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Sample records for bones of upper extremity

  1. Bone multicentric epithelioid hemangioendothelioma of the lower and upper extremities with pulmonary metastases: A case report

    Science.gov (United States)

    ZHANG, HUA; FU, YANBIAO; YE, ZHAOMING

    2015-01-01

    The present study reports a rare case of bone multicentric epithelioid hemangioendothelioma (EH) involving the upper and lower extremities simultaneously, with visceral involvement of the lung. Osteolytic lesions were first identified in the right distal femur and proximal tibia. Slight increased radionuclide uptake was observed in the right shoulder joint on bone scintigraphy, however, this was ignored, as no clinical symptoms were present. The patient was initially misdiagnosed with multifocal chondroblastoma, and an extra-articular curettage of lesions was performed in the proximal tibia and medial femoral condyle, which was filled with bone cement. The histopathological diagnosis was corrected post-operatively following immunohistochemical analysis, which indicated EH, and subsequently, an amputation of the right leg at thigh level was performed. In addition, multiple lytic lesions in the right shoulder joint and pulmonary metastases were identified on whole-body radiological examination. Radiotherapy was administered to the right shoulder joint, however, the patient refused chemotherapy or further surgery. At 15 months after the initial surgery, the patient currently remains alive. This case indicates that an improved understanding with regard to the clinical features of this disease may prevent misdiagnosis and improve EH treatment. PMID:26137035

  2. Angiography of the upper extremity

    International Nuclear Information System (INIS)

    This thesis provides a description of the technical and medical aspects of arteriography of the upper extremity and an extensive analysis of the angiographic anatomy and pathology of 750 selective studies performed in more than 500 patients. A short historical review is provided of angiography as a whole and of arteriography of the hand in particular. The method of percutaneous transfemoral catheterization of the arteries of the upper extremity and particularly the arteries of the hand is considered, discussing the problems the angiographer encounters frequently, describing the angiographic complications which may occur and emphasizing the measures to keep them to a minimum. The use of vasodilators in hand angiography is discussed. A short description of the embryological patterns persisting in the arteries of the arm is included in order to understand the congenital variations of the arteries of the upper extremity. The angiographic patterns and clinical aspects of the most common pathological processes involving the arteries of the upper extremities are presented. Special attention is paid to the correlation between angiography and pathology. (Auth.)

  3. Current management of the mangled upper extremity.

    Science.gov (United States)

    Bumbasirevic, Marko; Stevanovic, Milan; Lesic, Aleksandar; Atkinson, Henry D E

    2012-11-01

    Mangled describes an injury caused by cutting, tearing, or crushing, which leads to the limb becoming unrecognizable; in essence, there are two treatment options for mangled upper extremities, amputation and salvage reconstruction. With advances in our understanding of human physiology and basic science, and with the development of new fixation devices, modern microsurgical techniques and the possibility of different types of bony and soft tissue reconstruction, the clinical and functional outcomes are often good, and certainly preferable to those of contemporary prosthetics. Early or even immediate (emergency) complete upper extremity reconstruction appears to give better results than delayed or late reconstruction and should be the treatment of choice where possible. Before any reconstruction is attempted, injuries to other organs must be excluded. Each step in the assessment and treatment of a mangled extremity is of utmost importance. These include radical tissue debridement, prophylactic antibiotics, copious irrigation with a lavage system, stable bone fixation, revascularization, nerve repair, and soft tissue coverage. Well-planned and early rehabilitation leads to a better functional outcome. Despite the use of scoring systems to help guide decisions and predict outcomes, the decision to reconstruct or to amputate still ultimately lies with the surgical judgment and experience of the treating surgeon.

  4. Intra-arterial Autologous Bone Marrow Cell Transplantation in a Patient with Upper-extremity Critical Limb Ischemia

    International Nuclear Information System (INIS)

    Induction of therapeutic angiogenesis by autologous bone marrow mononuclear cell transplantation has been identified as a potential new option in patients with advanced lower-limb ischemia. There is little evidence of the benefit of intra-arterial cell application in upper-limb critical ischemia. We describe a patient with upper-extremity critical limb ischemia with digital gangrene resulting from hypothenar hammer syndrome successfully treated by intra-arterial autologous bone marrow mononuclear cell transplantation.

  5. Intra-arterial Autologous Bone Marrow Cell Transplantation in a Patient with Upper-extremity Critical Limb Ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Madaric, Juraj, E-mail: jurmad@hotmail.com [National Institute of Cardiovascular Diseases (NUSCH) and Slovak Medical University, Department of Cardiology and Angiology (Slovakia); Klepanec, Andrej [National Institute of Cardiovascular Diseases, Department of Diagnostic and Interventional Radiology (Slovakia); Mistrik, Martin [Clinic of Hematology and Transfusiology, Faculty Hospital (Slovakia); Altaner, Cestmir [Slovak Academy of Science, Institute of Experimental Oncology (Slovakia); Vulev, Ivan [National Institute of Cardiovascular Diseases, Department of Diagnostic and Interventional Radiology (Slovakia)

    2013-04-15

    Induction of therapeutic angiogenesis by autologous bone marrow mononuclear cell transplantation has been identified as a potential new option in patients with advanced lower-limb ischemia. There is little evidence of the benefit of intra-arterial cell application in upper-limb critical ischemia. We describe a patient with upper-extremity critical limb ischemia with digital gangrene resulting from hypothenar hammer syndrome successfully treated by intra-arterial autologous bone marrow mononuclear cell transplantation.

  6. Quantitative three-phase bone scintigraphy in the evaluation of intravenous regional blockade treatment in patients with stage-I reflex sympathetic dystrophy of upper extremity

    International Nuclear Information System (INIS)

    The objective this study was to investigate the role of quantitative three phase bone scintigraphy (QTPBS) in the evaluation of efficacy of intravenous regional blockade treatment in patients having reflex sympathetic dystrophy (RSD) of the upper extremity. Twenty-six patients with stage-I RSD were focused on in this study. Patients were treated with physical therapy and intravenous (I.V.) regional blockade therapy consisting of dexamethasone and lidocaine. All patients were clinically evaluated before and 1 month after the completion of the therapy protocol. QTPBS was applied to patients before therapy and 1 month after the therapy. As a control group, 11 healthy subjects also underwent QTPBS. Perfusion, hyperemic and fixation indices were calculated from three-phase bone scintigraphy. All patients showed statistically significant clinical improvement after the therapy (p<0.01). Pre-treatment, perfusion (1.67±0.63), hyperemic (1.44±0.48) and fixation (1.69±0.48) indices of patients were higher than those of healthy subjects (perfusion index (PI): 0.95±0.05, hyperemic index (HI): 0.94±0.06, fixation (FI): 1.01±0.2) (p<0.01) and all indices significantly decreased after the treatment (PI: 1.33±0.46, HI: 1.18±0.23, FI: 1.42±0.26) (p<0.01). I.V. regional blockade therapy combined with corticosteroids is a simple, safe and effective method for the treatment of patients with stage-I RSD in the upper extremity. QTPBS is a valuable and objective method to evaluate the response to therapy and may be useful for staging of patients and predicting the response to therapy. (authors)

  7. Deep venous thrombosis of the upper extremity

    DEFF Research Database (Denmark)

    Klitfod, Lotte; Broholm, R; Baekgaard, N

    2013-01-01

    Upper extremity deep venous thrombosis (UEDVT) occurs either spontaneously, as a consequence of strenuous upper limb activity (also known as the Paget-Schroetter syndrome) or secondary to an underlying cause. Primary and secondary UEDVT differs in long-term sequelae and mortality. This review...... to the condition. Malignancy and therapeutic interventions are major risk factors for the secondary deep vein thrombosis in combination with the patient's characteristics, comorbidities and prior history of deep vein thrombosis. Complications: recurrent deep venous thrombosis, pulmonary embolism and Post...

  8. Current management of the mangled upper extremity

    OpenAIRE

    Bumbasirevic, Marko; Stevanovic, Milan; Lesic, Aleksandar; Atkinson, Henry D. E.

    2012-01-01

    Mangled describes an injury caused by cutting, tearing, or crushing, which leads to the limb becoming unrecognizable; in essence, there are two treatment options for mangled upper extremities, amputation and salvage reconstruction. With advances in our understanding of human physiology and basic science, and with the development of new fixation devices, modern microsurgical techniques and the possibility of different types of bony and soft tissue reconstruction, the clinical and functional ou...

  9. Radiogrammetric analysis of upper limb long bones

    Directory of Open Access Journals (Sweden)

    Stojanović Zlatan

    2011-01-01

    Full Text Available Radiogrammetry is radiological method of bone mineral density quantification. Besides giving an insight in diagnostics and evolution of metabolic bone disorders (osteoporosis, osteomalacia, osteitis deformans- Paget's disease, it can also explain some specific biomechanical characteristics of bone structures. The aim of this study is to evaluate the significance and perspectives of radiogrammetry as a scientific model for further inquiry of skeletal system. The work demonstrates mathematical parameters (Ca-Cortical area, CI- Cortical index, GI- Garn's index, ESI- Exton Smith's index of upper limb long bones (humerus, radius, ulna. Two standard radiological projections of bones were taken: antero-posterior (AP and latero-lateral (LL. Correlation with metacarpal and lower limb bones was also performed. The value of the cortical area of humerus is significantly higher comparing with the two other examined bones (Xmean 2,2443 cm2, p < 0.01. Radial bone has the highest values of the relational mathematical parameters, which implicates its higher strength by volumetric unit concerning humerus and ulna. Despite the development of contemporary osteometric procedures (ultrasound densitometry, dual X-ray absorptiometry, digital X-ray radiogrammetry, the classical radiogrammetry sustains its important role in diagnostics of metabolic bone disorders and it can be successfully used for biomechanical inquiry of skeletal system.

  10. Reliability of the mangled extremity severity score in combat-related upper and lower extremity injuries

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    Tolga Ege

    2015-01-01

    Full Text Available Background: Decision of limb salvage or amputation is generally aided with several trauma scoring systems such as the mangled extremity severity score (MESS. However, the reliability of the injury scores in the settling of open fractures due to explosives and missiles is challenging. Mortality and morbidity of the extremity trauma due to firearms are generally associated with time delay in revascularization, injury mechanism, anatomy of the injured site, associated injuries, age and the environmental circumstance. The purpose of the retrospective study was to evaluate the extent of extremity injuries due to ballistic missiles and to detect the reliability of mangled extremity severity score (MESS in both upper and lower extremities. Materials and Methods: Between 2004 and 2014, 139 Gustillo Anderson Type III open fractures of both the upper and lower extremities were enrolled in the study. Data for patient age, fire arm type, transporting time from the field to the hospital (and the method, injury severity scores, MESS scores, fracture types, amputation levels, bone fixation methods and postoperative infections and complications retrieved from the two level-2 trauma center's data base. Sensitivity, specificity, positive and negative predictive values of the MESS were calculated to detect the ability in deciding amputation in the mangled limb. Results: Amputation was performed in 39 extremities and limb salvage attempted in 100 extremities. The mean followup time was 14.6 months (range 6–32 months. In the amputated group, the mean MESS scores for upper and lower extremity were 8.8 (range 6–11 and 9.24 (range 6–11, respectively. In the limb salvage group, the mean MESS scores for upper and lower extremities were 5.29 (range 4–7 and 5.19 (range 3–8, respectively. Sensitivity of MESS in upper and lower extremities were calculated as 80% and 79.4% and positive predictive values detected as 55.55% and 83.3%, respectively. Specificity of MESS

  11. Congenital monomelic muscular hypertrophy of the upper extremity.

    NARCIS (Netherlands)

    Gilhuis, H.J.; Zophel, O.T.; Lammens, M.M.Y.; Zwarts, M.J.

    2009-01-01

    Pathological muscular hypertrophy results from either muscular or neurogenic damage. Rarely, it is caused by a congenital malformation consisting of a unilateral muscular hyperplasia of the upper extremity. We report on a young woman with an enlargement of the right upper extremity. Electromyography

  12. Multibody model of the human upper extremity for fracture simulation

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    Milanowicz, Marcin; Kędzior, Krzysztof

    2016-01-01

    About 3.8 million people are injured in accidents at work in Europe every year. The resulting high costs are incurred by the victims themselves, their families, employers and society. We have used a numerical simulation to reconstruct accidents at work for several years. To reconstruct these accidents MADYMO R7.5 with a numerical human model (pedestrian model) is used. However, this model is dedicated to the analysis of car-to-pedestrian accidents and thus cannot be fully used for reconstructing accidents at work. Therefore, we started working on the development of a numerical model of the human body for the purpose of simulating accidents at work. Developing a new numerical model which gives an opportunity to simulate fractures of the upper extremity bones is a stage of that work. PMID:26651896

  13. Multibody model of the human upper extremity for fracture simulation.

    Science.gov (United States)

    Milanowicz, Marcin; Kędzior, Krzysztof

    2016-09-01

    About 3.8 million people are injured in accidents at work in Europe every year. The resulting high costs are incurred by the victims themselves, their families, employers and society. We have used a numerical simulation to reconstruct accidents at work for several years. To reconstruct these accidents MADYMO R7.5 with a numerical human model (pedestrian model) is used. However, this model is dedicated to the analysis of car-to-pedestrian accidents and thus cannot be fully used for reconstructing accidents at work. Therefore, we started working on the development of a numerical model of the human body for the purpose of simulating accidents at work. Developing a new numerical model which gives an opportunity to simulate fractures of the upper extremity bones is a stage of that work. PMID:26651896

  14. Skin Cancer of the Hand and Upper Extremity

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    ... a Hand Therapist? Media Find a Hand Surgeon Skin Cancer of the Hand and Upper Extremity Email to ... cell carcinoma is the most common type of skin cancer of the hand, followed by basal cell carcinoma ...

  15. A Case Report on Upper Extremity Pain of Cardiac Origin

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    Turgay Altınbilek

    2016-08-01

    Full Text Available Upper extremity pain can originate from the musculoskeletal system, or be a reflection of problems originating from various organs. Therefore, it is highly important to perform a detailed clinical evaluation on patients during differential diagnosis. In this case report, we present a 61 year-old male patient who was admitted with pain in both upper extremities and the upper back that presumed to be of cardiac origin following our clinical evaluations. The patient was referred to the cardiology department, where he was diagnosed with coronary heart disease. The patient’s complaints of pain were fully resolved through the application of an intracoronary stent.

  16. Application of RFID technology-upper extremity rehabilitation training.

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    Chen, Chih-Chen; Chen, Yu-Luen; Chen, Shih-Ching

    2016-01-01

    [Purpose] Upper extremity rehabilitation after an injury is very important. This study proposes radio frequency identification (RFID) technology to improve and enhance the effectiveness of the upper extremity rehabilitation. [Subjects and Methods] People use their upper extremities to conduct daily activities. When recovering from injuries, many patients neglect the importance of rehabilitation, which results in degraded function. This study recorded the training process using the traditional rehabilitation hand gliding cart with a RFID reader, RFID tags in the panel, and a servo host computer. [Results] Clinical evidence, time taken to achieve a full score, counts of missing the specified spots, and Brunnstrom stage of aided recovery, the proximal part of the upper extremity show that the RFID-based upper extremity training significantly and reduce negative impacts of the disability in daily life and activities. [Conclusion] This study combined a hand-gliding cart with an RFID reader, and when patients moved the cart, the movement could be observed via the activated RFID tags. The training data was collected and quantified for a better understanding of the recovery status of the patients. Each of the participating patients made progress as expected.

  17. Application of RFID technology-upper extremity rehabilitation training.

    Science.gov (United States)

    Chen, Chih-Chen; Chen, Yu-Luen; Chen, Shih-Ching

    2016-01-01

    [Purpose] Upper extremity rehabilitation after an injury is very important. This study proposes radio frequency identification (RFID) technology to improve and enhance the effectiveness of the upper extremity rehabilitation. [Subjects and Methods] People use their upper extremities to conduct daily activities. When recovering from injuries, many patients neglect the importance of rehabilitation, which results in degraded function. This study recorded the training process using the traditional rehabilitation hand gliding cart with a RFID reader, RFID tags in the panel, and a servo host computer. [Results] Clinical evidence, time taken to achieve a full score, counts of missing the specified spots, and Brunnstrom stage of aided recovery, the proximal part of the upper extremity show that the RFID-based upper extremity training significantly and reduce negative impacts of the disability in daily life and activities. [Conclusion] This study combined a hand-gliding cart with an RFID reader, and when patients moved the cart, the movement could be observed via the activated RFID tags. The training data was collected and quantified for a better understanding of the recovery status of the patients. Each of the participating patients made progress as expected. PMID:27065539

  18. Experience of using vascularized bone grafts in reconstructive surgery of the upper limbs

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    Atamanov, E. A.; Keosyan, V. T.; Bryukhanov, A. V.; Tsaregorodtseva, E. M.; Danilov, A. V.

    2015-11-01

    The article describes the results of treatment patients with defects and diseases of bone tissue using bone grafting with vascularized bone grafts from different areas of the body. The results of treatment of 27 patients with bone tissue defects of the upper extremities are demonstrated. 16 of patients had scaphoid nonunion. 2 cases of nonunion were reported: one scaphoid nonunion due to unstable osteosynthesis and one lunate fragmentation nonunion in patient with late stage Kienbock`s disease. Vascularized bone graft from distal radius was used in both cases. We had two cases of delayed union at 18 months in surgical treatment of scaphoid. 2 patients had metacarpal bone defect, 1 patient with radius bone defect, 2 patients with SLAC (scapholunate advanced collapse), 2 patients with bone defect of the humerus, 1 patient with bone defect of the ulna. In all cases we used vascularized bone crafts from various anatomical areas. We achieved union in all other cases. The study shows high efficiency of upper extremity bone defect replacement methods.

  19. PERIPHERAL BLOCK ANESTHESIA OF UPPER EXTREMITY AND ITS COMPLICATIONS

    OpenAIRE

    Tapar, Hakan; SÜREN, Mustafa; Kaya, Ziya; Arıcı, Semih; Karaman, Serkan; Kahveci, Mürsel

    2012-01-01

    Successful peripheral blocks and selection of appropriate technique according to surgery is possible with a good knowledge of anatomy. Regional peripheral block anesthesia of upper extremity which applied by single injection to plexus brachialis is the most recommended method of anesthesia in daily surgical procedures. The most important advantages of peripheral nerve blocks which are type of regional anesthesia according to general anesthesia and central blocks are less effect to...

  20. Upper Extremity Proprioceptive Training

    OpenAIRE

    Partin, Nina B.; Stone, Jennifer A; Ryan, Edward J.; Lueken, Joseph S.; Timm, Kent E.

    1994-01-01

    Proprioception following lower extremity injuries is commonly recommended, but there is little information on proprioception training following upper extremity injuries. No studies have evaluated whether proprioception programs for athletes in open kinetic chain activities (throwing, shot putting) should be different than programs for athletes in closed kinetic chain activities (gymnastics, swimming, kayaking, or rowing). In this paper, we provide a rationale for proprioception training for u...

  1. Modelling and control of an upper extremity exoskeleton for rehabilitation

    Science.gov (United States)

    Taha, Zahari; Majeed, Anwar P. P. Abdul; Tze, Mohd Yashim Wong Paul; Abdo Hashem, Mohammed; Mohd Khairuddin, Ismail; Azraai Mohd Razman, Mohd

    2016-02-01

    This paper presents the modelling and control of a two degree of freedom upper extremity exoskeleton for rehabilitation. The Lagrangian formulation was employed to obtain the dynamic modelling of both the anthropometric based human upper limb as well as the exoskeleton that comprises of the upper arm and the forearm. A proportional-derivative (PD) architecture is employed to investigate its efficacy performing a joint task trajectory tracking in performing flexion/extension on the elbow joint as well as the forward adduction/abduction on the shoulder joint. An active force control (AFC) algorithm is also incorporated into the aforementioned controller to examine its effectiveness in compensating disturbances. It was found from the study that the AFC-PD performed well against the disturbances introduced into the system without compromising its tracking performances as compared to the conventional PD control architecture.

  2. The effect of upper extremity weight bearing on upper extremity function in children with hemiplegic type of cerebral palsy

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    P. Jayaraman

    2010-02-01

    Full Text Available The main objective of this study was to quantify the effects ofweight bearing on upper limb function in children with hemiplegic cerebralpalsy. This study also sought to monitor the change in spasticity immediatelyfollowing weight bearing exercises. A  quasi-experimental, one group pre-test,post-test design was used. Eleven children with hemiplegic type of cerebral palsyfrom a special school in KwaZulu Natal participated after fully informed consentof the caretaking guardian. The intervention consisted of a standardized programof weight bearing. The Melbourne A ssessment of Upper Extremity function wasused to quantify upper extremity function of reach, grasp and manipulation and the modified A shworth grading of spasticity was used to grade and monitor spasticity. The data was analysed using the Wilcoxon signed rank test.  A  significant decrease in spasticity during elbow extension (p= 0,004, wrist flexion (p=0,026 and extension (p=0,004was noted. Statistically significant improvement in function, reach (p=0, 00, grasp (p=0, 02 manipulation (p=0, 05and overall quality of function (p= 0,003 was also found. A n overall significant effect of weight bearing exercises onupper extremity function was noted providing evidence for practice.

  3. CRPS of the upper or lower extremity: surgical treatment outcomes

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    Rosson Gedge D

    2009-02-01

    Full Text Available Abstract The hypothesis is explored that CRPS I (the "new" RSD persists due to undiagnosed injured joint afferents, and/or cutaneous neuromas, and/or nerve compressions, and is, therefore, a misdiagnosed form of CRPS II (the "new" causalgia. An IRB-approved, retrospective chart review on a series of 100 consecutive patients with "RSD" identified 40 upper and 30 lower extremity patients for surgery based upon their history, physical examination, neurosensory testing, and nerve blocks. Based upon decreased pain medication usage and recovery of function, outcome in the upper extremity, at a mean of 27.9 months follow-up (range of 9 to 81 months, gave results that were excellent in 40% (16 of 40 patients, good in 40% (16 of 40 patients and failure 20% (8 of 40 patients. In the lower extremity, at a mean of 23.0 months follow-up (range of 9 to 69 months the results were excellent in 47% (14 of 30 patients, good in 33% (10 of 30 patients and failure 20% (6 of 30 patients. It is concluded that most patients referred with a diagnosis of CRPS I have continuing pain input from injured joint or cutaneous afferents, and/or nerve compressions, and, therefore, similar to a patient with CRPS II, they can be treated successfully with an appropriate peripheral nerve surgical strategy.

  4. Electrodiagnosis of brachial plexopathies and proximal upper extremity neuropathies.

    Science.gov (United States)

    Simmons, Zachary

    2013-02-01

    This article describes the normal anatomy of the brachial plexus and its major terminal branches, as well as the major causes and clinical presentations of lesions of these structures. An approach to electrodiagnosis of brachial plexopathies and proximal upper extremity neuropathies is provided, with an emphasis on those nerve conduction studies and portions of the needle examination, which permit localization of lesions to specific trunks, cords, and terminal branches. The importance of specific sensory nerve conduction studies for differentiating plexopathies from radiculopathies and mononeuropathies is emphasized.

  5. A review of bilateral training for upper extremity hemiparesis.

    Science.gov (United States)

    Stoykov, Mary Ellen; Corcos, Daniel M

    2009-01-01

    Upper extremity hemiparesis is the most common post-stroke disability. Longitudinal studies have indicated that 30-66% of stroke survivors do not have full arm function 6 months post-stroke. The current gold standard for treatment of mild post-stroke upper limb impairment is constraint-induced therapy but, because of the inclusion criteria, alternative treatments are needed which target more impaired subjects. Bilateral arm training has been investigated as a potential rehabilitation intervention. Bilateral arm training encompasses a number of methods including: (1) bilateral isokinematic training; (2) mirror therapy using bilateral training; (3) device-driven bilateral training; and (4) bilateral motor priming. Neural mechanisms mediating bilateral training are first reviewed. The key bilateral training studies that have demonstrated evidence of efficacy will then be discussed. Finally, conclusions are drawn concerning clinical implications based on the reviewed literature. PMID:19517519

  6. [Upper extremity arterial diseases].

    Science.gov (United States)

    Becker, F

    2007-02-01

    Compared to lower limb arterial diseases, upper limb arterial diseases look rare, heterogeneous with various etiologies and a rather vague clinical picture, but with a negligible risk of amputation. Almost all types of arterial diseases can be present in the upper limb, but the anatomical and hemodynamic conditions particular to the upper limb often confuse the issue. Thus, atherosclerosis affects mainly the subclavian artery in its proximal segment where the potential of collateral pathway is high making the symptomatic forms not very frequent whereas the prevalence of subclavian artery stenosis or occlusion is relatively high. The clinical examination and the etiologies are discussed according to the clinical, anatomical and hemodynamic context.

  7. Tumors involving the skin of the upper extremity.

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    Fleegler, E J

    1987-05-01

    This review can only introduce the subject of tumors found involving the skin of the upper extremity. Many benign masses as well as some malignant tumors have to be considered when a patient calls to the physician's attention a lump, firm area, color change, ulcer, or other alteration in the skin. In response, the physician must have a high index of suspicion, take a careful history, and carry out a thorough examination in order to develop a safe approach. Thought has to be given to the complex anatomy of this area. Understanding of the pathophysiology of tumors and of possible later additional therapy is needed to plan an appropriate biopsy. In the brief discussions of treatment, the difficulty in choosing margins of resection and assessing the efficacy of lymph node dissection is mentioned. An open mind and assessment of future reports of studies in progress may be helpful. Whatever treatment is applied to the malignant tumors under consideration, it is my opinion that one must persist in this until one obtains tumor-free margins. The surgeon undertaking this responsibility must apply the same tumor techniques including operating room discipline that would be applied to any serious malignancy. Consultation and careful work with colleagues that are able to assess the potential for response to chemotherapy, immunotherapy, and/or radiotherapy, should be sought. Subtle hazards in our environment, such as changing risk of sun exposure, industrial chemicals, and irradiation should be pointed out to our patients. These are a challenge to the student of this subject, just as tobacco products are to those involved with malignancies of the head and neck, respiratory, and other systems. All of the previously mentioned methods must be used in the anatomically complex upper extremity to preserve function while ridding the patient of the burden of a disfiguring or painful benign process, or even a life-threatening malignancy. PMID:3034925

  8. Complete 3D kinematics of upper extremity functional tasks.

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    van Andel, Carolien J; Wolterbeek, Nienke; Doorenbosch, Caroline A M; Veeger, DirkJan H E J; Harlaar, Jaap

    2008-01-01

    Upper extremity (UX) movement analysis by means of 3D kinematics has the potential to become an important clinical evaluation method. However, no standardized protocol for clinical application has yet been developed, that includes the whole upper limb. Standardization problems include the lack of a single representative function, the wide range of motion of joints and the complexity of the anatomical structures. A useful protocol would focus on the functional status of the arm and particularly the orientation of the hand. The aim of this work was to develop a standardized measurement method for unconstrained movement analysis of the UX that includes hand orientation, for a set of functional tasks for the UX and obtain normative values. Ten healthy subjects performed four representative activities of daily living (ADL). In addition, six standard active range of motion (ROM) tasks were executed. Joint angles of the wrist, elbow, shoulder and scapula were analyzed throughout each ADL task and minimum/maximum angles were determined from the ROM tasks. Characteristic trajectories were found for the ADL tasks, standard deviations were generally small and ROM results were consistent with the literature. The results of this study could form the normative basis for the development of a 'UX analysis report' equivalent to the 'gait analysis report' and would allow for future comparisons with pediatric and/or pathologic movement patterns.

  9. Obesity-induced Upper Extremity Lymphedema

    OpenAIRE

    Arin K. Greene, MD, MMSc; Reid A. Maclellan, MD, MMSc

    2013-01-01

    Summary: Obesity increases the risk of upper extremity lymphedema following treatment for breast cancer and can cause lower extremity lymphatic dysfunction in extremely obese individuals. We report the first patient with obesity-induced upper extremity lymphedema. A 62-year-old man with a previous body mass index (BMI) of 105.6, presented with a BMI 60.3 following weight loss. He complained of lymphedema of all 4 extremities, which was confirmed by lymphoscintigraphy. Because the upper limbs ...

  10. Systematic review of the effectiveness of mirror therapy in upper extremity function

    NARCIS (Netherlands)

    Ezendam, Danielle; Bongers, Raoul M.; Jannink, Michiel J. A.

    2009-01-01

    Purpose. This review gives an overview of the current state of research regarding the effectiveness of mirror therapy in upper extremity function. Method. A systematic literature search was performed to identify studies concerning mirror therapy in upper extremity. The included journal articles were

  11. Technology improves upper extremity rehabilitation.

    Science.gov (United States)

    Kowalczewski, Jan; Prochazka, Arthur

    2011-01-01

    Stroke survivors with hemiparesis and spinal cord injury (SCI) survivors with tetraplegia find it difficult or impossible to perform many activities of daily life. There is growing evidence that intensive exercise therapy, especially when supplemented with functional electrical stimulation (FES), can improve upper extremity function, but delivering the treatment can be costly, particularly after recipients leave rehabilitation facilities. Recently, there has been a growing level of interest among researchers and healthcare policymakers to deliver upper extremity treatments to people in their homes using in-home teletherapy (IHT). The few studies that have been carried out so far have encountered a variety of logistical and technical problems, not least the difficulty of conducting properly controlled and blinded protocols that satisfy the requirements of high-level evidence-based research. In most cases, the equipment and communications technology were not designed for individuals with upper extremity disability. It is clear that exercise therapy combined with interventions such as FES, supervised over the Internet, will soon be adopted worldwide in one form or another. Therefore it is timely that researchers, clinicians, and healthcare planners interested in assessing IHT be aware of the pros and cons of the new technology and the factors involved in designing appropriate studies of it. It is crucial to understand the technical barriers, the role of telesupervisors, the motor improvements that participants can reasonably expect and the process of optimizing IHT-exercise therapy protocols to maximize the benefits of the emerging technology. PMID:21763524

  12. A pilot study of myoelectrically controlled FES of upper extremity

    NARCIS (Netherlands)

    Thorsen, Rune; Spadone, Rafaella; Ferrarin, Maurizio

    2001-01-01

    Functional electrical stimulation (FES) of upper limbs can be used for the recovery of some hand functions on patients with CNS lesions. This study deals with the control of FES by means of myoelectrical activity detected from voluntarily activated paretic muscles. The specific aim of this paper is

  13. Analysis of upper-extremity performance in athletes and musicians.

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    An, K N; Bejjani, F J

    1990-08-01

    Injuries can result from direct or indirect trauma and overuse in sports and the performing arts. These injuries occur when the objective exceeds the physiologic tolerance. Biomechanics analysis enables the estimation of the capacities of the body as well as the loading environment encountered by the tendons, muscles, bones, and joints during various types of sports and musical activities.

  14. Motor Cortex Stimulation for the Treatment of Chronic Facial, Upper Extremity, and Throat Pain.

    Science.gov (United States)

    2016-02-22

    Trigeminal Neuralgia (Burchiel Type I); Trigeminal Neuralgia (Burchiel Type II); Trigeminal Neuropathic Pain; Trigeminal Deafferentation Pain; Complex Regional Pain Syndrome (Types I and II, Involving the Upper Extremity); Glossopharyngeal Neuralgia; Upper Extremity Pain Due to Deafferentation of the Cervical Spine; Central Pain Syndromes

  15. Reliability of the mangled extremity severity score in combat-related upper and lower extremity injuries

    OpenAIRE

    Tolga Ege; Aytekin Unlu; Huseyin Tas; Dogan Bek; Selim Turkan; Aytac Cetinkaya

    2015-01-01

    Background: Decision of limb salvage or amputation is generally aided with several trauma scoring systems such as the mangled extremity severity score (MESS). However, the reliability of the injury scores in the settling of open fractures due to explosives and missiles is challenging. Mortality and morbidity of the extremity trauma due to firearms are generally associated with time delay in revascularization, injury mechanism, anatomy of the injured site, associated injuries, age and the envi...

  16. Injuries sustained to the upper extremity due to modern warfare and the evolution of care.

    Science.gov (United States)

    Hofmeister, Eric P; Mazurek, Michael; Ingari, Jack

    2007-10-01

    The formation of the American Society for Surgery of the Hand was related to world conflicts and hostilities. Therefore, it is appropriate that upper-extremity surgeons understand injuries resulting from modern-day combat. Because of ongoing warfare, many countries have experienced a large increase in the number of wounded service members and civilians, particularly wounds of the extremities. As a result of increased rate of survival in battlefield trauma in part because of the use of modern body armor, there is increasing complexity of extremity injuries that require complex reconstructions. Decreased mortality and a consequent increase in the incidence of injured extremities underline the need for the development of new treatment options. The purpose of this presentation is to describe upper-extremity injury patterns in modern warfare, the levels of care available, and the treatment at each level of care based on the experience of the United States Military Medical Support System.

  17. Magnetic resonance angiographic assessment of upper extremity vessels prior to vascular access surgery: feasibility and accuracy

    Energy Technology Data Exchange (ETDEWEB)

    Planken, Nils R. [Maastricht University Hospital, Department of Vascular Surgery, Maastricht (Netherlands); Maastricht University Hospital, Department of Radiology, Maastricht (Netherlands); Maastricht University Medical School, Cardiovascular Research Institute Maastricht, Maastricht (Netherlands); Tordoir, Jan H. [Maastricht University Hospital, Department of Vascular Surgery, Maastricht (Netherlands); Maastricht University Medical School, Cardiovascular Research Institute Maastricht, Maastricht (Netherlands); Duijm, Lucien E.; Bosch, Harrie C. van den [Catharina Hospital, Department of Radiology, Eindhoven (Netherlands); Sande, Frank M. van der; Kooman, Jeroen P. [Maastricht University Hospital, Department of Nephrology, Maastricht (Netherlands); Maastricht University Medical School, Cardiovascular Research Institute Maastricht, Maastricht (Netherlands); Haan, Michiel W. de; Leiner, Tim [Maastricht University Hospital, Department of Radiology, Maastricht (Netherlands); Maastricht University Medical School, Cardiovascular Research Institute Maastricht, Maastricht (Netherlands)

    2008-01-15

    A contrast-enhanced magnetic resonance angiography (CE-MRA) protocol for selective imaging of the entire upper extremity arterial and venous tree in a single exam has been developed. Twenty-five end-stage renal disease (ESRD) patients underwent CE-MRA and duplex ultrasonography (DUS) of the upper extremity prior to hemodialysis vascular access creation. Accuracy of CE-MRA arterial and venous diameter measurements were compared with DUS and intraoperative (IO) diameter measurements, the standard of reference. Upper extremity vasculature depiction was feasible with CE-MRA. CE-MRA forearm and upper arm arterial diameters were 2.94 {+-} 0.67 mm and 4.05 {+-} 0.84 mm, respectively. DUS arterial diameters were 2.80 {+-} 0.48 mm and 4.38 {+-} 1.24 mm; IO diameters were 3.00 {+-} 0.35 mm and 3.55 {+-} 0.51 mm. Forearm arterial diameters were accurately determined with both techniques. Both techniques overestimated upper arm arterial diameters significantly. Venous diameters were accurately determined with CE-MRA but not with DUS (forearm: CE-MRA: 2.64 {+-} 0.61 mm; DUS: 2.50 {+-} 0.44 mm, and IO: 3.40 {+-} 0.22 mm; upper arm: CE-MRA: 4.09 {+-} 0.71 mm; DUS: 3.02 {+-} 1.65 mm, and IO: 4.30 {+-} 0.78 mm). CE-MRA enables selective imaging of upper extremity vasculature in patients requiring hemodialysis access. Forearm arterial diameters can be assessed accurately by CE-MRA. Both CE-MRA and DUS slightly overestimate upper arm arterial diameters. In comparison to DUS, CE-MRA enables a more accurate determination of upper extremity venous diameters. (orig.)

  18. Updating upper extremity temporary prosthesis: thermoplastics.

    Science.gov (United States)

    Fletchall, S; Tran, T; Ungaro, V; Hickerson, W

    1992-01-01

    Since 1989 amputees with upper-extremity burns have been fitted with a temporary prosthesis fabricated from low-temperature thermoplastic. Before 1989 conventional temporary prostheses were fabricated with plaster. The use of the thermoplastic material has produced a lightweight, cost-effective, modular system. No patients exhibited skin breakdown with the thermoplastic material. It appears that thermoplastics may be the next major breakthrough in terms of a design for a temporary upper-extremity prosthesis.

  19. Magnetic resonance imaging of acute 'wiiitis' of the upper extremity

    Energy Technology Data Exchange (ETDEWEB)

    Nett, Michael P.; Sperling, John W. [Mayo Clinic, Department of Orthopedic Surgery, Rochester, MN (United States); Collins, Mark S. [Mayo Clinic, Department of Radiology, Rochester, MN (United States)

    2008-05-15

    We present the first reported case of acute 'wiiitis', documented clinically and by imaging, of the upper extremity, caused by prolonged participation in a physically interactive virtual video-game. Unenhanced magnetic resonance imaging (MRI) demonstrated marked T2-weighted signal abnormality within several muscles of the shoulder and upper arm, without evidence of macroscopic partial- or full-thickness tearing of the muscle or of intramuscular hematoma. (orig.)

  20. A rare disease in an atypical location - Kimura's Disease of the upper extremity

    Energy Technology Data Exchange (ETDEWEB)

    Lam, Alan Cheuk Si; Lau, Vince Wing Hang [Queen Mary Hospital, Department of Radiology, Hong Kong (China); Au Yeung, Rex Kwok Him [University of Hong Kong, Department of Pathology, Li Ka Shing Faculty of Medicine, Hong Kong (China)

    2015-12-15

    Kimura's disease is a rare chronic inflammatory disorder predominantly affecting young Asian male patients, occurring mainly in the head and neck regions. Kimura's disease of the upper extremity is extremely rare, and previous case reports in the literature show similar imaging characteristics with consistent location at the medial epitrochlear region, predominantly with unilateral involvement. We present the first reported case of Kimura's disease affecting the anterolateral aspect of the upper arm, sparing the medial epitrochlear region, illustrating that with typical MR appearance and serology, the involvement of this rare disease in an atypical location still warrants consideration of this diagnosis. There was also bilateral asymmetrical involvement in our patient, suggesting the possibility of a propensity for Kimura's disease affecting the upper extremities to have bilateral involvement, which may necessitate imaging of the clinically asymptomatic contralateral limb in these patients for early lesion identification and treatment. (orig.)

  1. Brief Assessment of Motor Function: Content Validity and Reliability of the Upper Extremity Gross Motor Scale

    Science.gov (United States)

    Cintas, Holly Lea; Parks, Rebecca; Don, Sarah; Gerber, Lynn

    2011-01-01

    Content validity and reliability of the Brief Assessment of Motor Function (BAMF) Upper Extremity Gross Motor Scale (UEGMS) were evaluated in this prospective, descriptive study. The UEGMS is one of five BAMF ordinal scales designed for quick documentation of gross, fine, and oral motor skill levels. Designed to be independent of age and…

  2. Time Series Analysis of Spontaneous Upper-Extremity Movements of Premature Infants With Brain Injuries

    OpenAIRE

    Ohgi, Shohei; Morita, Satoru; Loo, Kek Khee; Mizuike, Chihiro

    2008-01-01

    Background and Purpose: Comparisons of spontaneous movements of premature infants with brain injuries and those without brain injuries can provide insights into normal and abnormal processes in the ontogeny of motor development. In this study, the characteristics of spontaneous upper-extremity movements of premature infants with brain injuries and those without brain injuries were examined with time series analysis.

  3. Occupational performance, pain, and global quality of life in women with upper extremity fractures

    DEFF Research Database (Denmark)

    Dekkers, Merete Klindt; Nielsen, Tove Lise

    2010-01-01

    on the COPM and with the COPM satisfaction score, and it can be argued that a finding of a low DASH score in elderly women with upper extremity fractures should be followed up by a referral to occupational therapy. Future studies, preferably follow-up studies, are called for to further explore the multiple......To examine pain, occupational performance problems, and quality of life (QoL) and possible associations between these variables, 41 elderly women with acute pain due to a fracture of the upper extremity were assessed with COPM, DASH, validated questions on pain, and a global question on Qo...

  4. Statin-induced focal myositis of the upper extremity. A report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Wagner, M., E-mail: wagner.radiologie@herzchirurgie.de [Department of Radiology, Herz- und Gefaessklinik GmbH, Salzburger Leite 1, D-97616 Bad Neustadt an der Saale (Germany); Muehldorfer-Fodor, M.; Prommersberger, K.J. [Department of Handsurgery, Herz- und Gefaessklinik GmbH, Bad Neustadt an der Saale (Germany); Schmitt, R. [Department of Radiology, Herz- und Gefaessklinik GmbH, Salzburger Leite 1, D-97616 Bad Neustadt an der Saale (Germany)

    2011-02-15

    Statins are widely used to lower increased cholesterol levels with the aim to prevent major cardiovascular events. However, they bare the risk of myotoxic side effects. We report on two patients with focal weakness and pain in the upper extremities. In both patients, abnormal MRI signal heights in the muscle groups involved were indicative of the final diagnosis of focal myositis during statin therapy.

  5. Functional adaptation of long bone extremities involves the localized ``tuning'' of the cortical bone composition; evidence from Raman spectroscopy

    Science.gov (United States)

    Buckley, Kevin; Kerns, Jemma G.; Birch, Helen L.; Gikas, Panagiotis D.; Parker, Anthony W.; Matousek, Pavel; Goodship, Allen E.

    2014-11-01

    In long bones, the functional adaptation of shape and structure occurs along the whole length of the organ. This study explores the hypothesis that adaptation of bone composition is also site-specific and that the mineral-to-collagen ratio of bone (and, thus, its mechanical properties) varies along the organ's length. Raman spectroscopy was used to map the chemical composition of long bones along their entire length in fine spatial resolution (1 mm), and then biochemical analysis was used to measure the mineral, collagen, water, and sulfated glycosaminoglycan content where site-specific differences were seen. The results show that the mineral-to-collagen ratio of the bone material in human tibiae varies by 10% toward the flared extremities of the bone. Comparisons with long bones from other large animals (horses, sheep, and deer) gave similar results with bone material composition changing across tens of centimeters. The composition of the bone apatite also varied with the phosphate-to-carbonate ratio decreasing toward the ends of the tibia. The data highlight the complexity of adaptive changes and raise interesting questions about the biochemical control mechanisms involved. In addition to their biological interest, the data provide timely information to researchers developing Raman spectroscopy as a noninvasive tool for measuring bone composition in vivo (particularly with regard to sampling and measurement protocol).

  6. The clinical aspects of the upper extremity exoskeleton "EXAR" use

    Science.gov (United States)

    Vorobiev, A. A.; Krivonozhkina, P. S.; Andryushchenko, F. A.; Zasypkina, O. A.

    2015-11-01

    The article considers some of indications and contraindications for the use of the exoskeleton "EXAR". Our experience with the present construction use shows that the exoskeleton "EXAR" is able to make up the following lost or disturbed muscle functions:- an arm raise; a drawing of the arm aside from the trunk;- a bending of the arm in shoulder or elbow joints.

  7. Quality of Life Following Amputation or Limb Preservation in Patients with Lower Extremity Bone Sarcoma

    OpenAIRE

    Gary E Mason; Lele eAung; Sarah eGall; Meyers, Paul A; Robert eButler; Sarah eKrug; Mimi eKim; Healey, John H.; Richard eGorlick

    2013-01-01

    PURPOSE: Although functional differences have been described between patients with lower extremity bone sarcoma with amputation and limb preservation surgery, differences have not clearly been shown between the two groups related to quality of life. The aim of the study was to determine if there is a difference in overall quality of life in lower extremity bone sarcoma survivors related to whether they had an amputation or a limb preservation procedure. PATIENTS AND METHODS: Eighty-two lon...

  8. Electrical stimulation of the upper extremity in stroke: cyclic versus EMG-triggered stimulation

    NARCIS (Netherlands)

    Kroon, de Joke R.; IJzerman, Maarten J.

    2008-01-01

    Objective: To compare the effect of cyclic and electromyography (EMG)-triggered electrical stimulation on motor impairment and function of the affected upper extremity in chronic stroke. Design: Randomized controlled trial. Setting: Outpatient clinic of a rehabilitation centre. Subjects and inte

  9. Endovascular stent placement in the treatment of upper extremity central venous obstruction in hemodialysis patients

    Energy Technology Data Exchange (ETDEWEB)

    Aytekin, Cueneyt E-mail: cuneytaytekin@hotmail.com; Boyvat, Fatih; Yagmurdur, Mahmut Can; Moray, Goekhan; Haberal, Mehmet

    2004-01-01

    Objective: To evaluate the efficacy of stent placement for treating upper extremity central venous obstruction in chronic hemodialysis patients. Methods and Material: Between January 1999 and October 2001, we inserted metallic stents into the upper extremity central veins of 14 patients with shunt dysfunction and/or arm swelling. The indications for stent placement were stenosis or occlusion of the central vein in the upper extremity used for dialysis. Six of the individuals were diagnosed with subclavian vein stenosis, and 5 with brachiocephalic vein stenosis. Of the remaining 3 patients, 2 had subclavian vein occlusion, and 1 had left brachiocephalic vein occlusion. Results: All the stent placement procedures were technically successful, and there were no major complications. Follow-up ranged from 2 weeks to 29 months. The 1-, 3-, 6- and 12-month primary stent patency rates were 92.8, 85.7, 50 and 14.3%, respectively. Repeat interventions, including percutaneous transluminal angioplasty and additional stent placement, were required in 9 patients. The 3-, 6-, 12-month, and 2-year assisted primary stent patency rates were 100, 88.8, 55.5 and 33.3%, respectively. Conclusion: Endovascular stent placement is an effective alternative to surgery in patients with shunt dysfunction due to obstruction of an upper extremity central vein. Repeated interventions are usually required to prolong stent patency.

  10. Upper extremities flexibility comparisons of collegiate "soft" martial art practitioners with other athletes.

    Science.gov (United States)

    Huang, C-C; Yang, Y-H; Chen, C-H; Chen, T-W; Lee, C-L; Wu, C-L; Chuang, S-H; Huang, M-H

    2008-03-01

    The aim of this study was to compare the flexibility of the upper extremities in collegiate students involved in Aikido (a kind of soft martial art attracting youth) training with those involved in other sports. Fifty freshmen with a similar frequency of exercise were divided into the Aikido group (n = 18), the upper-body sports group (n = 17), and the lower-body sports group (n = 15) according to the sports that they participated in. Eight classes of range of motion in upper extremities were taken for all subjects by the same clinicians. The Aikido group had significantly better flexibility than the upper-body sports group except for range of motion in shoulder flexion (p = 0.22), shoulder lateral rotation (p > 0.99), and wrist extension (p > 0.99). The Aikido group also had significantly better flexibility than the lower-body sports group (p martial arts had good upper extremities flexibility that might not result from regular exercise alone.

  11. The influence of wheelchair propulsion hand pattern on upper extremity muscle power and stress.

    Science.gov (United States)

    Slowik, Jonathan S; Requejo, Philip S; Mulroy, Sara J; Neptune, Richard R

    2016-06-14

    The hand pattern (i.e., full-cycle hand path) used during manual wheelchair propulsion is frequently classified as one of four distinct hand pattern types: arc, single loop, double loop or semicircular. Current clinical guidelines recommend the use of the semicircular pattern, which is based on advantageous levels of broad biomechanical metrics implicitly related to the demand placed on the upper extremity (e.g., lower cadence). However, an understanding of the influence of hand pattern on specific measures of upper extremity muscle demand (e.g., muscle power and stress) is needed to help make such recommendations, but these quantities are difficult and impractical to measure experimentally. The purpose of this study was to use musculoskeletal modeling and forward dynamics simulations to investigate the influence of the hand pattern used on specific measures of upper extremity muscle demand. The simulation results suggest that the double loop and semicircular patterns produce the most favorable levels of overall muscle stress and total muscle power. The double loop pattern had the lowest full-cycle and recovery-phase upper extremity demand but required high levels of muscle power during the relatively short contact phase. The semicircular pattern had the second-lowest full-cycle levels of overall muscle stress and total muscle power, and demand was more evenly distributed between the contact and recovery phases. These results suggest that in order to decrease upper extremity demand, manual wheelchair users should consider using either the double loop or semicircular pattern when propelling their wheelchairs at a self-selected speed on level ground.

  12. Aging contributes to inflammation in upper extremity tendons and declines in forelimb agility in a rat model of upper extremity overuse.

    Directory of Open Access Journals (Sweden)

    David M Kietrys

    Full Text Available We sought to determine if tendon inflammatory and histopathological responses increase in aged rats compared to young rats performing a voluntary upper extremity repetitive task, and if these changes are associated with motor declines. Ninety-six female Sprague-Dawley rats were used in the rat model of upper extremity overuse: 67 aged and 29 young adult rats. After a training period of 4 weeks, task rats performed a voluntary high repetition low force (HRLF handle-pulling task for 2 hrs/day, 3 days/wk for up to 12 weeks. Upper extremity motor function was assessed, as were inflammatory and histomorphological changes in flexor digitorum and supraspinatus tendons. The percentage of successful reaches improved in young adult HRLF rats, but not in aged HRLF rats. Forelimb agility decreased transiently in young adult HRLF rats, but persistently in aged HRLF rats. HRLF task performance for 12 weeks lead to increased IL-1beta and IL-6 in flexor digitorum tendons of aged HRLF rats, compared to aged normal control (NC as well as young adult HRLF rats. In contrast, TNF-alpha increased more in flexor digitorum tendons of young adult 12-week HRLF rats than in aged HRLF rats. Vascularity and collagen fibril organization were not affected by task performance in flexor digitorum tendons of either age group, although cellularity increased in both. By week 12 of HRLF task performance, vascularity and cellularity increased in the supraspinatus tendons of only aged rats. The increased cellularity was due to increased macrophages and connective tissue growth factor (CTGF-immunoreactive fibroblasts in the peritendon. In conclusion, aged rat tendons were overall more affected by the HRLF task than young adult tendons, particularly supraspinatus tendons. Greater inflammatory changes in aged HRLF rat tendons were observed, increases associated temporally with decreased forelimb agility and lack of improvement in task success.

  13. The first results of the development and implementation of the upper extremity exoskeleton "EXAR"

    Science.gov (United States)

    Vorobiev, A. A.; Krivonozhkina, P. S.; Zasypkina, O. A.; Andrewshenko, F. A.

    2015-11-01

    This research considers the first results of the development and implementation of the upper extremity exoskeleton "EXAR". Made anatomical parameterization developed the device the testing of the apparatus have been conducted in accordance with the bioethics regulations with the girl I. Sh. at the age of 4 years suffering the artrogryposis. The parameters of the exoskeleton "EXAR" selected according to our methods allowed us to conduct its use in the period of 4 months. There have been no defects at all. By the analysis of the first results of the passive upper limb skeleton EXAR development we should consider them as positive and worthy of the widespread adoption in the remedial practice.

  14. Frequency of Painful Shoulder Limitation of Motion after Long Casting of Upper Extremity

    OpenAIRE

    A.R. Yavarikia

    2004-01-01

    The aim of this study was determination of frequency of painful reduced shoulder motion after long casting of upper extremity and its relation with age , sex and education . The present work was a descriptive analytic prospective study and included 388 patients who referred to Mobasher hospital of Hamadan during 2001. The selected patients in recurrent referring to orthopedic department were classified to 10 age groups and were examined by researcher in 1 , 1.5 and...

  15. Content Range and Precision of a Computer Adaptive Test of Upper Extremity Function for Children with Cerebral Palsy

    Science.gov (United States)

    Montpetit, Kathleen; Haley, Stephen; Bilodeau, Nathalie; Ni, Pengsheng; Tian, Feng; Gorton, George, III; Mulcahey, M. J.

    2011-01-01

    This article reports on the content range and measurement precision of an upper extremity (UE) computer adaptive testing (CAT) platform of physical function in children with cerebral palsy. Upper extremity items representing skills of all abilities were administered to 305 parents. These responses were compared with two traditional standardized…

  16. Upper extremity cumulative trauma disorders in the makers of Maraş pounded ice cream

    Directory of Open Access Journals (Sweden)

    Betül Bakan

    2013-01-01

    Full Text Available Objective: Upper Extremity Cumulative Trauma Disorders(UE-CTD are among the major health problems affectingthe workers. The aim of this study was to investigateUE-CTD in the makers of Maras pounded ice cream(MMPICMethods: This study was conducted among 50 volunteerswho work as a MMPIC and 50 control in our downtownarea. During face-to-face conversion, the participantsfilled out a survey inquiring about age, duration ofwork (in years in job, daily working time, occupation withanother job, health history, and medication usage. Thesubjects were questioned regarding the musculoskeletalcomplaints within the last six months and upper bodyphysical examination was performed in all participants.Results: The study group was composed of males.The mean age of study group and control group were31.78±6.58 and 30.74±5.99 years (p=0.411, respectively.The mean duration of work in pounded ice creambusiness and the mean duration of work in control were11.64± 6.26 years and 10.68±5.48 years (p=0.417, respectively.The mean daily working time in the studygroup and in control group were 10.64±1.82 hours and11.12±1.62 hours (p= 0.168, respectively. Musculoskeletalcomplaints of the upper extremity were found in 52%of the study group, and 28% of the control group. Musculoskeletaldisease of upper extremity was found in 28% ofthe study group and in 12% of the control group. Upperextremity musculoskeletal system complaints and illnesswere difference statistically between the two groups (p=0.014; p= 0.046, respectively.Conclusion: UE-CTD was seen in the makers of poundedice cream and its prevalence was similar to the otherlaborers work in the areas needing repetitive arm andhand motion.Key words: Makers of Maras pounded ice cream, cumulativetrauma disorders, upper extremity problems

  17. Critical review of the impact of core stability on upper extremity athletic injury and performance

    Directory of Open Access Journals (Sweden)

    Sheri P. Silfies

    2015-10-01

    Full Text Available BACKGROUND: Programs designed to prevent or rehabilitate athletic injuries or improve athletic performance frequently focus on core stability. This approach is based upon the theory that poor core stability increases the risk of poor performance and/or injury. Despite the widespread use of core stability training amongst athletes, the question of whether or not sufficient evidence exists to support this practice remains to be answered.OBJECTIVES: 1 Open a dialogue on the definition and components of core stability. 2 Provide an overview of current science linking core stability to musculoskeletal injuries of the upper extremity. 3 Provide an overview of evidence for the association between core stability and athletic performance.DISCUSSION: Core stability is the ability to control the position and movement of the trunk for optimal production, transfer, and control of forces to and from the upper and lower extremities during functional activities. Muscle capacity and neuromuscular control are critical components of core stability. A limited body of evidence provides some support for a link between core stability and upper extremity injuries amongst athletes who participate in baseball, football, or swimming. Likewise, few studies exist to support a relationship between core stability and athletic performance.CONCLUSIONS: A limited body of evidence exists to support the use of core stability training in injury prevention or performance enhancement programs for athletes. Clearly more research is needed to inform decision making when it comes to inclusion or emphasis of core training when designing injury prevention and rehabilitation programs for athletes.

  18. Upper-extremity deep venous thrombosis: a review.

    Science.gov (United States)

    Mai, Cuc; Hunt, Daniel

    2011-05-01

    Upper-extremity deep venous thrombosis is less common than lower-extremity deep venous thrombosis. However, upper-extremity deep venous thrombosis is associated with similar adverse consequences and is becoming more common in patients with complex medical conditions requiring central venous catheters or wires. Although guidelines suggest that this disorder be managed using approaches similar to those for lower-extremity deep venous thrombosis, studies are refining the prognosis and management of upper-extremity deep venous thrombosis. Physicians should be familiar with the diagnostic and treatment considerations for this disease. This review will differentiate between primary and secondary upper-extremity deep venous thromboses; assess the risk factors and clinical sequelae associated with upper-extremity deep venous thrombosis, comparing these with lower-extremity deep venous thrombosis; and describe an approach to treatment and prevention of secondary upper-extremity deep venous thrombosis based on clinical evidence.

  19. Correlation of crossed cerebellar diaschisis with motor impairment of the hemiplegic upper extremity in stroke patients

    Energy Technology Data Exchange (ETDEWEB)

    Song, Ho Chun; Choi, In Sung; Heo, Young Jun; Min, Jeong Jun; Lee, Sam Gyu; Bom, Hee Seung [School of Medicine, Chonnam National University, Gwangju (Korea, Republic of)

    2004-07-01

    The aim of this study was to investigate the correlation between crossed cerebellar diaschisis (CCD) and motor evoked potentials (MEPs) and to study the relationship between CCD and the severity and prognosis of stroke. Twenty-eight patients with first-ever unilateral stroke underwent brain perfusion SPECT with Tc-99m ECD. The existence of CCD was evaluated by visual inspection on SPECT images. The central motor conduction times were obtained from Abductor pollicis brevis and Abductor hallucis by recording MEPs. The National Institutes of Health stroke scale, the motricity Index (MI), and the functional outcome scales were measured. Fifteen of 28 patients (53.6%) had CCD. The presence of CCD was significantly correlated with 'not evoked' MEPs in the upper extremity (p<0.01). The existence of CCD was not associated with locations (p>0.05) and volume of brain lesion (p>0.05). There was a significant correlation between the presence of CCD and lower MI score of upper extremity (p<0.05). The presence of CCD would indicate the damage on the descending motor pathways and be associated with the severe motor impairment of the upper extremity in stroke patients.

  20. Computed tomographic myelography characteristics of spinal cord atrophy in juvenile muscular atrophy of the upper extremity

    International Nuclear Information System (INIS)

    Although atrophy of the lower cervical and upper thoracic cord in juvenile muscular atrophy of distal upper extremity has been reported, the atrophic patterns of the cord, especially in the transverse section, have not been studied extensively. The aim of this study is to clarify the atrophic patterns of the cord by CT myelography (CTM) and to discuss the pathogenesis of cord atrophy. Sixteen patients with juvenile muscular atrophy of distal upper extremity were examined by CTM. Atrophy of the lower cervical and upper thoracic cord, consistent with the segmental weakness, was seen in all patients. Flattening of the ventral convexity was a characteristic atrophic pattern of the cord. Bilateral cord atrophy was commonly observed; 8/12 patients with unilateral clinical form and all 4 patients with bilateral form showed bilateral cord atrophy with dominance on the clinical side. There was no correlation between the degree of cord atrophy and duration of symptoms. Flattening of the ventral convexity, associated with purely motor disturbances, reflects selective atrophy of the anterior horns in the cord, which is attributable to chronic ischemia. Cord atrophy proved to precede clinical manifestations. The characteristic atrophy of the cord provides useful information to confirm the diagnosis without long-term observation. (author). 21 refs.; 3 figs.; 2 tabs

  1. Two-point discrimination of the upper extremities of healthy Koreans in their 20's.

    Science.gov (United States)

    Koo, Ja-Pung; Kim, Soon-Hee; An, Ho-Jung; Moon, Ok-Gon; Choi, Jung-Hyun; Yun, Young-Dae; Park, Joo-Hyun; Min, Kyoung-Ok

    2016-03-01

    [Purpose] The present study attempted to measure two-point discrimination in the upper extremities of healthy Koreans in their 20's. [Subjects and Methods] Using a three-point esthesiometer, we conducted an experiment with a group of 256 college students (128 male and 128 female), attending N University in Chonan, Republic of Korea. [Results] Females showed two-point discrimination at a shorter distance than males at the following points: (i) 5 cm above the elbow joint, the middle part, and 5 cm below the shoulder joint of the anterior upper arm; (ii) 5 cm above the elbow joint and 5 cm below the shoulder joint of the posterior upper arm; (iii) 5 cm above the front of the wrist joint of the forearm; 5 cm below the elbow joint, the palmar part of the distal interphalangeal joint of the thumb, the dorsal part of the distal interphalangeal joint of the middle and little fingers. It was also found that females showed greater two-point discrimination than males in distal regions rather than proximal regions. [Conclusion] The findings of this study will help establish normal values for two-point discrimination of upper extremities of young Koreans in their 20's.

  2. Upper extremity rehabilitation of stroke: Facilitation of corticospinal excitability using virtual mirror paradigm

    OpenAIRE

    Kang Youn; Park Hae; Kim Hyun; Lim Taeo; Ku Jeonghun; Cho Sangwoo; Kim Sun I; Park Eun

    2012-01-01

    Abstract Background Several experimental studies in stroke patients suggest that mirror therapy and various virtual reality programs facilitate motor rehabilitation. However, the underlying mechanisms for these therapeutic effects have not been previously described. Objectives We attempted to delineate the changes in corticospinal excitability when individuals were asked to exercise their upper extremity using a real mirror and virtual mirror. Moreover, we attempted to delineate the role of v...

  3. Re-Education Movements of the Paretic Upper Extremity in Children age by Using Non-robotic Equipment

    Directory of Open Access Journals (Sweden)

    Hana Padyšaková

    2015-06-01

    Full Text Available Background: Pilot study tested re-education movements of upper extremity in children with hemiparesis syndrome and this study determined the effect of therapy on Armeo® equipment on movement and the ability to grip of upper extremity. Methods: This Investigation consisted of twenty-three children with impaired upper extremity. They had twenty therapies in Armeo® equipment. Results: After rehabilitation by equipment Armeo® the children achieved greater range of motions in the upper extremity which resulted in a higher average output score than the input score. Significant better results demonstrate the improvement in hand grip which resulted in higher average output score compared with the input score. Conclusion: By the therapy in Armeo® equipment were achieved statistically significant results in improving manual activities of upper extremity, improvement the range of motions and also improvement of grip of paretic hand.

  4. Effects of Increased Physiological Arousal on Upper Extremity Positional Awareness in Healthy Young Adults

    Directory of Open Access Journals (Sweden)

    Christopher Kovacs

    2010-01-01

    Full Text Available Problem statement: The purpose of this investigation was to examine the effects of increased physiological arousal on the ability to perceive upper extremity positional awareness in healthy young adults. Approach: Thirty-eight participants were pre- and post-tested for upper extremity positional awareness using a manual kinesthesiometer. Participants in the experimental group underwent a combination of the Stroop color-word task and timed arithmetic problems to produce a state of physiological arousal. Heart rate and blood pressure measurements were taken during data collection to assess levels of physiological arousal. Pre-and post-test absolute error scores for each participant were compared. Results: ANCOVA revealed a significant time effect (pConclusion: The results suggested positional awareness is altered under a state of elevated physiological arousal and that these results may have significant implications for individuals performing various types of motor skills.

  5. Segmental neurofibromatosis of the hand and upper extremity: a case report.

    Science.gov (United States)

    Ilyas, Asif M; Nourissat, Geoffroy; Jupiter, Jesse B

    2007-12-01

    A case of segmental neurofibromatosis of the upper extremity is presented. Multiple neurofibromas involving different peripheral nerves limited to a single body part or limb is a rare form of neurofibromatosis. The clinical, genetic, and histologic findings of segmental neurofibromatosis are described. The criteria for segmental neurofibromatosis are reviewed, and the differentiation of neurofibromatosis types 1 and 2 and schwannomatosis is also briefly reviewed. PMID:18070641

  6. [Identification of male somatotype based on osteometric characteristics of the upper and lower extremities].

    Science.gov (United States)

    Zviagin, V N; Sineva, I M

    2009-01-01

    This osteologic study included examination of 101 skeletons from the collections of the Department of Anthropology, M. V. Lomonosov Moscow State University, and Peter the Great Museum of Anthropology and Ethnography (Sankt-Peterburg). The results were compared with the data obtained by examining materials excavated from grave sites of an Yoshkar-Ola cemetery and from the Isupovo necropole (Kostroma) to evaluate the possibility of identifying human somatotypes from bone remains. Multidimensional discriminative analysis demonstrated that the equation derived by comparing characteristic signs of all long tubular bones of the extremities was of highest diagnostic value for the purpose of the study. Diagnostic equations are proposed for the identification of individual somatotypes based on the analysis of skeletal remains for the use in practical forensic medical examination. PMID:20058841

  7. A case report of a patient with upper extremity symptoms: differentiating radicular and referred pain

    Directory of Open Access Journals (Sweden)

    Daub Clifford W

    2007-07-01

    Full Text Available Abstract Background Similar upper extremity symptoms can present with varied physiologic etiologies. However, due to the multifaceted nature of musculoskeletal conditions, a definitive diagnosis using physical examination and advanced testing is not always possible. This report discusses the diagnosis and case management of a patient with two episodes of similar upper extremity symptoms of different etiologies. Case Presentation On two separate occasions a forty-four year old female patient presented to a chiropractic office with a chief complaint of insidious right-sided upper extremity symptoms. During each episode she reported similar pain and parasthesias from her neck and shoulder to her lateral forearm and hand. During the first episode the patient was diagnosed with a cervical radiculopathy. Conservative treatment, including manual cervical traction, spinal manipulation and neuromobilization, was initiated and resolved the symptoms. Approximately eighteen months later the patient again experienced a severe acute flare-up of the upper extremity symptoms. Although the subjective complaint was similar, it was determined that the pain generator of this episode was an active trigger point of the infraspinatus muscle. A diagnosis of myofascial referred pain was made and a protocol of manual trigger point therapy and functional postural rehabilitative exercises improved the condition. Conclusion In this case a thorough physical evaluation was able to differentiate between radicular and referred pain. By accurately identifying the pain generating structures, the appropriate rehabilitative protocol was prescribed and led to a successful outcome for each condition. Conservative manual therapy and rehabilitative exercises may be an effective treatment for certain cases of cervical radiculopathy and myofascial referred pain.

  8. The Influence of Dynamic Orthosis Training on Upper Extremity Function after Stroke: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Rodrigo Cappato de Araújo

    2014-01-01

    Full Text Available The goal of this study was to assess the use of a dynamic orthosis on upper extremity function in chronic stroke patients. A case series approach was utilized, with provision of a training program (3x/week, 50 minutes/session for 8 weeks and employment of a dynamic orthosis. Six volunteers with persistent hemiparesis due to a single, unilateral stroke performed task-oriented movements with the aid of a dynamic orthosis. Tests were administered before and after training. Functional capacity was assessed using the TEMPA (Test d'Évaluation des Membres Supérieurs de Personnes Âgées test. The Wilcoxon test was used for pre-training and post-training comparisons of TEMPA scores. The volunteers showed significant improvement of upper extremity function in the performance of a bilateral task (p = 0.01 and three unilateral tasks (p = 0.04. This pilot study suggests that the dynamic orthosis associated with the performance of functional tasks can have positive outcomes regarding the improvement of functional capacity of upper extremity.

  9. Muscle fatigue does not lead to increased instability of upper extremity repetitive movements

    OpenAIRE

    Gates, Deanna H.; Dingwell, Jonathan B.

    2009-01-01

    Muscle fatigue alters neuromuscular responses. This may lead to increased sensitivity to perturbations and possibly to subsequent injury risk. We studied the effects of muscle fatigue on movement stability during a repetitive upper extremity task. Twenty healthy young subjects performed a repetitive work task, similar to sawing, synchronized with a metronome before and after performing each of two fatiguing tasks. The first fatigue task (“LIFT”) primarily fatigued the shoulder flexor muscles,...

  10. Intermittent pneumatic compression pump in upper extremity impairments of breast cancer-related lymphedema

    OpenAIRE

    UZKESER, Hülya; Karatay, Saliha

    2013-01-01

    To investigate the effect of intermittent pneumatic compression (IPC) pumps on upper extremity impairments in breast cancer-related lymphedema. Materials and methods: Twenty-five patients with lymphedema were randomized into 2 groups. For 3 weeks, the pneumatic compression group (n = 12) underwent a treatment program including skin care, compression bandage, exercise therapy, manual lymph drainage (MLD), and IPC. The control group (n = 13) participated in the same program, but without IPC. ...

  11. Effect of mirror therapy on upper extremity motor function in stroke patients: a randomized controlled trial

    Science.gov (United States)

    Gurbuz, Nigar; Afsar, Sevgi Ikbali; Ayaş, Sehri; Cosar, Sacide Nur Saracgil

    2016-01-01

    [Purpose] This study aimed to evaluate the effectiveness of mirror therapy combined with a conventional rehabilitation program on upper extremity motor and functional recovery in stroke patients. [Subjects and Methods] Thirty-one hemiplegic patients were included. The patients were randomly assigned to a mirror (n=16) or conventional group (n=15). The patients in both groups underwent conventional therapy for 4 weeks (60–120 minutes/day, 5 days/week). The mirror group received mirror therapy, consisting of periodic flexion and extension movements of the wrist and fingers on the non-paralyzed side. The patients in the conventional group performed the same exercises against the non-reflecting face of the mirror. The patients were evaluated at the beginning and end of the treatment by a blinded assessor using the Brunnstrom stage, Fugl-Meyer Assessment (FMA) upper extremity score, and the Functional Independence Measure (FIM) self-care score. [Results] There was an improvement in Brunnstrom stage and the FIM self-care score in both groups, but the post-treatment FMA score was significantly higher in the mirror therapy group than in the conventional treatment group. [Conclusion] Mirror therapy in addition to a conventional rehabilitation program was found to provide additional benefit in motor recovery of the upper extremity in stroke patients. PMID:27799679

  12. Role of Anomalous States of Upper Tropospheric Circulation on Extremely Dry and Wet Summer Monsoon Events

    Science.gov (United States)

    Ahmad, S.; Koike, T.; Nishii, K.; Shrestha, M.

    2011-12-01

    Seasonal changes in wind pattern, monsoon, sometimes result in severe droughts and intense flooding in many parts of the world including South Asian countries like Pakistan. The livelihood of a vast population in Pakistan depends on agriculture and land use is strongly influenced by water-based ecosystems that depend on the monsoon rains. Furthermore, climate change studies undertaken so far reveal that action is essential in order to prevent long term damage to water cycle and thus of great concern to the community and stakeholders. Pakistan Summer Monsoon (PSM) is affected by both the disturbances from the tropical and the extratropical regions; however there is lack of understanding of physical mechanisms of PSM compared to other regional studies i.e. Indian Summer Monsoon (ISM) and South-East Asian Monsoon (SEAM). In our study, we applied heat and vorticity budgets, and wave train analysis to reveal the mechanisms of the extremely dry and wet PSM events associated with the anomalous upper tropospheric conditions. We found that the extremely dry (wet) PSM events were closely related with the anomalous cyclonic (anticyclonic) upper-tropospheric circulation around northwest of Pakistan, and mid-upper tropospheric cooling (warming) anomaly around Pakistan and to its north/northwest. We also found in addition to Rossby wave response due to the suppressed (enhanced) convective activities around monsoon regions, the midlatitude wave energy propagation emanating around cyclonic/anticyclonic anomaly around northwestern Atlantic, northeastern Atlantic, Europe or Mediterranean regions induced/reinforced/maintained the anomalous upper tropospheric cyclonic (anticyclonic) circulation around northwest of Pakistan during extremely dry (wet) PSM events. Therefore, devastating drought (flood) events over the PSM region resulting from weak (strong) convection anomalies are induced by both the tropical and extratropical processes.

  13. Kinematic Analysis of the Neck and Upper Extremities During Walking in Healthy Young Adults

    Institute of Scientific and Technical Information of China (English)

    Kwon Son; Junghong Park; Seonghun Park

    2011-01-01

    The objective of this paper is to quantify the local stabilities of the neck and upper extremities (right/left shoulders and right/left elbows), and investigate differences between linear and nonlinear measurements of the associated joint motions and differences in the local stability between the upper and lower extremities. This attempt involves the calculation of a nonlinear parameter, Lyapunov Exponent (LE), and a linear parameter, Range of Motion (ROM), during treadmill walking in conjunction with a large population of healthy subjects. Joint motions of subjects were captured using a three-dimensional motion-capture system. Then mathematical chaos theory and the Rosenstein algorithm were employed to calculate LE of joints as the extent of logarithmic divergence between the neighboring state-space trajectories of flexion-extension angles. LEs computed over twenty males and twenty females were 0.037±0.023 for the neck, 0.043±0.021 for the right shoulder, 0.045±0.030 for the left shoulder, 0.032±0.021 for the right elbow, and 0.034±0.026 for the left elbow. Although statistically significant difference in the ROM was observed between all pairs of the neck and upper extremity joints, differences in the LE between all pairs of the joints as well as between males and females were not statistically significant. Between the upper and lower extremities, LEs of the neck, shoulder, and elbow were significantly smaller than those of the hip (~0.064) and the knee (~0.062). These results indicate that a statistical difference in the local stability between the upper extremity joints is not significant. However, the different result between the ROM and LE gives a strong rationale for applying both linear and nonlinear tools together to the evaluation of joint movement. The LEs of the joints calculated from a large population of healthy subjects could provide normative values for the associated joints and can be used to evaluate the recovery progress of patients with

  14. EVALUATION OF RESULTS OF TITANIUM ELASTIC NAILING SYSTEM IN PAEDIATRIC LOWER EXTREMITY FRACTURES OF LONG BONES

    Directory of Open Access Journals (Sweden)

    Pradeep

    2014-12-01

    Full Text Available BACKGROUND: Flexible intramedullary nails have gained widespread popularity for stabilization of pediatric fractures of long bones of lower extremity. AIMS: Purpose of our study was to evaluate safety and efficacy of titanium elastic nailing system (TENS for paediatric lower extremity long bone fractures. METHODS: All children operated for lower extremity long bone fractures at our tertiary care centre (Sri Aurobindo Institute of Medical Sciences, Indore between Jan 2012 to Dec 2013 who underwent fixation with TENS were reviewed. Out of 57 cases identified, 4 cases were lost to follow-up. Of the 53 cases, 58.49 per cent were males (boys 31 and girls 22. The average age of patients was 10.8 years (range 6- 14 years. The mean weight was 28.8 kg (range 16 kg - 42 kg. All fractures were reduced by closed manipulation. Outcomes were classified as excellent, satisfactory or poor according to Flynn flexible nail fixation classification. RESULTS: As per Flynn classification, we had 36 excellent, 14 good and 1 poor result. All patients attained complete healing at mean of 11.2 weeks (Range 7 - 16 weeks. Mean duration of hospital stay was of 5 days (Range 3 - 16 days. CONCLUSION: On the basis of results obtained TENS is an effective method for management of unstable paediatric fractures of long bones of lower extremity allowing rapid mobilization with minimal complications.

  15. Isolated Upper Extremity Posttransplant Lymphoproliferative Disorder in a Child.

    Science.gov (United States)

    Halula, Sarah E; Leino, Daniel G; Patel, Manish N; Racadio, John M; Lungren, Matthew P

    2015-01-01

    Posttransplant lymphoproliferative disorder (PTLD) is a well-described complication of solid organ and bone marrow transplants. The most common presentation is intra-abdominal lymphadenopathy or single or multiple intraparenchymal masses involving the liver, spleen, or kidneys. Here we describe the imaging and pathology findings of an unusual case of PTLD appearing as an intramuscular forearm lesion in a pediatric male. The manifestation of PTLD as an isolated upper extremity mass in a pediatric patient has to our knowledge not been described. PMID:26167324

  16. Upper extremity rehabilitation of stroke: Facilitation of corticospinal excitability using virtual mirror paradigm

    Directory of Open Access Journals (Sweden)

    Kang Youn

    2012-10-01

    Full Text Available Abstract Background Several experimental studies in stroke patients suggest that mirror therapy and various virtual reality programs facilitate motor rehabilitation. However, the underlying mechanisms for these therapeutic effects have not been previously described. Objectives We attempted to delineate the changes in corticospinal excitability when individuals were asked to exercise their upper extremity using a real mirror and virtual mirror. Moreover, we attempted to delineate the role of visual modulation within the virtual environment that affected corticospinal excitability in healthy subjects and stroke patients. Methods A total of 18 healthy subjects and 18 hemiplegic patients were enrolled into the study. Motor evoked potential (MEPs from transcranial magnetic stimulation were recorded in the flexor carpi radialis of the non-dominant or affected upper extremity using three different conditions: (A relaxation; (B real mirror; and (C virtual mirror. Moreover, we compared the MEPs from the virtual mirror paradigm using continuous visual feedback or intermittent visual feedback. Results The rates of amplitude increment and latency decrement of MEPs in both groups were higher during the virtual mirror task than during the real mirror. In healthy subjects and stroke patients, the virtual mirror task with intermittent visual feedback significantly facilitated corticospinal excitability of MEPs compared with continuous visual feedback. Conclusion Corticospinal excitability was facilitated to a greater extent in the virtual mirror paradigm than in the real mirror and in intermittent visual feedback than in the continuous visual feedback, in both groups. This provides neurophysiological evidence supporting the application of the virtual mirror paradigm using various visual modulation technologies to upper extremity rehabilitation in stroke patients.

  17. Soft Tissue Coverage of the Hand and Upper Extremity: The Reconstructive Elevator.

    Science.gov (United States)

    Miller, Erin Anne; Friedrich, Jeffrey

    2016-07-01

    Soft tissue reconstruction of the upper extremity is a complex topic because every defect has multiple potential solutions. Whereas the often-cited reconstructive ladder advised selection of the simplest reconstruction of the defect, the newer concept of the reconstructive elevator allows freedom to choose a more complex reconstruction to account for specialized function and aesthetic outcome. An algorithm for assessment of the defect is presented and demonstrated in this review, using 6 case examples to highlight key concepts. Representative flaps are presented and a discussion of functional and aesthetic outcomes is undertaken to provide a framework for achieving the patient's and surgeon's goals of reconstruction. PMID:27288305

  18. Quality of Life Following Amputation or Limb Preservation in Patients with Lower Extremity Bone Sarcoma

    Directory of Open Access Journals (Sweden)

    Gary E Mason

    2013-08-01

    Full Text Available PURPOSE: Although functional differences have been described between patients with lower extremity bone sarcoma with amputation and limb preservation surgery, differences have not clearly been shown between the two groups related to quality of life. The aim of the study was to determine if there is a difference in overall quality of life in lower extremity bone sarcoma survivors related to whether they had an amputation or a limb preservation procedure. PATIENTS AND METHODS: Eighty-two long-term survivors of lower extremity bone sarcoma were studied to make a comparison of the overall quality of life, pain assessment and psychological evaluations in limb preservation and amputation patients. Forty-eight patients with limb preservation and thirty-four patients with amputations were enrolled in the study. Validated psychometric measures including the Quality of Life Questionnaire, the Minnesota Multiphasic Personality Inventory and visual analog scales were utilized.RESULTS: The overall quality of life of patients with limb preservation was significantly higher than patients with amputation (p-value < 0.01. Significant differences were noted in the categories of material well being, job satisfiers and occupational relations. CONCLUSION: The overall quality of life of patients with limb preservation appears to be better than for those patients with amputation based on the quality of life questionnaire in patients surviving lower extremity bone sarcoma. Further analysis needs to verify the results and focus on the categories that significantly affect the overall quality of life.

  19. The frequency and risk factors of developing lymphedema of the upper extremity after breast conserving therapy

    International Nuclear Information System (INIS)

    The aim of the study was to evaluate the frequency of lymphedema of the upper extremity in breast cancer patients after breast conserving therapy (BCT) and to assess the risk factors influencing this complication. We evaluated 174 patients with breast cancer, mean age 53 yrs, stage 0, I and II undergoing BCT at the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology in Warsaw between the years 1995 and 1999. Mean follow-up time was 50 months. Adjuvant chemotherapy or hormonotherapy had been administered to 83 pts. The circumference of both arms was measured by tape 10 cm above the lateral picondyle, 10 cm below it and at the metacarpal level. A difference of 2-4 cm was recognized as mild; of 4-6 cm as moderate and over 6 cm as severe lymphedema. In order to assess the risk factors of lymphedema we performed a statistical analysis of the following elements: age, tumour location, number of excised nodes, number of metastatic lymph nodes, radiotherapy to lymph node areas and adjuvant systemic therapy. We observed 17/174 (10%) cases of lymphedema - 15/17 mild; 1/17 moderate and 1/17 severe. On statistical analysis we found, that the only factor affecting lymphedema was irradiation to the lymph node areas. The incidence of lymphedema of the upper extremity after breast conserving therapy is low (10%), similar to published data. Radiotherapy of the lymph node areas is the only factor increasing the risk of lymphedema. (author)

  20. Quality of Life, Upper Extremity Function and the Effect of Lymphedema Treatment in Breast Cancer Related Lymphedema Patients

    OpenAIRE

    Park, Ji Eung; Jang, Hye Jin; Seo, Kwan Sik

    2012-01-01

    Objective To evaluate quality of life (QOL), upper extremity function and the effect of lymphedema treatment in patients with breast cancer related lymphedema. Method The basic data comprised medical records (detailing age, sex, dominant side, location of tumor, cancer stage, operation record, cancer treatment and limb circumferences) and questionnaires (lymphedema duration, satisfaction, self-massage). Further to this, we measured upper extremity function and QOL, administered the DASH (Disa...

  1. Treatment of upper extremity reflex sympathetic dystrophy with joint stiffness using sympatholytic Bier blocks and manipulation.

    Science.gov (United States)

    Duncan, K H; Lewis, R C; Racz, G; Nordyke, M D

    1988-06-01

    Twenty patients with reflex sympathetic dystrophy involving the upper extremity with associated joint stiffness were treated by manipulation under Bier blocks composed of lidocaine, methylprednisolone, and reserpine or guanethidine. Depending on the patients' response, repeat blocks were performed at 48- to 72-hour intervals. Range of motion in the affected joints (primarily the hand and wrist) improved from a pre-block mean of 46% to 81% of normal following the blocks. Patients also reported an 80% mean improvement in their pain. The treatment of advanced reflex sympathetic dystrophy using joint manipulation under sympatholytic Bier blocks appears to be a safe and effective method of treatment.

  2. Subcutaneous emphysema of the upper extremity following penetrating blackthorn injury to the wrist.

    LENUS (Irish Health Repository)

    Tiong, W H C

    2009-02-01

    SUMMARY: Noninfective subcutaneous emphysema of the upper extremity, albeit rare, has to be borne in mind when treating patients with subcutaneous emphysema. The misdiagnosis of this condition as its serious infective counterpart often leads to unnecessary aggressive treatment. Noninfective subcutaneous emphysema often accompanies a patient who has no systemic symptoms of illness. Unfortunately, the distinction is not always easy especially when history of injury suggests involvement of an infective or reactive element. Penetrating blackthorn injury is common, especially in rural communities, and often occurs from farming or gardening activities. Blackthorn penetration can cause numerous tissue reactions once embedded under the skin and they are often contaminated with soil. Here we present, for the first time, a case where penetrating blackthorn injury to the wrist resulted in noninfective subcutaneous emphysema involving the whole upper limb and neck, and its subsequent management.

  3. The WISTAH hand study: A prospective cohort study of distal upper extremity musculoskeletal disorders

    Directory of Open Access Journals (Sweden)

    Garg Arun

    2012-06-01

    Full Text Available Abstract Background Few prospective cohort studies of distal upper extremity musculoskeletal disorders have been performed. Past studies have provided somewhat conflicting evidence for occupational risk factors and have largely reported data without adjustments for many personal and psychosocial factors. Methods/design A multi-center prospective cohort study was incepted to quantify risk factors for distal upper extremity musculoskeletal disorders and potentially develop improved methods for analyzing jobs. Disorders to analyze included carpal tunnel syndrome, lateral epicondylalgia, medial epicondylalgia, trigger digit, deQuervain’s stenosing tenosynovitis and other tendinoses. Workers have thus far been enrolled from 17 different employment settings in 3 diverse US states and performed widely varying work. At baseline, workers undergo laptop administered questionnaires, structured interviews, two standardized physical examinations and nerve conduction studies to ascertain demographic, medical history, psychosocial factors and current musculoskeletal disorders. All workers’ jobs are individually measured for physical factors and are videotaped. Workers are followed monthly for the development of musculoskeletal disorders. Repeat nerve conduction studies are performed for those with symptoms of tingling and numbness in the prior six months. Changes in jobs necessitate re-measure and re-videotaping of job physical factors. Case definitions have been established. Point prevalence of carpal tunnel syndrome is a combination of paraesthesias in at least two median nerve-served digits plus an abnormal nerve conduction study at baseline. The lifetime cumulative incidence of carpal tunnel syndrome will also include those with a past history of carpal tunnel syndrome. Incident cases will exclude those with either a past history or prevalent cases at baseline. Statistical methods planned include survival analyses and logistic regression. Discussion A

  4. Quantitative Assessment of ADL: A Pilot Study of Upper Extremity Reaching Tasks

    Directory of Open Access Journals (Sweden)

    Saiyi Li

    2015-01-01

    Full Text Available Effective telerehabilitation technologies enable patients with certain physiological disabilities to engage in rehabilitative exercises for performing Activities of Daily Living (ADLs. Therefore, training and assessment scenarios for the performance of ADLs are vital for the promotion for telerehabilitation. In this paper we investigate quantitatively and automatically assessing patient’s kinematic ability to perform functional upper extremity reaching tasks. The shape of the movement trajectory and the instantaneous acceleration of kinematically crucial body parts, such as wrists, are used to compute the approximate entropy of the motions to represent stability (smoothness in addition to the duration of the activity. Computer simulations were conducted to illustrate the consistency, sensitivity and robustness of the proposed method. A preliminary experiment with kinematic data captured from healthy subjects mimicking a reaching task with dyskinesia showed a high degree of correlation (Cohen’s kappa 0.85 with p<0.05 between a human observer and the proposed automatic classification tool in terms of assigning the datasets to various levels to represent the subjects’ kinematic abilities to perform reaching tasks. This study supported the use of Microsoft Kinect to quantitatively evaluate the ability of individuals with involuntary movements to perform an upper extremity reaching task.

  5. Probability modeling of high flow extremes in Yingluoxia watershed, the upper reaches of Heihe River basin

    Science.gov (United States)

    Li, Zhanling; Li, Zhanjie; Li, Chengcheng

    2014-05-01

    Probability modeling of hydrological extremes is one of the major research areas in hydrological science. Most basins in humid and semi-humid south and east of China are concerned for probability modeling analysis of high flow extremes. While, for the inland river basin which occupies about 35% of the country area, there is a limited presence of such studies partly due to the limited data availability and a relatively low mean annual flow. The objective of this study is to carry out probability modeling of high flow extremes in the upper reach of Heihe River basin, the second largest inland river basin in China, by using the peak over threshold (POT) method and Generalized Pareto Distribution (GPD), in which the selection of threshold and inherent assumptions for POT series are elaborated in details. For comparison, other widely used probability distributions including generalized extreme value (GEV), Lognormal, Log-logistic and Gamma are employed as well. Maximum likelihood estimate is used for parameter estimations. Daily flow data at Yingluoxia station from 1978 to 2008 are used. Results show that, synthesizing the approaches of mean excess plot, stability features of model parameters, return level plot and the inherent independence assumption of POT series, an optimum threshold of 340m3/s is finally determined for high flow extremes in Yingluoxia watershed. The resulting POT series is proved to be stationary and independent based on Mann-Kendall test, Pettitt test and autocorrelation test. In terms of Kolmogorov-Smirnov test, Anderson-Darling test and several graphical diagnostics such as quantile and cumulative density function plots, GPD provides the best fit to high flow extremes in the study area. The estimated high flows for long return periods demonstrate that, as the return period increasing, the return level estimates are probably more uncertain. The frequency of high flow extremes exhibits a very slight but not significant decreasing trend from 1978 to

  6. Evolving Role of Ultrasound in Therapeutic Injections of the Upper Extremity.

    Science.gov (United States)

    Wilson, David J; Scully, William F; Rawlings, John M

    2015-11-01

    Ultrasound machines are creating more refined pictures and becoming more user-friendly and readily accessible. As a result, ultrasound is being increasingly used for therapeutic purposes. One example involves the use of ultrasound guidance in musculoskeletal interventional procedures, such as joint injections, tendon sheath injections, and peripheral nerve blocks. Technical considerations and therapeutic results have been described for multiple locations about the upper extremities, with varying levels of success. The implementation of ultrasound-guided injections in the orthopedist's clinic has therapeutic, financial, and provider role implications. Given these potential benefits, orthopedic providers, both in practice and residency, would benefit from increased exposure and education in ultrasound use. Ultrasound provides the benefit of real-time, dynamic imaging without the radiation exposure of fluoroscopy, and ultrasound-guided injections can be performed in the office, as opposed to the operating room, which is frequently required when using fluoroscopy. A basic knowledge of the principles and terms used in ultrasound is required. With these simple principles, a practitioner can review techniques for specific areas of the musculoskeletal system and begin using ultrasound to guide injections. Many locations for diagnostic and/or therapeutic injections in the upper extremities have improved accuracy and benefit with the use of ultrasound vs blind techniques, although a few have not been shown to have a significant difference in the literature. The educational and professional implications can be significant, but these potential benefits need to be carefully weighed against costs by each orthopedic practice. PMID:26558666

  7. Upper extremity cumulative trauma disorders in the makers of Maraş pounded ice cream

    OpenAIRE

    Betül Bakan; Mustafa Haki Sucaklı

    2013-01-01

    Objective: Upper Extremity Cumulative Trauma Disorders (UE-CTD) are among the major health problems affecting the workers. The aim of this study was to investigate UE-CTD in the makers of Maras pounded ice cream (MMPIC) Methods: This study was conducted among 50 volunteers who work as a MMPIC and 50 control in our downtown area. During face-to-face conversion, the participants filled out a survey inquiring about age, duration of work (in years) in job, daily working time, occupation with ...

  8. Predictors of upper extremity discomfort: a longitudinal study of industrial and clerical workers.

    Science.gov (United States)

    Werner, Robert A; Franzblau, Alfred; Gell, Nancy; Ulin, Sheryl S; Armstrong, Thomas J

    2005-03-01

    Upper extremity discomfort associated with work activity is common with a prevalence of over 50% in many settings. This study followed a cohort of 501 active workers for an average of 5.4 years. Cases were defined as workers who were asymptomatic or had a low discomfort score of 1 or 2 at baseline testing and went on to report a discomfort score of 4 or above on a 10-point visual analog scale. This change is considered clinically significant. Controls had a low baseline discomfort score and continued to have a low discomfort rating throughout the study. The risk factors found to have the highest predictive value for identifying a person who is likely to develop a significant upper extremity discomfort rating included age over 40, a BMI over 28, a complaint of baseline discomfort, the severity of the baseline discomfort rating and a job that had a high hand activity level (based upon hand repetition and force). The risk profile identified both ergonomic and personal health factors as risks and both factors may be amenable to prevention strategies.

  9. Upper extremity thrombosis in Behçet’s disease

    Directory of Open Access Journals (Sweden)

    Adem Küçük

    2013-09-01

    Full Text Available Behçet’s disease (BD is a systemic disease characterizedby oral aphthosis, genital ulcers, ocular lesions andalso gastrointestinal, musculoskeletal, neurological andvessel involvements may develop. Venous manifestationsare more common than arterial involvement. Venousinvolvement often occurs in the veins of lower extremity.Upper extremity venous involvement is rare. In this paperwe report a case of BH presenting with upper extremitysuperficial vein thrombosis.Key words: Behçet’s disease, upper extremity, superficialvein thrombosis

  10. The Chauvet 2014 Meeting Report: Psychiatric and Psychosocial Evaluation and Outcomes of Upper Extremity Grafted Patients.

    Science.gov (United States)

    Jowsey-Gregoire, Sheila G; Kumnig, Martin; Morelon, Emmanuel; Moreno, Elisa; Petruzzo, Palmina; Seulin, Christian

    2016-07-01

    Under the auspices for the International Society on Hand and Composite Tissue Allotransplantation, a section of The Transplantation Society (IHCTAS), a meeting was convened on March 21-22, 2014 in Paris to review the following areas that were deemed significant in the understanding of the psychosocial evaluation and outcomes of upper extremity transplant recipients: required domains of the evaluation, screening instruments, clinical monitoring pretransplant, clinical monitoring posttransplant, patient and team expectations, body image, psychiatric complications, functional goals and quality of life, ethics and media relations. Experts in the fields of psychiatry and psychology, transplantation, social work, ethics, and transplant administration met and reviewed center experiences and literature. The attendees highlighted the importance and the complexity of the psychiatric assessment in this field of transplantation. Moreover, the necessity to develop common instruments and evaluation protocols to predict psychosocial outcomes as well as to understand whether we are transplanting the right patients and how the transplantation is affecting the patients were pointed out. Psychiatric complications in upper extremity transplanted patients have been reported by the majority of teams. Preexisting psychiatric difficulties, the initial trauma of amputation, or adjusting to the transplantation process itself (especially the medical follow-up and rehabilitation process) appeared to be important factors. Monitoring during the whole follow-up was recommended to detect psychiatric issues and to facilitate and ensure long-term adherence. The participants proposed an annual meeting format to build upon the findings of this inaugural meeting to be called the Chauvet Workgroup meeting. PMID:26636738

  11. Rehabilitation of the Upper Extremity after Stroke: Current Practice As a Guide for Curriculum

    Directory of Open Access Journals (Sweden)

    Mylene Schriner PhD, OTR/L

    2014-01-01

    Full Text Available Stroke is the leading cause of disability in the United States and a top diagnosis for occupational therapy (OT services among neurological conditions. Academic programs teach OT students neurological frames of reference (FORs to provide a foundation for future practice. To meet accreditation standards, entry-level curricula must reflect current practice and evidence-based interventions. A survey of OT practitioners working in upper extremity stroke rehabilitation was conducted to investigate current clinical practice in a variety of treatment settings. Survey questions probed the use of motor rehabilitation techniques exclusive to one of six neurological FORs: Brunnstrom, Constraint-induced Movement Therapy, Neurodevelopmental Treatment, Proprioceptive Neuromuscular Facilitation, Rood, and Task-Oriented. Responses from 167 OT professionals indicated interventions representing all six FORs are currently being utilized in stroke rehabilitation. Techniques from the Task-Oriented and Neurodevelopmental Treatment approaches were used most frequently; however, the Rood–based techniques were used much less than interventions from the other FORs. No single neurological approach was found to dominate practice regardless of the number of years of experience in stroke rehabilitation or years since graduation from an entry-level program. A majority of participants appear to employ techniques from multiple approaches frequently, suggesting contemporary OT practice in upper extremity stroke rehabilitation is eclectic in nature.

  12. Computer work and musculoskeletal disorders of the neck and upper extremity: A systematic review

    Directory of Open Access Journals (Sweden)

    Veiersted Kaj Bo

    2010-04-01

    Full Text Available Abstract Background This review examines the evidence for an association between computer work and neck and upper extremity disorders (except carpal tunnel syndrome. Methods A systematic critical review of studies of computer work and musculoskeletal disorders verified by a physical examination was performed. Results A total of 22 studies (26 articles fulfilled the inclusion criteria. Results show limited evidence for a causal relationship between computer work per se, computer mouse and keyboard time related to a diagnosis of wrist tendonitis, and for an association between computer mouse time and forearm disorders. Limited evidence was also found for a causal relationship between computer work per se and computer mouse time related to tension neck syndrome, but the evidence for keyboard time was insufficient. Insufficient evidence was found for an association between other musculoskeletal diagnoses of the neck and upper extremities, including shoulder tendonitis and epicondylitis, and any aspect of computer work. Conclusions There is limited epidemiological evidence for an association between aspects of computer work and some of the clinical diagnoses studied. None of the evidence was considered as moderate or strong and there is a need for more and better documentation.

  13. Adaptive Control of a Wearable Exoskeleton for Upper-Extremity Neurorehabilitation

    Directory of Open Access Journals (Sweden)

    Sivakumar Balasubramanian

    2012-01-01

    Full Text Available The paper describes the implementation and testing of two adaptive controllers developed for a wearable, underactuated upper extremity therapy robot – RUPERT (Robotic Upper Extremity Repetitive Trainer. The controllers developed in this study were used to implement two adaptive robotic therapy modes – the adaptive co-operative mode and the adaptive active-assist mode – that are based on two different approaches for providing robotic assistance for task practice. The adaptive active-assist mode completes therapy tasks when a subject is unable to do so voluntarily. This robotic therapy mode is a novel implementation of the idea of an active-assist therapy mode; it utilizes the measure of a subject’s motor ability, along with their real-time movement kinematics to initiate robotic assistance at the appropriate time during a movement trial. The adaptive co-operative mode, on the other hand, is based on the idea of enabling task completion instead of completing the task for the subject. Both these therapy modes were designed to adapt to a stroke subject's motor ability, and thus encourage voluntary participation from the stroke subject. The two controllers were tested on three stroke subjects practicing robot-assisted reaching movements. The results from this testing demonstrate that an underactuated wearable exoskeleton, such as RUPERT, can be used for administering robot-assisted therapy, in a manner that encourages voluntary participation from the subject undergoing therapy.

  14. Clinicopathological features and treatment of extremity bone metastasis in patients with endometrial carcinoma: a case report and review

    Institute of Scientific and Technical Information of China (English)

    JIANG Guo-qing; GAO Yu-nong; GAO Min; ZHENG Hong; YAN Xin; WANG Wen; AN Na; CAO Kun

    2011-01-01

    Unlike other non-gynecologic solid tumors, such as breast cancer, lung cancer, metastasis to bone from endometrial carcinoma is rare, metastasis to extremity is extremely rare. We report a 51-year-old multiparous woman with FIGO Stage IVb Grade 2 endometrial adenocarcinoma which metastasized to left lower extremity bone. She received an amputation of left lower extremity below the knees, and a total abdominal hysterectomy and bilateral salpingo-oophorectomy, and followed by systemic chemotherapy, radiation therapy to the pelvis and progestational agent. She had a complete response to above treatments, and disease-free survival for 10 months. After recurrence, she received chemotherapy, radiotherapy and progestational agent once again. She had lived 56 months and is still alive by the time of report. Metastasis of endometrial carcinoma to extremity bone can rarely occur and should be considered when the patient with endometrial carcinoma complained of unexplained pain and swelling associated with extremity bone.

  15. Dual-energy CT angiography of pelvic and lower extremity arteries: dual-energy bone subtraction versus manual bone subtraction

    International Nuclear Information System (INIS)

    Aim: To analyse the effect of dual-energy bone subtraction (DEBS) on the image quality of peripheral computed tomography (CT) angiograms. Materials and methods: Twenty patients underwent dual-energy CT angiography of the pelvic and lower extremity arteries using commercially available equipment. Two different methods of image processing were employed for each CT angiographic dataset: (1) DEBS, and (2) manual bone subtraction (MBS). Effects on vessel visibility and artificial vessel alterations were compared. Results: Bone removal, and the resultant visibility of vessel segments, were significantly better with DEBS than with MBS (p = 0.011). The overall frequency of vessel-related alterations was lower in MBS compared with DEBS (p = 0.001). Specifically, in the 249 vessel segments with calcified plaques, MBS generated fewer vessel alterations than DEBS (p < 0.001). In the 309 vessel segments without calcified plaques, there was no difference in vessel alteration between the two techniques (p = 0.22). Conclusion: DEBS facilitates bone removal in peripheral CT angiography, but generates more vessel alterations, particularly in the presence of calcified plaque.

  16. Dual-energy CT angiography of pelvic and lower extremity arteries: dual-energy bone subtraction versus manual bone subtraction

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, S., E-mail: syamamoto@gmail.co [David Geffen School of Medicine, Department of Radiology, University of California-Los Angeles, Los Angeles (United States); McWilliams, J.; Arellano, C.; Marfori, W.; Cheng, W.; Mcnamara, T.; Quinones-Baldrich, W.J.; Ruehm, S.G. [David Geffen School of Medicine, Department of Radiology, University of California-Los Angeles, Los Angeles (United States)

    2009-11-15

    Aim: To analyse the effect of dual-energy bone subtraction (DEBS) on the image quality of peripheral computed tomography (CT) angiograms. Materials and methods: Twenty patients underwent dual-energy CT angiography of the pelvic and lower extremity arteries using commercially available equipment. Two different methods of image processing were employed for each CT angiographic dataset: (1) DEBS, and (2) manual bone subtraction (MBS). Effects on vessel visibility and artificial vessel alterations were compared. Results: Bone removal, and the resultant visibility of vessel segments, were significantly better with DEBS than with MBS (p = 0.011). The overall frequency of vessel-related alterations was lower in MBS compared with DEBS (p = 0.001). Specifically, in the 249 vessel segments with calcified plaques, MBS generated fewer vessel alterations than DEBS (p < 0.001). In the 309 vessel segments without calcified plaques, there was no difference in vessel alteration between the two techniques (p = 0.22). Conclusion: DEBS facilitates bone removal in peripheral CT angiography, but generates more vessel alterations, particularly in the presence of calcified plaque.

  17. International Spinal Cord Injury Upper Extremity Basic Data Set

    DEFF Research Database (Denmark)

    Biering-Sørensen, F; Bryden, A; Curt, A;

    2014-01-01

    OBJECTIVE: To develop an International Spinal Cord Injury (SCI) Upper Extremity Basic Data Set as part of the International SCI Data Sets, which facilitates consistent collection and reporting of basic upper extremity findings in the SCI population. SETTING: International. METHODS: A first draft...

  18. Injury to the upper extremity caused by extravasation of contrast medium: a true emergency.

    Science.gov (United States)

    Fallscheer, Philipp; Kammer, Erich; Roeren, Thomas; Meuli-Simmen, Claudia

    2007-01-01

    This retrospective clinical study, over a period of four years, includes 16 patients who had extravasation of iopromidum 623 mg (Ultravist 300) in the upper extremity during computed tomography (CT). Although conservative management is sufficient in most cases, seven patients were operated on. The mean time between extravasation and operation was 155 minutes. The most complicated postoperative course occurred when the operation was delayed 300 minutes after extravasation. When patients were treated early, there was no permanent postoperative impairment. Extravasation of contrast is an increasing cause of potential complications in the forearm as a result of the use of power injectors in CT. Immediate assessment by an experienced plastic surgeon followed by either conservative treatment or quick intervention if necessary may avoid serious damage.

  19. A comparison of ultrasound-guided supraclavicular and infraclavicular blocks for upper extremity surgery

    DEFF Research Database (Denmark)

    Koscielniak-Nielsen, Z J; Frederiksen, B S; Rasmussen, H;

    2009-01-01

    -guided supraclavicular or infraclavicular blocks. We hypothesized that the supraclavicular approach, being more superficial and easier to visualize using a 10 MHz transducer, will produce a faster and a more extensive sensory block. METHODS: One hundred and twenty patients were randomized to two equal groups......BACKGROUND: Ultrasound (US)-guided supraclavicular or infraclavicular blocks are commonly used for upper extremity surgery. The aims of this randomized study were to compare the block performance and onset times, effectiveness, incidence of adverse events and patient's acceptance of US......) of the seven terminal nerves was assessed every 10 min. Patients were declared ready for surgery when they had an effective surgical block--anaesthesia or analgesia of the five nerves below the elbow. Thirty minutes after the block, the unblocked nerves were supplemented. The block performance and...

  20. Trans-femoral thromboaspiration for upper extremity ischemia

    OpenAIRE

    Gordhan, Ajeet

    2015-01-01

    Introduction Endovascular trans-femoral access catheter aspiration of thrombus within the proximal subclavian, brachial, radial and ulnar arteries for symptomatic upper extremity ischemic pain has not been previously reported. We describe a case in which a successful clinical outcome was achieved using long length neuro-endovascular aspiration catheters. Presentation of case A 45 year old female presented with diffuse left upper limb pain. Sonography revealed compromised upper extremity blood...

  1. Biomechanical model for evaluation of pediatric upper extremity joint dynamics during wheelchair mobility.

    Science.gov (United States)

    Schnorenberg, Alyssa J; Slavens, Brooke A; Wang, Mei; Vogel, Lawrence C; Smith, Peter A; Harris, Gerald F

    2014-01-01

    Pediatric manual wheelchair users (MWU) require high joint demands on their upper extremity (UE) during wheelchair mobility, leading them to be at risk of developing pain and pathology. Studies have examined UE biomechanics during wheelchair mobility in the adult population; however, current methods for evaluating UE joint dynamics of pediatric MWU are limited. An inverse dynamics model is proposed to characterize three-dimensional UE joint kinematics and kinetics during pediatric wheelchair mobility using a SmartWheel instrumented handrim system. The bilateral model comprises thorax, clavicle, scapula, upper arm, forearm, and hand segments and includes the sternoclavicular, acromioclavicular, glenohumeral, elbow and wrist joints. A single 17 year-old male with a C7 spinal cord injury (SCI) was evaluated while propelling his wheelchair across a 15-meter walkway. The subject exhibited wrist extension angles up to 60°, large elbow ranges of motion and peak glenohumeral joint forces up to 10% body weight. Statistically significant asymmetry of the wrist, elbow, glenohumeral and acromioclavicular joints was detected by the model. As demonstrated, the custom bilateral UE pediatric model may provide considerable quantitative insight into UE joint dynamics to improve wheelchair prescription, training, rehabilitation and long-term care of children with orthopedic disabilities. Further research is warranted to evaluate pediatric wheelchair mobility in a larger population of children with SCI to investigate correlations to pain, function and transitional changes to adulthood.

  2. The effects of very early mirror therapy on functional improvement of the upper extremity in acute stroke patients.

    Science.gov (United States)

    Yeldan, Ipek; Huseyınsınoglu, Burcu Ersoz; Akıncı, Buket; Tarakcı, Ela; Baybas, Sevim; Ozdıncler, Arzu Razak

    2015-11-01

    [Purpose] The aim of the study was to evaluate the effects of a very early mirror therapy program on functional improvement of the upper extremity in acute stroke patients. [Subjects] Eight stroke patients who were treated in an acute neurology unit were included in the study. [Methods] The patients were assigned alternatively to either the mirror therapy group receiving mirror therapy and neurodevelopmental treatment or the neurodevelopmental treatment only group. The primary outcome measures were the upper extremity motor subscale of the Fugl-Meyer Assessment, Motricity Index upper extremity score, and the Stroke Upper Limb Capacity Scale. Somatosensory assessment with the Ayres Southern California Sensory Integration Test, and the Barthel Index were used as secondary outcome measures. [Results] No statistically significant improvements were found for any measures in either group after the treatment. In terms of minimally clinically important differences, there were improvements in Fugl-Meyer Assessment and Barthel Index in both mirror therapy and neurodevelopmental treatment groups. [Conclusion] The results of this pilot study revealed that very early mirror therapy has no additional effect on functional improvement of upper extremity function in acute stroke patients. Multicenter trials are needed to determine the results of early application of mirror therapy in stroke rehabilitation. PMID:26696729

  3. Detection of rheumatoid arthritis bone erosions by 2 different dedicated extremity MRI units and conventional radiography

    DEFF Research Database (Denmark)

    Duer, Anne; Vestergaard, Aage; Døhn, Uffe Møller;

    2008-01-01

    OBJECTIVES: To compare the ability of 2 different dedicated extremity magnetic resonance imaging (E-MRI) units and conventional radiography (CR) for identifying bone erosions in rheumatoid arthritis (RA) metacarpophalangeal (MCP) and wrist joints. METHODS: CR and 2 MRI-examinations (on 0.2T Esaote...... carpal bones. MagneVu and CR detected 100% and 89%, respectively, of large erosions (OMERACT-RAMRIS-score > 1 on Artoscan) in MCP-joints, and 69% and 15.8% of large erosions in wrists. CONCLUSIONS: Both E-MRI units detected more erosions than CR, particularly due to a higher sensitivity in metacarpal...... Artoscan and 0.2T portable MagneVu MV1000 units) of 418 bones in the dominant wrist and 2.-5. MCP-joints of 15 RA patients and 4 healthy controls were performed and blindedly evaluated for bones being visible and for erosions. RESULTS: In MCP-joints, MagneVu visualized 18.5% of bones entirely and 71...

  4. Assessing upper extremity motor function in practice of virtual activities of daily living.

    Science.gov (United States)

    Adams, Richard J; Lichter, Matthew D; Krepkovich, Eileen T; Ellington, Allison; White, Marga; Diamond, Paul T

    2015-03-01

    A study was conducted to investigate the criterion validity of measures of upper extremity (UE) motor function derived during practice of virtual activities of daily living (ADLs). Fourteen hemiparetic stroke patients employed a Virtual Occupational Therapy Assistant (VOTA), consisting of a high-fidelity virtual world and a Kinect™ sensor, in four sessions of approximately one hour in duration. An unscented Kalman Filter-based human motion tracking algorithm estimated UE joint kinematics in real-time during performance of virtual ADL activities, enabling both animation of the user's avatar and automated generation of metrics related to speed and smoothness of motion. These metrics, aggregated over discrete sub-task elements during performance of virtual ADLs, were compared to scores from an established assessment of UE motor performance, the Wolf Motor Function Test (WMFT). Spearman's rank correlation analysis indicates a moderate correlation between VOTA-derived metrics and the time-based WMFT assessments, supporting the criterion validity of VOTA measures as a means of tracking patient progress during an UE rehabilitation program that includes practice of virtual ADLs.

  5. Deep vein thrombosis of the upper extremity: intra- and interobserver study of digital subtraction venography

    Energy Technology Data Exchange (ETDEWEB)

    Baarslag, Henk J.; Delden, Otto M. van; Bakker, Ad J.; Reekers, Jim A. [Department of Radiology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Beek, Edwin J.R. van [Department of Radiology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Section of Academic Radiology, Floor C, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF (United Kingdom); Tijssen, Jan G.P. [Department of Cardiology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands)

    2003-02-01

    Our objective was to assess the inter-observer and intra-observer agreement in the interpretation of digital subtraction venography (DSV) in patients with suspected deep vein thrombosis of the upper extremity (DVTUE). Prospectively, 62 consecutive DSV studies in 54 patients with clinically suspected DVTUE were included. Hard copies were presented without demographic data or original report. All venograms were read twice, at 3-month intervals, by an interventional vascular radiologist (observer 1) and an experienced general radiologist (observer 2). Consensus reading took place in the presence of a third experienced interventional radiologist. Inter-observer and intra-observer agreement were assessed using kappa statistics. Initial reading in 62 venograms showed an inter-observer agreement of 71% (kappa 0.48). The inter-observer agreement of the second reading was 83% (kappa 0.71). The agreement with the consensus report ranged from 76 to 94%. The intra-observer agreement for the first and second observer was 94% (kappa 0.89) and 76% (kappa 0.56), respectively (p<0.01). Digital subtraction venography has moderate to excellent intra- and inter-observer agreement, suggesting that digital subtraction venography is reliable for the diagnosis of DVTUE. (orig.)

  6. Deep vein thrombosis of the upper extremity: intra- and interobserver study of digital subtraction venography

    International Nuclear Information System (INIS)

    Our objective was to assess the inter-observer and intra-observer agreement in the interpretation of digital subtraction venography (DSV) in patients with suspected deep vein thrombosis of the upper extremity (DVTUE). Prospectively, 62 consecutive DSV studies in 54 patients with clinically suspected DVTUE were included. Hard copies were presented without demographic data or original report. All venograms were read twice, at 3-month intervals, by an interventional vascular radiologist (observer 1) and an experienced general radiologist (observer 2). Consensus reading took place in the presence of a third experienced interventional radiologist. Inter-observer and intra-observer agreement were assessed using kappa statistics. Initial reading in 62 venograms showed an inter-observer agreement of 71% (kappa 0.48). The inter-observer agreement of the second reading was 83% (kappa 0.71). The agreement with the consensus report ranged from 76 to 94%. The intra-observer agreement for the first and second observer was 94% (kappa 0.89) and 76% (kappa 0.56), respectively (p<0.01). Digital subtraction venography has moderate to excellent intra- and inter-observer agreement, suggesting that digital subtraction venography is reliable for the diagnosis of DVTUE. (orig.)

  7. Clinical effect of radiation synovectomy of the upper extremity joints : a randomised, double-blind, placebo-controlled study

    NARCIS (Netherlands)

    van der Zant, F. M.; Jahangier, Z. N.; Moolenburgh, J. D.; Swen, W. A. A.; Boer, R. O.; Jacobs, J. W. G.

    2007-01-01

    Purpose: To compare the clinical efficacy of radiosynoviorthesis (RSO) with intra-articular radionuclide plus glucocorticoid ( GC) injection ( group A) with that of placebo plus GC injection ( group B) for the treatment of persistent synovitis in joints of the upper extremity. Methods: At baseline a

  8. Muscle activation patterns of the upper and lower extremity during the windmill softball pitch.

    Science.gov (United States)

    Oliver, Gretchen D; Plummer, Hillary A; Keeley, David W

    2011-06-01

    Fast-pitch softball has become an increasingly popular sport for female athletes. There has been little research examining the windmill softball pitch in the literature. The purpose of this study was to describe the muscle activation patterns of 3 upper extremity muscles (biceps, triceps, and rhomboids [scapular stabilizers]) and 2 lower extremity muscles (gluteus maximus and medius) during the 5 phases of the windmill softball pitch. Data describing muscle activation were collected on 7 postpubescent softball pitchers (age 17.7 ± 2.6 years; height 169 ± 5.4 cm; mass 69.1 ± 5.4 kg). Surface electromyographic data were collected using a Myopac Jr 10-channel amplifier (RUN Technologies Scientific Systems, Laguna Hills, CA, USA) synchronized with The MotionMonitor™ motion capture system (Innovative Sports Training Inc, Chicago IL, USA) and presented as a percent of maximum voluntary isometric contraction. Gluteus maximus activity reached (196.3% maximum voluntary isometric contraction [MVIC]), whereas gluteus medius activity was consistent during the single leg support of phase 3 (101.2% MVIC). Biceps brachii activity was greatest during phase 4 of the pitching motion. Triceps brachii activation was consistently >150% MVIC throughout the entire pitching motion, whereas the scapular stabilizers were most active during phase 2 (170.1% MVIC). The results of this study indicate the extent to which muscles are activated during the windmill softball pitch, and this knowledge can lead to the development of proper preventative and rehabilitative muscle strengthening programs. In addition, clinicians will be able to incorporate strengthening exercises that mimic the timing of maximal muscle activation most used during the windmill pitching phases.

  9. The utility of onion extract gel containing topical allantoin and heparin after surgical treatment of upper extremity burn scars

    Directory of Open Access Journals (Sweden)

    Mehmet Ihsan Okur

    2014-12-01

    Conclusion: Although no significant difference was obtained with Contractubex gel treatment in this study, cosmetic and functional success can be achieved through excision of the scar and use of medium thickness skin graft in patients with upper extremity hypertrophic burn scarring that is resistant to conservative treatments. [Hand Microsurg 2014; 3(3.000: 74-79

  10. Frequency of Painful Shoulder Limitation of Motion after Long Casting of Upper Extremity

    Directory of Open Access Journals (Sweden)

    A.R. Yavarikia

    2004-01-01

    Full Text Available The aim of this study was determination of frequency of painful reduced shoulder motion after long casting of upper extremity and its relation with age , sex and education . The present work was a descriptive analytic prospective study and included 388 patients who referred to Mobasher hospital of Hamadan during 2001. The selected patients in recurrent referring to orthopedic department were classified to 10 age groups and were examined by researcher in 1 , 1.5 and 3 months after treatment and data was collected in check list. The primary data were analyzed with 2 & Anova by employing EPI 6. Out of 388 studied patients 73.5% after 3 months had no mobility limitation and 26.5% had some limitation. There was significant statistical difference in limitation of abduction shoulder joint movement after 1 , 1.5 and 3 months after treatment among 10 different age groups (P<0.05. Mobility limitation of internal rotation after 3 months in 74 cases (19.1%(P=0.0001. Final mobility limitation in 59.5% of female patients and 40.5% of male patients(P=0.001. Mobility limitation in 54.1% of illiterate people , 24.5% under high school diploma and 21.4% high school diploma and higher. Painful limitation of motion in 50-80 year aged is most frequent, then early mobility and physiotherapy in this age range is indicated. There is significant relation between sex and frozen shoulder and it is more common in females also in illiterate people.

  11. [Disorders of the cervical spine and the upper extremities and occupations].

    Science.gov (United States)

    Krapac, L

    1989-12-01

    A chronological review of damage to the spine and upper extremities associated with work was carried out in a sample of 120 retired disabled workers. Examination of risk factors for cervicobrachial syndrome (CBS) showed that the forced, bent position of the body at work contributed significantly to the frequency of the disease, particularly in women (70.0% against 38% in controls P less than 0.01). The lifting of heavy loads was also frequently observed in women with CBS (12% compared to 6% in the control group (P less than 0.05). Repeated movements during work were claimed by 52.9% of the males and 80% of the females with CBS and by only 41.4% of the males and 50% of the females without it (P less than 0.01). The heaviest load lifted by subjects with CBS at work exceeded significantly that of control subjects. It is considered that there is a causal link between excessive burden and the occurrence of CBS in women. For early diagnosis of CBS, tiredness, pain in the cervical spine, reduced strength in the hands and poor ability to endure manual work are signs to be looked for. Early recognition of disease, improved working conditions and recreation can help prevent the disease or slow down its progress. PMID:2637664

  12. Metastatic tumours in upper maxillary bone of esophageal adenocarcinoma. A case report.

    Science.gov (United States)

    Sánchez-Jiménez, Juan; Acebal-Blanco, Faustino; Arévalo-Arévalo, Rafael E; Molina-Martínez, Manuel

    2005-01-01

    Metastases in the oral cavity are rare lesions which represent approximately 1% of all malignant neoplasms in the oral cavity. Oral metastases are located in the mandible 80-90% on average, the maxilla location being rarer. Metastases in mouth soft tissue are also rare, and within these it is on the gums where they more frequently occur. Primary tumours which metastasize to mouth are most commonly: lung, breast and kidney. Oral cavity metastases appear as a result of distant disease spreading and show wrong prognosis, with short survival. Here we present a clinical case of a patient diagnosed with esophagus adenocarcinoma which presented metastasis in upper-left maxillary bone.

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

    International Nuclear Information System (INIS)

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

  14. Upper extremity neurodynamic tests: range of motion asymmetry may not indicate impairment.

    Science.gov (United States)

    Covill, Laura G; Petersen, Shannon M

    2012-10-01

    Upper extremity (UE) neurodynamic tests are used to examine neural tissue in patients with neuro-musculoskeletal disorders. Although comparisons between involved and uninvolved limbs are made clinically, minimal data exist reflecting the normal variation between sides. The purpose of this study was to determine if within-subject differences exist between limbs in the UE component of neurodynamic tests of the median, radial, and ulnar nerves. Sixty-one healthy subjects were examined. Difference between limbs for the median nerve-biased test was significant (right=16.4° ± 11.4°, left=20.1° ± 13.7°; p=0.045). There was no significant difference between limbs for the radial or ulnar nerve-biased tests. Correlation between limbs was poor for all tests (median r(2) =0.14; radial r(2) =0.20; ulnar r(2) =0.13). Lower-bound scores were calculated to determine the amount of difference needed to consider asymmetry beyond measurement error; the scores for each neurodynamic test were as follows: median 27°, radial 20°, and ulnar 21°. The results of this study show that between-limb values have low correlation and that it may be normal for an individual to have range of motion differences between limbs with neurodynamic tests. PMID:22201643

  15. Circulation of whale-bone artifacts in the northern Pyrenees during the late Upper Paleolithic.

    Science.gov (United States)

    Pétillon, Jean-Marc

    2013-11-01

    The importance of coastal resources in the late Upper Paleolithic of western Europe has been reevaluated in recent years thanks to a growing body of new archeological evidence, including the identification of more than 50 implements made of whale bone in the Magdalenian level of the Isturitz cave (western Pyrenees). In the present study, the assemblages of osseous industry from 23 Magdalenian sites and site clusters in the northern Pyrenees were investigated, systematically searching for whale-bone implements. The objective of this research was to determine if, and how, tools and weapons of coastal origin were circulated beyond Isturitz into the inland, and if similar implements existed on the eastern, Mediterranean side of the Pyrenees. A total of 109 whale-bone artifacts, mostly projectile heads of large dimensions, were identified in 11 sites. Their geographic distribution shows that whale bone in the Pyrenean Magdalenian is exclusively of Atlantic origin, and that objects made of this material were transported along the Pyrenees up to the central part of the range at travel distances of at least 350 km from the seashore. This phenomenon seems to have taken place during the second half of the Middle Magdalenian and the first half of the Late Magdalenian, ca. 17,500-15,000 cal BP (calibrated years before present). The existence of a durable, extended coastal-inland interaction network including the circulation of regular tools is thus demonstrated. Additionally, differences between the whale-bone projectile heads of the Middle Magdalenian and those of the Late Magdalenian document an evolutionary process in the design of hunting weapons. PMID:24103459

  16. Validity and intra- and interobserver reliability of an indirect volume measurements in patients with upper extremity lymphedema

    NARCIS (Netherlands)

    Meijer, R.S.; Rietman, J.S.; Geertzen, J.H.B.; Bosmans, J.C.; Dijkstra, P.U.

    2004-01-01

    We investigated a method of indirect volume measurement that utilized surface measurements and a simplified formula derived from the formula for a frustum (Sitzia's method) to determine limb volumes in patients with breast cancer-related lymphedema of the upper extremity. Repeated measurements of up

  17. Acute Bouts of Assisted Cycling Improves Cognitive and Upper Extremity Movement Functions in Adolescents with Down Syndrome

    Science.gov (United States)

    Ringenbach, Shannon D. R; Albert, Andrew R.; Chen, Chih-Chia; Alberts, Jay L.

    2014-01-01

    The aim of this study was to examine the effectiveness of 2 modes of exercise on cognitive and upper extremity movement functioning in adolescents with Down syndrome (DS). Nine participants randomly completed 3 interventions over 3 consecutive weeks. The interventions were: (a) voluntary cycling (VC), in which participants cycled at their…

  18. Stimulus-response characteristics of motor evoked potentials and silent periods in proximal and distal upper-extremity muscles.

    NARCIS (Netherlands)

    Kuijk, A.A. van; Anker, L.C.; Pasman, J.W.; Hendriks, J.C.M.; Elswijk, G.A.F. van; Geurts, A.C.H.

    2009-01-01

    OBJECTIVE: To compare stimulus-response characteristics of both motor evoked potentials (MEP) and silent periods (SP) induced by transcranial magnetic stimulation (TMS) in proximal and distal upper-extremity muscles. METHODS: Stimulus-response curves of MEPs and SPs were obtained from the biceps bra

  19. To Constrain or Not to Constrain, and Other Stories of Intensive Upper Extremity Training for Children with Unilateral Cerebral Palsy

    Science.gov (United States)

    Gordon, Andrew M.

    2011-01-01

    Impaired hand function is among the most functionally disabling symptoms of unilateral cerebral palsy. Evidence-based treatment approaches are generally lacking. However, recent approaches providing intensive upper extremity training appear promising. In this review, we first describe two such approaches, constraint-induced movement therapy (CIMT)…

  20. Upper extremity pain and computer use among engineering graduate students

    OpenAIRE

    Schlossberg, E B; Morrow, S; Llosa, A E; Mamary, E; Dietrich, P.; Rempel, D M

    2004-01-01

    Background The objective of this study was to investigate risk factors associated with persistent or recurrent upper extremity and neck pain among engineering graduate students. Methods A random sample of 206 Electrical Engineering and Computer Science (EECS) graduate students at a large public university completed an online questionnaire. Results Approximately 60% of respondents reported upper extremity or neck pain attributed to computer use and reported a mean pain severity score of 4.5 (+...

  1. The effects of mirror therapy with tasks on upper extremity function and self-care in stroke patients.

    Science.gov (United States)

    Park, Youngju; Chang, Moonyoung; Kim, Kyeong-Mi; An, Duk-Hyun

    2015-05-01

    [Purpose] The purpose of this study was to determine the effects of mirror therapy with tasks on upper extremity unction and self-care in stroke patients. [Subjects] Thirty participants were randomly assigned to either an experimental group (n=15) or a control group (n=15). [Methods] Subjects in the experimental group received mirror therapy with tasks, and those in the control group received a sham therapy; both therapies were administered, five times per week for six weeks. The main outcome measures were the Manual Function Test for the paralyzed upper limb and the Functional Independence Measure for self-care performance. [Results] The experimental group had more significant gains in change scores compared with the control group after the intervention. [Conclusion] We consider mirror therapy with tasks to be an effective form of intervention for upper extremity function and self-care in stroke patients. PMID:26157249

  2. Acute deep venous thrombosis of the upper extremity as demonstrated by scintigraphy with {sup 99m}Tc-apcitide

    Energy Technology Data Exchange (ETDEWEB)

    Dunzinger, A.; Piswanger-Soelkner, J.; Lipp, R. [Medical Univ. Graz (Austria). Div. of Nuclear Medicine; Hafner, F.; Brodmann, M. [Medical Univ. Graz (Austria). Div. of Angiology

    2008-07-01

    With an incidence of 0.7% inhabitants per year, acute deep venous thrombosis (DVT) is a common occurrence (20). Its incidence in the upper extremities, however, is not as precisely known; the literature reports that 1% to 10% of all DVT cases involve the upper limbs. Acute DVT of upper limb is mainly iatro-genic following interventions like implantation of pacemakers or central venous catheters, and is more likely to occur in obese patients or those with malignant diseases. Life-threatening pulmonary embolism (PE) may occur if acute DVT remains undetected. The presented case report demonstrates the feasibility of {sup 9}9mTc-apcitide scintigraphy for diagnosis of acute DVT of the upper limb and exclusion of PE in a single examination.

  3. Ergotamine-induced upper extremity ischemia: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Man Deuk; Lee, Gun [Bundang CHA General Hospital, Pochon (China); Shin, Sung Wook [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2005-06-15

    Ergotamine-induced limb ischemia is an extremely rare case. We present a case of a 64-year-old man, who developed ischemia on the right upper extremity due to long-term use of Ergot for migraine headache. Angiography revealed diffused, smooth, and tapered narrowing of the brachial artery. The patient was successfully treated with intravenous nitroprusside.

  4. Ergotamine-Induced Upper Extremity Ischemia: A Case Report

    OpenAIRE

    Kim, Man Deuk; Lee, Gun; Shin, Sung Wook

    2005-01-01

    Ergotamine-induced limb ischemia is an extremely rare case. We present a case of a 64-year-old man, who developed ischemia on the right upper extremity due to long-term use of Ergot for migraine headache. Angiography revealed diffused, smooth, and tapered narrowing of the brachial artery. The patient was successfully treated with intravenous nitroprusside.

  5. Challenging the Dogma of Tourniquet Pressure Requirements for Upper Extremity Surgery.

    Science.gov (United States)

    Sarfani, Shumaila; Cantwell, Sean; Shin, Alexander Y; Kakar, Sanjeev

    2016-05-01

    Background Traditional teaching supports upper extremity tourniquet pressure to be set at 250 mm Hg. Complications have been associated with increased pressure and duration of tourniquet use. We hypothesized that there will be no significant difference in intraoperative variables between tourniquet pressures of 125, 150, 175, or 200 mm Hg as compared with the current practice of 250 mm Hg during mini-open carpal tunnel release. Case Description A retrospective review was conducted of patients undergoing open carpal tunnel release from June 2009 to June 2012. Those undergoing surgery with a tourniquet pressure of 250 mm Hg were compared with those with lower tourniquet pressures regarding their demographics, operative and anesthesia time, and whether the tourniquet pressure needed to be increased to 250 mm Hg during surgery. Literature Review A total of 432 patients underwent carpal tunnel release over the 3-year period. There were no differences with respect to patient demographics. There was no significant difference between operative or anesthesia time between different tourniquet pressure groups. There were no reported problems with breakthrough bleeding or difficulty with visualization of structures in any of the pressure groups. None of the patients with lower tourniquet pressures needed the tourniquet pressure to be adjusted during surgery. Clinical Relevance This study demonstrated that using lower tourniquet pressures had no effect on the operation for open carpal tunnel release including effect on operative or anesthesia time, breakthrough bleeding, or complications directly related to tourniquet pressures. Orthopedic surgeons may consider reducing tourniquet pressures during carpal tunnel release. PMID:27104077

  6. Testing the concurrent validity of a naturalistic upper extremity reaching task.

    Science.gov (United States)

    Schaefer, S Y; Hengge, C R

    2016-01-01

    Point-to-point reaching has been widely used to study upper extremity motor control. We have been developing a naturalistic reaching task that adds tool manipulation and object transport to this established paradigm. The purpose of this study was to determine the concurrent validity of a naturalistic reaching task in a sample of healthy adults. This task was compared to the criterion measure of standard point-to-point reaching. Twenty-eight adults performed unconstrained out-and-back movements in three different directions relative to constant start location along midline using their nondominant arm. In the naturalistic task, participants manipulated a tool to transport objects sequentially between physical targets anchored to the planar workspace. In the standard task, participants moved a digital cursor sequentially between virtual targets, veridical to the planar workspace. In both tasks, the primary measure of performance was trial time, which indicated the time to complete 15 reaches (five cycles of three reaches/target). Two other comparator tasks were also designed to test concurrent validity when components of the naturalistic task were added to the standard task. Spearman's rank correlation coefficients indicated minimal relationship between the naturalistic and standard tasks due to differences in progressive task difficulty. Accounting for this yielded a moderate linear relationship, indicating concurrent validity. The comparator tasks were also related to both the standard and naturalistic task. Thus, the principles of motor control and learning that have been established by the wealth of point-to-point reaching studies can still be applied to the naturalistic task to a certain extent. PMID:26438508

  7. An accelerometry-based methodology for assessment of real-world bilateral upper extremity activity.

    Directory of Open Access Journals (Sweden)

    Ryan R Bailey

    Full Text Available The use of both upper extremities (UE is necessary for the completion of many everyday tasks. Few clinical assessments measure the abilities of the UEs to work together; rather, they assess unilateral function and compare it between affected and unaffected UEs. Furthermore, clinical assessments are unable to measure function that occurs in the real-world, outside the clinic. This study examines the validity of an innovative approach to assess real-world bilateral UE activity using accelerometry.Seventy-four neurologically intact adults completed ten tasks (donning/doffing shoes, grooming, stacking boxes, cutting playdough, folding towels, writing, unilateral sorting, bilateral sorting, unilateral typing, and bilateral typing while wearing accelerometers on both wrists. Two variables, the Bilateral Magnitude and Magnitude Ratio, were derived from accelerometry data to distinguish between high- and low-intensity tasks, and between bilateral and unilateral tasks. Estimated energy expenditure and time spent in simultaneous UE activity for each task were also calculated.The Bilateral Magnitude distinguished between high- and low-intensity tasks, and the Magnitude Ratio distinguished between unilateral and bilateral UE tasks. The Bilateral Magnitude was strongly correlated with estimated energy expenditure (ρ = 0.74, p<0.02, and the Magnitude Ratio was strongly correlated with time spent in simultaneous UE activity (ρ = 0.93, p<0.01 across tasks.These results demonstrate face validity and construct validity of this methodology to quantify bilateral UE activity during the performance of everyday tasks performed in a laboratory setting, and can now be used to assess bilateral UE activity in real-world environments.

  8. Structural bone allografts with intramedullary vascularized fibular autografts for the treatment of massive bone defects in extremities

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To report the clinical outcome of repairing massive bone defects biologically in limbs by homeochronous using structural bone allografts with intramedullary vascularized fibular auto-grafts. Methods: From January 2001 to December 2005. large bone defects in 19 patients (11 men and 8 women, aged 6 to 35 years) were repaired by structural bone allografts with intramedullary vascularized fibular autografts in the homeochronous period. The range of the length of bone defects was 11 to 25 cm (mean 17. 6 cm), length of vascularized free fibular was 15 to 29 cm (mean 19. 2 cm), length of massive bone allografts was 11 to 24 cm (mean 17. 1 cm). Location of massive bone defects was in humerus(n = 1), in femur(n = 9) and in tibia(n = 9), respectively. Results: After 9 to 69 months (mean 38. 2 months) follow-up, wounds of donor and recipient sites were healed in Ⅰ stage, monitoring-flaps were alive, eject reaction of massive bone allografts were slight, no complications in donor limbs. Fifteen patients had the evidence of radiographic union 3 to 6 months after surgery, 3 cases united 8 months later, and the remained one case of malignant synovioma in distal femur recurred and amputated the leg 2. 5 months, post-operatively. Five patients had been removed internal fixation, complete bone unions were found one year postoperatively. None of massive bone allografts were absorbed or collapsed at last follow-up. Conclusion: The homeochronous usage of structural bone allograft with an intramedullary vascularized fibular au-tograft can biologically obtain a structure with the immediate mechanical strength of the allograft, a potential result of revascularization through the vascularized fibula, and accelerate bone union not only between fibular autograft and the host but also between massive bone allograft and the host.

  9. Prevalence of Symptoms of Depression, Anxiety, and Posttraumatic Stress Disorder in Workers With Upper Extremity Complaints.

    Science.gov (United States)

    Degen, Ryan M; MacDermid, Joy C; Grewal, Ruby; Drosdowech, Darren S; Faber, Kenneth J; Athwal, George S

    2016-07-01

    Study Design Cross-sectional cohort study. Background Symptoms of depression, panic disorder (PD), and posttraumatic stress disorder (PTSD) have been associated with musculoskeletal complaints and could represent barriers to recovery in injured workers. Objectives To determine the prevalence of symptoms of depression, PD, and PTSD utilizing the Patient Health Questionnaire (PHQ) in a cohort of patients presenting to an upper extremity injured-worker clinic; secondarily, to identify any relationships between patients screening positive and patient-reported outcome measures. Methods In 2010, 418 patients completed the PHQ during their initial evaluation. Patients with PHQ scores exceeding threshold values for symptoms of depression, PD, or PTSD were compared based on patient-reported outcome scores, including the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH) and Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). The prevalence of symptoms, and their relationship with presenting complaints and patient-reported outcomes, were calculated. Results Thirty-one percent of patients scored above thresholds for symptoms of at least 1 mental health disorder. Of those who screened positive, 67% screened positive for depression, 44% for PTSD, and 50% for PD, with 43% of patients positive for multiple symptoms. Patients experiencing neck pain had significantly higher screening rates of depressive symptoms (62.5% versus 20.1%, P = .004) and PD (37.5% versus 12.9%, P = .044) compared with other presenting complaints. Similarly, patients with chronic pain had higher rates of depression (54.5% versus 20.1%, P = .006), PD (63.6% versus 12%, P<.001), and PTSD (36.4% versus 14.8%, P = .05) compared with other presenting complaints. Patients endorsing depressive symptoms had significantly lower SF-36 mental component summary scores (26.3 ± 10.7 versus 37.6 ± 9.9, P<.001) and higher shortened-version DASH (72.3 ± 16.7 versus 61.5 ± 11.1, P = .003) and

  10. The diagnosis of a fully flexed neck position MRI diagnosis in juvenile muscular atrophy of the distal upper extremity

    International Nuclear Information System (INIS)

    Objective: To investigate the value of the diagnosis of MRI during neck flexion in juvenile muscular atrophy of the distal upper extremity. Methods: Five young male patients (mean age 21 years old) with clinical and electrophysiological alterations were performed MR examination with routine neck position and a fully flexed neck position. Eight age-match young men were examined as control subjects. SE T1WI, T2WI, Fluid-attenuated inversion recovery (FLAIR) sequences were scanned. Results: A distinctive finding in the disorder was forward displacement of the cervical dural sac, compressive flattening of the lower cervical cord during neck flexion and flow void in the posterior epidural space. The forward displacement was significantly greater in patients than in age-matched control subjects. Conclusion: Flexed neck position MRI is helpful to find radiological abnormalities of the lower cervical dural sac and spinal cord, which were combined with clinical disorder to diagnose juvenile muscular atrophy of the distal upper extremity. (authors)

  11. Finger Muscle Attachments for an OpenSim Upper-Extremity Model

    OpenAIRE

    Lee, Jong Hwa; Asakawa, Deanna S.; Dennerlein, Jack T.; Jindrich, Devin L.

    2015-01-01

    We determined muscle attachment points for the index, middle, ring and little fingers in an OpenSim upper-extremity model. Attachment points were selected to match both experimentally measured locations and mechanical function (moment arms). Although experimental measurements of finger muscle attachments have been made, models differ from specimens in many respects such as bone segment ratio, joint kinematics and coordinate system. Likewise, moment arms are not available for all intrinsic fin...

  12. The effects of very early mirror therapy on functional improvement of the upper extremity in acute stroke patients

    OpenAIRE

    Yeldan, Ipek; Huseyınsınoglu, Burcu Ersoz; Akıncı, Buket; Tarakcı, Ela; Baybas, Sevim; Ozdıncler, Arzu Razak

    2015-01-01

    [Purpose] The aim of the study was to evaluate the effects of a very early mirror therapy program on functional improvement of the upper extremity in acute stroke patients. [Subjects] Eight stroke patients who were treated in an acute neurology unit were included in the study. [Methods] The patients were assigned alternatively to either the mirror therapy group receiving mirror therapy and neurodevelopmental treatment or the neurodevelopmental treatment only group. The primary outcome measure...

  13. Two-point discrimination of the upper extremities of healthy Koreans in their 20’s

    Science.gov (United States)

    Koo, Ja-Pung; Kim, Soon-Hee; An, Ho-Jung; Moon, Ok-Gon; Choi, Jung-Hyun; Yun, Young-Dae; Park, Joo-Hyun; Min, Kyoung-Ok

    2016-01-01

    [Purpose] The present study attempted to measure two-point discrimination in the upper extremities of healthy Koreans in their 20’s. [Subjects and Methods] Using a three-point esthesiometer, we conducted an experiment with a group of 256 college students (128 male and 128 female), attending N University in Chonan, Republic of Korea. [Results] Females showed two-point discrimination at a shorter distance than males at the following points: (i) 5 cm above the elbow joint, the middle part, and 5 cm below the shoulder joint of the anterior upper arm; (ii) 5 cm above the elbow joint and 5 cm below the shoulder joint of the posterior upper arm; (iii) 5 cm above the front of the wrist joint of the forearm; 5 cm below the elbow joint, the palmar part of the distal interphalangeal joint of the thumb, the dorsal part of the distal interphalangeal joint of the middle and little fingers. It was also found that females showed greater two-point discrimination than males in distal regions rather than proximal regions. [Conclusion] The findings of this study will help establish normal values for two-point discrimination of upper extremities of young Koreans in their 20’s. PMID:27134375

  14. Selection of acupoints for managing upper-extremity spasticity in chronic stroke patients

    Directory of Open Access Journals (Sweden)

    Wang BH

    2014-01-01

    Full Text Available Bi-Huei Wang,1,* Chien-Lin Lin,1,2,* Te-Mao Li,2,3 Shih-Din Lin,3 Jaung-Geng Lin,2 Li-Wei Chou1,2,4 1Department of Physical Medicine and Rehabilitation, China Medical University Hospital; 2School of Chinese Medicine, College of Chinese Medicine; 3Graduate Institute of Acupuncture Science, 4Acupuncture Research Center, China Medical University, Taichung, Taiwan *These authors contributed equally to this work Background: This study investigated the clinical efficacy of electroacupuncture (EA in inhibiting upper-extremity spasticity in chronic stroke patients, and also in mapping a unique preliminary acupoint-selection protocol. Methods: Fifteen patients were divided into two groups: patients in the control group (n=6 received minimal acupuncture (MA, and those in the experimental group (n=9 received EA. Four acupoints, which include Neiguan (PC6, Shaohai (HT3, Zeqian (Ex-UE, A32, and Shounizhu (EX-UE, were treated near the motor points of the muscles for elbow flexion, forearm pronation, and finger flexion. Both groups were treated for twelve sessions, 20 minutes per session, for 6 weeks (two sessions per week. The outcome measures in this study included angle of muscle reaction (R1, passive range of motion (R2, and dynamic component (R2–R1. Results: In the experimental group, the R2–R1 of the elbow joint was significantly decreased at 1 (P=0.0079, 3 (P=0.0013, and 6 weeks (P=0.0149 after treatment compared with pretreatment levels (P<0.05. The between-group difference in the R2–R1 of the elbow joint after the 6-week treatment was statistically significant. Conclusion: Combining the 6-week EA and standard rehabilitation treatment reduced the spasticity of the elbow for chronic stroke survivors. However, no significant effect was observed in the spasticity of the wrist joints. The choice of acupoints and the frequency of EA have to be taken into account to achieve a positive treatment effect. The correlation between acupoints and motor points

  15. Vascular injuries after minor blunt upper extremity trauma: pitfalls in the recognition and diagnosis of potential "near miss" injuries

    OpenAIRE

    Bravman Jonathan T; Ipaktchi Kyros; Biffl Walter L; Stahel Philip F

    2008-01-01

    Abstract Background Low energy trauma to the upper extremity is rarely associated with a significant vascular injury. Due to the low incidence, a high level of suspicion combined with appropriate diagnostic algorithms are mandatory for early recognition and timely management of these potentially detrimental injuries. Methods Review of the pertinent literature, supported by the presentation of two representative "near miss" case examples. Results A major diagnostic pitfall is represented by th...

  16. A Randomized Controlled Trial Comparing Botulinum Toxin A Dosage in the Upper Extremity of Children with Spasticity

    Science.gov (United States)

    Kawamura, Anne; Campbell, Kent; Lam-Damji, Sophie; Fehlings, Darcy

    2007-01-01

    This study compared the effects of low and high doses of botulinum toxin A (BTX-A) to improve upper extremity function. Thirty-nine children (22 males, 17 females) with a mean age of 6 years 2 months (SD 2y 9mo) diagnosed with spastic hemiplegia or triplegia were enrolled into this double-blind, randomized controlled trial. The high-dose group…

  17. Overuse injuries of the upper extremity in the competitive athlete: magnetic resonance imaging findings associated with repetitive trauma.

    Science.gov (United States)

    Banks, Kevin P; Ly, Justin Q; Beall, Douglas P; Grayson, David E; Bancroft, Laura W; Tall, Michael A

    2005-01-01

    Overuse injuries are a very common cause of pain in athletes, accounting for a significant loss of training time and missed competitions. Magnetic resonance imaging (MRI) is playing an increasing role in facilitating the expeditious and safe return of these individuals to their preinjury level of physical performance by allowing accurate diagnosis. Sports physicians are increasingly relying on the exquisite anatomic detail afforded by this technique to formulate diagnoses that assist with the optimal management of these athletic injuries. Some upper extremity overuse entities are well recognized; two examples are medial epicondylitis, classically appearing in baseball pitchers, and lateral epicondylitis, in tennis players. Other less well-known injuries of the upper extremity, such as intersection syndrome in rowers and distal clavicular stress fractures in weightlifters, are frequent occurrences in certain circles of athletes. The following article is a pictorial review of the MRI findings of upper extremity overuse injuries encountered in the competitive athlete, with an emphasis on the sports scenarios in which they occur. We will depict mechanisms of injury and applicable anatomy and show characteristic imaging findings. A wide range of entities are addressed, including but not limited to overuse injuries occurring in baseball, swimming, gymnastics, weightlifting, bowling, and cycling. PMID:16012484

  18. The effects of mirror therapy with tasks on upper extremity function and self-care in stroke patients

    OpenAIRE

    Park, Youngju; Chang, Moonyoung; Kim, Kyeong-Mi; An, Duk-Hyun

    2015-01-01

    [Purpose] The purpose of this study was to determine the effects of mirror therapy with tasks on upper extremity unction and self-care in stroke patients. [Subjects] Thirty participants were randomly assigned to either an experimental group (n=15) or a control group (n=15). [Methods] Subjects in the experimental group received mirror therapy with tasks, and those in the control group received a sham therapy; both therapies were administered, five times per week for six weeks. The main outcome...

  19. Vascular injuries after minor blunt upper extremity trauma: pitfalls in the recognition and diagnosis of potential "near miss" injuries

    Directory of Open Access Journals (Sweden)

    Bravman Jonathan T

    2008-11-01

    Full Text Available Abstract Background Low energy trauma to the upper extremity is rarely associated with a significant vascular injury. Due to the low incidence, a high level of suspicion combined with appropriate diagnostic algorithms are mandatory for early recognition and timely management of these potentially detrimental injuries. Methods Review of the pertinent literature, supported by the presentation of two representative "near miss" case examples. Results A major diagnostic pitfall is represented by the insidious presentation of significant upper extremity arterial injuries with intact pulses and normal capillary refill distal to the injury site, due to collateral perfusion. Thus, severe vascular injuries may easily be missed or neglected at the upper extremity, leading to a long-term adverse outcome with the potential need for a surgical amputation. Conclusion The present review article provides an outline of the diagnostic challenges related to these rare vascular injuries and emphasizes the necessity for a high level of suspicion, even in the absence of a significant penetrating or high-velocity trauma mechanism.

  20. ACUTE EFFECTS OF STATIC STRETCHING, DYNAMIC EXERCISES, AND HIGH VOLUME UPPER EXTREMITY PLYOMETRIC ACTIVITY ON TENNIS SERVE PERFORMANCE

    Directory of Open Access Journals (Sweden)

    Ertugrul Gelen

    2012-12-01

    Full Text Available The purpose of this study was to compare the acute effects of static stretching; dynamic exercises and high volume upper extremity plyometric activity on tennis serve performance. Twenty-six elite young tennis players (15.1 ± 4.2 years, 167.9 ± 5.8 cm and 61.6 ± 8.1 kg performed 4 different warm-up (WU routines in a random order on non-consecutive days. The WU methods consisted of traditional WU (jogging, rally and serve practice (TRAD; traditional WU and static stretching (TRSS; traditional WU and dynamic exercise (TRDE; and traditional WU and high volume upper extremity plyometric activity (TRPLYP. Following each WU session, subjects were tested on a tennis serve ball speed test. TRAD, TRSS, TRDE and TRPLYO were compared by repeated measurement analyses of variance and post-hoc comparisons. In this study a 1 to 3 percent increase in tennis serve ball speed was recorded in TRDE and TRPLYO when compared to TRAD (p 0.05. ICCs for ball speed showed strong reliability (0.82 to 0.93 for the ball speed measurements.The results of this study indicate that dynamic and high volume upper extremity plyometric WU activities are likely beneficial to serve speed of elite junior tennis players.

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

    NARCIS (Netherlands)

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

    2010-01-01

    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 prosthe

  2. Simulated bone remodeling around two types of osseointegrated implants for direct fixation of upper-leg prostheses

    NARCIS (Netherlands)

    Tomaszewski, P.K.; Verdonschot, N.; Bulstra, S.K.; Rietman, J.S.; Verkerke, G.J.

    2012-01-01

    Direct attachment of an upper leg prosthesis to the skeletal system by a percutaneous implant is an alternative solution to the traditional socket fixation. In this study, we investigated long-term periprosthetic bone changes around two types of fixation implants using two different initial conditio

  3. Magnetic resonance imaging of peripheral nerve tumours in the upper extremity

    DEFF Research Database (Denmark)

    Nilsson, Jessica; Sandberg, Kristina; Søe Nielsen, Niels;

    2009-01-01

    Clinical assessment and various diagnostic tools, particularly magnetic resonance imaging (MRI), of tumours of peripheral nerves are used to get an accurate diagnosis and to plan surgical intervention. Our purpose was to examine the usefulness of MRI in assessing nerve tumours in the upper...

  4. An important Norwegian contribution to the study of the bursae of the upper and lower extremities

    OpenAIRE

    Musil, Vladimir; Selnes, Christoffer V; Falck, Aleksander T; Sandve, Lars; Shekarchi, Siamek; O'Donnell, Bruce; Kachlik, David

    2010-01-01

    We present a critical analysis of the monograph of A.S.D. Synnestvedt (1869) “En anatomisk beskrivelse af de paa over- og underestremiteterne forekommende Bursae mucosae”. The analysis was completed using anatomical information from the historically oldest publications dealing with the bursae of the extremities: Albinus (1734), Monro (1788), Rosenmüller (1799). We are of the opinion that Synnestvedt's publication is important, not only historically but also as a source of information for rece...

  5. Bilateral macrodystrophia lipomatosa of the upper extremities with syndactyly and multiple lipomas

    NARCIS (Netherlands)

    van der Meer, Saskia; Nicolai, Jean-Philippe A.; Schut, Simone M.; Meek, Marcel F.

    2011-01-01

    Macrodystrophia lipomatosa is a rare disease that causes congenital local gigantism of part of an extremity, which is characterised by an increase in all mesenchymal elements, particularly fibroadipose tissue. This is the first report to our knowledge of a case of histologically confirmed bilateral

  6. Upper extremity sensorimotor control among collegiate football players.

    Science.gov (United States)

    Laudner, Kevin G

    2012-03-01

    Injuries stemming from shoulder instability are very common among athletes participating in contact sports, such as football. Previous research has shown that increased laxity negatively affects the function of the sensorimotor system potentially leading to a pathological cycle of shoulder dysfunction. Currently, there are no data detailing such effects among football players. Therefore, the purpose of this study was to examine the differences in upper extremity sensorimotor control among football players compared with that of a control group. Forty-five collegiate football players and 70 male control subjects with no previous experience in contact sports participated. All the subjects had no recent history of upper extremity injury. Each subject performed three 30-second upper extremity balance trials on each arm. The balance trials were conducted in a single-arm push-up position with the test arm in the center of a force platform and the subjects' feet on a labile device. The trials were averaged, and the differences in radial area deviation between groups were analyzed using separate 1-way analyses of variance (p football players showed significantly more radial area deviation of the dominant (0.41 ± 1.23 cm2, p = 0.02) and nondominant arms (0.47 ± 1.63 cm2, p = 0.03) when compared with the control group. These results suggest that football players may have decreased sensorimotor control of the upper extremity compared with individuals with no contact sport experience. The decreased upper extremity sensorimotor control among the football players may be because of the frequent impacts accumulated during football participation. Football players may benefit from exercises that target the sensorimotor system. These findings may also be beneficial in the evaluation and treatment of various upper extremity injuries among football players.

  7. Upper Extremity Sports Injury : Risk Factors in Comparison to Lower Extremity Injury in More Than 25 000 Cases

    NARCIS (Netherlands)

    Sytema, Renee; Dekker, Rienk; Dijkstra, Pieter U.; ten Duis, Hendrik J.; van der Sluis, Corry K.

    2010-01-01

    Objective: To analyze differences in sports injury characteristics of the upper and lower extremity and to identify factors that contribute to the risk of sustaining an upper extremity injury compared with the risk of sustaining a lower extremity injury. Design: Retrospective cohort study. Setting:

  8. Upper Extremity Sports Injury: Risk Factors in Comparison to Lower Extremity Injury in More Than 25 000 Cases

    NARCIS (Netherlands)

    Sytema, R.; Dekker, R.; Dijkstra, P.U.; ten Duis, H.J.; van der Sluis, C.K.

    2010-01-01

    Objective: To analyze differences in sports injury characteristics of the upper and lower extremity and to identify factors that contribute to the risk of sustaining an upper extremity injury compared with the risk of sustaining a lower extremity injury. Design: Retrospective cohort study. Setting:

  9. Motor relearning program and Bobath method improve motor function of the upper extremities in patients with stroke

    Institute of Scientific and Technical Information of China (English)

    Jinjing Liu; Fengsheng Li; Guihua Liu

    2006-01-01

    BACKGROUND: In the natural evolution of cerebrovascular disease, unconscious use of affected extremity during drug treatment and daily life can improve the function of affected upper extremity partially, but it is very slow and alsc accompanied by the formation of abnormal mode. Therefore, functional training should be emphasized in recovering the motor function of extremity.OBJECTIVE: To observe the effects of combination of motor relearning program and Bobath method on motor function of upper extremity of patients with stroke.DESIGN: Comparison of therapeutic effects taking stroke patients as observation subjects.SETTING: Department of Neurology, General Hospital of Beijing Jingmei Group.PARTICIPANTS: Totally 120 stroke patients, including 60 males and 60 females, averaged (59±3) years, who hospitalized in the Department of Neurology, General Hospital of Beijing Jingmei Group between January 2005 and June 2006 were recruited. The involved patients met the following criteria: Stroke attack within 2 weeks;diagnosis criteria of cerebral hemorrhage or infarction made in the 4th National Cerebrovascular Disease Conference; confirmed by skull CT or MRI; Informed consents of therapeutic regimen were obtained. The patients were assigned into 2 groups according to their wills: rehabilitation group and control group, with 30 males and 30 females in each group. Patients in rehabilitation group averaged (59±2)years old, and those in the control group averaged (58±2)years old.METHODS: ① Patients in two groups received routine treatment in the Department of Neurology. When the vital signs of patients in the rehabilitation group were stable, individualized treatment was conducted by combined application of motor relearning program and Bobath method. Meanwhile, training of activity of daily living was performed according to the disease condition changes of patients at different phases, including the nursing and instruction of body posture, the maintenance of good extremity

  10. Effort thrombosis of the upper extremity in a young sportsman: Paget-Schroetter syndrome.

    Science.gov (United States)

    Roche-Nagle, Graham; Ryan, Ronan; Barry, Mary; Brophy, David

    2007-08-01

    Paget-Schroetter syndrome is the spontaneous thrombosis of the axillary/subclavian vein. A 16-year-old male presented with acute onset of right upper limb swelling after vigorous weight training. A venogram confirmed the diagnosis of Paget-Schroetter syndrome. He was started on intravenous thrombolytics followed by oral anticoagulation therapy. His symptoms resolved and he was symptom free at six-month follow-up. Thrombolytics and anticoagulation is the most widely accepted first-line therapy for this syndrome. Defining any anatomical anomaly as the predisposing factor in this condition is essential in the selection of which patients will benefit from thoracic outlet decompression. PMID:17289856

  11. "RISK ASSESSMENT OF DEVELOPING DISTAL UPPER EXTREMITY DISORDERS BY STRAIN INDEX METHOD IN AN ASSEMBLING ELECTRONIC INDUSTRY"

    OpenAIRE

    M. Pourmahabadian; Saraji, J. N.; M. Aghabeighi H. Saddeghi-Naeeni

    2005-01-01

    The strain index (SI) is a substantial advancement and has been devised to analyze ergonomic risks for distal upper extremity (DUE) disorders. This semi-quantitative tool allows for the measurement of hazards and does not require unduly lengthy training to begin to use it accurately. Uses of the strain index include analysis of a current job to assess whether it is safe or hazardous, quantification of the risks, and assistance in the initial design of a job or in the redesign of a job. The ai...

  12. Accelerometer measurement of upper extremity movement after stroke: a systematic review of clinical studies.

    Science.gov (United States)

    Noorkõiv, Marika; Rodgers, Helen; Price, Christopher I

    2014-10-09

    The aim of this review was to identify and summarise publications, which have reported clinical applications of upper limb accelerometry for stroke within free-living environments and make recommendations for future studies. Data was searched from MEDLINE, Scopus, IEEExplore and Compendex databases. The final search was 31st October 2013. Any study was included which reported clinical assessments in parallel with accelerometry in a free-living hospital or home setting. Study quality is reflected by participant numbers, methodological approach, technical details of the equipment used, blinding of clinical measures, whether safety and compliance data was collected. First author screened articles for inclusion and inclusion of full text articles and data extraction was confirmed by the third author. Out of 1375 initial abstracts, 8 articles were included. All participants were stroke patients. Accelerometers were worn for either 24 hours or 3 days. Data were collected as summed acceleration counts over a specified time or as the duration of active/inactive periods. Activity in both arms was reported by all studies and the ratio of impaired to unimpaired arm activity was calculated in six studies. The correlation between clinical assessments and accelerometry was tested in five studies and significant correlations were found. The efficacy of a rehabilitation intervention was assessed using accelerometry by three studies: in two studies both accelerometry and clinical test scores detected a post-treatment difference but in one study accelerometry data did not change despite clinical test scores showing motor and functional improvements. Further research is needed to understand the additional value of accelerometry as a measure of upper limb use and function in a clinical context. A simple and easily interpretable accelerometry approach is required.

  13. Mechanical Performance of Actuators in an Active Orthosis for the Upper Extremities

    Directory of Open Access Journals (Sweden)

    Roland Wiegand

    2011-01-01

    Full Text Available The aim of the project OrthoJacket is to develop a lightweight, portable, and active orthosis for the upper limps. The system consists of two special designed fluidic actuators which are used for supporting the elbow function and the internal rotation of the shoulder. A new design of flexible fluid actuator (FFA is presented that enables more design options of attaching parts, as it is allowed by conventional actuators with a stationary centre of rotation. This advantage and the inherent flexibility and the low weight of this kind of actuator predestined them for the use in exoskeletons, orthoses, and prostheses. The actuator for the elbow generates a maximum torque of 32 Nm; the internal rotation is supported with 7 Nm. Both actuators support the movement with up to 100% of the necessary power. The shells for the arm and forearm are made of carbon reinforced structures in combination with inflatable cushions.

  14. Rehabilitation of Motor Function after Stroke: A Multiple Systematic Review Focused on Techniques to Stimulate Upper Extremity Recovery

    Science.gov (United States)

    Hatem, Samar M.; Saussez, Geoffroy; della Faille, Margaux; Prist, Vincent; Zhang, Xue; Dispa, Delphine; Bleyenheuft, Yannick

    2016-01-01

    Stroke is one of the leading causes for disability worldwide. Motor function deficits due to stroke affect the patients' mobility, their limitation in daily life activities, their participation in society and their odds of returning to professional activities. All of these factors contribute to a low overall quality of life. Rehabilitation training is the most effective way to reduce motor impairments in stroke patients. This multiple systematic review focuses both on standard treatment methods and on innovating rehabilitation techniques used to promote upper extremity motor function in stroke patients. A total number of 5712 publications on stroke rehabilitation was systematically reviewed for relevance and quality with regards to upper extremity motor outcome. This procedure yielded 270 publications corresponding to the inclusion criteria of the systematic review. Recent technology-based interventions in stroke rehabilitation including non-invasive brain stimulation, robot-assisted training, and virtual reality immersion are addressed. Finally, a decisional tree based on evidence from the literature and characteristics of stroke patients is proposed. At present, the stroke rehabilitation field faces the challenge to tailor evidence-based treatment strategies to the needs of the individual stroke patient. Interventions can be combined in order to achieve the maximal motor function recovery for each patient. Though the efficacy of some interventions may be under debate, motor skill learning, and some new technological approaches give promising outcome prognosis in stroke motor rehabilitation. PMID:27679565

  15. Bone histology of the stegosaur Kentrosaurus aethiopicus (Ornithischia: Thyreophora) from the Upper Jurassic of Tanzania.

    Science.gov (United States)

    Redelstorff, Ragna; Hübner, Tom R; Chinsamy, Anusuya; Sander, P Martin

    2013-06-01

    Using bone histology, a slow growth rate, uncommon for most dinosaurs, has been interpreted for the highly derived stegosaur Stegosaurus (Ornithischia: Thyreophora) and the basal thyreophoran Scutellosaurus. In this study, we examine whether this slow growth rate also occurs in the more basal stegosaur Kentrosaurus from the Tendaguru beds of Tanzania. The bone histology of six femora of Kentrosaurus representing an ontogenetic series from subadult to adult was studied, as well as one scapula. The primary bone is mainly highly vascularized fibro-lamellar bone with some reticular organization of the vascular canals. In addition to LAGs and annuli, distinctive shifts in the pattern of vascularization occur, which have been interpreted as potential growth marks. The variation in the development of growth marks may reflect annual climatic fluctuations. The overall bone depositional rate, and hence growth rate in Kentrosaurus appears to be higher than in Stegosaurus and Scutellosaurus. Considering that Stegosaurus is the larger-sized of the two stegosaurs, this would be contrary to an earlier supposition that small-bodied dinosaurs have slower growth rates than larger ones. Our finding of rapid rates of bone deposition in Kentrosaurus suggests that slow growth rates previously reported in Scutellosaurus and Stegosaurus are not a phylogenetic characteristic of the Thyreophora. Thus, slow growth rates are not plesiomorphic for the Thyreophora. We propose that the slow growth rates documented in the highly derived Stegosaurus could have been secondarily derived or alternatively that Kentrosaurus is the exception having increased growth rates.

  16. Bone histology of the stegosaur Kentrosaurus aethiopicus (Ornithischia: Thyreophora) from the Upper Jurassic of Tanzania.

    Science.gov (United States)

    Redelstorff, Ragna; Hübner, Tom R; Chinsamy, Anusuya; Sander, P Martin

    2013-06-01

    Using bone histology, a slow growth rate, uncommon for most dinosaurs, has been interpreted for the highly derived stegosaur Stegosaurus (Ornithischia: Thyreophora) and the basal thyreophoran Scutellosaurus. In this study, we examine whether this slow growth rate also occurs in the more basal stegosaur Kentrosaurus from the Tendaguru beds of Tanzania. The bone histology of six femora of Kentrosaurus representing an ontogenetic series from subadult to adult was studied, as well as one scapula. The primary bone is mainly highly vascularized fibro-lamellar bone with some reticular organization of the vascular canals. In addition to LAGs and annuli, distinctive shifts in the pattern of vascularization occur, which have been interpreted as potential growth marks. The variation in the development of growth marks may reflect annual climatic fluctuations. The overall bone depositional rate, and hence growth rate in Kentrosaurus appears to be higher than in Stegosaurus and Scutellosaurus. Considering that Stegosaurus is the larger-sized of the two stegosaurs, this would be contrary to an earlier supposition that small-bodied dinosaurs have slower growth rates than larger ones. Our finding of rapid rates of bone deposition in Kentrosaurus suggests that slow growth rates previously reported in Scutellosaurus and Stegosaurus are not a phylogenetic characteristic of the Thyreophora. Thus, slow growth rates are not plesiomorphic for the Thyreophora. We propose that the slow growth rates documented in the highly derived Stegosaurus could have been secondarily derived or alternatively that Kentrosaurus is the exception having increased growth rates. PMID:23613282

  17. Effect of upper extremity proprioceptive neuromuscular facilitation combined with elastic resistance bands on respiratory muscle strength: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Guilherme P. T. Areas

    2013-12-01

    Full Text Available BACKGROUND: Elastic resistance bands (ERB combined with proprioceptive neuromuscular facilitation (PNF are often used in resistance muscle training programs, which have potential effects on peripheral muscle strength. However, the effects of the combination of ERB and PNF on respiratory muscle strength warrant further investigation. OBJECTIVES: The assessment of the effects of PNF combined with ERB on respiratory muscle strength. METHOD: Twenty healthy, right-handed females were included. Subjects were randomized to either the resistance training program group (TG, n=10 or the control group (CG, n=10. Maximal expiratory pressure (MEP and inspiratory pressure (MIP were measured before and after four weeks of an upper extremity resistance training program. The training protocol consisted of upper extremity PNF combined with ERB, with resistance selected from 1 repetition maximum protocol. RESULTS: PNF combined with ERB showed significant increases in MIP and MEP (p<0.05. In addition, there were significant differences between the TG and CG regarding ∆MIP (p=0.01 and ∆MEP (p=0.04. CONCLUSIONS: PNF combined with ERB can have a positive impact on respiratory muscle strength. These results may be useful with respect to cardiopulmonary chronic diseases that are associated with reduced respiratory muscle strength.

  18. Integrated case management for work-related upper-extremity disorders: impact of patient satisfaction on health and work status.

    Science.gov (United States)

    Feuerstein, Michael; Huang, Grant D; Ortiz, Jose M; Shaw, William S; Miller, Virginia I; Wood, Patricia M

    2003-08-01

    An integrated case management (ICM) approach (ergonomic and problem-solving intervention) to work-related upper-extremity disorders was examined in relation to patient satisfaction, future symptom severity, function, and return to work (RTW). Federal workers with work-related upper-extremity disorder workers' compensation claims (n = 205) were randomly assigned to usual care or ICM intervention. Patient satisfaction was assessed after the 4-month intervention period. Questionnaires on clinical outcomes and ergonomic exposure were administered at baseline and at 6- and 12-months postintervention. Time from intervention to RTW was obtained from an administrative database. ICM group assignment was significantly associated with greater patient satisfaction. Regression analyses found higher patient satisfaction levels predicted decreased symptom severity and functional limitations at 6 months and a shorter RTW. At 12 months, predictors of positive outcomes included male gender, lower distress, lower levels of reported ergonomic exposure, and receipt of ICM. Findings highlight the utility of targeting workplace ergonomic and problem solving skills. PMID:12915782

  19. A hybrid joint based controller for an upper extremity exoskeleton

    Science.gov (United States)

    Mohd Khairuddin, Ismail; Taha, Zahari; Majeed, Anwar P. P. Abdul; Hakeem Deboucha, Abdel; Azraai Mohd Razman, Mohd; Aziz Jaafar, Abdul; Mohamed, Zulkifli

    2016-02-01

    This paper presents the modelling and control of a two degree of freedom upper extremity exoskeleton. The Euler-Lagrange formulation was used in deriving the dynamic modelling of both the human upper limb as well as the exoskeleton that consists of the upper arm and the forearm. The human model is based on anthropometrical measurements of the upper limb. The proportional-derivative (PD) computed torque control (CTC) architecture is employed in this study to investigate its efficacy performing joint-space control objectives specifically in rehabilitating the elbow and shoulder joints along the sagittal plane. An active force control (AFC) algorithm is also incorporated into the PD-CTC to investigate the effectiveness of this hybrid system in compensating disturbances. It was found that the AFC- PD-CTC performs well against the disturbances introduced into the system whilst achieving acceptable trajectory tracking as compared to the conventional PD-CTC control architecture.

  20. Detection of rheumatoid arthritis bone erosions by 2 different dedicated extremity MRI units and conventional radiography

    DEFF Research Database (Denmark)

    Duer, Anne; Vestergaard, Aage; Døhn, Uffe Møller;

    2008-01-01

    and carpal bones. MagneVu and CR detected 100% and 89%, respectively, of large erosions (OMERACT-RAMRIS-score > 1 on Artoscan) in MCP-joints, and 69% and 15.8% of large erosions in wrists. CONCLUSIONS: Both E-MRI units detected more erosions than CR, particularly due to a higher sensitivity in metacarpal...... heads and carpal bones. The MagneVu detected fewer erosions than the Artoscan, due to a lower average image quality and a smaller proportion of bones being visualized....

  1. Minor rheumatology: Nonsystemic rheumatic disease of juxta-articular soft tissues of the upper extremity. Part 1

    Directory of Open Access Journals (Sweden)

    A. E. Karateev

    2015-01-01

    Full Text Available Rheumatic diseases of juxta-articular soft tissues (RDJAST (tendinitis, tenosynovitis, bursitis, etc. are one of the most common causes of disability and one the most common reasons for seeking medical advice. To manage patients with RDJAST is an important part of practising rheumatologists’ work. But unfortunately, the issues of diagnosis and therapy of this pathology have been relatively rarely discussed on the pages of Russian medical journals and at the scientific congresses and conferences of rheumatologists in recent years. This review is to refresh physicians’interest in this problem. Part 1 of this review briefly considers the general issues relating to the epidemiology, pathogenesis, and diagnosis of RDJAST of the upper extremity, such as rotator cuff tendinitis, lateral and medial epicondylitis, stenosing flexor tenosynovitis, de Quervain’s syndrome, and carpal tunnel syndrome.

  2. Nonspecific collagenolytic activity of the femoral bone in immobilized rat extremities.

    Science.gov (United States)

    Prokopová, D; Tesárek, B; Susta, A

    1975-01-01

    Nonspecific collagenolytic activity was studied in rat bones after immobilization. The left hind limb was immobilized by sectioning the sciatic nerve. Enzyme activity was determined by using synthetic pentapeptide substrate (Pz-Pro-Leu-Gly-Pro-D-Arg). After immobilization the activity of nonspecific collagenase increased and reached its maximum on the third day after the operation. The activity was decreased after one week and attained levels of control bones three weeks after sciatic nerve section. PMID:167392

  3. Modul femur prosthesis for major upper femoral bone defects

    International Nuclear Information System (INIS)

    The Koelner modul femur prosthesis MECROSET represents a device to be composed of standardised units. It allows the surgeon dealing with large bone defects of the upper femoral end to meet the special local requirements by building up the appropriate implant. This device may cope with bone losses of up to 22 cms, measured down from the tip of the major trochanter. Combination with ordinary cups is possible. Indications proven are upper femoral defects following disease, exchange of prosthesis and trauma. The ten patients thus provided did not show any complications during a 2-year period of observation. Long-term results are still to be awaited. (orig.)

  4. MR imaging findings of high-voltage electrical burns in the upper extremities: correlation with angiographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Gyung Kyu; Kang, Ik Won; Hwang, Dae Hyun; Min, Seon Jung; Han, You Mi (Dept. of Radiology, Hallym Univ. College of Medicine, Hangang Sacred Heart Hospital, Seoul (Korea, Republic of)); Suh, Kyung Jin (Dept. of Radiology, Dongguk Univ. College of Medicine, Gyeongju Hospital, Gyeongju (Korea, Republic of)), email: kyungjin.suh@gmail.com; Choi, Min Ho (Dept. of Internal Medicine, Hallym Univ. College of Medicine, Hangang Sacred Heart Hospital, Seoul (Korea, Republic of))

    2011-02-15

    Background: A high-voltage electrical burn is often associated with deep muscle injuries. Hidden, undetected deep muscle injuries have a tendency for progressive tissue necrosis, and this can lead to major amputations or sepsis. MRI has excellent soft tissue contrast and it may aid in differentiating the areas of viable deep muscle from the areas of non-viable deep muscle. Purpose: To describe the MR imaging findings of a high-voltage electrical burn in the upper extremity with emphasis on the usefulness of the gadolinium-enhanced MRI and to compare the MR imaging findings with angiography. Material and Methods: We retrospectively reviewed the imaging studies of six patients with high-voltage electrical burns who underwent both MRI and angiography at the burn center of our hospital from January 2005 to December 2009. The imaging features were evaluated for the involved locations, the MR signal intensity of the affected muscles, the MR enhancement pattern, the involved arteries and the angiographic findings (classified as normal, sluggish flow, stenosis or occlusion) of the angiography of the upper extremity. We assessed the relationship between the MR imaging findings and the angiographic findings. Results: The signal intensities of affected muscles were isointense or of slightly high signal intensity as compared with the adjacent unaffected skeletal muscle on the T1-weighted MR images. Affected muscles showed heterogenous high signal intensity relative to the adjacent unaffected skeletal muscle on the T2- weighted images. The gadolinium-enhanced T1-weighted images showed diffuse inhomogeneous enhancement or peripheral rim enhancement of the affected muscles. The angiographic findings of the arterial injuries showed complete occlusion in three patients, severe stenosis in two patients and sluggish flow in one patient. Of these, the five patients with complete occlusion or severe stenosis on angiography showed non-perfused and non-viable areas of edematous muscle on

  5. Ectopic major transplantation for salvage of upper and lower extremity amputations

    Institute of Scientific and Technical Information of China (English)

    Shahram Nazerani; Hamed Vaseghi; Saied Hesami; Tina Nazerani

    2013-01-01

    Objective:Ectopic tissue transplantation is not a new idea.Godina and his colleagues pioneered this method in the 1980s.This method is a last resort method of preserving an amputated body part,which consists of banking the amputated segment in an ectopic area and returning it to its native place at a later date.In this article we present our experience with this demanding procedure.Methods:Debridement was the mainstay of this procedure.The stump and amputated part are carefully debrided and the stump was either closed primarily or covered by a flap.The amputated part was transplanted to one of several banking sites in the body and at a later date it will be transferred to its native site in an elective setting.Results:Seven patients meeting the set criteria for ectopic transplantation were enrolled in this study.The overall success rate was about 70%,lower than expected but these are cases of severe crush injury.Although the functional recovery of these patients are very low,all of the successful cases except one could find a job as a janitor or light manual worker.No patient could return to his previous job.Conclusion:Ectopic transplantation of body parts is an accepted method of treatment of severely crushed extremity or finger injuries.In our country an amputee has very little chance of finding a job instead a disabled person can.In addition in Iran cultures amputation is seen as punishment of either the God or the society,so it is not well accepted and many patients persist on saving the limb even with no functional recovery.None of our successful cases could return to his previous occupation but almost all of them could find a job as janitors or light manual workers.

  6. Ectopic major transplantation for salvage of upper and lower extremity amputations

    Directory of Open Access Journals (Sweden)

    Nazerani Shahram

    2013-12-01

    Full Text Available 【Abstract】Objective: Ectopic tissue transplanta- tion is not a new idea. Godina and his colleagues pioneered this method in the 1980s. This method is a last resort method of preserving an amputated body part, which consists of banking the amputated segment in an ectopic area and re- turning it to its native place at a later date. In this article we present our experience with this demanding procedure. Methods: Debridement was the mainstay of this procedure. The stump and amputated part are carefully de- brided and the stump was either closed primarily or covered by a flap. The amputated part was transplanted to one of several banking sites in the body and at a later date it will be transferred to its native site in an elective setting. Results: Seven patients meeting the set criteria for ectopic transplantation were enrolled in this study. The over- all success rate was about 70%, lower than expected but these are cases of severe crush injury. Although the func- tional recovery of these patients are very low, all of the successful cases except one could find a job as a janitor or light manual worker. No patient could return to his previous job. Conclusion: Ectopic transplantation of body parts is an accepted method of treatment of severely crushed ex- tremity or finger injuries. In our country an amputee has very little chance of finding a job instead a disabled person can. In addition in Iran cultures amputation is seen as pu- nishment of either the God or the society, so it is not well accepted and many patients persist on saving the limb even with no functional recovery. None of our successful cases could return to his previous occupation but almost all of them could find a job as janitors or light manual workers. Key words: Replantation; Transplantation; Extremities; Amputation, traumatic

  7. Clinical effect of radiation synovectomy of the upper extremity joints: a randomised, double-blind, placebo-controlled study

    Energy Technology Data Exchange (ETDEWEB)

    Zant, F.M. van der; Boer, R.O. [Hospital Medical Center Alkmaar, Department of Nuclear Medicine, Alkmaar (Netherlands); Jahangier, Z.N.; Jacobs, J.W.G. [University Medical Center, Department of Rheumatology and Clinical Immunology, Utrecht (Netherlands); Moolenburgh, J.D.; Swen, W.A.A. [Hospital Medical Center Alkmaar, Department of Rheumatology, Alkmaar (Netherlands)

    2007-02-15

    To compare the clinical efficacy of radiosynoviorthesis (RSO) with intra-articular radionuclide plus glucocorticoid (GC) injection (group A) with that of placebo plus GC injection (group B) for the treatment of persistent synovitis in joints of the upper extremity. At baseline and at 6 and 12 months after intra-articular injection, six clinical parameters were scored. Changes in clinical values over time were summed to provide a change composite index (CCI), ranging from 0 (no effect) to 12 (maximal effect). A CCI {>=}6 was considered to indicate successful treatment. Differences in response rate and CCI between groups A and B were examined. Regression analyses were performed to explore whether baseline variables could predict therapeutic effect. Sixty-eight joints in 44 patients were treated. Six months after intra-articular injection, response rates (CCI {>=}6) were 69% (25/36) in group A and 29% (9/31) in group B (p=0.001). The mean CCIs {+-} standard deviation at 6 months were 6.7{+-}3.2 for group A and 3.3{+-}3.8 for group B (p=0.001). At 12 months the response rates were 69% (25/36) in group A and 32% (8/25) in group B (p=0.004). The mean CCIs at 12 months were 6.8{+-}3.3 for group A and 4.2{+-}4.7 for group B (p= 0.046). None of the baseline variables predicted the therapeutic effect. RSO (radionuclide plus GC) of upper extremity joints with immobilisation for 72 h shows a significantly better response rate than placebo plus GC in patients with persistent synovitis after at least one failed outpatient intra-articular GC injection. (orig.)

  8. Clinical effect of radiation synovectomy of the upper extremity joints: a randomised, double-blind, placebo-controlled study

    International Nuclear Information System (INIS)

    To compare the clinical efficacy of radiosynoviorthesis (RSO) with intra-articular radionuclide plus glucocorticoid (GC) injection (group A) with that of placebo plus GC injection (group B) for the treatment of persistent synovitis in joints of the upper extremity. At baseline and at 6 and 12 months after intra-articular injection, six clinical parameters were scored. Changes in clinical values over time were summed to provide a change composite index (CCI), ranging from 0 (no effect) to 12 (maximal effect). A CCI ≥6 was considered to indicate successful treatment. Differences in response rate and CCI between groups A and B were examined. Regression analyses were performed to explore whether baseline variables could predict therapeutic effect. Sixty-eight joints in 44 patients were treated. Six months after intra-articular injection, response rates (CCI ≥6) were 69% (25/36) in group A and 29% (9/31) in group B (p=0.001). The mean CCIs ± standard deviation at 6 months were 6.7±3.2 for group A and 3.3±3.8 for group B (p=0.001). At 12 months the response rates were 69% (25/36) in group A and 32% (8/25) in group B (p=0.004). The mean CCIs at 12 months were 6.8±3.3 for group A and 4.2±4.7 for group B (p= 0.046). None of the baseline variables predicted the therapeutic effect. RSO (radionuclide plus GC) of upper extremity joints with immobilisation for 72 h shows a significantly better response rate than placebo plus GC in patients with persistent synovitis after at least one failed outpatient intra-articular GC injection. (orig.)

  9. Multiple myeloma of an extremity: must the whole bone be irradiated?

    International Nuclear Information System (INIS)

    Purpose/Objective: Radiation of the entire shaft of a long bone affected by multiple myeloma is often advocated to prevent recurrent disease in the bone remote from the symptomatic site. Our standard of care has been to irradiate only the symptomatic area. We investigated the pattern of recurrence in patients treated in this manner. Materials and Methods: 163 patients with multiple myeloma were treated between 1971 and 1994. Twenty-seven patients received treatment to a long bone with 43 sites irradiated (17 humeri, 24 femurs, 1 radius, 1 ulna.) The most common long bone treated was the femur. All patients were treated with megavoltage therapy. The symptomatic lesion, plus a margin of 1-2 cm was treated with no attempt to treat the entire shaft. Mean radiation dose was 2782 cGy (range 600-4480 cGy). The length of the field was measured in centimeters and expressed as both an absolute (AL) and relative (RL) length (i.e. percentage of total length of bone). Results: The mean total AL and RL for femur fields was 18 cm and 42% respectively. For the humerus, the AL and RL were 20 cm and 68% respectively. Only 4 patients developed progressive disease in the same bone but outside the previously irradiated field. In 3 of the 4 patients the RL was between 20 and 30%. The dose of radiation given to these patients was 1250, 2100, 3000 and 3500 cGy. In all of these 4 cases, treatment of progressive disease in adjacent sites provided effective palliation of symptoms. Conclusion: Radiation therapy to the symptomatic portion of a long bone affected by MM is effective for palliation. Symptomatic recurrence out of the irradiated field is uncommon and can be effectively treated. Potential benefits of this approach include irradiation of less normal marrow and elimination of use of pairs of fields or extended distance treatment to cover the entire femur

  10. Upper extremity activity in adults: Referent values using accelerometry

    OpenAIRE

    Bailey, Ryan R.; Lang, Catherine E.

    2014-01-01

    The goal of physical rehabilitation following upper extremity (UE) impairment is functional restoration of the UE for use in daily activities. Because capacity for UE function may not translate into real-world activity, it is important that assessment of real-world UE activity be used in conjunction with clinical measures of capacity. Accelerometry can be used to quantify duration of UE activity outside of the clinic. The purpose of this study was to characterize hours of UE activity and pote...

  11. An extremely sensitive species-specific ARMS PCR test for the presence of tiger bone DNA.

    Science.gov (United States)

    Wetton, Jon H; Tsang, Carol S F; Roney, Chris A; Spriggs, Adrian C

    2002-04-18

    The survival of the tiger (Panthera tigris) is seriously threatened by poaching to provide raw materials for traditional Chinese medicines (TCMs). Most highly prized are the tiger's bones, which are used in combination with other animal and plant derivatives in pills and plasters for the treatment of rheumatism and other ailments. Hundreds of patent remedies have been produced which claim to contain tiger bone, but proof of its presence is needed if legislation prohibiting the trade in endangered species is to be enforced.A highly sensitive tiger-specific real-time PCR assay has been developed to address this problem. Using primers specific to the tiger mitochondrial cytochrome b gene, successful amplification has been reliably achieved from blood, hair and bone as well as from a range of TCMs spiked with 0.5% tiger bone. Although capable of detecting fewer than 10 substrate molecules, the seven varieties of TCM pills and plasters tested showed no detectable trace of tiger DNA before spiking. Furthermore, sequencing several "tiger bone" fragments seized from TCM shops has shown that they actually originated from cattle and pigs. The potential effects of traditional bone preparation methods, evidence that much lower concentrations are used than alleged on TCM packaging, and substitution of bones from other species all suggest a low likelihood of detecting tiger DNA in patent medicines. Despite this, the basic methods have been thoroughly proven and can be readily applied to derivatives from other Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) protected species, providing a rapid and highly sensitive forensic test for species of origin. Potential applications to the monitoring of wild populations are demonstrated by the successful identification of shed hairs and faecal samples. PMID:12084490

  12. An extremely sensitive species-specific ARMs PCR test for the presence of tiger bone DNA.

    Science.gov (United States)

    Wetton, Jon H; Tsang, Carol S F; Roney, Chris A; Spriggs, Adrian C

    2004-02-10

    The survival of the tiger (Panthera tigris) is seriously threatened by poaching to provide raw materials for Traditional Chinese Medicines (TCMs). Most highly prized are the tiger's bones, which are used in combination with other animal and plant derivatives in pills and plasters for the treatment of rheumatism and other ailments. Hundreds of patent remedies have been produced which claim to contain tiger bone, but proof of its presence is needed, if legislation prohibiting the trade in endangered species is to be enforced. A highly sensitive tiger-specific real-time PCR assay has been developed to address this problem. Using primers specific to the tiger mitochondrial cytochrome b gene, successful amplification has been reliably achieved from blood, hair and bone as well as from a range of TCMs spiked with 0.5% tiger bone. Although capable of detecting fewer than 10 substrate molecules, the seven varieties of TCM pills and plasters tested showed no detectable trace of tiger DNA before spiking. Furthermore, sequencing several "tiger bone" fragments seized from TCM shops has shown that they actually originated from cattle and pigs. The potential effects of traditional bone preparation methods, evidence that much lower concentrations are used than alleged on TCM packaging, and substitution of bones from other species all suggest a low likelihood of detecting tiger DNA in patent medicines. Despite this, the basic methods have been thoroughly proven and can be readily applied to derivatives from other CITES protected species providing a rapid and highly sensitive forensic test for species of origin. Potential applications to the monitoring of wild populations are demonstrated by the successful identification of shed hairs and faecal samples.

  13. Upper extremity constraint-induced movement therapy in infantile hemiplegia

    Directory of Open Access Journals (Sweden)

    Selvam Ramachandran

    2011-01-01

    Full Text Available Infantile hemiplegia is one of the clinical forms of cerebral palsy that refers to impaired motor function of one half of the body owing to contralateral brain damage due to prenatal, perinatal and postnatal causes amongst which vascular lesion is the most common causative factor. We report here the effects of constraint-induced movement therapy in a five-year-old female child with infantile hemiplegia on improvement of upper extremity motor skills.

  14. Satisfaction with upper extremity surgery in individuals with tetraplegia

    DEFF Research Database (Denmark)

    Gregersen, Hanne; Lybæk, Mille; Lauge Johannesen, Inger;

    2015-01-01

    to strongly disagree regarding satisfaction. Forty patients completed the questionnaire. RESULTS: Median time from first surgery was 13 years (2-36). Sixty-five percent of the sample had a C5-C6 SCI, with 64% experiencing complete injury. Initially, 76% of the sample expressed general satisfaction with life...... questions (P satisfaction with upper extremity surgery is high. It can have a positive impact on life in general, ability to perform ADL, as well as supplying an increased level of independence.......OBJECTIVE: To supplement the scant information available regarding the satisfaction of patients with tetraplegia following upper extremity reconstructive surgery for such individuals with spinal cord injury (SCI). STUDY DESIGN: Retrospective study with questionnaire follow-up. SETTING: The Danish...

  15. Neuromusculoskeletal disorders in the neck and upper extremities among drivers of all-terrain vehicles – a case series

    Directory of Open Access Journals (Sweden)

    Nilsson Tohr

    2004-01-01

    Full Text Available Abstract Background The purpose of this study was to investigate whether professional drivers of all-terrain vehicles (ATVs with neck pain have a different array of neuromusculoskeletal disorders in the neck and upper extremities than a referent group with neck pain from the general population. It is hypothesized that exposure to shock-type vibration and unfavorable working postures in ATVs have the capacity to cause peripheral nervous lesions. Methods This study was based on a case series analyzed according to a case-case comparison design. The study population consisted of 60 male subjects, including professional drivers of forest machines (n = 15, snowmobiles (n = 15, snowgroomers (n = 15 and referents from the general population (n = 15 all of whom had reported neck pain in a questionnaire and underwent an extensive physical examination of the neck and upper extremities. Based on symptom history, symptoms and signs, and in some cases chemical, electroneurographical and radiological findings, subjects were classified as having a nociceptive or neuropathic disorder or a mix of these types. Results The occurrence of asymmetrical and focal neuropathies (peripheral nervous lesion, pure or in a mix with a nociceptive disorder was common among cases in the ATV driver groups (47%–79%. This contrasted with the referents that were less often classified as having asymmetrical and focal neuropathy (27%, but instead had more nociceptive disorders. The difference was most pronounced among drivers of snowgroomers, while drivers of forest machines were more frequently classified as having a nociceptive disorder originating in the muscles. Conclusion This study found a high prevalence of assymetrical and focal neuropathies among drivers with pain in the neck, operating various ATVs. It seems as if exposure to shock-type whole-body vibration (WBV and appurtenant unfavorable postures in ATVs may be associated to peripheral nervous lesions.

  16. Free anterolateral thigh flaps for upper extremity soft tissue reconstruction

    Directory of Open Access Journals (Sweden)

    Spindler, Nick

    2015-02-01

    Full Text Available Introduction: Limb-threatening wounds of the upper extremity pose a challenge to the micro vascular surgeon. The aim of this study is to analyze the outcome of free anterolateral thigh flaps for upper extremity soft tissue reconstruction.Methods: A retrospective review of patients undergoing this procedure from 2005 to 2012 was performed. Case note analysis was performed to determine demographic and perioperative factors, and complications and outcomes.Results: Thirty-two patients with a mean age of 53 years (9–84 yrs underwent upper extremity reconstruction with an anterolateral thigh (ALT flap. There were 24 (75% males and 8 (25% females. The etiology of the soft tissue defects was: infection (44.6%; post-tumor ablation (40%; and trauma (15.6%. The defect site was most commonly in the forearm (53.1%, followed by the elbow (12.5 %, arm (12.5% and hand (21.9%. The mean timing of free flap transfer was 6.8 days after admission to our institution (minimum 1 days, maximum 9 days. Mean operative time of surgery was 4 h 39 min (minimum 3 h 2 min, maximum 20 min. The mean hospitalization was 24.8 days (minimum 5, maximum 85. The ALT success rate was at 92.3%. Partial flap necrosis was documented in five cases (15.6%. Complete flap loss occurred in two post-traumatic cases who both lost their limbs.Discussion: This flap, in the hands of experienced surgeons, provides reliable coverage of upper extremity defects.

  17. On the assessment of coordination between upper extremities: towards a common language between rehabilitation engineers, clinicians and neuroscientists.

    Science.gov (United States)

    Shirota, Camila; Jansa, Jelka; Diaz, Javier; Balasubramanian, Sivakumar; Mazzoleni, Stefano; Borghese, N Alberto; Melendez-Calderon, Alejandro

    2016-09-08

    Well-developed coordination of the upper extremities is critical for function in everyday life. Interlimb coordination is an intuitive, yet subjective concept that refers to spatio-temporal relationships between kinematic, kinetic and physiological variables of two or more limbs executing a motor task with a common goal. While both the clinical and neuroscience communities agree on the relevance of assessing and quantifying interlimb coordination, rehabilitation engineers struggle to translate the knowledge and needs of clinicians and neuroscientists into technological devices for the impaired. The use of ambiguous definitions in the scientific literature, and lack of common agreement on what should be measured, present large barriers to advancements in this area. Here, we present the different definitions and approaches to assess and quantify interlimb coordination in the clinic, in motor control studies, and by state-of-the-art robotic devices. We then propose a taxonomy of interlimb activities and give recommendations for future neuroscience-based robotic- and sensor-based assessments of upper limb function that are applicable to the everyday clinical practice. We believe this is the first step towards our long-term goal of unifying different fields and help the generation of more consistent and effective tools for neurorehabilitation.

  18. Our experience on brachial plexus blockade in upper extremity surgery

    Directory of Open Access Journals (Sweden)

    Ömer Uslukaya

    2012-03-01

    Full Text Available Objective: Peripheral nerve blocks are usually used either alone or along with general anesthesia for postoperative analgesia. We also aimed to present the results and experiences.Materials and methods: This retrospective study was conducted to scan the files of patients who underwent orthopedic upper extremity surgery with peripheral nerve block between September 2009 and October 2010. After ethics committee approval was obtained, 114 patients who were ASA physical status I-III, aged 18-70, performed upper extremity surgery in the Orthopedics and Traumatology Clinic were included to study. Patients’ demographic data, clinical diagnoses, premedication status, peripheral block type, local anesthetic dose, stimuplex needle types, hemodynamic parameters at the during surgery, the first postoperative analgesic requirements, complications and patient satisfaction were recorded.Results: Demographic data were similar to each other. Brachial plexus block was commonly performed for the forearm surgery. Infraclavicular block was performed the most frequently to patients. As the classical methods in the supine position were preferred in 98.2% of patients, Stimuplex A needle (B. Braun, Melsungen AG, Germany have been used for blockage in 80.7% of patients. Also, in 54.4% of patients, 30 ml of local anesthetic solution composed of bupivacaine + prilocaine was used for blockade. Blocks applied to patients had provided adequate anesthesia.Conclusion: Since the brachial plexus blockade guided peripheral nerve stimulator for upper extremity surgery provide adequate depth of anesthesia and analgesia, it may be a good alternative to general anesthesia because of unwanted side effects

  19. Upper Extremity Injured Workers Stratified by Current Work Status: An Examination of Health Characteristics, Work Limitations and Work Instability

    Directory of Open Access Journals (Sweden)

    H Grant

    2010-06-01

    Full Text Available Background: Upper extremity injured workers are an under-studied population. A descriptive comparison of workers with shoulder, elbow and hand injuries reporting to a Canadian Workplace Safety and Insurance Board (WSIB clinic was undertaken.Objective: To determine if differences existed between injury groups stratified by current work status.Methods: All WSIB claimants reporting to our upper extremity clinic between 2003 and 2008 were approached to participate in this descriptive study. 314 working and 146 non-working WSIB claimants completed the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH; Short Form health survey (SF36; Worker’s Limitations Questionnaire and the Work Instability Scale. Various parametric and non-parametric analyses were used to assess significant differences between groups on demographic, work and health related variables.Results: Hand, followed by the shoulder and elbow were the most common site of injury. Most non-workers listed their current injury as the reason for being off work, and attempted to return to work once since their injury occurrence. Non-workers and a subset of workers at high risk for work loss showed significantly worse mental functioning. Workers identified physical demands as the most frequent injury-related on the job limitation. 60% of current workers were listed as low risk for work loss on the Work Instability Scale.Conclusions: Poorer mental functioning, being female and sustaining a shoulder injury were risk factors for work instability. Our cohort of injured non-workers were unable to return to work due to their current injury, reinforcing the need to advocate for modified duties, shorter hours and a work environment where stress and injury recurrence is reduced. Future studies examining pre-injury depression as a risk factor for prolonged work absences are warranted.

  20. Exercise-induced bone gain is due to enlargement in bone size without a change in volumetric bone density: a peripheral quantitative computed tomography study of the upper arms of male tennis players.

    Science.gov (United States)

    Haapasalo, H; Kontulainen, S; Sievänen, H; Kannus, P; Järvinen, M; Vuori, I

    2000-09-01

    due to a change in volumetric bone density. These upper arm results may not be generalized to the entire skeleton, but the finding may give new insight into conventional dual-energy X-ray absorptiometry (DXA)-based bone density measurements when interpreting the effects of exercise on bone.

  1. Detection of rheumatoid arthritis bone erosions by two different dedicated extremity MRI units and conventional radiography

    DEFF Research Database (Denmark)

    Duer-Jensen, A.; Vestergaard, A.; Dohn, U.M.;

    2008-01-01

    was particularly more sensitive than CR for metacarpal heads and carpal bones. MagneVu MRI and CR detected 100% and 89%, respectively, of large erosions (Outcome Measures in Rheumatoid Arthritis Clinical Trials-Rheumatoid Arthritis MRI Scoring System (OMERACT-RAMRIS) score >1 on Artoscan) in MCP joints and 69......% and 15.8% of large erosions in wrists. Conclusions: Both E-MRI units detected more erosions than CR, in particular due to a higher sensitivity in metacarpal heads and carpal bones. The MagneVu unit detected fewer erosions than the Artoscan unit due to a lower average image quality and a smaller...

  2. Lymphatic Filariasis Disseminating to the Upper Extremity

    Directory of Open Access Journals (Sweden)

    Catherine Maldjian

    2014-01-01

    Full Text Available Lymphatic filariasis is the most common cause of acquired lymphedema worldwide (Szuba and Rockson, 1998. It is endemic to tropical and subtropical regions, and its effects are devastating. With over 100 million infected persons, it ranks second only to leprosy as the leading cause of permanent and long-term disability. Wuchereria bancrofti is the etiologic agent in 90% of cases. There is a dearth of published MRI findings with pathologically proven active infections, making this entity even more of a diagnostic dilemma. Imaging may provide the first clue that one is dealing with a parasite and may facilitate proper treatment and containment of this disease. This is the first report of pathologic correlation with MRI findings in the extremity in active filariasis. The magnetic resonance images demonstrate an enhancing, infiltrative, mass-like appearance with partial encasement of vasculature that has not been previously described in filariasis. Low signal strands in T2-hyperintense dilated lymphatic channels are seen and may depict live adult worms. We hypothesize that the low signal strands correspond to the collagen rich acellular cuticle. This, in combination with the surrounding hyperintense T2 signal, corresponding to a dilated lymphatic channel, may provide more specific MRI findings for active nematodal infection, which can prompt early biopsy, pathological correlation, and diagnosis.

  3. Lymphatic Filariasis Disseminating to the Upper Extremity

    Science.gov (United States)

    Maldjian, Catherine; Khanna, Vineet; Tandon, Bevan; Then, Matthew; Yassin, Mohamed; Adam, Richard; Klein, Michael J.

    2014-01-01

    Lymphatic filariasis is the most common cause of acquired lymphedema worldwide (Szuba and Rockson, 1998). It is endemic to tropical and subtropical regions, and its effects are devastating. With over 100 million infected persons, it ranks second only to leprosy as the leading cause of permanent and long-term disability. Wuchereria bancrofti is the etiologic agent in 90% of cases. There is a dearth of published MRI findings with pathologically proven active infections, making this entity even more of a diagnostic dilemma. Imaging may provide the first clue that one is dealing with a parasite and may facilitate proper treatment and containment of this disease. This is the first report of pathologic correlation with MRI findings in the extremity in active filariasis. The magnetic resonance images demonstrate an enhancing, infiltrative, mass-like appearance with partial encasement of vasculature that has not been previously described in filariasis. Low signal strands in T2-hyperintense dilated lymphatic channels are seen and may depict live adult worms. We hypothesize that the low signal strands correspond to the collagen rich acellular cuticle. This, in combination with the surrounding hyperintense T2 signal, corresponding to a dilated lymphatic channel, may provide more specific MRI findings for active nematodal infection, which can prompt early biopsy, pathological correlation, and diagnosis. PMID:24707427

  4. Effectiveness of workplace interventions in the prevention of upper extremity musculoskeletal disorders and symptoms: an update of the evidence.

    Science.gov (United States)

    Van Eerd, D; Munhall, C; Irvin, E; Rempel, D; Brewer, S; van der Beek, A J; Dennerlein, J T; Tullar, J; Skivington, K; Pinion, C; Amick, B

    2016-01-01

    The burden of disabling musculoskeletal pain and injuries (musculoskeletal disorders, MSDs) arising from work-related causes in many workplaces remains substantial. There is little consensus on the most appropriate interventions for MSDs. Our objective was to update a systematic review of workplace-based interventions for preventing and managing upper extremity MSD (UEMSD). We followed a systematic review process developed by the Institute for Work & Health and an adapted best evidence synthesis. 6 electronic databases were searched (January 2008 until April 2013 inclusive) yielding 9909 non-duplicate references. 26 high-quality and medium-quality studies relevant to our research question were combined with 35 from the original review to synthesise the evidence on 30 different intervention categories. There was strong evidence for one intervention category, resistance training, leading to the recommendation: Implementing a workplace-based resistance training exercise programme can help prevent and manage UEMSD and symptoms. The synthesis also revealed moderate evidence for stretching programmes, mouse use feedback and forearm supports in preventing UEMSD or symptoms. There was also moderate evidence for no benefit for EMG biofeedback, job stress management training, and office workstation adjustment for UEMSD and symptoms. Messages are proposed for both these and other intervention categories.

  5. Lower extremity lipedema, upper extremity lipodystrophy and severe calcinosis complicating juvenile dermatomyositis.

    Science.gov (United States)

    Pavlov-Dolijanovic, Slavica R; Vujasinovic Stupar, Nada Z; Gavrilov, Nikola; Seric, Srdjan

    2014-11-01

    Juvenile dermatomyositis (JDM) is a rare but complex and potentially life-threatening autoimmune disease of childhood. Significant proportions of patients have residual weakness, muscle atrophy, joint contractures, and calcinosis. Recently, new clinical findings, such as lipodystrophy accompanied with increased fat deposition in certain areas, have been reported. So far, it is not known whether the redistribution of body fat may be the type of lipedema of lower extremity. We describe a 39-year-old woman who was diagnosed with JDM at the age of 7. Later she developed symmetrical lipodystrophy of upper extremities and symmetrical lipedema of lower extremities (making 2 and 58.3 % of total body fat mass, respectively), with multiple calcified nodules in the subcutaneous tissues. These nodules gradually increased in size despite therapy. Capillaroscopy findings showed scleroderma-like abnormalities. ANA and anti-U1RNP antibodies were positive. Similar cases with simultaneous occurrence of the lipedema of lower extremities, lipodystrophy of upper extremities, and severe calcinosis complicating JDM have not been published so far. We showed that the calcinosis and lipodystrophy were associated with short duration of active disease. Also, we display case that raises the question whether it is possible overlapping autoimmune diseases revealed during follow-up.

  6. Validation of a mechanism to balance exercise difficulty in robot-assisted upper-extremity rehabilitation after stroke

    Directory of Open Access Journals (Sweden)

    Zimmerli Lukas

    2012-02-01

    Full Text Available Abstract Background The motivation of patients during robot-assisted rehabilitation after neurological disorders that lead to impairments of motor functions is of great importance. Due to the increasing number of patients, increasing medical costs and limited therapeutic resources, clinicians in the future may want patients to practice their movements at home or with reduced supervision during their stay in the clinic. Since people only engage in an activity and are motivated to practice if the outcome matches the effort at which they perform, an augmented feedback application for rehabilitation should take the cognitive and physical deficits of patients into account and incorporate a mechanism that is capable of balancing i.e. adjusting the difficulty of an exercise in an augmented feedback application to the patient's capabilities. Methods We propose a computational mechanism based on Fitts' Law that balances i.e. adjusts the difficulty of an exercise for upper-extremity rehabilitation. The proposed mechanism was implemented into an augmented feedback application consisting of three difficulty conditions (easy, balanced, hard. The task of the exercise was to reach random targets on the screen from a starting point within a specified time window. The available time was decreased with increasing condition difficulty. Ten subacute stroke patients were recruited to validate the mechanism through a study. Cognitive and motor functions of patients were assessed using the upper extremity section of the Fugl-Meyer Assessment, the modified Ashworth scale as well as the Addenbrookes cognitive examination-revised. Handedness of patients was obtained using the Edinburgh handedness inventory. Patients' performance during the execution of the exercises was measured twice, once for the paretic and once for the non-paretic arm. Results were compared using a two-way ANOVA. Post hoc analysis was performed using a Tukey HSD with a significance level of p Results

  7. Dosimetry of upper extremities of personnel in nuclear medicine hot labs

    OpenAIRE

    Παπαδόγιαννης, Παναγιώτης

    2012-01-01

    The specific nature of work in nuclear medicine departments involves the use of isotopes and handling procedures, which contribute to the considerable value of the equivalent dose received, in particular, by the fingertips. Workers of nuclear medicine units who label radiopharmaceuticals are exposed to ionizing radiation. The doses of nuclear medicine workers determined by individual dosimeters, which supply data on the magnitude of personal dose equivalent. The dosimetry pointing to a con...

  8. Evaluating the Impact of Player Experience in the Design of a Serious Game for Upper Extremity Stroke Rehabilitation.

    Science.gov (United States)

    Cordeiro d'Ornellas, Marcos; Cargnin, Diego João; Cervi Prado, Ana Lúcia

    2015-01-01

    Video games have become a major entertainment industry and one of the most popular leisure forms, ranging from laboratory experiments to a mainstream cultural medium. Indeed, current games are multimodal and multidimensional products, relying on sophisticated features including not only a narrative-driven story but also impressive graphics and detailed settings. All of these elements helped to create a seamless and appealing product that have resulted in a growing number of players and in the number of game genres. Although video games have been used in education, simulation, and training, another application that exploits serious gaming is the exploration of player experience in the context of game research. Recent advances in the natural user interfaces and player experience have brought new perspectives on the in-game assessment of serious games. This paper evaluates the impact of player experience in the design of a serious game for upper extremity stroke rehabilitation. The game combines biofeedback and mirror neurons both in single and multiplayer mode. Results have shown that the game is a feasible solution to integrate serious games into the physical therapy routine. PMID:26262072

  9. Impact of Location and Geometry on Patency and Reintervention of Upper Extremity Arteriovenous Hemodialysis Grafts

    OpenAIRE

    Losak, Michael John

    2015-01-01

    Introduction: Vascular access is a key component of hemodialysis (HD). Thus, in order to ensure optimal and successful long-term HD treatments, it is imperative to choose appropriate access tailored to individual patients. Although only 5% of patients have a functional or maturing arteriovenous grafts (AVG) at dialysis initiation, the proportion of patients using an AVG increases to 15% at one year [1]. The present work aims at assessing the impact of access characteristics on the cumulati...

  10. Critical review of the impact of core stability on upper extremity athletic injury and performance

    OpenAIRE

    Silfies, Sheri P.; David Ebaugh; Marisa Pontillo; Courtney M. Butowicz

    2015-01-01

    BACKGROUND: Programs designed to prevent or rehabilitate athletic injuries or improve athletic performance frequently focus on core stability. This approach is based upon the theory that poor core stability increases the risk of poor performance and/or injury. Despite the widespread use of core stability training amongst athletes, the question of whether or not sufficient evidence exists to support this practice remains to be answered. OBJECTIVES: 1) Open a dialogue on the definition and comp...

  11. Assessing agreement of self-reported and observed physical exposures of the upper extremity

    OpenAIRE

    Dale, Ann Marie; Strickland, Jaime; Gardner, Bethany; Symanzik, Jürgen; Evanoff, Bradley

    2010-01-01

    Assessment of workplace physical exposures by self-reported questionnaires has logistical advantages in population studies but is subject to exposure misclassification. This study measured agreement between eight self-reported and observer-rated physical exposures to the hands and wrists, and evaluated predictors of inter-method agreement. Workers (n=341) from three occupational categories (clerical/technical, construction, and service) completed self-administered questionnaires and worksite ...

  12. Movement patterns of the upper extremity and trunk before and after corrective surgery of impaired forearm rotation in patients with cerebral palsy

    NARCIS (Netherlands)

    M. Kreulen; M.J.C. Smeulders; H.E.J. Veeger; J.J. Hage

    2006-01-01

    The effect of surgical correction of impaired forearm rotation on associated body movement patterns was studied prospectively by comparison of preoperative and postoperative three-dimensional video analysis of the upper extremity and trunk in eight male and two female patients with hemiplegic cerebr

  13. Dyskinesion of upper extremity in stroke patients%偏瘫上肢的运动障碍

    Institute of Scientific and Technical Information of China (English)

    王耀山

    2000-01-01

    Upper extremity dyskinesia is one of common clinical features in stroke patients.Muscle power is divided into 6 grades in clincal examination.In order to observe the degree of muscle power decrease carefully, we suggested a new plus- grades of examing power. Other methods included using squeeze dynamometer, goniometer, magnetic stimular reaction and tronscutaneous oxygen tention examination etc.In the recovery of the patient with stroke there is a progression from flaccidity to spasticity with arm pain and relactive sympathetic nerve dystrophy.Various pathogenic combined movements were also founded.Agonistic and antagonistic muscle triphasic electric pattern were founded in Electromyography.Dyskinesia of upper extremity had different features in different brain area lesion. Some sign can forecast functional prognosis of brachial palsy in stroke.%摘要 偏瘫上肢运动障碍是脑中风常见的症状和体征之一,临床检查肌力分为6级,为精细观察肌力减弱程度提出一种补充分级法。其他尚可应用握力针、量角器、磁刺激反应和经皮氧张力检测等方法。中风偏瘫上肢运动障碍早期为弛缓性瘫,在恢复期中逐渐转变为痉挛性瘫。可伴有瘫侧上肢疼痛和反射性交感神经营养不良现象,并伴有各型病理性联合运动。肌电图表现为主动肌拮抗肌3相型电活动。脑内不同部位病变的上肢运动障碍各具不同特点,一些征象可预测中风瘫痪上肢的功能预后。

  14. Impact of musculoskeletal co-morbidity of neck and upper extremities on healthcare utilisation and sickness absence for low back pain.

    NARCIS (Netherlands)

    W. IJzelenberg (Wilhelmina); A. Burdorf (Alex)

    2004-01-01

    textabstractAIMS: To describe the presence of musculoskeletal co-morbidity of the neck and upper extremities among industrial workers with low back pain, and to examine whether it has an impact on healthcare utilisation and sickness absence for low back pain. METHODS: A self admini

  15. Short-term effects and long-term use of a hybrid orthosis for neuromuscular electrical stimulation of the upper extremity in patients after chronic stroke.

    NARCIS (Netherlands)

    Meijer, J.W.; Voerman, G.E.; Santegoets, K.M.; Geurts, A.C.H.

    2009-01-01

    OBJECTIVE: To associate the short-term effects of the Handmaster orthosis on disabling symptoms of the affected upper extremity with long-term Handmaster orthosis use after stroke. DESIGN: Historic cohort study. PATIENTS: Patients with chronic stroke. METHODS: The Modified Ashworth Scale (0-5) for w

  16. Side-to-side comparisons of bone mineral density in upper and lower limbs of collegiate athletes.

    Science.gov (United States)

    McClanahan, Barbara S; Harmon-Clayton, Karen; Ward, Kenneth D; Klesges, Robert C; Vukadinovich, Christopher M; Cantler, Edwin D

    2002-11-01

    This cross-sectional study investigated the effects of participation in various sports on side-to-side (contralateral) differences in bone mineral density (BMD) of the upper and lower limbs. The BMD of the arms and legs was measured using dual energy X-ray absorptiometry. The subjects were 184 collegiate athletes, both men and women, who participated in NCAA Division I-A baseball, basketball, football, golf, soccer, tennis, cross-country, indoor/outdoor track, and volleyball. Results revealed greater BMD of the right arms compared with the left arms for all teams, with the most pronounced differences observed in men's and women's tennis and men's baseball. Differences in the lower limbs were less common. No significant differences in lower limb BMD were found in the women. In men, differences in lower limb BMD were found in the football and tennis teams, with the nondominant leg having greater bone mass. Recognition of contralateral differences in bone density may be of particular interest to strength and conditioning professionals as they consider the need to include bilateral and unilateral training programs in an effort to maximize performance and minimize stress-related injuries. PMID:12423190

  17. Kinesiology Taping reduces lymphedema of the upper extremity in women after breast cancer treatment: a pilot study

    Directory of Open Access Journals (Sweden)

    Iwona Malicka

    2014-09-01

    Full Text Available Introduction : Secondary lymphedema affects approximately 40% of women treated for breast cancer and is recognized as a major problem associated with the therapy of malignant tumors. Consequently, new therapeutic methods are constantly being sought to effectively eliminate the condition. One of the new forms of edema management, especially in the initial stages of edematous development, is Kinesiology Taping (KT. Aim of the study : The aim of the study was to assess the effects of KT applications on the extent of lymphedema of the upper extremity in women post cancer treatment. Material and methods: The study group consisted of 28 women after axillary lymphadenectomy due to breast cancer. All the patients were diagnosed with grade I secondary lymphedema. Kinesiology Taping was applied to a total of 14 randomly selected women. The remaining 14 patients constituted a control group. The extent of lymphedema was measured using a centimeter tape and Limb Volumes Professional 5.0 software. Results : A significant reduction in the extent of lymphedema (p = 0.0009 was achieved in the KT group between baseline and post-treatment assessments. No such reduction, however, was found in the control group (p = 0.36. Conclusions : Kinesiology Taping applications are an effective method of early-stage edema management. Kinesiology Taping may be a safe new therapeutic option in patients who are contraindicated for the use of other methods.

  18. Hydatid disease of scapula and upper third of humerus treated by en bloc excision and fibular bone grafting

    Directory of Open Access Journals (Sweden)

    Chari P

    2007-01-01

    Full Text Available 35-year-old male patient presented with gradually increasing painful swelling of the right shoulder, which was incised and drained and wound persisted as a discharging sinus on the anterolateral aspect of the deltoid region with seropurulent discharge. A clinical diagnosis of tuberculosis of the shoulder was made. Plain skiagram of the right shoulder revealed multicystic lesion involving the entire scapula and upper third of the humerus with loss of joint space and pathological fracture at the junction of upper one-third and lower two-thirds of the humerus. A clinico-radiological diagnosis of hydatid disease was made. In view of the extensive involvement of the scapula with stiff shoulder and an active sinus, a two-stage surgical procedure was performed. Stage 1 consisted of en bloc excision of the scapula, upper half of the humerus and lateral end of the clavicle. Stage II surgery, consisting of fibular bone grafting. Tablet albendazole (400 mg, thrice daily was given as systemic scolicidal agent. This case is reported in view of it′s rarity and to highlight the management.

  19. An Upper Limit on the Ratio Between the Extreme Ultraviolet and the Bolometric Luminosities of Stars Hosting Habitable Planets

    Indian Academy of Sciences (India)

    Sujan Sengupta

    2016-06-01

    A large number of terrestrial planets in the classical habitable zone of stars of different spectral types have already been discovered and many are expected to be discovered in the near future. However, owing to the lack of knowledge on the atmospheric properties, the ambient environment of such planets are unknown. It is known that sufficient amount of Extreme Ultraviolet (EUV) radiation from the star can drive hydrodynamic outflow of hydrogen that may drag heavier species from the atmosphere of the planet. If the rate of mass loss is sufficiently high, then substantial amount of volatiles would escape causing the planet to become uninhabitable. Considering energy-limited hydrodynamical mass loss with an escape rate that causes oxygen to escape alongwith hydrogen, an upper limit for the ratio between the EUV and the bolometric luminosities of stars which constrains the habitability of planets around them is presented here. Application of the limit to planet-hosting stars with known EUV luminosities implies that many M-type of stars should not have habitable planets around them.

  20. "RISK ASSESSMENT OF DEVELOPING DISTAL UPPER EXTREMITY DISORDERS BY STRAIN INDEX METHOD IN AN ASSEMBLING ELECTRONIC INDUSTRY"

    Directory of Open Access Journals (Sweden)

    M. Pourmahabadian

    2005-08-01

    Full Text Available The strain index (SI is a substantial advancement and has been devised to analyze ergonomic risks for distal upper extremity (DUE disorders. This semi-quantitative tool allows for the measurement of hazards and does not require unduly lengthy training to begin to use it accurately. Uses of the strain index include analysis of a current job to assess whether it is safe or hazardous, quantification of the risks, and assistance in the initial design of a job or in the redesign of a job. The aim of this study was to assess and analyze risk of developing DUE disorders in different jobs as well as hazard classification in an assembling electronic industry through SI method. Also, DUE disorders prevalence, work-related absenteeism and turnover extracted from SI results were compared and assessed by those obtained by Nordic musculoskeletal questionnaire (NMQ. The findings of this study showed that more than 50% of investigated jobs are categorized as "hazardous" and there is a significant difference between SI mean in hazardous and safe jobs (P < 0.0001. In addition, significant difference was found between prevalence of DUE disorders in "safe" and "hazardous" jobs (P < 0.049. But, no significant difference (P = 0.3 was obtained between mean absenteeism in "safe" and hazardous jobs. Also, no significant difference statistically was found between turnover in "safe" and hazardous jobs (X2 = 0.133, P = 1 and high prevalence of DUE disorders is due to low turnover rate of workers.

  1. Magnetic resonance venography in consecutive patients with suspected deep vein thrombosis of the upper extremity: initial experience

    International Nuclear Information System (INIS)

    To assess the feasibility and accuracy of two magnetic resonance (MR) venography methods in a consecutive series of patients with suspected deep vein thrombosis of the upper extremity (DVTUE). Consecutive in- and outpatients who were referred for imaging of suspected DVTUE in a large teaching hospital during the period April 2001 to October 2002 were eligible for inclusion. All patients were scheduled to undergo contrast venography with the intention to perform additional MR venography. Both time-of-flight and gadolinium-enhanced 3D MR venography were scheduled. All MR imaging were interpreted independently by consensus of two experienced radiologists, who were blinded for contrast venography outcome. Patients were managed based on contrast venography only. A total of 44 patients were eligible for inclusion. Thirteen patients were excluded (5 refused consent, 2 inability to gain venous access, 2 renal failure, 4 logistic reasons). Contrast venography was performed in 31 patients, and demonstrated DVTUE in 11 patients. MR imaging was not feasible in 10 patients (4 unable to lie flat, 3 claustrophobia, 1 too large for MR scanner, 1 osteosynthesis of shoulder, 1 pacemaker). The sensitivity and specificity of TOF MRV versus Gadolinium 3D MRV was 71% and 89% versus 50% and 80%, respectively. A high number of patients were unable to undergo MR venography in this setting. Contrast-enhanced MRV did not improve diagnostic accuracy. The clinical utility of MR venography in the setting of suspected DVTUE seems disappointing

  2. Magnetic resonance venography in consecutive patients with suspected deep vein thrombosis of the upper extremity: initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Baarslag, H.J.; Reekers, J.A. [Academic Medical Centre, Amsterdam (Netherlands). Dept. of Radiology; Beek, E.J. van [Royal Hallamshire Hospital, Sheffield (United Kingdom). Unit of Academic Radiology

    2004-02-01

    To assess the feasibility and accuracy of two magnetic resonance (MR) venography methods in a consecutive series of patients with suspected deep vein thrombosis of the upper extremity (DVTUE). Consecutive in- and outpatients who were referred for imaging of suspected DVTUE in a large teaching hospital during the period April 2001 to October 2002 were eligible for inclusion. All patients were scheduled to undergo contrast venography with the intention to perform additional MR venography. Both time-of-flight and gadolinium-enhanced 3D MR venography were scheduled. All MR imaging were interpreted independently by consensus of two experienced radiologists, who were blinded for contrast venography outcome. Patients were managed based on contrast venography only. A total of 44 patients were eligible for inclusion. Thirteen patients were excluded (5 refused consent, 2 inability to gain venous access, 2 renal failure, 4 logistic reasons). Contrast venography was performed in 31 patients, and demonstrated DVTUE in 11 patients. MR imaging was not feasible in 10 patients (4 unable to lie flat, 3 claustrophobia, 1 too large for MR scanner, 1 osteosynthesis of shoulder, 1 pacemaker). The sensitivity and specificity of TOF MRV versus Gadolinium 3D MRV was 71% and 89% versus 50% and 80%, respectively. A high number of patients were unable to undergo MR venography in this setting. Contrast-enhanced MRV did not improve diagnostic accuracy. The clinical utility of MR venography in the setting of suspected DVTUE seems disappointing.

  3. Effects of functional electrical therapy on upper extremity functional motor recovery in patients after stroke: Our experience and future directions

    Directory of Open Access Journals (Sweden)

    Plavšić Aleksandra

    2011-01-01

    Full Text Available Introduction. New neurorehabilitation together with conventional techniques provide methods and technologies for maximizing what is preserved from the sensory motor system after cerebrovascular insult. The rehabilitation technique named functional electrical therapy was investigated in more than 60 patients in acute, subacute and chronic phase after cerebrovascular insult. The functional sensory information generated by functional electrical therapy was hypothesized to result in the intensive functional brain training of the activities performed. Functional Electrical Therapy. Functional electrical therapy is a combination of functional exercise and electrical therapy. The functional electrical therapy protocol comprises voluntary movement of the paretic arm in synchrony with the electrically assisted hand functions in order to perform typical daily activities. The daily treatment of 30 minutes lasts three weeks. The outcome measures include several tests for the evaluation of arm/hand functionality: upper extremity function test, drawing test, modified Aschworth scale, motor activity log and passive range of movement. Results of Functional Electrical Therapy Studies. Results from our several clinical studies showed that functional electrical therapy, if applied in acute and subacute stroke patients, leads to faster and greater improvement of functioning of the hemiplegic arm/hand compared to the control group. The outcomes were significantly superior at all times after the treatment for the higher functioning group. Discussion. Additional well-planned clinical studies are needed to determine the adequate dose of treatment (timing, duration, intensity with functional electrical therapy regarding the patient’s status. A combination with other techniques should be further investigated.

  4. Influence of augmented feedback on learning upper extremity tasks after stroke

    OpenAIRE

    Molier, B.I.

    2012-01-01

    With upcoming innovative technologies more possibilities arise in the application of augmented feedback in rehabilitation therapy of the hemiparetic arm after stroke. The effect of different aspects and types of augmented feedback on motor functions and motor activities of the hemiparetic arm after stroke are studied in a systematic literature review. Based on current literature it was not possible to determine which combinations of aspects and types of augmented feedback are most essential f...

  5. Mirror therapy enhances upper extremity motor recovery in stroke patients.

    Science.gov (United States)

    Mirela Cristina, Luca; Matei, Daniela; Ignat, Bogdan; Popescu, Cristian Dinu

    2015-12-01

    The purpose of this study was to evaluate the effects of mirror therapy program in addition with physical therapy methods on upper limb recovery in patients with subacute ischemic stroke. 15 subjects followed a comprehensive rehabilitative treatment, 8 subjects received only control therapy (CT) and 7 subjects received mirror therapy (MT) for 30 min every day, five times a week, for 6 weeks in addition to the conventional therapy. Brunnstrom stages, Fugl-Meyer Assessment (upper extremity), the Ashworth Scale, and Bhakta Test (finger flexion scale) were used to assess changes in upper limb motor recovery and motor function after intervention. After 6 weeks of treatment, patients in both groups showed significant improvements in the variables measured. Patients who received MT showed greater improvements compared to the CT group. The MT treatment results included: improvement of motor functions, manual skills and activities of daily living. The best results were obtained when the treatment was started soon after the stroke. MT is an easy and low-cost method to improve motor recovery of the upper limb. PMID:25850528

  6. Tumours of peripheral nerves in the upper extremity: a 22-year epidemiological study

    DEFF Research Database (Denmark)

    Sandberg, Kristina; Nilsson, Jessica; Søe Nielsen, Niels;

    2009-01-01

    Peripheral nerve tumours are uncommon. Our aims were to calculate the incidence and relative frequencies, to define sites of nerve tumours and to judge preoperative symptoms and outcomes of intervention. The results of 53 patients, with 68 tumours and histopathological diagnoses of true neoplasms...

  7. Optimal Dimensional Synthesis of a Symmetrical Five-Bar Planar Upper-Extremity Neuromotor Device

    Institute of Scientific and Technical Information of China (English)

    GAO Jianshe; LI Mingxiang; ALLISON Garry; CUI Lei

    2015-01-01

    Individuals with hemiplegia suffer from impaired arm movements that appear as a marked change in arm stiffness. A quantitative measure of arm stiffness would characterize rehabilitation therapy effectively, while little mechanism is designed to implement the function. A symmetrical five-bar linkage consisting of two revolute joints and three prismatic joints is presented. Inverse kinematics and forward kinematics are obtained first. Then inverse singularities and direct singularities of the mechanism are gained. The global stiffness index is defined based on the results of kinematics analysis. Finally, optimal dimensional synthesis of the mechanism in terms of maximum stiffness is conducted by genetic algorithms. The calculation results show that with the length of both the two linkage a=830 mm, the interacting angle of the two guides 2δ=4.48 radian, and the maximum range of displacement of the two carriers dmax=940 mm, the mechanism achieves highest rigidity and its workspace is singularity-free, which covers the human left and right arm range of motion. The proposed novel mechanism featuring high rigidity and a singularity-free workspace can provide rehabilitation training, also solve the problem of quantitative measure of arm stiffness.

  8. The Sequence of Hip and Selected Upper-Extremity Joint Movements During the Golf Drive.

    Science.gov (United States)

    Hunter, Charles L.

    This study analyzed wrist, elbow, and hip actions of golfers who were accurately driving a golf ball a maximum distance. Electrogoniometry and cinematography were used to measure wrist, forearm, elbow, and hip actions during the downswing of 10 low-handicap golfers who were attempting to drive a minimum of 225 yards within a 50-yard corridor.…

  9. Effectiveness of a feedback signal in a computer mouse on upper extremity musculoskeletal symptoms: a randomised controlled trial with an 8-month follow-up

    NARCIS (Netherlands)

    E.M. Meijer; J.K. Sluiter; M.H.W. Frings-Dresen

    2009-01-01

    OBJECTIVES: To study the effectiveness of using a computer mouse with a feedback signal for upper extremity musculoskeletal symptoms in office workers. METHODS: A randomised controlled trial with 8 months of follow-up was carried out. The intervention consisted of a computer mouse with a feedback si

  10. Free Functional Muscle Transfers to Restore Upper Extremity Function.

    Science.gov (United States)

    Krauss, Emily M; Tung, Thomas H; Moore, Amy M

    2016-05-01

    Free functional muscle transfer provides an option for functional restoration when nerve reconstruction and tendon transfers are not feasible. To ensure a successful outcome, many factors need to be optimized, including proper patient selection, timing of intervention, donor muscle and motor nerve selection, optimal microneurovascular technique and tension setting, proper postoperative management, and appropriate rehabilitation. Functional outcomes of various applications to the upper extremity and the authors' algorithm for the use of free functional muscle transfer are also included in this article. PMID:27094895

  11. Ultrasonographic evaluation of the iatrogenic peripheral nerve injuries in upper extremity

    International Nuclear Information System (INIS)

    The aim of our study is to assess the efficiency of the ultrasonography (US) in the diagnosis of peripheral nerve injury. This study includes nine patients (six radial, one median and two posterior interosseous (PIO) nerves) with peripheral nerve injury diagnosed by clinical and electrophysiological methods in the last 3 years. Preoperatively, an ultrasonographic examination was performed and correlated with physical exam and surgical findings. Five patients, who were diagnosed as peripheral nerve transection by US, underwent surgery. The ultrasonographic findings were concordant with the intraoperative findings. Axonal swelling alone was found in the remaining three patients, who were treated conservatively because of preserved nerve continuity without display of nerve compression. In one patient, we were unable to visualize the nerve due to obesity and soft tissue edema. High-resolution US provide morphological information about the exact location, intensity and extent of the nerve injuries, facilitating the preoperative diagnosis. Thus, US may be a useful method for planning optimal treatment strategy in especially iatrogenic nerve injuries.

  12. The Acute Effects of Upper Extremity Stretching on Throwing Velocity in Baseball Throwers

    Directory of Open Access Journals (Sweden)

    Michael Williams

    2013-01-01

    Full Text Available Purpose. To examine the effects of static and proprioceptive neuromuscular facilitation (PNF stretching of the shoulder internal rotators on throwing velocity. Subjects. 27 male throwers (mean age = 25.1 years old, SD = 2.4 with adequate knowledge of demonstrable throwing mechanics. Study Design. Randomized crossover trial with repeated measures. Methods. Subjects warmed up, threw 10 pitches at their maximum velocity, were randomly assigned to 1 of 3 stretching protocols (static, PNF, or no stretch, and then repeated their 10 pitches. Velocities were recorded after each pitch and average and peak velocities were recorded after each session. Results. Data were analyzed using a repeated measures ANOVA. No significant interaction between stretching and throwing velocity was observed. Main effects for time were not statistically significant. Main effects for the stretching groups were statistically significant. Discussion. Results suggest that stretching of the shoulder internal rotators did not significantly affect throwing velocity immediately after stretching. This may be due to the complexity of the throwing task. Conclusions. Stretching may be included in a thrower's warm-up without any effects on throwing velocity. Further research should be performed using a population with more throwing experience and skill.

  13. Mechanisms of Injury and Countermeasures for EVA Associated Upper Extremity Medical Issues: Extended Vent Tube Study

    Science.gov (United States)

    Jones, Jeff; Hoffman, Ron; Harvey, Craig; Bowen, C. K.; Hudy, C. E.; Tuxhorn, Jennifer; Gernhardt, Mike; Scheuring, Richard A.

    2007-01-01

    The goal of this study is to determine the role that moisture plays in the injury to the fingers and fingernails during EVA training operations in the Neutral Buoyancy Laboratory. Current Extravehicular Mobility Unit (EMU, with a PLSS) as configured in the NBL was used for all testing and a vent tube was extended down a single arm of the crewmember during the test; vent tube was moved between left and right arm to serve as experimental condition being investigated and the other arm served as control condition.

  14. Improvement of Upper Extremity Lymphedema after Delayed Breast Reconstruction with an Extended Latissimus Dorsi Myocutaneous Flap

    Directory of Open Access Journals (Sweden)

    Kyeong Tae Lee

    2012-03-01

    Full Text Available Lymphedema is a common complication after mastectomy in breast cancer patients. Manytreatment options are available, but no treatment results in a complete cure. We report acase of lymphedema that occurred after modified radical mastectomy in a breast cancerpatient who showed objective improvement after delayed breast reconstruction with anlatissimus dorsi myocutaneous flap. A 41-year-old female patient with left breast cancer hadundergone modified radical mastectomy with axillary lymph node dissection and postoperativeradiotherapy 12 years previously. Four years after surgery, lymphedema developed andincreased in aggravation despite conservative treatment. Eight years after the first operation,the patient underwent delayed breast reconstruction using the extended latissimus dorsimyocutaneous flap method. After reconstruction, the patient’s lymphedema symptomsshowed dramatic improvement by subjective measures including tissue softness and feeling oflightness, and by objective measures of about 7 mL per a week, resulting in near normal rangesof volume. At a postoperative follow-up after 3 years, no recurrence was observed. Delayedbreast reconstruction with extended latissimus dorsi myocutaneous flaps may be helpful topatients with lymphedema after mastectomy. This may be a good option for patients who areworried about the possibility of the occurrence or aggravation of secondary lymphedema.

  15. Improvement of Upper Extremity Lymphedema after Delayed Breast Reconstruction with an Extended Latissimus Dorsi Myocutaneous Flap

    OpenAIRE

    Kyeong Tae Lee; So-Young Lim; Jai-Kyung Pyun; Goo-Hyun Mun; Kap-Sung Oh; Sa-Ik Bang

    2012-01-01

    Lymphedema is a common complication after mastectomy in breast cancer patients. Many treatment options are available, but no treatment results in a complete cure. We report a case of lymphedema that occurred after modified radical mastectomy in a breast cancer patient who showed objective improvement after delayed breast reconstruction with an latissimus dorsi myocutaneous flap. A 41-year-old female patient with left breast cancer had undergone modified radical mastectomy with axillary lymph ...

  16. High-Pressure Transvenous Perfusion of the Upper Extremity in Human Muscular Dystrophy: A Safety Study with 0.9% Saline.

    Science.gov (United States)

    Fan, Zheng; Kocis, Keith; Valley, Robert; Howard, James F; Chopra, Manisha; Chen, Yasheng; An, Hongyu; Lin, Weili; Muenzer, Joseph; Powers, William

    2015-09-01

    We evaluated safety and feasibility of high-pressure transvenous limb perfusion in an upper extremity of adult patients with muscular dystrophy, after completing a similar study in a lower extremity. A dose escalation study of single-limb perfusion with 0.9% saline was carried out in nine adults with muscular dystrophies under intravenous analgesia. Our study demonstrates that it is feasible and definitely safe to perform high-pressure transvenous perfusion with 0.9% saline up to 35% of limb volume in the upper extremities of young adults with muscular dystrophy. Perfusion at 40% limb volume is associated with short-lived physiological changes in peripheral nerves without clinical correlates in one subject. This study provides the basis for a phase 1/2 clinical trial using pressurized transvenous delivery into upper limbs of nonambulatory patients with Duchenne muscular dystrophy. Furthermore, our results are applicable to other conditions such as limb girdle muscular dystrophy as a method for delivering regional macromolecular therapeutics in high dose to skeletal muscles of the upper extremity. PMID:25953425

  17. Effects of a novel forced intensive strengthening technique on muscle size and upper extremity function in a patient with chronic stroke.

    Science.gov (United States)

    Jeong, Hee-Won; Chon, Seung-Chul

    2015-11-01

    [Purpose] This research demonstrated a forced intensive strength technique as a novel treatment for muscle power and function in the affected upper extremity muscle to determine the clinical feasibility with respect to upper extremity performance in a stroke hemiparesis. [Subject and Methods] The subject was a patient with chronic stroke who was dependent on others for performing the functional activities of his affected upper extremity. The technique incorporates a comprehensive approach of forced, intensive, and strength-inducing activities to enhance morphological changes associated with motor learning of the upper extremity. The forced intensive strength technique consisted of a 6-week course of sessions lasting 60 minutes per day, five times a week. [Results] After the 6-week intervention, the difference between relaxation and contraction of the affected extensor carpi radialis muscle increased from 0.28 to 0.63 cm(2), and that of the affected triceps brachii muscle increased from 0.30 to 0.90 cm(2). The results of clinical tests including the modified Ashworth scale (MAS; from 1+ to 1), muscle strength (from 15 to 32 kg), the manual function test (MFT; scores of 16/32 to 27/32 score), the Fugl-Meyer assessment (FMA; scores of 29/66 to 49/66 score), and the Jebsen-Taylor hand function test (JTHFT; from 38/60 to 19/60 sec) were improved. [Conclusion] Our results suggest that the forced intensive strength technique may have a beneficial effect on the muscle size of the upper extremity and motor function in patients with chronic stroke.

  18. UPPER EXTREMITY D.V.T: A REVIEW ARTICLE

    Directory of Open Access Journals (Sweden)

    Aneeta

    2013-04-01

    Full Text Available ABSTRACT: Upper extremity deep venous thrombosis (UEDVT is also known as thrombosis of the axillary-subclavian vein, or Paget-Schroetter s yndrome. It has primary and secondary varieties. Once considered rare, over the past decad es U.E.D.V.T. has emerged as an increasingly important clinical entity. It makes up approximately 1 -4% of all episodes of deep venous thrombosis (DVT and carries a potential for consid erable morbidity. Pulmonary embolism (PE is present in up to one third of patients. Primary UEDVT is still a relatively infrequent diso rder of predominantly young, otherwise healthy people who participate in repetitive upper extremity activity. From an epidemiologic perspective, the general incidence of UE DVT remains low (approximately 2/100 000 persons per year, even though it is the most com mon vascular condition among athletes. Although early clinical recognition of UEDVT is impo rtant, diagnosis can be difficult due to its indeterminate cause and indistinct pathophysiology. P RIMARY (idiopathic UEDVT is rare with controversial pathogenesis and treatment.

  19. SURGICAL TREATMENT OF PATIENTS WITH DISLOCATION OF HEAD OF THE ARM AND ROTATIONAL CONTRACTURE OF THE FOREARM WITH BIRTH PALSY OF THE UPPER EXTREMITY

    Directory of Open Access Journals (Sweden)

    Николай Александрович Овсянкин

    2014-03-01

    Full Text Available Introduction. The obstetrical upper limb paralysis and its sequelae are an actual problem of pediatric orthopedics and traumatology. Relevance of the problem is due to high incidence of this disease and increase of child disability. Purpose. To present the method of treating patients with a dislocated radius head and forearm rotation contracture in birth paralysis of the upper extremity. ^Materials and Methods. This article presents the clinical material on the survey in the Institute and the surgical treatment of 12 patients aged from three to 15 years with the pathology of the elbow and forearm, developed after the obstetrical upper limb paralysis. Results. We present the clinical picture, diagnostic methods, indications to surgical treatment, as well as new and effective methods of performing the proximal radioulnar joint arthrodesis in young children with obstetrical paralysis of the upper extremity. The use of surgical methods of treatment in such patients has improved the function of the arm and self-care in 95 per cent of cases, reduced their disability and increased their choice for occupation activities.

  20. The effect of forearm posture on wrist flexion in computer workers with chronic upper extremity musculoskeletal disorders

    Directory of Open Access Journals (Sweden)

    Thompson R Terry

    2008-04-01

    Full Text Available Abstract Background Occupational computer use has been associated with upper extremity musculoskeletal disorders (UEMSDs, but the etiology and pathophysiology of some of these disorders are poorly understood. Various theories attribute the symptoms to biomechanical and/or psychosocial stressors. The results of several clinical studies suggest that elevated antagonist muscle tension may be a biomechanical stress factor. Affected computer users often exhibit limited wrist range of motion, particularly wrist flexion, which has been attributed to increased extensor muscle tension, rather than to pain symptoms. Recreational or domestic activities requiring extremes of wrist flexion may produce injurious stress on the wrist joint and muscles, the symptoms of which are then exacerbated by computer use. As these activities may involve a variety of forearm postures, we examined whether changes in forearm posture have an effect on pain reports during wrist flexion, or whether pain would have a limiting effect on flexion angle. Methods We measured maximum active wrist flexion using a goniometer with the forearm supported in the prone, neutral, and supine postures. Data was obtained from 5 subjects with UEMSDs attributed to computer use and from 13 control subjects. Results The UEMSD group exhibited significantly restricted wrist flexion compared to the control group in both wrists at all forearm postures with the exception of the non-dominant wrist with the forearm prone. In both groups, maximum active wrist flexion decreased at the supine forearm posture compared to the prone posture. No UEMSD subjects reported an increase in pain symptoms during testing. Conclusion The UEMSD group exhibited reduced wrist flexion compared to controls that did not appear to be pain related. A supine forearm posture reduced wrist flexion in both groups, but the reduction was approximately 100% greater in the UEMSD group. The effect of a supine forearm posture on wrist

  1. Is There Any Association between PEEP and Upper Extremity DVT?

    Directory of Open Access Journals (Sweden)

    Farah Al-Saffar

    2015-01-01

    Full Text Available Background. We hypothesized that positive end-exploratory pressure (PEEP may promote venous stasis in the upper extremities and predispose to upper extremity deep vein thrombosis (UEDVT. Methods. We performed a retrospective case control study of medical intensive care unit patients who required mechanical ventilation (MV for >72 hours and underwent duplex ultrasound of their upper veins for suspected DVT between January 2011 and December 2013. Results. UEDVT was found in 32 (28.5% of 112 patients. Nineteen (67.8% had a central venous catheter on the same side. The mean ± SD duration of MV was 13.2±9.5 days. Average PEEP was 7.13±2.97 cm H2O. Average PEEP was ≥10 cm H2O in 23 (20.5% patients. Congestive heart failure (CHF significantly increased the odds of UEDVT (OR 4.53, 95% CI 1.13–18.11; P=0.03 whereas longer duration of MV (≥13 vs. <13 days significantly reduced it (OR 0.29, 95% CI 0.11–0.8; P=0.02. Morbid obesity showed a trend towards significance (OR 3.82, 95% CI 0.95–15.4; P=0.06. Neither PEEP nor any of the other analyzed predictors was associated with UEDVT. Conclusions. There is no association between PEEP and UEDVT. CHF may predispose to UEDVT whereas the risk of UEDVT declines with longer duration of MV.

  2. Lymphatic Filariasis Disseminating to the Upper Extremity

    OpenAIRE

    Catherine Maldjian; Vineet Khanna; Bevan Tandon; Matthew Then; Mohamed Yassin; Richard Adam; Klein, Michael J.

    2014-01-01

    Lymphatic filariasis is the most common cause of acquired lymphedema worldwide (Szuba and Rockson, 1998). It is endemic to tropical and subtropical regions, and its effects are devastating. With over 100 million infected persons, it ranks second only to leprosy as the leading cause of permanent and long-term disability. Wuchereria bancrofti is the etiologic agent in 90% of cases. There is a dearth of published MRI findings with pathologically proven active infections, making this entity even ...

  3. Risk Factors for Neck and Upper Extremity Disorders among Computers Users and the Effect of Interventions: An Overview of Systematic Reviews

    OpenAIRE

    Andersen, Johan H; Fallentin, Nils; Thomsen, Jane F.; Mikkelsen, Sigurd

    2011-01-01

    Background To summarize systematic reviews that 1) assessed the evidence for causal relationships between computer work and the occurrence of carpal tunnel syndrome (CTS) or upper extremity musculoskeletal disorders (UEMSDs), or 2) reported on intervention studies among computer users/or office workers. Methodology/Principal Findings PubMed, Embase, CINAHL and Web of Science were searched for reviews published between 1999 and 2010. Additional publications were provided by content area expert...

  4. Upper extremity deep vein thrombosis in a 25 years old apparently healthy man

    Directory of Open Access Journals (Sweden)

    Fitsum Habte

    2010-01-01

    Full Text Available This case of upper extremity deep vein thrombosis is selected for case report as it is a rare form of deep vein thrombosis without a very well established treatment modality and prognosis. The objective of this study was to report the outcome of a 25 years old male patient with idiopathic upper extremity deep vein thrombosis treated conservatively with low molecular weight heparin (LMWH and oral warfarin. The data sources used were patient interview, laboratory and radiology investigation results and patient charts. The patient had no apparent recurrence or complication for 3 years except the presence of occasional dull pain over the affected left upper extremity

  5. FREE FIBULA FLOW THROUGH OSTEOCUTANEOUS FLAP IN THE UPPER EXTREMITY SARCOMA RECONSTRUCTION

    Directory of Open Access Journals (Sweden)

    Balakrishnan

    2015-03-01

    Full Text Available INTRODUCTION: With the evolution of modern reconstructive methods amputations for malignant tumours of the upper limb can be prevented. Of all the methods, the free fibula is most commonly used to bridge bone gaps during limb salvage. OBJECTIVE: to study the effectivene ss of flow through fibula osteocutaneous flap in the reconstruction of upper extremity following oncological excision of forearm sarcomas, where both axial vessels are excised or dominant vessel is excised. MATERIALS: This study was conducted between March 2012 to March 2013 at our institute. A total of 6 cases ( 4 male and 2 female aged between 19 and 40 years with Soft tissue sarcoma of the forearm were treated with Wide Local Excision and reconstruction using flow through osteocutaneous fibula flap. Of these , 4 patients had both the ulnar and radial arteries removed and in 2 patients the dominant/ codominant radial aretery was removed. The 4 patients in the first group received post op RT and the other 2 patients received post op chemothe rapy. All patients were followed up for a mean period of 9 months. RESULTS: Histopathology was varied - Spindle cell sarcoma (2pts, synoviosarcoma (2 pts, osteosarcoma (1pt and fibrosarcoma (1pt. All the tumours were located in the distal 1/3 rd of the f orearm. All the flaps survived, and all the patients had good to reasonable hand function at follow up. One patient developed pulmonary metastasis and 1 patient developed CRPS type 2. CONCLUSION: Amputation of the upper limb was thought to be the best appr oach for STS of the forearm. With the flow through flaps the vascularity and function of the hand can be maintained. Thus an irreplaceable vital organ, namely hand, can be saved with these flaps . The missing vascular conduit is reestablished and at the sam e time, bone and soft tissue is reconstructed.

  6. Effects of mirror therapy combined with motor tasks on upper extremity function and activities daily living of stroke patients.

    Science.gov (United States)

    Kim, Kyunghoon; Lee, Sukmin; Kim, Donghoon; Lee, Kyoungbo; Kim, Youlim

    2016-01-01

    [Purpose] The objective of this study was to investigate the effects of mirror therapy combined with exercise tasks on the function of the upper limbs and activities of daily living. [Subjects and Methods] Twenty-five stroke patients who were receiving physical therapy at K Hospital in Gyeonggi-do, South Korea, were classified into a mirror therapy group (n=12) and a conventional therapy group (n=13). The therapies were applied for 30 minutes per day, five times per week, for a total of four weeks. Upper limb function was measured with the Action Research Arm test, the Fugl-Meyer Assessment, and the Box and Block test, and activities of daily living were measured with the Functional Independence Measure. A paired test was performed to compare the intragroup differences between before training and after four weeks of therapy, and an independent t-test was performed to compare the differences between the two groups before and after four weeks of therapy. [Results] In the intragroup comparison, both groups showed significant differences between measurements taken before and after four weeks of therapy. In the intergroup comparison, the mirror therapy group showed significant improvements compared with the conventional therapy group, both in upper limb function and activities of daily living. [Conclusion] The findings of this study demonstrated that mirror therapy is more effective than conventional therapy for the training of stroke patients to improve their upper limb function and activities of daily living. PMID:27065534

  7. Upper extremity neuromotor dysfunction caused by local vibration

    Directory of Open Access Journals (Sweden)

    O. A. Shavlovskaya

    2015-01-01

    Full Text Available Vibration disease (VD (pneumatic hammer disease is a leader among occupational diseases. The prolonged use of vibrating tools is a high occupational health risk. The clinical picture of VD caused by local vibration includes sensorineural and upper extremity locomotor impairments that are polymorphic, polysyndromic, and not always specific. The International List of Occupational Diseases (2010 defines VD using the terms «vibration-induced white finger» (VWF and «hand-arm vibration syndrome» (HAVS. VWF as a manifestation of secondary Raynaud’s syndrome is the most noticeable vascular injury in HAVS. According to the recommendations of the International Labor Organization (2011 and the order of the Ministry of Health of Russia (2012, the clinical manifestations of local vibration include upper extremity polyneuropathy, secondary Raynaud’s phenomenon, and carpal tunnel syndrome (CTS. The paper considers approaches to differentially diagnosing CTS and HAVS, primary and secondary Raynaud’s syndrome, as well as clinical, laboratory, and electrodiagnostic studies. Prolonged exposure to vibration may affect the large myelinated (Ab fibers responsible for tactile touch, pressure, and vibration. Patients with VWF are frequently found to have hyperresponsiveness of the sympathetic nervous system, which affects digital vascular tone and appears as lower fingertip skin temperature. The paper discusses some possible mechanisms for the pathogenesis of vibration neuropathy (e.g. demyelinationof peripheral nerve fiber, as well as the involvement of plasma endothelin-1 in vascular response to cold as one of the components of the pathogenesis of vascular disorders. The central nervous system (cortical reorganization, plasticity phenomenon is believed to be implicated in the development and maintenance of vibration neuropathy.

  8. The effects of game-based virtual reality movement therapy plus mental practice on upper extremity function in chronic stroke patients with hemiparesis: a randomized controlled trial.

    Science.gov (United States)

    Park, Jin-Hyuck; Park, Ji-Hyuk

    2016-03-01

    [Purpose] The purpose of this study was to investigate the effects of game-based virtual reality movement therapy plus mental practice on upper extremity function in chronic stroke patients with hemiparesis. [Subjects] The subjects were chronic stroke patients with hemiparesis. [Methods] Thirty subjects were randomly assigned to either the control group or experimental group. All subjects received 20 sessions (5 days in a week) of virtual reality movement therapy using the Nintendo Wii. In addition to Wii-based virtual reality movement therapy, experimental group subjects performed mental practice consisting of 5 minutes of relaxation, Wii games imagination, and normalization phases before the beginning of Wii games. To compare the two groups, the upper extremity subtest of the Fugl-Meyer Assessment, Box and Block Test, and quality of movement subscale of the Motor Activity Log were performed. [Results] Both groups showed statistically significant improvement in the Fugl-Meyer Assessment, Box and Block Test, and quality of the movement subscale of Motor Activity Log after the interventions. Also, there were significant differences in the Fugl-Meyer Assessment, Box and Block Test, and quality of movement subscale of the Motor Activity Log between the two groups. [Conclusion] Game-based virtual reality movement therapy alone may be helpful to improve functional recovery of the upper extremity, but the addition of MP produces a lager improvement.

  9. The effects of game-based virtual reality movement therapy plus mental practice on upper extremity function in chronic stroke patients with hemiparesis: a randomized controlled trial.

    Science.gov (United States)

    Park, Jin-Hyuck; Park, Ji-Hyuk

    2016-03-01

    [Purpose] The purpose of this study was to investigate the effects of game-based virtual reality movement therapy plus mental practice on upper extremity function in chronic stroke patients with hemiparesis. [Subjects] The subjects were chronic stroke patients with hemiparesis. [Methods] Thirty subjects were randomly assigned to either the control group or experimental group. All subjects received 20 sessions (5 days in a week) of virtual reality movement therapy using the Nintendo Wii. In addition to Wii-based virtual reality movement therapy, experimental group subjects performed mental practice consisting of 5 minutes of relaxation, Wii games imagination, and normalization phases before the beginning of Wii games. To compare the two groups, the upper extremity subtest of the Fugl-Meyer Assessment, Box and Block Test, and quality of movement subscale of the Motor Activity Log were performed. [Results] Both groups showed statistically significant improvement in the Fugl-Meyer Assessment, Box and Block Test, and quality of the movement subscale of Motor Activity Log after the interventions. Also, there were significant differences in the Fugl-Meyer Assessment, Box and Block Test, and quality of movement subscale of the Motor Activity Log between the two groups. [Conclusion] Game-based virtual reality movement therapy alone may be helpful to improve functional recovery of the upper extremity, but the addition of MP produces a lager improvement. PMID:27134363

  10. Refining 14C dating of bone >30,000 BP : establishing an accurate chronology for the Middle to Upper Palaeolithic transition in France.

    NARCIS (Netherlands)

    Talamo, Sahra

    2012-01-01

    This thesis aims to improve the chronology of the transition from the Middle to Upper Palaeolithic in France through the radiocarbon dating of bone collagen samples. This requires accurate calibration of the radiocarbon time scale for this time interval, reliable extraction of collagen from prehisto

  11. Three-dimensional evaluation of upper anterior alveolar bone dehiscence after incisor retraction and intrusion in adult patients with bimaxillary protrusion malocclusion

    Institute of Scientific and Technical Information of China (English)

    Qing-yuan GUO; Shi-jie ZHANG; Hong LIU; Chun-ling WANG; Fu-lan WEI; Tao LV; Na-na WANG; Dong-xu LIU

    2011-01-01

    Objective: The purpose of this study was to evaluate three-dimensional (3D) dehiscence of upper anterior alveolar bone during incisor retraction and intrusion in adult patients with maximum anchorage.Methods: Twenty adult patients with bimaxillary dentoalveolar protrusion had the four first premolars extracted.Miniscrews were placed to provide maximum anchorage for upper incisor retraction and intrusion.A computed tomography (CT) scan was performed after placement of the miniscrews and treatment.The 3D reconstructions of pre- and post-CT data were used to assess the dehiscence of upper anterior alveolar bone.Results: The amounts of upper incisor retraction at the edge and apex were (7.64±1.68) and (3.91±2.10) mm,respectively,and (1.34±0.74) mm of upper central incisor intrusion.Upper alveolar bone height losses at labial alveolar ridge crest (LAC) and palatal alveolar ridge crest (PAC) were 0.543 and 2.612 mm,respectively,and the percentages were (6.49±3.54)% and (27.42±9.77)%,respectively.The shape deformations of LAC-labial cortex bending point (LBP) and PAC-palatal cortex bending point (PBP) were (15.37±5.20)° and (6.43±3.27)°,respectively.Conclusions: Thus,for adult patients with bimaxillary protrusion,mechanobiological response of anterior alveolus should be taken into account during incisor retraction and intrusion.Pursuit of maximum anchorage might lead to upper anterior alveolar bone loss.

  12. Mirror therapy combined with biofeedback functional electrical stimulation for motor recovery of upper extremities after stroke: a pilot randomized controlled trial.

    Science.gov (United States)

    Kim, Jung Hee; Lee, Byoung-Hee

    2015-06-01

    The objective of this study was to evaluate the effects of mirror therapy in combination with biofeedback functional electrical stimulation (BF-FES) on motor recovery of the upper extremities after stroke. Twenty-nine patients who suffered a stroke > 6 months prior participated in this study and were randomly allocated to three groups. The BF-FES + mirror therapy and FES + mirror therapy groups practiced training for 5 × 30 min sessions over a 4-week period. The control group received a conventional physical therapy program. The following clinical tools were used to assess motor recovery of the upper extremities: electrical muscle tester, electrogoniometer, dual-inclinometer, electrodynamometer, the Box and Block Test (BBT) and Jabsen Taylor Hand Function Test (JHFT), the Functional Independence Measure, the Modified Ashworth Scale, and the Stroke Specific Quality of Life (SSQOL) assessment. The BF-FES + mirror therapy group showed significant improvement in wrist extension as revealed by the Manual Muscle Test and Range of Motion (p therapy group showed significant improvement in the BBT, JTHT, and SSQOL compared with the FES + mirror therapy group and control group (p therapy induced motor recovery and improved quality of life. These results suggest that mirror therapy, in combination with BF-FES, is feasible and effective for motor recovery of the upper extremities after stroke.

  13. Upper Extremity Kinematics and Muscle Activation Patterns in Subjects With Facioscapulohumeral Dystrophy

    NARCIS (Netherlands)

    Bergsma, Arjen; Murgia, Alessio; Cup, Edith H.; Verstegen, Paul P.; Meijer, Kenneth; de Groot, Imelda J.

    2014-01-01

    Objective: To compare the kinematics and muscle activity of subjects with facioscapulohumeral dystrophy (FSHD) and healthy control subjects during the performance of standardized upper extremity tasks. Design: Exploratory case-control study. Setting: A movement laboratory. Participants: Subjects (N=

  14. The results of bone deformity correction using a spider frame with web-based software for lower extremity long bone deformities

    Science.gov (United States)

    Tekin, Ali Çağrı; Çabuk, Haluk; Dedeoğlu, Süleyman Semih; Saygılı, Mehmet Selçuk; Adaş, Müjdat; Esenyel, Cem Zeki; Büyükkurt, Cem Dinçay; Tonbul, Murat

    2016-01-01

    Aim: To present the functional and radiological results and evaluate the effectiveness of a computer-assisted external fixator (spider frame) in patients with lower extremity shortness and deformity. Materials and methods: The study comprised 17 patients (14 male, 3 female) who were treated for lower extremity long bone deformity and shortness between 2012 and 2015 using a spider frame. The procedure’s level of difficulty was determined preoperatively using the Paley Scale. Postoperatively, the results for the patients who underwent tibial operations were evaluated using the Paley criteria modified by ASAMI, and the results for the patients who underwent femoral operations were evaluated according to the Paley scoring system. The evaluations were made by calculating the External Fixator and Distraction indexes. Results: The mean age of the patients was 24.58 years (range, 5–51 years). The spider frame was applied to the femur in 10 patients and to the tibia in seven. The mean follow-up period was 15 months (range, 6–31 months) from the operation day, and the mean amount of lengthening was 3.0 cm (range, 1–6 cm). The mean duration of fixator application was 202.7 days (range, 104–300 days). The mean External Fixator Index was 98 days/cm (range, 42–265 days/cm). The mean Distraction Index was 10.49 days/cm (range, 10–14 days/cm). Conclusion: The computer-assisted external fixator system (spider frame) achieves single-stage correction in cases of both deformity and shortness. The system can be applied easily, and because of its high-tech software, it offers the possibility of postoperative treatment of the deformity. PMID:27163100

  15. The results of bone deformity correction using a spider frame with web-based software for lower extremity long bone deformities

    Directory of Open Access Journals (Sweden)

    Tekin Ali Çağrı

    2016-01-01

    Full Text Available Aim: To present the functional and radiological results and evaluate the effectiveness of a computer-assisted external fixator (spider frame in patients with lower extremity shortness and deformity. Materials and methods: The study comprised 17 patients (14 male, 3 female who were treated for lower extremity long bone deformity and shortness between 2012 and 2015 using a spider frame. The procedure’s level of difficulty was determined preoperatively using the Paley Scale. Postoperatively, the results for the patients who underwent tibial operations were evaluated using the Paley criteria modified by ASAMI, and the results for the patients who underwent femoral operations were evaluated according to the Paley scoring system. The evaluations were made by calculating the External Fixator and Distraction indexes. Results: The mean age of the patients was 24.58 years (range, 5–51 years. The spider frame was applied to the femur in 10 patients and to the tibia in seven. The mean follow-up period was 15 months (range, 6–31 months from the operation day, and the mean amount of lengthening was 3.0 cm (range, 1–6 cm. The mean duration of fixator application was 202.7 days (range, 104–300 days. The mean External Fixator Index was 98 days/cm (range, 42–265 days/cm. The mean Distraction Index was 10.49 days/cm (range, 10–14 days/cm. Conclusion: The computer-assisted external fixator system (spider frame achieves single-stage correction in cases of both deformity and shortness. The system can be applied easily, and because of its high-tech software, it offers the possibility of postoperative treatment of the deformity.

  16. Perfusion Assessment with the SPY System after Arterial Venous Reversal for Upper Extremity Ischemia

    Directory of Open Access Journals (Sweden)

    Darrell Brooks, MD

    2014-07-01

    Conclusions: AVR effectively reestablished blood flow in patients with terminal upper extremity ischemia. ICG angiography with SPY technology revealed that, in most cases, kinetic curves, timing, and patterns of perfusion gradually normalized over several PODs.

  17. Upper extremity deep vein thrombosis in a 25 years old apparently healthy man

    OpenAIRE

    Fitsum Habte

    2010-01-01

    This case of upper extremity deep vein thrombosis is selected for case report as it is a rare form of deep vein thrombosis without a very well established treatment modality and prognosis. The objective of this study was to report the outcome of a 25 years old male patient with idiopathic upper extremity deep vein thrombosis treated conservatively with low molecular weight heparin (LMWH) and oral warfarin. The data sources used were patient interview, laboratory and radiology investigation re...

  18. Upper Extremity Muscle Volumes and Functional Strength After Resistance Training in Older Adults

    OpenAIRE

    Daly, Melissa; Vidt, Meghan E.; Eggebeen, Joel D.; Simpson, W. Greg; Miller, Michael E; Marsh, Anthony P; Saul, Katherine R.

    2012-01-01

    Aging leads to a decline in strength and an associated loss of independence. The authors examined changes in muscle volume, maximum isometric joint moment, functional strength, and 1-repetition maximum (1RM) after resistance training (RT) in the upper extremity of older adults. They evaluated isometric joint moment and muscle volume as predictors of functional strength. Sixteen healthy older adults (average age 75 ± 4.3 yr) were randomized to a 6-wk upper extremity RT program or control group...

  19. Using Free Internet Videogames in Upper Extremity Motor Training for Children with Cerebral Palsy

    OpenAIRE

    Marisa Sevick; Elizabeth Eklund; Allison Mensch; Matthew Foreman; John Standeven; Jack Engsberg

    2016-01-01

    Movement therapy is one type of upper extremity intervention for children with cerebral palsy (CP) to improve function. It requires high-intensity, repetitive and task-specific training. Tedium and lack of motivation are substantial barriers to completing the training. An approach to overcome these barriers is to couple the movement therapy with videogames. This investigation: (1) tested the feasibility of delivering a free Internet videogame upper extremity motor intervention to four childr...

  20. Life in an extreme environment: phytoplankton blooms in the upper Scheldt estuary

    OpenAIRE

    Muylaert, K.; Kromkamp, J.

    2002-01-01

    Being extremely turbid environments characterised by short residence times and rapid changes in salinity, the upper reaches of estuaries comprise an extreme environment for phytoplankton to live and grow in. Nevertheless, in many estuaries including the Schelde estuary, these reaches often support dense phytoplankton populations. In the past, these phytoplankton blooms in the upper reaches of estuaries have often been found difficult to explain. In this presentation, we will describe the exte...

  1. Effects of neuromuscular electrical stimulation on arterial hemodynamic properties and body composition in paretic upper extremities of patients with subacute stroke

    Directory of Open Access Journals (Sweden)

    Shu-Chun Huang

    2014-08-01

    Full Text Available Background: Neuromuscular electric stimulation (NMES induces repeated muscular contraction, possibly promoting the perfusion/oxygenation of the regional tissues. It remains unclear how NMES influences vascular hemodynamic property and segmental fluid distribution/composition in paretic extremities of hemiplegic patients. Methods: Eleven hemiplegic patients aged 62.6 ± 12.5 years in the subacute stage of stroke received NMES for paretic wrist extensor and flexor muscles 30 min daily, 5 days per week for 4 weeks. The non-paretic upper extremities (NPUE that did not receive NMES served as control. Distribution of fluid to intra/extracellular milieu and arterial hemodynamic properties were determined by using the multi-frequency bioelectrical impedance and pulse wave analysis, respectively. Results: Compared with NPUE without NMES, paretic upper extremity (PUE with NMES revealed a significantly less decrease in arterial blood flow, impedance quotient, slope quotient, and less increase in crest width and crest time of arterial pulse wave. NMES for 4 weeks increased body cell mass in PUE. Furthermore, NPUE without NMES reduced intracellular water, whereas PUE with NMES retarded loss of intracellular water after stroke. Conclusion: NMES therapy increases body cell mass, attenuates reduction of intracellular water, and alleviates arterial hemodynamic disturbance in PUE in subacute stroke. However, stroke-related physical deconditioning may negatively regulate body composition and impair hemodynamic function in NPUE.

  2. Recapitulating flesh with silicon and steel: advancements in upper extremity robotic prosthetics.

    Science.gov (United States)

    Lee, Brian; Attenello, Frank J; Liu, Charles Y; McLoughlin, Michael P; Apuzzo, Michael L J

    2014-01-01

    With the loss of function of an upper extremity because of stroke or spinal cord injury or a physical loss from amputation, an individual's life is forever changed, and activities that were once routine become a magnitude more difficult. Much research and effort have been put into developing advanced robotic prostheses to restore upper extremity function. For patients with upper extremity amputations, previously crude prostheses have evolved to become exceptionally functional. Because the upper extremities can perform a wide variety of activities, several types of upper extremity prostheses are available ranging from passive cosmetic limbs to externally powered robotic limbs. In addition, new developments in brain-machine interface are poised to revolutionize how patients can control these advanced prostheses using their thoughts alone. For patients with spinal cord injury or stroke, functional electrical stimulation promises to provide the most sophisticated prosthetic limbs possible by reanimating paralyzed arms of these patients. Advances in technology and robotics continue to help patients recover vital function. This article examines the latest neurorestorative technologies for patients who have either undergone amputation or lost the use of their upper extremities secondary to stroke or spinal cord injury.

  3. The structure of long tubular bones fractures of lower extremity by the data of the regional bureau of forensic-medical examination

    Directory of Open Access Journals (Sweden)

    Savka I.H.

    2013-10-01

    Full Text Available The main purpose of the research is carrying out forensic-medical analysis of cases from expert’s practice with fractures of the long bones based on the findings of the Regional Bureau of Forensic-Medical Examination over 2009-2012 years period. The research has been carried out using methods of statistical and comparative analysis. Their distribution by gender, age, localization, character and type of external influence, the conditions of their occurrence and participation of other persons has been outlined. Fractures of lower extremity bones make up from 15,8 to 22,5% of all the cases of mechanical trauma with lethal outcomes. Therewith male persons suffer more often from injury of the left extremity at different day time and season. The principal mechanism of their origin is injury resulting from road accidents in the countryside with the participation of other persons.

  4. Effects of mirror therapy combined with motor tasks on upper extremity function and activities daily living of stroke patients

    OpenAIRE

    Kim, Kyunghoon; Lee, Sukmin; Kim, Donghoon; Lee, Kyoungbo; Kim, Youlim

    2016-01-01

    [Purpose] The objective of this study was to investigate the effects of mirror therapy combined with exercise tasks on the function of the upper limbs and activities of daily living. [Subjects and Methods] Twenty-five stroke patients who were receiving physical therapy at K Hospital in Gyeonggi-do, South Korea, were classified into a mirror therapy group (n=12) and a conventional therapy group (n=13). The therapies were applied for 30 minutes per day, five times per week, for a total of four ...

  5. Use of extended curettage with osteotomy and fenestration followed by reconstruction with conservation of muscle insertion in the treatment of Enneking stage II locally aggressive bone tumor of the proximal extremities: resection and treatment of bone tumors

    Science.gov (United States)

    2013-01-01

    Background The purpose of this study was to investigate the clinical efficacy of extended resection with osteotomy, fenestration and conservation of muscle (tendon) insertion in the treatment of bone tumors. Methods A total of 15 patients with locally aggressive bone tumors (Enneking stage II) in the adjacent muscle (tendon) insertion of the proximal extremity were enrolled in the present study (mean age of 29 years). Extended curettage of lesions with osteotomy, fenestration and/or conservation of muscle (tendon) insertion and internal fixation with a bone graft or bone cement was performed at stage I. Postsurgical brace protection was used for 4 to 12 weeks and the patients were periodically followed-up by X-ray and functional assessment. Recurrence, postsurgical Enneking score and outcome rating were assessed. Results Treated cases included 15 patients aged 29 ±7.75 years (range, 18 to 42) with a male to female ratio of 8:7. Six had a femoral tumor and nine had a humeral tumor. These tumors comprised three chondroblastomas, five giant-cell tumors and seven aneurysmal bone cysts. Follow-up for 48 ±12.95 months (range, 25 to 72) revealed that 13 of 15 (87%) patients exhibited no recurrence. Local recurrence was observed in a patient with an aneurysmal bone cyst (nine months) and one with a giant-cell tumor (12 months). Mean Enneking scores were 27 ±4.07 (range, 18 to 29). Except for the patient with the recurrent giant-cell tumor, all patients reported good (13%, 2 out of 15) or very good (80%, 12 out of 15) outcomes. Very good outcomes were reported in 92% of patients (12 out of 13) without recurrence. Conclusions The procedures used in this study achieved high clinical efficacy, complete lesion removal, reduced recurrence and good restoration of joint function in patients with primary locally aggressive Enneking stage II bone tumors of the proximal extremities. PMID:23497479

  6. A comparative ergonomic study of work-related upper extremity musculo skeletal disorder among the unskilled and skilled surgical blacksmiths in West Bengal, India

    Directory of Open Access Journals (Sweden)

    Tirthankar Ghosh

    2011-01-01

    Full Text Available Objective: The main aim of the study was to determine the nature and extent of work-related upper extremity musculoskeletal disorders (MSDs and physiological stress among the blacksmiths involved in surgical instrument industry. Materials and Methods: In the present investigation, 50 male blacksmiths of each skilled and unskilled groups of the forging section had been selected. For the symptom survey, a questionnaire on discomfort symptoms was performed. Repetitiveness of work and hand grip strength of both the groups were measured. Results: It was revealed that upper limb MSD was a major problem among both group of blacksmith, primarily involving the hand, wrist, fingers, and shoulder. From this study it was found that 66% (33 skilled and 80% (40 unskilled blacksmith workers are feeling discomfort. The most commonly affected regions among the skilled and unskilled blacksmith workers were lower back (skilled 65% and unskilled 80%, neck (skilled 60% and unskilled 80%, and hand (skilled 50% and unskilled.

  7. Upper extremity deep vein thrombosis in a TV cameraman.

    Science.gov (United States)

    Beasley, R; Braithwaite, I; Evans, R

    2015-06-01

    We report the case of a 40-year-old right-handed man who developed a right subclavian vein thrombosis due to work as a TV cameraman. He presented with a sudden onset of marked swelling and blue discolouration of his right arm 3 weeks after the most strenuous and prolonged episode of TV camera work that he had ever undertaken. This involved carrying a 9kg camera on his shoulder, with his right arm flexed and abducted, for a 60min period with provocation of severe pain and marked discomfort persisting during the subsequent 3 weeks before presentation. A clinical diagnosis of upper extremity deep vein thrombosis (UEDVT) was made, with the diagnosis confirmed by ultrasound. He was treated with catheter-induced thrombolysis and a 3 month course of anticoagulation. He was advised that his UEDVT was caused by his occupation and that he should no longer work as a cameraman. This case shows the importance of identifying any occupational cause of UEDVT. PMID:25733529

  8. A Study on Extremely Dry and Wet Summer Monsoon in Pakistan by Focusing on the Anomalous States of the Upper Troposphere

    Science.gov (United States)

    Ahmad, S.; Koike, T.; Nishii, K.

    2012-04-01

    Seasonally-changes in wind pattern, monsoon, sometimes results in severe droughts and intense flooding in many parts of the world including South Asian countries like Pakistan. The livelihood of a vast population in Pakistan depends on agriculture and land use is strongly influenced by water-based ecosystems that depend on the monsoon rains. Furthermore, climate change studies undertaken so far reveal that action is essential in order to prevent long term damage to water cycle and thus of great concern to the community and stakeholders. Pakistan Summer Monsoon (PSM) is generally affected by both the disturbances from the tropical and the extratropical regions; however there is lack of understanding of physical mechanisms of PSM compared to other regional studies i.e. Indian Summer Monsoon (ISM) and South-East Asian Monsoon (SEAM). In our study, we applied heat and vorticity budgets and wave train analysis to reveal the mechanisms of the extremely dry and wet PSM events associated with the anomalous upper tropospheric circulation. We found that the extremely dry (wet) PSM events are closely related with the strengthening(weakening) of the upper-tropospheric central Asian high. We also found that in addition to Rossby-wave (Matsuno-Gill) type atmospheric response, the Rossby wave train along the Asian Jet originating from northwestern Europe or North Atlantic Ocean strengthened(weakened) the upper-tropospheric central Asian high. Therefore strong convection anomalies resulting in severe flooding (drought) events over the PSM region are induced by both the tropical and extratropical processes. Key Words: Pakistan, Extremes Monsoon Events, Physical Processes, Heat Budget, Vorticity, Wave Train

  9. Self-reported musculoskeletal disorders of the distal upper extremities and the neck in German veterinarians: a cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Agnessa Kozak

    Full Text Available BACKGROUND: Veterinary work is a physically demanding profession and entails the risk of injuries and diseases of the musculoskeletal system, particularly in the upper body. The prevalence of musculoskeletal disorders (MSD, the consequences and work-related accidents in German veterinarians were investigated. Work-related and individual factors associated with MSD of upper extremities and the neck were analyzed. METHODS: In 2011, a self-reporting Standardized Nordic Questionnaire was mailed to registered veterinarians in seven federal medical associations in Germany. A total of 3174 (38.4% veterinarians responded. Logistic regression analysis was used to determine the association between risk factors and MSD-related impairment of daily activities. RESULTS: MSD in the neck (66.6% and shoulder (60.5% were more prevalent than in the hand (34.5% or elbow (24.5%. Normal activities were affected in 28.7% (neck, 29.5% (shoulder, 19.4% (hand and 14% (elbow of the respondents. MSD in the upper body occurred significantly more often in large animal practitioners. Accidents that resulted in MSD were most frequently reported in the hand/wrist (14.3% or in the shoulder (10.8%. The majority of all accidents in the distal upper extremities were caused by animals than by other factors (19% vs. 9.2%. For each area of the body, a specific set of individual and work-related factors contributed significantly to severe MSD: Older age, gender, previous injuries, BMI, practice type, veterinary procedures such as dentistry, rectal procedures and obstetric procedures as well as high demands and personal burnout. CONCLUSION: From the perspective of occupational health and safety, it seems to be necessary to improve accident prevention and to optimize the ergonomics of specific tasks. Our data suggest the need for target group-specific preventive measures that also focus on the psychological factors at work.

  10. Effect of whole-body vibration exercise in a sitting position prior to therapy on muscle tone and upper extremity function in stroke patients

    OpenAIRE

    Boo, Jung-A; Moon, Sang-Hyun; Lee, Sun-Min; Choi, Jung-Hyun; Park, Si-Eun

    2016-01-01

    [Purpose] The purpose of this study was to determine the effect of whole-body vibration exercise in a sitting position prior to therapy in stroke patients. [Subjects and Methods] Fourteen chronic stroke patients were included in this study. Prior to occupational therapy, whole-body exercise was performed for 10 minutes, 5 times per week, for a total of 8 weeks. Muscle tone and upper extremity function were measured. The Modified Ashworth Scale (MAS) was used to measure muscle tone, and the Ma...

  11. Conservative treatment of upper extremity lymphedema after breast cancer surgery%乳腺癌术后上肢淋巴水肿的保守治疗

    Institute of Scientific and Technical Information of China (English)

    杨蓉

    2013-01-01

    Objective To analyze the clinical efficacy of conservative treatment for upper extremity lymphedema after breast cancer surgery. Methods 40 patients of upper extremity lymphedema after breast cancer surgery from March 2010 to December 2011 in our hospital were selected as the object of study.The patients were given conservative treatment(drug therapy,physical exercise,mechanical and physical therapy,massage,etc.),and the therapeutic effect of patients were observed. Results The upper extremity lymphedema of all patients had different degrees fadeaway,mild and moderate patients had better rehabilitation,while severe patients had slightly worse rehabilitation. Conclusion Conservative treatment of upper extremity lymphedema after breast cancer surgery has better efficacy,and can significantly improve the patient's condition,and clinical study may be further strengthened to enhance the application value.%目的:分析乳腺癌术后上肢淋巴水肿的保守治疗的临床疗效。方法选取2010年3月~2011年12月在我院实施乳腺癌手术且术后发生上肢淋巴水肿的患者40例为研究对象,实施保守治疗(药物治疗、肢体锻炼、机械物理疗法、按摩等),观察治疗效果。结果所有患者上肢淋巴水肿均有不同程度消退,轻度和中度患者康复较好,重度患者略差。结论保守疗法治疗乳腺癌术后淋巴水肿效果较好,能够显著改善患者病情,临床可以进一步加强研究,提升应用价值。

  12. Quantification of radiation exposure in the operating theatre during management of common fractures of the upper extremity in children.

    Science.gov (United States)

    Maempel, J F; Stone, O D; Murray, A W

    2016-09-01

    Introduction Surgical procedures to manage trauma to the wrist, forearm and elbow in children are very common. Image intensifiers are used routinely, yet studies/guidelines that quantify expected radiation exposure in such procedures are lacking. Methods Information on demographics, injury type, surgeon grade and dose area product (DAP) of radiation exposure per procedure was collected prospectively for 248 patients undergoing manipulation/fixation of injuries to the elbow, forearm or wrist at a paediatric hospital over 1 year. Results DAP exposure (in cGycm(2)) differed significantly across different procedures (pfracture MUA and k-wiring (2.23) and open reduction and internal fixation of the lateral humeral condyle (0.96). Fixation of a Gartland grade-3 supracondylar fracture (2.94cGycm(2)) was associated with higher exposure than grade-2 fixation (1.95cGycm(2)) (p=0.048). Fractures of the wrist or forearm necessitating metalwork fixation resulted in higher exposure than those requiring manipulation only (both p<0.001). For procedures undertaken by trainees, trainee seniority (between year-5 and year-8 and clinical fellow, p≥0.24) did not affect the DAP significantly. Conclusions The spectrum of radiation exposures for common procedures utilised in the management of paediatric upper limb trauma were quantified. These findings will be useful to surgeons auditing their practice and quantifying radiation-associated risks to patients. Our data may serve as a basis for implementing protocols designed to improve patient safety. PMID:27580309

  13. The influence of the Extreme Ultraviolet spectral energy distribution on the structure and composition of the upper atmosphere of exoplanets

    CERN Document Server

    Guo, J H

    2015-01-01

    By varying the profiles of stellar extreme ultraviolet (EUV) spectral energy distribution (SED), we tested the influences of stellar EUV SEDs on the physical and chemical properties of the escaping atmosphere. We apply our model to study four exoplanets, HD\\,189733b, HD\\,209458b, GJ \\,436b, and Kepler-11b. We found that the total mass loss rates of an exoplanet, which are determined mainly by the integrated fluxes, are moderately affected by the profiles of the EUV SED, but the composition and species distributions in the atmosphere can be dramatically modified by the different profiles of the EUV SED. For exoplanets with a high hydrodynamic escape parameter ($\\lambda$), the amount of atomic hydrogen produced by photoionization at different altitudes can vary by one to two orders of magnitude with the variation of stellar EUV SEDs. The effect of photoionization of H is prominent when the EUV SED is dominated by the low-energy spectral region (400-900${\\AA}$), which pushes the transition of H/H$^{+}$ to low al...

  14. Quantification of radiation exposure in the operating theatre during management of common fractures of the upper extremity in children.

    Science.gov (United States)

    Maempel, J F; Stone, O D; Murray, A W

    2016-09-01

    Introduction Surgical procedures to manage trauma to the wrist, forearm and elbow in children are very common. Image intensifiers are used routinely, yet studies/guidelines that quantify expected radiation exposure in such procedures are lacking. Methods Information on demographics, injury type, surgeon grade and dose area product (DAP) of radiation exposure per procedure was collected prospectively for 248 patients undergoing manipulation/fixation of injuries to the elbow, forearm or wrist at a paediatric hospital over 1 year. Results DAP exposure (in cGycm(2)) differed significantly across different procedures (pexposure than grade-2 fixation (1.95cGycm(2)) (p=0.048). Fractures of the wrist or forearm necessitating metalwork fixation resulted in higher exposure than those requiring manipulation only (both pexposures for common procedures utilised in the management of paediatric upper limb trauma were quantified. These findings will be useful to surgeons auditing their practice and quantifying radiation-associated risks to patients. Our data may serve as a basis for implementing protocols designed to improve patient safety.

  15. Assessment of image quality in soft tissue and bone visualization tasks for a dedicated extremity cone-beam CT system

    Energy Technology Data Exchange (ETDEWEB)

    Demehri, S. [Johns Hopkins University, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Johns Hopkins Outpatient Center, JHOC 5168, Musculoskeletal Radiology, Baltimore, MD (United States); Muhit, A.; Zbijewski, W.; Stayman, J.W. [Johns Hopkins University, Department of Biomedical Engineering, Baltimore, MD (United States); Yorkston, J.; Packard, N.; Senn, R.; Yang, D.; Foos, D. [Carestream Health, Rochester, NY (United States); Thawait, G.K.; Fayad, L.M.; Chhabra, A.; Carrino, J.A. [Johns Hopkins University, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Siewerdsen, J.H. [Johns Hopkins University, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Johns Hopkins University, Department of Biomedical Engineering, Baltimore, MD (United States)

    2015-06-01

    To assess visualization tasks using cone-beam CT (CBCT) compared to multi-detector CT (MDCT) for musculoskeletal extremity imaging. Ten cadaveric hands and ten knees were examined using a dedicated CBCT prototype and a clinical multi-detector CT using nominal protocols (80kVp-108mAs for CBCT; 120kVp- 300mAs for MDCT). Soft tissue and bone visualization tasks were assessed by four radiologists using five-point satisfaction (for CBCT and MDCT individually) and five-point preference (side-by-side CBCT versus MDCT image quality comparison) rating tests. Ratings were analyzed using Kruskal-Wallis and Wilcoxon signed-rank tests, and observer agreement was assessed using the Kappa-statistic. Knee CBCT images were rated ''excellent'' or ''good'' (median scores 5 and 4) for ''bone'' and ''soft tissue'' visualization tasks. Hand CBCT images were rated ''excellent'' or ''adequate'' (median scores 5 and 3) for ''bone'' and ''soft tissue'' visualization tasks. Preference tests rated CBCT equivalent or superior to MDCT for bone visualization and favoured the MDCT for soft tissue visualization tasks. Intraobserver agreement for CBCT satisfaction tests was fair to almost perfect (κ ∝ 0.26-0.92), and interobserver agreement was fair to moderate (κ ∝ 0.27-0.54). CBCT provided excellent image quality for bone visualization and adequate image quality for soft tissue visualization tasks. (orig.)

  16. THE INFLUENCE OF THE EXTREME ULTRAVIOLET SPECTRAL ENERGY DISTRIBUTION ON THE STRUCTURE AND COMPOSITION OF THE UPPER ATMOSPHERE OF EXOPLANETS

    Energy Technology Data Exchange (ETDEWEB)

    Guo, J. H. [Yunnan Observatories, Chinese Academy of Sciences, P.O. Box 110, Kunming 650011 (China); Ben-Jaffel, Lotfi, E-mail: guojh@ynao.ac.cn, E-mail: bjaffel@iap.fr [Sorbonne Universités, UPMC Univ. Paris 6 et CNRS, UMR 7095, Institut Astrophysique de Paris, F-75014 Paris (France)

    2016-02-20

    By varying the profiles of stellar extreme ultraviolet (EUV) spectral energy distributions (SEDs), we tested the influences of stellar EUV SEDs on the physical and chemical properties of an escaping atmosphere. We apply our model to study four exoplanets: HD 189733b, HD 209458b, GJ 436b, and Kepler-11b. We find that the total mass loss rates of an exoplanet, which are determined mainly by the integrated fluxes, are moderately affected by the profiles of the EUV SED, but the composition and species distributions in the atmosphere can be dramatically modified by the different profiles of the EUV SED. For exoplanets with a high hydrodynamic escape parameter (λ), the amount of atomic hydrogen produced by photoionization at different altitudes can vary by one to two orders of magnitude with the variation of stellar EUV SEDs. The effect of photoionization of H is prominent when the EUV SED is dominated by the low-energy spectral region (400–900 Å), which pushes the transition of H/H{sup +} to low altitudes. In contrast, the transition of H/H{sup +} moves to higher altitudes when most photons are concentrated in the high-energy spectral region (50–400 Å). For exoplanets with a low λ, the lower temperatures of the atmosphere make many chemical reactions so important that photoionization alone can no longer determine the composition of the escaping atmosphere. For HD 189733b, it is possible to explain the time variability of Lyα between 2010 and 2011 by a change in the EUV SED of the host K-type star, yet invoking only thermal H i in the atmosphere.

  17. The Association of Upper Extremity Deep Vein Thrombosis and Homozygosity for the MTHFR 1298A-C Mutation in a Young Women with Membranoproliferative Glomerulonephritis

    Directory of Open Access Journals (Sweden)

    İsmail YILDIZ

    2014-05-01

    Full Text Available Nephrotic syndrome increases the tendency to thromboembolic complications in both adults and children. Changes in the plasma concentrations of many proteins concerned with regulation of clotting and fibrinolytic systems, hyperviscosity, dehydration, corticosteroid and diuretic therapy may also contribute to thromboembolism. In addition, some of the genetic disorders also increase tendency to thromboembolic events. One of these disorders is methylene tetrahydrofolate reductase (MTHFR A1298C mutation, which may cause hyperhomocysteinemia and thrombotic events when the folate level is low. A 26-year-old female was admitted to hospital with upper extremity deep vein thrombosis and nephrotic range proteinuria. On her renal biopsy, membranoproliferative glomerulonephritis (MPGN was found. The other causes of thrombosis were excluded and homozygosity for the MTHFR A1298C mutation was determined. The levels of homocysteine and folic acid were normal. We report a first case of MPGN together with homozygosity for MTHFR 1298C mutation in adult nephrotic syndrome, complicated with unusual upper extremity venous thrombosis.

  18. A comparative study of the effects of daily minodronate and weekly alendronate on upper gastrointestinal symptoms, bone resorption, and back pain in postmenopausal osteoporosis patients.

    Science.gov (United States)

    Yoshioka, Toru; Okimoto, Nobukazu; Okamoto, Ken; Sakai, Akinori

    2013-03-01

    The purpose of the present study was to precisely compare both the efficacy and abdominal symptom-related quality of life after treatment with daily minodronate and weekly alendronate in patients with primary postmenopausal osteoporosis. The efficacy of the two drugs was assessed based on improvements in a bone turnover marker, back pain, and gastrointestinal symptoms that impair quality of life, which was assessed using the Izumo scale questionnaire. In the minodronate group, there were no significant changes during the treatment period in the specific scores for heartburn, epigastralgia and epigastric fullness, whereas all of the scores were significantly elevated at some time point after drug administration in the alendronate group. Urinary N-telopeptide of type I collagen (uNTX), a bone resorption marker, and bone-specific alkaline phosphatase, a bone formation marker, significantly decreased in both groups, but decreases in uNTX in the minodronate group was observed significantly earlier compared with those in the alendronate group. The back pain scores, which were obtained using a visual analog scale, were significantly reduced in both groups. However, analgesic effects were detected earlier in the minodronate group. In conclusion, compared with weekly alendronate, daily minodronate improved bone turnover and back pain more promptly without causing upper gastrointestinal symptoms.

  19. Sediment transport and development of banner banks and sandwaves in an extreme tidal system: Upper Bay of Fundy, Canada

    Science.gov (United States)

    Li, Michael Z.; Shaw, John; Todd, Brian J.; Kostylev, Vladimir E.; Wu, Yongsheng

    2014-07-01

    Multibeam sonar mapping and geophysical and geological groundtruth surveys were coupled with tidal current and sediment transport model calculations to investigate the sediment transport and formation processes of the complex seabed features off the Cape Split headland in the upper Bay of Fundy. The Cape Split banner bank, composed of coarse to very coarse sand, is a southwest-northeast oriented, large tear-drop shaped sand body with superimposed sand waves that show wavelengths from 15 to 525 m and heights from 0.5 to 19 m. Isolated and chains of barchan dunes occur on top of a shadow bank to the southeast of the banner bank. The barchan dunes are composed of well-sorted medium sand and are oriented northwest-southeast. Their mean height and width are 1.5 and 55 m, respectively. A gravel bank, with an elongated elliptical shape and west-east orientation, lies in the Minas Passage erosional trough east of the headland to form the counterpart to the sandy Cape Split banner bank. The southern face is featureless but the northern face is covered by gravel megaripples. Tidal model predictions and sediment transport calculations show that the formation of the banner bank and the gravel bank are due to the development of the transient counter-clockwise and clockwise tidal eddies respectively to the west and east of the headland. The formation of barchan dunes is controlled by the nearly unidirectional flow regime in outer Scots Bay. Sand waves on the flanks of the Cape Split banner bank show opposite asymmetry and the barchan dunes are asymmetric to the northeast. The tidal current and sediment transport predictions corroborate bedform asymmetry to show that sand wave migration and net sediment transport is to southwest on the northern flank of the banner bank but to northeast on the southern bank. Long-term migration of the Scots Bay barchan dunes is to the northeast. Spring-condition tidal currents can cause frequent mobilization and high-stage transport over the

  20. Upper extremity muscle volumes and functional strength after resistance training in older adults.

    Science.gov (United States)

    Daly, Melissa; Vidt, Meghan E; Eggebeen, Joel D; Simpson, W Greg; Miller, Michael E; Marsh, Anthony P; Saul, Katherine R

    2013-04-01

    Aging leads to a decline in strength and an associated loss of independence. The authors examined changes in muscle volume, maximum isometric joint moment, functional strength, and 1-repetition maximum (1RM) after resistance training (RT) in the upper extremity of older adults. They evaluated isometric joint moment and muscle volume as predictors of functional strength. Sixteen healthy older adults (average age 75 ± 4.3 yr) were randomized to a 6-wk upper extremity RT program or control group. The RT group increased 1RM significantly (p strength (p = .003), isometric shoulder-adduction moment (p = .041), elbow-flexor volume (p = .017), and shoulder-adductor volume (p = .009). Shoulder-muscle volumes and isometric moments were good predictors of functional strength. The authors conclude that shoulder strength is an important factor for performing functional reaching and pulling tasks and a key target for upper extremity RT interventions. PMID:22952203

  1. Minor rheumatology: Nonsystemic rheumatic disease of juxta-articular soft tissues of the upper extremity. Part 2. Drug and non-drug treatments

    Directory of Open Access Journals (Sweden)

    Andrei Evgenyevich Karateev

    2015-01-01

    Full Text Available The treatment of rheumatic diseases of juxta-articular soft tissues (RDJAST of the upper extremity (rotator cuff tendinitis, epicondylitis, de Quervain’s syndrome, trigger finger, carpal tunnel syndrome entails a combination of drug and nondrug therapies. The basic agents that have been proven to be efficacious in this pathology are nonsteroidal anti-inflammatory drugs (NSAIDs and glucocorticosteroids (GCs. The paper considers the largest and known studies that are an evidence base for the expediency of using agents, such NSAIDs, local administration of GCs, hyaluronic acid, and plateletrich plasma, as well as different non-drug treatments, in RDJAST. The latter (physiotherapy, exercises, and rehabilitation programs should be regarded as a necessary component of the therapeutic process in patients with RDJAST-associated chronic pain. Preservation of obvious pain and impaired function despite medical therapy should be regarded as an indication for surgical treatment.

  2. [Modification of bone quality by extreme physical stress. Bone density measurements in high-performance athletes using dual-energy x-ray absorptiometry].

    Science.gov (United States)

    Sabo, D; Reiter, A; Pfeil, J; Güssbacher, A; Niethard, F U

    1996-01-01

    The treatment of osteoporosis is still controversial. Rehabilitation programs which stress strengthening exercises as well as impact loading activities increase the bone mass. On the other side activity level early in life has not been proven to correlate with increased bone mineral content later in life. Little is known on the influence of high performance sports on the bone density especially in athletes with high demands on weight bearing of the spine. In (n = 40) internationally top ranked high performance athletes of different disciplines (n = 28 weight-lifters, n = 6 sports-boxers and n = 6 bicycle-racers) bone density measurements of the lumbar spine and the left hip were performed. The measurements were carried out by dual-photonabsorptiometry (DEXA; QDR 2000, Siemens) and evaluated by an interactive software-programme (Hologic Inc.). The results were compared to the measurements of 21 age-matched male control individuals. In the high performance weight lifters there was an increase of bone density compared to the control individuals of 23% in the Ward's triangle (p boxers had an increase up to 17% (lumbar spine), 9% (hip) and 7% (Wards' triangle). In the third athletes group (Tour de France-bikers) BMD was decreased 10% in the lumbar spine, 14% in the hip and 17% in the Wards' triangle. Our results show that training programs stressing axial loads of the skeletal system may lead to an increase of BMD in the spine and the hip of young individuals. Other authors findings, that the BMD of endurance athletes may decrease, is confirmed. Nevertheless the bikers BMD-loss of 10 to 17% was surprisingly high.

  3. Upper extremity impairments in women with or without lymphedema following breast cancer treatment

    OpenAIRE

    Smoot, Betty; Wong, Josephine; Cooper, Bruce; Wanek, Linda; Topp, Kimberly; Byl, Nancy; Dodd, Marylin

    2010-01-01

    Introduction Breast-cancer-related lymphedema affects ∼25% of breast cancer (BC) survivors and may impact use of the upper limb during activity. The purpose of this study is to compare upper extremity (UE) impairment and activity between women with and without lymphedema after BC treatment. Methods 144 women post BC treatment completed demographic, symptom, and Disability of Arm-Shoulder-Hand (DASH) questionnaires. Objective measures included Purdue pegboard, finger-tapper, Semmes-Weinstein m...

  4. Tooth-marked small theropod bone: an extremely rare trace

    DEFF Research Database (Denmark)

    Jacobsen, Aase Roland

    2001-01-01

    Tooth-marked dinosaur bones provide insight into feeding behaviours and biting strategies of theropod dinosaurs. The majority of theropod tooth marks reported to date have been found on herbivorous dinosaur bones, although some tyrannosaurid bones with tooth marks have also been reported. In 1988...

  5. High-intensity, unilateral resistance training of a non-paretic muscle group increases active range of motion in a severely paretic upper extremity muscle group after stroke.

    Directory of Open Access Journals (Sweden)

    M. A. Urbin

    2015-05-01

    Full Text Available Limited rehabilitation strategies are available for movement restoration when paresis is too severe following stroke. Previous research has shown that high-intensity resistance training of one muscle group enhances strength of the homologous, contralateral muscle group in neurologically-intact adults. How this cross education phenomenon might be exploited to moderate severe weakness in an upper extremity muscle group after stroke is not well understood. The primary aim of this study was to examine adaptations in force-generating capacity of severely paretic wrist extensors resulting from high-intensity, dynamic contractions of the non-paretic wrist extensors. A secondary, exploratory aim was to probe neural adaptations in a subset of participants from each sample using a single-pulse, transcranial magnetic stimulation protocol. Separate samples of neurologically-intact controls (n=7 and individuals > 4 months post stroke (n=6 underwent 16 sessions of training. Following training, one-repetition maximum of the untrained wrist extensors in the control group and active range of motion of the untrained, paretic wrist extensors in the stroke group were significantly increased. No changes in corticospinal excitability, intracortical inhibition or interhemispheric inhibition were observed in control participants. Both stroke participants who underwent TMS testing, however, exhibited increased voluntary muscle activation following the intervention. In addition, motor-evoked potentials that were unobtainable prior to the intervention were readily elicited afterwards in a stroke participant. Results of this study demonstrate that high-intensity resistance training of a non-paretic upper extremity muscle group can enhance voluntary muscle activation and force-generating capacity of a severely paretic muscle group after stroke. There is also preliminary evidence that corticospinal adaptations may accompany these gains.

  6. Rescue procedures in the major trauma of upper extremities – The role of the polish medical air rescue in the therapeutic process

    Directory of Open Access Journals (Sweden)

    Robert Gałązkowski

    2014-12-01

    Full Text Available Background: Due to the growing use of various types of industrial and agricultural machinery, occupational accidents are among the most serious ones and quite frequently result in the permanent posttraumatic disability of the injured person. In Poland, a replantation service has been operating since 2010. Each day, one out of six centres provides emergency replantation service accepting amputation calls from across the country. Patients qualified for replantation often need to be transported from places located even several hundred kilometres from the target hospital. Material and Methods: The analysis covered 174 Helicopter Emergency Medical Service (HEMS missions and 112 interhospital transports. The data were obtained as a result of a retrospective analysis of the air and medical documentation of 23 460 missions carried out by the Polish Medical Air Rescue (Samodzielny Publiczny Zakład Opieki Zdrowotnej Lotnicze Pogotowie Ratunkowe – SP ZOZ LPR aircrafts in the years 2011–2013. Results: In the period under study, the Polish Medical Air Rescue helicopters dressed 135 patients with upper extremity amputations at the scene and transported them to hospitals as part of HEMS missions. At the same time, SP ZOZ LPR aircrafts made 102 interhospital transports. Ninety patients were qualified for treatment in replantation service centres. The average air transport time was 76 min, while the total transport time was 172.3 min. With transport exceeding 300 km, the average time advantage over the ground transport was approximately 1.5 h. Conclusions: In justified cases, the use of helicopters and airplanes is an optimal method of transporting patients with the major trauma to upper extremities. Med. Pr. 2014;65(6:765–776

  7. The Psychometric Properties of a Modified Sit-to-Stand Test With Use of the Upper Extremities in Institutionalized Older Adults.

    Science.gov (United States)

    Le Berre, Melanie; Apap, David; Babcock, Jade; Bray, Sarah; Gareau, Esther; Chassé, Kathleen; Lévesque, Nicole; Robbins, Shawn M

    2016-08-01

    Current sit-to-stand protocols do not permit use of upper extremities, limiting the protocols' utility for institutionalized older adults with diminished physical function. The objective of this study was to modify a 30-s sit-to-stand protocol to allow for arm use and to examine test-retest reliability and convergent validity; 54 institutionalized older adult men (age = 91 ± 3 year) performed the 30-s sit-to-stand twice within a span of 3 to 7 days. Results suggest good test-retest reliability (intraclass correlation coefficient = .84) and convergent validity with the Timed Up and Go Test (r = -.62). This modified 30-s sit-to-stand can be used to assess physical function performance in institutionalized older adults and will ensure that individuals with lower physical function capacity can complete the test, thus eliminating the floor effect demonstrated with other sit-to-stand protocols.

  8. Vascular calcification of the lower extremities demonstrated by Tc-99m MDP bone scintigraphy in a patient with diabetes mellitus

    International Nuclear Information System (INIS)

    The femoral vessels are sometimes visualized on bone scintigraphy. This is almost always caused by calcification of the femoral artery associated with atherosclerotic changes of the arterial wall. Vascular calcification is frequently seen in the elderly and in diabetics. A 78 year old woman was admitted for non-insulin dependent diabetes mellitus. In this patient with diabetes mellitus, tibial arteries as well as femoral arteries were visualized onTc-99m MDP bone scintigraphy in contrast with visualization of femoral artery alone observed in the elderly

  9. Vascular calcification of the lower extremities demonstrated by Tc-99m MDP bone scintigraphy in a patient with diabetes mellitus

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Seok Tae; Sohn, Myung Hee [Chonbuk National University Medical School, Chonju, l (Korea, Republic of)

    2001-06-01

    The femoral vessels are sometimes visualized on bone scintigraphy. This is almost always caused by calcification of the femoral artery associated with atherosclerotic changes of the arterial wall. Vascular calcification is frequently seen in the elderly and in diabetics. A 78 year old woman was admitted for non-insulin dependent diabetes mellitus. In this patient with diabetes mellitus, tibial arteries as well as femoral arteries were visualized onTc-99m MDP bone scintigraphy in contrast with visualization of femoral artery alone observed in the elderly.

  10. Effect of short-term upper-body resistance training on muscular strength, bone metabolic markers, and BMD in premenopausal women

    Directory of Open Access Journals (Sweden)

    Liang MT

    2012-11-01

    Full Text Available Michael TC Liang,1 Lorena Quezada,1 WY Jamie Lau,1 Bulent Sokmen,2 Thomas W Spalding11Department of Kinesiology and Health Promotion, California State Polytechnic University, Pomona, CA, USA; 2Department of Kinesiology, Sonoma State University, Rohnert Park, CA, USAAbstract: To examine the effect of a 10-week upper-body resistance training program on bone turnover markers and site-specific bone mineral density (BMD in the wrist and distal half of the ulna and radius in untrained and healthy young premenopausal women.Methods: Twenty-two subjects (aged 22.1 ± 1.8 years were randomly assigned to a resistance training (n = 12 or no training control (n = 10 group. The following outcome variables were measured before and after 10 weeks of resistance training: (1 bone formation biomarker osteocalcin, and bone resorption biomarker tartrate-resistant acid phosphatase isoform 5b; (2 BMD in the wrist and distal half of the ulna and radius; (3 isokinetic strength of the elbow and knee extensors and flexors; (4 dynamic strength of the arm extensors and flexors; and (5 maximum number of push-ups.Results: The 10-week upper body resistance training intervention resulted in improved strength performance in push-ups (resistance training versus control: P < 0.05, chest presses (P < 0.05, and pulldowns (P < 0.05. However, there was no improvement in the BMD of the wrist (P > 0.05, BMD of the distal half of the ulna and radius (P > 0.05, and metabolic biomarkers osteocalcin (P > 0.05 and tartrate-resistant acid phosphatase isoform 5b (P > 0.05, except for the osteocalcin/tartrate-resistant acid phosphatase isoform 5b ratio. Also, no improvement in the resistance training group was observed for isokinetic strength of the knee and elbow flexion/extension.Conclusion: Upper-body muscular strength performance, but not bone metabolic markers and BMD of the wrist, can be improved with a 10-week upper body resistance training program of the nonweight-bearing limbs in

  11. Upper extremity proprioception in healthy aging and stroke populations, and the effects of therapist- and robot-based rehabilitation therapies on proprioceptive function

    Directory of Open Access Journals (Sweden)

    Charmayne Mary Lee Hughes

    2015-03-01

    Full Text Available The world’s population is aging, with the number of people ages 65 or older expected to surpass 1.5 billion people, or 16% of the global total. As people age, there are notable declines in proprioception due to changes in the central and peripheral nervous systems. Moreover, the risk of stroke increases with age, with approximately two-thirds of stroke-related hospitalizations occurring in people over the age of 65. In this literature review we first summarize behavioral studies investigating proprioceptive deficits in normally aging older adults and stroke patients, and discuss the differences in proprioceptive function between these populations. We then provide a state of the art review the literature regarding therapist- and robot-based rehabilitation of the upper extremity proprioceptive dysfunction in stroke populations and discuss avenues of future research.

  12. Upper extremity proprioception in healthy aging and stroke populations, and the effects of therapist- and robot-based rehabilitation therapies on proprioceptive function.

    Science.gov (United States)

    Hughes, Charmayne Mary Lee; Tommasino, Paolo; Budhota, Aamani; Campolo, Domenico

    2015-01-01

    The world's population is aging, with the number of people ages 65 or older expected to surpass 1.5 billion people, or 16% of the global total. As people age, there are notable declines in proprioception due to changes in the central and peripheral nervous systems. Moreover, the risk of stroke increases with age, with approximately two-thirds of stroke-related hospitalizations occurring in people over the age of 65. In this literature review, we first summarize behavioral studies investigating proprioceptive deficits in normally aging older adults and stroke patients, and discuss the differences in proprioceptive function between these populations. We then provide a state of the art review the literature regarding therapist- and robot-based rehabilitation of the upper extremity proprioceptive dysfunction in stroke populations and discuss avenues of future research.

  13. Effects of Low-Impact Dance on Blood Biochemistry, Bone Mineral Density, the Joint Range of Motion of Lower Extremities, Knee Extension Torque, and Fall in Females.

    Science.gov (United States)

    Wu, Hui Ying; Tu, Jui Hung; Hsu, Chin Hsing; Tsao, Te Hung

    2016-01-01

    The effect of low-impact dance on blood metabolites, the joint range of motion (ROM) of the lower extremities, knee extension torque, bone mass density (BMD), the number of falls, and the confidence to perform daily activities (Modified Falls Efficacy Scale [MFES]) was examined in older sedentary women (age: 59 ± 4 years) before and after a 16-week intervention. Results showed that the average score for the MFES, some parameters of blood chemistry, and joint ROM were significantly improved after low-impact intervention. In addition to improvements in blood lipids and body fat percentages, the increases shown in the parameters regarding the lower extremities may contribute to confidence in performing common daily activities in older women, although the number of falls did not significantly differ between the two groups during the 16-week period. PMID:25642949

  14. Effects of Low-Impact Dance on Blood Biochemistry, Bone Mineral Density, the Joint Range of Motion of Lower Extremities, Knee Extension Torque, and Fall in Females.

    Science.gov (United States)

    Wu, Hui Ying; Tu, Jui Hung; Hsu, Chin Hsing; Tsao, Te Hung

    2016-01-01

    The effect of low-impact dance on blood metabolites, the joint range of motion (ROM) of the lower extremities, knee extension torque, bone mass density (BMD), the number of falls, and the confidence to perform daily activities (Modified Falls Efficacy Scale [MFES]) was examined in older sedentary women (age: 59 ± 4 years) before and after a 16-week intervention. Results showed that the average score for the MFES, some parameters of blood chemistry, and joint ROM were significantly improved after low-impact intervention. In addition to improvements in blood lipids and body fat percentages, the increases shown in the parameters regarding the lower extremities may contribute to confidence in performing common daily activities in older women, although the number of falls did not significantly differ between the two groups during the 16-week period.

  15. A piano training program to improve manual dexterity and upper extremity function in chronic stroke survivors

    Directory of Open Access Journals (Sweden)

    Myriam eVilleneuve

    2014-08-01

    Full Text Available Objective: Music-supported therapy was shown to induce improvements in motor skills in stroke survivors. Whether all stroke individuals respond similarly to the intervention and whether gains can be maintained over time remain unknown. We estimated the immediate and retention effects of a piano training program on upper extremity function in persons with chronic stroke. Methods: Thirteen stroke participants engaged in a 3-week piano training comprising of supervised sessions (9 x 60min and home practice. Fine and gross manual dexterity, movement coordination and functional use of the upper extremity were assessed at baseline, pre-intervention, post-intervention and at a 3-week follow-up. Results: Significant improvements were observed for all outcomes at post-intervention and follow-up, compared to pre-intervention scores. Larger magnitudes of change in manual dexterity and functional use of the upper extremity were associated with higher initial levels of motor recovery. Conclusions: Piano training can result in sustainable improvements in upper extremity function in chronic stroke survivors. Individuals with a higher initial level of motor recovery at baseline appear to benefit the most from this intervention.

  16. An intelligent active force control algorithm to control an upper extremity exoskeleton for motor recovery

    Science.gov (United States)

    Hasbullah Mohd Isa, Wan; Taha, Zahari; Mohd Khairuddin, Ismail; Majeed, Anwar P. P. Abdul; Fikri Muhammad, Khairul; Abdo Hashem, Mohammed; Mahmud, Jamaluddin; Mohamed, Zulkifli

    2016-02-01

    This paper presents the modelling and control of a two degree of freedom upper extremity exoskeleton by means of an intelligent active force control (AFC) mechanism. The Newton-Euler formulation was used in deriving the dynamic modelling of both the anthropometry based human upper extremity as well as the exoskeleton that consists of the upper arm and the forearm. A proportional-derivative (PD) architecture is employed in this study to investigate its efficacy performing joint-space control objectives. An intelligent AFC algorithm is also incorporated into the PD to investigate the effectiveness of this hybrid system in compensating disturbances. The Mamdani Fuzzy based rule is employed to approximate the estimated inertial properties of the system to ensure the AFC loop responds efficiently. It is found that the IAFC-PD performed well against the disturbances introduced into the system as compared to the conventional PD control architecture in performing the desired trajectory tracking.

  17. 双侧上肢训练在脑卒中患者康复中的应用%Preliminary application of bilateral upper extremities training in rehabilitation of stroke patients

    Institute of Scientific and Technical Information of China (English)

    郑雅丹; 胡昔权; 李奎; 陈颖蓓; 解东风

    2011-01-01

    目的:初步观察双侧上肢训练对上肢功能中度到重度残损的恢复期脑卒中患者的疗效.方法:48例上肢功能中度到重度残损的恢复期脑卒中患者随机分为双侧训练组(n=24)、对照组(n=24),前者接受双侧(患侧、健侧)上肢同向、节律运动的重复练习,后者接受常规上肢训练,即以患侧上肢为主的单侧训练.两组患者上肢训练的时间均为1h/d,5d/周,持续4周,其余康复治疗如运动疗法和日常生活活动训练等两组均相同.两组患者分别于治疗前、治疗后予以FMA上肢部分(FMA-UE)、MAS上肢部分和MBI评定.结果:两组患者治疗后FMA-UE、FMA上肢的近端部分(FMA-PUE)和远端部分(FMA-DUE)、MAS-UE及MBI的评分均较治疗前提高,治疗前、后各量表的评分差异具有显著性(P<0.05=;与对照组相比,双侧训练组患者FMA-UE、FMA-PUE的评分提高幅度更大(P<0.05).结论:对于上肢功能中度到重度残损的恢复期脑卒中患者,采用双侧上肢训练可以更好地改善其患侧上肢,尤其是上肢近端的运动功能.%Objective: To observe the effect of bilateral upper extremities training on upper extremities function of stroke patient in convalescent phase with moderate to severe upper extremity impairment.Method: Forty-eight subjects participated in the randomized, single-blind training study. Subjects in the bilateral training group (n=24) practiced bilateral upper extremities(affected and unaffected sides) symmetrical thythmic repetitive activities, and the control group (n=24) performed conventional upper extremities training, mainly affected upper extremity unilateral training. The program of upper extremities training for both groups were 1h per day, 5d per week for 4 weeks. Physical therapy and training of activities of daily living were the same in both groups.Fugl-Meyer assessment of upper extremity (FMA-UE), motor assessment scale of upper extremity (MAS-UE) and modified Barthel index

  18. Feasibility of the adaptive and automatic presentation of tasks (ADAPT system for rehabilitation of upper extremity function post-stroke

    Directory of Open Access Journals (Sweden)

    Choi Younggeun

    2011-08-01

    Full Text Available Abstract Background Current guidelines for rehabilitation of arm and hand function after stroke recommend that motor training focus on realistic tasks that require reaching and manipulation and engage the patient intensively, actively, and adaptively. Here, we investigated the feasibility of a novel robotic task-practice system, ADAPT, designed in accordance with such guidelines. At each trial, ADAPT selects a functional task according to a training schedule and with difficulty based on previous performance. Once the task is selected, the robot picks up and presents the corresponding tool, simulates the dynamics of the tasks, and the patient interacts with the tool to perform the task. Methods Five participants with chronic stroke with mild to moderate impairments (> 9 months post-stroke; Fugl-Meyer arm score 49.2 ± 5.6 practiced four functional tasks (selected out of six in a pre-test with ADAPT for about one and half hour and 144 trials in a pseudo-random schedule of 3-trial blocks per task. Results No adverse events occurred and ADAPT successfully presented the six functional tasks without human intervention for a total of 900 trials. Qualitative analysis of trajectories showed that ADAPT simulated the desired task dynamics adequately, and participants reported good, although not excellent, task fidelity. During training, the adaptive difficulty algorithm progressively increased task difficulty leading towards an optimal challenge point based on performance; difficulty was then continuously adjusted to keep performance around the challenge point. Furthermore, the time to complete all trained tasks decreased significantly from pretest to one-hour post-test. Finally, post-training questionnaires demonstrated positive patient acceptance of ADAPT. Conclusions ADAPT successfully provided adaptive progressive training for multiple functional tasks based on participant's performance. Our encouraging results establish the feasibility of ADAPT; its

  19. A review of the progression and future implications of brain-computer interface therapies for restoration of distal upper extremity motor function after stroke.

    Science.gov (United States)

    Remsik, Alexander; Young, Brittany; Vermilyea, Rebecca; Kiekhoefer, Laura; Abrams, Jessica; Evander Elmore, Samantha; Schultz, Paige; Nair, Veena; Edwards, Dorothy; Williams, Justin; Prabhakaran, Vivek

    2016-05-01

    Stroke is a leading cause of acquired disability resulting in distal upper extremity functional motor impairment. Stroke mortality rates continue to decline with advances in healthcare and medical technology. This has led to an increased demand for advanced, personalized rehabilitation. Survivors often experience some level of spontaneous recovery shortly after their stroke event, yet reach a functional plateau after which there is exiguous motor recovery. Nevertheless, studies have demonstrated the potential for recovery beyond this plateau. Non-traditional neurorehabilitation techniques, such as those incorporating the brain-computer interface (BCI), are being investigated for rehabilitation. BCIs may offer a gateway to the brain's plasticity and revolutionize how humans interact with the world. Non-invasive BCIs work by closing the proprioceptive feedback loop with real-time, multi-sensory feedback allowing for volitional modulation of brain signals to assist hand function. BCI technology potentially promotes neuroplasticity and Hebbian-based motor recovery by rewarding cortical activity associated with sensory-motor rhythms through use with a variety of self-guided and assistive modalities. PMID:27112213

  20. 儿童双骨肢体单骨骨折对关节的影响%Influence on Joints Due to Fracture of Single Bone on Double Bone Extremities in Children

    Institute of Scientific and Technical Information of China (English)

    俞志涛; 王承武; 范源

    1997-01-01

    Objective:To observe the overgrowth after the fracture of a single bone in double bone extremities in children.Methods:179 cases of forearm fracture and 123 of lower leg fracture (excluding Monteggia fracture,Galeazzi fracture or physeal injuries)were reviewed.The time of follow-up was 5~8 years(mean 7.5 years).Comparative assessments of bilateral extremities on X-ray examination included length of ulna and radius,radioulnar angle,anteversion of the radius,radiocapitular line,position of the capitellium,length of the tibia and fibula,and anteroposteriorproject of the ankle.Ranges of motion of the wrist,elbow,forearm and ankle were examined.Results:Overgrowth of affected bones With 2~4 mm in length were found only in 4 cases of forearm fracture and in 7 cases of lower leg fracture.Conclusions:In most cases of fracture of singlebone on double bone extremities,overgrowth of affected bone has been rarely observed.%目的:为了观察儿童双骨肢体单骨骨折后的过度生长.方法:对前臂单骨骨折179例(不包括孟氏骨折、盖氏骨折及骨骺损伤),小腿单骨骨折123例(不包括骨骺损伤),进行了5~6年的随访,平均7.5年.对比测量了双侧X线片中的尺、桡骨长度、胫腓骨长度、桡尺角、桡骨内倾角、桡骨头线、肱骨小头的位置以及踝关节正位片,并对腕、肘关节、踝关节活动进行了对比.结果:前臂有4例,小腿有7例较对侧长2~4 mm.前臂、腕、肘关节及踝关节活动无异常.结论:前臂是双骨均衡支撑肢体,小腿虽以胫骨负重为主,但单骨骨折后另一骨同样可起支撑作用,因此均不会出现明显的过度生长.

  1. The utility of onion extract gel containing topical allantoin and heparin after surgical treatment of upper extremity burn scars

    OpenAIRE

    Mehmet Ihsan Okur; Alpagan Mustafa Yildirim; Bilsev Ince

    2014-01-01

    Background: The development of hypertrophic scars after burns can lead to esthetic as well as functional disorders. The aim of the study was to determine the functional and cosmetic effects of Contractubex and reg; (onion extract, heparin, allantoin) gel applied in burn scar patients after surgery for scar excision and skin grafts. Patients and Methods: The study included seven male patients who presented to our clinic between 2005 and 2012 for the treatment of hypertrophic burn scar and w...

  2. Free style perforator based propeller flaps: Simple solutions for upper extremity reconstruction!

    Science.gov (United States)

    Panse, Nikhil; Sahasrabudhe, Parag

    2014-01-01

    Background: The introduction of perforator flaps by Koshima et al. was met with much animosity in the plastic surgery fraternity. The safety concerns of these flaps following the intentional twist of the perforators have prevented widespread adoption of this technique. Use of perforator based propeller flaps in the lower extremity is gradually on the rise, but their use in upper extremity reconstruction is infrequently reported, especially in the Indian subcontinent. Materials and Methods: We present a retrospective series of 63 free style perforator flaps used for soft tissue reconstruction of the upper extremity from November 2008 to June 2013. Flaps were performed by a single surgeon for various locations and indications over the upper extremity. Patient demographics, surgical indication, defect features, complications and clinical outcome are evaluated and presented as an uncontrolled case series. Results: 63 free style perforator based propeller flaps were used for soft tissue reconstruction of 62 patients for the upper extremity from November 2008 to June 2013. Of the 63 flaps, 31 flaps were performed for trauma, 30 for post burn sequel, and two for post snake bite defects. We encountered flap necrosis in 8 flaps, of which there was complete necrosis in 4 flaps, and partial necrosis in four flaps. Of these 8 flaps, 7 needed a secondary procedure, and one healed secondarily. Although we had a failure rate of 12-13%, most of our failures were in the early part of the series indicative of a learning curve associated with the flap. Conclusion: Free style perforator based propeller flaps are a reliable option for coverage of small to moderate sized defects. Level of Evidence: Therapeutic IV. PMID:24987209

  3. Free style perforator based propeller flaps: Simple solutions for upper extremity reconstruction!

    Directory of Open Access Journals (Sweden)

    Nikhil Panse

    2014-01-01

    Full Text Available Background: The introduction of perforator flaps by Koshima et al. was met with much animosity in the plastic surgery fraternity. The safety concerns of these flaps following the intentional twist of the perforators have prevented widespread adoption of this technique. Use of perforator based propeller flaps in the lower extremity is gradually on the rise, but their use in upper extremity reconstruction is infrequently reported, especially in the Indian subcontinent. Materials and Methods: We present a retrospective series of 63 free style perforator flaps used for soft tissue reconstruction of the upper extremity from November 2008 to June 2013. Flaps were performed by a single surgeon for various locations and indications over the upper extremity. Patient demographics, surgical indication, defect features, complications and clinical outcome are evaluated and presented as an uncontrolled case series. Results: 63 free style perforator based propeller flaps were used for soft tissue reconstruction of 62 patients for the upper extremity from November 2008 to June 2013. Of the 63 flaps, 31 flaps were performed for trauma, 30 for post burn sequel, and two for post snake bite defects. We encountered flap necrosis in 8 flaps, of which there was complete necrosis in 4 flaps, and partial necrosis in four flaps. Of these 8 flaps, 7 needed a secondary procedure, and one healed secondarily. Although we had a failure rate of 12-13%, most of our failures were in the early part of the series indicative of a learning curve associated with the flap. Conclusion: Free style perforator based propeller flaps are a reliable option for coverage of small to moderate sized defects. Level of Evidence: Therapeutic IV.

  4. Finger muscle attachments for an OpenSim upper-extremity model.

    Directory of Open Access Journals (Sweden)

    Jong Hwa Lee

    Full Text Available We determined muscle attachment points for the index, middle, ring and little fingers in an OpenSim upper-extremity model. Attachment points were selected to match both experimentally measured locations and mechanical function (moment arms. Although experimental measurements of finger muscle attachments have been made, models differ from specimens in many respects such as bone segment ratio, joint kinematics and coordinate system. Likewise, moment arms are not available for all intrinsic finger muscles. Therefore, it was necessary to scale and translate muscle attachments from one experimental or model environment to another while preserving mechanical function. We used a two-step process. First, we estimated muscle function by calculating moment arms for all intrinsic and extrinsic muscles using the partial velocity method. Second, optimization using Simulated Annealing and Hooke-Jeeves algorithms found muscle-tendon paths that minimized root mean square (RMS differences between experimental and modeled moment arms. The partial velocity method resulted in variance accounted for (VAF between measured and calculated moment arms of 75.5% on average (range from 48.5% to 99.5% for intrinsic and extrinsic index finger muscles where measured data were available. RMS error between experimental and optimized values was within one standard deviation (S.D of measured moment arm (mean RMS error = 1.5 mm < measured S.D = 2.5 mm. Validation of both steps of the technique allowed for estimation of muscle attachment points for muscles whose moment arms have not been measured. Differences between modeled and experimentally measured muscle attachments, averaged over all finger joints, were less than 4.9 mm (within 7.1% of the average length of the muscle-tendon paths. The resulting non-proprietary musculoskeletal model of the human fingers could be useful for many applications, including better understanding of complex multi-touch and gestural movements.

  5. Finger muscle attachments for an OpenSim upper-extremity model.

    Science.gov (United States)

    Lee, Jong Hwa; Asakawa, Deanna S; Dennerlein, Jack T; Jindrich, Devin L

    2015-01-01

    We determined muscle attachment points for the index, middle, ring and little fingers in an OpenSim upper-extremity model. Attachment points were selected to match both experimentally measured locations and mechanical function (moment arms). Although experimental measurements of finger muscle attachments have been made, models differ from specimens in many respects such as bone segment ratio, joint kinematics and coordinate system. Likewise, moment arms are not available for all intrinsic finger muscles. Therefore, it was necessary to scale and translate muscle attachments from one experimental or model environment to another while preserving mechanical function. We used a two-step process. First, we estimated muscle function by calculating moment arms for all intrinsic and extrinsic muscles using the partial velocity method. Second, optimization using Simulated Annealing and Hooke-Jeeves algorithms found muscle-tendon paths that minimized root mean square (RMS) differences between experimental and modeled moment arms. The partial velocity method resulted in variance accounted for (VAF) between measured and calculated moment arms of 75.5% on average (range from 48.5% to 99.5%) for intrinsic and extrinsic index finger muscles where measured data were available. RMS error between experimental and optimized values was within one standard deviation (S.D) of measured moment arm (mean RMS error = 1.5 mm < measured S.D = 2.5 mm). Validation of both steps of the technique allowed for estimation of muscle attachment points for muscles whose moment arms have not been measured. Differences between modeled and experimentally measured muscle attachments, averaged over all finger joints, were less than 4.9 mm (within 7.1% of the average length of the muscle-tendon paths). The resulting non-proprietary musculoskeletal model of the human fingers could be useful for many applications, including better understanding of complex multi-touch and gestural movements. PMID:25853869

  6. Using Free Internet Videogames in Upper Extremity Motor Training for Children with Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Marisa Sevick

    2016-06-01

    Full Text Available Movement therapy is one type of upper extremity intervention for children with cerebral palsy (CP to improve function. It requires high-intensity, repetitive and task-specific training. Tedium and lack of motivation are substantial barriers to completing the training. An approach to overcome these barriers is to couple the movement therapy with videogames. This investigation: (1 tested the feasibility of delivering a free Internet videogame upper extremity motor intervention to four children with CP (aged 8–17 years with mild to moderate limitations to upper limb function; and (2 determined the level of intrinsic motivation during the intervention. The intervention used free Internet videogames in conjunction with the Microsoft Kinect motion sensor and the Flexible Action and Articulated Skeleton Toolkit software (FAAST software. Results indicated that the intervention could be successfully delivered in the laboratory and the home, and pre- and post- impairment, function and performance assessments were possible. Results also indicated a high level of motivation among the participants. It was concluded that the use of inexpensive hardware and software in conjunction with free Internet videogames has the potential to be very motivating in helping to improve the upper extremity abilities of children with CP. Future work should include results from additional participants and from a control group in a randomized controlled trial to establish efficacy.

  7. Using Free Internet Videogames in Upper Extremity Motor Training for Children with Cerebral Palsy

    Science.gov (United States)

    Sevick, Marisa; Eklund, Elizabeth; Mensch, Allison; Foreman, Matthew; Standeven, John; Engsberg, Jack

    2016-01-01

    Movement therapy is one type of upper extremity intervention for children with cerebral palsy (CP) to improve function. It requires high-intensity, repetitive and task-specific training. Tedium and lack of motivation are substantial barriers to completing the training. An approach to overcome these barriers is to couple the movement therapy with videogames. This investigation: (1) tested the feasibility of delivering a free Internet videogame upper extremity motor intervention to four children with CP (aged 8–17 years) with mild to moderate limitations to upper limb function; and (2) determined the level of intrinsic motivation during the intervention. The intervention used free Internet videogames in conjunction with the Microsoft Kinect motion sensor and the Flexible Action and Articulated Skeleton Toolkit software (FAAST) software. Results indicated that the intervention could be successfully delivered in the laboratory and the home, and pre- and post- impairment, function and performance assessments were possible. Results also indicated a high level of motivation among the participants. It was concluded that the use of inexpensive hardware and software in conjunction with free Internet videogames has the potential to be very motivating in helping to improve the upper extremity abilities of children with CP. Future work should include results from additional participants and from a control group in a randomized controlled trial to establish efficacy. PMID:27338485

  8. Using Free Internet Videogames in Upper Extremity Motor Training for Children with Cerebral Palsy.

    Science.gov (United States)

    Sevick, Marisa; Eklund, Elizabeth; Mensch, Allison; Foreman, Matthew; Standeven, John; Engsberg, Jack

    2016-01-01

    Movement therapy is one type of upper extremity intervention for children with cerebral palsy (CP) to improve function. It requires high-intensity, repetitive and task-specific training. Tedium and lack of motivation are substantial barriers to completing the training. An approach to overcome these barriers is to couple the movement therapy with videogames. This investigation: (1) tested the feasibility of delivering a free Internet videogame upper extremity motor intervention to four children with CP (aged 8-17 years) with mild to moderate limitations to upper limb function; and (2) determined the level of intrinsic motivation during the intervention. The intervention used free Internet videogames in conjunction with the Microsoft Kinect motion sensor and the Flexible Action and Articulated Skeleton Toolkit software (FAAST) software. Results indicated that the intervention could be successfully delivered in the laboratory and the home, and pre- and post- impairment, function and performance assessments were possible. Results also indicated a high level of motivation among the participants. It was concluded that the use of inexpensive hardware and software in conjunction with free Internet videogames has the potential to be very motivating in helping to improve the upper extremity abilities of children with CP. Future work should include results from additional participants and from a control group in a randomized controlled trial to establish efficacy. PMID:27338485

  9. Using Free Internet Videogames in Upper Extremity Motor Training for Children with Cerebral Palsy.

    Science.gov (United States)

    Sevick, Marisa; Eklund, Elizabeth; Mensch, Allison; Foreman, Matthew; Standeven, John; Engsberg, Jack

    2016-01-01

    Movement therapy is one type of upper extremity intervention for children with cerebral palsy (CP) to improve function. It requires high-intensity, repetitive and task-specific training. Tedium and lack of motivation are substantial barriers to completing the training. An approach to overcome these barriers is to couple the movement therapy with videogames. This investigation: (1) tested the feasibility of delivering a free Internet videogame upper extremity motor intervention to four children with CP (aged 8-17 years) with mild to moderate limitations to upper limb function; and (2) determined the level of intrinsic motivation during the intervention. The intervention used free Internet videogames in conjunction with the Microsoft Kinect motion sensor and the Flexible Action and Articulated Skeleton Toolkit software (FAAST) software. Results indicated that the intervention could be successfully delivered in the laboratory and the home, and pre- and post- impairment, function and performance assessments were possible. Results also indicated a high level of motivation among the participants. It was concluded that the use of inexpensive hardware and software in conjunction with free Internet videogames has the potential to be very motivating in helping to improve the upper extremity abilities of children with CP. Future work should include results from additional participants and from a control group in a randomized controlled trial to establish efficacy.

  10. Dual-energy imaging of bone marrow edema on a dedicated multi-source cone-beam CT system for the extremities

    Science.gov (United States)

    Zbijewski, W.; Sisniega, A.; Stayman, J. W.; Thawait, G.; Packard, N.; Yorkston, J.; Demehri, S.; Fritz, J.; Siewerdsen, J. H.

    2015-03-01

    Purpose: Arthritis and bone trauma are often accompanied by bone marrow edema (BME). BME is challenging to detect in CT due to the overlaying trabecular structure but can be visualized using dual-energy (DE) techniques to discriminate water and fat. We investigate the feasibility of DE imaging of BME on a dedicated flat-panel detector (FPD) extremities cone-beam CT (CBCT) with a unique x-ray tube with three longitudinally mounted sources. Methods: Simulations involved a digital BME knee phantom imaged with a 60 kVp low-energy beam (LE) and 105 kVp high-energy beam (HE) (+0.25 mm Ag filter). Experiments were also performed on a test-bench with a Varian 4030CB FPD using the same beam energies as the simulation study. A three-source configuration was implemented with x-ray sources distributed along the longitudinal axis and DE CBCT acquisition in which the superior and inferior sources operate at HE (and collect half of the projection angles each) and the central source operates at LE. Three-source DE CBCT was compared to a double-scan, single-source orbit. Experiments were performed with a wrist phantom containing a 50 mg/ml densitometry insert submerged in alcohol (simulating fat) with drilled trabeculae down to ~1 mm to emulate the trabecular matrix. Reconstruction-based three-material decomposition of fat, soft tissue, and bone was performed. Results: For a low-dose scan (36 mAs in the HE and LE data), DE CBCT achieved combined accuracy of ~0.80 for a pattern of BME spherical lesions ranging 2.5 - 10 mm diameter in the knee phantom. The accuracy increased to ~0.90 for a 360 mAs scan. Excellent DE discrimination of the base materials was achieved in the experiments. Approximately 80% of the alcohol (fat) voxels in the trabecular phantom was properly identified both for single and 3-source acquisitions, indicating the ability to detect edemous tissue (water-equivalent plastic in the body of the densitometry insert) from the fat inside the trabecular matrix

  11. Kinesiology Taping reduces lymphedema of the upper extremity in women after breast cancer treatment: a pilot study

    OpenAIRE

    Iwona Malicka; Agnieszka Rosseger; Justyna Hanuszkiewicz; Marek Woźniewski

    2014-01-01

    Introduction : Secondary lymphedema affects approximately 40% of women treated for breast cancer and is recognized as a major problem associated with the therapy of malignant tumors. Consequently, new therapeutic methods are constantly being sought to effectively eliminate the condition. One of the new forms of edema management, especially in the initial stages of edematous development, is Kinesiology Taping (KT). Aim of the study : The aim of the study was to assess the effects of KT ap...

  12. Modeling and Design of a Spring-loaded, Cable-driven, Wearable Exoskeleton for the Upper Extremity

    Directory of Open Access Journals (Sweden)

    Lelai Zhou

    2015-07-01

    Full Text Available An approach to the design of wearable exoskeletons on the basis of simulation of the exoskeleton and a human body model is proposed in this paper. The new approach, addressing the problem of physical human-exoskeleton interactions, models and simulates the mechanics of both the exoskeleton and the human body, which allows designers to effectively analyze and evaluate an exoskeleton design for their function in concert with the human body. A simulation platform is developed by integrating a biomechanical model of the human body and the exoskeleton. With the proposed approach, an exoskeleton is designed for assisting patients with neuromuscular injuries. Results of the analysis and optimization are included.

  13. ISAKOS upper extremity committee consensus statement on the need for diversification of the Rockwood classification for acromioclavicular joint injuries

    DEFF Research Database (Denmark)

    Beitzel, Knut; Mazzocca, Augustus D; Bak, Klaus;

    2014-01-01

    Optimal treatment for the unstable acromioclavicular (AC) joint remains a highly debated topic in the field of orthopaedic medicine. In particular, no consensus exists regarding treatment of grade III injuries, which are classified according to the Rockwood classification by disruption of both th...

  14. Severe upper extremity polyneuropathy due to inferior brachial plexus compression as a result of left subclavian artery pseudoaneurism

    Directory of Open Access Journals (Sweden)

    George Kosmadakis

    2012-01-01

    Full Text Available In the present report, we describe the case of a 76-year-old hemodialysis patient who was admitted with clinical features of neurological thoracic exit syndrome due to subclavian artery pseudoaneurism following the insertion of a dual lumen vascular internal jugular catheter (vascath with excellent outcome after endo-arterial stent placement.

  15. Effects of concurrent physical and cognitive demands on arm movement kinematics in a repetitive upper-extremity precision task.

    Science.gov (United States)

    Srinivasan, Divya; Mathiassen, Svend Erik; Samani, Afshin; Madeleine, Pascal

    2015-08-01

    The effect of concurrent physical and cognitive demands on arm motor control is poorly understood. This exploratory study compared movement kinematics in a repetitive high-precision pipetting task with and without additional concurrent cognitive demands in the form of instructions necessary to locate the correct target tube. Thirty-five healthy female subjects performed a standardized pipetting task, transferring liquid repeatedly from one pick-up tube to different target tubes. In the reference condition, lights indicated the target tube in each movement cycle, while the target tube had to be deciphered from a row and column number on a computer screen in the condition with additional cognitive demands. Kinematics of the dominant arm was assessed using the central tendency and variability of the pipette-tip end-point trajectory and joint kinematics properties of the shoulder and elbow. Movements slowed down (lower velocities and higher area under the movement curves) and trajectory variability increased in the condition with additional cognitive demands, but there were no changes in the kinematics properties such as joint range of motion, times of acceleration and deceleration (as indicated by the time to peak velocity), average angles, or phase relationships between angle and angular velocity of shoulder or elbow movements between the two conditions. Further, there were also no differences in the size or structure of variability of the shoulder and elbow joint angles, suggesting that subjects could maintain the motor repertoire unaltered in the presence of these specific additional cognitive demands. Further studies should address motor control at other levels of concurrent cognitive demands, and with motor tasks that are less automated than the pipetting task used in the present study, so as to gain an increased understanding of the effect of concurrent cognitive demands for other activities of relevance to daily life. PMID:26024788

  16. Experience from the in-flight calibration of the Extreme Ultraviolet Explorer (EUVE) and Upper Atmosphere Research Satellite (UARS) fixed head star trackers (FHSTs)

    Science.gov (United States)

    Lee, Michael

    1995-01-01

    Since the original post-launch calibration of the FHSTs (Fixed Head Star Trackers) on EUVE (Extreme Ultraviolet Explorer) and UARS (Upper Atmosphere Research Satellite), the Flight Dynamics task has continued to analyze the FHST performance. The algorithm used for inflight alignment of spacecraft sensors is described and the equations for the errors in the relative alignment for the simple 2 star tracker case are shown. Simulated data and real data are used to compute the covariance of the relative alignment errors. Several methods for correcting the alignment are compared and results analyzed. The specific problems seen on orbit with UARS and EUVE are then discussed. UARS has experienced anomalous tracker performance on an FHST resulting in continuous variation in apparent tracker alignment. On EUVE, the FHST residuals from the attitude determination algorithm showed a dependence on the direction of roll during survey mode. This dependence is traced back to time tagging errors and the original post launch alignment is found to be in error due to the impact of the time tagging errors on the alignment algorithm. The methods used by the FDF (Flight Dynamics Facility) to correct for these problems is described.

  17. The Physiological Mechanisms of Performance Enhancement with Sprint Interval Training Differ between the Upper and Lower Extremities in Humans

    DEFF Research Database (Denmark)

    Zinner, Christoph; Morales-Alamo, David; Ørtenblad, Niels;

    2016-01-01

    , reducing the O2 deficit after SIT. The levels of muscle glycogen, as well as the myosin heavy chain composition were unchanged in both cases, while the activities of 3-hydroxyacyl-CoA-dehydrogenase and citrate synthase were elevated only in the legs and capillarization enhanced in both limbs. Multiple...

  18. Design of a Passive Exoskeleton for the Upper Extremity through Co-simulation with a Biomechanical Human Arm Model

    DEFF Research Database (Denmark)

    Zhou, Lelai; Bai, Shaoping; Rasmussen, John

    2013-01-01

    , which allows designers to analyze and evaluate an exoskeleton for its functioning, effectively. A simulation platform is developed by integrating a biomechanical model of human body and the exoskeleton. With the proposed approach, two types of exoskeletons with gravity compensating capability...

  19. Between- and within-subject variance of motor variability metrics in females performing repetitive upper-extremity precision work.

    Science.gov (United States)

    Srinivasan, Divya; Rudolfsson, Thomas; Mathiassen, Svend Erik

    2015-02-01

    Kinematic motor variability is extensively studied in occupational, clinical and sports biomechanics, but the consistency of most motor variability metrics have never been reported. In this study, fourteen subjects performed a repetitive pipetting task on three separate days. Movements of hand, arm and pipette tip were recorded in 3D and used to compute shoulder elevation, elbow flexion and shoulder-arm coordination angles, as well as pipette-tip endpoint precision. Cycle-to-cycle motor variability was quantified using linear dispersion measures of standard kinematics properties such as peak velocity, range of motion, and inter-segmental relative phase. Between- and within-subject consistencies of these variability metrics were quantified by variance components estimated using a nested random effects model. For most metrics, the variance between subjects was larger than that between days and cycles. Entering the variance components in statistical power equations showed that for most metrics, a total of 80-100 subjects will be required to detect a 20% difference between two groups with sufficient power, while this difference can typically be detected in repeated-measures (paired) designs using 25 subjects. The reported between and within-subject variance components can be used as a data base to facilitate efficient designs of future studies of kinematic motor variability. PMID:25467549

  20. The Physiological Mechanisms of Performance Enhancement with Sprint Interval Training Differ between the Upper and Lower Extremities in Humans

    Science.gov (United States)

    Zinner, Christoph; Morales-Alamo, David; Ørtenblad, Niels; Larsen, Filip J.; Schiffer, Tomas A.; Willis, Sarah J.; Gelabert-Rebato, Miriam; Perez-Valera, Mario; Boushel, Robert; Calbet, Jose A. L.; Holmberg, Hans-Christer

    2016-01-01

    To elucidate the mechanisms underlying the differences in adaptation of arm and leg muscles to sprint training, over a period of 11 days 16 untrained men performed six sessions of 4–6 × 30-s all-out sprints (SIT) with the legs and arms, separately, with a 1-h interval of recovery. Limb-specific VO2peak, sprint performance (two 30-s Wingate tests with 4-min recovery), muscle efficiency and time-trial performance (TT, 5-min all-out) were assessed and biopsies from the m. vastus lateralis and m. triceps brachii taken before and after training. VO2peak and Wmax increased 3–11% after training, with a more pronounced change in the arms (P < 0.05). Gross efficiency improved for the arms (+8.8%, P < 0.05), but not the legs (−0.6%). Wingate peak and mean power outputs improved similarly for the arms and legs, as did TT performance. After training, VO2 during the two Wingate tests was increased by 52 and 6% for the arms and legs, respectively (P < 0.001). In the case of the arms, VO2 was higher during the first than second Wingate test (64 vs. 44%, P < 0.05). During the TT, relative exercise intensity, HR, VO2, VCO2, VE, and Vt were all lower during arm-cranking than leg-pedaling, and oxidation of fat was minimal, remaining so after training. Despite the higher relative intensity, fat oxidation was 70% greater during leg-pedaling (P = 0.017). The aerobic energy contribution in the legs was larger than for the arms during the Wingate tests, although VO2 for the arms was enhanced more by training, reducing the O2 deficit after SIT. The levels of muscle glycogen, as well as the myosin heavy chain composition were unchanged in both cases, while the activities of 3-hydroxyacyl-CoA-dehydrogenase and citrate synthase were elevated only in the legs and capillarization enhanced in both limbs. Multiple regression analysis demonstrated that the variables that predict TT performance differ for the arms and legs. The primary mechanism of adaptation to SIT by both the arms and legs

  1. Risk Reduction and Measures of Injury for EVA Associated Upper Extremity Medical Issues: Extended Vent Tube Study

    Science.gov (United States)

    Jones, Jeffrey A.; Hoffman, Ronald B.; Harvey, C. M.; Bowen, C. K.; Hudy, C. E.; Gernhardt, M. L.

    2007-01-01

    During Neutral Buoyancy Lab (NBL) training sessions, a large amount of moisture accumulates in the EVA gloves. The glove design restricts the extension of the EVA suit s ventilation/cooling system to the hand. Subungual redness and fingernail pain develops for many astronauts following their NBL training sessions with subsequent oncholysis occurring over succeeding weeks. Various attempts have been made to reduce or avoid this problem. The causal role of moisture has yet to be defined. Methods: To determine the contribution that moisture plays in the injury to the fingers and fingernails during EVA training operations in NBL, the current Extravehicular Mobility Unit (EMU), with a Portable Life Support System (PLSS) was configured with a ventilation tube that extended down a single arm of the crewmember during the test and compared with the unventilated contralateral arm; with the ventilated hand serving as the experimental condition (E) and the opposite arm as the control (C). A cross-over design was used with opposite handedness for the vent tube on a subsequent NBL training run. Moisture content measures were conducted at six points on each hand with three types of moisture meters. A questionnaire was administered to determine subjective thermal hand discomfort, skin moisture perception, and hand and nail discomfort. Photographs and video were recorded. Measures were applied to six astronauts pre- and post-run in the NBL. Results: The consistent trends in relative hydration ratios at the dorsum, from 3.34 for C to 2.11 for E, and first ring finger joint locations, from 2.46 for C to 1.96 for E, indicated the extended vent tube promoted skin drying. The experimental treatment appeared to be more effective on the left hand versus the right hand, implying an interaction with hand anthropometry and glove fit. Video analyses differentiated fine and gross motor training tasks during runs and will be discussed. Conclusions: This potential countermeasure was effective in

  2. [Case of anti VGKC-complex antibody associated disorder presenting with severe pain and fasciculations predominant in unilateral upper extremity].

    Science.gov (United States)

    Hara, Kenju; Watanabe, Osamu; Shibano, Ken; Ishiguro, Hideaki

    2012-01-01

    A 21-year-old man complained of severe pain and muscle twitching localized in his right arm. Neurological examination showed muscle fasciculations in his right forearm but no myokymia or myotonia. Needle electromyography revealed fibrillation potentials in his biceps brachii muscle and extensor carpi radialis muscle at rest but no myokymic discharges. His serum anti-voltage-gated potassium channel (VGKC)-complex antibody level was significantly high (194.2pM; controls VGKC-complex antibody associated disorder.

  3. Effects of modified constraint-induced movement therapy and functional bimanual training on upper extremity function and daily activities in a patient with incomplete spinal cord injury: a case study.

    Science.gov (United States)

    Kim, Yeon-Ju; Kim, Jin-Kyung; Park, So-Yeon

    2015-12-01

    [Purpose] In this study, we examined effects of modified constraint-induced movement therapy (m-CIMT) and functional bimanual training, when applied to a patient with incomplete spinal cord injury, on upper extremity function and daily activities. [Subject and Methods] One patient, diagnosed with C4 incomplete spinal cord injury, underwent physical therapy with constraint-induced movement therapy for 3 hours and task-oriented bimanual training for 1 hour, per day. This combined 4-hour session was performed five times a week, for 3 weeks, totaling 15 sessions. Upper extremity function was measured using the Manual Function Test (MFT) and Box & Block Test (BBT). Additionally, Spinal Cord Independence Measure Version III (SCIM-III) and Short Form 36 Health Survey (SF-36) were used to assess functional outcomes. [Results] Mobility of the hand and overall function of upper extremities were enhanced following intervention. Moreover, the subject's quality of life and ability to carry out daily activities also improved. [Conclusion] Modified constraint-induced movement therapy and bimanual training was effective in enhancing upper extremity function and performance of daily routines in a patient with incomplete spinal cord injury. Further studies, recruiting multiple subjects, should focus on m-CIMT using diverse methods, performed during the course of daily activities.

  4. Methodological validation of the isotopic analysis of fossil bones and contributions to the paleo-ecological reconstitutions of the Upper Paleolithic of south-west France

    International Nuclear Information System (INIS)

    A methodology for investigating fossil bone collagen carbon and nitrogen isotopic signatures has been established in order to obtain palaeo-ecological informations. The archaeological, biochemical and geochemical reliability has been estimated. Almost 500 animal and human specimens from southwestern France upper Palaeolithic sites ranging in age from 36,000 to 9,000 years BP have been treated. It has been demonstrated that different dietary resources were isotopically distinct, with a resolution better than the expectations. Small mammals have been distinguished from ungulates, and Reindeer, Horse and Bovines presented specific isotopic signatures. Moreover, isotopic differences have been evidenced between gregarious and solitary species. Time changes of ecological patterns have been described using the isotopic signatures of some mammal species. Biomass fluctuation and exploitation have been demonstrated during upper Palaeolithic. The methodology allowed to use the isotopic signatures of animal predators as a proxy for meat resources availability in the environment. This approach allows to investigate environmental global factors as well as human behaviour with a common tool. (author)

  5. Trombose venosa profunda de membros superiores: estudo coorte retrospectivo de 52 casos Upper-extremity deep vein thrombosis: a retrospective cohort study of 52 cases

    Directory of Open Access Journals (Sweden)

    Ricardo de Alvarenga Yoshida

    2005-09-01

    Full Text Available OBJETIVO: Rever os fatores predisponentes e a evolução em série de casos de trombose venosa profunda dos membros superiores de nossa instituição. MÉTODOS: Cinqüenta e dois pacientes consecutivos, com trombose venosa profunda dos membros superiores (29 homens e 23 mulheres, idade média de 52,3 anos, documentados por mapeamento dúplex (71,1%, flebografia (11,1% ou clinicamente (15,6%, foram incluídos no presente estudo. RESULTADOS: As manifestações clínicas foram: dor no antebraço (24 casos - 46,1%, dor no braço (27 casos - 51,9%, edema do membro superior (45 casos - 86,5%, dor à compressão do membro superior (36 casos - 70,2% e dor à movimentação do mesmo (32 casos - 61,7%. Os principais fatores de risco foram: punção ou acesso venoso (20 casos - 39,1% e câncer (16 casos - 32,6%. As veias envolvidas foram: umeral (n = 18, axilar (n = 27, subclávia (n = 15 e jugular (n = 11. A embolia pulmonar estava inicialmente presente em quatro casos (7,6%. O tratamento inicial foi feito com heparina não-fracionada intravenosa (64,3%, subcutânea (16,7%, ou heparina de baixo peso molecular (17,1%, seguido de varfarina. Doze pacientes morreram antes da alta, em função de causas não relacionadas à embolia pulmonar. Foram acompanhados os 40 pacientes restantes por período de 3 meses a 10 anos, sendo que dois morreram de causas não relacionadas à embolia pulmonar, um paciente desenvolveu seqüelas pós-trombóticas, como edema residual e limitações aos movimentos, e seis ficaram com discretos sintomas residuais (edema e dor. CONCLUSÕES: A trombose venosa profunda dos membros superiores foi mais freqüente em pacientes submetidos a acessos venosos e com neoplasia em atividade. Comparando com dados da literatura, a evolução dos pacientes sob tratamento exclusivo com anticoagulantes foi, no mínimo, similar a outros tratamentos propostos.OBJECTIVE: To review the predisposing factors and the evolution of upper-extremity deep vein

  6. Reduction of pain-related fear and increased function and participation in work-related upper extremity pain (WRUEP): effects of exposure in vivo.

    Science.gov (United States)

    de Jong, Jeroen R; Vlaeyen, Johan W S; van Eijsden, Marjon; Loo, Christoph; Onghena, Patrick

    2012-10-01

    There is increasing evidence that pain-related fear influences the development and maintenance of pain disability, presumably mediated through the fear-related avoidance of valued activities. Individually tailored graded exposure in vivo (GEXP) has been demonstrated to reduce pain-related fear and increase functional abilities in patients with chronic low back pain, neck pain, and complex regional pain syndrome. The current study aimed to test whether these effects generalize towards patients with work-related upper extremity pain. A sequential replicated and randomized single-case experimental phase design with multiple measurements was used. Within each participant, GEXP was compared to a no-treatment baseline period and a no-treatment 6-month follow-up period. Eight patients who reported a high level of pain-related fear were included in the study. Daily changes in pain catastrophizing, pain-related fear, and pain intensity were assessed using a diary, and subjected to randomization tests. Before the start of the baseline period, just after GEXP, and at 6-month follow-up, clinically relevant changes of pain catastrophizing, pain-related fear, perceived harmfulness of physical activity, pain disability, and participation/autonomy were verified. When GEXP was introduced, levels of pain catastrophizing and pain-related fear decreased significantly. Clinically relevant improvements were observed for pain disability, perceived participation, and autonomy. These favourable changes were maintained until 6-month follow-up. The findings of the current study underscore the external validity of a cognitive-behavioural GEXP treatment for patients with chronic pain reporting increased pain-related fear.

  7. Upper extremity tumor embolization using a transradial artery approach: technical note.

    Science.gov (United States)

    Zaw, Taryar; Ni, Jason C; Park, Jonathan K; Walsworth, Matthew

    2016-09-01

    Transradial access is being used with increasing frequency for interventional radiology procedures and offers several key advantages, including decreased access site complications and increased patient comfort. We report the technique of using transradial access to perform preoperative embolization of a humeral renal cell carcinoma metastasis and pathologic fracture. A transradial approach for performing humeral preoperative tumor embolization has not been previously reported, to our knowledge. In the appropriately selected patient, this approach may be safely used to perform upper extremity embolization. PMID:27594948

  8. Risk factors for breast cancer-related upper extremity lymphedema: a meta-analysis

    International Nuclear Information System (INIS)

    Objective: To systematically evaluate the risk factors for upper extremity lymphedema after breast cancer treatment and the strength of their associations. Methods: PubMed, Ovid, EMbase, and the Cochrane Library were searched to identify clinical trials published up to December 2012. The quality of included studies was assessed by the Newcastle-Ottawa Scale;data analysis was performed by Stata 10.0 and RevMan 5.2; the strength of associations between risk factors and breast cancer-related upper extremity lymphedema was described as odds ratio (OR) and 95% confidence intervals (CI). Results: Twenty-two studies involving 10106 patients were included in the meta-analysis. The risk factors for upper extremity lymphedema after breast cancer treatment mainly included axillary lymph node dissection (OR=2.72, 95% CI=1.06-6.99, P=0.038), hypertension (OR=1.84, 95% CI=1.38-2.44, P=0.000), body mass index (OR=1.68, 95% CI=1.22-2.32, P=0.001), and radiotherapy (OR=1.65, 95% CI=1.20-2.25, P=0.002), while no significant associations were found for such factors as chemotherapy, age, number of positive lymph nodes, and number of dissected lymph nodes. Conclusions: The incidence of upper extremity lymphedema is high among patients with breast cancer after treatment, and axillary lymph node dissection, hypertension,body mass index, and radiotherapy are the main risk factors for lymphedema after breast cancer treatment. (authors)

  9. Playing piano can improve upper extremity function after stroke: case studies.

    Science.gov (United States)

    Villeneuve, Myriam; Lamontagne, Anouk

    2013-01-01

    Music-supported therapy (MST) is an innovative approach that was shown to improve manual dexterity in acute stroke survivors. The feasibility of such intervention in chronic stroke survivors and its longer-term benefits, however, remain unknown. The objective of this pilot study was to estimate the short- and long-term effects of a 3-week piano training program on upper extremity function in persons with chronic stroke. A multiple pre-post sequential design was used, with measurements taken at baseline (week0, week3), prior to (week6) and after the intervention (week9), and at 3-week follow-up (week12). Three persons with stroke participated in the 3-week piano training program that combined structured piano lessons to home practice program. The songs, played on an electronic keyboard, involved all 5 digits of the affected hand and were displayed using a user-friendly MIDI program. After intervention, all the three participants showed improvements in their fine (nine hole peg test) and gross (box and block test) manual dexterity, as well as in the functional use of the upper extremity (Jebsen hand function test). Improvements were maintained at follow-up. These preliminary results support the feasibility of using an MST approach that combines structured lessons to home practice to improve upper extremity function in chronic stroke. PMID:23533954

  10. Playing Piano Can Improve Upper Extremity Function after Stroke: Case Studies

    Directory of Open Access Journals (Sweden)

    Myriam Villeneuve

    2013-01-01

    Full Text Available Music-supported therapy (MST is an innovative approach that was shown to improve manual dexterity in acute stroke survivors. The feasibility of such intervention in chronic stroke survivors and its longer-term benefits, however, remain unknown. The objective of this pilot study was to estimate the short- and long-term effects of a 3-week piano training program on upper extremity function in persons with chronic stroke. A multiple pre-post sequential design was used, with measurements taken at baseline (week0, week3, prior to (week6 and after the intervention (week9, and at 3-week follow-up (week12. Three persons with stroke participated in the 3-week piano training program that combined structured piano lessons to home practice program. The songs, played on an electronic keyboard, involved all 5 digits of the affected hand and were displayed using a user-friendly MIDI program. After intervention, all the three participants showed improvements in their fine (nine hole peg test and gross (box and block test manual dexterity, as well as in the functional use of the upper extremity (Jebsen hand function test. Improvements were maintained at follow-up. These preliminary results support the feasibility of using an MST approach that combines structured lessons to home practice to improve upper extremity function in chronic stroke.

  11. Assessment of Genotoxic and Cytotoxic Hazards in Brain and Bone Marrow Cells of Newborn Rats Exposed to Extremely Low-Frequency Magnetic Field

    Directory of Open Access Journals (Sweden)

    Monira M. Rageh

    2012-01-01

    Full Text Available The present study aimed to evaluate the association between whole body exposure to extremely low frequency magnetic field (ELF-MF and genotoxic , cytotoxic hazards in brain and bone marrow cells of newborn rats. Newborn rats (10 days after delivery were exposed continuously to 50 Hz, 0.5 mT for 30 days. The control group was treated as the exposed one with the sole difference that the rats were not exposed to magnetic field. Comet assay was used to quantify the level of DNA damage in isolated brain cells. Also bone marrow cells were flushed out to assess micronucleus induction and mitotic index. Spectrophotometric methods were used to measure the level of malondialdehyde (MDA and the activity of glutathione (GSH and superoxide dismutase (SOD. The results showed a significant increase in the mean tail moment indicating DNA damage in exposed group (P<0.01,0.001,0.0001. Moreover ELF-MF exposure induced a significant (P<0.01,0.001 four folds increase in the induction of micronucleus and about three folds increase in mitotic index (P<0.0001. Additionally newborn rats exposed to ELF-MF showed significant higher levels of MDA and SOD (P<0.05. Meanwhile ELF-MF failed to alter the activity of GSH. In conclusion, the present study suggests an association between DNA damage and ELF-MF exposure in newborn rats.

  12. Application of virtual reality technique in rehabilitation of hemiplegic upper extremities function of stroke patients%虚拟现实技术在脑卒中患者偏瘫上肢功能康复中的应用

    Institute of Scientific and Technical Information of China (English)

    梁明; 窦祖林; 王清辉; 熊巍; 郑雅丹; 陈颖蓓; 杨琼; 邱雅贤

    2013-01-01

    目的:初步观察虚拟厨房上肢康复训练结合常规作业治疗对脑卒中恢复期患者偏瘫上肢功能康复的临床疗效.方法:将33例脑卒中恢复期偏瘫上肢功能障碍的患者随机分为治疗组(16例)和对照组(17例).对照组接受常规作业治疗每次40min,每日1次,每周5次,共3周.治疗组接受常规作业治疗和虚拟厨房上肢康复训练各20min,每次共40min,每日1次,每周5次,共3周.其余康复治疗如运动疗法和日常生活活动训练等两组均相同.两组患者分别于治疗前、治疗后予以FMA上肢部分(FMA-UE)、MAS上肢部分(MAS-UE)和MBI评定,比较两组的疗效.结果:两组患者治疗后FMA-UE、MAS-UE及MBI的评分均较治疗前提高,治疗前、后各量表的评分差异具有显著性(P< 0.05);与对照组相比,治疗组患者FMA-UE、MBI的评分提高幅度更大(P<0.05).结论:虚拟厨房上肢康复训练结合常规康复作业治疗能更好地改善脑卒中恢复期患者偏瘫上肢的运动功能,更有效地提高患者日常生活活动能力.%Objective: To observe the effect of virtual kitchen upper extremities training combined with traditional occupational therapy on hemiplegic upper extremities function of stroke patients in convalescent phase. Method: Thirty-three stroke patients with hemiplegic upper extremities dysfunction in convalescent phase, were divided into therapy group (n=16) and control group (n=17). The patients in control group accepted traditional occupational therapy, 40 min/d, 5d/week for 3 weeks. The patients in therapy group accepted virtual kitchen upper extremities training and traditional occupational therapy. Each part of virtual reality trainning lasted 20 min and the total was 40 min, the training schedule in therapy group was 40min/rl, 5d/week for 3 weeks. Physical therapy and training of activities of daily living were the same in both groups. Fugl-Meyer assessment of upper extremity (FMA-UE), motor assessment scale

  13. Simultaneous toe-to-hand transfer and lower extremity amputations for severe upper and lower limb defects: the use of spare parts.

    Science.gov (United States)

    Chang, J; Jones, N F

    2002-06-01

    From 1995 to 2000, five microvascular toe-to-hand transfers were performed in three children who were simultaneously undergoing lower extremity amputations. Their ages at time of transfer ranged from 4 to 10 years and the types of lower extremity amputation included toe amputation, foot amputation and through-knee amputation. The resulting toe-to-hand transfers included three great toe-to-thumb transfers and one combined great and second toe-to-hand transfer. The toe-to-hand transfers were all successful and all the lower extremity amputations healed without complications. In all cases, improved hand function and lower extremity function was noted by the families. These unique cases represent the ultimate use of spare parts in congenital hand surgery.

  14. Optimised, low cost, low field dedicated extremity MRI is highly specific and sensitive for synovitis and bone erosions in rheumatoid arthritis wrist and finger joints

    DEFF Research Database (Denmark)

    Ejbjerg, B J; Narvestad, E; Jacobsen, Søren;

    2005-01-01

    To evaluate a low field dedicated extremity MRI unit for detection of bone erosions, synovitis, and bone marrow oedema in wrist and metacarpophalangeal (MCP) joints, with a high field MRI unit as the standard reference.......To evaluate a low field dedicated extremity MRI unit for detection of bone erosions, synovitis, and bone marrow oedema in wrist and metacarpophalangeal (MCP) joints, with a high field MRI unit as the standard reference....

  15. 牵拉成骨技术治疗下肢大段骨缺损%Distraction osteogenesis for large bone defect of the lower extremity

    Institute of Scientific and Technical Information of China (English)

    王富明; 陈鸿奋; 陈滨; 任高宏; 杨运平; 秦煜; 王钢

    2011-01-01

    Objective To discuss the therapeutic effect of distraction osteogenesis for large bone defect of the lower extremity. Methods From August 2002 to August 2010, 11 patients with large bone defect at the lower extremity were treated with distraction osteogenesis. They were 10 men and one woman, aged from 14 to 53 years (average, 34. S years). The defect was at the right tibia in 7 cases, left tibia in 3 cases and right femur in one case. The lengths of bone defect ranged from 5 to 15 cm (average, 8. 6 cm). Results The patients were followed up for 7 to 48 months, with a mean period of 27. 3 months. The treatment of 9 cases was over, with a mean healing index of 1. 99 months/cm. According to the Paley evaluation system, the bony results were excellent in 6 and good in 3 patients; the functional results were excellent in 4, good in 4, and fair in one patient. Two cases were still in the mineralization period. Conclusion Treatment of large bone defects with distraction osteogenesis is simple and can obtain satisfactory therapeutic effects, especially when a monolateral external fixator is used for the simple shaft bone defect.%目的 探讨应用牵拉成骨技术治疗下肢大段骨缺损的临床疗效.方法 回顾性分析2002年8月至2010年8月收治的11例下肢大段骨缺损患者临床资料,男10例,女1例;年龄14~53岁,平均34.5岁.均行牵拉成骨治疗,右侧胫骨7例,左侧胫骨3例,右侧股骨1例;骨缺损长度5~15cm,平均8.6 cm;9例治疗已结束,2例仍处于矿化阶段.结果 所有患者术后获7~48个月(平均27.3个月)随访.9例治疗结束患者,平均骨愈合指数为1.99个月/cm;根据Paley评价系统评价骨性结果:优6例,良3例,优良率为100%;功能结果:优4例,良4例,一般1例.结论应用牵拉成骨技术治疗大段骨缺损,手术操作简单,尤其是对于单纯骨干缺损患者,采用单边外固定支架治疗,且其手术操作更为简洁.

  16. Sports nuclear medicine. Bone imaging for lower extremity pain in athletes

    International Nuclear Information System (INIS)

    Increased participation in sports by the general public has led to an increase in sports-induced injuries, including stress fractures, shin splints, arthritis, and a host of musculotendinous maladies. Bone scintigraphy with Tc-99m MDP has been used with increasing frequency in detecting stress fractures, but this study can miss certain important conditions and detect other lesions of lesser clinical significance. This paper demonstrates the spectrum of findings on bone scanning in nonacute sports trauma and offers suggestions for the optimal use of Tc-99m MDP for detecting the causes of lower extremity pain in athletes

  17. Limb salvage surgery in a patient with macrodystrophia lipomatosa involving an entire upper extremity

    Institute of Scientific and Technical Information of China (English)

    GAO Bo; ZHENG Long-po; CAI Zheng-dong

    2010-01-01

    @@ Macrodystrophia lipomatosa is a rare form of congenital localized gigantism, which is characterized by slowly progressive overgrowth of the mesenchymal elements, especially the fibroadipose tissue,in a limb. Frequently, multiple contiguous digits are involved on the lateral side of the hand or the medial side of the foot. Overabundance of the fibroadipose tissue and osseous overgrowth are most remarkable at the distal ends of the extremity. Macrodystrophia lipomatosa involving an entire limb has been previously reported for only one case in a 45-year-old adult male;1 however, no details of treatment were described. Here, we present the first report of successful limb salvage surgery of macrodystrophia lipomatosa in an adolescent involving an entire upper extremity.

  18. The Efficacy of Intraoperative Neurophysiological Monitoring Using Transcranial Electrically Stimulated Muscle-evoked Potentials (TcE-MsEPs) for Predicting Postoperative Segmental Upper Extremity Motor Paresis After Cervical Laminoplasty

    Science.gov (United States)

    Manabe, Hideki; Izumi, Bunichiro; Tanaka, Hiroyuki; Kawai, Kazumi; Tanaka, Nobuhiro

    2016-01-01

    Study Design: Prospective study. Objective: To investigate the efficacy of transcranial electrically stimulated muscle-evoked potentials (TcE-MsEPs) for predicting postoperative segmental upper extremity palsy following cervical laminoplasty. Summary of Background Data: Postoperative segmental upper extremity palsy, especially in the deltoid and biceps (so-called C5 palsy), is the most common complication following cervical laminoplasty. Some papers have reported that postoperative C5 palsy cannot be predicted by TcE-MsEPs, although others have reported that it can be predicted. Methods: This study included 160 consecutive cases that underwent open-door laminoplasty, and TcE-MsEP monitoring was performed in the biceps brachii, triceps brachii, abductor digiti minimi, tibialis anterior, and abductor hallucis. A >50% decrease in the wave amplitude was defined as an alarm point. According to the monitoring alarm, interventions were performed, which include steroid administration, foraminotomies, etc. Results: Postoperative deltoid and biceps palsy occurred in 5 cases. Among the 155 cases without segmental upper extremity palsy, there were no monitoring alarms. Among the 5 deltoid and biceps palsy cases, 3 had significant wave amplitude decreases in the biceps during surgery, and palsy occurred when the patients awoke from anesthesia (acute type). In the other 2 cases in which the palsy occurred 2 days after the operation (delayed type), there were no significant wave decreases. In all of the cases, the palsy was completely resolved within 6 months. Discussion: The majority of C5 palsies have been reported to occur several days after surgery, but some of them have been reported to occur immediately after surgery. Our results demonstrated that TcE-MsEPs can predict the acute type, whereas the delayed type cannot be predicted. Conclusions: A >50% wave amplitude decrease in the biceps is useful to predict acute-type segmental upper extremity palsy. Further examination

  19. Recurrent Upper Quadrant Pain: A Fish Bone Secondary to Gastric Perforation and Liver Abscess

    Directory of Open Access Journals (Sweden)

    Hui Liang

    2011-12-01

    Full Text Available A 60-year-old male patient was admitted to our hospital for recurrent upper quadrant pain for 1 month. He had a past history of coronary artery disease. After admission, he repeatedly suffered from high-grade fever, chills and upper quadrant pain. Computed tomography (CT showed a round hypodense mass in the left lobe of the liver, approximately 2.7 × 2.2 cm in size, and a fish bone was confirmed by surgery in the left lobe of liver. The patient was cured completely after surgical removal of the fish bone and liver abscess. CT scan 1 month after discharge showed that the liver abscess had disappeared completely.

  20. Bone printing: new frontiers in the treatment of bone defects.

    Science.gov (United States)

    Arealis, Georgios; Nikolaou, Vasileios S

    2015-12-01

    Bone defects can be congenital or acquired resulting from trauma, infection, neoplasm and failed arthroplasty. The osseous reconstruction of these defects is challenging. Unfortunately, none of the current techniques for the repair of bone defects has proven to be fully satisfactory. Bone tissue engineering (BTE) is the field of regenerative medicine (RM) that focuses on alternative treatment options for bone defects that will ideally address all the issues of the traditional techniques in treating large bone defects. However, current techniques of BTE is laborious and have their own shortcomings. More recently, 2D and 3D bone printing has been introduced to overcome most of the limitations of bone grafts and BTE. So far, results are extremely promising, setting new frontiers in the management of bone defects.

  1. Entrenamiento de las extremidades superiores en el paciente con enfermedad pulmonar obstructiva crónica Upper extremity exercise training in the rehabilitation of patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    MANUEL DE LA PRIDA C

    2011-06-01

    Full Text Available En los pacientes con enfermedad pulmonar obstructiva crónica (EPOC se observa una reducción de la capacidad de generación de fuerza de los grupos musculares de las extremidades superiores (EESS y de la pared torácica comparado con sujetos sanos. Existen evidencias que el ejercicio de las EESS se asocia a un significativo costo metabólico y ventilatorio que es particularmente evidente en los pacientes con EPOC moderada a severa. Clínicamente, estos pacientes tienen disnea y fatiga con actividades sencillas de la vida diaria. En este capitulo se evaluó la evidencia científica que existe en cuanto a los beneficios del entrenamiento muscular de EESS en la rehabilitación respiratoria en pacientes con EPOC. Las características técnicas de dicho entrenamiento también fueron revisadas. Se recomendó la realización de entrenamiento muscular de EESS en la rehabilitación respiratoria de pacientes con EPOC, por cuanto mejora la capacidad de ejercicio, reduce la ventilación y el consumo de oxígeno (calidad de la evidencia: B, fuerza de la recomendación: moderada. El entrenamiento muscular de EESS puede ser asociado al entrenamiento muscular de extremidades inferiores por cuanto se obtienen mejores resultados para el paciente. Los ejercicios de EESS pueden realizarse sin apoyo, con carga incremental o carga constante.In patients with chronic obstructive pulmonary disease (COPD showed a reduction in force generating capacity of the muscle groups of the upper extremities (UE and the chest wall compared with healthy subjects. Also, there is evidence that the exercise of the UE is associated with significant metabolic and ventilatory cost, this is particularly evident in patients with moderate and severe COPD. Clinically, patients have a significant increase in dyspnea and fatigue for simple activities of daily life.This chapter therefore evaluated the scientific evidence regarding the beneficial effect of upper extremities exercise in the

  2. Three-Dimensional Upper Lip and Nostril Sill Changes After Cleft Alveolus Reconstruction Using Autologous Bone Grafting Versus Recombinant Human Bone Morphogenetic Protein-2.

    Science.gov (United States)

    Raposo-Amaral, Cassio Eduardo; Denadai, Rafael; Alonso, Nivaldo

    2016-06-01

    Cleft alveolus in patients with unilateral complete cleft lip and palate has been alternatively reconstructed with recombinant human bone morphogenetic protein (rhBMP)-2. However, its effects on upper lip and nostril sill anatomy are not known. Thus, the objective of this investigation was to assess and compare upper lip and nostril sill changes after cleft alveolus reconstruction with autologous bone from the iliac crest region and rhBMP-2. Patients were randomly allocated into 2 groups. In group 1, autologous bone from the iliac crest region was used to fill the cleft alveolus (n = 4), and in group 2, rhBMP-2 was used to fill the cleft alveolus (n = 8). Preoperatively and at one after the surgery, computerized tomography (CT) was performed. Reformatted CT imaging was used to perform cephalometric linear measurements of the upper lip and nostril sill regions. Inter- and intragroup data of the pre and postoperative reformatted CT measurements of the upper lip and nostril sill regions did not show differences (P >0.05) in cutaneous upper lip height and projection, nostril sill elevation, and subnasale projection. There were no significant upper lip and nostril sill anatomical changes after cleft alveolus reconstruction using autologous bone grafting and rhBMP-2. PMID:27244210

  3. Steroid injections in the upper extremity: experienced clinical opinion versus evidence-based practices.

    Science.gov (United States)

    Kegel, Gary; Marshall, Astrid; Barron, O Alton; Catalano, Louis W; Glickel, Steven Z; Kuhn, Margaret

    2013-09-01

    A survey regarding upper-extremity steroid injection practices was distributed to all active members of the American Society for Surgery of the Hand (ASSH) and American Shoulder and Elbow Surgeons (ASES) using SurveyMonkey. Response rates for the ASSH and ASES were 26% and 24%, respectively. The potency-adjusted dose of steroid injected for common hand and wrist injections ranged from 0.375 to 133.33 mg and for shoulder injections ranged from 0.375 to 250 mg. These ranges span 356-fold and 667-fold differences, respectively. Potency-adjusted doses differed significantly between steroid types for all injections evaluated in this study. American Society for Surgery of the Hand members gave significantly smaller doses of steroid for the glenohumeral and acromioclavicular joints than ASES members. Only 9% of respondents based injection practice on a scientific reference. Sixteen percent of ASSH and 31% of ASES respondents reported no specific rationale for their steroid injection practice; 78% of ASSH and 52% of ASES respondents attributed their rationale to some kind of instruction from their mentors or colleagues. Upper-extremity surgeons demonstrate substantial variability in their practice of steroid injections, with up to a 667-fold range in steroid dose. Experienced clinical opinion is the principal rationale for these injection practices; little rationale is based on formal scientific evidence. PMID:24025004

  4. From confounders to suspected risk factors: psychosocial factors and work-related upper extremity disorders.

    Science.gov (United States)

    Feuerstein, Michael; Shaw, William S; Nicholas, Rena A; Huang, Grant D

    2004-02-01

    Psychosocial variables have recently been more prominent among epidemiologic risk factors for work-related upper extremity disorders (WRUEDs), but bio-behavioral mechanisms underlying these associations have been elusive. One reason is that the psychosocial domain has included many broad and disparate variables (e.g. mood, coping skills, job control, job satisfaction, job stress, social support), and this lack of specificity in the conceptualization of psychosocial factors has produced limited hypothesis testing opportunities. Therefore, recent research efforts have focused on identifying and conceptualizing specific psychosocial factors that might more clearly delineate plausible bio-behavioral mechanisms linking psychosocial factors to WRUEDs. One such factor is workstyle, a strategy that workers may employ for completing, responding to, or coping with job demands that might affect musculoskeletal health. Preliminary studies have provided support for measurable differences in workstyle among individual workers and an association with upper extremity pain and discomfort. An initial self-report measure of workstyle has been pilot tested among office workers and shown acceptable reliability and validity. Future studies are needed to study this construct among other working populations and to determine its relationship with other clinical endpoints. Nevertheless, early findings suggest workstyle may be a potential focus of WRUED prevention efforts. PMID:14759762

  5. Bone marrow stem cells do not repopulate the healthy upper respiratory tract.

    Science.gov (United States)

    Davies, Jane C; Potter, Mike; Bush, Andrew; Rosenthal, Mark; Geddes, Duncan M; Alton, Eric W F W

    2002-10-01

    Recent studies reported differentiation of both bone marrow and tissue-specific stem cells into cells of other organs. The demonstration that bone marrow stem cells differentiate into human hepatocytes in vivo has raised the possibility of new therapeutic approaches for liver disease. For diseases such as cystic fibrosis (CF), correction of the respiratory epithelium is being attempted by gene therapy. Differentiation of bone marrow stem cells into epithelium of the lung and airway was recently reported in an animal model, and would provide an alternative approach. We examined the nasal epithelium of female patients up to 15 years after gender-mismatched bone marrow transplantation. Donor-derived epithelial cells were sought with a combination of Y-chromosome fluorescence in situ hybridization and anti-cytokeratin antibody. In nasal brushing samples from 6 transplant-recipients, a median of 2.5% (range, 0.7-18.1%) of nuclei was male and identified as being of donor-origin. However, a complete absence of staining with anti-cytokeratin antibodies confirmed that these were not epithelial cells, but were likely to be either intraepithelial lymphocytes or mesenchymal cells. Following whole bone marrow transplantation, bone marrow progenitor cells do not differentiate into respiratory epithelium of the healthy upper airway. The differences between this and other studies could relate to the cells transplanted, to differential rates of turnover, or to the requirement for specific triggers to stimulate migration and differentiation. In the absence of such conditions, whole bone marrow transplantation is unlikely to provide a route for correction of the CF airway. PMID:12205565

  6. Determination of bone mineral density of the distal extremity of the radio in Rottweiller, by radiographic optic densitometry;Determinacao da densidade mineral ossea da extremidade distal do radio de caes da raca Rottweiller, por meio da densitometria optica radiografica

    Energy Technology Data Exchange (ETDEWEB)

    Alves, Jefferson Douglas Soares, E-mail: radiologia@unifeob.edu.b [Fundacao de Ensino Octavio Bastos (UNIFEOB), Sao Joao da Boa Vista, SP (Brazil). Fac. de Medicina e Veterinaria; Sterman, Franklin de Almeida [Universidade de Sao Paulo (USP), Butanta, SP (Brazil). Fac. de Medicina Veterinaria e Zootecnia. Dept. de Cirurgia

    2010-06-15

    This study allowed the standardization of the bone mineral density (BMD) of the distal extremity of the radio of 36 dogs adults in Rottweiler breed by radiographic optic densitometry. The limbs of the animals were radiographed with scale of aluminum that served as a reference. The radiographs images were digitalized and analyzed by a computer program for comparison of gray tones between the standard image and the image of the reference scale radiographed with the bone. Afterwards the values of density were expressed in millimeters of aluminum. Also studied the correlations between BMD and the sex, weight and external measures as the length of spine, height of the animal and circumference the distal extremity of the limb in study. The mean values and standard deviations of the bone mineral density of the distal extremity of the radio were: for the metaphyseal region the average of BMD of 7,88+-0,89 mmAl, the diaphyseal region 1 the average of BMD of 8,58+-0,80 mmAl and for diaphyseal region 2 of BMD of 9,00+-0,74 mmAl. (author)

  7. Role of magnetic resonance imaging in entrapment and compressive neuropathy - what, where, and how to see the peripheral nerves on the musculoskeletal magnetic resonance image: Part 2. Upper extremity

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sungjun [Yonsei University, Department of Diagnostic Radiology, College of Medicine, Seoul (Korea); Hanyang University, Kuri Hospital, Department of Diagnostic Radiology, College of Medicine, Kuri City, Kyunggi-do (Korea); Choi, Jin-Young; Huh, Yong-Min; Song, Ho-Taek; Lee, Sung-Ah [Yonsei University, Department of Diagnostic Radiology, College of Medicine, Seoul (Korea); Kim, Seung Min [Yonsei University, Department of Neurology, College of Medicine, Seoul (Korea); Suh, Jin-Suck [Yonsei University, Department of Diagnostic Radiology, College of Medicine, Seoul (Korea); Yonsei University, Research Institute of Radiological Science, College of Medicine, Seoul (Korea)

    2007-02-15

    The diagnosis of nerve entrapment and compressive neuropathy has been traditionally based on the clinical and electrodiagnostic examinations. As a result of improvements in the magnetic resonance (MR) imaging modality, it plays not only a fundamental role in the detection of space-occupying lesions, but also a compensatory role in clinically and electrodiagnostically inconclusive cases. Although ultrasound has undergone further development in the past decades and shows high resolution capabilities, it has inherent limitations due to its operator dependency. We review the course of normal peripheral nerves, as well as various clinical demonstrations and pathological features of compressed and entrapped nerves in the upper extremities on MR imaging, according to the nerves involved. The common sites of nerve entrapment of the upper extremity are as follows: the brachial plexus of the thoracic outlet; axillary nerve of the quadrilateral space; radial nerve of the radial tunnel; ulnar nerve of the cubital tunnel and Guyon's canal; median nerve of the pronator syndrome, anterior interosseous nerve syndrome, and carpal tunnel syndrome. Although MR imaging can depict the peripheral nerves in the extremities effectively, radiologists should be familiar with nerve pathways, common sites of nerve compression, and common space-occupying lesions resulting in nerve compression in MR imaging. (orig.)

  8. Application of direct CT venography in upper extremity deep vein diseases%直接法 CTV 在上肢深静脉疾病中的应用

    Institute of Scientific and Technical Information of China (English)

    李治; 樊健慧

    2014-01-01

    Objective to explore the application value and scanning techniques of direct ct venography in upper extremity deep vein diseases. Methods 31 cases of patients who were highly suspected with upper limb vein stenosis or occlusion were examined by direct venography including 27 cases of dual-source ct and 7 cases of 16-slice ct. then multi—planar reconstruction(MPr), maximum intensity projection(MiP), volume rendering(Vr) and curved planar reformation (cPr) were used to treat the images. Results location, range, degree, condition of outer surface and its collateral circulation of patients with upper extremity deep vein stenosis can be seen clearly from 31 cases on ct images. Conclusions the direct ct venography can be used in 16 or more than 16 -slice ct. it can help to show upper extremity deep vein stenosis and thrombosis, with fast, noninvasive and clear advantages. and it’s very helpful for the judgement of upper extremity deep vein stenosis and thrombosis as well as important evidence for clinical treatment and clinical evaluation.%目的:探讨直接法 ct 静脉成像在上肢深静脉疾病中的应用价值及扫描技术要点。方法对31例临床考虑上肢静脉狭窄、闭塞等疾病患者行直接法 ct(双源 ct 24例、16排 ct 7例)静脉成像,采用多平面重建(MPr)、最大密度投影(MiP)、容积再现(Vr)、曲面重组(cPr)等方法进行后处理。结果31例患者均能清楚显示病变位置、范围及程度腔外情况及周围侧枝开放情况。结论 ct 直接法静脉造影可在16排及以上 ct 开展,能快速、无创、清晰地显示病变的部位、范围、侧支循环建立情况及病变原因,可作为上肢深静脉疾病诊断的可靠手段,还可为临床治疗及疗效评估提供重要依据。

  9. Diagnostic accuracy of indirect laryngoscopy and x-ray neck in the diagnosis of fish bone impaction in upper aero digestive tract

    International Nuclear Information System (INIS)

    This study was aimed at finding the validity of indirect laryngoscopy (IDL) and neck X-Rays in the diagnosis of fish bone impaction. Study Design: Validation study. Place and Duration of Study: CMH Nowshera from August 2012 to February 2013. Material and Methods: A total of 50 patients were selected by consecutive sampling presenting with history of fishbone impaction in aerodigestive tract. IDL examination and neck X-rays were performed and findings were recorded. Those with no fishbone on both the investigations were discharged from hospital with follow up after 03 days. Those with fishbone detected on either of investigations underwent removal. Fishbone easily approachable were removed under local anaesthesia with foreceps and in others Endoscopy (Direct laryngoscopy or Oesophagoscopy) was performed under General Anaesthesia. Sensitivities and specificities of both the modalities were calculated using standard 2/2 Table. ROC curve analysis was carried out and significance level p < 0.05 was taken as significant. Results: In 20 patients no fishbone was found, 26 patients were diagnosed on IDL and in 04 patients fishbone was detected by neck X-Rays. Most common site for fishbone impaction was pharyngeal tonsil. In 22 patients fishbone was removed with foreceps and in 08 patients endoscopy was performed. Diagnostic accuracy for IDL 86% and Neck X-Rays 48% was calculated. ROC curve analysis revealed AUC for IDL 0.933 and Significance level (P) as <0.0001. ROC curve analysis for X-ray gives AUC of 0.567 and Significance level (p) 0.4132. Conclusion: IDL shows higher diagnostic accuracy than neck X-Rays for detection of fishbone in upper aerodigestive tract. Neck X-rays are more useful for impacted foreign bodies in oesophagus. (author)

  10. Spectroscopic Studies on Organic Matter from Triassic Reptile Bones, Upper Silesia, Poland.

    Science.gov (United States)

    Surmik, Dawid; Boczarowski, Andrzej; Balin, Katarzyna; Dulski, Mateusz; Szade, Jacek; Kremer, Barbara; Pawlicki, Roman

    2016-01-01

    Fossil biomolecules from an endogenous source were previously identified in Cretaceous to Pleistocene fossilized bones, the evidence coming from molecular analyses. These findings, however, were called into question and an alternative hypothesis of the invasion of the bone by bacterial biofilm was proposed. Herewith we report a new finding of morphologically preserved blood-vessel-like structures enclosing organic molecules preserved in iron-oxide-mineralized vessel walls from the cortical region of nothosaurid and tanystropheid (aquatic and terrestrial diapsid reptiles) bones. These findings are from the Early/Middle Triassic boundary (Upper Roetian/Lowermost Muschelkalk) strata of Upper Silesia, Poland. Multiple spectroscopic analyses (FTIR, ToF-SIMS, and XPS) of the extracted "blood vessels" showed the presence of organic compounds, including fragments of various amino acids such as hydroxyproline and hydroxylysine as well as amides, that may suggest the presence of collagen protein residues. Because these amino acids are absent from most proteins other than collagen, we infer that the proteinaceous molecules may originate from endogenous collagen. The preservation of molecular signals of proteins within the "blood vessels" was most likely made possible through the process of early diagenetic iron oxide mineralization. This discovery provides the oldest evidence of in situ preservation of complex organic molecules in vertebrate remains in a marine environment. PMID:26977600

  11. Spectroscopic Studies on Organic Matter from Triassic Reptile Bones, Upper Silesia, Poland.

    Directory of Open Access Journals (Sweden)

    Dawid Surmik

    Full Text Available Fossil biomolecules from an endogenous source were previously identified in Cretaceous to Pleistocene fossilized bones, the evidence coming from molecular analyses. These findings, however, were called into question and an alternative hypothesis of the invasion of the bone by bacterial biofilm was proposed. Herewith we report a new finding of morphologically preserved blood-vessel-like structures enclosing organic molecules preserved in iron-oxide-mineralized vessel walls from the cortical region of nothosaurid and tanystropheid (aquatic and terrestrial diapsid reptiles bones. These findings are from the Early/Middle Triassic boundary (Upper Roetian/Lowermost Muschelkalk strata of Upper Silesia, Poland. Multiple spectroscopic analyses (FTIR, ToF-SIMS, and XPS of the extracted "blood vessels" showed the presence of organic compounds, including fragments of various amino acids such as hydroxyproline and hydroxylysine as well as amides, that may suggest the presence of collagen protein residues. Because these amino acids are absent from most proteins other than collagen, we infer that the proteinaceous molecules may originate from endogenous collagen. The preservation of molecular signals of proteins within the "blood vessels" was most likely made possible through the process of early diagenetic iron oxide mineralization. This discovery provides the oldest evidence of in situ preservation of complex organic molecules in vertebrate remains in a marine environment.

  12. Autologous Bone Marrow Stem Cells combined with Allograft Cancellous Bone in Treatment of Nonunion

    OpenAIRE

    Le Thua Trung Hau; Duc Phu Bui; Nguyen Duy Thang; Pham Dang Nhat; Le Quy Bao; Nguyen Phan Huy; Tran Ngoc Vu; Le Phuoc Quang; Boeckx willy Denis; Mey Albert De

    2015-01-01

    Autologous cancellous bone graft is currently used as a gold standard method for treatment of bone nonunion. However, there is a limit to the amount of autologous cancellous bone that can be harvested and the donor site morbidity presents a major disadvantage to autologous bone grafting. Embedding viable cells within biological scaffolds appears to be extremely promising. The purpose of this study was to assess the outcome of autologous bone marrow stem cells combined with a cancellous bone a...

  13. [Primary liposarcoma of bone].

    Science.gov (United States)

    Tatić, V; Cerović, S; Skaro-Milić, A; Jovanović, Z

    2001-01-01

    A case of 75-year-old man with extremely rare primary liposarcoma of the bone was presented. Stains for lipid, Sudan III, Sudan IV, and Oil Red "O", demonstrated the presence of intracellular lipid in the lipoblasts. Similarly, the S-100 immunoreactivity and electron microscopic findings of tumor cells confirmed the diagnosis of liposarcoma. Histochemical stains for PAS, Alcian-blue, mucikarmin, Toluidin-blue and Coloidal Iron were negative. PMID:11419292

  14. What is known about temperature and complaints in the upper extremity? A systematic review in the VDU work environment

    NARCIS (Netherlands)

    E.M. Meijer; J.K. Sluiter; M.H.W. Frings-Dresen

    2006-01-01

    Upper extremity musculoskeletal complaints and disorders are frequently reported among visual display units (VDU) workers. These complaints include cold forearms, hands or fingers. Objective: The aim of this systematic review was to gain an insight into the relationship between objective and subject

  15. Upper Extremity Muscle Endurance in Children with Cerebral Palsy

    OpenAIRE

    Gulliksen, Anette

    2011-01-01

    Aim: The aim of this study was to evaluate whether submaximal muscle endurance at 20% of maximal voluntary isometric contraction (MVIC) is as reduced as muscle strength in elbow flexion in children with cerebral palsy (CP), and whether motor unit recruitment to compensate muscle fatigue is hampered in this group.Methods: Twelve subjects with cerebral palsy and seventeen control subjects performed three MVICs of elbow extension and flexion, and an endurance task holding a load of approximately...

  16. Pneumatic compression for embolic protection during upper extremity endovascular intervention.

    Science.gov (United States)

    Cassar, Andrew; Barsness, Gregory W; Wysokinski, Waldemar E; Gifford, Shaun M; Bower, Thomas C; Edwards, William D; Gulati, Rajiv

    2014-01-01

    Embolic protection devices are occasionally employed during endovascular interventions to prevent complications caused by embolic debris. However, these devices have imperfect efficacy, confer risk of endovascular trauma, and are expensive. We report a patient with giant cell arteritis and symptomatic axillary artery stenosis, with a perceived elevated risk of distal embolization during endovascular intervention. We describe a straightforward embolic protection technique of brachial pressure cuff inflation during endovascular intervention and aspiration of displaced thrombotic material from the static column of blood. This novel, effective, and cost-free technique could also be employed in other vascular beds during endovascular intervention.

  17. Mechanical load on the upper extremity during wheelchair activities

    NARCIS (Netherlands)

    Van Drongelen, Stefan; Van der Woude, Lucas H; Janssen, Thomas W; Angenot, Edmond L; Chadwick, Edward K; Veeger, DirkJan (H. E. J.)

    2005-01-01

    OBJECTIVE: To determine the net moments on the glenohumeral joint and elbow joint during wheelchair activities. DESIGN: Kinematics and external forces were measured during wheelchair activities of daily living (level propulsion, riding on a slope, weight-relief lifting, reaching, negotiating a curb)

  18. Concurrent neuromechanical and functional gains following upper-extremity power training post-stroke

    Directory of Open Access Journals (Sweden)

    Patten Carolynn

    2013-01-01

    Full Text Available Abstract Background Repetitive task practice is argued to drive neural plasticity following stroke. However, current evidence reveals that hemiparetic weakness impairs the capacity to perform, and practice, movements appropriately. Here we investigated how power training (i.e., high-intensity, dynamic resistance training affects recovery of upper-extremity motor function post-stroke. We hypothesized that power training, as a component of upper-extremity rehabilitation, would promote greater functional gains than functional task practice without deleterious consequences. Method Nineteen chronic hemiparetic individuals were studied using a crossover design. All participants received both functional task practice (FTP and HYBRID (combined FTP and power training in random order. Blinded evaluations performed at baseline, following each intervention block and 6-months post-intervention included: Wolf Motor Function Test (WMFT-FAS, Primary Outcome, upper-extremity Fugl-Meyer Motor Assessment, Ashworth Scale, and Functional Independence Measure. Neuromechanical function was evaluated using isometric and dynamic joint torques and concurrent agonist EMG. Biceps stretch reflex responses were evaluated using passive elbow stretches ranging from 60 to 180º/s and determining: EMG onset position threshold, burst duration, burst intensity and passive torque at each speed. Results Primary outcome: Improvements in WMFT-FAS were significantly greater following HYBRID vs. FTP (p = .049, regardless of treatment order. These functional improvements were retained 6-months post-intervention (p = .03. Secondary outcomes: A greater proportion of participants achieved minimally important differences (MID following HYBRID vs. FTP (p = .03. MIDs were retained 6-months post-intervention. Ashworth scores were unchanged (p > .05. Increased maximal isometric joint torque, agonist EMG and peak power were significantly greater following HYBRID vs. FTP (p p

  19. Bone graft substitutes for the treatment of traumatic fractures of the extremities [Knochenersatzmaterialien zur Behandlung von traumatischen Frakturen der Extremitäten

    Directory of Open Access Journals (Sweden)

    Hagen, Anja

    2012-06-01

    Full Text Available [english] Bone graft substitutes are increasingly being used as supplements to standard care or as alternative to bone grafts in the treatment of traumatic fractures.The efficacy and cost-effectiveness of bone graft substitutes for the treatment of traumatic fractures as well as the ethical, social and legal implications of their use are the main research questions addressed.A systematic literature search was conducted in electronic medical databases (MEDLINE, EMBASE etc. in December 2009. Randomised controlled trials (RCT, where applicable also containing relevant health economic evaluations and publications addressing the ethical, social and legal aspects of using bone graft substitutes for fracture treatment were included in the analysis. After assessment of study quality the information synthesis of the medical data was performed using metaanalysis, the synthesis of the health economic data was performed descriptively. 14 RCT were included in the medical analysis, and two in the heath economic evaluation. No relevant publications on the ethical, social and legal implications of the bone graft substitute use were found. In the RCT on fracture treatment with bone morphogenetic protein-2 (BMP-2 versus standard care without bone grafting (RCT with an elevd high risk of bias there was a significant difference in favour of BMP-2 for several outcome measures. The RCT of calcium phosphate (CaP cement and bone marrow-based composite materials versus autogenous bone grafts (RCT with a high risk of bias revealed significant differences in favour of bone graft substitutes for some outcome measures. Regarding the other bone graft substitutes, almost all comparisons demonstrated no significant difference.The use of BMP-2 in addition to standard care without bone grafting led in the study to increased treatment costs considering all patients with traumatic open fractures. However, cost savings through the additional use of BMP-2 were calculated in a

  20. 护理干预预防PICC相关性上肢静脉血栓的系统评价%System evaluation on nursing intervention for prevention of PICC related upper extremity venous thrombosis

    Institute of Scientific and Technical Information of China (English)

    陈璐; 谢新芳; 沈洪; 杨金丽; 宋建文

    2016-01-01

    Objective:To evaluate the effect of nursing intervention for PICC related upper extremity deep vein thrombosis.Methods:The controlled trials of nursing intervention on PICC related upper extremity deep vein thrombosis were collected by using the databases PubMed,Cochrane,OVID,CNKI,Wangfang Data snd VIP. The quantitative or qualitative analysis were selected according to the homogeneity of included studies.Results:8 RCTs were included(973 cases).Comprehensive evaluation before PICC,soak the catheter in advance with heparin sodium and DXM,physical prophylaxis,hot wet compression with magnesium sulfate and using hiru-doid cream after PICC could reduce PICC related upper extremity deep vein thrombosis.Conclusion:Nursing intervention could prevent PICC related upper extremity deep vein thrombosis,which had positive effect for in-travenous infusion therapy.%[目的]评价护理干预预防 PICC 相关性上肢静脉血栓的效果。[方法]计算机检索 PubMed、Cochrane Li-brary、OVID、CNKI、WanFang Data、VIP等数据库,纳入采用护理干预预防PICC相关性上肢静脉血栓的对照试验,根据纳入研究的同质性选择定量或定性评价分析。[结果]纳入8篇文献,均为随机对照试验,共973例病人。分析结果表明置管前全面评估、肝素钠加地塞米松预浸泡导管,置管后采用物理预防、硫酸镁湿热敷、喜疗妥外涂等干预措施能够减少PICC相关性上肢静脉血栓的形成。[结论]护理干预能够预防PICC相关性上肢静脉血栓,对静脉输液治疗有积极意义。

  1. Sports injuries to the upper extremity. How to recognize and deal with some common problems.

    Science.gov (United States)

    Cooney, W P

    1984-09-15

    Upper extremity syndromes caused by a single stress or by repetitive microtrauma occur in a variety of sports. The throwing motion, long-distance swimming, bowling, golf, gymnastics, basketball, volleyball, and field events can repetitively stress the hand, wrist, elbow, and shoulder. The biomechanical evaluation of racquet handling, throwing, and swimming motions has progressed considerably, and the future looks promising for better identification and prevention of sports injuries due to stress. These insights will help the physician more adequately understand and treat athletic injuries. As for the present, we must recognize athletic injuries for what they are--debilitating single or repetitive trauma to active persons who want a rapid return to their sport. The goal of both the injured athlete and the treating physician must be 100% recovery; compromise in treatment is not warranted. To achieve the best results, the physician should emphasize to the athlete, coach, and parent that healing is a matter of time. PMID:6473225

  2. 康复机器人训练对脑卒中偏瘫患者上肢功能的影响%Effect of rehabilitation robot on upper extremity function of hemiplegic patients

    Institute of Scientific and Technical Information of China (English)

    龙耀斌

    2012-01-01

    Objective: To observe the effect of the upper limb rehabilitation robot combined with conventional rehabilitation on upper extremity function of hemiplegic patients. Methods: 80 cases of hemiplegic upper limb dysfunction were divided into two groups. Both groups were given normal limb function training, at the same time the treatment group was given the upper iitnb rehabilitation robot training. Modified ashworth scale (MAS) score, simplified Fugl-Meyer upper limb motor function (FMA) score and the modified Barthel index (MBI) were compared before and after the treatment. Results: After 1 month of treatment, MAS scores in two groups were decreased as compared with those before treatment (F<0. 05), and those in treatment group was reduced as compared with control group (P<0. 05). FMA and ADL in two groups after treatment were improved as compared with those before treatment(Pof upper limb rehabilitation robot training with conventional rehabilitation can not only effectively improve the upper limb function of hemiplegic patients, but also can promote the recovery of activities of daily living.%目的:探讨上肢康复机器人训练结合常规康复治疗对脑卒中偏瘫患者上肢功能的影响.方法:80例脑梗死患者随机分为2组,均接受基础药物治疗和常规康复治疗;观察组增加上肢康复机器人训练.治疗前后分别进行上肢肌张力改良Ashworth量表(MAS)评分、上肢运动功能(FMA)评分及改良Barthel指数(MBI)评定.结果:治疗1个月后,2组患者上肢MAS评分均较治疗前明显下降(P<0.05),且观察组更低于对照组(P<0.05);FMA及改良Barthel指数(MBI)评分均较治疗前明显提高(P<0.05),且观察组较对照组更加显著(P<0.05).结论:上肢康复机器人训练结合常规康复治疗不仅能改善脑梗死患者上肢功能,而且能促进日常生活活动能力的恢复.

  3. Variables associated with upper extremity function in patients with Duchenne muscular dystrophy.

    Science.gov (United States)

    Janssen, Mariska M H P; Hendriks, Jan C M; Geurts, Alexander C H; de Groot, Imelda J M

    2016-09-01

    Preserving upper extremity (UE) function in patients with Duchenne muscular dystrophy (DMD) is extremely important as it is related to independence and quality of life. For clinical decision making, knowledge of variables associated with UE function is necessary. This knowledge is, however, limited. Therefore, this study aims to gain more insight into the variables associated with UE function in DMD. Data from an international web-based questionnaire on UE function, obtained from 213 DMD patients, were used. Six dependent variables regarding UE function were used in multivariable linear regression analyses. In addition, 26 independent variables regarding patient characteristics, medication, therapy, supportive aids, pain, stiffness and participation were used. Twelve independent variables showed a significant relation to UE function. Variables with a negative relation to UE function were: later disease stage, occurrence of scoliosis, higher age, use of UE splints, more frequent stiffness complaints, more limitations due to stiffness, more frequent elbow pain, and having physical therapy. A positive relation with UE function was seen for going to school or work, use of corticosteroids, higher BMI, and higher age at diagnosis. These variables explained 56-81 % of the variation of the different measures of UE function. Knowledge of variables associated with UE function is very important in the clinical management of DMD patients. The results of this study suggest that corticosteroid use and participation in school and work related activities are positively related to UE function in DMD patients, as well as reducing pain and stiffness and preventing scoliosis. PMID:27314968

  4. Invited commentary on comparison of robotics, functional electrical stimulation, and motor learning methods for treatment of persistent upper extremity dysfunction after stroke: a randomized controlled trial.

    Science.gov (United States)

    Kwakkel, Gert; van Wegen, Erwin E; Meskers, Carel M

    2015-06-01

    In this issue of Archives of Physical Medicine and Rehabilitation, Jessica McCabe and colleagues report findings from their methodologically sound, dose-matched clinical trial in 39 patients beyond 6 months poststroke. In this phase II trial, the effects of 60 treatment sessions, each involving 3.5 hours of intensive practice plus either 1.5 hours of functional electrical stimulation (FES) or a shoulder-arm robotic therapy, were compared with 5 hours of intensive daily practice alone. Although no significant between-group differences were found on the primary outcome measure of Arm Motor Ability Test and the secondary outcome measure of Fugl-Meyer Arm motor score, 10% to 15% within-group therapeutic gains were on the Arm Motor Ability Test and Fugl-Meyer Arm. These gains are clinically meaningful for patients with stroke. However, the underlying mechanisms that drive these improvements remain poorly understood. The approximately $1000 cost reduction per patient calculated for the use of motor learning (ML) methods alone or combined with FES, compared with the combination of ML and shoulder-arm robotics, further emphasizes the need for cost considerations when making clinical decisions about selecting the most appropriate therapy for the upper paretic limb in patients with chronic stroke.

  5. The Axolotl Fibula as a Model for the Induction of Regeneration across Large Segment Defects in Long Bones of the Extremities.

    Science.gov (United States)

    Chen, Xiaoping; Song, Fengyu; Jhamb, Deepali; Li, Jiliang; Bottino, Marco C; Palakal, Mathew J; Stocum, David L

    2015-01-01

    We tested the ability of the axolotl (Ambystoma mexicanum) fibula to regenerate across segment defects of different size in the absence of intervention or after implant of a unique 8-braid pig small intestine submucosa (SIS) scaffold, with or without incorporated growth factor combinations or tissue protein extract. Fractures and defects of 10% and 20% of the total limb length regenerated well without any intervention, but 40% and 50% defects failed to regenerate after either simple removal of bone or implanting SIS scaffold alone. By contrast, scaffold soaked in the growth factor combination BMP-4/HGF or in protein extract of intact limb tissue promoted partial or extensive induction of cartilage and bone across 50% segment defects in 30%-33% of cases. These results show that BMP-4/HGF and intact tissue protein extract can promote the events required to induce cartilage and bone formation across a segment defect larger than critical size and that the long bones of axolotl limbs are an inexpensive model to screen soluble factors and natural and synthetic scaffolds for their efficacy in stimulating this process. PMID:26098852

  6. The Axolotl Fibula as a Model for the Induction of Regeneration across Large Segment Defects in Long Bones of the Extremities.

    Science.gov (United States)

    Chen, Xiaoping; Song, Fengyu; Jhamb, Deepali; Li, Jiliang; Bottino, Marco C; Palakal, Mathew J; Stocum, David L

    2015-01-01

    We tested the ability of the axolotl (Ambystoma mexicanum) fibula to regenerate across segment defects of different size in the absence of intervention or after implant of a unique 8-braid pig small intestine submucosa (SIS) scaffold, with or without incorporated growth factor combinations or tissue protein extract. Fractures and defects of 10% and 20% of the total limb length regenerated well without any intervention, but 40% and 50% defects failed to regenerate after either simple removal of bone or implanting SIS scaffold alone. By contrast, scaffold soaked in the growth factor combination BMP-4/HGF or in protein extract of intact limb tissue promoted partial or extensive induction of cartilage and bone across 50% segment defects in 30%-33% of cases. These results show that BMP-4/HGF and intact tissue protein extract can promote the events required to induce cartilage and bone formation across a segment defect larger than critical size and that the long bones of axolotl limbs are an inexpensive model to screen soluble factors and natural and synthetic scaffolds for their efficacy in stimulating this process.

  7. The Axolotl Fibula as a Model for the Induction of Regeneration across Large Segment Defects in Long Bones of the Extremities.

    Directory of Open Access Journals (Sweden)

    Xiaoping Chen

    Full Text Available We tested the ability of the axolotl (Ambystoma mexicanum fibula to regenerate across segment defects of different size in the absence of intervention or after implant of a unique 8-braid pig small intestine submucosa (SIS scaffold, with or without incorporated growth factor combinations or tissue protein extract. Fractures and defects of 10% and 20% of the total limb length regenerated well without any intervention, but 40% and 50% defects failed to regenerate after either simple removal of bone or implanting SIS scaffold alone. By contrast, scaffold soaked in the growth factor combination BMP-4/HGF or in protein extract of intact limb tissue promoted partial or extensive induction of cartilage and bone across 50% segment defects in 30%-33% of cases. These results show that BMP-4/HGF and intact tissue protein extract can promote the events required to induce cartilage and bone formation across a segment defect larger than critical size and that the long bones of axolotl limbs are an inexpensive model to screen soluble factors and natural and synthetic scaffolds for their efficacy in stimulating this process.

  8. Serum IL-6 and CRP levels in patients with trauma involving low-extremity bone fractures

    OpenAIRE

    Karakaya, Cengiz; Tevfik, Noyana; Ekin, Suat; Elnur, Babayev

    2014-01-01

    Abstract. Cytokines and acute phase proteins have been implicated in the systemic response to trauma. The aim of this study was to measure the IL-6, CRP, ALP, calcium and phosphorus levels in patients with trauma involving low-extremity bone fractures at 6, 24 and 48 hours following trauma. Serum samples were obtained from 21 trauma patients with femoral or tibial fractures at 6th, 24th and 48th hour following trauma. Serum IL-6, CRP, ALP, calcium and phosphorus levels were measured in these ...

  9. 上肢腱鞘巨细胞瘤术后复发相关因素分析%Analysis on recurrence factors associate with giant cell tumor of tendon sheath in upper extremity

    Institute of Scientific and Technical Information of China (English)

    刘扬波; 林丁盛; 王建; 张怀保; 陈雷

    2011-01-01

    目的:了解上肢腱鞘巨细胞瘤患者的性别、年龄、肿瘤生长部位、术中化学处理情况和肿瘤术后复发的相关性.方法:回顾分析2000年1月至2011年8月47例上肢腱鞘巨细胞瘤住院患者的病史,对其性别、年龄、肿瘤生长部位、术中是否接受化学灭活处理、手术并发症、肿瘤复发情况及病理结果做统计和分析.本组女28例,男19例;年龄17~78岁,平均38.15岁.所有病例接受手术局部切除.14例术中使用化学方法灭活肿瘤细胞(术中使用乙醇或碘酒浸泡手术创面).对患者定期随访,观察创口愈合情况、病理结果、肿瘤是否复发,并做必要的影像学检查.结果:47例平均随访53.89个月(22~129个月),其中4例术中采用乙醇灭活的病例术后出现创口红肿、坏死组织排出、创口延迟愈合等并发症;15例报告肿瘤组织生长活跃,1例为低度恶性的腱鞘巨细胞瘤.术前X线发现有骨质破坏组术后复发率明显增高(P=0.003);术中接受化学方法灭活的病例术后复发率小于未接受化学方法灭活病例(P=0.042).结论:上肢腱鞘巨细胞瘤患者术后是否复发与肿瘤生长部位、是否有骨质破坏、是否采取术中化学灭活密切相关.局部切除是治疗上肢腱鞘巨细胞瘤的有效方案,配合术中化学方法灭活能够降低术后复发风险.如何在术中确定复发高危人群,降低其复发率及重建广泛切除肿瘤后的手功能是将来研究的重点和难点.%Objective:To study the relation of the sex,age,location and chemotherapy with recurrence of the tumor. Methods: From January 2000 to August 2010,47 patients with giant cell tumor of tendon sheath in upper extremity were retrospectively analyzed. Statistical analysis of sex,age at presentation,lesion location,chemical inactivation,surgical complications, tumor recurrence and pathological findings were explored. There were 28 females and 19 males,ranging in age from 17

  10. Archaeomagnetic study of five mounds from Upper Mesopotamia between 2500 and 700 BCE: Further evidence for an extremely strong geomagnetic field ca. 3000 years ago

    Science.gov (United States)

    Ertepinar, P.; Langereis, C. G.; Biggin, A. J.; Frangipane, M.; Matney, T.; Ökse, T.; Engin, A.

    2012-12-01

    The distribution of archaeomagnetic data in eastern Europe and the Near and Middle East shows a remarkable gap in Turkey. This study presents the first archaeomagnetic results from five different mounds in southeast Turkey, the northern part of Mesopotamia. The rock magnetic experiments indicate that in the majority of the samples the dominant magnetic carrier is magnetite, which is stable to heating to temperatures of 700 °C. In general, the demagnetization diagrams are single component and all five sets display well-defined characteristic magnetizations and clustered directions. For the period between 2500 and 700 BCE, the declinations are between 350° and 20° while inclinations are in the range of 49-64°. The directional results are compared with the global geomagnetic field models (CALS7k.2, ARCH3k_cst.1 and CALS3k.4) and the data from the archaeomagnetic database GEOMAGIA50v2. The results are coherent with both the data and the models except for two near-contemporaneous sets dating ˜2000 BCE, which are offset to the east by more than 20° with respect to CALS7k.2. Archaeointensity measurements were made using the microwave and conventional thermal Thellier methods applied to five sets of samples (four furnaces and a mud-brick wall). These yielded comparable and intriguing results. While those from the furnaces are slightly higher than the CALS7k.2 model and in agreement with the GEOMAGIA50v2 and the Middle East data, the results from the mud-brick wall suggest a high intensity of 100.8 μT (17.7×1022 Am2) at ˜1000 BCE. This result is in excellent agreement with recent claims of extremely high intensity measured in other regions of the Middle East for this time period though less consistent with these being associated with extremely short-lived events. Finally, we discuss our new and other recently published archaeointensity results in terms of geomagnetic intensity versus climate.

  11. An archaeomagnetic study of Upper Mesopotamia and Central Anatolia between 2500 and 700 BCE. Further evidence for an extremely strong geomagnetic field ca. 3000 years ago

    Science.gov (United States)

    Ertepinar, Pinar; Langereis, Cor; Biggin, Andrew; de Groot, Lennart

    2014-05-01

    The distribution of archaeomagnetic data in eastern Europe and the Near and Middle East shows a remarkable gap in Turkey. This study presents the first archaeomagnetic results from eight different archaeological sites in Central and Southeast Turkey. We sampled furnaces, burnt mud-brick walls, and granite and ignimbrite foundation stones. The rock magnetic experiments indicate that in the majority of the samples the dominant magnetic carrier is magnetite, which is stable to heating to temperatures of 700° C. In general, the demagnetization diagrams are single component and all sets display well-defined characteristic magnetizations and clustered directions. For the period between 2500 and 700 BCE, the declinations are between 350° and 20° while inclinations are in the range of 49-64° . The directional results are compared with the global geomagnetic field models (CALS7k.2, ARCH3k_cst.1 and CALS3k.4) and the data from the archaeomagnetic database GEOMAGIA50v2. The results are coherent with both the data and the models except for two near-contemporaneous sets dating ~2000 BCE, which are offset to the east by more than 20° with respect to CALS7k.2. Archaeointensity measurements were made using the microwave and conventional thermal Thellier methods, as well as the multi-specimen method. These different methods yielded comparable and intriguing results. While intensities from the furnaces are slightly higher than the CALS7k.2 model and in agreement with the GEOMAGIA50v2 and the Middle East data, the results from mud-brick walls suggest a high intensity of 100.8μT (17.7 x 1022 Am2 )at ~1000 BCE. This result is in excellent agreement with recent claims of extremely high intensity measured in other regions of the Middle East for this time period though less consistent with these being associated with extremely short-lived events. Finally, we discuss our new and other recently published archaeointensity results in terms of geomagnetic intensity versus climate.

  12. Principios de evaluación y resultados funcionales en los reimplantes de miembro superior Principles of evaluation and functional results in upper extremity replantation surgery

    Directory of Open Access Journals (Sweden)

    D. Camporro Fernández

    2012-09-01

    Full Text Available El objetivo de este trabajo es evaluar nuestros resultados funcionales y subjetivos en pacientes sometidos a reimplante de miembro superior. Medimos rango de movilidad articular, fuerza de la prensión y otros tests en 41 pacientes con edad media 44,8 años que sufrieron amputación de miembro superior y fueron sometidos a reimplante quirúrgico en nuestro hospital entre enero del 2005 y diciembre del 2009. Los resultados funcionales se midieron con la tabla de Mayo modificada para lesiones de pulgar, dedos largos y mano, distal a muñeca. Las amputaciones proximales a muñeca se evaluaron según los criterios de Chen. Los resultados subjetivos fueron documentados aplicando a todos los casos el cuestionario de Russell. La mayoría de las lesiones fueron provocadas por mecanismos de avulsión y 30 (74 % fueron accidentes laborales. La tasa final de supervivencia fue del 85 % (35 pacientes incluyendo 2 pacientes en los que se realizó trasplante de pie a mano para salvar la amputación. Aplicando la tabla de Mayo modificada, los resultados fueron buenos en pulgar y discretos en mano y dedos largos. En reimplantes proximales obtuvimos 1 resultado excelente y 2 discretos. Diecinueve pacientes retornaron al mundo laboral en una media de 10 meses. Veintisiete manifiestan satisfacción alta con los resultados obtenidos. Los resultados de cualquier reimplante deben superar los del cierre simple de una amputación. Aunque los resultados objetivos de la serie son moderados, muchos pacientes retornan al trabajo y la mayoría es capaz de realizar sus actividades cotidianas.The aim of this study was to evaluate functional and subjective outcome after upper limb replantation, with assessment or range of motions, grip strength, and additional functional tests. Forty-one patients, mean age 44.8 years old, with upper limb amputations were treated in our hospital with replantation between January 2005 and December 2009. Functional results were assessed by

  13. Arm positions and movement analysis that are used on the upper extremity in Bolu women dances

    Directory of Open Access Journals (Sweden)

    Nihal Ötken

    2011-07-01

    Full Text Available Folk dances are the cultural products that are created by the people and transferred from generation to generation. These cultural products have a very rich variety that differs from region to region, in terms of style and type. These differences are tight-knit with the past, civilization level, beliefs and traditions of a society which creates every dance. These differences also reveal themselves on elements, such as the movement styles used during the dance, dance forms, the accompanying music, rhythm and costume. Thus, the differences that are seen on all of these factors appear as the dance richness. Being a part of this richness, Bolu women dances have a remarkable significance among the folk dances, as well.The process of recording and analyzing the movement scientifically has been made with a gradually increasing consciousness in also folk dances, just like in all other disciplines related to the body. Considering that our folk dances have been changing each passing day as a part of the tradition as well, it is inevitable to determine our existing dances in terms of all of the elements that constitute them and hand them down the next generations. Therefore, some of the women dances of the region of Bolu, Which is a small city in Turkey, will be discussed in terms of the factor of movement that constitutes the dance and examined in this article. The arm positions that are used on the upper extremity which is one of the main parts of the body in the dances of Adayolu, Men men, Karaköy Sekmesi, Ziller, Estireyim mi, Halimem, Değirmen and Ördek that are still being performed by women in the center and villages of Bolu, were determined through being assessed via some video images that are shot during various shows and competitions. These determined positions were exposed by digital camera records that were taken for this study one by one and the determined visual material was computerized with the help of various programs. After this phase

  14. Arm positions and movement analysis that are used on the upper extremity in Bolu women dances

    Directory of Open Access Journals (Sweden)

    Nihal Ötken

    2011-07-01

    Full Text Available Folk dances are the cultural products that are created by the people and transferred from generation to generation. These cultural products have a very rich variety that differ from region to region, in terms of style and type. These differences are tight-knit with the past, civilization level, beliefs and traditions of a society which creates every dance. These differences also reveal themselves on elements, such as the movement styles used during the dance, dance forms, the accompanying music, rhythm and costume. Thus, the differences that are seen on all of these factors appear as the dance richness. Being a part of this richness, Bolu women dances have a remarkable significance among the folk dances, as well. The process of recording and analysing the movement scientifically has been made with a gradually increasing consciousness in also folk dances, just like in all other disciplines related to the body. Considering that our folk dances have been changing each passing day as a part of the tradition as well, it is inevitable to determine our existing dances in terms of all of the elements that constitute them and hand them down the next generations. Therefore, some of the women dances of the region of Bolu, Which is a small city in Turkey, will be discussed in terms of the factor of movement that constitutes the dance and examined in this article. The arm positions that are used on the upper extremity which is one of the main parts of the body in the dances of Adayolu, Men men, Karaköy Sekmesi, Ziller, Estireyim mi, Halimem, Değirmen and Ördek that are still being performed by women in the center and villages of Bolu, were determined through being assessed via some video images that are shot during various shows and competitions. These determined positions were exposed by digital camera records that were taken for this study one by one and the determined visual material was computerized with the help of various programs. After this

  15. Statistics of extremes

    CERN Document Server

    Gumbel, E J

    2012-01-01

    This classic text covers order statistics and their exceedances; exact distribution of extremes; the 1st asymptotic distribution; uses of the 1st, 2nd, and 3rd asymptotes; more. 1958 edition. Includes 44 tables and 97 graphs.

  16. The MR trainer. Upper extremities. 2. rev. and enl. ed.; Der MR-Trainer. Obere Extremitaet

    Energy Technology Data Exchange (ETDEWEB)

    Breitenseher, Martin [Landesklinikum Waldviertel Horn (Austria). Inst. fuer Radiologie und Interventionelle Radiologie

    2016-05-01

    The MR (magnetic resonance) trainer covers the indications in NMR images of hands, elbows and shoulder, including fractures and instabilities at the wrist, tendon and ligament lesions, carpal tunnel syndrome, ulnar tunnel syndrome, scaphoid bone fracture, (posttraumatic) osteonecrosis, synovial lesions, luxations, osteocondrosis, soft tissue rumors and bone tumors. The book includes training tasks for each issue.

  17. Upper Extremity Functional Evaluation by Fugl-Meyer Assessment Scoring Using Depth-Sensing Camera in Hemiplegic Stroke Patients.

    Directory of Open Access Journals (Sweden)

    Won-Seok Kim

    Full Text Available Virtual home-based rehabilitation is an emerging area in stroke rehabilitation. Functional assessment tools are essential to monitor recovery and provide current function-based rehabilitation. We developed the Fugl-Meyer Assessment (FMA tool using Kinect (Microsoft, USA and validated it for hemiplegic stroke patients. Forty-one patients with hemiplegic stroke were enrolled. Thirteen of 33 items were selected for upper extremity motor FMA. One occupational therapist assessed the motor FMA while recording upper extremity motion with Kinect. FMA score was calculated using principal component analysis and artificial neural network learning from the saved motion data. The degree of jerky motion was also transformed to jerky scores. Prediction accuracy for each of the 13 items and correlations between real FMA scores and scores using Kinect were analyzed. Prediction accuracies ranged from 65% to 87% in each item and exceeded 70% for 9 items. Correlations were high for the summed score for the 13 items between real FMA scores and scores obtained using Kinect (Pearson's correlation coefficient = 0.873, P<0.0001 and those between total upper extremity scores (66 in full score and scores using Kinect (26 in full score (Pearson's correlation coefficient = 0.799, P<0.0001. Log transformed jerky scores were significantly higher in the hemiplegic side (1.81 ± 0.76 compared to non-hemiplegic side (1.21 ± 0.43 and showed significant negative correlations with Brunnstrom stage (3 to 6; Spearman correlation coefficient = -0.387, P = 0.046. FMA using Kinect is a valid way to assess upper extremity function and can provide additional results for movement quality in stroke patients. This may be useful in the setting of unsupervised home-based rehabilitation.

  18. SWALLOWED FISH BONES IN MALI

    Directory of Open Access Journals (Sweden)

    Sacko HB

    2015-07-01

    Full Text Available Objective: To study the different aspects, clinical, diagnostic and therapeutic of 114 cases of fish bones in the upper digestive tract . Methods: One hundred fourteen patients with fish bones suspected in the upper digestive tract were admitted in our department between February 2010 and October 2012. Results: There was a predominance of the male: 66 men (58%. The average age of the patients was 26 years with extremes 3 to 62 years old. The tongue base and vallecula are constituted the principals locations 66.66%. In the majority of the cases the fish bones were removed by direct pharyngoscopy in 43.86 %. We have not notified any serious complications. Conclusion: Therefore this study shows the foreign fish bones are frequently just as well in children as adult. The fish bones are particularly lodged in tongue base. The classical methods of extraction are permit to remove the all foreign fish bones.

  19. Survival of extreme opinions

    Science.gov (United States)

    Hsu, Jiann-wien; Huang, Ding-wei

    2009-12-01

    We study the survival of extreme opinions in various processes of consensus formation. All the opinions are treated equally and subjected to the same rules of changing. We investigate three typical models to reach a consensus in each case: (A) personal influence, (B) influence from surroundings, and (C) influence to surroundings. Starting with uniformly distributed random opinions, our calculated results show that the extreme opinions can survive in both models (A) and (B), but not in model (C). We obtain a conclusion that both personal influence and passive adaptation to the environment are not sufficient enough to eradicate all the extreme opinions. Only the active persuasion to change the surroundings eliminates the extreme opinions completely.

  20. Upper Extremity Functional Evaluation by Fugl-Meyer Assessment Scoring Using Depth-Sensing Camera in Hemiplegic Stroke Patients.

    Science.gov (United States)

    Kim, Won-Seok; Cho, Sungmin; Baek, Dongyoub; Bang, Hyunwoo; Paik, Nam-Jong

    2016-01-01

    Virtual home-based rehabilitation is an emerging area in stroke rehabilitation. Functional assessment tools are essential to monitor recovery and provide current function-based rehabilitation. We developed the Fugl-Meyer Assessment (FMA) tool using Kinect (Microsoft, USA) and validated it for hemiplegic stroke patients. Forty-one patients with hemiplegic stroke were enrolled. Thirteen of 33 items were selected for upper extremity motor FMA. One occupational therapist assessed the motor FMA while recording upper extremity motion with Kinect. FMA score was calculated using principal component analysis and artificial neural network learning from the saved motion data. The degree of jerky motion was also transformed to jerky scores. Prediction accuracy for each of the 13 items and correlations between real FMA scores and scores using Kinect were analyzed. Prediction accuracies ranged from 65% to 87% in each item and exceeded 70% for 9 items. Correlations were high for the summed score for the 13 items between real FMA scores and scores obtained using Kinect (Pearson's correlation coefficient = 0.873, Phemiplegic side (1.81 ± 0.76) compared to non-hemiplegic side (1.21 ± 0.43) and showed significant negative correlations with Brunnstrom stage (3 to 6; Spearman correlation coefficient = -0.387, P = 0.046). FMA using Kinect is a valid way to assess upper extremity function and can provide additional results for movement quality in stroke patients. This may be useful in the setting of unsupervised home-based rehabilitation.

  1. Study of treating tibial large bone defect with migration of lengthened bone segment in goats

    Institute of Scientific and Technical Information of China (English)

    YANG liu; LI Qi-hong; ZHOU Zhong-an; TAN Zu-jian; PENG Yi-liang

    2001-01-01

    To study the effects of migration of lengthened bone segment (MLBS) on the blood circulation and repair remodeling process at the ends of large bone defect of a long bone. Methods: A total of 18 adult goats were used and more than 35% of the original length of their left tibia was resected. Upper metaphysiotomy to lengthen upper part of the tibia was done and the lengthened bone segment was migrated to repair the large bone defect. The results were observed with X-ray films, Chinese-ink permeated transparent sections and histological study. Results: After MLBS, the defect ends of the tibia were supplied with abundant blood circulation which resulted in rapid and solid long bone healing. Conclusion: Repair of large bone defect of long bones with MLBS provides a new method for clinical practice.

  2. Spoof surface plasmon-based bandpass filter with extremely wide upper stopband

    Science.gov (United States)

    Xiaoyong, Liu; Lei, Zhu; Yijun, Feng

    2016-03-01

    We investigate the guiding modes of spoof surface plasmon polaritons (SPPs) on a symmetric ultra-thin plasmonic structure. From the analysis, we deduce the operating frequency region of the single-mode propagation. Based on this property, a spoof SPPs lowpass filter is then constituted in the microwave frequency. By introducing a transmission zero at the lower frequency band using a pair of stepped-impedance stubs, a wide passband filter is further realized. The proposed filter is fed by a transducer composed of a microstrip line with a flaring ground. The simulated results show that the presented filter has an extremely wide upper stopband in addition to excellent passband filtering characteristics such as low loss, wide band, and high square ratio. A prototype passband filter is also fabricated to validate the predicted performances. The proposed spoof-SPPs filter is believed to be very promising for other surface waveguide components in microwave and terahertz bands. Project supported by the Key Grant Project of Ministry of Education of China (Grant No. 313029), the FDCT Research Grant from Macao Science and Technology Development Fund, China (Grant No. 051/2014/A1), and the Multi-Year Research Grant from University of Macau, Macau SAR, China (Grant No. MYRG2014-00079-FST).

  3. [Remote intelligent Brunnstrom assessment system for upper limb rehabilitation for post-stroke based on extreme learning machine].

    Science.gov (United States)

    Wang, Yue; Yu, Lei; Fu, Jianming; Fang, Qiang

    2014-04-01

    In order to realize an individualized and specialized rehabilitation assessment of remoteness and intelligence, we set up a remote intelligent assessment system of upper limb movement function of post-stroke patients during rehabilitation. By using the remote rehabilitation training sensors and client data sampling software, we collected and uploaded the gesture data from a patient's forearm and upper arm during rehabilitation training to database of the server. Then a remote intelligent assessment system, which had been developed based on the extreme learning machine (ELM) algorithm and Brunnstrom stage assessment standard, was used to evaluate the gesture data. To evaluate the reliability of the proposed method, a group of 23 stroke patients, whose upper limb movement functions were in different recovery stages, and 4 healthy people, whose upper limb movement functions were normal, were recruited to finish the same training task. The results showed that, compared to that of the experienced rehabilitation expert who used the Brunnstrom stage standard table, the accuracy of the proposed remote Brunnstrom intelligent assessment system can reach a higher level, as 92.1%. The practical effects of surgery have proved that the proposed system could realize the intelligent assessment of upper limb movement function of post-stroke patients remotely, and it could also make the rehabilitation of the post-stroke patients at home or in a community care center possible.

  4. Extrinsic and intrinsic index finger muscle attachments in an OpenSim upper-extremity model.

    Science.gov (United States)

    Lee, Jong Hwa; Asakawa, Deanna S; Dennerlein, Jack T; Jindrich, Devin L

    2015-04-01

    Musculoskeletal models allow estimation of muscle function during complex tasks. We used objective methods to determine possible attachment locations for index finger muscles in an OpenSim upper-extremity model. Data-driven optimization algorithms, Simulated Annealing and Hook-Jeeves, estimated tendon locations crossing the metacarpophalangeal (MCP), proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints by minimizing the difference between model-estimated and experimentally-measured moment arms. Sensitivity analysis revealed that multiple sets of muscle attachments with similar optimized moment arms are possible, requiring additional assumptions or data to select a single set of values. The most smooth muscle paths were assumed to be biologically reasonable. Estimated tendon attachments resulted in variance accounted for (VAF) between calculated moment arms and measured values of 78% for flex/extension and 81% for ab/adduction at the MCP joint. VAF averaged 67% at the PIP joint and 54% at the DIP joint. VAF values at PIP and DIP joints partially reflected the constant moment arms reported for muscles about these joints. However, all moment arm values found through optimization were non-linear and non-constant. Relationships between moment arms and joint angles were best described with quadratic equations for tendons at the PIP and DIP joints. PMID:25281408

  5. Short-term effects of teriparatide versus placebo on bone biomarkers, structure, and fracture healing in women with lower-extremity stress fractures: A pilot study

    Directory of Open Access Journals (Sweden)

    Ellen A. Almirol

    2016-09-01

    Conclusions: In this randomized, pilot study, brief administration of TPTD showed anabolic effects that TPTD may help hasten fracture healing in premenopausal women with lower-extremity stress fractures. Larger prospective studies are warranted to determine the effects of TPTD treatment on stress fracture healing in premenopausal women.

  6. Statistics of Extremes

    KAUST Repository

    Davison, Anthony C.

    2015-04-10

    Statistics of extremes concerns inference for rare events. Often the events have never yet been observed, and their probabilities must therefore be estimated by extrapolation of tail models fitted to available data. Because data concerning the event of interest may be very limited, efficient methods of inference play an important role. This article reviews this domain, emphasizing current research topics. We first sketch the classical theory of extremes for maxima and threshold exceedances of stationary series. We then review multivariate theory, distinguishing asymptotic independence and dependence models, followed by a description of models for spatial and spatiotemporal extreme events. Finally, we discuss inference and describe two applications. Animations illustrate some of the main ideas. © 2015 by Annual Reviews. All rights reserved.

  7. 作业疗法对脑卒中患者上肢运动功能的影响%Effect of Occupational Therapy on Upper Extremity Function in Stroke Patients

    Institute of Scientific and Technical Information of China (English)

    邸叶青; 韩振萍; 马将

    2011-01-01

    Objective: To investigate the effect of occupational therapy on stroke patients with motor dysfunction of upper extremities. Methods: Forty patients with stoke, aged from 60 to 75 years, were randomly divided into the occupational therapy group (n= 20) and control group (n = 20). Both two groups received exercise therapy, including active movement,passive movement and motor imagery therapy, etc. Besides, patients in the occupational therapy group received occupational therapy additionally, including the training of control ability of upper limbs, the training of ROM and the training of mental movement. The motor function of upper extremities was evaluated by Fugl-Meyer Assessment (FMA) before and 2, 4, 8 weeks after treatment. Results: The scores of FMA in occupational therapy group were continually increased from 2nd week, 8th week>4th week>2nd week (P<0. 05 ). The scores of FMA in control group were increased from 4th week (P<0.05). The scores of FMA in occupational therapy group were significantly higher than in control group at each time point (P<0.05 or P<0.01). Conclusion: Early intervention of occupational therapy in stroke patients with hemiplegia can provide positive effects on recovery of upper extremities function.%目的:比较两种不同的康复治疗技术对存在有上肢运动功能障碍的脑卒中患者的治疗作用.方法:40例脑卒中患者随机分为作业组和对照组各20例,均配合运动疗法,包括主被动运动,运动想象等.作业组增加作业疗法,主要内容为上肢控制能力、关节活动度及精细动作训练.训练前及训练2、4、6及8周时均采用Fugl-Meyer评定量表(FMA)对2组患者上肢运动功能评分.结果:与训练前比较,作业组在介入训练2周后FMA评分持续上升,8周>4周>2周;对照组在训练4周后FMA评分开始上升,作业组在各训练时间段FMA评分均高于对照组(均P<0.05,0.01).结论:早期介入作业疗法对脑卒中偏瘫患者

  8. Effects of denosumab on bone mineral density and bone turnover in postmenopausal women.

    Science.gov (United States)

    Wensel, Terri M; Iranikhah, Maryam M; Wilborn, Teresa W

    2011-05-01

    Osteoporosis is a degenerative bone disease affecting approximately 10 million American adults. Several options are available to prevent development of the disease or slow and even stop its progression. Nonpharmacologic measures include adequate intake of calcium and vitamin D, exercise, fall prevention, and avoidance of tobacco and excessive alcohol intake. Current drug therapy includes bisphosphonates, calcitonin, estrogen or hormone therapy, selective estrogen receptor modulators, and teriparatide. Denosumab, a receptor activator of nuclear factor-K B ligand (RANKL) inhibitor, was recently approved by the United States Food and Drug Administration for treatment of postmenopausal osteoporosis. Patients treated with denosumab experienced significant gains in bone mineral density, rapid reductions in markers of bone turnover, and a reduced risk for new vertebral fracture. Compared with placebo, patients receiving denosumab 60 mg subcutaneously once every 6 months experienced gains in bone mineral density of 6.5-11% when treated for 24-48 months. One trial demonstrated the superiority of denosumab compared with alendronate, but the differences were small. The most common adverse reactions to denosumab include back pain, pain in extremities, musculoskeletal pain, and cystitis. Serious, but rare, adverse reactions include the development of serious infections, dermatologic changes, and hypocalcemia. The recommended dosing of denosumab is 60 mg every 6 months as a subcutaneous injection in the upper arm, upper thigh, or abdomen. Although beneficial effects on bone mineral density and fracture rate have been established in clinical trials, the risks associated with denosumab must be evaluated before therapy initiation. Of concern is the risk of infection, and denosumab should likely be avoided in patients taking immunosuppressive therapy or at high risk for infection. Therefore, bisphosphonates will likely remain as first-line therapy. Denosumab should be considered in

  9. Upper end plug of fuel rod

    International Nuclear Information System (INIS)

    The present invention concerns a seal-welding of an upper end plug of a fuel rod for nuclear fuels conducted in a final stage of molding fabrication of the fuel rod in a pressurized helium gas. A welding protrusion is formed at the periphery of a vent hole on the upper surface of the upper end plug, and the welding protrusion is melted by irradiation of laser beams. The melted protrusion intrudes into the end portion of the bent hole by capillary to close the vent hole. The upper end plug can be closed by an extremely simple operation of irradiating the laser beams to the protrusion. Control for electrode gap on every fuel rods and exchange for the electrodes as in TIG welding can be saved, thereby enabling to speed up and simplify the sealing operation for the upper end plug. (N.H.)

  10. Discourse of gender extremism

    Directory of Open Access Journals (Sweden)

    Butaeva M. A.

    2010-06-01

    Full Text Available The phenomenon of a gender discourse, being interdisciplinary on the base properties, interests also representatives of social philosophy, sociology, social psychology, cultural science, economic and legal sciences. In a gender discourse it is possible to allocate masculinistic and feministic currents. These organizations are bright representatives of gender extremism.

  11. Discourse of gender extremism

    OpenAIRE

    Butaeva M. A.

    2010-01-01

    The phenomenon of a gender discourse, being interdisciplinary on the base properties, interests also representatives of social philosophy, sociology, social psychology, cultural science, economic and legal sciences. In a gender discourse it is possible to allocate masculinistic and feministic currents. These organizations are bright representatives of gender extremism.

  12. Estimation of levels of radiation in the upper and lower extremities of interventional physicians;Estimativa dos niveis de radiacao nas extremidades superiores e inferiores de medicos intervencionistas

    Energy Technology Data Exchange (ETDEWEB)

    Rodrigues, B.B.O. [Universidade Federal do Rio de Janeiro (PEN/COPPE/UFRJ), RJ (Brazil). Coordenacao dos Programas de Pos-Graduacao de Engenharia. Programa de Energia Nuclear; Lima, A.L.S.; Silva, M.W.; Mione, F.R.; Canevaro, L.V.; Mauricio, C.L.P. [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil)

    2009-07-01

    Interventional cardiology procedures are, in general, associated with high doses in patients and professionals. The objective of this study is to measure the radiation levels on the hands and left knees of professionals. The professional dosimetry was performed in three departments of hemodynamics of Rio de Janeiro in procedures of coronary angiography of percutaneous transluminal coronary angioplasty (PTCA) and electrophysiology. For this, we used thermoluminescent dosimeters of LiF: Mg, Ti to monitor the knee and left wrist of professional. The results show a higher dose of radiation in the left knee on the left wrist. This is due to the proximity of the X-ray tube. The lack of an adequate quality control in equipment can raise the levels of exposure of professionals. Due to the non-homogeneous exposure of professionals, in some cases it is recommended the use of additional dosimeters and quality control in the X-ray equipment. (author)

  13. Statistics of Local Extremes

    DEFF Research Database (Denmark)

    Larsen, Gunner Chr.; Bierbooms, W.; Hansen, Kurt Schaldemose

    2003-01-01

    . A theoretical expression for the probability density function associated with local extremes of a stochasticprocess is presented. The expression is basically based on the lower four statistical moments and a bandwidth parameter. The theoretical expression is subsequently verified by comparison with simulated...

  14. Effect of Neural Feedback Rehabilitation Training for Upper Extremity Exercise Function of Stroke Patients%神经反馈康复训练对脑卒中患者上肢运动功能的作用

    Institute of Scientific and Technical Information of China (English)

    李明芬; 贾杰; 刘烨; 吴毅; 刘斯饶

    2013-01-01

    目的:研究基于脑机接口的神经反馈康复训练对脑卒中患者上肢运动功能的作用及其机制。方法:15名脑卒中后严重上肢运动功能障碍患者随机分为观察组与对照组,两组均接受常规康复训练,观察组另予BCI神经反馈康复训练,对照组予BCI随机反馈康复训练;评价两组FMA、ARAT及ERD。结果:观察组FMA及ARAT评分显著高于对照组(P<0.05);观察组患侧脑区ERD显著强于对照组(P<0.05)。结论:基于BCI的神经反馈康复训练可改善脑卒中患者的上肢运动功能,增强患者患侧脑区ERD强度,促进患者功能重塑。%Objective:To investigate the effect of neural feedback rehabilitation training based on brain computer interface (BCI) for stroke patients’ upper extremity exercise function. Methods:15 stroke patients were randomly divided into observation group and control group, two groups received routine rehabilitation training, the observation group were additionally treated with BCI neural feedback rehabilitation training, while the control group was treated for BCI random feedback rehabilitation training;evaluation of two groups of Fugl-Meyer Motor Assessment (FMA), Action Re-search Arm Test (ARAT) and Event-Related Desynchronization (ERD). Results:FMA and ARAT in observation group was significantly higher than that of control group (P<0.05);observation group ipsilateral brain ERD was significantly stronger than that in the control group (P<0.05). Conclu-sion:Neural feedback rehabilitation training based on BCI can improve stroke patients’upper extremity exercise function and can enhance ERD of affected hemisphere, which may promote stroke patients’brain reorganization.

  15. NEW ABELISAURID MATERIAL FROM THE UPPER CRETACEOUS (CENOMANIAN OF MOROCCO

    Directory of Open Access Journals (Sweden)

    SIMONE D'ORAZI PORCHETTI

    2011-11-01

    Full Text Available Fragmentary cranial bones of dinosaur origin have been recently recovered from the Kem Kem beds (Upper Cretaceous, Cenomanian of Morocco. They include two incompletely preserved maxillary bones evidencing diagnostic features of abelisaurid theropods. These new finds provide further evidence of Abelisauridae in the Late Cretaceous of Morocco. 

  16. Bone marrow stem cell transplantation for lymphedema of the extremities%干细胞移植治疗肢体淋巴肿29例临床研究

    Institute of Scientific and Technical Information of China (English)

    孙岩; 阴法文; 金星; 吴学君; 袁海; 周华; 高斌斌

    2012-01-01

    目的:探讨自体骨髓基质干细胞移植术治疗肢体淋巴水肿.方法:回顾性分析山东大学附属省立医院血管外科2008年8月-2011年6月采用自体骨髓基质干细胞移植术治疗的29例淋巴肿患者的临床资料.结果:抽取骨髓过程中2例出现乏力症状,第2天好转,其余患者均无异常.分离的单个核细胞计数为(110 ~ 820)×108 mL-1,干细胞移植过程顺利.术后有3例患者自述患肢局部注射部位发热、胀痛感,后逐渐缓解,无其他明显并发症.平均随访18.3个月,10例患者肢围较术前无明显改善,但肢体皮质硬化程度有所下降;19例患者患肢与健肢周径之差明显减小,未发现明显并发症.结论:骨髓间充质干细胞移植治疗淋巴水肿在理论上具有可行性,但远期安全问题需密切关注.%Objective:To explore autologous bone marrow stem cell transplantation for lym phedema of the extremities. Methods: Retrospective analysis of 29 cases of lymphedema of the extremities hospitalized in department of vascular surgery, Provincial Hospital affiliated to Shandong University from Aug 2008 to Jun 2011. All patients underwent autologous bone marrow stem cell transplantation and were followed up after discharge from hospital. Results: Bone marrow aspiration was performed successfully in all patients. Besides, 2 patients felt week during the procedure but recovered well after the aspiration. The number of isolated mononuclear cell was 110~820 ×108 mL-1 Subsequent bone marrow stem cell transplantation was successfully performed in all patients. No intraoperative and postoperative complications occurred, except 3 patients felt fever and pain on operative location but gradually decreased. The average follow- up was 18.3 months, Swelling of the extremities were improved obviously in 19 patients, but not improved in 10 patients. However, scle-roderma of the extremities in these 10 patients was alleviated. Conclusion* Autologous bone marrow stem

  17. Varus deformity of the left lower extremity causing degenerative lesion of the posterior horn of the left medial meniscus in a patient with Paget’s disease of bone

    Directory of Open Access Journals (Sweden)

    Al Kaissi, Ali

    2014-09-01

    Full Text Available [english] We report on a 42-year-old woman who presented with persistent pain in her left knee with no history of trauma. Sagittal T1-weighted MRI of the left knee showed discontinuity between the anterior and posterior horns of the left medial meniscus, causing effectively the development of degenerative lesion of the posterior horn. The latter was correlated to varus deformity of the left lower extremity associated with subsequent narrowing of the medial knee joint. The unusual craniofacial contour of the patient, the skeletal survey and the elevated serum alkaline phosphatase were compatible with the diagnosis of Paget’s disease of the bone. To alleviate the adverse effect of the mal-alignment of the left femur onto the left knee, corrective osteotomy of the left femoral diaphysis by means of fixators was performed. To the best of our knowledge this is the first clinical report describing the management and the pathological correlation of a unilateral varus deformity of the femoral shaft and degenerative lesions of the left knee in a patient with Paget’s disease of the bone.

  18. Hormonal and neuromuscular responses to mechanical vibration applied to upper extremity muscles.

    Directory of Open Access Journals (Sweden)

    Riccardo Di Giminiani

    Full Text Available OBJECTIVE: To investigate the acute residual hormonal and neuromuscular responses exhibited following a single session of mechanical vibration applied to the upper extremities among different acceleration loads. METHODS: Thirty male students were randomly assigned to a high vibration group (HVG, a low vibration group (LVG, or a control group (CG. A randomized double-blind, controlled-parallel study design was employed. The measurements and interventions were performed at the Laboratory of Biomechanics of the University of L'Aquila. The HVG and LVG participants were exposed to a series of 20 trials ×10 s of synchronous whole-body vibration (WBV with a 10-s pause between each trial and a 4-min pause after the first 10 trials. The CG participants assumed an isometric push-up position without WBV. The outcome measures were growth hormone (GH, testosterone, maximal voluntary isometric contraction during bench-press, maximal voluntary isometric contraction during handgrip, and electromyography root-mean-square (EMGrms muscle activity (pectoralis major [PM], triceps brachii [TB], anterior deltoid [DE], and flexor carpi radialis [FCR]. RESULTS: The GH increased significantly over time only in the HVG (P = 0.003. Additionally, the testosterone levels changed significantly over time in the LVG (P = 0.011 and the HVG (P = 0.001. MVC during bench press decreased significantly in the LVG (P = 0.001 and the HVG (P = 0.002. In the HVG, the EMGrms decreased significantly in the TB (P = 0.006 muscle. In the LVG, the EMGrms decreased significantly in the DE (P = 0.009 and FCR (P = 0.006 muscles. CONCLUSION: Synchronous WBV acutely increased GH and testosterone serum concentrations and decreased the MVC and their respective maximal EMGrms activities, which indicated a possible central fatigue effect. Interestingly, only the GH response was dependent on the acceleration with respect to the subjects' responsiveness.

  19. The characteristic appearance and analysis of H reflex in hemiplegic upper extremity patients with post-stroke%H反射在脑卒中后上肢偏瘫患者中的特征表现及分析

    Institute of Scientific and Technical Information of China (English)

    李红玲; 徐凌娇; 岳崴; 刘春辉; 潘拴针; 王淑英

    2012-01-01

    Objective: To investigate the valuable application of H reflex in electrophysiological evaluation by study of the relationship between the characteristic appearance of H reflex and muscular tone of affected side in upper extremity of hemiplegic patients post-stroke.Method: Forty-two hemiplegic inpatients with post-stroke in convalescence stage who fulfilled the study entry criteria were in various levels of upper extremity dysfunction. The H reflex examination was given to abductor polli- cis brevis (APB) dominanted by median nerve, abductor digiti minimi (ADM) dominanted by ulnar nerve, extensor digitorum communis dominanted by radial nerve of the patients' both affected and unaffected sides. At the same time, affected upper extremity was assessed by modified Ashworth scale (MAS), to determine whether H reflex could be easily obtained from all the nerves above mentioned. Then the changes in H reflex latencies and ratios of Hmax/Mmax of both sides were compared; the correlation between MAS and H reflex latency and Hmax/Mmax ratio in affected upper extremities were analysed.Result: H reflex was easily obtained from APB dominanted by median nerve, ADM dominanted by ulnar nerve of both sides, and the elicitation rates were 100%. But elicitation rate of extensor digitorum communis dominanted by radial nerve was only 7.14%. The mean (SD) H reflex latencies for medium nerve and ulnar nerve of affected sides were (25.89 ± 3.66)ms and (25.71 ± 3.26)ms respectirely, and those of unaffected sides were (26.60 ± 3.1 l)ms and (26.44 ± 2.87)ms recpectively. The medians of Hmax/Mmax ratio value for the median nerve and ulnar nerve of affected sides were 0.185 and 0.217 respectively, and those of unaffected sides were 0.126 and 0.112 respectively. The H reflex latency reduced and the Hmax/Mmax ratio increased in affected side comparing with unaffected side for median nerve and ulnar nerve, and the differences of both sides were statistically significant(P<0.05). By using

  20. Tromboflebitis en miembro superior como origen de un tromboembolismo pulmonar masivo: A propósito de un caso Thromboflebitis in upper extremity as origin of a massive pulmonary embolism: A case report

    Directory of Open Access Journals (Sweden)

    S. Díaz

    2005-01-01

    Full Text Available El tromboembolismo pulmonar (TEP masivo es una de las causas de muerte súbita en el adulto que se encuentra con frecuencia nada despreciable en las autopsias forenses. El origen del trombo suele ser una trombosis venosa profunda de las extremidades inferiores en el contexto de una enfermedad tromboembólica venosa. No obstante, en ocasiones, el origen del trombo se encuentra en las extremidades superiores como consecuencia de una tromboflebitis. Presentamos el caso de un paciente ingresado en un hospital, por patología digestiva, en el que se produce una tromboflebitis del miembro superior izquierdo donde portaba una vía intravenosa falleciendo de forma súbita. La autopsia demostró que la causa de la muerte era un TEP masivo. Las implicaciones médico legales del TEP no solo se limitan a determinar la causa de la muerte sino que puede ser necesaria la valoración de una supuesta mala praxis por interposición de una denuncia.Pulmonary thromboembolism is commonly associated with sudden death in adults and is a frequent post-mortem finding in forensic autopsies. The emboli aetiology and emplacement are usually related to deep vein thrombosis in lower extremities in the context of a venous thromboembolic disease. However, in some cases, the origin of the thrombus is located in the upper extremities as a result of a thromboflebitis. A case is presented of a patient admitted in hospital with bowel disease who died suddenly after intravenous therapy with thromboflebitis in the left arm. The post-mortem study showed a massive pulmonary embolism as the cause of death. The forensic implications of pulmonary embolism not only imply the investigation of the cause of death but it could also be related, in some cases, to the evaluation of malpractice claims.

  1. Prevalence of musculoskeletal pain of the neck, upper extremities and lower back among dental practitioners working in Riyadh, Saudi Arabia: a cross-sectional study

    OpenAIRE

    Al-Mohrej, Omar A.; AlShaalan, Nouf S; Al-Bani, Waad M; Masuadi, Emad M; Almodaimegh, Hind S

    2016-01-01

    Objectives Studies have shown that dentists have a higher incidence of work-related musculoskeletal (MSK) pain than those in other occupations. The risk factors contributing to MSK pain among Saudi dentists has not been fully studied so this study aims to estimate the prevalence of MSK pain and investigate its associated risk factors among dentists in Saudi Arabia. Setting and participants A cross-sectional survey was carried out in the capital city Riyadh, Saudi Arabia, using random cluster ...

  2. Image diagnosis of nasal bone fracture

    International Nuclear Information System (INIS)

    Twenty cases of nasal bone fractures were evaluated as to the types of fractures based upon HRCT findings. Conventional X-Ray films for nasal bones were analyzed and compared with HRCT findings. Nasal bone fractures were classified into lateral and frontal fractures. HRCT images were evaluated in three planes including upper, middle and lower portions of the nasal bone. Fractures favored males of teens. Lateral fracture gave rise to the fractures of the nasal bone opposite to the external force, loosening of the ipsilateral nasomaxillary sutures and fractures of the frontal process of the maxilla. Conventional X-Ray films were reevaluated after HRCT evaluation and indications of nasal bone fractures were determined. In addition to the discontinuity of the nasal dorsum, fracture lines parallel to and beneath the nasal dorsum and indistinct fracture lines along the nasomaxillary sutures are the indication of nasal bone fractures by conventional X-Ray films. (author)

  3. Abdominal Skin Flaps in the Repair of 108 Patients with Complex Defects of Upper Extremity%腹部皮瓣修复上肢复杂损伤108例

    Institute of Scientific and Technical Information of China (English)

    王恒; 胡洪良; 沈卫军; 王战磊; 闫纪涛; 龚俊武

    2016-01-01

    目的:探讨应用腹部皮瓣修复上肢复杂损伤的临床疗效及安全性。方法:回顾性分析2011年8月-2014年8月在本院接受腹部皮瓣修复上肢复杂损伤的108例患者的临床资料。术后随访6~12个月,观察修复效果。结果:108例患者皮瓣均成活,其中101例获得随访,随访率为93.5%。随访101例患者皮瓣血运良好,皮瓣质地柔软,厚度适中,触之弹性较好,皮瓣恢复保护性感觉,两点分辨觉15 mm左右。供区愈合良好,无明显瘢痕,仅有少量增生,上肢功能基本得到恢复。1例患者因皮瓣下血肿压迫出现皮瓣供血障碍,经拆除部分缝线后血运恢复;2例多指脱套损伤患者在修复后对外观不甚满意,经二期整形修复后满意出院;2例手部掌背两侧复合脱套伤患者修复后精细活动功能受到轻微的影响。101例随访患者中96例评价满意,满意率为95.0%。结论:腹部皮瓣适用于修复各类上肢复杂性损伤,安全可靠。不过,临床需要加强修复过程的护理,以切实减少后遗症,提高患者生存质量。%Objective:To investigate the clinical efficacy and safety of the application of abdominal skin flaps in the repair of complex defects of upper extremity.Method:The clinical data of 108 patients with complex defects of upper extremity who accepted abdominal skin flaps admitted to our hospital from August 2011 to August 2014 were retrospectively analyzed.The postoperative followed-up was taken for 6 to 12 months,the repair effects were observed.Result:All flaps of the 108 cases survived,and 101 cases got followed-up service,so the follow-up rate was 93.5%.The flaps of the followed-up 101 cases were soft with good blood circulation,the thickness of the skin was moderate,the elasticity of the skin was good with touching,the sense of protection of the skin flaps restored,the two-point-discrimination of the digits was 15 mm.The donor sites healed

  4. Effect of occupational therapy on upper extremity function and daily activities in spastic hemiplegic cerebral palsied children%作业治疗对痉挛型偏瘫患儿上肢运动功能的影响

    Institute of Scientific and Technical Information of China (English)

    张洪梅; 姜南; 赵晓科; 高夫宁

    2012-01-01

    Objective To investigate the occupational therapeutic effect on the upper extremity function and daily activities in spastic hemiplegic cerebral palsied childrea Methods Thirty children with spastic hemiplegic cerebral palsy were equally randomized into two groups of A (treated with occupational therapy plus conventional treatments of exercise, massage and neuromuscular electrostimulation) and B( treated with conventional treatments alone). The fine motor, suitability and individual-society were evaluated with Gesell development scale and the activities of daily living( ADD before and after one month therapy. Results Compared with group B, the scores of Gesell and ADL after treatment in group A were significantly increased (P<0. 05). Conclusion The occupational therapy can improve movement of the upper extremities and daily living activity.%目的 探讨作业治疗对痉挛型偏瘫儿童上肢精细运动功能及日常生活能力的治疗作用.方法 30例痉挛型偏瘫患儿随机均分为治疗组和对照组,均进行运动疗法、推拿、神经肌肉电刺激等常规康复治疗1个月;治疗组在此基础上加用作业治疗.治疗前后采用Gesell发育量表进行评估,计算精细运动、适应性、个人社会的发育商及总发育商及日常生活活动能力.结果 治疗后,治疗组患儿精细运动、适应性、个人社会等能区的发育商、总发育商及日常生活活动能力均较对照组显著改善(P<0.05).结论 作业治疗有助于提高痉挛型偏瘫患儿的精细运动功能及日常生活活动能力.

  5. Factors Associated With Upper Extremity Functional Recovery Following Low-Frequency Repetitive Transcranial Magnetic Stimulation in Stroke Patients

    Science.gov (United States)

    2016-01-01

    Objective To investigate the factors related to upper extremity functional improvement following inhibitory repetitive transcranial magnetic stimulation (rTMS) in stroke patients. Methods Forty-one stroke patients received low-frequency rTMS over the contralesional hemisphere according to a standard protocol, in addition to conventional physical and occupational therapy. The rTMS-treated patients were divided into two groups according to their responsiveness to rTMS measured by the self-care score of the Korean version of Modified Barthel Index (K-MBI): responded group (n=19) and non-responded group (n=22). Forty-one age-matched stroke patients who had not received rTMS served as controls. Neurological, cognitive and functional assessments were performed before rTMS and 4 weeks after rTMS treatment. Results Among the rTMS-treated patients, the responded group was significantly younger than the non-responded group (51.6±10.5 years and 65.5±13.7 years, respectively; p=0.001). Four weeks after rTMS, the National Institutes of Health Stroke Scale, the Brunnstrom recovery stage and upper extremity muscle power scores were significantly more improved in the responded group than in the control group. Besides the self-care score, the mobility score of the K-MBI was also more improved in the responded group than in the non-responded group or controls. Conclusion Age is the most obvious factor determining upper extremity functional responsiveness to low-frequency rTMS in stroke patients.

  6. 家属健康教育对脑卒中患者上肢功能及ADL的影响%Effect of Intensive Health Education to Dependents of Cerebral Accident Patients on Recovery of Upper Extremity Function and ADL

    Institute of Scientific and Technical Information of China (English)

    毕研贞; 王桂芬; 郑志雄

    2012-01-01

    目的:观察住院期间进行家属健康教育对脑卒中患者上肢功能及ADL的影响.方法:选择我科住院脑卒中患者2009年1月~2009年12月间64例为对照组,2010年1月~2010年12月间70例为观察组.2组均按常规给予药物及对症支持治疗,观察组在此基础上对患者家属进行强化康复知识教育,包括康复评定并制定康复目标、并发症相关知识、康复训练及护理技能、心理治疗及出院康复指导等.结果:干预1个月后,观察组上肢并发症发生率明显低于对照组(P<0.05),FMA及BI评分均较对照组明显提高(P<0.05);随访6个月后,2组上肢各项并发症发生率均较干预1个月时提高(P<0.05),但观察组显著低于对照组(P<0.01),FMA及BI评分2组较干预1个月时明显提高,且观察组均明显高于对照组(P<0.05).结论:对患者家属进行强化康复知识教育可以明显降低偏瘫上肢并发症的发生率,提高偏瘫上肢运动功能,改善ADL能力.%Objective: To observe the effect of intensive health education to the dependents of cerebral accident patients on the recovery of upper extremity function and activities of daily living (ADI.). Methods, Sixty-four cases in control group were chosen from the cerebral accident patients hospitalized in our Department of Neurology from January to December in 2009. and 70 cases in experimental group came from the cerebral accident patients hospitalized from January to December in 2010. All cases accepted routine drugs and supportive treatment. In addition, intensive health education was applied to dependents in the experimental group, including rehabilitation assessment and formulation of rehabilitation goals, related knowledge about complications, rehabilitation training and nursing skill, psychotherapy, and rehabilitation directions after discharge. Results: One month after intervention, the incidence of the complications of upper limb in the experiment group was lower than in

  7. 极限学习机集成在骨髓细胞分类中的应用%Classification of bone marrow cells based on ensemble of extreme learning machine

    Institute of Scientific and Technical Information of China (English)

    陈林伟; 吴向平; 潘晨; 侯庆岑

    2015-01-01

    骨髓细胞的分类有重要的医学诊断意义。先对骨髓细胞图像分割和特征提取,用提取出来的训练集对极限学习机训练,再用该分类器对未知样本识别。针对单个分类器性能的不稳定,提出基于元胞自动机的极限学习机集成算法。通过元胞自动机抽样策略构建差异大的训练子集,多个分类器并行学习,多数投票法联合决策。实验结果表明,与BP、支持向量机比较,该算法基本无参数调整,学习速度快,分类精度高能达到97.33%,且有效克服了神经网络分类器不稳定的缺点。%Classification of bone marrow cells has important medical diagnostic significance. The training samples set extracted from the segmented images of bone marrow cells is used to train the extreme learning machine. Then this trained extreme learning machine automatically classifies the unknown bone marrow cells. For the instability of perfor-mance of single classifier, the ensemble of extreme learning machine algorithm based on cellular automata is proposed. The different training subsets are constructed by cellular automata strategy through sampling, then they are learned in par-allel with multiple classifiers, finally the outputs are combined by majority voting. Experimental results show that this pro-posed algorithm has fast learning speed and gains high classification accuracy reached 97.33% without adjusting any parameters during run-time compared with BP neural networks and support vector machines. Moreover, it effectively solves the disadvantage of instability for the neural network classifier.

  8. Properties of deproteinized bone for reparation of big segmental defect in long bone

    Institute of Scientific and Technical Information of China (English)

    JIAN Yue-kui; TIAN Xiao-bin; LI Bo; QIU Bing; ZHOU Zuo-jia; YANG Zheng; LI Qi-hong

    2008-01-01

    Objective: To explore suitable scaffold material for big segmental long bone defect by studying the properties of the prepared deproteinized bone. Methods: Cancellated bone were made as 30 mm ×3 mm ×3 mm bone blocks from inferior extremity of pig femur along bone trabecula. The deproteinized bone was prepared with an improved method. Their morphological features, components, cell compatibility, mechanical and immunological properties were investigated respectively. Results: Deproteinized bone maintained natural re ticular pore system. The main organic material is collagen Ⅰand inorganic composition is hydroxyapatite. It has good mechanical properties, cell adhesion rate and histocompatibility. Conlusion: This deproteinized bone can be applicable as scaffold for reparation of big segmental defect in long bone.

  9. Findings of skin and bones in mastocytosis

    Energy Technology Data Exchange (ETDEWEB)

    Rohner, H.G.; Bartl, R.; Koischwitz, D.; Rodermund, O.E.

    1982-12-01

    The syndrome of mastocytosis can include isolated urticaria pigmentosa, systemic mastocytosis, or the extremely rare form of mast cell leucemia. Our investigations of many patients have shown more frequently than earlier suspected, that the mastocytosis is a systemic disease. The frequency of attacked bone marrow is noteworthy. Because of the inflammatory granulomatous manifestation in bone marrow, considerations of the pathogenesis of an immune and reactive event are taken into account. The mast cell granulomas are mostly found in the endosteal region, which is the reason for frequently occurring bone lesions (half of all patients show bone lesions). The bone changes can develop generalized (osteoporosis-osteosclerosis) or localized (osteolytic-osteosclerotic foci). In clinical work bone biopsies and skeletal radiology are supplementing each other: bone biopsy and skin biopsy give the first diagnosis of mastocytosis and reveal the systemic disease; X-ray pictures give information of shape and dimension of the induced osteopathy.

  10. Taphonomy of the vertebrate bone beds from the Klūnas fossil site, Upper Devonian Tērvete Formation of Latvia

    Directory of Open Access Journals (Sweden)

    Jeļena Vasiļkova

    2012-05-01

    Full Text Available Combined sedimentological and taphonomical study of the siliciclastic sequence of the Tērvete Formation in the stratotypical area was aimed at revealing the formation of the three oryctocoenoses discovered and related structural and textural features of the deposits, as well as at detailed observation of the taphonomical peculiarities of the obtained palaeontological material. The fossil vertebrate assemblage is represented by 14 taxa comprising placoderms, acanthodians, sarcopterygians and actinopterygians. The three oryctocoenoses, first recognized in 2010, differ in the proportions of repeatedly buried material, in the number and degree of preservation of small and fragile skeletal elements, as well as in the evaluated current velocity and the transportation distance. Sedimentary concentrations of marine vertebrate remains, dominated by the antiarchs Bothriolepis ornata and B. jani, have been formed under the influence of fluvial and tidal processes in the shallow-water environment, deltaic or estuarine settings. Elongated placoderm and sarcopterygian bones are probably better indicators of the palaeoflow direction than acanthodian spines or sarcopterygian teeth.

  11. Restoring motor control and sensory feedback in people with upper extremity amputations using arrays of 96 microelectrodes implanted in the median and ulnar nerves

    Science.gov (United States)

    Davis, T. S.; Wark, H. A. C.; Hutchinson, D. T.; Warren, D. J.; O'Neill, K.; Scheinblum, T.; Clark, G. A.; Normann, R. A.; Greger, B.

    2016-06-01

    Objective. An important goal of neuroprosthetic research is to establish bidirectional communication between the user and new prosthetic limbs that are capable of controlling >20 different movements. One strategy for achieving this goal is to interface the prosthetic limb directly with efferent and afferent fibres in the peripheral nervous system using an array of intrafascicular microelectrodes. This approach would provide access to a large number of independent neural pathways for controlling high degree-of-freedom prosthetic limbs, as well as evoking multiple-complex sensory percepts. Approach. Utah Slanted Electrode Arrays (USEAs, 96 recording/stimulating electrodes) were implanted for 30 days into the median (Subject 1-M, 31 years post-amputation) or ulnar (Subject 2-U, 1.5 years post-amputation) nerves of two amputees. Neural activity was recorded during intended movements of the subject’s phantom fingers and a linear Kalman filter was used to decode the neural data. Microelectrode stimulation of varying amplitudes and frequencies was delivered via single or multiple electrodes to investigate the number, size and quality of sensory percepts that could be evoked. Device performance over time was assessed by measuring: electrode impedances, signal-to-noise ratios (SNRs), stimulation thresholds, number and stability of evoked percepts. Main results. The subjects were able to proportionally, control individual fingers of a virtual robotic hand, with 13 different movements decoded offline (r = 0.48) and two movements decoded online. Electrical stimulation across one USEA evoked >80 sensory percepts. Varying the stimulation parameters modulated percept quality. Devices remained intrafascicularly implanted for the duration of the study with no significant changes in the SNRs or percept thresholds. Significance. This study demonstrated that an array of 96 microelectrodes can be implanted into the human peripheral nervous system for up to 1 month durations. Such an

  12. Archaeomagnetic study of five mounds from Upper Mesopotamia between 2500 and 750 BCE: further evidence for an extremely strong geomagnetic field ca. 3000 years ago

    NARCIS (Netherlands)

    Ertepinar, P.; Langereis, C.G.; Biggin, A.J.; Frangipane, M.; Matney, T.; Ökse, T.; Engin, A.

    2012-01-01

    The distribution of archaeomagnetic data in eastern Europe and the Near and Middle East shows a remarkable gap in Turkey. This study presents the first archaeomagnetic results from five different mounds in southeast Turkey, the northern part of Mesopotamia. The rock magnetic experiments indicate tha

  13. Rehabilitation of the Upper Extremity after Stroke: A Case Series Evaluating REO Therapy and an Auditory Sensor Feedback for Trunk Control

    Directory of Open Access Journals (Sweden)

    G. Thielman

    2012-01-01

    Full Text Available Background and Purpose. Training in the virtual environment in post stroke rehab is being established as a new approach for neurorehabilitation, specifically, ReoTherapy (REO a robot-assisted virtual training device. Trunk stabilization strapping has been part of the concept with this device, and literature is lacking to support this for long-term functional changes with individuals after stroke. The purpose of this case series was to measure the feasibility of auditory trunk sensor feedback during REO therapy, in moderate to severely impaired individuals after stroke. Case Description. Using an open label crossover comparison design, 3 chronic stroke subjects were trained for 12 sessions over six weeks on either the REO or the control condition of task related training (TRT; after a washout period of 4 weeks; the alternative therapy was given. Outcomes. With both interventions, clinically relevant improvements were found for measures of body function and structure, as well as for activity, for two participants. Providing auditory feedback during REO training for trunk control was found to be feasible. Discussion. The degree of changes evident varied per protocol and may be due to the appropriateness of the technique chosen, as well as based on patients impaired arm motor control.

  14. Observed differences in upper extremity forces, muscle efforts, postures, velocities and accelerations across computer activities in a field study of office workers

    NARCIS (Netherlands)

    Garza, J.L.B.; Eijckelhof, B.H.W.; Johnson, P.W.; Raina, S.M.; Rynell, P.W.; Huysmans, M.A.; Dieën, J.H. van; Beek, A.J. van der; Blatter, B.M.; Dennerlein, J.T.

    2012-01-01

    This study, a part of the PRedicting Occupational biomechanics in OFfice workers (PROOF) study, investigated whether there are differences in field-measured forces, muscle efforts, postures, velocities and accelerations across computer activities. These parameters were measured continuously for 120

  15. Effect of Hydrotherapy Combined with Tizanidine Efficacy for Stroke Patients with Upper Extremity Spasticity%水疗联合替扎尼定用于脑卒中患者上肢痉挛的疗效观察

    Institute of Scientific and Technical Information of China (English)

    莫林宏; 聂忆秋; 刘翠; 路芳; 刘爱贤

    2015-01-01

    目的:观察水疗联合替扎尼定对脑卒中患者上肢痉挛的改善作用.方法:将26例脑卒中恢复期患者随机分为治疗组和对照组,两组均给予康复训练、常规治疗、口服替扎尼定,治疗组除上诉治疗外,联合温水疗法.治疗前与治疗1月后根据改良Ashworth痉挛评定量表(MAS)、简式Fugl-Meyer运动量表(FMA)和改良Barthel指数评定法(MBI)对两组患者进行评定.结果:治疗后两组患者上肢肌张力较治疗前均有明显降低(P<0.05),日常生活活动能力、上肢运动功能较治疗前均有提高(P<0.05),观察组疗效明显优于对照组(P<0.05).结论:康复训练结合替扎尼定对脑卒中后出现的上肢痉挛可起到显著改善作用;结合水疗后,上肢痉挛的改善、运动功能及生活生活活动能力的提高更加显著.%Objective: To observe the effect of hydrotherapy combined with Tizanidine on stroke patients with upper extremity spasticity. Methods: 26 patients with stroke recovery period were randomly divided into the treatment group and control group, two groups were given rehabilitation training, conventional treatment,oral tizanidine set, the treatment group in addition to the appeal treatment, combined with warm water therapy. Before treatment and after treatment, the patients were assessed by the modified Ashworth spasm Rating Scale (MAS), Fugl-Meyer (FMA) and modified Barthel index (MBI) in January. Results:After treatment, the upper limb muscle tension in the two groups were significantly lower than before treatment (P<0.05), daily living activity and the upper limb motor function were significantly improved (P<0.05), the observation group was significantly beter than the control group (P<0.05).Conclusion:Combined with rehabilitation training of tizanidine on upper limb spasm after stroke can play to significantly improve; combination of spa, improvement in upper limb spasticity, motor function and daily life ability is more significant.

  16. Increased serum and musculotendinous fibrogenic proteins following persistent low-grade inflammation in a rat model of long-term upper extremity overuse.

    Directory of Open Access Journals (Sweden)

    Helen G L Gao

    Full Text Available We examined the relationship between grip strength declines and muscle-tendon responses induced by long-term performance of a high-repetition, low-force (HRLF reaching task in rats. We hypothesized that grip strength declines would correlate with inflammation, fibrosis and degradation in flexor digitorum muscles and tendons. Grip strength declined after training, and further in weeks 18 and 24, in reach limbs of HRLF rats. Flexor digitorum tissues of reach limbs showed low-grade increases in inflammatory cytokines: IL-1β after training and in week 18, IL-1α in week 18, TNF-α and IL-6 after training and in week 24, and IL-10 in week 24, with greater increases in tendons than muscles. Similar cytokine increases were detected in serum with HRLF: IL-1α and IL-10 in week 18, and TNF-α and IL-6 in week 24. Grip strength correlated inversely with IL-6 in muscles, tendons and serum, and TNF-α in muscles and serum. Four fibrogenic proteins, TGFB1, CTGF, PDGFab and PDGFbb, and hydroxyproline, a marker of collagen synthesis, increased in serum in HRLF weeks 18 or 24, concomitant with epitendon thickening, increased muscle and tendon TGFB1 and CTGF. A collagenolytic gelatinase, MMP2, increased by week 18 in serum, tendons and muscles of HRLF rats. Grip strength correlated inversely with TGFB1 in muscles, tendons and serum; with CTGF-immunoreactive fibroblasts in tendons; and with MMP2 in tendons and serum. Thus, motor declines correlated with low-grade systemic and musculotendinous inflammation throughout task performance, and increased fibrogenic and degradative proteins with prolonged task performance. Serum TNF-α, IL-6, TGFB1, CTGF and MMP2 may serve as serum biomarkers of work-related musculoskeletal disorders, although further studies in humans are needed.

  17. Retrograde Tempofilter II{sup TM} Placement within the Superior Vena Cava in a Patient with Acute Upper Extremity Deep Venous Thrombosis: the Filter Stands on Its Head

    Energy Technology Data Exchange (ETDEWEB)

    Yim, Nam Yeol [The Armed Forces Yangju Hospital, Yangju (Korea, Republic of); Chang, Nam Kyu; Lim, Jae Hoon; Kim, Jae Kyu [Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2011-02-15

    The Tempofilter II is a widely used temporary vena cava filter. Its unique design, which includes a long tethering catheter with a subcutaneous anchor, facilitates the deployment and retrieval of the device. Despite this, the Tempofi lter II has been used only in the inferior vena cava of patients with lower extremity deep venous thrombosis. In this article, we present a case of superior vena cava filtering using the Tempofilter II in patients with upper extremity deep venous thrombosis

  18. Effects of Ving Tsun Chinese Martial Art Training on Upper Extremity Muscle Strength and Eye-Hand Coordination in Community-Dwelling Middle-Aged and Older Adults: A Pilot Study.

    Science.gov (United States)

    Fong, Shirley S M; Ng, Shamay S M; Cheng, Yoyo T Y; Wong, Janet Y H; Yu, Esther Y T; Chow, Gary C C; Chak, Yvonne T C; Chan, Ivy K Y; Zhang, Joni; Macfarlane, Duncan; Chung, Louisa M Y

    2016-01-01

    Objectives. To evaluate the effects of Ving Tsun (VT) martial art training on the upper extremity muscle strength and eye-hand coordination of middle-aged and older adults. Methods. This study used a nonequivalent pretest-posttest control group design. Forty-two community-dwelling healthy adults participated in the study; 24 (mean age ± SD = 68.5 ± 6.7 years) underwent VT training for 4 weeks (a supervised VT session twice a week, plus daily home practice), and 18 (mean age ± SD = 72.0 ± 6.7 years) received no VT training and acted as controls. Shoulder and elbow isometric muscle strength and eye-hand coordination were evaluated using the Lafayette Manual Muscle Test System and a computerized finger-pointing test, respectively. Results. Elbow extensor peak force increased by 13.9% (P = 0.007) in the VT group and the time to reach peak force decreased (9.9%) differentially in the VT group compared to the control group (P = 0.033). For the eye-hand coordination assessment outcomes, reaction time increased by 2.9% in the VT group and decreased by 5.3% in the control group (P = 0.002). Conclusions. Four weeks of VT training could improve elbow extensor isometric peak force and the time to reach peak force but not eye-hand coordination in community-dwelling middle-aged and older adults. PMID:27525020

  19. Effects of Ving Tsun Chinese Martial Art Training on Upper Extremity Muscle Strength and Eye-Hand Coordination in Community-Dwelling Middle-Aged and Older Adults: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Shirley S. M. Fong

    2016-01-01

    Full Text Available Objectives. To evaluate the effects of Ving Tsun (VT martial art training on the upper extremity muscle strength and eye-hand coordination of middle-aged and older adults. Methods. This study used a nonequivalent pretest-posttest control group design. Forty-two community-dwelling healthy adults participated in the study; 24 (mean age ± SD = 68.5±6.7 years underwent VT training for 4 weeks (a supervised VT session twice a week, plus daily home practice, and 18 (mean age ± SD = 72.0±6.7 years received no VT training and acted as controls. Shoulder and elbow isometric muscle strength and eye-hand coordination were evaluated using the Lafayette Manual Muscle Test System and a computerized finger-pointing test, respectively. Results. Elbow extensor peak force increased by 13.9% (P=0.007 in the VT group and the time to reach peak force decreased (9.9% differentially in the VT group compared to the control group (P=0.033. For the eye-hand coordination assessment outcomes, reaction time increased by 2.9% in the VT group and decreased by 5.3% in the control group (P=0.002. Conclusions. Four weeks of VT training could improve elbow extensor isometric peak force and the time to reach peak force but not eye-hand coordination in community-dwelling middle-aged and older adults.

  20. Effects of Ving Tsun Chinese Martial Art Training on Upper Extremity Muscle Strength and Eye-Hand Coordination in Community-Dwelling Middle-Aged and Older Adults: A Pilot Study.

    Science.gov (United States)

    Fong, Shirley S M; Ng, Shamay S M; Cheng, Yoyo T Y; Wong, Janet Y H; Yu, Esther Y T; Chow, Gary C C; Chak, Yvonne T C; Chan, Ivy K Y; Zhang, Joni; Macfarlane, Duncan; Chung, Louisa M Y

    2016-01-01

    Objectives. To evaluate the effects of Ving Tsun (VT) martial art training on the upper extremity muscle strength and eye-hand coordination of middle-aged and older adults. Methods. This study used a nonequivalent pretest-posttest control group design. Forty-two community-dwelling healthy adults participated in the study; 24 (mean age ± SD = 68.5 ± 6.7 years) underwent VT training for 4 weeks (a supervised VT session twice a week, plus daily home practice), and 18 (mean age ± SD = 72.0 ± 6.7 years) received no VT training and acted as controls. Shoulder and elbow isometric muscle strength and eye-hand coordination were evaluated using the Lafayette Manual Muscle Test System and a computerized finger-pointing test, respectively. Results. Elbow extensor peak force increased by 13.9% (P = 0.007) in the VT group and the time to reach peak force decreased (9.9%) differentially in the VT group compared to the control group (P = 0.033). For the eye-hand coordination assessment outcomes, reaction time increased by 2.9% in the VT group and decreased by 5.3% in the control group (P = 0.002). Conclusions. Four weeks of VT training could improve elbow extensor isometric peak force and the time to reach peak force but not eye-hand coordination in community-dwelling middle-aged and older adults.

  1. The response of bone to unloading

    Science.gov (United States)

    Bikle, D. D.; Halloran, B. P.

    1999-01-01

    Skeletal unloading leads to decreased bone formation and decreased bone mass. Bone resorption is uncoupled from bone formation, contributing to the bone loss. During spaceflight bone is lost principally from the bones most loaded in the 1-g environment, and some redistribution of bone from the lower extremities to the head appears to take place. Although changes in calcitropic hormones have been demonstrated during skeletal unloading (PTH and 1,25(OH)2D decrease), it remains unclear whether such changes account for or are in response to the changes in bone formation and resorption. Bed rest studies with human volunteers and hindlimb elevation studies with rats have provided useful data to help explain the changes in bone formation during spaceflight. These models of skeletal unloading reproduce a number of the conditions associated with microgravity, and the findings from such studies confirm many of the observations made during spaceflight. Determining the mechanism(s) by which loading of bone is sensed and translated into a signal(s) controlling bone formation remains the holy grail in this field. Such investigations couple biophysics to biochemistry to cell and molecular biology. Although studies with cell cultures have revealed biochemical responses to mechanical loads comparable to that seen in intact bone, it seems likely that matrix-cell interactions underlie much of the mechanocoupling. The role for systemic hormones such as PTH, GH, and 1,25(OH)2D compared to locally produced factors such as IGF-I, PTHrP, BMPs, and TGF-beta in modulating the cellular response to load remains unclear. As the mechanism(s) by which bone responds to mechanical load with increased bone formation are further elucidated, applications of this knowledge to other etiologies of osteoporosis are likely to develop. Skeletal unloading provides a perturbation in bone mineral homeostasis that can be used to understand the mechanisms by which bone mineral homeostasis is maintained, with

  2. Upper extremities musculoskeletal disorders: Prevalence and associated ergonomic factors in an electronic assembly factory

    Directory of Open Access Journals (Sweden)

    Somthus Pullopdissakul

    2013-10-01

    Full Text Available Objectives:To determine the magnitude, distribution and associated ergonomic factors of upper extremities musculoskeletal disorders (UEMSD among workers of electronic assembly in Thailand. Material and Methods: This was a cross-sectional study. 591 of 853 workers in an electronic and electrical appliance assembly factory in Bangkok, Thailand, participated in this study. A self-administered questionnaire consisting of demographic data and ergonomic factors was collected from October 2010 to January 2011. Clinical examination of each worker was performed by an occupational physician. The criteria for diagnosis of UEMSD came as a result of a consensus reached by a group of orthopedists. The associated factors were analyzed using a multiple logistic regression. Results: The point prevalence of clinically diagnosed UEMSD was as follows: radial styloid tenosynovitis - 13.03% (95% CI: 10.31-15.75, trigger finger - 9.48% (95% CI: 7.11-11.84, carpal tunnel syndrome - 8.12% (95% CI: 5.91-10.33, lateral epicondylitis - 3.38% (95% CI: 1.92-4.85, and medial epicondylitis - 1.69% (95% CI: 0.65-2.73, respectively. The adjusted odds ratio with statistical significance associated with UEMSD was as follows: high force of wrist - 1.78 (95% CI: 1.06-2.99, awkward posture of wrist - 2.37 (95% CI: 1.28-4.37 and contact stress at wrists - 1.75 (95% CI: 1.02-3.00 to develop radial styloid tenosynovitis. For trigger finger, the ratios were awkward posture of fingers - 2.09 (95% CI: 1.12-3.90 and contact stress on finger - 1.86 (95% CI: 1.04-3.34. For medial epicondylitis, it was an awkward posture of using elbows - 3.14 (95% CI: 1.10-8.95. However, this study did not find any associations between repetitive motion and any UEMSD. Conclusions: UEMSD are most commonly found in electronic assembly workers. The relevant parties should provide comprehensive ergonomic resolution for these workers.

  3. Metagenomics of extreme environments.

    Science.gov (United States)

    Cowan, D A; Ramond, J-B; Makhalanyane, T P; De Maayer, P

    2015-06-01

    Whether they are exposed to extremes of heat or cold, or buried deep beneath the Earth's surface, microorganisms have an uncanny ability to survive under these conditions. This ability to survive has fascinated scientists for nearly a century, but the recent development of metagenomics and 'omics' tools has allowed us to make huge leaps in understanding the remarkable complexity and versatility of extremophile communities. Here, in the context of the recently developed metagenomic tools, we discuss recent research on the community composition, adaptive strategies and biological functions of extremophiles.

  4. Enzymatic maceration of bone

    DEFF Research Database (Denmark)

    Uhre, Marie-Louise; Eriksen, Anne Marie; Simonsen, Kim Pilkjær;

    2015-01-01

    the bones. The DNA analysis showed that DNA was preserved on all the pieces of bones which were examined. Finally, the investigation suggests that enzyme maceration could be gentler on the bones, as the edges appeared less frayed. The enzyme maceration was also a quicker method; it took three hours compared...

  5. Does low-field dedicated extremity MRI (E-MRI) reliably detect RA bone erosions? A comparison of two different E-MRI units and conventional radiography with high resolution CT

    DEFF Research Database (Denmark)

    Duer, Anne; Ejbjerg, Bo; Albrecht-Beste, Elisabeth;

    2008-01-01

    . RESULTS: 550 bones were examined. CT, Artoscan, MagneVu and CR detected 188, 116, 55 and 45 bones with erosions, respectively. The majority were located in the carpal bones. The sensitivity of Artoscan for detecting erosions was higher than of MagneVu and CR (MCP joints: 0.68, 0.54 and 0.57, respectively...

  6. Does low-field dedicated extremity MRI (E-MRI) reliably detect bone erosions in rheumatoid arthritis? A comparison of two different E-MRI units and conventional radiography with high-resolution CT scanning

    DEFF Research Database (Denmark)

    Duer-Jensen, A; Ejbjerg, B; Albrecht-Beste, E;

    2008-01-01

    . RESULTS: 550 bones were examined. CT, Artoscan, MagneVu and CR detected 188, 116, 55 and 45 bones with erosions, respectively. The majority were located in the carpal bones. The sensitivity of the Artoscan for detecting erosions was higher than that of the MagneVu and CR (MCP joints: 0.68, 0.54 and 0...

  7. Malignant Hemangioendothelioma of Occipital Bone

    Institute of Scientific and Technical Information of China (English)

    Amit Agrawal; Arvind Bhake; Pankaj Banode; Brij Raj Singh

    2012-01-01

    Epithelioid hemangioendothelioma is a rare vascular tumor of bone,and rarely these lesions can present as unique and extremely aggressive tumor.We report a case of highly aggressive epithelioid hemangioendothelioma and discuss the imaging findings.CT brain plain study revealed a poorly-defined,mixed density expansile and lytic lesion involving the occipital bone with extension to the left side with poorly defined trabecula formation.There was significant but irregular enhancement after intravenous administration of contrast material and also marked bone destruction.Microscopic examination of the fine needle aspiration cytology showed a tumor composed of vascular channels lined by plump endothelial cells,which had enlarged hyperchromatic nuclei.In view of the extensive infiltration the patient was submitted for the radiotherapy.

  8. Translating measurement findings into rehabilitation practice: An example using Fugl-Meyer Assessment-Upper Extremity with patients following stroke

    Directory of Open Access Journals (Sweden)

    Craig A. Velozo, PhD, OTR/L

    2011-12-01

    Full Text Available Standardized assessments are critical for advancing clinical rehabilitation, yet assessment scores often provide little information for rehabilitation treatment planning. A keyform recovery map is an innovative way for a therapist to record patient responses to standardized assessment items. The form enables a therapist to view the specific items that a patient can or cannot perform. This information can assist a therapist in tailoring treatments to a patient’s individual ability level. We demonstrate how a keyform recovery map can be used to inform clinical treatment planning for individuals with stroke-related upper-limb motor impairment. A keyform map of poststroke upper-limb recovery defined by items of the Fugl-Meyer Assessment-Upper Extremity (FMA-UE was generated by a previously published Rasch analysis. Three individuals with stroke enrolled in a separate research study were randomly selected from each of the three impairment strata of the FMA-UE. Their performance on each item was displayed on the FMA-UE keyform. The forms directly connected qualitative descriptions of patients’ motor ability to assessment measures, thereby suggesting appropriate shorter and longer term rehabilitation goals. This study demonstrates how measurement theory can be used to translate a standardized assessment into a useful, evidence-based tool for making clinical practice decisions.

  9. Constraint-induced movement therapy as a rehabilitation intervention for upper extremity in stroke patients: systematic review and meta-analysis.

    Science.gov (United States)

    Etoom, Mohammad; Hawamdeh, Mohannad; Hawamdeh, Ziad; Alwardat, Mohammad; Giordani, Laura; Bacciu, Serenella; Scarpini, Claudia; Foti, Calogero

    2016-09-01

    Constraint-induced movement therapy (CIMT) is a neurorehabilitation technique designed to improve upper extremity motor functions after stroke. This review aimed to investigate evidence of the effect of CIMT on upper extremity in stroke patients and to identify optimal methods to apply CIMT. Four databases (MEDLINE, EMBASE, CINHAL, and PEDro) and reference lists of relevant articles and reviews were searched. Randomized clinical trials that studied the effect of CIMT on upper extremity outcomes in stroke patients compared with other rehabilitative techniques, usual care, or no intervention were included. Methodological quality was assessed using the PEDro score. The following data were extracted for each trial: patients' characteristics, sample size, eligibility criteria, protocols of CIMT and control groups, outcome measurements, and the PEDro score. A total of 38 trials were identified according to the inclusion criteria. The trials included were heterogeneous in CIMT protocols, time since stroke, and duration and frequency of treatment. The pooled meta-analysis of 36 trials found a heterogeneous significant effect of CIMT on upper extremity. There was no significant effect of CIMT at different durations of follow-up. The majority of included articles did not fulfill powered sample size and quality criteria. The effect of CIMT changed in terms of sample size and quality features of the articles included. These meta-analysis findings indicate that evidence for the superiority of CIMT in comparison with other rehabilitative interventions is weak. Information on the optimal dose of CIMT and optimal time to start CIMT is still limited. PMID:27123790

  10. Constraint-induced movement therapy as a rehabilitation intervention for upper extremity in stroke patients: systematic review and meta-analysis.

    Science.gov (United States)

    Etoom, Mohammad; Hawamdeh, Mohannad; Hawamdeh, Ziad; Alwardat, Mohammad; Giordani, Laura; Bacciu, Serenella; Scarpini, Claudia; Foti, Calogero

    2016-09-01

    Constraint-induced movement therapy (CIMT) is a neurorehabilitation technique designed to improve upper extremity motor functions after stroke. This review aimed to investigate evidence of the effect of CIMT on upper extremity in stroke patients and to identify optimal methods to apply CIMT. Four databases (MEDLINE, EMBASE, CINHAL, and PEDro) and reference lists of relevant articles and reviews were searched. Randomized clinical trials that studied the effect of CIMT on upper extremity outcomes in stroke patients compared with other rehabilitative techniques, usual care, or no intervention were included. Methodological quality was assessed using the PEDro score. The following data were extracted for each trial: patients' characteristics, sample size, eligibility criteria, protocols of CIMT and control groups, outcome measurements, and the PEDro score. A total of 38 trials were identified according to the inclusion criteria. The trials included were heterogeneous in CIMT protocols, time since stroke, and duration and frequency of treatment. The pooled meta-analysis of 36 trials found a heterogeneous significant effect of CIMT on upper extremity. There was no significant effect of CIMT at different durations of follow-up. The majority of included articles did not fulfill powered sample size and quality criteria. The effect of CIMT changed in terms of sample size and quality features of the articles included. These meta-analysis findings indicate that evidence for the superiority of CIMT in comparison with other rehabilitative interventions is weak. Information on the optimal dose of CIMT and optimal time to start CIMT is still limited.

  11. Virtual reality for the rehabilitation of upper extremity function after stroke%虚拟现实技术对不同类型脑卒中患者偏瘫上肢功能的影响

    Institute of Scientific and Technical Information of China (English)

    梁明; 窦祖林; 王清辉; 熊巍; 温红梅; 姜丽; 郑雅丹; 陈颖蓓; 杨琼

    2014-01-01

    Objective To observe the effect of upper extremity training in a virtual kitchen combined with conventional occupational therapy on the hemiplegic upper extremity function of patients with hemorrhagic and ischemic stroke in the convalescent phase.Methods Sixty convalescing stroke patients with hemiplegia were divided into a therapy group (n =30) and a control group (n =30) using a random number table.The control group accepted conventional occupational therapy.The therapy group accepted virtual kitchen training in addition.Before the experiment and after 3 weeks of therapy,surface electromyogram (sEMG) signals over the biceps and triceps brachii during maximum isometric voluntary contractions (MIVCs) flexing and extending the affected elbow were recorded.The Fugl-Meyer assessment for the upper extremities (FMA-UE),the modified Barthel index (MBI) and the relevant cocontraction ratio (CR) were used as outcome measures.Results Compared with pre-training,both groups showed significant improvements post-training on all of the measures.But the therapy group showed significantly greater improvement in terms of both average FMA-UE score and average MBI.Both hemorrhagic and ischemic stroke patients showed these significant improvements.Conclusion Conventional occupational therapy for retraining the upper limbs after stroke may be more effective when combined with training using a virtual kitchen.%目的 观察虚拟厨房上肢训练结合常规作业治疗对不同类型脑卒中(脑出血和脑梗死)恢复期患者偏瘫上肢功能康复的临床疗效.方法 选取脑卒中恢复期偏瘫患者60例,按随机数字表法随机分为治疗组(30例)和对照组(30例).对照组接受常规作业治疗,治疗组在常规作业治疗基础上增加虚拟厨房上肢训练.2组患者均于治疗前和治疗3周后(治疗后)进行上肢运动功能评定(FMA-UE)及以改良巴氏指数(MBI)评定日常生活活动能力,同时记录患肘屈曲/伸展最大等长收

  12. Changes in upper-extremity muscle activities due to head position in subjects with a forward head posture and rounded shoulders.

    Science.gov (United States)

    Kwon, Jung Won; Son, Sung Min; Lee, Na Kyung

    2015-06-01

    [Purpose] This study investigated upper-extremity muscle activities in natural, ideal, and corrected head positions. [Subjects and Methods] Forty subjects with a forward head posture and rounded shoulder were recruited and randomly assigned to the natural head position group (n = 13), ideal head position group (n = 14), or corrected head position group (n = 13). Muscle activities were measured using a four-channel surface electromyography system at the sternocleidomastoideus, upper and lower trapezius, and serratus anterior muscles on the right side during an overhead reaching task. [Results] The muscle activities of the upper trapezius and serratus anterior differed significantly among head positions. Post hoc tests revealed significant differences between natural and ideal head positions, and natural and ideal head positions for both the upper trapezius and serratus anterior. [Conclusion] Recovery of normal upper trapezius and serratus anterior muscle functions plays an important role in correcting forward head posture and rounded shoulders.

  13. 空气波压力治疗乳腺癌术后上肢淋巴水肿的临床观察%Observation of intermittent pneumatic compression therapy on breast carcinoma-related upper extremity lymphedema

    Institute of Scientific and Technical Information of China (English)

    王海燕; 张建秀; 王玉霞; 张翠华

    2010-01-01

    目的 探讨空气波压力治疗配合传统方法 治疗乳腺癌术后上肢淋巴水肿的临床效果.方法 对收治的40例乳腺癌术后上肢淋巴水肿患者随机分为试验组和对照组,每组20例,实验组用空气波压力治疗配合常规传统治疗,对照组采用常规传统治疗.结果 治疗前与治疗2 w后上臂周径差值两组分别为(4.7±0.6)cm、(3.9±0.4)cm,前臂周径差值两组分别为(2.0±0.7)cm、(1.1±0.4)cm,两组对比都有统计学意义(P<0.05);两组症状消失时间分别为(7.5±1.4)d、(12.6±2.8)d(P<0.05).结论 空气波压力治疗配合传统治疗,在乳腺癌术后上肢淋巴水肿的治疗中疗效明显、安全且经济实用.%Objective To evaluate the efficacy of intermittent pneumatic compression (IPC) therapy on breast carcinoma - related upper extremity lymphedema. Methods 40 patients with breast carcinoma - related lymphedema between January 2005 and January 2008. Were randomly divided into experimental group (n = 20) and control group (n = 20) . The routine therapy was applied both in the two groups, in addition, IPC was used in experimental group. Results The differences of upper arm perimeter of pretherapy and post - treatment were ( 4. 7 + 0. 6) cm and ( 3.9 ± 0. 4) cm. The differences of forearm perimeter of pretherapy and post - treatment were ( 2. 0 ± 0. 7)cm and ( 1.1 ± 0. 4) cm. Symptoms disappeared time of experimental group was (7.5 + 1.4) days, and it was ( 12. 6 ± 2. 8) days in control group. There were all significant differences ( P<0. 05 ) . Conclusions When IPC is used with routine therapy for breast carcinoma - related lymphedema, it can provide an enhancement of the therapeutic response. It is well tolerated and economic as well.

  14. Botulinum toxin-a in children with congenital spastic hemiplegia does not improve upper extremity motor-related function over rehabilitation alone: a randomized controlled trial.

    NARCIS (Netherlands)

    Rameckers, E.A.A.; Speth, L.A.; Duysens, J.E.J.; Vles, J.S.; Smits-Engelsman, B.C.M.

    2009-01-01

    BACKGROUND: Rehabilitation of the upper extremity in children with hemiplegic cerebral palsy has not been compared to the same intensity of therapy combined with injected botulinum toxin (BTX). OBJECTIVE: To measure the short-term (2 weeks) and long-term (6 and 9 months) effects of a standardized fu

  15. Hormonal and reproductive factors are associated with chronic low back pain and chronic upper extremity pain in women--the MORGEN study.

    NARCIS (Netherlands)

    Wijnhoven, Hanneke A H; Vet, Henrica C W de; Smit, Henriëtte A; Picavet, H Susan J

    2006-01-01

    STUDY DESIGN: Cross-sectional study of 11,428 women aged 20-59 years who were included in a postal questionnaire survey in the Dutch general population. OBJECTIVE: To examine how hormonal and reproductive factors are associated with chronic low back pain (LBP) and chronic upper extremity pain (UEP)

  16. Transplantation of bone-marrow stem cell on chronic lower extremity ischemia%骨髓于细胞移植治疗慢性下肢缺血性疾病

    Institute of Scientific and Technical Information of China (English)

    方青波; 戈小虎

    2008-01-01

    Atheroselerosis and thrombangiitis obliterans are the chief factors of chronic lower extremity ischemia. Usually we utilize intervcntional treatment which includs balloon dilatation and stent implantation or surgical revascularization for the patients who have good target vessels, but those methods are not suitable for the patients who have small target vessels. The transplantation of bone marrow stem cells is the new tech-nology for chronic lower extremity isehemia, which utilize the capacity of stem cells that have multiple differ-entiation activity and high self renewal potentiality. It can direetionally differentiated into endothelial cells. It has a good perspective in chronic lower extremity isehemia.%动脉粥样硬化及血栓闭塞性脉管炎所引起的慢性下肢缺血在临床上最常见,对于血管流出道好的采用血运重建或介入下球囊扩张及支架置入,但对于血管流出道差的严重慢性下肢缺血上述方法 则不适用.干细胞移植是近年来发展起来的新技术,它是利用于细胞多重分化括性及高度自我更新的潜能,定向分化为具有血管活性的内皮细胞,在治疗慢性下肢缺血性疾病中有很好的前景.

  17. 易化技术配合针炙治疗脑卒中后上肢痉挛%Rehabilitation therapy centralized on facilitation and acupuncture on upper extremities spasm after stroke

    Institute of Scientific and Technical Information of China (English)

    屈云; 盛敏; 蒋毅; 熊淑芳; 何成奇; 罗祖明

    2003-01-01

    AIM: To observe the therapeutic effect of rehabilitation therapy centralized on facilitation and acupuncture on upper extremities spasm after stroke.METHODS:56 cases of stroke patients with upper extremities spasm were divided into two groups by random.28 patients in treatment group were received rehabilitation therapy centralized on facilitation and acupuncture treatment.Others in control group were received traditional method. RESULT:All patients were evaluated by muscle tone evaluation of Ashworth Scale.The outcomes of two groups had significant different (P< 0.01). CONCLUSION:We could archive the satisfactory effects with acupuncture and rehabilitation therapy centralized on facilitation on upper extremities spasm of stroke patients.

  18. Do work-related factors affect care-seeking in general practice for back pain or upper extremity pain?

    DEFF Research Database (Denmark)

    Jensen, J. C.; Haahr, J. P.; Frost, P.;

    2012-01-01

    OBJECTIVES: Musculoskeletal pain conditions remain a major cause of care-seeking in general practice. Not all patients with musculoskeletal pain (MP) seek care at their general practitioner (GP), but for those who do, the GP's knowledge of what work-related factors might have influenced the patient...... with a baseline questionnaire and eighteen-month follow-up. Among the registered patients of 8 GPs, we identified 8,517 persons between 17 and 65 years of age, who all received the questionnaire. A total of 5,068 (59.5 %) persons answered. During the eighteen months of follow-up, we used the International...... Classification for Primary Care (ICPC) to identify all care-seekers with either back pain or upper extremity pain. Of these, all currently employed persons were included in our analysis, in all 4,325 persons. For analysis, we used Cox proportional hazards regression analysis. Analyses were stratified by gender...

  19. Imaging of Bone Marrow.

    Science.gov (United States)

    Lin, Sopo; Ouyang, Tao; Kanekar, Sangam

    2016-08-01

    Bone marrow is the essential for function of hematopoiesis, which is vital for the normal functioning of the body. Bone marrow disorders or dysfunctions may be evaluated by blood workup, peripheral smears, marrow biopsy, plain radiographs, computed tomography (CT), MRI and nuclear medicine scan. It is important to distinguish normal spinal marrow from pathology to avoid missing a pathology or misinterpreting normal changes, either of which may result in further testing and increased health care costs. This article focuses on the diffuse bone marrow pathologies, because the majority of the bone marrow pathologies related to hematologic disorders are diffuse. PMID:27444005

  20. Upper extremity kinematics and body roll during preferred-side breathing and breath-holding front crawl swimming.

    Science.gov (United States)

    Payton, C J; Bartlett, R M; Baltzopoulos, V; Coombs, R

    1999-09-01

    Front crawl swimmers often restrict the number of breaths they take during a race because of the possible adverse effects of the breathing action on resistance or stroke mechanics. The aim of this study was to determine whether differences exist in the kinematics of the trunk and upper extremity used during preferred-side breathing and breath-holding front crawl swimming. Six male swimmers performed trials at their 200 m race pace under breathing and breath-holding conditions. The underwater arm stroke was filmed from the front and side using video cameras suspended over periscope systems. Video recordings were digitized at 50 Hz and the three-dimensional coordinates of the upper extremity obtained using a direct linear transformation algorithm. Body roll angles were obtained by digitizing video recordings of a balsa wood fin attached to the swimmers' backs. The swimmers performed the breathing action without any decrement in stroke length (mean +/- s: breathing 2.24 +/- 0.27 m; breath-holding 2.15 +/- 0.22 m). Stroke widths were similar in the breathing (0.28 +/- 0.07 m) and breath-holding (0.27 +/- 0.07 m) trials, despite swimmers rolling further when taking a breath (66 +/- 5 degrees) than when not (57 +/- 4 degrees). The timing of the four underwater phases of the stroke was also unaffected by the breathing action, with swimmers rolling back towards the neutral position during the insweep phase. In conclusion, the results suggest that front crawl swimmers can perform the breathing action without it interfering with their basic stroke parameters. The insweep phase of the stroke assists body roll and not vice versa as suggested in previous studies.

  1. Bone dosimetry and scintigraphy in post-traumatic reflex sympathetic dystrophy syndrome (RSDS) with upper limb involvement

    International Nuclear Information System (INIS)

    In 24 patients affected with post-traumatic reflex sympathetic dystrophy syndrome (RSDS) with upper limb involvement following humeral fractures, bone mineral density (BMD, mg/cm2) was measured by means of dual-photon absorptiometry in the distal radius of both the affected and the normal contralateral limbs. Subsequently, all patients underwent dynamic and static scintigraphic exams after i.v. injection of 99mTc-MDP (20 mCi), with gamma camera collimator centered in both limbs. BMD values were significantly lower in the affected sides than in the normal contralateral ones. Time-activity curves with MDP showed increased flow in the involved limbs. Significant increase in blood pool and in bone uptake was also oserved. After carbocalcin treatment (80 U/q.d.i.m. in 12 cases and 40 U/q.d.i.m. in the other 12 cases for month) all the patients presented improved clinical symptoms and significant increase in BMD, that was restored to normal values in 7 of the patients who had a longer treatment (40 U/q.d.i.m. for 2 months). Both local blood flow and bone up-take in the affected side significantly decreased after carbocalcitonin therapy while bone avidity index increased in those patients in whom this parameter had been measured. Results confirmed the usefulness of radioisotopic procedures in post-traumatic RSDS for both diagnosis (by demonstrating increased local blood flow and early bone demineralization) and monitoring response to treatment with carbocalcitonin, which seems to play an important role in this condition

  2. Reliability and validity of the Chinese version of the quality of upper extremity skills test on upper limb function of children with cerebral palsy%中文版上肢技巧质量量表在脑性瘫痪患儿上肢功能评定中的信度和效度

    Institute of Scientific and Technical Information of China (English)

    王军; 陈静; 朱登纳; 袁俊英; 牛国辉; 孙二亮; 程萍萍

    2016-01-01

    目的:评估中文版上肢技巧质量量表(quality of upper extremity skills test,QUEST)在痉挛型脑瘫患儿上肢功能评定中的信度和效度.方法:将英文版QUEST翻译并完善成中文版,研究对象为75例在我院就诊的痉挛型脑瘫儿童,检测其重测信度及评定者间信度.同时进行Peabody运动发育量表的精细运动部分(peabody developmental motor scale fine motor,PDMS-FM),精细运动能力(fine motor function measure scale,FMFM),分析PDMS-FM原始分、FMFM各区分数与中文版QUEST各分测试项原始分之间的相关性,评估量表的平行效度.结果:中文版QUEST分测试项得分及总分具有优良的重测信度及评估者间信度(ICC值均>0.890),中文版QUEST分测试项原始分与PDMS-FM、FMFM各区原始分间具有较好的平行效度(Pearson/Spearson秩相关系数分别为r1=0.563-0.816、r2=0.389-0.830).结论:中文版QUEST量表具有良好的信度和效度,可以作为评估痉挛型脑瘫患儿上肢运动功能的首选方法.

  3. Spectroscopic Studies on Organic Matter from Triassic Reptile Bones, Upper Silesia, Poland

    OpenAIRE

    Surmik, Dawid; Boczarowski, Andrzej; Balin, Katarzyna; Dulski, Mateusz; Szade, Jacek; Kremer, Barbara; Pawlicki, Roman

    2016-01-01

    Fossil biomolecules from an endogenous source were previously identified in Cretaceous to Pleistocene fossilized bones, the evidence coming from molecular analyses. These findings, however, were called into question and an alternative hypothesis of the invasion of the bone by bacterial biofilm was proposed. Herewith we report a new finding of morphologically preserved blood-vessel-like structures enclosing organic molecules preserved in iron-oxide-mineralized vessel walls from the cortical re...

  4. Genetic control of bone mass.

    Science.gov (United States)

    Boudin, Eveline; Fijalkowski, Igor; Hendrickx, Gretl; Van Hul, Wim

    2016-09-01

    Bone mineral density (BMD) is a quantitative traits used as a surrogate phenotype for the diagnosis of osteoporosis, a common metabolic disorder characterized by increased fracture risk as a result of a decreased bone mass and deterioration of the microarchitecture of the bone. Normal variation in BMD is determined by both environmental and genetic factors. According to heritability studies, 50-85% of the variance in BMD is controlled by genetic factors which are mostly polygenic. In contrast to the complex etiology of osteoporosis, there are disorders with deviating BMD values caused by one mutation with a large impact. These mutations can result in monogenic bone disorders with either an extreme high (sclerosteosis, Van Buchem disease, osteopetrosis, high bone mass phenotype) or low BMD (osteogenesis imperfecta, juvenile osteoporosis, primary osteoporosis). Identification of the disease causing genes, increased the knowledge on the regulation of BMD and highlighted important signaling pathways and novel therapeutic targets such as sclerostin, RANKL and cathepsin K. Genetic variation in genes involved in these pathways are often also involved in the regulation of normal variation in BMD and osteoporosis susceptibility. In the last decades, identification of genetic factors regulating BMD has proven to be a challenge. Several approaches have been tested such as linkage studies and candidate and genome wide association studies. Although, throughout the years, technological developments made it possible to study increasing numbers of genetic variants in populations with increasing sample sizes at the same time, only a small fraction of the genetic impact can yet be explained. In order to elucidate the missing heritability, the focus shifted to studying the role of rare variants, copy number variations and epigenetic influences. This review summarizes the genetic cause of different monogenic bone disorders with deviating BMD and the knowledge on genetic factors

  5. Advances in 3D-Printed Pediatric Prostheses for Upper Extremity Differences.

    Science.gov (United States)

    Tanaka, Kara S; Lightdale-Miric, Nina

    2016-08-01

    ➤The prohibitive cost of cutting-edge prostheses prevents many children with a limb difference from obtaining them; however, new developments in 3-dimensional (3D) printing have the potential to increase the accessibility, customization, and procurement of such devices.➤Children with upper limb differences are ideal candidates for currently available 3D-printed devices because they quickly damage and outgrow prostheses, and the low cost of 3D printing makes repairs and upgrades substantially more affordable.➤Physicians and medical practitioners should become familiar with the possibilities of 3D-printed devices in order to determine the benefits and utility for their patients. PMID:27489324

  6. The Extreme Hosts of Extreme Supernovae

    CERN Document Server

    Neill, James D; Gal-Yam, Avishay; Quimby, Robert; Ofek, Eran; Wyder, Ted K; Howell, D Andrew; Nugent, Peter; Seibert, Mark; Martin, D Christopher; Overzier, Roderik; Barlow, Tom A; Foster, Karl; Friedman, Peter G; Morrissey, Patrick; Neff, Susan G; Schiminovich, David; Bianchi, Luciana; Donas, José; Heckman, Timothy M; Lee, Young-Wook; Madore, Barry F; Milliard, Bruno; Rich, R Michael; Szalay, Alex S

    2010-01-01

    We use GALEX ultraviolet (UV) and optical integrated photometry of the hosts of seventeen luminous supernovae (LSNe, having peak M_V 100 M_sun), by appearing in low-SFR hosts, are potential tests for theories of the initial mass function that limit the maximum mass of a star based on the S FR.

  7. Bone

    Science.gov (United States)

    Helmberger, Thomas K.; Hoffmann, Ralf-Thorsten

    The typical clinical signs in bone tumours are pain, destruction and destabilization, immobilization, neurologic deficits, and finally functional impairment. Primary malignant bone tumours are a rare entity, accounting for about 0.2% of all malignancies. Also benign primary bone tumours are in total rare and mostly asymptomatic. The most common symptomatic benign bone tumour is osteoid osteoma with an incidence of 1:2000.

  8. Statistical analysis of extreme auroral electrojet indices

    Science.gov (United States)

    Nakamura, Masao; Yoneda, Asato; Oda, Mitsunobu; Tsubouchi, Ken

    2015-09-01

    Extreme auroral electrojet activities can damage electrical power grids due to large induced currents in the Earth, degrade radio communications and navigation systems due to the ionospheric disturbances and cause polar-orbiting satellite anomalies due to the enhanced auroral electron precipitation. Statistical estimation of extreme auroral electrojet activities is an important factor in space weather research. For this estimation, we utilize extreme value theory (EVT), which focuses on the statistical behavior in the tail of a distribution. As a measure of auroral electrojet activities, auroral electrojet indices AL, AU, and AE, are used, which describe the maximum current strength of the westward and eastward auroral electrojets and the sum of the two oppositely directed in the auroral latitude ionosphere, respectively. We provide statistical evidence for finite upper limits to AL and AU and estimate the annual expected number and probable intensity of their extreme events. We detect two different types of extreme AE events; therefore, application of the appropriate EVT analysis to AE is difficult.

  9. Chondroblastoma of the sphenoid bone

    Directory of Open Access Journals (Sweden)

    Patrocíni, Tomas Gomes

    2008-12-01

    Full Text Available Introduction: Chondroblastoma is an uncommon cartilaginous benign neoplasm, highly destructive, which specifically appears in the epiphysis of long bones in young patients. Its occurrence is extremely rare in the cranial base, normally occurring in the temporal bone. Objective: To describe a rare case in a patient presenting with a sphenoid bone chondroblastoma that invaded the middle cranial cavity, submitted to a successful surgical resection, without recurrence after 2 years. Case Report: W.J.S, 37 years old, male, forwarded to the otorhinolaryngology service with persistent and strong otalgia for 3 months. He had normal otoscopy and without visible tumorations. The computerized tomography confirmed tumor mass in the left infra-temporal cavity, invading the middle cranial cavity. The biopsy suggested giant cells tumor. After wide resection by frontal approach via orbitozygomatic osteotomy. During the surgery, we confirmed tomographic statements and didn't find temporal bone involvement. The histopathological exam confirmed chondroblastoma. After 18 months after the surgery, he doesn't present with complaints, without motor, sensitive deficits or of cranial nerves and without recurrence tomographic signals. Conclusion: The importance of differential diagnosis of chondroblastoma is remarkable in the cranial base lesions and its therapeutic approach, whose objective must always be the major possible resection with the maximum function conservation.

  10. Autologous Bone Marrow Stem Cells combined with Allograft Cancellous Bone in Treatment of Nonunion

    Directory of Open Access Journals (Sweden)

    Le Thua Trung Hau

    2015-12-01

    Full Text Available Autologous cancellous bone graft is currently used as a gold standard method for treatment of bone nonunion. However, there is a limit to the amount of autologous cancellous bone that can be harvested and the donor site morbidity presents a major disadvantage to autologous bone grafting. Embedding viable cells within biological scaffolds appears to be extremely promising. The purpose of this study was to assess the outcome of autologous bone marrow stem cells combined with a cancellous bone allograft as compared to an autologous bone graft in the treatment of bone nonunion. Bone marrow aspiration concentrate (BMAC was previously produced from bone marrow aspirate via a density gradient centrifugation. Autologous cancellous bone was harvested in 9 patients and applied to the nonunion site. In 18 patients of the clinical trial group after the debridement, the bone gaps were filled with a composite of BMAC and allograft cancellous bone chips (BMAC-ACB. Bone consolidation was obtained in 88.9 %, and the mean interval between the cell transplantation and union was 4.6 +/- 1.5 months in the autograft group. Bone union rate was 94.4 % in group of composite BMAC-ACB implantation. The time to union in BMAC-ACB grafting group was 3.3 +/- 0.90 months, and led to faster healing when compared to the autograft. A mean concentration of autologous progenitor cells was found to be 2.43 +/- 1.03 (x106 CD34+ cells/ml, and a mean viability of CD34+ cells was 97.97 +/- 1.47 (%. This study shows that the implantation of BMAC has presented the efficacy for treatment of nonunion and may contribute an available alternative to autologous cancellous bone graft. But large clinical application of BM-MSCs requires a more appropriate and profound scientific investigations. [Biomed Res Ther 2015; 2(12.000: 409-417

  11. Enzymatic maceration of bone

    DEFF Research Database (Denmark)

    Uhre, Marie-Louise; Eriksen, Anne Marie; Simonsen, Kim Pilkjær;

    2015-01-01

    This proof of concept study investigates the removal of soft tissue from human ribs with the use of two common methods: boiling with a laundry detergent and using enzymes. Six individuals were autopsied, and one rib from each individual was removed for testing. Each rib was cut into pieces...... the bones. The DNA analysis showed that DNA was preserved on all the pieces of bones which were examined. Finally, the investigation suggests that enzyme maceration could be gentler on the bones, as the edges appeared less frayed. The enzyme maceration was also a quicker method; it took three hours compared...

  12. Osteomyelitis of frontal bone

    OpenAIRE

    Chaturvedil, V. N.; Raizada, R. M.; Singh, A. K. Kennedy; Puttewar, M. P.; Bali, S.

    2004-01-01

    A case of Osteomyelitis of the frontal bone with a subperiosteal absces s, an extrudural abscess and a frontal sinus fistula is presented here for its rarity. A brief review of literature and management of the condition is also discussed.

  13. Identification of a new hominin bone from Denisova Cave, Siberia using collagen fingerprinting and mitochondrial DNA analysis

    Science.gov (United States)

    Brown, Samantha; Higham, Thomas; Slon, Viviane; Pääbo, Svante; Meyer, Matthias; Douka, Katerina; Brock, Fiona; Comeskey, Daniel; Procopio, Noemi; Shunkov, Michael; Derevianko, Anatoly; Buckley, Michael

    2016-03-01

    DNA sequencing has revolutionised our understanding of archaic humans during the Middle and Upper Palaeolithic. Unfortunately, while many Palaeolithic sites contain large numbers of bones, the majority of these lack the diagnostic features necessary for traditional morphological identification. As a result the recovery of Pleistocene-age human remains is extremely rare. To circumvent this problem we have applied a method of collagen fingerprinting to more than 2000 fragmented bones from the site of Denisova Cave, Russia, in order to facilitate the discovery of human remains. As a result of our analysis a single hominin bone (Denisova 11) was identified, supported through in-depth peptide sequencing analysis, and found to carry mitochondrial DNA of the Neandertal type. Subsequent radiocarbon dating revealed the bone to be >50,000 years old. Here we demonstrate the huge potential collagen fingerprinting has for identifying hominin remains in highly fragmentary archaeological assemblages, improving the resources available for wider studies into human evolution.

  14. Age-related vessel calcification at distal extremities is a risk factor of osteoporosis

    Directory of Open Access Journals (Sweden)

    Ling Qin

    2014-01-01

    Full Text Available We conducted a cohort study to investigate if the vessel calcifications (VCs found in the distal extremities are an index of low bone mass at multiskeletal sites. A total of 332 healthy women aged 41–80 years were recruited for bone mineral content (BMC and bone mineral density measurement using peripheral quantitative computed tomography (pQCT and dual-energy X-ray absorptiometry (DXA. Seven percent of the women showed VC at both upper and lower distal extremities based on pQCT images. Women who had VC were then compared with their age-matched non-VC counterparts. Results showed that peripheral VC was mainly formed at distal lower extremities, and the prevalence of VC increased with advancing age, with 0%, 5.6%, 9.3%, and up to 34.5% in the age groups of 41–50 years, 51–60 years, 61–70 years, and 71–80 years, respectively. Compared with the control group, the VC group showed a significantly higher body mass index (25.2 vs. 23.2, p < 0.01, lower BMC at the spine (27.4 g vs. 31.3 g, p < 0.05, and lower BMC (1.8 g vs. 2.0 g, p < 0.05 and bone mineral density (0.57 g/cm2 vs. 0.66 g/cm2, p < 0.05 at the hip as measured by DXA. The diagnosis of VC in the distal extremities by pQCT increased the diagnosis sensitivity of osteoporosis by 50%. The significance of our findings imply that in clinical settings using pQCT for bone assessment and identification of patients with VC in the distal extremities, patients should also be referred for central DXA measurement at the femoral neck for diagnosis of osteoporosis as well as further assessment of vascular disorders.

  15. Predictability of extreme events in social media

    CERN Document Server

    Miotto, José M

    2014-01-01

    It is part of our daily social-media experience that seemingly ordinary items (videos, news, publications, etc.) unexpectedly gain an enormous amount of attention. Here we investigate how unexpected these events are. We propose a method that, given some information on the items, quantifies the predictability of events, i.e., the potential of identifying in advance the most successful items defined as the upper bound for the quality of any prediction based on the same information. Applying this method to different data, ranging from views in YouTube videos to posts in Usenet discussion groups, we invariantly find that the predictability increases for the most extreme events. This indicates that, despite the inherently stochastic collective dynamics of users, efficient prediction is possible for the most extreme events.

  16. Effects of interlocking intramedullary nailing on multiple fracture of extremities long bone%带锁髓内钉治疗四肢长管骨多发骨折的临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    苟三怀; 欧阳跃平; 刘岩; 席焱海

    2008-01-01

    Objective To evaluate the operative treatment of multiple fracture of the extremities long bone with interlocking intramedullary nailing. Methods Sixty-three cases with 134 fractures were retrospective analyzed, all fractures were treated with closed reduction interlocking intramedullary nailing with no reaming marrow cavity. Twenty of the patients were dynamical bond fixation, and 114 cases were static bond fixation. Results Sixty-three patients were successfully operated. They were followed up for an average of 6 months(ranged 3 to 12 months). Twenty-one humeral fractures had an average healing time of 6 months(ranged 4 to 8 months), 47 femoral fractures 6.5 months(ranged 5 to 8 months), 66 tibial fractures 8 months(ranged 7 to 10 months). The average time of stay in hospital was 18.5 days(ranged 10 to 32 days). Conclusions The interlocking intramedullary nailing with bond fixation, easy operation and less blood, was effective on operative treatment of multiple fracture of the extremities long bone with few complications.%目的 评价带锁髓内钉治疗四肢长管骨多发骨折的疗效. 方法 对四肢多发骨折的诊断和分类均采用AO标准,134处多发长管骨骨折全部采用带锁髓内钉不扩髓、闭合穿钉技术进行内固定,20处为动力性内固定,114处为静力性内固定. 结果 本组63例,全部抢救成功.本组住院日10~32 d,平均住院日18.5 d.随访时间3~12个月,平均6个月.骨折愈合时间为:21处肱骨骨折愈合时间4~8个月,平均6个月;47处股骨骨折愈合时间5~8个月,平均6.5个月;66处胫骨骨折愈合时间7~10个月,平均8个月. 结论 带锁髓内钉是目前治疗四肢长管骨多发骨折的有效内固定方法,其手术操作方便,术中出血少,内固定确实可靠,并发症少.

  17. Statistical Model of Extreme Shear

    DEFF Research Database (Denmark)

    Larsen, Gunner Chr.; Hansen, Kurt Schaldemose

    2004-01-01

    In order to continue cost-optimisation of modern large wind turbines, it is important to continously increase the knowledge on wind field parameters relevant to design loads. This paper presents a general statistical model that offers site-specific prediction of the probability density function...... (PDF) of turbulence driven short-term extreme wind shear events, conditioned on the mean wind speed, for an arbitrary recurrence period. The model is based on an asymptotic expansion, and only a few and easily accessible parameters are needed as input. The model of the extreme PDF is supplemented...... by a model that, on a statistically consistent basis, describe the most likely spatial shape of an extreme wind shear event. Predictions from the model have been compared with results from an extreme value data analysis, based on a large number of high-sampled full-scale time series measurements...

  18. The features of HPOA on dynamic bone scintigraphy: A reflection of underlying pathophysiology

    International Nuclear Information System (INIS)

    Full text: Hypertrophic pulmonary osteoarthropathy (HPOA) is the clinical syndrome of clubbing, arthritis and periostitis which may accompany a spectrum of underlying disease processes. Increased blood flow through involved extremities is an invariable accompaniment of the syndrome and it is hypothesised that the chronic increase in peripheral blood flow results in the known pathological changes of periosteal inflammation and proliferation, oedema, synovial congestion and exudation and hyperplasia of the finger pulp. The dynamic and blood pool phases of bone scintigraphy provide a unique tool for examining the vascular changes in bone and soft tissues and we describe the previously unreported features of the dynamic bone scan in HPOA. We performed three-phase bone scans on two adolescent patients with cystic fibrosis with knee discomfort. Both studies showed marked hyperaemia to the knees. On the blood pool phase, hyperaemia was seen to the tissues closely related to the periosteum of the long bones in upper and lower limbs, periarticular tissues and finger pulps. The delayed images showed the classic features of HPOA with linear uptake of tracer in the shafts and metaphyseal regions of the long bones and minor periarticular uptake of tracer. A WBC scan performed in one patient showed WBC accumulation in the periosteum of the metaphyseal regions, extending in the shafts, of the distal femurs and proximal tibias. Negligible WBC accumulation was seen in the synovium of the knees reflecting the non-inflammatory nature of the articular changes as is described in most patients with HPOA. In conclusion, the dynamic phases of the bone scan examination in HPOA reflect the pivotal underlying pathophysiological process of abnormally increased blood flow to the periosteal and periarticular tissues of involved long bones and finger pulps and further expands the known diagnostic features of this disease on bone scintigraphy

  19. Bone

    International Nuclear Information System (INIS)

    Bone scanning provides information on the extent of primary bone tumors, on possible metastatic disease, on the presence of osteomyelitis prior to observation of roentgenographic changes so that earlier therapy is possible, on the presence of collagen diseases, on the presence of fractures not disclosed by x-ray films, and on the evaluation of aseptic necrosis. However, the total effect and contribution of bone scanning to the diagnosis, treatment, and ultimate prognosis of pediatric skeletal diseases is, as yet, unknown. (auth)

  20. Extreme Value Theory and Statistics of Univariate Extremes: A Review

    OpenAIRE

    Gomes, Maria Ivette; Guillou, Armelle

    2015-01-01

    International audience Statistical issues arising in modelling univariate extremes of a random sample have been successfully used in the most diverse fields, such as biometrics, finance, insurance and risk theory. Statistics of univariate extremes (SUE), the subject to be dealt with in this review paper, has recently faced a huge development, partially because rare events can have catastrophic consequences for human activities, through their impact on the natural and constructed environmen...

  1. Fibrosarcoma of bone

    International Nuclear Information System (INIS)

    A general clinical-radiological description of fibrosarcoma of bone, including tumours with features of malignant fibrous histiocytoma is presented. 104 patients with fibrosarcoma of the long bones are analysed in terms of age and sex distribution, symptoms, duration of symptoms and tumour localization. The radiological findings obtained in patients with fibrosarcoma of the long bones are discussed. The treatment and course of fibrosarcoma of the long bones are discussed. Data on the type of therapy given were available on 103 patients: 67 were treated by ablative surgery either immediately or within three months of preceding local surgery and/or radiotherapy. In the remaining 36 cases treatment consisted of local surgery, radiotherapy or a combination of these, or non-curative (palliative) treatment. In a few cases ablative surgery was performed at a later stage. 13 patients with fibrosarcoma of the axial skeleton and 14 with fibrosarcoma of the jaws are considered. A causistic discussion of patients with a secondary fibrosarcoma is presented. Secondary fibrosarcoma was found in a total of 19 patients (14%); 4 after irradiation. The features of significance for the course of the disease are discussed: general features such as age and sex, tumour localization in the long bones, presence or absence of a pathological fracture, and the radiological and histological characteristics of the tumour. The type of therapy and the occurrence of lung metastases in relation to the course of the disease is also discussed. (Auth.)

  2. Excess functions and estimation of the extreme-value index

    OpenAIRE

    Beirlant, Jan; Vynckier, Petra; Teugels, Josef L.

    1996-01-01

    A general class of estimators of the extreme-value index is generated using estimates of mean, median and trimmed excess functions. Special cases yield earlier proposals in the literature, such as Pickands' (1975) estimator. A particular restatement of the mean excess function yields an estimator which can be derived from the slope at the right upper tail from a generalized quantile plot. From this viewpoint algorithms can be constructed to search for the number of extremes needed to minimize...

  3. Incidence and imaging characteristics of skeletal metastases detected by bone scintigraphy in lung cancer patients

    Directory of Open Access Journals (Sweden)

    Jauković Ljiljana

    2006-01-01

    Full Text Available Background/Aim. Detection of metastatic bone disease by skeletal scintigraphy is a classical application of nuclear medicine in cancer patients. Detection of bone metastases in patients with lung cancer is necessary for an appropriate treatment modality. The aim of this study was to report the frequency and imaging characteristics of bone metastases detected by bone scintigraphy (BS using technetium-99m phosphonates in patients with lung cancer. Methods. We retrospectively analyzed a total of one hundred patients (78 males and 22 females, mean age of 63.3 years, with the diagnosis of lung cancer, who underwent BS during a three-year period (2003−2005. Scintiscans were classified as positive, negative and suspicious with regard to the presence of bone metastases. Results. The incidence of positive, negative and suspicious findings were 57%. 32% and 11%, respectively. Out of 57 patients with bone metastases, 51 had multiple asymmetric foci of increased tracer activity localized in the ribs, spine, extremities, pelvis, sternum, scapula and skull in 72%, 54%, 49%, 37%, 12%, 9% and 5% of scans, respectively. BS revealed solitary metastases in 6 of the patients. The lesions were located in the lower limbs in three patients and in the upper limbs, pelvis and sternum in the remaining three patients. Conclusion. Bone scintigraphy plays a significant role in staging and selecting of patients for curative lung surgery. Due to the fact that metastatic involvment of the extremities was frequently shown, our study suggests that systematic inclusion of the limbs in BS acquisition should be obligatory.

  4. Osteolipoma independent of bone tissue: a case report

    OpenAIRE

    Demiralp, Bahtiyar; Alderete, Joseph F; Kose, Ozkan; Ozcan, Ayhan; Cicek, Ilker; Basbozkurt, Mustafa

    2009-01-01

    Introduction Lipomas are the most common benign soft tissue tumors and appear in any part of the body. They typically consist of mature adipose tissue. Osteolipoma is an extremely rare histologic variant of lipoma that contains mature lamellar bone within the tumor and osteolipoma independent of bone tissue are very rare. We report a case of histologically confirmed osteolipoma independent of bone located in the thigh. Case presentation A 47-year-old male presented with a progressively enlarg...

  5. Limb salvage surgery for malignant bone tumors of the extremities in children and adolescents%儿童及青少年保留骨骺的保肢手术临床研究

    Institute of Scientific and Technical Information of China (English)

    Zhen Wang; Zheng Guo; Xiangdong Li; Luyu Huang; Qiang Ji; Haiqiang Wang; Hongxun Sang; Jun Fu

    2009-01-01

    lost to follow up. 29 cases had complete clinical data. Postoperative follow-up was 12-72 months. Recurrences were seen in 3 cases, with one local recurrence in type Ⅲ cases one year post tumor resection, other 2 recurrences around the femoral vessels in type Ⅱ cases 15 months and 30 months after the tumor resection respectively. The recurrence rate accounted for 10.34%. Amputation was performed for the cases with recurrences. But pulmonary metastasis developed and the patients died. In this cohort, 9 cases died. Five-year survival rate constituted 57.94% demonstrated by Kaplan-Meier sur-vival analysis. The median survival time for male patients was 64.36 months, and that for female patients was 56.00 months (P=0.0403). The sites, stages and types were not associated with the survival time. Four cases reported 5 complications (17.24%). The complications included fracture of the allograft, limb length discrepancy, nerve injury, breakage of nails, and loosening of the screws. No patient reported skin necrosis, hematoma, infection, rejection to the allograft, and nonunion at the end of the follow-up. According to the functional evaluation criteria after surgical treatment of malignant tumors of the extremities introduced by Enneking, excellent functional results were reported in 11 cases, good in 13 cases, fair in 3 cases, and poor in 2 cases. The excellent or good result rate was 83%. The excision interface involved partial epiphysis in 4 cases, involved the epiphyseal plate in 8 cases. Intact epiphysis was preserved in 17 cases. Five cases with poor postoperative functional results were in types Ⅱ and Ⅲ. Average time of bone union was 2.5 months for epiphyseal end and 3.8 months for diaphyseal end. According to the Intemational Society of Limb Salvage (ISOLS) radiological implants evaluation system, excellent reconstruction was observed in 23 cases, good reconstruction in 4 cases, fair reconstruction in 1 case, and poor reconstruction in 1 case. All patients in

  6. INCIDENCE OF INTERPARIETAL (INCA BONES IN THE POPULATION OF ASSAM

    Directory of Open Access Journals (Sweden)

    Bijoy Kumar

    2015-07-01

    Full Text Available The occipital bone forms the region of the back of the head. It consists of three parts - the squamous part, the basilar part and the two condylar parts on either side of the foramen magnum. The squamous part of the occipital bone consists of two parts – the upper interparietal and the lower supraoccipital part. Usually the interparietal part fuses with the supraoccipital part but sometimes it may remain separated by a suture. Then it is called interparietal bone or Inca bone. AIM & OBJECTIVES: The aim of the present study is to find out the incidence of interparietal or Inca bones in this part of north east India as data regarding its incidence rate and number of fragments of Inca bones from Assam is still underreported. MATERIALS & METHOD: In the present study, a total of 126 dry adult skulls were examined to know the incidence of Inca bones. All the specimens were procured from various departments in Assam Medical College, Dibrugarh, Assam. They were first examined for presence or absence of Inca bones and then for number of fragments. RESULTS & OBSERVATIO NS: The incidence of Inca bone was found to be 1.58%. One skull presented with a single triangular Inca bone while another skull presented with two fragments of Inca bones. CONCLUSIONS: The knowledge regarding interparietal bones and that it may present with many fragments is certainly very useful for neurosurgeons, radiologists and anthropologists

  7. Prosthetic rehabilitation of the upper limb amputee

    Directory of Open Access Journals (Sweden)

    Bernard O′Keeffe

    2011-01-01

    Full Text Available The loss of all or part of the arm is a catastrophic event for a patient and a significant challenge to rehabilitation professionals and prosthetic engineers. The large, upper extremity amputee population in India has, historically, been poorly served, with most having no access to support or being provided with ineffective prostheses. In recent years, the arrival of organisations like Otto Bock has made high quality service standards and devices accessible to more amputees. This review attempts to provide surgeons and other medical professionals with an overview of the multidisciplinary, multistage rehabilitation process and the solution options available. With worldwide upper extremity prosthesis rejection rates at significant levels, the review also describes some of the factors which influence the outcome. This is particularly relevant in the Indian context where the service can involve high cost investments. It is the responsibility of all contributing professionals to guide vulnerable patients through the process and try to maximise the benefit that can be obtained within the resources available.

  8. Functional metagenomics of extreme environments.

    Science.gov (United States)

    Mirete, Salvador; Morgante, Verónica; González-Pastor, José Eduardo

    2016-04-01

    The bioprospecting of enzymes that operate under extreme conditions is of particular interest for many biotechnological and industrial processes. Nevertheless, there is a considerable limitation to retrieve novel enzymes as only a small fraction of microorganisms derived from extreme environments can be cultured under standard laboratory conditions. Functional metagenomics has the advantage of not requiring the cultivation of microorganisms or previous sequence information to known genes, thus representing a valuable approach for mining enzymes with new features. In this review, we summarize studies showing how functional metagenomics was employed to retrieve genes encoding for proteins involved not only in molecular adaptation and resistance to extreme environmental conditions but also in other enzymatic activities of biotechnological interest.

  9. A型肉毒毒素注射配合康复功能训练对痉挛型偏瘫脑瘫患儿上肢运动功能疗效观察%Effect of Botulinum Toxin Type A Injection Combined with Rehabilitation Functional Training on Upper Extremity Motor Function in Children with Spastic Hemiplegic Cerebral Palsy

    Institute of Scientific and Technical Information of China (English)

    颜华; 张惠佳; 阳伟红; 王益梅; 郭春光; 胡继红; 周平秋; 何金华; 段华林

    2012-01-01

    目的 观察A型肉毒毒素(BTX-A)注射治疗配合康复功能训练对痉挛型偏瘫脑瘫患儿上肢功能障碍的疗效.方法 60例痉挛型偏瘫型脑瘫患儿均接受BTX-A注射治疗,治疗后进行强制性诱导运动训练、物理疗法、肌电生物反馈治疗、作业治疗及家庭训练.在治疗前与治疗3个月后,分别用改良Ashworth痉挛量表(MAS)评定患侧上肢肌张力、关节量角器法测量患侧腕关节主动背伸角度、Peabody运动发育量表(PDMS-II)进行患侧手精细运动商(FMQ)的评估、日常生活活动能力(ADL)量表评估ADL能力以比较观察疗效.结果 治疗后患儿上述指标均较治疗前显著改善(P<0.001).结论 BTX-A注射治疗配合康复功能训练能明显降低痉挛型偏瘫型脑瘫患儿的上肢肌张力,改善关节活动范围,明显提高上肢运动功能.%Objective To observe the effect of Botulinum toxin type A (BTX-A) injection combined with rehabilitation functional training on upper extremity motor function in children with spastic hemiplegic cerebral palsy (CP). Methods 60 spastic hemiplegic CP children were treated with constraint-induced movement therapy (CIMT), physical therapy, electromyographic biofeedback stimulation therapy, occupational therapy, family-based training and so on after injected with BTX-A. The muscle tension of the hemiplegic upper extremity accessed by Modified Ashworth Scale (MAS), the wrist angle of active dorsiextention motion by orthrometer, fine movement quotient (FMQ) by Pea-body developmental motor scale (PDMS- II), and activities of daily living (ADL) were performed to evaluate the effects before and 3 months after treatment. Results These outcomes were improved significantly after treatment (P<0.001). Conclusion BTX-A injection combined with rehabilitation functional training could rapidly reduce spasticity of the upper extremity, increase the range of motion, improve motor function of upper extremity in children with spastic

  10. Biochemical markers of bone turnover

    International Nuclear Information System (INIS)

    Biochemical markers of bone turnover has received increasing attention over the past few years, because of the need for sensitivity and specific tool in the clinical investigation of osteoporosis. Bone markers should be unique to bone, reflect changes of bone less, and should be correlated with radiocalcium kinetics, histomorphometry, or changes in bone mass. The markers also should be useful in monitoring treatment efficacy. Although no bone marker has been established to meet all these criteria, currently osteocalcin and pyridinium crosslinks are the most efficient markers to assess the level of bone turnover in the menopausal and senile osteoporosis. Recently, N-terminal telopeptide (NTX), C-terminal telopeptide (CTX) and bone specific alkaline phosphatase are considered as new valid markers of bone turnover. Recent data suggest that CTX and free deoxypyridinoline could predict the subsequent risk of hip fracture of elderly women. Treatment of postmenopausal women with estrogen, calcitonin and bisphosphonates demonstrated rapid decrease of the levels of bone markers that correlated with the long-term increase of bone mass. Factors such as circadian rhythms, diet, age, sex, bone mass and renal function affect the results of biochemical markers and should be appropriately adjusted whenever possible. Each biochemical markers of bone turnover may have its own specific advantages and limitations. Recent advances in research will provide more sensitive and specific assays

  11. Double Trouble: A Rare Case of Bilateral Upper Pole Ureteropelvic Junction Obstruction

    Directory of Open Access Journals (Sweden)

    Craig A. Peters

    2014-09-01

    Full Text Available A 16-year-old girl presented with bilateral back pain caused by bilateral upper pole ureteropelvic junction obstructions; an extremely rare phenomenon. Bilateral robotically assisted upper pole pyeloplasties were preformed at the same setting with an excellent clinical response. Although rare, upper pole ureteropelvic junction obstruction is a defined entity that urologists should be aware of.

  12. Chondroblastoma of temporal bone

    Energy Technology Data Exchange (ETDEWEB)

    Tanohta, K.; Noda, M.; Katoh, H.; Okazaki, A.; Sugiyama, S.; Maehara, T.; Onishi, S.; Tanida, T.

    1986-07-01

    The case of a 55-year-old female with chondroblastoma arising from the left temporal bone is presented. Although 10 cases of temporal chondroblastoma have been reported, this is the first in which plain radiography, pluridirectional tomography, computed tomography (CT) and angiography were performed. We discuss the clinical and radiological aspects of this rare tumor.

  13. Cancellous structure of tarsal bones.

    OpenAIRE

    D N Sinha

    1985-01-01

    The internal structure of the tarsal bones has been studied to investigate their cancellous architecture. It is revealed that these bones have fine and coarse meshworks and even a tendency for obliteration of the trabecular pattern in the bones lying distal to this midtarsal joint. Internal structure of the talus does not show an arched pattern of bony lamellae. An increased density of bony lamellae in the internal structure of the navicular bone could result from excessive stress, enforced b...

  14. CEPHALOMETRIC STUDY OF UPPER AIRWAY AND THE HYOID BONE POSTION IN MIXED DENTITION CHILDREN WITH SKELETAL CLASS (Ⅲ) MALOCCLUSION%替牙期骨性Ⅲ类错(牙合)儿童上气道形态及舌骨位置的X线头影测量

    Institute of Scientific and Technical Information of China (English)

    赵志婷; 范存晖; 杨茜; 陈杰; 刘新强; 许涛

    2013-01-01

    目的 探讨替牙期骨性Ⅲ类错(牙合)儿童上气道形态及舌骨位置的特征.方法 选取替牙期(颈椎骨龄7~11岁)骨性Ⅲ类错(牙合)及骨性Ⅰ类正常对照组儿童各30例,拍摄X线头颅定位侧位片,应用Winceph 8.0 X线头影测量分析软件进行气道宽度和舌骨位置的头影测量.比较两组鼻咽、腭咽、舌咽和喉咽各部位气道宽度和舌骨位置的差异.结果 替牙期骨性Ⅲ类错(牙合)儿童的上气道各段均明显窄于正常对照组儿童(t=2.035~4.578,P<0.05),软腭宽度明显增大(t=2.389,P<0.05),舌骨位置更靠前(t=2.583、2.696,P<0.05).结论 替牙期骨性Ⅲ类错(牙合)儿童气道形态和舌骨位置存在特征性改变.%Objective To investigate the features of upper airway appearance and the position of hyoid bone in mixed dentition children with skeletal class Ⅲ malocclusion.Methods Thirty children in mixed dentition (cervical vertebral maturation 7-11 years) with skeletal class Ⅲ malocclusion,and 30 normal children were included in this study.Cephalometric radiographs were taken for the children.The width of the upper airway and the position of the hyoid bone were measured by using Winceph 8.0 software.The width of each part airway and the position of hyoid bone between the two groups were compared.Results Compared with normal children,the width of each part upper airway in skeletal class Ⅲ malocclusion ones was markedly narrowed (t =2.035-4.578,P<0.05),the width of the soft palate increased (t =2.389,P<0.05),and the position of hyoid bone located more anteriorly (t=2.583,2.696;P<0.05).Conclusion There are characteristic changes in the appearance of upper airway and the position of hyoid bone in mixed dentition children with skeletal class Ⅲ malocclusion.

  15. Incidence of delayed complications following percutaneous CT-guided biopsy of bone and soft tissue lesions of the spine and extremities: A 2-year prospective study and analysis of risk factors

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Ambrose J.; Rosenthal, Daniel I. [Massachusetts General Hospital, Boston, MA (United States); Halpern, Elkan F. [Massachusetts General Hospital, Institute of Technology Assessment, Boston, MA (United States)

    2013-01-15

    To prospectively evaluate the incidence of delayed complications (bleeding, pain, infection) following CT-guided biopsies of bone or soft tissue lesions and to identify risk factors that predispose to their occurrence. All adults presenting for CT-guided biopsy of a bone or soft tissue lesion were eligible for the study. Risk factors considered included patient gender and age, bone versus soft tissue, lesion location, lesion depth, anticoagulation, conscious sedation, coaxial biopsy technique, bleeding during the biopsy, dressing type and duration of placement, final diagnosis, needle gauge, number of passes, and number of days to follow-up. Outcomes measured included fever, pain, bruising/hematoma formation, and swelling and were collected by a follow-up phone call within 14 days of the biopsy. Fisher's exact test, the Wald Chi-square test, and univariate, multivariate, and stepwise logistic regression were performed to evaluate the influence of the risk factors on the outcomes. A total of 386 patients participated in the study. The rates of post-biopsy fever, pain, bruising, and swelling were 1.0, 16.1, 15.6, and 9.6 %, respectively. Anticoagulants were identified as a risk factor for fever. Increasing patient age was identified as a risk factor for pain. Female gender and lesion location were identified as risk factors for bruising. Increasing patient age and lesion location were identified as risk factors for swelling. Patient age, female gender, and lesion location are risk factors for delayed minor complications following CT-guided biopsy of a bone or soft tissue lesion. There were no major complications. None of the complications in this series altered patient management. (orig.)

  16. [Pharmacology of bone anabolic agents].

    Science.gov (United States)

    Matsumoto, Toshio

    2015-10-01

    Bone is constantly remodeled to maintain its volume, structural integrity and strength Currently available bone anabolic agent is teriparatide. Teriparatide increases bone mass and strength via both remodeling-dependent and -independent mechanisms, although remodeling-dependent mechanism overweighs the other. Canonical Wnt signal plays an important role in enhancing osteoblast differentiation and bone formation, and its osteocyte-derived inhibitor, sclerostin, regulates bone formation via the regulation of Wnt signaling. Anti-sclerostin antibody stimulates Wnt signaling and enhances bone formation. Phase II clinical trials with anti-sclerostin antibodies, romosozumab and blosozumab, demonstrated a marked increase in bone mineral density after one year of treatment. The new modality of anabolic agents via remodeling-independent stimulation of bone formation may open up a new avenue for the treatment of osteoporosis.

  17. Chondrosarcoma of the hyoid bone

    Energy Technology Data Exchange (ETDEWEB)

    Demeyere, A.; Somer, F. de; Perdieus, D.; Lemmens, L.; Schillebeeckx, J. [Dept. of Radiology, Imeldaziekenhuis Bonheiden (Belgium); Hauwe, L. van den [Dept. of Radiology, University Hospital Antwerp (Belgium)

    2000-02-01

    The CT and MRI findings in a case of chondrosarcoma of the hyoid bone are reported. Although chondrosarcoma is the second most common primary malignant bone tumor, only 10 % of chondrosarcomas occur in the head and neck region. The hyoid bone is a rare site of involvement with only seven cases reported previously. (orig.)

  18. Existence of extremal periodic solutions for quasilinear parabolic equations

    Directory of Open Access Journals (Sweden)

    Siegfried Carl

    1997-01-01

    bounded domain under periodic Dirichlet boundary conditions. Our main goal is to prove the existence of extremal solutions among all solutions lying in a sector formed by appropriately defined upper and lower solutions. The main tools used in the proof of our result are recently obtained abstract results on nonlinear evolution equations, comparison and truncation techniques and suitably constructed special testfunction.

  19. Gout: Value of bone scanning

    Energy Technology Data Exchange (ETDEWEB)

    Oliva, J.P.; Cardenas, R.; Bell, L.; Gonzalez Griego, J.

    1986-12-01

    11 male patients with gout were studied by means of bone scintigraphy with /sup 99m/TcMDP. This diagnostic method rendered possible the diagnosis of clinically or roentgenologically occult bone involvement. Bone scintigraphy may be useful procedure to monitor therapy of gout.

  20. Models of Pluto's upper atmosphere

    International Nuclear Information System (INIS)

    Best guesses as to the thermal structure and composition of Pluto's atmosphere have led to speculations of substantial loss rates (∼1028 s-1) of methane from the planet over cosmogonic time scales. Results from recent stellar occultation measurements, and using a Parker-type hydrodynamic calculation, show that the loss rates may actually be lower by as much as a factor ∼5, depending upon the efficiency of heating of the atmosphere via the absorption of solar EUV and upon the true atmospheric composition, if the thermal structure of the upper atmosphere is properly taken into account. The loss rate may even be less (by another factor ∼10) if there is minimal heating of the upper atmosphere

  1. Gracile bone dysplasias

    Energy Technology Data Exchange (ETDEWEB)

    Kozlowski, Kazimierz [Department of Medical Imaging, The Children' s Hospital at Westmead, Locked Bag 4001, Westmead 2145, NSW (Australia); Masel, John [Department of Radiology, Royal Children' s Hospital, Brisbane (Australia); Sillence, David O. [Department of Paediatrics and Child Health, The University of Sydney (Australia); Arbuckle, Susan [Department of Anatomical Pathology, The Children' s Hospital at Westmead, NSW (Australia); Juttnerova, Vera [Oddeleni Lekarske Genetiky, Hradec Kralove (Czech Republic)

    2002-09-01

    Gracile bone dysplasias constitute a group of disorders characterised by extremely slender bones with or without fractures. We report four newborns, two of whom showed multiple fractures. Two babies had osteocraniostenosis and one had features of oligohydramnios sequence. The diagnosis in the fourth newborn, which showed thin long bones and clavicles and extremely thin, poorly ossified ribs, is uncertain. Exact diagnosis of a gracile bone dysplasia is important for genetic counselling and medico-legal reasons. (orig.)

  2. On using the Microsoft Kinect$^{\\rm TM}$ sensors to determine the lengths of the arm and leg bones of a human subject in motion

    CERN Document Server

    Malinowski, M J

    2015-01-01

    The present study is part of a broader programme, exploring the possibility of involving the Microsoft Kinect$^{\\rm TM}$ sensor in the analysis of human motion. We examine the output obtained from the two available versions of this sensor in relation to the variability of the estimates of the lengths of eight bones belonging to the subject's extremities: of the humerus (upper arm), ulna (lower arm, forearm), femur (upper leg), and tibia (lower leg, shank). Large systematic effects in the output of the two sensors have been observed.

  3. Clinical study of upper extremity lymph nodes metastasis in breast cancer patients staging pN1~3%N1~3期乳腺癌患者合并上肢淋巴结转移的临床研究

    Institute of Scientific and Technical Information of China (English)

    欧林洋; 雷睿文; 黄湛; 杨传盛; 李敏; 张凯; 陈卓荣

    2015-01-01

    Objective Through the study of upper extremity lymph nodes metastasis in the patients with pN1~3 breast cancer, to provide theoretical basis for the preserving upper extremity lymph nodes in positive axillary lymph nodes patients in axillary lymph nodes dissection (ALND). Methods Forty-five newly diagnosed breast cancer pa-tients with axillary lymph nodes metastasis were included. Using carbon nanoparticles suspension for axillary reverse mapping, 42 patients were labelled successfully and performed axillary lymph nodes dissection (included arm lym-phtics). 1~3 blue dye arm lymph nodes were checked out, and the average number was (2±0.9). 15~37 not-dyed axil-lary lymph nodes were checked out, and the average number was (26±6.9). Lymph nodes of the two groups were per-formed pathological section to study the statuses of the upper extremity lymph nodes metastasis and the stages of axil-lary lymph nodes. Results Twenty-six patients were graded as pN1, one of which was detected with upper extremity lymph nodes metastasis. Ten patients were graded as pN2, 2 of which were detected with upper extremity lymph nodes metastasis. Six patients were graded as pN3, 5 of which were detected with upper extremity lymph nodes metastasis. Conclusion It's feasible to use carbon nanoparticles suspension to carry out axillary reverse mapping during ALND for breast cancer patients staging pN1~3. Axillary lymph nodes metastasis might merge upper extremity lymph nodes metastasis, indicating the communications of the two. Accordingly, it's not rigorous to decide whether preserve the up-per extremity lymph nodes during ALND by pathologic axillary lymph node staging for these patients only. It's re-quired to search for more reliable methods to evaluate the axillary reverse mapping.%目的:通过研究N1~3期乳腺癌患者上肢淋巴结转移情况,为腋窝淋巴结阳性患者在行腋窝淋巴结清扫术(ALND)中的上肢淋巴结保留术提供理论依据。方法45例初诊伴

  4. 强制性使用运动疗法对恢复期脑卒中患者上肢功能的影响%The effect of constraint-induced movement therapy on upper extremity function in recovering stroke patients

    Institute of Scientific and Technical Information of China (English)

    李奎; 胡昔权; 郑金利; 周利红; 谢丽君

    2008-01-01

    目的 探讨强制性使用运动疗法(CIMT)对恢复期脑卒中患者上肢功能和日常生活活动能力的影响.方法 将符合入选条件的30例恢复期脑卒中偏瘫患者随机分为观察组和对照组,每组15例.观察组用CIMT,即用休息位夹板和吊带将健侧上肢固定,限制使用,每天在清醒时的固定时间不少于90%;每天强制性训练患者使用偏瘫侧上肢6 h(其中1 h在作业治疗室进行任务指向性塑形训练,其它5 h在家属监督下使用患手),每周6 d,持续3周.对照组用神经发育疗法(NDT),每天在作业治疗室以运动再学习方案训练为主,训练患者使用偏瘫侧上肢1 h,每周6 d,持续3周.2组患者均同时予以常规药物治疗及其它康复治疗,治疗前、后采用Wolf运动功能评价量表(WMFT)评定偏瘫侧上肢运动功能,采用Barthel指数(BI)评定ADL能力.结果 治疗前2组患者WMFT评分和BI评分比较,差异无统计学意义(P>0.05);2组治疗前、后比较,偏瘫侧上肢运动功能和ADL能力均有提高,差异具有统计学意义(P<0.001);治疗后2组患者WMFT评分比较,观察组优于对照组,差异具有统计学意义(P<0.05),而BI评分比较,差异无统计学意义(P>0.05).结论 CIMT与NDT对恢复期脑卒中患者上肢功能都有促进作用,都可提高患者ADL能力,但CIMT对促进恢复期脑卒中患者的上肢功能优于NDT.%Objective To observe the effect of constraint-induced movement therapy(CIMT)on upper extremity function and the ADL performance of recovering stroke patients. Methods Thirty recovering stroke patients were recruited and randomly and evenly divided into intervention and control groups.The patients in the intervention group were trained using constraint-induced movement therapy(CIMT),in which their unaffected upper extremities were immobilized by a resting splint and an arm sling no less than 90% of the waking time every day.They were forced to use their affected upper extremities

  5. Treatment of tibial defect and bone nonunion with limb shortening with external fixator and reconstituted bone xenograft

    Institute of Scientific and Technical Information of China (English)

    王志刚; 刘建; 胡蕴玉; 孟国林; 金格勒; 袁志; 王海强; 戴先文

    2003-01-01

    Objective: To explore the effect of external fixator and reconstituted bone xenograft (RBX) in the treatment of tibial bone defect, tibial bone nonunion and congenital pseudarthrosis of the tibia with limb shortening. Methods: Twenty patients ( 13 males and 7 females) with tibial bone defect, tibial bone nonunion or congenital pseudarthrosis of the tibia with limb shortening were treated with external fixation. Two kinds of external fixators were used: a half ring sulcated external fixator used in 13 patients and a combined external fixator in 7 patients. Foot-drop was corrected at the same time with external fixation in 4 patients. The shortened length of the tibia was in the range of 2-9 cm, with an average of 4.8 cm. For bone grafting, RBX was used in 12 patients, autogenous ilium was used in 3 patients and autogenous fibula was implanted as a bone plug into the medullary canal in 1 case, and no bone graft was used in 4 patients. Results: All the 20 patients were followed-up for 8 months to 7 years, averaging 51 months. Satisfactory function of the affected extremities was obtained. All the shortened extremities were lengthened to the expected length. For all the lengthening area and the fracture sites, bone union was obtained at the last. The average healing time of 12 patients treated with RBX was 4.8 months. Conclusions: Both the half ring sulcated external fixator and the combined external fixator have the advantages of small trauma, simple operation, elastic fixation without stress shielding and non-limitation from local soft tissue conditions, and there is satisfactory functional recovery of affected extremities in the treatment of tibial bone defects, tibial bone nonunion and congenital pseudarthrosis of the tibia combined with limb shortening. RBX has good biocompatibility and does not cause immunological rejections. It can also be safely used in treatment of bone nonunion and has reliable effect to promote bone healing.

  6. Primary non-Hodgkin lymphoma of bone: An unusual presentation

    OpenAIRE

    Pinheiro Ronald; Filho Francisco; Lima Gabrielle; Ferreira Francisco

    2009-01-01

    Primary lymphoma of bone (PLB) is an extremely rare condition that is usually confused with other primary injuries of the bone. It is characterized by the involvement of one or more bone locations, with or without involvement of regional lymph nodes and viscera. PLB constitutes 3-7% of all malignant bone tumors and approximately 3% of all extranodal lymphomas. It is found at all ages, being most frequently seen in adult life. Any part of the skeleton can be involved, but a trend...

  7. The role of bone scanning in the cancer patient

    International Nuclear Information System (INIS)

    The past few years have been notable by the torrent of work which has served to establish bone scanning as one of the most useful nuclear medicine procedures. The quantitative radiopharmacology of the sup(99m) Tc phosphates has great possibilities for obtaining reliable and reproducible bone scans of high quality. Bone scans are extremely useful in staging malignant disease, particularly with primaries involving breast, prostate, lung, kidney and thyroid, but are also useful in the workup of the lymphomas, in the female genital cancer tract, and primary bone malignancy. The full potential of these compounds in the care of the cancer patient has been confirmed. (orig.)

  8. [Contemporary management of bone tumors at Semmelweis University].

    Science.gov (United States)

    Szendrői, Miklós; Antal, Imre; Kiss, János; Perlaky, Tamás; Szalay, Krisztián

    2014-06-01

    The incidence of bone tumors is low therefore it is highly recommended to treat patients in specialized centers. In the late 70ies a bone tumor registry was initiated at the Department of Orthopedics of the Semmelweis University followed by the development of a specialized diagnostic unit and a bone cancer center. Several novel surgical procedures have been introduced, including the extremity-sparing surgery, leading to a significant improvement of the patients survival. This is fully supported by a specialized bone cancer oncoteam of experts. The 6000-sized registry and biobank now allows the development of translational research in this orphan tumor type. PMID:25010756

  9. Computerized geometric features of carpal bone for bone age estimation

    Institute of Scientific and Technical Information of China (English)

    Chi-Wen Hsieh; Tai-Lang Jong; Yi-Hong Chou; Chui-Mei Tiu

    2007-01-01

    Background Bone age development is one of the significant indicators depicting the growth status of children.However, bone age assessment is an heuristic and tedious work for pediatricians. We developed a computerized bone age estimation system based on the analysis of geometric features of carpal bones.Methods The geometric features of carpals were extracted and analyzed to judge the bone age of children by computerized shape and area description. Four classifiers, linear, nearest neighbor, back-propagation neural network,and radial basis function neural network, were adopted to categorize bone age. Principal component and discriminate analyses were employed to improve assorting accuracy.Results The hand X-ray films of 465 boys and 444 girls served as our database. The features were extracted from carpal bone images, including shape, area, and sequence. The proposed normalization area ratio method was effective in bone age classification by simulation. Besides, features statistics showed similar results between the standard of the Greulich and Pyle atlas and our database.Conclusions The bone area has a higher discriminating power to judge bone age. The ossification sequence of trapezium and trapezoid bones between Taiwanese and the atlas of the GP method is quite different. These results also indicate that carpal bone assessment with classification of neural networks can be correct and practical.

  10. Ultrasound guided distal peripheral nerve block of the upper limb: A technical review

    Directory of Open Access Journals (Sweden)

    Herman Sehmbi

    2015-01-01

    Full Text Available Upper extremity surgery is commonly performed under regional anesthesia. The advent of ultrasonography has made performing upper extremity nerve blocks relatively easy with a high degree of reliability. The proximal approaches to brachial plexus block such as supraclavicular plexus block, infraclavicular plexus block, or the axillary block are favored for the most surgical procedures of distal upper extremity. Ultrasound guidance has however made distal nerve blocks of the upper limb a technically feasible, safe and efficacious option. In recent years, there has thus been a resurgence of distal peripheral nerve blocks to facilitate hand and wrist surgery. In this article, we review the technical aspects of performing the distal blocks of the upper extremity and highlight some of the clinical aspects of their usage.

  11. RARE PRESENTATION OF MELORHEOSTEOSIS INVOLVING CARPAL BONES

    Directory of Open Access Journals (Sweden)

    Ramana

    2014-02-01

    Full Text Available Melorheostosis is a rare sclerosing bone dysplasia, known as Leri disease characterized by a “flowing” hyperostosis of the cortex. Classically, melorheostosis affects the long bones of the skeleton, especially those in the lower extremities . Involvement of wrist is rare. The radiographic appearance has been likened to “dripping wax down the side of a candle.” The clinical and the radiographic manifestations of melorheostosis have been encountered in a 12 - year - old male child. Examination revealed limitation of movements of right wrist. Conventional radiographs of right hand showed increase in density of scaphoid, lunate, Triquetrum and Pisiform, skeletal survey showed isolated carpal involvement, 3D CT s canning showed patchy increase of density with cortical dripping appearance of carpal bones