WorldWideScience

Sample records for bones of upper extremity

  1. Disorders of the upper extremity in children.

    Science.gov (United States)

    Azouz, E M; Oudjhane, K

    1998-08-01

    This article presents a brief overview of the indications of MR imaging in a variety of disorders of the upper extremity of the pediatric patient. This covers congenital anomalies: Sprengel shoulder, Poland sequence, arthrogryposis; posttraumatic lesions of cartilage, bone, tendon, muscle and nerve including the brachial plexus injury; inflammatory arthritis and synovitis; bone and joint infection; osteochondritis dissecans, bone necrosis and infarcts in sickle cell anemia and juvenile Gaucher disease, as well as tumors. In this last category, the authors briefly describe the appearances of cysts and tumors of bones and soft tissues of the upper extremity. Indications for the intravenous administration of Gadolinium are given throughout the article with emphasis on the synovial enhancement seen in active arthritis and synovitis. PMID:9654591

  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. Schwannoma of the upper extremity

    International Nuclear Information System (INIS)

    The study was undertaken to review 22 patients with schwannoma in the upper extremity. Fourteen patients noticed some clinical symptoms such as pain, numbness or Tinel's sign, whereas a lump was only manifestation of the tumor in 8 patients. It was not difficult to obtain preoperatively the diagnosis of schwannoma via clinical symptoms and modern imaging modality such as MRI. The average follow-up period after operation was 29 months, and satisfactory results were obtained in all patients without any recurrence of the tumor. Functional disability was never encountered in any patients, although 6 patients had mild neurological deficit, all of which located in the median nerve distribution. (author)

  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. Washing Machine Injuries of the Upper Extremity

    Science.gov (United States)

    Suresh, S S

    2008-01-01

    Washing machines are part of every household and there are various reports of upper extremity injuries due to inadequate safety precautions while operating the machine. Most of the injuries occur when an attempt is made to remove the clothes from the machine and the hand gets caught in the spinning machine. The presentation can vary from minor soft tissue injuries to a mangled upper extremity. The chance of neurovascular damage resulting in compartment syndrome is very high. The author reports three cases of washing machine injuries to draw attention to this not so uncommon injury. The relevant literature is also considered. PMID:21654964

  6. Muscles of the Upper Extremity

    Science.gov (United States)

    ... Thyroid & Parathyroid Glands Adrenal Gland Pancreas Gonads Other Endocrine Glands Review Quiz Cardiovascular System Heart Structure of the Heart Physiology of the Heart Blood Classification & Structure of Blood ...

  7. 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)

  8. Arterial embolism of the upper extremities

    International Nuclear Information System (INIS)

    The angiographic signs, the frequency and the site of distribution of acute emboli of the arteries of the upper extremity are described. The conclusions are based on the author's own experience gained from selective studies of acute arterial embolism of the upper limb, during a period of 15 years. A comparison is made with the results of two of the largest series reported in the literature. In addition, a brief review of the aetiology, pathogenesis, the clinical and roentgenological signs of the condition is given. (orig.)

  9. Arterial embolism of the upper extremities

    Energy Technology Data Exchange (ETDEWEB)

    Janevski, B.

    1986-10-01

    The angiographic signs, the frequency and the site of distribution of acute emboli of the arteries of the upper extremity are described. The conclusions are based on the author's own experience gained from selective studies of acute arterial embolism of the upper limb, during a period of 15 years. A comparison is made with the results of two of the largest series reported in the literature. In addition, a brief review of the aetiology, pathogenesis, the clinical and roentgenological signs of the condition is given.

  10. Arterial embolism of the upper extremities.

    Science.gov (United States)

    Janevski, B

    1986-10-01

    The angiographic signs, the frequency and the site of distribution of acute emboli of the arteries of the upper extremity are described. The conclusions are based on the author's own experience gained from selective studies of acute arterial embolism of the upper limb, during a period of 15 years. A comparison is made with the results of two of the largest series reported in the literature. In addition, a brief review of the aetiology, pathogenesis, the clinical and roentgenological signs of the condition is given. PMID:3022344

  11. 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 will...... 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....... Early diagnosis and treatment is essential to prevent PTS in primary UEDVT; however, there is no consensus on which treatment is the best. Anticoagulation is still considered the treatment of choice for at least 3-6 months, until Randomized Controlled Trials may have demonstrated otherwise....

  12. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  14. Current perspective of venous thrombosis in the upper extremity

    OpenAIRE

    Flinterman, L.E.; Meer, van der, W.; Rosendaal, F.R.; Doggen, C.J.M.

    2008-01-01

    Venous thrombosis of the upper extremity is a rare disease. Therefore, not as much is known about risk factors, treatment and the risk of recurrence as for venous thrombosis of the leg. Only central venous catheters and strenuous exercise are commonly known risk factors for an upper extremity venous thrombosis. In this review an overview of the different risk factors, possible treatments and the complications for patients with a venous thrombosis of the upper extremity is given

  15. 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

  16. 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

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

    Science.gov (United States)

    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

  18. Skin Cancer of the Hand and Upper Extremity

    Science.gov (United States)

    ... 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 ...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    International Nuclear Information System (INIS)

    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.)

  1. 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

  2. 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

  3. Vascular Disorders of the Upper Extremity

    Science.gov (United States)

    ... Symptom Picker Hand and Arm Conditions Carpal Tunnel Ganglion Cysts Trigger Finger Arthritis Base of the Thumb See ... Symptom Picker Hand and Arm Conditions Carpal Tunnel Ganglion Cysts Trigger Finger Arthritis Base of the Thumb See ...

  4. Nerve Injuries of the Upper Extremity

    Science.gov (United States)

    ... Symptom Picker Hand and Arm Conditions Carpal Tunnel Ganglion Cysts Trigger Finger Arthritis Base of the Thumb See ... Symptom Picker Hand and Arm Conditions Carpal Tunnel Ganglion Cysts Trigger Finger Arthritis Base of the Thumb See ...

  5. Incidence estimates of hand and upper extremity injuries in Italy

    Directory of Open Access Journals (Sweden)

    Marco Giustini

    2015-12-01

    Full Text Available OBJECTIVE: The purpose of this investigation is to estimate the incidence rates of upper extremity injuries and to give an overview of the most frequent diagnoses. MATERIALS AND METHODS: Two population databases were queried for all injuries in the upper extremities, the SINIACA-IDB (S-IDB: Emergency Department Injury Database in Italy and the Hospital Discharge Register (HDR. The diagnoses codes of hand trauma were selected from both databases in order to estimate the national incidence rate. RESULTS: According to the S-IDB data of year 2011, total 1 479 510 ED attendances per year in Italy were estimated with an upper extremity injury (incidence rate: 2491 per 100 000 persons/year. About 880 816 Emergency Department (ED attendances per year are due to hand injuries, while over 653 336 attendances per year concern arm injuries. The incidence rates are 1483 and 1100 per 100 000 person/year respectively. About 201 940 hospitalizations are observed in the HDR because of upper extremity injuries (incidence rate: 340 per 100 000 persons/year. Males have higher incidence rate (387 vs 280 per 100 000 persons per year. The trend in the incidence rates for the age group of inpatients shows two peaks: at age 12 (400 cases per 100 000 persons/year, and in the older age groups (700 cases per 100 000 persons/year.

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

    Science.gov (United States)

    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.

  7. Congenital disorders of the hand and upper extremity.

    Science.gov (United States)

    Van Heest, A E

    1996-10-01

    This article summarizes normal formation and growth of the upper limb as a basis for understanding malformation. Shoulder anomalies, including Sprengel's undescended scapula, clavicle pseudarthrosis, cleidocraniodystostosis, and Poland's syndrome, are presented. Classification and examples of limb malformations are discussed as well as neuromuscular disorders, such as obstetric brachial plexopathy, cerebral palsy, and arthrogryposis. The author hopes that this article provides a basic understanding of the evaluation necessary for appropriate counseling and referrals for treatment of the child with hand and upper extremity congenital deformities. PMID:8858076

  8. 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...

  9. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Management of catheter-associated upper extremity deep venous thrombosis.

    Science.gov (United States)

    Crawford, Jeffrey D; Liem, Timothy K; Moneta, Gregory L

    2016-07-01

    Central venous catheters or peripherally inserted central catheters are major risk factors for upper extremity deep venous thrombosis (UEDVT). The body and quality of literature evaluating catheter-associated (CA) UEDVT have increased, yet strong evidence on screening, diagnosis, prevention, and optimal treatment is limited. We herein review the current evidence of CA UEDVT that can be applied clinically. Principally, we review the anatomy and definition of CA UEDVT, identification of risk factors, utility of duplex ultrasound as the preferred diagnostic modality, preventive strategies, and an algorithm for management of CA UEDVT. PMID:27318061

  12. 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

  13. Malignant bone tumors of the pelvis and of the extremities

    International Nuclear Information System (INIS)

    Bone tumors of the extremities are usually diagnosed by conventional radiography. A good angiogram may render information not only about intra- and extraosseous extension of the tumor, but often also about the biological dignity. CT is usually not necessary, especially since it is sometimes difficult to define the extraosseous borders of these extremity tumors with this method. In bone tumors of the pelvis, however, neither conventional radiography nor angiography render reliable information about the extent of the tumor, which CT is very well able to do. Therefore CT is primarily indicated for evaluation of bone tumors in this region. Angiography is done only for preoperative evaluation of the vascular architecture or for potential therapeutic embolisation. (orig.)

  14. Tumors involving the skin of the upper extremity.

    Science.gov (United States)

    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

  15. 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 ...

  16. UPPER EXTREMES OF THE RAINLESS PERIODS IN BANAT AND SREM

    OpenAIRE

    Nešković-Zdravić, Verica; Zelenhasić, Emir; Berić, Milica

    1990-01-01

    Abstract: The Zelenhasić-Todorović method of describing and analysing the extremes in hydrology, which is modified for extreme dry weather intervals, is presented. The basic assumption of the method is that the extreme dry weather intervals are independent, identically distributed random variables and that their occurence is subject to the Poisson probability law. According to the theory of supreme of random number of random variables, the explanation and analyses of the largest rainfall defi...

  17. Upper extremity myoelectric prosthetics.

    Science.gov (United States)

    Uellendahl, J E

    2000-08-01

    Myoelectric control of upper limb prostheses has proven to be an effective and efficient means of controlling prosthetic components. This means of control has been used extensively for over 30 years, during which time these systems have become reliable and durable in most situations. Myoelectric control, or any other prosthetic control scheme, should not be considered as the optimal control for arm prostheses, but rather as one of the several effective ways of producing desired function. Advanced clinical practice calls for a blending of all control schemes, as appropriate, to allow the prosthesis to serve the intentions of the user efficiently and with little mental effort. Technology continues to change, bringing with it new and sometimes better ways of fitting amputees. Microprocessors and programmable controllers have opened new and exciting avenues for improvement in function. New, and as of yet unidentified, electronic and mechanical advances are certainly on the horizon. There is much work to be done before upper limb prostheses rightfully are called arm replacements. But progress is occurring and advances are being made toward the goal of replacing the function and appearance of that marvelous tool, the human arm. PMID:10989484

  18. 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

  19. Upper extremity injuries in golf.

    Science.gov (United States)

    Bayes, Matthew C; Wadsworth, L Tyler

    2009-04-01

    Golf is an asymmetric sport with unique patterns of injury depending upon the skill level. Higher handicap players typically experience injuries that result from swing mechanics, whereas lower handicap and professional players have overuse as the major cause of their injuries. The majority of shoulder injuries affecting golfers occur in the nondominant shoulder. Common shoulder injuries include subacromial impingement, rotator cuff pathology, glenohumeral instability, and arthritis involving the acromioclavicular and/or glenohumeral joints. Lead arm elbow pain resulting from lateral epicondylosis (tennis elbow) is the leading upper extremity injury in amateur golfers. Tendon injury is the most common problem seen in the wrist and forearm of the golfer. Rehabilitation emphasizing improvement in core muscle streng is important in the treatment of golf injury. Emerging treatments for tendinopathy include topical nitrates, ultrasound-guided injection of therapeutic substances, and eccentric rehabilitation. There is evidence supporting physiotherapy, and swing modification directed by a teaching professional, for treatment of upper extremity golf injuries. This article focuses on upper extremity injuries in golf, including a discussion of the epidemiology, causes, diagnosis, treatment, and prevention of injuries occurring in the shoulder, elbow, wrist, and hand. PMID:20048492

  20. 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

  1. Washing Machine Injuries of the Upper Extremity: Case reports with a review of the literature

    OpenAIRE

    Suresh, S. S.

    2008-01-01

    Washing machines are part of every household and there are various reports of upper extremity injuries due to inadequate safety precautions while operating the machine. Most of the injuries occur when an attempt is made to remove the clothes from the machine and the hand gets caught in the spinning machine. The presentation can vary from minor soft tissue injuries to a mangled upper extremity. The chance of neurovascular damage resulting in compartment syndrome is very high. The author report...

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

    OpenAIRE

    Garg Arun; Hegmann Kurt T; Wertsch Jacqueline J; Kapellusch Jay; Thiese Matthew S; Bloswick Donald; Merryweather Andrew; Sesek Richard; Deckow-Schaefer Gwen; Foster James; Wood Eric; Kendall Richard; Sheng Xiaoming; Holubkov Richard

    2012-01-01

    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 ...

  3. 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.)

  4. 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.)

  5. Washing Machine Injuries of the Upper Extremity: Case reports with a review of the literature.

    Science.gov (United States)

    Suresh, S S

    2008-03-01

    Washing machines are part of every household and there are various reports of upper extremity injuries due to inadequate safety precautions while operating the machine. Most of the injuries occur when an attempt is made to remove the clothes from the machine and the hand gets caught in the spinning machine. The presentation can vary from minor soft tissue injuries to a mangled upper extremity. The chance of neurovascular damage resulting in compartment syndrome is very high. The author reports three cases of washing machine injuries to draw attention to this not so uncommon injury. The relevant literature is also considered. PMID:21654964

  6. Solid variant of aneurysmal bone cist on the distal extremity of the radius in a child.

    Science.gov (United States)

    Ferreira, Adriano Jander; de Almeida Leitão, Sebastião; Rocha, Murilo Antônio; Nascimento, Valdênia das Graças; Lima, Giovanni Bessa Pereira; de Meneses, Antonio Carlos Oliveira

    2016-01-01

    The solid variant of aneurismal bone cysts (ABC) is considered rare. It occurs with greater frequency in pediatric patients and in the tibia, femur, pelvis and humerus. We present a case of a metaphyseal lytic lesion on the distal extremity of the radius in a child whose radiograph was requested after low-energy trauma. The hypothesis of a pathological bone fracture secondary to an aneurysmal bone cyst was suggested. After biopsy, the child underwent intralesional excision without bone grafting and the histopathological findings were compatible with the solid variant of aneurysmal bone cyst. PMID:27274493

  7. 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.)

  8. The interventional treatment of arteriovenous fistula stenosis or occlusion in upper extremity in hemodialysis patients

    International Nuclear Information System (INIS)

    Objective: To investigate the clinical effect of percutaneous balloon angioplasty for the treatment of arteriovenous fistula stenosis or occlusion in upper extremity in hemodialysis patients. Methods: Percutaneous balloon angioplasty was performed in 14 hemodialysis patients with arteriovenous fistula stenosis or occlusion in upper extremity. The preoperative and post operative clinical manifestations, the color Doppler ultrasonographic findings, the blood flow during hemodialysis and the angiographic demonstrations were recorded and compared. Results: After balloon dilatation, the constricted segment was remarkably dilated and the occluded site was re-opened in all patients. Angiographic findings showed that the degree of stenosis was less than 30%. Conclusion: As a simple, mini-invasive and safe technique with remarkable short-term effectiveness, percutaneous balloon angioplasty is an valuable therapy for arteriovenous fistula stenosis or occlusion in upper extremity in hemodialysis patients. (authors)

  9. Construct Validity of the Quality of Upper Extremity Skills Test for Children with Cerebral Palsy

    Science.gov (United States)

    Thorley, Megan; Lannin, Natasha; Cusick, Anne; Novak, Iona; Boyd, Roslyn

    2012-01-01

    Aim: The aim of the study was to investigate the construct validity of the Quality of Upper Extremity Skills Test (QUEST) in children with cerebral palsy (CP). Method: A total of 170 QUEST assessments from a convenience sample of 94 children with CP involved in clinical and research treatment programmes (54 males, 40 females; mean age 6y 10mo, SD…

  10. 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…

  11. 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.

  12. Assessment of Functions and Functional Activities of the Upper Extremity

    OpenAIRE

    Meeteren, Jetty

    2006-01-01

    textabstractThe author was born in Rotterdam on the 21 of July 1963 and spent her childhood in Breda and Dordrecht. From 1975 to 1981 she attended Het Christelijk Lyceum (VWO ) in Dordrecht. In 1981 she started medical studies at the Erasmus University Rotterdam and obtained her medical degree in 1988. After this she worked as a resident in the departments of Surgery, Neurology and Rehabilitation Medicine for children. Three years later, in 1992, she started her residency in the department of...

  13. 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).

  14. 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.

  15. 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...

  16. 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.

  17. Bone Density Changes After Radiation for Extremity Sarcomas: Exploring the Etiology of Pathologic Fractures

    International Nuclear Information System (INIS)

    Purpose: The incidental irradiation (RT) of adjacent bone that takes place during treatment of soft tissue extremity sarcomas is generally presumed to 'weaken' the bone by decreasing its density, which subsequently increases the risk for pathologic fracture. This investigation intended to assess the relative effects on bone density of both RT and diminished mechanical loading secondary to tumor-induced and therapy-induced functional extremity impairment. Methods and Materials: 19 patients treated with surgical excision and RT for soft tissue extremity sarcomas had bone density measured using dual energy X-ray absorptiometry at four sites: the irradiated (A) and contralateral (B) bone, and an uninvolved bone (C) in the treated extremity and its contralateral counterpart (D). Analysis included (1) [A-B], (2) [C-D], (3) [(A-B), - (C-D)], and (4) [(A-B)/B - (C-D)/D]. Results: The mean bone density for all irradiated sites was increased 0.08 ± 0.22 g/cm2 (variance) compared to the contralateral unirradiated side when corrected for weight-bearing effects (3). An average increase in bone density of 9 ± 22% (p = 0.08) was also seen when the differences were divided by individual control densities to normalize variation in density of different anatomic sites (4). Conclusions: RT does not routinely decrease bone density when corrected for weight bearing or mechanical effects. The pathogenesis for the known increased risk of pathologic fracture in irradiated bones is likely multifactorial, including possible alterations in bone remodeling that can result in stable, or even increased, bone density. Further clinical and basic studies are needed to confirm our unexpected findings.

  18. The biomechanics of upper extremity kinematic and kinetic modeling: applications to rehabilitation engineering.

    Science.gov (United States)

    Slavens, Brooke A; Harris, Gerald F

    2008-01-01

    Human motion analysis has evolved from the lower extremity to the upper extremity. Rehabilitation engineering is reliant upon three-dimensional biome-chanical models for a thorough understanding of upper body motions and forces in order to improve treatment methods, rehabilitation strategies and to prevent injury. Due to the complex nature of upper body movements, a standard biomechanical model does not exist. This paper reviews several kinematic and kinetic rehabilitation engineering models from the literature. These models may capture a single joint; multijoints such as the shoulder, elbow and wrist; or a combination of joints and an ambulatory aid, which serves as the extension of the upper arm. With advances in software and hardware, new models continuously arise due to the clinical questions at hand. When designing a biomechanical upper extremity model, several key components must be determined. These include deciding on the anatomic segments of the model, the number of markers and placement on bony landmarks, the definition of joint coordinate systems, and the description of the joint motions. It is critical to apply the proper model to further our understanding of pathologic populations. PMID:19740069

  19. 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. PMID:27062591

  20. 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.

  1. 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.

  2. US of the Peripheral Nerves of the Upper Extremity: A Landmark Approach.

    Science.gov (United States)

    Brown, Jordan M; Yablon, Corrie M; Morag, Yoav; Brandon, Catherine J; Jacobson, Jon A

    2016-01-01

    Ultrasonography (US) has become a first-line modality for the evaluation of the peripheral nerves of the upper extremity. The benefits of US over magnetic resonance (MR) imaging include higher soft-tissue resolution, cost effectiveness, portability, real-time and dynamic imaging, and the ability to scan an entire extremity quickly and efficiently. US can be performed on patients who are not eligible for MR imaging. Metallic implant artifacts are usually not problematic. US has been shown to have equal specificity and greater sensitivity than MR imaging in the evaluation of peripheral nerves. Any abnormal findings can be easily compared with the contralateral side. The published literature has shown that US has demonstrated clinical utility in patients with suspected peripheral nerve disease by guiding diagnostic and therapeutic decisions as well as by confirming electrodiagnostic findings. Common indications for upper extremity peripheral nerve US are the evaluation for injury due to penetrating trauma, entrapment by scar tissue, and tumor. US of the upper extremity is most commonly performed to evaluate carpal and cubital tunnel syndrome. It is important for the radiologist or sonographer to have a detailed knowledge of anatomy and specific anatomic landmarks for each nerve to efficiently and accurately perform an examination. The goal of this article is to introduce readers to the basics of US of the peripheral nerves of the upper extremity with a focus on the median, ulnar, and radial nerves. Common sites of disease and the location of important anatomic landmarks will be reviewed. (©)RSNA, 2016. PMID:26963456

  3. 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...

  4. Extremely rare presentation of soft tissue metastasis from carcinoma breast as a massive swelling of upper extremity.

    Science.gov (United States)

    Purkayastha, Abhishek; Sharma, Neelam

    2016-04-01

    Soft tissue metastasis from any primary malignancy is considered very rare and a breast carcinoma metastasizing to soft tissue is still rarer. To the best of our knowledge, carcinoma breast with soft tissue metastasis to upper extremity is very uncommon with only six cases been reported in world literature till date and our case is the seventh such case in an 80-year-old female, previously treated for carcinoma right breast 15 years ago. The patient presented with progressive painful massive swelling of right upper arm measuring 21 cm × 17 cm, of 2 months duration. Histopathological examination of the swelling showed metastatic deposits from a poorly differentiated adenocarcinoma. Further immunohistochemical (IHC) analysis revealed tumor cells staining positive for estrogen and progesterone receptors while negative for HER 2-Nu, desmin, epithelial membrane antigen, CK7 and thyroid transcription factor-1 (TTF-1), suggestive of metastasis from a primary breast carcinoma. Only few case series and isolated cases reports have been published regarding any primary malignancy or breast carcinoma metastasizing to soft tissues. A thorough review of literature also reveals that our case is the largest soft tissue metastatic swelling from breast carcinoma ever reported. We hereby present this case with review of literature to highlight its extreme rarity, unusual presentation, clinicopathological characteristics and its overall prognosis. PMID:27121743

  5. 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…

  6. 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

  7. 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.

  8. Reliability and validity of the closed kinetic chain upper extremity stability test

    OpenAIRE

    Lee, Dong-Rour; Kim, Laurentius Jongsoon

    2015-01-01

    [Purpose] The purpose of this study was to examine the reliability and validity of the Closed Kinetic Chain Upper Extremity Stability (CKCUES) test. [Subjects and Methods] A sample of 40 subjects (20 males, 20 females) with and without pain in the upper limbs was recruited. The subjects were tested twice, three days apart to assess the reliability of the CKCUES test. The CKCUES test was performed four times, and the average was calculated using the data of the last 3 tests. In order to test t...

  9. 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.

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

    International Nuclear Information System (INIS)

    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 (p0.05) 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

  11. 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

  12. 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. PMID:27134375

  13. 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...

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

    DEFF Research Database (Denmark)

    Nilsson, Jessica; Sandberg, Kristina; Søe Nielsen, Niels; Dahlin, Lars B

    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...... extremity. Medical records of 19 patients (20 MRI examinations) with 29 histopathologically verified benign nerve tumours were examined retrospectively. In 12/20 cases MRI suggested a correct diagnosis of the type of nerve tumour. An additional 3/20 cases had an uncertain diagnosis, but nerve relations to...... the tumour were established. In 5/20 cases MRI gave a doubtful diagnosis with no suspicion of the tumour being located in a nerve trunk. MRI can localise and diagnose a nerve tumour in the upper extremity in 75% of cases, but it is difficult to specify the type of tumour....

  15. 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.

  16. 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.

  17. 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

  18. Effects of mental practice on stroke patients’ upper extremity function and daily activity performance

    OpenAIRE

    Park, Juhyung; Lee, Nayun; Cho, MiLim; Kim, DeokJu; Yang, YeongAe

    2015-01-01

    [Purpose] The purpose of this study was to evaluate the effects of mental practice on stroke patients’ upper extremity function and activities of daily living (ADL). [Subjects and Methods] In this study, 29 stroke patients were randomly assigned to two groups: an experimental group (n=14) and a control group (n=15). The experimental group performed 10 minutes of mental practice once a day, 5 days a week for 2 weeks in combination with conventional rehabilitation therapy. For the control group...

  19. [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

  20. 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 of...... a SCI Upper Extremity Data Set was developed by an international working group. This was reviewed by many different organisations, societies and individuals over several months. A final version was created. VARIABLES: The final version of the International SCI Upper Extremity Data Set contains...... variables related to basic hand-upper extremity function, use of assistive devices, SCI-related complications to upper extremity function and upper extremity/hand reconstructive surgery. Instructions for data collection and the data collection form are freely available on the ISCoS website (www...

  1. 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.

  2. Validity and reliability of upper extremity three-dimensional kinematics during a typing task.

    Science.gov (United States)

    Levanon, Yafa; Gefen, Amit; Lerman, Yehuda; Givon, Uri; Ratzon, Navah Z

    2010-10-01

    Computer use continues to be considered a risk factor for work-related musculoskeletal disorders despite a greater awareness of the risk associated with excessive use, the implementation of safety features and the introduction of extensive interventional programs. Better understanding of risk factors in movement patterns is needed. This study identified the most suitable variable for work-related upper extremity motion analysis as being peak-to-peak range of motion. Assessment was by three-dimensional motion analysis for upper extremity ergonomics. The study was designed to validate and examine the reliability of these parameters in the setting of keyboarding. Sixty-two right-hand dominant participants (non-skilled typists) were recruited. Motion analysis was performed using the Cartesian Optoelectronic Dynamic Anthropometric CX-1 (CODA) system with markers which were attached to the right hand, elbow, wrist and fingers. Range of motion and angular velocity were recorded while the subjects repeatedly typed a predetermined sentence five times. The re-test examination was repeated after an interval of one week. The findings clearly demonstrated discriminative validity in wrist range of motion (pICC>.70) and inter-rater reliability (.95>ICC>.70) for most variables. The CODA system has considerable potential for understanding movement patterns in the upper extremities. These findings can provide the basis for future studies on the efficacy of ergonomic intervention programs. PMID:20678936

  3. Upper extremity peripheral neuropathies: role and impact of MR imaging on patient management

    International Nuclear Information System (INIS)

    To investigate the role of MR imaging (MRI) in the evaluation of peripheral nerve lesions of the upper extremities and to assess its impact on the patient management. Fifty-one patients with clinical evidence of radial, median, and/or ulnar nerve lesions and unclear or ambiguous clinical findings had MRI of the upper extremity at 1.5 T. MR images and clinical data were reviewed by two blinded radiologists and a group of three clinical experts, respectively, with regard to radial, median, and/or ulnar nerve, as well as muscle abnormalities. MRI and clinical findings were correlated using Spearman's (p) rank correlation test. The impact of MRI on patient management was assessed by the group of experts and ranked as ''major,'' ''moderate,'' or ''no'' impact. The correlation of MRI and clinical findings was moderate for the assessment of the median/radial nerve and muscles (p=0.51/0.51/0.63, respectively) and weak for the ulnar nerve (p=0.40). The impact of MRI on patient management was assessed as ''major'' in 24/51 (47%), ''moderate'' in 19/51 (37%), and ''no'' in 8/51 (16%) patients. MRI in patients with upper extremity peripheral neuropathies and unclear or ambiguous clinical findings substantially influences the patient management. (orig.)

  4. Upper extremity peripheral neuropathies: role and impact of MR imaging on patient management

    Energy Technology Data Exchange (ETDEWEB)

    Andreisek, Gustav [University Hospital Zurich, Institute for Diagnostic Radiology, Department of Medical Radiology, Zurich (Switzerland); University of Toronto, Department of Medical Imaging, 5th Floor, Mount Sinai Hospital and the University Health Network, Toronto, ON (Canada); Burg, Doris [University Hospital Zurich (Academic Medical Center), Division for Plastic, Hand- and Reconstructive Surgery, Department of Surgery, Zurich (Switzerland); Studer, Ansgar [University Hospital Zurich, Department of Neurology, Zurich (Switzerland); Weishaupt, Dominik [University Hospital Zurich, Institute for Diagnostic Radiology, Department of Medical Radiology, Zurich (Switzerland)

    2008-09-15

    To investigate the role of MR imaging (MRI) in the evaluation of peripheral nerve lesions of the upper extremities and to assess its impact on the patient management. Fifty-one patients with clinical evidence of radial, median, and/or ulnar nerve lesions and unclear or ambiguous clinical findings had MRI of the upper extremity at 1.5 T. MR images and clinical data were reviewed by two blinded radiologists and a group of three clinical experts, respectively, with regard to radial, median, and/or ulnar nerve, as well as muscle abnormalities. MRI and clinical findings were correlated using Spearman's (p) rank correlation test. The impact of MRI on patient management was assessed by the group of experts and ranked as ''major,'' ''moderate,'' or ''no'' impact. The correlation of MRI and clinical findings was moderate for the assessment of the median/radial nerve and muscles (p=0.51/0.51/0.63, respectively) and weak for the ulnar nerve (p=0.40). The impact of MRI on patient management was assessed as ''major'' in 24/51 (47%), ''moderate'' in 19/51 (37%), and ''no'' in 8/51 (16%) patients. MRI in patients with upper extremity peripheral neuropathies and unclear or ambiguous clinical findings substantially influences the patient management. (orig.)

  5. Biomechanical Model for Evaluation of Pediatric Upper Extremity Joint Dynamics during Wheelchair Mobility

    OpenAIRE

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

    2013-01-01

    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 ...

  6. 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,...

  7. Cluster Analysis of Symptoms Among Patients with Upper Extremity Musculoskeletal Disorders

    OpenAIRE

    Gold, J.E.; Piligian, G.; Glutting, J.J.; Hanlon, A.; Frings-Dresen, M.H.W.; Sluiter, J.K.

    2010-01-01

    Introduction Some musculoskeletal disorders of the upper extremity are not readily classified. The study objective was to determine if there were symptom patterns in self-identified repetitive strain injury (RSI) patients. Methods Members (n = 700) of the Dutch RSI Patients Association filled out a detailed symptom questionnaire. Factor analysis followed by cluster analysis grouped correlated symptoms. Results Eight clusters, based largely on symptom severity and quality were formulated. All ...

  8. Neurological Deficits before and after Surgical Resection of Schwannomas in the Upper Extremities.

    Science.gov (United States)

    Mizushima, Hideyuki

    2016-06-01

    Background Schwannomas are the most common primary solitary tumor among peripheral nerve sheath tumors. The occurrence of transient or permanent neurological deficits after schwannoma resection is more common than previously recognized. Here, the neurological deficits before and after surgical resection of schwannomas in the upper extremities were examined. Methods The study included 43 upper-extremity schwannomas that were treated surgically between January 2000 and July 2013. The neurological status of each patient (such as pain, sensory disturbances, and motor disturbances) was evaluated preoperatively, immediately postoperatively, and at the final postoperative follow-up. Results Out of the 43 cases, 34 cases exhibited neurological symptoms before the operation, and in 31 of the 34 cases, neurological symptoms were either reduced or disappeared after the surgery. In 20 of the 43 cases, new neurological deficits that had not been observed preoperatively were noted immediately postoperatively; the newly acquired neurological deficits disappeared over time in 5 of the 20 cases. Significantly, more newly acquired neurological deficits remained in cases where the tumor was located in the upper arm and elbow than in cases where the tumor was located in the distal forearm. Conclusion New neurological deficits occurred after surgery in about half of the cases. This ratio was higher than expected, suggesting that schwannoma resection is not always a complication-free operation. Therefore, patients should be informed preoperatively about the possibility of neurological deficits. Furthermore, extreme care should be taken not to damage the affected and uninvolved nerves during surgery. PMID:26872028

  9. 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.

  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. 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

    Objectives: To compare the ability of two different dedicated extremity MRI (E-MRI) units and conventional radiography (CR) for identifying bone erosions in rheumatoid arthritis (RA) metacarpophalangeal (MCP) and wrist joints. Methods: CR and two MRI examinations (using 0.2 T Esaote Artoscan and 0...... 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 T portable MagneVu MV1000 units) of 418 bones in the dominant wrist and second to fifth MCP joints of 15 patients with RA and 4 healthy controls were performed and evaluated blindly for bones being visible and for erosions. Results: In MCP joints, MagneVu visualised 18.5% of bones entirely and 71...

  12. 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.

  13. Vascular Access Effects on Motor Performance and Anthropometric Indices of Upper Extremities.

    Science.gov (United States)

    Bučar Pajek, Maja; Čuk, Ivan; Pajek, Jernej

    2016-06-01

    A decrement of upper extremity motor performance is a concern with vascular access creation. We analyzed differences in handgrip strength, tapping test and anthropometric indices of arms with and without vascular access (N = 87) and compared them to bilateral differences in control subjects (N = 140). Fistula harboring arms had weaker grip strength than contralateral arms of 2.7 kg and this difference was statistically marginally larger than the difference between non-dominant and dominant arms in controls of 1.6 kg (mean difference 1.1 kg, P = 0.06). No difference in the magnitude of inferiority of fistula arms compared to control non-dominant arms was present in the tapping test. Absolute results of both motor tests on any side were significantly worse in dialysis patients. Although weaker and slower, fistula arms showed larger mean upper-arm and forearm circumferences of 0.4-0.6 cm. Our results show no significant negative effect of arteriovenous access on motor performance of upper extremities. PMID:27312918

  14. 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.

  15. Evaluation of negative viscosity as upper extremity training for stroke survivors

    Science.gov (United States)

    Huang, Felix C.; Patton, James L.

    2016-01-01

    With stroke survivors (n=30) as the test population, we investigated how upper extremity training with negative viscosity affects coordination in unassisted conditions. Using a planar force-feedback device, subjects performed exploratory movements within an environment that simulated 1) negative viscosity added to elbow and shoulder joints 2) augmented inertia to the upper and lower arm combined with negative viscosity, or 3) a null force field (control). After training, we evaluated each subject’s ability to perform circular movements in the null field. Negative viscosity training resulted in greater within-day reductions in error compared with the combined field training. Negative viscosity promoted greater distributions of accelerations during free exploration, especially in the sagittal axis, while combined field training diminished overall activity. Both force field training groups exhibited next day retention, while this was not observed for the control group. The improvement in performance suggests that greater range of kinematic experiences contribute to learning, even despite novel force field environments. These findings provide support for the use of movement amplifying environments for upper extremity rehabilitation, allowing greater access to training while maintaining user engagement. PMID:22275710

  16. Systemic thrombolysis in the upper extremity deep vein thrombosis

    OpenAIRE

    Sadeghi, Roxana; Safi, Morteza

    2011-01-01

    Almost 4% of all patients with venous thrombosis have upper extremity deep vein thrombosis (UEDVT) and the incidence of UEDVT increases over time. The frequency of post-thrombotic syndrome (PTS) after UEDVT is not low and upper extremity PTS is a potentially major morbidity that adversely affects quality of life, particularly if the dominant arm is involved. We discuss briefly the role of thrombolytic therapy in the treatment of upper extremity deep vein thrombosis and also the role of system...

  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. 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)

  19. The effect of mirror therapy on upper-extremity function and activities of daily living in stroke patients

    OpenAIRE

    Park, Jin-Young; Chang, Moonyoung; Kim, Kyeong-Mi; Kim, Hee-Jung

    2015-01-01

    The purpose of this study was to examine the effects of mirror therapy on upper-extremity function and activities of daily living in chronic stroke patients. [Subjects and Methods] Fifteen subjects were each assigned to a mirror therapy group and a sham therapy group. The Fugl-Meyer Motor Function Assessment and the Box and Block Test were performed to compare paretic upper-extremity function and hand coordination abilities. The functional independence measurement was conducted to compare abi...

  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. 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.

  2. 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.

  3. 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

  4. 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 ...

  5. 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

    L. The participants reported 802 performance problems: 38% within self-care, 52% within productivity, and 10% within leisure. Strength demanding bilateral activities in cleaning, hygiene, and cooking were most frequently reported. The median COPM performance and satisfaction scores were 2.8 and 3.4; the mean DASH...... 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...

  6. Three-dimensional CT angiography of the vascular disorders in the upper extremity

    International Nuclear Information System (INIS)

    This study was conducted to determine the usefulness of three-dimensional CT angiography (3DCTA) as a diagnostic tool in the evaluation of vascular disorders in the upper extremity. 11 cases, including 3 cases with vascular malformation and 8 cases to be confirmed the existence of vascular occlusion, were examined by a multidetector-row CT scanner after the administration of contrast media in the vein. 3D image was composed of the maximum intensity projection technique and the volume rendering technique. The location and extent of the lesion was clearly confirmed in all cases of vascular malformation by the 3DCTA image. The existence of vascular occlusion was confirmed in 4 of 8 cases by the image. Even in the finger level, the running of the artery could be confirmed in all cases by the 3DCTA. We found 3DCTA to be a useful procedure in the investigation and diagnosis of vascular disorders in the upper extremity. 3DCTA is a method with the possibility of replacing the conventional angiography. (author)

  7. 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

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

    OpenAIRE

    GRANT, H; D Pichora

    2010-01-01

    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 ...

  9. A phased-array coil for MR imaging of the upper extremities. Preliminary evaluation

    International Nuclear Information System (INIS)

    The purpose of this paper is to construct a phased-array coil for magnetic resonance (MR) imaging of the upper extremities, and to compare MR images obtained with it to those with a commercially available GP flex coil. A phased-array coil was constructed so that two rectangular shaped loop coils were connected to a dual array adapter. In a phantom study, signal to noise ratio (SNR) and spatial resolution obtained with the phased-array coil were compared to those obtained with a GP flex coil. Four types of MR images of the elbow joint were obtained with the phased-array coil and a GP flex coil in three healthy volunteers, and these images were evaluated by five blinded reviewers. The phased-array coil provided better SNR than a GP flex coil in the phantom study. The mean value of SNR of the phased-array coil was approximately 1.3 times higher. Spatial resolution of the phased-array coil was equivalent to that of a GP flex coil. In most instances, MR images obtained with the phased-array coil were judged to be superior in image quality to those obtained with a GP flex coil by the reviewers. The phased-array coil was useful for MR imaging of the upper extremities. (author)

  10. 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.

  11. A case report of sudden-onset upper and lower extremity weakness.

    Science.gov (United States)

    Haddad, Heba; Rotblatt, Michael

    2015-02-01

    Thyrotoxic hypokalemic periodic paralysis is characterized by acute attacks of muscle paralysis, hypokalemia, and thyrotoxicosis. It is a medical emergency, as fatal and life-threatening ventricular arrhythmia associated with hypokalemia has been reported. A 24-year-old man presented with severe lower extremity weakness, which progressed to his trunk and arms. He denied any associated symptoms and had no history of a similar episode or predisposing condition. The physical examination was significant for bilateral extremity weakness, more severe in the lower as compared to the upper extremities. The rest of the neurologic exam was normal. A small, smooth, nontender goiter was palpated. Laboratory data was significant for a potassium level of 2.0 mEq/L. Final lab data revealed a thyroid panel consistent with hyperthyroidism. Once the patient's potassium level normalized after repletion, he recovered his strength and was able to walk again. He was diagnosed with thyrotoxic hypokalemic periodic paralysis, a potentially lethal complication of hyperthyroidism. Because it is reversible with treatment of hyperthyroidism, it is imperative that this condition be considered, recognized and managed appropriately. PMID:25556330

  12. 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.

  13. 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.

  14. Accuracy and consequences of 3D-fluoroscopy in upper and lower extremity fracture treatment: A systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Beerekamp, M.S.H., E-mail: m.s.beerekamp@amc.nl [Trauma Unit, Department of Surgery, Academic Medical Center, Amsterdam (Netherlands); Sulkers, George S.I., E-mail: georgesulkers@gmail.com [Trauma Unit, Department of Surgery, Academic Medical Center, Amsterdam (Netherlands); Ubbink, Dirk T., E-mail: D.Ubbink@amc.nl [Department of Quality and Process Innovation, Academic Medical Center, Amsterdam (Netherlands); Maas, Mario, E-mail: M.Maas@amc.nl [Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); Schep, Niels W.L., E-mail: N.W.Schep@amc.nl [Trauma Unit, Department of Surgery, Academic Medical Center, Amsterdam (Netherlands); Goslings, J. Carel, E-mail: J.C.Goslings@amc.nl [Trauma Unit, Department of Surgery, Academic Medical Center, Amsterdam (Netherlands)

    2012-12-15

    Objectives: The aim of this systematic review was to compare the diagnostic accuracy, subjective image quality and clinical consequences of 3D-fluoroscopy with standard imaging modalities (2D-fluoroscopy, X-ray or CT) during reduction and fixation of intra-articular upper and lower extremity fractures. Methods: A systematic literature search was performed in MEDLINE, EMBASE and the Cochrane library. In total 673 articles were identified (up to March 2012). The 19 included studies described patients/cadavers with intra-articular upper/lower extremity fractures and compared 3D-fluoroscopy to standard imaging. The study was performed in accordance with the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) guidelines. Diagnostic accuracy was defined by the quality of fracture reduction or implant position and, if possible, expressed as sensitivity and specificity; subjective image quality was determined by the quality of depiction of bone or implants; clinical consequences were defined as corrections in reduction or implant position following 3D-fluoroscopy. Results: Ten cadaver- and nine clinical studies were included. A meta-analysis was not possible, because studies used different scoring protocols to express diagnostic accuracy and reported incomplete data. Based on the individual studies, diagnostic accuracy of 3D-fluoroscopy was better than 2D-fluoroscopy and X-ray, but similar to CT-scanning. Subjective image quality of 3D-fluoroscopy was inferior compared to all other imaging modalities. In 11–40% of the operations additional corrections were performed after 3D-fluoroscopy, while the necessity for these corrections were not recognized based on 2D-fluoroscopic images. Conclusions: Although subjective image quality is rated inferior compared to other imaging modalities, intra-operative use of 3D-fluoroscopy is a helpful diagnostic tool for improving the quality of reduction and implant position in intra-articular fractures.

  15. Accuracy and consequences of 3D-fluoroscopy in upper and lower extremity fracture treatment: A systematic review

    International Nuclear Information System (INIS)

    Objectives: The aim of this systematic review was to compare the diagnostic accuracy, subjective image quality and clinical consequences of 3D-fluoroscopy with standard imaging modalities (2D-fluoroscopy, X-ray or CT) during reduction and fixation of intra-articular upper and lower extremity fractures. Methods: A systematic literature search was performed in MEDLINE, EMBASE and the Cochrane library. In total 673 articles were identified (up to March 2012). The 19 included studies described patients/cadavers with intra-articular upper/lower extremity fractures and compared 3D-fluoroscopy to standard imaging. The study was performed in accordance with the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) guidelines. Diagnostic accuracy was defined by the quality of fracture reduction or implant position and, if possible, expressed as sensitivity and specificity; subjective image quality was determined by the quality of depiction of bone or implants; clinical consequences were defined as corrections in reduction or implant position following 3D-fluoroscopy. Results: Ten cadaver- and nine clinical studies were included. A meta-analysis was not possible, because studies used different scoring protocols to express diagnostic accuracy and reported incomplete data. Based on the individual studies, diagnostic accuracy of 3D-fluoroscopy was better than 2D-fluoroscopy and X-ray, but similar to CT-scanning. Subjective image quality of 3D-fluoroscopy was inferior compared to all other imaging modalities. In 11–40% of the operations additional corrections were performed after 3D-fluoroscopy, while the necessity for these corrections were not recognized based on 2D-fluoroscopic images. Conclusions: Although subjective image quality is rated inferior compared to other imaging modalities, intra-operative use of 3D-fluoroscopy is a helpful diagnostic tool for improving the quality of reduction and implant position in intra-articular fractures.

  16. Upper Extremity Musculoskeletal Disorders among Computer Users

    OpenAIRE

    Ali AYDENİZ; Savaş GÜRSOY

    2008-01-01

    Aim: The aim of this study was to determine whether upper extremity musculoskeletal disorders are more prevalent in intense computer users and the relation between cumulative hours of computer use and symptoms. Materials and Methods: The study group included 100 bank workers, who worked more than 6 h per day for at least 2 years on a video display unit and were recruited through convenience sampling. Sixty-five age and sex matched healthy subjects who worked not more than 2 h on computer ke...

  17. US-guided injection of the upper and lower extremity joints

    Energy Technology Data Exchange (ETDEWEB)

    Collins, James M.P., E-mail: j.collins@znb.nl [Department of Radiology, Medical Center Leeuwarden, H. Dunantweg 2, AD Leeuwarden (Netherlands); Smithuis, Robin [Department of Radiology, Rijnland Hospital, Leiderdorp (Netherlands); Rutten, Matthieu J.C.M. [Department of Radiology, Jeroen Bosch Hospital, ‘s-Hertogenbosch (Netherlands)

    2012-10-15

    There is a growing interest in the application of ultrasound (US) guidance for diagnostic and therapeutic joint injections. US provides direct visualization of soft tissues and the outer borders of bony structures. With real-time needle guidance the success rate of intra-articular injections improves and iatrogenic damage to anatomic structures can be avoided. An US machine is more readily available, transferrable and more affordable than a fluoroscopy machine or CT scanner and lacks the risk of radiation. These factors make US a valuable alternative to procedures performed either blind or under fluoroscopic or CT guidance. This article focuses on the rationale for injections in the upper and lower extremity joints and describes and illustrates the different US-guided injection techniques.

  18. 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...

  19. Catheter-Directed Thrombolysis for Treatment of Deep Venous Thrombosis in the Upper Extremities

    International Nuclear Information System (INIS)

    Traditional anticoagulant treatment of deep venous thrombosis (DVT) in the upper extremities (UEDVT) is associated with a relatively high incidence of postthrombotic syndrome (PTS). Catheter-directed thrombolysis (CDT) for UEDVT would provide efficient thrombolysis with less subsequent PTS than during traditional anticoagulation. Primary efficacy, complications, and long-term results after CDT are reported in a retrospective cohort (2002-2007) of patients (n = 30) with DVT in the upper extremities. PTS was assessed by a modified Villalta scale. UEDVT was unprovoked in 11 (37%) cases and effort related in 9 (30%) cases. The median duration of symptoms prior to CDT was 7.0 days (range, 1-30); median duration of thrombolysis treatment, 70 h (range, 24-264 h); and the median amount of rt-PA infused during CDT, 52 mg (range, 19-225 mg). Major bleeding was registered in three (9%) patients, and CDT was stopped prematurely in three patients due to local hematoma. No intracerebral bleeding, clinical pulmonary embolism, or deaths occurred during treatment. Grade II (>50%) or III (>90%) lysis was present in 29 patients (97%) at the end of CDT. Bleeding complications increased by each day of delay from the debut of symptoms to the start of treatment (OR, 1.20; 95% CI, 1.01-1.42). At follow-up (n = 29; median, 21 months; range, 5-58 months), 11 (38%) patients had occluded veins, whereas 18 (62%) had patent veins. However, stenosis of varying severity was present in eight of those with a patent vein. No patients had severe PTS, whereas six (21%) experienced mild PTS. In conclusion, our retrospective cohort study of patients with UEDVT showed that treatment restored venous drainage, with a subsequent low frequency of mild PTS at follow-up. Early intervention with CDT prevented bleeding complications.

  20. Review of supplemental views and stress radiography in musculoskeletal trauma: upper extremity.

    Science.gov (United States)

    Friedman, Michael V; Smith, Chris; Hillen, Travis J; Baker, Jonathan C

    2015-10-01

    The standard radiographic series is not always sufficient to diagnose and characterize subtle musculoskeletal injuries. Missed or delayed diagnoses can negatively affect patient acute morbidity and long-term outcomes. Similarly, management based on erroneous diagnoses may lead to unnecessary treatment and restrictions. Body part or joint specific supplemental radiographic views and stress radiography offer an alternative for further evaluation of subtle injuries in specific clinical situations and may obviate the need for the added cost and potential ionizing radiation exposure of further cross-sectional imaging. Familiarity with these complementary exams allows radiologists to play an important role in patient care, as their utilization can improve diagnostic accuracy, clarify subtle or uncertain findings, and direct timely patient management. This review highlights important supplemental views and stress radiographic examinations useful in the evaluation of emergent upper extremity musculoskeletal trauma. PMID:25850394

  1. The role of ultrasonography and MRI in patients with non-traumatic nerve fascicle torsion of the upper extremity

    International Nuclear Information System (INIS)

    Aim: To evaluate the role of ultrasonography and magnetic resonance imaging (MRI) in the diagnosis of non-traumatic nerve fascicle torsion of the upper extremity. Materials and methods: Eleven patients (unilateral upper extremity) who underwent surgical treatment for nerve fascicle torsion were included in the study. Ultrasonography and MRI showed the detailed anatomy of the region well enough to reveal nerve fascicle torsion. The characterization and classification (single-segmental or multi-segmental) based on ultrasonography and diffusion-weighted (DW) MRI findings were recorded. Results: The hourglass-shaped appearance was a characteristic feature of nerve fascicle torsion, Characterization and classification based on ultrasonography and MRI findings were consistent with intraoperative findings. Conclusion: Ultrasonography and MRI may be valuable in the diagnosis of non-traumatic nerve fascicle torsion of the upper extremity

  2. 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...

  3. 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

  4. Management of disorders of the rotator cuff: proceedings of the ISAKOS upper extremity committee consensus meeting.

    Science.gov (United States)

    Arce, Guillermo; Bak, Klaus; Bain, Gregory; Calvo, Emilio; Ejnisman, Benno; Di Giacomo, Giovanni; Gutierrez, Vicente; Guttmann, Dan; Itoi, Eiji; Ben Kibler, W; Ludvigsen, Tom; Mazzocca, Augustus; de Castro Pochini, Alberto; Savoie, Felix; Sugaya, Hiroyuki; Uribe, John; Vergara, Francisco; Willems, Jaap; Yoo, Yon Sik; McNeil, John W; Provencher, Matthew T

    2013-11-01

    The goal of this article is to consolidate the International Society of Arthroscopy, Knee Surgery & Orthopaedic Sports Medicine (ISAKOS) Upper Extremity Committee's (UEC's) current knowledge on rotator cuff disease and management, as well as highlight key unresolved issues. The rotator cuff is an anatomically complex structure important for providing glenohumeral function and stability as part of a closed chain system. Current consensus suggests rotator cuff injuries are most accurately diagnosed, at levels similar to diagnosis by magnetic resonance imaging, with a combination of cuff- and impingement-specific clinical tests. Updates in the understanding of acromion morphology, the insertional anatomy of the rotator cuff, and the role of suprascapular nerve release may require changes to current classification systems and surgical strategies. Although initial management focuses on nonoperative protocols, discussion continues on whether surgery for isolated impingement is clinically more beneficial than rehabilitation. However, clear indications have yet to be established for the use of single- versus double-row repair because evidence confirms neither is clinically efficacious than the other. Biceps tenodesis, however, in non-isolated cuff tears has proven more successful in addressing the etiology of shoulder pain and yields improved outcomes over tenotomy. Data reviewing the benefits of tendon transfers, shoulder prostheses, and mechanical scaffolds, as well as new research on the potential benefit of platelet-rich plasma, pluripotential stem cells, and gene therapies, will also be presented. PMID:24041864

  5. The reasons for and diagnostics of algodystrophic syndrome of the upper extremity in own material

    International Nuclear Information System (INIS)

    Background. Despite progress in prevention and treatment, algodystrophic syndrome (reflex sympathetic dystrophy, CRPS I), a severe complication of initially minor injury or surgery, remains a difficult diagnostic and therapeutic problem. Analysis of events leading to CRPS I of the upper extremity and determination of the role of scintigraphy in the process of its diagnostics was the purpose of the study. Material and Methods. Between 2000 and 2005, 38 patients were treated because of algodystrophic syndrome at the Department of Trauma and Hand Surgery, of whom 18 had ambulatory treatment and 20 were hospitalized. Diagnosis was based on clinical tests, X-rays, and scintigraphy. Results. Patients with CRPS I as a consequence of distal radius fracture constituted the largest group of patients. Several repositions of fractures under local anesthesia and incorrect immobilization of fractures could influence the development of CRPS I. The sensitivity of scintigraphy was 85%. Conclusions. Incorrect treatment of distal radius fractures can be a reason for CRPS I. Scintigraphy is a useful but not a determining test in the diagnostics of CRPS I. (authors)

  6. Treatment of algodystrophic syndrome of the upper extremity in own material

    International Nuclear Information System (INIS)

    Background. In spite of the development of new diagnostic methods and treatment possibilities, algodystrophic syndrome (Sudeck's disease, CRPS I) still constitutes a challenge for the treating surgeon. Its etiopathogenesis is still not fully explained, diagnostic criteria are not uniform, and treatment results are unsatisfactory. Estimation of the treatment results of CRPS I of the upper extremity in own material was the purpose of this study. Material and Methods. Between 2000 and 2005, 38 patients were treated because of algodystrophic syndrome at the Department of Trauma and Hand Surgery. Diagnosis was based on clinical examination, X-ray, and scintigraphy. Rehabilitation and tricyclic antidepressants, anticonvulsants, vasodilators, Dexaven and Mannitol, brachial plexus blocks were used in the treatment depending on the phase of disease. Results. The best results were achieved in patients in the first, posttraumatic phase of disease. Amelioration was achieved in most patients after use of brachial plexus blocks in the second and third phases of disease, but recurrence of full function was achieved in less that 30% patients. Conclusions. Effective treatment and rapid rehabilitation in the posttraumatic phase of disease prevent its further progression. Use of a brachial plexus block and then rehabilitation is an efficient method of treating patients with CRPS. (authors)

  7. 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.)

  8. Reliability of the Quality of Upper Extremity Skills Test for Children with Cerebral Palsy Aged 2 to 12 Years

    Science.gov (United States)

    Thorley, Megan; Lannin, Natasha; Cusick, Anne; Novak, Iona; Boyd, Roslyn

    2012-01-01

    Aim: To investigate reliability of the Quality of Upper Extremity Skills Test (QUEST) scores for children with cerebral palsy (CP) aged 2-12 years. Method: Thirty-one QUESTs from 24 children with CP were rated once by two raters and twice by one rater. Internal consistency of total scores, inter- and intra-rater reliability findings for total,…

  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. 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

  12. [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

  13. The Effect of Extremely Low Frequency Magnetic Field and Manganese on Bone Mineral Content and Density

    OpenAIRE

    Akpolat, Veysi

    2008-01-01

    The aim of this study was to investigate the effect of extremely low frequency magnetic field (ELF MF) on bone that exposed us in our daily life. In our study, sixty four male Wistar-Albino rats were used. The rats were exposed to ELF MF (50Hz, 1.5mT) during 4 hours/day for 45 days. The experimental rats were divided into eight groups (n=8 per group). The groups were as follows; only ELF MF was exposed to 1.group, the ELF MF was exposed to the 2., 3. and 4.groups with the doses manganese (Mn)...

  14. 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.)

  15. 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

  16. User perceptions of gaming interventions for improving upper extremity motor function in persons with chronic stroke.

    Science.gov (United States)

    Finley, Margaret; Combs, Stephanie

    2013-04-01

    Finding ways to engage patients with stroke in repetitive intervention protocols long-term is poorly understood, particularly from the patients' perspective. Limited information exists that combines clinical expertise as well as user feedback on improving gaming interaction. The purpose of this study was to utilize input from focus groups of gaming intervention users with chronic stroke to identify characteristics of gaming that influence user/patient engagement in the activity. Two focus groups (n = 10) were conducted with each group participant playing two different gaming systems. Following exposure to the two systems, guided group interview sessions occurred that consisted of open-ended questions encompassing areas of overall gaming system preference, aspects that were liked or disliked, background appearance, music options, feedback provided, as well as recommendations for change. Findings revealed that participants enjoyed playing the gaming systems. Three primary themes emerged differentiating the systems: (1) musical encouragement; (2) focus and attention; and (3) motivation provided by performance feedback. It was concluded that when selecting a gaming system for upper extremity rehabilitation, a clinician should select a system that provides user-relevant music options with a modifiable background appearance for progression from basic to more challenging, providing appropriate feedback in an effort to encompass to a variety of user performance levels. PMID:22924427

  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. 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

  19. 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 (+...

  20. Thallium bone imaging as an indicator of response and outcome in nonmetastatic primary extremity osteosarcoma

    International Nuclear Information System (INIS)

    Purpose. We investigated one 201Tl bone scintigraphy method as a predictor of histologic response and event-free survival (EFS) of nonmetastatic extremity osteosarcoma. Materials and methods. We evaluated images of the primary tumor to determine whether they exhibited a donut of avidity for 40 patients enrolled on a single institutional protocol. Participants underwent three serial 201Tl bone scintigraphy studies during preoperative neoadjuvant chemotherapy. Intra- and interobserver variability of the method was assessed, and the presence of the donut of avidity was examined as a predictor of EFS and histologic response. Results. Fifty-three percent of patients were female and 75 % were Caucasian; the median age at diagnosis was 13.5 years. Intraobserver agreement was moderate to very good, ranging from 0.595 to 0.865. Interobserver agreement was moderate to good for all time points, ranging from 0.576 to 0.708. There was a significant difference in EFS among patients with and without the donut-shape at any of the three time points (P = 0.049); patients whose tumors displayed a donutshape had inferior EFS. Conclusion. The pattern of donut avidity in extremity OS is a predictor of lower EFS, but does not correlate with histologic response to therapy (orig.)

  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. Incidence of Central Vein Stenosis and Occlusion Following Upper Extremity PICC and Port Placement

    International Nuclear Information System (INIS)

    The purpose of this study was to determine the incidence of central vein stenosis and occlusion following upper extremity placement of peripherally inserted central venous catheters(PICCs) and venous ports. One hundred fifty-four patients who underwent venography of the ipsilateral central veins prior to initial and subsequent venous access device insertion were retrospectively identified. All follow-up venograms were interpreted at the time of catheter placement by one interventional radiologist over a 5-year period and compared to the findings on initial venography. For patients with central vein abnormalities, hospital and home infusion service records and radiology reports were reviewed to determine catheter dwelltime and potential alternative etiologies of central vein stenosis or occlusion. The effect of catheter caliber and dwell time on development of central vein abnormalities was evaluated. Venography performed prior to initial catheter placement showed that 150 patients had normal central veins. Three patients had central vein stenosis, and one had central vein occlusion. Subsequent venograms (n = 154)at the time of additional venous access device placement demonstrated 8 patients with occlusions and 10 with stenoses. Three of the 18 patients with abnormal follow-up venograms were found to have potential alternative causes of central vein abnormalities. Excluding these 3 patients and the 4 patients with abnormal initial venograms, a 7% incidence of central vein stenosis or occlusion was found in patients with prior indwelling catheters and normal initial venograms. Catheter caliber showed no effect on the subsequent development of central vein abnormalities. Patients who developed new or worsened central vein stenosis or occlusion had significantly (p =0.03) longer catheter dwell times than patients without central vein abnormalities. New central vein stenosis or occlusion occurred in 7% of patients following upper arm placement of venous access devices

  3. Investigation of the effects of mirror therapy on the upper extremity functions of stroke patients using the manual function test

    OpenAIRE

    Kim, Hwanhee; Shim, Jemyung

    2015-01-01

    [Purpose] The purpose of this study was to investigate the effects of mirror therapy on the upper extremity functions of stroke patients. [Subjects] The subjects of this study were 14 hemiplegia patients (8 males, 6 females; 9 infarction, 5 hemorrhage; 8 right hemiplegia, 6 left hemiplegia) who voluntarily consented to participate in the study. [Methods] The Korean version of the manual function test (MFT) was used in this study. The test was performed in the following order: arm movement (4 ...

  4. 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.

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

    International Nuclear Information System (INIS)

    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

  6. 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.

  7. 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

  8. 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

  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%, Pitems on the PHQ. Conclusion In this prospective cohort study of injured workers, we identified a relatively high prevalence of symptoms of psychological disorders utilizing the PHQ, with one third of injured workers screening positive for symptoms of depression, PD, or PTSD. Further longitudinal follow-up is

  10. Clinical report of an extremely severe bone marrow form of acute radiation sickness

    International Nuclear Information System (INIS)

    Objective: To sum up the experiences from the diagnosis and treatment of patient B subjected to an accidental 60Co exposure on October 21st, 2004, in Jining, Shandong Province, China. Methods: Radiation dose of B was assessed by analysis of chromosome aberration and microneucleus assay, simulation test of the accident site, autopsy and electron spin resonance (ESR). The ultimate clinical diagnosis was based on analysis of irradiation dose, clinical manifestations and laboratory results. In therapeutical aspects, total environmental protection, HLA-identical allogeneic peripheral blood stem cell transplantation (PBSCT), anti- infection and protection managements of organs were given. Results: Patient B was diagnosed as extremely severe bone marrow form of acute radiation sickness (ARS). HLA-identical allogeneic PBSCT was performed on the patient from his brother on the 7th day after the accident. The hematopoietic recovery began on the 9th day after transplantation. The patient acquired permanent full donor' engraftment without graft versus host disease (GVHD), But the radiation injury was continuing and the patient complicated with polyinfection in lung, and cardiac insufficiency. On the 45th day after the accident, patient B was performed with tracheotomy and maintained ventilation with respirator. On the 75th day after the accident, patient B died of multiple organ failure. Conclusions: Early triage diagnosis and total environmental protection should be performed as soon as possible for extremely severe bone marrow form of ARS. It is very important to perform a successful HLA-identical allogeneic PBSCT, in order to extend the life time of the patient. Multiple organ injuries and infections of bacteria and fungi usually occurred on this kind of patients, so intense measures of anti-infection and protection of multiple organs should be taken. The important and difficult point in the treatment of this kind ARS might be for help the immune-reconstruction and tissue

  11. 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)

  12. 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...

  13. Effects of task-oriented training on upper extremity function and performance of daily activities by chronic stroke patients

    OpenAIRE

    Park, Juhyung; Yoo, Chanuk

    2015-01-01

    [Purpose] The aim of this study was to determine the effects that task-oriented training has on upper extremity function and performance of daily activities by chronic stroke patients. [Subjects and Methods] Task-oriented training was applied to two chronic hemiplegic patients in this research. The training was provided to each patient for 30 minutes a day, five times a week for two weeks. The treatment program included six different types of training that could be performed by the patients t...

  14. 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...

  15. Influence of downscaling methods in projecting climate change impact on hydrological extremes of upper Blue Nile basin

    OpenAIRE

    M. T. Taye; Willems, P

    2013-01-01

    Methods from two statistical downscaling categories were used to investigate the impact of climate change on high rainfall and flow extremes of the upper Blue Nile basin. The main downscaling differences considered were on the rainfall variable while a generally similar method was applied for temperature. The applied downscaling methods are a stochastic weather generator, LARS-WG, and an advanced change factor method, the Quantile Perturbation Method (QPM). These were applied on 10 GCM run...

  16. 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

  17. Vascular injuries of the upper extremity Lesões vasculares de membros superiores

    Directory of Open Access Journals (Sweden)

    Raafat Shalabi

    2006-12-01

    Full Text Available OBJECTIVE: This study analyzes the causes of injuries, presentations, surgical approaches, outcome and complications of vascular trauma of the upper limbs, in spite of limited hospital resources. METHODS: A 5-year retrospective analysis. From 01/01/2001 to 31/12/2005, 165 patients were operated for vascular injuries at King Fahd Hospital, Medina, Saudi Arabia. Of all peripheral vascular trauma patients (115, upper limb trauma was present in 58. Diagnosis was made by physical examination and hand-held Doppler alone or in combination with Doppler scan/angiography. Primary vascular repair was performed whenever possible; otherwise, the interposition vein graft was used. Fasciotomy was considered when required. Patients with unsalvageable lower extremity injury requiring primary amputation were excluded from the study. RESULTS: Fifty patients were male (86% and eight were female (14%, aged between 2.5-55 years (mean 23 years. Mean duration of presentation was 8 h after the injury. The most common etiological factor was road traffic accidents, accounting for 50.5% in the blunt trauma group and 33% among all penetrating and stab wound injuries. Incidence of concomitant orthopedic injuries was very high in our study (51%. The brachial artery was the most affected (51%. Interposition vein grafts were used in 53% of the cases. Limb salvage rate was 100%. CONCLUSION: Patients who suffer vascular injuries of the upper extremities should be transferred to vascular surgery centers as soon as possible. Decisive management of peripheral vascular trauma will maximize patient survival and limb salvage. Priorities must be established in the management of associated injuries, and delay must be avoided when ischemic changes are present.OBJETIVO: Este estudo analisa as causas de lesões, apresentação, abordagens cirúrgicas, desfechos e complicações do trauma vascular de membros superiores, apesar de recursos hospitalares limitados. MÉTODOS: An

  18. 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

  19. 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...

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

    OpenAIRE

    Thompson R Terry; Burgess Ronald A; Rollman Gary B

    2008-01-01

    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, part...

  1. 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…

  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. 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

  4. 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...

  5. Management of periarticular fractures of long bones of the lower extremity by hybrid external fixation

    Directory of Open Access Journals (Sweden)

    Natarajan Mayil

    2006-01-01

    Full Text Available Background : Management of periarticular fractures is associated with many complications. Hybrid fixators allows for early partial weight bearing and range of motion exercises at adjoining joints. Furthermore, it promotes callous formation by continuous axial micro movements in the fixation frame. Methods : We have prospectively analyzed the results of hybrid external fixation in the management of periarticular fractures of long bones of the lower extremity in 20 patients accounting for 22 limbs. We treated 19 fractures (18 compound and 1 closed and three fracture nonunions with this method. The mean age of the patients was 36.5 years. In 12 patients hybrid fixation was the primary procedure while in 8 patients hybrid fixation was done following initial emergency AO Uniplanar external fixation. Fourteen patients required subsequent surgeries such as bone grafting and soft tissue cover. Results : The mean follow up of our patients was 13.2 months (5 - 25 months. We achieved excellent results in 10 fractures, good in 4 fractures, fair in 3 fractures and poor results in 3 fractures. Two patients were lost to follow up. Bony union was achieved in 18 of the fractures. A short-term acceptable result was achieved in 17 cases. Conclusion : Hybrid external fixation is a very effective and useful treatment modality in the management of fractures close to a joint providing excellent to good results. It combines the advantages of both Ilizarov and AO external fixators. It is minimally invasive, modular and yet efficient in promoting massive new proliferative callus formation at the fracture site.

  6. 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.

  7. Deep vein thrombosis of upper extremities due to reactive thrombocytosis in septic patients

    Directory of Open Access Journals (Sweden)

    Shakti Bedanta Mishra

    2014-01-01

    Full Text Available Deep venous thrombosis (DVT is not an uncommon condition in the intensive care unit (ICU, and having high morbidity and mortality. Upper limb DVT also is increasingly being recognized as a clinical entity. The presence of the indwelling catheter in neck veins is a risk for developing venous thrombus, which may be further aggravated by presence of thrombocytosis. In ICU patients with sepsis, reactive thrombocytosis has been found during the recovery phase. Here, we are presenting two cases, having thrombocytosis and central venous catheter who developed upper limb DVT.

  8. 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.

  9. Upper extremity compartmental anatomy: clinical relevance to radiologists

    Energy Technology Data Exchange (ETDEWEB)

    Toomayan, Glen A.; Robertson, Fabienne; Major, Nancy M. [Duke University Medical Center, Department of Radiology, P.O. Box 3808, Durham, NC (United States); Duke University Medical Center, Division of Orthopaedic Surgery, Department of Surgery, P.O. Box 3808, Durham, NC (United States); Brigman, Brian E. [Duke University Medical Center, Division of Orthopaedic Surgery, Department of Surgery, P.O. Box 3808, Durham, NC (United States)

    2006-04-15

    Malignant tumors of the upper extremity are uncommon, and their care should be referred to specialized facilities with experience treating these lesions. The Musculoskeletal Tumor Society (MSTS) staging system is used by the surgeon to determine appropriate surgical management, assess prognosis, and communicate with other healthcare providers. Magnetic resonance imaging (MRI) is employed pre-operatively to identify a lesion's compartment of origin, determine extent of spread, and plan biopsy and resection approaches. Involvement of neurovascular structures may result in devastating loss of upper extremity function, requiring amputation. Violation of high-resistance compartmental barriers necessitates more extensive surgical resection. Biopsy may be performed by the radiologist using imaging guidance. Knowledge of compartmental anatomy allows the radiologist or surgeon to use an easily excisable biopsy approach and prevent iatrogenic spread to unaffected compartments. Case examples are presented to illustrate the importance of compartmental anatomy in the management of benign and malignant upper extremity tumors. (orig.)

  10. Effect of mirror therapy with tDCS on functional recovery of the upper extremity of stroke patients

    OpenAIRE

    Cho, Hyuk-Shin; Cha, Hyun-Gyu

    2015-01-01

    [Purpose] This study aimed to determine the effect of mirror therapy (MT) with transcranial direct current stimulation (tDCS) on the recovery of the upper extremity function of chronic stroke patients. [Subjects] Twenty-seven patients at least 6 months after stroke onset were divided randomly into an experimental group (14 patients) and a control group (13 patients). [Methods] All subjects received tDCS for 20 min followed by a 5 min rest. Then the experimental group received MT while the con...

  11. Patient Satisfaction after Upper Extremity Laser Lipolysis without Suction

    OpenAIRE

    Kotlus, Brett S.; Charles Mok

    2011-01-01

    Background and Objective. There has been a heightened interest in laser-assisted fat reduction procedures. We aimed to determine if lipolysis with the 1,320 nm Nd-YAG short-pulsed laser without subsequent suction results in satisfactory contouring of the upper extremity. Materials and Methods. Unilateral laser lipolysis of the upper arm was performed on 5 patients. Subcutaneous, subdermal, and skin surface temperatures were monitored with flexible thermocouples throughout the procedure to aid...

  12. 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

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

    OpenAIRE

    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...

  14. 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

  15. "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...

  16. 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

    2014-01-01

    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. PMID:25297823

  17. Determination of bone mineral density of the distal extremity of the radio in Rottweiller, by radiographic optic densitometry

    International Nuclear Information System (INIS)

    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)

  18. Effects of task-oriented training on upper extremity function and performance of daily activities in chronic stroke patients with impaired cognition

    OpenAIRE

    Park, Juhyung

    2016-01-01

    [Purpose] This study aimed to determine the effects of task-oriented training on upper extremity function and performance of daily activities in chronic stroke patients with impaired cognition. [Subjects and Methods] In this study, 2 chronic hemiplegic stroke patients underwent task-oriented training. The training was conducted once a day for 30 minutes, 5 times/week, for 2 weeks. The patients were evaluated 3 times before and after the task-oriented training. Changes in upper extremity funct...

  19. 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.

  20. 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

  1. Influence of downscaling methods in projecting climate change impact on hydrological extremes of upper Blue Nile basin

    Science.gov (United States)

    Taye, M. T.; Willems, P.

    2013-06-01

    Methods from two statistical downscaling categories were used to investigate the impact of climate change on high rainfall and flow extremes of the upper Blue Nile basin. The main downscaling differences considered were on the rainfall variable while a generally similar method was applied for temperature. The applied downscaling methods are a stochastic weather generator, LARS-WG, and an advanced change factor method, the Quantile Perturbation Method (QPM). These were applied on 10 GCM runs and two emission scenarios (A1B and B1). The downscaled rainfall and evapotranspiration were input into a calibrated and validated lumped conceptual model. The future simulations were conducted for 2050s and 2090s horizon and were compared with 1980-2000 control period. From the results all downscaling methods agree in projecting increase in temperature for both periods. Nevertheless, the change signal on the rainfall was dependent on the climate model and the downscaling method applied. LARS weather generator was good for monthly statistics although caution has to be taken when it is applied for impact analysis dealing with extremes, as it showed a deviation from the extreme value distribution's tail shape. Contrary, the QPM method was good for extreme cases but only for good quality daily climate model data. The study showed the choice of downscaling method is an important factor to be considered and results based on one downscaling method may not give the full picture. Regardless, the projections on the extreme high flows and the mean main rainy season flow mostly showed a decreasing change signal for both periods. This is either by decreasing rainfall or increasing evapotranspiration depending on the downscaling method.

  2. Influence of downscaling methods in projecting climate change impact on hydrological extremes of upper Blue Nile basin

    Directory of Open Access Journals (Sweden)

    M. T. Taye

    2013-06-01

    Full Text Available Methods from two statistical downscaling categories were used to investigate the impact of climate change on high rainfall and flow extremes of the upper Blue Nile basin. The main downscaling differences considered were on the rainfall variable while a generally similar method was applied for temperature. The applied downscaling methods are a stochastic weather generator, LARS-WG, and an advanced change factor method, the Quantile Perturbation Method (QPM. These were applied on 10 GCM runs and two emission scenarios (A1B and B1. The downscaled rainfall and evapotranspiration were input into a calibrated and validated lumped conceptual model. The future simulations were conducted for 2050s and 2090s horizon and were compared with 1980–2000 control period. From the results all downscaling methods agree in projecting increase in temperature for both periods. Nevertheless, the change signal on the rainfall was dependent on the climate model and the downscaling method applied. LARS weather generator was good for monthly statistics although caution has to be taken when it is applied for impact analysis dealing with extremes, as it showed a deviation from the extreme value distribution's tail shape. Contrary, the QPM method was good for extreme cases but only for good quality daily climate model data. The study showed the choice of downscaling method is an important factor to be considered and results based on one downscaling method may not give the full picture. Regardless, the projections on the extreme high flows and the mean main rainy season flow mostly showed a decreasing change signal for both periods. This is either by decreasing rainfall or increasing evapotranspiration depending on the downscaling method.

  3. Effect of gender and stroke rate on joint power characteristics of the upper extremity during simulated rowing.

    Science.gov (United States)

    Attenborough, Alison S; Smith, Richard M; Sinclair, Peter J

    2012-01-01

    Males typically have greater upper body strength than do females, which is likely to impact on the rowing techniques adopted by each sex. The aim of this study was to quantify energy contributions and compare the joint power production of upper extremity joints between the sexes. Seven males and eight females performed 60 s trials at five different stroke rates. External forces were measured at the handle and stretcher, while kinematics were recorded by motion analysis. Joint moments were derived by inverse dynamic calculations, followed by the calculation of joint powers and gross mechanical energy expenditure. Male rowers expended more total external energy per stroke and made a larger percentage contribution of angular shoulder energy to their total external energy expenditure. As stroke rate increased, the contribution from elbow and angular shoulder energy contributions decreased for both males and females. Female rowers decreased their angular shoulder contribution at a slower rate than did males as stroke rate increased. The overall percentage of work done on the stretcher was higher for male rowers, and this difference further increased at higher stroke rates. The results of this study suggest that specific upper body conditioning may be particularly important for female rowers. PMID:22296106

  4. Upper extremity hemodynamics and sensation with backpack loads.

    Science.gov (United States)

    Kim, Sae Hoon; Neuschwander, Timothy B; Macias, Brandon R; Bachman, Larry; Hargens, Alan R

    2014-05-01

    Heavy backpacks are often used in extreme environments, for example by military during combat, therefore completion of tasks quickly and efficiently is of operational relevance. The purpose of this study was to quantify hemodynamic parameters (brachial artery Doppler and microvascular flow by photoplethysmography; tissue oxygenation by near-infrared spectroscopy; arterial oxygen saturation by pulse oximeter) and sensation in upper extremities and hands (Semmes-Weinstein monofilament test and 2-point discrimination test) while wearing a loaded backpack (12 kg) in healthy adults for 10 min. All values were compared to baseline before wearing a backpack. Moderate weight loaded backpack loads significantly decreased upper extremity sensation as well as all macrovascular and microvascular hemodynamic values. Decreased macrovascular and microvascular hemodynamics may produce neurological dysfunction and consequently, probably affect fine motor control of the hands. PMID:24075289

  5. Construction of pulse badge for upper extremities dosimetry in nuclear medicine

    International Nuclear Information System (INIS)

    In the manipulation of radioactive materials in nuclear medicine service the body parts of the worker who more is displayed to the ionizing radiation is hands, forearm and arm. Therefore it is necessary to developing badges for easy reproduction monitoring and low cost to determine the doses level radiation received by the worker in these extremities. The aim of this work is to investigation of a new pulse badge, that is developed with thermoluminescent detectors of CaSO4:Dy (TLD) in a small plate of acrylic, perforated cardboard to deposit the TLD. This set was involved in plastic to protect of humidity and other harmful ambient factors, moreover, a bracelet was inserted, adaptable for any worker. This badge had been gotten resulted satisfactory, with a reply to the enough dose for a dosimetric evaluation. (author)

  6. 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.

  7. Dynamic contrast-enhanced MR imaging in symptomatic bone stress of the pelvis and the lower extremity

    Energy Technology Data Exchange (ETDEWEB)

    Kiuru, M.J. [Helsinki Univ. Central Hospital (Finland). Dept. of Radiology; Pihlajamaeki, H.K. [Military Central Hospital, Helsinki (Finland). Dept. of Surgery; Perkioe, J.P [Helsinki Univ. Central Hospital (Finland). Dept. of Radiology; Ahovuo, J.A. [Military Central Hospital, Helsinki (Finland). Dept. of Radiology

    2001-05-01

    Purpose: To assess the value of dynamic contrast-enhanced MR imaging in bone stress of the pelvis and the lower extremity. Material and Methods: Thirty patients (37 reactions; aged 17-25 years, mean 20.5 years) with MR findings of 37 bone stress reactions were examined using dynamic gadolinium contrast enhancement. The enhancement was evaluated with time-intensity curves. The highest slope and maximum enhancement values were calculated and compared with the different precontrast MR imaging signs of bone stress reactions. Results: There was a significant difference in the highest slope values between the site of the bone stress reaction and the reference points. In 24 of the 37 reactions the dynamic contrast enhancement was regarded as positive. A fracture line, callus, and muscle edema were the MR imaging signs which had significant correlation to the dynamic contrast enhancement. Neither periosteal nor marrow changes showed any significant correlation. A new MR grading system for bone stress reactions could be assessed. Conclusion: Increased tissue perfusion could be seen if precontrast MR imaging revealed callus, fracture line or muscle edema surrounding the bone stress reaction.

  8. 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.

  9. Effect of Electrical Stimulation Combined with Electromyographic Biofeedback and Exercise Practices on Upper Extremity Rehabilitation after Stroke Original Article

    Directory of Open Access Journals (Sweden)

    Yavuz Selim Pehlivan

    2011-06-01

    Full Text Available Objective: In this study, we aimed to investigate the additional benefits of ES (electrical stimulation combined with EMG-BF (electromyographic biofeedback on motor and functional outcomes in 30 patients admitted to Eskişehir Osmangazi University Faculty of Medicine, Department of Physical Medicine and Rehabilitation.Metarials and Methods: Medicine and Rehabilitation, with hemiparetic upper xtremity after stroke. The patients were divided into three groups. Group 1 was assigned to exercise and ES, group 2 - to exercise, EMG-BF and ES, and group 3 – to exercise alone. All procedures were administered for one hour a day, 5 days in a week, for 4 weeks. The Barthel Index (BI, Upper Extremity Function Test, Brunnstrom stages of motor recovery for hands, goniometric measurement of active wrist extension and the Motricity Index (MI were used to assess the efficiency of treatment. Results: There were statistically significant improvements in Brunnstrom stages of motor recovery for hand (p<0.05, goniometric measurement of active wrist extension (p<0.05, upper extremity function test (p<0.01, BI (group 1 p<0.05, group 2 p<0.01 and MI (group 1 p<0.05, group 2 p<0.01 for both first and second groups after treatment. In group 3, significant improvement was found only in MI. Advanced significant improvement in surface EMG activity was observed only in group 2 (p<0.01.Conclusion: Although our results do not support the efficacy of combined therapy, considering the mechanisms of effects of ES and EMG-BF, it can be suggested that ES and EMG-BF are complementary procedures. We think that further studies are needed on this issue. Turk J Phys Med Rehab 2011;57:66-72.

  10. The role of bone scanning in severe frostbite of the extremities: a retrospective study of 88 cases

    International Nuclear Information System (INIS)

    We performed a retrospective study of the results of two-phase technetium-99m hydroxymethylene diphosphonate bone scans in 88 patients with severe frostbite of the extremities. All patients were evaluated within 48 h after rewarming and all underwent a first bone scan (BS1) within 5 days after rewarming (median, day 2) (group 1). An excellent correlation was found between absence of tracer uptake in the phalanges and later amputation; this correlation was especially strong during the bone phase of the scans (specificity = 0.99, sensitivity = 0.96, positive predictive value = 0.92). Normal or high uptake in the phalanges was a reliable indicator of ultimate healing (negative predictive value = 0.99). The sensitivity of the examination was enhanced by performing a second scan (BS2) more than 5 days (median, day 8) after rewarming (group 2, n=36). A comparative analysis of BS1 and BS2 demonstrated that some of the lesions continued to evolve between day 2 and day 8. This suggests that the lesions could still be modified during this period. On the basis of the findings it is recommended that bone scan be performed close to day 2 in all patients who present with lesions extending proximally to include the entirety of one or more phalanges. In the case of severe sepsis, the results of the first bone scan, BS1, can serve as an indication for emergency amputation. BS2 should be performed close to day 8 only if there is an area of low or absent uptake on BS1. It is concluded that scintigraphy is an excellent means of evaluating patients with severe frostbite of the extremities: as early as day 2 after the injury it can indicate whether amputation is necessary, and between days 2 and 8 it provides valuable information on the efficacy of treatment. (orig.)

  11. 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; Ejbjerg, Bo; Hetland, Merete; Albrecht-Beste, Elisabeth; Østergaard, Mikkel; Hetland, Merete Lund

    2008-01-01

    previously validated Artoscan-unit as standard reference, MagneVu and CR had sensitivities of 0.82 and 0.55, respectively, in MCP-joint bones and 0.41 and 0.14 in wrist bones. Specificities of CR and MagneVu were comparable (0.82-0.99). MagneVu was particularly more sensitive than CR in metacarpal heads and...

  12. 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

  13. 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.

  14. MR criteria for differentiation of 'pseudo tumourous' lesions from bone sarcomas of the extremities

    International Nuclear Information System (INIS)

    The MRT scans of 57 patients with Ewing or osteosarcomas and 34 patients with haematogenous osteomyelitis or periostitis/stress fractures were examined in order to determine whether a distinction between benign or malignant lesions is possible. Four criteria were evaluated: The margin of the bone marrow component; intensity and homogeneity of the T1-weighted signal in the bone marrow; presence of an extraosseus structured soft tissue mass and/or soft tissue edema. It was found that central osteosarcomas and Ewing's sarcomas reduced signal intensity of the marrow to become muscle-isointense with a well defined margin. In acute haematogenous osteomyelitis and periostitis/stress fracture the marrow lesion was not sharply demarcated. In contrast to patients with bone sarcomas only one case of osteomyelitis showed an extrosseus structured soft tissue mass. On the basis of these findings we believe that acute haematogenous osteomyelitis can be distinguished with high degree of accuracy from Ewing's sarcoma and central osteosarcomas. (orig.)

  15. 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.)

  16. 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

  17. 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

  18. 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

  19. 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

  20. 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.)

  1. 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.)

  2. Upper extremity hemolymphangiomas in children: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Hyo Jin; Kim, Yong Hoon; Hwang, Yoon Joon; Kim, Su Young; Kim, Han Seong [Inje Univ. College of Medicine, Goyang (Korea, Republic of)

    2012-06-15

    Hemolymphangiomas are rare benign soft tissue tumors that arise from congenital malformations of the vascular system. The malformations are usually diagnosed at birth or early in childhood and cases in the extremities have been scarcely reported. We present a very rare case of hemolymphangioma of the right upper extremity in a 7 year old male. The diagnosis was made by plain radiography and magnetic resonance imaging and finally confirmed by histopathology of the resected specimen. The hemolymphangioma showed a well-defined soft tissue mass with a phlebolith on plain radiography, and a multilocular cystic mass with peripheral and septal enhancement on magnetic resonance imaging.

  3. 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...

  4. 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.

  5. Transfusion-Related Acute Lung Injury Following Upper Extremity Replantation

    OpenAIRE

    Celalettin Sever; Yalçın Külahçı; Cihan Şahin; Sinan Öksüz; Haluk Duman; Fuat Yüksel

    2012-01-01

    Transfusion-related acute lung injury (TRALI) is a common adverse effect of blood transfusion that is often underrecognised and underreported. We would like to report a case of TRALI after the replantation and transfusion of blood components in a male patient who had sustained a complete amputation of the right upper extremity. The level of amputation was just proximal to the humeral condyles. Replantation was performed 5 hours after the accident and 36 units of blood products were transfused...

  6. Incomplete palmar fracture of the proximal extremity of the third metacarpal bone in horses: ten cases (1981-1986)

    International Nuclear Information System (INIS)

    In 4 adult horses, simple, non displaced, incomplete fracture of the proximal extremity of the third metacarpal bone (MC3) was identified radiographically only on the dorsopalmar projection. Lameness was slight to moderate. Although nerve blocks of the foot and fetlock did not alter the lameness, high palmar regional nerve block improved the gait in 1 of the 2 horses on which it was performed. Pain on palpation or swollen distal accessory (inferior check) ligament, flexor tendons, and suspensory ligament were not found in any horse. The fracture was localized to the palmar surface of the proximal extremity of the MC3 on the basis of the intense uptake of radiopharmaceutical (99MTc-labeled sodium medronate) observed in that area during the soft tissue and delayed bone phases of a nuclear scintigraphic examination (nuclear scan) performed concurrently with radiography. Of 4 horses evaluated 6 months after the initial diagnosis, 3 had medullary sclerosis without radiographic evidence of fracture; results of follow-up nuclear scintigraphy performed in one of these horses at the same time were normal. Incomplete fracture also was suspected in another 6 adult horses with clinical lameness referable to the proximal extremity of the MC3. Although a fracture line could not be seen radiographically, trabecular hypertrophy and/or medullary sclerosis of the proximal extremity of the MC3 were detected on the dorsopalmar projection. Further, during nuclear scintigraphy, an intense uptake of the radiopharmaceutical was observed on the palmar aspect of the proximal extremity of the MC3 in all 6 horses

  7. 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.

  8. 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.

  9. 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

  10. Psychometric Properties and Administration of the Wrist/Hand Subscales of the Fugl-Meyer Assessment in Minimally-Impaired Upper Extremity Hemiparesis in Stroke

    OpenAIRE

    Page, Stephen J.; Levine, Peter; Hade, Erinn

    2012-01-01

    There is a need for time-efficient, valid measures of distal paretic upper extremity (UE) movement. The purposes of this study were to: (a) determine the psychometric properties of the wrist stability and mobility and hand items of the upper extremity scale of the Fugl-Meyer (w/h UE FM) as a “stand alone” measure of distal UE movement; and (b) provide detailed instructions on w/h UE FM administration and scoring. The UE FM and Action Research Arm Test (ARAT) were administered on 2 separate oc...

  11. Relation between stimulation characteristics and clinical outcome in studies using electrical stimulation to improve motor control of the upper extremity in stroke

    OpenAIRE

    Kroon, de, H.; IJzerman, M.J.; Chae, J; Lankhorst, G.J.; Zilvold, G.

    2005-01-01

    Objective: Electrical stimulation can be applied in a variety of ways to the hemiparetic upper extremity following stroke. The aim of this review is to explore the relationship between characteristics of stimulation and the effect of electrical stimulation on the recovery of upper limb motor control following stroke. Methods: A systematic literature search was performed to identify clinical trials evaluating the effect of electrical stimulation on motor control. The reported outcomes were exa...

  12. 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.

  13. 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

  14. Unilateral variation of the arterial pattern of the human upper extremity with a muscle variation of the hand.

    Directory of Open Access Journals (Sweden)

    Yücel AH

    1999-04-01

    Full Text Available A unilateral variation in the origin and distribution of the arterial pattern of the human upper extremity on the right side is reported on. Apart from its usual branches, the third part of the right axillary artery gave origin to a common branch, the profunda brachii artery and the superior ulnar collateral artery. The right brachial artery, at a point 5.0 cm distal to its origin, bifurcated into the radial and ulnar arteries; their origin was in a position opposite the usual location. The radial artery continued on the medial side of the arm for 2.5 cm and crossed the ulnar artery anteriorly to gain a lateral position in the arm. The inferior ulnar collateral artery arose not from the brachial artery, but from the ulnar artery. A muscle variation was also observed in the right hand, which is compatible with the notion variations within one system of a limb will frequently be accompanied by variations in other systems of the same limb.

  15. Long-term follow-up of thalidomide embryopathy: malformations and development of osteoarthritis in the lower extremities and evaluation of upper extremity function

    OpenAIRE

    Ghassemi Jahani, Shadi A.; Danielson, Barbro; Karlsson, Jón; Danielsson, Aina J.

    2014-01-01

    Background Between 1959 and 1962, several children with multiple malformations were born after maternal intake of thalidomide during pregnancy, known as thalidomide embryopathy (TE). Objectives The aim of this study was to evaluate the malformations, their long-term effect on the function of the extremities and the development of degenerative osteoarthritis (OA) in the lower extremities. Methods All living persons with TE in Sweden were invited to participate in the study. Thirty-one patients...

  16. 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. PMID:26552695

  17. 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

  18. 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...

  19. 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

  20. 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...

  1. 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...

  2. 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

  3. 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

  4. 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.

  5. X-ray morphology of the joints and the bones of the extremities of aged people

    International Nuclear Information System (INIS)

    The radiograms of the healthy extremities of aged people are analyzed and the normal formations, typical at higher age, are differentiated from the pathological phenomena. The ''physiological'' decalcification can cause the following symptoms: trabecular microfractures, areas without structure, pseudoforamena, discrete spicules at the edges of the joints, periostoses, fibrous structure of the compacta. The deformations occurring in the different joints are detailed. The relationship between high age and arthrosis is also investigated. It is concluded that the occurrence of arthrosis is not inevitable and it is not seriously influenced neither by the weight nor by the profession of the patient. The thesis contains 49 radiograms. (L.E.)

  6. 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

  7. 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.

  8. 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 habitablezone of stars of different spectral types have already been discoveredand many are expected to be discovered in the near future. However,owing to the lack of knowledge on the atmospheric properties, the ambientenvironment of such planets are unknown. It is known that sufficientamount of Extreme Ultraviolet (EUV) radiation from the star can drivehydrodynamic outflow of hydrogen that may drag heavier species fromthe atmosphere of the planet. If the rate of mass loss is sufficiently high,then substantial amount of volatiles would escape causing the planet tobecome uninhabitable. Considering energy-limited hydrodynamical massloss with an escape rate that causes oxygen to escape alongwith hydrogen,an upper limit for the ratio between the EUV and the bolometricluminosities of stars which constrains the habitability of planets aroundthem is presented here. Application of the limit to planet-hosting starswith known EUV luminosities implies that many M-type of stars shouldnot have habitable planets around them.

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

    Science.gov (United States)

    Sengupta, Sujan

    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.

  10. "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.

  11. 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

  12. 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.

  13. 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...

  14. 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...

  15. 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

  16. 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.…

  17. Design of a perfect balance system for active upper-extremity exoskeletons.

    Science.gov (United States)

    Smith, Richard L; Lobo-Prat, Joan; van der Kooij, Herman; Stienen, Arno H A

    2013-06-01

    Passive gravity compensation in exoskeletons significantly reduces the amount of torque and energy needed from the actuators. So far, no design has been able to achieve perfect balance without compromising the exoskeleton characteristics. Here we propose a novel design that integrates an existing statically-balanced mechanism with two springs and four degrees of freedom into a general-purpose exoskeleton design, that can support any percentage of the combined weight of exoskeleton and arm. As it allows for three rotational degrees of freedom at the shoulder and one at the elbow, it does not compromise exoskeleton characteristics and can be powered with any choice of passive or active actuation method. For instance, with this design a perfectly balanced exoskeleton design with inherently safe, passive actuators on each joint axis becomes possible. The potential reduction in required actuator torque, power and weight, simplification of control, improved dynamic performance, and increased safety margin, all while maintaining perfect balance, are the major advantages of the design, but the integrated systems does add a significant amount of complexity. Future integration in an actual exoskeleton should prove if this tradeoff is beneficial. PMID:24187195

  18. Computational investigation of two interventions for neck and upper extremity pain in office workers

    DEFF Research Database (Denmark)

    Rasmussen, J.; De Zee, M.

    2010-01-01

    reduce the muscle loads, but a wrist cushion is the more effective intervention type for the vast majority of the muscles. It is concluded that the method can offer useful assistance for design and prescription of efficient interventions for particular ergonomic problems typical for office workers...

  19. 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.

  20. 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.

  1. The upper extremity deep venous thrombosis and its interventional treatment

    International Nuclear Information System (INIS)

    Upper extremity deep vein thrombosis (UEDVT) was once regarded as a kind of disorder that was not serious. With the development of medical knowledge and research, it is now has been well recognized that UEDVT is an important risk factor that can bring about the pulmonary embolus, even cause death in severe patients. This article aims to make a comprehensive review of UEDVT, focusing on the etiology, epidemiology, the clinical features, the diagnosis, the interventional treatment options, the nursing care, the complications as well as prevention strategies, etc. (authors)

  2. 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.

  3. 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 ...

  4. 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

  5. Different radionuclide imaging in diagnosis, assessment of response and detection of recurrence in bone and soft tissue tumours of the extremities

    International Nuclear Information System (INIS)

    The objectives of the present work are: a) to compare different radionuclides in the diagnosis of bone and soft tissue tumours; b) to evaluate the role of 99mTc-MIBI uptake and washout kinetics in assessing the tumour response to initial chemotherapy; c) to study the diagnostic efficacy of different radionuclides in detecting recurrent bone and soft tissue tumours (STS) of the extremities in comparison to CT and/or MRI

  6. Clinical evaluation of motion and position sense in the upper extremities of the elderly using motion analysis system

    Directory of Open Access Journals (Sweden)

    Li KY

    2014-07-01

    Full Text Available Kuan-yi Li,1 Yi-hui Wu2 1Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Healthy Aging Research Center, Chang Gung University, Kwei-shan, Tao-Yuan, Taiwan; 2Department of Rehabilitation, Taoyuan Chang Gung Memorial Hospital, Kwei-shan, Tao-Yuan, Taiwan Abstract: The purpose of this study was to measure kinesthetic accuracy in healthy older adults by using arm position and motion matching tests. We investigated the effect of task type, joint angle, and matching arm results on kinesthetic accuracy in the upper extremities of 17 healthy right-handed older adults. Blinded subjects were asked to match positions and motions at four reference joint angles: 1 shoulder flexion, 0°–60°; 2 elbow flexion, 90°–135°; 3 wrist extension, 0°–50° in the sagittal plane; and 4 shoulder abduction, 0°–60° in the frontal plane. The absolute difference in angular displacement between the reference and matching arms was calculated to determine kinesthetic accuracy. Results showed that subjects were more accurate at matching motion than position tasks (P=0.03. Shoulder and elbow joints were more sensitive than wrist joints in perceiving passive positions and motions (P<0.05. The effect of the matching arm was found only when matching the joint angles of shoulder abduction and wrist extension (P<0.01. These results are comparable to findings of other studies that used machine-generated kinesthetic stimuli. The manual measurement of kinesthetic accuracy could be effective as a preliminary screening tool for therapists in clinical settings. Keywords: joint position matching, proprioception, velocity perception

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

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    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.

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

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    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

  9. Nutritive orifice and nutritive channel in the long bones of the extremities of newborn children - roentgenanatomical and roentgenometric study

    International Nuclear Information System (INIS)

    A roentgenoanatomic and roentgenometric study was performed on 1239 bones from the limbs of dead newborn children from both sexes. Frontally made roentgenographies were used of the following kinds of bones: shoulder bones (210), cubit (222), radius (223), thigh bone (201), big tibia (192), and small tibia (191). The characteristics of the gastrointestinal tract for those bones are described, and measure the distance of its opening from the proximal and distal end along the bone, according to Pyle's method. The author offers the usage of the results as a norm for characterising the newborn children in the People's Republic of Bulgaria. The establishment of deviations in the characteristics of the gastrointestinal tract and its opening in the long bones, will enable the early diagnostic of congenital systematic diseases of the skeleton, as well as in forensic medicine in view of identification. (author)

  10. A review of technological and clinical aspects of robot-aided rehabilitation of upper-extremity after stroke.

    Science.gov (United States)

    Babaiasl, Mahdieh; Mahdioun, Seyyed Hamed; Jaryani, Poorya; Yazdani, Mojtaba

    2016-05-01

    Cerebrovascular accident (CVA) or stroke is one of the leading causes of disability and loss of motor function. Millions of people around the world are effected by it each year. Stroke results in disabled arm function. Restoration of arm function is essential to regaining activities of daily living (ADL). Along with traditional rehabilitation methods, robot-aided therapy has emerged in recent years. Robot-aided rehabilitation is more intensive, of longer duration and more repetitive. Using robots, repetitive dull exercises can turn into a more challenging and motivating tasks such as games. Besides, robots can provide a quantitative measure of the rehabilitation progress. This article overviews the terms used in robot-aided upper-limb rehabilitation. It continues by investigating the requirements for rehabilitation robots. Then the most outstanding works in robot-aided upper-limb rehabilitation and their control schemes have been investigated. The clinical outcomes of the built robots are also given that demonstrates the usability of these robots in real-life applications and their acceptance. This article summarizes a review done along with a research on the design, simulation and control of a robot for use in upper-limb rehabilitation after stroke. Implications for Rehabilitation Reviewing common terms in rehabilitation of upper limb using robots Reviewing rehabilitation robots built up to date Reviewing clinical outcomes of the mentioned rehabilitation robots. PMID:25600057

  11. 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 ...

  12. 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...

  13. 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.

  14. 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

  15. Transfusion-Related Acute Lung Injury Following Upper Extremity Replantation

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    Celalettin Sever

    2012-09-01

    Full Text Available Transfusion-related acute lung injury (TRALI is a common adverse effect of blood transfusion that is often underrecognised and underreported. We would like to report a case of TRALI after the replantation and transfusion of blood components in a male patient who had sustained a complete amputation of the right upper extremity. The level of amputation was just proximal to the humeral condyles. Replantation was performed 5 hours after the accident and 36 units of blood products were transfused intraoperatively. Subsequently, during the early postoperative period, TRALI was revealed. In this case report, the circumstances of this injury and preventive measures are discussed to understand and recognise this condition in order to reduce the morbidity and mortality of TRALI. It is important to distinguish TRALI from other causes of pulmonary oedema because early diagnosis and management are associated with a favourable outcome.

  16. 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

  17. 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

  18. An uncommon cause of tardy ulnar nerve palsy due to upper extremity prolonged malposition in a comatose child: a case report

    OpenAIRE

    Emamhadi, Mohammad Reza; Mahmoudi, Davood

    2012-01-01

    Abstract: Background: Ulnar nerve neuropathy is one of the most common peripheral nerve dysfunctions. Elbow is the most common area affected by ulnar nerve which is mainly because of fractures or dislocations of this area. Delayed ulnar nerve palsy (Tardy Ulnar Nerve Palsy) in children due to a malpositioning of upper extremity during hospitalization is an uncommon cause of ulnar nerve injury which we have already reported it. Methods: An eight-year-old conscious patient who had weakness, par...

  19. 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.

  20. 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

  1. Paget-Schroetter syndrome (Primary Upper extremity deep vein thrombosis: a case report

    Directory of Open Access Journals (Sweden)

    Toba kazemi

    2015-12-01

    Full Text Available Deep vein thrombosis (DVT is an important disease and occurred in lower extremities ,commonly. Approximately 10% of all cases of DVT involve the upper extremities. Upper-extremity DVT is an increasingly entity  due to more catheter user and pace maker implantation. Because of potential risk of Pulmonary embolism , Upper-extremity DVT is clinically important condition. Involvement of upper extremity DVT is due to catheter  ,trauma, infection, mechanical obstruction, IV drug abusing, surgery, etc. Primary Upper-extremity DVT is a rare disorder  that refers either to effort thrombosis (the so-called Paget-Schroetter Syndrome or idiopathic . Patients with Paget-Schroetter Syndrome develop  in young and healthy people ,in  dominant arm and after strenuous activity such as weight lifting, baseball pitching ,etc. In this article we report a young patient suffering from pain and swelling caused by the movement of glaciers in the right hand.After color Doppler ultrasonography and Venography, Upper-extremity DVT recognized. He was treated by anticoagulant. We will also talk about the next treatment and  patient, s 4-years follow up. In the present article . a young patient with a diagnosis of  right arm DVT post exertion with Paget-Schroetter syndrome and 4 years follow up is presented .

  2. The anabolic activity of bone tissue, suppressed by disuse, is normalized by brief exposure to extremely low-magnitude mechanical stimuli

    Science.gov (United States)

    Rubin, C.; Xu, G.; Judex, S.

    2001-01-01

    It is generally believed that mechanical signals must be large in order to be anabolic to bone tissue. Recent evidence indicates, however, that extremely low-magnitude (<10 microstrain) mechanical signals readily stimulate bone formation if induced at a high frequency. We examined the ability of extremely low-magnitude, high-frequency mechanical signals to restore anabolic bone cell activity inhibited by disuse. Adult female rats were randomly assigned to six groups: baseline control, age-matched control, mechanically stimulated for 10 min/day, disuse (hind limb suspension), disuse interrupted by 10 min/day of weight bearing, and disuse interrupted by 10 min/day of mechanical stimulation. After a 28 day protocol, bone formation rates (BFR) in the proximal tibia of mechanically stimulated rats increased compared with age-matched control (+97%). Disuse alone reduced BFR (-92%), a suppression only slightly curbed when disuse was interrupted by 10 min of weight bearing (-61%). In contrast, disuse interrupted by 10 min per day of low-level mechanical intervention normalized BFR to values seen in age-matched controls. This work indicates that this noninvasive, extremely low-level stimulus may provide an effective biomechanical intervention for the bone loss that plagues long-term space flight, bed rest, or immobilization caused by paralysis.

  3. 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=

  4. Methods for evaluating work-related musculoskeletal neck and upper-extremity disorders in epidemiological studies

    OpenAIRE

    Toomingas, Allan

    1998-01-01

    The aim of this thesis was to develop, evaluate and characterise assessment methods used within epidemiological studies of work-related musculoskeletal disorders in the neck and upper extremities. Special attention was paid to self-administered methods, relations to psychosocial risk factors and signs of nerve compression. Work-related musculoskeletal disorders in the neck and upper extremities are common and costly in many respects. Knowledge about the progression of th...

  5. 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...

  6. 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...

  7. 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.

  8. 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.

  9. 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 ...

  10. The MR trainer. Upper extremities. 2. rev. and enl. ed.

    International Nuclear Information System (INIS)

    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.

  11. Pulse monitor for upper extremities dosimetry in nuclear medicine

    International Nuclear Information System (INIS)

    In the manipulation of radioactive materials in Nuclear Medicine service the body parts of workers that are more displayed to the ionizing radiation are hands, underarm and arm. Therefore is necessary to developing personal dosimeters to monitoring of easy reproduction and low cost with purpose to determine the doses level radiation received by the worker in these extremities. However thermoluminescent dosimeters do not provide an instantaneous exposure reading, they are suitable for personal dosimetry because of their following advantages: wide useful dose range, small physical size and no need for high voltage or cables, i.e. stand alone character. The aim of this work is to investigation of a new pulse monitor, that has been developing with thermoluminescent detectors of CaSO4:Dy (TLD) using a small plate of acrylic, perforated cardboard to deposit the TLD. This set was involved in plastic to protect from humidity and other harmful ambient factors; moreover, a bracelet was inserted, adaptable for any worker. During the preparation of the personal dosimeters to monitor exposure it was necessary to verify their effectiveness to use by workers in a nuclear medicine service. The monitors have been submitted to procedures of performance evaluations by several tests: badges homogeneity, reproducibility, linearity, low detection limit, auto-irradiation, dosimeters stability, verification of the residual T.L. signal, visible light effect on dosimeters, energetic and angular dependence and TLD answer by influence of a simulator during radiation. Was possible to verify the efficiency of such upper extremities dosimeters and were obtained satisfactory results within of the limits demanded in the described tests above to this type of personal dosimeters. (authors)

  12. Motor learning perspectives on haptic training for the upper extremities.

    Science.gov (United States)

    Williams, Camille K; Carnahan, Heather

    2014-01-01

    Recent developments in neurorehabilitation have spawned numerous new robotic rehabilitation therapies. However, many of the concepts upon which these therapies are based are not fully understood and it may be necessary to explore some of the motor learning principles that apply to the use of haptics for motor learning in non-clinical scenarios/populations. We conducted a review of studies that utilized a haptic training paradigm teaching healthy participants to perform a motor skill involving the upper extremities. We discuss studies in the context of four important motor learning concepts: performance versus learning, feedback, observational learning, and functional task difficulty. Additionally, we note that the proliferation of research in haptic training has led to an extensive vocabulary of terms, some of which may be misnomers or redundant. We propose a classification of terms describing haptic training in an effort to provide clarity and further contextualize the studies. We believe that making connections to motor learning principles and clarifying meanings will facilitate a fuller understanding of the outcomes of studies in basic science research and allow for more directed applications of these training techniques to clinical populations. PMID:24968385

  13. 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

  14. 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.

  15. 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...

  16. 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.)

  17. Irradiated long bone transplants in limb saving surgeries for extremity bone cancers

    International Nuclear Information System (INIS)

    In the Philippines, the treatment of cancers of the limbs has always been by amputation. In recent decades, better understanding of these cancers and advances in the disciplines of cancer medicine have made the saving of these limbs almost routine in better developed countries. Surgeries entail two steps: (1) excision of the tumor and the bone from which the tumor arose, followed by (2) reconstruction of the defect resulting from the excision. Tumor implants, however, are not available locally, and are too costly for the average Filipino patient. Microvascular surgery is limited by the size of the defect it can bridge; and bone cement, not being biologic, can result in greater long term problems. Recently, the option of long bone transplants (aka large-segment allografts) to reconstruct these defects has become available locally. These bones are harvested from both cadaveric and live amputee donors after appropriate consent and medical work-up. After processing at the UP-PGH Tissue and Bone Bank, the bones are sterilized by irradiation at the PNRI(Philippine Nuclear Research Institute), and store in deep freezers until use. In the Philippines, limb saving surgery for bone cancers of the extremities using these large-segment alloografts was introduced in 1993 at the UP-PGH Musculoskeletal Tumor Unit. This paper will present the author's initial 3-year experience with 19 patients whose limbs were saved using bone transplantation. All surgeries were performed by the author and all patients have been personally followed up by the author (follow-up ranging from 6 months to 3-1/2 years). Cases will be presented to show the pre- and intraoperative processing of the irradiated bone; and the patients before and after the operations with emphasis on their improved quality of life and return to function. These results would seem to show that irradiated long bone transplants coupled with skills for limb saving surgery may make amputations a thing of the past for many of our

  18. 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。

  19. MESOLITHIC HUMAN BONES FROM THE UPPER VOLGA BASIN: RADIOCARBON AND TRACE ELEMENTS

    OpenAIRE

    Alexandrovskiy, A. L.; Alexandrovskaya, E. I.; Zhilin, M. I.; Van der Plicht, J

    2009-01-01

    Human bones from 3 Mesolithic sites in the Upper Volga basin were analyzed for trace elements, and dated by accelerator mass spectrometry (AMS). The radiocarbon dates of the bones correspond to the Mesolithic era. However, some dates differ from those obtained for the enclosing deposits and for the worked wood fragments in the cultural layer. The elemental composition of the bones is interpreted in terms of increased concentrations of some elements and their impact on human health and behavior.

  20. 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...

  1. The initial effects of an upper extremity neural mobilization technique on muscle fatigue and pressure pain threshold of healthy adults: a randomized control trial.

    Science.gov (United States)

    Kim, Myoung-Kwon; Cha, Hyun-Gyu; Ji, Sang Gu

    2016-03-01

    [Purpose] The purpose of this study was to determine the effects of an upper extremity neural mobilization technique on delayed onset muscle soreness. [Subjects] Forty-five healthy subjects were randomly assigned to two groups: a nerve mobilization group (experimental) and a control group. [Methods] The subjects of the experimental group were administered a median nerve mobilization technique and ultrasound for the biceps brachii muscle. The subjects in the control group were only administered ultrasound for the biceps brachii muscle. Muscle fatigue and the pressure pain threshold were assessed before and after the intervention. [Results] The experimental group showed significant improvements in all variables, compared to pre-intervention. Furthermore, the control group showed significant improvements in the pressure pain threshold, compared to pre-intervention. Significant differences in the post-intervention gains in muscle fatigue and pressure pain threshold were found between the experimental group and the control group. [Conclusion] Application of the upper extremity neural mobilization technique is considered to have a positive effect on recovery from delayed onset muscle soreness. PMID:27134351

  2. Nerve conduction studies in upper extremities: skin temperature corrections.

    Science.gov (United States)

    Halar, E M; DeLisa, J A; Soine, T L

    1983-09-01

    The relationship of skin to near nerve (NN) temperature and to nerve conduction velocity (NCV) and distal latency (DL) was studied in 34 normal adult subjects before and after cooling both upper extremities. Median and ulnar motor and sensory NCV, DL, and NN temperature were determined at ambient temperature (mean X skin temp = 33 C) and after cooling, at approximately 26, 28, and 30 C of forearm skin temperature. Skin temperatures on the volar side of the forearm, wrist, palm, and fingers and NN temperature at the forearm, midpalm, and thenar or hypothenar eminence were compared with respective NCV and DL. Results showed a significant linear correlation between skin temperature and NN temperature at corresponding sites (r2 range, 0.4-0.84; p less than 0.005). Furthermore, both skin and NN temperatures correlated significantly with respective NCV and DL. Midline wrist skin temperature showed the best correlation to NCV and DL. Median motor and sensory NCV were altered 1.5 and 1.4m/sec/C degree and their DL 0.2 msec/C degree of wrist skin temperature change, respectively. Ulnar motor and sensory NCV were changed 2.1 and 1.6m/sec/C degree respectively, and 0.2 msec/C degree wrist temperature for motor and sensory DL. Average ambient skin temperature at the wrist (33 C) was used as a standard skin temperature in the temperature correction formula: NCV or DL(temp corrected) = CF(Tst degree - Tm degree) + obtained NCV or DL, where Tst = 33 C for wrist, Tm = the measured skin temperature, and CF = correction factor of tested nerve. Use of temperature correction formula for NCV and DL is suggested in patients with changed wrist skin temperature outside 29.6-36.4C temperature range. PMID:6615178

  3. Biomechanical Pressures and Upper Extremity Asymmetry: A Study on Young Laborers

    OpenAIRE

    Özener, Baris

    2007-01-01

    The purpose of this study is to reveal the impacts of biomechanical pressures of heavy working conditions on the upper extremities of young laborers. The study covers the examination of the upper extremities of 104 young laborers in the industrial workshops of Ankara, Turkey regarding bilateral asymmetry. The average age of the laborers was 18.48±0.61 years. The control group consisted of 102 non-laborers with an average age of 18.39±0.58 years. The laborers were measured with reg...

  4. 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

  5. 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...

  6. 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.

  7. 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

  8. 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

  9. Venogram of the Upper Extremity Using the Tourniquet Technique for the Evaluation of Central Vein Patency: A Comparison to Conventional and CO{sub 2} Venogram

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seun Ah; Chung, Hwan Hoon; Lee, Seung Hwa; Cha, Sang Hoon; Je, Bo Kyung; Seo, Bo Kyoung; Kim, Baek Hyun; Seo, Hyung Seok [Dept. of Radiology, Korea University Asan Hospital, Korea University College of Medicine, Asan (Korea, Republic of)

    2011-07-15

    On compare the tourniquet technique (TT) with the conventional venogram (CV) and the carbon dioxide venogram (CO{sub 2}V) for the evaluation of central vein patency of the upper extremity. CO{sub 2}V, TT, and CV were performed on 100 upper extremities prior to an arteriovenous fistula operation. The central vein was divided into four segments. The best image of the venograms for each segment was chosen as a reference, and the venogram techniques for each segment were graded from 1 (invisible) to 5 (excellent) compared with those of the reference image. The grades of the various venogram techniques at each segment of the vein were compared statistically. For the SVC segment, the mean grades of CO{sub 2}V, TT, and CV were 4.32, 3.60, and 2.45, respectively. TT is statistically superior to CV but inferior to CO{sub 2}V. On the brachiocephalic vein, the mean grades of CO{sub 2}V, TT, and CV were 4.41, 4.37, and 2.77 and were 4.81, 4.85, and 3.78 for the subclavian vein and 4.75, 4.93, and 4.57, respectively, on the axillary vein. On these segments, TT was statistically superior to CV, but no difference was noted with CO{sub 2}V. TT is superior to CV in every segment of the central vein and presents similar values to those of the CO{sub 2}V, except for the SVC.

  10. 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

  11. 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

  12. A myoelectric-controlled virtual hand for the assessment and treatment of phantom limb pain in trans-radial upper extremity amputees: a research protocol.

    Science.gov (United States)

    Gaggioli, Andrea; Amoresano, Amedeo; Gruppioni, Emanuele; Verni, Gennaro; Riva, Giuseppe

    2010-01-01

    At least 90% of individuals of limb amputees experience phantom limb pain (PLP). Recent clinical research suggests that providing patients with the mirror image representation of the amputated limb may alleviate PLP. However, mirror therapy cannot be used with bilateral amputees, as visual feedback is dependent on the movement of the intact limb. To overcome this limitation, we designed a novel myoelectric-controlled virtual reality (VR) system for the treatment of phantom limb pain in trans-radial upper extremity amputees. The proposed system allows the patient to directly control the virtual limb by recognizing stump muscle patterns recorded with EMG sensors. The hypothesis behind this strategy is that the VR image of the amputated limb induces better limb imagery than the reflected image of their intact limb and, therefore, is more effective in reducing PLP. A research protocol to test this hypothesis is described. PMID:20543301

  13. Robotic Rehabilitator of the Rodent Upper Extremity: A System and Method for Assessing and Training Forelimb Force Production after Neurological Injury.

    Science.gov (United States)

    Sharp, Kelli G; Duarte, Jaime E; Gebrekristos, Berkenesh; Perez, Sergi; Steward, Oswald; Reinkensmeyer, David J

    2016-03-01

    Rodent models of spinal cord injury are critical for the development of treatments for upper limb motor impairment in humans, but there are few methods for measuring forelimb strength of rodents, an important outcome measure. We developed a novel robotic device--the Robotic Rehabilitator of the Rodent Upper Extremity (RUE)--that requires rats to voluntarily reach for and pull a bar to retrieve a food reward; the resistance of the bar can be programmed. We used RUE to train forelimb strength of 16 rats three times per week for 23 weeks before and 38 weeks after a mild (100 kdyne) unilateral contusion at the cervical level 5 (C5). We measured maximum force produced when RUE movement was unexpectedly blocked. We compared this blocked pulling force (BPF) to weekly measures of forelimb strength obtained with a previous, well-established method: the grip strength meter (GSM). Before injury, BPF was 2.6 times higher (BPF, 444.6 ± 19.1 g; GSM, 168.4 ± 3.1 g) and 4.9 times more variable (p GSM; the two measurement methods were uncorrelated (R(2) = 0.03; p = 0.84). After injury, there was a significant decrease in BPF of 134.35 g ± 14.71 g (p GSM and thus may provide a useful measure for quantifying the effects of treatment in rodent models of SCI. PMID:26414700

  14. 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.

  15. 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.

  16. Primary Pseudomyogenic Hemangioendothelioma of Bone.

    Science.gov (United States)

    Inyang, Alero; Mertens, Fredrik; Puls, Florian; Sumathi, Vaiyapuri; Inwards, Carrie; Folpe, Andrew; Lee, Cheng-Han; Zhang, Yaxia; Symmans, Pennie; Rubin, Brian; Nielsen, Gunnlaugur P; Nguyen, Van-Hung; Rosenberg, Andrew E

    2016-05-01

    Pseudomyogenic hemangioendothelioma (PMH) is a well-recognized neoplasm that usually arises in the soft tissue; concurrent bone involvement occurs in 24% of cases. PMH of bone without soft tissue involvement is rare. We describe the clinicopathologic findings of 10 such cases, the largest series reported to date. The study included 9 male and 1 female patient; their ages ranged from 12 to 74 years (mean 36.7 y). All patients had multiple tumors with a distinct regional distribution: 45% restricted to the lower extremity; 25% to the spine and pelvis; and 15% to the upper extremity. On imaging studies the tumors were well circumscribed and lytic. The neoplasms were composed of spindled cells arranged in intersecting fascicles with scattered epithelioid cells; epithelioid cells predominated in 3 cases. The neoplastic cells contained abundant densely eosinophilic cytoplasm and vesicular nuclei. There was limited cytologic atypia and necrosis, few mitoses (0 to 2/10 high-power fields), and inconspicuous stroma. Unique findings included abundant intratumoral reactive woven bone and hemorrhage with numerous osteoclast-like giant cells. Immunohistochemically, most tumors were positive for keratin, ERG, and CD31; CD34 was negative. The balanced t(7:19)(q22;13) translocation was documented in 3 cases. Follow-up is limited, but no patient developed documented visceral dissemination, and all have stable or progressive osseous disease. PMH exclusively involving bone is rare. It is multicentric, often involves the lower extremity, and has unusual morphology. The differential diagnosis includes epithelioid vascular neoplasms, giant cell tumor, bone forming neoplasms, and metastatic carcinoma. Because of its rarity, unusual presentation, and morphology, accurate diagnosis can be challenging. PMID:26872012

  17. 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

  18. Upper extremity evaluation test through TEMPA: Reference values, age, gender, dominance effect and relation to dexterity

    Directory of Open Access Journals (Sweden)

    S.M. Michaelsen

    2011-01-01

    Full Text Available The purpose of this study was to verify the effect of age, gender and dominance on upper limb functional capacity and develop reference values on Functional performance test for upper extremity, Brazilian version of TEMPA (Test d’Evaluation de la performance des Membres supérieurs dês Personnes Agées, and verify the relationship between hand and digital dexterity and arm functional capacity. Participated in the study 281 individuals, aging more than 40 years old. Manual dexterity and finger dexterity were assessed with Box and Blocks Test (BBT and Nine Hole Peg Test, respectively. ANOVA evaluated the effects of age in men and women and effects of gender and laterality. Pearson`s correlation evaluated the relation between dexterity and upper limb function. In 70 to 79 years strata and the strata older than 80 TEMPA tasks have shown a decline compared to the younger strata. No significant differences were see between 40-49, 50-59 e 60-69 years old strata for any task. Decline in digital dexterity in women and in hand dexterity in man was correlated with decrease in upper limb function. The knowledge on effects of aging on upper limb function and dexterity will help differentiate between normal and pathological aging in upper extremity performance.

  19. Upper airway obstruction and pulmonary abnormalities due to lymphoproliferative disease following bone marrow transplantation in children

    International Nuclear Information System (INIS)

    We report three patients who developed severe supraglottic airway obstruction due to Epstein-Barr virus lymphoproliferative disease following allogeneic bone marrow transplantation. In addition to enlarged pharyngeal lymphoid tissue seen in all three patients, two had supraglottic airway narrowing and two developed pulmonary lymphoproliferative disease. They were treated with unmanipulated T cells or EBV-specific cytotoxic T lymphocytes. Life-threatening upper airway obstruction is a radiologically detectable complication of allogeneic bone marrow transplantation in children. (orig.)

  20. 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

  1. 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

  2. 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...

  3. 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.

  4. 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

  5. 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

  6. 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.

  7. 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.

  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. PMID:27338485

  10. Extreme erosion response after wildfire in the Upper Ovens, south-east Australia: Assessment of catchment scale connectivity by an intensive field survey

    Science.gov (United States)

    Box, Walter; Keestra, Saskia; Nyman, Petter; Langhans, Christoph; Sheridan, Gary

    2015-04-01

    South-eastern Australia is generally regarded as one of the world's most fire-prone environments because of its high temperatures, low rainfall and flammable native Eucalyptus forests. Modifications to the landscape by fire can lead to significant changes to erosion rates and hydrological processes. Debris flows in particular have been recognised as a process which increases in frequency as a result of fire. This study used a debris flow event in the east Upper Ovens occurred on the 28th of February 2013 as a case study for analysing sediment transport processes and connectivity of sediment sources and sinks. Source areas were identified using a 15 cm resolution areal imagery and a logistic regression model was made based on fire severity, aridity index and slope to predict locations of source areas. Deposits were measured by making cross-sections using a combination of a differential GPS and a total station. In total 77 cross-sections were made in a 14.1 km2 sub-catchment and distributed based on channel gradient and width. A more detailed estimation was obtained by making more cross-sections where the volume per area is higher. Particle size distribution between sources and sink areas were obtained by combination of field assessment, photography imagery analyses and sieve and laser diffraction. Sediment was locally eroded, transported and deposited depending on factors such as longitude gradient, stream power and the composition of bed and bank material. The role of headwaters as sediment sinks changed dramatically as a result of the extreme erosion event in the wildfire affected areas. Disconnected headwaters became connected to low order streams due to debris flow processes in the contributing catchment. However this redistribution of sediment from headwaters to the drainage network was confined to upper reaches of the Ovens. Below this upper part of the catchment the event resulted in redistribution of sediment already existing in the channel through a

  11. 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...... partial skeleton of the dromaeosaurid Saurornitholestes was collected from southern Alberta, Canada, that bore marks on one dentary. The location and morphology of the tooth marks suggests that a theropod (possible a juvenile tyrannosaurid) included a Saurornitholestes in its diet....

  12. 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...

  13. 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

    An approach of designing 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 for both the exoskeleton and the human body...

  14. 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.

  15. 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)

  16. 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.

  17. 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...

  18. 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

  19. 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.

  20. 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

  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. Brunnstrom Recovery Stage and Motricity Index for the Evaluation of Upper Extremity in Stroke: Analysis for Correlation and Responsiveness

    Science.gov (United States)

    Safaz, Ismail; Ylmaz, Bilge; Yasar, Evren; Alaca, Rdvan

    2009-01-01

    The aim of this study was to find out first whether Brunnstrom recovery stage (BRS) and motricity index (MI) were correlated with each other and second to observe whether the two assessment tools were sensitive to changes regarding the rehabilitation outcome. Forty-six stroke patients who were admitted to the Stroke Rehabilitation Unit at our…

  3. Treatment of large skeletal defects in the lower extremities using double-strut, free vascularized fibular bone grafting.

    Science.gov (United States)

    Chang, M C; Lo, W H; Chen, C M; Chen, T H

    1999-08-01

    This article reports on the use of double-strut, free vascularized fibular grafts to treat six patients with infected nonunion or traumatic bone loss in the femur or tibia after prolonged treatment and multiple operations. The defects were 6-13 cm long. Five patients achieved solid union within 6 months, and one patient required additional cancellous grafting to achieve union at the distal end of the fibula. One patient experienced a stress fracture due to strenuous exercise, and union was achieved 3 months after reapplying an external fixator. Although three patients had some restricted knee motion, all patients had a satisfactory outcome in regard to walking, and no limb-length discrepancies were noted in any patient. PMID:10465486

  4. 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. PMID:22902198

  5. 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

  6. 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)

  7. 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.

  8. 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

  9. 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

  10. 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....

  11. 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

  12. Management of two patients with intestinal form of acute radiation sickness and extremely severe bone marrow form of acute radiation sickness complicated with disseminated fungous infection

    International Nuclear Information System (INIS)

    Objective: To present two patients diagnosed as intestinal form of acute radiation sickness (patient A) and extremely severe bone marrow form of acute radiation sickness(patient B) complicated with disseminated fungous infection in China. Methods: On October 21st, 2004, a nuclear accident occurred in Jining, Shandong Province, China. Two individuals were accidentally irradiated by a 60Co source. They were transferred to our hospital, and performed allogeneic stem cell transplantation and soon acquired hematopoiesis recovery; however, refractory disseminated fungous infection occurred in two patients. Results: High dosage of amphotericin B combined with itraconazole and concidas were used to kill fungi. The infection was once controlled, but the radiation injury and infection were still becoming worse even after many kinds of treatment. The patients finally died of multiple organ failure on day 33 and day 75, respectively after the accident. Conclusions: The combination of Ampghotec (amphotericin B) with Caspofungin (concidas) and Itraconazole in the treatment of disseminated fungous infection was effective and with no related toxicity. But during the continuous injury of radiation, we couldn't eradicate the fungous infection. The patients were finally died of multiple organs failure related with radiation and infection. (authors)

  13. 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.

  14. Efficacy of 99mTc-MDP bone scan in the diagnosis of bone metastases

    International Nuclear Information System (INIS)

    A radiographic bone survey and radionuclide bone scan are the principal methods for the detection of metastatic bone diseases. A retrospective study of 99mTc-MDP bone scan in 169 patients with various tumors, over a period of 2 years revealed 82 patients having metastasis to skeletal system. The bone scan finding in these 82 cases were correlated with clinical symptoms, laboratory data, and radiographic studies. The results were as follows: 1.Male to female ratio was 47:35. The 7th decade (25 cases, 30.5%) was the most prevalent age group, followed by the 8th decade (22 cases, 26.9%), and the 6th decade (21 cases, 25.6%). 2.The primary sites of metastases were lung (36 cases, 43.9%), followed by stomach and prostate (9 cases each, 43.9%), breast (8 cases, 9.7%), liver (4 cases, 4.7%), Kidney and lymphoma (3 cases, 3.7%). 3.False negative radiographic bone survey was seen in 47 cases (57.3%) of 82. 4.43 cases (52.4%) of 82 had bone pain, and of these, 36 cases (83.7%) showed correlation with bone scan findings. 5.52 cases (63.4%) showed elevated serum alkaline phosphatase and it was significant, especially in patients with bone pain, along with the elevation of serum calcium and phosphorus. 6.The metastatic sites in skeletal system were ribs and sternum (35 cases), lumber spine (32 cases), thoracic spine (25 cases), lower extremity (19 cases), pelvis (18 cases), upper extremity (6 cases), and skull and face (2 cases)

  15. 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

  16. 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

  17. 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

  18. 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

  19. 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)

  20. Computer-assisted upper extremity training using interactive biking exercise (iBikE) platform.

    Science.gov (United States)

    Jeong, In Cheol; Finkelstein, Joseph

    2012-01-01

    Upper extremity exercise training has been shown to improve clinical outcomes in different chronic health conditions. Arm-operated bicycles are frequently used to facilitate upper extremity training however effective use of these devices at patient homes is hampered by lack of remote connectivity with clinical rehabilitation team, inability to monitor exercise progress in real time using simple graphical representation, and absence of an alert system which would prevent exertion levels exceeding those approved by the clinical rehabilitation team. We developed an interactive biking exercise (iBikE) platform aimed at addressing these limitations. The platform uses a miniature wireless 3-axis accelerometer mounted on a patient wrist that transmits the cycling acceleration data to a laptop. The laptop screen presents an exercise dashboard to the patient in real time allowing easy graphical visualization of exercise progress and presentation of exercise parameters in relation to prescribed targets. The iBikE platform is programmed to alert the patient when exercise intensity exceeds the levels recommended by the patient care provider. The iBikE platform has been tested in 7 healthy volunteers (age range: 26-50 years) and shown to reliably reflect exercise progress and to generate alerts at pre-setup levels. Implementation of remote connectivity with patient rehabilitation team is warranted for future extension and evaluation efforts. PMID:23367319

  1. Upper extremity nerve block: how can benefit, duration, and safety be improved? An update

    Science.gov (United States)

    Brattwall, Metha; Jildenstål, Pether; Warrén Stomberg, Margareta; Jakobsson, Jan G.

    2016-01-01

    Upper extremity blocks are useful as both sole anaesthesia and/or a supplement to general anaesthesia and they further provide effective postoperative analgesia, reducing the need for opioid analgesics. There is without doubt a renewed interest among anaesthesiologists in the interscalene, supraclavicular, infraclavicular, and axillary plexus blocks with the increasing use of ultrasound guidance. The ultrasound-guided technique visualising the needle tip and solution injected reduces the risk of side effects, accidental intravascular injection, and possibly also trauma to surrounding tissues. The ultrasound technique has also reduced the volume needed in order to gain effective block. Still, single-shot plexus block, although it produces effective anaesthesia, has a limited duration of postoperative analgesia and a number of adjuncts have been tested in order to prolong analgesia duration. The addition of steroids, midazolam, clonidine, dexmedetomidine, and buprenorphine has been studied, all being off-label when administered by perineural injection, and the potential neurotoxicity needs further study. The use of perineural catheters is an effective option to improve and prolong the postoperative analgesic effect. Upper extremity plexus blocks have an obvious place as a sole anaesthetic technique or as a powerful complement to general anaesthesia, reducing the need for analgesics and hypnotics intraoperatively, and provide effective early postoperative pain relief. Continuous perineural infusion is an effective option to prolong the effects and improve postoperative quality.

  2. 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)

  3. 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...

  4. 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

    International Nuclear Information System (INIS)

    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.)

  5. 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.)

  6. [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

  7. A Rare Cause of Testicular Metastasis: Upper Tract Urothelial Carcinoma

    Science.gov (United States)

    Manav, Alper Nesip; Kazan, Ercan; Ertek, Mehmet Şirin; Amasyalı, Akın Soner; Çulhacı, Nil; Erol, Haluk

    2014-01-01

    Metastatic testicular cancers are rare. Primary tumor sources are prostate, lung, and gastrointestinal tract for metastatic testicular cancers. Metastasis of urothelial carcinoma (UC) to the testis is extremely rare. Two-thirds of upper tract urothelial carcinoma (UTUC) is of invasive stage at diagnosis and metastatic sites are the pelvic lymph nodes, liver, lung, and bone. We report a rare case of metastatic UTUC to the testis which has not been reported before, except one case in the literature. Testicular metastasis of UC should be considered in patients with hematuria and testicular swelling. PMID:25120937

  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. 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

  10. 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.

  11. 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

  12. 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

  13. Upper extremity and rib stress fractures in a child

    International Nuclear Information System (INIS)

    Stress fractures in children are rare compared with the incidence in [ults. This report describes an 11-year-old girl with stress fractures of the acromion, clavicle, and first rib on the left and contralateral fractures of the first and second ribs. It was eventually discovered that these fractures were caused by a nervous tic consisting of repetitive, vigorous shrugging and translation of the shoulders. (orig.)

  14. 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...

  15. 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

  16. A Physically Based Surface/ Subsurface Flow Model to Assess the Impacts of Climate Change Extremes on the Hydrology of an Upper Midwest U.S. Watershed

    Science.gov (United States)

    Acar, O.; Franz, K.; Simpkins, W. W.

    2014-12-01

    Climate change is already affecting the Midwest U.S. Occurrence and intensity of extreme events such as heat waves, droughts and floods are expected to increase in the next few decades. It is the climate extremes, not averages, that have the greater impact on crop and livestock productivity which are vital for the State's economy. Accordingly, potential changes in the hydrologic cycle under prospective climate conditions need to be addressed at the watershed scale for the Midwestern agricultural region to develop better management and adaptation solutions. For this purpose, the 3-D finite element model, HydroGeoSphere has been applied to and calibrated for a representative watershed in north-central Iowa, Tipton Creek watershed. The conceptual model for the watershed consists of all the elements of the hydrologic cycle from the ground surface through the Quaternary aquitard and into the underlying Mississippian limestone aquifer. Extreme wet and dry conditions derived from statistically downscaled climate model scenarios have been used as input to the basin model to simulate the impacts on streamflow and groundwater flow. The model accomplishes integrated hydrologic analysis by the coupled solution of the diffusion wave equation governing 2-D (areal) surface water flow and the Richards' equation governing 3-D unsaturated/ saturated subsurface flow. Thus, actual evapotranspiration is calculated internally as a function of the soil moisture at each node of the defined evaporative zone at each time step and interdependent processes like recharge that are critical for climate change can be handled more accurately. Preliminary results for HadCM3 scenario combined with two SRES projections, A2 and A1fi predict more remarkable increases in stream levels in response to wet periods than the decreases in flows for dry periods in comparison to control (contemporary) period simulations. The impacts on the water table levels seem to be more prominent, in the range of ±4 m for

  17. Cortical reorganization after macroreplantation at the upper extremity: a magnetoencephalographic study.

    Science.gov (United States)

    Blume, Kathrin R; Dietrich, Caroline; Huonker, Ralph; Götz, Theresa; Sens, Elisabeth; Friedel, Reinhard; Hofmann, Gunther O; Miltner, Wolfgang H R; Weiss, Thomas

    2014-03-01

    With the development of microsurgical techniques, replantation has become a feasible alternative to stump treatment after the amputation of an extremity. It is known that amputation often induces phantom limb pain and cortical reorganization within the corresponding somatosensory areas. However, whether replantation reduces the risk of comparable persisting pain phenomena as well as reorganization of the primary somatosensory cortex is still widely unknown. Therefore, the present study aimed to investigate the potential development of persistent pain and cortical reorganization of the hand and lip areas within the sensory cortex by means of magnetoencephalographic dipole analyses after replantation of a traumatically amputated upper limb proximal to the radiocarpal joint. Cortical reorganization was investigated in 13 patients with limb replantation using air puff stimulation of the phalanges of both thumbs and both corners of the lower lip. Displacement of the centre of gravity of lip and thumb representations and increased cortical activity were found in the limb and face areas of the primary somatosensory cortex contralateral to the replanted arm when compared to the ipsilateral hemisphere. Thus, cortical reorganization in the primary somatosensory cortex also occurs after replantation of the upper extremity. Patients' reports of pain in the replanted body part were negatively correlated with the amount of cortical reorganization, i.e. the more pain the patients reported, the less reorganization of the subjects' hand representation within the primary somatosensory cortex was observed. Longitudinal studies in patients after macroreplantation are necessary to assess whether the observed reorganization in the primary somatosensory cortex is a result of changes within the representation of the replanted arm and/or neighbouring representations and to assess the relationship between the development of persistent pain and reorganization. PMID:24480484

  18. Severe Upper Extremity Dysfunction After 4CMenB Vaccination in a Young Infant.

    Science.gov (United States)

    Tenenbaum, Tobias; Niessen, Johanna; Schroten, Horst

    2016-01-01

    The 4-component meningococcal serogroup B vaccine 4CMenB (Bexsero) is the first vaccine against this serogroup and has been approved by licensing authorities in Europe, Canada and Australia. Therefore, the vaccine may enter soon nationwide vaccine recommendation schemes. We report on a case of a 5-month-old infant who developed prolonged upper extremity dysfunction after the second injection of the 4CMenB vaccine in the left deltoid muscle and was concomitantly applied with 2 routine vaccinations. Myositis, periostitis, (peri-) vasculitis and axillary inflammation were confirmed by magnetic resonance imaging. Two months after initial initiation of an anti-inflammatory and an antibiotic treatment, symptoms completely resolved. Administration of 3 vaccines requires clear recommendations for the preferred injection site in infants because increased reactogenicity of 4CMenB may lead to local severe adverse events. PMID:26379162

  19. 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.

  20. Bone mineral density and bone markers in patients with a recent low-energy fracture: effect of 1 y of treatment with calcium and vitamin D

    DEFF Research Database (Denmark)

    Hitz, Mette F; Jensen, Jens-Erik B; Eskildsen, Peter C

    2007-01-01

    : In a double-blinded design, patients with fracture of the hip (lower-extremity fracture, or LEF) or upper extremity (UEF) were randomly assigned to receive 3000 mg calcium carbonate + 1400 IU cholecalciferol or placebo (200 IU cholecalciferol). BMD of the hip (HBMD) and lumbar spine (LBMD) were......BACKGROUND: Low-energy fractures of the hip, forearm, shoulder, and spine are known consequences of osteoporosis. OBJECTIVE: We evaluated the effect of 1 y of treatment with calcium and vitamin D on bone mineral density (BMD) and bone markers in patients with a recent low-energy fracture. DESIGN...... significantly related to physical performance. CONCLUSIONS: A 1-y intervention with calcium and vitamin D reduced bone turnover, significantly increased BMD in patients younger than 70 y, and decreased bone loss in older patients. The effect of treatment was related to physical performance....

  1. 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 ...

  2. 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.

  3. 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.

  4. Do work-related factors affect care-seeking in general practice for back pain or upper extremity pain?

    DEFF Research Database (Denmark)

    Jensen, Jens Christian; Haahr, Jens Peder; Frost, Poul; Andersen, JH

    2013-01-01

    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......'s decision to seek care could be important in order to give more well-founded advice to our patients. The objective of this study was to elucidate the effects of workloads on care-seeking for back pain or upper extremity pain during an eighteen-month follow-up period. METHODS: This is a prospective study...... among females. Repetitive work and psychosocial factors did not have any statistically significant impact on care-seeking for neither back pain nor upper extremity pain. CONCLUSION: Work-related factors such as heavy lifting do, to some extent, contribute to care-seeking with MP. We suggest that asking...

  5. 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.

  6. Identification of a new hominin bone from Denisova Cave, Siberia using collagen fingerprinting and mitochondrial DNA analysis

    OpenAIRE

    Samantha Brown; Thomas Higham; Viviane Slon; Svante Pääbo; Matthias Meyer; Katerina Douka; Fiona Brock; Daniel Comeskey; Noemi Procopio; Michael Shunkov; Anatoly Derevianko; Michael Buckley

    2016-01-01

    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 s...

  7. 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.

  8. 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.

  9. 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

  10. 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

  11. Upper extremity nerve block: how can benefit, duration, and safety be improved? An update [version 1; referees: 3 approved

    OpenAIRE

    Metha Brattwall; Pether Jildenstål; Margareta Warrén Stomberg; Jakobsson, Jan G.

    2016-01-01

    Upper extremity blocks are useful as both sole anaesthesia and/or a supplement to general anaesthesia and they further provide effective postoperative analgesia, reducing the need for opioid analgesics. There is without doubt a renewed interest among anaesthesiologists in the interscalene, supraclavicular, infraclavicular, and axillary plexus blocks with the increasing use of ultrasound guidance. The ultrasound-guided technique visualising the needle tip and solution injected reduces the risk...

  12. 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).

  13. 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

  14. 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.

  15. 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

  16. [Microdestruction of the bone].

    Science.gov (United States)

    Iankovskiĭ, V É

    2014-01-01

    The objective of the present study was the detection of microcracks in the compact bone tissue surrounding the fracture and in deformed bone undergoing subcritical loading. The portions of deformed bone tissue and terminal fragments of broken bones were obtained in the form of blocks longitudinally sawcut from the regions of primary and secondary bone rupture. A total of 300 such blocks were available for the examination. All portions of the deformed bone tissue and terminal fragments of broken bones showed up microcracks commensurate with the bone structures. They were actually hardened traces of deformation that preceded the fracture and reflected the volume of the destroyed bone tissue; moreover, in certain cases they allowed to identify the kind of the object that exerted the external action (either a blow or slow bending). PMID:25269164

  17. Bone Fractures Following External Beam Radiotherapy and Limb-Preservation Surgery for Lower Extremity Soft Tissue Sarcoma: Relationship to Irradiated Bone Length, Volume, Tumor Location and Dose

    International Nuclear Information System (INIS)

    Purpose: To examine the relationship between tumor location, bone dose, and irradiated bone length on the development of radiation-induced fractures for lower extremity soft tissue sarcoma (LE-STS) patients treated with limb-sparing surgery and radiotherapy (RT). Methods and Materials: Of 691 LE-STS patients treated from 1989 to 2005, 31 patients developed radiation-induced fractures. Analysis was limited to 21 fracture patients (24 fractures) who were matched based on tumor size and location, age, beam arrangement, and mean total cumulative RT dose to a random sample of 53 nonfracture patients and compared for fracture risk factors. Mean dose to bone, RT field size (FS), maximum dose to a 2-cc volume of bone, and volume of bone irradiated to ≥40 Gy (V40) were compared. Fracture site dose was determined by comparing radiographic images and surgical reports to fracture location on the dose distribution. Results: For fracture patients, mean dose to bone was 45 ± 8 Gy (mean dose at fracture site 59 ± 7 Gy), mean FS was 37 ± 8 cm, maximum dose was 64 ± 7 Gy, and V40 was 76 ± 17%, compared with 37 ± 11 Gy, 32 ± 9 cm, 59 ± 8 Gy, and 64 ± 22% for nonfracture patients. Differences in mean, maximum dose, and V40 were statistically significant (p = 0.01, p = 0.02, p = 0.01). Leg fractures were more common above the knee joint. Conclusions: The risk of radiation-induced fracture appears to be reduced if V40 <64%. Fracture incidence was lower when the mean dose to bone was <37 Gy or maximum dose anywhere along the length of bone was <59 Gy. There was a trend toward lower mean FS for nonfracture patients.

  18. 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.)

  19. 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.

  20. 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.

  1. 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)

  2. Clinical applications of SPECT/CT in imaging the extremities

    Energy Technology Data Exchange (ETDEWEB)

    Huellner, Martin W. [University Hospital Zurich, Department of Medical Radiology, Division of Nuclear Medicine, Zurich (Switzerland); Strobel, Klaus [Lucerne Cantonal Hospital, Department of Nuclear Medicine and Radiology, Lucerne (Switzerland)

    2014-05-15

    Today, SPECT/CT is increasingly used and available in the majority of larger nuclear medicine departments. Several applications of SPECT/CT as a supplement to or replacement for traditional conventional bone scintigraphy have been established in recent years. SPECT/CT of the upper and lower extremities is valuable in many conditions with abnormal bone turnover due to trauma, inflammation, infection, degeneration or tumour. SPECT/CT is often used in patients if conventional radiographs are insufficient, if MR image quality is impaired due to metal implants or in patients with contraindications to MR. In complex joints such as those in the foot and wrist, SPECT/CT provides exact anatomical correlation of pathological uptake. In many cases SPECT increases the sensitivity and CT the specificity of the study, increasing confidence in the final diagnosis compared to planar images alone. The CT protocol should be adapted to the clinical question and may vary from very low-dose (e.g. attenuation correction only), to low-dose for anatomical correlation, to normal-dose protocols enabling precise anatomical resolution. The aim of this review is to give an overview of SPECT/CT imaging of the extremities with a focus on the hand and wrist, knee and foot, and for evaluation of patients after joint arthroplasty. (orig.)

  3. 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.

  4. 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

  5. Statistics of Local Extremes

    DEFF Research Database (Denmark)

    Larsen, Gunner Chr.; Bierbooms, W.; Hansen, Kurt Schaldemose

    2003-01-01

    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...

  6. 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)

  7. 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.

  8. 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.

  9. Measurement scales in clinical research of the upper extremity, part 1: general principles, measures of general health, pain, and patient satisfaction.

    Science.gov (United States)

    Badalamente, Marie; Coffelt, Laureen; Elfar, John; Gaston, Glenn; Hammert, Warren; Huang, Jerry; Lattanza, Lisa; Macdermid, Joy; Merrell, Greg; Netscher, David; Panthaki, Zubin; Rafijah, Greg; Trczinski, Douglas; Graham, Brent

    2013-02-01

    Measurement is a fundamental cornerstone in all aspects of scientific discovery, including clinical research. To be useful, measurement instruments must meet several key criteria, the most important of which are satisfactory reliability, validity, and responsiveness. Part 1 of this article reviews the general concepts of measurement instruments and describes the measurement of general health, pain, and patient satisfaction. PMID:23351912

  10. 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.

  11. Mechanical properties of nacre and highly mineralized bone

    OpenAIRE

    Davies, P; Casinos, A.; Currey, J D; Zioupos, P

    2001-01-01

    We compared the mechanical properties of 'ordinary' bovine bone, the highly mineralized bone of the rostrum of the whale Mesoplodon densirostris, and mother of pearl (nacre) of the pearl oyster Pinctada margaritifera. The rostrum and the nacre are similar in having very little organic material. However, the rostral bone is much weaker and more brittle than nacre, which in these properties is close to ordinary bone. The ability of nacre to outperform rostral bone is the result of its extremely...

  12. Measurement scales in clinical research of the upper extremity, part 2: outcome measures in studies of the hand/wrist and shoulder/elbow.

    Science.gov (United States)

    Badalamente, Marie; Coffelt, Laureen; Elfar, John; Gaston, Glenn; Hammert, Warren; Huang, Jerry; Lattanza, Lisa; Macdermid, Joy; Merrell, Greg; Netscher, David; Panthaki, Zubin; Rafijah, Greg; Trczinski, Douglas; Graham, Brent

    2013-02-01

    Part 1 of this article outlined the basic characteristics of useful clinical measurement instruments and described scales used to measure general health, pain, and patient satisfaction. Part 2 describes the features of some of the scales most commonly used in clinical research in the hand, wrist, elbow, and shoulder. PMID:23351913

  13. 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

  14. 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.

  15. Findings of skin and bones in mastocytosis

    International Nuclear Information System (INIS)

    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 inflammatorygranulomatous 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 frequenctly occurring bone lesions (half on 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. (orig.)

  16. Prevalence of musculoskeletal pain of the neck, upper extremities and lower back among dental practitioners working in Riyadh, Saudi Arabia: a cross-sectional study

    Science.gov (United States)

    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 sampling. 224 surveys were distributed among dentists with a 91.1% response rate (101 women and 103 men). Outcomes The prevalence of MSK pain and its associated risk factors were investigated. Results 184 (90.2%) respondents reported having MSK pain. Lower back pain was the most commonly reported MSK pain (68.1%). Gender and age were reported to be predictors for at least one type of MSK pain. Older age was associated with lower back pain (OR 1.23; 95% CI 1.00 to 1.50) and women had double the risk of shoulder pain (OR 2.52; 95% CI 1.12 to 5.68). In addition, lower back pain was related to the time the dentist spent with patients (OR 0.28; 95% CI 0.14 to 0.54), while shoulder pain (OR 1.03; 95% CI 1.00 to 1.06) and lower back pain (OR 1.06; 95% CI 1.03 to 1.10) were significantly related to years of experience. Conclusions MSK pain is common among older and female Saudi dentists. Research on the impact of exercise and the ergonomics of the workplace on the intensity of MSK pain and the timing of its onset is required. PMID:27324712

  17. 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 ...

  18. 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.

  19. 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.

  20. 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

  1. 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.

  2. 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

  3. 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

  4. Speed-accuracy testing on the Apple iPad provides a quantitative test of upper extremity motor performance in children with dystonia.

    Science.gov (United States)

    Bertucco, Matteo; Sanger, Terence D

    2014-11-01

    The currently available scales for quantitative measurement of the severity of childhood dystonia require human observer ratings and provide poor granularity in the scores for individual limbs. We evaluated the use of new-generation high-quality touchscreens (an iPad) according with the Fitts law, which is a mathematical model that takes into account the relation between movement time and the task accuracy. We compared the abilities of healthy subjects and children with dystonia. The linear relation described by Fitts law held for all the groups. The movement time and the information transmitted were age and severity related. Our results provide evidence for the usability and validity of using Fitts law as a quantitative diagnostic tool in children with dystonia. Furthermore, testing on touchscreen tablets may help to guide the design of user interfaces to maximize the communication rate for children who depend upon assistive communication devices. PMID:23965400

  5. 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.

  6. 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

  7. Tunelizador metálico rígido na confecção de fístulas arteriovenosas dos membros superiores Rigid metallic tunneler for the creation of arteriovenous fistulas in the upper extremity

    Directory of Open Access Journals (Sweden)

    Heraldo Antonio Barbato

    2011-06-01

    Full Text Available A qualidade de um acesso vascular condiciona os resultados clínicos dos pacientes tratados por hemodiálise. A criação de um túnel para a acomodação do conduto é uma etapa importante durante a realização do acesso. Desenvolveu-se um tunelizador metálico rígido, empregado na confecção de acessos vasculares. O aparato utilizado apresentou vantagens e segurança nas cirurgias de confecções de acessos venosos para hemodiálise dos membros superiores.The quality of a vascular access determines clinical outcomes of patients on hemodialysis. The creation of the tunnel for conduit insertion is an important step during the access. A rigid metallic tunneler was developed and employed to create arteriovenous fistulas. The device has proven advantageous and safe in operations for the creation of venous accesses for hemodialysis in the upper extremity.

  8. 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.

  9. Skin temperature measured by infrared thermography after specific ultrasound-guided blocking of the musculocutaneous, radial, ulnar, and median nerves in the upper extremity

    DEFF Research Database (Denmark)

    Lange, K H W; Jansen, T; Asghar, S; Kristensen, P L; Skjønnemand, M; Nørgaard, P

    2011-01-01

    Sympathetic block causes vasodilatation and increases in skin temperature (T(s)). However, the T(s) response after specific nerve blocking is unknown. In this study, we hypothesized that T(s) would increase after specific blocking of the nerve innervating that area.......Sympathetic block causes vasodilatation and increases in skin temperature (T(s)). However, the T(s) response after specific nerve blocking is unknown. In this study, we hypothesized that T(s) would increase after specific blocking of the nerve innervating that area....

  10. Skin temperature measured by infrared thermography after specific ultrasound-guided blocking of the musculocutaneous, radial, ulnar, and median nerves in the upper extremity

    DEFF Research Database (Denmark)

    Lange, K H W; Jansen, T; Asghar, S; Kristensen, P L; Skjønnemand, M; Nørgaard, P

    2011-01-01

    Sympathetic block causes vasodilatation and increases in skin temperature (T(s)). However, the T(s) response after specific nerve blocking is unknown. In this study, we hypothesized that T(s) would increase after specific blocking of the nerve innervating that area....

  11. 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.

  12. Enzymatic maceration of bone

    DEFF Research Database (Denmark)

    Uhre, Marie-Louise; Eriksen, Anne Marie; Simonsen, Kim Pilkjær;

    2015-01-01

    afterwards macerated by one of the two methods. DNA extraction was performed to see the effect of the macerations on DNA preservation. Furthermore, the bone pieces were examined in a stereomicroscope to assess for any bone damage. The results demonstrated that both methods removed all flesh/soft tissue from...... 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...

  13. 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.

  14. 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.

  15. 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

  16. 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.

  17. 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.

  18. 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

  19. RARE PRESENTATION OF MELORHEOSTEOSIS INVOLVING CARPAL BONES

    OpenAIRE

    Ramana; Srinivas,; Reddy; Harshad; Guruvardhan

    2014-01-01

    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 ...

  20. Infantile lipofibromatosis of the upper limb

    Energy Technology Data Exchange (ETDEWEB)

    Teo, Harvey E.L.; Peh, Wilfred C.G. [KK Women' s and Children' s Hospital, Department of Diagnostic Imaging, Singapore (Singapore); Chan, Mei-Yoke [KK Women' s and Children' s Hospital, Department of Paediatric Medicine, Singapore (Singapore); Walford, Norman [Tan Tock Seng Hospital, Department of Pathology, Singapore (Singapore)

    2005-12-01

    The imaging features of extensive lipofibromatosis presenting in a 1-day-old female infant are reported. This lesion involved her entire right upper limb, extending from the axilla to the palm of the hand. Radiographs showed marked deformity and thinning of all the right upper-limb bones due to pressure effect of soft-tissue enlargement, especially affecting the distal humerus and proximal forearm bones. Magnetic resonance imaging showed a huge soft-tissue mass infiltrating most of the muscles of the entire upper limb, with bony erosion. The mass was largely T1-isointense, moderately T2-hyperintense and showed marked enhancement. There were intra-lesional signal changes consistent with fatty elements. A lesion debulking procedure was performed and the histology was that of lipofibromatosis. The limb was found to be non-viable after the procedure and a subsequent above-elbow amputation was performed. Although the resection margins were not clear, she had no further recurrence over a subsequent 3-year follow-up period. (orig.)

  1. 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

  2. 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

  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. Bolustherapy in the general chart of renewal of the lost functions of lower extremities for patients after the diaphyseal fracture of bones of shins

    Directory of Open Access Journals (Sweden)

    Zhelezniy A.D.

    2010-06-01

    Full Text Available The results of the use of medical clay are considered as a physical therapy mean in the general chart of physical rehabilitation of patients. The existent methods of treatment clay are adapted for the physical rehabilitation of patients. Considered chemical components of local clays. Presented recommendation to the use of clay with the dosage of procedures during the physical rehabilitation of patients. As a result of application of author method for patients on 1-3 weeks the terms of physical rehabilitation grew short.

  5. Value of bone scintigraphy in psoriasis

    Energy Technology Data Exchange (ETDEWEB)

    Nakayama, Chikashi; Nakata, Hajime; Kimoto, Tatsuya; Nakayama, Takashi; Yokomizo, Yu (University of Occupational and Environmental Health, Kitakyushu, Fukuoka (Japan). School of Medicine)

    1982-10-01

    We performed bone scintigraphy on 16 cases of psoriasis to evaluate its possible value in this disease and obtained the following results: 1) Bone scintigraph was abnormal in 15 of 16 cases and the frequent association of arthritis in psoriasis was confirmed. 2) Abnormal uptake on bone scintigraph was noted in various joints including peripheral joints of extremities, sternoclavicular joint, shoulder and rib. Abnormality of sacroiliac joint or ankle was less frequent than previously reported. 3) Findings of bone scintigraph were not necessarily related with clinical symptoms or laboratory data. Abnormal uptake was also noted in many joints whose X-ray examinations were negative. Bone scintigraphy thus seems to be useful in early detection of arthritis and to become an initial therapeutic indicator of arthritis in psoriasis.

  6. Value of bone scintigraphy in psoriasis

    International Nuclear Information System (INIS)

    We performed bone scintigraphy on 16 cases of psoriasis to evaluate its possible value in this disease and obtained the following results: 1) Bone scintigraph was abnormal in 15 of 16 cases and the frequent association of arthritis in psoriasis was confirmed. 2) Abnormal uptake on bone scintigraph was noted in various joints including peripheral joints of extremities, sternoclavicular joint, shoulder and rib. Abnormality of sacroiliac joint or ankle was less frequent than previously reported. 3) Findings of bone scintigraph were not necessarily related with clinical symptoms or laboratory data. Abnormal uptake was also noted in many joints whose X-ray examinations were negative. Bone scintigraphy thus seems to be useful in early detection of arthritis and to become an initial therapeutic indicator of arthritis in psoriasis. (author)

  7. Primary clear cell sarcoma of bone

    International Nuclear Information System (INIS)

    Clear cell sarcoma is a rare soft tissue sarcoma of young adults with melanocytic differentiation. It occurs predominantly in the soft tissue of extremities, typically involving tendons and aponeuroses. Primary clear cell sarcoma of bone is extremely rare. We report a case of primary clear cell sarcoma of the right first metatarsal in a 48-year-old woman and provide a literature review of the entity. (orig.)

  8. 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.

  9. Infections of bone and the neurotrophic foot

    International Nuclear Information System (INIS)

    Osteomyelitis, or an infection of bone, is a very debilitating disease that can occur anywhere in the body, but especially in the lower extremity. The bone infection may be due to bacteria, viral infections, or mycotic infections, but usually is due to bacteria. The usual clinical picture reveals infectious edema, soft tissue changes, subperiosteal alterations, active bone destruction, areas of dead bone, and areas of new bone production. Osteomyelitis must be distinguished from inflammatory disorders, arthritis, Paget's disease, neurofibromatosis, multiple myeloma, malignant disease, endocrine disorders, and metabolic disorders. All of these conditions may cause changes that can be confused with osteomyelitis. The author discusses the two basic types of osteomyelitis: hematogenous and direct extension

  10. 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.

  11. Genome-wide association study using extreme truncate selection identifies novel genes affecting bone mineral density and fracture risk.

    Directory of Open Access Journals (Sweden)

    Emma L Duncan

    2011-04-01

    Full Text Available Osteoporotic fracture is a major cause of morbidity and mortality worldwide. Low bone mineral density (BMD is a major predisposing factor to fracture and is known to be highly heritable. Site-, gender-, and age-specific genetic effects on BMD are thought to be significant, but have largely not been considered in the design of genome-wide association studies (GWAS of BMD to date. We report here a GWAS using a novel study design focusing on women of a specific age (postmenopausal women, age 55-85 years, with either extreme high or low hip BMD (age- and gender-adjusted BMD z-scores of +1.5 to +4.0, n = 1055, or -4.0 to -1.5, n = 900, with replication in cohorts of women drawn from the general population (n = 20,898. The study replicates 21 of 26 known BMD-associated genes. Additionally, we report suggestive association of a further six new genetic associations in or around the genes CLCN7, GALNT3, IBSP, LTBP3, RSPO3, and SOX4, with replication in two independent datasets. A novel mouse model with a loss-of-function mutation in GALNT3 is also reported, which has high bone mass, supporting the involvement of this gene in BMD determination. In addition to identifying further genes associated with BMD, this study confirms the efficiency of extreme-truncate selection designs for quantitative trait association studies.

  12. Catheter-Directed Thrombolysis with Percutaneous Rheolytic Thrombectomy Versus Thrombolysis Alone in Upper and Lower Extremity Deep Vein Thrombosis

    International Nuclear Information System (INIS)

    Purpose. To compare the efficacy of catheter-directed thrombolysis (CDT) alone versus CDT with rheolytic percutaneous mechanical thrombectomy (PMT) for upper and lower extremity deep vein thrombosis (DVT). Methods. A retrospective cohort of consecutive patients with acute iliofemoral or brachiosubclavian DVT treated with urokinase CDT was identified, and a chart review was conducted. Demographic characteristics, treatment duration, total lytic dose, clot lysis rates and complications were compared in patients treated with urokinase CDT alone or combined CDT and rheolytic PMT. Results. Forty limbs in 36 patients were treated with urokinase CDT alone. Twenty-seven limbs in 21 patients were treated with urokinase CDT and rheolytic PMT. The mean treatment duration for urokinase CDT alone was 48.0 ± 27.1 hr compared with 26.3 ± 16.6 hr for urokinase CDT and rheolytic PMT (p = 0.0004). The mean urokinase dose required for CDT alone was 5.6 ± 5.3 million units compared with 2.7 ± 1.8 million units for urokinase CDT with rheolytic PMT (p = 0.008). Complete clot lysis was achieved in 73% (29/40) of DVT treated with urokinase CDT alone compared with 82% (22/27) treated with urokinase CDT with rheolytic PMT. Conclusion. Percutaneous CDT with rheolytic PMT is as effective as CDT alone for acute proximal extremity DVT but requires significantly shorter treatment duration and lower lytic doses. Randomized studies to confirm the benefits of pharmacomechanical thrombolysis in the treatment of acute proximal extremity DVT are warranted

  13. 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

  14. 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

  15. Cortical reorganization and phantom phenomena in congenital and traumatic upper-extremity amputees

    OpenAIRE

    Flor, Herta; Elbert, Thomas; Mühlnickel, Werner; Pantev, Christo; Wienbruch, Christian; Taub, Edward

    1998-01-01

    The relationship between phantom limb phenomena and cortical reorganization was examined in five subjects with congenital absence of an upper limb and nine traumatic amputees. Neuromagnetic source imaging revealed minimal reorganization of primary somatosensory cortex in the congenital amputees (M=0.69 cm, SD 0.24) and the traumatic amputees without phantom limb pain (M=0.27 cm, SD 0.25); the amputees with phantom limb pain showed massive cortical reorganization (M=2.22 cm, SD 0.78). Phantom ...

  16. 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 and...... 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...

  17. 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.

  18. Stimulation of bone marrow cells and bone formation by nacre: in vivo and in vitro studies.

    Science.gov (United States)

    Lamghari, M; Almeida, M J; Berland, S; Huet, H; Laurent, A; Milet, C; Lopez, E

    1999-08-01

    There is frequently a loss of vertebral bone due to disease or aging. Nacre (mother of pearl from the oyster Pinctada maxima) stimulates bone cell differentiation and bone formation in vitro and in vivo. Experimental bone defects were prepared in the vertebrae of sheep and used to test the suitability of nacre as an injectable osteogenic biomaterial for treating vertebral bone loss. Twenty-one cavities were prepared in the first four upper lumbar vertebrae of 11 sheep and filled with nacre powder. The lumbar vertebrae were removed after 1 to 12 weeks, embedded undecalcified in methacrylate, and processed for histological studies. The nacre slowly dissolved and the experimental cavities contained a large active cell population. By 12 weeks, the experimental cavity was occupied by newly matured bone trabeculae in contact with or adjacent to the dissolving nacre. The functional new bone trabeculae were covered with osteoid lined with osteoblasts, indicating continuing bone formation. The in vitro study on rat bone marrow explants cultured with a water-soluble extract of the nacre organic matrix also resulted in the stimulation of osteogenic bone marrow cells with enhanced alkaline phosphatase activity. Thus, both the in vivo and in vitro findings suggest that nacre contains one or more signal molecules capable of activating osteogenic bone marrow cells. PMID:10458284

  19. 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.

  20. Immunoregulation of bone remodelling

    Science.gov (United States)

    Singh, Ajai; Mehdi, Abbass A; Srivastava, Rajeshwer N; Verma, Nar Singh

    2012-01-01

    Remodeling, a continuous physiological process maintains the strength of the bones, which maintains a delicate balance between bone formation and resorption process. This review gives an insight to the complex interaction and correlation between the bone remodeling and the corresponding changes in host immunological environment and also summarises the most recent developments occuring in the understanding of this complex field. T cells, both directly and indirectly increase the expression of receptor activator of nuclear factor kB ligand (RANKL); a vital step in the activation of osteoclasts, thus positively regulates the osteoclastogenesis. Though various cytokines, chemikines, transcription factors and co-stimulatory molecules are shared by both skeletal and immune systems, but researches are being conducted to establish and analyse their role and / or control on this complex but vital process. The understanding of this part of research may open new horizons in the management of inflammatory and autoimmune diseases, resulting into bone loss and that of osteoporosis also. PMID:22837895

  1. 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.

  2. 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)

  3. 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.

  4. 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

  5. The features of HPOA on dynamic bone scintigraphy: A reflection of underlying pathophysiology

    Energy Technology Data Exchange (ETDEWEB)

    Bernard, E.J.; Howman-Giles, R.; Macauley, D.I.; Uren, R.F. [Royal Alexander Hospital for Children, Sydney, NSW (Australia)

    1998-03-01

    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.

  6. Multiscale imaging of bone microdamage

    OpenAIRE

    Poundarik, Atharva A.; Vashishth, Deepak

    2015-01-01

    Bone is a structural and hierarchical composite that exhibits remarkable ability to sustain complex mechanical loading and resist fracture. Bone quality encompasses various attributes of bone matrix from the quality of its material components (type-I collagen, mineral and non-collagenous matrix proteins) and cancellous microarchitecture, to the nature and extent of bone microdamage. Microdamage, produced during loading, manifests in multiple forms across the scales of hierarchy in bone and fu...

  7. 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.

  8. 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.

  9. Pathogenetic differentiation of the bone superscan using bone marrow scintigraphy

    International Nuclear Information System (INIS)

    The case of a 54-year old patient suffering from a prostatic carcinoma is presented. At the time of diagnosis multiple bone metastases were detected by bone scintigraphy. An initial improvement was observed following antiandrogenic therapy. After three years the patient presented with increasing bone pain, which was most prominent in the knee joints. A 'superscan' was found in bone scintigraphy with an unusually high uptake in the peripheral skeleton. Bone marrow scintigraphy showed a nearly complete metastatic displacement of central bone marrow and a peripheral marrow extension as explanation for the bone scan findings. (orig.)

  10. 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.)

  11. 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...... 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. the...... consistent, given the inevitabel uncertainties associated with model as well as with the extreme value data analysis. Keywords: Statistical model, extreme wind conditions, statistical analysis, turbulence, wind loading, statistical analysis, turbulence, wind loading, wind shear, wind turbines....

  12. Bone scintigraphy of decompression sickness

    International Nuclear Information System (INIS)

    Value of bone scintigraphy in decompression sickness of 42 patients was retrospectively evaluated. Bone scintigraphy was positive in 30 of 42 patients (83 lesions), while radiography and symptoms were positive in 23 patients (48 lesions), and in 29 patients (44 lesions) respectively. Bone scintigraphy was positive in many lesions with negative radiography or symptoms. However, approximately half of the lesions in which either radiography or symptoms was positive could not be detected by bone scintigraphy. These cases mostly showed radiographic abnormalities such as irregular calcified areas and ''bone island'' in the cervical regions of the humerus, femur and tibia. Both bone scintigraphy and radiography were positive in most of the patients with symptoms of the bends and there seems to be a close relationship between the bends symptoms and bone lesion. We concluded that bone scintigraphy is useful for the evaluation of decompression sickness, but it must be complemented by bone radiography to avoid a significant number of false negative cases. (author)

  13. 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...

  14. 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...

  15. [Morphological analysis of bone dynamics and metabolic bone disease. Histomorphometric concepts of bone remodeling and modeling].

    Science.gov (United States)

    Takahashi, Hideaki E

    2011-04-01

    In tissue level turnover of bone cells, bone remodeling shows a sequential events of activation, resorption, reversal and formation. This may be observed as secondary osteons in the cortical bone and trabecular packets in the cancellous bone. Microcracks are repaired by targeted remodeling, and calcium is released by non-targeted remodeling. In macromodeling, a macroscopic size of a bone increases with growth, without changing its basic figure. In micromodelimg, a shift of trabecula, a minishift, is biomechnically controlled. New lamellar bone is added parallel to compressive and tensile force, and bone resorption occurs at the opposite surface of formation. In minimodeling new lamellar bone is formed with a sequence of activation, then directly formation, without scalloping at the cement line between newly formed bone and its basic bone. PMID:21447918

  16. The clinical and dermoscopic features of extremity melanomas

    Directory of Open Access Journals (Sweden)

    Fatma Pelin Cengiz

    2015-03-01

    Full Text Available Objectives: Dermoscopy is a noninvasive tool that helps to differentiate structures which can not be seen by naked eye. Dermoscopic and clinical features of malignant melanomas on the extremities are not well described in the literature. Therefore, in this study we aim to determine dermoscopic and clinical characteristics of melanoma on the extremities. Materials and Methods: 40 patients with melanoma on the extremities were included in this study. Their dermoscopic and clinical images, histopathological and clinical data were assessed. The relations between Breslow thickness and dermoscopic characteristics were evaluated. Results: The most frequent localization for women was lower extremities, whereas it was upper extremities for men. The most common subtype of melanoma was superficial spreading melanoma on the extremities. The mean age of patients with extremity melanoma was 56,21 ± 15,20 in men, as well as the mean age of patients with extremity melanoma was 53,09 ± 13,96 in women. The most common dermoscopic feature for extremity melanoma was irregular dots (85%. There were positive correlations between Breslow thickness and diameter, 3 or more colors in lesion, blue-white veil and lineer white streaks, respectively (p< 0.005, r= +0.462 (p< 0.001, r= +0.550 (p< 0.001, r= +0.606 (p< 0.001, r= +0.662. Conclusions: To our knowledge, this is the first study investigating dermoscopic and clinical features in patients with extremity melanomas. We should suggest that melanomas on the lower extremities are more common in women than men and the patients with lower extremity melanomas were younger than the patients with upper extremity melanomas and there are associations between Breslow thickness and some dermoscopic characteristics.

  17. Scintigraphic demonstration of lower extremity periostitis secondary to venous insufficiency

    International Nuclear Information System (INIS)

    The scintigraphic findings on bone imaging in two patients with extensive lower extremity periostitis secondary to venous insufficiency are presented. One of these patients had bilateral disease. The use of [67Ga]citrate scanning in an attempt to exclude concurrent osteomyelitis is also addressed

  18. Scintigraphic demonstration of lower extremity periostitis secondary to venous insufficiency

    Energy Technology Data Exchange (ETDEWEB)

    Gensburg, R.S.; Kawashima, A.; Sandler, C.M.

    1988-07-01

    The scintigraphic findings on bone imaging in two patients with extensive lower extremity periostitis secondary to venous insufficiency are presented. One of these patients had bilateral disease. The use of (/sup 67/Ga)citrate scanning in an attempt to exclude concurrent osteomyelitis is also addressed.

  19. 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...

  20. [Cytogenetics of bone sarcomas].

    Science.gov (United States)

    Vagner-Capodano, A M; Poitout, D

    There has been much progress in the cytogenesis, and molecular biology of bone tumours such as Ewing sarcoma and osteosarcomas, greatly improving diagnostic possibilities and prognosis. Ewing's sarcoma is an indifferentiated sarcoma with round cells which usually occurs in children or adolescents. Ewing's sarcoma corresponds to 6% of all bone tumours. Histologically Ewing's sarcoma belongs to a group of small round cell tumours including neuroblastoma, embryon and alveolar rhabdomyosarcoma and non-Hodgkin's lymphoma. Differential diagnosis is difficult. Cytogenetic examinations can now differentiate Ewing's sarcoma from other small round cell tumours. There is a specific 11:12 translocation (q24; q12) which can be used as a marker. PMID:8785922

  1. 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

  2. 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

    OBJECTIVES: To compare the ability of two different E-MRI units and conventional radiography (CR) to identify bone erosions in rheumatoid arthritis (RA) metacarpophalangeal (MCP) and wrist joints with CT scanning as the standard reference method. METHODS: 20 patients with RA and 5 controls...... underwent CR, CT and two E-MRI examinations (Esaote Biomedica Artoscan and MagneVu MV1000) of one hand during a 2-week period. In all modalities, each bone of the wrist and MCP joints was blindly evaluated for erosions. MagneVu images were also assessed for the proportion of each bone being visualised.......57, respectively; wrists: 0.50, 0.23 and 0.29). Corresponding specificities for detecting erosions were 0.94, 0.93 and 0.99, respectively, in the MCP joints and 0.92, 0.98 and 0.98 in the wrist. The MagneVu allowed visualisation of 1.5 cm of the ventral-dorsal diameter of the bone. In the wrist, 31.6% of bones...

  3. 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

    OBJECTIVES: To compare the ability of 2 different E-MRI units and conventional radiography (CR) to identify bone erosions in rheumatoid arthritis (RA) metacarpophalangeal (MCP) and wrist joints, with computed tomography (CT) as standard reference method. METHODS: 20 RA patients and 5 controls...... underwent, within 2 weeks, CR, CT and two E-MRI (Esaote Biomedica; Artoscan and MagneVu; MV1000) examination of one hand. In all modalities each bone of wrist and (MCP) joints was blindedly evaluated for erosions. Furthermore, MagneVu images were assessed for the proportion of each bone being visualized......; wrists: 0.50, 0.23 and 0.29). Corresponding specificities for detecting erosions were 0.94, 0.93 and 0.99, respectively, in the MCP joints and 0.92, 0.98 and 0.98 in the wrist. The MagneVu allowed visualization of 1.5 cm of the ventral-dorsal diameter of the bone. In the wrist 31.6% of bones were...

  4. Mimicking the nanostructure of bone matrix to regenerate bone.

    Science.gov (United States)

    Kane, Robert; Ma1, Peter X

    2013-11-01

    Key features of bone tissue structure and composition are capable of directing cellular behavior towards the generation of new bone tissue. Bone tissue, as well as materials derived from bone, have a long and successful history of use as bone grafting materials. Recent developments in design and processing of synthetic scaffolding systems has allowed the replication of the bone's desirable biological activity in easy to fabricate polymeric materials with nano-scale features exposed on the surface. The biological response to these new tissue-engineering scaffold materials oftentimes exceeds that seen on scaffolds produced using biological materials. PMID:24688283

  5. 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.

  6. Multiscale imaging of bone microdamage.

    Science.gov (United States)

    Poundarik, Atharva A; Vashishth, Deepak

    2015-04-01

    Bone is a structural and hierarchical composite that exhibits remarkable ability to sustain complex mechanical loading and resist fracture. Bone quality encompasses various attributes of bone matrix from the quality of its material components (type-I collagen, mineral and non-collagenous matrix proteins) and cancellous microarchitecture, to the nature and extent of bone microdamage. Microdamage, produced during loading, manifests in multiple forms across the scales of hierarchy in bone and functions to dissipate energy and avert fracture. Microdamage formation is a key determinant of bone quality, and through a range of biological and physical mechanisms, accumulates with age and disease. Accumulated microdamage in bone decreases bone strength and increases bone's propensity to fracture. Thus, a thorough assessment of microdamage, across the hierarchical levels of bone, is crucial to better understand bone quality and bone fracture. This review article details multiple imaging modalities that have been used to study and characterize microdamage; from bulk staining techniques originally developed by Harold Frost to assess linear microcracks, to atomic force microscopy, a modality that revealed mechanistic insights into the formation diffuse damage at the ultrastructural level in bone. New automated techniques using imaging modalities, such as microcomputed tomography are also presented for a comprehensive overview. PMID:25664772

  7. 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. PMID:26901403

  8. Pathological characteristics of extremely severe acute radiation injury in a patient's legs and hands after a very uneven accidental exposure to an extremely high dose of 192Ir

    International Nuclear Information System (INIS)

    The pathological characteristics of an extremely high dose radiation in the legs and hands of a patient is reported. the patient was exposed to 192Ir γ-rays for 9 hours and 20 minutes, the activity of which was 2.76 TBq. The amputations of the right thigh and left forearm had to be performed 8 days after the irradiation and the debridements and skin graftings were performed on the right hand and the inner side of left knee 55 days after the radiation. Microscopically, massive necrosis of cells of the epidermis, cutaneous appendages, hypodermics and skeletal muscles, and hemorrhage in the dermis, hypodermics and skeletal muscles were seen in the local irradiated parts of the right shank. But the arrector pili muscles in the dermis of the right shank remained. On the fingers and the palm of the left hand, vacuolar degeneration and massive necrosis of the cells of epidermis were present with extensive neutrophil infiltration. Cysts of large or small size were formed from the necrotic cells, separating epidermis from dermis. There were degeneration and necrosis of glandular epithelium cells of sweat glands. Hemorrhage was present in dermis and hypodermics. All the hematopoietic tissues in the bone marrow in the upper ends of the tibia and fibula and in the lower ends of the femur, the radius and the ulna disappeared. Acute radiation ulcers were present on the skin of the left knee and on the skin of the thumb, index finger and middle finger of the right hand. The extremely severe acute radiation injury caused by extremely high dose of 192Ir led to the necrosis of the extensive soft tissues deep to skeletal muscles and the disappearance of the hematopoietic tissues in the bone marrow

  9. Statistical Model of Extreme Shear

    DEFF Research Database (Denmark)

    Hansen, Kurt Schaldemose; Larsen, Gunner Chr.

    2005-01-01

    In order to continue cost-optimisation of modern large wind turbines, it is important to continuously increase the knowledge of wind field parameters relevant to design loads. This paper presents a general statistical model that offers site-specific prediction of the probability density function...... model that, on a statistically consistent basis, describes 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 full-scale measurements recorded with a high sampling rate...

  10. 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...

  11. Studies of bone marrow scintigrams with sup(99m)technetium sulfur colloid on various hematological disorders

    International Nuclear Information System (INIS)

    One hundred and eighty-five bone marrow scintigraphy on the whole body was performed on eight healthy adults and 151 patients with various hematologic diseases including 64 leukemia, 41 anemia, 23 other malignancy, etc. The positions of the investigated bone marrow were divided into the central marrow (five positions on the trunk bones) and the peripheral marrow (11 positions on the upper and 11 positions on the lower extremities) on the scintigram. The bone marrow scintigram was estimated by following three criteria. The first, ''Yuu-ryoiki'' (positive area), was the existence of sup(99m)Tc sulfur colloid accumulation on bone marrow (two grades; presence or absence). The second, ''Bunpu-kei'' (distribution form), was the extent of the sup(99m)Tc accumulation area of the investigated bone marrow and was divided into five grades. The last, ''Kido'' (intensity of radioactivity), was the density of the sup(99m)Tc accumulation on the area and was divided into five grades. Using this estimation, in the diseases with bone marrow hyperplasia such as Primary Thrombocythemia and Hemolytic Anemia, ''Yuu-ryoiki'' was enlarged, ''Bunpu-kei'' was extended, and ''Kido'' was increased comparing with those in healty adult. In contrast, in the diseases with bone marrow hypoplasia such as Myelofibrosis and Aplastic Anemia, ''Yuu-ryoiki'' was reduced, ''Bunpu-kei'' was contracted, and ''Kido'' was decreased. However, the enlargement of ''Yuu-ryoiki'' did not always mean bone marrow hyperplasia. The author could evaluate not only the range and distribution of hemopoiesis as a whole in malignant or benign diseases but also the residual effective hemopoiesis to know the suitable time of the initiation of the therapy or to predict the prognosis of these cases. In this study it was shown that the bone marrow scintigraphy with sup(99m)Tc sulfur colloid was an useful method to estimate the hemopoietic activity of the bone marrow. (J.P.N.)

  12. 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.)

  13. 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.)

  14. 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

    International Nuclear Information System (INIS)

    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.)

  15. 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.

  16. Bone formation following implantation of bone biomaterials into extraction sites

    OpenAIRE

    Molly, Liene; Vandromme, Heleen; Quirynen, Marc; Schepers, Evert; Adams, Jessica L; van Steenberghe, Daniel

    2008-01-01

    Background: Adequate bone volume is imperative for the osseointegration of endosseous implants, but post-extraction resorption and remodeling may challenge implant placement. The use of bone biomaterials has been advocated to fill extraction sites and to enhance primary implant stability during osseointegration. The objective of the case series was to evaluate bone formation histologically and biomechanically in extraction sites following implantation of three commercially available bone biom...

  17. Hierarchical microimaging of bone structure and function.

    Science.gov (United States)

    Müller, Ralph

    2009-07-01

    With recent advances in molecular medicine and disease treatment in osteoporosis, quantitative image processing of three-dimensional bone structures is critical in the context of bone quality assessment. Biomedical imaging technology such as MRI or CT is readily available, but few attempts have been made to expand the capabilities of these systems by integrating quantitative analysis tools and by exploring structure-function relationships in a hierarchical fashion. Nevertheless, such quantitative end points are an important factor for success in basic research and in the development of novel therapeutic strategies. CT is key to these developments, as it images and quantifies bone in three dimensions and provides multiscale biological imaging capabilities with isotropic resolutions of a few millimeters (clinical CT), a few tens of micrometers (microCT) and even as high as 100 nanometers (nanoCT). The technology enables the assessment of the relationship between microstructural and ultrastructural measures of bone quality and certain diseases or therapies. This Review focuses on presenting strategies for three-dimensional approaches to hierarchical biomechanical imaging in the study of microstructural and ultrastructural bone failure. From this Review, it can be concluded that biomechanical imaging is extremely valuable for the study of bone failure mechanisms at different hierarchical levels. PMID:19568252

  18. 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.

  19. Performance testing of extremity dosimeters

    International Nuclear Information System (INIS)

    The Health Physics Society Standing Committee (HPSSC) Working Group on Performance Testing of Extremity Dosimeters has issued a draft of a proposed standard for extremity dosimeters. The draft standard proposes methods to be used for testing dosimetry systems that determine occupational radiation dose to the extremities and the performance criterion used to determine compliance. The draft standard has been evaluated by testing the performance of existing processors of extremity dosimeters against the standard's proposed criterion. The proposed performance criterion is: absolute value of B + S ≤ 0.35, where B is the bias (calculated as the average of the performance quotients) of 15 dosimeter measurements and S is the standard deviation of the performance quotients. Dosimeter performance was tested in seven irradiation categories: low-energy photons (general and accident dosimetry), high-energy photons (general and accident dosimetry), beta particles, neutrons, and a mixture category. Twenty-one types of extremity dosimeters (both finger ring and wrist/ankle dosimeters) were received from 11 processors. The dosimeters were irradiated by the Pacific Northwest Laboratory (PNL) to specific dose levels in one or more of the seven categories as specified in the draft standard and were returned to the processors. The processors evaluated the doses and returned the results to PNL for analysis. The results were evaluated against the performance criterion specified in the draft standard. The results indicate that approximately 60% of both the finger ring and the wrist/ankle dosimeters met the performance criterion. Two-thirds of the dosimeters that did not meet the performance criterion had large biases (ranging from 0.25 to 0.80) but small standard deviations (less than 0.15). 21 refs., 3 figs., 20 tabs

  20. 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.

  1. 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.

  2. The role of bone scanning in the cancer patient

    International Nuclear Information System (INIS)

    The past few years have been notable by the torrent