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Sample records for avulsions revised technique

  1. A novel MIS technique for posterior cruciate ligament avulsion fractures.

    Science.gov (United States)

    Gavaskar, Ashok S; Karthik, Bhupesh; Gopalan, Hitesh; Srinivasan, Parthasarathy; Tummala, Naveen C

    2017-08-01

    Open surgical approaches to treat tibial avulsion fractures of the posterior cruciate ligament (PCL) often use large incisions involving extensive muscle dissection and retraction. The objective of this study was to describe a new mini-invasive approach targeting the fractured zone, to minimize surgical dissection and improve recovery and rehabilitation. The new approach was used in 15 males and seven females with isolated PCL avulsions. The length of the surgical incision, surgical time, need for conversion to open technique, visual analog scores (VAS) and duration of hospital stay were studied to assess the efficacy, learning curve and advantages of the new technique. Neurovascular complications were recorded. At the two-year follow-up, International Knee Documentation Committee (IKDC) scores were recorded to assess function. Patients were followed up for a mean of 29months (range: 34-41). The mean length of the incision was 4.1cm (range: 3.4 to five) measured at the end of the procedure. None of the patients required conversion to an open technique and no neurovascular complications were recorded. The mean surgical time was 40min (range: 25-50). The mean VAS on discharge was 2.2 (range: one to four) and patients stayed at the hospital for a mean of 2.2days (range: one to three). The mean IKDC score at one-year post surgery was 86.4 (range: 83.9-90.8). The new mini-invasive targeted approach provides adequate exposure for performing internal fixation of PCL avulsion fractures without the surgical morbidity associated with conventional open surgical approaches. The procedure is safe, fast and does not require a long learning curve. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Double row anchor fixation: a novel technique for a diabetic calanceal insufficiency avulsion fracture.

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    Greenhagen, Robert M; Highlander, Peter D; Burns, Patrick R

    2012-01-01

    Avulsion fractures of the calcaneal tuberosity represent only 1.3% to 2.7% of calcaneal fractures. These fractures are common pathologically in nature and attributed to decreased bone mineral density. Calcaneal insufficiency avulsion (CIA) fracture in patients with diabetes mellitus is most likely due to Charcot neuroarthropathy (CN) as described by the Brodsky classification (Brodsky 3B). Traditional open reduction and internal fixation is difficult in all calcaneal avulsion fractures because of poor bone quality. The authors report the first known description of the use of fracture fragment excision and double row anchor fixation.A 39-year-old woman with type I diabetes mellitus and a history of CN presented with an avulsion fracture of the calcaneal tuberosity. Excision of the fracture fragment and a gastrocnemius recession and reattachment of the Achilles tendon with double row anchor fixation to the calcaneus were performed. At 1 year, the patient's American Orthopaedic Foot & Ankle Society rearfoot score improved from 27/100 to 88/100. CIA fractures are an infrequently described injury. Because diabetes mellitus is frequently associated with this disease, it most likely represents a CN event. Traditionally, CIA fractures have been operatively treated with open reduction internal fixation. Previous authors have described difficulty with fixation because of poor quality. In the current report, the authors describe a novel operative approach to CIA fractures through the use of double row anchor fixation and excision of the fracture fragments. The authors feel that this previously undescribed treatment is superior to traditional methods and may serve as a new treatment option for all patients who have sustained this unusual pathology regardless of the underlying cause. The current authors provide a novel operative technique that provides inherent advantages to the traditional repair of CIA fractures. We believe CIA fractures represent a CN-type event and care

  3. Avulsion Fracture of the Calcaneus Treated With a Soft Anchor Bridge and Lag Screw Technique: A Report of Two Cases.

    Science.gov (United States)

    Yoshida, Kazushige; Kasama, Kentaro; Akahane, Tsutomu

    2016-01-01

    The displaced extra-articular avulsion fracture of the calcaneus has been classified as a Böhler type 1c calcaneal fracture, and most cases will require surgical repair. In the present report, we describe 2 patients in whom we performed the soft anchor bridge technique using single loaded suture anchors with lag screws for the repair of Böhler type 1c avulsion fractures of the calcaneus. In one of these patients, clinically relevant osteoporosis complicated the injury. In both cases, bone union was achieved, and by 1.5 months after surgery satisfactory recovery was observed. To our knowledge, the soft anchor bridge technique was first used for the treatment of rotator cuff tears, and the greatest merit of this technique is the ability to generate vertical compression force to the pulled out rotator cuff through the use of knotting sutures. In recent years, the soft anchor bridge technique using 4 suture anchors has also been used for fractures of the greater tuberosity of the humerus, an injury that poses operative difficulties similar to those encountered with an avulsion fracture of the calcaneus owing to the traction force of the rotator cuff and relative weakness of adjacent bone. The outcomes of our patients suggest that the soft anchor bridge technique combined with adjunct lag screws is useful in the fixation of avulsion fractures of the calcaneus. In addition, the result in the elderly patient indicates the possibility of using this technique for patients with osteoporosis. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  4. A new surgical technique for traumatic dislocation of posterior tibial tendon with avulsion fracture of medial malleolus.

    Science.gov (United States)

    Jeong, Soon-Taek; Hwang, Sun-Chul; Kim, Dong-Hee; Nam, Dae-Cheol

    2015-01-01

    We introduce a case of traumatic dislocation of the posterior tibial tendon with avulsion fracture of the medial malleolus in a 52-year-old female patient who was treated surgically with periosteal flap and suture anchor fixation. Based in the posteromedial ridge of the distal tibia, a quadrilateral periosteal flap was created and folded over the tendon, followed by fixation on the lateral aspect of the groove by use of multiple suture anchors. Clinical and radiological findings 25 months postoperatively showed well-preserved function of the ankle joint with stable tendon gliding.

  5. Repair of Double Head Pectoralis Major Tendon Avulsion into its Native Footprint Using Bi-cortical EndoButtons and Tendon Sliding Technique.

    Science.gov (United States)

    Prabhu, Jagadish; Faqi, Mohammed Khalid; Alkhalifa, Fahad; Tayara, Bader Kamal; Awad, Rashad Khamis

    2017-01-01

    Injuries to the pectoralis major muscle are relatively infrequent. The mechanism of injury is usually an eccentric shortening of the pectoralis major under heavy load, such as when performing a bench press exercise. We report a case that presented to us with a history of sudden pain in the left pectoral region while doing heavy bench press exercise. The patient sustained a type III D pectoralis muscle -tendon avulsion. Surgical repair was done through a bi-cortical tendon sliding technique using two cortical buttons. In this article we describe our modifications to the previously described surgical technique for the pectoralis major tendon repair using the EndoButton and tension - slide technique, aiming to overcome the possible complications.

  6. [Avulsion of the Proximal Hamstring Insertion. Case Reports].

    Science.gov (United States)

    Mizera, R; Harcuba, R; Kratochvíl, J

    2016-01-01

    Proximal hamstring avulsion is an uncommon muscle injury with a lack of consensus on indications and the timing and technique of surgery. Poor clinical symptoms and difficulties in the diagnostic process can lead to a false diagnosis. The authors present three cases of proximal hamstring avulsion, two complete and one partial ruptures of the biceps femoris muscle. MRI and ultrasound scans were used for optimal treatment alignment. Acute surgery reconstruction (hamstring strength. Two interesting systematic reviews published on the treatment of proximal hamstring avulsion are discussed in the final part of the paper. Key words: hamstring, rupture, avulsion.

  7. Scar modification. Techniques for revision and camouflage.

    Science.gov (United States)

    Horswell, B B

    1998-09-01

    The surgery and management of scars is a protracted and staged process that includes preparation of the skin through hygienic measures, scar softening (if indicated) with steroids, massage and pressure dressings, skilled execution of the surgical plan, and thorough postoperative wound care. This process generally covers a 1-year period for the various stages mentioned. Many general host and local skin factors will directly affect the final revision result. The two most important indirect factors that the surgeon must endeavor to control are optimal patient preparation and cutaneous health, and patient compliance with, and an ability to carry out, those wound care measures that the surgeon prescribes. Keloid and burn contracture scars represent two entities that are complicated and challenging to treat owing to their abnormal morphophysiologic features. Management of these scars is prolonged, and the patient must understand that the ultimate result will usually be a compromise. New grafting techniques, such as cultured autodermal grafts, offer improved initial management of burn wounds that may subsequently optimize scar revision in these patients. Keloids, and to a lesser extent hypertrophic scars, require steroid injections, pressure treatment, careful surgery, and protracted wound support and pressure treatment (exceeding 6 months) after surgery.

  8. Complete Ureteral Avulsion

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    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.

  9. Nasal avulsion injuries.

    Science.gov (United States)

    Denneny, J C

    1987-11-01

    The nose is the most frequently traumatized portion of the human face. High-speed motor vehicle accidents and interpersonal violence commonly produce bony pyramid and septal damage and occasional minor soft-tissue damage. Major soft-tissue injuries are much less commonly encountered. Avulsion injuries of this type may involve skin only or the bony and cartilaginous framework as well. The severity of these injuries can range from total avulsion to minor skin loss and anywhere within the spectrum between. My experience is reviewed, management guidelines and options are detailed, and selected cases are presented.

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

    International Nuclear Information System (INIS)

    Mellado, J.M.; Ramos, A.; Salvado, E.; Camins, A.; Sauri, A.; Calmet, J.

    2002-01-01

    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.)

  11. 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.

  12. Arthroscopic Revision Surgery for Failure of Open Latarjet Technique.

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    Cuéllar, Adrián; Cuéllar, Ricardo; de Heredia, Pablo Beltrán

    2017-05-01

    To evaluate the efficacy in treating pain, limited range of motion, and continued instability of the Latarjet open technique via the use of arthroscopy. A retrospective review of patients who underwent arthroscopic capsule plication after failure of an open Latarjet technique was performed. Revision surgery was indicated in cases of recurrent instability and associated pain. Only patients with a glenoid defect failed due to capsular redundancy is amenable to successful treatment with arthroscopic capsuloplasty. Arthroscopic approaches can offer a good solution for treating previously failed open Latarjet procedures. Level IV, therapeutic case series. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  13. Neglected, semimembranosus osteochondral avulsion fracture of the posteromedial tibial plateau

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    Rakesh John

    2018-06-01

    Full Text Available Semimembranosus avulsion fracture is infrequently reported and is easy to miss on plain radiographs; the mechanism of injury is highly controversial. Initial reports linked it to anterior cruciate ligament and medial meniscal tears. We report an osteochondral semimembranosus avulsion fracture of the posteromedial tibial plateau with associated posterior cruciate ligament rupture. Also described is a novel surgical fixation technique for such osteochondral fractures where the surgical exposure is limited due to the obliquity of the fracture line resulting in a greater involvement of the articular cartilage than the small bony component. The fixation technique described may be used for osteochondral fractures where the application of a conventional compression screw may not be feasible. Keywords: Osteochondral fracture, Semimembranosus avulsion fracture, Posteromedial tibial plateau, Neglected, Nonunion

  14. Characterization and Surgical Management of Achilles Tendon Sleeve Avulsions.

    Science.gov (United States)

    Huh, Jeannie; Easley, Mark E; Nunley, James A

    2016-06-01

    disease, while engaged in athletic activity. Suture anchor fixation, combined with addressing concomitant insertional pathology, was a reliable and safe technique for the operative management of Achilles tendon sleeve avulsions. The majority of patients returned to their preinjury levels of work and recreational activity. Level IV, retrospective case series. © The Author(s) 2016.

  15. Suture Anchor Fixation for Fifth Metatarsal Tuberosity Avulsion Fractures: A Case Series and Review of Literature.

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    Hong, Choon Chiet; Nag, Kushal; Yeow, Huifen; Lin, Adrian Zhigao; Tan, Ken Jin

    2018-05-17

    Fifth metatarsal tuberosity avulsion fractures are common. Despite good outcomes with nonoperative treatment, acute fractures with displacement, intra-articular involvement, comminution, or painful nonunion have been reported to benefit from early open reduction and internal fixation, especially in athletes. No consensus has been reached regarding the best surgical fixation technique. We present a case series of 4 patients with displaced fifth metatarsal tuberosity avulsion fractures and an innovative technique of fixation for the tuberosity avulsion fractures using a suture anchor. Copyright © 2018 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  16. Avulsion fractures of the scapula

    International Nuclear Information System (INIS)

    Heyse-Moore, G.H.; Stoker, D.J.

    1982-01-01

    Fractures of the scapula due to direct violence are relatively common. Wilber and Evans [18] reported 40 scapular fractures and reviewed the literature. All those injured has received direct trauma to the shoulder and they were able to divide their cases into two groups, based on anatomical location and functional results. Scapular fractures due to avulsion of the muscular attachments are uncommon and, as reports of these injuries in the literature are usually confined to single cases, no classification has been established which takes account of the anatomical sites at which these fractures occur and the mechanism of injury involved. In this paper the more common sites of avulsion injury of the scapula are described and illustrated by case reports. In several of these the skeletal injury resulted from muscle contraction against a resisted force on the upper limb during the course of an accident. This mechanism has been implicated in fractures of the coracoid and acromion, but is shown in this paper to contribute to other avulsion fractures. (orig.)

  17. First-Aid Algorithms in Dental Avulsion

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    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. Fixation of revision implants is improved by a surgical technique to crack the sclerotic bone rim.

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    Kold, Søren; Bechtold, Joan E; Mouzin, Olivier; Elmengaard, Brian; Chen, Xinqian; Søballe, Kjeld

    2005-03-01

    Revision joint replacement has poorer outcomes compared with primary joint replacement, and these poor outcomes have been associated with poorer fixation. We investigated a surgical technique done during the revision operation to improve access from the marrow space to the implant interface by locally cracking the sclerotic bone rim that forms during aseptic loosening. Sixteen implants were inserted bilaterally by distal femur articulation of the knee joint of eight dogs, using our controlled experimental model that replicates the revision setting (sclerotic bone rim, dense fibrous tissue, macrophages, elevated cytokines) by pistoning a loaded 6.0-mm implant 500 microm into the distal femur with particulate PE. At 8 weeks, one of two revision procedures was done. Both revision procedures included complete removal of the membrane, scraping, lavaging, and inserting a revision plasma-spray Ti implant. The crack revision procedure also used a splined tool to circumferentially locally perforate the sclerotic bone rim before insertion of an identical revision implant. Superior fixation was achieved with the cracking procedure in this experimental model. Revision implants inserted with the rim cracking procedure had a significantly higher pushout strength (fivefold median increase) and energy to failure (sixfold median increase), compared with the control revision procedure. Additional evaluation is needed of local perforation of sclerotic bone rim as a simple bone-sparing means to improve revision implant fixation and thereby increase revision implant longevity.

  19. Fixation of revision implants is improved by new surgical technique to crack the sclerotic endosteal rim.

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    Kold, S; Soballe, K; Mouzin, O; Chen, Xiangmei; Toft, M; Bechtold, J

    2002-01-01

    We used an experimental model producing a tissue response with a sclerotic endosteal neo-cortical rim associated with implant loosening in humans: a 6 mm PMMA cylinder pistoned 500 m concentrically in a 7.5 mm hole, with polyethylene particles. At a second operation at eight weeks, the standard revision procedure removed the fibrous membrane in one knee, and the crack revision procedure was used to crack the sclerotic endosteal rim in the contralateral knee. Once stability was achieved following the revision procedures, loaded Ti plasma sprayed implants were inserted into the revision cavities of 8 dogs for an additional 4 weeks. Revision implant fixation (ultimate shear strength and energy absorption) was significantly enhanced by cracking the sclerotic endosteal rim. In conclusion, we demonstrated a simple technique of cracking the sclerotic endosteal rim as an additional method for improving revision fixation. (Hip International 2002; 2: 77-9).

  20. Avulsion Fracture: How Is It Treated?

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    ... way to treat an avulsion fracture in a young athlete? Answers from Edward R. Laskowski, M.D. ... Clinic does not endorse any of the third party products and services advertised. Advertising and sponsorship policy ...

  1. Revised

    DEFF Research Database (Denmark)

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

    This report is a revised analysis of the Danish data on CO2 emissions from forest, afforestation and deforestation for the period 1990 - 2008 and a prognosis for the period until 2020. Revision have included measurements from 2009 in the estimations. The report is funded by the Ministry of Climate...

  2. 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

  3. 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.

  4. Implementation of a revised numerical integration technique into QAD

    International Nuclear Information System (INIS)

    De Gangi, N.L.

    1983-01-01

    A technique for numerical integration through a uniform volume source is developed. It is applied to gamma radiation transport shielding problems. The method is based on performing a numerical angular and ray point kernel integration and is incorporated into the QAD-CG computer code (i.e. QAD-UE). Several test problems are analyzed with this technique. Convergence properties of the method are analyzed. Gamma dose rates from a large tank and post LOCA dose rates inside a containment building are evaluated. Results are consistent with data from other methods. The new technique provides several advantages. User setup requirements for large volume source problems are reduced from standard point kernel requirements. Calculational efficiencies are improved. An order of magnitude improvement is seen with a test problem

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

    OpenAIRE

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

    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 functional result following minimally invasive pseudo-arthrosis repair of a posterior cruciate ligament avulsion fracture. There are no previous reports of similar pseudo-arthrosis repairs, and other aut...

  6. 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

  7. Ring Avulsion Injuries: A Systematic Review.

    Science.gov (United States)

    Bamba, Ravinder; Malhotra, Gautam; Bueno, Reuben A; Thayer, Wesley P; Shack, R Bruce

    2018-01-01

    Ring avulsion injuries can range from soft tissue injury to complete amputation. Grading systems have been developed to guide treatment, but there is controversy with high-grade injuries. Traditionally, advanced ring injuries have been treated with completion amputation, but there is evidence that severe ring injuries can be salvaged. The purpose of this systematic review was to pool the current published data on ring injuries. A systematic review of the English literature published from 1980 to 2015 in PubMed and MEDLINE databases was conducted to identify patients who underwent treatment for ring avulsion injuries. Twenty studies of ring avulsion injuries met the inclusion criteria. There were a total of 572 patients reported with ring avulsion injuries. The Urbaniak class breakdown was class I (54 patients), class II (204 patients), and class III (314 patients). The average total arc of motion (TAM) for patients with a class I injury was 201.25 (n = 40). The average 2-point discrimination was 5.6 (n = 10). The average TAM for patients with a class II injury undergoing microsurgical revascularization was 187.0 (n = 114), and the average 2-point discrimination was 8.3 (n = 40). The average TAM for patients with a class III injury undergoing microsurgical revascularization was 168.2 (n = 170), and the average 2-point discrimination was 10.5 (n = 97). Ring avulsion injuries are commonly classified with the Urbaniak class system. Outcomes are superior for class I and II injuries, and there are select class III injuries that can be treated with replantation. Shared decision making with patients is imperative to determine whether replantation is appropriate.

  8. Myelography for nerve root avulsion in birth palsy

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    Hashimoto, Tsutomu; Mitomo, Masanori; Hirabuki, Norio; Miura, Takashi; Kawai, Ryuji; Imakita, Satoshi; Harada, Koshi; Nakamura, Hironobu; Kozuka, Takahiro (Osaka Univ. (Japan). Faculty of Medicine)

    1990-04-01

    Myelography and CT myelography (CMT) were reviewed in 18 cases of birth palsy with clinically suspected avulsion injury. Root-somatosensory evoked potential (root-SEP) was also reviewed for myelographic evaluation of the nerve root avolusion in birth palsy. Root-SEP is not induced in case of avulsed nerve roots, but is induced in case of both normal and incompletely avulsed roots. Myelography demonstrated 58 abnormal nerve roots in 18 cases (19 limbs); 45 (78%) complete and 13 (22%) incomplete nerve root avulsions. Each of complete and incomplete avulsions was defined as total absence and partial presence of rootlets on myelography, respectively. Traumatic meningoceles were detected at 46 roots (79%) on myelography and/or CTM; 35 roots on myelography and 45 roots on CTM. CTM could not detect only a very small meningocele at one root. At 11 roots CTM was superior to myelography in delineating a meningocele because CTM is sensitive to a poorly enhanced meningocele. CTM, however, could not diagnose nerve root avulsions so accurately as myelography, since myelography detected 12 (7 completely and 5 incompletely) avulsed roots without meningocele, whereas CTM could not delineate the nerve roots clearly. Thus, myelography is indispensable to evaluate nerve root avulsions without meningocele. Root-SEP was examined in 9 patients who underwent branchial plexus exploration. SEP was negative at 22/25 roots with complete avulsion and was positive at 7/7 roots with myelographically incomplete avulsion, regardless of presence or absence of any traumatic meningocele. Myelography and root-SEP correlated well at 29 (92%) out of 32 roots in evaluating complete and incomplete avulsion injuries. Myelography and root-SEP were not considered in 3 roots. Though myelography demonstrated complete avulsions with traumatic meningocele, SEP was positive in these three roots, which were interpreted as partially avulsed roots. (J.P.N.).

  9. Myelography for nerve root avulsion in birth palsy

    International Nuclear Information System (INIS)

    Hashimoto, Tsutomu; Mitomo, Masanori; Hirabuki, Norio; Miura, Takashi; Kawai, Ryuji; Imakita, Satoshi; Harada, Koshi; Nakamura, Hironobu; Kozuka, Takahiro

    1990-01-01

    Myelography and CT myelography (CMT) were reviewed in 18 cases of birth palsy with clinically suspected avulsion injury. Root-somatosensory evoked potential (root-SEP) was also reviewed for myelographic evaluation of the nerve root avolusion in birth palsy. Root-SEP is not induced in case of avulsed nerve roots, but is induced in case of both normal and incompletely avulsed roots. Myelography demonstrated 58 abnormal nerve roots in 18 cases (19 limbs); 45 (78%) complete and 13 (22%) incomplete nerve root avulsions. Each of complete and incomplete avulsions was defined as total absence and partial presence of rootlets on myelography, respectively. Traumatic meningoceles were detected at 46 roots (79%) on myelography and/or CTM; 35 roots on myelography and 45 roots on CTM. CTM could not detect only a very small meningocele at one root. At 11 roots CTM was superior to myelography in delineating a meningocele because CTM is sensitive to a poorly enhanced meningocele. CTM, however, could not diagnose nerve root avulsions so accurately as myelography, since myelography detected 12 (7 completely and 5 incompletely) avulsed roots without meningocele, whereas CTM could not delineate the nerve roots clearly. Thus, myelography is indispensable to evaluate nerve root avulsions without meningocele. Root-SEP was examined in 9 patients who underwent branchial plexus exploration. SEP was negative at 22/25 roots with complete avulsion and was positive at 7/7 roots with myelographically incomplete avulsion, regardless of presence or absence of any traumatic meningocele. Myelography and root-SEP correlated well at 29 (92%) out of 32 roots in evaluating complete and incomplete avulsion injuries. Myelography and root-SEP were not considered in 3 roots. Though myelography demonstrated complete avulsions with traumatic meningocele, SEP was positive in these three roots, which were interpreted as partially avulsed roots. (J.P.N.)

  10. Excellent Aesthetic and Functional Outcome After Fractionated Carbon Dioxide Laser Skin Graft Revision Surgery: Case Report and Review of Laser Skin Graft Revision Techniques.

    Science.gov (United States)

    Ho, Derek; Jagdeo, Jared

    2015-11-01

    Skin grafts are utilized in dermatology to reconstruct a defect secondary to surgery or trauma of the skin. Common indications for skin grafts include surgical removal of cutaneous malignancies, replacement of tissue after burns or lacerations, and hair transplantation in alopecia. Skin grafts may be cosmetically displeasing, functionally limiting, and significantly impact patient's quality-of-life. There is limited published data regarding skin graft revision to enhance aesthetics and function. Here, we present a case demonstrating excellent aesthetic and functional outcome after fractionated carbon dioxide (CO2) laser skin graft revision surgery and review of the medical literature on laser skin graft revision techniques.

  11. All-arthroscopic treatment of tibial avulsion fractures of the posterior cruciate ligament

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    Gwinner, Clemens

    2016-01-01

    Full Text Available Background: The posterior cruciate ligament (PCL avulsion fracture from its tibial insertion is a rare condition. Despite the further technical advent in refixation of avulsion fractures, the reported failure rate of current approaches remains high and the optimal surgical technique has not been elucidated yet.The purpose of the current study is to present an all-inside arthroscopic reconstruction technique for bony tibial avulsion fractures of the PCL and initial clinical outcomes. Methods: Patients underwent a thorough clinical and radiological examination of both knees at 3, 6, 12, 18, and if possible also at 24 months.Clinical evaluation included subjective and objective IKDC 2000, Lysholm score, and KOOS score. Radiographic imaging studies included CT scans for assessment of osseous integration and anatomic reduction of the bony avulsion. In addition to that posterior stress radiographs of both knees using the Telos device (Arthrex, Naples, USA were conducted to measure posterior tibial translation.Results: A total of four patients (1 female, 3 male; ø 38 (± 18 years, who underwent arthroscopic refixation of a PCL avulsion fracture using the Tight Rope device were enrolled in this study. Mean follow up was 22 [18–24] months. The mean subjective IKDC was 72.6% (± 9.9%. Regarding the objective IKDC three patients accounted for grade A, one patient for grade C. The Lysholm score yielded 82 (± 6.9 points. The KOOS score reached 75% (± 13%; symptoms 76%, pain 81%, function 76%, sports 66%, QoL 64%.All patients showed complete osseous integration and anatomic reduction of the bony avulsion. The mean posterior tibial translation at final follow up was 2.8 [0–7] mm. Conclusions: All-arthroscopic treatment of tibial avulsion fractures of the posterior cruciate ligament provides satisfactory clinical results in a preliminary patient cohort. It is a reproducible technique, which minimizes soft tissue damage and obviates a second surgery for

  12. Traumatic avulsion of extraocular muscles: case reports

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    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.

  13. 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. © 2014 Australian Veterinary Association.

  14. C8 cross transfer for the treatment of caudal brachial plexus avulsion in three dogs.

    Science.gov (United States)

    Moissonnier, Pierre; Carozzo, Claude; Thibaut, Jean-Laurent; Escriou, Catherine; Hidalgo, Antoine; Blot, Stéphane

    2017-01-01

    To evaluate the cervical nerve 8 cross-transfer technique (C8CT) as a part of surgical treatment of caudal brachial plexus avulsion (BPA) in the dog. Case series. Client-owned dogs suspected to have caudal BPA based on neurological examination and electrophysiological testing (n = 3). The distal stump of the surgically transected contralateral C8 ventral branch (donor) was bridged to the proximal stump of the avulsed C8 ventral branch (recipient) and secured with 9-0 polypropylene suture under an operating microscope. A carpal panarthrodesis was performed on the injured limb after C8CT. Surgical exploration confirmed avulsion of nerve roots C7, C8, and T1 in all cases. There was no evidence of an iatrogenic effect on the donor forelimb. Gradual improvement in function of the affected forelimb occurred in all dogs, with eventual recovery of voluntary elbow extension. Reinnervation was evident in EMG recordings 6 months postoperatively in all three dogs. Stimulation of the donor C8 ventral branch led to motor evoked potentials in the avulsed side triceps brachialis and radial carpus extensor muscles. Variable functional outcome was observed in the 3 dogs during clinical evaluation 3-4 years after surgery. Digital abrasion wounds, distal interphalangeal infectious arthritis, and self-mutilation necessitated distal phalanx amputation of digits 3 and 4 in 2 dogs. C8CT provided partial reconnection of the donor C8 ventral branch to the avulsed brachial plexus in the 3 dogs of this series. Reinnervation resulted in active elbow extension and promoted functional recovery in the affected limb. © 2017 The American College of Veterinary Surgeons.

  15. Fixation of Hydroxyapatite-Coated Revision Implants Is Improved by the Surgical Technique of Cracking the Sclerotic Bone Rim

    Science.gov (United States)

    Elmengaard, Brian; Bechtold, Joan E.; Chen, Xinqian; Søballe, Kjeld

    2013-01-01

    Revision joint replacement has poorer outcomes that have been associated with poorer mechanical fixation. We investigate a new bone-sparing surgical technique that locally cracks the sclerotic bone rim formed during aseptic loosening. We inserted 16 hydroxyapatite-coated implants bilaterally in the distal femur of eight dogs, using a controlled weight-bearing experimental model that replicates important features of a typical revision setting. At 8 weeks, a control revision procedure and a crack revision procedure were performed on contralateral implants. The crack procedure used a splined tool to perform a systematic local perforation of the sclerotic bone rim of the revision cavity. After 4 weeks, the hydroxyapatite-coated implants were evaluated for mechanical fixation by a push-out test and for tissue distribution by histomorphometry. The cracking revision procedure resulted in significantly improved mechanical fixation, significantly more bone ongrowth and bone volume in the gap, and reduced fibrous tissue compared to the control revision procedure. The study demonstrates that the sclerotic bone rim prevents bone ingrowth and promotes fixation by fibrous tissue. The effect of the cracking technique may be due to improved access to the vascular compartment of the bone. The cracking technique is a simple surgical method that potentially can improve the fixation of revision implants in sclerotic regions important for obtaining the fixation critical for overall implant stability. PMID:19148940

  16. Influence of prosthesis design and implantation technique on implant stresses after cementless revision THR

    Directory of Open Access Journals (Sweden)

    Duda Georg N

    2011-05-01

    Full Text Available Abstract Background Femoral offset influences the forces at the hip and the implant stresses after revision THR. For extended bone defects, these forces may cause considerable bending moments within the implant, possibly leading to implant failure. This study investigates the influences of femoral anteversion and offset on stresses in the Wagner SL revision stem implant under varying extents of bone defect conditions. Methods Wagner SL revision stems with standard (34 mm and increased offset (44 mm were virtually implanted in a model femur with bone defects of variable extent (Paprosky I to IIIb. Variations in surgical technique were simulated by implanting the stems each at 4° or 14° of anteversion. Muscle and joint contact forces were applied to the reconstruction and implant stresses were determined using finite element analyses. Results Whilst increasing the implant's offset by 10 mm led to increased implant stresses (16.7% in peak tensile stresses, altering anteversion played a lesser role (5%. Generally, larger stresses were observed with reduced bone support: implant stresses increased by as much as 59% for a type IIIb defect. With increased offset, the maximum tensile stress was 225 MPa. Conclusion Although increased stresses were observed within the stem with larger offset and increased anteversion, these findings indicate that restoration of offset, key to restoring joint function, is unlikely to result in excessive implant stresses under routine activities if appropriate fixation can be achieved.

  17. A hybrid online scheduling mechanism with revision and progressive techniques for autonomous Earth observation satellite

    Science.gov (United States)

    Li, Guoliang; Xing, Lining; Chen, Yingwu

    2017-11-01

    The autonomicity of self-scheduling on Earth observation satellite and the increasing scale of satellite network attract much attention from researchers in the last decades. In reality, the limited onboard computational resource presents challenge for the online scheduling algorithm. This study considered online scheduling problem for a single autonomous Earth observation satellite within satellite network environment. It especially addressed that the urgent tasks arrive stochastically during the scheduling horizon. We described the problem and proposed a hybrid online scheduling mechanism with revision and progressive techniques to solve this problem. The mechanism includes two decision policies, a when-to-schedule policy combining periodic scheduling and critical cumulative number-based event-driven rescheduling, and a how-to-schedule policy combining progressive and revision approaches to accommodate two categories of task: normal tasks and urgent tasks. Thus, we developed two heuristic (re)scheduling algorithms and compared them with other generally used techniques. Computational experiments indicated that the into-scheduling percentage of urgent tasks in the proposed mechanism is much higher than that in periodic scheduling mechanism, and the specific performance is highly dependent on some mechanism-relevant and task-relevant factors. For the online scheduling, the modified weighted shortest imaging time first and dynamic profit system benefit heuristics outperformed the others on total profit and the percentage of successfully scheduled urgent tasks.

  18. ARTHROSCOPIC FIXATION OF ANTERIOR CRUCIATE LIGAMENT TIBIAL AVULSION FRACTURES USING FIBRE WIRE WITH OR WITHOUT ENDOBUTTON

    Directory of Open Access Journals (Sweden)

    Satyajeet Jagtap

    2017-06-01

    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 various modalities in arthroscopic fixation. The aim of our study is to assess the clinical and radiological results of arthroscopic fixation using fibre wire with or without Endobutton in the management of ACL avulsion fractures using a simpler technique. MATERIALS AND METHODS Fifteen patients (10 males and 5 females who underwent arthroscopic fixation with standard anteromedial and anterolateral ports using fibre wire with or without Endobutton (9 cases only fibre wire was used, 6 cases Endobutton was used in addition for displaced ACL avulsion fractures (Meyers and McKeever’s classification grade 2, grade 3 and grade 4 were analysed. The average age was 26.1 years with a mean follow up of 1 year. All patients were assessed clinically by calculating their Lysholm scores, Lachman test and the radiological union was assessed in the follow up radiographs. Study Design- Retrospective observational case series. RESULTS The mean Lysholm score was 94.93 ± 2.81 (mean ± SD. In 14 patients, Lachman test was negative at the end of final follow up while 1 patient had grade I laxity compared to normal knee. At final followup, all the patients were able to return to their preinjury activity level except one who had an extension lag, underwent arthrolysis subsequently and is improving. CONCLUSION Arthroscopic fixation using this technique of using fibre wire with or without Endobutton is a safe and reliable technique for producing clinicoradiological outcome in displaced ACL avulsion fractures.

  19. All-inside, anatomical lateral ankle stabilization for revision and complex primary lateral ankle stabilization: a technique guide.

    Science.gov (United States)

    Prissel, Mark A; Roukis, Thomas S

    2014-12-01

    Lateral ankle instability is a common mechanical problem that often requires surgical management when conservative efforts fail. Historically, myriad open surgical approaches have been proposed. Recently, consideration for arthroscopic management of lateral ankle instability has become popular, with promising results. Unfortunately, recurrent inversion ankle injury following lateral ankle stabilization can occur and require revision surgery. To date, arthroscopic management for revision lateral ankle stabilization has not been described. We present a novel arthroscopic technique combining an arthroscopic lateral ankle stabilization kit with a suture anchor ligament augmentation system for revision as well as complex primary lateral ankle stabilization. © 2014 The Author(s).

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

    International Nuclear Information System (INIS)

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

    2000-01-01

    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

  1. Rotational Osteotomy for Hallux Valgus. A New Technique for Primary and Revision Cases

    Science.gov (United States)

    Ortiz, Cristian; Wagner, Emilio

    2017-01-01

    More than 200 different surgical techniques exist for hallux valgus (HV). Some of them are designed for mild, moderate, or severe deformities depending on their correction power. Nevertheless, they all correct only the coronal and/or sagittal plane deformity. Just a handful of them correct the known axial malrotation that exists in most HV cases. This malrotation is one possible factor that could be the source of recurrence of an operated HV as it has been described. We describe a new technique which simultaneously corrects the metatarsal internal rotation and varus deformity by rotating the metatarsal through an oblique plane osteotomy. This is performed with no bone wedge resection. Also, there is a broader bone surface contact than on a transverse proximal osteotomy. This technique is easy to remember and relatively simple to perform in primary and revision cases. The authors results show that it is as safe and effective as other procedures, with some advantages to be discussed. Levels of Evidence: Diagnostic Level 5. See Instructions for Authors for a complete description of levels of evidence. PMID:28286430

  2. All-Arthroscopic Revision Eden-Hybinette Procedure for Failed Instability Surgery: Technique and Preliminary Results.

    Science.gov (United States)

    Giannakos, Antonios; Vezeridis, Peter S; Schwartz, Daniel G; Jany, Richard; Lafosse, Laurent

    2017-01-01

    To describe the technique of an all-arthroscopic Eden-Hybinette procedure in the revision setting for treatment of a failed instability procedure, particularly after failed Latarjet, as well as to present preliminary results of this technique. Between 2007 and 2011, 18 shoulders with persistent instability after failed instability surgery were treated with an arthroscopic Eden-Hybinette technique using an autologous bicortical iliac crest bone graft. Of 18 patients, 12 (9 men, 3 women) were available for follow-up. The average follow-up was 28.8 months (range, 15 to 60 months). A Latarjet procedure was performed as an index surgery in 10 patients (83%). Two patients (17%) had a prior arthroscopic Bankart repair. Eight patients (67%) obtained a good or excellent result, whereas 4 patients (33%) reported a fair or poor result. Seven patients (58%) returned to sport activities. A positive apprehension test persisted in 5 patients (42%), including 2 patients (17%) with recurrent subluxations. The Rowe score increased from 30.00 to 78.33 points (P Instability Index score showed a good result of 28.71% (603 points). The average anterior flexion was 176° (range, 150° to 180°), and the average external rotation was 66° (range, 0° to 90°). Two patients (16.67%) showed a progression of glenohumeral osteoarthritic changes, with each patient increasing by one stage in the Samilson-Prieto classification. All 4 patients (33%) with a fair or poor result had a nonunion identified on postoperative computed tomography scan. An all-arthroscopic Eden-Hybinette procedure in the revision setting for failed instability surgery, although technically demanding, is a safe, effective, and reproducible technique. Although the learning curve is considerable, this procedure offers all the advantages of arthroscopic surgery and allows reconstruction of glenoid defects and restoration of shoulder stability in this challenging patient population. In our hands, this procedure yields good

  3. A Simple Strategy in Avulsion Flap Injury: Prediction of Flap Viability Using Wood's Lamp Illumination and Resurfacing with a Full-thickness Skin Graft.

    Science.gov (United States)

    Lim, Hyoseob; Han, Dae Hee; Lee, Il Jae; Park, Myong Chul

    2014-03-01

    Extensive degloving injuries of the extremities usually result in necrosis of the flap, necessitating comprehensive skin grafting. Provided there is a sufficient tool to evaluate flap viability, full-thickness skin can be used from a nonviable avulsed flap. We used a Wood's lamp to determine the viability of avulsed flaps in the operation field after intravenous injection of fluorescein dye. We experienced 13 cases during 16 months. Fifteen minutes after the intravenous injection of fluorescein dye, the avulsed skin flaps were examined and non-fluorescent areas were marked under Wood's lamp illumination. The marked area was defatted for full-thickness skin grafting. The fluorescent areas were sutured directly without tension. The non-fluorescent areas were covered by defatted skin. Several days later, there was soft tissue necrosis within the flap area. We measured necrotic area and revised the flap. Among all the cases, necrotic area was 21.3% of the total avulsed area. However, if we exclude three cases, one of a carelessly managed patient and two cases of the flaps were inappropriately applied, good results were obtained, with a necrotic area of only 8.4%. Eight patients needed split-thickness skin grafts, and heel pad reconstruction was performed with free flap. A full-thickness skin graft from an avulsed flap is a good method for addressing aesthetic concerns without producing donor site morbidity. Fluorescein dye is a useful, simple, and cost-effective tool for evaluating flap viability. Avulsed flap injuries can be managed well with Wood's lamp illumination and a full-thickness skin graft.

  4. A Simple Strategy in Avulsion Flap Injury: Prediction of Flap Viability Using Wood's Lamp Illumination and Resurfacing with a Full-thickness Skin Graft

    Directory of Open Access Journals (Sweden)

    Hyoseob Lim

    2014-03-01

    Full Text Available Background Extensive degloving injuries of the extremities usually result in necrosis of the flap, necessitating comprehensive skin grafting. Provided there is a sufficient tool to evaluate flap viability, full-thickness skin can be used from a nonviable avulsed flap. We used a Wood's lamp to determine the viability of avulsed flaps in the operation field after intravenous injection of fluorescein dye. Methods We experienced 13 cases during 16 months. Fifteen minutes after the intravenous injection of fluorescein dye, the avulsed skin flaps were examined and non-fluorescent areas were marked under Wood's lamp illumination. The marked area was defatted for full-thickness skin grafting. The fluorescent areas were sutured directly without tension. The non-fluorescent areas were covered by defatted skin. Several days later, there was soft tissue necrosis within the flap area. We measured necrotic area and revised the flap. Results Among all the cases, necrotic area was 21.3% of the total avulsed area. However, if we exclude three cases, one of a carelessly managed patient and two cases of the flaps were inappropriately applied, good results were obtained, with a necrotic area of only 8.4%. Eight patients needed split-thickness skin grafts, and heel pad reconstruction was performed with free flap. Conclusions A full-thickness skin graft from an avulsed flap is a good method for addressing aesthetic concerns without producing donor site morbidity. Fluorescein dye is a useful, simple, and cost-effective tool for evaluating flap viability. Avulsed flap injuries can be managed well with Wood's lamp illumination and a full-thickness skin graft.

  5. Femoral component revision with use of impaction bone-grafting and a cemented polished stem. Surgical technique.

    NARCIS (Netherlands)

    Schreurs, B.W.; Arts, J.J.C.; Verdonschot, N.J.J.; Buma, P.; Slooff, T.J.J.H.; Gardeniers, J.W.M.

    2006-01-01

    BACKGROUND: The purpose of this study was to evaluate the clinical and radiographic outcomes of revision of the femoral component of a hip arthroplasty with use of an impaction bone-grafting technique and a cemented polished stem. METHODS: Thirty-three consecutive femoral reconstructions that were

  6. Construction of avulsion potential zone model for Kulik River of Barind Tract, India and Bangladesh.

    Science.gov (United States)

    Sarkar, Debabrata; Pal, Swades

    2018-04-21

    Avulsion is a natural fluvial process but considered it as a hazard in the populated region due to the chance of immense failure of lives and properties. So, early warning indicates that the zone of avulsion can facilitate the people living there. About 317 numbers of local and regional historical imprints of channel cutoff along river Kulik claim the need of this work. The present study tried to identify avulsion potential zone (APZ) of Kulik river of Indo-Bangladesh using multi-parametric weighted combination approach. Analytic hierarchy approach (AHP) is applied for weighting the used parameters. Avulsion potential model clearly exhibits that 9.51-km stream segment of middle and lower catchment is highly susceptible for avulsion especially during sudden high discharge and earthquake incidents. There is also high chance of channel avulsion following the existing Paleo-avulsion courses and left channels. Hard points can also be erected alongside the main channel for resisting channel avulsion propensity.

  7. Outcomes in Patients Treated with a Novel, Simple Method for Hemostasis of Dermal Avulsion Injuries.

    Science.gov (United States)

    Dowling, Sean Taylor; Lin, Brian Wai

    2017-10-01

    A recently described technique proposes a simple method to achieve permanent hemostasis of distal fingertip dermal avulsion injuries. It is simple to learn and easy to perform with readily available materials found in most emergency departments. However, long-term outcomes for patients treated with this technique have not yet been evaluated. A primary objective of the current article is to provide safety data for the technique using an off-label product indication. Emergency department of Kaiser Permanente Medical Center, San Francisco, California. Six patients were treated in the emergency department for fingertip dermal avulsion injuries using a tourniquet and tissue adhesive glue (Dermabond by Ethicon, Somerville, New Jersey). Patients were subsequently contacted to assess healing and satisfaction with cosmetic outcome through interview and photographs of their wounds at 9 months following the date of injury. All 6 patients were satisfied with the cosmetic outcome of treatment, and none received a diagnosis of serious complications. This series demonstrates cosmetic outcomes for injuries treated with the technique, highlights potential problems that may be perceived by patients during their clinical course, and creates the groundwork for a larger clinical study examining the use of the technique.

  8. 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

    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...

  9. Management of avulsed permanent maxillary central incisors during endotracheal intubation

    Directory of Open Access Journals (Sweden)

    Ritesh R Kalaskar

    2016-01-01

    Full Text Available Avulsion is serious injury that may encounter during endotracheal intubation and its management often presents a challenge. Replantation of the avulsed tooth can restore esthetic appearance and occlusal function shortly after the injury. The present article describes the management of air-dried maxillary permanent incisors that have been avulsed due to direct laryngoscopy during the induction of general anesthesia for tonsillectomy procedure. The replanted maxillary central incisors had maintained its function and esthetic for 1 year after replantation. Children in a mixed dentition phase are high-risk group children for traumatic dental injury during laryngoscopy; therefore, Anesthetic Departments should have local protocols to refer patients for dental treatment postoperatively in the event of trauma.

  10. New Treatments for Spinal Nerve Root Avulsion Injury

    Directory of Open Access Journals (Sweden)

    Thomas Carlstedt

    2016-08-01

    Full Text Available Further progress in the treatment of the longitudinal spinal cord injury has been made. In an inverted translational study, it has been demonstrated that return of sensory function can be achieved by bypassing the avulsed dorsal root ganglion neurons. Dendritic growth from spinal cord sensory neurons could replace dorsal root ganglion axons and re-establish a reflex arch. Another research avenue has led to the development of adjuvant therapy for regeneration following dorsal root to spinal cord implantation in root avulsion injury. A small, lipophilic molecule that can be given orally acts on the retinoic acid receptor system as an agonist. Upregulation of dorsal root ganglion regenerative ability and organization of glia reaction to injury were demonstrated in treated animals. The dual effect of this substance may open new avenues for the treatment of root avulsion and spinal cord injuries.

  11. Combined acromioclavicular joint dislocation and coracoid avulsion in an adult.

    Science.gov (United States)

    Naik, Monappa; Tripathy, Sujit Kumar; Goyal, Saumitra; Rao, Sarath K

    2015-05-20

    Avulsion fracture of coracoid process with acromioclavicular joint dislocation is extremely rare. We report a case of coracoid avulsion with acromioclavicular disruption in a 24-year-old man who sustained injuries in a road traffic accident. Although acromioclavicular (AC) dislocation was obvious from an initial radiograph, coracoid avulsion was picked up in a CT scan. Open reduction and internal fixations of the coracoid with a 4 mm cannulated screw, an AC joint with two K-wires and an anchor suture, resulted in rapid recovery. The patient had complete range of shoulder movements at the end of 3 months and he resumed his professional activities. After 1 year, he had normal shoulder movement without any functional limitations. 2015 BMJ Publishing Group Ltd.

  12. Splenic avulsion and bleeding shown on radiocolloid images

    International Nuclear Information System (INIS)

    Levy, H.A.; Sziklas, J.J.; Spencer, R.P.; Rosenberg, R.J.

    1983-01-01

    A case is discussed of a man who presented with trauma to the chest and abdomen. A radiocolloid image showed uptake by the liver. However, the spleen was not identified. Areas of activity outside of the spleen were noted. The patient had splenic avulsion; extra sites of activity likely represented bleeding sites in the abdomen. Failure to identify the spleen on a radiocolloid image, after trauma, should be an alerting sign to possible splenic avulsion (especially when there are also ectopic sites of accumulation of the radiocolloid)

  13. Splenic avulsion and bleeding shown on radiocolloid images

    Energy Technology Data Exchange (ETDEWEB)

    Levy, H.A.; Sziklas, J.J.; Spencer, R.P.; Rosenberg, R.J.

    1983-06-01

    A case is discussed of a man who presented with trauma to the chest and abdomen. A radiocolloid image showed uptake by the liver. However, the spleen was not identified. Areas of activity outside of the spleen were noted. The patient had splenic avulsion; extra sites of activity likely represented bleeding sites in the abdomen. Failure to identify the spleen on a radiocolloid image, after trauma, should be an alerting sign to possible splenic avulsion (especially when there are also ectopic sites of accumulation of the radiocolloid).

  14. [ARTHROSCOPIC TREATMENT OF ANTERIOR CRUCIATE LIGAMENT TIBIAL EMINENCE AVULSION FRACTURE IN ADOLESCENTS WITH EPIPHYSEAL UNCLOSURE].

    Science.gov (United States)

    Liu, Yang; Sun, Xuebin; Zhang, Keyuan; Li, Gang; Ni, Jiati

    2015-06-01

    To evaluate the clinical results of arthroscopic treatment of anterior cruciate ligament (ACL) tibial eminence avulsion fractures in adolescents with epiphyseal unclosure. Between January 2011 and October 2013, 35 knees with ACL tibial eminence avulsion fractures (35 patients with epiphyseal unclosure) were arthroscopically treated with suture fixation. There were 25 males and 10 females, aged 8-16 years (mean, 14.7 years). The causes included sports injury in 24 cases, traffic accident injury in 9 cases, and daily life injury in 2 cases. According to Meyers-McKeever classification criteria, there were 27 cases of type II and 8 cases of type III. Five cases had meniscus injury. The preoperative the International Knee Documentation Committee (IKDC) score was 48.7 ± 3.2, and Lysholm score was 51.2 ± 4.5. The time from injury to operation was 2-16 days (mean, 5 days). Primary healing of incision was obtained in all patients. The mean follow-up time was 22.4 months (range, 12-32 months). Anatomical reduction was achieved in 28 cases and satisfactory reduction in 7 cases. X-ray films showed all fractures healing at last follow-up. There was no limb shortening deformity, varus knee, or valgus knee. Lachman test results were all negative. The other knees had normal range of motion except 1 knee with limited flexion, whose range of motion returned to 0-120° after treatment. At last follow-up, the IKDC score was significantly improved to 93.2 ± 4.1 (t = -53.442, P = 0.000), and the Lysholm score was significantly increased to 96.2 ± 2.5 (t = -56.242, P = 0.000). The arthroscopic fixation technique has satisfactory results for the reduction and fixation of ACL tibial eminence avulsion fracture in the adolescents with epiphyseal unclosure because of little trauma and quick recovery.

  15. Perineal anterior dislocation of the hip with avulsion fracture of ...

    African Journals Online (AJOL)

    Traumatic anterior dislocation of the hip is rare even in children. Very uncommon also is the perineal variant of the inferior type of anterior dislocation with concomitant avulsion fracture of the greater trochanter. We report such a case highlighting the peculiarity of its management. No similar case of triumvirate injury of the hip ...

  16. Repair of gluteus medius muscle avulsion following transgluteal hip replacement

    NARCIS (Netherlands)

    Groot, Diederik; van Ooij, Andre; Haverkamp, Daniel; Morrenhof, Wim

    2011-01-01

    During a transgluteal approach to the hip joint the anterior part of the gluteus medius and minimus muscles are detached and subsequently reattached to the greater trochanter. Avulsion or rupture of these muscles may result in weak abduction, pain and/or instability. 15 patients with these symptoms

  17. 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.

  18. Double Outlet Right Ventricle With Intact Ventricular Septum: Avulsion or Exclusion.

    Science.gov (United States)

    Menon, Sabarinath; Kumar, C J Ashok; Mathew, Thomas; Venkateshwarn, S; Jayakumar, K; Dharan, Baiju S

    2016-03-01

    Double outlet right ventricle (DORV) is almost always associated with a ventricular septal defect. The variant of DORV with intact ventricular septum is very uncommon and may be associated with fetal demise or death immediately after birth. Reports of successful palliation of these patients to the stage of superior cavopulmonary anastomosis (bidirectional Glenn shunt) are rare. We describe the case of a child with DORV with intact ventricular septum who underwent successful palliation. This condition often provides a diagnostic, interventional, and surgical challenge. Patients generally require either balloon atrial septostomy or surgical atrial septectomy for survival, with the addition of a Blalock-Tausig shunt or pulmonary artery band depending on the pulmonary blood flow. Very few patients survive to a Glenn procedure. For those who do survive, a decision must be made regarding the management of the hypertensive and hypoplastic left ventricle (LV) and associated mitral regurgitation. The LV can be excluded by either mitral valve avulsion or closure (exclusion) of the mitral valve with a patch. The choice of the technique should be carefully made and depends in part on the size of the LV. In our patient, who was successfully palliated by bidirectional Glenn shunt, the LV was managed by means of mitral valve avulsion. © The Author(s) 2015.

  19. Prosthetic Rehabilitation of Child Victim of Avulsion of Anterior Teeth with Orthodontic Mini-Implant

    Directory of Open Access Journals (Sweden)

    Natalice Sousa de Oliveira

    2017-01-01

    Full Text Available The treatment of choice in cases of avulsed permanent teeth is the immediate reimplantation. However, this conduct does not always work favorably, either by failures in the initial approach or by inappropriate interventions. In this sense, the aim of this study is to present an alternative prosthetic rehabilitation with the use of orthodontic mini-implants in the anterior region. This case reports a ten-year-old child with history of avulsion of superior central incisors. The therapeutic approach was planned to promote physiological teeth contacts and acceptable esthetics and phonetics. First, the occlusal-gingival insertion of two orthodontic mini-implants was performed in the alveolar ridge, and, immediately after that, two provisional crowns were attached to the implants. The interventions achieved satisfactory cosmetic and functional results. After one-year follow-up, the adjacent periodontal tissues remained without signs and/or symptoms of inflammation. The provisional crowns presented no mobility and fractures. During radiographic examination, a healthy bone tissue appearance was observed. The simplicity of mini-implant installation makes them a promising alternative for temporary prosthetic rehabilitation of patients undergoing growth and development. The technique provides positive aesthetic and functional results that may reflect on self-esteem and social inclusion of children and adolescents.

  20. Double-Row Suture Anchor Repair of Posterolateral Corner Avulsion Fractures.

    Science.gov (United States)

    Gilmer, Brian B

    2017-08-01

    Posterolateral corner avulsion fractures are a rare variant of ligamentous knee injury primarily described in the skeletally immature population. Injury is often related to a direct varus moment placed on the knee during sporting activities. Various treatment strategies have been discussed ranging from nonoperative management, to excision of the bony fragment, to primary repair with screws or suture. The described technique is a means for achieving fixation of the bony avulsion using principles familiar to double-row transosseous equivalent rotator cuff repair. Proximal anchors are placed in the epiphysis, and sutures are passed in horizontal mattress fashion. Once tied, the limbs of these same sutures are then passed to more distal anchors. Remaining eyelet sutures can be used to manage peripheral tissue. The final repair provides anatomic reduction and compression of the fragment to its bony bed with minimal extracortical hardware prominence and no violation of the physis. Risks include potential for physeal injury or chondral damage to the lateral femoral condyle through aberrant anchor placement. Postoperative care includes toe-touch weight-bearing restrictions and range of motion restrictions of 0°-90° in a hinged brace for 6 weeks followed by gradual return to activity.

  1. 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

  2. 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.

  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. Stabilization and treatment of dental avulsions and fractures by emergency physicians using just-in-time training.

    Science.gov (United States)

    McIntosh, Mark S; Konzelmann, Jason; Smith, Jeffrey; Kalynych, Colleen J; Wears, Robert L; Schneider, Howard; Wylie, Todd; Kaminski, Anne; Matar-Joseph, Madeline

    2009-10-01

    The objective of this investigation is to use a dental simulation model to compare splinting and bandaging methods for managing tooth avulsions and fractures, as measured by dentist evaluators for quality and time to complete each stabilization procedure. This was a randomized crossover study comparing 3 splinting techniques for managing a traumatically avulsed tooth (periodontal pack, wire, and bondable reinforcement ribbon) and 2 bandage techniques for managing a fractured tooth (calcium hydroxide paste and light-cured composite). After viewing a Just-in-Time training video, a convenience sample of emergency physicians performed the 5 stabilization techniques on dental models containing extracted teeth embedded in clay to simulate a segment of the human dentition. Data collected included time to complete each procedure, the evaluation of dentists about whether the procedure was performed satisfactorily or unsatisfactorily, and the ranking of dentists' and participants' preferred technique. Twenty-five emergency physicians participated in the study: 17 residents, 2 pediatric emergency medicine fellows, and 6 attending physicians. Reported median time, as well as minimum and maximum times to complete each splinting technique for an avulsed tooth, was as follows: periodontal pack 4.4 minutes (2.5 to 6.5 minutes), wire 8.6 minutes (5.8 to 12.9 minutes), and bondable reinforcement ribbon 8.9 minutes (5.6 to 15 minutes). Median time (and minimum and maximum times) to complete each protective bandaging technique for a fractured tooth was calcium hydroxide paste 4.6 minutes (3 to 9.6 minutes) and light-cured composite 7.1 minutes (5.5 to 14.1 minutes). When asked to choose a preferred splinting and bandaging technique according to the performance of the physicians, the dentists chose the bondable reinforcement ribbon 96% (24/25) and the light-cured composite 100% (25/25) of the time. Study participants had no measurable or agreeable preference for a particular splinting

  5. Total scalp avulsion with microvascular reanastomosis: A case report and literature review.

    Science.gov (United States)

    Plant, Mathew A; Fialkov, Jeffrey

    2010-01-01

    Total scalp avulsion is a rare but potentially devastating injury that when treated (following a few basic principles) can have very good reconstructive results. The present article reviews the current literature and describes the steps involved in the successful replantation of a complete avulsed scalp of a 33-year-old woman. To the authors' knowledge, the present case regarding replantation of a complete avulsed scalp using only a single artery is the first to be described in the Canadian literature.

  6. Control of Delta Avulsion by Downstream Sediment Sinks

    Science.gov (United States)

    Salter, Gerard; Paola, Chris; Voller, Vaughan R.

    2018-01-01

    Understanding how fluxes are partitioned at delta bifurcations is critical for predicting patterns of land loss and gain in deltas worldwide. Although the dynamics of river deltas are influenced from both upstream and downstream, previous studies of bifurcations have focused on upstream controls. Using a quasi-1-D bifurcation model, we show that flow switching in bifurcations is strongly influenced by downstream sediment sinks. We find that coupling between upstream and downstream feedbacks can lead to oscillations in water and sediment flux partitioning. The frequency and initial rate of growth/decay of the oscillations depend on both upstream and downstream conditions, with dimensionless bifurcate length and bypass fraction emerging as key downstream parameters. With a strong offshore sink, causing bypass in the bifurcate branches, we find that bifurcation dynamics become "frozen"; that is, the bifurcation settles on a permanent discharge ratio. In contrast, under depositional conditions, we identify three dynamical regimes: symmetric; soft avulsion, where both branches remain open but the dominant branch switches; and full avulsion. Finally, we show that differential subsidence alters these regimes, with the difference in average sediment supply to each branch exactly compensating for the difference in accommodation generation. Additionally, the model predicts that bifurcations with shorter branches are less asymmetric than bifurcations with longer branches, all else equal, providing a possible explanation for the difference between backwater length distributaries, which tend to be avulsive, and relatively stable mouth-bar-scale networks. We conclude that bifurcations are sensitive both quantitatively and qualitatively to downstream sinks.

  7. Standards of compounds labeled with positron nuclides approved as established techniques for medical use (2001 revision)

    International Nuclear Information System (INIS)

    2001-01-01

    The subcommittee on Medical Application of Cyclotron-Produced Radionuclides, Medical Science and Pharmaceutical Committee, Japan Radioisotope Association, revised the Standards in the title for their manufacturing, quality, manufacturing work environment etc. The facilities must have the individual committee for the organization and its responsibility is for the control and hygiene in manufacturing the nuclides, for the quality control and for the medical use. Based on this, the Standard defined such pharmaceutical items as the general rule; gas agents and injection formulations; test methods involving γ-ray measurement including spectrometry and derived determination, determination with well-type scintillation counter and ionization chamber, method to measure half-time and determination of the nuclide purity; individual definition of [ 18 F]2-deoxy-2-fluoro-D-glucose, 15 O gas and 15 O-carbon monoxide and 15 O-carbon dioxide; and guideline of manufacturing the nuclides and its environment involving monitoring and records. (K.H.)

  8. Sciatic Nerve Injury After Proximal Hamstring Avulsion and Repair.

    Science.gov (United States)

    Wilson, Thomas J; Spinner, Robert J; Mohan, Rohith; Gibbs, Christopher M; Krych, Aaron J

    2017-07-01

    Muscle bellies of the hamstring muscles are intimately associated with the sciatic nerve, putting the sciatic nerve at risk of injury associated with proximal hamstring avulsion. There are few data informing the magnitude of this risk, identifying risk factors for neurologic injury, or determining neurologic outcomes in patients with distal sciatic symptoms after surgery. To characterize the frequency and nature of sciatic nerve injury and distal sciatic nerve-related symptoms after proximal hamstring avulsion and to characterize the influence of surgery on these symptoms. Cohort study; Level of evidence, 3. This was a retrospective review of patients with proximal partial or complete hamstring avulsion. The outcome of interest was neurologic symptoms referable to the sciatic nerve distribution below the knee. Neurologic symptoms in operative patients were compared pre- and postoperatively. The cohort consisted of 162 patients: 67 (41.4%) operative and 95 (58.6%) nonoperative. Sciatic nerve-related symptoms were present in 22 operative and 23 nonoperative patients, for a total of 45 (27.8%) patients (8 [4.9%] motor deficits, 11 [6.8%] sensory deficits, and 36 [22.2%] with neuropathic pain). Among the operative cohort, 3 of 3 (100.0%) patients showed improvement in their motor deficit postoperatively, 3 of 4 (75.0%) patients' sensory symptoms improved, and 17 of 19 (89.5%) patients had improvement in pain. A new or worsening deficit occurred in 5 (7.5%) patients postoperatively (2 [3.1%] motor deficits, 1 [1.5%] sensory deficit, and 3 [4.5%] with new pain). Predictors of operative intervention included lower age (odds ratio [OR], 0.952; 95% CI, 0.921-0.982; P = .001) and complete avulsion (OR, 10.292; 95% CI, 2.526-72.232; P hamstring avulsion are underrecognized. Currently, neurologic symptoms are not considered when determining whether to pursue operative intervention. Given the high likelihood of improvement with surgical treatment, neurologic symptoms should be

  9. Achilles tenodesis for calcaneal insufficiency avulsion fractures associated with diabetes mellitus.

    Science.gov (United States)

    Choi, Youngrak; Kwon, Young-Woo; Sim, Young-Suk; Kim, Taeho; Song, Dayoung; Lee, Soohyun

    2017-12-13

    Calcaneal insufficiency avulsion (CIA) fractures often present with neuropathic etiology, such as Charcot neuroarthropathy (CN). Under the same surgical procedures, the outcomes of CIA fractures are less desirable, compared to the outcomes of the traumatic calcaneal avulsion fractures. Here, the study suggests Achilles tenodesis technique using suture anchor after resection of the CIA fracture fragments could provide satisfactory clinical results in the cases of surgically indicated CIA fractures. This retrospective study included seven patients of calcaneal avulsion fracture who had underlying diabetes mellitus (DM) and no specific traumatic event. The patients were treated with Achilles tenodesis techniques for their CIA fractures. Achilles tenodesis was performed using suture anchor with removal of the fracture fragments. The patients were evaluated with the Foot and Ankle Outcome Score (FAOS), visual analogue scale (VAS), single-heel rise test, and X-ray images on their final follow-ups. Initially, three of the CIA fracture cases treated with traditional open reduction and internal fixation reported pullout failure. Consequently, all patients received Achilles tenodesis using suture anchor after bone fragment resection and had good clinical outcomes. Only one subject with low compliance reported poor outcome. The FAOS of each patient were obtained at a mean of 16.3 months after surgery. The results are as follows: pain 80.6 (SD = 6.2), symptom 83.8 (SD = 4.9), activities of daily living 80.5 (SD = 8.0), sport and recreation function 75.6 (SD = 11.93), and foot- and ankle-related quality of life 77.9 (SD = 6.7). On their final follow-ups, the average VAS was 2.6 (range, 1 to 4). Achilles tenodesis using suture anchor after bone fragment resection achieved competent clinical results in the patients with CIA fractures. The study proposes that this surgical procedure could be an appropriate treatment option for patients with CIA fractures. The

  10. Static antibiotic spacers augmented by calcium sulphate impregnated beads in revision TKA: Surgical technique and review of literature.

    Science.gov (United States)

    Risitano, Salvatore; Sabatini, Luigi; Atzori, Francesco; Massè, Alessandro; Indelli, Pier Francesco

    2018-06-01

    Periprosthetic joint infection (PJI) is a serious complication in total knee arthroplasty (TKA) and represents one of the most common causes of revision. The challenge for surgeons treating an infected TKA is to quickly obtain an infection-free joint in order to re-implant, when possible, a new TKA. Recent literature confirms the role of local antibiotic-loaded beads as a strong bactericidal, allowing higher antibiotic elution when compared with antibiotic loaded spacers only. Unfortunately, classical Polymethylmethacrylate (PMMA) beads might allow bacteria adhesion, secondary development of antibiotic resistance and eventually surgical removal once antibiotics have eluted. This article describes a novel surgical technique using static, custom-made antibiotic loaded spacers augmented by calcium sulphate antibiotic-impregnated beads to improve the success rate of revision TKA in a setting of PJI. The use of calcium sulphate beads has several potential benefits, including a longer sustained local antibiotic release when compared with classical PMMA beads and, being resorbable, not requiring accessory surgical interventions.

  11. PARTIAL ARTICULAR SUPRASPINATUS TENDON AVULSION (PASTA) LESION. CURRENT CONCEPTS IN REHABILITATION

    Science.gov (United States)

    2016-01-01

    ABSTRACT Rotator cuff pathology can contribute to shoulder pain and may affect the performance of sport activities, work, and activities of daily living. The partial articular supraspinatus tendon avulsion (PASTA) lesion represents a very common type of rotator cuff pathology seen in rehabilitation. When conservative treatment fails, surgery is generally required. Success of recovery depends on several factors, including: repair techniques, healing process related to timing, rehabilitation programs, and patient compliance with home exercises. To date, most treatment modalities and rehabilitation programs are based on clinical experience rather than scientific evidence. Therefore, the purpose of this clinical commentary is to provide an overview on the PASTA lesion, discuss the common treatment approaches adopted to date and to propose a rehabilitation program based on the available scientific evidence. Level of Evidence 5 PMID:27274431

  12. 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.

  13. 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.

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

    Science.gov (United States)

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

    1987-01-01

    A case of chronic, progressive avulsion of the anterior superior 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)

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

    1987-01-01

    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. (orig.)

  16. Clinical analysis of 54 cases of large area soft tissue avulsion in the lower limb

    Directory of Open Access Journals (Sweden)

    Yu Chen

    2016-12-01

    Conclusion: Treatment choices for skin avulsion on the lower limb should be based on the viability of the avulsed skin flap and the location of the wound. Proper choice can not only reduce the economic burden caused by using VSD, but also shorten the long hospital stay due to repeated wound dressing change or second stage surgery.

  17. Abduction in Proximal Hamstring Tendon Avulsion Injury Mechanism-A Report on 3 Athletes

    NARCIS (Netherlands)

    van der Made, Anne D.; Peters, Rolf W.; Verheul, Claire; Maas, Mario; Kerkhoffs, Gino M.

    2017-01-01

    Proximal hamstring tendon avulsions are typically sustained during forced hip hyperflexion combined with knee extension. We present 3 cases of athletes with a proximal hamstring tendon avulsion caused by an alternative injury mechanism that also involves a considerable hip abduction component

  18. Bilateral avulsion fractures of the anterior superior iliac spines in sprinters

    International Nuclear Information System (INIS)

    Khoury, M.B.; Kirks, D.R.; Martinez, S.; Apple, J.

    1985-01-01

    Three cases of bilateral pelvic avulsion fractures in adolescent sprinters are reviewed. An acute avulsion fracture of the anterior superior iliac spine (ASIS) occurred during active running in three teenaged sprinters. Radiography confirmed a healed fracture of the contralateral ASIS. The clinical features and radiologic appearances are characteristic. The pathophysiology of this type of unique pediatric fracture is discussed. Conservative treatment is successful. (orig.)

  19. Avulsion research using flume experiments and highly accurate and temporal-rich SfM datasets

    Science.gov (United States)

    Javernick, L.; Bertoldi, W.; Vitti, A.

    2017-12-01

    SfM's ability to produce high-quality, large-scale digital elevation models (DEMs) of complicated and rapidly evolving systems has made it a valuable technique for low-budget researchers and practitioners. While SfM has provided valuable datasets that capture single-flood event DEMs, there is an increasing scientific need to capture higher temporal resolution datasets that can quantify the evolutionary processes instead of pre- and post-flood snapshots. However, flood events' dangerous field conditions and image matching challenges (e.g. wind, rain) prevent quality SfM-image acquisition. Conversely, flume experiments offer opportunities to document flood events, but achieving consistent and accurate DEMs to detect subtle changes in dry and inundated areas remains a challenge for SfM (e.g. parabolic error signatures).This research aimed at investigating the impact of naturally occurring and manipulated avulsions on braided river morphology and on the encroachment of floodplain vegetation, using laboratory experiments. This required DEMs with millimeter accuracy and precision and at a temporal resolution to capture the processes. SfM was chosen as it offered the most practical method. Through redundant local network design and a meticulous ground control point (GCP) survey with a Leica Total Station in red laser configuration (reported 2 mm accuracy), the SfM residual errors compared to separate ground truthing data produced mean errors of 1.5 mm (accuracy) and standard deviations of 1.4 mm (precision) without parabolic error signatures. Lighting conditions in the flume were limited to uniform, oblique, and filtered LED strips, which removed glint and thus improved bed elevation mean errors to 4 mm, but errors were further reduced by means of an open source software for refraction correction. The obtained datasets have provided the ability to quantify how small flood events with avulsion can have similar morphologic and vegetation impacts as large flood events

  20. The Technique of the Sound Studio: Radio, Record Production, Television, and Film. Revised Edition.

    Science.gov (United States)

    Nisbett, Alec

    Detailed explanations of the studio techniques used in radio, record, television, and film sound production are presented in as non-technical language as possible. An introductory chapter discusses the physics and physiology of sound. Subsequent chapters detail standards for sound control in the studio; explain the planning and routine of a sound…

  1. [Treatment of calcaneal avulsion fractures with twinfix suture anchors fixation].

    Science.gov (United States)

    Zhao, Bin-xiu; Wang, Kun-zheng; Wang, Chun-sheng; Xie, Yue; Dai, Zhi-tang; Liu, Gang; Liu, Wei-dong

    2011-06-01

    For the calcaneal avulsion fracture, the current method is more commonly used screws or Kirschner wire to fix fracture fragment. This article intended to explore the feasibility and clinical efficacy for the treatment of avulsion fractures with TwinFix suture anchors. From July 2007 to November 2010, 21 patients were reviewed, including 15 males and 6 females, ranging in age from 49 to 65 years,with a mean of 58.7 years. Twelve patients had nodules in the right heel and 9 patients had nodules in the left heel. All the patients had closed fractures. The typical preoperative symptoms of the patients included pain in the upper heel and weak in heel lift. Body examination results: palpable sense of bone rubbing in the back of the heel, and swelling in the heel. Surgery treatment with TwinFix suture anchors performed as follows : to fix TwinFix suture anchors into the calcaneal body, then to drill the fracture block, to make the double strand suture through the fracture holes, to knot the suture eachother to fix the block, and to use stitch to fix the remaining suture in the Achilles tendon in order to improve the block fixation. The criteria of the AOFAS Foot and Ankle Surgery by the United States Association of ankle-rear foot functional recovery was used to evaluate the Achilles tendon. Total average score was (95.5 +/- 3.12) points, including pain items of(38.5 +/- 2.18) points,the average score of functional items of (49.5 +/- 3.09) points,and power lines of 10 points in all patients. Twenty-one patients got an excellent result, 16 good and 5 poor. The methods of treatment for the calcaneal avulsion fractures with TwinFix suture anchors is a simple operation, and have excellent clinical effect, which is worthy of promotion.

  2. Knowledge of Dentists on the Management of Tooth Avulsion Injuries in Rio de Janeiro, Brazil.

    Science.gov (United States)

    Menezes, Mariana Cezário; Carvalho, Ricardo G; Accorsi-Mendonça, Thais; De-Deus, Gustavo; Moreira, Edson J L; Silva, Emmanuel J N L

    2015-01-01

    To evaluate dentists' professional experience and knowledge of emergency management of tooth avulsion injuries in Rio de Janeiro, Brazil. A total of 100 questionnaires were evaluated. The first part of the questionnaire consisted of questions regarding personal information. The second part evaluated dentists' knowledge of emergency management in cases of dental avulsion. The responses for each question were counted and expressed as percentages. All dentists had a college degree or above. Only three dentists had a Master's or PhD degree. Most of the dentists (94.5%) considered time and storage media important for the prognosis of avulsed teeth. However, the dentists did not show consistent responses about the adequate time and ideal storage media to transport avulsed teeth. The study highlighted Brazilian dentists' need for continuing education in order to improve current knowledge in emergency management of avulsed teeth.

  3. Coronary sinus and atrioventricular groove avulsion after motor vehicle crash

    Directory of Open Access Journals (Sweden)

    Bradley M Dennis

    2014-01-01

    Full Text Available Simultaneous cardiac and pericardial rupture from blunt chest trauma is a highly lethal combination with rarely reported survival. We report of a case of young patient with a right atrioventricular groove injury, pericardial rupture and a unique description of a coronary sinus avulsion following blunt chest trauma. Rapid recognition of this injury is crucial to patient survival, but traditional diagnostic adjuncts such as ultrasound, echocardiography and computed tomography are often unhelpful. Successful repair of these injuries requires high suspicion of injury, early cardiac surgery involvement of and possible even placement of the patient on cardiopulmonary bypass.

  4. Avulsed Nasoenteric Bridle System Magnet as an Intranasal Foreign Body.

    Science.gov (United States)

    Puricelli, Michael D; Newberry, Christopher Ian; Gov-Ari, Eliav

    2016-02-01

    Nasoenteric tubes provide short-term nutrition support to patients unable to take an adequate oral diet. Bridling systems may be used to secure tubes to guard against displacement. We present the first case of an avulsed magnet from a bridling system to raise awareness of this potential complication. The primary methods of securing a nasogastric tube are reviewed, and comparative assessment of the 3 main systems is presented. Diagnosis and management of nasal foreign bodies relevant to this case are reviewed and prevention/safety considerations discussed. © 2015 American Society for Parenteral and Enteral Nutrition.

  5. 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.

  6. Channel Evolution Following Avulsion: an Example from the Yellow River Delta

    Science.gov (United States)

    Zheng, S.

    2017-12-01

    Long-term field observation of morphological adjustments of rivers following avulsions is lacked when studying the evolution of avulsive channel on deltas. Avulsion at the Yellow River Delta (YRD) is frequent with average lifespan of channels of only about a decade. The Qing-shui-gou channel, the recent lobe on the YRD, provides a rare opportunity for investigating channel evolution following artificial avulsion. The reasons for its longer lifespan also needs investigation of the channel evolution. In this study, we comprehensively analyzed the geomorphic adjustment of the channel based on filed survey data during 1976-2014. The evolution of the channel was impacted by anthropogenic activities, including artificial avulsion at the downstream channel reaches in 1996, alteration of runoff and sediment load through Water and Sediment Regulation Scheme (WSRS), construction of levees and dikes. Analysis on channel geometry showed that avulsions in 1976 and in 1996 both caused short-term (1 2 years) erosion at the upstream channel reaches. Following the avulsion in 1976, massive aggradation occurred at the channel reaches at the downstream of the avulsion point. A single-thread channel gradually formed, widened and enlarged as channel bed under-cut on the deposition material. As delta extended seaward and the longitudinal slope decreased with time, aggradation occurred and an alluvial ridge formed. The ratio of lateral slope to the longitudinal slope (i.e. gradient advantage) and the relative super-elevation of the channel were calculated to estimate the possibility of avulsion at the channel in the late 1990. Results showed that the slope ratio was greater than 20 locally and super-elevation near its critical value for avulsion. The fact, that natural avulsion did not occurred despite of high values of gradient advantage and super elevation, may indicate that they are not sufficient conditions for avulsion at highly human-controlled rivers, where channel boundaries are

  7. 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.

  8. Acute Gastric Volvulus Causing Splenic Avulsion and Hemoperitoneum

    Directory of Open Access Journals (Sweden)

    Yana Cavanagh

    2018-01-01

    Full Text Available Gastric volvulus is an abnormal, potentially life-threatening, torsion of the stomach. The presence of complications such as hemoperitoneum increases the diagnostic urgency; however it can also mask the presentation of gastric volvulus. We encountered a 66-year-old female who presented with symptomatic gastric outlet obstruction and was found to have hemoperitoneum and splenic avulsion on imaging. In our case, hemoperitoneum was a clinical red herring as initial imaging concentrated on the presence of hemoperitoneum and was nondiagnostic of gastric volvulus. Interestingly, our patient experienced complete resolution of her presenting symptomatology following placement of a nasogastric tube. Furthermore, endoscopic evaluation revealed no overt pathology to explain outlet obstruction. In light of these findings, gastric torsion was strongly suspected. A repeat CT scan was confirmatory, elucidated reduction of the stomach to its anatomic position, retroactively diagnosing a gastric volvulus. This case is unusual in its presentation and setting. The patient presented with two rare complications of gastric volvulus, hemoperitoneum and splenic avulsion. Additionally, ten years prior to this presentation the patient had a temporary gastrostomy tube. Gastropexy with a gastrostomy is the treatment for gastric volvulus and should have been preventative of her presentation with torsion. Furthermore, the gastric volvulus was not initially recognized radiographically due to the presence of masking radiographic findings. This case serves to highlight the utility of clinical acumen and maintain a high index of suspicion for gastric volvulus in all cases presenting with Borchardt’s triad.

  9. Proximal hamstring reconstruction using semitendinosus and gracilis autograft: a novel technique.

    Science.gov (United States)

    Muellner, Thomas; Kumar, Sandeep; Singla, Amit

    2017-01-01

    The complete proximal hamstring avulsion is relatively uncommon injury and predominantly occurs in young athletes but causes significant functional impairment. In chronic cases, the muscle mass is so much retracted that primary repair is not possible. A surgical technique for reconstruction of chronic proximal hamstring avulsion using contralateral semitendinosus and gracilis autograft is described in this case report. V.

  10. Avulsion of the Lesser Trochanter Following a Shot Put Sport Session

    Directory of Open Access Journals (Sweden)

    Mohamed H. Grissa

    2017-03-01

    Full Text Available Avulsion of the lesser trochanter is an uncommon injury. In children and adolescents it usually occurs as a sports injury via traumatic avulsion of the psoas major tendon. In adults, isolated fractures of the lesser trochanter are most commonly pathological due to metastatic tumor invasion of the proximal femur. This case report documents how a 14-year-old boy, who presented with an avulsion of the lesser trochanter of the proximal femur following a seemingly atraumatic shot put session at a track and field event, was diagnosed and successfully treated with a conservative approach.

  11. Brachialis periosteal avulsion injury: case report with magnetic resonance imaging findings

    International Nuclear Information System (INIS)

    Lam, Justin Chak Yiu; Lee, Ka Lok Ryan; Griffith, James F.

    2016-01-01

    Brachialis periosteal avulsion injury is an uncommon injury occurring in young children. The injury may be misinterpreted or overlooked because of misleading or subtle radiological findings. A case of 7-year-old child with post-traumatic elbow pain and subtle findings on elbow radiography is presented. The injury was initially misinterpreted as an avulsion fracture of the medial epicondyle. Following radiological review, a diagnosis of brachialis periosteal avulsion injury was made. The radiographic and magnetic resonance imaging (MRI) findings of this injury are presented to stress the value of comparing the radiographic findings with previous imaging and to increase awareness of this uncommon injury. (orig.)

  12. Partial Avulsion of Common Bile Duct and Duodenal Perforation in a Blunt Abdominal Trauma

    OpenAIRE

    Mirza, Bilal; Ijaz, Lubna; Iqbal, Shahid; Sheikh, Afzal

    2010-01-01

    Complete or partial avulsion of common bile duct is a very rare injury following blunt abdominal trauma in children. A 7-year old boy presented to ER following blunt abdominal trauma by a moving motorcycle. X ray abdomen revealed free air under diaphragm and CT scan showed pancreatic contusion injury. At operation anterior wall of common bile duct (CBD) along with a 2mm rim of duodenal tissue on either side of anterior wall of CBD were found avulsed from the duodenum. The avulsed portion of C...

  13. Brachialis periosteal avulsion injury: case report with magnetic resonance imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Lam, Justin Chak Yiu; Lee, Ka Lok Ryan; Griffith, James F. [Prince of Wales Hospital, Department of Imaging and Interventional Radiology, Shatin, N.T (China)

    2016-11-15

    Brachialis periosteal avulsion injury is an uncommon injury occurring in young children. The injury may be misinterpreted or overlooked because of misleading or subtle radiological findings. A case of 7-year-old child with post-traumatic elbow pain and subtle findings on elbow radiography is presented. The injury was initially misinterpreted as an avulsion fracture of the medial epicondyle. Following radiological review, a diagnosis of brachialis periosteal avulsion injury was made. The radiographic and magnetic resonance imaging (MRI) findings of this injury are presented to stress the value of comparing the radiographic findings with previous imaging and to increase awareness of this uncommon injury. (orig.)

  14. Outcomes following 50 consecutive endoscopic gastrojejunal revisions for weight gain following Roux-en-Y gastric bypass: a comparison of endoscopic suturing techniques for stoma reduction.

    Science.gov (United States)

    Patel, Lava Y; Lapin, Brittany; Brown, Craig S; Stringer, Thomas; Gitelis, Matthew E; Linn, John G; Denham, Woody E; Farwell, Elizabeth; Haggerty, Stephen; Ujiki, Michael B

    2017-06-01

    Approximately 20-30 % of morbidly obese patients undergoing Roux-en-Y gastric bypass (RYGB) will experience significant weight regain in the years following surgery. Endoscopic gastrojejunal revision (EGJR) has been shown to be a safe, effective and less invasive alternative to revisional surgery, with promising weight loss outcomes. However, minimal data exist regarding how to perform the procedure most effectively and what factors may predict good outcomes. We compared weight loss outcomes between patients undergoing endoscopic stoma revision by one of two full-thickness suturing techniques. A retrospective review of patients undergoing EGJR between 06/2012 and 09/2015 was performed. Included patients were adults 18-74 years of age who had experienced weight regain ≥2 years after initial RYGB with stoma dilation ≥15 mm in diameter. Revision was done with either an interrupted (IRT) or purse-string (PST) suture technique. A linear mixed effects model was constructed to predict postoperative weight loss. Fifty revisions (IRT = 36, PST = 14) were performed in 47 patients (92 % female, mean age of 50.9 ± 10.9 years and body mass index of 41.4 ± 7.1 kg/m 2 ). Technical success (stoma diameter ≤10 mm) was achieved in all cases. Final diameter was significantly smaller in the PST group, 6.6 ± 2.2 mm versus 4.8 ± 1.8 mm (p weight loss over time compared to IRT. Sixteen comorbid conditions resolved among 12 patients. No major complications occurred. Endoscopic revision of the gastric outlet results in meaningful weight loss and comorbidity resolution in select patients experiencing weight regain following RYGB. A PST revision likely results in higher and more sustainable weight loss when compared to IRT.

  15. 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.

  16. Knowledge and attitude of some nigerian school teachers on the emergency management of avulsed permanent incisor.

    Science.gov (United States)

    Olatosi, O O; Iwuala, S O; Isiekwe, G I; Oredugba, F A; Adenaike, A S; Oluwo, A O

    2013-01-01

    Tooth avulsion has been known to be the most severe of all dental injuries. The immediate action taken at the accident site will determine the prognosis of the tooth. Replantation of an avulsed tooth is the treatment of choice. To assess the knowledge and attitude of primary and secondary (Basic educational) school teachers on the emergency management of avulsed permanent incisors. Twenty public and private basic educational schools were randomly selected from Lagos State. Descriptive cross-sectional study. A 23 item self administered questionnaire was distributed to teachers to determine their knowledge and attitude on the emergency management of avulsed permanent incisors. Data was analysed using SPSS (Statistical Package for Social Sciences), Version 21.0. The responses obtained were tabulated and expressed as frequency distributions and then computed in percentages. Chi-square was used to test the association between knowledge of the schools teachers regarding the emergency management of avulsed permanent incisors and their socio-demographic variables. Multivariate analysis was used to adjust for confounding variables. The level of significance was set at P ≤0.05. A total of 320 teachers answered the questionnaires. Most of the teachers were female (63.1%). Only (30.9%) had received first aid training which included emergency management of dental trauma. Forty- two percent (134) didn't know that an avulsed permanent tooth could be replanted. Twenty teachers (44.4%) would clean an avulsed tooth with toothbrush and toothpaste. A greater proportion of the respondents 130 (40.6%) would transport an avulsed tooth using a clean white handkerchief. The overall knowledge of the school teachers was poor (84%).There was a statistically significant association between the knowledge of the school teachers and the inclusion of emergency management of dental trauma in the first aid training of the teachers P=0.05. Predictors of teachers' level of knowledge of emergency

  17. 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.

  18. SIMULTANEOUS BILATERAL AVULSION FRACTURE OF THE TIBIAL TUBEROSITY IN A TEENAGER: CASE REPORT AND THERAPY USED.

    Science.gov (United States)

    E Albuquerque, Rodrigo Pires; Giordano, Vincenzo; Carvalho, Antônio Carlos Pires; Puell, Thiago; E Albuquerque, Maria Isabel Pires; do Amaral, Ney Pecegueiro

    2012-01-01

    Simultaneous bilateral avulsion fracture of the tibial tuberosity in teenagers is a rare lesion. We describe the first case in the literature, in a teenage girl who sustained a fall while jumping during a volleyball match. No predisposing factors were iden tified. The lesions were treated with open surgical reduction and internal fixation. The aim of the present study was to present a case of simultaneous bilateral avulsion fracture of the tibial tuberosity in a teenage girl and the therapy used.

  19. A 12-Year Retrospective Study of Avulsion Cases in a Public Brazilian Dental Trauma Service.

    Science.gov (United States)

    Mesquita, Gabriela Campos; Soares, Priscilla Barbosa Ferreira; Moura, Camilla Christian Gomes; Roscoe, Marina Guimarães; Paiva, Saul Martins; Soares, Carlos José

    2017-01-01

    This study assessed the epidemiological characteristics and management of the permanent teeth avulsion cases attended in a Brazilian dental trauma service from December 2005 to August 2016. A retrospective study was conducted of case records of 93 patients involving 139 avulsed teeth. Data included sex, age, trauma etiology, location of the accident, number and position of avulsed teeth, and presence and type of associated traumatic lesions. Management of the avulsed teeth was addressed as: time elapsed until teeth were retrieved from the accident's location; teeth's cleaning method and storage media; time elapsed until seeking treatment and replantation. The majority of the patients were children from 6-10 (31.2%) and 11-15 years old (26.9%). Male patients were more affected than female. Bicycle accident was the main etiological factor (31.2%). In 56 (60.2%) cases, traumatic lesions to neighboring teeth were present. In 55 (59.1%) cases, lesions to adjacent soft tissues were reported. In 82 (88.2%) cases, patients requested treatment at the same day of the accident. Sixty-four teeth (46.0%) were immediately retrieved and 28 (20.1%) were not found. Forty-two teeth (30.2%) were kept dry. Only one tooth (0.7%) was immediately replanted at the accident's site, while 51 teeth (36.7%) were not replanted. Numerous avulsed teeth were inappropriately managed and immediate replantation was not frequent. Public policies must be created to raise awareness towards the particularities of avulsion cases.

  20. Sequential avulsions of the tibial tubercle in an adolescent basketball player.

    Science.gov (United States)

    Huang, Ying Chieh; Chao, Ying-Hao; Lien, Fang-Chieh

    2010-05-01

    Tibial tubercle avulsion is an uncommon fracture in physically active adolescents. Sequential avulsion of tibial tubercles is extremely rare. We reported a healthy, active 15-year-old boy who suffered from left tibial tubercle avulsion fracture during a basketball game. He received open reduction and internal fixation with two smooth Kirschner wires and a cannulated screw, with every effort to reduce the plate injury. Long-leg splint was used for protection followed by programmed rehabilitation. He recovered uneventfully and returned to his previous level of activity soon. Another avulsion fracture happened at the right tibial tubercle 3.5 months later when he was playing the basketball. From the encouragement of previous successful treatment, we provided him open reduction and fixation with two small-caliber screws. He recovered uneventfully and returned to his previous level of activity soon. No genu recurvatum or other deformity was happening in our case at the end of 2-year follow-up. No evidence of Osgood-Schlatter disease or osteogenesis imperfecta was found. Sequential avulsion fractures of tibial tubercles are rare. Good functional recovery can often be obtained like our case if we treat it well. To a physically active adolescent, we should never overstate the risk of sequential avulsion of the other leg to postpone the return to an active, functional life.

  1. Geomorphology, facies architecture, and high-resolution, non-marine sequence stratigraphy in avulsion deposits, Cumberland Marshes, Saskatchewan

    Science.gov (United States)

    Farrell, K. M.

    2001-02-01

    proposed by Smith et al. (Sedimentology, vol. 36 (1989) 1) is revised to include facies and geometries consistent with a bayfill model. By analogy with delta lobes, the avulsion sequence is a parasequence, provided that its definition is modified to be independent from sea level. In non-marine settings, facies contacts at the tops of regional peats, coals, and paleosols are analogous to marine flooding surfaces. A parasequence is redefined here as a relatively conformable succession of genetically related strata or landforms that is bounded by regional flooding surfaces or their correlative surfaces. This broader definition incorporates the concept of landscape evolution between regional flooding surfaces in a variety of depositional settings. With respect to landscape evolution, accommodation space has three spatial dimensions — vertical ( x), lateral ( y), and down-the-basin ( z). A flood basin fills in as landforms vertically ( x) and laterally accrete ( y), and prograde down-the-basin ( z). Vertical aggradation is limited by the elevation of maximum flood stage (local base level). Differential tectonism and geomorphology control the slope of the flood basin floor and the direction of landscape evolution. These processes produce parasequences that include inclined stratal surfaces and oriented, stacked macroforms (clinoforms) that show the magnitude and direction of landscape evolution.

  2. DENTAL SPLINTS: TYPES AND TIME OF IMMOBILIZATION POST TOOTH AVULSION

    Directory of Open Access Journals (Sweden)

    Samuel Rodrigo de Andrade VERAS

    2017-12-01

    Full Text Available Avulsion is defined as the complete displacement of the tooth out of its socket with disruption of the fibers of periodontal ligament, remaining some of them adhered to the cementum and the rest to the alveolar bone. This condition is more frequent in young permanent teeth, because the root development is still incomplete. Splints are used to immobilize traumatized teeth that suffered damage in their structures of support, preventing their constant movement. The literature has shown that after replantation, it is necessary to use splints in order to immobilize the teeth during the initial period, which is essential for the repair of periodontal ligament; the use of semi-rigid splint is more indicated than the rigid one, and long periods of splinting showed that substitutive resorption or ankylosis is an expected complication. Thus, the aim of this review is to describe the different types of splints; their time of permanency, and its influence on the process of healing and reparation on the occurrence of substitutive resorption or ankylosis. It is very important to keep gathering knowledge about this content, since it has been proved that the approaches and the protocols keep changing over time.

  3. [Ultrabraid SUTURE WITH FOOTPRINT RIVET FOR ANTERIOR CRUCIATE LIGAMENT TIBIAL EMINENCE AVULSION FRACTURE IN ADOLESCENTS UNDER ARTHROSCOPY].

    Science.gov (United States)

    Liang, Jinying; Zheng, Jiapeng; Ll, Qiang; Zhong, Shuyu; Chen, Minzhen

    2015-06-01

    To investigate the clinical effects of the Ultrabraid suture with FOOTPRINT rivet by arthroscopic technique for the treatment of anterior cruciate ligament (ACL) tibial eminence avulsion fracture. Between May 2011 and December 2013, 19 adolescent patients with ACL tibial eminence avulsion fracture were treated with arthroscopic reduction and fixation by Ultrabraid sutures with FOOTPRINT rivet. There were 13 males and 6 females with an average age of 15.8 years (range, 8-18 years). The left knees were involved in 10 cases and the right knees in 9 cases. The injury causes included traffic accident injury in 8 cases, sport injury in 6 cases, and sprain injury in 5 cases. Three patients had old fractures, and the others had fresh fractures. The results of Lachman test and anterior drawer test were both positive. The International Knee Documentation Committee (IKDC) subject score was 54.2 ± 4.0. Based on Meyers-McKeever classification, there were 3 cases of type II, 10 cases of type III, and 6 cases of type IV. The operation time was 50-60 minutes (mean, 55.2 minutes). X-ray film showed satisfactory fracture reduction at 1 day after operation. Primary healing of incision was obtained with no infection. Eighteen patients were followed up for 1-3 years (mean, 1.7 years). All fractures healed with smooth joint surface on the X-ray film at 3 months after operation. The results of Lachman test and anterior drawer test were both negative in 17 cases, and the results was negative for anterior drawer test and was weakly positive for Lachman test in 1 case. The IKDC subject score was significantly improved to 96.1 ± 2.1 at last follow-up (t = 34.600, P = 0.000). It could achieve early restoration of knee joint function to treat the ACL tibial eminence avulsion fracture by arthroscopic technique of the Ultrabraid suture with FOOTPRINT rivet because of satisfactory reduction, reliable fixation, small wound, and early rehabilitation.

  4. The diagnostic accuracy of 1.5T magnetic resonance imaging for detecting root avulsions in traumatic adult brachial plexus injuries.

    Science.gov (United States)

    Wade, Ryckie G; Itte, Vinay; Rankine, James J; Ridgway, John P; Bourke, Grainne

    2018-03-01

    Identification of root avulsions is of critical importance in traumatic brachial plexus injuries because it alters the reconstruction and prognosis. Pre-operative magnetic resonance imaging is gaining popularity, but there is limited and conflicting data on its diagnostic accuracy for root avulsion. This cohort study describes consecutive patients requiring brachial plexus exploration following trauma between 2008 and 2016. The index test was magnetic resonance imaging at 1.5 Tesla and the reference test was operative exploration of the supraclavicular plexus. Complete data from 29 males was available. The diagnostic accuracy of magnetic resonance imaging for root avulsion(s) of C5-T1 was 79%. The diagnostic accuracy of a pseudomeningocoele as a surrogate marker of root avulsion(s) of C5-T1 was 68%. We conclude that pseudomeningocoles were not a reliable sign of root avulsion and magnetic resonance imaging has modest diagnostic accuracy for root avulsions in the context of adult traumatic brachial plexus injuries. III.

  5. Laypeoples' preferred sources of health information on the emergency management of tooth avulsion.

    Science.gov (United States)

    Al-Sane, Mona; Bourisly, Nibal; Almulla, Taghreed; Andersson, Lars

    2011-12-01

    When planning nationwide information campaigns on the emergency management of tooth avulsion, the populations' preference to different modes of information delivery should be taken into consideration. We currently lack information on that. The aim of this study was, therefore, to assess laypeoples' preferred sources of information on the emergency management of tooth avulsion. This was a joint study undertaken by experts in media and experts in dental traumatology. Interview-assisted questionnaires were conducted on a sample of 579 adults from Kuwait. Subjects were asked to choose their three preferred sources of information on the emergency management of tooth avulsion. Subjects' responses and sociodemographic data were registered. The data were descriptively analyzed, and a chi-square test was used to assess the relation of the subjects' preferences to their registered demographics. The Internet, health care professionals, and TV were the three most preferred sources of information on the emergency management of tooth avulsion across all groups, regardless of the sociodemographic characteristics. Younger adults, singles and subjects with higher education significantly preferred the Internet. Older adults preferred TV. Family was a preferred source in geographic districts populated with extended families, while friends were a preferred source in geographic districts populated by expatriates. Younger people and those with higher education can be effectively targeted through the Internet, while it is more effective to target older people through TV. Information, on tooth avulsion management, given by health care professionals is preferred across all population segments. © 2011 John Wiley & Sons A/S.

  6. Primary School Teachers’ Knowledge Regarding Emergency Management of Avulsed Permanent Incisors

    Directory of Open Access Journals (Sweden)

    B. Touré

    2011-09-01

    Full Text Available Objective: The goal of this study was to evaluate primary school teachers' knowledge regarding emergency management of avulsed permanent incisors.Materials and Methods: The study was conducted in fifty randomly chosen primary schools from Casablanca, Morocco. All teachers of the selected schools were included in the study. The data were collected by self administered questionnaires. The questions focusedon the teachers' general characteristics, experience of avulsed teeth and the importance of emergency management. The data were analyzed using chi square test.Results: A total of 501 teachers, of which 23.6% were male and 75.4% were female, answered the questionnaire. The results showed that 44.5 % of the teachers had an experience of avulsed tooth at school, 82.82% of them knew the importance of emergency managementand 32.6% would look for a dentist for treatment of the cases. Only 15.8% would reimplant the tooth themselves. Regarding the storage media, 21.95% would keep the avulsed tooth in milk. There was no significant difference between gender and education level (p>0.05.Conclusion: This study shows school teachers' lack of knowledge regarding dental trauma and especially tooth avulsion. Therefore, the results indicated that educational programs are necessary for improvement in their level of knowledge.

  7. Radiographic and pathologic characterization of lateral palmar intercarpal ligament avulsion fractures in the horse.

    Science.gov (United States)

    Beinlich, Christopher P; Nixon, Alan J

    2004-01-01

    In this study, the radiographic and histologic appearance of lateral palmar intercarpal ligament (LPICL) avulsion in the horse was characterized. Thirty-seven horses with radiographic evidence of avulsion fragments originating from the medial palmar aspect of the ulnar carpal bone were examined. The dorsolateral to palmaromedial projection was useful for evaluating the size and shape of the avulsed bone fragment, and the dorsopalmar projection added information on the relative proximity of the fragment to its fracture bed. Radiographic features that differentiated LPICL avulsion from subchondral cystic lesions of the ulnar carpal bone included a variable-sized osseous opacity adjacent to the lucent concavity of the fracture bed and the consistent location within the palmar transition zone at the confluence of LPICL insertion and hyaline cartilage on the palmar surface of the ulnar carpal bone. All 26 horses having surgical removal of the fragments had arthroscopic confirmation that the fragment was within the LPICL. Histologic examination confirmed the fragments were fracture related rather than developmental or the result of dystrophic mineralization. Many of the fragments had attached remnants of a ligament. This study describes the radiographic, surgical, and histologic features in 37 horses which better characterize LPICL avulsion fracture in the carpus and provide differentiating features to assist in separating this syndrome from true osseous cyst-like lesions within the ulnar carpal bone.

  8. Unintended Avulsion of Hypertrophic Adenoids in Posterior Nasopharynx: A Case Report of a Rare Complication Caused by Nasotracheal Intubation

    Directory of Open Access Journals (Sweden)

    Hao-Hu Chen

    2014-01-01

    Full Text Available The enlarged adenoid serves as a mechanical obstacle on the nasopharynx to intricate nasotracheal intubation. No matter what video or direct laryngoscopic techniques are applied, nasotracheal tube navigation from the nasal valve area through the nasal cavity to the nasopharynx is always blind; trauma is not uncommon. Here we report a case of unintended avulsed adenoids that plugged the tube tip while the nasotracheal tube blindly navigated through the nasopharyngeal space. After failing to insert a bent tip of gum elastic bougie passing through the nasopharynx, an alternative method of NTI was performed by mounting the nasotracheal tube on a fiberoptic bronchoscope. The nasotracheal tube was successfully railroaded along the insertion tube of the fiberscope to the trachea.

  9. An in-vitro biomechanical study of different fixation techniques for the extended trochanteric osteotomy in revision THA.

    Science.gov (United States)

    Zhu, Zhonglin; Ding, Hui; Shao, Hongyi; Zhou, Yixin; Wang, Guangzhi

    2013-04-09

    The wire fixation and the cable grip fixation have been developed for the extended trochanteric osteotomy (ETO) in the revision of total hip arthroplasty (THA). Many studies reported the postoperative performance of the patients, but with little quantitative biomechanical comparison of the two fixation systems. An in-vitro testing approach was designed to record the loosening between the femoral bed and the greater trochanter after fixations. Ten cadaveric femurs were chosen in this study. Each femur underwent the THA, revision by ETO and fixations. The tension to the greater trochanter was from 0 to 500N in vertical and lateral direction, respectively. The translation and rotation of the greater trochanter with respect to the bony bed were captured by an optical tracking system. In the vertical tension tests, the overall translation of the greater trochanter was observed 0.4 mm in the cable fixations and 7.0 mm in the wire fixations. In the lateral tension tests, the overall motion of the greater trochanter was 2.0 mm and 1.2° in the cable fixations, while it was 6.2 mm and 5.3° in the wire fixations. The result was significantly different between the two fixation systems. The stability of the proximal femur after ETO using different fixations in the revision THA was investigated. The cable grip fixation was significantly more stable than the wire fixation.

  10. 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

  11. Avulsion and its implications for fluvial-deltaic architecture: insights from the Holocene Rhine-Meuse delta

    NARCIS (Netherlands)

    Stouthamer, E.; Cohen, K.M.; Gouw, M.J.P.

    2010-01-01

    Avulsion is a key process in the formation of fluvial-deltaic successions and a primary control on deltaic architecture. It determines the distribution of sediment and water and hence which location in the delta receives clastic sedimentation for what time. This makes the avulsion process an

  12. Experimental investigation of channel avulsion frequency on river deltas under rising sea levels

    Science.gov (United States)

    Silvestre, J.; Chadwick, A. J.; Steele, S.; Lamb, M. P.

    2017-12-01

    River deltas are low-relief landscapes that are socioeconomically important; they are home to over half a billion people worldwide. Many deltas are built by cycles of lobe growth punctuated by abrupt channel shifts, or avulsions, which often reoccur at a similar location and with a regular frequency. Previous experimental work has investigated the effect of hydrodynamic backwater in controlling channel avulsion location and timing on deltas under constant sea level conditions, but it is unclear how sea-level rise impacts avulsion dynamics. We present results from a flume experiment designed to isolate the role of relative sea-level rise on the evolution of a backwater-influenced delta. The experiment was conducted in the river-ocean facility at Caltech, where a 7m long, 14cm wide alluvial river drains into a 6m by 3m "ocean" basin. The experimental delta grew under subcritical flow, a persistent backwater zone, and a range of sea level rise rates. Without sea level rise, lobe progradation produced in-channel aggradation and periodic avulsions every 3.6 ± 0.9 hours, which corresponded to when channels aggraded to approximately one-half of their flow depth. With a modest rate of sea-level rise (0.25 mm/hr), we observed enhanced aggradation in the backwater zone, causing channels to aggrade more quickly and avulse more frequently (every 2.1 ± 0.6 hours). In future work, we expect further increases in the rate of relative sea-level rise to cause avulsion frequency to decrease as the delta drowns and the backwater zone retreats upstream. Experimental results can serve as tests of numerical models that are needed for hazard mitigation and coastal sustainability efforts on drowning deltas.

  13. Anterior avulsion fracture of the tibial tuberosity in adolescents - Two case reports

    Directory of Open Access Journals (Sweden)

    Aleilimar Teixeira da Silva Júnior

    Full Text Available ABSTRACT The objective here was to report two rare cases of anterior avulsion fracture of the tibial tuberosity in adolescents. Case 1 was a 15-year-old male who became injured through landing on his left knee and presented limited extension. Case 2 was a 16-year-old basketball player who presented sudden pain in the right knee and functional incapacity, after a jump. Imaging examinations (radiographs and computed tomography showed anterior avulsion fractures of the tibial tuberosity. Surgical fixation was performed using screws and anchors, while avoiding growth plate injury. The cases evolved without lower-limb deformities.

  14. 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.)

  15. Nuchal crest avulsion fracture in 2 horses : a cause of headshaking : clinical communication

    Directory of Open Access Journals (Sweden)

    A. Voigt

    2009-05-01

    Full Text Available The medical records of 2 Thoroughbred horses that developed headshaking after blunt trauma to the occipital region are reviewed. The history, signalment, clinical signs, diagnostic methods, diagnosis and treatment were recorded in each case. Both horses displayed headshaking, while one horse repeatedly lifted its upper lip and pawed excessively at the ground. In both horses, diagnostic imaging of the occipital region revealed avulsion fragments of the nuchal crest and a nuchal desmitis in association with hyperfibrinogenaemia. The presence of an avulsion fragment of the nuchal crest with associated nuchal desmitis should be considered in horses presenting with headshaking and may respond favourably to conservative therapy.

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

    International Nuclear Information System (INIS)

    Fernandes, Joao Luiz; Viana, Sergio Lopes; Mendonca, Jose Luiz Furtado de; Freitas, Flavia Mendes Oliveira; Lima, Gylse-Anne de Souza; Vila, Ana Fabiola da; Ribeiro, Nelmar

    2005-01-01

    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)

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

    International Nuclear Information System (INIS)

    Polyzoidis, Konstandinos; Vranos, Georgios; Petropoulou, Calliope; Argyropoulou, Paraskevi I.; Argyropoulou, Maria I.; Sarmas, Ioannis

    2002-01-01

    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.)

  18. Microvascular replantation of avulsed tissue after a dog bite of the face

    African Journals Online (AJOL)

    Various authors have described successful microsurgical replantation of totally avulsed facial tissue. In a significant nwnber of cases difficulties were experienced with the venous anastomoses and/or venous drainage of the tissue. Many different methods were used to overcome the problem. Despite these difficulties, good ...

  19. Lateral collateral ligament avulsion of the humeroradial joint in a horse

    International Nuclear Information System (INIS)

    Chopin, J.B.; Wright, J.D.; Melville, L.; Robinson, W.F.

    1997-01-01

    This report describes traumatic avulsion of the lateral collateral ligament of the humeroradial joint in a horse. The history and diagnostic procedures are included with relevant radiographs and ultrasonographs. The poor prognosis associated with this injury is due to degenerative joint disease

  20. 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.

  1. Results of operative treatment of avulsion fractures of the iliac crest apophysis in adolescents.

    Science.gov (United States)

    Li, Xigong; Xu, Sanzhong; Lin, Xiangjin; Wang, Quan; Pan, Jun

    2014-04-01

    Avulsion fracture of the iliac crest apophysis is a rare condition that commonly occurs in adolescent athletes. Conservative treatment for this injury can produce excellent functional outcomes. However, the rehabilitation process requires a rather long immobilisation period. This study aimed to evaluate the use of cannulated screws for fixation of avulsion fractures of iliac crest apophysis. Ten patients with avulsion fractures of iliac crest apophysis were treated by open reduction and internal fixation using cannulated screws. The mean age of patients was 14.6 years (range, 13-15 years). The mean intraoperative blood loss was 14.9 ml (range, 10-25 ml). The mean operative time was 40.3 min (range, 33-52 min). The mean follow-up period was 11.2 months (range, 6-20 months). At the 4-week follow-up, all patients returned to previously normal activity without pain and had no evidence of lower extremity muscle weakness. At the final follow-up, all patients resumed their athletic activity without any complications. Open reduction and internal fixation for the treatment of avulsion fracture of iliac crest apophysis can be recommended for patients requiring rapid rehabilitation. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Depositional record of an avulsive fluvial system controlled by peat compaction (Neogene, Most Basin, Czech Republic)

    Czech Academy of Sciences Publication Activity Database

    Rajchl, M.; Uličný, David

    2005-01-01

    Roč. 52, č. 3 (2005), s. 601-625 ISSN 0037-0746 R&D Projects: GA ČR GA205/01/0629 Institutional research plan: CEZ:AV0Z30120515 Keywords : avulsion * Eger Graben * fluvial channels Subject RIV: DB - Geology ; Mineralogy Impact factor: 1.876, year: 2005

  3. Traumatic partial avulsion of a single right subclavian artery from the aortic arch and definitive repair.

    Science.gov (United States)

    Kapetanakis, Emmanouil I; Sears-Rogan, Pamela; Young, Richard S; Kanda, Louis T; Ellis, Jennifer L

    2006-01-01

    Blunt injury to the right subclavian artery is a rare complication of severe deceleration trauma often associated with significant morbidity and mortality. We describe an atypical presentation in a patient who sustained a traumatic avulsion of his right subclavian artery arising off the aortic arch. An interposition graft was used to restore the continuity of the artery to the ascending thoracic aorta.

  4. 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

  5. Polish school nurses' knowledge of the first-aid in tooth avulsion of permanent teeth.

    Science.gov (United States)

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

    2016-03-09

    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. 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 referring to nurses' experience and training in dental trauma and questions checking knowledge of first-aid in the avulsion of permanent teeth. The maximum number of points to be scored was eight. Data were analyzed with the Kruskal-Wallis, the Mann-Whitney U and Chi(2) tests with the level of statistical significance at p nurses of which 70.1 % had experience with dental injuries and 45.7 % witnessed a tooth avulsion in pupils. 10.4 % nurses participated in training courses concerning tooth avulsion and 67.1 % of them independently broadened their knowledge. The knowledge of the first-aid management of an avulsed tooth was moderate (4.72 ± 1.95 points). 78.1 % of nurses chose a correct definition of the term of 'tooth avulsion'. Only 7.3 % of them were aware that the replantation could be conducted by any witness of an accident. Saline was most often chosen as a proper transport medium for an avulsed tooth (57.9 %), whereas 16.1 % of nurses indicated milk. 13.4 % of evaluated nurses showed readiness to conduct an immediate replantation. Most respondents preferred calling child's parents and advising them to bring the child to a dentist (63.4 %). The main factor influencing nurses' level of knowledge was self-education (p schools with sports classes (p = 0.0423) were positive determinants of improved knowledge. Nurses from large agglomerations had significantly lower knowledge (p = 0.005). The main source of information for self-education was the Internet. The evaluated nurses were in need of

  6. Internal fixation of severely displaced mandibular condylar neck fracture with the aid of ramus osteotomy. A revised technique

    DEFF Research Database (Denmark)

    Hillerup, S

    1997-01-01

    A technique is described whereby the mandibular condyle can be located, replaced and fixed in case of a severely displaced fracture with exarticulation of the condylar head.......A technique is described whereby the mandibular condyle can be located, replaced and fixed in case of a severely displaced fracture with exarticulation of the condylar head....

  7. Avulsion Fracture of the Coracoid Process at the Coracoclavicular Ligament Insertion: A Report of Three Cases

    Directory of Open Access Journals (Sweden)

    Takeshi Morioka

    2016-01-01

    Full Text Available Avulsion fracture at the site of attachment of the coracoid process of the coracoclavicular ligament (CCL is extremely rare. We presented three adult cases of this unusual avulsion fracture associated with other injuries. Case  1 was a 25-year-old right-handed male with a left distal clavicular fracture with an avulsion fracture of the coracoid attachment of the CCL; this case was treated surgically and achieved an excellent outcome. Case  2 was a 39-year-old right-handed male with dislocation of the left acromioclavicular joint with two avulsion fractures: one at the posteromedial surface of the coracoid process at the attachment of the conoid ligament and one at the inferior surface of the clavicle at the attachment site of the trapezoid ligament; this case was treated conservatively, and unfavorable symptoms such as dull pain at rest and sharp pain during some daily activities remained. Case  3 was a 41-year-old right-handed female with a right distal clavicular fracture with an avulsion fracture of the coracoid attachment of the conoid ligament; this case was treated conservatively, and the distal clavicular fracture became typical nonunion. These three cases corresponded to type I fractures according to Ogawa’s classification as the firm scapuloclavicular connection was destroyed and also to double disruption of the superior shoulder suspensory complex. We recommend surgical intervention when treating patients with this type of acute or subacute injury, especially in those engaging in heavy lifting or overhead work.

  8. Fatal intra-abdominal hemorrhage as a result of avulsion of the gallbladder: a postmortem case report

    International Nuclear Information System (INIS)

    Usui, Akihito; Kawasumi, Yusuke; Hosokai, Yoshiyuki; Saito, Haruo; Igari, Yui; Funayama, Masato

    2013-01-01

    Gallbladder injuries are extremely rare in blunt trauma, with a reported incidence of <2%. We report an autopsy case of fatal hemorrhagic shock due to intra-abdominal bleeding resulting from complete avulsion of the gallbladder associated with liver cirrhosis. Multiplanar images derived from multislice computed tomography (MSCT) performed as part of pre-autopsy screening showed complete avulsion of the gallbladder without any other associated intra-abdominal injuries, facilitating forensic autopsy planning. In this report, we discuss the role of MSCT in cases of fatal intra-abdominal bleeding caused by avulsion of the gallbladder and discuss the mechanism of this injury

  9. Late Glacial and Holocene avulsions of the Rio Pastaza Megafan (Ecuador-Peru): frequency and controlling factors

    Science.gov (United States)

    Bernal, Carolina; Christophoul, Frédéric; Darrozes, José; Soula, Jean-Claude; Baby, Patrice; Burgos, José

    2011-10-01

    The geomorphological study by means of remote sensing imagery of the Rio Pastaza Megafan (Ecuador and northern Peru) reveals the traces of numerous avulsions. One hundred and eight avulsion sites have been defined. The location of these sites, the available radiocarbon ages as well as historical maps of the seventeenth century, enable us to propose an evolution history of the migration and avulsions of the Rio Pastaza since the Last Glacial Maximum. The first avulsions of the Río Pastaza occurred after the LGM in a zone close to and roughly parallel to the sudandean front, where the developed avulsion gave a distributive pattern to the ancient stream of the Río Pastaza in an area located between the modern Río Morona and Pastaza, where they caused the Rio Pastaza to develop a fan-like distributary pattern. This is interpreted as a response to thrust-related forelimb tilt, progressively shifting eastward the Rio Pastaza and the apex of the megafan. This sequence of events ended with the Great Diversion of the Rio Pastaza towards the modern Rios Corrientes and Tigre. Avulsions occurred in the Tigre-Corrientes Area between 9200 and 8,500 years Cal BP. Afterwards, the Río Pastaza was diverted to its present-day north-south course. This last significant avulsion occurred before AD 1691. In the area located between the modern Río Morona and Pastaza, avulsion frequency—probably overestimated—ranges between 100 and 200 years. In the Ríos Tigre and Corrientes area, avulsion frequency—probably underestimated—ranges from 300 to 400 years. Regional tectonics is likely to have triggered most of the avulsions in the Morona Pastaza area but its influence is restricted to this area. The factors controlling the avulsions in the Tigre-Corrientes area are less clear because the frequently described "hydrologic"-driven avulsion as observed in areas characterized by contrasted hydrologic cycles are inconsistent with the characteristics of the hydrologic cycles of the Rio

  10. [Effectiveness of arthroscopic treatment of anterior cruciate ligament tibial eminence avulsion fracture with non-absorbable suture fixation combined with mini-plate].

    Science.gov (United States)

    Wang, Suiyuan; Xiao, Yang; Tong, Zuoming; Li, Guiqiu; Jiang, Juhua; Yao, Jinghui; Wu, Zhiyong; Li, Tengfei; Wu, Qun

    2013-09-01

    To evaluate the surgical techniques and effectiveness of arthroscopic treatment of anterior cruciate ligament (ACL) tibial eminence avulsion fracture with non-absorbable suture fixation combined with the miniplate. Between January 2009 and March 2012, 32 patients with ACL tibial eminence avulsion fractures were treated. There were 18 males and 14 females, aged 12-40 years (mean, 17.5 years). The injury causes included traffic accident injury in 15 cases, sport injury in 6 cases, and falling injury in 11 cases. The time from injury to operation ranged 7-18 days with an average of 9.5 days. Before operation, the results of Lachman test were all positive; the Lysholm score was 52.13 +/- 4.22 and the International Knee Documentation Committee (IKDC) score was 44.82 +/- 2.44. According to Meyers-McKeever classification criteria, there were 12 cases of type II and 20 cases of type III. After arthroscopic poking reduction of fracture, tibial eminence avulsion fractures were fixed with the Ethibond non-absorbable sutures bypass figure-of-eight tibial tunnel combined with the metacarpal and phalangeal mini-plate. Primary healing was obtained in all incisions; no joint infection or skin necrosis occurred after operation. All patients were followed up with an average time of 22.4 months (range, 12-50 months). The patients showed negative Lachman test at 12 weeks after operation. Except 3 patients having knee extension limitation at last follow-up, the knee extension range of motion (ROM) was normal in the other patients; the knee flexion ROM was normal in all patients. The Lysholm score and IKDC score were significantly improved to 94.19 +/- 0.93 and 94.35 +/- 1.22 at last follow-up, showing significant differences when compared with preoperative values (t = 55.080, P = 0.000; t = 101.715, P = 0.000). The arthroscopic treatment of ACL tibial eminence avulsion fracture with Ethibond non-absorbable suture fixation combined with mini-plate is an effective procedure with the

  11. The effect of laterally positioned flap-revised technique and 24% ethylenediaminetetraacetic acid root conditioning on root coverage: A case report

    Directory of Open Access Journals (Sweden)

    Jagmohan Singh

    2014-07-01

    Full Text Available Complete root coverage is considered the true goal of treatment of gingival recession defects because only complete coverage assures recovery from the hypersensitivity and esthetic defects associated with recession areas. Previous studies have shown that the laterally positioned flap (LPF technique or root surface biomodification yields a higher percentage of complete root coverage upon gingival recession treatment. This article highlights the use of the laterally positioned pedicle flap-revised technique (LPFRT as a modification of the LPF technique, along with 24% EDTA gel as a root surface biomodification agent, in the management of localized gingival recession defects. Clinical examination revealed a Miller class II recession defect on the buccal aspect of the lower right central incisor, as well as the presence of aberrant frenum pull adjacent to the recession defect. The LPFRT, together with 24% EDTA gel, was speculated to cover the gingival recession defect. The frenectomy, along with periosteal fenestration, was planned simultaneously with LPFRT. After 6 months of therapy, the clinical condition was stable with complete root coverage and satisfactory healing of the gingival tissues at both the donor and recipient sites with no signs of inflammation.

  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. 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

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

    International Nuclear Information System (INIS)

    Nishiura, Yasumasa; Ochiai, Naoyuki; Miyauchi, Yukio; Niitsu, Mamoru

    2002-01-01

    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

  15. 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)

    Akiyama, Haruhiko; Takemoto, Mitsuru; Morishima, Takkan

    2011-01-01

    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

  16. Post-traumatic Unilateral Avulsion of the Abducens Nerve with Damage to Cranial Nerves VII and VIII: Case Report

    OpenAIRE

    Yamasaki, Fumiyuki; Akiyama, Yuji; Tsumura, Ryu; Kolakshyapati, Manish; Adhikari, Rupendra Bahadur; Takayasu, Takeshi; Nosaka, Ryo; Kurisu, Kaoru

    2016-01-01

    Traumatic injuries of the abducens nerve as a consequence of facial and/or head trauma occur with or without associated cervical or skull base fracture. This is the first report on unilateral avulsion of the abducens nerve in a 29-year-old man with severe right facial trauma. In addition, he exhibited mild left facial palsy, and moderate left hearing disturbance. Magnetic resonance imaging (MRI) using fast imaging employing steady-state acquisition (FIESTA) revealed avulsion of left sixth cra...

  17. The phrenic nerve transfer in the treatment of a septuagenarian with brachial plexus avulsion injury: a case report.

    Science.gov (United States)

    Jiang, Ye; Lao, Jie

    2018-05-01

    Phrenic nerve transfer has been a well-established procedure for restoring elbow flexion function in patients with brachial plexus avulsion injury. Concerning about probably detrimental respiratory effects brought by the operation, however, stirred up quite a bit of controversy. We present a case report of the successful application of phrenic nerve as donor to reinnervate the biceps in a septuagenarian with brachial plexus avulsion injury, not accompanied with significant clinical respiratory problem.

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

    International Nuclear Information System (INIS)

    Kim, Sang Won; Hong, Hoon Pyo; Ryu, Kyung Nam; Jin, Wook

    2003-01-01

    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

  19. Crevasse Splays Versus Avulsions: A Recipe for Land Building With Levee Breaches

    Science.gov (United States)

    Nienhuis, Jaap H.; Törnqvist, Torbjörn E.; Esposito, Christopher R.

    2018-05-01

    Natural-levee breaches can not only initiate an avulsion but also, under the right circumstances, lead to crevasse splay formation and overbank sedimentation. The formative conditions for crevasse splays are not well understood, yet such river sediment diversions form an integral part of billion-dollar coastal restoration projects. Here we use Delft3D to investigate the influence of vegetation and soil consolidation on the evolution of a natural-levee breach. Model simulations show that crevasse splays heal because floodplain aggradation reduces the water surface slope, decreasing water discharge into the flood basin. Easily erodible and unvegetated floodplains increase the likelihood for channel avulsions. Denser vegetation and less potential for soil consolidation result in small crevasse splays that are not only efficient sediment traps but also short-lived. Successful crevasse splays that generate the largest land area gain for the imported sediment require a delicate balance between water and sediment discharge, vegetation root strength, and soil consolidation.

  20. Cartilaginous avulsion fracture of the tibial spine in a 5-year-old girl

    International Nuclear Information System (INIS)

    Kim, Jung Ryul; Song, Ji Hun; Lee, Ju Hong; Lee, Sang Yong; Yoo, Wan Hee

    2008-01-01

    Fractures of the tibial spine usually occur in children aged 8 to 14 years. Usually, radiographs will demonstrate a tibial spine fracture, with the degree of displacement. Tibial spine fractures in younger children have not been reported in the previously published literature. We report a tibial spine fracture that occurred in 5-year-old girl. The cartilaginous avulsion fracture of the tibial spine was not revealed by radiographs because it was limited to the cartilaginous portion of the proximal tibia. (orig.)

  1. Dysphonia secondary to traumatic avulsion of the vocal fold in infants

    OpenAIRE

    Cavalli, L.; Bray, D.; Eze, N.; Hartley, B. E. J.

    2010-01-01

    Objective: Airway compromise due to paediatric intubation injuries is well documented; however, intubation injuries may also cause severe voice disorders. We report our experience and review the world literature on the voice effects of traumatic paediatric intubation. Case series: We report five cases of children referred to Great Ormond Street Hospital for Children who suffered traumatic avulsion of the vocal fold at the time of, or secondary to, endotracheal intubation. All children had sig...

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

    International Nuclear Information System (INIS)

    Lawande, M.A.; Sankhe, S.; Pungavkar, S.A.; Patkar, D.P.

    2007-01-01

    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

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

    International Nuclear Information System (INIS)

    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

  4. Amputation of finger by horse bite with complete avulsion of both flexor tendons.

    Science.gov (United States)

    Koren, Lior; Stahl, Shalom; Rovitsky, Alexey; Peled, Eli

    2011-08-08

    Amputation of fingers with tendon avulsion occurs through a traction injury, and most occur through a ring avulsion mechanism. Usually the flexor digitorum profundus is torn out with the amputated finger. Replantation usually is recommended only when the amputation is distal to the flexor digitorum superficialis insertion. Animal bites are relatively common, with a decreasing order of frequency of dogs, cats, and humans. Horse bites are relatively infrequent but are associated with crush injuries and tissue loss when they occur. This article describes a 23-year-old man with amputation of his middle finger at the level of the proximal phalanx after being bitten by a horse. The amputated stump was avulsed with the middle finger flexor digitorum profundus and flexor digitorum superficialis torn from the muscle-tendon junction from approximately the middle of the forearm. The patient had no other injuries, and he was able to move his other 4 fingers with only mild pain. As the amputated digit was not suitable for replantation, the wound was irrigated and debrided. The edges of the phalanx were trimmed, and the edges of the wound were sutured. Tetanus toxoid and rabies vaccine were administered, along with intravenous amoxicillin and clavulanic acid. The patient was discharged from the hospital 2 days later, with no sign of infection of the wound or compartment syndrome of the forearm. This case demonstrates the weakest point in the myotendinous junction and emphasizes the importance of a careful physical examination in patients with a traumatic amputation. Copyright 2011, SLACK Incorporated.

  5. Atypical Chronic Ankle Instability in a Pediatric Population Secondary to Distal Fibula Avulsion Fracture Nonunion.

    Science.gov (United States)

    El Ashry, Saad R; El Gamal, Tarek A; Platt, Simon R

    Chronic ankle instability is a disabling condition, often occurring as a result of traumatic ankle injury. A paucity of published data is available documenting chronic ankle instability in the pediatric population. Much of the data has been confined to the adult population. We present 2 cases of chronic ankle instability, 1 in a 12-year-old and 1 in a 9-year-old patient. Unlike the typical adult etiology, the cause of instability was a dysfunctional lateral ligamentous complex as a consequence of bony avulsion of the tip of the fibula. Both patients had sustained a twisting injury to the ankle. The fractures failed to unite. The nonunion resulted in dysfunction of the anterior talofibular ligament with consequent chronic ankle instability. At the initial clinical assessment, magnetic resonance imaging was requested for both patients. In patient 1 (12 years old), the fracture was fixed with 2 headless screws and was immobilized in a plaster cast for 6 weeks. In patient 2 (9 years old), because of the small size of the avulsed fragment, fixation was not possible. A modified Gould-Broström procedure was undertaken, facilitating repair of the avulsed fragment using anchor sutures. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  6. Concurrent patellar fracture and lateral collateral ligament avulsion as a result of trauma in three horses.

    Science.gov (United States)

    McLellan, Jonathan; Plevin, Sarah; Taylor, Elizabeth

    2012-05-15

    3 horses were evaluated because of lameness and swelling of the stifle joint subsequent to trauma. All horses had characteristic clinical signs of stifle joint pain and effusion. A medial patellar fracture and lateral collateral ligament avulsion fracture were visible ultrasonographically in each. Radiography, including standard as well as flexed lateromedial, cranioproximal-craniodistal oblique (skyline patellar), and laterally stressed caudocranial views, revealed similar findings. Arthroscopic surgery to remove the patellar fracture was attempted in 1 horse with severe desmitis of the lateral collateral ligament; it remained lame afterward. The other 2 horses, with less severe collateral ligament damage, were managed conservatively and returned to athletic use, despite the lack of surgical intervention to repair the patellar fractures. Special radiographic views were necessary for diagnosis of medial patellar fracture and lateral collateral ligament avulsion fracture in the 3 horses. Ultrasonographic findings pertaining to the collateral ligament may be prognostically important in such situations. The severity of a fracture involving ligament avulsion may be the limiting factor in horses with this combined injury, and this factor should be considered prior to attempting surgical correction of patellar fractures.

  7. 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.

  8. Sonographic Findings of Chondral Avulsion Fractures of the Lateral Ankle Ligaments in Children.

    Science.gov (United States)

    Maeda, Manabu; Maeda, Nana; Takaoka, Takanori; Tanaka, Yasuhito

    2017-02-01

    In this series, we aimed to describe the sonographic findings of chondral avulsion fractures that develop concomitant with lateral ankle ligament injury in children. We performed stress sonography during a manual anterior drawer stress procedure of the ankle in 9 skeletally immature patients who had recently had a lateral ankle sprain. Echo videos were obtained through the course of treatment, and all videos were reviewed. We elucidated the common features of chondral avulsion fractures of the lateral ankle ligaments in the children. The features of avulsion fractures on conventional sonography included absence of a fracture with hyperechoic spots (sonographic occult fracture type), cortical discontinuity with hyperechoic spots (cortical disruption fracture type), fracture line in the cortical bone (double-line fracture type), and a step-off deformity of the cortical bone with cartilage (displaced fracture type). In contrast, the features of chondral fractures on stress sonography included abnormal motion of the chondral lesions and mobility/fluidity of hyperechoic spots along the chondral fracture site. The presence of hyperechoic spots around the chondral lesion is an important sonographic sign for diagnosing chondral fractures concomitant with ankle lateral ligament injury. Hence, we believe that stress sonography should be considered for the detection of chondral fractures concomitant with radiographically negative ankle lateral ligament injuries in skeletally immature patients with lateral ankle pain and ankle sprains, if hyperechoic spots are present in the cartilage of the distal fibula. © 2017 by the American Institute of Ultrasound in Medicine.

  9. 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...

  10. 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.

  11. Arthroscopically assisted reconstruction of triangular fibrocartilage complex foveal avulsion in the ulnar variance-positive patient.

    Science.gov (United States)

    Kim, ByungSung; Yoon, Hong-Kee; Nho, Jae-Hwi; Park, Kang Hee; Park, Sung-Yong; Yoon, Jun-Hee; Song, Hyun Seok

    2013-11-01

    Our aim was to evaluate the clinical results of patients treated by arthroscopically assisted reconstruction of foveal avulsion injury of the triangular fibrocartilage complex (TFCC) using a suture anchor. We retrospectively reviewed the results of 15 patients (11 men and 4 women; mean age, 30.5 years) who underwent surgical procedures for the treatment of TFCC foveal avulsion at our hospital. The patients were followed up for a mean of 29 months. The patients had TFCC foveal avulsion caused by sprains (n = 8), falls (n = 4), playing baseball (n = 2), and a motor vehicle accident (n = 1). All the patients underwent magnetic resonance imaging. Radiographs obtained to assess ulnar variance (UV), ulnar-dorsal subluxation, and function of the wrist based on grip power; Disabilities of the Arm, Shoulder and Hand score; and Mayo wrist score were examined for all patients both preoperatively and postoperatively. On preoperative magnetic resonance imaging, TFCC foveal avulsion was observed in 13 of 15 cases. The mean UV value based on preoperative simple radiographic findings was 1.7 ± 1.0 mm, and dorsal subluxation at the distal ulna improved from 2.9 ± 3.0 mm to 0.2 ± 0.9 mm (P = .017). In all cases the distal radioulnar joint instability disappeared postoperatively. Grip power (compared with the uninvolved limb) was 79.3% preoperatively and 82.9% postoperatively (P = .086). The Disabilities of the Arm, Shoulder and Hand scores were 28.4 points preoperatively and 16.6 points postoperatively (P = .061). The Mayo wrist scores were excellent in 10 cases, good in 2, and fair in 3, and the mean score improved significantly from 64 points preoperatively to 84 points postoperatively (P = .007). Arthroscopic-assisted suture anchor reattachment of the TFCC in patients with traumatic TFCC foveal avulsion can prevent or reduce distal radioulnar joint instability and reduce pain even in chronic cases with positive UV. Level IV, therapeutic case series. Copyright © 2013

  12. 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.

  13. Third- or Fourth-Degree Intrapartum Anal Sphincter Tears Are Associated With Levator Ani Avulsion in Primiparas.

    Science.gov (United States)

    Valsky, Dan V; Cohen, Sarah M; Lipschuetz, Michal; Hochner-Celnikier, Drorith; Daum, Hagit; Yagel, Itai; Yagel, Simcha

    2016-04-01

    We evaluated primiparous women with clinically diagnosed third- and fourth-degree and anal sphincter tears, to evaluate the rate of levator ani muscle injury compared to primiparous women without sphincter tears. Primiparous women delivering in our maternity ward with intrapartum diagnoses of third- or fourth-degree anal sphincter tears, repaired by the overlapping technique, were recruited to undergo 3-dimensional transperineal sonography of the pelvic floor anatomy, including the anterior and posterior compartments. Primiparas with uncomplicated vaginal deliveries were recruited as a comparison group. Patient files were examined, and maternal backgrounds and delivery and neonatal details were extracted for all patients. Ninety-four women with tears were recruited to the study group, and 464 women with normal vaginal deliveries constituted the comparison group. The groups differed significantly in the rates of levator ani defects: 38 of 94 women (40.4%) in the study group versus 75 of 464 (16.2%) in the comparison group (P tears are associated with levator ani avulsion. Knowledge of complex pelvic floor damage may allow for prompt referral to secondary preventive measures for pelvic floor disorders. © 2016 by the American Institute of Ultrasound in Medicine.

  14. 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...

  15. Axillary artery injury after an anterior shoulder fracture dislocation and “periosteal sleeve avulsion of the rotator cuff” (SARC. Case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Ash Chehata

    2017-04-01

    Full Text Available We present the rare complication of an axillary artery injury associated with an anterior dislocation of the humerus and what we believe to be the first reported periosteal sleeve avulsion of the entire rotator cuff (SARC. We review the literature and discuss the cause of this unusual injury pattern. Keywords: Axillary artery, Shoulder fracture dislocation, Periosteal sleeve avulsion, SARC

  16. Avulsion of the L4 spinous process: an unusual injury in a professional rugby player: case report.

    Science.gov (United States)

    Jones, Alwyn; Andrews, John; Shoaib, Amer; Lyons, Kath; Ahuja, Sashin; Howes, John; Davies, Paul

    2005-06-01

    A case of L4 spinous process avulsion following a hyperflexion injury treated with surgical excision. To show that single photon emission computerized tomography is essential for the diagnosis and that excision can provide a successful outcome. The avulsion resulted from a forced hyperflexion injury at the L4/5 area, where the interspinous ligament provides a high resistance to flexion. A 29-year-old international rugby football player injured his low back during a match. Plain radiography and magnetic resonance imaging did not reveal the injury. Single photon emission computerized tomography and computerized tomography showed the lesion. Initial conservative therapy failed to control the symptoms, and, therefore, late excision was performed with pain-free return to contact sports at 3 months. Few cases of interspinous process avulsions have been described, and, to our knowledge, this is the first reported case of rugby football player who had a successful outcome with late surgical excision.

  17. 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.

  18. Acetabular Cup Revision.

    Science.gov (United States)

    Kim, Young-Ho

    2017-09-01

    The use of acetabular cup revision arthroplasty is on the rise as demands for total hip arthroplasty, improved life expectancies, and the need for individual activity increase. For an acetabular cup revision to be successful, the cup should gain stable fixation within the remaining supportive bone of the acetabulum. Since the patient's remaining supportive acetabular bone stock plays an important role in the success of revision, accurate classification of the degree of acetabular bone defect is necessary. The Paprosky classification system is most commonly used when determining the location and degree of acetabular bone loss. Common treatment options include: acetabular liner exchange, high hip center, oblong cup, trabecular metal cup with augment, bipolar cup, bulk structural graft, cemented cup, uncemented cup including jumbo cup, acetabular reinforcement device (cage), trabecular metal cup cage. The optimal treatment option is dependent upon the degree of the discontinuity, the amount of available bone stock and the likelihood of achieving stable fixation upon supportive host bone. To achieve successful acetabular cup revision, accurate evaluation of bone defect preoperatively and intraoperatively, proper choice of method of acetabular revision according to the evaluation of acetabular bone deficiency, proper technique to get primary stability of implant such as precise grafting technique, and stable fixation of implant are mandatory.

  19. Hypovolemic Shock and Hemoperitoneum from Spontaneous Avulsion of a Large Pedunculated Uterine Leiomyoma.

    Science.gov (United States)

    Mizrahi, Daniel J; Kaushik, Chhavi; Adamo, Robert

    2017-03-01

    Hemoperitoneum with hypovolemic shock from avulsion of a pedunculated leiomyoma is a rare but highly fatal condition that can occur spontaneously or as a result of trauma. We report a case of hemoperitoneum and hypovolemic shock secondary to a bleeding leiomyoma detected via computed tomography (CT) scan in a 39 year old premenopausal, gravida 0 female that presented with abdominal pain and became hemodynamically unstable in the emergency department. A preoperative bimanual exam revealed a mass consistent with a 20 week gestational uterus. Following fluid resuscitation, the patient underwent emergent myomectomy and ligation of the right uterine artery and was discharged home in good condition.

  20. [MINIMALLY INVASIVE TREATMENT OF POSTERIOR CRUCIATE LIGAMENT AVULSION FRACTURE IN A FLOPPY LATERAL POSITION].

    Science.gov (United States)

    Zhao, Junchao; Wang, Hao

    2016-09-08

    To conclude the effectiveness of arthroscopy combined with Burks and SchaVer's approach in the treatment of posterior cruciate ligament (PCL) avulsion fractures in a floppy lateral position. Between May 2010 and March 2014, 21 patients with PCL avulsion fractures were treated. There were 13 males and 8 females, aged 21 to 62 years (mean, 39.1 years). The causes included traffic accident injury in 10 cases, sports injury in 5 cases, and falling injury from height in 6 cases. The time from injury to hospital was 1-6 days (mean, 2.5 days). The results of posterior drawer test were all positive, and the results of anterior drawer test and lateral stress test were all negative. The Lysholm score was 28.0±5.5 before operation. And the American Orthopaedic Foot and Ankle Society (IKDC) score was 46.2±7.6 before operation. According to Meyer standards for fractures classification, 11 cases were rated as type II and 10 cases as type III. Arthroscopy was used to inspect and treat the intra-articular lesions, then avulsion fracture was fixed by Burks and SchaVer's approach in lateral position. Postoperative functional exercises were performed. Primary healing of incision was obtained, without nerve and vascular injury or joint infection. All patients were followed up 18-36 months (mean, 27.2 months). The X-ray films of the knee joint showed good fractures reduction and healing at 3 months after operation. The results of posterior drawer test and reverse Lachman test were negative. The knee range of motion was recovered to normal level. At last follow-up, the Lysholm score of the knee joint was significantly improved to 90.9±1.4 from preoperative one ( t =54.584, P =0.000), and the IKDC score was significantly increased to 90.5±5.3 from preoperative one ( t =15.638, P =0.000), including 19 cases of grade A and 2 cases of grade B. A combination of arthroscopy and Burks and SchaVer's approach for the treatment of PCL avulsion fractures in a floppy lateral position has the

  1. Penetrating head injury with bilateral eye avulsion due to Himalayan bear bite.

    Science.gov (United States)

    Roka, Yam B; Roka, Narayani; Shrestha, Manzil; Puri, Puspa R; Adhikari, Hari B

    2012-12-01

    The Himalayan black bear (Ursus thibetanus or Selenarctos thibetanus), although an omnivore, is more carnivorous than its American counterpart. It is also more aggressive towards humans and is a threatened species because of the deforestation in the Himalayas. Furthermore, poverty, encroachment of the forest, extensive deforestation, lack of education and living near the forest are factors that increase the probability of such animal injuries. We report the case of a 35-year-old woman who suffered a severe penetrating head injury with scalp and bilateral eye avulsion, which was managed successfully. © 2012 The Authors. EMA © 2012 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  2. Simultaneous bilateral tibial tubercle avulsion fracture in a male teenager: case report and literature review.

    Science.gov (United States)

    Nicolini, Alexandre P; Carvalho, Rogerio T; Ferretti, Mario; Cohen, Moises

    2018-01-01

    Tibial tuberosity avulsion fractures are injuries accounting for less than 3% of all epiphyseal and 1% of all physeal injuries in adolescents. Bilateral injuries are very rare, with only 19 cases described in the literature. These types of fractures occur commonly in male teenagers during sport activities and are often associated with other orthopaedic disorders. We report the case of a male teenager with simultaneous bilateral tibial tubercle fractures, describe the evolution and treatment of this injury and review the literature on this subject. Case report.

  3. Primary school health teachers’ knowledge regarding the emergency treatment of avulsed permanent teeth in Hamadan

    Directory of Open Access Journals (Sweden)

    Arghavan Kamali

    2016-11-01

    T-test. Results: 81 Health teachers were studied and the ratio of knowledge score of all of health teachers to a maximum knowledge score was obtained to be 43/1%. There was no significant relationship between the school health teacher knowledge and their work experiences and age (P=0.23-0.6, respectively. Average of knowledge score of who were educated was more than who were not educated previously (P<0.001. Conclusion: Primary school health teachers' knowledge of dealing with Avulsion was not at a high level. Therefore, training on the dental trauma cases is quite essential for them.

  4. A study on scar revision

    Directory of Open Access Journals (Sweden)

    Ashutosh Talwar

    2016-04-01

    Full Text Available Introduction: Scars are psychologically distressing for the patients and have an impact on the quality of life and self esteem of the patients. Scar revision is an aesthetic skill which is mastered by plastic surgeons and encroached now by dermatosurgeons. Scars on the face are aesthetically unacceptable and various techniques have been improvised for making a scar aesthetically acceptable. Various types of techniques are used for scar revision like W plasty, Z plasty and VY plasty. Aims: To see the efficacy of various scar revision techniques including Z plasty, VY plasty and W plasty in 30 patients with disfiguring scars. Methods: We selected twenty patients of disfiguring scars for the study. The scars from various causes including trauma and burns were included in our study. Various techniques of scar revision include Z plasty, W plasty and VY plasty were performed according to the type and site of scar. Results: Male: female was 1.5: 1. The scar revision surgery yielded excellent results with minimal complications including haematoma formation, secondary infection and delayed healing seen in 5% patients each. Regarding the efficacy of scar revision, excellent improvement was seen in 60% patients, moderate improvement was seen in 30% patients and mild improvement was seen in 10% patients. Conclusions: Dermatologists can employ a number of surgical scar revision techniques. While some are better suited to treat specific types of scars, they can be used in combination with each other or with adjunctive therapies to achieve optimal results.

  5. Post-traumatic Unilateral Avulsion of the Abducens Nerve with Damage to Cranial Nerves VII and VIII: Case Report.

    Science.gov (United States)

    Yamasaki, Fumiyuki; Akiyama, Yuji; Tsumura, Ryu; Kolakshyapati, Manish; Adhikari, Rupendra Bahadur; Takayasu, Takeshi; Nosaka, Ryo; Kurisu, Kaoru

    2016-07-01

    Traumatic injuries of the abducens nerve as a consequence of facial and/or head trauma occur with or without associated cervical or skull base fracture. This is the first report on unilateral avulsion of the abducens nerve in a 29-year-old man with severe right facial trauma. In addition, he exhibited mild left facial palsy, and moderate left hearing disturbance. Magnetic resonance imaging (MRI) using fast imaging employing steady-state acquisition (FIESTA) revealed avulsion of left sixth cranial nerve. We recommend thin-slice MR examination in patients with abducens palsy after severe facial and/or head trauma.

  6. Reconstruction of a total avulsion of the hepatic veins and the suprahepatic inferior vena cava secondary to blunt thoracoabdominal trauma.

    Science.gov (United States)

    Kaemmerer, Daniel; Daffner, Wolfgang; Niwa, Martin; Kuntze, Thomas; Hommann, Merten

    2011-02-01

    Blunt injury to the inferior vena cava is a rare but dramatic event having a high mortality up to 80%. The mortality increases after total avulsion especially in combination with secondary intra-abdominal injuries. We report on a 15-year-old boy who sustained a blunt trauma with a total, partially covered avulsion of the hepatic veins and the suprahepatic inferior vena cava. We treated the patient under internal bypassing of the retrohepatic vena cava by using the heart-lung machine and reconstructed the hepatic veins and suprahepatic vena cava with a conduit made of pericard.

  7. Humeral windows in revision total elbow arthroplasty.

    Science.gov (United States)

    Peach, Chris A; Salama, Amir; Stanley, David

    2016-04-01

    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.

  8. Incarceration of the medial collateral ligament in the intercondylar notch following proximal avulsion

    Energy Technology Data Exchange (ETDEWEB)

    Walton, Edward [Fiona Stanley Hospital, Department of Radiology, Perth, Western Australia (Australia); Williams, Martin [North Bristol NHS Trust, Department of Radiology, Bristol (United Kingdom); Robinson, James R. [Bristol Knee Group, Avon Orthopaedic Centre, Bristol (United Kingdom)

    2017-11-15

    Intra-articular entrapment of the medial collateral ligament (MCL) is a rare but recognised complication of traumatic injury to the posteromedial corner (PMC) of the knee. Considering the MCL is the most commonly injured ligament of the knee this complication is extremely rare with only a handful of cases describing MCL entrapment following distal avulsion of the MCL. We present the first known case of MCL entrapment following proximal avulsion of the MCL and posterior oblique ligament (POL) with the mid-substance of the MCL becoming entrapped in the joint, lying on the superior surface of the medial meniscus and extending up into the intercondylar notch. In addition, the medial patellar retinaculum was also entrapped in the medial aspect of the medial patellofemoral joint. MCL entrapment is best treated with expeditious surgical intervention and it is therefore crucial that the MRI findings are not overlooked. Details of the clinical assessment, MRI and operative findings are presented with a literature review of MCL entrapment. (orig.)

  9. Incarceration of the medial collateral ligament in the intercondylar notch following proximal avulsion

    International Nuclear Information System (INIS)

    Walton, Edward; Williams, Martin; Robinson, James R.

    2017-01-01

    Intra-articular entrapment of the medial collateral ligament (MCL) is a rare but recognised complication of traumatic injury to the posteromedial corner (PMC) of the knee. Considering the MCL is the most commonly injured ligament of the knee this complication is extremely rare with only a handful of cases describing MCL entrapment following distal avulsion of the MCL. We present the first known case of MCL entrapment following proximal avulsion of the MCL and posterior oblique ligament (POL) with the mid-substance of the MCL becoming entrapped in the joint, lying on the superior surface of the medial meniscus and extending up into the intercondylar notch. In addition, the medial patellar retinaculum was also entrapped in the medial aspect of the medial patellofemoral joint. MCL entrapment is best treated with expeditious surgical intervention and it is therefore crucial that the MRI findings are not overlooked. Details of the clinical assessment, MRI and operative findings are presented with a literature review of MCL entrapment. (orig.)

  10. Accessory atlantoaxial ligament avulsion fracture of the axis: Are there any clinical implications?

    Directory of Open Access Journals (Sweden)

    Hamid Reza Niknejad

    2016-01-01

    Full Text Available Injuries to the craniocervical support structures are frequently observed in neurotrauma cases. Stability of this region is of vital importance. Literature has mainly focused on three major ligaments of the craniocervical junction: The tectorial membrane, the transverse ligament, and the alar ligaments. However, the accessory atlantoaxial ligament (ALL also seems to be involved in craniocervical stability as shown in cadaveric specimens. Still, the biomechanical importance of this structure needs to be determined, especially in trauma settings. Here, we describe a case of isolated traumatic injury to this structure and discuss the clinical outcome. A 64 year old polytrauma patient with a remarkable avulsion fracture at the site of the insertion of the ALL was admitted to our center. We evaluated the patient both clinical and radiological at admission, after 3 months and after 1 year. We clinically assessed the upper cervical rotational stability using the cervical flexion rotation test. We observed no rotational instability or any other clinical repercussions at the long term after an isolated ALL injury. This case shows that isolated traumatic damage to the ALL is possible. Unilateral damage to the ALL probably does not cause rotational instability of the craniocervical junction. In case a similar avulsion fracture is observed, we recommend performing a magnetic resonance imaging of the craniovertebral region to assess for any ligamentous lesions.

  11. Arthroscopic-assisted repair of triangular fibrocartilage complex foveal avulsion in distal radioulnar joint injury

    Science.gov (United States)

    Woo, Sung Jong; Jegal, Midum; Park, Min Jong

    2016-01-01

    Background: Disruption of the triangular fibrocartilage complex (TFCC) foveal insertion can lead to distal radioulnar joint (DRUJ) instability accompanied by ulnar-sided pain, weakness, snapping, and limited forearm rotation. We investigated the clinical outcomes of patients with TFCC foveal tears treated with arthroscopic-assisted repair. Materials and Methods: Twelve patients underwent foveal repair of avulsed TFCC with the assistance of arthroscopy between 2011 and 2013. These patients were followed up for an average of 19 months (range 14–25 months). The avulsed TFCC were reattached to the fovea using a transosseous pull-out suture or a knotless suture anchor. At the final followup, the range of motion, grip strength and DRUJ stability were measured as objective outcomes. Subjective outcomes were assessed using the Visual Analog Scale (VAS) for pain, patient rated wrist evaluation (PRWE), Disabilities of the Arm, Shoulder and Hand questionnaire (DASH score) and return to work. Results: Based on the DRUJ stress test, 5 patients had normal stability and 7 patients showed mild laxity as compared with the contralateral side. Postoperatively, the mean range of pronation supination increased from 141° to 166°, and the mean VAS score for pain decreased from 5.3 to 1.7 significantly. The PRWE and DASH questionnaires also showed significant functional improvement. All patients were able to return to their jobs. However, two patients complained of persistent pain. Conclusions: Arthroscopically assisted repair of TFCC foveal injury can provide significant pain relief, functional improvement and restoration of DRUJ stability. PMID:27293286

  12. 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.

  13. 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...

  14. Management of High-energy Avulsive Ballistic Facial Injury: A Review of the Literature and Algorithmic Approach

    Directory of Open Access Journals (Sweden)

    Elbert E. Vaca, MD

    2018-03-01

    Conclusions:. Existing literature suggests that early and aggressive intervention improves outcomes following avulsive ballistic injuries. Further comparative studies are needed; however, although evidence is limited, the senior author presents a 3-stage reconstructive algorithm advocating early and definitive reconstruction with aesthetic free tissue transfer in an attempt to optimize reconstructive outcomes of these complex injuries.

  15. Knowledge and awareness of first aid of avulsed tooth among physicians and nurses of hospital emergency department

    Directory of Open Access Journals (Sweden)

    Sudeep Sreepad Iyer

    2017-01-01

    Full Text Available Introduction: Physicians and nurses of emergency department are often the first line of qualified health-care providers attending the patient in person or parent's query over phone reporting immediately following the dental avulsion. Prompt action by them becomes the decisive factor in survival and prognosis of the tooth. Although a few researchers have evaluated knowledge of emergency room physicians, there is scanty of reports concerning nurses who play a climacteric role. Materials and Methods: A 10-item questionnaire regarding clinical situation apropos dental injury and tooth avulsion, inquiring knowledge of physicians and nurses was administered to 150 each of nursing professionals and physicians of the emergency department. Results: With 100% response rate, the data obtained was subjected to statistical analysis. Results showed lack of knowledge and confidence in both groups. About 66.7% (n = 100 nurses and 74.7% (n = 112 considered reimplantation of avulsed tooth. There was overbalanced confusion regarding storage/transport media and handling of avulsed tooth. Conclusion: The findings from the results suggested a definite inadequacy in knowledge, demanding need for appropriate training for delivering treatment with more predictability and better prognosis.

  16. Knowledge and Awareness of First Aid of Avulsed Tooth among Physicians and Nurses of Hospital Emergency Department.

    Science.gov (United States)

    Iyer, Sudeep Sreepad; Panigrahi, Antarmayee; Sharma, Shalini

    2017-01-01

    Physicians and nurses of emergency department are often the first line of qualified health-care providers attending the patient in person or parent's query over phone reporting immediately following the dental avulsion. Prompt action by them becomes the decisive factor in survival and prognosis of the tooth. Although a few researchers have evaluated knowledge of emergency room physicians, there is scanty of reports concerning nurses who play a climacteric role. A 10-item questionnaire regarding clinical situation apropos dental injury and tooth avulsion, inquiring knowledge of physicians and nurses was administered to 150 each of nursing professionals and physicians of the emergency department. With 100% response rate, the data obtained was subjected to statistical analysis. Results showed lack of knowledge and confidence in both groups. About 66.7% ( n = 100) nurses and 74.7% ( n = 112) considered reimplantation of avulsed tooth. There was overbalanced confusion regarding storage/transport media and handling of avulsed tooth. The findings from the results suggested a definite inadequacy in knowledge, demanding need for appropriate training for delivering treatment with more predictability and better prognosis.

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

    Energy Technology Data Exchange (ETDEWEB)

    Rossi, F.; Dragoni, S. [Sports Science Inst., Rome (Italy)

    2001-03-01

    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.)

  18. Avulsion and its implications for fluvial-deltaic architecture: insights from the Holocene Rhine-Meuse delta

    NARCIS (Netherlands)

    Stouthamer, E.; Cohen, K.M.; Gouw, M.J.P.

    2010-01-01

    Avulsion is a principal process in the formation of fluvial-deltaic successions and a primary control on deltaic architecture. It determines the distribution of sediment and water and hence influences which location in the delta receives clastic sedimentation in what amounts for what time. It also

  19. The Effect of Root Coating with Titanium on Prevention of Root Resorption in Avulsed Teeth: An Animal Study

    Science.gov (United States)

    Heydari, Azar; Tahmasbi, Soodeh; Badiee, Mohammadreza; Izadi, SeyedSadra; Mashhadi Abbas, Fatemeh; Mokhtari, Sepideh

    2016-01-01

    Introduction: Tooth avulsion is a real dental emergency. If immediate replantation is not performed, the avulsed tooth may be lost due to inflammatory or replacement resorption. This animal study aimed to evaluate the bone response to the titanium coating of the root surface as an artificial barrier, and prevention of resorption of avulsed teeth. Methods and Materials: This experimental study was conducted on four male dogs. The dogs were randomly divided into two groups for assessment at two and eight weeks. Four teeth were extracted in each animal. The root surfaces of the test group were coated with a titanium layer using the Electron Beam Deposition system. After 24 h, replantation of the teeth was performed. Two animals were sacrificed after two weeks and the remaining dogs were killed after eight weeks. The presence of inflammation, inflammatory resorption, replacement resorption, periodontal regeneration, periapical granuloma and ankylosis were evaluated through histological analyses. Results: Inflammatory root resorption was not present in any tooth except one tooth in the coated group after eight weeks. Replacement resorption was noted just in three of the non-coated teeth after two weeks and two teeth after eight weeks. The McNemar's test revealed that the frequency of replacement resorption in the non-coated group was significantly higher than the coated group (P=0.031). Conclusion: Based on the results of this study, it seems that coating the root surfaces of avulsed teeth with titanium may control the replacement root resorption. PMID:27790261

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

    International Nuclear Information System (INIS)

    Rossi, F.; Dragoni, S.

    2001-01-01

    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.)

  1. Humeral avulsion of the anterior shoulder stabilizing structures after anterior shoulder dislocation: demonstration by MRI and MR arthrography

    International Nuclear Information System (INIS)

    Tirman, P.F.J.; Steinbach, L.S.; Feller, J.F.; Stauffer, A.E.

    1996-01-01

    Objective. To demonstrate the MRI findings of an anterior shoulder capsular avulsion from the humerus, with or without subscapularis rupture, after anterior dislocation or severe abduction external rotation injury. Design and patients. We retrospectively reviewed the MRI and MR arthrographic examinations of seven patients who were identified at surgery with avulsion of the anterior shoulder stabilizers from the humerus. MRI was correlated with clinical history and surgical results. Results. MRI findings included: inhomogeneity or frank disruption of the anterior capsule at the humeral insertion (all), fluid intensity anterior to the shoulder (six patients), tear of the subscapularis tendon (six patients), dislocation of the biceps tendon (four patients), and a Hill-Sachs deformity (four patients). MR arthrography additionally found extravasation of contrast through the capsular defect (two patients). Conclusions. Our findings suggest that MRI is helpful for diagnosing humeral avulsion of the anterior glenohumeral capsule, especially when a tear of the subscapularis tendon insertion is present. MR arthrography may be of benefit for diagnosing capsular avulsion without associated subscapularis tendon abnormality. (orig.). With 4 figs

  2. Modified dorsal root entry zone lesioning for intractable pain relief in patients with root avulsion injury.

    Science.gov (United States)

    Takai, Keisuke; Taniguchi, Makoto

    2017-08-01

    OBJECTIVE Dorsal root entry zone (DREZ) lesioning has been the most effective surgical treatment for the relief of intractable pain due to root avulsion injury, but residual pain and a decrease in pain relief in the follow-up period have been reported in 23%-70% of patients. Based on pain topography in the most recent studies on neuropathic pain, the authors modified the conventional DREZ lesioning procedure to improve clinical outcomes. The presumed rationale for this procedure is to eliminate the spontaneous discharges of neurons in the superficial spinal dorsal horn as well as wide dynamic range neurons in the deep spinal dorsal horn. METHODS Ten patients with avulsion-related pain underwent surgery between 2011 and 2015. The surgical procedure was described and postoperative pain relief was assessed as follows: excellent (residual pain never exceeded 3 on the visual analog scale [VAS] without medication), good (residual pain never exceeded 5 on the VAS with medication), and poor (residual pain was greater than 5 with medication). Specific perioperative complications were assessed. RESULTS The aim of this surgical procedure was to destroy the deeper layers of the posterior horn of spinal gray matter, which was in contrast to the procedures of Nashold and Sindou, which were to destroy the superficial layers. All patients achieved excellent (n = 7, pain relief without medication) or good (n = 3, pain relief with medication) pain relief postoperatively, and the recurrence of pain was not reported in any patients (median 29 months after surgery, range 12-64 months). Nine patients (90%) achieved complete pain relief (a score of 0 or 1 on the VAS) with or without medication. No surgical site complications such as infection or CSF leakage were noted. No motor deficit was observed in any patient. A sensory deficit was observed in 2 patients and disappeared within 1 month in 1 patient. New pain at the adjacent level of DREZ lesioning was observed in 3 patients and

  3. 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.

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

    International Nuclear Information System (INIS)

    Borissov, I.; Lazarova, L.

    2001-01-01

    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

  5. Acute Traumatic Patellar Tendon Rupture at the Tibial Tuberosity Attachment without Avulsion Fracture

    Directory of Open Access Journals (Sweden)

    Shuichi Miyamoto

    2017-01-01

    Full Text Available Patellar tendon rupture in children is especially rare. The fact that the area of traumatic rupture has wide variations makes surgical treatment difficult. We present an 11-year-old boy with acute traumatic patellar tendon rupture at the tibial tuberosity attachment without avulsion fracture. Primary end-to-end repair and reinforcement using 1.5 mm stainless steel wires as a surgical strategy were undertaken. Early range of motion began with a functional knee brace and the reinforced stainless wire was removed 3 months after surgery. Knee function at the final follow-up was satisfactory. We suggest that this strategy may provide a useful option for surgical treatment.

  6. Variability Matters: New Insights into Mechanics of River Avulsions on Deltas and Their Deposits

    Science.gov (United States)

    Ganti, V.

    2015-12-01

    River deltas are highly dynamic, often fan-shaped depositional systems that form when rivers drain into a standing body of water. They host over a half billion people and are currently under threat of drowning and destruction by relative sea-level rise, subsidence, and anthropogenic interference. Deltas often develop planform fan shapes through avulsions, whereby major river channel shifts occur via "channel jumping" about a spatial node, thus determining their fundamental length scale. Emerging theories suggest that the size of delta lobes is set by backwater hydrodynamics; however, these ideas are difficult to test on natural deltas, which evolve on centennial to millennial timescales. In this presentation, I will show results from the first laboratory delta built through successive deposition of lobes that maintain a constant size that scales with backwater hydrodynamics. The characteristic size of deltas emerges because of a preferential avulsion node that remains fixed spatially relative to the prograding shoreline, and is a consequence of multiple river floods that produce persistent morphodynamic river-bed adjustment within the backwater zone. Moreover, river floods cause erosion in the lowermost reaches of the alluvial river near their coastline, which may leave erosional boundaries in the sedimentary record that may appear similar to those previously interpreted to be a result of relative sea-level fall. I will discuss the implications of these findings in the context of sustainability management of deltas, decoding their stratigraphic record, and identifying ancient standing bodies of water on other planets such as Mars. Finally, I will place this delta study in a broader context of recent work that highlights the importance of understanding and quantifying variability in sedimentology and geomorphology.

  7. 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.

  8. Isolated avulsion fracture of the first metatarsal base at the peroneus longus tendon attachment: a case report.

    Science.gov (United States)

    Weinberg, Maxwell W; Krähenbühl, Nicola; Davidson, Nathan P; Hanrahan, Christopher J; Barg, Alexej

    2018-05-01

    Avulsion fractures of the first metatarsal (MT1) base at the peroneus longus (PL) tendon attachment are rare and may be undiagnosed during an emergency visit. If the injury is not treated properly, chronic pain or persistent impairment for inversion and plantar-flexion of the first ray may occur. This case report presents a 30-year-old woman who presented 10 weeks post trauma to a foot and ankle surgeon due to a swollen right midfoot with diffuse tenderness over the medial Lisfranc joint. Further evaluation showed an isolated avulsion fracture of the first metatarsal, which was undiagnosed during the emergent visit following the accident. In this case, the patient was successfully treated conservatively. The goal of this article is to raise awareness of this rare injury for radiologists and orthopedic surgeons.

  9. Motor Recovery and Synaptic Preservation after Ventral Root Avulsion and Repair with a Fibrin Sealant Derived from Snake Venom

    Science.gov (United States)

    Barbizan, Roberta; Castro, Mateus V.; Rodrigues, Antônio C.; Barraviera, Benedito; Ferreira, Rui S.; Oliveira, Alexandre L. R.

    2013-01-01

    Background Ventral root avulsion is an experimental model of proximal axonal injury at the central/peripheral nervous system interface that results in paralysis and poor clinical outcome after restorative surgery. Root reimplantation may decrease neuronal degeneration in such cases. We describe the use of a snake venom-derived fibrin sealant during surgical reconnection of avulsed roots at the spinal cord surface. The present work investigates the effects of this fibrin sealant on functional recovery, neuronal survival, synaptic plasticity, and glial reaction in the spinal motoneuron microenvironment after ventral root reimplantation. Methodology/Principal Findings Female Lewis rats (7 weeks old) were subjected to VRA and root replantation. The animals were divided into two groups: 1) avulsion only and 2) replanted roots with fibrin sealant derived from snake venom. Post-surgical motor performance was evaluated using the CatWalk system twice a week for 12 weeks. The rats were sacrificed 12 weeks after surgery, and their lumbar intumescences were processed for motoneuron counting and immunohistochemistry (GFAP, Iba-1 and synaptophysin antisera). Array based qRT-PCR was used to evaluate gene regulation of several neurotrophic factors and receptors as well as inflammatory related molecules. The results indicated that the root reimplantation with fibrin sealant enhanced motor recovery, preserved the synaptic covering of the motoneurons and improved neuronal survival. The replanted group did not show significant changes in microglial response compared to VRA-only. However, the astroglial reaction was significantly reduced in this group. Conclusions/Significance In conclusion, the present data suggest that the repair of avulsed roots with snake venom fibrin glue at the exact point of detachment results in neuroprotection and preservation of the synaptic network at the microenvironment of the lesioned motoneurons. Also such procedure reduced the astroglial reaction and

  10. Motor recovery and synaptic preservation after ventral root avulsion and repair with a fibrin sealant derived from snake venom.

    Directory of Open Access Journals (Sweden)

    Roberta Barbizan

    Full Text Available BACKGROUND: Ventral root avulsion is an experimental model of proximal axonal injury at the central/peripheral nervous system interface that results in paralysis and poor clinical outcome after restorative surgery. Root reimplantation may decrease neuronal degeneration in such cases. We describe the use of a snake venom-derived fibrin sealant during surgical reconnection of avulsed roots at the spinal cord surface. The present work investigates the effects of this fibrin sealant on functional recovery, neuronal survival, synaptic plasticity, and glial reaction in the spinal motoneuron microenvironment after ventral root reimplantation. METHODOLOGY/PRINCIPAL FINDINGS: Female Lewis rats (7 weeks old were subjected to VRA and root replantation. The animals were divided into two groups: 1 avulsion only and 2 replanted roots with fibrin sealant derived from snake venom. Post-surgical motor performance was evaluated using the CatWalk system twice a week for 12 weeks. The rats were sacrificed 12 weeks after surgery, and their lumbar intumescences were processed for motoneuron counting and immunohistochemistry (GFAP, Iba-1 and synaptophysin antisera. Array based qRT-PCR was used to evaluate gene regulation of several neurotrophic factors and receptors as well as inflammatory related molecules. The results indicated that the root reimplantation with fibrin sealant enhanced motor recovery, preserved the synaptic covering of the motoneurons and improved neuronal survival. The replanted group did not show significant changes in microglial response compared to VRA-only. However, the astroglial reaction was significantly reduced in this group. CONCLUSIONS/SIGNIFICANCE: In conclusion, the present data suggest that the repair of avulsed roots with snake venom fibrin glue at the exact point of detachment results in neuroprotection and preservation of the synaptic network at the microenvironment of the lesioned motoneurons. Also such procedure reduced the

  11. An evidence-based assessment of the clinical guidelines for replanted avulsed teeth. Part II: prescription of systemic antibiotics.

    Science.gov (United States)

    Hinckfuss, Susan Elisabeth; Messer, Louise Brearley

    2009-04-01

    Current clinical guidelines recommend prescribing systemic antibiotic therapy (SAT) for patients having an avulsed permanent tooth replanted. The principles of evidence-based dentistry can be used to assess whether this is the best approach based on currently-available evidence. The objective of this study was to use the principles of evidence-based dentistry to answer the PICO question: (P) for a replanted avulsed permanent tooth, (I) is prescribing SAT, (C) compared with not prescribing SAT, (O) associated with an increased likelihood of successful periodontal healing after tooth replantation? A literature search was performed across four internet databases (Ovid Medline, Cochrane Library, PubMed, ISI Web of Science), for relevant citations (n = 35 702). Limiting citations to those in English and removing duplicates produced a set of titles (n = 14 742) that were sieved according to evidence-based dentistry principles. Relevant titles were selected for abstract assessment (n = 782), identifying papers for examination (n = 74). Inclusion criteria were applied and three papers (326 total teeth) met the final criteria for meta-analysis. Meta-analyses found no statistically significant difference between prescribing or not prescribing antibiotics for acceptable periodontal healing without progressive root resorption (common odds ratio = 0.90, SE = 0.29, 95% confidence intervals = 0.51-1.58). The evidence for an association between prescribing SAT and an increased likelihood of acceptable periodontal healing outcome is inconclusive. This investigation of antibiotic use as defined in the clinical guidelines indicates there is inconclusive clinical evidence from studies of replanted avulsed human teeth to either contradict or support the guideline. Pending future research to the contrary, dentists are recommended to follow current guidelines in prescribing SAT when replanting avulsed teeth.

  12. Results of Non-operative and Operative Management Of Apophyseal Avulsion Fractures of the Hip and Pelvis in Adolescent Athletes

    OpenAIRE

    Heyworth, Benton E.; Bonner, Bryant; Suppan, Catherine A.; Kocher, Mininder S.; Yen, Yi-Meng; Micheli, Lyle J.

    2014-01-01

    Objectives: Apophyseal avulsion fractures of the hip and pelvis occur almost exclusively in the adolescent population, with greater numbers being seen recently as the popularity and intensity of youth sports increases. Limited evidence exists detailing the demographics or distribution of these fractures by injury site. The goal of the current study was to present a comprehensive perspective on 437 of these fractures, including the indications and clinical course of 25 cases that underwent sur...

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

    DEFF Research Database (Denmark)

    Lykke Hermansen, Lars; Gade Freund, Knud

    2016-01-01

    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 accomp...... was accomplished, and 4-month follow-up demonstrated a good outcome. © 2015, European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA)....

  14. 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.

  15. Posterior Cruciate Ligament Tibial Avulsion treated with Open Reduction and Internal Fixation through the Burks and Schaffer Approach

    Directory of Open Access Journals (Sweden)

    Khatri K

    2015-07-01

    Full Text Available Objective: To report functional outcome in Posterior Cruciate Ligament (PCL tibial avulsion fractures treated with open reduction and internal fixation through Burks and Schaffer approach. The patient specific functional outcome measures like IKDC grading together with objective grading with stress radiographs have rarely been used to assess PCL tibial avulsion fractures. Material and Methods: Twenty seven patients (21 males and 6 females were included in the study. The mean follow up duration was 22.30±6.82 months. They were assessed using international knee documentation committee (IKDC grades, Lysholm scoring and stress radiography. The injury severity scores (ISS of the patients were also recorded. Results: The mean Lysholm scores at the time of last follow up was 90.85±5.58. The IKDC grades achieved were normal in 20 patients, near normal in five and abnormal in two. The PCL laxity determined on active hamstring contraction stress radiography was grade I in 20 cases and grade II in seven cases. All patients had achieved bony union of tibial avulsion fractures at the time of last follow up. Statistically significant association was found between higher ISS and lower Lysholm scores. (t=3.455, p=0.0019. Good IKDC grades were associated with higher Lysholm scores (analysis of variance, F=32.51, p<.0001.There was no correlation between PCL laxity and functional outcome (t=.857, p =0.399. Conclusion: PCL tibial avulsion fractures treated through Burk and Schaffer approach with open reduction and internal fixation produces good results. The early rehabilitation without cast immobilisation prevents arthrofibrosis.

  16. 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.

  17. Isolated complete avulsion of the gallbladder (near traumatic cholecystectomy: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Pavlidis Theodoros E

    2011-08-01

    Full Text Available Abstract Introduction Injury of the gallbladder after blunt abdominal trauma is an unusual finding; the reported incidence is less than 2%. Three groups of injuries are described: simple contusion, laceration, and avulsion, the last of which can be partial, complete, or total traumatic cholecystectomy. Case presentation A case of isolated complete avulsion of the gallbladder (near traumatic cholecystectomy from its hepatic bed in a 46-year-old Caucasian man without any other sign of injury is presented. The avulsion was due to blunt abdominal trauma after a car accident. The rarity of this injury and the stable condition of our patient at the initial presentation warrant a description. The diagnosis was made incidentally after a computed tomography scan, and our patient was treated successfully with ligation of the cystic duct and artery, removal of the gallbladder, coagulation of the bleeding points, and placement of a drain. Conclusions Early diagnosis of such injuries is quite difficult because abdominal signs are poor, non-specific, or even absent. Therefore, a computed tomography scan should be performed when the mechanism of injury is indicated.

  18. Sequenced Peer Revision: Creating Competence and Community

    Science.gov (United States)

    Bowman, Ingrid K.; Robertson, John

    2013-01-01

    Mastering techniques of self- and peer revision is a valuable tool for all writers, especially US-educated Generation 1.5 students, whose near fluency enables them to dialogue successfully about their writing. Using action research, 2 academic writing instructors systematically trained students to more responsibly and effectively revise their…

  19. Thalamic deep brain stimulation for neuropathic pain after amputation or brachial plexus avulsion.

    Science.gov (United States)

    Pereira, Erlick A C; Boccard, Sandra G; Linhares, Paulo; Chamadoira, Clara; Rosas, Maria José; Abreu, Pedro; Rebelo, Virgínia; Vaz, Rui; Aziz, Tipu Z

    2013-09-01

    Fifteen hundred patients have received deep brain stimulation (DBS) to treat neuropathic pain refractory to pharmacotherapy over the last half-century, but few during the last decade. Deep brain stimulation for neuropathic pain has shown variable outcomes and gained consensus approval in Europe but not the US. This study prospectively evaluated the efficacy at 1 year of DBS for phantom limb pain after amputation, and deafferentation pain after brachial plexus avulsion (BPA), in a single-center case series. Patient-reported outcome measures were collated before and after surgery, using a visual analog scale (VAS) score, 36-Item Short-Form Health Survey (SF-36), Brief Pain Inventory (BPI), and University of Washington Neuropathic Pain Score (UWNPS). Twelve patients were treated over 29 months, receiving contralateral, ventroposterolateral sensory thalamic DBS. Five patients were amputees and 7 had BPAs, all from traumas. A postoperative trial of externalized DBS failed in 1 patient with BPA. Eleven patients proceeded to implantation and gained improvement in pain scores at 12 months. No surgical complications or stimulation side effects were noted. In the amputation group, after 12 months the mean VAS score improved by 90.0% ± 10.0% (p = 0.001), SF-36 by 57.5% ± 97.9% (p = 0.127), UWNPS by 80.4% ± 12.7% (p stimulation demonstrated efficacy at 1 year for chronic neuropathic pain after traumatic amputation and BPA. Clinical trials that retain patients in long-term follow-up are desirable to confirm findings from prospectively assessed case series.

  20. Evaluation of nerve transfer options for treating total brachial plexus avulsion injury: A retrospective study of 73 participants.

    Science.gov (United States)

    Gao, Kai-Ming; Hu, Jing-Jing; Lao, Jie; Zhao, Xin

    2018-03-01

    Despite recent great progress in diagnosis and microsurgical repair, the prognosis in total brachial plexus-avulsion injury remains unfavorable. Insufficient number of donors and unreasonable use of donor nerves might be key factors. To identify an optimal treatment strategy for this condition, we conducted a retrospective review. Seventy-three patients with total brachial plexus avulsion injury were followed up for an average of 7.3 years. Our analysis demonstrated no significant difference in elbow-flexion recovery between phrenic nerve-transfer (25 cases), phrenic nerve-graft (19 cases), intercostal nerve (17 cases), or contralateral C 7 -transfer (12 cases) groups. Restoration of shoulder function was attempted through anterior accessory nerve (27 cases), posterior accessory nerve (10 cases), intercostal nerve (5 cases), or accessory + intercostal nerve transfer (31 cases). Accessory nerve + intercostal nerve transfer was the most effective method. A significantly greater amount of elbow extension was observed in patients with intercostal nerve transfer (25 cases) than in those with contralateral C 7 transfer (10 cases). Recovery of median nerve function was noticeably better for those who received entire contralateral C 7 transfer (33 cases) than for those who received partial contralateral C 7 transfer (40 cases). Wrist and finger extension were reconstructed by intercostal nerve transfer (31 cases). Overall, the recommended surgical treatment for total brachial plexus-avulsion injury is phrenic nerve transfer for elbow flexion, accessory nerve + intercostal nerve transfer for shoulder function, intercostal nerves transfer for elbow extension, entire contralateral C 7 transfer for median nerve function, and intercostal nerve transfer for finger extension. The trial was registered at ClinicalTrials.gov (identifier: NCT03166033).

  1. Evaluation of nerve transfer options for treating total brachial plexus avulsion injury: a retrospective study of 73 participants

    Science.gov (United States)

    Gao, Kai-ming; Hu, Jing-jing; Lao, Jie; Zhao, Xin

    2018-01-01

    Despite recent great progress in diagnosis and microsurgical repair, the prognosis in total brachial plexus-avulsion injury remains unfavorable. Insufficient number of donors and unreasonable use of donor nerves might be key factors. To identify an optimal treatment strategy for this condition, we conducted a retrospective review. Seventy-three patients with total brachial plexus avulsion injury were followed up for an average of 7.3 years. Our analysis demonstrated no significant difference in elbow-flexion recovery between phrenic nerve-transfer (25 cases), phrenic nerve-graft (19 cases), intercostal nerve (17 cases), or contralateral C7-transfer (12 cases) groups. Restoration of shoulder function was attempted through anterior accessory nerve (27 cases), posterior accessory nerve (10 cases), intercostal nerve (5 cases), or accessory + intercostal nerve transfer (31 cases). Accessory nerve + intercostal nerve transfer was the most effective method. A significantly greater amount of elbow extension was observed in patients with intercostal nerve transfer (25 cases) than in those with contralateral C7 transfer (10 cases). Recovery of median nerve function was noticeably better for those who received entire contralateral C7 transfer (33 cases) than for those who received partial contralateral C7 transfer (40 cases). Wrist and finger extension were reconstructed by intercostal nerve transfer (31 cases). Overall, the recommended surgical treatment for total brachial plexus-avulsion injury is phrenic nerve transfer for elbow flexion, accessory nerve + intercostal nerve transfer for shoulder function, intercostal nerves transfer for elbow extension, entire contralateral C7 transfer for median nerve function, and intercostal nerve transfer for finger extension. The trial was registered at ClinicalTrials.gov (identifier: NCT03166033). PMID:29623932

  2. 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)

  3. The effect of laterally positioned flap-revised technique and 24% ethylenediaminetetraacetic acid root conditioning on root coverage: A case report

    OpenAIRE

    Singh, Jagmohan; Bharti, Vipin

    2014-01-01

    Complete root coverage is considered the true goal of treatment of gingival recession defects because only complete coverage assures recovery from the hypersensitivity and esthetic defects associated with recession areas. Previous studies have shown that the laterally positioned flap (LPF) technique or root surface biomodification yields a higher percentage of complete root coverage upon gingival recession treatment. This article highlights the use of the laterally positioned pedicle flap-rev...

  4. [Application of three-dimensional printing technology in treatment of internal or external ankle distal avulsed fracture].

    Science.gov (United States)

    Shi, Weixiang; Luo, Xiaozhong; Wu, Gang; Ding, Yong; Zhou, Xin

    2018-02-01

    To explore the effectiveness and advantage of three-dimensional (3D) printing technology in treatment of internal or external ankle distal avulsed fracture. Between January 2015 and January 2017, 20 patients with distal avulsed fracture of internal or external ankle were treated with the 3D guidance of shape-blocking steel plate fixation (group A), and 18 patients were treated with traditional plaster external fixation (group B). There was no significant difference in gender, age, injury cause, disease duration, fracture side, and fracture type between 2 groups ( P >0.05). Recording the fracture healing rate, fracture healing time, the time of starting to ankle functional exercise, residual ankle pain, and evaluating ankle function recovery of both groups by the American Orthopaedic Foot and Ankle Society (AOFAS) score. All patients were followed up 8-24 months, with an average of 15.5 months. In group A: all incisions healed by first intention, the time of starting to ankle functional exercise was (14±3) days, fracture healing rate was 100%, and the fracture healing time was (10.15±2.00) weeks. At 6 months, the AOFAS score was 90.35±4.65. Among them, 13 patients were excellent and 7 patients were good. All patients had no post-operative incision infection, residual ankle pain, or dysfunction during the follow-up. In group B: the time of starting to ankle functional exercise was (40±10) days, the fracture healing rate was 94.44%, and the fracture healing time was (13.83±7.49) weeks. At 6 months, the AOFAS score was 79.28±34.28. Among them, 15 patients were good, 2 patients were medium, and 1 patient was poor. During the follow-up, 3 patients (16.67%) had pain of ankle joint with different degrees. There were significant differences in the postoperative fracture healing rate, fracture healing time, the time of starting to ankle functional exercise, and postoperative AOFAS score between 2 groups ( P internal or external ankle distal avulsed fracture is simple

  5. Avulsion fractures of the anterior inferior iliac spine: spectrum of imaging findings; Avulsao da espinha iliaca antero-inferior: espectro dos achados de imagem

    Energy Technology Data Exchange (ETDEWEB)

    Fernandes, Joao Luiz [Hospital Santa Lucia, Brasilia, DF (Brazil). Dept. de Ressonancia Magnetica; Viana, Sergio Lopes; Mendonca, Jose Luiz Furtado de; Freitas, Flavia Mendes Oliveira; Lima, Gylse-Anne de Souza; Vila, Ana Fabiola da; Ribeiro, Nelmar [Clinica Radiologica Vila Rica, Brasilia, DF (Brazil). Dept. de Ressonancia Magnetica]. E-mail: radiolog@uol.com.br

    2005-07-15

    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)

  6. Management of High-energy Avulsive Ballistic Facial Injury: A Review of the Literature and Algorithmic Approach.

    Science.gov (United States)

    Vaca, Elbert E; Bellamy, Justin L; Sinno, Sammy; Rodriguez, Eduardo D

    2018-03-01

    High-energy avulsive ballistic facial injuries pose one of the most significant reconstructive challenges. We conducted a systematic review of the literature to evaluate management trends and outcomes for the treatment of devastating ballistic facial trauma. Furthermore, we describe the senior author's early and definitive staged reconstructive approach to these challenging patients. A Medline search was conducted to include studies that described timing of treatment, interventions, complications, and/or aesthetic outcomes. Initial query revealed 41 articles, of which 17 articles met inclusion criteria. A single comparative study revealed that early versus delayed management resulted in a decreased incidence of soft-tissue contracture, required fewer total procedures, and resulted in shorter hospitalizations (level 3 evidence). Seven of the 9 studies (78%) that advocated delayed reconstruction were from the Middle East, whereas 5 of the 6 studies (83%) advocating immediate or early definitive reconstruction were from the United States. No study compared debridement timing directly in a head-to-head fashion, nor described flap selection based on defect characteristics. Existing literature suggests that early and aggressive intervention improves outcomes following avulsive ballistic injuries. Further comparative studies are needed; however, although evidence is limited, the senior author presents a 3-stage reconstructive algorithm advocating early and definitive reconstruction with aesthetic free tissue transfer in an attempt to optimize reconstructive outcomes of these complex injuries.

  7. Management of High-energy Avulsive Ballistic Facial Injury: A Review of the Literature and Algorithmic Approach

    Science.gov (United States)

    Vaca, Elbert E.; Bellamy, Justin L.; Sinno, Sammy

    2018-01-01

    Background: High-energy avulsive ballistic facial injuries pose one of the most significant reconstructive challenges. We conducted a systematic review of the literature to evaluate management trends and outcomes for the treatment of devastating ballistic facial trauma. Furthermore, we describe the senior author’s early and definitive staged reconstructive approach to these challenging patients. Methods: A Medline search was conducted to include studies that described timing of treatment, interventions, complications, and/or aesthetic outcomes. Results: Initial query revealed 41 articles, of which 17 articles met inclusion criteria. A single comparative study revealed that early versus delayed management resulted in a decreased incidence of soft-tissue contracture, required fewer total procedures, and resulted in shorter hospitalizations (level 3 evidence). Seven of the 9 studies (78%) that advocated delayed reconstruction were from the Middle East, whereas 5 of the 6 studies (83%) advocating immediate or early definitive reconstruction were from the United States. No study compared debridement timing directly in a head-to-head fashion, nor described flap selection based on defect characteristics. Conclusions: Existing literature suggests that early and aggressive intervention improves outcomes following avulsive ballistic injuries. Further comparative studies are needed; however, although evidence is limited, the senior author presents a 3-stage reconstructive algorithm advocating early and definitive reconstruction with aesthetic free tissue transfer in an attempt to optimize reconstructive outcomes of these complex injuries. PMID:29707453

  8. Dragon's Blood Sap (Croton Lechleri) As Storage Medium For Avulsed Teeth: In Vitro Study Of Cell Viability.

    Science.gov (United States)

    Martins, Christine Men; Hamanaka, Elizane Ferreira; Hoshida, Thayse Yumi; Sell, Ana Maria; Hidalgo, Mirian Marubayashi; Silveira, Catarina Soares; Poi, Wilson Roberto

    2016-01-01

    Tooth replantation success depends on the condition of cementum periodontal ligament after tooth avulsion; which is influenced by storage medium. The dragon's blood (Croton lechleri) sap has been suggested as a promising medium because it supports collagen formation and exhibits healing, anti-inflammatory and antimicrobial properties. Thus, the aim of this study was to evaluate the efficacy of dragon's blood sap as a storage medium for avulsed teeth through evaluation of functional and metabolic cell viability. This in vitro study compared the efficacy of different storage media to maintain the viability of human peripheral blood mononuclear and periodontal ligament cells. A 10% dragon's blood sap was tested while PBS was selected as its control. Ultra pasteurized whole milk was used for comparison as a commonly used storage medium. DMEM and distilled water were the positive and negative controls, respectively. The viability was assessed through trypan blue exclusion test and colorimetric MTT assay after 1, 3, 6, 10 and 24 h of incubation. The dragon's blood sap showed promising results due to its considerable maintenance of cell viability. For trypan blue test, the dragon's blood sap was similar to milk (psap showed better results than all storage media, even better than milk (psap was as effective as milk, the gold standard for storage medium. The experimental sap preserved the membrane of all cells and the functional viability of periodontal ligament cells.

  9. Complete avulsion of the adductor longus in a semi-professional football player: Rapid return to play with nonoperative treatment

    Directory of Open Access Journals (Sweden)

    Vince W Lands

    2016-01-01

    Full Text Available The adductor longus has become recognized as one of the more commonly injured muscles in the medial compartment. Acute complete rupture injuries occurring at the proximal aspect of the muscle are less common. Limited data exist regarding management of the injuries in athletes required for return to play and functioning. The current data favors operative management; however, nonoperative treatment may be a viable option. Nonoperative management of avulsion injuries of the proximal adductor longus tendon may prove equal results to surgical repair in return to play and functioning. A semi-professional football player sustained a left groin injury while participating in the play. Due to continued pain, swelling, and suspicion of injury, a magnetic resonance imaging was performed diagnosing a complete tear of proximal adductor longus tendon. Physical examination, strength, and range of motion were recorded until the patient was able to function normally without strength deficit, the range of motion loss, and the return of speed. The player was treated nonoperatively and was eventually allowed to return to play. The time of return to play was 6 weeks. Strength deficit was not appreciated or loss of motion and player was able to return to baseline function. Nonoperative management of complete avulsion injuries of the proximal adductor longus tendon result in faster return to play than operative management even if significant retraction is present.

  10. Efficiency of Castor Oil as a Storage Medium for Avulsed Teeth in Maintaining the Viability of Periodontal Ligament Cells.

    Science.gov (United States)

    Nabavizadeh, Mohammadreza; Abbaszadegan, Abbas; Khodabakhsi, Afrooz; Ahzan, Shamseddin; Mehrabani, Davood

    2018-03-01

    Researchers always seek a new storage medium for avulsed teeth. Castor oil is a vegetable oil with several advantages such as antimicrobial and antioxidant properties, low toxicity, and glutathione preservation capability, low cost, and high availability. The purpose of this study was to evaluate and compare the capacity of castor oil as a new storage medium in preserving the viability of periodontal ligament (PDL) cells compared to Hank's balanced salt solution (HBSS) and milk. Forty freshly extracted human teeth were divided into 3 experimental and 2 control groups. The experimental teeth were stored dry for 30 min and then immersed for 45 min in one of the following media; castor oil, HBSS, and milk. The positive and negative control groups were exposed to 0 min and 2 h of dry time respectively with no immersion in any storage medium. The teeth were then treated with dispase grade II and collagenase and the number of viable PDL cells were counted. Data were analyzed using Kruskal- Wallis test. The percentage of viable cells treated with castor oil, HBSS and milk counted immediately after removal from these media were 46.93, 51.02 and 55.10 % respectively. The statistical analysis revealed that the value for castor oil was significantly lower than HBSS and milk ( p > 0.05). Within the parameters of this study, it appears that castor oil cannot be served as an ideal medium for storage of avulsed tooth. More investigations under in vivo conditions are required to justify the results of this study.

  11. 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...

  12. The importance of sand in the formation of avulsion channels within experimental fans that develop from sediment mixtures of mud and sand

    Science.gov (United States)

    Iscen, N.; Strom, K.

    2017-12-01

    Autogenic channel migration and avulsion has long been recognized as important drivers of alluvial fan dynamics. In the literature, several field studies have documented that the presence and the amount of sand transport through a channel is important for channel incision in alluvial fans and deltas. In our experiments, we present the general autogenic avulsion cycle of experimental alluvial fans with mixtures of cohesive sediment and sand with a range of boundary conditions, and we detail the importance of mobile sand fraction in the development of channels that lead to avulsion. Experimental observations demonstrate that new channels form at topographically low regions within the floodplain providing that sand is transported to these topographic lows due to overbank flow or levee breaching. In addition to the sediment transported from upstream, erosion of a previous deposit and an ongoing backfilling nearby are observed as the possible sources of sand getting into the ghost channels. We explore whether the presence of sand is important for channel development because it increases abrasion of the channel or because it changes the roughness characteristics of the flow. We also examine the affect of sediment and water supply change on the newly described channelization process and link distinctive channel morphologies to different stages of described channel development and the avulsion process.

  13. Magnetic resonance imaging for detecting root avulsions in traumatic adult brachial plexus injuries: protocol for a systematic review of diagnostic accuracy.

    Science.gov (United States)

    Wade, Ryckie G; Takwoingi, Yemisi; Wormald, Justin C R; Ridgway, John P; Tanner, Steven; Rankine, James J; Bourke, Grainne

    2018-05-19

    Adult brachial plexus injuries (BPI) are becoming more common. The reconstruction and prognosis of pre-ganglionic injuries (root avulsions) are different to other types of BPI injury. Preoperative magnetic resonance imaging (MRI) is being used to identify root avulsions, but the evidence from studies of its diagnostic accuracy are conflicting. Therefore, a systematic review is needed to address uncertainty about the accuracy of MRI and to guide future research. We will conduct a systematic search of electronic databases alongside reference tracking. We will include studies of adults with traumatic BPI which report the accuracy of preoperative MRI (index test) against surgical exploration of the roots of the brachial plexus (reference standard) for detecting either of the two target conditions (any root avulsion or any pseudomeningocoele as a surrogate marker of root avulsion). We will exclude case reports, articles considering bilateral injuries and studies where the number of true positives, false positives, false negatives and true negatives cannot be derived. The methodological quality of the included studies will be assessed using a tailored version of the QUADAS-2 tool. Where possible, a bivariate model will be used for meta-analysis to obtain summary sensitivities and specificities for both target conditions. We will investigate heterogeneity in the performance of MRI according to field strength and the risk of bias if data permits. This review will summarise the current diagnostic accuracy of MRI for adult BPI, identify shortcomings and gaps in the literature and so help to guide future research. PROSPERO CRD42016049702 .

  14. 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),

  15. Management of a type two avulsion fracture of the tibial intercondylar eminence in children: arthroscopic suture fixation versus conservative immobilization.

    Science.gov (United States)

    Zhao, Chen; Bi, Qing; Bi, Mingguang

    2018-06-01

    Treatment of a type II tibial eminence avulsion fracture was controversial. The aim of this study was to compare the clinical outcomes of a modified arthroscopic suture fixation versus conservative immobilization in treatment of this type fracture in immature population. A total of 43 type II avulsion fractures of tibial intercondylar eminence in immature patients were retrospectively enrolled in the study. Twenty-two (13 males, 9 females) were treated with arthroscopic suture fixation and 21(12 males, 9 females) with conservative cast immobilization. Radiograph, Lachman test, anterior drawer test (ADT), International Knee Documentation Committee (IKDC) 2000 subjective score, and Lysholm score were used to evaluate clinical outcomes in follow-up. All 43 paediatric or adolescent patients with a mean of 11.3 years (range, 8-16 years) were followed up for a median period of 34.5 months (range, 24-46 months). Radiographic evaluation showed optimal reduction immediately after surgery and bone union within three months. At the final follow-up, no limitation of knee motion range was found in any children. Grade II laxity was found in one case from surgical group and six from conservation group, showing significant difference based on ADT (χ2 = 7.927, P = 0.005) and Lachman tests (χ2 = 9.546, P = 0.002). IKDC and Lysholm scores were significantly improved; however, there were significant differences in the IKDC score (91.7 ± 4.34 vs. 84.7 ± 6.11, t = 4.35, P < 0.001) and Lysholm score (93.4 ± 4.04 vs. 87.1 ± 5.24, t = 4.53, P < 0.001), and the improvement of IKDC value (40.2 ± 7.83 vs. 31.4 ± 8.4, t = 3.57, P = 0.001) and Lysholm value (43.8 ± 6.55 vs. 35.4 ± 5.97, t = 4.36, P < 0.001) between the surgical group and the nonsurgical group. In treatment of type II tibial eminence avulsion fracture, a modified, 8 shape suture fixation under arthroscopy showed superior clinical

  16. [Treatment of posterior cruciate ligament avulsion fracture with rivet-assisted hollow nail:a case-control study].

    Science.gov (United States)

    Zhu, Jia-Fu; Ma, Gou-Ping; Xu, Wei-Xing; Guo, Qiao-Feng; Liu, Hong

    2017-04-25

    To retrospectively investigate the clinical effect of the rivet-assisted hollow screw in the treatment of posterior cruciate ligament avulsion fracture. Total 49 patients with knee cruciate ligament avulsion fracture in the ending point of the ligament from January 2010 to December 2014 were divided into the treatment group and the control group. Thirty-one patients in treatment group were treated with rivet-assisted double cannulate nail, including 13 males and 18 females, ranging in age from 38 to 51 years old, with a mean of (40.6±5.1) years old; according to Meyers classification, 23 cases of type 2, 8 cases of type 3; 5 patients were caused by the low energy injury and 26 patients were caused by the high energy injury. Eighteen patients in control group were treated with double gold hollow screw fixation, including 5 males and 13 females, ranging in age from 36 to 52 years old, with an average age of (4.16±4.7) years old; according to Meyers classification, 14 cases of type 2 and 4 cases of type 3;2 patients were caused by the low energy injury and 16 patients were caused by the high energy injury. The operation time, postoperative complications, fracture healing time and the last AKS scoring system were compared between the two groups. All the patients were followed up, and the duration ranged from 12 to 24 months, with an average of 14.2 months. The patients in treatment group had no displacement of fracture fragments and internal fixation failure. The results of AKS score:pain was 48.1±1.5, activity was 21.3±2.7, stability was 20.9±2.5, walking ability was 47.3±1.9, under the stairs ability was 43.4±2.1, the total score was 190.7±2.9. There were 2 cases in control group had fracture fragment displacement and 1 patient had nail withdraw. The results of AKS score:pain was 40.1±2.2, activity was 20.1±0.2, stability was 18.1±3.2, walking ability was 46.3±1.7, under the stairs ability was 40.2 ±1.3, the total score was 180.2±1.4. Therefore, the

  17. Use of platelet-rich fibrin as an autologous biologic rejuvenating media for avulsed teeth - an in vitro study.

    Science.gov (United States)

    Hiremath, Hemalatha; Kulkarni, Sadanand; Sharma, Robin; Hiremath, Vishwanath; Motiwala, Tejas

    2014-12-01

    The prognosis of replanted avulsed tooth depends on the existence of viable cells in the periodontal ligament and also on those cells which are able to proliferate on the damaged areas of the root. The purpose of this study was to evaluate the survival of periodontal ligament cells (PDL) when soaked in an autologous biologic rejuvenating media after an extra-oral dry time of 40 min. Thirty teeth were selected with intact crown which were advised for Orthodontic extraction having healthy PDL. They were divided into two experimental and two control groups. The positive and negative controls corresponded to 0-min and 1-h dry time, respectively. The experimental teeth were stored dry for 40 min and then immersed in one of the two media, combination of platelet-rich fibrin and platelet poor plasma (PRF+PPP) and PPP for 45 min. The teeth in each group were treated with dispase II and collagenase for 30 min and later centrifuged for 5 min at 50.17 g. The supernatant was removed with sterile micropipette, the cells labelled with 0.4% trypan blue, and the number of viable PDL cells was counted with a haemocytometer, under a light microscope. anova and Mann-Whitney U-test demonstrated statistically significant differences in the viability of PDL cells among experimental groups. Within the parameters of this study, a combination of platelet-rich fibrin and PPP demonstrated higher number of viable PDL cells and hence could be a good biologic rejuvenating media for avulsed teeth. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. 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

  19. The brain plasticity in patients with brachial plexus root avulsion after contralateral C7 nerve-root transfer: a FDG-PET study

    International Nuclear Information System (INIS)

    Zuo, C.T.; Guan, Y.H.; Xu, W.D.; Zhao, J.; Sun, G.X.; Lin, X.T.

    2002-01-01

    Objectives: To study FDG-PET for imaging the brain plasticity in patients with brachial plexus root avulsion after contralateral C7 nerve-root transfer. Methods: One male patient with left brachial plexus root avulsion underwent a two-stage procedure (first phase: C7 root → ulnar nerve; second phase: ulnar nerve → recipient nerve) 4 years ago; Another with right brachial plexus root avulsion also underwent a two-stage procedure 3 years ago. First two patients underwent basic FDG-PET imaging, the next day FDG-PET scans were performed after initiative or passive limb movement. Using ROI and MPI tools to evaluate the images. The ratios of sensorimotor frontal cingulated Thalami to white matter were used as the semiquantitive index. Results: Whether brain plasticity had occurred was determined by whether the affected limb can perform initiative movement. The increases in glucose metabolism of left sensorimotor frontal cingulated Thalami in patient with left brachial plexus root avulsion were 40.1%, 37.9%, 48.3%, 31.9% after initiative movement, the right corresponding brain regions were 39.4%, 34.3%, 48.5%,35.4% respectively. However, the increases in glucose metabolism of left sensorimotor frontal cingulated Thalami in patient with right brachial plexus root avulsion were increased by 12.6%, 9.6%, 10.7%, 5.3% after passive movement, the right corresponding brain regions were respectively 17.9%, 12.9%, 15.4%, 10.1%. It was founded that the metabolism of bilateral sensorimotor frontal cingulated Thalami increased after initiative movement, while the metabolism of right sensorimotor frontal cingulated Thalami increased more obviously than that of the left brain regions when using MPI tool to substract the images before and after the affected limb movement. Conclusions: Sensorimotor frontal cingulated Thalami were necessary to the initiative movement. After being activated by movement, the metabolisms of plasticised brain regions increased obviously. However, the

  20. 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.

  1. Bibliocable. Revised Edition.

    Science.gov (United States)

    Cable Television Information Center, Washington, DC.

    This selective, annotated bibliography is a revision of the original published in 1972 (ED 071 402). Some 104 books, articles, and reports included here deal with access, applications, franchising, regulation, technology, and other aspects of cable television. The listings are of two types in each category. First are revisions of the original…

  2. Consequences of Avulsion Fracture of the Proximal Phalanx Caused by a Technical Failure of Hallux Valgus Surgery.

    Science.gov (United States)

    Park, Young Uk; Lee, Kyung Tai; Jegal, Hyuk; Kim, Ki Chun; Choo, Ho Sik; Kweon, Heon Ju

    2016-01-01

    Several cases of avulsion fracture of the proximal phalanx of the big toe during the lateral capsular release procedure were observed. However, these fractures have not been reported as a complication of hallux valgus surgery. The purpose of the present study was to report the proximal phalanx base fracture as an unrecognized complication and to evaluate the clinical and radiographic consequences of this complication. We retrospectively reviewed 225 feet that had undergone hallux valgus surgery involving proximal chevron osteotomy and distal soft tissue release from May 2009 to December 2012. Of these 225 feet (198 patients), 12 (5.3%) developed proximal phalanx base fracture postoperatively. These patients were assigned to the fracture group. The remaining patients were assigned to the nonfracture group. Patients were followed to observe whether the fractures united and whether degenerative changes developed at the first metatarsophalangeal joint because of this fracture. The mean follow-up period was 36 (range 12 to 72) months. All the subjects in the fracture and nonfracture groups underwent weightbearing anteroposterior and lateral radiographs of the foot at the initial presentation and final follow-up point. The 2 groups were compared with respect to the hallux valgus angle, intermetatarsal angle, range of motion, American Orthopaedic Foot and Ankle Society score, satisfaction, and degenerative changes. No significant differences were found in age, follow-up period, hallux valgus angle, intermetatarsal angle, range of motion of the first metatarsophalangeal joint, American Orthopaedic Foot and Ankle Society score, satisfaction, and degenerative changes between the 2 groups. Ten (83.3%) of the 12 fractures healed, 2 (16.7% of the fractures, 0.89% of the operated feet) progressed to asymptomatic nonunion, and 3 (1.33%) developed first metatarsophalangeal joint degeneration. Avulsion fracture of the proximal phalanx of the big toe is an uncommon complication of

  3. Evaluation of the long-shelf life honey milk As a storage media for preservation of avulsed teeth

    Directory of Open Access Journals (Sweden)

    Ali Nozari

    2013-09-01

    Full Text Available Introduction: Tooth avulsion is defined as the complete displacement of the tooth from its alveolar socket which causes damage to the periodontal ligament structure, cementum, alveolar bone, gingiva, and dental pulp. The purpose of this study was to determine the ability of long-shelf life honey milk to serve as a temporary storage medium for the maintenance of periodontal ligament (PDL cell viability on avulsed teeth. Methods: PDL cells were obtained from premolars extracted for orthodontic purposes which were clinically healthy and had healthy gingiva (i.e. not inflamed.Then, 8×10³ cells were seeded in each well of 96-well plate. and Afterwards treated with long-shelf life milk and honey milk, Hank’s Balanced Salt Solution (HBSS and fresh milk. Different incubation periods were 1, 3, 6, and 9 hours. Dulbecco’s Modified Eagle Medium (DMEM and dry medium were considered as positive and negative control media, respectively. Cell viability was determined by using the MTT (Thiazolyl Blue Tetrazolium Bromide assay. Data were statistically analyzed with one-way anova, two-way anova and post hoc Scheffe tests. A level of p≤0.05 was accepted as statistically significant Results: The results indicate that all media performed significantly better in maintaining PDL cell viability than the negative control at all time periods. (p≤0.001 After 9 hours, Percentage of viable PDL cells in long-shelf life honey milk, long-shelf life milk and HBSS were 82±0.82, 75±8.13 and 87±2.78 respectively. Furthermore cells' viability in both long-shelf life honey milk and HBSS was significantly better than fresh milk medium (p=0.003. Moreover, the results of One-way ANOVA showed long-shelf life honey milk were more effective in preserving the PDL cell viability as well as HBSS after 9 hours. Conclusions: According to the study results, long-shelf life honey milk considered as appropriate storage media which are comparable to HBSS. These media are not only able

  4. Finger replantation: surgical technique and indications.

    Science.gov (United States)

    Barbary, S; Dap, F; Dautel, G

    2013-12-01

    In this article, we discuss the surgical technique of finger replantation in detail, distinguishing particularities of technique in cases of thumb amputation, children fingertip replantation, ring finger avulsion, and very distal replantations. We emphasize the principles of bone shortening, the spare part concept, the special importance of nerve sutures and the use of vein graft in case of avulsion or crushing. However, even if finger replantation is now a routine procedure, a clear distinction should be made between revascularization and functional success. The indications for finger replantation are then detailed in the second part of this paper. The absolute indications for replantation are thumb, multiple fingers, transmetacarpal or hand, and any upper extremity amputation in a child whatever the level. Fingertip amputations distal to the insertion of the Flexor digitorum superficialis (FDS) are also a good indication. Other cases are more controversial because of the poor functional outcome, especially for the index finger, which is often functionally excluded. Copyright © 2013. Published by Elsevier SAS.

  5. 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.

  6. Comparative evaluation of four transport media for maintaining cell viability in transportation of an avulsed tooth - An in vitro study.

    Science.gov (United States)

    Bharath, Makonahalli Jaganath; Sahadev, Chickmagravalli Krishnegowda; Ramachandra, Praveen Kumar Makonahalli; Rudranaik, Sandeep; George, Jijo; Thomas, Ashna

    2015-01-01

    The study was performed to compare and evaluate the efficacy of four experimental storage media (Hank's balanced salt solution, Ringer's lactate solution, tender coconut water, and green tea extract) for maintaining cell viability of human periodontal cells at different time intervals of 15 min 30 min, 60 min, and 90 min. Human periodontal cells were cultured and stored in the four media. After 15 min 30 min, 60 min, and 90 min, the different media were examined under optical microscope and viabilities analyzed using an optical calorimeter. Mean and standard deviation were estimated from the results that were statistically analyzed using one-way analysis of variance (ANOVA) to identify the significant groups. The results indicated that there was no difference in cell viability between the four media up to a period of 60 min, whereas green tea extract showed a lower cell viability after 90 min. Within the limitations of the present study, it appears that due to superior osmolality, cost effectiveness, and easier availability, Ringer's lactate, tender coconut water, and green tea extract can be used as alternate storage media for avulsed tooth.

  7. Publishing and Revising Content

    Science.gov (United States)

    Editors and Webmasters can publish content without going through a workflow. Publishing times and dates can be set, and multiple pages can be published in bulk. Making an edit to published content created a revision.

  8. 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...

  9. Comparing contemporary revision burden among hip and knee joint replacement registries

    Directory of Open Access Journals (Sweden)

    Brian J. McGrory, MD, MS

    2016-06-01

    Conclusions: Revision burden has gradually decreased for hip replacements and has remained relatively constant for knee replacements both for the last 4 years and compared to historic controls. Knee revision burden was lower than hip revision burden for each period examined. Revision burden is one measure that may be helpful in following the effect of changes in surgical technique and implant design over time in registry populations and may be a helpful way to compare overall results between registries.

  10. Postoperative pain outcomes after transvaginal mesh revision.

    Science.gov (United States)

    Danford, Jill M; Osborn, David J; Reynolds, W Stuart; Biller, Daniel H; Dmochowski, Roger R

    2015-01-01

    Although the current literature discusses mesh complications including pain, as well as suggesting different techniques for removing mesh, there is little literature regarding pain outcomes after surgical removal or revision. The purpose of this study is to determine if surgical removal or revision of vaginal mesh improves patient's subjective complaints of pelvic pain associated with original placement of mesh. After obtaining approval from the Vanderbilt University Medical Center Institutional Review Board, a retrospective review of female patients with pain secondary to previous mesh placement who underwent excision or revision of vaginal mesh from January 2000 to August 2012 was performed. Patient age, relevant medical history including menopause status, previous hysterectomy, smoking status, and presence of diabetes, fibromyalgia, interstitial cystitis, and chronic pelvic pain, was obtained. Patients' postoperative pain complaints were assessed. Of the 481 patients who underwent surgery for mesh revision, removal or urethrolysis, 233 patients met our inclusion criteria. One hundred and sixty-nine patients (73 %) reported that their pain improved, 19 (8 %) reported that their pain worsened, and 45 (19 %) reported that their pain remained unchanged after surgery. Prior history of chronic pelvic pain was associated with increased risk of failure of the procedure to relieve pain (OR 0.28, 95 % CI 0.12-0.64, p = 0.003). Excision or revision of vaginal mesh appears to be effective in improving patients' pain symptoms most of the time. Patients with a history of chronic pelvic pain are at an increased risk of no improvement or of worsening pain.

  11. Selective plasticity of primary afferent innervation to the dorsal horn and autonomic nuclei following lumbosacral ventral root avulsion and reimplantation in long term studies.

    Science.gov (United States)

    Wu, Lisa; Wu, Jun; Chang, Huiyi H; Havton, Leif A

    2012-02-01

    Previous studies involving injuries to the nerves of the cauda equina and the conus medullaris have shown that lumbosacral ventral root avulsion in rat models results in denervation and dysfunction of the lower urinary tract, retrograde and progressive cell death of the axotomized motor and parasympathetic neurons, as well as the emergence of neuropathic pain. Root reimplantation has also been shown to ameliorate several of these responses, but experiments thus far have been limited to studying the effects of lesion and reimplantation local to the lumbosacral region. Here, we have expanded the region of investigation after lumbosacral ventral root avulsion and reimplantation to include the thoracolumbar sympathetic region of the spinal cord. Using a retrograde tracer injected into the major pelvic ganglion, we were able to define the levels of the spinal cord that contain sympathetic preganglionic neurons innervating the lower urinary tract. We have conducted studies on the effects of the lumbosacral ventral root avulsion and reimplantation models on the afferent innervation of the dorsal horn and autonomic nuclei at both thoracolumbar and lumbosacral levels through immunohistochemistry for the markers calcitonin gene-related peptide (CGRP) and vesicular glutamate transporter 1 (VGLUT1). Surprisingly, our experiments reveal a selective and significant decrease of CGRP-positive innervation in the dorsal horn at thoracolumbar levels that is partially restored with root reimplantation. However, no similar changes were detected at the lumbosacral levels despite the injury and repair targeting efferent neurons, and being performed at the lumbosacral levels. Despite the changes evident in the thoracolumbar dorsal horn, we find no changes in afferent innervation of the autonomic nuclei at either sympathetic or parasympathetic segmental levels by CGRP or VGLUT1. We conclude that even remote, efferent root injuries and repair procedures can have an effect on remote and non

  12. Plasticity of Select Primary Afferent Projections to the Dorsal Horn after a Lumbosacral Ventral Root Avulsion Injury and Root Replantation in Rats

    Directory of Open Access Journals (Sweden)

    Allison J. Bigbee

    2017-07-01

    Full Text Available Injuries to the conus medullaris and cauda equina portions of the spinal cord result in neurological impairments, including paralysis, autonomic dysfunction, and pain. In experimental studies, earlier investigations have shown that a lumbosacral ventral root avulsion (VRA injury results in allodynia, which may be ameliorated by surgical replantation of the avulsed ventral roots. Here, we investigated the long-term effects of an L6 + S1 VRA injury on the plasticity of three populations of afferent projections to the dorsal horn in rats. At 8 weeks after a unilateral L6 + S1 VRA injury, quantitative morphological studies of the adjacent L5 dorsal horn showed reduced immunoreactivity (IR for the vesicular glutamate transporter, VGLUT1 and isolectin B4 (IB4 binding, whereas IR for calcitonin gene-related peptide (CGRP was unchanged. The IR for VGLUT1 and CGRP as well as IB4 binding was at control levels in the L5 dorsal horn at 8 weeks following an acute surgical replantation of the avulsed L6 + S1 ventral roots. Quantitative morphological studies of the L5 dorsal root ganglia (DRGs showed unchanged neuronal numbers for both the VRA and replanted series compared to shams. The portions of L5 DRG neurons expressing IR for VGLUT1 and CGRP, and IB4 binding were also the same between the VRA, replanted, and sham-operated groups. We conclude that the L5 dorsal horn shows selective plasticity for VGLUT1 and IB4 primary afferent projections after an L6 + S1 VRA injury and surgical repair.

  13. Assessment of knowledge and attitude before and after a health education program in East Madurai primary school teachers with regard to emergency management of avulsed teeth.

    Science.gov (United States)

    Taranath, M; Senaikarasi, R M; Manchanda, Kavita

    2017-01-01

    Children attend primary school from as early as 6 years to the mixed dentition stage of about 9 years and spend most of their time in school along with the teachers. School teachers are likely to be among the first to see a child immediately after an injury has occurred, and their knowledge regarding emergency procedures is critical to ensure good prognosis of the clinical treatment. The purpose of the study was to evaluate, by means of a questionnaire, the primary school teacher's knowledge and attitude with regard to emergency management of traumatized avulsed teeth and to test the effectiveness of a health education tool. A total of 214 primary school teachers from 24 government schools, in and around East Madurai Panchayat, participated in a 3-month long study. Baseline data were collected using a pretested questionnaire in the 1st month. Based on that data, a health educational tool was prepared. The final assessment was made using the same questionnaire in the 3rd month. Baseline data and final data were compared using Z-test. The knowledge level of 70.83% of primary school teachers was in the very good category after the health education tool, which was initially nil. Similarly, the attitude level also raised drastically with 0.90% initially in the very good category, and after the health education tool, it was 41.20%. From this study, the importance of the need for the steps to increase the knowledge about the emergency management of avulsion is clearly understood. Thus, the main implication of the study is that a health educational tool regarding the emergency management of avulsion is necessary for the primary school teachers during their teacher training program.

  14. Complex Channel Avulsion in the Meghna River Foodplain During the Mid to Late Holocene: The Potential Effect of Tectonic and Co-Seismic Uplift

    Science.gov (United States)

    Dunham, A.; Grall, C.; Mondal, D. R.; Steckler, M. S.; Rajapara, H.; Kumar, B.; Philibosian, B.; Akhter, S. H.; Singhvi, A. K.

    2016-12-01

    Channel migrations and river avulsions in deltaic river systems are mainly driven by differential changes of surface topography, such as the superelevation of channels due to sedimentation. In addition to such autocyclic processes, tectonic events, such as earthquakes, may also lead to avulsions from sudden uplift. The eastern part of the Ganges-Brahmaputra-Meghna Delta (GBMD) is underlain by the blind megathrust of the IndoBurma subduction zone. In this region we investigate a 100 km long sinuous abandoned channel of the Meghna River. Immediately south of the channel, it has been previously shown that the topography is slightly higher than on the rest of the Delta and there is an oxidized Holocene exposure surface. Part of the Titas River flows northward from this area into the abandoned channel belt, opposite of the southward flowing rivers of the delta. We provide results from a detailed investigation of this abandoned channel of the Meghna River using stratigraphic logs of hand-drilled wells, resistivity profiles, sediment analyses and OSL and C14 dating, The OSL ages to be presented constrain the possible date of the event. We employ numerical modeling to evaluate the hypothesis that the co-seismic uplift associated to an earthquake can trigger the channel migration. Our modeling approach aims to estimate the co-seismic uplift associated with potential seismic events using an elastic Coulomb's dislocation model. The geometry fault in our model is estimated using geologic and GPS constraints with standard elastic parameters (Young's modulus = 80 GPa; Poisson's ratio = 0.3). We explored different potential earthquakes geometries that involve the megathrust, a splay fault, or the megathrust terminating in the splay. The magnitude and distribution of co-seismic slip are also varied between a rupture length of 112.5km and 180km along a 225km long fault. We show that any class of models can produce the amount of uplift (1-2 m) necessary for triggering the river

  15. [Decoronation management of the replacement resorption after delayed replantation of avulsed teeth-case report with 4-year follow-up].

    Science.gov (United States)

    Ruizhen, Fang; Siyi, Li; Lei, Gao; Li'an, Wu

    2017-12-01

    Replacement resorption is the most frequent complication after delayed replantation of avulsed teeth. The resorption can interfere with the development of the alveolar ridge and lead to tilt of the adjacent teeth in growing patients. However, there is no means of arresting or reversing the process. Recently decoronation is recommended by International Assocaition of Dental Traumatology as the optimal choice to manage it. This paper demonstrates the procedure and effectiveness of the decoronation by literature review and a case report with 4-year follow-up.

  16. Revision of Pachycentria (Melastomataceae)

    NARCIS (Netherlands)

    Clausing, Gudrun

    2000-01-01

    A revision of Pachycentria Blume, which includes the monotypic Pogonanthera Blume, is presented. Pachycentria comprises eight species and one subspecies. Two species, P. vogelkopensis and P. hanseniana, are newly described. The genus is distinguished from other genera in the Medinillinae by a small

  17. Revision of Oxandra (Annonaceae)

    NARCIS (Netherlands)

    Junikka, L.; Maas, P.J.M.; Maas-van de Kamer, H.; Westra, L.Y.Th.

    2016-01-01

    A taxonomic revision is given of the Neotropical genus Oxandra (Annonaceae). Within the genus 27 species are recognized, 4 of which are new to science. Most of the species are occurring in tropical South America, whereas a few (6) are found in Mexico and Central America and two in the West Indies

  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

  19. 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...

  20. Functional connectivity of motor cortical network in patients with brachial plexus avulsion injury after contralateral cervical nerve transfer: a resting-state fMRI study

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Aihong; Cheng, Xiaoguang; Liang, Wei; Bai, Rongjie [The 4th Medical College of Peking University, Department of Radiology, Beijing Jishuitan Hospital, Xicheng Qu, Beijing (China); Wang, Shufeng; Xue, Yunhao; Li, Wenjun [The 4th Medical College of Peking University, Department of Hand Surgery, Beijing Jishuitan Hospital, Beijing (China)

    2017-03-15

    The purpose of this study is to assess the functional connectivity of the motor cortical network in patients with brachial plexus avulsion injury (BPAI) after contralateral C7 nerve transfer, using resting-state functional magnetic resonance imaging (RS-fMRI). Twelve patients with total brachial plexus root avulsion underwent RS-fMRI after contralateral C7 nerve transfer. Seventeen healthy volunteers were also included in this fMRI study as controls. The hand motor seed regions were defined as region of interests in the bilateral hemispheres. The seed-based functional connectivity was calculated in all the subjects. Differences in functional connectivity of the motor cortical network between patients and healthy controls were compared. The inter-hemispheric functional connectivity of the M1 areas was increased in patients with BPAI compared with the controls. The inter-hemispheric functional connectivity between the supplementary motor areas was reduced bilaterally. The resting-state inter-hemispheric functional connectivity of the bilateral M1 areas is altered in patients after contralateral C7 nerve transfer, suggesting a functional reorganization of cerebral cortex. (orig.)

  1. Functional connectivity of motor cortical network in patients with brachial plexus avulsion injury after contralateral cervical nerve transfer: a resting-state fMRI study

    International Nuclear Information System (INIS)

    Yu, Aihong; Cheng, Xiaoguang; Liang, Wei; Bai, Rongjie; Wang, Shufeng; Xue, Yunhao; Li, Wenjun

    2017-01-01

    The purpose of this study is to assess the functional connectivity of the motor cortical network in patients with brachial plexus avulsion injury (BPAI) after contralateral C7 nerve transfer, using resting-state functional magnetic resonance imaging (RS-fMRI). Twelve patients with total brachial plexus root avulsion underwent RS-fMRI after contralateral C7 nerve transfer. Seventeen healthy volunteers were also included in this fMRI study as controls. The hand motor seed regions were defined as region of interests in the bilateral hemispheres. The seed-based functional connectivity was calculated in all the subjects. Differences in functional connectivity of the motor cortical network between patients and healthy controls were compared. The inter-hemispheric functional connectivity of the M1 areas was increased in patients with BPAI compared with the controls. The inter-hemispheric functional connectivity between the supplementary motor areas was reduced bilaterally. The resting-state inter-hemispheric functional connectivity of the bilateral M1 areas is altered in patients after contralateral C7 nerve transfer, suggesting a functional reorganization of cerebral cortex. (orig.)

  2. Descriptive epidemiology of the Multicenter ACL Revision Study (MARS) cohort.

    Science.gov (United States)

    Wright, Rick W; Huston, Laura J; Spindler, Kurt P; Dunn, Warren R; Haas, Amanda K; Allen, Christina R; Cooper, Daniel E; DeBerardino, Thomas M; Lantz, Brett Brick A; Mann, Barton J; Stuart, Michael J

    2010-10-01

    Revision anterior cruciate ligament (ACL) reconstruction has worse outcomes than primary reconstructions. Predictors for these worse outcomes are not known. The Multicenter ACL Revision Study (MARS) Group was developed to perform a multisurgeon, multicenter prospective longitudinal study to obtain sufficient subjects to allow multivariable analysis to determine predictors of clinical outcome. To describe the formation of MARS and provide descriptive analysis of patient demographics and clinical features for the initial 460 enrolled patients to date in this prospective cohort. Cross-sectional study; Level of evidence, 2. After training and institutional review board approval, surgeons began enrolling patients undergoing revision ACL reconstruction, recording patient demographics, previous ACL reconstruction methods, intra-articular injuries, and current revision techniques. Enrolled subjects completed a questionnaire consisting of validated patient-based outcome measures. As of April 1, 2009, 87 surgeons have enrolled a total of 460 patients (57% men; median age, 26 years). For 89%, the reconstruction was the first revision. Mode of failure as deemed by the revising surgeon was traumatic (32%), technical (24%), biologic (7%), combination (37%), infection (MARS Group has been able to quickly accumulate the largest revision ACL reconstruction cohort reported to date. Traumatic reinjury is deemed by surgeons to be the most common single mode of failure, but a combination of factors represents the most common mode of failure. Allograft graft choice is more common in the revision setting than autograft. Concomitant knee injury is extremely common in this population.

  3. 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)

  4. 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.

  5. Aircast walking boot and below-knee walking cast for avulsion fractures of the base of the fifth metatarsal: a comparative cohort study.

    Science.gov (United States)

    Shahid, Mohammad Kamran; Punwar, Shahid; Boulind, Caroline; Bannister, Gordon

    2013-01-01

    Acute avulsion fractures of the base of the fifth metatarsal are common and are treated in a variety of ways. The aims of this study were to compare pain, functional outcome, and time taken off work after treatment with a walking boot or a short-leg cast. Of 39 patients with acute avulsion fractures of the base of the fifth metatarsal, 23 were treated with a short-leg cast and 16 with a walking boot, according to the preference of the consultant present at outpatient clinic. Functional outcome was assessed by the Visual Analogue Scale Foot and Ankle Questionnaire (VAS FA), pain, and other complaints on presentation and at 3, 6, 9, and 12 weeks after injury. The VAS FA scores were compared between the 2 groups by a paired Student t test. The mean time to return to the level of pain and function before injury was approximately 9 weeks after treatment in the walking boot group and 12 weeks with a short-leg cast. Patients with walking boots reported less pain between 3 and 12 weeks than did those with short-leg casts after 6 (P = .06), 9 (P = .020), and 12 weeks (P = .33). Function was significantly better with Aircast walking boots after 3 (P = .006), 6 (P = .002), and 9 weeks (P = .002) but not after 12 weeks (P = .09). Patients returned to their preinjury level of driving after 6 weeks with walking boots and 12 weeks with short-leg casts (P = .006). Employed patients took a mean of 35.8 days off work (range, 28-42 days), fewer with boots (31.5 days) than with short-leg casts (39.2 days). The walking boot was better treatment than a short-leg cast for avulsion fractures of the base of the fifth metatarsal. Patients had an improved combined level of pain and function 3 weeks earlier, at 9 weeks post injury, when managed in a walking boot. Level II, prospective comparative series.

  6. triceps tendon avulsion

    African Journals Online (AJOL)

    GB

    2014-01-01

    Jan 1, 2014 ... trauma. Systemic causes such as chronic renal failure, steriod use, diabetes mellitus, hyperparathyroidism, rheumatoid arthritis, osteogensis imperfecta and local causes like local steriod injection, olecranon bursitis and attritional changes due to degenerative arthritis are associated with tendon weakening.

  7. Trends in Revision Elbow Ulnar Collateral Ligament Reconstruction in Professional Baseball Pitchers.

    Science.gov (United States)

    Wilson, Alexander T; Pidgeon, Tyler S; Morrell, Nathan T; DaSilva, Manuel F

    2015-11-01

    To determine the frequency of revision elbow ulnar collateral ligament (UCL) reconstruction in professional baseball pitchers. Data were collected on 271 professional baseball pitchers who underwent primary UCL reconstruction. Each player was evaluated retrospectively for occurrence of revision UCL reconstructive surgery to treat failed primary reconstruction. Data on players who underwent revision UCL reconstruction were compiled to determine total surgical revision incidence and revision rate by year. The incidence of early revision was analyzed for trends. Average career length after primary UCL reconstruction was calculated and compared with that of players who underwent revision surgery. Logistic regression analysis was performed to assess risk factors for revision including handedness, pitching role, and age at the time of primary reconstruction. Between 1974 and 2014, the annual incidence of primary UCL reconstructions among professional pitchers increased, while the proportion of cases being revised per year decreased. Of the 271 pitchers included in the study, 40 (15%) required at least 1 revision procedure during their playing career. Three cases required a second UCL revision reconstruction. The average time from primary surgery to revision was 5.2 ± 3.2 years (range, 1-13 years). The average length of career following primary reconstruction for all players was 4.9 ± 4.3 years (range, 0-22 years). The average length of career following revision UCL reconstruction was 2.5 ± 2.4 years (range, 0-8 years). No risk factors for needing revision UCL reconstruction were identified. The incidence of primary UCL reconstructions among professional pitchers is increasing; however, the rate of primary reconstructions requiring revision is decreasing. Explanations for the decreased revision rate may include improved surgical technique and improved rehabilitation protocols. Therapeutic IV. Copyright © 2015 American Society for Surgery of the Hand. Published by

  8. Boosted Regeneration and Reduced Denervated Muscle Atrophy by NeuroHeal in a Pre-clinical Model of Lumbar Root Avulsion with Delayed Reimplantation.

    Science.gov (United States)

    Romeo-Guitart, David; Forés, Joaquim; Navarro, Xavier; Casas, Caty

    2017-09-20

    The "gold standard" treatment of patients with spinal root injuries consists of delayed surgical reconnection of nerves. The sooner, the better, but problems such as injury-induced motor neuronal death and muscle atrophy due to long-term denervation mean that normal movement is not restored. Herein we describe a preclinical model of root avulsion with delayed reimplantation of lumbar roots that was used to establish a new adjuvant pharmacological treatment. Chronic treatment (up to 6 months) with NeuroHeal, a new combination drug therapy identified using a systems biology approach, exerted long-lasting neuroprotection, reduced gliosis and matrix proteoglycan content, accelerated nerve regeneration by activating the AKT pathway, promoted the formation of functional neuromuscular junctions, and reduced denervation-induced muscular atrophy. Thus, NeuroHeal is a promising treatment for spinal nerve root injuries and axonal regeneration after trauma.

  9. 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

  10. 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.

  11. 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....

  12. Emotion Processes in Knowledge Revision

    Science.gov (United States)

    Trevors, Gregory J.; Kendeou, Panayiota; Butterfuss, Reese

    2017-01-01

    In recent years, a number of insights have been gained into the cognitive processes that explain how individuals overcome misconceptions and revise their previously acquired incorrect knowledge. The current study complements this line of research by investigating the moment-by-moment emotion processes that occur during knowledge revision using a…

  13. 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.

  14. Revised SRAC code system

    International Nuclear Information System (INIS)

    Tsuchihashi, Keichiro; Ishiguro, Yukio; Kaneko, Kunio; Ido, Masaru.

    1986-09-01

    Since the publication of JAERI-1285 in 1983 for the preliminary version of the SRAC code system, a number of additions and modifications to the functions have been made to establish an overall neutronics code system. Major points are (1) addition of JENDL-2 version of data library, (2) a direct treatment of doubly heterogeneous effect on resonance absorption, (3) a generalized Dancoff factor, (4) a cell calculation based on the fixed boundary source problem, (5) the corresponding edit required for experimental analysis and reactor design, (6) a perturbation theory calculation for reactivity change, (7) an auxiliary code for core burnup and fuel management, etc. This report is a revision of the users manual which consists of the general description, input data requirements and their explanation, detailed information on usage, mathematics, contents of libraries and sample I/O. (author)

  15. Microcomputers and the Improvement of Revision Skills.

    Science.gov (United States)

    Balajthy, Ernest; And Others

    1987-01-01

    Discusses use of word processing software as an effective tool in writing and revision instruction, and describes the role of the teacher. Examples of exercises that encourage revision and of software designed to teach effective revision skills are reviewed. (MBR)

  16. The Subunit Principle in Scar Face Revision.

    Science.gov (United States)

    Elshahat, Ahmed; Lashin, Riham

    2017-06-01

    Facial scaring is considered one of the most difficult cosmetic problems for any plastic surgeon to solve. The condition is more difficult if the direction of the scar is not parallel to relaxed skin tension lines. Attempts to manage this difficult situation included revisions using geometric designs, Z plasties or W plasties to camouflage the straight line visible scaring. The use of long-lasting resorbable sutures was tried too. Recently, the use of botulinum toxin during revision improved the results. Fractional CO2 lasers, microfat grafts, and platelet-rich plasma were added to the armamentarium. The scar is least visible if placed in the junction between the facial subunits. The aim of this study is to investigate the use of the subunit principle to improve the results of scar revision. Four patients were included in this study. Tissue expansion of the intact part of the subunit allowed shifting the scar to the junction between the affected subunit and the adjacent one. Tissue expansion, delivery of the expanders, and advancement of the flaps were successful in all patients. The fact that this is a 2-stage procedure and sacrifices some of the intact skin from the affected facial subunit, makes this technique reserved to patients with ugly facial scars who are ambitious to improve their appearance.

  17. Revision of ASCE 4

    International Nuclear Information System (INIS)

    Nelson, T.A.; Murray, R.C.; Short, S.A.

    1995-01-01

    The original version of ASCE Standard 4, ''Seismic Analysis of Safety-Related Nuclear Structures'' was published in September 1986. It is ASCE policy to update its standards on a five year interval and the Working Group on Seismic Analysis of Safety Related Nuclear Structures was reconvened to formulate the revisions. The goal in updating the standard is to make sure that it is still relevant and that it incorporates the state of the practice in seismic engineering or, in some cases, where it has been demonstrated that state-of-the-art improvements need to be made to standard practice; new improvements are included. The contents of the new standard cover the same areas as the original version, with some additions. The contents are as follows: Input - response spectra and time histories; modeling of structures; analysis of structures; soil-structure interaction; input for subsystem analysis; special structures - buried pipes and conduits, earth-retaining walls, above-ground vertical tanks, raceways, and base-isolated structures; and an appendix providing seismic probabilistic risk assessment and margin assessment

  18. Contact activation: a revision.

    Science.gov (United States)

    Schmaier, A H

    1997-07-01

    In conclusion, a revised view of the contact system has been presented. This system has little to do with the initiation of hemostasis. Like lupus anticoagulants, deficiencies of contact proteins give prolonged APTTs but may be risk factors for thrombosis. BK from kininogens is a potent modulator of vascular biology inducing vasodilation, tissue plasminogen activator release, and prostacyclin liberation. Kininogens, themselves, are selective inhibitors of alpha-thrombin-induced platelet activation preventing alpha-thrombin from cleaving the cloned thrombin receptor after arginine41. Kininogens' alpha-thrombin inhibitory activity exists in intact kininogens, BK, and all of BK's breakdown products. HK also is the pivotal protein for contact protein assembly on endothelium. It is the receptor for prekallikrein which when bound to HK becomes activated to kallikrein by an endothelial cell enzyme system independent of activated forms of plasma factor XII. Prekallikrein activation on endothelial cells results in kinetically favorable single chain urokinase and plasminogen activation. Thus the "physiologic, negatively charged surface" for contact system activation is really the assembly of these proteins on cell membranes and activation by membrane-associated enzymes.

  19. Cold-forceps avulsion with adjuvant snare-tip soft coagulation (CAST) is an effective and safe strategy for the management of non-lifting large laterally spreading colonic lesions.

    Science.gov (United States)

    Tate, David J; Bahin, Farzan F; Desomer, Lobke; Sidhu, Mayenaaz; Gupta, Vikas; Bourke, Michael J

    2018-01-01

     Non-lifting large laterally spreading colorectal lesions (LSLs) are challenging to resect endoscopically and often necessitate surgery. A safe, simple technique to treat non-lifting LSLs endoscopically with robust long-term outcomes has not been described.  In this single-center prospective observational study of consecutive patients referred for endoscopic mucosal resection (EMR) of LSLs ≥ 20 mm, LSLs not completely resectable by snare because of non-lifting underwent standardized completion of resection with cold-forceps avulsion and adjuvant snare-tip soft coagulation (CAST). Scheduled surveillance colonoscopies were performed at 4 - 6 months (SC1) and 18 months (SC2). Primary outcomes were endoscopic evidence of adenoma clearance and avoidance of surgery. The secondary outcome was safety.  From January 2012 to October 2016, 540 lifting LSLs (82.2 %) underwent complete snare excision at EMR. CAST was required for complete removal in 101 non-lifting LSLs (17.8 %): 63 naïve non-lifting lesions (NNLs; 62.7 %) and 38 previously attempted non-lifting lesions (PANLs; 37.3 %). PANLs were smaller ( P  < 0.001) and more likely to be non-granular ( P  = 0.001) than the lifting LSLs. NNLs were of similar size ( P  = 0.77) and morphology ( P  = 0.10) to the lifting LSLs. CAST was successful in all cases and adverse events were comparable to lifting LSLs resected by complete snare excision. Recurrence at SC1 was comparable for PANLs (15.2 %) and lifting LSLs (15.3 %; P  = 0.99), whereas NNLs recurred more frequently (27.5 %; P  = 0.049); however, surgery was no more common for either type of non-lifting LSL than for lifting LSLs.  CAST is a safe, effective, and surgery-sparing therapy for the majority of non-lifting LSLs. It is easy to use, inexpensive, and does not require additional equipment. © Georg Thieme Verlag KG Stuttgart · New York.

  20. Peritoneal Dialysis Access Revision in Children: Causes, Interventions, and Outcomes.

    Science.gov (United States)

    Borzych-Duzalka, Dagmara; Aki, T Fazil; Azocar, Marta; White, Colin; Harvey, Elizabeth; Mir, Sevgi; Adragna, Marta; Serdaroglu, Erkin; Sinha, Rajiv; Samaille, Charlotte; Vanegas, Juan Jose; Kari, Jameela; Barbosa, Lorena; Bagga, Arvind; Galanti, Monica; Yavascan, Onder; Leozappa, Giovanna; Szczepanska, Maria; Vondrak, Karel; Tse, Kei-Chiu; Schaefer, Franz; Warady, Bradley A

    2017-01-06

    Little published information is available about access failure in children undergoing chronic peritoneal dialysis. Our objectives were to evaluate frequency, risk factors, interventions, and outcome of peritoneal dialysis access revision. Data were derived from 824 incident and 1629 prevalent patients from 105 pediatric nephrology centers enrolled in the International Pediatric Peritoneal Dialysis Network Registry between 2007 and 2015. In total, 452 access revisions were recorded in 321 (13%) of 2453 patients over 3134 patient-years of follow-up, resulting in an overall access revision rate of 0.14 per treatment year. Among 824 incident patients, 186 (22.6%) underwent 188 access revisions over 1066 patient-years, yielding an access revision rate of 0.17 per treatment year; 83% of access revisions in incident patients were reported within the first year of peritoneal dialysis treatment. Catheter survival rates in incident patients were 84%, 80%, 77%, and 73% at 12, 24, 36, and 48 months, respectively. By multivariate logistic regression analysis, risk of access revision was associated with younger age (odds ratio, 0.93; 95% confidence interval, 0.92 to 0.95; P<0.001), diagnosis of congenital anomalies of the kidney and urinary tract (odds ratio, 1.28; 95% confidence interval, 1.03 to 1.59; P=0.02), coexisting ostomies (odds ratio, 1.42; 95% confidence interval, 1.07 to 1.87; P=0.01), presence of swan neck tunnel with curled intraperitoneal portion (odds ratio, 1.30; 95% confidence interval, 1.04 to 1.63; P=0.02), and high gross national income (odds ratio, 1.10; 95% confidence interval, 1.02 to 1.19; P=0.01). Main reasons for access revisions included mechanical malfunction (60%), peritonitis (16%), exit site infection (12%), and leakage (6%). Need for access revision increased the risk of peritoneal dialysis technique failure or death (hazard ratio, 1.35; 95% confidence interval, 1.10 to 1.65; P=0.003). Access dysfunction due to mechanical causes doubled the risk

  1. Peritoneal Dialysis Access Revision in Children: Causes, Interventions, and Outcomes

    Science.gov (United States)

    Aki, T. Fazil; Azocar, Marta; White, Colin; Harvey, Elizabeth; Mir, Sevgi; Adragna, Marta; Serdaroglu, Erkin; Sinha, Rajiv; Samaille, Charlotte; Vanegas, Juan Jose; Kari, Jameela; Barbosa, Lorena; Bagga, Arvind; Galanti, Monica; Yavascan, Onder; Leozappa, Giovanna; Szczepanska, Maria; Vondrak, Karel; Tse, Kei-Chiu; Schaefer, Franz; Warady, Bradley A.

    2017-01-01

    Background and objectives Little published information is available about access failure in children undergoing chronic peritoneal dialysis. Our objectives were to evaluate frequency, risk factors, interventions, and outcome of peritoneal dialysis access revision. Design, setting, participants, & measurements Data were derived from 824 incident and 1629 prevalent patients from 105 pediatric nephrology centers enrolled in the International Pediatric Peritoneal Dialysis Network Registry between 2007 and 2015. Results In total, 452 access revisions were recorded in 321 (13%) of 2453 patients over 3134 patient-years of follow-up, resulting in an overall access revision rate of 0.14 per treatment year. Among 824 incident patients, 186 (22.6%) underwent 188 access revisions over 1066 patient-years, yielding an access revision rate of 0.17 per treatment year; 83% of access revisions in incident patients were reported within the first year of peritoneal dialysis treatment. Catheter survival rates in incident patients were 84%, 80%, 77%, and 73% at 12, 24, 36, and 48 months, respectively. By multivariate logistic regression analysis, risk of access revision was associated with younger age (odds ratio, 0.93; 95% confidence interval, 0.92 to 0.95; P<0.001), diagnosis of congenital anomalies of the kidney and urinary tract (odds ratio, 1.28; 95% confidence interval, 1.03 to 1.59; P=0.02), coexisting ostomies (odds ratio, 1.42; 95% confidence interval, 1.07 to 1.87; P=0.01), presence of swan neck tunnel with curled intraperitoneal portion (odds ratio, 1.30; 95% confidence interval, 1.04 to 1.63; P=0.02), and high gross national income (odds ratio, 1.10; 95% confidence interval, 1.02 to 1.19; P=0.01). Main reasons for access revisions included mechanical malfunction (60%), peritonitis (16%), exit site infection (12%), and leakage (6%). Need for access revision increased the risk of peritoneal dialysis technique failure or death (hazard ratio, 1.35; 95% confidence interval, 1

  2. EPR first responders revision test

    International Nuclear Information System (INIS)

    2011-01-01

    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. Corporate Author Entries. Revision 5

    International Nuclear Information System (INIS)

    Hendricks, P.L.

    1986-05-01

    This reference authority has been created and is maintained to provide standard forms for recording the names of organizations consistently in bibliographic citations. This revision includes approximately 42,000 entries established since 1973

  4. Laparoscopic revision of failed antireflux operations.

    Science.gov (United States)

    Serafini, F M; Bloomston, M; Zervos, E; Muench, J; Albrink, M H; Murr, M; Rosemurgy, A S

    2001-01-01

    A small number of patients fail fundoplication and require reoperation. Laparoscopic techniques have been applied to reoperative fundoplications. We reviewed our experience with reoperative laparoscopic fundoplication. Reoperative laparoscopic fundoplication was undertaken in 28 patients, 19 F and 9 M, of mean age 56 years +/- 12. Previous antireflux procedures included 19 open and 12 laparoscopic antireflux operations. Symptoms were heartburn (90%), dysphagia (35%), and atypical symptoms (30%%). The mean interval from antireflux procedure to revision was 13 months +/- 4.2. The mean DeMeester score was 78+/-32 (normal 14.7). Eighteen patients (64%) had hiatal breakdown, 17 (60%) had wrap failure, 2 (7%) had slipped Nissen, 3 (11%) had paraesophageal hernias, and 1 (3%) had an excessively tight wrap. Twenty-five revisions were completed laparoscopically, while 3 patients required conversion to the open technique. Complications occurred in 9 of 17 (53%) patients failing previous open fundoplications and in 4 of 12 patients (33%) failing previous laparoscopic fundoplications and included 15 gastrotomies and 1 esophagotomy, all repaired laparoscopically, 3 postoperative gastric leaks, and 4 pneumothoraces requiring tube thoracostomy. No deaths occurred. Median length of stay was 5 days (range 2-90 days). At a mean follow-up of 20 months +/- 17, 2 patients (7%) have failed revision of their fundoplications, with the rest of the patients being essentially asymptomatic (93%). The results achieved with reoperative laparoscopic fundoplication are similar to those of primary laparoscopic fundoplications. Laparoscopic reoperations, particularly of primary open fundoplication, can be technically challenging and fraught with complications. Copyright 2001 Academic Press.

  5. Different functional reorganization of motor cortex after transfer of the contralateral C7 to different recipient nerves in young rats with total brachial plexus root avulsion.

    Science.gov (United States)

    Pan, Feng; Wei, Hai-feng; Chen, Liang; Gu, Yu-dong

    2012-12-07

    Clinically, contralateral C7 transfer is used for nerve reconstruction in brachial plexus injuries. Postoperatively, synchronous motions at the donor limb are noteworthy. This study studied if different recipient nerves influenced transhemispheric functional reorganization of motor cortex after this procedure. 90 young rats with total root avulsion of the brachial plexus were divided into groups 1-3 of contralateral C7 transfer to anterior division of the upper trunk, to both the musculocutaneous and median nerves, and to the median nerve, respectively. After reinnervation of target muscles, number of sites for forelimb representations in bilateral motor cortices was determined by intracortical microstimulation at 1.5, 3, 6, 9, and 12 months postoperatively. At nine months, transhemispheric reorganization of nerves neurotized by contralateral C7 was fulfilled in four of six rats in group 1, one of six in group 2 and none in group 3, respectively; at 12 months, that was fulfilled in five of six in group 1, four of six in groups 2 and 3, respectively. Logistic regression analysis showed that rate of fulfilled transhemispheric reorganization in group 1 was 12.19 times that in group 3 (95% CI 0.006-0.651, p=0.032). At 12 months, number of sites for hindlimb representations which had encroached upon original forelimb representations on the uninjured side was statistically more in group 3 than in group 2 (t=9.5, pmotor cortex than that to median nerve alone in rats. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  6. Dental Assistant, Advanced. Revision

    Science.gov (United States)

    1989-02-01

    insert the paper point into the aseptic technique at all times. All instruments used ing distance. Once in position, rotate the in endodontic ...are procedures you may per- form in the endodontics operatory. Ensure that all instruments are sterile and disinfect the Figure 5-25. -Sharpening hoe...starting the Figure 6-6.-Vacuum adapter. lathe. 6-5 The lathe is used with rotary instruments (burs, stones, and ragwheels, etc.). An adapter and/or

  7. Revised licensee event report system

    International Nuclear Information System (INIS)

    Mays, G.T.; Poore, W.P.

    1985-01-01

    Licensee Event Reports (LERs) provide the basis for evaluating and assessing operating experience information from nuclear power plants. The reporting requirements for submitting LERs to the Nuclear Regulatory Commission have been revised. Effective Jan. 1, 1984, all events were to be submitted in accordance with 10 CFR 50.73 of the Code of Federal Regulations. Report NUREG-1022, Licensee Event Report System-Description of System and Guidelines for Reporting, describes the guidelines on reportability of events. This article summarizes the reporting requirements as presented in NUREG-1022, high-lights differences in data reported between the revised and previous LER systems, and presents results from a preliminary assessment of LERs submitted under the revised LER reporting system

  8. Quantum interaction. Revised selected papers

    Energy Technology Data Exchange (ETDEWEB)

    Song, Dawei; Zhang, Peng; Wang, Lei [Aberdeen Univ. (United Kingdom). School of Computing; Melucci, Massimo [Padua Univ., Padova (Italy). Dept. of Information Engineering; Frommholz, Ingo [Bedfordshire Univ. (United Kingdom); Arafat, Sachi (eds.) [Glasgow Univ. (United Kingdom). School of Computing Science

    2011-07-01

    This book constitutes the thoroughly refereed post-conference proceedings of the 5th International Symposium on Quantum Interaction, QI 2011, held in Aberdeen, UK, in June 2011. The 26 revised full papers and 6 revised poster papers, presented together with 1 tutorial and 1 invited talk were carefully reviewed and selected from numerous submissions during two rounds of reviewing and improvement. The papers show the cross-disciplinary nature of quantum interaction covering topics such as computation, cognition, mechanics, social interaction, semantic space and information representation and retrieval. (orig.)

  9. HEDR modeling approach: Revision 1

    International Nuclear Information System (INIS)

    Shipler, D.B.; Napier, B.A.

    1994-05-01

    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

  10. Quantum interaction. Revised selected papers

    International Nuclear Information System (INIS)

    Song, Dawei; Zhang, Peng; Wang, Lei; Arafat, Sachi

    2011-01-01

    This book constitutes the thoroughly refereed post-conference proceedings of the 5th International Symposium on Quantum Interaction, QI 2011, held in Aberdeen, UK, in June 2011. The 26 revised full papers and 6 revised poster papers, presented together with 1 tutorial and 1 invited talk were carefully reviewed and selected from numerous submissions during two rounds of reviewing and improvement. The papers show the cross-disciplinary nature of quantum interaction covering topics such as computation, cognition, mechanics, social interaction, semantic space and information representation and retrieval. (orig.)

  11. 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...

  12. Revising Nabokov Revising”

    Directory of Open Access Journals (Sweden)

    Marie Bouchet

    2010-10-01

    Full Text Available Nabokov revised his works as he translated them and, on another plane, canon revisionism has been having its backlash and provoked other refracting waves. The purpose of the conference was to advance Nabokov studies through the discussion of how our view of Nabokov’s standing and his works today should be revised, especially after the publication of The Original of Laura. However the conference was not confined to just this theme, since “revising” is a word rich with implications. To borrow s...

  13. Decomposition of Some Well-Known Variance Reduction Techniques. Revision.

    Science.gov (United States)

    1985-05-01

    34use a family of transformatlom to convert given samples into samples conditioned on a given characteristic (p. 04)." Dub and Horowitz (1979), Granovsky ...34Antithetic Varlates Revisited," Commun. ACM 26, 11, 064-971. Granovsky , B.L. (1981), "Optimal Formulae of the Conditional Monte Carlo," SIAM J. Alg

  14. SOFT TREE: Fault Tree Technique as Applied to Software. Revision.

    Science.gov (United States)

    1983-10-01

    13 12 - 16 03 - 18 09 - 19 01 - 19 02 - 19 03 - 19 05 18. Con’t Non- Nuclear Munition, Non- Nuclear Munition Safety, Fuze Safety, Microprocessor...costucin the’ V’Y wvSoft Tree be ver fam-’il~. iar-a’--. that te persnns conihhsutnge thoftd refec be very familia wthipeetino microprocessosor atd idotwee h...ro 7- qSf" fart~b -To WA0 IFu t TOC6Lf e aF ’t9 q-EN rNz Al fC1~ATOk -1- 1AP6AG $ LA ? To.~ Yujiif’ ToA4. IWOv~:EAii CI~t~J~13Lf ToP5M A~E F CAP Avrif

  15. Centric relation: concepts revision and recording techniques. Part II

    OpenAIRE

    Orozco Varo, Ana; Arroyo Cruz, Gema; Martinez De Fuentes, Rafael; Ventura de la Torre, Javier; Cañadas Rodríguez, Diego; Jiménez-Castellanos Ballesteros, Emilio

    2008-01-01

    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 rela...

  16. Centric relation: concepts revision and recording techniques. Part I

    OpenAIRE

    Orozco Varo, A.; Arroyo Cruz, G.; Martínez de Fuentes, R.; Ventura de la Torre, J.; Cañadas Rodríguez, D.; Jiménez Castellanos, E.

    2008-01-01

    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 rela...

  17. Cement-in-cement acetabular revision with a constrained tripolar component.

    Science.gov (United States)

    Leonidou, Andreas; Pagkalos, Joseph; Luscombe, Jonathan

    2012-02-17

    Dislocation of a total hip replacement (THR) is common following total hip arthroplasty (THA). When nonoperative management fails to maintain reduction, revision surgery is considered. The use of constrained acetabular liners has been extensively described. Complete removal of the old cement mantle during revision THA can be challenging and is associated with significant complications. Cement-in-cement revision is an established technique. However, the available clinical and experimental studies focus on femoral stem revision. The purpose of this study was to present a case of cement-in-cement acetabular revision with a constrained component for recurrent dislocations and to investigate the current best evidence for this technique. This article describes the case of a 74-year-old woman who underwent revision of a Charnley THR for recurrent low-energy dislocations. A tripolar constrained acetabular component was cemented over the primary cement mantle following removal of the original liner by reaming, roughening the surface, and thoroughly irrigating and drying the primary cement. Clinical and radiological results were good, with the Oxford Hip Score improving from 11 preoperatively to 24 at 6 months postoperatively. The good short-term results of this case and the current clinical and biomechanical data encourage the use of the cement-in-cement technique for acetabular revision. Careful irrigation, drying, and roughening of the primary surface are necessary. Copyright 2012, SLACK Incorporated.

  18. Failure of aseptic revision total knee arthroplasties.

    Science.gov (United States)

    Leta, Tesfaye H; Lygre, Stein Håkon L; Skredderstuen, Arne; Hallan, Geir; Furnes, Ove

    2015-02-01

    In Norway, the proportion of revision knee arthroplasties increased from 6.9% in 1994 to 8.5% in 2011. However, there is limited information on the epidemiology and causes of subsequent failure of revision knee arthroplasty. We therefore studied survival rate and determined the modes of failure of aseptic revision total knee arthroplasties. This study was based on 1,016 aseptic revision total knee arthroplasties reported to the Norwegian Arthroplasty Register between 1994 and 2011. Revisions done for infections were not included. Kaplan-Meier and Cox regression analyses were used to assess the survival rate and the relative risk of re-revision with all causes of re-revision as endpoint. 145 knees failed after revision total knee arthroplasty. Deep infection was the most frequent cause of re-revision (28%), followed by instability (26%), loose tibial component (17%), and pain (10%). The cumulative survival rate for revision total knee arthroplasties was 85% at 5 years, 78% at 10 years, and 71% at 15 years. Revision total knee arthroplasties with exchange of the femoral or tibial component exclusively had a higher risk of re-revision (RR = 1.7) than those with exchange of the whole prosthesis. The risk of re-revision was higher for men (RR = 2.0) and for patients aged less than 60 years (RR = 1.6). In terms of implant survival, revision of the whole implant was better than revision of 1 component only. Young age and male sex were risk factors for re-revision. Deep infection was the most frequent cause of failure of revision of aseptic total knee arthroplasties.

  19. The nuclear liability conventions revised

    International Nuclear Information System (INIS)

    Reyners, P.

    2004-01-01

    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)

  20. Concise revision of the Sarcospermataceae

    NARCIS (Netherlands)

    Lam, H.J.; Royen, van P.

    1952-01-01

    After the senior writer, together with W. W. Varossieau, had published a revision of this monogeneric family (Blumea III, 1938—’39 and IV, 1941), some more material has been examined by us and, moreover, some new species have been described. Thanks to the courtesy of Prof. F. Gagnepain of Paris, and

  1. Guidelines for Curriculum Development. Revised.

    Science.gov (United States)

    Kistler, K.; And Others

    The curriculum development process explained in this booklet was first implemented at College of the Redwoods in May 1986 and then revised in June 1989. First, information on the college's Curriculum Committee is provided, indicating that the committee was formed to plan credit/non-credit courses; evaluate and approve additions, modifications, or…

  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. How Adults Learn. Revised Edition.

    Science.gov (United States)

    Kidd, J. R.

    The book's emphasis is on learning during the years of adulthood and examines present-day practice of adult education for practitioners. This revised edition brings up to date advances in such areas of learning as controversial theory; the effects of environment; sensory processes; intellectual capacities; motivation and attitude; transactional…

  4. A revision of the Paronychiinae

    NARCIS (Netherlands)

    Chaudhri, Mohammad Nazeer

    1968-01-01

    This study was undertaken, in April 1964, at the suggestion of Prof. Dr. J. Lanjouw. The need for such a revision, was, however, stressed by the authors of the subtribe, viz. PAX et K. HOFFMANN, who, while delimiting these genera, remarked that the Systematics of both the (main) genera of this

  5. 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.

  6. [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

  7. Revised Human Health Risk Assessment on Chlorpyrifos

    Science.gov (United States)

    We have revised our human health risk assessment and drinking water exposure assessment for chlorpyrifos that supported our October 2015 proposal to revoke all food residue tolerances for chlorpyrifos. Learn about the revised analysis.

  8. 75 FR 60485 - NRC Enforcement Policy Revision

    Science.gov (United States)

    2010-09-30

    ... NUCLEAR REGULATORY COMMISSION [NRC-2008-0497] NRC Enforcement Policy Revision AGENCY: Nuclear Regulatory Commission. ACTION: Policy statement. SUMMARY: The Nuclear Regulatory Commission (NRC or Commission) is publishing a major revision to its Enforcement Policy (Enforcement Policy or Policy) to...

  9. [APPLICATION OF COMPUTER-ASSISTED TECHNOLOGY IN ANALYSIS OF REVISION REASON OF UNICOMPARTMENTAL KNEE ARTHROPLASTY].

    Science.gov (United States)

    Jia, Di; Li, Yanlin; Wang, Guoliang; Gao, Huanyu; Yu, Yang

    2016-01-01

    To conclude the revision reason of unicompartmental knee arthroplasty (UKA) using computer-assisted technology so as to provide reference for reducing the revision incidence and improving the level of surgical technique and rehabilitation. The relevant literature on analyzing revision reason of UKA using computer-assisted technology in recent years was extensively reviewed. The revision reasons by computer-assisted technology are fracture of the medial tibial plateau, progressive osteoarthritis of reserved compartment, dislocation of mobile bearing, prosthesis loosening, polyethylene wear, and unexplained persistent pain. Computer-assisted technology can be used to analyze the revision reason of UKA and guide the best operating method and rehabilitation scheme by simulating the operative process and knee joint activities.

  10. A taxonomic revision of the genus Podocarpus

    NARCIS (Netherlands)

    Laubenfels, de D.J.

    1985-01-01

    In connection with the forthcoming revision of the Coniferae for the Flora Malesiana, the author thought it necessary to revise the genus Podocarpus. Although this genus has a substantial representation in Malesia (30 species), the revision is too involved to be appropriate with the Flora Malesiana

  11. 24 CFR 968.225 - Budget revisions.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Budget revisions. 968.225 Section... Fewer Than 250 Units) § 968.225 Budget revisions. (a) A PHA shall not incur any modernization cost in excess of the total HUD-approved CIAP budget. A PHA shall submit a budget revision, in a form prescribed...

  12. 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..., DEPARTMENT OF AGRICULTURE UNIFORM FEDERAL ASSISTANCE REGULATIONS Programmatic Changes and Budget Revisions § 3015.115 Budget revisions. (a) Nonconstruction projects. (1) Except as provided in paragraph (a)(2) of...

  13. 48 CFR 15.307 - Proposal revisions.

    Science.gov (United States)

    2010-10-01

    ... AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Source Selection 15.307 Proposal revisions. (a) If an... allow proposal revisions to clarify and document understandings reached during negotiations. At the... submit a final proposal revision. The contracting officer is required to establish a common cut-off date...

  14. Patterns of functional improvement after revision knee arthroplasty.

    Science.gov (United States)

    Ghomrawi, Hassan M K; Kane, Robert L; Eberly, Lynn E; Bershadsky, Boris; Saleh, Khaled J

    2009-12-01

    Despite the increase in the number of total knee arthroplasty revisions, outcomes of such surgery and their correlates are poorly understood. The aim of this study was to characterize patterns of functional improvement after revision total knee arthroplasty over a two-year period and to investigate factors that affect such improvement patterns. Three hundred and eight patients in need of revision surgery were enrolled into the study, conducted at seventeen centers, and 221 (71.8%) were followed for two years. Short Form-36 (SF-36), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Lower-Extremity Activity Scale (LEAS) scores were collected at baseline and every six months for two years postoperatively. A piecewise general linear mixed model, which models correlation between repeated measures and estimates separate slopes for different follow-up time periods, was employed to examine functional improvement patterns. Separate regression slopes were estimated for the zero to twelve-month and the twelve to twenty-four-month periods. The slopes for zero to twelve months showed significant improvement in all measures in the first year. The slopes for twelve to twenty-four months showed deterioration in the scores of the WOMAC pain subscale (slope = 0.67 +/- 0.21, p coefficient = -5.46 +/- 1.91, p coefficient = 5.41 +/- 2.35, p coefficient = 1.42 +/- 0.69, p < 0.05]). Factors related to the surgical technique did not predict outcomes. The onset of worsening pain and knee-specific function in the second year following revision total knee arthroplasty indicates the need to closely monitor patients, irrespective of the mode of failure of the primary procedure or the surgical technique for the revision. This information may be especially important for patients with multiple comorbidities.

  15. CUSTOM TRIFLANGE ACETABULAR COMPONENTS IN REVISION HIP REPLACEMENT (EXPERIENCE REVIEW

    Directory of Open Access Journals (Sweden)

    A. A. Korytkin

    2017-01-01

    Full Text Available Extensive defects of acetabulum especially accompanied by pelvis discontinuity at the level of acetabulum pose a serious challenge in revision hip replacement and create additional complexity in fixing the acetabular component. One of the perspective options to solve the above issue is the use of custom triflange acetabular components (CTAC designed based on preoperative computer tomography given the specifics of bone defects of the patient. Purpose of the study — to evaluate the outcomes of CTAC use in revision hip replacement.Materials and methods. The authors analyzed treatment outcomes of 12 patients after revision hip replacement using additive techniques of computer simulation and 3D printing CTAC. Follow up period after the surgery averaged 7±3 months (from one to ten months. 7 out of 12 patients had acetabular defects of Paprosky 3B type, 4 patients had defects of Paprosky 3A and in one patient — of Paprosky 2C.Results. Two out of twelve patients had prosthesis dislocations that required revision hip surgery, one of those patients underwent open reduction of dislocation with wound debridement, another patient underwent replacement of articulating couple of acetabular component. Total scores under Harris Hip Score and paint VAS score prior to treatment was 28±7 and 7±1 points respectively, postoperative scores were 76±9 and 3±1 respectively.Conclusion. The application of additive techniques for revision hip replacement in patients with extensive acetabular and pelvic defects allows to make a precise preoperative planning, to restore joint rotation center, to reconstruct bone defects and to securely fix triflange acetabular component that altogether significantly improve treatment outcomes and patients satisfaction with the surgery.

  16. ASSET guidelines. Revised 1991 Edition

    International Nuclear Information System (INIS)

    1991-12-01

    The present publication is an updated version of the IAEA Assessment of Safety Significant Events Team (ASSET) Guidelines, IAEA-TECDOC-573, published in 1990. Sections 5 and 6 include revised definitions and investigation guidelines for identification of both direct and root causes. These revisions were recommended by a Consultants Meeting held in Vienna on 3-7 December 1990. This guidance is not intended to infringe an expert's prerogative to investigate additional items. Its main purpose is to provide a basic structure and ensure consistency in the assessments. Use of the ASSET guidelines should also facilitate comparison between the observations made in different nuclear power plants and harmonize the reporting of generic ASSET results. The guidelines should always be used with a critical attitude and a view to possible improvements

  17. Trust Revision for Conflicting Sources

    Science.gov (United States)

    2017-02-01

    strategy is to first revise a priori trust assignments as a function of the degree of conflict, before the evidence is fused. This paper focuses on the...practical trust transitivity seems to be idiosyncratic for humans and animals, with no true analogue among non- living forms (and in the physical world ...visiting a foreign country Alice is looking for a restaurant where the locals go, because she would like to avoid places overrun by tourists. She meets a

  18. 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.

  19. Revised dietary guidelines for Koreans.

    Science.gov (United States)

    Jang, Young Ai; Lee, Haeng Shin; Kim, Bok Hee; Lee, Yoonna; Lee, Hae Jeung; Moon, Jae Jin; Kim, Cho-il

    2008-01-01

    With rapidly changing dietary environment, dietary guidelines for Koreans were revised and relevant action guides were developed. First, the Dietary Guidelines Advisory Committee was established with experts and government officials from the fields of nutrition, preventive medicine, health promotion, agriculture, education and environment. The Committee set dietary goals for Koreans aiming for a better nutrition state of all after a thorough review and analysis of recent information related to nutritional status and/or problems of Korean population, changes in food production/supply, disease pattern, health policy and agricultural policy. Then, the revised dietary guidelines were proposed to accomplish these goals in addition to 6 different sets of dietary action guides to accommodate specific nutrition and health problems of respective age groups. Subsequently, these guidelines and guides were subjected to the focus group review, consumer perception surveys, and a public hearing for general and professional comments. Lastly, the language was clarified in terms of public understanding and phraseology. The revised Dietary guidelines for Koreans are as follows: eat a variety of grains, vegetables, fruits, fish, meat, poultry and dairy products; choose salt-preserved foods less, and use less salt when you prepare foods; increase physical activity for a healthy weight, and balance what you eat with your activity; enjoy every meal, and do not skip breakfast; if you drink alcoholic beverages, do so in moderation; prepare foods properly, and order sensible amounts; enjoy our rice-based diet.

  20. Nerve Wrapping of the Sciatic Nerve With Acellular Dermal Matrix in Chronic Complete Proximal Hamstring Ruptures and Ischial Apophyseal Avulsion Fractures

    Science.gov (United States)

    Haus, Brian M.; Arora, Danny; Upton, Joseph; Micheli, Lyle J.

    2016-01-01

    Background: Patients with chronic injuries of the proximal hamstring can develop significant impairment because of weakness of the hamstring muscles, sciatic nerve compression from scar formation, or myositis ossificans. Purpose: To describe the surgical outcomes of patients with chronic injury of the proximal hamstrings who were treated with hamstring repair and sciatic neurolysis supplemented with nerve wrapping with acellular dermal matrix. Study Design: Retrospective case series; Level of evidence, 4. Methods: Fifteen consecutive patients with a diagnosis of chronic complete proximal hamstring rupture or chronic ischial tuberosity apophyseal avulsion fracture (mean age, 39.67 years; range, 14-69 years) were treated with proximal hamstring repair and sciatic neurolysis supplemented with nerve wrapping with acellular dermal matrix. Nine patients had preoperative sciatica, and 6 did not. Retrospective chart review recorded clinical outcomes measured by the degree of pain relief, the rate of return to activities, and associated postoperative complications. Results: All 15 patients were followed in the postoperative period for an average of 16.6 months. Postoperatively, there were 4 cases of transient sciatic nerve neurapraxia. Four patients (26%) required postoperative betamethasone sodium phosphate (Celestone Soluspan) injectable suspension USP 6 mg/mL. Among the 9 patients with preoperative sciatica, 6 (66%) had a good or excellent outcome and were able to return to their respective activities/sports; 3 (33%) had persistent chronic pain. One of these had persistent sciatic neuropathy that required 2 surgical reexplorations and scar excision after development of recurrent extraneural scar formation. Among the 6 without preoperative sciatica, 100% had a good or excellent outcomes and 83% returned to their respective activities/sports. Better outcomes were observed in younger patients, as the 3 cases of persistent chronic sciatic pain were in patients older than 45

  1. Re-visions of rationality?

    Science.gov (United States)

    Newell, Ben R

    2005-01-01

    The appeal of simple algorithms that take account of both the constraints of human cognitive capacity and the structure of environments has been an enduring theme in cognitive science. A novel version of such a boundedly rational perspective views the mind as containing an 'adaptive toolbox' of specialized cognitive heuristics suited to different problems. Although intuitively appealing, when this version was proposed, empirical evidence for the use of such heuristics was scant. I argue that in the light of empirical studies carried out since then, it is time this 'vision of rationality' was revised. An alternative view based on integrative models rather than collections of heuristics is proposed.

  2. Revised hypothesis and future perspectives

    DEFF Research Database (Denmark)

    Norsk, P; Drummer, C; Christensen, N J

    2001-01-01

    Results from space have been unexpected and not predictable from the results of ground-based simulations. Therefore, the concept of how weightlessness and gravity modulates the regulation of body fluids must be revised and a new simulation model developed. The main questions to ask in the future...... are the following: Does weightlessness induce a diuresis and natriuresis during the initial hours of space flight leading to an extracellular and intravascular fluid volume deficit? Can sodium in excess be stored in a hitherto unknown way, particularly during space flight? Why are fluid and sodium retaining systems...

  3. A taxonomic revision of the genus Podocarpus

    OpenAIRE

    Laubenfels, de, D.J.

    1985-01-01

    In connection with the forthcoming revision of the Coniferae for the Flora Malesiana, the author thought it necessary to revise the genus Podocarpus. Although this genus has a substantial representation in Malesia (30 species), the revision is too involved to be appropriate with the Flora Malesiana per se. One new subgenus and 17 new sections are described, and 94 species are enumerated, of which 11 species and 1 variety are described as new, and 3 varieties have been raised to specific rank....

  4. A suite of standards for radiation monitors and their revisions

    International Nuclear Information System (INIS)

    Noda, Kimio

    1991-01-01

    A suite of standards for radiation monitors applied in nuclear facilities in Japan was compiled mainly by Health Physicists in Power Reactor and Nuclear Fuel Development (PNC) and Japan Atomic Energy Research Institute (JAERI), and issued in 1971 as 'The Standard for Radiation Monitors'. PNC facilities such as Reprocessing Plant and Plutonium Fuel Fabrication Facility, as well as other nuclear industries have applied the standard, and contributed improvement of practical maintenability and availability of the radiation monitors. Meanwhile, the radiation monitors have remarkably progressed in its application and size of the monitors is growing. Furthermore, manufacturing techniques have significantly progressed especially in the field of system concepts and electronics elements. These progresses require revision of the standards. 'The Standard for Radiation Monitors' has been revised considering the problems in practical application and data processing capability. Considerations are given to keep compatibility of old and new modules. (author)

  5. High proximal migration in cemented acetabular revisions operated with bone impaction grafting; 47 revision cups followed with RSA for 17 years.

    Science.gov (United States)

    Mohaddes, Maziar; Herberts, Peter; Malchau, Henrik; Johanson, Per-Erik; Kärrholm, Johan

    2017-05-12

    Bone impaction grafting is a biologically and mechanically appealing option in acetabular revision surgery, allowing restitution of the bone stock and restoration of the biomechanics. We analysed differences in proximal migration of the revision acetabular components when bone impaction grafting is used together with a cemented or an uncemented cup. 43 patients (47 hips), revised due to acetabular loosening and judged to have less than 50% host bone-implant contact were included. The hips were randomised to either an uncemented (n = 20) or a cemented (n = 27) revision cup. Radiostereometry and radiography was performed postoperatively, at 3 and 6 months, 1, 2, 3, 5, 7, 10 and 13 and 17 years postoperatively. Clinical follow-up was performed at 1, 2 and 5 years postoperatively and thereafter at the same interval as in the radiographic follow-up. There were no differences in the base line demographic data between the 2 groups. At the last follow-up (17 years) 14 hips (10 cemented, 4 uncemented) had been re-revised due to loosening. 3 additional cups (1 uncemented and 2 cemented) were radiographically loose. There was a higher early proximal migration in the cemented cups. Cups operated on with cement showed a higher early migration measured with RSA and also a higher number of late revisions. The reason for this is not known, but factors such as inclusion of cases with severe bone defects, use of smaller bone chips and issues related to the impaction technique might have had various degrees of influence.

  6. 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)

  7. Revision Total Hip Arthoplasty: Factors Associated with Re-Revision Surgery

    OpenAIRE

    Khatod, M; Cafri, G; Inacio, MCS; Schepps, AL; Paxton, EW; Bini, SA

    2015-01-01

    The survivorship of implants after revision total hip arthroplasty and risk factors associated with re-revision are not well defined. We evaluated the re-revision rate with use of the institutional total joint replacement registry. The purpose of this study was to determine patient, implant, and surgeon factors associated with re-revision total hip arthroplasty.A retrospective cohort study was conducted. The total joint replacement registry was used to identify patients who had undergone revi...

  8. Revised nonstochastic health effects models

    International Nuclear Information System (INIS)

    Yaniv, S.S.; Scott, B.R.

    1991-01-01

    In 1989, the U.S. Nuclear Regulatory Commission (NRC) published a revision of the 1985 report, Health Effects Models for Nuclear Power Plant Accident Consequence Analysis, NUREG/CR-4214, that included models for early occurring and continuing nonstochastic effects, cancers and thyroid nodules, and genetic effects. This paper discusses specific models for lethality from early occurring and continuing effects. For brevity, hematopoietic-syndrome lethality is called hematopoietic death; pulmonary-syndrome lethality is called pulmonary death; and gastrointestinal syndrome lethality is called gastrointestinal death. Two-parameter Weibull risk functions are recommended for estimating the risk of hematopoietic, pulmonary, or gastrointestinal death. The risks are obtained indirectly by using hazard functions; as a result, this type of approach has been called hazard-function modeling and the models generated are called hazard-function models. In the 1989 NUREG/CR-4214 report, changes were made in the parameter values for a number of effects, and the models used to estimate hematopoietic and pulmonary deaths were substantially revised. Upper and lower estimates of model parameters are provided for all early health effects models. In this paper, we discuss the 1989 models for hematopoietic and pulmonary deaths, highlighting the differences between the 1989 and 1985 models. In addition, we give the reasons for which the 1985 models were modified

  9. 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…

  10. Increased risk of revision for infection in rheumatoid arthritis patients with total hip replacements

    DEFF Research Database (Denmark)

    Schrama, Johannes Cornelis; Fenstad, Anne M; Dale, Håvard

    2015-01-01

    Background and purpose-Medical treatment of rheumatoid arthritis (RA) has changed dramatically over the last 15 years, including immune modulation. We investigated the risk of revision for infection after primary total hip replacement (THR) in patients with rheumatoid arthritis over a 16-year...... period, and compared it with that in THR patients with osteoarthritis (OA).Patients and methods-We identified 13,384 THRs in RA patients and 377,287 THRs in OA patients from 1995 through 2010 in a dataset from the Nordic Arthroplasty Register Association (NARA). Kaplan-Meier survival curves......, with revision for infection as the endpoint, were constructed. Cox regression analyses were performed to calculate the relative risk (RR) of revision for infection adjusted for age, sex, fixation technique, and year of primary surgery.Results-RA patients had a 1.3 times (95% CI 1.0-1.6) higher risk of revision...

  11. 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

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

    Science.gov (United States)

    Keeling, Parnell; Lennon, Alexander B; Kenny, Patrick J; O'Reilly, Peter; Prendergast, Patrick J

    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. Primary cement mantles were formed by cementing a polished stem into sections of tubular steel. If in the test group, the mantle underwent conditioning in saline to simulate ageing and was subject to a fatigue of 1 million cycles. If in the control group no such conditioning or fatigue was carried out. The cement-in-cement procedure was then undertaken. Both groups underwent a fatigue of 1 million cycles subsequent to the revision procedure. Application of a Mann-Whitney test on the recorded subsidence (means: 0.51, 0.46, n=10+10, P=0.496) and inducible displacement (means: 0.38, 0.36, P=0.96) revealed that there was no statistical difference between the groups. This study represents further biomechanical investigation of the mechanical behaviour of cement-in-cement revision constructs. Results suggest that pre-revision fatigue and ageing of the cement may not be deleterious to the mechanical performance of the revision construct. Thus, this study provides biomechanical evidence to back-up recent successes with this useful revision technique. Copyright © 2012 Elsevier Ltd. All rights reserved.

  13. Revised GCFR safety program plan

    International Nuclear Information System (INIS)

    Kelley, A.P.; Boyack, B.E.; Torri, A.

    1980-05-01

    This paper presents a summary of the recently revised gas-cooled fast breeder reactor (GCFR) safety program plan. The activities under this plan are organized to support six lines of protection (LOPs) for protection of the public from postulated GCFR accidents. Each LOP provides an independent, sequential, quantifiable risk barrier between the public and the radiological hazards associated with postulated GCFR accidents. To implement a quantitative risk-based approach in identifying the important technology requirements for each LOP, frequency and consequence-limiting goals are allocated to each. To ensure that all necessary tasks are covered to achieve these goals, the program plan is broken into a work breakdown structure (WBS). Finally, the means by which the plan is being implemented are discussed

  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. 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.

  16. Hot sample archiving. Revision 3

    International Nuclear Information System (INIS)

    McVey, C.B.

    1995-01-01

    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. Radiological control manual. Revision 1

    International Nuclear Information System (INIS)

    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

  18. Formative research: pretesting, revising, and more pretesting.

    Science.gov (United States)

    Zimmerman, M; Steckel, L

    1985-01-01

    Thorough and extensive pretesting is the formative research technique that the Program for the Introduction and Adaptation of Contraceptive Technology (PIACT) and its sister organization, the Program for Appropriate Technology in Health (PATH), rely on to develop well-understood and culturally appropriate print materials. Formative research is defined as evaluation activities that occur during a project to determine if the objectives are being met and, if not, to modify the project's direction to ensure that they are. Before materials are finalized or printed, an interviewer should pretest them with representatives of the target population to determine if the intended message is being conveyed and if it is clear and acceptable to them. Pretesting should be done while the materials are still in an unfinished state so audience-generated alterations can be made easily. Revised materials also should be tested until they communicate the inforamtion as intended. Due to the fact that PIACT/PATH work with countries where large percentages of the population are illiterate, its motivational and instructional materials rely on pictures to convey the message. Often, pictures are augmented by a line or 2 of simple text in the local language. This text also requires careful pretesting. Examples from the field demonstrate the importance of pretesting to assure that print materials are appropriate to the group for whom they are being developed. The examples deal with sympbols, positive messages, the use of common objects, extraneous detail, messages about time, and text. Through pretesting, PIACT/PATH has learned that there can be a large discrepancy between what materials developers intend to convey and what the audience understands. Pretesting is an essential formative technique that builds upon information gathered during the materials development process, ensuring the message designer that the materials will effectively address the needs of the target audience.

  19. Transposition of branches of radial nerve innervating supinator to posterior interosseous nerve for functional reconstruction of finger and thumb extension in 4 patients with middle and lower trunk root avulsion injuries of brachial plexus.

    Science.gov (United States)

    Wu, Xia; Cong, Xiao-Bing; Huang, Qi-Shun; Ai, Fang-Xin; Liu, Yu-Tian; Lu, Xiao-Cheng; Li, Jin; Weng, Yu-Xiong; Chen, Zhen-Bing

    2017-12-01

    This study aimed to investigate the reconstruction of the thumb and finger extension function in patients with middle and lower trunk root avulsion injuries of the brachial plexus. From April 2010 to January 2015, we enrolled in this study 4 patients diagnosed with middle and lower trunk root avulsion injuries of the brachial plexus via imaging tests, electrophysiological examinations, and clinical confirmation. Muscular branches of the radial nerve, which innervate the supinator in the forearm, were transposed to the posterior interosseous nerve to reconstruct the thumb and finger extension function. Electrophysiological findings and muscle strength of the extensor pollicis longus and extensor digitorum communis, as well as the distance between the thumb tip and index finger tip, were monitored. All patients were followed up for 24 to 30 months, with an average of 27.5 months. Motor unit potentials (MUP) of the extensor digitorum communis appeared at an average of 3.8 months, while MUP of the extensor pollicis longus appeared at an average of 7 months. Compound muscle action potential (CMAP) appeared at an average of 9 months in the extensor digitorum communis, and 12 months in the extensor pollicis longus. Furthermore, the muscle strength of the extensor pollicis longus and extensor digitorum communis both reached grade III at 21 months. Lastly, the average distance between the thumb tip and index finger tip was 8.8 cm at 21 months. In conclusion, for patients with middle and lower trunk injuries of the brachial plexus, transposition of the muscular branches of the radial nerve innervating the supinator to the posterior interosseous nerve for the reconstruction of thumb and finger extension function is practicable and feasible.

  20. 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

  1. 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.

  2. Femoral revision with impaction allografting and an uncemented femoral component

    DEFF Research Database (Denmark)

    Nickelsen, T N; Erenbjerg, M; Retpen, J B

    2008-01-01

    A technique for uncemented revision of the femoral component which combines impaction allografting and the use of a long-stemmed proximally coated titanium prostheses (Bimetric, Biomet Inc.) is described. The results after a mean follow-up of 112 months are reported. From 1991 to 1995 femoral...... implants 88% had no pain, 10% had slight pain and only 2% had severe pain. Thirty-eight patients had radiographic signs of remodelling of the graft and/or cortical repair. In cases with a successful outcome, the results have been encouraging in relation to clinical performance, regeneration of bone...

  3. The economic impact of revision otologic surgery.

    Science.gov (United States)

    Nadimi, Sahar; Leonetti, John P; Pontikis, George

    2016-03-01

    Revision otologic surgery places a significant economic burden on patients and the healthcare system. We conducted a retrospective chart analysis to estimate the economic impact of revision canal-wall-down (CWD) mastoidectomy. We reviewed the medical records of all 189 adults who had undergone CWD mastoidectomy performed by the senior author between June 2006 and August 2011 at Loyola University Medical Center in Maywood, Ill. Institutional charges and collections for all patients were extrapolated to estimate the overall healthcare cost of revision surgery in Illinois and at the national level. Of the 189 CWD mastoidectomies, 89 were primary and 100 were revision procedures. The total charge for the revision cases was $2,783,700, and the net reimbursement (collections) was $846,289 (30.4%). Using Illinois Hospital Association data, we estimated that reimbursement for 387 revision CWD mastoidectomies that had been performed in fiscal year 2011 was nearly $3.3 million. By extrapolating our data to the national level, we estimated that 9,214 patients underwent revision CWD mastoidectomy in the United States during 2011, which cost the national healthcare system roughly $76 million, not including lost wages and productivity. Known causes of failed CWD mastoidectomies that often result in revision surgery include an inadequate meatoplasty, a facial ridge that is too high, residual diseased air cells, and recurrent cholesteatoma. A better understanding of these factors can reduce the need for revision surgery, which could have a positive impact on the economic strain related to this procedure at the local, state, and national levels.

  4. Cochlear implant revision surgeries in children.

    Science.gov (United States)

    Amaral, Maria Stella Arantes do; Reis, Ana Cláudia Mirândola B; Massuda, Eduardo T; Hyppolito, Miguel Angelo

    2018-02-16

    The surgery during which the cochlear implant internal device is implanted is not entirely free of risks and may produce problems that will require revision surgeries. To verify the indications for cochlear implantation revision surgery for the cochlear implant internal device, its effectiveness and its correlation with certain variables related to language and hearing. A retrospective study of patients under 18 years submitted to cochlear implant Surgery from 2004 to 2015 in a public hospital in Brazil. Data collected were: age at the time of implantation, gender, etiology of the hearing loss, audiological and oral language characteristics of each patient before and after Cochlear Implant surgery and any need for surgical revision and the reason for it. Two hundred and sixty-five surgeries were performed in 236 patients. Eight patients received a bilateral cochlear implant and 10 patients required revision surgery. Thirty-two surgeries were necessary for these 10 children (1 bilateral cochlear implant), of which 21 were revision surgeries. In 2 children, cochlear implant removal was necessary, without reimplantation, one with cochlear malformation due to incomplete partition type I and another due to trauma. With respect to the cause for revision surgery, of the 8 children who were successfully reimplanted, four had cochlear calcification following meningitis, one followed trauma, one exhibited a facial nerve malformation, one experienced a failure of the cochlear implant internal device and one revision surgery was necessary because the electrode was twisted. The incidence of the cochlear implant revision surgery was 4.23%. The period following the revision surgeries revealed an improvement in the subject's hearing and language performance, indicating that these surgeries are valid in most cases. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  5. 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...

  6. Individual questions of financial control and revision

    Directory of Open Access Journals (Sweden)

    В. М. Глібко

    2015-05-01

    Full Text Available Problem setting. In modern conditions at investigation and gathering of proofs in criminal proceedings according to item 93 CPC of Ukraine collecting of proofs which is carried out by the criminal proceedings parties, victim is important, the representative of the legal person, in which relation carries out manufacture, including a way истребования and receptions from public authorities, local governments, the enterprises, establishments and organisations, official and physical persons of things, documents, data, conclusions of experts, conclusions of revisions and certificates of checks. Recent research and publications analisis. In scientific sources questions of carrying out of revisions S. B.Zhivko, V.V.Akimov, G.Demjanchuk, J.Buzdugan is considered. Paper objective. Article purpose is studying and definition of a place of revision among forms of inspection of the state control and use of results of revision in criminal proceedings. Paper main body. Off-schedule exit revision that is revision which is not provided in plans of work of body of the state financial control is considered and is spent at presence at least one of the circumstances listed in item 11 of the Law of Ukraine «About main principles of realisation of the state financial control in Ukraine». If revision is carried out on request of investigating bodies it is spent on the basis of the petition of the inspector and accepted by the results of consideration of this petition of the decision of the investigatory judge. The primary goal of revision on request of investigating bodies or on the basis of court definition is reception of proofs on business. Therefore the revision certificate admits the written proof as on the basis of its conclusion of the inspector, the public prosecutor receives the information on a perfect crime, abusing, and also on the persons who have committed a crime, on the period of commission of crime and an amount of damage. In criminal

  7. Femoral component revision with use of impaction bone-grafting and a cemented polished stem.

    NARCIS (Netherlands)

    Schreurs, B.W.; Arts, J.J.C.; Verdonschot, N.J.J.; Buma, P.; Slooff, T.J.J.H.; Gardeniers, J.W.M.

    2005-01-01

    BACKGROUND: The purpose of this study was to evaluate the clinical and radiographic outcomes of revision of the femoral component of a hip arthroplasty with use of an impaction bone-grafting technique and a cemented polished stem. METHODS: Thirty-three consecutive femoral reconstructions that were

  8. 78 FR 27936 - Request for Extension and Revision of a Currently Approved Information Collection With Additional...

    Science.gov (United States)

    2013-05-13

    ..., or auditing services. Such information includes; the name and location of the person or company..., mechanical, or other technological collection techniques or other forms of information technology. All... Extension and Revision of a Currently Approved Information Collection With Additional Merge of Additional...

  9. Peer Scaffolding Behaviors Emerging in Revising a Written Task: A Microgenetic Analysis

    Science.gov (United States)

    Ranjbar, Naser; Ghonsooly, Behzad

    2017-01-01

    Vygotsky's writings on Sociocultural Theory (SCT) of mind, his concept of Zone of Proximal Development (ZPD) and its related metaphor, scaffolding, serve as the theoretical basis for the study of peer collaboration. This paper aimed at examining the effects of peer-scaffolding on EFL writing ability and finding out how revising techniques are…

  10. 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...

  11. Taxation and Welfare: A Revision Exercise.

    Science.gov (United States)

    Boden, Andrew

    1992-01-01

    Offers a revision exercise intended to remind students of some economic terminology associated with taxation and welfare. Provides a set of definitions for which students are to supply matching terms. Includes an answer list and suggests related exercises. (SG)

  12. Student-initiated revision in child health.

    Science.gov (United States)

    Alfaham, M; Gray, O P; Davies, D P

    1994-03-01

    Most teaching of child health in Cardiff takes place in block attachments of 8 weeks. There is an introductory seminar of 2 days followed by a 6-week clinical attachment in a district general hospital in Wales, and then a revision period of one week designed to help students formalize and structure their basic knowledge and to clarify aspects of child health which they may have had difficulty in understanding. The revision programme has to take into account: the short time available, the small number of teaching staff, the most relevant basic knowledge and active participation by the student. This paper describes how this week has been improved through the use of student-initiated revision (SIR). The students' appraisal of this revision and in particular SIR is presented.

  13. New and revised standards for coke production

    Energy Technology Data Exchange (ETDEWEB)

    G.A. Kotsyuba; M.I. Alpatov; Y.G. Shapoval [Giprokoks, the State Institute for the Design of Coke-Industry Enterprises, Kharkov (Ukraine)

    2009-07-15

    The need for new and revised standards for coke production in Ukraine and Russia is outlined. Such standards should address improvements in plant operation, working conditions, environmental protection, energy conservation, fire and explosion safety, and economic indices.

  14. FFTF operations procedures preparation guide. Revision 2

    International Nuclear Information System (INIS)

    1976-12-01

    The Guide is intended to provide guidelines for the initial preparation of FFTF Operating Procedures. The Procedures Preparation Guide was developed from the plan presented and approved in the FFTF Reactor Plant Procedures Plan, PC-1, Revision 3

  15. Revising incompletely specified convex probabilistic belief bases

    CSIR Research Space (South Africa)

    Rens, G

    2016-04-01

    Full Text Available revision employing the notion of optimum entropy, and point out some of the benefits and difficulties in those methods. Both the boundary distribution method and the optimum entropy method are reasonable, yet yield different results....

  16. Descriptor revision belief change through direct choice

    CERN Document Server

    Hansson, Sven Ove

    2017-01-01

    This book provides a critical examination of how the choice of what to believe is represented in the standard model of belief change. In particular the use of possible worlds and infinite remainders as objects of choice is critically examined. Descriptors are introduced as a versatile tool for expressing the success conditions of belief change, addressing both local and global descriptor revision. The book presents dynamic descriptors such as Ramsey descriptors that convey how an agent’s beliefs tend to be changed in response to different inputs. It also explores sentential revision and demonstrates how local and global operations of revision by a sentence can be derived as a special case of descriptor revision. Lastly, the book examines revocation, a generalization of contraction in which a specified sentence is removed in a process that may possibly also involve the addition of some new information to the belief set.

  17. Dismantling techniques

    International Nuclear Information System (INIS)

    Wiese, E.

    1998-01-01

    Most of the dismantling techniques used in a Decontamination and Dismantlement (D and D) project are taken from conventional demolition practices. Some modifications to the techniques are made to limit exposure to the workers or to lessen the spread of contamination to the work area. When working on a D and D project, it is best to keep the dismantling techniques and tools as simple as possible. The workers will be more efficient and safer using techniques that are familiar to them. Prior experience with the technique or use of mock-ups is the best way to keep workers safe and to keep the project on schedule

  18. Dismantling techniques

    Energy Technology Data Exchange (ETDEWEB)

    Wiese, E.

    1998-03-13

    Most of the dismantling techniques used in a Decontamination and Dismantlement (D and D) project are taken from conventional demolition practices. Some modifications to the techniques are made to limit exposure to the workers or to lessen the spread of contamination to the work area. When working on a D and D project, it is best to keep the dismantling techniques and tools as simple as possible. The workers will be more efficient and safer using techniques that are familiar to them. Prior experience with the technique or use of mock-ups is the best way to keep workers safe and to keep the project on schedule.

  19. NRC revision to 10 CFR Part 20

    International Nuclear Information System (INIS)

    Baker, R.E.; Cool, W.S.; Mills, W.A.

    1983-01-01

    The Nuclear Regulatory Commission's pollution standards have been revised since publication in the late 1950s, but the basic approach has not changed. The revisions resulted in inaccuracies, conflicts, and ambiguities in requirements. The need for comprehensive updating including radiation-protection principles, risk, occupational exposure dose limits, standards for the public (including de minimis level), surveys and monitoring, disposal into sewerage systems, and records is discussed. 2 tables

  20. Revised data taking schedule with ion beams

    CERN Document Server

    Gazdzicki, Marek; Aduszkiewicz, A; Andrieu, B; Anticic, T; Antoniou, N; Argyriades, J; Asryan, A G; Baatar, B; Blondel, A; Blumer, J; Boldizsar, L; Bravar, A; Brzychczyk, J; Bubak, A; Bunyatov, S A; Choi, K U; Christakoglou, P; Chung, P; Cleymans, J; Derkach, D A; Diakonos, F; Dominik, W; Dumarchez, J; Engel, R; Ereditato, A; Feofilov, G A; Fodor, Z; Ferrero, A; Gazdzicki, M; Golubeva, M; Grebieszkow, K; Grzeszczuk, A; Guber, F; Hasegawa, T; Haungs, A; Igolkin, S; Ivanov, A S; Ivashkin, A; Kadija, K; Katrynska, N; Kielczewska, D; Kikola, D; Kisiel, J; Kobayashi, T; Kolesnikov, V I; Kolev, D; Kolevatov, R S; Kondratiev, V P; Kowalski, S; Kurepin, A; Lacey, R; Laszlo, A; Lyubushkin, V V; Majka, Z; I Malakhov, A; Marchionni, A; Marcinek, A; Maris, I; Matveev, V; Melkumov, G L; Meregaglia, A; Messina, M; Mijakowski, P; Mitrovski, M; Montaruli, T; Mrówczynski, St; Murphy, S; Nakadaira, T; Naumenko, P A; Nikolic, V; Nishikawa, K; Palczewski, T; Pálla, G; Panagiotou, A D; Peryt, W; Planeta, R; Pluta, J; Popov, B A; Posiadala, M; Przewlocki, P; Rauch, W; Ravonel, M; Renfordt, R; Röhrich, D; Rondio, E; Rossi, B; Roth, M; Rubbia, A; Rybczynski, M; Sadovskii, A; Sakashita, K; Schuster, T; Sekiguchi, T; Seyboth, P; Shibata, M; Sissakian, A N; Skrzypczak, E; Slodkowski, M; Sorin, A S; Staszel, P; Stefanek, G; Stepaniak, J; Strabel, C; Ströbele, H; Susa, T; Szentpétery, I; Szuba, M; Tada, M; Taranenko, A; Tsenov, R; Ulrich, R; Unger, M; Vassiliou, M; Vechernin, V V; Vesztergombi, G; Wlodarczyk, Z; Wojtaszek, A; Zipper, W; CERN. Geneva. SPS and PS Experiments Committee; SPSC

    2009-01-01

    This document presents the revised data taking schedule of NA61 with ion beams. The revision takes into account limitations due to the new LHC schedule as well as final results concerning the physics performance with secondary ion beams. It is proposed to take data with primary Ar and Xe beams in 2012 and 2014, respectively, and to test and use for physics a secondary B beam from primary Pb beam fragmentation in 2010, 2011 and 2013.

  1. Introductory Business Textbook Revision Cycles: Are They Getting Shorter?

    Science.gov (United States)

    Zinser, Brian; Brunswick, Gary

    2010-01-01

    The rate of textbook revision cycles is examined in light of the recent trend towards more rapid revisions (and adoptions of textbooks). The authors conduct background research to better understand the context for textbook revision cycles and the environmental forces that have been influencing what appears to be more rapid textbook revisions. A…

  2. 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.

  3. 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.

  4. Revision surgery for failed thermal capsulorrhaphy.

    Science.gov (United States)

    Park, Hyung Bin; Yokota, Atsushi; Gill, Harpreet S; El Rassi, George; McFarland, Edward G

    2005-09-01

    With the failure of thermal capsulorrhaphy for shoulder instability, there have been concerns with capsular thinning and capsular necrosis affecting revision surgery. To report the findings at revision surgery for failed thermal capsulorrhaphy and to evaluate the technical effects on subsequent revision capsular plication. Case series; Level of evidence, 4. Fourteen patients underwent arthroscopic evaluation and open reconstruction for a failed thermal capsulorrhaphy. The cause of the failure, the quality of the capsule, and the ability to suture the capsule were recorded. The patients were evaluated at follow-up for failure, which was defined as recurrent subluxations or dislocations. The origin of the instability was traumatic (n = 6) or atraumatic (n = 8). At revision surgery in the traumatic group, 4 patients sustained failure of the Bankart repair with capsular laxity, and the others experienced capsular laxity alone. In the atraumatic group, all patients experienced capsular laxity as the cause of failure. Of the 14 patients, the capsule quality was judged to be thin in 5 patients and ablated in 1 patient. A glenoid-based capsular shift could be accomplished in all 14 patients. At follow-up (mean, 35.4 months; range, 22 to 48 months), 1 patient underwent revision surgery and 1 patient had a subluxation, resulting in a failure rate of 14%. Recurrent capsular laxity after failed thermal capsular shrinkage is common and frequently associated with capsular thinning. In most instances, the capsule quality does not appear to technically affect the revision procedure.

  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. Results of Latarjet Coracoid Transfer to Revise Failed Arthroscopic Instability Repairs

    OpenAIRE

    Nicholson, Gregory P.; Rahman, Zain; Verma, Nikhil N.; Romeo, Anthony A.; Cole, Brian J.; Gupta, Anil Kumar; Bruce, Benjamin

    2014-01-01

    Objectives: Arthroscopic instability repair has supplanted open techniques to anatomically reconstruct anteroinferior instability pathology. Arthroscopic technique can fail for a variety of reasons. We have utilized the Latarjet as a revision option in failed arthroscopic instability repairs when there is altered surgical anatomy, capsular deficiency and/or glenoid bone compromise and recurrent glenohumeral instability. Methods: We reviewed 51 shoulders (40 ?, 11?) that underwent Latarjet cor...

  7. Translation Techniques

    OpenAIRE

    Marcia Pinheiro

    2015-01-01

    In this paper, we discuss three translation techniques: literal, cultural, and artistic. Literal translation is a well-known technique, which means that it is quite easy to find sources on the topic. Cultural and artistic translation may be new terms. Whilst cultural translation focuses on matching contexts, artistic translation focuses on matching reactions. Because literal translation matches only words, it is not hard to find situations in which we should not use this technique.  Because a...

  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. 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.

  10. Erosion and deposition by supercritical density flows during channel avulsion and backfilling: Field examples from coarse-grained deepwater channel-levée complexes (Sandino Forearc Basin, southern Central America)

    Science.gov (United States)

    Lang, Jörg; Brandes, Christian; Winsemann, Jutta

    2017-03-01

    Erosion and deposition by supercritical density flows can strongly impact the facies distribution and architecture of submarine fans. Field examples from coarse-grained channel-levée complexes from the Sandino Forearc Basin (southern Central America) show that cyclic-step and antidune deposits represent common sedimentary facies of these depositional systems and relate to the different stages of avulsion, bypass, levée construction and channel backfilling. During channel avulsion, large-scale scour-fill complexes (18 to 29 m deep, 18 to 25 m wide, 60 to > 120 m long) were incised by supercritical density flows. The multi-storey infill of the large-scale scour-fill complexes comprises amalgamated massive, normally coarse-tail graded or widely spaced subhorizontally stratified conglomerates and pebbly sandstones, interpreted as deposits of the hydraulic-jump zone of cyclic steps. The large-scale scour-fill complexes can be distinguished from small-scale channel fills based on the preservation of a steep upper margin and a coarse-grained infill comprising mainly amalgamated hydraulic-jump zone deposits. Channel fills include repeated successions deposited by cyclic steps with superimposed antidunes. The deposits of the hydraulic-jump zone of cyclic steps comprise regularly spaced scours (0.2 to 2.6 m deep, 0.8 to 23 m long) infilled by intraclast-rich conglomerates or pebbly sandstones, displaying normal coarse-tail grading or backsets. These deposits are laterally and vertically associated with subhorizontally stratified, low-angle cross-stratified or sinusoidally stratified sandstones and pebbly sandstones, which were deposited by antidunes on the stoss side of the cyclic steps during flow re-acceleration. The field examples indicate that so-called spaced stratified deposits may commonly represent antidune deposits with varying stratification styles controlled by the aggradation rate, grain-size distribution and amalgamation. The deposits of small-scale cyclic

  11. Ultrasonic techniques validation on shell

    International Nuclear Information System (INIS)

    Navarro, J.; Gonzalez, E.

    1998-01-01

    Due to the results obtained in several international RRT during the 80's, it has been necessary to prove the effectiveness of the NDT techniques. For this reason it has been imperative to verify the goodness of the Inspection Procedure over different mock-ups, representative of the inspection area and with real defects. Prior to the revision of the inspection procedure and with the aim of updating the techniques used, it is a good practice to perform different scans on the mock-ups until the validation is achieved. It is at this point, where all the parameters of the inspection at hands are defined; transducer, step, scan direction,... and what it's more important, it will be demonstrated that the technique to be used for the area required to inspection is suitable to evaluate the degradation phenomena that could appear. (Author)

  12. 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.

  13. Recurrent instability after revision anterior shoulder stabilization surgery.

    Science.gov (United States)

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

    2014-03-01

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

  14. Single-stage Acetabular Revision During Two-stage THA Revision for Infection is Effective in Selected Patients.

    Science.gov (United States)

    Fink, Bernd; Schlumberger, Michael; Oremek, Damian

    2017-08-01

    patients were assessed before surgery, between stages, every 3 months during the first year after surgery, every 6 months during the second year postoperative, and at latest followup, and were retrospectively drawn from a longitudinally maintained institutional database. Thirty-four of 35 patients (97.2%; 95% CI, 85.4%-99.5%) appeared free of infection by criteria of Masri et al. and Zimmerli et al. at latest followup. The Harris hip score was 61 ± 13 points after the first operation and 82 ± 16 points 2 years after the second operation. This technique is a promising treatment option for periprosthetic infections of the hip in which substantial acetabular defects exclude implantation of a normal spacer and a two-stage revision of the femoral component is favored. Level IV, therapeutic study.

  15. Hanford Site technical baseline database. Revision 1

    International Nuclear Information System (INIS)

    Porter, P.E.

    1995-01-01

    This report lists the Hanford specific files (Table 1) that make up the Hanford Site Technical Baseline Database. Table 2 includes the delta files that delineate the differences between this revision and revision 0 of the Hanford Site Technical Baseline Database. This information is being managed and maintained on the Hanford RDD-100 System, which uses the capabilities of RDD-100, a systems engineering software system of Ascent Logic Corporation (ALC). This revision of the Hanford Site Technical Baseline Database uses RDD-100 version 3.0.2.2 (see Table 3). Directories reflect those controlled by the Hanford RDD-100 System Administrator. Table 4 provides information regarding the platform. A cassette tape containing the Hanford Site Technical Baseline Database is available

  16. Cryochemistry (2nd revised edition)

    Energy Technology Data Exchange (ETDEWEB)

    Sergeev, G.B.; Batiuk, V.A.

    1986-01-01

    Chemical reactions at low temperatures are characterized, summarizing the results of Soviet research since the late 1950s. Chapters are devoted to homogeneous and heterogeneous low-temperature reactions of gases and liquids, apparatus and techniques for cryochemistry, reactions of ions and radicals in frozen solids, low-temperature polymerization, chain reactions, spontaneous reactions, kinetic models of solid-phase reactions, reactions in multicomponent frozen systems, biochemical reactions at reduced and low temperatures, reactions involving metals, and science and engineering applications of low temperatures. 813 references.

  17. Diagnostic techniques

    International Nuclear Information System (INIS)

    Berquist, T.H.; Bender, C.E.; James, E.M.; Brown, M.L.; McLeod, R.A.; Broderick, D.F.; Welch, T.J.

    1989-01-01

    Proper application of imaging procedures is essential to obtain needed information for diagnosis and therapy planning in patients with suspected foot and/or ankle pathology. This paper provides basic background data for the numerous imaging techniques

  18. 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

  19. Revised Huang-Yang multipolar pseudopotential

    International Nuclear Information System (INIS)

    Derevianko, Andrei

    2005-01-01

    A number of authors have recently pointed out inconsistencies of results obtained with the Huang-Yang multipolar pseudopotential for low-energy scattering [K. Huang and K. C. Yang, Phys. Rev. 105, 767 (1957); later revised by Huang, Statistical Mechanics (Wiley, New York, 1963)]. The conceptual validity of their original derivation has been questioned. Here I show that these inconsistencies are rather due to an algebraic mistake made by Huang and Yang. With the corrected error, I present the revised version of the multipolar pseudopotential

  20. Plan-Belief Revision in Jason

    DEFF Research Database (Denmark)

    Jensen, Andreas Schmidt; Villadsen, Jørgen

    2015-01-01

    When information is shared between agents of unknown reliability, it is possible that their belief bases become inconsistent. In such cases, the belief base must be revised to restore consistency, so that the agent is able to reason. In some cases the inconsistent information may be due to use of...... of incorrect plans. We extend work by Alechina et al. to revise belief bases in which plans can be dynamically added and removed. We present an implementation of the algorithm in the AgentSpeak implementation Jason....

  1. 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....... Methods 29 patients were operated with 30 revision arthroplasties. Median age was 67 (34-84) years. All patients followed a standardized fast-track set-up designed for primary TKA. We determined the outcome regarding LOS, morbidity, mortality, and satisfaction. Results Median LOS was 2 (1-4) days...

  2. PWR secondary water chemistry guidelines: Revision 3

    International Nuclear Information System (INIS)

    Lurie, S.; Bucci, G.; Johnson, L.; King, M.; Lamanna, L.; Morgan, E.; Bates, J.; Burns, R.; Eaker, R.; Ward, G.; Linnenbom, V.; Millet, P.; Paine, J.P.; Wood, C.J.; Gatten, T.; Meatheany, D.; Seager, J.; Thompson, R.; Brobst, G.; Connor, W.; Lewis, G.; Shirmer, R.; Gillen, J.; Kerns, M.; Jones, V.; Lappegaard, S.; Sawochka, S.; Smith, F.; Spires, D.; Pagan, S.; Gardner, J.; Polidoroff, T.; Lambert, S.; Dahl, B.; Hundley, F.; Miller, B.; Andersson, P.; Briden, D.; Fellers, B.; Harvey, S.; Polchow, J.; Rootham, M.; Fredrichs, T.; Flint, W.

    1993-05-01

    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)

  3. Anatomic deltoid ligament repair with anchor-to-post suture reinforcement: technique tip.

    Science.gov (United States)

    Lack, William; Phisitkul, Phinit; Femino, John E

    2012-01-01

    The deltoid ligament is the primary ligamentous stabilizer of the ankle joint. Both superficial and deep components of the ligament can be disrupted with a rotational ankle fracture, chronic ankle instability, or in late stage adult acquired flatfoot deformity. The role of deltoid ligament repair in these conditions has been limited and its contribution to arthritis is largely unknown. Neglect of the deltoid ligament in the treatment of ankle injuries may be due to difficulties in diagnosis and lack of an effective method for repair. Most acute repair techniques address the superficial deltoid ligament with direct end-to-end repair, fixation through bone tunnels, or suture anchor repair of avulsion injuries. Deep deltoid ligament repair has been described using direct end-to-end repair with sutures, as well as by autograft and allograft tendon reconstruction utilizing various techniques. Newer tenodesis techniques have been described for late reconstruction of both deep and superficial components in patients with stage 4 adult acquired flatfoot deformity. We describe a technique that provides anatomic ligament-to-bone repair of the superficial and deep bundles of the deltoid ligament while reducing the talus toward the medial malleolar facet of the tibiotalar joint with anchor-to-post reinforcement of the ligamentous repair. This technique may protect and allow the horizontally oriented fibers of the deep deltoid ligament to heal with the appropriate resting length while providing immediate stability of the construct.

  4. Fatigue failure of the cephalomedullary nail: revision options, outcomes and review of the literature.

    Science.gov (United States)

    Tucker, Adam; Warnock, Michael; McDonald, Sinead; Cusick, Laurence; Foster, Andrew P

    2018-04-01

    Cephalomedullary nail (CMN) failure is a rare entity following hip fracture treatment. However, it poses significant challenges for revision surgery, both mechanically and biologically. Nail failure rates have been reported at failure, compared to "adequate" and "good" (p = 0.027). Tip-Apex Distance (TAD) mean was 23.2 ± 8.3 mm, and an adequate TAD with three-point fixation was seen in only 35% of cases. Mean time to failure was 401.0 ± 237.2 days, with mean age at failure of 74.0 ± 14.8 years. Options after failure included revision CMN nail, proximal femoral locking plate (PFLP), long-stem or restoration arthroplasty, or femoral endoprosthesis. Barthel Functional Index scores showed no significant difference at 3 and 12 months post-operatively, nor any difference between treatment groups. Mean 12-month mortality was 30%, akin to a primary hip fracture mortality risk according to NICE guidelines. Mortality rates were lowest in revision nails. Subsequent revision rates were higher in the PFLP group. There is no reported evidence on the best surgical technique for managing the failed CMN, with no clear functional benefit in the options above. Good surgical technique at the time of primary CMN surgery is critical in minimising fatigue failure. After revision, overall mortality rates were equivalent to reported primary hip fracture mortality rates. Further multicentre evaluations are required to assess which technique convey the best functional outcomes without compromising 12-month mortality rates.

  5. Decomposition techniques

    Science.gov (United States)

    Chao, T.T.; Sanzolone, R.F.

    1992-01-01

    Sample decomposition is a fundamental and integral step in the procedure of geochemical analysis. It is often the limiting factor to sample throughput, especially with the recent application of the fast and modern multi-element measurement instrumentation. The complexity of geological materials makes it necessary to choose the sample decomposition technique that is compatible with the specific objective of the analysis. When selecting a decomposition technique, consideration should be given to the chemical and mineralogical characteristics of the sample, elements to be determined, precision and accuracy requirements, sample throughput, technical capability of personnel, and time constraints. This paper addresses these concerns and discusses the attributes and limitations of many techniques of sample decomposition along with examples of their application to geochemical analysis. The chemical properties of reagents as to their function as decomposition agents are also reviewed. The section on acid dissolution techniques addresses the various inorganic acids that are used individually or in combination in both open and closed systems. Fluxes used in sample fusion are discussed. The promising microwave-oven technology and the emerging field of automation are also examined. A section on applications highlights the use of decomposition techniques for the determination of Au, platinum group elements (PGEs), Hg, U, hydride-forming elements, rare earth elements (REEs), and multi-elements in geological materials. Partial dissolution techniques used for geochemical exploration which have been treated in detail elsewhere are not discussed here; nor are fire-assaying for noble metals and decomposition techniques for X-ray fluorescence or nuclear methods be discussed. ?? 1992.

  6. Revision total hip arthoplasty: factors associated with re-revision surgery.

    Science.gov (United States)

    Khatod, Monti; Cafri, Guy; Inacio, Maria C S; Schepps, Alan L; Paxton, Elizabeth W; Bini, Stefano A

    2015-03-04

    The survivorship of implants after revision total hip arthroplasty and risk factors associated with re-revision are not well defined. We evaluated the re-revision rate with use of the institutional total joint replacement registry. The purpose of this study was to determine patient, implant, and surgeon factors associated with re-revision total hip arthroplasty. A retrospective cohort study was conducted. The total joint replacement registry was used to identify patients who had undergone revision total hip arthroplasty for aseptic reasons from April 1, 2001, to December 31, 2010. The end point of interest was re-revision total hip arthroplasty. Risk factors evaluated for re-revision total hip arthroplasty included: patient risk factors (age, sex, body mass index, race, and general health status), implant risk factors (fixation type, bearing surface, femoral head size, and component replacement), and surgeon risk factors (volume and experience). A multivariable Cox proportional hazards model was used. Six hundred and twenty-nine revision total hip arthroplasties with sixty-three (10%) re-revisions were evaluated. The mean cohort age (and standard deviation) was 57.0 ± 12.4 years, the mean body mass index (and standard deviation) was 29.5 ± 6.1 kg/m(2), and most of the patients were women (64.5%) and white (81.9%) and had an American Society of Anesthesiologists score of associated with the risk of re-revision. For every ten-year increase in patient age, the hazard ratio for re-revision decreases by a factor of 0.72 (95% confidence interval, 0.58 to 0.90). For every five revision surgical procedures performed by a surgeon, the risk of revision decreases by a factor of 0.93 (95% confidence interval, 0.86 to 0.99). At the time of revision, a new or retained cemented femoral implant or all-cemented hip implant increases the risk of revision by a factor of 3.19 (95% confidence interval, 1.22 to 8.38) relative to a retained or new uncemented hip implant. A ceramic on a

  7. Comparison of revision strategies for failed C2-posterior cervical pedicle screws: a biomechanical study.

    Science.gov (United States)

    Mayer, Michael; Zenner, Juliane; Bogner, Robert; Hitzl, Wolfgang; Figl, Markus; von Keudell, Arvind; Stephan, Daniel; Penzkofer, Rainer; Augat, Peter; Korn, Gundobert; Resch, Herbert; Koller, Heiko

    2013-01-01

    With increasing usage within challenging biomechanical constructs, failures of C2 posterior cervical pedicle screws (C2-pCPSs) will occur. The purpose of the study was therefore to investigate the biomechanical characteristics of two revision techniques after the failure of C2-pCPSs. Twelve human C2 vertebrae were tested in vitro in a biomechanical study to compare two strategies for revision screws after failure of C2-pCPSs. C2 pedicles were instrumented using unicortical 3.5-mm CPS bilaterally (Synapse/Synthes, Switzerland). Insertion accuracy was verified by fluoroscopy. C2 vertebrae were potted and fixed in an electromechanical testing machine with the screw axis coaxial to the pullout direction. Pullout testing was conducted with load and displacement data taken continuously. The peak load to failure was measured in newtons (N) and is reported as the pullout resistance (POR). After pullout, two revision strategies were tested in each vertebra. In Group-1, revision was performed with 4.0-mm C2-pCPSs. In Group-2, revision was performed with C2-pedicle bone-plastic combined with the use of a 4-mm C2-pCPSs. For the statistical analysis, the POR between screws was compared using absolute values (N) and the POR of the revision techniques normalized to that of the primary procedures (%). The POR of primary 3.5-mm CPSs was 1,140.5 ± 539.6 N for Group-1 and 1,007.7 ± 362.5 N for Group-2; the difference was not significant. In the revision setting, the POR in Group-1 was 705.8 ± 449.1 N, representing a reduction of 38.1 ± 32.9 % compared with that of primary screw fixation. For Group-2, the POR was 875.3 ± 367.9 N, representing a reduction of 13.1 ± 23.4 %. A statistical analysis showed a significantly higher POR for Group-2 compared with Group-1 (p = 0.02). Although the statistics showed a significantly reduced POR for both revision strategies compared with primary fixation (p plastic, the POR can be significantly increased compared with the use of only an

  8. Revision of the genus Phaeanthus (Annonaceae)

    NARCIS (Netherlands)

    Mols, J.B.; Keßler, P.J.A.

    2000-01-01

    A revision of the genus Phaeanthus Hook.f. & Thomson (Annonaceae) is presented. The genus comprises 8 species. A key to the fruiting and/or flowering specimens of the genus is included. The genus consists of shrubs to small-sized trees from Malesia and Vietnam. It is characterised by sepals and

  9. Revision of South African pavement design method

    CSIR Research Space (South Africa)

    Kannemeyer, L

    2015-08-01

    Full Text Available an improved mechanistic-empirical design method has been developed, based on the latest available local and international research and design trends. The process followed during revision as well as some of the key outcomes of this process are presented...

  10. A revision of the genus Mastixia (Cornaceae)

    NARCIS (Netherlands)

    Matthew, K.M.

    1976-01-01

    A revision of the genus in its entire range of distribution is presented. Out of more than 50 published specific names, 9 species (with 13 subspecies or varieties) are recognized, in addition to 4 new species and one new subspecies. The two subgenera Pentamastixia and Tetramastixia of Wangerin

  11. EU law revisions and legislative drift

    DEFF Research Database (Denmark)

    Borghetto, Enrico; Mäder, Lars Kai

    2014-01-01

    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...

  12. A synoptic revision of Inversodicraea (Podostemaceae)

    NARCIS (Netherlands)

    Cheek, M.; Feika, A.; Lebbie, A.; Goyder, D.; Tchiengue, B.; Sene, O.; Tchouto, P.; Burgt, van der X.

    2017-01-01

    Six new species of Inversodicraea (I. feika from Sierra Leone, I. liberia from Liberia, and I. ebo, I. eladii, I. tchoutoi, and I. xanderi from Cameroon) are described as new to science in the context of a synoptic revision of this African genus, now comprising 30 species, including I. cussetiana

  13. The Brosimum allene: a structural revision.

    Science.gov (United States)

    Hu, Gaojie; Liu, Kai; Williams, Lawrence J

    2008-12-04

    Insight derived from a synthetic model, calculated (13)C NMR data, and comparison to experimental data indicate that the proposed allenic structure A, originally assigned to an isolate from Brosimum acutifolium Huber, should be revised to B, a natural product and nonallenic substance, mururin C.

  14. Rhinoplasty for the multiply revised nose.

    Science.gov (United States)

    Foda, Hossam M T

    2005-01-01

    To evaluate the problems encountered on revising a multiply operated nose and the methods used in correcting such problems. The study included 50 cases presenting for revision rhinoplasty after having had 2 or more previous rhinoplasties. An external rhinoplasty approach was used in all cases. Simultaneous septal surgery was done whenever indicated. All cases were followed for a mean period of 32 months (range, 1.5-8 years). Evaluation of the surgical result depended on clinical examination, comparison of pre- and postoperative photographs, and degree of patients' satisfaction with their aesthetic and functional outcome. Functionally, 68% suffered nasal obstruction that was mainly caused by septal deviations and nasal valve problems. Aesthetically, the most common deformities of the upper two thirds of the nose included pollybeak (64%), dorsal irregularities (54%), dorsal saddle (44%), and open roof deformity (42%), whereas the deformities of lower third included depressed tip (68%), tip contour irregularities (60%), and overrotated tip (42%). Nasal grafting was necessary in all cases; usually more than 1 type of graft was used in each case. Postoperatively, 79% of the patients, with preoperative nasal obstruction, reported improved breathing; 84% were satisfied with their aesthetic result; and only 8 cases (16%) requested further revision to correct minor deformities. Revision of a multiply operated nose is a complex and technically demanding task, yet, in a good percentage of cases, aesthetic as well as functional improvement are still possible.

  15. Title TBA: Revising the Abstract Submission Process.

    Science.gov (United States)

    Tibon, Roni; Open Science Committee, Cbu; Henson, Richard

    2018-04-01

    Academic conferences are among the most prolific scientific activities, yet the current abstract submission and review process has serious limitations. We propose a revised process that would address these limitations, achieve some of the aims of Open Science, and stimulate discussion throughout the entire lifecycle of the scientific work. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. 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,

  17. 25 CFR 276.14 - Budget revision.

    Science.gov (United States)

    2010-04-01

    ... changes include: (1) The use of grantee funds in furtherance of program objectives over and above the... the objective of the grant-supported program. (2) The revision indicates the need for additional... programs, functions, and activities when budgeted separately for a grant, except that the Bureau shall...

  18. Revised Reynolds Stress and Triple Product Models

    Science.gov (United States)

    Olsen, Michael E.; Lillard, Randolph P.

    2017-01-01

    Revised versions of Lag methodology Reynolds-stress and triple product models are applied to accepted test cases to assess the improvement, or lack thereof, in the prediction capability of the models. The Bachalo-Johnson bump flow is shown as an example for this abstract submission.

  19. INDIRECT WRITTEN CORRECTIVE FEEDBACK, REVISION, AND LEARNING

    Directory of Open Access Journals (Sweden)

    Fatemeh Poorebrahim

    2017-01-01

    Full Text Available Corrective feedback, the necessity of providing it, and how it should be provided has been one of the hot topics in the area of ELT. Amid continuing controversies over whether providing feedback helps L2 learners improve their writing accuracy, many research studies have been undertaken to compare the relative effectiveness of different types of feedback. However, the difference between two types of indirect corrective feedback, namely indication and indication plus location, have not been properly examined yet. Motivated to narrow this gap, this study is designed to compare two groups of Iranian learners, each revising their papers based on one of the aforementioned options. For data analysis, a series of independent samples t tests were employed. The results revealed that the difference between the two groups in their reduction of errors from the original draft to the revision of each task followed a growing trend and became significant. Nonetheless, the difference in accuracy of new pieces of writing fell short of significance. Finally, it was found that error reduction in revision stage cannot be considered as learning. The results of the study, discussed in relation to that of others, implicate that the purpose for which feedback is provided is essential in determining the type of feedback; more explicit feedback is better for revising purposes while more implicit feedback is good for learning purposes.

  20. Migrant Education Administrative Handbook. Revised April 1973.

    Science.gov (United States)

    North Carolina State Dept. of Public Instruction, Raleigh. Div. of Compensatory Education.

    The revised handbook provides specific references to the legislation and the National Migrant Program Guidelines, while setting forth the administrative procedures required for migrant projects in North Carolina. Specific topics of discussion in migrant program administration cover Public Law 89-750, state and local educational agency…

  1. 76 FR 2291 - TRICARE Reimbursement Revisions

    Science.gov (United States)

    2011-01-13

    ... rule revises the regulation by removing references to specific numeric Diagnosis Related Group (DRG... following methods: Federal eRulemaking Portal: http://www.regulations.gov . Follow the instructions for... descriptions became obsolete, so we are removing the numeric references in the regulation and utilizing only...

  2. 78 FR 59982 - Revisions to Radiation Protection

    Science.gov (United States)

    2013-09-30

    ... NUCLEAR REGULATORY COMMISSION [NRC-2012-0268] Revisions to Radiation Protection AGENCY: Nuclear..., ``Radiation Sources,'' Section 12.3 -12.4, ``Radiation Protection Design Features,'' and Section 12.5, ``Operational Radiation Protection Program.'' DATES: The effective date of this Standard Review Plan update is...

  3. Abschluss einer Aphanocephalus-revision (Coleoptera. Discolomidae)

    NARCIS (Netherlands)

    John, H.

    1967-01-01

    Im Rijksmuseum van Natuurlijke Historie, Leiden, befand sich eine Anzahl noch von Grouvelle determinierter Exemplare der Gattung Aphanocephalus Wollaston, die bei meiner Revision dieser Gattung (John, 1956, Ent. Blätt. 52) nicht berücksichtigt werden konnte, da das Material mir damals nicht

  4. A revision of Jatropha (Euphorbiaceae) in Malesia

    NARCIS (Netherlands)

    Welzen, van P.C.; Sweet, F.S.T.; Fernández-Casas, F.J.

    2017-01-01

    Jatropha, a widespread, species rich genus, ranges from the Americas and Caribbean to Africa and India. In Malesia five species occur, all of which were introduced and originated in Central and South America. The five species are revised and an identification key, nomenclature, descriptions,

  5. 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.

  6. New Directions in Reading Instruction--Revised.

    Science.gov (United States)

    Hinson, Bess, Ed.

    The gains in knowledge about the nature of reading and how to most effectively teach it come from cognitive research. This booklet (in the form of a flipchart) synthesizes and summarizes much of the current research on effective instruction for improved literacy and greater student achievement. The booklet, a revised edition of "New…

  7. 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...

  8. Revision of Dorstenia sect. Nothodorstenia (Moraceae)

    NARCIS (Netherlands)

    Berg, C.C.

    1978-01-01

    The African genus Craterogyne Lanjouw has to be united with Dorstenia L. Most species of Craterogyne can be included in Dorstenia sect. Nothodorstenia Engl. A revision of this section is presented. 5 species have been accepted, viz. D. elliptica Bureau, D. djettii J. L. Guillaumet, D. oligogyna

  9. EPRI BWR Water Chemistry Guidelines Revision

    International Nuclear Information System (INIS)

    Garcia, Susan E.; Giannelli, Joseph F.

    2014-01-01

    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

  10. Revised analysis of the Transition Joint Life Test

    Energy Technology Data Exchange (ETDEWEB)

    Sartory, W K

    1984-07-01

    The Transition Joint Life Test was performed by General Electric and the Energy Technology Engineering Center and was analyzed earlier by General Electric. Because of later developments in analysis techniques and in our understanding of the stress behavior near a dissimilar metal weldment, agreement was reached between General Electric and Oak Ridge National Laboratory`s High-Temperature Structural Design program that a more up-to-date analysis was needed. This report presents results of a new analysis incorporating modified mechanical properties, revised constitutive equations, and a more refined finite element grid. The structural life prediction of the present report is quite conservative (approximately 3 cycles of predicted life compared to 12 to 25 cycles of measured life), whereas the earlier General Electric analysis was underconservative by a similar factor.

  11. 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.

  12. Outcome, revision rate and indication for revision following resurfacing hemiarthroplasty for osteoarthritis of the shoulder

    DEFF Research Database (Denmark)

    Rasmussen, J V; Polk, A; Sorensen, A K

    2014-01-01

    In this study, we evaluated patient-reported outcomes, the rate of revision and the indications for revision following resurfacing hemiarthroplasty of the shoulder in patients with osteoarthritis. All patients with osteoarthritis who underwent primary resurfacing hemiarthroplasty and reported...... to the Danish Shoulder Arthroplasty Registry (DSR), between January 2006 and December 2010 were included. There were 772 patients (837 arthroplasties) in the study. The Western Ontario Osteoarthritis of the Shoulder (WOOS) index was used to evaluate patient-reported outcome 12 months (10 to 14) post......-operatively. The rates of revision were calculated from the revisions reported to the DSR up to December 2011 and by checking deaths with the Danish National Register of Persons. A complete questionnaire was returned by 688 patients (82.2%). The mean WOOS was 67 (0 to 100). A total of 63 hemiarthroplasties (7...

  13. EPRI PWR primary water chemistry guidelines revision

    International Nuclear Information System (INIS)

    McElrath, Joel; Fruzzetti, Keith

    2014-01-01

    EPRI periodically updates the PWR Primary Water Chemistry Guidelines as new information becomes available and as required by NEI 97-06 (Steam Generator Program Guidelines) and NEI 03-08 (Guideline for the Management of Materials Issues). The last revision of the PWR water chemistry guidelines identified an optimum primary water chemistry program based on then-current understanding of research and field information. This new revision provides further details with regard to primary water stress corrosion cracking (PWSCC), fuel integrity, and shutdown dose rates. A committee of industry experts, including utility specialists, nuclear steam supply system (NSSS) and fuel vendor representatives, Institute of Nuclear Power Operations (INPO) representatives, consultants, and EPRI staff collaborated in reviewing the available data on primary water chemistry, reactor water coolant system materials issues, fuel integrity and performance issues, and radiation dose rate issues. From the data, the committee updated the water chemistry guidelines that all PWR nuclear plants should adopt. The committee revised guidance with regard to optimization to reflect industry experience gained since the publication of Revision 6. Among the changes, the technical information regarding the impact of zinc injection on PWSCC initiation and dose rate reduction has been updated to reflect the current level of knowledge within the industry. Similarly, industry experience with elevated lithium concentrations with regard to fuel performance and radiation dose rates has been updated to reflect data collected to date. Recognizing that each nuclear plant owner has a unique set of design, operating, and corporate concerns, the guidelines committee has retained a method for plant-specific optimization. Revision 7 of the Pressurized Water Reactor Primary Water Chemistry Guidelines provides guidance for PWR primary systems of all manufacture and design. The guidelines continue to emphasize plant

  14. Diagnosing parathyroid glands: a revision

    International Nuclear Information System (INIS)

    Soroa, V.E.; Rank, G.

    2015-01-01

    Descriptions of the different benign parathyroid pathologies: primary, secondary and tertiary hyperparathyroidism and the possible diagnostic nuclear medicine techniques. We discuss the different acquisition modalities: planar, pinhole, subtraction, SPECT, SPECT/CT and PET/CT. Optimal recommendations for the patient preparation and acquisition, as well as false positive and negative results are also mentioned. Radiopharmaceuticals dosimetry is included. Statements related to other imaging modalities and the one with highest specificity: Ultrasound plus Nuclear Medicine. Emphasize of optimal results of the dual Phase 99m Tc-Setamibi in SPECT and the best selection with SPECT/CT, if available. Mention is done of the curative surgical treatment and the selective venous PTH sampling (excellent result if pre-surgical levels descended to 50 %, circumstances of false outcomes are also presented). Brief enumeration of PET/CT compounds, as another possibility that still has to proof its role in the diagnostic armamentarium of parathyroid pathology. Conclusion: The best diagnostic performance has been obtained with 99m Tc-Sestamibi in SPECT/CT as well as with the subtraction 131 I / 99m Tc-Sestamibi or 99m Tc-pertecneciate/ 99m Tc-Sestamibi methods. Nuclear Medicine is relevant in pointing parathyroid pathology in the surgical act and for a second look re-intervention. PET/CT radiopharmaceuticals are other possibilities that must still demonstrate its value in the diagnostic armamentarium of parathyroid pathologies. (authors) [es

  15. Neutron techniques

    International Nuclear Information System (INIS)

    Charlton, J.S.

    1986-01-01

    The way in which neutrons interact with matter such as slowing-down, diffusion, neutron absorption and moderation are described. The use of neutron techniques in industry, in moisture gages, level and interface measurements, the detection of blockages, boron analysis in ore feedstock and industrial radiography are discussed. (author)

  16. 40 CFR 60.4124 - Hg budget permit revisions.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 6 2010-07-01 2010-07-01 false Hg budget permit revisions. 60.4124... Coal-Fired Electric Steam Generating Units Permits § 60.4124 Hg budget permit revisions. Except as provided in § 60.4123(b), the permitting authority will revise the Hg Budget permit, as necessary, in...

  17. Integrating Relational Reasoning and Knowledge Revision during Reading

    Science.gov (United States)

    Kendeou, Panayiota; Butterfuss, Reese; Van Boekel, Martin; O'Brien, Edward J.

    2017-01-01

    Our goal in this theoretical contribution is to connect research on knowledge revision and relational reasoning. To achieve this goal, first, we review the "knowledge revision components framework" (KReC) that provides an account of knowledge revision processes, specifically as they unfold during reading of texts. Second, we review a…

  18. Subjective and objective outcome after revision arthroscopic stabilization for recurrent anterior instability versus initial shoulder stabilization.

    Science.gov (United States)

    Krueger, David; Kraus, Natascha; Pauly, Stephan; Chen, Jianhai; Scheibel, Markus

    2011-01-01

    The value of arthroscopic revision shoulder stabilization after failed instability repair is still a matter of debate. Arthroscopic revision shoulder stabilization using suture anchors provides equivalent subjective and objective results compared with initial arthroscopic instability repair. Cohort study; Level of evidence, 3. Twenty consecutive patients who underwent arthroscopic revision shoulder stabilization using suture anchors (group 2) were matched for age, gender, and handedness (dominant or nondominant) with 20 patients who had initial arthroscopic instability repair using the same technique (group 1). At the time of follow-up, a complete physical examination of both shoulders and evaluation with the Rowe score, Walch-Duplay score, Melbourne Instability Shoulder Score, Western Ontario Shoulder Instability Index, and the Subjective Shoulder Value were performed. In addition, standard radiographs (true AP and axillary views) were taken to evaluate signs of osteoarthritis. After a minimum follow-up of 24 months, no recurrent dislocations were observed in either group. The apprehension sign was positive in 2 cases of revision surgery (0 vs 2; P > .05). No significant differences in the Rowe score (89 vs 81.8 points) were found between groups 1 and 2 (P > .05). However, group 2 revealed significantly lower scores in the Walch-Duplay score (85.3 vs 75.5 points), Melbourne Instability Shoulder Score (90.2 vs 73.7 points), Western Ontario Shoulder Instability Index (89.8% vs 68.9%), and Subjective Shoulder Value (91.8% vs 69.2%) (P instability arthropathy were found more often in patients with arthroscopic revision surgery (2 vs 5; P > .05). Arthroscopic revision shoulder stabilization is associated with a lower subjective outcome compared with initial arthroscopic stabilization. The objective results found in this study may overestimate the clinical outcome in this patient population.

  19. Revised SNAP III Training Manual

    Energy Technology Data Exchange (ETDEWEB)

    Moss, Calvin Elroy [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Gonzales, Samuel M. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Myers, William L. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Nelson, Mark Andrew [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Rothrock, Richard Brian [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Salazar, Samuel A. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Sorensen, Eric Byron [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Sundby, Gary M. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-11-21

    The Shielded Neutron Assay Probe (SNAP) technique was developed to determine the leakage neutron source strength of a radioactive object. The original system consisted of an EberlineTM Mini-scaler and discrete neutron detector. The system was operated by obtaining the count rate with the EberlineTM instrument, determining the absolute efficiency from a graph, and calculating the neutron source strength by hand. In 2003 the SNAP III, shown in Figure 1, was designed and built. It required the operator to position the SNAP, and then measure the source-to-detector and detectorto- reflector distances. Next the operator entered the distance measurements and started the data acquisition. The SNAP acquired the required count rate and then calculated and displayed the leakage neutron source strength (NSS). The original design of the SNAP III is described in SNAP III Training Manual (ER-TRN-PLN-0258, Rev. 0, January 2004, prepared by William Baird) This report describes some changes that have been made to the SNAP III. One important change is the addition of a LEMO connector to provide neutron detection output pulses for input to the MC-15. This feature is useful in active interrogation with a neutron generator because the MC-15 has the capability to only record data when it is not gated off by a pulse from the neutron generator. This avoids recording of a lot of data during the generator pulses that are not useful. Another change was the replacement of the infrared RS-232 serial communication output by a similar output via a 4-pin LEMO connector. The current document includes a more complete explanation of how to estimate the amount of moderation around a neutron-emitting source.

  20. RAVEN User Manual Revision 5

    International Nuclear Information System (INIS)

    Mandelli, Diego; Rabiti, Cristian; Cogliati, Joshua Joseph; Kinoshita, Robert Arthur; Alfonsi, Andrea; Sen, Ramazan Sonat; Wang, Congjian

    2017-01-01

    RAVEN is a generic software framework to perform parametric and probabilistic analy- sis based on the response of complex system codes. The initial development was aimed to provide dynamic risk analysis capabilities to the Thermo-Hydraulic code RELAP-7, currently under development at the Idaho National Laboratory (INL). Although the initial goal has been fully accomplished, RAVEN is now a multi-purpose probabilistic and uncer- tainty quantification platform, capable to agnostically communicate with any system code. This agnosticism includes providing Application Programming Interfaces (APIs). These APIs are used to allow RAVEN to interact with any code as long as all the parameters that need to be perturbed are accessible by inputs files or via python interfaces. RAVEN is capable of investigating the system response, and investigating the input space using Monte Carlo, Grid, or Latin Hyper Cube sampling schemes, but its strength is focused to- ward system feature discovery, such as limit surfaces, separating regions of the input space leading to system failure, using dynamic supervised learning techniques. The development of RAVEN has started in 2012, when, within the Nuclear Energy Advanced Modeling and Simulation (NEAMS) program, the need to provide a modern risk evaluation framework became stronger. RAVEN principal assignment is to provide the necessary software and algorithms in order to employ the concept developed by the Risk Informed Safety Margin Characterization (RISMC) program. RISMC is one of the pathways defined within the Light Water Reactor Sustainability (LWRS) program. In the RISMC approach, the goal is not just the individuation of the frequency of an event potentially leading to a system failure, but the closeness (or not) to key safety-related events. Hence, the approach is in- terested in identifying and increasing the safety margins related to those events. A safety margin is a numerical value quantifying the probability that a safety metric (e

  1. 75 FR 57597 - Revised Proposal for Revisions to the Schedules of Civil Penalties for a Violation of a Federal...

    Science.gov (United States)

    2010-09-21

    ... Revisions to the Schedules of Civil Penalties for a Violation of a Federal Railroad Safety Law or Federal... railroad safety laws and regulations are necessary because many of FRA's civil penalties have not been..., et al. Revised Proposal for Revisions to the Schedules of Civil Penalties for a Violation of a...

  2. Astrophysical techniques

    CERN Document Server

    Kitchin, CR

    2013-01-01

    DetectorsOptical DetectionRadio and Microwave DetectionX-Ray and Gamma-Ray DetectionCosmic Ray DetectorsNeutrino DetectorsGravitational Radiation Dark Matter and Dark Energy Detection ImagingThe Inverse ProblemPhotographyElectronic ImagingScanningInterferometrySpeckle InterferometryOccultationsRadarElectronic ImagesPhotometryPhotometryPhotometersSpectroscopySpectroscopy SpectroscopesOther TechniquesAstrometryPolarimetrySolar StudiesMagnetometryComputers and The Internet.

  3. Presentation Technique

    International Nuclear Information System (INIS)

    Froejmark, M.

    1992-10-01

    The report presents a wide, easily understandable description of presentation technique and man-machine communication. General fundamentals for the man-machine interface are illustrated, and the factors that affect the interface are described. A model is presented for describing the operators work situation, based on three different levels in the operators behaviour. The operator reacts routinely in the face of simple, known problems, and reacts in accordance with predetermined plans in the face of more complex, recognizable problems. Deep fundamental knowledge is necessary for truly complex questions. Today's technical status and future development have been studied. In the future, the operator interface will be based on standard software. Functions such as zooming, integration of video pictures, and sound reproduction will become common. Video walls may be expected to come into use in situations in which several persons simultaneously need access to the same information. A summary of the fundamental rules for the design of good picture ergonomics and design requirements for control rooms are included in the report. In conclusion, the report describes a presentation technique within the Distribution Automation and Demand Side Management area and analyses the know-how requirements within Vattenfall. If different systems are integrated, such as geographical information systems and operation monitoring systems, strict demands are made on the expertise of the users for achieving a user-friendly technique which is matched to the needs of the human being. (3 figs.)

  4. Predictors of unsuccessful outcome in cemented femoral revisions using bone impaction grafting; Cox regression analysis of 208 cases.

    Science.gov (United States)

    Te Stroet, Martijn A J; Rijnen, Wim H C; Gardeniers, Jean W M; Schreurs, B Willem; Hannink, Gerjon

    2016-09-29

    Despite improvements in the technique of femoral impaction bone grafting, reconstruction failures still can occur. Therefore, the aim of our study was to determine risk factors for the endpoint re-revision for any reason. We used prospectively collected demographic, clinical and surgical data of all 202 patients who underwent 208 femoral revisions using the X-change Femoral Revision System (Stryker-Howmedica), fresh-frozen morcellised allograft and a cemented polished Exeter stem in our department from 1991 to 2007. Univariable and multivariable Cox regression analyses were performed to identify potential factors associated with re-revision. The mean follow-up was 10.6 (5-21) years. The cumulative re-revision rate was 6.3% (13/208). After univariable selection, sex, age, body mass index (BMI), American Association of Anesthesiologists (ASA) classification, type of removed femoral component, and mesh used for reconstruction were included in multivariable regression analysis.In the multivariable analysis, BMI was the only factor that was significantly associated with the risk of re-revision after bone impaction grafting (BMI ≥30 vs. BMI <30, HR = 6.54 [95% CI 1.89-22.65]; p = 0.003). BMI was the only factor associated with the risk of re-revision for any reason. Besides BMI also other factors, such as Endoklinik score and the type of removed femoral component, can provide guidance in the process of preclinical decision making. With the knowledge obtained from this study, preoperative patient selection, informed consent, and treatment protocols can be better adjusted to the individual patient who needs to undergo a femoral revision with impaction bone grafting.

  5. [Results of revision after failed surgical treatment for traumatic anterior shoulder instability].

    Science.gov (United States)

    Lópiz-Morales, Y; Alcobe-Bonilla, J; García-Fernández, C; Francés-Borrego, A; Otero-Fernández, R; Marco-Martínez, F

    2013-01-01

    Persistent or recurrent glenohumeral instability after a previous operative stabilization can be a complex problem. Our aim is to establish the incidence of recurrence and its revision surgery, and to analyse the functional results of the revision instability surgery, as well as to determine surgical protocols to perform it. A retrospective analysis was conducted on 16 patients with recurrent instability out of 164 patients operated on between 1999 and 2011. The mean follow-up was 57 months and the mean age was 29 years. To evaluate functional outcome we employed Constant, Rowe, UCLA scores and the visual analogue scale. Of the 12 patients who failed the initial arthroscopic surgery, 6 patients underwent an arthroscopic antero-inferior labrum repair technique, 4 using open labrum repair techniques, and 2 coracoid transfer. The two cases of open surgery with recurrences underwent surgery for coracoid transfer. Results of the Constant score were excellent or good in 64% of patients. Surgical revision of instability is a complex surgery essentially for two reasons: the difficulty in recognising the problem, and the technical demand (greater variety and the increasingly complex techniques). Copyright © 2012 SECOT. Published by Elsevier Espana. All rights reserved.

  6. Revised National Pressure Ulcer Advisory Panel Pressure Injury Staging System: Revised Pressure Injury Staging System.

    Science.gov (United States)

    Edsberg, Laura E; Black, Joyce M; Goldberg, Margaret; McNichol, Laurie; Moore, Lynn; Sieggreen, Mary

    Our understanding of pressure injury etiology and development has grown in recent years through research, clinical expertise, and global interdisciplinary expert collaboration. Therefore, the National Pressure Ulcer Advisory Panel (NPUAP) has revised the definition and stages of pressure injury. The revision was undertaken to incorporate the current understanding of the etiology of pressure injuries, as well as to clarify the anatomical features present or absent in each stage of injury. An NPUAP-appointed Task Force reviewed the literature and created drafts of definitions, which were then reviewed by stakeholders and the public, including clinicians, educators, and researchers around the world. Using a consensus-building methodology, these revised definitions were the focus of a multidisciplinary consensus conference held in April 2016. As a result of stakeholder and public input, along with the consensus conference, important changes were made and incorporated into the new staging definitions. The revised staging system uses the term injury instead of ulcer and denotes stages using Arabic numerals rather than Roman numerals. The revised definition of a pressure injury now describes the injuries as usually occurring over a bony prominence or under a medical or other device. The revised definition of a Stage 2 pressure injury seeks to clarify the difference between moisture-associated skin damage and injury caused by pressure and/or shear. The term suspected has been removed from the Deep Tissue Pressure Injury diagnostic label. Each definition now describes the extent of tissue loss present and the anatomical features that may or may not be present in the stage of injury. These important revisions reflect the methodical and collaborative approach used to examine the available evidence and incorporate current interdisciplinary clinical expertise into better defining the important phenomenon of pressure injury etiology and development.

  7. A revised Self- and Family Management Framework.

    Science.gov (United States)

    Grey, Margaret; Schulman-Green, Dena; Knafl, Kathleen; Reynolds, Nancy R

    2015-01-01

    Research on self- and family management of chronic conditions has advanced over the past 6 years, but the use of simple frameworks has hampered the understanding of the complexities involved. We sought to update our previously published model with new empirical, synthetic, and theoretical work. We used synthesis of previous studies to update the framework. We propose a revised framework that clarifies facilitators and barriers, processes, proximal outcomes, and distal outcomes of self- and family management and their relationships. We offer the revised framework as a model that can be used in studies aimed at advancing self- and family management science. The use of the framework to guide studies would allow for the design of studies that can address more clearly how self-management interventions work and under what conditions. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Standards for vision science libraries: 2014 revision.

    Science.gov (United States)

    Motte, Kristin; Caldwell, C Brooke; Lamson, Karen S; Ferimer, Suzanne; Nims, J Chris

    2014-10-01

    This Association of Vision Science Librarians revision of the "Standards for Vision Science Libraries" aspires to provide benchmarks to address the needs for the services and resources of modern vision science libraries (academic, medical or hospital, pharmaceutical, and so on), which share a core mission, are varied by type, and are located throughout the world. Through multiple meeting discussions, member surveys, and a collaborative revision process, the standards have been updated for the first time in over a decade. While the range of types of libraries supporting vision science services, education, and research is wide, all libraries, regardless of type, share core attributes, which the standards address. The current standards can and should be used to help develop new vision science libraries or to expand the growth of existing libraries, as well as to support vision science librarians in their work to better provide services and resources to their respective users.

  9. Revision of Sciaphila (Triuridaceae in Taiwan

    Directory of Open Access Journals (Sweden)

    Tsung-Hsin Hsieh

    2003-12-01

    Full Text Available The genus Sciaphila (Triuridaceae is revised based on comparative morphological and palynological studies in Taiwan. Four species are recognized, i. E. Sciaphila arfakiana Becc., S. Maculata Miers, S. ramosa Fukuy. & T. Suzuki, and S. secundiflora Thwaites ex Benth. Sciaphila arfakiana and S. maculata are new record to Flora of Taiwan and S. secundiflora distributed in Kueishan Island is a new distribution. SEM micrographs of pollen grains, a key to species, species descriptions, and taxonomic notes are provided.

  10. Revised Unfilling Procedure for Solid Lithium Lenses

    International Nuclear Information System (INIS)

    Leveling, A.

    2003-01-01

    A procedure for unfilling used lithium lenses to has been described in Pbar Note 664. To date, the procedure has been used to disassemble lenses 20, 21, 17, 18, and 16. As a result of this work, some parts of the original procedure were found to be time consuming and ineffective. Modifications to the original procedure have been made to streamline the process and are discussed in this note. The revised procedure is included in this note.

  11. Benchmarking i eksternt regnskab og revision

    DEFF Research Database (Denmark)

    Thinggaard, Frank; Kiertzner, Lars

    2001-01-01

    løbende i en benchmarking-proces. Dette kapitel vil bredt undersøge, hvor man med nogen ret kan få benchmarking-begrebet knyttet til eksternt regnskab og revision. Afsnit 7.1 beskæftiger sig med det eksterne årsregnskab, mens afsnit 7.2 tager fat i revisionsområdet. Det sidste afsnit i kapitlet opsummerer...... betragtningerne om benchmarking i forbindelse med begge områder....

  12. Revised Safety Instruction 41 (IS41 REV.)

    CERN Multimedia

    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

  13. Revising strategies for different text types

    OpenAIRE

    Roussey, JY; Piolat, A; Guercin, F

    1990-01-01

    Forty-eight children and forty-eight adults of contrasting degrees of expertise made a series of corrections in order to improve a text (narrative or description) in which three within-statement errors and three between-statement errors had been inserted. Subjects used a simplified word processor (SCRIPREV) which recorded all movements of linguistic units. The purpose of this research was to study revising strategies by examining the correction-sequencing procedures implemented by these subje...

  14. Revised coordinates of variable stars in Cassiopeia

    Science.gov (United States)

    Nesci, R.

    2018-02-01

    The identification of the variable stars published on IBVS 3573 has ben revised on the basis of the original (unpublished) finding charts. Cross check with the 2MASS catalog has been made to get more accurate coordinates and to confirm their nature from their , colors. The Mira stars, given their known periods, could be used with the astrometric parallaxes of the forthcoming Gaia catalog to improve the Period-Luminosity relation.

  15. 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.

  16. 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.

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

    International Nuclear Information System (INIS)

    Thomas, J.T.

    1978-01-01

    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

  18. Revised inspection program for nuclear power plants

    International Nuclear Information System (INIS)

    1978-01-01

    The United States Nuclear Regulatory Commission (NRC) regulates nuclear power plants to assure adequate protection of the public and the environment from the dangers associated with nuclear materials. NRC fulfills this responsibility through comprehensive safety reviews of nuclear facilities, licensing of organizations that use nuclear materials, and continuing inspection. The NRC inspection program is currently conducted from the five regional offices in or near Philadelphia, Atlanta, Chicago, Dallas and San Francisco. Inspectors travel from the regional offices to nuclear power plants in various phases of construction, test and operation in order to conduct inspections. However, in June 1977 the Commission approved a revision to the inspection program that will include stationing inspectors at selected plants under construction and at all plants in operation. In addition, the revised program provides for appraising the performance of licensees on a national basis and involves more direct measurement and observation by NRC inspectors of work and tests in progress. The program also includes enhanced career management consisting of improved training and career development for inspectors and other professionals. The report was requested in the Conference Report on the NRC Authorization for Appropriations for Fiscal Year 1978. The report provides a discussion of the basis for both the current and revised inspection programs, describes these programs, and shows how the NRC inspection force will be trained and utilized. In addition, the report includes a discussion of the actions that will be taken to assure the objectivity of inspectors

  19. Single-stage revision for fungal peri-prosthetic joint infection: a single-centre experience.

    Science.gov (United States)

    Klatte, T O; Kendoff, D; Kamath, A F; Jonen, V; Rueger, J M; Frommelt, L; Gebauer, M; Gehrke, T

    2014-04-01

    Fungal peri-prosthetic infections of the knee and hip are rare but likely to result in devastating complications. In this study we evaluated the results of their management using a single-stage exchange technique. Between 2001 and 2011, 14 patients (ten hips, four knees) were treated for a peri-prosthetic fungal infection. One patient was excluded because revision surgery was not possible owing to a large acetabular defect. One patient developed a further infection two months post-operatively and was excluded from the analysis. Two patients died of unrelated causes. After a mean of seven years (3 to 11) a total of ten patients were available for follow-up. One patient, undergoing revision replacement of the hip, had a post-operative dislocation. Another patient, undergoing revision replacement of the knee, developed a wound infection and required revision 29 months post-operatively following a peri-prosthetic femoral fracture. The mean Harris hip score increased to 74 points (63 to 84; p prosthetic infection is feasible, with an acceptable rate of a satisfactory outcome.

  20. Astrophysical techniques

    Energy Technology Data Exchange (ETDEWEB)

    Kitchin, C R

    1984-01-01

    The subject is covered in chapters, entitled: detectors (optical and infrared detection; radio and microwave detection; X-ray and gamma-ray detection; cosmic ray detectors; neutrino detectors; gravitational radiation); imaging (photography; electronic imaging; scanning; interferometry; speckle interferometry; occultations; radar); photometry and photometers; spectroscopy and spectroscopes; other techniques (astrometry; polarimetry; solar studies; magnetometry). Appendices: magnitudes and spectral types of bright stars; north polar sequence; standard stars for the UBV photometric system; standard stars for the UVBY photometric system; standard stars for MK spectral types; standard stars for polarimetry; Julian date; catalogues; answers to the exercises.

  1. Llizarov technique

    International Nuclear Information System (INIS)

    Shankman, S.; Rosenberg, Z.S.; Frankel, V.; Golyakhovsky, V.

    1990-01-01

    This paper illustrates the radiographic manifestations of the Ilizarov distraction technique for the correction of short and deformed limbs. The radiographs of 130 patients who underwent Ilizarov distraction at 160 sites since December 1986 were reviewed retrospectively. Reasons for correction included fracture nonunion and malunion idiopathic leg length discrepancy, achondroplasia, and neurofibromatosis with tibial pseudarthrosis. Ninety patients were adults, and 40 were children. In order to assess cortical bone development during the fixation phase, CT of the regenerate bone was performed in 17 patients. Conventional tomograms were obtained in 20 patients for the evaluation of delayed or hypoplastic union at the distraction site

  2. Experimental Techniques

    International Nuclear Information System (INIS)

    Fournier, D.; Serin, L.

    1995-01-01

    Experimental techniques to be used in the new generation of high energy physics are presented. The emphasis is put on the new ATLAS and CMS detectors for the CERN LHC. For the most important elements of these detectors, a description of the underlying physics processes is given, sometimes with reference to comparable detectors used in the past. Some comparative global performances of the two detectors are also given, with reference to benchmark physics processes (detection of the Higgs boson in various mass regions, etc). (author)

  3. Revision of Krsko NPP Quality Assurance Plan

    International Nuclear Information System (INIS)

    Biscan, R.; Fifnja, I.; Kavsek, D.

    2012-01-01

    International standards from nuclear power plant operation area are being frequently upgraded and revised in accordance with the continuous improvement philosophy. This philosophy applies also to the area of Quality Assurance, which has also undergone significant improvement since the early 1950s. Besides just nuclear industry, there are also other international quality standards that are being continuously developed and revised, bringing needs for upgrades also in the nuclear application. Since the beginning of Krsko NPP construction, the overall Quality Assurance program and its applicable procedures were in place to assure that all planned and systematic actions necessary to provide adequate confidence that an item or service will satisfy given requirements to quality, are in place. The overall requirements for quality as one of the major objectives for Krsko NPP operation are also set forth in the Updated Safety Analyses Report, the document that serves as a base for operating license. During more than 30 years of Krsko NPP operation, the quality requirements and related documents were revised and upgraded in several attempts. The latest revision 6 of QD-1, Quality Assurance Plan was issued during the year 2011. The bases for the revision were: Changes of the Slovenian regulatory requirements (ZVISJV, JV5, JV9?), Changes of Krsko NPP licensing documents (USAR section 13?), SNSA inspection requirements, Changes of international standards (IAEA, ISO?), Conclusions of first PSR, Implementation of ISO standards in Krsko NPP (ISO14001, ISO17025), Changes of plant procedures, etc. One of the most obvious changes was the enlargement of the QA Plan scope to cover interdisciplinary areas defined in the plant management program MD-1, such as Safety culture, Self-assessment, Human performance, Industrial Safety etc. The attachment of the QA Plan defining relationships between certain standards was also updated to provide matrix for better correlation of requirements of

  4. 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.

  5. Industrial technique

    International Nuclear Information System (INIS)

    Robertson, D.H.

    1975-01-01

    Techniques for selectively extracting and storing only krypton and xenon in the waste gases that are released from a pressurized water nuclear power reactor are described. The illustrative fluorocarbon absorption system has three separation stages: an initial gas-fluorocarbon absorber, a flash chamber and fractionator for segregating all of the absorbed gases from the loaded absorber stage fluorocarbon (save for the krypton and xenon), and a stripper that receives the partially loaded fluorocarbon liquid directly from the fractionator in order to separate only the krypton and xenon. A molecular sieve filter dries the input process gas, a cartridge type solvent filter is used to remove radiation degradation products from the loaded liquid that flows from the absorber, a cold trap gas drier is provided to remove residual solvent vapor from the separated krypton and xenon, and radiation detectors automatically activate valves to establish safe conditions in the event of an accident or plant failure. (U.S.)

  6. Experimental techniques

    International Nuclear Information System (INIS)

    Roussel-Chomaz, P.

    2007-01-01

    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, γ 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)

  7. Combinatorial techniques

    CERN Document Server

    Sane, Sharad S

    2013-01-01

    This is a basic text on combinatorics that deals with all the three aspects of the discipline: tricks, techniques and theory, and attempts to blend them. The book has several distinctive features. Probability and random variables with their interconnections to permutations are discussed. The theme of parity has been specially included and it covers applications ranging from solving the Nim game to the quadratic reciprocity law. Chapters related to geometry include triangulations and Sperner's theorem, classification of regular polytopes, tilings and an introduction to the Eulcidean Ramsey theory. Material on group actions covers Sylow theory, automorphism groups and a classification of finite subgroups of orthogonal groups. All chapters have a large number of exercises with varying degrees of difficulty, ranging from material suitable for Mathematical Olympiads to research.

  8. How to Revise, and Revise Really Well, for Premier Academic Journals

    DEFF Research Database (Denmark)

    LaPlaca, Peter J.; Lindgreen, Adam; Vanhamme, Joelle

    2018-01-01

    Most of the premier academic journals in all fields routinely have rejection rates of 80%, 95%, or higher. All journals prefer articles that make significant contributions to the field. Revising a manuscript and responding properly to the comments of reviewers and editors often is challenging....... This article discusses how to revise effectively a manuscript according to the (minor or major) comments of reviewers and editors for premier academic journals. We provide a series of tips for helping the authors in their endeavor, making the process less arduous and improving the possibility of a positive...

  9. Do Bone Graft and Cracking of the Sclerotic Cavity Improve Fixation of Titanium and Hydroxyapatite-coated Revision Implants in an Animal Model?

    Science.gov (United States)

    Elmengaard, Brian; Baas, Joergen; Jakobsen, Thomas; Kold, Soren; Jensen, Thomas B; Bechtold, Joan E; Soballe, Kjeld

    2017-02-01

    We previously introduced a manual surgical technique that makes small perforations (cracks) through the sclerotic bone shell that typically forms during the process of aseptic loosening ("crack" revision technique). Perforating just the shell (without violating the proximal cortex) can maintain overall bone continuity while allowing marrow and vascular elements to access the implant surface. Because many revisions require bone graft to fill defects, we wanted to determine if bone graft could further increase implant fixation beyond what we have experimentally shown with the crack technique alone. Also, because both titanium (Ti6Al4V) and hydroxyapatite (HA) implant surfaces are used in revisions, we also wanted to determine their relative effectiveness in this model. We hypothesized that both (1) allografted plasma-sprayed Ti6Al4V; and (2) allografted plasma-sprayed HA-coated implants inserted with a crack revision technique have better fixation compared with a noncrack revision technique in each case. Under approval from our Institutional Animal Care and Use Committee, a female canine animal model was used to evaluate the uncemented revision technique (crack, noncrack) using paired contralateral implants while implant surface (Ti6Al4V, HA) was qualitatively compared between the two (unpaired) series. All groups received bone allograft tightly packed around the implant. This revision model includes a cylindrical implant pistoning 500 μm in a 0.75-mm gap, with polyethylene particles, for 8 weeks. This engenders a bone and tissue response representative of the metaphyseal cancellous region of an aseptically loosened component. At 8 weeks, the original implants were revised and followed for an additional 4 weeks. Mechanical fixation was assessed by load, stiffness, and energy to failure when loaded in axial pushout. Histomorphometry was used to determine the amount and location of bone and fibrous tissue in the grafted gap. The grafted crack revision improved

  10. Industrial technique

    International Nuclear Information System (INIS)

    Jabsen, F.S.

    1975-01-01

    An illustrative embodiment of the invention discloses a technique for disassembling a nuclear reactor fuel element without destroying the individual fuel pins and other structural components from which the element is assembled. A traveling bridge and trolley that span a water-filled spent fuel storage pool support a strongback. The strongback is under water and provides a working surface on which the spent fuel element is placed for inspection and for the manipulation that is associated with disassembly and assembly. To remove, in a non-destructive manner, the grids that hold the fuel pins in the proper relative positions within the element, bars are inserted through apertures in the grids with the aid of special tools. These bars are rotated to flex the adjacent grid walls and, in this way relax the physical engagement between protruding portions of the grid walls and the associated fuel pins. With the grid structure so flexed to relax the physical grip on the individual fuel pins, these pins can be withdrawn for inspection or replacement as necessary without imposing a need to destroy fuel element components. (U.S.)

  11. Microbiological diagnosis in revision of infected knee arthroplasties in Denmark

    DEFF Research Database (Denmark)

    Lindberg-Larsen, Martin; Pitter, Frederik Taylor; Voldstedlund, Marianne

    2017-01-01

    . METHODS: One hundred and two partial revisions (open debridement and exchange of tibial insert) and 213 two-stage procedures performed due to infection in 275 patients from 1 July 2011 to 30 June 2013 were included and analysed by linkage to data from a nationwide registry on microbiological test results....... RESULTS: 78 (24.8%) revisions were culture negative, 192 (60.9%) showed monomicrobial growth and 43 (14.3%) polymicrobial growth. Staphylococcus aureus was the most frequent isolate in mono-culture in 70 (22.2%) revisions and in polymicrobial culture in 15 revisions with a total frequency of 27.0%. Only...... one case (1.4%) of methicillin-resistance was registered. Coagulase-negative staphylococci (CoNS) were frequent, sole pathogen in 65 revisions and in polymicrobial cultures in 28 revisions with a total frequency of 29.5%. A pre-operative knee aspiration was performed in 50% and preoperative blood...

  12. Nuclear safety guide. TID-7016, Revision 2

    International Nuclear Information System (INIS)

    Thomas, J.T.

    1978-01-01

    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. The present revision 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 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 formerGuides 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

  13. Calculation code revised MIXSET for Purex process

    International Nuclear Information System (INIS)

    Gonda, Kozo; Oka, Koichiro; Fukuda, Shoji.

    1979-02-01

    Revised MIXSET is a FORTRAN IV calculation code developed to simulate steady and transient behaviors of the Purex extraction process and calculate the optimum operating condition of the process. Revised MIXSET includes all the functions of MIXSET code as shown below. a) Maximum chemical system of eight components can be handled with or without mutual dependence of the distribution of components. b) The flowrate and concentration of feed can be renewed successively at any state, transient or steady, for searching optimum operating conditions. c) Optimum inputs of feed concentrations and flowrates can be calculated to satisfy both of specification and recovery rate of a product. d) Radioactive decay reactions can be handled on each component. Besides these functions, the following chemical reactions concerned in Purex process are newly-included in Revised MIXSET code and the quantitative changes of components such as H + , U(IV), U(VI), Pu(III), Pu(IV), NH 2 OH, N 2 H 4 can be simulated. 1st Gr. (i) reduction of Pu(IV); U 4+ + 2Pu 4+ + 2H 2 O → UO 2 2+ + 2Pu 3+ + 4H + . (ii) oxidation of Pu(III); 2Pu 3+ + 3H + + NO 3 - → 2Pu 4+ + HNO 2 + H 2 O. (iii) oxidation of U(IV); U 4+ + NO 3 - + H 2 O → UO 2 2+ + H + + HNO 2 2U 4+ + O 2 + 2H 2 O → 2UO 2 2+ + 4H + . (iv) decomposition of HNO 2 ; HNO 2 + N 2 H 5 + → HN 3 + 2H 2 O + H + . (author)

  14. Nuclear safety guide. TID-7016, Revision 2

    Energy Technology Data Exchange (ETDEWEB)

    Thomas, J T [ed.

    1978-05-01

    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. The present revision 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 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 formerGuides 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.

  15. Closed cooling water chemistry guidelines revision

    International Nuclear Information System (INIS)

    McElrath, Joel; Breckenridge, Richard

    2014-01-01

    This second revision of the Closed Cooling Water Chemistry Guideline addresses the use of chemicals and monitoring methods to mitigate corrosion, fouling, and microbiological growth in the closed cooling-water (CCW) systems of nuclear and fossil-fueled power plants. This revision has been endorsed by the utility chemistry community and represents another step in developing a more proactive chemistry program to limit or control closed cooling system degradation with increased consideration of corporate resources and plant-specific design and operating concerns. These guidelines were developed using laboratory data, operating experience, and input from organizations and utilities within and outside of the United States of America. It is the intent of the Revision Committee that these guidelines are applicable to all nuclear and fossil-fueled generating stations around the world. A committee of industry experts—including utility specialists, Institute of Nuclear Power Operations representatives, water-treatment service-company representatives, consultants, a primary contractor, and EPRI staff—collaborated in reviewing available data on closed cooling-water system corrosion and microbiological issues. Recognizing that each plant owner has a unique set of design, operating, and corporate concerns, the Guidelines Committee developed a methodology for plant-specific optimization. The guideline provides the technical basis for a reasonable but conservative set of chemical treatment and monitoring programs. The use of operating ranges for the various treatment chemicals discussed in this guideline will allow a power plant to limit corrosion, fouling, and microbiological growth in CCW systems to acceptable levels. The guideline now includes closed cooling chemistry regimes proven successful in use in the international community. The guideline provides chemistry constraints for the use of phosphates control, as well as pure water with pH control. (author)

  16. Agencies revise standards for radiation protection

    International Nuclear Information System (INIS)

    Anon.

    1984-01-01

    The article deals with a guideline, compiled by the IAEA, for radiation protection. The guidelines aim at the control of individual risk through specified limits, optimisation of protection and the justification of all practices involving exposure to radiation. The guideline is a revision of the 1967 publication of the IAEA, Basic safety standards for radiation protection. According to the document the main resposibility for radiation protection lies with the employer. The workers should be responsible for observing protection procedures and regulations for their own as well as others' safety

  17. Impending revision of the euratom treaty

    International Nuclear Information System (INIS)

    Fahl, G.

    1979-01-01

    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.) [de

  18. Financial Wealth Distribution in Revised Financial Accounts

    Directory of Open Access Journals (Sweden)

    Václav Rybáček

    2012-09-01

    Full Text Available Financial statistics undergo dynamic evolution as apparent consequence of their rising importance. Structureof assets, source of fi nancing, price changes or net fi nancial position, all these indicators can detect oncomingfi nancial instability. Financial statistics as a logical extension of the national accounts provide such information.Th e aim of the following text is to present fi nancial statistics, relation between particular accounts, the impact of extraordinary revision carried out in 2011, and also to analyse current wealth distribution as described by fi nancial statistics.

  19. 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,

  20. Radiation protection planning and management during revision

    International Nuclear Information System (INIS)

    Gewehr, K.

    1984-01-01

    During the operation of nuclear power plants it is normally possible for the in-house personnel to take care of arising radiation protection problems. However, in the comparatively short revision phases, the duties of radiation protection become much more varied. Additional trained radiation protection crews are needed at short notice. This is also the time in which the largest contributions are made to the annual cumulated doses of the personnel. Recent guidelines and rules trying to reduce the radiation exposure of personnel concentrate on this very point. The article outlines the radiation protection activities performed by the service personnel in the course of a steam generator check. (orig.) [de

  1. The revision of the master's curiculm at Osaka Kyoiku University

    OpenAIRE

    赤松, 喜久; 伊藤, 敏雄

    2007-01-01

    The background covering the revision of the master's curriculum and a point concerning this revision in a teacher-training program at Osaka Kyoiku University are explained in this paper. Furthermore, future problems are organized and evaluated. The paper will help us to consider the revision of the curriculum expected as part of the master's course in a teacher's program. The number of required subjects is minimal so that a student may take more optional subjects to meet various needs. New su...

  2. 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...... in order to deal with inconsistencies and, particularly, the issue of inconsistencies, and belief revision is examined in relation to the GOAL agent programming language....

  3. Explanatory Coherence and Belief Revision in Naive Physics

    Science.gov (United States)

    1988-07-01

    continental drift (Thagard & Nowak, 1988), and debates about why the dinosaurs became extinct . Application of ECHO to the belief revisions in Pat and Hal...rewono of nocuamy Idid 4onoly by bodck number) Students of reasoning have long tried to understand how people revise systems of beliefs. We maintain...Princeton University Students of reasoning have long tried to understand how people revise systems of beliefs (see Wertheimer, 1945, for example). We will

  4. 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…

  5. RCBI-II: The Second Revision of the Revised Cyber Bullying Inventory

    Science.gov (United States)

    Topcu, Çigdem; Erdur-Baker, Özgür

    2018-01-01

    The aim of this study is to update the Turkish version of the Revised Cyber Bullying Inventory (RCBI) and eliminate specific technology names. Validity and reliability tests were carried out with 1,803 high school students. The updated version of the RCBI yields valid and reliable scores measuring cyberbullying and victimization.

  6. Revised description of the fine structure of in situ "zooxanthellae" genus Symbiodinium.

    Science.gov (United States)

    Wakefield, T S; Farmer, M A; Kempf, S C

    2000-08-01

    The fine structure of the symbiotic dinoflagellate genus Symbiodinium has been well described. All of the published descriptions are based on tissue that was fixed in standard aldehyde and osmium fixatives and dehydrated in an ethanol series before embedding. When the technique of freeze-substitution was used to fix tissue from Cassiopeia xamachana, Aiptasia pallida, and Phyllactis flosculifera and prepare it for embedding, thecal vesicles were revealed within the in situ symbionts of all three species. Although these structures have been identified in cultured symbionts, they have never been described in the in situ symbionts. A review of the literature has revealed several instances where thecal vesicles were either overlooked or identified incorrectly. Thus the formal description of the genus Symbiodinium, which describes the in situ symbionts, contains information that is based on artifact and should be revised. A revision of the genus is suggested, and the true nature of these structures and their significance in the symbiotic association are discussed.

  7. A Revised Piecewise Linear Recursive Convolution FDTD Method for Magnetized Plasmas

    International Nuclear Information System (INIS)

    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

  8. Clinical and Economic Burden of Revision Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Mohit Bhandari

    2012-01-01

    Full Text Available Surgery is indicated for symptomatic knee osteoarthritis (OA when conservative measures are unsuccessful. High tibial osteotomy (HTO, unicompartmental knee arthroplasty (UKA, and total knee arthroplasty (TKA are surgical options intended to relieve knee OA pain and dysfunction. The choice of surgical intervention is dependent on several factors such as disease location, patient age, comorbidities, and activity levels. Regardless of surgical treatment, complications such as infection, loosening or lysis, periprosthetic fracture, and postoperative pain are known risks and are indications for revision surgery. The clinical and economic implications for revision surgery are underappreciated. Over 55,000 revision surgeries were performed in 2010 in the US, with 48% of these revisions in patients under 65 years. Total costs associated with each revision TKA surgery have been estimated to be in excess of $49,000. The current annual economic burden of revision knee OA surgery is $2.7 billion for hospital charges alone. By 2030, assuming a 5-fold increase in the number of revision procedures, this economic burden will exceed $13 billion annually. It is appealing to envision a therapy that could delay or obviate the need for arthroplasty. From an actuarial standpoint, this would have the theoretical downstream effect of substantially reducing the number of revision procedures. Although no known therapies currently meet these criteria, such a breakthrough would have a tremendous impact in lessening the clinical and economic burden of knee OA revision surgery.

  9. Techniques de combustion Combustin Techniques

    Directory of Open Access Journals (Sweden)

    Perthuis E.

    2006-11-01

    Full Text Available L'efficacité d'un processus de chauffage par flamme est étroitement liée à la maîtrise des techniques de combustion. Le brûleur, organe essentiel de l'équipement de chauffe, doit d'une part assurer une combustion complète pour utiliser au mieux l'énergie potentielle du combustible et, d'autre part, provoquer dans le foyer les conditions aérodynamiques les plus propices oux transferts de chaleur. En s'appuyant sur les études expérimentales effectuées à la Fondation de Recherches Internationales sur les Flammes (FRIF, au Groupe d'Étude des Flammes de Gaz Naturel (GEFGN et à l'Institut Français du Pétrole (IFP et sur des réalisations industrielles, on présente les propriétés essentielles des flammes de diffusion aux combustibles liquides et gazeux obtenues avec ou sans mise en rotation des fluides, et leurs répercussions sur les transferts thermiques. La recherche des températures de combustion élevées conduit à envisager la marche à excès d'air réduit, le réchauffage de l'air ou son enrichissement à l'oxygène. Par quelques exemples, on évoque l'influence de ces paramètres d'exploitation sur l'économie possible en combustible. The efficiency of a flame heating process is closely linked ta the mastery of, combustion techniques. The burner, an essential element in any heating equipment, must provide complete combustion sa as to make optimum use of the potential energy in the fuel while, at the same time, creating the most suitable conditions for heat transfers in the combustion chamber. On the basis of experimental research performed by FRIF, GEFGN and IFP and of industrial achievements, this article describesthe essential properties of diffusion flames fed by liquid and gaseous fuels and produced with or without fluid swirling, and the effects of such flames on heat transfers. The search for high combustion temperatures means that consideration must be given to operating with reduced excess air, heating the air or

  10. Removal of well-fixed components in femoral revision arthroplasty with controlled segmentation of the proximal femur.

    Science.gov (United States)

    Megas, Panagiotis; Georgiou, Christos S; Panagopoulos, Andreas; Kouzelis, Antonis

    2014-12-31

    The transfemoral and the extended trochanteric osteotomies are the most common osteotomies used in femoral revision, both when proximal or diaphyseal fixation of the new component has been decided. We present an alternative approach to the trochanteric osteotomies, most frequently used with distally fixated stems, to overcome their shortcomings of osteotomy migration and nonunion, but, most of all, the uncontrollable fragmentation of the femur. The procedure includes a complete circular femoral osteotomy just below the stem tip to prevent distal fracture propagation and a subsequent preplanned segmentation of the proximal femur for better exposure and fast removal of the old prosthesis. The bone fragments are reattached with cerclage wires to the revision prosthesis, which is safely anchored distally. A modified posterolateral approach is used, as the preservation of the continuity of the abductors, the greater trochanter, and the vastus lateralis is a prerequisite. Between 2006 and 2012, 47 stems (33 women, 14 men, mean age 68 years, range 39-88 years) were revised using this technique. They were 12 (26%) stable and 35 (74%) loose prostheses and were all revised to tapered, fluted, grit-blasted stems. No fracture of the trochanters or the distal femur occurred intraoperatively. Mean follow-up was 28 months (range 6-70 months). No case of trochanteric migration or nonunion of the osteotomies was recorded. Restoration of the preexisting bone defects occurred in 83% of the patients. Three patients required repeat revision due to dislocation and one due to a postoperative periprosthetic fracture. None of the failures was attributed to the procedure itself. This new osteotomy technique may seem aggressive at first, but, at least in our hands, has effectively increased the speed of the femoral revision, particularly for the most difficult well-fixed components, but not at the expense of safety.

  11. The impact of electrocautery method on post-operative bleeding complications after non-newborn circumcision and revision circumcision.

    Science.gov (United States)

    Harty, Niall J; Nelson, Caleb P; Cendron, Marc; Turner, Shaunna; Borer, Joseph G

    2013-10-01

    We evaluated post-operative bleeding complications in non-newborns following use of monopolar versus bipolar electrocautery for circumcision or revision circumcision. We retrospectively reviewed sequentially performed cases of circumcision and revision circumcision performed by nine pediatric urologists at our institution from 2005 to 2010. In order to incorporate both the monopolar and bipolar electrocautery experience for a single surgeon employing bipolar technique, sequential cases from 2002 to 2010 were reviewed. Variables assessed included age, procedure, method of electrocautery, skin approximation and dressing, and bleeding complications. 1810 patients that underwent either circumcision or revision circumcision were reviewed. Complete data was available for 1617 patients. Age at operation was a mean 3.7 ± 4.9 yrs and median 1.5 yrs. Return for bleeding complication for all surgeons, was 2/336 (0.6%) for bipolar and 28/1281 (2.2%) for monopolar (p = 0.0545). For the single surgeon using bipolar technique, returns were 2/336 (0.6%) for bipolar and 5/309 (1.6%) for monopolar (p = 0.2133). Returns per procedure type were 1/200 (0.5%) bipolar and 24/844 (2.8%) monopolar for primary circumcision (p = 0.0513), and 1/136 (0.7%) bipolar and 4/437 (0.9%) monopolar (p = 0.84) for revision. Four of 1617 (0.2%) patients returned to the operating room [4/1281 (0.3%) monopolar (p = 0.31)]. There was no difference in return to the operating room for circumcision versus revision. Return for bleeding complications after circumcision and revision circumcision occurred more frequently after monopolar electrocautery compared to bipolar. However, there was no significant difference between the two electrocautery methods. Either form of electrocautery appears to be effective for this common pediatric urologic procedure. Copyright © 2012 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  12. Revision of failed shoulder hemiarthroplasty to reverse total arthroplasty: analysis of 157 revision implants.

    Science.gov (United States)

    Merolla, Giovanni; Wagner, Eric; Sperling, John W; Paladini, Paolo; Fabbri, Elisabetta; Porcellini, Giuseppe

    2018-01-01

    There remains a paucity of studies examining the conversion of failed hemiarthroplasty (HA) to reverse total shoulder arthroplasty (RTSA). Therefore, the purpose of this study was to examine a large series of revision HA to RTSA. A population of 157 patients who underwent conversion of a failed HA to a revision RTSA from 2006 through 2014 were included. The mean follow-up was 49 months (range, 24-121 months). The indications for revision surgery included instability with rotator cuff insufficiency (n = 127) and glenoid wear (n = 30); instability and glenoid wear were associated in 38 cases. Eight patients with infection underwent 2-stage reimplantation. Patients experienced significant improvements in their preoperative to postoperative pain and shoulder range of motion (P surgeries, secondary to glenoid component loosening (n = 3), instability (n = 3), humeral component disassembly (n = 2), humeral stem loosening (n = 1), and infection (n = 2). Implant survivorship was 95.5% at 2 years and 93.3% at 5 years. There were 4 reoperations including axillary nerve neurolysis (n = 2), heterotopic ossification removal (n = 1), and hardware removal for rupture of the metal cerclage for an acromial fracture (n = 1). At final follow-up, there were 5 "at-risk" glenoid components. Patients experience satisfactory pain relief and recovery of reasonable shoulder function after revision RTSA from a failed HA. There was a relatively low revision rate, with glenoid loosening and instability being the most common causes. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  13. An internally validated prognostic model for success in revision stapes surgery for otosclerosis.

    Science.gov (United States)

    Wegner, Inge; Vincent, Robert; Derks, Laura S M; Rauh, Simone P; Heymans, Martijn W; Stegeman, Inge; Grolman, Wilko

    2018-03-09

    To develop a prediction model that can accurately predict the chance of success following revision stapes surgery in patients with recurrent or persistent otosclerosis at 2- to 6-months follow-up and to validate this model internally. A retrospective cohort study of prospectively gathered data in a tertiary referral center. The associations of 11 prognostic factors with treatment success were tested in 705 cases using multivariable logistic regression analysis with backward selection. Success was defined as a mean air-bone gap closure to 10 dB or less. The most relevant predictors were used to derive a clinical prediction rule to determine the probability of success. Internal validation by means of bootstrapping was performed. Model performance indices, including the Hosmer-Lemeshow test, the area under the receiver operating characteristics curve (AUC), and the explained variance were calculated. Success was achieved in 57.7% of cases at 2- to 6-months follow-up. Certain previous surgical techniques, primary causes of failure leading up to revision stapes surgery, and positions of the prosthesis placed during revision surgery were associated with higher success percentages. The clinical prediction rule performed moderately well in the original dataset (Hosmer-Lemeshow P = .78; AUC = 0.73; explained variance = 22%), which slightly decreased following internal validation by means of bootstrapping (AUC = 0.69; explained variance = 13%). Our study established the importance of previous surgical technique, primary cause of failure, and type of the prosthesis placed during the revision surgery in predicting the probability of success following stapes surgery at 2- to 6-months follow-up. 2b. Laryngoscope, 2018. © 2018 The American Laryngological, Rhinological and Otological Society, Inc.

  14. Revised Distances to 21 Supernova Remnants

    Science.gov (United States)

    Ranasinghe, S.; Leahy, D. A.

    2018-05-01

    We carry out a comprehensive study of H I 21 cm line observations and 13CO line observations of 21 supernova remnants (SNRs). The aim of the study is to search for H I absorption features to obtain kinematic distances in a consistent manner. The 21 SNRs are in the region of sky covered by the Very Large Array Galactic Plane Survey (H I 21 cm observations) and Galactic Ring Survey (13CO line observations). We obtain revised distances for 10 SNRs based on new evidence in the H I and 13CO observations. We revise distances for the other 11 SNRs based on an updated rotation curve and new error analysis. The mean change in distance for the 21 SNRs is ≃25%, i.e., a change of 1.5 kpc compared to a mean distance for the sample of 6.4 kpc. This has a significant impact on interpretation of the physical state of these SNRs. For example, using a Sedov model, age and explosion energy scale as the square of distance, and inferred ISM density scales as distance.

  15. 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. © The Author(s) 2015.

  16. 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.

  17. REVISED STREAM CODE AND WASP5 BENCHMARK

    International Nuclear Information System (INIS)

    Chen, K

    2005-01-01

    STREAM is an emergency response code that predicts downstream pollutant concentrations for releases from the SRS area to the Savannah River. The STREAM code uses an algebraic equation to approximate the solution of the one dimensional advective transport differential equation. This approach generates spurious oscillations in the concentration profile when modeling long duration releases. To improve the capability of the STREAM code to model long-term releases, its calculation module was replaced by the WASP5 code. WASP5 is a US EPA water quality analysis program that simulates one-dimensional pollutant transport through surface water. Test cases were performed to compare the revised version of STREAM with the existing version. For continuous releases, results predicted by the revised STREAM code agree with physical expectations. The WASP5 code was benchmarked with the US EPA 1990 and 1991 dye tracer studies, in which the transport of the dye was measured from its release at the New Savannah Bluff Lock and Dam downstream to Savannah. The peak concentrations predicted by the WASP5 agreed with the measurements within ±20.0%. The transport times of the dye concentration peak predicted by the WASP5 agreed with the measurements within ±3.6%. These benchmarking results demonstrate that STREAM should be capable of accurately modeling releases from SRS outfalls

  18. Revised energy levels of singly ionized lanthanum

    Science.gov (United States)

    Güzelçimen, Feyza; Tonka, Mehdi; Uddin, Zaheer; Bhatti, Naveed Anjum; Windholz, Laurentius; Kröger, Sophie; Başar, Gönül

    2018-05-01

    Based on the experimental wavenumbers of 344 spectral lines from calibrated Fourier transform (FT) spectra as well as wavenumbers of 81 lines from the wavelength tables from literature, the energy of 115 fine structure levels of singly ionized lanthanum has been revised by weighted global fits. The classifications of the lines are provided by numerous previous investigations of lanthanum by different spectroscopic methods and authors. For the high accurate determination of the center of gravity wavenumbers from the experimental spectrum, the hyperfine constants of the involved levels have been taken into account, if possible. For the 94 levels with known hyperfine constants the accuracy of energy values is better than 0.01 cm-1. For 34 levels the magnetic dipole hyperfine constants A have been determined from FT spectra as part of this work. For four of these 34 levels even electric quadrupole hyperfine constants B could be estimated. For levels, which have experimentally unknown hyperfine constants and which are connected only by lines not found in the FT spectra but taken from literature, the uncertainties of energy values are about a factor of 10 higher. A list of all revised level energies together with a compilation of hyperfine structure data is given as well as a list of all lines used.

  19. [Revision of the drinking water regulations].

    Science.gov (United States)

    Hauswirth, S

    2011-11-01

    The revision the Drinking Water Regulations will come into effect on 01.11.2011. Surveillance authorities and owners of drinking water supply systems had hoped for simplifications and reductions because of the new arrangements. According to the official statement for the revision the legislature intended to create more clarity, consider new scientific findings, to change regulations that have not been proved to close regulatory gaps, to deregulate and to increase the high quality standards. A detailed examination of the regulation text, however, raises doubts. The new classification of water supply systems requires different modalities of registration, water analyses and official observation, which will complicate the work of the authorities. In particular, the implementation of requirements of registration and examination for the owners of commercial and publicly-operated large hot-water systems in accordance with DVGW Worksheet W 551 requires more effort. According to the estimated 30 000 cases of legionellosis in Germany the need for a check of such systems for Legionella, however, is not called into question. Furthermore, the development of sampling plans and the monitoring of mobile water supply systems requires more work for the health authorities. © Georg Thieme Verlag KG Stuttgart · New York.

  20. Maximum surgical blood ordering schedules for revision lower limb arthroplasty.

    Science.gov (United States)

    Mahadevan, Devendra; Challand, Christopher; Clarke, Andrew; Keenan, Jonathan

    2011-05-01

    Effective utilisation of blood products is fundamental. The introduction of maximum surgical blood ordering schedules (MSBOS) for operations has been shown to improve transfusion services. A retrospective analysis was undertaken to establish an evidence-based MSBOS for revision total hip replacement (THR) and total knee revision (TKR). The impact of this schedule on blood conservation was analysed. A retrospective analysis was undertaken on 397 patients who underwent revision THR and TKR over a 4-year period. The cross-match-to-transfusion ratio (CTR) and transfusion index (TI) were calculated. A MSBOS protocol was created based on the TIs and its' impact on transfusion services was assessed prospectively on 125 patients by comparing CTRs. In revision THR, TI was 1.19 for elective cases, 1.55 for emergency cases and 2.35 for infected cases. There was no difference in TI for revisions of cemented and uncemented components. Single component THR revision required less transfusion. In revision TKR, TI was 0.31 for elective cases, 2.0 for emergency cases and 1.23 for cases with infection. The introduction of the MSBOS protocol had resulted in a considerable improvement in blood ordering. Reductions in the CTR were seen for all types of revision surgery, but most evident in elective revision THR (3.24-2.18) and elective revision TKR (7.95-1.2). Analysis confirmed that excessive cross-matching occurred for revision lower limb arthroplasty. The introduction of our MSBOS protocol promoted blood conservation and compliance with established national guidelines.

  1. 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.

  2. Is Peer Review Training Effective in Iranian EFL Students' Revision?

    Science.gov (United States)

    Esmaeeli, Hadiseh; Abasi, Maasumeh; Soori, Afshin

    2014-01-01

    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…

  3. 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)

  4. Revised SWAT. The integrated burnup calculation code system

    International Nuclear Information System (INIS)

    Suyama, Kenya; Mochizuki, Hiroki; Kiyosumi, Takehide

    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)

  5. Do Writers Really Revise? Encouraging Unnatural Acts in Your Classroom.

    Science.gov (United States)

    Balajthy, Ernest

    Unless students have an appropriate attitude toward revision--the keystone of the writing process--teachers who institute writing process approaches face frustration and failure. Implementing the following suggestions may help increase revision in the classroom. First, while the mature writing process is not strictly linear, students developing…

  6. Modeling data revisions : Measurement error and dynamics of "true" values

    NARCIS (Netherlands)

    Jacobs, Jan P. A. M.; van Norden, Simon

    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

  7. Validity and Reliability of Revised Inventory of Learning Processes.

    Science.gov (United States)

    Gadzella, B. M.; And Others

    The Inventory of Learning Processes (ILP) was developed by Schmeck, Ribich, and Ramanaiah in 1977 as a self-report inventory to assess learning style through a behavioral-oriented approach. The ILP was revised by Schmeck in 1983. The Revised ILP contains six scales: (1) Deep Processing; (2) Elaborative Processing; (3) Shallow Processing; (4)…

  8. Text Revision in Deaf and Hearing Bilingual Students

    Science.gov (United States)

    Teruggi, Lilia A.; Gutiérrez-Cáceres, Rafaela

    2016-01-01

    In this study we explored the revision process and strategies implemented by deaf and hearing students who attend the same bilingual school context (LIS and Italian). For that we analysed and compared the types and quality of revisions made by deaf and hearing participants to their first draft of a narrative text ("Frog, Where Are You?")…

  9. 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…

  10. 75 FR 17253 - Revisions to the General Conformity Regulations

    Science.gov (United States)

    2010-04-05

    ... Part III Environmental Protection Agency 40 CFR Parts 51 and 93 Revisions to the General... under the minor source New Source Review (NSR) programs similar to the EPA's existing General Conformity... EPA is making two minor revisions to the definition. First, EPA is correcting the citation for the SIP...

  11. 14 CFR 152.323 - Budget revision: Airport development.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Budget revision: Airport development. 152... TRANSPORTATION (CONTINUED) AIRPORTS AIRPORT AID PROGRAM Accounting and Reporting Requirements § 152.323 Budget... change in the budget estimates, the sponsor shall submit a request for budget revision on a form...

  12. 45 CFR 63.19 - Budget revisions and minor deviations.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Budget revisions and minor deviations. 63.19 Section 63.19 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION GRANT PROGRAMS... Budget revisions and minor deviations. Pursuant to § 74.102(d) of this title, paragraphs (b)(3) and (b)(4...

  13. Carlsbad Area Office strategic plan, March 1995. Revision 1

    International Nuclear Information System (INIS)

    1995-03-01

    This edition of the Carlsbad Area Office Strategic Plan captures the US Department of Energy's (DOE's) new focus, and supersedes the edition issued previously (DOE, 1993a). This revision reflects: a revised strategy designed to demonstrate compliance with environmental regulations earlier than the previous course of action; and a focus on establishment of standardized transuranic waste characterization and acceptance criteria for disposal facilities

  14. 76 FR 1440 - Notice of Revised Child Outcomes Framework

    Science.gov (United States)

    2011-01-10

    ... Outcomes Framework, renamed The Head Start Child Development and Learning Framework: Promoting Positive Outcomes in Early Childhood Programs Serving Children 3-5 Years Old. The Framework was revised to give more... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Notice of Revised...

  15. Designing Automated Guidance to Promote Productive Revision of Science Explanations

    Science.gov (United States)

    Tansomboon, Charissa; Gerard, Libby F.; Vitale, Jonathan M.; Linn, Marcia C.

    2017-01-01

    Supporting students to revise their written explanations in science can help students to integrate disparate ideas and develop a coherent, generative account of complex scientific topics. Using natural language processing to analyze student written work, we compare forms of automated guidance designed to motivate productive revision and help…

  16. REVISION PERMISSIABILITY IN CIVIL PROCEDURE IN REPUBLIC OF MACEDONIA

    Directory of Open Access Journals (Sweden)

    Marina Gligorova

    2015-04-01

    Full Text Available The revision as an extraordinary legal remedy is one more legal instrument for litigant in the effort to achieve protection of the rights or to defend against ungrounded claims of the other party. Litigants may declare revision of the litigation process due to substantive violations of the provisions of Civil Procedure and incorrect application of substantive law. Declaring revision because of a substantive violation of the provisions of Civil Procedure is limited. The purpose of this research paper is to investigate the most common reasons for filing revision of the litigation process in the period from June 2011 to June in 2012. The research includes what kind of reasons are often repeated, and the volume, or the number of reviews submitted to the Supreme Court of the Republic of Macedonia. As general hypothesis is that most of the adopted revisions are due to substantial violations of the provisions of civil procedure. Two-thirds of the stated revisions in front of the Supreme Court of Republic of Macedonia were rejected as unfounded and only one third of the submitted revisions from June 2011 to June 2012 were grounded. Since accepted revisions 59% due to incorrect application of substantive law, and 41% due to substantial violations of the provisions of Civil Procedure.

  17. 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…

  18. A revision of the Pliocene and Quaternary Lutrinae from Europe

    NARCIS (Netherlands)

    Willemsen, G.F.

    1992-01-01

    In this paper, a revision of the Pliocene and Quaternary Lutrinae from Europe is presented. Such a revision, including fossil material, has not been published since the work of Pohle (1919). Three tribes within the Lutrinae are recognized: the Lutrini, the Aonyxini and the Enhydrini. The latter

  19. 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.

  20. 77 FR 73454 - Revision of Information Collection; Comment Request

    Science.gov (United States)

    2012-12-10

    ... proposed revision of its Senior Corps Grant Application (424-NSSC) (OMB Control Number 3045-0035). CNCS... questions to clarify new concepts; Simplify language and wording of questions; Revise questions to better... CNCS mailroom at Room 8100 at the mail address given in paragraph (1) above, between 9:00 a.m. and 4:00...

  1. 75 FR 81126 - Revisions to Lead Ambient Air Monitoring Requirements

    Science.gov (United States)

    2010-12-27

    ... tons per year of lead is necessary to provide sufficient information about airborne lead levels near... Revisions to Lead Ambient Air Monitoring Requirements AGENCY: Environmental Protection Agency (EPA). ACTION...) that revised the primary and secondary National Ambient Air Quality Standards (NAAQS) for lead and...

  2. Yakima fisheries project. Revised draft environmental impact statement

    International Nuclear Information System (INIS)

    1995-05-01

    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

  3. Transuranic waste characterization sampling and analysis methods manual. Revision 1

    International Nuclear Information System (INIS)

    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

  4. [The Use of Jumbo Cups in Revision Total Hip Arthroplasty].

    Science.gov (United States)

    von Roth, Philipp; Wassilew, Georgi I

    2017-10-01

    Extra-large uncemented jumbo cups are among the most common methods of acetabular revision. Jumbo cups do not contribute to bone stock restoration, and in the case of a subsequent revision, an even larger bone defect is to be expected. Thus, understanding long-term survival is essential. The present article discusses the literature relevant to this topic and addresses technical and implant-specific characteristics of jumbo cups. In summary, jumbo cups show an acceptable long-term survival rate, with aseptic loosening as the most common reason for revision and dislocation being the most common complication. Through the development of alternative revision systems, jumbo cups have lost their importance in today's practice. However, they can serve as a benchmark for studies of newer technologies in revision total hip arthroplasty. Georg Thieme Verlag KG Stuttgart · New York.

  5. Risk factors for total hip arthroplasty aseptic revision.

    Science.gov (United States)

    Khatod, Monti; Cafri, Guy; Namba, Robert S; Inacio, Maria C S; Paxton, Elizabeth W

    2014-07-01

    The purpose of this study was to evaluate patient, operative, implant, surgeon, and hospital factors associated with aseptic revision after primary THA in patients registered in a large US Total Joint Replacement Registry. A total of 35,960 THAs registered from 4/2001-12/2010 were evaluated. The 8-year survival rate was 96.7% (95% CI 96.4%-97.0%). Females had a higher risk of aseptic revision than males. Hispanic and Asian patients had a lower risk of revision than white patients. Ceramic-on-ceramic, ceramic-on-conventional polyethylene, and metal-on-conventional polyethylene bearing surfaces had a higher risk of revision than metal-on-highly cross-linked polyethylene. Body mass index, health status, diabetes, diagnosis, fixation, approach, bilateral procedures, head size, surgeon fellowship training, surgeon and hospital volume were not revision risk factors. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Waste Management Program management plan. Revision 1

    International Nuclear Information System (INIS)

    1997-02-01

    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

  7. 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.

  8. Local public document room directory. Revision 7

    International Nuclear Information System (INIS)

    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. Digital dream analysis: a revised method.

    Science.gov (United States)

    Bulkeley, Kelly

    2014-10-01

    This article demonstrates the use of a digital word search method designed to provide greater accuracy, objectivity, and speed in the study of dreams. A revised template of 40 word search categories, built into the website of the Sleep and Dream Database (SDDb), is applied to four "classic" sets of dreams: The male and female "Norm" dreams of Hall and Van de Castle (1966), the "Engine Man" dreams discussed by Hobson (1988), and the "Barb Sanders Baseline 250" dreams examined by Domhoff (2003). A word search analysis of these original dream reports shows that a digital approach can accurately identify many of the same distinctive patterns of content found by previous investigators using much more laborious and time-consuming methods. The results of this study emphasize the compatibility of word search technologies with traditional approaches to dream content analysis. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. A revision of the generalized uncertainty principle

    International Nuclear Information System (INIS)

    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 2 Pl . 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. Difficult acetabular revision. A preliminary report.

    Science.gov (United States)

    Newport, M L; Stuchin, S A; Frankel, V H; Zuckerman, J

    1986-01-01

    Thirteen patients (14 hips) underwent revision from conventional cemented total hip arthroplasty to uncemented acetabular threaded screw-in components and cementless femoral press-fit stems by means of the Autophor, Biofit, and Ti-Thread designs. The patients suffered from all forms of primary hip disease except rheumatoid arthritis; their average age was 34 years. The average preoperative Harris hip score was 39.4; the average postoperative score was 71.2 at six months, 90.6 at one year, and 91.6 at two years. Complications included two femoral shaft fractures, one femoral nerve palsy, and one dislocation. No signs have been observed of loosening or migration as of an early (6-24 months) follow-up.

  12. A Review of Criticality Accidents 2000 Revision

    International Nuclear Information System (INIS)

    McLaughlin, Thomas P.; Monahan, Shean P.; Pruvost, Norman L.; Frolov, Vladimir V.; Ryazanov, Boris G.; Sviridov, Victor I.

    2000-01-01

    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. Engineering drawing field verification program. Revision 3

    International Nuclear Information System (INIS)

    Ulk, P.F.

    1994-01-01

    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

  14. Waste Management Program management plan. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-02-01

    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.

  15. Revision of the Euratom Basic Standards

    International Nuclear Information System (INIS)

    Recht, P.; Eriskat, H.

    1976-01-01

    In the field of radiation protection, the Commission of the European Communities possesses certain powers which allowed it to develop a common health policy and to promote the harmonization of regulations on protecting the health of workers and the population from ionizing radiations. The Community directives constitute the legal instrument which enabled the policy to be achieved; the principles are based on the recommendations of the ICRP but are adapted to the requirements of the Euratom Treaty. The revision of the standards gave the experts and the Commission the opportunity to examine in detail a certain number of new concepts recently introduced in the international recommendations and to update and improve the standards laid down for the first time in 1959. (Auth) [fr

  16. 77 FR 47302 - South Dakota: Final Authorization of State Hazardous Waste Management Program Revisions

    Science.gov (United States)

    2012-08-08

    ...: Final Authorization of State Hazardous Waste Management Program Revisions AGENCY: Environmental... EPA proposed to authorize South Dakota's State Hazardous waste management Program revisions published... to the hazardous waste program revisions submitted by South Dakota. The Agency published a Proposed...

  17. 77 FR 15273 - Oklahoma: Final Authorization of State Hazardous Waste Management Program Revision

    Science.gov (United States)

    2012-03-15

    ...: Final Authorization of State Hazardous Waste Management Program Revision AGENCY: Environmental... hazardous waste management program. We authorized the following revisions: Oklahoma received authorization... its program revision in accordance with 40 CFR 271.21. The Oklahoma Hazardous Waste Management Act...

  18. Revised models of interstellar nitrogen isotopic fractionation

    Science.gov (United States)

    Wirström, E. S.; Charnley, S. B.

    2018-03-01

    Nitrogen-bearing molecules in cold molecular clouds exhibit a range of isotopic fractionation ratios and these molecules may be the precursors of 15N enrichments found in comets and meteorites. Chemical model calculations indicate that atom-molecular ion and ion-molecule reactions could account for most of the fractionation patterns observed. However, recent quantum-chemical computations demonstrate that several of the key processes are unlikely to occur in dense clouds. Related model calculations of dense cloud chemistry show that the revised 15N enrichments fail to match observed values. We have investigated the effects of these reaction rate modifications on the chemical model of Wirström et al. (2012) for which there are significant physical and chemical differences with respect to other models. We have included 15N fractionation of CN in neutral-neutral reactions and also updated rate coefficients for key reactions in the nitrogen chemistry. We find that the revised fractionation rates have the effect of suppressing 15N enrichment in ammonia at all times, while the depletion is even more pronounced, reaching 14N/15N ratios of >2000. Taking the updated nitrogen chemistry into account, no significant enrichment occurs in HCN or HNC, contrary to observational evidence in dark clouds and comets, although the 14N/15N ratio can still be below 100 in CN itself. However, such low CN abundances are predicted that the updated model falls short of explaining the bulk 15N enhancements observed in primitive materials. It is clear that alternative fractionating reactions are necessary to reproduce observations, so further laboratory and theoretical studies are urgently needed.

  19. 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.

  20. CUSTOMIZED ACETABULAR COMPONENTS IN REVISION HIP ARTHROPLASTY

    Directory of Open Access Journals (Sweden)

    G. M. Kavalersky

    2016-01-01

    Full Text Available In recent years, there is a trend of increasing demand for revision hip arthroplasty. Among these patients there are many with complex acetabular defects, including patients with pelvic discontinuity. To ensure stability for revised acetabular components in such cases becomes a challenging or unachievable task. Such defects give indications for printing customized tri-flange acetabular component. The authors analysed own experience of creating and applying custom made acetabular components in 3 patients with complex acetabular defects. Material and methods. Among the patients there were 2 women and 1 man. Average age was 60,3±19,4 years (38 to 78 years. Two patients had III B defects with pelvic discontinuity and one patient had III A defect by Paprosky classification. As the first step, the authors in collaboration with engineers printed a plaster full size pelvic 3D model, as the second step a customized tri-flange acetabular component was designed and printed. Harris Hip Score was evaluated preoperatively and 3 months postoperatively. Results. Average follow-up period was 5,3±2,5 months (3 to 8 months. The authors observed no cases of implant loosening, dislocation or deep periprosthetic infection. Average Harris Hip Score before surgery was 27,13 and after surgery – 74,1 indicating a significant improvement in 3 months postoperatively. Conclusion. Indications for use of individual acetabular components in reported patients correspond to indications formulated by Berasi et al. The authors obtained encouraging early follow-up outcomes that correspond to data of other authors. In one patient certain difficulties were reported due to insufficient pelvic distraction. Component’s flanges prevented achieving adequate pelvic distraction. Nevertheless, good primary stability was achieved. Modern software and 3D metal printers can significantly reduce the production cost of customized acetabular components. Application of this technology can be