognized anterior compartment syndrome following ankle fracture surgery: a case report.

    Science.gov (United States)

    Seyahi, Aksel; Uludag, Serkan; Akman, Senol; Demirhan, Mehmet

    2009-01-01

    A 35-year-old male sustained a lateral malleolar fracture while playing football. The fracture was treated by open reduction and internal fixation with a tourniquet. The next day, the patient returned with pain and swelling of the ankle and was admitted again to the hospital with a suspected diagnosis of cellulitis. Ten hours later, the patient developed the symptoms of anterior compartment syndrome. Emergency open fasciotomy of the anterior compartment was performed. The retrospective analysis of the patient's history was suggestive of a predisposition to an exercise-induced compartment syndrome. We think that exertional increase of the compartmental pressure before the injury and the tourniquet used during surgery contributed together to the development of compartment syndrome. Physicians should be vigilant in identifying the features of compartment syndrome when managing patients injured during a sporting activity.

  11. Uniform physical theory of diffraction equivalent edge currents for truncated wedge strips

    DEFF Research Database (Denmark)

    Johansen, Peter Meincke

    1996-01-01

    New uniform closed-form expressions for physical theory of diffraction equivalent edge currents are derived for truncated incremental wedge strips. In contrast to previously reported expressions, the new expressions are well behaved for all directions of incidence and observation and take a finite...... value for zero strip length. This means that the expressions are well suited for implementation in general computer codes. The new expressions are expressed as the difference between two terms. The first term is obtained by integrating the exact fringe wave current on a wedge along an untruncated...

  12. Management for the anterior combined with posterior urethral stricture: a 9-year single centre experience

    Science.gov (United States)

    Deng, Tuo; Liao, Banghua; Luo, Deyi; Liu, Bing; Wang, Kunjie; Liu, Jiaming; Jin, Tao

    2015-01-01

    Objective: Therapy for anterior combined with posterior urethral stricture is difficult and controversial. This study aims to introduce a standard process for managing anterior combined with posterior urethral stricture. Patients and methods: 19 patients with anterior combined with posterior urethral stricture were treated following our standard process. Average (range) age was 52 (21-72) years old. In this standard process, anterior urethral stricture should be treated first. Endoscopic surgery is applied for anterior urethra stricture as a priority as long as obliteration does not occur, and operation for posterior urethral stricture can be conducted in the same stage. Otherwise, an open reconstructive urethroplasty for anterior urethral is needed; while in this condition, the unobliterated posterior urethra can also be treated with endoscopic surgery in the same stage; however, if posterior urethra obliteration exists, then open reconstructive urethroplasty for posterior urethral stricture should be applied 2-3 months later. Results: The median (range) follow-up time was 25.8 (3-56) months. All 19 patients were normal in urethrography after 1 month of the surgery. 4 patients (21.1%) recurred urethral stricture during follow-up, and the locations of recurred stricture were bulbomembranous urethra (2 cases), bulbar urethra (1 case) and bladder neck (1 case). 3 of them restored to health through urethral dilation, yet 1 underwent a second operation. 2 patients (10.5%) complaint of dripping urination. No one had painful erection, stress urinary incontinence or other complications. Conclusions: The management for anterior combined with posterior urethral stricture following our standard process is effective and safe. PMID:26064293

  13. Cementless Hip Stem Anteversion in the Dysplastic Hip: A Comparison of Tapered Wedge vs Metaphyseal Filling.

    Science.gov (United States)

    Taniguchi, Naofumi; Jinno, Tetsuya; Koga, Daisuke; Hagino, Tetsuo; Okawa, Atsushi; Haro, Hirotaka

    2017-05-01

    Appropriate stem anteversion is important for achieving stability of the prosthetic joint in total hip arthroplasty. Anteversion of a cementless femoral stem is affected by the femoral canal morphology and varies according to stem geometry. We investigated the difference and variation of the increase in anteversion between 2 types of cementless stems, and the correlation between each stem and the preoperative femoral anteversion. We retrospectively compared 2 groups of hips that underwent total hip arthroplasty using a metaphyseal filling stem (78 hips) or a tapered wedge stem (83 hips). All the patients had osteoarthritis due to hip dysplasia. Computed tomography was used to measure preoperative femoral anteversion at 5 levels and postoperative stem anteversion. The increase in anteversion of the tapered wedge stem group (22.7° ± 11.6°) was more than that of the metaphyseal filling stem group (17.2° ± 8.3°; P = .0007). The variation of the increase in the tapered wedge stem group was significantly larger than that in the metaphyseal filling stem group (P = .0016). The metaphyseal filling stem group was more highly and positively correlated with femoral anteversion than the tapered wedge stem group. Femoral anteversion affects stem anteversion differently according to stem geometry. The tapered wedge stems had greater variation of the increase in anteversion than did the metaphyseal filling stems. Based on the results of this study, it is difficult to preoperatively estimate the increase in stem anteversion for tapered wedge stems. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Anisotropic structure of the mantle wedge beneath the Ryukyu arc from teleseismic receiver function analysis

    Science.gov (United States)

    McCormack, K. A.; Wirth, E. A.; Long, M. D.

    2011-12-01

    The recycling of oceanic plates back into the mantle through subduction is an important process taking place within our planet. However, many fundamental aspects of subduction systems, such as the dynamics of mantle flow, have yet to be completely understood. Subducting slabs transport water down into the mantle, but how and where that water is released, as well as how it affects mantle flow, is still an open question. In this study, we focus on the Ryukyu subduction zone in southwestern Japan and use anisotropic receiver function analysis to characterize the structure of the mantle wedge. We compute radial and transverse P-to-S receiver functions for eight stations of the broadband F-net array using a multitaper receiver function estimator. We observe coherent P-to-SV converted energy in the radial receiver functions at ~6 sec for most of the stations analyzed consistent with conversions originating at the top of the slab. We also observe conversions on the transverse receiver functions that are consistent with the presence of multiple anisotropic and/or dipping layers. The character of the transverse receiver functions varies significantly along strike, with the northernmost three stations exhibiting markedly different behavior than stations located in the center of the Ryukyu arc. We compute synthetic receiver functions using a forward modeling scheme that can handle dipping interfaces and anisotropic layers to create models for the depths, thicknesses, and strengths of anisotropic layers in the mantle wedge beneath Ryukyu.

  15. Linking Serpentinite Geochemistry with Possible Alteration and Evolution of Supra-Subduction Wedge Mantle

    Science.gov (United States)

    Scambelluri, M.; Cannaò, E.; Agostini, S.; Gilio, M.

    2016-12-01

    Serpentinites are able to transport and release volatiles and fluid-mobile elements (FME) found in arc magmas. Constraining the trace element compositions of these rocks and of fluids released by de-serpentinization improves our knowledge of mass transfer from subduction zones to volcanic arcs, and of the role of slab and wedge mantle in this global process. Studies of high-pressure ultramafic rocks exhumed from plate interface settings reveal the fluid/rock interactions atop the slab and the processes that can affect the mantle wedge. Alpine eclogite-facies antigorite serpentinite (Voltri Massif) and fully de-serpentinized meta-peridotite (Cima di Gagnone) are enriched in sediment-derived As, Sb, U, Pb before peak dehydration. Their Sr, Pb and B isotopic compositions are reset during prograde (forearc) interaction with slab fluids. The eclogitic garnet and olivine from the Cima di Gagnone metaperidotite trap primary inclusions of the fluid released during breakdown of antigorite and chlorite. The inclusions display FME enrichments (high Cl, S; variable Cs, Rb, Ba, B, Pb, As, Sb) indicating element release from rocks to fluids during dehydration under subarc conditions. Our studies show that serpentinized mantle rocks from subduction zones sequester FME from slab fluids and convey these components and radiogenic isotopes into the mantle wedge upon dehydration. The geochemical processes revealed by such plate-interface rocks can apply to the supra-subduction mantle. Shallow element release from slabs to mantle wedge, downdrag of this altered mantle and its subsequent (subarc) dehydration transfers crust-derived FMEs to the arc magma sources without the need of concomitant subarc dehydration/melting of metasedimentary slab components. The slab signature detected in arc lavas can thus result from geochemical mixing of sediment, oceanic crust and ultramafic reservoirs into altered wedge-mantle rocks, rather than being attributed to multiple fluids.

  16. An IBEM solution to the scattering of plane SH-waves by a lined tunnel in elastic wedge space

    Science.gov (United States)

    Liu, Zhongxian; Liu, Lei

    2015-02-01

    The indirect boundary element method (IBEM) is developed to solve the scattering of plane SH-waves by a lined tunnel in elastic wedge space. According to the theory of single-layer potential, the scattered-wave field can be constructed by applying virtual uniform loads on the surface of lined tunnel and the nearby wedge surface. The densities of virtual loads can be solved by establishing equations through the continuity conditions on the interface and zero-traction conditions on free surfaces. The total wave field is obtained by the superposition of free field and scattered-wave field in elastic wedge space. Numerical results indicate that the IBEM can solve the diffraction of elastic wave in elastic wedge space accurately and efficiently. The wave motion feature strongly depends on the wedge angle, the angle of incidence, incident frequency, the location of lined tunnel, and material parameters. The waves interference and amplification effect around the tunnel in wedge space is more significant, causing the dynamic stress concentration factor on rigid tunnel and the displacement amplitude of flexible tunnel up to 50.0 and 17.0, respectively, more than double that of the case of half-space. Hence, considerable attention should be paid to seismic resistant or anti-explosion design of the tunnel built on a slope or hillside.

  17. Characterizing and configuring motorized wedge for a new generation telecobalt machine in a treatment planning system

    Directory of Open Access Journals (Sweden)

    Kinhikar Rajesh

    2007-01-01

    Full Text Available A new generation telecobalt unit, Theratron Equinox-80, (MDS Nordion, Canada has been evaluated. It is equipped with a single 60-degree motorized wedge (MW, four universal wedges (UW for 150, 300, 450 and 600. MW was configured in Eclipse (Varian, Palo Alto, USA 3D treatment planning system (TPS. The profiles and central axis depth doses (CADD were measured with radiation field analyzer blue water phantom for MW. These profiles and CADD for MW were compared with UW in a homogeneous phantom generated in Eclipse for various field sizes. The absolute dose was measured for a field size of 10 x 10 cm2 only in a MEDTEC water phantom at 10 cm depth with a 0.13 cc thimble ion chamber (Scanditronix Wellhofer, Uppsala, Sweden and a NE electrometer (Nuclear Enterprises, UK. Measured dose with ion chamber was compared with the TPS predicted dose. MW angle was verified on the Equinox for four angles (15o, 30o, 45o and 60o. The variation in measured and calculated dose at 10 cm depth was within 2%. The measured and the calculated wedge angles were in well agreement within 2o. The motorized wedges were successfully configured in Eclipse for four wedge angles.

  18. Anterior lamina cribrosa surface position in idiopathic intracranial hypertension and glaucoma

    DEFF Research Database (Denmark)

    Villarruel, Jenni Martinez; Li, Xiao Q.; Bach-Holm, Daniella

    2017-01-01

    Purpose: To compare the anterior lamina cribrosa (LC) surface position in patients with idiopathic intracranial hypertension (IIH), primary open-angle glaucoma (high-tension glaucoma [HTG] and normal-tension glaucoma [NTG]), and healthy controls using enhanced depth imaging spectral-domain optical...

  19. Early age stress-crack opening relationships for high performance concrete

    DEFF Research Database (Denmark)

    Østergaard, Lennart; Lange, David A.; Stang, Henrik

    2004-01-01

    Stress–crack opening relationships for concrete in early age have been determined for two high performance concrete mixes with water to cementitious materials ratios of 0.307 and 0.48. The wedge splitting test setup was used experimentally and the cracked nonlinear hinge model based...... on the fictitious crack model was applied for the interpretation of the results. A newly developed inverse analysis algorithm was utilized for the extraction of the stress–crack opening relationships. Experiments were conducted at 8, 10, 13, 17, 22, 28, 48, 168 h (7 days) and 672 h (28 days). At the same ages...

  20. Nature of the Coastal Range Wedge Along the Rupture Area of the 2015, Illapel Chile Earthquake Mw 8.4

    Science.gov (United States)

    Farías, M.; Comte, D.; Roecker, S. W.; Brandon, M. T.

    2017-12-01

    Wedge theory is usually applied to the pro-side of active subduction margins, where fold-and-thrust belts related to frontal accretion develop, but rarely to the entire wedge, where the retro-side is also relevant. We present a new 3D body wave tomographic image that combines data from the Chile-Illapel Aftershock Experiment (CHILLAX) with previous temporary seismic networks, with the aim of illuminating the nature of the wedge of the continental margin above the seismogenic part of the subducting slab. The downdip extent of the coupled part, called the S-point in the wedge theory, corresponds to the place where upper plate completely decouples from the subducting slab. This point is characterized by a Vp/Vs contrast at about 60 km depth that extends upward-and-eastward in a west-dipping ramp-like geometry. This ramp emerges about 180 km from the trench, near the topographic break related to the front of the Andean retro-side. The Coastal wedge domain is characterized by a monotonous east-dipping homocline with the older rocks of this region along the coast. The offshore region, corresponding to the pro-side, exhibits normal faulting and a very small frontal accretionary complex. Normal faulting in this region is related to rapid uplift of marine terraces since ca. 2 Ma, suggesting strong basal accretion and thus high friction on the thrust. In fact, the epicentral region of the 2015 Illapel Earthquake coincides with the highest elevations along the coast, i.e., the region with the highest slope of the margin. In this region, the lack of a continental forearc basin suggests an overlapping between the Andean and Coastal wedges. The western edge of the Andean wedge is also part of the homocline about 10 km east of the topographic boundary between both wedges, suggesting that the Coastal wedge has been deforming a part of the retro-side of the Andean wedge during the Miocene. The east-ward tilting of the retro-side was acquired mainly before the late Miocene, since at

  1. BIRTH INJURY RELATED UNILATERAL ANTERIOR NARES PARTIAL FIBROUS ATRESIA: A RARE CASE REPORT

    Directory of Open Access Journals (Sweden)

    Jayagar

    2016-02-01

    Full Text Available Congenital atresia of anterior nares has been rarely reported and it may co-exist along with posterior choanal atresia. (1,2 In our case, birth injury caused by forceps delivery has caused unilateral anterior nares partial atresia. Twenty eight years old male patient came with the complaints of left nostril blocked sensation since birth, aggravated with attacks of upper respiratory tract infections. On examination he had left anterior nares partial atresia caused by fibrous bands as a result of birth injury due to instrumental delivery. Rhinoplasty performed to open-up left nostril and patient relieved of his symptoms and also on cosmetic appearance

  2. Modes of continental extension in a crustal wedge

    KAUST Repository

    Wu, Guangliang

    2015-07-01

    © 2015 Elsevier B.V. We ran numerical experiments of the extension of a crustal wedge as an approximation to extension in an orogenic belt or a continental margin. We study the effects of the strength of the lower crust and of a weak mid-crustal shear zone on the resulting extension styles. A weak mid-crustal shear zone effectively decouples upper crustal extension from lower crustal flow. Without the mid-crustal shear zone, the degree of coupling between the upper and the lower crust increases and extension of the whole crust tends to focus on the thickest part of the wedge. We identify three distinct modes of extension determined by the strength of the lower crust, which are characterized by 1) localized, asymmetric crustal exhumation in a single massif when the lower crust is weak, 2) the formation of rolling-hinge normal faults and the exhumation of lower crust in multiple core complexes with an intermediate strength lower crust, and 3) distributed domino faulting over the weak mid-crustal shear zone when the lower crust is strong. A frictionally stronger mid-crustal shear zone does not change the overall model behaviors but extension occurred over multiple rolling-hinges. The 3 modes of extension share characteristics similar to geological models proposed to explain the formation of metamorphic core complexes: 1) the crustal flow model for the weak lower crust, 2) the rolling-hinge and crustal flow models when the lower crust is intermediate and 3) the flexural uplift model when the lower crust is strong. Finally we show that the intensity of decoupling between the far field extension and lower crustal flow driven by the regional pressure gradient in the wedge control the overall style of extension in the models.

  3. Modes of continental extension in a crustal wedge

    KAUST Repository

    Wu, Guangliang; Lavier, Luc L.; Choi, Eunseo

    2015-01-01

    © 2015 Elsevier B.V. We ran numerical experiments of the extension of a crustal wedge as an approximation to extension in an orogenic belt or a continental margin. We study the effects of the strength of the lower crust and of a weak mid-crustal shear zone on the resulting extension styles. A weak mid-crustal shear zone effectively decouples upper crustal extension from lower crustal flow. Without the mid-crustal shear zone, the degree of coupling between the upper and the lower crust increases and extension of the whole crust tends to focus on the thickest part of the wedge. We identify three distinct modes of extension determined by the strength of the lower crust, which are characterized by 1) localized, asymmetric crustal exhumation in a single massif when the lower crust is weak, 2) the formation of rolling-hinge normal faults and the exhumation of lower crust in multiple core complexes with an intermediate strength lower crust, and 3) distributed domino faulting over the weak mid-crustal shear zone when the lower crust is strong. A frictionally stronger mid-crustal shear zone does not change the overall model behaviors but extension occurred over multiple rolling-hinges. The 3 modes of extension share characteristics similar to geological models proposed to explain the formation of metamorphic core complexes: 1) the crustal flow model for the weak lower crust, 2) the rolling-hinge and crustal flow models when the lower crust is intermediate and 3) the flexural uplift model when the lower crust is strong. Finally we show that the intensity of decoupling between the far field extension and lower crustal flow driven by the regional pressure gradient in the wedge control the overall style of extension in the models.

  4. Dehydration of chlorite explains anomalously high electrical conductivity in the mantle wedges.

    Science.gov (United States)

    Manthilake, Geeth; Bolfan-Casanova, Nathalie; Novella, Davide; Mookherjee, Mainak; Andrault, Denis

    2016-05-01

    Mantle wedge regions in subduction zone settings show anomalously high electrical conductivity (~1 S/m) that has often been attributed to the presence of aqueous fluids released by slab dehydration. Laboratory-based measurements of the electrical conductivity of hydrous phases and aqueous fluids are significantly lower and cannot readily explain the geophysically observed anomalously high electrical conductivity. The released aqueous fluid also rehydrates the mantle wedge and stabilizes a suite of hydrous phases, including serpentine and chlorite. In this present study, we have measured the electrical conductivity of a natural chlorite at pressures and temperatures relevant for the subduction zone setting. In our experiment, we observe two distinct conductivity enhancements when chlorite is heated to temperatures beyond its thermodynamic stability field. The initial increase in electrical conductivity to ~3 × 10(-3) S/m can be attributed to chlorite dehydration and the release of aqueous fluids. This is followed by a unique, subsequent enhancement of electrical conductivity of up to 7 × 10(-1) S/m. This is related to the growth of an interconnected network of a highly conductive and chemically impure magnetite mineral phase. Thus, the dehydration of chlorite and associated processes are likely to be crucial in explaining the anomalously high electrical conductivity observed in mantle wedges. Chlorite dehydration in the mantle wedge provides an additional source of aqueous fluid above the slab and could also be responsible for the fixed depth (120 ± 40 km) of melting at the top of the subducting slab beneath the subduction-related volcanic arc front.

  5. Plate Versus Intramedullary Nail Fixation of Anterior Tibial Stress Fractures: A Biomechanical Study.

    Science.gov (United States)

    Markolf, Keith L; Cheung, Edward; Joshi, Nirav B; Boguszewski, Daniel V; Petrigliano, Frank A; McAllister, David R

    2016-06-01

    Anterior midtibial stress fractures are an important clinical problem for patients engaged in high-intensity military activities or athletic training activities. When nonoperative treatment has failed, intramedullary (IM) nail and plate fixation are 2 surgical options used to arrest the progression of a fatigue fracture and allow bone healing. A plate will be more effective than an IM nail in preventing the opening of a simulated anterior midtibial stress fracture from tibial bending. Controlled laboratory study. Fresh-frozen human tibias were loaded by applying a pure bending moment in the sagittal plane. Thin transverse saw cuts, 50% and 75% of the depth of the anterior tibial cortex, were created at the midtibia to simulate a fatigue fracture. An extensometer spanning the defect was used to measure the fracture opening displacement (FOD) before and after the application of IM nail and plate fixation constructs. IM nails were tested without locking screws, with a proximal screw only, and with proximal and distal screws. Plates were tested with unlocked bicortical screws (standard compression plate) and locked bicortical screws; both plate constructs were tested with the plate edge placed 1 mm from the anterior tibial crest (anterior location) and 5 mm posterior to the crest. For the 75% saw cut depth, the mean FOD values for all IM nail constructs were 13% to 17% less than those for the saw cut alone; the use of locking screws had no significant effect on the FOD. The mean FOD values for all plate constructs were significantly less than those for all IM nail constructs. The mean FOD values for all plates were 28% to 46% less than those for the saw cut alone. Anterior plate placement significantly decreased mean FOD values for both compression and locked plate constructs, but the mean percentage reductions for locked and unlocked plates were not significantly different from each other for either plate placement. The percentage FOD reductions for all plate

  6. Perturbation solutions for flow through symmetrical hoppers with inserts and asymmetrical wedge hoppers

    Science.gov (United States)

    Cox, G. M.; Mccue, S. W.; Thamwattana, N.; Hill, J. M.

    Under certain circumstances, an industrial hopper which operates under the "funnel-flow" regime can be converted to the "mass-flow" regime with the addition of a flow-corrective insert. This paper is concerned with calculating granular flow patterns near the outlet of hoppers that incorporate a particular type of insert, the cone-in-cone insert. The flow is considered to be quasi-static, and governed by the Coulomb-Mohr yield condition together with the non-dilatant double-shearing theory. In two-dimensions, the hoppers are wedge-shaped, and as such the formulation for the wedge-in-wedge hopper also includes the case of asymmetrical hoppers. A perturbation approach, valid for high angles of internal friction, is used for both two-dimensional and axially symmetric flows, with analytic results possible for both leading order and correction terms. This perturbation scheme is compared with numerical solutions to the governing equations, and is shown to work very well for angles of internal friction in excess of 45°.

  7. Analysis of Mechanical Energy Transport on Free-Falling Wedge during Water-Entry Phase

    Directory of Open Access Journals (Sweden)

    Wen-Hua Wang

    2012-01-01

    Full Text Available For better discussing and understanding the physical phenomena and body-fluid interaction of water-entry problem, here mechanical-energy transport (wedge, fluid, and each other of water-entry model for free falling wedge is studied by numerical method based on free surface capturing method and Cartesian cut cell mesh. In this method, incompressible Euler equations for a variable density fluid are numerically calculated by the finite volume method. Then artificial compressibility method, dual-time stepping technique, and Roe's approximate Riemann solver are applied in the numerical scheme. Furthermore, the projection method of momentum equations and exact Riemann solution are used to calculate the fluid pressure on solid boundary. On this basis, during water-entry phase of the free-falling wedge, macroscopic energy conversion of overall body-fluid system and microscopic energy transformation in fluid field are analyzed and discussed. Finally, based on test cases, many useful conclusions about mechanical energy transport for water entry problem are made and presented.

  8. Complex Anisotropic Structure of the Mantle Wedge Beneath Kamchatka Volcanoes

    Science.gov (United States)

    Levin, V.; Park, J.; Gordeev, E.; Droznin, D.

    2002-12-01

    A wedge of mantle material above the subducting lithospheric plate at a convergent margin is among the most dynamic environments of the Earth's interior. Deformation and transport of solid and volatile phases within this region control the fundamental process of elemental exchange between the surficial layers and the interior of the planet. A helpful property in the study of material deformation and transport within the upper mantle is seismic anisotropy, which may reflect both microscopic effects of preferentialy aligned crystals of olivine and orthopyroxene and macroscopic effects of systematic cracks, melt lenses, layering etc. Through the mapping of anisotropic properties within the mantle wedge we can establish patterns of deformation. Volatile content affects olivine alignment, so regions of anomalous volatile content may be evident. Indicators of seismic anisotropy commonly employed in upper mantle studies include shear wave birefringence and mode-conversion between compressional and shear body waves. When combined together, these techniques offer complementary constraints on the location and intensity of anisotropic properties. The eastern coast of southern Kamchatka overlies a vigorous convergent margin where the Pacific plate descends at a rate of almost 80 mm/yr towards the northwest. We extracted seismic anisotropy indicators from two data sets sensitive to the anisotropic properties of the uppermost mantle. Firstly, we evaluated teleseismic receiver functions for a number of sites, and found ample evidence for anisotropicaly-influenced P-to-S mode conversion. Secondly, we measured splitting in S waves of earthquakes with sources within the downgoing slab. The first set of observations provides constraints on the depth ranges where strong changes in anisotropic properties take place. The local splitting data provides constraints on the cumulative strength of anisotropic properties along specific pathways through the mantle wedge and possibly parts of

  9. The solar photovoltaics wedge: pathways for growth and potential carbon mitigation in the US

    Energy Technology Data Exchange (ETDEWEB)

    Drury, Easan; Denholm, Paul [National Renewable Energy Laboratory, 1617 Cole Boulevard, Golden, CO 80401 (United States); Margolis, Robert M, E-mail: easan.drury@nrel.go [National Renewable Energy Laboratory, 901 D Street SW, Suite 930, Washington, DC 20024 (United States)

    2009-09-15

    The challenge of stabilizing global carbon emissions over the next 50 years has been framed in the context of finding seven 1.0 Gton C/year carbon reduction wedges. Solar photovoltaics (PV) could provide at least one carbon wedge, but will require significant growth in PV manufacturing capacity. The actual amount of installed PV capacity required to reach wedge-level carbon reductions will vary greatly depending on the mix of avoided fuels and the additional emissions from manufacturing PV capacity. In this work, we find that the US could reduce its carbon emissions by 0.25 Gton C/year, equal to the fraction of a global carbon wedge proportional to its current domestic electricity use, by installing 792-811 GW of PV capacity. We evaluate a series of PV growth scenarios and find that wedge-level reductions could be met by increasing PV manufacturing capacity and annual installations by 0.95 GW/year/year each year from 2009 to 2050 or by increasing up to 4 GW/year/year for a period of 4-17 years for early and late growth scenarios. This challenge of increasing PV manufacturing capacity and market demand is significant but not out of line with the recent rapid growth in both the global and US PV industry. We find that the rapid growth in PV manufacturing capacity leads to a short term increase in carbon emissions from the US electric sector. However, this increase is small, contributing less than an additional 0.3% to electric sector emissions for less than 4.5 years, alleviating recent concern regarding carbon emissions from rapid PV growth scenarios.

  10. Anterior colorectal duplication presenting as rectal prolapse.

    Science.gov (United States)

    Ramirez-Resendiz, Amador; Asz, Jose; Medina-Vega, F Antonio; Ortega-Salgado, J Arturo

    2007-09-01

    Duplications of the gastrointestinal (GI) tract are rare. Only 5% of them are rectal and there are very few reports of rectal prolapse (RP) caused by a duplication. An 11 month-old female presented with a RP caused by a blind-ended anterior tubular colorectal duplication. The duplication was successfully opened and connected to the normal rectum without complications. Although infrequent, a rectal duplication should be considered in the differential diagnosis of RP.

  11. Application of Green's differential equation to the analysis of ion-matrix sheaths around wedge-shaped cathodes

    International Nuclear Information System (INIS)

    Donolato, C

    2005-01-01

    A relation between the gradient of the electric field and mean curvature of equipotential surfaces (Green's differential equation) is applied to a two-dimensional free-boundary problem arising in the study of ion sheaths around wedge-shaped cathodes. With the assumption that the equipotential lines are hyperbolae, this relation leads to a nonlinear ordinary differential equation for the potential along the bisector line of the wedge. An approximate solution is found, which yields, in particular, the sheath width along this line as a function of the wedge angle. The resulting values are in good agreement with published results obtained by numerically solving Poisson's equation

  12. Head position in the MEG helmet affects the sensitivity to anterior sources.

    Science.gov (United States)

    Marinkovic, K; Cox, B; Reid, K; Halgren, E

    2004-11-30

    Current MEG instruments derive the whole-head coverage by utilizing a helmet-shaped opening at the bottom of the dewar. These helmets, however, are quite a bit larger than most people's heads so subjects commonly lean against the back wall of the helmet in order to maintain a steady position. In such cases the anterior brain sources may be too distant to be picked up by the sensors reliably. Potential "invisibility" of the frontal and anterior temporal sources may be particularly troublesome for the studies of cognition and language, as they are subserved significantly by these areas. We examined the sensitivity of the distributed anatomically-constrained MEG (aMEG) approach to the head position ("front" vs. "back") secured within a helmet with custom-tailored bite-bars during a lexical decision task. The anterior head position indeed resulted in much greater sensitivity to language-related activity in frontal and anterior temporal locations. These results emphasize the need to adjust the head position in the helmet in order to maximize the "visibility" of the sources in the anterior brain regions in cognitive and language tasks.

  13. Differential wedging of vertebral body and intervertebral disc in thoracic and lumbar spine in adolescent idiopathic scoliosis – A cross sectional study in 150 patients

    Directory of Open Access Journals (Sweden)

    Kim Hak-Jun

    2008-08-01

    Full Text Available Abstract Background Hueter-Volkmann's law regarding growth modulation suggests that increased pressure on the end plate of bone retards the growth (Hueter and conversely, reduced pressure accelerates the growth (Volkmann. Literature described the same principle in Rat-tail model. Human spine and its deformity i.e. scoliosis has also same kind of pattern during the growth period which causes wedging in disc or vertebral body. Methods This cross sectional study in 150 patients of adolescent idiopathic scoliosis was done to evaluate vertebral body and disc wedging in scoliosis and to compare the extent of differential wedging of body and disc, in thoracic and lumbar area. We measured wedging of vertebral bodies and discs, along with two adjacent vertebrae and disc, above and below the apex and evaluated them according to severity of curve (curve 30° to find the relationship of vertebral body or disc wedging with scoliosis in thoracic and lumbar spine. We also compared the wedging and rotations of vertebrae. Results In both thoracic and lumbar curves, we found that greater the degree of scoliosis, greater the wedging in both disc and body and the degree of wedging was more at apex supporting the theory of growth retardation in stress concentration area. However, the degree of wedging in vertebral body is more than the disc in thoracic spine while the wedging was more in disc than body in lumbar spine. On comparing the wedging with the rotation, we did not find any significant relationship suggesting that it has no relation with rotation. Conclusion From our study, we can conclude that wedging in disc and body are increasing with progression on scoliosis and maximum at apex; however there is differential wedging of body and disc, in thoracic and lumbar area, that is vertebral body wedging is more profound in thoracic area while disc wedging is more profound in lumbar area which possibly form 'vicious cycle' by asymmetric loading to spine for the

  14. Bone-femoral component interface gap after sagittal mechanical axis alignment is filled with new bone after cementless total knee arthroplasty.

    Science.gov (United States)

    Kuriyama, Shinichi; Hyakuna, Katsufumi; Inoue, Satoshi; Kawai, Yasutsugu; Tamaki, Yasuyuki; Ito, Hiromu; Matsuda, Shuichi

    2018-05-01

    This study retrospectively evaluated the fate of mismatch between an uncemented femoral component and each femoral cut surface (i.e., wedge-shaped gap) relative to sagittal mechanical alignment in total knee arthroplasty (TKA). Primary TKA was performed on 99 consecutive knees. The femoral components were aligned to the sagittal mechanical axis with CT-based navigation. All patients were assessed with postoperative true lateral radiographs. Bone-side surfaces of the uncemented femoral component were divided into five zones: anterior flange, anterior chamfer, posterior chamfer, posterior part, and distal part, which were defined as zones 1 to 5, respectively. Bone filling of wedge-shaped gaps in each zone was evaluated after 1 year. Femoral anterior notching did not occur. However, wedge-shaped gaps were observed in at least one zone in 23 of 99 knees (23%), most frequently in zone 5 (18%). There were 9 and 7 gaps in zones 1 and 2, respectively. The femoral component showed malpositioning of approximately 3° of flexion in cases with wedge-shaped gaps in zones 2 and/or 5. After one year, 67% (6/9) of zone 1, 100% (7/7) of zone 2, and 94% (17/18) of zone 5 wedge-shaped gaps were filled in with new bone. Femoral alignment relative to sagittal mechanical axis caused wedge-shaped gaps due to unstable anterior bone cutting through hard bone, but the small gaps were not clinically significant and filled in within one year. Sagittal setting of the femoral component should aim for the anatomical axis rather than the mechanical axis. IV.

  15. Return to Play Following Anterior Shoulder Dislocation and Stabilization Surgery.

    Science.gov (United States)

    Donohue, Michael A; Owens, Brett D; Dickens, Jonathan F

    2016-10-01

    Anterior shoulder instability in athletes may lead to time lost from participation and decreases in level of play. Contact, collision, and overhead athletes are at a higher risk than others. Athletes may successfully be returned to play but operative stabilization should be considered for long-term treatment of recurrent instability. Open and arthroscopic stabilization procedures for athletes with less than 20% to 25% bone loss improve return to play rates and decrease recurrent instability, with a slightly lower recurrence with open stabilization. For athletes with greater than 20% to 25% bone loss, an open osseous augmentation procedure should be considered. Published by Elsevier Inc.

  16. Anterior segment changes after pharmacologic mydriasis using Pentacam and optical coherence tomography in angle closure suspects

    Directory of Open Access Journals (Sweden)

    Jing-Min Guo

    2015-10-01

    Full Text Available AIM:To compare the dynamic changes of anterior segment parameters especially iris morphology induced by pharmacologic mydriasis between angle closure suspects and normal controls.METHODS:The study group comprised 19 eyes of 19 angle closure suspects and 19 eyes of 19 age- and sex-matched normal open-angle eyes. Pentacam and optical coherence tomography measurements before and 30min after instillation of compound tropicamide eye drop were performed and compared. Biometric evaluations of iris tomography and anterior chamber angle were estimated by a customized image-processing software.RESULTS:Baseline axial length, iris cross sectional area and volume did not differ significantly between angle closure suspects and normal controls. Angle closure suspects had smaller pupil size, narrower anterior segment dimension and axial length, thinner iris with greater curve in comparison with normal controls. Pharmacologic mydriasis led to significant increments in iris thickness at 750 μm, anterior chamber depth and volume, whereas significant decrements in iris curve, cross sectional area and volume in both groups. Angle opening distance at 500 μm was increased significantly in normal controls (from 0.465±0.115 mm to 0.539±0.167 mm, P=0.009, but not in angle closure suspects (from 0.125±0.100 mm to 0.145±0.131 mm, P=0.326. Iris volume change per millimeter of pupil dilation (△IV/△PD decreased significantly less in angle closure suspects than normal controls (-2.47±1.33 mm2 vs -3.63±1.58 mm2, P=0.019. Linear regression analysis showed that the change of angle opening distance at 500 μm was associated most with the change of central anterior chamber depth (β=0.841, P=0.002 and △IV/△PD (β=0.028, P=0.002, followed by gender (β=0.062, P=0.032.CONCLUSION:Smaller iris volume decrement per millimeter of pupil dilation is related significantly with the less anterior angle opening in angle closure suspects after pharmacologic mydriasis. Dynamic

  17. The Oldman River triangle zone: a complicated tectonic wedge delineated by new structural mapping and seismic interpretation

    Energy Technology Data Exchange (ETDEWEB)

    Stockmal, G. S. [Geological Survey of Canada, Calgary, AB (Canada). Inst. of Sedimentary and Petroleum Geology; Lawton, D. C.; Spratt, D. [Calgary Univ., AB (Canada). Dept. of Geology and Geophysics; MacKay, P. A.

    1996-06-01

    The triangle zone exposed along and adjacent to the Alberta Foothills was characterized on the basis of new structural mapping and seismic surveys. Results indicate that the zone is comprised of a complicated structure involving significant deformation in the hanging wall of the upper detachment, including orogenic thrusts and large orogen-vergent folds, as well as secondary orogen-directed tectonic wedging. This structure is considered to be an example of a `nested` triangle zone, where an `outer` tectonic wedge with modest shortening encases an `inner` counterpart with substantially more shortening. Both of these wedges show evidence of synchronous deformation. 23 refs., 9 figs.

  18. Comparison of gonioscopy and anterior segment ocular coherence tomography in detecting angle closure in different quadrants of the anterior chamber angle.

    Science.gov (United States)

    Sakata, Lisandro M; Lavanya, Raghavan; Friedman, David S; Aung, Han T; Gao, Hong; Kumar, Rajesh S; Foster, Paul J; Aung, Tin

    2008-05-01

    To compare the performance of gonioscopy and anterior segment (AS) optical coherence tomography (OCT) in detecting angle closure in the different quadrants of the anterior chamber angle (ACA). Cross-sectional observational study. Five hundred two consecutive subjects more than 50 years of age with no previous ophthalmic problems recruited from a community clinic in Singapore. All subjects underwent gonioscopy and AS OCT imaging in the dark. Using gonioscopy, the ACA was graded using the Scheie system by a single examiner masked to AS OCT findings. The ACA in a particular quadrant was classified as closed if the posterior trabecular meshwork could not be seen on gonioscopy. A closed ACA on AS OCT imaging was defined by the presence of any contact between the iris and angle wall anterior to the scleral spur. After excluding eyes with poor image quality, a total of 423 right eyes were included in the analysis. A closed angle in at least 1 quadrant was observed in 59% of the eyes by AS OCT and in 33% of the eyes by gonioscopy (Pgonioscopy were 48% versus 29% superiorly, 43% versus 22% inferiorly, 18% versus 14% nasally, and 12% versus 20% temporally, respectively. Of the 119 of 1692 quadrants that were closed on gonioscopy but open on AS OCT, a steep iris profile was present in 61 (51%) of 119 quadrants on AS OCT, and of the 276 of 1692 quadrants that were open on gonioscopy but closed on AS OCT, 196 (71%) of 276 quadrants showed short iridoangle contact on AS OCT. The highest rates of closed angles on gonioscopy and AS OCT images were observed in the superior quadrant. Anterior segment OCT tended to detect more closed ACAs than gonioscopy, particularly in the superior and inferior quadrants. Variations in the iris profile and level of iridoangle contact also may explain some of the differences seen between gonioscopy and AS OCT.

  19. A paired wedge filter system for compensation in dose differences

    International Nuclear Information System (INIS)

    Kobayashi, H.; Sakurai, Y.; Kondo, S.; Abe, S.; Hayakawa, N.; Aoyama, Y.; Obata, Y.; Ishigaki, T.

    1998-01-01

    Objective: In radiotherapy, it is important to conform the high dose volume to the planned target volume. A variable thickness paired wedge filter system was developed to compensate for dose inhomogeneity arising from field width segment variation in conformal irradiation. Materials and methods: The present study used a 6 MV linear accelerator equipped with multileaf collimator leaves and a paired wedge compensating filter system. The dose variation due to field width was measured in each field segment width. The variation in attenuation of the compensators was measured as a function of filter position. As the field width increases, the relative absorbed dose also increases; this is the point of requiring compensation, so it can be in reverse proportion. Results: As the field width increases, the relative absorbed dose also increases; this is why compensation is required and thus it must be in reverse proportion. Attenuation of the absorbed dose by the paired filters was in proportion to the filter position. The filter position to compensate for the difference of absorbed doses was defined by the square root of the field width. For a field varying in width from 4 to 16 cm, the variation in the absorbed dose across the field was reduced from 12% to 2.7%. Conclusion: This paired wedge filter system reduced absorbed dose variations across multileaf collimator shaped fields and can facilitate treatment planning in conformal therapy. (Copyright (c) 1998 Elsevier Science B.V., Amsterdam. All rights reserved.)

  20. Complex Wedge-Shaped Matrices: A Generalization of Jacobi Matrices

    Czech Academy of Sciences Publication Activity Database

    Hnětynková, Iveta; Plešinger, M.

    2015-01-01

    Roč. 487, 15 December (2015), s. 203-219 ISSN 0024-3795 R&D Projects: GA ČR GA13-06684S Keywords : eigenvalues * eigenvector * wedge-shaped matrices * generalized Jacobi matrices * band (or block) Krylov subspace methods Subject RIV: BA - General Mathematics Impact factor: 0.965, year: 2015

  1. Differences between Non-arteritic Anterior Ischemic Optic Neuropathy and Open Angle Glaucoma with Altitudinal Visual Field Defect.

    Science.gov (United States)

    Han, Sangyoun; Jung, Jong Jin; Kim, Ungsoo Samuel

    2015-12-01

    To investigate the differences in retinal nerve fiber layer (RNFL) change and optic nerve head parameters between non-arteritic anterior ischemic optic neuropathy (NAION) and open angle glaucoma (OAG) with altitudinal visual field defect. Seventeen NAION patients and 26 OAG patients were enrolled prospectively. The standard visual field indices (mean deviation, pattern standard deviation) were obtained from the Humphrey visual field test and differences between the two groups were analyzed. Cirrus HD-OCT parameters were used, including optic disc head analysis, average RNFL thickness, and RNFL thickness of each quadrant. The mean deviation and pattern standard deviation were not significantly different between the groups. In the affected eye, although the disc area was similar between the two groups (2.00 ± 0.32 and 1.99 ± 0.33 mm(2), p = 0.586), the rim area of the OAG group was smaller than that of the NAION group (1.26 ± 0.56 and 0.61 ± 0.15 mm(2), respectively, p field defects, optic disc head analysis of not only the affected eye, but also the unaffected eye, by using spectral domain optical coherence tomography may be helpful.

  2. [Characteristics of opening movement in patients with unilateral mastication].

    Science.gov (United States)

    Jia, Ling; Wang, Yun; Wang, Mengya

    2016-08-01

    To analyze characteristics of mandibular movement in patients with unilateral mastication.
 Undergraduate students in oral medicine from Grade 2011 and 2012 in Wannan Medical College were enrolled for this study by cluster sampling method, which include 30 people with unilateral mastication and 30 people with bilateral mastication. The surface electromyogram (sEMG) of masseter muscle and anterovent of digastric muscle were recorded and the trajectory of mandibular incisor point was recorded simultaneously in the maximum opening and closing movement. The results were analyzed by SPSS 19.0 software.
 Average electrical peak of left anterior digastric muscle and right anterior digastric muscle in the unilateral chewing group was lower than that in the bilateral chewing group (P<0.05). The jaw tangent point trajectory was separate in the unilateral chewing group. There were significant differences at the opening type between the 2 groups. The vertical displacement and the sagittal displacement in the unilateral chewing group were significantly lower than those in the bilateral chewing group (P<0.01). There was significant positive correlation between the average peak potential of masseter muscle and displacement on the right side.
 Average electrical peak of left masseter muscle, left anterior digastric muscle, and right anterior digastric muscle decreases in the unilateral chewing group. Jaw tracking in most people deflects to the working side. Opening and closing jaw tracking is separate in 50% unilateral chewing individuals with the decreased opening degree. Unilateral chewing leads to changes in muscle performance accompanied by trajectory anomalies.

  3. Kinematic segmentation of accretive wedges based on scaled sandbox experiments and their application to nature

    Science.gov (United States)

    Lohrmann, J.; Kukowski, N.; Oncken, O.

    2003-04-01

    Recording the incremental displacement field of scaled analogue simulations provides detailed data on wedge kinematics and timing of internal deformation. This is a very efficient tool to develop kinematic concepts and test mechanical theories, e.g. the critical-taper theory. Such models could not be validated until now by the available geological and geophysical data, since there was no information about the incremental displacement field. Recent GPS measurements and seismological investigations at convergent margins provide well-constrained strain-rates and kinematics of short-termed processes. These data allow the kinematic models that are based on analogue simulations to be tested against field observations. We investigate convergent accretive sand wedges in scaled analogue simulations. We define three kinematic segments based on distinctive wedge taper, displacement field and timing of deformation (recorded at a slow sampling rate, which represents the geological scale). Only one of these segments is in a critical state of stress, whereas the other segments are either in a sub-critical or stable state of stress. Such a kinematic segmentation is not predicted for ideally homogeneous wedge-shaped bodies by the critical-taper theory, but can be explained by the formation of localised weak shear zones, which preferentially accommodate deformation. These weak zones are formed in granular analogue materials, and also in natural rocks, since these materials show a strain-softening phase prior to the achievement of stable mechanical conditions. Therefore we suggest that the kinematic segmentation of convergent sand wedges should also be observed in natural settings, such as accretionary wedges, foreland fold-and-thrust belts and even entire orogens. To validate this hypothesis we compare strain rates from GPS measurements and kinematics deduced from focal mechanisms with the respective data from sandbox experiments. We present a strategy to compare strain rates and

  4. INTEGRITY OF THE SUBSCAPULARIS TENDON AFTER OPEN SURGERY FOR THE TREATMENT OF ANTERIOR SHOULDER INSTABILITY: A CLINICAL AND RADIOLOGICAL EVALUATION.

    Science.gov (United States)

    Lech, Osvandré; Piluski, Paulo; Tambani, Renato; Castro, Nero; Pimentel, Gilnei

    2009-01-01

    To evaluate the integrity of the subscapularis tendon by strength, function and magnetic resonance imaging after deltopectoralis access for anterior shoulder instability. 20 patients with anterior shoulder instability have been evaluated. Minimum follow-up was 12 months, with a mean of 40 months. Only male patients were included, with a mean of age of 29 years (20 - 42 years). The patients have been submitted to physical examinations of mobility, muscular strength, Belly Test and Gerber Test. The isokinetic strength in internal and external rotation, in angular speeds of 60(0)/s and 180(0)/s, for both shoulders was measured using a dynamometer. In 15 patients magnetic resonance imaging (MRI) was carried out on both shoulders for evaluating the thickness, cross-sectional area and atrophy of the subscapularis muscle. A significant difference was found between torque peaks at the speed of 60(0)/s for internal (p=0.036) and external (p=0.008) rotation. However, at 180(0)/s the opposite happens (internal rotation: p=0.133; external rotation: p=0.393). Subscapularis muscle thickness and area are significantly smaller than the normal side, with a deficit of 19% and 23%, respectively. According to Rowe and UCLA scores, we find excellent and good results for the majority of patients, with a mean of 88 and 31.6 points, respectively. Despite of the good functional results, open surgery can limit strength and reduce the thickness and the cross-sectional area of subscapularis muscle. However, the best results were found in the patients who had the dominant side operated.

  5. INTEGRITY OF THE SUBSCAPULARIS TENDON AFTER OPEN SURGERY FOR THE TREATMENT OF ANTERIOR SHOULDER INSTABILITY: A CLINICAL AND RADIOLOGICAL EVALUATION

    Science.gov (United States)

    Lech, Osvandré; Piluski, Paulo; Tambani, Renato; Castro, Nero; Pimentel, Gilnei

    2015-01-01

    Objective: To evaluate the integrity of the subscapularis tendon by strength, function and magnetic resonance imaging after deltopectoralis access for anterior shoulder instability. Methods: 20 patients with anterior shoulder instability have been evaluated. Minimum follow-up was 12 months, with a mean of 40 months. Only male patients were included, with a mean of age of 29 years (20 − 42 years). The patients have been submitted to physical examinations of mobility, muscular strength, Belly Test and Gerber Test. The isokinetic strength in internal and external rotation, in angular speeds of 600/s and 1800/s, for both shoulders was measured using a dynamometer. In 15 patients magnetic resonance imaging (MRI) was carried out on both shoulders for evaluating the thickness, cross-sectional area and atrophy of the subscapularis muscle. Results: A significant difference was found between torque peaks at the speed of 600/s for internal (p=0.036) and external (p=0.008) rotation. However, at 1800/s the opposite happens (internal rotation: p=0.133; external rotation: p=0.393). Subscapularis muscle thickness and area are significantly smaller than the normal side, with a deficit of 19% and 23%, respectively. According to Rowe and UCLA scores, we find excellent and good results for the majority of patients, with a mean of 88 and 31.6 points, respectively. Conclusion: Despite of the good functional results, open surgery can limit strength and reduce the thickness and the cross-sectional area of subscapularis muscle. However, the best results were found in the patients who had the dominant side operated. PMID:27004190

  6. Measurement of Rayleigh Wave Beams Using Angle Beam Wedge Transducers as the Transmitter and Receiver with Consideration of Beam Spreading.

    Science.gov (United States)

    Zhang, Shuzeng; Li, Xiongbing; Jeong, Hyunjo

    2017-06-20

    A theoretical model, along with experimental verification, is developed to describe the generation, propagation and reception of a Rayleigh wave using angle beam wedge transducers. The Rayleigh wave generation process using an angle beam wedge transducer is analyzed, and the actual Rayleigh wave sound source distributions are evaluated numerically. Based on the reciprocity theorem and considering the actual sound source, the Rayleigh wave beams are modeled using an area integral method. The leaky Rayleigh wave theory is introduced to investigate the reception of the Rayleigh wave using the angle beam wedge transducers, and the effects of the wave spreading in the wedge and transducer size are considered in the reception process. The effects of attenuations of the Rayleigh wave and leaky Rayleigh wave are discussed, and the received wave results with different sizes of receivers are compared. The experiments are conducted using two angle beam wedge transducers to measure the Rayleigh wave, and the measurement results are compared with the predictions using different theoretical models. It is shown that the proposed model which considers the wave spreading in both the sample and wedges can be used to interpret the measurements reasonably.

  7. Evaluation of the necessity for chest drain placement following thoracoscopic wedge resection.

    Science.gov (United States)

    Lu, Ting-Yu; Chen, Jian-Xun; Chen, Pin-Ru; Lin, Yu-Sen; Chen, Chien-Kuang; Kao, Pei-Yu; Huang, Tzu-Ming; Fang, Hsin-Yuan

    2017-05-01

    To evaluate the outcomes of patients who underwent thoracoscopic wedge resection without chest drain placement. The subjects of this retrospective study were 89 patients, who underwent thoracoscopic wedge resection at our hospital between January, 2013 and July, 2015. A total of 45 patients whose underlying condition did not meet the following criteria were assigned to the "chest drain placement group" (group A): peripheral lesions, healthy lung parenchyma, no intraoperative air leaks, hemorrhage or effusion accumulation, and no pleural adhesion. The other 44 patients whose underlying condition met the criteria were assigned to the "no chest drain placement group" (group B). Patient characteristics, specimen data, and postoperative conditions were analyzed and compared between the groups. Group A patients had poorer forced expiratory volume in one second (FEV1) values, less normal spirometric results, significantly higher resected lung volume, a greater maximum tumor-pleura distance, and a larger maximum tumor size. They also had a longer postoperative hospital stay. There was no difference between the two groups in postoperative complications. Avoiding chest drain placement after a thoracoscopic wedge resection appears to be safe and beneficial for patients who have small peripheral lesions and healthy lung parenchyma.

  8. Long-term stability of an adult Class III open-bite malocclusion treated with multiloop edgewise archwire

    Directory of Open Access Journals (Sweden)

    Chien-Chun Kuo

    2009-09-01

    Full Text Available This case report describes the treatment of a 17-year-old girl with an anterior open- bite and Class III malocclusion, who had a history of thumb-sucking habit in childhood. The multiloop edgewise archwire technique was used on the mandibular arch to facilitate uprighting of the mandibular posterior teeth, change the cant of occlusal plane, close the anterior open-bite, and correct the Class III malocclusion. At the end of treatment, Class I occlusion and correction of the anterior open-bite had been achieved. An examination 8 years 8 months after treatment revealed long-term stability of the treatment results.

  9. Anterior cervical fusion: the role of anterior plating.

    Science.gov (United States)

    Daffner, Scott D; Wang, Jeffrey C

    2009-01-01

    Treatment of cervical pathology requires a clear understanding of the biomechanical benefits and limitations of cervical plates, their indications, and their associated complications. The use of anterior cervical plates has evolved significantly since their early application in cervical trauma. They have become widely used for anterior cervical decompression and fusion for cervical spondylosis. Plate design has undergone significant refinement and innovation, from the initial unlocked plates requiring bicortical purchase to the latest rotationally and translationally semiconstrained dynamic plates. Excellent clinical results have been reported for single-level anterior cervical decompression and fusion with or without plate fixation; however, the addition of an anterior cervical plate clearly leads to earlier fusion and better clinical results in longer fusions. Longer fusions should ideally consist of corpectomies and strut grafting because the decreased number of fusion surfaces tends to lead to higher fusion rates. Although anterior plate fixation leads to higher fusion rates in fusions of three or more levels, the associated pseudarthrosis rate is still high. The use of dynamic plates, through increased load sharing across the graft and decreased stress shielding, may improve fusion rates, particularly in long fusions. Nevertheless, adjuvant posterior fixation is recommended for fusions of more than three vertebral levels. Anterior plate fixation may be of particular benefit in the management of traumatic injuries, in revision settings, and in the treatment of smokers. Complications unique to plate fixation include hardware breakage and migration as well as ossification of the adjacent disk levels.

  10. SU-E-T-362: Enhanced Dynamic Wedge Output Factors for Varian 2300CD and the Case for a Reference Database

    International Nuclear Information System (INIS)

    Njeh, C

    2015-01-01

    Purpose: Dose inhomogeneity in treatment planning can be compensated using physical wedges. Enhanced dynamic wedges (EDW) were introduced by Varian to overcome some of the short comings of physical wedges. The objectives of this study were to measure EDW output factors for 6 MV and 20 MV photon energies for a Varian 2300CD. Secondly to review the literature in terms of published enhanced dynamic wedge output factors (EDWOF) for different Varian models and thereby adding credence to the case of the validity of reference databases. Methods: The enhanced dynamic wedge output factors were measured for the Varian 2300CD for both 6 MV and 20 MV photon energies. Twelve papers with published EDWOF for different Varian Linac models were found in the literature. Results: The EDWOF for 6 MV varied from 0.980 for a 5×5 cm 10 degree wedge to 0.424 for 20×20 cm 60 degree wedge. Similarly for 20 MV, the EDWOF varied from 0.986 for 5×5 cm 10 degree wedge to 0.529 for 20×20 cm 60 degree wedge. EDWOF are highly dependent on field size. Comparing our results with the published mean, we found an excellent agreement for 6 MV EDWOF with the percentage differences ranging from 0.01% to 0.57% with a mean of 0.03%. The coefficient of variation of published EDWOF ranged from 0.17% to 0.85% and 0.1% to 0.9% for the for 6 MV and 18MV photon energies respectively. This paper provides the first published EDWOF for 20 MV photon energy. In addition, we have provided the first compendium of EDWOFs for different Varian linac models. Conclusion: The consistency of EDWOF across models and institution provide further support that, a standard data set of basic photon and electron dosimetry could be established, as a guide for future commissioning, beam modeling and quality assurance purposes

  11. [Anterior lumbar interbody fusion. Indications, technique, advantages and disadvantages].

    Science.gov (United States)

    Richter, M; Weidenfeld, M; Uckmann, F P

    2015-02-01

    Anterior lumbar interbody fusion (ALIF) for lumbar interbody fusion from L2 to the sacrum has been an established technique for decades. The advantages and disadvantages of ALIF compared to posterior interbody fusion techniques are discussed. The operative technique is described in detail. Complications and avoidance strategies are discussed. This article is based on a selective literature search using PubMed and the experience of the authors in this medical field. The advantages of ALIF compared to posterior fusion techniques are the free approach to the anterior disc space without opening of the spinal canal or the neural foramina. This gives the possibility of an extensive anterior release and placement of the largest possible cages without the risk of neural structure damage. The disadvantages of ALIF are the additional anterior approach and the related complications. The most frequent complication is due to damage of vessels. The rate of complications is significantly increased in revision surgery. The ALIF technique meaningfully expands the repertoire of the spinal surgeon especially for the treatment of non-union after interbody fusion, in patients with epidural scar tissue at the index level and spinal infections. Advantages and disadvantages should be considered when evaluating the indications for ALIF.

  12. Duodenal Wedge Resection for Large Gastrointestinal Stromal Tumour Presenting with Life-Threatening Haemorrhage

    Directory of Open Access Journals (Sweden)

    Alexander Shaw

    2013-01-01

    Full Text Available Background. Duodenal gastrointestinal stromal tumours (GISTs are an uncommon malignancy of the gastrointestinal (GI tract. We present a case of life-threatening haemorrhage caused by a large ulcerating duodenal GIST arising from the third part of the duodenum managed by a limited duodenal wedge resection. Case Presentation. A 61-year-old patient presented with acute life-threatening gastrointestinal bleeding. After oesophagogastroduodenoscopy failed to demonstrate the source of bleeding, a 5 cm ulcerating exophytic mass originating from the third part of the duodenum was identified at laparotomy. A successful limited wedge resection of the tumour mass was performed. Histopathology subsequently confirmed a duodenal GIST. The patient remained well at 12-month followup with no evidence of local recurrence or metastatic spread. Conclusion. Duodenal GISTs can present with life-threatening upper GI haemorrhage. In the context of acute haemorrhage, even relatively large duodenal GISTs can be treated by limited wedge resection. This is a preferable alternative to duodenopancreatectomy with lower morbidity and mortality but comparable oncological outcome.

  13. Dependence of wedge transmission factor on co-60 teletherapy ...

    African Journals Online (AJOL)

    Measuring the wedge factor (WF) for radiation field of 10 x 10 cm2 at a specified depth and Source to Surface Distance (SSD), and applying the value to all treatment depths and technique could introduce errors > ± 5 % of threshold stipulated for patient radiation dose delivery. Therefore, some Treatment Planning Systems ...

  14. Thoracoscopic pulmonary wedge resection without post-operative chest drain

    DEFF Research Database (Denmark)

    Holbek, Bo Laksafoss; Hansen, Henrik Jessen; Kehlet, Henrik

    2016-01-01

    %) patients had a pneumothorax of mean size 12 ± 12 mm on supine 8-h post-operative X-ray for which the majority resolved spontaneously within 2-week control. There were no complications on 30-day follow-up. Median length of stay was 1 day. CONCLUSIONS: The results support that VATS wedge resection...

  15. 3D seismic investigation of the structural and stratigraphic characteristics of the Pagasa Wedge, Southwest Palawan Basin, Philippines, and their tectonic implications

    Science.gov (United States)

    Ilao, Kimberly A.; Morley, Christopher K.; Aurelio, Mario A.

    2018-04-01

    The Pagasa Wedge is a poorly imaged deepwater orogenic wedge that has been variously interpreted as representing an accretionary prism, a former accretionary prism modified by thrusting onto a thinned continental margin, and a gravity-driven fold-thrust belt. This study, using 2D and 3D seismic data, together with well information indicates that at least the external part of the wedge is dominantly composed of mass transport complexes, capped by syn-kinematic sediments that have thrusts and normal faults superimposed upon them. Drilling shows that despite stratigraphic repetition of Eocene Middle Miocene units, there is stratigraphic omission of Oligocene and Early Miocene units. This absence suggests that mass transport processes have introduced the Eocene section into the wedge rather than tectonic thrusting. The accretionary prism stage (Oligocene) of the Central Palawan Ophiolite history appears to be marked by predominantly north-vergent deformation. The Deep Regional Unconformity (∼17 Ma) likely indicates the approximate time when obduction ceased in Palawan. The Pagasa Wedge is a late-stage product of the convergence history that was active in its final phase sometime above the top of the Nido Limestone (∼16 Ma) and the base of the Tabon Limestone in the Aboabo-A1X well (∼9 Ma). The top of the wedge is traditionally associated with the Middle Miocene Unconformity (MMU), However the presence of multiple unconformities, diachronous formation tops, local tectonic unconformities and regional diachronous events (e.g. migrating forebulges) all suggest simply giving a single age (or assigning a single unconformity, such as the MMU as defining the top of the Pagasa Wedge is inappropriate. The overall NE-SW trend of the wedge, and the dominant NW transport of structures within the wedge diverge from the more northerly transport direction determined from outcrops in Palawan, and also from the Nido Limestone in the SW part of the Pagasa Wedge. Possibly this NW

  16. [Radiocarbon dating of pollen and spores in wedge ice from Iamal and Kolyma].

    Science.gov (United States)

    Vasil'chuk, A K

    2004-01-01

    Radiocarbon dating of pollen concentrate from late Pleistocene syngenetic wedge ice was carried out using acceleration mass spectrometry (AMS) in Seyakha and Bizon sections. Comparison of the obtained dating with palynological analysis and AMS radiocarbon dating previously obtained for other organic fractions of the same samples allowed us to evaluate accuracy of dating of different fractions. Quantitative tests for data evaluation were considered in terms of possible autochthonous or allochthonous accumulation of the material on the basis of pre-Pleistocene pollen content in these samples. Paleoecological information content of pollen spectra from late Pleistocene syngenetic wedge ice was evaluated.

  17. RANS Analyses of Turbofan Nozzles with Internal Wedge Deflectors for Noise Reduction

    Science.gov (United States)

    DeBonis, James R.

    2009-01-01

    Computational fluid dynamics (CFD) was used to evaluate the flow field and thrust performance of a promising concept for reducing the noise at take-off of dual-stream turbofan nozzles. The concept, offset stream technology, reduces the jet noise observed on the ground by diverting (offsetting) a portion of the fan flow below the core flow, thickening and lengthening this layer between the high-velocity core flow and the ground observers. In this study a wedge placed in the internal fan stream is used as the diverter. Wind, a Reynolds averaged Navier-Stokes (RANS) code, was used to analyze the flow field of the exhaust plume and to calculate nozzle performance. Results showed that the wedge diverts all of the fan flow to the lower side of the nozzle, and the turbulent kinetic energy on the observer side of the nozzle is reduced. This reduction in turbulent kinetic energy should correspond to a reduction in noise. However, because all of the fan flow is diverted, the upper portion of the core flow is exposed to the freestream, and the turbulent kinetic energy on the upper side of the nozzle is increased, creating an unintended noise source. The blockage due to the wedge reduces the fan mass flow proportional to its blockage, and the overall thrust is consequently reduced. The CFD predictions are in very good agreement with experimental flow field data, demonstrating that RANS CFD can accurately predict the velocity and turbulent kinetic energy fields. While this initial design of a large scale wedge nozzle did not meet noise reduction or thrust goals, this study identified areas for improvement and demonstrated that RANS CFD can be used to improve the concept.

  18. Pulmonary abnormalities in mitral valve disease. Comparison between pulmonary wedge pressure, regional pulmonary blood flow and chest films

    Energy Technology Data Exchange (ETDEWEB)

    Andersen, L H; Andersen, Jr, P E [Odense Univ. (Denmark)

    1978-01-01

    Chest films, right sided heart catheterization, and measurement of the regional lung perfusion, using /sup 133/Xe, were carried out 31 times on patients with mitral valve disease. A relationship was found between the radiologic evaluation in 3 grades, and the values of pulmonary wedge pressure and the apical and basal perfusion. Changes in flow distribution as reflected in altered appearance of the vessels and the presence of interstitial edema were found to be the most sensitive factors in the evaluation of pulmonary wedge pressure. Chest radiography was thus found suitable for the evaluation of pulmonary wedge pressure in mitral valve disease.

  19. The effect of shoe design and lateral wedges on knee load and neuromuscular control in healthy subjects during walking

    DEFF Research Database (Denmark)

    Mølgaard, Carsten; Kersting, Uwe G.

    2014-01-01

    The increasing number of patients with developing osteoarthritis is accompanied by a growing scientific interest in non-operative early treatment strategies. It is generally believed that laterally wedged insoles can change the distribution of knee loading. However, the importance of footwear...... wedging is effective regardless of shoe design. Differences between the three neutral walking conditions underline the importance of footwear choice in individuals. It is safe to apply lateral wedges without jeopardising muscular control during walking regardless of shoe type. Possible effects of altering...

  20. Long-term stability of soft tissue changes in anterior open bite adults treated with zygomatic miniplate-anchored maxillary posterior intrusion.

    Science.gov (United States)

    Marzouk, Eiman S; Kassem, Hassan E

    2018-03-01

    To evaluate soft tissue changes and their long-term stability in skeletal anterior open bite adults treated by maxillary posterior teeth intrusion using zygomatic miniplates and premolar extractions. Lateral cephalograms of 26 patients were taken at pretreatment (T1), posttreatment (T2), 1 year posttreatment (T3), and 4 years posttreatment (T4). At the end of treatment, the soft tissue facial height and profile convexity were reduced. The lips increased in length and thickness, with backward movement of the upper lip and forward movement of the lower lip. The total relapse rate ranged from 20.2% to 31.1%. At 4 years posttreatment, 68.9% to 79.8% of the soft tissue treatment effects were stable. The changes in the first year posttreatment accounted for approximately 70% of the total relapse. Soft tissue changes following maxillary posterior teeth intrusion with zygomatic miniplates and premolar extractions appear to be stable 4 years after treatment.

  1. A rare case of post-splenectomy gastric volvulus managed by laparoscopic anterior gastropexy

    Directory of Open Access Journals (Sweden)

    Rahul Amreesh Gupta

    2017-01-01

    Full Text Available We report an extremely rare case of recurrent gastric volvulus after open splenectomy for hereditary spherocytosis. The initial episode was managed by endoscopic derotation. Later, for recurrent symptoms, she was successfully managed by laparoscopic anterior gastropexy.

  2. Anterior subcarinal node dissection on the left side using video thoracoscopy: an easier technique.

    Science.gov (United States)

    Baste, Jean-Marc; Haddad, Laura; Melki, Jean; Peillon, Christophe

    2015-04-01

    Lobectomy for lung carcinoma is usually associated with complete node dissection, but it is often difficult to perform using video thoracoscopy, especially on the left side. In this case, our team uses an anterior technique for subcarinal lymphadenectomy. After left lobectomy, we lift the bronchial stump by its anterior face to open and dissect the subcarinal space. Exposure is difficult using the more usual technique of posterior subcarinal lymphadenectomy, and the different techniques (often requiring retractors) remain complex because some vessels might be injured. We recommend using anterior lymphadenectomy, which should facilitate video thoracoscopy for lymphadenectomy on the left side. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Intensity-Modulated Radiotherapy Results in Significant Decrease in Clinical Toxicities Compared With Conventional Wedge-Based Breast Radiotherapy

    International Nuclear Information System (INIS)

    Harsolia, Asif; Kestin, Larry; Grills, Inga; Wallace, Michelle; Jolly, Shruti; Jones, Cortney; Lala, Moinaktar; Martinez, Alvaro; Schell, Scott; Vicini, Frank A.

    2007-01-01

    Purpose: We have previously demonstrated that intensity-modulated radiotherapy (IMRT) with a static multileaf collimator process results in a more homogenous dose distribution compared with conventional wedge-based whole breast irradiation (WBI). In the present analysis, we reviewed the acute and chronic toxicity of this IMRT approach compared with conventional wedge-based treatment. Methods and Materials: A total of 172 patients with Stage 0-IIB breast cancer were treated with lumpectomy followed by WBI. All patients underwent treatment planning computed tomography and received WBI (median dose, 45 Gy) followed by a boost to 61 Gy. Of the 172 patients, 93 (54%) were treated with IMRT, and the 79 patients (46%) treated with wedge-based RT in a consecutive fashion immediately before this cohort served as the control group. The median follow-up was 4.7 years. Results: A significant reduction in acute Grade 2 or worse dermatitis, edema, and hyperpigmentation was seen with IMRT compared with wedges. A trend was found toward reduced acute Grade 3 or greater dermatitis (6% vs. 1%, p = 0.09) in favor of IMRT. Chronic Grade 2 or worse breast edema was significantly reduced with IMRT compared with conventional wedges. No difference was found in cosmesis scores between the two groups. In patients with larger breasts (≥1,600 cm 3 , n = 64), IMRT resulted in reduced acute (Grade 2 or greater) breast edema (0% vs. 36%, p <0.001) and hyperpigmentation (3% vs. 41%, p 0.001) and chronic (Grade 2 or greater) long-term edema (3% vs. 30%, p 0.007). Conclusion: The use of IMRT in the treatment of the whole breast results in a significant decrease in acute dermatitis, edema, and hyperpigmentation and a reduction in the development of chronic breast edema compared with conventional wedge-based RT

  4. Electromagnetic Scattering from a PEC Wedge Capped with Cylindrical Layers with Dielectric and Conductive Properties

    Directory of Open Access Journals (Sweden)

    H. Ozturk

    2017-04-01

    Full Text Available Electromagnetic scattering from a layered capped wedge is studied. The wedge is assumed infinite in z-direction (longitudinal and capped with arbitrary layers of dielectric with varying thicknesses and dielectric properties including conductive loss. Scalar Helmholtz equation in two dimensions is formulated for each solution region and a matrix of unknown coefficients are arrived at for electric field representation. Closed form expressions are derived for 2- and 3-layer geometries. Numerical simulations are performed for different wedge shapes and dielectric layer properties and compared to PEC-only case. It has been shown that significant reduction in scattered electric field can be obtained with 2- and 3-layered cap geometries. Total electric field in the far field normalized to incident field is also computed as a precursor to RCS analysis. Analytical results can be useful in radar cross section analysis for aerial vehicles.

  5. Evaluation of the anterior chamber angle in pseudoexfoliation syndrome.

    Science.gov (United States)

    Iwanejko, Małgorzata; Turno-Kręcicka, Anna; Tomczyk-Socha, Martyna; Kaczorowski, Kamil; Grzybowski, Andrzej; Misiuk-Hojło, Marta

    2017-08-01

    Pseudoexfoliation syndrome (PEX) is the most frequently identifiable cause of secondary open-angle glaucoma, known as pseudoexfoliation glaucoma. The exact pathophysiology and etiology of PEX and associated glaucoma remains obscure. The purpose of this study was to determine the differences in the morphology of the anterior chamber angle in people with pseudoexfoliation syndrome and pseudoexfoliation glaucoma compared to a control group. We also evaluated the correlation between intraocular pressure (IOP) and pigmentation of the angle with the amount of exfoliated material in the anterior segment. The study group was composed of 155 eyes from 103 patients aged between 43 and 86 years. Each patient underwent a complete ophthalmological examination. Some difference was found in intraocular pressure between the PEX group and the control group and between the pseudoexfoliation glaucoma group and the control group, but no significant difference was found between the 2 study groups. There was a significant difference in the incidence of some degree of pigmentation in the anterior chamber angle and no difference in the widths of the angle between each group. A significant positive relationship was observed between intraocular pressure and the degree of pigmentation of the anterior chamber angle in both the PEX group and the pseudoexfoliation glaucoma group. The results of this study indicate that the amount of pigmentation and exfoliation material in the anterior segment significantly correlates with the level of IOP and possibly with the degree of trabecular dysfunction. It seems that for clear identification of PEX and pseudoexfoliation glaucoma factors, clinical assessment appears to be insufficient.

  6. Mandibular Range of Movement and Pain Intensity in Patients with Anterior Disc Displacement without Reduction

    Directory of Open Access Journals (Sweden)

    Marijana Gikić

    2015-01-01

    Full Text Available Objective: Temporomandibular disorders (TMD are the most common source of orofacial pain of a non-dental origin. The study was performed to investigate the therapeutic effect of the conventional occlusal splint therapy and the physical therapy. The hypothesis tested was that the simultaneous use of occlusal splint and physical therapy is an effective method for treatment of anterior disc displacement without reduction. Materials and Methods: Twelve patients (mean age =30.5 y with anterior disc displacement without reduction (according to RDC/TMD and confirmed by magnetic resonance imaging were randomly allocated into 2 groups: 6 received stabilization splint (SS and 6 received both physical therapy and stabilization splint (SS&PT. Treatment outcomes included pain-free opening (MCO, maximum assisted opening (MAO, path of mouth opening and pain as reported on visual analogue scale (VAS. Results: At baseline of treatment there were no significant differences among the groups for VAS scores, as well as for the range of mandibular movement. VAS scores improved significantly over time for the SS&PT group (F=28.964, p=0.0001, effect size =0.853 and SS group (F=8.794, p=0.001, effect size =0.638. The range of mouth opening improved significantly only in the SS&PT group (MCO: F=20.971, p=0.006; MAO: F=24.014, p=0.004 (Figure 2. Changes in path of mouth opening differ significantly between the groups (p=0.040. Only 1 patient in SS&PT group still presented deviations in mouth opening after completed therapy while in the SS group deviations were present in 5 patients after completed therapy. Conclusion: This limited study gave evidence that during the treatment period lasting for 6 months, the simultaneous use of stabilization splint and physical therapy was more efficient in reducing deviations and improving range of mouth opening than the stabilization splint used alone. Both treatment options were efficient in reducing pain in patients with anterior disc

  7. Integrated waste management as a climate change stabilisation wedge for the Maltese islands.

    Science.gov (United States)

    Falzon, Clyde; Fabri, Simon G; Frysinger, Steven

    2013-01-01

    The continuous increase in anthropogenic greenhouse gas emissions occurring since the Industrial Revolution is offering significant ecological challenges to Earth. These emissions are leading to climate changes which bring about extensive damage to communities, ecosystems and resources. The analysis in this article is focussed on the waste sector within the Maltese islands, which is the largest greenhouse gas emitter in the archipelago following the energy and transportation sectors. This work shows how integrated waste management, based on a life cycle assessment methodology, acts as an effective stabilisation wedge strategy for climate change. Ten different scenarios applicable to the Maltese municipal solid waste management sector are analysed. It is shown that the scenario that is most coherent with the stabilisation wedges strategy for the Maltese islands consists of 50% landfilling, 30% mechanical biological treatment and 20% recyclable waste export for recycling. It is calculated that 16.6 Mt less CO2-e gases would be emitted over 50 years by means of this integrated waste management stabilisation wedge when compared to the business-as-usual scenario. These scientific results provide evidence in support of policy development in Malta that is implemented through legislation, economic instruments and other applicable tools.

  8. Oral habits as risk factors for anterior open bite in the deciduous and mixed dentition - cross-sectional study.

    Science.gov (United States)

    Urzal, V; Braga, A C; Ferreira, A P

    2013-12-01

    Anterior open bite (AOB) is an occlusal anomaly commonly associated with oral habits (OH). The aim of this study was to determine the prevalence of OH as a risk factor for the AOB. A group of children aged between 3 and 12 years were observed. The statistical methodology included independent chi-square test, Fisher's exact test and binary logistic regression. The frequency of oral habits was of 43.5% in the deciduous dentition and 54.2% in the mixed dentition. There was a statistically significant association of pacifier sucking: 61.7 and 16.1 odd ratios (OR), and tongue thrust: 3.9 and 9.2 OR with AOB in both groups, respectively. Thumb sucking occurred only in the deciduous dentition with 5.6 OR. OH and AOB have a high frequency in children. They hinder the normal development of dental and skeletal structures. As OH are risk factors for AOB, the damaging habits most frequently associated are: pacifier sucking, thumb sucking, and tongue thrust. Due to the correlation between the prevalence of AOB and OH, prevention strategies incorporating psychological data related to children should be integrated into a national public health programme.

  9. Blunt pediatric anterior and posterior urethral trauma: 32-year experience and outcomes.

    Science.gov (United States)

    Voelzke, Bryan B; Breyer, Benjamin N; McAninch, Jack W

    2012-06-01

    To analyze our experience with delayed repair of pediatric urethral trauma. From 1978 to 2007, 26 boys posterior urethral injuries were separately stratified. There were 8 anterior and 18 posterior urethral strictures. All patients presented in a delayed fashion. Mean follow up of the anterior cohort was 2.9 years. All repairs were performed via a ventral onlay buccal graft or anastomotic approach. The mean follow up of the posterior cohort was 1.1 years, and all posterior urethral injuries were repaired via an anastomotic approach. Overall success for anterior stricture disease was 88.9% and for posterior stricture disease was 89.5%. All three urethroplasty failures responded favorably to internal urethrotomy; however, one failed anterior repair and one of the two failed posterior repairs required two internal urethrotomy operations for success. No secondary urethroplasty operations were required and ultimately all patients were voiding per urethra without need for urethral dilation. Delayed, definitive repair of pediatric urethral trauma via open urethroplasty has a high success rate. Copyright © 2011 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  10. anomalous left anterior cerebral artery with hypoplastic right anterior ...

    African Journals Online (AJOL)

    2018-02-28

    Feb 28, 2018 ... We report an extremely rare anomalous variation of left anterior cerebral artery arising from the ... paraclinoid internal carotid artery and right ... Studies on the arteries of the brain: II-The anterior cerebral artery: Some anatomic ...

  11. Factors related to stability following the surgical correction of skeletal open bite.

    Science.gov (United States)

    Ito, Goshi; Koh, Myongsun; Fujita, Tadashi; Shirakura, Maya; Ueda, Hiroshi; Tanne, Kazuo

    2014-05-01

    If a skeletal anterior open bite malocclusion is treated by orthognathic surgery directed only at the mandible, the lower jaw is repositioned upward in a counter-clockwise rotation. However, this procedure has a high risk of relapse. In the present study, the key factors associated with post-surgical stability of corrected skeletal anterior open bite malocclusions were investigated. Eighteen orthognathic patients were subjected to cephalometric analysis to assess the dental and skeletal changes following mandibular surgery for the correction of an anterior open bite. The patients were divided into two groups, determined by an increase or decrease in nasion-menton (N-Me) distance as a consequence of surgery. Changes in overbite, the displacements of molars and positional changes in Menton were evaluated immediately before and after surgery and after a minimum of one year post-operatively. The group with a decreased N-Me distance exhibited a significantly greater backward positioning of the mandible. The group with an increased N-Me distance experienced significantly greater dentoalveolar extrusion of the lower molars. A sufficient mandibular backward repositioning is an effective technique in the prevention of open bite relapse. In addition, it is important not to induce molar extrusion during post-surgical orthodontic treatment to preserve stability of the surgical open bite correction.

  12. Physical Analysis of Cross-Wedge Rolling Process of a Stepped Shaft

    Directory of Open Access Journals (Sweden)

    Łukasz Wójcik

    2017-12-01

    Full Text Available The paper presents experimental- model research results on the process of cross-wedge rolling of an axially-symmetrical element (stepped shaft. During research was used plastic mass on the basis of waxes in black and white colour. The aim of this experimental research was to determine the best option of forming in terms of values obtained and the course of forces. Physical examination was carried out using specialist machines, that is model and laboratory cross-wedge rolling mill. Experimental analysis was carried out using billets with the temperature of 15°C, whereas the actual process was carried out for billet from C45 carbon steel of temperature 1150°C. The study compared the dimensions of the components obtained during rolling tests and forming forces obtained in the result of physical modeling with forces obtained during real tests.

  13. Assessment of rotatory instability after anterior cruciate ligament reconstruction with a bone-patellar tendon-bone graft

    International Nuclear Information System (INIS)

    Tashiro, Yasutaka; Okazaki, Ken; Miura, Hiromasa

    2010-01-01

    Anatomically oriented anterior cruciate ligament (ACL) reconstruction has been advocated recently, but its effect on rotatory instability remains to be cleared objectively. The purpose of this study was to quantitatively evaluate rotatory instability in ACL reconstructed knees with a bone-patellar tendon-bone (BTB) graft using an open MRI system. Eighteen subjects underwent arthroscopic ACL reconstruction with a BTB graft. The tibial tunnel was placed in the center of the ACL footprint. The femoral tunnel was drilled transtibially at the 10:00 to 10:30-o'clock position for the right knees. Subjects were examined using a Slocum anterolateral rotatory instability test in open MRI. Anterior tibial translation was measured at the medial and lateral compartments by evaluating sagittal images. Anterior knee stability was evaluated using the KT-2000 arthrometer. The clinical knee function was assessed with the Lysholm and Tegner scoring scales before and after the surgery. Side-to-side differences of anterolateral tibial translation was 0.1 mm. Side-to-side difference on KT-2000 arthrometer measurement was 1.8 mm. The Lysholm score improved to 96 and the latest Tegner score reached substantially the preinjury level. ACL reconstruction with a BTB graft was successful in restoring rotatory stability as well as anterior stability and knee function. (author)

  14. Generation of vector beams using a double-wedge depolarizer: Non-quantum entanglement

    Science.gov (United States)

    Samlan, C. T.; Viswanathan, Nirmal K.

    2016-07-01

    Propagation of horizontally polarized Gaussian beam through a double-wedge depolarizer generates vector beams with spatially varying state of polarization. Jones calculus is used to show that such beams are maximally nonseparable on the basis of even (Gaussian)-odd (Hermite-Gaussian) mode parity and horizontal-vertical polarization state. The maximum nonseparability in the two degrees of freedom of the vector beam at the double wedge depolarizer output is verified experimentally using a modified Sagnac interferometer and linear analyser projected interferograms to measure the concurrence 0.94±0.002 and violation of Clauser-Horne-Shimony-Holt form of Bell-like inequality 2.704±0.024. The investigation is carried out in the context of the use of vector beams for metrological applications.

  15. [A Patient with a Wedge-shaped Pulmonary Lesion Associated with Streptococcus parasanguinis].

    Science.gov (United States)

    Miyamoto, Hiroya; Gomi, Harumi; Ishioka, Haruhiko; Shirokawa, Taijiro

    2016-05-01

    An 84-year-old man was admitted to our hospital with bloody sputum. He was found to have a right lower lobe wedge-shaped nodular lesion with chest X-ray and computed tomography of the chest. Ceftriaxone and minocycline were started empirically based on a working diagnosis of community-acquired pneumonia. Streptococcus parasanguinis was isolated with sputum cultures obtained on three consecutive days and was identified based on its biochemical properties. S. parasanguinis is a member of the sanguinis group of viridans Streptococci. It is known as a causative pathogen for endocarditis. There are very few reports of S. parasanguinis associated with pulmonary infections. The present report describes the association of S. parasanguinis with a wedge-shaped nodular lesion in the lungs.

  16. Anterior capsulotomy with an ultrashort-pulse laser.

    Science.gov (United States)

    Tackman, Ramon Naranjo; Kuri, Jorge Villar; Nichamin, Louis D Skip; Edwards, Keith

    2011-05-01

    To assess the precision of laser anterior capsulotomy compared with that of manual continuous curvilinear capsulorhexis (CCC). Asociación Para Evitar La Ceguera en México IAP, Hospital Dr. Luis Sánchez Bulnes, Mexico City, Mexico. Nonrandomized single-center clinical trial. In patients presenting for cataract surgery, the LensAR Laser System was used to create a laser anterior capsulotomy of the surgeon's desired size. Capsule buttons were retrieved and measured and then compared with buttons retrieved from eyes having a manually torn CCC. Deviation from the intended diameter and the regularity of shape were assessed. When removing the capsule buttons at the start of surgery, the surgeon rated the ease of removal on a scale of 1 to 10 (1 = required manual capsulorhexis around the whole diameter; 10 = button free floating or required no manual detachment from remaining capsule during removal). The mean deviation from the intended diameter was 0.16 mm ± 0.17 (SD) for laser anterior capsulotomy and 0.42 ± 0.54 mm for CCC (P=.03). The mean absolute deviation from the intended diameter was 0.20 ± 0.12 mm and 0.49 ± 0.47 mm, respectively (P=.003). The mean of the average squared residuals was 0.01 ± 0.03 and 0.02 ± 0.04, respectively (P=.09). The median rating of the ease of removal was 9 (range 5 to 10). Laser anterior capsulotomy created a more precise capsule opening than CCC, and the buttons created by the laser procedure were easy to remove at the beginning of cataract surgery. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  17. Satisfactory functional and radiological outcomes can be expected in young patients under 45 years old after open wedge high tibial osteotomy in a long-term follow-up.

    Science.gov (United States)

    Hantes, Michael E; Natsaridis, Prodromos; Koutalos, Antonios A; Ono, Yohei; Doxariotis, Nikolaos; Malizos, Konstantinos N

    2017-11-30

    To report the long-term outcomes of medial open wedge high tibial osteotomy (MOWHTO) for the treatment of medial compartment knee osteoarthritis in patients younger than 45 years old. It was hypothesized that the correction of knee alignment would result in preservation of knee function in a long-term follow-up. Patients under 45 years old, who underwent MOWHTO for symptomatic medial compartment knee osteoarthritis between 2001 and 2005 were retrospectively reviewed after a minimum of 10 years. The osteotomy was performed utilizing a locking plate without the use of bone graft. Patients were evaluated pre- and postoperatively using the International Knee Documentation Committee Score, the Oxford Knee Score, the Knee injury Osteoarthritis Outcome Score and the Short Form-12 Score. Standardized standing whole-limb radiographs were also obtained to assess mechanical tibiofemoral angle (mTFA) and the grade of osteoarthritis. A total of 20 patients (18 males, 2 females, mean age 35.4 years) with a mean follow-up of 12.3 years were included in the study. During the follow-up period, one patient required conversion to total knee replacement (95% survival rate). All clinical outcome scores (IKDC, KOOS, OKS, and SF-12) significantly improved postoperatively (p satisfactory and the survival rate is 95%, 12 years after the procedure. Level IV therapeutic, retrospective, cohort study.

  18. Spatial resolution of wedge shaped silicon microstrip detectors

    International Nuclear Information System (INIS)

    Anticic, T.; Barnett, B.; Blumenfeld, B.; Chien, C.Y.; Fisher, P.; Gougas, A.; Krizmanic, J.; Madansky, L.; Newman, D.; Orndorff, J.; Pevsner, A.; Spangler, J.

    1995-01-01

    Several wedge-shaped silicon microstrip detectors with pitches from 30 to 100 μm have been designed by our group and beam tested at the CERN SPS. We find the spatial resolution σ becomes larger at the rate of 0.21 μm per 1 μm increase in pitch, but the number of strips per cluster remains about the same as the pitch varies from 30 to 100 μm. (orig.)

  19. Estimating effective wedge factor for enhanced dynamic wedge 2100CD a Varian Clinac; Calculo De factor cuna efectiva para cuna dinamica mejorada de un Clinac 2100CD de Varian

    Energy Technology Data Exchange (ETDEWEB)

    Pizarro Trigo, F.; Morillas Ruiz, J.; Nunuz Martinez, L.; Sanchez Jimenez, J.

    2011-07-01

    The purpose of this paper is to compare different methods of calculating the effective factor enhanced dynamic wedge (EDWF) with the values ??obtained in measurements of symmetric and asymmetric fields.

  20. Preliminary assessment of potential underground stability (wedge and spalling) at Forsmark, Simpevarp and Laxemar sites

    Energy Technology Data Exchange (ETDEWEB)

    Martin, Derek [Univ. of Alberta, Edmonton (Canada). Geotechnical Engineering

    2005-12-15

    In SKB's Underground Design Premises the objective in the early design phase is to estimate if there is sufficient space for the repository at a site. One of the conditions that could limit the space available is stability of the underground openings, i.e., deposition tunnels and deposition boreholes. The purpose of this report is to provide a preliminary assessment of the potential for wedge instability and spalling that may be encountered at the Forsmark, Simpevarp and Laxemar sites based on information from the site investigations program up to July 30, 2004. The rock mass spalling strength was defined using the in-situ results from SKB's Aespoe Pillar Stability Experiment and AECL's Mine-by Experiment. These experiments suggest that the rock mass spalling strength for crystalline rocks can be estimated as 0.57 of the mean laboratory uniaxial compressive strength. A probability-based methodology utilizing this in-situ rock mass spalling strength has been developed for assessing the risk for spalling in a repository at the Forsmark, Simpevarp and Laxemar sites. The in-situ stresses and the uniaxial compressive strength data from these sites were used as the bases for the analyses. Preliminary findings from all sites suggest that, generally, the risk for spalling increases as the depth of the repository increases, simply because the stress magnitudes increase with depth. The depth at which the risk for spalling is significant, depends on the individual sites which are discussed below. The greatest uncertainty in the spalling analyses for Forsmark is related to the uncertainty in the horizontal stress magnitudes and associated stress gradients with depth. The confidence in these analyses can only be increased by increasing the confidence in the stress and geology model for the site. From the analyses completed it appears that spalling in the deposition tunnels can be controlled by orienting the tunnels approximately parallel to the maximum horizontal

  1. Open bite treatment using clear aligners.

    Science.gov (United States)

    Guarneri, Maria Paola; Oliverio, Teresa; Silvestre, Ivana; Lombardo, Luca; Siciliani, Giuseppe

    2013-09-01

    A 35-year-old female patient with dentoalveolar open bite of 4 mm, molar Class I malocclusion, centered midlines, moderate crowding, and labial inclination of the lower incisor was treated with clear aligners to reduce protrusion and close the anterior open bite. The result showed that clear aligners were an effective method with which to correct this malocclusion. The treatment was complete after 18 months. The patient was satisfied with her new appearance and function.

  2. Seismological evidence for a sub-volcanic arc mantle wedge beneath the Denali volcanic gap, Alaska

    Science.gov (United States)

    McNamara, D.E.; Pasyanos, M.E.

    2002-01-01

    Arc volcanism in Alaska is strongly correlated with the 100 km depth contour of the western Aluetian Wadati-Benioff zone. Above the eastern portion of the Wadati-Benioff zone however, there is a distinct lack of volcanism (the Denali volcanic gap). We observe high Poisson's ratio values (0.29-0.33) over the entire length of the Alaskan subduction zone mantle wedge based on regional variations of Pn and Sn velocities. High Poisson's ratios at this depth (40-70 km), adjacent to the subducting slab, are attributed to melting of mantle-wedge peridotites, caused by fluids liberated from the subducting oceanic crust and sediments. Observations of high values of Poisson's ratio, beneath the Denali volcanic gap suggest that the mantle wedge contains melted material that is unable to reach the surface. We suggest that its inability to migrate through the overlying crust is due to increased compression in the crust at the northern apex of the curved Denali fault.

  3. The effect of shoe design and lateral wedges on knee load and neuromuscular control in healthy subjects during walking

    DEFF Research Database (Denmark)

    Mølgaard, Carsten Møller; Kersting, Uwe G.

    2013-01-01

    and second peak knee adduction moments. However, the variability of this moment between shoe designs was of similar magnitude as the effect of laterally wedged insoles. Only marginal changes in muscle activity for gastrocnemius when walking with the wedged Oxford shoe were revealed. Conclusion: Lateral...

  4. The optimal design of stepped wedge trials with equal allocation to sequences and a comparison to other trial designs.

    Science.gov (United States)

    Thompson, Jennifer A; Fielding, Katherine; Hargreaves, James; Copas, Andrew

    2017-12-01

    Background/Aims We sought to optimise the design of stepped wedge trials with an equal allocation of clusters to sequences and explored sample size comparisons with alternative trial designs. Methods We developed a new expression for the design effect for a stepped wedge trial, assuming that observations are equally correlated within clusters and an equal number of observations in each period between sequences switching to the intervention. We minimised the design effect with respect to (1) the fraction of observations before the first and after the final sequence switches (the periods with all clusters in the control or intervention condition, respectively) and (2) the number of sequences. We compared the design effect of this optimised stepped wedge trial to the design effects of a parallel cluster-randomised trial, a cluster-randomised trial with baseline observations, and a hybrid trial design (a mixture of cluster-randomised trial and stepped wedge trial) with the same total cluster size for all designs. Results We found that a stepped wedge trial with an equal allocation to sequences is optimised by obtaining all observations after the first sequence switches and before the final sequence switches to the intervention; this means that the first sequence remains in the control condition and the last sequence remains in the intervention condition for the duration of the trial. With this design, the optimal number of sequences is [Formula: see text], where [Formula: see text] is the cluster-mean correlation, [Formula: see text] is the intracluster correlation coefficient, and m is the total cluster size. The optimal number of sequences is small when the intracluster correlation coefficient and cluster size are small and large when the intracluster correlation coefficient or cluster size is large. A cluster-randomised trial remains more efficient than the optimised stepped wedge trial when the intracluster correlation coefficient or cluster size is small. A

  5. Comparison between dose calculation in XiO® and dosimetric measurements in virtual wedge photon beams

    International Nuclear Information System (INIS)

    Almeida, Laila G.; Amaral, Leonardo L.; Oliveira, Harley F.; Maia, Ana F.

    2012-01-01

    The virtual wedge is useful tool in the radiation treatment planning since it has series of advantages over the hard wedge. Quality control tests ensure correct performance of the planning done in treatment planning systems (TPS). This study aimed to compare doses calculated by TPS and doses measured by ionization chamber (CI) and an ionization chambers array in virtual wedge photon beams of 6 MV. Measures carried out in Primus linear accelerator with a solid water phantom and dosimeter positioned at 10 cm depth with gantry at 0° in many fields sizes and angles in the virtual wedge. Measurements on the central axis used as dosimeter an IC and on off-axis used an IC array. The simulation in CMS-XiO used the CT images of the phantom in the same configuration of the irradiation. Maximum and minimum values of the percentage differences between the doses provided by TPS and measurements with ionization chamber on the central axis were 1.43 and -0.10%, respectively, with average percentage difference of 0.08% and confidence limit of Δ=1.72%. In the region off-axis, the average percentage difference was 0.04%, with a maximum of 1.9%, minimum of 0% and confidence limit of Δ=1.91%. All values for dose percentage differences were below 2% and lower confidence limit of 3% are thus, according to the recommendations of the Technical Report Series - TRS-430. (author)

  6. Open and Arthroscopic Surgical Treatment of Femoroacetabular Impingement

    Directory of Open Access Journals (Sweden)

    Benjamin D. Kuhns

    2015-12-01

    Full Text Available Femoroacetabular impingement (FAI is a common cause of hip pain, and when indicated, can be successfully managed through open surgery or hip arthroscopy. The goal of this review is to describe the different approaches to the surgical treatment of FAI. We present the indications, surgical technique, rehabilitation, and complications associated with (1 open hip dislocation, (2 reverse peri-acetabular osteotomy, (3 the direct anterior mini-open approach, and (4 arthroscopic surgery for femoroacetabular impingement.

  7. Dosimetry of normal and wedge fields for a cobalt-60 teletherapy unit

    International Nuclear Information System (INIS)

    Tripathi, U.B.; Kelkar, N.Y.

    1980-01-01

    A simple analytical method for computation of dose distributions for normal and wedge fields is described and the use of the method in planning radiation treatment is outlined. Formulas has been given to compute: (1) depth dose along central axis of cobalt-60 beam, (2) dose to off-axis points, and (3) dose distribution for a wedge field. Good agreement has been found between theoretical and experimental values. With the help of these formulae, the dose at any point can be easily and accurately calculated and radiotherapy can be planned for tumours of very odd shape and sizes. The limitation of the method is that the formulae have been derived for 50% field definition. For cobalt-60 machine having any other field definition, appropriate correction factors have to be applied. (M.G.B.)

  8. Stress Analysis and Model Test of Rock Breaking by Arc Blade Wedged Hob

    Directory of Open Access Journals (Sweden)

    Ying-chao Liu

    2016-07-01

    Full Text Available Based on rock compression-shear damage theory, the mechanical characteristics of an arc blade wedged hob were analyzed to study the rock fragmentation mechanism of hob during excavation, and rock fragmentation forecasting model of the arc blade wedged hob was improved. A spoke type cutter model which is similar to the tunnel boring machine (TBM cutter head was designed to study the rock fragmentation efficiency in different cutter spacing by adjusting the bearing sleeve size to obtain different distances between the hobs. The results show that the hob-breaking rock force mainly comes from three directions. The vertical force along the direction of the tunnel excavation, which is associated with uniaxial compressive strength of rock mass, plays a key role in the process of rock fragmentation. Field project data shows that the prediction model’s results of rock fragmentation in this paper are closer to the measured results than the results of the traditional linear cutting model. The optimal cutter spacing exists among different cutter spacings to get higher rock fragmentation rate and lower energy consumption during rock fragmentation. It is of great reference significance to design the arc blade wedged hob and enhance the efficiency of rock fragmentation in rock strata.

  9. Percutaneous dorsal closing wedge osteotomy of the metatarsal neck in management of metatarsalgia.

    Science.gov (United States)

    Lui, Tun Hing

    2014-12-01

    Metatarsalgia can be caused by plantarflexion of a central metatarsal or discrepancies in the metatarsals' length. Nonsurgical management is usually sufficient to achieve satisfactory results. For those recalcitrant cases, metatarsal osteotomy is needed to relieve the pain. We describe a technique of percutaneous dorsal closing wedge osteotomy of the metatarsal to manage the recalcitrant metatarsalgia. A case series was reviewed retrospectively. From March 2010 to March 2013, percutaneous dorsal closing wedge osteotomy of the metatarsal neck has been performed in 33 patients. Thirty six feet with 63 metatarsals were operated on. Thirty two second metatarsals, 22 third metatarsals, 5 fourth metatarsals and 4 fifth metatarsals were operated on. All the osteotomy sites healed up without any transverse plane deformity. The painful callosities subsided except in one operated metatarsal. Recurrence of painful callosities occurred in 2 operated metatarsals. Transfer metatarsalgia occurred in 2 feet. Floating toe deformity occurred in 2 operated rays. There was no nerve injury noted. Two patients had delayed wound healing with serous discharge and the wounds were eventually healed up with wound dressing. Percutaneous dorsal closing wedge osteotomy of the metatarsal neck is an effective and safe surgical treatment of recalcitrant metatarsalgia. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Altering Knee Abduction Angular Impulse Using Wedged Insoles for Treatment of Patellofemoral Pain in Runners: A Six-Week Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Ryan T Lewinson

    Full Text Available Determine if a change in internal knee abduction angular impulse (KAAI is related to pain reduction for runners with patellofemoral pain (PFP by comparing lateral and medial wedge insole interventions, and increased KAAI and decreased KAAI groups.Randomized controlled clinical trial (ClinicalTrials.gov ID# NCT01332110.Biomechanics laboratory and community.Thirty-six runners with physician-diagnosed PFP enrolled in the trial, and 27 were analyzed.Runners with PFP were randomly assigned to either an experimental 3 mm lateral wedge or control 6 mm medial wedge group. Participants completed a biomechanical gait analysis to quantify KAAIs with their assigned insole, and then used their assigned insole for six-weeks during their regular runs. Usual pain during running was measured at baseline and at six-week follow-up using a visual analog scale. Statistical tests were performed to identify differences between wedge types, differences between biomechanical response types (i.e. increase or decrease KAAI, as well as predictors of pain reduction.Percent change in KAAI relative to neutral, and % change in pain over six weeks.Clinically meaningful reductions in pain (>33% were measured for both footwear groups; however, no significant differences between footwear groups were found (p = 0.697. When participants were regrouped based on KAAI change (i.e., increase or decrease, again, no significant differences in pain reduction were noted (p = 0.146. Interestingly, when evaluating absolute change in KAAI, a significant relationship between absolute % change in KAAI and % pain reduction was observed (R2 = 0.21; p = 0.030, after adjusting for baseline pain levels.The greater the absolute % change in KAAI during running, the greater the % reduction in pain over six weeks, regardless of wedge type, and whether KAAIs increased or decreased. Lateral and medial wedge insoles were similar in effectiveness for treatment of PFP.Altering KAAI should be a focus of future

  11. Válvula de uretra anterior Anterior urethral valves

    Directory of Open Access Journals (Sweden)

    Silvio Tucci Jr.

    2003-02-01

    Full Text Available Objetivo: apresentar os aspectos clínicos, diagnósticos e terapêuticos de pacientes portadores de válvula da uretra anterior. Descrição: em dois neonatos, o diagnóstico presuntivo de patologia obstrutiva do trato urinário foi sugerido pela ultra-sonografia realizada no período pré-natal, confirmando-se o diagnóstico de válvula de uretra anterior pela avaliação pós-natal. Os pacientes foram submetidos a tratamento cirúrgico paliativo, com vesicostomia temporária e, posteriormente, definitivo, pela fulguração endoscópica das válvulas. Ambos evoluíram com função renal normal. Comentários: a válvula da uretra anterior é anomalia rara que deve ser considerada em meninos com quadro radiológico pré-natal sugestivo de obstrução infravesical, secundariamente à hipótese mais comum de válvula da uretra posterior. Ressaltamos a utilização da vesicostomia como derivação urinária temporária nestes casos, prevenindo potenciais complicações pela manipulação da uretra do recém-nascido.Objective: to discuss clinical signs, diagnostic tools and therapeutics of anterior urethral valves, an obstructive anomaly of the urinary system in males. Description: signs of urinary tract obstruction were identified on pre-natal ultrasound in two male fetuses and the diagnosis of anterior urethral valves was made through post-natal evaluation. As an initial treatment, vesicostomy was performed in both patients. Later, the valves were fulgurated using an endoscopic procedure. During the follow-up period both patients presented normal renal function. Comments: anterior urethral valves are a rare form of urethral anomaly that must be ruled out in boys with pre-natal ultrasound indicating infravesical obstruction. Vesicostomy used as an initial treatment rather than transurethral fulguration may prevent potential complications that can occur due to the small size of the neonatal urethra.

  12. Reproducibility of Scleral Spur Identification and Angle Measurements Using Fourier Domain Anterior Segment Optical Coherence Tomography

    Directory of Open Access Journals (Sweden)

    Ricardo J. Cumba

    2012-01-01

    Full Text Available Purpose. To evaluate intraobserver and interobserver agreement in locating the scleral spur landmark (SSL and anterior chamber angle measurements obtained using Fourier Domain Anterior Segment Optical Coherence Tomography (ASOCT images. Methods. Two independent, masked observers (SR and AZC identified SSLs on ASOCT images from 31 eyes with open and nonopen angles. A third independent reader, NPB, adjudicated SSL placement if identifications differed by more than 80 μm. Nine months later, SR reidentified SSLs. Intraobserver and interobserver agreement in SSL placement, trabecular-iris space area (TISA750, and angle opening distance (AOD750 were calculated. Results. In 84% of quadrants, SR’s SSL placements during 2 sessions were within 80 μm in both the X- and Y-axes, and in 77% of quadrants, SR and AZC were within 80 μm in both axes. In adjudicated images, 90% of all quadrants were within 80 μm, 88% in nonopen-angle eyes, and 92% in open-angle eyes. The intraobserver and interobserver correlation coefficients (with and without adjudication were above 0.9 for TISA750 and AOD750 for all quadrants. Conclusions. Reproducible identification of the SSL from images obtained with FD-ASOCT is possible. The ability to identify the SSL allows reproducible measurement of the anterior chamber angle using TISA750 and AOD750.

  13. The Hardy inequality and the heat flow in curved wedges

    Czech Academy of Sciences Publication Activity Database

    Krejčiřík, David

    2016-01-01

    Roč. 73, č. 2 (2016), s. 91-113 ISSN 0032-5155 R&D Projects: GA ČR(CZ) GA14-06818S Institutional support: RVO:61389005 Keywords : Hardy inequality * heat equation * large-time behaviour * curved wedges * Dirichlet Laplacian * conical singularities * Brownian motion * subcriticality Subject RIV: BE - Theoretical Physics Impact factor: 0.735, year: 2016

  14. Anterior Segment Imaging Predicts Incident Gonioscopic Angle Closure.

    Science.gov (United States)

    Baskaran, Mani; Iyer, Jayant V; Narayanaswamy, Arun K; He, Yingke; Sakata, Lisandro M; Wu, Renyi; Liu, Dianna; Nongpiur, Monisha E; Friedman, David S; Aung, Tin

    2015-12-01

    To investigate the incidence of gonioscopic angle closure after 4 years in subjects with gonioscopically open angles but varying degrees of angle closure detected on anterior segment optical coherence tomography (AS OCT; Visante; Carl Zeiss Meditec, Dublin, CA) at baseline. Prospective, observational study. Three hundred forty-two subjects, mostly Chinese, 50 years of age or older, were recruited, of whom 65 were controls with open angles on gonioscopy and AS OCT at baseline, and 277 were cases with baseline open angles on gonioscopy but closed angles (1-4 quadrants) on AS OCT scans. All subjects underwent gonioscopy and AS OCT at baseline (horizontal and vertical single scans) and after 4 years. The examiner performing gonioscopy was masked to the baseline and AS OCT data. Angle closure in a quadrant was defined as nonvisibility of the posterior trabecular meshwork by gonioscopy and visible iridotrabecular contact beyond the scleral spur in AS OCT scans. Gonioscopic angle closure in 2 or 3 quadrants after 4 years. There were no statistically significant differences in age, ethnicity, or gender between cases and controls. None of the control subjects demonstrated gonioscopic angle closure after 4 years. Forty-eight of the 277 subjects (17.3%; 95% confidence interval [CI], 12.8-23; P < 0.0001) with at least 1 quadrant of angle closure on AS OCT at baseline demonstrated gonioscopic angle closure in 2 or more quadrants, whereas 28 subjects (10.1%; 95% CI, 6.7-14.6; P < 0.004) demonstrated gonioscopic angle closure in 3 or more quadrants after 4 years. Individuals with more quadrants of angle closure on baseline AS OCT scans had a greater likelihood of gonioscopic angle closure developing after 4 years (P < 0.0001, chi-square test for trend for both definitions of angle closure). Anterior segment OCT imaging at baseline predicts incident gonioscopic angle closure after 4 years among subjects who have gonioscopically open angles and iridotrabecular contact on AS OCT at

  15. Can field-in-field technique replace wedge filter in radiotherapy treatment planning: a comparative analysis in various treatment sites

    International Nuclear Information System (INIS)

    Prabhakar, R.; Julka, P.K.; Rath, G.K.

    2008-01-01

    The aim of the study was to show whether field-in-field (FIF) technique can be used to replace wedge filter in radiation treatment planning. The study was performed in cases where wedges are commonly used in radiotherapy treatment planning. Thirty patients with different malignancies who received radiotherapy were studied. This includes patients with malignancies of brain, head and neck, breast, upper and lower abdomen. All the patients underwent computed tomography scanning and the datasets were transferred to the treatment planning system. Initially, wedge based planning was performed to achieve the best possible dose distribution inside the target volume with multileaf collimators (Plan1). Wedges were removed from a copy of the same plan and FIF plan was generated (Plan2). The two plans were then evaluated and compared for mean dose, maximum dose, median dose, doses to 2% (D 2 ) and 98% (D 9 8) of the target volume, volume receiving greater than 107% of the prescribed dose (V>107%), volume receiving less than 95% of the prescribed dose (V 2 , V>107% and CI for more of the sites with statistically significant reduction in monitor units. FIF results in better dose distribution in terms of homogeneity in most of the sites. It is feasible to replace wedge filter with FIF in radiotherapy treatment planning.

  16. A study on a characteristic of stem friction coefficient for motor operated flexible wedge gate valve

    International Nuclear Information System (INIS)

    Kim, Dae-Woong; Park, Sung-Geun; Lee, Sang-Guk; Kang, Shin-Cheul

    2009-01-01

    Stem friction coefficient is a coefficient that represents friction between thread leads of the stem and stem nut. It is an important factor to determine output thrust delivered from the actuator to the valve stem in assessing performance of motor operated valves. This study analyzes the effects of changes in differential pressure on stem friction coefficient, and determines the bounding value of stem friction coefficient. A dynamic test was conducted on multiple flexible wedge gate valves in various differential pressure conditions, and the test data was statistically analyzed to determine the bounding value. The results show that stem friction coefficient in middle and high differential pressure is influenced by fluid pressure, while stem friction coefficient in low differential pressure is almost not affected by fluid pressure. In addition, it is found that the bounding value of stem friction coefficient is higher in a closing stroke than in an opening stroke.

  17. Decarbonation and carbonation processes in the slab and mantle wedge - insights from thermomechanical modeling

    Science.gov (United States)

    Gonzalez, C. M.; Gorczyk, W.; Connolly, J. A.; Gerya, T.; Hobbs, B. E.; Ord, A.

    2013-12-01

    Subduction zones offer one of the most geologically active and complex systems to investigate. They initiate a process in which crustal sediments are recycled, mantle heterogeneities arise, and mantle wedge refertilization occurs via slab derived volatiles and magma generation. Slab derived volatiles, consisting primarily of H2O - CO2 fluids, are especially critical in subduction evolution as they rheologically weaken the mantle wedge, decrease solidus temperatures, and rock-fluid interactions result in metasomatism. While the effects of H2O in these processes have been well studied in the past decades, CO2's role remains open for much scientific study. This is partly attributed to the sensitivity of decarbonation to the thermal gradient of the subduction zone, bulk compositions (sediments, basalts, peridotites) and redox state of the mantle. Here we show benchmarking results of a subduction scenario that implements carbonation-decarbonation reactions into a fully coupled petrological-thermomechanical numerical modeling code. We resolve stable mineralogy and extract rock properties via Perple_X at a resolution of 5°C and 25 MPa. The numerical technique employed is a characteristics-based marker-in-cell technique with conservative finite-differences that includes visco-elastic-plastic rheologies (I2ELVIS). The devolatilized fluids are tracked via markers that are either generated or consumed based on P-T conditions. The fluids are also allowed to freely advect within the velocity field. The hosts for CO2 in this system are computed via GLOSS average sediments (H2O: 7.29 wt% & CO2: 3.01 wt%), metabasalts ( H2O: 2.63 & CO2: 2.90 wt%), and ophicarbonates (H2O: 1.98 wt% & CO2: 5.00 wt%). Our results demonstrate the feasibility of applying this decarbonation-carbonation numerical method to a range of geodynamic scenarios that simulate the removal of CO2 from the subducting slab. Such applicable scenarios include sediment diapirism into the convecting wedge and better

  18. Analysis of Ventilation Regimes of the Oblique Wedge-Shaped Surface Piercing Hydrofoil During Initial Water Entry Process

    Directory of Open Access Journals (Sweden)

    Ghadimi Parviz

    2018-03-01

    Full Text Available The suction side of a surface piercing hydrofoil, as a section of a Surface Piercing Propeller (SPP, is usually exposed to three phases of flow consisting air, water, and vapour. Hence, ventilation and cavitation pattern of such section during the initial phase of water entry plays an essential role for the propeller’s operational curves. Accordingly, in the current paper a numerical simulation of a simple surface piercing hydrofoil in the form of an oblique wedge is conducted in three-phase environment by using the coupled URANS and VOF equations. The obtained results are validated against water entry experiments and super-cavitation tunnel test data. The resulting pressure curves and free surface profiles of the wedge water entry are presented for different velocity ratios ranging from 0.12 to 0.64. Non-dimensional forces and efficiency relations are defined in order to present the wedge water entry characteristics. Congruent patterns are observed between the performance curves of the propeller and the wedge in different fully ventilated or partially cavitated operation modes. The transition trend from fully ventilated to partially cavitated operation of the surface piercing section of a SPP is studied and analyzed through wedge’s performance during the transitional period.

  19. Forearc Basin Stratigraphy and Interactions With Accretionary Wedge Growth According to the Critical Taper Concept

    Science.gov (United States)

    Noda, Atsushi

    2018-03-01

    Forearc basins are important constituents of sediment traps along subduction zones; the basin stratigraphy records various events that the basin experienced. Although the linkage between basin formation and accretionary wedge growth suggests that mass balance exerts a key control on their evolution, the interaction processes between basin and basement remain poorly understood. This study performed 2-D numerical simulations in which basin stratigraphy was controlled by changes in sediment fluxes with accretionary wedge growth according to the critical taper concept. The resultant stratigraphy depended on the degree of filling (i.e., whether the basin was underfilled or overfilled) and the volume balance between the sediment flux supplied to the basin from the hinterland and the accommodation space in the basin. The trenchward progradation of deposition with onlapping contacts on the trenchside basin floor occurred during the underfilled phase, which formed a wedge-shaped sedimentary unit. In contrast, the landward migration of the depocenter, with the tilting of strata, was characteristic for the overfilled phase. Condensed sections marked stratigraphic boundaries, indicating when sediment supply or accommodation space was limited. The accommodation-limited intervals could have formed during the end of wedge uplift or when the taper angle decreased and possibly associated with the development of submarine canyons as conduits for bypassing sediments from the hinterland. Variations in sediment fluxes and their balance exerted a strong influence on the stratigraphic patterns in forearc basins. Assessing basin stratigraphy could be a key to evaluating how subduction zones evolve through their interactions with changing surface processes.

  20. BILATERAL SIMULTANEOUS ANTERIOR AND POSTERIOR LENTICONUS WITHOUT SYSTEMIC SIGNS

    Directory of Open Access Journals (Sweden)

    Hima Bindu

    2015-02-01

    Full Text Available A 21 year male came for eye checkup with a refractive error OD - 12.00 sph, - 2.25 @ 160° cyl and OS - 15.00 sph, - 2.50 @ 5°cyl and was referred to department of refractive surgery for opinion His BCVA in OD 6 / 18, OS 6/ 24. Slit lamp examination under dilation with phenylephrine plus tropic amide revealed the abnormal contour of the anterior and posterior lens capsule. Rest of the findings were normal with clear cornea, Von Herricks grade 3 deep anterior chamber, open angles in Gonioscopy. Retro illumination showed the typical’ oil droplet configuration’ in the lens. Retinal examination with the 90 D lens was otherwise normal except of the peculiar ‘OMEGA' shaped curving of the slit beam over the retina which occurred due the difference in the refractive power of the lens in the axial and paraxial zones of the lens

  1. The effect of pharmacologic pupillary dilatation on anterior segment parameters in patients with exfoliation syndrome

    Directory of Open Access Journals (Sweden)

    Mehmet Cem Mocan

    2014-01-01

    Conclusion: Pupillary dilatation with a single drop of 1.0% cyclopentolate, 2.5% phenylephrine or 1% tropicamide is not associated with shallowing of the anterior chamber or narrowing of the ACA in patients with XFS who present with open angles.

  2. Inadequacy of ethical conduct and reporting of stepped wedge cluster randomized trials: Results from a systematic review.

    Science.gov (United States)

    Taljaard, Monica; Hemming, Karla; Shah, Lena; Giraudeau, Bruno; Grimshaw, Jeremy M; Weijer, Charles

    2017-08-01

    Background/aims The use of the stepped wedge cluster randomized design is rapidly increasing. This design is commonly used to evaluate health policy and service delivery interventions. Stepped wedge cluster randomized trials have unique characteristics that complicate their ethical interpretation. The 2012 Ottawa Statement provides comprehensive guidance on the ethical design and conduct of cluster randomized trials, and the 2010 CONSORT extension for cluster randomized trials provides guidelines for reporting. Our aims were to assess the adequacy of the ethical conduct and reporting of stepped wedge trials to date, focusing on research ethics review and informed consent. Methods We conducted a systematic review of stepped wedge cluster randomized trials in health research published up to 2014 in English language journals. We extracted details of study intervention and data collection procedures, as well as reporting of research ethics review and informed consent. Two reviewers independently extracted data from each trial; discrepancies were resolved through discussion. We identified the presence of any research participants at the cluster level and the individual level. We assessed ethical conduct by tabulating reporting of research ethics review and informed consent against the presence of research participants. Results Of 32 identified stepped wedge trials, only 24 (75%) reported review by a research ethics committee, and only 16 (50%) reported informed consent from any research participants-yet, all trials included research participants at some level. In the subgroup of 20 trials with research participants at cluster level, only 4 (20%) reported informed consent from such participants; in 26 trials with individual-level research participants, only 15 (58%) reported their informed consent. Interventions (regardless of whether targeting cluster- or individual-level participants) were delivered at the group level in more than two-thirds of trials; nine trials (28

  3. Catarata polar anterior piramidal deslocada para a câmara anterior causando edema de córnea: relato de caso Corneal edema caused by a pyramidal anterior polar cataract dislocated to the anterior chamber: case report

    Directory of Open Access Journals (Sweden)

    Ramon Coral Ghanem

    2004-08-01

    Full Text Available Cataratas polares anteriores piramidais são opacidades cônicas que se projetam para a câmara anterior a partir da cápsula anterior do cristalino. Na grande maioria dos pacientes a opacidade permanece aderida e estável durante toda a vida. O objetivo deste trabalho é documentar uma manifestação incomum desse tipo de catarata: a deiscência espontânea das pirâmides para a câmara anterior causando descompensação endotelial e edema corneal bilateral. Relatamos o caso de uma paciente feminina, de 66 anos, branca, que apresentava edema corneal localizado inferiormente no olho direito associado à lesão nodular branco-esclerótica compatível com a pirâmide anterior da catarata polar. O olho esquerdo apresentava edema corneal difuso intenso e presença de uma catarata polar anterior com a região piramidal deslocada para a câmara anterior. Sabe-se que a pirâmide anterior pode permanecer inabsorvida na câmara anterior por longo período, pois é composta de tecido colágeno denso. Isto causa perda endotelial progressiva e edema corneal e deve ser considerada indicação de remoção cirúrgica da catarata polar anterior e de seu fragmento. Ressalta-se, também, a importância do bom senso no julgamento das cataratas polares anteriores, considerando-se tamanho da opacidade, simetria das opacidades e componente cortical associado, na tentativa de se evitar ambliopia.Pyramidal anterior polar cataracts are conical opacities that project into the anterior chamber from the anterior capsule of the lens. In the vast majority of patients the opacity remains bound and stable throughout life. We report an unusual complication of this type of cataract: spontaneous dehiscence of the pyramids to the anterior chamber causing bilateral endothelial damage and corneal edema. 66-year-old white woman presented with inferior corneal edema in the right eye and diffuse corneal edema in the left eye. A white nodular lesion was observed in the inferior angle

  4. Arc-parallel extension and fluid flow in an ancient accretionary wedge: The San Juan Islands, Washington

    Science.gov (United States)

    Schermer, Elizabeth R.; Gillaspy, J.R.; Lamb, R.

    2007-01-01

    Structural analysis of the Lopez Structural Complex, a major Late Cretaceous terrane-bounding fault zone in the San Juan thrust system, reveals a sequence of events that provides insight into accretionary wedge mechanics and regional tectonics. After formation of regional ductile flattening and shear-related fabrics, the area was crosscut by brittle structures including: (1) southwest-vergent thrusts, (2) extension veins and normal faults related to northwest-southeast extension, and (3) conjugate strike-slip structures that record northwest-southeast extension and northeast-southwest shortening. Aragonite-bearing veins are associated with thrust and normal faults, but only rarely with strike-slip faults. High-pressure, low-temperature (HP-LT) minerals constrain the conditions for brittle deformation to ???20 km and formed in an accretionary prism during active subduction, which suggests that these brittle structures record internal wedge deformation at depth and early during uplift of the San Juan nappes. The structures are consistent with orogen-normal shortening and vertical thickening followed by vertical thinning and along-strike extension. The kinematic evolution may be related initially to changes in wedge strength, followed by response to overthickening of the wedge in an unbuttressed, obliquely convergent setting. The change in vein mineralogy indicates that exhumation occurred prior to the strike-slip event. The pressure and temperature conditions and spatial and temporal extent of small faults associated with fluid flow suggest a link between these structures and the silent earthquake process. ?? 2007 Geological Society of America.

  5. Interpretation and inverse analysis of the wedge splitting test

    DEFF Research Database (Denmark)

    Østergaard, Lennart; Stang, Henrik

    2002-01-01

    to the wedge splitting test and that it is well suited for the interpretation of test results in terms of s(w). A fine agreement between the hinge and FEM-models has been found. It has also been found that the test and the hinge model form a solid basis for inverse analysis. The paper also discusses possible...... three dimensional problems in the experiment as well as the influence of specimen size....

  6. Orthodontic treatment of an anterior openbite with the aid of corticotomy procedure: Case report.

    Science.gov (United States)

    Aljhani, Ali S; Aldrees, Abdullah M

    2011-04-01

    This case report illustrates the orthodontic treatment combined with the corticotomy technique in an adult patient to accelerate tooth movement and shorten the treatment time. The patient was a 22-year-old woman with an anterior open bite and flared and spaced upper and lower incisors. First, fixed orthodontic appliances (bidimensional edgewise brackets) were bonded, and a week later buccal and lingual corticotomy with alveolar augmentation procedure in the maxillary arch from the first molar to the contralateral first molar, and from canine to canine in the mandibular arch was performed. Orthodontic therapy proceeded with frequent activation of the appliances to retract the incisors every 2 weeks. The total treatment time was 5 months and no adverse effects were observed at the end of active treatment. The addition of the decortication procedure to the conventional orthodontic therapy decreased the duration of treatment significantly. Successful closure of the anterior open bite with adequate overbite and interdigitation of the teeth were achieved.

  7. Laser Oscillator Incorporating a Wedged Polarization Rotator and a Porro Prism as Cavity Mirror

    Science.gov (United States)

    Li, Steven

    2011-01-01

    A laser cavity was designed and implemented by using a wedged polarization rotator and a Porro prism in order to reduce the parts count, and to improve the laser reliability. In this invention, a z-cut quartz polarization rotator is used to compensate the wavelength retardance introduced by the Porro prism. The polarization rotator rotates the polarization of the linear polarized beam with a designed angle that is independent of the orientation of the rotator. This unique property was used to combine the retardance compensation and a Risley prism to a single optical component: a wedged polarization rotator. This greatly simplifies the laser alignment procedure and reduces the number of the laser optical components.

  8. Anterior tibial stress fractures treated with anterior tension band plating in high-performance athletes.

    Science.gov (United States)

    Cruz, Alexandre Santa; de Hollanda, João Paris Buarque; Duarte, Aires; Hungria Neto, José Soares

    2013-06-01

    The non-surgical treatment of anterior tibial cortex stress fractures requires long periods of abstention from sports activities and often results in non-union. Many different surgical techniques have already been previously described to treat these fractures, but there is no consensus on the best treatment. We describe the outcome of treatment using anterior tibial tension band plating in three high-performance athletes (4 legs) with anterior tibial cortex stress fractures. Tibial osteosynthesis with a 3.5-mm locking compression plate in the anterolateral aspect of the tibia was performed in all patients diagnosed with anterior tibial stress fracture after September 2010 at Santa Casa Hospital. All of the fractures were consolidated within a period of 3 months after surgery, allowing for an early return to pre-injury levels of competitive sports activity. There were no infection, non-union, malunion or anterior knee pain complications. Anterior tibial tension band plating leads to prompt fracture consolidation and is a good alternative for the treatment of anterior tibial cortex stress fractures. Bone grafts were shown to be unnecessary.

  9. Anterior ankle arthroscopy, distraction or dorsiflexion?

    Science.gov (United States)

    de Leeuw, Peter A J; Golanó, Pau; Clavero, Joan A; van Dijk, C Niek

    2010-05-01

    Anterior ankle arthroscopy can basically be performed by two different methods; the dorsiflexion- or distraction method. The objective of this study was to determine the size of the anterior working area for both the dorsiflexion and distraction method. The anterior working area is anteriorly limited by the overlying anatomy which includes the neurovascular bundle. We hypothesize that in ankle dorsiflexion the anterior neurovascular bundle will move away anteriorly from the ankle joint, whereas in ankle distraction the anterior neurovascular bundle is pulled tight towards the joint, thereby decreasing the safe anterior working area. Six fresh frozen ankle specimens, amputated above the knee, were scanned with computed tomography. Prior to scanning the anterior tibial artery was injected with contrast fluid and subsequently each ankle was scanned both in ankle dorsiflexion and in distraction. A special device was developed to reproducibly obtain ankle dorsiflexion and distraction in the computed tomography scanner. The distance between the anterior border of the inferior tibial articular facet and the posterior border of the anterior tibial artery was measured. The median distance from the anterior border of the inferior tibial articular facet to the posterior border of the anterior tibial artery in ankle dorsiflexion and distraction was 0.9 cm (range 0.7-1.5) and 0.7 cm (range 0.5-0.8), respectively. The distance in ankle dorsiflexion significantly exceeded the distance in ankle distraction (P = 0.03). The current study shows a significantly increased distance between the anterior distal tibia and the overlying anterior neurovascular bundle with the ankle in a slightly dorsiflexed position as compared to the distracted ankle position. We thereby conclude that the distracted ankle position puts the neurovascular structures more at risk for iatrogenic damage when performing anterior ankle arthroscopy.

  10. Fabrication of customizable wedged multilayer Laue lenses by adding a stress layer

    International Nuclear Information System (INIS)

    Niese, Sven; Krüger, Peter; Kubec, Adam; Laas, Roman; Gawlitza, Peter; Melzer, Kathleen; Braun, Stefan; Zschech, Ehrenfried

    2014-01-01

    Diffractive optics for hard X-rays feature superior properties in terms of resolution and efficiency, if volume diffraction effects are exploited all-over the aperture. For multilayer Laue lenses, preferably a wedged geometry is required to obtain this effect. We present an approach utilizing an additional stress layer to realize the necessary geometrical modifications where each lens can be customized to a selected photon energy independently of the given multilayer deposition. The quality of the deposition of the stress layer is evaluated using a laboratory X-ray microscope prior to its application at synchrotron radiation facilities with a special approach to measure the relative layer tilt at high spatial resolution. - Highlights: • Wedged multilayer Laue lenses were fabricated using an additional stress layer. • Each lens can be customized to any photon energy independently of the multilayer. • The relative layer tilt is measured using laboratory X-ray microscopy

  11. Anterior ankle arthroscopy, distraction or dorsiflexion?

    OpenAIRE

    de Leeuw, P.A.J.; Golanó, P.; Clavero, J.A.; van Dijk, C.N.

    2010-01-01

    Anterior ankle arthroscopy can basically be performed by two different methods; the dorsiflexion- or distraction method. The objective of this study was to determine the size of the anterior working area for both the dorsiflexion and distraction method. The anterior working area is anteriorly limited by the overlying anatomy which includes the neurovascular bundle. We hypothesize that in ankle dorsiflexion the anterior neurovascular bundle will move away anteriorly from the ankle joint, where...

  12. Heat conduction problem of an evaporating liquid wedge

    Directory of Open Access Journals (Sweden)

    Tomas Barta

    2015-02-01

    Full Text Available We consider the stationary heat transfer near the contact line of an evaporating liquid wedge surrounded by the atmosphere of its pure vapor. In a simplified setting, the problem reduces to the Laplace equation in a half circle, subject to a non-homogeneous and singular boundary condition. By classical tools (conformal mapping, Green's function, we reformulate the problem as an integral equation for the unknown Neumann boundary condition in the setting of appropriate fractional Sobolev and weighted space. The unique solvability is then obtained by means of the Fredholm theorem.

  13. Polymer gel measurement of dose homogeneity in the breast: comparing MLC intensity modulation with standard wedged delivery

    International Nuclear Information System (INIS)

    Love, P A; Evans, P M; Leach, M O; Webb, S

    2003-01-01

    Polymer gel dosimetry has been used to measure the radiotherapy dose homogeneity in a breast phantom for two different treatment methods. The first 'standard' method uses two tangential wedged fields while the second method has three static fields shaped by multileaf collimators (MLCs) in addition to the standard wedged fields to create intensity modulated fields. Gel dose distributions from the multileaf modulation treatment show an improved dose uniformity in comparison to the standard treatment with a decreased volume receiving doses over 105%

  14. Effects of Added Mass and Structural Damping on Dynamic Responses of a 3D Wedge Impacting on Water

    Directory of Open Access Journals (Sweden)

    Pengyao Yu

    2018-05-01

    Full Text Available The impact between the wave and the bottom of a high-speed vessel is often simplified as water-entry problems of wedges. Most investigations focus on the water entry of two dimensional (2D wedges. The effects of added mass and structural damping are still not fully investigated. By combining the normal mode method, the hydrodynamic impact model of rigid wedges and the potential flow theory, a dynamic model for predicting the response of a three dimensional (3D wedge impacting on water with a constant velocity is established in this paper. The present model can selectively consider the effects of the added mass and the structural damping. The present method has been validated through comparisons with results of published literatures and commercial software. It is found that the added mass can increase the stress response before the flow separation, and reduce the vibration frequency after the flow separation. Due to the effect of the added mass, the stress response of some positions after the flow separation is even higher than that before the flow separation. The structural damping has a negligible effect on the stress before the flow separation, but it can reduce vibration stress after the flow separation.

  15. Orthodontic treatment of severe anterior open bite and alveolar bone defect complicated by an ankylosed maxillary central incisor: a case report.

    Science.gov (United States)

    Lin, Feiou; Sun, Hao; Yao, Linjie; Chen, Qiushuo; Ni, Zhenyu

    2014-11-21

    Incisor trauma is common in children, and can cause severe complications during adolescent growth and development. This report describes the treatment of a 16-year-old patient with severe anterior open bite due to ankylosis of the maxillary left incisor after dental trauma as an 8-year-old. No examination or active treatment was undertaken until he was 16 years old. Clinical examination revealed that the maxillary left incisor was severely intruded accompanied by a vertical alveolar bone defect. Orthodontic treatment combined with surgical luxation took 3 years and 7 months. During treatment, the intruded incisor was moved to the occlusal level and the alveolar bone defect was restored, achieving normal occlusion. After two years of retention, the maxillary left incisor was retained in a stable normal position with a slightly reduced overbite. This case demonstrates that surgical luxation with orthodontic traction can be an effective approach, especially when the ankylosed tooth has a single root. Long-term monitoring of orthodontic stability and the maintenance of periodontal health are crucial in the post-treatment period.

  16. Dissolved organic carbon loss from Yedoma permafrost amplified by ice wedge thaw

    NARCIS (Netherlands)

    Vonk, J.E.; Mann, P.J.; Dowdy, K.L.; Davydova, A.; Davydov, S.P.; Zimov, N.; Spencer, R.G.M.; Bulygina, E.B.; Eglinton, T.I.; Holmes, R.M.

    2013-01-01

    Pleistocene Yedoma permafrost contains nearly a third of all organic matter (OM) stored in circum-arctic permafrost and is characterized by the presence of massive ice wedges. Due to its rapid formation by sediment accumulation and subsequent frozen storage, Yedoma OM is relatively well preserved

  17. Mandibular Flexure in Anterior-Posterior and Transverse Plane on Edentulous Patients in Mashhad Faculty of Dentistry

    Directory of Open Access Journals (Sweden)

    Azam Sadat Madani

    2013-01-01

    Full Text Available Introduction: Angle and internal position of lateral pterygoid muscle leads to contraction over two half of the mandible in maximum opening and protrusion position so it can affects impression prosthetic procedures. The aim of this study was to evaluate the mandibular flexure in two transverse and antro-posterior dimensions. Methods: Seventy edentulous patients at Mashhad Faculty of Dentistry as the main group and 50 dentulous patients as the control group were selected. In these patients, transverse dimensions between second molar areas and also canine eminence from one side to another side, and longitudinal dimensions based on the distance between canine to second molar area at centric occlusion and maximum mouth opening were measured. Dimensional differences as the mandibular flexure were measured. Results: The mandibular dimensions in maximum opening and closed mouth were different. Average reduction in transverse dimension on second molar region at maximum mouth opening and closing position were almost equal to -0.0787 mm for target group and 0.7512 mm for control group. On anterior side, averages of these changes were equal to 0.3069 mm for target group and were 0.2254 mm for control group. Conclusion: Transverse dimensions in anterior region at maximum opening position are smaller than the same dimension at closed mouth in edentulous and dentulous patients.

  18. Relationship between intraocular pressure and angle configuration: an anterior segment OCT study.

    Science.gov (United States)

    Chong, Rachel S; Sakata, Lisandro M; Narayanaswamy, Arun K; Ho, Sue-Wei; He, Mingguang; Baskaran, Mani; Wong, Tien Yin; Perera, Shamira A; Aung, Tin

    2013-03-05

    To assess the relationship between intraocular pressure (IOP) and anterior chamber angle (ACA) configuration as assessed by gonioscopy and anterior segment optical coherence tomography (AS-OCT). A total of 2045 subjects aged 50 years and older, were recruited from a community clinic and underwent AS-OCT, Goldmann applanation tonometry, and gonioscopy. A quadrant was classified as closed on gonioscopy if the posterior trabecular meshwork could not be seen. A closed quadrant on AS-OCT was defined by the presence of any contact between the iris and angle wall anterior to the scleral spur. Customized software (Zhongshan Angle Assessment Program, Guangzhou, China) was used to measure AS-OCT parameters on AS-OCT scans, including anterior chamber depth, area, and volume; iris thickness (IT) and curvature; lens vault; angle opening distance; and trabecular-iris space area. IOP values were adjusted for age, sex, diabetes and hypertension status, body mass index, central corneal thickness, and presence of peripheral anterior synechiae. Mean age of study subjects was 63.2 ± 8.0 years, 52.6% were female, and 89.4% were Chinese. Mean IOP was 14.8 ± 2.4 mm Hg (range 826). IOP (mean ± SE) increased with number of quadrants with gonioscopic angle closure (none: 14.6 ± 0.2; one: 14.7 ± 0.3; two: 15.0 ± 0.3; three: 15.0 ± 0.3; four: 15.6 ± 0.3 mm Hg; P gonioscopy, with increasing IOP.

  19. Pre-clinical test of the virtual wedge option of a PRIMUS linear accelerator and verification of the calculation algorithm in the treatment planning system HEAX-TMS

    International Nuclear Information System (INIS)

    Gesheva-Atanassova, N.; Balabanova, A.

    2006-01-01

    Full text: The purpose of the study is to check the long-time stability of the wedge angle and the wedge factor (WF) of Virtual Wedges for 6 and 18 MV photon beams, and the accuracy of the TPS HELAX-TMS, in order to accept the virtual wedge technique for patient treatment. All measurements - dose profiles, central axis dose distributions and applied dose for pre-calculated monitor units, have been performed in water, applying a calibrated 0.3 cm 3 ion chamber, 47 ion chamber array LA48 and the beam analyzing system MP3. The measured data has been compared with the corresponding planned data. During a four years time period the long time stability checking revealed no changes in the central axis distributions and variations of the wedge angles are within ± 2 deg. The values of WFs and the differences between calculated and measured dose values are in the acceptable limits, except for the 6 MV beam with wedge angle 60 deg and field size 20x20 cm 2 , where the deviation reaches 6.5%. The dose profile for depth up to 10 cm showed a good coincidence. Non acceptable deviations have been found for beam profiles at depth 20 cm and field size 20x20 cm 2 for both 6 and 18 MV. The Virtual Wedge Option of PRIMUS in combination with HELAX-TMS can be applied with confidence for radiotherapy with wedged beams except for the combination of field 20x20 cm 2 and angle 60 deg

  20. Optical necklaces generated by the diffraction on a stack of dielectric wedges

    Energy Technology Data Exchange (ETDEWEB)

    Izdebskaya, Yana [Nonlinear Physics Centre, Research School of Physical Sciences and Engineering, Australian National University, Canberra ACT 0200 (Australia); Department of Physics, V.I. Vernandsky Taurida National University, Simferopol 95007, Crimea (Ukraine)], E-mail: yvi124@rsphysse.anu.edu.au

    2008-05-19

    We demonstrate that the regular ring-shaped arrays of Gaussian beams, or optical necklaces, can be generated using diffraction on a stack of dielectric wedges. A condition for self-similarity and structural stability of the beams has been derived and shows good comparison with experimental data.

  1. A non-deltaic clinoform wedge fed by multiple sources off São Sebastião Island, southeastern Brazilian Shelf

    Science.gov (United States)

    Vieira, Ivo; Lobo, Francisco José; Montoya-Montes, Isabel; Siegle, Eduardo; Passos, Jorge Luiz; De Mahiques, Michel Michaelovitch

    2018-02-01

    São Sebastião Island (SSI) marks the latitudinal boundary between two sedimentological and geochemical provinces in the São Paulo Bight, an arc-shaped sector of the southeastern Brazilian Shelf. The island is separated from the continent by the narrow, deep São Sebastião Channel (SSC). A relatively thick sediment wedge—the São Sebastião Wedge (SSW)—has been formed offshore SSI. This study explores the possible genetic and evolutionary mechanisms of the wedge, bearing in mind that clinoform wedges can form at considerable distances from major fluvial sources. For that, a marine geological database has been interpreted comprising high-resolution seismic data, a surficial sediment map and several sediment cores, from which radiocarbon dates were obtained and sedimentation rates deduced. A wave model was also applied to obtain the dominant wave directions. The SSW is a wedge-shaped deposit, and its internal structure presents three seismic units. The two lowest are wedge shaped and arranged in a backstepping pattern. The most recent unit is mostly aggradational and can be divided into three seismic subunits. Sedimentological data show that at least the most recent unit is composed of a mixture of sands and silts. Modeled wave conditions indicate a major influence from southerly waves that are able to remobilize shelf sediments and to create a bypass sediment zone until the foreset of the deposit is reached at the water depths where the SSW is found. Taken together, these data suggest that the SSW formed through contributions from different sediment sources, and should be regarded as an intermediate case of a non-deltaic clinoform wedge. Sand transport in the area involves wind-driven currents passing through the SSC and sediment remobilization by energetic southerly waves. Fine-grained sediment is derived mostly from the joint contributions of many minor catchments located north of the island, and this sediment is later transported southwestward by the

  2. Laparoendoscopic single-site Heller myotomy with anterior fundoplication for achalasia.

    Science.gov (United States)

    Barry, Linda; Ross, Sharona; Dahal, Sujat; Morton, Connor; Okpaleke, Chinyere; Rosas, Melissa; Rosemurgy, Alexander S

    2011-06-01

    Laparoendoscopic single-site (LESS) surgery is beginning to include advanced laparoscopic operations such as Heller myotomy with anterior fundoplication. However, the efficacy of LESS Heller myotomy has not been established. This study aimed to evaluate the authors' initial experience with LESS Heller myotomy for achalasia. Transumbilical LESS Heller myotomy with concomitant anterior fundoplication for achalasia was undertaken for 66 patients after October 2007. Outcomes including operative time, complications, and length of hospital stay were recorded and compared with those for an earlier contiguous group of 66 consecutive patients undergoing conventional multi-incision laparoscopic Heller myotomy with anterior fundoplication. Symptoms before and after myotomy were scored by the patients using a Likert scale ranging from 0 (never/not severe) to 10 (always/very severe). Data were analyzed using the Mann-Whitney U test, the Wilcoxon matched-pairs test, and Fisher's exact test where appropriate. Patients undergoing LESS Heller myotomy were similar to those undergoing conventional laparoscopic Heller myotomy in gender, age, body mass index (BMI), blood loss, and length of hospital stay. However, the patients undergoing LESS Heller myotomies had operations of significantly longer duration (median, 117 vs. 93 min with the conventional laparoscopic approach) (pHeller myotomy, additional ports/incisions were required. No patients were converted to "open" operations, and no patients had procedure-specific complications. Symptom reduction was dramatic and satisfying after both LESS and conventional laparoscopic myotomy with fundoplication. The symptom reduction was similar with the two procedures. The LESS approach left no apparent umbilical scar. Heller myotomy with anterior fundoplication effectively treats achalasia. The findings showed LESS Heller myotomy with anterior fundoplication to be feasible, safe, and efficacious. Although the LESS approach increases operative

  3. Geometrical determinations of IMRT photon pencil-beam path in radiotherapy wedges and limit divergence angle with the Anisotropic Analytic Algorithm (AAA

    Directory of Open Access Journals (Sweden)

    Francisco Casesnoves

    2014-08-01

    Full Text Available Purpose: Static wedge filters (WF are commonly used in radiation therapy, forward and/or inverse planning. We calculated the exact 2D/3D geometrical pathway of the photon-beam through the usual alloy WF, in order to get a better dose related to the beam intensity attenuation factor(s, after the beam has passed through the WF. The objective was to provide general formulation into the Anisotropic Analytical Algorithm (AAA model coordinates system (depending on collimator/wedge angles that also can be applied to other models. Additionally, second purpose of this study was to develop integral formulation for 3D wedge exponential factor with statistical approximations, with introduction for the limit angle/conformal wedge.Methods: The radiotherapy model used to develop this mathematical task is the classical superposition-convolution algorithm, AAA (developed by Ulmer and Harder. We worked with optimal geometrical approximations to make the computational IMRT calculations quicker/reduce the planning-system time. Analytic geometry/computational-techniques to carry out simulations (for standard wedges are detailed/developed sharply. Integral developments/integral-statistical approximations are explained. Beam-divergence limit Angle for optimal wedge filtration formulas is calculated/sketched, with geometrical approximations. Fundamental trigonometry is used for this purpose.Results: Extent simulation tables for WF of 15º, 30º, 45º, and 60º are shown with errors. As a result, it is possible to determine the best individual treatment dose distribution for each patient. We presented these basic simulations/numerical examples for standard manufacturing WF of straight sloping surface, to check the accuracy/errors of the calculations. Simulations results give low RMS/Relative Error values (formulated for WF of 15º, 30º, 45º, and 60º.Conclusion: We obtained a series of formulas of analytic geometry for WF that can be applied for any particular dose

  4. Transanal stent in anterior resection does not prevent anastomotic leakage

    DEFF Research Database (Denmark)

    Bülow, Steffen; Bulut, O; Christensen, Ib Jarle

    2006-01-01

    OBJECTIVE: A defunctioning transanal stent may theoretically reduce the leakage rate after anterior rectal resection. We present a randomized open study with the aim of comparing the leakage rate after anterior resection with a loop ileostomy, a transanal stent, both or neither. PATIENTS...... completion of the operation the patients were randomized in two groups with and without a transanal stent. RESULTS: A clinically significant leakage was diagnosed in 25 patients (13%). No significant difference was found 17 of 98 patients with a stent and 8 of 96 without (P = 0.09), or in 9 of 44 ileostomy...... patients with a stent and in 3 of 45 without (P = 0.07). Several leaks over a short time led to an interim analysis after inclusion of 194 of 448 planned patients. The analysis showed no significant protective effect of the stent, and more leakages in the stent group, although not statistically significant...

  5. Wedge cutting of mild steel by CO 2 laser and cut-quality assessment in relation to normal cutting

    Science.gov (United States)

    Yilbas, B. S.; Karatas, C.; Uslan, I.; Keles, O.; Usta, Y.; Yilbas, Z.; Ahsan, M.

    2008-10-01

    In some applications, laser cutting of wedge surfaces cannot be avoided in sheet metal processing and the quality of the end product defines the applicability of the laser-cutting process in such situations. In the present study, CO 2 laser cutting of the wedge surfaces as well as normal surfaces (normal to laser beam axis) is considered and the end product quality is assessed using the international standards for thermal cutting. The cut surfaces are examined by the optical microscopy and geometric features of the cut edges such as out of flatness and dross height are measured from the micrographs. A neural network is introduced to classify the striation patterns of the cut surfaces. It is found that the dross height and out of flatness are influenced significantly by the laser output power, particularly for wedge-cutting situation. Moreover, the cut quality improves at certain value of the laser power intensity.

  6. Novel Ordered Stepped-Wedge Cluster Trial Designs for Detecting Ebola Vaccine Efficacy Using a Spatially Structured Mathematical Model.

    Directory of Open Access Journals (Sweden)

    Ibrahim Diakite

    2016-08-01

    Full Text Available During the 2014 Ebola virus disease (EVD outbreak, policy-makers were confronted with difficult decisions on how best to test the efficacy of EVD vaccines. On one hand, many were reluctant to withhold a vaccine that might prevent a fatal disease from study participants randomized to a control arm. On the other, regulatory bodies called for rigorous placebo-controlled trials to permit direct measurement of vaccine efficacy prior to approval of the products. A stepped-wedge cluster study (SWCT was proposed as an alternative to a more traditional randomized controlled vaccine trial to address these concerns. Here, we propose novel "ordered stepped-wedge cluster trial" (OSWCT designs to further mitigate tradeoffs between ethical concerns, logistics, and statistical rigor.We constructed a spatially structured mathematical model of the EVD outbreak in Sierra Leone. We used the output of this model to simulate and compare a series of stepped-wedge cluster vaccine studies. Our model reproduced the observed order of first case occurrence within districts of Sierra Leone. Depending on the infection risk within the trial population and the trial start dates, the statistical power to detect a vaccine efficacy of 90% varied from 14% to 32% for standard SWCT, and from 67% to 91% for OSWCTs for an alpha error of 5%. The model's projection of first case occurrence was robust to changes in disease natural history parameters.Ordering clusters in a step-wedge trial based on the cluster's underlying risk of infection as predicted by a spatial model can increase the statistical power of a SWCT. In the event of another hemorrhagic fever outbreak, implementation of our proposed OSWCT designs could improve statistical power when a step-wedge study is desirable based on either ethical concerns or logistical constraints.

  7. Agreement between Gonioscopic Examination and Swept Source Fourier Domain Anterior Segment Optical Coherence Tomography Imaging

    Directory of Open Access Journals (Sweden)

    Mohammed Rigi

    2016-01-01

    Full Text Available Purpose. To evaluate interobserver, intervisit, and interinstrument agreements for gonioscopy and Fourier domain anterior segment optical coherence tomography (FD ASOCT for classifying open and narrow angle eyes. Methods. Eighty-six eyes with open or narrow anterior chamber angles were included. The superior angle was classified open or narrow by 2 of 5 glaucoma specialists using gonioscopy and imaged by FD ASOCT in the dark. The superior angle of each FD ASOCT image was graded as open or narrow by 2 masked readers. The same procedures were repeated within 6 months. Kappas for interobserver and intervisit agreements for each instrument and interinstrument agreements were calculated. Results. The mean age was 50.9 (±18.4 years. Interobserver agreements were moderate to good for both gonioscopy (0.57 and 0.69 and FD ASOCT (0.58 and 0.75. Intervisit agreements were moderate to excellent for both gonioscopy (0.53 to 0.86 and FD ASOCT (0.57 and 0.85. Interinstrument agreements were fair to good (0.34 to 0.63, with FD ASOCT classifying more angles as narrow than gonioscopy. Conclusions. Both gonioscopy and FD ASOCT examiners were internally consistent with similar interobserver and intervisit agreements for angle classification. Agreement between instruments was fair to good, with FD ASOCT classifying more angles as narrow than gonioscopy.

  8. Agreement between Gonioscopic Examination and Swept Source Fourier Domain Anterior Segment Optical Coherence Tomography Imaging

    Science.gov (United States)

    Nguyen, Donna; Minnal, Vandana R.

    2016-01-01

    Purpose. To evaluate interobserver, intervisit, and interinstrument agreements for gonioscopy and Fourier domain anterior segment optical coherence tomography (FD ASOCT) for classifying open and narrow angle eyes. Methods. Eighty-six eyes with open or narrow anterior chamber angles were included. The superior angle was classified open or narrow by 2 of 5 glaucoma specialists using gonioscopy and imaged by FD ASOCT in the dark. The superior angle of each FD ASOCT image was graded as open or narrow by 2 masked readers. The same procedures were repeated within 6 months. Kappas for interobserver and intervisit agreements for each instrument and interinstrument agreements were calculated. Results. The mean age was 50.9 (±18.4) years. Interobserver agreements were moderate to good for both gonioscopy (0.57 and 0.69) and FD ASOCT (0.58 and 0.75). Intervisit agreements were moderate to excellent for both gonioscopy (0.53 to 0.86) and FD ASOCT (0.57 and 0.85). Interinstrument agreements were fair to good (0.34 to 0.63), with FD ASOCT classifying more angles as narrow than gonioscopy. Conclusions. Both gonioscopy and FD ASOCT examiners were internally consistent with similar interobserver and intervisit agreements for angle classification. Agreement between instruments was fair to good, with FD ASOCT classifying more angles as narrow than gonioscopy. PMID:27990300

  9. Changes in dip and frictional properties of the basal detachment controlling orogenic wedge propagation and frontal collapse: The external central Betics case

    Science.gov (United States)

    Jimenez-Bonilla, A.; Torvela, T.; Balanyá, J. C.; Expósito, I.; Díaz-Azpiroz, M.

    2016-12-01

    Thin-skinned fold-and-thrust belts (FTBs) have been extensively studied through both field examples and modeling. The overall dynamics of FTBs are, therefore, well understood. One less understood aspect is the combined influence of across-strike changes in the detachment properties and the basement topography on the behavior of an orogenic wedge. In this paper, we use field data together with reflection seismic interpretation from the external zones of the central Betics FTB, southern Spain, to identify a significant increase in the wedge basal dip (a basement "threshold") coinciding with the pinch-out of a weak substrate. This induced both changes to the wedge geometry and to the basal friction, which in turn influenced the wedge dynamics. The changing dynamics led to a transient "stagnation" of the FTB propagation, topographic buildup, and subsequent collapse of the FTB front. This in turn fed an important Langhian depocenter made up of mass transport deposits. Coevally with the FTB propagation, extension took place both parallel and perpendicular to the orogenic trend. This case study illustrates how across-strike changes in wedge basal properties can control the detailed behavior of a developing FTB front, but questions remain regarding the time-space interaction and relative importance of the basal parameters.

  10. Anterior ankle arthroscopy, distraction or dorsiflexion?

    NARCIS (Netherlands)

    de Leeuw, P.A.J.; Golanó, P.; Clavero, J.A.; van Dijk, C.N.

    2010-01-01

    Anterior ankle arthroscopy can basically be performed by two different methods; the dorsiflexion- or distraction method. The objective of this study was to determine the size of the anterior working area for both the dorsiflexion and distraction method. The anterior working area is anteriorly

  11. EVALUATION OF FUNCTIONAL RESULTS OF MEDIAL OPENING WEDGE HIGH TIBIAL OSTEOTOMY FOR UNICOMPARTMENTAL OSTEOARTHRITIS VARUS KNEE

    Directory of Open Access Journals (Sweden)

    Shyam Sundar Bakki

    2017-01-01

    Full Text Available BACKGROUND Osteoarthritis commonly affects the medial compartment of knee giving rise to varus deformity in majority of cases. Significant varus deformity further aggravates the pathology due to medialisation of the weight bearing line osteotomy of the proximal tibia realigns this weight bearing axis, thereby relieving pressure on the damaged medial compartment. OWHTO is a promising option in this scenario because it is associated with high accuracy in correcting the deformity and less number of complications when compared to lateral closing wedge HTO or UKA. In this study, we evaluate the functional outcome of HTO in patients with unicompartmental osteoarthritis. MATERIALS AND METHODS This is a prospective study of patients who attended the orthopaedic outpatient clinic in Government Hospital, Kakinada, between August 2013 to August 2015. The patients were evaluated by clinical examination and weight bearing radiographs. The patients who were found to have unicompartmental osteoarthritis with knee pain not relieved by conservative management and who satisfy the inclusion criteria were selected. RESULTS Excellent results can be achieved by appropriate selection criteria and planning with long limb weight bearing radiographs. There is an excellent relief of pain, which can be achieved within first few months postoperatively, which is assessed by VAS score. The KSS- knee score is excellent in 35%, good in 40%, fair in 20% and poor in 5%. The KSS- function score is excellent in 30%, good in 45%, fair in 20% and poor in 5%. There is significant improvement in the range of movement of the knee joint postoperatively. CONCLUSION In this study, we conclude that medial OWHTO is the preferred modality for unicompartmental OA in those aged <60 years and in developing nations like India where squatting is an important function, it has major role as it can restore near normal knee function without disturbing anatomy.

  12. Effects of primary selective laser trabeculoplasty on anterior segment parameters

    Science.gov (United States)

    Guven Yilmaz, Suzan; Palamar, Melis; Yusifov, Emil; Ates, Halil; Egrilmez, Sait; Yagci, Ayse

    2015-01-01

    AIM To investigate the effects of selective laser trabeculoplasty (SLT) on the main numerical parameters of anterior segment with Pentacam rotating Scheimpflug camera in patients with ocular hypertension (OHT) and primary open angle glaucoma (POAG). METHODS Pentacam measurements of 45 eyes of 25 (15 females and 10 males) patients (12 with OHT, 13 with POAG) before and after SLT were obtained. Measurements were taken before and 1 and 3mo after SLT. Pentacam parameters were compared between OHT and POAG patients, and age groups (60y and older, and younger than 60y). RESULTS The mean age of the patients was 57.8±13.9 (range 20-77y). Twelve patients (48%) were younger than 60y, while 13 patients (52%) were 60y and older. Measurements of pre-SLT and post-SLT 1mo were significantly different for the parameters of central corneal thickness (CCT) and anterior chamber volume (ACV) (P0.05). CONCLUSION SLT leads to significant increase in CCT and decrease in ACV at the 1st month of the procedure. Effects of SLT on these anterior segment parameters, especially for CCT that interferes IOP measurement, should be considered to ensure accurate clinical interpretation. PMID:26558208

  13. Fluxes and burial of particulate organic carbon along the Adriatic mud-wedge (Mediterranean Sea)

    Science.gov (United States)

    Tesi, T.; Langone, L.; Giani, M.; Ravaioli, M.; Miserocchi, S.

    2012-04-01

    Clinoform-shaped deposits are ubiquitous sedimentological bodies of modern continental margins, including both carbonate and silicoclastic platforms. They formed after the attainment of the modern sea level high-stand (mid-late Holocene) when river outlets and shoreline migrated landward. As clinoform-shape deposits are essential building blocks of the infill of sedimentary basins, they are sites of intense organic carbon (OC) deposition and account for a significant fraction of OC burial in the ocean during interglacial periods. In this study, we focused on sigmoid clinoforms that are generally associated with low-energy environments. In particular, we characterized the modern accumulation and burial of OC along the late-Holocene sigmoid in the Western Adriatic Sea (Mediterranean Sea). This sedimentary body consists of a mud wedge recognizable on seismic profiles as a progradational unit lying on top the maximum flooding surface that marks the time of maximum landward shift of the shoreline attained around 5.5 kyr cal BP. In the last two decades, several projects have investigated sediment dynamics and organic geochemistry along the Adriatic mud wedge (e.g., PRISMA, EURODELTA, EuroSTRATAFORM, PASTA, CIPE, VECTOR). All these studies increased our understanding of strata formation and organic matter cycling in this epicontinental margin. The overarching goal of this study was to combine the results gained during these projects with newly acquired data to assess fluxes to seabed and burial efficiency of organic carbon along the uppermost strata of the Adriatic mud-wedge. Our study benefited of an extensive number of radionuclide-based (Pb-210, and Cs-137) sediment accumulation rates and numerous biogeochemical data of surface sediments and sediment cores (organic carbon, total nitrogen, radiocarbon measurements, carbon stable isotopes, and biomarkers). In addition, because the accumulation of river-borne sediment may or may not be linked to a specific source, another

  14. Stratification and salt-wedge in the Seomjin river estuary under the idealized tidal influence

    Science.gov (United States)

    Hwang, Jin Hwan; Jang, Dongmin; Kim, Yong Hoon

    2017-12-01

    Advection, straining, and vertical mixing play primary roles in the process of estuarine stratification. Estuaries can be classified as salt-wedge, partially-mixed or well-mixed depending on the vertical density structure determined by the balancing of advection, mixing and straining. In particular, straining plays a major role in the stratification of the estuarine water body along the estuarine channel. Also, the behavior of a salt wedge with a halocline shape in a stratified channel can be controlled by the competition between straining and mixing induced by buoyancy from the riverine source and tidal forcing. The present study uses Finite Volume Coastal Ocean Model (FVCOM) to show that straining and vertical mixing play major roles in controlling along-channel flow and stratification structures in the Seomjin river estuary (SRE) under idealized conditions. The Potential Energy Anomaly (PEA) dynamic equation quantifies the governing processes thereby enabling the determination of the stratification type. By comparing terms in the equation, we examined how the relative strengths of straining and mixing alter the stratification types in the SRE due to changes in river discharge and the depth resulting from dredging activities. SRE under idealized tidal forcing tends to be partially-mixed based on an analysis of the balance between terms and the vertical structure of salinity, and the morphological and hydrological change in SRE results in the shift of stratification type. While the depth affects the mixing, the freshwater discharge mainly controls the straining, and the balance between mixing and straining determines the final state of the stratification in an estuarine channel. As a result, the development and location of a salt wedge along the channel in a partially mixed and highly stratified condition is also determined by the ratio of straining to mixing. Finally, our findings confirm that the contributions of mixing and straining can be assessed by using the

  15. Deep long-period earthquakes west of the volcanic arc in Oregon: evidence of serpentine dehydration in the fore-arc mantle wedge

    Science.gov (United States)

    Vidale, John E.; Schmidt, David A.; Malone, Stephen D.; Hotovec-Ellis, Alicia J.; Moran, Seth C.; Creager, Kenneth C.; Houston, Heidi

    2014-01-01

    Here we report on deep long-period earthquakes (DLPs) newly observed in four places in western Oregon. The DLPs are noteworthy for their location within the subduction fore arc: 40–80 km west of the volcanic arc, well above the slab, and near the Moho. These “offset DLPs” occur near the top of the inferred stagnant mantle wedge, which is likely to be serpentinized and cold. The lack of fore-arc DLPs elsewhere along the arc suggests that localized heating may be dehydrating the serpentinized mantle wedge at these latitudes and causing DLPs by dehydration embrittlement. Higher heat flow in this region could be introduced by anomalously hot mantle, associated with the western migration of volcanism across the High Lava Plains of eastern Oregon, entrained in the corner flow proximal to the mantle wedge. Alternatively, fluids rising from the subducting slab through the mantle wedge may be the source of offset DLPs. As far as we know, these are among the first DLPs to be observed in the fore arc of a subduction-zone system.

  16. Assessment of narrow angles by gonioscopy, Van Herick method and anterior segment optical coherence tomography.

    Science.gov (United States)

    Park, Seong Bae; Sung, Kyung Rim; Kang, Sung Yung; Jo, Jung Woo; Lee, Kyoung Sub; Kook, Michael S

    2011-07-01

    To evaluate anterior chamber (AC) angles using gonioscopy, Van Herick technique and anterior segment optical coherence tomography (AS-OCT). One hundred forty-eight consecutive subjects were enrolled. The agreement between any two of three diagnostic methods, gonioscopy, AS-OCT and Van Herick, was calculated in narrow-angle patients. The area under receiver-operating characteristic curves (AUC) for discriminating between narrow and open angles determined by gonioscopy was calculated in all participants for AS-OCT parameter angle opening distance (AOD), angle recess area, trabecular iris surface area and anterior chamber depth (ACD). As a subgroup analysis, capability of AS-OCT parameters for detecting angle closure defined by AS-OCT was assessed in narrow-angle patients. The agreement between the Van Herick method and gonioscopy in detecting angle closure was excellent in narrow angles (κ = 0.80, temporal; κ = 0.82, nasal). However, agreement between gonioscopy and AS-OCT and between the Van Herick method and AS-OCT was poor (κ = 0.11-0.16). Discrimination capability of AS-OCT parameters between open and narrow angles determined by gonioscopy was excellent for all AS-OCT parameters (AUC, temporal: AOD500 = 0.96, nasal: AOD500 = 0.99). The AUCs for detecting angle closure defined by AS-OCT image in narrow angle subjects was good for all AS-OCT parameters (AUC, 0.80-0.94) except for ACD (temporal: ACD = 0.70, nasal: ACD = 0.63). Assessment of narrow angles by gonioscopy and the Van Herick technique showed good agreement, but both measurements revealed poor agreement with AS-OCT. The angle closure detection capability of AS-OCT parameters was excellent; however, it was slightly lower in ACD.

  17. Decoding Pedophilia: Increased Anterior Insula Response to Infant Animal Pictures.

    Science.gov (United States)

    Ponseti, Jorge; Bruhn, Daniel; Nolting, Julia; Gerwinn, Hannah; Pohl, Alexander; Stirn, Aglaja; Granert, Oliver; Laufs, Helmut; Deuschl, Günther; Wolff, Stephan; Jansen, Olav; Siebner, Hartwig; Briken, Peer; Mohnke, Sebastian; Amelung, Till; Kneer, Jonas; Schiffer, Boris; Walter, Henrik; Kruger, Tillmann H C

    2017-01-01

    Previous research found increased brain responses of men with sexual interest in children (i.e., pedophiles) not only to pictures of naked children but also to pictures of child faces. This opens the possibly that pedophilia is linked (in addition to or instead of an aberrant sexual system) to an over-active nurturing system. To test this hypothesis we exposed pedophiles and healthy controls to pictures of infant and adult animals during functional magnetic resonance imaging of the brain. By using pictures of infant animals (instead of human infants), we aimed to elicit nurturing processing without triggering sexual processing. We hypothesized that elevated brain responses to nurturing stimuli will be found - in addition to other brain areas - in the anterior insula of pedophiles because this area was repeatedly found to be activated when adults see pictures of babies. Behavioral ratings confirmed that pictures of infant or adult animals were not perceived as sexually arousing neither by the pedophilic participants nor by the heathy controls. Statistical analysis was applied to the whole brain as well as to the anterior insula as region of interest. Only in pedophiles did infants relative to adult animals increase brain activity in the anterior insula, supplementary motor cortex, and dorsolateral prefrontal areas. Within-group analysis revealed an increased brain response to infant animals in the left anterior insular cortex of the pedophilic participants. Currently, pedophilia is considered the consequence of disturbed sexual or executive brain processing, but details are far from known. The present findings raise the question whether there is also an over-responsive nurturing system in pedophilia.

  18. Preliminary observation about anterior capsular changes in different patients after cataract phacoemulsification

    Directory of Open Access Journals (Sweden)

    Min Wang

    2013-09-01

    Full Text Available AIM: To compare changes of anterior capsular opening size between complicated and simple cataract patients who underwent phacoemulsification and foldable IOL implantation.METHODS:Patients complicated with high myopia, primary angle-closure glaucoma(PACG, diabetic cataract and simple cataract(control groupwere selected, 25 case in each group. All patients accepted phacoemulsification by the doctor with operation experience of more than 5 000 cases, and the same 1-piece hydrophilic acrylic IOL was implanted without any complicated happened. The measured value about anterior capsular area by Image-pro plus 6.0 was greater than 23mm2. Every patient was checked regularly through dilated pupil, take photos by slit-lamp camera and area was measured after operation 1 week, 1 month, 3 and 6 months, then to record the biological changes about anterior capsular in 4 groups.RESULTS: The average anterior capsular area in 4 groups 1 week after operation had no difference(P>0.05; No difference was found between simple and complicated high myopia group 6 months after operation(P>0.05. Capsule contraction was observed in complicated POAG group 3 months after operation and in diabetes mellitus group 6 months postoperatively, the average anterior capsular area become smaller than 1 week postoperatively(PCONCLUSION: Cataract patients who complicated PACG or diabetes mellitus maybe the high-risk groups, capsule contraction will be happened 1 month after operation. For high-risk groups, we should prolong the follow-up time, enrich the observation data, and provide the clinical basis for reasonable and preventive intervention.

  19. Refinement of the wedge bar technique for compression tests at intermediate strain rates

    Directory of Open Access Journals (Sweden)

    Stander M.

    2012-08-01

    Full Text Available A refined development of the wedge-bar technique [1] for compression tests at intermediate strain rates is presented. The concept uses a wedge mechanism to compress small cylindrical specimens at strain rates in the order of 10s−1 to strains of up to 0.3. Co-linear elastic impact principles are used to accelerate the actuation mechanism from rest to test speed in under 300μs while maintaining near uniform strain rates for up to 30 ms, i.e. the transient phase of the test is less than 1% of the total test duration. In particular, a new load frame, load cell and sliding anvil designs are presented and shown to significantly reduce the noise generated during testing. Typical dynamic test results for a selection of metals and polymers are reported and compared with quasistatic and split Hopkinson pressure bar results.

  20. Thrust initiation and its control on tectonic wedge geometry: An insight from physical and numerical models

    Science.gov (United States)

    Bose, Santanu; Mandal, Nibir; Saha, Puspendu; Sarkar, Shamik; Lithgow-Bertelloni, Carolina

    2014-10-01

    We performed a series of sandbox experiments to investigate the initiation of thrust ramping in tectonic wedges on a mechanically continuous basal decollement. The experiments show that the decollement slope (β) is the key factor in controlling the location of thrust initiation with respect to the backstop (i.e. tectonic suture line). For β = 0, the ramping begins right at the backstop, followed by sequential thrusting in the frontal direction, leading to a typical mono-vergent wedge. In contrast, the ramp initiates away from the backstop as β > 0. Under this boundary condition an event of sequential back thrusting takes place prior to the onset of frontal thrust progression. These two-coupled processes eventually give rise to a bi-vergent geometry of the thrust wedge. Using the Drucker-Prager failure criterion in finite element (FE) models, we show the location of stress intensification to render a mechanical basis for the thrust initiation away from the backstop if β > 0. Our physical and FE model results explain why the Main Central Thrust (MCT) is located far away from the Indo-Tibetan plate contact (ITSZ) in the Himalayan fold-and-thrust belts.

  1. Anthem simulation studies of the plasma opening switch

    International Nuclear Information System (INIS)

    Mason, R.J.

    1993-01-01

    For a deeper understanding of the physical processes governing the Plasma Opening Switch (POS) the authors use the ANTHEM 2D implicit simulation code to study: (1) ion dynamical effects on electrohydrodynamic (EHD) waves propagating along steep density interfaces in the switch plasmas. At radial interfaces where the density jumps toward the anode, these waves can drive a finger of magnetic field into the plasma toward the load. Ion dynamics can open the rear of such fingers into a wedge-like density gap. Then: (2) they examine ion effects in uniform switch plasmas. These first develop potential hill structures at the drive edge of the cathode from the competition between electron velocity advection and EHD magnetic exclusion waves. Magnetic pressure gradients at the hill periphery and EHD effects then establish a density gap propagating along the cathode with radial electron emission from its tip. Similar results are obtained under both multi-fluid and PIC modeling on the plasma components

  2. Evaluation of the effects of subgingival injection of Simvastatin on space re-opening after orthodontic space closure in adults.

    Science.gov (United States)

    Jahanbin, Arezoo; Abtahi, Mostafa; Namdar, Parastoo; Heravi, Farzin; Sadeghi, Fatemeh; Arab, Hamidreza; Shafaee, Hooman

    2016-01-01

    Background. This clinical trial evaluated the effect of Simvastatin on space re-opening after orthodontic space closure and its effect on the gingival index (GI) and clinical attachment loss (CAL). Methods. 16 females, 25-40 years old, with spaces between anterior mandibular teeth due to chronic periodontitis were participated in this study. The patients were randomly divided into control and experimental groups. In the experimental group, 1.2% Simvastatin gel and in the control group, 0.9% sodium chloride as a placebo was injected into the pocket depth of the six anterior teeth. The amount of space reopening, GI and CAL were measured. Results. No serious complications were observed during interventions and follow-up periods. Space re-opening was significantly reduced in patients receiving Simvastatin (P space re-opening after orthodontic space closure in human anterior teeth.

  3. Automated Mounting of Pole-Shoe Wedges in Linear Wave Power Generators—Using Industrial Robotics and Proximity Sensors

    Directory of Open Access Journals (Sweden)

    Tobias Kamf

    2017-03-01

    Full Text Available A system for automatic mounting of high tolerance wedges inside a wave power linear generator is proposed. As for any renewable energy concept utilising numerous smaller generation units, minimising the production cost per unit is vital for commercialization. The linear generator in question uses self-locking wedges, which are challenging to mount using industrial robots due to the high tolerances used, and because of the fact that any angular error remaining after calibration risks damaging the equipment. Using two types of probes, mechanical touch probes and inductive proximity sensors, combined with a flexible robot tool and iterative calibration routines, an automatic mounting system that overcomes the challenges of high tolerance wedge mounting is presented. The system is experimentally verified to work at mounting speeds of up to 50mm/s, and calibration accuracies of 0.25mmand 0.1 ∘ are achieved. The use of a flexible robot tool, able to move freely in one Cartesian plane, was found to be essential for making the system work.

  4. New Transition Wedge Design Composed by Prefabricated Reinforced Concrete Slabs

    OpenAIRE

    Real-Herráiz, Julia; Zamorano-Martín, Clara; Real-Herráiz, Teresa; Morales-Ivorra, Silvia

    2016-01-01

    [EN] Important track degradation occurs in structure-embankment transitions, in which an abrupt change in track vertical stiffness arises, leading to a reduction in passengers comfort and safety. Although granular wedges are suggested by different railroad administrations as a solution to avoid these problems, they present some disadvantages which may affect track long-term performance. In this paper, a new solution designed with prefabricated reinforced concrete slabs is proposed. The aim of...

  5. Reduced emissions of greenhouse gases 2050: Technological wedges - Input to the Commission on Low Emissions; Reduserte klimagassutslipp 2050: Teknologiske kiler - Innspill til Lavutslippsutvalget

    Energy Technology Data Exchange (ETDEWEB)

    Rosenberg, Eva; Espegren, Kari Aamodt; Finden, Per; Hageman, Rolf; Stenersen, Dag

    2006-09-15

    The Commission on Low Emissions was established in March 2005 and has been charged with the task of describing how Norway can achieve a 50-80 percent reduction in emissions of greenhouse gases by 2050. The commission describes the desired total reduction in emissions to be a set of actions or 'wedges', meaning that the reduction in emissions are linked to an array of technological and behavioural changes. The technological wedges are described here, while the behavioural wedges are treated in a different report. The potentials described are based on the Low Emission's reference line. Possible changes in the reference line will result in changed potentials. The technological wedges studied comprise to a great extent a potential of 50-80 percent reduction in greenhouse gases by 2050. This depends on considerable effort from research and development, and a determination to change external conditions.

  6. Combined Anterolateral, Anterior, and Anteromedial Ankle Impingement in an Adolescent Soccer Player-A Case Report and Review of the Literature.

    Science.gov (United States)

    Cosma, Dan I; Vasilescu, Dana E; Corbu, Andrei; Todor, Adrian; Valeanu, Madalina; Ulici, Alexandru

    2018-01-24

    A unique case of combined anterolateral, anterior, and anteromedial ankle impingement in an adolescent soccer player is presented in this article. To the best of our knowledge, this is the only report of circumferential, massive, anterior ankle impingement in children described in the literature. The importance of proper diagnosis and treatment of such a lesion is illustrated in this case report. We also emphasize that clinical examination combined with 3D computed tomography scan reconstruction is an excellent and cost-effective imaging modality that can help with the diagnosis of anterior ankle impingement. Finally, open surgical treatment showed excellent results in an elite athlete.

  7. Long-term stability of an anterior open-bite malocclusion treated in the mixed dentition: a case report Estabilidade a longo prazo do tratamento da mordida aberta anterior na dentadura mista: relato de caso clínico

    Directory of Open Access Journals (Sweden)

    Márcio Rodrigues de Almeida

    2006-12-01

    Full Text Available A clinical case with anterior open-bite, treated in the mixed dentition, is presented. This approach demonstrates one of the possible approaches of treatment, which is capable of interfering with growth and redirecting its vectors. Orthodontic and orthopedic methods were used, consisting of slow maxillary expansion, through a fixed palatal crib soldered in a bi-helix appliance, and high-pull traction on the mandible for 16 hours a day. After eight years of follow-up, stable outcomes were accomplished. These results may be explained by the fact that treatments were performed at the appropriate period of development, thus establishing perioral muscular equilibrium, matching the final period of facial growth. The combination of orthodontic and orthopedic treatments was necessary to prevent the need of further orthognathic surgery treatment.Apresentou-se um relato de caso clínico de mordida aberta anterior, tratada em dentadura mista, demonstrando uma das possíveis formas de tratamento, capaz de interferir no crescimento e redirecionar seus vetores. Os protocolos ortodônticos e ortopédicos utilizados foram a expansão lenta da maxila, utilizando grade palatina soldada a um expansor bihélice, com tração alta na mandíbula, num período diário de 16 horas. Oito anos de estabilidade foram alcançados, explicados pelo fato de o tratamento ter sido conduzido no momento oportuno do desenvolvimento, o que estabeleceu equilíbrio entre os músculos peribucais, em conjunto com o período final do crescimento. A combinação do tratamento ortodôntico e ortopédico foi necessária para se evitar a necessidade de tratamento cirúrgico.

  8. Combined endoscopic and laparoscopic approach for palliative resection of metastatic melanoma of the stomach

    Directory of Open Access Journals (Sweden)

    Pritchard SA

    2006-03-01

    Full Text Available Abstract Background Metastatic tumours of the stomach present a clinical dilemma for the surgeon. Palliative surgical resection can alleviate symptoms and prolong survival in selected patients. However, previous studies have used open methods of surgical resection with potentially high morbidity and mortality. We describe the use of laparoscopic wedge resection of the stomach for palliative resection of metastatic melanoma to highlight the benefits of this technique. Case presentation A 58 year old male was investigated for iron deficiency anaemia while under treatment for pulmonary metastatic malignant melanoma. An upper gastrointestinal endoscopy revealed a 5 cm diameter ulcer on the anterior wall of the stomach, biopsies from the ulcer confirmed metastatic melanoma. Laparoscopic wedge resection of the stomach lesion was performed without complication. Conclusion Laparoscopic approach has many benefits and is useful for the palliative resection of rare tumours of the stomach in order to preserve the quality of life. Its use should be considered in selected patients.

  9. Numerical simulation for heat transfer performance in unsteady flow of Williamson fluid driven by a wedge-geometry

    Science.gov (United States)

    Hamid, Aamir; Hashim; Khan, Masood

    2018-06-01

    The main concern of this communication is to investigate the two-layer flow of a non-Newtonian rheological fluid past a wedge-shaped geometry. One remarkable aspect of this article is the mathematical formulation for two-dimensional flow of Williamson fluid by incorporating the effect of infinite shear rate viscosity. The impacts of heat transfer mechanism on time-dependent flow field are further studied. At first, we employ the suitable non-dimensional variables to transmute the time-dependent governing flow equations into a system of non-linear ordinary differential equations. The converted conservation equations are numerically integrated subject to physically suitable boundary conditions with the aid of Runge-Kutta Fehlberg integration procedure. The effects of involved pertinent parameters, such as, moving wedge parameter, wedge angle parameter, local Weissenberg number, unsteadiness parameter and Prandtl number on the non-dimensional velocity and temperature distributions have been evaluated. In addition, the numerical values of the local skin friction coefficient and the local Nusselt number are compared and presented through tables. The outcomes of this study indicate that the rate of heat transfer increases with the growth of both wedge angle parameter and unsteadiness parameter. Moreover, a substantial rise in the fluid velocity is observed with enhancement in the viscosity ratio parameter while an opposite trend is true for the non-dimensional temperature field. A comparison is presented between the current study and already published works and results found to be in outstanding agreement. Finally, the main findings of this article are highlighted in the last section.

  10. Theoretical research of probability of wedging of particulate matters at polishing

    Directory of Open Access Journals (Sweden)

    V.F. Molchanov

    2017-12-01

    Full Text Available The mechanism of formation of mikroprofile of the polished surface is expounded taking into account influence of particulate matters, contained in lubricating-coolings liquids. Probability of wedging of abrasive particles is investigational in the area of contact of diamond-impregnated with the surface of detail. It is set that for determination of probability of event, when a particle, getting together with a liquid in the area of contact, abandons track-scratch on a superficial layer, it is necessary to take into account, that three mutual locations of hard particle are possible in the area of contact of diamond-impregnated with the surface of detail. It is set researches, that a hard particle, getting together with a liquid in the area of contact, abandons track-scratch on-the-spot in that case, when the sizes of particle are equal or a few exceed distance from the surface of detail to the ledges on-the-spot diamond-impregnated. Researches allow mathematically to define probability of wedging of particulate matters in the area of contact of diamond-impregnated with the surface of the polished detail.

  11. SAID/SAPS Revisited: A Causal Relation to the Substorm Current Wedge

    Science.gov (United States)

    Mishin, E. V.

    2017-12-01

    We present multi-spacecraft observations of enhanced flow/electric field channels in the inner magnetosphere and conjugate subauroral ionosphere, i.e., subauroral polarization streams (SAPS) near dusk and subauroral ion drifts (SAID) near midnight. The channels collocate with ring current (RC) injections lagging the onset of substorms by a few to ˜20 minutes, i.e., significantly shorter than the gradient-curvature drift time of tens of keV ions. The time lag is of the order of the propagation time of reconnection-injected hot plasma jets to the premidnight plasmasphere and the substorm current wedge (SCW) to dusk. The observations confirm and expand on the previous results on the SAID features that negate the paradigm of voltage and current generators. Fast-time duskside SAPS/RC injections appear intimately related to a two-loop circuit of the substorm current wedge (SCW2L). We suggest that the poleward electric field inherent in the SCW2L circuit, which demands closure of the Region 1- and Region 2-sense field-aligned currents via meridional currents, is the ultimate cause of fast RC injections and SAPS on the duskside.

  12. Tratamiento de la mordida cruzada anterior con plano inclinado anterior. Efecto sobre los arcos dentales

    OpenAIRE

    Carolina Rodríguez Manjarrés; Jesús Alberto Hernández Silva

    2017-01-01

    Objetivo: Evaluar los cambios dimensionales de los arcos dentales primarios tratados con plano inclinado anterior como método de corrección de la mordida cruzada anterior. Métodos: Se trataron 10 pacientes con edades entre 3 y 5 años afectados con mordida cruzada anterior completa, se colocó un plano inclinado anterior elaborado en acrílico, que estuvo en posición en promedio 8.5 semanas. Se obtuvieron modelos de estudio en 3 momentos T0: antes del tratamiento; T1: 6 meses después de iniciado...

  13. Evaluation of anterior chamber angle under dark and light conditions in angle closure glaucoma: An anterior segment OCT study.

    Science.gov (United States)

    Masoodi, Habibeh; Jafarzadehpur, Ebrahim; Esmaeili, Alireza; Abolbashari, Fereshteh; Ahmadi Hosseini, Seyed Mahdi

    2014-08-01

    To evaluate changes of nasal and temporal anterior chamber angle (ACA) in subjects with angle closure glaucoma using Spectralis AS-OCT (SAS-OCT) under dark and light conditions. Based on dark-room gonioscopy, 24 subjects with open angles and 86 with narrow angles participated in this study. The nasal and temporal angle opening distance at 500 μm anterior to the scleral spur (AOD500), nasal and temporal ACA were measured using SAS-OCT in light and dark conditions. In 2 groups, ACA and AOD500 in nasal and temporal quadrants were significantly greater in light compared to dark (all with p=0.000). The AOD500 and ACA were significantly higher in nasal than temporal in measured conditions for 2 groups except the ACA and AOD500 of normal group measured in light. The difference between nasal and temporal in dark (29.07 ± 65.71 μm for AOD500 and 5.7 ± 4.07° for ACA) was greater than light (24.86 ± 79.85 μm for AOD500 and 2.09 ± 7.21° for ACA) condition. But the difference was only significant for ACA (p=0.000). The correlation analysis showed a negative correlation between AOD500 and pupil diameter in temporal and nasal quadrants (both with p=0.000). While temporal AOD500 difference correlated with spherical equivalent, temporal and asal gonioscopy, nasal AOD correlated with IOP, temporal and nasal gonioscopy. Clinically important changes in ACA structure could be detected with SAS-OCT in nasal and temporal quadrants under different illumination intensity. The results could help in improvement of examination condition for better and more accurate assessment of individuals with angle closure glaucoma. Copyright © 2014 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  14. Anterior vaginal introitoplasty for an acquired sensation of wide vagina: a case report and new surgical intervention.

    Science.gov (United States)

    Ostrzenski, Adam

    2014-01-01

    A vaginal introital defect case and its symptomatology have never been published before. The objective of this presentation was to describe symptoms associated with an acquired sensation of wide vagina and to present a new surgical treatment for anterior vaginal introital defects. A 42-year-old, Caucasian woman, G4P4013, presented with a sensation of wide vagina at the vaginal opening and a history of colpoperineoplasty, without mesh, for the same condition 4 years prior. Clinical evaluation documented anterior vaginal introital defects and the absence of vaginal site-specific defects. Reconstruction of a vaginal introital defect was completed without complications. Surgical resolution of symptoms and signs of this condition were noted. Anterior vaginal introitoplasty can assist in the management of an acquired sensation of wide vagina.

  15. Metamaterials based on wedge-shaped electrodynamic structures

    Directory of Open Access Journals (Sweden)

    Mitrokhin Vladimir

    2017-01-01

    Full Text Available The paper studies a possibility of simulation of artificial composite media with negative values of the real part of the equivalent dielectric (magnetic permittivity, by the use of segments of hollow composite waveguides with cylindrical guided waves in evanescent mode. Reactive evanescent fields of wedge-shaped waveguide eigenmodes are formed in the evanescent region before the critical section of the waveguide which separates the quasistatic field region from the distributing field of the evanescent waveguide mode. The possibility of simulation is determined by the equivalence of dispersion equation of the eigenmode propagation constant and the dispersion equation for the electric (magnetic permittivity of plasma-like medium if cut-off frequency and electric (magnetic plasma frequency of the medium are equal.

  16. Anterior point of reference: Current knowledge and perspectives in prosthodontics

    Directory of Open Access Journals (Sweden)

    Prince Kumar

    2012-01-01

    Full Text Available The opening and closing mandibular axis is not a purely theoretical postulation, but an absolutely demonstrable biomechanical entity. It is very crucial to accurately record and transfer to articulators for the purpose of maxillofacial rehabilitation. Following the Face bow record and transfer of the mandibular axis to an anatomic articulator, we can then mount the casts so that they open and close on the articulator in the same fashion as the patient′s jaws. For this reason one of the fixed factors presented by the patient is taken into the consideration, which if properly considered, can be of inestimable value in all phases of dental treatment. This paper has sought to review the current concepts and practical implications regarding anterior point of reference in prosthodontics.

  17. Open preperitoneal groin hernia repair with mesh

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Rosenberg, Jacob

    2017-01-01

    Background For the repair of inguinal hernias, several surgical methods have been presented where the purpose is to place a mesh in the preperitoneal plane through an open access. The aim of this systematic review was to describe preperitoneal repairs with emphasis on the technique. Data sources...... A systematic review was conducted and reported according to the PRISMA statement. PubMed, Cochrane library and Embase were searched systematically. Studies were included if they provided clinical data with more than 30 days follow up following repair of an inguinal hernia with an open preperitoneal mesh......-analysis. Open preperitoneal techniques with placement of a mesh through an open approach seem promising compared with the standard anterior techniques. This systematic review provides an overview of these techniques together with a description of surgical methods and clinical outcomes....

  18. Open preperitoneal groin hernia repair with mesh

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Rosenberg, Jacob

    2017-01-01

    BACKGROUND: For the repair of inguinal hernias, several surgical methods have been presented where the purpose is to place a mesh in the preperitoneal plane through an open access. The aim of this systematic review was to describe preperitoneal repairs with emphasis on the technique. DATA SOURCES......: A systematic review was conducted and reported according to the PRISMA statement. PubMed, Cochrane library and Embase were searched systematically. Studies were included if they provided clinical data with more than 30 days follow up following repair of an inguinal hernia with an open preperitoneal mesh......-analysis. Open preperitoneal techniques with placement of a mesh through an open approach seem promising compared with the standard anterior techniques. This systematic review provides an overview of these techniques together with a description of surgical methods and clinical outcomes....

  19. Diffraction of an inhomogeneous plane wave by an impedance wedge in a lossy medium

    CSIR Research Space (South Africa)

    Manara, G

    1998-11-01

    Full Text Available The diffraction of an inhomogeneous plane wave by an impedance wedge embedded in a lossy medium is analyzed. The rigorous integral representation for the field is asymptotically evaluated in the context of the uniform geometrical theory...

  20. Anterior and posterior ocular biometry in healthy Chinese subjects: data based on AS-OCT and SS-OCT.

    Directory of Open Access Journals (Sweden)

    Wenbin Huang

    Full Text Available To measure the anterior and posterior ocular biometric characteristics concurrently and to determine the relationship between the iris and choroid in healthy Chinese subjects.A total of 148 subjects (270 eyes were enrolled in this cross-section study. The anterior and posterior ocular biometric characteristics were measured simultaneously by anterior segment optical coherence tomography (AS-OCT and swept-source optical coherence tomography (SS-OCT.Compared with male eyes, female eyes had narrower anterior biometric parameters that presented with smaller anterior segment parameters [including anterior chamber depth (ACD, width (ACW, area (ACA, and volume (ACV; (all p<0.001], narrower anterior chamber angle parameters [including angle opening distance (AOD750, trabecular-iris space area (TISA750, and angle recess area (ARA; (all p<0.001], higher iris curvature (ICURV (p = 0.003, and larger lens vaults (LV (p = 0.019. These anterior ocular biometric parameters were correlated with increasing age (p<0.01. Iris thickness (IT750 and iris area (IAREA were associated with age, ACW, and pupil diameter (all p<0.05, while choroidal thickness (CT was associated with age, gender, and axial length (all p<0.05. Univariate regression analysis showed that greater CT was significantly associated with smaller IAREA (p = 0.026.Compared with male eyes, female eyes had narrower anterior biometric parameters that correlated with increasing age, which would be helpful in explaining the higher prevalence of angle closure rates in the female gender and in aging people. Increased CT might be associated with smaller iris area; however, this possibility needs to be investigated in future studies before this conclusion is made.

  1. Role of Neogene Exhumation and Sedimentation on Critical-Wedge Kinematics in the Zagros Orogenic Belt, Northeastern Iraq, Kurdistan

    Science.gov (United States)

    Koshnaw, R. I.; Horton, B. K.; Stockli, D. F.; Barber, D. E.; Tamar-Agha, M. Y.; Kendall, J. J.

    2014-12-01

    The Zagros orogenic belt and foreland basin formed during the Cenozoic Arabia-Eurasia collision, but the precise histories of shortening and sediment accumulation remain ambiguous, especially at the NW extent of the fold-thrust belt in Iraqi Kurdistan. This region is characterized by well-preserved successions of Cenozoic clastic foreland-basin fill and deformed Paleozoic-Mesozoic hinterland bedrock. The study area provides an excellent opportunity to investigate the linkage between orogenic wedge behavior and surface processes of erosion and deposition. The aim of this research is to test whether the Zagros orogenic wedge advanced steadily under critical to supercritical wedge conditions involving in-sequence thrusting with minimal erosion or propagated intermittently under subcritical condition involving out-of-sequence deformation with intense erosion. These endmember modes of mountain building can be assessed by integrating geo/thermochronologic and basin analyses techniques, including apatite (U-Th)/He thermochronology, detrital zircon U-Pb geochronology, stratigraphic synthesis, and seismic interpretations. Preliminary apatite (U-Th)/He data indicate activation of the Main Zagros Fault (MZF) at ~10 Ma with frontal thrusts initiating at ~8 Ma. However, thermochronometric results from the intervening Mountain Front Flexure (MFF), located between the MZF and the frontal thrusts, suggest rapid exhumation at ~6 Ma. These results suggest that the MFF, represented by the thrust-cored Qaradagh anticline, represents a major episode of out-of-sequence deformation. Detrital zircon U-Pb analyses from the Neogene foreland-basin deposits show continuous sediment derivation from sources to the NNE in Iraq and western Iran, suggesting that out-of-sequence thrusting did not significantly alter sedimentary provenance. Rather, intense hinterland erosion and recycling of older foreland-basin fill dominated sediment delivery to the basin. The irregular distribution of

  2. 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.

  3. On the role of lateral waves in the radiation from the dielectric wedge

    DEFF Research Database (Denmark)

    Balling, Peter

    1973-01-01

    The field on the dielectric wedge is approximated by a plane-wave expansion as in [1]. Contributions from this solution to both the surface field and the radiation field are examined. Finally, an experimental radiation field is compared with the plane-wave solution and with a geometric-optical...

  4. The changes of the interspace angle after anterior correction and instrumentation in adolescent idiopathic scoliosis patients

    Directory of Open Access Journals (Sweden)

    Fei Qi

    2007-10-01

    Full Text Available Abstract Background In idiopathic scoliosis patients, after anterior spinal fusion and instrumentation, the discs (interspace angle between the lowest instrumented vertebra (LIV and the next caudal vertebra became more wedged. We reviewed these patients and analyzed the changes of the angle. Methods By reviewing the medical records and roentgenograms of adolescent idiopathic scoliosis patients underwent anterior spinal fusion and instrumentation, Cobb angle of the curve, correction rate, coronal balance, LIV rotation, interspace angle were measured and analyzed. Results There were total 30 patients included. The mean coronal Cobb angle of the main curve (thoracolumbar/lumbar curve before and after surgery were 48.9° and 11.7°, respectively, with an average correction rate of 76.1%. The average rotation of LIV before surgery was 2.1 degree, and was improved to 1.2 degree after surgery. The interspace angle before surgery, on convex side-bending films, after surgery, at final follow up were 3.2°, -2.3°, 1.8° and 4.9°, respectively. The difference between the interspace angle after surgery and that preoperatively was not significant (P = 0.261, while the interspace angle at final follow-up became larger than that after surgery, and the difference was significant(P = 0.012. The interspace angle after surgery was correlated with that on convex side-bending films (r = 0.418, P = 0.022, and the interspace angle at final follow-up was correlated with that after surgery (r = 0.625, P = 0.000. There was significant correlation between the loss of the interspace angle and the loss of coronal Cobb angle of the main curve during follow-up(r = 0.483, P = 0.007. Conclusion The interspace angle could be improved after anterior correction and instrumentation surgery, but it became larger during follow-up. The loss of the interspace angle was correlated with the loss of coronal Cobb angle of the main curve during follow-up.

  5. Decoding Pedophilia: Increased Anterior Insula Response to Infant Animal Pictures

    Directory of Open Access Journals (Sweden)

    Jorge Ponseti

    2018-01-01

    Full Text Available Previous research found increased brain responses of men with sexual interest in children (i.e., pedophiles not only to pictures of naked children but also to pictures of child faces. This opens the possibly that pedophilia is linked (in addition to or instead of an aberrant sexual system to an over-active nurturing system. To test this hypothesis we exposed pedophiles and healthy controls to pictures of infant and adult animals during functional magnetic resonance imaging of the brain. By using pictures of infant animals (instead of human infants, we aimed to elicit nurturing processing without triggering sexual processing. We hypothesized that elevated brain responses to nurturing stimuli will be found – in addition to other brain areas – in the anterior insula of pedophiles because this area was repeatedly found to be activated when adults see pictures of babies. Behavioral ratings confirmed that pictures of infant or adult animals were not perceived as sexually arousing neither by the pedophilic participants nor by the heathy controls. Statistical analysis was applied to the whole brain as well as to the anterior insula as region of interest. Only in pedophiles did infants relative to adult animals increase brain activity in the anterior insula, supplementary motor cortex, and dorsolateral prefrontal areas. Within-group analysis revealed an increased brain response to infant animals in the left anterior insular cortex of the pedophilic participants. Currently, pedophilia is considered the consequence of disturbed sexual or executive brain processing, but details are far from known. The present findings raise the question whether there is also an over-responsive nurturing system in pedophilia.

  6. Efeito do ajustamento da produção de leite para período de serviço anterior sobre os valores genéticos de bovinos da raça Holandesa Effect of adjusting production records for days open on breeding values in Holsteins

    Directory of Open Access Journals (Sweden)

    Nilson Milagres Teixeira

    2001-04-01

    Full Text Available Registros de produção e reprodução de 6.877 lactações de 4.673 vacas foram usados para se determinar o efeito do ajustamento para período de serviço anterior em avaliações genéticas. Os valores genéticos previstos para produção de leite em kg foram calculados usando-se três modelos: Modelo 1 - sem correção para período de serviço, com os efeitos fixos de rebanho-ano-estação de parto, grupo genético (1-PO, 2-PC, idade ao parto como covariável até 2º grau e os efeitos aleatórios de animal, meio permanente e erro; Modelo 2 - mesmo anterior com a inclusão de período de serviço anterior; Modelo 3 - mesmo que o modelo 1, com as produções padronizadas para 100 dias de período de serviço anterior, por meio de fatores de ajustamento. Os valores genéticos previstos obtidos para cada modelo foram comparados. Vacas entre as 2% melhores apresentaram, em média, mudanças de nove e onze posições, respectivamente, quando os modelos 2 e 3 foram usados, comparadas com suas ordens obtidas com o modelo 1. Além disso, oito e onze vacas foram excluídas da relação das 2% melhores quanto aos seus valores genéticos para produção de leite, quando avaliadas, respectivamente, pelos modelos 2 e 3. As confiabilidades dos valores genéticos previstos obtidos usando-se os três modelos foram semelhantes. As correlações de ordem entre os valores genéticos estimados, tanto para vacas quanto para touros, para todos os modelos foram próximas de um. Portanto, o ajustamento para período de serviço anterior não alterou a ordem dos animais nesta avaliação genética na raça Holandesa no Estado de Minas Gerais.Production and breeding records from 6,877 lactations of 4,673 cows were used to evaluate the effect of adjusting for previous days open on genetic evaluations. Predicted breeding values for kg of milk were calculated using three animal models. Model 1 - contained no adjustment for days open and accounted for the fixed effects

  7. Valgus osteotomy of the tibia with a Puddu plate combined with anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Albuquerque Roberto Freire da Mota e

    2003-01-01

    Full Text Available Anterior knee instability associated with a varus deformity is a complex condition with several treatment possibilities. Among these, anterior cruciate ligament (ACL associated to a simultaneous valgus tibial osteotomy is a increasing indication. This simultaneous procedure adds technical issues to those related to the isolated surgeries. Thus, the osteotomy plane and location of fixation hardware shouldn?t conflict with tibial tunnel and ACL graft fixation. Authors analyze the relations between a opening tibial valgus osteotomy stabilized with a Puddu plate and ACL reconstruction with a patellar tendon graft fixated with interference screws in 10 human cadaver knees. A straight oblique tibial osteotomy starting on the medial tibial cortex and oriented laterally and proximally was performed on all knees with a 10mm opening medially and stabilized with a Puddu plate on the most posterior aspect of the medial tibia, and a tibial tunnel drilled 50° to tibial plateau. With this technique there was no intersection between tibial tunnel or interference screw and the osteotomy or the plate fixation screws.

  8. The limited anterior approach of the elbow for open reduction and internal fixation of capitellum fractures. Surgical technique and clinical experience in 2 cases with more than 2 years follow-up.

    Science.gov (United States)

    Ballesteros-Betancourt, J R; Fernández-Valencia, J A; García-Tarriño, R; Domingo-Trepat, A; Sastre-Solsona, S; Combalia-Aleu, A; Llusá-Pérez, M

    Fractures involving the capitellum can be treated surgically by excision of the fragment, or by reduction and internal fixation with screws, with or without heads. The lateral Kocher approach is the most common approach for open reduction. We believe that the limited anterior approach of the elbow, could be a valid technique for treating these fractures, as it does not involve the detachment of any muscle group or ligament, facilitating the recovery process. A description is presented of the surgical technique, as well as of 2cases with a Bryan-Morrey type 1 fracture (Dubberley type 1A). Two different final quality of life evaluation questionnaires were completed by telephone: the EuroQol Five Dimensions Questionnaire (EQ-5D), and the patient part of the Liverpool Elbow Score (PAQ-LES) questionnaire. The 2patients showed favourable clinical progress at 36 and 24 months, respectively, with an extension/flexion movement arc of -5°/145° and -10°/145°, as well as a pronosupination of 85°/80° and 90°/90°. The 2patients showed radiological consolidation with no signs of osteonecrosis. The EQ-5D score was 0.857 and 0.910 (range: 0.36-1), and a PAQ-SLE of 35 and 35 (range: 17-36), respectively. We believe that the limited anterior approach of the elbow is a technical option to consider for the open surgical treatment of a capitellum fracture, although further studies are needed to demonstrate its superiority and clinical safety compared to the classical lateral Kocher approach. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Muon Intensity Increase by Wedge Absorbers for Low-E Muon Experiments

    Energy Technology Data Exchange (ETDEWEB)

    Neuffer, D. V. [Fermilab; Stratakis, D. [Fermilab; Bradley, J. [Fermilab

    2017-09-01

    Low energy muon experiments such as mu2e and g-2 have a limited energy spread acceptance. Following techniques developed in muon cooling studies and the MICE experiment, the number of muons within the desired energy spread can be increased by the matched use of wedge absorbers. More generally, the phase space of muon beams can be manipulated by absorbers in beam transport lines. Applications with simulation results are presented.

  10. 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.)

  11. Reconstruction of the anterior cruciate ligament of the knee

    Directory of Open Access Journals (Sweden)

    Nikolić Dragan

    2006-01-01

    Full Text Available Background/Aim. Numerous papers on reconstruction of the anterior cruciate ligament of the knee (ACL contribute to the significance of this method. The aim of this study was to analyze the outcome of the use of this surgical treatment method regardless the type of surgical intervention, graft, and the choice of the material for fixing. Methods. The study included 324 patients treated within the period from April 1997 to April 2004. Arthroscopically assisted ACL reconstruction was typically performed using the central one-third of the patellar ligament, as a graft, with bone blocks. Fixing was performed using screws (spongy or interferential, Mitek type. In the cases who required revision of the surgery, we used a graft m. semitendinosus and m. gracilise (STG or a graft of the patellar ligament (B-Pt-B. Fixation in these cases was performed using absorptive wedges according to the Rigidfix technique or metallic implants. Results. The analysis included the results of the reconstruction of the anterior cruciate ligament of the knee (B-Pt-B or STG graft in 139 of the knees. Chronic injuries were revealed in 132 (94.9% of the knees. According to the anamnesis and clinical findings, the feeling of instability prevailed in 132 (94.9% of the knees, pain in 72 (51.7%, effluents in 24 (17.2%, and blockages in 13 (9.3%. Early and late postoperative complications were noticeable in 3.5% each. Hypotrophy of the upper knee musculature up to 2 cm was present in 53.9% of the operated knees, while minor contractions in 13.6% of them. The final result of the reconstruction graded begusing the Lysholm Scale was 85.2, simultaneous reconstructions of other ligaments 75.3, and revision surgery 68.0. First-grade degenerative postoperative changes according to the K/L Scale were found in 55.0% of the surgically treated knees, while the worst, four-grade one in 2.5%. Conclusion. On the basis of these findings, we can conclude that this method is the method of choice in

  12. Irreducible Anterior Shoulder Dislocation Associated With Displaced Fracture of the Greater Tuberosity: An Analysis of Seven Cases

    Directory of Open Access Journals (Sweden)

    Morteza Nakhaei Amroodi

    2015-11-01

    Full Text Available Background: Although anterior shoulder dislocation is the most prevalent type of body dislocation, irreducible anterior shoulder dislocation is seldom reported in the literature, which is usually due to physical obstacles. Objectives: This study presents our findings regarding the causes of irreducibility of anterior shoulder dislocation associated with displaced fracture of the greater tuberosity. Patients and Methods: CT scans, open reduction of the joint, and internal fixation of the tuberosity was performed in seven patients with irreducible anterior shoulder dislocation associated with displaced fracture of the greater tuberosity. Results: As confirmed by intraoperative findings, the CT scans showed the cause of irreducible shoulder dislocation in six cases was the interposition of the long head of biceps (LHB in the anterior of the head that was displaced from the fracture line between the greater and lesser tuberosities. In another case, the greater and lesser tuberosities were attached to each other and were separated from the head. This fractured part was trapped. Conclusions: We suggest that performing CT scans in all cases of anterior shoulder dislocations with displaced fracture of the greater tuberosity can help surgeons to diagnose the accompanying fractures and possible complications, such as irreducibility. If the fracture line passes through the bicipital groove or in the case of a shield fracture, possible irreducibility should be borne in mind.

  13. Morphometric X-ray Absorptiometry: Reference Data for Vertebral Dimensions in a Population-based Sample of Young Danish Men

    International Nuclear Information System (INIS)

    Wulff, R.; Koch Holst, A.; Nielsen, T.L.; Andersen, M.; Hagen, C.; Brixen, K.

    2004-01-01

    Purpose: To determine reference values for vertebral heights in healthy young Danish males using morphometric X-ray absorptiometry (MXA). Material and Methods: A population-based study group of 487 males aged between 20 and 30 years (mean 25 years) from the county of Funen, Denmark, were recruited. Using a Hologic QDR 4500 (dual energy X-ray absorptiometry) DXA-scanner, MXA scans covering the vertebrae from T4 to L4 were acquired for each subject. Anterior (Ha), middle (Hm), and posterior (Hp) heights of the thoracic (T4-T12) and lumbar (L1-L4) vertebral bodies were measured. Moreover, wedge, mid-wedge, crush I, and crush II ratios were calculated. Results: No correlation between vertebral dimensions and crush indices on the one hand and age or weight on the other were found. Body height, however, correlated significantly with the cumulated vertebral heights. Reference data for vertebral dimensions, wedge, mid-wedge, crush I, and crush II are tabulated. Conclusion: The anterior, middle, and posterior heights of the vertebral bodies of T4 to L4 can be measured reproducible with MXA. In young men, the cumulative vertebral heights correlated with body height but not with age. Moreover, the wedge and crush indices were unrelated of both age and height

  14. Numerical Simulation and Experimental Validation of an Integrated Sleeve-Wedge Anchorage for CFRP Rods

    DEFF Research Database (Denmark)

    Schmidt, Jacob Wittrup; Smith, Scott T.; Täljsten, Björn

    2011-01-01

    . Recently, an integrated sleeve-wedge anchorage has been successfully developed specifically for CFRP rods. This paper in turn presents a numerical simulation of the newly developed anchorage using ABAQUS. The three-dimensional finite element (FE) model, which considers material non-linearity, uses...

  15. Managing the severely proclined maxillary anteriors by extracting traumatized right maxillary central incisor

    Directory of Open Access Journals (Sweden)

    Mahesh Jain

    2014-01-01

    Full Text Available A 14-year-old girl reported with severely proclined maxillary anterior teeth with fractured and discolored right maxillary central incisor with questionable prognosis. Autotransplantation of premolar to replace central incisor was considered a risky option as patient was 14-year-old with presence of advanced root development of premolar. The immediate placement of the prosthetic implant was also not possible because of patient′s age. Therefore, it was decided to use the space obtained by extracting questionable maxillary right central incisor for orthodontic purpose and also sacrificing the healthy premolar is invariably an excessive biological cost for a modest functional and aesthetic gain. Hence, the treatment plan for this case includes extraction of right maxillary central incisor and left maxillary first premolar, movement of right maxillary lateral incisor mesially, achieving normal axial inclination of maxillary anteriors with normal overjet and overbite. Mandibular arch was treated nonextraction due to congenitally missing central incisors with presence of normally inclined lower anteriors thereby maintaining Angles class I occlusion. Tipping, usually, seen in Begg mechanotherapy was used for our advantage to correct severely proclined maxillary anteriors with simultaneous bite opening mechanics. Case was completed in 19 months and posttreatment records including photographs, radiographs and study models were made. Begg wrap around the retainer was placed in the maxillary arch allowing natural settling of occlusion.

  16. Anterior approach for knee arthrography

    International Nuclear Information System (INIS)

    Zurlo, J.V.; Towers, J.D.; Golla, S.

    2001-01-01

    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.)

  17. A study to compare the motorised wedge output factor of an elekta synergy linear accelerator with reference data (TPS Data)

    International Nuclear Information System (INIS)

    Akosah, Kinsley

    2016-07-01

    For external beam radiotherapy treatments, high doses are delivered to the cancerous cell. Accuracy and precision of dose delivery are primary requirements for effective and efficient cancer treatment. The dose delivered to the patient might not be uniform and therefore need to be compensated for. In treatment these inhomogeneities are taken care of by using wedge filters and incorporating wedge factors in the Treatment Planning System. Computer controlled wedges were alternatives introduced by different manufacturers of which Motorized wedges (MW) is one of them. The MW was introduced by ELEKTA and this helps to overcome some of the shortcomings of physical wedges. The objectives of this study were to measure MW output factors for 6 MV and 15 MV photon energies for an ELEKTA Synergy. Secondly, to compare the results of MWOF obtained to that of the treatment planning system data. The Motorized Wedge Output Factors (MWOF) were measured for the ELEKTA Synergy for both 6 MV and 15 MV photon energies. With the help of PMMA solid water slabs phantom, the Elekta synergy, thermometer, barometer, PTW farmer type ionization chamber 30010 charges were collected at 100 cm source to surface distance for various square field sizes from 5x5 cm to 30x30 cm and depth of 1.5 cm and 2.5 cm for 6 MV and 15 MV photon energies. Comparing the results with the TPS data, an excellent agreement was found for 6 MV MWOF, with the percentage differences ranging from 0.03% to 1.50%, with a mean of 0.03%. The coefficient of variation of MWOF ranged from 0.023% to 1.07% and 0.001% to 12.89% for the two beams (6 MV and 15 MV) respectively. The relative differences between the calculated and the measured MWOFs increases with field size. In conclusion, there was general agreement between the calculated and measured MWOFs. The consistency of values provide further support that a standard dataset of photon and electron dosimetry could be established as a guide for future commissioning, beam modeling

  18. Long-term outcomes of wedge resection at the limbus for high irregular corneal astigmatism after repaired corneal laceration

    Directory of Open Access Journals (Sweden)

    Jun Du

    2016-06-01

    Full Text Available AIM: To evaluate the clinical value of wedge resection at corneal limbus in patients with traumatic corneal scarring and high irregular astigmatism. METHODS: Patients with traumatic corneal astigmatism received wedge resection at least 6mo after suture removal from corneal wound. The uncorrected distance visual acuities (UCVA and best corrected distance visual acuities (BCVA, pre- and post-operation astigmatism, spherical equivalent (SE, safety and complications were evaluated. RESULTS: Ten eyes (10 patients were enrolled in this study. Mean follow-up time after wedge resection was 37.8±15.4mo (range, 20-61mo. The mean UCVA improved from +1.07±0.55 logMAR to +0.43±0.22 logMAR (P=0.000 and the mean BCVA from +0.50±0.30 logMAR to +0.15±0.17 logMAR (P=0.000. The mean astigmatism power measured by retinoscopy was -2.03±2.27 D postoperatively and -2.83±4.52 D preoperatively (P=0.310. The mean SE was -0.74±1.61 D postoperatively and -0.64±1.89 D preoperatively (P=0.601. Two cases developed mild pannus near the sutures. No corneal perforation, infectious keratitis or wound gape occurred. CONCLUSION: Corneal-scleral limbal wedge resection with compression suture is a safe, effective treatment for poor patients with high irregular corneal astigmatism after corneal-scleral penetrating injury. Retinoscopy can prove particularly useful for high irregular corneal astigmatism when other measurements are not amenable.

  19. Two-dimensional electronic spectroscopy with birefringent wedges

    Energy Technology Data Exchange (ETDEWEB)

    Réhault, Julien; Maiuri, Margherita; Oriana, Aurelio; Cerullo, Giulio [IFN-CNR, Dipartimento di Fisica, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano (Italy)

    2014-12-15

    We present a simple experimental setup for performing two-dimensional (2D) electronic spectroscopy in the partially collinear pump-probe geometry. The setup uses a sequence of birefringent wedges to create and delay a pair of phase-locked, collinear pump pulses, with extremely high phase stability and reproducibility. Continuous delay scanning is possible without any active stabilization or position tracking, and allows to record rapidly and easily 2D spectra. The setup works over a broad spectral range from the ultraviolet to the near-IR, it is compatible with few-optical-cycle pulses and can be easily reconfigured to two-colour operation. A simple method for scattering suppression is also introduced. As a proof of principle, we present degenerate and two-color 2D spectra of the light-harvesting complex 1 of purple bacteria.

  20. Agreement of Anterior Segment Parameters Obtained From Swept-Source Fourier-Domain and Time-Domain Anterior Segment Optical Coherence Tomography.

    Science.gov (United States)

    Chansangpetch, Sunee; Nguyen, Anwell; Mora, Marta; Badr, Mai; He, Mingguang; Porco, Travis C; Lin, Shan C

    2018-03-01

    To assess the interdevice agreement between swept-source Fourier-domain and time-domain anterior segment optical coherence tomography (AS-OCT). Fifty-three eyes from 41 subjects underwent CASIA2 and Visante OCT imaging. One hundred eighty-degree axis images were measured with the built-in two-dimensional analysis software for the swept-source Fourier-domain AS-OCT (CASIA2) and a customized program for the time-domain AS-OCT (Visante OCT). In both devices, we examined the angle opening distance (AOD), trabecular iris space area (TISA), angle recess area (ARA), anterior chamber depth (ACD), anterior chamber width (ACW), and lens vault (LV). Bland-Altman plots and intraclass correlation (ICC) were performed. Orthogonal linear regression assessed any proportional bias. ICC showed strong correlation for LV (0.925) and ACD (0.992) and moderate agreement for ACW (0.801). ICC suggested good agreement for all angle parameters (0.771-0.878) except temporal AOD500 (0.743) and ARA750 (nasal 0.481; temporal 0.481). There was a proportional bias in nasal ARA750 (slope 2.44, 95% confidence interval [CI]: 1.95-3.18), temporal ARA750 (slope 2.57, 95% CI: 2.04-3.40), and nasal TISA500 (slope 1.30, 95% CI: 1.12-1.54). Bland-Altman plots demonstrated in all measured parameters a minimal mean difference between the two devices (-0.089 to 0.063); however, evidence of constant bias was found in nasal AOD250, nasal AOD500, nasal AOD750, nasal ARA750, temporal AOD500, temporal AOD750, temporal ARA750, and ACD. Among the parameters with constant biases, CASIA2 tends to give the larger numbers. Both devices had generally good agreement. However, there were proportional and constant biases in most angle parameters. Thus, it is not recommended that values be used interchangeably.

  1. Anterior vitrectomy and partial capsulectomy via anterior approach to treat chronic postoperative endophthalmitis

    Directory of Open Access Journals (Sweden)

    Mete Güler

    2013-02-01

    Full Text Available AIM:To describe the results of vitrectomy and partial capsulectomy via anterior approach surgical technique in treatment of chronic postoperative endophthalmitis (CPE.METHODS:Clinical records of 9 patients treated for CPE between 2006 and 2010 were reviewed retrospectively. All of these patients were treated with vitrectomy and partial capsulectomy via anterior approach.RESULTS:Six of 9 patients were male. The average patients’ age was (60±8.1 years. The average period between cataract extraction and onset of signs and symptoms was (3.6±1.3 weeks. The average presenting visual acuity was 0.3±0.1 and the average final post operative visual acuity was 0.7±0.2. The mean follow-up period was (28.1±8.9 weeks. In all patients, the inflammation subsided after surgery.CONCLUSION:Our results suggest that anterior vitrectomy and partial capsulectomy via anterior approach may be considered as potentially useful and relatively less invasive technique to treat CPE.

  2. [Anterior guidance in complete dentures].

    Science.gov (United States)

    Dubreuil, J; Trevelo, A

    1990-01-01

    Although the anterior guidance in complete dentures is not really a guide, the arrangement of the anterior maxillary and mandibular prosthetic teeth, defines a propulsive line called the virtual anterior guidance, a part from the cinematic criterias. The influence of this guide on cuspal movement is superior, in all mandibular points, to the influence of the condylar pathway. If this line is not respected, the practitioner may have to do excessive grindings during occlusal adjustments.

  3. Immediate postoperative anterior knee stability: double- versus triple-bundle anterior cruciate ligament reconstructions.

    Science.gov (United States)

    Mae, Tatsuo; Shino, Konsei; Matsumoto, Norinao; Yoneda, Kenji; Yoshikawa, Hideki; Nakata, Ken

    2013-02-01

    The purpose of this study was to compare the triple-bundle (TB) anterior cruciate ligament (ACL) reconstruction with the double-bundle (DB) ACL reconstruction in immediate postoperative anterior knee stability. This study involved 133 patients who had undergone the anatomic ACL reconstruction with autogenous hamstring tendon unilaterally. Then 83 patients (mean age, 28.8 years) underwent the DB between November 2004 and December 2005, and 50 patients (mean age, 29.6 years) underwent the TB ACL reconstruction between January and December 2006. The 2 femoral tunnels were created in the ideal ACL attachment area, whereas 2 tibial tunnels for the DB and 3 tunnels for the TB were created in the ACL footprint. The 2 doubled tendon grafts were fixed with EndoButton-CL (Smith & Nephew Endoscopy, Andover, MA) on the femur. The grafts were fixed to the tibia using a Double Spike Plate and a screw under the total initial tension of 20 N at 20° of flexion, after meticulous in situ pretensioning using a tensioning boot. Then immediate postoperative anterior knee laxity in response to 89 N of anterior load was measured by one experienced examiner (T.M.) with the KT-2000 Knee Arthrometer (MEDmedtric, San Diego, CA) under general anesthesia at 30° of knee flexion with muscle relaxants. The measured anterior laxity was 3.4 ± 1.2 mm in the DB and 2.5 ± 0.7 mm in the TB ACL reconstruction, a statistically significant difference. The side-to-side difference of the laxity was -3.2 ± 1.6 mm in the DB and -4.2 ± 2.0 mm in the TB, again a significant difference. TB ACL reconstruction resulted in better immediate postoperative anterior knee stability than DB ACL reconstruction under 89 N of anterior tibial load (P = .031). Level III, therapeutic retrospective comparative study. Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  4. Total Hip Intraoperative Femur Fracture: Do the Design Enhancements of a Second-Generation Tapered-Wedge Stem Reduce the Incidence?

    Science.gov (United States)

    Colacchio, Nicholas D; Robbins, Claire E; Aghazadeh, Mehran S; Talmo, Carl T; Bono, James V

    2017-10-01

    Intraoperative femur fracture (IFF) is a well-known complication in primary uncemented total hip arthroplasty (THA). Variations in implant instrumentation design and operative technique may influence the risk of IFF. This study investigates IFF between a standard uncemented tapered-wedge femoral stem and its second-generation successor with the following design changes: size-specific medial curvature, proportional incremental stem growth, modest reduction in stem length, and distal lateral relief. A single experienced surgeon's patient database was retrospectively queried for IFF occurring during primary uncemented THA using a standard tapered-wedge femoral stem system or a second-generation stem. All procedures were performed using soft tissue preserving anatomic capsule repair and posterior approach. The primary outcome measure was IFF. A z-test of proportions was performed to determine significant difference between the 2 stems with respect to IFF. Patient demographics, Dorr classification, and implant characteristics were also examined. Forty-one of 1510 patients (2.72%) who received a standard tapered-wedge femoral stem sustained an IFF, whereas 5 of 800 patients (0.63%) using the second-generation stem incurred an IFF. No other significant associations were found. A standard tapered-wedge femoral stem instrumentation system resulted in greater than 4 times higher incidence of IFF than its second-generation successor used for primary uncemented THA. Identifying risk factors for IFF is necessary to facilitate implant system improvements and thus maximize patient outcomes. Copyright © 2017. Published by Elsevier Inc.

  5. Monte Carlo simulation of the Varian Clinac 600C accelerator using dynamic wedges; Simulacao Monte Carlo do acelerador Varian Clinac 600C utilizando cunhas dinamicas

    Energy Technology Data Exchange (ETDEWEB)

    Moreno, S. [Universidade da Beira Interior (UBI), Covilha (Portugal); Chaves, A.; Lopes, M.C. [Instituto Portugues de Oncologia Doutor Francisco Gentil (IPO), Coimbra (Portugal); Peralta, L. [Laboratorio de Instrumentacao e Fisica Experimental de Particulas (LIP), Lisboa (Portugal)]|[Universidade de Lisboa (Portugal). Faculdade de Ciencias

    2004-07-01

    The advent of linear accelerators (linac) with computer-controlled dynamic collimation systems and functional and anatomical imaging techniques allowed a more exact delimitation and localisation of the target volume. These advanced treatment techniques inevitably increase the complexity level of dose calculation because of the introduction of the temporal variable. On account of this, it is mandatory the usage of more accurate modelling techniques of the collimator components, as it is the case of Monte Carlo (MC) simulation, which has created an enormous interest in research and clinical practice. Because the patients bodies are not homogenous nor are their body surfaces plane and regular, the dose distribution may differ significantly from the standard distribution from the linac calibration. It is in the treatment planning systems, which include algorithms that are usually measured in homogeneous water phantoms specific for each correction that the dose distributions from each case are obtained. In a real treatment, exception made to superficial lesions, two or more radiation fields are used in order to obtain the recommended dose distributions. The simplest arrangement is made from two parallel and opposed fields that originate a homogeneous dose distribution in almost all the irradiated volume. The available resources are, for example, different types of energies and of radiation, the application of bolus, the protection of healthy structures, the usage of wedged filters and the application of dynamic wedges. A virtual or dynamic wedge, modelled through the movement of one of the jaws, when compared with a set of physical wedges offers an alternative calculation method of an arbitrary number of wedged fields, instead of the four traditional fields of 15 deg, 30 deg, 45 deg and 60 deg angle and obtained with physical wedges. The goal of this work consists in the study of the application of dynamic wedges in tailoring the radiation field by the Varian Clinac 600

  6. HF wedge #1" detail of the wedge tip taken at VNIITF in the construction workshop. The jig mounted on top is used to measure the conformity to the drawings.

    CERN Multimedia

    Official photographer of VNIITF (photo scanned by T. Camporesi)

    2001-01-01

    The photo has been taken as documetation of the acceptance procedure of the first wedge for the very forward calorimeter of CMS (HF). The detail shows the holes where the quartz fibers are going to be stuffed and the jig used to measure that the geometry was within the specified tolerances and that the geometry alignement track was conforming to the specifications.

  7. Congenital anterior urethral valves and diverticula: Diagnosis and management in six cases

    Directory of Open Access Journals (Sweden)

    Rawat Jiledar

    2009-01-01

    Full Text Available Background: Anterior urethral valves (AUVs are rare congenital anomalies causing lower urinary tract obstruction in children. Although they are referred to as valves, these obstructive structures often occur in the form of a diverticulum. The urethra in these cases shows saccular or bulbar dilatation known as anterior urethral diverticulum (AUD. They typically occur where there is a defect in the corpus spongiosum, leaving a thin-walled urethra. This segment of the urethra balloons out during voiding, simulating a mass that is sometimes visible along the ventral wall of the penis. The swelling is fluctuant and urine dribbles from the meatus on compression. The present study highlights the clinical approach in identifying the condition and its treatment options, especially for those, presenting with urethral diverticula. Materials and Methods: We have studied children with congenital anterior urethral valves and diverticula. Six patients of AUVs with diverticula were admitted during the period of 2000-2007 and were prospectively evaluated. The mean age of presentation was 16 months (15 days to 4 years. Straining at micturition and a palpable penile swelling were the most common presenting features. The diagnosis was established by voiding cystourethrogram (VCUG and supported by ultrasonography (USG. All patients were treated with single-stage open surgical excision except one who died preoperatively due to urosepsis. Initial lay opening of the penoscrotal urethra and delayed repair were done in one patient. Results: The surgical outcome was successful in all but one patient, who died of delayed presentation with severe back pressure changes, urinary ascitis and urosepsis. On long-term follow-up, all patients demonstrated good stream of urine. The renal functions were normal and the patients had no evidence of urinary infections. Conclusion: We propose that, the patients of AUVs, if not excessively delayed for treatment are otherwise well in terms

  8. Technical note: A new wedge-shaped ionization chamber component module for BEAMnrc to model the integral quality monitoring system®

    Science.gov (United States)

    Oderinde, Oluwaseyi Michael; du Plessis, FCP

    2017-12-01

    The purpose of this study was to develop a new component module (CM) namely IQM to accurately model the integral quality monitoring (IQM) system® to be used in the BEAMnrc Monte Carlo (MC) code. The IQM is essentially a double wedge ionization chamber with the central electrode plate bisecting the wedge. The IQM CM allows the user to characterize the double wedge of this ionization chamber and BEAMnrc can then accurately calculate the dose in this CM including its enclosed air regions. This has been verified against measured data. The newly created CM was added into the standard BEAMnrc CMs, and it will be made available through the NRCC website. The BEAMnrc graphical user interface (GUI) and particle ray-tracing techniques were used to validate the IQM geometry. In subsequent MC simulations, the dose scored in the IQM was verified against measured data over a range of square fields ranging from 1 × 1-30 × 30 cm2. The IQM system is designed for the present day need for a device that could verify beam output in real-time during treatment. This CM is authentic, and it can serve as a basis for researchers that have an interest in real-time beam delivery checking using wedge-shaped ionization chamber based instruments like the IQM.

  9. 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 is...

  10. The Efficacy of Bulbar Urethral Mobilization for Anastomotic Anterior Urethroplasty in a Case With Recurrent Anterior Urethral Stricture

    OpenAIRE

    Fukui, Shinji; Aoki, Katsuya; Kaneko, Yoshiteru; Samma, Shoji; Fujimoto, Kiyohide

    2014-01-01

    A 2-month-old boy was diagnosed with febrile urinary tract infection. Voiding cystourethrography showed bulbar and anterior urethral strictures, and endoscopic internal urethrotomy was performed. He developed febrile urinary tract infection again and revealed the recurrence of the anterior urethral stricture. Consequently, endoscopic internal urethrotomy was performed 4 times. Because the anterior urethral stricture had not improved, he was referred to us. Anterior urethroplasty was performed...

  11. Secondary Subacromial Impingement after Valgus Closing-Wedge Osteotomy for Proximal Humerus Varus

    Directory of Open Access Journals (Sweden)

    Hirotaka Sano

    2015-01-01

    Full Text Available A 31-year-old construction worker had been suffering from both the motion pain and the restriction of elevation in his right shoulder due to severe varus deformity of humeral neck, which occurred after proximal humeral fracture. The angle for shoulder flexion and abduction was restricted to 50 and 80 degrees, respectively. Valgus closing-wedge osteotomy followed by the internal fixation using a locking plate was carried out at 12 months after injury. Postoperatively, the head-shaft angle of the humerus improved from 65 to 138 degrees. Active flexion and abduction angles improved from 80 to 135 degrees and from 50 to 135 degrees, respectively. However, the patient complained from a sharp pain with a clicking sound during shoulder abduction even after removal of the locking plate. Since subacromial steroid injection temporarily relieved his shoulder pain, we assumed that the secondary subacromial impingement was provoked after osteotomy. Thus, arthroscopic subacromial decompression was carried out at 27 months after the initial operation, which finally relieved his symptoms. In the valgus closing-wedge osteotomy, surgeons should pay attention to the condition of subacromial space to avoid causing the secondary subacromial impingement.

  12. Measuring linac photon beam energy through EPID image analysis of physically wedged fields

    Energy Technology Data Exchange (ETDEWEB)

    Dawoud, S. M., E-mail: samir.dawoud@leedsth.nhs.uk; Weston, S. J.; Bond, I.; Ward, G. C.; Rixham, P. A.; Mason, J.; Huckle, A. [Department of Medical Physics and Engineering, St. James Institute of Oncology, St. James University Hospital, Leeds LS9 7TF (United Kingdom); Sykes, J. R. [Institute of Medical Physics, School of Physics, The University of Sydney, New South Wales 2006, Australia and Department of Medical Physics and Engineering, St. James Institute of Oncology, St. James University Hospital, Leeds LS9 7TF (United Kingdom)

    2014-02-15

    Purpose: Electronic portal imaging devices (EPIDs) have proven to be useful tools for measuring several parameters of interest in linac quality assurance (QA). However, a method for measuring linac photon beam energy using EPIDs has not previously been reported. In this report, such a method is devised and tested, based on fitting a second order polynomial to the profiles of physically wedged beams, where the metric of interest is the second order coefficientα. The relationship between α and the beam quality index [percentage depth dose at 10 cm depth (PDD{sub 10})] is examined to produce a suitable calibration curve between these two parameters. Methods: Measurements were taken in a water-tank for beams with a range of energies representative of the local QA tolerances about the nominal value 6 MV. In each case, the beam quality was found in terms of PDD{sub 10} for 100 × 100 mm{sup 2} square fields. EPID images of 200 × 200 mm{sup 2} wedged fields were then taken for each beam and the wedge profile was fitted in MATLAB 2010b (The MathWorks, Inc., Natick, MA). α was then plotted against PDD{sub 10} and fitted with a linear relation to produce the calibration curve. The uncertainty in α was evaluated by taking five repeat EPID images of the wedged field for a beam of 6 MV nominal energy. The consistency of measuring α was found by taking repeat measurements on a single linac over a three month period. The method was also tested at 10 MV by repeating the water-tank crosscalibration for a range of energies centered approximately about a 10 MV nominal value. Finally, the calibration curve from the test linac and that from a separate clinical machine were compared to test consistency of the method across machines in a matched fleet. Results: The relationship betweenα and PDD{sub 10} was found to be strongly linear (R{sup 2} = 0.979) while the uncertainty in α was found to be negligible compared to that associated with measuring PDD{sub 10} in the water-tank (

  13. Evaluation of static and dynamic balance in athletes with anterior cruciate ligament injury – A controlled study

    Directory of Open Access Journals (Sweden)

    Tiago Lazzaretti Fernandes

    Full Text Available OBJECTIVES: Anterior cruciate ligament injury leads to adaptive responses to maintain postural control. However, there is no consensus regarding whether leg dominance also affects postural control in athletes with anterior cruciate ligament injury. The purpose of this study was to evaluate dynamic and static postural control among athletes with and without anterior cruciate ligament injury to the dominant leg. METHODS: Twenty-eight athletes, twenty-one males and seven females aged 15-45 years, were allocated to one of two groups: the anterior cruciate ligament injury group (26±3 years or the control group without anterior cruciate ligament injury (25±6.5 years. All subjects performed one legged stance tests under eyes open and eyes closed conditions and squat and kick movement tests using a postural control protocol (AccuSwayPlus force platform, Massachusetts. The center of pressure displacement and speed were measured by the force platform. In addition, the distance traveled on the single-leg hop test was assessed as an objective measure of function. RESULTS: Significantly greater mediolateral sway was found under the eyes closed condition (p=0.04 and during squat movement (p=0.01 in the anterior cruciate ligament injury group than in the control group. Analysis of the single-leg hop test results showed no difference between the groups (p=0.73. CONCLUSION: Athletes with anterior cruciate ligament injury had greater mediolateral displacement of the center of pressure toward the dominant leg under the eyes closed condition and during squat movement compared to control athletes.

  14. Hydroelastic slamming of flexible wedges: Modeling and experiments from water entry to exit

    Science.gov (United States)

    Shams, Adel; Zhao, Sam; Porfiri, Maurizio

    2017-03-01

    Fluid-structure interactions during hull slamming are of great interest for the design of aircraft and marine vessels. The main objective of this paper is to establish a semi-analytical model to investigate the entire hydroelastic slamming of a wedge, from the entry to the exit phase. The structural dynamics is described through Euler-Bernoulli beam theory and the hydrodynamic loading is estimated using potential flow theory. A Galerkin method is used to obtain a reduced order modal model in closed-form, and a Newmark-type integration scheme is utilized to find an approximate solution. To benchmark the proposed semi-analytical solution, we experimentally investigate fluid-structure interactions through particle image velocimetry (PIV). PIV is used to estimate the velocity field, and the pressure is reconstructed by solving the incompressible Navier-Stokes equations from PIV data. Experimental results confirm that the flow physics and free-surface elevation during water exit are different from water entry. While water entry is characterized by positive values of the pressure field, with respect to the atmospheric pressure, the pressure field during water exit may be less than atmospheric. Experimental observations indicate that the location where the maximum pressure in the fluid is attained moves from the pile-up region to the keel, as the wedge reverses its motion from the entry to the exit stage. Comparing experimental results with semi-analytical findings, we observe that the model is successful in predicting the free-surface elevation and the overall distribution of the hydrodynamic loading on the wedge. These integrated experimental and theoretical analyses of water exit problems are expected to aid in the design of lightweight structures, which experience repeated slamming events during their operation.

  15. Adopting wedge hepatic venography with CO2 during transjugular intrahepatic portosystemic shunt procedures

    International Nuclear Information System (INIS)

    Zhang Linpeng; Chen Songtao; Shi Xiulan

    2012-01-01

    Objective: To renovate angiography in identifying portal vein anatomy during transjugular intrahepatic portosystemic shunt (TIPS) procedures, saving the time of TIPS procedures, decreasing the risk of the complications of the post-procedure. Methods: The difference between the Wedge hepatic venography with Carbon Dioxide in 6 cases and Inferior Mesenteric artery angiography in 7 cases during TIPS procedures were compared in the identification of portal vein anatomy. The quality of images, their effects on the procedures, the complications and the recovery post-procedure were evaluated. Results: Using CO 2 , the portal veins were opacified in all 6 cases. TIPS procedures succeeded in all cases except 1 case because of poor coagulation function. Using Inferior Mesenteric artery angiography, the portal veins were opacified in all 7 cases. TIPS procedure succeeded in all cases except 1 case because of chronic portal occlusion. Puncture-site hematoma occurred in 1 case after TIPS procedure. Conclusion: Wedge hepatic venography with Carbon Dioxide is superior, safer and more convenient than Inferior Mesenteric Artery angiography in identifying portal vein anatomy during TIPS. (authors)

  16. Soil carbon sequestration is a climate stabilization wedge: comments on Sommer and Bossio (2014).

    Science.gov (United States)

    Lassaletta, Luis; Aguilera, Eduardo

    2015-04-15

    Sommer and Bossio (2014) model the potential soil organic carbon (SOC) sequestration in agricultural soils (croplands and grasslands) during the next 87 years, concluding that this process cannot be considered as a climate stabilization wedge. We argue, however, that the amounts of SOC potentially sequestered in both scenarios (pessimistic and optimistic) fulfil the requirements for being considered as wedge because in both cases at least 25 GtC would be sequestered during the next 50 years. We consider that it is precisely in the near future, and meanwhile other solutions are developed, when this stabilization effort is most urgent even if after some decades the sequestration rate is significantly reduced. Indirect effects of SOC sequestration on mitigation could reinforce the potential of this solution. We conclude that the sequestration of organic carbon in agricultural soils as a climate change mitigation tool still deserves important attention for scientists, managers and policy makers. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. [Pigment dispersion syndrome and pigmentary glaucoma. Morphometric analysis of the anterior chamber segment with SL-OCT].

    Science.gov (United States)

    Birner, B; Tourtas, T; Wessel, J M; Jünemann, A G; Mardin, C Y; Kruse, F E; Laemmer, R

    2014-01-01

    The purpose of this study was to analyze if anterior chamber parameters are risk factors for the development of pigment dispersion syndrome (PDS) and/or for the conversion to pigmentary glaucoma (PG). This study included a total of 63 eyes from 35 patients with PDS and PG and 65 eyes from 49 unaffected volunteers as the control group. The following parameters were measured by slit lamp optical coherence tomography (SL-OCT): anterior chamber volume (ACV) and depth (ACD), angle opening distance (AOD) and the trabecular iris space area (TISA) at 500 µm and 750 μm from the scleral spur. Comparisons between the following groups were performed: between the PDS/PG and the control group, between PDS and PG and between male and female patients. The results of ACV, ACD, AOD and TISA were significantly higher in PDS/PG patients when compared to the control group. There were no significant differences between PDS and PG. The gender-specific comparison also showed no significant differences. Significantly higher anterior chamber parameters are a possible risk factor for development of PDS; however, a higher risk of conversion to PG does not seem to correlate with increased anterior chamber parameters. The parameters of the anterior chamber are apparently not associated with the male predominance of PDS and PG.

  18. Long anterior zonules and pigment dispersion.

    Science.gov (United States)

    Moroi, Sayoko E; Lark, Kurt K; Sieving, Paul A; Nouri-Mahdavi, Kouros; Schlötzer-Schrehardt, Ursula; Katz, Gregory J; Ritch, Robert

    2003-12-01

    To describe pigment dispersion associated with long anterior zonules. Multicenter observational case series. Fifteen patients, seven of whom were treated for glaucoma or ocular hypertension, were identified with long anterior zonules and pigment dispersion. Transmission electron microscopy was performed on one anterior capsule specimen. All patients had anterior zonules that inserted centrally on the lens capsule. Signs of pigment dispersion included corneal endothelial pigmentation, loss of the pupillary ruff, and variable trabecular meshwork pigmentation. Ultrasound biomicroscopy verified the lack of posterior iris insertion and concavity. There was no exfoliation material. Transmission electron microscopy showed zonular lamellae with adherent pigment granules, and no exfoliation material. Long anterior zonules inserted onto the central lens capsule may cause mechanical disruption of the pigment epithelium at the pupillary ruff and central iris leading to pigment dispersion.

  19. Fenestration of the anterior cerebral artery

    International Nuclear Information System (INIS)

    Ito, J.; Washiyama, K.; Hong Kim, C.; Ibuchi, Y.

    1981-01-01

    Three cases of angiographically demonstrated fenestration of the anterior cerebral artery are reported. Fenestration occurred at the medial half of the horizontal segment of the anterior cerebral artery in all cases. Its embryology and clinical significance are briefly discussed, and the anatomical and radiological literature on fenestration of the anterior cerebral artery is reviewed. (orig.)

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

    International Nuclear Information System (INIS)

    Ryu, Jung Kyu; Yoon, Yeong Cheol; Ryu, Kyung Nam; Rhee, Yong Girl

    2001-01-01

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

  1. The Efficacy of Bulbar Urethral Mobilization for Anastomotic Anterior Urethroplasty in a Case With Recurrent Anterior Urethral Stricture.

    Science.gov (United States)

    Fukui, Shinji; Aoki, Katsuya; Kaneko, Yoshiteru; Samma, Shoji; Fujimoto, Kiyohide

    2014-05-01

    A 2-month-old boy was diagnosed with febrile urinary tract infection. Voiding cystourethrography showed bulbar and anterior urethral strictures, and endoscopic internal urethrotomy was performed. He developed febrile urinary tract infection again and revealed the recurrence of the anterior urethral stricture. Consequently, endoscopic internal urethrotomy was performed 4 times. Because the anterior urethral stricture had not improved, he was referred to us. Anterior urethroplasty was performed when he was 5 years. After excision of the scarred portions of the urethra, the defect of the urethra was 20 mm. Transperineal bulbar urethral mobilization was performed, and a single-stage end-to-end anterior urethroplasty without tension could be performed simultaneously.

  2. A developed wedge fixtures assisted high precision TEM samples pre-thinning method: Towards the batch lamella preparation

    Directory of Open Access Journals (Sweden)

    Dandan Wang

    2017-04-01

    Full Text Available Ion milling, wedge cutting or polishing, and focused ion beam (FIB milling are widely-used techniques for the transmission electron microscope (TEM sample preparation. Especially, the FIB milling provides a site-specific analysis, deposition, and ablation of materials in the micrometer and nanometer scale. However, the cost of FIB tools has been always a significant concern. Since it is inevitable to use the FIB technique, the improvement of efficiency is a key point. Traditional TEM sample preparation with FIB was routinely implemented on a single sample each time. Aiming at cost efficiency, a new pre-thinning technique for batch sample preparation was developed in this paper. The present proposal combines the sample preparation techniques with multi-samples thinning, cross-section scanning electron microscopy (SEM, wedge cutting, FIB and other sample pre-thinning techniques. The new pre-thinning technique is to prepare an edge TEM sample on a grinding and polishing fixture with a slant surface. The thickness of the wedges sample can be measured to 1∼2 μm under optical microscope. Therefore, this fixture is superior to the traditional optical method of estimating the membrane thickness. Moreover, by utilizing a multi-sample holding fixture, more samples can be pre-thinned simultaneously, which significantly improved the productivity of TEM sample preparation.

  3. Analysis of short-term results of monsieur′s tunica albuginea urethroplasty as a definitive procedure for pan-anterior urethral stricture

    Directory of Open Access Journals (Sweden)

    Adittya K Sharma

    2013-01-01

    Full Text Available Context: Long anterior urethral strictures are fairly common in developing world and the treatment is equally challenging. Aim: To assess the results and efficacy of Monsieur′s Tunica Albuginea Urethroplasty (TAU for anterior urethral stricture. Settings and Design: We analyzed the results in 10 consecutive patients with pan-anterior urethral stricture, who underwent Monsieur′s urethroplasty. Materials and Methods: The procedure involves mobilization of strictured urethra and laying it open with a dorsal slit. Edges of the slit-open urethra are sutured to edges of the urethral groove to the tunica of corporal bodies with catheter in situ. Results were assessed postoperatively 3, 6, 9 and 12 months. Patients were categorized as success and failure by comparative analysis of patient satisfaction along with urethroscopy, retrograde urethrogram, uroflowmetry. All patients were taken for post-operative urethroscopic analysis at 6 months to allow better understanding of both successful and failed cases. Results: Mean follow-up of 15.2 (11-19 months showed an 80% success rate. Mean uroflow rate showed Qmax 24.5 cc/sec with 8 cases showing no residual or recurrent stricture. Two cases failed and required intervention. Urethroscopic visualization of the reconstruction site showed wide, patent and distensible neourethra appearing epithelized over roof formed by tunica albuginea of the corpora cavernosa in successful cases. Conclusion: Monsieur′s TAU is effective technique in treatment of anterior urethral stricture especially cases with unavailable buccal mucosa, with results fairly acceptable at the end of one year.

  4. Role of an anatomically contoured plate and metal block for balanced stability between the implant and lateral hinge in open-wedge high-tibial osteotomy.

    Science.gov (United States)

    Jang, Young Woong; Lim, DoHyung; Seo, Hansol; Lee, Myung Chul; Lee, O-Sung; Lee, Yong Seuk

    2018-07-01

    Open-wedge high tibial osteotomy (OWHTO) is a well-established surgical option for medial compartment osteoarthritis of the varus knee. The initial strength of the fixation plate is critical for successful correction maintenance and healing of the osteotomy site. This study was conducted to verify if a newly designed anatomical plate (LCfit) improves the stability of both the medial implant and lateral hinge area, as well as to evaluate how the metal block contributes to both medial and lateral stability. A finite element (FE) tibial model was combined with TomoFix plate, a LCfit plate with and without a metal block. Data analysis was conducted to evaluate the balanced stability, which refers to the enforced lateral stability resulting from redistribution of overall stress. We assessed the balanced stability of the medial implant and lateral hinge area in three cases using the same Sawbones and loads using the tibia FE model. The LCfit plate reduced stress by 23.1% at the lateral hinge compared to the TomoFix plate (TomoFix vs. LCfit: 34.2 ± 23.3 MPa vs. 26.3 ± 17.5 MPa). The LCfit plate with a metal block reduced stress by 40.1% at the medial plate (210.1 ± 64.2 MPa vs. 125.8 ± 65.7 MPa) and by 31.2% (26.3 ± 17.5 MPa vs. 18.1 ± 12.1 MPa) at the lateral hinge area compared to the reduction using the LCfit plate without a metal block. The newly designed fixation system for OWHTO balanced the overall stress distribution and reduced stress at the lateral hinge area compared to that using a conventional fixation system. The addition of the metal block showed additional benefits for balanced stability between the medial implant and lateral hinge area. However, this conclusion could only be drawn using the FE model in this study. Therefore, further clinical studies are necessary to reveal the clinical effect of reduced lateral stress on the occurrence of the lateral hinge fracture and the biologic effect of the metal block on the

  5. Design, performance, and calibration of CMS hadron-barrel calorimeter wedges

    International Nuclear Information System (INIS)

    Abdullin, S.; Abramov, V.; Goncharov, P.; Khmelnikov, A.; Korablev, A.; Korneev, Y.; Krinitsyn, A.; Kryshkin, V.; Lukanin, V.; Pikalov, V.; Ryazanov, A.; Talov, V.; Turchanovich, L.; Volkov, A.; Acharya, B.; Banerjee, S.; Banerjee, S.; Chendvankar, S.; Dugad, S.; Kalmani, S.; Katta, S.; Mazumdar, K.; Mondal, N.; Nagaraj, P.; Patil, M.; Reddy, L.; Satyanarayana, B.; Sudhakar, K.; Verma, P.; Adams, M.; Burchesky, K.; Qian, W.; Akchurin, N.; Carrell, K.; Guemues, K.; Thomas, R.; Akgun, U.; Ayan, S.; Duru, F.; Merlo, J.P.; Mestvirishvili, A.; Miller, M.; Norbeck, E.; Olson, J.; Onel, Y.; Schmidt, I.; Anderson, E.W.; Hauptman, J.; Antchev, G.; Hazen, E.; Lawlor, C.; Machado, E.; Posch, C.; Rohlf, J.; Wu, S.X.; Aydin, S.; Dumanoglu, I.; Eskut, E.; Kayis-Topaksu, A.; Polatoz, A.; Onengut, G.; Ozdes-Koca, N.; Baarmand, M.; Ralich, R.; Vodopiyanov, I.; Baden, D.; Bard, R.; Eno, S.; Grassi, T.; Jarvis, C.; Kellogg, R.; Kunori, S.; Skuja, A.; Barnes, V.; Laasanen, A.; Pompos, A.; Bawa, H.; Beri, S.; Bhatnagar, V.; Kaur, M.; Kohli, J.; Kumar, A.; Singh, J.; Baiatian, G.; Sirunyan, A.; Bencze, G.; Vesztergombi, G.; Zalan, P.; Bodek, A.; Budd, H.; Chung, Y.; De Barbaro, P.; Haelen, T.; Camporesi, T.; Visser, T. de; Cankocak, K.; Cremaldi, L.; Reidy, J.; Sanders, D.A.; Cushman, P.; Sherwood, B.; Damgov, J.; Dimitrov, L.; Genchev, V.; Piperov, S.; Vankov, I.; Demianov, A.; Ershov, A.; Gribushin, A.; Kodolova, O.; Petrushanko, S.; Sarycheva, L.; Vardanyan, I.; Elias, J.; Elvira, D.; Freeman, J.; Green, D.; Los, S.; O'Dell, V.; Ronzhin, A.; Sergeyev, S.; Suzuki, I.; Vidal, R.; Whitmore, J.; Emeliantchik, I.; Massolov, V.; Shumeiko, N.; Stefanovich, R.; Fisher, W.; Tully, C.; Gavrilov, V.; Kaftanov, V.; Kisselevich, I.; Kolossov, V.; Krokhotin, A.; Kuleshov, S.; Stolin, V.; Ulyanov, A.; Gershtein, Y.; Golutvin, I.; Kalagin, V.; Kosarev, I.; Mescheryakov, G.; Smirnov, V.; Volodko, A.; Zarubin, A.; Grinev, B.; Lubinsky, V.; Senchishin, V.; Guelmez, E.; Hagopian, S.; Hagopian, V.; Johnson, K.; Heering, A.; Imboden, M.; Isiksal, E.; Karmgard, D.; Ruchti, R.; Kaya, M.; Lazic, D.; Levchuk, L.; Sorokin, P.; Litvintsev, D.; Litov, L.; Mans, J.; Ozkorucuklu, S.; Ozok, F.; Serin-Zeyrek, M.; Sever, R.; Zeyrek, M.; Paktinat, S.; Podrasky, V.; Sanzeni, C.; Winn, D.; Vlassov, E.

    2008-01-01

    Extensive measurements have been made with pions, electrons and muons on four production wedges of the compact muon solenoid (CMS) hadron barrel (HB) calorimeter in the H2 beam line at CERN with particle momenta varying from 20 to 300 GeV/c. The time structure of the events was measured with the full chain of preproduction front-end electronics running at 34 MHz. Moving-wire radioactive source data were also collected for all scintillator layers in the HB. The energy dependent time slewing effect was measured and tuned for optimal performance. (orig.)

  6. Design, performance, and calibration of CMS hadron-barrel calorimeter wedges

    Energy Technology Data Exchange (ETDEWEB)

    Abdullin, S. [Fermi National Accelerator Lab., Batavia, IL (United States)]|[Univ. of Maryland, College Park, MD (United States); Abramov, V.; Goncharov, P.; Khmelnikov, A.; Korablev, A.; Korneev, Y.; Krinitsyn, A.; Kryshkin, V.; Lukanin, V.; Pikalov, V.; Ryazanov, A.; Talov, V.; Turchanovich, L.; Volkov, A. [IHEP, Protvino (Russian Federation); Acharya, B.; Banerjee, S.; Banerjee, S.; Chendvankar, S.; Dugad, S.; Kalmani, S.; Katta, S.; Mazumdar, K.; Mondal, N.; Nagaraj, P.; Patil, M.; Reddy, L.; Satyanarayana, B.; Sudhakar, K.; Verma, P. [Tata Inst. of Fundamental Research, Mumbai (India); Adams, M.; Burchesky, K.; Qian, W. [Univ. of Illinois at Chicago, Chicago, IL (United States); Akchurin, N.; Carrell, K.; Guemues, K.; Thomas, R. [Texas Tech Univ., Dept. of Physics, Lubbock, TX (United States); Akgun, U.; Ayan, S.; Duru, F.; Merlo, J.P.; Mestvirishvili, A.; Miller, M.; Norbeck, E.; Olson, J.; Onel, Y.; Schmidt, I. [Univ. of Iowa, Iowa City, IA (United States); Anderson, E.W.; Hauptman, J. [Iowa State Univ., Ames, IA (United States); Antchev, G.; Hazen, E.; Lawlor, C.; Machado, E.; Posch, C.; Rohlf, J.; Wu, S.X. [Boston Univ., Boston, MA (United States); Aydin, S.; Dumanoglu, I.; Eskut, E.; Kayis-Topaksu, A.; Polatoz, A.; Onengut, G.; Ozdes-Koca, N. [Cukurova Univ., Adana (Turkey); Baarmand, M.; Ralich, R.; Vodopiyanov, I. [Florida Inst. of Technology, Melbourne, FL (United States); Baden, D.; Bard, R.; Eno, S.; Grassi, T.; Jarvis, C.; Kellogg, R.; Kunori, S.; Skuja, A. [Univ. of Maryland, College Park, MD (United States); Barnes, V.; Laasanen, A.; Pompos, A. [Purdue Univ., West Lafayette, IN (United States); Bawa, H.; Beri, S.; Bhatnagar, V.; Kaur, M.; Kohli, J.; Kumar, A.; Singh, J. [Panjab Univ., Chandigarh (India); Baiatian, G.; Sirunyan, A. [Yerevan Physics Inst., Yerevan (Armenia); Bencze, G.; Vesztergombi, G.; Zalan, P. [KFKI-RMKI, Research Inst. for Particle and Nuclear Physics, Budapest (Hungary)] [and others

    2008-05-15

    Extensive measurements have been made with pions, electrons and muons on four production wedges of the compact muon solenoid (CMS) hadron barrel (HB) calorimeter in the H2 beam line at CERN with particle momenta varying from 20 to 300 GeV/c. The time structure of the events was measured with the full chain of preproduction front-end electronics running at 34 MHz. Moving-wire radioactive source data were also collected for all scintillator layers in the HB. The energy dependent time slewing effect was measured and tuned for optimal performance. (orig.)

  7. Wedge Splitting Test on Fracture Behaviour of Fiber Reinforced and Regular High Performance Concretes

    DEFF Research Database (Denmark)

    Hodicky, Kamil; Hulin, Thomas; Schmidt, Jacob Wittrup

    2013-01-01

    The fracture behaviour of three fiber reinforced and regular High Performance Concretes (HPC) is presented in this paper. Two mixes are based on optimization of HPC whereas the third mix was a commercial mix developed by CONTEC ApS (Denmark). The wedge splitting test setup with 48 cubical specimens...

  8. Tax wedge on labour income in Croatia and the European Union : Preface to the special issue of Financial Theory and Practice

    Directory of Open Access Journals (Sweden)

    Ivica Urban

    2016-06-01

    Full Text Available This article is a preface to a special issue of Financial Theory and Practice, which is devoted to the comparison of tax wedge on labour income in Croatia and other EU countries. The articles in this issue have arisen from the students’ research project, undertaken in 2015. This Preface outlines the motivation behind the research project, explains the most important methodological issues, and reviews the literature on the measurement of tax wedge in Croatia.

  9. 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.

  10. 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 ...

  11. The Efficacy of Bulbar Urethral Mobilization for Anastomotic Anterior Urethroplasty in a Case With Recurrent Anterior Urethral Stricture

    Directory of Open Access Journals (Sweden)

    Shinji Fukui

    2014-05-01

    Full Text Available A 2-month-old boy was diagnosed with febrile urinary tract infection. Voiding cystourethrography showed bulbar and anterior urethral strictures, and endoscopic internal urethrotomy was performed. He developed febrile urinary tract infection again and revealed the recurrence of the anterior urethral stricture. Consequently, endoscopic internal urethrotomy was performed 4 times. Because the anterior urethral stricture had not improved, he was referred to us. Anterior urethroplasty was performed when he was 5 years. After excision of the scarred portions of the urethra, the defect of the urethra was 20 mm. Transperineal bulbar urethral mobilization was performed, and a single-stage end-to-end anterior urethroplasty without tension could be performed simultaneously.

  12. Sedimentation of Jurassic fan-delta wedges in the Xiahuayuan basin reflecting thrust-fault movements of the western Yanshan fold-and-thrust belt, China

    Science.gov (United States)

    Lin, Chengfa; Liu, Shaofeng; Zhuang, Qitian; Steel, Ronald J.

    2018-06-01

    Mesozoic thrusting within the Yanshan fold-and-thrust belt of North China resulted in a series of fault-bounded intramontane basins whose infill and evolution remain poorly understood. In particular, the bounding faults and adjacent sediment accumulations along the western segments of the belt are almost unstudied. A sedimentological and provenance analysis of the Lower Jurassic Xiahuayuan Formation and the Upper Jurassic Jiulongshan Formation have been mapped to show two distinctive clastic wedges: an early Jurassic wedge representing a mass-flow-dominated, Gilbert-type fan delta with a classic tripartite architecture, and an late Jurassic shoal-water fan delta without steeply inclined strata. The basinward migration of the fan-delta wedges, together with the analysis of their conglomerate clast compositions, paleocurrent data and detrital zircon U-Pb age spectra, strongly suggest that the northern-bounding Xuanhuan thrust fault controlled their growth during accumulation of the Jiulongshan Formation. Previous studies have suggested that the fan-delta wedge of the Xiahuayuan Formation was also syntectonic, related to movement on the Xuanhua thrust fault. Two stages of thrusting therefore exerted an influence on the formation and evolution of the Xiahuayuan basin during the early-late Jurassic.

  13. Anteriorly placed tumors to the conus: removal by interradicular window.

    Science.gov (United States)

    Ciappetta, P; Taurone, S; Spoletini, M; Artico, M

    2017-01-01

    Tumors anteriorly situated to the medullary conus are rarely encountered and represent a true surgical challenge. We examined the literature on this topic, concluding that there are no previous reports on alternative surgical techniques different to the traditional one. We report two cases of intradural extramedullary tumor operated on by a technique performed through a window opened between the spinal roots, which allows an easy, effective and useful resection. We describe a new operative technique which ensures a complete removal of these tumors and discuss clinical implications in the light of the available literature on this topic.

  14. Association of biometric factors with anterior chamber angle widening and intraocular pressure reduction after uneventful phacoemulsification for cataract.

    Science.gov (United States)

    Huang, Guofu; Gonzalez, Eduardo; Lee, Roland; Chen, Yi-Chun; He, Mingguang; Lin, Shan C

    2012-01-01

    To evaluate anterior chamber biometric factors associated with the degree of angle widening and intraocular pressure (IOP) reduction after phacoemulsification. University of California, San Francisco, California, USA. Case series. Anterior chamber parameters obtained by anterior segment coherence tomography were compared preoperatively and 3 months postoperatively. Measurements included the angle opening distance 500 μm anterior to the scleral spur (AOD500), trabecular-iris space area 500 μm from the scleral spur (TISA500), iris curvature (I-Curv), anterior chamber angle (ACA), trabecular-iris space area, anterior chamber volume, anterior chamber width, and lens vault (LV). The study enrolled 73 eyes. The mean patient age was 77.45 years ± 7.84 (SD); 65.75% of patients were women. From preoperatively to 3 months postoperatively, the mean AOD500 increased significantly (0.254 ± 0.105 to 0.433 ± 0.108 mm) and the mean IOP decreased significantly (14.97 ± 3.35 to 12.62 ± 3.37 mm Hg) (P<.001). The reduction in IOP was correlated with the increase in AOD500 (r = 0.240, P=.041) and preoperative LV (r = 0.235, P=.045). After adjusting for related factors, AOD500 widening was positively correlated with LV (β = 0.458, P=.044) and I-Curv (β = 0.235, P=.043) and negatively correlated with preoperative TISA500 (β = -0.269, P=.025) and ACA (β = -0.919, P=.027). Surgically induced AOD widening was significantly correlated with anterior chamber biometric factors. Preoperative LV appears to be a significant factor in angle widening and IOP reduction after phacoemulsification. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  15. Modification of the cranial closing wedge ostectomy technique for the treatment of canine cruciate disease. Description and comparison with standard technique.

    Science.gov (United States)

    Wallace, A M; Addison, E S; Smith, B A; Radke, H; Hobbs, S J

    2011-01-01

    To describe a modification of the cranial closing wedge ostectomy (CCWO) technique and to compare its efficacy to the standard technique on cadaveric specimens. The standard and modified CCWO technique were applied to eight pairs of cadaveric tibiae. The following parameters were compared following the ostectomy: degrees of plateau levelling achieved (degrees), tibial long axis shift (degrees), reduction in tibial length (mm), area of bone wedge removed (cm²), and the area of proximal fragment (cm²). The size of the removed wedge of bone and the reduction in tibial length were significantly less with the modified CCWO technique. The modified CCWO has two main advantages. Firstly a smaller wedge is removed, allowing a greater preservation of bone stock in the proximal tibia, which is advantageous for implant placement. Secondly, the tibia is shortened to a lesser degree, which might reduce the risk of recurvatum, fibular fracture and patella desmitis. These factors are particularly propitious for the application of this technique to Terrier breeds with excessive tibial plateau angle, where large angular corrections are required. The modified CCWO is equally effective for plateau levelling and results in an equivalent tibial long-axis shift. A disadvantage with the modified technique is that not all of the cross sectional area of the distal fragment contributes to load sharing at the osteotomy.

  16. Y-duplication of the male urethra: use of anterior anorectal wall for posterior urethral lengthening.

    Science.gov (United States)

    Sinha, S; Sen, S; Chacko, J; Thomas, G; Karl, S; Mathai, J

    2006-06-01

    We have approached two patients with Y-duplication of the male urethra by a new two-staged technique to provide better results. A strip of anterior anorectal wall in continuity with the posterior urethra was used for posterior urethral lengthening and a tubed pedicled prepucial flap was used to reconstruct the anterior urethra without using the native urethra. This was done under a covering colostomy. After a gap of 6 months to allow for healing of the anorectum and to ensure adequate functioning of the perineal neourethra, second stage reconstruction was done using buried scrotal tube for the mid urethra along with colostomy closure. On follow-up at 8 and 12 months, respectively, both children were well with no stricture or fistula. There was normal anal continence and no stenosis. This technique tackles the problem in Y-duplication of the male urethra of lengthening the posterior urethral channel, which is often difficult to bring to the anterior half of the perineum especially if the opening is high up in the anorectum (case 2).

  17. Resultados del tratamiento quirúrgico de los aneurismas del complejo cerebral anterior-arteria comunicante anterior

    Directory of Open Access Journals (Sweden)

    Armando Alemán Rivera

    2001-06-01

    Full Text Available Se realiza un estudio de 30 pacientes con aneurismas localizados en el complejo de la arteria cerebral anterior-arteria comunicante anterior (ACoA, operados en el Servicio de Neurocirugía del Hospital Universitario "Arnaldo Milián Castro", durante un período de 7 años. Se analizan variables tales como edad, sexo, estado neurológico preoperatorio, momento quirúrgico, complicaciones y estado al egreso. La mortalidad general fue del 10 %The authors carried out a study in 30 patients with aneurysms located in the anterior communicating artery-anterior cerebral complex (ACA-ACC, that were operated on at the Neurosurgery Service of "Arnaldo Milián Castro" Teaching Hospital, during a period of 7 years. Variables such as age, sex, preoperative neurologic state, surgical moment, complications and status on discharge were analyzed. General mortality was 10 %

  18. The effect of knee extensor open kinetic chain resistance training in the ACL-injured knee.

    Science.gov (United States)

    Barcellona, Massimo G; Morrissey, Matthew C; Milligan, Peter; Clinton, Melissa; Amis, Andrew A

    2015-11-01

    To investigate the effect of different loads of knee extensor open kinetic chain resistance training on anterior knee laxity and function in the ACL-injured (ACLI) knee. Fifty-eight ACLI subjects were randomised to one of three (12-week duration) training groups. The STAND group trained according to a standardised rehabilitation protocol. Subjects in the LOW and HIGH group trained as did the STAND group but with the addition of seated knee extensor open kinetic chain resistance training at loads of 2 sets of 20 repetition maximum (RM) and 20 sets of 2RM, respectively. Anterior knee laxity and measurements of physical and subjective function were performed at baseline, 6 and 12 weeks. Thirty-six subjects were tested at both baseline and 12 weeks (STAND n = 13, LOW n = 11, HIGH n = 12). The LOW group demonstrated a reduction in 133 N anterior knee laxity between baseline and 12 weeks testing when compared to the HIGH and the STAND groups (p = 0.009). Specifically, the trained-untrained knee laxity decreased an average of approximately 5 mm in the LOW group while remaining the same in the other two groups. Twelve weeks of knee extensor open kinetic chain resistance training at loads of 2 sets of 20RM led to a reduction in anterior knee laxity in the ACLI knee. This reduction in laxity does not appear to offer any significant short-term functional advantages when compared to a standard rehabilitation protocol. These results indicate that knee laxity can be decreased with resistance training of the thigh muscles. Randomised controlled trial, Level II.

  19. Combination nivolumab- and cabiralizumab-associated acute bilateral anterior and posterior scleritis and anterior uveitis

    Directory of Open Access Journals (Sweden)

    John A. Gonzales

    2018-06-01

    Full Text Available Purpose: To report on a case of uveitis and scleritis resulting as an immune-mediated side effect of cancer immunotherapy with nivolumab and cabiralizumab. Observations: Bilateral anterior nongranulomatous anterior uveitis and bilateral diffuse anterior and posterior scleritis occurred following the use of combination cancer immunotherapy. The uveitis and scleritis resolved following temporary discontinuation of nivolumab and cabiralizumab as well as systemic prednisone. Conclusions and importance: Ophthalmologists should be aware of the possibility of acute ocular inflammation developing with cancer immunotherapy. Systemic corticosteroids play a first-line role in managing such immune-mediated side effects. Keywords: Uveitis, Scleritis, Cancer immunotherapy, Side effects, Nivolumab, Cabiralizumab

  20. Anterior spinal cord syndrome of unknown etiology

    OpenAIRE

    Klakeel, Merrine; Thompson, Justin; Srinivasan, Rajashree; McDonald, Frank

    2015-01-01

    A spinal cord injury encompasses a physical insult to the spinal cord. In the case of anterior spinal cord syndrome, the insult is a vascular lesion at the anterior spinal artery. We present the cases of two 13-year-old boys with anterior spinal cord syndrome, along with a review of the anatomy and vasculature of the spinal cord and an explanation of how a lesion in the cord corresponds to anterior spinal cord syndrome.

  1. Evaluation of the effects of subgingival injection of Simvastatin on space re-opening after orthodontic space closure in adults

    Directory of Open Access Journals (Sweden)

    Arezoo Jahanbin

    2016-03-01

    Full Text Available Background. This clinical trial evaluated the effect of Simvastatin on space re-opening after orthodontic space closure and its effect on the gingival index (GI and clinical attachment loss (CAL. Methods. 16 females, 25‒40 years old, with spaces between anterior mandibular teeth due to chronic periodontitis were participated in this study. The patients were randomly divided into control and experimental groups. In the experimental group, 1.2% Simvastatin gel and in the control group, 0.9% sodium chloride as a placebo was injected into the pocket depth of the six anterior teeth. The amount of space reopening, GI and CAL were measured. Results. No serious complications were observed during interventions and follow-up periods. Space re-opening was significantly reduced in patients receiving Simvastatin (P < 0.001. Moreover, GI reduction was significantly greater in Sim-vastatin group compared to the control group (P < 0.001. However, CAL did not demonstrate a significant difference between the groups. Conclusion. Simvastatin may decrease space re-opening after orthodontic space closure in human anterior teeth.

  2. Choice of Surgical Procedure for Patients With Non-Small-Cell Lung Cancer ≤ 1 cm or > 1 to 2 cm Among Lobectomy, Segmentectomy, and Wedge Resection

    DEFF Research Database (Denmark)

    Dai, Chenyang; Shen, Jianfei; Ren, Yijiu

    2016-01-01

    PURPOSE: According to the lung cancer staging project, T1a (≤ 2 cm) non-small-cell lung cancer (NSCLC) should be additionally classified into ≤ 1 cm and > 1 to 2 cm groups. This study aimed to investigate the surgical procedure for NSCLC ≤ 1 cm and > 1 to 2 cm. METHODS: We identified 15...... multiple prognostic factors. RESULTS: OS and LCSS favored lobectomy compared with segmentectomy or wedge resection in patients with NSCLC ≤ 1 cm and > 1 to 2 cm. Multivariable analysis showed that segmentectomy and wedge resection were independently associated with poorer OS and LCSS than lobectomy...... for NSCLC ≤ 1 cm and > 1 to 2 cm. With sublobar resection, lower OS and LCSS emerged for NSCLC > 1 to 2 cm after wedge resection, whereas similar survivals were observed for NSCLC ≤ 1 cm. Multivariable analyses showed that wedge resection is an independent risk factor of survival for NSCLC > 1 to 2 cm...

  3. Near-Surface Profiles of Water Stable Isotope Components and Indicated Transitional History of Ice-Wedge Polygons Near Barrow

    Science.gov (United States)

    Iwahana, G.; Wilson, C.; Newman, B. D.; Heikoop, J. M.; Busey, R.

    2017-12-01

    Wetlands associated with ice-wedge polygons are commonly distributed across the Arctic Coastal Plain of northern Alaska, a region underlain by continuous permafrost. Micro-topography of the ice-wedge polygons controls local hydrology, and the micro-topography could be altered due to factors such like surface vegetation, wetness, freeze-thaw cycles, and permafrost degradation/aggradation under climate change. Understanding status of the wetlands in the near future is important because it determines biogeochemical cycle, which drives release of greenhouse gases from the ground. However, transitional regime of the ice-wedge polygons under the changing climate is not fully understood. In this study, we analyzed geochemistry of water extracted from frozen soil cores sampled down to about 1m depth in 2014 March at NGEE-Arctic sites in the Barrow Environmental Observatory. The cores were sampled from troughs/rims/centers of five different low-centered or flat-centered polygons. The frozen cores are divided into 5-10cm cores for each location, thawed in sealed plastic bags, and then extracted water was stored in vials. Comparison between the profiles of geochemistry indicated connection of soil water in the active layer at different location in a polygon, while it revealed that distinctly different water has been stored in permafrost layer at troughs/rims/centers of some polygons. Profiles of volumetric water content (VWC) showed clear signals of freeze-up desiccation in the middle of saturated active layers as low VWC anomalies at most sampling points. Water in the active layer and near-surface permafrost was classified into four categories: ice wedge / fresh meteoric / transitional / highly fractionated water. The overall results suggested prolonged separation of water in the active layer at the center of low-centered polygons without lateral connection in water path in the past.

  4. Numerical study and pilot evaluation of experimental data measured on specimen loaded by bending and wedge splitting forces

    Directory of Open Access Journals (Sweden)

    S. Seitl

    2017-01-01

    Full Text Available The fracture mechanical properties of silicate based materials are determined from various fracture mechanicals tests, e.g. three- or four- point bending test, wedge splitting test, modified compact tension test etc. For evaluation of the parameters, knowledge about the calibration and compliance functions is required. Therefore, in this paper, the compliance and calibration curves for a novel test geometry based on combination of the wedge splitting test and three-point bending test are introduced. These selected variants exhibit significantly various stress state conditions at the crack tip, or, more generally, in the whole specimen ligament. The calibration and compliance curves are compared and used for evaluation of the data from pilot experimental measurement.

  5. MRI of tibialis anterior tendon rupture

    International Nuclear Information System (INIS)

    Gallo, Robert A.; DeMeo, Patrick J.; Kolman, Brett H.; Daffner, Richard H.; Sciulli, Robert L.; Roberts, Catherine C.

    2004-01-01

    Ruptures of the tibialis anterior tendon are rare. We present the clinical histories and MRI findings of three recent male patients with tibialis anterior tendon rupture aged 58-67 years, all of whom presented with pain over the dorsum of the ankle. Two of the three patients presented with complete rupture showing discontinuity of the tendon, thickening of the retracted portion of the tendon, and excess fluid in the tendon sheath. One patient demonstrated a partial tear showing an attenuated tendon with increased surrounding fluid. Although rupture of the tibialis anterior tendon is a rarely reported entity, MRI is a useful modality in the definitive detection and characterization of tibialis anterior tendon ruptures. (orig.)

  6. Transumbilical Thoracoscopy Versus Conventional Thoracoscopy for Lung Wedge Resection: Safety and Efficacy in a Live Canine Model.

    Science.gov (United States)

    Chen, Tzu-Ping; Yen-Chu; Wu, Yi-Cheng; Yeh, Chi-Ju; Liu, Chien-Ying; Hsieh, Ming-Ju; Yuan, Hsu-Chia; Ko, Po-Jen; Liu, Yun-Hen

    2015-12-01

    Transumbilical single-port surgery has been associated with less postoperative pain and offers better cosmetic outcomes than conventional 3-port laparoscopic surgery. This study compares the safety and efficacy of transumbilical thoracoscopy and conventional thoracoscopy for lung wedge resection. The animals (n = 16) were randomly assigned to the transumbilical thoracoscopic approach group (n = 8) or conventional thoracoscopic approach group (n = 8). Transumbilical lung resection was performed via an umbilical incision and a diaphragmatic incision. In the conventional thoracoscopic group, lung resection was completed through a thoracic incision. For both procedures, we compared the surgical outcomes, for example, operating time and operative complications; physiologic parameters, for example, respiratory rate and body temperature; inflammatory parameters, for example, white blood cell count; and pulmonary parameters, for example, arterial blood gas levels. The animals were euthanized 2 weeks after the surgery for gross and histologic evaluations. The lung wedge resection was successfully performed in all animals. There was no significant difference in the mean operating times or complications between the transumbilical and the conventional thoracoscopic approach groups. With regard to the physiologic impact of the surgeries, the transumbilical approach was associated with significant elevations in body temperature on postoperative day 1, when compared with the standard thoracoscopic approach. This study suggests that both approaches for performing lung wedge resection were comparable in efficacy and postoperative complications. © The Author(s) 2014.

  7. Formation of forearc basins by collision between seamounts and accretionary wedges: an example from the New Hebrides subduction zone

    Science.gov (United States)

    Collot, J.-Y.; Fisher, M.A.

    1989-01-01

    Seabeam data reveal two deep subcircular reentrants in the lower arc slope of the New Hebrides island arc that may illustrate two stages in the development of a novel type of forearc basin. The Malekula reentrant lies just south of the partly subducted Bougainville seamount. This proximity, as well as the similarity in morphology between the reentrant and an indentation in the lower arc slope off Japan, suggests that the Malekula reentrant formed by the collision of a seamount with the arc. An arcuate fold-thrust belt has formed across the mouth of the reentrant, forming the toe of a new accretionary wedge. The Efate reentrant may show the next stage in basin development. This reentrant lies landward of a lower-slope ridge that may have begun to form as an arcuate fold-thrust belt across the mouth of a reentrant. This belt may have grown by continued accretion at the toe of the wedge, by underplating beneath the reentrant, and by trapping of sediment shed from the island arc. These processes could result in a roughly circular forearc basin. Basins that may have formed by seamount collision lie within the accretionary wedge adjacent to the Aleutian trenches. -Authors

  8. Humeral avulsion of the anterior shoulder stabilizing structures after anterior shoulder dislocation: demonstration by MRI and MR arthrography

    International Nuclear Information System (INIS)

    Tirman, P.F.J.; Steinbach, L.S.; Feller, J.F.; Stauffer, A.E.

    1996-01-01

    Objective. To demonstrate the MRI findings of an anterior shoulder capsular avulsion from the humerus, with or without subscapularis rupture, after anterior dislocation or severe abduction external rotation injury. Design and patients. We retrospectively reviewed the MRI and MR arthrographic examinations of seven patients who were identified at surgery with avulsion of the anterior shoulder stabilizers from the humerus. MRI was correlated with clinical history and surgical results. Results. MRI findings included: inhomogeneity or frank disruption of the anterior capsule at the humeral insertion (all), fluid intensity anterior to the shoulder (six patients), tear of the subscapularis tendon (six patients), dislocation of the biceps tendon (four patients), and a Hill-Sachs deformity (four patients). MR arthrography additionally found extravasation of contrast through the capsular defect (two patients). Conclusions. Our findings suggest that MRI is helpful for diagnosing humeral avulsion of the anterior glenohumeral capsule, especially when a tear of the subscapularis tendon insertion is present. MR arthrography may be of benefit for diagnosing capsular avulsion without associated subscapularis tendon abnormality. (orig.). With 4 figs

  9. Clinical Assessment of Lamina Cribrosa Curvature in Eyes with Primary Open-Angle Glaucoma.

    Directory of Open Access Journals (Sweden)

    Yong Woo Kim

    Full Text Available Quantitative evaluation of lamina cribrosa (LC posterior bowing in primary open-angle glaucoma (POAG eyes using swept-source optical coherence tomography.Patients with POAG (n = 123 eyes and healthy individuals of a similar age (n = 92 eyes were prospectively recruited. Anterior laminar insertion depth (ALID was defined as the vertical distance between the anterior laminar insertion and a reference plane connecting the Bruch's membrane openings (BMO. The mean LC depth (mLCD was approximated by dividing the area enclosed by the anterior LC, the BMO reference plane, and the two vertical lines for ALID measurement by the length between those two vertical lines. The LC curvature index was defined as the difference between the mLCD and the ALID. The factors influencing the LC curvature index were evaluated.The ALID and mLCD were significantly larger in POAG eyes than in healthy controls (P -6 dB and moderate-to-advanced glaucoma (MD < -6 dB, P = 0.95.LC posterior bowing was increased in POAG eyes, and was significantly associated with structural optic nerve head (ONH changes but not with functional glaucoma severity. Quantitative evaluation of LC curvature can facilitate assessment of glaucomatous ONH change.

  10. Imaging findings of anterior hip dislocations

    Energy Technology Data Exchange (ETDEWEB)

    Pfeifer, Kyle [Mallinckrodt Institute of Radiology, Department of Radiology, St. Louis, MO (United States); Leslie, Michael [Yale School of Medicine, Department of Orthopedics and Rehabilitation, New Haven, CT (United States); Menn, Kirsten; Haims, Andrew [Yale University School of Medicine, Department of Radiology and Biomedical Imaging, New Haven, CT (United States)

    2017-06-15

    Anterior hip dislocations are rare orthopedic emergencies resulting from high-energy trauma and have unique imaging characteristics on radiography, computed tomography (CT), and magnetic resonance imaging (MRI). Imaging findings on CT and MRI allow for the prompt recognition and classification of anterior hip dislocations, which guides patient management and reduces complications. The purpose of this article is to review imaging findings of anterior hip dislocations, specifically focusing on CT and MRI. (orig.)

  11. Medical Devices; Obstetrical and Gynecological Devices; Classification of the Pressure Wedge for the Reduction of Cesarean Delivery. Final order.

    Science.gov (United States)

    2017-12-28

    The Food and Drug Administration (FDA or we) is classifying the pressure wedge for the reduction of cesarean delivery into class II (special controls). The special controls that apply to the device type are identified in this order and will be part of the codified language for the pressure wedge for the reduction of cesarean delivery's classification. We are taking this action because we have determined that classifying the device into class II (special controls) will provide a reasonable assurance of safety and effectiveness of the device. We believe this action will also enhance patients' access to beneficial innovative devices, in part by reducing regulatory burdens.

  12. A NOVEL ANOMALY OF THE ANTERIOR DIGASTRIC MUSCLE. UNA ANOMALÍA NUEVA DEL MÚSCULO DIGÁSTRICO ANTERIOR

    Directory of Open Access Journals (Sweden)

    Timothy W Hegeman

    2016-03-01

    Full Text Available Documentamos una anomalía del músculo digástrico anterior en un cadáver femenino de 85 años de edad. La anomalía consiste en cuatro vientres adicionales que salen entre los dos típicos digástricos anterior. Analizamos el significado embriológico y clínico de esta variante. El músculo digástrico es derivado de dos arcos branquiales o arcos faríngeos. El primer arco branquial forma el vientre anterior y el segundo forma el vientre posterior. Actuando juntos, los vientres ayudan a impulsar hacia abajo la mandíbula y a estabilizar el hioides. Varias anormalidades en el vientre anterior del digástrico han sido previamente descriptas en la literatura, pero ninguna ha replicado la formación precisa descripta aquí.  We document a novel anomaly of the anterior digastrics of an 85 year old female cadaver, consisting of four additional muscle bellies existing between the two typical anterior digastrics and go on to explain the embryologic and clinical significance of the variant. The digastric muscle is derived from two pharyngeal arches, the first pharyngeal arch forming the anterior belly and the second forming the posterior belly. Acting together, both bellies help to depress the mandible and stabilize the hyoid. Several abnormalities in the anterior belly of the digastric muscle have previously been described in the literature, but none have replicated the precise formation described here.

  13. Dorsolateral onlay urethroplasty for anterior urethral strictures by a unilateral urethral mobilization approach.

    Science.gov (United States)

    Singh, Bhupendra P; Pathak, Hemant R; Andankar, Mukund G

    2009-04-01

    For management of long segment anterior urethral stricture, dorsal onlay urethroplasty is currently the most favored single-stage procedure. Conventional dorsal onlay urethroplasty requires circumferential mobilization of the urethra, which might cause ischemia of the urethra in addition to chordee. To determine the feasibility and short-term outcomes of applying a dorsolateral free graft to treat anterior urethral stricture by unilateral urethral mobilization through a perineal approach. A prospective study from September 2005 to March 2008 in a tertiary care teaching hospital. Seventeen patients with long or multiple strictures of the anterior urethra were treated by a dorsolateral free buccal mucosa graft. The pendulous urethra was accessed by penile eversion through the perineal wound. The urethra was not separated from the corporal bodies on one side and was only mobilized from the midline on the ventral aspect to beyond the midline on the dorsal aspect. The urethra was opened in the dorsal midline over the stricture. The buccal mucosa graft was secured on the ventral tunica of the corporal bodies. Mean and median. After a follow-up of 12-30 months, one recurrence developed and 1 patient needed an internal urethrotomy. A unilateral urethral mobilization approach for dorsolateral free graft urethroplasty is feasible for panurethral strictures of any length with good short-term success.

  14. Effects of primary selective laser trabeculoplasty on anterior segment parameters

    Directory of Open Access Journals (Sweden)

    Suzan Guven Yilmaz

    2015-10-01

    Full Text Available AIM:To investigate the effects of selective laser trabeculoplasty (SLT on the main numerical parameters of anterior segment with Pentacam rotating Scheimpflug camera in patients with ocular hypertension (OHT and primary open angle glaucoma (POAG.METHODS: Pentacam measurements of 45 eyes of 25 (15 females and 10 males patients (12 with OHT, 13 with POAG before and after SLT were obtained. Measurements were taken before and 1 and 3mo after SLT. Pentacam parameters were compared between OHT and POAG patients, and age groups (60y and older, and younger than 60y.RESULTS: The mean age of the patients was 57.8±13.9 (range 20-77y. Twelve patients (48% were younger than 60y, while 13 patients (52% were 60y and older. Measurements of pre-SLT and post-SLT 1mo were significantly different for the parameters of central corneal thickness (CCT and anterior chamber volume (ACV (P<0.05. These parameters returned back to pre-SLT values at post-SLT 3mo. Decrease of ACV at post-SLT 1mo was significantly higher in younger than 60y group than 60y and older group. There was no statistically significant difference in Pentacam parameters between OHT and POAG patients at pre- and post-treatment measurements (P>0.05.CONCLUSION:SLT leads to significant increase in CCT and decrease in ACV at the 1st month of the procedure. Effects of SLT on these anterior segment parameters, especially for CCT that interferes IOP measurement, should be considered to ensure accurate clinical interpretation.

  15. Novel spatula and dissector for safer deep anterior lamellar keratoplasty

    Directory of Open Access Journals (Sweden)

    Gustavo ,2,3 Bonfadini

    2014-10-01

    Full Text Available Objective: We describe a novel spatula and dissector to facilitate the big-bubble technique in deep anterior lamellar keratoplasty (DALK. Methods: A 29-year-old man who was diagnosed with bilateral keratoconus underwent deep anterior lamellar keratoplasty (DALK. After 350μm partial thickness incision of the recipient cornea, the Bonfadini dissector was inserted at the deepest point in the peripheral incision and could be advanced to the center of the cornea safely because of its "semi-sharp" tip. After achieving the big-bubble (BB separation of Descemet membrane (DM from the overlying stroma, the anterior stromal disc was removed. Viscoelastic material was placed on the stromal bed to prevent uncontrolled collapse and perforation of DM during the paracentesis blade incision into the BB. We could detect the safe opening of the BB using the Bonfadini dissector by the leakage of air bubbles into the viscoelastic material. After injecting viscoelastic material into the BB space, we inserted the Bonfadini spatula into the bigbubble safely because of its curved profile and blunt edges. The groove along the length of the Bonfadini spatula enables safe and efficient incision or the residual stromal tissue using the pointed end of a sharp blade while protecting the underlying DM. After removal of posterior stroma, the donor button was sutured with 16 interrupted 10-0 nylon sutures. Results: This technique and the use of the Bonfadini spatula and dissector facilitate exposure of Descemet membrane. Conclusion: The smooth Bonfadini DALK spatula and dissector facilitate safe and efficient completion of DALK surgery.

  16. Radiochromic film calibration wedge EBT2 using virtual fields; Calibracion de peliculas radiocromicos EBT2 mediante campos con cunas virtuales

    Energy Technology Data Exchange (ETDEWEB)

    Perez, M. A.; Macias, J.; Merchan, M. A.; Campo, J. L.; Moreno, J. C.; Terron, J. A.; Miras, H.; Ortiz, M.; Arrans, R.; Ortiz, A.; Fernandez, D.

    2011-07-01

    EBT2 film dosimetry after exposure to a gradient of these wedge dosimetry. In our case a virtual wedge 600. The primary objective is to automate the process, reduce the time spent in obtaining the calibration curve (color-dose). Time negligible due to the limited availability of accelerators. This method of obtaining the calibration curve provides similar results to the commonly accepted either with irradiation uniform of a single film with different dose levels (multiband ladder) or with irradiation uniform of small rectangular piece of film , decreasing by a factor about 20, the time spent. (Author)

  17. Failed anterior cruciate ligament reconstruction: analysis of factors leading to instability after primary surgery.

    Science.gov (United States)

    Ma, Yong; Ao, Ying-Fang; Yu, Jia-Kuo; Dai, Ling-Hui; Shao, Zhen-Xing

    2013-01-01

    Revision anterior cruciate ligament (ACL) surgery can be expected to become more common as the number of primary reconstruction keeps increasing. This study aims to investigate the factors causing instability after primary ACL reconstruction, which may provide an essential scientific base to prevent surgical failure. One hundred and ten revision ACL surgeries were performed at our institute between November 2001 and July 2012. There were 74 men and 36 women, and the mean age at the time of revision was 27.6 years (range 16 - 56 years). The factors leading to instability after primary ACL reconstruction were retrospectively reviewed. Fifty-one knees failed because of bone tunnel malposition, with too anterior femoral tunnels (20 knees), posterior wall blowout (1 knee), vertical femoral tunnels (7 knees), too posterior tibial tunnels (12 knees), and too anterior tibial tunnels (10 knees). There was another knee performed with open surgery, where the femoral tunnel was drilled through the medial condyle and the tibial tunnel was too anterior. Five knees were found with malposition of the fixation. One knee with allograft was suspected of rejection and a second surgery had been made to take out the graft. Three knees met recurrent instability after postoperative infection. The other factors included traumatic (48 knees) and unidentified (12 knees). Technical errors were the main factors leading to instability after primary ACL reconstructions, while attention should also be paid to the risk factors of re-injury and failure of graft incorporation.

  18. Anterior chamber angle assessment using gonioscopy and ultrasound biomicroscopy.

    Science.gov (United States)

    Narayanaswamy, Arun; Vijaya, Lingam; Shantha, B; Baskaran, Mani; Sathidevi, A V; Baluswamy, Sukumar

    2004-01-01

    Comparison of anterior chamber angle measurements using ultrasound biomicroscopy (UBM) and gonioscopy. Five hundred subjects were evaluated for grading of angle width by the Shaffer method. UBM was done in the same group to document angle width, angle opening distance (AOD 500), and anterior chamber depth. Biometric parameters were documented in all subjects. UBM and gonioscopic findings were compared. A study was conducted in 282 men and 218 women with a mean age of 57.32 +/- 12.48 years. Gonioscopic grading was used to segregate occludable (slit-like, grades 1 and 2) from nonoccludable (grades 3 and 4) angles. Subjective assessment by gonioscopy resulted in an overestimation of angle width within the occludable group when compared with values obtained by UBM. This did not affect the segregation of occludable versus nonoccludable angles by gonioscopy. Biometric parameters in eyes with occludable angles were significantly lower in comparison with eyes with nonoccludable angles, except for lens thickness. AOD 500 correlated well with angle width. We concluded that clinical segregation into occludable and nonoccludable angles by an experienced observer using gonioscopy is fairly accurate. However, UBM is required for objective quantification of angles, and AOD 500 can be a reliable and standard parameter to grade angle width.

  19. An anterior signaling center patterns and sizes the anterior neuroectoderm of the sea urchin embryo.

    Science.gov (United States)

    Range, Ryan C; Wei, Zheng

    2016-05-01

    Anterior signaling centers help specify and pattern the early anterior neuroectoderm (ANE) in many deuterostomes. In sea urchin the ANE is restricted to the anterior of the late blastula stage embryo, where it forms a simple neural territory comprising several types of neurons as well as the apical tuft. Here, we show that during early development, the sea urchin ANE territory separates into inner and outer regulatory domains that express the cardinal ANE transcriptional regulators FoxQ2 and Six3, respectively. FoxQ2 drives this patterning process, which is required to eliminate six3 expression from the inner domain and activate the expression of Dkk3 and sFRP1/5, two secreted Wnt modulators. Dkk3 and low expression levels of sFRP1/5 act additively to potentiate the Wnt/JNK signaling pathway governing the positioning of the ANE territory around the anterior pole, whereas high expression levels of sFRP1/5 antagonize Wnt/JNK signaling. sFRP1/5 and Dkk3 levels are rigidly maintained via autorepressive and cross-repressive interactions with Wnt signaling components and additional ANE transcription factors. Together, these data support a model in which FoxQ2 initiates an anterior patterning center that implements correct size and positions of ANE structures. Comparisons of functional and expression studies in sea urchin, hemichordate and chordate embryos reveal striking similarities among deuterostome ANE regulatory networks and the molecular mechanism that positions and defines ANE borders. These data strongly support the idea that the sea urchin embryo uses an ancient anterior patterning system that was present in the common ambulacrarian/chordate ancestor. © 2016. Published by The Company of Biologists Ltd.

  20. Assessing strain mapping by electron backscatter diffraction and confocal Raman microscopy using wedge-indented Si

    Energy Technology Data Exchange (ETDEWEB)

    Friedman, Lawrence H.; Vaudin, Mark D.; Stranick, Stephan J.; Stan, Gheorghe; Gerbig, Yvonne B.; Osborn, William; Cook, Robert F., E-mail: robert.cook@nist.gov

    2016-04-15

    The accuracy of electron backscatter diffraction (EBSD) and confocal Raman microscopy (CRM) for small-scale strain mapping are assessed using the multi-axial strain field surrounding a wedge indentation in Si as a test vehicle. The strain field is modeled using finite element analysis (FEA) that is adapted to the near-indentation surface profile measured by atomic force microscopy (AFM). The assessment consists of (1) direct experimental comparisons of strain and deformation and (2) comparisons in which the modeled strain field is used as an intermediate step. Direct experimental methods (1) consist of comparisons of surface elevation and gradient measured by AFM and EBSD and of Raman shifts measured and predicted by CRM and EBSD, respectively. Comparisons that utilize the combined FEA–AFM model (2) consist of predictions of distortion, strain, and rotation for comparison with EBSD measurements and predictions of Raman shift for comparison with CRM measurements. For both EBSD and CRM, convolution of measurements in depth-varying strain fields is considered. The interconnected comparisons suggest that EBSD was able to provide an accurate assessment of the wedge indentation deformation field to within the precision of the measurements, approximately 2×10{sup −4} in strain. CRM was similarly precise, but was limited in accuracy to several times this value. - Highlights: • We map strain by electron backscatter diffraction and confocal Raman microscopy. • The test vehicle is the multi-axial strain field of wedge-indented silicon. • Strain accuracy is assessed by direct experimental intercomparison. • Accuracy is also assessed by atomic force microscopy and finite element analyses. • Electron diffraction measurements are accurate; Raman measurements need refinement.