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Sample records for basal thumb prostheses

  1. Outcomes following double knot suspension arthroplasty for basal joint arthritis of the thumb

    International Nuclear Information System (INIS)

    Javed, M.; Nazar, T.; Collier, A.M

    2015-01-01

    Various surgical options used in the treatment of osteoarthritis of the basal joint of the thumb that are refractory to non-surgical management. This study was conducted to provide short term functional outcomes using the mentioned technique in treating basal joint arthritis of the thumb. Methods: We treated basal joint arthritis of the thumb by trapeziumectomy and volar oblique ligament reconstruction using flexor carpi radialis tendon and suspension interposition arthroplasty using the entire tendon split along its length and tied as a double knot at the base of the thumb metacarpal. Through a questionnaire based survey, we reviewed 24 thumbs in 24 patients with basal joint arthritis of the thumb who were followed up with the hand therapist. Postal questionnaires were sent to these patients to record DASH scores and satisfaction. Results: The mean time from surgery to discharge by the hand therapist following rehabilitation was 10 weeks. The DASH score averaged 25 points at 12 weeks postoperatively. There was statistical significance (p-value=0.0001) between the DASH score compared with time spent with the hand therapist. The postoperative net difference in grip strength and pinch grip compared with non-operated had was 9 kg and 3 kg respectively and the net difference in web span was 2 cm. Conclusion: We suggest this technique of suspension arthroplasty is a safe and effective method in treating basal joint arthritis of the thumb with good short-term functional outcomes and minimal complications. (author)

  2. Holder for standardized radiodiagnostic demonstration of ulnar, volar and radial capsuloligamentous lesions of the basal thumb joint

    International Nuclear Information System (INIS)

    Luetten, C.; Thomas, W.; Dihlmann, W.; Allgemeines Krankenhaus Barmbek, Hamburg

    1987-01-01

    We have constructed a device for standardised radiodiagnostics of ulnar, volar and radial capsulo-ligamentous lesions of the basal thumb joint. Used as hyperextensometer at the basal joint of the index finger the device is of equal value in objective diagnostics of ligamentous laxity. (orig.) [de

  3. Total arthroplasty of basal thumb joint with Elektra prothesis: an in vitro analysis.

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    Completo, A; Nascimento, A; Neto, F

    2016-11-01

    The reported outcomes of the Elektra thumb carpo-metacarpal joint implant have been very variable. This study evaluates the influence of daily cyclic loads and the type of the screw-fit cup insertion technique in the trapezium, with and without prior threading, on the structural bone behaviour. The study was performed experimentally to predict initial implant stability and cortical bone strains. Computational models were developed to assess the structural cancellous bone behaviour. The use of Elektra implant considerably changed the bone strain behaviour compared with the intact joint. This may be associated with risks of cancellous bone fatigue failure due to overload, particularly in the trapezium. The joint load magnitude has a more important structural role than that of the screw-fit cup insertion technique. Limiting the magnitude of thumb loads after arthroplasty may contribute positively to the longevity of this procedure. V.

  4. New basal iguanodonts from the Cedar Mountain formation of Utah and the evolution of thumb-spiked dinosaurs.

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    Andrew T McDonald

    Full Text Available BACKGROUND: Basal iguanodontian dinosaurs were extremely successful animals, found in great abundance and diversity almost worldwide during the Early Cretaceous. In contrast to Europe and Asia, the North American record of Early Cretaceous basal iguanodonts has until recently been limited largely to skulls and skeletons of Tenontosaurus tilletti. METHODOLOGY/PRINCIPAL FINDINGS: Herein we describe two new basal iguanodonts from the Yellow Cat Member of the Cedar Mountain Formation of eastern Utah, each known from a partial skull and skeleton. Iguanacolossus fortis gen. et sp. nov. and Hippodraco scutodens gen. et sp. nov. are each diagnosed by a single autapomorphy and a unique combination of characters. CONCLUSIONS/SIGNIFICANCE: Iguanacolossus and Hippodraco add greatly to our knowledge of North American basal iguanodonts and prompt a new comprehensive phylogenetic analysis of basal iguanodont relationships. This analysis indicates that North American Early Cretaceous basal iguanodonts are more basal than their contemporaries in Europe and Asia.

  5. New Basal Iguanodonts from the Cedar Mountain Formation of Utah and the Evolution of Thumb-Spiked Dinosaurs

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    McDonald, Andrew T.; Kirkland, James I.; DeBlieux, Donald D.; Madsen, Scott K.; Cavin, Jennifer; Milner, Andrew R. C.; Panzarin, Lukas

    2010-01-01

    Background Basal iguanodontian dinosaurs were extremely successful animals, found in great abundance and diversity almost worldwide during the Early Cretaceous. In contrast to Europe and Asia, the North American record of Early Cretaceous basal iguanodonts has until recently been limited largely to skulls and skeletons of Tenontosaurus tilletti. Methodology/Principal Findings Herein we describe two new basal iguanodonts from the Yellow Cat Member of the Cedar Mountain Formation of eastern Utah, each known from a partial skull and skeleton. Iguanacolossus fortis gen. et sp. nov. and Hippodraco scutodens gen. et sp. nov. are each diagnosed by a single autapomorphy and a unique combination of characters. Conclusions/Significance Iguanacolossus and Hippodraco add greatly to our knowledge of North American basal iguanodonts and prompt a new comprehensive phylogenetic analysis of basal iguanodont relationships. This analysis indicates that North American Early Cretaceous basal iguanodonts are more basal than their contemporaries in Europe and Asia. PMID:21124919

  6. Thumb Arthritis

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    ... Figure 4 - Treatment Diagram PDF Arthritis - Base of the Thumb Related Conditions Rheumatoid Arthritis Psoriatic Arthritis Osteoarthritis MP Joint Arthritis de Quervain's Tenosynovitis Other Links CME Mission Statement and Disclaimer Policies ...

  7. [The thumb in agony--osteoarthritis of the thumb].

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    Avisar, Erez; Wasrbrout, Ziv; Lin, Eran; Agashi, Maurice

    2011-10-01

    Osteoarthritis of the basal joint of the thumb is common, particuLarLy in postmenopausal females. The male to female ratio is 1:10 respectively. Basal joint arthritis can cause considerable pain and disability. Incompetence of the volar beak ligament is thought to be the pivotal injury that will eventually lead to joint degeneration. Patient history and physical examination can reliably lead to the diagnosis. Radiographs are used for the evaluation of the severity of the arthritis and for treatment strategy. Conservative treatment can be effective in the early stages of the disease. Operative treatment has been shown to be successful in relieving pain and restoring thumb function. The majority of reconstructive procedures include partial or complete trapezectomy with beak ligament reconstruction and tendon interposition.

  8. Conservative treatment for trigger thumb in children.

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    Watanabe, H; Hamada, Y; Toshima, T; Nagasawa, K

    2001-07-01

    Conservative treatment was performed for 60 trigger thumbs (19 right, 17 left, 12 bilateral) in 48 children (19 boys, 29 girls); the age at initial diagnosis ranged from 0 to 48 months old (mean 26 months). In this approach, only passive exercise of the affected thumb was performed by the mother. As a result, two patients (two thumbs) dropped out of treatment. Fifty-six thumbs out of 58 showed a satisfactory result (96%). Sixteen thumbs (in stage 2) and eight thumbs (in stage 3) showed completely recovery. Four thumbs (in stage 3) have not yet improved. In conclusion, we suggest that conservative treatment is effective for trigger thumbs in stage 2, while surgical therapy was thought to be indicated for stage 3 before the age of 3 years to avoid flexion deformity.

  9. Thumb troubles in rheumatoid arthritis

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    G. Garofalo

    2011-09-01

    Full Text Available Thumb involvement may play a relevant role in inducing a severe functional impairment in rheumatoid arthritis. The aim of this sonographic vignette is to show the value of sonography in detailing anatomic changes involving the thumb during a phase of active synovitis. The patient was a 50-year old man who presented with a 3-year history of rheumatoid arthritis. He complained of a 4-week history of a marked recrudescence inflammatory thumb involvement associated with clinical signs of carpal tunnel syndrome. Sonographic images were obtained with a real-time ultrasound system equipped with a 13 MHz linear transducer. Sonographic examination on longitudinal dorsal scan of the metacarpophalangeal joint of the thumb showed a moderate joint cavity widening with two evident bone erosions, one at the metacarpal head and the other one at the basis of the proximal phalanx. The longitudinal volar scan of the first metacarpophalangeal joint confirmed the presence of synovitis detecting a marked joint cavity widening, with aspect of synovial proliferation. The flexor pollicis longus tendon was severely involved (marked tendon sheath widening, synovial proliferation, loss of the normal homogeneous fibrillar echotexture, and a large intratendinous tear. Sonography allowed the depiction of a wide range of otherwise undetectable pathologic changes in the standard clinical setting.

  10. Two-Thumbed Robot Hand

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    Lee, Sukhan

    1989-01-01

    Robot hand includes thumblike members on left and right sides and fingerlike member at middle. Configuration of digits enables hand to adapt to variously shaped objects, grasp them robustly and reliably, and manipulate them. Reduces complexity of control mechanisms and provides kinesthetic perception of shapes of grasped objects. Mechanical hand with two thumbs and middle finger made from commercially available components. With specially designed dc motors and assemblies of gears, size of hand reduced considerably. Suited to handling objects in industrial tasks.

  11. Arterial supply of the thumb: Systemic review.

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    Miletin, J; Sukop, A; Baca, V; Kachlik, D

    2017-10-01

    We offer a complete systemic review of the anatomy of arteries of the thumb, including their sources in the first web space. Eleven studies were selected from the PubMed, Medline, Embase, Scopus and Ovid databases. Data about each artery of the thumb were obtained; in particular, the incidence and dominance of each of these arteries were calculated. The ulnopalmar digital artery of the thumb (UPDAT) was found in 99.63%, the radiopalmar digital artery of the thumb (RPDAT) in 99.26%, the ulnodorsal digital artery of the thumb (UDDAT) in 83.39%, and the radiodorsal digital artery of the thumb (RDDAT) in 70.38%. The sources for the thumb arteries are the first palmar metacarpal artery (for UPDAT in 63.15%, for RPDAT in 78.88%, for UDDAT in 56.95% and for RDDAT in 41.48%), the first dorsal metacarpal artery (for UPDAT in 20.54%, for RPDAT 2.53%, for UDDAT in 20.62%, and for RDDAT in 4.81%) and the superficial palmar arch, either complete or incomplete (for UPDAT in 25.57%, for RPDAT in 23.04%, for UDDAT in 0%, and for RDDAT in 5.19%). The dominant source could be identified in 88.2% of cases: the first palmar metacarpal artery (66.2%), the first dorsal metacarpal artery (15.5%) and the superficial palmar arch, complete or incomplete (8.2%). Four arteries usually supply the thumb. Any artery in the first web space can be a source for the thumb arteries. We propose a new classification of the arteries of the hand, dividing them into three systems (superficial palmar, deep palmar and dorsal system), and suggest that the term "princeps pollicis artery" be reconsidered and systemic anatomical terms of the thumb arteries preferred. Clin. Anat. 30:963-973, 2017. ©2017 Wiley-Liss, Inc. © 2017 Wiley Periodicals, Inc.

  12. Arterial anatomy of the thumb.

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    Ames, E L; Bissonnette, M; Acland, R; Lister, G; Firrell, J

    1993-08-01

    The anatomical literature has indicated that the arterial supply to the thumb comes from the princeps pollicis artery. However, this simplified description does not often correlate with intraoperative findings. The purpose of this study was to investigate and clarify this important area of anatomy by dissection of fresh cadaver hands. 40 dissections were completed on 35 intravascularly injected and five non-injected hands. Five patterns were identified. The most common pattern showed both a superficial and deep vessel to the first web space in 54% of specimens. Dominant vessels included the superficial palmar branch of the radial artery in 8%, first palmar metacarpal artery in 18% and dorsal metacarpal artery in 8%. Only three specimens correlated with the textbook description. We conclude that the term "princeps pollicis" is actually a misnomer.

  13. [Implant supported prostheses (1)].

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    del Río Highsmith, J; López Lozano, J F

    1988-11-01

    In the present article deals with a number of general considerations in the realization of prostheses over endosseous implants. The different principles to study in the construction of a fixed protesic rehabilitation implanto-supported are analyzed.

  14. On the classification of congenital thumb hypoplasia.

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    Tonkin, M A

    2014-11-01

    In 1937, Müller introduced the concept of a teratological sequence of thumb hypoplasia with increasing severity from mild deficiency, through severe deficiency, to thumb absence. Blauth subsequently detailed five specific grades. In 1992, Manske and McCarroll altered Blauth's classification such that Grade 3 was sub-divided into Grades 3A and 3B, according to a presence or absence of the proximal metacarpal. Buck-Gramcko added a Grade 3C in which there was only a remnant metacarpal head. This article investigates their publications and those of others to identify 'who said what' and clarify the definitions of grades of thumb hypoplasia. A modification of Blauth's classification is proposed, which retains the integrity of the concept of Müller and the skeletal and soft tissue grading of Blauth, but which also incorporates the disparate anomalies that may present in Grades 2 and 3 hypoplastic thumbs. © The Author(s) 2013.

  15. Suspension Arthroplasty Combined with Ligament Reconstruction of the Thumb Carpometacarpal Joint to Salvage Two Failed Arthroplasties: A Case Report.

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    Kakinoki, Ryosuke; Hashimoto, Kazuhiko; Tanaka, Hiroki; Akagi, Masao

    2017-01-01

    Thumb basal joint arthroplasty with removal of the entire trapezium is often followed by proximal subsidence and impingement of the thumb metacarpal to the scaphoid, which is a common cause of post-operative thumb pain. Treatment of this impingement is a challenge among surgeons. We performed suspension arthroplasty combined with intercarpal ligament reconstruction using a strip of the extensor carpi radialis longus (ECRL) tendon on a patient suffering from pain caused by this type of the impingement and obtained a successful outcome. We treated a 52-year-old female pianist who complained of pain in her left thumb carpometacarpal (CMC) joint. She had undergone two previous ligament reconstruction and tendon interposition arthroplasty procedures on the joint, for which strips of the flexor carpi radialis tendon and the abductor pollicis longus tendon were used in the first and second operations, respectively. The pre-operative X-ray demonstrated proximal subsidence and impingement of the first metacarpal on the scaphoid. We performed suspension arthroplasty combined with intercarpal ligament reconstruction using a strip of the ECRL tendon to create the trapezial space. 3 years after surgery, despite the 3 mm subsidence of the thumb compared with immediately after surgery, her thumb pinch and grip strength had improved, and the thumb basal pain was relieved. This case shows that suspension arthroplasty with intermetacarpal ligament reconstruction using an ECRL strip can be applied in revision surgery for impingement of the first metacarpal with the scaphoid following thumb CMC joint arthroplasty after removal of the entire trapezium. This is the first report to describe the treatment of first metacarpal impingement after CMC joint arthroplasty using suspension arthroplasty combined with intercarpal ligament reconstruction.

  16. Motion Analysis of Thumb in Cellular Phone Use

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    Naotaka Sakai

    2010-01-01

    Full Text Available The thumb motion of 10 normal subjects during cellular phone use was measured using a reflective marker detection system to compare the maximum, minimum and range of flexion angles of the interphalangeal (IP, metacarpophalangeal (MP and carpometacarpal (CM joints. Two micro-reflective markers 3 mm in diameter were each placed on the dorsal surface of the distal phalanx, basal phalanx and metacarpal bone of the thumb. Three markers were placed on the dorsal hand in order to define the dorsal hand plane. Each subject pushed the 12 keys of a folding cellular phone with an 85-mm-long and 40-mm-wide keypad, sequentially from ‘1’ to ‘#’, and the pushing motion was recorded by six infrared video cameras for 12 seconds, using the VICON 612 system. The mean maximum flexion angle of the MP joint was significantly (p < .05 larger than the CM joint, and the mean minimum flexion angle of the CM joint was significantly (p < .01 smaller than the IP and MP joints. The mean range of motion of the IP joint was significantly (p < .05 larger than the MP and the CM joints. In a comparison of different key-pushing motions, only the CM joint was significantly (p < .05 larger in its range of motion. In conclusion, thumb motion on pushing the keys of the cellular phone was produced mainly by the MP and the CM joints. In addition, the ability to reach keys in different areas of the cellular phone keypad is regulated by changing the flexion angle of the CM joint.

  17. MR imaging findings of trigger thumb

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    Chang, Eric Y.; Chen, Karen C.; Chung, Christine B. [VA San Diego Healthcare System, Radiology Service, San Diego, CA (United States); University of California, San Diego Medical Center, Department of Radiology, San Diego, CA (United States)

    2015-08-15

    Trigger finger (or trigger thumb), also known as sclerosing tenosynovitis, is a common clinical diagnosis that rarely presents for imaging. Because of this selection bias, many radiologists may not be familiar with the process. Furthermore, patients who do present for imaging frequently have misleading examination indications. To our knowledge, magnetic resonance (MR) imaging findings of trigger thumb have not been previously reported in the literature. In this article, we review the entity of trigger thumb, the anatomy involved, and associated imaging findings, which include flexor pollicis longus tendinosis with a distinct nodule, A1 pulley thickening, and tenosynovitis. In addition, in some cases, an abnormal Av pulley is apparent. In the rare cases of trigger finger that present for MR imaging, accurate diagnosis by the radiologist can allow initiation of treatment and avoid further unnecessary workup. (orig.)

  18. MR imaging findings of trigger thumb

    International Nuclear Information System (INIS)

    Chang, Eric Y.; Chen, Karen C.; Chung, Christine B.

    2015-01-01

    Trigger finger (or trigger thumb), also known as sclerosing tenosynovitis, is a common clinical diagnosis that rarely presents for imaging. Because of this selection bias, many radiologists may not be familiar with the process. Furthermore, patients who do present for imaging frequently have misleading examination indications. To our knowledge, magnetic resonance (MR) imaging findings of trigger thumb have not been previously reported in the literature. In this article, we review the entity of trigger thumb, the anatomy involved, and associated imaging findings, which include flexor pollicis longus tendinosis with a distinct nodule, A1 pulley thickening, and tenosynovitis. In addition, in some cases, an abnormal Av pulley is apparent. In the rare cases of trigger finger that present for MR imaging, accurate diagnosis by the radiologist can allow initiation of treatment and avoid further unnecessary workup. (orig.)

  19. A Rare Cause of Thumb Boutonniere Deformity: Flexor Pulley Rupture

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    Kin-Ho Leung

    2012-12-01

    Full Text Available We report a rare case of thumb boutonniere deformity secondary to closed rupture of thumb flexor pulley. The postulation of the development of boutonniere deformity, anatomical and biomechanical basis, and current treatment options are discussed.

  20. Revision of the Failed Thumb Carpometacarpal Arthroplasty.

    Science.gov (United States)

    Papatheodorou, Loukia K; Winston, Jonathan D; Bielicka, Deidre L; Rogozinski, Benjamin J; Lourie, Gary M; Sotereanos, Dean G

    2017-12-01

    To evaluate the outcome of revision surgery for failed thumb carpometacarpal (CMC) arthroplasty. We retrospectively analyzed 32 patients with failed thumb CMC arthroplasty. The primary reason for revision was pain caused by metacarpal subsidence. Revision surgery included soft tissue interposition and distraction pinning to address the metacarpal subsidence. Additional ligament reconstruction was performed in patients with thumb instability. Eight patients required additional metacarpophalangeal joint fusion for concomitant joint hyperextension. Eleven required additional partial excision of the trapezoid for concomitant scaphotrapezoidal joint arthritis. All patients were evaluated clinically and radiographically. Mean follow-up was 57 months (range, 24-121 months). Pain levels evaluated by visual analog scale were significantly reduced in all patients after revision surgery. Mean grip strength and key pinch strength significantly increased. Twenty-seven patients achieved good functional results; those for 5 patients were fair. This study showed that revision surgery with distraction pinning and soft tissue interposition with or without ligament reconstruction was an effective treatment for failed CMC arthroplasty of the thumb. Therapeutic IV. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  1. Varied anatomy of the thumb pulley system: implications for successful trigger thumb release.

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    Schubert, Manuel F; Shah, Vandan S; Craig, Clifford L; Zeller, John L

    2012-11-01

    The anatomical arrangement of the thumb pulley system continues to be revised through ongoing investigative research, changing our previous assumptions. This study demonstrates the components and anatomical features of this pulley system in an effort to improve surgical outcomes and to clarify current misconceptions. Researchers procured 75 hand specimens from 41 adult cadavers through our institution's anatomical donations program. Dissections of the thumb and thenar compartment identified the various pulleys. A detailed analysis of the thumb pulleys was performed through various measurements. Four different pulley categories were identified: type I (n = 5), type II (n = 29), type III (n = 29), and type IV (n = 12). The variable annular pulley was present in 70 of 75 hands (93%) in 1 of 3 arrangements: transverse, oblique, or fused with the A1 pulley. The pulley system of the thumb is composed of 4 components, as opposed to the traditional view of only 3. Along with the A1 pulley, the additional variable annular pulley might contribute to stenosis in trigger thumb. This might necessitate a more extensive surgical incision and its partial release to relieve triggering. Understanding the anatomical configuration of the thumb pulley system will aid in the surgical attempt to resolve triggering while avoiding complications such as bowstringing of the flexor pollicis longus tendon and iatrogenic nerve injury. Copyright © 2012 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  2. Prosthetic Rehabilitation of Amputated Thumb: A Simplified Approach.

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    Agrawal, Kaushal Kishor; Aggarawal, Himanshi; Singh, Kamleshwar

    2014-12-01

    This case report presents a case of prosthetic rehabilitation of an amputated thumb. It emphasizes that prosthetic replacement is a better option for aesthetic and psychological improvement, particularly in cases where the victim is unwilling to undergo complicated surgical procedures for reconstruction of thumb or where functioning of thumb cannot be restored even by multiple surgeries. In the present case, a 20 years old female patient, with missing thumb of her right hand was rehabilitated aesthetically by a non-invasive and cost effective prosthetic procedure by using heat temperature vulcanizing silicone material. The prosthesis (the thumb) was attached using medical adhesives. On 3 months recall appointment, no complications were observed. The prosthesis was in good shape and required no further intervention. The prosthetic thumb lacks the sensation of a normal or reconstructed thumb, although it does not require the multiple procedures of surgical reconstruction and the accompanying loss of time for rehabilitation and healing.

  3. Protective prostheses during radiation therapy

    International Nuclear Information System (INIS)

    Poole, T.S.; Flaxman, N.A.

    1986-01-01

    Current applications and complications in the use of radiotherapy for the treatment of oral malignancy are reviewed. Prostheses are used for decreasing radiation to vital structures not involved with the lesion but located in the field of radiation. With a program of oral hygiene and proper dental care, protective prostheses can help decrease greatly the morbidity seen with existing radiotherapy regimens

  4. The thumb: Guidelines for a robotic design

    OpenAIRE

    Chalon, Maxime; Grebenstein, Markus; Wimboeck, Thomas; Hirzinger, Gerd

    2010-01-01

    The impressive manipulation capabilities of the human hand are undoubtedly related to the thumb opposition. Such a versatility is highly desirable in the context of humanoid robots, in particular when performing object manipulation. Biomechanical data, surgery procedures and rehabilitation surveys represent an excellent base from which a robotic design can be inferred. This knowledge must be understood to identify the properties required for manipulation skills, and especially, to obtain a ho...

  5. Tracing the origin of the panda's thumb

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    Abella, Juan; Pérez-Ramos, Alejandro; Valenciano, Alberto; Alba, David M.; Ercoli, Marcos D.; Hontecillas, Daniel; Montoya, Plinio; Morales, Jorge

    2015-06-01

    We investigate the relative development of the carnivoran radial sesamoids to untangle the evolution of this iconic structure. In the pandas (both giant and red), this `false thumb' is known to perform a grasping role during bamboo feeding in both the red and giant pandas. An original locomotor role has been inferred for ailurids, but this remains to be ascertained for ursids. A large sample of radial sesamoids of Indarctos arctoides from the Miocene of Batallones-3 (Spain) indicates that this early ailuropodine bear displayed a relatively hypertrophied radial sesamoid, with a configuration more similar to that of the red panda and other carnivorans than to that of giant pandas. This false thumb is the first evidence of this feature in the Ursidae, which can be linked to a more herbivorous diet. Moreover, in the two extant pandas, the false thumb should not be interpreted as an anatomical convergence, but as an exaptive convergence regarding its use during the bamboo feeding, which changes the evolutionary view of this singular structure.

  6. Nuclear medicine and prostheses

    International Nuclear Information System (INIS)

    Bordenave, L.; Baquey, Ch.

    2004-01-01

    Whatever the bio-material, prosthesis or medical device concerned, from design to experimental then clinical validation, nuclear medicine (NM) techniques offer a unique opportunity in all indications, (in vitro diagnosis, in vivo diagnosis and therapy) to investigate, assess and predict the behaviour of the device, qualitatively and quantitatively. All research fields involving prostheses and their constitutive biomaterials may take advantage of NM. In order to review published works, one can analyze provided data according to two strategies: an upright one related to medical and surgical specialties that integrate NM and a more horizontal one, that is to describe what kind of contribution is brought by such investigations. The latter approach was preferred in our review. We discuss and illustrate benefits of NM in the following indications: as an in vitro tool, as an in vivo tool for the diagnosis i) of device integration in recipient, ii) of functional outcome after use or implantation, iii) and predictive assessment of undesirable side effects, iv) of occurrence of complications associated to the device implantation, v) of a new therapy efficiency; finally as in vivo tool of therapy. Tissue engineering and regenerative medicine domains with stem cell potential as well as that of medical device associated with vigilance are new fields in basic research and clinical assessment that seem increasingly promising for the nuclear physician and to which NM could and would contribute from molecule to integrated system in order to improve knowledge and achievement of prostheses. (author)

  7. Esthetic, functional, and prosthetic outcomes with implant-retained finger prostheses.

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    Aydin, Cemal; Nemli, Secil Karakoca; Yilmaz, Handan

    2013-04-01

    Traumatic amputation of fingers results in a serious impairment of hand function and affects the psychological status of the patients. The implant-retained finger prostheses are an alternative treatment. The aim of this case report is to represent the use of osseointegrated implants for retention of finger prostheses in a patient with amputated thumb and index finger. Dental implants were placed in the residual bone of the fingers using two-stage surgery. Custom-made attachments were used to provide retention between implants and silicone prostheses. Prosthetic fingernails were made of composite resin material. After 6 months, implants were clinically successful, and the patient was satisfied with the appearance and the function of the prostheses. The complications of broken prosthetic nail and mild discoloration were observed. Reconstruction of amputated fingers with implant-retained prosthesis is a worthwhile treatment providing esthetic, functional, and psychological benefits, although some complications might be experienced. Clinical relevance Implant-retained finger prostheses are an acceptable treatment modality for patients with amputated fingers. Evaluating implant prognosis, functional results and prosthetic results of the patients are necessary to address the benefits and complications of the treatment.

  8. An ergonomics study of thumb movements on smartphone touch screen.

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    Xiong, Jinghong; Muraki, Satoshi

    2014-01-01

    This study investigated the relationships between thumb muscle activity and thumb operating tasks on a smartphone touch screen with one-hand posture. Six muscles in the right thumb and forearm were targeted in this study, namely adductor pollicis, flexor pollicis brevis, abductor pollicis brevis (APB), abductor pollicis longus, first dorsal interosseous (FDI) and extensor digitorum. The performance measures showed that the thumb developed fatigue rapidly when tapping on smaller buttons (diameter: 9 mm compared with 3 mm), and moved more slowly in flexion-extension than in adduction-abduction orientation. Meanwhile, the electromyography and perceived exertion values of FDI significantly increased in small button and flexion-extension tasks, while those of APB were greater in the adduction-abduction task. This study reveals that muscle effort among thumb muscles on a touch screen smartphone varies according to the task, and suggests that the use of small touch buttons should be minimised for better thumb performance.

  9. Ulnar Collateral Ligament Injuries of the Thumb

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    McKeon, Kathleen E.; Gelberman, Richard H.; Calfee, Ryan P.

    2013-01-01

    Background: The clinical diagnosis of thumb ulnar collateral ligament disruption has been based on joint angulation during valgus stress testing. This report describes a definitive method of distinguishing between complete and partial ulnar collateral ligament injuries by quantifying translation of the proximal phalanx on the metacarpal head during valgus stress testing. Methods: Sixty-two cadaveric thumbs underwent standardized valgus stress testing under fluoroscopy with the ulnar collateral ligament intact, following an isolated release of the proper ulnar collateral ligament, and following a combined release of both the proper and the accessory ulnar collateral ligament (complete ulnar collateral ligament release). Following complete ulnar collateral ligament release, the final thirty-seven thumbs were also analyzed after the application of a valgus force sufficient to cause 45° of valgus angulation at the metacarpophalangeal joint to model more severe soft-tissue injury. Two independent reviewers measured coronal plane joint angulation (in degrees), ulnar joint line gap formation (in millimeters), and radial translation of the proximal phalanx on the metacarpal head (in millimeters) on digital fluoroscopic images that had been randomized. Results: Coronal angulation across the stressed metacarpophalangeal joint progressively increased through the stages of the testing protocol: ulnar collateral ligament intact (average [and standard deviation], 20° ± 8.1°), release of the proper ulnar collateral ligament (average, 23° ± 8.3°), and complete ulnar collateral ligament release (average, 30° ± 8.9°) (p collateral ligament release (5.7 ± 1.5 mm), to that following complete ulnar collateral ligament release (7.2 ± 1.5 mm) (p collateral ligament (1.6 ± 0.8 mm vs. 1.5 ± 0.9 mm in the intact state). There was a significant increase in translation following release of the complete ulnar collateral ligament complex (3.0 ± 0.9 mm; p collateral ligament

  10. Distance-based kinematics of the five-oblique-axis thumb model with intersecting axes at the metacarpophalangeal joint.

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    Rojas, Nicolas; Dollar, Aaron M

    2017-07-01

    This paper proposes a novel and simple method to compute all possible solutions of the inverse kinematics problem of the five-oblique-axis thumb model with intersecting axes at the metacarpophalangeal joint. This thumb model is one of the suggested results by a magnetic-resonance-imaging-based study that, in contrast to those based on cadaver fingers or on the tracking of the surface of the fingers, takes into account muscle and ligament behaviors and avoids inaccuracies resulting from the movement of the skin with respect to the bones. The proposed distance-based inverse kinematics method eliminates the use of arbitrary reference frames as is usually required by standard approaches; this is relevant because the numerical conditioning of the resulting system of equations with such traditional approaches depends on the selected reference frames. Moreover, contrary to other parametrizations (e.g., Denavit-Hartenberg parameters), the suggested distance-based parameters for the thumb have a natural, human-understandable geometric meaning that makes them easier to be determined from any posture. These characteristics make the proposed approach of interest for those working in, for instance, measuring and modeling the movement of the human hand, developing rehabilitation devices such as orthoses and prostheses, or designing anthropomorphic robotic hands.

  11. Variable Thumb Moment Arm Modeling and Thumb-Tip Force Production of a Human-Like Robotic Hand.

    Science.gov (United States)

    Niehues, Taylor D; Deshpande, Ashish D

    2017-10-01

    The anatomically correct testbed (ACT) hand mechanically simulates the musculoskeletal structure of the fingers and thumb of the human hand. In this work, we analyze the muscle moment arms (MAs) and thumb-tip force vectors in the ACT thumb in order to compare the ACT thumb's mechanical structure to the human thumb. Motion data are used to determine joint angle-dependent MA models, and thumb-tip three-dimensional (3D) force vectors are experimentally analyzed when forces are applied to individual muscles. Results are presented for both a nominal ACT thumb model designed to match human MAs and an adjusted model that more closely replicates human-like thumb-tip forces. The results confirm that the ACT thumb is capable of faithfully representing human musculoskeletal structure and muscle functionality. Using the ACT hand as a physical simulation platform allows us to gain a better understanding of the underlying biomechanical and neuromuscular properties of the human hand to ultimately inform the design and control of robotic and prosthetic hands.

  12. Injury to ulnar collateral ligament of thumb.

    Science.gov (United States)

    Madan, Simerjit Singh; Pai, Dinker R; Kaur, Avneet; Dixit, Ruchita

    2014-02-01

    Injury of the ulnar collateral ligament (UCL) of thumb can be incapacitating if untreated or not treated properly. This injury is notorious for frequently being missed by inexperienced health care personnel in emergency departments. It has frequently been described in skiers, but also occurs in other sports such as rugby, soccer, handball, basketball, volleyball and even after a handshake. The UCL of the thumb acts as a primary restraint to valgus stress and is injured if hyperabduction and hyperextension forces are applied to the first metacarpophalangeal joint. The diagnosis is best established clinically, though MRI is the imaging modality of choice. Many treatment options exist, surgical treatment being offered depending on various factors, including timing of presentation (acute or chronic), grade (severity of injury), displacement (Stener lesion), location of tear (mid-substance or peripheral), associated or concomitant surrounding tissue injury (bone, volar plate, etc.), and patient-related factors (occupational demands, etc.). This review aims to identify the optimal diagnostic techniques and management options for UCL injury available thus far. © 2014 Chinese Orthopaedic Association and Wiley Publishing Asia Pty Ltd.

  13. Quantifying thumb rotation during circumduction utilizing a video technique

    NARCIS (Netherlands)

    Coert, JH; van Dijke, GAH; Hovius, SER; Snijders, CJ; Meek, MF

    2003-01-01

    Thumb rotation is an essential component of circumduction in order to achieve pulp to pulp contact. In order to evaluate opponensplasty, a device was developed to quantify thumb rotation utilizing a special jig to hold the hand and video analysis. Twenty-seven healthy volunteers (12 female and 15

  14. HYDRODYNAMIC ANALYSIS OF DIFFERENT THUMB POSITIONS IN SWIMMING

    Directory of Open Access Journals (Sweden)

    António J. Silva

    2009-03-01

    Full Text Available The aim of the present study was to analyze the hydrodynamic characteristics of a true model of a swimmer hand with the thumb in different positions using numerical simulation techniques. A three-dimensional domain was created to simulate the fluid flow around three models of a swimmer hand, with the thumb in different positions: thumb fully abducted, partially abducted, and adducted. These three hand models were obtained through computerized tomography scans of an Olympic swimmer hand. Steady-state computational fluid dynamics analyses were performed using the Fluent® code. The forces estimated in each of the three hand models were decomposed into drag and lift coefficients. Angles of attack of hand models of 0º, 45º and 90º, with a sweep back angle of 0º were used for the calculations. The results showed that the position with the thumb adducted presented slightly higher values of drag coefficient compared with thumb abducted positions. Moreover, the position with the thumb fully abducted allowed increasing the lift coefficient of the hand at angles of attack of 0º and 45º. These results suggested that, for hand models in which the lift force can play an important role, the abduction of the thumb may be better, whereas at higher angles of attack, in which the drag force is dominant, the adduction of the thumb may be preferable

  15. Osteoarthritis of the carpometacarpal articulation of the thumb; a classification original arthroscopic and treatment algorithm

    International Nuclear Information System (INIS)

    Badia, Alejandro; Riano, Felix; Indriago, Igor; Orbay, Jorge; Gonzalez Hernandez, Eduardo; Khouri, Roger

    2005-01-01

    Osteoarthritis of the thumb basal joint is a very common and disabling condition that is most often seen in middle aged women with staging of the disease and treatment based upon clinical and radiographic findings. Arthroscopic assessment of the first carpometacarpal (CMC) joint combines easy identification and classification of joint pathology with minimal morbidity, this allows the condition to be managed either arthroscopically or converted to an open procedure as indicated. We obtained consistent arthroscopic findings, which did not necessarily correlate to the different radiographic stages. In arthroscopy stage I, diffuse synovitis and occasional capsular attenuation was found even in the absence of radiographic changes. Stage II was characterized by central wears on the articular cartilage of the trapezium and on the cubital side of the base of the first metacarpal. Finally in Stage III, extensive cartilage loss was a consistent finding. We therefore propose an arthroscopic classification and establish an algorithm for the treatment of basal joint osteoarthritis

  16. Estimation of continuous thumb angle and force using electromyogram classification

    Directory of Open Access Journals (Sweden)

    Abdul Rahman Siddiqi

    2016-09-01

    Full Text Available Human hand functions range from precise minute handling to heavy and robust movements. Remarkably, 50% of all hand functions are made possible by the thumb. Therefore, developing an artificial thumb that can mimic the actions of a real thumb precisely is a major achievement. Despite many efforts dedicated to this area of research, control of artificial thumb movements in resemblance to our natural movement still poses as a challenge. Most of the development in this area is based on discontinuous thumb position control, which makes it possible to recreate several of the most important functions of the thumb but does not result in total imitation. This work looks into the classification of electromyogram signals from thumb muscles for the prediction of thumb angle and force during flexion motion. For this purpose, an experimental setup is developed to measure the thumb angle and force throughout the range of flexion and simultaneously gather the electromyogram signals. Further, various features are extracted from these signals for classification and the most suitable feature set is determined and applied to different classifiers. A “piecewise discretization” approach is used for continuous angle prediction. Breaking away from previous research studies, the frequency-domain features performed better than the time-domain features, with the best feature combination turning out to be median frequency–mean frequency–mean power. As for the classifiers, the support vector machine proved to be the most accurate classifier giving about 70% accuracy for both angle and force classification and close to 50% for joint angle–force classification.

  17. Ergonomics study on mobile phones for thumb physiology discomfort

    Science.gov (United States)

    Bendero, J. M. S.; Doon, M. E. R.; Quiogue, K. C. A.; Soneja, L. C.; Ong, N. R.; Sauli, Z.; Vairavan, R.

    2017-09-01

    The study was conducted on Filipino undergraduate college students and aimed to find out about the significant factors associated with mobile phone usage and its effect on thumb pain.A correlation-prediction analysisand Multiple Linear Regression was adopted and used as the main tool in determining the significant factors and coming up with predictive models on thumb related pain. With the use of the software Statistical Package for the Social Sciences or SPSS in conducting linear regression, 2 significant factors on thumb-related pain (percentage of time using portrait as screen orientation when text messaging, amount of time playing games using one hand in a day) were found.

  18. [Biomechanic considerations in wrist prostheses].

    Science.gov (United States)

    Kapandji, A I

    1992-01-01

    At the present time, in disorders of the wrist, avulsion of the first carpal row is the most commonly used technique as a last resort. However, there are many wrist prostheses, which are reviewed here. Roughly, they belong to two families: the three axis prostheses (spherical) that cannot transmit to the hand the pronation supination torque, because of their geometrical characteristics, and the two axis prostheses (universal joint) that are able to transmit this movement. The characteristics of future prostheses must include: based on the "universal joint" principle, occupy minimum space, isometric, maintain tendon tension, an axis identical to the true axis of the wrist, to maintain the hand in line with the forearm, fixed without cement but, not shortened with time, possibilities of mechanical flexibility immediately and lastingly stable, to be easily replaced modularly. This ideal prosthesis will certainly exist one day and will take the place of the first carpal row avulsion. In the meantime, this technique will still have a long use.

  19. Thumb Sucking: Help Your Child Break the Habit

    Science.gov (United States)

    ... older kids who continue to suck their thumbs, peer pressure at school usually ends the habit. Remember, though, ... an incredibly difficult habit to break. Remember, though, peer pressure typically leads kids to stop daytime sucking habits ...

  20. Basal Cell Carcinoma

    Science.gov (United States)

    ... Kids’ zone Video library Find a dermatologist Basal cell carcinoma Overview Basal cell carcinoma: This skin cancer ... that has received years of sun exposure. Basal cell carcinoma: Overview Basal cell carcinoma (BCC) is the ...

  1. Cementless Hydroxyapatite Coated Hip Prostheses

    Directory of Open Access Journals (Sweden)

    Antonio Herrera

    2015-01-01

    Full Text Available More than twenty years ago, hydroxyapatite (HA, calcium phosphate ceramics, was introduced as a coating for cementless hip prostheses. The choice of this ceramic is due to its composition being similar to organic apatite bone crystals. This ceramic is biocompatible, bioactive, and osteoconductive. These qualities facilitate the primary stability and osseointegration of implants. Our surgical experience includes the implantation of more than 4,000 cementless hydroxyapatite coated hip prostheses since 1990. The models implanted are coated with HA in the acetabulum and in the metaphyseal area of the stem. The results corresponding to survival and stability of implants were very satisfactory in the long-term. From our experience, HA-coated hip implants are a reliable alternative which can achieve long term survival, provided that certain requirements are met: good design selection, sound choice of bearing surfaces based on patient life expectancy, meticulous surgical technique, and indications based on adequate bone quality.

  2. Cementless Hydroxyapatite Coated Hip Prostheses

    Science.gov (United States)

    Herrera, Antonio; Mateo, Jesús; Gil-Albarova, Jorge; Lobo-Escolar, Antonio; Ibarz, Elena; Gabarre, Sergio; Más, Yolanda

    2015-01-01

    More than twenty years ago, hydroxyapatite (HA), calcium phosphate ceramics, was introduced as a coating for cementless hip prostheses. The choice of this ceramic is due to its composition being similar to organic apatite bone crystals. This ceramic is biocompatible, bioactive, and osteoconductive. These qualities facilitate the primary stability and osseointegration of implants. Our surgical experience includes the implantation of more than 4,000 cementless hydroxyapatite coated hip prostheses since 1990. The models implanted are coated with HA in the acetabulum and in the metaphyseal area of the stem. The results corresponding to survival and stability of implants were very satisfactory in the long-term. From our experience, HA-coated hip implants are a reliable alternative which can achieve long term survival, provided that certain requirements are met: good design selection, sound choice of bearing surfaces based on patient life expectancy, meticulous surgical technique, and indications based on adequate bone quality. PMID:25802848

  3. Heat generated by knee prostheses.

    Science.gov (United States)

    Pritchett, James W

    2006-01-01

    Temperature sensors were placed in 50 knees in 25 patients who had one or both joints replaced. Temperature recordings were made before walking, after walking, and after cycling. The heat generated in healthy, arthritic, and replaced knees was measured. The knee replacements were done using eight different prostheses. A rotating hinge knee prosthesis generated a temperature increase of 7 degrees C in 20 minutes and 9 degrees C in 40 minutes. An unconstrained ceramic femoral prosthesis articulating with a polyethylene tibial prosthesis generated a temperature increase of 4 degrees C compared with a healthy resting knee. The other designs using a cobalt-chrome alloy and high-density polyethylene had temperature increases of 5 degrees-7 degrees C with exercise. Frictional heat generated in a prosthetic knee is not immediately dissipated and may result in wear, creep, and other degenerative processes in the high-density polyethylene. Extended periods of elevated temperature in joints may inhibit cell growth and perhaps contribute to adverse performance via bone resorption or component loosening. Prosthetic knees generate more heat with activity than healthy or arthritic knees. More-constrained knee prostheses generate more heat than less-constrained prostheses. A knee with a ceramic femoral component generates less heat than a knee with the same design using a cobalt-chromium alloy.

  4. Leukocyte-Reduced Platelet-Rich Plasma Treatment of Basal Thumb Arthritis: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Markus Loibl

    2016-01-01

    Full Text Available A positive effect of intra-articular platelet-rich plasma (PRP injection has been discussed for osteoarthritic joint conditions in the last years. The purpose of this study was to evaluate PRP injection into the trapeziometacarpal (TMC joint. We report about ten patients with TMC joint osteoarthritis (OA that were treated with 2 intra-articular PRP injections 4 weeks apart. PRP was produced using the Double Syringe System (Arthrex Inc., Naples, Florida, USA. A total volume of 1.47±0.25 mL PRP was injected at the first injection and 1.5±0.41 mL at the second injection, depending on the volume capacity of the joint. Patients were evaluated using VAS, strength measures, and the Mayo Wrist score and DASH score after 3 and 6 months. VAS significantly decreased from 6.2±1.6 to 5.4±2.2 at six-month follow-up (P<0.05. The DASH score was unaffected; however, the Mayo Wrist score significantly improved from 46.5±18.6 to 67.5±19.0 at six-month follow-up (P=0.05. Grip was unaffected, whereas pinch declined from 6.02±2.99 to 3.96±1.77 at six-month follow-up (P<0.05. We did not observe adverse events after the injection of PRP, except one occurrence of a palmar wrist ganglion, which resolved without treatment. PRP injection for symptomatic TMC OA is a reasonable therapeutic option in early stages TMC OA and can be performed with little to no morbidity.

  5. Hip prostheses in young adults. Surface prostheses and short-stem prostheses.

    Science.gov (United States)

    Gallart, X; Riba, J; Fernández-Valencia, J A; Bori, G; Muñoz-Mahamud, E; Combalia, A

    The poor results obtained in young patients when using a conventional prosthesis led to the resurgence of hip resurfacing to find less invasive implants for the bone. Young patients present a demand for additional activity, which makes them a serious challenge for the survival of implants. In addition, new information technologies contribute decisively to the preference for non-cemented prostheses. Maintaining quality of life, preserving the bone and soft tissues, as well as achieving a very stable implant, are the goals of every hip orthopaedic surgeon for these patients. The results in research point to the use of smaller prostheses, which use the metaphyseal zone more and less the diaphyseal zone, and hence the large number of the abovementioned short stem prostheses. Both models are principally indicated in the young adult. Their revision should be a more simple operation, but this is only true for hip resurfacing, not for short stems. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Rules of Thumb: Hints for the psychiatric nursing student.

    Science.gov (United States)

    Karshmer, J F

    1982-03-01

    The eight "rules of thumb" offered here are representative of numerous more that have been helpful stimulators for psychiatric nursing students. The suggest to the students a consistent approach based upon a rationale and do not encourage rote memorization of techniques. Students are encouraged to critically analyze the reasons and conceptual underpinnings for each encounter they have with patients. The "rules of thumb" encourage this self-exploration and attention to "What is it I'm really asking, or feeling, or thinking?" Only with this sort of continuous evaluation and reassessment can even the most novice of students begin to establish a therapeutic treatment approach with psychiatric patients.

  7. Delayed Case of Congenital Bilateral Trigger Thumb: A Case Report and Review of Literature

    Directory of Open Access Journals (Sweden)

    Y Bhanu Rekha

    2014-01-01

    Full Text Available Abstract Introduction: Congenital trigger thumb is an uncommon anamoly of children. Its management is controversial, ranging from observation to extensive surgical release. We report a case of delayed presentation of bilateral trigger thumb along with a brief review of past literature. Case Report: A six year old girl presented with fixed flexion deformity of interphalangeal joints of both thumbs and Notta’s nodules. It is diagnosed as trigger thumb and release of bilateral A1pulleys is done. But we found another constricting annular pulley just distal to A1. Only after splitting the distal pulley, we could get complete extension of interphalangeal joints. At two years follow-up, the child is free of complications. Conclusion: Splitting of A1 pulley alone may not be sufficient in few cases of trigger thumb. Keywords: Congenital trigger thumb, bilateral trigger thumb and variable pulley of thumb.

  8. Invisalign teen for thumb-sucking management. A case report.

    Science.gov (United States)

    Levrini, L; Tettamanti, L; Macchi, A; Tagliabue, A; Caprioglio, A

    2012-06-01

    Currently and with increasing frequency, treatments with Invisalign orthodontic devices are aimed also to adolescent patients: this evolution involves the management of some atypical characteristics, and among them also thumb- sucking. A 13-year-old adolescent girl with protracted thumb sucking and dentoalveolar open bite is presented. Infantile neuropsychiatric assessment was required before and after treatment. Small areas of the aligners were occlusally flipped like a bite ramp, in particular on the palatal surface of the upper incisors, in order to discourage thumb sucking. The selection of an invisible orthodontic device was shown to be interesting because it does not impact on the fragile and complex neuropsychiatric situations. Moreover, the active daily application of the device further motivates young patients. The vertical attachments were fundamental in repositioning the front teeth and to close the dentoalveolar open bite. Treatment was ended in eight months with no behavioural or neuropsychiatric consequences in the short period. Invisalign was shown to be a useful device for orthodontic correction even in the complex management of adolescent thumb sucking.

  9. Conservative treatment of thumb base osteoarthritis : A systematic review

    NARCIS (Netherlands)

    Spaans, Anne J.; Van Minnen, L. Paul; Kon, Moshe; Schuurman, Arnold H.; Schreuders, A. R.; Vermeulen, Guus M.

    2015-01-01

    Purpose To provide a systematic review of randomized controlled trials regarding the conservative treatment of thumb base osteoarthritis (OA). Methods A systematic literature search was conducted in the electronic bibliographic databases Medline (Pubmed) and Embase (both starting year to May 2014)

  10. Case report 525: Benign fibrous histiocytoma (BFH) of thumb

    International Nuclear Information System (INIS)

    Statz, E.M.; Philipps, E.; Pochebit, S.M.; Cooper, A.; Leslie, B.M.

    1989-01-01

    A case was presented of benign fibrous histiocytoma (BFH) involving the distal phalanx of the thumb, a location heretofore not described in the literature. The distinction between BFH and other lesions (e.g. non-ossifying fibroma) was considered in depth. The distinction between benign and malignant fibrous histiocytoma was also described. (orig.)

  11. The pulley system of the thumb: anatomic and biomechanical study.

    Science.gov (United States)

    Bayat, Ardeshir; Shaaban, Hassan; Giakas, Giannis; Lees, Vivien C

    2002-07-01

    To examine the precise conformation of the annular and oblique pulleys of the thumb flexor sheath, anatomic dissections were undertaken on 14 hands. In all specimens a distinct pulley was found between the A1 and oblique pulleys. This is named the variable annular pulley or Av pulley. There appear to be 3 discrete forms of this pulley designated type I to III. The biomechanical study was done on 8 limbs by using linear strain transduction techniques. The analysis showed that the strain in the oblique pulley was greater in extension than in flexion of the thumb. This statement remains true even after division of either the A1 or Av pulley and after section of both pulleys. The oblique pulley does not prevent bowstringing of the flexor pollicis longus when A1 and Av pulleys have been sectioned. These studies challenge current concepts of both the anatomy and mechanics of the thumb pulley system with implications for clinical procedures such as trigger thumb release and pulley reconstruction.

  12. Glomus Tumor of Thumb Occurring at Unusual Location

    African Journals Online (AJOL)

    Glomus Tumor of Thumb Occurring at Unusual Location. Samir Dwidmuthe, Amit Nemade, Santhosh Rai1. INTRODUCTION. Wood[1] first described glomus tumors in 1812 as painful subcutaneous tubercles. These are benign tumors that arise from one of the subcutaneous glomus bodies. These account for approximately ...

  13. Hypoplasia of the thumb. Clinical presentation and reconstruction

    International Nuclear Information System (INIS)

    Vergara A, Enrique M

    2008-01-01

    In the genesis of the partial or total absence of the thumb they are genetic, environmental factors or a combination of both. It is take part of a syndrome or to be isolated and frequently associated with problems of radial longitudinal deficiency of the forearm. Objective. The purpose of this study is shown the experience, the focus of the processing and the results obtained since the point esthetic and functional view. The most it accepted classification is the proposal by Blauth that helps to determine the forecast and the processing. Materials and methods. it is a work type series of cases in 22 children with hypoplasia of the thumb, with a minimum of 12 months, (average 28 months). In 15 cases there were association of radial dysplasia or another anomaly among them 4 patients with VATER, and the 7 remaining they corresponded to hypoplasia of the thumb as only entity. We carried out tendon transfer, with opening of the first comisure in 2 patients with hypoplasia type II. In 3 patients, with hypoplasia type III A, one carries out corner opening, transfer of the superficial flexor of the 4 finger to correct instability of the articulation MF and opposition of the thumb, and transfer for extension of the thumb. In 17 cases one carries out politicization of the index. Results. The outcome was evaluated in: non pinch, lateral pinch and fingertip pinch; the grade of opposition like good, minimal and non opposition, and the aesthetic result according to the satisfaction of the parents in bad, regular and good. The five children reconstructed with transfers of tendons and comisure opening had good result. In 17 children with politicization one patient had a necrosis, of the 16 remaining a good or acceptable result was obtained. Discussion. It is not easy to follow a good system of measure of the functional results. We find that a practical way to evaluate was the clip, opposition and aesthetics. Previous to the surgeries it is required to evaluate alterations

  14. The caring moment and the green-thumb phenomenon among Swedish nurses

    DEFF Research Database (Denmark)

    Jensen, Kirsten Pryds; Bäck-Pettersson, Siv; Segesten, K

    1993-01-01

    -exploratory design was used, and 16 nurses, recruited by their superiors, participated in semi-structured interviews. The findings revealed that the green-thumb nurse is competent, compassionate, and courageous. The essence of the caring moment was identified as the green-thumb nurse's ability to act on the spur......People who have a special gift for gardening are sometimes described as having a green thumb. Likewise, some nurses have a green thumb for nursing. The aims of this study were to identify and describe the characteristics of green-thumb nurses and of caring situations. A descriptive...... of the moment, using her competence, compassion, and courage...

  15. [Polypropylene-polyester prostheses. Experimental studies].

    Science.gov (United States)

    Staniszewska, J

    1980-01-01

    Polypropylene-polyester prostheses invented by the Research and Development Center of the Textile Industry in łódź are composed of two knitted polyester layers with perpendicular columns arrangement laminated by polypropylene. The prostheses were implanted in 10 pigs into the sternum and shoulder blade, the abdominal wall and peritoneal cavity. The autopsies of the animals were made 90 to 180 days after the operation. Both in bone and soft tissues, the prostheses healed up without local or general complications. The results obtained in surgical post-operative, macroscopic and microscopic examinations prove that the polypropylene-polyester prostheses fulfill the basic conditions for biomaterials. The different moulders of these materials may be used as temporary or permanent implants.

  16. The thumb carpometacarpal joint: curvature morphology of the articulating surfaces, mathematical description and mechanical functioning.

    Science.gov (United States)

    Dathe, Henning; Dumont, Clemens; Perplies, Rainer; Fanghänel, Jochen; Kubein-Meesenburg, Dietmar; Nägerl, Hans; Wachowski, Martin M

    2016-01-01

    The purpose is to present a mathematical model of the function of the thumb carpometacarpal joint (TCMCJ) based on measurements of human joints. In the TCMCJ both articulating surfaces are saddle-shaped. The aim was to geometrically survey the shapes of the articulating surfaces using precise replicas of 28 TCMCJs. None of these 56 articulating surfaces did mathematically extend the differential geometrical neighbourhood around the main saddle point so that each surface could be characterised by three main parameters: the two extreme radii of curvature in the main saddle point and the angle between the saddles' asymptotics (straight lines). The articulating surfaces, when contacting at the respective main saddle points, are incongruent. Hence, the TCMCJ has functionally five kinematical degrees of freedom (DOF); two DOF belong to flexion/extension, two to ab-/adduction. These four DOF are controlled by the muscular apparatus. The fifth DOF, axial rotation, cannot be adjusted but stabilized by the muscular apparatus so that physiologically under compressive load axial rotation does not exceed an angle of approximately ±3°. The TCMCJ can be stimulated by the muscular apparatus to circumduct. The mechanisms are traced back to the curvature incongruity of the saddle surfaces. Hence we mathematically proved that none of the individual saddle surfaces can be described by a quadratic saddle surface as is often assumed in literature. We derived an algebraic formula with which the articulating surfaces in the TCMCJ can be quantitatively described. This formula can be used to shape the articulating surfaces in physiologically equivalent TCMCJ-prostheses.

  17. NMR structure of the HIV-1 reverse transcriptase thumb subdomain

    Energy Technology Data Exchange (ETDEWEB)

    Sharaf, Naima G. [University of Pittsburgh, School of Medicine, Department of Structural Biology and Pittsburgh Center for HIV Protein Interactions (United States); Brereton, Andrew E. [Oregon State University, Department of Biochemistry and Biophysics, 2011 Ag & Life Sciences Bldg (United States); Byeon, In-Ja L. [University of Pittsburgh, School of Medicine, Department of Structural Biology and Pittsburgh Center for HIV Protein Interactions (United States); Andrew Karplus, P. [Oregon State University, Department of Biochemistry and Biophysics, 2011 Ag & Life Sciences Bldg (United States); Gronenborn, Angela M., E-mail: amg100@pitt.edu [University of Pittsburgh, School of Medicine, Department of Structural Biology and Pittsburgh Center for HIV Protein Interactions (United States)

    2016-12-15

    The solution NMR structure of the isolated thumb subdomain of HIV-1 reverse transcriptase (RT) has been determined. A detailed comparison of the current structure with dozens of the highest resolution crystal structures of this domain in the context of the full-length enzyme reveals that the overall structures are very similar, with only two regions exhibiting local conformational differences. The C-terminal capping pattern of the αH helix is subtly different, and the loop connecting the αI and αJ helices in the p51 chain of the full-length p51/p66 heterodimeric RT differs from our NMR structure due to unique packing interactions in mature RT. Overall, our data show that the thumb subdomain folds independently and essentially the same in isolation as in its natural structural context.

  18. NMR structure of the HIV-1 reverse transcriptase thumb subdomain

    International Nuclear Information System (INIS)

    Sharaf, Naima G.; Brereton, Andrew E.; Byeon, In-Ja L.; Andrew Karplus, P.; Gronenborn, Angela M.

    2016-01-01

    The solution NMR structure of the isolated thumb subdomain of HIV-1 reverse transcriptase (RT) has been determined. A detailed comparison of the current structure with dozens of the highest resolution crystal structures of this domain in the context of the full-length enzyme reveals that the overall structures are very similar, with only two regions exhibiting local conformational differences. The C-terminal capping pattern of the αH helix is subtly different, and the loop connecting the αI and αJ helices in the p51 chain of the full-length p51/p66 heterodimeric RT differs from our NMR structure due to unique packing interactions in mature RT. Overall, our data show that the thumb subdomain folds independently and essentially the same in isolation as in its natural structural context.

  19. Basal cell nevus syndrome

    Science.gov (United States)

    ... nevus syndrome Basal cell nevus syndrome - face References Evans DG, Farndon PA. Nevoid basal cell carcinoma syndrome. ... A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among ...

  20. 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.

  1. The effect of maintaining a constant preload or a constant degree of thumb abduction on the isometric twitch force of the thumb

    NARCIS (Netherlands)

    van Santen, G; Wierda, JMKH

    Objective. To investigate the effects of maintaining a constant preload and of maintaining a constant degree of thumb abduction on the isometric twitch force during mechanomyography of the thumb, we monitored neuromuscular function in patients anaesthetized without the use of a neuromuscular

  2. Macroscopic and Microscopic Analysis of the Thumb Carpometacarpal Ligaments

    Science.gov (United States)

    Ladd, Amy L.; Lee, Julia; Hagert, Elisabet

    2012-01-01

    Background: Stability and mobility represent the paradoxical demands of the human thumb carpometacarpal joint, yet the structural origin of each functional demand is poorly defined. As many as sixteen and as few as four ligaments have been described as primary stabilizers, but controversy exists as to which ligaments are most important. We hypothesized that a comparative macroscopic and microscopic analysis of the ligaments of the thumb carpometacarpal joint would further define their role in joint stability. Methods: Thirty cadaveric hands (ten fresh-frozen and twenty embalmed) from nineteen cadavers (eight female and eleven male; average age at the time of death, seventy-six years) were dissected, and the supporting ligaments of the thumb carpometacarpal joint were identified. Ligament width, length, and thickness were recorded for morphometric analysis and were compared with use of the Student t test. The dorsal and volar ligaments were excised from the fresh-frozen specimens and were stained with use of a triple-staining immunofluorescent technique and underwent semiquantitative analysis of sensory innervation; half of these specimens were additionally analyzed for histomorphometric data. Mixed-effects linear regression was used to estimate differences between ligaments. Results: Seven principal ligaments of the thumb carpometacarpal joint were identified: three dorsal deltoid-shaped ligaments (dorsal radial, dorsal central, posterior oblique), two volar ligaments (anterior oblique and ulnar collateral), and two ulnar ligaments (dorsal trapeziometacarpal and intermetacarpal). The dorsal ligaments were significantly thicker (p anterior oblique ligament (p anterior oblique ligament was consistently a thin structure with a histologic appearance of capsular tissue with low cellularity. Conclusions: The dorsal deltoid ligament complex is uniformly stout and robust; this ligament complex is the thickest morphometrically, has the highest cellularity histologically

  3. Injuries to the Collateral Ligaments of the Metacarpophalangeal Joint of the Thumb, Including Simultaneous Combined Thumb Ulnar and Radial Collateral Ligament Injuries, in National Football League Athletes.

    Science.gov (United States)

    Werner, Brian C; Belkin, Nicole S; Kennelly, Steve; Weiss, Leigh; Barnes, Ronnie P; Rodeo, Scott A; Warren, Russell F; Hotchkiss, Robert N

    2017-01-01

    Thumb collateral ligament injuries occur frequently in the National Football League (NFL). In the general population or in recreational athletes, pure metacarpophalangeal (MCP) abduction or adduction mechanisms yield isolated ulnar collateral ligament (UCL) and radial collateral ligament (RCL) tears, respectively, while NFL athletes may sustain combined mechanism injury patterns. To evaluate the incidence of simultaneous combined thumb UCL and RCL tears among all thumb MCP collateral ligament injuries in NFL athletes on a single team. Case series; Level of evidence, 4. A retrospective review of all thumb injuries on a single NFL team from 1991 to 2014 was performed. All players with a thumb MCP collateral ligament injury were included. Collateral ligament injuries were confirmed by review of both physical examination findings and magnetic resonance imaging. Player demographics, surgical details, and return-to-play data were obtained from the team electronic medical record and surgeons' records. A total of 36 thumbs in 32 NFL players were included in the study, yielding an incidence of 1.6 thumb MCP collateral ligament injuries per year on a single NFL team. Of these, 9 thumbs (25%) had a simultaneous combined UCL and RCL tear injury pattern confirmed on both physical examination and MRI. The remaining 27 thumbs (75%) were isolated UCL injuries. All combined UCL/RCL injuries required surgery due to dysfunction from instability; 63.0% of isolated UCL injuries required surgical repair ( P = .032) due to continued pain and dysfunction from instability. Repair, when required, was delayed until the end of the season. All players with combined UCL/RCL injuries and isolated UCL injuries returned to play professional football the following season. Simultaneous combined thumb UCL and RCL tear is a previously undescribed injury pattern that occurred in 25% of thumb MCP collateral ligament injuries on a single NFL team over a 23-year period. All players with combined thumb UCL

  4. Bilateral microvascular second toe transfer for bilateral post-traumatic thumb amputation

    Directory of Open Access Journals (Sweden)

    Rajendra Nehete

    2012-01-01

    Full Text Available In bilateral thumb amputations, the functional impairment is serious and every attempt should be made to reconstruct the thumb. We report a case of bilateral post traumatic thumb amputation, reconstructed with bilateral second toe transfer. Only two such cases have been reported in literature so far. Though there are various modalities for the reconstruction of thumb, microvascular toe transfer has its own merits. The convalescent period is minimal with excellent function. It is bilaterally symmetric and aesthetically superior to the osteoplastic reconstruction. The technical details are discussed, and the long term functional and aesthetic results are presented.

  5. [Modern types and usage of testicular prostheses].

    Science.gov (United States)

    Zieliński, Tomasz

    2010-10-01

    Agenesia or hypoplasia of testicle create not only physiological complications but also aesthetic and psychological problems. They can be effectively solved by implantation of testicular implants. Implantation of testicular prostheses was initiated in 40ies of XX century, and for years there has been search for the best material for their production. In the present paper we compared currently used testicles prostheses and controversies related to their usage. We discussed indications for the procedure and technical aspects. Particular attention was paid on complications of the procedure, methods to prevent them, and results of the treatment.

  6. 3D Printing Technology in Planning Thumb Reconstructions with Second Toe Transplant.

    Science.gov (United States)

    Zang, Cheng-Wu; Zhang, Jian-Lei; Meng, Ze-Zu; Liu, Lin-Feng; Zhang, Wen-Zhi; Chen, Yong-Xiang; Cong, Rui

    2017-05-01

    To report preoperative planning using 3D printing to plan thumb reconstructions with second toe transplant. Between December 2013 and October 2015, the thumbs of five patients with grade 3 thumb defects were reconstructed using a wrap-around flap and second toe transplant aided by 3D printing technology. CT scans of hands and feet were analyzed using Boholo surgical simulator software (www.boholo.com). This allowed for the creation of a mirror image of the healthy thumb using the uninjured thumb. Using 3D images of the reconstructed thumb, a model of the big toe and the second toe was created to understand the dimensions of the donor site. This model was also used to repair the donor site defect by designing appropriate iliac bone and superficial circumflex iliac artery flaps. The polylactic acid model of the donor toes and reconstructed thumb was produced using 3D printing. Surgically, the wrap-around flap of the first dorsal metatarsal artery and vein combined with the joint and bone of the second toe was based upon the model donor site. Sensation was reconstructed by anastomosing the dorsal nerve of the foot and the plantar digital nerve of the great toe. Patients commenced exercises 2 weeks after surgery. All reconstructed thumbs survived, although partial flap necrosis occurred in one case. This was managed with regular dressing changes. Patients were followed up for 3-15 months. The lengths of the reconstructed thumbs are 34-49 mm. The widths of the thumb nail beds are 16-19 mm, and the thickness of the digital pulp is 16-20 mm. The thumb opposition function was 0-1.5 cm; the extension angle was 5°-20° (mean, 16°), and the angle of flexion was 38°-55° (mean, 47°). Two-point discrimination was 9-11 mm (mean, 9.6 mm). The reconstructed thumbs had good appearance, function and sensation. Based on the criteria set forth by the Standard on Approval of Reconstructed Thumb and Finger Functional Assessment of the Chinese Medical Association, the results were

  7. The sensitivity of endpoint forces produced by the extrinsic muscles of the thumb to posture.

    Science.gov (United States)

    Goehler, Craig M; Murray, Wendy M

    2010-05-28

    This study utilizes a biomechanical model of the thumb to estimate the force produced at the thumb-tip by each of the four extrinsic muscles. We used the principle of virtual work to relate joint torques produced by a given muscle force to the resulting endpoint force and compared the results to two separate cadaveric studies. When we calculated thumb-tip forces using the muscle forces and thumb postures described in the experimental studies, we observed large errors. When relatively small deviations from experimentally reported thumb joint angles were allowed, errors in force direction decreased substantially. For example, when thumb posture was constrained to fall within +/-15 degrees of reported joint angles, simulated force directions fell within experimental variability in the proximal-palmar plane for all four muscles. Increasing the solution space from +/-1 degrees to an unbounded space produced a sigmoidal decrease in error in force direction. Changes in thumb posture remained consistent with a lateral pinch posture, and were generally consistent with each muscle's function. Altering thumb posture alters both the components of the Jacobian and muscle moment arms in a nonlinear fashion, yielding a nonlinear change in thumb-tip force relative to muscle force. These results explain experimental data that suggest endpoint force is a nonlinear function of muscle force for the thumb, support the continued use of methods that implement linear transformations between muscle force and thumb-tip force for a specific posture, and suggest the feasibility of accurate prediction of lateral pinch force in situations where joint angles can be measured accurately. Published by Elsevier Ltd.

  8. Microsurgical replantation of a small segment of thumb volar skin.

    Science.gov (United States)

    Akyürek, Mustafa; Safak, Tunç

    2004-06-01

    This report presents a case of microsurgical replantation of a volar skin segment of the thumb. In a 24-year-old patient, a heavy object falling over the dominant thumb resulted in a crush-avulsion injury of a pure skin segment measuring 4 x 2 cm. Examination revealed that the distal fingertip as well as the bone-tendon structures remained intact. Exploration demonstrated that both neurovascular bundles were included in the avulsed skin segment. Microsurgical replantation was achieved successfully, repairing the radial digital artery at both ends with vein grafts as well as anastomosing a palmar vein. Both digital nerves were coapted proximally and distally. An excellent functional and cosmetic result was accomplished with a good sensory recovery. The authors conclude that microsurgical replantation should be attempted in cases of more proximal pure skin avulsions, even if the injury spares distal fingertip tissue or bone-tendon units. In such cases, replantation is superior to any other method of reconstruction. Liberal use of vein grafts is crucial to achieve success.

  9. Failed total carpometacarpal joint prosthesis of the thumb

    DEFF Research Database (Denmark)

    Hansen, Torben Bæk; Homilius, Morten

    2010-01-01

    Total joint prosthesis in carpometacarpal joint arthritis of the thumb often fails. Loosening of the implant is often treated by resection arthroplasty, and we reviewed 10 patients, mean age 54 years (range 47-63) who were treated by resection arthroplasty after a failed total joint prosthesis. T...... in eight of 10 patients, but the mean Disabilities of the arm, shoulder, and hand (DASH) scores, self-reported pinch-grip-related function, and pain were comparable with our earlier published results with the Elektra carpometacarpal total joint prosthesis.......Total joint prosthesis in carpometacarpal joint arthritis of the thumb often fails. Loosening of the implant is often treated by resection arthroplasty, and we reviewed 10 patients, mean age 54 years (range 47-63) who were treated by resection arthroplasty after a failed total joint prosthesis....... The male:female ratio was 1:4 and the mean duration of observation 32 months (range 6-52). In three patients the revised implant was a MOJE uncemented carpometacarpal joint prosthesis and in seven patients an Elektra uncemented one. At follow-up grip strength was reduced to less than 90% of the other hand...

  10. Collagenase Treatment for Dupuytren Disease of the Thumb and First Web

    NARCIS (Netherlands)

    Dreise, Marieke M.; Stenekes, Martin W.; Werker, Paul M. N.

    Purpose To evaluate the short-term effectiveness of collagenase Clostridium histolyticum to treat thumb and first web contractures in Dupuytren disease. Methods We prospectively included 14 thumbs in 12 patients with a contracture at the metacarpophalangeal or interphalangeal joint of at least 20

  11. Surgical treatment for the thumb-in-palm deformity in patients with cerebral palsy

    NARCIS (Netherlands)

    Smeulders, M.; Coester, A.; Kreulen, M.

    2005-01-01

    BACKGROUND: Thumb-in-palm deformity in patients with spastic cerebral palsy is a deformity that impairs the ability to use the thumb and thus severely limits hand function. From the variety of operative procedures that have been described, it may be clear that there is no consensus on the surgical

  12. The gene for triphalangeal thumb maps to the subtelomeric region of chromosome 7q

    NARCIS (Netherlands)

    P. Heutink (Peter); J. Zguricas (Julia); L. van Oosterhout (L.); G.J. Breedveld (Guido); L. Testers; L.A. Sandkuijl (Lodewijk); P.J.L.M. Snijders (Pieter); J. Weissenbach (Jean); D. Lindhout (Dick); S.E.R. Hovius (Steven); B.A. Oostra (Ben)

    1994-01-01

    textabstractTriphalangeal thumb is a developmental anomaly, sometimes dominantly transmitted, characterized by a long, finger−like thumb with three phalanges instead of two. The underlying genetic defect is unknown, but presumably involves genes that regulate the differentiation of the developing

  13. Asking for 'rules of thumb': a way to discover tacit knowledge in general practice.

    Science.gov (United States)

    André, Malin; Borgquist, L; Foldevi, M; Mölstad, S

    2002-12-01

    Research in decision-making has identified heuristics (rules of thumb) as shortcuts to simplify search and choice. To find out if GPs recognize the use of rules of thumb and if they could describe what they looked like. An explorative and descriptive study was set up using focus group interviews. The interview guide contained the questions: Do you recognize the use of rules of thumb? Are you able to give some examples? What are the benefits and dangers in using rules of thumb? Where do they come from? The interviews were transcribed and analysed using the templates in the interview guide, and the examples of rules were classified by editing analysis. Four groups with 23 GPs were interviewed. GPs recognized using rules of thumb, producing examples covering different aspects of the consultation. The rules for somatic problems were formulated as axiomatic simplified medical knowledge and taken for granted, while rules for psychosocial problems were formulated as expressions of individual experience and were followed by an explanation. The rules seemed unaffected by the sparse objections given. A GP's clinical experience was judged a prerequisite for applying the rules. The origin of many rules was via word-of-mouth from a colleague. The GPs acknowledged the benefits of using the rules, thereby simplifying work. GPs recognize the use of rules of thumb as an immediate and semiconscious kind of knowledge that could be called tacit knowledge. Using rules of thumb might explain why practice remains unchanged although educational activities result in more elaborate knowledge.

  14. Thumb-pads up-a new species of thick-thumbed bat from Sumatra (Chiroptera: Vespertilionidae: Glischropus).

    Science.gov (United States)

    Csorba, Gábor; Görföl, Tamás; Wiantoro, Sigit; Kingston, Tigga; Bates, Paul J J; Huang, Joe Chun-Chia

    2015-06-29

    To date, three species of the genus Glischropus are recognized from the Indomalayan zoogeographic region-G. bucephalus from the Indochinese subregion, G. tylopus from the Sundaic subregion (Peninsular Thailand and Malaysia, Borneo, Sumatra, Moluccas) and G. javanus, restricted to Java. The investigation of the holotype and three topotype specimens of G. batjanus supported the view that the name was previously correctly regarded as the junior subjective synonym of G. tylopus. During review of material recently collected in southwestern Sumatra, Indonesia, one specimen of a yet undescribed species of Thick-thumbed bat was identified. G. aquilus n. sp. markedly differs from its congeners by its dark brown pelage, nearly black ear and tragus, and in skull proportions. The phylogenetic analysis based on cytb sequences also supports the specific distinctness of G. aquilus n. sp. Its discovery brings the count to 88 species of bats known from Sumatra.

  15. FEATURE EXTRACTION FOR EMG BASED PROSTHESES CONTROL

    Directory of Open Access Journals (Sweden)

    R. Aishwarya

    2013-01-01

    Full Text Available The control of prosthetic limb would be more effective if it is based on Surface Electromyogram (SEMG signals from remnant muscles. The analysis of SEMG signals depend on a number of factors, such as amplitude as well as time- and frequency-domain properties. Time series analysis using Auto Regressive (AR model and Mean frequency which is tolerant to white Gaussian noise are used as feature extraction techniques. EMG Histogram is used as another feature vector that was seen to give more distinct classification. The work was done with SEMG dataset obtained from the NINAPRO DATABASE, a resource for bio robotics community. Eight classes of hand movements hand open, hand close, Wrist extension, Wrist flexion, Pointing index, Ulnar deviation, Thumbs up, Thumb opposite to little finger are taken into consideration and feature vectors are extracted. The feature vectors can be given to an artificial neural network for further classification in controlling the prosthetic arm which is not dealt in this paper.

  16. The Pollexograph: a new device for palmar abduction measurements of the thumb.

    Science.gov (United States)

    de Kraker, M; Selles, R W; Schreuders, T A R; Hovius, S E R; Stam, H J

    2009-01-01

    Clinical measurement, cross sectional. To introduce a new measurement device, the Pollexograph, to easily measure palmar thumb abduction, and to compare its reliability with conventional goniometry. Fourteen hand therapists measured palmar abduction of the same healthy subject with the Pollexograph and a conventional goniometer. In addition, intrarater reliability of the Pollexograph was studied in 21 patients with a hypoplastic thumb. Variance between measurements of the same subject measured by the hand therapist was 2-6 times smaller with the Pollexograph compared to conventional goniometry. Pollexograph intrarater reliability in hypoplastic thumb patients was excellent (intraclass correlation coefficient (ICC)=0.98-0.99). A new tool to measure palmar abduction in clinical care, the Pollexograph, has been introduced. The Pollexograph reduces variability between raters when measuring the same subject compared with conventional goniometry and excellent measurement reliability in hypoplastic thumb patients. Not applicable.

  17. Simultaneous Bilateral Functional Radiography in Ulnar Collateral Ligament Lesion of the Thumb: An Original Technique.

    Science.gov (United States)

    Dominguez Gonzalez, Jose Javier; Zorrilla Ribot, Pedro; Perez Riverol, Elba Nieves; Martinez Rodriguez, Ana Sarai

    2015-08-01

    In any thumb injury, particularly one caused by hyperabduction, an ulnar collateral ligament lesion (gamekeeper's or skier's thumb) must be considered. If the diagnosis is suspected, and radiographs show no fracture, comparative radiographs should be obtained in forced valgus. This examination, which uses a stress test to cause joint tilt, is crucial in making an accurate diagnosis and deciding on the most appropriate therapeutic approach. The forced valgus maneuver typically is performed by the examiner, who must stay with the patient in the radiography room and wear radiologic protection. We report on a simple, reliable, reproducible method that allows the patient's thumbs to be compared, under the same force application conditions, on a single radiograph. This technique reduces the patient's and examiner's exposure to x-rays and is well tolerated by the patient. Anesthesia for the thumb is usually not necessary.

  18. [Digital artery bilobed flap for the treatment of skin degloving injury of thumb].

    Science.gov (United States)

    Zhang, Yang; Xin, Chang-Tai

    2014-04-01

    To explore clinical effects of digital artery bilobed flap for the treatment of skin degloving injury of thumb. From January 2007 to December 2012, 45 patients with skin degloving injury of thumb were treated with grafting of digital artery bilobed flap. There were 39 males and 6 females, ranging in age from 19 to 46 years, with an average of 32 years. The disease course ranged from 0.5 to 15 h. Eighteen patients suffered from defect of palmar skin above nail root and nail bed, 19 patients suffered from skin degloving injury of thumb phalangette, and 8 patients had whole skin degloving injury of thumb. The double lobe flaps were designed at the ulnar side of middle finger and the radial side of ring finger according to the defect of thumb skin. The arteria digitalis communis between the middle and ring fingers and its two branches of arteriae digitales propriae supplying the two fingers were used as a vessel pedicle. The flap with digitales proprii nervi was transposed and used to cover the exposed phalanx of thumb. Full thickness graft was used for the donor site. Observation of the appearance, texture, color and wear resistance of flap, appearance, color and depression of grafting area, skin feeling, and finger activities was conducted. All the flaps and grafts were alive. Forty-three patients were followed up with an average duration of 25 months, and two patients lost follow-up. The color and texture of the flaps were similar to that of the contralateral thumb pulp. The average two point discrimination was 4.2 +/- 0.3 mm. The color of graft skin was slightly deeper than that of the surroundings skin. Digital artery bilobed flap graft is an effective and ideal operation, which is of low risk and high success rates for skin degloving injury of thumb.

  19. Complete annular and partial oblique pulley release for pediatric locked trigger thumb.

    Science.gov (United States)

    Kuo, Meiying; Rayan, Ghazi M

    2010-12-01

    To report the surgical treatment outcome of pediatric locked trigger thumb by sequential release of the annular pulley and partial release of the oblique pulley. A retrospective review was undertaken on 28 operative thumbs in 24 patients with an average follow-up of 79 months. Intraoperative observations focused on the pathology of the pulley system. Surgical technique involved complete release of the annular pulley, which alone was insufficient in relieving the deformity, along with release of the proximal 50% of the oblique pulley in all patients. Postoperative parameters of bowstringing, resolution of Notta's node, thumb interphalangeal motion, and patient/parent satisfaction were assessed. The oblique pulley appeared stenotic, whereas the annular pulley was observed to be membranous and nearly indistinguishable from the tendon sheath. No patients had recurrence of thumb locking or triggering. No bowstringing was detected, and Notta's node resolved fully in 19 of 20 thumbs. Five thumbs had an average of 12(o) less active IP joint motion without flexion contracture (i.e., less flexion). All patients or families expressed overall satisfaction with the procedure. The annular pulley was attenuated in the majority of cases and the proximal half of the oblique pulley was stenotic in all patients. Releasing 50% of the oblique pulley after complete annular pulley release was necessary in all thumbs to achieve full FPL excursion. Mistaking the constricted proximal oblique pulley for an annular pulley may encourage releasing the entire oblique pulley, leading to an adverse result. Satisfactory outcome was achieved after surgical treatment of pediatric locked trigger thumbs. Therapeutic IV.

  20. Thumb Metacarpal Subsidence After Partial Trapeziectomy With Capsular Interposition Arthroplasty: A Biomechanical Study.

    Science.gov (United States)

    Salas, Christina; Mercer, Deana M; O'Mahony, Gavin; Love, James; LaBaze, Dukens; Moneim, Moheb S

    2016-12-01

    Background: In a cadaveric model, we evaluated thumb metacarpal subsidence, indicated by a decreased metacarpal-to-scaphoid distance, after 2 surgical procedures used to treat thumb carpometacarpal (CMC) osteoarthritis (OA): partial trapeziectomy with capsular interposition (PTCI), which involves removal of 2 mm of both the distal trapezium and base of the metacarpal; and total trapeziectomy with capsular interposition (TTCI). Methods: Nine matched pairs of cadaveric hands were randomly assigned to undergo either PTCI or TTCI. Preoperatively, physiologic forces were applied across the thumb CMC joint by loading 6 tendons, simulating lateral pinch. Anteroposterior radiographs were obtained, and the metacarpal-to-scaphoid distance on each image was estimated independently by 3 separate readers using customized software. A hand surgeon then performed the PTCI and TTCI procedures, and the measurements under loading were repeated. The results were assessed for interrater reliability. Mean values for metacarpal-to-scaphoid distance before and after the surgical procedures were compared. Results: Preoperatively, the metacarpal-to-scaphoid distance in the PTCI and TTCI groups was not significantly different. Postoperatively, metacarpal subsidence was significantly less in the PTCI group (17% compared with 34% for TTCI; P = .05). Conclusions: Metacarpal subsidence occurred after both PTCI and TTCI, but significantly less subsidence was observed after PTCI; thus, thumb length was better preserved. Previous research has shown an inverse correlation between maintenance of thumb length and overall Disabilities of the Arm, Shoulder, and Hand (DASH) score. A procedure for treating thumb CMC OA that preserves thumb length and minimizes disruption of stabilizing joint tissue may provide enhanced maintenance of thumb stability and improved patient outcomes.

  1. Fracture of the radial sesamoid bone of the thumb: an unusual fracture

    Directory of Open Access Journals (Sweden)

    Deabate Luca

    2012-02-01

    Full Text Available 【Abstract】The hand consists of five sesamoids. Two of them are present at the metacarpophalangeal (MCP joint of the thumb. Fracture of the sesamoid bones of the thumb is a rare injury and the literature on the radial side is seldom reported. We reported a case of a patient with a fracture of the radial sesamoid at the MCP joint of the thumb in order to increase attention regarding this type of injuries. A 44-year-old male, high level gymnastic trainer, was helping one of his athletes during an exercise while he reported a hyperextension trauma to the MCP joint of the right thumb. One week after trauma, he presented to the hand surgeon complaining of a painful thumb at the MCP joint level on its palmar aspect. Standard A-P and lateral X-rays revealed a fracture of the radial sesamoid and the fracture was treated with a splint for 3 weeks. He was able to resumed his entire work 6 weeks after the injury. The sesamoid fractures is an indicator of the magnitude of the hyperextension injury and sometimes associated with tears of the volar plate ligament of the MCP joint. And a failure to recognize the ligament injury may lead to a long-term hyperextension instability on pinching. Key words: Fracture, bone; Sesamoid bones; Thumb

  2. Accuracy and feasibility of using an electrogoniometer for measuring simple thumb movements.

    Science.gov (United States)

    Jonsson, Per; Johnson, Peter W; Hagberg, Mats

    2007-05-01

    The aim of this study was to determine the accuracy and feasibility of using an electrogoniometer (Model SG 110; Biometrics, Gwent, UK) for measuring simple thumb movements. Thumb disorders have been associated with the use of hand held devices such as mobile phones and these devices have become an integral part of modern life. In 15 young subjects, the measurements of eight flexion/extension (Flex/Ext) and adduction/abduction (Ad/Ab) thumb positions were compared between a thumb-mounted electrogoniometer and manual goniometer (which was taken as the benchmark). Group mean electrogoniometric measurement errors were below 4 degrees and 5 degrees for Ad/Ab and Flex/Ext measurements, respectively. During mobile phone use, the electrogoniometers measured differences in maximal joint angle postures, which appeared to be related to differences in mobile phone size. High movement velocities may increase the risk of musculoskeletal injury and the results indicated that Ad/Ab movements were twice the speed of Flex/Ext movements during mobile phone use. Electrogoniometers have utility for studying thumb movements during mobile phone use and may be used to evaluate other thumb-based input devices.

  3. Influence of thumb sucking on peer social acceptance in first-grade children.

    Science.gov (United States)

    Friman, P C; McPherson, K M; Warzak, W J; Evans, J

    1993-04-01

    Chronic thumb sucking in school-age children may reduce peer social acceptance, an important contributor to social development. The influence of thumb sucking on social acceptance was assessed among 40 first-grade children, who were shown four slides of two 7-year-old children (one boy, one girl) in two poses (one thumb sucking, one not). After viewing each slide in their classrooms, the children answered 10 numerically weighted questions related to peer acceptance. To limit the possibility that the children would determine the girl and boy were the same in each pose, the slide presentation was counterbalanced across two sessions 1 week apart. Using a repeated-measures analysis of variance, the authors compared composite scores on each question for both poses. The results indicate that while in the thumb-sucking pose, the children were rated as significantly less intelligent, happy, attractive, likeable, and fun and less desirable as a friend, playmate, seatmate, classmate, and neighbor than when they were in the non-thumb-sucking pose. These findings suggest that the risk of reduced social acceptance should be added to the list of potentially harmful effects of chronic thumb sucking in school-age children.

  4. SPONGE ROBOTIC HAND DESIGN FOR PROSTHESES

    OpenAIRE

    Mine Seçkin

    2016-01-01

    In this study robotic hands and fingers’ materials are investigated from past to present and a sponge robotic hand is designed for biomedical applications. Emergence and necessity of soft robotic technology are explained and description of soft robot is made. Because of the importance of hand in a person’s body, researchers have dealt with robotic hand prostheses for many centuries and developed many hand types. To mimic the best for the human limbs, softness of the hand is one of the importa...

  5. Stimulation and recording electrodes for neural prostheses

    CERN Document Server

    Pour Aryan, Naser; Rothermel, Albrecht

    2015-01-01

    This book provides readers with basic principles of the electrochemistry of the electrodes used in modern, implantable neural prostheses. The authors discuss the boundaries and conditions in which the electrodes continue to function properly for long time spans, which are required when designing neural stimulator devices for long-term in vivo applications. Two kinds of electrode materials, titanium nitride and iridium are discussed extensively, both qualitatively and quantitatively. The influence of the counter electrode on the safety margins and electrode lifetime in a two electrode system is explained. Electrode modeling is handled in a final chapter.

  6. Oral cavity anaerobic pathogens in biofilm formation on voice prostheses

    NARCIS (Netherlands)

    Bertl, Kristina; Zijnge, Vincent; Zatorska, Beata; Leonhard, Matthias; Schneider-Stickler, Berit; Harmsen, Hermie J. M.

    BACKGROUND: A polymerase chain reaction (PCR)-based method has been used to identify oral anaerobic pathogens in biofilms on voice prostheses. The purpose of the present study was to determine the location of those pathogens inside the biofilms. METHODS: Biofilms of 15 voice prostheses were sampled

  7. Lactobacilli : Important in biofilm formation on voice prostheses

    NARCIS (Netherlands)

    Buijssen, Kevin J. D. A.; Harmsen, Hermie J. M.; van der Mei, Henny C.; Busscher, Henk J.; van der Laan, Bernard F. A. M.

    OBJECTIVE: We sought to identify bacterial strains responsible for biofilm formation on silicone rubber voice prostheses. STUDY DESIGN: We conducted an analysis of the bacterial population in biofilms on used silicone rubber voice prostheses by using new microbiological methods. METHODS: Two

  8. Basal cell carcinoma

    International Nuclear Information System (INIS)

    Baruah, J.D.

    1981-01-01

    Seven cases of basal cell carcinoma are reported in this paper. The incidence of this disease is two percent of all malignancies seen at the Miraj Medical Centre, Miraj, Maharashtra. There were five male and two female patients in this series. The youngest patient was 40 years old and the oldest 70 years. The average age of the patients was 57.3 years. All the cases in the series had lesions confined to the head and neck region. Radiation therapy was given to all the seven cases which was the primary form of treatment in five cases. In two cases surgical excision had been done and the growth in both the cases had recurred. Radiation therapy is considered more ideal and suitable in the treatment of basal cell carcinomas. (auth.)

  9. [Definition and classification of basal joint osteoarthritis. A critical analysis and proposals. Treatment options].

    Science.gov (United States)

    Comtet, J J; Gazarian, A; Fockens, W

    2001-02-01

    Several definitions and classifications of basal joint osteoarthritis exist. Each of them can be criticized. The authors propose to define basal thumb osteoarthritis as osteoarthritis of the trapezometacarpal joint associated or not with lesions of scapho-trapezio-trapezoid and/or metacarpophalangeal joints. The proposed classification is derived from the Eaton-Littler classification. Stage O is identical to stage I of the Eaton-Littler classification: trapeziometacarpal instability without cartilage lesions. Stage I is osteoarthritis of the trapeziometacarpal joint only, without metacarpophalangeal deformity. Stage II is trapeziometacarpal osteoarthrites combined with reductible hyperextension deformity of the metacarpophalangeal joint. Stage III is trapeziometacarpal osteoarthrites combined with irreductible metacarpophalangeal deformity. Stage IV is identical to stage IV of the Eaton-Littler classification: combined trapeziometacarpal and scapho-trapezio-trapezoid osteoarthritis. The advantage of the proposed classification is that basal joint osteoarthritis is not only defined as real or potential (stage O) osteoarthritis of the trapeziometacarpal joint, but also includes precise evaluation of two other joints at the base of the thumb. This classification can be a guide for treatment options.

  10. [Abdominal wall prostheses. Biomechanic and histological study].

    Science.gov (United States)

    Rath, A M; Zhang, J; Amouroux, J; Chevrel, J P

    1996-01-01

    The best prosthetic material is one which provides the best mechanical resistance with the best biological tolerance. In order to assess the mechanical and histological properties of abdominal wall prostheses, we performed experimental tests in animal models comparing four materials: polypropylene, dacron, polyglactine 910 and a dacron-polyglactine 910 composite. One hundred thirty rabbits were used including 10 controls and 120 test animals. A medial laparotomy was closed with an antemuscular aponevrotic prosthesis in the test animals. Animals were sacrificed at one, two and three months after the operation. Abdominal wall and prosthesis samples were tested to determine resistance to pressure and extension, deformability and elasticity. Histology tests were also done to determine resistance quality and biological tolerance. Dacron was tolerated best and was less resistant than polypropylene, though resistance was satisfactory. There was no advantage with polyglactine compared with non-resorbable prostheses; its only indication would be a septic site. The composite material tested had a resistance comparable with that of dacron but was less well tolerated.

  11. Radiological and scintigraphic evaluation of hip prostheses

    International Nuclear Information System (INIS)

    Bessler, W.; Schaub, W.

    1979-01-01

    The radiological findings following the introduction of hip prostheses are often equivocal. Additional bone scintigrams often provide important information for the evaluation of the prostheses. 1. An unstable hip prosthesis is characterised by abnormal uptake in bone, due to static and mechanical stress. 2. A positive scintigram does not necessarily indicate instability of the prosthesis. Increased uptake may also be due to inflammatory bone changes, healing, bone replacement, abnormal local stresses or soft tissue calcification. 3. In evaluating the scintigram one must take account not only of the intensity of isotope uptake, but also its distribution and exact localisation. 4. It is essential to compare the scintigram with the radiograph. Radiological features of possible instability become diagnostic if they correspond with appropriate increased radioactivity. If the latter is absent, the of instability remains doubtful. 5. In some cases early loosening of the stem of the prosthesis can be diagnosed while the radiograph is still negative. Increased radioactivity in the acetabulum is frequently seen in the presence of a stable acetabular prosthesis and must be interpreted with caution as a sign of loosening of the prosthesis. (orig.) [de

  12. [Understanding the elderly user of auditory prostheses].

    Science.gov (United States)

    de Paiva, Karina Mary; Maciel, Paulete Maria Ambrósio; Cintra, Letícia Guedes

    2011-06-01

    The main goal was to identify the factors involved in the application for and use of auditory prostheses by the elderly as well as their awareness of the Policy of Care to Auditory Health. 25 elderly people of both sexes using auditory prostheses in Vitória (Espírito Santo, Brazil) were selected. They were contacted by telephone to participate in the research by answering a questionnaire. The results demonstrated that most of the elderly people interviewed (52%) use the device all day which suggests good adaptation to the process. Thirteen elderly people reported that they contacted the prosthesis company of their own accord. The advantages involved better communication and listening to TV (64%) while the difficulties were due to noisy environments; 56% were unable to understand what was being said at lectures, in church, and on the telephone, 72% reported no improvement with the prosthesis. 88% of the elderly participants are unaware of donation policies for auditory devices and 100% are unaware of this kind of service. Research and practices in health services about auditory issues still have far to go. There is a need for a change in management with the objective of putting into action policies which define the responsibilities of the State.

  13. Future of newer basal insulin

    OpenAIRE

    Madhu, S. V.; Velmurugan, M.

    2013-01-01

    Basal insulin have been developed over the years. In recent times newer analogues have been added to the armanentarium for diabetes therapy. This review specifically reviews the current status of different basal insulins

  14. Thumb Reach of Indonesian Young Adult When Interacting with Touchscreen of Single-Handed Device: A Preliminary Study

    Science.gov (United States)

    Umami, M. K.

    2018-01-01

    This study is a preliminary survey on thumb reach of Indonesian population when interacting with single-handed device. This study was aimed to know the thumb reach envelope on the screen of mobile phone. The correlation between the thumb reach vs. the hand length and thumb length was also identified. Thirty young adults participated in the study. All participants had normal body stature and were right-handed person. In the observational phase, the participant was asked to colour the canvas area on the screen of the mobile phone by using his/her thumb. The participant had to complete the task by applying the single hand interaction. The participant should grab the mobile phone as he/she use it normally in his/her daily activities. The thumb reach envelope of participants was identified from the coloured area of the canvas. The results of this study found that participants with a large hand length and thumb length tend to have a large thumb reach. The results of this study also show the thumb reach area of the participants is forming an elliptical shape that runs from the northeast to southwest on the device screen.

  15. The comparison between the length of vertical dimension of occlusion and the length of thumb on undergraduate Mongoloid students

    Directory of Open Access Journals (Sweden)

    Goh Li Teng

    2011-03-01

    Full Text Available The Thumb Rule of Leonardo da Vinci states that many proportions of the face show relationship with the length of thumb which is measured from the proximal tip of the proximal phalanx to the distal tip of the distal phalanx. Previous studies have shown that the length of the vertical dimension of occlusion (VDO is similar to the length of thumb of the Caucasoid race. The purpose of this study is to determine whether the length of VDO have correlations with the length of thumb among those of the Mongoloid race. This study took a survey method with the analytical cross-sectional approach. A total of 80 students of Faculty of Dentistry who have fulfilled all population criteria were randomly chosen to measure the length of VDO and the length of the thumb. Results analyzed with Student's t-test statistic revealed that there was a significant difference between males and females in the length of VDO and the length of the thumb, however, there was no significant difference between the length of VDO and the length of the thumb. There were very strong correlations (P<0.05 between the length of VDO and the length of the thumb. As a conclusion, the length of thumb can be suggested as an objective method to determine the length of VDO in this population.

  16. Involuntary Neuromuscular Coupling between the Thumb and Finger of Stroke Survivors during Dynamic Movement

    Directory of Open Access Journals (Sweden)

    Christopher L. Jones

    2018-03-01

    Full Text Available Finger–thumb coordination is crucial to manual dexterity but remains incompletely understood, particularly following neurological injury such as stroke. While being controlled independently, the index finger and thumb especially must work in concert to perform a variety of tasks requiring lateral or palmar pinch. The impact of stroke on this functionally critical sensorimotor control during dynamic tasks has been largely unexplored. In this study, we explored finger–thumb coupling during close–open pinching motions in stroke survivors with chronic hemiparesis. Two types of perturbations were applied randomly to the index with a novel Cable-Actuated Finger Exoskeleton: a sudden joint acceleration stretching muscle groups of the index finger and a sudden increase in impedance in selected index finger joint(s. Electromyographic signals for specific thumb and index finger muscles, thumb tip trajectory, and index finger joint angles were recorded during each trial. Joint angle perturbations invoked reflex responses in the flexor digitorum superficialis (FDS, first dorsal interossei (FDI, and extensor digitorum communis muscles of the index finger and heteronymous reflex responses in flexor pollicis brevis of the thumb (p < 0.017. Phase of movement played a role as a faster peak reflex response was observed in FDI during opening than during closing (p < 0.002 and direction of perturbations resulted in shorter reflex times for FDS and FDI (p < 0.012 for extension perturbations. Surprisingly, when index finger joint impedance was suddenly increased, thumb tip movement was substantially increased, from 2 to 10 cm (p < 0.001. A greater effect was seen during the opening phase (p < 0.044. Thus, involuntary finger–thumb coupling was present during dynamic movement, with perturbation of the index finger impacting thumb activity. The degree of coupling modulated with the phase of motion. These findings reveal a potential

  17. Isolated flexor pollicis longus nerve fascicle lesion – a rare differential diagnosis of thumb flexion deficiency

    Directory of Open Access Journals (Sweden)

    Glauser, Eva

    2016-12-01

    Full Text Available A rare differential diagnosis of thumb flexion deficiency is an isolated flexor pollicis longus (FPL nerve fascicle lesion. We present a 42-year-old otherwise healthy female patient who developed a weak thumb-to-index pinch and deficient right thumb flexion following the removal of osteosynthesis plates after a forearm fracture. Clinically,the flexor pollicis longus function was absent, yet index flexion and sensibility were unimpaired. Tendon rupture was excluded using a tenodesis test and the electro-physiological result of isolated interosseus nerve fascicle lesion was confirmed intraoperatively by inspection and electrostimulation. Tendon transfer using the extensor carpi radialis longus reconstruct strong thumb flexion during pinch. In summary, due to its specific location and anatomy, the FPL branch is more prone to isolated neuropathy, e.g. by injections or operations, than to other fascicles of the anterior interosseus nerve. When confronted with sudden and isolated thumb flexion deficiency, specialists should be aware of this rare phenomenon.

  18. Basal Cell Carcinoma

    OpenAIRE

    Seum Chung

    2012-01-01

    Basal cell carcinoma (BCC) is the most common form of skin cancer, predominantly affecting the head and neck, and can be diagnosed clinically in most cases. Metastasis of BCC is rare, but localised tissue invasion and destruction can lead to morbidity.Risk factors for BCC include tendency to freckle, degree of sun exposure, excessive sun-bed use, and smoking.Incidence of BCC increases markedly after the age of 40 years, but incidence in younger people is rising, possibly as a result of inc...

  19. Perianal Basal Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Isil Bulur

    2015-02-01

    Full Text Available Basal cell carcinoma (BCC is the most common non-melanoma skin cancer. Exposure to ultraviolet light is an important risk factor for BCC development and the disorder therefore develops commonly on body areas that are more exposed to sunlight, such as the face and neck. It is uncommon in the closed area of the body and quite rare in the perianal and genital regions. Herein, we report a 34-year-old patient with perianal BCC who had no additional risk factors.

  20. Basal Cell Carcinoma of the Dorsal Hand: An Update and Comprehensive Review of the Literature.

    Science.gov (United States)

    Loh, Tiffany Y; Rubin, Ashley G; Brian Jiang, Shang I

    2016-04-01

    Excessive ultraviolet radiation (UVR) exposure is the primary predisposing factor for basal cell carcinoma (BCC). However, surprisingly, BCCs occur very rarely on the dorsal hand, which is subject to intense sun exposure, and their infrequent presentation in this location suggests that other factors besides UVR may play a role in BCC pathogenesis. Because dorsal hand BCCs are uncommon, knowledge of their characteristics is limited, and more data are needed to describe their clinical presentation and treatment. To perform an updated review of the literature on the management of dorsal hand BCCs. The authors conducted a comprehensive literature review by searching the PubMed database with the key phrases "basal cell carcinoma dorsal hand," "basal cell carcinoma hand," and "basal cell carcinoma finger," and "basal cell carcinoma thumb." The authors identified 176 cases of dorsal hand BCCs in the literature, 120 of which had sufficient data for analysis. Only 4 cases were treated with Mohs micrographic surgery (MMS). The authors present 14 additional cases of dorsal hand BCCs treated with MMS. Basal cell carcinomas on the dorsal hand occur infrequently, and potential risk factors include being a male of white descent and personal history of skin cancer. Mohs micrographic surgery seems to be an effective treatment method.

  1. Basal cell carcinoma: pathophysiology.

    Science.gov (United States)

    Sehgal, Virendra N; Chatterjee, Kingshuk; Pandhi, Deepika; Khurana, Ananta

    2014-01-01

    Basal cell carcinoma (BCC) is the most common skin cancer in humans, which typically appears over the sun-exposed skin as a slow-growing, locally invasive lesion that rarely metastasizes. Although the exact etiology of BCC is unknown, there exists a well-established relationship between BCC and the pilo-sebaceous unit, and it is currently thought to originate from pluri-potential cells in the basal layer of the epidermis or the follicle. The patched/hedgehog intracellular signaling pathway plays a central role in both sporadic BCCs and nevoid BCC syndrome (Gorlin syndrome). This pathway is vital for the regulation of cell growth, and differentiation and loss of inhibition of this pathway is associated with development of BCC. The sonic hedgehog protein is the most relevant to BCC; nevertheless, the Patched (PTCH) protein is the ligand-binding component of the hedgehog receptor complex in the cell membrane. The other protein member of the receptor complex, smoothened (SMO), is responsible for transducing hedgehog signaling to downstream genes, leading to abnormal cell proliferation. The importance of this pathway is highlighted by the successful use in advanced forms of BCC of vismodegib, a Food and Drug Administration-approved drug, that selectively inhibits SMO. The UV-specific nucleotide changes in the tumor suppressor genes, TP53 and PTCH, have also been implicated in the development of BCC.

  2. Tribology of total hip arthroplasty prostheses

    Science.gov (United States)

    Rieker, Claude B.

    2016-01-01

    Articulating components should minimise the generation of wear particles in order to optimize long-term survival of the prosthesis. A good understanding of tribological properties helps the orthopaedic surgeon to choose the most suitable bearing for each individual patient. Conventional and highly cross-linked polyethylene articulating either with metal or ceramic, ceramic-on-ceramic and metal-on-metal are the most commonly used bearing combinations. All combinations of bearing surface have their advantages and disadvantages. An appraisal of the individual patient’s objectives should be part of the assessment of the best bearing surface. Cite this article: Rieker CB. Tribology of total hip arthroplasty prostheses: what an orthopaedic surgeon should know. EFORT Open Rev 2016;1:52-57. DOI: 10.1302/2058-5241.1.000004. PMID:28461928

  3. The two-thumb technique using an elevated surface is preferable for teaching infant cardiopulmonary resuscitation.

    Science.gov (United States)

    Huynh, Trang K; Hemway, Rae Jean; Perlman, Jeffrey M

    2012-10-01

    To determine whether the two-thumb technique is superior to the two-finger technique for administering chest compressions using the floor surface and the preferred location for performing infant cardiopulmonary resuscitation (CPR) (ie, floor, table, or radiant warmer). Twenty Neonatal Resuscitation Program trained medical personnel performed CPR on a neonatal manikin utilizing the two-thumb vs two-finger technique, a compression to ventilation ratio of 30:2 for 2 minutes in random order on the floor, table, and radiant warmer. Compression depth favored the two-thumb over two-finger technique on the floor (27 ± 8 mm vs 23 ± 7), table (26 ± 7 mm vs 22 ± 7), and radiant warmer (29 ± 4 mm vs 23 ± 4) (all P CPR preferably using an elevated firm surface. Copyright © 2012 Mosby, Inc. All rights reserved.

  4. A Population-Based Study of Replantation After Traumatic Thumb Amputation, 2007-2012.

    Science.gov (United States)

    Mahmoudi, Elham; Huetteman, Helen E; Chung, Kevin C

    2017-01-01

    The recommended surgical treatment after thumb amputation is replantation. In the United States, fewer than 40% of thumb amputation injuries are replanted, and little is known about factors associated with the probability of replantation. We aimed to investigate recent trends and examine patient and hospital characteristics that are associated with increased probability of attempted thumb replantation. We hypothesized that higher-volume teaching hospitals and level-I trauma centers attempted more replantations. We used 2007-2012 data from the National Trauma Data Bank. Our final sample included 2,206 traumatic thumb amputation patients treated in 1 of 365 centers during the study period. First, we used a 2-level hierarchical logistic model to estimate the odds of replantation. In addition, we used a treatment effect estimation method, with the inverse propensity score weighting to examine the difference in thumb replantation if the only variation among patients was their presumptive payer. There was a higher probability of attempted replantation at teaching hospitals than nonteaching hospitals (odds ratio [OR], 1.40). Patients were less likely to undergo replantation at a level II (OR, 0.53) or a level III (OR, 0.33) trauma center. The uninsured were less likely to undergo replantation (OR, 0.61) than those with private insurance. Having insurance coverage and being treated in a high-volume, teaching, level-I trauma hospital increased the odds of replantation after traumatic thumb amputation. Regionalization may lead to a higher number of indicated cases of replantation actually being attempted. Therapeutic II. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  5. Transverse anatomic landmarks for the A1 pulley of the thumb.

    Science.gov (United States)

    Hazani, Ron; Elston, Josh; Wilhelmi, Bradon J

    2011-12-01

    Triggering of the thumb is a common entity resulting in pain and disability. Operative management requires accurate knowledge of the pulley system for proper release of the A1 pulley. The purpose of this study was to predict the location of the A1 pulley with surface anatomic landmarks while avoiding injury to the neurovascular bundles and the critical oblique pulley. Thirteen fresh cadaveric thumbs were dissected while the volar digital creases of the thumb served as our potential anatomic landmarks for the A1 pulley. These included the distal crease and the two identifiable proximal creases. Measurements from the proximal edge of the A1 pulley to the surface landmarks were obtained. The pulley system was also inspected for variability, and the length of the A1 pulley was measured. Of the three volar creases in the thumb, the proximal-proximal crease (PPC) corresponded anatomically to the A1 pulley and demonstrated minimal variability compared to the other landmarks. It measured 0.10 ± 0.15 cm distal to the proximal edge of the A1 pulley. The average length of the thumb A1 pulley measured 0.61 ± 0.17 cm. Therefore, the distal edge of the A1 pulley is predicted to be located 0.51 cm distal to the PPC. Hand surface landmarks can be used reliably to predict the location of the thumb A1 pulley, thus avoiding injury to adjacent structures such as the critical oblique pulley.

  6. Performance and Return to Sport After Thumb Ulnar Collateral Ligament Surgery in National Football League Players.

    Science.gov (United States)

    Sochacki, Kyle R; Jack, Robert A; Nauert, Richard; Liberman, Shari R; McCulloch, Patrick C; Lintner, David M; Harris, Joshua D

    2018-02-01

    Acute ruptures of the ulnar collateral ligament (UCL) of the thumb are common injuries in sports. Surgical repair of complete tears has yielded excellent results in elite athletes. National Football League (NFL) players who underwent thumb UCL surgery and matched controls were identified. Demographic and performance data were collected. Performance scores were calculated using a standardized scoring system. Return to sport (RTS) in the NFL was defined as playing in at least 1 NFL game after thumb UCL surgery. Comparisons between case and control groups and preoperative and postoperative time points were made using paired-samples Student t tests. Twenty-three players were identified (mean age: 28.8 ± 3.4 years and mean experience in the NFL: 5.9 ± 3.4 years). Twenty-two players (95.7%) were able to return to sport in the NFL at an average of 132.2 ± 126.1 days. The overall 1-year NFL career survival rate of players undergoing thumb UCL surgery was 87.0%. There was not a statistically significant decrease in games per season and career length for any position following surgery. No positions had a significant difference in postoperative performance when compared with preoperative performance, and there was no significant performance difference postoperatively when compared with matched controls. There is a high rate of RTS in the NFL following thumb UCL surgery. Players who underwent thumb UCL surgery played in a similar number of games per season and had similar career lengths in the NFL as controls. No position group had any significant postoperative performance score differences when compared with postindex matched controls.

  7. Fabrication techniques for ocular prostheses--an overview.

    Science.gov (United States)

    Goiato, Marcelo Coelho; Bannwart, Lisiane Cristina; Haddad, Marcela Filié; dos Santos, Daniela Micheline; Pesqueira, Aldiéris Alves; Miyahara, Glauco Issamu

    2014-06-01

    The goals of treatment with ocular prostheses are to restore facial aesthetics and self-esteem to anophthalmic patients. Fabricated in acrylic resin, artificial eyes should be aesthetically pleasing, scratch-resistant, and adequately polished. Use of a prosthesis without such characteristics can lead to psychological damage, as well as infection and inflammation due to the accumulation of microorganisms and other substances on an irregularly shaped prosthesis. The present literature review describes the different techniques for fabricating ocular prostheses. Reproduction of the iris color and color stability are important factors that promote adequate aesthetics. The fabrication of an individual ocular prosthesis in acrylic resin provides satisfactory aesthetic results because the impression process establishes the defect contour. Additionally, the iris and sclera can be individually characterized. As the techniques, materials, and manufacturing methods for ocular prostheses continue to evolve, the aesthetics and functionality of prostheses will also improve.

  8. Candida albicans in patients with oronasal communication and obturator prostheses

    OpenAIRE

    MATTOS, Beatriz Silva Câmara; SOUSA, Andréa Alves de; MAGALHÃES, Marina Helena C. G. de; ANDRÉ, Marcia; BRITO E DIAS, Reinaldo

    2009-01-01

    Patients using obturator prostheses often present denture-induced stomatitis. In order to detect the presence of oral Candida albicans in patients with oronasal communications and to evaluate the effectiveness of a topical antifungal treatment, cytological smears obtained from the buccal and palatal mucosa of 10 adult patients, and from the nasal acrylic surface of their obturator prostheses were examined. A therapeutic protocol comprising the use of oral nystatin (Mycostatin®) and prosthesis...

  9. Testicular prostheses in children: Is earlier better?

    Science.gov (United States)

    Peycelon, M; Rossignol, G; Muller, C O; Carricaburu, E; Philippe-Chomette, P; Paye-Jaouen, A; El Ghoneimi, A

    2016-08-01

    The absence of a testis occurs for various reasons in children, but testicular prosthesis implantation in children is uncommon. The optimal time for prosthesis placement is still unclear, and its complication rate has been poorly studied in children. The aim of this study was to determine the risk factors of complications in cases of testicular prosthesis implantation in children. A monocentric, retrospective review was performed of children implanted with a testicular prosthesis between 2008 and 2014. All implantations were performed through an inguinal incision with a standardized procedure. Children were divided into two groups depending on the interval after orchiectomy: (A) early implantation (delay between surgeries prosthesis implantation at the mean age of 14.7 years (range 9-18) (A, 14.3; B, 14.6) with a mean delay of 36.1 months (A, 1.3; B, 80.3). Indications were mainly spermatic cord torsion (27%), bilateral anorchia (27%), and testicular atrophy after cryptorchidism surgery (19.2%). Complications (10.5%) included two cases of extrusion, one infection and one migration. Patient 1 had a history of acute lymphoblastic leukemia with testicle relapse 2 years after induction therapy. High-dose chemotherapy, total body irradiation and bilateral orchiectomies were performed, and bilateral prostheses were implanted 12 years after the end of chemotherapy. Complications happened 85 days after surgery. Patient 2 was followed-up for a proximal hypospadias. The tunica vaginalis flap, which was used during a redo urethroplasty, lead to testicular atrophy. Thirteen years after the last penile surgery, a testicular prosthesis was placed through an inguinal incision, and extrusion occurred 203 days after surgery. Bacterial cultures of the prostheses were sterile and histological review showed no sign of granuloma or graft rejection. The complication rate was significantly higher if the delay between the two surgeries exceeded 1 year (P = 0.01). Indications of

  10. A Study of Thumb Print Patterns and ABO Blood Group Distribution ...

    African Journals Online (AJOL)

    The aim of this study was to establish a possible relationship between thumb print pattern and ABO blood group distribution. The study involves two hundred and nine-two volunteers comprising 159 female and 133 male. The blood group and finger print patterns were determined using standard techniques. Results ...

  11. Partial trapeziectomy and interposition of fascia lata allograft in the operative treatment of thumb base osteoarthritis

    NARCIS (Netherlands)

    Spaans, Anne J.; Weijns, Marieke E.; Braakenburg, Assa; Van Minnen, Leo Paul; Mink Van Der Molen, Aebele B.

    2016-01-01

    Aim: The purpose of this retrospective cohort study was to evaluate the results of fascia lata allograft interposition after partial trapeziectomy in patients with symptomatic first carpometacarpal joint osteoarthritis. Methods and results: Twenty-one patients (22 thumbs) with Eaton-Glickel stage II

  12. The Effect of an Open Carpal Tunnel Release on Thumb CMC Biomechanics

    Directory of Open Access Journals (Sweden)

    Marc A. Tanner

    2012-01-01

    Full Text Available Purpose. We have observed worsening thumb pain following carpal tunnel release (CTR in some patients. Our purpose was to determine the effect of open CTR on thumb carpometacarpal (CMC biomechanics. Methods. Five fresh-frozen cadaver arms with intact soft tissues were used. Each specimen was secured to a jig which fixed the forearm at 45° supination, and the wrist at 20° dorsiflexion, with thumb pointing up. The thumb was axially loaded with a force of 130 N. We measured 3D translation and rotation of the trapezium, radius, and first metacarpal, before and after open CTR. Motion between radius and first metacarpal, radius and trapezium, and first metacarpal and trapezium during loading was calculated using rigid body mechanics. Overall stiffness of each specimen was determined. Results. Total construct stiffness following CTR was reduced in all specimens but not significantly. No significant changes were found in adduction, pronation, or dorsiflexion of the trapezium with respect to radius after open CTR. Motion between radius and first metacarpal, between radius and trapezium, or between first metacarpal and trapezium after open CTR was not decreased significantly. Conclusion. From this data, we cannot determine if releasing the transverse carpal ligament alters kinematics of the CMC joint.

  13. Weilby-Burton arthroplasty of the trapeziometacarpal joint of the thumb

    DEFF Research Database (Denmark)

    Thomsen, N O; Jensen, Claus Hjorth; Nygaard, H

    2000-01-01

    Twenty-three patients (25 thumbs) were treated by tendon interposition arthroplasty for trapeziometacarpal arthrosis as described by Weilby and modified slightly as described by Burton and Pellegrini. There was good (4/25, 16%) or complete (19/25, 76%) pain relief in 23 (92%) of the cases...

  14. Use of twin dorsal middle phalangeal finger flaps for thumb or index finger reconstruction.

    Science.gov (United States)

    Qi, W; Chen, K J

    2013-05-01

    Amputation or degloving injuries of the thumb or index finger are highly disabling. We describe the use of twin dorsal middle finger flaps harvested from the dorsal aspects of the middle and ring fingers, and based on one palmar proper digital artery, its venae comitantes, and the dorsal branches of the palmar digital nerves of the middle and ring fingers, respectively. These flaps offer advantages when large soft tissue defects of the thumb or index finger are present. In this study, twin dorsal middle finger flaps were used in nine patients (six thumbs, three index fingers). All flaps completely survived. At the mean follow-up of 20 months, the appearance of the reconstructed thumbs or index fingers was acceptable, the length was maintained, and the mean static 2-point discrimination values were 10 mm in the palmar flap and 13 mm in the dorsal flap of the reconstructed digit. All patients were satisfied with the appearance and mobility of the donor fingers. All but one donor finger showed normal finger pulp sensibility, with a static 2-point discrimination between 3 and 6 mm.

  15. Collateral ligament reconstruction of the chronic thumb injury with bio-tenodesis screw fixation

    DEFF Research Database (Denmark)

    Gvozdenovic, Robert; Boeckstyns, Michel

    2014-01-01

    We describe a new technique for the reconstruction of chronic lesions of the collateral ligaments of the metacarpophalangeal ligaments of the thumb, using a Bio-Tenodesis screw for the fixation of a tendon graft in a triangular manner with proximal apex and allowing early mobilization, starting 2...

  16. Assessing Financial Education Methods: Principles vs. Rules-of-Thumb Approaches

    Science.gov (United States)

    Skimmyhorn, William L.; Davies, Evan R.; Mun, David; Mitchell, Brian

    2016-01-01

    Despite thousands of programs and tremendous public and private interest in improving financial decision-making, little is known about how best to teach financial education. Using an experimental approach, the authors estimated the effects of two different education methodologies (principles-based and rules-of-thumb) on the knowledge,…

  17. [Arthrodesis of the carpometacarpal joint of the thumb using a cannulated screw].

    Science.gov (United States)

    Zdráhal, Marek

    2009-08-01

    To present the results of surgical treatment of carpometacarpal joint arthritis of the thumb, using cannulated screw fixation which is stable and, after bony union, allows the patient to do also harder manual work In the years 2000 to 2005, this method was used for 20 operations in 18 patients (16 women and two men); one man and one woman had bilateral surgery. The right hand was operated on in seven cases and the left one in 13 cases. The average age of the patients was 61 years. The procedure was performed from the dorsoradial approach, access to the joint was gained between the extensor pollicis brevis and abductor pollicis longus tendons, and care was taken to protect the superficial branch of the radial nerve. The articular surface of the trapezium bone and the first metacarpal base including osteophytes were resected and arthrodesis was carried out by means of a 4.5 mm cannulated screw. The final position of the thumb axis was at 40 degrees to 45 degrees palmar abduction, 20 degrees to 25 degrees extension and 10 degrees to 15 degrees pronation. A plaster hand splint was applied for 6 to 8 weeks post- operatively. The patients were capable of full use of the hand at 3 months after surgery. Evaluation included a pain scale of 1 to 5 grades, range of motion, reduction of muscle strength and fine motor function. All operative wounds healed by first intention, no infection or neurological complications were recorded. Primary union was achieved in 18 cases, two developed pseudoarthrosis. The patients reported improvement on the pain scale by 2 grades on average. However, in thumb opposition tasks, the range between the tip of the thumb and the fifth metacarpophalangeal joint decreased on average by 20 mm. Fourteen patients reported deterioration of fine motor function. All patients were satisfied with improved muscle strength enabling them to do more demanding physical work. The results of carpometacarpal joint arthrodesis by means of a cannulated screw are

  18. of basal cell carcinoma

    Directory of Open Access Journals (Sweden)

    Michał Sobjanek

    2016-10-01

    Full Text Available Introduction : Polymorphic variants of MCP-1 and RANTES genes and their protein serum levels have been implicated in the increased risk and severity of several malignancies. However, the subject has not been explored in basal cell carcinoma (BCC patients so far. Aim : To investigate the association between monocyte chemoattractant protein 1 (MCP-1 (–2518 A/G and RANTES (–403 G/A polymorphism and risk and clinical course of BCC. Material and methods : The study group consisted of 150 unrelated patients with BCC and 140 healthy, unrelated, age- and sex-matched volunteers. The polymorphisms were analysed using the amplification refractory mutation system polymerase chain reaction method (ARMS-PCR and single specific primer-polymerase chain reaction (SSP-PCR. Serum cytokine levels were measured with ELISA. Results : The presence of the MCP-1 –2518 GG genotype was statistically more frequent in BCC patients and it increased the risk of BCC (OR = 2.63, p = 0.003. Genotype –330 GG was statistically more common in patients with less advanced tumours (OR = 2.8, p = 0.017. Monocyte chemoattractant protein 1 serum level was statistically higher with GG genotype. In the BCC group MCP-1 serum levels were decreased. Neither polymorphic variants of RANTES nor the chemokine serum concentration differed significantly between the study groups. Conclusions : These findings suggest that –2518 A/G MCP-1 polymorphism may be involved in BCC pathogenesis.

  19. Platelet thrombosis in cardiac-valve prostheses

    Energy Technology Data Exchange (ETDEWEB)

    Dewanjee, M.K.

    1989-01-01

    The contribution of platelets and clotting factors in thrombosis on cardiovascular prostheses had been quantified with several tracers. Thrombus formation in vivo could be measured semiquantitatively in animal models and patients with indium-111, Technetium-99m labeled platelets, iodine-123, iodine-131 labeled fibrinogen, and In-111 and Tc-99m labeled antibody to the fibrinogen-receptor on the platelet- membrane, or fibrin. The early studies demonstrated that certain platelet-inhibitors, e.g. sulfinpyrazone, aspirin or aspirin- persantine increased platelet survival time with mechanical valves implanted in the baboon model and patients. Thrombus localization by imaging is possible for large thrombus on thrombogenic surface of prosthesis in the acute phase. The majority of thrombus was found in the sewing ring (Dacron) in the acute phase in both the mechanical and tissue valves. The amount of retained thrombus in both mechanical and tissue valves in our one-day study in the dog model was similar (< 1% if injected In-111 platelets = 5 billion platelets). As the fibrous ingrowth covered the sewing ring, the thrombus formation decreased significantly. Only a small amount of thrombus was found on the leaflets at one month in both the dog and calf models. 38 refs., 9 figs., 5 tabs.

  20. Platelet thrombosis in cardiac-valve prostheses

    International Nuclear Information System (INIS)

    Dewanjee, M.K.

    1989-01-01

    The contribution of platelets and clotting factors in thrombosis on cardiovascular prostheses had been quantified with several tracers. Thrombus formation in vivo could be measured semiquantitatively in animal models and patients with indium-111, Technetium-99m labeled platelets, iodine-123, iodine-131 labeled fibrinogen, and In-111 and Tc-99m labeled antibody to the fibrinogen-receptor on the platelet- membrane, or fibrin. The early studies demonstrated that certain platelet-inhibitors, e.g. sulfinpyrazone, aspirin or aspirin- persantine increased platelet survival time with mechanical valves implanted in the baboon model and patients. Thrombus localization by imaging is possible for large thrombus on thrombogenic surface of prosthesis in the acute phase. The majority of thrombus was found in the sewing ring (Dacron) in the acute phase in both the mechanical and tissue valves. The amount of retained thrombus in both mechanical and tissue valves in our one-day study in the dog model was similar (< 1% if injected In-111 platelets = 5 billion platelets). As the fibrous ingrowth covered the sewing ring, the thrombus formation decreased significantly. Only a small amount of thrombus was found on the leaflets at one month in both the dog and calf models. 38 refs., 9 figs., 5 tabs

  1. Red Dot Basal Cell Carcinoma

    Science.gov (United States)

    2017-01-01

    Red dot basal cell carcinoma, a distinctive morphologic variant of basal cell carcinoma that presents as a small red macule (dot) or papule, is described on a woman’s thigh. A high index of suspicion is necessary to consider the diagnosis since the tumor mimics a telangiectasia or an angioma. PMID:28670359

  2. An alternative technique for stabilisation of the carpometacarpal joint of the thumb after dislocation or subluxation.

    Science.gov (United States)

    Zhang, X; Shao, X; Huang, W; Zhu, H; Yu, Y

    2015-11-01

    We report a new surgical technique for the treatment of traumatic dislocation of the carpometacarpal (CMC) joint of the thumb. This is a tenodesis which uses part of the flexor carpi radialis. Between January 2010 and August 2013, 13 patients with traumatic instability of the CMC joint of the thumb were treated using this technique. The mean time interval between injury and ligament reconstruction was 13 days (0 to 42). The mean age of the patients at surgery was 38 years: all were male. At a mean final follow-up of 26 months (24 to 29), no patient experienced any residual instability. The mean total palmar abduction of the CMC joint of the thumb was 61° and the mean radial abduction 65° The mean measurements for the uninjured hand were 66° (60° to 73°) and 68° (60° to 75°), respectively. The mean Kapandji thumb opposition score was 8.5° (8° to 9°). The mean pinch and grip strengths of the hand were 6.7 kg (3.4 to 8.2) and 40 kg (25 to 49), respectively. The mean Disabilities of the Arm, Shoulder, and Hand questionnaire score was 3 (1 to 6). Based on the Smith and Cooney score, we obtained a mean score of 85 (75 to 95), which included four excellent, seven good, and two fair results. Our technique offers an alternative method of treating traumatic dislocation of the CMC joint of the thumb: it produces a stable joint and acceptable hand function. ©2015 The British Editorial Society of Bone & Joint Surgery.

  3. In vivo analysis of trapeziometacarpal joint arthrokinematics during multi-directional thumb motions.

    Science.gov (United States)

    Su, Fong-Chin; Lin, Chien-Ju; Wang, Chien-Kuo; Chen, Guan-Po; Sun, Yung-Nien; Chuang, Alan K; Kuo, Li-Chieh

    2014-11-01

    The investigation of the joint arthrokinematics of the trapeziometacarpal joint is critical to comprehend the causative mechanism underlying this common form of osteoarthritis. Therefore, the purpose of this study is to evaluate the arthrokinematics of the trapeziometacarpal joint during thumb postures in vivo. Fifteen healthy participants were enrolled in this study. Static computed tomography images of the 1st metacarpal bone and trapezium were taken at specific thumb postures during thumb flexion-extension, abduction-adduction, and circumduction motions. Images were analyzed to examine the joint gliding, expressed as displacement of the centroid of the articular surface of the 1st metacarpal bone, relative to the trapezium. The gliding ratio, defined as joint gliding in each direction normalized to the dimension of the trapezium joint surface in the given direction, was computed and compared between different thumb motions. The results indicate that thumb motions influenced joint gliding. The centroids of the articular surface of the 1st metacarpal bone were primarily located at the central and dorsal-radial regions while executing these motions. The maximum joint gliding of the 1st metacarpal bone occurred in the radial-ulnar direction when performing abduction-adduction, and in the dorsal-volar direction while performing flexion-extension and circumduction, with the gliding ratio values of 42.35%, 51.65%, and 51.85%, respectively. Activities that involved abduction-adduction in the trapeziometacarpal joint caused greater joint gliding in the ulnar-radial direction, while flexion-extension resulted in greater joint gliding in the dorsal-volar and distal-proximal directions. Understanding normal joint kinematics in vivo may provide insights into the possible mechanism leading to osteoarthritis of the trapeziometacarpal joint, and help to improve the design of implants. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. New basal temperature and basal melt rate maps of Antarctica

    Science.gov (United States)

    Martos, Yasmina M.; Martin, Carlos; Vaughan, David G.

    2017-04-01

    Ice sheet basal conditions are key to initialize ice flow models and be able to estimate the future of the cryosphere. The thermal conditions are of importance because of the widespread presence of water beneath the Antarctic continent that affects both the ice-dynamics and the mass budget. The melting or freezing at the base of the ice sheet is consequence of several contributions to the heat balance. This includes the geothermal heat flux, the heat conducted or advected through the ice sheet, the latent heat and the friction heat at the interface. Here we present a new basal temperature and a total basal melting rate distributions of Antarctica. For this we use the most recent heat flux map (Martos et al., 2016) and an advanced ice flow model to incorporate the effect of advection and estimate frictional heat. We assume steady state conditions to estimate the basal properties. We found higher basal melting rates in West Antarctica than in East Antarctica as well as in the coastal regions of the continent and ice shelves. The spatial variation of our new basal temperature and basal melting rate distributions are greater than previously proposed which will help to unveil the Antarctic subglacial hydrology.

  5. An overview of robotic/mechanical devices for post-stroke thumb rehabilitation.

    Science.gov (United States)

    Suarez-Escobar, Marian; Rendon-Velez, Elizabeth

    2018-01-15

    This article aims to clarify the current state-of-the-art of robotic/mechanical devices for post-stroke thumb rehabilitation as well as the anatomical characteristics and motions of the thumb that are crucial for the development of any device that aims to support its motion. A systematic literature search was conducted to identify robotic/mechanical devices for post-stroke thumb rehabilitation. Specific electronic databases and well-defined search terms and inclusion/exclusion criteria were used for such purpose. A reasoning model was devised to support the structured abstraction of relevant data from the literature of interest. Following the main search and after removing duplicated and other non-relevant studies, 68 articles (corresponding to 32 devices) were left for further examination. These articles were analyzed to extract data relative to (i) the motions assisted/permitted - either actively or passively - by the device per anatomical joint of the thumb and (ii) mechanical-related aspects (i.e., architecture, connections to thumb, other fingers supported, adjustability to different hand sizes, actuators - type, quantity, location, power transmission and motion trajectory). Most articles describe preliminary design and testing of prototypes, rather than the thorough evaluation of commercially ready devices. Defining appropriate kinematic models of the thumb upon which to design such devices still remains a challenging and unresolved task. Further research is needed before these devices can actually be implemented in clinical environments to serve their intended purpose of complementing the labour of therapists by facilitating intensive treatment with precise and repeatable exercises. Implications for Rehabilitation Post-stroke functional disability of the hand, and particularly of the thumb, significantly affects the capability to perform activities of daily living, threatening the independence and quality of life of the stroke survivors. The latest studies

  6. Cobalt release and complications resulting from the use of dental prostheses.

    Science.gov (United States)

    Al-Imam, Hiba; Benetti, Ana R; Özhayat, Esben B; Pedersen, Anne M L; Johansen, Jeanne D; Thyssen, Jacob P; Jellesen, Morten S; Gotfredsen, Klaus

    2016-12-01

    Cobalt release from dental prostheses has been shown to elicit allergic reactions in cobalt-allergic patients. It is therefore important to investigate whether these prostheses are possible sources of sensitization. To assess (i) cobalt release from dental prostheses and (ii) allergic reactions to components of dental prostheses, and (iii) to investigate the oral mucosa for inflammation 1-5 years after insertion of the prostheses. Clinical oral examination was conducted in 66 patients with 84 dental prostheses. Cobalt release from 84 functional (used) and 32 non-functional (new) prostheses was investigated with the cobalt spot test. Contact allergy was assessed by patch testing. Smear tests for Candida spp. were performed in patients showing signs of inflammation of the oral mucosa. The prostheses were assessed for biological and technical complications. None of the functional prostheses released cobalt, whereas this was observed in 24 of 32 non-functional prostheses. None of the patients had contact allergy to cobalt. Of the 66 patients, 11 showed signs of inflammation of the oral mucosa, 2 had oral candidiasis, 16 had ill-fitting prostheses, and all had insufficient oral hygiene. Dental prostheses released cobalt during the fabrication stages, but not 1-5 years after insertion. No allergic reactions were observed. Signs of inflammation were related to candidiasis, insufficient oral hygiene, and ill-fitting prostheses. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Retroca valvular Replacement of heart valves prostheses

    Directory of Open Access Journals (Sweden)

    Pablo M. A Pomerantzeff

    1987-12-01

    replacement, at our Institution. These patients received a total of 157 prostheses and 4 had their Starr-Edwards valve ball replaced due to ball variance. Six patients were submitted to a third valvular replacement in the mitral position, withouth deaths. Nine patients had a third valvular replacement in the aortic position with 1 death in the immediate postoperative period. Rupture or calcification of the dura mater leaflets were the main reason for the indication of prosthetic replacement. In the mitral position 41 patients presented rupture of the leaflets and 19 showed calcification. In the aortic position 32 bioprostheses underwent rupture and 12, calcification. Bio-prostheses were utilized in the majority of cases of replace the dysfunctioning prostheses. Porcine bioprostheses were implanted in 63 cases and bovine pericardial bioprostheses, in 35. Immediate mortality was 8.3% (12 patients; low cardiac output was the main cause of death. The most frequent immediate complications were low cardiac output, arrhythmias and bleeding. In the preoperative period 90% of the patients were in functional classes III and IV (NYHA. After the replacement, 89% of the aortics and 82% of the mitral were in functional classes I an II.

  8. Cobalt release and complications resulting from the use of dental prostheses

    DEFF Research Database (Denmark)

    Al-Imam, Hiba; Benetti, Ana R.; Özhayat, Esben B.

    2016-01-01

    of the functional prostheses released cobalt, whereas this was observed in 24 of 32 non-functional prostheses. None of the patients had contact allergy to cobalt. Of the 66 patients, 11 showed signs of inflammation of the oral mucosa, 2 had oral candidiasis, 16 had ill-fitting prostheses, and all had insufficient...... oral hygiene. CONCLUSIONS: Dental prostheses released cobalt during the fabrication stages, but not 1-5 years after insertion. No allergic reactions were observed. Signs of inflammation were related to candidiasis, insufficient oral hygiene, and ill-fitting prostheses.......) allergic reactions to components of dental prostheses, and (iii) to investigate the oral mucosa for inflammation 1-5 years after insertion of the prostheses. METHOD: Clinical oral examination was conducted in 66 patients with 84 dental prostheses. Cobalt release from 84 functional (used) and 32 non...

  9. Implant-retained craniofacial prostheses for facial defects

    Science.gov (United States)

    Federspil, Philipp A.

    2012-01-01

    Craniofacial prostheses, also known as epistheses, are artificial substitutes for facial defects. The breakthrough for rehabilitation of facial defects with implant-retained prostheses came with the development of the modern silicones and bone anchorage. Following the discovery of the osseointegration of titanium in the 1950s, dental implants have been made of titanium in the 1960s. In 1977, the first extraoral titanium implant was inserted in a patient. Later, various solitary extraoral implant systems were developed. Grouped implant systems have also been developed which may be placed more reliably in areas with low bone presentation, as in the nasal and orbital region, or the ideally pneumatised mastoid process. Today, even large facial prostheses may be securely retained. The classical atraumatic surgical technique has remained an unchanged prerequisite for successful implantation of any system. This review outlines the basic principles of osseointegration as well as the main features of extraoral implantology. PMID:22073096

  10. Cardiovascular effects of basal insulins

    Directory of Open Access Journals (Sweden)

    Mannucci E

    2015-07-01

    Full Text Available Edoardo Mannucci,1 Stefano Giannini,2 Ilaria Dicembrini1 1Diabetes Agency, Careggi Teaching Hospital, Florence, 2Section of Endocrinology, Department of Biomedical Clinical and Experimental Sciences, University of Florence and Careggi University Hospital, Florence, Italy Abstract: Basal insulin is an important component of treatment for both type 1 and type 2 diabetes. One of the principal aims of treatment in patients with diabetes is the prevention of diabetic complications, including cardiovascular disease. There is some evidence, although controversial, that attainment of good glycemic control reduces long-term cardiovascular risk in both type 1 and type 2 diabetes. The aim of this review is to provide an overview of the potential cardiovascular safety of the different available preparations of basal insulin. Current basal insulin (neutral protamine Hagedorn [NPH], or isophane and basal insulin analogs (glargine, detemir, and the more recent degludec differ essentially by various measures of pharmacokinetic and pharmacodynamic effects in the bloodstream, presence and persistence of peak action, and within-subject variability in the glucose-lowering response. The currently available data show that basal insulin analogs have a lower risk of hypoglycemia than NPH human insulin, in both type 1 and type 2 diabetes, then excluding additional harmful effects on the cardiovascular system mediated by activation of the adrenergic system. Given that no biological rationale for a possible difference in cardiovascular effect of basal insulins has been proposed so far, available meta-analyses of publicly disclosed randomized controlled trials do not show any signal of increased risk of major cardiovascular events between the different basal insulin analogs. However, the number of available cardiovascular events in these trials is very small, preventing any clear-cut conclusion. The results of an ongoing clinical trial comparing glargine and degludec with

  11. Counseling on early childhood concerns: sleep issues, thumb sucking, picky eating, and school readiness.

    Science.gov (United States)

    Tseng, Ann G; Biagioli, Frances E

    2009-07-15

    Sleep issues, thumb sucking, coping with picky eating, and determining if a child is ready for school are common concerns of families with young children. Information and resources to help counsel on these topics include recommendations from the American Academy of Sleep Medicine, the American Dental Association, and the U.S. Department of Agriculture. Infant sleep times can be prolonged by unmodified or graduated extinction, maintaining routines, scheduled awakenings, and parent education. Thumb sucking can be addressed with positive reinforcement, alternative comfort measures, reminders, and child involvement in solutions. Worry about picky eating can be eased by educating parents about the dietary requirements of toddlers. Social and emotional factors most influence kindergarten success. Keeping children from starting school may not be in their best interest academically.

  12. Terminal phalangeal accessory ossification center of the thumb: an additional radiographic finding in Larsen syndrome

    International Nuclear Information System (INIS)

    Alanay, Yasemin; Utine, Gulen E.; Tuncbilek, Ergul; Lachman, Ralph S.; Krakow, Deborah

    2006-01-01

    Larsen syndrome is an autosomal-dominant disorder characterized by multiple joint dislocations, vertebral anomalies and dysmorphic facies. Both autosomal-dominant and autosomal-recessive forms of the disorder have been proposed. Individuals with autosomal-dominant Larsen syndrome have characteristic ''cylindrical-shape'' thumbs caused by broad, shortened phalanges. Autosomal-dominant Larsen syndrome results from heterozygosity for mutations in filamin B, a cytoskeletal protein involved in multicellular processes. We report here a patient with a duplicated or accessory distal thumb phalanx and multiple large joint dislocations who was shown to be heterozygous for a filamin B mutation predicting the amino acid substitution G1691S. This adds a new radiographic finding, duplicated or accessory distal phalanx, to the radiographic abnormalities seen in this rare dominant disorder. (orig.)

  13. Adipofascial plus cross-finger flap augment reconstructive options in thumb defects: A case report

    Directory of Open Access Journals (Sweden)

    Pradeoth Mukundan Korambayil

    2017-04-01

    Full Text Available Cross-finger flaps are a powerful tool in terms of soft tissue reconstruction for defects of the fingers and thumb. In conditions where the cause is based on to infection or inflammation, there is always doubt on the part of plastic surgeons with regards to skeletonizing the pedicle for ease of transfer. Here, we present a case of cross finger flap with inclusion of an adipofascial component for reconstruction of the thumb soft tissue defect. The adipofascial component helps in reducing donor site exposure to extensor expansion and helps by filling up the deficit in recipient defect. In the current study, we used a hyperbaric oxygen therapy as an adjunct during the treatment process. The results were satisfactory with no flap complications. [Hand Microsurg 2017; 6(1.000: 39-42

  14. Metacarpophalangeal Joint Arthrodesis of the Thumb - Minimum of Eight Months Follow-up

    DEFF Research Database (Denmark)

    Jørgensen, Rasmus Wejnold; Brorson, Stig; Jensen, Claus Hjorth

    2016-01-01

    the disabilities of the Arm, Shoulder, and Hand-questionnaire (DASH). In addition, patient satisfaction, pain, stiffness, and impairment of activities of daily living were assessed on a Visual Analogue Scale (VAS) followed by a question stating whether they would undergo the same procedure again. RESULTS: Two...... was to report outcome and disability following thumb MCP joint arthrodesis in the treatment of chronic instability after traumatic injuries. METHODS: A retrospective review of 26 patients operated on with MCP joint arthrodesis, median follow-up 42 months (8-104months). Subjective outcome was assessed using...... and age matched individuals. Many lived with pain, but all reported that they were willing to undergo the same procedure again. We suggest that the disability scale by the National Board of Industrial Injuries should be reconsidered for patients operated on with thumb MCP arthrodesis....

  15. CAD/CAM generated all-ceramic primary telescopic prostheses.

    Science.gov (United States)

    Kurbad, A; Ganz, S; Kurbad, S

    2012-01-01

    Computer-aided design and manufacturing (CAD/CAM) systems have proven effective not only for the manufacture of crown and bridge frameworks, inlays, onlays and veneers, but also for the generation of all-ceramic primary telescopic prostheses in more than 10 years of use in dental technology. The new InLab 4.0 software generation makes it possible to design and mill primary telescopic prostheses with CAD/CAM technology. The computer-generated raw crowns for these restorations require very little manual adaptation. The secondary crowns are manufactured by electroforming and bonded onto the tertiary structure or framework.

  16. Flexor pulley reconstruction after rupture following corticosteroid injections for trigger thumb: a case report.

    Science.gov (United States)

    Kimura, Michio; Kuroshima, Nagatsugu; Matsushita, Takashi

    2013-01-01

    We report a rare case of limitation of active flexion and subcutaneous bow-stringing as a result of flexor pulley rupture after repeated corticosteroid injections for trigger thumb. Complete rupture of the A1 and oblique flexor pulleys was confirmed during surgery, and the pulley system was reconstructed with a "three-loop technique" using a free palmaris longus autograft. This technique provided enough strength to allow early mobilization and prompt recovery to full range of motion.

  17. Programmers guide to Finger, Thumb, and Triple Axis real time experiment control programs

    Energy Technology Data Exchange (ETDEWEB)

    Pinter, T.G.; Notis, E.M.

    1978-03-01

    This manual describes the algorithms and codes written to control the neutron scattering real-time experiments. These experiments consist of three diffractometers, called Thumb, Finger, and Triple Axis, as well as an x-y Plotter. The basic control system consists of an experiment interfaced to an SDS-910 which is in turn interfaced to a PDP-15. All direct experiment control is performed in the 910, e.g., setting angles, handling experiment interrupts, etc. Thus, all three experiments ''look'' the same to the 15. The Thumb diffractometer consists of a sample table of rotation for the crystal being studied and a detector arm which is rotated about the sample table axis. All other angles are fixed. Thus, only elastic scattering can be performed on this diffractometer. The Finger diffractometer has an analyzing crystal where the Thumb detector is located. This crystal can be rotated to select a given energy from the beam scattered by the sample before it enters the detector. Thus, inelastic scattering can be performed. The Triple Axis resembles the Finger except the monochromator and drum angles as well as the detector and analyzer crystal angles can all move independently.

  18. Osteoarthritis of the thumb carpometacarpal joint: Correlation of ultrasound appearances to disability and treatment response

    International Nuclear Information System (INIS)

    Mallinson, P.I.; Tun, J.K.; Farnell, R.D.; Campbell, D.A.; Robinson, P.

    2013-01-01

    Aim: To evaluate grading of thumb carpometacarpal joint (CMCJ) osteoarthritis (OA) using ultrasound, correlating findings with disability and treatment response. Materials and methods: Patients with symptomatic thumb OA attending for ultrasound-guided CMCJ steroid injection and a group of asymptomatic controls were recruited prospectively. Thumb CMCJ ultrasound was graded (osteophytes, joint-space narrowing, capsule size, and measured capsule size), and a Disabilities of the Arm Shoulder and Hand (DASH) questionnaire was completed for each patient. Symptomatic patients then underwent injection with DASH repeated 6 weeks post-treatment. Ultrasound features were correlated with the initial DASH disability score and response as defined by change in DASH 6 weeks after treatment. Results: Thirty-one patients with symptomatic OA and 37 asymptomatic controls were recruited. With the exception of osteophytes (p = 0.017), no statistically significant correlation was demonstrated between severity of ultrasound features and patient disability. However, all features demonstrated statistically significant higher grades in the symptomatic group compared to controls. Ultrasound grading did not have statistical correlation with treatment response. Conclusion: No correlation was found between the majority of ultrasound features and the clinical severity of OA or likely response to treatment. However, these features are significantly more common in the symptomatic population

  19. The evolution of the hominin thumb and the influence exerted by the non-dominant hand during stone tool production.

    Science.gov (United States)

    Key, Alastair J M; Dunmore, Christopher J

    2015-01-01

    Modern humans possess a highly derived thumb that is substantially stronger and more robust than the fingers. Previous hypotheses concerning the evolution of such traits have focused upon the manipulation of hammerstones during stone tool production and of stone tools during their use. To date there has been no research on the manipulative pressures exerted by the non-dominant (core-holding) hand during stone tool production and its potential influence on the evolutionary history of the thumb. Here we provide the first investigation into the frequencies of digit recruitment and the relative manipulative forces experienced in the non-dominant hand during stone tool production. Eight experienced knappers produced flake cutting tools under four distinct conditions while pressure sensors, secured to the volar pads of the thumb, index and middle fingers of the non-dominant hand, recorded manipulative forces. Results indicate that relative to the fingers, the thumb was recruited significantly more frequently and experienced significantly greater manipulative forces during core repositioning events and the securing of the core during flake detachments. Our results support the hypothesis that the robust thumb anatomy observed in the hominin lineage was selected for, at least in part, as a result of more frequent and greater manipulative pressures acting upon the thumb relative to the fingers on the non-dominant hand during stone tool production. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Cardiovascular effects of basal insulins.

    Science.gov (United States)

    Mannucci, Edoardo; Giannini, Stefano; Dicembrini, Ilaria

    2015-01-01

    Basal insulin is an important component of treatment for both type 1 and type 2 diabetes. One of the principal aims of treatment in patients with diabetes is the prevention of diabetic complications, including cardiovascular disease. There is some evidence, although controversial, that attainment of good glycemic control reduces long-term cardiovascular risk in both type 1 and type 2 diabetes. The aim of this review is to provide an overview of the potential cardiovascular safety of the different available preparations of basal insulin. Current basal insulin (neutral protamine Hagedorn [NPH], or isophane) and basal insulin analogs (glargine, detemir, and the more recent degludec) differ essentially by various measures of pharmacokinetic and pharmacodynamic effects in the bloodstream, presence and persistence of peak action, and within-subject variability in the glucose-lowering response. The currently available data show that basal insulin analogs have a lower risk of hypoglycemia than NPH human insulin, in both type 1 and type 2 diabetes, then excluding additional harmful effects on the cardiovascular system mediated by activation of the adrenergic system. Given that no biological rationale for a possible difference in cardiovascular effect of basal insulins has been proposed so far, available meta-analyses of publicly disclosed randomized controlled trials do not show any signal of increased risk of major cardiovascular events between the different basal insulin analogs. However, the number of available cardiovascular events in these trials is very small, preventing any clear-cut conclusion. The results of an ongoing clinical trial comparing glargine and degludec with regard to cardiovascular safety will provide definitive evidence.

  1. Magnetic resonance imaging of breast prostheses | Corr | SA ...

    African Journals Online (AJOL)

    Breast MR imaging is the most accurate imaging investigation to detect breast prosthesis rupture. Rupture is common in older prostheses (> 10 years post implantation) and is often asymptomatic. The radiological signs of rupture are due to collapse of the elastomer shell which is eneveloped by silicone gel and when the ...

  2. Critiquing the Computer-Aided Design of Dental Prostheses.

    Science.gov (United States)

    Fitzpatrick, F. J.; And Others

    This paper describes RaPiD, a computer-aided assistant for the design of dental prostheses called removable partial dentures. The user manipulates icons directly to indicate the desired design solution to a given clinical situation. A developing design is represented as a logic database of components in a design; expert rules are applied as…

  3. Study of effects of radiation on silicone prostheses

    International Nuclear Information System (INIS)

    Shedbalkar, A.R.; Devata, A.; Padanilam, T.

    1980-01-01

    Radiation effects on silicone gel and dose distribution of radiation through mammary prostheses were studied. Silicone gel behaves like tissue. Half value thickness for silicone gel and water are almost the same. Linear absorption coefficient for silicone gel and water are comparable

  4. Evaluation of pneumatic cylinder actuators for hand prostheses

    NARCIS (Netherlands)

    Peerdeman, B.; Smit, Gerwin; Stramigioli, Stefano; Plettenburg, Dick; Misra, Sarthak

    2012-01-01

    DC motors are currently the preferred actuation method for externally powered hand prostheses. However, they are often heavy and large, which limits the number of actuators that can be integrated into the prosthesis. Alternative actuation methods are being researched, but have not yet found wide

  5. Microbial colonization of silicone voice prostheses used in laryngectomized patients

    NARCIS (Netherlands)

    Eerenstein, S. E.; Grolman, W.; Schouwenburg, P. F.

    1999-01-01

    The aim of this study was to identify the microbial colonization of dysfunctioning voice prostheses in laryngectomized patients and determine the influence of patient radiation therapy on prosthesis life span. In a 40-month period, 257 outpatient voice prosthesis replacements were carried out in a

  6. Novel strategies to improve the patency of vascular prostheses

    NARCIS (Netherlands)

    Heyligers, J.M.M.

    2006-01-01

    Two novel strategies to improve the patency of vascular prostheses are described in this thesis. To improve the outcome of synthetic vascular bypass surgery, cell seeding is a promising concept that has extensively been investigated and is still evolving. To improve the short term effects due to

  7. AICRG, Part IV: Patient satisfaction reported for Ankylos implant prostheses.

    Science.gov (United States)

    Morris, Harold F; Ochi, Shigeru; Rodriguez, Arthur; Lambert, Paul M

    2004-01-01

    Although many maxillary dentures exhibit sufficient retention and stability for patients to adapt well to them, mandibular dentures present a major challenge. The introduction of the endosseous dental implant provided the opportunity for the patient to have esthetic replacements (implant prostheses) that were retentive and stable for all missing natural teeth. This paper reports on the satisfaction of over 470 patients with implant prostheses fabricated using a new and innovative implant design (Ankylos, Dentsply-Friadent, Mannheim, Germany). A total of 1500 Ankylos implants were placed, restored, and followed for 3 to 5 years. Patients were asked to respond to a series of questions related to their satisfaction with their new replacements for missing natural teeth. A total of 95.6% of the patients rated chewing ability with Ankylos prosthesis as excellent to good; 92.2% indicated a significant improvement in their ability to chew; 92.6% reported overall clinical function much better than conventional dentures; 99.1% indicated that speech had improved or was not changed; 96.3% indicated hot and cold foods tasted better; 98.8% indicated no pain or discomfort during clinical function; 99.4% liked their new implant prosthesis; 98.0% would seek implant-prostheses treatment again, if necessary; 99.1% would recommend implant prostheses to friends and relatives; and 98.8% indicated the advantages of Ankylos prostheses far exceeded any disadvantages that may exist. Patients indicated that they (1) were highly satisfied with the final results of the replacements for their natural teeth that were retained or supported by this new implant design, (2) would not hesitate to recommend this form of treatment to their friends and relatives, and (3) would not hesitate to seek the same treatment again if necessary in the future.

  8. Fracture analysis of randomized implant-supported fixed dental prostheses.

    Science.gov (United States)

    Esquivel-Upshaw, Josephine F; Mehler, Alex; Clark, Arthur E; Neal, Dan; Anusavice, Kenneth J

    2014-10-01

    Fractures of posterior fixed dental all-ceramic prostheses can be caused by one or more factors including prosthesis design, flaw distribution, direction and magnitude of occlusal loading, nature of supporting infrastructure (tooth root/implant), and presence of adjacent teeth. This clinical study of implant-supported, all-ceramic fixed dental prostheses, determined the effects of (1) presence of a tooth distal to the most distal retainer; (2) prosthesis loading either along the non-load bearing or load bearing areas; (3) presence of excursive contacts or maximum intercuspation contacts in the prosthesis; and (4) magnitude of bite force on the occurrence of veneer ceramic fracture. 89 implant-supported FDPs were randomized as either a three-unit posterior metal-ceramic (Au-Pd-Ag alloy and InLine POM, Ivoclar, Vivadent) FDP or a ceramic-ceramic (ZirCAD and ZirPress, Ivoclar, Vivadent) FDP. Two implants (Osseospeed, Dentsply) and custom abutments (Atlantis, Dentsply) supported these FDPs, which were cemented with resin cement (RelyX Universal Cement). Baseline photographs were made with markings of teeth from maximum intercuspation (MI) and excursive function. Patients were recalled at 6 months and 1-3 years. Fractures were observed, their locations recorded, and images compared with baseline photographs of occlusal contacts. No significant relationship existed between the occurrence of fracture and: (1) the magnitude of bite force; (2) a tooth distal to the most distal retainer; and (3) contacts in load-bearing or non-load-bearing areas. However, there was a significantly higher likelihood of fracture in areas with MI contacts only. Because of the absence of a periodontal ligament, this clinical study demonstrates that there is a need to evaluate occlusion differently with implant-supported prostheses than with natural tooth supported prostheses. Implant supported prostheses should have minimal occlusion and lighter contacts than those supported by natural dentition

  9. Nevoid basal cell carcinoma syndrome

    Directory of Open Access Journals (Sweden)

    Kannan Karthiga

    2006-01-01

    Full Text Available Binkley and Johnson first reported this syndrome in 1951. But it was in 1960, Gorlin-Goltz established the association of basal cell epithelioma, jaw cyst and bifid ribs, a combination which is now frequently known as Gorlin-Goltz syndrome as well as Nevoid Basal Cell Carcinoma Syndrome (NBCCS. NBCCS is inherited as an autosomal dominant trait with high penetrance and variable expressivity. NBCCS is characterized by variety of cutaneous, dental, osseous, opthalmic, neurologic and sexual abnormalities. One such case of Gorlin-Goltz syndrome is reported here with good illustrations.

  10. Measurement of quality of life among patient undergoing arthroplasty of the thumb to treat CMC arthritis

    Directory of Open Access Journals (Sweden)

    Marcio Aurélio Aita

    2016-08-01

    Full Text Available ABSTRACT OBJECTIVE: To present the clinical and functional results, including measurement of quality of life, of patients undergoing trapeziometacarpal arthroplasty. METHOD: This was a prospective evaluation on 45 patients (53 thumbs with a diagnosis of idiopathic rhizarthrosis who underwent resection arthroplasty and interposition of an uncemented Ascension(r implant, made of pyrocarbon. The clinical and functional results were analyzed through radiography, range of motion (ROM in degrees (°, visual analog scale (VAS for pain and the disability of arm, shoulder and hand (DASH questionnaire for quality of life. In the group analyzed, 38 were women and seven were men, and their mean age was 63.17 years (range: 50-78. Eight patients were treated bilaterally. RESULTS: After 42.08 months of follow-up (range: 8-73, the subjective pain evaluation (VAS score was 1.37 (range: 1-4. The complete ROM of the thumb increased to 95.75% (range: 75-100% in relation to the contralateral side. The mean DASH questionnaire score was 9.98 (range: 1-18. The complication rate (negative events was 11.32%. Five patients presented dislocation of the thumb prosthesis. All of them were reoperated by means of dorsal capsuloplasty using a portion of the retinaculum of the extensors as a graft, and good clinical evolution was achieved in these cases. One patient presented fracturing of the metacarpal and was treated by means of osteosynthesis using Kirschner wires. CONCLUSION: This method is effective for treating rhizarthrosis, according to the measurements made on the clinical and functional results, even after taking the complication rate into consideration. Moreover, it provides an improvement of quality of life for these patients.

  11. Racial Variation in Treatment of Traumatic Finger/Thumb Amputation: A National Comparative Study of Replantation and Revision Amputation.

    Science.gov (United States)

    Mahmoudi, Elham; Swiatek, Peter R; Chung, Kevin C; Ayanian, John Z

    2016-03-01

    Traumatic finger/thumb amputations are some of the most prevalent traumatic injuries affecting Americans each year. Rates of replantation after traumatic finger/thumb amputation, however, have been declining steadily across U.S. hospitals, which may make these procedures less accessible to minorities and vulnerable populations. The specific aim of this study was to examine racial variation in finger replantation after traumatic finger/thumb amputation. Using a two-level hierarchical model, the authors retrospectively compared replantation rates for African American patients with those of whites, adjusting for patient and hospital characteristics. Patients younger than 65 years with traumatic finger/thumb amputation injuries who sought care at a U.S. trauma center between 2007 and 2012 were included in the study sample. The authors analyzed 13,129 patients younger than 65 years with traumatic finger/thumb amputation. Replantation rates declined over time from 19 percent to 14 percent (p = 0.004). Adjusting for patient and hospital characteristics, African Americans (OR, 0.81; 95 percent CI, 0.66 to 0.99; p = 0.049) were less likely to undergo replantation procedures than whites, and uninsured patients (OR, 0.73; 95 percent CI, 0.62 to 0.84; p amputation injuries. Regionalization of care for these injuries may not only provide a higher quality care but also reduce variations in treatment. Risk, III.

  12. Hormonal induction of thumb pads and the evolution of secondary sexual characteristics of the Southeast Asian fanged frog, Rana blythii.

    Science.gov (United States)

    Emerson, S B; Carroll, L; Hess, D L

    1997-12-15

    The fanged frogs of Southeast Asia do not express most of the hormone-dependent secondary sexual characteristics such as thumb pads that are common to other ranid frogs. At the same point in the evolutionary history of the group that these androgen-mediated characteristics are lost, male parental care first evolves. This behavior is often correlated with low androgen levels. Prior work indicates that in one of the fanged frogs, Rana blythii, adult males have low androgen levels compared to North Temperate species of Rana. This leads to the question of whether these low androgen levels are related to the unusual male parental care and the lack of expression of the thumb pad and other hormone-dependent secondary sexual characteristics in this species. We tested that hypothesis by examining the effects of exogenous dihydrotestosterone supplements on the expression of thumb pads in Rana blythii. Dihydrotestosterone injections appear to stimulate the expression of the thumb pad in R. blythii. These results support the hypothesis that low androgen levels are involved in the loss of the thumb pad in R. blythii. This work provides an example of how mapping characters on phylogenies can be a powerful approach for gaining insights into proximate physiological mechanisms of selection at the evolutionary level.

  13. Effects of button position on a soft keyboard: Muscle activity, touch time, and discomfort in two-thumb text entry.

    Science.gov (United States)

    Chang, Joonho; Choi, Bori; Tjolleng, Amir; Jung, Kihyo

    2017-04-01

    Intensive use of the thumbs for text entry on smartphones may contribute to discomfort, pain, or musculoskeletal disorders. This study investigated the effect of twenty-five button positions (5 rows × 5 columns) on a soft keyboard for two-thumb entry. Two experiments measured muscle activity, touch time, and discomfort as a function of the button positions. In Phase I, the muscle activities of two intrinsic (abductor pollicis brevis and first dorsal interossei) and two extrinsic (abductor pollicis longus and extensor digitorum communis) muscles associated with thumb motions were observed for ten college students (age: 24.2). In Phase II, touch time and discomfort were measured for 40 college students (age: 23.6). The results demonstrated that the %MVCs of the intrinsic muscles significantly increased when the thumbs flexed and abducted. Also, the button positions near the rest positions of the thumbs resulted in significantly shorter touch times (0.66 s) and lower discomfort ratings (0.70 pt) than their peripheral buttons (0.76 s; 2.29 pt). Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. A Case of Distal Epithelioid Sarcoma of the Thumb Expressing Podoplanin, TLE1 and Ca 125

    Directory of Open Access Journals (Sweden)

    George Karagkounis

    2013-01-01

    Full Text Available Distal epithelioid sarcoma is a rare and slowly growing tumor that usually develops in the upper extremities of young adults. Neoplastic cells have both spindle and epithelioid appearance and are characterized by the loss of the nuclear protein SMARCB1/INI1. We present the case of a distal epithelioid sarcoma arising in the thumb of a 14-year-old girl, which immunohistochemically was characterized by the loss of SMARCB1/INI1 protein as well as the expression of podoplanin (D2-40, TLE1, Glut1, and Ca 125; plus, we highlight the differential diagnosis of epithelioid sarcoma from its histological mimics.

  15. Modified quad helix appliance for thumb sucking and cross bite correction

    Directory of Open Access Journals (Sweden)

    C Vinay

    2013-01-01

    Full Text Available Digit sucking habit is a learned pattern of behavior commonly seen in children of preschool age. Prolonged digit sucking beyond the preschool age, lead to the development of malocclusion such as anterior open bite, maxillary constriction and posterior crossbite. Treatment strategies include interception of habit and correction of the malocclusion. The present case report describes a modified quad helix appliance used successfully in a 9-year-old child to intercept thumb sucking habit and simultaneous correction of posterior crossbite. The appliance has the advantage of easy fabrication, being versatile and more patients compliant.

  16. Shower emboli and digital necrosis after a single corticosteroid injection for trigger thumb: case report.

    Science.gov (United States)

    Park, Jonathan; Dumanian, Gregory A

    2009-02-01

    Local corticosteroid injection into the hand is the preferred initial step in the management of trigger finger owing to its safety and efficacy. We report the case of a patient with shower emboli and digital necrosis after a local corticosteroid injection for the treatment of trigger thumb. Given the patient's subsequent negative hypercoagulability workup, we suspect that the patient's symptoms resulted from the injection of steroids into the princeps pollicis artery, with subsequent retrograde flow into multiple other arteries of the hand. The patient was managed conservatively and ultimately her symptoms resolved. No new areas of digital necrosis have appeared in 8 years of follow-up.

  17. Development and Reliability of the OMERACT Thumb Base Osteoarthritis Magnetic Resonance Imaging Scoring System

    DEFF Research Database (Denmark)

    Kroon, Féline P B; Conaghan, Philip G; Foltz, Violaine

    2017-01-01

    : The TOMS assessed the first carpometacarpal (CMC-1) and scaphotrapeziotrapezoid (STT) joints for synovitis, subchondral bone defects (including erosions, cysts, and bone attrition), osteophytes, cartilage, and bone marrow lesions on a 0-3 scale (normal to severe). Subluxation was evaluated only in the CMC......, with better performance for subchondral bone defects, subluxation, and bone marrow lesions. CONCLUSION: A thumb base OA MRI scoring system has been developed. The OMERACT TOMS demonstrated good intrareader and interreader reliability. Longitudinal studies are warranted to investigate reliability of change...

  18. Manufacturing Implant Supported Auricular Prostheses by Rapid Prototyping Techniques

    Science.gov (United States)

    Karatas, Meltem Ozdemir; Cifter, Ebru Demet; Ozenen, Didem Ozdemir; Balik, Ali; Tuncer, Erman Bulent

    2011-01-01

    Maxillofacial prostheses are usually fabricated on the models obtained following the impression procedures. Disadvantages of conventional impression techniques used in production of facial prosthesis are deformation of soft tissues caused by impression material and disturbance of the patient due to. Additionally production of prosthesis by conventional methods takes longer time. Recently, rapid prototyping techniques have been developed for extraoral prosthesis in order to reduce these disadvantages of conventional methods. Rapid prototyping technique has the potential to simplify the procedure and decrease the laboratory work required. It eliminates the need for measurement impression procedures and preparation of wax model to be performed by prosthodontists themselves In the near future this technology will become a standard for fabricating maxillofacial prostheses. PMID:21912504

  19. Indium-111 chloride imaging in the detection of infected prostheses

    Energy Technology Data Exchange (ETDEWEB)

    Sayle, B.A.; Fawcett, H.D.; Wilkey, D.J.; Cierny, G. III; Mader, J.T.

    1985-07-01

    Thirty-three patients with painful joint prostheses and a suspicion of infection were imaged with (/sup 111/In)chloride. A final diagnosis was established by culture in 19. Of these, 12 were categorized as true positives and three as true negatives. There were two false-positive studies, occurring in patients with knee prostheses. In both, the culture was obtained by aspiration. The sensitivity was 86%, specificity 60%, and accuracy 79%. Seventeen of the proven cases had bone imaging prior to (/sup 111/In)chloride imaging. All 17 static images were positive and were not helpful in differentiating loosening from infection. Using increased uptake on the blood-pool image as a criteria for infection, the sensitivity was 89%, but the specificity was 0. Adding flow studies made little difference in interpreting the blood-pool images. This study shows that (/sup 111/In)chloride imaging is more accurate in evaluating infection in prosthesis than bone imaging.

  20. Recent Patents and Designs on Hip Replacement Prostheses

    Science.gov (United States)

    Derar, H; Shahinpoor, M

    2015-01-01

    Hip replacement surgery has gone through tremendous evolution since the first procedure in 1840. In the past five decades the advances that have been made in technology, advanced and smart materials innovations, surgical techniques, robotic surgery and methods of fixations and sterilization, facilitated hip implants that undergo multiple design revolutions seeking the least problematic implants and a longer survivorship. Hip surgery has become a solution for many in need of hip joint remedy and replacement across the globe. Nevertheless, there are still long-term problems that are essential to search and resolve to find the optimum implant. This paper reviews several recent patents on hip replacement surgery. The patents present various designs of prostheses, different materials as well as methods of fixation. Each of the patents presents a new design as a solution to different issues ranging from the longevity of the hip prostheses to discomfort and inconvenience experienced by patients in the long-term. PMID:25893020

  1. Polyrethene nasolacrimal prostheses. Assessment of the complications using computed tomography

    International Nuclear Information System (INIS)

    Pino, I. T.; Paul, L.; Duran, M. A.; Grande, C.

    1999-01-01

    To assess the outcome of treatment of epiphora secondary to nasolacrimal duct obstruction by placement of a polyurethane prosthesis. We placed 20 polyurethane prostheses (song's prostheses) in 19 patients with nasolacrimal duct obstruction who presented idiopathic grade III-IV epiphora. All the patients underwent CT with follow-up studies 10 days, one month and three months after prosthesis placement. Epiphora resolved completely in 13 cases and partially in four. In two cases, the prosthesis was poorly positioned; one of them was replaced and the other functions to date. There were three cases of obstruction. We observed limited epistaxis in 7 patients and headache in one. The treatment of epiphora by polyurethane prosthesis placement is a simple procedure that is well tolerated by patients and has a high success rate. (Author) 14 refs

  2. Two Fungal Infections of Inflatable Penile Prostheses in Diabetics

    Directory of Open Access Journals (Sweden)

    Brittney H. Cotta, MD

    2015-12-01

    Conclusions: This report supports the emerging literature that the flora of IPP infections is changing. We suggest considering adding antifungal agents to antibiotic coatings, dips, or washout solutions at the time of penile prosthesis surgery in diabetic patients. Cotta BH, Butcher M, Welliver C, McVary K, and Köhler T. Two fungal infections of inflatable penile prostheses in diabetics. Sex Med 2015;3:339–342.

  3. Tissue Engineered Testicular Prostheses With Prolonged Testosterone Release

    Science.gov (United States)

    2008-12-01

    in infertile men. Fertil. Steril ., Epub ahead of print. Marshall, S., 1986: Potential problems with testicular prostheses. Urology, 28, 388-390...strengths to maintain structural integrity. The polymers were sterilized in ethylene oxide and placed under sterile conditions until cell delivery...washed in Povidone-iodine 10% solution, and dissected into 2 to 3 mm tissue fragments. Chondrocytes were isolated under sterile conditions using a

  4. Basal cell carcinoma does metastasize.

    Science.gov (United States)

    Ozgediz, Doruk; Smith, E B; Zheng, Jie; Otero, Jose; Tabatabai, Z Laura; Corvera, Carlos U

    2008-08-15

    Basal cell carcinoma (BCC) rarely metastasizes. However, this unfortunate outcome can occur, usually in neglected tumors. We report a 52-year-old man with a BCC on the left chest that enlarged and then ulcerated over a 6-year period. Metastasis of the tumor to lymph nodes in the left axilla resulted, but the patient remains free of disease 24 months after wide excision, lymph node dissection, and local radiation therapy to the axilla.

  5. Effect of occlusal support by implant prostheses on brain function.

    Science.gov (United States)

    Okamoto, Naoko

    2011-10-01

    The present study was carried out to identify how gum chewing with and without occlusal support by implant prostheses affects brain function as well as chewing function. Twenty-four subjects rehabilitated with implant-supported fixed prostheses were evaluated. An electroencephalograph (EEG) (ESA-Pro) and mandibular kinesiograph (Bio PAK(®)) wear used to measure brain function and chewing function, respectively, before and after gum chewing with and without an implant superstructure. Based on brain function estimated by the Dα values derived from measurement data, the subjects were divided into the normal region group (including the sub-normal region group) (n=15; Dα≥0.952) and the impaired region group (n=9; DαBrain function in the normal region group showed no change after gum chewing, whether or not an implant superstructure was in place (p>0.05). However, brain function in the impaired region group showed significant improvement after gum chewing (pbrain function compared to the results without an implant superstructure. In the impaired region group, there was a high positive correlation between brain function and masticatory movement (γ=0.75). Subjects in the impaired region group revealed a strong positive correlation between brain function and masticatory movement, indicating that occlusal support by implant-supported fixed prostheses has the potential to enhance brain function. Copyright © 2011 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  6. The Hand of Cercopithecoides williamsi (Mammalia, Primates: Earliest Evidence for Thumb Reduction among Colobine Monkeys.

    Directory of Open Access Journals (Sweden)

    Stephen R Frost

    Full Text Available Thumb reduction is among the most important features distinguishing the African and Asian colobines from each other and from other Old World monkeys. In this study we demonstrate that the partial skeleton KNM-ER 4420 from Koobi Fora, Kenya, dated to 1.9 Ma and assigned to the Plio-Pleistocene colobine species Cercopithecoides williamsi, shows marked reduction of its first metacarpal relative to the medial metacarpals. Thus, KNM-ER 4420 is the first documented occurrence of cercopithecid pollical reduction in the fossil record. In the size of its first metacarpal relative to the medial metacarpals, C. williamsi is similar to extant African colobines, but different from cercopithecines, extant Asian colobines and the Late Miocene colobines Microcolobus and Mesopithecus. This feature clearly links the genus Cercopithecoides with the extant African colobine clade and makes it the first definitive African colobine in the fossil record. The postcranial adaptations to terrestriality in Cercopithecoides are most likely secondary, while ancestral colobinans (and colobines were arboreal. Finally, the absence of any evidence for pollical reduction in Mesopithecus implies either independent thumb reduction in African and Asian colobines or multiple colobine dispersal events out of Africa. Based on the available evidence, we consider the first scenario more likely.

  7. The Hand of Cercopithecoides williamsi (Mammalia, Primates): Earliest Evidence for Thumb Reduction among Colobine Monkeys.

    Science.gov (United States)

    Frost, Stephen R; Gilbert, Christopher C; Pugh, Kelsey D; Guthrie, Emily H; Delson, Eric

    2015-01-01

    Thumb reduction is among the most important features distinguishing the African and Asian colobines from each other and from other Old World monkeys. In this study we demonstrate that the partial skeleton KNM-ER 4420 from Koobi Fora, Kenya, dated to 1.9 Ma and assigned to the Plio-Pleistocene colobine species Cercopithecoides williamsi, shows marked reduction of its first metacarpal relative to the medial metacarpals. Thus, KNM-ER 4420 is the first documented occurrence of cercopithecid pollical reduction in the fossil record. In the size of its first metacarpal relative to the medial metacarpals, C. williamsi is similar to extant African colobines, but different from cercopithecines, extant Asian colobines and the Late Miocene colobines Microcolobus and Mesopithecus. This feature clearly links the genus Cercopithecoides with the extant African colobine clade and makes it the first definitive African colobine in the fossil record. The postcranial adaptations to terrestriality in Cercopithecoides are most likely secondary, while ancestral colobinans (and colobines) were arboreal. Finally, the absence of any evidence for pollical reduction in Mesopithecus implies either independent thumb reduction in African and Asian colobines or multiple colobine dispersal events out of Africa. Based on the available evidence, we consider the first scenario more likely.

  8. Rules of thumb for assessing reductive dechlorination pathways of PCDDs in specific systems

    International Nuclear Information System (INIS)

    Lu Guining; Dang Zhi; Fennell, Donna E.; Huang Weilin; Li Zhong; Liu Congqiang

    2010-01-01

    This paper reports a theoretical validation and proposition of the reductive dechlorination pathways for polychlorinated dibenzo-p-dioxin (PCDD) congeners. Density functional theory (DFT) calculations were carried out at the B3LYP/6-31G(d) level for all PCDDs and Mulliken atomic charges on chlorine atoms were adopted as the probe of the dechlorination reaction activity. The experimentally substantiated dechlorination pathways of 1,2,3,4-tetrachlorodibenzo-p-dioxin (1,2,3,4-TCDD) and its daughter products in the presence of zero-valent zinc were validated and the complete pathway of dechlorination of octachlorodibenzo-p-dioxin (OCDD) was proposed. The proposed pathways were found to be consistent with anaerobic biotransformation of several PCDD congeners. Four rules of thumb arrived from this study include (1) the chlorine atoms in the longitudinal (1,4,6,9) positions are removed in preference to the chlorine atoms on lateral (2,3,7,8) positions; (2) the chlorine atom that has more neighboring chlorine atoms at ortho-, meta- and para-positions is to be eliminated; (3) reductive dechlorination prefers to take place on the benzene ring having more chlorine substitutions; and (4) a chlorine atom on the side of the longitudinal symmetry axis containing more chlorine atoms is preferentially eliminated. These rules of thumb can be conveniently used for rapidly predicting the major dechlorination pathway for a given PCDD in specific systems.

  9. Management of subluxation injury in a thumb-sucking child: a case report.

    Science.gov (United States)

    Celik, Berna; Cehreli, Zafer C

    2008-08-01

    This case report presents use of a custom trauma splint that was fabricated to prevent excessive thumb-sucking trauma to a previously-subluxated permanent incisor. A 10-year-old boy was referred to the clinic 10 days after falling in the schoolyard that resulted in a trauma to his maxillary left central incisor. The extent of clinical mobility stipulated fabrication of a custom trauma splint that would prevent further trauma to the incisor caused by excessive pressure of the thumb. A light-cured resin composite splint, covering the incisal edges of the central incisors and labial surfaces of the lateral incisors was made, and approximately 1-mm composite within the impressions of central incisors were trimmed off. The splint was bonded to the neighboring lateral incisors with flowable resin composite and root canal therapy was initiated on the subluxated incisor. After one week, the patient stopped his sucking habit completely. The treatment not only allowed for complete healing of the subluxated incisor without being exposed to further trauma, but also for spontaneous eruption of the tooth and closure of the existing open-bite.

  10. Clinical evaluation vs magnetic resonance imaging of the skier’s thumb: A prospective cohort of 30 patients

    Energy Technology Data Exchange (ETDEWEB)

    Mahajan, Mandhkani, E-mail: mahajanmch@gmail.com [Medical Center Haaglanden, Department of Surgery, Lijnbaan 32, 2512 VA The Hague (Netherlands); Tolman, Christine, E-mail: c.tolman@mchaaglanden.nl [Medical Center Haaglanden, Department of Radiology, Lijnbaan 32, 2512 VA The Hague (Netherlands); Würth, B., E-mail: b.wurth@mchaaglanden.nl [Medical Center Haaglanden, Department of Emergency Care, Lijnbaan 32, 2512 VA The Hague (Netherlands); Rhemrev, Steven J., E-mail: s.rhemrev@mchaaglanden.nl [Medical Center Haaglanden, Department of Surgery, Lijnbaan 32, 2512 VA The Hague (Netherlands)

    2016-10-15

    Highlights: • A skier’s thumb can be diagnosed by any physician when correctly instructed. • Additional imaging should be reserved when clinical examination is inconclusive. • MR imaging has excellent inter-rater agreement when diagnosing a skier’s thumb. - Abstract: Introduction: A skiers thumb, or a partial or complete rupture of the ulnar collateral ligament (UCL) is a clinical diagnosis. Swelling, pain, natural left-right difference and inexperience of a young physician can cause difficulty to correctly diagnose this injury. However, our theory is that any physician, given the correct instructions, should be able to diagnose this injury solely on clinical findings, without the necessity of additional imaging. Material and methods: In a large Dutch teaching hospital, physicians (residents with working experience of 6 months–3 years) working at the ER received instructions for physical examination. Patients >18 years, with an injury <1 week old, suspected of a true skier’s thumb had an MRI reported by two independent radiologists to confirm the diagnosis. Results: Thirty patients were included. Seven patients had no fixed endpoint (23%), all had a complete ligamentous rupture of the UCL on MRI, of which three patients had a Stener lesion. Fifteen patients (50%) met with the criteria  >35° laxity in extension of MCP/ >20° laxity in 30° flexion of the MCP. Of these, thirteen patients (81%) had a complete rupture (nine Stener lesions (56%)). One patient had a partial injury and one patient had no UCL-injury. Eight patients (27%) had inconclusive results during physical examination. Of these, two had a complete rupture (40%, 1 Stener). Three patients had a partial rupture and three patients had an intact UCL. Conclusion: A skier’s thumb can be diagnosed by any resident when correctly instructed. Additional imaging when diagnosing a skier’s thumb should be reserved in cases when physical examination remains inconclusive.

  11. Basal cell carcinoma of penis: case report.

    OpenAIRE

    Sulaiman, M Z; Polacarz, S V; Partington, P E

    1988-01-01

    Basal cell carcinoma of the penis is rare. A patient who presented with a penile and scrotal ulcer due to basal cell carcinoma is reported. Wide local excision and split skin grafting were performed to excise the lesion completely.

  12. Basal Cell Carcinoma Metastatic to Parotid Gland

    OpenAIRE

    Kurian, Rinsey Rose; Di Palma, Silvana; Barrett, A. W.

    2013-01-01

    Metastasis from basal cell carcinoma of the skin is very rare with cases being documented in the lymph nodes, lung, bone and parotid gland. The main histopathological differential diagnosis is the locally arising basal cell adenocarcinoma from which it is difficult to distinguish by morphology and routine immunohistochemistry. Approximately 85 % of all reported metastatic basal cell carcinomas arise in the head and neck region. Here we present a case of basal cell carcinoma of the skin of the...

  13. Increase in twitch force of the adductor pollicis muscle with stabilized preload at constant thumb abduction before and after administration of muscle relaxant

    NARCIS (Netherlands)

    van Santen, G; Wierda, JMKH; Fidler, [No Value

    Objective. To determine whether the twitch force of the adductor pollicis remains stable when 0.1 Hz single twitch stimulation is started after stabilization of the thumb preload at a constant degree of thumb abduction; also to study any possible increase in twitch force before the onset of and

  14. Basal cell carcinoma-treatment with cryosurgery

    Directory of Open Access Journals (Sweden)

    Kaur S

    2003-03-01

    Full Text Available Basal cell carcinoma is a common cutaneous malignancy, frequently occurring over the face in elderly individuals. Various therapeutic modalities are available to treat these tumors. We describe three patients with basal cell carcinoma successfully treated with cryosurgery and discuss the indications and the use of this treatment modality for basal cell carcinomas.

  15. Fabrication of biosynthetic vascular prostheses by 193-nm excimer laser radiation

    Science.gov (United States)

    Husinsky, Wolfgang; Csek, Ch.; Bartel, A.; Grabenwoeger, M.; Fitzal, F.; Wolner, Ernst

    1998-05-01

    This study was undertaken to investigate the feasibility of transmural capillary ingrowth into the inner surface of biosynthetic vascular prostheses (OmniflowTM) through perforations created by an excimer-laser, thus inducing an endothelial cell coverage. The biosynthetic vascular prostheses (10 cm length, 6 mm (phi) ) were perforated with an excimer laser ((phi) of the holes 50 - 100 micrometer, distance 4 mm) and implanted into the carotid arteries of 8 sheep. The laser tissue interaction process of 193 nm radiation ensures minimal thermal damage to the prostheses. They were compared to untreated OmniflowTM prostheses implanted at the contralateral side. Three months after implantation the prostheses were explanted and evaluated by gross morphology, histological examination and scanning electron microscopy. Scanning electron microscopy showed endothelial cells in the midgraft portion of all perforated prostheses, whereas collagen fibers, fibrin meshwork and activated platelets formed the inner layer in 6 out of 8 untreated OmniflowTM prostheses. It can be concluded, that spontaneous endothelialization of biosynthetic vascular prostheses can be achieved by transmural capillary ingrowth through perforations in the wall of the prostheses in an experimental sheep model.

  16. [REPAIR OF THUMB PULP DEFECTS WITH SIDE ISLAND FLAP COINCIDING DORSAL BRANCH OF DIGITAL NERVE].

    Science.gov (United States)

    Yang, Huanyou; Wang, Bin; Lu, Aidong; Li, Ruiguo; Chen, Chao; Ma, Tiepeng

    2014-07-01

    To explore the effectiveness of the side island flap coinciding dorsal branch of the digital. nerve for repairing thumb pulp defects. Between May 2008 and July 2012, 36 cases of thumb pulp defects were treated with the side island flap coinciding dorsal branch of the digital nerve. There were 26 males and 10 females, aged 21-51 years (mean, 32.4 years). The injury causes included electric saw injury in 14 cases, punchpress injury in 8 cases, machine twist injury in 5 cases, door crushing injury in 5 cases, and glass cutting injury in 4 cases. The left hand was involved in 12 cases and the right hand in 24 cases. Combined injuries included tendon and bone exposure in all cases, fracture of the distal phalanx in 3 cases, and nail bed lacerations in 2 cases. The defect size ranged from 1.4 cm x 1.2 cm to 2.5 cm x 2.1 cm; and the flap size ranged from 1.8 cm x 1.4 cm to 3.0 cm x 2.5 cm. Two flaps with distal skin flap tension blisters and skin scabbing, which were cured after dressing changes; the wound healed by first intension in the other 34 cases. The skin grafts at donor site survived, and primary healing of incision was obtained. The patients were followed up 3-15 months (mean, 8 months). The appearance and function restored well. Two-point discrimination of the flap was 5.2 mm on average (range, 4-8 mm) at last follow-up. The finger joint had no stiff. According to the upper extremity function evaluation criteria issued by the Hand Surgery Society of Chinese Medical Association, the sensation was S4 in 33 and S3+ in 3 cases. No ectopic feeling was observed. The extension and flexion activity of fingers at donor site was normal, the sensation reached S4 with no atrophy of the finger. With constant anatomy, reliable blood supply, and safe operation, the anastomoses of the finger side island flap with dorsal branch of digital nerve is a better method to repair thumb pulp defects because it also effectively overcome the ectopic feeling with traditional methods and

  17. A prospective randomized comparison of neoprene vs thermoplast hand-based thumb spica splinting for trapeziometacarpal arthrosis

    NARCIS (Netherlands)

    Becker, S. J. E.; Bot, A. G. J.; Curley, S. E.; Jupiter, J. B.; Ring, D.

    2013-01-01

    Objective: In patients with trapeziometacarpal arthrosis, we tested the hypothesis that there is no difference in arm-specific disability 5-15 weeks after prescription of a pre-fabricated neoprene or a custom-made thermoplast hand-based thumb spica splint with the metacarpophalangeal joint included

  18. Immediate effect of a wrist and thumb brace on bimanual activities in children with hemiplegic cerebral palsy

    NARCIS (Netherlands)

    Louwers, Annoek; Meester-Delver, Anke; Folmer, Katinka; Nollet, Frans; Beelen, Anita

    2011-01-01

    AIM The aim of this study was to determine the immediate effect of wearing a wrist and thumb brace on the performance of bimanual activities in children with spastic hemiplegic cerebral palsy. METHOD In a pre- and post-test cohort study of 25 children (age range 4-11y; mean age 8y 4mo [SD 2y 2mo];

  19. A THUMB OPPOSITION SPLINT TO IMPROVE MANUAL DEXTERITY AND UPPER-LIMB FUNCTIONING IN CHARCOT-MARIE-TOOTH DISEASE

    NARCIS (Netherlands)

    Videler, Annemieke; Eijffinger, Elianne; Nollet, Frans; Beelen, Anita

    2012-01-01

    Objective: To assess initial efficacy and tolerability of a thumb opposition splint on manual dexterity, perceived upper limb functioning and occupational performance in patients with Charcot-Marie-Tooth disease. Design: One group pre-post design. Patients and methods: Thirteen patients were

  20. Metacarpophalangeal joint of the thumb arthrodesis using intramedullary interlocking screws XMCP™.

    Science.gov (United States)

    Novoa-Parra, C N; Montaner-Alonso, D; Morales-Rodríguez, J

    2017-09-04

    The study objective was to assess the results of a thumb metacarpophalangeal joint (MCPJ) arthrodesis using intramedullary interlocking screws at 25°, XMCP ™ (Extremity Medical, Parsippany, NJ). Radiographs evaluated the angle of arthrodesis, time of fusion and fixation of the implant. Clinical and functional outcomes were assessed using the DASH questionnaire and the VAS scale. Any complications found during surgery or the follow-up period were noted. We studied 9 patients. The mean follow-up was 27.6 months. Patients showed clinical and radiological evidence of fusion in an average of 8 weeks, the angle of fusion was 25°. There were no complications and no implant had to be removed. The XMCP™ system provides a reliable method for MCPJ arthrodesis for several indications and can be used with other procedures in the complex hand. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Ectopic banking of amputated great toe for delayed thumb reconstruction: case report.

    Science.gov (United States)

    Valerio, Ian L; Hui-Chou, Helen G; Zelken, Jonathan; Basile, Patrick L; Ipsen, Derek; Higgins, James P

    2014-07-01

    Ectopic banking of amputated parts is a recognized technique for delayed replantation of an amputated part when the amputation stump will not permit immediate replantation. This is conventionally performed with the intent of transferring the injured part back to its anatomic position when the amputation stump is more appropriate for replantation. Current warfare conditions have led to a commonly encountered military trauma injury pattern of multiple extremity amputations with protected trunk and core structures. This pattern poses many challenges, including the limit or absence of donor sites for immediate or delayed flap reconstructive procedures. We describe a case in which we ectopically banked the great toe of an amputated lower extremity for delayed thumb reconstruction. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  2. Immediate loading of tooth-implant-supported telescopic mandibular prostheses.

    Science.gov (United States)

    Romanos, George E; May, Stephan; May, Dittmar

    2012-01-01

    Extractions in partially edentulous patients often lead to insufficient stability of an existing partial prosthesis and a need for additional anchorage. Implants may therefore be placed as supplementary abutments to increase patient comfort and satisfaction. The aim of this study was to evaluate the long-term clinical outcome of implants combined with teeth to support telescopic abutment-retained removable full-arch prostheses under an immediate functional loading protocol. The present retrospective study included implants placed and connected via removable prostheses with periodontally healthy teeth immediately postplacement using prefabricated abutments. Secondary copings, precisely fit to the abutments, were placed and the partial dentures were relined chairside. The prosthetic restorations were not removed for 10 days. Clinical and radiographic evaluations of implants loaded for at least 2 years were performed. One hundred ten implants with a progressive thread design (Ankylos, Dentsply) were placed in 55 patients (mean age, 63.51±9.95 years). Twenty-five implants were placed in fresh extraction sockets (22.73%) and 85 implants were placed in healed ridges. All implants were placed 2 to 3 mm subcrestally (measured from the midfacial bone level). After a mean follow-up of 61.58±28.47 months (range, 24 to 125 months), there were only three failures (2.73%); another six implants (5.45%) displayed crestal bone loss greater than 2 mm but remained stable. Therefore, the failure rate was 8.18% for the entire observation period of 5.13 years. The success rate was 91.82% and the cumulative survival rate was 97.27%. All patients were satisfied with the stability of their prostheses, and no prosthetic, peri-implant, or abutment tooth problems were observed. Telescopic tooth-implant-supported mandibular restorations with immediate loading present an alternative prosthetic solution for partially edentulous patients, providing a long-term predictable clinical outcome.

  3. Monte Carlo dose calculations for phantoms with hip prostheses

    International Nuclear Information System (INIS)

    Bazalova, M; Verhaegen, F; Coolens, C; Childs, P; Cury, F; Beaulieu, L

    2008-01-01

    Computed tomography (CT) images of patients with hip prostheses are severely degraded by metal streaking artefacts. The low image quality makes organ contouring more difficult and can result in large dose calculation errors when Monte Carlo (MC) techniques are used. In this work, the extent of streaking artefacts produced by three common hip prosthesis materials (Ti-alloy, stainless steel, and Co-Cr-Mo alloy) was studied. The prostheses were tested in a hypothetical prostate treatment with five 18 MV photon beams. The dose distributions for unilateral and bilateral prosthesis phantoms were calculated with the EGSnrc/DOSXYZnrc MC code. This was done in three phantom geometries: in the exact geometry, in the original CT geometry, and in an artefact-corrected geometry. The artefact-corrected geometry was created using a modified filtered back-projection correction technique. It was found that unilateral prosthesis phantoms do not show large dose calculation errors, as long as the beams miss the artefact-affected volume. This is possible to achieve in the case of unilateral prosthesis phantoms (except for the Co-Cr-Mo prosthesis which gives a 3% error) but not in the case of bilateral prosthesis phantoms. The largest dose discrepancies were obtained for the bilateral Co-Cr-Mo hip prosthesis phantom, up to 11% in some voxels within the prostate. The artefact correction algorithm worked well for all phantoms and resulted in dose calculation errors below 2%. In conclusion, a MC treatment plan should include an artefact correction algorithm when treating patients with hip prostheses

  4. Residual Stresses in Porcelain-veneered Zirconia Prostheses

    Science.gov (United States)

    Baldassarri, Marta; Stappert, Christian F. J.; Wolff, Mark S.; Thompson, Van P.; Zhang, Yu

    2012-01-01

    Objectives Compressive stress has been intentionally introduced into the overlay porcelain of zirconia-ceramic prostheses to prevent veneer fracture. However, recent theoretical analysis has predicted that the residual stresses in the porcelain may be also tensile in nature. This study aims to determine the type and magnitude of the residual stresses in the porcelain veneers of full-contour fixed-dental prostheses (FDPs) with an anatomic zirconia coping design and in control porcelain with the zirconia removed using a well-established Vickers indentation method. Methods Six 3-unit zirconia FDPs were manufactured (NobelBiocare, Gothenburg, Sweden). Porcelain was hand-veneered using a slow cooling rate. Each FDP was sectioned parallel to the occlusal plane for Vickers indentations (n = 143; load = 9.8 N; dwell time = 5 s). Tests were performed in the veneer of porcelain-zirconia specimens (bilayers, n = 4) and porcelain specimens without zirconia cores (monolayers, n = 2). Results The average crack lengths and standard deviation, in the transverse and radial directions (i.e. parallel and perpendicular to the veneer/core interface, respectively), were 67 ± 12 μm and 52 ± 8 μm for the bilayers and 64 ± 8 μm and 64 ± 7 μm for the monolayers. These results indicated a major hoop compressive stress (~40 to 50 MPa) and a moderate radial tensile stress (~10 MPa) in the bulk of the porcelain veneer. Significance Vickers indentation is a powerful method to determine the residual stresses in veneered zirconia systems. Our findings revealed the presence of a radial tensile stress in the overlay porcelain, which may contributed to the large clinical chip fractures observed in these prostheses. PMID:22578663

  5. Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms

    Science.gov (United States)

    Deshaies, Eric M; Villwock, Mark R; Singla, Amit; Toshkezi, Gentian; Padalino, David J

    2015-01-01

    Less invasive surgical approaches for intracranial aneurysm clipping may reduce length of hospital stay, surgical morbidity, treatment cost, and improve patient outcomes. We present our experience with a minimally invasive pterional approach for anterior circulation aneurysms performed in a major tertiary cerebrovascular center and compare the results with an aged matched dataset from the Nationwide Inpatient Sample (NIS). From August 2008 to December 2012, 22 elective aneurysm clippings on patients ≤55 years of age were performed by the same dual fellowship-trained cerebrovascular/endovascular neurosurgeon. One patient (4.5%) experienced transient post-operative complications. 18 of 22 patients returned for follow-up imaging and there were no recurrences through an average duration of 22 months. A search in the NIS database from 2008 to 2010, also for patients aged ≤55 years of age, yielded 1,341 hospitalizations for surgical clip ligation of unruptured cerebral aneurysms. Inpatient length of stay and hospital charges at our institution using the minimally invasive thumb-sized pterional technique were nearly half that of NIS (length of stay: 3.2 vs 5.7 days; hospital charges: $52,779 vs. $101,882). The minimally invasive thumb-sized pterional craniotomy allows good exposure of unruptured small and medium-sized supraclinoid anterior circulation aneurysms. Cerebrospinal fluid drainage from key subarachnoid cisterns and constant bimanual microsurgical techniques avoid the need for retractors which can cause contusions, localized venous infarctions, and post-operative cerebral edema at the retractor sites. Utilizing this set of techniques has afforded our patients with a shorter hospital stay at a lower cost compared to the national average. PMID:26325337

  6. Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms.

    Science.gov (United States)

    Deshaies, Eric M; Villwock, Mark R; Singla, Amit; Toshkezi, Gentian; Padalino, David J

    2015-08-11

    Less invasive surgical approaches for intracranial aneurysm clipping may reduce length of hospital stay, surgical morbidity, treatment cost, and improve patient outcomes. We present our experience with a minimally invasive pterional approach for anterior circulation aneurysms performed in a major tertiary cerebrovascular center and compare the results with an aged matched dataset from the Nationwide Inpatient Sample (NIS). From August 2008 to December 2012, 22 elective aneurysm clippings on patients ≤55 years of age were performed by the same dual fellowship-trained cerebrovascular/endovascular neurosurgeon. One patient (4.5%) experienced transient post-operative complications. 18 of 22 patients returned for follow-up imaging and there were no recurrences through an average duration of 22 months. A search in the NIS database from 2008 to 2010, also for patients aged ≤55 years of age, yielded 1,341 hospitalizations for surgical clip ligation of unruptured cerebral aneurysms. Inpatient length of stay and hospital charges at our institution using the minimally invasive thumb-sized pterional technique were nearly half that of NIS (length of stay: 3.2 vs 5.7 days; hospital charges: $52,779 vs. $101,882). The minimally invasive thumb-sized pterional craniotomy allows good exposure of unruptured small and medium-sized supraclinoid anterior circulation aneurysms. Cerebrospinal fluid drainage from key subarachnoid cisterns and constant bimanual microsurgical techniques avoid the need for retractors which can cause contusions, localized venous infarctions, and post-operative cerebral edema at the retractor sites. Utilizing this set of techniques has afforded our patients with a shorter hospital stay at a lower cost compared to the national average.

  7. [Functional, mechanical, and structural demands in microvascular prostheses (author's transl)].

    Science.gov (United States)

    Tizian, C H

    1980-01-01

    Fundamental conclusions can be made based on initial experimental experiences concerning microvascular prostheses. Beside having high durability, the microprostheses need to be compatible with other tissues and easy to handle. They must have a microporous structure to allow tissue ingrowth. Negative surface charge, hydrophobic property, and inertness of the synthetic material contribute to avoiding thrombosis. The isodiametric relationship between vessel and micrograft appears to create an optimal hemodynamic situation. For insertion, the use of microsurgical techniques is necessary in determining the future of the implanted micrograft. By performing everting continuous over-and-over suture, the end-to-end anastomosis showed excellent results.

  8. [COMBINED ACRYLIC-POLYPROPYLEN REMOVABLE PROSTHESES FOR PROSTHODONTIC TREATMENT].

    Science.gov (United States)

    Shuturminsky, V

    2015-10-01

    The article deals with the development of methods to prevent complications with prosthetic dentures patients with psychiatric status. The authors developed a method of manufacturing the denture using modern thermoplastic materials, the use of which in practice does not cause prosthetic stomatitis in patients with psychiatric status. The proposed methodology has been tested clinically. Based on Schiller- Pisarev and study fixation of prostheses has been shown the advantage of the prosthesis used for prosthetics partial dentition defects that can not be fixed prosthetics in this category of patients.

  9. Modular externally-powered system for limb prostheses

    Energy Technology Data Exchange (ETDEWEB)

    Seamone, W.; Hoshall, C.H.; Schmeisser, G.

    Many upper limb amputees especially those who have sustained high level amputations of injury to remaining portions of the body, are unable to use conventional prosthetic devices effectively. In an effort to help the more severely handicapped amputees and those who may for other reasons require capabilities that standard prostheses cannot provide, the Applied Physics Laboratory, in conjunction with the Johns Hopkins Medical Institutions, has developed a prosthetic system which is powered by rechargeable batteries. The amputee need supply only a control signal. This article describes the concept which is now being evaluated with the aid of amputee subjects, and discusses results obtained to data in field tests.

  10. Heart valve prostheses: who protects our patients, and from what?

    Science.gov (United States)

    Beall, A C

    1977-01-01

    Phenomenal advances in the development of cardiac valve prostheses have taken place in less than two decades. However, the currently prevailing atmosphere of consumer protectionism in existence 20 years ago probably would have made such developments impossible. Recent passage of the Medical Device Amendments of 1976 (P.L. 94-295) will not only make future development extremely difficult, but also may force the field of cardiac valve replacement back into the era of the 1950s. Regulations implementing this legislation may be even more disastrous. It is time for someone to protect patients from their so-called protectors.

  11. Provisional prostheses during ridge augmentation and implant dentistry.

    Science.gov (United States)

    Livada, Rania; Hottel, Timothy L; Shiloah, Jacob

    2013-01-01

    Recent advancements in ridge augmentation and bone regeneration have expanded the pool of patients that could benefit from dental implants. However, providing the patient with a temporary prosthesis during the wound healing phase without impairing the process is a challenging task. This article summarizes available information pertaining to provisional prostheses, both tooth-supported and soft tissue-supported, that may meet the patient needs. The advantages and disadvantages of each class of prosthesis, along with indications and contraindications, were taken into consideration to aid the restorative dentist in choosing the optimal provisional for their patients.

  12. Evolution and homologies of primate and modern human hand and forearm muscles, with notes on thumb movements and tool use.

    Science.gov (United States)

    Diogo, Rui; Richmond, Brian G; Wood, Bernard

    2012-07-01

    In this paper, we explore how the results of a primate-wide higher-level phylogenetic analysis of muscle characters can improve our understanding of the evolution and homologies of the forearm and hand muscles of modern humans. Contrary to what is often suggested in the literature, none of the forearm and hand muscle structures usually present in modern humans are autapomorphic. All are found in one or more extant non-human primate taxa. What is unique is the particular combination of muscles. However, more muscles go to the thumb in modern humans than in almost all other primates, reinforcing the hypothesis that focal thumb movements probably played an important role in human evolution. What makes the modern human thumb myology special within the primate clade is not so much its intrinsic musculature but two extrinsic muscles, extensor pollicis brevis and flexor pollicis longus, that are otherwise only found in hylobatids. It is likely that these two forearm muscles play different functional roles in hylobatids and modern humans. In the former, the thumb is separated from elongated digits by a deep cleft and there is no pulp-to-pulp opposition, whereas modern humans exhibit powerful thumb flexion and greater manipulative abilities, such as those involved in the manufacture and use of tools. The functional and evolutionary significance of a third peculiar structure, the intrinsic hand structure that is often called the 'interosseous volaris primus of Henle' (and which we suggest is referred to as the musculus adductor pollicis accessorius) is still obscure. The presence of distinct contrahentes digitorum and intermetacarpales in adult chimpanzees is likely the result of prolonged or delayed development of the hand musculature of these apes. In relation to these structures, extant chimpanzees are more neotenic than modern humans. Copyright © 2012 Elsevier Ltd. All rights reserved.

  13. Biofilm formation on voice prostheses : Influence of dairy products in vitro

    NARCIS (Netherlands)

    Free, RH; Van der Mei, HC; Dijk, F; Van Weissenbruch, R; Busscher, HJ; Albers, FWJ

    2001-01-01

    Laryngectomized patients use silicone rubber voice prostheses to regain their speech: however. the lifetime of these devices is limited due to biofilm formation. Following anecdotal evidence. the influence of various dairy products on biofilm formation on voice prostheses was studied, using the

  14. The sense or nonsense of mobile-bearing total knee prostheses

    NARCIS (Netherlands)

    Wolterbeek, Nienke

    2011-01-01

    The focus of this thesis was if the in vivo kinematics of total knee prostheses was consistent with the kinematics intended by design and to determine the additional value of insert mobility and thus ‘the sense or nonsense’ of mobile-bearing knee prostheses. The added value of this thesis to the

  15. A study of technical changes to lower limb prostheses after initial fitting

    NARCIS (Netherlands)

    Rommers, GM; Vos, LDW; Klein, L; Groothoff, JW; Eisma, W H

    There is little published material in recent years about the use of lower limb prostheses in an elderly amputee population. In this study the authors were interested in the technical changes to lower limb prostheses after a first limb fitting procedure in a post-rehabilitation population in the

  16. In vivo fragmentation of microporous polyurethane- and copolyester elastomer-based vascular prostheses

    NARCIS (Netherlands)

    Hinrichs, W.L.J.; Hinrichs, W.L.J.; Kuit, J.; Feil, H.; Feil, H.; Wildevuur, Ch.R.H.; Feijen, Jan

    1992-01-01

    A previous study showed that microporous, compliant and (bio)degradable vascular prostheses prepared from a polyurethane/poly(-lactic acid) mixture can function as a temporary scaffold for the regeneration of small-calibre arteries. In this study the mechanism of fragmentation of vascular prostheses

  17. Methods used for assessing stresses in buccomaxillary prostheses: photoelasticity, finite element technique, and extensometry.

    Science.gov (United States)

    Goiato, Marcelo Coelho; Tonella, Bianca Piccolotto; Ribeiro, Paula do Prado; Ferraço, Renato; Pellizzer, Eduardo Piza

    2009-03-01

    The authors describe a literature revision on assessing stresses in buccomaxillary prostheses photoelasticity, finite element technique, and extensometry. They describe the techniques and the importance for use of each method in buccomaxillary prostheses with implants and the need of accomplishing more studies in this scarce literary area.

  18. Recovering a "Disfigured"¹ Face: Cosmesis in the Everyday Use of Facial Prostheses

    NARCIS (Netherlands)

    Yaron, Gili; Widdershoven, G.A.M.; Slatman, Jenny

    2017-01-01

    Prosthetic devices that replace an absent body part are generally considered to be either cosmetic or functional. Functional prostheses aim to restore (some degree of) lost physical functioning. Cosmetic prostheses attempt to restore a “normal” appearance to bodies that lack (one or more) limbs by

  19. Movement characteristics of upper extremity prostheses during basic goal-directed tasks

    NARCIS (Netherlands)

    Bouwsema, Hanneke; van der Sluis, Corry K.; Bongers, Raoul M.

    Background: After an upper limb amputation a prosthesis is often used to restore the functionality. However, the frequency of prostheses use is generally low. Movement kinematics of prostheses use might suggest origins of this low use. The aim of this study was to reveal movement patterns of

  20. Movement characteristics of upper extremity prostheses during basic goal-directed tasks.

    Science.gov (United States)

    Bouwsema, Hanneke; van der Sluis, Corry K; Bongers, Raoul M

    2010-07-01

    After an upper limb amputation a prosthesis is often used to restore the functionality. However, the frequency of prostheses use is generally low. Movement kinematics of prostheses use might suggest origins of this low use. The aim of this study was to reveal movement patterns of prostheses during basic goal-directed actions in upper limb prosthetic users and to compare this with existing knowledge of able-bodied performance during these actions. Movements from six users of upper extremity prostheses were analyzed, three participants with a hybrid upper arm prosthesis, and three participants with a myoelectric forearm prosthesis. Two grasping tasks and a reciprocal pointing task were investigated during a single lab session. Analyses were carried out on the kinematics of the tasks. When grasping, movements with both prostheses showed asymmetric velocity profiles of the reach and had a plateau in the aperture profiles. Reach and grasp were decoupled. Kinematics with the prostheses differed in that the use of upper arm prostheses required more time to execute the movements, while the movements were less smooth, more asymmetric, and showed more decoupling between reach and grasp. The pointing task showed for both prostheses less harmonic movements with higher task difficulty. Characterizing prosthetic movement patterns revealed specific features of prosthetic performance. Developments in technology and rehabilitation should focus on these issues to improve prosthetic use, in particular on improving motor characteristics and the control of the elbow, and learning to coordinate the reach and the grasp component in prehension. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

  1. Differences in aerodynamic characteristics of new and dysfunctional Provox (R) 2 voice prostheses in vivo

    NARCIS (Netherlands)

    Schwandt, LQ; Tjong-Ayong, HJ; van Weissenbruch, R; der Mei, HC; Albers, FWJ

    Tracheoesophageal voice prostheses need to be replaced due to increased airflow resistance or retrograde leakage of fluid into the trachea as a consequence of biofilm formation. Previous in vitro studies show a change of aerodynamic features of biofilm covered voice prostheses after removal of the

  2. Focus on Basal Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Venura Samarasinghe

    2011-01-01

    Full Text Available Nonmelanoma skin cancers (NMSCs, which include basal and squamous cell cancers are the most common human cancers. BCCs have a relatively low metastatic rate and slow growth and are frequently underreported. Whilst there is a definite role of sunexposure in the pathogenesis of BCC, several additional complex genotypic, phenotypic and environmental factors are contributory. The high prevalence and the frequent occurrence of multiple primary BCC in affected individuals make them an important public health problem. This has led to a substantial increase in search for newer noninvasive treatments for BCC. Surgical excision with predetermined margins remains the mainstay treatment for most BCC. Of the newer non-invasive treatments only photodynamic therapy and topical imiquimod have become established in the treatment of certain BCC subtypes, while the search for other more effective and tissue salvaging therapies continues. This paper focuses on the pathogenesis and management of BCC.

  3. Effect of probiotic bacteria on prevalence of yeasts in oropharyngeal biofilms on silicone rubber voice prostheses in vitro

    NARCIS (Netherlands)

    van der Mei, HC; Free, RH; Elving, GJ; Van Weissenbruch, R; Albers, FWJ; Busscher, HJ

    The proliferation of yeasts in the mixed bacterial and fungal biofilms colonising silicone rubber voice prostheses in laryngectomised patients is the main cause of malfunctioning of the valve mechanism on the oesophageal side of the prostheses. Indwelling voice prostheses usually have to be replaced

  4. Titania nanotube arrays as interfaces for neural prostheses

    Energy Technology Data Exchange (ETDEWEB)

    Sorkin, Jonathan A. [Department of Mechanical Engineering, Colorado State University, Fort Collins CO 80523 (United States); Hughes, Stephen [Department of Chemical and Biological Engineering, Colorado State University, Fort Collins CO 80523 (United States); School of Biomedical Engineering, Colorado State University, Fort Collins CO 80523 (United States); Soares, Paulo [Department of Mechanical Engineering, Polytechnic School, Pontifícia Universidade Católica do Paraná, Curitiba, PR 80215-901 (Brazil); Popat, Ketul C., E-mail: ketul.popat@colostate.edu [Department of Mechanical Engineering, Colorado State University, Fort Collins CO 80523 (United States); School of Biomedical Engineering, Colorado State University, Fort Collins CO 80523 (United States)

    2015-04-01

    Neural prostheses have become ever more acceptable treatments for many different types of neurological damage and disease. Here we investigate the use of two different morphologies of titania nanotube arrays as interfaces to advance the longevity and effectiveness of these prostheses. The nanotube arrays were characterized for their nanotopography, crystallinity, conductivity, wettability, surface mechanical properties and adsorption of key proteins: fibrinogen, albumin and laminin. The loosely packed nanotube arrays fabricated using a diethylene glycol based electrolyte, contained a higher presence of the anatase crystal phase and were subsequently more conductive. These arrays yielded surfaces with higher wettability and lower modulus than the densely packed nanotube arrays fabricated using water based electrolyte. Further the adhesion, proliferation and differentiation of the C17.2 neural stem cell line was investigated on the nanotube arrays. The proliferation ratio of the cells as well as the level of neuronal differentiation was seen to increase on the loosely packed arrays. The results indicate that loosely packed nanotube arrays similar to the ones produced here with a DEG based electrolyte, may provide a favorable template for growth and maintenance of C17.2 neural stem cell line. - Highlights: • Titania nanotube arrays can be fabricated with to have loosely or densely packed morphologies. • Titania nanotube arrays support higher C17.2 neural stem cell adhesion and proliferation. • Titania nanotube arrays support higher C17.2 neural stem cell differentiation towards neuronal lineage.

  5. Titania nanotube arrays as interfaces for neural prostheses.

    Science.gov (United States)

    Sorkin, Jonathan A; Hughes, Stephen; Soares, Paulo; Popat, Ketul C

    2015-04-01

    Neural prostheses have become ever more acceptable treatments for many different types of neurological damage and disease. Here we investigate the use of two different morphologies of titania nanotube arrays as interfaces to advance the longevity and effectiveness of these prostheses. The nanotube arrays were characterized for their nanotopography, crystallinity, conductivity, wettability, surface mechanical properties and adsorption of key proteins: fibrinogen, albumin and laminin. The loosely packed nanotube arrays fabricated using a diethylene glycol based electrolyte, contained a higher presence of the anatase crystal phase and were subsequently more conductive. These arrays yielded surfaces with higher wettability and lower modulus than the densely packed nanotube arrays fabricated using water based electrolyte. Further the adhesion, proliferation and differentiation of the C17.2 neural stem cell line was investigated on the nanotube arrays. The proliferation ratio of the cells as well as the level of neuronal differentiation was seen to increase on the loosely packed arrays. The results indicate that loosely packed nanotube arrays similar to the ones produced here with a DEG based electrolyte, may provide a favorable template for growth and maintenance of C17.2 neural stem cell line. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Oral Implant-Prostheses: New Teeth for a Brighter Brain.

    Directory of Open Access Journals (Sweden)

    Vincenzo De Cicco

    Full Text Available Several studies have demonstrated that chewing can be regarded as a preventive measure for cognitive impairment, whereas masticatory deficiency, associated with soft-diet feeding, is a risk factor for the development of dementia. At present the link between orofacial sensorimotor activity and cognitive functions is unknown. In subjects with unilateral molar loss we have shown asymmetries in both pupil size and masticatory muscles electromyographic (EMG activity during clenching: the molar less side was characterized by a lower EMG activity and a smaller pupil. Since implant-prostheses, greatly reduced both the asymmetry in EMG activity and in pupil's size, trigeminal unbalance, leading to unbalance in the activity of the Locus Coeruleus (LC, may be responsible for the pupil's asymmetry. According to the findings obtained in animal models, we propose that the different activity of the right and left LC may induce an asymmetry in brain activity, thus leading to cognitive impairment. According to this hypothesis, prostheses improved the performance in a complex sensorimotor task and increased the mydriasis associated with haptic tasks. In conclusion, the present study indicates that the implant-prosthesis therapy, which reduces the unbalance of trigeminal proprioceptive afferents and the asymmetry in pupil's size, may improve arousal, boosting performance in a complex sensorimotor task.

  7. Elbow joint biomechanics for preclinical evaluation of total elbow prostheses.

    Science.gov (United States)

    Kincaid, Brian L; An, Kai-Nan

    2013-09-27

    Total elbow arthroplasty is a clinically successful procedure, yet long-term implant survival rates have historically lagged behind those reported for total hips and knees. Clinical complications associated with implant wear, osteolysis, stem loosening and device fracture have been implicated as reasons for limited long-term survivorship. Unfortunately, there is little published information on the biomechanics and method(s) for preclinical evaluation of total elbow prostheses that could provide insight into the mechanisms of failure. Additionally, there are no consensus testing standards or summaries of loading profiles of the humero-ulnar joint associated with a range of activities of daily living. Such data would facilitate the standardized preclinical assessment of total elbow devices such is commonplace for other large joints. The objective of the work here is therefore to provide a comprehensive review of elbow joint biomechanics as it relates to preclinical evaluation of total elbow implants. This summary includes a review of elbow joint forces, kinematics, the types and frequency of humero-ulnar joint motions associated with activities of daily living and clinical outcomes, as well as proposing a methodology for deriving humero-ulnar joint reaction force magnitudes and vector orientations as a function of a known mass/force at the hand. From these data, a scalable, bi-axial loading profile is proposed as a foundation for the development of clinically relevant, laboratory simulations for assessment of total elbow prostheses performance. © 2013 Elsevier Ltd. All rights reserved.

  8. Positron emission tomography and basal ganglia functions

    International Nuclear Information System (INIS)

    Kato, Motohiro; Otsuka, Makoto; Taniwaki, Koukyo; Hosokawa, Shinichi; Kuwabara, Yasuo; Ichiya, Yuichi

    1990-01-01

    With the advent of positron emission tomography (PET), studies on the human brain function and pathophysiology of brain damage have been extremely progressed. It is well-known that the basal ganglia plays an important role as one of the central nervous system involved in exercise regulation. More recently, the potential involvement of the basal ganglia in psychological processes, such as cognitive function, has been pointed out, receiving much attention. In spite of such a lot of studies, however, basal ganglia function remains unclear. This paper describes the relationships between PET findings and basal ganglia function. PET findings are discussed in relation to brain energy metabolism and striatal dopamine function. Pathophysiology of the basal ganglia are described in terms of the following diseases: Parkinson's disease, Parkinson's syndrome, progressive supranuclear palsy, Huntington's disease, and dystonia. Physiological backgrounds of the basal ganglia for PET images are also referred to. (N.K.) 75 refs

  9. [Application of negative molds technology based on three-dimensional printing in digital maxillofacial prostheses].

    Science.gov (United States)

    Gu, X Y; Chen, X B; Jiao, T; Zhang, F Q; Jiang, X Q

    2017-06-09

    Objective: To explore a digital negative molds technique based on three-dimensional (3D) printing to assist in the manufacture of maxillofacial prostheses, and to improve the deficiency of the current clinical treatment. Methods: Seventeen patients with maxillofacial defects (including nasal defects, orbital defects, cheek defects, auricle defect) were scanned by means of facial optical scanning and computer tomography (CT). The 3D models were then reconstructed and global registration was made to merge the reconstructed models into a new digital model for 3D design. The 3D design of the prostheses was implemented in software. The mechanical connection structure was designed by forward engineering technology for 3 patients with intra-oral defects in maxilla who needed to make removable partial dentures, so that the silicone prostheses and removable partial denture could be combined. The removable partial dentures were made by conventional method and connected with the prostheses. According to the 3D data of the prostheses, the digital negative molds were designed, and the 3D printing technology was used to finish the processing of the resin molds. Silicone for prostheses were filled and cured in the resin molds to fabricate the clinical restorations for the patients. The margin adaptation and retention of the prostheses was detected. Results: Twenty patients with varying degrees of maxillofacial defects were rehabilitated using the courses developed in the study. All patients reported no pain or discomfort during the treatment; and they were satisfied with the final prostheses of the shape, color, retention, stability, etc. Eighteen of the prostheses showed good marginal adaptation, and sixteen of the prostheses showed good retention effect. Conclusions: The digital negative molds technique used in this study could greatly reduce the intensity of manual operation and provided a good therapeutic effect for patients with maxillofacial defects.

  10. Photodynamic therapy for basal cell carcinoma.

    Science.gov (United States)

    Fargnoli, Maria Concetta; Peris, Ketty

    2015-11-01

    Topical photodynamic therapy is an effective and safe noninvasive treatment for low-risk basal cell carcinoma, with the advantage of an excellent cosmetic outcome. Efficacy of photodynamic therapy in basal cell carcinoma is supported by substantial research and clinical trials. In this article, we review the procedure, indications and clinical evidences for the use of photodynamic therapy in the treatment of basal cell carcinoma.

  11. Modern basal insulin analogs: An incomplete story

    OpenAIRE

    Singh, Awadhesh Kumar; Gangopadhyay, Kalyan Kumar

    2014-01-01

    The currently available basal insulin does not completely mimic the endogenous insulin secretion. This has continued to promote the search for ideal basal insulin. The newer basal insulin have primarily focused on increasing the duration of action, reducing variability, and reducing the incidence of hypoglycemia, particularly nocturnal. However, the changing criteria of hypoglycemia within a short span of a few years along with the surprising introduction of major cardiac events as another ou...

  12. The carpometacarpal joint of the thumb: MR appearance in asymptomatic volunteers

    International Nuclear Information System (INIS)

    Hirschmann, Anna; Sutter, Reto; Pfirrmann, Christian W.A.; Schweizer, Andreas

    2013-01-01

    To prospectively characterize the MR appearance of the carpometacarpal (CMC) joint of the thumb in asymptomatic volunteers. Thirty-four asymptomatic volunteers (17 women, 17 men, mean age, 33.9 ± 9.2 years) underwent MR imaging of the thumb after approval by the local ethical committee. Two musculoskeletal radiologists independently classified visibility and signal intensity (SI) characteristics of the anterior oblique (AOL/beak ligament), the posterior oblique (POL), the intermetacarpal (IML), and the dorsoradial ligaments (DRL) on a three-point Likert scale. The thickness of all ligaments, cartilage integrity, and presence of joint fluid were assessed. The alignment of the first metacarpal base with the trapezium was quantified on sagittal and coronal planes. The ligaments of the CMC joint were constantly visible in all volunteers for the POL and IML, and in all but one for the AOL and DRL. On intermediate-weighted fat-saturated images the POL (65 %/74 % reader 1/reader 2) and DRL (58 %/64 %) were commonly of increased SI, while the IML had a striated appearance in 91 %/76 % of subjects. The AOL showed a variable SI (36 %/42 % low, 27 %/27 % increased, 36 %/30 % striated). The IML was the thickest ligament with a mean of 2.9 mm/3.1 mm and the DRL the thinnest (1.2 mm/1.4 mm). There was a mean dorsal subluxation of 1.8 mm/2.0 mm and radial subluxation of 2.8 mm/3.4 mm of the metacarpal base. The AOL was significantly thicker in men (1.7 mm) than in women (1.2 mm; p = 0.02). Radial subluxation was significantly larger in men (3.4 mm) than in women (2.2 mm; p = 0.02). No subluxation in palmar or ulnar direction was seen. Radial and dorsal subluxation of the CMC joint can be a normal finding in a resting position at MR imaging. The CMC ligaments showed a considerable variability of signal intensity with a typically striated IML; thickness of the AOL is typically less than 2.2 mm, of the POL typically less than 2.9 mm. (orig.)

  13. The carpometacarpal joint of the thumb: MR appearance in asymptomatic volunteers

    Energy Technology Data Exchange (ETDEWEB)

    Hirschmann, Anna; Sutter, Reto; Pfirrmann, Christian W.A. [Orthopedic University Hospital Balgrist, University of Zurich, Department of Radiology, Zurich (Switzerland); Schweizer, Andreas [Orthopedic University Hospital Balgrist, University of Zurich, Department of Orthopedic Surgery, Zurich (Switzerland)

    2013-08-15

    To prospectively characterize the MR appearance of the carpometacarpal (CMC) joint of the thumb in asymptomatic volunteers. Thirty-four asymptomatic volunteers (17 women, 17 men, mean age, 33.9 {+-} 9.2 years) underwent MR imaging of the thumb after approval by the local ethical committee. Two musculoskeletal radiologists independently classified visibility and signal intensity (SI) characteristics of the anterior oblique (AOL/beak ligament), the posterior oblique (POL), the intermetacarpal (IML), and the dorsoradial ligaments (DRL) on a three-point Likert scale. The thickness of all ligaments, cartilage integrity, and presence of joint fluid were assessed. The alignment of the first metacarpal base with the trapezium was quantified on sagittal and coronal planes. The ligaments of the CMC joint were constantly visible in all volunteers for the POL and IML, and in all but one for the AOL and DRL. On intermediate-weighted fat-saturated images the POL (65 %/74 % reader 1/reader 2) and DRL (58 %/64 %) were commonly of increased SI, while the IML had a striated appearance in 91 %/76 % of subjects. The AOL showed a variable SI (36 %/42 % low, 27 %/27 % increased, 36 %/30 % striated). The IML was the thickest ligament with a mean of 2.9 mm/3.1 mm and the DRL the thinnest (1.2 mm/1.4 mm). There was a mean dorsal subluxation of 1.8 mm/2.0 mm and radial subluxation of 2.8 mm/3.4 mm of the metacarpal base. The AOL was significantly thicker in men (1.7 mm) than in women (1.2 mm; p = 0.02). Radial subluxation was significantly larger in men (3.4 mm) than in women (2.2 mm; p = 0.02). No subluxation in palmar or ulnar direction was seen. Radial and dorsal subluxation of the CMC joint can be a normal finding in a resting position at MR imaging. The CMC ligaments showed a considerable variability of signal intensity with a typically striated IML; thickness of the AOL is typically less than 2.2 mm, of the POL typically less than 2.9 mm. (orig.)

  14. The artificial synapse chip: From proteins to prostheses

    Science.gov (United States)

    Peterman, Mark Charles

    Most retinal prostheses use an electric field to stimulate retinal circuitry, yet information transfer in the retina is primarily through neurotransmitters. To address this difference, this thesis describes a proof of concept retinal interface based on localized chemical delivery. This system, the Artificial Synapse Chip, is based on a 5 mum aperture in a silicon nitride membrane overlying a microfluidic channel. The effectiveness of this interface is demonstrated by ejecting bradykinin on cultured excitable cells. Even with manual fluidic control, the relationship between the extent of stimulation and concentration is linear, providing enough control to limit stimulation to individual cells. A neurotransmitter-based prosthesis will require advanced fluidic control. This thesis reports the use of electroosmosis to eject or withdraw fluid from an aperture in a channel wall. This effect is demonstrated experimentally, and numerically, using a finite-element method. Our primary device is a prototype interface with four individually addressable apertures in a 2 x 2 array. Using this array, we demonstrate stimulation of both PC12 and retinal ganglion cells. This demonstration of localized chemical stimulation of excitable cells illustrates the potential of this technology for retinal prostheses. As a final application of the Artificial Synapse Chip, we applied the concept to lipid bilayer membranes and membrane-bound proteins. Not only are membrane-bound proteins crucial to the function of biological synapses, but also are important from a technological point of view. In this thesis, we use a Langmuir-Blodgett technique to producing lipid bilayers across apertures in a modified version of the Artificial Synapse Chip. These bilayers display many of the same properties as bilayers across apertures in Teflon films. In addition, these bilayers remain unbroken at transmembrane potentials over +/-400 mV, higher than Teflon-supported bilayers. We also demonstrate single

  15. A prospective evaluation of zirconia anterior partial fixed dental prostheses: Clinical results after seven years.

    Science.gov (United States)

    Solá-Ruíz, Maria Fernanda; Agustin-Panadero, Rubén; Fons-Font, Antonio; Labaig-Rueda, Carlos

    2015-06-01

    Because of the high mechanical strength of zirconium dioxide, the metal in fixed partial prostheses can now be replaced. However, the material is susceptible to aging or hydrothermal degradation and to chipping of the feldspathic veneer. The purpose of this prospective study was to evaluate the survival (without failure) and success (survival without any complication or failure) rate and clinical efficacy of anterior zirconia partial fixed dental prostheses. Twenty-seven anterior partial fixed dental prostheses of 3 to 6 units were fabricated. All participants were examined after 1 month and 6 months, then annually for 7 years. Three partial fixed dental prostheses failed and had to be removed: 2 because of secondary caries, which increased failure significantly (P=.001) and 1 because of severe chipping. Six partial fixed dental prostheses had complications: 2 debonded, 3 had chipping, and 1 had periapical pathology. All veneer porcelain fractures occurred in 6-unit fixed partial prostheses (P=.002). The clinical success rate was 88.8% after the 7-year follow-up. The clinical behavior of partial fixed dental prostheses with a zirconium dioxide core in the anterior region provides an adequate medium-term survival rate. The main cause of failure was secondary caries. The most frequent complication was chipping, which was directly related to the number of units of the prosthesis. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  16. The future of basal insulin supplementation

    NARCIS (Netherlands)

    Simon, Airin C. R.; DeVries, J. Hans

    2011-01-01

    This review presents an overview of the candidates for an improved basal insulin in the pharmaceutical pipeline. The first new basal insulin to enter the market is most likely insulin degludec (IDeg), currently reporting in phase 3 of development, from Novo Nordisk (Bagsvaerd, Denmark). IDeg has a

  17. Fusarium basal rot in the Netherlands

    NARCIS (Netherlands)

    Visser, de C.L.M.; Broek, van den R.C.F.M.; Brink, van den L.

    2006-01-01

    Fusarium basal rot of onion, caused by Fusarium oxysporum f.sp. cepae, is a steadily increasing problem in The Netherlands. Financial losses for Dutch farmers confronted with Fusarium basal rot is substantial, due to yield reduction and high storage costs. This paper describes the development and

  18. Queuing Rule of Thumb based on M/M/s Queuing Theory with Applications in Construction Management

    Directory of Open Access Journals (Sweden)

    Teknomo K.

    2012-01-01

    Full Text Available The current trend of queuing theory development is toward more precision which requires higher mathematical manipulation. In this paper, we attempted to reverve the current trend toward simplification of queuing formulas such that it can be used in more practical purposes, especially in construction industry. Through numerical examples of two case studies on concreting and earth moving, how to model the construction activities as queuing systems is illustrated systematically. Through the numerical examples, it is shown that when the customer cost is much lower than the server cost, queuing system can be simplified only to incorporate the constraint equation. The queueing constraint equation is suggested to be used as queuing rule of thumb. The proposed rule of thumb is rather conservative in term of queuing performance compared to the standard stochastic queuing formula because it is assumed that all the customers arrive at once in the beginning of the service.

  19. From art to science: the functional damage due to thumb osteoarthritis finely described by Velazquez 300 years before its clinical description

    Directory of Open Access Journals (Sweden)

    J.H. Villafañe

    2017-09-01

    Full Text Available Velazquez showed to know the entity of thumb osteoarthritis by finely describing it in one of his paintings. The concepts of anatomical damage, loss of strenght, and functional impairment are transmitted to the observer.

  20. From art to science: the functional damage due to thumb osteoarthritis finely described by Velazquez 300 years before its clinical description.

    Science.gov (United States)

    Villafañe, J H; Cantero-Tellez, R; Negrini, S; Berjano, P

    2017-09-21

    Velazquez showed to know the entity of thumb osteoarthritis by finely describing it in one of his paintings. The concepts of anatomical damage, loss of strenght, and functional impairment are transmitted to the observer.

  1. Nevoid Basal Cell Carcinoma Syndrome (Gorlin Syndrome).

    Science.gov (United States)

    Bresler, Scott C; Padwa, Bonnie L; Granter, Scott R

    2016-06-01

    Nevoid basal cell carcinoma syndrome, or basal cell nevus syndrome (Gorlin syndrome), is a rare autosomal dominantly inherited disorder that is characterized by development of basal cell carcinomas from a young age. Other distinguishing clinical features are seen in a majority of patients, and include keratocystic odontogenic tumors (formerly odontogenic keratocysts) as well as dyskeratotic palmar and plantar pitting. A range of skeletal and other developmental abnormalities are also often seen. The disorder is caused by defects in hedgehog signaling which result in constitutive pathway activity and tumor cell proliferation. As sporadic basal cell carcinomas also commonly harbor hedgehog pathway aberrations, therapeutic agents targeting key signaling constituents have been developed and tested against advanced sporadically occurring tumors or syndromic disease, leading in 2013 to FDA approval of the first hedgehog pathway-targeted small molecule, vismodegib. The elucidation of the molecular pathogenesis of nevoid basal cell carcinoma syndrome has resulted in further understanding of the most common human malignancy.

  2. [Comparison of the clinical effects of selective laser melting deposition basal crowns and cobalt chromium alloy base crowns].

    Science.gov (United States)

    Li, Jing-min; Wang, Wei-qian; Ma, Jing-yuan

    2014-06-01

    To evaluate the clinical effects of selective laser melting (SLM) deposition basal crowns and cobalt chromium alloy casting base crowns. One hundred and sixty eight patients treated with either SLM deposition basal crowns (110 teeth) or cobalt chromium alloy casting basal crowns (110 teeth) were followed-up for 1 month, 6 months, 12 months and 24 months. The revised standard of American Public Health Association was used to evaluate the clinical effect of restoration, including the color of porcelain crowns, gingival inflammation, gingival margin discoloration, and crack or fracture. Data analysis was conducted with SPSS 20 software package for Student's t test and Chi-square test. Six cases were lost to follow-up. The patients who were treated with SLM deposition basal crowns (104 teeth) and cobalt chromium alloy casting base crowns (101 teeth) completed the study. Patients were more satisfied with SLM deposition cobalt chromium alloy porcelain crowns. There was 1 prosthesis with poor marginal fit after 24 months of restoration in SLM crowns. There were 6 prostheses with edge coloring and 8 with poor marginal fit in cobalt chromium alloy casting base crowns, which was significantly different between the 2 groups(P<0.05). The SLM deposition copings results in smaller edge coloring and better marginal fit than those of cobalt-chrome copings. Patients are pleased with short-term clinical results.

  3. Tablet Keyboard Configuration Affects Performance, Discomfort and Task Difficulty for Thumb Typing in a Two-Handed Grip.

    Directory of Open Access Journals (Sweden)

    Matthieu B Trudeau

    Full Text Available When holding a tablet computer with two hands, the touch keyboard configuration imposes postural constraints on the user because of the need to simultaneously hold the device and type with the thumbs. Designers have provided users with several possible keyboard configurations (device orientation, keyboard layout and location. However, potential differences in performance, usability and postures among these configurations have not been explored. We hypothesize that (1 the narrower standard keyboard layout in the portrait orientation leads to lower self-reported discomfort and less reach than the landscape orientation; (2 a split keyboard layout results in better overall outcomes compared to the standard layout; and (3 the conventional bottom keyboard location leads to the best outcomes overall compared to other locations. A repeated measures laboratory experiment of 12 tablet owners measured typing speed, discomfort, task difficulty, and thumb/wrist joint postures using an active marker system during typing tasks for different combinations of device orientation (portrait and landscape, keyboard layout (standard and split, and keyboard location (bottom, middle, top. The narrower standard keyboard with the device in the portrait orientation was associated with less discomfort (least squares mean (and S.E. 2.9±0.6 than the landscape orientation (4.5±0.7. Additionally, the split keyboard decreased the amount of reaching required by the thumb in the landscape orientation as defined by a reduced range of motion and less MCP extension, which may have led to reduced discomfort (2.7±0.6 compared to the standard layout (4.5±0.7. However, typing speed was greater for the standard layout (127±5 char./min. compared to the split layout (113±4 char./min. regardless of device orientation and keyboard location. Usage guidelines and designers can incorporate these findings to optimize keyboard design parameters and form factors that promote user performance

  4. Macroscopic and microscopic analysis of the thumb carpometacarpal ligaments: a cadaveric study of ligament anatomy and histology.

    Science.gov (United States)

    Ladd, Amy L; Lee, Julia; Hagert, Elisabet

    2012-08-15

    Stability and mobility represent the paradoxical demands of the human thumb carpometacarpal joint, yet the structural origin of each functional demand is poorly defined. As many as sixteen and as few as four ligaments have been described as primary stabilizers, but controversy exists as to which ligaments are most important. We hypothesized that a comparative macroscopic and microscopic analysis of the ligaments of the thumb carpometacarpal joint would further define their role in joint stability. Thirty cadaveric hands (ten fresh-frozen and twenty embalmed) from nineteen cadavers (eight female and eleven male; average age at the time of death, seventy-six years) were dissected, and the supporting ligaments of the thumb carpometacarpal joint were identified. Ligament width, length, and thickness were recorded for morphometric analysis and were compared with use of the Student t test. The dorsal and volar ligaments were excised from the fresh-frozen specimens and were stained with use of a triple-staining immunofluorescent technique and underwent semiquantitative analysis of sensory innervation; half of these specimens were additionally analyzed for histomorphometric data. Mixed-effects linear regression was used to estimate differences between ligaments. Seven principal ligaments of the thumb carpometacarpal joint were identified: three dorsal deltoid-shaped ligaments (dorsal radial, dorsal central, posterior oblique), two volar ligaments (anterior oblique and ulnar collateral), and two ulnar ligaments (dorsal trapeziometacarpal and intermetacarpal). The dorsal ligaments were significantly thicker (p anterior oblique ligament (p anterior oblique ligament was consistently a thin structure with a histologic appearance of capsular tissue with low cellularity. The dorsal deltoid ligament complex is uniformly stout and robust; this ligament complex is the thickest morphometrically, has the highest cellularity histologically, and shows the greatest degree of sensory

  5. Custom hip prostheses by integrating CAD and casting technology

    Science.gov (United States)

    Silva, Pedro F.; Leal, Nuno; Neto, Rui J.; Lino, F. Jorge; Reis, Ana

    2012-09-01

    Total Hip Arthroplasty (THA) is a surgical intervention that is being achieving high rates of success, leaving room to research on long run durability, patient comfort and costs reduction. Even so, up to the present, little research has been done to improve the method of manufacturing customized prosthesis. The common customized prostheses are made by full machining. This document presents a different approach methodology which combines the study of medical images, through CAD (Computer Aided Design) software, SLadditive manufacturing, ceramic shell manufacture, precision foundry with Titanium alloys and Computer Aided Manufacturing (CAM). The goal is to achieve the best comfort for the patient, stress distribution and the maximum lifetime of the prosthesis produced by this integrated methodology. The way to achieve this desiderate is to make custom hip prosthesis which are adapted to each patient needs and natural physiognomy. Not only the process is reliable, but also represents a cost reduction comparing to the conventional full machined custom hip prosthesis.

  6. Bionic balance organs: progress in the development of vestibular prostheses.

    Science.gov (United States)

    Smith, Paul F

    2017-09-01

    The vestibular system is a sensory system that is critically important in humans for gaze and image stability as well as postural control. Patients with complete bilateral vestibular loss are severely disabled and experience a poor quality of life. There are very few effective treatment options for patients with no vestibular function. Over the last 10 years, rapid progress has been made in developing artificial 'vestibular implants' or 'prostheses', based on cochlear implant technology. As of 2017, 13 patients worldwide have received vestibular implants and the results are encouraging. Vestibular implants are now becoming part of an increasing effort to develop artificial, bionic sensory systems, and this paper provides a review of the progress in this area.

  7. Cortical visual prostheses: from microstimulation to functional percept

    Science.gov (United States)

    Najarpour Foroushani, Armin; Pack, Christopher C.; Sawan, Mohamad

    2018-04-01

    Cortical visual prostheses are intended to restore vision by targeted electrical stimulation of the visual cortex. The perception of spots of light, called phosphenes, resulting from microstimulation of the visual pathway, suggests the possibility of creating meaningful percept made of phosphenes. However, to date electrical stimulation of V1 has still not resulted in perception of phosphenated images that goes beyond punctate spots of light. In this review, we summarize the clinical and experimental progress that has been made in generating phosphenes and modulating their associated perceptual characteristics in human and macaque primary visual cortex (V1). We focus specifically on the effects of different microstimulation parameters on perception and we analyse key challenges facing the generation of meaningful artificial percepts. Finally, we propose solutions to these challenges based on the application of supervised learning of population codes for spatial stimulation of visual cortex.

  8. Electric stimulation with sinusoids and white noise for neural prostheses

    Directory of Open Access Journals (Sweden)

    Daniel K Freeman

    2010-02-01

    Full Text Available We are investigating the use of novel stimulus waveforms in neural prostheses to determine whether they can provide more precise control over the temporal and spatial pattern of elicited activity as compared to conventional pulsatile stimulation. To study this, we measured the response of retinal ganglion cells to both sinusoidal and white noise waveforms. The use of cell-attached and whole cell patch clamp recordings allowed the responses to be observed without significant obstruction from the stimulus artifact. Electric stimulation with sinusoids elicited robust responses. White noise analysis was used to derive the linear kernel for the ganglion cell’s spiking response as well as for the underlying excitatory currents. These results suggest that in response to electric stimulation, presynaptic retinal neurons exhibit bandpass filtering characteristics with peak response that occur 25ms after onset. The experimental approach demonstrated here may be useful for studying the temporal response properties of other neurons in the CNS.

  9. Expert opinions on success factors for upper-limb prostheses.

    Science.gov (United States)

    Schultz, Aimee E; Baade, Susan P; Kuiken, Todd A

    2007-01-01

    The goal of this study was to gather the opinions of prosthetics experts on the most important factors for the successful use of upper-limb (UL) prostheses, compare them with those of prosthesis users, and ultimately direct research efforts in this field. UL prosthetics experts were asked to compare the importance of the comfort, function, and cosmesis of a prosthetic device for a transhumeral amputee. Categories were subdivided into weight, socket-interface comfort, power, agility, color, and shape. The majority of those who responded viewed comfort as the most important factor for a unilateral amputee and considered socket-interface comfort to be more important than weight. Function was considered to be the most important factor for a bilateral amputee, with agility considered more important than power. Cosmesis was consistently reported as being less important than comfort and function, and shape was considered more important than color.

  10. Light and electronmicroscopic studies on Polycel ossicular replacement prostheses.

    Science.gov (United States)

    Cousins, V C; Jahnke, K

    1987-06-01

    Recently, a new form of porous high density polyethylene (Polycel) has been promoted for use in ossicular chain reconstruction. However, we have found no reports of investigation of the fate of this material used for this purpose in either animals or man. This study was undertaken to look at the tissue tolerance and fate of Polycel in the middle ear of gerbils before its extensive use in humans. We present the light and transmission electromicroscopic findings from these prostheses, removed from the middle ear between 1 and 5 months post-implantation. The results are similar to those found with Plastipore, showing a strong foreign body reaction and the likelihood of phagocytic consumption. As with the other porous plastics, we have reservations about the use of Polycel for ossicular reconstruction.

  11. Traumatic Floating 1st Metacarpal in a 14-Year-Old Boy Managed by Close Reduction and Thumb Spica Immobilization: A Rare Case Report.

    Science.gov (United States)

    Tyagi, Himanshu Ravindra; Kamat, Nandan; Wajekar, Sagar; Mandalia, Saumil H

    2014-01-01

    Double dislocation of thumb metacarpal (MC) is a rare injury which may be secondarily complicated by growth plate injury in children. The management of floating 1st MC is also controversial since the treatment ranges from simple reduction to complex reconstruction surgeries. It is also important to understand the long-term results of different management strategies (close reduction, K-wire fixation, ligament reconstruction) as any residual stiffness or instability of thumb may result in severe disability of the hand. A 14-year-old boy with an alleged history of injury to the thumb due to a fall. The postulated mechanism of injury was forced hyperextension of thumb and axial loading of hand in the prone position. On examination, there was prominent bony swelling over the dorsal aspect of carpometacarpal (CMC) and metacarpophalangeal (MCP) joints which was very tender with diffuse swelling over entire thumb. X-ray showed dorsal dislocation of both MCP and CMC joints, without any fracture (bony avulsion) or volar plate avulsion. Treatment was by way of closed reduction performed by axial traction followed by forced flexion at MCP joint with continuous pressure over the dorsal aspect of the joint. The reduction of CMC joint was done by direct pressure over the dorsal aspect and full abduction of thumb. Following reduction, the thumb was immobilized in a thumb spica. Thus, we conclude it is possible to manage a case of floating 1st MC by closed reduction and immobilization, using proper reduction technique. However, a careful clinical and radiological assessment should be done beforehand for signs of bony injury or ligamentous instability.

  12. Modular neck prostheses in DDH patients: 11-year results.

    Science.gov (United States)

    Traina, Francesco; De Fine, Marcello; Tassinari, Enrico; Sudanese, Alessandra; Calderoni, Pierina Paola; Toni, Aldo

    2011-01-01

    Total hip replacement in developmental dysplasia of the hip is a demanding procedure and usually requires dedicated devices and special surgical techniques. Nevertheless, the described techniques have shown variable outcomes. The aim of this study was to assess the 11-year outcomes of an off-the-shelf modular neck prosthesis in dysplastic patients and to evaluate the ability of the modular neck system to adequately restore femoral offset, abductor muscles lever arm and leg length. We retrospectively evaluated 61 modular neck prostheses implanted in 47 patients between June 1995 and March 2004. The preoperative diagnosis was developmental dysplasia of the hip in all cases. The clinical outcomes were assessed using the Harris hip score and the Western Ontario and McMaster Universities score. The femoral offset, abductor muscles lever arm, height and medialization of the hip center of rotation, and differences in leg length were evaluated on postoperative radiographs. Prosthesis survival was calculated according to the Kaplan-Meier method considering any reason for revision as failure. The average follow-up was 117.2 months (range 57-162 months). The cumulative survival at 11 years was 97.5%. One prosthesis failed 5 years after surgery because of a ceramic liner fracture due to an inappropriate obstetric maneuver during labour. At the latest follow-up the mean Harris hip score was 74.7 (range 23-91). Leg length discrepancy was avoided in the majority of cases; femoral offset was almost always restored. The results of this series support the use of modular neck prostheses as an effective alternative in the treatment of developmental dysplasia of the hip. The modularity was very efficient in restoring offset, leg length and maintaining stability with a good mid-long-term follow-up. Unlike other proposed surgical techniques, these good results are achievable by a standard surgical technique and with an off-the-shelf prosthesis.

  13. A Case of Mayer-Rokitansky-Kuster-Hayser Syndrome with Absence of the Right Thumb

    Directory of Open Access Journals (Sweden)

    Pal Ranabir

    2008-01-01

    Full Text Available A 14-year-old feminine adolescent, presented with congenital absence of right thumb, scoliosis, severe anemia, primary amenorrhea without secondary sexual characteristics, except for normally developed breasts. In the genital area, there was a pair of ill developed labia majora fused at upper end with a whirling pattern containing inside the urethral opening. The lower end of genitalia had loose skin folds containing adequate amounts of rugae with a raphe, mimicking the texture of scrotal skin. There was no vaginal orifice. Diagnostic work-up included routine hematological studies, skeletal radiography, renal ultrasonography, and renal scan to demonstrate possible association between the congenital genitourinary and skeletal anomalies. Ultrasound imaging studies confirmed that she had structures close to uterus with hematometra, but vagina and ovary were not found. Sonologically, the left kidney could not be visualized. Renal scan confirmed agenesis of the left kidney and hypoplastic, parenchymally insufficient, right kidney. Cytogenetic karyotyping revealed a 46, XX karyotyping and the presence of Barr chromatin body. Based on the clinical examination and investigations, a diagnosis of Mayer-Rokitansky-Kuster-Hauser syndrome was established with associated limb and skeletal deformities.

  14. Trapezium excision and suture suspensionplasty (TESS) for the treatment of thumb carpometacarpal arthritis.

    Science.gov (United States)

    Putnam, Matthew D; Meyer, Nicholas J; Baker, Daniel; Brehmer, Jess; Carlson, Brent D

    2014-06-01

    Basilar thumb arthritis, or first carpometacarpal arthritis, is a common condition affecting older women and some men. It is estimated that as many as one third of postmenopausal woman are affected. Surgical treatment of this condition includes options ranging from arthrodesis to prosthetic arthroplasty. Intermediate options include complete or partial trapezial excision with or without interposition of a cushioning/stabilizing material (auto source, allo source, synthetic source). A multitude of methods appear to offer similar end results, although some methods definitely involve more surgical work and perhaps greater patient risk. Through retrospective evaluation of a cohort of patients who underwent suture suspensionplasty, we determined the postoperative effect on strength, motion, patient satisfaction, complications, and radiographic maintenance of the scaphoid-metacarpal distance. This review shows the method to be clinically effective and, by comparison with a more traditional ligament reconstruction trapezial interposition arthroplasty, the method does not require use of autograft or allograft tendon and has fewer surgical steps. Forty-four patients were included in this retrospective study. The results showed that 91% of patients were satisfied with the procedure. Pinch and grip strength remained the same preoperatively and postoperatively. A Disabilities of the Arm, Shoulder, and Hand patient-reported outcome instrument (DASH) scores averaged 30 at final follow-up. Three patients developed a late complication requiring further surgical intervention. In summary, this technique appears to be technically reproducible, requires no additional tendon material, and achieves objectively and subjectively similar results to other reported procedures used to manage first CMC Arthritis.

  15. Second-toe transfer for traumatic thumb amputation in children under 5 years: bone and soft-tissue growth.

    Science.gov (United States)

    Wolff, German; Posso, Carolina

    2014-12-01

    Posttraumatic thumb amputations in children under 5 years are uncommon. The final clinical long-term results have been reported shortly in literature. We report our clinical experience in children under 5 years with traumatic amputation of the thumb that were reconstructed using a second-toe transfer. There were 7 boys and 2 girls between the ages of 1 and 5 years. The follow-up was between 6 and 14 years. The average age at the time of transfer was 2.8 years, and the average follow-up was 10.7 years (range, between 6 and 14 y). The most frequent cause of amputation was avulsion (33.3%). All the transferred toes survived and achieved bone union and static 2-point discrimination was averaged at 5 mm. They acquired good prehensile pinch and grasp. All of the structures of the transferred toes showed substantial growth. Second-toe transfer for traumatic amputation of the thumb continues to be one of the best choices. Children require secondary procedures less often and in some cases late functional recovery can be expected. It is a safe procedure and there are fewer complications and a better success rate.

  16. Auditory Neural Prostheses – A Window to the Future

    Directory of Open Access Journals (Sweden)

    Mohan Kameshwaran

    2015-06-01

    Full Text Available Hearing loss is one of the commonest congenital anomalies to affect children world-over. The incidence of congenital hearing loss is more pronounced in developing countries like the Indian sub-continent, especially with the problems of consanguinity. Hearing loss is a double tragedy, as it leads to not only deafness but also language deprivation. However, hearing loss is the only truly remediable handicap, due to remarkable advances in biomedical engineering and surgical techniques. Auditory neural prostheses help to augment or restore hearing by integration of an external circuitry with the peripheral hearing apparatus and the central circuitry of the brain. A cochlear implant (CI is a surgically implantable device that helps restore hearing in patients with severe-profound hearing loss, unresponsive to amplification by conventional hearing aids. CIs are electronic devices designed to detect mechanical sound energy and convert it into electrical signals that can be delivered to the coch­lear nerve, bypassing the damaged hair cells of the coch­lea. The only true prerequisite is an intact auditory nerve. The emphasis is on implantation as early as possible to maximize speech understanding and perception. Bilateral CI has significant benefits which include improved speech perception in noisy environments and improved sound localization. Presently, the indications for CI have widened and these expanded indications for implantation are related to age, additional handicaps, residual hearing, and special etiologies of deafness. Combined electric and acoustic stimulation (EAS / hybrid device is designed for individuals with binaural low-frequency hearing and severe-to-profound high-frequency hearing loss. Auditory brainstem implantation (ABI is a safe and effective means of hearing rehabilitation in patients with retrocochlear disorders, such as neurofibromatosis type 2 (NF2 or congenital cochlear nerve aplasia, wherein the cochlear nerve is damaged

  17. The future of basal insulin supplementation.

    Science.gov (United States)

    Simon, Airin C R; DeVries, J Hans

    2011-06-01

    This review presents an overview of the candidates for an improved basal insulin in the pharmaceutical pipeline. The first new basal insulin to enter the market is most likely insulin degludec (IDeg), currently reporting in phase 3 of development, from Novo Nordisk (Bagsvaerd, Denmark). IDeg has a longer duration of action than currently available analogs. Phase 2 studies show comparable efficacy and safety outcomes compared with insulin glargine once daily with less hypoglycemia in type 1 diabetes. The final results of phase 3 studies seem to confirm this, also in type 2 diabetes. Biodel (Danbury, CT) has two long-acting basal insulin formulations in the pipeline, both in the preclinical phase of development: BIOD-Adjustable Basal, a modified formulation of insulin glargine, is available in long-, medium-, and short-acting forms and could be mixed, and BIOD-Smart Basal releases insulin proportional to the subcutaneous glucose concentration. Eli Lilly (Indianapolis, IN) is also developing a basal insulin. Phase 2 trials have been completed, but no results are published yet. Clinical trials with the new patch pump from CeQur (Montreux, Switzerland) have recently started in Europe. This patch pump delivers both basal and bolus doses subcutaneously and is intended for people with type 2 diabetes who need multiple daily injection insulin therapy.

  18. Neglected giant scalp Basal cell carcinoma

    DEFF Research Database (Denmark)

    Larsen, Anne Kristine; El-Charnoubi, Waseem-Asim Ghulam; Gehl, Julie

    2014-01-01

    SUMMARY: Rarely, basal cell carcinoma grows to a giant size, invading the underlying deep tissue and complicating the treatment and reconstruction modalities. A giant basal cell carcinoma on the scalp is in some cases treated with a combination of surgery and radiation therapy, resulting in local...... control, a satisfactory long-term cosmetic and functional result. We present a case with a neglected basal cell scalp carcinoma, treated with wide excision and postoperative radiotherapy, reconstructed with a free latissimus dorsi flap. The cosmetic result is acceptable and there is no sign of recurrence...

  19. Neglected Giant Scalp Basal Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Anne Kristine Larsen, MD

    2014-03-01

    Full Text Available Summary: Rarely, basal cell carcinoma grows to a giant size, invading the underlying deep tissue and complicating the treatment and reconstruction modalities. A giant basal cell carcinoma on the scalp is in some cases treated with a combination of surgery and radiation therapy, resulting in local control, a satisfactory long-term cosmetic and functional result. We present a case with a neglected basal cell scalp carcinoma, treated with wide excision and postoperative radiotherapy, reconstructed with a free latissimus dorsi flap. The cosmetic result is acceptable and there is no sign of recurrence 1 year postoperatively.

  20. Basal encephalocele and morning glory syndrome.

    Science.gov (United States)

    Caprioli, J; Lesser, R L

    1983-01-01

    Basal encephaloceles are often associated with other midline anomalies such as hypertelorism, broad nasal root, cleft lip, and cleft palate. Optic disc anomalies such as pallor, dysplasia, optic pit, coLoboma, and megalopapilla have been reported to occur in patients with basal encephalocele We report a case of a child with a sphenoethmoidal encephalocele and morning glory syndrome of the optic nerve. The presence of such optic nerve anomalies with facial midline anomalies should alert the clinician to the possible presence of a basal encephalocele. Images PMID:6849854

  1. Hydrodynamic characteristics of mechanical heart valve prostheses in steady and pulsatile flow

    Czech Academy of Sciences Publication Activity Database

    Klimeš, František; Kořenář, Josef

    2002-01-01

    Roč. 9, č. 4 (2002), s. 249-258 ISSN 1210-2717 Institutional research plan: CEZ:AV0Z2060917 Keywords : mechanical heart valve prostheses * flow visualization- steady and pulsatile flow Subject RIV: BO - Biophysics

  2. Soft tissue facial morphometry before and after total oral rehabilitation with implant-supported prostheses.

    Science.gov (United States)

    Tartaglia, Gianluca M; Dolci, Claudia; Sidequersky, Fernanda V; Ferrario, Virgilio F; Sforza, Chiarella

    2012-11-01

    The objective of the current study was to assess a low-cost, noninvasive facial morphometric digitizer to assist the practitioner in three-dimensional soft-tissue changes before and after oral rehabilitation. Twenty-two patients aged 45 to 82 years, all with edentulous maxilla and mandible, were assessed both before and after receiving their definitive complete implant-supported prostheses (each received 4-11 implants in each dental arch; full-arch fixed prostheses were made). The three-dimensional coordinates of 50 soft-tissue facial landmarks were collected with a noninvasive digitizer; labial and facial areas, volumes, angles, and distances were compared without and with the prostheses. Dental prostheses induced significant reductions in the nasolabial, mentolabial, and interlabial angles, with increased labial prominence (P provisional prosthetic restoration, providing quantitative information to prepare the best definitive prosthesis.

  3. Progress in the clinical development and utilization of vision prostheses: an update.

    Science.gov (United States)

    Brandli, Alice; Luu, Chi D; Guymer, Robyn H; Ayton, Lauren N

    2016-01-01

    Vision prostheses, or "bionic eyes", are implantable medical bionic devices with the potential to restore rudimentary sight to people with profound vision loss or blindness. In the past two decades, this field has rapidly progressed, and there are now two commercially available retinal prostheses in the US and Europe, and a number of next-generation devices in development. This review provides an update on the development of these devices and a discussion on the future directions for the field.

  4. Sonic hedgehog signaling in basal cell carcinomas.

    Science.gov (United States)

    Daya-Grosjean, Leela; Couvé-Privat, Sophie

    2005-07-28

    The development of basal cell carcinoma, the commonest human cancer in fair skinned populations, is clearly associated with constitutive activation of sonic hedgehog signaling. Insight into the genesis of BCC came from the identification of germline mutations of the tumor suppressor gene, PATCHED, a key regulatory component of hedgehog signaling in the nevoid basal cell carcinoma syndrome. Analysis of sporadic basal cell carcinomas and those from repair deficient xeroderma pigmentosum patients has revealed mutational inactivation of PATCHED and gain of function mutations of the proto-oncogenes, SMOOTHENED and SONIC HEDGEHOG associated with solar UV exposure. The molecular mechanisms involved in alterations of the hedgehog signaling pathway that lead to the formation of basal cell carcinomas are being unraveled and has already allowed the investigation of future therapeutic strategies for treating these skin cancers.

  5. Trichoepithelioma And Multiple Basal Cell Epithelioma

    Directory of Open Access Journals (Sweden)

    Dey S.K

    1996-01-01

    Full Text Available A combination of multiple trichoepithelioma and basal cell epithelioma is reported. Although malignant degeneration of trichoepithelioma is debated, clinical and histopathological studies, in our case, hint at that. The case is reported for its rarity.

  6. Molecular basis of basal cell carcinoma*

    Science.gov (United States)

    Montagna, Erik; Lopes, Otávio Sérgio

    2017-01-01

    Basal cell carcinoma is the most common cancer, presenting low mortality but high morbidity, and it has as risk factor exposure to sunlight, especially UVB spectrum. The most important constitutional risk factors for basal cell carcinoma development are clear phototypes (I and II, Fitzpatrick classification), family history of basal cell carcinoma (30-60%), freckles in childhood, eyes and light hair. The environmental risk factor better established is exposure to ultraviolet radiation. However, different solar exposure scenarios probably are independent risk factors for certain clinical and histological types, topographies and prognosis of this tumor, and focus of controversy among researchers. Studies confirm that changes in cellular genes Hedgehog signaling pathway are associated with the development of basal cell carcinoma. The cellular Hedgehog signaling pathway is activated in organogenesis, but is altered in various types of tumors. PMID:28954101

  7. Molecular basis of basal cell carcinoma.

    Science.gov (United States)

    Montagna, Erik; Lopes, Otávio Sérgio

    2017-01-01

    Basal cell carcinoma is the most common cancer, presenting low mortality but high morbidity, and it has as risk factor exposure to sunlight, especially UVB spectrum. The most important constitutional risk factors for basal cell carcinoma development are clear phototypes (I and II, Fitzpatrick classification), family history of basal cell carcinoma (30-60%), freckles in childhood, eyes and light hair. The environmental risk factor better established is exposure to ultraviolet radiation. However, different solar exposure scenarios probably are independent risk factors for certain clinical and histological types, topographies and prognosis of this tumor, and focus of controversy among researchers. Studies confirm that changes in cellular genes Hedgehog signaling pathway are associated with the development of basal cell carcinoma. The cellular Hedgehog signaling pathway is activated in organogenesis, but is altered in various types of tumors.

  8. Histological evaluation of novel ossicular chain replacement prostheses: an animal study in rabbits.

    Science.gov (United States)

    Turck, Christina; Brandes, Gudrun; Krueger, Ilka; Behrens, Peter; Mojallal, Hamidreza; Lenarz, Thomas; Stieve, Martin

    2007-08-01

    The improved biocompatibility of Bioverit II coated with a nanostructured surface shows promising qualities for use in human reconstructive middle ear surgery. In the case of chitosan-hydroxyapatite composite prostheses, further investigations regarding composition of the material, degree of purity and design are necessary before clinical application. The selection of optimal materials for reconstructive middle ear surgery continues to be a problem. In the present study novel materials were tested as total ossicular replacement prostheses (TORPs) in an animal model. Bioverit II coated with a nanostructured surface and chitosan-hydroxyapatite composites were placed in the middle ear of 40 rabbits. Uncoated Bioverit II was used as control. After an implantation period of 28, 84 or 300 days petrous bones were extracted, embedded in epoxy resin and examined by light microscopy. Uncoated and coated Bioverit prostheses revealed a mucosal coverage and a little osseogenic response after 28 days. The results of the coated Bioverit prostheses slightly surpassed those of the plain prostheses. Chitosan-hydroxyapatite composite prostheses were mostly found to be dislocated after 28 days. Formations of granulation tissue and fibrotic capsules were observed around these implants. This reaction could be caused by the instability of the composite material or may be due to impurities present in the chitosan.

  9. [Morphological features of utilization intraperitoneal double-sided prostheses in inguinoplasty in dogs].

    Science.gov (United States)

    de Andrade, Luiz Carlos; Ceneviva, Reginaldo; Coutinho-Netto, Joaquim; Silva Júnior, Orlando de Castro e; dos Santos, José Sebastião; Sukeda, Daniel Hirochi

    2009-10-01

    To asses the morphological features of the behavior of a double-sided prostheses using inguinoplasty laparotomy in dogs with latex side turned to the visceras. Twenty dogs were divided into two groups of 10 and submitted into infraumbilical laparotomy with double-sided prostheses fixed in an inguinal area and in the other side area a control prostheses of polipropilene (PPL). Macroscopics itens were studied on the 14th and 28th day post-operatory, and they were related to obstruction and intestinal fistulas, encystation, fusion and especially sticker. The microscopic analysis covered the inflammatory process in its acute, chronic and restored phase Infectious process, obstruction or intestinal fistula did not happen. The prostheses presented good accommodation and incorporation. The stickers happened with more prevalent and intensity with the PPL (p0,05). The double-sided prostheses in its parietal side adds the advantages of the incorporation's potential to the noticed material with PPL to the biocompatibility from the latex in its visceral side. The little distance between the PPL disc and the edge of the double-sided prostheses (2 cm) allied to its sticking with just five staples is not enough to avoid gaps, through which the epíploon migrated towards to the inflammatory process provoked by PPL in the parietal side.

  10. Relative maxima of diameter and basal area

    Science.gov (United States)

    Thomas B. Lynch; Difei Zhang

    2012-01-01

    It has often been observed that maximum dbh growth occurs at an earlier age than maximum individual tree basal area growth. This can be deduced from the geometry of the tree stem, by observing that a dbh increment at a given radius will be associated with a larger basal area increment than an equal dbh increment occurring at a shorter radius from the stem center. Thus...

  11. Degludec insulin: A novel basal insulin

    OpenAIRE

    Kalra, Sanjay; Unnikrishnan, Ambika Gopalakrishnan; Baruah, Manash; Kalra, Bharti

    2011-01-01

    This paper reviews a novel insulin analogue, degludec, which has the potential to emerge as an ideal basal insulin. It reviews the limitations of existing basal insulin and analogues, and highlights the need for a newer molecule. The paper discusses the potential advantages of degludec, while reviewing its pharmacologic and clinical studies done so far. The paper assesses the potential role of insulin degludec and degludec plus in clinical diabetes practice.

  12. Basal cell carcinoma metastatic to parotid gland.

    Science.gov (United States)

    Kurian, Rinsey Rose; Di Palma, Silvana; Barrett, A W

    2014-01-01

    Metastasis from basal cell carcinoma of the skin is very rare with cases being documented in the lymph nodes, lung, bone and parotid gland. The main histopathological differential diagnosis is the locally arising basal cell adenocarcinoma from which it is difficult to distinguish by morphology and routine immunohistochemistry. Approximately 85 % of all reported metastatic basal cell carcinomas arise in the head and neck region. Here we present a case of basal cell carcinoma of the skin of the left lateral canthus of the eye which metastasized to the intraparotid lymph nodes with infiltration of the adjacent parotid parenchyma. More awareness and vigilance is required on the part of the reporting pathologist to consider metastasis in the presence of a parotid tumour. Features favouring metastasis include history of primary cutaneous basal cell carcinoma, histological similarity to the primary lesion and absence of any demonstrable direct extension from the skin lesion. We also review the literature on metastatic basal cell carcinoma and discuss the need for adequate follow up in high risk patients.

  13. [Basal cell carcinoma of unusual site].

    Science.gov (United States)

    Mlika, Rym Benmously; Kerkeni, Nadia; Jebali, Amel; Zghal, Mohamed; Debbiche, Achraf; Ayed, Mohamed Ben; Mokhtar, Insaf; Fenniche, Samy

    2011-02-01

    Labial mucosa is an atypical site of basal cell carcinoma. The involvement of the vermilion lip, devoid of hair follicles and sweat glands, contrasts with the concept of its origin from pilar structures. We report a case of basal cell carcinoma developed on the vermilion upper lip. A 49-year-old woman, presented with an asymptomatic, 1-cm-diameter, erythematous, telangiectatic and crusted nodule on the upper lip evolving for 9 months and having once interested the vermilion border. There were no cervical lymph nodes. Diagnosis of infiltrative basal cell carcinoma was made by histological study, which showed a tumoral proliferation of epithelial basal cells infiltrating the dermis with perineural and muscular infiltration. Our report illustrates a rare but not exceptional site of basal cell carcinoma. The nodule, initially confined to the vermilion border, has then developed onto the mucosal and the cutaneous areas. Histopathological study revealed, as previously reported, infiltarative features. Basal cell carcinoma of the lip should be rapidly managed since its invasion to deeper structures occurs early. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  14. Application of dexterous space robotics technology to myoelectric prostheses

    Science.gov (United States)

    Hess, Clifford; Li, Larry C. H.; Farry, Kristin A.; Walker, Ian D.

    1994-01-01

    Future space missions will require robots equipped with highly dexterous robotic hands to perform a variety of tasks. A major technical challenge in making this possible is an improvement in the way these dexterous robotic hands are remotely controlled or teleoperated. NASA is currently investigating the feasibility of using myoelectric signals to teleoperate a dexterous robotic hand. In theory, myoelectric control of robotic hands will require little or no mechanical parts and will greatly reduce the bulk and weight usually found in dexterous robotic hand control devices. An improvement in myoelectric control of multifinger hands will also benefit prosthetics users. Therefore, as an effort to transfer dexterous space robotics technology to prosthetics applications and to benefit from existing myoelectric technology, NASA is collaborating with the Limbs of Love Foundation, the Institute for Rehabilitation and Research, and Rice University in developing improved myoelectric control multifinger hands and prostheses. In this paper, we will address the objectives and approaches of this collaborative effort and discuss the technical issues associated with myoelectric control of multifinger hands. We will also report our current progress and discuss plans for future work.

  15. Implant-supported prostheses versus conventional permanent and removable dentures

    Directory of Open Access Journals (Sweden)

    Koszuta Agnieszka

    2014-06-01

    Full Text Available Social, economic and technological progress results in an increasing range of treatment and rehabilitation methods for patients with partial or complete edentulism. The role of the dentist is to inform the patient about the full range of available missing teeth treatment options leading to complete rehabilitation of the masticatory organ in agreement with the patient’s aesthetic and functional expectations. The aim of the paper was to identify the type of prostheses used by patients before opting for implantsupported teeth replacements, according to the patients’ age, sex, marital status, place of residence and education. The study covered 464 patients, women and men, aged 20-74, treated with dental implants. The patients answered questions in an anonymous questionnaire. The influence of the prosthetic replacement type according to age and marital status was highly statistically significant, whereas it was statistically significant according to sex, place of residence and education. The female respondents who previously used tissue-borne complete or partial dentures opted for implant treatment more frequently. The respondents younger than 40 and between 40-60 years of age who did not previously used any prosthetic replacements opted for implant treatment more frequently. The respondents who did not use any prosthetic replacements decided to undergo implant treatment most frequently, regardless of their marital status, education and place of residence. The patients opted for implant treatment to improve their quality of life, despite the high cost of such therapy.

  16. Complete integration of technology for improved reproduction of auricular prostheses.

    Science.gov (United States)

    Watson, Jason; Hatamleh, Muhanad M

    2014-05-01

    The accurate reproduction of the form and surface details of missing body structures is an essential part of any successful prosthetic rehabilitation. It helps mask the prosthesis and gives confidence to the patient. This clinical report details the integration of multiple in-house digital technologies of laser scanning, rapid prototyping, and digital color scanning and formulating to improve the shape, texture, orientation, and color of auricular prostheses for 3 patients with missing unilateral ears. A structured light laser scanner was used to digitize the patient's nondefect ear. The digitized data were then manipulated in specialist software and mirrored to reflect the opposing side. A rapid prototyping machine was used to manufacture a 3-dimensional (3D) model of the soft tissue required. This 3D mirrored ear model allowed the accurate reproduction of missing soft tissue. A color spectrometer was used to accurately reproduce the skin tones digitally and physically. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  17. Hydrogel-Electrospun Fiber Mat Composite Coatings for Neural Prostheses

    Directory of Open Access Journals (Sweden)

    Ning eHan

    2011-03-01

    Full Text Available Achieving stable, long-term performance of implanted neural prosthetic devices has been challenging because of implantation related neuron loss and a foreign body response that results in encapsulating glial scar formation. To improve neuron-prosthesis integration and form chronic, stable interfaces, we investigated the potential of neurotrophin-eluting hydrogel-electrospun fiber mat (EFM composite coatings. In particular, poly(ethylene glycol-poly(ε-caprolactone (PEGPCL hydrogel- poly(ε-caprolactone (PCL EFM composites were applied as coatings for multielectrode arrays (MEAs. Coatings were stable and persisted on electrode surfaces for over 1 month under an agarose gel tissue phantom and over 9 months in a PBS immersion bath. To demonstrate drug release, a neurotrophin, nerve growth factor (NGF, was loaded in the PEGPCL hydrogel layer, and coating cytotoxicity and sustained NGF release were evaluated using a PC12 cell culture model. Quantitative MTT assays showed that these coatings had no significant toxicity toward PC12 cells, and neurite extension at day 7 and 14 confirmed sustained release of NGF at biologically significant concentrations for at least 2 weeks. Our results demonstrate that hydrogel-EFM composite materials can be applied to neural prostheses as a means to improve neuron-electrode proximity and enhance long-term device performance and function.

  18. Sensory feedback add-on for upper-limb prostheses.

    Science.gov (United States)

    Fallahian, Nader; Saeedi, Hassan; Mokhtarinia, Hamidreza; Tabatabai Ghomshe, Farhad

    2017-06-01

    Sensory feedback systems have been of great interest in upper-limb prosthetics. Despite tremendous research, there are no commercial modality-matched feedback systems. This article aims to introduce the first detachable and feedback add-on option that can be attached to in-use prostheses. A sensory feedback system was tested on a below-elbow myoelectric prosthesis. The aim was to have the amputee grasp fragile objects without crushing while other accidental feedback sources were blocked. A total of 8 successful trials (out of 10) showed that sensory feedback system decreased the amputee's visual dependency by improving awareness of his prosthesis. Sensory feedback system can be used either as post-fabrication (prosthetic add-on option) or para-fabrication (incorporated into prosthetic design). The use of these direct feedback systems can be explored with a current prosthesis before ordering new high-tech prosthesis. Clinical relevance This technical note introduces the first attach/detach-able sensory feedback system that can simply be added to in-use (myo)electric prosthesis, with no obligation to change prosthesis design or components.

  19. Polyurethane unicondylar knee prostheses: simulator wear tests and lubrication studies

    Energy Technology Data Exchange (ETDEWEB)

    Scholes, S C [Centre for Biomedical Engineering, Durham University, DH1 3LE (United Kingdom); Unsworth, A [Centre for Biomedical Engineering, Durham University, DH1 3LE (United Kingdom); Jones, E [Stryker Orthopaedics, Limerick (United Kingdom)

    2007-01-07

    Many materials are used as artificial joint bearing surfaces; these include conventional stainless steel or CoCrMo-on-ultra-high molecular weight polyethylene (UHMWPE), CoCrMo on itself and alumina-on-alumina. However, these joints have a limited lifespan resulting in failure of the prosthesis and the need for revision surgery. A number of materials have been introduced recently in an attempt to overcome these problems. Polycarbonate urethane (PU) is a compliant material that can be used as an artificial joint bearing surface which has been developed to mimic the natural synovial joint more accurately by promoting fluid film lubrication. Tribological tests were performed on CoCrMo-on-PU unicondylar knee prostheses to assess their performance in vitro. The wear produced by these components was considerably lower than that found for conventional joints. They also exhibited low friction and operated close to full-fluid film lubrication with viscosities of lubricant similar to those found in patients with arthritis. These tests gave encouraging results for the tribological performance of this material couple for use as an alternative bearing combination.

  20. Repairing method of fixed partial prostheses in dentistry: laser welding

    Science.gov (United States)

    Negrutiu, Meda L.; Sinescu, Cosmin; Cozarov, Dalibor; Culea, Laurentiu; Rominu, Mihai; Pop, Daniela M.

    2008-02-01

    Laser Welding is an advantageous method of connecting or repairing metal prosthetic frameworks because there are fewer effects of heating on the area surrounding the spot to be welded, and no further procedures, such as those used for conventional soldering, are necessary. Laser welding has been increasingly applied for fabricating the metal frameworks of prostheses and for other procedures, such as recovering the metal ridge and cusp, blocking holes on the occlusal surfaces after excess occlusal adjustment, thickening the metal framework, or adding contact points after excess grinding and adjusting of the crown margins. The objective of this study are represented by investigation and evaluation of three types of soldering compare to laser welding. The method is represented by the laser welding with a pulsed Nd-Yag Laser equipment. Other joints were produced, using three different soldering techniques. These joining areas were investigated for their quality and their corrosion properties. Corrosion attack was confirmed by electron microscopy. The investigations confirm the quality of laser welding. The investigated different laser welding methods revealed minimal corrosion and offers clear-cut advantages compared to the other soldering methods. Dental alloys are subjected to functional influences in the oral cavity and interact with the intraoral enviroment.

  1. Volar dislocation of the index carpometacarpal joint in association with a Bennett's fracture of the thumb: a rare injury pattern.

    LENUS (Irish Health Repository)

    Dillon, J P

    2012-02-03

    We describe a case of volar dislocation of the index carpometacarpal (CMC) joint in association with a Bennett\\'s fracture of the thumb following a motorcycle accident. Volar dislocation of the index carpometacarpal joint is an exceedingly rare but easily missed injury, with only a few reported cases in the literature. This report highlights the importance of a true lateral radiograph and close scrutiny of the film to detect this injury. Closed reduction supplemented with Kirschner wire fixation restored normal anatomical relations and achieved an excellent clinical result.

  2. Rule of Thumb Proposing the Size of Aperture Expected to be Sufficient to Resolve Double Stars with Given Parameters

    Science.gov (United States)

    Knapp, Wilfried

    2018-01-01

    Visual observation of double stars is an anachronistic passion especially attractive for amateurs looking for sky objects suitable for visual observation even in light polluted areas. Session planning then requires a basic idea which objects might be suitable for a given equipment—this question is a long term issue for visual double star observers and obviously not easy to answer, especially for unequal bright components. Based on a reasonably large database with limited aperture observations (done with variable aperture equipment iris diaphragm or aperture masks) a heuristic approach is used to derive a statistically well founded Rule of Thumb formula.

  3. Return to football and long-term clinical outcomes after thumb ulnar collateral ligament suture anchor repair in collegiate athletes.

    Science.gov (United States)

    Werner, Brian C; Hadeed, Michael M; Lyons, Matthew L; Gluck, Joshua S; Diduch, David R; Chhabra, A Bobby

    2014-10-01

    To evaluate return to play after complete thumb ulnar collateral ligament (UCL) injury treated with suture anchor repair for both skill position and non-skill position collegiate football athletes and report minimum 2-year clinical outcomes in this population. For this retrospective study, inclusion criteria were complete rupture of the thumb UCL and suture anchor repair in a collegiate football athlete performed by a single surgeon who used an identical technique for all patients. Data collection included chart review, determination of return to play, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) outcomes. A total of 18 collegiate football athletes were identified, all of whom were evaluated for follow-up by telephone, e-mail, or regular mail at an average 6-year follow-up. Nine were skill position players; the remaining 9 played in nonskill positions. All players returned to at least the same level of play. The average QuickDASH score for the entire cohort was 1 out of 100; QuickDASH work score, 0 out of 100; and sport score, 1 out of 100. Average time to surgery for skill position players was 12 days compared with 43 for non-skill position players. Average return to play for skill position players was 7 weeks postoperatively compared with 4 weeks for non-skill position players. There was no difference in average QuickDASH overall scores or subgroup scores between cohorts. Collegiate football athletes treated for thumb UCL injuries with suture anchor repair had quick return to play, reliable return to the same level of activity, and excellent long-term clinical outcomes. Skill position players had surgery sooner after injury and returned to play later than non-skill position players, with no differences in final level of play or clinical outcomes. Management of thumb UCL injuries in collegiate football athletes can be safely and effectively tailored according to the demands of the player's football position. Therapeutic IV. Copyright © 2014

  4. An in vivo comparative study of the e-polytetrafluoroethylene vascular prostheses: Vitaflon and Gore-Tex.

    Science.gov (United States)

    Dobrova, N B; Gorodkov, A J; Sidorenko, E S; Schekhter, A B; Baquey, C

    1999-12-01

    A comparative study was performed in order to validate new Russian e-PTFE vascular prostheses Vitaflon (St. Petersburg, Russia). The Gore-Tex prostheses were chosen as a referential model. The prostheses were implanted in the venous and arterial positions in 13 dog experiments. After the implantation time was over a comprehensive histological and histochemical examination of excized specimens was performed. It was demonstrated that there is no difference in healing and functional properties between the two studied prostheses. Copyright 1999 Kluwer Academic Publishers

  5. Localized basal meningeal enhancement in tuberculous meningitis

    Energy Technology Data Exchange (ETDEWEB)

    Theron, Salomine; Andronikou, Savvas; Grobbelaar, Marie; Steyn, Freda; Mapukata, Ayanda; Plessis, Jaco du [University of Stellenbosch, Department of Radiology, Tygerberg Hospital, P.O. BOX 19063, Tygerberg (South Africa)

    2006-11-15

    Focal basal meningeal enhancement may produce a confusing CT picture in children with suspected tuberculous meningitis (TBM). To demonstrate the incidence, distribution and appearance of localized basal meningeal enhancement in children with TBM. CT scans of patients with definite (culture proven) and probable (CSF suggestive) TBM were retrospectively evaluated by two observers. Localized basal enhancement was documented as involving: unilateral cistern of the lateral fossa (CLF), unilateral sylvian fissure, unilateral CLF and sylvian fissure in combination, unilateral CLF and sylvian fissure with ipsi- or contralateral ambient cistern and isolated quadrigeminal plate cistern. The study included 130 patients with TBM (aged 2 months to 13 years 9 months). Focal basal enhancement was seen in 11 patients (8.5%). The sylvian fissure was involved most commonly, followed by the lateral fossa cistern. The ambient cistern was involved in three patients and the quadrigeminal plate cistern in one. Focal areas of enhancement corresponded to the areas of infarction in every patient. Focal basal meningeal enhancement is common (8.5%) in paediatric TBM. This must be kept in mind when evaluating CT scans in children presenting with focal neurological findings, seizures or meningism in communities where TBM is endemic. (orig.)

  6. Localized basal meningeal enhancement in tuberculous meningitis

    International Nuclear Information System (INIS)

    Theron, Salomine; Andronikou, Savvas; Grobbelaar, Marie; Steyn, Freda; Mapukata, Ayanda; Plessis, Jaco du

    2006-01-01

    Focal basal meningeal enhancement may produce a confusing CT picture in children with suspected tuberculous meningitis (TBM). To demonstrate the incidence, distribution and appearance of localized basal meningeal enhancement in children with TBM. CT scans of patients with definite (culture proven) and probable (CSF suggestive) TBM were retrospectively evaluated by two observers. Localized basal enhancement was documented as involving: unilateral cistern of the lateral fossa (CLF), unilateral sylvian fissure, unilateral CLF and sylvian fissure in combination, unilateral CLF and sylvian fissure with ipsi- or contralateral ambient cistern and isolated quadrigeminal plate cistern. The study included 130 patients with TBM (aged 2 months to 13 years 9 months). Focal basal enhancement was seen in 11 patients (8.5%). The sylvian fissure was involved most commonly, followed by the lateral fossa cistern. The ambient cistern was involved in three patients and the quadrigeminal plate cistern in one. Focal areas of enhancement corresponded to the areas of infarction in every patient. Focal basal meningeal enhancement is common (8.5%) in paediatric TBM. This must be kept in mind when evaluating CT scans in children presenting with focal neurological findings, seizures or meningism in communities where TBM is endemic. (orig.)

  7. Topical treatment of Basal cell carcinomas in nevoid Basal cell carcinoma syndrome with a smoothened inhibitor

    NARCIS (Netherlands)

    Skvara, Hans; Kalthoff, Frank; Meingassner, Josef G.; Wolff-Winiski, Barbara; Aschauer, Heinrich; Kelleher, Joseph F.; Wu, Xu; Pan, Shifeng; Mickel, Lesanka; Schuster, Christopher; Stary, Georg; Jalili, Ahmad; David, Olivier J.; Emotte, Corinne; Antunes, Ana Monica Costa; Rose, Kristine; Decker, Jeremy; Carlson, Ilene; Gardner, Humphrey; Stuetz, Anton; Bertolino, Arthur P.; Stingl, Georg; de Rie, Menno A.

    2011-01-01

    Basal cell carcinoma (BCC) is a distinctive manifestation in nevoid basal cell carcinoma syndrome (NBCCS) patients. Both inherited and acquired mutations of patched 1 (PTCH1), a tumor-suppressor gene controlling the activity of Smoothened (SMO), are the primary cause of the constitutive activation

  8. Functional analysis and treatment of chronic hair pulling in a child with cri du chat syndrome: effects on co-occurring thumb sucking.

    Science.gov (United States)

    Vorndran, Christina M; Pace, Gary M; Luiselli, James K; Flaherty, Jennifer; Christian, Lauren; Kleinmann, Ava

    2008-01-01

    The relation between hair pulling and thumb sucking in a child with Cri du Chat syndrome was evaluated during the assessment and treatment of hair pulling. A functional analysis suggested that both behaviors were maintained by automatic reinforcement and possibly by attention. Treatment combining differential reinforcement (praise), response interruption, and access to toys decreased hair pulling. A corresponding decrease in thumb sucking was observed even though it was not directly treated. After an initial evaluation in a controlled setting, the treatment was extended to the participant's classroom setting. A 1-year follow up revealed that hair pulling, but not thumb sucking, remained at near-zero frequency. Clinical and research-to-practice implications are discussed.

  9. Prenatal Three-Dimensional Ultrasound Detection of Adducted Thumbs in X-Linked Hydrocephaly: Two Case Reports with Molecular Genetic Studies

    Science.gov (United States)

    Corral, Edgardo; Barrios, Andres; Isnard, Monica; Saugier-Veber, Pascale; Fortier, Sophie M.; Durrin, Sarah; Sepulveda, Waldo

    2015-01-01

    X-linked hydrocephaly is a rare sex-linked genetic recessive condition occurring in 1/30,000 deliveries. Adduction of thumbs and mental retardation are additional associated clinical findings. We describe two cases of X-linked hydrocephaly with associated adducted thumbs that were diagnosed prenatally with the combined use of three-dimensional (3D) ultrasound and fetal blood sampling for cytogenetic and molecular analyses. This report suggests that 3D ultrasound can facilitate the identification of adducted thumbs in fetuses affected by X-linked hydrocephaly and supports evaluation of the fetal hands as an integral part of the ultrasound anatomical assessment in male fetuses with hydrocephaly secondary to aqueductal stenosis. PMID:26078893

  10. Simulating auditory and visual sensorineural prostheses: a comparative review

    Science.gov (United States)

    Hallum, L. E.; Dagnelie, G.; Suaning, G. J.; Lovell, N. H.

    2007-03-01

    Microelectronic vision prosthesis proposes to render luminous spots (so-called phosphenes) in the visual field of the otherwise blind subject by way of an implanted array of stimulating electrodes, and in doing so restore some spatial vision. There are now many research teams worldwide working towards a therapeutic device, analogous to the cochlear implant, for the profoundly blind. Despite the similarities between the cochlear implant and vision prostheses, there are few instances in the literature where the two approaches are compared and contrasted with a mind to informing the science and engineering of the latter. This is the focus of the present review; specifically, our interest is psychophysics and signal processing. Firstly, we examine the cochlear implant, and review a handful of psychophysical work: the acoustic simulation of cochlear implants and the method used. We focus on the use of normally hearing subjects (played coloured noise bands or sine waves) as a means of investigating cochlear-implant efficacy and speech processing algorithms. These results provide guidance to vision researchers, for they address the interpretation of simulation data, and flag key areas, such as 'artificial' perception in the presence of noise, that require experimental work in coming years. Secondly, we provide an up-to-date review of the body of analogous psychophysical work: the visual simulation, involving normal observers, of microelectronic vision prosthesis. These simulations allow predictions as to the likely clinical efficacy of the prosthesis; indeed, results to date suggest that a number on the order of 100 implanted electrodes will afford subjects mobility and recognition of faces (and other complex stimuli), while even fewer electrodes facilitate reading printed text and very simple visuomanual tasks. Further, the simulations allow investigations of image and signal processing strategies, plus they provide researchers in the field, and other interested persons

  11. Dentistry investigations of teeth and dental prostheses using OCT

    Science.gov (United States)

    Sinescu, C.; Duma, V.-F.; Canjau, S.; Dobre, G.; Demian, D.; Cernat, R.; Negrutiu, M. L.; Todea, C.; Topala, F. I.; Hutiu, Gh.; Bradu, A.; Podoleanu, A. G.

    2016-04-01

    We present some of our recent investigations in Dental Medicine using Optical Coherence Tomography (OCT). Time Domain (TD), Spectral Domain (SD), and Swept Source (SS) OCT in-house developed systems are being used, for both ex vivo and in vivo investigations in the oral cavity. We study ex vivo the interface between the tooth and the dental sealant and demonstrate the limitations of the X-rays investigations that are now the gold standard for such procedures. Using OCT, defects in the interface that cannot be identified in radiographs can be determined both as position and magnitude. The drilling process of teeth can also be characterized in real time using OCT, to monitor the remaining dentin thickness (RDT) in order to avoid opening the pulp chamber. We demonstrate in this respect that an RDT of 0.5 mm is the minimum value to assure the integrity of the dentin wall between the drilled cavity and the pulp chamber; at an RDT of 0.3 mm or less a fracture is initiated, the dentin is punctured and endodontic treatment must follow. In vivo OCT investigations in the oral cavity were also performed (i.e., for metalloceramic prostheses and for ceramic inlay tooth interfaces), with the low cost, light weight and versatile handheld probes with 1D galvoscanners that we have developed and applied for a range of in-house developed OCT systems, in various clinical applications. They are briefly discussed, as well as some of our current and future work in the field, including for studies of soft tissue in the mouth.

  12. Adherence of Staphylococcus aureus to Dyneema Purity® Patches and to Clinically Used Cardiovascular Prostheses.

    Directory of Open Access Journals (Sweden)

    Amir Basir

    Full Text Available Various materials that are used for vascular and heart valve prostheses carry drawbacks: some require anticoagulant drugs or have moderate durability; others are not suitable for endovascular treatment. These prostheses are associated with bacterial infections. A material potentially suitable for prostheses is Dyneema Purity®, made of ultra-high-molecular-weight polyethylene. Dyneema Purity® fibers are very thin, flexible, resistant to fatigue and abrasion, and have high strength. S. aureus adherence to Dyneema Purity® was tested and compared with currently used cardiovascular prostheses. We compared adhesion of S. aureus to Dyneema Purity® (1 membrane-based and 1 yarn-composed patch with 5 clinically used yarn-composed polyester and membrane-based expanded polytetrafluoroethylene patches. Patches were contaminated with S. aureus bacteria and bacterial adherence was quantified. S. aureus adherence was also visualized in flow conditions. Overall, bacterial adherence was higher on yarn-composed prosthesis materials, with a rough surface, than on the membrane-based materials, with a smooth surface. Adherence to Dyneema Purity® materials was non-inferior to the currently used materials. Therefore, patches of Dyneema Purity® might be attractive for use in cardiovascular applications such as catheter-based heart valves and endovascular prostheses by their good mechanical properties combined with their noninferiority regarding bacterial adhesion.

  13. A Study of Ossiculoplasty in Chronic Otitis Media using different types of Prostheses

    Directory of Open Access Journals (Sweden)

    Parthapratim Laha

    2013-12-01

    Full Text Available Abstract Introduction: A wide range of prostheses, autologus and synthetic are available for use these days. Ideally, the ossicular reconstruction prosthesis should be biocompatible, safe, easy to handle and capable of efficient sound transmission. Aim and objectives: To study operative ease and post-operative hearing results in patients undergoing ossiculoplasty with different types of prostheses. Materials and methods: A prospective randomized study of 25 patients with Chronic Otitis Media, undergoing ossiculoplasty was conducted at Command Hospital, Kolkata. Tragal cartilage was used in 05 patients, conchal cartilage in 05, refashioned incus in 05, hydroxyapatite in 05 and titanium prostheses in 05 patients. Subjects with mixed hearing loss, multiple co-morbidities and revision surgeries were excluded. Hearing assessment was done by pure tone audiometry pre-operatively and 04 and 12 weeks postoperatively. Results were analyzed statistically. Results: Using tragal or conchal cartilage took almost equal time as autologus incus. Using synthetic material saved time. Titanium prosthesis gives maximum surgical ease. Post-operative air-bone gap reduction within 20 dB was seen in all, irrespective of type of prostheses.  Conclusion: Surgical ease is considerably better with titanium prostheses; however hearing results are equally good in all.

  14. Fabrication of low cost soft tissue prostheses with the desktop 3D printer

    Science.gov (United States)

    He, Yong; Xue, Guang-Huai; Fu, Jian-Zhong

    2014-11-01

    Soft tissue prostheses such as artificial ear, eye and nose are widely used in the maxillofacial rehabilitation. In this report we demonstrate how to fabricate soft prostheses mold with a low cost desktop 3D printer. The fabrication method used is referred to as Scanning Printing Polishing Casting (SPPC). Firstly the anatomy is scanned with a 3D scanner, then a tissue casting mold is designed on computer and printed with a desktop 3D printer. Subsequently, a chemical polishing method is used to polish the casting mold by removing the staircase effect and acquiring a smooth surface. Finally, the last step is to cast medical grade silicone into the mold. After the silicone is cured, the fine soft prostheses can be removed from the mold. Utilizing the SPPC method, soft prostheses with smooth surface and complicated structure can be fabricated at a low cost. Accordingly, the total cost of fabricating ear prosthesis is about $30, which is much lower than the current soft prostheses fabrication methods.

  15. Fabrication of low cost soft tissue prostheses with the desktop 3D printer

    Science.gov (United States)

    He, Yong; Xue, Guang-huai; Fu, Jian-zhong

    2014-01-01

    Soft tissue prostheses such as artificial ear, eye and nose are widely used in the maxillofacial rehabilitation. In this report we demonstrate how to fabricate soft prostheses mold with a low cost desktop 3D printer. The fabrication method used is referred to as Scanning Printing Polishing Casting (SPPC). Firstly the anatomy is scanned with a 3D scanner, then a tissue casting mold is designed on computer and printed with a desktop 3D printer. Subsequently, a chemical polishing method is used to polish the casting mold by removing the staircase effect and acquiring a smooth surface. Finally, the last step is to cast medical grade silicone into the mold. After the silicone is cured, the fine soft prostheses can be removed from the mold. Utilizing the SPPC method, soft prostheses with smooth surface and complicated structure can be fabricated at a low cost. Accordingly, the total cost of fabricating ear prosthesis is about $30, which is much lower than the current soft prostheses fabrication methods. PMID:25427880

  16. Fabrication of low cost soft tissue prostheses with the desktop 3D printer.

    Science.gov (United States)

    He, Yong; Xue, Guang-huai; Fu, Jian-zhong

    2014-11-27

    Soft tissue prostheses such as artificial ear, eye and nose are widely used in the maxillofacial rehabilitation. In this report we demonstrate how to fabricate soft prostheses mold with a low cost desktop 3D printer. The fabrication method used is referred to as Scanning Printing Polishing Casting (SPPC). Firstly the anatomy is scanned with a 3D scanner, then a tissue casting mold is designed on computer and printed with a desktop 3D printer. Subsequently, a chemical polishing method is used to polish the casting mold by removing the staircase effect and acquiring a smooth surface. Finally, the last step is to cast medical grade silicone into the mold. After the silicone is cured, the fine soft prostheses can be removed from the mold. Utilizing the SPPC method, soft prostheses with smooth surface and complicated structure can be fabricated at a low cost. Accordingly, the total cost of fabricating ear prosthesis is about $30, which is much lower than the current soft prostheses fabrication methods.

  17. Genotype variation in grain yield response to basal N fertilizer ...

    African Journals Online (AJOL)

    So, a field experiment was conducted at Wuxi, China, under non-basal N and basal N fertilizer conditions, to identify the variation of grain yield response to basal fertilizer among 199 rice varieties with different genetic background, and finally choose the suitable rice varieties for us to increase basal N fertilizer efficiency and ...

  18. The connectome of the basal ganglia.

    Science.gov (United States)

    Schmitt, Oliver; Eipert, Peter; Kettlitz, Richard; Leßmann, Felix; Wree, Andreas

    2016-03-01

    The basal ganglia of the laboratory rat consist of a few core regions that are specifically interconnected by efferents and afferents of the central nervous system. In nearly 800 reports of tract-tracing investigations the connectivity of the basal ganglia is documented. The readout of connectivity data and the collation of all the connections of these reports in a database allows to generate a connectome. The collation, curation and analysis of such a huge amount of connectivity data is a great challenge and has not been performed before (Bohland et al. PloS One 4:e7200, 2009) in large connectomics projects based on meta-analysis of tract-tracing studies. Here, the basal ganglia connectome of the rat has been generated and analyzed using the consistent cross-platform and generic framework neuroVIISAS. Several advances of this connectome meta-study have been made: the collation of laterality data, the network-analysis of connectivity strengths and the assignment of regions to a hierarchically organized terminology. The basal ganglia connectome offers differences in contralateral connectivity of motoric regions in contrast to other regions. A modularity analysis of the weighted and directed connectome produced a specific grouping of regions. This result indicates a correlation of structural and functional subsystems. As a new finding, significant reciprocal connections of specific network motifs in this connectome were detected. All three principal basal ganglia pathways (direct, indirect, hyperdirect) could be determined in the connectome. By identifying these pathways it was found that there exist many further equivalent pathways possessing the same length and mean connectivity weight as the principal pathways. Based on the connectome data it is unknown why an excitation pattern may prefer principal rather than other equivalent pathways. In addition to these new findings the local graph-theoretical features of regions of the connectome have been determined. By

  19. Radiologic study of basal cell nevus syndrome

    International Nuclear Information System (INIS)

    Park, Tae Won

    1988-01-01

    Several cases of jaw cyst-basal cell nevus-bifid rib syndrome are presented. This syndrome consists principally of multiple jaw cysts, basal cell nevi, and bifid ribs but no one component is present in all patients. The purpose of this paper is to review the multiple characteristics of this syndrome and present three cases in a family and additional 4 cases. The many malformations associated with the syndrome have variable expressively. In the cases, multiple jaw cysts, pal mar and plantar pittings, bridging of sella, temporoparietal bossing, hypertelorism, cleft palate, and dystopia canthoru m have been observed.

  20. Educational Quality of YouTube Videos in Thumb Exercises for Carpometacarpal Osteoarthritis: A Search on Current Practice.

    Science.gov (United States)

    Villafañe, Jorge Hugo; Cantero-Tellez, Raquel; Valdes, Kristin; Usuelli, Federico Giuseppe; Berjano, Pedro

    2017-09-01

    Conservative treatments are commonly performed therapeutic interventions for the management of carpometacarpal (CMC) joint osteoarthritis (OA). Physical and occupational therapies are starting to use video-based online content as both a patient teaching tool and a source for treatment techniques. YouTube is a popular video-sharing website that can be accessed easily. The purpose of this study was to analyze the quality of content and potential sources of bias in videos available on YouTube pertaining to thumb exercises for CMC OA. The YouTube video database was systematically searched using the search term thumb osteoarthritis and exercises from its inception to March 10, 2017. Authors independently selected videos, conducted quality assessment, and extracted results. A total of 832 videos were found using the keywords. Of these, 10 videos clearly demonstrated therapeutic exercise for the management of CMC OA. In addition, the top-ranked video found by performing a search of "views" was a video with more than 121 863 views uploaded in 2015 that lasted 12.33 minutes and scored only 2 points on the Global Score for Educational Value rating scale. Most of the videos viewed that described conservative interventions for CMC OA management have a low level of evidence to support their use. Although patients and novice hand therapists are using YouTube and other online resources, videos that are produced by expert hand therapists are scarce.

  1. Magnetic resonance imaging technology in evaluating the presence and integrity of the anterior oblique ligament of the thumb

    Directory of Open Access Journals (Sweden)

    Evan D. Collins

    2012-06-01

    Full Text Available The investigation examines the reliability and reproducibility of magnetic resonance imaging (MRI technology in evaluating the anterior oblique ligament (AOL of the trapeziometacarpal joint (TMC of the thumb, in order to establish an effective imaging protocol to use in the early identification of conditions leading to degenerative arthritis. We used cadaver specimens, three hand surgeons independently rated from X-rays each specimen. The specimens were then scanned in a General Electric MRI machine with a standard wrist coil. An effort was made to reproduce the image of the AOL - with a unique technique to obtain images of the obliquely oriented thumb and its ligaments. Following the MRI, the specimens were dissected to expose the AOL and visualize the TMC joint. A standard MRI fiducial was sewn to the proximal and distal extent of the volar side of the AOL. The soft tissues were replaced and the skin was closed. They were then rescanned following the same protocol, and pre and post-dissection ligamentlabeled specimens were compared. Following dissection and tagging of the AOL ligament, a repeat MRI confirmed its location and validated the protocol in all cases. The open dissection and ligament tagging confirmed that what was visualized was in fact the structure of interest. This investigation demonstrated that with an appropriate MRI protocol it is feasible to guide the scanner to catch appropriate images of a ligament that is closely correlated with degenerative arthritis.

  2. Nerve and Free Gracilis Muscle Transfers for Thumb and Finger Extension Reconstruction in Long-standing Tetraplegia.

    Science.gov (United States)

    Bertelli, Jayme Augusto; Ghizoni, Marcos Flávio

    2016-11-01

    With spinal cord injuries, muscles below the level of the lesion remain innervated despite the absence of volitional control. This persistent innervation protects against denervation atrophy and may allow for nerve transfers to treat long-standing lesions within the spinal cord. We tested the hypothesis that in chronic spinal cord lesions, muscles remained viable for reinnervation. To test this hypothesis, we operated on 7 patients with tetraplegia to reconstruct thumb and finger extension after a mean interval of 5 years since injury. During surgery, if electrical stimulation of the posterior interosseous nerve (PIN) produced muscle contraction, the nerve to the supinator (NS) was transferred to the PIN. If no contractions were demonstrated, the muscles of the extensor compartment of the forearm were replaced via a free gracilis transfer with innervation supplied by the NS. After an average of 26 months, M3 recovery of thumb and finger extension was observed in the 3 upper limbs from the 2 youngest patients who underwent a nerve transfer. None of the free gracilis-treated patients achieved scores above M2. In our youngest patients aged 27 and 34 years, who were operated on 6 years after spinal cord injury, transfer of the NS to the PIN partially restored hand span. Therapeutic V. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  3. Counseling on Early Childhood Concerns: Sleep Issues, Thumb-Sucking, Picky Eating, School Readiness, and Oral Health.

    Science.gov (United States)

    Nasir, Arwa; Nasir, Laeth

    2015-08-15

    Family physicians are often a source of information and advice on early childhood concerns regarding sleep, thumb-sucking/pacifier use, picky eating, school readiness, and oral health. Evidence indicates that family variables are important in the genesis of sleep difficulties, and that traditional behavioral methods are not as effective as previously thought. Attention to family psychosocial well-being, especially maternal functioning, is important in addressing childhood sleep difficulties. Thumb-sucking and pacifier use may be associated with negative consequences if they persist, and referral is recommended after four years of age if appropriate behavioral interventions are ineffective. Picky eating is heavily influenced by environmental factors, and food neophobia is a normal stage of development. The main approaches to childhood eating problems include social modeling of normal eating behaviors, repeated exposures to new foods, and positive mealtime experiences. School readiness focuses on supporting the psychosocial variables that are associated with school success. Reading with the child enhances literacy skills. Quality early childhood education programs are also effective in enhancing school success. Delaying school entry is not beneficial and may be detrimental. School readiness includes the schools' role in supporting the learning needs of all children regardless of their abilities and skills. Oral health is increasingly recognized as an important contributor to overall health. Oral health should be incorporated into well-child visits beginning at the eruption of the first tooth.

  4. Zirconia-Based Screw-Retained Prostheses Supported by Implants: A Retrospective Study on Technical Complications and Failures.

    Science.gov (United States)

    Worni, Andreas; Kolgeci, Lumni; Rentsch-Kollar, Andrea; Katsoulis, Joannis; Mericske-Stern, Regina

    2015-12-01

    Little information is yet available on zirconia-based prostheses supported by implants. To evaluate technical problems and failures of implant-supported zirconia-based prostheses with exclusive screw-retention. Consecutive patients received screw-retained zirconia-based prostheses supported by implants and were followed over a time period of 5 years. The implant placement and prosthetic rehabilitation were performed in one clinical setting, and all patients participated in the maintenance program. The treatment comprised single crowns (SCs) and fixed dental prostheses (FDPs) of three to 12 units. Screw-retention of the CAD/CAM-fabricated SCs and FDPs was performed with direct connection at the implant level. The primary outcome was the complete failure of zirconia-based prostheses; outcome measures were fracture of the framework or extensive chipping resulting in the need for refabrication. A life table analysis was performed, the cumulative survival rate (CSR) calculated, and a Kaplan-Meier curve drawn. Two hundred and ninety-four implants supported 156 zirconia-based prostheses in 95 patients (52 men, 43 women, average age 59.1 ± 11.7 years). Sixty-five SCs and 91 FDPs were identified, comprising a total of 441 units. Fractures of the zirconia framework and extensive chipping resulted in refabrication of nine prostheses. Nearly all the prostheses (94.2%) remained in situ during the observation period. The 5-year CSR was 90.5%, and 41 prostheses (14 SCs, 27 FDPs) comprising 113 units survived for an observation time of more than 5 years. Six SCs exhibited screw loosening, and polishing of minor chipping was required for five prostheses. This study shows that zirconia-based implant-supported fixed prostheses exhibit satisfactory treatment outcomes and that screw-retention directly at the implant level is feasible. © 2014 Wiley Periodicals, Inc.

  5. Proximity Interactions among Basal Body Components in Trypanosoma brucei Identify Novel Regulators of Basal Body Biogenesis and Inheritance

    Directory of Open Access Journals (Sweden)

    Hung Quang Dang

    2017-01-01

    Full Text Available The basal body shares similar architecture with centrioles in animals and is involved in nucleating flagellar axonemal microtubules in flagellated eukaryotes. The early-branching Trypanosoma brucei possesses a motile flagellum nucleated from the basal body that consists of a mature basal body and an adjacent pro-basal body. Little is known about the basal body proteome and its roles in basal body biogenesis and flagellar axoneme assembly in T. brucei. Here, we report the identification of 14 conserved centriole/basal body protein homologs and 25 trypanosome-specific basal body proteins. These proteins localize to distinct subdomains of the basal body, and several of them form a ring-like structure surrounding the basal body barrel. Functional characterization of representative basal body proteins revealed distinct roles in basal body duplication/separation and flagellar axoneme assembly. Overall, this work identified novel proteins required for basal body duplication and separation and uncovered new functions of conserved basal body proteins in basal body duplication and separation, highlighting an unusual mechanism of basal body biogenesis and inheritance in this early divergent eukaryote.

  6. IMPROVED HEALING OF SMALL-CALIBER POLYTETRAFLUOROETHYLENE VASCULAR PROSTHESES BY INCREASED HYDROPHILICITY AND BY ENLARGED FIBRIL LENGTH - AN EXPERIMENTAL-STUDY IN RATS

    NARCIS (Netherlands)

    STRONCK, JWS; VANDERLEI, B; WILDEVUUR, CRH

    This study was undertaken to test whether increasing the hydrophilicity of small-caliber polytetrafluoroethylene vascular prostheses by alcohol pretreatment or increasing their fibril length might improve their healing without affecting their patency. Polytetrafluoroethylene vascular prostheses

  7. Comparison of Clinical Efficacy Between Modular Cementless Stem Prostheses and Coated Cementless Long-Stem Prostheses on Bone Defect in Hip Revision Arthroplasty.

    Science.gov (United States)

    Li, Huibin; Chen, Fang; Wang, Zhe; Chen, Qian

    2016-02-29

    BACKGROUND The aim of this study was to investigate and compare the clinical efficacy of modular cementless stem and coated cementless long-stem prostheses in hip revision arthroplasty. MATERIAL AND METHODS Sixty-five patients with complete hip revision surgery data during January 2005 to March 2015 were selected from the People's Hospital of Linyi City and randomly divided into a S-ROM group (implanted with cementless modular stem prostheses, n=32) and a SLR-PLUS group (implanted with cementless coated long-stem prostheses, n=33). Harris score was used to evaluate the hip function of the patients in order to measure the clinical efficacy of the prostheses in total hip arthroplasty. Anteroposterior pelvic radiographs and lateral pelvic radiographs were taken and each patient's hip arthroplasty condition was recorded. Kaplan-Meier method was applied to compare the cumulative 5-year non-revision rate between the 2 prostheses and log-rank method was used to inspect the statistical data. RESULTS The Harris scores of both the S-ROM group and the SLR-PLUS group were significantly higher at 12 months after the operation than those before the operation (both P0.05), while the Harris scores of the patients with type IIIA/IIIB in the S-ROM group were both significantly higher than those of the same types in the SLR-PLUS group at 3 months, 6 months, and 12 months after the operation (all Prevision rate between the type I/II patients in the S-ROM group (92.31%) and the patients of the same types in the SLR-PLUS group (85.71%) (P>0.05). However, the cumulative 5-year non-revision rate of the type IIIA/IIIB patients in the S-ROM group (89.47%) was significantly different from the patients of the same types in the SLR-PLUS group (42.11%) (Phip revision arthroplasty were clinically more effective in the treatment of type IIIA and IIIB bone defects than the coated long-stem prostheses according to the Harris score and the cumulative 5-year non-revision rate.

  8. Progress in the clinical development and utilization of vision prostheses: an update

    Directory of Open Access Journals (Sweden)

    Brandli A

    2016-05-01

    Full Text Available Alice Brandli, Chi D Luu, Robyn H Guymer, Lauren N Ayton Centre for Eye Research Australia, Department of Surgery (Ophthalmology, The University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia Abstract: Vision prostheses, or “bionic eyes”, are implantable medical bionic devices with the potential to restore rudimentary sight to people with profound vision loss or blindness. In the past two decades, this field has rapidly progressed, and there are now two commercially available retinal prostheses in the US and Europe, and a number of next-generation devices in development. This review provides an update on the development of these devices and a discussion on the future directions for the field. Keywords: vision prostheses, bionic eye, vision restoration, blindness, medical bionics, retinitis pigmentosa

  9. ["Bionic" arm prostheses. State of the art in research and development].

    Science.gov (United States)

    Pylatiuk, C; Döderlein, L

    2006-11-01

    A new generation of arm prostheses is being developed worldwide. These so-called bionic prostheses are intended to offer additional functions, such as sensory feedback, extended range of possible movement, intuitive movement control as far as possible, and a more natural cosmetic appearance. In recent years, prosthetic components with much enhanced performance have been developed for use at various levels of the upper limb. Artificial hands that allow for additional grips are are being tested in clinical settings. Innovative methods of signal acquisition and communication with the patient are being intensively researched. Several patients have been provided with prototypes of new arm prostheses. At the moment, the results are limited by the restricted communication between patient and prosthesis. However, we can expect the options for prosthesis control to be extended in the near future.

  10. Induced resistance: an enhancement of basal resistance?

    NARCIS (Netherlands)

    Vos, M. de; Robben, C.; Pelt, J.A. van; Loon, L.C. van; Pieterse, C.M.J.

    2002-01-01

    Upon primary pathogen attack, plants activate resistance mechanisms at the site of infection. Besides this so-called basal resistance, plants have also the ability to enhance their defensive capacity against future pathogen attack. There are at least two types of biologically induced resistance.

  11. Basal Cell Carcinoma in The Netherlands

    NARCIS (Netherlands)

    S.C. Flohil (Sophie)

    2012-01-01

    textabstractThere are many different cutaneous malignancies, but malignant melanoma, squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) represent approximately 98% of all skin cancers.In literature, these three skin cancers are often divided into melanoma and nonmelanoma skin cancers

  12. Adhesion molecule expression in basal cell carcinoma

    NARCIS (Netherlands)

    Verhaegh, M.; Beljaards, R.; Veraart, J.; Hoekzema, R.; Neumann, M.

    1998-01-01

    Basal cell carcinomas (BCCs) are frequently associated with a peritumoral mononuclear infiltrate. Until now, the function of this inflammatory infiltrate and its possible role in the control of tumor growth is unclear. Mechanisms controlling endothelial and target cell adhesiveness for leukocytes

  13. TEMPORAL VARIABILITY IN BASAL ISOPRENE EMISSION FACTOR

    Science.gov (United States)

    Seasonal variability in basal isoprene emission factor (micrograms C /g hr or nmol/ m2 sec, leaf temperature at 30 degrees C and photosynthetically active radiation (PAR) at 1000 micromol/ m2 sec) was studied during the 1998 growing season at Duke Forest in the North Carolina Pie...

  14. Optical coherence tomography of basal cell carcinoma

    DEFF Research Database (Denmark)

    Yücel, D.; Themstrup, L.; Manfredi, Maddalena

    2016-01-01

    Background: Basal cell carcinoma (BCC) is the most prevalent malignancy in Caucasians. Optical coherence tomography (OCT) is a non-invasive optical imaging technology using the principle of interferometry. OCT has shown a great potential in diagnosing, monitoring, and follow-up of BCC. So far most...

  15. Giant basal cell carcinoma Carcinoma basocelular gigante

    Directory of Open Access Journals (Sweden)

    Nilton Nasser

    2012-06-01

    Full Text Available The basal cell carcinoma is the most common skin cancer but the giant vegetating basal cell carcinoma reaches less than 0.5 % of all basal cell carcinoma types. The Giant BCC, defined as a lesion with more than 5 cm at its largest diameter, is a rare form of BCC and commonly occurs on the trunk. This patient, male, 42 years old presents a Giant Basal Cell Carcinoma which reaches 180 cm2 on the right shoulder and was negligent in looking for treatment. Surgical treatment was performed and no signs of dissemination or local recurrence have been detected after follow up of five years.O carcinoma basocelular é o tipo mais comum de câncer de pele, mas o carcinoma basocelular gigante vegetante não atinge 0,5% de todos os tipos de carcinomas basocelulares. O Carcinoma Basocelular Gigante, definido como lesão maior que 5 cm no maior diâmetro, é uma forma rara de carcinoma basocelular e comumente ocorre no tronco. Este paciente apresenta um Carcinoma Basocelular Gigante com 180cm² no ombro direito e foi negligente em procurar tratamento. Foi realizado tratamento cirúrgico e nenhum sinal de disseminação ou recorrência local foi detectada após 5 anos.

  16. Panoramic study of mandibular basal bone height

    Directory of Open Access Journals (Sweden)

    Raviraj Jayam

    2015-01-01

    Full Text Available Aims and Objectives: To provide information regarding the changes of mandibular basal bone height using panoramic radiography, in relation to age, sex, and the state of dentulousness, which could be utilized in clinical practice, especially in implantology and pre-prosthetic surgery. Materials and Methods: A total of 200 subjects, who were categorized according to age, sex, and state of dentulousness, were subjected to vertical measurements of mandibular basal bone in panoramic radiographs. Two measurements were made, D 1 and D 2 . The distance measured between the lower border of mental foramen to the lower border of the mandible was termed as D 1 . The distance between the lowest point of mandibular canal to the lower border of the mandible was termed as D 2 . These measurements were compared between males/females and dentulous/edentulous, which were further subjected to statistical analysis with Student′s t-test. Results: Males had higher D 1 and D 2 values compared to females and edentulous groups had higher D 1 and D 2 values compared to dentulous subjects. Conclusions: Men have higher values of mandibular basal bone height compared to females and also that there exists some potential for mandibular basal bone to increase in height as the age progresses.

  17. Basal Cell Carcinoma: 10 Years of Experience

    International Nuclear Information System (INIS)

    Cigna, E.; Tarallo, M.; Maruccia, M.; Sorvillo, V.; Pollastrini, A.; Scuderi, N.

    2011-01-01

    Introduction. Basal cell carcinoma (BCC) is a locally invasive malignant epidermal tumour. Incidence is increasing by 10% per year; incidence of metastases is minimal, but relapses are frequent (40%-50%). The complete excision of the BCC allows reduction of relapse. Materials and Methods. The study cohort consists of 1123 patients underwent surgery for basal cell carcinoma between 1999 and 2009. Patient and tumor characteristics recorded are: age; gender; localization (head and neck, trunk, and upper and lower extremities), tumor size, excisional margins adopted, and relapses. Results. The study considered a group of 1123 patients affected by basal cell carcinoma. Relapses occurred in 30 cases (2,67%), 27 out of 30 relapses occurred in noble areas, where peripheral margin was <3mm. Incompletely excised basal cell carcinoma occurred in 21 patients (1,87%) and were treated with an additional excision. Discussion. Although guidelines indicate 3mm peripheral margin of excision in BCC <2cm, in our experience, a margin of less than 5mm results in a high risk of incomplete excisions

  18. Apico-basal polarity complex and cancer

    Indian Academy of Sciences (India)

    Loss of cell polarity is a hallmark for carcinoma, and its underlying molecular mechanism is beginning to emerge from studies on model organisms and cancer cell lines. Moreover, deregulated expression of apico-basal polarity complex components has been reported in human tumours. In this review, we provide an ...

  19. Neglected basal cell carcinoma on scalp

    Directory of Open Access Journals (Sweden)

    Sudip Sarkar

    2016-01-01

    Full Text Available Giant basal cell carcinoma (BCC is a very rare entity. Usually, they occur due to the negligence of the patient. Local or distant metastasis is present in most cases. Here, we present a case of giant BCC that clinically resembled squamous cell carcinoma and demonstrated no metastasis at presentation.

  20. Apico-basal polarity complex and cancer

    Indian Academy of Sciences (India)

    Apico-basal polarity is a cardinal molecular feature of adult eukaryotic epithelial cells and appears to be involved in several key cellular processes including polarized cell migration and maintenance of tissue architecture. Epithelial cell polarity is maintained by three well-conserved polarity complexes, namely, PAR, Crumbs ...

  1. Heterogeneity of limbal basal epithelial progenitor cells.

    Science.gov (United States)

    Hayashida, Yasutaka; Li, Wei; Chen, Ying-Ting; He, Hua; Chen, Szu-yu; Kheirkah, Ahmad; Zhu, Ying-Tien; Matsumoto, Yukihiro; Tseng, Scheffer C G

    2010-11-01

    Although corneal epithelial stem cells (SCs) are located at the limbus between the cornea and the conjunctiva, not all limbal basal epithelial cells are SCs. Using 2 dispase digestions to remove different amounts of limbal basal epithelial cells for cross-sections, flat mounts, and cytospin preparations, double immunostaining to pancytokeratins (PCK) and vimentin (Vim) identified 3 p63+ epithelial progenitors such as PCK-/Vim+, PCK/Vim, and PCK-/Vim+ and 1 p63+ mesenchymal cell, PCK-/Vim+. PCK-/Vim- progenitors had the smallest cell size were 10-20 times more enriched on collagen I-coated dishes in the 5-minute rapid adherent fraction that contained the highest percentage of p63+ cells but the lowest percentage of cytokeratin12+ cells, and gave rise to high Ki67 labeling and vivid clonal growth. In contrast, PCK+/Vim+ and PCK+/Vim- progenitors were found more in the slow-adherent fraction and yielded poor clonal growth. PCK/Vim progenitors and clusters of PCK-/Vim+ mesenchymal cells, which were neither melanocytes nor Langerhans cells, were located in the limbal basal region. Therefore, differential expression of PCK and Vim helps identify small PCK-/Vim- cells as the most likely candidate for SCs among a hierarchy of heterogeneous limbal basal progenitors, and their close association with PCK-/Vim+ presumed "niche" cells.

  2. [Parotid basal cell adenoma of membranous type].

    Science.gov (United States)

    Farah-Klibi, Faten; Ferchiou, Malek; Kourda, Jihène; El Amine, Olfa; Ferjaoui, Mohamed; Ben Jilani, Sarrah; Zermani, Rachida

    2009-02-01

    Basal cell adenoma (BCA) is a rare benign neoplasm characterized by the basaloid appearance of the tumour cells and the lack of myxo-chondroid stromal component present in pleomorphic adenoma. We report a case of basal cell adenoma of membranous type, highly suspected of malignancy because of the presence of mediastinal lymph nodes and pulmonary nodules which finally were related to an associated sarcoidosis. Our patient was an 80-year-old woman who presented a swelling of the right parotid two years ago. The clinical examination revealed a solid, indolent and mobile mass. A chest radiography noted mediastinal lymph nodes. The CT-scan confirmed the presence of mediastinal and tracheal lymph nodes with pulmonary nodules. So the diagnosis of metastatic malignant salivary gland tumor was suspected. Finally, the histological examination concluded to a basal cell adenoma of membranous type with sarcoidosis granulomas in the parotid and in the lymph nodes. The BCA is a benign tumor located generally in the parotid gland. When the malignancy is suspected, like in our case, this tumor must be differentiated from the basal cell adenocarcinoma using histological criteria.

  3. Prevention of biofilm formation by dairy products and N-acetylcysteine on voice prostheses in an artificial throat

    NARCIS (Netherlands)

    Schwandt, LQ; Van Weissenbruch, R; Stokroos, [No Value; Van der Mei, HC; Busscher, HJ; Albers, FWJ

    Objective - To evaluate the preventive effect of buttermilk, Yakult Light fermented milk drink and N-acetylcysteine on biofilm formation on voice prostheses in vitro. Material and Methods - Groningen button and Provox(R) 2 voice prostheses were inoculated with a mixture of bacteria and yeasts

  4. Adhesion to silicone rubber of yeasts and bacteria isolated from voice prostheses : Influence of salivary conditioning films

    NARCIS (Netherlands)

    Busscher, HJ; GeertsemaDoornbusch, GI; vanderMei, HC

    Adhesion of yeasts and bacteria to silicone rubber is one of the first steps in the biodeterioration of silicone rubber voice prostheses. In this paper, adhesion of two streptococcal, staphylococcal, Candida albicans and Candida tropicalis strains, isolated from explanted voice prostheses was

  5. New total ossicular replacement prostheses with a resilient joint: experimental data from human temporal bones.

    Science.gov (United States)

    Arechvo, Irina; Bornitz, Matthias; Lasurashvili, Nikoloz; Zahnert, Thomas; Beleites, Thomas

    2012-01-01

    New flexible total ossicular prostheses with an integrated microjoint can compensate for large static displacements in the reconstructed ossicular chain. When properly designed, they can mimic the function of the joints of the intact chain and ensure good vibration transfer in both straight and bent conditions. Prosthesis dislocations and extrusions are frequently observed after middle ear surgery. They are mainly related to the altered distance between the coupling points because of large static eardrum displacements. The new prostheses consist of 2 titanium shafts, which are incorporated into a silicone body. The sound transfer function and stapes footplate displacement at static loads were evaluated in human temporal bones after ossicular reconstruction using prostheses with 2 different silicones with different hardness values. The stiffness and bending characteristics of the prostheses were investigated with a quasi-static load. The sound transfer properties of the middle ears with the prostheses inserted under uncompressed conditions were comparable with those of ears with intact ossicular chains. The implant with the soft silicone had improved acoustic transfer characteristics over the implant with the hard silicone in a compressed state. In the quasi-static experiments, the minimum medial footplate displacement was found with the same implant. The bending characteristics depended on the silicone stiffness and correlated closely with the point and angle of the load incidence. The titanium prostheses with a resilient joint that were investigated in this study had good sound transfer characteristics under optimal conditions as well as in a compressed state. As a result of joint bending, the implants compensate for the small changes in length of the ossicular chain that occur under varying middle ear pressure. The implants require a stable support at the stapes footplate to function properly.

  6. Distal cantilever in full-arch prostheses and immediate loading: a retrospective clinical study.

    Science.gov (United States)

    Romanos, Georgios E; Gupta, Bhumija; Gaertner, Kathrin; Nentwig, Georg-Hubertus

    2014-01-01

    The purpose of this study was to analyze and evaluate the clinical success of distal cantilevers of fixed full-arch prostheses for the rehabilitation of edentulous arches in conjunction with immediate loading. Twenty-seven patients (15 men and 12 women) with a mean age of 59 years received 203 implants (Ankylos, Dentsply), either in edentulous jaws or after extraction and immediate implant placement. All implants were splinted together with provisional restorations and loaded immediately after surgery. After an average of 60 days, the definitive prostheses were fabricated and cemented provisionally. Thirty-one prostheses were delivered. A total of 92 units on distal cantilevers were incorporated into the prostheses. Implant stability was recorded (via percussion testing) after prostheses were removed and crestal bone levels were measured with radiographs. Average crestal bone loss was 0.33 mm. After a follow-up of 5 years, only one prosthesis broke (at the connection between the main part of the denture and the distal extension). A total of five implants were lost because of overloading or peri-implantitis (during early healing). The success rate of implants was 94.5%, the survival rate was 97.5%, and the survival rate of the prostheses was 96.7% after a loading period of 79.30 ± 35.31 months. Based on the long-term clinical data, distal cantilevers on a full-arch prosthesis can be a successful treatment modality and can be employed in patient treatment planning when posterior support is indicated.

  7. All-ceramic inlay-retained fixed dental prostheses: An update.

    Science.gov (United States)

    Chaar, M Sad; Passia, Nicole; Kern, Matthias

    2015-10-01

    Inlay-retained fixed dental prostheses (IRFDPs) represent a minimally invasive alternative to conventional fixed dental prostheses (FDPs) to replace single posterior missing teeth. The aim of the present review article is to assess the clinical outcome of different IRFDPs in order to derive recommendations regarding their clinical application. Hence, it is essential to highlight important factors that influence the longevity and success of IRFDPs, such as treatment plan, appropriate case selection with proper indications, as well as tooth preparation. Furthermore, a good understanding of bonding technologies and awareness of pretreatment procedures for different materials are indispensable for the long-term success of IRFDPs.

  8. Metastatic giant basal cell carcinoma: a case report.

    Science.gov (United States)

    Bellahammou, Khadija; Lakhdissi, Asmaa; Akkar, Othman; Rais, Fadoua; Naoual, Benhmidou; Elghissassi, Ibrahim; M'rabti, Hind; Errihani, Hassan

    2016-01-01

    Basal cell carcinoma is the most common skin cancer, characterised by a slow growing behavior, metastasis are extremely rare, and it occurs in less than 0, 1% of all cases. Giant basal cell carcinoma is a rare form of basal cell carcinoma, more aggressive and defined as a tumor measuring more than 5 cm at its largest diameter. Only 1% of all basal cell carcinoma develops to a giant basal cell carcinoma, resulting of patient's negligence. Giant basal cell carcinoma is associated with higher potential of metastasis and even death, compared to ordinary basal cell carcinoma. We report a case of giant basal cell carcinoma metastaticin lung occurring in a 79 years old male patient, with a fatal evolution after one course of systemic chemotherapy. Giant basal cell carcinoma is a very rare entity, early detection of these tumors could prevent metastasis occurrence and improve the prognosis of this malignancy.

  9. Patient-Reported and Clinical Outcomes of Implant-Supported Fixed Complete Dental Prostheses: A Comparison of Metal-Acrylic, Milled Zirconia, and Retrievable Crown Prostheses.

    Science.gov (United States)

    Box, Virginia Hogsett; Sukotjo, Cortino; Knoernschild, Kent L; Campbell, Stephen D; Afshari, Fatemeh S

    2018-02-01

    The purpose of this retrospective study was to assess the incidence of biologic and technical complications for implant-supported fixed complete dental prostheses (IFCDPs) and their relationship to oral health-related quality of life (OHQoL) and patient-reported outcomes. Metal-acrylic (MA), retrievable crown (RC), monolithic zirconia (MZ), and porcelain veneered zirconia (PVZ) prostheses were included. Patients who received an IFCDP at least 1 year prior to recall were identified. Exclusion criteria were: (1) an opposing complete denture and (2) time in service >70 months. A total of 37 patients with 49 prostheses, including 22 MA, 14 RC, 7 MZ, and 6 PVZ prostheses were recalled. Patient-reported outcomes were assessed via OHIP-49 (Oral Health Impact Profile) and a scripted interview with open-ended questions. All designs had high complication rates (12 of 22 MA, 10 of 14 RC, 2 of 7 MZ, and 5 of 6 PVZ). The most common complications were: (1) MA: posterior tooth wear, (2) RC: chipping and fracturing of the restorations, (3) MZ: wear of opposing restorations, and (4) PVZ: chipping of opposing restorations. Average OHIP-49 scores ranged from 7 to 29, indicating high OHQoL, patient satisfaction, regardless of prosthetic design ( P = .16). The standardized interview highlighted that although most patients were extremely satisfied (73%), some continued to be bothered by material bulk (14%) and felt that maintenance of oral hygiene was excessively time-consuming (16%). In the context of this study, despite high complication rates and maintenance needs, all IFCDP designs resulted in high OHQoL and patient satisfaction.

  10. Immediately loaded mandibular fixed implant prostheses using the all-on-four protocol: a report of 183 consecutively treated patients with 1 year of function in definitive prostheses.

    Science.gov (United States)

    Galindo, Daniel F; Butura, Caesar C

    2012-01-01

    The purpose of this study was to evaluate a specific protocol using four implants to support immediately loaded fixed prostheses to restore edentulous and partially edentulous mandibles and report on the outcome after 1 year of function with the definitive prostheses. A retrospective study was conducted of all patients who were treated between June 2008 and December 2010 with fixed prostheses that were loaded immediately after placement of implants. The provisional prostheses were later replaced with computer-aided design/computer-assisted manufacture titanium frames supporting acrylic resin and denture teeth in the definitive prosthesis. All patients were followed for a minimum of 12 months and were assessed for implant survival and prosthetic performance, with descriptive statistics utilized to demonstrate results. One hundred eighty-three consecutive patients received immediately loaded axial and tilted implants according to the defined protocol. One implant failed, resulting in a 99.86% implant success rate. There were two catastrophic prosthetic failures (fracture of the titanium framework), for a 98.9% prosthetic success rate. Three patients (1.6%) presented with fracture of a prosthetic mandibular incisor tooth. No prosthetic screw loosening or fractures were seen. Radiographic evaluation revealed no major bone loss around dental implants. Based on this retrospective study, the following conclusions can be drawn: (1) this technique appears to provide a highly predictable implant performance; (2) it is necessary to critically evaluate framework design, especially around the connectors for cantilever extensions around the most distal implants; and (3) minor complications related to acrylic resin tooth fracture may be anticipated during the early phases of prosthetic treatment.

  11. Novel missense mutation in the L1 gene in a child with corpus callosum agenesis, retardation, adducted thumbs, spastic paraparesis, and hydrocephalus

    NARCIS (Netherlands)

    Sztriha, L; Frossard, P; Hofstra, RMW; Verlind, E; Nork, M

    Corpus callosum agenesis, retardation, adducted thumbs, spastic paraparesis, and hydrocephalus (CRASH syndrome) is an X-linked recessive disorder caused by mutations in the neuronal cell adhesion molecule L1 (L1CAM) gene. L1 plays a key role in axon outgrowth and pathfinding during the development

  12. Evaluation of Health on the Net seal label and DISCERN as content quality indicators for patients seeking information about thumb sucking habit.

    Science.gov (United States)

    Shital Kiran, D P; Bargale, Seema; Pandya, Parth; Bhatt, Kuntal; Barad, Nirav; Shah, Nilay; Venkataraghavan, Karthik; Ramesh, K

    2015-08-01

    The aim of this study was to evaluate the reliability of websites on the thumb sucking habit using DISCERN instrument and Health on the Net (HON) seal code at a single moment in time. An Internet search engine (www.google.com) was used to identify websites comprising information on "thumb sucking habit." Of over 204,000 links for thumb sucking habit, the first 100 were analyzed in detail. After excluding discussion groups, news and video feeds, and removing carbon copy sites, only 36 relevant websites remained, which were then assessed using the DISCERN instrument and HON seal code. Using the 16 questions of DISCERN for assessing the reliability and quality of the consumer information which were scored from 1 to 5, an appropriate index of the quality of the information was generated. All the assessed websites were also checked for presence or absence of HON seal code. The maximum score attainable for an outstanding website is 80. Of the 36 websites that were scored the highest score obtained by one of the websites according to the DISCERN tool was 55 of 80, and the lowest score achieved was 16 of 80. The websites achieving the maximum and minimum score were children.webmd.com and thebehaviorsolution.com, respectively. The HON seal was displayed only in three websites, which were medicinenet.com, righthealth.com, and children.webmd.com. By directing patients to validated websites on the thumb sucking habit, clinicians can ensure patients find appropriate information.

  13. Learning Reward Uncertainty in the Basal Ganglia.

    Directory of Open Access Journals (Sweden)

    John G Mikhael

    2016-09-01

    Full Text Available Learning the reliability of different sources of rewards is critical for making optimal choices. However, despite the existence of detailed theory describing how the expected reward is learned in the basal ganglia, it is not known how reward uncertainty is estimated in these circuits. This paper presents a class of models that encode both the mean reward and the spread of the rewards, the former in the difference between the synaptic weights of D1 and D2 neurons, and the latter in their sum. In the models, the tendency to seek (or avoid options with variable reward can be controlled by increasing (or decreasing the tonic level of dopamine. The models are consistent with the physiology of and synaptic plasticity in the basal ganglia, they explain the effects of dopaminergic manipulations on choices involving risks, and they make multiple experimental predictions.

  14. The thumb domain is not essential for the catalytic action of HoLaMa DNA polymerase.

    Science.gov (United States)

    Gatius, Angela Gala Morena; Piaz, Fabrizio Dal; Hochkoeppler, Alejandro

    2017-12-01

    A structural and kinetic characterization of a fragment of the HoLaMa DNA polymerase is presented here. In particular, a truncated form of HoLaMa, devoid of a consistent portion of the thumb domain, was isolated and purified. This HoLaMa fragment, denoted as ΔNter-HoLaMa, is surprisingly competent in catalyzing DNA extension, albeit featuring a k cat one order of magnitude lower than the corresponding kinetic constant of its full-length counterpart. The conformational rearrangements, if any, of enzyme tryptophanes triggered by DNA binding or extension were assayed under pre-steady-state conditions. The fluorescence of HoLaMa tryptophanes was found to significantly change upon DNA binding and extension. On the contrary, no fluorescence changes of ΔNter-HoLaMa tryptophanes were detected under the same conditions, suggesting that major conformational transitions are not required for DNA binding or extension by this truncated DNA polymerase.

  15. Simulator comparison of thumball, thumb switch, and touch screen input concepts for interaction with a large screen cockpit display format

    Science.gov (United States)

    Jones, Denise R.; Parrish, Russell V.

    1990-01-01

    A piloted simulation study was conducted comparing three different input methods for interfacing to a large screen, multiwindow, whole flight deck display for management of transport aircraft systems. The thumball concept utilized a miniature trackball embedded in a conventional side arm controller. The multifunction control throttle and stick (MCTAS) concept employed a thumb switch located in the throttle handle. The touch screen concept provided data entry through a capacitive touch screen installed on the display surface. The objective and subjective results obtained indicate that, with present implementations, the thumball concept was the most appropriate for interfacing with aircraft systems/subsystems presented on a large screen display. Not unexpectedly, the completion time differences between the three concepts varied with the task being performed, although the thumball implementation consistently outperformed the other two concepts. However, pilot suggestions for improved implementations of the MCTAS and touch screen concepts could reduce some of these differences.

  16. Linear Basal Cell Carcinoma: A Case Report

    Directory of Open Access Journals (Sweden)

    Yuko Ichinokawa

    2011-07-01

    Full Text Available Basal cell carcinoma (BCC presents with diverse clinical features, and several morphologic and histologic variants of BCC have been reported [Sexton et al.: J Am Acad Dermatol 1990;23:1118–1126]. Linear BCC was first described as a new clinical subtype in 1985 by Lewis [Int J Dematol 1985;24:124–125]. Here, we present a case of linear BCC that we recently encountered in an elderly Japanese patient, and review other cases reported in Japan.

  17. Basal ganglia lesions in children and adults

    International Nuclear Information System (INIS)

    Bekiesinska-Figatowska, Monika; Mierzewska, Hanna; Jurkiewicz, Elżbieta

    2013-01-01

    The term “basal ganglia” refers to caudate and lentiform nuclei, the latter composed of putamen and globus pallidus, substantia nigra and subthalamic nuclei and these deep gray matter structures belong to the extrapyramidal system. Many diseases may present as basal ganglia abnormalities. Magnetic resonance imaging (MRI) and computed tomography (CT) – to a lesser degree – allow for detection of basal ganglia injury. In many cases, MRI alone does not usually allow to establish diagnosis but together with the knowledge of age and circumstances of onset and clinical course of the disease is a powerful tool of differential diagnosis. The lesions may be unilateral: in Rassmussen encephalitis, diabetes with hemichorea/hemiballism and infarction or – more frequently – bilateral in many pathologic conditions. Restricted diffusion is attributable to infarction, acute hypoxic–ischemic injury, hypoglycemia, Leigh disease, encephalitis and CJD. Contrast enhancement may be seen in cases of infarction and encephalitis. T1-hyperintensity of the lesions is uncommon and may be observed unilaterally in case of hemichorea/hemiballism and bilaterally in acute asphyxia in term newborns, in hypoglycemia, NF1, Fahr disease and manganese intoxication. Decreased signal intensity on GRE/T2*-weighted images and/or SWI indicating iron, calcium or hemosiderin depositions is observed in panthotenate kinase-associated neurodegeneration, Parkinson variant of multiple system atrophy, Fahr disease (and other calcifications) as well as with the advancing age. There are a few papers in the literature reviewing basal ganglia lesions. The authors present a more detailed review with rich iconography from the own archive

  18. Basal ganglia lesions in children and adults

    Energy Technology Data Exchange (ETDEWEB)

    Bekiesinska-Figatowska, Monika, E-mail: m.figatowska@mp.pl [Department of Diagnostic Imaging, Institute of Mother and Child, ul. Kasprzaka 17a, 01-211 Warsaw (Poland); Mierzewska, Hanna, E-mail: h.mierzewska@gmail.com [Department of Neurology of Children and Adolescents, Institute of Mother and Child, ul. Kasprzaka 17a, 01-211 Warsaw (Poland); Jurkiewicz, Elżbieta, E-mail: e-jurkiewicz@o2.pl [Department of Diagnostic Imaging, Children' s Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warsaw (Poland)

    2013-05-15

    The term “basal ganglia” refers to caudate and lentiform nuclei, the latter composed of putamen and globus pallidus, substantia nigra and subthalamic nuclei and these deep gray matter structures belong to the extrapyramidal system. Many diseases may present as basal ganglia abnormalities. Magnetic resonance imaging (MRI) and computed tomography (CT) – to a lesser degree – allow for detection of basal ganglia injury. In many cases, MRI alone does not usually allow to establish diagnosis but together with the knowledge of age and circumstances of onset and clinical course of the disease is a powerful tool of differential diagnosis. The lesions may be unilateral: in Rassmussen encephalitis, diabetes with hemichorea/hemiballism and infarction or – more frequently – bilateral in many pathologic conditions. Restricted diffusion is attributable to infarction, acute hypoxic–ischemic injury, hypoglycemia, Leigh disease, encephalitis and CJD. Contrast enhancement may be seen in cases of infarction and encephalitis. T1-hyperintensity of the lesions is uncommon and may be observed unilaterally in case of hemichorea/hemiballism and bilaterally in acute asphyxia in term newborns, in hypoglycemia, NF1, Fahr disease and manganese intoxication. Decreased signal intensity on GRE/T2*-weighted images and/or SWI indicating iron, calcium or hemosiderin depositions is observed in panthotenate kinase-associated neurodegeneration, Parkinson variant of multiple system atrophy, Fahr disease (and other calcifications) as well as with the advancing age. There are a few papers in the literature reviewing basal ganglia lesions. The authors present a more detailed review with rich iconography from the own archive.

  19. Traumatisk basal subaraknoidal blødning

    DEFF Research Database (Denmark)

    Lundgaard, Peter; Leth, Peter Mygind; Gregersen, Markil

    2003-01-01

    mod den posterolaterale del af kraniebasis. I det typiske tilfælde falder offeret øjeblikkeligt bevidstløs sammen, og døden indtræder efter få minutter. Blødningen udgår enten fra arteria vertebralis på halsen eller fra de intrakraniale basale hjernearterier. I en del tilfælde kan blødningskilden ikke...

  20. Thumb Ossification Composite Index (TOCI) for Predicting Peripubertal Skeletal Maturity and Peak Height Velocity in Idiopathic Scoliosis

    Science.gov (United States)

    Hung, Alec L.H.; Chau, W.W.; Shi, B.; Chow, Simon K.; Yu, Fiona Y.P.; Lam, T.P.; Ng, Bobby K.W.; Qiu, Y.; Cheng, Jack C.Y.

    2017-01-01

    Background: Accurate skeletal maturity assessment is important to guide clinical evaluation of idiopathic scoliosis, but commonly used methods are inadequate or too complex for rapid clinical use. The objective of the study was to propose a new simplified staging method, called the thumb ossification composite index (TOCI), based on the ossification pattern of the 2 thumb epiphyses and the adductor sesamoid bone; to determine its accuracy in predicting skeletal maturation when compared with the Sanders simplified skeletal maturity system (SSMS); and to validate its interrater and intrarater reliability. Methods: Hand radiographs of 125 girls, acquired when they were newly diagnosed with idiopathic scoliosis prior to menarche and during longitudinal follow-up until skeletal maturity (a minimum of 4 years), were scored with the TOCI and SSMS. These scores were compared with digital skeletal age (DSA) and radius, ulna, and small hand bones (RUS) scores; anthropometric data; peak height velocity; and growth-remaining profiles. Correlations were analyzed with the chi-square test, Spearman and Cramer V correlation methods, and receiver operating characteristic curve analysis. Reliability analysis using the intraclass correlation (ICC) was conducted. Results: Six hundred and forty-five hand radiographs (average, 5 of each girl) were scored. The TOCI staging system was highly correlated with the DSA and RUS scores (r = 0.93 and 0.92, p 0.97. Conclusions: The new proposed TOCI could provide a simplified staging system for the assessment of skeletal maturity of subjects with idiopathic scoliosis. The index needs to be subjected to further multicenter validation in different ethnic groups. PMID:28872525

  1. Thumb fingertip reconstruction with palmar V-Y flaps combined with bone and nail bed grafts following amputation.

    Science.gov (United States)

    Zhou, Xiao; Wang, Libo; Mi, Jingyi; Xu, Yajun; Rui, Yongjun; Xue, Mingyu; Shen, Xiaofang; Qiang, Li

    2015-04-01

    The aim of treating thumb fingertip amputations with no indication for replantation is to reestablish functional and esthetic properties. From March 2005 to October 2008, we treated 14 patients with thumb fingertip amputation using palmar V-Y flaps combined with bone and nail bed grafts. There were 10 men and 4 women, whose ages at surgery ranged from 19 to 63 years (mean 35.8 years). In all, 11 of the injuries occurred in the dominant hand. According to Allen's classification, two were type II, seven were type III, and five were type IV. All patients underwent emergency surgery, with a time delay after injury of 3-12 h (mean 6.4 h). In each case, the amputation was a crush or avulsion injury, making microsurgical replantation not feasible. All of the flaps survived. At 8-17 months (average 12.8 months) of follow-up, the average subjective satisfaction score was 8.64. All patients experienced cold intolerance, and none of the patients complained of dysesthesia. Favorable results (excellent or good) were found in 78.6%. Thin primary nails appeared on the grafted nail bed about 3 weeks after surgery, following which the newly formed nail thickened and developed a more natural appearance. In one case, the new nail plate showed abnormal thickening due to hyperkeratosis. The bone graft healed at 5 weeks. The mean two-point discrimination was 7.5 mm. Grip strength was 10% less than that in the unaffected hand. Metacarpophalangeal and proximal interphalangeal joint mobility losses were less than 10°. All patients returned to their jobs. No patients had postoperative complications. We believe that the combination of palmar V-Y flap and bone and nail bed grafts provides a distinct advantage over other choices. It improves function when replantation is not an option.

  2. Measuring outcomes and determining long-term disability after revision amputation for treatment of traumatic finger and thumb amputation injuries.

    Science.gov (United States)

    Giladi, Aviram M; McGlinn, Evan P; Shauver, Melissa J; Voice, Taylor P; Chung, Kevin C

    2014-11-01

    Disability ratings after finger amputations are based on anatomical injury according to the American Medical Association's Guides to the Evaluation of Permanent Impairment. These ratings determine disability and compensation, without considering validated outcomes measures. The authors hypothesize that patient-reported outcomes reflect function and health-related quality of life after traumatic finger amputations, and that Guides scoring does not accurately rate postamputation disability. Patients were classified by amputation: single finger, thumb, multifinger, or multifinger plus thumb. Eighty-four patients completed functional tests, the Jebsen-Taylor Hand Function Test, and patient-reported outcomes [Brief Michigan Hand Questionnaire (MHQ), Quick Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, and the Short Form-36 health-related quality-of-life questionnaire). Patients were given disability scores according to the Guides. Pearson correlations between outcomes metrics were calculated, and linear regression evaluated associations between amputation group, Guides score, and outcomes measures. The Brief MHQ and Quick DASH questionnaires had significant correlation with functional tests, the Jebsen-Taylor test, and the physical component summary of Short Form-36. Only the Brief MHQ correlated with the mental component summary of the Short Form-36 (r=0.29, p=0.02). The Guides score only correlated with the Jebsen-Taylor test (r=0.47, pamputation group and Guides score do not predict patient-reported outcomes. The American Medical Association Guides score represents anatomical and functional outcomes without addressing mental health and other components of disability. As a result, Guides scoring is inadequate for determining postamputation disability. In evaluating composite amputation outcomes, Brief Michigan Hand Questionnaire outperformed other metrics. Risk, II.

  3. Isometric Thumb Exertion Induces B Cell and T Cell Lymphocytosis in Trained and Untrained Males: Physical Aptitude Determines Response Profiles

    Directory of Open Access Journals (Sweden)

    Adam Michael Szlezak

    2016-01-01

    Full Text Available Purpose: The present study examined the effect of low-dose thumb exertion on lymphocyte subpopulation trafficking. The potential role of blood lactate in mediating lymphocyte redistribution was also investigated. Methods: 27 male participants (18 weightlifting-trained; 9 untrained were separated into 3 groups of 9 (Weightlifting and Untrained Experimental: WLEXP, UTEXP; Weightlifting Placebo: WLPLA. WLEXP and UTEXP performed 4x60 second isometric thumb intervals separated by 60 second rest intervals in a single-blinded placebo-controlled study.  Participants were assessed over a 60 minute post-intervention recovery period for pain, blood lactate and lymphocyte subpopulation counts. Results: WLPLA did not change for any measured variable (p>0.05. The two experimentalgroups increased significantly (p0.05. No differences in cell count were seen for CD56+/CD16+ lymphocytes across time for any group (p>0.05. UTEXP showed an early significant increase (20 min post-intervention in CD4+CD3+ (20.78%, p0.05. Conversely, WLEXP group showed no early increase followed by a delayed increase in cell count evident at the final time-point; CD4+CD3+ (19.06%, p<0.01, CD8+CD3+ (11.46%, p=0.033 and CD19+ (28.87%, p<0.01. Blood lactate was not correlated with lymphocyte counts. Conclusions: Physical aptitude and not cellular energy demand influences the lymphocyte response to resistance-exercise. Keywords: B-Lymphocytes; Exercise; Lactic Acid; Lymphocytosis; Resistance Training; T-Lymphocytes

  4. [Image processing system of visual prostheses based on digital signal processor DM642].

    Science.gov (United States)

    Xie, Chengcheng; Lu, Yanyu; Gu, Yun; Wang, Jing; Chai, Xinyu

    2011-09-01

    This paper employed a DSP platform to create the real-time and portable image processing system, and introduced a series of commonly used algorithms for visual prostheses. The results of performance evaluation revealed that this platform could afford image processing algorithms to be executed in real time.

  5. Differences in performance of five types of aortic valve prostheses: haemodynamic assessment by dobutamine stress echocardiography.

    Science.gov (United States)

    Khoo, Jeffrey P; Davies, Joan E; Ang, Keng Leong; Galiñanes, Manuel; Chin, Derek T

    2013-01-01

    In patients being considered for aortic valve replacement, there remains controversy over which design or tissue offers the best performance. We aimed to evaluate in a single study the haemodynamic performances of five different widely used aortic valve prostheses: stentless porcine xenograft (Elan), stentless bovine pericardium (Pericarbon Freedom), stented porcine xenograft (Aspire), stented bovine pericardium (More) and mechanical (Ultracor). We also compared them with normal aortic valves and stenosed valves of variable severity. Preoperative echocardiography and dobutamine stress echocardiography at 1 year postoperatively were undertaken in 106 patients (n=18-24 from each group). Stentless bioprostheses, whether porcine or bovine, displayed superior haemodynamics across nearly all echocardiographic parameters: lower gradients, larger effective orifice area, higher dimensionless severity index (DSI) and lower resistance, when compared with stented or mechanical prostheses. Comparing both stented designs, bovine tissue performed the worst at rest, but with stress, there was no difference. The stress performances of the stentless bioprostheses were similar to the mildly stenosed native aortic valve, whereas the performances of the stented and mechanical prostheses resembled that of native valves with mild-to-moderate stenoses. Haemodynamic differences, however, did not translate into differences in left ventricular mass reduction at 1 year. Stentless bioprostheses displayed haemodynamics superior to stented or mechanical prostheses and had the closest performance to a normal, native aortic valve. Stress DSI data, least reliant on variable annulus/valve sizes and flow rates, provided the best haemodynamic discrimination.

  6. [Aftercare for durability and profitability of single-unit and multi-unit fixed dental prostheses

    NARCIS (Netherlands)

    Baat, C. de; Loveren, C. van; Maarel-Wierink, C.D. van der; Witter, D.J.; Creugers, N.H.J.

    2013-01-01

    An important aim ofa treatment with single-unit and multi-unit fixed dental prostheses is a durable and profitable treatment outcome. That requires aftercare, too. First, the frequency of routine oral examinations should be assessed, using an individual risk profile. The objectives of the routine

  7. Clinical Fit of Partial Removable Dental Prostheses Based on Alginate or Polyvinyl Siloxane Impressions.

    NARCIS (Netherlands)

    Fokkinga, W.A.; Witter, D.J.; Bronkhorst, E.M.; Creugers, N.H.J.

    2017-01-01

    PURPOSE: The aim of this study was to analyze the clinical fit of metal-frame partial removable dental prostheses (PRDPs) based on custom trays used with alginate or polyvinyl siloxane impression material. MATERIALS AND METHODS: Fifth-year students of the Nijmegen Dental School made 25 correct

  8. Fate of implant-retained craniofacial prostheses : Life span and aftercare

    NARCIS (Netherlands)

    Visser, Anita; Raghoebar, Gerry M.; van Oort, Robert P.; Vissink, Arjan

    2008-01-01

    Purpose: To assess the need for surgical and prosthetic aftercare of craniofacial prostheses supported by endosseous implants. Materials and Methods: A retrospective clinical study assessing the surgical and prosthetic aftercare from implant placement to last visit of follow-up was performed in

  9. Stemmed femoral knee prostheses: effects of prosthetic design and fixation on bone loss.

    NARCIS (Netherlands)

    Lenthe, G.H. van; Willems, P.C.P.H.; Verdonschot, N.J.J.; Waal Malefijt, M.C. de; Huiskes, R.

    2002-01-01

    Although the revision rates for modern knee prostheses have decreased drastically, the total number of revisions a year is increasing because many more primary knee replacements are being done. At the time of revision, bone loss is common, which compromises prosthetic stability. To improve

  10. Temporary cosmetic painted prostheses in anophthalmic surgery: an alternative to early postoperative clear conformers.

    Science.gov (United States)

    Avisar, I; Norris, J H; Quinn, S; Allan, D; McCalla, M; Dugdale, D; Parulekar, M; Malhotra, R

    2011-11-01

    To evaluate the use and safety of temporary, cosmetic, painted prostheses as an alternative to clear conformers immediately post removal of eye or socket surgery in children and adults. A 2-year, two-centre, retrospective audit of 54 patients undergoing enucleation, evisceration, secondary implant or socket reconstruction receiving a temporary painted prosthesis as an alternative to clear conformers immediately post surgery. Patient questionnaire and review of clinical notes was conducted for all patients. We reviewed 54 consecutive patients (22 females, 32 males, mean age 18.6 years, range 6 days to 82 years) who received cosmetic painted prostheses from January 2009 to December 2010. Procedures included: evisceration with primary implant (5), enucleation with primary implant (37), secondary implant (9), dermis fat graft (2) and fornix reconstruction with buccal graft (1). Complications included: pyogenic granuloma (2), mucous discharge (2) and exposure (2). All adults found their prosthesis comfortable, and no problems were reported by the parents of the children included in this study. In all, 46 patients (88% of respondents) returned to normal activities within 2 weeks. The temporary prosthesis fell out at least once in 25% of cases. In all, 90% of respondents expressed a definite preference towards the painted shell over a clear shell. Temporary cosmetic painted prostheses placed immediately after removal of the eye or socket surgery are well tolerated and preferred to standard clear shells. Painted prostheses, matched to the contralateral iris are a valuable option in anophthalmic surgery as an alternative to traditional clear conformers.

  11. HEALING OF MICROVENOUS PTFE PROSTHESES IMPLANTED INTO THE RAT FEMORAL VEIN

    NARCIS (Netherlands)

    VANDERLEI, B; DIJK, F; JONGEBLOED, WL; ROBINSON, PH; Bartels, H.

    44 PTFE prostheses (Gore-Tex(R); ID 1 mm) were implanted into rats' femoral veins by means of the sleeve anastomotic technique and were evaluated at regular intervals from 1 h up till 24 weeks after implantation by means of light and electron microscopy to study in detail their healing process. All

  12. The relative merits of cemented and uncemented prostheses in total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Joanna Maggs

    2017-01-01

    Full Text Available The results of modern cemented and uncemented total hip arthroplasties are outstanding and both systems have their advantages and disadvantages. This paper aims to examine the designs of different types of prostheses, some history behind their development and the reported results. Particular emphasis is placed on cemented stem design and the details of cementing technique.

  13. Metal release from hip prostheses: cobalt and chromium toxicity and the role of the clinical laboratory.

    Science.gov (United States)

    Campbell, Jonathon R; Estey, Mathew P

    2013-01-01

    Individuals with advanced hip disease suffer from pain, impaired hip function, and decreased quality of life. Roughly one million metal-on-metal (MoM) hip prostheses have been implanted worldwide in order to ameliorate these issues. While most MoM hip replacements are successful, some patients suffer from serious adverse effects secondary to the release of metal debris due to implant wear and corrosion. MoM hip prostheses are comprised predominantly of cobalt and chromium, and the serum concentration of these metal ions has been shown to correlate with both implant wear and the accumulation of metal debris in the periprosthetic tissue. Consequently, measurement of cobalt and chromium concentrations may be useful in the assessment of implant function and the potential for adverse effects in the follow-up of patients with MoM hip prostheses. The purpose of this Mini Review is to describe the adverse biological consequences of metal release from hip prostheses, provide an overview of the clinical utility of cobalt and chromium measurement and the current recommendations for testing, and alert laboratorians and physicians to the many challenges associated with measuring these metal ions.

  14. [Loading and strength of single- and multi-unit fixed dental prostheses. 1. Retention and resistance

    NARCIS (Netherlands)

    Baat, C. de; Witter, D.J.; Meijers, C.C.A.J.; Vergoossen, E.L.; Creugers, N.H.J.

    2014-01-01

    The degree to which single- and multi-unit fixed dental prostheses are able to withstand loading forces is dependent, among other things, on the quality of their retention and resistance. The quality of the retention and resistance of the configuration of an abutment tooth prepared for a metal and

  15. [Loading and strength of single- and multi-unit fixed dental prostheses 2. Strength

    NARCIS (Netherlands)

    Baat, C. de; Witter, D.J.; Meijers, C.C.A.J.; Vergoossen, E.L.; Creugers, N.H.J.

    2014-01-01

    The ultimate strength of a dental prosthesis is defined as the strongest loading force applied to the prosthesis until afracture failure occurs. Important key terms are strength, hardness, toughness and fatigue. Relatively prevalent complications of single- and multi-unit fixed dental prostheses are

  16. MODELING OF DENTAL PROSTHESES REMOVAL PROCESS BY MEANS OF VIBROIMPACT ULTRASONIC SYSTEM

    Directory of Open Access Journals (Sweden)

    M. G. Kiselev

    2007-01-01

    Full Text Available The results of experimental research on modeling dental prostheses removal process are given in the paper. It is determined on the basis of their analysis that the best conditions for detachment of prosthesis from a tooth body are provided in the case when a vibroiinpact mode of fracturing a cement layer used for crown fixation is realized.

  17. Evaluation of osseous integration of PVD-silver-coated hip prostheses in a canine model.

    Science.gov (United States)

    Hauschild, Gregor; Hardes, Jendrik; Gosheger, Georg; Stoeppeler, Sandra; Ahrens, Helmut; Blaske, Franziska; Wehe, Christoph; Karst, Uwe; Höll, Steffen

    2015-01-01

    Infection associated with biomaterials used for orthopedic prostheses remains a serious complication in orthopedics, especially tumor surgery. Silver-coating of orthopedic (mega)prostheses proved its efficiency in reducing infections but has been limited to surface areas exposed to soft tissues due to concerns of silver inhibiting osseous integration of cementless stems. To close this gap in the bactericidal capacity of silver-coated orthopedic prostheses extension of the silver-coating on surface areas intended for osseous integration seems to be inevitable. Our study reports about a PVD- (physical-vapor-deposition-) silver-coated cementless stem in a canine model for the first time and showed osseous integration of a silver-coated titanium surface in vivo. Radiological, histological, and biomechanical analysis revealed a stable osseous integration of four of nine stems implanted. Silver trace elemental concentrations in serum did not exceed 1.82 parts per billion (ppb) and can be considered as nontoxic. Changes in liver and kidney functions associated with the silver-coating could be excluded by blood chemistry analysis. This was in accordance with very limited metal displacement from coated surfaces observed by laser ablation inductively coupled plasma-mass spectrometry (LA-ICP-MS) 12 months after implantation. In conclusion our results represent a step towards complete bactericidal silver-coating of orthopedic prostheses.

  18. [Technical aspects of treatments with single- and multi-unit fixed dental prostheses

    NARCIS (Netherlands)

    Wiersema, E.J.; Kreulen, C.M.; Latzke, P.; Witter, D.J.; Creugers, N.H.J.

    2014-01-01

    For the manufacture of single- and multi-unit fixed dental prostheses, effective communication between dentist and dental technician is required. Mutual insight concerning the (im)possibilities of available treatments and technical options is prerequisitefor this communication. The manufacture of

  19. In vitro evaluation of failure loads of nonmetal cantilevered resin-bonded fixed dental prostheses

    NARCIS (Netherlands)

    van Dalen, A.; Feilzer, A.J.; Kleverlaan, C.J.

    2008-01-01

    Purpose: To evaluate in vitro the influence of fiber reinforcement on the failure loads of resin composite beams, simulating cantilevered two-unit resin-bonded fixed dental prostheses, and compare the results with similarly obtained failure loads of ZrO2 and CoCr beams of a comparable design.

  20. Grasping force and slip feedback through vibrotactile stimulation to be used in myoelectric forearm prostheses

    NARCIS (Netherlands)

    Muijzer-Witteveen, Heintje Johanna Berendina; Rietman, Johan Swanik; Veltink, Petrus H.

    User feedback about grasping force or slip of objects is lacking in current myoelectric forearm prostheses, resulting in a high number of prosthesis abandonment, because a high level of concentration is required to hold an object. Several approaches to provide force feedback to the user via

  1. Waterjet cutting of periprosthetic interface tissue in loosened hip prostheses: an in vitro feasibility study

    NARCIS (Netherlands)

    Kraaij, Gert; Tuijthof, Gabrielle J. M.; Dankelman, Jenny; Nelissen, Rob G. H. H.; Valstar, Edward R.

    2015-01-01

    Waterjet cutting technology is considered a promising technology to be used for minimally invasive removal of interface tissue surrounding aseptically loose hip prostheses. The goal of this study was to investigate the feasibility of waterjet cutting of interface tissue membrane. Waterjets with 0.2

  2. Achieving immediate function with provisional prostheses after implant placement: a clinical report.

    Science.gov (United States)

    Kwon, Kung-Rock; Sachdeo, Amit; Weber, Hans-Peter

    2005-06-01

    When using a conventional implant treatment protocol in edentulous patients, reduced function and comfort for up to 6 months after implant surgery is inevitable until bone healing is complete and a prosthesis is securely attached to the implants. The following report highlights 2 treatment modalities that enable immediate function by inserting provisional prostheses immediately after implant placement.

  3. CT brain demonstration of basal ganglion calcification in adult HIV ...

    African Journals Online (AJOL)

    brain barrier has been postulated. Calcification of the basal ganglia in encephalopathic HIV/AIDS children has been relatively well documented. Only two adult HIV cases with basal ganglion calcification (BGC) have been reported in the literature.

  4. Basal cell nevus syndrome - close-up of palm (image)

    Science.gov (United States)

    ... skeletal abnormalities. Skin manifestations include pits in the palms and soles, and numerous basal cell carcinomas. This ... close-up of the pits found in the palm of an individual with basal cell nevus syndrome.

  5. Evaluation of taper joints with combined fatigue and crevice corrosion testing: Comparison to human explanted modular prostheses

    Energy Technology Data Exchange (ETDEWEB)

    Reclaru, L., E-mail: lucien.reclaru@pxgroup.com [PX Group S.A., Dep R and D Corrosion and Biocompatibility Group, Bd. des Eplatures 42, CH-2304 La Chaux-de-Fonds (Switzerland); Brooks, R.A. [Orthopaedic Research, Addenbrooke' s Hospital, University of Cambridge, Box 180 Hills Road, CB2 0QQ Cambridge (United Kingdom); Zuberbühler, M. [Smith and Nephew Orthopaedics AG, Schachenalle 29, 5001 Aarau (Switzerland); Eschler, P.-Y.; Constantin, F. [PX Group S.A., Dep R and D Corrosion and Biocompatibility Group, Bd. des Eplatures 42, CH-2304 La Chaux-de-Fonds (Switzerland); Tomoaia, G. [University of Medicine and Pharmacy Iuliu Hateganu of Cluj-Napoca, Dept. of Orthopaedics and Traumatology, Cluj-Napoca (Romania)

    2014-01-01

    The requirement for revision surgery of total joint replacements is increasing and modular joint replacement implants have been developed to provide adjustable prosthetic revision systems with improved intra-operative flexibility. An electrochemical study of the corrosion resistance of the interface between the distal and proximal modules of a modular prosthesis was performed in combination with a cyclic fatigue test. The complexity resides in the existence of interfaces between the distal part, the proximal part, and the dynamometric screw. A new technique for evaluating the resistance to cyclic dynamic corrosion with crevice stimulation was used and the method is presented. In addition, two components of the proximal module of explanted Ti6Al4V and Ti6Al7Nb prostheses were investigated by optical and electron microscopy. Our results reveal that: The electrolyte penetrates into the interface between the distal and proximal modules during cyclic dynamic fatigue tests, the distal module undergoes cracking and corrosion was generated at the interface between the two models; The comparison of the explanted proximal parts with the similar prostheses evaluated following cyclic dynamic crevice corrosion testing showed that there were significant similarities indicating that this method is suitable for evaluating materials used in the fabrication of modular prostheses. - Highlights: • Electrochemical crevice corrosion testing combined with fatigue test conducted on Ti6Al7Nb and Ti6Al4V modular prostheses • Cations released from integral prostheses • Comparison of human explanted modular prostheses with the similar prostheses evaluated in cyclic dynamic crevice corrosion.

  6. Prevention of biofilm formation by dairy products and N-acetylcysteine on voice prostheses in an artificial throat.

    Science.gov (United States)

    Schwandt, Leonora Q; Van Weissenbruch, Ranny; Stokroos, Ietse; Van der Mei, Henny C; Busscher, Henk J; Albers, Frans W J

    2004-08-01

    To evaluate the preventive effect of buttermilk, Yakult Light fermented milk drink and N-acetylcysteine on biofilm formation on voice prostheses in vitro. Groningen button and Provox 2 voice prostheses were inoculated with a mixture of bacteria and yeasts isolated from previously explanted Groningen button voice prostheses. After 5 h, separate throats were flushed with buttermilk, Yakult Light fermented milk drink, N-acetylcysteine or phosphate-buffered saline, which served as a control. After 7 days, the microflora on each voice prosthesis was determined. On Groningen button voice prostheses, buttermilk, Yakult Light fermented milk drink and N-acetylcysteine all reduced the amount of both bacteria and yeasts. On Provox 2 voice prostheses, buttermilk, Yakult Light fermented milk drink and N-acetylcysteine reduced the amount of bacteria but, conversely, increased the amount of yeasts. These in vitro experiments demonstrate that biofilm formation on voice prostheses is reduced in an artificial throat by the use of buttermilk, Yakult Light fermented milk drink and N-acetylcysteine. However, the structural differences between the type of voice prostheses may influence the ultimate effects.

  7. Evaluation of taper joints with combined fatigue and crevice corrosion testing: Comparison to human explanted modular prostheses

    International Nuclear Information System (INIS)

    Reclaru, L.; Brooks, R.A.; Zuberbühler, M.; Eschler, P.-Y.; Constantin, F.; Tomoaia, G.

    2014-01-01

    The requirement for revision surgery of total joint replacements is increasing and modular joint replacement implants have been developed to provide adjustable prosthetic revision systems with improved intra-operative flexibility. An electrochemical study of the corrosion resistance of the interface between the distal and proximal modules of a modular prosthesis was performed in combination with a cyclic fatigue test. The complexity resides in the existence of interfaces between the distal part, the proximal part, and the dynamometric screw. A new technique for evaluating the resistance to cyclic dynamic corrosion with crevice stimulation was used and the method is presented. In addition, two components of the proximal module of explanted Ti6Al4V and Ti6Al7Nb prostheses were investigated by optical and electron microscopy. Our results reveal that: The electrolyte penetrates into the interface between the distal and proximal modules during cyclic dynamic fatigue tests, the distal module undergoes cracking and corrosion was generated at the interface between the two models; The comparison of the explanted proximal parts with the similar prostheses evaluated following cyclic dynamic crevice corrosion testing showed that there were significant similarities indicating that this method is suitable for evaluating materials used in the fabrication of modular prostheses. - Highlights: • Electrochemical crevice corrosion testing combined with fatigue test conducted on Ti6Al7Nb and Ti6Al4V modular prostheses • Cations released from integral prostheses • Comparison of human explanted modular prostheses with the similar prostheses evaluated in cyclic dynamic crevice corrosion

  8. Objective clinical assessment of change in swallowing ability of maxillectomy patients when wearing obturator prostheses.

    Science.gov (United States)

    Matsuyama, Miwa; Tsukiyama, Yoshihiro; Koyano, Kiyoshi

    2005-01-01

    Evaluation of treatment outcome is important in maxillofacial rehabilitation. Although eating is one of the oral functions that most strongly influences patients' quality of life, only a few reports exist on the objective assessment of swallowing for maxillectomy patients. The purpose of this study was to identify changes in the swallowing ability of maxillectomy patients when wearing obturator prostheses through the use of an objective clinical assessment. The swallowing ability of 38 postmaxillectomy patients consecutively treated with obturator prostheses was objectively evaluated with the "water-drinking test" that was developed for the assessment of dysphagia patients after cerebrovascular disease. In this test, the subjects were instructed to drink 30 mL of water in one swallow. The profile was evaluated with the combination of the time required for drinking the water and the incidence of cough reflex. Statistical analysis was performed using the Wilcoxon signed-rank test, the paired t test, and the Chi-square test with StatView 5.0 for the Macintosh. Performance improved significantly when the patients wore prostheses (P = .0026, Wilcoxon signed-rank test). The mean drinking times without and with prostheses were 8.2 +/- 6.3 s and 5.0 +/- 3.5 s, respectively. Drinking time was shortened significantly when the prosthesis was worn (P = .0002, paired t test). The assessment of behavior and episodes revealed that the swallowing ability of the maxillectomy patients was significantly improved when a prosthesis was worn (P = .0002, Chi-square test). The swallowing ability of maxillectomy patients was quantitatively and qualitatively improved with obturator prostheses.

  9. Basal Cell Ameloblastoma: A Rare Histological Variant of an ...

    African Journals Online (AJOL)

    Ameloblastomas are an inscrutable group of oral tumors. Basal cell ameloblastoma is a rare variant of ameloblastoma with very few cases reported until date. The tumor is composed of more primitive cells and has less conspicuous peripheral palisading. It shows remarkable similarity to basal cell carcinoma, basal cell ...

  10. Traumatic bilateral basal ganglia hematoma: A report of two cases

    OpenAIRE

    Bhargava, Pranshu; Grewal, Sarvpreet Singh; Gupta, Bharat; Jain, Vikas; Sobti, Harman

    2012-01-01

    Traumatic Basal ganglia hemorrhage is relatively uncommon. Bilateral basal ganglia hematoma after trauma is extremely rare and is limited to case reports. We report two cases of traumatic bilateral basal ganglia hemorrhage, and review the literature in brief. Both cases were managed conservatively.

  11. [Descriptive study on basal cell eyelid carcinoma].

    Science.gov (United States)

    Pfeiffer, M J; Pfeiffer, N; Valor, C

    2015-09-01

    To describe a series of cases of basal cell carcinomas of the eyelid. A descriptive and retrospective study was conducted by reviewing the medical outcome, histopathological history, and photographic images of 200 patients with basal cell eyelid carcinomas. All were treated in the Herzog Carl Theodor Eye Hospital in Munich, Germany, between 2000 and 2013. In the present study, it was found that females are more affected than males. The mean age of presentation of the tumor occurred at the age of 70 years. In 50% of the cases the tumor was found on the lower lid, especially medially from the center of the lid. The lid margin was involved in 47% of all tumors. The mean diameter was 9.2mm. The recurrence rate after surgery with histologically clear resection margins was 5%. There was a significant relationship between tumor diameter and age. As tumors where located farther away from medial and closer to the lid margin, they became larger. There is a predominance of women affected by this tumor. This may be related to the fact that the sample was taken from those attending an oculoplastic surgery clinic, where there are generally more women than men attending. The formation of basal cell carcinomas increases with age. The infrequent involvement of the upper lid could be explained by the protection of the the eyebrow. The frequent involvement of the lower lid may be due to the light reflection (total reflection) by the cornea on the lower lid margin. Also chemical and physical effects of the tears may be more harmful on the lower lid. Patients tend to ask for medical help when they are females, younger, when the tumor is closer to the medial canthus or when the tumor is away from the lid margin. Copyright © 2014 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  12. Dopaminergic innervation of human basal ganglia.

    Science.gov (United States)

    Prensa, L; Cossette, M; Parent, A

    2000-12-01

    This paper summarises the results of some of our recent tyrosine hydroxylase (TH) immunohistochemical studies of the dopaminergic innervation of the human basal ganglia. It also reports new findings on the presence of TH-immunoreactive (ir) neurons in the striatum. Our data show the existence of nigrostriatal TH-ir axons that provide collaterals arborizing in the globus pallidus and subthalamic nucleus. These thin and varicose collaterals emerge from thick and smooth axons that course along the main output pathways of the basal ganglia, including the ansa lenticularis, the lenticular fasciculus and Wilson's pencils. We postulate that this extrastriatal innervation, which allows nigral dopaminergic neurons to directly affect the pallidum and subthalamic nucleus, plays a critical role in the functional organisation of human basal ganglia. The TH-ir fibres that reach the striatum arborize according to a highly heterogeneous pattern. At rostral striatal levels, numerous small TH-poor zones embedded in a TH-rich matrix correspond to calbindin-poor striosomes and calbindin-rich extrastriosomal matrix, respectively. At caudal striatal levels, in contrast, striosomes display a TH immunostaining that is more intense than that of the matrix. A significant number of small, oval, aspiny TH-ir neurons scattered throughout the rostrocaudal extent of the caudate nucleus and putamen, together with a few larger, multipolar, spiny TH-ir neurons lying principally within the ventral portion of the putamen, were disclosed in human. This potential source of intrinsic striatal dopamine might play an important role in the functional organisation of the human striatum, particularly in case of Parkinson's disease.

  13. Nonsurgical Treatment Options for Basal Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Mary H. Lien

    2011-01-01

    Full Text Available Basal cell carcinoma (BCC remains the most common form of nonmelanoma skin cancer (NMSC in Caucasians, with perhaps as many as 2 million new cases expected to occur in the United States in 2010. Many treatment options, including surgical interventions and nonsurgical alternatives, have been utilized to treat BCC. In this paper, two non-surgical options, imiquimod therapy and photodynamic therapy (PDT, will be discussed. Both modalities have demonstrated acceptable disease control rates, cosmetically superior outcomes, and short-term cost-effectiveness. Further studies evaluating long-term cure rates and long-term cost effectiveness of imiquimod therapy and PDT are needed.

  14. The Basal Ganglia and Adaptive Motor Control

    Science.gov (United States)

    Graybiel, Ann M.; Aosaki, Toshihiko; Flaherty, Alice W.; Kimura, Minoru

    1994-09-01

    The basal ganglia are neural structures within the motor and cognitive control circuits in the mammalian forebrain and are interconnected with the neocortex by multiple loops. Dysfunction in these parallel loops caused by damage to the striatum results in major defects in voluntary movement, exemplified in Parkinson's disease and Huntington's disease. These parallel loops have a distributed modular architecture resembling local expert architectures of computational learning models. During sensorimotor learning, such distributed networks may be coordinated by widely spaced striatal interneurons that acquire response properties on the basis of experienced reward.

  15. Immunosuppressive Environment in Basal Cell Carcinoma

    DEFF Research Database (Denmark)

    Omland, Silje Haukali; Nielsen, Patricia S; Gjerdrum, Lise M R

    2016-01-01

    Interaction between tumour survival tactics and anti-tumour immune response is a major determinant for cancer growth. Regulatory T cells (T-regs) contribute to tumour immune escape, but their role in basal cell carcinoma (BCC) is not understood. The fraction of T-regs among T cells was analysed...... by immunohistochemistry followed by automated image analysis in facial BCC, peritumoural skin and normal, buttock skin. Quantitative real-time PCR (qRT-PCR) was performed for FOXP3 and cytokines involved in T-reg attraction and T-cell activation. T-regs comprised 45% of CD4-cells surrounding BCC. FOXP3 was highly...

  16. Basal cell carcinoma after radiation therapy

    International Nuclear Information System (INIS)

    Shimbo, Keisuke; Terashi, Hiroto; Ishida, Yasuhisa; Tahara, Shinya; Osaki, Takeo; Nomura, Tadashi; Ejiri, Hirotaka

    2008-01-01

    We reported two cases of basal cell carcinoma (BCC) that developed after radiation therapy. A 50-year-old woman, who had received an unknown amount of radiation therapy for the treatment of intracranial germinoma at the age of 22, presented with several tumors around the radiation ulcer. All tumors showed BCC. A 33-year-old woman, who had received an unknown amount of radiation therapy on the head for the treatment of leukemia at the age of 2, presented with a black nodule within the area of irradiation. The tumor showed BCC. We discuss the occurrence of BCC after radiation therapy. (author)

  17. Nonsurgical Treatment Options for Basal Cell Carcinoma

    International Nuclear Information System (INIS)

    Lien, M. H.; Sondak, V. K.; Sondak, V. K.

    2011-01-01

    Basal cell carcinoma (BCC) remains the most common form of non melanoma skin cancer (NMSC) in Caucasians, with perhaps as many as 2 million new cases expected to occur in the United States in 2010. Many treatment options, including surgical interventions and nonsurgical alternatives, have been utilized to treat BCC. In this paper, two non-surgical options, imiquimod therapy and photodynamic therapy (PDT), will be discussed. Both modalities have demonstrated acceptable disease control rates, cosmetically superior outcomes, and short-term cost-effectiveness. Further studies evaluating long-term cure rates and long-term cost effectiveness of imiquimod therapy and PDT are needed.

  18. Soft tissue metastasis in basal cell carcinoma

    Directory of Open Access Journals (Sweden)

    Shrivastava Rajeev

    2007-01-01

    Full Text Available Basal cell carcinoma (BCC is the most common of the cutaneous malignancies, accounting for 65-75% of all skin cancers. The natural history of this disease is one of chronic local invasion. Metastatic BCC Is a rare clinical entity, with a reported incidence of only 0.0028-0.5%. Approximately 85% of all metastatic BCCs arise in the head and neck region. We present a case of BCC that spread to the muscles of the cheek and nodes (intraparotid and internal jugular, in a man who had a lesion near the inner canthus of his right eye and adjoining nasal bridge.

  19. The Use of Prostheses in Pelvic Reconstructive Surgery: Joy or Toy?

    Directory of Open Access Journals (Sweden)

    Ming-Ping Wu

    2008-06-01

    Full Text Available The high recurrence rate of pelvic organ prolapse (POP of up to 30% after pelvic reconstructive surgery makes a more refined surgery imperative, as well as the need for either biological or synthetic prostheses as adjuvant treatment. Patients with recurrence risks may benefit from the adjuvant treatment: (1 to substitute for the lack of supportive tissue; (2 to reinforce inadequate tissue; (3 to induce new supportive tissue; and (4 to consolidate and complement the insufficient surgical techniques. However, some debatable issues in use of the prosthetics remain. The use of prosthetics enables the simultaneous repair of all vaginal defects of POP and concomitant anti-incontinence surgery to be faster, easier and more precise. Nevertheless, great care should be devoted to the actual and theoretical short- and long-term risks, many of which have not been fully elucidated. Despite the lack of various ideal characteristics, the type I monofilament, macroporous polypropylene, has been suggested to have the lowest incidence of infection and erosion among the nonabsorbable prostheses. There is good evidence to support the use of nonabsorbable synthetic mesh for abdominal sacrocolpopexy, while the use of prostheses for repairing isolated anterior and posterior compartment defects remains controversial. There have been no long-term studies with sufficient patient numbers to prove whether synthetic or biological prostheses are superior during vaginal surgery. Tension-free vaginal mesh techniques with procedural kits are being adopted increasingly, despite the paucity of data. Although short-term follow-up studies have shown tension-free vaginal mesh to be a safe and effective technique to correct POP, anatomic and functional results of long-term follow-up studies, however, have not yet confirmed the effectiveness and safety. Mesh erosion remains a concern, with variable rates according to different materials and approaches. Newly developed prostheses offer

  20. Oscillatory activity in the basal ganglia.

    Science.gov (United States)

    Eusebio, Alexandre; Brown, Peter

    2007-01-01

    The exact mechanisms underlying the dysfunction of the basal ganglia (BG) that leads to movement disorders such as Parkinson's disease (PD) and dystonia still remain unclear. The classic model, based on two distinct pathways and described nearly 20 years ago by Albin and Delong, fails to explain why lesion or stimulation of the globus pallidus interna improves dyskinesias and why lesion or stimulation of the thalamus does not cause prominent bradykinesia. These paradoxes, initially highlighted out by Marsden and Obeso, led to the proposition that the pattern of neuronal discharge determines pathological function. Accordingly, over the past decade, attention has switched from considerations of discharge rate to the characterisation of synchronised activity within BG networks. Here we would like to briefly review current knowledge about synchronised oscillatory activity in the BG and focus on its relationship to abnormal motor function. In particular, we hypothesise that the frequency of synchronisation helps determine the nature of any motor deficit, perhaps as a consequence of the different tuning properties of basal ganglia-cortical sub-circuits.

  1. Preliminary observations on influence of dairy products on biofilm removal from silicone rubber voice prostheses in vitro

    NARCIS (Netherlands)

    Busscher, HJ; Free, RH; Van Weissenbruch, R; Albers, FWJ; Van der Mei, HC

    We determined oropharyngeal biofilm removal from silicone rubber voice prostheses in an artificial throat after perfusion with different commercially available dairy products, including buttermilk, Lactobacillus casei Shirota fermented milk (Yakult, Yakult Netherlands BV, Almere, The Netherlands),

  2. Fitting a bilateral transhumeral amputee with utensil prostheses and their functional assessment 10 years later: a case report.

    Science.gov (United States)

    Hung, Jen Wen; Wu, Yee Hwa

    2005-11-01

    Traumatic transhumeral amputations resulting from electric burn injury are uncommon and present a significant rehabilitation challenge. Compensating for loss of fine, coordinated function of the upper extremities with prostheses is difficult medically, technologically, psychologically, and socially. We followed up a patient with traumatic bilateral transhumeral amputation who was fitted with specially designed bilateral low-temperature utensil prostheses for 10 years. A bilateral utensil prosthesis consists of 2 thermoplastic sockets, an elastic harness, 2 utensil holders, and several different utensils. The characteristics of utensil prostheses are low cost, quick fabrication, and responsiveness to a patient's needs. Ten years after the patient's first prosthesis fitting, he still used these specially designed prostheses. By using these devices and his feet, the patient has regained independence in most activities of daily living and gained a new working skill.

  3. Phylogenetic differences of mammalian basal metabolic rate are not explained by mitochondrial basal proton leak.

    Science.gov (United States)

    Polymeropoulos, E T; Heldmaier, G; Frappell, P B; McAllan, B M; Withers, K W; Klingenspor, M; White, C R; Jastroch, M

    2012-01-07

    Metabolic rates of mammals presumably increased during the evolution of endothermy, but molecular and cellular mechanisms underlying basal metabolic rate (BMR) are still not understood. It has been established that mitochondrial basal proton leak contributes significantly to BMR. Comparative studies among a diversity of eutherian mammals showed that BMR correlates with body mass and proton leak. Here, we studied BMR and mitochondrial basal proton leak in liver of various marsupial species. Surprisingly, we found that the mitochondrial proton leak was greater in marsupials than in eutherians, although marsupials have lower BMRs. To verify our finding, we kept similar-sized individuals of a marsupial opossum (Monodelphis domestica) and a eutherian rodent (Mesocricetus auratus) species under identical conditions, and directly compared BMR and basal proton leak. We confirmed an approximately 40 per cent lower mass specific BMR in the opossum although its proton leak was significantly higher (approx. 60%). We demonstrate that the increase in BMR during eutherian evolution is not based on a general increase in the mitochondrial proton leak, although there is a similar allometric relationship of proton leak and BMR within mammalian groups. The difference in proton leak between endothermic groups may assist in elucidating distinct metabolic and habitat requirements that have evolved during mammalian divergence.

  4. Should silicone prostheses be considered for specimen banking? A pilot study into their use for human biomonitoring.

    Science.gov (United States)

    Allan, Ian J; Bæk, Kine; Kringstad, Alfhild; Roald, Helge E; Thomas, Kevin V

    2013-09-01

    Persistent organic pollutant (POP) biomonitoring in humans is challenging and generally carried out using blood, breast milk or adipose tissue, with concentrations normalised to the lipid content of the sample matrix. The goal of this cross-sectional pilot study was to evaluate the validity and feasibility of explanted silicone prostheses as a matrix for persistent organic pollutant biomonitoring in humans. We postulate that pollutant concentrations in silicone prostheses inserted in the body will equilibrate with that in the body over time and provide a measure of the overall body burden. This study included silicone prostheses from 22 female patients of the Colosseum clinic (Oslo, Norway) collected between September 2010 and April 2012. Absorption of chlorinated and brominated POPs into silicone prostheses during implantation was observed. Relative levels of the different contaminants measured in prostheses were in agreement with those from serum and breast milk analyses from the general Norwegian population. The comparison of serum and breast milk-based literature data with prosthesis concentrations transposed into lipid-normalised concentrations supports the validity of the prosthesis measurements. The median of relative percent differences between measurements with replicate silicone prostheses from 11 patients was below 30%. Observed increases in prosthesis concentrations with patients' age were found to be very similar to literature data from studies of the Norwegian population. Silicone prostheses therefore represent a promising matrix for the biomonitoring of nonpolar and non-ionic pollutants in humans. Sample accessibility and body burden representativeness of the silicone prostheses suggest that specimen banking should be initiated. © 2013.

  5. Similar Marginal Precision of Zirconia- and Metal-Ceramic Fixed Dental Prostheses

    DEFF Research Database (Denmark)

    Nicolaisen, Maj Høygaard; Bahrami, Golnosh; Schropp, Lars

    Similar Marginal Precision of Zirconia- and Metal-Ceramic Posterior Fixed Dental Prostheses Objective: An increased gap between restoration and prepared tooth causes more luting material to be exposed to the oral environment resulting in increased deterioration, leading to bacterial accumulation...... which can cause marginal periodontitis and secondary caries. The purpose of this randomized clinical study was to compare the marginal precision of CAD/CAM Zirconia-ceramic (ZC) and cast gold alloy metal-ceramic (MC) posterior fixed dental prostheses. Methods: As part of an ongoing randomized controlled...... clinical trial, 34 patients were randomized into two groups to receive a 3-unit fixed dental prosthesis (FDP) replacing a second premolar or a first molar. 17 ZC FDPs (BeCe CAD Zirkon, BEGO with Vita VM9, VITA ) and 17 MC FDPs (Bio PontoStar, BEGO with Vita VM13, VITA). All FDPs were made in accordance...

  6. Cross-pinning: the philosophy of retrievability applied practically to fixed, implant-supported prostheses.

    Science.gov (United States)

    Gervais, M J; Hatzipanagiotis, P; Wilson, P R

    2008-03-01

    Biologic and technical complications are widely reported in the dental literature and often compromise the functional and/or aesthetic features of fixed, implant-supported prostheses. Managing complications without damaging or destroying a restoration is an obvious advantage of implant-based dentistry where the option of prosthetic retrievability is almost always available. The technique of cross-pinning uses a transverse screw to secure a prosthesis to a milled implant abutment, allowing prosthetic retrievability irrespective of dental implant alignment. This study presents guidelines for cross-pinning implant-supported prostheses based on resistance form, screw mechanics and natural tooth contours. The technical aspects of cross-pinning are also discussed using examples from four implant systems.

  7. Direct 3D printing of silicone facial prostheses: A preliminary experience in digital workflow.

    Science.gov (United States)

    Unkovskiy, Alexey; Spintzyk, Sebastian; Brom, Joern; Huettig, Fabian; Keutel, Constanze

    2018-02-08

    Direct silicone printing may be applied to the fabrication of maxillofacial prostheses, although its clinical feasibility is unknown. The present clinical report shows an early application of a directly printed silicone prosthesis for the rehabilitation of a nasal defect. Two extraoral scanning systems were used to capture the face and the defect. The virtual construction of the nasal prosthesis was performed with free-form software. Two prostheses were printed in silicone and post-processed by manual sealing and coloring. The clinical outcome was acceptable for an interim prosthesis; however, the marginal adaptation and color match were not satisfactory without further individualization. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  8. Knee Angle Estimation Algorithm for Myoelectric Control of Active Transfemoral Prostheses

    Science.gov (United States)

    Delis, Alberto López; de Carvalho, João Luiz Azevedo; Da Rocha, Adson Ferreira; de Oliveira Nascimento, Francisco Assis; Borges, Geovany Araújo

    This paper presents a bioinstrumentation system for the acquisition and pre-processing of surface electromyographic (SEMG) signals, and a knee angle estimation algorithm for control of active transfemoral leg prostheses, using methods for feature extraction and classification of myoelectric signal patterns. The presented microcontrolled bioinstrumentation system is capable of recording up to four SEMG channels, and one electrogoniometer channel. The proposed neural myoelectric controller algorithm is capable of predicting the intended knee joint angle from the measured SEMG signals. The algorithm is designed in three stages: feature extraction, using auto-regressive model and amplitude histogram; feature projection, using self organizing maps; and pattern classification, using a Levenberg-Marquardt neural network. The use of SEMG signals and additional mechanical information such as that provided by the electrogoniometer may improve precision in the control of leg prostheses. Preliminary results are presented.

  9. Human endothelium on vascular prostheses modified by extracellular matrix proteins in a flow experiment

    Czech Academy of Sciences Publication Activity Database

    Chlupáč, Jaroslav; Filová, Elena; Riedel, Tomáš; Brynda, Eduard; Remy-Zolghadri, M.; Bareille, R.; Fernandez, P.; Daculsi, R.; Bordenave, L.; Bačáková, Lucie

    2006-01-01

    Roč. 9, č. 58-60 (2006), s. 10-13 ISSN 1429-7248 R&D Projects: GA AV ČR(CZ) IAA5011301; GA AV ČR(CZ) IAA4050202; GA AV ČR(CZ) IAA400500507; GA AV ČR(CZ) 1QS500110564 Institutional research plan: CEZ:AV0Z50110509; CEZ:AV0Z40500505 Keywords : bioartificial vascular prostheses * laminin * fibrin Subject RIV: EI - Biotechnology ; Bionics

  10. An integrated CAD/CAM/robotic milling method for custom cementless femoral prostheses.

    Science.gov (United States)

    Wen-ming, Xi; Ai-min, Wang; Qi, Wu; Chang-hua, Liu; Jian-fei, Zhu; Fang-fang, Xia

    2015-09-01

    Aseptic loosening is the primary cause of cementless femoral prosthesis failure and is related to the primary stability of the cementless femoral prosthesis in the femoral cavity. The primary stability affects both the osseointegration and the long-term stability of cementless femoral prostheses. A custom cementless femoral prosthesis can improve the fit and fill of the prosthesis in the femoral cavity and decrease the micromotion of the proximal prosthesis such that the primary stability of the custom prosthesis can be improved, and osseointegration of the proximal prosthesis is achieved. These results will help to achieve long-term stability in total hip arthroplasty (THA). In this paper, we introduce an integrated CAD/CAM/robotic method of milling custom cementless femoral prostheses. The 3D reconstruction model uses femoral CT images and 3D design software to design a CAD model of the custom prosthesis. After the transformation matrices between two units of the robotic system are calibrated, consistency between the CAM software and the robotic system can be achieved, and errors in the robotic milling can be limited. According to the CAD model of the custom prosthesis, the positions of the robotic tool points are produced by the CAM software of the CNC machine. The normal vector of the three adjacent robotic tool point positions determines the pose of the robotic tool point. In conclusion, the fit rate of custom pig femur stems in the femoral cavities was 90.84%. After custom femoral prostheses were inserted into the femoral cavities, the maximum gaps between the prostheses and the cavities measured less than 1 mm at the diaphysis and 1.3 mm at the metaphysis. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

  11. Effect of beverages and mouthwashes on the hardness of polymers used in intraoral prostheses.

    Science.gov (United States)

    Goiato, Marcelo Coelho; Dos Santos, Daniela Micheline; Andreotti, Agda Marobo; Nobrega, Adhara Smith; Moreno, Amalia; Haddad, Marcela Filié; Pesqueira, Aldiéris Alves

    2014-10-01

    The mechanical properties of acrylic resins used in intraoral prostheses may be altered by frequent exposure to liquids such as beverages and mouthwashes. This study aimed to evaluate the effect of thermocycling and liquid immersion on the hardness of four brands of acrylic resins commonly used in removable prostheses (Onda Cryl, QC-20, Clássico, Lucitone). For each brand of resin, seven specimens were immersed in each of six solutions (coffee, cola, red wine, Plax-Colgate, Listerine [LI], Oral B), and seven more were placed in artificial saliva (control). The hardness was tested using a microhardness tester before and after 5000 thermocycles and after 1, 3, 24, 48, and 96 hours of immersion. The results were analyzed using three-way repeated-measures ANOVA and Tukey's test (p hardness of the resins decreased following thermocycling and immersion in the solutions. Specimens immersed in cola and wine exhibited significant decreases in hardness after immersion for 96 hours, although the greatest significant decrease in hardness occurred in specimens immersed in LI. However, according to American Dental Association specification 12, the Knoop hardness of acrylic resins for intraoral prostheses should not be below 15. Thus, the median values of superficial hardness observed in most of the acrylic resins in this study are considered clinically acceptable. The microhardness of polymers used for intraoral prostheses decreases following thermocycling. Among specimens immersed in beverages, those immersed in cola or wine experienced the greatest decrease in microhardness. Immersion of acrylic resins in LI significantly decreased the microhardness in relation to the initial value. Among the resins assessed, QC-20 exhibited the lowest initial hardness. © 2014 by the American College of Prosthodontists.

  12. The quality of working impressions for the fabrication of fixed prosthodontics prostheses (crown and bridgework)

    OpenAIRE

    Ahmad Syahir Ahmad Zu Saifudin; Fazlieha Kamaruddin; Siti Mariam Ab Ghani

    2014-01-01

    Objective: The study was carried out to assess the quality of working impressions sent to commercial laboratories for fabrication of fixed prostheses. Materials and Methods: Impressions (n: 200) received by four dental laboratories were evaluated by two calibrated examiners. The type of work, tray designs, impression materials and techniques were recorded for each impression. Quality data on crucial details of the tooth preparations, voids at tooth preparations, tears along the finished margi...

  13. Immunoscintigraphy with antigranulocyte monoclonal antibodies for the diagnosis of septic loosening of hip prostheses

    International Nuclear Information System (INIS)

    Boubaker, A.; Bischof Delaloye, A.; Blanc, C.H.; Dutoit, M.; Leyvraz, P.F.; Delaloye, B.

    1995-01-01

    To determine the value of immunoscintigraphy (IS) with antigranulocyte monoclonal antibodies (Mab) in the diagnosis of subacute or chronic infection of hip prostheses, we prospectively studied 57 patients (23 women and 34 men; age 29-92 years, mean 72.7 years) sent to our institution in the past 6 years for clinical suspicion of septic loosening of a hip prosthesis. Nineteen patients had bilateral prostheses and one of them was studied twice. A total of 78 prostheses were examined. All patients had three-phase bone scans followed by IS with technetium-99m antigranulocyte Mab BW 250/183. Intervals between bone scans and IS varied from 2 days to 4 weeks. Final diagnosis was assessed by culture in 48 cases (articular puncture or intraoperative sampling) and by clinical follow-up of at least 8 months in 30 cases. Twelve prostheses were considered septic and 66 non-septic. The overall sensitivity and specificity were 92% and 64% respectively for bone scans, 67% and 75% for IS and 67% and 84% for both modalities together. In three cases, IS was doubtful and the final clinical diagnosis was negative for infection. False-positive results were observed in the presence of massive loosening of the prosthesis or in association with metaplastic peri-articular bone formation. In three of the four false-negative results, infection was proven only after enrichment of the culture, and the bacterium was Staphylococcus epidermidis. In 12/33 (36%) positive bone scans IS allowed the diagnosis of infection to be excluded. Overall accuracy of both modalities together was 81% and the negative predictive value was 93%, which compares favourably with the results reported for other non-invasive methods. (orig.)

  14. Comparison of polyetheretherketone (PEEK) cage and cervical disc prostheses used in anterior cervical microscopic discectomy operations

    OpenAIRE

    Bahadir Alkan; Murat Cosar; Mustafa Guven; Adem Bozkurt Aras; Tarik Akman

    2017-01-01

    Objective: The aim of this study was to radiologically and clinically compare the polyetheretherketone (PEEK) cage and cervical disc prostheses used in anterior cervical microdiscectomy operations during the postoperative period. Methods: The study evaluated 25 cervical disc hernia patients. The cervical disc prosthesis group (Group A) comprised 10 patients while the PEEK cage group (Group B) comprised 15 patients. Before and after the operation, the cervical graphics from radiological mon...

  15. Clinical outcomes of full arch fixed implant-supported zirconia prostheses: A systematic review.

    Science.gov (United States)

    Bidra, Avinash S; Rungruanganunt, Patchanee; Gauthier, Marissa

    The primary aim of this systematic review was to study the clinical outcomes of one-piece fixed complete dentures (complete arch fixed implant-supported prostheses) made of zirconia for edentulous patients. The secondary aim was to compare the clinical outcomes of monolithic zirconia vs zirconia veneered with porcelain (conventional, minimal or gingival) for fixed complete dentures. Two investigators conducted an independent electronic search of the literature, using PubMed and Scopus search engines from January 1, 2000, to August 31, 2016. After application of pre-determined inclusion and exclusion criteria, the final list of articles was reviewed to meet the aims of this review. A total of 12 observational studies were identified that satisfied the inclusion criteria of this systematic review. Short-term results from a combined 223 patients with 285 one-piece zirconia fixed complete dentures showed a mean failure rate of 1.4% due to the fracture of four prostheses. Prosthetic complications occurred in 46 prostheses (16.1%). Out of these, 42 prostheses (14.7%) had minor complications exclusive to fracture of veneered porcelain. Current evidence indicates that zirconia fixed complete dentures have a very low failure rate in the short term, but have a substantial rate of minor complications related to chipping of veneered porcelain. Use of monolithic zirconia with only gingival stains, or zirconia that is veneered only at the gingiva may offer promising results, but will need to be validated by future long-term studies. Conflict-of-interest statement: All authors report no conflict of interest.

  16. Sensory Feedback for Lower Extremity Prostheses Incorporating Targeted Muscle Reinnervation (TMR)

    Science.gov (United States)

    2016-10-01

    AWARD NUMBER: W81XWH-15-1-0417 TITLE: Sensory Feedback for Lower Extremity Prostheses Incorporating Targeted Muscle Reinnervation (TMR...SUPPLEMENTARY NOTES 14. ABSTRACT The purpose of this research is to improve stair descent for lower limb amputees by providing sensory feedback of foot placement...the site of the surgery can feel like they are originating from the amputated limb . This capability is an unprecedented opportunity to provide

  17. PERSPECTIVE: Is acuity enough? Other considerations in clinical investigations of visual prostheses

    Science.gov (United States)

    Lepri, Bernard P.

    2009-06-01

    Visual impairing eye diseases are the major frontier facing ophthalmic research today in light of our rapidly aging population. The visual skills necessary for improving the quality of daily function and life are inextricably linked to these impairing diseases. Both research and reimbursement programs are emphasizing outcome-based results. Is improvement in visual acuity alone enough to improve the function and quality of life of visually impaired persons? This perspective summarizes the types of effectiveness endpoints for clinical investigations of visual prostheses that go beyond visual acuity. The clinical investigation of visual prostheses should include visual function, functional vision and quality of life measures. Specifically, they encompass contrast sensitivity, orientation and mobility, activities of daily living and quality of life assessments. The perspective focuses on the design of clinical trials for visual prostheses and the methods of determining effectiveness above and beyond visual acuity that will yield outcomes that are measured by improved function in the visual world and quality of life. The visually impaired population is the primary consideration in this presentation with particular emphases on retinitis pigmentosa and age-related macular degeneration. Clinical trials for visual prostheses cannot be isolated from the need for medical rehabilitation in order to obtain measurements of effectiveness that produce outcomes/evidence-based success. This approach will facilitate improvement in daily function and quality of life of patients with diseases that cause chronic vision impairment. The views and opinions are those of the author and do not necessarily reflect those of the US Food and Drug Administration, the US Department of Health and Human Services or the Public Health Service.

  18. Comparison of fixed implant-supported prostheses, removable implant-supported prostheses, and complete dentures: patient satisfaction and oral health-related quality of life.

    Science.gov (United States)

    Oh, Sung-Hee; Kim, Younhee; Park, Joo-Yeon; Jung, Yea Ji; Kim, Seong-Kyun; Park, Sun-Young

    2016-02-01

    The purpose of this study was to compare patient satisfaction and oral health-related quality of life (OHRQoL) among fully edentulous patients treated with either fixed implant-supported prostheses (FP), removable implant-supported prostheses (RP), or complete dentures (CD). Eighty-six patients - 29 FP, 27 RP, and 30 CD patients - participated in this study. The survey was conducted using face-to-face interviews with a questionnaire that included a patient satisfaction scale and Oral Health Impact Profile (OHIP-14). We measured patient satisfaction after prosthetic treatments and OHRQoL before and after the treatments. After prosthetic treatments, OHRQoL increased in all three groups (P patient satisfaction and OHRQoL, and both groups showed greater improvement compared with the CD group. Specifically, the OHRQoL dimensions of functional limitation, physical pain, psychological discomfort, and psychological disability in the FP group, and functional limitation in the RP group, improved greatly in comparison with the CD group (P patient satisfaction than the CD treatment. Reliable information of OHRQoL and patient satisfaction helps experts and patients choose the best prosthetic treatment option. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Thumb-size ultrasonic-assisted spectroscopic imager for in-situ glucose monitoring as optional sensor of conventional dialyzers

    Science.gov (United States)

    Nogo, Kosuke; Mori, Keita; Qi, Wei; Hosono, Satsuki; Kawashima, Natsumi; Nishiyama, Akira; Wada, Kenji; Ishimaru, Ichiro

    2016-03-01

    We proposed the ultrasonic-assisted spectroscopic imaging for the realization of blood-glucose-level monitoring during dialytic therapy. Optical scattering and absorption caused by blood cells deteriorate the detection accuracy of glucose dissolved in plasma. Ultrasonic standing waves can agglomerate blood cells at nodes. In contrast, around anti-node regions, the amount of transmitted light increases because relatively clear plasma appears due to decline the number of blood cells. Proposed method can disperse the transmitted light of plasma without time-consuming pretreatment such as centrifugation. To realize the thumb-size glucose sensor which can be easily attached to dialysis tubes, an ultrasonic standing wave generator and a spectroscopic imager are required to be small. Ultrasonic oscillators are ∅30[mm]. A drive circuit of oscillators, which now size is 41×55×45[mm], is expected to become small. The trial apparatus of proposed one-shot Fourier spectroscopic imager, whose size is 30×30×48[mm], also can be little-finger size in principal. In the experiment, we separated the suspension mixed water and micro spheres (Θ10[mm) into particles and liquid regions with the ultrasonic standing wave (frequency: 2[MHz]). Furthermore, the spectrum of transmitted light through the suspension could be obtained in visible light regions with a white LED.

  20. Biomechanic analysis of trapeziectomy, ligament reconstruction with tendon interposition, and tie-in trapezium implant arthroplasty for thumb carpometacarpal arthritis: a cadaver study.

    Science.gov (United States)

    Luria, Shai; Waitayawinyu, Thanapong; Nemechek, Nicholas; Huber, Philippe; Tencer, Allan F; Trumble, Thomas E

    2007-01-01

    Thumb carpometacarpal joint arthritis has been commonly treated with some combination of resection of the trapezium and interposition of a spacer using either a biologic or artificial material plus tenodesis to reconstruct the volar oblique ligament. The purpose of this study was to evaluate the biomechanic stability of the classic ligament reconstruction with tendon interposition (LRTI) or without tendon interposition compared with a newly developed 1-piece silicone trapezium implant. Twelve cadaver arm specimens had the following procedures: resection of the trapezium, tendon interposition, ligament reconstruction, LRTI, and the silicone implant. Biomechanic testing of joint stability was performed with a physiologic loading protocol before and after each procedure. The implant significantly corrected the axial displacement after trapeziectomy and resulted in less radial displacement than LRTI. It significantly reduced angulation of the thumb metacarpal base but resulted in more rotation of the thumb during simulated pinch. There was no significant difference in stability measures between trapeziectomy and LRTI or ligament reconstruction without tendon interposition. We found several biomechanic advantages to the implant compared with LRTI. Advantages include reduction in axial and radial displacement and maintenance of the trapezial space. We attribute these advantages to the effect of the implant as a spacer. The significant rotation with the implant, however, raises questions concerning implant design and fixation. We found no biomechanic advantage to LRTI or ligament reconstruction without tendon interposition over trapeziectomy alone.

  1. A rule-of-thumb approach to estimate annual deep percolation and runoff in irrigated landscapes at field to farm scales

    Science.gov (United States)

    Selle, B.; Githui, F.; Thayalakumaran, T.

    2009-04-01

    The rootzone of a field or farm in irrigated landscapes is the logical unit that can be managed or influenced by farmers, catchment managers and water authorities. Increasing scarcity, variability and expensive nature of water supplies necessitates better understanding of the rootzone water balance in irrigated landscapes. The major terms of the annual water balance in the rootzone include rainfall, irrigation, evapotranspiration, deep percolation below the rootzone and runoff. While information on annual rainfall, irrigation and evapotranspiration can often be readily obtained at field to farm scales, deep percolation and runoff are typically unavailable as their continuous measurement is difficult and/or uneconomical. Consequently, these terms are often calculated using models that are able to simulate the rootzone water balance. In this case study, we developed a rule-of-thumb approach to estimate annual deep percolation and runoff for the Barr Creek catchment in northern Victoria, Australia. Firstly, annual deep percolation and runoff were calculated at field to farm scales using an integrated SWAT-MODFLOW model calibrated against a comprehensive data set including drain flows and salinity, remotely sensed evapotranspiration and watertable levels. Secondly, a rule-of-thumb approach was developed to approximate annual deep percolation and runoff from readily available information on annual irrigation, rainfall, evapotranspiration, soils, watertable levels and landuse. This rule-of-thumb approach can be applied to continuously estimate deep percolation and runoff.

  2. EFFICIENCY OF PROSTHETIC TREATMENT WITH POST RESECTION PROSTHESES WITH SOLID SUBSTITUTE PART

    Directory of Open Access Journals (Sweden)

    Ivan Gerdzhikov

    2016-08-01

    Full Text Available Aim: The aim of this study is to track the effectiveness of prosthetic treatment with post resection dentures with solid substitute part and their role in the restoration of damaged functions. Materials and methods: The study included 14 patients (9 men and 5 women with different size and location of defects in the upper jaw treated in the period 2010-2016 with post resection prostheses with a solid substitute part. The impressions were taken with irreversible hydrocolloid impression material. The prostheses were completed by heat-curing acrylic with low quantity residual monomer. The effectiveness of prosthetics was evaluated by the method of Mihaylov for both oral-nasal examination of the pressure with the device "Oronasopneumotest." For objectifying and assess the occlusal-articulation ratios was held computerized occlusal analysis with the system T-SCAN 8. Results: The results showed successful obturation and sealing of defects in all patients. It was found satisfactory recovery of the speaking function and normalization of occlusal-articulation ratios. Conclusion: The prosthetic treatment with post resection prostheses with a solid substitute part allows successful recovery of the lost speech and chewing functions, helping to restore self esteem and social rehabilitation of patients.

  3. Dental prostheses mimic the natural enamel behavior under functional loading: A review article

    Directory of Open Access Journals (Sweden)

    Ahmed A. Madfa

    2016-02-01

    Full Text Available Alumina- and zirconia-based ceramic dental restorations are designed to repair functionality as well as esthetics of the failed teeth. However, these materials exhibited several performance deficiencies such as fracture, poor esthetic properties of ceramic cores (particularly zirconia cores, and difficulty in accomplishing a strong ceramic–resin-based cement bond. Therefore, improving the mechanical properties of these ceramic materials is of great interest in a wide range of disciplines. Consequently, spatial gradients in surface composition and structure can improve the mechanical integrity of ceramic dental restorations. Thus, this article reviews the current status of the functionally graded dental prostheses inspired by the dentino-enamel junction (DEJ structures and the linear gradation in Young's modulus of the DEJ, as a new material design approach, to improve the performance compared to traditional dental prostheses. This is a remarkable example of nature's ability to engineer functionally graded dental prostheses. The current article opens a new avenue for recent researches aimed at the further development of new ceramic dental restorations for improving their clinical durability.

  4. Control Capabilities of Myoelectric Robotic Prostheses by Hand Amputees: A Scientific Research and Market Overview.

    Science.gov (United States)

    Atzori, Manfredo; Müller, Henning

    2015-01-01

    Hand amputation can dramatically affect the capabilities of a person. Cortical reorganization occurs in the brain, but the motor and somatosensorial cortex can interact with the remnant muscles of the missing hand even many years after the amputation, leading to the possibility to restore the capabilities of hand amputees through myoelectric prostheses. Myoelectric hand prostheses with many degrees of freedom are commercially available and recent advances in rehabilitation robotics suggest that their natural control can be performed in real life. The first commercial products exploiting pattern recognition to recognize the movements have recently been released, however the most common control systems are still usually unnatural and must be learned through long training. Dexterous and naturally controlled robotic prostheses can become reality in the everyday life of amputees but the path still requires many steps. This mini-review aims to improve the situation by giving an overview of the advancements in the commercial and scientific domains in order to outline the current and future chances in this field and to foster the integration between market and scientific research.

  5. Control Capabilities of Myoelectric Robotic Prostheses by Hand Amputees: A Scientific Research and Market Overview

    Directory of Open Access Journals (Sweden)

    Manfredo eAtzori

    2015-11-01

    Full Text Available Hand amputation can dramatically affect the capabilities of a person. Cortical reorganization occurs in the brain, but the motor and somatosensorial cortex can interact with the remnant muscles of the missing hand even many years after the amputation, leading to the possibility to restore the capabilities of hand amputees through myoelectric prostheses. Myoelectric hand prostheses with many degrees of freedom are commercially available and recent advances in rehabilitation robotics suggest that their natural control can be performed in real life. The first commercial products exploiting pattern recognition to recognize the movements have recently been released, however the most common control systems are still usually unnatural and must be learned through long training. Dexterous and naturally controlled robotic prostheses can become reality in the everyday life of amputees but the path still requires many steps. This mini-review aims to improve the situation by giving an overview of the advancements in the commercial and scientific domains in order to outline the current and future chances in this field and to foster the integration between market and scientific research.

  6. PARTICIPATORY DESIGN OF PEDIATRIC UPPER LIMB PROSTHESES: QUALITATIVE METHODS AND PROTOTYPING.

    Science.gov (United States)

    Sims, Tara; Cranny, Andy; Metcalf, Cheryl; Chappell, Paul; Donovan-Hall, Maggie

    2017-01-01

    The study aims to develop an understanding of the views of children and adolescents, parents, and professionals on upper limb prosthetic devices to develop and improve device design. Previous research has found that children are dissatisfied with prostheses but has relied heavily on parent proxy reports and quantitative measures (such as questionnaires) to explore their views. Thirty-four participants (eight children aged 8-15 years with upper limb difference, nine parents, eight prosthetists, and nine occupational therapists) contributed to the development of new devices through the BRIDGE methodology of participatory design, using focus groups and interviews. The study identified areas for improving prostheses from the perspective of children and adolescents, developed prototypes based on these and gained feedback on the prototypes from the children and other stakeholders (parents and professionals) of paediatric upper limb prostheses. Future device development needs to focus on ease of use, versatility, appearance, and safety. This study has demonstrated that children and adolescents can and should be involved as equal partners in the development of daily living equipment and that rapid prototyping (three-dimensional printing or additive manufacturing), used within a participatory design framework, can be a useful tool for facilitating this.

  7. Towards high-resolution retinal prostheses with direct optical addressing and inductive telemetry

    Science.gov (United States)

    Ha, Sohmyung; Khraiche, Massoud L.; Akinin, Abraham; Jing, Yi; Damle, Samir; Kuang, Yanjin; Bauchner, Sue; Lo, Yu-Hwa; Freeman, William R.; Silva, Gabriel A.; Cauwenberghs, Gert

    2016-10-01

    Objective. Despite considerable advances in retinal prostheses over the last two decades, the resolution of restored vision has remained severely limited, well below the 20/200 acuity threshold of blindness. Towards drastic improvements in spatial resolution, we present a scalable architecture for retinal prostheses in which each stimulation electrode is directly activated by incident light and powered by a common voltage pulse transferred over a single wireless inductive link. Approach. The hybrid optical addressability and electronic powering scheme provides separate spatial and temporal control over stimulation, and further provides optoelectronic gain for substantially lower light intensity thresholds than other optically addressed retinal prostheses using passive microphotodiode arrays. The architecture permits the use of high-density electrode arrays with ultra-high photosensitive silicon nanowires, obviating the need for excessive wiring and high-throughput data telemetry. Instead, the single inductive link drives the entire array of electrodes through two wires and provides external control over waveform parameters for common voltage stimulation. Main results. A complete system comprising inductive telemetry link, stimulation pulse demodulator, charge-balancing series capacitor, and nanowire-based electrode device is integrated and validated ex vivo on rat retina tissue. Significance. Measurements demonstrate control over retinal neural activity both by light and electrical bias, validating the feasibility of the proposed architecture and its system components as an important first step towards a high-resolution optically addressed retinal prosthesis.

  8. High Cable Forces Deteriorate Pinch Force Control in Voluntary-Closing Body-Powered Prostheses.

    Directory of Open Access Journals (Sweden)

    Mona Hichert

    Full Text Available It is generally asserted that reliable and intuitive control of upper-limb prostheses requires adequate feedback of prosthetic finger positions and pinch forces applied to objects. Body-powered prostheses (BPPs provide the user with direct proprioceptive feedback. Currently available BPPs often require high cable operation forces, which complicates control of the forces at the terminal device. The aim of this study is to quantify the influence of high cable forces on object manipulation with voluntary-closing prostheses.Able-bodied male subjects were fitted with a bypass-prosthesis with low and high cable force settings for the prehensor. Subjects were requested to grasp and transfer a collapsible object as fast as they could without dropping or breaking it. The object had a low and a high breaking force setting.Subjects conducted significantly more successful manipulations with the low cable force setting, both for the low (33% more and high (50% object's breaking force. The time to complete the task was not different between settings during successful manipulation trials.High cable forces lead to reduced pinch force control during object manipulation. This implies that low cable operation forces should be a key design requirement for voluntary-closing BPPs.

  9. APPLICATION OF SELECTIVE LASER MELTING IN MANUFACTURING OF FIXED DENTAL PROSTHESES

    Directory of Open Access Journals (Sweden)

    Dzhendo Dzhendov

    2016-12-01

    Full Text Available The additive technologies characterize with the building of one layer at a time from a powder or liquid that is bonded by means of melting, fusing or polymerization. They offer a number of advantages over traditional methods: production of complex personalized objects without the need of complex machinery; manufacturing of parts with dense as well as the porous structure and predetermined surface roughness; controllable, easy and relatively quick process. The methods, mostly used in prosthetic dentistry, include stereolithography, selective laser sintering, and selective laser melting. The aim of the present paper is to review the features of the Selective Laser Melting (SLM process and the possibilities of its application for production of fixed dental prostheses. The features of the SLM process, the microstructure and mechanical characteristics of dental alloys as well as the properties of fixed dental prostheses, fabricated via SLM, were discussed. It was revealed that the SLM Co-Cr dental alloys possess higher mechanical and tribo-corrosion properties, comparatively good fitting ability and higher adhesion strength of the porcelain comparing to the cast alloys. All this is a good precondition for successful application of the SLM process in the production of fixed dental prostheses, mainly of frameworks for metal-ceramic and constructions covered with polymer/composite, intended for areas with high loading.

  10. Mid-term results after implantation of rotating-hinge knee prostheses: primary versus revision

    Directory of Open Access Journals (Sweden)

    Turgay Efe

    2012-12-01

    Full Text Available The aim of the study was to evaluate the mid-term clinical results and survivorship of a rotating-hinge knee prosthesis (LINK® Endo-Model in difficult primary and complex revision situations. Results after primary implantation were compared with those of revision procedures. Forty-nine prostheses in 45 patients were reviewed clinically during follow up. Twenty-one of these were implanted in primary and 28 in revision situations. Outcome was evaluated using commonly used scores (Knee Society, UCLA Activity, Lequesne and a visual analog scale after a mean follow up of 56±37 months for 49 prostheses. Implant survival was analyzed using the Kaplan-Meier method. There were no significant differences in clinical examination and evaluation scores between the two groups (P>0.05. Survival rates at final follow up were 95% after primary implantation and 76% in revision procedures. The risk of prosthesis loss (odds ratio 5.7 was significantly higher after revision procedures (P=0.004. These data suggest that rotating-hinge knee prostheses provided good clinical and functional results in selected cases of advanced primary gonarthrosis associated with severe bone loss, ligamentous instability or comminuted fractures. They also provide good results in revision situations. However, the failure rate was significantly higher in cases of revision surgery.

  11. Comparison of Various Functionally Graded Femoral Prostheses by Finite Element Analysis

    Science.gov (United States)

    Seyed Shirazi, Seyed Farid; Bayat, Mehdi; Yau, Yat Huang; Tarlochan, Faris; Abu Osman, Noor Azuan

    2014-01-01

    This study is focused on finite element analysis of a model comprising femur into which a femoral component of a total hip replacement was implanted. The considered prosthesis is fabricated from a functionally graded material (FGM) comprising a layer of a titanium alloy bonded to a layer of hydroxyapatite. The elastic modulus of the FGM was adjusted in the radial, longitudinal, and longitudinal-radial directions by altering the volume fraction gradient exponent. Four cases were studied, involving two different methods of anchoring the prosthesis to the spongy bone and two cases of applied loading. The results revealed that the FG prostheses provoked more SED to the bone. The FG prostheses carried less stress, while more stress was induced to the bone and cement. Meanwhile, less shear interface stress was stimulated to the prosthesis-bone interface in the noncemented FG prostheses. The cement-bone interface carried more stress compared to the prosthesis-cement interface. Stair climbing induced more harmful effects to the implanted femur components compared to the normal walking by causing more stress. Therefore, stress shielding, developed stresses, and interface stresses in the THR components could be adjusted through the controlling stiffness of the FG prosthesis by managing volume fraction gradient exponent. PMID:25302331

  12. Comparison of Various Functionally Graded Femoral Prostheses by Finite Element Analysis

    Directory of Open Access Journals (Sweden)

    Azim Ataollahi Oshkour

    2014-01-01

    Full Text Available This study is focused on finite element analysis of a model comprising femur into which a femoral component of a total hip replacement was implanted. The considered prosthesis is fabricated from a functionally graded material (FGM comprising a layer of a titanium alloy bonded to a layer of hydroxyapatite. The elastic modulus of the FGM was adjusted in the radial, longitudinal, and longitudinal-radial directions by altering the volume fraction gradient exponent. Four cases were studied, involving two different methods of anchoring the prosthesis to the spongy bone and two cases of applied loading. The results revealed that the FG prostheses provoked more SED to the bone. The FG prostheses carried less stress, while more stress was induced to the bone and cement. Meanwhile, less shear interface stress was stimulated to the prosthesis-bone interface in the noncemented FG prostheses. The cement-bone interface carried more stress compared to the prosthesis-cement interface. Stair climbing induced more harmful effects to the implanted femur components compared to the normal walking by causing more stress. Therefore, stress shielding, developed stresses, and interface stresses in the THR components could be adjusted through the controlling stiffness of the FG prosthesis by managing volume fraction gradient exponent.

  13. Biomedical Titanium alloy prostheses manufacturing by means of Superplastic and Incremental Forming processes

    Directory of Open Access Journals (Sweden)

    Piccininni Antonio

    2016-01-01

    Full Text Available The present work collects some results of the three-years Research Program “BioForming“, funded by the Italian Ministry of Education (MIUR and aimed to investigate the possibility of using flexible sheet forming processes, i.e. Super Plastic Forming (SPF and Single Point Incremental Forming (SPIF, for the manufacturing of patient-oriented titanium prostheses. The prosthetic implants used as case studies were from the skull; in particular, two different Ti alloys and geometries were considered: one to be produced in Ti-Gr23 by SPF and one to be produced in Ti-Gr2 by SPIF. Numerical simulations implementing material behaviours evaluated by characterization tests were conducted in order to design both the manufacturing processes. Subsequently, experimental tests were carried out implementing numerical results in terms of: (i gas pressure profile able to determine a constant (and optimal strain rate during the SPF process; (ii tool path able to avoid rupture during the SPIF process. Post forming characteristics of the prostheses in terms of thickness distributions were measured and compared to data from simulations for validation purposes. A good correlation between numerical and experimental thickness distributions has been obtained; in addition, the possibility of successfully adopting both the SPF and the SPIF processes for the manufacturing of prostheses has been demonstrated.

  14. Interest of Flow Diversion Prostheses in the Management of Unruptured Intracranial Aneurysms

    Directory of Open Access Journals (Sweden)

    Xavier Armoiry

    2012-01-01

    Full Text Available Flow diversion prostheses represent a new endovascular approach aimed at treating patients with large wide-neck aneurysms. Our objective is to present this new technology, to review the clinical studies on efficacy, and to emphasize its current limits. Flow diversion prostheses consist of a cylinder made of a large number of braided microfilaments providing a large metallic surface when deployed and inducing a blood flow diversion outside the aneurysm. Two different brands are currently available. Clinical data supporting their efficacy are currently limited to six non comparative cohort studies that included between 18 and 107 patients. Procedural implantation was shown to be feasible in more than 90% and safe with a thirty-day mortality between 2.8 and 5.5%. Complete occlusion rates at twelve months varied between 85.7 and 100%. Even though promising, the current status of flow diversion prostheses needs further evaluation with randomized, prospective, clinical trials with comparison to conventional strategies including endovascular coiling or surgical clipping.

  15. Visual prostheses: The enabling technology to give sight to the blind

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Maghami

    2014-01-01

    Full Text Available Millions of patients are either slowly losing their vision or are already blind due to retinal degenerative diseases such as retinitis pigmentosa (RP and age-related macular degeneration (AMD or because of accidents or injuries. Employment of artificial means to treat extreme vision impairment has come closer to reality during the past few decades. Currently, many research groups work towards effective solutions to restore a rudimentary sense of vision to the blind. Aside from the efforts being put on replacing damaged parts of the retina by engineered living tissues or microfabricated photoreceptor arrays, implantable electronic microsystems, referred to as visual prostheses, are also sought as promising solutions to restore vision. From a functional point of view, visual prostheses receive image information from the outside world and deliver them to the natural visual system, enabling the subject to receive a meaningful perception of the image. This paper provides an overview of technical design aspects and clinical test results of visual prostheses, highlights past and recent progress in realizing chronic high-resolution visual implants as well as some technical challenges confronted when trying to enhance the functional quality of such devices.

  16. Interest of Flow Diversion Prostheses in the Management of Unruptured Intracranial Aneurysms

    Science.gov (United States)

    Armoiry, Xavier; Paysant, Mélanie; Hartmann, Daniel; Aulagner, Gilles; Turjman, Francis

    2012-01-01

    Flow diversion prostheses represent a new endovascular approach aimed at treating patients with large wide-neck aneurysms. Our objective is to present this new technology, to review the clinical studies on efficacy, and to emphasize its current limits. Flow diversion prostheses consist of a cylinder made of a large number of braided microfilaments providing a large metallic surface when deployed and inducing a blood flow diversion outside the aneurysm. Two different brands are currently available. Clinical data supporting their efficacy are currently limited to six non comparative cohort studies that included between 18 and 107 patients. Procedural implantation was shown to be feasible in more than 90% and safe with a thirty-day mortality between 2.8 and 5.5%. Complete occlusion rates at twelve months varied between 85.7 and 100%. Even though promising, the current status of flow diversion prostheses needs further evaluation with randomized, prospective, clinical trials with comparison to conventional strategies including endovascular coiling or surgical clipping. PMID:22121490

  17. Laser-assisted removal of all ceramic fixed dental prostheses: A comprehensive review.

    Science.gov (United States)

    Kellesarian, Sergio Varela; Ros Malignaggi, Vanessa; Aldosary, Khaled M; Javed, Fawad

    2017-12-28

    The aim of this comprehensive review was to assess the effectiveness of erbium lasers in the removal of all ceramic fixed dental prostheses (FDPs). Indexed databases were searched without language or time restriction up to and including December 2017 using different combinations of the following keywords: "lasers"; "phototherapy"; "crowns"; "prostheses and implants"; "inlays"; "ceramics"; "dental porcelain"; "zirconium"; "removal"; "debonding"; "fixed dental prostheses"; "veneers"; "laminates"; and "fixed bridge." All levels of available evidence including experimental studies, case reports and case series were included. Six clinical studies reporting a total of 13 cases and 6 experimental studies were included. Results from all studies showed that erbium lasers are effective reducing the shear bond strengths of all ceramic FDPs, in terms of easy removal of the restorations with none or minimal damage to teeth or ceramic surfaces. Laser-assisted removal of all ceramic FDPs is a promising treatment protocol. Further well-designed controlled clinical trials and longitudinal prospective studies are needed to determine the precise laser parameters and duration of irradiation that could be used for removal of ceramic restorations with varying thicknesses. Benefits of lasers over mechanical instrumentation for crown removal encompass efficient restoration retrievability without restoration or teeth surfaces damages; and relatively easier and time effective procedure with no prerequisite for anesthetic agents. It is however imperative for clinicians to be well-trained and exhibit adequate knowledge regarding recommended power settings and laser-safety parameters with reference to interactions between light and different tissues and ceramics. © 2017 Wiley Periodicals, Inc.

  18. The dermatoscopic universe of basal cell carcinoma

    Science.gov (United States)

    Lallas, Aimilios; Apalla, Zoe; Argenziano, Giuseppe; Longo, Caterina; Moscarella, Elvira; Specchio, Francesca; Raucci, Margaritha; Zalaudek, Iris

    2014-01-01

    Following the first descriptions of the dermatoscopic pattern of basal cell carcinoma (BCC) that go back to the very early years of dermatoscopy, the list of dermatoscopic criteria associated with BCC has been several times updated and renewed. Up to date, dermatoscopy has been shown to enhance BCC detection, by facilitating its discrimination from other skin tumors and inflammatory skin diseases. Furthermore, upcoming evidence suggests that the method is also useful for the management of the tumor, since it provides valuable information about the histopathologic subtype, the presence of clinically undetectable pigmentation, the expansion of the tumor beyond clinically visible margins and the response to non-ablative treatments. In the current article, we provide a summary of the traditional and latest knowledge on the value of dermatoscopy for the diagnosis and management of BCC. PMID:25126452

  19. Histologic Mimics of Basal Cell Carcinoma.

    Science.gov (United States)

    Stanoszek, Lauren M; Wang, Grace Y; Harms, Paul W

    2017-11-01

    - Basal cell carcinoma (BCC) is the most common human malignant neoplasm and is a frequently encountered diagnosis in dermatopathology. Although BCC may be locally destructive, it rarely metastasizes. Many diagnostic entities display morphologic and immunophenotypic overlap with BCC, including nonneoplastic processes, such as follicular induction over dermatofibroma; benign follicular tumors, such as trichoblastoma, trichoepithelioma, or basaloid follicular hamartoma; and malignant tumors, such as sebaceous carcinoma or Merkel cell carcinoma. Thus, misdiagnosis has significant potential to result in overtreatment or undertreatment. - To review key features distinguishing BCC from histologic mimics, including current evidence regarding immunohistochemical markers useful for that distinction. - Review of pertinent literature on BCC immunohistochemistry and differential diagnosis. - In most cases, BCC can be reliably diagnosed by histopathologic features. Immunohistochemistry may provide useful ancillary data in certain cases. Awareness of potential mimics is critical to avoid misdiagnosis and resulting inappropriate management.

  20. Concentrated insulins: the new basal insulins

    Directory of Open Access Journals (Sweden)

    Lamos EM

    2016-03-01

    Full Text Available Elizabeth M Lamos,1 Lisa M Younk,2 Stephen N Davis3 1Division of Endocrinology, Diabetes and Nutrition, 2Department of Medicine, University of Maryland School of Medicine, 3Department of Medicine, University of Maryland Medical Center, Baltimore, MD, USA Introduction: Insulin therapy plays a critical role in the treatment of type 1 and type 2 diabetes mellitus. However, there is still a need to find basal insulins with 24-hour coverage and reduced risk of hypoglycemia. Additionally, with increasing obesity and insulin resistance, the ability to provide clinically necessary high doses of insulin at low volume is also needed. Areas covered: This review highlights the published reports of the pharmacokinetic (PK and glucodynamic properties of concentrated insulins: Humulin-R U500, insulin degludec U200, and insulin glargine U300, describes the clinical efficacy, risk of hypoglycemic, and metabolic changes observed, and finally, discusses observations about the complexity of introducing a new generation of concentrated insulins to the therapeutic market. Conclusion: Humulin-R U500 has a similar onset but longer duration of action compared with U100 regular insulin. Insulin glargine U300 has differential PK/pharmacodynamic effects when compared with insulin glargine U100. In noninferiority studies, glycemic control with degludec U200 and glargine U300 is similar to insulin glargine U100 and nocturnal hypoglycemia is reduced. Concentrated formulations appear to behave as separate molecular entities when compared with earlier U100 insulin analog compounds. In the review of available published data, newer concentrated basal insulins may offer an advantage in terms of reduced intraindividual variability as well as reducing the injection burden in individuals requiring high-dose and large volume insulin therapy. Understanding the PK and pharmacodynamic properties of this new generation of insulins is critical to safe dosing, dispensing, and administration

  1. Immunohistochemical Characteristics of Triple Negative/Basal-like Breast Cancer

    OpenAIRE

    Emel Ebru PALA; Ümit BAYOL; Süheyla CUMURCU; Elif KESKİN

    2012-01-01

    Objective: Triple-negative-breast-cancer that accounts for 10-20% of all breast carcinomas is defined by the lack of estrogen receptor, progesterone receptor, HER2 expression, and agressive clinical behavior. Triple-negative-breast-cancer is categorized into basal like and other types. The basal-like subtype is characterized by the expression of myoepithelial/basal markers.Material and Method: We studied 41 immunohistochemically triplenegative- breast-cancer patients to determine EGFR, Cytoke...

  2. Basal Cell Carcinoma Arising in a Tattooed Eyebrow

    Science.gov (United States)

    Lee, Jong-Sun; Park, Jin; Kim, Seong-Min; Kim, Han-Uk

    2009-01-01

    Malignant skin tumors, including squamous cell carcinoma and malignant melanoma, have occurred in tattoos. Seven documented cases of basal cell carcinoma associated with tattoos have also been reported in the medical literature. We encountered a patient with basal cell carcinoma in a tattooed eyebrow. We report on this case as the eighth reported case of a patient with basal cell carcinoma arising in a tattooed area. PMID:20523804

  3. Body composition and basal metabolic rate in Hidradenitis Suppurativa

    DEFF Research Database (Denmark)

    Miller, I M; Rytgaard, Helene Charlotte; Mogensen, U B

    2016-01-01

    composition (e.g. abdominal fat) may be more so. Basal metabolic rate (BMR) is an expression of resting metabolism and may serve as a complementary tool when assessing the possibly underlying metabolism behind a persons' body composition. OBJECTIVE: To investigate the body composition and basal metabolic rate.......70-105.56) (P basal metabolic rate (BMR) in HS patients may reflect...... a dysfunctional metabolism contributing to the high-fat-body composition....

  4. Pigmented basal cell carcinoma mimicking a superficial spreading melanoma.

    Science.gov (United States)

    Hasbún Acuña, Paula; Cullen Aravena, Roberto; Maturana Donaire, César; Ares Mora, Raúl; Porras Kusmanic, Ninoska

    2016-12-20

    Basal cell carcinoma is the most common form of skin cancer, especially in elderly people. Pigmented basal cell carcinoma is a rare subtype and has been described in the literature as a nodular and hyperpigmented lesion; rarely, it can appear as an extensive pigmented plate, which may be clinically indistinguishable from superficial spreading melanoma and Bowen disease. Dermatoscopy has a high sensitivity in the diagnosis of basal cell carcinoma. When Menzies criteria are used; however, the final diagnosis is made by histopathology. The objective of the present report is to analyze the case of a patient with pigmented basal cell carcinoma simulating a superficial spreading melanoma.

  5. Metastatic Basal cell carcinoma: a biological continuum of Basal cell carcinoma?

    Science.gov (United States)

    Mehta, Karaninder S; Mahajan, Vikram K; Chauhan, Pushpinder S; Sharma, Anju Lath; Sharma, Vikas; Abhinav, C; Khatri, Gayatri; Prabha, Neel; Sharma, Saurabh; Negi, Muninder

    2012-01-01

    Basal cell carcinoma (BCC) accounts for 80% of all nonmelanoma skin cancers. Its metastasis is extremely rare, ranging between 0.0028 and 0.55 of all BCC cases. The usual metastasis to lymph nodes, lungs, bones, or skin is from the primary tumor situated in the head and neck region in nearly 85% cases. A 69-year-old male developed progressively increasing multiple, fleshy, indurated, and at places pigmented noduloulcerative plaques over back, chest, and left axillary area 4 years after wide surgical excision of a pathologically diagnosed basal cell carcinoma. The recurrence was diagnosed as infiltrative BCC and found metastasizing to skin, soft tissue and muscles, and pretracheal and axillary lymph nodes. Three cycles of chemotherapy comprising intravenous cisplatin (50 mg) and 5-florouracil (5-FU, 750 mg) on 2 consecutive days and repeated at every 21 days were effective. As it remains unclear whether metastatic BCC is itself a separate subset of basal cell carcinoma, we feel that early BCC localized at any site perhaps constitutes a biological continuum that may ultimately manifest with metastasis in some individuals and should be evaluated as such. Long-standing BCC is itself potentially at risk of recurrence/dissemination; it is imperative to diagnose and appropriately treat all BCC lesions at the earliest.

  6. Metastatic Basal Cell Carcinoma: A Biological Continuum of Basal Cell Carcinoma?

    Directory of Open Access Journals (Sweden)

    Karaninder S. Mehta

    2012-01-01

    Full Text Available Basal cell carcinoma (BCC accounts for 80% of all nonmelanoma skin cancers. Its metastasis is extremely rare, ranging between 0.0028 and 0.55 of all BCC cases. The usual metastasis to lymph nodes, lungs, bones, or skin is from the primary tumor situated in the head and neck region in nearly 85% cases. A 69-year-old male developed progressively increasing multiple, fleshy, indurated, and at places pigmented noduloulcerative plaques over back, chest, and left axillary area 4 years after wide surgical excision of a pathologically diagnosed basal cell carcinoma. The recurrence was diagnosed as infiltrative BCC and found metastasizing to skin, soft tissue and muscles, and pretracheal and axillary lymph nodes. Three cycles of chemotherapy comprising intravenous cisplatin (50 mg and 5-florouracil (5-FU, 750 mg on 2 consecutive days and repeated at every 21 days were effective. As it remains unclear whether metastatic BCC is itself a separate subset of basal cell carcinoma, we feel that early BCC localized at any site perhaps constitutes a biological continuum that may ultimately manifest with metastasis in some individuals and should be evaluated as such. Long-standing BCC is itself potentially at risk of recurrence/dissemination; it is imperative to diagnose and appropriately treat all BCC lesions at the earliest.

  7. Biomechanical evaluation of two types of short-stemmed hip prostheses compared to the trust plate prosthesis by three-dimensional measurement of micromotions.

    Science.gov (United States)

    Fottner, Andreas; Schmid, Markus; Birkenmaier, Christof; Mazoochian, Farhad; Plitz, Wolfgang; Volkmar, Jansson

    2009-06-01

    Stemless and short-stemmed hip prostheses have been developed to preserve femoral bone stock. While all these prostheses claim a more or less physiological load transfer, clinical long-term results are only available for the stemless thrust plate prosthesis. In this study, the in vitro primary stability of the thrust plate prosthesis was compared to two types of short-stemmed prostheses. In addition to the well-established Mayo prosthesis, the modular Metha prosthesis was tested using cone adapters with 130 degrees and 140 degrees neck-shaft-angles. The prostheses were implanted in composite femurs and loaded dynamically (300-1700 N). Three-dimensional micromotions at the bone-prosthesis interface were measured. In addition, the three-dimensional deformations at the surface of the composite femur were measured to gain data on the strain distribution. For all tested prostheses, the micromotions did not exceed 150 microm, the critical value for osteointegration. The thrust plate prosthesis revealed similar motions as the short-stemmed prostheses. The short-stemmed prosthesis with the 130 degrees cone tended to have the highest micromotions of all tested short-stemmed prostheses. The thrust plate prosthesis revealed the lowest alteration of bone surface deformation after implantation. The comparably low micromotions of the thrust plate prosthesis and the short-stemmed prostheses should be conducive to osseous integration. The higher alteration of load transmission after implantation reveals a higher risk of stress shielding for the short-stemmed prostheses.

  8. In vitro and in vivo microbial adhesion and growth on argon plasma-treated silicone rubber voice prostheses.

    Science.gov (United States)

    Everaert, E P; van de Belt-Gritter, B; van der Mei, H C; Busscher, H J; Verkerke, G J; Dijk, F; Mahieu, H F; Reitsma, A

    1998-03-01

    Patients who undergo a total laryngectomy usually receive a silicone rubber voice prosthesis for voice rehabilitation. Unfortunately, biofilm formation on the esophageal side of voice prostheses limits their lifetime to 3-4 mon on average. The effects of repeated argon plasma treatment of medical grade, hydrophobic silicone rubber on in vitro adhesion and growth of bacteria and yeasts isolated from voice prostheses, as well as in vivo biofilm formation are presented here. In vitro experiments demonstrated that initial microbial adhesion over a 4 h time span to plasma-treated, hydrophilized, silicone rubber was generally less than on original, hydrophobic silicone rubber, both in the absence and presence of a salivary conditioning film on the biomaterial. Growth studies over a time period of 14 d at 37 degrees C in a modified Robbins device, showed that fewer Candida cells adhered on plasma-treated, hydrophilized silicone rubber as compared to on original, hydrophobic silicone rubber. For the in vivo evaluation of biofilm formation on plasma-treated silicone rubber voice prostheses, seven laryngectomized patients received a partly hydrophilized "Groningen Button" voice prosthesis for a planned evaluation period of 4 wk. After removal of the voice prostheses, the border between the hydrophilized and the original, hydrophobic side of the prostheses was clearly visible. However, biofilm formation was, unexpectedly, less on the original, hydrophobic sides, although the microbial compositions of the biofilms on both sides were not significantly different. Summarizing, this study demonstrates that in vitro microbial adhesion and growth on silicone rubber can be reduced by plasma treatment, but in vivo biofilm formation on silicone rubber voice prostheses is oppositely enhanced by hydrophilizing the silicone rubber surface. Nevertheless, from the results of this study the important conclusion can be drawn that in vivo biofilm formation on voice prostheses is controlled by

  9. Nevoid basal cell carcinoma syndrome (Gorlin syndrome

    Directory of Open Access Journals (Sweden)

    Lo Muzio Lorenzo

    2008-11-01

    Full Text Available Abstract Nevoid basal cell carcinoma syndrome (NBCCS, also known as Gorlin syndrome, is a hereditary condition characterized by a wide range of developmental abnormalities and a predisposition to neoplasms. The estimated prevalence varies from 1/57,000 to 1/256,000, with a male-to-female ratio of 1:1. Main clinical manifestations include multiple basal cell carcinomas (BCCs, odontogenic keratocysts of the jaws, hyperkeratosis of palms and soles, skeletal abnormalities, intracranial ectopic calcifications, and facial dysmorphism (macrocephaly, cleft lip/palate and severe eye anomalies. Intellectual deficit is present in up to 5% of cases. BCCs (varying clinically from flesh-colored papules to ulcerating plaques and in diameter from 1 to 10 mm are most commonly located on the face, back and chest. The number of BBCs varies from a few to several thousand. Recurrent jaw cysts occur in 90% of patients. Skeletal abnormalities (affecting the shape of the ribs, vertebral column bones, and the skull are frequent. Ocular, genitourinary and cardiovascular disorders may occur. About 5–10% of NBCCS patients develop the brain malignancy medulloblastoma, which may be a potential cause of early death. NBCCS is caused by mutations in the PTCH1 gene and is transmitted as an autosomal dominant trait with complete penetrance and variable expressivity. Clinical diagnosis relies on specific criteria. Gene mutation analysis confirms the diagnosis. Genetic counseling is mandatory. Antenatal diagnosis is feasible by means of ultrasound scans and analysis of DNA extracted from fetal cells (obtained by amniocentesis or chorionic villus sampling. Main differential diagnoses include Bazex syndrome, trichoepithelioma papulosum multiplex and Torre's syndrome (Muir-Torre's syndrome. Management requires a multidisciplinary approach. Keratocysts are treated by surgical removal. Surgery for BBCs is indicated when the number of lesions is limited; other treatments include laser

  10. Hedgehog Pathway Inhibition for Locally Advanced Periocular Basal Cell Carcinoma and Basal Cell Nevus Syndrome.

    Science.gov (United States)

    Ozgur, Omar K; Yin, Vivian; Chou, Eva; Ball, Sharon; Kies, Merrill; William, William N; Migden, Michael; Thuro, Bradley A; Esmaeli, Bita

    2015-08-01

    To review our experience treating patients with the Hedgehog pathway inhibitor, vismodegib, in patients with orbital or periocular locally advanced or metastatic basal cell carcinoma (BCC) or basal cell nevus syndrome. Retrospective interventional case series. We reviewed all patients with locally advanced or metastatic orbital or periocular BCC or basal cell nevus syndrome treated with the Hedgehog pathway inhibitor, vismodegib, at a comprehensive cancer center from 2009 through 2015. Reviewed data included age; sex; American Joint Commission on Cancer tumor, node, metastasis staging system designation; type and grade of drug-related side effects; response to treatment; duration of follow-up, and status at last follow-up. The study included 10 white men and 2 white women; the median age was 64.5 years. Ten patients had locally advanced BCC; 2 had basal cell nevus syndrome. Among the patients with locally advanced BCC, 5 had T3bN0M0 disease at presentation; 1 each had T3aN0M0, T3bN1M0, T2N1M1, T4N1M1, and T4N2cM1 disease. Overall, 3 patients had a complete response, 6 had a partial response, and 3 had stable disease at last follow-up. Two patients developed progressive disease after a complete response for 38 months and stable disease for 16 months, respectively. All patients developed grade I drug-related adverse effects, most commonly muscle spasms (12 patients), weight loss (10), dysgeusia (9), alopecia (9), decreased appetite (5), and fatigue (4). Five patients developed grade II adverse effects. At last follow-up, none of the 5 patients presenting with T3bN0M0, nor the patient with T3bN1M0 disease, had required orbital exenteration. Hedgehog pathway inhibition produces a significant clinical response in most patients with locally advanced or metastatic orbital or periocular BCC or basal cell nevus syndrome and can obviate orbital exenteration in some patients. Drug-related adverse effects are manageable in most patients. Copyright © 2015 Elsevier Inc. All

  11. Patterned basal seismicity shows sub-ice stream bedforms

    Science.gov (United States)

    Barcheck, C. G.; Tulaczyk, S. M.; Schwartz, S. Y.

    2017-12-01

    Patterns in seismicity emanating from the bottom of fast-moving ice streams and glaciers may indicate localized patches of higher basal resistance— sometimes called 'sticky spots', or otherwise varying basal properties. These seismogenic basal areas resist an unknown portion of the total driving stress of the Whillans Ice Plain (WIP), in West Antarctica, but may play an important role in the WIP stick-slip cycle and ice stream slowdown. To better understand the mechanism and importance of basal seismicity beneath the WIP, we analyze seismic data collected by a small aperture (micro-earthquakes in Dec 2014, and we compare the resulting map of seismicity to ice bottom depth measured by airborne radar. The number of basal earthquakes per area within the network is spatially heterogeneous, but a pattern of two 400m wide streaks of high seismicity rates is evident, with >50-500 earthquakes detected per 50x50m grid cell in 2 weeks. These seismically active streaks are elongated approximately in the ice flow direction with a spacing of 750m. Independent airborne radar measurements of ice bottom depth from Jan 2013 show a low-amplitude ( 5m) undulation in the basal topography superposed on a regional gradient in ice bottom depth. The flow-perpendicular wavelength of these low-amplitude undulations is comparable to the spacing of the high seismicity bands, and the streaks of high seismicity intersect local lows in the undulating basal topography. We interpret these seismic and radar observations as showing seismically active sub-ice stream bedforms that are low amplitude and elongated in the direction of ice flow, comparable to the morphology of mega scale glacial lineations (MSGLs), with high basal seismicity rates observed in the MSGL troughs. These results have implications for understanding the formation mechanism of MSGLS and well as understanding the interplay between basal topographic roughness, spatially varying basal till and hydrologic properties, basal

  12. Design of mixed-mode natural convection solar crop dryers: Application of principles and rules of thumb

    Energy Technology Data Exchange (ETDEWEB)

    Forson, F.K.; Akuffo, F.O. [Department of Mechanical Engineering, Kwame Nkrumah University of Science and Technology, Kumasi (Ghana); Nazha, M.A.A.; Rajakaruna, H. [Department of Mechanical Engineering, De Montfort University, Queens Building, Leicester LE1 9BH (United Kingdom)

    2007-11-15

    A mixed-mode natural convection solar crop dryer (MNCSCD) designed and used for drying cassava and other crops in an enclosed structure is presented. A prototype of the dryer was constructed to specification and used in experimental drying tests. This paper outlines the systematic combination of the application of basic design concepts, and rules of thumb resulting from numerous and several years of experimental studies used and presents the results of calculations of the design parameters. A batch of cassava 160 kg by mass, having an initial moisture content of 67% wet basis from which 100 kg of water is required to be removed to have it dried to a desired moisture content of 17% wet basis, is used as the drying load in designing the dryer. A drying time of 30-36 h is assumed for the anticipated test location (Kumasi; 6.7 N,1.6 W) with an expected average solar irradiance of 400 W/m{sup 2} and ambient conditions of 25 C and 77.8% relative humidity. A minimum of 42.4 m{sup 2} of solar collection area, according to the design, is required for an expected drying efficiency of 12.5%. Under average ambient conditions of 28.2 C and 72.1% relative humidity with solar irradiance of 340.4 W/m{sup 2}, a drying time of 35.5 h was realised and the drying efficiency was evaluated as 12.3% when tested under full designed load signifying that the design procedure proposed is sufficiently reliable. (author)

  13. Does basal metabolic rate drive eating rate?

    Science.gov (United States)

    Henry, Christiani Jeyakumar; Ponnalagu, Shalini; Bi, Xinyan; Forde, Ciaran

    2018-05-15

    There have been recent advances in our understanding of the drivers of energy intake (EI). However, the biological drivers of differences in eating rate (ER) remain less clear. Studies have reported that the fat-free mass (FFM) and basal metabolic rate (BMR) are both major components that contribute to daily energy expenditure (EE) and drive EI. More recently, a number of observations report that higher ER can lead to greater EI. The current study proposed that adults with a higher BMR and higher energy requirements would also exhibit higher ERs. Data on BMR, FFM, and ER were collected from 272 Chinese adults (91 males and 181 females) in a cross-sectional study. Analysis showed significant positive associations between BMR and ER (r s  = 0.405, p BMR explained about 15% of the variation in ER which was taken to be metabolically significant. This association provides metabolic explanation that the differences in an individual's BMR (hence energy requirements) may be correlated with ERs. This merits further research. Copyright © 2018 Elsevier Inc. All rights reserved.

  14. Fluctuating selection on basal metabolic rate.

    Science.gov (United States)

    Nilsson, Johan F; Nilsson, Jan-Åke

    2016-02-01

    BMR (Basal metabolic rate) is an important trait in animal life history as it represents a significant part of animal energy budgets. BMR has also been shown to be positively related to sustainable work rate and maximal thermoregulatory capacity. To this date, most of the studies have focused on the causes of interspecific and intraspecific variation in BMR, and fairly little is known about the fitness consequences of different metabolic strategies. In this study, we show that winter BMR affects local survival in a population of wild blue tits (Cyanistes caeruleus), but that the selection direction differs between years. We argue that this fluctuating selection is probably a consequence of varying winter climate with a positive relation between survival and BMR during cold and harsh conditions, but a negative relation during mild winters. This fluctuating selection can not only explain the pronounced variation in BMR in wild populations, but will also give us new insights into how energy turnover rates can shape the life-history strategies of animals. Furthermore, the study shows that the process of global warming may cause directional selection for a general reduction in BMR, affecting the general life-history strategy on the population level.

  15. Distrofia de la membrana basal epitelial

    Directory of Open Access Journals (Sweden)

    Zaadia Pérez Parra

    Full Text Available La distrofia de Cogan es la distrofia corneal anterior más común, frecuente en adultos del sexo femenino, entre 40-70 años de edad. Presentamos un caso de una paciente de 50 años de edad, del sexo femenino, quien refiere visión borrosa, lagrimeo y fotofobia. Al examen de la córnea en lámpara de hendidura se observan imágenes de color grisáceo en forma de huellas dactilares y de mapa. Esta afección es causada por alteraciones de la membrana basal epitelial que provoca la separación parcial o total del epitelio corneal. Generalmente asintomática, es la causa más frecuente de erosión corneal recurrente. Las opciones terapéuticas varían desde lubricantes, soluciones hipertónicas tópicas, lentes de contacto de vendaje, desbridamiento del epitelio central, micropunciones mecánicas o diatermia y fotoqueratectomía con láser excímer.

  16. Basal cell carcinoma in skin of color.

    Science.gov (United States)

    Ahluwalia, Jesleen; Hadjicharalambous, Elena; Mehregan, Darius

    2012-04-01

    Non-melanoma skin cancer most commonly affects Caucasians, and only rarely affects darker-skinned individuals. However, skin cancer in these groups is associated with greater morbidity and mortality. Ultraviolet radiation is the major etiologic factor in basal cell carcinoma (BCC) and likely plays a pivotal role in the development of other forms of skin cancer. Yet it is commonly thought among patients as well as physicians that darker pigmentation inherently affords complete protection from skin cancer development. This low index of suspicion results in delayed diagnoses and poorer outcomes. This review follows a detailed computer search that cross-matched the diagnosis of BCC with skin color type in a large commercial dermatopathology facility. The reported skin types, all Fitzpatrick skin types IV, V, and VI, and histories were confirmed. A predominance of pigmented BCCs was found in sun-exposed areas of these older individuals. Although less common in darker-skinned ethnic groups, BCC does occur and can pose significant morbidity. Thus, it is essential that dermatologists are familiar with the epidemiology and clinical presentation of all cutaneous malignancies in darker skin so that these patients are fully aware of risks as well as prevention of the disease.

  17. Basal insulin and cardiovascular and other outcomes in dysglycemia

    DEFF Research Database (Denmark)

    Gerstein, Hertzel C; Bosch, Jackie; Dagenais, Gilles R

    2012-01-01

    The provision of sufficient basal insulin to normalize fasting plasma glucose levels may reduce cardiovascular events, but such a possibility has not been formally tested.......The provision of sufficient basal insulin to normalize fasting plasma glucose levels may reduce cardiovascular events, but such a possibility has not been formally tested....

  18. Genotype variation in grain yield response to basal N fertilizer ...

    African Journals Online (AJOL)

    user

    2012-07-24

    Jul 24, 2012 ... pollution. During the past decades, many investigations have been reported, related to nitrogen efficiency of different plant genotypes (Zhang et al., 1997; .... 274. 411. 548. Gr ai n yi el d wi t hout basal grain yield with basal fertilizer (g/8 plants). I. Ⅱ. (a). -20. -10. 0. 10. 20. -1. 99. 199. Rice variety number. A.

  19. Basal cell epithelioma (carcinoma) in children and teenagers

    Energy Technology Data Exchange (ETDEWEB)

    Rahbari, H.; Mehregan, A.H.

    1982-01-15

    Among over 390,000 routine dermatopathologic specimens there were 85 cases diagnosed as basal cell epithelioma (carcinoma) (BCE) in persons 19 years old or younger. This number was refined to 40 cases de novo BCE in children and teenagers. Basal cell epithelioma unrelated to other conditions is rare in the young and it should be differentiated from similar fibroepithelial growths.

  20. A whole stand basal area projection model for Appalachian hardwoods

    Science.gov (United States)

    John R. Brooks; Lichun Jiang; Matthew Perkowski; Benktesh Sharma

    2008-01-01

    Two whole-stand basal area projection models were developed for Appalachian hardwood stands. The proposed equations are an algebraic difference projection form based on existing basal area and the change in age, trees per acre, and/or dominant height. Average equation error was less than 10 square feet per acre and residuals exhibited no irregular trends.

  1. Basal Cell Ameloblastoma: A Rare Histological Variant of an ...

    African Journals Online (AJOL)

    of ameloblastoma.[4] The microscopic features of basal cell ameloblastoma, however, are similar to those of several malignant tumors, including basaloid squamous cell carcinoma (BSCC),[5,6] cutaneous basal cell carcinoma (BCC) and solid‑type adenoid cystic carcinoma (ACC).[1] The pathologist may sometimes fail to.

  2. Incorporating crown dimensions into stem height and basal area for ...

    African Journals Online (AJOL)

    Four crown dimensions (crown diameter, crown projection area, crown length and crown ratio) were each incorporated into nonlinear individual tree total height and basal area increment models for African white wood (Triplochiton scleroxylon K. Schum). The basic height/basal area growth model was formulated as a ...

  3. Reduction of metal artifacts from hip prostheses on CT images of the pelvis: value of iterative reconstructions.

    Science.gov (United States)

    Morsbach, Fabian; Bickelhaupt, Sebastian; Wanner, Guido A; Krauss, Andreas; Schmidt, Bernhard; Alkadhi, Hatem

    2013-07-01

    To assess the value of iterative frequency split-normalized (IFS) metal artifact reduction (MAR) for computed tomography (CT) of hip prostheses. This study had institutional review board and local ethics committee approval. First, a hip phantom with steel and titanium prostheses that had inlays of water, fat, and contrast media in the pelvis was used to optimize the IFS algorithm. Second, 41 consecutive patients with hip prostheses who were undergoing CT were included. Data sets were reconstructed with filtered back projection, the IFS algorithm, and a linear interpolation MAR algorithm. Two blinded, independent readers evaluated axial, coronal, and sagittal CT reformations for overall image quality, image quality of pelvic organs, and assessment of pelvic abnormalities. CT attenuation and image noise were measured. Statistical analysis included the Friedman test, Wilcoxon signed-rank test, and Levene test. Ex vivo experiments demonstrated an optimized IFS algorithm by using a threshold of 2200 HU with four iterations for both steel and titanium prostheses. Measurements of CT attenuation of the inlays were significantly (P algorithm for CT image reconstruction significantly reduces metal artifacts from hip prostheses, improves the reliability of CT number measurements, and improves the confidence for depicting pelvic abnormalities.

  4. Radial Force: An Underestimated Parameter in Oversizing Transcatheter Aortic Valve Replacement Prostheses: In Vitro Analysis with Five Commercialized Valves.

    Science.gov (United States)

    Egron, Sandrine; Fujita, Buntaro; Gullón, Lucía; Désirée, Pott; Schmitz-Rode, Thomas; Ensminger, Stephan; Steinseifer, Ulrich

    2017-09-05

    The goal is to inform in depth on transcatheter aortic valve replacement (TAVR) prosthesis mechanical behavior, depending on frame type, design, and size, and how it crucially impacts the oversizing issue in clinical use, and ultimately the procedure outcome. Transcatheter aortic valve replacement is an established therapy for high-risk patients suffering from aortic stenosis, and the indication for TAVR is progressively expanding to intermediate-risk patients. Choosing the optimal oversizing degree is crucial to safely anchor the TAVR valve-which involves limiting the risks for embolism, aortic regurgitation, conductance disturbance, or annulus rupture-and to increase the valve prosthesis performance. The radial force (RF) profiles of five TAVR prostheses were measured in vitro: the CoreValve 23 and 26 (Medtronic, MN), the Acurate neo S (Symetis, Switzerland), and the SAPIEN XT 23 and 26 (Edwards Lifesciences, CA). Measurements were run with the RX Machine equipment (Machine Solutions Inc., AZ), which is used in ISO standard tests for intravascular stents. Test protocols were adapted for TAVR prostheses. With the prostheses RF profiles' results, mechanical behavior differences could be described and discussed in terms of oversizing strategy and clinical impact for all five valves. Besides, crossing the prostheses' RF profiles with their recommended size windows made the assessment of borderline size cases possible and helped analyze the risks when accurate measurement of patient aortic annulus proves difficult. The prostheses' RF profiles bring new support in clinical decision-making for valve type and size in patients.

  5. Development of friction and wear full-scale testing for TKR prostheses with reliable low cost apparatus

    Science.gov (United States)

    Suwandi, Agri; Soemardi, Tresna P.; Kiswanto, Gandjar; Kusumaningsih, Widjajalaksmi; I. Gusti Agung I. G., W.

    2018-02-01

    Prostheses products must undergo simulation and physical testing, before clinical testing. Finite element method is a preliminary simulation for in vivo test. The method visualizes the magnitude of the compressive force and the critical location of the Total Knee Replacement (TKR) prostheses design. In vitro testing is classified as physical testing for prostheses product. The test is conducted to evaluate the potential failure of the product and the characteristics of the prostheses TKR material. Friction and wear testing are part of the in vivo test. Motion of knee joints, which results in the phenomena of extension and deflection in the femoral and tibia insert, is represented by friction and wear testing. Friction and wear tests aim to obtain an approximate lifetime in normal and extreme load patterns as characterized by the shape of the friction surface area. The lifetime estimation requires friction and wear full-scale testing equipments for TKR prostheses products. These are necessary in obtaining initial data on potential product failures and characterizing of the material based on the ASTM F2724-08 standards. Based on the testing result and statistical analysis data, the average wear rate value per year is 2.19 × 10-3 mg/MC, with a 10 % safety limit of volume and 14,400 cycles times, for 15 hours moving nonstop then the prediction of wear life of the component tibia insert is ± 10 years.

  6. Basal ganglia mechanisms underlying precision grip force control.

    Science.gov (United States)

    Prodoehl, Janey; Corcos, Daniel M; Vaillancourt, David E

    2009-06-01

    The classic grasping network has been well studied but thus far the focus has been on cortical regions in the control of grasping. Sub-cortically, specific nuclei of the basal ganglia have been shown to be important in different aspects of precision grip force control but these findings have not been well integrated. In this review, we outline the evidence to support the hypothesis that key basal ganglia nuclei are involved in parameterizing specific properties of precision grip force. We review literature from different areas of human and animal work that converges to build a case for basal ganglia involvement in the control of precision gripping. Following on from literature showing anatomical connectivity between the basal ganglia nuclei and key nodes in the cortical grasping network, we suggest a conceptual framework for how the basal ganglia could function within the grasping network, particularly as it relates to the control of precision grip force.

  7. [What is new in basal cell carcinoma?

    Science.gov (United States)

    Heppt, M; von Braunmühl, T; Berking, C

    2016-11-01

    Basal cell carcinoma (BCC) is the most common skin cancer in fair-skinned individuals. Although lymph node or visceral metastases are observed in less than 0.5 % of all cases, BCC can have a fatal course due to its highly invasive growth pattern. To provide a comprehensive update on diagnosis, treatment, and prevention of BCC. We review the current literature and recommendations of the German guidelines on treatment and prevention of skin cancer. The most pertinent developments are summarized in this review article. The use of optical coherence tomography and reflectance confocal microscopy can significantly improve the diagnosis of BCC compared with clinical assessment and dermoscopy alone. Mohs micrographic surgery remains the therapeutic gold standard for tumors in the head and facial area and tumors with high-risk features. The application of imiquimod, 5‑fluorouracil, or photodynamic therapy should be restricted to low-risk superficial tumors. Topical inhibitors of the sonic hedgehog (SHH) pathway are currently being evaluated in early clinical trials. In contrast, vismodegib and sonidegib have been approved for the systemic treatment of locally advanced and metastatic BCC with good response rates. The most common adverse events of both agents are muscle cramps, dysgeusia, diffuse alopecia, weight loss, and fatigue. In an Australian phase III trial, oral nicotinamide (vitamin B3) reduced the occurrence of new BCC by 20 % in skin cancer patients. Targeted therapy with SHH inhibitors has improved the prognosis of locally advanced and metastatic BCC, albeit at the cost of a significant number of adverse events.

  8. Basal ganglia - thalamus and the crowning enigma

    Directory of Open Access Journals (Sweden)

    Marianela eGarcia-Munoz

    2015-11-01

    Full Text Available When Hubel (1982 referred to layer 1 of primary visual cortex as …a ‘crowning mystery’ to keep area-17 physiologists busy for years to come... he could have been talking about any cortical area. In the 80’s and 90’s there were no methods to examine this neuropile on the surface of the cortex: a tangled web of axons and dendrites from a variety of different places with unknown specificities and doubtful connections to the cortical output neurons some hundreds of microns below. Recently, three changes have made the crowning enigma less of an impossible mission: the clear presence of neurons in layer 1 (L1, the active conduction of voltage along apical dendrites and optogenetic methods that might allow us to look at one source of input at a time. For all of those reasons alone, it seems it is time to take seriously the function of L1. The functional properties of this layer will need to wait for more experiments but already L1 cells are GAD67 positive, i.e., inhibitory! They could reverse the sign of the thalamic glutamate (GLU input for the entire cortex. It is at least possible that in the near future normal activity of individual sources of L1 could be detected using genetic tools. We are at the outset of important times in the exploration of thalamic functions and perhaps the solution to the crowning enigma is within sight. Our review looks forward to that solution from the solid basis of the anatomy of the basal ganglia output to motor thalamus. We will focus on L1, its afferents, intrinsic neurons and its influence on responses of pyramidal neurons in layers 2/3 and 5. Since L1 is present in the whole cortex we will provide a general overview considering evidence mainly from the somatosensory cortex before focusing on motor cortex.

  9. A computer-based biomechanical analysis of the three-dimensional motion of cementless hip prostheses.

    Science.gov (United States)

    Gilbert, J L; Bloomfeld, R S; Lautenschlager, E P; Wixson, R L

    1992-04-01

    A computer-based mathematical technique was developed to measure and completely describe the migration and micromotion of a femoral hip prosthesis relative to the femur. This technique utilized the mechanics of rigid-body motion analysis and apparatus of seven linear displacement transducers to measure and describe the complete three-dimensional motion of the prosthesis during cyclic loading. Computer acquisition of the data and custom analysis software allowed one to calculate the magnitude and direction of the motion of any point of interest on the prostheses from information about the motion of two points on the device. The data were also used to replay the tests using a computer animation technique, which allowed a magnified view of the three-dimensional motion of the prosthesis. This paper describes the mathematical development of the rigid-body motion analysis, the experimental method and apparatus for data collection, the technique used to animate the motion, the sources of error and the effect of the assumptions (rigid bodies) on the results. Selected results of individual test runs of uncemented and cemented prostheses are presented to demonstrate the efficacy of the method. The combined effect of the vibration and electrical noise resulted in a resolution of the system of about 3-5 microns motion for each transducer. Deformation effects appear to contribute about 3-15 microns to the measurement error. This measurement and analysis technique is a very sensitive and powerful means of assessing the effects of different design parameters on the migration and micromotion of total joint prostheses and can be applied to any other case (knee, dental implant) where three-dimensional relative motion between two bodies is important.

  10. How do the outcomes of the DEKA Arm compare to conventional prostheses?

    Science.gov (United States)

    Resnik, Linda J; Borgia, Matthew L; Acluche, Frantzy; Cancio, Jill M; Latlief, Gail; Sasson, Nicole

    2018-01-01

    Objectives were to 1) compare self-reported function, dexterity, activity performance, quality of life and community integration of the DEKA Arm to conventional prostheses; and 2) examine differences in outcomes by conventional prosthesis type, terminal device type and by DEKA Arm configuration level. This was a two-part study; Part A consisted of in-laboratory training. Part B consisted of home use. Study participants were 23 prosthesis users (mean age = 45 ± 16; 87% male) who completed Part A, and 15 (mean age = 45 ± 18; 87% male) who completed Parts A and B. Outcomes including self-report and performance measures, were collected at Baseline using participants' personal prostheses and at the End of Parts A and B. Scores were compared using paired t-tests. Wilcoxon signed-rank tests were used to compare outcomes for the full sample, and for the sample stratified by device and terminal device type. Analysis of outcomes by configuration level was performed graphically. At the End of Part A activity performance using the DEKA Arm and conventional prosthesis was equivalent, but slower with the DEKA Arm. After Part B, performance using the DEKA Arm surpassed conventional prosthesis scores, and speed of activity completion was equivalent. Participants reported using the DEKA Arm to perform more activities, had less perceived disability, and less difficulty in activities at the End of A and B as compared to Baseline. No differences were observed in dexterity, prosthetic skill, spontaneity, pain, community integration or quality of life. Comparisons stratified by device type revealed similar patterns. Graphic comparisons revealed variations by configuration level. Participants using the DEKA Arm had less perceived disability and more engagement of the prosthesis in everyday tasks, although activity performance was slower. After home use experience, activity performance was improved and activity speed equivalent to using conventional prostheses.

  11. In vitro evaluation of failure loads of nonmetal cantilevered resin-bonded fixed dental prostheses.

    Science.gov (United States)

    van Dalen, Andy; Feilzer, Albert J; Kleverlaan, Cornelis J

    2008-12-01

    To evaluate in vitro the influence of fiber reinforcement on the failure loads of resin composite beams, simulating cantilevered two-unit resin-bonded fixed dental prostheses, and compare the results with similarly obtained failure loads of ZrO2 and CoCr beams of a comparable design. Peel tests were performed using resin composite, fiber-reinforced resin composite, and zirconia beams, simulating two-unit cantilevered resin-bonded fixed dental prostheses, luted with Panavia F2.0 onto flat-ground buccal surfaces of bovine mandibular incisors. The recorded failure loads were compared with those of CoCr beams of a similar size and design from earlier research. Finite element analysis revealed the stress concentrations within the cement layers at failure. The failure loads (N) of the peel tests, depending on the beam type and including the type of failure, were statistically analyzed. The highest failure values were obtained with the fiber-reinforced resin composite beams, which were luted with the exposed fibers directly on the bovine enamel. Finite element analysis showed that peak stress locations depend on the beam type and facilitate the explanation of the different failure modes. Fiber-reinforcement of simulated two-unit cantilevered resin composite resin-bonded fixed dental prostheses does not necessarily lead to higher failure loads. This study identified significant differences in peel failure loads between identical specimens, depending on whether or not the fiber reinforcement was exposed on the luting surface. Further research needs to be carried out regarding the combination of resin composite and fiber reinforcement.

  12. Immediate loading with fixed full-arch prostheses in the maxilla: Review of the literature

    Science.gov (United States)

    Peñarrocha-Oltra, David; Covani, Ugo; Peñarrocha-Diago, Miguel

    2014-01-01

    Objectives: To critically review the evidence-based literature on immediate loading of implants with fixed full-arch prostheses in the maxilla to determine 1) currently recommended performance criteria and 2) the outcomes that can be expected with this procedure. Study Desing: Studies from 2001 to 2011 on immediate loading with fixed full-arch maxillary prostheses were reviewed. Clinical series with at least 5 patients and 12 months of follow-up were included. Case reports, studies with missing data and repeatedly published studies were excluded. In each study the following was assessed: type of study, implant type, number of patients, number of implants, number of implants per patient, use of post-extraction implants, minimum implant length and diameter, type of prosthesis, time until loading, implant survival rate, prosthesis survival rate, marginal bone loss, complications andmean follow-up time. Criteria for patient selection, implant primary stability and bone regeneration were also studied. Results: Thirteen studies were included, reporting a total of 2484 immediately loaded implants in 365 patients. Currently accepted performance criteria regarding patient and implant selection, and surgical and prosthetic procedures were deduced from the reviewed articles. Implant survival rates went from 87.5% to 100%, prosthesis survival rates from 93.8% to 100% and radiographic marginal bone loss from 0.8 mm to 1.6 mm.No intraoperative complications and only minor prosthetic complications were reported. Conclusions: The literature on immediate loading with fixed full-arch prostheses in the maxilla shows that a successful outcome can be expected if adequate criteria are used to evaluate the patient, choose the implant and perform the surgical and prosthetic treatment. Lack of homogeneity within studies limits the relevance of the conclusions that can be drawn, and more controlled randomized studies are necessary to enable comparison between the immediate and the

  13. [Clinical characteristics of the Soviet low-profile heart valve prostheses EMIKS and LIKS].

    Science.gov (United States)

    Tsukerman, G I; Dobrova, N B; Faminskiĭ, D O; Pomortseva, L V; Gvakhariia, I N; Chigogidze, N A; Zaretskiĭ, Iu V

    1989-01-01

    The present work is devoted to the clinical assessment of the Soviet-made cardiac valve prostheses 'EMIKS' and 'LIKS'. From 1983 to May 1, 1988, 632 prostheses were implanted to 508 patients. A group of 348 patients were assessed: 139 after mitral (M) replacement, 130 after aortal (A) replacement, and 79 after mitral-aortal (M+A) replacement. Hospital mortality rate was: in M group--4.3 per cent, in A group--5.3 per cent, in M+A group--8.8 per cent. Survival rate on the fifth postoperative year was: in M group--89.5 +/- 9.2 per cent, in a group--90.0 +/- 4.2 per cent, in M+A group--91.0 +/- 6.2 per cent, the stability of the good results being 85.5 +/- 7.2, 79.5 +/- 6.2, and 75.0 +/- 9.1 per cent, respectively. At year 5 of the follow-up, patient numbers without thromboembolic complications amounted to 95.0 +/- 4.7 per cent in M group, 95.5 +/- 4.2 per cent in A group, and 85.0 +/- 9.1 in M+A group. 95.1 per cent patients belong to functional classes I and II. In mitral replacement, the mean 'EMIKS' gradient was 4.2 +/- 0.58 mm Hg, the 'LIKS' one--4.58 +/- 0.62 mm Hg. Intravascular hemolysis was not observed. The 'EMIKS' and 'LIKS' prostheses match the models produced in other countries. No significant differences between the two models were found.

  14. Implant placement under existing removable dental prostheses and its effect on masticatory performance.

    Science.gov (United States)

    Wolfart, S; Wolf, K; Brunzel, S; Wolfart, M; Caliebe, A; Kern, M

    2016-12-01

    The aim of this within-subject study was to evaluate the outcome with implant-tooth-supported removable partial dental prostheses (RPDP group) and implant-supported removable complete dental prostheses (edentulous group) in terms of masticatory performance and self-assessment. Thirty patients participated in this prospective clinical study (RPDP group: n = 12; edentulous group: n = 18). The prostheses were supported in strategically advantageous regions by placing implants with ball attachments and corresponding matrices in the existing dentures. The masticatory performance was evaluated with the Swallowing Threshold Test Index (STTI), the number of chewing strokes, and the time needed until swallowing at pre-treatment and 6 weeks after integration of ball attachments. Additionally, patients scored chewing satisfaction before and after implantation on a visual analogue scale. The STTI increased significantly (p ≤ 0.05) after implant therapy in the edentulous group but not in the RPDP group. Furthermore, the STTI was significantly higher (p ≤ 0.05) in the RPDP group than in the edentulous group at pre-treatment, however, not after therapy (P > 0.05). All patients were very satisfied after therapy concerning ability of speaking, chewing, and stability of their prosthesis. Patients of the edentulous group benefit more from strategically placed implants under the existing dentures than patients from the RPDP group. However, according to the subjective assessment, the chewing satisfaction generally increased for both groups after implant therapy. Patients with a strongly reduced dentition and edentulous patients benefit from strategically placed implants under the existing removable dentures.

  15. How do the outcomes of the DEKA Arm compare to conventional prostheses?

    Directory of Open Access Journals (Sweden)

    Linda J Resnik

    Full Text Available Objectives were to 1 compare self-reported function, dexterity, activity performance, quality of life and community integration of the DEKA Arm to conventional prostheses; and 2 examine differences in outcomes by conventional prosthesis type, terminal device type and by DEKA Arm configuration level.This was a two-part study; Part A consisted of in-laboratory training. Part B consisted of home use. Study participants were 23 prosthesis users (mean age = 45 ± 16; 87% male who completed Part A, and 15 (mean age = 45 ± 18; 87% male who completed Parts A and B. Outcomes including self-report and performance measures, were collected at Baseline using participants' personal prostheses and at the End of Parts A and B. Scores were compared using paired t-tests. Wilcoxon signed-rank tests were used to compare outcomes for the full sample, and for the sample stratified by device and terminal device type. Analysis of outcomes by configuration level was performed graphically.At the End of Part A activity performance using the DEKA Arm and conventional prosthesis was equivalent, but slower with the DEKA Arm. After Part B, performance using the DEKA Arm surpassed conventional prosthesis scores, and speed of activity completion was equivalent. Participants reported using the DEKA Arm to perform more activities, had less perceived disability, and less difficulty in activities at the End of A and B as compared to Baseline. No differences were observed in dexterity, prosthetic skill, spontaneity, pain, community integration or quality of life. Comparisons stratified by device type revealed similar patterns. Graphic comparisons revealed variations by configuration level.Participants using the DEKA Arm had less perceived disability and more engagement of the prosthesis in everyday tasks, although activity performance was slower. After home use experience, activity performance was improved and activity speed equivalent to using conventional prostheses.

  16. Fixed and mobile-bearing total ankle prostheses: Effect on tibial bone strain.

    Science.gov (United States)

    Terrier, Alexandre; Fernandes, Caroline Sieger; Guillemin, Maïka; Crevoisier, Xavier

    2017-10-01

    Total ankle replacement is associated to a high revision rate. To improve implant survival, the potential advantage of prostheses with fixed bearing compared to mobile bearing is unclear. The objective of this study was to test the hypothesis that fixed and mobile bearing prostheses are associated with different biomechanical quantities typically associated to implant failure. With a validated finite element model, we compared three cases: a prosthesis with a fixed bearing, a prosthesis with a mobile bearing in a centered position, and a prosthesis with mobile bearing in an eccentric position. Both prostheses were obtained from the same manufacturer. They were tested on seven tibias with maximum axial compression force during walking. We tested the hypothesis that there was a difference of bone strain, bone-implant interfacial stress, and bone support between the three cases. We also evaluated, for the three cases, the correlations between bone support, bone strain and bone-implant interfacial stress. There were no statistically significant differences between the three cases. Overall, bone support was mainly trabecular, and less effective in the posterior side. Bone strain and bone-implant interfacial stress were strongly correlated to bone support. Even if slight differences are observed between fixed and mobile bearing, it is not enough to put forward the superiority of one of these implants regarding their reaction to axial compression. When associated to the published clinical results, our study provides no argument to warn surgeons against the use of two-components fixed bearing implants. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Axillary basal cell carcinoma in patients with Goltz-Gorlin syndrome: report of basal cell carcinoma in both axilla of a woman with basal cell nevus syndrome and literature review.

    Science.gov (United States)

    Cohen, Philip R

    2014-08-17

    Basal cell carcinoma of the axilla, an area that is not usually exposed to the sun, is rare. Individuals with basal cell nevus syndrome, a disorder associated with a mutation in the patch 1 (PTCH1) gene, develop numerous basal cell carcinomas. To describe a woman with basal cell nevus syndrome who developed a pigmented basal cell carcinoma in each of her axilla and to review the features of axillary basal cell carcinoma patients with Goltz-Gorlin syndrome. Pubmed was used to search the following terms: axillary basal cell carcinoma and basal cell nevus syndrome. The papers and their citations were evaluated. Basal cell nevus syndrome patients with basal cell carcinoma of the axilla were observed in two women; this represents 2.5% (2 of 79) of the patients with axillary basal cell carcinoma. Both women had pigmented tumors that were histologically nonaggressive. The cancers did not recur after curettage or excision. Basal cell carcinoma of the axilla has only been described in 79 individuals; two of the patients were women with pigmented tumors who had basal cell nevus syndrome. Similar to other patients with axillary basal cell carcinoma, the tumors were histologically nonaggressive and did not recur following treatment. Whether PTCH1 gene mutation predisposes basal cell nevus patients to develop axillary basal cell carcinomas remains to be determined.

  18. Metastatic Basal Cell Carcinoma: A Biological Continuum of Basal Cell Carcinoma?

    OpenAIRE

    Karaninder S. Mehta; Vikram K. Mahajan; Pushpinder S. Chauhan; Anju Lath Sharma; Vikas Sharma; C. Abhinav; Gayatri Khatri; Neel Prabha; Saurabh Sharma; Muninder Negi

    2012-01-01

    Basal cell carcinoma (BCC) accounts for 80% of all nonmelanoma skin cancers. Its metastasis is extremely rare, ranging between 0.0028 and 0.55 of all BCC cases. The usual metastasis to lymph nodes, lungs, bones, or skin is from the primary tumor situated in the head and neck region in nearly 85% cases. A 69-year-old male developed progressively increasing multiple, fleshy, indurated, and at places pigmented noduloulcerative plaques over back, chest, and left axillary area 4 years after wide s...

  19. Early rehabilitation of facial defects using interim removable prostheses: A clinical case report

    Directory of Open Access Journals (Sweden)

    Vivekanandhan Ramkumar

    2013-01-01

    Full Text Available Surgical resection of neoplasms or malformations of the face may result in defects that are not amenable to immediate surgical reconstruction. Such defects can have a severe adverse effect on patient perceptions of body image and self-esteem. In these cases, the use of an interim removable facial prosthesis can offer a rapid alternative treatment solution. The patient may then resume social interactions more comfortably while permitting easy access to the facial defect to observe tissue healing while awaiting definitive rehabilitation. This article presents a case report describing the use of interim nasal prostheses to provide rapid patient rehabilitation of facial defects.

  20. Restoring natural sensory feedback in real-time bidirectional hand prostheses

    DEFF Research Database (Denmark)

    Raspopovic, Stanisa; Capogrosso, Marco; Petrini, Francesco Maria

    2014-01-01

    used by the subject. The results also demonstrate that a high complexity of perception can be obtained, allowing the subject to identify the stiffness and shape of three different objects by exploiting different characteristics of the elicited sensations. This approach could improve the efficacy......Hand loss is a highly disabling event that markedly affects the quality of life. To achieve a close to natural replacement for the lost hand, the user should be provided with the rich sensations that we naturally perceive when grasping or manipulating an object. Ideal bidirectional hand prostheses...

  1. Estética en prótesis removibles The aesthetics in removable prostheses

    Directory of Open Access Journals (Sweden)

    LVM Lucas

    2010-06-01

    Full Text Available La estética actualmente recibe una importante consideración en el contexto social. Una sonrisa atractiva es aspiración de la mayoría de los pacientes que precisan tratamiento protésico. Los implantes propiciaron una mejoría significativa, con relación a las prótesis removibles, debido a su funcionalidad. El objetivo de este estudio fue explorar en la literatura científica moderna, a fin de hallar aspectos relacionados con la estética en la rehabilitación mediante prótesis removibles. Fueron encontrados factores importantes como: la selección de los dientes artificiales, la disposición de los mismos, la caracterización de la base de resina acrílica, además de los tipos de retenedores para las prótesis parciales removibles. La planificación y aplicación apropiada de este procedimiento, con criterios estéticos correctos, debe ser responsabilidad del profesional.Nowadays, aesthetics is very appreciated in the social context and a attractive smile is the object of desire in most of patients requiring prosthesis treatment. In case of removable prosthesis, total or partial, this feature is more significant since some or all teeth may be absents. Implants leading to a significant improvement in relation to function and comfort of removable prosthesis users, but the aesthetics of these prostheses had little attention in the current scientific literature. Thus, the aim of present article was to make a review of the literature on the aesthetic features related to rehabilitation with removable prostheses. In present study we found as significant factors for the aesthetics in removable partial and total prostheses: selection of artificial teeth and their arrangement, characterization of acrylic resin basis and also the types and location of retainers for the removable partial prostheses. We conclude that the involvement and the aesthetic knowledge during the appropriate planning of this process is responsibility of the professional.

  2. High-density EMG e-textile systems for the control of active prostheses

    DEFF Research Database (Denmark)

    Farina, Dario; Lorrain, Thomas; Negro, Francesco

    2010-01-01

    Myoelectric control of active prostheses requires electrode systems that are easy to apply for daily repositioning of the electrodes by the user. In this study we propose the use of Smart Fabric and Interactive Textile (SFIT) systems as an alternative solution for recording high-density EMG signals...... for myoelectric control. A sleeve covering the upper and lower arm, which contains 100 electrodes arranged in four grids of 5 * 5 electrodes, was used to record EMG signals in 3 subjects during the execution of 9 tasks of the wrist and hand. The signals were analyzed by extracting wavelet coefficients which were...

  3. Superiority of Nitinol Piston Over Conventional Prostheses in Stapes Surgery: First Comparative Results in the Chinese Population in Taiwan

    Directory of Open Access Journals (Sweden)

    Chin-Lung Kuo

    2010-05-01

    Conclusion: The Nitinol piston has a distinct advantage over conventional prostheses, providing an easier, safer and more effective treatment option in otosclerosis surgery. To our knowledge, this is the first comparative analysis of hearing results of the Nitinol piston with conventional prostheses in the Chinese population in Taiwan. In this population, there is a much lower prevalence of otosclerosis, leading to a lack of surgical experience in otosclerosis surgery, even at large medical centers. This may explain, in part, the relative lack of studies conducted on stapes prostheses in Asian patients. Therefore, our preliminary research may provide a reference for future investigations on stapes surgery in Asian patients with otosclerosis based on ethnic differences.

  4. Hydrogen/Deuterium Exchange Kinetics Demonstrate Long Range Allosteric Effects of Thumb Site 2 Inhibitors of Hepatitis C Viral RNA-dependent RNA Polymerase.

    Science.gov (United States)

    Deredge, Daniel; Li, Jiawen; Johnson, Kenneth A; Wintrode, Patrick L

    2016-05-06

    New nonnucleoside analogs are being developed as part of a multi-drug regimen to treat hepatitis C viral infections. Particularly promising are inhibitors that bind to the surface of the thumb domain of the viral RNA-dependent RNA polymerase (NS5B). Numerous crystal structures have been solved showing small molecule non-nucleoside inhibitors bound to the hepatitis C viral polymerase, but these structures alone do not define the mechanism of inhibition. Our prior kinetic analysis showed that nonnucleoside inhibitors binding to thumb site-2 (NNI2) do not block initiation or elongation of RNA synthesis; rather, they block the transition from the initiation to elongation, which is thought to proceed with significant structural rearrangement of the enzyme-RNA complex. Here we have mapped the effect of three NNI2 inhibitors on the conformational dynamics of the enzyme using hydrogen/deuterium exchange kinetics. All three inhibitors rigidify an extensive allosteric network extending >40 Å from the binding site, thus providing a structural rationale for the observed disruption of the transition from distributive initiation to processive elongation. The two more potent inhibitors also suppress slow cooperative unfolding in the fingers extension-thumb interface and primer grip, which may contribute their stronger inhibition. These results establish that NNI2 inhibitors act through long range allosteric effects, reveal important conformational changes underlying normal polymerase function, and point the way to the design of more effective allosteric inhibitors that exploit this new information. © 2016 by The American Society for Biochemistry and Molecular Biology, Inc.

  5. The interaction between the first transmembrane domain and the thumb of ASIC1a is critical for its N-glycosylation and trafficking.

    Directory of Open Access Journals (Sweden)

    Lan Jing

    Full Text Available Acid-sensing ion channel-1a (ASIC1a, the primary proton receptor in the brain, contributes to multiple diseases including stroke, epilepsy and multiple sclerosis. Thus, a better understanding of its biogenesis will provide important insights into the regulation of ASIC1a in diseases. Interestingly, ASIC1a contains a large, yet well organized ectodomain, which suggests the hypothesis that correct formation of domain-domain interactions at the extracellular side is a key regulatory step for ASIC1a maturation and trafficking. We tested this hypothesis here by focusing on the interaction between the first transmembrane domain (TM1 and the thumb of ASIC1a, an interaction known to be critical in channel gating. We mutated Tyr71 and Trp287, two key residues involved in the TM1-thumb interaction in mouse ASIC1a, and found that both Y71G and W287G decreased synaptic targeting and surface expression of ASIC1a. These defects were likely due to altered folding; both mutants showed increased resistance to tryptic cleavage, suggesting a change in conformation. Moreover, both mutants lacked the maturation of N-linked glycans through mid to late Golgi. These data suggest that disrupting the interaction between TM1 and thumb alters ASIC1a folding, impedes its glycosylation and reduces its trafficking. Moreover, reducing the culture temperature, an approach commonly used to facilitate protein folding, increased ASIC1a glycosylation, surface expression, current density and slowed the rate of desensitization. These results suggest that correct folding of extracellular ectodomain plays a critical role in ASIC1a biogenesis and function.

  6. Osteoarthritis of the carpometacarpal joint of the thumb: a new MR imaging technique for the standardized detection of relevant ligamental lesions

    International Nuclear Information System (INIS)

    Dumont, Clemens; Lerzer, Sebastian; Tezval, Mohammad; Stuermer, Klaus Michael; Vafa, Morad Ali; Lotz, Joachim; Dechent, Peter

    2014-01-01

    To assess ligament lesions and subluxations of the carpometacarpal joints of the thumbs (CMC I) of asymptomatic volunteers and of patients with CMC I osteoarthritis using advanced magnetic resonance imaging (MRI). A total of 20 CMC I joints of 14 asymptomatic volunteers (6 x both sides) and 28 CMC I joints of 22 patients (6 x both sides) with symptomatic and X-ray-diagnosed osteoarthritis of CMC I joints were studied. During extension, flexion, abduction and adduction of the thumb, the anterior oblique (AOL), intermetacarpal (IML), posterior oblique (POL) and dorsal radial (DRL) ligaments were evaluated using 3-T MRI on two standard planes, and translation of metacarpal I (MC I) was assessed. The MRI demonstrated that ligament lesions of the AOL and IML are frequent. Isolated rupture of the AOL was found in 6 of 28 (21 %), combined rupture of the AOL + IML in 5 of 28 (18 %) and isolated IML rupture in 4 of 28 (14 %) joints. The patients had a significantly increased dorsal translation of MC I during extension with a median of 6.4 mm vs. 5.4 mm in asymptomatic volunteers (p < 0.05). MRIs of CMC I in two standardized planes frequently show combined ligament ruptures. The dorsal subluxation of MC I, which is increased in patients, correlates with OA severity based on X-ray and can be quantified by MRI. For joint-preserving surgical procedures and for prosthesis implantation of the CMC I, we recommend performing an MRI in two planes of the thumb - extension and abduction - to evaluate the ligaments and dorsal subluxation of MC I. (orig.)

  7. Osteoarthritis of the carpometacarpal joint of the thumb: a new MR imaging technique for the standardized detection of relevant ligamental lesions

    Energy Technology Data Exchange (ETDEWEB)

    Dumont, Clemens [University Medical Center Goettingen, Department of Trauma Surgery, Plastic and Reconstructive Surgery, Goettingen (Germany); Georg-August-Universitaet, Department of Trauma Surgery, Plastic and Reconstructive Surgery, Goettingen (Germany); Lerzer, Sebastian; Tezval, Mohammad; Stuermer, Klaus Michael [University Medical Center Goettingen, Department of Trauma Surgery, Plastic and Reconstructive Surgery, Goettingen (Germany); Vafa, Morad Ali; Lotz, Joachim [University Medical Center Goettingen, Department of Diagnostic Radiology and Interventional Radiology, Goettingen (Germany); Dechent, Peter [University Medical Center Goettingen, MR-Research in Neurology and Psychiatry, Department of Cognitive Neurology, Goettingen (Germany)

    2014-10-15

    To assess ligament lesions and subluxations of the carpometacarpal joints of the thumbs (CMC I) of asymptomatic volunteers and of patients with CMC I osteoarthritis using advanced magnetic resonance imaging (MRI). A total of 20 CMC I joints of 14 asymptomatic volunteers (6 x both sides) and 28 CMC I joints of 22 patients (6 x both sides) with symptomatic and X-ray-diagnosed osteoarthritis of CMC I joints were studied. During extension, flexion, abduction and adduction of the thumb, the anterior oblique (AOL), intermetacarpal (IML), posterior oblique (POL) and dorsal radial (DRL) ligaments were evaluated using 3-T MRI on two standard planes, and translation of metacarpal I (MC I) was assessed. The MRI demonstrated that ligament lesions of the AOL and IML are frequent. Isolated rupture of the AOL was found in 6 of 28 (21 %), combined rupture of the AOL + IML in 5 of 28 (18 %) and isolated IML rupture in 4 of 28 (14 %) joints. The patients had a significantly increased dorsal translation of MC I during extension with a median of 6.4 mm vs. 5.4 mm in asymptomatic volunteers (p < 0.05). MRIs of CMC I in two standardized planes frequently show combined ligament ruptures. The dorsal subluxation of MC I, which is increased in patients, correlates with OA severity based on X-ray and can be quantified by MRI. For joint-preserving surgical procedures and for prosthesis implantation of the CMC I, we recommend performing an MRI in two planes of the thumb - extension and abduction - to evaluate the ligaments and dorsal subluxation of MC I. (orig.)

  8. Implications of basal micro-earthquakes and tremor for ice stream mechanics: Stick-slip basal sliding and till erosion

    Science.gov (United States)

    Barcheck, C. Grace; Tulaczyk, Slawek; Schwartz, Susan Y.; Walter, Jacob I.; Winberry, J. Paul

    2018-03-01

    The Whillans Ice Plain (WIP) is unique among Antarctic ice streams because it moves by stick-slip. The conditions allowing stick-slip and its importance in controlling ice dynamics remain uncertain. Local basal seismicity previously observed during unstable slip is a clue to the mechanism of ice stream stick-slip and a window into current basal conditions, but the spatial extent and importance of this basal seismicity are unknown. We analyze data from a 2010-2011 ice-plain-wide seismic and GPS network to show that basal micro-seismicity correlates with large-scale patterns in ice stream slip behavior: Basal seismicity is common where the ice moves the least between unstable slip events, with small discrete basal micro-earthquakes happening within 10s of km of the central stick-slip nucleation area and emergent basal tremor occurring downstream of this area. Basal seismicity is largely absent in surrounding areas, where inter-slip creep rates are high. The large seismically active area suggests that a frictional sliding law that can accommodate stick-slip may be appropriate for ice stream beds on regional scales. Variability in seismic behavior over inter-station distances of 1-10 km indicates heterogeneity in local bed conditions and frictional complexity. WIP unstable slips may nucleate when stick-slip basal earthquake patches fail over a large area. We present a conceptual model in which basal seismicity results from slip-weakening frictional failure of over-consolidated till as it is eroded and mobilized into deforming till.

  9. Efficacy of cleansing agents in killing microorganisms in mixed species biofilms present on silicone facial prostheses-an in vitro study

    NARCIS (Netherlands)

    Ariani, Nina; Visser, Anita; Teulings, Margot R. I. M.; Dijk, Melissa; Rahardjo, Tri Budi W.; Vissink, Arjan; van der Mei, Henny C.

    2015-01-01

    The purpose of this study was to assess the efficacy of different cleansing agents in killing mixed species biofilms on silicone facial prostheses. Two bacterial and three yeast strains, isolated from silicone facial prostheses, were selected for the mixed species biofilms. A variety of agents used

  10. IMPROVED HEALING OF SMALL-CALIBER POLYTETRAFLUOROETHYLENE PROSTHESES BY INDUCTION OF A CLOT LAYER - A REVIEW OF EXPERIMENTAL STUDIES IN RATS

    NARCIS (Netherlands)

    VANDERLEI, B; STRONCK, JW; WILDEVUUR, CRH

    1991-01-01

    This report reviews our experiments that have been undertaken to test the hypothesis whether the induction of a clot layer on the graft surface of small-caliber polytetrafluoroethylene ( PTFE) prostheses might improve their healing. 1 2 PTFE prostheses with a fibril length of 30-mu-m, PTFE

  11. Risks resulting from using rules-of-thumb when cementing oil wells; Riscos decorrentes do uso de chavoes nas cimentacoes de pocos de petroleo

    Energy Technology Data Exchange (ETDEWEB)

    Silva, Maria das Gracas Pena; Miranda, Cristiane Richard de [PETROBRAS, Rio de Janeiro, RJ (Brazil). Centro de Pesquisas. Superintendencia de Pesquisa de Exploracao e Producao

    1994-07-01

    In the oil industry the two most popular rules-of-thumb related to interpreting the thickening time tests are: 'On reaching 50 Uc (consistency units) the cement slurries are no longer pumpable' and 'Time spent on mixing and displacing the slurries should not exceed 60% of the thickening time'. To check these rules more then 200 experimental tests were carried out which show that depending on the additives used, the consistometry curves may require individual interpretation and slurries with different composition have great changes of showing different apparent viscosities even when having the same consistency. (author)

  12. Occupational Traumatic Amputation of Distal Part of Thumb Caused by Constriction Effect of Nylon Rope: A Case Report with Review of Literature

    Directory of Open Access Journals (Sweden)

    M. Kalra

    2011-01-01

    Full Text Available A 60-year-old farmer came to the accident and emergency department complaining of traumatic amputation of distal part of right thumb. On examination, there was a circumferential wound located at the base of right thumbnail with injury to both neurovascular bundles and fracture of distal part of distal phalanx with the distal part hanging by volar skin only. The wound was irrigated and the distal part terminalised with direct loose skin closure. Discussion with the patient about the scenario of trauma revealed a mechanism of injury which may appear unique.

  13. Modified Bluegrass Appliance: A Nonpunitive Therapy for Thumb Sucking in Pediatric Patients—A Case Report with Review of the Literature

    Directory of Open Access Journals (Sweden)

    Amish Diwanji

    2013-01-01

    Full Text Available Oral habits in form of digit/thumb sucking are common phenomenon and part of childhood behavior. They are normally associated with oral pleasure, hunger, anxiety, and sometimes psychological disturbances. Chronic practice can cause major orthopedic alterations to the skeletal structures of the oral cavity and lower face. Aversive approaches in form of punitive therapy have been moderately effective. Modified bluegrass appliance is nonpunitive therapy to treat sucking habits. It acts as a habit reversal technique and installs positive reinforcement in children. Modified blue grass appliance proved to be very comfortable to patients and encourages neuromuscular stimulations.

  14. Immediate versus conventional loading with fixed full-arch prostheses in mandibles with failing dentition: a prospective controlled study.

    Science.gov (United States)

    Peñarrocha-Oltra, David; Covani, Ugo; Peñarrocha, Miguel; Peñarrocha-Diago, Maria

    2015-01-01

    To compare immediate and conventional loading protocols for fixed full-arch mandibular prostheses supported by immediate and nonimmediate implants. A prospective controlled nonrandomized study with 12 months of follow-up included patients requiring fixed full-arch rehabilitations supported by immediate and nonimmediate implants. Eighteen patients were treated with conventional loading (control group), and 18 were treated with immediate loading (test group). Each patient received four to six implants; implants with insertion torque loaded conventionally. The following variables were assessed: implant success, biologic and prosthetic complications, success of the immediately loaded provisional prostheses, and marginal bone loss. Statistical analysis was performed with nonparametric tests (chi-square, Mann-Whitney, Kruskal-Wallis) with an alpha value of .05. Thirty-six patients consecutively enrolled in the study. Two control group patients failing to attend control visits and 12 implants that did not achieve an insertion torque of 35 Ncm were excluded. The final sample consisted of 34 patients and 183 implants (98 test and 85 control implants). Implant success rates were 99.0% (test) and 97.6% (control). Within the test group, success rates for immediate and nonimmediate implants were 100% and 97.6%, respectively. Differences were not statistically significant. All immediately loaded prostheses were successful. Five provisional fixed prostheses presented with loosened screws; all control group patients reported discomfort with the provisional denture. Average bone loss was 0.71 mm (standard deviation 0.25 mm) in the test group and 0.60 mm (standard deviation 0.28 mm) in the control group. No significant differences were seen in implant success and peri-implant marginal bone loss between immediate and conventional loading of mandibular fixed full-arch prostheses supported by immediate and nonimmediate implants. Biologic and prosthetic complications were rare, and all

  15. A basal stem cell signature identifies aggressive prostate cancer phenotypes

    Science.gov (United States)

    Smith, Bryan A.; Sokolov, Artem; Uzunangelov, Vladislav; Baertsch, Robert; Newton, Yulia; Graim, Kiley; Mathis, Colleen; Cheng, Donghui; Stuart, Joshua M.; Witte, Owen N.

    2015-01-01

    Evidence from numerous cancers suggests that increased aggressiveness is accompanied by up-regulation of signaling pathways and acquisition of properties common to stem cells. It is unclear if different subtypes of late-stage cancer vary in stemness properties and whether or not these subtypes are transcriptionally similar to normal tissue stem cells. We report a gene signature specific for human prostate basal cells that is differentially enriched in various phenotypes of late-stage metastatic prostate cancer. We FACS-purified and transcriptionally profiled basal and luminal epithelial populations from the benign and cancerous regions of primary human prostates. High-throughput RNA sequencing showed the basal population to be defined by genes associated with stem cell signaling programs and invasiveness. Application of a 91-gene basal signature to gene expression datasets from patients with organ-confined or hormone-refractory metastatic prostate cancer revealed that metastatic small cell neuroendocrine carcinoma was molecularly more stem-like than either metastatic adenocarcinoma or organ-confined adenocarcinoma. Bioinformatic analysis of the basal cell and two human small cell gene signatures identified a set of E2F target genes common between prostate small cell neuroendocrine carcinoma and primary prostate basal cells. Taken together, our data suggest that aggressive prostate cancer shares a conserved transcriptional program with normal adult prostate basal stem cells. PMID:26460041

  16. Basal forebrain cholinergic system: a functional analysis.

    Science.gov (United States)

    Olton, D; Markowska, A; Voytko, M L; Givens, B; Gorman, L; Wenk, G

    1991-01-01

    This chapter has been organized empirically, focusing on the types of approaches that have been taken to understand BFCS function. This approach reflects the state of our knowledge about the behavioral and psychological functions of the BFCS. Considerable information has been gathered in the very short time that the BFCS has been the object of intense investigation. The results from the neurotoxic lesions and from the HACU studies provide some points of consistency and some puzzling differences. Both approaches to the study of basal forebrain function suggest that the MSA is involved in tasks that require spatial working memory; MSA lesions impaired choice accuracy, and HACU in the HIP was increased after performance. The pattern of results in simpler tasks is more difficult to interpret. In a left-right reference memory discrimination in a T-maze, MSA lesions did not impair acquisition or performance, whereas HACU in the HIP was activated during performance. This pattern of results suggests that although the MSA is engaged during this type of task, its activity is not necessary for normal performance. These, and other comparisons indicate the need for a systematic analysis of task demand (Olton, 1989b). Parametric manipulations of different task demands in a systematic fashion can indicate the extent to which the BFCS is involved in the function associated with each parametric manipulation. Ultimately, of course, the organization of this material should focus on particular psychological functions, rather than the techniques and procedures used to gather the information. Achieving this goal is going to require careful attention to the design of behavioral experiments so that definitive conclusions can be made about the extent to which the BFCS is involved in a given psychological function. A systematic application of task analysis can achieve this goal (Olton, 1986, 1989a, 1989b). For example, BFCS lesions in rats impair choice accuracy in spatial working memory

  17. How good are our impressions? An audit of alginate impression quality in the production of removable prostheses.

    Science.gov (United States)

    Horwitz, Richard

    2014-05-01

    Impressions are taken regularly in practice giving vital information to the dental laboratory, but are there quality assurance systems in place to make sure that they are up to a sufficient standard? As dental professionals we have to appreciate that dental technicians can only work with the information given to them. This makes the skill of taking a good impression vital in order for us as clinicians to provide prostheses of good quality. This paper outlines an audit of alginate impressions and their quality in the making of removable prostheses. To record the quality of impression taking, and how one's own ability to critique an impression may differ from that of our colleagues.

  18. Red Dot Basal Cell Carcinoma: Report of Cases and Review of This Unique Presentation of Basal Cell Carcinoma.

    Science.gov (United States)

    Cohen, Philip R

    2017-03-22

    Red dot basal cell carcinoma is a unique variant of basal cell carcinoma. Including the three patients described in this report, red dot basal cell carcinoma has only been described in seven individuals. This paper describes the features of two males and one female with red dot basal cell carcinoma and reviews the characteristics of other patients with this clinical subtype of basal cell carcinoma. A 70-year-old male developed a pearly-colored papule with a red dot in the center on his nasal tip. A 71-year-old male developed a red dot surrounded by a flesh-colored papule on his left nostril. Lastly, a 74-year-old female developed a red dot within an area of erythema on her left mid back. Biopsy of the lesions all showed nodular and/or superficial basal cell carcinoma. Correlation of the clinical presentation and pathology established the diagnosis of red dot basal cell carcinoma. The tumors were treated by excision using the Mohs surgical technique. Pubmed was searched with the keyword: basal, cell, cancer, carcinoma, dot, red, and skin. The papers generated by the search and their references were reviewed. Red dot basal cell carcinoma has been described in three females and two males; the gender was not reported in two patients. The tumor was located on the nose (five patients), back (one patient) and thigh (one patient). Cancer presented as a solitary small red macule or papule; often, the carcinoma was surrounded by erythema or a flesh-colored papule. Although basal cell carcinomas usually do not blanch after a glass microscope slide is pressed against them, the red dot basal cell carcinoma blanched after diascopy in two of the patients, resulting in a delay of diagnosis in one of these individuals. Dermoscopy may be a useful non-invasive modality for evaluating skin lesions when the diagnosis of red dot basal cell carcinoma is considered. Mohs surgery is the treatment of choice; in some of the patients, the ratio of the area of the postoperative wound to that

  19. Amyloid in basal cell carcinoma and seborrheic keratosis

    DEFF Research Database (Denmark)

    Olsen, K E; Westermark, Per

    1994-01-01

    The frequency of amyloid substance was studied in two different types of skin tumours: basal cell carcinoma and seborrheic keratosis. In 9 out of 49 cases of seborrheic keratosis amyloid substance was found. In the basal cell carcinomas, 194 out of 260 cases showed amyloid deposits, a rate...... that is higher than that previously reported. The basal cell carcinoma material was further studied regarding the amount of amyloid, mitotic rate, degree of apoptosis and the age of the patients. There was no correlation between the amount of amyloid and the mitotic rate, or the degree of apoptosis...

  20. Electromyographic evaluation of mastication and swallowing in elderly individuals with mandibular fixed implant-supported prostheses

    Directory of Open Access Journals (Sweden)

    Giédre Berretin-Felix

    2008-04-01

    Full Text Available This study evaluated the effect of implant-supported oral rehabilitation in the mandible on the electromyographic activity during mastication and swallowing in edentulous elderly individuals. Fifteen patients aged more than 60 years were evaluated, being 10 females and 5 males. All patients were edentulous, wore removable complete dentures on both dental arches, and had the mandibular dentures replaced by implant-supported prostheses. All patients were submitted to electromyographic evaluation of the masseter, superior orbicularis oris muscles, and the submental muscles, before surgery and 3, 6 and 18 months postoperatively, using foods of different textures. The results obtained at the different periods were analyzed statistically by Kruskal-Wallis non-parametric test. Statistical analysis showed that only the masseter muscle had a significant loss in electromyographic activity (p<0.001, with a tendency of similar response for the submental muscles. Moreover, there was an increase in the activity of the orbicularis oris muscle during rubber chewing after treatment, yet without statistically significant difference. Mandibular fixed implant-supported prostheses in elderly individuals revealed a decrease in electromyographic amplitude for the masseter muscles during swallowing, which may indicate adaptation to new conditions of stability provided by fixation of the complete denture in the mandibular arch.

  1. Electromyography data for non-invasive naturally-controlled robotic hand prostheses.

    Science.gov (United States)

    Atzori, Manfredo; Gijsberts, Arjan; Castellini, Claudio; Caputo, Barbara; Hager, Anne-Gabrielle Mittaz; Elsig, Simone; Giatsidis, Giorgio; Bassetto, Franco; Müller, Henning

    2014-01-01

    Recent advances in rehabilitation robotics suggest that it may be possible for hand-amputated subjects to recover at least a significant part of the lost hand functionality. The control of robotic prosthetic hands using non-invasive techniques is still a challenge in real life: myoelectric prostheses give limited control capabilities, the control is often unnatural and must be learned through long training times. Meanwhile, scientific literature results are promising but they are still far from fulfilling real-life needs. This work aims to close this gap by allowing worldwide research groups to develop and test movement recognition and force control algorithms on a benchmark scientific database. The database is targeted at studying the relationship between surface electromyography, hand kinematics and hand forces, with the final goal of developing non-invasive, naturally controlled, robotic hand prostheses. The validation section verifies that the data are similar to data acquired in real-life conditions, and that recognition of different hand tasks by applying state-of-the-art signal features and machine-learning algorithms is possible.

  2. Clinical study on the success of posterior monolithic zirconia crowns and fixed dental prostheses: preliminary report

    Directory of Open Access Journals (Sweden)

    Merve Bankoğlu Güngör

    2017-09-01

    Full Text Available Objective: The purpose of this report was to present preliminary clinical results regarding the success rates and technical outcomes of posterior monolithic zirconia single tooth crowns (STs and fixed dental prostheses (FDPs. Materials and Method: Thirty-four patients received 43 posterior monolithic zirconia restorations as single tooth crowns (STs and/or fixed dental prostheses (FDPs, which were fabricated using a CAD-CAM (Computer Aided Design - Computer Aided Manufacturing system. At baseline and every 6 months, the restorations were examined for survival and technical outcomes. Success of the restorations was defined as the restoration remaining in situ, with no need for removal or replacement at follow-up visits. Technical outcomes were evaluated with a modified version of the United States Public Health Services criteria. Survival of restorations was estimated by using the Kaplan-Meier survival analysis. For each restoration, duration of follow-up was calculated from the time of placement to the date of its first failure. Results: After a mean observation period of 18.6 ± 3.9 months (between 8-24 months, cumulative survival rates were 86.7% and 92.3% for STs and FDPs, respectively. Technical evaluation revealed good marginal adaptation and crown contours; however, modifications were needed for shade and occlusion of restorations. Conclusion: These preliminary results revealed high survival rate and generally successful technical outcomes for posterior monolithic zirconia STs and FDPs.

  3. Inducing repetitive action potential firing in neurons via synthesized photoresponsive nanoscale cellular prostheses.

    Science.gov (United States)

    Lu, Siyuan; Madhukar, Anupam

    2013-02-01

    Recently we reported an analysis that examined the potential of synthesized photovoltaic functional abiotic nanosystems (PVFANs) to modulate membrane potential and activate action potential firing in neurons. Here we extend the analysis to delineate the requirements on the electronic energy levels and the attendant photophysical properties of the PVFANs to induce repetitive action potential under continuous light, a capability essential for the proposed potential application of PVFANs as retinal cellular prostheses to compensate for loss of photoreceptors. We find that repetitive action potential firing demands two basic characteristics in the electronic response of the PVFANs: an exponential dependence of the PVFAN excited state decay rate on the membrane potential and a three-state system such that, following photon absorption, the electron decay from the excited state to the ground state is via intermediate state(s) whose lifetime is comparable to the refractory time following an action potential. In this study, the potential of synthetic photovoltaic functional abiotic nanosystems (PVFANs) is examined under continuous light to modulate membrane potential and activate action potential firing in neurons with the proposed potential application of PVFANs as retinal cellular prostheses. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Evaluation of non-conformities of hip prostheses made of titanium alloys and stainless steel

    International Nuclear Information System (INIS)

    Bezerra, Ewerton de Oliveira Teotonio; Nascimento, Jose Jeferson da Silva; Luna, Carlos Bruno Barreto; Morais, Crislene Rodrigues da Silva; Campos, Karla Valeria Miranda de

    2017-01-01

    A large number of metallic alloys has satisfactory behavior when used to manufacture implants for hip prostheses. However, they must be in conformity with standards, to ensure their quality for long periods without losing its functionality. Therefore, this paper aims to study the non-conformities in two hip prostheses, one of titanium and other stainless steel according to standards. The implants studied passed by X-ray diffraction (XRD), X-ray fluorescence, tensile test and optical microscopy (OM). Specimens for the tensile test were made according to ASTM E 8M, as well, MO samples passed by metallographic procedure. The results evidenced that some chemical compositions showed in relation to the standards. The XRD analysis showed peaks of austenite and absence of ferrite for the stainless steel, while the titanium alloy presents an alpha phase (HCP) more significant than the beta phase (BCC). The stainless steel alloys and titanium have yield strength and tensile strength that meet the standards. On the other hand, the elastic modulus of the titanium alloy and stainless steel, comes to be ten times greater than the human bone. Therefore, the high modulus of elasticity of the alloys, favors bone resorption problems. The stainless steel microstructure is typical of an austenitic matrix, while the titanium alloy presents α + β microstructure. (author)

  5. Electromyography data for non-invasive naturally-controlled robotic hand prostheses

    Science.gov (United States)

    Atzori, Manfredo; Gijsberts, Arjan; Castellini, Claudio; Caputo, Barbara; Hager, Anne-Gabrielle Mittaz; Elsig, Simone; Giatsidis, Giorgio; Bassetto, Franco; Müller, Henning

    2014-01-01

    Recent advances in rehabilitation robotics suggest that it may be possible for hand-amputated subjects to recover at least a significant part of the lost hand functionality. The control of robotic prosthetic hands using non-invasive techniques is still a challenge in real life: myoelectric prostheses give limited control capabilities, the control is often unnatural and must be learned through long training times. Meanwhile, scientific literature results are promising but they are still far from fulfilling real-life needs. This work aims to close this gap by allowing worldwide research groups to develop and test movement recognition and force control algorithms on a benchmark scientific database. The database is targeted at studying the relationship between surface electromyography, hand kinematics and hand forces, with the final goal of developing non-invasive, naturally controlled, robotic hand prostheses. The validation section verifies that the data are similar to data acquired in real-life conditions, and that recognition of different hand tasks by applying state-of-the-art signal features and machine-learning algorithms is possible. PMID:25977804

  6. Microflora on explanted silicone rubber voice prostheses: taxonomy, hydrophobicity and electrophoretic mobility.

    Science.gov (United States)

    Neu, T R; Verkerke, G J; Herrmann, I F; Schutte, H K; Van der Mei, H C; Busscher, H J

    1994-05-01

    Silicone rubber voice prostheses are implants which are inserted in a non-sterile environment and therefore become quickly colonized by micro-organisms. The micro-organisms exist on the medical grade silicone rubber as mixed biofilms of bacteria and yeasts. A total of 79 bacterial and 39 yeast strains were isolated from these biofilms by soft ultrasonic treatment. Gram-positive/catalase-negative and Gram-positive/catalase-positive cocci represented the dominant bacterial strains. The yeasts were mainly Candida species. Further characterization of cell surface properties such as hydrophobicity by microbial adhesion to hexadecane and electrophoretic mobility showed a distinct difference when the bacterial strains were compared with the yeasts. The bacterial hydrophobicities ranged from 0 to 100% adhesion to hexadecane, whereas the yeast strains, especially the Candida albicans strains, all had markedly hydrophilic cell surfaces. A comparison of the electrophoretic mobilities showed also differences between bacteria and yeast. The values for the bacteria were found to be between -2.5 to -0.5 (10(-8) m2 V-1 s-1), whereas for the yeasts electrophoretic mobilities were more positive. Based on the adhesive properties of the isolated micro-organisms, strategies can now be developed to modify the properties of the silicone rubber to reduce biofilm formation on such prostheses.

  7. Wireless radio channel for intramuscular electrode implants in the control of upper limb prostheses.

    Science.gov (United States)

    Stango, Antonietta; Yazdandoost, Kamya Yekeh; Farina, Dario

    2015-01-01

    In the last few years the use of implanted devices has been considered also in the field of myoelectric hand prostheses. Wireless implanted EMG (Electromyogram) sensors can improve the functioning of the prosthesis, providing information without the disadvantage of the wires, and the usability by amputees. The solutions proposed in the literature are based on proprietary communication protocols between the implanted devices and the prosthesis controller, using frequency bands that are already assigned to other purposes. This study proposes the use of a standard communication protocol (IEEE 802.15.6), specific for wireless body area networks (WBANs), which assign a specific bandwidth to implanted devices. The propagation losses from in-to-on body were investigated by numerical simulation with a 3D human model and an electromagnetic solver. The channel model resulting from the study represents the first step towards the development of myoelectric prosthetic hands which are driven by signals acquired by implanted sensors. However these results can provide important information to researchers for further developments, and manufacturers, which can decrease the production costs for hand prostheses having a common standard of communication with assigned frequencies of operation.

  8. 500 penile prostheses implanted by a surgeon in Italy in the last 30 years

    Directory of Open Access Journals (Sweden)

    Diego Pozza

    2015-09-01

    Full Text Available Objectives: The aim of our study was to report our experience with patients affected by Erectile Dysfunction (ED and undergoing penile prosthetic implantation (PPI in a single center by a single surgeon. Material and Methods: We retrospectively evaluated the clinical outcome of 500 patients (mean age: 51.5 years, range: 20-86 years affected by ED and referred to our private andrological center from January 1984 to December 2013 who underwent penile prosthesis implantation, including the reported level of patient satisfaction. Results: 182 silicone, 180 malleable, 18 monocomponent hydraulic and 120 multicomponents hydraulic prostheses were implanted by the same experienced surgeon. All patients were hospitalized for the procedure. All patients were evaluated immediately, 1 month (496 patients and, for the great majority, every year after implantation. One hundred twenty five patients were lost to follow-up. Twenty two patients underwent revision surgery for complications in the postoperative period. The most serious postoperative complications were mechanical problems (45 patients, 9.0% and infection (15 patients, 3%. Forty two (8.4% prostheses were explanted. Overall, 80% (400/500 of patients were able to have sexual intercourse and were fully satisfied with the results. Conclusions: In our experience prosthetic surgery should be considered a good solution for men affected by ED and not responsive to other therapeutic solutions. Prosthetic surgery can be performed not only in large public hospitals but also in smaller private facilities.

  9. Wear Distribution Detection of Knee Joint Prostheses by Means of 3D Optical Scanners

    Directory of Open Access Journals (Sweden)

    Saverio Affatato

    2017-03-01

    Full Text Available The objective of this study was to examine total knee polyethylene inserts from in vitro simulation to evaluate and display—using a 3D optical scanner—wear patterns and wear rates of inserts exposed to wear by means of simulators. Various sets of tibial inserts have been reconstructed by using optical scanners. With this in mind, the wear behavior of fixed and mobile bearing polyethylene knee configurations was investigated using a knee wear joint simulator. After the completion of the wear test, the polyethylene menisci were analyzed by an innovative 3D optical scanners in order to evaluate the 3D wear distribution on the prosthesis surface. This study implemented a new procedure for evaluating polyethylene bearings of joint prostheses obtained after in vitro wear tests and the proposed new approach allowed quantification of the contact zone on the geometry of total knee prostheses. The results of the present study showed that mobile TKPs (total knee prosthesis have lower wear resistance with respect to fixed TKPs.

  10. Quantification and identification of bacteria in acrylic resin dentures and dento-maxillary obturator-prostheses.

    Science.gov (United States)

    Takeuchi, Yasuhisa; Nakajo, Kazuko; Sato, Takuichi; Koyama, Shigeto; Sasaki, Keiichi; Takahashi, Nobuhiro

    2012-06-01

    To quantify and identify bacteria detected in acrylic resin dentures and dento-maxillary obturator-prostheses after long-term use. The internal layer of denture bases from 13 daily-use removable acrylic resin dentures was sampled, while the inner fluid samples/no-fluid samples of obturators were collected from 11 in-use acrylic resin dento-maxillary obturator-prostheses. Samples were cultured, and isolated bacteria were counted and identified by molecular biological methods. Bacteria were detected in five (38.5%) acrylic resin dentures and six (54.5%) acrylic resin obturators. Four Lactobacillus species and one Propionibacterium species were isolated from three repaired denture bases, and from two non-repaired dentures, two Actinomyces species and Streptococcus mutans were isolated. On the other hand, 17 bacterial species, belonging to the family and genera of Olsenella, Bacillus, Citrobacter, Enterobacteriaceae, Lactobacillus, Pantoea, Peptoniphilus, Klebsiella and Pseudomonas, were isolated from obturators. Several species of viable bacteria were detected in acrylic resin denture bases and obturators.

  11. Anterior Cantilever Resin-Bonded Fixed Dental Prostheses: A Review of the Literature.

    Science.gov (United States)

    Mourshed, Bilal; Samran, Abdulaziz; Alfagih, Amal; Samran, Ahalm; Abdulrab, Saleem; Kern, Matthias

    2018-03-01

    This review evaluated the survival rate of single retainer anterior resin-bonded fixed dental prostheses (RBFDPs) to determine whether the choice of material affects their clinical outcome. An electronic search of the English peer-reviewed dental literature in PubMed was conducted to identify all publications reporting on cantilever RBFDPs until May 2016. Study information extraction and methodological quality assessments were accomplished by two reviewers independently. The searched keywords were as follows: "resin-bonded, single retainer, all-ceramic resin-bonded fixed dental prostheses (RBFDPs), all-ceramic RBFDPs, cantilever resin, RBFDPs, cantilever resin-bonded bridge, two units cantilevered, two-unit cantilevered, metal-ceramic cantilever, and metal-ceramic." Furthermore, the ''Related Articles'' feature of PubMed was used to identify further references of interest within the primary search. The bibliographies of the obtained references were used to identify pertinent secondary references. Review articles were also used to identify relevant articles. After the application of exclusion criteria, the definitive list of articles was screened to extract the qualitative data, and the results were analyzed. Overall 2588 articles were dedicated at the first review phase; however, only 311 studies were left after the elimination of duplicates and unrelated studies. Seventeen studies passed the second review phase. Five studies were excluded because they were follow-up studies of the same study cohort. Twelve studies were finally selected. The use of cantilever RBFDPs showed promising results and high survival rates. © 2016 by the American College of Prosthodontists.

  12. Slow zoledronic acid releasing testis prostheses in the treatment of prostate cancer patients with bone metastases.

    Science.gov (United States)

    Serefoglu, Ege Can; Balbay, M Derya

    2009-09-01

    Surgical castration is still considered the 'gold standard' for androgen deprivation therapy which have become the mainstay for the management of advanced prostate cancer. The main drawback of this safe operation is that it may have a negative psychological effect, thus, in recent years, a decline in the utilization of bilateral orchiectomy which is the most cost-effective form of androgen deprivation therapy can be witnessed. Testicular prostheses have been shown to reduce the psychological impact resulting from loss or absence of a testicle in those patients. Besides, patients with advanced prostate cancer are at risk of skeletal complications and bisphosphonates are used in treatment. Zoledronic acid is the only bisphosphonate agent demonstrated to effectively reduce skeletal related events in patients with advanced prostate cancer metastatic to bone. Therefore, zoledronic acid releasing testicular prostheses can be used in the treatment of prostate cancer patients with bone metastases after bilateral orchiectomy. This technology has the potential to become the preferred clinical management tool for prostate cancer patients with bone metasthases after bilateral orchiectomy.

  13. [Single- and multi-unit fixed dental prostheses in relation to the occlusal system].

    Science.gov (United States)

    Witter, D J; Gerritsen, A E; van Spijker, A; Creugers, N H J

    2013-02-01

    Occlusion concepts based on functional aspects offer more solid ground in the diagnostic process and in the treatment of (reduced) dentitions than morphologically and mechanically oriented occlusion concepts. Nevertheless, for occlusal reconstruction morphologically oriented guidelines are necessary. These guidelines are based on the border movements and positions of the mandible in the orofacial system, and on the location and modelling of the occlusal contacts in the occlusal system. The modelling of single- and multi-unit fixed dental prostheses must harmonize with the occlusal system. Moreover, an important feature is the relation of the anterior teeth which enables mutually protected occlusion. Characteristics of a healthy orofacial and occlusal system are: absence of pathology, perceived sufficient oral functions, variability inform and function, and adaptive capacity. When designing single- or multiunit fixed dental prostheses, a pragmatic starting point is to maintain the existing occlusion and the existing speech pattern unless arguments can be provided for alterations. The occlusal design should aim at optimizing oral functions, such as mandibular and occlusal stability.

  14. A systematic review on marginal bone loss around short dental implants (implant-supported fixed prostheses.

    Science.gov (United States)

    Monje, Alberto; Suarez, Fernando; Galindo-Moreno, Pablo; García-Nogales, Agustín; Fu, Jia-Hui; Wang, Hom-Lay

    2014-10-01

    This systematic review aimed to evaluate the effect of implant length on peri-implant marginal bone loss (MBL) and its associated influencing factors. An electronic search of the PubMed and MEDLINE databases for relevant studies published in English from November 2006 to July 2012 was performed by one examiner (AM). Selected studies were randomized clinical trials, human experimental clinical trials or prospective studies (e.g., cohort as well as case series) with a clear aim of investigating marginal bone loss of short dental implants (implant length." Additionally, a subgroup analysis, by means of a random-effect one-way ANOVA model, comparing mean MBL values at different levels of each factor ("type of connection" and "type of prostheses") was also performed. The meta-regression of mean MBL on the moderator "implant length" was found to be insignificant (P = 0.633). Therefore, it could not be concluded that implant length had an effect on peri-implant MBL. In addition, standardized differences in mean MBL on the subgroups short (implants, as determined by the meta-analysis (random-effect model), were found to be statistically insignificant (P = 0.222). Within limitations of the present systematic review, it could be concluded that short dental implants (implant MBL as standard implants (≥ 10 mm) for implant-supported fixed prostheses. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Association between self-rated oral appearance and the need for dental prostheses among elderly Brazilians

    Directory of Open Access Journals (Sweden)

    Emília Araújo Vilela

    2013-06-01

    Full Text Available We investigated the association between poor self-rated oral appearance and the need for dental prostheses among elderly Brazilians. National data from an epidemiological survey on oral health in Brazil conducted from 2002 to 2003 by the Ministry of Health (SB, Brazil with a multistage random sample of 4,839 individuals aged 65–74 years in 250 towns were analyzed. The dependent variable was self-rated oral appearance, dichotomized into “poor” (poor∕very poor and “good” (fair∕good∕very good. The main independent variable was the need for an upper or lower dental prosthesis. Other variables included sociodemographic characteristics, approach to dental care, oral health conditions, and self-reported oral disadvantage. Data were analyzed using the chi-square test and Poisson regression models at a 95% significance level. The prevalence of poor self-rated oral appearance was 20.6% and was higher in the elderly who needed a partial or complete upper or lower prosthesis, independent of other variables. This prevalence was associated with age, the use of dental services, access to information about oral disease prevention, number of decayed teeth, self-perception of the need for treatment, dental pain, chewing ability, and the perception that oral health affects relationships with other people. The elderly who needed dental prostheses had a higher prevalence of poor self-rated oral appearance than those who did not need any.

  16. Facial skin follllicular hyperkeratosis of patients with basal cell carcinoma

    Directory of Open Access Journals (Sweden)

    M. V. Zhuchkov

    2016-01-01

    Full Text Available This article provides a clinical observation of paraneoplastic syndrome of a patient with basal cell carcinoma of skin. Authors present clinical features of the described for the first time, paraneoplastic retentional follicular hyperkeratosis of facial area.

  17. Basal ganglia calcification on computed tomography in systemic lupus erythematosus

    International Nuclear Information System (INIS)

    Nagaoka, Shohei; Tani, Kenji; Ishigatsubo, Yoshiaki

    1988-01-01

    The development of basal ganglia calcification was studied in 85 patients with systemic lupus erythematosus (SLE) by computed tomography (CT). Bilateral calcification of the basal ganglia was found to occur in 5 patients (5.9 %) with SLE, but was not seen in patients with rheumatoid arthritis and progressive systemic sclerosis. All were female with a mean age of 42 years (range 29 - 49). The patients with calcification of the basal ganglia had neurological symptoms, such as psychiatric problems (3 cases), grand mal seizures (1 case), CSF abnormalities (2 cases), and EEG changes (4 cases). There were significantly higher incidences of alopecia, cutaneous vasculitis, leukopenia, and thrombocytopenia in the group with calcifications than those in the group with normal CT findings. Circulating immune complexes were detected and LE tests were positive in 2 patients. Endocrinological examination showed no abnormality in any. We suggest that basal ganglia calcification in SLE might be related to cerebral vasculitis. (author)

  18. The Basal Cell Marker p63 and Prostate Stem Cells

    National Research Council Canada - National Science Library

    Signoretti, Sabina

    2003-01-01

    ...(s) involved in prostate carcinogenesis. The p53-homologue p63 is selectively expressed in the basal cell compartment of a variety of epithelial tissues and p63 deficient mice show severe defects in the development of epithelial organs...

  19. The Basal Cell Marker p63 and Prostate Stem Cells

    National Research Council Canada - National Science Library

    Signoretti, Sabina

    2004-01-01

    ...(s) involved in prostate carcinogenesis. The p53-homologue p63 is selectively expressed in the basal cell compartment of a variety of epithelial tissues and p63 deficient mice show severe defects in the development of epithelial organs...

  20. Computed tomography of calcification of the basal ganglia

    International Nuclear Information System (INIS)

    Park, Churl Min; Suh, Soo Jhi; Kim, Soon Yong

    1981-01-01

    Calcifications of the basal ganglia are rarely found at routine autopsies and in skull radiographs. CT is superior to the plain skull radiographs in detecting intracranial attenuation differences and may be stated to be the method of choice in the diagnosis of intracranial calcifications. Of 5985 brain CT scans performed in Kyung Hee University Hospital during past 3 years, 36 cases were found to have high attenuation lesions suggesting calcifications within basal ganglia. 1. The incidence of basal ganglia calcification on CT scan was about 0.6%. 2. Of these 36 cases, 34 cases were bilateral and the remainder was unilateral. 3. The plain skull films of 23 cases showed visible calcification of basal ganglia in 3 cases (13%). 4. No specific metabolic disease was noted in the cases

  1. Basal ganglia calcification on computed tomography in systemic lupus erythematosus

    Energy Technology Data Exchange (ETDEWEB)

    Nagaoka, Shohei; Tani, Kenji; Ishigatsubo, Yoshiaki and others

    1988-09-01

    The development of basal ganglia calcification was studied in 85 patients with systemic lupus erythematosus (SLE) by computed tomography (CT). Bilateral calcification of the basal ganglia was found to occur in 5 patients (5.9 %) with SLE, but was not seen in patients with rheumatoid arthritis and progressive systemic sclerosis. All were female with a mean age of 42 years (range 29 - 49). The patients with calcification of the basal ganglia had neurological symptoms, such as psychiatric problems (3 cases), grand mal seizures (1 case), CSF abnormalities (2 cases), and EEG changes (4 cases). There were significantly higher incidences of alopecia, cutaneous vasculitis, leukopenia, and thrombocytopenia in the group with calcifications than those in the group with normal CT findings. Circulating immune complexes were detected and LE tests were positive in 2 patients. Endocrinological examination showed no abnormality in any. We suggest that basal ganglia calcification in SLE might be related to cerebral vasculitis.

  2. Nevoid Basal Cell Carcinoma Syndrome and Hairy Skin Patches.

    Science.gov (United States)

    Notay, Manisha; Kamangar, Faranak; Awasthi, Smita; Fazel, Nasim

    2017-03-01

    We report a case of an increasing number of discrete patches of darkly pigmented terminal hair in a patient with nevoid basal cell carcinoma syndrome. This case adds to a small case series of three patients which have previously reported this observation. We report this case to highlight hairy patches as an important clinical feature associated with nevoid basal cell carcinoma syndrome. © 2017 Wiley Periodicals, Inc.

  3. Treatment of basal cell epithelioma with high energy electron beam

    Energy Technology Data Exchange (ETDEWEB)

    Ogawa, Y. (Hyogo-ken Cancer Center, Kobe (Japan)); Kumano, M.; Kumano, K.

    1981-11-01

    Thirty patients with basal cell epithelioma received high energy electron beam therapy. They were irradiated with a dose ranging from 4,800 rad (24 fractions, 35 days) to 12,000 rad (40 fractions, 57 days). Tumors disappeared in all cases. These were no disease-related deaths; in one patient there was recurrence after 2 years. We conclude that radiotherapy with high energy electron beam is very effective in the treatment of basal cell epithelioma.

  4. Bilateral basal ganglia calcifications visualised on CT scan.

    OpenAIRE

    Brannan, T S; Burger, A A; Chaudhary, M Y

    1980-01-01

    Thirty-eight cases of basal ganglia calcification imaged on computed axial tomography were reviewed. Most cases were felt to represent senescent calcification. The possibility of a vascular aetiology in this group is discussed. A less common group of patients was identified with calcification secondary to abnormalities in calcium metabolism or radiation therapy. Three cases of basal ganglia calcifications were detected in juvenile epileptic patients receiving chronic anticonvulsants. These ca...

  5. Basal Ganglia Mechanisms Underlying Precision Grip Force Control

    OpenAIRE

    Prodoehl, Janey; Corcos, Daniel M.; Vaillancourt, David E.

    2009-01-01

    The classic grasping network has been well studied but thus far the focus has been on cortical regions in the control of grasping. Sub-cortically, specific nuclei of the basal ganglia have been shown to be important in different aspects of precision grip force control but these findings have not been well integrated. In this review we outline the evidence to support the hypothesis that key basal ganglia nuclei are involved in parameterizing specific properties of precision grip force. We revi...

  6. Enigmatic basal archosauromorph from the Late Triassic of Poland

    OpenAIRE

    Toljagic, Olja

    2012-01-01

    Choristodera, a lineage of basal archosauromorphs (Reptilia: Diapsida), first appeared in Early/Middle Jurassic (possibly Late Triassic; approximately 201 million years ago) and extended all the way into early Miocene (approximately 23 million years ago). Choristoderans are the only group of more basal archosauromorphs that survived after the Jurassic period, along with Archosauriformes (a more derived group of Archosauromorphs). The time of origin of the lineage is still speculative and prec...

  7. Shell bone histology indicates terrestrial palaeoecology of basal turtles

    OpenAIRE

    Scheyer, Torsten; Sander, P. Martin

    2009-01-01

    The palaeoecology of basal turtles from the Late Triassic was classically viewed as being semi-aquatic, similar to the lifestyle of modern snapping turtles. Lately, this view was questioned based on limb bone proportions, and a terrestrial palaeoecology was suggested for the turtle stem. Here, we present independent shell bone microstructural evidence for a terrestrial habitat of the oldest and basal most well-known turtles, i.e. the Upper Triassic Proterochersis robusta and Proganochelys que...

  8. [Basal cell carcinoma. Molecular genetics and unusual clinical features].

    Science.gov (United States)

    Reifenberger, J

    2007-05-01

    Basal cell carcinoma is the most common human cancer. Its incidence is steadily increasing. The development of basal cell carcinoma is linked to genetic factors, including the individual skin phototype, as well as the cumulative exposure to UVB. The vast majority of basal cell carcinomas are sporadic tumors, while familial cases associated with certain hereditary syndromes are less common. At the molecular level, basal cell carcinomas are characterized by aberrant activation of sonic hedgehog signaling, usually due to mutations either in the ptch or smoh genes. In addition, about half of the cases carry mutations in the tp53 tumor suppressor gene, which are often UVB-associated C-->T transition mutations. Clinically, basal cell carcinomas may show a high degree of phenotypical variability. In particular, tumors occurring in atypical locations, showing an unusual clinical appearance, or imitating other skin diseases may cause diagnostic problems. This review article summarizes the current state of the art concerning the etiology, predisposition and molecular genetics of basal cell carcinoma. In addition, examples of unusual clinical manifestations are illustrated.

  9. The Shark Basal Hypothalamus: Molecular Prosomeric Subdivisions and Evolutionary Trends

    Science.gov (United States)

    Santos-Durán, Gabriel N.; Ferreiro-Galve, Susana; Menuet, Arnaud; Mazan, Sylvie; Rodríguez-Moldes, Isabel; Candal, Eva

    2018-01-01

    The hypothalamus is a key integrative center of the vertebrate brain. To better understand its ancestral morphological organization and evolution, we previously analyzed the segmental organization of alar subdivisions in the catshark Scyliorhinus canicula, a cartilaginous fish and thus a basal representative of gnathostomes (jawed vertebrates). With the same aim, we deepen here in the segmental organization of the catshark basal hypothalamus by revisiting previous data on ScOtp, ScDlx2/5, ScNkx2.1, ScShh expression and Shh immunoreactivity jointly with new data on ScLhx5, ScEmx2, ScLmx1b, ScPitx2, ScPitx3a, ScFoxa1, ScFoxa2 and ScNeurog2 expression and proliferating cell nuclear antigen (PCNA) immunoreactivity. Our study reveals a complex genoarchitecture for chondrichthyan basal hypothalamus on which a total of 21 microdomains were identified. Six belong to the basal acroterminal region, the rostral-most point of the basal neural tube; seven are described in the tuberal region (Tu/RTu); four in the perimamillar region (PM/PRM) and four in the mamillar one (MM/RM). Interestingly, the same set of genes does not necessarily describe the same microdomains in mice, which in part contributes to explain how forebrain diversity is achieved. This study stresses the importance of analyzing data from basal vertebrates to better understand forebrain diversity and hypothalamic evolution. PMID:29593505

  10. CT and MRI diagnosis of traumatic basal ganglia hemorrhage

    International Nuclear Information System (INIS)

    Wu Shike; Zhang Yalin; Xu Derong; Zou Gaowei; Chen Dan; He Sujun; Zhou Lichao

    2009-01-01

    Objective: To analyze CT and MRI features of traumatic basal ganglia hemorrhage and investigate the diagnostic value. Methods: 21 cases with traumatic basal ganglia hemorrhage diagnosed by clinic, CT and MRI in our hospital were collected in this study Plain CT scan were immediately performed in 21 cases after injury, plain MR scan were performed in 1 to 3 days. 12 cases of them underwent diffusion weighted imagine (DWI). The CT and MRI findings were retrospectively summarized. Results: 8 cases were found with simple traumatic basal ganglia hemorrhage. Complexity of basal ganglia hemorrhage occurred in 13 cases, 6 cases combined with subdural hemorrhage, 3 cases with epidural hematoma, 2 cases with subarachnoid hemorrhage, 6 cases with brain contusion and laceration in other locations, 4 cases with skull fracture. 26 lesions of basal ganglia hematoma were showed in 21 cases, 14 lesions of pallidum hemorrhage in 11 cases confirmed by MR could not be distinguished from calcification at the fast CT scan. 5 more lesions of brain contusion and laceration and 4 more lesions of brain white matter laceration were found by MR. Conclusion: CT in combination with MRI can diagnose traumatic basal ganglia hemorrhage and its complications early, comprehensively and accurately, which plays an important role in the clinical therapy selection and prognosis evaluation. (authors)

  11. Axillary basal cell carcinoma in patients with Goltz-Gorlin syndrome: report of basal cell carcinoma in both axilla of a woman with basal cell nevus syndrome and literature review

    OpenAIRE

    Cohen, Philip R

    2014-01-01

    Background: Basal cell carcinoma of the axilla, an area that is not usually exposed to the sun, is rare. Individuals with basal cell nevus syndrome, a disorder associated with a mutation in the patch 1 (PTCH1) gene, develop numerous basal cell carcinomas.Purpose: To describe a woman with basal cell nevus syndrome who developed a pigmented basal cell carcinoma in each of her axilla and to review the features of axillary basal cell carcinoma patients with Goltz-Gorlin syndrome.Methods: Pubmed w...

  12. [Evaluation of the stress distribution in tooth implant-supported fixed partial prostheses on different bone types under dynamic loads].

    Science.gov (United States)

    Zhang, Yang; Wang, Chao; Zhang, Xiaonan; Xu, Ling

    2015-06-01

    This study aims to evaluate the influence of different bone types on the stress distribution in tooth implant-supported fixed partial prostheses by using finite element (FE) analysis. Four FE models of mandibular arch containing one implant splinted to the mandibular second premolar were built according to bone types I, II, III, and IV. Dynamic loads of 250 N were applied to the buccal and lingual cusps of the prostheses in different directions to simulate the masticatory cycle. The maximum Von Mises stresses were calculated using the FE analysis software. The maximum Von Mises stresses of the cortical bones were 89.229, 91.860, 125.840, and 158.420 MPa, increasing from type I to type IV, respectively. The maximum Von Mises stresses of the trabecular bone were 58.584, 43.645, 21.688, and 18.249 MPa, decreasing from type I to type IV, respectively. During the process of dynamic loading, the maximum Von Mises stresses of the cortical and trabecular bones followed the order buccal to tongue loading>tongue to buccal loading>vertical loading. The results showed that bone type significantly influenced the stress distribution in bones, and that for tooth implant-supported fixed partial prostheses, bone types I and II were a better choice than bone types III and IV. More caution should be exercised when restoring missing teeth using tooth implant-supported fixed partial prostheses in softer bone regions.

  13. [The conventional and the digital impression method for single-unit and multi-unit fixed dental prostheses

    NARCIS (Netherlands)

    Wiersema, E.J.; Kreulen, C.M.; Creugers, N.H.J.

    2013-01-01

    To manufacture single-unit and multi-unit fixed dental prostheses, an accurate cast is required. Casts can be obtained either by the conventional or the digital impression method. For both methods, dry tooth surfaces and a well exposed finish line of the tooth preparation are required. The

  14. In vitro and in vivo microbial adhesion and growth on argon plasma-treated silicone rubber voice prostheses

    NARCIS (Netherlands)

    Everaert, EPJM; Van de Belt-Gritter, B; Van der Mei, HC; Busscher, HJ; Verkerke, GJ; Dijk, F; Mahieu, HF; Reitsma, A

    Patients who undergo a total laryngectomy usually receive a silicone rubber voice prosthesis for voice rehabilitation. Unfortunately, biofilm formation on the esophageal side of voice prostheses limits their lifetime to 3-4 mon on average. The effects of repeated argon plasma treatment of medical

  15. Objective clinical performance outcome of total knee prostheses. A study of mobile bearing knees using fluoroscopy, electromyography and roentgenstereophotogrammetry

    NARCIS (Netherlands)

    Garling, Eric Harald

    2008-01-01

    The aim of the thesis was to to assess with accurate and objective methods the function and fixation of total knee prostheses with special emphasis on mobile bearing total knee designs. The mobile bearing of a rotating platform design showed limited motion or no motion during a step-up task thereby

  16. Interference in adhesion of bacteria and yeasts isolated from explanted voice prostheses to silicone rubber by rhamnolipid biosurfactants

    NARCIS (Netherlands)

    Rodrigues, LR; Banat, IM; van der Mei, HC; Teixeira, JA; Oliveira, R

    Aims: The effects and extent of adhesion of four different bacterial and two yeast strains isolated from explanted voice prostheses to silicone rubber with and without an adsorbed rhamnolipid biosurfactant layer obtained from Pseudomonasaeruginosa DS10-129 was studied. Methods and Results: The

  17. Sport prostheses and prosthetic adaptations for the upper and lower limb amputees : an overview of peer reviewed literature

    NARCIS (Netherlands)

    Bragaru, Mihai; Dekker, Rienk; Geertzen, Jan H. B.

    Background: Sport prostheses are used by both upper- and lower-limb amputees while participating in sports and other physical activities. Although the number of these devices has increased over the past decade, no overview of the peer reviewed literature describing them has been published

  18. ENHANCED HEALING OF 30-MU-M GORE-TEX PTFE MICROARTERIAL PROSTHESES BY ALCOHOL-PRETREATMENT

    NARCIS (Netherlands)

    VANDERLEI, B; STRONCK, JW; WILDEVUUR, CRH

    1991-01-01

    Polytetrafluoroethylene (PTFE) microvascular prostheses with a fibril length of 30-mu-m were pretreated with alcohol (n = 18), implanted into the abdominal aorta of rats and were evaluated at 1 day (n = 3), 1 week (n = 3), 3 weeks (n = 6) and 6 weeks (n = 6) to determine whether alcohol-pretreatment

  19. [Determining and recording maxillomandibular relationships for the fabrication of single-unit and multi-unit fixed dental prostheses

    NARCIS (Netherlands)

    Wiersema, E.J.; Kreulen, C.M.; Baat, C. de; Witter, D.J.; Creugers, N.H.J.

    2013-01-01

    In a correctly functioning occlusal system, the design of the occlusal parts of single-unit and multi-unit fixed dental prostheses is generally determined by the maximum intercuspation. Determining and recording the maxillomandibular relationships is only required in case the adjacent teeth do not

  20. Effect of dairy products on the lifetime of Provox2 voice prostheses in vitro and in vivo

    NARCIS (Netherlands)

    Schwandt, LQ; van Weissenbruch, R; van der Mei, HC; Busscher, HJ; Albers, FWJ

    Background. Reduction of biofilm formation on tracheoesophageal voice prostheses by certain dairy products might extend their clinical lifetime. The purpose of this study was to determine the influence of certain dairy products on voice prosthetic biofilms and lifetimes in vitro and in vivo.