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Sample records for avulsions revised technique

  1. First Results in new technique of Arthrosc. Button-to-Button repair of PCL avulsion injuries

    OpenAIRE

    Thiele, Joern; Woelfl, Christoph; von Recum, Jan

    2016-01-01

    Aims and Objectives: The goal of the study was to describe the short time results of our new surgical technique of arthroscopic Button-to-Button fixation for acute tibial posterior cruciate ligament (PCL) avulsion fractures. Concerning clinical and radiographic outcomes, and complication rates. Materials and Methods: This prospective study includes patients with an acute tibial avulsion fracture of the PCL. The reduction and fixation was performed all arthroscopic, reduction and suture fixati...

  2. First Results in new technique of Arthrosc. Button-to-Button repair of PCL avulsion injuries

    Science.gov (United States)

    Thiele, Joern; Woelfl, Christoph; von Recum, Jan

    2016-01-01

    Aims and Objectives: The goal of the study was to describe the short time results of our new surgical technique of arthroscopic Button-to-Button fixation for acute tibial posterior cruciate ligament (PCL) avulsion fractures. Concerning clinical and radiographic outcomes, and complication rates. Materials and Methods: This prospective study includes patients with an acute tibial avulsion fracture of the PCL. The reduction and fixation was performed all arthroscopic, reduction and suture fixation by Tight Rope ABS and 2 ABS Buttons (Fa. Arthrex). Indication for image-proven displaced tibial PCL avulsion fractures with posterior knee instability of grade II or higher. The mean follow-up period was 6 months. Follow-up assessment included clinical assessment, functional scores, and radiographic evaluation. Results: First Results showed that Patients had better range of motion compared to Patients with an open technique. The postoperative physiotherapy was not limited by the dorsal approach. We have seen no leck of extension after 6 months due to all arthroscopic technique. All fractures achieved union. We have seen no procedure connected complications like wound infections, Button dislocations or nonunions. Conclusion: Treatment of tibial PCL avulsion fractures by all arthroscopic Button-to-Button fixation seems to be a successful technique. The benefit with an stable fixation without a dorsal approach helps the postoperative treatment and avoids soft tissue problems , especially limitations of the extension due to Arthrofibrosis and dorsal scar formation. Intermediate and long term results have to prove the clinical results.

  3. Heel pad avulsion injury: an approach with hyperbaric oxygen therapy

    Directory of Open Access Journals (Sweden)

    Pradeoth Korambayil Mukundan

    2015-04-01

    Full Text Available Aim: Crush injuries of the foot are often associated with partial or complete degloving of the heel pad. The purpose of this study is to present an algorithm for the management of various types of heel pad avulsion injuries, including hyperbaric oxygen (HBO therapy in the treatment regimen. Methods: We present a prospective study of 27 patients with various types of heel pad avulsion managed in our institution from December 2012 to June 2013. Heel pad avulsion injuries were classified according to the angiosomal pattern. Partial or complete avulsions were classified and treated accordingly. HBO therapy was administered postoperatively. The postoperative period, hospital course, and follow-up were documented in patients with heel pad avulsion injuries. Results: Of 27 patients, 20 cases presented with partial avulsion and 7 cases were complete avulsion. Of 20 cases of partial avulsion, one of the flaps was anchored with K-wire. Nineteen cases of partial heel pad avulsion were managed by suturing. Eight patients out of 20 required skin grafting as a secondary procedure at a later date. Out of 7 cases of complete avulsion, one was managed by full-thickness skin grafting, one case by reverse sural artery flap coverage, and four cases were managed by free tissue transfer. No flap revisions were required, and no complications were experienced for the transferred flaps. Conclusion: HBO therapy may be a useful adjunct in the treatment of heel pad avulsion injuries.

  4. Infrared Devices And Techniques (Revision)

    OpenAIRE

    Rogalski A.; Chrzanowski K.

    2014-01-01

    The main objective of this paper is to produce an applications-oriented review covering infrared techniques and devices. At the beginning infrared systems fundamentals are presented with emphasis on thermal emission, scene radiation and contrast, cooling techniques, and optics. Special attention is focused on night vision and thermal imaging concepts. Next section concentrates shortly on selected infrared systems and is arranged in order to increase complexity; from image intensifier systems,...

  5. Infrared Devices And Techniques (Revision

    Directory of Open Access Journals (Sweden)

    Rogalski A.

    2014-12-01

    Full Text Available The main objective of this paper is to produce an applications-oriented review covering infrared techniques and devices. At the beginning infrared systems fundamentals are presented with emphasis on thermal emission, scene radiation and contrast, cooling techniques, and optics. Special attention is focused on night vision and thermal imaging concepts. Next section concentrates shortly on selected infrared systems and is arranged in order to increase complexity; from image intensifier systems, thermal imaging systems, to space-based systems. In this section are also described active and passive smart weapon seekers. Finally, other important infrared techniques and devices are shortly described, among them being: non-contact thermometers, radiometers, LIDAR, and infrared gas sensors.

  6. Acute Traumatic Musculotendinous Avulsion of the Flexor Pollicis Longus Tendon Treated with Primary Flexor Digitorum Superficialis Transfer: A Novel Technique of Management

    Directory of Open Access Journals (Sweden)

    P. Kiran Sasi

    2016-01-01

    Full Text Available Traumatic musculotendinous junction avulsions are rare injuries except in avulsion amputations. They pose a significant challenge to the treating surgeon. We present a 24-year-old male who sustained an open musculotendinous avulsion of the flexor pollicis longus tendon. He was treated with primary tendon transfer using the flexor digitorum superficialis of ring finger, in flexor zone 3. The functional result at 10 months following surgery was excellent.

  7. Complete Ureteral Avulsion

    Directory of Open Access Journals (Sweden)

    V. Gupta

    2005-01-01

    Full Text Available Complete avulsion of the ureter is one of the most serious complications of ureteroscopy. It requires open or laparoscopic intervention for repair. This case report emphasizes its management and presents recommendations for prevention in current urological practice.

  8. Complete Ureteral Avulsion

    OpenAIRE

    Gupta, V.; Sadasukhi, T. C.; K.K. Sharma; R. G. Yadav; Mathur, R; Tomar, V.; Yadav, S.S.; Priyadarshi, S.; Gupta, P.

    2005-01-01

    Complete avulsion of the ureter is one of the most serious complications of ureteroscopy. It requires open or laparoscopic intervention for repair. This case report emphasizes its management and presents recommendations for prevention in current urological practice.

  9. Nonoperatively treated infraglenoid tubercle avulsion

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    Renjit Issac

    2014-10-01

    Full Text Available 【Abstract】Infraglenoid tubercle avulsion fractures are extremely rare injuries. We report a 38-year-old male with glenoid cavity fracture and infraglenoid tubercle avulsion of the left shoulder following a fall from bike. He refused surgery and was treated nonoperatively. Follow-up radiography and CT at 18 months revealed a malunited infraglenoid tubercle with signs of early glenohumeral osteoarthritis. He did not have shoulder instability or pain and had a fair-good functional outcome. There are no previously published data on the anatomic outcome of nonoperatively treated displaced infraglenoid tubercle avulsion fractures based on CT. Key words: Tomography, X-ray computed; Infraglenoid tubercle; Avulsion

  10. Avulsion fractures and chronic avulsion injuries of the knee: role of MR imaging

    International Nuclear Information System (INIS)

    Avulsion fractures and chronic avulsion injuries of the knee are common lesions in sports-related trauma, especially among adolescents. Magnetic resonance imaging may prove useful in detecting and characterizing such lesions, and has several advantages with regard to other imaging modalities. We review, illustrate, and discuss the MR imaging features of some of the more frequent avulsion fractures and chronic avulsion injuries of the knee, including avulsion fractures of the cruciate ligaments, avulsion fractures of lateral and medial stabilizers, avulsion fractures and chronic avulsion injuries of the extensor mechanism, and avulsive cortical irregularities of the distal femur. The role of MR imaging in evaluating such lesions is emphasized. (orig.)

  11. Avulsion fractures and chronic avulsion injuries of the knee: role of MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Mellado, J.M.; Ramos, A.; Salvado, E.; Camins, A.; Sauri, A. [Institut de Diagnostic per la Imatge, Hospital Universitari de Tarragona Joan XXIII, 43007 Tarragona (Spain); Calmet, J. [Department of Orthopaedic Surgery, Hospital Universitari de Tarragona Joan XXIII, 43007 Tarragona (Spain)

    2002-10-01

    Avulsion fractures and chronic avulsion injuries of the knee are common lesions in sports-related trauma, especially among adolescents. Magnetic resonance imaging may prove useful in detecting and characterizing such lesions, and has several advantages with regard to other imaging modalities. We review, illustrate, and discuss the MR imaging features of some of the more frequent avulsion fractures and chronic avulsion injuries of the knee, including avulsion fractures of the cruciate ligaments, avulsion fractures of lateral and medial stabilizers, avulsion fractures and chronic avulsion injuries of the extensor mechanism, and avulsive cortical irregularities of the distal femur. The role of MR imaging in evaluating such lesions is emphasized. (orig.)

  12. Face Avulsion and Degloving

    OpenAIRE

    Panse, Nikhil; Sahasrabudhe, Parag; Joshi, Namrata

    2014-01-01

    There have been sparse reports in literature of avulsion and degloving injuries of individual areas of face like the nose, eyelids, ear and even mandible. Hemi-facial degloving is extremely rare. We present a case of post-assault degloving of the nose, part of forehead with anterior wall of frontal sinus, entire upper and lower eyelids and the cheek. Proper planning and staging of the surgical procedures and use of local flaps, meticulous and proper alignment of tissues gave us good aesthetic...

  13. Delayed replantation of avulsed teeth

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    Adil N

    2007-05-01

    Full Text Available Dental injuries are very common and their extent has been classified by Ellis. Avulsion of tooth is a grievous injury and ranges from 1-16% among the traumatic injuries, of which maxillary anterior are commonest. Reimplantation of avulsed teeth is a standard procedure. However, it has certain limitations. Most often their management is very challenging. In this case report we are presenting the management of maxillary incisors by replantation after 36 hrs in a 12 year old girl.

  14. Transosseous-Equivalent Repair for Distal Patellar Tendon Avulsion.

    Science.gov (United States)

    Galos, David K; Konda, Sanjit R; Kaplan, Daniel J; Ryan, William E; Alaia, Michael J

    2016-04-01

    Extensor mechanism disruptions are relatively uncommon injuries involving injury to the quadriceps tendon, patella, or patellar tendon. Patellar tendon avulsions from the tibial tubercle in adults are rare; as such, little technical information has been written regarding surgical management of this injury in the adult. Transosseous-equivalent repairs have been described in the management of several types of tendon ruptures, including rotator cuff and distal triceps tendon ruptures, but not previously in patellar injuries. We present a technique for repairing an avulsion injury of the patellar tendon from the tibial tubercle using suture anchors in a transosseous-equivalent manner. This technique for treating distal patellar tendon avulsion injuries likely increases contact area at the repair site while potentially improving fixation strength. PMID:27462538

  15. Proximal Rectus Femoris Avulsion Repair.

    Science.gov (United States)

    Dean, Chase S; Arbeloa-Gutierrez, Lucas; Chahla, Jorge; Pascual-Garrido, Cecilia

    2016-06-01

    Proximal rectus femoris tendon avulsions are rare and occur mostly in male athletes. Currently, the standard of care for complete tendinous avulsions of the direct arm of the rectus femoris is nonoperative treatment. However, surgical repair may be considered in high-level athletes who have a high demand for repetitive hip flexion performed in an explosive manner or in patients in whom nonoperative treatment has failed. The purpose of this technical note is to describe the method for surgical repair of the proximal direct arm of the rectus femoris to its origin at the anterior inferior iliac spine using suture anchors. PMID:27656376

  16. Iliotibial band avulsion fracture: a case report with differential diagnosis.

    Science.gov (United States)

    Fay, Kristin; Mannem, Rajeev; Baynes, Keith; Sarin, Dhruv; DuBois, Melissa

    2016-02-01

    Avulsion injuries of the knee are common sequelae of significant trauma given the number of ligamentous and tendinous insertions around the joint. Commonly discussed avulsion fractures of the lateral knee include the Segond fracture of the lateral tibial plateau and the arcuate complex avulsion fracture of the fibular styloid process. A less common avulsion fracture is the iliotibial (IT) band avulsion fracture involving the anterolateral corner of the tibia (Gerdy's tubercle). It is crucial to identify IT band avulsion fractures because of the frequent associated internal derangements of the knee. This case report describes the imaging of an acute IT band avulsion fracture and compares these findings with other lateral knee avulsion fractures.

  17. First-Aid Algorithms in Dental Avulsion

    Science.gov (United States)

    Baginska, Joanna; Wilczynska-Borawska, Magdalena

    2012-01-01

    Almost one fourth of traumatic dental injuries occur at schools or in their surroundings. Prevalence of tooth avulsion varies from 0.5% to 16% of all cases of dental trauma. Children with dental avulsion may seek help from school nurses so they should be able to provide first-aid treatment. However, many studies showed that the general level of…

  18. Optic Nerve Avulsion after Blunt Trauma

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    Hacı Halil Karabulut

    2014-05-01

    Full Text Available Optic nerve avulsion is an uncommon presentation of ocular trauma with a poor prognosis. It can be seen as complete or partial form due to the form of trauma. We assessed the complete optic nerve avulsion in a 16-year-old female patient complaining of loss of vision in her left eye after a traffic accident. (Turk J Ophthalmol 2014; 44: 249-51

  19. [Revision of the anterior cruciate ligament in TransFix(R)- and OATS(R)-technique].

    Science.gov (United States)

    Attmanspacher, W; Dittrich, V; Stedtfeld, H W

    2002-10-01

    Transplant failure after anterior cruciate ligament-plastic is a typical complication. In larger collectives, revisions amount to about 8-12 % of the reconstructive operations of the anterior cruciate ligament. The number of revisions is also growing in our clinic and makes at present 11 %. There are different reasons of transplant failure. Many mistakes occur as a result of technical pitfalls during the preparation. A new "adequate trauma" is rarely the cause of a rerupture. In this paper a new concept of revision in failed anterior cruciate ligament reconstructions will be presented, which can be frequently performed as one-step technique even in bone tunnel enlargement or sclerosis of the tunnel. Our results in 21 cases will be discussed with the literature. In our opinion the TransFix(R) technique, if necessary in conjunction with the OATS(R) technical equipment, is a reproducable alternative for one step revision surgery and should be recommended. PMID:12410451

  20. Extrusion of bone anchor suture following flexor digitorum profundus tendon avulsion injury repair.

    LENUS (Irish Health Repository)

    Tiong, William H C

    2011-09-01

    Flexor digitorum profundus (FDP) zone I tendon avulsion injury is traditionally repaired with a pullout suture technique. More recently, bone anchor sutures have been used as a viable alternative and have largely replaced areas in hand surgery where pullout suture technique was once required. To date, there have been very few complications reported related to bone anchor suture use in FDP tendon reattachment to the bone. We report a very unusual case of extrusion of bone anchor through the nailbed, 6 years after zone I FDP tendon avulsion injury repair and a brief review of literature.

  1. DISTAL TRICEPS AVULSION: A CASE REPORT

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    Ramkumar Reddy

    2015-05-01

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

  2. Two-Stage Revision Anterior Cruciate Ligament Reconstruction: Bone Grafting Technique Using an Allograft Bone Matrix.

    Science.gov (United States)

    Chahla, Jorge; Dean, Chase S; Cram, Tyler R; Civitarese, David; O'Brien, Luke; Moulton, Samuel G; LaPrade, Robert F

    2016-02-01

    Outcomes of primary anterior cruciate ligament (ACL) reconstruction have been reported to be far superior to those of revision reconstruction. However, as the incidence of ACL reconstruction is rapidly increasing, so is the number of failures. The subsequent need for revision ACL reconstruction is estimated to occur in up to 13,000 patients each year in the United States. Revision ACL reconstruction can be performed in one or two stages. A two-stage approach is recommended in cases of improper placement of the original tunnels or in cases of unacceptable tunnel enlargement. The aim of this study was to describe the technique for allograft ACL tunnel bone grafting in patients requiring a two-stage revision ACL reconstruction.

  3. Two-Stage Revision Anterior Cruciate Ligament Reconstruction: Bone Grafting Technique Using an Allograft Bone Matrix.

    Science.gov (United States)

    Chahla, Jorge; Dean, Chase S; Cram, Tyler R; Civitarese, David; O'Brien, Luke; Moulton, Samuel G; LaPrade, Robert F

    2016-02-01

    Outcomes of primary anterior cruciate ligament (ACL) reconstruction have been reported to be far superior to those of revision reconstruction. However, as the incidence of ACL reconstruction is rapidly increasing, so is the number of failures. The subsequent need for revision ACL reconstruction is estimated to occur in up to 13,000 patients each year in the United States. Revision ACL reconstruction can be performed in one or two stages. A two-stage approach is recommended in cases of improper placement of the original tunnels or in cases of unacceptable tunnel enlargement. The aim of this study was to describe the technique for allograft ACL tunnel bone grafting in patients requiring a two-stage revision ACL reconstruction. PMID:27274452

  4. Iliotibial band avulsion fracture: a case report with differential diagnosis.

    Science.gov (United States)

    Fay, Kristin; Mannem, Rajeev; Baynes, Keith; Sarin, Dhruv; DuBois, Melissa

    2016-02-01

    Avulsion injuries of the knee are common sequelae of significant trauma given the number of ligamentous and tendinous insertions around the joint. Commonly discussed avulsion fractures of the lateral knee include the Segond fracture of the lateral tibial plateau and the arcuate complex avulsion fracture of the fibular styloid process. A less common avulsion fracture is the iliotibial (IT) band avulsion fracture involving the anterolateral corner of the tibia (Gerdy's tubercle). It is crucial to identify IT band avulsion fractures because of the frequent associated internal derangements of the knee. This case report describes the imaging of an acute IT band avulsion fracture and compares these findings with other lateral knee avulsion fractures. PMID:26403089

  5. Triceps tendon avulsion and associated injuries of the elbow

    OpenAIRE

    Canbora, Kerem; Ozyurek, Selahattin; Gumussuyu, Gurkan; Kose, Ozkan

    2013-01-01

    A rupture or avulsion of the triceps tendon is very rare but concomitant elbow injuries with avulsion of the triceps tendon are even rarer. In this study, an extraordinary and unusual injury combination (radial head and trochlear fracture associated with triceps tendon avulsion), which happened during a fall onto the elbow with outstretched hand, was identified and has been discussed in the literature.

  6. Partial salvage of avulsed tissue after dog bite.

    Science.gov (United States)

    Øregaard, J S; Lang, C L; Venzo, A

    2016-02-01

    Injuries to the nose can be severe from both a functional and cosmetic perspective. After suffering a dog bite to the central part of the face, an 18-year old woman underwent replantation of the avulsed tissue with the help of microsurgical arterial anastomosis. A venous anastomosis was impossible and venous congestion was treated with leech therapy. Subsequent skin necrosis occurred after a few days and the replantation was revised, revealing healthy tissue immediately below. The defect was covered with a full-thickness skin graft. At follow-up review eight months later, the functional and cosmetic result was satisfactory. To our knowledge, this is one of few cases where an injury of this severity healed with a cosmetically acceptable result. PMID:26673050

  7. Aneurysmal bone cyst: revision of different techniques in imaging diagnostic

    International Nuclear Information System (INIS)

    We study simple radiology, conventional tomography, computed tomography and angiography in 8 cases of aneurysmal bone cyst for the purpose of assessing the utility of these diagnostic techniques. Our results, in agreement with those in the literature, indicate that the presence of a generally well-defined lytic, insufflated lesion containing septi should suggest this disorder. (Author)

  8. Modeling coupled avulsion and earthquake timescale dynamics

    Science.gov (United States)

    Reitz, M. D.; Steckler, M. S.; Paola, C.; Seeber, L.

    2014-12-01

    River avulsions and earthquakes can be hazardous events, and many researchers work to better understand and predict their timescales. Improvements in the understanding of the intrinsic processes of deposition and strain accumulation that lead to these events have resulted in better constraints on the timescales of each process individually. There are however several mechanisms by which these two systems may plausibly become linked. River deposition and avulsion can affect the stress on underlying faults through differential loading by sediment or water. Conversely, earthquakes can affect river avulsion patterns through altering the topography. These interactions may alter the event recurrence timescales, but this dynamic has not yet been explored. We present results of a simple numerical model, in which two systems have intrinsic rates of approach to failure thresholds, but the state of one system contributes to the other's approach to failure through coupling functions. The model is first explored for the simplest case of two linear approaches to failure, and linearly proportional coupling terms. Intriguing coupling dynamics emerge: the system settles into cycles of repeating earthquake and avulsion timescales, which are approached at an exponential decay rate that depends on the coupling terms. The ratio of the number of events of each type and the timescale values also depend on the coupling coefficients and the threshold values. We then adapt the model to a more complex and realistic scenario, in which a river avulses between either side of a fault, with parameters corresponding to the Brahmaputra River / Dauki fault system in Bangladesh. Here the tectonic activity alters the topography by gradually subsiding during the interseismic time, and abruptly increasing during an earthquake. The river strengthens the fault by sediment loading when in one path, and weakens it when in the other. We show this coupling can significantly affect earthquake and avulsion

  9. Elbow Dislocation with Complete Triceps Avulsion

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    S. V. Karuppiah

    2014-01-01

    Full Text Available Radio-ulnar Fracture dislocation of the elbow is a high-energy trauma which can be associated with significant ligamentous injury in adults. We report an unusual triad of injury in a patient with avulsion injury of the triceps. This injury can be thought of as a variant of “terrible triad” with dislocation of radio-ulnar joint, radial head fracture, and medial collateral ligament injury with avulsion of the triceps. Elbow has to be stabilized with early repair of the ligaments for a successful outcome.

  10. Pseudo-arthrosis repair of a posterior cruciate ligament avulsion fracture.

    NARCIS (Netherlands)

    Hoogervorst, P.; Gardeniers, J.W.M.; Moret-Wever, S.; Kampen, A. van

    2010-01-01

    A pseudo-arthrosis repair of a 4-year-old bony avulsion fracture of the PCL using a minimally invasive technique, screw fixation, and bone grafting is reported. The case presented seems to be rather unique due to the fragment size and the approach for pseudo-arthrosis repair. There was a good functi

  11. Arthroscopic Conjoint Tendon Transfer: A Technique for Revision Anterior Shoulder Stabilization.

    Science.gov (United States)

    Tennent, Duncan; Colaço, Henry B; Arnander, Magnus; Pearse, Eyiyemi

    2016-02-01

    Revision anterior stabilization of the shoulder presents a challenge to the surgeon and carries a higher risk of recurrent dislocation than primary repair. The Latarjet procedure may be more reliable than revision soft-tissue repair but may not be indicated in patients without significant glenoid bone loss. We describe an arthroscopic technique of conjoint tendon transfer using a combination of suspensory and interference screw fixation for patients without significant glenoid bone loss (tendon, accurate bone tunnel placement, and subsequent labral repair. It avoids the additional steps of bone block preparation and the larger portals required for arthroscopic Latarjet techniques, in addition to eliminating potential complications due to coracoid bone block resorption. PMID:27274454

  12. Possible Complications of Ureteroscopy in Modern Endourological Era: Two-Point or “Scabbard” Avulsion

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    Andrius Gaizauskas

    2014-01-01

    Full Text Available Indication has led ureteroscopy to be a worldwide technique, with the expected appearance of multiple types of complications. Severe complications are possible including ureteral perforation or avulsion. Ureteral avulsion has been described as an upper urinary tract injury related to the action of blunt trauma, especially from traffic accidents, being the mechanism of injury, the result of an acute deceleration/acceleration movement. With the advent of endourology, that term is also applied to the extensive degloving injury resulting from a mechanism of stretching of the ureter that eventually breaks at the most weakened site, or ureteral avulsion is referred to as a discontinuation of the full thickness of the ureter. The paper presents a case report and literature review of the two-point or “scabbard” avulsion. The loss of long segment of the upper ureter, when end-to-end anastomosis is not technically feasible, presents a challenge to the urological surgeon. In the era of small calibre ureteroscopes these complications, due to growing incidence of renal stones will become more and more actual. Our message to other urologists is to know such a complication, to know the ways of treatment, and to analyse ureteroscopic signs, when to stop or pay attention.

  13. Possible complications of ureteroscopy in modern endourological era: two-point or "scabbard" avulsion.

    Science.gov (United States)

    Gaizauskas, Andrius; Markevicius, Marius; Gaizauskas, Sergejus; Zelvys, Arunas

    2014-01-01

    Indication has led ureteroscopy to be a worldwide technique, with the expected appearance of multiple types of complications. Severe complications are possible including ureteral perforation or avulsion. Ureteral avulsion has been described as an upper urinary tract injury related to the action of blunt trauma, especially from traffic accidents, being the mechanism of injury, the result of an acute deceleration/acceleration movement. With the advent of endourology, that term is also applied to the extensive degloving injury resulting from a mechanism of stretching of the ureter that eventually breaks at the most weakened site, or ureteral avulsion is referred to as a discontinuation of the full thickness of the ureter. The paper presents a case report and literature review of the two-point or "scabbard" avulsion. The loss of long segment of the upper ureter, when end-to-end anastomosis is not technically feasible, presents a challenge to the urological surgeon. In the era of small calibre ureteroscopes these complications, due to growing incidence of renal stones will become more and more actual. Our message to other urologists is to know such a complication, to know the ways of treatment, and to analyse ureteroscopic signs, when to stop or pay attention. PMID:25610699

  14. Combined preputial advancement and phallopexy as a revision technique for treating paraphimosis in a dog.

    Science.gov (United States)

    Wasik, S M; Wallace, A M

    2014-11-01

    A 7-year-old neutered male Jack Russell terrier-cross was presented for signs of recurrent paraphimosis, despite previous surgical enlargement of the preputial ostium. Revision surgery was performed using a combination of preputial advancement and phallopexy, which resulted in complete and permanent coverage of the glans penis by the prepuce, and at 1 year postoperatively, no recurrence of paraphimosis had been observed. The combined techniques allow preservation of the normal penile anatomy, are relatively simple to perform and provide a cosmetic result. We recommend this combination for the treatment of paraphimosis in the dog, particularly when other techniques have failed. PMID:25348145

  15. Triceps tendon avulsion and associated injuries of the elbow

    Science.gov (United States)

    Canbora, Kerem; Ozyurek, Selahattin; Gumussuyu, Gurkan; Kose, Ozkan

    2013-01-01

    A rupture or avulsion of the triceps tendon is very rare but concomitant elbow injuries with avulsion of the triceps tendon are even rarer. In this study, an extraordinary and unusual injury combination (radial head and trochlear fracture associated with triceps tendon avulsion), which happened during a fall onto the elbow with outstretched hand, was identified and has been discussed in the literature. PMID:23667221

  16. Traumatic avulsion of extraocular muscles: case reports

    Directory of Open Access Journals (Sweden)

    Nilza Minguini

    2013-04-01

    Full Text Available We described the clinical, surgical details and results (motor and sensory of the retrieving procedure of traumatically avulsed muscles in three patients with no previous history of strabismus or diplopia seen in the Department of Ophthalmology, State University of Campinas, Brazil. The slipped muscle portion was reinserted at the original insertion and under the remaining stump, which was sutured over the reinserted muscle. For all three cases there was recovery of single binocular vision and stereopsis.

  17. MRI of radiographically occult ischial apophyseal avulsions

    Energy Technology Data Exchange (ETDEWEB)

    Meyers, Arthur B. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, MLC 5031, Cincinnati, OH (United States); Children' s Hospital of Wisconsin, Milwaukee, WI (United States); Laor, Tal; Zbojniewicz, Andrew M.; Anton, Christopher G. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, MLC 5031, Cincinnati, OH (United States)

    2012-11-15

    Acute avulsions of unossified ischial apophyses in children may go undetected on radiography. Therapy includes rest and rehabilitation; however, substantial displacement may require surgery. Our purpose is to illustrate the utility of MRI in the detection of these radiographically occult injuries in skeletally immature children. This retrospective study of more than 5 years included children with ischial avulsions who were evaluated with both radiography and MRI within 3 weeks of acute injury. Initially, radiographs were reviewed to identify those children with unossified ischial apophyses. Subsequently, their MRI examinations were assessed for physeal disruption, bone/soft tissue edema, periosteal/perichondrial elevation and disruption. Initial and follow-up radiographs (if available) were reviewed. Patient age, symptoms and offending activity were determined from clinical records. Five children met inclusion criteria. All initial radiographs were normal. MRI showed: edema (n = 5), periosteal elevation (n = 4), periosteal/perichondrial disruption (n = 4), >5.5 mm displacement (n = 0). Follow-up radiographs in two children (2 and 2.5 months from MRI) showed osseous ischial irregularity. The apophyses remained unossified. Acute unossified ischial apophyseal avulsions in children may be radiographically undetected. In the setting of correlative clinical symptoms, MRI can be used to identify these injuries and to help direct appropriate therapy. (orig.)

  18. Flexor digitorum profundus tendon avulsion in an amateur basketball player: Jersey finger

    OpenAIRE

    KUYUBAŞI, Numan Sabit; ÇIRAKLI, Alper; ZENGİN, Çağatay Eyüp; Murat ERDOĞAN; PİŞKİN, Ahmet

    2013-01-01

    Flexor tendon injury of the finger may be open or closed, but it is not as common as extensor tendon injuries. Pathogenesis is associated with many factors. Sports injuries are also among those causes. Applied treatment approach is primary repair or pull-out technique. In this paper, we discussed the case in the light of the literature, that we performed repair via pull out technique for flexor digitorum profundus tendon avulsion in an amateur sportsman.

  19. Two-Tension-Band Technique in Revision Surgery for Fixation Failure of Patellar Fractures.

    Science.gov (United States)

    Xue, Zichao; Qin, Hui; Ding, Haoliang; Xu, Haitao; An, Zhiquan

    2016-01-01

    BACKGROUND Failed patellar fracture fixation is rare, and is usually attributed to technical errors. There are no specific details available on how to address this problem. We present our two-tension-band technique for fixing patellar fractures. MATERIAL AND METHODS Between March 2010 and March 2013, 4 men and 2 women with failed fixation patellar fractures were treated in our department. Their average age was 34 years (range 23-49 years). The initial fracture type was C1 in 3, C2 in 1, and C3 in 2, according to the AO classification. The initial fracture patterns included 3 transverse and 3 comminuted fractures. There were no open fractures. All patients underwent internal fixation with a modified anterior tension band (MATB) supplemented with cerclage wiring. All failures were caused by tension bands sliding past the tip of the Kirschner wires. The mean time between the primary and revision operations was 16.2 months (range 2-63 months). We revised the fractures by two-separate-tension-band technique. RESULTS The mean follow-up was 52 months (range 31-67 months). All patients healed radiographically without complications at an average of 14.7 weeks (range 8-20 weeks). The Bostman knee score was excellent in 3 and good in 3. All patients regained full extension and the mean range of flexion was 147.5° (135-155°). CONCLUSIONS Use of this two-tension-band technique can avoid technical errors and provide more secure fixation. We recommend it for both primary and revision surgery of patellar fractures. PMID:27485104

  20. Avulsion cycles and their stratigraphic signature on an experimental backwater-controlled delta

    Science.gov (United States)

    Ganti, Vamsi; Chadwick, Austin J.; Hassenruck-Gudipati, Hima J.; Lamb, Michael P.

    2016-09-01

    River deltas grow in large part through repeated cycles of lobe construction and channel avulsion. Understanding avulsion cycles is important for coastal restoration and ecology, land management, and flood hazard mitigation. Emerging theories suggest that river avulsions on lowland deltas are controlled by backwater hydrodynamics; however, our knowledge of backwater-controlled avulsion cycles is limited. Here we present results from an experimental delta that evolved under persistent backwater hydrodynamics achieved through variable flood discharges, shallow bed slopes, and subcritical flows. The experimental avulsion cycles consisted of an initial phase of avulsion setup, an avulsion trigger, selection of a new flow path, and abandonment of the parent channel. Avulsions were triggered during the largest floods (78% of avulsions) after the channel was filled by a fraction (0.3 ± 0.13) of its characteristic flow depth at the avulsion site, which occurred in the upstream part of the backwater zone. The new flow path following avulsion was consistently one of the shortest paths to the shoreline, and channel abandonment occurred through temporal decline in water flow and sediment delivery to the parent channel. Experimental synthetic stratigraphy indicates that bed thicknesses were maximum at the avulsion sites, consistent with our morphologic measurements of avulsion setup and the idea that there is a record of avulsion locations and thresholds in sedimentary rocks. Finally, we discuss the implications of our findings within the context of sustainable management of deltas, their stratigraphic record, and predicting avulsions on deltas.

  1. Combined Tibial Tubercle Avulsion Fracture and Patellar Avulsion Fracture: An Unusual Variant in an Adolescent Patient.

    Science.gov (United States)

    Stepanovich, Matthew T; Slakey, Joseph B

    2016-01-01

    Traumatic extensor dysfunction of the knee in children is a rare injury, with the majority resulting from tibial tubercle avulsion fracture or patellar sleeve fracture. We report a rare case of combined patellar avulsion fracture and tibial tubercle fracture. With open anatomic reduction, both injuries were successfully treated. While many variations of tibial tubercle fracture have been reported, the authors believe this to be the first report in the English-language literature of this particular combined injury to the knee extensor mechanism in an adolescent. Advanced imaging with computed tomography provided vital information to aid with operative planning, especially since the majority of the unossified tubercle was not seen on plain radiographs, and all fracture fragments were originally believed to be from the tibial tubercle. Computed tomography distinguished the patellar fracture from the tibial tubercle fragments, verifying preoperatively the complexity of the injury. PMID:26761925

  2. A Description of the Revised ATHEANA (A Technique for Human Event Analysis)

    Energy Technology Data Exchange (ETDEWEB)

    FORESTER,JOHN A.; BLEY,DENNIS C.; COOPER,SUSANE; KOLACZKOWSKI,ALAN M.; THOMPSON,CATHERINE; RAMEY-SMITH,ANN; WREATHALL,JOHN

    2000-07-18

    This paper describes the most recent version of a human reliability analysis (HRA) method called ``A Technique for Human Event Analysis'' (ATHEANA). The new version is documented in NUREG-1624, Rev. 1 [1] and reflects improvements to the method based on comments received from a peer review that was held in 1998 (see [2] for a detailed discussion of the peer review comments) and on the results of an initial trial application of the method conducted at a nuclear power plant in 1997 (see Appendix A in [3]). A summary of the more important recommendations resulting from the peer review and trial application is provided and critical and unique aspects of the revised method are discussed.

  3. Functional reconstruction following brachial plexus root avulsion

    Institute of Scientific and Technical Information of China (English)

    Guixin Sun; Cunyi Fan; Yudong Gu

    2007-01-01

    OBJECTIVE: To sum up the treatment of brachial plexus root avulsion and the progress in functional reconstruction and rehabilitation following brachial plexus root avulsion.DATA SOURCES: A search of Medline was performed to select functional reconstruction and rehabilitation following brachial plexus injury-related English articles published between January 1990 and July 2006, with key words of "brachial plexus injury, reconstruction and rehabilitation". Meanwhile, a computer-based search of CBM was carried out to select the similar Chinese articles published between January 1998 and July 2006,with key words of "brachial plexus injury, reconstruction and rehabilitation".STUDY SELECTION: The materials were checked primarily, and the literatures of functional reconstruction and rehabilitation of brachial plexus injury were selected and the full texts were retrieved.Inclusive criteria: ① Functional reconstruction following brachial plexus injury. ② Rehabilitation method of brachial plexus injury. Exclusive criteria: Reviews, repetitive study, and Meta analytical papers.DATA EXTRACTION: Forty-six literatures about functional reconstruction following brachial plexus injury were collected, and 36 of them met the inclusive criteria.DATA SYNTHESIS: Brachial plexus injury causes the complete or incomplete palsy of muscle of upper extremity. The treatment of brachial plexus is to displace not very important nerves to the distal end of very important nerve, called nerve transfer, which is an important method to treat brachial plexus injury.Postoperative rehabilitations consist of sensory training and motor functional training. It is very important to keep the initiativeness of exercise. Besides recovering peripheral nerve continuity by operation, combined treatment and accelerating neural regeneration, active motors of cerebral cortex is also the important factor to reconstruct peripheral nerve function.CONCLUSION: Consciously and actively strengthening functional

  4. APOPHYSEAL FRACTURE OR AVULSION OF THE GREATER TROCHANTER

    Science.gov (United States)

    FREITAS, ANDERSON; MACEDO, SÍLVIO LEITE DE

    2016-01-01

    ABSTRACTS The apophyseal fracture or avulsion of the greater trochanter occurs in skeletally immature patients. It has at etiological factors indirect mechanisms (avulsion) and direct mechanisms (trauma on the trochanter), the latter being the most common. The clinical presentation is easily identified and a simple X- ray can confirm the diagnosis. Regardless of the treatment chosen, this pathology has a high correlation with osteonecrosis of the femoral head, even as a rare fact, however with innocent appearance, on this pathology. PMID:27217820

  5. Analysis of the Gender Variable in the Eysenck Personality Questionnaire--Revised Scales Using Differential Item Functioning Techniques

    Science.gov (United States)

    Escorial, Sergio; Navas, Maria J.

    2007-01-01

    Studies in the field of personality have systematically found gender differences in two of the three dimensions of the Eysenck model: neuroticism and psychoticism. This study aims to analyze these differences in the Eysenck Personality Questionnaire--Revised (EPQ-R) scales using differential item functioning (DIF) techniques to determine whether…

  6. Diagnosis of nerve root avulsion injuries in adults with traumatic brachial plexopathies: MRI compared with CT myelography

    Directory of Open Access Journals (Sweden)

    Ewoudt van der Linde

    2015-03-01

    Full Text Available Background: Computed tomography myelography (CTM has been broadly adopted as the ‘gold standard’ imaging technique in the diagnosis of nerve root avulsion injuries in traumatic brachial plexopathies. CTM has the distinct advantage of better spatial resolution than magnetic resonance imaging (MRI; however, this technique is invasive and can result in significant patient discomfort. MRI, therefore, seems relatively more advantageous as it is less invasive (requires no lumbar puncture, lacks radiation exposure, has no adverse reactions related to intrathecal contrast agents and confers excellent soft-tissue contrast. Objectives: To compare the sensitivity and specificity of MRI with CTM in the diagnosis of preganglionic nerve root avulsion injuries in adults with traumatic brachial plexopathies at the Inkosi Albert Luthuli Central Hospital.Method: A retrospective comparative analysis was performed on 16 adult patients with traumatic preganglionic brachial plexopathies who underwent both MRI and CTM at Inkosi Albert Luthuli Central Hospital. Radiologists experienced in both CTM and MRI interpreted the data and a comparison was made using CTM as the gold standard. Results: The sensitivity and specificity for MRI detecting preganglionic nerve root avulsion injuries and pseudomeningoceles was 82% and 100% respectively. The interobserver agreement between CTM and MRI for the detection of preganglionic nerve root avulsion injuries was 81.25% (Kappa = 0.77 and 87.5% (Kappa = 0.84 for the detection of pseudomeningoceles. Conclusion: MRI was as sensitive as CTM at detecting preganglionic nerve root avulsion injuries and pseudomeningoceles of spinal nerve roots C7–T1 of the brachial plexus. Some mild discrepancies existed at the C5 and C6 nerve root levels. Owing to the invasiveness of the procedure and resultant patient discomfort, CTM should be reserved for complicated cases or for patients with contraindications to MRI.

  7. 前交叉韧带胫骨髁间棘撕脱骨折三种内固定生物力学研究%A biomechanical comparison of anterior cruciate ligament tibial eminence avulsion fracture under various techniques of fixation

    Institute of Scientific and Technical Information of China (English)

    韩亮; 黄长明; 范华强; 董辉详

    2012-01-01

    Objective To compare various techniques of fixation for anterior cruciate ligament tibial eminence avulsion fracture biomechanically. Methods By using 15 cadaveric human knees, three different fixation techniques of anterior cruciate ligament tibial eminence avulsion fractures were compared between suture fixation group, suture and cannulated screw fixation group, cannulated screw fixation group. The knee joint specimens were fixed at flexion of 30°and subject to continuous stretch stresses of 60, 90, 120 and 150 N respectively on a Material Test System-585, which conducted a simulated Lachman test. The specimens were scanned by 3D Digital Corp. Data were recorded and processed by geomagic studio 5.0 software to establish three techniques of fixation. Results There were significant differences between each fixation group in the mean length change of ACL (P <0.05). Suture and cannulated screw fixation group's was (3.53±0.24)mm, which was significantly the strongest among the three groups. Suture fixation group's was (5.75±0.53)mra, which was the smallest. Cannulated screw fixation group's was (4.63 ±0.37 )mm. Conclusion The initial ultimate strength of suture and cannulated screw fixation of tibial eminence fractures in these specimens is the strongest, followed by cannulated screw fixation. The suture fixation is the weakest%目的 探讨前交叉韧带(ACL)胫骨髁间棘撕脱骨折3种内固定方式的生物力学性能比较.方法 取防腐成人膝关节标本15具,随机分为三组,每组5具,标本制作成ACL胫骨髁间棘撕脱骨折后不同内固定方式模型,分别为:缝线组、缝线结合空心钉组、空心钉组.每具标本分别在MTS-858材料测试系统进行屈曲30°加载60、90、120、150 N正常、术后及疲劳后测试,模拟Lachman试验.实验过程中三维激光扫描仪从不同角度自动捕捉膝关节运动变化,采集实验数据,用geomagic studio 5.0软件处理.结果 不同应力及不同状态下三组

  8. Measurement of gastric emptying time of solids in healthy subjects using scintigraphic method: A revised technique

    International Nuclear Information System (INIS)

    The gastric emptying half time (GET) of solid food in 24 healthy volunteers (11 M/13 F) was evaluated using a revised technique and a gamma camera scan. Within 20 min and after 8 h of fasting, each volunteer ate two pieces of toast with a two-egg-omelette that was mixed with 18.5 MBq 99mTc-labelled phytate. The raw data were analysed in the MATLAB program to establish the gastric intestine tract (GI tract) biokinetic model. The GI tract model defines the metabolic mechanism with reference to five compartments, which are stomach, body fluid, small intestine (SI), upper large intestine and lower large intestine, according to the ICRP-30 report. The model was expressed using four simultaneous time-dependent differential equations. The gastric emptying half-time and T1/2eff(SI) of males were 62.6±15.4 and 149.8±204.1 min, respectively, and those of females were 98.8±16.3 and 131.6±38.4 min. (authors)

  9. [Aspects of expert opinions of avulsion fractures].

    Science.gov (United States)

    Schröter, F

    2016-03-01

    The apophyses as secondary ossification centers are connected with the bone by cartilage. During the growth phase of puberty, the apophyseal plate is a mechanical weak spot. Especially, apophyses in the hip and pelvic area are exposed to considerable tensile and sheer stresses due to the strong muscles which are inserted here. The frequency of injuries to the apophyses correlates with the extent of sporting activities. For athletes participating in "Youth Train for the Olympics", this is the most common injury of all. Most often, the apophysis of the rectus femoris muscle is affected at the anterior inferior iliac spine. In adults, after complete ossification of the apophyseal plate such injuries are rare. However, in a very unusual mechanism of injury with maximum forced hip flexion and simultaneous maximum knee extension, avulsions of the ischial tuberosity are observed in adults. During the causality test-especially in the legal area of statutory accident insurance-the question is always whether the alleged course of events has to be regarded as a legally significant (partial) cause or if a longer period of time has been involved, so that the resulting morbid apophysis detachment was predominately due to fate, in which the alleged event must be interpreted as legally immaterial. PMID:26924516

  10. Avulsion Fractures of the Knee: Imaging Findings and Clinical Significance

    Directory of Open Access Journals (Sweden)

    Babak Sanei

    2010-05-01

    Full Text Available The knee is an intricate joint with numerous tendinous, ligamentous, and meniscal attachments, which make it particularly vulnerable to complex injuries after trauma. A variety of avulsion fractures of the knee can occur, including Segond and reverse Segond fractures; avulsions of the anterior and posterior cruciate ligaments; arcuate complex avulsion; iliotibial band avulsion; avulsions of the biceps femoris, semimembranous, and quadriceps tendons; Sinding-Larsen-Johansson syndrome; and Osgood- Schlatter disease. These fractures often have a subtle appearance at conventional radiography, which is typically the first imaging modality performed in these cases. Advanced imaging modalities, particularly magnetic resonance imaging, are helpful and can provide valuable additional information for adequately defining the extent of damage. The onus is on the radiologist to identify the pattern of injury and to understand the substantial underlying damage that it frequently represents. Conveying this information to the referring clinician is crucial and represents the first step toward additional evaluation and probable orthopedic referral. By recognizing the significance of these injuries at initial presentation, radiologists can facilitate appropriate patient work-up and prevent the chronic morbidity associated with delayed treatment.

  11. Subtle Radiological Features of Splenic Avulsion following Abdominal Trauma

    Directory of Open Access Journals (Sweden)

    S. A. Rehim

    2010-01-01

    Full Text Available Splenic trauma in children following blunt abdominal injury is usually treated by nonoperative management (NOM. Splenectomy following abdominal trauma is rare in children. NOM is successful as in the majority of instances the injury to the spleen is contained within its capsule or a localised haematoma. Rarely, the spleen may suffer from an avulsion injury that causes severe uncontrollable bleeding and necessitates an emergency laparotomy and splenectomy. We report two cases of children requiring splenectomy following severe blunt abdominal injury. In both instances emergency laparotomy was undertaken for uncontrollable bleeding despite resuscitation. The operating team was unaware of the precise source of bleeding preoperatively. Retrospective review of the computed tomography (CT scans revealed subtle radiological features that indicate splenic avulsion. We wish to highlight these radiological features of splenic avulsion as they can help to focus management decisions regarding the need/timing for a laparotomy following blunt abdominal trauma in children.

  12. Iliac Crest Avulsion Fracture in a Young Sprinter.

    Science.gov (United States)

    Casabianca, L; Rousseau, R; Loriaut, P; Massein, A; Mirouse, G; Gerometta, A; Khiami, F

    2015-01-01

    Avulsion fracture of the iliac crest is an uncommon pathology. It usually occurs in teenagers during sport activities, more common in boys. We report a case of 16-year-old male competitive sprinter, who had an avulsion of a part of the iliac crest and the anterior-superior iliac spine during a competition. The traumatism occurred during the period of acceleration phase out of the blocks which corresponds to the maximum traction phase on the tendons. Then a total loss of function of the lower limb appears forcing him to stop the run. X-ray and CT scan confirmed the rare diagnosis of avulsion of the quasitotality of the iliac crest apophysis, corresponding to Salter 2 fracture. We performed an open reduction and internal fixation with two screws, allowing a return to sport after 3 months and his personal best record in the 100 meters at the 6th postoperative month.

  13. Iliac Crest Avulsion Fracture in a Young Sprinter

    Directory of Open Access Journals (Sweden)

    L. Casabianca

    2015-01-01

    Full Text Available Avulsion fracture of the iliac crest is an uncommon pathology. It usually occurs in teenagers during sport activities, more common in boys. We report a case of 16-year-old male competitive sprinter, who had an avulsion of a part of the iliac crest and the anterior-superior iliac spine during a competition. The traumatism occurred during the period of acceleration phase out of the blocks which corresponds to the maximum traction phase on the tendons. Then a total loss of function of the lower limb appears forcing him to stop the run. X-ray and CT scan confirmed the rare diagnosis of avulsion of the quasitotality of the iliac crest apophysis, corresponding to Salter 2 fracture. We performed an open reduction and internal fixation with two screws, allowing a return to sport after 3 months and his personal best record in the 100 meters at the 6th postoperative month.

  14. Treatment of Skin Avulsion Injuries with Basic Fibroblast Growth Factor

    OpenAIRE

    Hajime Matsumine, MD, PhD

    2015-01-01

    Summary: This report describes favorable outcomes in 9 patients with skin avulsion injuries of the extremities who underwent full-thickness skin grafting and basic fibroblast growth factor (bFGF) application. Following removal of contaminated subcutaneous fat tissue on the inside of skin, the avulsed skin was processed into a full-thickness skin graft, with as much of the skin used as possible irrespective of damage. Several drainage holes (5–10 mm in diameter) were made on the graft for drai...

  15. Displaced anterior cruciate ligament avulsion fractures: Arthroscopic staple fixation

    Directory of Open Access Journals (Sweden)

    S R Sundararajan

    2011-01-01

    Full Text Available Background: Anterior cruciate ligament (ACL avulsion fracture is commonly associated with knee injuries and its management is controversial ranging from conservative treatment to arthroscopic fixation. The aim of our study was to assess the clinical and radiological results of arthroscopic staple fixation in the management of ACL avulsion fractures. Materials and Methods: Twenty-two patients (17 males and 5 females who underwent arthroscopic staple fixation for displaced ACL avulsion fractures were analysed. The mean age was 32.2 years (15-55 years with a mean followup of 21 months (6-36 months. All patients were assessed clinically by calculating their Lysholm and International Knee Documentation Committee (IKDC scores and the radiological union was assessed in the followup radiographs. Results: The mean Lysholm score was 95.4(83-100 and the mean IKDC score was 91.1(77-100 at the final followup. In 20 patients anterior drawer′s test was negative at the end of final followup while two patients had grade I laxity. Associated knee injuries were found in seven cases. The final outcome was not greatly influenced by the presence of associated injuries when treated simultaneously. At final followup all the patients were able to return to their pre-injury occupation Conclusion: Arthroscopic staple fixation is a safe and reliable method for producing clinical and radiological outcome in displaced ACL avulsion fractures.

  16. Laterally positioned flap-revised technique along with platelet rich fibrin in the management of Miller class II gingival recession

    Directory of Open Access Journals (Sweden)

    Jagmohan Singh

    2013-01-01

    Full Text Available Gingival recession is a complex phenomenon that may present numerous therapeutic challenges to the clinician. The laterally positioned flap is commonly used to cover isolated, denuded roots that have adequate donor tissue laterally and vestibular depth. Various modifications in laterally sliding flap have been proposed in order to avoid the reported undesirable results on the donor teeth. Recently, use of growth factors has been proposed in combination with surgical techniques. This article highlights the use of laterally positioned pedicle flap-revised technique as a modification of laterally sliding flap technique along with autologous suspension of growth factors, platelet rich fibrin membrane (PRF for the management of localized Miller class-II gingival recession. After 6 months of follow-up, the clinical condition was stable with 80% root coverage and satisfactory gingival tissue healing at both donor and recipient site with no signs of inflammation. An excellent esthetical outcome was achieved and the patient was satisfied with case resolution.

  17. Determination of reactivity by a revised rod-drop technique in the muse-4 programme - comparison with dynamic measurements

    International Nuclear Information System (INIS)

    The MUSE-4 experimental programme in the zero power fast facility MASURCA at CEA Cadarache aims at studying accelerator-driven-systems (ADS). One of the main objectives is the qualification of measuring and monitoring sub-critical reactivities. Rossi α and Feynman α and pulsed neutron source techniques based on the use of the GENEPI deuteron accelerator are investigated to assess the prompt neutron decay constant a and to deduce the reactivity. Reactivity reference levels are determined using a revised rod drop technique and static source multiplication methods for comparison with values extracted from dynamic measurements. This article focuses on the determination of the inherent source and the reactivity sensitivity to kinetic constants and counting rate in the rod drop technique using the point kinetic model. (author)

  18. Revision Rotator Cuff Reconstruction for Large Tears With Retraction: A Novel Technique Using Autogenous Tendon and Autologous Marrow.

    Science.gov (United States)

    Skoff, Hillel D

    2015-07-01

    Revision rotator cuff reconstruction for large tears with retraction results in a high rate of recurrent cuff tearing. To try to obtain more consistent results, I conducted a study of a technique that addresses the potential factors involved. Ten patients (7 men, 3 women) were enrolled. Mean age was 58 years. Mean follow-up was 24 months. Mean time between primary and revision cuff surgery was 36 months. The cardinal inclusion criterion was a symptomatic, full-thickness rotator cuff tear with at least 3 cm of retraction in a shoulder that previously underwent rotator cuff repair. Ultrasound was used for postoperative radiographic assessment of cuff integrity. Validated Constant, American Shoulder and Elbow Surgeons (ASES), and University of California Los Angeles (UCLA) shoulder scoring systems were used. Surgical technique included mini-open incision, adequate débridement and mobilization of remaining cuff, reconstitution of cuff defect with autogenous biceps tendon incubated in concentrated autologous bone marrow, and sewing under zero tissue tension. Constant, ASES, and UCLA scores improved significantly (standard error at .001). Ultrasound revealed 0% incidence of full-thickness rotator cuff retearing. In patients with large recurrent retracted rotator cuff tears the technique presented in the current study consistently yields satisfactory clinical results and promotes rotator cuff tissue healing without full-thickness retearing.

  19. Age-dependent fracture risk in hip revisions with radial impaction grafting technique: a 5-10 year medium-term follow-up study.

    Science.gov (United States)

    Chomrikh, Laila; Gebuhr, Peter; Bierling, Roelf; Lind, Ulla; Zwart, Hendrik J J

    2014-02-01

    Radial impaction grafting (RIG) potentially improves the durability and reliability of cementing the femoral components in revision total hip arthroplasty (THA). In this multicenter, prospective study, 88 revision THAs (87 patients) with RIG technique were performed. The average follow-up time was 7.0 years (range, 5.0-10.2). There were 14 femur fractures: 2 intraoperative, 5 within 3 months after surgery, and 7 later in the postoperative stage (range, 5-84 months). Sixteen patients were lost to follow-up and 20 died without stem re-revision. None of the patients have been re-revised for any reason during follow-up. Age was observed to be a significant factor for determining fracture risk. In conclusion, RIG can be considered a reliable surgical technique, especially for younger patients. PMID:23891061

  20. Simultaneous bilateral tibal tubercle avulsion: A rare fracture

    Directory of Open Access Journals (Sweden)

    Hasan Metineren

    2013-12-01

    Full Text Available Tibial tuberosity avulsion is a rare fracture in adolescence.Due to the shear forces on the immature epiphysis. Thirteenyears old girl was admitted to the emergency departmentwith knee pain and tenderness in both knees afterjumping from a height of about one meter. İn examinationshe had tenderness and swelling over both tibial tuberosities.The patient could not do active knee extension. TypeIIA fracture on the left and type IIIA fracture on the rightknee were detected. For the patient’s fractures, closedreduction and fixation with 3 smooth Kirschner wires wasperformed. After immobilization in long-leg brace for threeweeks the brace was removed and she include in therehabilitation program. In this report, we discuss similarcases in the literature and the results of the treatment appliedto our patient.Key words: Tuberositas tibia, avulsion fracture, percutaneouspinning

  1. Heterotopic ossification following surgical treatment of avulsion fracture of the anterior inferior iliac spine

    OpenAIRE

    Gojković Zoran; Harhaji Vladimir; Milankov Miroslav Ž.; Drapšin Miodrag

    2011-01-01

    Avulsion fractures of the anterior inferior iliac spine are rare injuries of the pelvic ring and occur during sports activities. Hereby is presented a case of a 22-year-old professional football player who was diagnosed to have an avulsion fracture of the anterior inferior iliac spine on the right side four months after the initial injury and he was treated surgically with the excision of the avulsed fragment. The football player recovered completely and returned to his usual sports act...

  2. Physical Education Teachers’ Knowledge Assessment on Reimplant-Avulsion

    Directory of Open Access Journals (Sweden)

    Ana Flávia GRANVILLE-GARCIA

    2007-03-01

    Full Text Available Objective: To assess the knowledge on reimplant-avulsion of Physical Education Teachers’ in the city of Caruaru (PE. Methods: The study was carried on in the city of Caruaru, Pernambuco (BR, and the participants were 79 professionals who were interviewed through a standard questionnaire containing 11 questions related to dental avulsion as well as to the procedures to be followed in such cases.  Results: Only 20.3% of teachers knew what dental traumas are, but none of them had studied the subject during their undergraduate course.  It was explained to participants what a dental avulsion was and 44.3% of them answered that they had already seen this kind of trauma in their classes.  All professionals said they would give children a handkerchief or a towel for them to bite in order to control bleeding. 19% of the participants would not know what to do and 81% would wash the tooth in water. Most of them (86.1% recognized the importance of an immediate treatment; all of them said they would wrap the tooth in a paper napkin until the child was assisted; and 26.6% said they would suggest an analgesic for the pain.  Conclusion: Teachers did not show any knowledge of the emergency procedures that should be taken in a case of dental avulsion. The inclusion of such procedures in the programs of physical education courses and the availability of preventive educational programs is needed in order to increase the chances of a successful dental reimplant.

  3. Timing of pulp extirpation for replanted avulsed teeth.

    LENUS (Irish Health Repository)

    Stewart, Chris

    2009-01-01

    A search was performed (April 2004) across four databases, namely Ovid Medline, Cochrane Library, PubMed and Web of Science, relevant to the proposed PICO ( Patient or problem, Intervention, Comparison, Outcome) question: (P) for a replanted avulsed permanent tooth, (I) is early pulp extirpation within 10-14 days of replantation, (C) compared with delayed pulp extirpation, (O) associated an increased likelihood of successful periodontal healing after tooth replantation. Only articles published in the English language were considered.

  4. Atypical stress-avulsion fracture of the Lisfranc joint complex.

    LENUS (Irish Health Repository)

    O'Neill, Barry J

    2014-04-01

    Antiphospholipid syndrome and systemic erythematosus have been associated with metatarsal stress fractures. Stress fractures of the Lisfranc joint complex are uncommon injuries but have been reported to occur most frequently in ballet dancers. We present a case of an avulsion fracture of the Lisfranc joint complex that occurred spontaneously. We have reviewed the association between systemic conditions and metatarsal fractures and proposed a series of hypothetical pathological events that may have contributed to this unusual injury.

  5. TIBIAL TUBERCLE AVULSION FRACTURE IN A MALE ADOLESCENT.

    Science.gov (United States)

    Matoković, Damir; Šimić-Klarić, Andrea; Rajić, Marijana Tomić; Crnković, Helena Tesari; Jurinić, Mislav; Jovanović, Savo

    2015-06-01

    Tibial tuberosity fractures are rare in childhood, most frequently due to excessive quadriceps muscle contraction. On performing long jump, a 15-year-old boy sustained tibial tuberosity avulsion fracture type II according to Watson-Jones. The patient was treated operatively with fragment repositioning and screw fixation. Ten months after the injury and rehabilitation, he resumed his sports activities with full range knee motion. PMID:26415319

  6. Finger avulsion injuries: A report of four cases

    Directory of Open Access Journals (Sweden)

    Fejjal N

    2008-01-01

    Full Text Available Injury that occurs to a finger wearing a ring though rare can have grave consequences. It is a preventable injury which has a peculiar mode of trauma that is usually occupational. Injury ranges from simple contusion to degloving of soft tissues to traumatic amputation. We hereby report our experience of four cases of finger avulsion injuries due to a ring and discuss their variable clinical presentation and individualized management.

  7. Tibial avulsion fracture of the posterior root of the medial meniscus in children

    DEFF Research Database (Denmark)

    Iversen, Jonas Vestergård; Krogsgaard, Michael Rindom

    2012-01-01

    Few reports have described avulsion fractures of the posterior root of the medial meniscus in skeletally immature patients. This lesion should not be overlooked as it damages the load absorptive (distributive) function of the meniscus, increasing the risk of cartilage degeneration. Two cases of...... displaced avulsion fractures of the posterior root of the medial meniscus in children are presented along with a concise report of the literature regarding avulsion fractures of the posterior root of the medial meniscus. Both avulsions were reattached arthroscopically by trans-tibial pull-out sutures with a...

  8. Venous arterialization for the treatment of large-area foot skin retrograde avulsion.

    Science.gov (United States)

    Xiao, Wan-an; Jiang, Jia-xi; Tian, Feng; Li, Xiao-chuan; Tian, Li-jie

    2013-08-01

    Between 2009 and 2011, three patients with large-area foot skin retrograde avulsion (more than 1% of the body surface area) underwent venous arterialization. Anastomosis of the artery in the wound surface with the vein in the skin flap and an appropriate number of venous end-to-end anastomoses were performed. The skin flaps survived in all 3 patients. Six months postoperatively, the flap elasticity and appearance were close to that of normal skin, and foot function was better without scar contracture. When venous arterialization is used to treat foot avulsion, the following points should be noted. Surgical indications include no fresh bleeding from the wound edge of the avulsed skin after debridement, more complete avulsed skin, and superficial veins that do not completely separate from the avulsed skin. Venous arterialization is not suitable to avulsion with fresh bleeding, avulsed skin in small fragments, and avulsion with a subcutaneous venous network embolism. During debridement, the subcutaneous venous network should be protected to avoid exposing the vein stems outside the fat layer. If the avulsion is less than 1% of the body surface area, arterial-venous anastomosis can provide adequate blood supply. Venous-venous anastomosis is performed as much as possible to enhance venous return and decrease microcirculatory pressure, which is conducive to the establishment of effective blood circulation.

  9. The significance of avulsion phenomena in the alluvial filling configuration of a mountain stream: Venero Claro (Central Spain)

    Science.gov (United States)

    Ruiz-Villanueva, V.; Díez-Herrero, A.; Bodoque, J. M.; Fernández-García, P.; Ballesteros, J. A.

    2009-04-01

    In the dynamics and evolution of large river floodplains, alluvial fans and debris cones, avulsion phenomena have been considered very important. However, traditionally, in mountain streams, avulsion phenomena have been underestimated because they are not very frequent, and usually they are restricted to little chute cut-off. Nevertheless, there are mountainous areas where the valley bottom gets wider, and the alluvial filling works like an elongated debris cone. The Cabrera Stream in the Venero Claro reach (Spanish Central System) is one of these special areas. In this case, avulsion phenomena took place triggered by flash floods, and they were usually associated with hyperconcentrated flows, which exceeded the upper level of levees and banks, redefining the sedimentary architecture of the alluvial filling. In this study, an analysis of geomorphologic and sedymentological evolution of the alluvial filling in Venero Claro have been carried out. On this way, cartography made from the 19th Century until ninety ages were compared, and a stereoscopic analysis of aerial photographs and digital ortoimages were applied. Furthermore, the sedimentary filling was studied applying classic sedimentological techniques, such as a description and interpretation of sedimentary structures and facies analysis at field. As a result of the geomorphologic evolution analysis, a straightforward evolution model is proposed. This model enhances the relevant importance of the avulsion phenomena in the geomorphologic configuration of the Cabrera Stream in the Venero Claro reach. From the river pattern point of view, the avulsion phenomena originate capture processes in the main stream and its tributaries. As a result of these processes, the drainage network pattern changes successively from dendritic to sub-parallel. On other hand, from the sedimentologic point of view, the stratigraphy is composed of channel facies (debris flow facies and fluvial-torrential gravelbars) and back

  10. Storage media for avulsed teeth: a literature review.

    Science.gov (United States)

    Poi, Wilson Roberto; Sonoda, Celso Koogi; Martins, Christine Men; Melo, Moriel Evangelista; Pellizzer, Eduardo Pizza; de Mendonça, Marcos Rogério; Panzarini, Sônia Regina

    2013-01-01

    Dental avulsion is the most severe type of traumatic tooth injuries because it causes damage to several structures and results in the complete displacement of the tooth from its socket in the alveolar bone. The ideal situation is to replant an exarticulated tooth immediately after avulsion because the extraoral time is a determinant factor for treatment success and for a good prognosis. However, it is not always possible. The success of replantation depends on a number of factors that may contribute to accelerate or minimize the occurrence of root resorption or ankylosis, among which is the type and characteristics of the medium used for temporary storage during the time elapsed between avulsion and replantation. Maintaining the tooth in an adequate wet medium that can preserve, as longer as possible, the vitality of the periodontal ligament cells that remain on root surface is the key to success of replantation. Recent research has led to the development of storage media that produce conditions that closely resemble the original socket environment, with adequate osmolality (cell pressure), pH, nutritional metabolites and glucose, and thus create the best possible conditions for storage. Although these storage media can now be purchased in the form of retail products, the most common scenario is that such a product will not be readily available at the moment of the accident This paper reviews the literature on the different storage media that have been investigated for avulsed teeth based on full-length papers retrieved from PubMed/Medline, Lilacs, BBO and SciELO electronic databases using the key words 'storage medium', 'transportation medium', 'avulsion', 'tooth avulsion', 'replantation', 'tooth replantation', 'milk' and 'propolis'. After application of inclusion and exclusion criteria, 39 papers were selected and critically reviewed with respect to the characteristics, efficacy and ease of access of the storage medium. The review of the literature showed that a

  11. Isolated Avulsion of the Common Hepatic Duct from Blunt Abdominal Trauma

    Directory of Open Access Journals (Sweden)

    Victor W. Wong

    2012-01-01

    Full Text Available Isolated extrahepatic biliary tract injury following blunt abdominal trauma is rare. The underlying pathogenic mechanisms remain obscure, but include shear and/or compression forces on the biliary system. Associated morbidity rates are high and largely the result of delays in diagnosis. Imaging modalities commonly employed for diagnosis include ultrasonography, computed tomography, nuclear medicine, and magnetic resonance imaging. Percutaneous and endoscopic techniques have been used both for diagnosis and treatment. Treatment options are dictated by the stability of the patient and the extent of bile duct and concomitant injuries. In this paper, we discuss a case of isolated avulsion of the hepatic duct confluence following blunt trauma that was successfully managed with Roux-en-Y hepaticojejunostomy. To our knowledge, this specific injury pattern has not been previously reported.

  12. Radar-raingauge data combination techniques: a revision and analysis of their suitability for urban hydrology.

    Science.gov (United States)

    Wang, Li-Pen; Ochoa-Rodríguez, Susana; Simões, Nuno Eduardo; Onof, Christian; Maksimović, Cedo

    2013-01-01

    The applicability of the operational radar and raingauge networks for urban hydrology is insufficient. Radar rainfall estimates provide a good description of the spatiotemporal variability of rainfall; however, their accuracy is in general insufficient. It is therefore necessary to adjust radar measurements using raingauge data, which provide accurate point rainfall information. Several gauge-based radar rainfall adjustment techniques have been developed and mainly applied at coarser spatial and temporal scales; however, their suitability for small-scale urban hydrology is seldom explored. In this paper a review of gauge-based adjustment techniques is first provided. After that, two techniques, respectively based upon the ideas of mean bias reduction and error variance minimisation, were selected and tested using as case study an urban catchment (∼8.65 km(2)) in North-East London. The radar rainfall estimates of four historical events (2010-2012) were adjusted using in situ raingauge estimates and the adjusted rainfall fields were applied to the hydraulic model of the study area. The results show that both techniques can effectively reduce mean bias; however, the technique based upon error variance minimisation can in general better reproduce the spatial and temporal variability of rainfall, which proved to have a significant impact on the subsequent hydraulic outputs. This suggests that error variance minimisation based methods may be more appropriate for urban-scale hydrological applications.

  13. Clinical and neurobiological advances in promoting regeneration of the ventral root avulsion lesion

    NARCIS (Netherlands)

    Eggers, R.; Tannemaat, Martijn R; De Winter, F.; Malessy, Martijn J A; Verhaagen, J.

    2016-01-01

    Root avulsions due to traction to the brachial plexus causes complete and permanent loss of function. Until fairly recent, such lesions were considered impossible to repair. Here we review clinical repair strategies and current progress in experimental ventral root avulsion lesions. The current gold

  14. Break dance hip: Chronic avulsion of the anterior superior iliac spine

    Energy Technology Data Exchange (ETDEWEB)

    Winkler, A.R.; Barnes, J.C.; Ogden, J.A.

    1987-10-01

    A case of chronic, progressive avulsion of the anterior iliac spine leading to the formation of a long, attenuated spur of bone in an 18-year-old black male break dancer is described. The mechanism of formation appeared to be repetitive avulsion from break dancing.

  15. Break dance hip: Chronic avulsion of the anterior superior iliac spine

    International Nuclear Information System (INIS)

    A case of chronic, progressive avulsion of the anterior iliac spine leading to the formation of a long, attenuated spur of bone in an 18-year-old black male break dancer is described. The mechanism of formation appeared to be repetitive avulsion from break dancing. (orig.)

  16. Algorithm and techniques for using Sientra's silicone gel shaped implants in primary and revision breast augmentation.

    Science.gov (United States)

    Schwartz, Michael R

    2014-07-01

    With the 2006 Food and Drug Administration approval of round silicone gel breast implants in the United States, there still remained a lack of versatility in implant options. The approval of Sientra's shaped cohesive implants in 2012 brought with it the innovations needed to address varying patient needs. Because access to shaped devices is still fairly recent in the United States, some surgeons remain uncomfortable with implementing shaped cohesive gel implants into their practice. The author outlines surgical techniques and algorithms from experience with the Sientra shaped device, covering the preoperative stage, measurements (base diameter, sternal notch to nipple, tissue pinch, and nipple to inframammary fold), ideal first candidates, operative techniques, and complication avoidance, as well as important factors for shaped-implant selection, including chest base diameter, implant height, implant volume, and implant projection for the patient's desired outcome. With experience, surgeons will find new utility with shaped implants for a variety of patients in their practices.

  17. Techniques and Technology to Revise Content Delivery and Model Critical Thinking in the Neuroscience Classroom

    OpenAIRE

    Illig, Kurt R.

    2015-01-01

    Undergraduate neuroscience courses typically involve highly interdisciplinary material, and it is often necessary to use class time to review how principles of chemistry, math and biology apply to neuroscience. Lecturing and Socratic discussion can work well to deliver information to students, but these techniques can lead students to feel more like spectators than participants in a class, and do not actively engage students in the critical analysis and application of experimental evidence. I...

  18. Diagnosing adductor muscle avulsion at the symphysis pubis with ultrasound.

    Science.gov (United States)

    Chen, David J; Caldera, Franklin E; Kim, Woojin

    2014-04-01

    A 58-yr-old woman presented after experiencing left hip and groin pain for 1 mo. She denies any history of trauma, falls or any bruising, or history of sports injury or extreme physical exertion before her symptoms. On ultrasonography, she was found to have an avulsion tear at the origin of the adductor muscles, predominantly involving the adductor longus and brevis muscles. The treatment course was conservative: nonsteroidal anti-inflammatory drugs for pain control and physical therapy for muscle strengthening and balance improvement. Upon follow-up, she demonstrated significant improvement and resolution of her pain. PMID:24196970

  19. Techniques and Technology to Revise Content Delivery and Model Critical Thinking in the Neuroscience Classroom.

    Science.gov (United States)

    Illig, Kurt R

    2015-01-01

    Undergraduate neuroscience courses typically involve highly interdisciplinary material, and it is often necessary to use class time to review how principles of chemistry, math and biology apply to neuroscience. Lecturing and Socratic discussion can work well to deliver information to students, but these techniques can lead students to feel more like spectators than participants in a class, and do not actively engage students in the critical analysis and application of experimental evidence. If one goal of undergraduate neuroscience education is to foster critical thinking skills, then the classroom should be a place where students and instructors can work together to develop them. Students learn how to think critically by directly engaging with course material, and by discussing evidence with their peers, but taking classroom time for these activities requires that an instructor find a way to provide course materials outside of class. Using technology as an on-demand provider of course materials can give instructors the freedom to restructure classroom time, allowing students to work together in small groups and to have discussions that foster critical thinking, and allowing the instructor to model these skills. In this paper, I provide a rationale for reducing the use of traditional lectures in favor of more student-centered activities, I present several methods that can be used to deliver course materials outside of class and discuss their use, and I provide a few examples of how these techniques and technologies can help improve learning outcomes. PMID:26240525

  20. Treatment of Skin Avulsion Injuries with Basic Fibroblast Growth Factor

    Directory of Open Access Journals (Sweden)

    Hajime Matsumine, MD, PhD

    2015-04-01

    Full Text Available Summary: This report describes favorable outcomes in 9 patients with skin avulsion injuries of the extremities who underwent full-thickness skin grafting and basic fibroblast growth factor (bFGF application. Following removal of contaminated subcutaneous fat tissue on the inside of skin, the avulsed skin was processed into a full-thickness skin graft, with as much of the skin used as possible irrespective of damage. Several drainage holes (5–10 mm in diameter were made on the graft for drainage from the graft bed and to prevent seroma and hematoma formation. Genetically recombinant human bFGF was sprayed at a dose of 1 μg/cm2 onto the graft bed, which was then covered with the graft and sutured. Pressure immobilization with ointment gauzes and elastic bandages was administered for 1 week postoperatively, and the surface of the skin grafts that did not take was scraped away, preserving the revascularized dermal component on the debrided raw surface as much as possible. bFGF was sprayed again onto the debrided surface to promote epithelialization. Wound closure was achieved in all cases with conservative therapy. The surgical procedure was effective in preventing postoperative ulcer formation and scar contracture and resulted in wound healing with the formation of good-quality, flexible scars.

  1. Penile erectile dysfunction after brachial plexus root avulsion injury in rats

    Institute of Scientific and Technical Information of China (English)

    Guo Fu; Xuejia Li; Liqiang Gu; Bengang Qin; Li Jiang; Xijun Huang; Qinsen Lu; Dechun Zhang; Xiaolin Liu; Jiakai Zhu; Jianwen Zheng

    2014-01-01

    Our previous studies have demonstrated that some male patients suffering from brachial plexus injury, particularly brachial plexus root avulsion, show erectile dysfunction to varying degrees. However, the underlying mechanism remains poorly understood. In this study, we evaluated the erectile function after establishing brachial plexus root avulsion models with or without spinal cord injury in rats. After these models were established, we administered apomorphine (via a sub-cutaneous injection in the neck) to observe changes in erectile function. Rats subjected to simple brachial plexus root avulsion or those subjected to brachial plexus root avulsion combined with spinal cord injury had signiifcantly fewer erections than those subjected to the sham operation. Expression of neuronal nitric oxide synthase did not change in brachial plexus root avulsion rats. However, neuronal nitric oxide synthase expression was signiifcantly decreased in brachial plexus root avulsion + spinal cord injury rats. These ifndings suggest that a decrease in neuronal nitric oxide synthase expression in the penis may play a role in erectile dysfunction caused by the combi-nation of brachial plexus root avulsion and spinal cord injury.

  2. Avulsion fracture of the iliac crest in a child☆☆☆

    Science.gov (United States)

    Mortati, Rafael Borghi; Borghi Mortati, Lucas; Silva Teixeira, Matheus; Itiro Takano, Marcelo; Armelin Borger, Richard

    2014-01-01

    Avulsion fractures of the apophysis of the iliac crest have rare incidence and are little known. In this article, we report the case of an 11-year-old female patient who presented this injury after indirect trauma. From careful radiographic analysis, an avulsion fracture of the iliac crest was identified. It was decided to use nonsurgical treatment comprising analgesia and load restriction. This case report emphasizes the importance of suspecting avulsion fractures in cases of low-energy trauma, and also guides the treatment, so as to prevent functional deficit and deformities. PMID:26229818

  3. Skin avulsion injury during endotracheal tube extubation – case report of an unusual complication

    Directory of Open Access Journals (Sweden)

    Gurunluoglu Raffi

    2008-05-01

    Full Text Available Abstract We report a geriatric case with a full-thickness skin avulsion injury during extubation due to a tube securing tape used to fixate the endotracheal tube. The avulsed skin was sutured back to its original place. Based on this single geriatric patient, we recommend anesthesiologists/anesthetists and surgeons be aware of the potential risk of avulsing the skin with tape during a standard extubation procedure. This may especially occur in geriatric patients who have age related changes as decreased elasticity and resistance to shearing forces that predispose the skin to get traumatized easily.

  4. Surgical repair of central slip avulsion injuries with Mitek bone anchor--retrospective analysis of a case series.

    LENUS (Irish Health Repository)

    Chan, Jeffrey C Y

    2007-01-01

    The purpose of this study is to describe our technique of central slip repair using the Mitek bone anchor and to evaluate the treatment outcome. Eight digits in eight patients were reconstructed using the bone anchor: three little fingers, two middle fingers, two index fingers and one ring finger. There were two immediate and six delayed repairs (range from one day to eight months). Four patients had pre-operative intensive splinting and physiotherapy to restore passive extension of the proximal interphalangeal joint prior to central slip reconstruction. All patients have made good progress since surgery. No patient requires a second procedure and none of the bone anchors have dislodged or loosened. We conclude that the Mitek bone anchor is a reliable technique to achieve soft tissue to bone fixation in central slip avulsion injuries. We recommend that this technique be considered as a treatment option for patients requiring surgical repair.

  5. Combined anterior and posterior cruciate ligaments avulsion from the tibial side in adult patient: case report

    Directory of Open Access Journals (Sweden)

    Marcos George de Souza Leao

    2013-12-01

    Full Text Available The authors describe a rare case of a 28-year-old male patient, victim of motorcycle crash, with direct impact on the right knee, who sustained a bicruciate ligament fracture avulsion from the tibial side, dislocated and with large dimensions, without associated ligamentary lesions; he has undergone surgical treatment - open reduction and internal fixation, of the avulsions, and the follow up was at least six months, presenting good outcome using the Tegner -Lysholm scale.

  6. Displaced avulsion of the ischial apophysis: a hamstring injury requiring internal fixation.

    Science.gov (United States)

    Servant, C T; Jones, C B

    1998-09-01

    A case is reported of an adolescent sprinter who was chronically disabled by pain after non-operative management for an acute hamstring injury. He had sustained an avulsion fracture of the ischial apophysis with displacement of 2.5 cm. Avulsion fractures of the ischial apophysis with displacement of 2 cm or more are unusual, but they frequently result in a symptomatic non-union, and early diagnosis, open reduction, and internal fixation is to be encouraged.

  7. The Riverbed Evolution, Avulsions and Backwater Hydrodynamics on the Huanghe River Delta

    Science.gov (United States)

    Chu, Z.; Ganti, V.; Lamb, M. P.

    2013-12-01

    The Huanghe River is known for high suspended sediment concentration and resultant heavy sedimentation and frequent channel-shifting among major rivers in the world. This plain coastal river is the main contributor of terrestrial sediment to the Bohai Sea and the Yellow Sea. Since 1855, there have been 11 major avulsions (versus 4 avulsions on the Mississippi River during the Holocene) on the lower reach with an recurrence interval of ~10 years, developing individual lobes that build up the modern Huanghe River delta. We summarize the main features of riverbed evolution on the delta with a database of measured data. The observed avulsions on the delta often occurred along a persistent spatial node, whose distance from the shoreline scales with the computed backwater length. In order to explain the avulsion locations on the delta, and meanwhile to test the viewpoint of river backwater controls on avulsion locations on deltas, we simulate the long profile evolution of the riverbed on the delta considering river discharge, river plume spreading, land subsidence and sea level rise, with a 1D fluvial morphodynamic model. The main results from the numerical simulations provide insights into how the long profile of the river on the delta evolves at the time scales of flood events and avulsions.

  8. Clinical and neurobiological advances in promoting regeneration of the ventral root avulsion lesion.

    Science.gov (United States)

    Eggers, Ruben; Tannemaat, Martijn R; De Winter, Fred; Malessy, Martijn J A; Verhaagen, Joost

    2016-02-01

    Root avulsions due to traction to the brachial plexus causes complete and permanent loss of function. Until fairly recent, such lesions were considered impossible to repair. Here we review clinical repair strategies and current progress in experimental ventral root avulsion lesions. The current gold standard in patients with a root avulsion is nerve transfer, whereas reimplantation of the avulsed root into the spinal cord has been performed in a limited number of cases. These neurosurgical repair strategies have significant benefit for the patient but functional recovery remains incomplete. Developing new ways to improve the functional outcome of neurosurgical repair is therefore essential. In the laboratory, the molecular and cellular changes following ventral root avulsion and the efficacy of intervention strategies have been studied at the level of spinal motoneurons, the ventral spinal root and peripheral nerve, and the skeletal muscle. We present an overview of cell-based pharmacological and neurotrophic factor treatment approaches that have been applied in combination with surgical reimplantation. These interventions all demonstrate neuroprotective effects on avulsed motoneurons, often accompanied with various degrees of axonal regeneration. However, effects on survival are usually transient and robust axon regeneration over long distances has as yet not been achieved. Key future areas of research include finding ways to further extend the post-lesion survival period of motoneurons, the identification of neuron-intrinsic factors which can promote persistent and long-distance axon regeneration, and finally prolonging the pro-regenerative state of Schwann cells in the distal nerve.

  9. Valproic acid protects neurons and promotes neuronal regeneration after brachial plexus avulsion****

    Institute of Scientific and Technical Information of China (English)

    Qiang Li; Dianxiu Wu; Rui Li; Xiaojuan Zhu; Shusen Cui

    2013-01-01

    Valproic acid has been shown to exert neuroprotective effects and promote neurite outgrowth in several peripheral nerve injury models. However, whether valproic acid can exert its beneficial effect on neurons after brachial plexus avulsion injury is currently unknown. In this study, brachial plexus root avulsion models, established in Wistar rats, were administered daily with valproic acid dis-solved in drinking water (300 mg/kg) or normal water. On days 1, 2, 3, 7, 14 and 28 after avulsion injury, tissues of the C 5-T 1 spinal cord segments of the avulsion injured side were harvested to in-vestigate the expression of Bcl-2, c-Jun and growth associated protein 43 by real-time PCR and western blot assay. Results showed that valproic acid significantly increased the expression of Bcl-2 and growth associated protein 43, and reduced the c-Jun expression after brachial plexus avulsion. Our findings indicate that valproic acid can protect neurons in the spinal cord and enhance neuronal regeneration fol owing brachial plexus root avulsion.

  10. Fixation of tibial avulsion fractures of the posterior cruciate ligament using pull through suture and malleolar screw

    Directory of Open Access Journals (Sweden)

    Farzad Omidi Kashani

    2007-05-01

    Full Text Available BACKGROUND: Tibial avulsion fractures of the posterior cruciate ligament are not infrequent. However, controversies exist between the fixation of the fragments and their reconstruction in the cases with small bony fragments. This prospective study was undertaken to study the results after fixation of the fragments by the malleolar screw and the pull through suture techniques.  METHODS: From June 2003 to March 2005, 26 patients with acute isolated posterior cruciate ligament avulsion fracture of the tibial attachment were treated surgically at Qhaem and Emam Reza hospitals at Mashhad University of Medical Sciences. The screw fixation was used in 18 cases with large bony fragments and the suturing method for other cases who had small or comminuted fragments. The patients were followed for an average of 14 months; and according to The International Knee Documentation Committee the results were evaluated.  RESULTS:  All our patients were men and all the avulsion fractures achieved union at an average of 4.8 months (range, 3-8 months. All the patients had sever posterior instability (>10mm pre-operatively. However, when the union of the fracture was achieved, no one suffered severe instability.

    CONCLUSIONS: Both of these two techniques (especially screw fixation had satisfactory results. Although the number

  11. Aneurysmal bone cyst: revision of different techniques in imaging diagnostic. Quiste oseo aneurismatico: revision de diferentes tecnicas de diagnostico por la imagen

    Energy Technology Data Exchange (ETDEWEB)

    Parra Blanco, J.A.; Fernandez Echevarria, M.A.; Pagola Serrano, M.A.; Vara Vara, A.; Gonzalez Tutor, A. (Hospital Universitario ' ' Marques de Valdecilla' ' . Servicio de Radiodiagnostico. Santander (Spain))

    1993-05-01

    We study simple radiology, conventional tomography, computed tomography and angiography in 8 cases of aneurysmal bone cyst for the purpose of assessing the utility of these diagnostic techniques. Our results, in agreement with those in the literature, indicate that the presence of a generally well-defined lytic, insufflated lesion containing septi should suggest this disorder. (Author)

  12. Knowledge of emergency management of avulsed teeth among a sample of Egyptian parents

    Directory of Open Access Journals (Sweden)

    Abeer M. Abdellatif

    2011-04-01

    Full Text Available Traumatic dental injuries (TDIs frequently occur in society and may occur at home. The ultimate prognosis of an avulsed tooth occurring in a child may depend on the parents’ knowledge of appropriate emergency measures. Therefore this study aimed at evaluating the knowledge level of a sample of Egyptian parents in the management of a case of tooth avulsion in a child. A total of 985 parents attending a Pediatric Dental Clinic formed the sample of the study. A questionnaire comprising 13 questions in simple Arabic language was used. The parents were categorized into two groups according to their education level. The tabulated data were statistically analyzed using the Chi-square test. Markedly low knowledge levels were noted in both groups. This was evidenced in replanting the avulsed primary teeth, brushing and using antiseptics to clean the roots, holding the root instead of the crown, dry storage of the avulsed permanent teeth, and neglect over time from most of the parents. However, 24.3% of group 1 and 15.6% of group 2 chose milk as a transport medium. Therefore, educational programs would be necessary to improve awareness of the immediate management of avulsed teeth.

  13. Knowledge of physical education teachers about emergency management of tooth avulsion

    Directory of Open Access Journals (Sweden)

    Claudia Londero Pagliarin

    2011-01-01

    Full Text Available A great number of traumatic dental injuries occur at school, during sports-related activities. However, physical education teachers are often not prepared to provide emergency management of dental trauma in general and of tooth avulsion in particular. The aim of this study was to assess the knowledge of emergency management of tooth avulsion among physical education teachers at public and private schools of a city in southern Brazil. A questionnaire covering personal and professional information and eight multiple-choice questions to assess knowledge of emergency management of tooth avulsion was sent to 217 physical education teachers. Of a total of 217 questionnaires distributed, 102 returned. Only 23.5% of the teachers had received prior information on dental trauma. When asked about the fi rst action to be taken if faced with an avulsed tooth, only 12.7% informed they would attempt to replant the tooth. Fifty two teachers (51% were not aware of the optimum extraoral time. Signifi cant differences were found between teachers who had and who had not received prior information with regard to adequate transport medium and adequate time for replantation (chi-square, p = 0.03 and p = 0.02, respectively. There is a general lack of knowledge of emergency management of avulsed teeth among physical education teachers, pointing to an urgent need to implement regular, continuing education so as to increase the level of knowledge and improve prognosis of this important traumatic dental injury.

  14. Suture Anchor Fixation for Avulsion Fracture Around Knee%缝合锚钉技术治疗膝关节周围撕脱性骨折

    Institute of Scientific and Technical Information of China (English)

    曾金; 戴闽; 姚浩群; 李卫平; 张志宏; 刘虎诚; 雷刚刚

    2013-01-01

    Objective To investigate the feasibility and clinical efficacy of suture anchor fixation in avulsion fracture around the knee. Methods Thirty-seven cases of avulsion fracture a-round the knee were treated with Twinfix suture anchors,including 18 cases of avulsion fracture of lower pole of the patella,13 cases of avulsion fracture of medial femoral condyle,and 6 cases of avulsion fracture of external femoral condyle. Knee function and activity were assessed using the HSS knee score. Results were followed up with X-ray examination. Results All patients were fol-lowed-up for an average of 19. 3 months (range 12 to 48 months). After 6 months of follow-up,X-ray examination revealed the healing of avulsion fracture. HSS knee score was 86. 5 ± 4. 3. Among the 37 cases,the outcome was excellent in 28,good in 7 and fair in 2. The excellent and good rate was 94. 95%. Knee function was improved without ligamentous laxity and instability and other complications. Conclusion Suture anchor fixation is reliable for avulsion fracture around the knee. The technique conduces to the recovery of joint function and does not require the secondary surgery.%目的 探讨缝合锚钉技术治疗膝关节周围撕脱性骨折的方法和临床效果.方法 对37例膝关节周围撕脱性骨折患者采用Twinfix带线锚钉治疗,其中髌骨下极撕脱性骨折18例,股骨内髁撕脱性骨折13例,股骨外髁撕脱性骨折6例.评估术后膝关节HSS功能评分及膝关节活动度,随访X线检查结果.结果 所有患者均获得随访,随访时间12~48个月,平均19.3个月.术后6个月随访摄X线片显示撕脱性骨折均获得骨性愈合;HSS膝关节功能评分(86.5±4.3)分,优28例,良7例,中2例,优良率94.95%;无韧带松弛不稳及其他并发症,功能明显改善.结论 采用缝合锚钉技术治疗膝关节周围撕脱性骨折具有固定可靠、有助于关节功能恢复,且不需要二次手术的优点.

  15. Knowledge regarding emergency management of avulsed teeth among elementary school teachers in Jaboatão dos Guararapes, Pernambuco, Brazil

    Directory of Open Access Journals (Sweden)

    A de Lima Ludgero

    2012-01-01

    Conclusions: A lack of technical information was observed among teachers regarding management of tooth avulsion. Educational campaigns at schools are necessary to modify the behavior of the teachers with regard to management of tooth avulsion. Further studies should be carried out for the assessment of teachers who have participated in educational campaigns to make the treatment of dental trauma a matter of public interest.

  16. One-dimensional modeling of a recent Ganga avulsion : Assessing the potential effect of tectonic subsidence on a large river

    NARCIS (Netherlands)

    Gupta, Niladri; Kleinhans, Maarten G.; Addink, Elisabeth A.; Atkinson, Peter M.; Carling, Paul A.

    2014-01-01

    River avulsion as studied in small-sized and medium-sized rivers is partly explained by the water surface gradient advantage of a new channel course over the old course, caused by spatial differences in aggradation and compaction. Recently, the effect of meandering upstream of the avulsion node, or

  17. Large-scale avulsion of the late Quaternary Sutlej river in the NW Indo-Gangetic foreland basin

    Science.gov (United States)

    Singh, Ajit; Gupta, Sanjeev; Sinha, Rajiv; Carter, Andrew; Thomsen, Kristina J.; Mark, Darren F.; Buylaert, Jan-Pieter; Mason, Philippa J.; Murray, Andrew S.; Jain, Mayank; Paul, Debajyoti

    2015-04-01

    River avulsions are important processes in the spatial evolution of river systems in tectonically active sedimentary basins as they govern large-scale patterns of sediment routing. However, the pattern and timing of avulsions in large river systems are poorly documented and not well understood. Here we document late Quaternary paleo-river channel changes in the Indo-Gangetic basin of northwest India. Using a combination of satellite remote sensing and detailed sediment coring, we analyse the large-scale planform geometry, and detailed sedimentary and stratigraphic nature of a major fluvial sedimentary deposit in the shallow subsurface. This sediment body records aggradation of multiple fluvial channel fills. Satellite remote sensing analysis indicates the trace of the buried channel complex and demonstrates that it exists in region of the Himalayan foreland where no major rivers are currently present. Thus it records the former drainage pathway of a major river, which has since been diverted. We use optically stimulated luminescence dating techniques to develop an age model for the stratigraphic succession and hence constrain the timing of river channel existence and diversion. Provenance analysis based on U-Pb dating of detrital zircons and detrital mica Ar-Ar ages indicate sediment sources in the Higher Himalayan Crystalline and Lesser Himalayan Crystalline Series indicating that this paleo-river channel system formed a major perennial river derived from the main body of the Himalaya. Specifically we are able to fingerprint bedrock sources in the catchment of the present-day Sutlej river indicating that the paleo-fluvial system represents the former course of the Sutlej river prior to a major nodal avulsion to its present day course. Our results indicate that on geologically relatively short time-scales, we observe dramatic along strike shifts in the location of major Himalayan rivers. Our sediment records when combined with high-resolution dating and

  18. Reversal of phantom pain and hand-to-face remapping after brachial plexus avulsion.

    Science.gov (United States)

    Tsao, Jack W; Finn, Sacha B; Miller, Matthew E

    2016-06-01

    Following left brachial plexus avulsion, a 20-year-old man had phantom limb pain and remapping of sensation from his paralyzed hand onto his face. Mirror therapy (15 min daily, 5 days/week) led immediately to good movement of the phantom limb with decreased pain. Within 2 weeks following nerve graft surgery, remapping of hand sensation onto the face disappeared along with resolution of phantom limb pain. Mirror therapy coupled with nerve grafting may relieve phantom limb pain due to brachial plexus avulsion and reverse hand-to-face remapping, suggesting that both peripheral and central mechanisms mediate development of phantom limb pain and cortical reorganization/neuroplasticity after brachial plexus avulsion. PMID:27547774

  19. Avulsion fracture of the anterior inferior iliac spine with abundant reactive ossification in the soft tissue.

    Science.gov (United States)

    Resnick, J M; Carrasco, C H; Edeiken, J; Yasko, A W; Ro, J Y; Ayala, A G

    1996-08-01

    Patients who have sustained an avulsion fracture and present clinically during the healing phase of the injury may manifest a mass that clinically and radiographically mimics a malignant neoplasm. A 15-year-old male soccer goalkeeper presented with a large ossified mass in the soft tissues overlying the right hip 6 months after experiencing a popping sensation in his hip joint during a game. Although an osteosarcoma was suspected clinically and radiographically, a Tru-Cut needle biopsy of the lesion revealed reactive bone formation. Correlation of the clinical, radiographic, and pathologic findings indicated an avulsion fracture of the anterior inferior iliac spine with abundant reactive ossification in the soft tissues. The healing phase of an avulsion fracture may clinically and radiographically be mistaken for neoplasia. In such cases, a Tru-Cut needle biopsy may reveal the reactive nature of the process. PMID:8865496

  20. Avulsion of the brachial plexus in a great horned owl (Bubo virginaus)

    Science.gov (United States)

    Moore, M.P.; Stauber, E.; Thomas, N.J.

    1989-01-01

    Avulsion of the brachial plexus was documented in a Great Horned Owl (Bubo virginianus). A fractured scapula was also present. Cause of these injuries was not known but was thought to be due to trauma. Differentiation of musculoskeletal injury from peripheral nerve damage can be difficult in raptors. Use of electromyography and motor nerve conduction velocity was helpful in demonstrating peripheral nerve involvement. A brachial plexus avulsion was suspected on the basis of clinical signs, presence of electromyographic abnormalities in all muscles supplied by the nerves of the brachial plexus and absence of median-ulnar motor nerve conduction velocities.

  1. Avulsion fractures of the anterior inferior iliac spine: spectrum of imaging findings

    International Nuclear Information System (INIS)

    Avulsive injuries of the pelvic aphophyses are relatively common among 13-18 year old athletes, particularly among soccer players in Brazil. Diagnosis is made upon clinical and imaging findings. These lesions show three distinct phases: acute, repair and consolidation phases. Although acute and consolidation phases usually represent no diagnostic challenge, the repair phase may appear as an aggressive process on diagnostic images simulating neoplasic lesions. In this paper, the authors present the imaging findings of patients with avulsion of the anterior inferior iliac spine on plain radiographs, computerized tomography and magnetic resonance imaging, emphasizing the typical features of the three evolutive phases of these lesions. (author)

  2. Coconut Water (Cocos nucifera) as Storage Media for the Avulsed Tooth

    OpenAIRE

    Aan Mi’dad Arrizza; Amatul Firdaus Ramadhan

    2012-01-01

    Avulsion is a condition of tooth displacement outside the socket due to the trauma. In a case of tooth avulsion case of per-manent teeth, the treatment of choice is replanting the tooth back to the socket. The main concern prior to tooth replanta-tion is to maintain the vitality of periodontal ligament (PDL) cells. The vitality of PDL cells is crucial to form new perio-dontal ligament tissue to support the teeth in order to achieve the success of replantation treatment. Therefore the tooth st...

  3. Lumbar nerve root avulsions with secondary ipsilateral hip dysplasia in a child

    Energy Technology Data Exchange (ETDEWEB)

    Polyzoidis, Konstandinos; Vranos, Georgios [Department of Neurosurgery, Medical School, University of Ioannina, 45110, Ioannina (Greece); Petropoulou, Calliope; Argyropoulou, Paraskevi I.; Argyropoulou, Maria I. [Department of Radiology, Medical School, University of Ioannina, 45110, Ioannina (Greece); Sarmas, Ioannis [Department of Neurology, Medical School, University of Ioannina, 45110, Ioannina (Greece)

    2002-09-01

    We report on an 8-year-old child with avulsions of the left L3, L4 and L5 nerve roots and traumatic meningoceles that were not associated with lumbar spine or pelvic girdle fractures. The patient had a history of a road traffic accident. Plain radiographs of the pelvis revealed left hip dysplasia. The magnetic resonance imaging findings of the lumbar spine are illustrated. The pathogenesis of lumbar nerve root avulsions and their association with ipsilateral hip dysplasia are discussed. (orig.)

  4. Idiopathic odontoma formation following avulsion of immature permanent incisors: two case reports.

    Science.gov (United States)

    Motokawa, W; Braham, R L; Taniguchi, K

    1990-01-01

    From the findings of Case 1 and those cases reviewed in the literature it would appear that overfilling a canal with gutta percha prevents continued root formation after reimplantation of the tooth. The canal should be underfilled, therefore, if gutta percha is used as the obturating medium. Consequently, the authors recommend that calcium hydroxide be used as the root canal filling material of choice after reimplanting immature permanent teeth subsequent to traumatic avulsion. Since, however, calcium hydroxide paste tends to be resorbed, periodic refilling of the canal with the paste is required. Case 2 emphasizes the importance of periodic postoperative radiographic evaluation for several years after traumatic avulsion of immature permanent teeth.

  5. Revision Knee Surgery

    Medline Plus

    Full Text Available ... right. I still like to do a very traditional type of technique on my revisions in which ... middle third of the tubercle, sort of the traditional rotational landmark. I don’t want to overhang ...

  6. A retrospective study of 92 avulsed primary teeth in 69 children assisted at a dental urgency service

    Directory of Open Access Journals (Sweden)

    Orlando Aguirre Guedes

    2013-01-01

    Full Text Available The purpose of this study was to evaluate the epidemiological aspects associated with avulsion of primary teeth. The sample consisted of 92 avulsed teeth of 69 patients seen at the dental urgency service of the Dental School of the Federal University of Goiás, Brazil, from 1998 to 2005. The data obtained from the records included children’s gender and age, causes of tooth avulsion, daily and monthly distribution, type and number of avulsed teeth and the treatment procedures. Frequency distribution and the chi-square test were calculated. The level of significance was set at 5% for all analyses. The highest incidence was found among boys (52.17% aged 4 years (31.88%. The main etiologic factors were falls (82.61% and traffic accidents (5.80%. Most cases occurred during weekdays (82.61%, from March to June (autumn; n=28; 40.58% and from September to December (spring; n=18; 26.09%. Most avulsed teeth were maxillary central incisors (68.48%, followed by maxillary lateral incisors (22.83%. The most frequent treatments were analysis of clinical history and clinical exam (64 teeth; 69.57% and space maintainer (18 teeth; 19.57%. The epidemiological and clinical aspects of tooth avulsion in this study were similar to those reported in other studies. There was a high number of avulsed primary teeth in boys aged less than 4 years and caused by falls.

  7. Evaluation of sixth grade primary schoolchildren's knowledge about avulsion and dental reimplantation.

    Science.gov (United States)

    Castilho, Lithiene Ribeiro; Sundefeld, Maria Lucia Marçal Mazza; de Andrade, Dalton Francisco; Panzarini, Sônia Regina; Poi, Wilson Roberto

    2009-08-01

    Dental trauma, particularly tooth avulsion, is a frequent cause of tooth loss in children, adolescents, and young adults. The avulsed tooth should be immediately reimplanted in its alveolus. This procedure can be performed by anyone at the accident site and not only by dental surgeons. Therefore, the purpose of this study is to evaluate the knowledge of sixth graders of the city of Araçatuba, SP, about dental avulsion and tooth reimplantation through a structured and standardized survey. Our sample consisted of 778 students. The data collected was processed using the program EPIINFO 2000. Most students were around 12 years of age and 94.5% related to practice some kind of sports. Results demonstrated that the possibility of tooth reimplantation after dental avulsion is not acknowledged among these students and dental traumatism was associated to caries, toothache, and use of orthodontic appliances. Only 18.9% of the students associated dental traumatism to an impact trauma; 3.6% would store the tooth in milk, and 3.1% believed the tooth could be reimplanted by anyone present at the accident site. In summary, the results show an overall the lack of knowledge about dental traumatism and highlight the need of special programs designed to educate school-aged students about emergency procedures to handle cases of dental traumatisms. PMID:19459922

  8. Conservative treatment of anterior inferior and superior avulsion fractures of spina iliaca in adolescent amateur footballer

    Directory of Open Access Journals (Sweden)

    Umut Hatay Gölge

    2015-06-01

    Full Text Available The anterior inferior iliac spine (AIIS and the anterior superior iliac spine (ASIS avulsion fracture is a rare injury of pelvis. It usually occurs during the sport activities especially in football while hitting the ball. It is commonly misdiagnosed so that a detailed history and physical examination have a great importance. We present two cases of AIIS and ASIS avulsion fracture. Both of the patients applied to outpatient clinics with hip pain and difficulty in walking. History revealed the complaints started after hitting the ball during the football match and hip movements were limited. The patients were fifteen and sixteen years and after physical examination and radiological evaluation, avulsion fracture of the AIIS and the ASIS were diagnosed. Patients were treated conservatively with non-steroidal anti-inflammatory drugs and limited weight bearing with crutches for a month. The patients were free of pain and had full range of hip movements after one month period. At the end of the second month patients returned to active sports. AIIS and ASIS avulsion fractures are more common in adolescent football players but clinicians sometimes fail to diagnose this rare injury. We emphasize the importance of the detailed history and clinical examination and direct radiography could be enough for the diagnosis.

  9. Avulsions, channel evolution and floodplain sedimentation rates of the anastomosing upper Columbia River, British Columbia, Canada

    NARCIS (Netherlands)

    Makaske, B.; Smith, D.G.; Berendsen, H.J.A.

    2002-01-01

    Ages of channels of the anastomosing upper Columbia River, south-eastern British Columbia, Canada, were investigated in a cross-valley transect by C-14 dating of subsurface floodplain organic material from beneath levees. The avulsion history within the transect was deduced from these data, and morp

  10. Long-term effects of a lumbosacral ventral root avulsion injury on axotomized motor neurons and avulsed ventral roots in a non-human primate model of cauda equina injury.

    Science.gov (United States)

    Ohlsson, M; Nieto, J H; Christe, K L; Havton, L A

    2013-10-10

    Here, we have translated from the rat to the non-human primate a unilateral lumbosacral injury as a model for cauda equina injury. In this morphological study, we have investigated retrograde effects of a unilateral L6-S2 ventral root avulsion (VRA) injury as well as the long-term effects of Wallerian degeneration on avulsed ventral roots at 6-10 months post-operatively in four adult male rhesus monkeys. Immunohistochemistry for choline acetyl transferase and glial fibrillary acidic protein demonstrated a significant loss of the majority of the axotomized motoneurons in the affected L6-S2 segments and signs of an associated astrocytic glial response within the ventral horn of the L6 and S1 spinal cord segments. Quantitative analysis of the avulsed ventral roots showed that they exhibited normal size and were populated by a normal number of myelinated axons. However, the myelinated axons in the avulsed ventral roots were markedly smaller in caliber compared to the fibers of the intact contralateral ventral roots, which served as controls. Ultrastructural studies confirmed the presence of small myelinated axons and a population of unmyelinated axons within the avulsed roots. In addition, collagen fibers were readily identified within the endoneurium of the avulsed roots. In summary, a lumbosacral VRA injury resulted in retrograde motoneuron loss and astrocytic glial activation in the ventral horn. Surprisingly, the Wallerian degeneration of motor axons in the avulsed ventral roots was followed by a repopulation of the avulsed roots by small myelinated and unmyelinated fibers. We speculate that the small axons may represent sprouting or axonal regeneration by primary afferents or autonomic fibers. PMID:23830908

  11. A novel technique for impaction bone grafting in acetabular reconstruction of revision total hip arthroplasty using an ex vivo compaction device

    International Nuclear Information System (INIS)

    Impaction bone grafting allows restoration of the acetabular bone stock in revision hip arthroplasty. The success of this technique depends largely on achieving adequate initial stability of the component. To obtain well-compacted, well-graded allograft aggregates, we developed an ex vivo compaction device to apply it in revision total hip arthroplasty on the acetabular side, and characterized mechanical properties and putative osteoconductivity of allograft aggregates. Morselized allograft bone chips were compacted ex vivo using the creep technique and subsequent impaction technique to form the bone aggregates. Impaction allograft reconstruction of the acetabulum using an ex vivo compaction device was performed on eight hips. The mechanical properties and three-dimensional micro-CT-based structural characteristics of the bone aggregates were investigated. In clinical practice, this technique offered good reproducibility in reconstructing the cavity and the segmental defects of the acetabulum, with no migration and no loosening of the component. In vitro analysis showed that the aggregates generated from 25 g fresh-frozen bone chips gained compression stiffness of 13.5-15.4 MPa under uniaxial consolidation strain. The recoil of the aggregates after compaction was 2.6-3.9%. The compression stiffness and the recoil did not differ significantly from those measured using a variety of proportions of large- and small-sized bone chips. Micro-CT-based structural analysis revealed average pore sizes of 268-299 μm and average throat diameter of pores in the bone aggregates of more than 100 μm. These sizes are desirable for osteoconduction, although large interconnected pores of more than 500 μm were detectable in association with the proportion of large-sized bone chips. Cement penetration into the aggregates was related to the proportion of large-sized bone chips. This study introduces the value of an ex vivo compaction device in bone graft compaction in clinical

  12. PCL tibial avulsion with an associated medial meniscal tear in a child: a case report on diagnosis and management.

    LENUS (Irish Health Repository)

    2012-02-01

    Posterior cruciate ligament (PCL) injuries from tibial avulsions are rare in the paediatric setting. One would need a high index of suspicion as clinical examination may be difficult, especially in the early period. Magnetic resonance imaging is an excellent diagnostic modality for this condition and other associated injuries within the knee. We report a rare case in which the patient had a PCL avulsion off the tibial insertion site with an associated posterior horn medial meniscal tear off the posterior capsule. He was treated through open reduction and internal fixation of the avulsed fragment with suture repair of the meniscal tear. We emphasize the importance of diagnosing and managing associated intra-articular injuries when dealing with the rare condition of PCL tibial avulsion in the paediatric setting.

  13. A Middle to Late Holocene avulsion history of the Euphrates river: a case study from Tell ed-Dēr, Iraq, Lower Mesopotamia

    Science.gov (United States)

    An Heyvaert, Vanessa Mary; Baeteman, Cecile

    2008-12-01

    Geoarchaeological research was performed to reconstruct the floodplain history in the surroundings of two ancient Mesopotamian cities: Tell ed-Dēr and Sippar. The mapping of the floodplain is based on facies analyses of the sedimentary succession of 225 hand-operated boreholes. The archaeological sites Tell ed-Dēr and Sippar are closely linked to a palaeochannelbelt of the Euphrates, located in the western part of the study area. Channel activity started at least in ca 3100 BC/5050 cal BP, until ca 1400-1000 BC/3350-2950 cal BP. The channel belt was part of an avulsion driven multiple Euphrates channel network that gradually became abandoned from the second half of the 2nd millennium BC. A second mapped Euphrates, Tigris or Joint Euphrates -Tigris palaeochannel belt became abandoned well before 3100 BC. Examples of natural processes as well as human interactions triggering avulsion are given. Moreover, textual, archaeological and geological data show clearly that flood-control techniques and the construction of large-scale dikes seemed to be a common practice.

  14. Stress avulsion of the tibial tuberosity after tension band wiring of a patellar fracture: a case report

    OpenAIRE

    Hirschmann, Michael T; Wind, Björn; Mauch, Christian; Ickler, Gesa; Friederich, Niklaus F

    2009-01-01

    Introduction To the best of our knowledge there is no other report of an elderly patient who was surgically treated for a patellar fracture with tension band wiring and who subsequently suffered from an avulsion fracture of the tibial tuberosity. The combination of a patellar fracture and avulsion of the patellar ligament has only been described as complication after bone-patellar tendon-bone anterior cruciate ligament reconstructions. However, due to demographic changes and more elderly pati...

  15. Radiographic and Arthroscopic Assessment of DRUJ Instability Due to Foveal Avulsion of the Radioulnar Ligament in Distal Radius Fractures.

    Science.gov (United States)

    Nakamura, Toshiyasu; Iwamoto, Takuji; Matsumura, Noboru; Sato, Kazuki; Toyama, Yoshiaki

    2014-02-01

    Background As the triangular fibrocartilage complex (TFCC) anchors the distal radius to the ulna via the radioulnar ligament (RUL), a severely displaced distal fragment of the radius may be associated with a foveal avulsion of the TFCC. The purpose of this retrospective study was to assess, radiographically and arthroscopically, the relationship between displacement of the radius, the ulnar styloid, and avulsion of the RUL resulting in distal radioulnar joint (DRUJ) instability. Materials and Methods Twenty-nine wrists of 29 patients with intra- and extra-articular distal radius fractures/malunion who underwent reduction or a corrective osteotomy of the displaced/malunited fracture, and/or wrist arthroscopy, were assessed radiographically and arthroscopically. Radial translation, radial inclination, radial shortening, volar or dorsal tilt, and the presence of an ulnar styloid fracture with more than 4 mm of displacement were measured from the initial films. Radiocarpal arthroscopy was used to assess peripheral lesions of the TFCC, while DRUJ arthroscopy was used to assess the foveal attachment. The relationship between displacement of the distal radius or the ulnar styloid fracture and the TFCC injury, including avulsion of the RUL, was recorded. Results Univariate analysis revealed that increased radial translation, decreased radial inclination, increased radial shortening, and an ulnar styloid fragment radially displaced by more than 4 mm were significant predictors of RUL avulsion at the fovea. Volar or dorsal tilt of the radius and ulnar variance did not correlate with RUL avulsion or TFCC injuries. Multiple logistic regression analysis revealed that radial translation was an independent risk factor of foveal avulsion of the RUL. Conclusions Increased radial translation and radial shortening and decreased radial inclination of the distal fragment can be associated with a foveal avulsion of the RUL. Radial translation can be an independent risk

  16. The Brahmaputra River: a stratigraphic analysis of Holocene avulsion and fluvial valley reoccupation history

    Science.gov (United States)

    Hartzog, T. R.; Goodbred, S. L.

    2011-12-01

    The Brahmaputra River, one of the world's largest braided streams, is a major component of commerce, agriculture, and transportation in India and Bangladesh. Hence any significant change in course, morphology, or behavior would be likely to influence the regional culture and economy that relies on this major river system. The history of such changes is recorded in the stratigraphy deposited by the Brahmaputra River during the Holocene. Here we present stratigraphic analysis of sediment samples from the boring of 41 tube wells over a 120 km transect in the upper Bengal Basin of northern Bangladesh. The transect crosses both the modern fluvial valley and an abandoned fluvial valley about 60 km downstream of a major avulsion node. Although the modern Brahmaputra does not transport gravel, gravel strata are common below 20 m with fluvial sand deposits dominating most of the stratigraphy. Furthermore, the stratigraphy preserves very few floodplain mud strata below the modern floodplain mud cap. These preliminary findings will be assessed to determine their importance in defining past channel migration, avulsion frequency, and the reoccupation of abandoned fluvial valleys. Understanding the avulsion and valley reoccupation history of the Brahmaputra River is important to assess the risk involved with developing agriculture, business, and infrastructure on the banks of modern and abandoned channels. Based on the correlation of stratigraphy and digital surface elevation data, we hypothesize that the towns of Jamalpur and Sherpur in northern Bangladesh were once major ports on the Brahmaputra River even though they now lie on the banks of small underfit stream channels. If Jamalpur and Sherpur represent the outer extent of the Brahmaputra River braid-belt before the last major avulsion, these cities and any communities developed in the abandoned braid-belt assume a high risk of devastation if the next major avulsion reoccupies this fluvial valley. It is important to

  17. The usefulness of MR myelography for evaluation of nerve root avulsion in brachial plexus injury

    Energy Technology Data Exchange (ETDEWEB)

    Nishiura, Yasumasa; Ochiai, Naoyuki; Miyauchi, Yukio; Niitsu, Mamoru [Tsukuba Univ., Ibaraki (Japan). Inst. of Clinical Medicine

    2002-10-01

    Myelography has been the most popular and reliable method for evaluation of nerve root avulsion in brachial plexus injury. However, it is invasive because it requires the use of contrast medium, dural puncture and exposure to radiation. In addition, it has a fault. When a nerve rootlet is not filled with contrast medium, it is impossible to evaluate it. It has sometimes been a problem in the injury to upper roots. Recently, MRI also has been used for diagnosis of brachial plexus injury. But it was not until recently that it has had a high resolution to detect affected nerve rootlets. We have used MR myelography with high resolution for diagnosis of brachial plexus injury. The purpose of this study is to investigate the usefulness of it. MR myelography was preoperatively performed in 14 cases, consisting of 13 traumatic brachial plexus injuries and an obstetrical palsy. In them, 12 cases had root avulsion injuries and 2 cases had infraclavicular injuries. A 1.5 Tesla MR system (Philips) and a cervical coil were used. Coronal sections with 2 mm-overcontiguous thickness were obtained by heavily T2-weighted sequence fast spin echo (TR/TE=3000/450). The fat signal was suppressed by a presaturation inversion-pulse. The scanning time was about five minutes. The three-dimensional image was reconstructed by using maximum intensity projection (MIP) method. MIP images and individual coronal images were used for evaluation for root avulsion. In evaluation the shape of a nerve sleeve and nerve rootlets was compared on both sides. The abnormal shape of a nerve sleeve or the defect of nerve rootlets was diagnosed as root avulsion. The brachial plexus lesions were exposed operatively and examined with electrophysiologic methods (SEP and/or ESCP) in all cases. Operative findings were compared with MR myelography. Twenty-four roots had been diagnosed as normal and 46 roots had been diagnosed as root avulsion with MR myelography preoperatively. In the former only one root was

  18. The usefulness of MR myelography for evaluation of nerve root avulsion in brachial plexus injury

    International Nuclear Information System (INIS)

    Myelography has been the most popular and reliable method for evaluation of nerve root avulsion in brachial plexus injury. However, it is invasive because it requires the use of contrast medium, dural puncture and exposure to radiation. In addition, it has a fault. When a nerve rootlet is not filled with contrast medium, it is impossible to evaluate it. It has sometimes been a problem in the injury to upper roots. Recently, MRI also has been used for diagnosis of brachial plexus injury. But it was not until recently that it has had a high resolution to detect affected nerve rootlets. We have used MR myelography with high resolution for diagnosis of brachial plexus injury. The purpose of this study is to investigate the usefulness of it. MR myelography was preoperatively performed in 14 cases, consisting of 13 traumatic brachial plexus injuries and an obstetrical palsy. In them, 12 cases had root avulsion injuries and 2 cases had infraclavicular injuries. A 1.5 Tesla MR system (Philips) and a cervical coil were used. Coronal sections with 2 mm-overcontiguous thickness were obtained by heavily T2-weighted sequence fast spin echo (TR/TE=3000/450). The fat signal was suppressed by a presaturation inversion-pulse. The scanning time was about five minutes. The three-dimensional image was reconstructed by using maximum intensity projection (MIP) method. MIP images and individual coronal images were used for evaluation for root avulsion. In evaluation the shape of a nerve sleeve and nerve rootlets was compared on both sides. The abnormal shape of a nerve sleeve or the defect of nerve rootlets was diagnosed as root avulsion. The brachial plexus lesions were exposed operatively and examined with electrophysiologic methods (SEP and/or ESCP) in all cases. Operative findings were compared with MR myelography. Twenty-four roots had been diagnosed as normal and 46 roots had been diagnosed as root avulsion with MR myelography preoperatively. In the former only one root was

  19. Scintigraphy for diagnosis of avulsions of the origin of the suspensory ligament in horses: 51 cases (1980-1993)

    International Nuclear Information System (INIS)

    The medical records of 34 horses with a diagnosis of avulsion of the origin of the suspensory ligament that had been admitted to the veterinary medical teaching hospital between 1980 and 1993 were identified. In addition to clinical examination, 21 of 34 horses had scintigraphy and radiography performed during their examination. The usefulness of scintigraphy and radiography were assessed by comparing the initial findings reported in the medical record to those obtained in a retrospective review of the images. Thirty other horses with scintigraphic lesions of the proximal aspect of the third metacarpal/metatarsal bone but with a confirmed diagnosis other than avulsion of the suspensory ligament served as controls for lesion specificity. Scintigraphy (bone phase, n = 21) revealed increased uptake in all horses in both reviews. Only 14 of 21 (67%) horses radiographed, however, had at least 1 lesion during the initial radiographic evaluation that was reported to be suggestive of avulsion. When the radiographs were reviewed retrospectively, the radiologist identified 18 of 21 (86%) horses with lesions consistent with avulsion. The interpretation of scintigraphy appeared to be a more repeatable and sensitive diagnostic method than radiography. However, though scintigraphy was sensitive in identifying inflammation of the proximal aspect of the metacarpal/metatarsal region, no specific diagnosis of avulsion could be made without coincident radiography; the specificity of scintigraphy in diagnosing avulsion of the suspensory ligament was only 41% (21/51)

  20. MR Imaging findings of avulsion fracture of the tibial spine of the knee, focusing of cruciate ligament tear

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sang Won; Hong, Hoon Pyo; Ryu, Kyung Nam [Kyung Hee University Hospital, Seoul (Korea, Republic of); Jin, Wook [Gachon Medical School Gil Hospital, Incheon (Korea, Republic of)

    2003-04-01

    To determine the presence of cruciate ligament tears following avulsion injuries involving the ACL and PCL, and to correlate the findings with those of surgery. Between March 1997 and May 2002, avulsion injury involving the ACL and PCL was diagnosed in 19 patients. Ten of these [8 males and 2 females aged 10-51 (avergae, 27.7) years] were included in this study. We assessed the presence of cruciate ligament tears at MR imaging, correlating the findings with those of surgery. Associated intra-articular injuries, treatment methods and follow-up results were also evaluated. Among seven patients with ACL avulsion injury, this was assessed at MR imaging as complete tear (n=1), partial tear (n=5), or intact (n=1), while all MR images of PCL avulsion injury (n=3) showed that this was partial teat. All imaging findings corresponded with the surgical findings. In four patients there was associated knee injury involving, respectively, teats of the medial meniscus, lateral meniscus, PCL and MCL, and popliteal ligament. Our findings showed that with one exception, patients with avulsion injury of the ACL or PCL had suffered either a partial or complete tear. MR imaging may be useful in the diagnosis of tears of the cruciate ligament which have not been noticed at surgery or arthroscopy in avulsion injuries involving the ACL and PCL.

  1. MR Imaging findings of avulsion fracture of the tibial spine of the knee, focusing of cruciate ligament tear

    International Nuclear Information System (INIS)

    To determine the presence of cruciate ligament tears following avulsion injuries involving the ACL and PCL, and to correlate the findings with those of surgery. Between March 1997 and May 2002, avulsion injury involving the ACL and PCL was diagnosed in 19 patients. Ten of these [8 males and 2 females aged 10-51 (avergae, 27.7) years] were included in this study. We assessed the presence of cruciate ligament tears at MR imaging, correlating the findings with those of surgery. Associated intra-articular injuries, treatment methods and follow-up results were also evaluated. Among seven patients with ACL avulsion injury, this was assessed at MR imaging as complete tear (n=1), partial tear (n=5), or intact (n=1), while all MR images of PCL avulsion injury (n=3) showed that this was partial teat. All imaging findings corresponded with the surgical findings. In four patients there was associated knee injury involving, respectively, teats of the medial meniscus, lateral meniscus, PCL and MCL, and popliteal ligament. Our findings showed that with one exception, patients with avulsion injury of the ACL or PCL had suffered either a partial or complete tear. MR imaging may be useful in the diagnosis of tears of the cruciate ligament which have not been noticed at surgery or arthroscopy in avulsion injuries involving the ACL and PCL

  2. Nontraumatic avulsion of the lesser trochanter: A pathognomonic sign of metastatic disease?

    International Nuclear Information System (INIS)

    Isolated avulsion fractures of the lesser trochanter resulting from trauma are most commonly seen in adolescent athletes and are rare in adults. Standard therapy is nonsurgical with bedrest and immobilization of the leg. However, when this lesion is seen in the adult without significant trauma, it should be regarded as secondary to metastatic neoplasm until proven otherwise. Treatment should be surgical with prophylactic internal fixation of the hip to help prevent the commonly associated subtrochanteric pathologic fracture. In a patient without a known primary malignancy, biopsy should be carried out before therapy. We describe four patients with isolated avulsion fracture of the lesser trochanter due to metastatic carcinoma. Radiologists should be aware of this lesion because its presence has a decisive effect on therapy. (orig.)

  3. Cervical myelography of nerve root avulsion injuries using water-soluble contrast media.

    Science.gov (United States)

    Cobby, M J; Leslie, I J; Watt, I

    1988-08-01

    Eight cases of cervical nerve root avulsion injury are presented which were investigated by cervical myelography using a water-soluble contrast medium. The previous literature describes the appearances of this lesion using an oil-based agent and has resulted in emphasis being placed on looking for a traumatic meningocele rather than an abnormality of the roots themselves. The excellent definition of the nerve rootlets and axillary pouch that are obtained with a water-soluble contrast medium resulted in more root lesions per patient being detected than with an oil-based medium. There was complete correlation with the surgical findings at all but one root level explored. The appearances of root avulsion injuries and the advantages of using a water-soluble contrast medium are discussed. PMID:3416107

  4. Simultaneous bilateral avulsion fractures of the anterior superior iliac spines in an adolescent sprinter.

    Science.gov (United States)

    Boyce, Stephen H; Quigley, Michael A

    2009-01-01

    A 16-year-old boy presented to the emergency department with sudden onset of bilateral hip pain while performing in a 100 m sprint race. Examination revealed diffuse swelling and tenderness at both anterior superior iliac spines (ASIS). Pelvic x ray revealed bilateral displaced avulsion fractures of the ASIS at the origin of the sartorius muscle. He was managed conservatively with analgesia and bed rest with both hips held partially flexed at approximately 60°. Further x rays showed good healing and no further displacement of the avulsed fragments. Following physiotherapy he had a full range of hip movements at 6 weeks post-injury. He was able to return to full activity by 18 weeks post-injury.

  5. Evaluation of geophysical techniques for identifying fractures in program wells in Deaf Smith County, Texas: Revision 1, Topical report

    Energy Technology Data Exchange (ETDEWEB)

    Gillespie, R.P.; Siminitz, P.C.

    1987-08-01

    Quantitative information about the presence and orientation of fractures is essential for the understanding of the geomechanical and geohydrological behavior of rocks. This report evaluates various borehole geophysical techniques for characterizing fractures in three Civilian Radioactive Waste Management (CRWM) Program test wells in the Palo Duro Basin in Deaf Smith County, Texas. Emphasis has been placed on the Schlumberger Fracture Identification Log (FIL) which detects vertical fractures and provides data for calculation of orientation. Depths of FIL anomalies were compared to available core. It was found that the application of FIL results to characterize fracture frequency or orientation is inappropriate at this time. The uncertainties associated with the FIL information render the information unreliable. No geophysical logging tool appears to unequivocally determine the location and orientation of fractures in a borehole. Geologic mapping of the exploratory shafts will ultimately provide the best data on fracture frequency and orientation at the proposed repository site. 22 refs., 6 figs., 3 tabs.

  6. Evaluation of geophysical techniques for identifying fractures in program wells in Deaf Smith County, Texas: Revision 1, Topical report

    International Nuclear Information System (INIS)

    Quantitative information about the presence and orientation of fractures is essential for the understanding of the geomechanical and geohydrological behavior of rocks. This report evaluates various borehole geophysical techniques for characterizing fractures in three Civilian Radioactive Waste Management (CRWM) Program test wells in the Palo Duro Basin in Deaf Smith County, Texas. Emphasis has been placed on the Schlumberger Fracture Identification Log (FIL) which detects vertical fractures and provides data for calculation of orientation. Depths of FIL anomalies were compared to available core. It was found that the application of FIL results to characterize fracture frequency or orientation is inappropriate at this time. The uncertainties associated with the FIL information render the information unreliable. No geophysical logging tool appears to unequivocally determine the location and orientation of fractures in a borehole. Geologic mapping of the exploratory shafts will ultimately provide the best data on fracture frequency and orientation at the proposed repository site. 22 refs., 6 figs., 3 tabs

  7. Revising Translations

    DEFF Research Database (Denmark)

    Rasmussen, Kirsten Wølch; Schjoldager, Anne

    2011-01-01

    The paper explains the theoretical background and findings of an empirical study of revision policies, using Denmark as a case in point. After an overview of important definitions, types and parameters, the paper explains the methods and data gathered from a questionnaire survey and an interview...... survey. Results clearly show that most translation companies regard both unilingual and comparative revisions as essential components of professional quality assurance. Data indicate that revision is rarely fully comparative, as the preferred procedure seems to be a unilingual revision followed by a more...... or less comparative rereading. Though questionnaire data seem to indicate that translation companies use linguistic correctness and presentation as the only revision parameters, interview data reveal that textual and communicative aspects are also considered. Generally speaking, revision is not carried...

  8. Polish school nurses’ knowledge of the first-aid in tooth avulsion of permanent teeth

    OpenAIRE

    Baginska, Joanna; Rodakowska, Ewa; Milewski, Robert; Wilczynska-Borawska, Magdalena; KIERKLO, Anna

    2016-01-01

    Background The frequency of dental trauma in schools is secondary only to accidents at home. The aim of this study was to evaluate the knowledge of first aid in the avulsion of permanent teeth presented by Polish school nurses from different areas. Methods A cross-sectional study with the use of a structured self-administrative questionnaire was conducted in 2014 on school nurses working in randomly selected Polish provinces. The instrument consisted of demographic questions, questions referr...

  9. Adductor insertion avulsion syndrome with stress fracture of femoral shaft: MRI findings

    International Nuclear Information System (INIS)

    Full text: Chronic vague hip pain may be caused by stress-related injury in the proximal or mid-femoral diaphysis. This has been described as an entity called adductor insertion avulsion syndrome, or thigh splints. In the appropriate clinical setting, the radiologist interpreting the magnetic resonance imaging must be aware of this condition as its imaging findings are subtle. The diagnosis will help the clinician plan the appropriate management. Magnetic resonance imaging can also depict the complications such as stress fracture

  10. The Use of Aloe Vera Extract as a Novel Storage Media for the Avulsed Tooth

    OpenAIRE

    Samaneh Badakhsh; Tahereh Eskandarian; Tahereh Esmaeilpour

    2014-01-01

    Background: Tooth avulsion is one of the most severe dental traumas which most often occur in children. When immediate replantation is not possible, storage in a proper media may lead to a prolonged survival rate. Aloe Vera is a cactus like plant with green, tapered leaves that are filled with a transparent viscous gel. This medicinal plant has significant anti-inflammatory, antioxidant, antibacterial and antifungal effects. The purpose of this study was to assess the effectiveness of differe...

  11. The Effectiveness of Oral Rehydration Solution at Various Concentrations as a Storage Media for Avulsed Teeth

    OpenAIRE

    Eskandarian, Tahereh; Badakhsh, Samaneh; Esmaeilpour, Tahereh

    2013-01-01

    Introduction Following avulsion, the periodontal ligament (PDL) cells are at risk of necrosis. To achieve a favorable survival prognosis, the PDL cells must be kept viability. Therefore, immediate replantation is considered as the treatment of choice and in case it is not possible, storing the tooth in an appropriate storage media should be considered. Oral Rehydration Solution (ORS) is a glucose-electrolyte solution which can keep the optimal osmolality as well as pH and can even provide nut...

  12. Displaced avulsion fractures of the posterior cruciate ligament: Treated by stellate steel plate fixation

    Directory of Open Access Journals (Sweden)

    Lijun Li

    2015-01-01

    Full Text Available Background: The open reduction with internal fixation is an effective approach for treatment of avulsion fracture of posterior cruciate ligament. The previously used internal fixation materials including hollow screws, absorbable screw, tension bands and sutures have great defects such as insufficient fixation strength, susceptibility to re-fracture, etc. Stellate steel plate is novel material for internal fixation which has unique gear-like structure design. We used stellate steel plate for treatment of displaced avulsion fractures of posterior cruciate ligament in this study. Materials and Methods: 14 patients (9 men, 5 women; aged, 19-35 years; mean age, 28 years with displaced avulsion fractures of the tibial insertion of the posterior cruciate ligament were retrospectively analyzed between June 2009 and June 2011. The mean duration from injury to the operation was 8.3 days (range 6-15 days. All the patients were treated with open reduction and internal fixation of a stellate steel plate (DePuy, Raynham, MA 02767, USA. The Lysholm-Tegner knee function score criteria were used to analyze results. Results: The mean followup was 24.6 months (range 18-32 months. After 6 months, all the fractures healed and knee joint activity was normal, with no knee stiffness or instability. The Lysholm-Tegner scores were 97.1 ± 1.7 points at the final followup. Conclusion: Owing to its unique gear structure, the stellate steel plate design can effectively fix an avulsion fracture block and it is a simple operation with short postoperative rehabilitation time and firm fixation.

  13. Degeneration of primary afferent terminals following brachial plexus extensive avulsion injury in rats

    OpenAIRE

    Muñetón-Gómez, Vilma; Taylor, Julian S.; Averill, Sharon; Priestley, John V.; Nieto-Sampedro, Manuel

    2004-01-01

    Important breakthroughs in the understanding regeneration failure in an injured CNS have been made by studies of primary afferent neurons. Dorsal rhizotomy has provided an experimental model of brachial plexus (BP) avulsion. This is an injury in which the central branches of primary afferents are disrupted at their point of entry into the spinal cord, bringing motor and sensory dysfunction to the upper limbs. In the present work, the central axonal organization of primary afferents was examin...

  14. Heterotopic ossification following surgical treatment of avulsion fracture of the anterior inferior iliac spine

    Directory of Open Access Journals (Sweden)

    Gojković Zoran

    2011-01-01

    Full Text Available Avulsion fractures of the anterior inferior iliac spine are rare injuries of the pelvic ring and occur during sports activities. Hereby is presented a case of a 22-year-old professional football player who was diagnosed to have an avulsion fracture of the anterior inferior iliac spine on the right side four months after the initial injury and he was treated surgically with the excision of the avulsed fragment. The football player recovered completely and returned to his usual sports activities. Two years later, due to the pain in the hip an x-ray and MR image were made, which established the existence of crescent formation, a heterotopic bone, in the area of the anterior inferior iliac spine, which was surgically removed. Physical and medical therapy was conducted and after four months, the professional athlete was back playing football. Two years after the surgical excision of heterotopic ossification, the patient was completely asymptomatic with the same ROM without any thigh muscle hypotrophy, although isokinetic muscle testing did show some weakness of the thigh extensor muscles. An x-ray did not show any signs of heterotopic ossification.

  15. Pomegranate Juice (Punica Granatum): A New Storage Medium for Avulsed Teeth

    Science.gov (United States)

    Tavassoli-Hojjati, Sara; Aliasghar, Elham; Babaki, Fatemeh Ahmadian; Emadi, Fatemeh; Parsa, Maliheh; Tavajohi, Shohreh; Ahmadyar, Maryam; Ostad, Seyed Nasser

    2014-01-01

    Objective There is evidence indicating that pomegranate juice contains many of the essential properties necessary to retain cell viability and cell proliferation. These properties indicate that pomegranate juice is a suitable storage medium for avulsed teeth. However, this idea has not yet been tested. In this study, the capacity of pomegranate juice (PJ) as a storage medium for retaining avulsed teeth was evaluated. Materials and Methods: PDL fibroblasts were obtained from healthy human premolars and cultured in Dulbecco’s Modified Eagle’s Medium (DMEM). Cultured cells were subjected to different concentrations of pomegranate juice (PJ), 1% Hank’s balanced salt solution (HBSS) and tap water for 1, 3, 6 and 24 hours. PDL cell viability was assessed by the neutral red uptake assay. Results: The results indicated that 7.5% PJ was the most effective solution for maintaining PDL cell viability amongst all the experimental solution’s and time intervals (P<0.05). The results also showed that 1% PJ was as effective as HBSS for maintaining PDL cell viability. The amount of cell viability increased with increasing concentration of PJ at all time intervals (P<0.001). This effect is suggestive of the proliferative potential of PJ solution. Conclusion: In conclusion, PJ can be recommended as a suitable transport medium for avulsed teeth. PMID:24910699

  16. Pomegranate juice (punica granatum: a new storage medium for avulsed teeth.

    Directory of Open Access Journals (Sweden)

    Sara Tavassoli-Hojjati

    2014-04-01

    Full Text Available There is evidence indicating that pomegranate juice contains many of the essential properties necessary to retain cell viability and cell proliferation. These properties indicate that pomegranate juice is a suitable storage medium for avulsed teeth. However, this idea has not yet been tested. In this study, the capacity of pomegranate juice (PJ as a storage medium for retaining avulsed teeth was evaluated.PDL fibroblasts were obtained from healthy human premolars and cultured in Dulbecco's Modified Eagle's Medium (DMEM. Cultured cells were subjected to different concentrations of pomegranate juice (PJ, 1% Hank's balanced salt solution (HBSS and tap water for 1, 3, 6 and 24 hours. PDL cell viability was assessed by the neutral red uptake assay.The results indicated that 7.5% PJ was the most effective solution for maintaining PDL cell viability amongst all the experimental solution's and time intervals (P<0.05. The results also showed that 1% PJ was as effective as HBSS for maintaining PDL cell viability. The amount of cell viability increased with increasing concentration of PJ at all time intervals (P<0.001. This effect is suggestive of the proliferative potential of PJ solution.In conclusion, PJ can be recommended as a suitable transport medium for avulsed teeth.

  17. Revision of earthquake hypocenter locations in GEOFON bulletin data using global source-specific station terms technique

    Science.gov (United States)

    Nooshiri, N.; Saul, J.; Heimann, S.; Tilmann, F. J.; Dahm, T.

    2015-12-01

    The use of a 1D velocity model for seismic event location is often associated with significant travel-time residuals. Particularly for regional stations in subduction zones, where the velocity structure strongly deviates from the assumed 1D model, residuals of up to ±10 seconds are observed even for clear arrivals, which leads to strongly biased locations. In fact, due to mostly regional travel-time anomalies, arrival times at regional stations do not match the location obtained with teleseismic picks, and vice versa. If the earthquake is weak and only recorded regionally, or if fast locations based on regional stations are needed, the location may be far off the corresponding teleseismic location. In this case, implementation of travel-time corrections may leads to a reduction of the travel-time residuals at regional stations and, in consequence, significantly improve the relative location accuracy. Here, we have extended the source-specific station terms (SSST) technique to regional and teleseismic distances and adopted the algorithm for probabilistic, non-linear, global-search earthquake location. The method has been applied to specific test regions using P and pP phases from the GEOFON bulletin data for all available station networks. By using this method, a set of timing corrections has been calculated for each station varying as a function of source position. In this way, an attempt is made to correct for the systematic errors, introduced by limitations and inaccuracies in the assumed velocity structure, without solving for a new earth model itself. In this presentation, we draw on examples of the application of this global SSST technique to relocate earthquakes from the Tonga-Fiji subduction zone and from the Chilean margin. Our results have been showing a considerable decrease of the root-mean-square (RMS) residual in earthquake location final catalogs, a major reduction of the median absolute deviation (MAD) of the travel-time residuals at regional

  18. Process Management and Exception Handling in Multiprocessor Operating Systems Using Object-Oriented Design Techniques. Revised Sep. 1988

    Science.gov (United States)

    Russo, Vincent; Johnston, Gary; Campbell, Roy

    1988-01-01

    The programming of the interrupt handling mechanisms, process switching primitives, scheduling mechanism, and synchronization primitives of an operating system for a multiprocessor require both efficient code in order to support the needs of high- performance or real-time applications and careful organization to facilitate maintenance. Although many advantages have been claimed for object-oriented class hierarchical languages and their corresponding design methodologies, the application of these techniques to the design of the primitives within an operating system has not been widely demonstrated. To investigate the role of class hierarchical design in systems programming, the authors have constructed the Choices multiprocessor operating system architecture the C++ programming language. During the implementation, it was found that many operating system design concerns can be represented advantageously using a class hierarchical approach, including: the separation of mechanism and policy; the organization of an operating system into layers, each of which represents an abstract machine; and the notions of process and exception management. In this paper, we discuss an implementation of the low-level primitives of this system and outline the strategy by which we developed our solution.

  19. Surgical scar revision: An overview

    Directory of Open Access Journals (Sweden)

    Shilpa Garg

    2014-01-01

    Full Text Available Scar formation is an inevitable consequence of wound healing from either a traumatic or a surgical intervention. The aesthetic appearance of a scar is the most important criteria to judge the surgical outcome. An understanding of the anatomy and wound healing along with experience, meticulous planning and technique can reduce complications and improve the surgical outcome. Scar revision does not erase a scar but helps to make it less noticeable and more acceptable. Both surgical and non-surgical techniques, used either alone or in combination can be used for revising a scar. In planning a scar revision surgeon should decide on when to act and the type of technique to use for scar revision to get an aesthetically pleasing outcome. This review article provides overview of methods applied for facial scar revision. This predominantly covers surgical methods.

  20. Quadriceps Tendon Rupture and Contralateral Patella Tendon Avulsion Post Primary Bilateral Total Knee Arthroplasty: A Case Report

    Directory of Open Access Journals (Sweden)

    Gaurav Sharma

    2016-07-01

    Full Text Available Background: Extensor mechanism failure secondary to knee replacement could be due to tibial tubercle avulsion, Patellar tendon rupture, patellar fracture or quadriceps tendon rupture. An incidence of Patella tendon rupture of 0.17% and Quadriceps tendon rupture of around 0.1% has been reported after Total knee arthroplasty. These are considered a devastating complication that substantially affects the clinical results and are challenging situations to treat with surgery being the mainstay of the treatment. Case Description: We report here an interesting case of a patellar tendon rupture of one knee and Quadriceps tendon rupture of the contralateral knee following simultaneous bilateral knee replacement in a case of inflammatory arthritis patient. End to end repair for Quadriceps tear and augmentation with Autologous Hamstring tendon graft was done for Patella tendon rupture. OUTCOME: Patient was followed up for a period of 1 year and there was no Extension lag with a flexion of 100 degrees in both the knees. DISCUSSION: The key learning points and important aspects of diagnosing these injuries early and the management techniques are described in this unique case of bilateral extensor mechanism disruption following knee replacements.

  1. Association between fixation technique and revision risk in total hip arthroplasty patients younger than 55 years of age. Results from the Nordic Arthroplasty Register Association

    DEFF Research Database (Denmark)

    Pedersen, A B; Mehnert, F; Havelin, L I;

    2014-01-01

    Objectives: To evaluate implant survival following primary total hip replacement (THR) in younger patients. To describe the diversity in use of cup-stem implant combinations. Design: 29,558 primary THRs osteoarthritis (OA) patients younger than 55 years of age performed from 1995 through 2011 were...... identified using the Nordic Arthroplasty Registry Association database. We estimated adjusted relative risk (aRR) of revision with 95% confidence interval (CI) using Cox regression. Results: In general, no difference was observed between uncemented and cemented implants in terms of risk of any revision...... uncemented and hybrid implants led to elevated risk of revision due to other causes, as well as elevated risk of revision due to any reason within 2 years. 183 different uncemented cup-stem implant combinations were registered in Denmark, of these, 172 were used in less than 100 operations which is similar...

  2. Humeral windows in revision total elbow arthroplasty

    Science.gov (United States)

    Salama, Amir; Stanley, David

    2016-01-01

    The use of cortical windows for revision elbow arthroplasty has not previously been widely reported. Their use aids safe revision of a well fixed humeral prosthesis and can be used in the setting of dislocation, periprosthetic fracture or aseptic loosening of the ulnar component. We describe our technique and results of cortical windows in the distal humerus for revision elbow arthroplasty surgery. PMID:27583011

  3. Revision Notes

    CERN Document Server

    Matthewson, Siobhan; Debbadi, Margaret

    2012-01-01

    Revision Notes: CCEA ICT for GCSE has been written by experienced teachers and examiners so that you can be confident that it covers only the facts and ideas you will be expected to recall and use in the exam. - Essential facts are carefully organised to make revising easier. - Exams tips show you how to avoid losing marks and get the best grade. - Check your understanding questions support you in the run-up to the exams, with answers provided free online at www.hodderplus.co.uk. This book will help you plan and pace your revision to suit your learning needs and can be integrated with other re

  4. Peripheral nerve stimulation (PNS) in the trapezius muscle region alleviate chronic neuropathic pain after lower brachial plexus root avulsion lesion: A case report

    DEFF Research Database (Denmark)

    Sørensen, Jens Christian Hedemann; Meier, Kaare; Perinpam, Larshan;

    Peripheral nerve stimulation (PNS) in the trapezius muscle region alleviate chronic neuropathic pain after lower brachial plexus root avulsion lesion: A case report......Peripheral nerve stimulation (PNS) in the trapezius muscle region alleviate chronic neuropathic pain after lower brachial plexus root avulsion lesion: A case report...

  5. Ethical Revision.

    Science.gov (United States)

    Jackman, Mary Kathryn

    1994-01-01

    Discusses the dilemma of how to respond to student papers advancing morally repugnant positions. Advocates conceptualizing writing as an ethical act and connecting ethics and revision. Describes briefly how three such student papers were handled. (SR)

  6. Hip Revision

    Medline Plus

    Full Text Available Hip Revision Featuring the ZMR® Hip System Tapered Distal Stem Zimmer, Inc. Winfield, Illinois September 3, 2009 Welcome to this OR Live webcast presentation, brought to you by Zimmer. ...

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

    Science.gov (United States)

    Umemoto, Takahisa; Fukuda, Kimitaka; Kajino, Tomomichi

    2016-01-01

    Coracoid fractures are uncommon, mostly occur at the base or neck of the coracoid process (CP), and typically present with ipsilateral acromioclavicular joint (ACJ) dislocation. However, CP avulsion fractures at the coracoclavicular ligament (CCL) attachment with ACJ dislocation have not been previously reported. A 59-year-old woman receiving glucocorticoid treatment fell from bed and complained of pain in her shoulder. Radiographs revealed an ACJ dislocation with a distal clavicle fracture. Three-dimensional computed tomography (3D-CT) reconstruction showed a small bone fragment at the medial apex of the CP. She was treated conservatively and achieved a satisfactory outcome. CP avulsion fractures at the CCL attachment can occur in osteoporotic patients with ACJ dislocations. Three-dimensional computed tomography is useful for identifying this fracture type. CP avulsion fractures should be suspected in patients with ACJ dislocations and risk factors for osteoporosis or osteopenia. PMID:27493819

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

    Directory of Open Access Journals (Sweden)

    Yoshihiro Onada

    2016-01-01

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

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

    Science.gov (United States)

    Onada, Yoshihiro; Umemoto, Takahisa; Fukuda, Kimitaka; Kajino, Tomomichi

    2016-01-01

    Coracoid fractures are uncommon, mostly occur at the base or neck of the coracoid process (CP), and typically present with ipsilateral acromioclavicular joint (ACJ) dislocation. However, CP avulsion fractures at the coracoclavicular ligament (CCL) attachment with ACJ dislocation have not been previously reported. A 59-year-old woman receiving glucocorticoid treatment fell from bed and complained of pain in her shoulder. Radiographs revealed an ACJ dislocation with a distal clavicle fracture. Three-dimensional computed tomography (3D-CT) reconstruction showed a small bone fragment at the medial apex of the CP. She was treated conservatively and achieved a satisfactory outcome. CP avulsion fractures at the CCL attachment can occur in osteoporotic patients with ACJ dislocations. Three-dimensional computed tomography is useful for identifying this fracture type. CP avulsion fractures should be suspected in patients with ACJ dislocations and risk factors for osteoporosis or osteopenia. PMID:27493819

  10. Bilateral atraumatic tibial tubercle avulsion fractures: case report and review of the literature.

    Science.gov (United States)

    Khoriati, Al-Achraf; Guo, Shigong; Thakrar, Raj; Deol, Rupinderbir S; Shah, Khalil Y

    2015-04-01

    An avulsion fracture of the tibial tubercle is an uncommon injury, comprising less than 1% of all physeal injuries. The occurrence of such injuries bilaterally is even rarer. We report a case of bilateral atraumatic tibial tubercle avulsion fractures and its presentation, mechanism of injury, surgical management, post-operative rehabilitation and implications for clinical practice. A 17-year-old healthy male presented to the emergency department with severe pain on the anterior aspect of both knees and was unable to walk, having been brought in by ambulance after hearing a crack whilst jogging. On examination, there was significant swelling of both knees which were held in extension. On both sides there was a prominent deformity on the region of the tibial tubercle with a palpable gap, although no open skin wound. He was unable to actively move either knee joint. No neurovascular deficit was present. Plain radiographs revealed bilateral tibial tubercle avulsion fractures. Gentle manipulation was performed in the emergency department to the fragments in order to remove the tension from the skin. The fragments were reduced and fixed surgically with 4mm cannulated screws in an anterior to posterior direction. Both limbs were placed in temporary casts in 20 degrees of flexion. Postoperatively, the patient was kept non-weight bearing for four weeks then placed into a range of motion brace and movement commenced. Full weight bearing was permitted at the one month stage and he was advised to avoid any sporting activity until the 8 week stage and contact sports until the 10 week stage. Full movement of both joints was regained and the patient returned to full sporting activity in the absence of symptoms. This case emphasises the need for a high degree of vigilance when faced with such a presentation and a low threshold for further investigation and surgical intervention. PMID:25638599

  11. Stress avulsion fracture of the tarsal navicular. An uncommon sports-related overuse injury.

    Science.gov (United States)

    Orava, S; Karpakka, J; Hulkko, A; Takala, T

    1991-01-01

    We report nine cases of stress-related avulsion fracture of the tarsal navicular in athletes. This uncommon over-use injury is thought to occur following repetitive cyclic compressive loading secondary to an impingement of the tarsal navicular. The small dorsal triangular fragment is best seen in weightbearing lateral view radiographs and isotope scan and/or tomography help confirm the diagnosis. We feel that operative treatment is the method of choice in highly symptomatic cases and among top athletes because of the shorter recovery time. PMID:1897656

  12. The Use of Aloe Vera Extract as a Novel Storage Media for the Avulsed Tooth

    Directory of Open Access Journals (Sweden)

    Samaneh Badakhsh

    2014-07-01

    Full Text Available Background: Tooth avulsion is one of the most severe dental traumas which most often occur in children. When immediate replantation is not possible, storage in a proper media may lead to a prolonged survival rate. Aloe Vera is a cactus like plant with green, tapered leaves that are filled with a transparent viscous gel. This medicinal plant has significant anti-inflammatory, antioxidant, antibacterial and antifungal effects. The purpose of this study was to assess the effectiveness of different concentrations of Aloe Vera extract compared to DMEM (cell culture medium and egg white. Methods: The periodontal ligament (PDL cells were cultured and certain number of cells were treated with Aloe Vera extract (in four different concentrations, egg white and culture media for 1, 3, 6, and 9 hours. Cell viability was determined by using the (3-[4, 5-dimethylthiazolyl-2]-2, 5-diphenyltetrazolium bromide assay. Moreover, One-way ANOVA and post hoc (LSD test were used for analyzing the study groups. Results: The results indicate that culture media and Aloe Vera extract (10, 30, and 50% concentration were statistically similar and significantly preserved more PDL cells compared to other experimental storage media. Conclusion: Aloe Vera 10, 30, and 50% may be recommended as a suitable storage media for avulsed teeth.

  13. COMBINED TIBIAL AVULSION OF ANTERIOR AND POSTERIOR CRUCIATE LIGAMENT OF KNEE JOINT: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Ajaybir

    2015-01-01

    Full Text Available Avulsion fractures of tibial intercondylar eminence is a rare injury mainly affecting the pediatric population between 8 to 14 and is even rarer in adults with very few cases reported in literature. It occurs with high energy trauma in adults and may be associated with knee dislocation and neurovascular injuries. A 30 yr old male presented with a painful swollen left knee , limite d knee motion , and difficulty with weight bearing after a history of fall from motorcycle. Imaging revealed Type 3 Meyers and McKeever tibial spine avulsion of both ACL and PCL. A two staged surgical procedure was performed : (a Arthroscopic reduction and fixation with headed cannulated sc r ew of ACL tibial fragment; (b ORIF with headed cannulated screw of PCL tibial fragment via posterior approach to knee. Good functional outcome and early mobilization was achieved. Diagnostic arthroscopic helps to evaluat e the condition of the cruciate ligaments as well as fracture bed. Simultaneously fixation of ACL fragment with cannulated screw can be done , which is a simpler procedure to suture fixation. ORIF of PCL fragment in a staged manner has helped to address the injury in a detailed manner achieving goal of anatomical reduction and early mobilization.

  14. Efficacy of a comprehensive dental education program regarding management of avulsed permanent teeth as a valid indicator of increased success rate of treatment of avulsion in a North Indian population

    Directory of Open Access Journals (Sweden)

    Navneet Grewal

    2015-01-01

    Full Text Available Aims: To assess whether educating the parents, teachers, and intermediate school children of Amritsar city about the emergency management of tooth avulsion was an effective method of increasing success rate of treatment of avulsion. Subjects and Methods: Self-administered questionnaires were prepared for 200 parents, teachers, and for intermediate school children to assess baseline knowledge. Sociodemographic distribution of the targeted group was carried out applying Kuppuswamy scale. Two months later, flip cards and posters were distributed to the selected sample followed by a reinforcement session conducted after 1 month in the form of slide presentations on dental trauma. After 3 months, reassessment performance was distributed to the same participants for reassessing any change in baseline knowledge. Further analysis of knowledge, attitude, and practices were carried out after 6 months. The scores based on Likert scale ranging 0-3 were obtained and put to statistical analysis to analyze efficacy of this program 12 months from baseline data. Results and Conclusion: Wilcoxon signed ranked test was applied to nonparametric data to study the knowledge before and after education was carried out. There was a significant change in the knowledge level of children, teachers, and parents after the campaign and teachers showed more positive change in the practice of emergency management of tooth avulsion, endorsing the fact that comprehensive dental education programs targeting school teachers and children can change the perspective of individuals toward treatment needs for dental trauma involving avulsion.

  15. River diversions, avulsions and captures in the Tortuguero coastal plain

    Science.gov (United States)

    Galve, Jorge Pedro; Alvarado, Guillermo; Pérez Peña, José Vicente; Azañón, José Miguel; Mora, Mauricio; Booth-Rea, Guillermo

    2016-04-01

    The Tortuguero area is a coastal plain that forms part of the North Limón sedimentary basin, the back-arc region of the Caribbean side of Costa Rica. This coastal plain is characterised by an abnormal drainage pattern with river captures, diversions and shifts in channel directions. We are analyzing this anomalous drainage network adopting a classical geomorphological approach combined with geomorphometric techniques. The SRTM DEM at 1 arc-second of resolution (~30 m) from NASA, topographic maps 1:50,000, satellital images and the digital cartography of the drainage network have been used for inventorying the channel pattern anomalies. River segments were categorized according to sinuosity, orientation, slope changes and incision using GIS tools. Initially, anomalies in the analyzed river courses suggested that buried thrust fronts could disrupt their natural pattern. However, we have not identified any evidence to link the activity of buried structures with the disruption of natural drainage. Blind thrusts detected through seismic subsurface exploration in the SE sector of the Tortuguero plain do not seem to produce changes in the sinuosity, orientation, slope and incision of rivers as those observed in the deeply studied tectonically active area of the Po Plain (Italy). The identified river pattern anomalies have been explained due to other alternative causes: (1) the migration of the mouths of Reventazón, Pacuare and Matina rivers is produced by sand sedimentation in the coast because of a successive ridge beach formation. This migration to the SE has the same direction than the main ocean currents those deposited the sand. (2) The anomalous course of Parismina river is most probably conditioned by the fracturation of the dissected volcanic apron of Turrialba volcano. (3) Channel migration and capture of Barbilla river by Matina river can be triggered by the tectonic tilting of the coastal plain towards the SE. The subsidence of the SE sector of the plain was

  16. Isolated avulsion fracture of lesser tuberosity of the humerus: Review of the literature and report of two cases

    Directory of Open Access Journals (Sweden)

    Bilgehan Tosun

    2011-01-01

    Full Text Available Two cases of acute isolated avulsion fracture of the lesser tuberosity of the humerus and their short-term outcome are presented with a review of previously reported cases. Open reduction and internal fixation was performed. Outcomes were excellent, and the patients regained their normal pain-free shoulder function 3 months after the operation. This was a Level IV study.

  17. Avulsion of puborectalis muscle and other risk factors for cystocele recurrence: a 2-year follow-up study

    NARCIS (Netherlands)

    Weemhoff, M.; Vergeldt, T.F.; Notten, K.; Serroyen, J.; Kampschoer, P.H.; Roumen, F.J.M.E.

    2012-01-01

    INTRODUCTION AND HYPOTHESIS: This study aimed to determine the relationship of recurrent cystocele with avulsion of puborectalis muscle and other risk factors. METHODS: In this prospective observational cohort study, 245 women undergoing anterior colporrhaphy were invited for a 2-year follow-up visi

  18. Bifocal osseous avulsion of the patellar tendon from the distal patella and tibial tuberosity in a child.

    Science.gov (United States)

    Hermansen, Lars L; Freund, Knud G

    2016-03-01

    This case report describes a 12-year-old boy, who suffered an injury to the right knee in a skateboard accident. Radiographs and surgery confirmed the extremely rare bifocal avulsion fracture including the distal patellar pole and tibial tuberosity. Open reduction and internal fixation was accomplished, and 4-month follow-up demonstrated a good outcome.

  19. Acute avulsion fractures of the pelvis in adolescent competitive athletes: prevalence, location and sports distribution of 203 cases collected

    International Nuclear Information System (INIS)

    Objective. To describe the prevalence, location and sports distribution of pelvic avulsion fractures in adolescent competitive athletes. Design and patients. One thousand two hundred and thirty-eight radiographs of the pelvis taken for focal traumatic symptoms in athletes with an age range of 11-35 years over a period of 22 years were reviewed. Results. One hundred and ninety-eight adolescent athletes were affected by 203 avulsion fractures of the pelvic apophyses (five cases presented multiple locations). The localisation was the ischial tuberosity (IT) in 109 cases, anterior inferior iliac spine (AIIS) in 45 cases, anterior superior iliac spine (ASIS) in 39 cases, superior corner of pubic symphysis (SCPS) in 7 cases and iliac crest (IC) in 3 cases. Soccer (74 cases) and gymnastics (55 cases) were the sports with the highest number of avulsion fractures documented. Conclusions. Apophyseal avulsion fractures of the pelvis in adolescent competitive athletes are most common in soccer and gymnastics. The lesions are usually the consequence of sudden and forceful muscle-tendon contractions during sport activities. Plain radiographs, are determinant for the diagnosis. (orig.)

  20. Formulas of Revised MRP

    OpenAIRE

    Alfredo Bregni; Marco D’Avino; Valerio De Simone; Massimiliano M. Schiraldi

    2013-01-01

    Information sharing among supply chain echelons is now an acquired result. As a consequence, most of the traditional techniques and procedures in production management must be revised and updated, exploiting the opportunities provided by new technologies. This paper presents an improved version of Material Requirement Planning procedure, which assumes information sharing capabilities and permits the creation of new business opportunities. In Orlickyʹs MRP, orders are computed considering t...

  1. The "flying" bile duct: avulsion of the common bile duct in a plane crash survivor.

    LENUS (Irish Health Repository)

    Mohan, H

    2012-02-01

    Blunt trauma is an unusual cause of extrahepatic bile duct injury. This is a case of a 51-year-old gentleman who sustained a significant seatbelt injury in a plane crash. Laparotomy, performed due to persistent abdominal pain, revealed that the common bile duct (CBD) was completely avulsed from the duodenum. Following insertion of drains and transfer to a hepatobiliary centre, the devascularised CBD was excised and replaced with a roux-en-y hepaticojejunostomy. Necrotic tissue was debrided from the pancreatic head. A persistent bile leak developed from the sub-hepatic drain. Repeat laparotomy revealed a bile leak from small ducts on the liver surface. Ligation of the ducts and bioglue sealing of the area were successfully performed. Subsequent to this a pancreatic fistula developed from the main pancreatic duct, which has since resolved. This unusual case illustrates the need for prompt recognition and early repair to optimise outcomes in traumatic CBD injury.

  2. Log jams and flood sediment buildup caused channel avulsion in the Pennsylvanian of Atlantic Canada

    DEFF Research Database (Denmark)

    Gibling, Martin R; Bashforth, Arden Roy; Falcon-Lang, Howard J;

    2010-01-01

    Accumulations of logs and flood sediment frequently block modern channels and may trigger avulsion, but these effects are difficult to demonstrate for the ancient record. Braided-fluvial channels in the Pennsylvanian South Bar Formation of Atlantic Canada contain sandstone successions up to 6 m...... thick of sigmoidal cross-beds, plane beds, and antidunes, deposited rapidly at highflow-stage. These strata are commonly capped by accumulations up to 2.5 m thick of flattened, coalified logs and coal intraclasts (originally peat fragments), many of which are overlain by mudstone laid down in abandoned...... channels. The logs include lycopsids, calamiteans, tree ferns, pteridosperms and cordaitaleans, inferred to have grown on inactive braided tracts near the channels. A compaction estimate suggests that one log accumulation was originally more than four times its present thickness. Most accumulations...

  3. Type IV FDP avulsion: lessons learned clinically and through review of the literature.

    Science.gov (United States)

    Henry, Steven L; Katz, Mark A; Green, David P

    2009-12-01

    The type IV flexor digitorum profundus avulsion is a rare injury involving fracture of the volar base of the distal phalanx and separation of the tendon from the fracture fragment. Recommendations for management are sparse and are substantiated only by a few isolated case reports. We recently encountered two of these injuries, both of which proved challenging, particularly with regard to joint incongruity and tendon adhesions. In reviewing the literature, it is apparent that no consensus exists regarding surgical strategies. However, based on our experience and that of other authors, we can suggest the following: (1) high index of suspicion of this potentially deceptive injury, with use of magnetic resonance imaging or ultrasound if preoperative confirmation is needed; (2) rigid bony fixation that prevents dorsal subluxation of the distal phalanx; (3) tendon repair that is independent of the bony fixation; and (4) early range of motion therapy. PMID:19399559

  4. Proximal rectus femoris avulsion in an elite, olympic-level sprinter.

    Science.gov (United States)

    Langer, Phillip R; Selesnick, Harlan

    2010-11-01

    Quadriceps injuries, ranging from simple strains to disabling muscle ruptures, are common athletic injuries. The rectus femoris is the most commonly injure portion of the quadriceps musculature. This article is, to our knowledge, the first report of a proximal rectus femoris avulsion in an elite, Olympic-level 100-meter sprinter, acutely managed with surgical repair. Several key factors must be considered and carefully assessed when determining the appropriate course of management (ie, deciding between operative and nonoperative treatment): amount of distal retraction of the tendon, severity of associated soft-tissue trauma, physical examination, and postoperative goals (eg, return to elite-level competitive sports involving running or kicking vs resuming basic activities of daily living). We believe that these factors in our elite, high-performance athlete dictated an operative course of management.

  5. Avulsion of posterior primary teeth and space maintaining appliance: case report.

    Science.gov (United States)

    Rocha, M J; Cardoso, M; de Oliveira, J

    2000-01-01

    A four-year-old child was presented to the Pediatric Dentistry Clinic of the Federal University, 21 days after an incident in which canine first and second primary molar teeth were avulsed, due to a trauma to the face. This was confirmed on radiological examination. The clinical examinations showed that tissues were normal. A removable space-maintaining dental-mucosa supported appliance was made in acrylic resin to replace the three missing teeth. After a period of eight months, the tissues were preserved, the device is helping the child to eat, to speak, and preserving the appearance of the patient. Radiograph examinations have shown that the first molar tooth and canine, first pre molar and second pre molar teeth are erupting normally. Trauma in primary dentition can cause psychological, morphological and functional problems. In the presented case the treatment was planned to recuperate the function and to avoid problems from the premature loss of primary teeth.

  6. Class IIA ring avulsion injuries: an absolute indication for microvascular repair.

    Science.gov (United States)

    Nissenbaum, M

    1984-11-01

    The class II ring avulsion category, includes those patients in whom only digital arteries are damaged but all other structures are intact and functional (here labeled class IIA). Current literature suggests this is a rare lesion. Seven patients with this specific injury in whom the affected digits were nonviable are reported. Four of the seven were misdiagnosed on initial emergency room evaluation. Two did not seek additional medical attention and the condition progressed to necrosis and amputation. The other two, who sought additional treatment because of progressive ischemia, and three additional patients who were correctly diagnosed on initial examination underwent simple digital arterial repair. All digits operated on survived and demonstrated near normal function. Since failure to operate results in digital loss, this is an absolute indication for microvascular repair.

  7. Experimental studies on the treatment of traumatic dental avulsion in dogs

    International Nuclear Information System (INIS)

    The experiments were performed on 7 dogs aged between 2 and 4 years weighing 12-16 kg in the period October 1998- January 2000. After anaesthesia, the following dental procedures were accomplished; performance of a dental avulsion, endodontic treatment, apical dentotomy, tooth replantation and fixation with an orthodontic splint, figure-of-eight wire ligature and photopolymer. The treatment was effective in 71.4% of experimental replantations of incisors and the replanted teeth persisted for more than 8-9 months. The radiological survey showed that the regeneration began as early as the first post replantation days. In the period between days 30-45, a bone bridging was observed and the regeneration was complete by the end of the second month

  8. One-dimensional modeling of a recent Ganga avulsion: Assessing the potential effect of tectonic subsidence on a large river

    Science.gov (United States)

    Gupta, Niladri; Kleinhans, Maarten G.; Addink, Elisabeth A.; Atkinson, Peter M.; Carling, Paul A.

    2014-05-01

    River avulsion as studied in small-sized and medium-sized rivers is partly explained by the water surface gradient advantage of a new channel course over the old course, caused by spatial differences in aggradation and compaction. Recently, the effect of meandering upstream of the avulsion node, or bifurcation, was shown to have an equally large effect on avulsion duration as gradient advantage. These effects remain poorly understood for the largest rivers on Earth, where gradients are very small, subtle gradient advantages are affected by tectonics, and often several anabranches remain active simultaneously. Our objective was to assess the relative importance of these factors in the River Ganga in determining the pacing of an avulsion. We used a combination of historical data, remote sensing, and one-dimensional modeling. The course of the Ganga in historical times was through the present Ganga-Bhagirathi system but then there was either a gradual or sudden shift to the present Ganga-Padma system. Historical evidence and remnant paleochannels, as observed in satellite sensor data, corroborate the changing pattern of the Ganga River system, but the exact causes of the shifting and of the short avulsion duration remain unclear. Based on generalized data, using a one-dimensional model we ran idealized scenarios bracketing different tectonic subsidence estimates for long-term morphodynamic evolution of the upstream channel and the two downstream bifurcates. The model predicts flow and sediment partitioning at the bifurcation node, and includes the effect of migrating meanders at the bifurcation and width adjustment of the bifurcates. Our modeling demonstrates that the old and the new branches can remain 'open' and morphologically active for a long time because of the large backwater effect and the high mobility of the sediment. The bifurcation stabilizes at an asymmetrical flow and sediment division, which in smaller rivers (such as the River Rhine) would be followed

  9. Reimplantation combined with transplantation of transgenic neural stem cells for treatment of brachial plexus root avulsion

    Institute of Scientific and Technical Information of China (English)

    CHEN Lei; LU Lai-jin; MENG Xiao-ting; CHEN Dong; ZHANG Zhi-xin; YANG Fan

    2008-01-01

    Objective: To explore a new method to treat brachial plexus root avulsion experimentally by reimplantation combined with transplantation of neural stem cells (NSCs) modified by neurotrophin-3 gene (NT-3).Methods: The total RNA was extracted from neonatal rat striatum and the NT-3 cDNA was obtained by reverse transcription and amplified by polymerase chain reaction.The NT-3 gene was transferred into NSCs via the pLEGFP-Cl,an expression plasmid vectors.The untransfected NSCs,the pLEGFP-Cl treated NSCs,and the pLEGFP-Cl-NT-3 treated NSCs were transplanted into corresponding spinal cord segment with brachial plexus root avulsion.The survival,differentiation,and migration of the transplanted cells were determined under confoeal laser scanning microscope or by immunohistochemistry method.The nerve regeneration was evaluated by gross observation,electrophysiologieal examination and reverse horseradish peroxidase tracing.Results: The NT-3 gene was successfully amplified and transferred into neural stem cells via the plasmid vectors.The transplanted cells survived,differentiated,and migrated and NT-3 was expressed within the spinal cord.The animals regained some muscle strength which was less than 3-degree muscular strength according to the British Medical Research Council (BMRC) evaluating system.The resuits of electrophysiological examination and reverse horseradish peroxidase tracing were superior in the pLEGFP-Cl-NT-3 group to the NSCs untransfected group orthe pLEGFP-Cl group.Conclusion: Transplantation of NSCs modified by NT-3gene combined with reimplantantion is a relatively effective way to treat brachial plexus root avuision experimentally.It still need further study to improve the results.

  10. Surgical options in the management of cystic duct avulsion during laparoscopic cholecystectomy

    Directory of Open Access Journals (Sweden)

    Mirsharifi Rasoul

    2008-06-01

    Full Text Available Abstract Background Avulsion of cystic duct during laparoscopic cholecystectomy (LC is not a common intraoperative complication, but may be encountered by any laparoscopic surgeon. Surgeons are rarely familiar with management of this condition. Methods Patients with gall stone related problems who were scheduled for LC at the minimal invasive surgery unit of a tertiary referral hospital during a 5 years period (April 2002–April 2007 were prospectively enrolled. Results 12 cases were identified (incidence: 1.15%. All 12 patients had gallbladder inflammation. Five patients had acute and seven patients had chronic cholecystitis. The avulsed cystic duct (ACD was managed by clipping in 4, intracorporeal suturing in 3, converting to open surgery with suture ligation in 2, and lonely external drainage in 3 patients. Bile leakage had ceased within 3 days in 2, 14 days in one, and 20 days in the other patient. Bile volume increased gradually in one of the patients, which stopped only after endoscopic sphincterotomy (ES at 25th postoperative day. No major late complication or mortality occurred. Conclusion ACD during LC is a rare complication. Almost all standard methods of treatment yield to successful outcomes with low morbidity. According to the situation, ACD may be successfully managed laparoscopically. Available cystic stump remnant was clipped. Intracorporeal suture ligation was performed when short length of stump precluded clipping. Deeply retracted cystic duct with active bile leak led to conversion to open surgery. With minimal or no bile leak at ACD stump, closed tube drainage of sub-hepatic area was attempted. Persistent bile leak was assumed to be controlled by ES, successfully accomplished in one patient.

  11. Circumcision revision in male children

    Directory of Open Access Journals (Sweden)

    Mohammed A. Al-Ghazo

    2006-08-01

    Full Text Available OBJECTIVE: To determine indications for circumcision revision and to identify the specialty of the person who performed unsatisfactory primary circumcision. MATERIALS AND METHODS: The authors reviewed medical records of 52 cases that underwent circumcision revision over a 6-year period (1998 to 2004. Sleeve surgical technique was used for revision in patients with redundant foreskin or concealed penis, penoplasty for partial or complete degloving of the penis and meatotomy for external meatal stenosis. The mean age of children was 32 months (range 6 months to 9 years. RESULTS: Most of unsatisfactory primary circumcisions (86.7% were performed by laymen. All patients who underwent circumcision revision had good to excellent cosmetic results. CONCLUSION: Primary circumcision performed by laymen carry a high complication rate and serious complications may occur. A period of training and direct supervision by physicians is required before allowing laymen to perform circumcision independently.

  12. Admissible and Restrained Revision

    CERN Document Server

    Booth, R; 10.1613/jair.1874

    2011-01-01

    As partial justification of their framework for iterated belief revision Darwiche and Pearl convincingly argued against Boutiliers natural revision and provided a prototypical revision operator that fits into their scheme. We show that the Darwiche-Pearl arguments lead naturally to the acceptance of a smaller class of operators which we refer to as admissible. Admissible revision ensures that the penultimate input is not ignored completely, thereby eliminating natural revision, but includes the Darwiche-Pearl operator, Nayaks lexicographic revision operator, and a newly introduced operator called restrained revision. We demonstrate that restrained revision is the most conservative of admissible revision operators, effecting as few changes as possible, while lexicographic revision is the least conservative, and point out that restrained revision can also be viewed as a composite operator, consisting of natural revision preceded by an application of a "backwards revision" operator previously studied by Papini. ...

  13. Rehabilitation of Avulsed Teeth in Fractured Jaws via Bone Grafting and Implant Placement: Report of Two Cases.

    Science.gov (United States)

    Jain, Anshul; Baliga, Shridhar

    2015-07-01

    The maxillofacial region is one of the most injury-prone areas during road traffic accidents, personal violence, falls and sports. Maxillofacial trauma can lead to breakage or avulsion of upper anterior teeth, which may cause significant aesthetic and functional problems. There are many treatment options available for rehabilitation including removable partial dentures, fixed partial dentures, crown and bridges and implant-supported prostheses. Herein, two cases are presented where implant placement was done for upper anterior teeth, which were traumatized or avulsed following maxillofacial trauma. Both patients demonstrated a history of maxillofacial trauma and had undergone open reduction and internal fixation. The first patient had a severe maxillary alveolar defect treated via autogenous bone grafting and a six-month period was given for proper integration of the bone graft. The second patient was a smoker with very poor oral hygiene and a deep bite. Thus, implant placement was not initially justified. PMID:26877745

  14. Rehabilitation of Avulsed Teeth in Fractured Jaws via Bone Grafting and Implant Placement: Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Anshul Jain

    2016-01-01

    Full Text Available The maxillofacial region is one of the most injury-prone areas during road traffic accidents, personal violence, falls and sports. Maxillofacial trauma can lead to breakage or avulsion of upper anterior teeth, which may cause significant aesthetic and functional problems. There are many treatment options available for rehabilitation including removable partial dentures, fixed partial dentures, crown and bridges and implant-supported prostheses.Herein, two cases are presented where implant placement was done for upper anterior teeth, which were traumatized or avulsed following maxillofacial trauma. Both patients demonstrated a history of maxillofacial trauma and had undergone open reduction and internal fixation. The first patient had a severe maxillary alveolar defect treated via autogenous bone grafting and a six-month period was given for proper integration of the bone graft. The second patient was a smoker with very poor oral hygiene and a deep bite. Thus, implant placement was not initially justified.

  15. Evaluation of Avulsion-Induced Neuropathology in Rat Spinal Cords with 18F-FDG Micro-PET/CT.

    Directory of Open Access Journals (Sweden)

    Ze-Min Ling

    Full Text Available Brachial plexus root avulsion (BPRA leads to dramatic motoneuron death and glial reactions in the corresponding spinal segments at the late stage of injury. To protect spinal motoneurons, assessment of the affected spinal segments should be done at an earlier stage of the injury. In this study, we employed 18F-FDG small-animal PET/CT to assess the severity of BPRA-induced cervical spinal cord injuries. Adult Sprague-Dawley rats were randomly treated and divided into three groups: Av+NS (brachial plexus root avulsion (Av treated with normal saline, Av+GM1 (treated with monosialoganglioside, and control. At time points of 3 day (d, 1 week (w, 2 w, 4 w and 8 w post-injury, 18F-FDG micro-PET/CT scans and neuropathology assessments of the injured spinal roots, as well as the spinal cord, were performed. The outcomes of the different treatments were compared. The results showed that BPRA induced local bleeding and typical Wallerian degeneration of the avulsed roots accompanied by 18F-FDG accumulations at the ipsilateral cervical intervertebral foramen. BPRA-induced astrocyte reactions and overexpression of neuronal nitric oxide synthase in the motoneurons correlated with higher 18F-FDG uptake in the ipsilateral cervical spinal cord during the first 2 w post-injury. The GM1 treatment reduced BPRA-induced astrocyte reactions and inhibited the de novo nNOS expressions in spinal motoneurons. The GM1 treatment also protected spinal motoneurons from avulsion within the first 4 w post-injury. The data from this study suggest that 18F-FDG PET/CT could be used to assess the severity of BPRA-induced primary and secondary injuries in the spinal cord. Furthermore, GM1 is an effective drug for reducing primary and secondary spinal cord injuries following BPRA.

  16. A Prospective Outcome Evaluation of Humeral Avulsions of the Glenohumeral ligament (HAGL) Tears Repairs in an Active Population

    OpenAIRE

    Provencher, Matthew; McCormick, Frank; LeClere, Lance E.; Dewing, Christopher B.; Solomon, Daniel J.

    2014-01-01

    Objectives: Humeral Avulsions of the Glenohumeral ligament (HAGL) are an infrequent and underappreciated cause of shoulder instability and dysfunction. The purposes of this study are to prospectively evaluate the presentation, clinical history and surgical outcomes of patients with HAGL tears. Methods: Over an eight-year period, patients with failed non-operative shoulder dysfunction with a confirmed HAGL tear on MR Arthrogram, who elected to undergo surgical treatment were prospectively inve...

  17. Rehabilitation of Avulsed Teeth in Fractured Jaws via Bone Grafting and Implant Placement: Report of Two Cases

    OpenAIRE

    Anshul Jain; Shridhar Baliga

    2015-01-01

    The maxillofacial region is one of the most injury-prone areas during road traffic accidents, personal violence, falls and sports. Maxillofacial trauma can lead to breakage or avulsion of upper anterior teeth, which may cause significant aesthetic and functional problems. There are many treatment options available for rehabilitation including removable partial dentures, fixed partial dentures, crown and bridges and implant-supported prostheses.Herein, two cases are presented where implant pla...

  18. Avulsion of puborectalis muscle and other risk factors for cystocele recurrence: a 2-year follow-up study

    OpenAIRE

    Weemhoff, Mirjam; Vergeldt, Tineke F. M.; Notten, Kim; Serroyen, Jan; Kampschoer, Paul H. N. M.; Roumen, Frans J. M. E.

    2011-01-01

    Introduction and hypothesis This study aimed to determine the relationship of recurrent cystocele with avulsion of puborectalis muscle and other risk factors. Methods In this prospective observational cohort study, 245 women undergoing anterior colporrhaphy were invited for a 2-year follow-up visit consisting of a questionnaire, physical examination, and translabial 3D ultrasonography. Women with and without recurrent cystocele were compared to identify recurrence risk factors. Results Of the...

  19. Lithium accelerates functional motor recovery by improving remyelination of regenerating axons following ventral root avulsion and reimplantation.

    Science.gov (United States)

    Fang, Xin-Yu; Zhang, Wen-Ming; Zhang, Chao-Fan; Wong, Wai-Man; Li, Wen; Wu, Wutian; Lin, Jian-Hua

    2016-08-01

    Brachial plexus injury (BPI) often involves the complete or partial avulsion of one or more of the cervical nerve roots, which leads to permanent paralysis of the innervated muscles. Reimplantation surgery has been attempted as a clinical treatment for brachial plexus root avulsion but has failed to achieve complete functional recovery. Lithium is a mood stabilizer drug that is used to treat bipolar disorder; however, its effects on spinal cord or peripheral nerve injuries have also been reported. The purpose of this study was to investigate whether lithium can improve functional motor recovery after ventral root avulsion and reimplantation in a rat model of BPI. The results showed that systemic treatment with a clinical dose of lithium promoted motor neuron outgrowth and increased the efficiency of motor unit regeneration through enhanced remyelination. An analysis of myelin-associated genes showed that the effects of lithium started during the early phase of remyelination and persisted through the late stage of the process. Efficient remyelination of the regenerated axons in the lithium-treated rats led to an earlier functional recovery. Therefore, we demonstrated that lithium might be a potential clinical treatment for BPI in combination with reimplantation surgery. PMID:27185485

  20. Integrating Delta Building Physics & Economics: Optimizing the Scale of Engineered Avulsions in the Mississippi River Delta

    Science.gov (United States)

    Kenney, M. A.; Mohrig, D.; Hobbs, B. F.; Parker, G.

    2011-12-01

    Land loss in the Mississippi River Delta caused by subsidence and erosion has resulted in habitat loss, interference with human activities, and increased exposure of New Orleans and other settled areas to storm surge risks. Prior to dam and levee building and oil and gas production in the 20th century, the long term rates of land building roughly balanced land loss through subsidence. Now, however, sediment is being deposited at dramatically lower rates in shallow areas in and adjacent to the Delta, with much of the remaining sediment borne by the Mississippi being lost to the deep areas of the Gulf of Mexico. A few projects have been built in order to divert sediment from the river to areas where land can be built, and many more are under consideration as part of State of Louisiana and Federal planning processes. Most are small scale, although there have been some proposals for large engineered avulsions that would divert a significant fraction of the remaining available sediment (W. Kim, et al. 2009, EOS). However, there is debate over whether small or large diversions are the economically optimally and socially most acceptable size of such land building projects. From an economic point of view, the optimal size involves tradeoffs between scale economies in civil work construction, the relationship between depth of diversion and sediment concentration in river water, effects on navigation, and possible diminishing returns to land building at a single location as the edge of built land progresses into deeper waters. Because land building efforts could potentially involve billions of dollars of investment, it is important to gain as much benefit as possible from those expenditures. We present the result of a general analysis of scale economies in land building from engineered avulsions. The analysis addresses the question: how many projects of what size should be built at what time in order to maximize the amount of land built by a particular time? The analysis

  1. Posteromedial approach of gastrocnemius for reduction and internal fixation of avulsed tibial attachment of posterior cruciate ligament

    Institute of Scientific and Technical Information of China (English)

    ZHANG Chun-li; XU Hu; LI Ming-quan

    2006-01-01

    Objective:To introduce a posteromedial approach through the medial border of the medial head of gastrocnemius for reduction and reattachment of bony avulsion of the posterior cruciate ligament (PCL) from the tibia.Methods: Eleven patients with avulsed tibial attachment of the PCL underwent an operative reduction and internal fixation through the posteromedial approach of the gastrocnemius in our department from February 1998 to March 2000. The skin incision was reversed L-shaped along the medial border of the medial head of the gastrocnemius and the posterior capsule was exposed by dissecting the medial border and lateral retraction, avoiding the damage of the popliteal neurovascular structures. After that, the posterior capsule was vertically dissected a little medially to the posterior intercondylar sulcus and just on the posterior medial tibial eminence positioned by finger palpation. Then the PCL and its tibial attachment were easily accessible. In the delayed cases, PCL peripheral releasing was necessary to overcome the ligament retraction and to refresh the fracture bed for optimal reduction and bony healing. At last, one or two biodegradable screws were used to fix the avulsed bone segment and 30° flexion knee plaster cast immobilization was regularly applied after the wound was closed. The evaluation included X-ray, posterior sag sign and posterior drawer test compared with the contralateral side. The functional assessment of the low limbs was not available because of concomitant injuries.Results: The posteromedial approach of the gastrocnemius used in repair of tibial attachment avulsed injury of the PCL could provide benefit of clear anatomical exposure, few blood loss (20 ml on average), no need for detachment or reattachment of any structure. The patients were followed up for 11 months on an average (ranging from 6 months to 2 years ). It demonstrated that bony healing was achieved within 4-6 weeks in cases of fresh injury and 7-9 weeks in cases of

  2. A new evaluation system for early and successful conservative treatment for acute ischial tuberosity avulsion

    Directory of Open Access Journals (Sweden)

    Ceretti Marco

    2013-08-01

    Full Text Available 【Abstract】In this report we analyse a case of ischi-atic tuberosity avulsion. A 15-year-old patient who came to our first aid department two days after a football match ac-cident was treated conservatively and examined at month 1-4, 6 and 12. In order to examine patient condition, a new index was formulated: the inability score index (ISI, which is based on hip range of motion and scales for rest, walking, running pain and compared to other parameters such as oedema area, fragment diastasis evaluated by X-ray and CT accordingly. ISI defines the inability as severe, moderate and mild. It guides the rehabilitative program in the right way. In this case, the patient was able to run softly after 35 days and to go back to the full agonist activity after 4 months. At the end of treatment the patient referred to the complete pain remission, full range of motion recovery and a good fracture consolidation. After 1 year we discuss about thera-peutic strategies used and results obtained. Key words: Fractures, bone; Sports medicine; Reha-bilitation

  3. A new evaluation system for early and successful conservative treatment for acute ischial tuberosity avulsion

    Institute of Scientific and Technical Information of China (English)

    Marco Ceretti; Sara Di Renzo

    2013-01-01

    In this report we analyse a case of ischiatic tuberosity avulsion.A 15-year-old patient who came to our first aid department two days after a football match accident was treated conservatively and examined at month 1-4,6 and 12.In order to examine patient condition,a new index was formulated:the inability score index (ISI),which is based on hip range of motion and scales for rest,walking,running pain and compared to other parameters such as oedema area,fragment diastasis evaluated by X-ray and CT accordingly.ISI defines the inability as severe,moderate and mild.It guides the rehabilitative program in the right way.In this case,the patient was able to run softly after 35 days and to go back to the full agonist activity after 4 months.At the end of treatment the patient referred to the complete pain remission,full range of motion recovery and a good fracture consolidation.After 1 year we discuss about therapeutic strategies used and results obtained.

  4. Hip Revision

    Medline Plus

    Full Text Available ... and we're going to be having live operative techniques of the ZMR Tapered System performed by Dr. Scott Sporer. We're going to initially look at Scott's preoperative x-rays ...

  5. Two Extension Block Kirschner Wires' Technique for Bony Mallet Thumb

    Science.gov (United States)

    Takase, Fumiaki; Ueda, Yasuhiro; Shinohara, Issei; Kuroda, Ryosuke; Kokubu, Takeshi

    2016-01-01

    Mallet fingers with an avulsion fracture of the distal phalanx or rupture of the terminal tendon of the extensor mechanism is known as a common injury, while mallet thumb is very rare. In this paper, the case of a 19-year-old woman with a sprained left thumb sustained while playing basketball is presented. Plain radiographs and computed tomography revealed an avulsion fracture involving more than half of the articular surface at the base of the distal phalanx. Closed reduction and percutaneous fixation were performed using the two extension block Kirschner wires' technique under digital block anesthesia. At 4 months postoperatively, the patient had achieved excellent results according to Crawford's evaluation criteria and had no difficulties in working or playing basketball. Various conservative and operative treatment strategies have been reported for management of mallet thumb. We chose the two extension block Kirschner wires' technique to minimize invasion of the extensor mechanism and nail bed and to stabilize the large fracture fragment.

  6. Comparative review of techniques used for in situ remediation of contaminated soils; Revision comparativa de tecnicas empleadas para la descontaminacion in situ de suelos contaminados

    Energy Technology Data Exchange (ETDEWEB)

    Escusol Tomey, M.; Rodriguez Abad, R.

    2014-07-01

    Soil pollution may influence the geotechnical parameters of the soil itself, properties such as solid particle density or water within its pores. It may also vary its friction angle, modify its structure and texture, or change the properties of its constitutive minerals due to the inclusion of polluting components. For these reasons, soil decontamination is an important factor to consider in geotechnics. This work focuses on those soil decontamination techniques carried out in situ, since they allow to eliminate soil pollutants in a less invasive way than confinement, containment or ex situ remediation techniques, causing a minor soil alteration and, therefore, affecting less to its mechanical properties. These factors should be taken into account when carrying out a geotechnical performance on a previously decontaminated soil. (Author)

  7. Vacuum sealing drainage for skin avulsion of the limbs%高分子泡沫材料覆盖负压封闭引流用于四肢皮肤撕脱伤

    Institute of Scientific and Technical Information of China (English)

    谢志进; 方跃; 王彦川; 石磊; 余强; 刘勇

    2012-01-01

    BACKGROUND: Vacuum sealing drainage technique has been increasingly popular in clinical treatment of skin avulsion injuries.OBJECTIVE: To investigate and generalize technical issues and details of the vacuum sealing drainage method in the treatment of limb skin avulsion.METHODS: A total of 22 patients with limb skin avulsion were admitted and then treated with vacuum sealing drainage after skin replantation. Firstly, the main points and difficulties of the treatment process were retrospectively reviewed, and then the appropriate technical approach was proposed.RESULTS AND CONCLUSION: Although 21 eligible patients received effective treatment and the clinical results were quite satisfactory, there were six cases of failure to complete primary healing. All of these cases provide us a good clinical support for the summary of the related technical points. To conclude, skin replantation combined with vacuum sealing drainage technique is a good way to deal with limb skin avulsion, and a better grasp of technical issues and details of the approach helps improve the cure rate.%背景:高分子泡沫材料覆盖负压封闭引流技术现已广泛地应用于皮肤撕脱伤的临床治疗.目的:探讨并归纳高分子泡沫材料覆盖负压封闭引流治疗四肢皮肤撕脱伤过程中的技术要点和细节处理方法.方法:纳入22 例四肢皮肤撕脱伤患者,行撕脱皮肤回植的高分子泡沫材料覆盖负压封闭引流治疗,然后归纳总结治疗过程中的要点、难点,并提出相应的技术处理办法.结果与结论:21 例有效病例创面均获得治愈,临床疗效满意,但仍有6 例创面未能完全一期成活,这些实例为总结相关技术要点提供了良好的临床支持.通过总结可以认为皮片回植结合高分子泡沫材料覆盖负压封闭引流技术是治疗四肢皮肤撕脱伤的良好方法,更好的把握技术要点和细节处理方法有助于提高治愈率.

  8. Research progress of dorsal root entry zone lesioning for the treatment of pain after brachial plexus avulsion

    Directory of Open Access Journals (Sweden)

    Qing-jun LIU

    2015-08-01

    Full Text Available Pain after brachial plexus avulsion (BPA is a clinically common drug-refractory neuropathic pain. Overactive spontaneous potential due to deafferentation in the neurons of spinal dorsal horn is the main pathogenesis of pain after BPA. Dorsal root entry zone (DREZ lesioning is one way that damages overactive spontaneous potential neurons in spinal dorsal horn through radio-frequency electrode or bipolar coagulation so as to achieve pain relief. Dorsal root entry zone lesioning is a safe and effective treatment approach for pain after BPA. DOI: 10.3969/j.issn.1672-6731.2015.08.014

  9. Improved C3-4 transfer for treatment of root avulsion of the brachial plexus upper trunk

    OpenAIRE

    Zou, Lin; Cao, Xuecheng; Li, Jing; Liu, Lifeng; Wang, Pingshan; Cai, Jinfang

    2012-01-01

    Experimental rats with root avulsion of the brachial plexus upper trunk were treated with the improved C3-4 transfer for neurotization of C5-6. Results showed that Terzis grooming test scores were significantly increased at 6 months after treatment, the latency of C5-6 motor evoked potential was gradually shortened, and the amplitude was gradually increased. The rate of C3 instead of C5 and the C4 + phrenic nerve instead of C6 myelinated nerve fibers crossing through the anastomotic stoma was...

  10. Common Peroneal Nerve Palsy with Multiple-Ligament Knee Injury and Distal Avulsion of the Biceps Femoris Tendon

    OpenAIRE

    Takeshi Oshima; Junsuke Nakase; Hitoaki Numata; Yasushi Takata; Hiroyuki Tsuchiya

    2015-01-01

    A multiple-ligament knee injury that includes posterolateral corner (PLC) disruption often causes palsy of the common peroneal nerve (CPN), which occurs in 44% of cases with PLC injury and biceps femoris tendon rupture or avulsion of the fibular head. Approximately half of these cases do not show functional recovery. This case report aims to present a criteria-based approach to the operation and postoperative management of CPN palsy that resulted from a multiple-ligament knee injury in a 22-y...

  11. Horizontal intra-articular patellar dislocation resulting in quadriceps avulsion and medial patellofemoral ligament tear: a case report.

    Science.gov (United States)

    Kramer, Dennis E; Simoni, Michael K

    2013-07-01

    Intra-articular patellar dislocations are rare. We present a 13-year-old boy who sustained a complete horizontal intra-articular patellar dislocation following blunt trauma to the flexed knee. Closed reduction was unsuccessful and open reduction indicated a repairable quadriceps avulsion and medial patellofemoral ligament tear. He is the youngest patient to sustain a quadriceps rupture and the only patient to sustain a medial patellofemoral ligament tear to date. His flexed knee and the horizontally positioned patella (seen on lateral radiograph) were indicative of a complete rotational injury with extensor mechanism involvement. Open reduction allowed for the repair of both injuries and a favorable outcome.

  12. A new model of skin avulsion injuries in rats%一种大鼠皮肤撕脱伤模型初探

    Institute of Scientific and Technical Information of China (English)

    王忠堂; 郭树忠; 修志夫; 鲁开化; 李青山

    2008-01-01

    目的 建立稳定可靠的大鼠皮肤撕脱伤模型.方法 雄性SD大鼠30只,随机分为轴型皮瓣(9cm×3cm)对照组及牵拉组,任意皮瓣(6cm×4cm)对照组及牵拉组.轴型皮瓣施予牵拉力6kg,任意皮瓣施予牵拉力8kg,牵拉时间分别为8秒和12秒.观察创面收缩及皮瓣坏死情况.结果 术后第7天,牵拉组较对照组创面收缩率明显增加(P<0.05);术后第14天,牵拉组创面收缩率较术后第7天时增加近1倍(P<0.01),但牵拉8秒组与12秒组间差异无统计学意义.术后第7天,牵拉组皮瓣100%发生部分或大部坏死.轴型皮瓣牵拉8秒导致38%~77%面积坏死,牵拉12秒导致40%~80%面积坏死;任意皮瓣牵拉8秒导致17%~40%面积坏死,牵拉12秒导致24%~43%面积坏死.结论 应用大鼠制作皮肤撕脱伤模型是可行的.%Objective To create a stable and reliable model of skin avulsion in rats.Methods 30 male,SD rats were randomly divided into axial pattern skin flap(9cm×3cm)group and random pattern skin flap group(6cm×4cm),each having the control groups and avulsion groups.Flaps were subjected to avulsion force of 6 kg in axial pattern skin flaps or 8 kg in random pattern skin flaps,and the lasting time was 8s or 12s,respectively.Retraction of wounds and necrosis of skin flaps were observed.Results There was more significant wound retraction in avulsion groups than that in control groups on post-operation day 7(P<0.05).The proportion of the wound retraction increased by 1 fold in avulsion groups on post-operation day 14 as compared to post-operation day 7(P<0.01).Interestingly,necrosis of partial or most of skin flaps was observed in all animals of avulsion groups,while slight necrosis happened in one of six in control animals.The necrosis area of flaps was 38%~77%when avulsed for 8s,and was 40%~80%when avulsed for 12s in axial pattern skin flaps.However,the necrosis area in random pattern skin flaps was smaller than that in axial pattern skin flaps

  13. Loosening After Acetabular Revision

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  14. Avulsion at a drift-dominated mesotidal estuary: The Chubut River outlet, Patagonia, Argentina

    Science.gov (United States)

    Isla, Federico; Espinosa, Marcela; Rubio, Belén; Escandell, Alejandra; Gerpe, Marcela; Miglioranza, Karina; Rey, Daniel; Vilas, Federico

    2015-10-01

    The Chubut River flows from the Andes to the Atlantic Ocean, and is interrupted by a single dam built at the middle valley. The lower valley is dominated by the aggradation of an alluvial plain induced by a complex of spits that enclosed the inlet in the last 5000 years. The river has reduced its flow because the blocking of the upper basin by terminal moraines during the Upper Pleistocene. At least the last two marine transgressions have flooded this estuary, and contributed to the aggradation during regressions. The area is of particular interest in regard to irrigation channels practiced since the XIX century. Today, the mean monthly flow is less than 10 m3/s although peaks of 95 m3/s have been recorded in Gaiman in July 2001. The dynamics of the estuary is dominated by waves (wave-dominated estuary) as tidal effects attenuate in less than 5 km. Three vibracores were collected within this floodplain: (a) at Gaiman, an area without any effect of the sea (35 km from the coast); (b) at Trelew, at the former avulsion plain of the river (18 km from the coast); and (c) at Playa Magagna, a saltmarsh located 0.4 km from the beach. At the Gaiman core (1.54 m long) fresh-water epiphytic diatoms dominate (Epithemia sorex, Cocconeis placentula, Ulnaria ulna) suggesting the aggradation of an alluvial plain. The Trelew core (2.19 m long) was collected from a deltaic plain. It was composed by fine sand with organic matter at the base that evolved into silty layers to the top. Several unconformities and laminae with heavy minerals were detected by their geochemical composition analysed by micro X-ray fluorescence (Itrax XRF core scanner). Fine-sand laminated layers were perfectly detected by their high content in S and Cl. On the other hand, mud layers presented lower content in Mg and Al with increments in Ca and V. The core from the marsh area (1.67 m long) was analysed in terms of the diatom evolution in order to detect Holocene sea-level and salinity effects. The sand flats

  15. The effect of severing a normal S1 nerve root to use for reconstruction of an avulsed contralateral lumbosacral plexus: a pilot study.

    Science.gov (United States)

    Zhu, L; F Zhang; Yang, D; Chen, A

    2015-03-01

    The aim of this study was to evaluate the feasibility of using the intact S1 nerve root as a donor nerve to repair an avulsion of the contralateral lumbosacral plexus. Two cohorts of patients were recruited. In cohort 1, the L4-S4 nerve roots of 15 patients with a unilateral fracture of the sacrum and sacral nerve injury were stimulated during surgery to establish the precise functional distribution of the S1 nerve root and its proportional contribution to individual muscles. In cohort 2, the contralateral uninjured S1 nerve root of six patients with a unilateral lumbosacral plexus avulsion was transected extradurally and used with a 25 cm segment of the common peroneal nerve from the injured leg to reconstruct the avulsed plexus. The results from cohort 1 showed that the innervation of S1 in each muscle can be compensated for by L4, L5, S2 and S3. Numbness in the toes and a reduction in strength were found after surgery in cohort 2, but these symptoms gradually disappeared and strength recovered. The results of electrophysiological studies of the donor limb were generally normal. Severing the S1 nerve root does not appear to damage the healthy limb as far as clinical assessment and electrophysiological testing can determine. Consequently, the S1 nerve can be considered to be a suitable donor nerve for reconstruction of an avulsed contralateral lumbosacral plexus.

  16. Does the prevalence of levator ani muscle avulsion differ when assessed using tomographic ultrasound imaging at rest vs on maximum pelvic floor muscle contraction?

    NARCIS (Netherlands)

    Delft, K. van; Thakar, R.; Sultan, A.H.; Kluivers, K.B.

    2015-01-01

    OBJECTIVE: It has been suggested that transperineal ultrasound images obtained during maximum pelvic floor muscle contraction improve the diagnosis of levator ani muscle (LAM) avulsion by comparison with those obtained at rest. The objective of this study was to establish, using transperineal tomogr

  17. Avulsion in action: reconstruction and modeling sedimentation pace and upstream flood water levels following a Medieval tidal-river diversion catastrophe (Biesbosch, The Netherlands, 1421–1750 AD)

    NARCIS (Netherlands)

    Kleinhans, M.G.; Weerts, H.J.T.; Cohen, K.M.

    2010-01-01

    Deltaic land inundated by storm surges may reform by sedimentation from natural or human-induced river diversions. This is a well-known trigger mechanism for creation of new channels in coastal plains and deltas, which may develop into main channels and lead to abandonment of older (avulsion), parti

  18. 恒牙全脱位再植的研究现状%Present Studies of Replantation of Avulsed Permanent Teeth

    Institute of Scientific and Technical Information of China (English)

    钱瀚宇; 丁允鹏

    2015-01-01

    Permanent teeth are prone to avulsion by trauma.Replantation is the preferred treatment for avulsed perma-nent teeth, and the ideal prognosis of replantation is to achieve functional healing of periodontal ligament. If the avulsed teeth are immature, revascularization of the dental pulp is expected. The duration of extra-alveolar time, preservation of the root and storage media of the tooth, all of which determine the prognosis for dental replantation, but the current prognosis is not satisfactory. Present studies of replantation of avulsed permanent teeth were reviewed in the present paper.%恒牙外伤常导致牙齿全脱位,再植术是恒牙全脱位的首选治疗方法. 理想的预后是实现牙周功能性愈合,若牙根尖未完全封闭,尚有牙髓再生的可能. 恒牙再植术的预后与很多因素有关,如牙齿脱离牙槽窝的时间、牙根的保存以及牙齿的储存介质等,目前临床治疗效果尚不理想. 本文就恒牙全脱位再植的研究现状作一综述.

  19. C型臂透视下定位腘窝纵行小切口治疗后交叉韧带止点胫骨嵴撕脱骨折%Treatment of Tibial Plateau Avulsion Fracture Implicating Accreting of Posterior Cruciate Ligament (PCL) through Popliteal with Longitudinal Small Incision under the Orientation of C-Arm X-Ray

    Institute of Scientific and Technical Information of China (English)

    韩立民; 宓士军; 张远成

    2011-01-01

    Objective To explore the methods and efficacy of treatment of tibial plateau avulsion fracture implicating accreting of posterior cruciate ligament ( PCL ) through popliteal with longitudinal small incision under the orientation of C-Arm X - ray to provide effective method for treatment of avulsion fracture of tibial spine. Methods Retrospectively analyze 35 cases admitted from March 2007 to September 2009. Orientation tibial plateau avulsion fracture piece was fixed under C -Arm X -ray, and the fixed piece was reset with longitudinal small incision at popliteal fossa orientation. Results All the patients have little intraoperative bleeding, short operative time, and have no neurological vascular injury. Postoperative follow-up shows that all avulsion fractures show osseous healing, and the average function is 96 7 % by lysholm grade. Conclusion This surgical technique can reduce the surgical incision as well as the operation time, and it is in line with minimally invasive surgical operation.%目的 探讨C型臂透视下定位腘窝纵行小切口治疗后交叉韧带止点胫骨嵴撕脱骨折的手术方法及疗效.方法 2007年3月-2009年9月对35例患者在C型臂透视下定位后交叉韧带止点胫骨嵴撕脱骨折块,在定位处行腘窝纵行小切口将撕脱骨折块复位固定.结果 本组患者术中出血较少,平均20~40 ml,手术时间短,平均25 min,无神经血管损伤.术后全部病例经随访观察,撕脱骨折均获骨性愈合;术后6个月行lysholm评分,平均功能评分96.7分.结论 采用此手术方法可以减小手术切口,缩短手术时间,符合微创外科操作.

  20. Metaphyseal bone loss in revision knee arthroplasty.

    Science.gov (United States)

    Ponzio, Danielle Y; Austin, Matthew S

    2015-12-01

    The etiology of bone loss encountered during revision total knee arthroplasty (TKA) is often multifactorial and can include stress shielding, osteolysis, osteonecrosis, infection, mechanical loss due to a grossly loose implant, and iatrogenic loss at the time of implant resection. Selection of the reconstructive technique(s) to manage bone deficiency is determined by the location and magnitude of bone loss, ligament integrity, surgeon experience, and patient factors including the potential for additional revision, functional demand, and comorbidities. Smaller, contained defects are reliably managed with bone graft, cement augmented with screw fixation, or modular augments. Large metaphyseal defects require more extensive reconstruction such as impaction bone grafting with or without mesh augmentation, prosthetic augmentation, use of bulk structural allografts, or use of metaphyseal cones or sleeves. While each technique has advantages and disadvantages, the most optimal method for reconstruction of large metaphyseal bone defects during revision TKA is not clearly established. PMID:26362647

  1. A rare case of bicondylar Hoffa fracture associated with ipsilateral tibial spine avulsion and extensor mechanism disruption

    Institute of Scientific and Technical Information of China (English)

    Kamal Bali; Aditya Krishna Mootha; Vibhu Krishnan; Vishal Kumar; Saurabh Rawall

    2011-01-01

    Intra-articular coronal fractures (Hoffas fractures) of distal femur are rare. Although bicondylar involvement in these fractures has been reported in the literature in association with high velocity traumata, the occurrence of these fractures involving extensor mechanism rupture and avulsion of ipsilateral tibial spine is extremely rare. To our acquaintance, such a fracture pattern has not yet been reported in the literature so far. In this article, we report one such case and discuss the importance of early diagnosis and prompt internal fixation in the management of such cases. We believe that these rare combinations of injuries should be treated aggressively by early open reduction and anatomic rigid internal fixation in order toachieve good recovery of function.

  2. Legacy Morphologies: Channel Avulsions and Historical Engineering Structures Drive Form and Process in the Lower Yuba and Feather Rivers, California

    Science.gov (United States)

    James, L. A.; Singer, M. B.; Aalto, R.

    2008-12-01

    Geomorphic changes in the lower Yuba and Feather Rivers due to hydraulic mining provide a chance to study centennial-scale processes. Channel changes over 150 years were determined using channel-bank stratigraphy, geochemical signatures (total Hg, grain-size distributions, bulk geochemistry, fallout radionuclides, and Sr/Nd isotopes), and spatial analyses of high-resolution topographic data, historical maps, and aerial photos. Repeated avulsions and broad erosion/deposition patterns are shown, including a downstream shift in activity through time. In the 20th century, both rivers experienced deep main-channel incision and floodplain alluviation of natural levees and abandoned channels. Buried trees rooted in pre- mining soils indicate the Feather has not returned to pre-mining base levels below the Yuba confluence. Early engineering works controlled channel responses and recovery. For example, the Feather River avulsed into a channel dredged through Shanghai Bend (c.1907) so it now crosses resistant Quaternary alluvium over a 3-m knickpoint bench that could soon be breached. Moreover, levees and channelization near the Yuba-Feather confluence at Marysville (c.1905) narrowed and deepened flows, encouraging the bed incision noted by Gilbert. Effects of legacy sediment on channel processes are well known. Here, channel recovery was also constrained by channel morphologies engineered with boulder wing dams and revetment in the Yuba and channelization and levees in the Feather. The resulting bed incision reduces lateral connectivity between channels and floodplains and increases sediment conveyance. Historical and anthropogenic perspectives are essential to explaining channel dynamics at these scales. Unless models of channel and floodplain evolution recognize historical changes and engineering works, they may miss crucial components of geomorphic change and potential impacts downstream. In such systems, the historical dimension is essential to river management, water

  3. Results after replantation of avulsed permanent teeth. II. Periodontal healing and the role of physiologic storage and antiresorptive-regenerative therapy.

    Science.gov (United States)

    Pohl, Yango; Filippi, Andreas; Kirschner, Horst

    2005-04-01

    The status of the periodontal ligament (PDL) and of the pulp are decisive for the healing of avulsed and replanted teeth. A tooth rescue box was developed and distributed to offer optimal storage conditions for avulsed teeth. The therapy comprised extraoral endodontic treatment and applications of medicaments to enhance periodontal healing. In this long-term clinical study the healing results following avulsion and replantation were investigated. Twenty-eight permanent teeth in 24 patients were evaluated. The extraoral storage media and periods varied considerably. Soon after avulsion six teeth were stored in a cell culture medium (tooth rescue box Dentosafe) for 1-53 h; the PDL was defined as not compromised. Sixteen teeth were stored in a non-physiologic situation temporarily, the PDL was considered as compromised. Six teeth were stored in non-physiologic conditions for longer periods; the condition of the PDL was defined as hopeless. On 14 teeth antiresorptive-regenerative therapy (ART) with the local application of glucocorticoids and enamel matrix derivative and the systemic administration of doxycyclin was used. In all teeth extraoral endodontic treatment by retrograde insertion of posts was performed. The mean observation period was 31.2 months (+/-24.1; 5.1-100.2; median: 23.8). All six teeth rescued physiologically healed with a functional PDL (functional healing, FH) irrespective of the storage period. Of eight teeth with a compromised PDL on which ART was used, three teeth healed with a functional PDL. All other teeth showed replacement resorption, in three teeth additionally infection-related resorption was recorded. The predominant influence on the healing results was the immediate physiologic rescue of avulsed teeth (chi-square, P = 0.0001). The use of ART seemed to support FH (chi-square, P = 0.0547) in teeth with a compromised PDL. No other factors (maturity of roots, crown fractures, gender, age, antibiotics) were related to healing. In a linear

  4. Revision Knee Surgery

    Medline Plus

    Full Text Available Revision Knee Surgery Featuring the Zimmer® NexGen® LCCK System. Zimmer, Inc. Indio, California March 31, 2010 Welcome to this ... surgery, demonstrating the role of the NexGen LCCK Knee Revision System. If we could go to the ...

  5. Revision Knee Surgery

    Medline Plus

    Full Text Available Revision Knee Surgery Featuring the Zimmer® NexGen® LCCK System. Zimmer, Inc. Indio, California March 31, 2010 Welcome ... the role of the NexGen LCCK Knee Revision System. If we could go to the slides, please. ...

  6. Acute simultaneous bilateral avulsion fractures of the tibial tubercles in a 15-year-old male hurler: case report and literature review.

    LENUS (Irish Health Repository)

    Hanley, C

    2012-02-01

    BACKGROUND: Avulsion fractures of the tibial tubercle are an unusual injury pattern generally occurring in the adolescent male during sporting activities. Bilateral simultaneous fractures are extremely rare. They are often associated with other underlying orthopaedic pathology. AIMS: We present a case of bilateral tibial tubercle avulsions occurring in a 15 year-old male hurler. We describe the management and necessary investigations required for this type of trauma and present a literature review on this rarely encountered injury. CONCLUSION: Although this type of atypical fracture pattern is associated with high energy trauma and other underlying pathology, we have shown that once treated, the patient can expect to make a prompt return to sporting activities with no significant long-term functional deficit.

  7. Improved C3-4 transfer for treatment of root avulsion of the brachial plexus upper trunk Animal experiments and clinical application

    Institute of Scientific and Technical Information of China (English)

    Lin Zou; Xuecheng Cao; Jing Li; Lifeng Liu; Pingshan Wang; Jinfang Cai

    2012-01-01

    Experimental rats with root avulsion of the brachial plexus upper trunk were treated with the improved C3-4 transfer for neurotization of C5-6. Results showed that Terzis grooming test scores were significantly increased at 6 months after treatment, the latency of C5-6 motor evoked potential was gradually shortened, and the amplitude was gradually increased. The rate of C3 instead of C5 and the C4 + phrenic nerve instead of C6 myelinated nerve fibers crossing through the anastomotic stoma was approximately 80%. Myelinated nerve fibers were arranged loosely but the thickness of the myelin sheath was similar to that of the healthy side. In clinical applications,39 patients with root avulsion of the brachial plexus upper trunk were followed for 6 months to 4.5 years after treatment using the improved C3 instead of C5 nerve root transfer and C4 nerve root and phrenic nerve instead of C6 nerve root transfer. Results showed that the strength of the brachial biceps and deltoid muscles recovered to level III-IV, scapular muscle to level III-IV, latissimus dorsi and pectoralis major muscles to above level III, and the brachial triceps muscle to level 0-III. Results showed that the improved C3-4 transfer for root avulsion of the brachial plexus upper trunk in animal models is similar to clinical findings and that C3-4 and the phrenic nerve transfer for neurotization of C5-6 can innervate the avulsed brachial plexus upper trunk and promote the recovery of nerve function in the upper extremity.

  8. Avulsion fracture of the coracoid process in a patient with chronic anterior shoulder instability treated with the Latarjet procedure: a case report

    OpenAIRE

    Schneider, Marco Michael; Balke, Maurice; Koenen, Paola; Bouillon, Bertil; Banerjee, Marc

    2014-01-01

    Introduction Shoulder dislocations can cause acute and chronic instabilities that need to be addressed in order to restore joint functioning. The transfer of the coracoid process has become a feasible surgical procedure in patients with shoulder instability. Several concomitant injuries after recurrent dislocations have been described. Case presentation A 32-year-old German man presented to our department with a history of recurrent shoulder dislocations. He was diagnosed with an avulsion fra...

  9. Effects of C8 ventral root avulsion or transection on spinal alpha motoneurons in adult rats A qualitative light and electron microscopic study

    Institute of Scientific and Technical Information of China (English)

    Khulood M.AL-Khater; Bassem Y.Sheikh

    2008-01-01

    BACKGROUND:Nerve root avulsion is a frequent finding in patients with brachial plexus injury following road traffic accidents or as a result of severe arm traction during complicated deliveries.This injury constitutes a challenging clinical and surgical problem.The orphological characteristics of motoneurons after nerve root avulsion deserve further analysis.OBJECTIVE:To study the different morphological changes of u -motoneurons under light and electron microscopy after C8 spinal ventral rootlets avulsion and transection at various stages.DESIGN:Controlled animal study.SETTING:Department of Anatomy,King Faisal University.MATERIALS:The experiment was carried out at the Department of Anatomy,College of Medicine,King Faisal University between January 2005 and March 2006.Six adult Sprague Dawley rats weighing 200-350 g, irrespective of gender,were used for this study.The animals were bred at the animal house,College of Medicine,King Faisal University,and fed on rat maintenance diet.Water and standard diet were supplied ad libitum.Animal interventions were carried out according to animal ethical standards.METHODS:Three animals were randomly chosen for avulsion of the right ventral rootlets of C8 spinal nerves.The other three received transection of the right ventral rootlets of C8 spinal nerves.①Avulsion experiment:After rats were anesthetized,the right ventral rootlets of C8 spinal nerves were identified.The ventral rootlets were avulsed from the spinal cord by traction with a fine hook(Fine Science Tools Inc.,No. 10031-13,Germany).Traction was exerted in a direction parallel to the course of the spinal root.Under the operating microscope,the Cs segment was exactly located.After checking the successfulness of the surgical procedure,the Ca segment was separated from the spinal cord.The outcome of the avulsion procedure was as follows:two animals had true avulsion,i.e.,no remaining stump was attached to the spinal cord surface.One rat had a stump still attached

  10. Letter of Map Revision

    Data.gov (United States)

    Earth Data Analysis Center, University of New Mexico — The National Flood Hazard Layer (NFHL) data incorporates all Digital Flood Insurance Rate Map(DFIRM) databases published by FEMA, and any Letters Of Map Revision...

  11. Common Peroneal Nerve Palsy with Multiple-Ligament Knee Injury and Distal Avulsion of the Biceps Femoris Tendon

    Directory of Open Access Journals (Sweden)

    Takeshi Oshima

    2015-01-01

    Full Text Available A multiple-ligament knee injury that includes posterolateral corner (PLC disruption often causes palsy of the common peroneal nerve (CPN, which occurs in 44% of cases with PLC injury and biceps femoris tendon rupture or avulsion of the fibular head. Approximately half of these cases do not show functional recovery. This case report aims to present a criteria-based approach to the operation and postoperative management of CPN palsy that resulted from a multiple-ligament knee injury in a 22-year-old man that occurred during judo. We performed a two-staged surgery. The first stage was to repair the injuries to the PLC and biceps femoris. The second stage involved anterior cruciate ligament reconstruction. The outcomes were excellent, with a stable knee, excellent range of motion, and improvement in the palsy. The patient was able to return to judo competition 27 weeks after the injury. To the best of our knowledge, this is the first case report describing a return to sports following CPN palsy with multiple-ligament knee injury.

  12. Variable scale channel avulsion history using fan architecture and stratigraphy, and sediment provenance of Sutlej-Yamuna fans in northwest Gangetic plains during Late Quaternary

    Science.gov (United States)

    Singh, Ajit; Gupta, Sanjeev; Sinha, Rajiv; Densmore, Alexander; Buylaert, Jan-Pieter; Carter, Andrew; Van-Dijk, Wout M.; Joshi, Suneel; Nayak, Nibedita; Mason, Philippa J.; Kumar, Dewashish; Mondal, Setbandhu; Murray, Andrew; Rai, Shiv P.; Shekhar, Shashank

    2016-04-01

    Channel avulsion during fan development controls distribution and deposition of channel sandbodies and hence alluvial architecture of a fan system. Variable scale spatio-temporal information of fluvial responses to past climate changes is stored in these channel sandbodies. Further these channel sandbodies form fluvial aquifers in alluvial fans and therefore understanding of alluvial architecture and stratigraphy of a fan is crucial for development of groundwater management strategies. In this study we used multiple approaches to map subsurface fluvial aquifer architecture and alluvial stratigraphy, and to estimate sediment provenance using U-Pb dating of detrital zircon grains of Sutlej-Yamuna fan system in northwest India. Satellite imagery based geomorphic mapping shows two large fan system with interfan area. The fan surfaces show presence of major and minor paleochannels. 2D resistivity tomography along several transects across fan surfaces shows distinct layers with contrasting resistivity values. These geo-electric facies corresponds to presence of channel sandbodies beneath surface signature of paleochannels and finer floodplain deposits useful to demarcate lateral extent of subsurface channel sandbodies. A more detailed subsurface stratigraphy using ~50m deep sediment cores and their luminescence ages from across fan surface shows presence of multi-storey sandbodies (MSB) separated by floodplain fines. Within the MSB, individual channel deposits are identified by presence of channel scour surfaces located at coarse sand overlying fine sand layer. Depositional ages of MSB's ranges from ~81 ka (late MIS5) to ~15 ka (MIS2) with major depositional break during MIS3 in parts of the fans. Sediment aggradation rate varies laterally across fan surface as well as vertically down the depth with an average rate of 0.54 mm/year. Fluvial channel persistence for studied time interval (about last 81 ka BP) shows major depositional breaks (and possible incision) at ~41 ka

  13. Direct anastomosis of contralateral C7 nerve root transfer with affected-side inferior trunk for repair of brachial plexus avulsion injury

    Institute of Scientific and Technical Information of China (English)

    Houjun Yan; Changqing Hu; Yingli Jia; Chunjie Cui; Xuefeng Li; Jingyang Zhang

    2006-01-01

    AIM:To observe the effect of direct anastomosis of contralateral C7 nerve root transferred through prespinal route with affected-side inferior trunk for repair of brachial plexus avulsion injury,and investigate its feasibility. METHODS:Two male patients.with the age of 24 and 41 years respectively,were retrieved.When admitted to the hospital,they were diagnosed as brachial plexus avulsion injury.They subjected the operation in the 252 Hospital of Chinese PLA in March 2006 and May 2006 respectively.The proximal end of contralateral C7 nerve root was dissociated to nerve root pore and the distal end was dissociated to anterior and posterior divisions of middle trunk.The injured C7 nerve root was widely dissociated to inferior trunk,medial cord,ulnar nerve and medial head of median nerve.When elbow and shoulder joints were in flexion,the injured C7 nerve root was directly anastomosed with contralateral C7 nerve root in the gap between affected-side cervical vagina vasorum and esophagus with no tensions. RESULTS:Durling 3 to 5 hours of operation,little hemorrhage was found,nerves were not used for connection.Dyspnea,hoarse voice and other complications did not appear,either.In the postoperative 7th to 8th months.electremyogram examination showed that the growth velocity of anastomosed nerve was normal.CONCLUSION:Direct anastomosis of contralateral C7 nerve root transferred through prespinal route with affected-side inferior trunk can be used for repair of brachial plexus avulsion injury with satisfying therapeutic effects.

  14. Traction avulsion amputation of the major upper limb: a proposed new classification, guidelines for acute management, and strategies for secondary reconstruction.

    Science.gov (United States)

    Chuang, D C; Lai, J B; Cheng, S L; Jain, V; Lin, C H; Chen, H C

    2001-11-01

    Major replantation of a traction avulsion amputation is undertaken with the goal of not only the reestablishment of circulation, but also functional outcome. This type of amputation is characterized by different levels of soft-tissue divisions involving crushing, traction, and avulsion injuries to various structures. Between 1985 and 1998, 27 cases were referred for secondary reconstruction following amputation of the upper extremity involving both arm and forearm. Replantation was performed by at least 12 qualified plastic surgeons using different approaches and management, resulting in different outcomes. Initial replantation management significantly affects the later reconstruction. For comparing studies and prognostic implications, the authors propose a new classification according to the level of injury to muscles and innervated nerves: type I, amputation at or close to the musculotendinous aponeurosis with muscles remaining essentially intact; type II, amputation within the muscle bellies but with the proximal muscles still innervated; type III, amputation involving the motor nerve or neuromuscular junction, thereby causing total loss of muscle function; and type IV, amputation through the joint; i.e., disarticulation of the elbow or shoulder joint. Some patients required further reconstruction for functional restoration after replantation, but some did not. Through this retrospective study based on the proposed classification system, prospective guidelines for the management of different types of traction avulsion amputation are provided, including the value of replantation, length of bone shortening, primary or delayed muscle or nerve repair, necessity of fasciotomy, timing for using free tissue transfer for wound coverage, and the role of functioning free muscle transplantation for late reconstruction. The final functional outcome can also be anticipated prospectively through this classification system.

  15. Traumatic avulsion of kidney and spleen into the chest through a ruptured diaphragm in a young worker: a case report

    Directory of Open Access Journals (Sweden)

    Stamatiou Konstantinos

    2007-12-01

    Full Text Available Abstract Introduction Rupture of the diaphragm is almost always due to major trauma. Diaphragmatic injuries are rare (5–7%, usually secondary to blunt, or more rarely to penetrating, thoracic or abdominal trauma. No single investigation provides a reliable diagnosis of diaphragmatic rupture when a patient first arrives at hospital. Almost 33% are suspected on initial chest x-ray, but the percentage is lower in patients who are immediately intubated. Mortality in patients with diaphragmatic rupture following blunt abdominal trauma is generally associated with coexistent vascular and visceral injuries that could be rapidly fatal. It's mandatory that the right diagnosis is reached as soon as possible given that mortality is influenced by the time elapsing between trauma and diagnosis. Case presentation A 35-year-old worker was hit by a heavy object while working in the factory. He was transferred immediately to our emergency room. Chest x-ray showed massive left hemothorax without any additional signs to suggest diaphragmatic injury. It was decided to perform immediate surgical exploration before further radiological examination. During surgery, the right kidney and liver appeared normal, but the left kidney and spleen were not found in their anatomical position. The left hemidiaphragm had a10-cm oblique posterior tear. The left kidney was found lacerated in the left side of the chest, separated completely from its vascular pedicle and ureter, along with the entire spleen which was also separated from its vascular tree. Conclusion The avulsion of both kidney and spleen following abdominal trauma is uncommon and survival depends on prompt diagnosis and treatment.

  16. Revising and editing for translators

    CERN Document Server

    Mossop, Brian

    2014-01-01

    Revising and Editing for Translators provides guidance and learning materials for translation students learning to edit texts written by others, and professional translators wishing to improve their self-revision ability or learning to revise the work of others. Editing is understood as making corrections and improvements to texts, with particular attention to tailoring them to the given readership. Revising is this same task applied to draft translations. The linguistic work of editors and revisers is related to the professional situations in which they work. Mossop offers in-depth coverage of a wide range of topics, including copyediting, style editing, structural editing, checking for consistency, revising procedures and principles, and translation quality assessment. This third edition provides extended coverage of computer aids for revisers, and of the different degrees of revision suited to different texts. The inclusion of suggested activities and exercises, numerous real-world examples, a proposed gra...

  17. Predictors of Revision Surgery After Primary Anterior Cruciate Ligament Reconstruction

    Science.gov (United States)

    Yabroudi, Mohammad A.; Björnsson, Haukur; Lynch, Andrew D.; Muller, Bart; Samuelsson, Kristian; Tarabichi, Majd; Karlsson, Jón; Fu, Freddie H.; Harner, Christopher D.; Irrgang, James J.

    2016-01-01

    Background: Revision anterior cruciate ligament (ACL) reconstruction surgery occurs in 5% to 15% of individuals undergoing ACL reconstruction. Identifying predictors for revision ACL surgery is of essence in the pursuit of creating adequate prevention programs and to identify individuals at risk for reinjury and revision. Purpose: To determine predictors of revision ACL surgery after failed primary ACL reconstruction. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 251 participants (mean age ± SD, 26.1 ± 9.9 years) who had undergone primary ACL reconstruction 1 to 5 years earlier completed a comprehensive survey to determine predictors of revision ACL surgery at a mean 3.4 ± 1.3 years after the primary ACL reconstruction. Potential predictors that were assessed included subject characteristics (age at the time of surgery, time from injury to surgery, sex, body mass index, preinjury activity level, return to sport status), details of the initial injury (mechanism; concomitant injury to other ligaments, menisci, and cartilage), surgical details of the primary reconstruction (Lachman and pivot shift tests under anesthesia, graft type, femoral drilling technique, reconstruction technique), and postoperative course (length of rehabilitation, complications). Univariate and multivariate logistic regression analyses were performed to identify factors that predicted the need for revision ACL surgery. Results: Overall, 21 (8.4%) subjects underwent revision ACL surgery. Univariate analysis showed that younger age at the time of surgery (P = .003), participation in sports at a competitive level (P = .023), and double-bundle ACL reconstruction (P = .024) predicted increased risk of revision ACL surgery. Allograft reconstructions also demonstrated a trend toward greater risk of revision ACL surgery (P = .076). No other variables were significantly associated with revision ACL surgery. Multivariate analysis revealed that revision ACL surgery was

  18. Revision without ordinals

    NARCIS (Netherlands)

    Rivello, Edoardo

    2013-01-01

    We show that Herzberger’s and Gupta’s revision theories of truth can be recast in purely inductive terms, without any appeal neither to the transfinite ordinal numbers nor to the axiom of Choice. The result is presented in an abstract and general setting, emphasising both its validity for a wide ran

  19. Revision of the Sarcospermataceae

    NARCIS (Netherlands)

    Lam, H.J.; Varossieau, W.W.

    1938-01-01

    The genus Sarcosperma was excluded from the Sapotaceae by the first-named writer in 1925, the group being considered as of family rank. In 1926 the same author published a concise and fragmentary revision of the monotypic order, in which two new Malaysian species were described. The continental spec

  20. Code A1 Revised

    CERN Multimedia

    SC Secretariat

    2004-01-01

    Please note that the revised safety code A1 entitled 'MEDICAL CODE' is available on the web at the following url: https://edms.cern.ch/document/335476/last_released Paper copies can also be obtained from the SC Secretariat, e-mail : sc.secretariat@cern.ch SC Secretariat

  1. Belief and Its Revision

    NARCIS (Netherlands)

    Bewersdorf, Benjamin

    2013-01-01

    The role of experience for belief revision is seldom explicitly discussed. This is surprising as it seems obvious that experiences play a major role for most of our belief changes. In this work, the two most plausible views on the role of experience for belief change are investigated: the view that

  2. Translation Expert (TranslationQ & RevisionQ): Automated translation process with real-time feedback & evaluation/ revision with PIE

    OpenAIRE

    Steurs, Frieda; Segers, Winibert; Kockaert, Hendrik

    2015-01-01

    Translation Expert (TranslationQ & RevisionQ): Automated translation process with real-time feedback & evaluation/ revision with PIE Winibert Segers, Hendrik Kockaert & Frieda Steurs KU Leuven This paper reports on an experiment working with a new evaluation technique for translator training. Organizing high level translation classes in a master in translation involves intensive assessment of the work delivered by the students. The evaluation has to be precise, professional, and at...

  3. Avulsion of malleoincudal complex with dislocation: A rare ossicular chain injury by using an indigenous claw-like ear hook with review of literature

    Directory of Open Access Journals (Sweden)

    Produl Hazarika

    2014-01-01

    Full Text Available Direct ear trauma through external auditory canal causing an avulsion injury of malleoincudal complex is a grievous injury that can happen during ear cleaning with indigenous ear hook. One such case of avulsion injury is presented here with its symptomatology, investigation, and management with the review of available literature because of its rarity. Various locally designed indigenous ear hooks are available in street side markets and even online for purchase and used by many without knowing its ill effects on health. Injury caused by these types of hooks may lead to a severe hearing disability, if not properly treated. This presentation is to highlight the fact that indigenous ear hooks; rampantly available online for purchase can cause a potentially major injury leading to hearing disability and thereafter poor quality of life. Reporting and highlighting of such incidents among the ENT community can help increase the public awareness; thereby, eliminating such disastrous consequences. Wikipedia, PubMed, and Google search engine has been used for our data collection and analysis.

  4. Quaternary evolution of the rivers of northeast Hainan Island, China: Tracking the history of avulsion from mineralogy and geochemistry of river and delta sands

    Science.gov (United States)

    Pe-Piper, Georgia; Piper, David J. W.; Wang, Ying; Zhang, Yongzhan; Trottier, Corwin; Ge, Chendong; Yin, Yong

    2016-03-01

    The mineralogy and geochemistry of sands were investigated in the Nandu and Wanquan rivers, Hainan Island, China, to determine the history of avulsion in the lower reaches of the Nandu River. The study also provided the opportunity to assess the utility of geochemical analysis of sands as a provenance tool. Much of the heavy mineral fraction in the rivers consists of subangular Fe-Ti oxide and Fe-(hydr)oxide minerals, and less stable minerals such as amphibole, epidote, and andalusite, whereas rounded resistant ilmenite, rutile, tourmaline and zircon predominate on the deltaic coast. Mineral assemblage and chemical composition of individual samples are related to specific source areas and river tributaries. The results demonstrate northwestwards flow of the Nandu River during the mid-Holocene and earlier avulsion of the river to the northeast coast, probably during a Late Pleistocene marine highstand. Minor basement tilting, producing little relief, was sufficient to divert the lower reaches of rivers, and this effect was enhanced where basalt flows dammed former river courses. Bulk sample REE geochemistry is largely controlled by the relative abundance of monazite, allanite, titanite, zircon and epidote, derived principally from granites. Detrital geochemistry alone shows too much variability to interpret provenance. However, a smaller number of heavy mineral analyses provide an understanding of the mineralogical origins of geochemical variation, thus enabling interpretations of provenance.

  5. Replantation after extended dry storage of avulsed permanent incisors: report of a case.

    Science.gov (United States)

    Cobankara, Funda Kont; Ungor, Mete

    2007-08-01

    A 15-year-old boy lost his maxillary right and left central incisor teeth in a bicycle accident. He was referred to our clinic 1 week after the injury. The crown-root integrities of both the teeth were not damaged. Although the teeth were stored under dry conditions for 1 week, reimplantation of the teeth was planned to retain the teeth in the mouth for as long a period as possible because of the patient's age. Following the debridement and sterilization of root surfaces in 2.5% NaOCl, root canals were prepared and filled with calcium hydroxide. Then, about 2 mm of the apexes were resected to ensure that the roots easily seated in the alveolar socket and the prepared cavities in root ends were obturated with the amalgam. The teeth were placed into their respective sockets and splinted temporarily. The root canal therapy was completed 5 weeks later. Ankylosis was observed radiographically after 10 months. The patient is now 23 years old and he is still able to use both the central incisors functionally. However, there is a pink appearance on the cervical buccal surface of left central incisor because of progressive replacement resorption. In this case, the new treatment plan is to perform a permanent restoration with dental implants following the extraction of both teeth. Even though the long-term prognosis is uncertain, this treatment technique has provided an advantage for the patient in his adolescent period by maintaining the height of alveolar bone and making the provision of an aesthetically acceptable permanent restoration at a later age possible.

  6. Two Extension Block Kirschner Wires’ Technique for Bony Mallet Thumb

    Directory of Open Access Journals (Sweden)

    Yutaka Mifune

    2016-01-01

    Full Text Available Mallet fingers with an avulsion fracture of the distal phalanx or rupture of the terminal tendon of the extensor mechanism is known as a common injury, while mallet thumb is very rare. In this paper, the case of a 19-year-old woman with a sprained left thumb sustained while playing basketball is presented. Plain radiographs and computed tomography revealed an avulsion fracture involving more than half of the articular surface at the base of the distal phalanx. Closed reduction and percutaneous fixation were performed using the two extension block Kirschner wires’ technique under digital block anesthesia. At 4 months postoperatively, the patient had achieved excellent results according to Crawford’s evaluation criteria and had no difficulties in working or playing basketball. Various conservative and operative treatment strategies have been reported for management of mallet thumb. We chose the two extension block Kirschner wires’ technique to minimize invasion of the extensor mechanism and nail bed and to stabilize the large fracture fragment.

  7. The significance of diagnostic MRI for visualisation of trauma-induced cervical nerve root avulsion. Case report; Die Bedeutung der MRT-Diagnostik zur Darstellung traumatisch bedingter zervikaler Wurzelausrisse. Kasuistik

    Energy Technology Data Exchange (ETDEWEB)

    Muth, C.P. [Carl-Thiem-Klinikum, Cottbus (Germany). Inst. fuer Radiologie; Biemelt, F. [Carl-Thiem-Klinikum, Cottbus (Germany). Inst. fuer Radiologie; Kamenz, M. [Carl-Thiem-Klinikum, Cottbus (Germany). Inst. fuer Radiologie

    1996-11-01

    The article is intended to show the value of MRI for diagnostic visualisation and evaluation of posttraumatic nerve root avulsion as a brachial plexus injury. (orig./MG) [Deutsch] Das Ziel der Arbeit besteht in der Darstellung des Wertes der MRT-Diagnostik bei der Abklaerung traumatischer Wurzelausrisse im Bereich des Plexus brachialis. (orig./MG)

  8. High voltage test techniques

    CERN Document Server

    Kind, Dieter

    2001-01-01

    The second edition of High Voltage Test Techniques has been completely revised. The present revision takes into account the latest international developments in High Voltage and Measurement technology, making it an essential reference for engineers in the testing field.High Voltage Technology belongs to the traditional area of Electrical Engineering. However, this is not to say that the area has stood still. New insulating materials, computing methods and voltage levels repeatedly pose new problems or open up methods of solution; electromagnetic compatibility (EMC) or components and systems al

  9. The mechanical effect of the existing cement mantle on the in-cement femoral revision.

    LENUS (Irish Health Repository)

    Keeling, Parnell

    2012-08-01

    Cement-in-cement revision hip arthroplasty is an increasingly popular technique to replace a loose femoral stem which retains much of the original cement mantle. However, some concern exists regarding the retention of the existing fatigued and aged cement in such cement-in-cement revisions. This study investigates whether leaving an existing fatigued and aged cement mantle degrades the mechanical performance of a cement-in-cement revision construct.

  10. Avulsion processes at the terminus of low-gradient semi-arid fluvial systems: Lessons from the Río Colorado, Altiplano endorheic basin, Bolivia

    Science.gov (United States)

    Donselaar, M. E.; Cuevas Gozalo, M. C.; Moyano, S.

    2013-01-01

    The Río Colorado dryland river system in the southeast of the endorheic Altiplano Basin (Bolivia) terminates on a very flat coastal plain at the edge of the Salar de Uyuni, the world's largest salt pan with an area of ca. 12,500 km2. Since the Pleistocene the basin has experienced several lake expansion and contraction cycles in response to wetter and drier climate periods, respectively. At present the basin is in a dry climate period which results in a lake level lowstand and progradation of fluvial systems such as the Río Colorado onto the former lake bottom. The present field study of the terminus of the Río Colorado shows that the river experiences a gradual downstream decrease of bankfull width and depth. This bankfull decrease is caused by the combined effects of: (1) extremely low gradient of the lake bottom and, hence, loss of flow energy, and (2) downstream transmission losses due to high evaporation potential and river water percolation through the channel floor. Peak water discharge in seasonal, short-duration rain periods causes massive overbank flooding and floodplain inundation. On satellite images the morphology of the river terminus has a divergent pattern and resembles a network of coeval sinuous distributary channels. However, field observations show that only one channel is active at low flow stage, and at high-flow stage an abandoned, partially infilled channel may be active as well. The active channel at its termination splits into narrow and shallow anastomosing streams before its demise on the lacustrine coastal plain. The rest of the channels which form the divergent network are older sediment-filled abandoned sinuous river courses with multiple random avulsion points. These channel deposits, together with extensive amalgamated crevasse-splay deposits, form an intricate network of fluvial sand deposits. Successive stages of progressively deeper crevasse-channel incision into the floodplain are the result of waning-stage return flow of

  11. MARKOWITZ STRATEGIES REVISED

    Institute of Scientific and Technical Information of China (English)

    Yan Jia-an; Zhou Xunyu

    2009-01-01

    Continuous-time Markowitz's mean-variance efficient strategies are modified by parameterizing a critical quantity. It is shown that these parameterized Markowitz strategies could reach the original mean target with arbitrarily high probabilities. This, in turn, motivates the introduction of certain stopped strategies where stock holdings are liquidated whenever the parameterized Markowitz strategies reach the present value of the mean target. The risk aspect of the revised Markowitz strategies are examined via expected discounted loss from the initial budget. A new portfolio selection model is suggested based on the results of the paper.

  12. Morphological and sedimentological evidences of repeated avulsions of Someşu Mic River (Romania), associated to salt tectonics

    Science.gov (United States)

    Persoiu, I.; Radoane, M.

    2009-04-01

    . Four palaeochannels are visible on the floodplain's surface, these being also evident in the sedimentary structure of the valley infill, as revealed by the electrical imaging and drilling. Former channel infills consist mainly of massive and sandy clays (low electrical resistivity - 5.8 ohm.m), whereas the sectors between them are filled by pebbles and sands interpreted to be channel deposits (high values of the electrical resistivity - 80 ohm.m).The absence of coarse gravels from the bottom, direct disposal of fine sediments on marls and the presence of massive clay suggests 3 stages in the channels evolution. The first one is a long period of stability, supposed to be associated to a low sinuous course, when river incised the sedimentary complex of the floodplain, until it was intersected the valley bottom. The second stage is an abrupt avulsion to the right, produced probably during an important flood, and the third stage corresponds to the period of complete abandonment of it and the evolution as oxbow lake. If we take in consideration the presence of the diapiric syncline on the right side of the valley, and the disposal of parallel channels with it (including the present-day one), we conclude that this behavior is caused by a lateral tilting of the floodplain trough the right.

  13. Identification and management of chronic shoulder pain in the presence of an MRA-confirmed humeral avulsion of the inferior glenohumeral ligament (HAGL) lesion

    Science.gov (United States)

    Karmali, Arif; McLeod, Jennifer

    2016-01-01

    Objective: To present the assessment and conservative management of chronic shoulder pain in the presence of a humeral avulsion of the inferior glenohumeral ligament (HAGL) lesion in an active individual. Clinical Features: A 47 year-old female office-worker with constant, deep, right shoulder pain with occasional clicking and catching claimed to have “tore something” in her right shoulder five years ago while performing reverse bicep curls. A physical exam led to differential diagnoses of a Superior Labrum Anterior to Posterior (SLAP) lesion, Bankart lesion, and bicipital tendinopathy. A Magnetic Resonance Arthrogram revealed a HAGL lesion. Intervention and Outcome: A conservative chiropractic treatment plan in addition to physical therapy was initiated. The patient reported 75% improvement in symptoms after 4 treatments over a four-week duration. Summary: This case demonstrates the successful implementation of a conservative plan of management suggesting that the treatment provided to this patient should be considered and attempted prior to arthroscopic surgery. PMID:27385837

  14. Efficacy of two cannabis based medicinal extracts for relief of central neuropathic pain from brachial plexus avulsion: results of a randomised controlled trial.

    Science.gov (United States)

    Berman, Jonathan S; Symonds, Catherine; Birch, Rolfe

    2004-12-01

    The objective was to investigate the effectiveness of cannabis-based medicines for treatment of chronic pain associated with brachial plexus root avulsion. This condition is an excellent human model of central neuropathic pain as it represents an unusually homogenous group in terms of anatomical location of injury, pain descriptions and patient demographics. Forty-eight patients with at least one avulsed root and baseline pain score of four or more on an 11-point ordinate scale participated in a randomised, double-blind, placebo-controlled, three period crossover study. All patients had intractable symptoms regardless of current analgesic therapy. Patients entered a baseline period of 2 weeks, followed by three, 2-week treatment periods during each of which they received one of three oromucosal spray preparations. These were placebo and two whole plant extracts of Cannabis sativa L.: GW-1000-02 (Sativex), containing Delta(9)tetrahydrocannabinol (THC):cannabidiol (CBD) in an approximate 1:1 ratio and GW-2000-02, containing primarily THC. The primary outcome measure was the mean pain severity score during the last 7 days of treatment. Secondary outcome measures included pain related quality of life assessments. The primary outcome measure failed to fall by the two points defined in our hypothesis. However, both this measure and measures of sleep showed statistically significant improvements. The study medications were generally well tolerated with the majority of adverse events, including intoxication type reactions, being mild to moderate in severity and resolving spontaneously. Studies of longer duration in neuropathic pain are required to confirm a clinically relevant, improvement in the treatment of this condition. PMID:15561385

  15. Revised Rules for Concrete Bridges

    DEFF Research Database (Denmark)

    Thoft-Christensen, Palle; Jensen, F. M.; Middleton, C.;

    This paper is based on research performed for the Highway Agency, London, UK under the project DPU/9/44 "Revision of Bridge Assessment Rules Based on Whole Life Performance: Concrete Bridges" It contains details of a methodology which can be used to generate Whole Life (WL) reliability profiles....... These WL reliability profiles may be used to establish revised rules for Concrete Bridges....

  16. Perioperative complications in revision hip surgery.

    Science.gov (United States)

    Thomasson, E; Guingand, O; Terracher, R; Mazel, C

    2001-01-01

    Revision hip surgery now constitutes 10-30% of all joint procedures. The morbidity and associated with this demanding operation are not well established. The goal of this paper is to determine these rates and to identify some predictive factors. The complication rate ranges from 31,5 to more than 77% in the literature. Life threatening complications represent 1,8 to 8% of these, leading to death in about 1,6%. ASA score and age above 75 appear to be correlated with medical complications. The injection rate varies from 1 to 5,8%, and may be as high as 14% in cases with a past history of infection. Heterotopic ossification occurred in 13 to 65%, reaching severity in 3,3 to 8,3%. Surgical complications include dislocation and femoral injuries. Dislocations occur in almost 10%, leading to revision in1-4,2%. Age and the number of previous surgical operations appear to be significant risk factors. Femoral injuries (perforations or femoral fractures) occur in 6-37%, especially in impaction grafting technique and when uncemented implants are used. Age over 75 years and femoral defects appear to be significant risk factors for femoral fractures. The rate of complications in revision hip surgery continues to be high, but successful clinical outcome can be attained even in elderly patients. Attentive preoperative exams, good prevention of technical pitfalls, the experience of the surgeon and the use of specific tools may decrease these complications and make this demanding procedure safer.

  17. Clinical effect analysis of hyperbaric oxygen to reduce the swelling and pain caused by limb avulsion%高压氧治疗减轻肢体撕脱伤肿胀、疼痛效果的临床分析

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Background: In recent years, most major avulsion of limb skin were caused by traffic accidents, industry accidents and mechanical traumas, the tissue damage, the operational elimination of subcutaneous fat or skin flap transfer may cause ischemia and hypoxia at the wound, the limb swelling and pain were obvious, the routine treatment was slow and of long recovering time. Objective: To discuss the effects of hyperbaric oxygen to reduce the swelling and pain caused by limb avulsion. Unit: The People's Hospital of Sanshui.

  18. Philippines revises power plans

    Energy Technology Data Exchange (ETDEWEB)

    Hayes, D.

    1988-02-01

    Following an unexpected surge in electricity demand the Philippines has revised its medium term power development programme. The sharp increase in electricity consumption follows three years of slack demand due to civil disturbances before the end of the Macros administration and the election of Corazon Aquino as President in 1986. Originally, the Aquino government's medium term power development plans called for about 500MW of generating capacity to be installed between 1986 and 1992. The three proposed plants were scheduled for commissioning in 1991 and 1992. However, a spurt in power demand growth during the past nine months has caused concern among industrialists that power shortages could occur by the end of the decade. So additional capacity will be installed to prevent an anticipated shortfall in electricity supplies by the early 1990s.

  19. Two-Stage Revision Anterior Cruciate Ligament Reconstruction.

    Science.gov (United States)

    Erickson, Brandon J; Cvetanovich, Gregory; Waliullah, Khalid; Khair, Michael; Smith, Patrick; Bach, Bernard; Sherman, Seth

    2016-05-01

    The number of primary anterior cruciate ligament (ACL) tears is rapidly increasing. In patients who wish to return to their preoperative level of function, specifically as it pertains to participation in sports, the gold standard of treatment following an ACL tear remains an anterior cruciate ligament (ACL) reconstruction. Despite a majority of good/excellent results following primary ACL reconstruction, there is a growing subset of patients with persistent or recurrent functional instability who require revision ACL reconstruction. Preoperative planning for revision ACL reconstruction requires a careful understanding of the root cause of ACL failure, including possible technical causes of primary ACL failure and the presence of combined knee pathology that was not addressed at the index ACL reconstruction. The decision to perform 2-stage revision ACL reconstruction is multifactorial and is reached by technical considerations that may make a 1-stage revision less optimal, including tunnel widening, arthrofibrosis, active infection, and others. Concomitant knee pathology such as meniscal deficiency, malalignment (including an increase in posterior tibial slope), chondral lesions, and other ligamentous laxity may also require a staged approach to treatment. This evidence-based review covers the indications for 2-stage revision ACL reconstruction, surgical techniques, evidence for and technique of bone grafting prior ACL tunnels, and outcomes of 2-stage revision stratified by initial cause of ACL reconstruction failure. With proper preoperative planning and an understanding of the cause of failure following the primary ACL reconstruction, revision ACL reconstruction can offer excellent outcomes in the motivated patient. [Orthopedics. 2016; 39(3):e456-e464.]. PMID:27045480

  20. Hip Revision with Cup Removal System and Revision Shell

    Medline Plus

    Full Text Available The Zimmer® Explant® Cup Removal System and Trabecular Metal™ Revision Shell You must have Javascript enabled in your web browser. View Program Transcript Click Here to view ...

  1. Type V avulsion injury of the insertion of the lfexor digitorum profundus tendon:2 cases report%V 型指深屈肌腱撕脱性损伤附二例报告

    Institute of Scientific and Technical Information of China (English)

    李文军; 陈山林; 田光磊; 田文; 王树锋; 张友乐

    2014-01-01

    Objective To report uncommon and non-sports type V avulsion injury of the insertion of the lfexor digitorum profundus tendon and to investigate the treatment methods. Methods The clinical results of 2 patients who were both treated in our department on October 29, 2012 were retrospectively analyzed. Results A male patient was 38 years old, whose left ring finger injuries were caused by heavy things. A female patient was 31 years old, whose left little ifnger injures were caused by collision. They were both treated with Kirschner wire ifxation combined with snap pullout of the absorbable polydioxanone suture ( PDS ) II. The 2 patients were followed up for 14 months. The active range of motion of the distal interphalangeal ( DIP ) joint recovered to 90%of that of the normal side. Conclusions Type V avulsion injury of the insertion of the lfexor digitorum profundus tendon is uncommon, and the early diagnosis and surgical treatment is a good choice, with good clinical results.

  2. EPR first responders revision test

    International Nuclear Information System (INIS)

    In this revision test evaluates the acquired knowledge in case of radiological emergency confront. Actions to be taken in relation to people, equipment and the environment. Doses, radioactive sources, pollution

  3. A revision of Neonauclea (Rubiaceae)

    NARCIS (Netherlands)

    Ridsdale, C.E.

    1989-01-01

    An illustrated revision of the 65 species of the genus Neonauclea (Rubiaceae-Naucleeae) with a key to all species. The 61 Malesian species are treated in full, 28 new species are described and 5 new combinations are made.

  4. Revision du Genre Aseraggodes Kaup

    NARCIS (Netherlands)

    Chabanaud, P.

    1930-01-01

    Le présent travail comprend la définition du genre Aseraggodes Kaup et la revision, sous forme d'une clef dichotomique, de toutes les espèces qui le composent, revision établie d'après les types eux-mêmes de ces espèces. Ce genre Aseraggodes appartient à la famille des Soleidae et à la sousfamille d

  5. Revision Knee Surgery

    Medline Plus

    Full Text Available ... your cement technique? You talked about cementing the housing of the tibia. Is it the same on ... I’m going to put cement around the housing of the tibial component so that I’m ...

  6. Relación céntrica: revisión de conceptos y técnicas para su registro. Parte I Centric relation: concepts revision and recording techniques. Part I

    Directory of Open Access Journals (Sweden)

    A. Orozco Varo

    2008-12-01

    Full Text Available La relación céntrica ha sido objeto de disparidad de criterios en la odontología durante más de un siglo. A lo largo de este trabajo, vamos a exponer diferentes métodos usados tanto para obtener el registro, como para comprobar su certeza y corroborar la posición condilar. Dado que no existe evidencia científica en el tema, en este trabajo, revisaremos los estudios experimentales que aparecen en la literatura. Los hemos divididos en dos partes, la primera relacionada con la definición de relación céntrica y la segunda parte relacionada con técnicas de registro, posición condilar y la discrepancia entre relación céntrica y oclusión céntrica.The centric relation has been controversial on dentistry during more of one century. Along of this work, we are going to expose different methods to recording as checking the accuracy and condilar position. Given that there aren’t scientific evidence, in this work, we review the researches publicated. We have divided them into two parts; the first is related with the definition of centric relation and the second part is related with recording techniques, condilar position and centric relation- centric occlusion discrepancy.

  7. Relación céntrica: revisión de conceptos y técnicas para su registro. Parte II Centric relation: concepts revision and recording techniques. Part II

    Directory of Open Access Journals (Sweden)

    A. Orozco Varo

    2008-12-01

    Full Text Available La relación céntrica ha sido objeto de disparidad de criterios en la odontología durante más de un siglo. A lo largo de este trabajo, vamos a exponer diferentes métodos usados tanto para obtener el registro, como para comprobar su certeza y corroborar la posición condilar. Dado que no existe evidencia científica en el tema, en este trabajo, revisaremos los estudios experimentales que aparecen en la literatura. Los hemos divididos en dos partes, la primera relacionada con la definición de relación céntrica y la segunda parte relacionada con técnicas de registro, posición condilar y la discrepancia entre relación céntrica y oclusión céntrica.The centric relation has been controversial on dentistry during more of one century. Along of this work, we are going to expose different methods to recording as checking the accuracy and condilar position. Given that there aren’t scientific evidence, in this work, we review the researches publicated. We have divided them into two parts; the first is related with the definition of centric relation and the second part is related with recording techniques, condilar position and centric relation- centric occlusion discrepancy.

  8. Functional compensative mechanism of upper limb with root avulsion of C5-C6 of brachial plexus after ipsilateral C7 transfer

    Institute of Scientific and Technical Information of China (English)

    SONG Jie; CHEN Liang; GU Yu-dong

    2008-01-01

    Objective: To investigate the compensative mechanism of no further impairment of the upper limb after ipsilateral C7 transfer for treatment of root avuision of C5-C6 of the bra- chial plexus. Methods: Sixty Sprague Dawley SD rats were randomly divided into a CT-transection group and a control group, 30 rats each. In the C7-transection group, the left forelimbs of the animals underwent transection of ipsilat- eral C7 nerve root while C5 and C6 nerve roots were avulsed. In the control group, the left forelimbs only underwent C5 and C6 root avulsion. The representative muscles of C7 innervated mainly by C7 including latissimus dorsi, triceps, extensor carpi radialis brevis and extensor digitorum com- munis were evaluated with neurophysiological investigation, muscular histology and motor end plate histomorphometry 3, 6 and 12 weeks after operation. The right forelimbs of all rats were taken as the control sides. Results: Three weeks after operation, the recovery rates of amplitudes of compound muscle action potential CMAP and CMAP latency, muscular wet weight and cross-sec-tional area of muscle fibers, and area of postsynaptic membranes of those four representative muscles in the C7transection group were significantly lower than those of the control group P <0.05 or P <0.01. Six weeks postoperatively, the recovery rates of CMAP amplitude and latency of the triceps showed no significant difference between the C7transection group and the control group P0.05. For the extensor carpi radialis brevis and the extensor digitorum communis, the recovery rates of the cross-sectional area of muscle fibers, the amplitude and latency of CMAP and the area of postsynaptic membranes showed no significant difference between the two groups P 0.05, while the rest parameters were still significantly different between the two group P <0.05 or P <0.01. As far as the ultramicrostructure was concerned in the C7-transection group, more motor end plates of four representative muscles were

  9. Arthroscopic Treatment for Tibial Avulsion Fractures of Anterior Crucial Ligament with Orthocord Suture Fixation%关节镜下Orthocord缝线固定治疗前交叉韧带胫骨止点撕脱骨折

    Institute of Scientific and Technical Information of China (English)

    王洪; 孙川; 孟春庆; 杨述华; 杜靖远; 邵增务

    2011-01-01

    Objective To investigate the methods and effects of the arthroscopic treatment for tibial avulsion fractures of anterior crucial ligament. Methods Twenty seven patients with tibial avulsion fractures were treated with operation. The avulsion fragment was reduced under arthroscopy. Two bone tunnels were drilled from internal tibial tuberosity to the both sides of the avulsed fragment.2# Orthocord suture was used for arthroscopic fixation of the fractures. Results All patients were followed up for 12.3 months on average (7-24 months). X-ray confirmed satisfactory healing. At the latest follow-up, the average Lysholm knee score was 93.1 points (84-100 points), the Lach-man test and anterior drawer test were both negative and the range of motion was normal in 22 cases while limited in 5 cases. Conclusion Arthroscopic treatment for tibial avulsion fractures of anterior crucial ligament with Orthocord suture fixation is easy and minimally invasive. It can lead to reliable fixation and less complications, and facilitate early rehabilitation.%目的 探讨前交叉韧带(ACL)胫骨止点撕脱骨折关节镜下治疗的方法及疗效.方法 对27例ACL胫骨止点撕脱骨折进行手术,关节镜下将骨折复位后,从胫骨结节内侧向骨折块的两侧钻取两个骨隧道,使用2号Orthocord缝线固定骨折.结果 本组均得到随访,平均12.3个月(7~24个月),X线片示骨折愈合良好.术后末次随访Lysholm评分平均93.1分(84~100分),Lachman试验及前抽屉试验均为阴性,22例关节活动度达到正常,5例存在关节活动受限.结论 关节镜下使用Orthocord缝线固定治疗ACL胫骨止点撕脱骨折具有固定可靠、操作简单、手术创伤小、术后恢复快、并发症少等优点.

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

    Directory of Open Access Journals (Sweden)

    Rajesh Malhotra

    2012-01-01

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

  11. Revision Knee Surgery

    Medline Plus

    Full Text Available ... Right. So the cementing technique is still critical. Well and to be honest, you almost did a little bit of ... with this lady, she hasn’t been functioning well for the last two years. There’s no way her endurance and strength can be to any significant degree. And don’t you ...

  12. Revision of infected knee arthroplasties in Denmark.

    Science.gov (United States)

    Lindberg-Larsen, Martin; Jørgensen, Christoffer C; Bagger, Jens; Schrøder, Henrik M; Kehlet, Henrik

    2016-08-01

    Background and purpose - The surgical treatment of periprosthetic knee infection is generally either a partial revision procedure (open debridement and exchange of the tibial insert) or a 2-stage exchange arthroplasty procedure. We describe the failure rates of these procedures on a nationwide basis. Patients and methods - 105 partial revisions (100 patients) and 215 potential 2-stage revision procedures (205 patients) performed due to infection from July 1, 2011 to June 30, 2013 were identified from the Danish Knee Arthroplasty Register (DKR). Failure was defined as surgically related death ≤ 90 days postoperatively, re-revision due to infection, or not reaching the second stage for a planned 2-stage procedure within a median follow-up period of 3.2 (2.2-4.2) years. Results - The failure rate of the partial revisions was 43%. 71 of the partial revisions (67%) were revisions of a primary prosthesis with a re-revision rate due to infection of 34%, as compared to 55% in revisions of a revision prosthesis (p = 0.05). The failure rate of the 2-stage revisions was 30%. Median time interval between stages was 84 (9-597) days. 117 (54%) of the 2-stage revisions were revisions of a primary prosthesis with a re-revision rate due to infection of 21%, as compared to 29% in revisions of a previously revised prosthesis (p = 0.1). Overall postoperative mortality was 0.6% in high-volume centers (> 30 procedures within 2 years) as opposed to 7% in the remaining centers (p = 0.003). Interpretation - The failure rates of 43% after the partial revision procedures and 30% after the 2-stage revisions in combination with the higher mortality outside high-volume centers call for centralization and reconsideration of surgical strategies. PMID:26900908

  13. Survey of marine natural product structure revisions: a synergy of spectroscopy and chemical synthesis.

    Science.gov (United States)

    Suyama, Takashi L; Gerwick, William H; McPhail, Kerry L

    2011-11-15

    The structural assignment of new natural product molecules supports research in a multitude of disciplines that may lead to new therapeutic agents and or new understanding of disease biology. However, reports of numerous structural revisions, even of recently elucidated natural products, inspired the present survey of techniques used in structural misassignments and subsequent revisions in the context of constitutional or configurational errors. Given the comparatively recent development of marine natural products chemistry, coincident with modern spectroscopy, it is of interest to consider the relative roles of spectroscopy and chemical synthesis in the structure elucidation and revision of those marine natural products that were initially misassigned. Thus, a tabulated review of all marine natural product structural revisions from 2005 to 2010 is organized according to structural motif revised. Misassignments of constitution are more frequent than perhaps anticipated by reliance on HMBC and other advanced NMR experiments, especially when considering the full complement of all natural products. However, these techniques also feature prominently in structural revisions, specifically of marine natural products. Nevertheless, as is the case for revision of relative and absolute configuration, total synthesis is a proven partner for marine, as well as terrestrial, natural products structure elucidation. It also becomes apparent that considerable 'detective work' remains in structure elucidation, in spite of the spectacular advances in spectroscopic techniques.

  14. Brain glucose metabolic changes associated with chronic spontaneous Pain due to brachial plexus avulsion:a preliminary positron emission tomography study

    Institute of Scientific and Technical Information of China (English)

    CHEN Fu-yong; TAO Wei; CHENG Xin; WANG Hong-yan; HU Yong-sheng; ZHANG Xiao-hua; LI Yong-jie

    2008-01-01

    Background Previous brain imaging studies suggested that the brain activity underlying the perception of chronic pain maV differ from that underlying acute pain.To investigate the brain regions involved in chronic spontaneous pain due to brachial plexus avulsion(BPA),fluorine-18fluorodeoxygIucose (19F-FDG) positron emission tomography (PET) scanning was applied to determine the glucose metabolic changes in patients with pain due to BPA.Methods Six right-handed patients with chronic spontaneous pain due to left-BPA and twelve right-handed age-and sex-matched healthy control subjects participated in the 18F-FDG PET study.The patients were rated by visual analog scale (VAS) during scanning and Hamilton depression scale and Hamilton anxiety scale after scanning.Statistical parametric mapping 2 (SPM2) was applied for data analysis.Results Compared with healthy subjects,the patients had significant glucose metabolism decreases in the right thalamus and S I(P<0.001,uncorrected),and significant glucose metabolism increases in the right orbitofrontaI cortex (OFC) (BA11),left rostral insula cortex and left dorsolateral prefrontal codex (DLPFC) (BA10/46) (P<0.001,uncorrected).Conclusion These findings suggest that the brain areas involved in emotion.aRention and internal modulation of pain may be related to the chronic spontaneous pain due to BPA.

  15. HEDR modeling approach: Revision 1

    International Nuclear Information System (INIS)

    This report is a revision of the previous Hanford Environmental Dose Reconstruction (HEDR) Project modeling approach report. This revised report describes the methods used in performing scoping studies and estimating final radiation doses to real and representative individuals who lived in the vicinity of the Hanford Site. The scoping studies and dose estimates pertain to various environmental pathways during various periods of time. The original report discussed the concepts under consideration in 1991. The methods for estimating dose have been refined as understanding of existing data, the scope of pathways, and the magnitudes of dose estimates were evaluated through scoping studies

  16. Medical writing, revising and editing

    DEFF Research Database (Denmark)

    Pilegaard, Morten

    2006-01-01

    The globalization of science makes medical writing, editing and revision a rapidly growing field of linguistic study and practice. Medical science texts are written according to uniform, general guidelines and medical genres have become highly conventionalized in terms of structure and linguistic...... form. Medical editing often takes the form of peer review and mainly addresses issues of contents and overall validity. Medical revision incorporates the checking of the macrostructure and the microstructure of the text, its language and style and its suitability for the target reader or client...

  17. Arthroscopic Ethibond suture and anchor fixation for avulsion fracture of anterior cruciate ligament tibial insertion%关节镜下爱惜邦缝线锚钉固定法治疗新鲜前交叉韧带胫骨止点撕脱骨折

    Institute of Scientific and Technical Information of China (English)

    段平国; 郭润生; 程明; 周通华; 徐屹; 戴闽

    2016-01-01

    目的 探讨关节镜下爱惜邦不可吸收缝线锚钉固定法治疗前交叉韧带(ACL)胫骨止点撕脱骨折的手术疗效. 方法 回顾性分析2013年7月-2014年6月ACL胫骨止点撕脱骨折患者20例,男12例,女8例;年龄18~41岁,平均25.3岁.Meyers-McKeever分型为Ⅱ型或Ⅲ型骨折.Lachman试验和前抽屉试验均为阳性.所有患者均在伤后3周内手术,均在关节镜下使用爱惜邦不可吸收缝线联合锚钉复位固定ACL胫骨止点.随访复查X线片,采用Lysholm评分和国际膝关节文献委员会(IKDC)评分对膝关节功能进行评价. 结果 手术时间45 ~ 70 min,平均50 min.出血量5~15 ml,平均10 ml.随访12 ~ 24个月,平均16.3个月.所有患者术后复查X线片提示ACL胫骨止点撕脱骨折均复位及愈合良好.术后Lachman试验和前抽屉试验均为阴性,膝关节功能恢复良好.术前Lysholm评分为42 ~61分[(51.1±6.2)分],末次随访时为89~96分[(93.5±2.3)分](P<0.05);术前IKDC评分为46~68分[(55.2±7.0)分],末次随访时为84 ~96分[(91.0±3.9)分](P<0.05). 结论 关节镜下爱惜邦不可吸收缝线锚钉固定法治疗ACL胫骨止点撕脱骨折,其操作简单,创伤小,固定可靠,功能恢复良好,临床疗效满意.%Objective To investigate the clinical effect of Ethibond suture and anchor fixation by arthroscopic technique for the treatment of avulsion fracture of the anterior cruciate ligament (ACL) tibial insertion.Methods Twenty patients with avulsion fracture of the ACL tibial insertion hospitalized between July 2013 and June 2014 were collected retrospectively.There were 12 males and 8 females,aged 18-41 years (mean,25.3 years).All patients were identified with type Ⅱ and type Ⅲ fractures according to the Meyers-McKeever classification.Results of Lachman test and anterior drawer test were both positive.All patients accepted the operation that avulsion fracture of the ACL tibial insertion was treated with the Ethibond suture

  18. Revised Code of Ethics wins CMA approval.

    OpenAIRE

    Rafuse, J

    1996-01-01

    Canadian physicians now operate under a revised Code of Ethics. In August General Council endorsed a revised code put forward by the CMA's Committee on Ethics. The endorsement brings 4 years' work to a positive conclusion.

  19. [Revised practice guideline 'Anaemia in midwifery practice'

    NARCIS (Netherlands)

    Beentjes, M.; Jans, S.M.P.J.

    2012-01-01

    The practice guideline of the Royal Dutch Organization of Midwives 'Anaemia in primary care midwifery practice' published in 2000, has recently been revised. The revised guideline takes physiological haemodilution during pregnancy into consideration and provides gestation specific reference values f

  20. Diet History Questionnaire: Database Revision History

    Science.gov (United States)

    The following details all additions and revisions made to the DHQ nutrient and food database. This revision history is provided as a reference for investigators who may have performed analyses with a previous release of the database.

  1. Revised Safety Code A2

    CERN Document Server

    SC Secretariat

    2005-01-01

    Please note that the revised Safety Code A2 (Code A2 rev.) entitled "REPORTING OF ACCIDENTS AND NEAR MISSES" is available on the web at the following url: https://edms.cern.ch/document/335502/LAST_RELEASED Paper copies can also be obtained from the SC Unit Secretariat, e-mail: sc.secretariat@cern.ch SC Secretariat

  2. Revised Accounting for Business Combinations

    Science.gov (United States)

    Wilson, Arlette C.; Key, Kimberly

    2008-01-01

    The Financial Accounting Standards Board (FASB) has recently issued Statement of Financial Accounting Standards No. 141 (Revised 2007) Business Combinations. The object of this Statement is to improve the relevance, representational faithfulness, and comparability of reported information about a business combination and its effects. This Statement…

  3. The nuclear liability conventions revised

    International Nuclear Information System (INIS)

    The signature on 12 February 2004 of the Protocols amending respectively the 1960 Paris Convention and the 1963 Brussels Supplementary Convention was the second step of the process of modernisation of the international nuclear liability regime after the adoption in September 1997 of a Protocol revising the 1963 Vienna Convention and of a new Convention on Supplementary Compensation for Nuclear Damage. The common objective of the new instruments is to provide more funds to compensate a larger number of potential victims in respect of a broader range of damage. Another goal of the revision exercise was to maintain the compatibility between the Paris and Vienna based systems, a commitment enshrined in the 1988 Joint Protocol, as well as to ascertain that Paris/Brussels countries could also become a Party to the Convention on Supplementary Compensation. However, while generally consistent vis a vis the Joint Protocol, the provisions of the Paris and Vienna Conventions, as revised, differ on some significant aspects. Another remaining issue is whether the improved international nuclear liability regime will succeed in attracting in the future a larger number of countries, particularly outside Europe, and will so become truly universal. Therefore, the need for international co-operation to address these issues, to facilitate the adoption of new implementing legislation and to ensure that this special regime keeps abreast of economic and technological developments, is in no way diminished after the revision of the Conventions.(author)

  4. Vision for IT revision 2020

    OpenAIRE

    Berthing, Hans Henrik

    2014-01-01

    Denne præsentation inddrager dele af resultatet som arbejdsgruppe IT Assurance Task force nedsat af ISACA Knowledge board er kommet frem til i løbet af gruppens arbejde 2013-2014 med henblik på at finde trends og tendenser for IT revision i 20220

  5. REVISION MASTOIDECTOMY AND ITS GOAL

    Directory of Open Access Journals (Sweden)

    Sampath Kumar Singh Katewad

    2016-06-01

    Full Text Available BACKGROUND The main aims in doing surgery for chronic otitis media are: 1. Complete clearance of progressive disease from its site and form dry and well-epithelialised cavity. 2. Prevention of recurrent and residual cholesteatoma achieved by modifying the anatomy of tympanomastoid compartments. 3. Hearing improvement by reconstructing the ossicles and tympanic membrane. The main indication for revision surgery is failure to achieve above said aims by previous surgeon. The aim of our study was to identify the causes of recurrent disease and the factors that helps in chronic otitis media surgery to minimise the revisions & report the results of revision mastoidectomy. MATERIALS AND METHODS In this study, thirty patients are selected and operated for revision mastoidectomy surgery at our institute during the period from May 2013 – Dec 2015. These cases were analysed retrospectively, patients who had discharging ear with the history of previous intact canal wall and canal down mastoidectomy surgeries were selected for this study. OBSERVATION AND RESULTS In this study, the common age group of patients who underwent revision surgery - 8-46 yrs. (mean 19 yrs.. Majority of patients are female, 16 cases (53.33%; and males 14 cases (46.66%. Revision mastoidectomies were applied to 12 cases (40% of previous canal wall up mastoidectomies and 18 cases (60% of prior canal down mastoidectomies. 60% of cases had residual/recurrent cholesteatoma which was the most common finding seen. While in 33.3% cases patient had only chronic granulations. The most frequent site of cholesteatoma was mastoid antrum/mastoid cavity seen in 73% followed by attic 42.3% and mesotympanum in 40% of cases. The common failure in primary surgery was inadequate clearance of diseased mastoid air cells - 48%, high facial bridge - 48%, stenotic meatoplasty - 40%, incomplete removal of buttress - 30%. Tympanic membrane perforation - 6.66% of cases with poor architecture of mastoidectomy

  6. 可吸收螺钉治疗膝后交叉韧带胫骨附着点撕脱骨折%Treatment of tibial avulsion fracture of the posterior cruciate ligament with absorbable screw

    Institute of Scientific and Technical Information of China (English)

    刘笠; 任国文; 王振汉

    2011-01-01

    目的 探讨应用可吸收螺钉治疗膝后交叉韧带胫骨附着点撕脱性骨折的治疗效果.方法 2006年1月~2011年1月对16例膝后交叉韧带胫骨附着点撕脱骨折进行可吸收螺钉内固定治疗.结果 经3个月~1年随访,无感染、瘘道形成,无骨折再移位和关节僵硬,16例骨折全部愈合,按HSS膝关节评分法,优13例,良3例,优良率100%.结论 可吸收螺钉在后交叉韧带撕脱骨折固定治疗中具有较好的疗效.%Objective To investigate the therapeutic effect of absorbable screw in treating tibial avulsion fracture of the posterior cruciate ligolnent. Methods Froln Jan. 2006 to Jan. 2011,16 cases of tibial avulsion fracture of the posterior crueiate ligoment were internally fixated by using absorbable screw,and were retrospectively analyzed.Results The follow-up tilne ranged ffoln 3 months to 1 year,indicating no itffeetion,no stiffness,no fistula formation and no re-displacelnent of fracture. And the 16 eases were totally healed. According to the HSS score of knee joint,13 eases were excellent,3 cases were good,with excellent and good rate of 100%. Conclusion Application of absorbable screw is a good way in treating tibia] avulsion fracture of the posterior cruciate ligoment.

  7. Survey of marine natural product structure revisions: a synergy of spectroscopy and chemical synthesis

    OpenAIRE

    Suyama, Takashi L.; Gerwick, William H.; McPhail, Kerry L.

    2011-01-01

    The structural assignment of new natural product molecules supports research in a multitude of disciplines that may lead to new therapeutic agents and or new understanding of disease biology. However, reports of numerous structural revisions, even of recently elucidated natural products, inspired the present survey of techniques used in structural misassignments and subsequent revisions in the context of constitutional or configurational errors. Given the comparatively recent development of m...

  8. Solution of the Falkner-Skan wedge flow by a revised optimal homotopy asymptotic method.

    Science.gov (United States)

    Madaki, A G; Abdulhameed, M; Ali, M; Roslan, R

    2016-01-01

    In this paper, a revised optimal homotopy asymptotic method (OHAM) is applied to derive an explicit analytical solution of the Falkner-Skan wedge flow problem. The comparisons between the present study with the numerical solutions using (fourth order Runge-Kutta) scheme and with analytical solution using HPM-Padé of order [4/4] and order [13/13] show that the revised form of OHAM is an extremely effective analytical technique. PMID:27186477

  9. A modified replantation for thumb rotating avulsion amputation%拇指旋转撕脱离断的再植术式改进

    Institute of Scientific and Technical Information of China (English)

    李瑞华; 阚世廉; 高燕新; 王晓刚; 殷中罡

    2012-01-01

    Objective To introduce a modified replantation for thumb rotating avulsion amputation,and to evaluate its short term clinical outcome.Methods From January 2007 to July 2009,7 patients with thumb rotating avulsion amputation underwent replantation,including 6 males and 1 female,aged from 21 to 47 years (average,28.3 years).The amputation level of each thumb was metacarpophalangeal joint.During operation,fusion of metacarpophalangeal joint was performed according to injury degree of soft tissue; interphalangeal joint of the thumb was fixed in 15 degrees of flexion by sewing flexor pollicis longus muscle tendon and extensor pollicis longus muscle tendon to tendon sheath or soft tissue; the superficial vein harvested from ipsilateral forearm was used to bridge the dorsal carpal branch of radial artery and the ulnar palmacollateral artery of the thumb; direct anastomoses of dorsal veins were performed in 6 cases and venous transplantation in 1 case; and bilateral nerves were transferred to the back of the first metacarpal and anastomosed to the superficial branch of the radial nerve.Results All 7 replanted thumbs survived completely.Arterial crisis occurred in 1 case after operation,which was cured after operative and medication treatment.The follow-up period ranged from 3 to 24 months.The appearance and opposition function of replanted thumbs were satisfactory and the sensation of fingertip recovered to S4 in 4 cases and to S3 in 3 cases.The two point discrimination ranged from 8 to 12 mm.Conclusion Because bridging the dorsal carpal branch of radial artery and the ulnar palmar collateral artery of the thumb with a superficial vein harvested from ipsilateral forearm to reconstruct blood supply of the thumb is available and easy to be performed,this modified replantation is an ideal way to repair thumb rotating avulsion amputation.%目的 对拇指旋转撕脱离断再植术进行改良,并评估其近期临床疗效.方法 2007年1月至2009年7月,对

  10. Clean Air Act. Revision 5

    Energy Technology Data Exchange (ETDEWEB)

    1994-02-15

    This Reference Book contains a current copy of the Clean Air Act, as amended, and those regulations that implement the statute and appear to be most relevant to DOE activities. The document is provided to DOE and contractor staff for informational purposes only and should not be interpreted as legal guidance. This Reference Book has been completely revised and is current through February 15, 1994.

  11. Knwoledge revision in Markov networks

    OpenAIRE

    Gebhardt, Jörg; Bogerlt, Christian; Kruse, Rudolf; Detmer, Heinz

    2004-01-01

    A lot of research in graphical models has been devoted to developing correct and eficient evidence propagation methods, like join tree propagation or bucket elimination. With these methods it is possible to condition the represented probability distribution on given evidence, a reasoning process that is sometimes also called focusing. In practice, however, there is the additional need to revise the represented probability distribution in order to reflect some knowledge chang...

  12. An Uncertain Past: Data Revisions and Monetary Policy in Canada

    OpenAIRE

    Greg Tkacz

    2010-01-01

    Many important economic variables are subject to revision. This article explains how, when, and why such revisions occur; how revisions to Canadian gross domestic product (GDP) compare with GDP revisions in some other countries; which GDP components are subject to the largest revisions; and how data revisions can affect policy decisions. The author finds that revisions to Canadian GDP tend to be smaller, on average, than those of some other countries, and that among the GDP components, export...

  13. Primary and revision lumbar discectomy: A three-year review from one center

    Directory of Open Access Journals (Sweden)

    Acharya K

    2008-01-01

    Full Text Available Background: Despite variations in technique, the results of primary and revision lumbar discectomy have been good. The aim of this study was to retrospectively review cases of primary and revision lumbar discectomy performed in our institute over a three-year period. Materials and Methods: The case records of 273 patients who underwent lumbar discectomy between January 2001-2004 and fulfilled our inclusion and exclusion criteria were reviewed. Of these, 259 were primary discectomies and 14 were revision surgeries. Recurrence was defined as ipsilateral disc herniation at the previously operated level. Demographic parameters, magnetic resonance imaging of the disc, patient satisfaction and rate of recurrence were analyzed. Results: The primary surgery group had 52 (20.08% contained and 207 (79.92% extruded or sequestered discs, while the numbers in the revision group were three (21.43% and 11 (78.57% respectively. "Satisfactory" outcome was noted in 96.5% of the primary surgeries, with a recurrence rate of 3.5%. In the revision group 78.6% had "satisfactory" outcome. In 9.4% of the primary group we encountered complications, while it was 21.43% in the revision group. Conclusions: Lumbar discectomy is a safe, simple and effective procedure with satisfactory outcome in 96.5% of primary disc surgery and 78.6% of revision disc surgery.

  14. Creating and coupling a high-resolution DTM with a 1-D hydraulic model in a GIS for scenario-based assessment of avulsion hazard in a gravel-bed river

    Science.gov (United States)

    Aggett, G. R.; Wilson, J. P.

    2009-12-01

    In this paper we explore the development and assimilation of a high resolution topographic surface with a one-dimensional hydraulic model for investigation of avulsion hazard potential on a gravel-bed river. A detailed channel and floodplain digital terrain model (DTM) is created to define the geometry parameter required by the 1D hydraulic model HEC-RAS. The ability to extract dense and optimally located cross-sections is presented as a means to optimize HEC-RAS performance. A number of flood scenarios are then run in HEC-RAS to determine the inundation potential of modeled events, the post-processed output of which facilitates calculation of spatially explicit shear stress ( τ) and level of geomorphic work (specific stream power per unit bed area, ω) for each of these. Further enhancing this scenario-based approach, the DTM is modified to simulate a large woody debris (LWD) jam and active-channel sediment aggradation to assess impact on innundation, τ, and ω, under previously modeled flow conditions. The high resolution DTM facilitates overlay and evaluation of modeled scenario results in a spatially explicit context containing considerable detail of hydrogeomorphic and other features influencing hydraulics (bars, secondary and scour channels, levees). This offers advantages for: (i) assessing the avulsion hazard potential and spatial distribution of other hydrologic and fluvial geomorphic processes; and (ii) exploration of the potential impacts of specific management strategies on the channel, including river restoration activities.

  15. 前交叉韧带胫骨止点撕脱骨折研究进展%Advances in the study of avulsion fracture of the anterior cruciate ligament

    Institute of Scientific and Technical Information of China (English)

    牛金龙; 黄远章; 王晋豫; 张民

    2016-01-01

    前交叉韧带(ACL)胫骨止点撕脱骨折临床上少见,好发于儿童和青少年。虽然损伤的发生率低,如不及时诊治,将严重影响膝关节的功能。最近,各种内置物的相继出现及关节镜的应用对该疾病的治疗增添了选择性。本文结合流行病学、病因、诊断及治疗方案研究进展等方面对ACL下附着点撕脱骨折进行阐述。%Avulsion fracture of the anterior cruciate ligament (ACL) is rare in clinic, which usually occurs in children and adolescents. Although the incidence of injury is low, if it is not timely diagnosed and treated, it will seriously affect the function of the knee joint. Recently, the emergence of a variety of implants and the use of arthroscopic treatment of the disease has increased the selectivity. In this paper, the combination of epidemiology, etiology, diagnosis and treatment of the progress of the ACL avulsion fracture were described.

  16. Avulsão traumática do nervo óptico por projétil de arma de fogo de grosso calibre: relato de caso Traumatic optic nerve avulsion by high caliber bullet: case report

    Directory of Open Access Journals (Sweden)

    Rogério de Almeida Tárcia

    2006-06-01

    Full Text Available A avulsão traumática do nervo óptico ocorre mais comumente devido a traumas contusos óculo-orbitários. A avulsão do mesmo por projétil de arma de fogo de grosso calibre é causa excepcional desta lesão e deve ser pensada no manejo dos pacientes vítimas de lesões por arma de fogo na região cefálica. O presente trabalho descreve o primeiro caso documentado desta singular lesão ao nervo óptico e tece comentários sobre as diversas outras causas relatadas, mecanismos fisiopatológicos, histologia e condutas.Traumatic optic nerve avulsion occurs most commonly after blunt ocular trauma. Optic nerve avulsion by high caliber bullet is exceptional and must be thought of in the management of those patients victims of gunshot wounds to the globe and orbit. The present paper reports the first documented case of this singular condition of optic nerve injury and comments on several other related causes, pathophysiology mechanisms, histology and management.

  17. Revising the Atlanta Fed dollar index

    OpenAIRE

    Bryan Acree

    1999-01-01

    For more than a decade the Federal Reserve Bank of Atlanta's trade-weighted dollar index has served as a summary statistic for foreign exchange movements of the dollar. Recent revisions acknowledging significant changes in the worldwide economy ensure that the index will continue to contribute valuable information into the future. ; One significant revision to the Atlanta Fed index is to include all eleven countries that adopted the euro on January 4, 1999. Other revisions take into account t...

  18. INFORMATICS SYSTEMS FOR FINANCIAL AUDIT AND REVISION

    OpenAIRE

    Popeanga Vasile Nicolae; Vatuiu Teodora

    2009-01-01

    The activity of the financial auditors is regulated by International Standards of Revision for financial situations and information, through which the fundamental procedures and principles for this kind of missions are established. CIEL Audit and Revision application has been conceived as a support for financial auditors and expert accountants in Romania, offering help in the domain of informatics for the audit and accounting revision activities, since it is adapted both to the legal requ...

  19. My revision notes Edexcel GCSE computer science

    CERN Document Server

    Cushing, Steve

    2015-01-01

    Unlock your full potential with this revision guide which focuses on the key content and skills you need to know. With My Revision Notes for AQA GCSE Computer Science, which perfectly matches the latest examined elements of the course, you can: - Take control of your revision: plan and focus on the areas you need to revise, with advice, summaries and notes from author Steve Cushing - Show you fully understand key topics by using specific strategies and theories to add depth to your knowledge of programming and computing issues and processes - Apply programming and com

  20. My revision notes AQA GCSE English Language

    CERN Document Server

    Brindle, Keith

    2015-01-01

    Unlock your full potential with this revision guide for the new AQA GCSE English Language which focuses on the key content and skills you need to know. -Take control of your revision: plan and focus on the areas you need to revise. -Improve your exam skills with self-testing and exam-style questions. -Keep focused on what you need to know with Key Terms based around the exam questions. -Unpick each exam question with guidance on how to approach them and specific Revision Tasks

  1. Revision surgeries following vagus nerve stimulator implantation.

    Science.gov (United States)

    Lam, Sandi; Lin, Yimo; Curry, Daniel J; Reddy, Gaddum D; Warnke, Peter C

    2016-08-01

    The vagus nerve stimulator (VNS) has been shown to provide a safe, albeit costly, treatment for intractable epilepsy. We aimed to analyze the incidence, timing, and clinical/demographic associations of revision surgery post-VNS implantation in epilepsy patients. The Thomson Reuters MarketScan database, containing data from 23-50million individuals, was used. Epilepsy patients receiving VNS implantations from 2003 to 2009 were identified by Current Procedural Terminology and International Classification Of Diseases Ninth Revision codes. Incidence and timing of subsequent implant-related surgeries were recorded. Events were described using time-to-event methodology, with Kaplan-Meier failure estimation/Cox proportional hazard models adjusted for clinical/demographic factors. In 1234 patients, average incidence of revision surgeries over 6years of follow-up were <1%, <3%, 4-10%, and <1% for VNS electrode revision, battery revision/removal, battery replacement/implantation, and infection washout, respectively. For electrode revision and battery revision/replacement, the incidence was higher in the first year and for battery replacement in later years. Age, sex, insurance type, or geographic region did not significantly impact event occurrence. Implant-related revision surgeries are rare. Some events occur more often in certain follow-up years than others; none are significantly impacted by age, sex, insurance type, or geographic region. The most common reason for revision was battery replacement several years after VNS placement. PMID:27050913

  2. Experimental techniques; Techniques experimentales

    Energy Technology Data Exchange (ETDEWEB)

    Roussel-Chomaz, P. [GANIL CNRS/IN2P3, CEA/DSM, 14 - Caen (France)

    2007-07-01

    This lecture presents the experimental techniques, developed in the last 10 or 15 years, in order to perform a new class of experiments with exotic nuclei, where the reactions induced by these nuclei allow to get information on their structure. A brief review of the secondary beams production methods will be given, with some examples of facilities in operation or under project. The important developments performed recently on cryogenic targets will be presented. The different detection systems will be reviewed, both the beam detectors before the targets, and the many kind of detectors necessary to detect all outgoing particles after the reaction: magnetic spectrometer for the heavy fragment, detection systems for the target recoil nucleus, {gamma} detectors. Finally, several typical examples of experiments will be detailed, in order to illustrate the use of each detector either alone, or in coincidence with others. (author)

  3. Revising Lecture Notes: How Revision, Pauses, and Partners Affect Note Taking and Achievement

    Science.gov (United States)

    Luo, Linlin; Kiewra, Kenneth A.; Samuelson, Lydia

    2016-01-01

    Note taking has been categorized as a two-stage process: the recording of notes and the review of notes. We contend that note taking might best involve a three-stage process where the missing stage is revision. This study investigated the benefits of revising lecture notes and addressed two questions: First, is revision more effective than…

  4. Revised

    DEFF Research Database (Denmark)

    Johannsen, Vivian Kvist; Nord-Larsen, Thomas; Riis-Nielsen, Torben;

    and Energy and the Ministry of Environment. The report is based on the data from the Danish National Forest Inventory (NFI), performed for the Ministry of Environment and the SINKS project in relation to Article 3.4 of the Kyoto protocol for the Ministry of Climate and Energy. Forest & Landscape, Copenhagen...

  5. Surface analysis the principal techniques

    CERN Document Server

    Vickerman, John C

    2009-01-01

    This completely updated and revised second edition of Surface Analysis: The Principal Techniques, deals with the characterisation and understanding of the outer layers of substrates, how they react, look and function which are all of interest to surface scientists. Within this comprehensive text, experts in each analysis area introduce the theory and practice of the principal techniques that have shown themselves to be effective in both basic research and in applied surface analysis. Examples of analysis are provided to facilitate the understanding of this topic and to show readers how they c

  6. Revision of the genus Endospermum Bth. (Euphorbiaceae)

    NARCIS (Netherlands)

    Schaeffer, J.

    1971-01-01

    The revision was undertaken because the latest monograph by Pax & Hoffmann, dating from 1912, did not provide a satisfactory key, and because since that time a very large amount of new material has been collected and several new species were described. In the present revision 12 species have been re

  7. 76 FR 4258 - Occupational Radiation Protection; Revision

    Science.gov (United States)

    2011-01-25

    ... Part 835 RIN 1901-AA-95 Occupational Radiation Protection; Revision AGENCY: Department of Energy...) proposes to revise the values in an appendix to its Occupational Radiation Protection requirements. The... are given in appendix C. DOE first published, a final rule on December 14, 1993, (58 FR...

  8. Revised State Budget Sells Kids Short

    Science.gov (United States)

    Children Now, 2012

    2012-01-01

    The Administration's May Revision of the 2012-2013 state budget addresses a $15.7 billion shortfall through funding shifts, cuts, and new revenue sources that place children squarely in harms way. California's kids are already grossly underserved relative to the rest of the nation's children. If the May Revise budget is passed by the Legislature,…

  9. Postoperative pain treatment' practice guideline revised

    NARCIS (Netherlands)

    Houweling, P.L.; Molag, M.L.; Boekel, R.L.M. van; Verbrugge, S.J.; Haelst, I.M. van; Hollmann, M.W.

    2013-01-01

    - On the initiative of the Dutch Association of Anaesthesiologists, a multidisciplinary workgroup has revised the 2003 practice guideline on 'Postoperative pain treatment' for adults and children.- The main reason for revision was the availability of new drugs and new methods of administration. The

  10. Surgical treatment of tibial avulsion fracture at the posterior ligament- to- bone insertion site%手术治疗后交叉韧带胫骨止点撕脱性骨折

    Institute of Scientific and Technical Information of China (English)

    陈红峰; 王东明; 徐明勇

    2012-01-01

    Objective To study the clinical effect of the medial knee after surgical fixation of posterior cruciate ligament surgery tibial avulsion fracture. Methods Fifteen cases of cruciate ligament tibial avulsion fractures were performed with knee down "L-shaped" incision and anatomic fracture reduction was fixed with hollow screws and anchors. Patients were followed up for 6 months. Data regarding fractures, healing and joint stability, and range were collected. The recovery of knee function was assessed by Lysholm scale for knee function. Results All patients were cured after 8 to 13 weeks with no displacement. After 6 months, 2 cases of posteriordrawer test was weakly positive. There was 1 case with mild knee flexion limitation, but no knee extension limitation was observed. Lysholmknee score was (92 ± 2. 4) points. Conclusion Knee medial approach with a line of hollow screw and anchor screw fixation of posterior cruciate ligament tibial avulsion fracture is simple, safe, effective and reliable.%目的 探讨膝关节后内侧入路手术内固定治疗手术后交叉韧带胫骨止点撕脱性骨折的临床效果.方法 对15例交叉韧带胫骨止点撕脱性骨折患者行膝后倒“L”形小切口显露,解剖复位骨折,予以中空螺钉及带线锚钉内固定.术后随访6个月,收集骨折复位、愈合及关节稳定性、活动度以及Lysholm膝关节功能评分标准评估膝关节功能恢复情况.结果 术后8~13周均骨性愈合,未见位移.术后6个月,有2例后抽屉试验弱阳性,1例轻度屈膝受限,无伸膝受限,Lysholm膝关节功能评分( 92.0±2.4)分.结论 膝后内侧入路中空螺钉及带线锚钉内固定治疗后交叉韧带胫骨止点撕脱性骨折操作简单、安全、效果可靠.

  11. Nursing of tibial avulsion fracture of anterior cruciate ligament with arthroscopy%关节镜下治疗前交叉韧带胫骨止点撕脱性骨折的护理

    Institute of Scientific and Technical Information of China (English)

    孙文萍; 林芃; 陈传霞

    2012-01-01

    目的 探讨关节镜下治疗前交叉韧带(ACL)胫骨止点撕脱性骨折的临床护理.方法 通过对12例ACL胫骨止点撕脱性骨折的患者采取术前心理护理、术前准备、术前适应性训练,术后一般护理、患肢与疼痛的观察护理和康复护理相结合,并在工作中小断总结护理经验,提高护理水平.结果 本组12例患者平均随访16个月,所有骨折均获愈合,未出现骨折移位等并发症.结论 科学、系统、细致的护理措施及有效的功能锻炼是确保治疗成功的关键,有利于ACL胫骨止点撕脱性骨折患者关节功能的恢复,减少并发症的发生.%Objective To explore the clinical nursing of tibial avulsion fracture of anterior cruciate ligament (ACL) with arthroscopy. Methods Twelve patients with tibial avulsion fracture of anterior cruciate ligament were provided with preoperative psychological nursing, perioperative preparation, preoperative adaptive exercise, general postoperative nursing, limb and pain nursing, and rehabilitation nursing. The nursing experience has been summarized in order to improve nursing management. Results An average of 16 -month follow -up of all the 12 patients revealed that all fractures were healed with no complications such as fracture dislocation. Conclusion Scientific, systematic, careful nursing measures and effective functional exercise are essential to a successful treatment, which is conducive to the recovery of patients with tibial avulsion fracture of anterior cruciate ligament and the reduction of complications.

  12. Avulsão do plexo braquial em cães -1: aspectos clínicos e neurológicos Brachial plexus avulsion in dogs -1: clinical and neurological aspects

    Directory of Open Access Journals (Sweden)

    Mônica Vicky Bahr Arias

    1997-03-01

    Full Text Available A avulsão do plexo braquial é afecção de ordem traumática relativamente comum, ocasionando paralisia grave do membro torácico. É freqüentemente confundida com paralisia do nervo radial, havendo controvérsias sobre o tratamento. O objetivo deste trabalho foi: avaliar clinica e neurologicamente cães com avulsão do plexo braquial, demonstrando os aspectos significativos para o diagnóstico desta afecção. Observou-se predominância de cães sem raça definida, fêmea, com menos de três anos de idade, sendo o atropelamento a etiologia principal. As alterações clinicam/neurológicas mais freqüentes foram: paralisia flácida, ausência do reflexo dopanículo, ausência dos reflexos tricipital, bicipital e extensor do carpo radial, atrofia dos músculos tríceps, bíceps, supra-espinhal, infra-espinhal e extensores do carpo, anestesia cutânea abaixo do nível do cotovelo e abrasão/ulceração em face dorsal da mão. A associação destes resultados com os aspectos da histologia e da eletroneuroestimulação (relatados na parte 2 e 3 deste trabalho, respectivamente sugeriu envolvimento quase que total das raízes do plexo braquial em todos os casos.Brachial plexus avulsion is a relatively common affection, causing serious paralysis of the thoracic limb. It is often misdiagnosed as radial paralysis and there are controversies about the treatment. The main purposes of this work were: to evaluate clinically and neurologically dogs with brachial plexus avulsion and to demonstrate the relevant aspects in the diagnosis of this affection. Predominantly mixed breed dogs, females under three years of age were observed, and the brachial plexus avulsion was mainly a result of road accidents. The more frequent clinical and neurological signs were: flacid paralysis, loss of the panniculus, triceps, biceps and extensor carpi radial muscle reflexes, atrophy of the muscles triceps, biceps, extensor carpi radial, supraspinatus and infraespinatus

  13. Computed tomography in evaluation of revision hip arthroplasty outcomes.

    Science.gov (United States)

    Kochman, Andrzej; Morawska-Kochman, Monika; Guziński, Maciej; Drobniewski, Marek; Sibiński, Marcin; Synder, Marek

    2014-01-01

    Background. This study aimed to assess contact between Recon Shell reinforcement cages used in revision hip arthroplasty and the bony base. Radiographic examinations were performed with the use of multi-energy computed tomography. Material and methods. We tentatively assess the fixation of Burch-Schneider reinforcement cages (Recon Shell made by Aesculap company) implanted in 10 patients, using two methods of evaluation. An analysis of dual energy CT scans enabled us to assess contact between the reinforcement cages and the bony base. Results. The two methods of evaluation produced different results. The evaluation method based on the division of the acetabular component into a weight-bearing zone and a non-weight-bearing zone (accounting for screw fixation) showed lack of support in the weight-bearing zone in 6 out of 10 cases and direct contact with the implant bed in only one case. The assessment of contact at anchorage holes of reinforcement cages fixed at primary procedures revealed no such support in only one case and the presence of direct contact in 5 cases. There was no correlation between the radiological outcomes and clinical results based on the Harris Hip Score. Conclusions. 1. Multi-energy computed tomography (MARS) is useful in evaluating results of revision hip allo-plasty. 2. The introduction of new imaging techniques for the evaluation of revision procedures demonstrates a need for new, unified methods of outcome assessment adjusted to the characteristics of a particular procedure. PMID:25406920

  14. Radiological control manual. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    Kloepping, R.

    1996-05-01

    This Lawrence Berkeley National Laboratory Radiological Control Manual (LBNL RCM) has been prepared to provide guidance for site-specific additions, supplements and interpretation of the DOE Radiological Control Manual. The guidance provided in this manual is one methodology to implement the requirements given in Title 10 Code of Federal Regulations Part 835 (10 CFR 835) and the DOE Radiological Control Manual. Information given in this manual is also intended to provide demonstration of compliance to specific requirements in 10 CFR 835. The LBNL RCM (Publication 3113) and LBNL Health and Safety Manual Publication-3000 form the technical basis for the LBNL RPP and will be revised as necessary to ensure that current requirements from Rules and Orders are represented. The LBNL RCM will form the standard for excellence in the implementation of the LBNL RPP.

  15. Radiological control manual. Revision 1

    International Nuclear Information System (INIS)

    This Lawrence Berkeley National Laboratory Radiological Control Manual (LBNL RCM) has been prepared to provide guidance for site-specific additions, supplements and interpretation of the DOE Radiological Control Manual. The guidance provided in this manual is one methodology to implement the requirements given in Title 10 Code of Federal Regulations Part 835 (10 CFR 835) and the DOE Radiological Control Manual. Information given in this manual is also intended to provide demonstration of compliance to specific requirements in 10 CFR 835. The LBNL RCM (Publication 3113) and LBNL Health and Safety Manual Publication-3000 form the technical basis for the LBNL RPP and will be revised as necessary to ensure that current requirements from Rules and Orders are represented. The LBNL RCM will form the standard for excellence in the implementation of the LBNL RPP

  16. Hot sample archiving. Revision 3

    International Nuclear Information System (INIS)

    This Engineering Study revision evaluated the alternatives to provide tank waste characterization analytical samples for a time period as recommended by the Tank Waste Remediation Systems Program. The recommendation of storing 40 ml segment samples for a period of approximately 18 months (6 months past the approval date of the Tank Characterization Report) and then composite the core segment material in 125 ml containers for a period of five years. The study considers storage at 222-S facility. It was determined that the critical storage problem was in the hot cell area. The 40 ml sample container has enough material for approximately 3 times the required amount for a complete laboratory re-analysis. The final result is that 222-S can meet the sample archive storage requirements. During the 100% capture rate the capacity is exceeded in the hot cell area, but quick, inexpensive options are available to meet the requirements

  17. Potentialities of Revised Quantum Electrodynamics

    Directory of Open Access Journals (Sweden)

    Lehnert B.

    2013-10-01

    Full Text Available The potentialities of a revised quantum electrodynamic theory (RQED earlier established by the author are reconsidered, also in respect to other fundamental theories such as those by Dirac and Higgs. The RQED theory is characterized by intrinsic linear symmetry breaking due to a nonzero divergence of the electric field strength in the vacuum state, as supported by the Zero Point Energy and the experimentally confirmed Casimir force. It includes the results of electron spin and antimatter by Dirac, as well as the rest mass of elementary particles predicted by Higgs in terms of spontaneous nonlinear symmetry breaking. It will here be put into doubt whether the approach by Higgs is the only theory which becomes necessary for explaining the particle rest masses. In addition, RQED theory leads to new results beyond those being available from the theories by Dirac, Higgs and the Standard Model, such as in applications to leptons and the photon.

  18. Algebra Sets, Symbols, and the Language of Thought (Revised Edition)

    CERN Document Server

    Tabak, John

    2011-01-01

    Algebra, Revised Edition describes the history of both strands of algebraic thought. This updated resource describes some of the earliest progress in algebra as well as some of the mathematicians in Mesopotamia, Egypt, China, and Greece who contributed to this early period. It goes on to explore the many breakthroughs in algebraic techniques as well as how letters were used to represent numbers. New material has been added to the chapter on "modern" algebra, a type of mathematical research that continues to occupy the attention of many mathematicians today.

  19. Revision anterior cruciate ligament reconstruction with bone-patellar tendon-bone allograft and extra-articular iliotibial band tenodesis.

    Science.gov (United States)

    Mascarenhas, Randy; McConkey, Mark O; Forsythe, Brian; Harner, Christopher D

    2015-04-01

    Revision anterior cruciate ligament (ACL) reconstruction is a technically demanding procedure with outcomes that generally fail to reach those seen with primary ACL reconstruction. With most index procedures using autograft tissue, it is not uncommon for allograft tissue to be required for revision ACL reconstruction. Compared with autografts, allografts take longer to incorporate and lead to more episodes of instability. In this article, we describe ipsilateral iliotibial band tenodesis performed to augment use of bone-patellar tendon-bone allograft in revision ACL reconstruction. This technique adds rotational stability to protect the allograft tissue while it incorporates.

  20. Revision anterior cruciate ligament reconstruction with bone-patellar tendon-bone allograft and extra-articular iliotibial band tenodesis.

    Science.gov (United States)

    Mascarenhas, Randy; McConkey, Mark O; Forsythe, Brian; Harner, Christopher D

    2015-04-01

    Revision anterior cruciate ligament (ACL) reconstruction is a technically demanding procedure with outcomes that generally fail to reach those seen with primary ACL reconstruction. With most index procedures using autograft tissue, it is not uncommon for allograft tissue to be required for revision ACL reconstruction. Compared with autografts, allografts take longer to incorporate and lead to more episodes of instability. In this article, we describe ipsilateral iliotibial band tenodesis performed to augment use of bone-patellar tendon-bone allograft in revision ACL reconstruction. This technique adds rotational stability to protect the allograft tissue while it incorporates. PMID:25844596

  1. 55例踝关节外侧副韧带损伤合并外踝撕脱骨折的手术治疗分析%Surgical treatment for ankle lateral collateral ligament injury with avulsion fracture:a report of 55 cases

    Institute of Scientific and Technical Information of China (English)

    谢兴; 胡跃林; 焦晨; 江东; 陈临新; 梅宇; 郭秦炜

    2015-01-01

    Background:Injury of the lateral collateral ligament (LCL) is one of the most common ankle injuries. There are many stud-ies on isolated ankle LCL injury. However, few studies have been reported on combined injuries of the LCL and avulsion fracture in ankle joint. Objective:To evaluate clinical features and outcomes of ankle LCL injury combined with avulsion fracture. Methods:A total of 55 patients who suffered from ankle LCL injury combined with avulsion fracture and received modified Broström procedure and avulsion bone resection between January 2013 and January 2014 were enrolled in the study. Preop-erative X-ray and MRI were performed in all patients. AOFAS hindfoot functional evaluation system was used preoperative-ly and 6 months postoperatively. Results:Avulsion fracture was found in 51 patients by X-ray and in 4 by MRI. As compared with preoperative one, AOFAS score was significantly increased 6 months postoperatively (54.62±10.31 vs 87.70±3.22, P Conclusions:X-ray and MRI can accurately diagnose avulsion fractures of the lateral malleolus. The lateral ligament injury with avulsion fracture of ankle should be treated as soon as possible so as to prevent chronic instability. Modified Broström procedure and avulsion bone resection can achieve good clinical outcomes for the patients suffered from lateral collateral ligament injury with avulsion fracture of the ankle.%背景:踝关节外踝韧带损伤是最高发的踝关节损伤,目前针对外踝韧带损伤方面的研究较多,而对于外踝韧带损伤合并撕脱骨折的报道较少。  目的:评价踝关节外侧副韧带损伤合并外踝撕脱骨折的临床特点及手术治疗效果。  方法:2013年1月至2014年1月,55例踝关节外侧副韧带损伤合并外踝撕脱骨折患者接受了改良Broström法外踝韧带修复和撕脱骨块切除术。术前行X线片检查及MRI,术前及术后6个月随访时进行AOFAS踝-后足功能评分。  结果:55

  2. Endovenous laser plus stab avulsion in the treatment of lower-limb varicose veins%腔内激光联合点式剥脱治疗下肢浅静脉曲张206例

    Institute of Scientific and Technical Information of China (English)

    车星; 朱网林; 戴翔; 桑凯

    2013-01-01

    Objective To explore the advantages of endovenous laser plus stab avulsion in the treatment of lower-limb varicose veins. Methods Between July 1, 2010, and June 31, 2012, 206 patients with a total of 267 lower limbs were submitted to EVLT plus a surgical approach. Results The follow-up from 1 month to 25 months showed no recurrence and no clinical symptoms or signs. After treatment, the edema and itching disappeared, the pigmentation reduced, and all the ulcers healed. Conclusion Endovenous laser plus stab avulsion not only ensure the curative effect, but also achieve the purpose of minimally invasive in the treatment of lower-limb varicose veins.%目的 探讨腔内激光联合点式剥脱治疗下肢浅静脉曲张的优势.方法 2010 年7 月至2012 年7月,206 例患者共267 条患肢确诊为下肢浅静脉曲张,采取腔内激光联合手术治疗.结果 术后随访1~25 个月,所有患肢曲张静脉消失,未见复发,肿胀消退,瘙痒消失,色素沉着有所减轻,溃疡均愈合.结论 腔内激光联合手术治疗下肢浅静脉曲张,其在保证疗效的同时,达到了微创的目的.

  3. Modern techniques of surface science

    CERN Document Server

    Woodruff, D Phil

    2016-01-01

    This fully revised, updated and reorganised third edition provides a thorough introduction to the characterisation techniques used in surface science and nanoscience today. Each chapter brings together and compares the different techniques used to address a particular research question, including how to determine the surface composition, surface structure, surface electronic structure, surface microstructure at different length scales (down to sub-molecular), and the molecular character of adsorbates and their adsorption or reaction properties. Readers will easily understand the relative strengths and limitations of the techniques available to them and, ultimately, will be able to select the most suitable techniques for their own particular research purposes. This is an essential resource for researchers and practitioners performing materials analysis, and for senior undergraduate students looking to gain a clear understanding of the underlying principles and applications of the different characterisation tec...

  4. Revision of infected knee arthroplasties in Denmark

    DEFF Research Database (Denmark)

    Lindberg-Larsen, Martin; Jørgensen, Christoffer C; Bagger, Jens;

    2016-01-01

    Background and purpose - The surgical treatment of periprosthetic knee infection is generally either a partial revision procedure (open debridement and exchange of the tibial insert) or a 2-stage exchange arthroplasty procedure. We describe the failure rates of these procedures on a nationwide...... basis. Patients and methods - 105 partial revisions (100 patients) and 215 potential 2-stage revision procedures (205 patients) performed due to infection from July 1, 2011 to June 30, 2013 were identified from the Danish Knee Arthroplasty Register (DKR). Failure was defined as surgically related death...

  5. Computer Assisted Audit Techniques

    Directory of Open Access Journals (Sweden)

    Eugenia Iancu

    2007-01-01

    Full Text Available From the modern point of view, audit takes intoaccount especially the information systems representingmainly the examination performed by a professional asregards the manner for developing an activity by means ofcomparing it to the quality criteria specific to this activity.Having as reference point this very general definition ofauditing, it must be emphasized that the best known segmentof auditing is the financial audit that had a parallel evolutionto the accountancy one.The present day phase of developing the financial audithas as main trait the internationalization of the accountantprofessional. World wide there are multinational companiesthat offer services in the financial auditing, taxing andconsultancy domain. The auditors, natural persons and auditcompanies, take part at the works of the national andinternational authorities for setting out norms in theaccountancy and auditing domain.The computer assisted audit techniques can be classified inseveral manners according to the approaches used by theauditor. The most well-known techniques are comprised inthe following categories: testing data techniques, integratedtest, parallel simulation, revising the program logics,programs developed upon request, generalized auditsoftware, utility programs and expert systems.

  6. PEER REVISION OF WRITING IN L2 CLASSROOM

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Peer revision,a supplementary strategy to teacher revisionof writing in L2 classroom,makes passive receivers of teacherrevision become active revisers,enabling students to involve inmore motivated language learning.Benefits of peer revision andits implications for teacher and student roles are discussed.Thisarticle also tentatively analyzes ways of preparing students foreffective peer revision.

  7. Nevada Test Site Radiological Control Manual. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2010-02-09

    This document supersedes DOE/NV/25946--801, “Nevada Test Site Radiological Control Manual,” Revision 0 issued in October 2009. Brief Description of Revision: A minor revision to correct oversights made during revision to incorporate the 10 CFR 835 Update; and for use as a reference document for Tenant Organization Radiological Protection Programs.

  8. Revised Nuffield Chemistry: October 1979 School Survey.

    Science.gov (United States)

    Dawson, B. E.

    1980-01-01

    Presents some of the preliminary results of a survey study about the use of both the revised publications and GCE O-Level examinations for Nuffield Chemistry in 495 British schools and colleges in 1979. (HM)

  9. Suggested revision for west mexican archeological sequences.

    Science.gov (United States)

    Long, S V; Taylor, R E

    1966-12-16

    A review of the radiocarbon dates and published and unpublished archeological data from the West Mexican states of Sinaloa, Nayarit, Jalisco, and Colima has resulted in a revised tentative chronology for West Mexico.

  10. Facial Scar Revision: Understanding Facial Scar Treatment

    Science.gov (United States)

    ... the Campaign Campaign Update Member Donors Corporate Partners Recognition Program Planned Giving 1887 Annual Giving Annual Report Donate Contact Us Trust your face to a facial plastic surgeon Facial Scar Revision ...

  11. Parker River NWR : Revised Hunting Plan

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This document contains revisions to the 1978 Parker River National Wildlife Refuge Hunt Management Plan. Refuge hunters must obtain a permit to use the hunting...

  12. The revision of classical stock model

    Institute of Scientific and Technical Information of China (English)

    叶柏青; 王洪利

    2001-01-01

    On the basis of the analysis of classical stock model, according to the limitation of the model, the article puts forward the revision of classical model and enforces the applicability of the stock model.

  13. The revision of classical stock model

    Institute of Scientific and Technical Information of China (English)

    YE Bai-qing; WANG Hong-li

    2001-01-01

    On the basis of the analysis of classical stock model, according to th e limitation of the model, the article puts forward the revision of classical mo del and enforces the applicability of the stock model.

  14. Heuristic revision by Heuristic Space Exploration

    OpenAIRE

    Taillandier, Patrick

    2009-01-01

    International audience Heuristics are often used to solve complex problems. Indeed, such problem-specific knowledge, when pertinent, helps to efficiency find good solutions to complex problems. Unfortunately, acquiring and maintaining a heuristic set can be fastidious. In order to face this problem, a approach consists in revising the heuristic sets by means of experiments. In this paper, we are interested in a specific revision method of this type based on the exploration of the heuristic...

  15. Revisions to workforce jobs: December 2007

    OpenAIRE

    Nick Barford

    2008-01-01

    Describes the changes made to Annual Business Inquiry methods in the transition to a new survey, and the associated discontinuitiesThis article was first published on the National Statistics website on 12 December 2007, to coincide with the Labour Market Statistics First Release and the planned revisions made to the workforce jobs (WFJ) series. The revisions are mainly due to benchmarking the short-term employee jobs series to the latest estimates from the Annual Business Inquiry (ABI/1). The...

  16. UK audit committees and the Revised Code

    OpenAIRE

    Cowton, Christopher J.; Avison, Lynn

    2012-01-01

    Purpose - The audit committee is one of the most prominent board sub-committees, having a potentially important role to play in ensuring sound corporate governance. This paper examines and discusses the behaviour of companies following revisions to the UK’s Revised Code. Design/methodology/approach - A variety of annual report data from a sample of 50 UK companies, stratified according to size, is collected and analyzed. Findings - General compliance with many provisions of the Rev...

  17. Non-proliferation under revision

    International Nuclear Information System (INIS)

    At the 3rd NPT Revision Conference held in Geneva between August 27 and September 21, 1985, the member states to the Treaty reconfirmed their conviction that the agreement had become an essential part in the efforts to secure peace in the world and that is fundamental objectives continued to serve this purpose. Since the ratification in 1968 and the entering into force in 1970 of the Non-proliferation Treaty, the number of member states had risen continually to, at present, 130. In 1975, 92 states in 1980, 114 states had signed the agreement. The three nuclear weapon states, USA, UK, and USSR, are depositary states. France acts as if she had acceded to the Treaty, and the People's Republic of China as the 5th nuclear weapon state seems to take steps in the same direction by voluntarily opening nuclear installations to checks by IAEA inspectors. Incidentally, an effective framework of non-proliferation in the South American region has been created in the Treaty of Tlatelolco. 98% of all nuclear installations in the non-nuclear weapon countries are covered by IAEA safeguards. (orig.)

  18. Photon Physics of Revised Electromagnetics

    Directory of Open Access Journals (Sweden)

    Lehnert B.

    2006-04-01

    Full Text Available Conventional theory, as based on Maxwell’s equations and associated quantum electrodynamical concepts in the vacuum, includes the condition of zero electric field divergence. In applications to models of the individual photon and to dense light beams such a theory exhibits several discrepancies from experimental evidence. These include the absence of angular momentum (spin, and the lack of spatially limited geometry in the directions transverse to that of the propagation. The present revised theory includes on the other hand a nonzero electric field divergence, and this changes the field equations substantially. It results in an extended quantum electrodynamical approach, leading to nonzero spin and spatially limited geometry for photon models and light beams. The photon models thereby behave as an entirety, having both particle and wave properties and possessing wave-packet solutions which are reconcilable with the photoelectric effect, and with the dot-shaped marks and interference patterns on a screen by individual photons in a two-slit experiment.

  19. Revision of Khoikhoiinae (Hymenoptera, Braconidae

    Directory of Open Access Journals (Sweden)

    Michael Sharkey

    2009-09-01

    Full Text Available The species of the two genera of Khoikhoiinae (Hymenoptera, Braconidae are revised. Thirteen species are recognized, of which five are new and eight were previously described: Khoikhoia anthelion Sharkey, sp. n., K. lission Mason, 1984, K. oligospilos Sharkey, sp. n., K. semiadusta Mason, 1983, K. solata Mason, 1983, K. townesi Mason, 1983, K. turneri Mason, 1984, Sania browni Sharkey, sp. n., S. capensis Mason, 1983, S. henryi Mason, 1983, S. marjoriae Mason, 1983, S. masneri Sharkey, sp. n., and S. masoni Sharkey, sp. n.. All are from the Cape Region of South Africa, and all but one species are confined to the western Cape. A dichotomous key to species is presented; links to electronic interactive keys and to distribution maps are also included. Based on phylogenetic position and morphological characters, speculations on life history are made, and it is suggested that some species may be parasitoids of wood- or stem-boring Lepidoptera. The DELTA data matrix and images for the key are available at 10.3897/zookeys.20.108.app.1.ik; Intkey files are available at 10.3897/zookeys.20.108.app.2.ik; Lucid files in LIF and SDD format are available at doi:10.3897/zookeys.20.108.app.3.ik and doi:10.3897/zookeys.20.108.app.4.ik. Publishing of DELTA raw data will facilitate future workers to edit keys and to add newly discovered taxa.

  20. Autologous hamstring tendon used for revision of quadiceps tendon tears.

    Science.gov (United States)

    McCormick, Frank; Nwachukwu, Benedict U; Kim, Jaehon; Martin, Scott D

    2013-04-01

    A paucity of literature exists on quadriceps tendon reruptures. Failed quadriceps tendon repair can cause significant morbidity and disability. Surgical management of quadriceps tendon rerupture can be challenging due to tissue degeneration, tendon retraction, muscle atrophy, and poor bone fixation. A lack of guidance in the literature exists on the appropriate surgical techniques for managing quadriceps tendon reruptures.This article describes the case of a male recreational athlete with a failed primary quadriceps tendon repair who presented 10 months after rerupture. Examination was significant for morbid obesity, assisted ambulation, and a significant defect at the superior pole of the patella on the affected side. Intraoperative findings were consistent with a 2.0- to 4.5-cm tendon defect across the extensor mechanism with complete retinaculi tears. The authors performed a novel surgical approach for revision of quadriceps tears using a bilateral hamstring autograft through a quadriceps tendon weave and a transosseous patellar repair. Tendon length was restored, and extensor mechanism tension was reapproximated. Postoperatively, the patient achieved a good outcome and had returned to full, painless, sport participation at 2-year follow-up.This surgical technique is suitable for revision quadriceps tendon repairs of large tendon gap defects, repairs desiring tendon-to-bone in-growth, and repairs requiring large-force transmission across the repair.

  1. Revision of the DELFIC Particle Activity Module

    Energy Technology Data Exchange (ETDEWEB)

    Hooper, David A [ORNL; Jodoin, Vincent J [ORNL

    2010-09-01

    The Defense Land Fallout Interpretive Code (DELFIC) was originally released in 1968 as a tool for modeling fallout patterns and for predicting exposure rates. Despite the continual advancement of knowledge of fission yields, decay behavior of fission products, and biological dosimetry, the decay data and logic of DELFIC have remained mostly unchanged since inception. Additionally, previous code revisions caused a loss of conservation of radioactive nuclides. In this report, a new revision of the decay database and the Particle Activity Module is introduced and explained. The database upgrades discussed are replacement of the fission yields with ENDF/B-VII data as formatted in the Oak Ridge Isotope Generation (ORIGEN) code, revised decay constants, revised exposure rate multipliers, revised decay modes and branching ratios, and revised boiling point data. Included decay logic upgrades represent a correction of a flaw in the treatment of the fission yields, extension of the logic to include more complex decay modes, conservation of nuclides (including stable nuclides) at all times, and conversion of key variables to double precision for nuclide conservation. Finally, recommended future work is discussed with an emphasis on completion of the overall radiation physics upgrade, particularly for dosimetry, induced activity, decay of the actinides, and fractionation.

  2. Segmented arch or continuous arch technique? A rational approach

    Directory of Open Access Journals (Sweden)

    Sergei Godeiro Fernandes Rabelo Caldas

    2014-04-01

    Full Text Available This study aims at revising the biomechanical principles of the segmented archwire technique as well as describing the clinical conditions in which the rational use of scientific biomechanics is essential to optimize orthodontic treatment and reduce the side effects produced by the straight wire technique.

  3. A REVISION OF MALAYSIAN BAUHINIEAE

    Directory of Open Access Journals (Sweden)

    H. C. D. de Wit

    2015-11-01

    Full Text Available SummaryThis revision deals with the tribus Bauhinieae (Caesalpiniaceae as occurring in Malaysia. The tribe includes the genera Bauhinia L. s. str., Bracteolanthus de Wit gen. nov., Gigasiphon Drake del Cast., Lasiobema (Korth. Miq., Lysiphyllum (Benth. de Wit gen. & stat. nov., Phanera Lour., and Piliostigma Hochst. Bauhinia is reduced to the original Lin-nean delimitation; 9 species are treated (inclusive of a number of varieties ; 2 species are reduced to the rank of varieties and 3 new varieties are described, accounting for 3 new varietal combinations and 3 new varietal names. Bracteolanthus contains a single species for which a new combination is proposed. Gigasiphon is represented by 3 species; 3 new specific combinations are made. Lasiobema is represented by 5 species; in this ge- nus 1 new species is described, 4 new combinations and 1 new varietal combination are proposed, and a new but insufficiently represented species is recorded. Some new combinations for extra-Malaysian species are also proposed. Of Lysiphyllum 2 species are treated; 2 new combinations and some new combinations for extra-Malaysian species were necessary. Pha-nera is by far the largest genus: 44 species, many of which are divided into subspecies and/or varieties. The genus is subdivided into three sub-genera, Phanera, Biporina de Wit, and Austrocercis de Wit. Of these, subgenus Phanera, in its turn, contains 3 sections, all new, viz Pha.nero-siphon, Meganthera, and Micranthera. Subgenus Biporina comprises the 3 new sections Bifoliola, Palmatifolia, and Cinnamomifolia. Subgenus Austrocercis consists of a single species. The recognition of Phanera as a genus, as well as the description of new taxa and the revaluation of some previously described ones made necessary a large number of new names and new combinations.

  4. Analysis of the Changes in Circulation of Sub-dermal Vascular Network Flap Made from Flap-type Skin Avulsion and Replanted to Origin Site%皮瓣型皮肤撕脱伤修成暴露真皮下血管网皮瓣回植创面的血循环变化分析

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To find out the characteristics of the changes in circulation of sub-dermal vascular network flap made from flap-type skin avulsion Injury and replanted to origin site. Method: Pig skin avulsion model was used in this experiment. Flap's blood circulation was monitored and surviving flap length measured. Result. Flap blood circulation was markedly improved. Conclusion: Sub-dermal vascular network flap made from skin avulsion flap and replanted to origin site can improved the survival length of the flap.%目的:了解皮肤撕脱伤修成暴露真皮下血管网皮瓣回植创面的血循环变化特点和对皮瓣成活的影响。方法:以猪为实验对象,制作皮肤撕脱伤模型,观察皮瓣的血循环变化和成活情况。结果:将撕脱瓣修成暴露真皮下血管网的皮瓣再回植,可以使皮瓣血循环显著改善。结论:将撕脱瓣修成暴露真皮下血管网的皮瓣再回植,可以使皮瓣成活长度显著增加。

  5. Acquired Techniques

    DEFF Research Database (Denmark)

    Lunde Nielsen, Espen; Halse, Karianne

    2013-01-01

    Acquired Techniques - a Leap into the Archive, at Aarhus School of Architecture. In collaboration with Karianne Halse, James Martin and Mika K. Friis. Following the footsteps of past travelers this is a journey into tools and techniques of the architectural process. The workshop will focus upon...

  6. Fraturas com arrancamento do anel apofisário ("limbus" póstero-superior da vértebra L5, associado com hérnia discal pré-marginal em atletas Avulsion fractures of apophysial ring ("limbus" posterior superior of the L5 vertebra, associated to pre-marginal hernia in athletes

    Directory of Open Access Journals (Sweden)

    Eduardo Barros Puertas

    2002-03-01

    Full Text Available O aumento de adolescentes praticando esportes de forma cada vez mais competitiva tem causado o aumento de lesões relacionadas à prática desportiva. A dor lombar é uma queixa freqüente entre os atletas, geralmente relacionada a contraturas da musculatura paravertebral e fraturas ( espondilólise devido ao excesso de treinamento e aplicação de técnicas incorretas. Porém, outras etiologias podem causar a dor lombar, como processos infecciosos, tumorais e fraturas. As fraturas com arrancamento do anel apofisário são lesões incomuns e raramente ocorrem na região póstero-superior da vértebra L5. Os relatos da literatura mostram que o local mais acometido é a região póstero-inferior da vértebra L4. Apresentamos dois casos de atletas jovens com esta incomum lesão. O objetivo deste trabalho é discutir a possível etiologia, os melhores métodos para o diagnóstico e possíveis formas de tratamento desta patologia.The number of sport related injuries has raised as the increasing number of adolescents practicing competitive sports. Lumbar pain is a frequent complaint among young athletes. It is usually related to the contracture of paravertebral muscles and fractures (spondylolysis caused by excessive practicing and incorrect techniques. However, other etiologies can cause lumbar pain, such as infectious processes, tumor and fractures. Avulsion fractures of the apophysial ring are uncommon lesions which rarely happen in the posterior superior area of the L5 vertebra. The literature shows that the most susceptible place to injuries is the posterior inferior area of the L4 vertebra. This paper presents two cases of young athletes with this unusual lesion. The objective of this work is to discuss the possible etiology and the best diagnostic and treatment procedures for this pathology.

  7. Clinical study on the clinical curative effect of comprehensive rehabilitation for brachial plexus avulsion%综合康复治疗臂丛神经撕脱伤的临床疗效

    Institute of Scientific and Technical Information of China (English)

    周莹; 周丽

    2014-01-01

    Objective To study the clinical curative effect of comprehensive rehabilitation treatment on acupuncture and physiotherapy in brachial plexus avulsion.Methods Totally 184 patients with brachial plexus avulsion in our hospital were se-lected ,and were randomly divided into control group of 92 cases and observation group of 92 cases ,then the control group wsa treated by low-frequency electrical stimulation pulses with neuromuscular electrical stimulation. The observe group was treaded by comprehensive rehabilitation ,including acupuncture management therapy ,massage and IF electric massage ,then pain visual analog scale assessment of pain ,function of the brachial plexus of two groups were analyzed and compared.Results Before treatment ,brachial plexus function and VAS scores in the patients of two groups had no significant difference (P>0 .05).After treatment of 4 and 8 weeks ,the brachial plexus function and VAS scores of two groups improved after treatment than before treatment ,and the observation group was better than the control group (P<0 .05). The total effective rate in the control group was 77 .17% ,which was 90 .22% in observation group. The patients limb functional recovery was significantly better than the control group ,with a significant difference (P<0 .05).Conclusion Acupuncture management therapy ,massage therapy method and frequency electric comprehensive rehabilitation therapy can be helpful in brachial plexus avulsion recovery of limb function , the efficacy is significantly better than the family functional exercise.%目的:探讨以针灸理疗为主的综合康复治疗臂丛神经撕脱伤的临床疗效。方法纳入臂丛神经撕脱伤患者共184例,随机分为对照组和观察组,对照组采用神经肌肉电刺激仪进行低频脉冲电刺激,观察组采用综合康复疗法,包括针灸理疗法、推拿按摩法和中频电疗法,采用疼痛视觉模拟评分评定疼痛程度和臂丛

  8. Tratamento ortodôntico em pacientes com dentes reimplantados após avulsão traumática: relato de caso Orthodontic treatment in patients with reimplanted teeth after traumatic avulsion: a case report

    Directory of Open Access Journals (Sweden)

    Simone Requião Thá Rocha

    2010-08-01

    Full Text Available INTRODUÇÃO: a alta prevalência de indivíduos com traumatismo dentário prévio ao tratamento ortodôntico justifica os cuidados a serem observados antes e durante o tratamento, considerando todas as implicações do movimento ortodôntico sobre os dentes traumatizados. Entre as lesões traumáticas dentárias, a avulsão com posterior reimplantação do dente é a que apresenta maior risco de complicações - como necrose pulpar, reabsorção radicular e anquilose -, sendo também a que inspira maiores cuidados pelo ortodontista. OBJETIVO: este trabalho busca, através do relato de um caso clínico, analisar as implicações do reimplante dentário após avulsão traumática, em pacientes que requerem tratamento ortodôntico. CONCLUSÕES: a movimentação ortodôntica de um dente reimplantado, após sua avulsão traumática, é possível desde que não ocorra qualquer sinal de anormalidade. Porém, dentes que sofrem anquilose não são passíveis de movimentação ortodôntica, mas devem ser preservados como mantenedores de espaço, até a reabsorção total da raiz, desde que não apresentem infraposição severa. Ocorrendo infraposição severa do dente anquilosado, é indicada a amputação da coroa e o sepultamento da raiz, como meio de favorecer a manutenção do osso alveolar na região, pois ocorrerá reabsorção por substituição da raiz sepultada, como ocorreu no caso clínico apresentado.INTRODUCTION: The high prevalence of individuals with dental trauma prior to orthodontic treatment justifies the precautions that should be followed before and during treatment, considering all possible effects of orthodontic movement on traumatized teeth. Among the major traumatic dental injuries, avulsion with subsequent tooth reimplantation entails a higher than average risk of complications, such as pulp necrosis, root resorption and ankylosis. Therefore, it gives orthodontists several reasons for concern. OBJECTIVE: This case report sought

  9. 改良小切口治疗单纯膝后交叉韧带胫骨止点撕脱骨折%Treatment of Avulsion Fracture of the Tibial insertion of Posterior Cruciate Ligament with Improved Small Incision

    Institute of Scientific and Technical Information of China (English)

    李海波; 苟永胜; 付柏林; 王勇; 车峥; 李蓉

    2016-01-01

    Objective:To investigate the effect of treatment of avulsion fracture of the tibial insertion of posterior cruciate ligament( PCL) through improved small incision .Methods:Patients prone , intraoperative first palpable lateral fibular head , knee joint posterior median offset from the plane to the proximal fibular head vertex incision , about 2-3cm, along the margin between medial gastrocnemius muscle and semitendinosus finger blunt separation into the gastrocnemius soleus , medial head retracted medially , the lateral head of gas-trocnemius soleus , tibialis artery and vein , posterior tibial nerve retracted laterally , open the rear part of the joint capsule , expose the pos-terior cruciate ligament tibial attachment point , cruciate ligament tibial avulsion fracture with absorbable screw block or anchor fixation af -ter reduction.Results:All cases were followed up for 6-36 months, average 12.5 months follow-up.Postoperative fracture was satis-factory reduction, and healed in 3-6 months.Knee joint function recovered satisfactorily , without obvious complications .Conclusion:It has advantages of minimal invasion and enough exposure in the treatment of avulsion fracture of PCL through improved small incision .%目的:评价改良小切口治疗单纯膝后交叉韧带胫骨止点撕脱性骨折的手术疗效,为临床治疗单纯膝后交叉韧带胫骨止点撕脱骨折提供帮助。方法:2010年9月~2013年9月我院进行改良小切口治疗单纯膝后交叉韧带胫骨止点撕脱性骨折共48例,男性33例,女性15例,平均年龄38.5岁;患者采用俯卧位,术中先扪及外侧腓骨头,于膝关节后正中偏内从腓骨头顶点平面向近端延长切口,约2~3cm,沿半腱肌与腓肠肌内侧缘之间用手指钝性分离进入,将胫动静脉、胫神经、小腿三头肌外侧头牵向外侧,小腿三头肌内侧头牵向内侧,将部分后方关节囊切开,显露出膝后交叉韧带胫骨止点撕脱骨

  10. 锚钉内固定治疗后交叉韧带胫骨止点撕脱性骨折%Open reduction and internal fixation with anchor screw for tibial avulsion fracture of the posterior cruciate ligament

    Institute of Scientific and Technical Information of China (English)

    李建赤; 黄必留; 梁江声; 谭加群; 徐自强; 吴春辉

    2013-01-01

    Objective To investigate the clinical efficacy of the treatment for tibial avulsion fracture of the posterior cruciate ligament ( PCL) with open reduction and anchor screw internal fixation. Methods 32 patients of tibial avulsion fracture of the posterior cruciate ligament were treated with open reduction and anchor screw internal fixation through inverted L-shaped posterior-medial approach. All the patients were given postoperative plaster immobilization of knee at 30° flexion for about four weeks. The patients were allowed to appropriate functional exercise of knee flexion and extension after removal of the plaster. Results 30 patients were followed up for seven to 30 months with an average of (13 ±5.2) months. The bony union was achieved in all the patients after operation in two to four months, (3 ±0. 6) months in average. According to Lysholm knee score system, six months after surgery, 26 cases were excellent, three cases were good and one case was fair . The excellent rate was 96. 7%. Conclusions Inverted L-shaped posterior-medial approach and anchor screw internal fixation is a safe, effective method for tibial avulsion fracture of PCL. Reliable internal fixation may be effective in the early reconstruction of the knee stability and restoring knee function.%目的 探讨锚钉内固定治疗后交叉韧带(PCL)胫骨止点撕脱性骨折的临床疗效.方法 对32例膝关节PCL胫骨止点撕脱骨折患者,采用膝关节后内侧倒"L"形入路切开复位,以锚钉内固定治疗,术后给予石膏托固定膝关节屈曲30°约4周,拆除石膏外固定后适当行膝关节伸屈功能锻炼.结果 30例获得随访,时间7~30个月,平均(13 ± 5.2)个月.术后2~4个月均获骨性愈合,平均为(3 ± 0.6)个月.手术6个月后依据Lysholm 等膝关节评分系统评估膝关节功能,评定优26 例,良3例,可1例,优良率96.7%.结论 膝后内侧"L"形入路应用锚钉内固定治疗PCL胫骨止点撕脱骨折是安全有效、内固

  11. 带线锚钉治疗后交叉韧带胫骨止点撕脱骨折21例报告%Surgical treatment with anchor screws for tibial avulsion fracture of the posterior cruciate ligament

    Institute of Scientific and Technical Information of China (English)

    张中兴; 许峰; 金伟

    2016-01-01

    目的:探讨带线锚钉治疗后交叉韧带( posterior cruciate ligament,PCL )胫骨止点撕脱骨折的临床疗效。方法对21例膝关节 PCL 胫骨止点撕脱骨折患者采用带线锚钉治疗,术后给予膝关节屈曲30°石膏固定4周,拆除石膏外固定后进行膝关节功能锻炼。结果所有患者均获7~11个月随访,平均9.2个月。Lysholm 评分术前与术后6个月分别为:(59.4±8.1)分,(86.4±9.1)分,差异有统计学意义( P<0.05);关节活动度术前与术后6个月分别为:(86.8±13.5)°(139.1±8.9)°,差异有统计学意义( P<0.05);IKDC 评分术前与术后6个月分别为:(50.6±6.1)分,(92.8±5.5)分,差异有统计学意义( P<0.05)。结论带线锚钉治疗 PCL 胫骨止点撕脱骨折内固定可靠,安全有效,可早期有效重建膝关节稳定性,恢复膝关节功能。%Objective To investigate clinical effects on the treatment of tibial avulsion fracture of the posterior cruciate ligament with anchor screws. Methods Twenty-one patients of tibial avulsion fracture of the posterior cruciate ligament were treated with anchor screws. All patients had been applied postoperative plaster immobilization of the knee at 30° flexion for 4 weeks. Functional exercises of the knee were conducted after the removal of the plaster. Results All patients were followed up for 7 - 11 months with the average of 9.2 months. The Lysholm score preoperatively and 6 months postoperatively were ( 59.4 ± 8.1 ) point, ( 86.4 ± 9.1 ) point, respectively. Differences were statistically significant ( P < 0.05 ). The range of motion of the knee preoperatively and 6 months postoperatively were ( 86.8 ± 13.5 ) °, ( 139.1 ± 8.9 ) °, respectively. Differences were statistically significant ( P <0.05 ). IKDC score preoperatively and 6 months postoperatively were ( 50.6 ± 6.1 ) point, ( 92.8 ± 5.5 ) point, respectively. Differences were statistically significant ( P < 0.05 ). Conclusions

  12. Minimally invasive treatment through arthroscope for anterior cruciate ligament tibial avulsion fracture%关节镜微创治疗前交叉韧带胫骨部撕脱骨折

    Institute of Scientific and Technical Information of China (English)

    崔宗杰; 茹朝阳

    2015-01-01

    目的:探讨关节镜微创治疗前交叉韧带(ACL)胫骨部撕脱骨折的治疗效果。方法关节镜微创治疗ACL胫骨附着部撕脱骨折38例,其中Ⅰ型3例,Ⅱ型12例,Ⅲ型23例。所有患者均采取常规膝关节前外侧入路进镜检查,行骨折复位,然后自胫骨结节两侧钻孔,直达骨折块,用2枚导针穿入,将直径0.7 mm钢丝穿入固定骨块,在骨外拧紧钢丝,观察治疗效果。结果本组38例经4~32个月随访,6周愈合24例,8周愈合8例,12周愈合6例,膝关节功能良好。结论关节镜微创治疗ACL胫骨部撕脱骨折,对膝关节损伤小,用较粗钢丝内固定,固定可靠、恢复快,可早期行膝关节功能锻炼,利于关节功能恢复。%Objective To explore the curative effect of minimally invasive treatment through arthroscope for anterior cruciate ligament (ACL) tibial avulsion fracture.Methods Among 38 patients of ACL tibial avulsion fracture undergoing minimally invasive treatment through arthroscope, there were 3 cases of type Ⅰ, 12 cases of type Ⅱ, and 23 cases of type Ⅲ. Arthroscopy was performed into the front knee with the conventional approach and the reduction of fracture was carried out in all the patients. Then drilling was done from both sides of the tibia to the fracture fragments. After the penetration of two needles, the wire of 0.7 mm diameter was introduced to fix the bone fragments and tightened out of the bone. Curative effects were observed.Results The follow-up of 38 cases lasted 4~32 months. There were 24 healed cases in 6 weeks, 8 healed cases in 8 weeks, and 6 cases in 12 weeks. They all had good knee joint function.Conclusion Minimally invasive treatment through arthroscope for ACL tibial avulsion fracture has few damage to knee joint. Thick wire can provide reliable internal fixation, which can recover quickly. Early exercise of knee joint function can be conducted to benefit joint function recovery.

  13. Arthroscopic Treatment of Anterior Cruciate Ligament Tibial Avulsion Fracture in 16 Cases%关节镜下治疗前交叉韧带下止点撕脱骨折16例

    Institute of Scientific and Technical Information of China (English)

    俞胜宝; 胡四生; 汪炜; 凌健

    2011-01-01

    Objective To observe the surgical skill and the clinical outcomes of arthroscopic treatment of anterior cruciate ligament(ACL) tibial avulsion fracture. Methods From January 2007 to December 2010,16 cases of avulsion fracture of intercondylar eminence( according to Meyers and Mckeever classification, type Ⅰ 1 case, type Ⅱ 13 cases, type Ⅲ 3 cases) received the arthroscopic treatment. The surgical approach was both sides of the patellar ligament, the fracture reduction was performed under arthroscopy,and then the Kirschner wire was inserted from a point medial to the tibial tubercle to hold the intraarticular fracture fragments. The epidural tube was first penetrated through the Kirschner wire hole,and then the guiding tension suture( No. 2 polyethylene line, diameter was 0.5 - 0.7 mm) was penetrated through the epidural tube to fix the bone block. Results Sixteen patients were followed up for 2 to 36 months,14 cases were healed in 12 weeks,other 2 cases in 18 weeks. 14 cases(87.5% ) recovered completely with a good joint stability and negative drawer test; other 2 cases gained a good functional recovery with a good joint stability but positive drawer test. Conclusion Arthroscopic surgery,with a small incision,simple operation,less postoperafive injury,secure internal fixation, is an effective method for the ACL tibial avulsion fracture. The early functional exercise of knee joint should improve the recovery of knee.%目的 观察关节镜下微创治疗前交叉韧带(ACL)胫骨止点撕脱骨折的手术方法及疗效.方法 2007年1月-2010年12月,关节镜下治疗ACL下止点撕脱骨折16例,其中按meyem-meckeever分型1型1例,2型13例,3型2例.常规膝关节髌韧带两侧入路进入关节腔,镜下骨折复位,然后自胫骨结节内侧钻入克氏针,达骨折块,自克氏针孔穿入硬膜外麻醉套管,直径0.5~0.7 mm钢丝导引张力缝线(2号聚乙烯线)经硬膜外麻醉套管穿入固定骨折块.结果 术后16例经2~36

  14. Exploration the Clinical Effect of Artificial Dermis in Treating Skin Avulsion Injury%人工真皮在治疗皮肤撕脱伤的临床应用

    Institute of Scientific and Technical Information of China (English)

    陈柏秋(通讯作者); 彭文要; 邱加崇; 余继超; 刘冰峰; 招伟峰

    2013-01-01

    Objective:To explore the clinical effect of artificial dermis in treating skin avulsion injury .Methods:48 cases of the skin avulsion injury in our hospital from 2008 January to 2013 January was retrospective analysis , we can randomly divide them into 2 groups . 24 cases in the control group was treated with anti -infection, microcirculation improving, dressing treatment, and operating skin graft-ing or flap repairing when the fresh granulation tissue grew .The observation group included 24 cases, treated with anti -infection, mi-crocirculation improving , early debridement and dressing , after fresh granulation tissue grew , external application of artificial dermis (skin Nike), then induced dermal reconstruction, promoted fresh granulation tissue growth, and operated skin grafting when the granula-tion tissue growing satisfactorily .Results:The average hospitalization days of the control group was 38.2 ±1.3 days.Due to the burn area is larger;the scar hyperplasia of 11 cases among the control group was obvious after the wound was repaired by split -thickness skin or mid-thickness skin.In observation group, the average hospital stay 28.4 ±1.1 days, the scar hyperplasia was not obvious or lighter after the wound was healed .Conclusion:The application of artificial dermis in treatment of skin avulsion injury can effectively shorten the days of hospitalization , reduce the operation risk , promote wound healing , plus the simple operation process and no obvious scar hyper-plasia or lighter , it is truly worth further popularization and application in clinic .%目的:探索人工真皮治疗皮肤撕脱伤的临床效果。方法:回顾性分析我院2008年1月~2013年1月48例皮肤撕脱伤的治疗方法。随机分成2组,对照组24例,予抗感染,改善微循环和换药治疗后,待创面有新鲜肉芽组织生长后行植皮或皮瓣修复术。观察组24例,予抗感染,改善微循环,早期清创、换药,创面有新鲜肉芽

  15. EU law revisions and legislative drift

    DEFF Research Database (Denmark)

    Borghetto, Enrico; Mäder, Lars Kai

    2014-01-01

    European Union research has made great strides in understanding the dynamics of the European Union decision-making process. In contrast to this progress, the dynamics unfolding after the enactment of a European Union secondary legislative act has largely been ignored. Some of these acts remain...... in force in their original form for several years while others are revised soon after their enactment. What factors account for this variation? We empirically analyze the proposition that in the presence of ‘legislative drift,’ i.e. the intertemporal variation of decision-makers’ preferences, major...... revisions of European Union legislative acts are more likely to occur. Based on an analysis of the revision histories of 158 major European Union acts in the time period between 1958 and 2003, we find significant support for this hypothesis....

  16. A new harvest site for bone graft in anterior cruciate ligament revision surgery.

    Science.gov (United States)

    Franceschi, Francesco; Papalia, Rocco; Di Martino, Alberto; Rizzello, Giacomo; Allaire, Robert; Denaro, Vincenzo

    2007-05-01

    During revision anterior cruciate ligament (ACL) surgery, femoral interference screws frequently require removal. This may lead to significant tunnel widening and possible graft fixation failure as a result. Solutions include drilling the revision tunnel in a different location, using stacked interference screws, or using bone graft to fill the defect. Autogenous iliac crest graft and allograft are both used, but there are significant comorbidities associated with each. We developed a new technique for harvesting autogenous bone graft that avoids many of the complications associated with other graft sources. By use of the existing surgical incision from the initial harvest of the bone-patellar tendon-bone autograft, bone from the medial tibial metaphyseal safe zone is harvested via an OATS tube harvester (Arthrex, Naples, FL). A bone plug 1 mm larger in size than the femoral defect is harvested and arthroscopically inserted via a press-fit technique. At 3 months after bone grafting, patients undergo revision ACL reconstruction. The proximal tibial metaphysis is a safe bone graft harvest site in revision ACL surgery and offers an effective method for filling large bony defects, allowing anatomic reconstruction of the ACL after bone healing has occurred. Furthermore, it eliminates the problems associated with allograft or use of a remote graft donor site. PMID:17478290

  17. Resource description and access 2013 revision

    CERN Document Server

    2013-01-01

    This e-book contains the 2013 Revision of RDA: Resource Description and Access, and includes the July 2013 Update. This e-book offers links within the RDA text and the capability of running rudimentary searches of RDA, but please note that this e-book does not have the full range of content or functionality provided by the subscription product RDA Toolkit. Included: A full accumulation of RDA- the revision contains a full set of all current RDA instructions. It replaces the previous version of RDA Print as opposed to being an update packet to that version. RDA has gone through many changes sin

  18. PWR secondary water chemistry guidelines: Revision 3

    International Nuclear Information System (INIS)

    An effective, state-of-the art secondary water chemistry control program is essential to maximize the availability and operating life of major PWR components. Furthermore, the costs related to maintaining secondary water chemistry will likely be less than the repair or replacement of steam generators or large turbine rotors, with resulting outages taken into account. The revised PWR secondary water chemistry guidelines in this report represent the latest field and laboratory data on steam generator corrosion phenomena. This document supersedes Interim PWR Secondary Water Chemistry Recommendations for IGA/SCC Control (EPRI report TR-101230) as well as PWR Secondary Water Chemistry Guidelines--Revision 2 (NP-6239)

  19. A programmable approach to revising knowledge bases

    Institute of Scientific and Technical Information of China (English)

    LUAN Shangmin; DAI Guozhong; LI Wei

    2005-01-01

    This paper presents a programmable approach to revising knowledge bases consisting of clauses. Some theorems and lemmas are shown in order to give procedures for generating maximally consistent subsets. Then a complete procedure and an incomplete procedure for generating the maximal consistent subsets are presented, and the correctness of the procedures is also shown. Furthermore, a way to implement knowledge base revision is presented, and a prototype system is introduced. Compared with related works, the main characteristic of our approach is that the approach can be implemented by a computer program.

  20. AN OVERVIEW ON BLOOM'S REVISED TAKSONOMY

    OpenAIRE

    TUTKUN, Ömer Faruk

    2013-01-01

    In this study, the main purpose is to present the main frame of revised version in 2001 of Bloom's taxonomy that has been accepted extensively in our country since 1956 as well as around the world. In accordance with this purpose, in the study, answers have been searched to these questions: 1- The rise of the original Bloom's taxonomy and what are the key features of? 2- What are the reasons for renewal of original taxonomy? 3- What kind of arrangements has been made in revised taxonomy? 4- W...

  1. Insuficiência aórtica aguda por avulsão de comissura valvar aórtica Acute aortic insufficiency due to avulsion of aortic valve comissure

    Directory of Open Access Journals (Sweden)

    Claudio Ribeiro da Cunha

    2012-03-01

    Full Text Available Paciente do sexo masculino, de 66 anos, previamente hipertenso, com história de ortopneia, palpitações e dor precordial de início súbito, que teve o diagnóstico de avulsão espontânea de uma comissura valvar aórtica e consequente insuficiência aórtica aguda, evoluindo com insuficiência cardíaca esquerda refratária ao tratamento clínico. O paciente foi submetido precocemente à substituição cirúrgica da valva aórtica por uma bioprótese, e apresentou evolução pós-operatória satisfatória. Atualmente, quatro anos após o evento, continua em acompanhamento ambulatorial em classe funcional I.A 66-year-old male patient, prior hypertension, a history of orthopnea, palpitations and chest pain of sudden onset, which was diagnosed as spontaneous avulsion of aortic valve commissure and consequent aortic insufficiency progressing to acute left heart failure refractory to medical treatment. The patient underwent early surgical replacement of the aortic valve by a bioprosthesis, and presented satisfactory postoperative course. Currently, four years after the event, still in attendance in functional class I.

  2. 髂前上棘撕脱骨折18例治疗回顾%Treatment of 18 cases with anterior superior iliac spine avulsion fracture: a respective review

    Institute of Scientific and Technical Information of China (English)

    张立峰; 王达辉; 裴新红; 马瑞雪

    2014-01-01

    目的 回顾18例髂前上棘(anterior superior iliac spine,ASIS)撕脱骨折的治疗,分析小儿髂前上棘撕脱骨折受伤机制,手术治疗的效果、预后、并发症.方法 2003年7月至2013年7月复旦大学附属儿科医院共收治髂前上棘撕脱骨折患儿18例.男15例,女3例,年龄3岁8个月至16岁.均为急性损伤:快速跑步时或急加速时14例,打篮球突然跳跃1例,踢球1例,车祸伤2例.X线片及CT了解骨折片的大小及移位情况:2例车祸伤者1例因合并股骨颈骨折行股骨颈切开复位空心钉内固定术,髂前上棘撕脱未处理,1年后X片及CT发现形成骨化中心,无症状未处理;1例行保守治疗骨折愈合;其余均行切开复位空心钉内固定.结果 18例患儿治疗效果优良,术后无深部组织感染,髋关节无活动受限,肌力正常,运动能力恢复,局部无疼痛、无包块.结论 髂前上棘撕脱骨折切开复位空心钉内固定效果好,恢复快,并发症少,并且可避免以后可能出现的股外侧区疼痛症,运动员可尽早恢复训练,但需二次手术取出内固定.%Objective To retrospectively review the treatment experiences of 18 cases of anterior superior iliac spine (ASIS) avulsion fracture so as to analyze its injury mechanism,treatment,complications and prognosis.Methods The clinical follow-up data were collected for 18 children with ASIS avulsion fracture treated at Children's Hospital,Fudan University during the period of July 2003 to July 2013.There were 15 males and 3 females with an age range of 44-192 months.All of them had acute injuries from rapid running or sudden acceleration (n =14),sudden jumping while playing basketball (n =1),football-related (n =1) and traffic accident (n =2).Radiology and computed tomography (CT) scan were used to analyze the size of bone fragments and shifting.One traffic accident patient coupled with femoral neck fractures underwent femoral neck open reduction and cannulated screw fixation while

  3. Revised Law Provides Better Protection for Minor Citizens

    Institute of Scientific and Technical Information of China (English)

    JU QING

    2007-01-01

    @@ On December 29, 2006, the revised Law of the People's Republic of China on the Protection of Minors(hereinafter referred to as "the revised Law" for short) was approved at the 25th meeting of the Tenth National People's Congress (NPC), China's highest legislature. The revised Law is to become effective on June 1, 2007. Revision of the Law, which was adopted in 1991, took three years to complete, during which period a dozen drafts were produced.

  4. Impact of peer revision on second language writing

    OpenAIRE

    Öztürk, Burcu

    2006-01-01

    Cataloged from PDF version of article. This study investigates the characteristics and effectiveness of peer revision on second language writing as an aid to teacher feedback. It compares peer revision with the individual revision, helping analyze the former in a more controlled way in terms of its general usefulness. The study was conducted at Middle East Technical University. The data was collected through peer revision processes, in which peers reviewed each other’s writi...

  5. Revisions Policy for Official Statistics; A Matter of Governance

    OpenAIRE

    Carol S. Carson; Sarmad Khawaja; Thomas K. Morrison

    2004-01-01

    This paper proposes a set of good practices for the revision of macroeconomic data. The authors argue that revisions are a routine part of disseminating quality data. Revisions are made not just to correct errors but also to incorporate better source data, update base periods, and make other improvements. It is argued, using country examples and views from policymakers and other users, that national statistical agencies should have explicit revisions policies.

  6. Analysis of stem tip pain in revision total knee arthroplasty.

    Science.gov (United States)

    Kimpton, Christine I; Crocombe, Andrew David; Bradley, William Neil; Gavin Huw Owen, Brigstocke

    2013-06-01

    Stem tip pain following revision total knee arthroplasty is a significant cause of patient dissatisfaction, which in the presence of an aseptic well-fixed component has no widely accepted surgical solution. A definitive cause of stem tip pain remains elusive, however it has been suggested that high stress concentrations within the region of the stem tip may play a role. This paper reports a finite element study of a novel clinical technique where a plate is attached to the tibia within the region of the stem tip to reduce stem tip pain. The results demonstrate that the plate reduces stress concentrations in the bone at the stem tip of the implant. The magnitude of stress reduction is dependent upon plate location, material and attachment method. PMID:23523204

  7. US Department of Energy radiological control manual. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    1994-04-01

    This manual establishes practices for the conduct of Department of Energy radiological control activities. The Manual states DOE`s positions and views on the best courses of action currently available in the area of radiological controls. Accordingly, the provisions in the Manual should be viewed by contractors as an acceptable technique, method or solution for fulfilling their duties and responsibilities. This Manual shall be used by DOE in evaluating the performance of its contractors. This Manual is not a substitute for Regulations; it is intended to be consistent with all relevant statutory and regulatory requirements and shall be revised whenever necessary to ensure such consistency. Some of the Manual provisions, however, challenge the user to go well beyond minimum requirements. Following the course of action delineated in the Manual will result in achieving and surpassing related statutory or regulatory requirements.

  8. [Revised objectives of postgraduate clinical training in JSCP].

    Science.gov (United States)

    Kumasaka, K; Fujimaki, M

    1994-05-01

    Japanese medical graduates are recommended to receive clinical training for more than two years after graduation, because undergraduate clinical training is insufficient. In 1979, the educational committee of the Japan Society of Clinical Pathology (JSCP) proposed the objectives of postgraduate training for clinical pathologist, and the minimal training period should be 5 years of which at least 1 year should be completed in internal medicine or anatomic pathology or clinical physiology. The field of clinical pathology seen dramatic development since 1979. Therefore, we here present the revised objectives of basic clinical training in 1993. This training in general internal medicine should be the precondition for further postgraduate training in clinical pathology or laboratory medicine. It is emphasized that clinical trainees should have basic clinical skills which include interviewing techniques, skills in physical examination and communication skills to other doctors and other medical co-workers in POS (Problem Oriented System). PMID:8022079

  9. Tantalum cones and bone defects in revision total knee arthroplasty.

    Science.gov (United States)

    Boureau, F; Putman, S; Arnould, A; Dereudre, G; Migaud, H; Pasquier, G

    2015-04-01

    Management of bone loss is a major challenge in revision total knee arthroplasty (TKA). The development of preformed porous tantalum cones offers new possibilities, because they seem to have biological and mechanical qualities that facilitate osseointegration. Compared to the original procedure, when metaphyseal bone defects are too severe, a single tantalum cone may not be enough and we have developed a technique that could extend the indications for this cone in these cases. We used 2 cones to fill femoral bone defects in 7 patients. There were no complications due to wear of the tantalum cones. Radiological follow-up did show any migration or loosening. The short-term results confirm the interest of porous tantalum cones and suggest that they can be an alternative to allografts or megaprostheses in case of massive bone defects.

  10. 36 CFR 219.9 - Revision.

    Science.gov (United States)

    2010-07-01

    ... Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE PLANNING National Forest System Land and Resource Management Planning The Framework for Planning § 219.9 Revision. (a) Application... is a review of the overall management of a unit of the National Forest System and an opportunity...

  11. Fast-track revision knee arthroplasty

    DEFF Research Database (Denmark)

    Husted, Henrik; Otte, Niels Kristian Stahl; Kristensen, Billy B;

    2011-01-01

    Abstract Background and purpose Fast-track surgery has reduced the length of hospital stay (LOS), morbidity, and convalescence in primary hip and knee arthroplasty (TKA). We assessed whether patients undergoing revision TKA for non-septic indications might also benefit from fast-track surgery...

  12. Anomalies of Nuclear Criticality, Revision 6

    Energy Technology Data Exchange (ETDEWEB)

    Clayton, E. D.; Prichard, Andrew W.; Durst, Bonita E.; Erickson, David; Puigh, Raymond J.

    2010-02-19

    This report is revision 6 of the Anomalies of Nuclear Criticality. This report is required reading for the training of criticality professionals in many organizations both nationally and internationally. This report describes many different classes of nuclear criticality anomalies that are different than expected.

  13. Revised Safety Instruction 4 (IS4 REV.)

    CERN Multimedia

    2006-01-01

    Please note that the revised safety instruction 4 (IS4 REV.) entitled 'Safety Inspections' is available on the web at the following url: https://edms.cern.ch/file/335741/LAST_RELEASED/E_IS4.pdf Paper copies can also be obtained from the SC unit secretariat, e-mail: sc.secretariat@cern.ch SC Secretariat

  14. Hermann Weyl's intuitionistic mathematics (revised edition)

    NARCIS (Netherlands)

    Dalen, D. van

    2012-01-01

    It is common knowledge that for a short while Hermann Weyl joined Brouwer in his pursuit of a revision of mathematics according to intuitionistic principles. There is, however, little in the literature that sheds light on Weyl's role, and in particular on Brouwer's reaction to Weyl's allegiance to t

  15. Revision of the genus Aponogeton (Aponogetonaceae)

    NARCIS (Netherlands)

    Bruggen, van H.W.E.

    1970-01-01

    In this revision are recorded 9 species from continental Asia and Indonesia, and 2 from New Guinea. Of the latter 1 is new to science. Some species frequently confused in the past could be described exactly. All names have been properly typified and all existing types could be examined by the author

  16. Revision of the genus Labisia (Myrsinaceae)

    OpenAIRE

    Sunarno, B.

    2005-01-01

    The genus Labisia (Myrsinaceae) is revised for the Flora Malesiana region. Seven species are recognised. Several earlier described species are synonymous to L. pumila and reduced to varieties of that species: var. alata, var. lanceolata, var. neriifolia and var. sessilifolia. A new record of L. longistyla is mentioned. Labisia malouiana and L. obtusifolia are excluded from the genus.

  17. Revised Recommendation Concerning Technical and Vocational Education.

    Science.gov (United States)

    United Nations Educational, Scientific, and Cultural Organization, Paris (France).

    The UNESCO (United Nations Education, Scientific, and Cultural Organization) revised recommendation setting forth general principles, goals, and guidelines concerning technical and vocational education (adopted by the General Conference at its 18th session in Paris, 19 November 1974) is presented under the following headings: (1) Technical and…

  18. Revision of Coelogyne section Speciosae (Orchidaceae)

    OpenAIRE

    Gravendeel, B.; Vogel, de, V.

    1999-01-01

    Section Speciosae Pfitzer & Kraenzl. of the genus Coelogyne Lindl. is revised. Sixteen species are recognized, including one new ( C. tommii) and one dubious species ( (C. dichroantha). Three former varieties are raised to subspecies level ( C. speciosa subsp. speciosa, subsp. incarnata and subsp. fimbriata). Two species formerly included in sect. Speciosae by several authors are excluded (C. eberhardtii and C. lawrenceana).

  19. 78 FR 59982 - Revisions to Radiation Protection

    Science.gov (United States)

    2013-09-30

    ... COMMISSION Revisions to Radiation Protection AGENCY: Nuclear Regulatory Commission. ACTION: Standard review..., ``Radiation Protection Design Features,'' and Section 12.5, ``Operational Radiation Protection Program..., ``Radiation Protection Design Features,'' (ADAMS Accession No. ML13151A475); and Section 12.5,...

  20. A taxonomic revision of Lamium (Lamiaceae)

    NARCIS (Netherlands)

    Mennema, J.

    1989-01-01

    The present study deals with the systematics and taxonomy of the genus Lamium (Lamiaceae). The taxonomic revision is mainly based on the study of herbarium collections, and to a smaller degree on field observations and abstracts from literature. The research was done at the Rijksherbarium, Leyden, w

  1. 77 FR 23176 - Revisions to Procedural Rules

    Science.gov (United States)

    2012-04-18

    ... extensive discovery and oral cross- examination opportunities in all cases. The authority of regulatory agencies like the Commission to revise their regulations to place limits on the use of formal litigation... Commission to permit extensive discovery and sufficient time to allow preparation of technical...

  2. 7 CFR 3015.115 - Budget revisions.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Budget revisions. 3015.115 Section 3015.115 Agriculture Regulations of the Department of Agriculture (Continued) OFFICE OF THE CHIEF FINANCIAL OFFICER, DEPARTMENT OF AGRICULTURE UNIFORM FEDERAL ASSISTANCE REGULATIONS Programmatic Changes and Budget...

  3. Geography: A Guide to Reference Sources. [Revised].

    Science.gov (United States)

    Marley, Carol

    This revised annotated bibliography about geography concentrates on reference materials located in the McLennan Library of McGill University (Montreal, Quebec), and it emphasizes human rather than physical geography. The resources are presented in nine areas: (1) guides to the literature; (2) dictionaries; (3) gazeteers and place names; (4)…

  4. Revision of the genus Castillomys (Muridae, Rodentia)

    NARCIS (Netherlands)

    Martín Suárez, E.; Mein, P.

    1991-01-01

    In this paper a revision of the genus Castillomys Michaux, 1969 is given. Previously described subspecies are elevated to species rank, and a new species, Castillomys rivas, is proposed. Several populations from Italy and Turkey are transferred to the genus Centralomys de Giuli, 1989. For a populati

  5. A revision of Madagascan Bertiera (Rubiaceae)

    NARCIS (Netherlands)

    Wittle, P.M.; Davis, A.P.

    2010-01-01

    A taxonomic revision of the Madagascan representatives of the genus Bertiera is presented, to include three species, B. brevithyrsa, B. crinita and B. longithyrsa. A key to their identification is provided, each species is fully described, and summaries of distribution, habitat and ecology, and phen

  6. Revision of Lecananthus (Rubiaceae-Schradereae)

    OpenAIRE

    Puff, C.; Buchner, R.; Greimler, J.

    1998-01-01

    A taxonomic revision of Lecananthus Jack, a genus of three species occurring in Sumatra, the Peninsular Malaysia, and Borneo, is presented. A new species, L. peduncularis Puff, endemic to Sarawak, is described, and a new combination, L. pentander (Merr.) Puff (syn. Lucinaea pentandra Merr.), is published.

  7. A revision of Mitragyna and Uncaria (Rubiaceae)

    NARCIS (Netherlands)

    Ridsdale, C.E.

    1978-01-01

    A world wide revision of the genera Mitragyna s.l. and Uncaria both placed in the subtribe Mitragyninae Havil. of the tribe Cinchoneae, with a general discussion on the affinities of the genera, the growth form and architecture. In Mitragyna 10 species and in Uncaria 34 species are recognized; 4 new

  8. Personalisation: The Emerging "Revised" Code of Education?

    Science.gov (United States)

    Hartley, David

    2007-01-01

    In England, a "revised" educational code appears to be emerging. It centres upon the concept of "personalisation". Its basis is less in educational theory, more in contemporary marketing theory. Personalisation can be regarded in two ways. First, it provides the rationale for a new mode of public-service delivery, one which seeks to enable "users"…

  9. Assessing the Impact of Peer Revision on L2 Writing.

    Science.gov (United States)

    Villamil, Olga S.; de Guerrero, Maria C. M.

    1998-01-01

    A study investigated the impact of peer revision on writers' final drafts in two rhetorical modes, narration and persuasion, among 14 Spanish-speaking college students of English-as-a-Second-Language. Results revealed 74% of revisions made in peer sessions were incorporated into final drafts, and writers made many further self-revisions,…

  10. Uncovering Substance: Teaching Revision in High School Classrooms

    Science.gov (United States)

    Early, Jessica Singer; Saidy, Christina

    2014-01-01

    This article shares the process and outcomes from a three-day revision workshop designed and implemented in a diverse high school language arts classroom. The revision workshop included: direct instruction, self-reflection, and peer feedback to provide struggling writers with opportunities to take part in substantive revision. The authors examine…

  11. 78 FR 44596 - Minor Boundary Revision at Yosemite National Park

    Science.gov (United States)

    2013-07-24

    ... National Park Service Minor Boundary Revision at Yosemite National Park AGENCY: National Park Service, Interior. ACTION: Notification of Boundary Revision. SUMMARY: The boundary of Yosemite National Park is... boundary of Yosemite National Park. DATES: The effective date of this boundary revision is July 24,...

  12. EPRI BWR Water Chemistry Guidelines Revision

    International Nuclear Information System (INIS)

    BWRVIP-190: BWR Water Chemistry Guidelines – 2008 Revision has been revised. The revision committee consisted of U.S. and non-U.S. utilities (members of the BWR Vessel and Internals Protection (BWRVIP) Mitigation Committee), reactor system manufacturers, fuel suppliers, and EPRI and industry experts. The revised document, BWRVIP-190 Revision 1, was completely reformatted into two volumes, with a simplified presentation of water chemistry control, diagnostic and good practice parameters in Volume 1 and the technical bases in Volume 2, to facilitate use. The revision was developed in parallel and in coordination with preparation of the Fuel Reliability Guidelines Revision 1: BWR Fuel Cladding Crud and Corrosion. Guidance is included for plants operating under normal water chemistry (NWC), moderate hydrogen water chemistry (HWC-M), and noble metal application (GE-Hitachi NobleChem™) plus hydrogen injection. Volume 1 includes significant changes to BWR feedwater and reactor water chemistry control parameters to provide increased assurance of intergranular stress corrosion cracking (IGSCC) mitigation of reactor materials and fuel reliability during all plant conditions, including cold shutdown (≤200°F (93°C)), startup/hot standby (>200°F (93°C) and ≤ 10%) and power operation (>10% power). Action Level values for chloride and sulfate have been tightened to minimize environmentally assisted cracking (EAC) of all wetted surfaces, including those not protected by hydrogen injection, with or without noble metals. Chemistry control guidance has been enhanced to minimize shutdown radiation fields by clarifying targets for depleted zinc oxide (DZO) injection while meeting requirements for fuel reliability. Improved tabular presentations of parameter values explicitly indicate levels at which actions are to be taken and required sampling frequencies. Volume 2 provides the technical bases for BWR water chemistry control for control of EAC, flow accelerated corrosion

  13. Experimental Techniques

    CERN Document Server

    Engelfried, J

    1999-01-01

    In this course we will give examples for experimental techniques used in particle physics experiments. After a short introduction, we will discuss applications in silicon microstrip detectors, wire chambers, and single photon detection in Ring Imaging Cherenkov (RICH) counters. A short discussion of the relevant physics processes, mainly different forms of energy loss in matter, is enclosed.

  14. Approximation Techniques

    OpenAIRE

    2006-01-01

    This interactive tutorial presents the following concepts of Approximation Techniques: Methods of Weighted Residual (MWR), Weak Formulatioin, Piecewise Continuous Function, Galerkin Finite Element FormulationExplanations especially for mathematical statements are provided using mouseover the highlight equations. ME4613 Finite Element Methods

  15. Experimental in-vitro bone cements disintegration with ultrasonic pulsating water jet for revision arthroplasty

    OpenAIRE

    S. Hloch; Foldyna, J.; Pude, F.; Kloc, J.; M. Zeleňák; Hvizdoš, P.; Monka, P.; Smolko, I.; Ščučka, J. (Jiří); Kozak, D.; A. Sedmak; Mihalčinová, E.

    2015-01-01

    The paper deals with the study of using the selective property of ultrasonic pulsating water jet for the disintegration of the interface created by bone cement between cemented femoral stem and trabecular bone tissue as a potential technique for revision arthroplasty. Six types of commercial bone cements based on Polymethyl Methacrylate were used for investigation. The cements were mixed using the DePuy - SmartMix® CTS / vacuum mixing bowl. Mechanical properties of hardened bone cements were ...

  16. Investigating Student Attitudes and Performance in a Revised Introductory Physics Sequence II

    Science.gov (United States)

    Crowder, Juliette; Martinez, Aramis; Lopez, Ramon

    2001-10-01

    Research shows that the traditional lecture-and-lab format is not the most effective way to introduce students to calculus-based physics. Accordingly, the curriculum for UTEP's introductory calculus based physics courses was revised for the 2000-01 academic year to include techniques that have proven to improve students' understanding of physics. This paper will focus on student attitudes and retention rates.

  17. 30 CFR 285.617 - What activities require a revision to my SAP, and when will MMS approve the revision?

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What activities require a revision to my SAP... OUTER CONTINENTAL SHELF Plans and Information Requirements Activities Under An Approved Sap § 285.617 What activities require a revision to my SAP, and when will MMS approve the revision? (a) You...

  18. Bilateral sagittal split osteotomy by the splitter-separator technique : technical aspects, safety, and predictability

    NARCIS (Netherlands)

    Mensink, Gertjan

    2015-01-01

    The goal of this thesis is to prove the safety and predictability of BSSO by the splitter– separator technique in an extensive study of its possible major sequelae. The revised BSSO technique will be assessed by the following means: 1. Reviewing both BSSO techniques and their incidences of postoper

  19. Experimental Techniques

    DEFF Research Database (Denmark)

    Wyer, Jean

    2013-01-01

    Gas-phase ion spectroscopy requires specialised apparatus, both when it comes to measuring photon absorption and light emission (fluorescence). The reason is much lower ion densities compared to solution-phase spectroscopy. In this chapter different setups are described, all based on mass spectro...... in data interpretation, and the advantages and disadvantages of the different techniques are clarified. New instrumental developments involving cryo-cooled storage rings, which show great promise for the future, are briefly touched upon....

  20. Electrochemical Techniques

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Gang; Lin, Yuehe

    2008-07-20

    Sensitive and selective detection techniques are of crucial importance for capillary electrophoresis (CE), microfluidic chips, and other microfluidic systems. Electrochemical detectors have attracted considerable interest for microfluidic systems with features that include high sensitivity, inherent miniaturization of both the detection and control instrumentation, low cost and power demands, and high compatibility with microfabrication technology. The commonly used electrochemical detectors can be classified into three general modes: conductimetry, potentiometry, and amperometry.

  1. Guidance document for revision of DOE Order 5820.2A, Radioactive Waste Technical Support Program. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    Kudera, D.E.; McMurtrey, C.D.; Meagher, B.G.

    1993-04-01

    This document provides guidance for the revision of DOE Order 5820.2A, ``Radioactive Waste Management.`` Technical Working Groups have been established and are responsible for writing the revised order. The Technical Working Groups will use this document as a reference for polices and procedures that have been established for the revision process. The overall intent of this guidance is to outline how the order will be revised and how the revision process will be managed. In addition, this document outlines technical issues considered for inclusion by a Department of Energy Steering Committee.

  2. Bicyclic graphs with maximal revised Szeged index

    CERN Document Server

    Li, Xueliang

    2011-01-01

    The revised Szeged index $Sz^*(G)$ is defined as $Sz^*(G)=\\sum_{e=uv \\in E}(n_u(e)+ n_0(e)/2)(n_v(e)+ n_0(e)/2),$ where $n_u(e)$ and $n_v(e)$ are, respectively, the number of vertices of $G$ lying closer to vertex $u$ than to vertex $v$ and the number of vertices of $G$ lying closer to vertex $v$ than to vertex $u$, and $n_0(e)$ is the number of vertices equidistant to $u$ and $v$. Hansen used the AutoGraphiX and made the following conjecture about the revised Szeged index for a connected bicyclic graph $G$ of order $n \\geq 6$:

  3. Revising the senior walking environmental assessment tool

    Science.gov (United States)

    Michael, Yvonne L.; Keast, Erin M.; Chaudhury, Habib; Day, Kristen; Mahmood, Atiya; Sarte, Ann F.I.

    2016-01-01

    Background The Senior Walking Environmental Assessment Tool (SWEAT), an instrument for measuring built environmental features associated with physical activity of older adults, was revised to create an easier-to-use tool for use by practitioners and community members. Methods Inter-rater and intra-rater reliability of the modified instrument (SWEAT-R) was assessed in Portland, Oregon in 2007. Five trained observers audited street segments in 12 neighborhoods, resulting in 361 pairs of audits, including 63 repeated audits. Results Overall, 88% and 75% of items assessed had good or excellent inter-rater and intra-rater reliability, respectively. The revised instrument required less time to complete than the original instrument, while obtaining more information. Conclusion SWEAT-R provides easy to gather, reliable data for use in community-based audits of built environment in relation to walking among older adults. PMID:19136025

  4. Revision of the genus Calpurnia (Sophoreae: Leguminosae

    Directory of Open Access Journals (Sweden)

    A. J. Beaumont

    1999-12-01

    Full Text Available Taxa recognised in this revision are:  Calpurnia aurea (Aiton Benth. subsp.  aurea; C.  aurea (Aiton Benth. subsp.  indica Brummitt; C. floribunda Harv ; C. glabrata Brummitt; C. intrusa (R.Br in W.T.Aiton E.Mey.; C. reflexus A.J.Beaumont sp nov.;  C. sericea Harv. and  C. woodii Schinz. A putative hybrid between  C. sericea and  C. woodii is recorded. With the exception of C aurea, all species are restricted to southern Africa.  C. reflexus is possibly extinct, and C.  woodii is considered rare. Characters examined in this revision are habitat, habit, vestiture, leaf morphology and anatomy; floral, pollen, fruit and seed morphology and anatomy; and seedling morphology. Illustrations and a key to taxa are provided.

  5. Operational and Complete Approaches to Belief Revision

    Institute of Scientific and Technical Information of China (English)

    LI Wei; LUAN Shangmin

    2000-01-01

    Two operational approaches to belief revision are presented in this paper. The rules of R-calculus are modified in order to deduce all the maximal consistent subsets. Another set of rules is given in order to deduce all the minimal inconsistent subsets. Then a procedure, which can generate all the maximal consistent subsets, is presented. They are complete approaches, since all the maximal consistent subsets can be deduced or generated. In this paper, only the case of propositional logic is considered.

  6. Women's sexual dysfunction: revised and expanded definitions

    OpenAIRE

    Basson, Rosemary

    2005-01-01

    ACCEPTANCE OF AN EVIDENCE-BASED CONCEPTUALIZATION OF WOMEN'S SEXUAL RESPONSE combining interpersonal, contextual, personal psychological and biological factors has led to recently published recommendations for revision of definitions of women's sexual disorders found in the American Psychiatric Association's Diagnostic and Statistical Manual (DSM–IV-TR). DSM-IV definitions have focused on absence of sexual fantasies and sexual desire prior to sexual activity and arousal, even though the frequ...

  7. Revision of ISO 15859 Aerospace Fluid Standards

    Science.gov (United States)

    Greene, Benjamin; McClure, Mark B.

    2012-01-01

    A detailed review of ISO 15859 "Space Systems - Fluid Characteristics, Sampling and Test Methods" was performed An approach to revising Parts 1-9 and 11-13 was developed and concurred by the NASA Technical Standards Program Office. The approach was to align them with the highest level source documents, and not to program-specific requirements. The updated documents were prepared and presented.

  8. Rationale of Revision Lumbar Spine Surgery

    OpenAIRE

    Elgafy, Hossein; Vaccaro, Alexander R; Chapman, Jens R.; Dvorak, Marcel F.

    2012-01-01

    Revision lumbar spine surgeries are technically challenging with inconstant outcome results. This article discusses the preoperative, intraoperative, as well as postoperative management in these difficult patients. Successful intervention requires a detailed history and physical examination and carefully chosen diagnostic tests. Preoperative planning is paramount in these cases. The decision-making process should address the timing of the surgery, surgical approach, level of interbody fusion ...

  9. Revised Safety Instruction 41 (IS41 REV.)

    CERN Document Server

    SC Secretariat

    2005-01-01

    Please note that the Revised Safety Instruction No. 41 (IS41 REV.), entitled 'The use of plastic and other non-metallic materials at CERN with respect to fire safety and radiation resistance' is available on the web at the following url: https://edms.cern.ch/document/335806/LAST_RELEASED Paper copies can also be obtained from the SC Unit Secretariat, e-mail: sc.secretariat@cern.ch SC Secretariat

  10. Revision of Coelogyne section Fuliginosae (Orchidaceae)

    OpenAIRE

    Pelser, P.B.; Gravendeel, B.; Vogel, de, V.

    2000-01-01

    Section Fuliginosae Pfitzer & Kraenzl. of the genus Coelogyne Lindl. is revised. With the help of a pollen study, principal component and cluster analyses with morphological characters and a survey of some additional data, two species are recognized (C. fimbriata and C. triplicatula), including one dubious variety (C. fimbriata var. acuminata). Eleven names are reduced to synonymy. Three species formerly included in sect. Fuliginosae by several authors are excluded ( (C. micrantha, C. treutle...

  11. Clinical Outcomes Following Revision Anterior Shoulder Stabilization

    Science.gov (United States)

    Frank, Rachel M.; Mellano, Chris; Shin, Jason J.; Feldheim, Terrence F.; Mascarenhas, Randhir; Yanke, Adam Blair; Cole, Brian J.; Nicholson, Gregory P.; Romeo, Anthony A.; Verma, Nikhil N.

    2015-01-01

    Objectives: The purpose of this study was to determine the clinical outcomes following revision anterior shoulder stabilization performed either via all-arthroscopic soft tissue repair or via Latarjet coracoid transfer. Methods: A retrospective review of prospectively collected data on 91 shoulders undergoing revision anterior shoulder stabilization was performed. All patients underwent prior soft tissue stabilization; those with prior open bone grafting procedures were excluded. For patients with 25% glenoid bone loss, Latarjet was performed (n=28). Patients were queried regarding recurrent instability (subluxation or dislocation). Clinical outcomes were evaluated using validated patient reported outcome questionnaires including the American Shoulder and Elbow Surgeons (ASES) score, Simple Shoulder Test (SST), visual analog scale (VAS) for pain, and Western Ontario Shoulder Instability Index (WOSI). Results: A total of 63 shoulders in 62 patients (46 males, 16 females) with an average age of 23.2 ± 6.9 years were included in the revision arthroscopy group. At an average follow-up of 46.9 ± 16.8 months (range, 15 to 78), the mean WOSI score was 80.1 (range, 15.0 to 100), and there were significant improvements (pLatarjet group. Thirteen (46%) had more than one previous stabilization attempt. ), the average WOSI score was 71.9, and there were significant improvements (pLatarjet. Conclusion: Both arthroscopic revision stabilization and Latarjet coracoid transfer result in satisfactory outcomes in patients who have failed previous arthroscopic capsulolabral repair. Recurrent instability rates were higher in the all-arthroscopic group (19% versus 7%). Longer-term studies are required to determine whether similar results are maintained over time, and to provide guidance on focused clinical indications for this challenging patient population.

  12. The Revision of Japans Early Commercial Treaties.

    OpenAIRE

    Nigel Brailey; Sir Hugh Cortazzi; James Hoare; Ayako Hotta-Lister

    1999-01-01

    A joint symposium between the Japan Society and the London School of Economics and Political Science was held in the Suntory and Toyota International Centres for Economics and Related Disciplines on 9 July 1999 to mark the centenary of Treaty Revision in Japan. In the Bakumatsu period of the 1850s and 1860s Japan had entered into a number of commercial treaties with foreign countries which (among other things) gave foreign nationals extraterritorial rights in Japanese treaty ports. These trea...

  13. The revision of Japan's early commercial treaties

    OpenAIRE

    CORTAZZI, Hugh; Hoare, James; Brailey, Nigel; Hotta-Lister, Ayako

    1999-01-01

    A joint symposium between the Japan Society and the London School of Economics and Political Science was held in the Suntory and Toyota International Centres for Economics and Related Disciplines on 9 July 1999 to mark the centenary of Treaty Revision in Japan. In the Bakumatsu period of the 1850s and 1860s Japan had entered into a number of commercial treaties with foreign countries which (among other things) gave foreign nationals extraterritorial rights in Japanese treaty ports. These trea...

  14. How should we revise the paratactic theory?

    OpenAIRE

    Frankish, Keith

    1996-01-01

    This paper takes another look at Davidson's paratactic theory of indirect discourse and evaluates some revisions to it, proposed recently by Ian Rumfitt (Mind, 1993). Davidson's original version of the theory – according to which indirect speech reports refer to token utterances – has a problem dealing with ambiguity. Rumfitt suggests that we can solve this problem by supposing that the immediate objects of verbs in indirect speech are token representations of disambiguated LF tree-structures...

  15. Review of traffic conflicts technique studies. Third edition.

    NARCIS (Netherlands)

    Kraay, J.H.

    1983-01-01

    A review of literature concerning traffic conflicts technique studies is presented. The 204 references arranged, alphabetically by authors' names are given with abstracts. The procedure used in comping this survey is outlined. Third revised edition, with 103 new publications since 1979.

  16. A retrospective study on pulpal tissue prognosis of avulsed permanent teeth in children%儿童恒牙全脱出牙髓组织预后的回顾性研究

    Institute of Scientific and Technical Information of China (English)

    白洁; 秦满; 赵玉鸣

    2015-01-01

    Objective:To analyze the pulpal prognosis of replanted permanent teeth in children and to examine the associated factors .Methods:The samples consisted of 67 children with 81 avulsed perma-nent teeth treated in Peking University Hospital of Stomatology from 2000 to 2012 .Their clinical data of the replanted teeth were collected , and the follow-up period was no less than 12 months.The pulpal prognosis was classified as pulp necrosis and pulp non-necrosis .Results: The replantation within 30 minutes after avulsion led to the most significant increase in pulpal healing (P<0.05).The dental pulp of 80% ( 4/5 ) young permanent teeth replanted within 30 minutes remained vital , while all the teeth replanted after 30 minutes developed pulp necrosis within 60 days after replantation .Conclusion: The extra-alveolar period significantly affects the prognosis of pulp in immature permanent teeth after replanta-tion.When the extra-alveolar period is more than 30 minutes, the chance of pulp revascularization after replantation is very low , therefore pulp extirpation should be performed .%目的:观察儿童恒牙全脱出后再植牙的牙髓组织预后类型,牙髓坏死出现的时间,分析影响再植牙牙髓组织预后的因素。方法:对2000年至2012年在北京大学口腔医院就诊的儿童恒牙全脱出且观察期大于12个月的病例进行回顾性研究,观察再植牙的牙髓组织预后方式,牙髓坏死、钙变出现的时间,分析影响再植牙预后的相关因素,并进行统计学分析。结果:超过30 min再植的全脱出牙再植后60 d内全部发生了牙髓坏死,且出现牙髓坏死的时间明显早于30 min内再植的全脱出牙(P<0.05);30 min内再植的牙齿80%(4/5)牙髓存活,主要表现为牙髓钙变。结论:离体时间会影响再植牙的牙髓组织预后,超过30 min再植的牙齿牙髓几乎没有存活机会,临床上应考虑施行牙髓摘除术。

  17. Analysis of 23 cases of avulsion fractures of posterior cruciate ligament of knee joint treated by tension band wire fixation%张力带钢丝固定治疗膝关节后交叉韧带止点撕脱骨折23例分析

    Institute of Scientific and Technical Information of China (English)

    张朝凯; 吴莉; 丁晶; 刘庆波; 李迎辉; 吴明贵; 俞超

    2013-01-01

    目的 探讨张力带钢丝固定治疗膝关节后交叉韧带止点撕脱骨折的效果.方法 23例膝关节后交叉韧带止点撕脱骨折患者,采用张力带钢丝复位固定,并对关节腔进行修整;采用Lysholm膝关节评分法评价疗效.结果 23例患者随访6个月~2年,22例(95.7%)术后膝关节功能恢复良好,1例老年患者术前即有骨性关节炎,关节间隙狭窄,术后仍有慢性疼痛及曲伸功能障碍.结论 张力带钢丝固定治疗膝关节后交叉韧带止点撕脱骨折简单、经济、有效.%Objective To investigate the outcomes of avulsion fractures of posterior cruciate ligament of knee joint treated by tension band wire fixation. Methods Twenty-three patients with avulsion fractures of posterior cruciate ligament of knee joint were treated with tension band wire fixation, and the outcomes were evaluated by Lysholm knee joint scoring. Results All the patients were followed up for 6 months to 2 years. Favorable function recovery was achieved in 22 (95.7%) patients. The other senior patient suffered from osteoarthritis and narrow joint space before operation, and there still existed chronic pain and flexion-extension dysfunction after operation. Conclusion Treatment of avulsion fractures of posterior cruciate ligament of knee joint by tension band wire fixation is simple, economical and effective.

  18. Nuclear safety guide: TID--7016, Revision 2

    International Nuclear Information System (INIS)

    The Nuclear Safety Guide was first issued in 1956 as classified AEC report LA-2063 and was reprinted the next year, unclassified, as TID-7016. Revision 1, published in 1961, extended the scope and refined the guiding information. Revision 2 of the Guide differs significantly from its predecessor in that the latter was intentionally conservative in its recommendations. Firmly based on experimental evidence of criticality, the original Guide and the first revision were considered to be of most value to organizations whose activities with fissionable materials were not extensive and, secondarily, that it would serve as a point of departure for members of established nuclear safety teams experienced in the field. The advance of calculational capability has permitted validated calculations to extend and substitute for experimental data. The broadened data base has enabled better interpolation, extension, and understanding of available information, especially in areas previously addressed by undefined but adequate factors of safety. The content has been thereby enriched in qualitative guidance. The information inherently contains, and the user can recapture, the quantitative guidance characteristic of the former Guides by employing appropriate safety factors

  19. Subsequent Surgery after Revision Anterior Cruciate Ligament Reconstruction

    Science.gov (United States)

    Ding, David; Group, Mars

    2016-01-01

    tunnels before rACLR) were also significant predictors for need for reoperation within 2 years. Patients with grade IV cartilage damage seen during rACLR were 47% less likely to undergo subsequent operations within 2 years. Gender, BMI, smoking history, Marx activity score, technique for femoral tunnel placement and meniscal tear or meniscal treatment at the time of rACLR showed no significant effect on reoperation rate. Conclusion: There is a significant reoperation rate following rACLR at two years (10.1%). The most prevalent reoperations involved meniscal procedures. Independent risk factors for subsequent surgery on the ipsilateral knee include age<20 years old, a staged revision and use of allograft tissue at the time of rACLR.

  20. Some special treatment of skin avulsion for the elderly patients%老年患者中一些特殊皮肤撕脱伤的治疗体会

    Institute of Scientific and Technical Information of China (English)

    张志华; 王肃生; 梁刚; 冀航; 侯春

    2014-01-01

    目的:探讨老年患者中一些特殊皮肤撕脱伤的特点及治疗体会。方法回顾分析收治的22例特殊老年皮肤撕脱伤患者的诊治,撕脱皮肤均采用清创后原位缝合、加压包扎的治疗方法。结果21例患者中再植皮片全部或大部分成活,1例因感染导致皮片坏死,经清创后二次植皮愈合,经4个月至3年随访,回植皮肤弹性、感觉及活动度良好。结论因此类老年患者皮肤损伤存在撕脱层次浅、撕脱皮肤损伤不重的特点,采用清创后原位缝合、加压包扎的治疗可取得满意的效果。%Objective To investigate the characteristic and experience of special skin avulsion’s treatment with elderly patients. Methods According to 22 cases of special patients tearing for the diagnosis and treatment,avulsion skin are used after debridement suture in situ, pressurized bandaging treatment method. Results All the grafts or most survived,one cases caused a skin graft necrosis by infection, skin graft healing later. From 4 months to 3 years, feeling and activity are good after the replantation skin. Conclusion The features of elderly patients with shallow, less trauma, the clear suture and bandaging treatment can obtain satisfactory effect.

  1. Yakima Fisheries Project : Revised Draft Environmental Impact Statement.

    Energy Technology Data Exchange (ETDEWEB)

    United States. Bonneville Power Administration.

    1995-05-01

    BPA proposes to fund several fishery-related activities in the Yakima River Basin. The Yakima Fisheries Project (YFP), included in the Northwest Power Planning Council`s fish and wildlife program, would be jointly managed by the State of Washington and the Yakima Indian Nation. Fisheries resources in the Yakima River are severely reduced from historical levels and there is a significant potential for enhancement of these resources. BPA`s proposed action is to fund (1) information gathering on the implementation of supplementation techniques and on feasibility of reintroducing coho salmon in an environment where native populations have become extinct; (2) research activities based on continuous assessment, feedback and improvement of research design and activities ({open_quotes}adaptive management{close_quotes}); and (3) the construction, operation, and maintenance of facilities for supplementing populations of upper Yakima spring chinook salmon. The project has been considerably revised from the original proposal described in the first draft EIS. Examined in addition to No Action (which would leave present anadromous fisheries resources unchanged in the, Basin) are two alternatives for action: (1) supplementation of depressed natural populations of upper Yakima spring chinook and (2) that same supplementation plus a study to determine the feasibility of re-establishing (via stock imported from another basin) naturally spawning population and a significant fall fishery for coho in the Yakima Basin. Alternative 2 has been identified as the preferred action. Major issues examined in the Revised Draft EIS include potential impacts of the project on genetic and ecological resources of existing fish populations, on water quality and quantity, on threatened and endangered species listed under the Endangered Species Act, and on the recreational fishery.

  2. 3D打印技术辅助手术治疗骶骨骨折伴骶丛神经损伤%Surgical treatment of sacral fractures accompanied with lumbosacral plexus avulsion assisted by 3D printing

    Institute of Scientific and Technical Information of China (English)

    杨鹏; 叶添文; 张帆; 杨迪; 朱磊; 何翔; 陈爱民

    2015-01-01

    Objective To report the preliminary results of using 3D printing technology to assist surgical treatment of sacral fractures accompanied with lumbosacral plexus avulsion.Methods From May 2013 to August 2014,11 hospitalized patients with sacral fracture accompanied with lumbosacral plexus avulsion were enrolled in the present study.They were 6 males and 5 females,28 to 57 years of age (mean,42.3 years).Seven fractures were fresh and 4 obsolete.According to the Denis classification,3 fractures were type Ⅱ and 8 type Ⅲ.All the cases experienced a decrease or loss in skin sensation in the saddle area or in the area innervated by the sacral plexus at the lower extremity.Ten cases reported radiating pain and dysfunction of the lower extremity,and 5 had dysfunction of bladder sphincter,anal sphincter,or sexual performance.Their average Injury Severity Score was 21.5.All patients underwent 3D reconstruction of CT scans.Their fracture models were manufactured by 3D printing before operation.A bundle of wire 3 mm in diameter was used to stimulate the course of sacral plexus by which we evaluated the distribution and compression of the nerves.After surgical stimulation on the 3D printing models,operations were performed on the patients.Lumbo-sacral internal fixation,sacral plexus exploration and decompression were taken as the standard surgical pattern.The postoperative sensory and motor function was evaluated according to the criteria proposed by the British Medical Research Council.Results The mean surgical time was 3.2 hours and the mean intraoperative bleeding was 1 845 mL for the 11 patients.All the patients were followed up from 6 to 15 months (average,8.2 months).Their sacral fractures obtained stable fixation and bone healing after 13.5 weeks.Their recovery of motor function increased 2.5 levels and their sensory recovery increased 2.6 levels compared to the preoperation.Radiating pain at the lower limb was alleviated in 10 cases and disappeared in 3.Conclusion 3D

  3. The arthroscopic treatment for children with tibial intercondylar eminence avulsion fractures:a report of 24 cases%关节镜治疗儿童胫骨髁间棘撕脱骨折24例分析

    Institute of Scientific and Technical Information of China (English)

    吴星火; 段德宇; 何宇; 方为志; 苏正兵; 孟春庆; 王洪; 杨述华

    2013-01-01

    Objective To explore minimally invasive treatment for tibial intercondylar eminence avulsion fractures under arthroscopy.Methods From Jan 2009 to Dec 2010,24 patient with skeletal immaturity (16 boys and 8 girls,8~ 14 years old) underwent the arthroscopic reduction and PDS-Ⅱ suture fixation of the anterior cruciate ligament or the avulsion fracture.Having taken the advantage of ACL-aimer,the sutures were pulled out and tied outside the joint accurately.According to the standard of International Knee Documentation Committee (IKDC),the Lysholm knee scoring method was used to measure the knee function preoperatively and postoperatively.Results Twenty-four patients were followed up for 6 to 30 months.All patient gained normal range of motion,and the X ray examination demonstrated bone union in all the cases.At the end of the follow-up,all the patients got improved range of movement without complications such as joint stiffness,joint relaxation,epiphyseal injury or malformations dysfunction.The mean Lysholm knee scores were improved from 48.6 ± 7.2 preoperatively to 94.5 ± 4.1 at the end of the follow-up period (P<0.001)and the mean IKDC subjective evaluation scores were increased from 53.5 ± 4.8 preoperatively to 92.8 ± 3.7 at the end of the follow-up period (P<0.001).Conclusions The arthroscopical operation with absorbable suture fixation,which leads to less trauma,is a simple and effective alternative for patients with the avulsion fracture of tibial intercondylar eminence.%目的 探讨经关节镜下骨折块复位,辅助PDS-Ⅱ丝线内固定治疗儿童胫骨髁间棘撕脱骨折的临床效果.方法 选择我院自2009年1月至2010年12月间胫骨髁间棘撕脱骨折的患儿24例(男16例,女8例,年龄8~14岁),采用经关节镜下骨折块复位,以类似成人前交叉韧带重建方式,自胫骨结节内上方1 cm(骨骺上方)以胫骨定位器定位,以直径1~1.2 mm克氏针钻孔,然后以16号腰穿针导入2根不可吸收的PDS-

  4. Laparoscopy for ventriculoperitoneal shunt implantation and revision surgery

    Institute of Scientific and Technical Information of China (English)

    Fernando; Campos; Gomes; Pinto; Matheus; Fernandes; de; Oliveira

    2014-01-01

    Ventriculoperitoneal shunting(VPS) is a widely accepted technique for the treatment of hydrocephalus. The probability of shunt dysfunction is pretty high throughout life. Laparoscopy has become a valuable tool to perform VPS and treat abdominal complications. An electronic literature search was performed to reveal the published data relating laparoscopy and ventriculoperitoneal shunt in Medline, Embase, Scielo and Lilacs databases. The keywords employed were “laparoscopy” OR “laparoscopic surgery” AND “ventriculoperitoneal shunt” OR “shunt” AND “surgery” OR “implantation” OR “revision” OR “complication”. No high quality trials were developed comparing conventional laparotomic incision vs laparoscopic approach. Both approaches have evolved and currently there are less invasive options for laparotomy, like periumbilical small incisions; and for laparoscopy, like smaller and less incisions. Operating room time, blood loss and hospital stay may be potentially smaller in laparoscopic surgery and complications are probably the same as laparotomy. In revision surgery for abdominal complications after VPS,visualization of whole abdominal cavity is fundamental to address properly the problem and laparoscopic approach is valuable once it is safe, fast and much less invasive than laparotomy. Ventriculoperitoneal shunting is a widely accepted technique for the treatment of hydrocephalus. Laparoscopy assisted shunt surgery in selected cases might be a less invasive and more effective option for intrabdominal manipulation. The laparoscopic approach allows a better catheter positioning, lysis of fibrotic bundles and peritoneal inspection as well, without any additional complication.

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

    Science.gov (United States)

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

    2010-10-01

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

  6. A Single Counterexample Leads to Moral Belief Revision.

    Science.gov (United States)

    Horne, Zachary; Powell, Derek; Hummel, John

    2015-11-01

    What kind of evidence will lead people to revise their moral beliefs? Moral beliefs are often strongly held convictions, and existing research has shown that morality is rooted in emotion and socialization rather than deliberative reasoning. In addition, more general issues-such as confirmation bias-further impede coherent belief revision. Here, we explored a unique means for inducing belief revision. In two experiments, participants considered a moral dilemma in which an overwhelming majority of people judged that it was inappropriate to take action to maximize utility. Their judgments contradicted a utilitarian principle they otherwise strongly endorsed. Exposure to this scenario led participants to revise their belief in the utilitarian principle, and this revision persisted over several hours. This method provides a new avenue for inducing belief revision. PMID:25810137

  7. A Single Counterexample Leads to Moral Belief Revision.

    Science.gov (United States)

    Horne, Zachary; Powell, Derek; Hummel, John

    2015-11-01

    What kind of evidence will lead people to revise their moral beliefs? Moral beliefs are often strongly held convictions, and existing research has shown that morality is rooted in emotion and socialization rather than deliberative reasoning. In addition, more general issues-such as confirmation bias-further impede coherent belief revision. Here, we explored a unique means for inducing belief revision. In two experiments, participants considered a moral dilemma in which an overwhelming majority of people judged that it was inappropriate to take action to maximize utility. Their judgments contradicted a utilitarian principle they otherwise strongly endorsed. Exposure to this scenario led participants to revise their belief in the utilitarian principle, and this revision persisted over several hours. This method provides a new avenue for inducing belief revision.

  8. A Revised Piecewise Linear Recursive Convolution FDTD Method for Magnetized Plasmas

    Institute of Scientific and Technical Information of China (English)

    Liu Song; Zhong Shuangying; Liu Shaobin

    2005-01-01

    The piecewise linear recursive convolution (PLRC) finite-different time-domain (FDTD) method improves accuracy over the original recursive convolution (RC) FDTD approach and current density convolution (JEC) but retains their advantages in speed and efficiency. This paper describes a revised piecewise linear recursive convolution PLRC-FDTD formulation for magnetized plasma which incorporates both anisotropy and frequency dispersion at the same time,enabling the transient analysis of magnetized plasma media. The technique is illustrated by numerical simulations of the reflection and transmission coefficients through a magnetized plasma layer. The results show that the revised PLRC-FDTD method has improved the accuracy over the original RC FDTD method and JEC FDTD method.

  9. Bias-Driven Revision of Logical Domain Theories

    OpenAIRE

    Koppel, M.; Feldman, R; Segre, A. M.

    1994-01-01

    The theory revision problem is the problem of how best to go about revising a deficient domain theory using information contained in examples that expose inaccuracies. In this paper we present our approach to the theory revision problem for propositional domain theories. The approach described here, called PTR, uses probabilities associated with domain theory elements to numerically track the ``flow'' of proof through the theory. This allows us to measure the precise role of a clause or liter...

  10. Diced Cartilage Graft for Revision Rhinoplasty in a 64-year-old Cleft Patient: A Case Report.

    Science.gov (United States)

    Lin, Susie; Hsiao, Yen-Chang; Chang, Chun-Shin; Chen, Philip Kuo-Ting; Chen, Jyh-Ping

    2016-07-01

    Pure diced cartilage graft has been the technique of choice for revision rhinoplasty in cleft patients since 2003 at our center. This technique has several advantages over the traditional en bloc cartilage onlay graft including minimal risk of warping, its technical simplicity, and the ability to adjust the shape of the graft with manual massage for up to 3 weeks postoperatively. Calcification of the costal cartilage, however, poses a real concern for surgeons. In this case report, we are presenting a 64-year-old woman with a right unilateral complete cleft lip and palate deformity who presented to our clinic for secondary revision. Central-pattern rib calcification was encountered during the operation. Outcomes, details of the operation, and potential limitations of this technique are discussed in this case report. PMID:27536492

  11. Is Peer Review Training Effective in Iranian EFL Students’ Revision?

    Directory of Open Access Journals (Sweden)

    Hadiseh Esmaeeli

    2014-08-01

    Full Text Available This study aims to investigate the effect of peer review training on the Iranian EFL students’ subsequent revision in an advanced writing class in Larestan Islamic Azad University. After 12 weeks class demonstration, teacher-reviewer conferences with 20 male and female students, the students’ first drafts, revisions, and reviewers’ comments were collected and compared the comments before and after peer review training. The findings revealed that the students incorporated significantly more comments into subsequent revisions after peer review training. Therefore, peer review training had a positive effect on the students’ subsequent revisions.

  12. My revision notes AQA GCSE computer science computing fundamentals

    CERN Document Server

    Cushing, Steve

    2013-01-01

    Unlock your full potential with this revision guide which focuses on the key content and skills you need to know. With My Revision Notes for AQA GCSE Computer Science, which perfectly matches the latest examined elements of the course, you can:. - Take control of your revision: plan and focus on the areas you need to revise, with advice, summaries and notes from author Steve Cushing. - Show you fully understand key topics by using specific strategies and theories to add depth to your knowledge of programming and computing issues and processes. - Apply programming and computing terms accurately

  13. Revising Economics for the Next Generation

    OpenAIRE

    Gerardo P. Sicat

    2003-01-01

    The revision of Economics, a textbook in elementary economics, using the Philippines as the basis of the study material, will be available in academic year 2003-4. The paper begins with a review of the antecedents of the efforts at the University of the Philippines School of Economics to improve economic teaching materials in the country. The first part – elementary economics – builds on the concepts of the markets and on the law of supply and demand and illustrates the principles with actual...

  14. The thesaurus review, renaissance, and revision

    CERN Document Server

    Roe, Sandra K

    2013-01-01

    Use this single source to uncover the origin and development of the thesaurus! The Thesaurus: Review, Renaissance, and Revision examines the historical development of the thesaurus and the standards employed for thesaurus construction. This book provides both the history of thesauri and tutorials on usage to increase your understanding of thesaurus creation, use, and evaluation. This reference tool offers essential information on thesauri in the digital environment, including Web sites, databases, and software. For 50 years, the thesaurus has been a core reference book; The Thesaurus: Review,

  15. A Modest Revision of the Standard Model

    CERN Document Server

    Stephenson,, G J

    2015-01-01

    With a modest revision of the mass sector of the Standard Model, the systematics of the fermion masses and mixings can be fully described and interpreted as providing information on matrix elements of physics beyond the Standard Model. A by-product is a reduction of the largest Higgs Yukawa fine structure constant by an order of magnitude. The extension to leptons provides for insight on the difference between quark mixing and lepton mixing as evidenced in neutrino oscillations. The large difference between the scale for up-quark and down-quark masses is not addressed.

  16. Impending revision of the euratom treaty

    International Nuclear Information System (INIS)

    The decision by the European Court of Justice in the matter of the EEC's participation in international negotiations on safety problems of the nuclear fuel cycle is of basic importance, beyond the case to which it referred, in the interpretation of the respective provisions of the Euratom Treaty in the nuclear fuel sector. The reasoning of the European Court of Justice, which constitutes a reinforcement and advancement of the responsibilities and rights of the EEC, has made France ask for a revision of the Treaty. (orig.)

  17. 78 FR 37164 - Revisions to the Air Emissions Reporting Requirements: Revisions to Lead (Pb) Reporting Threshold...

    Science.gov (United States)

    2013-06-20

    ... INFORMATION CONTACT section. \\1\\ As prescribed by the Tribal Authority Rule (63 FR 7253, February 12, 1998... Lead (73 FR 66964, November 12, 2008) and the associated Revisions to Lead Ambient Air Monitoring Requirements (75 FR 81126), and because use of the previous AERR over the past few years has revealed...

  18. Revising in two languages: A multidimensional comparison of online writing revisions in L1 en FL

    NARCIS (Netherlands)

    M. Stevenson; R. Schoonen; K. de Glopper

    2006-01-01

    It has frequently been claimed that, in foreign language writing, attention to linguistic processes inhibits attention available for higher level conceptual processing [e.g., Chenoweth & Hayes, 2001; Whalen & Ménard, 1995]. This study examines this hypothesis for foreign language revision processes

  19. Actitud Hacia las Matematicas: Revision Bibliografica (Attitudes Toward Mathematics: Revised Bibliography). Publication No. 39.

    Science.gov (United States)

    Rodriguez Feijoo, Nelida

    Investigations about attitudes toward mathematics carried out in the past decade were revised. The instruments used to measure attitudes toward mathematics were analysed as well as the attitudes toward different aspects of mathematics, their relation with other school subjects and their stability through time. Opinions about the influence of…

  20. Incentive inspiration therapy: a review concerning volume and flow incentive spirometry techniques and Breath-Stacking

    OpenAIRE

    Claudiney de Lima Batista Marques; Ingrid de Castro Bolina Faria

    2009-01-01

    Objectives: To revise the literature concerning the differences between incentive spirometers (IS) and the technique of Breath-Stacking (BS), comparing volume and flow incentive spirometers devices between themselves and both with the Breath-Stacking. Method: After a search on PUBMED data basis with the terms “incentive spirometry” and “Breath Stacking”, we selected for this revision only the works that approached the differences between IS and the ones that compared those to the BS. Results:...

  1. DELPHI TECHNIQUE: ENHANCING RESEARCH IN TECHNICAL AND VOCATIONAL EDUCATION

    Directory of Open Access Journals (Sweden)

    Irdayanti Mat Nashir

    2015-12-01

    Full Text Available Empirical studies conducted within the Technical and Vocational Education (TVE discipline in Malaysia tends to give greater emphasis to quantitative data collection techniques. Aware of the potential usefulness of combination of techniques, this paper discusses the application of the Delphi technique where qualitative and quantitative data collection techniques are used to reach useful results. The Delphi technique provides the opportunity for researchers to gather input from participants without requiring them to work face-to-face. Often, the process is used to find consensus among experts who have differing views and perspectives. The Delphi technique enables group problem-solving using an iterative process of problem definition, discussion, feedback, and revisions.This paper discusses the basics of the Delphi techniques, its application potential, the selection of expert panels and the means on how consensus can be reached among the participants using examples from our past research using the technique.

  2. [Anterior cruciate ligament-plasty using the "U-dos" technique].

    Science.gov (United States)

    Morales-Trevizo, C; Paz-García, M; Leal-Berumen, I; Leal-Contreras, C; Berumen-Nafarrate, E

    2013-01-01

    The knee is a compound diarthrodial joint, vulnerable to serious injuries such as ligament injuries of: medial collateral ligament, lateral collateral ligament, anterior cruciate ligament and posterior cruciate ligament, as cruciate ligaments limit rotation movement in the joint. The purpose of our study was to create a new technique to treat injuries of the anterior cruciate ligament, which is composed of two bundles--anteromedial and posterolateral--trying to achieve an anatomical reconstruction that allows for a normal biomechanical recovery. This technique reduces the use of fixation material and costs. The diagnosis of anterior cruciate ligament injuries was made with the pivot shift test. There are currently two repair methods for anterior cruciate ligament injuries: single bundle or double bundle repair; none of these techniques is considered as the gold standard, as their results are very similar. This paper describes a technique used for the treatment of anterior cruciate ligament injuries, known as "U-dos", and its clinical results. Cross-sectional, observational study that enrolled 20 patients with total anterior cruciate ligament injuries who underwent anterior cruciate ligament plasty using the "U-dos" technique between June 2009 and June 2010. The technique requires the use of bone bank allograft, in this case of the anterior tibial ligament. Patients were assessed using the Lysholm scale and the pivot shift test. Our results show that all the pivot shift tests were negative and assessments according to the Lysholm scale were from normal to excellent in 95% of cases (19/20). Only one failure was reported, with avulsion of the graft attachment which required a surgical intervention.

  3. Arthroscopic Reduction and Internal Fixation of Avulsion Fracture of Anterior Cruciate Ligament from Tibial Eminence with Stainless Steel Wire%关节镜下钢丝固定治疗前交叉韧带胫骨止点撕脱骨折

    Institute of Scientific and Technical Information of China (English)

    卢华定; 史德海; 董云旭; 王昆; 曾春

    2011-01-01

    Objective To investigate the therapeutic efficacy of arthroscopic internal fixation of avulsion fracture of the anterior cruciate ligament (ACL) from the tibial eminence with stainless steel wire. Methods Thirteen cases of displaced avulsion fracture of the ACL from the tibial eminence were treated by arthroscopic reduction and internal fixation with stainless steel wire from January 2003 to June 2006.Adjustable brace was used for protection after surgery, and active rehabilitation training was conducted. The Lysholm scoring scale system was used to evaluate knee functions before and after surgery. Regular X-ray plain films at AP and lateral views were conducted to detect the bony healing of avulsed fragments postoperatively. Results Thirteen cases were followed up for 6 to 32 months and the average time was 14 months. No complications of intraarticular infection, iatrogenic injury, anchylosis, loss of knee extension, or nonunion of fracture were found. X-ray films revealed good bone union in all the 13 cases three months after surgery. No knee instability was detected, and knee flexion and extension function was normal in all patients. The Lysholm scores were improved from 39.4±9.98 preoperatively to 95.2±2.94 postoperatively, with significant statistical difference by the student-t test (t = 24.001,P <0.01). Conclusion Arthroscopic reduction and internal fixation with stainless steel wire in the treatment of avulsion fracture of the anterior crnciate ligament from the tibial eminence has advantages of simplicity, broad indications,minimal invasion, and rapid postoperative recovery. It is believed as an ideal choice for such avulsion fracture of the anterior cruciate ligament from the tibial eminence.%目的 探讨关节镜下钢丝内固定治疗前交叉韧带(ACL)胫骨止点撕脱骨折的临床疗效.方法 自2003年1月~2009年6月采用关节镜下复位钢丝内固定治疗13例移位的ACL胫骨止点撕脱骨折,术后可调式支具保护,积

  4. Three Principles to REVISE People's Unethical Behavior.

    Science.gov (United States)

    Ayal, Shahar; Gino, Francesca; Barkan, Rachel; Ariely, Dan

    2015-11-01

    Dishonesty and unethical behavior are widespread in the public and private sectors and cause immense annual losses. For instance, estimates of U.S. annual losses indicate $1 trillion paid in bribes, $270 billion lost due to unreported income, and $42 billion lost in retail due to shoplifting and employee theft. In this article, we draw on insights from the growing fields of moral psychology and behavioral ethics to present a three-principle framework we call REVISE. This framework classifies forces that affect dishonesty into three main categories and then redirects those forces to encourage moral behavior. The first principle, reminding, emphasizes the effectiveness of subtle cues that increase the salience of morality and decrease people's ability to justify dishonesty. The second principle, visibility, aims to restrict anonymity, prompt peer monitoring, and elicit responsible norms. The third principle, self-engagement, increases people's motivation to maintain a positive self-perception as a moral person and helps bridge the gap between moral values and actual behavior. The REVISE framework can guide the design of policy interventions to defeat dishonesty.

  5. A Way to Revised Quantum Electrodynamics

    Directory of Open Access Journals (Sweden)

    Lehnert B.

    2012-04-01

    Full Text Available In conventional theoretical physics and its Standard Model the guiding principle is that the equations are symmetrical. This limitation leads to a number of difficulties, because it does not permit masses for leptons and quarks, the electron tends to “explode” un- der the action of its self-charge, a corresponding photon model has no spin, and such a model cannot account for the “needle radiation” proposed by Einstein and observed in the photoelectric e ff ect and in two-slit experiments. This paper summarizes a revised Lorentz and gauge invariant quantum electrodynamic theory based on a nonzero electric field divergence in the vacuum and characterized by linear intrinsic broken symmetry. It thus provides an alternative to the Higgs concept of nonlinear spontaneous broken sym- metry, for solving the difficulties of the Standard Model. New results are obtained, such as nonzero and finite lepton rest masses, a point-charge-like behavior of the electron due to a revised renormalization procedure, a magnetic volume force which counteracts the electrostatic eigen-force of the electron, a nonzero spin of the photon and of light beams, needle radiation, and an improved understanding of the photoelectric effect, two-slit ex- periments, electron-positron pair formation, and cork-screw-shaped light beams.

  6. Three Principles to REVISE People's Unethical Behavior.

    Science.gov (United States)

    Ayal, Shahar; Gino, Francesca; Barkan, Rachel; Ariely, Dan

    2015-11-01

    Dishonesty and unethical behavior are widespread in the public and private sectors and cause immense annual losses. For instance, estimates of U.S. annual losses indicate $1 trillion paid in bribes, $270 billion lost due to unreported income, and $42 billion lost in retail due to shoplifting and employee theft. In this article, we draw on insights from the growing fields of moral psychology and behavioral ethics to present a three-principle framework we call REVISE. This framework classifies forces that affect dishonesty into three main categories and then redirects those forces to encourage moral behavior. The first principle, reminding, emphasizes the effectiveness of subtle cues that increase the salience of morality and decrease people's ability to justify dishonesty. The second principle, visibility, aims to restrict anonymity, prompt peer monitoring, and elicit responsible norms. The third principle, self-engagement, increases people's motivation to maintain a positive self-perception as a moral person and helps bridge the gap between moral values and actual behavior. The REVISE framework can guide the design of policy interventions to defeat dishonesty. PMID:26581728

  7. Curriculum revision: product innovation for quality outcomes.

    Science.gov (United States)

    Thomas, Georgianna; Carroll, V Susan

    2006-01-01

    The education of any professional discipline rests on a curricular foundation that reflects the discipline's theory and knowledge bases, practice patterns, and unique skills. In addition, professional health care education must respond to and reflect changes in technology, societal definitions of health and wellness, and broad social issues such as access to care, health care funding, and changing patient demographics. These issues are interwoven with efforts to also provide high-quality education with positive learning outcomes. In this article, the authors describe a school of nursing's efforts to revise its curriculum to reflect a professional shift in focus to community-based nursing practice and the goals of the federal health goals outlined in Healthy People 2010. The revision also served as the starting point for a change in the process through which the college will seek accreditation in the future; this process-Academic Quality Improvement Program-requires institutions of higher learning to use a continuous quality model as its base.

  8. The JFK Coma Recovery Scale--Revised.

    Science.gov (United States)

    Kalmar, Kathleen; Giacino, Joseph T

    2005-01-01

    The JFK Coma Recovery Scale (CRS) was developed to help characterise and monitor patients functioning at Rancho Levels I-IV and has been used widely in both clinical and research settings within the US and Europe. The CRS was recently revised to address a number of concerns emanating from our own clinical experience with the scale, feedback from users and researchers as well as the results of Rasch analyses. Additionally, the CRS did not include all of the behavioural criteria necessary to diagnose the minimally conscious state (MCS), thereby limiting diagnostic utility. The revised JFK Coma Recovery Scale (CRS-R) includes addition of new items, merging of items found to be statistically similar, deletion or modification of items showing poor fit with the scale's underlying construct, renaming of items, more stringent scoring criteria, and quantification of elicited behaviours to improve accuracy of rating. Psychometric properties of the CRS-R appear to meet standards for measurement and evaluation tools for use in clinical and research settings, and diagnostic application suggests that the scale is capable of discriminating patients in the minimally conscious state from those in the vegetative state.

  9. Revisions to the staging and classification of mycosis fungoides and Sezary syndrome: a proposal of the International Society for Cutaneous Lymphomas (ISCL) and the cutaneous lymphoma task force of the European Organization of Research and Treatment of Cancer (EORTC).

    Science.gov (United States)

    Olsen, Elise; Vonderheid, Eric; Pimpinelli, Nicola; Willemze, Rein; Kim, Youn; Knobler, Robert; Zackheim, Herschel; Duvic, Madeleine; Estrach, Teresa; Lamberg, Stanford; Wood, Gary; Dummer, Reinhard; Ranki, Annamari; Burg, Gunter; Heald, Peter; Pittelkow, Mark; Bernengo, Maria-Grazia; Sterry, Wolfram; Laroche, Liliane; Trautinger, Franz; Whittaker, Sean

    2007-09-15

    The ISCL/EORTC recommends revisions to the Mycosis Fungoides Cooperative Group classification and staging system for cutaneous T-cell lymphoma (CTCL). These revisions are made to incorporate advances related to tumor cell biology and diagnostic techniques as pertains to mycosis fungoides (MF) and Sézary syndrome (SS) since the 1979 publication of the original guidelines, to clarify certain variables that currently impede effective interinstitution and interinvestigator communication and/or the development of standardized clinical trials in MF and SS, and to provide a platform for tracking other variables of potential prognostic significance. Moreover, given the difference in prognosis and clinical characteristics of the non-MF/non-SS subtypes of cutaneous lymphoma, this revision pertains specifically to MF and SS. The evidence supporting the revisions is discussed as well as recommendations for evaluation and staging procedures based on these revisions.

  10. Incisor reduction: a provisional aesthetic technique for traumatised teeth.

    LENUS (Irish Health Repository)

    Darby, L J

    2010-12-11

    Patients in the mixed dentition who have suffered severe extrusion or avulsion injuries often present with difficult treatment decisions, especially when the initial emergency care has been compromised. Here we describe a well-tolerated, aesthetically acceptable and conservative method for treating such patients until a definitive treatment plan is possible.

  11. Inferential revision in narrative texts: An ERP study.

    Science.gov (United States)

    Pérez, Ana; Cain, Kate; Castellanos, María C; Bajo, Teresa

    2015-11-01

    We evaluated the process of inferential revision during text comprehension in adults. Participants with high or low working memory read short texts, in which the introduction supported two plausible concepts (e.g., 'guitar/violin'), although one was more probable ('guitar'). There were three possible continuations: a neutral sentence, which did not refer back to either concept; a no-revise sentence, which referred to a general property consistent with either concept (e.g., '…beautiful curved body'); and a revise sentence, which referred to a property that was consistent with only the less likely concept (e.g., '…matching bow'). Readers took longer to read the sentence in the revise condition, indicating that they were able to evaluate their comprehension and detect a mismatch. In a final sentence, a target noun referred to the alternative concept supported in the revise condition (e.g., 'violin'). ERPs indicated that both working memory groups were able to evaluate their comprehension of the text (P3a), but only high working memory readers were able to revise their initial incorrect interpretation (P3b) and integrate the new information (N400) when reading the revise sentence. Low working memory readers had difficulties inhibiting the no-longer-relevant interpretation and thus failed to revise their situation model, and they experienced problems integrating semantically related information into an accurate memory representation.

  12. Belief Revision and Verisimilitude Based on Preference and Truth Orderings

    NARCIS (Netherlands)

    Renardel de Lavalette, Gerard R.; Zwart, Sjoerd D.

    2011-01-01

    In this rather technical paper we establish a useful combination of belief revision and verisimilitude according to which better theories provide better predictions, and revising with more verisimilar data results in theories that are closer to the truth. Moreover, this paper presents two alternativ

  13. 76 FR 62002 - Revisions to the California State Implementation Plan

    Science.gov (United States)

    2011-10-06

    ... by limiting the VOCs of commercial coatings and solvents. SJVUAPCD Rule 4612 is revised to implement... Measure (SCM) titled, ``Suggested Control Measure for Automotive Coatings.'' SJVUAPCD Rule 4653 is revised... of Reasonably Available Control Technology and Best Available Retrofit Control Technology...

  14. 78 FR 3083 - Revised Pricing for Five 2013 Products

    Science.gov (United States)

    2013-01-15

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE TREASURY United States Mint Revised Pricing for Five 2013 Products AGENCY: United States Mint, Department of the Treasury. ACTION: Notice. SUMMARY: The United States Mint is announcing revised pricing for five...

  15. Using a Local Area Network to Teach Computer Revision Skills.

    Science.gov (United States)

    Thompson, Diane P.

    1989-01-01

    Describes the use of a local area network and video switching equipment in teaching revision skills on computer. Explains that reading stories from texts, rewriting them from differing character viewpoints, and editing them as a group exposed students to a variety of writing problems and stimulated various revision strategies. (SG)

  16. Modeling data revisions : Measurement error and dynamics of "true" values

    NARCIS (Netherlands)

    Jacobs, Jan P. A. M.; van Norden, Simon

    2011-01-01

    Policy makers must base their decisions on preliminary and partially revised data of varying reliability. Realistic modeling of data revisions is required to guide decision makers in their assessment of current and future conditions. This paper provides a new framework with which to model data revis

  17. 40 CFR 97.24 - NOX Budget permit revisions.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false NOX Budget permit revisions. 97.24... (CONTINUED) FEDERAL NOX BUDGET TRADING PROGRAM AND CAIR NOX AND SO2 TRADING PROGRAMS Permits § 97.24 NOX Budget permit revisions. (a) For a NOX Budget source with a title V operating permit, except as...

  18. 40 CFR 96.25 - NOX Budget permit revisions.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false NOX Budget permit revisions. 96.25... (CONTINUED) NOX BUDGET TRADING PROGRAM AND CAIR NOX AND SO2 TRADING PROGRAMS FOR STATE IMPLEMENTATION PLANS Permits § 96.25 NOX Budget permit revisions. (a) For a NOX Budget source with a title V operating...

  19. 75 FR 62459 - Revision of Class E Airspace; Unalakleet, AK

    Science.gov (United States)

    2010-10-12

    ... for air traffic management of Instrument Flight Rules (IFR) operations. DATES: Effective 0901 UTC... Federal Register to revise Class E airspace at Unalakleet, AK (75 FR 32865). Interested parties were... amendments to existing SIAPs require that the orientation and dimensions of Class E airspace be revised...

  20. Revised SWAT. The integrated burnup calculation code system

    Energy Technology Data Exchange (ETDEWEB)

    Suyama, Kenya; Mochizuki, Hiroki [Department of Fuel Cycle Safety Research, Nuclear Safety Research Center, Tokai Research Establishment, Japan Atomic Energy Research Institute, Tokai, Ibaraki (Japan); Kiyosumi, Takehide [The Japan Research Institute, Ltd., Tokyo (Japan)

    2000-07-01

    SWAT is an integrated burnup code system developed for analysis of post irradiation examination, transmutation of radioactive waste, and burnup credit problem. This report shows an outline and a user's manual of revised SWAT. This revised SWAT includes expansion of functions, increasing supported machines, and correction of several bugs reported from users of previous SWAT. (author)

  1. Proposal for revision of ISO 4377: Flat-V weirs

    NARCIS (Netherlands)

    Kalkwijk, J.P.T.; Lianxiang, W.

    1983-01-01

    In ISO/TC 113/SC 2/308 it was suggested that ISO 4377 could be significantly simplified as far as the calculation of discharge was involved. The proposal for revision is based upon this suggestion. The revision is fully based upon the material given in ISO 4377. In that respect no changes have been

  2. 40 CFR 93.151 - State implementation plan (SIP) revision.

    Science.gov (United States)

    2010-07-01

    ... SIP revision allowed under 40 CFR 51.851. When EPA approves a State's or Tribe's conformity provisions... 40 Protection of Environment 20 2010-07-01 2010-07-01 false State implementation plan (SIP... implementation plan (SIP) revision. The Federal conformity rules under this subpart, in addition to any...

  3. 77 FR 4880 - Revision of Form FHWA-1273

    Science.gov (United States)

    2012-01-31

    ... Federal Highway Administration Revision of Form FHWA-1273 AGENCY: Federal Highway Administration (FHWA... revision of form FHWA-1273--``Required Contract Provisions Federal-Aid Construction Contracts.'' This form... after submitting comments electronically. Anyone is able to search the electronic form of all...

  4. 77 FR 59739 - Revision to Form No. 6

    Science.gov (United States)

    2012-10-01

    ... throughput that combines interstate and intrastate data.\\11\\ \\8\\ Revision to Form No. 6, 76 FR 46668 (Aug. 3...\\ Regulations Implementing the National Environmental Policy Act, Order No. 486, 486 FR 1750 (Jan. 22, 1988... Energy Regulatory Commission 18 CFR Part 357 Revision to Form No. 6 AGENCY: Federal Energy...

  5. Inferential revision in narrative texts: An ERP study.

    Science.gov (United States)

    Pérez, Ana; Cain, Kate; Castellanos, María C; Bajo, Teresa

    2015-11-01

    We evaluated the process of inferential revision during text comprehension in adults. Participants with high or low working memory read short texts, in which the introduction supported two plausible concepts (e.g., 'guitar/violin'), although one was more probable ('guitar'). There were three possible continuations: a neutral sentence, which did not refer back to either concept; a no-revise sentence, which referred to a general property consistent with either concept (e.g., '…beautiful curved body'); and a revise sentence, which referred to a property that was consistent with only the less likely concept (e.g., '…matching bow'). Readers took longer to read the sentence in the revise condition, indicating that they were able to evaluate their comprehension and detect a mismatch. In a final sentence, a target noun referred to the alternative concept supported in the revise condition (e.g., 'violin'). ERPs indicated that both working memory groups were able to evaluate their comprehension of the text (P3a), but only high working memory readers were able to revise their initial incorrect interpretation (P3b) and integrate the new information (N400) when reading the revise sentence. Low working memory readers had difficulties inhibiting the no-longer-relevant interpretation and thus failed to revise their situation model, and they experienced problems integrating semantically related information into an accurate memory representation. PMID:26047776

  6. 76 FR 2611 - Olympic Coast National Marine Sanctuary Regulations Revisions

    Science.gov (United States)

    2011-01-14

    ... other matter from a cruise ship except clean vessel engine cooling water, clean vessel generator cooling... Sanctuary Regulations Revisions AGENCY: Office of National Marine Sanctuaries (ONMS), National Ocean Service... sanctuary's terms of designation (59 FR 24586, May 11, 1994). This proposed rule revises the...

  7. The Use of Genre-Specific Evaluation Criteria for Revision

    Science.gov (United States)

    Philippakos, Zoi A.; MacArthur, Charles A.

    2016-01-01

    Revision is a challenging step of the writing process and students often focus their attention to mechanics or grammar instead of making organizational and meaning changes. It is important for students to critically read and independently evaluate their work when revising. This practitioner article discusses the importance of genre-specific…

  8. 75 FR 57956 - Draft Revision of the Federalwide Assurance

    Science.gov (United States)

    2010-09-23

    ... HUMAN SERVICES Draft Revision of the Federalwide Assurance AGENCY: Department of Health and Human... Assistant Secretary for Health, is announcing the availability of the draft revised Federalwide Assurance (FWA) form and Terms of Assurance, and is seeking comment on these draft documents. OHRP is...

  9. China Revises Its Oil Resources Rules for Foreign Cooperation

    Institute of Scientific and Technical Information of China (English)

    Sun Xiujuan

    2001-01-01

    @@ The State Council has recently revised two regulations concerning recovery of oil and gas resources to relax the restrictions on foreign companies.The revised regulations are "The Rules of the People's Republic of China for Cooperative Recovery of Onshore Petroleum Resources" and "The Rules of the People's Republic of China for Cooperative Recovery of Offshore Petroleum Resources".

  10. Setting Writing Revision Goals after Assessment for Learning

    Science.gov (United States)

    Huang, Shu-Chen

    2015-01-01

    This study examined the effects of goal setting for revision in an EFL writing classroom where principles of assessment "for" learning (AfL) were followed. Following draft writing, instruction, and assessment, college freshmen were put into control, goal, and goal+ groups. Before students started to revise their drafts, individuals in…

  11. Merlin C. Wittrock and the Revision of Bloom's Taxonomy

    Science.gov (United States)

    Krathwohl, David R.; Anderson, Lorin W.

    2010-01-01

    Merl Wittrock, a cognitive psychologist who had proposed a generative model of learning, was an essential member of the group that over a period of 5 years revised the "Taxonomy of Educational Objectives," originally published in 1956. This article describes the development of that 2001 revision (Anderson and Krathwohl, Editors) and Merl's…

  12. Belief Revision in the GOAL Agent Programming Language

    DEFF Research Database (Denmark)

    Spurkeland, Johannes Svante; Jensen, Andreas Schmidt; Villadsen, Jørgen

    2013-01-01

    Agents in a multiagent system may in many cases find themselves in situations where inconsistencies arise. In order to properly deal with these, a good belief revision procedure is required. This paper illustrates the usefulness of such a procedure: a certain belief revision algorithm is consider...

  13. Revisions of endoprosthetic reconstructions after limb salvage in musculoskeletal oncology

    NARCIS (Netherlands)

    Renard, AJS; Veth, RPH; Schreuder, HWB; van Horn, J; Keller, A; Schraffordt Koops, H.

    1998-01-01

    Of 91 limb-salvage procedures using prosthetic reconstructions because of primary or metastatic bone and soft-tissue tumors 26 revisions were performed in 16 patients. Revision was due to polyethylene wear (9 cases), aseptic loosening (8 cases), recurrent hip dislocation (3 cases), prosthetic stem f

  14. The New & Revised Consumer Price Indexes. ERS Information Aid.

    Science.gov (United States)

    Kowalski, Joan P. Sullivan; Porwoll, Paul J.

    The purpose of this Information Aid is to alert school officials to changes and revisions in the Consumer Price Index (CPI), to familiarize them with differences between the former CPI and the new and revised indexes, to demonstrate how the U.S. Bureau of Labor Statistics (BLS) computes changes in the CPI, to indicate appropriate uses of the CPI,…

  15. Blog-Based Peer Response for L2 Writing Revision

    Science.gov (United States)

    Pham, Vu Phi Ho; Usaha, Siriluck

    2016-01-01

    Few studies have been conducted to see how blog-based peer response helps students to improve their writing revisions. The present study investigates peer comments made through blogs, the nature of the comments and their areas of focus, and the ratios of students incorporating suggestions made through blog-based comments into revisions of their…

  16. The reliability of the Structured Interview for Schizotypy-Revised

    NARCIS (Netherlands)

    Vollema, MG; Ormel, J

    2000-01-01

    We investigated the reliability of the Structured Interview for Schizotypy-Revised (SIS-R). The original interview (SIS) was developed by Kendler, We revised the SIS, primarily by standardizing the rating procedures. Operational definitions and explicit criteria for rating were given. We introduced

  17. The association between metal allergy, total knee arthroplasty, and revision

    DEFF Research Database (Denmark)

    Münch, Henrik J; Jacobsen, Stig; Olesen, Jens T;

    2015-01-01

    database from the greater Copenhagen area (n = 27,020). RESULTS: 327 patients were registered in both databases. The prevalence of contact allergy to nickel, chromium, and cobalt was comparable in patients with and without revision surgery. However, in patients with 2 or more episodes of revision surgery......, the prevalence of cobalt and chromium allergy was markedly higher. Metal allergy that was diagnosed before implant surgery appeared not to increase the risk of implant failure and revision surgery. INTERPRETATION: While we could not confirm that a positive patch test reaction to common metals is associated...... with complications and revision surgery after knee arthroplasty, metal allergy may be a contributor to the multifactorial pathogenesis of implant failure in some cases. In cases with multiple revisions, cobalt and chromium allergies appear to be more frequent....

  18. Fostering revision of argumentative writing through structured peer assessment.

    Science.gov (United States)

    Tsai, Ya-Chin; Chuang, Min-Tun

    2013-02-01

    This quasi-experimental study investigated the effect of structured peer assessment on revision of an argumentative writing. Two intact classes (N = 22, 26) were randomly assigned to be the trained and control groups. The latter received no facilitative resources, while the former participated in structured peer assessment based on Calibrated Peer Review, a web-based program purposefully designed for students to receive peer-assessment training, assess their peers' writing, and make written commentary online. At the end of the treatment, both groups revised their writing. The trained group revised their writing more extensively, outperforming the control group on frequency and type of revision, as well as the holistic quality of argumentative writing. After structured peer assessment, participants of the trained group became critical of their own work and invested more effort in spontaneous revision to produce higher-quality argumentative writing. PMID:23829147

  19. Transuranic waste characterization sampling and analysis methods manual. Revision 1

    International Nuclear Information System (INIS)

    This Methods Manual provides a unified source of information on the sampling and analytical techniques that enable Department of Energy (DOE) facilities to comply with the requirements established in the current revision of the Transuranic Waste Characterization Quality Assurance Program Plan (QAPP) for the Waste Isolation Pilot Plant (WIPP) Transuranic (TRU) Waste Characterization Program (the Program) and the WIPP Waste Analysis Plan. This Methods Manual includes all of the testing, sampling, and analytical methodologies accepted by DOE for use in implementing the Program requirements specified in the QAPP and the WIPP Waste Analysis Plan. The procedures in this Methods Manual are comprehensive and detailed and are designed to provide the necessary guidance for the preparation of site-specific procedures. With some analytical methods, such as Gas Chromatography/Mass Spectrometry, the Methods Manual procedures may be used directly. With other methods, such as nondestructive characterization, the Methods Manual provides guidance rather than a step-by-step procedure. Sites must meet all of the specified quality control requirements of the applicable procedure. Each DOE site must document the details of the procedures it will use and demonstrate the efficacy of such procedures to the Manager, National TRU Program Waste Characterization, during Waste Characterization and Certification audits

  20. Transuranic waste characterization sampling and analysis methods manual. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    Suermann, J.F.

    1996-04-01

    This Methods Manual provides a unified source of information on the sampling and analytical techniques that enable Department of Energy (DOE) facilities to comply with the requirements established in the current revision of the Transuranic Waste Characterization Quality Assurance Program Plan (QAPP) for the Waste Isolation Pilot Plant (WIPP) Transuranic (TRU) Waste Characterization Program (the Program) and the WIPP Waste Analysis Plan. This Methods Manual includes all of the testing, sampling, and analytical methodologies accepted by DOE for use in implementing the Program requirements specified in the QAPP and the WIPP Waste Analysis Plan. The procedures in this Methods Manual are comprehensive and detailed and are designed to provide the necessary guidance for the preparation of site-specific procedures. With some analytical methods, such as Gas Chromatography/Mass Spectrometry, the Methods Manual procedures may be used directly. With other methods, such as nondestructive characterization, the Methods Manual provides guidance rather than a step-by-step procedure. Sites must meet all of the specified quality control requirements of the applicable procedure. Each DOE site must document the details of the procedures it will use and demonstrate the efficacy of such procedures to the Manager, National TRU Program Waste Characterization, during Waste Characterization and Certification audits.

  1. Yakima fisheries project. Revised draft environmental impact statement

    International Nuclear Information System (INIS)

    BPA proposes to fund several fishery-related activities in the Yakima River Basin. These activities, known as the Yakima Fisheries Project (YFP), would be jointly managed by the State of Washington and the Yakima Indian Nation. The YFP is included in the Northwest Power Planning Council's (Council's) fish and wildlife program. The Council selected the Yakima River system for attention because fisheries resources are severely reduced from historical levels and because there is a significant potential for enhancement of these resources. BPA's proposed action is to fund (1) information gathering on the implementation of supplementation techniques and on feasibility of reintroducing coho salmon in an environment where native populations have become extinct; (2) research activities based on continuous assessment, feedback and improvement of research design and activities (adaptive management); and (3) the construction, operation, and maintenance of facilities for supplementing populations of upper Yakima spring chinook salmon. Major issues examined in the Revised Draft EIS include potential impacts of the project on genetic and ecological resources of existing fish populations, on water quality and quantity, on threatened and endangered species listed under the Endangered Species Act, and on the recreational fishery. Only minor differences in environmental consequences were found between Alternatives 1 and 2. Potentially high impacts on wild, native, and non-target fish populations under both alternatives would be mitigated through careful adherence to the adaptive management process outlined in the EIS

  2. Calibration of ophthalmic applicators at NIST: A revised approach

    International Nuclear Information System (INIS)

    A revised approach to the problem of measuring a surface-absorbed dose from beta-particle-emitting ophthalmic applicators is presented. The technique chosen employs an extrapolation chamber equipped with a 4-mm-diam collecting electrode to make current measurements at air gaps from 0.08 to 0.20 mm at 0.02-mm intervals. These data yield a linear relationship between current and air gap, the slope of which is used to determine average surface-absorbed-dose rate over the central area of the source. For additional information about the distribution of the activity over the source surface, autoradiographs using calibrated radiochromic dye films are analyzed to map the dose-rate profile across the surface of the applicator. Experiments varying several parameters of the extrapolation chamber measurement, including collecting electrode area, voltage gradient, range of air gaps used, and entrance foil material, are described. Also treated are calibrations of, and a description of the use of, radiochromic dye films for source profiling. Experiments for determining correction factors for the extrapolation chamber measurements are described, and an assessment of the uncertainties associated with these measurements is given

  3. 20 CFR 404.992 - Notice of revised determination or decision.

    Science.gov (United States)

    2010-04-01

    ... revision and of your right to request that a disability hearing be held before a revised reconsidered... AND DISABILITY INSURANCE (1950- ) Determinations, Administrative Review Process, and Reopening...

  4. The practices of competing discourses revised

    DEFF Research Database (Denmark)

    Nielsen, Charlotte Marie Bisgaard

    and studied in everyday interaction in the context of health communication? I will discuss 1) the order of competing discourses with examples drawn from a modern practice study at the nursing home which specialize in persons with aquired brain damage. Since some of the participants have severe brain damage I......The practices of competing discourses revised Contrasting perceptions of practices have been observed at a nursing home and research center, these produce discrepancies and problematic interaction patterns in for instance therapeutical situations. How may traits of contrasting practices be observed...... how ’sense-making’ may be approached as real persons experienced understandings’. Getting closer to the people communicating and their experienced understandings seem crucial when working with organizational intervention. May a new analytical perspective help distinguish the experienced communication...

  5. Waste Management Program management plan. Revision 1

    International Nuclear Information System (INIS)

    As the prime contractor to the Department of Energy Idaho Operations Office (DOE-ID), Lockheed Martin Idaho Technologies Company (LMITCO) provides comprehensive waste management services to all contractors at the Idaho National Engineering and Environmental Laboratory (INEEL) through the Waste Management (WM) Program. This Program Management Plan (PMP) provides an overview of the Waste Management Program objectives, organization and management practices, and scope of work. This document will be reviewed at least annually and updated as needed to address revisions to the Waste Management's objectives, organization and management practices, and scope of work. Waste Management Program is managed by LMITCO Waste Operations Directorate. The Waste Management Program manages transuranic, low-level, mixed low-level, hazardous, special-case, and industrial wastes generated at or transported to the INEEL

  6. Local public document room directory. Revision 7

    International Nuclear Information System (INIS)

    This directory (NUREG/BR-0088, Revision 7) lists local public document rooms (LPDRs) for commercial nuclear power plants with operating or possession-only licenses or under construction, plus the LPDRs for potential high-level radioactive waste repository sites, gaseous diffusion plants, certain fuel cycle facilities, certain low-level waste disposal facilities, and any temporary LPDRs established for the duration of licensing proceedings. In some instances, the LPDR libraries maintain document collections for more than one licensed facility. The library staff members listed are the persons most familiar with the LPDR collections. Reference librarians in the NRC Headquarters Public Document Room (PDR) are also available to assist the public in locating NRC documents

  7. A Review of Criticality Accidents 2000 Revision

    International Nuclear Information System (INIS)

    Criticality accidents and the characteristics of prompt power excursions are discussed. Sixty accidental power excursions are reviewed. Sufficient detail is provided to enable the reader to understand the physical situation, the chemistry and material flow, and when available the administrative setting leading up to the time of the accident. Information on the power history, energy release, consequences, and causes are also included when available. For those accidents that occurred in process plants, two new sections have been included in this revision. The first is an analysis and summary of the physical and neutronic features of the chain reacting systems. The second is a compilation of observations and lessons learned. Excursions associated with large power reactors are not included in this report

  8. Local public document room directory. Revision 7

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-04-01

    This directory (NUREG/BR-0088, Revision 7) lists local public document rooms (LPDRs) for commercial nuclear power plants with operating or possession-only licenses or under construction, plus the LPDRs for potential high-level radioactive waste repository sites, gaseous diffusion plants, certain fuel cycle facilities, certain low-level waste disposal facilities, and any temporary LPDRs established for the duration of licensing proceedings. In some instances, the LPDR libraries maintain document collections for more than one licensed facility. The library staff members listed are the persons most familiar with the LPDR collections. Reference librarians in the NRC Headquarters Public Document Room (PDR) are also available to assist the public in locating NRC documents.

  9. A Revised Collection of Sunspot Group Numbers

    CERN Document Server

    Vaquero, J M; Carrasco, V M S; Clette, F; Lefèvre, L; Gallego, M C; Arlt, R; Aparicio, A J P; Richard, J -G; Howe, R

    2016-01-01

    We describe a revised collection of the number of sunspot groups from 1610 to the present. This new collection is based on the work of Hoyt and Schatten (Solar Phys. 179, 189, 1998). The main changes are the elimination of a considerable number of observations during the Maunder Minimum (hereafter, MM) and the inclusion of several long series of observations. Numerous minor changes are also described. Moreover, we have calculated the active-day percentage during the MM from this new collection as a reliable index of the solar activity. Thus, the level of solar activity obtained in this work is greater than the level obtained using the original Hoyt and Schatten data, although it remains compatible with a grand minimum of solar activity. The new collection is available in digital format.

  10. A revision of the Generalized Uncertainty Principle

    CERN Document Server

    Bambi, Cosimo

    2008-01-01

    The Generalized Uncertainty Principle arises from the Heisenberg Uncertainty Principle when gravity is taken into account, so the leading order correction to the standard formula is expected to be proportional to the gravitational constant $G_N = L_{Pl}^2$. On the other hand, the emerging picture suggests a set of departures from the standard theory which demand a revision of all the arguments used to deduce heuristically the new rule. In particular, one can now argue that the leading order correction to the Heisenberg Uncertainty Principle is proportional to the first power of the Planck length $L_{Pl}$. If so, the departures from ordinary quantum mechanics would be much less suppressed than what is commonly thought.

  11. Engineering drawing field verification program. Revision 3

    International Nuclear Information System (INIS)

    Safe, efficient operation of waste tank farm facilities is dependent in part upon the availability of accurate, up-to-date plant drawings. Accurate plant drawings are also required in support of facility upgrades and future engineering remediation projects. This supporting document establishes the procedure for performing a visual field verification of engineering drawings, the degree of visual observation being performed and documenting the results. A copy of the drawing attesting to the degree of visual observation will be paginated into the released Engineering Change Notice (ECN) documenting the field verification for future retrieval and reference. All waste tank farm essential and support drawings within the scope of this program will be converted from manual to computer aided drafting (CAD) drawings. A permanent reference to the field verification status will be placed along the right border of the CAD-converted drawing, referencing the revision level, at which the visual verification was performed and documented

  12. A Review of Criticality Accidents 2000 Revision

    Energy Technology Data Exchange (ETDEWEB)

    Thomas P. McLaughlin; Shean P. Monahan; Norman L. Pruvost; Vladimir V. Frolov; Boris G. Ryazanov; Victor I. Sviridov

    2000-05-01

    Criticality accidents and the characteristics of prompt power excursions are discussed. Sixty accidental power excursions are reviewed. Sufficient detail is provided to enable the reader to understand the physical situation, the chemistry and material flow, and when available the administrative setting leading up to the time of the accident. Information on the power history, energy release, consequences, and causes are also included when available. For those accidents that occurred in process plants, two new sections have been included in this revision. The first is an analysis and summary of the physical and neutronic features of the chain reacting systems. The second is a compilation of observations and lessons learned. Excursions associated with large power reactors are not included in this report.

  13. Reasons for revision surgery after orbital decompression for Graves’ orbitopathy

    Directory of Open Access Journals (Sweden)

    Stefano Sellari-Franceschini

    2008-06-01

    Full Text Available Stefano Sellari-Franceschini1, Luca Muscatello1, Veronica Seccia1, Riccardo Lenzi1, Amelia Santoro1, Marco Nardi2, Barbara Mazzi3, Aldo Pinchera3, Claudio Marcocci31Department of Neuroscience, 1st ENT division, 2Ophthalmology Division, 3Department of Endocrinology and Metabolism, Orthopaedics and Traumatology, Occupational Medicine, University of Pisa, ItalyObjectives: An analysis of complications and causes of failure in orbital decompression necessitating a second operation.Methods: Between December 1992 and April 2007, 375 patients (719 orbits were operated on using various techniques. Fourteen patients were initially operated on in our unit: 8 (group A1 were re-operated on after a short time due to complications connected with the decompression operation, 7 (group A2 were operated on after some time due to recurrence of the illness or unsatisfactory decompression (one patient is in both group A1 and A2. Five patients (group B underwent a first operation elsewhere.Results: For group A1 the most serious complications were connected to the nasal approach. For group A2 the operations were performed either because of a neuropathy recurrence or for further proptosis reduction due to recurrence or patient dissatisfaction. Lack of preoperative data hinders conclusions about group B, apart from one patient where the operation had not resolved a serious optic neuropathy after decompression based on Olivari technique combined with three-wall operation according to Mourits and colleagues (1990.Conclusions: We can deduce from group A1 that extreme attention is necessary during endonasal access, from group A2 that balancing the eyes is advisable, sacrificing maximum proptosis reduction to gain greater patient satisfaction, and from group B that decompression of the orbital apex is fundamental in the case of neuropathy.Keywords: orbital decompression, Graves’ orbitopathy, revision surgery

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  15. Nuclear safety guide TID-7016 Revision 2

    International Nuclear Information System (INIS)

    The present revision of TID-7016 Nuclear Safety Guide is discussed. This Guide differs significantly from its predecessor in that the latter was intentionally conservative in its recommendations. Firmly based on experimental evidence of criticality, the original Guide and the first revision were considered to be of most value to organizations whose activities with fissionable materials were not extensive and, secondarily, that it would serve as a point of departure for members of established nuclear safety teams, experienced in the field. The reader will find a significant change in the character of information presented in this version. Nuclear Criticality Safety has matured in the past twelve years. The advance of calculational capability has permitted validated calculations to extend and substitute for experimental data. The broadened data base has enabled better interpolation, extension, and understanding of available, information, especially in areas previously addressed by undefined but adequate factors of safety. The content has been thereby enriched in qualitative guidance. The information inherently contains, and the user can recapture, the quantitative guidance characteristic of the former Guides by employing appropriate safety factors. In fact, it becomes incumbent on the Criticality Safety Specialist to necessarily impose safety factors consistent with the possible normal and abnormal credible contingencies of an operation as revealed by his evaluation. In its present form the Guide easily becomes a suitable module in any compendium or handbook tailored for internal use by organizations. It is hoped the Guide will continue to serve immediate needs and will encourage continuing and more comprehensive efforts toward organizing nuclear criticality safety information

  16. Revised spatially distributed global livestock emissions

    Science.gov (United States)

    Asrar, G.; Wolf, J.; West, T. O.

    2015-12-01

    Livestock play an important role in agricultural carbon cycling through consumption of biomass and emissions of methane. Quantification and spatial distribution of methane and carbon dioxide produced by livestock is needed to develop bottom-up estimates for carbon monitoring. These estimates serve as stand-alone international emissions estimates, as input to global emissions modeling, and as comparisons or constraints to flux estimates from atmospheric inversion models. Recent results for the US suggest that the 2006 IPCC default coefficients may underestimate livestock methane emissions. In this project, revised coefficients were calculated for cattle and swine in all global regions, based on reported changes in body mass, quality and quantity of feed, milk production, and management of living animals and manure for these regions. New estimates of livestock methane and carbon dioxide emissions were calculated using the revised coefficients and global livestock population data. Spatial distribution of population data and associated fluxes was conducted using the MODIS Land Cover Type 5, version 5.1 (i.e. MCD12Q1 data product), and a previously published downscaling algorithm for reconciling inventory and satellite-based land cover data at 0.05 degree resolution. Preliminary results for 2013 indicate greater emissions than those calculated using the IPCC 2006 coefficients. Global total enteric fermentation methane increased by 6%, while manure management methane increased by 38%, with variation among species and regions resulting in improved spatial distributions of livestock emissions. These new estimates of total livestock methane are comparable to other recently reported studies for the entire US and the State of California. These new regional/global estimates will improve the ability to reconcile top-down and bottom-up estimates of methane production as well as provide updated global estimates for use in development and evaluation of Earth system models.

  17. Subsequent Surgery after Revision Anterior Cruciate Ligament Reconstruction

    Science.gov (United States)

    Ding, David; Group, Mars

    2016-01-01

    Objectives: Failure or reinjury after anterior cruciate ligament (ACL) reconstruction can lead to recurrent instability and concomitant intra-articular injuries. While revision ACL reconstruction (rACLR) can be performed to restore knee stability and improve patient activity level, outcomes after these surgeries are reported to be inferior to primary ACL reconstruction. Further reoperation after rACLR can have an even more profound effect on patient satisfaction and outcome. Yet, there is a current lack of information regarding the rate and risk factors for subsequent surgery after rACLR. Methods: 1205 patients who underwent rACLR were enrolled between 2006 and 2011, comprising the prospective cohort. Two-year questionnaire follow-up was obtained on 989 (82%), while telephone follow-up was obtained on 1112 (92%). If a patient reported having a subsequent surgery, operative reports detailing the subsequent procedure(s) were obtained and categoriezed. A repeated meaures ANOVA was used to reveal significatnt differences in patient reported outcomes. Multivariate regression analysis was performed to determine independent risk factors for reoperation. Results: One hundred and twenty-two patients (10.1%) underwent a total of 172 subsequent procedures on the ipsilateral knee at 2-year follow-up. Of the reoperation procedures, 26.7% were meniscus procedures (69% meniscectomy, 26% repair), 18.6% were subsequent rACLR, 17.4% were cartilage procedures (61% chondroplasty, 17% microfracture, and 13% mosaicplasty), 10% hardware removal, and 9.3% were procedures for arthrofibrosis such has lysis of adhesions and synovectomy. Patients who had reoperations had significantly lower IKDC, KOOS symptoms and pain scores, and WOMAC stiffness scores at two-year follow up. Multivariate analysis revealed that patients under 20 years old were 2.1 times more likely than patients aged 20-29 to have a reoperation. Use of allograft at the time of rACLR and staged revision (bone grafting of

  18. Safety assessment of discharge chute isolation barrier preparation and installation activities. Revision 3

    Energy Technology Data Exchange (ETDEWEB)

    Meichle, R.H.

    1994-11-08

    This revision adds a section addressing impacts of dropping surfacing tool and rack cutter on the basin floor, and corrects typographical errors. The safety assessment is made for the activities for the preparation and installation of the discharge chute isolation barriers. The safety assessment includes a hazard assessment and comparisons of potential accidents/events to those addressed by the current safety basis documentation. No significant hazards were identified. An evaluation against the USQ evaluation questions was made and the determination made that the activities do not represent a USQ. Hazard categorization techniques were used to provide a basis for readiness review classifications.

  19. Treatment of the avulsion fractures of calcaneal tuberosity in elderly osteoporotic patients with fixation of shaped locking plate%锁定钢板塑形固定治疗老年骨质疏松性跟骨后结节撕脱骨折

    Institute of Scientific and Technical Information of China (English)

    王旭; 王晨; 张超; 黄加张; 马昕

    2014-01-01

    Objective To investigate the clinical results after treatment of the avulsion fractures of calcaneal tuberosity in elderly patients using shaped locking plate. Methods We retrospectively reviewed the elderly patients with the avulsion fractures of calcaneal tuberosity who received ORIF (open reduction internal fixation) with shaped locking plate from January 2006 to December 2011. Only the patients aged more than 60 were included. The AOFAS hindfoot scale was used for clinical evaluation at the last follow-up.Results Seventeen patients were identified with a mean age of 67.2. The follow-up durations was ranged from 1.2-7.1 years, 4.3 years in average. All the fractures achieved bony union and one patient associated with wound delayed healing was finally recovered by dress changing. The mean AOFAS hindfoot score at the last follow-up was 91.2. Discussion The avulsion fractures of calcaneal tuberosity were prone to happen in elderly patients. The peak occurrence age was around 70. The osteoporotic calcaneaus was avulsed by the Achilles tendon due to reduced biomechanical strength. It could be comsed by the strongly dorsiflexed ankle, the isometric contraction of gastrocnemius or the direct stress. Such mechanism was different from the fractures of calcaneal medial tuberosity in young patients which was caused by longitudinal forces. Most studies were recommended for surgical intervention of the calcaneal avulsion fractures. However, due to the risk factors of diabetes, hyperlipidemia or lower limb vascular dysfunction, the occurrence of wound problems was increased. Meanwhile, the results of clinical reports varied due to different choice of internal fixations. The present study found that satisfied stability and clinical result could be achieved by fixed the avulsion fragment to the inferior medial side of the calcaneaus with shaped locking plate. Conclusion The treatment of avulsion fractures of calcaneal tuberosity in elderly patients using shaped locking plate

  20. Ventriculoperitoneal shunt complications needing shunt revision in children: A review of 5 years of experience with 48 revisions

    Directory of Open Access Journals (Sweden)

    Rajendra K Ghritlaharey

    2012-01-01

    Full Text Available Background: The aim of this study was to review the management of ventriculoperitoneal (VP shunt complications in children. Patients and Methods: During the last 5 years (January 1, 2006 to December 31, 2010, 236 VP shunt operations were performed in children under 12 years of age; of these, 40 (16.94% developed shunt complications and those who underwent VP shunt revisions were studied. Results: This prospective study included 40 (28 boys and 12 girls children and required 48 shunt revisions. Complications following VP shunts that required shunt revisions were peritoneal catheter/peritoneal end malfunction (18, shunt/shunt tract infections (7, extrusion of peritoneal catheter through anus (5, ventricular catheter malfunction (4, cerebrospinal fluid (CSF leak from abdominal wound (4, shunt system failure (2, ventricular end/shunt displacement (2, CSF pseudocysts peritoneal cavity (2, extrusion of peritoneal catheter from neck, chest, abdominal scar and through umbilicus, one each. Four-fifth of these shunt complications occurred within 6 months of previous surgery. Surgical procedures done during shunt revisions in order of frequency were revision of peritoneal part of shunt (27, 56.25%, revision of entire shunt system (6, 12.5%, extra ventricular drainage and delayed re-shunt (5, 10.41%, shunt removal and delayed re-shunt (5, 10.41%, opposite side shunting (2, 4.16%, cysts excision and revision of peritoneal catheter (2, 4.16% and revision of ventricular catheter (1, 2.08%. The mortalities following VP shunt operations were 44 (18.64% and following shunt revisions were 4 (10%. Conclusions: VP shunt done for hydrocephalus in children is not only prone for complications and need for revision surgery but also associated with considerable mortality.

  1. Social Skills: Adolf Meyer’s Revision of Clinical Skill for the New Psychiatry of the Twentieth Century

    OpenAIRE

    Lamb, Susan

    2015-01-01

    Adolf Meyer (1866–1950) exercised considerable influence over the development of Anglo-American psychiatry during the first half of the twentieth century. The concepts and techniques he implemented at his prominent Phipps Psychiatric Clinic at Johns Hopkins remain important to psychiatric practice and neuro-scientific research today. In the 1890s, Meyer revised scientific medicine’s traditional notion of clinical skill to serve what he called the ‘New Psychiatry’, a clinical discipline that e...

  2. Clinical analysis of tibial avulsion fracture of posterior cruciate ligament using bold screw in 19 cases%Bold空心螺钉治疗后交叉韧带胫骨撕脱骨折19例临床分析

    Institute of Scientific and Technical Information of China (English)

    郭珊成; 张峡; 郝勇

    2011-01-01

    Objective To evaluate the results of treatment of tibial avulsion fracture of the posterior cruciate ligament using bold screw.Methods A retrospective analysis of 19 cases of tibial avulsion fracture of the posterior cruciate ligament was conducted.Results The operation was all right in all patients,no case happened infection and deep venous thrombosis of lower limbs.Followedup period ranged from 6 months to 24 months (average 9 months) in all cases.All fractures were healed in Ⅰ period.Lysholm score reached 96.6.Conclusion Treatment of tibial avulsion fracture of the posterior cruciate ligament using bold screw is safe and effective methods,the effect is satisfied by postoperative function exercise.%目的 评价应用bold空心螺钉治疗后交叉韧带胫骨撕脱骨折的方法 及疗效.方法 回顾性分析bold空心螺钉治疗后交叉韧带胫骨撕脱骨折19例.结果 本组手术过程顺利,住院期间无感染及下肢深静脉血栓形成等并发症.19例均获门诊随访复查,随访时间6~24个月,平均9个月,所有患者术后骨折均Ⅰ期愈合,膝关节活动度均正常,Lysholm评分由术前平均65.4分提高至最后一次随访平均96.6分.结论 应用bold空心螺钉治疗后交叉韧带胫骨撕脱骨折是一种的安全、有效方法 .术后配合功能锻炼可获得满意的疗效.

  3. Use of hollow screw combined with suture anchor in treatment of tibia avulsion fracture of posterior cruciate ligament%空心钉联合带线锚钉固定治疗后交叉韧带胫骨撕脱骨折

    Institute of Scientific and Technical Information of China (English)

    张平; 舒科杰; 付廷; 付炯; 张松; 秦晋; 李锐冬; 尹良军

    2016-01-01

    Objective To investigate the curative effect of hollow screw combined with suture anchor on tibia avulsion fracture of knee posterior cruciate ligament. Methods Seventeen patients with tibia avulsion fracture of knee posterior cruciate ligament were treated well by hollow screws combined with suture anchors from March 2010 to February 2014. The curative effect was evaluated by Lysholm points-scoring system. Results In the postoperative follow-up survey for 6 to 12 months, bone healing took an average of 4.2 months. The result of Lysholm points-scoring system showed 15 excellent cases and 2 good cases. Conclusions Hollow screw combined with suture anchor is easy to learn and operate for the treatment of tibia avulsion fracture of knee posterior cruciate ligament. Simultaneously, the patients will be more satisfied and get better functions from early rehabilitation training.%目的:探讨经膝关节后内侧小切口空心钉、带线锚钉双联固定治疗后交叉韧带胫骨撕脱骨折的手术效果。方法选取2010年3月-2014年2月该院收治的17例后交叉韧带胫骨撕脱骨折患者,采用后内侧小切口空心钉联合带线锚钉固定,Lysholm膝关节评分系统评价疗效。结果术后随访6~12个月,平均4.2个月骨性愈合,Lysholm评分显示优15例,良2例。结论空心钉和带线锚钉双联固定治疗后交叉韧带胫骨撕脱骨折学习曲线短,操作容易,术后能更早康复锻炼,获得更好的功能,效果满意。

  4. Clinical experience of 11 cases of avulsion fracture of the tibial eminence to approach the anterior cruciate ligament insersion under arthroscope%关节镜辅助内固定治疗胫骨髁间嵴骨折11例临床体会

    Institute of Scientific and Technical Information of China (English)

    宋琦

    2011-01-01

    目的 探讨关节镜辅助下治疗胫骨髁间嵴前交叉韧带止点撕脱骨折的手术方式.方法 对11例患者根据髁间嵴骨折不同的形态类型,分别选择丝线、克氏针、可吸收螺钉、空心螺钉固定前交叉韧带止点撕脱骨块,术后指导功能锻炼.结果 所有病例随访3~36个月,术后3~4个月骨折部位均愈合,采用Lysholm膝关节评价疗效,平均得分92.6分.结论 关节镜辅助下根据髁间嵴撕脱骨折的不同类型选择不同内固定方式,可得到准确的复位、良好的骨折愈合及满意的膝关节功能恢复.%Objective To discuss the operation approach which treats avulsion fracture of the tibial eminence to approach the anterior cruciate ligament insersion under arthroscope. Methods 11 cases respectively chose silk suture, Kirschner wire, absorbed screw, hollow screw to fix avulsion bone on the anterior cruciate ligament insersion according to different types of the tibial eminence fracture, and postoperative functional exercise were directed. Restlts All cases were followed up from 3 to 36 months, all cases healed after 3 to 4 months on fracture part. According to the Lysholm knee joint score which was used to evaluate the curative effect, the average score was 92.6. Conclusion Through different internal fixation under arthroscope according to different avulsion fracture of the tibial eminence ,we can abtain precise reduction, good union of fracture and satisfactory functional recovery of knee joint.

  5. Revised Iterative Solution for Groundstate of Schroedinger Equation

    Institute of Scientific and Technical Information of China (English)

    ZHAOWei-Qin

    2004-01-01

    A revised iterative method based on Green function defined by quadratures along a single trajectory is proposed to solve the low-lying quantum wave function for Schroedinger equation. Specially a new expression of the perturbed energy is obtained, which is much simpler than the traditional one. The method is applied to solve the unharmonic oscillator potential. The revised iteration procedure gives exactly the same result as those based on the single trajectory quadrature method. A comparison of the revised iteration method to the old one is made using the example of Stark effect. The obtained results are consistent to each other after making power expansion.

  6. Revision of Code of Ethics proving to be complicated procedure

    OpenAIRE

    Sullivan, Patrick

    1995-01-01

    Although the CMA Code of Ethics is only a 10-page booklet, revising it is proving to be complicated and time consuming. It is currently undergoing its first major revision in 25 years in an attempt to bring it up to date with changes within the medical profession and medical practice. The work was to have been completed in time for presentation to General Council during the 1995 annual meeting, but because of its complexity and the need for consensus the revised code will not be presented to ...

  7. Revised Bloom Taxonomy And Its Apllication In Algebra Area

    OpenAIRE

    Mehmet BEKDEMİR; SELİM, Yavuz

    2008-01-01

     The aim of this study was to introduce “Revised Bloom Taxonomy” and apply it to field of learning algebra in New Elementary Turkish Mathematics Pro- grams (for grades 6-8). Anderson at all (2001) revised Bloom Taxonomy in order to eliminate defi- ciencies and contradictions, improve and make it more modern, and renamed it as “Revised Bloom Taxonomy”. It has a two-dimension framework: Knowledge which indicates subject matter (content) and cognitive process which indicates a description of wha...

  8. A reliability analysis of the revised competitiveness index.

    Science.gov (United States)

    Harris, Paul B; Houston, John M

    2010-06-01

    This study examined the reliability of the Revised Competitiveness Index by investigating the test-retest reliability, interitem reliability, and factor structure of the measure based on a sample of 280 undergraduates (200 women, 80 men) ranging in age from 18 to 28 years (M = 20.1, SD = 2.1). The findings indicate that the Revised Competitiveness Index has high test-retest reliability, high inter-item reliability, and a stable factor structure. The results support the assertion that the Revised Competitiveness Index assesses competitiveness as a stable trait rather than a dynamic state. PMID:20712175

  9. Perioperative transfusion threshold and ambulation after hip revision surgery

    DEFF Research Database (Denmark)

    Nielsen, Kamilla; Johansson, Pär I; Dahl, Benny;

    2014-01-01

    BACKGROUND: Transfusion with red blood cells (RBC) may be needed during hip revision surgery but the appropriate haemoglobin concentration (Hb) threshold for transfusion has not been well established. We hypothesized that a higher transfusion threshold would improve ambulation after hip revision...... received RBC. CONCLUSIONS: A Hb transfusion threshold of 8.9 g/dL was associated with a statistically significantly faster TUG after hip revision surgery compared to a threshold of 7.3 g/dL but the clinical importance is questionable and the groups did not differ in Hb at the time of testing....

  10. Lateral progression of brachial plexus avulsion injury

    Institute of Scientific and Technical Information of China (English)

    GU Yudong

    2007-01-01

    @@ All reports on brachial plexus injury which were presented on the 9th International Hand Surgery Meeting (2004),the 5th Asia-Pacific Area Hand Surgery Meeting (2005),the 10th Europe Hand Surgery Meeting (2005) and 49th Japan Hand Surgery Meeting (2006),were collected and reviewed.We also went through our own research on brachial plexus injury,and a cumulative review of all these reports and researches was made.

  11. Insurance Cover for Revised Nuclear Liability

    International Nuclear Information System (INIS)

    The financial security to be provided to victims of an incident at a nuclear installation is the main objective of international nuclear liability conventions. As from the introduction of the Paris Convention on Third Party Liability in the Field of Nuclear Energy in 1960 and the Vienna Convention on Liability for Nuclear Damage in 1963 insurers have been prepared to provide the financial capacity needed to cover the liability under both conventions. They did so in close co-operation with the competent national and international authorities, which has resulted in the insurability of as much of the nuclear liability under the conventions as possible. This tradition of co-operation between authorities and insurers was extended to include the revision negotiations regarding the above conventions, which were concluded in 1997 and 2004 respectively. This has resulted in the insurability of by far the largest part of the convention based liability. However, some heads of damage have been introduced about which insurers had expressed concerns as to their likelihood to attract insurance support. In view of the explicit choice by Convention States to include the uninsurable heads of damage into the revised conventions one would expect that liability for them would fall upon national Governments. This would reflect practice in a number of States, which already assume liability for uninsurable mandatory liabilities for a long time. Nonetheless some other States now seem reluctant to do so, the resulting deadlock having a tendency to manifest itself in a negative perception of the insurance industry. Insurers are therefore appreciative of the forum provided by the CNS to once again explain the areas where problems as regards insurability have arisen and why this is the case. This presentation will show that those areas are few in number and notably relate to a limited number of environmental damages as well as the extension of prescription periods. Furthermore, thoughts will

  12. WASTE CERTIFICATION PROGRAM PLAN - REVISION 7

    Energy Technology Data Exchange (ETDEWEB)

    MORGAN, LK

    2002-01-08

    The primary changes that have been made to this revision reflect the relocation of the Waste Certification Official (WCO) organizationally from the Quality Services Division (QSD) into the Laboratory Waste Services (LWS) Organization. Additionally, the responsibilities for program oversight have been differentiated between the QSD and LWS. The intent of this effort is to ensure that those oversight functions, which properly belonged to the WCO, moved with that function; but retain an independent oversight function outside of the LWS Organization ensuring the potential for introduction of organizational bias, regarding programmatic and technical issues, is minimized. The Waste Certification Program (WCP) itself has been modified to allow the waste certification function to be performed by any of the personnel within the LWS Waste Acceptance/Certification functional area. However, a single individual may not perform both the technical waste acceptance review and the final certification review on the same 2109 data package. Those reviews must be performed by separate individuals in a peer review process. There will continue to be a designated WCO who will have lead programmatic responsibility for the WCP and will exercise overall program operational oversite as well as determine the overall requirements of the certification program. The quality assurance organization will perform independent, outside oversight to ensure that any organizational bias does not degrade the integrity of the waste certification process. The core elements of the previous WCP have been retained, however, the terms and process structure have been modified.. There are now two ''control points,'' (1) the data package enters the waste certification process with the signature of the Generator Interface/Generator Interface Equivalent (GI/GIE), (2) the package is ''certified'', thus exiting the process. The WCP contains three steps, (1) the technical review

  13. Programme for the Environmental Control at the Swedish Nuclear Facilities, Revision; Omgivningskontrollprogram foer de kaerntekniska anlaeggningarna, revision

    Energy Technology Data Exchange (ETDEWEB)

    Linden, Ann-Marie

    2004-12-01

    This report contains a revised version of the Environmental Monitoring Programme for the Swedish Nuclear Facilities. The revision is based on earlier experiences and evaluations. Some samples have been excluded. Some have been added, for example spruce cone and the food products apple and currant. The sediment samples of 2 cm length have been completed with samples of 10 cm length every fourth year to follow the migration of radio nuclides down the sediment layers over time. The revised Environmental Monitoring Programme is valid from the 1st of January 2005.

  14. 关节镜下钢丝固定治疗后交叉韧带胫骨止点撕脱骨折的临床疗效%Anatomic Fixation Under Athroscopy for Posterior Cruciate Ligament Tibial Avulsion Fractures Using Kirschnerwires

    Institute of Scientific and Technical Information of China (English)

    李明亮; 姜鑫

    2015-01-01

    Objective To investigate the operation methods and clinical ef ect of anatomic fixation under athroscopy for Posterior cruciate ligament ( PCL) tibial avulsion fractures using Kirschner wires.Methods From Jan 2012 to Jan 2013 20 patients with isolated PCL tibial avulsion fractures underwent anatomic fixation under athroscopy treated at our institutionwere selected,in which 14 men, 6women aged 19~35years old, an average of 27 ,8 cases of sports injury history , and 12 cases of traf ic accident injury history. Patients had varying degrees of the symptoms of knee pain,pain arc positive and restricted activitie . Preoperative X-ray and MRI images showed PCL tibial avulsion fractures .Al patients were treated with arthroscopic surgery. The clinical examination, preoperative anterior drawer test, gravity drawer teat was fol owed-up,the knee-joint function was evaluated with Lysholm score,KT-1000 and the ef ectswere analyzed. Results The fol ow-up of 12 months, Lysholm score,KT-1000 have significantly improved relative to preoperative.Conclusion Athroscopy assisted anatomic fixation for Posterior anterior cruciate ligament ( PCL) tibial avulsion fractures using Kirschner wires has the advantages of lit le trauma,firm fixation,early rehabilitation and lit le complications,and the ef ect is satisfactory,more close to the anatomical biomechanical tibial insertion of PCL.%目的:探讨关节镜下钢丝解剖固定治疗后交叉韧带( PCL)胫骨止点撕脱骨折的临床疗效。方法2012年1月~2013年1月对20例后交叉韧带胫骨止点撕脱骨折患者行关节镜下钢丝解剖固定,其中男14例,女6例;年龄19~35岁(平均27岁);左膝9例,右膝11例。8例为运动伤,12例为车祸伤。所有患者均有不程度的膝关节疼痛、肿胀、活动受限,后抽屉试验及重力实验阳性,术前X射线片、MRI检查可见胫骨髁间窝后方撕脱骨折块。全部行关节镜下钢丝固定骨折块治疗。术前及末次随访一般情况、

  15. Segmental Embedding for Curing Full-thickness Complete Ureteral Avulsion(a report of 1 case and literature review)%分段包埋法治愈输尿管全层全段撕脱伤(附1例报告并文献复习)

    Institute of Scientific and Technical Information of China (English)

    唐顺利; 钟明; 李凯

    2012-01-01

    [Objective] To summarize the treatment of ureteral avulsion in order to provide the reference and guidance for clinical practice. [Methods]Full-thickness complete ureteral avulsion occurred in a 53-year-old female patient with oracle ureteral junction obstruction(UPJO) undergoing ureteroscopy. The patient was cured by ureteropelvic anastomosis in situ, ureteral segment embedding and ureter-bladder anastomosis. The literature was combined for analysis and discussion. [Results]No complication occurred during and after operation. No hydronephrosis was found by B-ultrasound reexamination 3 months after operation. B-ultrasound re-examination a half year after operation showed slight dropsy of left kidney. B-ultrasound a year after operation showed moderate dropsy of left kidney. IVP showed UPJO and moderate dropsy of left kidney. Reoperation including the resection of the stenosis of left kidney and nephropyelopolasty was performed. The patient recovered well after operation. During a year of follow-up, B-ultrasound showed that blood supply and size of the kidney were normal and no hydronephrosis was found. [Conclusion]The operation is the ideal method for the treatment of full-thickness complete ureteral avulsion, and the reference for long-segment uretheral avulsion. The surgical procedure is relatively simple and safe with few complications.%[目的]总结输尿管撕脱伤的处理方法,为临床工作提供借鉴和指导.[方法]报告1例53岁女性肾盂输尿管连接部梗阻(UPJO)患者行输尿管镜检查时发生输尿管全层全段撕脱,经采用输尿管肾盂原位吻合、输尿管分段包埋及输尿管膀胱吻合术而治愈,结合文献进行分析讨论.[结果]术中、术后无并发症发生,术后3个月B超复查无肾积水;术后半年B超复查示左肾轻度积水,1年后B超示左肾中度积水,IVP示UPJO并左肾中度积水,遂再次手术行左肾盂输尿管连接部(UPJ)狭窄段切除及肾盂成

  16. Operator licensing examination standards for power reactors. Interim revision 8

    International Nuclear Information System (INIS)

    These examination standards are intended to assist NRC examiners and facility licensees to better understand the processes associated with initial and requalification examinations. The standards also ensure the equitable and consistent administration of examinations for all applicants. These standards are for guidance purposes and are not a substitute for the operator licensing regulations (i.e., 10 CFR Part 55), and they are subject to revision or other changes in internal operator licensing policy. This interim revision permits facility licensees to prepare their initial operator licensing examinations on a voluntary basis pending an amendment to 10 CFR Part 55 that will require facility participation. The NRC intends to solicit comments on this revision during the rulemaking process and to issue a final Revision 8 in conjunction with the final rule

  17. A revised picture: has our view of the economy changed?

    OpenAIRE

    Theodore G. Bernard

    1986-01-01

    A discussion of the major statistical changes in the December 1985 benchmark revisions of the National Income and Product Accounts statistics and of their impact on business cycle timing and magnitudes.

  18. 33 CFR 151.28 - Plan review and revision.

    Science.gov (United States)

    2010-07-01

    ... BALLAST WATER Implementation of MARPOL 73/78 and the Protocol on Environmental Protection to the Antarctic Treaty as it Pertains to Pollution from Ships Oil Pollution § 151.28 Plan review and revision. (a)...

  19. Environmental Assessment Revised Hunting Plan Erie National Wildlife Refuge 1987

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — In 1984 a serious review of the existing plans led to a decision to completely post the boundary and make the necessary revisions/addendums to the hunting plan that...

  20. Revised Mulliken Electronegativities I. Calculation and Conversion to Pauling Units.

    Science.gov (United States)

    Bratsch, Steven G.

    1988-01-01

    Discusses a revision and extension of the Mulliken electronegativity scale to consider 50 elements. Describes the calculation of valence-state promotion energies and Mulliken atomic electronegativities and the conversion of Mulliken electronegativities to Pauling units. (CW)