WorldWideScience

Sample records for broad ligament mimicking

  1. Broad Ligament Pregnancy - Success Story of a Laparoscopically Managed Case.

    Science.gov (United States)

    Nayar, Jayashree; Nair, Sobha S

    2016-07-01

    Abdominal pregnancies constitute 1% of ectopic pregnancies, among which broad ligament pregnancy is a rare form. The maternal mortality rate has been reported to be as high as 20%. The diagnosis is seldom established before surgery. Laparoscopic management of broad ligament ectopic pregnancy is the ideal form of treatment in appropriately selected patients. We present the case report of successful laparoscopic treatment of a 3x3.5cm broad ligament pregnancy. A search of literature shows that ours is the 6(th) case report of such a rare ectopic pregnancy managed endoscopically successfully. PMID:27630914

  2. Round ligament lipoma mimicking acute appendicitis in a 24-week pregnant female: a case report.

    Science.gov (United States)

    Miller, T J; Paulk, D G

    2013-04-01

    An exhaustive search of the literature using the Pub Med database revealed no reports of round ligament lipomas mimicking acute appendicitis in pregnant patients. There are relatively few articles on round ligament lipomas and even less on round ligament lipomas during pregnancy. This case report is on a 27-year-old 24-week pregnant female who presented with signs and symptoms similar to acute appendicitis who in fact had a large right pelvic round ligament lipoma that was causing her pain.

  3. Broad ligament pregnancy a diagnostic dilemma: a case report

    Directory of Open Access Journals (Sweden)

    Amit Gupta

    2016-07-01

    Full Text Available Broad ligament pregnancy is one of the rarest forms of ectopic pregnancy with high risk of maternal mortality. Although ultrasonography is usually helpful in making the diagnosis but it is mostly established during laparotomy. 34 year old G2P1 with previous caesarean section reported at 8th month of pregnancy with inability to perceive foetal movements. Ultrasonography confirmed intrauterine fetal demise. Patient was taken for caesarean section after failed induction. Intraoperative diagnosis of broad ligament pregnancy was made and broad ligament along with fetus, sac, fallopian tube and ovary was excised. Post-operative period was uneventful. [Int J Reprod Contracept Obstet Gynecol 2016; 5(7.000: 2478-2480

  4. Laparoscopic repair of a small bowel herniation through a broad ligament defect

    Directory of Open Access Journals (Sweden)

    Agustin Buero

    2014-01-01

    Full Text Available A 44-year-old female presented with a diagnosis of intestinal obstruction from unknown origin. Laparoscopy revealed herniation of small bowel trough a defect in the left broad ligament. After reduction, the defect was corrected laparoscopically. The post operative recovery was uneventful.

  5. Laparoscopic repair of a small bowel herniation through a broad ligament defect.

    Science.gov (United States)

    Buero, Agustín; Silberman, Ezequiel A; Medina, Pablo; Morra, Matias E; Bogetti, Diego J; Porto, Eduardo A

    2014-07-01

    A 44-year-old female presented with a diagnosis of intestinal obstruction from unknown origin. Laparoscopy revealed herniation of small bowel trough a defect in the left broad ligament. After reduction, the defect was corrected laparoscopically. The post operative recovery was uneventful.

  6. Multiple and bilateral benign cystic teratomas of ovary with broad ligament leiomyoma: a case report

    OpenAIRE

    Choukimath S.M; Ramalingappa C.A

    2012-01-01

    Background: Benign cystic teratoma is the most common tumor of ovary. Though bilateralism is seen in 10-15% of the cases, bilateral and multiple benign cystic teratomas are rare and very few cases have been reported in the literature. Aim: We present a case of bilateral and multiple benign cystic teratomas with a broad ligament leiomyoma. Case findings: A 38 –year- old female presented with lower abdominal pain of 5 months duration. Ultrasonography of abdomen showed bilateral multiple adnexal...

  7. Ultrasonographic diagnosis of round ligament varicosities mimicking inguinal hernia: report of two cases with literature review

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    Ryu, Kyeong Hwa; Yoon, Jung Hee [Dept. of Radiology, Inje University Haeundae Paik Hospital, College of Medicine, Busan (Korea, Republic of)

    2014-10-15

    Round ligament varicosities are rare, and the mass mimics an inguinal hernia. Round ligament varicosities should be considered in the differential diagnosis of a groin swelling in a female, especially during pregnancy. The diagnosis of round ligament varicosities can be established on grayscale and color Doppler ultrasonography. We report two cases of round ligament varicosities in a 33-year-old non pregnant woman and a 28-year-old pregnant woman, and these patients were diagnosed using ultrasonography. We also reviewed the literature on round ligament varicosities including the present cases. Ultrasonography is diagnostic and can prevent unnecessary surgical intervention and associated morbidity.

  8. Hernia of the bladder through the broad ligament with renal agenesis and ipsilateral ureter blind ending

    Science.gov (United States)

    El Madi, Aziz; Khattala, Khalid; Rami, Mohammed; Bouabdallah, Youssef

    2014-01-01

    Hernia through a defect of the broad ligament is extremely rare in children. These defects can result from a developmental defect or a spontaneous rupture of cystic formations remnants of mesonephric ducts or Müller. Genital anomalies associated with unilateral renal agenesis are more common in females. We report the case of a 13 months girl allowed for assessment of recurrent urinary tract infection; abdominal examination did not objectified palpable mass, the external genitalia were without abnormalities. Abdominal ultrasound revealed a left renal space is empty with a retrovesical cyst. Cystography was requested that objectified a large pelvic cystic mass retrovesical communicating with the bladder, there was also a left vesicoureteral reflux. Uro- MRI showed a cystic formation retrovesical communicating with the bladder, the right pelvic kidney; uterus is normal size for age. DMSA scintigraphy confirmed the absence of the left kidney with the right kidney that ensures 100% of total renal function. To surgical exploration we found a hernia of the bladder through the left broad ligament, the uterus was dislocated on the right side; left ovary was hypoplasic; the ipsilateral ureter was blind with renal agenesis, we performed by reduction of the bladder then closing the hernial orifice, dissection of the ureter with its ligation and section at the vesical stoma. The postoperative course was uneventful. Evolution is favorable. This observation illustrates a hernia of the bladder through the broad ligament associated with ovarian hypoplasia, renal agenesis and ipsilateral ureter blind ending; this association was not described to our knowledge in the literature. PMID:25422693

  9. Hernia of the bladder through the broad ligament with renal agenesis and ipsilateral ureter blind ending.

    Science.gov (United States)

    El Madi, Aziz; Khattala, Khalid; Rami, Mohammed; Bouabdallah, Youssef

    2014-01-01

    Hernia through a defect of the broad ligament is extremely rare in children. These defects can result from a developmental defect or a spontaneous rupture of cystic formations remnants of mesonephric ducts or Müller. Genital anomalies associated with unilateral renal agenesis are more common in females. We report the case of a 13 months girl allowed for assessment of recurrent urinary tract infection; abdominal examination did not objectified palpable mass, the external genitalia were without abnormalities. Abdominal ultrasound revealed a left renal space is empty with a retrovesical cyst. Cystography was requested that objectified a large pelvic cystic mass retrovesical communicating with the bladder, there was also a left vesicoureteral reflux. Uro- MRI showed a cystic formation retrovesical communicating with the bladder, the right pelvic kidney; uterus is normal size for age. DMSA scintigraphy confirmed the absence of the left kidney with the right kidney that ensures 100% of total renal function. To surgical exploration we found a hernia of the bladder through the left broad ligament, the uterus was dislocated on the right side; left ovary was hypoplasic; the ipsilateral ureter was blind with renal agenesis, we performed by reduction of the bladder then closing the hernial orifice, dissection of the ureter with its ligation and section at the vesical stoma. The postoperative course was uneventful. Evolution is favorable. This observation illustrates a hernia of the bladder through the broad ligament associated with ovarian hypoplasia, renal agenesis and ipsilateral ureter blind ending; this association was not described to our knowledge in the literature. PMID:25422693

  10. Multiple and bilateral benign cystic teratomas of ovary with broad ligament leiomyoma: a case report

    Directory of Open Access Journals (Sweden)

    Choukimath S.M

    2012-01-01

    Full Text Available Background: Benign cystic teratoma is the most common tumor of ovary. Though bilateralism is seen in 10-15% of the cases, bilateral and multiple benign cystic teratomas are rare and very few cases have been reported in the literature. Aim: We present a case of bilateral and multiple benign cystic teratomas with a broad ligament leiomyoma. Case findings: A 38 –year- old female presented with lower abdominal pain of 5 months duration. Ultrasonography of abdomen showed bilateral multiple adnexal cystic masses with multiple hyper-echoic solid components. Laparoscopy was done. There were bilateral tumors, two on right side and three on left side. Posterior surface of the uterus showed a fibroid. Ovarian cystectomy and myomectomy was done under general anesthesia with preservation of both ovaries. Report of bilateral and multiple benign cystic teratomas with broad ligament fibroid was given. Conclusion: When teratomas are multiple and bilateral, recurrence in the form of a dermoid cyst (3% or immature teratoma (2-2.6% in the residual ipsilateral ovary is most frequent. Because of the rarity and increased recurrence rate, we are presenting this case.

  11. The Ultrasound Diagnosis of Round Ligament Varices That Mimicked Inguinal Hernias During Pregnancy:A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hyung Jo; Shin, Hyun Woong; Kim, Seong Hun [Daegu Fatima Hospital, Daegu (Korea, Republic of); Cho, Sang Hee; Byun, Kyung Hwan [CHA Gumi Medical Center, CHA University, Gumi (Korea, Republic of)

    2010-03-15

    Round ligament varices during pregnancy are an important part of the differential diagnosis of inguinal hernia as they may cause symptoms and clinical features that are similar to those of inguinal hernia. When this condition is correctly diagnosed, an unnecessary operation may be prevented. The diagnosis of round ligament varices should be considered for pregnant women who present with a palpable mass in the groin. We describe here a case of round ligament varices that presented during pregnancy and this was readily diagnosed with Doppler sonography

  12. Bowel Obstruction and Peritoneal Dialysis: A Case Report of a Patient with Complications from a Broad Ligament Hernia

    Science.gov (United States)

    Otani-Takei, Naoko; Akimoto, Tetsu; Sadatomo, Ai; Saito, Osamu; Muto, Shigeaki; Kusano, Eiji; Nagata, Daisuke

    2016-01-01

    Abdominal hernias are a common cause of bowel obstruction. The major types of abdominal hernias are external or abdominal wall hernias, which occur at areas of congenital or acquired weakness in the abdominal wall. An alternative entity is internal hernias, which are characterized by a protrusion of viscera through the peritoneum or mesentery. We herein present the case of a female peritoneal dialysis patient with bowel obstruction due to an internal hernia. Although an initial work-up did not lead to a correct diagnosis, an exploratory laparotomy revealed that she had intestinal herniation due to a defect in the broad ligament of the uterus, which was promptly corrected by surgery. The concerns about the perioperative dialytic management as well as the diagnostic problems regarding the disease that arose in our experience with the present patient are also discussed.

  13. 阔韧带肌瘤的低场磁共振诊断价值%The value of low field MRI in diagnosis of broad ligament leiomyoma

    Institute of Scientific and Technical Information of China (English)

    王清涛; 韩慧敏

    2011-01-01

    目的:探讨低场MRI对阔韧带肌瘤的诊断价值.方法:回顾性分析15例阔韧带肌瘤的临床与MR资料.结果:15例阔韧带肌瘤患者中单发11例,合并子宫其他部位肌瘤4例,阔韧带肌瘤一般较大,常合并变性,将子宫推向肌瘤对侧.结论:低场磁共振对阔韧带肌瘤的定性和定位很有价值,能明确诊断阔韧带肌瘤,也可作为临床制定手术计划及术后随访的首选检查方法.%Objective : To explore the diagnostic value of low field MRI in broad ligament leiomyoma. Methods : 15 cases of broad ligament leiomyoma with clinical and MR data were retrospectively analyzed. Results:Of the 15 cases of broad ligament leiomyoma.11 cases were unilateral. 4 cases were merged with uterine myoma in other position. Broad ligament leiomyoma was generally big, which was often associated with degeneration and introduced to contralateral uterine fibroids.Conclusion: Low-field MRI is of great value in qualifying and positioning broad ligament leiomyoma. It can diagnose this tumor definitely, and may be the first choice to make a operation or post-operation plan.

  14. Synthetic RNAs Mimicking Structural Domains in the Foot-and-Mouth Disease Virus Genome Elicit a Broad Innate Immune Response in Porcine Cells Triggered by RIG-I and TLR Activation

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    Belén Borrego

    2015-07-01

    Full Text Available The innate immune system is the first line of defense against viral infections. Exploiting innate responses for antiviral, therapeutic and vaccine adjuvation strategies is being extensively explored. We have previously described, the ability of small in vitro RNA transcripts, mimicking the sequence and structure of different domains in the non-coding regions of the foot-and-mouth disease virus (FMDV genome (ncRNAs, to trigger a potent and rapid innate immune response. These synthetic non-infectious molecules have proved to have a broad-range antiviral activity and to enhance the immunogenicity of an FMD inactivated vaccine in mice. Here, we have studied the involvement of pattern-recognition receptors (PRRs in the ncRNA-induced innate response and analyzed the antiviral and cytokine profiles elicited in swine cultured cells, as well as peripheral blood mononuclear cells (PBMCs.

  15. Synthetic RNAs Mimicking Structural Domains in the Foot-and-Mouth Disease Virus Genome Elicit a Broad Innate Immune Response in Porcine Cells Triggered by RIG-I and TLR Activation

    Science.gov (United States)

    Borrego, Belén; Rodríguez-Pulido, Miguel; Revilla, Concepción; Álvarez, Belén; Sobrino, Francisco; Domínguez, Javier; Sáiz, Margarita

    2015-01-01

    The innate immune system is the first line of defense against viral infections. Exploiting innate responses for antiviral, therapeutic and vaccine adjuvation strategies is being extensively explored. We have previously described, the ability of small in vitro RNA transcripts, mimicking the sequence and structure of different domains in the non-coding regions of the foot-and-mouth disease virus (FMDV) genome (ncRNAs), to trigger a potent and rapid innate immune response. These synthetic non-infectious molecules have proved to have a broad-range antiviral activity and to enhance the immunogenicity of an FMD inactivated vaccine in mice. Here, we have studied the involvement of pattern-recognition receptors (PRRs) in the ncRNA-induced innate response and analyzed the antiviral and cytokine profiles elicited in swine cultured cells, as well as peripheral blood mononuclear cells (PBMCs). PMID:26193305

  16. Synthetic RNAs Mimicking Structural Domains in the Foot-and-Mouth Disease Virus Genome Elicit a Broad Innate Immune Response in Porcine Cells Triggered by RIG-I and TLR Activation

    OpenAIRE

    Belén Borrego; Miguel Rodríguez-Pulido; Concepción Revilla; Belén Álvarez; Francisco Sobrino; Javier Domínguez; Margarita Sáiz

    2015-01-01

    The innate immune system is the first line of defense against viral infections. Exploiting innate responses for antiviral, therapeutic and vaccine adjuvation strategies is being extensively explored. We have previously described, the ability of small in vitro RNA transcripts, mimicking the sequence and structure of different domains in the non-coding regions of the foot-and-mouth disease virus (FMDV) genome (ncRNAs), to trigger a potent and rapid innate immune response. These synthetic non-in...

  17. Artificial Ligaments: Promise or Panacea?

    Science.gov (United States)

    Lubell, Adele

    1987-01-01

    The Food and Drug Administration has approved a prosthetic ligament for limited use in persons with damaged anterior cruciate ligaments (ACL). This article addresses ligament repair, ACL tears, current treatment, development of the Gore-Tex artificial ligament, other artificial ligaments in process, and arguments for and against their use.…

  18. Anterior cruciate ligament (ACL) injury

    Science.gov (United States)

    Cruciate ligament injury - anterior; ACL injury; Knee injury - anterior cruciate ligament (ACL) ... knee. It prevents the knee from bending out. Anterior cruciate ligament (ACL) is in the middle of the knee. ...

  19. Endoscopic Intermetatarsal Ligament Decompression.

    Science.gov (United States)

    Lui, Tun Hing

    2015-12-01

    Morton neuroma is an entrapment of the intermetatarsal nerve by the deep intermetatarsal ligament. It is usually treated conservatively. Surgery is considered if there is recalcitrant pain that is resistant to conservative treatment. The surgical options include resection of the neuroma or decompression of the involved nerve. Decompression of the nerve by release of the intermetatarsal ligament can be performed by either an open or minimally invasive approach. We describe 2-portal endoscopic decompression of the intermetatarsal nerve. The ligament is released by a retrograde knife through the toe-web portal under arthroscopic guidance through the plantar portal. PMID:27284515

  20. Cruciate ligament reflexes

    DEFF Research Database (Denmark)

    Krogsgaard, Michael R; Dyhre-Poulsen, Poul; Fischer-Rasmussen, Torsten

    2002-01-01

    the anterior cruciate ligament (ACL) was pulled, and tension in the ligament caused activity of the gamma motor neurones of the muscles around the knee. Impulses from the sensory nerves in ACL were activated during motion of the knee, in particular overstretching and combined extension and rotation. In humans......The idea of muscular reflexes elicited from sensory nerves of the cruciate ligaments is more than 100 years old, but the existence of such reflexes has not been proven until the recent two decades. First in animal experiments, a muscular excitation could be elicited in the hamstrings when...

  1. Urticaria mimickers in children.

    Science.gov (United States)

    Mathur, Anubhav N; Mathes, Erin F

    2013-01-01

    Acute urticaria is a self-limited cutaneous condition marked by transient, erythematous, and pruritic wheals. It is a hypersensitivity response that is often secondary to infection, medications, or food allergies in children. In contrast, the urticarial "mimickers" described in this review article are often seen in the context of fever and extracutaneous manifestations in pediatric patients. The differential diagnosis ranges from benign and self-limited hypersensitivity responses to multisystem inflammatory diseases. Establishing the correct diagnosis of an urticarial rash in a pediatric patient is necessary to both prevent an unnecessary work up for self-limited conditions and to appropriately recognize and evaluate multisystem inflammatory disorders. Herein, we describe two cases to illustrate the clinical manifestations, laboratory findings, histopathology and differential diagnoses for several mimickers of acute urticaria including: urticaria multiforme, serum sickness like reaction, Henoch-Schönlein purpura, acute hemorrhagic edema of infancy, systemic onset juvenile idiopathic arthritis, cryopyrin associated periodic syndromes, and urticarial vasculitis. PMID:24552410

  2. Endoscopic Intermetatarsal Ligament Decompression

    OpenAIRE

    Lui, Tun Hing

    2015-01-01

    Morton neuroma is an entrapment of the intermetatarsal nerve by the deep intermetatarsal ligament. It is usually treated conservatively. Surgery is considered if there is recalcitrant pain that is resistant to conservative treatment. The surgical options include resection of the neuroma or decompression of the involved nerve. Decompression of the nerve by release of the intermetatarsal ligament can be performed by either an open or minimally invasive approach. We describe 2-portal endoscopic ...

  3. Ankle ligament injuries

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    Per A.F.H. Renström

    1998-06-01

    Full Text Available Acute ankle ligament sprains are common injuries. The majority of these occur during athletic participation in the 15 to 35 year age range. Despite the frequency of the injury, diagnostic and treatment protocols have varied greatly. Lateral ligament complex injuries are by far the most common of the ankle sprains. Lateral ligament injuries typically occur during plantar flexion and inversion, which is the position of maximum stress on the anterotalofibular liagment (ATFL. For this reason, the ATFL is the most commonly torn ligament during an inversion injury. In more severe inversion injuries the calcaneofibular (CFL, posterotalofibular (PTFL and subtalar ligament can also be injured. Most acute lateral ankle ligament injuries recover quickly with nonoperative management. The treatment program, called "functional treatment," includes application of the RICE principle (rest, ice, compression, and elevation immediately after the injury, a short period of immobilization and protection with an elastic or inelastic tape or bandage, and early motion exercises followed by early weight bearing and neuromuscular ankle training. Proprioceptive training with a tilt board is commenced as soon as possible, usually after 3 to 4 weeks. The purpose is to improve the balance and neuromuscular control of the ankle. Sequelae after ankle ligament injuries are very common. As much as 10% to 30% of patients with a lateral ligament injury may have chronic symptoms. Symptoms usually include persistent synovitis or tendinitis, ankle stiffness, swelling, and pain, muscle weakness, and frequent giving-way. A well designed physical therapy program with peroneal strengthening and proprioceptive training, along with bracing and/or taping can alleviate instability problems in most patients. For cases of chronic instability that are refractory to bracing and external support, surgical treatment can be explored. If the chronic instability is associated with subtalar instability

  4. MR imaging of cruciate ligaments.

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    Naraghi, Ali; White, Lawrence M

    2014-11-01

    Cruciate ligament injuries, and in particular injuries of the anterior cruciate ligament (ACL), are the most commonly reconstructed ligamentous injuries of the knee. As such, accurate preoperative diagnosis is essential in optimal management of patients with cruciate ligament injuries. This article reviews the anatomy and biomechanics of the ACL and posterior cruciate ligament (PCL) and describes the magnetic resonance (MR) imaging appearances of complete and partial tears. Normal postoperative appearances of ACL and PCL reconstructions as well as MR imaging features of postoperative complications will also be reviewed. PMID:25442023

  5. MORPHOMETRIC STUDY OF MEDIAL COLLATERAL LIGAMENTS OF ANKLE

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    Neelu Prasad

    2016-06-01

    is very poorly understood. The ligament in case of tear or injury has to be repaired which is impossible to do so if a proper morphometric knowledge is not known. So a sincere effort has been put in the study to find the morphometry of the deltoid ligament. METHODS  One hundred specimens were dissected. In this, fifty belonged to the right and fifty belonged to the left side.  The study was done in the Department of Anatomy, Nalanda Medical College, Patna.  The study was done from June 2015 to April 2016.  The morphometry was seen and the comparisons were done.  The dissection was done to expose the deltoid ligament. The anterior, middle and posterior length was taken. Then, the superior, middle and inferior width was taken. Then, the thickness was measured.  Then, the presence or absence of the deep part was noted. RESULTS Irrespective of the side and sex to which the ligaments belong, the mean value of the length of the deltoid ligaments in the anterior, middle and posterior parts are 24.40 mm, 21.53 mm and 17.20 mm. The widths in the superior, middle and inferior parts are 19.94 mm, 22.59 mm and 27.45 mm. The thickness mean measurement is 6.94 mm. Deep Part was found in 100% of cases. The superficial part trapezoid in shape wide anteriorly and narrow posteriorly, also is narrow superiorly where it arises and broad inferiorly where it gets inserted. CONCLUSION The ligaments of the talocrural joint are one of the most difficult ligaments to study. A sincere effort has been put in this study to find the morphometry of ligaments of ankle joint. The same has been studied and reported successfully to help the surgeons to understand and help the needful in a better way.

  6. Mimicking human texture classification

    Science.gov (United States)

    van Rikxoort, Eva M.; van den Broek, Egon L.; Schouten, Theo E.

    2005-03-01

    In an attempt to mimic human (colorful) texture classification by a clustering algorithm three lines of research have been encountered, in which as test set 180 texture images (both their color and gray-scale equivalent) were drawn from the OuTex and VisTex databases. First, a k-means algorithm was applied with three feature vectors, based on color/gray values, four texture features, and their combination. Second, 18 participants clustered the images using a newly developed card sorting program. The mutual agreement between the participants was 57% and 56% and between the algorithm and the participants it was 47% and 45%, for respectively color and gray-scale texture images. Third, in a benchmark, 30 participants judged the algorithms' clusters with gray-scale textures as more homogeneous then those with colored textures. However, a high interpersonal variability was present for both the color and the gray-scale clusters. So, despite the promising results, it is questionable whether average human texture classification can be mimicked (if it exists at all).

  7. Incidental Anterior Cruciate Ligament Calcification: Case Report.

    Science.gov (United States)

    Hayashi, Hisami; Fischer, Hans

    2016-03-01

    The calcification of knee ligaments is a finding noted only in a handful of case reports. The finding of an anterior cruciate ligament calcification has been reported once in the literature. Comparable studies involving the posterior cruciate ligament, medial collateral ligament and an ossicle within the anterior cruciate ligament are likewise discussed in reports of symptomatic patients. We report a case of incidentally discovered anterior cruciate ligament calcification. We discuss the likely etiology and clinical implications of this finding.

  8. Endoscopic Repair of the Superficial Deltoid Ligament and Spring Ligament.

    Science.gov (United States)

    Lui, Tun Hing

    2016-06-01

    The plantar calcaneonavicular ligament, also known as the spring ligament, is an important static stabilizer of the medial longitudinal foot arch. Compromise of this ligament is a primary causative factor of peritalar subluxation, and it should be repaired in addition to treatment of tibialis posterior tendon abnormalities. Open repair of the ligament requires extensive soft-tissue dissection. The development of the high distal portal for posterior tibial tendoscopy allows repair of the ligament endoscopically. This, together with endoscopically assisted reconstruction of the tibialis posterior tendon, allows complete endoscopic treatment of stage 2 posterior tibial tendon deficiency. The major structure at risk is the medial plantar nerve. This technique is technically demanding and should be reserved for experienced foot and ankle arthroscopists. PMID:27656387

  9. Hindlimb unloading alters ligament healing

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    Provenzano, Paolo P.; Martinez, Daniel A.; Grindeland, Richard E.; Dwyer, Kelley W.; Turner, Joanne; Vailas, Arthur C.; Vanderby, Ray Jr

    2003-01-01

    We investigated the hypothesis that hindlimb unloading inhibits healing in fibrous connective tissue such as ligament. Male rats were assigned to 3- and 7-wk treatment groups with three subgroups each: sham control, ambulatory healing, and hindlimb-suspended healing. Ambulatory and suspended animals underwent surgical rupture of their medial collateral ligaments, whereas sham surgeries were performed on control animals. After 3 or 7 wk, mechanical and/or morphological properties were measured in ligament, muscle, and bone. During mechanical testing, most suspended ligaments failed in the scar region, indicating the greatest impairment was to ligament and not to bone-ligament insertion. Ligament testing revealed significant reductions in maximum force, ultimate stress, elastic modulus, and low-load properties in suspended animals. In addition, femoral mineral density, femoral strength, gastrocnemius mass, and tibialis anterior mass were significantly reduced. Microscopy revealed abnormal scar formation and cell distribution in suspended ligaments with extracellular matrix discontinuities and voids between misaligned, but well-formed, collagen fiber bundles. Hence, stress levels from ambulation appear unnecessary for formation of fiber bundles yet required for collagen to form structurally competent continuous fibers. Results support our hypothesis that hindlimb unloading impairs healing of fibrous connective tissue. In addition, this study provides compelling morphological evidence explaining the altered structure-function relationship in load-deprived healing connective tissue.

  10. Anterior cruciate ligament - updating article.

    Science.gov (United States)

    Luzo, Marcus Vinicius Malheiros; Franciozi, Carlos Eduardo da Silveira; Rezende, Fernando Cury; Gracitelli, Guilherme Conforto; Debieux, Pedro; Cohen, Moisés

    2016-01-01

    This updating article on the anterior cruciate ligament (ACL) has the aim of addressing some of the most interesting current topics in this field. Within this stratified approach, it contains the following sections: ACL remnant; anterolateral ligament and combined intra and extra-articular reconstruction; fixation devices; and ACL femoral tunnel creation techniques.

  11. Anterior cruciate ligament - updating article.

    Science.gov (United States)

    Luzo, Marcus Vinicius Malheiros; Franciozi, Carlos Eduardo da Silveira; Rezende, Fernando Cury; Gracitelli, Guilherme Conforto; Debieux, Pedro; Cohen, Moisés

    2016-01-01

    This updating article on the anterior cruciate ligament (ACL) has the aim of addressing some of the most interesting current topics in this field. Within this stratified approach, it contains the following sections: ACL remnant; anterolateral ligament and combined intra and extra-articular reconstruction; fixation devices; and ACL femoral tunnel creation techniques. PMID:27517015

  12. Kawasaki Disease Mimicking Retropharyngeal Abscess

    Science.gov (United States)

    Srividhya, Vazhkudai Sridharan; Vasanthi, Thiruvengadam; Shivbalan, Somu

    2010-01-01

    Kawasaki disease is an acute, self-limiting febrile mucocutaneous vasculitis of infants and young children. Retropharyngeal lymphadenopathy is a rare presentation of Kawasaki disease. We present a case of Kawasaki disease mimicking a retropharyngeal abscess, with upper airway obstruction resulting in delayed diagnosis. PMID:20635457

  13. Multicystic Hepatocarcinoma Mimicking Liver Abscess

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    Evangelos Falidas

    2013-01-01

    Full Text Available The diagnosis of hepatocellular carcinoma (HCC became easier in relation to the improved radiological examinations; however, the neoplasm may occur under atypical presentations mimicking other benign or malignant processes. Multicystic HCC mimicking a liver abscess associated with septic-type fever and leukocytosis is rare, has a poor prognosis, and poses diagnostic and therapeutic dilemmas. We present the case of an 80-year-old patient, who presented with fever, leukocytosis, and large cystic masses involving right and left lobes of the liver initially considered abscesses and finally diagnosed as HCC after open drainage and liver biopsy. Although the patient died on the tenth postoperative day due to pulmonary oedema, the authors emphasize the high index of suspicion needed in the diagnosis of this unusual presentation of HCC.

  14. OVARIAN CALCIFICATION MIMICKING VESICLE CALCULUS

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    Pallavi

    2013-04-01

    Full Text Available INTRODUCTION: Calcification in ovary is usually dystrophic in natu re, forming secondary to degeneration of the epithelium or in association wit h areas of necrosis. It may occur in cases of endometriosis [1] or in some ovarian tumor eg. Fibro thecoma [2] , Brenner’s tumor [3] , cavernous hemangioma [4] etc. Benign unilateral densely calcified ovary wit hout any association with tumor or endometriosis has not been reported previously. We report a case of heavily calcified left ovary which mimicked as vesicle calculus on X- ray leading to confusion in diagnosis.

  15. Cervicofacial actinomycosis mimicking lymphangioma circumscriptum

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    Mahendra M Kura

    2011-01-01

    Full Text Available Primary cutaneous actinomycosis caused by Actinomyces israelii occurs most commonly in the cervicofacial area. It commonly presents as "lumpy jaw" with draining sinuses which discharge the characteristic "sulfur granules". A low index of suspicion and a low sensitivity in culturing the organism, due to its fastidious nature often delays the diagnosis. An atypical clinical presentation mimicking lymphangioma circumscriptum with grouped papulovesicular and nodular lesions along the lower jaw extending from skin to the inner buccal mucosa, confirmed on histology and an excellent therapeutic response to penicillin is reported.

  16. Anterior cruciate ligament allograft transplantation for intraarticular ligamentous reconstruction.

    Science.gov (United States)

    Goertzen, M; Dellmann, A; Gruber, J; Clahsen, H; Bürrig, K F

    1992-01-01

    A multiplicity of surgical operations have been developed in an attempt to achieve satisfactory function after anterior cruciate ligament (ACL) repair. None of these procedures have been able to reproduce the fiber organization anatomy of attachment site, vascularity, or function of the ACL. Twenty-nine foxhounds received a deep-frozen bone-ACL-bone allograft and a ligament augmentation device (LAD). Biomechanical, microvascular, and histological changes were evaluated 3, 6, and 12 months following implantation. The maximum loads of the allograft/LADs were 34.3% (387.2 N) after 3 months, 49.3% (556.6 N) after 6 months, and 61.1% (698.8 N) after a year. The maximum load was 69.1% (780 N). In general, after 6 months the allografts showed normal collagen orientation. The allografts demonstrated no evidence of infection or immune reaction. No bone ingrowth into the LAD was observed. Polarized light microscopy and periodic acid-schiff staining showed that the new bone-ligament substance interface had intact fiber orientation at the area of the ligament insertion. Microvascular examination using the Spalteholtz technique revealed revascularization and the importance of an infrapatellar fat pad for the nourishment of ACL allografts.

  17. Anterior cruciate ligament allograft transplantation for intraarticular ligamentous reconstruction.

    Science.gov (United States)

    Goertzen, M; Dellmann, A; Gruber, J; Clahsen, H; Bürrig, K F

    1992-01-01

    A multiplicity of surgical operations have been developed in an attempt to achieve satisfactory function after anterior cruciate ligament (ACL) repair. None of these procedures have been able to reproduce the fiber organization anatomy of attachment site, vascularity, or function of the ACL. Twenty-nine foxhounds received a deep-frozen bone-ACL-bone allograft and a ligament augmentation device (LAD). Biomechanical, microvascular, and histological changes were evaluated 3, 6, and 12 months following implantation. The maximum loads of the allograft/LADs were 34.3% (387.2 N) after 3 months, 49.3% (556.6 N) after 6 months, and 61.1% (698.8 N) after a year. The maximum load was 69.1% (780 N). In general, after 6 months the allografts showed normal collagen orientation. The allografts demonstrated no evidence of infection or immune reaction. No bone ingrowth into the LAD was observed. Polarized light microscopy and periodic acid-schiff staining showed that the new bone-ligament substance interface had intact fiber orientation at the area of the ligament insertion. Microvascular examination using the Spalteholtz technique revealed revascularization and the importance of an infrapatellar fat pad for the nourishment of ACL allografts. PMID:1389780

  18. Multiple Ligament Knee Injury: Complications

    OpenAIRE

    Manske, Robert C; Hosseinzadeh, Pooya; Giangarra, Charles E.

    2008-01-01

    Non-operative and operative complications are common following multiple ligament knee injuries. This article will describe common complications seen by the surgeon and physical therapist following this complex injury. Complications include fractures, infections, vascular and neurologic complications following injury and surgery, compartment syndrome, complex regional pain syndrome, deep venous thrombosis, loss of motion and persistent laxity issues. A brief description of these complications ...

  19. Status and headway of the clinical application of artificial ligaments

    Directory of Open Access Journals (Sweden)

    Tianwu Chen

    2015-01-01

    Full Text Available The authors first reviewed the history of clinical application of artificial ligaments. Then, the status of clinical application of artificial ligaments was detailed. Some artificial ligaments possessed comparable efficacy to, and fewer postoperative complications than, allografts and autografts in ligament reconstruction, especially for the anterior cruciate ligament. At the end, the authors focused on the development of two types of artificial ligaments: polyethylene glycol terephthalate artificial ligaments and tissue-engineered ligaments. In conclusion, owing to the advancements in surgical techniques, materials processing, and weaving methods, clinical application of some artificial ligaments so far has demonstrated good outcomes and will become a trend in the future.

  20. Gout: radiographic findings mimicking infection

    Energy Technology Data Exchange (ETDEWEB)

    Rousseau, I.; Raymond-Tremblay, D. [Dept. of Diagnostic Radiology, Centre Hospitalier de l' Univ. de Montreal, Que. (Canada); Cardinal, E. [Dept. of Radiology, Centre Hospitalier de l' Univ. de Montreal, Que. (Canada); Beauregard, C.G. [Dept. of Diagnostic Radiology, Hopital du Sacre-Coeur de Montreal,Que. (Canada); Braunstein, E.M. [Dept. of Radiology, Indiana University Hospital (United States); Saint-Pierre, A. [Rheumatology Unit, Centre Hospitalier de l' Univ. de Montreal, Que. (Canada)

    2001-10-01

    Objective: To describe radiographic features of gout that may mimic infection. Design and patients: We report five patients with acute bacterial gout who presented with clinical as well as radiological findings mimicking acute bacterial septic arthritis or osteomyelitis. Three patients had delay in the appropriate treatment with the final diagnosis being established after needle aspiration and identification of urate crystals under polarized light microscopy. Two patients underwent digit amputation for not responding to antibiotic treatment and had histological findings confirming the diagnosis of gout. Conclusion: It is important for the radiologist to be aware of the radiological manifestations of acute gout that can resemble infection in order to avoid inappropriate diagnosis and delay in adequate treatment. The definitive diagnosis should rely on needle aspiration and a specific search for urate crystals. (orig.)

  1. Multiple-ligament injured knee

    Institute of Scientific and Technical Information of China (English)

    SUN Lei; NING Zhi-jie; ZHANG Hui; TIAN Min; NING Tin-min

    2006-01-01

    Objective: To explore the clinical characteristic of the multiple-ligament injured knee and evaluate the protocol,technique and outcome of treatment for the multipleligament injured knee.Methods: From October 2001 to March 2005, 9 knees with combined anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) tears in 9 patients were identified with clinical and arthroscopic examinations. Of them, 5 knees were combined with ruptures of posteromedial corner (PMC) and medial collateral ligament (MCL), 4 with disruptions of posterolateral corner ( PLC), 2 with popliteal vascular injuries and 1 with peroneal nerve injuries. Six patients were hospitalized in acute phase of trauma, 2 received repairs of popliteal artery and 4 had repairs of PMC and MCL. Reconstructions of ACL and PCL with autografts under arthroscope were performed in all patients at 4 to 10 weeks after trauma,including reconstruction of PLC with the posterior half of biceps femoris tendon tenodesis in 4 patients and reconstructions of PMC and MCL with femoral fascia in 1 patient.Results: No severe complications occurred at early stage after operation in the 9 patients. All of them were followed up for 10-39 months with an average of 23. 00 months ± 9.46 months. Lysholm score was 70-95 with an average of 85.00 ± 8.29. International Knee Documentation Committee (IKDC) score was from severely abnormal (Grade D) in 9 knees at initial examination to normal (Grade A) in 2 knees, nearly normal (Grade B ) in 6 knees and abnormal in 1 knee at the last follow-up. Of the 9 patients, 7 returned to the same activity level before injury and 2 were under the level.Conclusions: The multiple-ligament injured knee with severe instability is usually combined with other important structure damages. Therefore, careful assessment and treatment of the combined injuries are essential. Reconstructions of ACL and PCL under arthroscope, combined with repairs or reconstructions of the extraarticular ligaments

  2. The 2010 Broad Prize

    Science.gov (United States)

    Education Digest: Essential Readings Condensed for Quick Review, 2011

    2011-01-01

    A new data analysis, based on data collected as part of The Broad Prize process, provides insights into which large urban school districts in the United States are doing the best job of educating traditionally disadvantaged groups: African-American, Hispanics, and low-income students. Since 2002, The Eli and Edythe Broad Foundation has awarded The…

  3. Acquired vulval lymphangiectases mimicking genital warts

    OpenAIRE

    Sharma Rajeev; Tomar Sudarshan; Chandra Mithilesh

    2002-01-01

    Acquired lymphangiectasia can sometimes occur on the vulva and cause diagnostic difficulties especially if they have a warty appearance. We report a case of acquired vulva I lymphangiectasia which mimicked genital warts.

  4. Acquired vulval lymphangiectases mimicking genital warts

    Directory of Open Access Journals (Sweden)

    Sharma Rajeev

    2002-01-01

    Full Text Available Acquired lymphangiectasia can sometimes occur on the vulva and cause diagnostic difficulties especially if they have a warty appearance. We report a case of acquired vulva I lymphangiectasia which mimicked genital warts.

  5. Humanlike Robots - Synthetically Mimicking Humans

    Science.gov (United States)

    Bar-Cohen, Yoseph

    2012-01-01

    Nature inspired many inventions and the field of technology that is based on the mimicking or inspiration of nature is widely known as Biomimetics and it is increasingly leading to many new capabilities. There are numerous examples of biomimetic successes including the copying of fins for swimming, and the inspiration of the insects and birds flight. More and more commercial implementations of biomimetics are appearing and behaving lifelike and applications are emerging that are important to our daily life. Making humanlike robots is the ultimate challenge to biomimetics and, for many years, it was considered science fiction, but such robots are becoming an engineering reality. Advances in producing such robot are allowing them to perform impressive functions and tasks. The development of such robots involves addressing many challenges and is raising concerns that are related to fear of their application implications and potential ethical issues. In this paper, the state-of-the-art of humanlike robots, potential applications and challenges will be reviewed.

  6. Nanofiltration of hormone mimicking trace organic contaminants

    OpenAIRE

    Nghiem, D.L.; Schaefer, Andrea; Elimelech, M.

    2005-01-01

    The removal mechanisms of three hormone mimicking organic compounds by nanofiltration (NF) membranes have been examined. Two NF membranes having different pore size were used in laboratory-scale nanofiltration experiments with feed solutions spiked with a hormone mimicking compound ¾ nonylphenol, tert-butyl phenol, or bisphenol A. Retention of the compounds was determined at various solution chemistries, namely aqueous solution pH, ionic strength, and presence of natural organi...

  7. Tissue mimicking materials for dental ultrasound

    OpenAIRE

    Singh, Rahul S.; Culjat, Martin O.; Grundfest, Warren S.; Brown, Elliott R.; White, Shane N

    2008-01-01

    While acoustic tissue mimicking materials have been explored for a variety of soft and hard biological tissues, no dental hard tissue mimicking materials have been characterized. Tooth phantoms are necessary to better understand acoustic phenomenology within the tooth environment and to accelerate the advancement of dental ultrasound imaging systems. In this study, soda lime glass and dental composite were explored as surrogates for human enamel and dentin, respectively, in terms of compressi...

  8. Variations in meniscofemoral ligaments at anatomical study and MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Cho, J.M.; Suh, J.S. [Department of Diagnostic Radiology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Na, J.B. [Department of Diagnostic Radiology, Kyungsang National University, College of Medicine, Jinju (Korea, Republic of); Cho, J.H. [Department of Diagnostic Radiology, Ajou University College of Medicine, Suwon (Korea, Republic of); Kim, Y.; Yoo, W.K. [Department of Rehabilitation, Yonsei University College of Medicine, Seoul (Korea, Republic of); Lee, H.Y.; Chung, I.H. [Department of Anatomy, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1999-04-01

    Purpose To demonstrate variations in the meniscofemoral ligaments (ligaments of Wrisberg and Humphrey) at anatomical study and magnetic resonance (MR) imaging. Design Twenty-eight cadaveric knees were partially dissected for the examination of the meniscofemoral ligaments. One hundred knee MR examinations were reviewed by two experienced musculoskeletal radiologists. Proximal variations in the meniscofemoral ligaments at MR imaging were classified into three types according to the attachment site: type I, medial femoral condyle; type II, proximal half of the posterior cruciate ligament (PCL); type III, distal half of the PCL. Distal variations were classified into vertical or oblique types according to the orientation of the intermediate signal at the interface of the ligament and lateral meniscus. Results At anatomical study, six cases showed variations in the proximal insertion site of the meniscofemoral ligaments. At MR imaging 93 cases had one or more meniscofemoral ligaments, giving a total of 107 ligaments: 90 ligaments of Wrisberg and 17 ligaments of Humphrey. Forty-one ligaments of Wrisberg were type I, 28 type II, 19 type III, and with two indeterminate type, while 6 ligaments of Humphrey were type I and the remaining 11 were indeterminate. Seven cases showed no meniscofemoral ligament. Of the 107 meniscofemoral ligaments, the distal insertion orientation was of vertical type in 10 ligaments, oblique type in 70 and unidentified in 27. Conclusion An understanding of the high incidence of meniscofemoral ligament variations may help in the interpretation of knee MR studies. (orig.) With 7 figs., 1 tab., 16 refs.

  9. Triphasic scaffolds for the regeneration of the bone-ligament interface.

    Science.gov (United States)

    Criscenti, G; Longoni, A; Di Luca, A; De Maria, C; van Blitterswijk, C A; Vozzi, G; Moroni, L

    2016-03-01

    A triphasic scaffold (TPS) for the regeneration of the bone-ligament interface was fabricated combining a 3D fiber deposited polycaprolactone structure and a polylactic co-glycolic acid electrospun. The scaffold presented a gradient of physical and mechanical properties which elicited different biological responses from human mesenchymal stem cells. Biological test were performed on the whole TPS and on scaffolds comprised of each single part of the TPS, considered as the controls. The TPS showed an increase of the metabolic activity with culturing time that seemed to be an average of the controls at each time point. The importance of differentiation media for bone and ligament regeneration was further investigated. Metabolic activity analysis on the different areas of the TPS showed a similar trend after 7 days in both differentiation media. Total alkaline phosphatase (ALP) activity analysis showed a statistically higher activity of the TPS in mineralization medium compared to the controls. A different glycosaminoglycans amount between the TPS and its controls was detected, displaying a similar trend with respect to ALP activity. Results clearly indicated that the integration of electrospinning and additive manufacturing represents a promising approach for the fabrication of scaffolds for the regeneration of tissue interfaces, such as the bone-to-ligament one, because it allows mimicking the structural environment combining different biomaterials at different scales. PMID:26824799

  10. Interstitial fluid flow in tendons or ligaments: a porous medium finite element simulation.

    Science.gov (United States)

    Butler, S L; Kohles, S S; Thielke, R J; Chen, C; Vanderby, R

    1997-11-01

    The purpose of this study is to describe interstitial fluid flow in axisymmetric soft connective tissue (ligaments or tendons) when they are loaded in tension. Soft hydrated tissue was modelled as a porous medium (using Darcy's Law), and the finite element method was used to solve the resulting equations governing fluid flow. A commercially available computer program (FiDAP) was used to create an axisymmetric model of a biomechanically tested rat ligament. The unknown variables at element nodes were pressure and velocity of the interstitial fluid (Newtonian and incompressible). The effect of variations in fluid viscosity and permeability of the solid matrix was parametrically explored. A transient loading state mimicking a rat ligament mechanical experiment was used in all simulations. The magnitude and distribution of pressure, stream lines, shear (stress) rate, vorticity and velocity showed regular patterns consistent with extension flow. Parametric changes of permeability and viscosity strongly affected fluid flow behaviour. When the radial permeability was 1000 times less than the axial permeability, shear rate and vorticity increased (approximately 5-fold). These effects (especially shear stress and pressure) suggested a strong interaction with the solid matrix. Computed levels of fluid flow suggested a possible load transduction mechanism for cells in the tissue.

  11. Leptospirosis mimicking sepsis after orthopedic surgery: a case report

    Directory of Open Access Journals (Sweden)

    C. S. Abboud

    2001-10-01

    Full Text Available We report a case of leptospirosis that occurred after elective surgery involving tendon transfer and shoulder arthroscopy. The disease mimicked hospital infection after orthopedic surgery and was at first misdiagnosed as post-operative sepsis. The patient was 60 year old female that developed sepsis with hypotension, shock, bleeding, jaundice and renal insufficiency 4 hours after surgery. Shock treatment procedures were performed and broad spectrum antibiotic therapy was used with coverage for bacteria acquired in hospitals. A careful investigation was carried out by the Hospital Infection Control Service in search of the possible source of the infection. After clinical evaluation by a specialist in infectious diseases, the hypothesis of leptospirosis was put forward based on clinical and epidemiological data. The hypothesis was later confirmed by the positive result of serological tests with the microagglutination method that yielded 1:800 and then 1:12,600 7 days later. This is the first reported case of leptospirosis manifest directly following surgery, mimicking postoperative sepsis.

  12. Anatomy of the ankle ligaments: a pictorial essay

    NARCIS (Netherlands)

    P. Golanó; J. Vega; P.A.J. de Leeuw; F. Malagelada; M.C. Manzanares; V. Götzens; C.N. van Dijk

    2010-01-01

    Understanding the anatomy of the ankle ligaments is important for correct diagnosis and treatment. Ankle ligament injury is the most frequent cause of acute ankle pain. Chronic ankle pain often finds its cause in laxity of one of the ankle ligaments. In this pictorial essay, the ligaments around the

  13. Engineered nanoparticles mimicking cell membranes for toxin neutralization.

    Science.gov (United States)

    Fang, Ronnie H; Luk, Brian T; Hu, Che-Ming J; Zhang, Liangfang

    2015-08-01

    Protein toxins secreted from pathogenic bacteria and venomous animals rely on multiple mechanisms to overcome the cell membrane barrier to inflict their virulence effect. A promising therapeutic concept toward developing a broadly applicable anti-toxin platform is to administer cell membrane mimics as decoys to sequester these virulence factors. As such, lipid membrane-based nanoparticulates are an ideal candidate given their structural similarity to cellular membranes. This article reviews the virulence mechanisms employed by toxins at the cell membrane interface and highlights the application of cell-membrane mimicking nanoparticles as toxin decoys for systemic detoxification. In addition, the implication of particle/toxin nanocomplexes in the development of toxoid vaccines is discussed. PMID:25868452

  14. Malignant Mesothelioma Mimicking Invasive Mammary Carcinoma in a Male Breast

    Directory of Open Access Journals (Sweden)

    Mohamed Mokhtar Desouki

    2015-01-01

    Full Text Available Malignant mesothelioma is an uncommon tumor with strong association with asbestos exposure. Few cases of malignant pleural mesothelioma metastatic to the female breast have been reported. Herein, we presented, for the first time, a case of locally infiltrating malignant pleural mesothelioma forming a mass in the breast of a male as the first pathologically confirmed manifestation of the disease. Breast ultrasound revealed an irregular mass in the right breast which involves the pectoralis muscle. Breast core biopsy revealed a proliferation of neoplastic epithelioid cells mimicking an infiltrating pleomorphic lobular carcinoma. IHC studies showed the cells to be positive for calretinin, CK5/6, WT1, and CK7. The cells were negative for MOC-31, BerEp4, ER, and PR. A final diagnosis of malignant mesothelioma, epithelioid type, was rendered. This case demonstrates the importance of considering a broad differential diagnosis in the setting of atypical presentation with application of a panel of IHC markers.

  15. Transverse ligament of the knee in humans.

    Science.gov (United States)

    Ratajczak, Wojciech; Jakubowicz, Marian; Pytel, Andrzej

    2003-01-01

    The purpose of this study was to trace the histological structure of the transverse ligament of the knee and its relation to the inferior lateral genicular artery. Investigations were carried out on 20 lower limbs (10 males, and 10 females) from the Department of Anatomy. It was found that close to the attachment of the transverse ligament to the menisci, bundles of fibres pass in vertical, oblique and horizontal directions, occupying a wide area on the anterior margin of the menisci. These fibres intermingle with bundles of the fibrocartilage of the menisci. In the area of the lateral attachment the inferior lateral genicular artery passes anteriorly to the transverse ligament, giving off numerous branches to the ligament. The medial part of the transverse ligament presents a thick rounded structure, surrounded by loose connective tissue. The fibres are arranged irregularly in bundles running horizontally on a tortuous course and with single spindle-like cells with darkly stained nuclei. The cells are not found at the ends of the ligament. Numerous blood vessels are observed between the bundles of fibres and on the periphery of the ligament.

  16. Functional tissue engineering of ligament healing

    Directory of Open Access Journals (Sweden)

    Hsu Shan-Ling

    2010-05-01

    Full Text Available Abstract Ligaments and tendons are dense connective tissues that are important in transmitting forces and facilitate joint articulation in the musculoskeletal system. Their injury frequency is high especially for those that are functional important, like the anterior cruciate ligament (ACL and medial collateral ligament (MCL of the knee as well as the glenohumeral ligaments and the rotator cuff tendons of the shoulder. Because the healing responses are different in these ligaments and tendons after injury, the consequences and treatments are tissue- and site-specific. In this review, we will elaborate on the injuries of the knee ligaments as well as using functional tissue engineering (FTE approaches to improve their healing. Specifically, the ACL of knee has limited capability to heal, and results of non-surgical management of its midsubstance rupture have been poor. Consequently, surgical reconstruction of the ACL is regularly performed to gain knee stability. However, the long-term results are not satisfactory besides the numerous complications accompanied with the surgeries. With the rapid development of FTE, there is a renewed interest in revisiting ACL healing. Approaches such as using growth factors, stem cells and scaffolds have been widely investigated. In this article, the biology of normal and healing ligaments is first reviewed, followed by a discussion on the issues related to the treatment of ACL injuries. Afterwards, current promising FTE methods are presented for the treatment of ligament injuries, including the use of growth factors, gene delivery, and cell therapy with a particular emphasis on the use of ECM bioscaffolds. The challenging areas are listed in the future direction that suggests where collection of energy could be placed in order to restore the injured ligaments and tendons structurally and functionally.

  17. Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears

    Energy Technology Data Exchange (ETDEWEB)

    McIntyre, J. [San Francisco Magnetic Resonance Center, CA (United States); Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH (United States); Moelleken, S.; Tirman, P. [San Francisco Magnetic Resonance Center, CA (United States)

    2001-06-01

    Objective. To describe the MR features of mucoid degeneration of the anterior cruciate ligament (ACL) in a series of patients with MRI findings that were mistaken for tears in the majority of cases but who were found to have an intact ligament at arthroscopy. We will suggest a pathologic entity corresponding to this finding and describe some characteristic features that can be used to identify this entity on MRI.Design. A retrospective analysis of 10 MRI examinations of the knee was performed after arthroscopic evaluation. Prearthroscopic MRI findings had been interpreted as a tear in six patients prospectively and in the remaining four the diagnosis of mucoid degeneration was suggested and ultimately proven. All patients had an intact ACL by preoperative clinical examination, examination under anesthesia, and at arthroscopy.Results. MRI examinations demonstrated an ill-defined ACL, greater in girth than the normal ligament and characterized by increased signal on all sequences. The high-signal ligament was oriented in the normal direction of the ACL. The overall appearance of the ligament was retrospectively described as like a celery stalk. Arthroscopy demonstrated mechanically intact ligaments with a normal to expanded external appearance. Probing of three of the ligaments caused a material to be expressed and pathologic evaluation resulted in the diagnosis of cystic, mucoid degeneration.Conclusion. Mucoid degeneration and an intact ACL can be suspected when an apparently thickened and ill-defined ligament with increased signal intensity on all sequences is identified in a patient with a clinically intact ligament. (orig.)

  18. Arthrographic diagnosis of ruptured calcaneofibular ligament. I

    International Nuclear Information System (INIS)

    A new projection, oblique axial, is recommended for the arthrography of the acute sprained ankle for the correct diagnosis of a ruptured calcaneofibular ligament. Its value is experimentally confirmed. (Auth.)

  19. Guideline on anterior cruciate ligament injury

    NARCIS (Netherlands)

    D.E. Meuffels (Duncan); M.T. Poldervaart (Michelle T.); R.L. Diercks (Ron L.); A.W.F.M. Fievez (Alex W.F.M.); T.W. Patt (Thomas W.); C.P. van der Hart (Cor P.); E.R. Hammacher (Eric); F. van der Meer (Fred); E.A. Goedhart (Edwin A.); A.F. Lenssen (Anton F); S.B. Muller-Ploeger (Sabrina B); M.A. Pols (Margreet); D.B.F. Saris (Daniel)

    2012-01-01

    textabstractThe Dutch Orthopaedic Association has a long tradition of development of practical clinical guidelines. Here we present the recommendations from the multidisciplinary clinical guideline working group for anterior cruciate ligament injury. The following 8 clinical questions were formulate

  20. Peripancreatic fat necrosis mimicking pancreatic cancer

    Energy Technology Data Exchange (ETDEWEB)

    Thurnher, M.M.; Schima, W.; Turetschek, K.; Thurnher, S.A. [Vienna Univ. (Austria). Inst. fuer Radiologie; Fuegger, R. [Dept. of Surgery, University of Vienna (Austria); Oberhuber, G. [Dept. of Pathology, University of Vienna (Austria)

    2001-06-01

    A case of peripancreatic fat necrosis, after an episode of acute pancreatitis, which mimicked pancreatic cancer with lymph node metastases, is presented. We describe the imaging findings with helical CT scanning and with unenhanced and mangafodipir-enhanced MR imaging, with special emphasis on the differential diagnoses. (orig.)

  1. Microfilariasis of the breast mimicking malignancy

    OpenAIRE

    Tamojit Chaudhuri; Kamlesh Yadava; Pabitra Ray

    2013-01-01

    We report a 65-year-old female who presented with a 3.5x3 cm retro-areolar lump of the right breast with associated right axillary lymphadenopathy, mimicking breast cancer. Mammography showed a well-defined mass in the central quadrant of the right breast. Fine needle aspiration cytology from the breast lump demonstrated many microfilariae of Wuchereria bancrofti.

  2. Microfilariasis of the breast mimicking malignancy

    OpenAIRE

    Chaudhuri, Tamojit; Yadava, Kamlesh; Ray, Pabitra

    2013-01-01

    We report a 65-year-old female who presented with a 3.5×3 cm retro-areolar lump of the right breast with associated right axillary lymphadenopathy, mimicking breast cancer. Mammography showed a well-defined mass in the central quadrant of the right breast. Fine needle aspiration cytology from the breast lump demonstrated many microfilariae of Wuchereria bancrofti.

  3. Giant Hidroacanthoma Simplex Mimicking Bowen's Disease

    OpenAIRE

    Niiyama, Shiro; Oharaseki, Toshiaki; Mukai, Hideki

    2015-01-01

    Hidroacanthoma simplex is a benign tumor of the skin, macroscopically resembling seborrheic keratosis or Bowen's disease and histologically mimicking clonal-type seborrheic keratosis. We observed a plaque of 70 × 50 mm on the right flank part. From clinical appearance, we suspected Bowen's disease; however, based on immunohistochemical findings, we made a diagnosis of hidroacanthoma simplex.

  4. Pulmonary hyalinizing granuloma mimicking lung carcinoma.

    Science.gov (United States)

    Basoglu, A; Findik, S; Celik, B; Yildiz, L

    2006-06-01

    Pulmonary hyalinizing granuloma has rarely been reported and is a benign entity of unknown origin. The chest radiograph reveals multiple and frequently bilateral pulmonary nodules. We describe a patient with pulmonary hyalinizing granuloma who presented with a central mass in the left lung mimicking lung carcinoma. PMID:16755455

  5. An adult intussusception mimicking early appendicitis

    Institute of Scientific and Technical Information of China (English)

    Wei-Chun Tseng; Cheng-Ting Hsiao; Yu-Cheng Hung

    2012-01-01

    Adult intussusception is rare with variable clinical presentation. We reported a case of adult intussusception presenting with symptoms mimicking acute appendicitis. The patient presented as an abdominal pain from epigastric area with shifting gradually to RLQ. The atypical presentation of adult intussusception remains a diagnostic challenge to the emergency physician.

  6. Acute dystonia mimicking angioedema of the tongue

    DEFF Research Database (Denmark)

    Rasmussen, Eva Rye; Pallesen, Kristine A U; Bygum, Anette

    2013-01-01

    We report a case of acute dystonia of the face, jaw and tongue caused by metoclopramide and mimicking angioedema. The patient had attacks for several years before the correct diagnosis was made and we present the first ever published video footage of an attack. This adverse drug reaction is known...

  7. MR imaging of the meniscofemoral ligament : incidence and classification

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Jae Min; Yoo, Wjoo Kyoung; Suh, Jin Suck; Jeon, Pyeong Jeon; Hwang, Geum Joo; Kim, Yoo Cheol; Lee, Hae Yeon [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    1996-05-01

    To demonstrate the incidence and variation of the meniscofemoral ligament in Koreans. A total of 100 MR studies of 95 patients were reviewed with special attention to the appearance and incidence of the meniscofemoral ligaments. The ligament. the ligament of Wrisberg was classified according to proximal insertion : type I, insertion at the posterofemoral condyle ; type II, insertion at the distal portion of the posterior cruciate ligament ; type III, insertion at the distal portion of the posterior cruciate ligament. on T2-weighted images, the high signal at the meniscal insertion of the meniscofemoral ligament was classified according to its shape. The ligament o Humprey was observed in 17 cases and the ligament of Wrisberg was in 90 : type I in 41 cases ; type II, 19 cases ; type III, in 28 cases ; unclassified , in 2 cases. In 77 cases, the cleft with high signal intensity was seen between the menicsofemoral ligament and the posterior cruciate ligament. From our results, the incidence of the ligament of Wrisberg on MRI was more prevelant than the ligament of Humprey. An exact knowledge of the meniscofemoral ligament could be helpful in distinguishing it from pathologic lesions.

  8. Predisposition for temporomandibular joint disorders: loose ligaments.

    Science.gov (United States)

    Deodato, Francesco; Trusendi, Raffaello; Giorgetti, Roberto; Scalese, Marco U

    2006-07-01

    Loose ligaments are often a predisposing factor of temporomandibular joint (TMJ) disorders. This causal factor was analyzed in 701 subjects presenting at the TMJ and Posture Center of Siena University with TMJ pain or dysfunction. Along with the conventional jaw examination, a Carter and Wilkinson test as modified by Beighton was also done. We found a correlation among the parameters of age, gender, TMJ disorder, joint pain, muscle pain, and loose ligaments. PMID:16933458

  9. Tissue Engineering Strategies in Ligament Regeneration

    Directory of Open Access Journals (Sweden)

    Caglar Yilgor

    2012-01-01

    Full Text Available Ligaments are dense fibrous connective tissues that connect bones to other bones and their injuries are frequently encountered in the clinic. The current clinical approaches in ligament repair and regeneration are limited to autografts, as the gold standard, and allografts. Both of these techniques have their own drawbacks that limit the success in clinical setting; therefore, new strategies are being developed in order to be able to solve the current problems of ligament grafting. Tissue engineering is a novel promising technique that aims to solve these problems, by producing viable artificial ligament substitutes in the laboratory conditions with the potential of transplantation to the patients with a high success rate. Direct cell and/or growth factor injection to the defect site is another current approach aiming to enhance the repair process of the native tissue. This review summarizes the current approaches in ligament tissue engineering strategies including the use of scaffolds, their modification techniques, as well as the use of bioreactors to achieve enhanced regeneration rates, while also discussing the advances in growth factor and cell therapy applications towards obtaining enhanced ligament regeneration.

  10. The Cruciate Ligaments in Total Knee Arthroplasty.

    Science.gov (United States)

    Parcells, Bertrand W; Tria, Alfred J

    2016-01-01

    The early knee replacements were hinge designs that ignored the ligaments of the knee and resurfaced the joint, allowing freedom of motion in a single plane. Advances in implant fixation paved the way for modern designs, including the posterior-stabilized (PS) total knee arthroplasty (TKA) that sacrifices both cruciate ligaments while substituting for the posterior cruciate ligament (PCL), and the cruciate-retaining (CR) TKA designs that sacrifice the anterior cruciate ligament but retain the PCL. The early bicruciate retaining (BCR) TKA designs suffered from loosening and early failures. Townley and Cartier designed BCR knees that had better clinical results but the surgical techniques were challenging.Kinematic studies suggest that normal motion relies on preservation of both cruciate ligaments. Unicompartmental knee arthroplasty retains all knee ligaments and closely matches normal motion, while PS and CR TKA deviate further from normal. The 15% to 20% dissatisfaction rate with current TKA has renewed interest in the BCR design. Replication of normal knee kinematics and proprioception may address some of the dissatisfaction. PMID:27327919

  11. Cardiac sarcoidosis mimicking right ventricular dysplasia.

    Science.gov (United States)

    Shiraishi, Jun; Tatsumi, Tetsuya; Shimoo, Kazutoshi; Katsume, Asako; Mani, Hiroki; Kobara, Miyuki; Shirayama, Takeshi; Azuma, Akihiro; Nakagawa, Masao

    2003-02-01

    A 59-year-old woman with skin sarcoidosis was admitted to hospital for assessment of complete atrioventricular block. Cross-sectional echocardiography showed that the apical free wall of the right ventricle was thin and dyskinetic with dilation of the right ventricle. Thallium-201 myocardial imaging revealed a normal distribution. Both gallium-67 and technetium-99m pyrophosphate scintigraphy revealed no abnormal uptake in the myocardium. Right ventriculography showed chamber dilation and dyskinesis of the apical free wall, whereas left ventriculography showed normokinesis, mimicking right ventricular dysplasia. Cardiac sarcoidosis was diagnosed on examination of an endomyocardial biopsy specimen from the right ventricle. A permanent pacemaker was implanted to manage the complete atrioventricular block. After steroid treatment, electrocardiography showed first-degree atrioventricular block and echocardiography revealed an improvement in the right ventricular chamber dilation. Reports of cardiac sarcoidosis mimicking right ventricular dysplasia are extremely rare and as this case shows, right ventricular involvement may be one of its manifestations.

  12. Wells Syndrome Mimicking Erythema Elevatum Diutinum

    OpenAIRE

    Rai Ranju; Sharma Vinod Kumar; Kaur Inderjeet; Kumar Bhushan

    2001-01-01

    Wells syndrome is a rare inflammatory dermatosis clinically characterised by recurrent itchy erythematous oedematous plaques with features resembling both urticaria and cellulites and histologically characterised by tissue eosinophilia, oedema and flame figures. Erythema elevatum diutinum(EED) is a chronic localized form of cutaneous vasculitis clinically consisting of symmetrical papules and nodules most often of the back of the hands. We present a case of wells syndrome mimicking EED clini...

  13. Wells Syndrome Mimicking Erythema Elevatum Diutinum

    Directory of Open Access Journals (Sweden)

    Rai Ranju

    2001-01-01

    Full Text Available Wells syndrome is a rare inflammatory dermatosis clinically characterised by recurrent itchy erythematous oedematous plaques with features resembling both urticaria and cellulites and histologically characterised by tissue eosinophilia, oedema and flame figures. Erythema elevatum diutinum(EED is a chronic localized form of cutaneous vasculitis clinically consisting of symmetrical papules and nodules most often of the back of the hands. We present a case of wells syndrome mimicking EED clinically.

  14. [Pulmonary hyalinizing granuloma mimicking pulmonary carcinoma].

    Science.gov (United States)

    Uçvet, Ahmet; Tözüm, Halil; Gürsoy, Soner; Gülle, Ali Alper; Yaldiz, Sadik; Aydoğdu Dinç, Zekiye

    2006-01-01

    Pulmonary hyalinizing granuloma is a rare fibrosing nodular disease of the lung characterized by solitary or multiple pulmonary nodules. They can occur after inflammatory or post-inflammatory changes. A 60 years old asymptomatic patient admitted to our clinic because of a solid mass of 6 cm in his routine chest radiography. A lobectomy was performed and the histological diagnosis was reported as pulmonary hyalinizing granuloma. This case, mimicking pulmonary carcinoma, is rarely found in the literature. PMID:16615022

  15. A Pilocytic Astrocytoma Mimicking a Clinoidal Meningioma

    OpenAIRE

    Hong, Christopher S.; Lehman, Norman L.; Eric Sauvageau

    2014-01-01

    Pilocytic astrocytomas and meningiomas are benign, primary brain tumors that may involve the optic tract. Classically, the presence of a dural “tail” sign may differentiate a meningioma from other intracranial lesions. In this report, we describe a mass with the typical appearance of a clinoidal meningioma on magnetic resonance imaging (MRI) but postoperatively diagnosed as a pilocytic astrocytoma. This case illustrates the rare occurrence of a pilocytic astrocytoma mimicking a meningioma on ...

  16. Acute Myopericarditis Mimicking Acute Myocardial Infarction

    OpenAIRE

    Seval İzdeş; Neriman Defne Altıntaş; Gülin Karaaslan; Recep Uygun; Abdulkadir But

    2011-01-01

    Acute coronary syndromes among young adults are relatively low when compared with older population in the intensive care unit. Electrocardiographic abnormalities mimicking acute coronary syndromes may be caused by non-coronary syndromes and the differential diagnosis requires a detailed evaluation. We are reporting a case of myopericarditis presenting with acute ST elevation and elevated cardiac enzymes simulating acute coronary syndrome. In this case report, the literature is reviewed to dis...

  17. Deltoid ligament in acute ankle injury: MR imaging analysis

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Min Sun; Choi, Yun Sun; Kim, Yun Jung; Jung, Yoon Young [Eulji University, Department of Radiology, Eulji Hospital, Seoul (Korea, Republic of); Kim, Jin Su; Young, Ki Won [Eulji University, Department of Orthopedic Surgery, Eulji Hospital, Seoul (Korea, Republic of)

    2014-05-15

    To identify the pattern of deltoid ligament injury after acute ankle injury and the relationship between ankle fracture and deltoid ligament tear by magnetic resonance imaging (MRI). Thirty-six patients (32 male, and 4 female; mean age, 29.8 years) with acute deltoid ligament injury who had undergone MRI participated in this study. The deltoid ligament was classified as having 3 superficial and 2 deep components. An image analysis included the integrity and tear site of the deltoid ligament, and other associated injuries. Association between ankle fracture and deltoid ligament tear was assessed using Fisher's exact test (P < 0.05). Of the 36 patients, 21 (58.3 %) had tears in the superficial and deep deltoid ligaments, 6 (16.7 %) in the superficial ligaments only, and 4 (11.1 %) in the deep ligaments only. The most common tear site of the three components of the superficial deltoid and deep anterior tibiotalar ligaments was their proximal attachments (94 % and 91.7 % respectively), and that of the deep posterior tibiotalar ligament (pTTL) was its distal attachment (82.6 %). The common associated injuries were ankle fracture (63.9 %), syndesmosis tear (55.6 %), and lateral collateral ligament complex tear (44.4 %). All the components of the deltoid ligament were frequently torn in patients with ankle fractures (tibionavicular ligament, P = 0.009). The observed injury pattern of the deltoid ligament was complex and frequently associated with concomitant ankle pathology. The most common tear site of the superficial deltoid ligament was the medial malleolar attachment, whereas that of the deep pTTL was near its medial talar insertion. (orig.)

  18. Differences in Men's and Women's Mean Ankle Ligamentous Laxity

    OpenAIRE

    Wilkerson, Ricky D; Mason, Melanie A

    2000-01-01

    The incidence of ligamentous ankle injuries is known to be one of the most common athletic injuries that exists. Recently, there has been a great deal of interest regarding the increased risk of female ligamentous injury, such as the anterior cruciate ligament, lateral ankle sprains and others. The purpose of this study is to evaluate whether or not normal lateral ankle ligamentous laxity is similar in male and female athletes. This study selects 22 male and 27 female college athletes who hav...

  19. Deltoid ligament in acute ankle injury: MR imaging analysis

    International Nuclear Information System (INIS)

    To identify the pattern of deltoid ligament injury after acute ankle injury and the relationship between ankle fracture and deltoid ligament tear by magnetic resonance imaging (MRI). Thirty-six patients (32 male, and 4 female; mean age, 29.8 years) with acute deltoid ligament injury who had undergone MRI participated in this study. The deltoid ligament was classified as having 3 superficial and 2 deep components. An image analysis included the integrity and tear site of the deltoid ligament, and other associated injuries. Association between ankle fracture and deltoid ligament tear was assessed using Fisher's exact test (P < 0.05). Of the 36 patients, 21 (58.3 %) had tears in the superficial and deep deltoid ligaments, 6 (16.7 %) in the superficial ligaments only, and 4 (11.1 %) in the deep ligaments only. The most common tear site of the three components of the superficial deltoid and deep anterior tibiotalar ligaments was their proximal attachments (94 % and 91.7 % respectively), and that of the deep posterior tibiotalar ligament (pTTL) was its distal attachment (82.6 %). The common associated injuries were ankle fracture (63.9 %), syndesmosis tear (55.6 %), and lateral collateral ligament complex tear (44.4 %). All the components of the deltoid ligament were frequently torn in patients with ankle fractures (tibionavicular ligament, P = 0.009). The observed injury pattern of the deltoid ligament was complex and frequently associated with concomitant ankle pathology. The most common tear site of the superficial deltoid ligament was the medial malleolar attachment, whereas that of the deep pTTL was near its medial talar insertion. (orig.)

  20. Advanced imaging of the scapholunate ligamentous complex.

    Science.gov (United States)

    Shahabpour, Maryam; Staelens, Barbara; Van Overstraeten, Luc; De Maeseneer, Michel; Boulet, Cedric; De Mey, Johan; Scheerlinck, Thierry

    2015-12-01

    The scapholunate joint is one of the most involved in wrist injuries. Its stability depends on primary and secondary stabilisers forming together the scapholunate complex. This ligamentous complex is often evaluated by wrist arthroscopy. To avoid surgery as diagnostic procedure, optimization of MR imaging parameters as use of three-dimensional (3D) sequences with very thin slices and high spatial resolution, is needed to detect lesions of the intrinsic and extrinsic ligaments of the scapholunate complex. The paper reviews the literature on imaging of radial-sided carpal ligaments with advanced computed tomographic arthrography (CTA) and magnetic resonance arthrography (MRA) to evaluate the scapholunate complex. Anatomy and pathology of the ligamentous complex are described and illustrated with CTA, MRA and corresponding arthroscopy. Sprains, mid-substance tears, avulsions and fibrous infiltrations of carpal ligaments could be identified on CTA and MRA images using 3D fat-saturated PD and 3D DESS (dual echo with steady-state precession) sequences with 0.5-mm-thick slices. Imaging signs of scapholunate complex pathology include: discontinuity, nonvisualization, changes in signal intensity, contrast extravasation (MRA), contour irregularity and waviness and periligamentous infiltration by edema, granulation tissue or fibrosis. Based on this preliminary experience, we believe that 3 T MRA using 3D sequences with 0.5-mm-thick slices and multiplanar reconstructions is capable to evaluate the scapholunate complex and could help to reduce the number of diagnostic arthroscopies.

  1. Longitudinal ligaments of the lumbar spine

    International Nuclear Information System (INIS)

    The diagnosis of disruption of the posterior longitudinal ligament in disk herniation is important in deciding between surgical or percutaneous management of HNP. The normal ligaments studied on spine specimens are better seen on long repetition time (TR), short echo time (TE) images and appear as linear structures with very low signal intensity on all pulse sequences surrounding the outer anulus. The authors prospectively imaged 20 HNPs in 18 patients who underwent surgery. In eight cases, the posterior longitudinal ligament was seen intact around the HNP on both short TR, short TE and long TR, short TE images. All were subligamentous at surgery. MR imaging demonstrated disruption of the longitudinal ligament in ten cases because of interruption, absence around the disk fragment, or interposition between disk and fragment. The ligament was disrupted at surgery in only eight of these cases. The two false-positive images showed a pseudointerruption related to a chemical shift antifact. The two remaining studies were qualified as questionable. The overall sensitivity of MR imaging was 100%, and its specificity was 77%

  2. Advanced imaging of the scapholunate ligamentous complex

    Energy Technology Data Exchange (ETDEWEB)

    Shahabpour, Maryam; Maeseneer, Michel de; Boulet, Cedric; Mey, Johan de [Universitair Ziekenhuis Brussel (UZ Brussel), Department of Radiology, Brussels (Belgium); Staelens, Barbara; Scheerlinck, Thierry [Universitair Ziekenhuis Brussel (UZ Brussel), Department of Orthopaedics and Traumatology, Brussels (Belgium); Overstraeten, Luc van [Hand and Foot Surgery Unit (HFSU), Tournai (Belgium)

    2015-12-15

    The scapholunate joint is one of the most involved in wrist injuries. Its stability depends on primary and secondary stabilisers forming together the scapholunate complex. This ligamentous complex is often evaluated by wrist arthroscopy. To avoid surgery as diagnostic procedure, optimization of MR imaging parameters as use of three-dimensional (3D) sequences with very thin slices and high spatial resolution, is needed to detect lesions of the intrinsic and extrinsic ligaments of the scapholunate complex. The paper reviews the literature on imaging of radial-sided carpal ligaments with advanced computed tomographic arthrography (CTA) and magnetic resonance arthrography (MRA) to evaluate the scapholunate complex. Anatomy and pathology of the ligamentous complex are described and illustrated with CTA, MRA and corresponding arthroscopy. Sprains, mid-substance tears, avulsions and fibrous infiltrations of carpal ligaments could be identified on CTA and MRA images using 3D fat-saturated PD and 3D DESS (dual echo with steady-state precession) sequences with 0.5-mm-thick slices. Imaging signs of scapholunate complex pathology include: discontinuity, nonvisualization, changes in signal intensity, contrast extravasation (MRA), contour irregularity and waviness and periligamentous infiltration by edema, granulation tissue or fibrosis. Based on this preliminary experience, we believe that 3 T MRA using 3D sequences with 0.5-mm-thick slices and multiplanar reconstructions is capable to evaluate the scapholunate complex and could help to reduce the number of diagnostic arthroscopies. (orig.)

  3. Characteristics of bone tunnel changes after anterior cruciate ligament reconstruction using Ligament Advanced Reinforcement System artificial ligament

    Institute of Scientific and Technical Information of China (English)

    HUANG Jian-ming; LIU Hao-yuan; CHEN Feng-rong; JIAN Guo-jian; CHEN Qi; WANG Zi-min; KANG Yi-fan

    2012-01-01

    Background There are different materials used for anterior cruciate ligament(ACL)reconstruction.It has been reported that both autologous grafts and allografts used in ACL reconstruction can cause bone tunnel enlargement.This study aimed to observe the characteristics of bone tunnel changes and possible causative factors following ACL reconstruction using Ligament Advanced Reinforcement System(LARS)artificial ligament.Methods Forty-three patients underwent ACL reconstruction using LARS artificial ligament and were followed up for 3 years.X-ray and CT examinations were performed at 1,3,6,12,24,and 36 months after surgery,to measure the width of tibial and femoral tunnels.Knee function was evaluated according to the Lysholm scoring system.The anterior and posterior stability of the knee was measured using the KT-1000 arthrometer.Results According to the Peyrache grading method,grade 1 femoral bone tunnel enlargement was observed in three cases six months after surgery.No grade 2 or grade 3 bone tunnel enlargement was found.The bone tunnel enlargement in the three cases was close to the articular surface with an average tunnel enlargement of(2.5±0.3)mm.Forty cases were evaluated as grade 0.The average tibial and femoral tunnel enlargements at the last follow-up were(0.8±0.3)and(1.1±0.3)mm,respectively.There was no statistically significant difference in bone tunnel width changes at different time points(P>0.05).X-ray and CT measurements were consistent.Conclusions There was no marked bone tunnel enlargement immediately following ACL reconstruction using LARS artificial ligament.Such enlargement may,however,result from varying grafting factors involving the LARS artificial ligament or from different fixation methods.

  4. Bone-patellar tendon-bone autograft versus LARS artificial ligament for anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Pan, Xiaoyun; Wen, Hong; Wang, Lide; Ge, Tichi

    2013-10-01

    The optimized graft for use in anterior cruciate ligament (ACL) reconstruction is still in controversy. The bone-patellar tendon-bone (BPTB) autograft has been accepted as the gold standard for ACL reconstruction. However, donor site morbidities cannot be avoided after this treatment. The artificial ligament of ligament advanced reinforcement system (LARS) has been recommended for ACL reconstruction. The purpose of this study is to compare the midterm outcome of ACL reconstruction using BPTB autografts or LARS ligaments. Between July 2004 and March 2006, the ACL reconstruction using BPTB autografts in 30 patients and LARS ligaments in 32 patients was performed. All patients were followed up for at least 4 years and evaluated using the Lysholm knee score, Tegner score, International Knee Documentation Committee (IKDC) score, and KT-1000 arthrometer test. There were no significant differences between the two groups with respect to the data of Lysholm scores, Tegner scores, IKDC scores, and KT-1000 arthrometer test at the latest follow-up. Our study demonstrates that the similarly good clinical results are obtained after ACL reconstruction using BPTB autografts or LARS ligaments at midterm follow-up. In addition to BPTB autografts, the LARS ligament may be a satisfactory treatment option for ACL rupture.

  5. MRI of injuries to the first interosseous cuneometatarsal (Lisfranc) ligament

    Energy Technology Data Exchange (ETDEWEB)

    MacMahon, P.J.; Kavanagh, E.C. [Mater Misericordiae University Hospital, Department of Radiology, Dublin 7 (Ireland); Dheer, S.; Morrison, W.B.; Zoga, A. [Thomas Jefferson University Hospital, Department of Radiology, Philadelphia, PA (United States); Raikin, S.M.; Elias, I. [Thomas Jefferson University Hospital, Rothman Institute, Philadelphia, PA (United States)

    2009-03-15

    The objective of this study was to assess the utility of MRI in diagnosing injury to the first interosseous cuneometatarsal (Lisfranc) ligament and to additionally determine the associated patterns of traumatic soft tissue and osseous injury. Fifteen patients (16 feet) who were referred for MRI evaluation of the Lisfranc ligament, and had operative exploration or examination under anesthesia, were included for analysis. Standard non-contrast MRI foot imaging was performed in all cases. Evaluation of the following components was performed: the dorsal and plantar bundles of the Lisfranc ligament, the plantar tarsal metatarsal ligaments, soft tissue edema and fluid, and bone marrow edema and fractures. Surgical reports were regarded as the reference standard in all cases. Seven of 10 cases of grade 3 Lisfranc ligament injuries at surgery were correctly graded at MRI. No cases of surgically proven complete Lisfranc ligament tears (grade 3) were interpreted as normal at MRI. All Lisfranc ligament sprains (grade 2 or 3) at surgery were detected at MRI. Two of six cases reported as grade 1 injuries at MRI were normal at surgery. No cases of surgically proven normal or sprained Lisfranc ligaments were interpreted as grade 3 tears on MRI. Four of six of our cases of normal or sprained Lisfranc ligaments demonstrated fractures; while the minority of complete Lisfranc ligament tears (3/10) contained fractures. MRI is reasonably accurate at detecting traumatic injury to the Lisfranc ligament. However, in clinically suspected cases of traumatic Lisfranc ligament injury, true positive rate for sprain is low. (orig.)

  6. Lateral ligamentous injury to the carpus of a racing Greyhound

    International Nuclear Information System (INIS)

    The lateral collateral ligament of the ulna and the dorsolateral ligaments of the radiocarpal joint of a racing Greyhound were ruptured, resulting in instability of the carpus when the joint was flexed. This report describes a technique for making a ligament prosthesis, using the ulnaris lateralis tendon. Although the dog did not return to racing, the carpus was stable enough for general activity

  7. Surgical treatment of anterior cruciate ligament injury in adults.

    Science.gov (United States)

    Alazzawi, Sulaiman; Sukeik, Mohamed; Ibrahim, Mazin; Haddad, Fares S

    2016-04-01

    Anterior cruciate ligament injury is among the most common soft tissue injuries of the knee joint and reconstruction of the anterior cruciate ligament is the gold standard treatment for young active symptomatic patients. This review summarizes the surgical treatment of anterior cruciate ligament injury.

  8. Characterization of the anatomy of the anterolateral ligament of the knee using magnetic resonance imaging

    International Nuclear Information System (INIS)

    The anterolateral ligament (ALL) may limit tibial internal rotation and pivot-shift following anterior cruciate ligament reconstruction. Previous studies, using magnetic resonance imaging (MRI) to identify this structure, have been inconsistent. We aimed to further characterize the anatomy of this ligament with reference to previous work. Institutional Review Board approval was gained and a retrospective study of 154 consecutive 1.5-T MRI studies was performed by a consultant musculoskeletal radiologist. Cases with a lateral compartment or cruciate injury and patients under 16 years were excluded. A total of 100 MRIs (98 patients; 63 males: 35 females; mean age, 45.3 years, range, 16-85 years) were included in the study. The ALL was visualized partially in 94 (94.0 %) of the cases and fully with distinct femoral and tibial fibers in 57 (57.0 %) of the cases. Although the femoral origin was discreet in only 57 (57.0 %) of cases, the tibial insertion (7.64 ± 1.26 mm below the joint-line) and meniscal attachment were demonstrated in all cases where the ligament was seen. Where the femoral origin was not seen, a broad expansion of the ligament was noted. We identified four types of meniscal attachment (complete, central, bipolar, and inferior-only). The thickness of the ALL, at the level of the joint-line, was 1.75 ± 0.57 mm. The ALL is a consistent structure with meniscal and tibial portions identifiable in the majority of MRI studies of the uninjured knee. There is an attachment to the lateral meniscus with anatomical variation described by our subclassification. (orig.)

  9. Characterization of the anatomy of the anterolateral ligament of the knee using magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kosy, Jonathan D.; Mandalia, Vipul I.; Anaspure, Rahul [Royal Devon and Exeter Hospital, Princess Elizabeth Orthopaedic Centre, Exeter (United Kingdom)

    2015-11-15

    The anterolateral ligament (ALL) may limit tibial internal rotation and pivot-shift following anterior cruciate ligament reconstruction. Previous studies, using magnetic resonance imaging (MRI) to identify this structure, have been inconsistent. We aimed to further characterize the anatomy of this ligament with reference to previous work. Institutional Review Board approval was gained and a retrospective study of 154 consecutive 1.5-T MRI studies was performed by a consultant musculoskeletal radiologist. Cases with a lateral compartment or cruciate injury and patients under 16 years were excluded. A total of 100 MRIs (98 patients; 63 males: 35 females; mean age, 45.3 years, range, 16-85 years) were included in the study. The ALL was visualized partially in 94 (94.0 %) of the cases and fully with distinct femoral and tibial fibers in 57 (57.0 %) of the cases. Although the femoral origin was discreet in only 57 (57.0 %) of cases, the tibial insertion (7.64 ± 1.26 mm below the joint-line) and meniscal attachment were demonstrated in all cases where the ligament was seen. Where the femoral origin was not seen, a broad expansion of the ligament was noted. We identified four types of meniscal attachment (complete, central, bipolar, and inferior-only). The thickness of the ALL, at the level of the joint-line, was 1.75 ± 0.57 mm. The ALL is a consistent structure with meniscal and tibial portions identifiable in the majority of MRI studies of the uninjured knee. There is an attachment to the lateral meniscus with anatomical variation described by our subclassification. (orig.)

  10. MR imaging of posterior cruciate ligament injuries

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Nobuyuki [Tsukuba Univ., Ibaraki (Japan). Hospital; Niitsu, Mamoru; Itai, Yuji; Sato, Motohiro; Kujiraoka, Yuka; Ikeda, Kotaro; Kanamori, Akihiro

    2001-07-01

    Posterior cruciate ligament (PCL) injuries are less frequent than anterior cruciate ligament (ACL) injuries, but are presumably more common than once thought. Thirty-nine patients with PCL injuries identified on MR images were studied. The criteria for PCL injury were complete tear, partial tear, and avulsion fracture. The approximate site of a partial tear was categorized as proximal, midsubstance, distal, or combination. Fourteen patients (35.9%) had complete tears of the PCL, 21 patients (53.8%) had partial tears, and four patients (10.3%) had avulsion fractures. A total of 12 patients (30.7%) had isolated PCL injuries, while the remaining 27 patients demonstrated evidence of other coexistent knee injuries, such as meniscal tears and ligamentous injuries. Of coexistent knee injuries, meniscal tears (18 patients, 46.2%) were most often seen. (author)

  11. MR imaging of posterior cruciate ligament injuries

    International Nuclear Information System (INIS)

    Posterior cruciate ligament (PCL) injuries are less frequent than anterior cruciate ligament (ACL) injuries, but are presumably more common than once thought. Thirty-nine patients with PCL injuries identified on MR images were studied. The criteria for PCL injury were complete tear, partial tear, and avulsion fracture. The approximate site of a partial tear was categorized as proximal, midsubstance, distal, or combination. Fourteen patients (35.9%) had complete tears of the PCL, 21 patients (53.8%) had partial tears, and four patients (10.3%) had avulsion fractures. A total of 12 patients (30.7%) had isolated PCL injuries, while the remaining 27 patients demonstrated evidence of other coexistent knee injuries, such as meniscal tears and ligamentous injuries. Of coexistent knee injuries, meniscal tears (18 patients, 46.2%) were most often seen. (author)

  12. [Trauma sequalae after complex knee ligament injuries].

    Science.gov (United States)

    Jagodzinski, M; Ettinger, M; Liodakis, E; Hawi, N; Petri, M; Krettek, C

    2013-05-01

    Complex ligament injuries can compromise a knee joint and residual conditions comprise stiffness (arthrofibrosis), instability, cartilage damage leading to osteoarthritis and bone deformity. Accurate diagnosis must address the direction and extent of the instability, the severity of any cartilage lesion and an analysis of the axis and bone deformity as well as important cofactors. Therapeutic options are adhesiolysis, ligament reconstruction, cartilage regeneration and axis correction. As a consequence patients mostly profit from the procedure but there is never a return to the functional level that existed before injury. PMID:23604338

  13. Biological fixation in anterior cruciate ligament surgery

    Directory of Open Access Journals (Sweden)

    Chih-Hwa Chen

    2014-04-01

    Full Text Available Successful anterior cruciate ligament (ACL reconstruction with tendon graft requires extensive tendon-to-bone healing in the bone tunnels and progressive graft ligamentization for biological, structural, and functional recovery of the ACL. Improvement in graft-to-bone healing is crucial for facilitating early, aggressive rehabilitation after surgery to ensure an early return to pre-injury activity levels. The use of various biomaterials for enhancing the healing of tendon grafts in bone tunnels has been developed. With the biological enhancement of tendon-to-bone healing, biological fixation of the tendon graft in the tunnel can be achieved in ACL reconstruction.

  14. Cruciate ligament loading during common knee rehabilitation exercises.

    Science.gov (United States)

    Escamilla, Rafael F; Macleod, Toran D; Wilk, Kevin E; Paulos, Lonnie; Andrews, James R

    2012-09-01

    Cruciate ligament injuries are common and may lead to dysfunction if not rehabilitated. Understanding how to progress anterior cruciate ligament and posterior cruciate ligament loading, early after injury or reconstruction, helps clinicians prescribe rehabilitation exercises in a safe manner to enhance recovery. Commonly prescribed therapeutic exercises include both weight-bearing exercise and non-weight-bearing exercise. This review was written to summarize and provide an update on the available literature on cruciate ligament loading during commonly used therapeutic exercises. In general, weight-bearing exercise produces smaller loads on the anterior cruciate ligament and posterior cruciate ligament compared with non-weight-bearing exercise. The anterior cruciate ligament is loaded less at higher knee angles (i.e. 50-100 degrees). Squatting and lunging with a more forward trunk tilt and moving the resistance pad proximally on the leg during the seated knee extension unloads the anterior cruciate ligament. The posterior cruciate ligament is less loaded at lower knee angles (i.e. 0-50 degrees), and may be progressed from level ground walking to a one-leg squat, lunges, wall squat, leg press, and the two-leg squat (from smallest to greatest). Exercise type and technique variation affect cruciate ligament loading, such that the clinician may prescribe therapeutic exercises to progress ligament loading safely, while ensuring optimal recovery of the musculoskeletal system. PMID:23025167

  15. Image-anatomic research of the alar ligament

    International Nuclear Information System (INIS)

    Objective: To detect position and morphous as well as coursing of the alar ligament, and to further investigate the sectional anatomy and CT and MRI imaging of the alar ligament. Methods: Twelve formalin fixed specimens including head and neck utilized, three of the twelve were observed in gross anatomy, nine of them were dissectioned. Fifty- one healthy volunteers from each group were selected to perform CT and MRI examination respectively. By combining gross and sectional anatomy. CT and MRI manifestations of the alar ligament were analyzed, the alar ligament width was measured. Results: Location and shape, as well as coursing of the alar ligament could be demonstrated clearly in gross and sectional anatomy. The transverse plane across the upper dens and the coronal plane by the middle dens were the optimal planes for demonstrating the alar ligament. The display ratio of the alar ligament was even 100% (51/51) in both images of CT and MRI. MRI had better advantages than CT in respect of demonstrating the alar ligament, PDWI (proton density weighted imaging, PDWI) is the most optimal sequence for the alar ligament. There were no significant differences of the alar ligament width between male and female and between the right and the left side (P>0.05). Conclusion: In combination with gross and sectional anatomy. CT and MRI could both provide an imageo-anatomic basis for diagnosis of the alar ligament trauma and malformation as well as infection. (authors)

  16. MR imaging features of chronically torn anterior cruciate ligament

    Energy Technology Data Exchange (ETDEWEB)

    Niitsu, Mamoru; Kuramochi, Masashi; Ikeda, Kotaroh; Fukubayashi, Tohru; Anno, Izumi; Itai, Yuji [Tsukuba Univ., Ibaraki (Japan). Inst. of Clinical Medicine

    1995-06-01

    Magnetic resonance (MR) images of 40 knee joints with arthroscopically proved chronic anterior cruciate ligament (ACL) tears were retrospectively evaluated. MRI demonstrated various features of chronic ACL tears: 19 knees revealed with no identifiable ligamentous structure, and 21 had residual ligamentous structures. These pseudoligaments, 14 discontinuous bands and seven continuous bands with elongation, were residual torn ligamentous fibers and/or synovial tissues. All the discontinuous bands were disrupted from the femoral attachment and were likely to traverse the lower intercondylar space. Six disrupted ligaments were attached to the lateral aspect of the posterior cruciate ligament (PCL). Coronal T2{sup *}-weighted gradient echo images showed better delineation of the disrupted femoral attachment and adhesion to the PCL. A chronic ACL tear with minimal elongation or with PCL attachment at a higher position may occasionally be difficult to distinguish from an intact ligament. (author).

  17. MR imaging features of chronically torn anterior cruciate ligament

    International Nuclear Information System (INIS)

    Magnetic resonance (MR) images of 40 knee joints with arthroscopically proved chronic anterior cruciate ligament (ACL) tears were retrospectively evaluated. MRI demonstrated various features of chronic ACL tears: 19 knees revealed with no identifiable ligamentous structure, and 21 had residual ligamentous structures. These pseudoligaments, 14 discontinuous bands and seven continuous bands with elongation, were residual torn ligamentous fibers and/or synovial tissues. All the discontinuous bands were disrupted from the femoral attachment and were likely to traverse the lower intercondylar space. Six disrupted ligaments were attached to the lateral aspect of the posterior cruciate ligament (PCL). Coronal T2*-weighted gradient echo images showed better delineation of the disrupted femoral attachment and adhesion to the PCL. A chronic ACL tear with minimal elongation or with PCL attachment at a higher position may occasionally be difficult to distinguish from an intact ligament. (author)

  18. MR imaging of cruciate ligament injury of the knee

    International Nuclear Information System (INIS)

    Diagnostic accuracy of MRI in cruciate ligament injury of the knee was evaluated on 41 knees which were confirmed by means of arthroscopy or arthrotomy. Normal and abnormal conditions of both anterior and posterior cruciate ligaments were correctly identified in 40 of 41 knees (98%). Diagnostic criteria of ligament injury on MRI were as follows: (1) interruption or discontinuity with a partially retained normal morphology of the ligament, (2) expansion or retraction of the width of the ligament, and (3) complete loss of the normal morphology of the ligament. T1-weighted sagittal images alone were satisfactory for diagnosis and additional proton and T2-weighted images were considered to be unnecessary in most cases. MR imaging is a reliable method for the detection of the cruciate ligament injury of the knee. (author)

  19. Nontuberculous mycobacterial pulmonary disease mimicking lung cancer

    Science.gov (United States)

    Hong, Su Jin; Kim, Tae Jung; Lee, Jae-Ho; Park, Jeong-Soo

    2016-01-01

    Abstract To describe the features and clinical implications of computed tomography (CT), positron emission tomography (PET), and percutaneous needle aspiration biopsy (PCNB) in pulmonary nontuberculous mycobacterial (NTM) disease manifesting as a solitary nodule, mass, or mass-like consolidation mimicking malignancy. Among a cohort of 388 patients with NTM pulmonary disease, 14 patients with clinically and radiologically suspected lung cancer were included in our study. Two chest radiologists evaluated CT features, including lesion type (nodule, mass, or mass-like consolidation), morphologic features (margin, degree of enhancement, calcification), and presence of accompanying findings suggestive of NTM pulmonary disease (bronchiectasis with clustered centrilobular nodules or upper-lobe cavitary lesions) by consensus. Diagnostic procedures for microbiologic diagnosis of NTM disease and clinical outcome were reviewed. Incidence of NTM pulmonary disease presenting as solitary nodule/mass (n = 8) or mass-like consolidation (n = 6) was 3.6% (14 of 388). Most lesions were detected incidentally during routine health check-up or evaluation of other disease (11 of 14, 79%). Lesions typically showed poor contrast-enhancement (9 of 12) and internal calcification (6 of 14). No lesions had CT features suggestive of NTM pulmonary disease. All 4 lesions for which PET/CT imaging was performed showed strong fluorodeoxyglucose uptake simulating malignant lesions (mean, 4.9; range, 3.6–7.8). PCNB revealed mycobacterial histology in 6 of 11 specimens and positive culture results were obtained for 7 of 7 specimens. NTM pulmonary disease may present as a solitary nodule, mass, or mass-like consolidation mimicking malignancy. CT features and PCNB are important to diagnose NTM disease mimicking lung cancer to avoid unnecessary surgery. PMID:27367996

  20. Reconstruction of the Scapholunate Ligament Using Capitohamate Bone-Ligament-Bone.

    Science.gov (United States)

    Nakamura, Toshiyasu; Abe, Koji; Iwamoto, Takuji; Ochi, Kensuke; Sato, Kazuki

    2015-11-01

    Background The biomechanical properties of the capitohamate (CH) ligament are equivalent to those of the scapholunate (SL) interosseous ligament. We reconstructed the SL ligament using the CH bone-ligament-bone substitute for chronic injury of the SL ligament. Patients and Methods Beginning in 2008, 15 wrists of 14 patients with an average age of 38 years underwent this procedure with a minimum follow-up of 2 years. Thirteen wrists had an SL joint gap more than 3 mm, and two had a complete SL ligament disruption with a severe dorsal intercalated segment instability (DISI) deformity. Kirschner wires (K-wires) were removed 8 weeks after the surgery, then active ROM exercise began. Pain (on visual analog scale [VAS]), wrist motion (angle), radiographic characteristics, such as SL gap (mm) and SL angle, and Modified Mayo Wrist Score (MMWS) were evaluated. Technique The SL joint was reduced by manipulation or with the use of joysticks, then temporary fixed with K-wires. A dorsal trough was then made between the scaphoid and the lunate. The proximal half of the CH ligament was harvested with attached bone from the capitate and hamate (CH bone-ligament-bone), inset into the SL trough, and fixed firmly with 1.2-mm diameter titanium screws in the scaphoid and lunate, respectively. Results The VAS improved from 77 preoperatively to 12 postoperatively. The average wrist extension/flexion was 74°/60°. There was no ossification of the reconstructed SL at the final follow-up. The SL gap improved from an average of 4.8 mm to an average of 2.1 mm, and the SL angle changed from 67° to 55°. The MMWS improved to 82 points postoperatively from a preoperative average of 47 with eight excellent, five good, and two fair results.

  1. Actinomycosis mimicking recurrent carcinoma after Whipple's operation

    Institute of Scientific and Technical Information of China (English)

    Jun-Te Hsu; Hung-Chieh Lo; Yi-Yin Jan; Han-Ming Chen

    2005-01-01

    Actinomycosis is a rare, chronic, spreading, suppurative,granulomatous and fibrosing infection. Actinomyces are normal inhabitants of the oral cavity and gastrointestinal tract. They rarely cause disease and are seldom reported as pathogens. Herein, we reported on a 69-year-old male patient who had undergone Whipple's operation due to ampulla Vater carcinoma, and became infected with actinomycosis at the pancreaticojejunostomy, which mimicked a recurrent malignancy. He was treated with radical resection of the mass at the pancreaticojejunostomy and had an uneventful postoperative course.

  2. Post-pancreatitis Fat Necrosis Mimicking Carcinomatosis.

    Science.gov (United States)

    Smith, Joshua P; Arnoletti, J Pablo; Varadarajulu, Shyam; Morgan, Desiree E

    2008-01-01

    Acute pancreatitis can result in retroperitoneal fat necrosis, typically occurring in the peripancreatic region, with extension into the transverse mesocolon, omentum and mesenteric root. When evaluated with contrast enhanced computed tomography (CECT), acute peripancreatic post necrotic collections typically become lower in attenuation over time, and often appear as homogeneous fluid collections. Saponification as a complication of fat necrosis in patients with acute pancreatitis is a well recognized clinical entity. While retroperitonal fat necrosis is commonly seen on CECT, saponification is not a prominent imaging feature. We present a case of acute pancreatitis complicated by extensive saponification of fat throughout the retroperitoneum and peritoneal lining, mimicking carcinomatosis.

  3. Injury of the ankle joint ligaments

    International Nuclear Information System (INIS)

    The diagnosis of lateral collateral ankle ligament trauma is based on patient history, clinical examination and clinical stress tests. If the clinical stress test is positive, stress radiography can be performed. There is, however, no consensus about the usefulness of stress radiography in acute ankle sprain, and in particular about the cut-off talar tilt angle beyond which a two-ligament rupture would be certain, ranging from 5 to 30 . Today, magnetic resonance imaging (MRI) is not used in this area, although it does allow controlled positioning of the foot and defined section visualization of injured lateral collateral ankle ligaments. In acute and chronic sinus tarsi injuries, MRI forms the established basis for diagnostic imaging, and can provide a definitive answer in most cases. MRI is also the method of choice for chronic posttraumatic pain with anterolateral impingement after rupture of the anterior talofibular ligament. Generally, for the evaluation of acute ankle injuries, MRI has developed to be the most important second-step procedure when projection radiology is non-diagnostic. (orig.)

  4. MR imaging of posterior cruciate ligament injury

    International Nuclear Information System (INIS)

    There is increasing awareness of the clinical importance of early detection and treatment of posterior cruciate ligament(PCL) injury. We evaluate the usefulness of Magnetic resonance(MR) imaging in the diagnosis of PCL injury. We retrospectively analysed the MR images of 140 cases with clinically suspected knee injury. Arthroscopic or surgical correlation was available in 63 cases. We observed the finding and extent of PCL injury and other associated abnormalities. The frequency of anterior and posterior meniscofemoral ligament was evaluated. Eleven PCL injuries were observed, six midsubstance tears, two tibial attachment tears, two femoral attachment tear, one laxity. The sensitivity, specificity and accuracy of MR imaging diagnosis are 100%, 98.1%, 98.4%. MR findings of PCL injury are discontinuity and focal mass formation, irregular increased signal intensity, detachment or redundancy of the ligament with avulsed bony fragment. In all cases of injured PCL, other associated abnormalities of adjacent structures were observed. Accessory anterior and posterior meniscofemoral ligaments were observed in 67.4%(87/129). MR imaging is useful in evaluation of presence or absence of PCL injury, accurate extent of PCL injury and other important associated abnormalities of adjacent structures

  5. Causes of anterior cruciate ligament injuries

    Directory of Open Access Journals (Sweden)

    Ristić Vladimir

    2010-01-01

    Full Text Available In order to prevent anterior cruciate ligament injuries it is necessary to define risk factors and to analyze the most frequent causes of injuries - that being the aim of this study. The study sample consisted of 451 surgically treated patients, including 400 sportsmen (65% of them being active and 35% recreational sportsmen, 29% female and 71% male; of whom 90% were younger than 35. Sports injuries, as the most frequent cause of anterior cruciate ligament injuries, were recorded in 88% of patients (non-contact ones in 78% and contact ones in 22%, injuries occurring in everyday activities in 11% and in traffic in 1%. Among sportsmen, reconstruction of the anterior cruciate ligament was most frequently performed in football players (48%, then in handball players (22%, basketball players (13%, volleyball players (8%, martial arts fighters (4%. However, the injury incidence was the highest among the active basketball players (1 injured among 91 active players. Type of footwear, warming up before the activity, genetic predisposition and everyday therapy did not have a significant influence on getting injured. Anterior cruciate ligament injuries happened three times more often during matches, in the middle and at the end of a match and training session (79%, at landing after the jump or when changing direction of movement (75% without a contact with other competitors, on dry surfaces (79%, among not so well prepared sportsmen.

  6. [Posterior longitudinal ligament ossification: case report].

    Science.gov (United States)

    Tella, Oswaldo Inácio de; Herculano, Marco Antonio; Paiva Neto, Manoel Antonio; Faedo Neto, Atílio; Crosera, João Francisco

    2006-03-01

    Posterior longitudinal ligament ossification of cervical spine is a rare condition among caucasians. A 42 years old japanese patient with progressive walking difficulty was diagnosed with this pathology by CT scan and MRI and treated surgically by an anterior approach with arthrodesis. Pathophysiology, racial prevalence, clinical picture, radiological characteristics and surgical approaches options are revised.

  7. Treatment for acute anterior cruciate ligament tear

    DEFF Research Database (Denmark)

    Frobell, Richard B; Roos, Harald P; Roos, Ewa M;

    2013-01-01

    To compare, in young active adults with an acute anterior cruciate ligament (ACL) tear, the mid-term (five year) patient reported and radiographic outcomes between those treated with rehabilitation plus early ACL reconstruction and those treated with rehabilitation and optional delayed ACL...

  8. Tunnel widening in anterior cruciate ligament reconstruction

    DEFF Research Database (Denmark)

    Clatworthy, M G; Annear, P; Bulow, J U;

    1999-01-01

    We report a prospective series evaluating the incidence and degree of tunnel widening in a well-matched series of patients receiving a hamstring or patella tendon graft for anterior cruciate ligament (ACL) deficiency. We correlated tunnel widening with clinical factors, knee scores, KT-1000...

  9. Guideline on anterior cruciate ligament injury

    NARCIS (Netherlands)

    Meuffels, Duncan E; Poldervaart, Michelle T; Diercks, Ronald; Fievez, Alex W F M; Patt, Thomas W; Hart, Cor P van der; Hammacher, Eric R; Meer, Fred van der; Goedhart, Edwin A; Lenssen, Anton F; Muller-Ploeger, Sabrina B; Pols, Margreet A; Saris, Daniel B F

    2012-01-01

    The Dutch Orthopaedic Association has a long tradition of development of practical clinical guidelines. Here we present the recommendations from the multidisciplinary clinical guideline working group for anterior cruciate ligament injury. The following 8 clinical questions were formulated by a steer

  10. Novel Insights into Anterior Cruciate Ligament Injury

    NARCIS (Netherlands)

    D.E. Meuffels (Duncan)

    2011-01-01

    textabstractAnterior cruciate ligament (ACL) injury is one of the most common sports injuries of the knee. ACL reconstruction has become, standard orthopaedic practice worldwide with an estimated 175,000 reconstructions per year in the United States.6 The ACL remains the most frequently studied liga

  11. Treatment for acute anterior cruciate ligament tear

    DEFF Research Database (Denmark)

    Frobell, Richard B; Roos, Harald P; Roos, Ewa M;

    2015-01-01

    STUDY QUESTION: In young active adults with an acute anterior cruciate ligament (ACL) rupture, do patient reported or radiographic outcomes after five years differ between those treated with rehabilitation plus early ACL reconstruction and those treated with rehabilitation and optional delayed ACL...

  12. Mimicked Web Page Detection over Internet

    Directory of Open Access Journals (Sweden)

    Y. Narasimha Rao

    2014-01-01

    Full Text Available Phishing is process of steeling valuable information such as ATM pins, Credit card details over internet. Where the attacker creates mimicked web pages from the legitimate web pages to fool users. In this paper, we propose an effective anti-phishing solution, by combining image based visual similarity based approach to detect plagiarized web pages. We used effective algorithms for our detection mechanism, speeded up Robust Features (SURF algorithm in order to generate signature based on extracting stable key points from the screen shot of the web page. When a legitimate web page is registered with our system, this algorithm applied on that web page in order to generate signatures, and these signatures are stored in the database for our trained system. When there is a suspected web page, this algorithm is applied to generate both the signatures of the suspected page and is verified against our database of corresponding legitimate web pages. Our results verified that our proposed system is very effective to detect the mimicked web pages with minimal false positives

  13. Inflammatory Myofibroblastic Tumor Mimicking Apical Periodontitis.

    Science.gov (United States)

    Adachi, Makoto; Kiho, Kazuki; Sekine, Genta; Ohta, Takahisa; Matsubara, Makoto; Yoshida, Takakazu; Katsumata, Akitoshi; Tanuma, Jun-ichi; Sumitomo, Shinichiro

    2015-12-01

    Inflammatory myofibroblastic tumors (IMTs) are rare. IMTs of the head and neck occur in all age groups, from neonates to old age, with the highest incidence occurring in childhood and early adulthood. An IMT has been defined as a histologically distinctive lesion of uncertain behavior. This article describes an unusual case of IMT mimicking apical periodontitis in the mandible of a 42-year-old man. At first presentation, the patient showed spontaneous pain and percussion pain at teeth #28 to 30, which continued after initial endodontic treatment. Panoramic radiography revealed a radiolucent lesion at the site. Cone-beam computed tomographic imaging showed osteolytic lesions, suggesting an aggressive neoplasm requiring incisional biopsy. Histopathological examination indicated an IMT. The lesion was removed en bloc under general anesthesia, and the patient manifested no clinical evidence of recurrence for 24 months. Lesions of nonendodontic origin should be included in the differential diagnosis of apical periodontitis. Every available diagnostic tool should be used to confirm the diagnosis. Cone-beam computed tomographic imaging is very helpful for differential diagnosis in IMTs mimicking apical periodontitis. PMID:26602450

  14. Mimicking Seawater For Culturing Marine Bacteria

    DEFF Research Database (Denmark)

    Rygaard, Anita Mac; Sonnenschein, Eva; Gram, Lone;

    2015-01-01

    Only about 1% of marine bacteria have been brought into culture using traditional techniques. The purpose of this study was to investigate if mimicking the natural bacterial environment can increase culturability.We used marine substrates containing defined algal polymers or gellan gum as solidif......Only about 1% of marine bacteria have been brought into culture using traditional techniques. The purpose of this study was to investigate if mimicking the natural bacterial environment can increase culturability.We used marine substrates containing defined algal polymers or gellan gum...... as solidifying agents, and enumerated bacteria from seawater and algal exudates. We tested if culturability could be influenced by addition of quorum sensing signals (AHLs). All plates were incubated at 15°C. Bacterial counts (CFU/g) from algal exudates from brown algae were highest on media containing algal...... polymers. In general, bacteria isolated from algal exudates preferred more rich media than bacteria isolated from seawater. Overall, culturability ranged from 0.01 to 0.8% as compared to total cell count. Substitution of agar with gellan gum increased the culturability of seawater bacteria approximately...

  15. The ligament augmentation device: an historical perspective.

    Science.gov (United States)

    Kumar, K; Maffulli, N

    1999-05-01

    Anterior cruciate ligament (ACL) injury is the most common ligament injury in the knee, and a significant number of patients may develop progressive instability and disability despite aggressive rehabilitation. Various materials have been used for its reconstruction. These include autografts, allografts, prosthetic ligaments, and synthetic augmentation of the biological tissue. The concept of ligament augmentation device (LAD) arose from the observation that biological grafts undergo a phase of degeneration and loss of strength before being incorporated. The LAD is meant to protect the biological graft during this vulnerable phase. However, it provokes an inflammatory reaction in the knee, and has been found to delay maturation of autogenous graft in humans. In experimental situations, the LAD has been found to share loads in a composite graft. It has also been found to be substantially stronger than the biological graft. However, in clinical situations no significant advantages have been observed with the use of LAD to augment patellar tendon or hamstring reconstruction of the chronic ACL-deficient knee or in the acute setting to augment repair of the torn ACL. There are very few reports of the use of LAD in reconstruction of the posterior cruciate ligament, and again these do not suggest any advantage in its use. Insertion of the LAD implies the introduction of a foreign material into the knee, has been associated with complications such as reactive synovitis and effusions, and may also be associated with an increased risk of infection. At present, there is no evidence that its routine use should be advocated in uncomplicated reconstructions of the ACL using biological grafts.

  16. The ligament augmentation device: an historical perspective.

    Science.gov (United States)

    Kumar, K; Maffulli, N

    1999-05-01

    Anterior cruciate ligament (ACL) injury is the most common ligament injury in the knee, and a significant number of patients may develop progressive instability and disability despite aggressive rehabilitation. Various materials have been used for its reconstruction. These include autografts, allografts, prosthetic ligaments, and synthetic augmentation of the biological tissue. The concept of ligament augmentation device (LAD) arose from the observation that biological grafts undergo a phase of degeneration and loss of strength before being incorporated. The LAD is meant to protect the biological graft during this vulnerable phase. However, it provokes an inflammatory reaction in the knee, and has been found to delay maturation of autogenous graft in humans. In experimental situations, the LAD has been found to share loads in a composite graft. It has also been found to be substantially stronger than the biological graft. However, in clinical situations no significant advantages have been observed with the use of LAD to augment patellar tendon or hamstring reconstruction of the chronic ACL-deficient knee or in the acute setting to augment repair of the torn ACL. There are very few reports of the use of LAD in reconstruction of the posterior cruciate ligament, and again these do not suggest any advantage in its use. Insertion of the LAD implies the introduction of a foreign material into the knee, has been associated with complications such as reactive synovitis and effusions, and may also be associated with an increased risk of infection. At present, there is no evidence that its routine use should be advocated in uncomplicated reconstructions of the ACL using biological grafts. PMID:10355719

  17. Neck ligament strength is decreased following whiplash trauma

    Science.gov (United States)

    Tominaga, Yasuhiro; Ndu, Anthony B; Coe, Marcus P; Valenson, Arnold J; Ivancic, Paul C; Ito, Shigeki; Rubin, Wolfgang; Panjabi, Manohar M

    2006-01-01

    Background Previous clinical studies have documented successful neck pain relief in whiplash patients using nerve block and radiofrequency ablation of facet joint afferents, including capsular ligament nerves. No previous study has documented injuries to the neck ligaments as determined by altered dynamic mechanical properties due to whiplash. The goal of the present study was to determine the dynamic mechanical properties of whiplash-exposed human cervical spine ligaments. Additionally, the present data were compared to previously reported control data. The ligaments included the anterior and posterior longitudinal, capsular, and interspinous and supraspinous ligaments, middle-third disc, and ligamentum flavum. Methods A total of 98 bone-ligament-bone specimens (C2–C3 to C7-T1) were prepared from six cervical spines following 3.5, 5, 6.5, and 8 g rear impacts and pre- and post-impact flexibility testing. The specimens were elongated to failure at a peak rate of 725 (SD 95) mm/s. Failure force, elongation, and energy absorbed, as well as stiffness were determined. The mechanical properties were statistically compared among ligaments, and to the control data (significance level: P < 0.05; trend: P < 0.1). The average physiological ligament elongation was determined using a mathematical model. Results For all whiplash-exposed ligaments, the average failure elongation exceeded the average physiological elongation. The highest average failure force of 204.6 N was observed in the ligamentum flavum, significantly greater than in middle-third disc and interspinous and supraspinous ligaments. The highest average failure elongation of 4.9 mm was observed in the interspinous and supraspinous ligaments, significantly greater than in the anterior longitudinal ligament, middle-third disc, and ligamentum flavum. The average energy absorbed ranged from 0.04 J by the middle-third disc to 0.44 J by the capsular ligament. The ligamentum flavum was the stiffest ligament, while the

  18. Ligament-induced sacral fractures of the pelvis are possible.

    Science.gov (United States)

    Steinke, Hanno; Hammer, Niels; Lingslebe, Uwe; Höch, Andreas; Klink, Thomas; Böhme, Jörg

    2014-07-01

    Pelvic ring stability is maintained passively by both the osseous and the ligamentous apparatus. Therapeutic approaches focus mainly on fracture patterns, so ligaments are often neglected. When they rupture along with the bone after pelvic ring fractures, disrupting stability, ligaments need to be considered during reconstruction and rehabilitation. Our aim was to determine the influence of ligaments on open-book injury using two experimental models with body donors. Mechanisms of bone avulsion related to open-book injury were investigated. Open-book injuries were induced in human pelves and subsequently investigated by anatomical dissection and endoscopy. The findings were compared to CT and MRI scans of open-book injuries. Relevant structures were further analyzed using plastinated cross-sections of the posterior pelvic ring. A fragment of the distal sacrum was observed, related to open-book injury. Two ligaments were found to be responsible for this avulsion phenomenon: the caudal portion of the anterior sacroiliac ligament and another ligament running along the ventral surface of the third sacral vertebra. The sacral fragment remained attached to the coxal bone by this second ligament after open-book injury. These results were validated using plastination and the structures were identified. Pelvic ligaments are probably involved in sacral avulsion caused by lateral traction. Therefore, ligaments should to be taken into account in diagnosis of open-book injury and subsequent therapy. PMID:24452928

  19. Value of 13-MHz high-frequency ultrasound of the lateral ankle ligaments and the anterior tibiofibular ligament

    International Nuclear Information System (INIS)

    Purpose: Determination of the value of 13-MHz high-frequency ultrasound in the diagnosis of acute injuries of the lateral ankle ligaments and the anterior tibiofibular ligament by comparison with MRI. Method: Sonography was performed prospectively in 64 acutely injured patients using a mechanical 13-MHz sector probe; for diagnosis of the anterior tibiofibular ligament a 15-MHz sector probe was employed during the course of this trial. Using a 0.2-T unit for MRI examination, T1-weighted (TR 580 ms, TE 24 ms) and T2-weighted (TR 3000 ms, TE 80 ms) spin-echo sequences were obtained in various oblique axial imaging planes. Results: In the differentiation of intact and injured ligaments, ultrasound and MRI agreed in 95.3/% of cases for the anterior fibulotalar ligament, in 88.3% for the fibulocalcanear ligament and in 85.0% for the anterior tibiofibular ligament. Conclusion: Lesions of the anterior talofibular and fibulocalcanear ligament can be accurately demonstrated by ultrasound if a 13-MHz sector scanner is used. The detection of lesions in the anterior tibiofibular ligament is more difficult. With increasing experience and by using a 15-MHz sector scanner, better results can be expected for this ligament. (orig.)

  20. Neck ligament strength is decreased following whiplash trauma

    Directory of Open Access Journals (Sweden)

    Rubin Wolfgang

    2006-12-01

    Full Text Available Abstract Background Previous clinical studies have documented successful neck pain relief in whiplash patients using nerve block and radiofrequency ablation of facet joint afferents, including capsular ligament nerves. No previous study has documented injuries to the neck ligaments as determined by altered dynamic mechanical properties due to whiplash. The goal of the present study was to determine the dynamic mechanical properties of whiplash-exposed human cervical spine ligaments. Additionally, the present data were compared to previously reported control data. The ligaments included the anterior and posterior longitudinal, capsular, and interspinous and supraspinous ligaments, middle-third disc, and ligamentum flavum. Methods A total of 98 bone-ligament-bone specimens (C2–C3 to C7-T1 were prepared from six cervical spines following 3.5, 5, 6.5, and 8 g rear impacts and pre- and post-impact flexibility testing. The specimens were elongated to failure at a peak rate of 725 (SD 95 mm/s. Failure force, elongation, and energy absorbed, as well as stiffness were determined. The mechanical properties were statistically compared among ligaments, and to the control data (significance level: P Results For all whiplash-exposed ligaments, the average failure elongation exceeded the average physiological elongation. The highest average failure force of 204.6 N was observed in the ligamentum flavum, significantly greater than in middle-third disc and interspinous and supraspinous ligaments. The highest average failure elongation of 4.9 mm was observed in the interspinous and supraspinous ligaments, significantly greater than in the anterior longitudinal ligament, middle-third disc, and ligamentum flavum. The average energy absorbed ranged from 0.04 J by the middle-third disc to 0.44 J by the capsular ligament. The ligamentum flavum was the stiffest ligament, while the interspinous and supraspinous ligaments were most flexible. The whiplash

  1. Proliferation of the human periodontal ligament fibroblast by laser biostimulation: an in vitro study

    Science.gov (United States)

    Shelly, Ahuja; Shaila, Kothiwale; Kishore, Bhat

    2006-02-01

    Laser produces a monochormatic collimated and coherent radiation. In dentistry, diode lasers have been used predominantly for application which are broadly termed "Low level laser therapy (LLLT) or biostimulation (L.J. Walch 1997)". Periodontal ligament fibroblast (PDLF) have a key function in periodontal regeneration. Stimulatory effects on the proliferation of these cells could therefore be beneficial for the reestablishment of connective tissue attachment. The aim of this in vitro study was to evaluate the potential stimulatory effect of low level laser irradiation on the proliferation of PDLF.

  2. Integrating Hot and Cool Intelligences: Thinking Broadly about Broad Abilities

    Directory of Open Access Journals (Sweden)

    W. Joel Schneider

    2016-01-01

    Full Text Available Although results from factor-analytic studies of the broad, second-stratum abilities of human intelligence have been fairly consistent for decades, the list of broad abilities is far from complete, much less understood. We propose criteria by which the list of broad abilities could be amended and envision alternatives for how our understanding of the hot intelligences (abilities involving emotionally-salient information and cool intelligences (abilities involving perceptual processing and logical reasoning might be integrated into a coherent theoretical framework.

  3. MRI of injuries of the lateral ankle ligaments

    International Nuclear Information System (INIS)

    The most frequent sport injury of the ankle is located in the lateral ankle ligaments. The diagnosis of lateral collateral ankle ligament trauma is based on patient history, clinical examination, and stress radiography, allowing a fair diagnosis for the daily routine. For the direct visualization and precise diagnosis of the lateral ankle ligaments MRI provides the best answer. MRI is used with controlled positioning of the foot, correct angulation of sequenzes, and distinct analysis of MR findings. Sinus tarsi ligaments and ligaments of the distal syndesmosis should be included to the report. In selected patients MRI allows the best evaluation of the extent of the lateral ankle ligaments. MRI is the method of choice for combined osteochondral injuries and soft tissue lesions too. (orig.)

  4. CARTILAGE-LIKE PHENOMENON IN THE ANTERIOR CRUCIATE LIGAMENT

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective. To detect histological characteristic of anterior cruciate ligament (ACL) and medial collateral ligament (MCL). Methods. In each of 20 skeletally mature male mongrels and 4 men, the ACL and MCL were examined by standard hematoxylin-eosin procedure and toluidine blue staining for histologic observation. Results. The fibroblasts in medial collateral are elongated to spindle shape and aligned in a row between the bundles of collagenous fibers. Toluidine blue staining is negative. The anterior cruciate ligament demonstrated more heterogenous cell types and arrangement. It had three major cell forms:spindle, round and ovoid type, which were shorter but greater than the cells in medial collateral ligament. Toluidine blue staining was positive in anterior cruciate ligament. Most cells in anterior cruciate ligament were enclosed within lacunae. Conclusion. This study suggests that the ACL has different histological characteristics from MCL, and is more cartilage-like in nature.

  5. CARTILAGE-LIKE PHENOMENON IN THE ANTERIOR CRUCIATE LIGAMENT

    Institute of Scientific and Technical Information of China (English)

    蒋青; 林共周; 典绵域; 崔国庆; 滕华建

    2001-01-01

    Objective. To detect histological characteristic of anterior cruciate ligament (ACL) and medial collateral ligament (MCL). Methods. In each of 20 skeletally mature male mongrels and 4 men, the ACL and MCL were examined by standard hematoxylin-eosin procedure and toluidine blue staining for histologic observation. Results. The fibroblasts in medial collateral are elongated to spindle shape and aligned in a row between the bundles of collagenous fibers. Toluidine blue staining is negative. The anterior cruciate ligament demonstrated more heterogenous cell types and arrangement. It had three major cell forms: spindle, round and ovoid type,which were shorter but greater than the cells in medial collateral ligament. Toluidine blue staining was positive in anterior cruciate ligament. Most cells in anterior cruciate ligament were enclosed within lacunae. Conclusion. This study suggests that the ACL has different histological characteristics from MCL, and is more cartilage-like in nature.

  6. Orthokeratinised odontogenic cyst mimicking periapical cyst.

    Science.gov (United States)

    Rajalakshmi, R; Sreeja, C; Vijayalakshmi, D; Leelarani, V

    2013-01-01

    Orthokeratinised odontogenic cyst (OOC) denotes the odontogenic cyst that microscopically has an orthokeratinised epithelial lining. OOC is characterised by a less-aggressive behaviour and a low rate of recurrence. This report describes a case of OOC involving posterior part of the mandible that mimicked periapical cyst in a 14-year-old boy. The initial clinical diagnosis was given as periapical cyst based on the clinical and radiographical features. Enucleation of the cyst was performed and the specimen was sent for histopathological examination. A definite diagnosis of OOC was made by histopathological examination of the biopsy specimen. This case emphases on including OOC in the differential diagnosis of radiolucencies occurring in the periapical region of non-vital tooth. PMID:24099763

  7. Prolonged acute hepatitis A mimicking autoimmune hepatitis

    Institute of Scientific and Technical Information of China (English)

    Rintaro Mikata; Osamu Yokosuka; Fumio Imazeki; Kenichi Fukai; Tatsuo Kanda; Hiromitsu Saisho

    2005-01-01

    AIM: We report a case with a prolonged course of hepatitisA, with alanine aminotransferase (ALT) higher than 500 IU/Lfor more than 2 mo.METHODS: A middle-aged woman had an elevated IgG level of more than 2 000 mg/dL, positive arti-nudear antibodies (ANA) and anti-smooth muscle antibodies (ASMA), but no evidence of persistent hepatitis A virus (HAV) infection. Liver biopsy findings were compatible with prolonged acute hepatitis, although acute onset of autoimmune hepatitis could not be ruled out.RESULTS: It was assumed that she developed a course of hepatitis similar to autoimmune hepatitis triggered by HAV infection. Ursodeoxycholic acid (UDCA) treatment was initiated and a favorable outcome was obtained. CONCLUSION: We describe a case of a middle-aged woman who showed a prolonged course of acute hepatitis A mimicking autoimmune hepatitis. Treatment with UDCAproved to be effective.

  8. A subtle mimicker in emergency department

    Science.gov (United States)

    Angelis, Maria Vittoria De; Giacomo, Roberta Di; Muzio, Antonio Di; Onofrj, Marco; Bonanni, Laura

    2016-01-01

    Abstract Background: Movement disorder emergencies include any movement disorder which develops over hours to days, in which failure to appropriately diagnose and manage can result in patient morbidity or mortality. Movement disorder emergencies include acute dystonia: sustained or intermittent muscle contractions causing abnormal, often repetitive, movements. Acute dystonia is a serious challenge for emergency room doctors and neurologists, because of the high probability of misdiagnosis, due to the presence of several mimickers including partial seizures, meningitis, localized tetanus, serum electrolyte level abnormalities, strychnine poisoning, angioedema, malingering, catatonia, and conversion. Methods: We describe 2 examples, accompanied by videos, of acute drug-induced oro-mandibular dystonia, both subsequent to occasional haloperidol intake. Results: Management and treatment of this movement disorder are often difficult: neuroleptics withdrawal, treatment with benzodiazepines, and anticholinergics are recommended. Conclusion: Alternative treatment options are also discussed. PMID:27741141

  9. Case report. Pityriasis versicolor mimicking Pityriasis rotunda.

    Science.gov (United States)

    Aste, Nicola; Pau, Monica; Aste, Natalia; Biggio, P

    2002-04-01

    Pityriasis versicolor is a common dermatomycosis, occurring throughout the world, characterized by irregular, slightly scaly patches, varying in color from red/light brown to white. Pityriasis rotunda, on the other hand, is an uncommon disease, reported in specific ethnic groups, and characterized by perfectly round or oval patches of varying color, with a scaly surface. The histologic pattern is that of ichthyosis vulgaris. We report here the case of a male patient, aged 31, from Sardinia (Italy), affected by Pityriasis versicolor mimicking Pityriasis rotunda. Mycological examination allowed us to formulate the correct diagnosis, and ensuing treatment with antifungal drugs was entirely successful. The authors, while pointing out the rarity of this case, stress the possibility that Pityriasis versicolor mimics Pityriasis rotunda and vice-versa, especially in those countries in which the two diseases are endemic. More widespread recourse to microscopic examination can help avoid the risk of mistaken diagnosis and consequent incorrect treatment.

  10. Contiguous spinal metastasis mimicking infectious spondylodiscitis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Chul Min; Lee, Seung Hun [Dept. of Radiology, Hanyang University Hospital, Seoul (Korea, Republic of); Bae, Ji Yoon [Dept. of Pathology, National Police Hospital, Seoul (Korea, Republic of)

    2015-12-15

    Differential diagnosis between spinal metastasis and infectious spondylodiscitis is one of the occasional challenges in daily clinical practice. We encountered an unusual case of spinal metastasis in a 75-year-old female breast cancer patient that mimicked infectious spondylodiscitis. Magnetic resonance imaging (MRI) showed diffuse bone marrow infiltrations with paraspinal soft tissue infiltrative changes in 5 contiguous cervical vertebrae without significant compression fracture or cortical destruction. These MRI findings made it difficult to differentiate between spinal metastasis and infectious spondylodiscitis. Infectious spondylodiscitis such as tuberculous spondylodiscitis was regarded as the more appropriate diagnosis due to the continuous involvement of > 5 cervical vertebrae. The patient's clinical presentation also supported the presumptive diagnosis of infectious spondylodiscitis rather than spinal metastasis. Intravenous antibiotics were administered, but clinical symptoms worsened despite treatment. After pathologic confirmation by computed tomography-guided biopsy, we were able to confirm a final diagnosis of spinal metastasis.

  11. EVENTRATION OF LEFT HEMIDIAPHRAGM MIMICKING AS CAVITY

    Directory of Open Access Journals (Sweden)

    Kansal

    2015-10-01

    Full Text Available Eventration of diaphragm is a condition in which there is abnormal elevation of the diaphragm as a result of thinning of muscular layer. It can be congenital as well as acquired. It is more common left sided. Herniation of the abdominal contents can be there. Clinical manifestations range from asymptomatic to life threatening respiratory distress requiring mechanical ventilator support. Ultrasound provides valuable information regarding the integrity of the diaphragm. Other imaging modalities include fluoroscopy, CT and MRI that provide valuable information when diagnosis is in doubt. We are presenting a case report of 25-year-old male with eventration of left hemidiaphragm mimicking as cavity. After taking detail history, examination and proper investigations we finally reached to this diagnosis.

  12. Neck ligament strength is decreased following whiplash trauma

    OpenAIRE

    Rubin Wolfgang; Ito Shigeki; Ivancic Paul C; Valenson Arnold J; Coe Marcus P; Ndu Anthony B; Tominaga Yasuhiro; Panjabi Manohar M

    2006-01-01

    Abstract Background Previous clinical studies have documented successful neck pain relief in whiplash patients using nerve block and radiofrequency ablation of facet joint afferents, including capsular ligament nerves. No previous study has documented injuries to the neck ligaments as determined by altered dynamic mechanical properties due to whiplash. The goal of the present study was to determine the dynamic mechanical properties of whiplash-exposed human cervical spine ligaments. Additiona...

  13. Optimal management of ulnar collateral ligament injury in baseball pitchers

    OpenAIRE

    Hibberd EE; Brown JR; Hoffer JT

    2015-01-01

    Elizabeth E Hibberd,1 J Rodney Brown,2 Joseph T Hoffer21Department of Health Science, The University of Alabama, Tuscaloosa, AL, USA; 2Department of Intercollegiate Athletics, The University of Alabama, Tuscaloosa, AL, USAAbstract: The ulnar collateral ligament stabilizes the elbow joint from valgus stress associated with the throwing motion. During baseball pitching, this ligament is subjected to tremendous stress and injury if the force on the ulnar collateral ligament during pitching excee...

  14. Understanding acute ankle ligamentous sprain injury in sports

    OpenAIRE

    Fong Daniel TP; Chan Yue-Yan; Mok Kam-Ming; Yung Patrick SH; Chan Kai-Ming

    2009-01-01

    Abstract This paper summarizes the current understanding on acute ankle sprain injury, which is the most common acute sport trauma, accounting for about 14% of all sport-related injuries. Among, 80% are ligamentous sprains caused by explosive inversion or supination. The injury motion often happens at the subtalar joint and tears the anterior talofibular ligament (ATFL) which possesses the lowest ultimate load among the lateral ligaments at the ankle. For extrinsic risk factors to ankle sprai...

  15. MR imaging of anterior cruciate ligament tears

    Energy Technology Data Exchange (ETDEWEB)

    Takaki, Kazuhiro; Tomari, Kazuhide; Asao, Tsunenori [Shinbeppu Hospital, Oita (Japan)

    1995-09-01

    To investigate magnetic resonance (MR) imaging of anterior cruciate ligament (ACL) tears, the authors retrospectively reviewed 39 MR imaging examinations in 39 patients. We classified the MR imaging patterns of the torn ACL into four types. Torn ACL appears as a homogeneous iso-intensity mass on Type I images; as a continuous thin and waving low-intensity band with or without high-signal-intensity spots on the Type II images; as a disrupted band with a high-signal-intensity area on Type III images and as an absence of the ACL on Type IV images. We also report secondary lesions on MR imaging findings associated with tears of the ACL, posterior cruciate ligament index and bone bruising, in our patients. (author).

  16. MR imaging of anterior cruciate ligament tears

    International Nuclear Information System (INIS)

    To investigate magnetic resonance (MR) imaging of anterior cruciate ligament (ACL) tears, the authors retrospectively reviewed 39 MR imaging examinations in 39 patients. We classified the MR imaging patterns of the torn ACL into four types. Torn ACL appears as a homogeneous iso-intensity mass on Type I images; as a continuous thin and waving low-intensity band with or without high-signal-intensity spots on the Type II images; as a disrupted band with a high-signal-intensity area on Type III images and as an absence of the ACL on Type IV images. We also report secondary lesions on MR imaging findings associated with tears of the ACL, posterior cruciate ligament index and bone bruising, in our patients. (author)

  17. Pseudocyclops: two cases of ACL graft partial tears mimicking cyclops lesions on MRI.

    Science.gov (United States)

    Simpfendorfer, Claus; Miniaci, Anthony; Subhas, Naveen; Winalski, Carl S; Ilaslan, Hakan

    2015-08-01

    Arthroscopic reconstruction of the anterior cruciate ligament (ACL) using autografts or allografts is a common surgical procedure, particularly in young athletes. Although the procedure has excellent success rates, complications such as mechanical impingement, graft rupture, and arthrofibrosis can occur, often necessitating additional surgery. Magnetic resonance (MR) imaging has become a valuable tool in evaluating complications after ACL reconstruction. We report two cases of ACL reconstruction complicated by arthroscopically proven partial graft tears. In both cases the torn anterior graft fibers were flipped into the intercondylar notch, mimicking anterior arthrofibrosis, i.e., a "cyclops lesion," on MR imaging. Careful review of the direction of graft fibers on MR imaging in the "pseudocyclops" lesions can help differentiate these partial tears from the fibrosis of a true cyclops. The "pseudocyclops" lesion is a previously undescribed MR imaging sign of partial ACL graft tear. Larger studies are required to determine the sensitivity and specificity of the sign, as well as the clinical importance of these partial graft tears. PMID:25620690

  18. Pseudocyclops: two cases of ACL graft partial tears mimicking cyclops lesions on MRI

    Energy Technology Data Exchange (ETDEWEB)

    Simpfendorfer, Claus; Subhas, Naveen; Winalski, Carl S.; Ilaslan, Hakan [Cleveland Clinic, Department of Radiology, Cleveland, OH (United States); Miniaci, Anthony [Cleveland Clinic, Department of Orthopedics, Cleveland, OH (United States)

    2015-08-15

    Arthroscopic reconstruction of the anterior cruciate ligament (ACL) using autografts or allografts is a common surgical procedure, particularly in young athletes. Although the procedure has excellent success rates, complications such as mechanical impingement, graft rupture, and arthrofibrosis can occur, often necessitating additional surgery. Magnetic resonance (MR) imaging has become a valuable tool in evaluating complications after ACL reconstruction. We report two cases of ACL reconstruction complicated by arthroscopically proven partial graft tears. In both cases the torn anterior graft fibers were flipped into the intercondylar notch, mimicking anterior arthrofibrosis, i.e., a ''cyclops lesion,'' on MR imaging. Careful review of the direction of graft fibers on MR imaging in the ''pseudocyclops'' lesions can help differentiate these partial tears from the fibrosis of a true cyclops. The ''pseudocyclops'' lesion is a previously undescribed MR imaging sign of partial ACL graft tear. Larger studies are required to determine the sensitivity and specificity of the sign, as well as the clinical importance of these partial graft tears. (orig.)

  19. Psychological Aspects of Anterior Cruciate Ligament Injuries

    OpenAIRE

    Ardern, Clare; Kvist, Joanna; Webster, Kate E.

    2016-01-01

    Impairment-based evaluation has, until recently, been the mainstay of orthopaedic research in anterior cruciate ligament (ACL) reconstruction. However, participation-based outcomes, in particular returning to sport, have lately garnered increased research attention. This is important because returning to sport is typically a main concern of injured athletes. Recent metaanalyses have demonstrated that the return to sport rate after ACL reconstruction is disappointingly low, and that a range of...

  20. Ulnar nerve entrapment by anconeus epitrochlearis ligament.

    LENUS (Irish Health Repository)

    Tiong, William H C

    2012-01-01

    Ulnar nerve entrapment at the elbow is the second most common upper limb entrapment neuropathy other than carpal tunnel syndrome. There have been many causes identified ranging from chronic aging joint changes to inflammatory conditions or systemic disorders. Among them, uncommon anatomical variants accounts for a small number of cases. Here, we report our experience in managing ulnar nerve entrapment caused by a rare vestigial structure, anconeus epitrochlearis ligament, and provide a brief review of the literature of its management.

  1. Imaging of meniscus and ligament injuries of the knee.

    Science.gov (United States)

    Faruch-Bilfeld, M; Lapegue, F; Chiavassa, H; Sans, N

    2016-01-01

    Magnetic resonance imaging has now an indisputable role for the diagnosis of meniscus and ligament injuries of the knee. Some technical advances have improved the diagnostic capabilities of magnetic resonance imaging so that diagnoses, which may change the therapeutic approach, such as a partial tear of the anterior cruciate ligament or confirmation of unstable meniscal injuries, are now made easier. This article describes the essential about magnetic resonance imaging technique and pathological results for the menisci, collateral ligaments and damage to the central pivot of the cruciate knee ligaments. PMID:27452631

  2. Management of Intercarpal Ligament Injuries Associated with Distal Radius Fractures.

    Science.gov (United States)

    Desai, Mihir J; Kamal, Robin N; Richard, Marc J

    2015-08-01

    The prevalence of ligamentous injury associated with fractures of the distal radius is reported to be as high as 69% with injury to the scapholunate interosseous ligament and lunotriquetral interosseous ligament occurring in 16% to 40% and 8.5% to 15%, respectively. There is a lack of consensus on which patients should undergo advanced imaging, arthroscopy, and treatment and whether this changes their natural history. Overall, patients with high-grade intercarpal ligament injuries are shown to have longer-term disability and sequelae compared with those with lower-grade injuries. This article reviews the diagnosis and treatment options for these injuries. PMID:26205702

  3. Anterior cruciate ligament reconstruction using the bone-posterior cruciate ligament-bone allograft

    Institute of Scientific and Technical Information of China (English)

    JIAO Chen; AO Ying-fang; LIU Ping; XIE Xing; LIU Chen; MA Yong

    2013-01-01

    Background AIIografts were widely used in anterior cruciate ligament (ACL) reconstruction for patients with ACL rupture of the knee.This study was to approve the feasibility of bone-posterior cruciate ligament-bone (BPCLB) allograft transplantation in ACL reconstruction.Methods Eight patients underwent ACL reconstructions with BPCLB allografts and were followed up for an average period of 32 months after operation.Results Subjective parameters including Intemational Knee Documentation Committee (IKDC),modified Larson knee ligament,Lysholm,and Tegner rating scales were much improved and side to side KT-2000 arthrometer difference was much less postoperatively.Pivot shift test was negative in all patients.The reconstructed ACL had satisfactory shape and tension.Conclusions BPCLB allograft is an optional choice forACL reconstruction.

  4. Minimally Invasive Anterolateral Ligament Reconstruction in the Setting of Anterior Cruciate Ligament Injury.

    Science.gov (United States)

    Sonnery-Cottet, Bertrand; Barbosa, Nuno Camelo; Tuteja, Sanesh; Daggett, Matt; Kajetanek, Charles; Thaunat, Mathieu

    2016-02-01

    Recent evidence on the anatomy, function, and biomechanical properties of the anterolateral ligament has led to the recognition of the importance of this structure in the rotational control of the knee. This article describes a technique that allows for minimally invasive anterolateral ligament reconstruction as a complement to most techniques of anterior cruciate ligament reconstruction. A gracilis tendon autograft is harvested and prepared in a double-strand, inverted V-shaped graft. The graft is percutaneously placed through a femoral stab incision, and each strand is then passed deep to the iliotibial band, emerging through each tibial stab incision. After the femoral-end loop graft is fixed, the tibial fixation of each strand is performed in full extension for optimal isometry. PMID:27274456

  5. Posttraumatic incarceration of medial collateral ligament into knee joint with anterior cruciate ligament injury

    Institute of Scientific and Technical Information of China (English)

    Sunil Gurpur Kini; Karel du Pre; Warwick Bruce

    2015-01-01

    Medial collateral ligament of the knee is an important coronal stabiliser and often injured in isolation or as combination of injuries.The article reports a case of incarcerated medial collateral ligament (MCL) injury in combination with anterior cruciate ligament (ACL) injury in 20 year old male who presented to us 4 weeks after injury.Clinical examination and MRI was correlated to complete ACL tear with torn distal MCL and incarceration into the joint.Patient was taken up for ACL hamstring graft reconstruction with mini-arthrotomy and repair of the torn MCL.Patient was followed up with dedicated rehabilitation protocol with good functional results.At one year follow-up, patient exhibited full range of motion with negative Lachman, Pivot shift and valgus stress tests.This article highlights the rare pattern of MCL tear and also reviews the literature on this pattern of injury.

  6. Cruciate ligament reconstruction using LARS artificial ligament under arthroscopy: 81 cases report

    Institute of Scientific and Technical Information of China (English)

    HUANG Jian-ming; WANG Qian; SHEN Feng; WANG Zi-min; KANG Yi-fan

    2010-01-01

    Background There are many different materials used for ligament reconstruction. Currently, autograft, allograft, and artificial ligaments are used in the reconstruction. The objective of this study was to explore the clinical result of cruciate ligament reconstruction under arthroscopy.Methods Eighty-one cases were reconstructed with the LARS ligament under arthroscopy, including 43 cases of anterior cruciate ligament (ACL) injury, 20 cases of posterior cruciate ligament (PCL) injury, and 18 cases of ACL combined with PCL injuries of the knee. The follow up period was 10 to 49 months. The International Knee Documentation Committee (IKDC) and Lysholm knee score scales were used for functional evaluation. We examined the anterior and posterior stability of the knee with KT-1000.Results According to the Lysholm knee function score scale, the average preoperative score of (44.6±1.4) increased to a postoperative score of (82.8±2.5) in the ACL group and from (46.6±2.3) to (80.8±2.0) in the PCL group. In the ACL combined with PCL injury group, the preoperative score increased from (45.2±1.2) to (85.5±2.3). According to IKDC score standards, in ACL group we evaluated 19 cases as C and 24 cases as D, preoperatively, and postoperatively 27 cases as A, 14 cases as B and two cases as C. In the preoperative PCL group, we had 11 cases defined as C and nine cases as D that resolved to 12 cases as A, seven as B and one case of C in postoperative evaluation. In the ACL combined with PCL injury group we defined four cases as C and 14 as D during preoperative scoring. These patients had postoperative grades of six cases as A, 10 as B, and two cases as C. All of the results have statistical significance. Conclusions ACL, PCL, or combined ACL and PCL reconstruction using the LARS ligament under arthroscopy is a minimally invasive, safe and effective method to treat cruciate ligament injuries of the knee. Clinical results are satisfactory in the short term.

  7. Reconstruction of anterior cruciate ligament and anterolateral ligament using interlinked hamstrings - technical note.

    Science.gov (United States)

    Ferreira, Marcio de Castro; Zidan, Flavio Ferreira; Miduati, Francini Belluci; Fortuna, Caio Cesar; Mizutani, Bruno Moreira; Abdalla, Rene Jorge

    2016-01-01

    Recent anatomical and biomechanical studies on the anterolateral ligament (ALL) of the knee have shown that this structure has an important function in relation to joint stability, especially when associated with anterior cruciate ligament (ACL) injury. However, the criteria for its reconstruction have not yet been fully established and the surgical techniques that have been described present variations regarding anatomical points and fixation materials. This study presents a reproducible technique for ALL and ACL reconstruction using hamstring tendons, in which three interference screws are used for fixation.

  8. Reconstruction of anterior cruciate ligament and anterolateral ligament using interlinked hamstrings - technical note.

    Science.gov (United States)

    Ferreira, Marcio de Castro; Zidan, Flavio Ferreira; Miduati, Francini Belluci; Fortuna, Caio Cesar; Mizutani, Bruno Moreira; Abdalla, Rene Jorge

    2016-01-01

    Recent anatomical and biomechanical studies on the anterolateral ligament (ALL) of the knee have shown that this structure has an important function in relation to joint stability, especially when associated with anterior cruciate ligament (ACL) injury. However, the criteria for its reconstruction have not yet been fully established and the surgical techniques that have been described present variations regarding anatomical points and fixation materials. This study presents a reproducible technique for ALL and ACL reconstruction using hamstring tendons, in which three interference screws are used for fixation. PMID:27517028

  9. High prevalence of anterolateral ligament abnormalities in magnetic resonance images of anterior cruciate ligament-injured knees.

    Science.gov (United States)

    Claes, Steven; Bartholomeeusen, Stijn; Bellemans, Johan

    2014-03-01

    The purpose of this study was to identify the newly described anterolateral ligament of the human knee on magnetic resonance imaging and to describe its eventual radiological abnormalities in anterior cruciate ligament-injured subjects. A retrospective cohort study on a series of consecutive subjects undergoing anterior cruciate ligament reconstructive surgery was performed. The MR images of 206 included knees were studied and the status of the anterolateral ligament status was judged to be either "non-visualized", "normal" or "abnormal". Of all the visualized anterolateral ligaments, 44 (21.3%) were considered uninjured, while 162 (78.8%) knees demonstrated radiological ALL abnormalities. The majority of ALL abnormalities were situated in the distal part of the ligament (77.8%). In conclusion, the anterolateral ligament can be identified on classic knee magnetic resonance images. Although anterior cruciate ligament injured subjects often demonstrated associated anterolateral ligament lesions, further research is needed in order to establish the clinical relevance of these highly frequent radiological abnormalities. PMID:24873084

  10. Immunoglobulin G4 -related kidney disease: A comprehensive pictorial review of the imaging spectrum, Mimickers, and clinicopathological characteristics

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Ni Eun; Kim, Jin Hee; Byun, Jae Ho; Lee, Seung Soo; Kim, Hyoung Jung; Lee, Moon Gyu [Dept. of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2015-10-15

    Immunoglobulin G4 (IgG4)-related kidney disease (IgG4-KD) has recently been demonstrated to be an important part of IgG4-related sclerosing disease (IgG4-SD). However, since IgG4-KD is still relatively unfamiliar to radiologists and physicians as compared to IgG4-SD involving other organs, it could, therefore, be easily missed. In this article, we present a comprehensive pictorial review of IgG4-KD with regards to the imaging spectrum, mimickers, and clinicopathologic characteristics, based on our clinical experience with 48 patients during the past 13 years, as well as a literature review. Awareness of the broad imaging spectrum of IgG4-KD and differential diagnosis from its mimickers will thus facilitate its early diagnosis and treatment.

  11. Hyperdense dots mimicking microcalcifications : Mammographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Nam Hyeon; Park, Jeong Mi; Goo, Hyun Woo; Bang, Sun Woo [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    1996-12-01

    To differentiate fine hyperdense dots mimicking microcalcifications from true microcalcifications on mammography. Mammograms showing hyperdense dots in ten patients (mean age, 59 years) were evaluated. Two radiologists were asked to differentiate with the naked eye the hyperdense dots seen on ten mammograms and proven microcalcifications seen on ten mammograms. Densitometry was also performed for all lesions and the contrast index was calculated. The shape and distribution of the hyperdense dots were evaluated and enquires were made regarding any history of breast disease and corresponding treatment. Biopsies were performed for two patients with hyperdense dots. Two radiologists made correct diagnoses in 19/20 cases(95%). The contrast index was 0.10-0.88 (mean 0.58) for hyperdense dots and 0.02-0.45 (mean 0.17) for true microcalcifications. The hyperdense dots were finer and homogeneously rounder than the microcalcifications. Distribution of the hyperdense dots was more superficial in subcutaneous fat (seven cases) and subareolar area (six cases). All ten patients with hyperdense dots had history of mastitis and abscesses and had been treated by open drainage (six cases) and/or folk remedy (four cases). In eight patients, herb patches had been attached. Biopsies of hyperdense dots did not show any microcalcification or evidence of malignancy. These hyperdense dots were seen mainly in older patients. Their characteristic density, shape, distribution and clinical history makes differential diagnosis from true microcalcifications easy and could reduce unnecessary diagnostic procedures such as surgical biopsy.

  12. Hyperdense dots mimicking microcalcifications : Mammographic findings

    International Nuclear Information System (INIS)

    To differentiate fine hyperdense dots mimicking microcalcifications from true microcalcifications on mammography. Mammograms showing hyperdense dots in ten patients (mean age, 59 years) were evaluated. Two radiologists were asked to differentiate with the naked eye the hyperdense dots seen on ten mammograms and proven microcalcifications seen on ten mammograms. Densitometry was also performed for all lesions and the contrast index was calculated. The shape and distribution of the hyperdense dots were evaluated and enquires were made regarding any history of breast disease and corresponding treatment. Biopsies were performed for two patients with hyperdense dots. Two radiologists made correct diagnoses in 19/20 cases(95%). The contrast index was 0.10-0.88 (mean 0.58) for hyperdense dots and 0.02-0.45 (mean 0.17) for true microcalcifications. The hyperdense dots were finer and homogeneously rounder than the microcalcifications. Distribution of the hyperdense dots was more superficial in subcutaneous fat (seven cases) and subareolar area (six cases). All ten patients with hyperdense dots had history of mastitis and abscesses and had been treated by open drainage (six cases) and/or folk remedy (four cases). In eight patients, herb patches had been attached. Biopsies of hyperdense dots did not show any microcalcification or evidence of malignancy. These hyperdense dots were seen mainly in older patients. Their characteristic density, shape, distribution and clinical history makes differential diagnosis from true microcalcifications easy and could reduce unnecessary diagnostic procedures such as surgical biopsy

  13. Controlled Deposition of HAp Mimicking Tooth Enamel

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Chemical compositions and microsturcture of mature human tooth enamel were investigated by XRD , FTIR and SEM to further understand the characteristics of tooth enamel. In order to obtain apatite crystals chemically and structurally similar to those in tooth enamel, biomimetic way was employed. Selfassembled monolyers terminated with-SO3 H groups were used as deposition substrates and 1.5 SBF ( the concentrations of Ca2+ and PO43- ions 1.5 times than those in simulated body fluid ) with and without 5 ppm F- were used as soaking medium. The XRD and FTIR results showed that both the deposited fluoride-substituted hydroxyapatite( F-HAp ) crystals in 1.5 SBF with F- and hydroxyapatite ( HAp ) crystals in 1.5 SBF were carbonate-containing, mimicking human tooth enamel in chemical compositions. The SEM photos showed that needle-like F-HAp crystals bad large aspect ratios and grew in bundles, which were similar to the crystals in human tooth enamel.The results provide available information on dental restoration.

  14. Mimicking Bone - Chemical and Physical Challenges

    Directory of Open Access Journals (Sweden)

    Sophie C Cox

    2014-08-01

    Full Text Available It is known that chemical and physical features of bone contribute to its functionality, reactivity and mechanical performance. This fundamental rationale underpins the author’s research strategy. This paper presents a summary of efforts to fabricate a synthetic structure, referred to as a scaffold, that both chemically and physical emulates the intricate structure of bone. An understanding of key features of bone tissue that contribute to its remarkable properties is presented as a background to this work. Novel work aimed at improving the understanding of the synthesis of a ceramic biomaterial, namely hydroxyapatite, that is chemically similar to bone mineral is discussed. A case study involving the manufacture of porous scaffolds by 3D printing is also presented. In summary, this article highlights a number of on-going challenges that multidisciplinary tissue engineers aim to solve to get one step closer to mimicking bone, which clinically could improve the quality of life for millions of people worldwide.  Photo credit: By Doc. RNDr. Josef Reischig, CSc. (Author's archive [CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0], via Wikimedia Commons

  15. Microfabricated adhesive mimicking gecko foot-hair

    Science.gov (United States)

    Geim, A. K.; Dubonos, S. V.; Grigorieva, I. V.; Novoselov, K. S.; Zhukov, A. A.; Shapoval, S. Yu.

    2003-07-01

    The amazing climbing ability of geckos has attracted the interest of philosophers and scientists alike for centuries. However, only in the past few years has progress been made in understanding the mechanism behind this ability, which relies on submicrometre keratin hairs covering the soles of geckos. Each hair produces a miniscule force ~10-7 N (due to van der Waals and/or capillary interactions) but millions of hairs acting together create a formidable adhesion of ~10 N cm-2: sufficient to keep geckos firmly on their feet, even when upside down on a glass ceiling. It is very tempting to create a new type of adhesive by mimicking the gecko mechanism. Here we report on a prototype of such 'gecko tape' made by microfabrication of dense arrays of flexible plastic pillars, the geometry of which is optimized to ensure their collective adhesion. Our approach shows a way to manufacture self-cleaning, re-attachable dry adhesives, although problems related to their durability and mass production are yet to be resolved.

  16. Anterior Cruciate Ligament OsteoArthritis Score (ACLOAS)

    DEFF Research Database (Denmark)

    Roemer, Frank W; Frobell, Richard; Lohmander, Stefan;

    2014-01-01

    OBJECTIVE: To develop a whole joint scoring system, the Anterior Cruciate Ligament OsteoArthritis Score (ACLOAS), for magnetic resonance imaging (MRI)-based assessment of acute anterior cruciate ligament (ACL) injury and follow-up of structural sequelae, and to assess its reliability. DESIGN...

  17. Reconstruction of the Anterior Cruciate Ligament : Alternative Strategies

    NARCIS (Netherlands)

    van Eijk, F.

    2009-01-01

    This thesis describes the long-term results of reconstruction of the anterior cruciate ligament with an allograft. Due to the poor results found, further studies were performed to investigate alternative strategies for reconstruction of the anterior cruciate ligament in the field of tissue engineeri

  18. Triplane ankle fracture with deltoid ligament tear and syndesmotic disruption

    OpenAIRE

    Cummings, Robert Jay

    2008-01-01

    In patients with immature skeletons, ligamentous injuries rarely accompany ankle fractures. In this article, we report about deltoid ligament tears and syndesmotic disruptions accompanying triplane ankle fractures in two children, and make recommendations as to the evaluation and treatment of children with such injuries.

  19. Return to Play Following Anterior Cruciate Ligament Reconstruction.

    Science.gov (United States)

    Morris, Ryan C; Hulstyn, Michael J; Fleming, Braden C; Owens, Brett D; Fadale, Paul D

    2016-10-01

    Anterior cruciate ligament reconstructions are commonly performed in an attempt to return an athlete to sports activities. Accelerated rehabilitation has made recovery for surgery more predictable and shortened the timeline for return to play. Despite success with and advancements in anterior cruciate ligament reconstructions, some athletes still fail to return to play. PMID:27543405

  20. Reconstruction of the Anterior Cruciate Ligament : Alternative Strategies

    OpenAIRE

    Eijk, F. van

    2009-01-01

    This thesis describes the long-term results of reconstruction of the anterior cruciate ligament with an allograft. Due to the poor results found, further studies were performed to investigate alternative strategies for reconstruction of the anterior cruciate ligament in the field of tissue engineering.

  1. Bilateral agenesis of the anterior cruciate ligament: MRI evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Bedoya, Maria A.; Jaramillo, Diego [The Children' s Hospital of Philadelphia, Radiology Department, Philadelphia, PA (United States); McGraw, Michael H. [Hospitalof theUniversityof Pennsylvania, Divisionof Orthopaedics, Philadelphia, PA (United States); Wells, Lawrence [The Children' s Hospital of Philadelphia, Division of Orthopaedics, Philadelphia, PA (United States)

    2014-09-15

    Bilateral agenesis of the anterior cruciate ligament (ACL) is extremely rare. We describe a 13-year-old girl who presented with bilateral knee pain without history of trauma; she has two family members with knee instability. Magnetic resonance imaging showed bilateral absence of the ACL, and medial posterior horn meniscal tears. Bilateral arthroscopic partial meniscectomy and anterior cruciate ligament reconstruction was performed. (orig.)

  2. Features extraction in anterior and posterior cruciate ligaments analysis.

    Science.gov (United States)

    Zarychta, P

    2015-12-01

    The main aim of this research is finding the feature vectors of the anterior and posterior cruciate ligaments (ACL and PCL). These feature vectors have to clearly define the ligaments structure and make it easier to diagnose them. Extraction of feature vectors is obtained by analysis of both anterior and posterior cruciate ligaments. This procedure is performed after the extraction process of both ligaments. In the first stage in order to reduce the area of analysis a region of interest including cruciate ligaments (CL) is outlined in order to reduce the area of analysis. In this case, the fuzzy C-means algorithm with median modification helping to reduce blurred edges has been implemented. After finding the region of interest (ROI), the fuzzy connectedness procedure is performed. This procedure permits to extract the anterior and posterior cruciate ligament structures. In the last stage, on the basis of the extracted anterior and posterior cruciate ligament structures, 3-dimensional models of the anterior and posterior cruciate ligament are built and the feature vectors created. This methodology has been implemented in MATLAB and tested on clinical T1-weighted magnetic resonance imaging (MRI) slices of the knee joint. The 3D display is based on the Visualization Toolkit (VTK).

  3. The normal anterior cruciate ligament as a model for tensioning strategies in anterior cruciate ligament grafts

    NARCIS (Netherlands)

    Arnold, MP; Verdonschot, N; van Kampen, A

    2005-01-01

    Background: There is some confusion about the relationship between the tension placed on the graft and the joint position used in the fixation of anterior cruciate ligament grafts. This is because of deficiency in accurate basic science about this important interaction in the normal and reconstructe

  4. The normal anterior cruciate ligament as a model for tensioning strategies in anterior cruciate ligament grafts.

    NARCIS (Netherlands)

    Arnold, M.P.; Verdonschot, N.J.J.; Kampen, A. van

    2005-01-01

    BACKGROUND: There is some confusion about the relationship between the tension placed on the graft and the joint position used in the fixation of anterior cruciate ligament grafts. This is because of deficiency in accurate basic science about this important interaction in the normal and reconstructe

  5. Infrasellar craniopharyngioma mimicking a clival chordoma : a case report.

    Directory of Open Access Journals (Sweden)

    Kachhara R

    2002-04-01

    Full Text Available An unusual case of entirely infrasellar craniopharyngioma mimicking a clival chordoma is described. Only 22 cases of craniopharyngioma with nasopharyngeal extension have been reported in the literature. Of the reported cases, most were primarily intracranial with secondary downward extension; only two were thought to originate from an infrasellar location. The present case is another example of an entirely infrasellar craniopharyngioma, with extensive clival destruction, mimicking a clival chordoma. Relevant literature on the subject is reviewed.

  6. Non-harmful insertion of data mimicking computer network attacks

    Science.gov (United States)

    Neil, Joshua Charles; Kent, Alexander; Hash, Jr, Curtis Lee

    2016-06-21

    Non-harmful data mimicking computer network attacks may be inserted in a computer network. Anomalous real network connections may be generated between a plurality of computing systems in the network. Data mimicking an attack may also be generated. The generated data may be transmitted between the plurality of computing systems using the real network connections and measured to determine whether an attack is detected.

  7. Mimicking Stem Cell Niches to Increase Stem Cell Expansion

    OpenAIRE

    Dellatore, Shara M.; Garcia, A. Sofia; Miller, William M.

    2008-01-01

    Niches regulate lineage-specific stem cell self-renewal vs. differentiation in vivo and are comprised of supportive cells and extracellular matrix components arranged in a 3-dimensional topography of controlled stiffness in the presence of oxygen and growth factor gradients. Mimicking stem cell niches in a defined manner will facilitate production of the large numbers of stem cells needed to realize the promise of regenerative medicine and gene therapy. Progress has been made in mimicking com...

  8. Atypical pyoderma gangrenosum mimicking an infectious process.

    Science.gov (United States)

    To, Derek; Wong, Aaron; Montessori, Valentina

    2014-01-01

    We present a patient with atypical pyoderma gangrenosum (APG), which involved the patient's arm and hand. Hemorrhagic bullae and progressive ulcerations were initially thought to be secondary to an infectious process, but a biopsy revealed PG. Awareness of APG by infectious disease services may prevent unnecessary use of broad-spectrum antibiotics. PMID:25024856

  9. Atypical Pyoderma Gangrenosum Mimicking an Infectious Process

    Directory of Open Access Journals (Sweden)

    Derek To

    2014-01-01

    Full Text Available We present a patient with atypical pyoderma gangrenosum (APG, which involved the patient’s arm and hand. Hemorrhagic bullae and progressive ulcerations were initially thought to be secondary to an infectious process, but a biopsy revealed PG. Awareness of APG by infectious disease services may prevent unnecessary use of broad-spectrum antibiotics.

  10. Characterization and role of the immune response during ligament healing

    Science.gov (United States)

    Chamberlain, Connie S.

    Scar formation of ligaments after rupture remains a great challenge. Ligament healing involves a complex, coordinated series of events that form a neo-ligament, which is more disorganized and fibrotic in character than the native tissue. The repair process may extend from months to years, and the injured ligament never fully recovers its original mechanical properties. With little intrinsic healing potential, ruptures of the anterior cruciate ligament (ACL) are usually reconstructed. The "healed" tissues, however, do not regenerate native tissues or recapitulate their mechanical function. ACL grafts often lengthen (incidents range from 40-100%) and their strength can drop by ˜50% after remodeling. Reconstructed knees are often less stable and fail to restore normal joint kinematics. Our overall goal is to improve healing, making ligaments more regenerative. The first 2 studies characterized ligament healing in a spatial and temporal manner over 28 days. The experiments demonstrated creeping substitution and the potential role of the immune system to control the repair and/or regenerative process. From these studies, macrophages were identified as significant players during healing. Macrophages paralleled creeping substitution, were abundant within the healing ligament, and potentially played a destructive role via matrix phagocytosis. The role of macrophages during early ligament healing was then evaluated using liposome-encapsulated clodronate to inhibit phagocytosing macrophages. Clodronate attenuated the early infiltration of macrophages, resulting in delayed structural and functional healing. Macrophage re-infiltration into the wound resulted in continued ligament healing. These results suggested that early inhibition of phagocytosing macrophages is detrimental to ligament healing. The final experiment evaluated the effects of interleukin-4 on ligament healing. Interleukin-4 (IL-4) is reported to stimulate the Th2 lymphocyte/M2 macrophage pathway, reducing

  11. Anterolateral Ligament Reconstruction Technique: An Anatomic-Based Approach.

    Science.gov (United States)

    Chahla, Jorge; Menge, Travis J; Mitchell, Justin J; Dean, Chase S; LaPrade, Robert F

    2016-06-01

    Restoration of anteroposterior laxity after an anterior cruciate ligament reconstruction has been predictable with traditional open and endoscopic techniques. However, anterolateral rotational stability has been difficult to achieve in a subset of patients, even with appropriate anatomic techniques. Therefore, differing techniques have attempted to address this rotational laxity by augmenting or reconstructing lateral-sided structures about the knee. In recent years, there has been a renewed interest in the anterolateral ligament as a potential contributor to residual anterolateral rotatory instability in anterior cruciate ligament-deficient patients. Numerous anatomic and biomechanical studies have been performed to further define the functional importance of the anterolateral ligament, highlighting the need for surgical techniques to address these injuries in the unstable knee. This article details our technique for an anatomic anterolateral ligament reconstruction using a semitendinosus tendon allograft. PMID:27656361

  12. Infections after reconstructions of anterior cruciate ligament

    Directory of Open Access Journals (Sweden)

    Ristić Vladimir

    2014-01-01

    Full Text Available Introduction. Infections after anterior cruciate ligament reconstructions are rare, but, on the other hand, they are difficult to be treated. The aim of this study was to analyze causes of infections, risk factors, diagnostics, and possibilities of their prevention. Material and Methods. Seventeen deep infections (1.2% were found in 1425 patients who had undergone anterior cruciate ligament reconstructions. Fifteen patients were males and two were females. Out of 475 professional athletes nine (1.9% had this postoperative complication. Eleven patients with septic arthritis were allergic to penicillin. Three of them had immunosuppressive diseases. Results. Staphylococcus aureus was isolated in eleven cases (65%, other Staphylococcus and Streptococcus groups were found in four and three patients, respectively; while one patient had infection although the punctate was negative. Out of 965 patients with the patellar tendon grafts, ten (1.03% had this complication, while the incidence was 1.52% (7/460 in those with the hamstring grafts. Fifteen infections were acute with obvious symptoms within 14 days after surgery. Severe pain, limited range of motion, swelling of the knee joint and fever were the most common symptoms, while rubor and pus developed rarely. The infection was three times more frequent in the patients who had undergone surgery lasting more than 1.5 hour. Discussion and Conclusion. The following population groups are at risk of developing septic arthritis after anterior cruciate ligament reconstructions: professional athletes, those who are allergic to penicillin, and those with immunosuppressive diseases. Staphyllococus aureus is the most common cause of infection. The patients with the hamstring autografts have a higher risk than those with the patellar tendon grafts. Preventive measures that should be performed include aseptic conditions in operative rooms, irrigation of the graft before its placement into the bone tunnels

  13. Skeletal ligament healing using the recombinant human amelogenin protein.

    Science.gov (United States)

    Hanhan, Salem; Ejzenberg, Ayala; Goren, Koby; Saba, Faris; Suki, Yarden; Sharon, Shay; Shilo, Dekel; Waxman, Jacob; Spitzer, Elad; Shahar, Ron; Atkins, Ayelet; Liebergall, Meir; Blumenfeld, Anat; Deutsch, Dan; Haze, Amir

    2016-05-01

    Injuries to ligaments are common, painful and debilitating, causing joint instability and impaired protective proprioception sensation around the joint. Healing of torn ligaments usually fails to take place, and surgical replacement or reconstruction is required. Previously, we showed that in vivo application of the recombinant human amelogenin protein (rHAM(+) ) resulted in enhanced healing of the tooth-supporting tissues. The aim of this study was to evaluate whether amelogenin might also enhance repair of skeletal ligaments. The rat knee medial collateral ligament (MCL) was chosen to prove the concept. Full thickness tear was created and various concentrations of rHAM(+) , dissolved in propylene glycol alginate (PGA) carrier, were applied to the transected MCL. 12 weeks after transection, the mechanical properties, structure and composition of transected ligaments treated with 0.5 μg/μl rHAM(+) were similar to the normal un-transected ligaments, and were much stronger, stiffer and organized than control ligaments, treated with PGA only. Furthermore, the proprioceptive free nerve endings, in the 0.5 μg/μl rHAM(+) treated group, were parallel to the collagen fibres similar to their arrangement in normal ligament, while in the control ligaments the free nerve endings were entrapped in the scar tissue at different directions, not parallel to the axis of the force. Four days after transection, treatment with 0.5 μg/μl rHAM(+) increased the amount of cells expressing mesenchymal stem cell markers at the injured site. In conclusion application of rHAM(+) dose dependently induced mechanical, structural and sensory healing of torn skeletal ligament. Initially the process involved recruitment and proliferation of cells expressing mesenchymal stem cell markers. PMID:26917487

  14. Tissue engineering of ligaments : A comparison of bone marrow stromal cells, anterior cruciate ligament, and skin fibroblasts as cell source

    NARCIS (Netherlands)

    Van Eijk, F; Riesle, J; Willems, WJ; Van Blitterswijk, CA; Verbout, AJ; Dhert, WJA

    2004-01-01

    Anterior cruciate ligament (ACL) reconstruction surgery still has important problems to overcome, such as "donor site morbidity" and the limited choice of grafts in revision surgery. Tissue engineering of ligaments may provide a solution for these problems. Little is known about the optimal cell sou

  15. Standardization of lesions of external bone ligaments

    International Nuclear Information System (INIS)

    In the time from March 1978 until September 1978, 100 patients having a lesion of the capsular ligament at the upper ankle joint immediately after an accident were examined. The manual X-ray diagnosis was compared with a diagnosis using a newly-created holding apparatus. This way of diagnosing was carried out at the same time on the same patient; this gave an optimal possibility of comparing the two ways of examination. Generally seen, apparative X-ray diagnosis achieved higher values thus giving the possibility of more exact classification as to the diagnosis and therapy. (orig./MG)

  16. The Broad Autism Phenotype Questionnaire

    Science.gov (United States)

    Hurley, Robert S. E.; Losh, Molly; Parlier, Morgan; Reznick, J. Steven; Piven, Joseph

    2007-01-01

    The broad autism phenotype (BAP) is a set of personality and language characteristics that reflect the phenotypic expression of the genetic liability to autism, in non-autistic relatives of autistic individuals. These characteristics are milder but qualitatively similar to the defining features of autism. A new instrument designed to measure the…

  17. MR imaging of normal extrinsic wrist ligaments using thin slices with clinical and surgical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Shahabpour, M., E-mail: maryam.shahabpour@uzbrussel.be [Department of Radiology, Universitair Ziekenhuis Brussel, Brussels (Belgium); De Maeseneer, M., E-mail: michel.demaeseneer@uzbrussel.be [Department of Radiology, Universitair Ziekenhuis Brussel, Brussels (Belgium); Pouders, C. [Department of Experimental Anatomy, Vrije Universiteit Brussel (Belgium); Van Overstraeten, L. [Department of Foot and Hand Surgery, Centre Hospitalier Regional de Wallonie Picarde, Tournai (Belgium); Ceuterick, P. [Department of Hand Surgery, Europa Ziekenhuizen, Brussels (Belgium); Fierens, Y. [Department of Radiology, Universitair Ziekenhuis Brussel, Brussels (Belgium); Goubau, J. [Department of Orthopaedic Surgery, UZ Brussel, Brussels (Belgium); De Mey, J. [Department of Radiology, Universitair Ziekenhuis Brussel, Brussels (Belgium)

    2011-02-15

    Eighty-nine MR examinations of the wrist were retrospectively analyzed. MRI results were compared with clinical findings and/or arthroscopy. Thin proton density and T2 weighted sequences and 3D DESS weighted sequences were applied on a 1.5 T scanner. On the palmar side three radiocarpal ligaments are recognized including the radioscaphocapitate, radiolunotriquetral, radioscapholunate, and midcarpal triquetroscaphoidal ligaments. Ulnocarpal ligaments include the ulnolunate ligament and the ulnotriquetral ligament. On the dorsal side three ligaments are recognized: the dorsal radiolunotriquetral, and the midcarpal triquetroscaphoidal and triquetro-trapezoido-trapezial. The collateral ligaments include the radial and ulnar collateral ligament. MR is a valuable technique in the assessment of the extrinsic and midcarpal ligaments. Depiction of the extrinsic ligaments can best be accomplished with coronal 3D DESS sequences and sagittal and transverse proton density and T2 weighted sequences with thin slices.

  18. MRI of anterior cruciate ligament autografts

    Energy Technology Data Exchange (ETDEWEB)

    Ogi, Shigeyuki; Ariizumi, Mitsuko; Yamagishi, Tsuneo [The Aoyama Tokyo Metropolitan office' s Hospital (Japan); Agata, Toshihiko; Tada, Shinpei; Fukuda, Kunihiko

    2000-09-01

    The purpose of this study was to assess the usefulness of MRI in the evaluation of autografts after anterior cruciate ligament reconstruction. The subjects were 110 patients with anterior cruciate ligament reconstruction using patellar tendon autografts who underwent clinical examination, MRI, and arthroscopy of the knee. T1- and T2-weighted MR images were obtained in sagittal plane. Clinical findings were categorized into three groups: normal, borderline, and abnormal. The MRI appearances of the autografts were categorized into three types: straight continuous band (type I), interrupted band (type II) and generalized increased intensity band (type III). The clinical findings and MRI findings were compared with arthroscopic findings. Ninety-six percent of the type I showed no autograft tear on arthroscopy. In comparison with the clinical findings, MRI was found to be well correlated with arthroscopic findings. In conclusion, if the clinical findings are normal, patients are to be followed-up without MRI and arthroscopy. However, if clinical findings are either borderline or abnormal, MRI should be performed prior to arthroscopy. (author)

  19. Anterior cruciate ligament repair with LARS (ligament advanced reinforcement system: a systematic review

    Directory of Open Access Journals (Sweden)

    Machotka Zuzana

    2010-12-01

    Full Text Available Abstract Background Injury to the anterior cruciate ligament (ACL of the knee is common. Following complete rupture of the ACL, insufficient re-vascularization of the ligament prevents it from healing completely, creating a need for reconstruction. A variety of grafts are available for use in ACL reconstruction surgery, including synthetic grafts. Over the last two decades new types of synthetic ligaments have been developed. One of these synthetic ligaments, the Ligament Advanced Reinforcement System (LARS, has recently gained popularity. The aim of this systematic review was to assess the current best available evidence for the effectiveness of the LARS as a surgical option for symptomatic, anterior cruciate ligament rupture in terms of graft stability, rehabilitation time and return to pre-injury function. Method This systematic review included studies using subjects with symptomatic, ACL ruptures undergoing LARS reconstruction. A range of electronic databases were searched in May 2010. The methodological quality of studies was appraised with a modified version of the Law critical appraisal tool. Data relating to study characteristics, surgical times, complication rates, outcomes related to knee stability, quality of life, function, and return to sport as well as details of rehabilitation programs and timeframes were collected. Results This review identified four studies of various designs, of a moderate methodological quality. Only one case of knee synovitis was reported. Patient satisfaction with LARS was high. Graft stability outcomes were found to be inconsistent both at post operative and at follow up periods. The time frames of rehabilitation periods were poorly reported and at times omitted. Return to pre-injury function and activity was often discussed but not reported in results. Conclusions There is an emerging body of evidence for LARS with comparable complication rates to traditional surgical techniques, and high patient

  20. Magnetic resonance imaging of ankle ligaments and tendon injuries

    International Nuclear Information System (INIS)

    Today MRI allows evaluation of the integrity of injured ankle ligaments. The major difficulty in MRI is inconsistency in visualization by inadequate appreciation of the three-dimensional orientation of each ankle ligament. Using this technique, 52 patients with sprained ankles underwent MRI. The integrity of rupture of the collateral lateral ligaments was obtained in all 52 ankles. Full-lenght visualization is essential for evaluation of the ankle ligaments with MRI. In these 52 patients the angle of tilt on the stress X-ray was compared with the rate of MRI findings showing an injury affecting two ligaments. We found that none of the patients in whom the angle of lateral tilt was less than 5 had rupture of two laterial ligaments, while 32% of patients with angles of tilt of 6-14 and 42% of those with angles of tilt over 15 on stress X-ray had two ruptured lateral ligaments. The advantages of MRI are that it offers the best visualization of the extent of the tendon lesion. MRI, however, seems to be superior to US in detecting and quantifying lesions of the Achilles tendon. Therefore, MRI may be indicated in particularly difficult cases of tendons injuries in the foot. (orig.)

  1. Oblique reconstruction of the cruciate ligaments on computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Ihara, Hidetoshi; Nishino, Koshi; Koga, Masayuki; Kitakata, Akira; Deya, Keizo; Nakagawa, Hiroto

    1984-12-01

    Optimal positioning where the entire longitudinal axis of the cruciate ligaments could be demonstrated on computed tomography was discovered by using an amputated knee and was applied clinically. To demonstrate the anterior cruciate ligament, the patient was positioned on the table with the hip flexed, abducted, externally rotated and knee flexed at a 110-140 degrees angle. For the posterior cruciate ligament, the patient was placed in a prone position on the table with the knee flexed at a 50 degrees angle. These positions, especially the one for the anterior cruciate ligament, were difficult for some patients with gonalgia or limited range of motion. Reconstruction in the oblique planes was studied for those patients by using an amputated knee and quasi-ligament made of gum. Clinically, an axial image was obtained by the simple position of the patient lying prone on the table with knee extended. Oblique reconstruction was made from the axial images and this reconstructed image also demonstrated the entire longitudinal axis of the ligament. The rupture of the cruciate ligaments could be assessed by the reconstructed image in the oblique plane. (author).

  2. Pollical oblique ligament in humans and non-human primates.

    Science.gov (United States)

    Shrewsbury, Marvin

    2003-04-01

    A morphological study of the oblique ligament in the thumb is presented. The ligament was consistently described in human specimens and compared with dissections of non-human primates from different species. The oblique ligament was found in some, but not all, specimens in each of the following species examined: chimpanzee, orangutan, gibbon, anubis baboon, hamadryas baboon, squirrel monkey, lemur and marmoset. A revised identity of the oblique ligament is proposed as a reinforced distal border of a fibro-osseous annular pollical flexor sheath and whose function is not independent of the flexor sheath. The constant presence and tendinous trait of the pollical oblique ligament in humans, when compared with non-human primates, supports the notion that the oblique ligament strengthens the pollical flexor sheath in humans for restraint of the flexor pollicis longus tendon during forceful precision pinching. A derivation of the pollical oblique ligament is considered as representing a vestigial radial limb of a flexor pollicis superficialis tendon in the thumb.

  3. Broad Diphotons from Narrow States

    CERN Document Server

    An, Haipeng; Zhang, Yue

    2015-01-01

    ATLAS and CMS have each reported a modest diphoton excess consistent with the decay of a broad resonance at ~ 750 GeV. We show how this signal can arise in a weakly coupled theory comprised solely of narrow width particles. In particular, if the decaying particle is produced off-shell, then the associated diphoton resonance will have a broad, adjustable width. We present simplified models which explain the diphoton excess through the three-body decay of a scalar or fermion. Our minimal ultraviolet completion is a weakly coupled and renormalizable theory of a singlet scalar plus a heavy vector-like quark and lepton. The smoking gun of this mechanism is an asymmetric diphoton peak recoiling against missing transverse energy, jets, or leptons.

  4. Cochlear microphonic broad tuning curves

    Science.gov (United States)

    Ayat, Mohammad; Teal, Paul D.; Searchfield, Grant D.; Razali, Najwani

    2015-12-01

    It is known that the cochlear microphonic voltage exhibits much broader tuning than does the basilar membrane motion. The most commonly used explanation for this is that when an electrode is inserted at a particular point inside the scala media, the microphonic potentials of neighbouring hair cells have different phases, leading to cancelation at the electrodes location. In situ recording of functioning outer hair cells (OHCs) for investigating this hypothesis is exceptionally difficult. Therefore, to investigate the discrepancy between the tuning curves of the basilar membrane and those of the cochlear microphonic, and the effect of phase cancellation of adjacent hair cells on the broadness of the cochlear microphonic tuning curves, we use an electromechanical model of the cochlea to devise an experiment. We explore the effect of adjacent hair cells (i.e., longitudinal phase cancellation) on the broadness of the cochlear microphonic tuning curves in different locations. The results of the experiment indicate that active longitudinal coupling (i.e., coupling with active adjacent outer hair cells) only slightly changes the broadness of the CM tuning curves. The results also demonstrate that there is a π phase difference between the potentials produced by the hair bundle and the soma near the place associated with the characteristic frequency based on place-frequency maps (i.e., the best place). We suggest that the transversal phase cancellation (caused by the phase difference between the hair bundle and the soma) plays a far more important role than longitudinal phase cancellation in the broadness of the cochlear microphonic tuning curves. Moreover, by increasing the modelled longitudinal resistance resulting the cochlear microphonic curves exhibiting sharper tuning. The results of the simulations suggest that the passive network of the organ of Corti determines the phase difference between the hair bundle and soma, and hence determines the sharpness of the

  5. The Collateral Ligaments and Posterolateral Corner: What Radiologists Should Know.

    Science.gov (United States)

    Vasilevska Nikodinovska, Violeta; Gimber, Lana H; Hardy, Jolene C; Taljanovic, Mihra S

    2016-02-01

    Ligamentous and tendinous structures of the posterolateral corner of the knee provide important static and dynamic stability to the knee joint and act in conjunction with anterior and posterior cruciate ligaments. Injuries of these structures are not uncommon. Failure to treat posterolateral corner injuries leads to posterolateral instability of the knee and subsequently poor outcome of cruciate ligament reconstructions. Currently, MRI is the diagnostic modality of choice in the evaluation of posterolateral corner injuries of the knee. We review normal MR imaging anatomy of the complex anatomical structures of the posterolateral corner of the knee, their biomechanical function, injuries, and current treatment options. PMID:27077587

  6. Absence of sensory function in the reconstructed anterior cruciate ligament

    DEFF Research Database (Denmark)

    Krogsgaard, Michael R; Fischer-Rasmussen, Torsten; Dyhre-Poulsen, Poul

    2011-01-01

    Cruciate ligaments provide sensory information that cause excitatory as well as inhibitory effects to the activity of the muscles around the knee. The aim of the study was to determine whether these muscular reflexes are reestablished after anterior cruciate ligament (ACL) re-construction. Wire...... electrodes were inserted during arthroscopy into the normal posterior cruciate ligament (PCL) and the reconstructed ACL in 11 patients who had a successful ACL re-construction 8 months to 12 years earlier. After the anesthesia had subsided, the PCL was stimulated electrically through the electrodes...

  7. Immunohistological analysis of extracted anterior cruciate ligament graft impinged against posterior cruciate ligament

    Directory of Open Access Journals (Sweden)

    Kato So

    2011-11-01

    Full Text Available Abstract A young female athlete suffered from the residual instability of the knee after anterior cruciate ligament (ACL reconstruction with hamstring autograft. The 3-dimensional (3-D CT scan showed the "high noon" positioning of the primary femoral bone tunnel. The revision surgery with anatomic double-bundle technique was performed two years after the primary surgery and the femoral tunnels were created with the assistance of the 3-D fluoroscopy-based navigation. An arthroscopic examination confirmed the ACL graft impingement against posterior cruciate ligament (PCL when the knee was deeply flexed. The histological analysis of the resected primary ACL graft showed local inflammatory infiltration, enhanced synovial coverage and vascularization at the impinged site. The enhanced expression of vascular endothelial growth factor (VEGF at the impinged area when compared with non-impinged area was observed on immunohistochemical analysis. Abnormal mechanical stress by the impingement against PCL might have induced chronic inflammation and VEGF overexpression.

  8. Ultrastructure of periprosthetic Dacron knee ligament tissue. Two cases of ruptured anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Salvi, M; Velluti, C; Misasi, M; Bartolozzi, P; Quacci, D; Dell'Orbo, C

    1991-04-01

    Light- and electron-microscopic investigations were performed on two failed Dacron ligaments that had been removed from 2 patients shortly after failure of the implant 2-3 years after reconstruction of the anterior cruciate ligament. Two different cell populations and matrices were correlated with closeness to the Dacron threads. Fibroblasts surrounded by connective tissue with collagen fibrils were located far from the Dacron threads. Roundish cells, appearing to be myofibroblasts surrounded by a more lax connective tissue and elastic fibers, were found close to the Dacron threads. The presence of myofibroblasts and the matrix differentiation could be attributed to the different mechanical forces acting on the Dacron and on the connective tissue because of their different coefficients of elasticity. The sparse occurrence of inflammatory cells in the synovial membrane and in the connective tissue surrounding the Dacron supports the biologic inertness of this artificial material. However, the repair tissue was not structured to resist tension stresses.

  9. Combined anterolateral ligament and anatomic anterior cruciate ligament reconstruction of the knee.

    Science.gov (United States)

    Smith, James O; Yasen, Sam K; Lord, Breck; Wilson, Adrian J

    2015-11-01

    Although anatomic anterior cruciate ligament (ACL) reconstruction is established for the surgical treatment of anterolateral knee instability, there remains a significant cohort of patients who continue to experience post-operative instability. Recent advances in our understanding of the anatomic, biomechanical and radiological characteristics of the native anterolateral ligament (ALL) of the knee have led to a resurgent interest in reconstruction of this structure as part of the management of knee instability. This technical note describes our readily reproducible combined minimally invasive technique to reconstruct both the ACL and ALL anatomically using autologous semitendinosus and gracilis grafts. This method of ALL reconstruction can be easily integrated with all-inside ACL reconstruction, requiring minimal additional operative time, equipment and expertise. Level of evidence V.

  10. Dynamic Mechanical and Nanofibrous Topological Combinatory Cues Designed for Periodontal Ligament Engineering.

    Science.gov (United States)

    Kim, Joong-Hyun; Kang, Min Sil; Eltohamy, Mohamed; Kim, Tae-Hyun; Kim, Hae-Won

    2016-01-01

    Complete reconstruction of damaged periodontal pockets, particularly regeneration of periodontal ligament (PDL) has been a significant challenge in dentistry. Tissue engineering approach utilizing PDL stem cells and scaffolding matrices offers great opportunity to this, and applying physical and mechanical cues mimicking native tissue conditions are of special importance. Here we approach to regenerate periodontal tissues by engineering PDL cells supported on a nanofibrous scaffold under a mechanical-stressed condition. PDL stem cells isolated from rats were seeded on an electrospun polycaprolactone/gelatin directionally-oriented nanofiber membrane and dynamic mechanical stress was applied to the cell/nanofiber construct, providing nanotopological and mechanical combined cues. Cells recognized the nanofiber orientation, aligning in parallel, and the mechanical stress increased the cell alignment. Importantly, the cells cultured on the oriented nanofiber combined with the mechanical stress produced significantly stimulated PDL specific markers, including periostin and tenascin with simultaneous down-regulation of osteogenesis, demonstrating the roles of topological and mechanical cues in altering phenotypic change in PDL cells. Tissue compatibility of the tissue-engineered constructs was confirmed in rat subcutaneous sites. Furthermore, in vivo regeneration of PDL and alveolar bone tissues was examined under the rat premaxillary periodontal defect models. The cell/nanofiber constructs engineered under mechanical stress showed sound integration into tissue defects and the regenerated bone volume and area were significantly improved. This study provides an effective tissue engineering approach for periodontal regeneration-culturing PDL stem cells with combinatory cues of oriented nanotopology and dynamic mechanical stretch.

  11. Proprioception in anterior cruciate ligament deficient knees and its relevance in anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Mandeep S Dhillon

    2011-01-01

    Full Text Available Injury to the anterior cruciate ligament (ACL not only causes mechanical instability but also leads to a functional deficit in the form of diminished proprioception of the knee joint. "Functional" recovery is often incomplete even after "anatomic" arthroscopic ACL reconstruction, as some patients with a clinically satisfactory repair and good ligament tension continue to complain of a feeling of instability and giving way, although the knee does not sublux on clinical testing. Factors that may play a role could be proprioceptive elements, as the intact ACL has been shown to have significant receptors. Significant data have come to light demonstrating proprioceptive differences between normal and injured knees, and often between injured and reconstructed knees. ACL remnants have been shown to have proprioceptive fibers that could enhance functional recovery if they adhere to or grow into the reconstructed ligament. Conventionally the torn remnants are shaved off from the knee before graft insertion; modern surgical techniques, with remnant sparing methods have shown better outcomes and functional recovery, and this could be an avenue for future research and development. This article analyzes and reviews our understanding of the sensory element of ACL deficiency, with specific reference to proprioception as an important component of functional knee stability. The types of mechanoreceptors, their distribution and presence in ACL remnants is reviewed, and suggestions are made to minimize soft tissue shaving during ACL reconstruction to ensure a better functional outcome in the reconstructed knee.

  12. Ligaments: a source of musculoskeletal disorders.

    Science.gov (United States)

    Solomonow, Moshe

    2009-04-01

    The mechanical and neurological properties of ligaments are reviewed and updated with recent development from the perspective which evaluates their role as a source of neuromusculoskeletal disorders resulting from exposure to sports and occupational activities. Creep, tension-relaxation, hysteresis, sensitivity to strain rate and strain/load frequency were shown to result not only in mechanical functional degradation but also in the development of sensory-motor disorders with short- and long-term implication on function and disability. The recently exposed relationships between collagen fibers, applied mechanical stimuli, tissue micro-damage, acute and chronic inflammation and neuromuscular disorders are delineated with special reference to sports and occupational stressors such as load duration, rest duration, work/rest ratio, number of repetitions of activity and velocity of movement. PMID:19329050

  13. Tibial Tuberosity-Posterior Cruciate Ligament Distance.

    Science.gov (United States)

    Daynes, Jake; Hinckel, Betina Bremer; Farr, Jack

    2016-08-01

    When trochlear dysplasia is present, it is difficult to measure the tibial tuberosity to trochlear groove (TT-TG) distance. A new measurement to assess tuberosity position was recently described by Seitlinger et al, which avoids the difficulty of identifying the TG as it references the posterior cruciate ligament (PCL). To evaluate the reproducibility of the Seitlinger et al findings, 42 knees in 41 patients with a documented history of recurrent patellar instability and 84 knees in patients with no history of patellar instability or patellofemoral symptoms were evaluated with magnetic resonance imaging. The TT-PCL distance was increased in the instability group (mean, 21.6 mm) compared with the control group (mean, 19.0 mm). The TT-PCL distance is an independent risk factor for patients with recurrent patellar instability. Its role in surgical planning remains to be determined. PMID:26509659

  14. Surgical Dissection of the Anterolateral Ligament.

    Science.gov (United States)

    Daggett, Matthew; Busch, Kyle; Sonnery-Cottet, Bertrand

    2016-02-01

    Recent investigations into the structure and function of the anterolateral ligament (ALL) have resulted in renewed interest in the role of the lateral extra-articular structures in rotational control of the knee. With increased focus on the ALL, debate about the anatomic characteristics, the functional role in knee stability, and even the existence of this lateral structure has ensued. This article describes our dissection method for the ALL. Through careful dissection and precise elevation of the iliotibial band, the ALL can be clearly identified as a distinct structure with an attachment near the lateral epicondyle on the femur and an insertion in a fan-like fashion onto the tibia, between the Gerdy tubercle and the fibular head. This investigation provides the surgeon with anatomic landmarks to use during surgical reconstruction of the ALL. PMID:27274451

  15. Pathologic ligamentous constraint of the hip.

    Science.gov (United States)

    Crowninshield, R D; Johnston, R C; Brand, R A; Pedersen, D R

    1983-12-01

    A mathematic model of the hip capsule and lower extremity musculature was utilized to predict the forces present in the hip ligaments during locomotion. The results demonstrate principles and trends (rather than absolute results) in hip mechanics, the details of which are affected by the associated modeling assumptions. The active stretching of a hip joint capsule tightened by scarring or surgical transfer may appreciably increase the hip contact force. Capsular elements that prevent hip flexion and adduction play a major role in hip contact force exaggeration during common activities. The positive effect of maintaining the hip capsule to reduce total hip component dislocation contrasts with the potential negative effects of restricting joint motion and increasing the joint contact force. Increased joint loading due to capsular restriction may contribute to prosthetic component loosening. PMID:6641064

  16. MR imaging evaluation of anterior cruciate ligaments

    International Nuclear Information System (INIS)

    On 546 knees, the authors have obtained MR images (0.5 T or 1.5 T). The protocol included 5-mm-thick contiguous sagittal and oblique coronal images (in the plane of the anterior cruciate ligament [ACL]) and T1-, proton-density-, and T2-weighted sequences. In 174 patients, correlations with arthroscopic or surgical findings were available. In these cases, sagittal and oblique coronal images were retrospectively and separately read by two radiologists, who were blinded to other results. The mean accuracy of sagittal MR images alone was 88% for the depiction of partial and complete ACL tears, intraligamental bleeding, and scarring; the accuracy of oblique coronal images alone was 96%. Use of sagittal and oblique coronal images together achieved 98% accuracy

  17. Patellotibial contusions in anterior cruciate ligament tears.

    Science.gov (United States)

    Wissman, Robert D; England, Eric; Mehta, Kaushal; Nepute, Joshua; Von Fischer, Nathaniel; Apgar, Josh; Javadi, Ariyan

    2014-02-01

    Bone contusions are an important ancillary finding of many knee injuries. Not only are they a source of pain, they may suggest a mechanism of injury or a specific derangement of the knee joint. We have encountered a small number of patients being evaluated for anterior cruciate ligament (ACL) tears with unexplained patellar and tibial edema at magnetic resonance (MR) imaging. We present three individuals with contusions of the inferior patella with a corresponding contusion of the anteromedial tibial plateau. Internal derangements in these patients were similar to other individuals with acute ACL tears, however osseous contusions were more widespread. In conclusion, patellotibial contusions are rare and may indicate an injury with forces greater than usually encountered in most ACL tears. A careful search for uncommon associated injuries is prudent in these high-energy knee injuries. PMID:24037484

  18. Anterior cruciate ligament injuries: etiology and prevention.

    Science.gov (United States)

    Brophy, Robert H; Silvers, Holly J; Mandelbaum, Bert R

    2010-03-01

    The relatively high risk of noncontact anterior cruciate ligament (ACL) rupture among female athletes has been a major impetus for investigation into the etiology of this injury. A number of risk factors have been identified, both internal and external to the athlete, including neuromuscular, anatomical, hormonal, shoe-surface interaction, and environmental, such as weather. The anatomic and neuromuscular risk factors, often gender related, are the focus of most ACL injury prevention programs. Although studies have shown that biomechanic- centered prevention programs can reduce the risk of ACL injury, many questions remain unanswered. More research is needed to increase our understanding of the risk factors for ACL injury; how injury prevention programs work and can the clinical application of such programs be optimized. PMID:20160623

  19. Tendon and ligament adaptation to exercise, immobilization, and remobilization.

    Science.gov (United States)

    Wren, T A; Beaupré, G S; Carter, D R

    2000-01-01

    This study provides a theoretical and computational basis for understanding and predicting how tendons and ligaments adapt to exercise, immobilization, and remobilization. In a previous study, we introduced a model that described the growth and development of tendons and ligaments. In this study, we use the same model to predict changes in the cross-sectional area, modulus, and strength of tendons and ligaments due to increased or decreased loading. The model predictions are consistent with the results of experimental exercise and immobilization studies performed by other investigators. These results suggest that the same fundamental principles guide both development and adaptation. A basic understanding of these principles can contribute both to prevention of tendon and ligament injuries and to more effective rehabilitation when injury does occur.

  20. Intra-articular ganglion cysts of the cruciate ligaments

    Energy Technology Data Exchange (ETDEWEB)

    Tyrrell, P.N.M.; Cassar-Pullicino, V.N.; McCall, I.W. [Department of Diagnostic Imaging and The Institute of Orthopaedics, The Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Oswestry, Shropshire (United Kingdom)

    2000-08-01

    Intra-articular ganglion cysts of the cruciate ligaments are associated with non-specific clinical signs and symptoms. Familiarity with the MR appearances in particular is important to make an accurate diagnosis, exclude associated abnormalities, and avoid misdiagnosis. (orig.)

  1. MR for assessing anterior cruciate ligament reconstructions by tendon grafts

    International Nuclear Information System (INIS)

    150 patients were examined via magnetic resonance (MR) after anterior cruciate (ACL) ligament reconstruction (76 patellar tendon grafts, 53 semitendinosous tendon grafts and 21 sutures). The results of MR were compared with clinical tests (Lachman, pivot-shift and anterior drawer test), in 2 cases with the operative findings, and in one case with arthroscopy findings. In 91% of patients with a clinically stable knee we found a continuous low-intensity ligamental structure. 10 patients were examined twice or more between 8 days and 6 months after surgery. Ligamental structures of low signal intensity did not significantly change their MR characteristics. MR is a valuable noninvasive method for evaluating ligament reconstructions. (orig./GDG)

  2. Ganglion cysts of the cruciate ligaments detected by MRI

    OpenAIRE

    Sumen, Y.; Ochi, M.; Deie, M.; Adachi, N.; Ikuta, Y.

    1999-01-01

     Eight patients with ganglion cysts arising from the cruciate ligaments of the knee joint underwent arthroscopic excision after the MR examination. The MR findings, clinical features and arthroscopic findings were evaluated comparatively.

  3. Telomere length of anterior crucial ligament after rupture

    DEFF Research Database (Denmark)

    Ponsot, Elodie; Langberg, Henning; Krogsgaard, Michael R;

    2011-01-01

    The regeneration of ligaments following injury is a slow process compared to the healing of many other tissues and the underlying mechanisms remain unknown. The purpose of the study was to evaluate the proliferative potential of ligaments by assessing telomere length within three distinct parts...... of human anterior cruciate ligament (ACL) obtained during ACL reconstruction: the macroscopically injured proximal part and macroscopically noninjured mid- and distal portions in eight subjects (age 28 ± 8 years). The mean telomere length in ACL was within normal range of values usually reported for other......) and there was no relationship between mean telomere length in ACL and the healing duration after rupture. This implies that despite the occurrence of ligament repair including a phase of intense cell proliferation the proliferative potential of ruptured ACL is not impaired. This knowledge is important for scientists...

  4. Mesalamine treatment mimicking relapse in a child with ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Iva Hojsak; Ana M Pavić; Sanja Kolaček

    2014-01-01

    Background: There are reports on mesalamine-induced bloody diarrhea mimicking ulcerative colitis (UC) relapse, mostly in adults. Methods: Herein we present a case of a child with UC who developed relapse of hemorrhagic colitis related to mesalamine. Results: A 10-year-old girl developed severe symptoms mimicking UC relapse 3 weeks after introduction of mesalamine therapy. After mesalamine was withdrawn, her symptoms improved, but deteriorated again during the challenge of mesalamine despite concomitant use of corticosteroids. Conclusion: This is the fi rst case report on such a young child during the concomitant use of corticosteroids.

  5. Strain measurement at the knee ligament insertion sites

    OpenAIRE

    Hinterwimmer, S; Baumgart, R.; Plitz, W.

    2003-01-01

    We describe the modification of an existing method of ligament strain measurement at the knee joint in detail. At ten fresh joint specimens we used that technique where strain gauges are attached to the ligamentous insertions and origins. We both improved the preparation of the attachment site and the application of the strain gauges. In a special apparatus the specimens were moved from 0degrees extension to 100degrees flexion while simulating muscle strength and axial force. Testing was perf...

  6. Tissue Engineering Applications for Ligament and Tendon Reconstruction

    Institute of Scientific and Technical Information of China (English)

    J.C.H.; GOH; H.W.; OU; YANG; Z.G.; GE; S.L.; TOH

    2005-01-01

    Tendons and ligaments are subjected to high physiological loads. As such, injuries due to high impact activities are common. Due to the avascular nature of these connective tissues, the healing rate is rather slow. Currently the therapeutic options to treat tendon and ligament injuries are autografts, allografts and prosthetic devices. However, there are many disadvantages in using biological grafts, as well as concerns over long-term performance of synthetic prostheses. Therefore, further research for alte...

  7. MR imaging of the lateral collateral ligaments after ankle sprain

    International Nuclear Information System (INIS)

    35 patients with ankle sprain were examined by MRI and stress radiographs. 13 were operated afterwards, 22 patients underwent a functional conservative therapy and were examined by MRI and stress radiographs and second time after three months. MRI reports were correct in 12 of 13 operated cases. After conservative therapy we did not find any disrupted ankle ligament. MRI showed intact ligaments thickened by scar. (orig./MG)

  8. Medial collateral ligament injuries of the knee: current treatment concepts

    OpenAIRE

    Chen, Lan; Kim, Paul D.; Ahmad, Christopher S.; Levine, William N.

    2007-01-01

    The medial collateral ligament is one of the most commonly injured ligaments of the knee. Most injuries result from a valgus force on the knee. The increased participation in football, ice hockey, and skiing has all contributed to the increased frequency of MCL injuries. Prophylactic knee bracing in contact sports may prevent injury; however, performance may suffer. The majority of patients who sustain an MCL injury will achieve their pre-injury activity level with non-operative treatment alo...

  9. MR imaging of the posterior cruciate ligament of the knee

    International Nuclear Information System (INIS)

    The significance of posterior cruciate ligament (PCL) tears is controversial, and the reliability of physical examination has recently been questioned in the orthopedic literature. The authors reviewed the MR examinations of 60 patients. Normal anatomy of the PCL and surrounding structures, including the ligaments of Humphrey and Wrisberg, are identified on anatomic drawings and MR images. Changes in the PCl with varying degrees of flexion are demonstrated. Examples of tear and avulsions of the PCL confirmed with arthroscopy or arthrotomy are presented

  10. MR examination of the distensibility of healthy cruciate ligaments

    International Nuclear Information System (INIS)

    A functional MR study was performed using a Magnetom Open (0.2 Tesla, Fa. Siemens). We measured the length and width of the anterior and posterior cruciate ligament in volunteers (n=12), age 20-40. We examined in 4 knee positions between maximal extension and maximal flexion. Using the Wilcoxon test, the statistics do not show any significant difference between the length and width of the cruciate ligaments in the monoaxial movement. (orig./MG)

  11. [Chondroblastoma in the anterior cruciate ligament origo: a case report].

    Science.gov (United States)

    Aydin, Hafız; Turhan, Ahmet Uğur; Karataş, Metin; Onay, Atilgan; Yildiz, Kadriye

    2012-01-01

    Chondroblastoma is a rarely seen cartilage originated tumor. It is mostly localized in the epiphysis of long bones. In this article, we present an 18-year-old male case in whom the tumor was located in the right distal femoral lateral condyle and destroyed anterior cruciate ligament origo. The tumor was curetted and the cavity was filled with cement. Anterior cruciate ligament resection was mandatory for this treatment. The patient had no complaint in the postoperative period.

  12. [Chondroblastoma in the anterior cruciate ligament origo: a case report].

    Science.gov (United States)

    Aydin, Hafız; Turhan, Ahmet Uğur; Karataş, Metin; Onay, Atilgan; Yildiz, Kadriye

    2012-01-01

    Chondroblastoma is a rarely seen cartilage originated tumor. It is mostly localized in the epiphysis of long bones. In this article, we present an 18-year-old male case in whom the tumor was located in the right distal femoral lateral condyle and destroyed anterior cruciate ligament origo. The tumor was curetted and the cavity was filled with cement. Anterior cruciate ligament resection was mandatory for this treatment. The patient had no complaint in the postoperative period. PMID:22765492

  13. MRI assessment of mid-urethral ligament changes in female stress urinary incontinence

    International Nuclear Information System (INIS)

    Objective: To evaluate the MRI value in changes of mid-urethral ligament injury of female stress urinary incontinence (SUI). Methods: Comparison of MRI changes of mid-urethral ligament on 30 healthy female volunteers and 20 female SUI patients. Chi-square test was used to compare the form of SUI patient's mid-urethral support ligaments. Results: The female mid-urethral support ligaments were composed of 4 groups of ligaments, including the periurethral ligament and pubourethral ligaments (1 pair), and at both sides of the urethra's paraurethral ligaments (1 pair) and suburethral ligament lying dorsal urethra, connecting the urethra and pelvic arcus tendinous fasciae. In normal MRI, ligament was a thin strip and showed low signal on both T1WI and T2WI, T2WI sagittal and cross-section scan was the best combination to show the middle urethral support ligaments changes, with tension; 6 patients (20%) in the 30 patients normal control group could be seen tortuously and slack like around the urethra ligaments. Twenty SUI patients mid-urethral support ligaments were performance laxity or rupture,rates were 39% (47/120) and 42% (50/120) (χ2=43.191, P<0.05). On T2WI, the ligamentous laxity was floating,and loss tension, also could performance one side extension and thinner than the other side. The ligament rupture was performance of the signal interruption, ligament contracture and one end of ligament attachment points separation. Conclusion: MRI can objective effective evaluate the mid-urethral support ligaments' pathological changes in stress urinary incontinence patients. (authors)

  14. Chronic multiple knee ligament injuries: epidemiological analysis of more than one hundred cases

    Directory of Open Access Journals (Sweden)

    Rosalvo Zosimo Bispo Júnior

    2008-01-01

    Full Text Available INTRODUCTION: Diagnosis and treatment of multiple ligament injuries of the knee remain a real challenge for most surgeons. OBJECTIVE: To find out the epidemiological profile of patients surgically treated at a Reference Service with more than one chronic ligament injury in the knee joint. MATERIALS AND METHODS: Of a total of 978 operated patients, 109 presented at least two associated ligament injuries in the same knee. Demographic and clinical variables were evaluated. RESULTS: The anterior cruciate ligament group presented a larger number of cases of ligament injuries related with sports practice and falls, while the posterior cruciate ligament and anterior cruciate ligament + posterior cruciate ligament groups presented more cases related to traffic accidents and trauma with object (weight on the knee (p<0.001. The varus group presented significantly higher values of time since injury (p<0.01. In the group with new anterior cruciate ligament injury (neoligament associated with other ligament injuries the disruption times were higher, showing statistical significance (p<0.001. CONCLUSIONS: Anterior cruciate ligament injury associated with other ligament injuries other than posterior cruciate ligament injury are related to sports practice and falls. Posterior cruciate ligament injury associated to other ligament injuries, including or not anterior cruciate ligament injury, are related to traffic accidents and direct trauma caused by an object on the knee. Significant delay between primary ligament injuries and their reconstructions generates varus deformity of the affected knee. In spite of the large delay in seeking medical treatment, few patients with neoligament anterior cruciate ligament injury and other combined disruptions will develop varus deformity.

  15. [PARTICULAR QUALITIES OF DIAGNOSTIC ACUTE LATERAL ANKLE LIGAMENT INJURIES].

    Science.gov (United States)

    Krasnoperov, S N; Shishka, I V; Golovaha, M L

    2015-01-01

    Delayed diagnosis of acute lateral ankle ligaments injury and subsequent inadequate treatment leads to the development of chronic instability and rapid progression of degenerative processes in the joint. The aim of our work was to improve treatment results by developing an diagnostic algorithm and treatment strategy of acute lateral ankle ligament injuries. The study included 48 patients with history of acute inversion ankle injury mechanism. Diagnostic protocol included clinical and radiological examination during 48 hours and after 7-10 days after injury. According to the high rate of inaccurate clinical diagnosis in the first 48 hours of the injury a short course of conservative treatment for 7-10 days is needed with follow-up and controlling clinical and radiographic instability tests. Clinical symptoms of ankle inversion injury showed that the combination of local tenderness in the projection of damaged ligaments, the presence of severe periarticular hematoma in the lateral department and positive anterior drawer and talar tilt tests in 7-10 days after the injury in 87% of cases shows the presence of ligament rupture. An algorithm for diagnosis of acute lateral ankle ligament injury was developed, which allowed us to determine differential indications for surgical repair of the ligaments and conservative treatment of these patients.

  16. Relationship between stress ankle radiographs and injured ligaments on MRI

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyoung Min; Chung, Chin Youb; Chung, Myung Ki; Won, Sung Hun; Lee, Seung Yeol; Park, Moon Seok [Seoul National University Bundang Hospital, Department of Orthopaedic Surgery, Kyungki (Korea, Republic of); Kwon, Soon-Sun [Seoul National University Bundang Hospital, Biomedical Research Institute, Kyungki (Korea, Republic of)

    2013-11-15

    This study was performed to investigate the relationship between the injured lateral ankle ligaments on MRI and stress ankle radiographs. Two hundred and twenty-nine consecutive patients (mean age 35.5 years, SD 14.6 years; 136 males and 93 females) that underwent ankle stress radiographs and MRI for lateral ankle instability were included. Tibiotalar tilt angle and anterior translation of talus were measured on stress ankle radiographs. Degree of lateral ligaments (anterior talofibular, calcaneofibular, and posterior talofibular) and deltoid ligament injuries were evaluated and scored as intact (0), partial injury (1), and complete injury (2) on MR images. Effusion of ankle joint was also recorded. The effects of gender, age, injuries of ligaments, and ankle joint effusion on stress radiographs were statistically analyzed. Gender (p = 0.010), age (p = 0.020), and anterior talofibular ligament (ATFL) injury (p < 0.001) were the factors significantly affecting tibiotalar tilt angle. Posterior talofibular ligament (PTFL) injury (p = 0.014) was found to be the only significant factor affecting the anterior translation on the anterior drawer radiographs. ATFL injury and PTFL injury on MRI significantly affected tibiotalar tilt angle and anterior drawer on stress radiographs. Other factors, such as age and gender, need to be considered in evaluating radiographic lateral ankle instability. (orig.)

  17. [PARTICULAR QUALITIES OF DIAGNOSTIC ACUTE LATERAL ANKLE LIGAMENT INJURIES].

    Science.gov (United States)

    Krasnoperov, S N; Shishka, I V; Golovaha, M L

    2015-01-01

    Delayed diagnosis of acute lateral ankle ligaments injury and subsequent inadequate treatment leads to the development of chronic instability and rapid progression of degenerative processes in the joint. The aim of our work was to improve treatment results by developing an diagnostic algorithm and treatment strategy of acute lateral ankle ligament injuries. The study included 48 patients with history of acute inversion ankle injury mechanism. Diagnostic protocol included clinical and radiological examination during 48 hours and after 7-10 days after injury. According to the high rate of inaccurate clinical diagnosis in the first 48 hours of the injury a short course of conservative treatment for 7-10 days is needed with follow-up and controlling clinical and radiographic instability tests. Clinical symptoms of ankle inversion injury showed that the combination of local tenderness in the projection of damaged ligaments, the presence of severe periarticular hematoma in the lateral department and positive anterior drawer and talar tilt tests in 7-10 days after the injury in 87% of cases shows the presence of ligament rupture. An algorithm for diagnosis of acute lateral ankle ligament injury was developed, which allowed us to determine differential indications for surgical repair of the ligaments and conservative treatment of these patients. PMID:27089717

  18. Relationship between stress ankle radiographs and injured ligaments on MRI

    International Nuclear Information System (INIS)

    This study was performed to investigate the relationship between the injured lateral ankle ligaments on MRI and stress ankle radiographs. Two hundred and twenty-nine consecutive patients (mean age 35.5 years, SD 14.6 years; 136 males and 93 females) that underwent ankle stress radiographs and MRI for lateral ankle instability were included. Tibiotalar tilt angle and anterior translation of talus were measured on stress ankle radiographs. Degree of lateral ligaments (anterior talofibular, calcaneofibular, and posterior talofibular) and deltoid ligament injuries were evaluated and scored as intact (0), partial injury (1), and complete injury (2) on MR images. Effusion of ankle joint was also recorded. The effects of gender, age, injuries of ligaments, and ankle joint effusion on stress radiographs were statistically analyzed. Gender (p = 0.010), age (p = 0.020), and anterior talofibular ligament (ATFL) injury (p < 0.001) were the factors significantly affecting tibiotalar tilt angle. Posterior talofibular ligament (PTFL) injury (p = 0.014) was found to be the only significant factor affecting the anterior translation on the anterior drawer radiographs. ATFL injury and PTFL injury on MRI significantly affected tibiotalar tilt angle and anterior drawer on stress radiographs. Other factors, such as age and gender, need to be considered in evaluating radiographic lateral ankle instability. (orig.)

  19. [VARIANT ANATOMY OF SPLENIC LIGAMENTS AND ARTERIES PASSING THROUGH THEM].

    Science.gov (United States)

    Gaivoronskiy, I V; Kotiv, B N; Alekseyev, V S; Nichiporuk, G I

    2015-01-01

    The research was performed on 15 non embalmed bodies and 32 abdominal complexes of adult individuals. The comparative study of variant anatomy of splenic ligaments and architectonics of arteries passing through them was carried out to substantiate the mobilization of splenopancreatic complex. Anatomical and angiographic restudied were carried out using preparation, morphometry, injection of gastric, pancreatic and splenic vascular bed with red lead suspension. It was established that the form and sizes of splenic ligaments and their interrelation with the branches of the splenic artery were variable. The minimal and maximal sizes of gastrolienal, phrenicosplenic and splenocolic ligaments differed 2-3 times. In most cases, spleen was fixed in abdominal cavity by many short ligaments. It was shown that architectonics and topography of main branches of spleen artery were determined by morphometric characteristics of the spleen proper and its ligaments. The knowledge of splenic ligament variant anatomy allows a new perspective to approach to substantiate different methods of the mobilization of spleno-pancreatic complex during surgical operations on organs of the upper part of the peritoneal cavity and organ-preserving surgery of the spleen.

  20. Cable-Augmented, Quad Ligament Tenodesis Scapholunate Reconstruction.

    Science.gov (United States)

    Bain, Gregory I; Watts, Adam C; McLean, James; Lee, Yu C; Eng, Kevin

    2015-11-01

    Maintaining reduction of the scapholunate interval after reconstruction can be difficult. The authors performed scapholunate reconstruction using tensionable suture anchors in 8 patients. The anchors provide a fixed cable that both fixes the graft, and reduces the scapholunate diastasis and maintains reduction. The flexor carpi radialis tendon graft stabilizes not only the volar scaphotrapezial ligament, and dorsal scapholunate ligament, but also the dorsal intercarpal and dorsal radiocarpal ligament. The Berger flap is closed using an ulnar advancement capsulodesis that further reinforces the dorsal intercarpal and dorsal radiocarpal ligament. The mean pain score improved from 5.8 to 2.1. Mean extension was 56° (91% of contralateral side), flexion 44° (70% of contralateral side), and grip strength was 41kg (95% of the contralateral side). The mean scapholunate angle was 71°, radiolunate angle 16° and scapholunate interval 3.0 mm. The cable augmented, quad ligament scapholunate ligament reconstruction offers theoretical advantages but long term follow up is required.

  1. Tissue Engineering of Ligament/tendon-Part II-Importance of Biochemical and Mechanical Factors on the Neogenesis of Ligament

    Institute of Scientific and Technical Information of China (English)

    Sylvaine; Muller; Shalaw; Fawzi-Grancher; Said; Slimani

    2005-01-01

    1 IntroductionLigaments and tendons are bands of parallel fibers, made of dense connective tissue, that play an important role in mediating normal movement and stability of joints. Injury to these structures can cause significant joint instability, which may lead to injury of others tissues and the development of degenerative joint diseases. Tissue engineering offers the potential to improve the reconstruction of tendons and ligaments. The concept is based on the manipulation of cellular and molecular media...

  2. Ghost imaging with broad distance

    Institute of Scientific and Technical Information of China (English)

    段德洋; 张路; 杜少将; 夏云杰

    2015-01-01

    We present a scheme that is able to achieve the ghost imaging with broad distance. The physical nature of our scheme is that the different wavelength beams are separated in free space by an optical media according to the slow light or dispersion principle. Meanwhile, the equality of the optical distance of the two light arms is not violated. The photon correlation is achieved by the rotating ground glass plate (RGGP) and spatial light modulator (SLM), respectively. Our work shows that a monochromic ghost image can be obtained in the case of RGGP. More importantly, the position (or distance) of the object can be ascertained by the color of the image. Thus, the imaging and ranging processes are combined as one process for the first time to the best of our knowledge. In the case of SLM, we can obtain a colored image regardless of where the object is.

  3. Various Tumor-Mimicking Lesions in the Musculoskeletal System: Causes and Diagnostic Approach

    OpenAIRE

    Kim, Sue Yon; Park, Ji Seon; Ryu, Kyung Nam; Jin, Wook; Park, So Young

    2011-01-01

    Tumor-mimicking lesions in the musculoskeletal system can be defined as lesions mistaken as tumors due to the presence of palpation upon physical examination or a tumor-like appearance upon radiological examination. Moreover, tumor-mimicking lesions show diverse etiologies and anatomic locations. We illustrated the various tumor-mimicking lesions involving bone and soft tissue. In this review, the tumor-mimicking lesions were classified into those based on clinical examination and those based...

  4. Cutaneous Silicone Granuloma Mimicking Breast Cancer after Ruptured Breast Implant

    Directory of Open Access Journals (Sweden)

    Waseem Asim Ghulam El-Charnoubi

    2011-01-01

    Full Text Available Cutaneous manifestations due to migration of silicone from ruptured implants are rare. Migrated silicone with cutaneous involvement has been found in the chest wall, abdominal wall, and lower extremities. We describe a case of cutaneous silicone granuloma in the breast exhibiting unusual growth mimicking breast cancer after a ruptured implant.

  5. Spinal MRI of vincristine neuropathy mimicking Guillain-Barre syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Yun Woo; Yoon, Hye-Kyung; Cho, Jae Min [Department of Radiology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Kangnam-gu, Seoul 135-710 (Korea); Sung, Ki Woong [Department of Paediatrics, Samsung Medical Centre, Seoul 135-710 (Korea)

    2003-11-01

    A 4.3-year-old girl with acute leukaemia, who was being treated with chemotherapy (including vincristine), developed paraplegia. Spinal MRI showed diffusely enhancing nerve roots on contrast-enhanced images. Spinal fluid analysis showed a normal protein level. Vincristine neuropathy mimicking Guillain-Barre syndrome is thought to be the cause of the MRI abnormalities. (orig.)

  6. Cutaneous lymphoid hyperplasia mimicking cutaneous lymphoma in a hyperthyroid cat.

    Science.gov (United States)

    Snead, Elisabeth; Kerr, Moira; Macdonald, Valerie

    2013-10-01

    A 12-year-old neutered male domestic shorthair cat presented for chronic, localized, swelling and crusting of the left upper lip, weight loss, sporadic vomiting, and focal alopecia between the scapulae was diagnosed with hyperthyroidism and regional eosinophilic lymphadenitis. Treatment with methimazole exacerbated an underlying hypersensitivity disorder leading to marked generalized lymphadenopathy that histologically mimicked lymphoma.

  7. Retroperitoneal Bronchogenic Cyst Mimicking Hydatid Liver: A Case Report

    OpenAIRE

    Parray, Fazl Q.; Afak Yusuf Sherwani; Sajad Ahmad Dangroo; Rafia Aziz Bisati; Nighat Shaffi Malik

    2012-01-01

    Bronchogenic cysts frequently occur in the mediastinum. They may be rarely encountered in the abdomen and retroperitoneum. Bronchogenic cysts can in fact mimic hydatid cysts. We report a case of retroperitoneal bronchogenic cyst below the right hemidiaphragm mimicking a hydatid cyst of the liver in a 30-year-old female.

  8. Intracranial Gossypiboma Mimicking a Recurrent Low Grade Astrocytoma : Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jin Young; Koo, Joon Bum [Dept. of Radiology, Dongguk University Il-San Hospital, Iksan (Korea, Republic of)

    2011-05-15

    Gossypiboma is an inflammatory pseudomass formed by a retained surgical sponge or gauze with reactive tissue after surgery. Gossypiboma has been reported most frequently after abdominal or thoracic surgery. As such, gossypiboma following brain surgery is very rare. We report a case of gossypiboma mimicking tumor recurrence in the brain after a craniotomy and surgical excision of a low grade astrocytoma.

  9. Retroperitoneal Bronchogenic Cyst Mimicking Hydatid Liver: A Case Report

    Directory of Open Access Journals (Sweden)

    Fazl Q. Parray

    2012-01-01

    Full Text Available Bronchogenic cysts frequently occur in the mediastinum. They may be rarely encountered in the abdomen and retroperitoneum. Bronchogenic cysts can in fact mimic hydatid cysts. We report a case of retroperitoneal bronchogenic cyst below the right hemidiaphragm mimicking a hydatid cyst of the liver in a 30-year-old female.

  10. Headache attributed to unruptured saccular aneurysm, mimicking hemicrania continua.

    Science.gov (United States)

    Vikelis, Michail; Xifaras, Michail; Magoufis, Georgios; Gekas, Georgios; Mitsikostas, Dimos Dimitrios

    2005-06-01

    Unruptured cerebral arterial aneurysms most often remain asymptomatic, but they may cause headache or other symptoms or signs. We describe herewith a case of headache attributed to an unruptured internal carotid artery aneurysm, clearly mimicking the phenotype of hemicrania continua. Potential pathophysiological explanations and recommendations for recognition of similar cases are discussed.

  11. A Case of Pyomyositis and Primary Thigh Abscess in a Systemic Lupus Erythematous Patient MimickingThigh Hematoma

    Directory of Open Access Journals (Sweden)

    Rahele Mehrain

    2011-05-01

    Full Text Available Routes of extension of infection into the thigh can"nbe either direct, through the subcutaneous tissue, or"nthrough naturally occurring defects in the abdominal"nwall. These include: (1 Along the psoas muscle deep"nto the inguinal ligament; (2 Through the femoral"ncanal; (3 By way of the obturator foramen; and (4"nThrough the sacrosciatic notch. Pyomyositis is a"nprimary deep bacterial infection of the skeletal muscle"nwithout contiguous spread from adjacent structures,"nusually accompanied by abscess formation within"nthe skeletal muscle, but may also present as a diffuse"ninflammatory or a rapidly progressing myonecrotic"nprocess. Pyomyositis in patients with SLE has rarely"nbeen reported. Because of its rarity and often vague"nclinical presentation, it is unlikely to be considered"nduring the initial differential diagnosis. Moreover,"nthe diagnosis may be delayed as the affected muscle is"ndeeply situated and local signs are not apparent. This"ndelay in diagnosis may result in increased morbidity"nand sometimes a significant mortality rate. Here,"nwe describe a 57-year-old woman, known case of"nSLE with pyomyositis and primary left thigh abscess"nthat mimicked DVT in physical examination and"nhematoma in MRI. The purpose of this report was to"ndraw attention to this rare occurrence and to highlight"nthe etiology, presentation and the imaging features.

  12. Pitfalls of magnetic resonance imaging of alar ligament

    Energy Technology Data Exchange (ETDEWEB)

    Roy, Sumit; Hol, Per Kristian; Tillung, Terje [Interventional Centre, Rikshospitalet University Hospital, Oslo (Norway); Laerum, L. Thea [Anglo-European College of Chiropractic, Bournemouth (United Kingdom)

    2004-05-01

    An observational study of variations in the appearance of the alar ligament on magnetic resonance imaging (MRI) and the normal range of lateral flexion and rotation of the atlas was performed to validate some of the premises underlying the use of MRI for the detection of injuries to the alar ligament. Fifteen healthy volunteers were included. Three sets of coronal proton-density images, and axial T2-weighted images of the craniovertebral junction, were obtained at 0.5 T with the neck in neutral position and laterally flexed (coronal proton density) or rotated (axial T2). Five of the subjects also underwent imaging at 1.5 T. The scans were independently examined twice by two radiologists. The presence of alar ligaments was recorded and a three-point scale used to grade the extent of hyperintensity exhibited by the structures: the ligament were graded as 2 and 3 if, respectively, less or more of its cross-section was hyperintense, whereas grade 1 represented a hypointense ligament. The effect of lateral flexion on image quality was assessed. Concordance analysis of the data were performed before and after dichotomising the data on grading. The atlanto-axial angle and rotation of the atlas were measured. The magnitude of movement to right was normalised to that to the left to give, respectively, the flexion index and the rotation index. The alar ligaments were most reliably seen on coronal proton-density scans, with a Maxwell's RE of 0.96 as compared with 0.46 for sagittal images. Flexion of the neck improved definition of the ligaments in only rare instances. (orig.)

  13. Ulnar Collateral Ligament Reconstruction; the Rush Experience

    Science.gov (United States)

    Erickson, Brandon J.; Bach, Bernard R.; Cohen, Mark S.; Bush-Joseph, Charles A.; Cole, Brian J.; Verma, Nikhil N.; Nicholson, Gregory P.; Romeo, Anthony A.

    2016-01-01

    Objectives: Background: Ulnar collateral ligament reconstruction (UCLR) is now a common surgery performed in both professional, as well as high level athletes Purpose: To report the patient demographics, surgical techniques, and outcomes of all UCLR performed at a single institution from 2004-2014 Hypothesis: UCLR will be performed mostly in male pitchers and will have a complication rate of less than 5%. Methods: Methods: The surgical database of one institution was searched from January 1st 2004-December 31st 2014 for the current procedural terminology (CPT) code 24346 “Reconstruction medial collateral ligament, elbow, with tendon graft (includes harvesting of graft)”. Charts were reviewed to determine patient age, gender, date of surgery, sport played, athletic level, surgical technique, graft type, and complications were recorded. Patients were contacted via phone calls to obtain the return to sport rate, Conway-Jobe score, Timmerman & Andrews score, and Kerlan-Jobe Orthopaedic Clinic (KJOC) Shoulder and Elbow score. Results: Results: One hundred eighty-nine patients underwent UCLR during the study period (92% male, average age 19.6 +/- 4.9 years, 77.8% were right elbows). There were 166 baseball players (87.8% of all patients), 156 of which were pitchers (82.5% of all patients). Ninety-eight (51.6%) were college athletes, 62 (36%) were high school athletes, and 25 (13.2%) were professional athletes at the time of surgery. The docking technique was used in 111 (58.7%) patients while the double docking technique was used in 78 (41.3%). An ipsilateral palmaris longus graft was used in 111 (58.7%) of patients while a hamstring autograft was used in 48 (25.4%) patients. The ulnar nerve was subcutaneously transposed in 79 (41.8%) patients. Overall 95.7% of patients were able to return to sport and had a Conway-Jobe score of good/excellent while 4.3% had a score of fair. The average KJOC score was 94.7 +/- 5.7 and average Timmerman-Andrews score was 93.7 +/- 7

  14. Ghost imaging with broad distance

    Science.gov (United States)

    Duan, De-Yang; Zhang, Lu; Du, Shao-Jiang; Xia, Yun-Jie

    2015-10-01

    We present a scheme that is able to achieve the ghost imaging with broad distance. The physical nature of our scheme is that the different wavelength beams are separated in free space by an optical media according to the slow light or dispersion principle. Meanwhile, the equality of the optical distance of the two light arms is not violated. The photon correlation is achieved by the rotating ground glass plate (RGGP) and spatial light modulator (SLM), respectively. Our work shows that a monochromic ghost image can be obtained in the case of RGGP. More importantly, the position (or distance) of the object can be ascertained by the color of the image. Thus, the imaging and ranging processes are combined as one process for the first time to the best of our knowledge. In the case of SLM, we can obtain a colored image regardless of where the object is. Project supported by the National Natural Science Foundation of China (Grant Nos. 61178012, 11204156, 11304179, and 11247240), the Specialized Research Fund for the Doctoral Program of Higher Education of China (Grant Nos. 20133705110001 and 20123705120002), the Scientific Research Foundation for Outstanding Young Scientists of Shandong Province, China (Grant No. BS2013DX034), and the Natural Science Foundation of Shandong Province, China (Grant No. ZR2012FQ024).

  15. MRI of anterior cruciate ligament healing

    Energy Technology Data Exchange (ETDEWEB)

    Ihara, Hidetoshi; Miwa, Megumi; Deya, Keizo; Torisu, Kenji [Kyushu Rosai Hospital, Kitakyushu (Japan)

    1996-03-01

    The purpose of this study was to evaluate using MRI the natural healing of the anterior cruciate ligament (ACL) when treated conservatively by early protective motion. Consecutive acute complete intraligamentous ruptures of the ACL in 50 cases that were allowed to heal without surgery were evaluated before and after 3 month treatment by MRI, arthroscopy, and stress radiographs. Twenty-nine of the 50 patients were also reevaluated 11 months from the initial injury, of which 7 were reevaluated again 24 months from the initial injury by MRI. The MR appearance of the treated ACL was categorized into four grades depending on homogeneity, straight band, and size. MR assessment of the ACL after 3 month treatment demonstrated a well defined normal-sized straight band in 37 cases (74%). There was a significant relationship between the 3 and 11 month MR evaluations (r. = 0.801, p < 0.0001). There were also significant relationships between the MR and arthroscopic evaluations (r, = 0.455, p < 0.005) and between the MR and stress radiographic evaluations (r, = 0.348, p < 0.025) after the 3 month treatment. MRI can demonstrate ACL healing when treated conservatively with early protective mobilization. 40 refs., 3 figs., 2 tabs.

  16. Medial patellofemoral ligament reconstruction in patellar instability

    Directory of Open Access Journals (Sweden)

    M S Krishna Kumar

    2014-01-01

    Full Text Available Background: Medial patellofemoral ligament (MPFL is one of the major static medial stabilising structures of the patella. MPFL is most often damaged in patients with patellar instability. Reconstruction of MPFL is becoming a common surgical procedure in treating patellar instability. We hypothesised that MPFL reconstruction was adequate to treat patients with patellar instability if the tibial tubercle and the centre of the trochlear groove (TT-TG value was less than 20 mm and without a dysplastic trochlea. Materials and Methods: 30 patients matching our inclusion criteria and operated between April 2009 and May 2011 were included in the study. MPFL reconstruction was performed using gracilis tendon fixed with endobutton on the patellar side and bio absorbable interference screw or staple on the femoral side. Patients were followed up with subjective criteria, Kujala score and Lysholm score. Results: The mean duration of followup was 25 months (range 14-38 months. The mean preoperative Kujala score was 47.5 and Lysholm score was 44.7. The mean postoperative Kujala score was 87 and Lysholm score was 88.06. None of the patients had redislocation. Conclusion: MPFL reconstruction using gracilis tendon gives excellent results in patients with patellar instability with no redislocations. Some patients may have persistence of apprehension.

  17. Principles of postoperative anterior cruciate ligament rehabilitation.

    Science.gov (United States)

    Saka, Tolga

    2014-09-18

    It is known that anterior cruciate ligament (ACL) reconstruction needs to be combined with detailed postoperative rehabilitation in order for patients to return to their pre-injury activity levels, and that the rehabilitation process is as important as the reconstruction surgery. Literature studies focus on how early in the postoperative ACL rehabilitation period rehabilitation modalities can be initiated. Despite the sheer number of studies on this topic, postoperative ACL rehabilitation protocols have not been standardized yet. Could common, "ossified" knowledge or modalities really prove themselves in the literature? Could questions such as "is postoperative brace use really necessary?", "what are the benefits of early restoration of the range of motion (ROM)?", "to what extent is neuromuscular electrical stimulation (NMES) effective in the protection from muscular atrophy?", "how early can proprioception training and open chain exercises begin?", "should strengthening training start in the immediate postoperative period?" be answered for sure? My aim is to review postoperative brace use, early ROM restoration, NMES, proprioception, open/closed chain exercises and early strengthening, which are common modalities in the very comprehensive theme of postoperative ACL rehabilitation, on the basis of several studies (Level of Evidence 1 and 2) and to present the commonly accepted ways they are presently used. Moreover, I have presented the objectives of postoperative ACL rehabilitation in tables and recent miscellaneous studies in the last chapter of the paper. PMID:25232521

  18. [Rehabilitation after arthroscopic anterior cruciate ligament reconstruction].

    Science.gov (United States)

    Smékal, D; Kalina, R; Urban, J

    2006-12-01

    Rehabilitation is an important part of therapy in patients who have had arthroscopic anterior cruciate ligament reconstruction. A well-designed rehabilitation program avoids potential graft damage and speeds up patients' return to their full function level. The course of rehabilitation depends on the type of surgery, mode of fixation and possible co-existing injury to the knee's soft tissues. The rehabilitation program presented here is based on the present-day knowledge of neurophysiological and biomechanical principles and is divided into five phases. In the pre-operative phase (I), the main objective is to prepare patients for surgery in terms of maximum muscle strength and range of motion. It also includes providing full information on the procedure. In the early post-operative phase (II) we are concerned with pain alleviation and reduction of knee edema. After suture removal we begin with soft techniques for the patella and post-operative physical therapy to reduce scarring. In the next post-operative phase (III) patients are able to walk with their full weight on the extremity operated on, and we continue doing exercises that improve flexor/extensor co-contraction. In this phase we also begin with exercises improving the patient's proprioceptive and sensorimotor functions. In the late post-operative phase (IV) we go on with exercises promoting proprioception of both lower extremities with the aim of increasing muscle control of the knee joints. In the convalescent phase (V) patients gradually return to their sports activities.

  19. One-stage anatomic double bundle anterior and posterior cruciate ligament reconstruction

    OpenAIRE

    Acar, Baver; Başarır, Kerem; Armangil, Mehmet; Binnet, Mehmet Serdar

    2014-01-01

    Introduction: Main evidence of the heavy knee dislocations is the rupture of both Anterior Cruciate Ligament (ACL) and Posterior Cruciate Ligament (PCL). There are limited sources for the treatment of both ligaments at a single stage. Materials-method: One-staged anatomic double-bundle ACL and PCL reconstruction technique has been applied to 2 cases aged 20 and 36 with traumatic knee dislocation. Lateral collateral ligament and posteriolateral corner reconstruction added to one case, and medi...

  20. Biomechanical study on the suture strength of ligament in cruciate ligament reconstruction

    Institute of Scientific and Technical Information of China (English)

    张春礼; 李起鸿; 杨柳

    2003-01-01

    Objective: To test the suture strength on the tendon or ligament end and evaluate the stitch in the reconstruction of cruciate ligament and its clinical application. Methods: Twenty-four specimens of patellar tendon with free ends were divided into 3 groups: Group I (3 Krackow stitches), Group II (2 Krackow stitches) and Group III (2 Krackow stitches with the first stitch passing through the tendon tissue as a modified Krackow stitch). These 3 groups were further divided into 6 subgroups according to different suture materials, No 1 Ethilon or stainless steel wire (φ= 0.4 mm). Tensile test was undertaken to find out the least stitches with efficient suture pattern. Results: Two Krackow locking stitches had stronger strength than 0.4 mm-diameter stainless steel wire. The fixation strength of 2 stitches with No 1 Ethilon was more than 80 N, superior to the failure strength of the material itself. The same strength was maintained if the first stitch was across the tendon tissue transversely. There was no statistically significant difference in the suture strength between 2 and 3 Krackow locking stitches. Conclusions: The suture strength is greater than the failure strength of the suture material. Less suture exposure can be achieved when the first stitch is across the tendon tissue while maintaining a comparable strength to other sutures. To attain higher suture strength, stronger materials or multiple strands rather than more stitches are preferred. Therefore, a rapid early rehabilitation of range of motion (ROM) is possible and reliable in practice.

  1. Human periodontal ligament stem cells repair mental nerve injury*

    Institute of Scientific and Technical Information of China (English)

    Bohan Li; Hun-Jong Jung; Soung-Min Kim; Myung-Jin Kim; Jeong Won Jahng; Jong-Ho Lee

    2013-01-01

    Human periodontal ligament stem cells are easily accessible and can differentiate into Schwann cells. We hypothesized that human periodontal ligament stem cells can be used as an alternative source for the autologous Schwann cells in promoting the regeneration of injured peripheral nerve. To validate this hypothesis, human periodontal ligament stem cells (1 × 106) were injected into the crush-injured left mental nerve in rats. Simultaneously, autologous Schwann cells (1 × 106) and PBS were also injected as controls. Real-time reverse transcriptase polymerase chain reaction showed that at 5 days after injection, mRNA expression of low affinity nerve growth factor receptor was sig-nificantaly increased in the left trigeminal ganglion of rats with mental nerve injury. Sensory tests, histomorphometric evaluation and retrograde labeling demonstrated that at 2 and 4 weeks after in-jection, sensory function was significantly improved, the numbers of retrograde labeled sensory neurons and myelinated axons were significantly increased, and human periodontal ligament stem cells and autologous Schwann cells exhibited similar therapeutic effects. These findings suggest that transplantation of human periodontal ligament stem cells show a potential value in repair of mental nerve injury.

  2. Ligamentous structures in foramen magnum: sectional anatomy, CT and MRI

    International Nuclear Information System (INIS)

    Objective: To study the thin sectional anatomy and CT and MR imaging of ligamentous structures of foramen magnum (FM). Methods: Six formalin fixed (10%) specimens including head and neck were selected, and each specimen was imaged with CT and MR. Three specimens were sectioned with frozen section technique, the others were sectioned with plastination. Ligamentous structures of FM on continuous thin sections were observed and compared with the images of CT and MRI. Results: Continuous sections of 3.0 mm slice thickness for the axial, coronal, and sagittal planes of FM sectioned with frozen section technique were obtained. Continuous thin sections of 1mm slice thickness for the axial, coronal, and sagittal planes of FM sectioned with plastination were obtained. The resulting sections demonstrated excellent distinction of ligamentous structures of FM (including ligamentum alare, ligamentum transversum, membrana tectoria, anterior obturator membrane of atlas, posterior obturator membrane of atlas, and anterior atlanto-axial ligament). A good overall correlation between sections and images of CT and MR was found. Conclusions: In combination with CT and MRI, continuous thin sections of FM offers a better understanding of ligamentous structures of FM. (authors)

  3. Artificial phrenoesophageal ligament. An experimental study in dogs.

    Science.gov (United States)

    Sader, A A; Dantas, R O; Campos, A D; Evora, P R B

    2016-01-01

    This report deals with the preparation of a 'true' artificial phrenoesophageal ligament aimed at restoring effective anchoring of the esophagus to the diaphragm, keeping the esophagogastric sphincter in the abdomen. A total of 24 mongrel dogs were assigned to four groups: (i) Group I (n = 4): the esophageal diaphragm hiatus left wide open; (ii) Group II (n = 8): the anterolateral esophagus walls were attached to the diaphragm by the artificial ligament and the esophageal hiatus was left wide opened; (iii) Group III (n = 5): in addition to the use of the artificial ligament, the esophageal hiatus was narrowed with two retroesophageal stitches; (iv) Group IV (n = 7): the only procedure was the esophageal hiatus narrowing with two retroesophageal stitches. The phrenoesophagogastric connections were released, sparing the vagus nerves. Five animals of groups III and IV, which did not develop hiatal hernia, were submitted to esophageal manometry immediately before and 15 days after surgery. In group I, all animals developed huge sliding hiatal hernias. In group II, two dogs (25%) had a paraesophageal hernia between the two parts of the artificial ligament. In group III, neither sliding hiatal hernia nor paraesophageal hernia occurred. In group IV, two animals (28.6%) developed sliding esophageal hiatus hernia. Regarding esophageal manometry, postoperative significant difference between groups III and IV (P = 0.008) was observed. Thus, the artificial phrenoesophageal ligament maintained the esophagus firmly attached to the diaphragm in all animals and the esophagogastric sphincter pressure was significantly higher in this group.

  4. Reduction of artifacts in computer simulation of breast Cooper's ligaments

    Science.gov (United States)

    Pokrajac, David D.; Kuperavage, Adam; Maidment, Andrew D. A.; Bakic, Predrag R.

    2016-03-01

    Anthropomorphic software breast phantoms have been introduced as a tool for quantitative validation of breast imaging systems. Efficacy of the validation results depends on the realism of phantom images. The recursive partitioning algorithm based upon the octree simulation has been demonstrated as versatile and capable of efficiently generating large number of phantoms to support virtual clinical trials of breast imaging. Previously, we have observed specific artifacts, (here labeled "dents") on the boundaries of simulated Cooper's ligaments. In this work, we have demonstrated that these "dents" result from the approximate determination of the closest simulated ligament to an examined subvolume (i.e., octree node) of the phantom. We propose a modification of the algorithm that determines the closest ligament by considering a pre-specified number of neighboring ligaments selected based upon the functions that govern the shape of ligaments simulated in the subvolume. We have qualitatively and quantitatively demonstrated that the modified algorithm can lead to elimination or reduction of dent artifacts in software phantoms. In a proof-of concept example, we simulated a 450 ml phantom with 333 compartments at 100 micrometer resolution. After the proposed modification, we corrected 148,105 dents, with an average size of 5.27 voxels (5.27nl). We have also qualitatively analyzed the corresponding improvement in the appearance of simulated mammographic images. The proposed algorithm leads to reduction of linear and star-like artifacts in simulated phantom projections, which can be attributed to dents. Analysis of a larger number of phantoms is ongoing.

  5. Artificial phrenoesophageal ligament. An experimental study in dogs.

    Science.gov (United States)

    Sader, A A; Dantas, R O; Campos, A D; Evora, P R B

    2016-01-01

    This report deals with the preparation of a 'true' artificial phrenoesophageal ligament aimed at restoring effective anchoring of the esophagus to the diaphragm, keeping the esophagogastric sphincter in the abdomen. A total of 24 mongrel dogs were assigned to four groups: (i) Group I (n = 4): the esophageal diaphragm hiatus left wide open; (ii) Group II (n = 8): the anterolateral esophagus walls were attached to the diaphragm by the artificial ligament and the esophageal hiatus was left wide opened; (iii) Group III (n = 5): in addition to the use of the artificial ligament, the esophageal hiatus was narrowed with two retroesophageal stitches; (iv) Group IV (n = 7): the only procedure was the esophageal hiatus narrowing with two retroesophageal stitches. The phrenoesophagogastric connections were released, sparing the vagus nerves. Five animals of groups III and IV, which did not develop hiatal hernia, were submitted to esophageal manometry immediately before and 15 days after surgery. In group I, all animals developed huge sliding hiatal hernias. In group II, two dogs (25%) had a paraesophageal hernia between the two parts of the artificial ligament. In group III, neither sliding hiatal hernia nor paraesophageal hernia occurred. In group IV, two animals (28.6%) developed sliding esophageal hiatus hernia. Regarding esophageal manometry, postoperative significant difference between groups III and IV (P = 0.008) was observed. Thus, the artificial phrenoesophageal ligament maintained the esophagus firmly attached to the diaphragm in all animals and the esophagogastric sphincter pressure was significantly higher in this group. PMID:25604516

  6. STUDY OF ANTERIOR CRUCIATE LIGAMENT INJURY AND ITS MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Tummala Venkata

    2016-03-01

    Full Text Available BACKGROUND The anterior cruciate ligament is the weaker of the two cruciate ligaments stabilizing the knee joint, and therefore gets torn easier than the posterior cruciate ligament. OBJECTIVE To determine pattern of anterior cruciate ligament injury and its management in a tertiary care center. MATERIALS AND METHODS A prospective study was carried out for two years, 28 patients with ACL injury were included. A detailed history regarding the pattern of injury was noted and ACL reconstruction was done using BT Bautograft with mini-arthrotomy and arthroscopic assisted ACL reconstruction. RESULTS The mean age of the study subjects was 30.6±7.3 years & majority were males. Majority of the ACL injury was sports related & was on the right knee. 64% underwent arthroscopic assisted ACL reconstruction & majority of them had normal range of motion of the knee. CONCLUSION Our present study concludes that most common age group involved was 20-30 years & ACL injury was more common among males. Patients with an early ACL reconstruction were more satisfied with the end result. Also, ACL reconstruction techniques using BTB auto graft leads to good ligamentous stability and function of the knee.

  7. Psychological Aspects of Recovery Following Anterior Cruciate Ligament Reconstruction.

    Science.gov (United States)

    Christino, Melissa A; Fantry, Amanda J; Vopat, Bryan G

    2015-08-01

    Recovery following anterior cruciate ligament reconstruction is an arduous process that requires a significant mental and physical commitment to rehabilitation. Orthopaedic research in recent years has focused on optimizing anterior cruciate ligament surgical techniques; however, despite stable anterior cruciate ligament reconstructions, many athletes still never achieve their preinjury ability or even return to sport. Psychological factors associated with patient perceptions and functional outcomes following anterior cruciate ligament reconstruction are important to acknowledge and understand. Issues related to emotional disturbance, motivation, self-esteem, locus of control, and self-efficacy can have profound effects on patients' compliance, athletic identity, and readiness to return to sport. The psychological aspects of recovery play a critical role in functional outcomes, and a better understanding of these concepts is essential to optimize the treatment of patients undergoing anterior cruciate ligament reconstruction, particularly those who plan to return to sport. Identifying at-risk patients, encouraging a multidisciplinary approach to patient care, and providing early referral to a sports psychologist may improve patient outcomes and increase return-to-play rates among athletes.

  8. Sonoanatomy and injection technique of the iliolumbar ligament.

    LENUS (Irish Health Repository)

    Harmon, Dominic

    2012-01-31

    BACKGROUND: The iliolumbar ligament plays an important biomechanic role in anchoring the spine to the pelvic ring and stabilizing the sacroiliac joint. Iliolumbar syndrome is a back pain condition caused by pathology of the iliolumbar ligament. History and physical examination are important in the assessment of back pain, but they lack sufficient specificity. Injection of small volumes of local anesthetic into the structure considered to be the source of the pain (i.e. the iliolumbar ligament) increases the specificity of the diagnostic workup. OBJECTIVE: To describe an ultrasound - guided technique for injecting the iliolumbar ligament. STUDY DESIGN: Case report based on knowledge of topographic anatomy and sonoanatomy. SETTING: Outpatient clinic. METHODS: A patient with a clinical picture suggestive of iliolumbar syndrome was selected. An ultrasound-guided injection of the iliolumbar ligament with local anesthetic was performed. We recorded the patient\\'s subjective assessment of pain and the change in range of movement and pain scores during provocative tests. RESULTS: Following the injection, the patient\\'s pain score decreased, provocation tests became negative, and the range of movement increased. LIMITATIONS: Case report. Target specificity and dispersion of local anesthetic spread not confirmed with an independent technique (i.e. magnetic resonance imaging). CONCLUSIONS: Ultrasound guidance allows the selective deposition of small volumes of local anesthetic into structures believed to cause soft tissue back pain and thus to confirm or exclude the working diagnosis. Further studies are needed to confirm our conclusions and to prove the clinical feasibility of this technique.

  9. 78 FR 20119 - Broad Stakeholder Survey

    Science.gov (United States)

    2013-04-03

    ... SECURITY Broad Stakeholder Survey AGENCY: National Protection and Programs Directorate, DHS. ACTION: 30-day... soliciting comments concerning the Broad Stakeholder Survey. DHS previously published this ICR in the Federal... responders across the Nation. The Broad Stakeholder Survey is designed to gather stakeholder feedback on...

  10. 77 FR 50144 - Broad Stakeholder Survey

    Science.gov (United States)

    2012-08-20

    ... SECURITY Broad Stakeholder Survey AGENCY: National Protection and Programs Directorate, DHS. ACTION: 60-day... comments concerning the Broad Stakeholder Survey. DATES: Comments are encouraged and will be accepted until... across the Nation. The Broad Stakeholder Survey is designed to gather stakeholder feedback on...

  11. 76 FR 34087 - Broad Stakeholder Survey

    Science.gov (United States)

    2011-06-10

    ... SECURITY Broad Stakeholder Survey AGENCY: National Protection and Programs Directorate, DHS. ACTION: 60-day... comments concerning the Broad Stakeholder Survey. DATES: Comments are encouraged and will be accepted until.... The Broad Stakeholder Survey is designed to gather stakeholder feedback on the effectiveness of...

  12. Patellofemoral ligament reconstruction in a patient with Rubinstein-Taybi syndrome.

    Directory of Open Access Journals (Sweden)

    Fardin Mirzatolooei

    2014-03-01

    Full Text Available Recurrent dislocation of patella may occur in patients with ligament laxity. Method of treatment in this condition is controversial but patellofemoral ligament reconstruction is the most accepted method. We present a patient with Rubinstein-Taybi syndrome and recurrent patellar dislocation who managed successfully by patellofemoral ligament reconstruction.

  13. Dynamic sonography with valgus stress to assess elbow ulnar collateral ligament injury in baseball pitchers

    International Nuclear Information System (INIS)

    Sonography is a valuable method for imaging superficial tendons and ligaments. The ability to obtain comparison images easily with dynamic stress allows assessment of ligament and tendon integrity. We studied the medial elbow joints of two baseball pitchers using MR imaging and dynamic sonography. Both sonography and MR imaging identified the ulnar collateral ligament tears. Dynamic sonography uniquely demonstrated the medial joint instability. (orig.)

  14. A Comparison of Anterior and Posterior Cruciate Ligament Laxity Between Female and Male Basketball Players.

    Science.gov (United States)

    Weesner, Carol L.; And Others

    1986-01-01

    The anterior cruciate ligament and posterior cruciate ligament laxity of 90 uninjured male and female high school players were measured. No significant differences were found, indicating that the greater female injury rate may be due to inadequate conditioning, not greater knee ligament laxity. (Author/MT)

  15. Granuloma inguinale mimicking as squamous cell carcinoma of penis

    Directory of Open Access Journals (Sweden)

    Abhishek Pilani

    2014-01-01

    Full Text Available Granuloma inguinale (GI is an acquired chronic, slowly progressive, mildly contagious disease of venereal origin, characterized by granulomatous ulceration of the genitalia and neighboring sites, with little or no tendency to spontaneous healing caused by Klebsiella (Calymmatobacterium granulomatis. A 55-year-old male presented with fissured, foul smelling, fungating growth over prepuce with phimosis mimicking squamous cell carcinoma (SCC without lymphadenopathy. It started with painless papulonodular showed pseudoepitheliomatous hyperplasia, infiltration in dermis, acanthosis and vacuolated macrophages suggestive of GI and not showing any histopathological features of SCC. Patient was successfully treated by giving cotrimoxazole twice a day for 21 days. Here, we presented a case of GI mimicking SCC of penis, which was diagnosed on basis of histopathology and treated with excision followed by medical therapy with cotrimoxazole.

  16. Injured lateral ankle ligaments: technique and assessment of MRI

    International Nuclear Information System (INIS)

    56 patients with the clinical diagnosis of sprained ankles were investigated. Evaluation of the anterior (AFTL) and posterior fibulotalar ligament (PFTL) was performed with the foot in dorsiflexion (20 ) and of the fibulo calcanear ligament (FCL) in plantarflexion (45 ). Axial T1w-SE and T2w-TSE images were obtained. Full-length visualisation of ligmaments in one slice and the extent of injury were evaluated. 12 ankle injuries were confirmed by operation. With MRI full-length visualisation of lateral ankle ligaments was possible in 86%. A partial/complete rupture of the AFTL was noticed in 33/64% and of the FCI in 29/39%, and of the PFTL in 27/5%. Sensitivity/specificity of MRI when compared to surgery was 100/100% for injuries of the AFTL, 64/100% for the FCL, and 33/78% for the PFTL. (orig./MG)

  17. Compartment syndrome with mononeuropathies after anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Kindle, Brett J; Murthy, Naveen; Stolp, Kathryn

    2015-05-01

    Compartment syndrome rarely follows anterior cruciate ligament reconstruction. However, when it does, it may result in mononeuropathies that are amenable to neurolysis. The authors of this study present an 18-yr-old woman who sustained a right anterior cruciate ligament tear and underwent uneventful anterior cruciate ligament reconstruction using femoral and popliteal nerve blocks. Postoperatively, she developed compartment syndrome requiring emergent fasciotomies. At 11 wks after fasciotomy, results of electrophysiologic tests showed evidence of severe fibular and tibial neuropathies. Magnetic resonance images showed extensive tricompartmental myonecrosis. Fibular and tibial neurolysis as well as decompression were performed, followed by intensive outpatient rehabilitation. At the 6-mo follow-up, she reported resolution of pain as well as significant improvement in sensation, strength, and function. Early recognition and intervention are crucial to prevent serious neurologic damage. Excessive tourniquet pressure and anesthetic nerve blocks may have been responsible.

  18. Absence of sensory function in the reconstructed anterior cruciate ligament

    DEFF Research Database (Denmark)

    Krogsgaard, Michael R; Fischer-Rasmussen, Torsten; Dyhre-Poulsen, Poul

    2011-01-01

    Cruciate ligaments provide sensory information that cause excitatory as well as inhibitory effects to the activity of the muscles around the knee. The aim of the study was to determine whether these muscular reflexes are reestablished after anterior cruciate ligament (ACL) re-construction. Wire...... electrodes were inserted during arthroscopy into the normal posterior cruciate ligament (PCL) and the reconstructed ACL in 11 patients who had a successful ACL re-construction 8 months to 12 years earlier. After the anesthesia had subsided, the PCL was stimulated electrically through the electrodes...... and the sensory threshold was determined. Stimulus amplitudes were increased to 1.5-2.0 times the sensory threshold, and inhibitory reflexes could be elicited from PCL in the quadriceps during active extension and in the hamstrings muscles during active flexion in all patients. Subsequently the ACL re-constructions...

  19. A proposed index for residual periodontal ligament support.

    Science.gov (United States)

    Abe, Yasuhiko; Taji, Tsuyoshi; Hiasa, Kyou; Tsuga, Kazuhiro; Akagawa, Yasumasa

    2010-01-01

    An index was developed to estimate the residual periodontal ligament support for individual teeth during treatment planning for partially edentulous patients. The Residual Periodontal Ligament Index (rPLI) was derived from a formula that calculates the remaining area of periodontal attachment and the Normal Periodontal Ligament Index (nPLI). To illustrate the applicability of the rPLI, the total nPLI scores of the remaining teeth corresponding to Eichner subclasses of partial edentulism were charted by assessing the average occlusal support numerically. The rPLI is proposed to be a possible suitable tool for epidemiologic research on the progression of tooth loss and the survival rate of prostheses. PMID:20859566

  20. Sarcoidosis mimicking metastatic thyroid cancer following radioactive iodine therapy

    OpenAIRE

    Myint, Zin W.; Chow, Robert D.

    2015-01-01

    Introduction: Sarcoidosis is an inflammatory disease characterized by non-caseating granulomas that can be present in diverse organ systems. Sarcoidosis can be associated with malignancy, presenting either preceding, during, or after chemotherapy. We herewith report a case of sarcoidosis mimicking cancer recurrence that developed after radioactive iodine therapy for papillary thyroid cancer.Background: A 68-year-old Caucasian woman was found to have an incidental mediastinal lymph node. She u...

  1. Osteofibrous dysplasia of clavicle clinically mimicking chronic osteomyelitis

    Directory of Open Access Journals (Sweden)

    Nirmal Raj Gopinathan

    2016-01-01

    Full Text Available Osteofibrous dysplasia or ossifying fibroma is an uncommon benign fibro-osseous lesion of childhood, commonly described in the maxilla and the mandible. Among long bones, it usually presents in the tibia as a painless swelling or anterior bowing. Ossifying fibroma of clavicle has never been reported in English literature, to the best of our knowledge. Here, we would like to present an unusual case of osteofibrous dysplasia of clavicle clinically mimicking chronic osteomyelitis.

  2. Traumatic Thumb Radial Sagittal Band Injury Mimicking EPL Rupture.

    Science.gov (United States)

    Dissanayake, Ravi M; Moore, Peter; McCarten, Gregory M

    2016-06-01

    We present the case of a closed traumatic disruption of the thumb radial sagittal band (RSB) that sonographically mimicked rupture of the extensor pollicis longus (EPL) tendon. This injury was treated with primary repair of the RSB and lead to a good functional outcome for the patient. This case report highlights how early recognition and treatment can lead to a good functional outcome. PMID:27454647

  3. Spitz Nevus on the Earlobe Mimicking Cutaneous Leishmaniasis

    Directory of Open Access Journals (Sweden)

    İbrahim Özmen

    2010-06-01

    Full Text Available Spitz nevus is a benign, usually acquired melanocytic tumor which is seen especially in children and adolescents. It usually appears as a pink or light-brown, smooth-surfaced, well-circumscribed and asymptomatic papulonodular lesion. A large group of dermatologic disorders should be considered in the differential diagnosis. Herein we present a case of Spitz nevus with a two month history of a nodular lesion on the earlobe which mimicks cutaneous leishmaniasis clinically.

  4. A Case of Hidroacanthoma Simplex Mimicking Bowen s Disease

    Directory of Open Access Journals (Sweden)

    Pinar Ozuguz

    2013-10-01

    Full Text Available Hidroacanthoma simplex is a rare benign tumor that originates from eccrine sweet gland ducts. The lesions are characterized by slowly-growing, flat or slightly elevated, skin-colored, brown or erythematous, verrucous papules or plaques. Clinically, plaques may resemble seborrheic keratosis, basal cell carcinoma and Bowen%u2019s disease. Here, we present a case of atypically localized hidroacanthoma simplex mimicking Bowen%u2019s disease.

  5. A Case of Hidroacanthoma Simplex Mimicking Bowen s Disease

    OpenAIRE

    Pinar Ozuguz

    2013-01-01

    Hidroacanthoma simplex is a rare benign tumor that originates from eccrine sweet gland ducts. The lesions are characterized by slowly-growing, flat or slightly elevated, skin-colored, brown or erythematous, verrucous papules or plaques. Clinically, plaques may resemble seborrheic keratosis, basal cell carcinoma and Bowen%u2019s disease. Here, we present a case of atypically localized hidroacanthoma simplex mimicking Bowen%u2019s disease.

  6. Heterotopic Pancreas Mimicking Cholangiocarcinoma. Case Report and Literature Review

    OpenAIRE

    Atindriya Biswas; Ehab A. Husain; Roger M Feakins; Abraham, Ajit T

    2007-01-01

    Context Majority of the patients developing obstructive jaundice have an underlying malignancy. Identification of a benign pathology like heterotopic pancreas as an aetiology is uncommon and usually occurs only subsequent to a major operation. Case report We report a case of heterotopic pancreas adjacent to the ampulla of Vater mimicking distal cholangiocarcinoma. A 47- year-old patient presented with abdominal pain and obstructive jaundice. ERCP demonstrated a distal common bile duct strictu...

  7. Xanthogranulomatous Endometritis: An Unusual Pathological Entity Mimicking Endometrial Carcinoma

    Science.gov (United States)

    Makkar, M; Gill, MK; Singh, DP

    2013-01-01

    Xanthogranulomatous endometritis is an unusual pathological entity mimicking endometrial carcinoma. This shows sheets of foamy histiocytes alongwith other inflammatory cells. We, hereby, report a case of 45 year multigravida female with irregular menstrual history, clinically diagnosed as carcinoma and histopathologically turned out as xanthogranulomatous endometritis. So, this condition should always be dealt with caution, and pathologists and clinicians should be aware of it. PMID:24349850

  8. MRI features of the anterolateral ligament of the knee

    International Nuclear Information System (INIS)

    Evaluate the visibility and describe the anatomical features of the anterolateral ligament of the knee using MRI. Magnetic resonance imaging examinations of the knee were independently reviewed by two musculoskeletal radiologists and assessed for the visibility of the anterolateral ligament under direct cross-referencing of axial and coronal images as complete, partial, or non-visible. Distal insertion site (tibial, meniscal), distance to lateral tibial plateau, measurements (length, width, thickness), and associated imaging findings were also tabulated. Clinical and surgical records were also reviewed. Seventy MRI scans from 60 consecutive subjects were included in the study. Mean age was 40 years, body mass 74.9 kg, and height 1.72 m. The subject population was 53 % male, most of the knees were from the left side (51 %), and chronic pain was the main clinical symptom (40 %). Nine knees (13 %) had undergone previous surgery. The anterolateral ligament was identified in 51 % of the knees: completely visible in 11 % and partially visible in 40 %. In all visible cases, the distal insertion site was identified on the tibia, with a mean distance of 5.7 mm to the plateau. A completely visible ligament had a mean length of 33.2 mm, thickness of 5.6 mm, and width of 1.9 mm. Inter-observer agreement for ligament presence was significant (κ = 0.7). Statistical analyses showed a trend to be more visible in men, with a longer length compared with women. Magnetic resonance imaging clearly identifies the anterolateral ligament of the knee in slightly more than half of cases, being partially visible in most of them. In all cases, a tibial insertion is characterized. (orig.)

  9. MRI features of the anterolateral ligament of the knee

    Energy Technology Data Exchange (ETDEWEB)

    Taneja, Atul K. [Hospital Israelita Albert Einstein, Musculoskeletal Radiology Division, Imaging Department, Sao Paulo, SP (Brazil); Hospital do Coracao (HCor), and Teleimagem, Musculoskeletal Imaging, Diagnostic Center, Sao Paulo, SP (Brazil); Miranda, Frederico C.; Braga, Cesar A.P.; Hartmann, Luiz G.C.; Santos, Durval C.B.; Rosemberg, Laercio A. [Hospital Israelita Albert Einstein, Musculoskeletal Radiology Division, Imaging Department, Sao Paulo, SP (Brazil); Gill, Corey M. [Department of Neurology and Cancer Center, Pappas Center for Neuro-Oncology, Boston, MA (United States)

    2014-11-27

    Evaluate the visibility and describe the anatomical features of the anterolateral ligament of the knee using MRI. Magnetic resonance imaging examinations of the knee were independently reviewed by two musculoskeletal radiologists and assessed for the visibility of the anterolateral ligament under direct cross-referencing of axial and coronal images as complete, partial, or non-visible. Distal insertion site (tibial, meniscal), distance to lateral tibial plateau, measurements (length, width, thickness), and associated imaging findings were also tabulated. Clinical and surgical records were also reviewed. Seventy MRI scans from 60 consecutive subjects were included in the study. Mean age was 40 years, body mass 74.9 kg, and height 1.72 m. The subject population was 53 % male, most of the knees were from the left side (51 %), and chronic pain was the main clinical symptom (40 %). Nine knees (13 %) had undergone previous surgery. The anterolateral ligament was identified in 51 % of the knees: completely visible in 11 % and partially visible in 40 %. In all visible cases, the distal insertion site was identified on the tibia, with a mean distance of 5.7 mm to the plateau. A completely visible ligament had a mean length of 33.2 mm, thickness of 5.6 mm, and width of 1.9 mm. Inter-observer agreement for ligament presence was significant (κ = 0.7). Statistical analyses showed a trend to be more visible in men, with a longer length compared with women. Magnetic resonance imaging clearly identifies the anterolateral ligament of the knee in slightly more than half of cases, being partially visible in most of them. In all cases, a tibial insertion is characterized. (orig.)

  10. Active knee motion after cruciate ligament rupture. Stereoradiography.

    Science.gov (United States)

    Kärrholm, J; Selvik, G; Elmqvist, L G; Hansson, L I

    1988-04-01

    In 10 patients with an old injury of the anterior cruciate ligament, the three-dimensional movements of the knee joint were studied when the patients flexed their knees. Tibial motions were recorded using roentgen stereophotogrammetric analysis. Internal rotation and adduction of the tibia were reduced in the injured knees when compared with the intact knees; during flexion of the knee joint, the tibial intercondylar eminence occupied a more lateral and posterior position on the injured side. Our results may indicate that the knee joint is continuously exposed to abnormal stresses when the anterior cruciate ligament is torn. PMID:3364185

  11. Pathologic conditions of the ligaments and tendons of the knee.

    Science.gov (United States)

    El-Dieb, Adam; Yu, Joseph S; Huang, Guo-Shu; Farooki, Shella

    2002-09-01

    Excellent spatial resolution and unparalleled contrast resolution have allowed MRI to emerge as the dominant imaging modality for diagnosis of ligament and tendon pathology of the knee joint This article presents several important mechanisms of injury associated with tendon and ligament disruptions. When present, the pattern of bone contusions may reveal the vector of force. When one is aware of the mechanism of injury, it is possible to analyze systematically the structures of the knee and maximize the detection of pathology. Recognition of a knee dislocation pattern is important because the diagnosis may be unsuspected, and the clinician may have to be alerted to the possibility of vascular and neural injury.

  12. Acute finger injuries: part I. Tendons and ligaments.

    Science.gov (United States)

    Leggit, Jeffrey C; Meko, Christian J

    2006-03-01

    Improper diagnosis and treatment of finger injuries can cause deformity and dysfunction over time. A basic understanding of the complex anatomy of the finger and of common tendon and ligament injury mechanisms can help physicians properly diagnose and treat finger injuries. Evaluation includes a general musculoskeletal examination as well as radiography (oblique, anteroposterior, and true lateral views). Splinting and taping are effective treatments for tendon and ligament injuries. Treatment should restrict the motion of injured structures while allowing uninjured joints to remain mobile. Although family physicians are usually the first to evaluate patients with finger injuries, it is important to recognize when a referral is needed to ensure optimal outcomes.

  13. Anterior Cruciate Ligament Reconstruction in Ehlers-Danlos Syndrome

    Directory of Open Access Journals (Sweden)

    John Williams

    2015-01-01

    Full Text Available This report details the reconstruction of the anterior cruciate ligament in an 18-year-old man with Ehlers-Danlos syndrome (EDS. The reduced mechanical properties of the tissue in EDS can pose a challenge to the orthopaedic surgeon. In this case, we describe the use of a hamstring autograft combined with a Ligament Advanced Reinforcement System (LARS. There was a good radiographical, clinical, and functional outcome after two years. This technique gave a successful outcome in the reconstruction of the ACL in a patient with EDS and therefore may help surgeons faced with the same clinical scenario.

  14. Retinoid-induced ossification of the posterior longitudinal ligament

    International Nuclear Information System (INIS)

    Vitamin A and its synthetic congeners are known to produce a variety of skeletal abnormalities in patients on prolonged treatment with these medications. Two patients are described who developed posterior longitudinal ligament ossification following treatment with the synthetic retinoid 13-cis-retinoic acid. In both cases, this finding became apparent after other retinoid-induced skeletal abnormalities were observed and was less marked than the ossification of the anterior longitudinal ligament. Although spinal cord compression did not occur in our patients, patients on long-term retinoid therapy should be carefully observed for this complication. (orig.)

  15. Medial patellofemoral ligament: Research progress in anatomy and injury imaging

    International Nuclear Information System (INIS)

    The medial patellofemoral ligament (MPFL) is considered as the most important soft tissue restraint providing medial stability of the patellofemoral joint. During patellar dislocation, the MPFL is subjected to severe stretching forces, resulting in injuries of the ligament in the most patients. With the development of medical imaging technology, a variety of non-invasive diagnostic imaging methods have been becoming important means in diagnosis of MPFL injury. In this paper, MPFL anatomy, the applications of medical imaging technology in diagnosis of MPFL injury and the distributions of MPFL injury site were reviewed. (authors)

  16. Patella fracture following anterior cruciate ligament reconstruction: A case report

    OpenAIRE

    Milankov Miroslav; Kecojević Vaso; Ninković Srđan; Gajdobranski Đorđe R.

    2003-01-01

    Introduction The most frequent procedure in treatment of acute or chronic anterior cruciate ligament (ACL) rupture is the so called bone-tendon-bone reconstruction. A transverse dislocated patella fracture is a rare complication of this procedure with an incidence of 0.23%-2.3%. In a five year period, (1998-2002), 407 arthroscopic reconstructions of the anterior cruciate ligaments were done at our Clinic, and there was only one case of patella fracture. Case report An 18-year-old female patie...

  17. Anterior Cruciate Ligament: Structure, Injuries and Regenerative Treatments.

    Science.gov (United States)

    Negahi Shirazi, Ali; Chrzanowski, Wojciech; Khademhosseini, Ali; Dehghani, Fariba

    2015-01-01

    Anterior cruciate ligament (ACL) is one of the most vulnerable ligaments of the knee. ACL impairment results in episodic instability, chondral and meniscal injury and early osteoarthritis. The poor self-healing capacity of ACL makes surgical treatment inevitable. Current ACL reconstructions include a substitution of torn ACL via biological grafts such as autograft, allograft. This review provides an insight of ACL structure, orientation and properties followed by comparing the performance of various constructs that have been used for ACL replacement. New approaches, undertaken to induce ACL regeneration and fabricate biomimetic scaffolds, are also discussed. PMID:26545750

  18. Anterior Cruciate Ligament: Structure, Injuries and Regenerative Treatments.

    Science.gov (United States)

    Negahi Shirazi, Ali; Chrzanowski, Wojciech; Khademhosseini, Ali; Dehghani, Fariba

    2015-01-01

    Anterior cruciate ligament (ACL) is one of the most vulnerable ligaments of the knee. ACL impairment results in episodic instability, chondral and meniscal injury and early osteoarthritis. The poor self-healing capacity of ACL makes surgical treatment inevitable. Current ACL reconstructions include a substitution of torn ACL via biological grafts such as autograft, allograft. This review provides an insight of ACL structure, orientation and properties followed by comparing the performance of various constructs that have been used for ACL replacement. New approaches, undertaken to induce ACL regeneration and fabricate biomimetic scaffolds, are also discussed.

  19. Gd-DTPA enhanced MR-follow-up of autologous patellar ligament transplants for anterior cruciate ligament repair

    International Nuclear Information System (INIS)

    Eighteen patients with autologous patellar tendon transplant for reconstruction the anterior cruciate ligament were examined postoperatively. The time between operation and MR study was up to 3 weeks in ten patients, between 3 and 35 weeks in three patients and more than 35 weeks in five patients. In all patients, Gd-DTPA enhancement on the surface of the ligamentous transplant was visualized. This enhancement was between 1 and 10 mm thick. In all patients, complete stability of the knee joint was postoperatively. In 15 patients achieved flexion and extension were normal at the postoperative investigation. Three patients had a limitation of knee movement. In these MR studies, significant hyperplasia of the synovial membrane of the entire joint was diagnosed, explaining the persisting problems. Gd-DTPA-enhanced MR of the knee joint allows non-invasive documentation of remodelling following a patellar ligament transplant and possible complications. (orig.)

  20. MRI of rupture of the spring ligament complex with talo-cuboid impaction

    International Nuclear Information System (INIS)

    The spring ligament complex is essential for the stability of the longitudinal arch of the foot and includes the ligaments between the calcaneus and the talus at the superomedial to inferoplantar aspect of the foot. Tears of the spring ligament complex are most commonly degenerative in etiology and secondary to concomitant abnormality of the posterior tibial tendon. We report MRI findings in a 30-year-old man who presented with traumatic rupture of the spring ligament complex, seen following dislocation of the talonavicular joint. We also describe the previously unreported MRI features of talo-cuboid impaction secondary to disruption of the spring ligament complex. (orig.)

  1. MRI of rupture of the spring ligament complex with talo-cuboid impaction

    Energy Technology Data Exchange (ETDEWEB)

    Kavanagh, E.C. [University of Pittsburgh Medical Center, Department of Radiology, Pittsburgh, PA (United States); Koulouris, G. [Department of Radiology, Melbourne, VIC (Australia); Gopez, A.; Zoga, A.; Morrison, W.B. [Thomas Jefferson University Hospital, Department of Radiology, Philadelphia, PA (United States); Raikin, S. [Thomas Jefferson University Hospital, Department of Orthopedics, Philadelphia, PA (United States)

    2007-06-15

    The spring ligament complex is essential for the stability of the longitudinal arch of the foot and includes the ligaments between the calcaneus and the talus at the superomedial to inferoplantar aspect of the foot. Tears of the spring ligament complex are most commonly degenerative in etiology and secondary to concomitant abnormality of the posterior tibial tendon. We report MRI findings in a 30-year-old man who presented with traumatic rupture of the spring ligament complex, seen following dislocation of the talonavicular joint. We also describe the previously unreported MRI features of talo-cuboid impaction secondary to disruption of the spring ligament complex. (orig.)

  2. MR imaging evaluation of the injured and operatively reconstructed cruciate ligament

    International Nuclear Information System (INIS)

    One hundred fifty patients with recent or older cruciate ligament injuries have been examined with MR imaging, and the MR findings were compared with the operative results. Ninety-three percent of all cases with a complete rupture of the anteriorand/or posterior ligament were diagnosed preoperatively. One hundred fifteen patients with reconstruction of one or both cruciate ligaments have been examined, and their MR findings were compared with the clinical findings at orthopedic examination. With a standardized MR technique identical to that used in patients with rupture of the cruciate ligaments, there was a good correlation between MR and clinical findings, for stable as well as unstable ligament reconstruction

  3. Biological and Biomechanical Evaluation of the Ligament Advanced Reinforcement System (LARS AC) in a Sheep Model of Anterior Cruciate Ligament Replacement: A 3-Month and 12-Month Study

    OpenAIRE

    Viateau, Véronique; MANASSERO, Mathieu; ANAGOSTOU, Fani; GUERARD, Sandra; Mitton, David; Migonney, Véronique

    2013-01-01

    PurposeThe purposes of this study were to assess tissue ingrowth within the Ligament Advanced Reinforcement System (LARS) artificial ligament (LARS AC; LARS, Arc sur Tille, France) and to study the biomechanical characteristics of the reconstructed knees in a sheep model of anterior cruciate ligament (ACL) replacement.MethodsTwenty-five female sheep underwent excision of the proximal third of the left ACL and intra-articular joint stabilization with a 44-strand polyethylene terephthalate liga...

  4. Sex Differences in Patient-Reported Outcomes After Anterior Cruciate Ligament Reconstruction: Data From the Swedish Knee Ligament Register

    DEFF Research Database (Denmark)

    Ageberg, Eva; Forssblad, Magnus; Herbertsson, Pär;

    2010-01-01

    BACKGROUND: Female gender is a risk factor for sustaining anterior cruciate ligament (ACL) injury. However, little is known about possible sex differences in patients with ACL injury/reconstruction. PURPOSE: To study sex differences in patient-reported outcomes before and at 1 and 2 years after ACL...... reconstruction and to present reference values. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: Between 2005 and 2008, 10 164 patients (mean age, 27 years; SD, 9.8; 42% females) with primary ACL reconstruction were registered in the Swedish national knee ligament register. There were 4438 (44...

  5. The response of periodontal ligament collagen fibres and the thickness of inserting periodontal ligament fibre bundles at cementum pressure sites of fixed orthodontic appliances

    Directory of Open Access Journals (Sweden)

    Noengki Prameswari

    2007-06-01

    Full Text Available Previous research has indicated that there were several reactions in cellular activity and periodontal ligament collagen fibre as a response after orthodontic force application. Cementum has function to give attachment to collagen fibres of the periodontal ligament, maintaining the integrity of the root, helping to maintain the tooth in its functional position in the mouth, and being involved in tooth repair and regeneration so in the orthodontic tooth movement can induce changes in the cementum. The aim of this research is to investigate that fixed orthodontic appliance can change the amount of periodontal ligament collagen fibre and the thickness of inserting periodontal ligament fibre bundles at pressure site of cementum. This experimental study was held in laboratory with post test only control group design. Twenty two (22 premolar sample from 11 patient were divided into 2 groups. K group as control group (without treatment and P group as treatment group (with using fixed orthodontic appliance. The amount of periodontal ligament collagen fibre and thickness of inserting periodontal ligament fibre bundles was examined by light microscopy and measured by image tool program. In the summary, there are increasing amount of periodontal ligament collagen fibre and the thickness of inserting periodontal ligament fibre bundles at cementum pressure sites as a normal response to remodeling and regenerating to orthodontic appliance and have function for strengthen adhering tooth cementum to the periodontal ligament.

  6. Benign Multicystic Mesothelioma in the Left Round Ligament: Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Bae, So Young; Yi, Boem Ha; Lee, Hae Kyung; Park, Seong Jin; Cho, Gyu Seok; Kwak, Jeong Ja [Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of)

    2010-02-15

    Benign multicystic mesothelioma is a rare mesothelial lesion that forms multicystic masses in the upper abdomen, pelvis, and retroperitoneum. Most cases have a benign course. We present the ultrasound and MR findings of benign multicystic mesothelioma in the left round ligament, which caused a left inguinal hernia in a 46-year-old woman.

  7. Nocardia Septic Arthritis Complicating an Anterior Cruciate Ligament Repair.

    Science.gov (United States)

    Yong, Elaine X L; Cheong, Elaine Y L; Boutlis, Craig S; Chen, Darren B; Liu, Eunice Y-T; McKew, Genevieve L

    2015-08-01

    Nocardia infection following anterior cruciate ligament (ACL) allograft reconstruction is a rare occurrence. We report a case of Nocardia infection of an allograft ACL reconstruction and septic arthritis of the knee joint due to an organism most similar to the novel Nocardia species Nocardia aobensis.

  8. Anatomy and histology of the transverse humeral ligament.

    Science.gov (United States)

    Snow, Brian J; Narvy, Steven J; Omid, Reza; Atkinson, Roscoe D; Vangsness, C Thomas

    2013-10-01

    The classic literature describes the transverse humeral ligament (THL) as a distinct anatomic structure with a role in biceps tendon stability; however, recent literature suggests that it is not a distinct anatomic structure. The purpose of this study was to evaluate the gross and microscopic anatomy of the THL, including a specific investigation of the histology of this ligament. Thirty frozen, embalmed cadaveric specimens were dissected to determine the gross anatomy of the THL. Seven specimens were evaluated histologically for the presence of mechanoreceptors and free nerve endings. Two tissue layers were identified in the area described as the THL. In the deep layer, fibers of the subscapularis tendon were found to span the bicipital groove with contributions from the coracohumeral ligament and the supraspinatus tendon. Superficial to this layer was a fibrous fascial covering consisting of distinct bands of tissue. Neurohistology staining revealed the presence of free nerve endings but no mechanoreceptors. This study's findings demonstrate that the THL is a distinct structure continuous with the rotator cuff tendons and the coracohumeral ligament. The finding of free nerve endings in the THL suggests a potential role as a shoulder pain generator.

  9. Ossification of the posterior longitudinal ligament of the lumbar spine

    International Nuclear Information System (INIS)

    The ossification on the cervical posterior longitudinal ligament (OPLL) is widely known and studied in Japan where a roentgenological incidence of 2.6% adults affected has been found. Data concerning the ossification of the lumbar posterior longitudinal ligament are few and occasional. An epidemiological survey on lumbar OPLL was performed by the authors in Matsumoto, Japan, on a total of 972 subjects, 554 of whom over the age of 35, by means of X-ray of the lumbar spine. Ossification of the lumbar posterior longitudinal ligament was detected in 23 subjects (2.9%), with no significant difference between males (3.0%) and females (2.8). Lumbar OPLL was absent in the 238 subjects aged less than 34; it was most prevalent after the age of 45 (5.1% in males and 4.5% in females). The ossification developed in two ways: continuous ossified layer extending over several vertebrae; circumscribed ossification of the ligament corresponding to the level of the invertebral disk (retrodiscal type). The results of this epidemiological survey showed a roentgenological incidence of lumbar OPLL of the same magnitude than that of cervical OPLL

  10. Arthroscopic management of mucoid degeneration of anterior cruciate ligament

    Directory of Open Access Journals (Sweden)

    Chirag H Chudasama

    2012-01-01

    Conclusions: Mucoid hypertrophy of the ACL should be suspected in elderly persons presenting pain on terminal extension or flexion without preceding trauma, especially when there is no associated meniscal lesion or ligamentous insufficiency. They respond well to a judicious arthroscopic release of the ACL with notchplasty.

  11. Enthesiopathy of the short radial collateral ligaments in racing greyhounds

    International Nuclear Information System (INIS)

    In a radiographic survey of the carpi of 100 racing greyhounds there was a 14 per cent incidence of enthesiopathy of the origin of the straight part of the short radial collateral ligament. Enthesiopathy was not identified as a clinical problem in any case, nor was there historical evidence of any adverse effect on performance

  12. Anatomic Reconstruction Technique for a Plantar Calcaneonavicular (Spring) Ligament Tear.

    Science.gov (United States)

    Palmanovich, Ezequiel; Shabat, Shay; Brin, Yaron S; Feldman, Viktor; Kish, Benny; Nyska, Meir

    2015-01-01

    Acquired flatfoot deformity in adults is usually due to partial or complete tearing of the posterior tibial tendon, with secondary failure of other structures such as the plantar calcaneonavicular (spring) ligament (SL), which maintain the medial longitudinal arch. In flexible cases, the tibialis posterior can be replaced with the flexor digitorum longus. It is common practice to suture the SL directly in the case of a tear; however, if the tear is complete, suturing directly to the ligament alone will not be possible. Reconstruction of the ligament is needed; however, no validated methods are available to reconstruct this ligament. The operative technique of SL reconstruction described in this report as a part of acquired flatfoot deformity reconstruction consists of augmenting remnants of the spring from the navicularis to the sustentaculum tali and suspending it to the medial malleolus using 2-mm-wide, long-chain polyethylene suture tape. This technique results in the firm anatomic reconstruction of the SL, in addition to "classic" medial arch reconstruction. We recommend SL reconstruction for medial arch reconstruction when the SL is torn. PMID:26253476

  13. Degenerative Suspensory Ligament Desmitis – A New Reality

    Directory of Open Access Journals (Sweden)

    Jaroslava Halper*, Ahrar Khan1 and P. O. Eric Mueller2

    2011-01-01

    Full Text Available Degenerative suspensory ligament desmitis (DSLD is a chronic, debilitating disease occurring primarily in Peruvian Pasos and Peruvian Paso crosses. However, many other breeds are afflicted as well. DSLD is characterized by a slowly progressing bilateral or quadrilateral lameness. Typically, the owner does not recall any trauma or performance related injury. Fetlock effusion, static and dynamic hyperextension and degenerative joint disease are hallmarks on physical examination. Ultrasonography of affected ligaments reveals diffuse loss of echogenicity, and an irregular fiber pattern. Though until recently DSLD was considered a collagen disorder strictly limited to suspensory ligaments (SLs, our data show that it is a systemic disease involving tissues with high content of collagen. We have identified abnormal accumulations of proteoglycans not only in the SLs, but also in the superficial and deep digital flexor tendons, patellar and nuchal ligaments, aorta, coronary arteries and sclerae of DSLD-affected horses. Our most recent data point to the presence of an abnormal form of decorin in these proteoglycan deposits. This decorin also exhibited altered biological activity. Treatment for DSLD-affected horses is empirical and directed at minimizing musculoskeletal pain and providing support for the suspensory apparatus. Restricted exercise, supportive bandages and nonsteroidal anti-inflammatory drugs provide some, but usually only temporary relief. Unfortunately, unrelenting pain, severe lameness and suffering require all too often humane euthanasia.

  14. Secondary signs of anterior cruciate ligament tear at MR imaging

    International Nuclear Information System (INIS)

    The value of secondary signs of anterior cruciate ligament (ACL) tear was evaluated. MR images of 47 knees, 15 with normal, 6 with acutely torn and 26 with chronically torn ACLs confirmed at arthroscopy, were reviewed. Lateral and medial anterior tibial translocations (ATT), posterior cruciate ligament (PCL) bowing ratio and depth of lateral femoral notch (LFN) were measured. The degrees of lateral and medial ATTs and the PCL bowing ratio of the chronically torn ACLs were significantly higher than those of normal ACLs. With cutoff values of 5-mm lateral ATT, 2.5-mm medial ATT and 0.35-PCL bowing ratio, torn ligaments were distinguished from intact ligaments with accuracies of over 80%. Depth of LFN was less sensitive and less accuracies. All knees with lateral ATT of 6.4 mm medial ATT of 3.5 mm, PCL bowing ratio of 0.43 and LFN depth of 1.5 mm or more had torn ACLs. Higher correlations were revealed between lateral ATT and medial ATT, and also between lateral ATT and PCL bowing ratio. Combined criteria of lateral ATT and PCL bowing ratio indicated the highest diagnostic value as a reliable secondary sign of torn ACLs. (author)

  15. Editorial Commentary: Anterior Cruciate Ligament Reconstruction: Auto or Allo?

    Science.gov (United States)

    Verma, Nikhil N

    2016-01-01

    Considerable controversy exists regarding appropriate graft choice for patients undergoing anterior cruciate ligament reconstruction. Allografts pretreated with high-dose irradiation should be avoided. Otherwise, multiple factors should be considered to individualize patient decision making, including patient age and activity level, graft type, and fixation type.

  16. Miniopen coracohumeral ligament release and manipulation for idiopathic frozen shoulder

    Directory of Open Access Journals (Sweden)

    Abdelsalam Eid

    2012-01-01

    Full Text Available In the management of idiopathic frozen shoulder, manipulation under anaesthesia is known to have serious potential complications including fractures and intra-articular injuries. Arthroscopy is a safer treatment modality but requires special instruments, experience, and involves added cost. The aim of this work was to study the use of miniopen Coracohumeral ligament release and manipulation of the shoulder as a safe and simple method of treating idiopathic frozen shoulder that could be performed as a quick procedure under short duration anaesthesia obtaining a significant improvement of shoulder function while avoiding complications that are feared to occur with the use of manipulation under anaesthesia. Miniopen Coracohumeral ligament release is performed through a 3-cm incision. The Coracohumeral ligament is divided, and then the shoulder is manipulated without undue force. A case series including fifteen patients (19 shoulders with idiopathic frozen shoulder operated by this technique is described. Miniopen Coracohumeral ligament release and manipulation is a quick procedure that may be performed under short duration anaesthesia obtaining a significant improvement of shoulder function meanwhile avoiding complications that are feared to occur with the use of manipulation under anaesthesia.

  17. Nocardia Septic Arthritis Complicating an Anterior Cruciate Ligament Repair

    OpenAIRE

    Yong, Elaine X. L.; Cheong, Elaine Y. L.; Boutlis, Craig S.; Chen, Darren B.; Liu, Eunice Y.-T.; McKew, Genevieve L.

    2015-01-01

    Nocardia infection following anterior cruciate ligament (ACL) allograft reconstruction is a rare occurrence. We report a case of Nocardia infection of an allograft ACL reconstruction and septic arthritis of the knee joint due to an organism most similar to the novel Nocardia species Nocardia aobensis.

  18. Nocardia Septic Arthritis Complicating an Anterior Cruciate Ligament Repair.

    Science.gov (United States)

    Yong, Elaine X L; Cheong, Elaine Y L; Boutlis, Craig S; Chen, Darren B; Liu, Eunice Y-T; McKew, Genevieve L

    2015-08-01

    Nocardia infection following anterior cruciate ligament (ACL) allograft reconstruction is a rare occurrence. We report a case of Nocardia infection of an allograft ACL reconstruction and septic arthritis of the knee joint due to an organism most similar to the novel Nocardia species Nocardia aobensis. PMID:26041900

  19. Editorial Commentary: Anterior Cruciate Ligament Reconstruction: Auto or Allo?

    Science.gov (United States)

    Verma, Nikhil N

    2016-01-01

    Considerable controversy exists regarding appropriate graft choice for patients undergoing anterior cruciate ligament reconstruction. Allografts pretreated with high-dose irradiation should be avoided. Otherwise, multiple factors should be considered to individualize patient decision making, including patient age and activity level, graft type, and fixation type. PMID:26743418

  20. The effect of anterior cruciate ligament injury on bone curvature

    DEFF Research Database (Denmark)

    Hunter, D J; Lohmander, Stefan; Makovey, J;

    2014-01-01

    OBJECTIVE: Investigate the 5-year longitudinal changes in bone curvature after acute anterior cruciate ligament (ACL) injury, and identify predictors of such changes. METHODS: In the KANON-trial (ISRCTN 84752559), 111/121 young active adults with an acute ACL tear to a previously un-injured knee...

  1. Study on the nuchal ligament ossification on lateral cephalometric radiograph

    International Nuclear Information System (INIS)

    The purpose of this study was to assess the prevalence and radiographic characteristics of the nuchal ligament ossification on lateral cephalometric radiographs in Koreans. I review and interpreted the lateral cephalometric radiographs from 4,558 patients (1,857 males and 2,701 females, age range from 2 to 79 years) who visited the Kyungpook National University Dental Hospital from January 1, 2008 to February 3, 2009. I grouped the shapes of nuchal ligament ossification as round, rod-like, and segmented shape. And localized the ossification as the involvement of anterior cervical vertebral body. The data were analyzed by using chi-squared test with two-tailed and at a 5% significance level. Among those who showed the nuchal ligament ossification, the mean age of the 143 males was 51.1 and that of the 97 females was 48.0 years. It was not observed completely below teens, and was observed 1% in twenties, 6.1% in thirties, 18.6% in forties, and 26.3% over fifties. It was significantly prevalent in older age group (P<0.01) and in males than females among the same age group (P<0.05). The shapes of nuchal ligament ossification were as follows in order of frequency : rod-like (49.2%), round (30.4%), and segmented (20.4%). The highest involvement of ossification was found at the level of C5 (67.9%), C4 (29.2%), C6 (22.9%), C3 (3.3%), C7 (2.9%), C2 (0.8%), and C1 (0.4%). The nuchal ligament ossifications on lateral cephalometric radiographs were showed as round, rodlike, or segmented shape. The nuchal ligament ossification is often observed after the age of 40 and is observed more frequently in males than females. The highest shape of nuchal ligament ossification was rod-like shape and the highest involvement of cervical spine was C5.

  2. Patella fracture following anterior cruciate ligament reconstruction: A case report

    Directory of Open Access Journals (Sweden)

    Milankov Miroslav

    2003-01-01

    Full Text Available Introduction The most frequent procedure in treatment of acute or chronic anterior cruciate ligament (ACL rupture is the so called bone-tendon-bone reconstruction. A transverse dislocated patella fracture is a rare complication of this procedure with an incidence of 0.23%-2.3%. In a five year period, (1998-2002, 407 arthroscopic reconstructions of the anterior cruciate ligaments were done at our Clinic, and there was only one case of patella fracture. Case report An 18-year-old female patient, a handball player, suffered an acute rupture of anterior cruciate ligament of the left knee, so arthroscopic bone-tendon-bone reconstruction of the anterior cruciate ligament was performed. After adequate skin incision, a bone graft was taken from the patella and upper part of trapezoid tibia, which was 25 mm long, 10 mm wide and 5 mm thick, together with a part of patellar ligament. After the remains of the anterior cruciate ligament had been arthroscopically removed, tunnels were made in tibia and femur and a graft was inserted and fixed with two metal interference screws. Knee stability was tested, and drainage was put in the knee joint. The wound was closed by layers. The quadriceps exercises and passive knee movements started immediately. Full range of movements was accomplished six weeks later when the patient started to walk with full weight-bearing on her operated leg. Three weeks later, (nine weeks after the operation, the patient has accidentally lost her balance and fell. A transverse, dislocated fracture of the left patella was diagnosed and osteosynthesis of the fractured patella with two Kirschner wires and a metallic loop was performed. Postoperatively, full range of movement was allowed. Six months later, the patient felt no pain, there was no swelling, full range of knee movement was achieved, while the Lachman Test was identical in both knees and the pivot shift test was negative. Discussion Fracture of patella after ACL reconstruction is

  3. Stress changes of lateral collateral ligament at different

    Directory of Open Access Journals (Sweden)

    ZHONG Yan-lin

    2011-04-01

    Full Text Available 【Abstract】 Objective: To create a 3-dimensional finite element model of knee ligaments and to analyse the stress changes of lateral collateral ligament (LCL with or without displaced movements at different knee flexion conditions. Methods: A four-major-ligament contained knee specimen from an adult died of skull injury was prepared for CT scanning with the detectable ligament insertion footprints, locations and orientations precisely marked in advance. The CT scanning images were converted to a 3-dimensional model of the knee with the 3-dimensional reconstruction technique and transformed into finite element model by the software of ANSYS. The model was validated using experimental and numerical results obtained by other scientists. The natural stress changes of LCL at five different knee flexion angles (0°, 30°, 60°, 90°, 120° and under various motions of anterior-posterior tibial translation, tibial varus rotation and internal-external tibial rotation were measured. Results: The maximum stress reached to 87%-113% versus natural stress in varus motion at early 30° of knee flexions. The stress values were smaller than the peak value of natural stress at 0° (knee full extension when knee bending was over 60° of flexion in anterior-posterior tibial translation and internal-external rotation. Conclusion: LCL is vulnerable to varus motion in almost all knee bending positions and susceptible to anterior- posterior tibial translation or internal-external rotation at early 30° of knee flexions. Key words: Knee joint; Collateral ligaments; Finite element analysis

  4. Simultaneous reconstruction of anterior cruciate ligament and posterior cruciate ligament by using allogeneic patellar tendon under arthroscopy

    Institute of Scientific and Technical Information of China (English)

    ZHOU Li-ping; ZHEN Min-qing; XU Zhong-he

    2005-01-01

    Objective: To evaluate operative effects of a new method to reconstruct anterior crucial ligament (ACL) and posterior crucial ligament (PCL) simultaneously by using patellar tendon under arthroscopy.Methods: From November 1999 to November 2003,the injured ACL and PCL of 11 patients were fixated with compressed screws and reconstructed under arthroscopy with the bone-patellar tendon-bone treated with deep hypothermia and T radiation. At the same time, 2 patients were treated with medial collateral ligament (MCL)reconstruction, 3 with lateral collateral ligament (LCL)reconstruction, 1 with meniscus suture and 4 with whole or partial resection.Results: All patients were followed up for 12-26months (average 16.5 months ). The Lysholm score method was employed to evaluate the knee function. The average preoperative score was 45.3 and the postoperative score was 86.4. Anterior drawer test (ADT) was positive in 11 knees preoperatively and feeble positive in one knee postoperatively. Lachman test was positive in 11 knees preoperatively and in one postoperatively, and feebly positive in two postoperatively. Posterior drawer test was positive in 11 knees preoperatively and feebly positive in 2postoperatively. There were 2 knees with tolerable pain and 2 with knee flexion of 5°-20°.Conclusions: As for simultaneous reconstruction of ACL and PCL under arthroscopy, ailogeneic bone-patellar tendon-bone can not only avoid injury and complication caused by autografting, but also help rehabilitation of the knee function.

  5. Broad Prize: Do the Successes Spread?

    Science.gov (United States)

    Samuels, Christina A.

    2011-01-01

    When the Broad Prize for Urban Education was created in 2002, billionaire philanthropist Eli Broad said he hoped the awards, in addition to rewarding high-performing school districts, would foster healthy competition; boost the prestige of urban education, long viewed as dysfunctional; and showcase best practices. Over the 10 years the prize has…

  6. Lepra reaction with lucio phenomenon mimicking cutaneous vasculitis.

    Science.gov (United States)

    Misra, Durga Prasanna; Parida, Jyoti Ranjan; Chowdhury, Abhra Chandra; Pani, Krushna Chandra; Kumari, Niraj; Krishnani, Narendra; Agarwal, Vikas

    2014-01-01

    Leprosy is a disease typically found in the tropics. Patients with leprosy can have varying presentation with constitutional symptoms, joint pains, skin nodules, and rarely a vasculitis-like picture with skin ulcers and neuropathy. We present a young lady who presented with the rare manifestation of skin infarcts mimicking cutaneous vasculitis, diagnosed on histopathology to have Lucio phenomenon on a background of lepromatous leprosy. With increasing migration and widespread use of biologic response modifiers, clinicians all over the world need to be aware of various presentations of leprosy as well as needing to keep an open mind while considering the differential diagnoses of vasculitis.

  7. Symptomatic ecchordosis physaliphora mimicking as an intracranial arachnoid cyst.

    Science.gov (United States)

    Filis, Andreas; Kalakoti, Piyush; Nanda, Anil

    2016-06-01

    Ecchordosis physaliphora (EP) is a rare, benign tumor derived from the notochordal remnants. Usually slow growing with an indolent course, most cases are incidental findings on autopsy. Limited data exists on symptomatic patients with EP. Diagnosis mainly relies on correlating histopathologic findings confirming the notochordal elements with MRI. We herein present a middle aged woman with symptomatic EP in the pre-pontine cistern that mimicked an arachnoid cyst on preoperative scans. Additionally, we emphasize the pathological and radiological characteristics of EP that could aid in prompt diagnosis of the lesion with emphasis on considering EP as a differential for mass lesions localized in the pre-pontine cistern.

  8. A huge renal capsular leiomyoma mimicking retroperitoneal sarcoma

    Directory of Open Access Journals (Sweden)

    Lal Anupam

    2009-01-01

    Full Text Available A huge left renal capsular leiomyoma mimicking retroperitoneal sarcoma presented in a patient as an abdominal mass. Computed tomography displayed a large heterogeneous retro-peritoneal mass in the left side of the abdomen with inferior and medial displacement as well as loss of fat plane with the left kidney. Surgical exploration revealed a capsulated mass that was tightly adherent to the left kidney; therefore, total tumor resection with radical left nephrectomy was performed. Histopathology ultimately confirmed the benign nature of the mass. This is the largest leiomyoma reported in literature to the best of our knowledge.

  9. Pancreatitis with Electrocardiographic Changes Mimicking Acute Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Paul Khairy

    2001-01-01

    Full Text Available A 64-year-old woman with mild acute pancreatitis presented with epigastric pain, nausea and vomiting while undergoing hemodialysis for chronic renal insufficiency. Serial electrocardiograms revealed new onset ST segment elevations in leads V2 to V4 mimicking an anterior myocardial infarction, followed by diffusely inverted deep T waves. No cardiac pathology was demonstrated by echocardiography or coronary angiography. A review of the literature and possible pathophysiological mechanisms of electrocardiographic changes in acute pancreatitis, such as metabolic abnormalities, hemodynamic instability, vasopressors, pericarditis, myocarditis, a cardiobiliary reflex, exacerbation of underlying cardiac pathology, coagulopathy and coronary vasospasm, are discussed.

  10. Hızma Induced Papul of Nose Mimicking Pyogenic Granuloma

    Directory of Open Access Journals (Sweden)

    Mualla Polat

    2014-09-01

    Full Text Available The application of body piercing is popular among young people, who consider it as a sign of marginality, beauty, or group identity. Piercing procedure is observed to cause a large number of complications such as infections, pain, inflammatory reactions, bleeding, dental fractures or fissures, and gingival damage, etc., mostly in young individuals. Hizma is a traditional body ornament worn by Anatolian women via a piercing procedure. Herein, we describe a papule of nose mimicking pyogenic granuloma as an uncommon complication of Hızma.

  11. Xanthogranulomatous Appendicitis Mimicking Residual Burkitt's Lymphoma After Chemotherapy.

    Science.gov (United States)

    Nam, Soomin; Kang, Jeonghyun; Choi, Sung-Eun; Kim, Yu Ri; Baik, Seung Hyuk; Sohn, Seung-Kook

    2016-04-01

    The case of a 23-year-old female treated with aggressive high-dose therapy for Burkitt's lymphoma is reported. A positron emission tomography and computed tomography scan after completion of chemotherapy revealed a residual hypermetabolic lesion in the right pelvic cavity. A pelvic magnetic resonance imaging scan showed circumferential wall thickening at the tip of the appendix. A laparoscopic exploration and appendectomy were performed, and a pathologic examination of the resected appendix revealed xanthogranulomatous appendicitis. This is a rare case of a xanthogranulomatous appendicitis mimicking remnant Burkitt's lymphoma after completion of chemotherapy. PMID:27218100

  12. An Adult Gastric Duplication Cyst Mimicking a Gastrointestinal Stromal Tumor.

    Science.gov (United States)

    Yoda, Takenori; Furihata, Makoto; Nagao, Sayaka; Wada, Tomonori

    2016-01-01

    We herein describe a rare case of a 24-year-old man who presented with severe epigastralgia after consuming a considerable amount of broiled meat. Computed tomography revealed a cystic lesion adjacent to the distal stomach, with high intensity on T2-weighted magnetic resonance imaging. Upper endoscopy showed a cystic mass measuring 6 cm in diameter, mimicking a submucosal tumor adjacent to the pyloric valve, with duodenum invagination, characteristic of ball valve syndrome. Endoscopic ultrasonography showed that the lesion was contiguous through the first to the third layer of the stomach. Therefore, we performed distal gastrectomy. Pathology showed that the lesion was a gastric duplication cyst without malignancy. PMID:27580540

  13. Giant Ectopic Ureter Mimicking Pelvic Organ Prolapse: A Case Report

    OpenAIRE

    Adnan Simsir; Fuat Kizilay; Bilbasar Yildiz; Oktay Nazli

    2011-01-01

    Ectopic ureter is one of the most common urinary tract anomalies. We, herein, present a case of a giant ureter with ectopic orifice, mimicking pelvic organ prolapse, which is the first in the literature. A 59-year-old female patient presenting with frequently recurrent urinary tract infection had grade 3 pelvic organ prolapse. On examination, the organ producing the appearance of prolapse was found to be a right ureter of giant size and was obstructed by a large stone at the distal segment. T...

  14. A CUTANEOUS HORN MIMICKING POLYDACTYLY: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Funda Tamer

    2015-04-01

    Full Text Available A cutaneous horn is a general name for cornified material protruding from skin. On the other hand, polydactyly is a common congenital anomaly of the hand and foot which is characterized by extra finger or toe. A cutaneous horn might mimick polydactyly by resembling an extra toe. Hereby, we present a 72-year-old white Caucasian male with an extra toe-like projection on his fourth toe. Initially, polydactyly was suspected, however a cutaneous horn was also considered. The lesion was surgically removed. The histopathological examination of the specimen revealed hyperkeratosis, and thus confirmed the  lesion to be a cutaneous horn. 

  15. Dual anaplastic large cell lymphoma mimicking meningioma: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Keun Ho; Kim, Ki Hwan; Lee, Ghi Jai; Lee, Hye Kyung; Shim, Jae Chan; Lee, Kyoung Eun; Suh, Jung Ho [Seoul Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of); Lee, Chae Heuck [Dept. of Neurosurgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang (Korea, Republic of)

    2014-01-01

    Anaplastic large cell lymphoma (ALCL) is a rare T cell lymphoma composed of CD30-positive lymphoid cells. Most ALCLs present as nodal disease, with skin, bone, soft tissue, lung, and liver as common extranodal sites. ALCL rarely occurs in the central nervous system and is even more infrequent in the dura of the brain. We report a case of dural-based ALCL secondary to systemic disease in a 17-year-old male that mimicked meningioma on magnetic resonance imaging and angiography.

  16. Subcutaneous Phaeohyphomycosis Due to Pyrenochaeta romeroi Mimicking a Synovial Cyst

    Science.gov (United States)

    Dinh, Aurélien; Levy, Bruno; Bouchand, Frédérique; Davido, Benjamin; Duran, Clara; Cristi, Marin; Felter, Adrien; Salomon, Jérôme; Ait Ammar, Nawel

    2016-01-01

    Opportunistic subcutaneous fungal infections are increasing nowadays due to the growing number of medical conditions causing immunosuppression, especially organ transplant. The incidence rate of subcutaneous phaeohyphomycosis is very low. Most studies found are case reports. They showed a wide variation of clinical presentations. Pyrenochaeta romeroi, a fungus from the Dematiaceae group is a saprophyte found in soil and plants and a possible causative agent of phaeohyphomycosis. We present a rare case of subcutaneous phaeohyphomycosis caused by P. romeroi mimicking a synovial cyst in a diabetic patient.

  17. Mimicking the effect of gravity using an elastic membrane

    Science.gov (United States)

    Wu, Yecun; Zhu, Changqing; Wang, Yijun; Shi, Qingfan

    2014-05-01

    Comparing astrospace with an elastic membrane is an interesting analogy but it lacks a theoretical basis and experimental support. We develop a theoretical model that brings to light the relationship between the conceptual model of a gravity well and an elastic deformation equation of a membrane supporting a heavy ball, and further derive the ‘gravitational constant’ for such a small ‘elastic space’. The experimental data obtained are consistent with the prediction of our model, in mimicking the revolution of a small planet. Teaching practice shows that using an elastic membrane is a simple, intuitive and reliable method to enhance the quality of learning about the effect of gravity.

  18. Intracortical bone metastasis mimicking intracortical osteoid osteoma: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Yu Ri; Kim, Jee Young [St. Vincent' s Hospital, The Catholic University of Korea, Suwon (Korea, Republic of)

    2007-08-15

    Cortical metastasis usually occurs in the diaphysis of the long bones with the appearance of a cookie-bite pattern; this is associated with cortical destruction extending into the soft tissue as well as into the medullary cavity, or there can be a periosteal reaction. We report here on a 66-year-old woman who was diagnosed with intracortical metastasis in the proximal metaphysis of the right femur as an initial metastatic focus from primary lung cancer. CT detected an intracortical osteolytic lesion without cortical destruction or thickening. The MR images showed extensive peritumoral edema in the surrounding soft tissue and adjacent bone marrow edema, and this all mimicked osteoid osteoma.

  19. Viability of ligaments after freezing: an experimental study in a rabbit model

    Energy Technology Data Exchange (ETDEWEB)

    Frank, C.; Edwards, P.; McDonald, D.; Bodie, D.; Sabiston, P.

    1988-01-01

    Our purpose in this study was to assess ligament fibroblast viability after freezing by quantifying the subsequent ability of fibroblasts to synthesize collagen in vitro. Both medial collateral ligament (MCL) complexes from 40 adolescent rabbits were studied. Collagen production was determined by in vitro incubation of ligaments in /sup 3/H-proline (a collagen precursor) and subsequent analysis of /sup 3/H-hydroxyproline (a marker of newly synthesized collagen). Autoradiographs determined the distributions of ligament cell activity. All right MCL complexes served as fresh controls, providing a baseline of collagen production. Each left MCL was assigned to an experimental group and was either incubated fresh (10 animals); killed by drying, multiple freeze thawing, or cycloheximide (six animals); or slowly frozen at -70 degrees C without cryoprotection (24 animals). Collagen production of rapidly thawed ligaments was studied by proline incubation at 1 day, 9 days, or 6 weeks after freezing and was compared with that of contralateral fresh controls. Results demonstrate that some cells in the substance of these rabbit ligaments retained the ability to synthesize collagen in vitro after being frozen for up to 6 weeks. Mean collagen production of frozen ligaments was decreased, but tests of mean and median values as well as ratios were statistically similar to fresh contralateral ligaments in all animals. This postfreezing ligament cell survival and collagen production after -70 degrees C storage may have implications for ligament transplantation.

  20. Spatial Change of Cruciate Ligaments in Rat Embryo Knee Joint by Three-Dimensional Reconstruction.

    Directory of Open Access Journals (Sweden)

    Xiangkai Zhang

    Full Text Available This study aimed to analyze the spatial developmental changes of rat cruciate ligaments by three-dimensional (3D reconstruction using episcopic fluorescence image capture (EFIC. Cruciate ligaments of Wister rat embryos between embryonic day (E 16 and E20 were analyzed. Samples were sectioned and visualized using EFIC. 3D reconstructions were generated using Amira software. The length of the cruciate ligaments, distances between attachment points to femur and tibia, angles of the cruciate ligaments and the cross angle of the cruciate ligaments were measured. The shape of cruciate ligaments was clearly visible at E17. The lengths of the anterior cruciate ligament (ACL and posterior cruciate ligament (PCL increased gradually from E17 to E19 and drastically at E20. Distances between attachment points to the femur and tibia gradually increased. The ACL angle and PCL angle gradually decreased. The cross angle of the cruciate ligaments changed in three planes. The primordium of the 3D structure of rat cruciate ligaments was constructed from the early stage, with the completion of the development of the structures occurring just before birth.

  1. Paraffin-gel tissue-mimicking material for ultrasound-guided needle biopsy phantom.

    Science.gov (United States)

    Vieira, Sílvio L; Pavan, Theo Z; Junior, Jorge E; Carneiro, Antonio A O

    2013-12-01

    Paraffin-gel waxes have been investigated as new soft tissue-mimicking materials for ultrasound-guided breast biopsy training. Breast phantoms were produced with a broad range of acoustical properties. The speed of sound for the phantoms ranged from 1425.4 ± 0.6 to 1480.3 ± 1.7 m/s at room temperature. The attenuation coefficients were easily controlled between 0.32 ± 0.27 dB/cm and 2.04 ± 0.65 dB/cm at 7.5 MHz, depending on the amount of carnauba wax added to the base material. The materials do not suffer dehydration and provide adequate needle penetration, with a Young's storage modulus varying between 14.7 ± 0.2 kPa and 34.9 ± 0.3 kPa. The phantom background material possesses long-term stability and can be employed in a supine position without changes in geometry. These results indicate that paraffin-gel waxes may be promising materials for training radiologists in ultrasound biopsy procedures.

  2. Lateral Ulnar Collateral ligament Lesions in patients with Lateral Epicondylitis: MR Imaging Findings

    Directory of Open Access Journals (Sweden)

    Mohamed Farouk Aggag*and Ragy Tantawi Amin

    2005-06-01

    Full Text Available Objective. The aim of this work was to determine if a correlation between lateral epicondylitis and abnormalities of the lateral ulnar collateral ligament is found on MR imaging. Subjects and Methods. The Study group comprised 50 consecutive patients who were referred for MR imaging to rule out lateral epicondylitis. On MR imaging "lateral epicondylitis" was defined as increased signal intensity of the extensor tendons close to their insertion on the lateral epicondylitis. The severity of the lateral epicondylitis was graded as mild, moderate or severe. The origin of the lateral colleteral ligamantous complex was characterized and the lateral ulnar collateral ligament was normal, thickened, partially torn or torn. Sixteen patients underwent elbow surgery after the initial MR examination. Results. In 15 patients, MR imaging revealed characteristics of mild lateral epicondylitis. In 13 of these patients the lateral ulnar collateral ligament was normal. One patient showed a thickened lateral ulnar collateral ligament and one patient had a thinned ligament. In 17 patients, MR imaging showed features of moderate lateral epicondylitis. One patient had a thinned ligament feature of moderate lateral epicondylitis. In 14 of these patients, the lateral ulnar collateral ligament was thickened and in the remaining three patients, the ligament was normal All eighteen patients with severe lateral epicondylitis showed abnormalities of the lateral ulnar collateral ligament on MR imaging. In two of these patients, the lateral ulnar collateral ligament was thickened. In Six patients we saw a partial tear, and in the remaining ten patients we saw a complete tear of the ligament. Conclusion. In our study, MR imaging features of lateral epicondylitis were offen associated with thickening and tear of the lateral ulnar collateral ligament and the frequency and severity of lateral ulnar collatered ligament lesions were directly related the severity (degree of lateral

  3. Radio sterilized human ligaments and their clinical application;Ligamentos humanos radioesterilizados y su aplicacion clinica

    Energy Technology Data Exchange (ETDEWEB)

    Luna Z, D.; Reyes F, M. L. [ININ, Carretera Mexico-Toluca s/n, 52750 Ocoyoacac, Estado de Mexico (Mexico); Diaz M, I.; Hernandez R, G., E-mail: daniel.luna@inin.gob.m [Centro Estatal de Trasplantes del Estado de Mexico, Pablo Sidar No. 602, Col. Universidad, 50130 Toluca, Estado de Mexico (Mexico)

    2009-10-15

    The ligaments are human tissues that are used in the transplantation area. A ligament is an anatomical structure in band form, composed by resistant fibers that connect the tissues that unite the bones with the articulations. In an articulation, the ligaments allow and facilitate the movement inside the natural anatomical directions, while it restricts those movements that are anatomically abnormal, impeding lesions that could arise of this type of movements. The kneecap ligament is a very important tissue in the knee mobility and of walking in the human beings. This ligament can injure it because of automobile accidents, for sport lesions or illnesses, and in many cases the only form of recovering the knee movement is carried out a transplant with the purpose of replacing the damage ligament by allo gen kneecap ligament processed in specialized Tissue Banks where the tissue is sterilized with gamma radiation of {sup 60}Co at very low temperatures, obtaining high quality ligaments for clinical application in injured patients. The kneecap ligaments are processed in the Tissue Banks with a segment of kneecap bone, a segment of tibial bone, the contained ligament between both bones and in some cases a fraction of the quadriceps tendon. In this work is given a description of the selection method of the tissue that includes the donor's serologic control, the kneecap ligament processing in the Radio Sterilized Tissues Bank, its sterilization with gamma radiation of {sup 60}Co, also it is indicated like the clinical application of the allo gen ligament was realized in a hasty patient and whose previous crossed ligament was injured. Finally the results are presented from the tissue obtaining until the clinical application of it is, and in this case is observed a favorable initial evolution of the transplantation patient. (Author)

  4. [Anterior cruciate ligament-plasty using the "U-dos" technique].

    Science.gov (United States)

    Morales-Trevizo, C; Paz-García, M; Leal-Berumen, I; Leal-Contreras, C; Berumen-Nafarrate, E

    2013-01-01

    The knee is a compound diarthrodial joint, vulnerable to serious injuries such as ligament injuries of: medial collateral ligament, lateral collateral ligament, anterior cruciate ligament and posterior cruciate ligament, as cruciate ligaments limit rotation movement in the joint. The purpose of our study was to create a new technique to treat injuries of the anterior cruciate ligament, which is composed of two bundles--anteromedial and posterolateral--trying to achieve an anatomical reconstruction that allows for a normal biomechanical recovery. This technique reduces the use of fixation material and costs. The diagnosis of anterior cruciate ligament injuries was made with the pivot shift test. There are currently two repair methods for anterior cruciate ligament injuries: single bundle or double bundle repair; none of these techniques is considered as the gold standard, as their results are very similar. This paper describes a technique used for the treatment of anterior cruciate ligament injuries, known as "U-dos", and its clinical results. Cross-sectional, observational study that enrolled 20 patients with total anterior cruciate ligament injuries who underwent anterior cruciate ligament plasty using the "U-dos" technique between June 2009 and June 2010. The technique requires the use of bone bank allograft, in this case of the anterior tibial ligament. Patients were assessed using the Lysholm scale and the pivot shift test. Our results show that all the pivot shift tests were negative and assessments according to the Lysholm scale were from normal to excellent in 95% of cases (19/20). Only one failure was reported, with avulsion of the graft attachment which required a surgical intervention.

  5. Successful Treatment of Infectious Endocarditis Associated Glomerulonephritis Mimicking C3 Glomerulonephritis in a Case with No Previous Cardiac Disease

    Directory of Open Access Journals (Sweden)

    Yosuke Kawamorita

    2014-01-01

    Full Text Available We report a 42-year-old man with subacute infectious endocarditis (IE with septic pulmonary embolism, presenting rapidly progressive glomerulonephritis and positive proteinase 3-anti-neutrophil cytoplasmic antibody (PR3-ANCA. He had no previous history of heart disease. Renal histology revealed diffuse endocapillary proliferative glomerulonephritis with complement 3- (C3- dominant staining and subendothelial electron dense deposit, mimicking C3 glomerulonephritis. Successful treatment of IE with valve plastic surgery gradually ameliorated hypocomplementemia and renal failure; thus C3 glomerulonephritis-like lesion in this case was classified as postinfectious glomerulonephritis. IE associated glomerulonephritis is relatively rare, especially in cases with no previous history of valvular disease of the heart like our case. This case also reemphasizes the broad differential diagnosis of renal involvement in IE.

  6. Meniscus and ligament injuries; Meniskus- und Bandlaesionen

    Energy Technology Data Exchange (ETDEWEB)

    Glaser, C.; Trumm, C. [Klinikum Grosshadern der Ludwig-Maximilians-Universitaet Muenchen, Institut fuer Klinische Radiologie (Germany); Scheidler, J.; Heuck, A. [Radiologisches Zentrum Muenchen, Pasing (Germany)

    2006-01-01

    The knee is one of the major weight-bearing joints and is relatively exposed to trauma. Capsuloligamentous structures are essential to provide joint stability and - in turn - persistent instability bears a risk for osteoarthritis that needs timely and comprehensive diagnosis. Using MRI it may be beneficial to routinely apply (T)SE sequences in all three major planes as a basic protocol and to add additional sequences according to the clinical information available and imaging findings in the basic protocol. Especially fat-suppressed sequences (STIR, T2w/PDw FS TSE) are very useful because they sensitively depict bone marrow edema pattern (BMEP)-like changes. This finding often alerts the reader to - sometimes only discrete - underlying pathologies and may - if found in typical locations - give information about the mechanism of injury and thus lead the radiologist to look for specific concomitant capsuloligamentous, cartilage, and/or meniscal injury. BMEP is quite prominent in contusion injury, whereas often it is but discrete in avulsion lesions. There is extensive literature about the signs, possible pitfalls, and the accuracy of MRI for the diagnosis of specific pathologies such as meniscal tears or cruciate or collateral ligament ruptures. However, combined injuries of more than one structure are frequent and affect the therapeutic approach. Thus, the primary goal of the radiologist is to go beyond the description of any isolated lesion and to give a comprehensive description of (or to reliably exclude) any injury to other structures. A necessary prerequisite to accomplish this is a thorough knowledge of the - in some locations - complex anatomic relationships, pitfalls, and locations where lesions typically occur and where they may be overlooked. (orig.) [German] Das Knie ist vergleichsweise exponiert gegenueber Traumata. Sein Kapsel-Band-Apparat ist ein wesentlicher Faktor fuer die Gelenkstabilitaet. Umgekehrt erhoeht persistierende Instabilitaet das Risiko

  7. Characterization of various tissue mimicking materials for medical ultrasound imaging

    Science.gov (United States)

    Thouvenot, Audrey; Poepping, Tamie; Peters, Terry M.; Chen, Elvis C. S.

    2016-04-01

    Tissue mimicking materials are physical constructs exhibiting certain desired properties, which are used in machine calibration, medical imaging research, surgical planning, training, and simulation. For medical ultrasound, those specific properties include acoustic propagation speed and attenuation coefficient over the diagnostic frequency range. We investigated the acoustic characteristics of polyvinyl chloride (PVC) plastisol, polydimethylsiloxane (PDMS), and isopropanol using a time-of-light technique, where a pulse was passed through a sample of known thickness contained in a water bath. The propagation speed in PVC is approximately 1400ms-1 depending on the exact chemical composition, with the attenuation coefficient ranging from 0:35 dB cm-1 at 1MHz to 10:57 dB cm-1 at 9 MHz. The propagation speed in PDMS is in the range of 1100ms-1, with an attenuation coefficient of 1:28 dB cm-1 at 1MHz to 21:22 dB cm-1 at 9 MHz. At room temperature (22 °C), a mixture of water-isopropanol (7:25% isopropanol by volume) exhibits a propagation speed of 1540ms-1, making it an excellent and inexpensive tissue-mimicking liquid for medical ultrasound imaging.

  8. Understanding acute ankle ligamentous sprain injury in sports

    Directory of Open Access Journals (Sweden)

    Fong Daniel TP

    2009-07-01

    Full Text Available Abstract This paper summarizes the current understanding on acute ankle sprain injury, which is the most common acute sport trauma, accounting for about 14% of all sport-related injuries. Among, 80% are ligamentous sprains caused by explosive inversion or supination. The injury motion often happens at the subtalar joint and tears the anterior talofibular ligament (ATFL which possesses the lowest ultimate load among the lateral ligaments at the ankle. For extrinsic risk factors to ankle sprain injury, prescribing orthosis decreases the risk while increased exercise intensity in soccer raises the risk. For intrinsic factors, a foot size with increased width, an increased ankle eversion to inversion strength, plantarflexion strength and ratio between dorsiflexion and plantarflexion strength, and limb dominance could increase the ankle sprain injury risk. Players with a previous sprain history, players wearing shoes with air cells, players who do not stretch before exercising, players with inferior single leg balance, and overweight players are 4.9, 4.3, 2.6, 2.4 and 3.9 times more likely to sustain an ankle sprain injury. The aetiology of most ankle sprain injuries is incorrect foot positioning at landing – a medially-deviated vertical ground reaction force causes an explosive supination or inversion moment at the subtalar joint in a short time (about 50 ms. Another aetiology is the delayed reaction time of the peroneal muscles at the lateral aspect of the ankle (60–90 ms. The failure supination or inversion torque is about 41–45 Nm to cause ligamentous rupture in simulated spraining tests on cadaver. A previous case report revealed that the ankle joint reached 48 degrees inversion and 10 degrees internal rotation during an accidental grade I ankle ligamentous sprain injury during a dynamic cutting trial in laboratory. Diagnosis techniques and grading systems vary, but the management of ankle ligamentous sprain injury is mainly conservative

  9. MR imaging of anterior cruciate ligament injury: associated findings

    International Nuclear Information System (INIS)

    Authors investigated the associated findings and their value in the diagnosis of anterior cruciate ligament (ACL) injury in MR image. The knee MR images of 47 patients with ACL injury (complete;24, partial;23) and 61 patients with normal ACL confirmed by the knee arthroscopy or operation were reviewed retrospectively. The degree of anterior translocation of tibia and the degree of posterior cruciate ligament (PCL) buckling were evaluated. The prevalence and pattern of associated adjacent bone, ligament and meniscus injuries were studied. The means(± 2 standard errors) of anterior translocation were different significantly in statistical analysis (ρ < 0.001, student t-test) between injury group (7.51 ± 1.16 mm) and normal group (-0.56 ± 0.92mm). In the level of 5mm of anterior translocation for the criteria of ACL injury, the sensitivity, specificity, accuracy were 78.7%, 89.5%, 84.3% for each. The means of PCL buckling ratio were also different statistically between injury group(0.23 ± 0.02) and normal group(0.17 ± 0.01)(ρ < 0.001). In the level of 0.20 for diagnostic criteria of ACL injury, the sensitivity, specificity, accuracy were 71.4%, 83.6%, 78.4% for each. Thirty one medial meniscus tear (66%), thirteen lateral meniscus tear (28%), ten medial collateral ligament injury (28%), one PCL injury(2%) were associated with ACL injury. The twenty nine bone marrow changes were found in twenty patients (43%) which included acutely injured seven patients. In acute cases, the bone marrow changes were depicted as diffuse or focal high signal intensity lesions in lateral femoral or tibial condyles in contrast to the changes in chronic cases depicted as focal low signal intensity lesions in variable location. Lateral femoral condylar notch depression were found in nine patients (19%) and avulsion fractures of anterior tibial spine in four patients(9%). The associated findings with ACL injury (anterior translocation, buckling of PCL, associated bone, ligament and

  10. Influence of thermofixation on artificial ACL ligament dimensional and mechanical properties

    Science.gov (United States)

    Ben Abdessalem, S.; Jedda, H.; Skhiri, S.; Karray, S.; Dahmen, J.; Boughamoura, H.

    2005-11-01

    The anterior cruciate ligament (ACL) is the major articular ligamentous structure of the knee, it functions as a joint stabilizer. When ruptured, the natural ACL ligament can be replaced by a textile synthetic ligament such as a braid, knitted cord, or woven cord. Theses structures are composed of biocompatible materials such as polyester or Gore-Tex filaments. The success of an ACL replacement is widely linked to its mechanical and dimensional properties such as tensile strength, dimensional stability and resistance to abrasion. We introduced an additional treatment in the manufacturing of textile ACL ligaments based on the thermofixation of the textile structure by using textile industry stabilization techniques. Boiling water, saturated vapor and dry heat have been tested to stabilize a braided ligament made of Dacron polyester. The application of these three techniques led to shrinkage and an increase of breaking strength of the textile structure.

  11. Measuring Prevention More Broadly, An Empirical...

    Data.gov (United States)

    U.S. Department of Health & Human Services — Measuring Prevention More Broadly, An Empirical Assessment of CHIPRA Core Measures Differences in CHIP design and structure, across states and over time, may limit...

  12. Injuries of the lateral collateral ligaments of the ankle: assessment with MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kreitner, K.F.; Ferber, A.; Grebe, P.; Thelen, M. [Department of Radiology, Johannes Gutenberg University Mainz (Germany); Runkel, M. [Department of Traumatologic and Reconstructive Surgery, Johannes Gutenberg University Mainz (Germany); Berger, S. [Department of Pediatric Surgery, Johannes Gutenberg University Mainz (Germany)

    1999-04-01

    The aim of this study was to evaluate the ability of MRI to display injuries of the lateral collateral ligamentous complex in patients with an acute ankle distorsion trauma. The MR examinations of 36 patients with ankle pain after ankle distorsion were evaluated retrospectively without knowledge of clinical history, outcome and/or operative findings. The examinations were performed on a 1.5-T whole-body imager using a flexible surface coil. The signs for ligamentous abnormality were as follows: complete or partial discontinuity, increased signal within, and irregularity and waviness of the ligament. The results were compared with operative findings in 18 patients with subsequent surgical repair. Eighteen patients with conservative therapy had a follow-up MR examination after 3 months. There was 1 sprain, 3 partial and 32 complete tears of the anterior talofibular ligament, and 5 sprains, 5 partial, and 7 complete tears of the calcaneofibular ligament. There were no lesions of the posterior talofibular ligament. Compared with surgery, MRI demonstrated in 18 of 18 cases the exact extent of anterior talofibular ligament injuries and underestimated the extent in 2 of 8 cases of calcaneofibular ligament injury. In patients with follow-up MRI after conservative therapy, a thickened band-like structure was found along the course of the injured ligament in 17 of 18 cases. The absence of ligament repair after conservative treatment was confirmed during operative revision in one case. The MRI technique allows for grading of the extent of injury of the lateral collateral ligamentous complex after acute ankle strain. It seems to be suitable for monitoring the healing process after conservative-functional treatment of ligament tears. (orig.) With 5 figs., 2 tabs., 26 refs.

  13. Resect or not to resect: the role of posterior longitudinal ligament in lumbar total disc replacement

    OpenAIRE

    Cakir, Balkan; Richter, Marcus; Schmoelz, Werner; Schmidt, René; Reichel, Heiko; Wilke, Hans Joachim

    2009-01-01

    With regard to the literature, several factors are considered to have an impact on postoperative mobility after lumbar total disc replacement (TDR). As TDR results in a distraction of the ligamentous structures, theoretically the postoperatively disc height and ligamentous integrity have also an influence on biomechanics of a treated segment. The purpose of the study was to evaluate the influence of posterior longitudinal ligament (PLL) resection and segmental distraction on range of motion (...

  14. Biomechanics of the anterior cruciate ligament: Physiology, rupture and reconstruction techniques

    OpenAIRE

    Domnick, Christoph; Raschke, Michael J.; Herbort, Mirco

    2016-01-01

    The influences and mechanisms of the physiology, rupture and reconstruction of the anterior cruciate ligament (ACL) on kinematics and clinical outcomes have been investigated in many biomechanical and clinical studies over the last several decades. The knee is a complex joint with shifting contact points, pressures and axes that are affected when a ligament is injured. The ACL, as one of the intra-articular ligaments, has a strong influence on the resulting kinematics. Often, other meniscal o...

  15. Injury Thresholds of Knee Ligaments Under Lateral–Medial Shear Loading: An Experimental Study

    OpenAIRE

    MO, Fuhao; Arnoux, Pierre-Jean; ZAHIDI, Omar; Masson, Catherine

    2013-01-01

    Knee ligament injuries frequently cause devastating impairment to the injured. In car–pedestrian impact accidents, lateral–medial shear displacement is one of principal mechanisms of knee ligament injuries. The current study aims to investigate injury thresholds of knee ligaments under lateral–medial shear loading to improve pedestrian safety. Methods: Ten isolated human knee joints without surrounding muscles were tested under dynamic lateral–medial shear loading in 2...

  16. Viscoelastic properties of soft tissues: application to knee ligaments and tendons

    OpenAIRE

    Pioletti, Dominique P; Meister, Jean-Jacques

    2005-01-01

    Ligaments play a central role in the stability of the knee. Due to the increase in sport activities of the young population, rupture of the anterior cruciate ligament (ACL) has become a frequent clinical problem. A surgical procedure replacing the deficient ligament is performed to restore the knee's initial stability. Although this surgical technique is widespread and well established, long term clinical results are inconsistent and the stability of the knee is not always restored, leading t...

  17. Injuries of the lateral collateral ligaments of the ankle: assessment with MR imaging

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate the ability of MRI to display injuries of the lateral collateral ligamentous complex in patients with an acute ankle distorsion trauma. The MR examinations of 36 patients with ankle pain after ankle distorsion were evaluated retrospectively without knowledge of clinical history, outcome and/or operative findings. The examinations were performed on a 1.5-T whole-body imager using a flexible surface coil. The signs for ligamentous abnormality were as follows: complete or partial discontinuity, increased signal within, and irregularity and waviness of the ligament. The results were compared with operative findings in 18 patients with subsequent surgical repair. Eighteen patients with conservative therapy had a follow-up MR examination after 3 months. There was 1 sprain, 3 partial and 32 complete tears of the anterior talofibular ligament, and 5 sprains, 5 partial, and 7 complete tears of the calcaneofibular ligament. There were no lesions of the posterior talofibular ligament. Compared with surgery, MRI demonstrated in 18 of 18 cases the exact extent of anterior talofibular ligament injuries and underestimated the extent in 2 of 8 cases of calcaneofibular ligament injury. In patients with follow-up MRI after conservative therapy, a thickened band-like structure was found along the course of the injured ligament in 17 of 18 cases. The absence of ligament repair after conservative treatment was confirmed during operative revision in one case. The MRI technique allows for grading of the extent of injury of the lateral collateral ligamentous complex after acute ankle strain. It seems to be suitable for monitoring the healing process after conservative-functional treatment of ligament tears. (orig.)

  18. Graded stress radiography in acute injury to the lateral ligaments of the ankle

    International Nuclear Information System (INIS)

    The diagnostic accuracy of graded stress radiography in 26 patients with acute injury to the lateral ankle ligaments has been compared with findings at arthrography and surgery. Measuring talar tilt angles and anterior talar displacement over a range of pressures applied to the distal tibia using a commercially available stress device allows diagnostic distinction between isolated anterior talofibular ligament injury and a combined lesion that involves the calcaneofibular ligament. The results compare well with arthrographic and surgical findings. (orig.)

  19. Spatial Change of Cruciate Ligaments in Rat Embryo Knee Joint by Three-Dimensional Reconstruction

    OpenAIRE

    Xiangkai Zhang; Tomoki Aoyama; Ryota Takaishi; Shinya Higuchi; Shigehito Yamada; Hiroshi Kuroki; Tetsuya Takakuwa

    2015-01-01

    This study aimed to analyze the spatial developmental changes of rat cruciate ligaments by three-dimensional (3D) reconstruction using episcopic fluorescence image capture (EFIC). Cruciate ligaments of Wister rat embryos between embryonic day (E) 16 and E20 were analyzed. Samples were sectioned and visualized using EFIC. 3D reconstructions were generated using Amira software. The length of the cruciate ligaments, distances between attachment points to femur and tibia, angles of the cruciate l...

  20. Tissue Engineering of Ligaments/tendons .Part I .Biomaterial and Mechanical Aspects

    Institute of Scientific and Technical Information of China (English)

    X.; WANG; C.; VAQUETTE; L.; ZHANG; S.; SLIMANI; S.; MULLER1

    2005-01-01

    1 IntroductionTendons and ligaments play important roles in the mediation of skeletal equilibrium and movement. Ruptures or tears of these tissues often result in a significant loss of joint function and long term problems such as degenerative diseases. The healing of some tendons and ligaments is a complex process, and in some cases (for exapmple,rupture the anterior cruciate ligament), no healing is possible, surgical implantation of grafts is necessary for the reparation. However, in surgical implantatio...

  1. Irrigation of meniscus and cruciate ligament of the knee.

    Directory of Open Access Journals (Sweden)

    Homero F. Bianchi

    2010-09-01

    Full Text Available During this paper a revision of the irrigation of the meniscus and cruciate ligaments is made. 25 fresh dissected preparations were used: 24 fetal between the 8th and 9th months of gestation and one knee adult. It concludes that the meniscus possess a perimeniscal single artery source and a medial perimeniscal artery than in the majority of cases consists of an arterial anastomosis between one anterior and another posterior arteries from different source, to ensure the blood supply of the side of the meniscus, allowing the reintegration or conservation of the external part of the meniscus in agreement with the pathology and inclusive the meniscus allograft transplantation. The vessels of the cruciate ligaments, branches from middle knee artery are longitudinal, reason for which techniques of sutures when repairing the injury in early form should respect this provision.

  2. Periodontal ligament distraction: A simplified approach for rapid canine retraction

    Directory of Open Access Journals (Sweden)

    K C Prabhat

    2012-01-01

    Full Text Available Distraction osteogenesis is a method of inducing new bone formation by applying mechanical strains on preexisting bone. The process of osteogenesis in the periodontal ligament during orthodontic tooth movement is similar to the osteogenesis in the midpalatal suture during rapid palatal expansion. A new concept of "distracting the periodontal ligament" is proposed to elicit rapid canine retraction in two weeks. At the time of first premolar extraction, the interseptal bone distal to the canine was undermined with a bone bur, grooving vertically inside the extraction socket along the buccal and lingual sides and extending obliquely toward the socket base. Then, a tooth-borne, custom-made, intraoral distraction device was placed to distract the canine distally into the extraction space. It was activated 0.5 mm/day, immediately after the extraction. Canine was distracted 6.5 mm into the extraction space within two weeks.

  3. Repair of rectus femoris rupture with LARS ligament.

    Science.gov (United States)

    Taylor, Clare; Yarlagadda, Rathan; Keenan, Jonathan

    2012-03-20

    The rectus femoris muscle is the most frequently involved quadriceps muscle in strain pathologies. The majority of quadriceps muscle belly injuries can be successfully treated conservatively and even significant tears in the less active and older population, non-operative management is a reasonable option. The authors report the delayed presentation of a 17-year-old male who sustained an injury to his rectus femoris muscle belly while playing football. This young patient did not recover the functional outcome required to get back to running and participating in sport despite 15 months of physiotherapy and non-operative management. Operative treatment using the ligament augmentation and reconstruction system ligament to augment Kessler repair allowed immediate full passive flexion of the knee and an early graduated physiotherapy programme. Our patient was able to return to running and his previous level of sport without any restrictions.

  4. Diagnosis of ligament injuries in the superior ankle joint

    International Nuclear Information System (INIS)

    Nearly 40 years after ankle arthrography was first introduced, the anterior and inversion stress views of the ankle are still widely preferred as a noninvasive method of evaluating ligament injuries in the upper ankle. We consider the stress test, bilaterally performed using a standardized stress apparatus, as a basic examination by which to differentiate between slight and severe sprain. Intensive muscel splinting due to painful swelling can sometimes be treated by injection of local anesthetic. Like many authors, we perform ankle arthrography in cases where there is a significant difference between the clinical findings and the stress test. The technique of ankle arthrography can be readily learned and is extremely accurate in delineating the extent of ligamentous injury produced by moderate or severe ankle sprains. It can be performed in any X-ray department. (orig.)

  5. Clinics in diagnostic imaging. 141. Complete anterior cruciate ligament tear.

    Science.gov (United States)

    Lim, Hollie M Y; Peh, Wilfred C G

    2012-09-01

    A 38-year-old man presented with right knee pain and swelling following a football injury. Magnetic resonance (MR) imaging showed a complete anterior cruciate ligament (ACL) tear and lateral meniscal tears. The torn ACL was repaired with a graft obtained from the semitendinosus muscle, and the menisci were debrided. The mechanisms of injury to the ACL are varied and may be due to direct or indirect contact with the knee as well as with twisting injuries. Knowledge of the ACL's normal anatomy, together with MR imaging technique and understanding of the appearance of the lesion on MR examination, is crucial to aid in the identification of an ACL tear. Diagnosis of an ACL tear should be based on direct MR imaging signs, although indirect signs may be helpful, particularly in chronic tears. Other associated injuries to be aware of include meniscal and other ligamentous injuries. Normal ACL graft and post-ACL graft reconstruction complications are also briefly discussed. PMID:23023908

  6. Ganglion cyst of the posterior cruciate ligament in a child.

    Science.gov (United States)

    Hameed, Shamsi Abdul; Sujir, Premjit; Naik, Monappa A; Rao, Sharath K

    2012-04-01

    Ganglion cysts are more commonly associated with the anterior cruciate ligament than the posterior cruciate ligament (PCL). A literature review showed that all reported cases of ganglion cysts to date involved adults. We report a rare case of ganglion cyst in the PCL of a four-year-old boy, and discuss its aetiology, clinical presentation, imaging features and management. Ganglion cysts of the PCL may be confused with meniscal cysts arising from tears of the posterior horn of the medial meniscus on magnetic resonance (MR) imaging. Hence, the posterior horn of the medial meniscus has to be carefully evaluated to rule out a tear. MR imaging is the method of choice to confirm diagnosis, and arthroscopic resection is a safe treatment modality even in children. PMID:22511069

  7. In Vitro Periodontal Ligament Cell Viability in Different Storage Media.

    Science.gov (United States)

    Sharma, Meenakshi

    2016-01-01

    The aim of this study was to evaluate the viability of periodontal ligament cells of avulsed teeth in three different storage media. Forty-five mature premolars extracted for orthodontic therapeutic purposes were randomly and equally divided into three groups according to the storage medium: milk (control), rice water and egg white. After placing extracted teeth for 30 min in storage media, the scrapings of the periodontal ligament (PDL) were collected in Falcon tubes containing collagenase in 2.5 mL of phosphate buffer saline and were incubated for 30 min and centrifuged for 5 min at 800 rpm. Cell viability was analyzed by Trypan blue exclusion. Rice water had a significantly higher number of viable cells compared to egg white and milk. There was no statistically significant difference between egg white and milk. Rice water may be able to maintain PDL cell viability of avulsed teeth better than egg white or milk. PMID:27652702

  8. The anatomic coracoclavicular ligament reconstruction: surgical technique and indications.

    Science.gov (United States)

    Carofino, Brad C; Mazzocca, Augustus D

    2010-03-01

    The anatomic coracoclavicular ligament reconstruction (ACCR) is a surgical procedure to address acriomioclavicular joint instability. The coracoclavicular ligaments are reconstructed using a semitendinosus allograft passed beneath the coracoid and through bone tunnels in the clavicle. The graft is secured with interference screw fixation, and the acromioclavicular joint is retained. Here we describe the authors' surgical technique, indications, and rehabilitation protocol. Also, a preliminary case series of seventeen patients is presented. Patients demonstrated significant improvement in pain levels and function. The mean ASES score increased from 52 preoperatively to 92. The Constant Murley rose from 66.6 to 94.7. There were three failures in this series, and two required revision surgery. PMID:20188267

  9. A Brief History of Anterior Cruciate Ligament Reconstruction

    Directory of Open Access Journals (Sweden)

    Nikolaos Davarinos

    2014-01-01

    Full Text Available Reconstructions of the anterior cruciate ligament (ACL are among the most frequently performed procedures in knee surgery nowadays. The history of ACL surgery can be traced as far back as the Egyptian times. The early years reflect the efforts to establish a viable, consistently successful reconstruction technique while, during the early 20th century, we witness an increasing awareness of, and interest in, the ligament and its lesions. Finally, we highlight the most important steps in the evolution of the ACL reconstruction surgery by discussing the various techniques spanning the years using not only autologous grafts (fascia lata, meniscal, hamstring, patella tendon, bone-patella tendon-bone, and double bundle grafts but also synthetic ones and allografts.

  10. Carpal ligamentous laxity with bilateral perilunate dislocation in Marfan syndrome

    International Nuclear Information System (INIS)

    A case of persistent bilateral perilunate dislocation unrelated to trauma in a patient with Marfan syndrome is discussed. This finding is believed to be a manifestation of the generalized ligamentous laxity occurring in this disorder. Radiographs of eight additional Marfan syndrome patients failed to demonstrate similar carpal instability. Because some carpal derangements are dynamic events, stress views or wrist fluoroscopy may be necessary to demonstrate unsuspected carpal instability in Marfan patients. (orig.)

  11. Carpal ligamentous laxity with bilateral perilunate dislocation in Marfan syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Pennes, D.R.; Braunstein, E.M.; Shirazi, K.K.

    1985-01-01

    A case of persistent bilateral perilunate dislocation unrelated to trauma in a patient with Marfan syndrome is discussed. This finding is believed to be a manifestation of the generalized ligamentous laxity occurring in this disorder. Radiographs of eight additional Marfan syndrome patients failed to demonstrate similar carpal instability. Because some carpal derangements are dynamic events, stress views or wrist fluoroscopy may be necessary to demonstrate unsuspected carpal instability in Marfan patients.

  12. Managing ankle ligament sprains and tears: current opinion

    OpenAIRE

    McGovern RP; Martin RL

    2016-01-01

    Ryan P McGovern,1 RobRoy L Martin,1,2 1Department of Physical Therapy, Rangos School of Health Sciences, Duquesne University, 2Centers for Sports Medicine – University of Pittsburgh, Pittsburgh, PA, USA Abstract: The purpose of this paper is to present a current review of pathoanatomical features, differential diagnosis, objective assessment, intervention, and clinical course associated with managing lateral ankle ligament sprains. Proper diagnosis and identification of affected st...

  13. Anterior Cruciate Ligament Reconstruction Using a Flexible Reamer System

    OpenAIRE

    Fitzgerald, Judd; Saluan, Paul; Richter, Dustin L.; Huff, Nathan; Schenck, Robert C.

    2015-01-01

    Anatomic reconstruction of the anterior cruciate ligament (ACL) has been shown to improve stability of the knee, particularly rotational stability, potentially leading to superior clinical outcomes and a shorter return to sport. Nonanatomic ACL reconstruction has been linked to graft failure and abnormal cartilage loading thought to contribute to progression of degenerative joint disease. Use of the far anteromedial portal (FAMP) to uncouple the tibial and femoral tunnels has led to improved ...

  14. Injury of the ankle joint ligaments; Bandverletzungen des Sprunggelenks

    Energy Technology Data Exchange (ETDEWEB)

    Breitenseher, M.J. [Institut fuer Radiologie, Landesklinikum Waldviertel Horn, Horn (Austria); Karl Landsteiner Institut, St. Poelten (Austria)

    2007-03-15

    The diagnosis of lateral collateral ankle ligament trauma is based on patient history, clinical examination and clinical stress tests. If the clinical stress test is positive, stress radiography can be performed. There is, however, no consensus about the usefulness of stress radiography in acute ankle sprain, and in particular about the cut-off talar tilt angle beyond which a two-ligament rupture would be certain, ranging from 5 to 30 . Today, magnetic resonance imaging (MRI) is not used in this area, although it does allow controlled positioning of the foot and defined section visualization of injured lateral collateral ankle ligaments. In acute and chronic sinus tarsi injuries, MRI forms the established basis for diagnostic imaging, and can provide a definitive answer in most cases. MRI is also the method of choice for chronic posttraumatic pain with anterolateral impingement after rupture of the anterior talofibular ligament. Generally, for the evaluation of acute ankle injuries, MRI has developed to be the most important second-step procedure when projection radiology is non-diagnostic. (orig.) [German] Die Diagnose einer lateralen Bandverletzung nach einem Sprunggelenktrauma basiert auf der Anamnese, der klinischen Untersuchung und klinischen Stresstests. Bei positiven klinischen Stresstests kann eine Stressradiographie durchgefuehrt werden. Es gibt keine Uebereinstimmung hinsichtlich des Stellenwerts der Stressradiographie beim frischen Supinationstrauma des Sprunggelenks, insbesondere fuer den Winkel der Aufklappbarkeit bei einer Zweibandverletzung, der von 5 -30 reicht. Die MRT wird bei dieser Indikation zurzeit nur in Einzelfaellen benutzt, obwohl sie mit definierter Fusspositionierung und Ausrichtung der Untersuchungsebene eine ausgezeichnete Beurteilung der Sprunggelenkbaender erlaubt. Sie ist im besonderen Masse geeignet, akute und chronische Verletzungen des Sinus tarsi zu beurteilen. Bei chronischen Beschwerden nach Bandverletzung ist die MRT zur

  15. MRI in acute ligamentous injuries of the ankle.

    Science.gov (United States)

    Martella, Ilenia; Azzali, Emanuele; Milanese, Gianluca; Praticò, Francesco Emanuele; Ruggirello, Margherita; Trunfio, Vincenzo; Parziale, Raffaele; Corrado, Michele; Della Casa, Giovanni; Capasso, Raffaella; De Filippo, Massimo

    2016-01-01

    Ankle sprains are the most common lower limb injuries and affect more frequently young athletes; imaging is needed for an accurate diagnosis of such traumatic injuries. The purpose of this review is to analyse the magnetic resonance (MR) findings of both normal and pathological ankle's ligaments; indeed, MRI is the gold standard for the diagnosis of acute traumatic injuries and is useful for differentiation of the causes of ankle instability as well as for pre-operative planning. PMID:27467862

  16. Platelets lysate-based membranes for periodontal ligament regeneration

    OpenAIRE

    Babo, P. M.; Santo, Vítor E.; Duarte, Ana Rita C.; Gomes, Manuela E.; Reis, R. L.

    2013-01-01

    The periodontal ligament (PDL) is a group of specialized connective tissue fibers that attach a tooth to the alveolar bone where it is deployed. These fibers help the tooth withstand the substantial compressive forces which occur during chewing and remain embedded in the bone. Periodontitis is a prevalent infection disease that causes the destruction of the tooth supportive tissues including the PDL. Given its low ability of regeneration in adult patients, concerted efforts have been made to ...

  17. Do Cells Contribute to Tendon and Ligament Biomechanics?

    Science.gov (United States)

    Hammer, Niels; Huster, Daniel; Fritsch, Sebastian; Hädrich, Carsten; Koch, Holger; Schmidt, Peter; Sichting, Freddy; Wagner, Martin Franz-Xaver; Boldt, Andreas

    2014-01-01

    Introduction Acellular scaffolds are increasingly used for the surgical repair of tendon injury and ligament tears. Despite this increased use, very little data exist directly comparing acellular scaffolds and their native counterparts. Such a comparison would help establish the effectiveness of the acellularization procedure of human tissues. Furthermore, such a comparison would help estimate the influence of cells in ligament and tendon stability and give insight into the effects of acellularization on collagen. Material and Methods Eighteen human iliotibial tract samples were obtained from nine body donors. Nine samples were acellularized with sodium dodecyl sulphate (SDS), while nine counterparts from the same donors remained in the native condition. The ends of all samples were plastinated to minimize material slippage. Their water content was adjusted to 69%, using the osmotic stress technique to exclude water content-related alterations of the mechanical properties. Uniaxial tensile testing was performed to obtain the elastic modulus, ultimate stress and maximum strain. The effectiveness of the acellularization procedure was histologically verified by means of a DNA assay. Results The histology samples showed a complete removal of the cells, an extensive, yet incomplete removal of the DNA content and alterations to the extracellular collagen. Tensile properties of the tract samples such as elastic modulus and ultimate stress were unaffected by acellularization with the exception of maximum strain. Discussion The data indicate that cells influence the mechanical properties of ligaments and tendons in vitro to a negligible extent. Moreover, acellularization with SDS alters material properties to a minor extent, indicating that this method provides a biomechanical match in ligament and tendon reconstruction. However, the given protocol insufficiently removes DNA. This may increase the potential for transplant rejection when acellular tract scaffolds are used in

  18. Concomitant ligamentous and meniscal injuries in floating knee

    OpenAIRE

    Liu, Ya; Jun ZHANG; Zhang, Shu; Li, Rui; Yue, Xianhu

    2015-01-01

    Background: To identify and characterize the concomitant ligamentous and meniscal injuries in floating knee. Methods: A total of 37 cases of floating knee were enrolled. Arthroscopic or open surgical examination of the knee, Lachman test, posterior drawer’s test, and varus and valgus stress tests under anesthesia were carried out to determine the incidence of knee injury. Results: Through arthroscopic and open surgical examinations, a medial meniscal tear was detected in 14 (37.8%) cases and ...

  19. Trial analysis of swine's periodontal ligament with Bragg grating sensors

    Science.gov (United States)

    Menegotto, G. F.; Grabarski, L.; Kalinowski, H. J.; Simões, J. A.

    2009-10-01

    In this work it is reported the measurement of the differential strain between the dental and bone tissues under effect of an applied load. Slices of swine mandible, containing the premolar tooth, are cut and measured in fresh condition. The strain is measured using fibre Bragg grating sensors glued to both tissues. In the measured range the results show a linear behaviour and confirm the importance of the periodontal ligament in the load transfer mechanism.

  20. Do cells contribute to tendon and ligament biomechanics?

    Directory of Open Access Journals (Sweden)

    Niels Hammer

    Full Text Available Acellular scaffolds are increasingly used for the surgical repair of tendon injury and ligament tears. Despite this increased use, very little data exist directly comparing acellular scaffolds and their native counterparts. Such a comparison would help establish the effectiveness of the acellularization procedure of human tissues. Furthermore, such a comparison would help estimate the influence of cells in ligament and tendon stability and give insight into the effects of acellularization on collagen.Eighteen human iliotibial tract samples were obtained from nine body donors. Nine samples were acellularized with sodium dodecyl sulphate (SDS, while nine counterparts from the same donors remained in the native condition. The ends of all samples were plastinated to minimize material slippage. Their water content was adjusted to 69%, using the osmotic stress technique to exclude water content-related alterations of the mechanical properties. Uniaxial tensile testing was performed to obtain the elastic modulus, ultimate stress and maximum strain. The effectiveness of the acellularization procedure was histologically verified by means of a DNA assay.The histology samples showed a complete removal of the cells, an extensive, yet incomplete removal of the DNA content and alterations to the extracellular collagen. Tensile properties of the tract samples such as elastic modulus and ultimate stress were unaffected by acellularization with the exception of maximum strain.The data indicate that cells influence the mechanical properties of ligaments and tendons in vitro to a negligible extent. Moreover, acellularization with SDS alters material properties to a minor extent, indicating that this method provides a biomechanical match in ligament and tendon reconstruction. However, the given protocol insufficiently removes DNA. This may increase the potential for transplant rejection when acellular tract scaffolds are used in soft tissue repair. Further research

  1. Septic arthritis of the knee following anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Matjaz Sajovic

    2009-04-01

    Full Text Available Septic arthritis of the knee is a rare complication after arthroscopic anterior cruciate ligament reconstruction, and the most appropriate treatment is unclear. All case series reported so far have been retrospective, and case numbers of septic arthritis have ranged from 4 to 11. From a consecutive case series of 1,283 patients who underwent arthroscopic anterior cruciate ligament reconstruction between January 1997 and May 2008, we report on 3 patients (0.23% with post-operative septic arthritis. All patients had acute infection (≤ 2 weeks, bacterial cultures showed Staphylococcus species in 2 patients, while the bacterial culture was negative in the third. All of them underwent immediate arthroscopic debridement and lavage with continuous irrigation, as well as antibiotic treatment. The results were evaluated with physical and radiographic examination, functional testing, KT-2000, Lysholm and Tegner scales. The infection was successfully eradicated without further surgical treatment and the ligament graft was retained in all patients. Follow-up, at an average of 33 months, revealed that the patients had full symmetric knee range of motion and no effusion. The average Lysholm score was 91 points. In the patient with a lower subjective score, radiographs demonstrated patellofemoral joint-space narrowing, which is most probably in correlation with his anterior knee pain problems and lower activity level. The 134 N KT-2000 arthrometer side-to-side differences averaged 13 mm. Their performance in the single-legged hop test gave excellent results. The goals of treatment for septic arthritis after anterior cruciate ligament reconstruction are, primarily, to protect the articular cartilage and, secondly, to protect the graft. Through early diagnosis and prompt treatment, the infection can be successfully eradicated, with stability of the knee and full range of motion achieved.

  2. FUNCTIONAL OUTCOME OF ARTHROSCOPIC RECONSTRUCTION OF ANTERIOR CRUCIATE LIGAMENT TEARS

    Directory of Open Access Journals (Sweden)

    Ashok Kumar

    2016-02-01

    Full Text Available BACKGROUND Anterior Cruciate Ligament (ACL tear is the most common serious ligamentous injury to the knee joint. Anterior Cruciate Ligament (ACL injury is quite common among young active population, athletes and contact sports. The exact incidence of anterior cruciate ligament tears is not known as the cases are being under reported. The ACL is the primary stabilizer against anterior translation of the tibia on the femur and is important in counteracting rotation and valgus stress. MATERIALS AND METHODS Between November 2012 to October 2014, 34 consecutive patients who underwent arthroscopic assisted ACL reconstructions in the Department of Orthopedics and Traumatology, King George Hospital, Visakhapatnam were the material in our study. Age groups between 18 to 45 years considered. We utilised both BPTB and Quadrupled hamstring graft depending on the patient’s age, outcome testing in all cases was performed at the latest follow-up (at least 6 months. Post-operative physiotherapy rehabilitation protocol followed for 06 months. RESULTS Standard protocol of Lysholm and IKDC knee scoring system were used for evaluation of the results of the surgery during followup. Patients were evaluated periodically at preop, 3 months, 6 months, 12 months, 18 months and 24 months. CONCLUSION Patients with isolated ACL injury had better outcome compared to patients who underwent associated meniscectomy. Most common mechanism of injury was activity of sports in 20 patients. Postoperatively at 3 months, anterior drawer’s was 1+ in 6, 29 (85.2% patients had normal range of motion; 29 (85.29% patients had 5/5 quadriceps power (MRC grading 94% of them had 5/5 power at latest followup. No significant difference between outcomes of BPTB and Hamstrings graft. Functional outcome of our study were similar to the previously published studies.

  3. Anatomic anterior cruciate ligament reconstruction using an individualized approach

    Directory of Open Access Journals (Sweden)

    Carola F. van Eck

    2014-01-01

    Full Text Available Anterior cruciate ligament (ACL reconstruction is one of the most commonly performed orthopaedic procedures. Recently, there has been a shift in interest towards reconstruction techniques that more closely restore the native anatomy of the ACL. This review paper discusses our approach to individualized anatomic ACL reconstruction, including the anatomy of the ACL, the physical exam, imaging modalities, the surgical technique for anatomic reconstruction including pre- and intraoperative considerations and our postoperative rehabilitation protocol.

  4. Proprioception and performance after anterior cruciate ligament rupture

    OpenAIRE

    Katayama, Masayoshi; Higuchi, Hiroshi; Kimura, Masashi; Kobayashi, Atsushi; Hatayama, Kazuhisa; Terauchi, Masanori; Takagishi, Kenji

    2004-01-01

    The aim of this study was to investigate the characteristics of proprioception in patients with an anaterior-cruciate-ligament (ACL)-injured knee and to determine whether there is a correlation between proprioception and performance. We studied 32 patients with unilateral isolated ACL ruptures. Proprioception of the knee was evaluated by examining the joint position sense. Functional performance was evaluated with the one-leg hop (OLH) and one-leg vertical jump (OLV) tests. The mean error ang...

  5. Fracture of the patella after the anterior cruciate ligament reconstruction

    OpenAIRE

    Milović Milan; Bojat Veselin; Kovačev Nemanja; Rašović Predrag; Milankov Miroslav

    2012-01-01

    Introduction. Fracture of the patella, after harvesting the central third of the patellar tendon for a bone-tendon-bone autograft, is a rare complication. Material and Methods. We made 1714 reconstructions of the anterior cruciate ligament of the knee using bone-patellar tendon-bone technique, and 7 patients had fracture of the patella (0.42%). The fracture was immediately recognized in the patients with vertical non-displaced patellar fracture and the broken screw osteosynthesis was ca...

  6. Anatomic Double-Bundle Posterior Cruciate Ligament Reconstruction

    OpenAIRE

    Chahla, Jorge; Nitri, Marco; Civitarese, David; Dean, Chase S.; Moulton, Samuel G.; LaPrade, Robert F.

    2016-01-01

    The posterior cruciate ligament (PCL) is known to be the main posterior stabilizer of the knee. Anatomic single-bundle PCL reconstruction, focusing on reconstruction of the larger anterolateral bundle, is the most commonly performed procedure. Because of the residual posterior and rotational tibial instability after the single-bundle procedure and the inability to restore the normal knee kinematics, an anatomic double-bundle PCL reconstruction has been proposed in an effort to re-create the n...

  7. Graft selection in arthroscopic anterior cruciate ligament reconstruction

    OpenAIRE

    Romanini, Emilio; D’Angelo, Franca; De Masi, Salvatore; Adriani, Ezio; Magaletti, Massimiliano; Lacorte, Eleonora; Laricchiuta, Paola; Sagliocca, Luciano; Morciano, Cristina; Mele, Alfonso

    2010-01-01

    Background Anterior cruciate ligament (ACL) surgical reconstruction is performed with the use of an autogenic, allogenic or synthetic graft. The document issued by the Italian National Guidelines System (SNLG, Sistema Nazionale Linee Guida) at the National Institute of Health aims to guide orthopaedic surgeons in selecting the optimal graft for ACL reconstruction using an evidence-based approach. Materials and methods A monodisciplinary panel was formed to define a restricted number of clinic...

  8. MRI of the lateral ankle ligaments: value of three-dimensional orientation

    International Nuclear Information System (INIS)

    Purpose: To determine the three-dimensional orientation of the lateral ankle ligaments with MRI. Materials and Methods: Twenty healthy volunteers without previous injury to the ankle were included in the study. With the right ankle in the normal anatomic position stabilized in a splint, coronal T2-weighted spin-echo sequences (TSE) were obtained. The three-dimensional orientation was determined by placing paths through the ligaments and by measuring the angles between corresponding tangents and the three main imaging planes. Results: Using the calculated angles, full-length visualization of the lateral ligaments of the ankle was achieved. The angles deviating from the axial imaging plane were 18.0 degrees for the anterior talofibular ligament, 52.3 degrees for the calcaneofibular ligament and 28.2 degrees for the posterior talofibular ligament. Conclusion: MRI enables the exact determination of the three-dimensional orientation of the lateral ankle ligaments. Orienting the imaging planes according to the calculated angular deviation allows the full-length visualization of the ligaments and is the basis for optimal imaging of the lateral ankle ligaments. (orig.)

  9. Postoperative MRI findings after anterior cruciate ligament reconstruction. A prospective study with 50 patients

    International Nuclear Information System (INIS)

    Aim: Identification of typical postoperative change after anterior cruciate ligament reconstruction (sutures, tendon grafts) and comparison with clinical tests and ultrasound. Patients and methods: 50 patients with anterior cruciate ligament ruptures were examinated with MRI (1.0 T, surface coil, sagittal T1-3DFT-Fast and sagittal spin-echo), US and clinical function tests (Lachmann, pivot-shift, anterior drawer test). Results: In 19 of 21 patients with continuous low-intensity ligament structures in the MRI, knee stability was very good or good in the clinical tests and US. In 17 of 20 patients with a diagnosis of partial rupture at MRI, we also found a stable knee. 5 of 7 patients with the MRI-signs of ligament rupture showed knee stability at US and clinical tests. Furthermore, at MRI we found minor effusions in 10 patients, meniscus tears in 8 patients and ligament impingement in 2 patients. Conclusion: MRI is a valuable method for evaluating and assessing anterior ligament reconstructions. We found a good correlation between the continuous low-intensity ligaments at MRI and knee-stability. In contrast there is a bad correlation between discontinuous ligament structures at MRI and clinical stability of the knee. MRI seems to provide more information than US and clinical tests (for example: minor effusion, meniscus tears, ligament impingement, bone lesions). (orig.)

  10. Tuberculous abscess in hepatoduodenal ligament: Evaluation with contrast-enhanced computed tomography

    Institute of Scientific and Technical Information of China (English)

    Peng Dong; Bin Wang; Ye-Quan Sun

    2008-01-01

    Two patients with tuberculous abscess in the hepatoduodenal ligament were studied. Both patients underwent contrast-enhanced computed tomography (CT) scan. The abscess showed a low density with an irregular thick wall in the hepatoduodenal ligament on CT images, the margin was poorly defined. Contrastenhanced CT images showed the contrast-enhanced thick wall, homogeneous and peripheral-enhanced lymph nodes. Although features of the tuberculous abscess in the hepatoduodenal ligament could be conspicuously shown with contrast-enhanced CT, further experience is needed to evaluate the potential value of CT in detecting early tuberculous abscess in relation to other entities in the hepatoduodenal ligament.

  11. Collagenolytic activity is produced by rabbit ligaments and tendon

    International Nuclear Information System (INIS)

    The authors examined the patellar tendon (PT), anterior cruciate ligament (ACL) and medial collateral ligament (MCL) from normal rabbits for collagenase activity. All three connective tissues contain large amounts of collagen and the catabolism of this structural protein is important to their integrity. The authors cultured each tissue in serum free medium for 14 days. Collagenase was produced by all three connective tissues after a lag period of up to 7 days, as detected by the 14C-glycine peptide-release assay. Culture media that did not express enzyme the authors found to contain inhibitory activity. The collagenases and inhibitors from each tissue have been quantitated and characterized. After 9 days the collagenase activity for the rabbit periarticular tissues was 6.1 (PT), 4.4 (MCL) and 8.6 (ACL) units per milligram of secreted protein. The cleavage site of all three collagenases was found to be similar to that observed for rabbit skin collagenase, and generation of reaction products TC/sup A/ and TC/sup B/ was demonstrated by collagenases from PT, MCL and ACL. These results suggest that the metabolism of ligaments and tendon is regulated by the production of zymogen, active collagenase and inhibitor, similar to other connective tissues. The role of these components in joint injury and joint diseases is currently being investigated

  12. ARTHROSCOPIC RECONSTRUCTION OF ANTERIO R CRUCIATE LIGAMENT TEARS: OUR EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Thimma Reddy

    2015-09-01

    Full Text Available BACKGROUND: Anterior knee instability associated with rupture of the ACL (Anterior Cruciate Ligament is a disabling clinical problem. The ACL has a poor capacity for intrinsic repair. Thus for patients who have knee symptoms related to ACL deficiency, one may consider ligament reconstruction as a means of stabilizing the T ibio - F emoral articulation and restoring high level function of the knee joint. Arthroscopically assisted ACLR ( ACL Reconstruction has the advantage of being minimally invasive, accurate graft placement, less disturbance of normal tissue resulting in quicker recovery and rehabilitation, minimal hospital stay and very less infection rate. MATERIAL AND METHODS: Between April 2012 to May 2013, 30 patients who underwent arthroscopic assisted ACL reconstructions using either bone - patellar tendon - bone auto graft ( BTB or Quadrupled hamstring auto graft ( QHG or Quadriceps tendon graft ( QTG in the Department of Orthopaedics and Traumatology, Osmania Medical College, Hyderabad, Andhra Pradesh is the material in our study. CONCLUSIONS : Arthroscopic reconstruction of Anterior Cruciate Ligament is a reliable, safe procedure. It helps in the early restoration of function and stability of the Knee joint and helps the patient to get back to his normal activity much earlier than with the traditional open surgical methods. The choice of the graft does not play a major role in the function of the knee in the long run.

  13. Reconstruction of chronic acromioclavicular joint disruption with artificial ligament prosthesis

    Institute of Scientific and Technical Information of China (English)

    Devendra Kumar Chouhan; Uttam Chand Saini; Mandeep Singh Dhillon

    2013-01-01

    Objective:Management of Rockwood type 3 acromioclavicular disruptions is a matter of debate.Should we adopt conservative or operative measures at first presentation? It is not clear but most of the evidences are in favour of conservative management.We present our experience in managing these patients surgically.Methods:We present a prospective series of eight cases of chronic Rockwood type 3 acromioclavicular joint disruptions treated surgically.Anatomical reconstruction of the coracoclavicular ligament was done by artificial braided polyester ligament prosthesis.Results:All the patients were able to perform daily activities from an average of the 14th postoperative day.All patients felt an improvement in pain,with decrease in average visual analogue scale from preoperative 6.5 points (range 3-9 points) to 2.0 points (range 0-5 points),Constant score from 59% to 91% and American Shoulder and Elbow Surgeons shoulder score from 65 to 93 points postoperatively.These results improved or at least remained stationary on midterm follow-up,and no deterioration was recorded at an average follow-up of 46 months.Conclusion:This midterm outcome analysis of the artificial ligament prosthesis is the first such follow-up study with prosthesis.Our results are encouraging and justify the further use and evaluation of this relatively new and easily reproducible technique.

  14. Biologic characteristics of fibroblast cells cultured from the knee ligaments

    Institute of Scientific and Technical Information of China (English)

    陈鸿辉; 唐毅; 李斯明; 沈雁; 刘向荣; 钟灿灿

    2002-01-01

    Objective: To culture fibroblast cells from the kneeligaments and to study the biological characteristics of thesecells.Methods: Cells of the anterior cruciate ligament(ACL) and the medial collateral ligament (MCL) fromNew Zealand white rabbit were cultured in vitro. Cellulargrowth and expression of the collagen were analyzed.Moreover, an in vitro wound closure model was establishedand the healing of the ACL and the MCL cells wascompared.Results: Maximal growth for all these cells wereobtained with Dulbecco's modified Eagle's mediumsupplemented with 10% fetal bovine serum, but RPMI 1640and Ham's F12 media were not suitable to maintain thesecells. Morphology of both ACL and MCL cells from NewZealand white rabbit was alike in vitro, but the MCL cellsgrew faster than the ACL cells. Both cell types producedsimilar amount of collagen in culture, but the ratio ofcollage type I to type III produced by ACL cells was higherthan that produced by MCL cells. Wound closure assayshowed that at 36 hours after injury, cell-free zones createdin the ACL cultures were occupied partially by the ACLcells; in contrast, the wounded zone in the MCL cultureswas almost completely covered by the cells.Conclusions: Although the ACL cells and the MCLcells from New Zealand white rabbit show similarappearance in morphology in culture, the cellular growthand the biochemical synthesis of collagen as well as thehealing in vitro were significantly different. Thesedifferences in intrinsic properties of the two types of cells invitro might contribute to the differential healing potentialsof these ligaments in vivo.

  15. Ring-shaped lateral meniscus with hypoplasic anterior cruciate ligament.

    Science.gov (United States)

    Esteves, Cátia; Castro, Ricardo; Cadilha, Rui; Raposo, Frederico; Melão, Lina

    2015-12-01

    Knee joint lesions can be solitary or occur concomitantly with other lower limb abnormalities. Ring-shaped lateral meniscus (RSM) and hypoplasic anterior cruciate ligament (ACL) are two rare malformations. The therapeutic management of such abnormalities is not consensual, and highly depends on clinical symptomatology. We report a case of a 25-year-old girl with progressive knee pain whose MRI demonstrated a continuous segment of lateral meniscus situated along the medial aspect of the lateral compartment, continuous with the otherwise normal-appearing lateral meniscus, compatible with an RSM. This anatomic variant can be mistaken by a displaced meniscal fragment, like a bucket-handle tear, a central tear of a discoid meniscus, or incomplete discoid meniscus, as previously reported. Her MRI examination also showed a thinned ACL with anomalous lateral course. This abnormality may be mistaken for an ACL rupture and/or a meniscofemoral ligament with agenesis of ACL. Multiple images in different planes as well as following the course of meniscal and ligaments are critical clues to avoid misdiagnosis. As a result, the diagnosis of an RSM along with hypoplasic ACL with abnormal attachment was assumed based on MRI and confirmed during arthroscopy. The patient was treated conservatively with clinical outcome improvement.

  16. Non-traumatic Thickening of the Anterior Cruciate Ligament

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Hyun Jun; Park, Jin Gyoon; Song, Sang Gook [Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2009-08-15

    To describe the magnetic resonance (MR) imaging findings of non-traumatic thickening of the anterior cruciate ligament (ACL) and to evaluate the associated lesions. Between January 2003 and August 2005, 44 knees of 44 patients who had thickened ACLs on MR images and had no history of knee trauma were analyzed retrospectively. The normal thickness of the ACL was measured on axial T2-weighted images of 40 healthy adult knees. The MR imaging findings of the thickened ACLs and associated lesions were analyzed. In 40 cases of healthy knees, the thickness of the proximal ACL was 3-6 mm. In 44 cases of non-traumatic thickening of the ACL, the thickness of the proximal ACL was 8-14 mm. There was an increased signal intensity and ill-defined border in all cases of thickened ACLs, linear low-signal intensity fibers parallel to the long axis of the thickened ACL (celery stalk appearance) in 24 cases, and entrapment in 10 cases. With respect to associated lesions, there was osteoarthritis in 40 cases, meniscal tears in 42 cases, and degeneration of the posterior cruciate ligament in 7 cases. Non-traumatic thickening of the ACL was associated with osteoarthritis and meniscal tears in almost all cases and showed increased signal intensity and ill-defined borders simulating acute ligamentous tears

  17. [Augmented anterior cruciate ligament replacement with the Kennedy-LAD (ligament augmentation device)--long term outcome].

    Science.gov (United States)

    Riel, K A

    1998-01-01

    The ligament augmentation device (Kennedy-LAD) is used to protect tendon grafts during the posttransplantation decrease in strength in anterior cruciate ligament (acl) reconstructions. The augmentation with the LAD is based on the concept of load sharing. Since 1983 we used the LAD in acl-reconstructions in 856 patients. In 63 cases we had to treat complications like infection (8), recurrent effusions (21), arthrofibrosis (34). The overall results are good with respect to stability, regain of strength and sports activity. In 73 cases resurgery was necessary because of synovitis (7), LAD-rupture due to re-injury (9), fatigue-rupture of the LAD (22), meniscal tears (35), 2.7 +/- 2.3 years (range: 2 months to 10 years) after LAD implantation. Modern techniques in acl reconstruction lead to comparable results without synthetic augmentation. Therefore, we now recommend the use of a LAD only in cases of repeated acl replacement with week tendon grafts, to avoid an allograft.

  18. Amiodarone-induced pulmonary toxicity mimicking acute pulmonary edema.

    Science.gov (United States)

    Fabiani, Iacopo; Tacconi, Danilo; Grotti, Simone; Brandini, Rossella; Salvadori, Claudia; Caremani, Marcello; Bolognese, Leonardo

    2011-05-01

    Amiodarone is a highly effective antiarrhythmic drug. Its long-term use may, however, lead to several adverse effects, with pulmonary toxicity being the most serious. The article presents the case of a 78-year-old woman with a history of cardiac surgery, who after 2 years of amiodarone therapy for prophylactic treatment of atrial fibrillation developed amiodarone pneumonitis mimicking an acute pulmonary edema. The patient failed to respond to diuretic therapy and several courses of anti-infective therapy. Differential diagnosis of different causes of pulmonary infiltrates did not demonstrate any other abnormality. Lung biopsy findings were consistent with the diagnosis of amiodarone pneumonitis. Given the widespread use of amiodarone as an antiarrhythmic agent, pneumologists and cardiologists should consider this important adverse effect as a differential diagnosis of pulmonary distress refractory to therapy in all patients treated with amiodarone who present with respiratory symptoms and pneumonia-like illness. PMID:19924000

  19. Gastric Metastasis of Lung Cancer Mimicking an Adrenal Tumor

    Directory of Open Access Journals (Sweden)

    Tsung I Hung

    2014-03-01

    Full Text Available Lung cancer is one of the leading causes of cancer deaths worldwide. Metastatic spreads of lung cancer are often found in the adrenal glands, bone, liver, brain and kidneys; the gastrointestinal tract is less commonly involved. However, according to some reports in the literature, the incidence of gastrointestinal metastases, most of them asymptomatic, might be as frequent as 11% in autopsy studies of lung cancer, which suggests that this condition is not as rare as it was previously considered. We report a very rare case of small cell lung cancer with a solitary gastric metastasis mimicking an adrenal tumor which was belatedly diagnosed due to its unusual presentation and treated actively with surgery and chemotherapy, achieving a relatively favorable outcome.

  20. Liquid optical phantoms mimicking spectral characteristics of laboratory mouse biotissues

    Science.gov (United States)

    Loginova, D. A.; Sergeeva, E. A.; Krainov, A. D.; Agrba, P. D.; Kirillin, M. Yu

    2016-06-01

    Optical phantoms mimicking optical properties of real biotissues in the visible and IR spectral regions are developed based on measurements of the spectral characteristics of ex vivo samples of laboratory mouse biotissues. The phantoms are composed of aqueous solutions of Lipofundin, Indian ink and red ink with different spectral characteristics. The deviations of the measured absorption and scattering coefficients of phantoms in the wavelength range 480 – 580 nm from the corresponding values for real biotissues do not exceed 25% and 2%, respectively. For phantoms in the wavelength region 580 – 880 nm, the deviations of the absorption coefficient do not exceed 40% and the deviations of the scattering coefficient do not exceed 25%. These values, in general, fall within the range of variations for different individual mice of one strain.

  1. Optofluidic phantom mimicking optical properties of porcine livers

    Energy Technology Data Exchange (ETDEWEB)

    Long, Ruiqi [Texas A& M University; King, Travis [Texas A& M University; Akl, Tony [Texas A& M University; Ericson, Milton Nance [ORNL; Wilson, Mark A. [University of Pittsburgh School of Medicine, Pittsburgh PA; Cote, Gerard L. [Texas A& M University; McShane, Michael J. [Texas A& M University

    2011-01-01

    One strategy for assessing efficacy of a liver transplant is to monitor perfusion and oxygenation after transplantation. An implantable optical sensor is being developed to overcome inadequacies of current monitoring approaches. To facilitate sensor design while minimizing animal use, a polydimethylsiloxane (PDMS)-based liver phantom was developed to mimic the optical properties of porcine liver in the 630-1000 nm wavelength range and the anatomical geometry of liver parenchyma. Using soft lithography to construct microfluidic channels in pigmented elastomer enabled the 2D approximation of hexagonal liver lobules with 15mm sinusoidal channels, which will allow perfusion with blood-mimicking fluids to facilitate the development of the liver perfusion and oxygenation monitoring system.

  2. Adenoid Cystic Carcinoma Mimicking an Oroantral Fistula: A Case Report

    Science.gov (United States)

    Monteiro, Bárbara Vanessa de Brito; Grempel, Rafael Grotta; Gomes, Daliana Queiroga de Castro; Godoy, Gustavo Pina; Miguel, Márcia Cristina da Costa

    2013-01-01

    Introduction Adenoid cystic carcinoma (ACC) is one of the most frequent malignant salivary gland tumors, which commonly affects the minor salivary glands of the mouth and is rare in the nose and paranasal sinuses. In the maxillary sinus, ACC can mimic inflammatory diseases and has a poor prognosis. Objective To report a case of a 50-year-old man with ACC of the maxillary sinus whose clinical findings in the alveolar ridge mimicked an oroantral fistula. Case Report An excisional biopsy was performed and histopathologic analysis revealed ACC. Lung metastases and residual tumor in the maxillary sinus were detected by imaging methods. In view of the poor general health of the patient, no new surgical intervention was performed and he was only treated by radiotherapy and follow-up. Conclusion Although rare in the maxillary sinus, ACC should be included in the differential diagnosis of lesions affecting this site. PMID:25992095

  3. Adenoid Cystic Carcinoma Mimicking an Oroantral Fistula: A Case Report

    Directory of Open Access Journals (Sweden)

    Monteiro, Bárbara Vanessa de Brito

    2014-01-01

    Full Text Available Introduction Adenoid cystic carcinoma (ACC is one of the most frequent malignant salivary gland tumors, which commonly affects the minor salivary glands of the mouth and is rare in the nose and paranasal sinuses. In the maxillary sinus, ACC can mimic inflammatory diseases and has a poor prognosis. Objective To report a case of a 50-year-old man with ACC of the maxillary sinus whose clinical findings in the alveolar ridge mimicked an oroantral fistula. Case Report An excisional biopsy was performed and histopathologic analysis revealed ACC. Lung metastases and residual tumor in the maxillary sinus were detected by imaging methods. In view of the poor general health of the patient, no new surgical intervention was performed and he was only treated by radiotherapy and follow-up. Conclusion Although rare in the maxillary sinus, ACC should be included in the differential diagnosis of lesions affecting this site.

  4. Oral manifestion of Langerhans cell histiocytosis mimicking inflammation

    Directory of Open Access Journals (Sweden)

    K S Divya

    2014-01-01

    Full Text Available Langerhans cell histiocytosis (LCH is a rare idiopathic disease characterized by the clonal proliferation of Langerhans cells. LCH affects five children per million population. The peak incidence is from 1 to 4 years of age. LCH involves the head and neck region quite commonly. Oral soft tissue lesions are also common. The differential diagnosis of oral LCH includes leukemia, neutropenia, prepubertal periodontitis, hypophosphatasia, fibrous dysplasia, and Papillon-Lefevre syndrome. The prognosis of LCH depends on early detection and appropriate management. Surgical management alone is used in 50% of cases with an additional 23% of the lesions being treated with both surgery and radiation therapy. A case of LCH in a 6-year-old girl involving the mid root level of developing first permanent molar with a floating developing tooth bud of permanent second molar mimicking an inflammation is reported.

  5. Malignant fibrous histiocytoma presenting as hemoperitoneum mimicking hepatocellular carcinoma rupture

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Malignant fibrous histiocytoma (MFH) is a pleomorphic mesenchynal sarcoma. It is uncommonly arises primarily from the intra-peritoneal cavity. Primary peritoneal MFH with tumor bleeding and rupture is rare. We describe the imaging features of a 70-year-old patient presenting with ruptured hemorrhagic peritoneal MFH at subhepatic area, accompanied by massive hemoperitoneum,mimicking a ruptured pedunculated hepatocellular carcinoma. Computed tomography (CT) revealed a large heterogeneous enhanced subhepatic mass with adjacent liver, gallbladder and colon invasion. Tumor hemorrhage and rupture complicated with peritoneal seeding and massive bloody ascites were also detected.Angiography showed a hypervascular tumor fed by enlarged right hepatic arteries, cystic artery and omental branches of gastroepiploic artery. The patient underwent laparotomy for tumor resection, but the tumor recurred one month after operation. To our knowledge, the CT appearance of ruptured intraperitoneal MFH complicated by hemoperitoneum has not been previously described.

  6. Dentinogenic Ghost Cell Tumor of the Peripheral Variant Mimicking Epulis

    Directory of Open Access Journals (Sweden)

    Uddipan Kumar

    2010-01-01

    Full Text Available Dentinogenic ghost cell tumor (DGCT is an uncommon locally invasive odontogenic tumor regarded by many as a variant of calcifying odontogenic cyst. The peripheral variant of this clinical rarity appears as a well-circumscribed mass mimicking a nonspecific gingival enlargement. Microscopic appearance of odontogenic epithelium admixed with focal areas of dentinoid formation and sheets of ghost cells giving the definitive diagnosis of dentinogenic ghost cell tumor imply that microscopic examination is compulsory for any gingival mass. Van Gieson histochemical stain further confirmed the nature of dentinoid-like material. A complete workup of a case of peripheral dentinogenic ghost cell tumor is presented in this paper and the current concept as well as the appraisal of literature is presented.

  7. Myelodysplastic changes mimicking MDS following treatment for osteosarcoma

    DEFF Research Database (Denmark)

    Løhmann, Ditte

    -MDS/AML) is a feared long-term complication of paediatric cancer including osteosarcoma. Few develop t-MDS/AML, but it is not known how many have significant haematological changes after finishing treatment for osteosarcoma. In this study we reviewed biochemistry from a consecutive series of children for up to two......Myelodysplastic changes mimicking MDS following treatment for osteosarcoma Ditte Juel Adolfsen Løhmann, Department of Pediatrics, Aarhus University Hospital, Skejby, Denmark Authors: Ditte Juel Adolfsen Løhmann and Henrik Hasle. Therapy-related myelodysplastic syndrome/acute myeloid leukaemia (t...... years after finishing treatment. We included all children (n=14) who where diagnosed from October 2006 to January 2011 at our department and treated according to the EURAMOS-1 protocol. Four patients relapsed and died before the end of the study period. We found noteworthy changes in MCV, platelets...

  8. Impedance of tissue-mimicking phantom material under compression

    Directory of Open Access Journals (Sweden)

    Barry Belmont

    2013-02-01

    Full Text Available The bioimpedance of tissues under compression is a field in need of study. While biological tissues can become compressed in a myriad of ways, very few experiments have been conducted to describe the relationship between the passive electrical properties of a material (impedance/admittance during mechanical deformation. Of the investigations that have been conducted, the exodus of fluid from samples under compression has been thought to be the cause of changes in impedance, though until now was not measured directly. Using a soft tissue-mimicking phantom material (tofu whose passive electrical properties are a function of the conducting fluid held within its porous structure, we have shown that the mechanical behavior of a sample under compression can be measured through bioimpedance techniques.

  9. Epineurium-mimicking chitosan conduits for peripheral nervous tissue engineering.

    Science.gov (United States)

    Nawrotek, Katarzyna; Tylman, Michał; Rudnicka, Karolina; Gatkowska, Justyna; Wieczorek, Marek

    2016-11-01

    In this investigation, we report on a fabrication method of epineurium-mimicking tubular conduits based on electrodeposition from chitosan solution. The pre-enrichment of electrodeposition solution with hyaluronic acid and/or collagen components results in structures which structural, morphological, and physicochemical properties can be controlled. In order to determine the optimal composition of the initial chitosan solution resulting in conduits meeting the requirements imposed on peripheral nerve implants, we perform chemical, physical, and biological studies. Both the molecular weight of hyaluronic acid and the concentration of additives are found to be crucial for the final mechanical as well as biological performance of conduits. Because, the obtained structures show biocompatibility when contacting with a mouse hippocampal cell line (mHippoE-18), we further plan to test their application potential on an animal model. PMID:27516256

  10. Giant Ectopic Ureter Mimicking Pelvic Organ Prolapse: A Case Report

    Directory of Open Access Journals (Sweden)

    Adnan Simsir

    2011-01-01

    Full Text Available Ectopic ureter is one of the most common urinary tract anomalies. We, herein, present a case of a giant ureter with ectopic orifice, mimicking pelvic organ prolapse, which is the first in the literature. A 59-year-old female patient presenting with frequently recurrent urinary tract infection had grade 3 pelvic organ prolapse. On examination, the organ producing the appearance of prolapse was found to be a right ureter of giant size and was obstructed by a large stone at the distal segment. The proximal end of the ureter ended blindly. After exploration, the stone was removed, the ureter was detached from the urethra, and the lumen was tied off and cut 5 cm proximally. At 6 months postoperatively, the patient is being followed up without any clinical problems. In such cases with nonfunctioning renal segment draining proximally, the chance of cure can be obtained without a need for a comprehensive intervention such as total abdominal ureterectomy.

  11. Tunable Transmission-Line Metamaterials Mimicking Electromagnetically Induced Transparency

    Science.gov (United States)

    Feng, T. H.; Han, H. P.

    2016-11-01

    Tunable transmission-line (TL) metamaterials mimicking electromagnetically induced transparency (EIT) have been studied. Firstly, two types of tunable TL EIT-like metamaterial, based on the double split-ring resonator (DSRR) and single split-ring resonator (SSRR), were fabricated and their transmission properties carefully compared. The results showed that the transmittance maximum was almost invariable with shift of the transparency window for the tunable DSRR-based TL EIT-like metamaterial, but for the tunable SSRR-based TL EIT-like metamaterial, the transmittance maximum gradually diminished with shift of the transparency window toward the center of the absorption band. Moreover, the reason for these different transmission properties was explored, revealing that the reduction of the transmittance maximum of the transparency window for the tunable SSRR-based TL EIT-like metamaterial is mainly due to energy loss caused by the resistance of the loaded varactor diodes.

  12. Ewing sarcoma mimicking a peripheral nerve sheath tumor.

    Science.gov (United States)

    Mitchell, B D; Fox, B D; Viswanathan, A; Mitchell, A H; Powell, S Z; Cech, D A

    2010-10-01

    We describe the first patient with an extradural, extramedullary Ewing's sarcoma tumor mimicking a nerve sheath tumor with no overt evidence of metastasis. A 28-year-old woman with no past medical history presented with a progressive 3-year history of low back pain and right-sided lower extremity radiculopathy after having failed conservative therapies. MRI of the lumbar spine revealed a right-sided enhancing, dumbbell-shaped lesion at the right neural foramen appearing to originate from the L4 nerve root, suspicious for a peripheral nerve sheath tumor or schwannoma. The patient and findings are discussed in the context of the literature, including an update on the relatively recent diagnostic redesignation of the Ewing's sarcoma family tumors.

  13. Mimicking unfolding motion of a beetle hind wing

    Institute of Scientific and Technical Information of China (English)

    MUHAMMAD Azhar; PARK Hoon C; HWANG Do Y; BYUN Doyoung; GOO Nam S

    2009-01-01

    This paper presents an experimental research aiming to realize an artificial hind wing that can mimic the wing unfolding motion of Allomyrina dichotoma, an insect in coleopteran order. Based on the understanding of working principles of beetle wing folding/unfolding mechanisms, the hind wing unfolding motion is mimicked by a combination of creative ideas and state-of-art artificial muscle actuator. In this work, we devise two types of artificial wings and the successfully demonstrate that they can be unfolded by actuation of shape memory alloy wires to provide actuation force at the wing base and along the leading edge vein. The folding/unfolding mechanisms may provide an insight for portable nano/micro air vehicles with morphing wings.

  14. Outcome of hamstring ligament harvest for Anterior Cruciate Ligament reconstruction with allograft versus autograft: a clinical trial

    Directory of Open Access Journals (Sweden)

    Mehdi Moghtadaei

    2013-11-01

    Full Text Available Background: The goal of this study was to evaluate, functional capacity of the knee in flexion and internal rotation after hamstring ligament harvest for Anterior Cruciate Ligament (ACL reconstruction.Methods: Fifty patients (male and 18-45 years old with isolated ACL injury, randomly allocated in two equal groups (in one group, ACL reconstruction was performed with Tibialis Posterior allograft and in another group with quadruple hamstring ligament auto graft and before and 6 months after surgery in both groups isokinetic flexion strength and isometric internal rotation strength of knee evaluated with Biodex System 4 dynamometer and rotational torque recorder, in order. Isokinetic flexion strength evaluated in sitting and prone position; the later position was performed for deep flexion strength evaluation. Also subjective and objective assessment of all patients pre operatively and 6 months post operatively was documented with International Knee Documentation Committee (IKDC questionnaire. In this study for first time, rotational torque strength of knee was recorded with new design measure, from isometric aspect and not isokinetic.Results: Although significant improvements in IKDC scores, flexion and internal rotation capacity of the knee were observed in both groups, post operatively in respect to pre operatively; there was no significant difference between 2 groups. (P<0.05 or more than 95% confidence Interval of the differenceConclusion: This study demonstrates that ACL reconstruction surgery, improves knee performance in flexion and internal rotation, regardless of hamstring tendon harvesting. Considering potential complications of allograft (for example: transfer of harmful diseases from donor to recipient, it is logical to use hamstring auto graft ligament for ACL reconstruction surgery. Because result of this study is not longstanding follow up and limited to male sex, for more worthfull conclusion, we suggest future study in both sex

  15. Definition of the to be named ligament and vertebrodural ligament and their possible effects on the circulation of CSF.

    Science.gov (United States)

    Zheng, Nan; Yuan, Xiao-Ying; Li, Yun-Fei; Chi, Yan-Yan; Gao, Hai-Bin; Zhao, Xin; Yu, Sheng-Bo; Sui, Hong-Jin; Sharkey, John

    2014-01-01

    Few studies have been conducted specifically on the dense connective tissue located in the posterior medial part of the cervical epidural space. This study was undertaken to examine the presence of this connection between the cervical dura mater and the posterior wall of spinal canal at the level of C1-C2. 30 head-neck specimens of Chinese adults were used. Gross dissection was performed on the suboccipital regions of the 20 specimens. Having been treated with the P45 plastination method, 10 specimens were sliced (9 sagittal and 1 horizontal sections). As a result, a dense fibrous band was identified in the nuchal ligament of 29 specimens (except for one horizontal section case). This fascial structure arose from the tissue of the posterior border of the nuchal ligament and then projected anteriorly and superiorly to enter the atlantoaxial interspace. It was termed as to be named ligament (TBNL). In all 30 specimens the existence of a fibrous connection was found between the posterior aspect of the cervical dura mater and the posterior wall of the spinal canal at the level of the atlas to the axis. This fibrous connection was identified as vertebrodural ligament (VDL). The VDL was mainly subdivided into three parts, and five variations of VDL were identified. These two structures, TBNL and VDL, firmly link the posterior aspect of cervical dura mater to the rear of the atlas-axis and the nuchal region. According to these findings, the authors speculated that the movements of the head and neck are likely to affect the shape of the cervical dural sleeve via the TBNL and VDL. It is hypothesized that the muscles directly associated with the cervical dural sleeve, in the suboccipital region, may work as a pump providing an important force required to move the CSF in the spinal canal. PMID:25084162

  16. Definition of the to be named ligament and vertebrodural ligament and their possible effects on the circulation of CSF.

    Directory of Open Access Journals (Sweden)

    Nan Zheng

    Full Text Available Few studies have been conducted specifically on the dense connective tissue located in the posterior medial part of the cervical epidural space. This study was undertaken to examine the presence of this connection between the cervical dura mater and the posterior wall of spinal canal at the level of C1-C2. 30 head-neck specimens of Chinese adults were used. Gross dissection was performed on the suboccipital regions of the 20 specimens. Having been treated with the P45 plastination method, 10 specimens were sliced (9 sagittal and 1 horizontal sections. As a result, a dense fibrous band was identified in the nuchal ligament of 29 specimens (except for one horizontal section case. This fascial structure arose from the tissue of the posterior border of the nuchal ligament and then projected anteriorly and superiorly to enter the atlantoaxial interspace. It was termed as to be named ligament (TBNL. In all 30 specimens the existence of a fibrous connection was found between the posterior aspect of the cervical dura mater and the posterior wall of the spinal canal at the level of the atlas to the axis. This fibrous connection was identified as vertebrodural ligament (VDL. The VDL was mainly subdivided into three parts, and five variations of VDL were identified. These two structures, TBNL and VDL, firmly link the posterior aspect of cervical dura mater to the rear of the atlas-axis and the nuchal region. According to these findings, the authors speculated that the movements of the head and neck are likely to affect the shape of the cervical dural sleeve via the TBNL and VDL. It is hypothesized that the muscles directly associated with the cervical dural sleeve, in the suboccipital region, may work as a pump providing an important force required to move the CSF in the spinal canal.

  17. MRI appearance of the distal insertion of the anterior cruciate ligament of the knee: an additional criterion for ligament ruptures

    Energy Technology Data Exchange (ETDEWEB)

    Oldrini, G.; Teixeira, P.G.; Chanson, A.; Osemont, B.; Louis, M.; Blum, A. [CHU Nancy, Service d' imagerie Guilloz, Nancy (France); Erpelding, M.L. [CHU Nancy, Hopitaux de Brabois Allee du Morvan, Service Epidemiologie et Evaluation Cliniques, Vandoeuvre-les-Nancy (France)

    2012-09-15

    Anterior cruciate ligament tears are frequent and if not diagnosed may lead to relevant patient disability. Magnetic resonance imaging is the method of choice for the non-invasive diagnosis of these tears. Despite the high performance of this method some cases are challenging and the criteria described in the literature are not sufficient to reach a diagnosis. We propose a systematic method for the evaluation of anterior cruciate ligament tears based on the aspect of its distal portion. Magnetic resonance studies of 132 knees were evaluated in correlation with arthroscopy. The performance of the proposed method was compared with that of classic imaging signs of anterior cruciate ligament tear. The impact of image quality and reader expertise on the proposed method and the classic signs of tear were taken into account. This method had a sensitivity and specificity of 91.1% and 82.9% for the detection of abnormal ACLs. The interobserver agreement (kappa) of the proposed method was significantly higher than that of the classic signs at all levels of expertise (0.89 vs 0.76). This method was not influenced by image quality. Distal ACL analysis identified more partial tears and synovialization (granulation scar tissue) than the conventional method (71% vs 58.5% for partial tears and 83.5% vs 58.5% for synovialization). The proposed classification has a high performance and reproducibility for the identification of abnormal anterior cruciate ligament. The results were influenced neither by the level of expertise of the readers nor by the image quality. (orig.)

  18. Reconstruction of the anterior cruciate ligament of the knee

    Directory of Open Access Journals (Sweden)

    Nikolić Dragan

    2006-01-01

    Full Text Available Background/Aim. Numerous papers on reconstruction of the anterior cruciate ligament of the knee (ACL contribute to the significance of this method. The aim of this study was to analyze the outcome of the use of this surgical treatment method regardless the type of surgical intervention, graft, and the choice of the material for fixing. Methods. The study included 324 patients treated within the period from April 1997 to April 2004. Arthroscopically assisted ACL reconstruction was typically performed using the central one-third of the patellar ligament, as a graft, with bone blocks. Fixing was performed using screws (spongy or interferential, Mitek type. In the cases who required revision of the surgery, we used a graft m. semitendinosus and m. gracilise (STG or a graft of the patellar ligament (B-Pt-B. Fixation in these cases was performed using absorptive wedges according to the Rigidfix technique or metallic implants. Results. The analysis included the results of the reconstruction of the anterior cruciate ligament of the knee (B-Pt-B or STG graft in 139 of the knees. Chronic injuries were revealed in 132 (94.9% of the knees. According to the anamnesis and clinical findings, the feeling of instability prevailed in 132 (94.9% of the knees, pain in 72 (51.7%, effluents in 24 (17.2%, and blockages in 13 (9.3%. Early and late postoperative complications were noticeable in 3.5% each. Hypotrophy of the upper knee musculature up to 2 cm was present in 53.9% of the operated knees, while minor contractions in 13.6% of them. The final result of the reconstruction graded begusing the Lysholm Scale was 85.2, simultaneous reconstructions of other ligaments 75.3, and revision surgery 68.0. First-grade degenerative postoperative changes according to the K/L Scale were found in 55.0% of the surgically treated knees, while the worst, four-grade one in 2.5%. Conclusion. On the basis of these findings, we can conclude that this method is the method of choice in

  19. BROAD PHONEME CLASSIFICATION USING SIGNAL BASED FEATURES

    Directory of Open Access Journals (Sweden)

    Deekshitha G

    2014-12-01

    Full Text Available Speech is the most efficient and popular means of human communication Speech is produced as a sequence of phonemes. Phoneme recognition is the first step performed by automatic speech recognition system. The state-of-the-art recognizers use mel-frequency cepstral coefficients (MFCC features derived through short time analysis, for which the recognition accuracy is limited. Instead of this, here broad phoneme classification is achieved using features derived directly from the speech at the signal level itself. Broad phoneme classes include vowels, nasals, fricatives, stops, approximants and silence. The features identified useful for broad phoneme classification are voiced/unvoiced decision, zero crossing rate (ZCR, short time energy, most dominant frequency, energy in most dominant frequency, spectral flatness measure and first three formants. Features derived from short time frames of training speech are used to train a multilayer feedforward neural network based classifier with manually marked class label as output and classification accuracy is then tested. Later this broad phoneme classifier is used for broad syllable structure prediction which is useful for applications such as automatic speech recognition and automatic language identification.

  20. Arthrographic differential diagnosis between ruptures of the anterior talofibular ligament, the joint capsule and the anterior tibiofibular ligament

    International Nuclear Information System (INIS)

    Aus einem Studium der Literatur, chirurgischen Befunden und Untersuchungen an Leichen kann es als unwahrscheinlich angesehen werden, dass bei einer Fussverstauchung vom Inversionstyp ein Riss des vorderen tibiofibularen Ligraments haeufig zusammen mit einem Gelenkkapselriss und einem seitlichen Baenderriss auftritt. Entgegen der Beobachtung anderer Verfasser fanden wir, dass ein Riss des vorderen tibiofularen Ligaments in keiner Weise aus dem Vorhandensein oder Nichtvorhandensein folgender arthrographischer Befunde geschlossen werden konnte: a) kontrastfreie Zone, b) tibiofibularer Rezessus, oder c) beide zusammen. Ein Gelenkkapselriss kann angenommen werden, wenn Kontrastmittel aus dem Gelenk in das weiche Gewebe austritt, ohne unterhalb oder seitlich in den Aussenknoechel zu dringen. Ein Austritt des Kontrastmittels unterhalb und seitlich des Aussenknoechels deutet auf einen Riss des vorderen tabofibularen Ligaments hin. Die anatomischen Zusammenhaenge zwischen Bandverbindung, Gelenkkapsel, tibiofibularem Rezessus und dem vorderen talofibularen Ligament wurden an Leichen und waehrend der chirurgischen Eingriffe studiert. Ausbreitung des Kontrastmittels im weichen Gewebe wird wahrscheinlich bestimmt durch die Anordnung und Beschaedigung der Weichteile und durch die Groesse des entstandenen Haematoms und folgt dem Weg des kleinsten Widerstandes. (orig.)

  1. Modeling of failure mode in knee ligaments depending on the strain rate

    Directory of Open Access Journals (Sweden)

    Hyman William

    2002-01-01

    Full Text Available Abstract Background The failure mechanism of the knee ligament (bone-ligament-bone complex at different strain rates is an important subject in the biomechanics of the knee. This study reviews and summarizes the literature describing ligament injury as a function of stain rate, which has been published during the last 30 years. Methods Three modes of injury are presented as a function of strain rate, and they are used to analyze the published cases. The number of avulsions is larger than that of ligament tearing in mode I. There is no significant difference between the number of avulsions and ligament tearing in mode II. Ligament tearing happens more frequently than avulsion in mode III. Results When the strain rate increases, the order of mode is mode I, II, III, I, and II. Analytical models of ligament behavior as a function of strain rate are also presented and used to provide an integrated framework for describing all of the failure regimes. In addition, this study showed the failure mechanisms with different specimens, ages, and strain rates. Conclusion There have been several a numbers of studies of ligament failure under various conditions including widely varying strain rates. One issue in these studies is whether ligament failure occurs mid-ligament or at the bone attachment point, with assertions that this is a function of the strain rate. However, over the range of strain rates and other conditions reported, there has appeared to be discrepancies in the conclusions on the effect of strain rate. The analysis and model presented here provides a unifying assessment of the previous disparities, emphasizing the differential effect of strain rate on the relative strengths of the ligament and the attachment.

  2. Giant Broad Line Regions in Dwarf Seyferts

    CERN Document Server

    Devereux, Nick

    2015-01-01

    High angular resolution spectroscopy obtained with the Hubble Space Telescope (HST) has revealed a remarkable population of galaxies hosting dwarf Seyfert nuclei with an unusually large broad-line region (BLR). These objects are remarkable for two reasons. Firstly, the size of the BLR can, in some cases, rival those seen in the most luminous quasars. Secondly, the size of the BLR is not correlated with the central continuum luminosity, an observation that distinguishes them from their reverberating counterparts. Collectively, these early results suggest that non-reverberating dwarf Seyferts are a heterogeneous group and not simply scaled versions of each other. Careful inspection reveals broad H Balmer emission lines with single peaks, double peaks, and a combination of the two, suggesting that the broad emission lines are produced in kinematically distinct regions centered on the black hole (BH). Because the gravitational field strength is already known for these objects, by virtue of knowing their BH mass, ...

  3. The Weak Link in Anterior Cruciate Ligament Reconstruction: What is the Evidence for Graft Fixation Devices?

    Science.gov (United States)

    Campbell, Kirk A; Looze, Christopher; Bosco, Joseph A; Strauss, Eric J

    2016-03-01

    Anterior cruciate ligament (ACL) rupture is a common injury that mostly affects young adults. The mechanisms of injury and surgical treatment have been extensively studied in both the laboratory and clinical arenas; however, great controversy still exists in regards to the best surgical technique, graft choice, and graft fixation device. In the area graft fixation, multiple breakthroughs have occurred in terms of fixation devices. These devices generally fall within the broad categories of interference screw, cross-pins, or cortical-based devices. Furthermore, some of these devices are available in either metal or bioabsorbable materials, which adds to the already great variety of options. Although biomechanically these devices have been shown to be able to withstand the typical forces experienced by the ACL graft during the early phases of rehabilitation before the graft has fully incorporated into the bone, little is known about the clinical outcomes. It is well recognized that graft fixation is the weakest link in the early postoperative period after ACL reconstruction. This review of the outcomes of ACL fixation devices explores some of the evidence available for the different devices. PMID:26977545

  4. Hybrid Graft Anterior Cruciate Ligament Reconstruction: A Predictable Graft for Knee Stabilization.

    Science.gov (United States)

    Alvarez-Pinzon, Andres M; Barksdale, Leticia; Krill, Michael K; Leo, Brian M

    2015-06-01

    Trauma to the anterior cruciate ligament (ACL) is a season-ending injury and involves months of activity modification and rehabilitation. The annual incidence of ACL tears in the United States is approximately 200,000, which allows for a broad range of individualized treatment options. Various surgical techniques, including transtibial and independent tunnel drilling, allograft and autograft tissue, and various implants, have been described in the literature. This article describes the indications and technique for a hybrid soft tissue graft for ACL reconstruction. Autologous grafts eliminate the risk of disease transmission and have recently been shown to have a lower rerupture rate, particularly in younger, active patients; however, the harvesting of autologous hamstring grafts carries a risk of donor-site morbidity, iatrogenic injury of the graft, and inadequate graft size. In contrast to a traditional autologous soft tissue graft, the hybrid graft allows for graft size customization for a desired reconstruction, especially in cases where autograft hamstrings may be iatrogenically damaged or of inadequate size when harvested. The goal of a hybrid graft ACL reconstruction is to provide a favorable-sized graft with clinical outcomes comparable with autologous soft tissue grafts. In contrast to a traditional autologous soft tissue graft, this technique provides another option in the event of unforeseen deficiencies or complications associated with harvesting and preparation of the autologous gracilis and semitendinosis soft tissue graft.

  5. Hybrid Graft Anterior Cruciate Ligament Reconstruction: A Predictable Graft for Knee Stabilization.

    Science.gov (United States)

    Alvarez-Pinzon, Andres M; Barksdale, Leticia; Krill, Michael K; Leo, Brian M

    2015-06-01

    Trauma to the anterior cruciate ligament (ACL) is a season-ending injury and involves months of activity modification and rehabilitation. The annual incidence of ACL tears in the United States is approximately 200,000, which allows for a broad range of individualized treatment options. Various surgical techniques, including transtibial and independent tunnel drilling, allograft and autograft tissue, and various implants, have been described in the literature. This article describes the indications and technique for a hybrid soft tissue graft for ACL reconstruction. Autologous grafts eliminate the risk of disease transmission and have recently been shown to have a lower rerupture rate, particularly in younger, active patients; however, the harvesting of autologous hamstring grafts carries a risk of donor-site morbidity, iatrogenic injury of the graft, and inadequate graft size. In contrast to a traditional autologous soft tissue graft, the hybrid graft allows for graft size customization for a desired reconstruction, especially in cases where autograft hamstrings may be iatrogenically damaged or of inadequate size when harvested. The goal of a hybrid graft ACL reconstruction is to provide a favorable-sized graft with clinical outcomes comparable with autologous soft tissue grafts. In contrast to a traditional autologous soft tissue graft, this technique provides another option in the event of unforeseen deficiencies or complications associated with harvesting and preparation of the autologous gracilis and semitendinosis soft tissue graft. PMID:26091219

  6. Silicon micromachined broad band light source

    Science.gov (United States)

    George, Thomas (Inventor); Jones, Eric (Inventor); Tuma, Margaret L. (Inventor); Eastwood, Michael (Inventor); Hansler, Richard (Inventor)

    2004-01-01

    A micro electromechanical system (MEMS) broad band incandescent light source includes three layers: a top transmission window layer; a middle filament mount layer; and a bottom reflector layer. A tungsten filament with a spiral geometry is positioned over a hole in the middle layer. A portion of the broad band light from the heated filament is reflective off the bottom layer. Light from the filament and the reflected light of the filament are transmitted through the transmission window. The light source may operate at temperatures of 2500 K or above. The light source may be incorporated into an on board calibrator (OBC) for a spectrometer.

  7. CELL-SEEDING OF PERIODONTAL-LIGAMENT FIBROBLASTS - A NOVEL TECHNIQUE TO CREATE NEW ATTACHMENT - A PILOT-STUDY

    NARCIS (Netherlands)

    VANDIJK, LJ; SCHAKENRAAD, JM; VANDERVOORT, HM; HERKSTROTER, FM; BUSSCHER, HJ

    1991-01-01

    This study was undertaken to test the hypothesis that seeded periodontal ligament cells are able to create new attachment. In one beagle dog, a premolar was removed and scrapings of the ligament were cultured. Artificial periodontal defects were made and the cultured ligament cells were seeded on th

  8. [Application of silk-based tissue engineering scaffold for tendon / ligament regeneration].

    Science.gov (United States)

    Hu, Yejun; Le, Huihui; Jin, Zhangchu; Chen, Xiao; Yin, Zi; Shen, Weiliang; Ouyang, Hongwei

    2016-03-01

    Tendon/ligament injury is one of the most common impairments in sports medicine. The traditional treatments of damaged tissue repair are unsatisfactory, especially for athletes, due to lack of donor and immune rejection. The strategy of tissue engineering may break through these limitations, and bring new hopes to tendon/ligament repair, even regeneration. Silk is a kind of natural biomaterials, which has good biocompatibility, wide range of mechanical properties and tunable physical structures; so it could be applied as tendon/ligament tissue engineering scaffolds. The silk-based scaffold has robust mechanical properties; combined with other biological ingredients, it could increase the surface area, promote more cell adhesion and improve the biocompatibility. The potential clinical application of silk-based scaffold has been confirmed by in vivo studies on tendon/ligament repairing, such as anterior cruciate ligament, medial collateral ligament, achilles tendon and rotator cuff. To develop novel biomechanically stable and host integrated tissue engineered tendon/ligament needs more further micro and macro studies, combined with product development and clinical application, which will give new hope to patients with tendon/ligament injury.

  9. Acromioclavicular joint reconstruction with coracoacromial ligament transfer using the docking technique

    Directory of Open Access Journals (Sweden)

    Gobezie Reuben

    2009-01-01

    Full Text Available Abstract Background Symptomatic Acromioclavicular (AC dislocations have historically been surgically treated with Coracoclavicular (CC ligament reconstruction with transfer of the Coracoacromial (CA ligament. Tensioning the CA ligament is the key to success. Methods Seventeen patients with chronic, symptomatic Type III AC joint or acute Type IV and V injuries were treated surgically. The distal clavicle was resected and stabilized with CC ligament reconstruction using the CA ligament. The CA ligament was passed into the medullary canal and tensioned, using a modified 'docking' technique. Average follow-up was 29 months (range 12–57. Results Postoperative ASES and pain significantly improved in all patients (p = 0.001. Radiographically, 16 (94% maintained reduction, and only 1 (6% had a recurrent dislocation when he returned to karate 3 months postoperatively. His ultimate clinical outcome was excellent. Conclusion The docking procedure allows for tensioning of the transferred CA ligament and healing of the ligament in an intramedullary bone tunnel. Excellent clinical results were achieved, decreasing the risk of recurrent distal clavicle instability.

  10. Androgen action during male sex differentiation includes suppression of cranial suspensory ligament development

    NARCIS (Netherlands)

    J.M.A. Emmen (Judith); A. McLuskey; J.A. Grootegoed (Anton); A.O. Brinkmann (Albert)

    1998-01-01

    textabstractThe cranial suspensory ligament is located on the border of the cranial (mesonephric) mesentery in adult female mammals, which runs between the cranial pole of the internal genitalia and the dorsal abdominal wall. Absence of the cranial suspensory ligament i

  11. Effects of Shuanghuangbu on the total protein content and ultrastructure in cultured human periodontal ligament cells

    Institute of Scientific and Technical Information of China (English)

    许彦枝; 邹慧儒; 王小玲; 刘世正; 王永军

    2004-01-01

    Background Successful periodontal regeneration depends on the migration, proliferation and differentiation of periodontal ligament cells in periodontal defects. The total protein content and the ultrastructure demonstrate the metabolizability and activity of periodontal ligament cells. This study was conducted to observe the effects of Shuanghuangbu, a mixture of medicinal herbs, on the total protein content and the ultrastructure of human periodontal ligament cells.Methods Periodontal ligament cells were grown to confluence and then cultured in Dulbecco's modified eagle medium (DMEM) supplemented with Shuanghuangbu over the concentration range of 0 to 1000 μg/ml. The total protein content in cultured cells was determined by using Coommasie brilliant blue technique. Periodontal ligament cells were incubated in 0 and 100 μg/ml Shuanghuangbu decoction for 5 days, then observed through transmission electron microscope.Results The total protein content of human periodontal ligament cells increased in each experiment group added 10-1000 μg/ml Shuanghuangbu respectively, and the effect of 100 μg/ml was excellent. Under the transmission electron microscope, there were more rough endoplasmic reticulums and mitochodrias in the experiment group than those in the control group. Conclusion Shuanghuangbu stimulates the protein synthesis of human periodontal ligament cells and improves human periodontal ligament cells' metabolizability and activity.

  12. Quadriceps muscle contraction protects the anterior cruciate ligament during anterior tibial translation.

    Science.gov (United States)

    Aune, A K; Cawley, P W; Ekeland, A

    1997-01-01

    The proposed skiing injury mechanism that suggests a quadriceps muscle contraction can contribute to anterior cruciate ligament rupture was biomechanically investigated. The effect of quadriceps muscle force on a knee specimen loaded to anterior cruciate ligament failure during anterior tibial translation was studied in a human cadaveric model. In both knees from six donors, average age 41 years (range, 31 to 65), the joint capsule and ligaments, except the anterior cruciate ligament, were cut. The quadriceps tendon, patella, patellar tendon, and menisci were left intact. One knee from each pair was randomly selected to undergo destructive testing of the anterior cruciate ligament by anterior tibial translation at a displacement rate of 30 mm/sec with a simultaneously applied 889 N quadriceps muscle force. The knee flexion during testing was 30 degrees. As a control, the contralateral knee was loaded correspondingly, but only 5 N of quadriceps muscle force was applied. The ultimate load for the knee to anterior cruciate ligament failure when tested with 889 N quadriceps muscle force was 22% +/- 18% higher than that of knees tested with 5 N of force. The linear stiffness increased by 43% +/- 30%. These results did not support the speculation that a quadriceps muscle contraction contributes to anterior cruciate ligament failure. In this model, the quadriceps muscle force protected the anterior cruciate ligament from injury during anterior tibial translation.

  13. Acute and chronic tears of anterior cruciate ligament : role of gadolinium-enhanced MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Jung; Jee, Won Hee; Im, Soo A; Chun, Ho Jong; Jung, Hyun Seouk; Kim, Soo Young; Kwon, Tae An; Song, Sun Wha; Choi, Kyu Ho [Catholic Univ. Medical College. Kangnam St. Mary' s Hospital, Seoul (Korea, Republic of)

    1998-07-01

    To evaluate the efficacy of fat-suppressed gadolinium-enhanced MR imaging in differentiating acute from chronic ligament tears of anterior cruciate ligament. Materials and Methods : MR images of 22 patients with arthroscopically proven complete tear of the anterior cruciate ligament were retrospectively reviewed. The interval between injury and MR examination was one day to seven years. When ligament tear was detected on MR image with three months of injury, the case was considered acute;if detected after three months had elapsed, it was judged to be chronic. The extent of contrast enhancement was graded as 1, 2 or 3; grade 1, enhancement was confined to the expected ligament region; grade 2, enhancement extended to the joint capsule; grade 3, enhancement extended beyond the joint capsule. The grades of contrast enhancement correlated with the acute and chronic stages of ligament tears. Associated bone bruise and/or adjacent soft tissue edema were also evaluated. Results : Among 15 patients with acute ligament tear, nine (60%) showed grade 3 enhancement; among seven in whom tearing was chronic, four (57%) showed grade 1 enhancement. Bone bruising was present in 100% of acute tears (15/15) and 29 % of chronic tears (2/7). Soft tissue edema was associated in 87% of acute tears (13/15) and 29% of chronic tears(2/7). Conclusion : Fat-suppressed gadolinium-enhanced MR imaging could help differentiate acute from chronic tears of anterior cruciate ligament, as well as bone bruising and tissue edema.

  14. Acute and chronic tears of anterior cruciate ligament : role of gadolinium-enhanced MR imaging

    International Nuclear Information System (INIS)

    To evaluate the efficacy of fat-suppressed gadolinium-enhanced MR imaging in differentiating acute from chronic ligament tears of anterior cruciate ligament. Materials and Methods : MR images of 22 patients with arthroscopically proven complete tear of the anterior cruciate ligament were retrospectively reviewed. The interval between injury and MR examination was one day to seven years. When ligament tear was detected on MR image with three months of injury, the case was considered acute;if detected after three months had elapsed, it was judged to be chronic. The extent of contrast enhancement was graded as 1, 2 or 3; grade 1, enhancement was confined to the expected ligament region; grade 2, enhancement extended to the joint capsule; grade 3, enhancement extended beyond the joint capsule. The grades of contrast enhancement correlated with the acute and chronic stages of ligament tears. Associated bone bruise and/or adjacent soft tissue edema were also evaluated. Results : Among 15 patients with acute ligament tear, nine (60%) showed grade 3 enhancement; among seven in whom tearing was chronic, four (57%) showed grade 1 enhancement. Bone bruising was present in 100% of acute tears (15/15) and 29 % of chronic tears (2/7). Soft tissue edema was associated in 87% of acute tears (13/15) and 29% of chronic tears(2/7). Conclusion : Fat-suppressed gadolinium-enhanced MR imaging could help differentiate acute from chronic tears of anterior cruciate ligament, as well as bone bruising and tissue edema

  15. Three-dimensional loading model for periodontal ligament regeneration in vitro.

    NARCIS (Netherlands)

    Berendsen, A.D.; Smit, T.H.; Walboomers, X.F.; Everts, V.; Jansen, J.A.; Bronckers, A.L.

    2009-01-01

    In this study we present a new three-dimensional (3D) model to study effects of mechanical loading on tendon/ligament formation in vitro. The model mimics a functional periodontal ligament (PDL), which anchors dental roots to the jaw bone and transfers the axial load of mastication to the jaw bone.

  16. Three-dimensional loading model for periodontal ligament regeneration in vitro

    NARCIS (Netherlands)

    A.D. Berendsen; T.H. Smit; X.F. Walboomers; V. Everts; J.A. Jansen; A.L.J.J. Bronckers

    2009-01-01

    In this study we present a new three-dimensional (3D) model to study effects of mechanical loading on tendon/ligament formation in vitro. The model mimics a functional periodontal ligament (PDL), which anchors dental roots to the jaw bone and transfers the axial load of mastication to the jaw bone.

  17. Trunk position modulates anterior cruciate ligament forces and strains during a single-leg squat

    NARCIS (Netherlands)

    Kulas, Anthony S.; Hortobagyi, Tibor; DeVita, Paul

    2012-01-01

    Background: Although the squat exercise and its variations are commonly prescribed for anterior cruciate ligament rehabilitation, whether trunk position affects these ligament forces and strains during the squat is unclear. Our purpose was to evaluate the effects of trunk position on anterior crucia

  18. The remains of anterior cruciate ligament graft tension after cyclic knee motion

    NARCIS (Netherlands)

    Arnold, MR; Lie, DTT; Verdonschot, N; de Graaf, R; Amis, AA; van Kampen, A

    2005-01-01

    Background: There is sometimes a return of excess knee laxity after anterior cruciate ligament reconstruction. One of the contributing factors might be a loss in graft tension. It is unknown whether the tension imposed on an anterior cruciate ligament graft degrades with time and, if so, the effect

  19. Mechanisms of anterior cruciate ligament injury in basketball - Video analysis of 39 cases

    NARCIS (Netherlands)

    Krosshaug, Tron; Nakamae, Atsuo; Boden, Barry P.; Engebretsen, Lars; Smith, Gerald; Slauterbeck, James R.; Hewett, Timothy E.; Bahr, Roald

    2007-01-01

    Background: The mechanisms of anterior cruciate ligament injury in basketball are not well defined. Purpose: To describe the mechanisms of anterior cruciate ligament injury in basketball based on videos of injury situations. Study Design: Case series; Level of evidence, 4. Methods: Six international

  20. The GREGOR Broad-Band Imager

    Science.gov (United States)

    von der Lühe, O.; Volkmer, R.; Kentischer, T. J.; Geißler, R.

    2012-11-01

    The design and characteristics of the Broad-Band Imager (BBI) of GREGOR are described. BBI covers the visible spectral range with two cameras simultaneously for a large field and with critical sampling at 390 nm, and it includes a mode for observing the pupil in a Foucault configuration. Samples of first-light observations are shown.

  1. Broad resonances and beta-decay

    DEFF Research Database (Denmark)

    Riisager, K.; Fynbo, H. O. U.; Hyldegaard, S.;

    2015-01-01

    Beta-decay into broad resonances gives a distorted lineshape in the observed energy spectrum. Part of the distortion arises from the phase space factor, but we show that the beta-decay matrix element may also contribute. Based on a schematic model for p-wave continuum neutron states it is argued...

  2. Role of muscles in the stabilization of ligament-deficient wrists.

    Science.gov (United States)

    Esplugas, Mireia; Garcia-Elias, Marc; Lluch, Alex; Llusá Pérez, Manuel

    2016-01-01

    This article reviews the results of a series of cadaver investigations aimed at clarifying the role of muscles in the stabilization of ligament-deficient wrists. According to these studies, isometric contraction of some forearm muscles induces midcarpal (MC) supination (ie, the abductor pollicis longus, extensor carpi radialis longus, and flexor carpi ulnaris), whereas other muscles induce MC pronation (ie, the extensor carpi ulnaris). Because MC supination implies tightening of the volar scaphoid-distal row ligaments, the MC supination muscles are likely to prevent scaphoid collapse of wrists with scapholunate ligament insufficiency. MC pronator muscles, by contrast, would be beneficial in stabilizing wrists with ulnar-sided ligament deficiencies owing to their ability to tighten the triquetrum-distal row ligaments. Should these laboratory findings be validated by additional clinical research, proprioceptive reeducation of selected muscles could become an important tool for the treatment of dynamic carpal instabilities. PMID:27264901

  3. The demonstration of lesions of the cruciate ligaments by MR tomography

    International Nuclear Information System (INIS)

    The cruciate ligaments of the knee joint can be demonstrated by magnetic resonance tomography, without using invasive methods. High resolution coils and section thickness of less than 5 mm are necessary. Sixty-six patients and volunteers were examined; the results show that the normal cruciate ligaments present as homogeneous zones of low signal intensity within the surrounding fat. Injuries to the cruciate ligaments interrupt the image of the ligaments, change their anatomical position or produce a signal of intermediate intensity. Eighteen operations were carried out on fifteen patients with cruciate ligament injuries and there was good agreement between the MR and the operative findings. Sixteen patients had had previous cruciate surgery and in these there was only partial correlation with the clinical findings. (orig)

  4. Ossified Posterior Longitudinal Ligament With Massive Ossification of the Anterior Longitudinal Ligament Causing Dysphagia in a Diffuse Idiopathic Skeletal Hyperostosis Patient

    OpenAIRE

    Murayama, Kazuhiro; Inoue, Shinichi; Tachibana, Toshiya; Maruo, Keishi; Arizumi, Fumihiro; Tsuji, Shotaro; Yoshiya, Shinichi

    2015-01-01

    Abstract Descriptive case report. To report a case of a diffuse idiopathic skeletal hyperostosis (DISH) patient with both massive ossification of the anterior longitudinal ligament (OALL) leading to severe dysphagia as well as ossification of the posterior longitudinal ligament (OPLL) causing mild cervical myelopathy, warranting not only an anterior approach but also a posterior one. Although DISH can cause massive OALL in the cervical spine, severe dysphagia resulting from DISH is a rare occ...

  5. Rehabilitation therapy for old rupture of collateral ligament and cross ligament%陈旧性十字韧带和侧副韧带断裂康复治疗探讨

    Institute of Scientific and Technical Information of China (English)

    陈秋生; 杨建成; 陈霞

    2002-01-01

    Objective To investigate therapeutic method for old rupture of cross ligament and collateral ligament of the knee. Method Reduce and fix the tibia migrated to anterior and posterior anatomically with three sets of Charnley articulated splints. Reconstruct cross ligament and collateral ligament with the tendon of semitendinosus. Result Clinical symptoms disappeared in 15 cases and normal function resumed; 9 cases had different degree of symptoms after following up for 7 months to three years and 5 months. Conclusion It is an effective method to reduce tibia femoral and patellar femoral joints anatomically, reconstruct cross and collateral ligaments and resume biological function.

  6. MRI appearance of the superior transverse scapular ligament

    Energy Technology Data Exchange (ETDEWEB)

    Simeone, F.J.; Bredella, Miriam A.; Chang, Connie Y.; Torriani, Martin; Huang, Ambrose J. [Massachusetts General Hospital, Department of Radiology, Division of Musculoskeletal Imaging and Intervention, Boston, MA (United States)

    2015-11-15

    The superior transverse scapular ligament (STSL) forms the roof of the suprascapular notch, which is the most common location of entrapment of the suprascapular nerve, a cause of shoulder pain and weakness. The purpose of this study is to determine the frequency of visualization of the STSL on routine shoulder MRIs, to identify the sequences and imaging planes on which it is visualized most frequently, and to describe its typical MRI appearance, none of which have been previously addressed in the radiologic literature. One hundred twenty-one consecutive shoulder MRIs were reviewed for the presence or absence of the STSL, including the imaging plane and sequence that best depicted the ligament. Dimensions of the ligament were recorded. Fifty four of 121 shoulder MRIs were technically adequate for visualization of the STSL, and it was identified on 51 of these studies (94 %). There was no statistically significant difference between 1.5-T and 3-T systems. The best individual sequence for visualizing the STSL was the sagittal T1-weighted sequence, in which the STSL was visible on 75/80 technically adequate sequences (94 %). The sagittal plane was the best plane for visualizing the STSL, in which it was visible on 65/69 technically adequate studies (94 %). The STSL on average measured 12.8 ± 1.5 mm in transverse dimension. The STSL can be visualized on the majority of shoulder MRIs and is best seen on sagittal T1-weighted images on our imaging protocol. Evaluation of the STSL can potentially help in identifying pathologic conditions affecting the suprascapular nerve. (orig.)

  7. Two-Stage Revision Anterior Cruciate Ligament Reconstruction.

    Science.gov (United States)

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

    2016-05-01

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

  8. Morphology of the medial collateral ligament of the knee

    Directory of Open Access Journals (Sweden)

    Gill Thomas J

    2010-09-01

    Full Text Available Abstract Background Quantitative knowledge on the anatomy of the medial collateral ligament (MCL is important for treatment of MCL injury and for MCL release during total knee arthroplasty (TKA. The objective of this study was to quantitatively determine the morphology of the MCL of human knees. Methods 10 cadaveric human knees were dissected to investigate the MCL anatomy. The specimens were fixed in full extension and this position was maintained during the dissection and morphometric measurements. The outlines of the insertion sites of the superficial MCL (sMCL and deep MCL (dMCL were digitized using a 3D digitizing system. Results The insertion areas of the superficial MCL (sMCL were 348.6 ± 42.8 mm2 and 79.7 ± 17.6 mm2 on the tibia and femur, respectively. The insertion areas of the deep MCL (dMCL were 63.6 ± 13.4 mm2 and 71.9 ± 14.8 mm2 on the tibia and femur, respectively. The distances from the centroids of the tibial and femoral insertions of the sMCL to the tibial and femoral joint line were 62.4 ± 5.5 mm and 31.1 ± 4.6 mm, respectively. The distances from the centroids of dMCL in the tibial insertion and the femoral insertion to the tibial and femoral joint line were 6.5 ± 1.3 mm and 20.5 ± 4.2 mm, respectively. The distal portion of the dMCL (meniscotibial ligament - MTL was approximately 1.7 times wider than the proximal portion of the dMCL (meniscofemoral ligament - MFL, whereas the MFL was approximately 3 times longer than the MTL. Conclusions The morphologic data on the MCL may provide useful information for improving treatments of MCL-related pathology and performing MCL release during TKA.

  9. LARS人工韧带同时重建前、后交叉韧带%Reconstruction of both the anterior cruciate ligament and posterior cruciate ligament with ligament advanced reinforcement system artificial ligament transplantation under knee arthroscopy

    Institute of Scientific and Technical Information of China (English)

    尚平; 贺宪; 江永发; 刘志祥; 才忠民; 杨俊龙

    2007-01-01

    目的 探讨关节镜下LARS(Ligament Advanced Reinforcement System,LARS)人工韧带同时重建前(Anterior cruciate ligament,ACL)、后交叉韧带(posterior cruciate ligament,PCL)的方法和临床疗效.方法 从2006年1月至2007年4月,用LARS人工韧带同时重建ACL、PCL2例.应用Lysholm功能评分表评估膝关节功能,采用抽屉实验检查膝关节前后松弛度.结果 2例均获得随访,随访时间分别为8月、3月.2例患者术后患膝关节不稳定症状消失,胫骨后坠征阴性,前、后抽屉试验阴性.膝关节功能评估采用Lysholm功能评分标准,术前平均分别为45.6±7.6分,术后平均为80.3±9.1分.结论 关节镜下应用LARS人工韧带同时重建ACL、PCL可更好地恢复膝关节的稳定性,且创伤小,并发症少,近期疗效满意,但远期效果仍需进一步观察.

  10. Asymptomatic vesical mass mimicked malignancy due to isolated vesical endometriosis in the absence of previous surgery:a case report%无症状孤立性膀胱子宫内膜异位症误诊为膀胱肿瘤一例

    Institute of Scientific and Technical Information of China (English)

    卢扬柏; 湛海伦; 杨飞; 张泳欣; 黄杰夫; 周祥福

    2011-01-01

    @@ Endometriosis,defined as the presence of functionally active endometrial glands and stroma outside the uterine cavity and a benign condition,shares many malignancy biological behavior .The most common location is pelvic region,especially the ovaries and the broad ligaments.Occasionally the condition can involves urinary tract and the bladder is 84% of all urinary tract endometriosis,followed by ureter (15%), kidney (4%), and urethra (2%).

  11. Evaluation of the anterolateral ligament of the knee by means of magnetic resonance examination

    Directory of Open Access Journals (Sweden)

    Camilo Partezani Helito

    2015-04-01

    Full Text Available OBJECTIVE: To evaluate the presence of the anterolateral ligament (ALL of the knee in magnetic resonance imaging (MRI examinations.METHODS: Thirty-three MRI examinations on patients' knees that were done because of indications unrelated to ligament instability or trauma were evaluated. T1-weighted images in the sagittal plane and T2-weighted images with fat saturation in the axial, sagittal and coronal planes were obtained. The images were evaluated by two radiologists with experience of musculoskeletal pathological conditions. In assessing ligament visibility, we divided the analysis into three portions of the ligament: from its origin in the femur to its point of bifurcation; from the bifurcation to the meniscal insertion; and from the bifurcation to the tibial insertion. The capacity to view the ligament in each of its portions and overall was taken to be a dichotomous categorical variable (yes or no.RESULTS: The ALL was viewed with signal characteristics similar to those of the other ligament structures of the knee, with T2 hyposignal with fat saturation. The main plane in which the ligament was viewed was the coronal plane. Some portion of the ligament was viewed clearly in 27 knees (81.8%. The meniscal portion was evident in 25 knees (75.7%, the femoral portion in 23 (69.6% and the tibial portion in 13 (39.3%. The three portions were viewed together in 11 knees (33.3%.CONCLUSION: The anterolateral ligament of the knee is best viewed in sequences in the coronal plane. The ligament was completely characterized in 33.3% of the cases. The meniscal portion was the part most easily identified and the tibial portion was the part least encountered.

  12. Sonography of injury of the ulnar collateral ligament of the elbow - initial experience

    International Nuclear Information System (INIS)

    The purpose of this study is to describe the sonographic appearance of injuries of the ulnar collateral ligament (UCL) of the elbow. Eight non-professional male baseball pitchers, ages 13-35 years, with medial elbow pain and clinical suspicion of ulnar collateral ligament injury, were referred for imaging. All eight underwent sonography of the affected and contralateral asymptomatic elbow, and six also underwent MR imaging. Neither valgus stress nor power Doppler was used during the sonographic examinations. Time from onset of symptoms to imaging was 1.5 weeks to 6 months. Three patients had surgical confirmation of their injuries, with time from imaging to surgery of 2 days to 9 months. In four patients, the UCL was ruptured, manifest sonographically in three cases as discontinuity of the normally hyperechoic ligament with anechoic fluid in the gap and in one case as non-visualization of the ligament with heterogeneous echogenicity in the expected location of the ligament. Two adolescent patients had avulsions of the UCL from the medial epicondyle, with sonographic demonstration of the avulsed echogenic bony fragment in both cases. One patient had a mild sprain, manifest as mild thickening and decreased echogenicity of the ligament sonographically compared with the contralateral normal elbow, with mild surrounding hypoechoic edema. The eighth patient had a small partial tear of the deep surface of the distal aspect of the ligament, visualized as a hypoechoic focus between the deep surface of the ligament and its ulnar attachment. Tears of the ulnar collateral ligament are manifested sonographically as non-visualization of the ligament or alteration of the normal morphology. (orig.)

  13. Anterior cruciate ligament injury in indoor ball games.

    Science.gov (United States)

    Ebstrup, J F; Bojsen-Møller, F

    2000-04-01

    Three videorecorded incidents of knee injuries inflicted during indoor ball games are reported. Injuries and especially anterior cruciate ligament ruptures seemed to be triggered in varus loaded knees by femural external rotation, or in valgus loaded knees by femural internal rotation with the pivot shifted to the lateral femurotibial compartment. The observations suggest that it may be to the players' advantage to be trained in not letting their knees sag medially or laterally during side-stepping or sudden changes in speed. PMID:10755283

  14. Radiological diagnosis of fibulo-talar ligamentous lesions

    International Nuclear Information System (INIS)

    Of 343 patients with sprained ankles the results of conventional stress a.p. roentgenograms in supination and stressed X-ray in lateral view with a device, similar to the technique, described by Noesberger, are compared. In 63 of 91 pathological findings the lesions could only be diagnosed in X-rays in lateral view. The advantages and disadvantages of both techniques are discussed. In our opinion the stressed X-ray in lateral projection are a useful method for diagnosis of ligamentous lesions of the ankle joint. (orig.)

  15. Return to Play After Medial Collateral Ligament Injury.

    Science.gov (United States)

    Kim, Christopher; Chasse, Patrick M; Taylor, Dean C

    2016-10-01

    Medial collateral ligament injuries are common in the athletic population. Partial injuries are treated nonoperatively with excellent outcomes. Complete ruptures may be treated nonoperatively, although some will require surgery. A comprehensive rehabilitation program is critical to outcome, but a standardized program for all injuries does not exist. Most of the literature regarding nonoperative and postoperative rehabilitation include observational reports and case studies. Level I studies comparing rehabilitation protocols have not been published. The goal of the injured athlete is to not only return to play with no functional limitations, but to also address risk factors and prevent future injuries. PMID:27543407

  16. Potential wrist ligament injury in rescuers performing cardiopulmonary resuscitation

    Directory of Open Access Journals (Sweden)

    Robert Curran

    2013-01-01

    Full Text Available Wrist pain in rescuers performing chest compressions as part of cardiopulmonary resuscitation has been reported anecdotally and recently in the literature. Studies have indicated that rescuers apply as much as 644 N of force to the victim′s chest with each compression, while standards require one hundred compressions per minute. Recent research suggests that forces transmitted through the rescuers′ wrists of less than 10% of those seen during the performance of chest compressions significantly strain the scapholunate ligament. Biomechanical research should be performed to further evaluate this possible correlation. Compensation for worker injury maybe involved.

  17. Anterior Cruciate Ligament Injuries in Children and Adolescents.

    Science.gov (United States)

    Fabricant, Peter D; Kocher, Mininder S

    2016-10-01

    Dramatic increases in youth competitive athletic activity, early sport specialization, and year-round training and competition, along with increased awareness of anterior cruciate ligament (ACL) injuries in children, have led to a commensurate increase in the frequency of ACL tears in the skeletally immature. Recent understanding of the risks of nonoperative treatment and surgical delay have supported a trend toward early operative treatment. This article discusses treatment strategies for ACL injuries in children and adolescents, and offers our preferred treatment strategy for skeletally immature youth athletes with ACL tears. PMID:27637664

  18. Arthrography of the ankle - diagnostic method in ligamental injuries

    International Nuclear Information System (INIS)

    Results were analyzed of 143 arthrographies in patients with severe distortions of the ankle: 97 men and 46 women at mean age 34,3 years. Arthrography was realized by Gordon's original technique. The following X-ray diagnostic features were considered evidential for demonstration of the ligamental apparatus of the joint: 1. Extracapsular presence of contrast matter beneath and aside for the lateral maleolus with spread in cranial direction; 2. 'effluence' of contrast matter around the medial maleolus in the antero-posterior roentgenogram; 3. Absence of contrast-matter-free zone on lateral roentgenography. The author's arthrographic interpretations were confirmed on the subsequent operative correction

  19. Periodontal ligament stem cells: an update and perspectives.

    Science.gov (United States)

    Chamila Prageeth Pandula, P K; Samaranayake, L P; Jin, L J; Zhang, Chengfei

    2014-05-01

    Chronic periodontitis is a serious infectious and inflammatory oral disease of humans worldwide. Conventional treatment modalities are effective for controlling periodontal disease. However, the regeneration of damaged periodontal tissues remains a major challenge in clinical practice due to the complex structure of the periodontium. Stem cell-based regenerative approaches combined with the usage of emerging biomaterials are entering a new era in periodontal regeneration. The present review updates the current knowledge of periodontal ligament stem cell-based approaches for periodontal regeneration, and elaborates on the potentials for clinical application. PMID:24610628

  20. A nonlinear poroelastic model for the periodontal ligament

    Science.gov (United States)

    Favino, Marco; Bourauel, Christoph; Krause, Rolf

    2016-05-01

    A coupled elastic-poroelastic model for the simulation of the PDL and the adjacent tooth is presented. A poroelastic constitutive material model for the periodontal ligament (PDL) is derived. The solid phase is modeled by means of a Fung material law, accounting for large displacements and strains. Numerical solutions are performed by means of a multigrid Newton method to solve the arising large nonlinear system. Finally, by means of numerical experiments, the biomechanical response of the PDL is studied. In particular, the effect of the hydraulic conductivity and of the mechanical parameters of a Fung potential is investigated in two realistic applications.

  1. Optimization of a biomimetic poly-(lactic acid) ligament scaffold

    Science.gov (United States)

    Uehlin, Andrew F.

    The anterior cruciate ligament (ACL) is the most commonly injured ligament of the knee, often requiring orthopedic reconstruction using autograft or allograph tissue, both with significant disadvantages. As a result, tissue engineering an ACL replacement graft has been heavily investigated. The present study attempts to replicate the morphology and mechanical properties of the ACL using a nanomatrix composite of highly-aligned poly(lactic acid) (PLA) fibers with various surface and biochemical modifications. Additionally, this study attempts to recreate the natural mineralization gradient found at the ACL enthesis onto the scaffold, capable of inducing a favorable cellular response in vitro. Unidirectional electrospinning was used to create nanofibers of PLA, followed by an induced degradation of the nanofibers via 0.25M NaOH hydrolysis. The effects of the unidirectional electrospinning as well as the effects of NaOH hydrolysis on fiber alignment, fiber diameter, surface morphology, crystallinity, in vitro swelling, immobilization of fibrin, and mechanical properties were investigated, resulting in a modified morphology correlating to the microstructure of native ligament tissue with similar mechanical properties. Furthering the development of the PLA nanomatrix composite, a bioinkjet printer was used to immobilize nanoparticulate hydroxyapatite (HANP) on the surface of the scaffold. A series of 300pL droplets of HANP bioink were printed over a gradient pattern mimetic of (and spatially corresponding to) the mineralization gradient found over the microanatomy at the ACL enthesis. Proliferation and differentiation response of human mesenchymal stem cells (hMSCs) in vitro was assessed on a variety of conditions and combinations of the PLA nanofiber scaffold surface modifications (inclusive and exclusive of HANP, fibrin, and various time dependent NaOH treatments). It was found that a combinatory effect of the HANP gradient with fibrin on 20 minute NaOH treated PLA

  2. A historical perspective on ankle ligaments reconstructive surgery.

    Science.gov (United States)

    Di Matteo, Berardo; Tarabella, Vittorio; Filardo, Giuseppe; Tomba, Patrizia; Viganò, Anna; Marcacci, Maurilio; Zaffagnini, Stefano

    2016-04-01

    Ankle sprains are by far the most common injuries treated by sport medicine physicians. Treatment is mainly conservative, but in some cases surgical intervention is required. The aim of the present manuscript is to give an insight into the origins and developments of ankle ligaments reconstructive surgery, underlining the fundamental steps that marked the transition from a mere conservative approach to surgical treatment options. In this historical note, the most illustrious figures who contributed to this particular field of orthopaedic practice are also acknowledged. Level of evidence V. PMID:26718639

  3. Proprioceptive exercises for ankle ligament injury: a CAT

    Directory of Open Access Journals (Sweden)

    Raúl Aguilera Eguía

    2013-06-01

    Full Text Available This CAT (Critically Appraised Topic answered the question: In recreational athletes suffering from chronic ankle sprain, can proprioceptive exercises reduce its recurrence?The clinical question was analyzed in three parts: patient, intervention and outcome. The purpose was to test the validity, results and effectiveness of proprioceptive exercises in recreational athletes suffering from chronic ankle sprain to reduce its recurrence from the article "Effectiveness of proprioceptive exercises for ankle ligament injury in adults: A systematic literature and meta-analisys "Postle”1 (2012.

  4. Return to Play Following Ankle Sprain and Lateral Ligament Reconstruction.

    Science.gov (United States)

    Shawen, Scott B; Dworak, Theodora; Anderson, Robert B

    2016-10-01

    Ankle sprains are the most common musculoskeletal injury occurring during athletics. Proper initial treatment with supportive pain control, limited immobilization, early return to weight bearing and range of motion, and directed physical therapy are essential for preventing recurrent injury. Reconstruction of the lateral ligaments is indicated for patients with continued instability and dysfunction despite physical therapy. Return to athletic activity should be reserved for athletes who have regained strength, proprioception, and range of motion of the injured ankle. Athletes with a history of an ankle sprain should be prophylactically braced or tapped to reduce risk of recurrent injury. PMID:27543408

  5. Anatomic Double-Bundle Posterior Cruciate Ligament Reconstruction.

    Science.gov (United States)

    Chahla, Jorge; Nitri, Marco; Civitarese, David; Dean, Chase S; Moulton, Samuel G; LaPrade, Robert F

    2016-02-01

    The posterior cruciate ligament (PCL) is known to be the main posterior stabilizer of the knee. Anatomic single-bundle PCL reconstruction, focusing on reconstruction of the larger anterolateral bundle, is the most commonly performed procedure. Because of the residual posterior and rotational tibial instability after the single-bundle procedure and the inability to restore the normal knee kinematics, an anatomic double-bundle PCL reconstruction has been proposed in an effort to re-create the native PCL footprint more closely and to restore normal knee kinematics. We detail our technique for an anatomic double-bundle PCL reconstruction using Achilles and anterior tibialis tendon allografts. PMID:27284530

  6. Anatomical reconstruction of the anterior cruciate ligament: a logical approach

    Directory of Open Access Journals (Sweden)

    Julio Cesar Gali

    2015-08-01

    Full Text Available ABSTRACT We describe the surgical approach that we have used over the last years for anterior cruciate ligament (ACL reconstruction, highlighting the importance of arthroscopic viewing through the anteromedial portal (AMP and femoral tunnel drilling through an accessory anteromedial portal (AMP. The AMP allows direct view of the ACL femoral insertion site on the medial aspect of the lateral femoral condyle, does not require guides for anatomic femoral tunnel reaming, prevents an additional lateral incision in the distal third of the thigh (as would be unavoidable when the outside-intechnique is used and also can be used for double-bundle ACL reconstruction.

  7. Darier-Roussy Sarcoidosis Mimicking Metastatic Breast Cancer

    Directory of Open Access Journals (Sweden)

    Lokesh Viswanath

    2009-12-01

    Full Text Available Subcutaneous sarcoidosis (also known as ‘Darier-Roussy sarcoid’ is a cutaneous condition characterized by numerous deep-seated nodules on the trunk and extremities. Coexistence of sarcoidosis and breast cancer are reported in the literature, but there will always be a chance of misdiagnosis. It is very crucial to obtain a tissue diagnosis of suspicious metastatic lesions. We report a case of breast cancer presenting with a subcutaneous sarcoid lesion masquerading as a metastatic lesion. A 50-year-old female patient, who had had cancer of the left breast, was on hormone therapy 2 years after treatment with surgery, radiotherapy and chemotherapy. The patient presented with a sudden onset of a forehead subcutaneous swelling mimicking metastasis which on excision biopsy was proved to be sarcoidosis. In India, sarcoidosis is reported rarely. We have to keep in mind that there is a chance of the metastatic lesions being of sarcoidosis origin or another granulomatous disease. To avoid misdiagnosis, it is better to obtain a tissue diagnosis.

  8. Riboswitch Structure: an Internal Residue Mimicking the Purine Ligand

    Energy Technology Data Exchange (ETDEWEB)

    Delfosse, V.; Bouchard, P; Bonneau, E; Dagenais, P; Lemay, J; Lafontaine, D; Legault, P

    2009-01-01

    The adenine and guanine riboswitches regulate gene expression in response to their purine ligand. X-ray structures of the aptamer moiety of these riboswitches are characterized by a compact fold in which the ligand forms a Watson-Crick base pair with residue 65. Phylogenetic analyses revealed a strict restriction at position 39 of the aptamer that prevents the G39-C65 and A39-U65 combinations, and mutational studies indicate that aptamers with these sequence combinations are impaired for ligand binding. In order to investigate the rationale for sequence conservation at residue 39, structural characterization of the U65C mutant from Bacillus subtilis pbuE adenine riboswitch aptamer was undertaken. NMR spectroscopy and X-ray crystallography studies demonstrate that the U65C mutant adopts a compact ligand-free structure, in which G39 occupies the ligand-binding site of purine riboswitch aptamers. These studies present a remarkable example of a mutant RNA aptamer that adopts a native-like fold by means of ligand mimicking and explain why this mutant is impaired for ligand binding. Furthermore, this work provides a specific insight into how the natural sequence has evolved through selection of nucleotide identities that contribute to formation of the ligand-bound state, but ensures that the ligand-free state remains in an active conformation.

  9. Mammary tuberculosis mimicking breast cancer: a case report

    Directory of Open Access Journals (Sweden)

    Maroulis Ioannis

    2008-02-01

    Full Text Available Abstract Introduction The incidence of tuberculosis is rising worldwide and rare manifestations of the past are seen more often nowadays. Mammary tuberculosis is a rare clinical entity, often mimicking breast cancer or abscesses of benign or malignant origin. Clinical awareness is necessary during diagnostic work-up for establishing the correct diagnosis and treatment. Case presentation We present a case of breast tuberculosis diagnosed in a 73 year old woman at our institution. The patient presented with a palpable mass of the right breast with clinical, laboratory and mammographic findings indicative of breast carcinoma. The patient underwent lumpectomy and sentinel lymph node biopsy. Frozen section of the tumor and the sentinel node revealed "granulomatous inflammation", while gross examination confirmed the diagnosis of tuberculous mastitis. The patient received anti-tuberculosis therapy for six months with no side effects or any further complications. Conclusion Breast tuberculosis is an obscure disease often mistaken for carcinoma or pyogenic abscess of the breast, especially if well-defined clinical features are absent. A high index of suspicion is required because the disease can usually be treated conservatively with current antituberculous modalities while surgical intervention is reserved for rare cases only.

  10. Preparation of artificial plasma membrane mimicking vesicles with lipid asymmetry.

    Science.gov (United States)

    Lin, Qingqing; London, Erwin

    2014-01-01

    Lipid asymmetry, the difference in lipid distribution across the lipid bilayer, is one of the most important features of eukaryotic cellular membranes. However, commonly used model membrane vesicles cannot provide control of lipid distribution between inner and outer leaflets. We recently developed methods to prepare asymmetric model membrane vesicles, but facile incorporation of a highly controlled level of cholesterol was not possible. In this study, using hydroxypropyl-α-cyclodextrin based lipid exchange, a simple method was devised to prepare large unilamellar model membrane vesicles that closely resemble mammalian plasma membranes in terms of their lipid composition and asymmetry (sphingomyelin (SM) and/or phosphatidylcholine (PC) outside/phosphatidylethanolamine (PE) and phosphatidylserine (PS) inside), and in which cholesterol content can be readily varied between 0 and 50 mol%. We call these model membranes "artificial plasma membrane mimicking" ("PMm") vesicles. Asymmetry was confirmed by both chemical labeling and measurement of the amount of externally-exposed anionic lipid. These vesicles should be superior and more realistic model membranes for studies of lipid-lipid and lipid-protein interaction in a lipid environment that resembles that of mammalian plasma membranes.

  11. Mimicking biochar-albedo feedback in complex Mediterranean agricultural landscapes

    International Nuclear Information System (INIS)

    Incorporation of charcoal produced by biomass pyrolysis (biochar) in agricultural soils is a potentially sustainable strategy for climate change mitigation. However, some side effects of large-scale biochar application need to be investigated. In particular a massive use of a low-reflecting material on large cropland areas may impact the climate via changes in surface albedo. Twelve years of MODIS-derived albedo data were analysed for three pairs of selected agricultural sites in central Italy. In each pair bright and dark coloured soil were identified, mimicking the effect of biochar application on the land surface albedo of complex agricultural landscapes. Over this period vegetation canopies never completely masked differences in background soil colour. This soil signal, expressed as an albedo difference, induced a local instantaneous radiative forcing of up to 4.7 W m−2 during periods of high solar irradiance. Biochar mitigation potential might therefore be reduced up to ∼30%. This study proves the importance of accounting for crop phenology and crop management when assessing biochar mitigation potential and provides more insights into the analysis of its environmental feedback. (letter)

  12. A Case of Congenital Adrenal Hyperplasia Mimicking Cushing's Syndrome

    Science.gov (United States)

    Kim, Hye Jeong; Kang, Mira; Kim, Jae Hyeon; Kim, Sun Wook; Chung, Jae Hoon; Min, Yong-Ki; Lee, Moon-Kyu; Kim, Kwang-Won

    2012-01-01

    Congenital adrenal hyperplasia (CAH) is characterized by decreased adrenal hormone production due to enzymatic defects and subsequent rise of adrenocorticotrophic hormone that stimulates the adrenal cortex to become hyperplastic, and sometimes tumorous. As the pathophysiology is basically a defect in the biosynthesis of cortisol, one may not consider CAH in patients with hypercortisolism. We report a case of a 41-yr-old man with a 4 cm-sized left adrenal tumorous lesion mimicking Cushing's syndrome who was diagnosed with CAH. He had central obesity and acanthosis nigricans involving the axillae together with elevated 24-hr urine cortisol level, supporting the diagnosis of Cushing's syndrome. However, the 24-hr urine cortisol was suppressed by 95% with the low dose dexamethasone suppression test. CAH was suspected based on the history of precocious puberty, short stature and a profound suppression of cortisol production by dexamethasone. CAH was confirmed by a remarkably increased level of serum 17-hydroxyprogesterone level. Gene mutation analysis revealed a compound heterozygote mutation of CYP21A2 (I173N and R357W). PMID:23166432

  13. Synchrony and motor mimicking in chimpanzee observational learning.

    Science.gov (United States)

    Fuhrmann, Delia; Ravignani, Andrea; Marshall-Pescini, Sarah; Whiten, Andrew

    2014-01-01

    Cumulative tool-based culture underwrote our species' evolutionary success, and tool-based nut-cracking is one of the strongest candidates for cultural transmission in our closest relatives, chimpanzees. However the social learning processes that may explain both the similarities and differences between the species remain unclear. A previous study of nut-cracking by initially naïve chimpanzees suggested that a learning chimpanzee holding no hammer nevertheless replicated hammering actions it witnessed. This observation has potentially important implications for the nature of the social learning processes and underlying motor coding involved. In the present study, model and observer actions were quantified frame-by-frame and analysed with stringent statistical methods, demonstrating synchrony between the observer's and model's movements, cross-correlation of these movements above chance level and a unidirectional transmission process from model to observer. These results provide the first quantitative evidence for motor mimicking underlain by motor coding in apes, with implications for mirror neuron function. PMID:24923651

  14. A case of relapsing polychondritis mimicking Ludwig’s angina

    Directory of Open Access Journals (Sweden)

    Adnan Agha

    2009-09-01

    Full Text Available Relapsing polychondritis (RP is a severe progressive inflammatory condition involving cartilaginous structures and caused by an autoimmune process, for which there is no confirmatory serological biomarker and which still is diagnosed on a mainly clinical basis. RP has been associated with many diseases like Sweet’s syndrome, Behcet’s disease, rheumatoid arthritis, and other autoimmune disorders. We attempt to describe here a unique case of a 38-year-old female with a high-grade fever, sore throat, difficulty in swallowing, hoarseness of the voice, and found to have signs of tongue swelling and inflammation of the oral cavity that mimicked Ludwig’s angina, necessitating antibiotic use. On careful re-evaluation the patient was diagnosed to have relapsing polychondritis based on auricular and respiratory tract chondritis and response to steroids. The purpose of this report is to emphasize the fact that careful clinical assessment is needed to diagnose RP, which may be misdiagnosed as Ludwig’s angina.

  15. Bartonella henselae Infection: An Uncommon Mimicker of Autoimmune Disease

    Directory of Open Access Journals (Sweden)

    Despoina N. Maritsi

    2013-01-01

    Full Text Available We present a case of a seven-year-old immunocompetent female patient who developed systemic symptoms mimicking an autoimmune rather than an infectious disease. The patient presented with rash, biquotidian fever, night sweats, and arthralgias. There was no antecedent history of cat contact. Investigations showed increased inflammatory markers, leukocytosis, thrombocytosis, hypercalcemia, and raised angiotensin-converting enzyme. Interferon-gamma releasing assay for tuberculosis infection was negative. Abdominal imaging demonstrated multifocal lesions of the liver and spleen (later proved to be granulomata, chest X-ray showed enlarged hilar lymph nodes, and ophthalmology review revealed uveitis. Clinical, laboratory, and imaging features pointed towards sarcoidosis. Subsequently, raised titers (IgM 1 : 32, IgG 1 : 256 against Bartonella confirmed the diagnosis of B. henselae infection. She was treated with gentamycin followed by ciprofloxacin; repeat investigations showed complete resolution of findings. The presence of hepatic and splenic lesions in children with bartonellosis is well documented. Our case, however, exhibited certain unusual findings such as the coexistence of acute ocular and systemic involvement in an immunocompetent host. Serological testing is an inexpensive and effective way to diagnose bartonellosis in immunocompetent patients; we suggest that bartonella serology is included in the baseline tests performed on children with prolonged fever even in the absence of contact with cats in countries where bartonellosis is prevalent.

  16. Mimicking biochar-albedo feedback in complex Mediterranean agricultural landscapes

    Science.gov (United States)

    Bozzi, E.; Genesio, L.; Toscano, P.; Pieri, M.; Miglietta, F.

    2015-08-01

    Incorporation of charcoal produced by biomass pyrolysis (biochar) in agricultural soils is a potentially sustainable strategy for climate change mitigation. However, some side effects of large-scale biochar application need to be investigated. In particular a massive use of a low-reflecting material on large cropland areas may impact the climate via changes in surface albedo. Twelve years of MODIS-derived albedo data were analysed for three pairs of selected agricultural sites in central Italy. In each pair bright and dark coloured soil were identified, mimicking the effect of biochar application on the land surface albedo of complex agricultural landscapes. Over this period vegetation canopies never completely masked differences in background soil colour. This soil signal, expressed as an albedo difference, induced a local instantaneous radiative forcing of up to 4.7 W m-2 during periods of high solar irradiance. Biochar mitigation potential might therefore be reduced up to ˜30%. This study proves the importance of accounting for crop phenology and crop management when assessing biochar mitigation potential and provides more insights into the analysis of its environmental feedback.

  17. Heterotopic Pancreas Mimicking Cholangiocarcinoma. Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Atindriya Biswas

    2007-01-01

    Full Text Available Context Majority of the patients developing obstructive jaundice have an underlying malignancy. Identification of a benign pathology like heterotopic pancreas as an aetiology is uncommon and usually occurs only subsequent to a major operation. Case report We report a case of heterotopic pancreas adjacent to the ampulla of Vater mimicking distal cholangiocarcinoma. A 47- year-old patient presented with abdominal pain and obstructive jaundice. ERCP demonstrated a distal common bile duct stricture suspicious of cholangiocarcinoma. He underwent a pylorus-preserving pancreaticoduodenectomy. Histology showed a nodule of heterotopic pancreatic tissue adjacent to the ampulla. Conclusion We have reviewed the literature on heterotopic pancreas of the periampullary region presenting with biliary obstruction. This is a rare entity and remains difficult to diagnose, despite advances in radiological and endoscopic imaging techniques. For symptomatic patients with an established diagnosis of periampullary heterotopic pancreas, local excision may be sufficient. However, in the absence of unequivocal imaging or histological confirmation of benign pathology, and when there is a suspicion of underlying malignancy, pancreaticoduodenectomy may be the only treatment option, as in this case.

  18. Wernicke's Encephalopathy Mimicking Acute Onset Stroke Diagnosed by CT Perfusion

    Directory of Open Access Journals (Sweden)

    Alok Bhan

    2014-01-01

    Full Text Available Background. Metabolic syndromes such as Wernicke’s encephalopathy may present with a sudden neurological deficit, thus mimicking acute onset stroke. Due to current emphasis on rapid admission and treatment of acute stroke patients, there is a significant risk that these stroke mimics may end up being treated with thrombolysis. Rigorous clinical and radiological skills are necessary to correctly identify such metabolic stroke mimics, in order to avoid doing any harm to these patients due to the unnecessary use of thrombolysis. Patient. A 51-year-old Caucasian male was admitted to our hospital with suspicion of an acute stroke due to sudden onset dysarthria and unilateral facial nerve paresis. Clinical examination revealed confusion and dysconjugate gaze. Computed tomography (CT including a CT perfusion (CTP scan revealed bilateral thalamic hyperperfusion. The use of both clinical and radiological findings led to correctly diagnosing Wernicke’s encephalopathy. Conclusion. The application of CTP as a standard diagnostic tool in acute stroke patients can improve the detection of stroke mimics caused by metabolic syndromes as shown in our case report.

  19. Darier-Roussy Sarcoidosis Mimicking Metastatic Breast Cancer.

    Science.gov (United States)

    Viswanath, Lokesh; Pallade, Siddanna; Krishnamurthy, B; Naveen, T; Preethi, B L; Pramod, K P R; Reddy, Obula; Padma, G

    2009-01-01

    Subcutaneous sarcoidosis (also known as 'Darier-Roussy sarcoid') is a cutaneous condition characterized by numerous deep-seated nodules on the trunk and extremities. Coexistence of sarcoidosis and breast cancer are reported in the literature, but there will always be a chance of misdiagnosis. It is very crucial to obtain a tissue diagnosis of suspicious metastatic lesions. We report a case of breast cancer presenting with a subcutaneous sarcoid lesion masquerading as a metastatic lesion. A 50-year-old female patient, who had had cancer of the left breast, was on hormone therapy 2 years after treatment with surgery, radiotherapy and chemotherapy. The patient presented with a sudden onset of a forehead subcutaneous swelling mimicking metastasis which on excision biopsy was proved to be sarcoidosis. In India, sarcoidosis is reported rarely. We have to keep in mind that there is a chance of the metastatic lesions being of sarcoidosis origin or another granulomatous disease. To avoid misdiagnosis, it is better to obtain a tissue diagnosis. PMID:20737045

  20. Thyroid Ultrasound Pitfalls: Esophageal Fibrovascular Polyp Mimicking Thyroid Nodule

    Directory of Open Access Journals (Sweden)

    Anna Ansaloni

    2016-01-01

    Full Text Available Background. Ultrasound (US is the most accurate tool in the diagnosis of thyroid nodules if performed by expert physician. Misdiagnosis due to extrathyroidal lesions mimicking thyroid nodules is reported in literature. We describe the first case of an esophageal fibrovascular polyp misdiagnosed as a thyroid nodule on US examination. Patient Findings. A 54-year-old woman presented to emergency department for headache and underwent carotid Doppler extended to neck ultrasound with incidental finding of a nodule in the posterior side of the left thyroid lobe. A following thyroid US performed by an endocrinologist allowed the characterization of the lesion as an esophageal pathology, considering the extrathyroidal position, the typical peripheral hyperechoic spots and hypoechoic rim, the connection to the esophagus, and the swallowing connected movement. The patient was addressed to further investigations and finally to anterior pharyngotomy with histological diagnosis of esophageal fibrovascular polyp. Summary. Differential diagnosis between thyroid nodules and other neck lesions is important to prevent an unnecessary fine needle aspiration biopsy and to treat the extrathyroidal pathology. In this case, an US performed by an expert endocrinologist allowed detecting an esophageal fibrovascular polyp requiring surgical removal. In conclusion, the possibility of an esophageal pathology, and even fibrovascular polyp, should be considered during US thyroid examination.

  1. Osteopoikilosis: A Sign Mimicking Skeletal Metastases in a Cancer Patient

    Directory of Open Access Journals (Sweden)

    Hamid Nasrolahi

    2011-01-01

    Full Text Available Osteopoikilosis is a rare benign osteosclerotic bone disorder that may be misdiagnosed as skeletal metastases. Here we describe a case of coincidental breast cancer and osteopoikilosis mimicking skeletal metastases. A 41-year-old woman underwent right modified radical mastectomy in April 2007. Twenty-eight months after initial treatment,the patient complained of bilateral knee and foot pain. Plain X-rays of the feet and knees showed multiple well-defined osteosclerotic lesions. According to the radiographic appearance, the most likely differential diagnoses included skeletal metastases from breast cancer and osteopoikilosis. A whole-body bone scintigraphy showed no increase in uptake by the sclerotic lesions, and serum lactic dehydrogenase, carcinoembryonic antigen, alkaline phosphatase and cancer antigen 15-3 were not elevated. We therefore diagnosed the patient’s skeletal lesions as osteopoikilosis. This case and ourliterature review suggest that the radiographic appearance of osteopoikilosis may mimic or mask skeletal metastases, potentially leading to misdiagnosis in patients with cancer.

  2. Mimicking static anisotropic fluid spheres in general relativity

    Science.gov (United States)

    Boonserm, Petarpa; Ngampitipan, Tritos; Visser, Matt

    2016-11-01

    We argue that an arbitrary general relativistic static anisotropic fluid sphere, (static and spherically symmetric but with transverse pressure not equal to radial pressure), can nevertheless be successfully mimicked by suitable linear combinations of theoretically attractive and quite simple classical matter: a classical (charged) isotropic perfect fluid, a classical electromagnetic field and a classical (minimally coupled) scalar field. While the most general decomposition is not unique, a preferred minimal decomposition can be constructed that is unique. We show how the classical energy conditions for the anisotropic fluid sphere can be related to energy conditions for the isotropic perfect fluid, electromagnetic field, and scalar field components of the model. Furthermore, we show how this decomposition relates to the distribution of both electric charge density and scalar charge density throughout the model. The generalized TOV equation implies that the perfect fluid component in this model is automatically in internal equilibrium, with pressure forces, electric forces, and scalar forces balancing the gravitational pseudo-force. Consequently, we can build theoretically attractive matter models that can be used to mimic almost any static spherically symmetric spacetime.

  3. Broad iron lines in Active Galactic Nuclei

    CERN Document Server

    Fabian, A C; Reynolds, C S; Young, A J

    2000-01-01

    An intrinsically narrow line emitted by an accretion disk around a black hole appears broadened and skewed as a result of the Doppler effect and gravitational redshift. The fluorescent iron line in the X-ray band at 6.4-6.9keV is the strongest such line and is seen in the X-ray spectrum of many active galactic nuclei and, in particular, Seyfert galaxies. It is an important diagnostic with which to study the geometry and other properties of the accretion flow very close to the central black hole. The broad iron line indicates the presence of a standard thin accretion disk in those objects, often seen at low inclination. The broad iron line has opened up strong gravitational effects around black holes to observational study with wide-reaching consequences for both astrophysics and physics.

  4. Broad line regions in Seyfert-1 galaxies

    International Nuclear Information System (INIS)

    To reproduce observed emission profiles of Seyfert galaxies, rotation in an accretion disk has been proposed. In this thesis, the profiles emitted by such an accretion disk are investigated. Detailed comparison with the observed profiles yields that a considerable fraction can be fitted with a power-law function, as predicted by the model. The author analyzes a series of high quality spectra of Seyfert galaxies, obtained with the 2.5m telescope at Las Campanas. He presents detailed analyses of two objects: Mkn335 and Akn120. In both cases, strong evidence is presented for the presence of two separate broad line zones. These zones are identified with an accretion disk and an outflowing wind. The disk contains gas with very high densities and emits predominantly the lower ionization lines. He reports on the discovery of very broad wings beneath the strong forbidden line 5007. (Auth.)

  5. Fourier evaluation of broad Moessbauer spectra

    International Nuclear Information System (INIS)

    It is shown by the Fourier analysis of broad Moessbauer spectra that the even part of the distribution of the dominant hyperfine interaction (hyperfine field or quadrupole splitting) can be obtained directly without using least-square fitting procedures. Also the odd part of this distribution correlated with other hyperfine parameters (e.g. isomer shift) can be directly determined. Examples for amorphous magnetic and paramagnetic iron-based alloys are presented. (author)

  6. Crx broadly modulates the pineal transcriptome

    OpenAIRE

    Rovsing, Louise; Clokie, Samuel; Bustos, Diego M.; Rohde, Kristian; Steven L Coon; Litman, Thomas; Rath, Martin F.; Møller, Morten; Klein, David C.

    2011-01-01

    Cone-rod homeobox (Crx) encodes Crx, a transcription factor expressed selectively in retinal photoreceptors and pinealocytes, the major cell type of the pineal gland. Here, the influence of Crx on the mammalian pineal gland was studied by light and electron microscopy and by use of microarray and qRTPCR technology, thereby extending previous studies on selected genes (Furukawa et al. 1999). Deletion of Crx was not found to alter pineal morphology, but was found to broadly modulate the mouse p...

  7. A Broad View of Macroeconomic Stability

    OpenAIRE

    José Antonio Ocampo

    2005-01-01

    This paper recommends a broad concept of macroeconomic stability, whereby “sound macroeconomic frameworks” include not only price stability and sound fiscal policies, but also a well-functioning real economy, sustainable debt ratios and healthy public and private sector balance sheets. These multiple dimensions imply using multiple policy instruments. The paper elaborates a framework for developing countries that involves active use of counter-cyclical macroeconomic policies (exchange rate, m...

  8. Functional results from reconstruction of the anterior cruciate ligament using the central third of the patellar ligament and flexor tendons

    Directory of Open Access Journals (Sweden)

    Marcos George de Souza Leao

    2015-12-01

    Full Text Available ABSTRACT OBJECTIVES: To evaluate knee function in patients undergoing reconstruction of the anterior cruciate ligament (ACL using the central third of the patellar ligament or the medial flexor tendons of the knee, i.e. quadruple ligaments from the semitendinosus and gracilis (ST-G, by means of the Knee Society Score (KSS and the Lysholm scale. METHODS: This was a randomized prospective longitudinal study on 40 patients who underwent arthroscopic ACL reconstruction between September 2013 and August 2014. They comprised 37 males and three females, with ages ranging from 16 to 52 years. The patients were numbered randomly from 1 to 40: the even numbers underwent surgical correction using the ST-G tendons and the odd numbers, using the patellar tendon. Functional evaluations were made using the KSS and Lysholm scale, applied in the evening before the surgical procedure and six months after the operation. RESULTS: From the statistical analysis, it could be seen that the patients' functional capacity was significantly greater after the operation than before the operation. There was strong evidence that the two forms of therapy had similar results ( p= >0.05, in all the comparisons. CONCLUSIONS: The results from the ACL reconstructions were similar with regard to functional recovery of the knee and improvement of quality of life, independent of the type of graft. It was not possible to identify the best method of surgical treatment. The surgeon's clinical and technical experience and the patient are the factors that determine the choice of graft type for use in ACL surgery.

  9. Relativistic redshifts in quasar broad lines

    CERN Document Server

    Tremaine, Scott; Liu, Xin; Loeb, Abraham

    2014-01-01

    The broad emission lines commonly seen in quasar spectra have velocity widths of a few per cent of the speed of light, so special- and general-relativistic effects have a significant influence on the line profile. We have determined the redshift of the broad H-beta line in the quasar rest frame (determined from the core component of the [OIII] line) for over 20,000 quasars from the Sloan Digital Sky Survey DR7 quasar catalog. The mean redshift as a function of line width is approximately consistent with the relativistic redshift that is expected if the line originates in a randomly oriented Keplerian disk that is obscured when the inclination of the disk to the line of sight exceeds ~30-45 degrees, consistent with simple AGN unification schemes. This result also implies that the net line-of-sight inflow/outflow velocities in the broad-line region are much less than the Keplerian velocity when averaged over a large sample of quasars with a given line width.

  10. Isolated Pancreatic Tuberculosis Mimicking Focal Pancreatitis and Causing Segmental Portal Hypertension

    OpenAIRE

    Rana, Surinder S.; Deepak K Bhasin; Chalapathi Rao; Kartar Singh

    2010-01-01

    Context Isolated pancreatic tuberculosis is a common mimicker of pancreatic malignancy and a common presentation is abdominal pain. However, segmental portal hypertension is very uncommon. Case report A case of isolated pancreatic tuberculosis mimicking focal pancreatitis and causing segmental portal hypertension is presented. Conclusion A histological or microbiological diagnosis of the presence of pancreatic masses is necessary to detect potentially treatable diseases, such as tuberculosis,...

  11. Reconstruction of medial patellofemoral ligament using quadriceps tendon combined with reconstruction of medial patellotibial ligament using patellar tendon: initial experience☆

    Science.gov (United States)

    Hinckel, Betina Bremer; Gobbi, Riccardo Gomes; Bonadio, Marcelo Batista; Demange, Marco Kawamura; Pécora, José Ricardo; Camanho, Gilberto Luis

    2016-01-01

    Objective To describe a surgical technique for anatomical reconstruction of the medial patellofemoral ligament using the quadriceps tendon, combined with reconstruction of the medial patellotibial ligament using the patellar tendon; and to present the initial results from a case series. Method The proposed technique was used on a series of cases of patients with diagnoses of patellofemoral instability and indications for surgical treatment, who were attended by the Knee Group of HC-IOT, University of São Paulo. The following were evaluated before and after the operation: range of motion (ROM), apprehension test, lateral translation test, patellar inclination test, inverted J sign, subluxation upon extension, pain from compression of the patella and pain from contraction of the quadriceps. After the operation, the patients were asked whether any new episode of dislocation had occurred, what their degree of satisfaction with the surgery was (on a scale from 0 to 10) and whether they would be prepared to go through this operation again. Results Seven knees were operated, in seven patients, with a mean follow-up of 5.46 months (±2.07). Four patients who presented apprehension before the operation did not show this after the operation. The lateral translation test became normal for all the patients, while the patellar inclination test remained positive for two patients. The patients with an inverted J sign continued to be positive for this sign. Five patients were positive for subluxation upon extension before the operation, but all patients were negative for this after the operation. None of the patients presented any new episode of dislocation of the patella. All of them stated that they were satisfied: five gave a satisfaction score of 9 and two, a score of 10. All of them said that they would undergo the operation again. Only one patient presented a postoperative complication: dehiscence of the wound. Conclusion Reconstruction of the medial patellofemoral ligament

  12. Reconstruction of medial patellofemoral ligament using quadriceps tendon combined with reconstruction of medial patellotibial ligament using patellar tendon: initial experience

    Directory of Open Access Journals (Sweden)

    Betina Bremer Hinckel

    2016-02-01

    Full Text Available ABSTRACT OBJECTIVE: To describe a surgical technique for anatomical reconstruction of the medial patellofemoral ligament using the quadriceps tendon, combined with reconstruction of the medial patellotibial ligament using the patellar tendon; and to present the initial results from a case series. METHOD: The proposed technique was used on a series of cases of patients with diagnoses of patellofemoral instability and indications for surgical treatment, who were attended by the Knee Group of HC-IOT, University of São Paulo. The following were evaluated before and after the operation: range of motion (ROM, apprehension test, lateral translation test, patellar inclination test, inverted J sign, subluxation upon extension, pain from compression of the patella and pain from contraction of the quadriceps. After the operation, the patients were asked whether any new episode of dislocation had occurred, what their degree of satisfaction with the surgery was (on a scale from 0 to 10 and whether they would be prepared to go through this operation again. RESULTS: Seven knees were operated, in seven patients, with a mean follow-up of 5.46 months (±2.07. Four patients who presented apprehension before the operation did not show this after the operation. The lateral translation test became normal for all the patients, while the patellar inclination test remained positive for two patients. The patients with an inverted J sign continued to be positive for this sign. Five patients were positive for subluxation upon extension before the operation, but all patients were negative for this after the operation. None of the patients presented any new episode of dislocation of the patella. All of them stated that they were satisfied: five gave a satisfaction score of 9 and two, a score of 10. All of them said that they would undergo the operation again. Only one patient presented a postoperative complication: dehiscence of the wound. CONCLUSION: Reconstruction of the

  13. Measurement of guided mode wavenumbers in soft tissue–bone mimicking phantoms using ultrasonic axial transmission

    International Nuclear Information System (INIS)

    Human soft tissue is an important factor that influences the assessment of human long bones using quantitative ultrasound techniques. To investigate such influence, a series of soft tissue–bone phantoms (a bone-mimicking plate coated with a layer of water, glycerol or silicon rubber) were ultrasonically investigated using a probe with multi-emitter and multi-receiver arrays in an axial transmission configuration. A singular value decomposition signal processing technique was applied to extract the frequency-dependent wavenumbers of several guided modes. The results indicate that the presence of a soft tissue-mimicking layer introduces additional guided modes predicted by a fluid waveguide model. The modes propagating in the bone-mimicking plate covered by the soft-tissue phantom are only slightly modified compared to their counterparts in the free bone-mimicking plate, and they are still predicted by an elastic transverse isotropic two-dimensional waveguide. Altogether these observations suggest that the soft tissue–bone phantoms can be modeled as two independent waveguides. Even in the presence of the overlying soft tissue-mimicking layer, the modes propagating in the bone-mimicking plate can still be extracted and identified. These results suggest that our approach can be applied for the purpose of the characterization of the material and structural properties of cortical bone. (paper)

  14. [Ligament ruptures of the lower extremity in the elderly].

    Science.gov (United States)

    Herbort, M; Raschke, M J

    2011-08-01

    There is an increasing incidence of ligament ruptures of the lower extremities in older patients. This higher incidence is caused by the typical current demographic changes in the population and the higher level of activity and athletic motivation of the older people in our society. In this review we address the most important ligament ruptures of the lower extremity in the old patient. Quadriceps tendon and Achilles tendon ruptures are mostly the result of degenerative and abrasion changes. The ACL rupture on the other hand occurs spontaneously after adequate trauma and without former degenerative changes especially in highly active patients. For a differentiated treatment of the older patient with tendon ruptures, secondary diseases, an increased risk and complication profile and a potentially decreased compliance during rehabilitation must be taken into consideration before indicating operative or conservative therapy. There are no strict age-related limitations for indication of an operative treatment of tendon ruptures in the older patient. In this patient group a differentiated treatment decision is recommended. PMID:21766204

  15. Variations in cell morphology in the canine cruciate ligament complex.

    Science.gov (United States)

    Smith, K D; Vaughan-Thomas, A; Spiller, D G; Clegg, P D; Innes, J F; Comerford, E J

    2012-08-01

    Cell morphology may reflect the mechanical environment of tissues and influence tissue physiology and response to injury. Normal cruciate ligaments (CLs) from disease-free stifle joints were harvested from dog breeds with a high (Labrador retriever) and low (Greyhound) risk of cranial cruciate ligament (CCL) rupture. Antibodies against the cytoskeletal components vimentin and alpha tubulin were used to analyse cell morphology; nuclei were stained with 4',6-diamidino-2-phenylindole, and images were collected using conventional and confocal microscopy. Both cranial and caudal CLs contained cells of heterogenous morphologies. Cells were arranged between collagen bundles and frequently had cytoplasmic processes. Some of these processes were long (type A cells), others were shorter, thicker and more branched (type B cells), and some had no processes (type C cells). Processes were frequently shown to contact other cells, extending longitudinally and transversely through the CLs. Cells with longer processes had fusiform nuclei, and those with no processes had rounded nuclei and were more frequent in the mid-substance of both CLs. Cells with long processes were more commonly noted in the CLs of the Greyhound. As contact between cells may facilitate direct communication, variances in cell morphology between breeds at a differing risk of CCL rupture may reflect differences in CL physiology. PMID:22465617

  16. Median arcuate ligament syndrome: a nonvascular, vascular diagnosis.

    Science.gov (United States)

    Skeik, Nedaa; Cooper, Leslie T; Duncan, Audra A; Jabr, Fadi I

    2011-07-01

    Median arcuate ligament syndrome (MALS) is often diagnosed when idiopathic, episodic abdominal pain is associated with dynamic compression of the proximal celiac artery by fibers of the median arcuate ligament. The character of the abdominal pain is often postprandial and associated with gradual weight loss from poor food intake, suggestive of chronic mesenteric ischemia. However, the pathognomonic imaging feature of dynamic, ostial celiac artery compression with expiration does not consistently predict clinical improvement from revascularization. Proposed but unproven pathophysiological mechanisms include neurogenic pain from compression of the splanchnic nerve plexus and intermittent ischemia from compression of the celiac artery. Alterations in blood flow and ganglion compression are both associated with delayed gastric emptying, another physiological correlate of the clinical syndrome. Published reports describe a variable response to revascularization and nerve plexus resection suggest a need for translational research to better characterize this poorly understood clinical entity. We illustrate the current gaps in our knowledge of MALS with the case of a 51-year-old woman with a 4-year history of chronic abdominal pain who responded to a combination of ganglion resection and celiac artery reconstruction. PMID:21536596

  17. To Broad-Match or Not to Broad-Match : An Auctioneer's Dilemma ?

    CERN Document Server

    Singh, Sudhir Kumar

    2008-01-01

    We initiate the study of an interesting aspect of sponsored search advertising, namely the consequences of broad match-a feature where an ad of an advertiser can be mapped to a broader range of relevant queries, and not necessarily to the particular keyword(s) that ad is associated with. Starting with a very natural setting for strategies available to the advertisers, and via a careful look through algorithmic and complexity theoretic glasses, we first propose a solution concept called broad match equilibrium(BME) for the game originating from the strategic behavior of advertisers as they try to optimize their budget allocation across various keywords. Next, we consider two broad match scenarios based on factors such as information asymmetry between advertisers and the auctioneer, and the extent of auctioneer's control on the budget splitting. In the first scenario, the advertisers have the full information about broad match and relevant parameters, and can reapportion their own budgets to utilize the extra i...

  18. Anatomy and histology of apical support: a literature review concerning cardinal and uterosacral ligaments.

    Science.gov (United States)

    Ramanah, Rajeev; Berger, Mitchell B; Parratte, Bernard M; DeLancey, John O L

    2012-11-01

    The objective of this work was to collect and summarize relevant literature on the anatomy, histology, and imaging of apical support of the upper vagina and the uterus provided by the cardinal (CL) and uterosacral (USL) ligaments. A literature search in English, French, and German languages was carried out with the keywords apical support, cardinal ligament, transverse cervical ligament, Mackenrodt ligament, parametrium, paracervix, retinaculum uteri, web, uterosacral ligament, and sacrouterine ligament in the PubMed database. Other relevant journal and textbook articles were sought by retrieving references cited in previous PubMed articles. Fifty references were examined in peer-reviewed journals and textbooks. The USL extends from the S2 to the S4 vertebra region to the dorsal margin of the uterine cervix and/or to the upper third of the posterior vaginal wall. It has a superficial and deep component. Autonomous nerve fibers are a major constituent of the deep USL. CL is defined as a perivascular sheath with a proximal insertion around the origin of the internal iliac artery and a distal insertion on the cervix and/or vagina. It is divided into a cranial (vascular) and a caudal (neural) portions. Histologically, it contains mainly vessels, with no distinct band of connective tissue. Both the deep USL and the caudal CL are closely related to the inferior hypogastric plexus. USL and CL are visceral ligaments, with mesentery-like structures containing vessels, nerves, connective tissue, and adipose tissue.

  19. Elastic properties of Thiel-embalmed human ankle tendon and ligament.

    Science.gov (United States)

    Liao, Xiaochun; Kemp, Sandy; Corner, George; Eisma, Roos; Huang, Zhihong

    2015-10-01

    Thiel embalming is recommended as an alternative to formalin-based embalming because it preserves tissue elasticity, color, and flexibility in the long term, with low infection and toxicity risk. The degree to which Thiel embalming preserves elasticity has so far been assessed mainly by subjective scoring, with little quantitative verification. The aim of this study is to quantify the effect of Thiel embalming on the elastic properties of human ankle tendons and ligament. Biomechanical tensile tests were carried out on six Thiel-embalmed samples each of the peroneus longus, peroneus brevis, and calcaneal tendons, and the calcaneofibular ligament, with strain rates of 0.25%s(-1), 2%s(-1), and 8%s(-1). The stress-strain relationship was calculated from the force-extension response with cross-sectional area and gauge length. Young's modulus was determined from the stress-strain curve. The results showed that the tendon and ligament elasticity were lower after Thiel embalming than the literature values for fresh nonembalmed tendons and ligament. The biomechanical tensile test showed that the measured elasticity of Thiel-embalmed tendons and ligaments increased with the strain rate. The Thiel embalming method is useful for preserving human ankle tendons and ligaments for anatomy and surgery teaching and research, but users need to be aware of its softening effects. The method retains the mechanical strain rate effect on tendons and ligament. PMID:25707906

  20. Surgical treatment of grade Ⅲ collateral ligament injury of knee joint caused by military training

    Directory of Open Access Journals (Sweden)

    Qiang ZHANG

    2011-08-01

    Full Text Available Objective To explore the method and effect of surgical treatment on grade Ⅲ collateral ligament injuries caused by military training.Methods Sixteen cases of grade Ⅲ collateral ligament injuries caused by military training were involved in the present study.Injuries to insertion of collateral ligament was repaired with suture anchor,fresh rupture of medial collateral ligament parenchyma was sutured directly,old rupture of medial collateral ligament parenchyma was repaired by direct suture and strengthening with autologous semitendinosus-gracilis tendon graft,while both fresh and old rupture of lateral collateral ligament parenchyma was reconstructed with autologous semitendinosus-gracilis tendon graft.Knee function was assessed 1 year after operation by Lysholm scores and compared with that before the operation.Results All the 16 patients were followed-up for 12 to 33 months with a mean of 20.5 months.The Lysholm knee scores of 1 year after peration(92.45±4.03 was significantly higher than that before operation(56.45±11.03,P < 0.05.Conclusions For the grade Ⅲ collateral ligament injuries caused by military training,the treatment principle was early diagnosis and early operation,and different surgical methods should be used according to the injury types for the sake of obtaining best therapeutic effects.

  1. Comparative transcriptional analysis of three human ligaments with distinct biomechanical properties

    Science.gov (United States)

    Lorda-Diez, Carlos I; Canga-Villegas, Ana; Cerezal, Luis; Plaza, Santiago; Hurlé, Juan M; García-Porrero, Juan A; Montero, Juan A

    2013-01-01

    One major aim of regenerative medicine targeting the musculoskeletal system is to provide complementary and/or alternative therapeutic approaches to current surgical therapies, often involving the removal and prosthetic substitution of damaged tissues such as ligaments. For these approaches to be successful, detailed information regarding the cellular and molecular composition of different musculoskeletal tissues is required. Ligaments have often been considered homogeneous tissues with common biomechanical properties. However, advances in tissue engineering research have highlighted the functional relevance of the organisational and compositional differences between ligament types, especially in those with higher risks of injury. The aim of this study was to provide information concerning the relative expression levels of a subset of key genes (including extracellular matrix components, transcription factors and growth factors) that confer functional identity to ligaments. We compared the transcriptomes of three representative human ligaments subjected to different biomechanical demands: the anterior cruciate ligament (ACL); the ligamentum teres of the hip (LT); and the iliofemoral ligament (IL). We revealed significant differences in the expression of type I collagen, elastin, fibromodulin, biglycan, transforming growth factor β1, transforming growth interacting factor 1, hypoxia-inducible factor 1-alpha and transforming growth factor β-induced gene between the IL and the other two ligaments. Thus, considerable molecular heterogeneity can exist between anatomically distinct ligaments with differing biomechanical demands. However, the LT and ACL were found to show remarkable molecular homology, suggesting common functional properties. This finding provides experimental support for the proposed role of the LT as a hip joint stabiliser in humans. PMID:24128114

  2. FUNCTIONAL OUTCOME OF ARTHROSCOPY ASSISTED ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING BONE PATELLAR TENDON BONE AUTOGRAFT

    Directory of Open Access Journals (Sweden)

    Vinod Kumar

    2015-04-01

    Full Text Available INTRODUCTION: The anterior cruciate ligament (ACL is one of the most frequently injured ligaments in the human body. 1 The Anterior Cruciate ligament (ACL is the primary stabilizer of the knee and prevents the knee against anterior translation. 2 It is also important in counteracting rotational and valgus stress. 1 The middle third of the patellar tendon autograft for ACL reconstruction can be readily procured and firmly fixed. 3 It can tolerate the loads produced by an intensive rehabilitation programme. 3 Fixation of bone plugs using interference screws provides sufficient stability to meet the demand of a vigorous postoperative protocol. 3 It remains the gold standard for ACL reconstruction. 3 This study is to assess the functional outcome of arthroscopy assisted anterior cruciate ligament reconstruction using bone patellar tendon bone autograft. METHODS: This study was conducted in Kempegowda Institute of Medical Sciences Hospital from November 2012 to April 2014. During this period 20 cases of adult patients with ACL deficient patients were selected according to the inclusion criteria. Study aims to assess the functional outcome of arthroscopy assisted anterior cruciate ligament reconstruction using bone - patellar tendon - bone autograft in terms of range of motion, postoperative knee stability, graft site morbidity and subjective knee functions. RESULTS: Results of our study showed that arthroscopy assisted anterior cruciate ligament reconstruction with bone - patellar tendon - bone autograft could effectively improve knee stability and functions after surgery without any complication. CONCLUSION : Arthroscopy assisted anterior cruciate l igament reconstruction with bone - patellar tendon - bone autograft is an excellent treatment option for anterior cruciate ligament deficient knees. It provides a stable knee and reduces postoperative morbidity and enables early rehabilitation. The functional outcome of arthroscopy assisted anterior

  3. MR imaging of the anterior intermeniscal ligament: classification according to insertion sites

    Energy Technology Data Exchange (ETDEWEB)

    Aydingoez, Uestuen; Kaya, Ayten [Department of Radiology, Hacettepe University Medical Center, Ankara (Turkey); Atay, Ahmet Oe.; Doral, Nedim M. [Department of Orthopaedics and Traumatology, Hacettepe University Medical Center, Ankara (Turkey); Oeztuerk, Halil M. [Department of Radiology, SSK Ankara Hospital, Ankara (Turkey)

    2002-04-01

    Our objective was to study the frequency of anterior intermeniscal ligament on MR imaging and to make a classification according to its insertion sites on MR images. Sagittal T1-weighted and thin-section transverse T2*-weighted MR images of the knee were prospectively evaluated in 229 subjects without significant synovial effusion or total rupture of the anterior cruciate ligament. By using thin-section transverse images, the ligament was classified into three types according to its insertion sites (type A: between anterior horns of medial and lateral menisci; type B: between anterior horn of medial meniscus and anterior margin of lateral meniscus; type C: between anterior margins of medial and lateral menisci). On sagittal images location of the ligament was determined with respect to a line drawn between anterior of the tibial epiphysis and posterior of the intercondylar notch to look for a relation between its type on transverse images and location on sagittal images. Separately, arthroscopy was made in 36 patients to verify the MR assessment of the presence of the ligament. Anterior intermeniscal ligament was found in 53% of the subjects. Type B was the most common group (58%). Magnetic resonance imaging has a sensitivity and a specificity of 67 and 100%, respectively, in the detection of the ligament. Types A and C had a statistically significant location posterior and anterior, respectively, to the master line on sagittal images. In arthroscopy, the ligament was either cord-like (67%) or flat (33%) in appearance. Routine sagittal MR images can help identify anterior intermeniscal ligament. (orig.)

  4. Mimicking Nonequilibrium Steady States with Time-Periodic Driving

    Science.gov (United States)

    Raz, O.; Subaşı, Y.; Jarzynski, C.

    2016-04-01

    Under static conditions, a system satisfying detailed balance generically relaxes to an equilibrium state in which there are no currents. To generate persistent currents, either detailed balance must be broken or the system must be driven in a time-dependent manner. A stationary system that violates detailed balance evolves to a nonequilibrium steady state (NESS) characterized by fixed currents. Conversely, a system that satisfies instantaneous detailed balance but is driven by the time-periodic variation of external parameters—also known as a stochastic pump (SP)—reaches a periodic state with nonvanishing currents. In both cases, these currents are maintained at the cost of entropy production. Are these two paradigmatic scenarios effectively equivalent? For discrete-state systems, we establish a mapping between nonequilibrium stationary states and stochastic pumps. Given a NESS characterized by a particular set of stationary probabilities, currents, and entropy production rates, we show how to construct a SP with exactly the same (time-averaged) values. The mapping works in the opposite direction as well. These results establish a proof of principle: They show that stochastic pumps are able to mimic the behavior of nonequilibrium steady states, and vice versa, within the theoretical framework of discrete-state stochastic thermodynamics. Nonequilibrium steady states and stochastic pumps are often used to model, respectively, biomolecular motors driven by chemical reactions and artificial molecular machines steered by the variation of external, macroscopic parameters. Our results loosely suggest that anything a biomolecular machine can do, an artificial molecular machine can do equally well. We illustrate this principle by showing that kinetic proofreading, a NESS mechanism that explains the low error rates in biochemical reactions, can be effectively mimicked by a constrained periodic driving.

  5. Atypical lymphocytes in malaria mimicking dengue infection in Thailand

    Directory of Open Access Journals (Sweden)

    Polrat Wilairatana

    2010-09-01

    Full Text Available Polrat Wilairatana1, Noppadon Tangpukdee1, Sant Muangnoicharoen1, Srivicha Krudsood2, Shigeyuki Kano31Department of Clinical Tropical Medicine, 2Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; 3Department of Tropical Medicine and Malaria, Research Institute, National Center for Global Health and Medicine, Tokyo, JapanAbstract: Patients with uncomplicated falciparum or vivax malaria usually present with acute febrile illness and thrombocytopenia similar to dengue infection. We retrospectively studied atypical lymphocytes (AL and atypical lymphocytosis (ALO, defined as AL > 5% of total white blood cells in 1310 uncomplicated malaria patients. In 718 falciparum malaria patients, AL and ALO on day 0 were found in 53.2% and 5.7% of the patients, respectively, with median AL on admission of 1% (range 0%–10%, whereas in 592 vivax malaria patients, AL and ALO on day 0 were found in 55.4% and 9.5% of the patients, respectively, with median AL on admission of 1% (range 0%–14%. After antimalarial treatment, AL and ALO declined in both falciparum and vivax malaria. However, AL and ALO remained in falciparum malaria on days 7, 14, and 21, whereas AL and ALO remained in vivax malaria on days 7, 14, 21, and 28. In both falciparum and vivax malaria patients, there was a positive correlation between AL and total lymphocytes, but a negative correlation between AL and highest fever on admission, white blood cells, and neutrophils, eosinophils, and platelets (P < 0.05. In conclusion, AL or ALO may be found in uncomplicated falciparum and vivax malaria mimicking dengue infection. In tropical countries where both dengue and malaria are endemic, presence of AL or ALO in any acute febrile patients with thrombocytopenia (similar to the findings in dengue malaria could not be excluded. Particularly if the patients have risk of malaria infection, confirmative microscopic examination for malaria should be carried out

  6. Chronic multifocal non-bacterial osteomyelitis in hypophosphatasia mimicking malignancy

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    Warmuth-Metz Monika

    2007-01-01

    Full Text Available Abstract Background Hypophosphatasia (HP is characterized by a genetic defect in the tissue-nonspecific alkaline phosphatase (TNSALP gene and predominantly an autosomal recessive trait. HP patients suffer from reduced bone mineralization. Biochemically, elevated concentrations of substrates of TNSALP, including pyridoxal-5'-phosphate and inorganic pyrophosphate occur in serum, tissues and urine. The latter has been associated with chronic inflammation and hyperprostaglandinism. Case presentation We report on 2 affected children presenting with multifocal inflammatory bone lesions mimicking malignancy: A 6 years old girl with short stature had been treated with human growth hormone since 6 months. Then she started to complain about a painful swelling of her left cheek. MRI suggested a malignant bone lesion. Bone biopsy, however, revealed chronic inflammation. A bone scan showed a second rib lesion. Since biopsy was sterile, the descriptive diagnosis of chronic non-bacterial osteomyelitis (CNO was established. The diagnostic tests related to growth failure were repeated and subsequent analyses demonstrated a molecular defect in the TNSALP gene. The second girl (10 years old complained about back pain after she had fallen from her bike. X rays of her spine revealed compressions of 2 thoracic vertebrae. At first these were considered trauma related, however a bone scan did show an additional lesion in the right 4th rib. A biopsy of this rib revealed a sterile lympho- plasmocytoid osteomyelitis suggesting multifocal CNO. Further analyses did show a decreased TNSALP in leukocytes and elevated pyridoxal phosphate in plasma, suggesting a heterozygous carrier status of HP. Conclusion Chronic bone oedema in adult HP and chronic hyper-prostaglandinism in childhood HP do suggest that in some HP patients bone inflammation is present in conjunction with the metabolic defect. Sterile multifocal osteomyelitis could be demonstrated. Non-steroidal anti

  7. Mimicking Ribosomal Unfolding of RNA Pseudoknot in a Protein Channel.

    Science.gov (United States)

    Zhang, Xinyue; Xu, Xiaojun; Yang, Zhiyu; Burcke, Andrew J; Gates, Kent S; Chen, Shi-Jie; Gu, Li-Qun

    2015-12-23

    Pseudoknots are a fundamental RNA tertiary structure with important roles in regulation of mRNA translation. Molecular force spectroscopic approaches such as optical tweezers can track the pseudoknot's unfolding intermediate states by pulling the RNA chain from both ends, but the kinetic unfolding pathway induced by this method may be different from that in vivo, which occurs during translation and proceeds from the 5' to 3' end. Here we developed a ribosome-mimicking, nanopore pulling assay for dissecting the vectorial unfolding mechanism of pseudoknots. The pseudoknot unfolding pathway in the nanopore, either from the 5' to 3' end or in the reverse direction, can be controlled by a DNA leader that is attached to the pseudoknot at the 5' or 3' ends. The different nanopore conductance between DNA and RNA translocation serves as a marker for the position and structure of the unfolding RNA in the pore. With this design, we provided evidence that the pseudoknot unfolding is a two-step, multistate, metal ion-regulated process depending on the pulling direction. Most notably, unfolding in both directions is rate-limited by the unzipping of the first helix domain (first step), which is Helix-1 in the 5' → 3' direction and Helix-2 in the 3' → 5' direction, suggesting that the initial unfolding step in either pulling direction needs to overcome an energy barrier contributed by the noncanonical triplex base-pairs and coaxial stacking interactions for the tertiary structure stabilization. These findings provide new insights into RNA vectorial unfolding mechanisms, which play an important role in biological functions including frameshifting. PMID:26595106

  8. Brugada ECG Sign & Chest Pain Mimicking ST Elevation Myocardial Infarction

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    Omar Mousa

    2013-11-01

    Full Text Available Background: Management of patients with the brugada ECG sign who have no previous history of syncope is still negotiable. We present a case of a 57 year-old Caucasian lady who presented to the emergency department with substernal chest pain. Results: Her past medical history showed that she had two previous episodes of lightheadedness, but no syncope. She had a family history of sudden death secondary to unknown cause in her aunt at the age of 61. Physical exam was unremarkable except for diaphoresis. Electrocardiography (ECG showed ST elevation in the right precordial leads (V1-V2 with T inversion, mimicking a STEMI. Emergent cardiac catheterization revealed normal coronary arteries. Echocardiogram was normal. Again, interpretation of ECG revealed a Brugada type 1 pattern, characterized by coved-type, gradually descending ST-T segment, elevated J point of more than 2 mm and T wave inversion. Electrophysiological (EPS testing with a Sodium channel blocker challenge showed a persistent Brugada type 1 pattern with non inducible ventricular tachycardia. This patient had Brugada type 1 ECG pattern with no previous history of syncope (asymptomatic. Thus she was considered at low risk of developing a serious arrhythmogenic event in the future. Conclusion: A history of syncope remains the best available predictor for arrhythmogenic events. EPS testing in such patients, to stratify the risk and predict for any future events, is still controversial. It is still unjustified to place an implantable cardioverter-defibrillator in asymptomatic non-inducible individuals with the Brugada pattern. These patients should follow up closely with a cardiologist and be aware of the risk of possible triggers of ventricular arrhythmias.

  9. Pleomorphic adenoma mimicking lymphoma of the palatine tonsil

    International Nuclear Information System (INIS)

    Full text: Introduction: Pleomorphic adenoma is a mixed benign tumor of the salivary glands having myoepithelial and epithelial components. It is frequently encountered in big salivary glands such as parotid glands. Those originating from small salivary glands are usually seen in the palatal region. They can be rarely seen in buccal region, tongue, base of the oral cavity, tonsils, pharynx, retromolar region and nasal cavity. Objectives and tasks: In this article, we aimed to represent computed tomography (CT) and Magnetic resonance imaging findings of a case with pleomorphic adenoma located in the palatine tonsil region mimicking lymphoma. Material and methods: 19-year-old boy was referred to our radiology clinic due asymmetrical hypertrophic changes in the left palatine tonsil region. The case was evaluated by contrast enhanced CT and MR. Results: In CT, a 2.5x3 cm hypodense solid lesion without prominent contrast enhancement located in the left palatine tonsil region narrowing the nasopharyngeal-oropharyngeal passage was revealed. In MR imaging lesion was isointense to the muscle tissue in T1WI and hyperintense in T2WI. It was showing heterogeneous contrast enhancement in postcontrast T1WI. As a consequence, palatine tonsil lymphoma was compatible with radiologic features. But, diagnosis was turned out to be pleomorphic adenoma by histopathologic assessment. Conclusion: Salivary gland neoplasia is rarely seen in the minor salivary glands. The diagnosis of atypically located salivary gland tumor may be challenging. CT and MR imaging can be used to assess the location, dimensions, extension and relationship with the adjacent structures of the tumor. The minor salivary gland tumor such as pleomorphic adenoma should be included in the differential diagnoses in lesion located in the oral-nasal-pharyngeal regions

  10. [Augmented anterior cruciate ligament replacement with the Kennedy-LAD (ligament augmentation device)--long term outcome].

    Science.gov (United States)

    Riel, K A

    1998-01-01

    The ligament augmentation device (Kennedy-LAD) is used to protect tendon grafts during the posttransplantation decrease in strength in anterior cruciate ligament (acl) reconstructions. The augmentation with the LAD is based on the concept of load sharing. Since 1983 we used the LAD in acl-reconstructions in 856 patients. In 63 cases we had to treat complications like infection (8), recurrent effusions (21), arthrofibrosis (34). The overall results are good with respect to stability, regain of strength and sports activity. In 73 cases resurgery was necessary because of synovitis (7), LAD-rupture due to re-injury (9), fatigue-rupture of the LAD (22), meniscal tears (35), 2.7 +/- 2.3 years (range: 2 months to 10 years) after LAD implantation. Modern techniques in acl reconstruction lead to comparable results without synthetic augmentation. Therefore, we now recommend the use of a LAD only in cases of repeated acl replacement with week tendon grafts, to avoid an allograft. PMID:9816660

  11. Broad spectrum antibiotic compounds and use thereof

    Energy Technology Data Exchange (ETDEWEB)

    Koglin, Alexander; Strieker, Matthias

    2016-07-05

    The discovery of a non-ribosomal peptide synthetase (NRPS) gene cluster in the genome of Clostridium thermocellum that produces a secondary metabolite that is assembled outside of the host membrane is described. Also described is the identification of homologous NRPS gene clusters from several additional microorganisms. The secondary metabolites produced by the NRPS gene clusters exhibit broad spectrum antibiotic activity. Thus, antibiotic compounds produced by the NRPS gene clusters, and analogs thereof, their use for inhibiting bacterial growth, and methods of making the antibiotic compounds are described.

  12. Three-dimensional magnetic resonance imaging for ruptures of the lateral ligaments of the ankle

    International Nuclear Information System (INIS)

    The accuracy has been determined of three-dimensional MRI in visualizing the anterior talofibular and the calcaneofibular ligament in young athletes with an acute severe sprain of the lateral ligaments of the ankle by comparing these findings with those found at operation and evaluating three-dimensional fast imaging with steady state precession (3D FISP) as a diagnostic aid to operative planning for tears of both the anterior talofibular and the calcaneofibular ligament in younger competitive athletes. (author). 20 refs.; 2 figs

  13. The stress-tenogram in the diagnosis of ruptures of the lateral ligament of the ankle

    International Nuclear Information System (INIS)

    The stress-tenogram is a radiological technique for the investigation of injuries to the lateral ligament of the ankle, and combines the information previously provided by inversion and anterior stress radiographs, and the peroneal tenogram. It is designed to differentiate between stable and unstable ankles, and between isolated ruptures of the anterior talofibular ligament and combined tears of the anterior talofibular and calcaneofibular ligaments. A high degree of diagnostic accuracy has been confirmed at operative repair in a group of thirty-two patients. (author)

  14. Location and tension of the medial palpebral ligament.

    Science.gov (United States)

    Hwang, Kun; Huan, Fan; Nam, Yong Seok; Han, Seung Ho; Kim, Dae Joong

    2013-11-01

    The aim of this study was to elucidate the precise anatomic location and tension of the medial palpebral ligament (MPL). Eleven hemifaces of 10 fresh Korean adult cadavers were used in this study. Nine specimens were used for measurement of dissection and tension, and 2 were used for histologic study. Measurements of tensile strength of each part of the MPL and Horner muscle were performed using a force gauge.The MPL consisted of 2 layers in all specimens dissected. The superficial layer of the palpebral ligament (SMPL) was observed from the anterior lacrimal crest to the upper and lower tarsal plates. The deep layer of the palpebral ligament (DMPL) lay from the anterior lacrimal crest to the posterior lacrimal crest, covering the lacrimal sac. The Horner muscle was observed at the posterior lacrimal crest just lateral to the attachment of the DMPL and ran laterally to the tarsal plate deep to the SMPL. The SMPL began at 4.5 ± 2.3 mm lateral to the nasomaxillary suture line to the upper and lower tarsal plates. Its transverse length was 9.6 ± 1.5 mm, and vertical width was 2.4 ± 0.7 mm, and its thickness was 4.5 ± 2.3 mm. The transverse length of the DMPL was 3.7 ± 0.4 mm, and its vertical width was 2.9 ± 1.3 mm, with a thickness of 0.3 ± 0.1 mm. The transverse length of the Horner muscle was 7.6 ± 1.9 mm, and its vertical width was 4.06 ± 1.5 mm, with a thickness of 0.4 ± 0.1 mm. The tensile strength of the SMPL was 13.4 ± 3.2 N, that of the DMPL was 4.1 ± 1.7 N, and that for Horner muscle was 9.0 ± 3.1 N. The tensile strength of the SMPL was significantly higher than that of the DMPL (P = 0.003).We reconfirmed that the MPL consisted of 2 layers: superficial layer and deep layer. Our results might be of use in surgeries of the medial canthi.

  15. Location and tension of the medial palpebral ligament.

    Science.gov (United States)

    Hwang, Kun; Huan, Fan; Nam, Yong Seok; Han, Seung Ho; Kim, Dae Joong

    2013-11-01

    The aim of this study was to elucidate the precise anatomic location and tension of the medial palpebral ligament (MPL). Eleven hemifaces of 10 fresh Korean adult cadavers were used in this study. Nine specimens were used for measurement of dissection and tension, and 2 were used for histologic study. Measurements of tensile strength of each part of the MPL and Horner muscle were performed using a force gauge.The MPL consisted of 2 layers in all specimens dissected. The superficial layer of the palpebral ligament (SMPL) was observed from the anterior lacrimal crest to the upper and lower tarsal plates. The deep layer of the palpebral ligament (DMPL) lay from the anterior lacrimal crest to the posterior lacrimal crest, covering the lacrimal sac. The Horner muscle was observed at the posterior lacrimal crest just lateral to the attachment of the DMPL and ran laterally to the tarsal plate deep to the SMPL. The SMPL began at 4.5 ± 2.3 mm lateral to the nasomaxillary suture line to the upper and lower tarsal plates. Its transverse length was 9.6 ± 1.5 mm, and vertical width was 2.4 ± 0.7 mm, and its thickness was 4.5 ± 2.3 mm. The transverse length of the DMPL was 3.7 ± 0.4 mm, and its vertical width was 2.9 ± 1.3 mm, with a thickness of 0.3 ± 0.1 mm. The transverse length of the Horner muscle was 7.6 ± 1.9 mm, and its vertical width was 4.06 ± 1.5 mm, with a thickness of 0.4 ± 0.1 mm. The tensile strength of the SMPL was 13.4 ± 3.2 N, that of the DMPL was 4.1 ± 1.7 N, and that for Horner muscle was 9.0 ± 3.1 N. The tensile strength of the SMPL was significantly higher than that of the DMPL (P = 0.003).We reconfirmed that the MPL consisted of 2 layers: superficial layer and deep layer. Our results might be of use in surgeries of the medial canthi. PMID:24220420

  16. Effects of mechanical strain on human mesenchymal stem cells and ligament fibroblasts in a textured poly(L-lactide) scaffold for ligament tissue engineering.

    Science.gov (United States)

    Kreja, Ludwika; Liedert, Astrid; Schlenker, Heiter; Brenner, Rolf E; Fiedler, Jörg; Friemert, Benedikt; Dürselen, Lutz; Ignatius, Anita

    2012-10-01

    The purpose of this study was to prove the effect of cyclic uniaxial intermittent strain on the mRNA expression of ligament-specific marker genes in human mesenchymal stem cells (MSC) and anterior cruciate ligament-derived fibroblasts (ACL-fibroblasts) seeded onto a novel textured poly(L-lactide) scaffold (PLA scaffold). Cell-seeded scaffolds were mechanically stimulated by cyclic uniaxial stretching. The expression of ligament matrix gene markers: collagen types I and III, fibronectin, tenascin C and decorin, as well as the proteolytic enzymes matrix metalloproteinase MMP-1 and MMP-2 and their tissue specific inhibitors TIMP-1 and TIMP-2 was investigated by analysing the mRNA expression using reverse transcriptase polymerase chain reaction and related to the static control. In ACL-fibroblasts seeded on PLA, mechanical load induced up-regulation of collagen types I and III, fibronectin and tenascin C. No effect of mechanical stimulation on the expression of ligament marker genes was found in undifferentiated MSC seeded on PLA. The results indicated that the new textured PLA scaffold could transfer the mechanical load to the ACL-fibroblasts and improved their ligament phenotype. This scaffold might be suitable as a cell-carrying component of ACL prostheses.

  17. In Vivo Study of Ligament-Bone Healing after Anterior Cruciate Ligament Reconstruction Using Autologous Tendons with Mesenchymal Stem Cells Affinity Peptide Conjugated Electrospun Nanofibrous Scaffold

    Directory of Open Access Journals (Sweden)

    Jingxian Zhu

    2013-01-01

    Full Text Available Electrospinning nanofibrous scaffold was commonly used in tissue regeneration recently. Nanofibers with specific topological characteristics were reported to be able to induce osteogenic differentiation of MSCs. In this in vivo study, autologous tendon grafts with lattice-like nanofibrous scaffold wrapping at two ends of autologous tendon were used to promote early stage of ligament-bone healing after rabbit ACL reconstruction. To utilize native MSCs from bone marrow, an MSCs specific affinity peptide E7 was conjugated to nanofibrous meshes. After 3 months, H-E assessment and specific staining of collagen type I, II, and III showed direct ligament-bone insertion with typical four zones (bone, calcified fibrocartilage, fibrocartilage, and ligament in bioactive scaffold reconstruction group. Diameters of bone tunnel were smaller in nanofibrous scaffold conjugated E7 peptide group than those in control group. The failure load of substitution complex also indicated a stronger ligament-bone insertion healing using bioactive scaffold. In conclusion, lattice-like nanofibrous scaffold with specific MSCs affinity peptide has great potential in promoting early stage of ligament-bone healing after ACL reconstruction.

  18. Proliferative activity in the juxtaradicular human periodontal ligament.

    Science.gov (United States)

    Sayaniwas, M; Hilliges, M; Lindskog, S

    1999-08-01

    The aim of the present study was to evaluate cell proliferation, assessed by MIB 1, with respect to the type and the distribution of proliferating cells in the healthy juxtaradicular periodontal ligament (PDL) from completely formed human teeth. Immunohistochemical markers against vimentin, CD68 and S-100 were used to characterize cell type. The applicability of the immunohistochemical method on explants of human PDL was also evaluated. The results indicated that under physiological conditions, the majority of the proliferating cells in the PDL were mesenchymal cells predominantly located paravascularly in the middle third of the PDL. Furthermore, MIB 1 reacting with the Ki-67 antigen together with the avidin-biotin-complex technique was proved to be an efficient marker of cell proliferation in explants of human PDL. PMID:10815567

  19. Round Ligament of Uterus Leiomyoma: An Unusual Cause of Dyspareunia

    Directory of Open Access Journals (Sweden)

    Ozer Birge

    2015-01-01

    Full Text Available Round ligament of uterus leiomyoma is a rare, benign tumor of the vulva. Its incidence is not known exactly, and the mean age ranges from 13 to 70. Although clinical properties of benign and malignant diseases in the vulvar area are frequently similar, early diagnosis and treatment are essential. Local excision is recommended as definitive therapy. We present an 28-year-old female without any birth with a mass in anterior vaginal wall diagnosed as vulvar leiomyoma. In conclusion, a brief review of relevant literature emphasizes that leiomyomas are quite rare outside of the uterus but they might occur in any tissue or organ containing smooth muscle, spontaneously or parasitically after the spreading effect of an accident or surgical trauma. Clinicians should be alert especially for the diagnosis in a tissue with smooth muscle content.

  20. Rupture of the Posterior Cruciate Ligament: Preoperative and Postoperative Assessment.

    Science.gov (United States)

    Parkar, Anagha P; Alcalá-Galiano, Andrea

    2016-02-01

    Posterior cruciate ligament (PCL) ruptures are not common, but reconstruction is increasing because PCL-deficient knees are prone to develop osteoarthritis. Preoperative MRI may confirm a total or partial disruption of PCL fibers. An overstretched PCL is often mistaken for an intact PCL while the knee is functionally PCL deficient, resulting in false-negative MRI reports. Posterior translation of the medial condyle is a useful indirect sign on imaging. Preoperative stress radiographs are used to quantify the degree of PCL deficiency, and posterior translation determines whether to treat conservatively or with surgery. Early postoperative imaging is performed to evaluate tunnel placement and fixation devices. Late postoperative imaging is performed to assess graft rupture, arthrofibrosis, or tunnel widening. Pre- and postoperative imaging plays an important part in planning and treating functionally PCL-deficient knees and PCL ruptures. PMID:27077586