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Sample records for bucket-handle meniscal tears

  1. Magnetic resonance imaging of meniscal bucket-handle tears

    International Nuclear Information System (INIS)

    To define MR signs of meniscal bucket-handle tears and evaluate the diagnostic efficiency of this technique. Retrospective study of 30 patients with a meniscal bucket-handle tear and 30 with a different type of tear, all proven by arthroscopy. The following MR signs of a bucket-handle tear were evaluated: 'separate meniscal fragment, 'double posterior cruciate ligament', 'snake sign' and 'double anterior horn'. A correct diagnosis of a bucket-handle tear was only made in 18/30 of patients. Several of the MR signs were seen in the same patient in 17 cases. A double posterior cruciate ligament was present only in cases of medial meniscus tears. The 12 menisci without these signs, and therefore not diagnosed as bucket-handle tears, were all classified as meniscal tears on the basis of signal extending to the meniscal surface. Nine of these were not displaced into the inter-condylar notch at arthroscopy. The interobserver agreement was excellent: kappa 0.88. The diagnosis of a bucket-handle meniscal tear, if it is displaced, can be made when one or more of the four MR evaluated signs are present. Other forms of meniscal tears are only exceptionally diagnosed as bucket-handle tears. (authors)

  2. Free medial meniscal fragment which mimics the dislocated bucket-handle tear on MRI.

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    Türkmen, Faik; Korucu, Ismail Hakkı; Sever, Cem; Demirayak, Mehmet; Goncü, Gani; Toker, Serdar

    2014-01-01

    The bucket-handle meniscal tear is a specific type of meniscal injuries which has specific signs on MRI. An attached fragment displaced away from the meniscus with any type of tear causes bucket-handle tear of the meniscus. Magnetic resonance imaging (MRI) is the most commonly used diagnostic tool for meniscal injuries. We present a case of free medial meniscal fragment which mimics the dislocated bucket-handle tear on MRI. The presence of "fragment within the intercondylar notch sign" and "the absence of the bow tie sign" may be an indication of a free meniscal fragment. This should be considered during diagnosis. PMID:25002980

  3. Free Medial Meniscal Fragment Which Mimics the Dislocated Bucket-Handle Tear on MRI

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    Faik Türkmen

    2014-01-01

    Full Text Available The bucket-handle meniscal tear is a specific type of meniscal injuries which has specific signs on MRI. An attached fragment displaced away from the meniscus with any type of tear causes bucket-handle tear of the meniscus. Magnetic resonance imaging (MRI is the most commonly used diagnostic tool for meniscal injuries. We present a case of free medial meniscal fragment which mimics the dislocated bucket-handle tear on MRI. The presence of “fragment within the intercondylar notch sign” and “the absence of the bow tie sign” may be an indication of a free meniscal fragment. This should be considered during diagnosis.

  4. Displaced Medial and Lateral Bucket Handle Meniscal Tears With Intact ACL and PCL.

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    Boody, Barrett S; Omar, Imran M; Hill, James A

    2015-08-01

    Bucket handle lesions are vertical longitudinal tears in the meniscus that may displace centrally into the respective medial or lateral compartment, frequently causing mechanical symptoms, including pain, perceived instability, and mechanical locking. Bucket handle meniscal tears are most commonly from a traumatic etiology and are frequently found with concomitant anterior cruciate ligament (ACL) injuries. Multiple imaging signs and associations have been described for the diagnosis of bucket handle meniscus tears, including coronal truncation, absent bow tie sign, double posterior cruciate ligament (PCL), double ACL, displacement of the bucket handle fragment, and disproportionate posterior horn signs. Among meniscal pathology encountered on magnetic resonance imaging or during arthroscopy, bucket handle meniscal tears are infrequent occurrences. Furthermore, the occurrence of displaced medial and lateral bucket handle tears found on imaging and during arthroscopy is very uncommon and is only sparsely reported in the literature. When displaced medial and lateral bucket handle meniscal segments are visualized within the intercondylar notch along with the ACL and PCL, the radiologic findings are referred to as the "quadruple cruciate" sign or the "Jack and Jill lesion." Of the few case reports described in the literature, only one noted displaced medial and lateral bucket handle meniscus tears with an intact ACL and PCL. The current case report outlines a similar rare case of the quadruple cruciate sign: displaced medial and lateral bucket handle meniscal tears located within the intercondylar notch and an intact ACL and PCL. PMID:26270763

  5. Simultaneous bicompartmental bucket handle meniscal tears with a clinically competent Anterior Cruciate Ligament

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    Wright Jonathan

    2010-09-01

    Full Text Available Abstract Bucket handle meniscal tears (BHMT of the knee occur infrequently (approximately 10% of meniscal injuries. Simultaneous, bicompartmental BHMT are extremely rare. Previously, these have only been reported in association with a ruptured anterior cruciate ligament (ACL. The pathomechanism of this injury was thought to be due to the lack of knee stability following the ACL injury. We present a case of a 38 year old male patient with bicompartmental BHMT with a clinically competent ACL. This highlights the need for clinical and radiological suspicion of simultaneous BHMTs even in the presence of an intact ACL.

  6. The displaced bucket-handle tear of the meniscus: MRI findings

    International Nuclear Information System (INIS)

    To describe the features of displaced bucket-handle tears of the menisci on magnetic resonance(MR) images and to assess associated knee injuries. We retrospectively reviewed coronal and sagittal MR images in 21 bucket-handle tears. The subjects were patients who had underwent preoperative MR evaluations of the knee and were identified from the arthroscopic surgical records as bucket-handle tear. We also described patterns of associated injuries. On coronal MR images, (a) in all cases, peripheral portion of the meniscus(bucket) had the appearance of a truncated or altered wedge; (b) central fragments(handle) were observed to be sitting in the intercondylar notch (16 cases) or located between the femoral condyle and tibial plateau (5 cases). On sequential sagittal MR images, (c) the bow-tie appearance of the body of the meniscus was not seen (13 cases); (d) the bow-tie appearance of the displaced inner fragment was seen at the intercondylar notch level (9 cases); (e) 'double posterior cruciate ligament' sign was presented (7 cases). Associated joint abnormalities included anterior cruciate ligament tears(11), contralateral meniscal tears(11), posterior cruciate ligament tears(3), medial collateral ligament tears(3), osteoarthritis(1), and Baker's cyst(1). Awareness of these characteristic MR images(a-e) may increase the sensitivity of MR imaging in the diagnosis of displaced bucket-handle tears, and the MRI may be helpful to correctly characterize the displaced fragment and patterns of associated injury, providing arthroscopists a guide to appropriate surgical plans

  7. The Diagnostic Value of Sonography in Bucket Handle Tear of Meniscus and Complete MCL Tear Compared with Arthroscopy

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    J. Najafi

    2006-05-01

    Full Text Available Background/Objective: The concept of evaluating the musculoskeletal system with ultrasound was initially introduced in the late 1970s. For evaluating meniscal tears, which are a common injury in traumatic events of knee, linear probes with high resolution have been used. In this study, we compared the results of sonography with arthroscopy in diagnosing bucket handle tear of meniscus and MCL tear. Patients and Methods: 218 clinically symptomatic knee joints with clinical indication of arthro-scopy were examined by sonography in a referral sport medicine center. The patients eventually had arthroscopic exam. The results were compared, and statistically analyzed using Fisher’s exact. Results: In this study, of 218 patient who had arthroscopy and sonography, the sensitivity and specificity of sonography in meniscal tear were 68.1% and 100%, respectively. 34 patients had bucket handle tear of the posterior horn of the medial meniscus on sonography; six cases (17.6% of which had abnormally small posterior horns of medial meniscus (in favor of meniscal tear but in 60 patients with other types of meniscal tear, sonography revealed tear in 58 (96.6%(P<0.0001. Six patients had complete MCL tear in arthroscopy, while in sonography 4 complete MCL tears were shown. Sensitivity of ultrasound in diagnosing complete MCL tear was 66.6% and specificity of 98%. Conclusion: Ultrasound is easily applicable in evaluation of knee derangement: however, for bucket handle tears it has limited application. For MCL tears, sonography seems an accurate method. Ultrasonography is rapid, low-cost and non-invasive examination.

  8. The double flipped meniscus sign: unusual MRI findings in bucket-handle tear of the lateral meniscus.

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    Ahn, Jin Hwan; Yim, Soo Jae; Seo, Yu Seok; Ko, Taeg Su; Lee, Joon Hee

    2014-01-01

    Bucket-handle meniscal tears are either longitudinal, vertical, or oblique in direction with an attached tear fragment displaced from the meniscus. Magnetic resonance imaging (MRI) signs are widely used in the diagnosis of these tears, including the 'fragment within the intercondylar notch sign', 'flipped meniscus sign', 'double anterior horn sign', 'absence of the bow tie sign', 'double posterior cruciate ligament (PCL) sign', 'posterior double PCL sign', and 'triple PCL sign'. We report an unusual case, not yet described in previous studies, of a bucket-handle tear presenting as a double longitudinal tear of the lateral meniscus (LM). Two longitudinal tears were observed in the white-white zone and the red-white zone of the LM, where both fragments were shown to be displaced and locked within the intercondylar notch. Partial menisectomy was performed for the central fragment and a repair with modified all-inside sutures was performed for the peripheral fragment. PMID:24156924

  9. 半月板桶柄状撕裂的MRI诊断与关节镜下分类的相关研究%MR imaging of meniscal bucket-handle tears:a retrospective study of signs and the relation to arthroscopic classification

    Institute of Scientific and Technical Information of China (English)

    刘亚非; 张兵; 赵玉霞

    2010-01-01

    Objective To evaluate the arthroscopic findings of meniscal bucket handle tears and to correlate them with the proposed MR imaging signs of meniscal bucket handle tears suggested in the literature. Methods Sixty-three patients who had a diagnosis of bucket handle tear in arthroscopy were included in our study.Meniscal tears were evaluated in arthroscopy according to Dandy's classification.The MRIs were retrospectively analyzed regarding the following findings:absence of bow tie sign,presence of double posterior cruciate ligament(PCL), fragment within the intercondylar region,flipped meniscus sign, abnormal circumferential meniscus sign. Sensitivity were evaluated for the presence of each individual sign. Results Locked types Ⅰand Ⅱfragment of medial meniscus and half-length,whole-width and whole length-half-width fragement of lateral meniscus in arthroscopy were correlated with fragement within the intercondylar notch and absent bow tie signs in MRI.We didn't find the double PCL sign in any of the patients with a lateral meniscal bucket handle tear.The most common signs in MR imagings of meniscal bucket handle tears were the fragement in the notch sign and the absent bow tie sign.They were observed with frequency of 84.6% and 81.5% respectively.The presence of double posterior cruciate ligament, flipped meniscus sign, abnormal circumferential meniscus sign were less common(43%,21.5% and 29.2%,respectively). Conclusions The presence of at least two of the five MRI signs should be regarded as highly suggestive for bucket handle tears of menisci.%目的 探讨MRI对半月板桶柄状撕裂的诊断与关节镜下分类的比较研究.方法 分析63例患者65个经关节镜检查证实为半月板桶柄状撕裂的术前MRI的特征性表现,并将5种MRI征象(双后交叉韧带征、半月板翻转征、空领结征、碎块内移征和外周残半月板征)与关节镜下Dandy分型进行比较.结果 MRI桶柄状撕裂诊断符合率89.2%.碎块内移征和

  10. Spontaneous healing of bucket handle tear of the medial meniscus associated with ACL tear Resolução espontânea da lesão alça de balde do menisco medial associado com rotura de LCA

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    Neiffer Nunes Rabelo; Nícollas Nunes Rabelo; Aluísio Augusto Gonçalves Cunha; Francisco Correia

    2013-01-01

    We report a case of injury of the medial bucket handle meniscal tears (BH), which resolved spontaneously, in association with anterior cruciate ligament (ACL) injury. The patient twisted his left knee during a fight in martial arts, progressing to pain and joint locking and a sense of distortion. In NMR it could be seen bucket-handle tear of the medial meniscus with displacement of the fragment to the intercondylar region, rupture of the lateral meniscus and ACL tear. After conservative treat...

  11. Bucket-handle tear of a discoid lateral meniscus in a 6-year-old girl

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    Yalcin, Nadir; Bektaser, Bulent; Cicekli, Ozgur; Dogan, Metin

    2004-01-01

    A six-year-old girl was examined upon development of pain, swelling, and locking in her right knee after a considerable period of discomfort and popping sensation. She had no history of trauma. Magnetic resonance imaging showed a discoid lateral meniscus, filling the entire lateral plateau and exhibiting signs of degeneration. On arthroscopic examination, a bucket-handle tear of the discoid lateral meniscus was noted and the patient was treated with arthroscopic subtotal meniscectomy. During ...

  12. MRI demonstration of occult purely chondral fractures of the tibia: a potential mimic of meniscal tears

    International Nuclear Information System (INIS)

    We report the case of a 12-year-old boy with bilateral, purely chondral fractures of the tibia. The patient had Crohn's disease treated with systemic corticosteroids. MR images of the knee were initially interpreted to show a bucket-handle tear of the lateral meniscus. However, arthroscopic evaluation revealed purely chondral fractures of the tibial plateau without meniscal damage. Re-evaluation of the MR study identified the chondral fracture of the lateral tibial articular cartilage detected arthroscopically. This purely chondral fracture of the tibial plateau represented a rare finding in the symptomatic knee that mimicked a meniscal tear by history, physical exam, and MR imaging. (orig.). With 4 figs

  13. Painful locking of the knee due to bucket handle tear of mediopatellar plica

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    HE Rui; YANG Liu; GUO Lin

    2011-01-01

    A case of swelling and anterior painful knee due to tear of mediopatellar plica is reported. The patient also felt clunk of the patellofemoral joint and knee locking. Under arthroscopic examination, a thick and fibrous plica was found medial to patellar, and a bucket tear along the plica fi.om medial patellar retinaculum to infrapatellar fat pad. Polarized microscopic examination showed collagen fiber fragment and loss of light reflecting property. Neuroimmunohistology suggested up-regulation of synovial plica innervation in the area around the crack. This may be related to the pain. The bucket tear of mediopatellar plicacaused pain and lock of knee are more common than previously reported.

  14. Painful locking of the knee due to bucket handle tear of

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    HE Rui

    2011-04-01

    Full Text Available 【Abstract】 A case of swelling and anterior painful knee due to tear of mediopatellar plica is reported. The patient also felt clunk of the patellofemoral joint and knee locking. Under arthroscopic examination, a thick and fibrous plica was found medial to patellar, and a bucket tear along the plica from medial patellar retinaculum to infrapatellar fat pad. Polarized microscopic examination showed collagen fiber fragment and loss of light reflecting property. Neuroimmunohistology suggested up-regulation of synovial plica innervation in the area around the crack. This may be related to the pain. The bucket tear of mediopatellar plicacaused pain and lock of knee are more common than previously reported. Key words: Knee injuries; Arthroscopy; Patellofemoral joint

  15. The Special Sign Analysis of Bucket Handle Tears of Lateral Meniscus on the Low Field MRI%外侧半月板桶柄状撕裂低场MRI特殊征象分析

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    姚海泉; 胡智斌; 林洪平

    2011-01-01

    Objective To report special sign of bucket handle tears( BHT) of lateral meniscus on the low field MRI. Materials and Methods The low field MRI findings of 12 patients with BHT of lateral meniscus were retrospectively analyzed. The typical signs were summarized, the analysis for double anterior cruciate ligament sign and thick cake sign and "triple ligament sign"were focused. Results Of 12 cases,double anterior cruciate ligament signs were seen in 3 cases, flipped meniscus signs were seen in 6 cases, absent bow tie signs were seen in 12 cases, internal displaced fragment signs were seen in 10 cases, abnormal circumferential meniscus signs were seen in 9 cases, thick cake signs were seen in 4 cases, "triple ligament signs" were seen in 3 cases. Conclusion Internal displaced fragment sign, abnormal circumferential meniscus sign, flipped meniscus sign and absent bow tie sign are seen on the the medial meniscal as the same as on the lateral meniscal,double anterior cruciate ligament sign and thick cake sign and "triple ligament sign" are more common seen in bucket handle tears( BHT) of lateral meniscus.%目的 分析膝关节外侧半月板桶柄状撕裂(bucket-handle tears,BHT)的低场MRI特殊征象.资料与方法回顾性分析12例经关节镜证实为膝关节外侧半月板BHT患者的低场强MRI图像,总结MRI征象,除碎块内移征、外周残半月板征、半月板翻转征、空领结征外,着重分析双前交叉韧带征、厚饼征、三韧带征.结果 12例外侧半月板BHT中,碎块内移征10例、外周残半月板征9例、半月板翻转征6例、空领结征12例、双前交叉韧带征3例、厚饼征4例、三韧带征3例.结论 碎块内移征、外周残半月板征、半月板翻转征、空领结征见于内侧半月板BHT,同样见于外侧半月板BHT,前交叉韧带征、厚饼征和三韧带征为外侧半月板BHT特殊征象.

  16. MR diagnosis of meniscal tears of the knee

    International Nuclear Information System (INIS)

    Many reports have been published about the utilization of MR imaging for the diagnosis of the meniscal injury of the knee. The grading system frequently used in these reports was proposed by Mink, although, this grading does not measure menisci with structural abnormality such as discoid deformity and bucket handle tear. Accordingly, there is ample room for further improvement in this evaluating system. To pursuit the accuracy of our newly designed grading system, we performed retrospective study on 128 patients who underwent MRI examination prior to arthroscopic examination. Furthermore, follow up study of the menisci, which showed high-intensity signal, was done to ascertain whether such abnormalities progress to meniscal tears. Based upon the newly developed grading system, the accuracy in identifying meniscal tears of lateral meniscus was 91.4% and median meniscus was 88.3% respectively. These accuracy compare favorably with the results of previously reported grading systems. Follow up MRIs and confirmation with arthroscopic examination were carried out in 13 cases which showed high-intensity signal in the meniscus. The mean interval between the initial and follow up imaging was 29 months (range, 15-50 months). In 7 cases of stable knee, increment of intra-meniscal intensity and zone were observed, although, there was no progression of grade and no tear was revealed by arthroscopic examination. On the other hand, in 6 cases with cruciate ligament injury, progression of the grade was observed. The results suggest that intra-meniscal derangement does not progress if the knee is stable and patient's activity is within recreation sports activity. (author)

  17. MRI diagnosis of meniscal tears

    International Nuclear Information System (INIS)

    We studied the accuracy of magnetic resonance imaging (MRI) of the knee in fifty-six patients who were also examined arthroscopically. The accuracy, sensitivity, and specificity were 96%, 100%, and 95% for medial meniscal tears, and 91%, 67%, and 100% for lateral meniscal tears respectively. Two MRIs of the medial meniscus were false-positives. These MRI findings were both meniscocapsular separation of the medial meniscus, but the arthroscopic findings were normal. One case was an ACL injury and the other PCL and MCL injury. Hemorrhage and edema of the medial capsule caused by valgus stress at injury may look like a meniscal pseudo-tear on MRI. Five MRIs of the lateral meniscus were false-negatives. All menisci showed normal signal and shape on MRI but traumatic and stable tears of the lateral meniscus were identified arthroscopically. All were associated with ACL tears and lateral condylar bone bruise. The traumatic and stable tear of the meniscus tended to be overlooked on MRI because a meniscus without degeneration shows a normal signal. (author)

  18. Spontaneous healing of bucket handle tear of the medial meniscus associated with ACL tear Resolução espontânea da lesão alça de balde do menisco medial associado com rotura de LCA

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    Neiffer Nunes Rabelo

    2013-01-01

    Full Text Available We report a case of injury of the medial bucket handle meniscal tears (BH, which resolved spontaneously, in association with anterior cruciate ligament (ACL injury. The patient twisted his left knee during a fight in martial arts, progressing to pain and joint locking and a sense of distortion. In NMR it could be seen bucket-handle tear of the medial meniscus with displacement of the fragment to the intercondylar region, rupture of the lateral meniscus and ACL tear. After conservative treatment and physiotherapy, in an interval of one year, later examinations showed that there was spontaneous healing of ABNeste trabalho é relatado um caso de lesão do menisco medial do tipo em alça de balde (AB, que se resolveu espontaneamente, em associação com lesão de ligamento cruzado anterior (LCA. O paciente torceu o joelho esquerdo durante uma luta em artes maciais, evoluindo com dor e bloqueio articular e sensação de falseamento. Na RMN havia rotura em alça de balde do menisco medial com deslocamento do fragmento para a região intercondilar, rotura do menisco lateral e rotura do LCA. Após tratamento clínico e fisioterápico, em um intervalo de um ano, o exame de controle demonstrou que havia ocorrido resolução espontânea da AB.

  19. Rotura em "alça de balde" simultânea dos meniscos no mesmo joelho Simultaneous "bucket-handle" tear of both menisci on the same knee

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    Andre Francisco Gomes

    2009-01-01

    Full Text Available Rotura em "alça de balde" de ambos os meniscos do mesmo joelho é um fenômeno raro. Apresentamos o caso de um paciente em que a ressonância magnética demonstrou rotura em "alça de balde" dos meniscos medial e lateral do mesmo joelho, associada a rotura do ligamento cruzado anterior, confirmado por videoartroscopia. A ressonância magnética demonstra sinais que permitem o diagnóstico preciso.Simultaneous "bucket-handle" tear of menisci on the same knee is a rare phenomenon. We describe a case of a bucket-handle tear of menisci and tear of anterior cruciate ligament of the same knee showed on magnetic resonance imaging and confirmed by arthroscopy. The magnetic resonance imaging can provide accurate diagnosis of this type of injury.

  20. MRI诊断膝关节半月板桶柄状撕裂%The bucket-handle tears of knee menisci on MRI

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    蔡泽银; 麦春华

    2011-01-01

    Objective : To evaluate the MR imaging findings in diagnosing the bucket handle tears (BHT) of menisci of the knee. Methods: MR imaging of 146 knees with arthroscopy exams were retrospectively evaluated. Based on the results of arthroscopy,28 knees had BHT. Five MRI signs were observed, including internal displaced fragment sign, abnormal circumferential meniscus sign,double posterior cruciate ligament sign,absent bow tie sign and flipped meniscus sign. Sensitivity, specificity, positive and negative predictive values,and accuracy for diagnosing menisci BHT of the five signs were calculated. Results: Of the five MRI signs, the internal displaced fragment sign had highest diagnostic sensitivity, accuracy and negative predictive values. The double posterior cruciate ligament sign has the highest specificity and positive predictive value. Conclusion : BHT of menisci had characteristic MRI findings and the internal displaced fragment sign is the most essential and reliable sign.%目的:总结分析半月板桶柄状撕裂的MRI征象和诊断价值.方法:回顾性分析146个经关节镜证实的膝关节MR图像,其中28个膝关节存在半月板桶柄状撕裂,记录如下5种MRI征象:碎块内移征、外周残半月板征、双PCL征、空领结征及双前角征,并分别计算每种征象诊断半月板桶柄状撕裂的敏感度、特异度、准确度、阳性预测值和阴性预测值.结果:5种征象中碎块内移征具有最高的敏感度、准确度和阴性预测值,而双PCL征具有最高的特异性和阳性预测值.结论:半月板桶柄状撕裂具有典型的MRI征象,其中碎块内移征是诊断半月板桶柄状撕裂的最基础、可靠的征象.

  1. Association of peripheral vertical meniscal tears with anterior cruciate ligament tears

    International Nuclear Information System (INIS)

    The purpose of this article is to describe a type of meniscal tear seen on magnetic resonance (MR) imaging, the peripheral vertical tear, and to determine the prevalence of anterior cruciate ligament (ACL) tears in knees with this type of meniscal tear compared to knees with other types of meniscal tears. Following Institutional Review Board approval, a retrospective review of 200 knee MR examinations with imaging diagnoses of 'meniscal tear' was performed to assess the location and morphology of the meniscal tear, and to assess the status of the ACL. Nineteen peripheral vertical meniscal tears were identified in 17 patients, 14 of whom had acute ACL tears, prior ACL reconstruction, or chronic ACL deficiency. Three peripheral vertical tears were seen in the setting of a normal ACL. Of the 183 examinations with other types of meniscal tears, there were 17 cases with acute ACL tears, prior ACL reconstruction, or chronic ACL deficiency. The difference in the prevalence of ACL tear, reconstruction, or deficiency in knees with meniscal tears of the peripheral vertical type (82.4%) compared with the prevalence of ACL tear, reconstruction, or deficiency in knees with other types of meniscal tears (9.3%) was statistically significant (P < 0.001). The calculated specificity of the presence of peripheral vertical tear morphology in detecting an ACL injury in patients with meniscal tears was 98.2%. Peripheral vertical meniscal tears, particularly when involving the posterior horn, are highly associated with ACL tear, deficiency, or reconstruction. The finding of this type of tear on knee MR imaging should prompt close inspection of the ACL for evidence of acute or chronic injury, and its presence may help make the diagnosis of ACL tear in equivocal cases. (orig.)

  2. Association of peripheral vertical meniscal tears with anterior cruciate ligament tears

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    Vinson, Emily N.; Gage, Jeffrey A.; Lacy, Joe N. [Duke University Medical Center, Department of Radiology, Durham, NC (United States)

    2008-07-15

    The purpose of this article is to describe a type of meniscal tear seen on magnetic resonance (MR) imaging, the peripheral vertical tear, and to determine the prevalence of anterior cruciate ligament (ACL) tears in knees with this type of meniscal tear compared to knees with other types of meniscal tears. Following Institutional Review Board approval, a retrospective review of 200 knee MR examinations with imaging diagnoses of 'meniscal tear' was performed to assess the location and morphology of the meniscal tear, and to assess the status of the ACL. Nineteen peripheral vertical meniscal tears were identified in 17 patients, 14 of whom had acute ACL tears, prior ACL reconstruction, or chronic ACL deficiency. Three peripheral vertical tears were seen in the setting of a normal ACL. Of the 183 examinations with other types of meniscal tears, there were 17 cases with acute ACL tears, prior ACL reconstruction, or chronic ACL deficiency. The difference in the prevalence of ACL tear, reconstruction, or deficiency in knees with meniscal tears of the peripheral vertical type (82.4%) compared with the prevalence of ACL tear, reconstruction, or deficiency in knees with other types of meniscal tears (9.3%) was statistically significant (P < 0.001). The calculated specificity of the presence of peripheral vertical tear morphology in detecting an ACL injury in patients with meniscal tears was 98.2%. Peripheral vertical meniscal tears, particularly when involving the posterior horn, are highly associated with ACL tear, deficiency, or reconstruction. The finding of this type of tear on knee MR imaging should prompt close inspection of the ACL for evidence of acute or chronic injury, and its presence may help make the diagnosis of ACL tear in equivocal cases. (orig.)

  3. Is Surgery Always Needed for Meniscal Tears of the Knee?

    Science.gov (United States)

    ... A meniscal tear is a common and disabling knee injury affecting many Americans at some point in their ... Services, or federal policy. More Health News on: Knee Injuries and Disorders Surgery Recent Health News Related MedlinePlus ...

  4. Isolated medial meniscal tear in a Border Collie.

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    Ridge, P A

    2006-01-01

    A three-year-old, female Border Collie was successfully treated for an isolated, torn, medial meniscus by arthroscopic meniscal tear resection. The dog returned to agility competition without recurrence of lameness. PMID:16810354

  5. Posterior horn medial meniscal root tear: the prequel

    International Nuclear Information System (INIS)

    To determine whether subarticular marrow changes deep to the posterior horn medial meniscal root anchor might predict subsequent medial meniscal root tear. Fifteen patients with MR-diagnosed posterior horn medial meniscal root (PHMMR) tear and a knee MRI antecedent to the tear were identified at three imaging centers over a 7-year period. The pre- and post-tear MR images were evaluated for marrow signal changes deep to the root anchor, meniscal root signal intensity, medial compartment articular cartilage thinning, and meniscal body extrusion. Images of 29 age- and gender-matched individuals with two MRIs of the same knee were reviewed as a control group. MRI in 11 of 15 (73 %) cases with subsequent PHMMR tear demonstrated linear subcortical marrow edema deep to the meniscal root anchor on the antecedent MRI compared to only 1 of 29 (3 %) non-tear controls (p < 0.0001). The abnormal signal resolved on post-tear MRI in all but two patients. Cyst-like changes deep to the PHMMR were present on initial MRI in three of 15 (23 %) cases and three of 29 (10 %) controls, persisting in all but one case on follow-up imaging. The PHMMR was gray on the initial MRI in seven of 15 (47 %) of cases that developed tears compared to four of 29 (14 %) controls (p < 0.0001). There was medial meniscal extrusion (MME) prior to tear in two of 15 (13 %) patients and in ten of 15 (67 %) patients after PHMMR failure. In the control group, MME was present in one (3 %) and three (10 %) of 29 subjects on the initial and follow-up MRIs, respectively. Articular cartilage loss was noted in two of 15 (15 %) cases before tear and nine of 15 (69 %) on follow-up imaging, as compared to one (3 %) and four (14 %) of 29 subjects in the control group. Subcortical marrow edema deep to the PHMMR may result from abnormal stresses and thus be a harbinger of meniscal root failure. This hypothesis is supported by resolution of these marrow signal changes after root tear. Following tear, extrusion of the

  6. Posterior horn medial meniscal root tear: the prequel

    Energy Technology Data Exchange (ETDEWEB)

    Umans, H. [Albert Einstein College of Medicine, Bronx, NY (United States); Lenox Hill Radiology and Imaging Associates, New York, NY (United States); Morrison, W. [Thomas Jefferson University Hospital, Philadelphia, PA (United States); DiFelice, G.S. [Hospital for Special Surgery, New York, NY (United States); Vaidya, N. [Crystal Run Healthcare, Middletown, NY (United States); Winalski, C.S. [Cleveland Clinic, Imaging Institute, Department of Biomedical Engineering, Lerner Research Institute, Cleveland, OH (United States)

    2014-06-15

    To determine whether subarticular marrow changes deep to the posterior horn medial meniscal root anchor might predict subsequent medial meniscal root tear. Fifteen patients with MR-diagnosed posterior horn medial meniscal root (PHMMR) tear and a knee MRI antecedent to the tear were identified at three imaging centers over a 7-year period. The pre- and post-tear MR images were evaluated for marrow signal changes deep to the root anchor, meniscal root signal intensity, medial compartment articular cartilage thinning, and meniscal body extrusion. Images of 29 age- and gender-matched individuals with two MRIs of the same knee were reviewed as a control group. MRI in 11 of 15 (73 %) cases with subsequent PHMMR tear demonstrated linear subcortical marrow edema deep to the meniscal root anchor on the antecedent MRI compared to only 1 of 29 (3 %) non-tear controls (p < 0.0001). The abnormal signal resolved on post-tear MRI in all but two patients. Cyst-like changes deep to the PHMMR were present on initial MRI in three of 15 (23 %) cases and three of 29 (10 %) controls, persisting in all but one case on follow-up imaging. The PHMMR was gray on the initial MRI in seven of 15 (47 %) of cases that developed tears compared to four of 29 (14 %) controls (p < 0.0001). There was medial meniscal extrusion (MME) prior to tear in two of 15 (13 %) patients and in ten of 15 (67 %) patients after PHMMR failure. In the control group, MME was present in one (3 %) and three (10 %) of 29 subjects on the initial and follow-up MRIs, respectively. Articular cartilage loss was noted in two of 15 (15 %) cases before tear and nine of 15 (69 %) on follow-up imaging, as compared to one (3 %) and four (14 %) of 29 subjects in the control group. Subcortical marrow edema deep to the PHMMR may result from abnormal stresses and thus be a harbinger of meniscal root failure. This hypothesis is supported by resolution of these marrow signal changes after root tear. Following tear, extrusion of the

  7. Marginal fractures of the medial tibial plateau: possible association with medial meniscal root tear

    International Nuclear Information System (INIS)

    We report two cases of marginal fractures of the medial tibial plateau associated with medial meniscal root tears. Both patients sustained knee dislocations, with complete tears of the posterior horn medial meniscal root. One sustained a ''reverse Segond fracture''; the other sustained an ''anteromedial impingement fracture'' of the tibial plateau. The meniscal root tears were arthroscopically confirmed and repaired. In the first patient, the integrity of the meniscal root repair was confirmed at a 6-month follow-up arthroscopy for lysis of adhesions. In the second patient, follow-up MRI at 10 months demonstrated a healed meniscal root. The association of medial meniscal root tear with marginal fractures of the medial tibial plateau has not been previously reported. (orig.)

  8. Marginal fractures of the medial tibial plateau: possible association with medial meniscal root tear

    Energy Technology Data Exchange (ETDEWEB)

    Engelsohn, Eliyahu [Jacobi Medical Center, Department of Radiology, Bronx, NY (United States); Umans, Hilary [Jacobi Medical Center, Department of Radiology, Bronx, NY (United States); Jacobi Medical Center, Department of Orthopedic Surgery, Ardsley, NY (United States); DiFelice, Gregory S. [Jacobi Medical Center, Department of Orthopedic Surgery, Ardsley, NY (United States)

    2007-01-15

    We report two cases of marginal fractures of the medial tibial plateau associated with medial meniscal root tears. Both patients sustained knee dislocations, with complete tears of the posterior horn medial meniscal root. One sustained a ''reverse Segond fracture''; the other sustained an ''anteromedial impingement fracture'' of the tibial plateau. The meniscal root tears were arthroscopically confirmed and repaired. In the first patient, the integrity of the meniscal root repair was confirmed at a 6-month follow-up arthroscopy for lysis of adhesions. In the second patient, follow-up MRI at 10 months demonstrated a healed meniscal root. The association of medial meniscal root tear with marginal fractures of the medial tibial plateau has not been previously reported. (orig.)

  9. Multiple MRI signs in diagnosis of bucket-handle tears of the knee menisci%MRI多征象分析诊断半月板桶柄状撕裂

    Institute of Scientific and Technical Information of China (English)

    梁绮玲; 韩立新; 曹惠霞; 杜渭清; 崔静

    2011-01-01

    目的 探讨MRI多征象分析诊断半月板桶柄状撕裂(BHT)的价值.方法 回顾性分析84个经关节镜证实为半月板损伤的膝关节的MR图像,其中42个膝关节为半月板BHT,另42个膝关节为非BHT.观察以下8种征象:双后交叉韧带(PCL)征、半月板翻转征、空领结征、领结残破征、后角残破征、厚饼征、碎块内移征及外周残半月板征,分别计算每种征象诊断半月板BHT的敏感度、特异度、阳性预测值、阴性预测值和准确率.结果 双PCL征、半月板翻转征、厚饼征、碎块内移征及外周残半月板征具有相对高的特异度,但除碎块内移征及外周残半月板征的敏感度相对高外,其余6种MRI征象的敏感度均较小.结论 半月板BHT可有多种MRI表现,碎块内移征与外周残半月板征最具诊断价值,而双PCL征、半月板翻转征及厚饼征特异度较高,这些征象的出现强烈提示半月板BHT.%Objective To assess the diagnostic value of multiple MRI signs in diagnosis of bucket-handle tears (BHT) of the knee menisci. Methods MRI images of 84 knee joints with menisci injury were retrospectively analyzed. There were 42 knees with BHT of menisci and 42 knees without BHT of menisci according to arthroscopy. Double posterior cruciate ligament sign, flipped meniscus sign, absent bow tie sign, bow tie broken sign, posterior angle broken sign, thick pastry sign, internal displaced fragment sign and abnormal circumferential meniscus sign were observed. The sensitivity, specificity, positive and negative predictive values and accuracy for diagnosing BHT of menisci were calculated for the presence of each individual sign. Results Among these eight signs, double posterior cruciate ligament sign, flipped meniscus sign, thick pastry sign, internal displaced fragment sign and abnormal circumferential meniscus sign had relative high specificities. Most of the signs except internal displaced fragment sign and abnormal circumferential

  10. Kissing contusion between the posterolateral tibial plateau and lateral femoral condyle: associated ligament and meniscal tears

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Hyun Pyo; Lee, Jae Gue; Park, Ji Seon; Ryu, Kyung Nam [Kyunghee Univ., Seoul (Korea, Republic of)

    2004-02-01

    Kissing contusion between the posterolateral tibial plateau and lateral femoral condyle is frequently found in association with a tear of the anterior cruciate liagment (ACL). The purpose of this study was to determine which ligamentous and meniscal tears are associated with kissing contusion. We retrospectively reviewed the findings depicted by 323 consecutive MR images of the knee and confirmed at arthroscopy. For the diagnosis of disruption, ligaments, medial menisci (MM) and lateral menisci (LM) were evaluated using accepted criteria. We compared the prevalence and location of meniscal and ligamentous tears between group I (44 knees with kissing contusion) and group II (279 knees without kissing contusion). For statistical analysis the chi-square test was used. ACLs were torn in all 44 knees (100%) with kissing contusion, and 78 (28%) of 279 without kissing contusion. There were ten medial collateral ligament (MCL) tears (23%) in group I, and 17 MCL tears (6%), five lateral collateral ligament (LCL) tears (2%) and ten posterior cruciate ligament (PCL) tears (4%) in group II. In group I, meniscal tears were found in 22 MM (50%) and in 19 LM (43%), while in group II, they occurred in 128 MM (46%) and 128 LM (46%), In group I, 17 (77%) of 22 MM tears and 13 (68%) of 19 LM tears were located in the posterior horn, while in group II, the corresponding figures were 97/128 (76%) and 60 of 128 (47%). The differing prevalence of ACL and MCL tears between the groups was statistically significant (p<0.05), but differences in the prevalence and location of meniscal tears were not (p>0.05). Although kissing contusion was a highly specific sign of ACL tears, its presence was also significant among MCL tears. There was no significant difference in meniscal tears with or without kissing contusion.

  11. Kissing contusion between the posterolateral tibial plateau and lateral femoral condyle: associated ligament and meniscal tears

    International Nuclear Information System (INIS)

    Kissing contusion between the posterolateral tibial plateau and lateral femoral condyle is frequently found in association with a tear of the anterior cruciate liagment (ACL). The purpose of this study was to determine which ligamentous and meniscal tears are associated with kissing contusion. We retrospectively reviewed the findings depicted by 323 consecutive MR images of the knee and confirmed at arthroscopy. For the diagnosis of disruption, ligaments, medial menisci (MM) and lateral menisci (LM) were evaluated using accepted criteria. We compared the prevalence and location of meniscal and ligamentous tears between group I (44 knees with kissing contusion) and group II (279 knees without kissing contusion). For statistical analysis the chi-square test was used. ACLs were torn in all 44 knees (100%) with kissing contusion, and 78 (28%) of 279 without kissing contusion. There were ten medial collateral ligament (MCL) tears (23%) in group I, and 17 MCL tears (6%), five lateral collateral ligament (LCL) tears (2%) and ten posterior cruciate ligament (PCL) tears (4%) in group II. In group I, meniscal tears were found in 22 MM (50%) and in 19 LM (43%), while in group II, they occurred in 128 MM (46%) and 128 LM (46%), In group I, 17 (77%) of 22 MM tears and 13 (68%) of 19 LM tears were located in the posterior horn, while in group II, the corresponding figures were 97/128 (76%) and 60 of 128 (47%). The differing prevalence of ACL and MCL tears between the groups was statistically significant (p0.05). Although kissing contusion was a highly specific sign of ACL tears, its presence was also significant among MCL tears. There was no significant difference in meniscal tears with or without kissing contusion

  12. Occupational kneeling and meniscal tears: a magnetic resonance imaging study in floor layers

    DEFF Research Database (Denmark)

    Rytter, Søren; Jensen, Lilli Kirkeskov; Bonde, Jens Peter;

    2009-01-01

    presence of grade 3 MRI signal intensities indicating degenerative tears of the anterior, middle, and posterior one-third of the lateral and medial menisci was assessed on 1.5-Tesla MRI scans. The odds ratio (OR) of meniscal tears was determined among floor layers compared to graphic designers. Using...

  13. Posterior horn lateral meniscal tears simulating meniscofemoral ligament attachment in the setting of ACL tear: MRI findings

    International Nuclear Information System (INIS)

    We have noted apparent far lateral meniscal attachment of the meniscofemoral ligament (MFL) with an anterior cruciate ligament (ACL) tear. This study evaluates MFL attachment and association with posterior horn lateral meniscus (PHLM) tear. Nine months of knee arthroscopy reports were reviewed to classify the PHLM and ACL as torn or normal. After excluding those with prior knee surgery, MR images were reviewed by two radiologists to determine the number of images lateral to PCL, which showed the ligaments of Humphrey and Wrisberg visible as structures separate from the PHLM. Any patient with abnormal PHLM surface signal not continuous with the MFL was excluded. MRI findings were compared with arthroscopy using Student's t test and Fisher's exact test. Of the 54 participants, 5 had PHLM tears and 49 were normal. Twenty-one had ACL tears; all those with an PHLM tear had an ACL tear. The ligament of Humphrey inserted on average 0.9 consecutive images lateral to the PCL without an PHLM tear and 4.7 with an PHLM tear; the ligament of Wrisberg inserted on average 3.0 consecutive images without an PHLM tear and 4.5 with an PHLM tear (slice thickness/gap = 3 mm/0.5 mm). There was a significant association between PHLM tear and number of images (p = 0.0028), and between ACL tear and this type of PHLM tear (p = 0.0064). Apparent far lateral meniscal extension of a meniscofemoral ligament (greater than or equal to four images lateral to the PCL) should be considered as a possible PHLM tear, especially in the setting of an ACL tear. (orig.)

  14. Posterior horn lateral meniscal tears simulating meniscofemoral ligament attachment in the setting of ACL tear: MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Park, Lawrence S.; Jacobson, Jon A.; Jamadar, David A.; Caoili, Elaine; Kalume-Brigido, Monica [University of Michigan, Department of Radiology, Ann Arbor, MI (United States); Wojtys, Edward [University of Michigan, Department of Orthopaedic Surgery, 24 Frank Lloyd Wright Drive, Box 391, Ann Arbor, MI (United States); University of Michigan Sports Medicine Program, Department of MedSport, 24 Frank Lloyd Wright Drive, Box 391, Ann Arbor, MI (United States)

    2007-05-15

    We have noted apparent far lateral meniscal attachment of the meniscofemoral ligament (MFL) with an anterior cruciate ligament (ACL) tear. This study evaluates MFL attachment and association with posterior horn lateral meniscus (PHLM) tear. Nine months of knee arthroscopy reports were reviewed to classify the PHLM and ACL as torn or normal. After excluding those with prior knee surgery, MR images were reviewed by two radiologists to determine the number of images lateral to PCL, which showed the ligaments of Humphrey and Wrisberg visible as structures separate from the PHLM. Any patient with abnormal PHLM surface signal not continuous with the MFL was excluded. MRI findings were compared with arthroscopy using Student's t test and Fisher's exact test. Of the 54 participants, 5 had PHLM tears and 49 were normal. Twenty-one had ACL tears; all those with an PHLM tear had an ACL tear. The ligament of Humphrey inserted on average 0.9 consecutive images lateral to the PCL without an PHLM tear and 4.7 with an PHLM tear; the ligament of Wrisberg inserted on average 3.0 consecutive images without an PHLM tear and 4.5 with an PHLM tear (slice thickness/gap = 3 mm/0.5 mm). There was a significant association between PHLM tear and number of images (p = 0.0028), and between ACL tear and this type of PHLM tear (p = 0.0064). Apparent far lateral meniscal extension of a meniscofemoral ligament (greater than or equal to four images lateral to the PCL) should be considered as a possible PHLM tear, especially in the setting of an ACL tear. (orig.)

  15. Reversed double PCL sign: unusual location of a meniscal fragment of the knee observed by MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Niitsu, M.; Itai, Y. [Dept. of Radiology, Inst. of Clinical Medicine, Univ. of Tsukuba, Ibaraki (Japan); Ikeda, K. [Inst. of Clinical Medicine, Univ. of Tsukuba, Ibaraki (Japan)

    2003-12-01

    A 36-year-old woman with tears of the anterior cruciate ligament and medial meniscus received a meniscectomy. The MR images obtained prior to the partial meniscectomy showed a bucket-handle meniscal tear with centrally displaced fragment lying anterior to the posterior cruciate ligament (PCL), representing a ''double PCL sign''; however, after the meniscectomy, MR images demonstrated a fragment in the space posterior to the PCL where no structure is generally recognized except for the ligament of wrisberg. This article reports a ''reversed'' double PCL sign, caused by inadequate surgical clearance of a bucket-handle tear of the medial meniscus. (orig.)

  16. Meniscal Tear Film Fluid Dynamics Near Marx’s Line

    KAUST Repository

    Zubkov, V. S.

    2013-07-03

    Extensive studies have explored the dynamics of the ocular surface fluid, though theoretical investigations are typically limited to the use of the lubrication approximation, which is not guaranteed to be uniformly valid a-priori throughout the tear meniscus. However, resolving tear film behaviour within the meniscus and especially its apices is required to characterise the flow dynamics where the tear film is especially thin, and thus most susceptible to evaporatively induced hyperosmolarity and subsequent epithelial damage. Hence, we have explored the accuracy of the standard lubrication approximation for the tear film by explicit comparisons with the 2D Navier-Stokes model, considering both stationary and moving eyelids. Our results demonstrate that the lubrication model is qualitatively accurate except in the vicinity of the eyelids. In particular, and in contrast to lubrication theory, the solution of the full Navier-Stokes equations predict a distinct absence of fluid flow, and thus convective mixing in the region adjacent to the tear film contact line. These observations not only support emergent hypotheses concerning the formation of Marx\\'s line, a region of epithelial cell staining adjacent to the contact line on the eyelid, but also enhance our understanding of the pathophysiological consequences of the flow profile near the tear film contact line. © 2013 Society for Mathematical Biology.

  17. The relationship between prevalent medial meniscal intrasubstance signal changes and incident medial meniscal tears in women over a 1-year period assessed with 3.0 T MRI

    Energy Technology Data Exchange (ETDEWEB)

    Crema, Michel D. [Boston University School of Medicine, Department of Radiology, Quantitative Imaging Center, Boston, MA (United States); Ribeirao Preto School of Medicine, University of Sao Paulo (USP), Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, and Department of Internal Medicine, Radiology Division, Ribeirao Preto (Brazil); Institute of Diagnostic Imaging (IDI), Ribeirao Preto (Brazil); Hunter, David J. [The University of Sydney, Sydney School of Medicine, Sydney (Australia); Roemer, Frank W. [Boston University School of Medicine, Department of Radiology, Quantitative Imaging Center, Boston, MA (United States); Klinikum Augsburg, Department of Radiology, Augsburg (Germany); Li, Ling [New England Baptist Hospital, Division of Research, Boston, MA (United States); Marra, Monica D. [Boston University School of Medicine, Department of Radiology, Quantitative Imaging Center, Boston, MA (United States); Institute of Diagnostic Imaging (IDI), Ribeirao Preto (Brazil); Nogueira-Barbosa, Marcello H. [Ribeirao Preto School of Medicine, University of Sao Paulo (USP), Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, and Department of Internal Medicine, Radiology Division, Ribeirao Preto (Brazil); Hellio Le Graverand, Marie-Pierre; Wyman, Bradley T. [Pfizer Global Research and Development, New London, CT (United States); Guermazi, Ali [Boston University School of Medicine, Department of Radiology, Quantitative Imaging Center, Boston, MA (United States)

    2011-08-15

    Intrasubstance meniscal signal changes not reaching the articular surface on fast spin echo (FSE) sequences are considered to represent mucoid degeneration on MRI. The aim of this study was to evaluate the association of prevalent intrasubstance signal changes with incident tears of the medial meniscus detected on 3.0 T MRI over a 1-year period. A total of 161 women aged {>=}40 years participated in a longitudinal 1-year observational study of knee osteoarthritis. MRI (3.0 T) was performed at baseline and 12-month follow-up. The anterior horn, body, and posterior horn of the medial meniscus were scored by two experienced musculoskeletal radiologists using the Boston-Leeds Osteoarthritis Knee Score (BLOKS) system. Four grades were used to describe the meniscal morphology: grade 0 (normal), grade 1 (intrasubstance signal changes not reaching the articular surface), grade 2 (single tears), and grade 3 (complex tears and maceration). Fisher's exact test and the Cochran-Armitage trend test were performed to evaluate whether baseline intrasubstance signal changes (grade 1) predict incident meniscal tears/maceration (grades 2 and/or 3) in the same subregion of the medial meniscus, when compared to subregions without pathology as the reference group (grade 0). Medial meniscal intrasubstance signal changes at baseline did not predict tears at follow-up when evaluating the anterior and posterior horns (left-sided p-values 0.06 and 0.59, respectively). No incident tears were detected in the body. We could not demonstrate an association between prevalent medial meniscal intrasubstance signal changes with incident tears over a 1-year period. (orig.)

  18. Comparison of CT and MRI in patients with tibial plateau fracture: can CT findings predict ligament tear or meniscal injury?

    International Nuclear Information System (INIS)

    (1) To determine the accuracy of computed tomography (CT) in the evaluation of ligament tear and avulsion in patients with tibial plateau fracture. (2) To evaluate whether the presence or severity of fracture gap and articular depression can predict meniscal injury. A fellowship-trained musculoskeletal radiologist retrospectively reviewed knee CT and MRI examinations of 41 consecutive patients presenting to a level 1 trauma center with tibial plateau fractures. Fracture gap, articular depression, ligament tear and footprint avulsions were assessed on CT examinations. The MRI studies were examined for osseous and soft tissue injuries, including meniscal tear, meniscal displacement, ligament tear, and ligament avulsion. CT demonstrated torn ligaments with 80% sensitivity and 98% specificity. Only 2% of ligaments deemed intact on careful CT evaluation had partial or complete tears on MRI. Although the degree of fracture gap and articular depression was significantly greater in patients with meniscal injury compared with those without meniscal injury, ROC analysis demonstrated no clear threshold for gap or depression that yielded a combination of high sensitivity and specificity. In the acute setting, CT offers high sensitivity and specificity for depicting osseous avulsions, as well as high negative predictive value for excluding ligament injury. However, MRI remains necessary for the preoperative detection of meniscal injury. (orig.)

  19. Comparison of CT and MRI in patients with tibial plateau fracture: can CT findings predict ligament tear or meniscal injury?

    Energy Technology Data Exchange (ETDEWEB)

    Mui, Leonora W.; Engelsohn, Eliyahu; Umans, Hilary [Jacobi Medical Center, Albert Einstein College of Medicine, Department of Radiology, Bronx, NY (United States)

    2007-02-15

    (1) To determine the accuracy of computed tomography (CT) in the evaluation of ligament tear and avulsion in patients with tibial plateau fracture. (2) To evaluate whether the presence or severity of fracture gap and articular depression can predict meniscal injury. A fellowship-trained musculoskeletal radiologist retrospectively reviewed knee CT and MRI examinations of 41 consecutive patients presenting to a level 1 trauma center with tibial plateau fractures. Fracture gap, articular depression, ligament tear and footprint avulsions were assessed on CT examinations. The MRI studies were examined for osseous and soft tissue injuries, including meniscal tear, meniscal displacement, ligament tear, and ligament avulsion. CT demonstrated torn ligaments with 80% sensitivity and 98% specificity. Only 2% of ligaments deemed intact on careful CT evaluation had partial or complete tears on MRI. Although the degree of fracture gap and articular depression was significantly greater in patients with meniscal injury compared with those without meniscal injury, ROC analysis demonstrated no clear threshold for gap or depression that yielded a combination of high sensitivity and specificity. In the acute setting, CT offers high sensitivity and specificity for depicting osseous avulsions, as well as high negative predictive value for excluding ligament injury. However, MRI remains necessary for the preoperative detection of meniscal injury. (orig.)

  20. Meniscal tears of the knee : diagnosis with fast spin-echo MR imaging and role of gadolinium-enhancement

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Kyung Mi; Jee, Won Hee; Choe, Bo Young; Rhim, Soo A.; Lee, Jung Whee; Ku, Young Mi; Yoon, Young Hyun; Choi, Si Young; Choi, Kyu Ho; Shinn, Kyung Sub [Catholic Univ., Seoul (Korea, Republic of). Medical Coll.

    1998-01-01

    The usefulness of fast spin-echo MR imaging for the diagnosis of meniscal tear to the knee is a matter of debate. The purpose of this study was to evaluate the accuracy of diagnosis of meniscal tears by fast spin-echo MR imaging and the role of gadolinium enhancement. In 68 cases of arthroscopically-proven meniscal tears, MR sensitivity to tear was 93% (63/68) for spin-echo alone and 96% (40/41) for combined fast spin-echo and fat-suppressed gadolinium-enhanced T1-weighted MR images. MR sensitivity to medial meniscus tear was 98% (40/41) for fast spin-echo alone and 98% (40/41) for combined fast spin-echo and fat-suppressed gadolinium-enhanced T1-weighted MR images. MR sensitivity to lateral meniscus tear was 85 % (23/27) for fast spin-echo alone and 93% (25/27) for combined fast spin-echo and fat-suppressed gadolinium-enhanced T1-weighted MR images. Fast spin-echo MR imaging with adequate imaging parameters is suitable for the diagnosis of meniscal tears, and additional fat-suppressed gadolinium-enhanced T1-weighted MR imaging may increase diagnostic sensitivity to such tears. (author). 13 refs., 1 tab., 3 figs.

  1. Knee function and knee muscle strength in middle-aged patients with degenerative meniscal tears eligible for arthroscopic partial meniscectomy

    DEFF Research Database (Denmark)

    Stensrud, Silje; Risberg, May Arna; Roos, Ewa M.

    2014-01-01

    BACKGROUND: Functional limitations exist postmeniscectomy, but preoperative data are scarce. PURPOSE: To examine knee function, knee muscle strength and performance in middle-aged patients with degenerative meniscal tears, eligible for arthroscopic partial meniscectomy. STUDY DESIGN: Cross......-sectional study. METHODS: Eighty-two participants with MRI verified degenerative meniscal tear (35% women, mean age 49 years) answered the Knee injury and Osteoarthritis Outcome Score (KOOS) and were tested for isokinetic knee muscle strength and lower extremity performance (one-leg hop for distance, 6 m timed...

  2. MR imaging characteristics and clinical symptoms related to displaced meniscal flap tears

    Energy Technology Data Exchange (ETDEWEB)

    Lance, Valentin; Heilmeier, Ursula R.; Joseph, Gabby B.; Steinbach, Lynne; Link, Thomas M. [University of California, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Ma, Benjamin [University of California, Department of Orthopedic Surgery and Sports Medicine, San Francisco (United States)

    2014-11-16

    The purpose of our study was (1) to analyze the flap tear location, direction of displacement and size on magnetic resonance (MR) imaging, (2) to describe associated knee abnormalities including presence of effusion, synovitis, bone marrow edema pattern or ligamentous tear, and (3) to assess clinical findings found with flap tears, including the pain score, and determine differences between operative and nonoperative groups. A retrospective radiology database search over the last 3 years identified 238 patients with flap tears, of which ultimately 58 with isolated flap tears were included after exclusion of patients with other significant knee internal derangement, severe degenerative change or prior surgery. MR studies of the knee were analyzed by two radiologists. Imaging characteristics were correlated with associated knee abnormalities and clinical findings. Statistical analysis employed linear and logistic regression models. Inter- and intrareader reliability was calculated. The medial meniscus was the most common site of flap tears (52/60, 87 %), with inferior displacement (47/60, 78 %). The degree of tibial cartilage loss had a positive correlation with the visual analog pain scale (p = 0.03). Patients who underwent arthroscopy were younger than those who did not (p = 0.01) and more likely to have a positive clinical McMurray test (p = 0.01). Medially and inferiorly displaced flap tears are the most common tear pattern. Those undergoing arthroscopy are more likely to have positive meniscal signs on clinical examination. A greater degree of cartilage loss involving the tibia on MR imaging was associated with increasing visual analog pain scores. (orig.)

  3. MR imaging characteristics and clinical symptoms related to displaced meniscal flap tears

    International Nuclear Information System (INIS)

    The purpose of our study was (1) to analyze the flap tear location, direction of displacement and size on magnetic resonance (MR) imaging, (2) to describe associated knee abnormalities including presence of effusion, synovitis, bone marrow edema pattern or ligamentous tear, and (3) to assess clinical findings found with flap tears, including the pain score, and determine differences between operative and nonoperative groups. A retrospective radiology database search over the last 3 years identified 238 patients with flap tears, of which ultimately 58 with isolated flap tears were included after exclusion of patients with other significant knee internal derangement, severe degenerative change or prior surgery. MR studies of the knee were analyzed by two radiologists. Imaging characteristics were correlated with associated knee abnormalities and clinical findings. Statistical analysis employed linear and logistic regression models. Inter- and intrareader reliability was calculated. The medial meniscus was the most common site of flap tears (52/60, 87 %), with inferior displacement (47/60, 78 %). The degree of tibial cartilage loss had a positive correlation with the visual analog pain scale (p = 0.03). Patients who underwent arthroscopy were younger than those who did not (p = 0.01) and more likely to have a positive clinical McMurray test (p = 0.01). Medially and inferiorly displaced flap tears are the most common tear pattern. Those undergoing arthroscopy are more likely to have positive meniscal signs on clinical examination. A greater degree of cartilage loss involving the tibia on MR imaging was associated with increasing visual analog pain scores. (orig.)

  4. Double anterior cruciate ligament sign: a MR finding of lateral meniscal bucket-handle tear%双前交叉韧带征:外侧半月板桶柄状撕裂MR征象

    Institute of Scientific and Technical Information of China (English)

    龚静山; 陈蓟; 徐坚民; 潘晓华; 朱进; 饶梓彬; 杨忠; 黄国鑫

    2008-01-01

    目的:报道外侧半月板桶柄状撕裂的一个MR征象-双"ACL"征.方法:回顾性分析7例经关节镜证实外侧半月板桶柄状撕裂的MR表现.结果:7例患者中,4例MR机检查矢状位T2W图像上观察到ACL后方与ACL平行的条状低信号影,呈现双"ACL"征.结论:双"ACL"征可以提示ACL桶柄状撕裂可能,其临床价值有待于进一步研究.

  5. Fast presurgical magnetic resonance imaging of meniscal tears and concurrent subchondral bone marrow lesions. Study of dogs with naturally occurring cranial cruciate ligament rupture.

    Science.gov (United States)

    Olive, J; d'Anjou, M-A; Cabassu, J; Chailleux, N; Blond, L

    2014-01-01

    Meniscal tears and subchondral bone marrow lesions have both been described in dogs with cranial cruciate ligament rupture, but their possible concurrence has not been evaluated. In a population of 14 dogs exhibiting signs of stifle pain with surgically confirmed cranial cruciate ligament rupture, a short presurgical 1.5T magnetic resonance (MR) imaging protocol including dorsal proton density, dorsal T1-weighted gradient recalled echo, and sagittal fat-saturated dual echo sequences was tested to further investigate these features and illustrate meniscal tears. Interobserver agreement for detection of medial meniscal tears (k=0.83) and bone marrow lesions (k=0.87) was excellent. Consensus MR reading allowed detection of nine out of 12 surgically confirmed medial meniscal tears and there was no false positive. All dogs had cruciate ligament enthesis-related bone marrow lesions in the tibia, femur or both bones. Additionally, among the 12 dogs with confirmed medial meniscal tears, subchondral bone marrow lesions were present in the caudomedial (9 dogs) and caudoaxial (11 dogs) regions of the tibial plateau, resulting in odds ratios (13.6, p=0.12, and 38.3, p=0.04, respectively) that had large confidence intervals due to the small group size of this study. The other two dogs had neither tibial bone marrow lesions in these locations nor medial meniscal tears. These encouraging preliminary results warrant further investigation using this clinically realistic preoperative MR protocol. As direct diagnosis of meniscal tears remained challenging in dogs even with high-field MR, identification of associated signs such as subchondral bone marrow lesions might indirectly allow suspicion of an otherwise unrecognized meniscal tear. PMID:24226972

  6. PCL tibial avulsion with an associated medial meniscal tear in a child: a case report on diagnosis and management.

    LENUS (Irish Health Repository)

    2012-02-01

    Posterior cruciate ligament (PCL) injuries from tibial avulsions are rare in the paediatric setting. One would need a high index of suspicion as clinical examination may be difficult, especially in the early period. Magnetic resonance imaging is an excellent diagnostic modality for this condition and other associated injuries within the knee. We report a rare case in which the patient had a PCL avulsion off the tibial insertion site with an associated posterior horn medial meniscal tear off the posterior capsule. He was treated through open reduction and internal fixation of the avulsed fragment with suture repair of the meniscal tear. We emphasize the importance of diagnosing and managing associated intra-articular injuries when dealing with the rare condition of PCL tibial avulsion in the paediatric setting.

  7. Meniscal ossification.

    Science.gov (United States)

    Mine, Takatomo; Taguchi, Tosihiko; Ihara, Koichiro; Tanaka, Hiroshi; Moriwaki, Tohru; Kawai, Shinya

    2003-02-01

    Meniscal ossicles are rare in the human knee. We present one case. A 57-year-old taxi driver complained of right knee pain and swelling with radiographic findings of a meniscal ossicle. Arthroscopic inspection showed a degenerative and horizontal tear and calcium deposit at the middle and posterior thirds of lateral discoid meniscus. His lateral discoid meniscus, containing the ossicle, was removed. He was asymptomatic at a 3-year follow-up. PMID:12579140

  8. Medial meniscal posterior root/horn radial tears correlate with cartilage degeneration detected by T1ρ relaxation mapping

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Kenji, E-mail: Kenji-am@nms.ac.jp [Department of Orthopaedic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603 (Japan); Hashimoto, Sanshiro, E-mail: info@msorc.jp [Minami-Shinjuku Orthopaedic Rehabilitation Clinic, 2-16-7 Yoyogi, Shibuya-ku, Tokyo 151-0053 (Japan); Nakamura, Hiroshi, E-mail: nakamura@nms.ac.jp [Department of Orthopaedic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603 (Japan); Mori, Atsushi, E-mail: atsu@nms.ac.jp [Department of Orthopaedic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603 (Japan); Sato, Akiko, E-mail: akiko-sato@nms.ac.jp [Department of Orthopaedic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603 (Japan); Majima, Tokifumi, E-mail: tkmajima@iuhw.ac.jp [Department of Orthopaedic Surgery, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasu-shiobara, Tochigi 329-2763 (Japan); Takai, Shinro, E-mail: takai-snr@nms.ac.jp [Department of Orthopaedic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603 (Japan)

    2015-06-15

    Highlights: • Posterior radial tears in medial meniscus associate T1ρ values of cartilage. • Posterior radial tears relate to cartilage degeneration even in early-stage osteoarthritis. • Abnormalities in meniscus on MRI are useful for screening early-stage osteoarthritis. - Abstract: Objective: This study aimed to identify factors on routine pulse sequence MRI associated with cartilage degeneration observed on T1ρ relaxation mapping. Materials and methods: This study included 137 subjects with knee pain. T1ρ values were measured in the regions of interest on the surface layer of the cartilage on mid-coronal images of the femorotibial joint. Assessment of cartilage, subchondral bone, meniscus and ligaments was performed using routine pulse sequence MRI. Radiographic evaluation for osteoarthritis was also performed. Results: Multiple regression analysis revealed posterior root/horn tears to be independent factors increasing the T1ρ values of the cartilage in the medial compartment of the femorotibial joint. Even when adjusted for radiographically defined early-stage osteoarthritis, medial posterior meniscal radial tears significantly increased the T1ρ values. Conclusions: This study showed that posterior root/horn radial tears in the medial meniscus are particularly important MRI findings associated with cartilage degeneration observed on T1ρ relaxation mapping. Morphological factors of the medial meniscus on MRI provide findings useful for screening early-stage osteoarthritis.

  9. Medial meniscal posterior root/horn radial tears correlate with cartilage degeneration detected by T1ρ relaxation mapping

    International Nuclear Information System (INIS)

    Highlights: • Posterior radial tears in medial meniscus associate T1ρ values of cartilage. • Posterior radial tears relate to cartilage degeneration even in early-stage osteoarthritis. • Abnormalities in meniscus on MRI are useful for screening early-stage osteoarthritis. - Abstract: Objective: This study aimed to identify factors on routine pulse sequence MRI associated with cartilage degeneration observed on T1ρ relaxation mapping. Materials and methods: This study included 137 subjects with knee pain. T1ρ values were measured in the regions of interest on the surface layer of the cartilage on mid-coronal images of the femorotibial joint. Assessment of cartilage, subchondral bone, meniscus and ligaments was performed using routine pulse sequence MRI. Radiographic evaluation for osteoarthritis was also performed. Results: Multiple regression analysis revealed posterior root/horn tears to be independent factors increasing the T1ρ values of the cartilage in the medial compartment of the femorotibial joint. Even when adjusted for radiographically defined early-stage osteoarthritis, medial posterior meniscal radial tears significantly increased the T1ρ values. Conclusions: This study showed that posterior root/horn radial tears in the medial meniscus are particularly important MRI findings associated with cartilage degeneration observed on T1ρ relaxation mapping. Morphological factors of the medial meniscus on MRI provide findings useful for screening early-stage osteoarthritis

  10. Meniscal and cruciate ligaments tears diagnosed with MR imaging versus arthroscopy

    International Nuclear Information System (INIS)

    MR studies of knee joints in 37 patients were performed. The clinical diagnostics was traumatic lesions of menisci or cruciate ligaments. Arthroscopy of the knee joint was performed in 21 patients. MR showed meniscal lesion in 25 patients and anterior cruciate ligament (ACL) lesions in 18 patients. Arthroscopy showed meniscal lesions in 16 of 21 patients and ACL lesions in 11 of 21 patients. MR correlated with arthroscopy in 16 of examined menisci and 15 of 21 examined ACL. (author)

  11. Meniscal tear evaluation. Comparison of a conventional spin-echo proton density sequence with a fast spin-echo sequence utilizing a 512x358 matrix size

    International Nuclear Information System (INIS)

    Aim: To determine the sensitivities, specificities, and receiver-operating characteristics (ROCs) for sagittal conventional spin-echo proton density (SE-PD) and fast spin-echo proton density (FSE-PD) sequences in the diagnosis of meniscal tears when compared to arthroscopic findings utilizing increased FSE matrix acquisition size. Method and materials: Magnetic resonance imaging (MRI) studies of 97 knees (194 menisci) were independently and prospectively interpreted by two experienced musculoskeletal radiologists over four separate readings at least 3 weeks apart. Readings 1 and 2 included images in all three planes in accordance with the standard protocol with either a SE or FSE sagittal PD, at readings 3 and 4 just the SE or FSE sagittal PD sequences were reported. The FSE sequence was acquired with an increased matrix size, compared to the SE sequence, to provide increased resolution. Menisci were graded for the presence of a tear and statistical analysis to calculate sensitivity and specificity was performed comparing to arthroscopy as the reference standard. ROC analysis for the diagnosis of meniscal tears on the SE and FSE sagittal sequences was also evaluated. Reader concordance for the SE and FSE sequences was calculated. Results: Sixty-seven tears were noted at arthroscopy; 60 were detected on SE and 56 on FSE. The sensitivity and specificity for SE was 90 and 90%, and for FSE was 84 and 94%, respectively, with no significant difference. ROC analysis showed no significant difference between the two sequences and kappa values demonstrated a higher level of reader agreement for the FSE than for the SE reading. Conclusion: Use of a FSE sagittal PD sequence with an increased matrix size provides comparable performance to conventional SE sagittal PD when evaluating meniscal disease with a modern system. The present study indicates an increased level of concordance between readers for the FSE sagittal sequence compared to the conventional SE.

  12. Correlation of histological examination of meniscus with MR images; Focused on high signal intensity of the meniscus not caused by definite meniscal tear and impact on MR diagnosis of tears

    Energy Technology Data Exchange (ETDEWEB)

    Li, Chun Ai; Kim, Min Ki; Kim, In Hwan; Lee, Ju Hong; Jang, Kyu Yun; Lee, Sang Yong [Chonbuk National University Hospital, Chonbuk National University College of Medicine, Jeonju (Korea, Republic of)

    2013-12-15

    To document the causes of high signal intensity of the meniscus which is not caused by definite meniscal tears on MR imaging, through correlation with histological examination. For the correlation between the MR image and histology, we obtained prospectively 31 meniscal specimens from 21 patients. Proton density-weighted turbo spin-echo MR images were used. Minimal tear, thinning of the lamellar layer, degeneration of the central layer, and radial tie fibers were detected upon histological examination, and were correlated with the corresponding MR images. Minimal tear of the lamellar layer was seen in 60 zones out of 100 slides. On MR images, 29 (48.3%) of these 60 zones had high signal intensity. Thinning of the lamellar layer was seen in 24 zones, with 7 (29.2%) having high signal intensity. 57 central zones showed degenerative change in the central layer and high signal intensity on all corresponding MR images. Radial tie fibers in the central layer appeared as high signal intensity areas. Minimal tear and thinning of the lamellar layer, degeneration and radial tie fibers of the central layer of the meniscus cause high signal intensity on MR images.

  13. Dynamic Alterations in Microarchitecture, Mineralization and Mechanical Property of Subchondral Bone in Rat Medial Meniscal Tear Model of Osteoarthritis

    Directory of Open Access Journals (Sweden)

    De-Gang Yu

    2015-01-01

    Full Text Available Background: The properties of subchondral bone influence the integrity of articular cartilage in the pathogenesis of osteoarthritis (OA. However, the characteristics of subchondral bone alterations remain unresolved. The present study aimed to observe the dynamic alterations in the microarchitecture, mineralization, and mechanical properties of subchondral bone during the progression of OA. Methods: A medial meniscal tear (MMT operation was performed in 128 adult Sprague Dawley rats to induce OA. At 2, 4, 8, and 12 weeks following the MMT operation, cartilage degeneration was evaluated using toluidine blue O staining, whereas changes in the microarchitecture indices and tissue mineral density (TMD, mineral-to-collagen ratio, and intrinsic mechanical properties of subchondral bone plates (BPs and trabecular bones (Tbs were measured using micro-computed tomography scanning, confocal Raman microspectroscopy and nanoindentation testing, respectively. Results: Cartilage degeneration occurred and worsened progressively from 2 to 12 weeks after OA induction. Microarchitecture analysis revealed that the subchondral bone shifted from bone resorption early (reduced trabecular BV/TV, trabecular number, connectivity density and trabecular thickness [Tb.Th], and increased trabecular spacing (Tb.Sp at 2 and 4 weeks to bone accretion late (increased BV/TV, Tb.Th and thickness of subchondral bone plate, and reduced Tb.Sp at 8 and 12 weeks. The TMD of both the BP and Tb displayed no significant changes at 2 and 4 weeks but decreased at 8 and 12 weeks. The mineral-to-collagen ratio showed a significant decrease from 4 weeks for the Tb and from 8 weeks for the BP after OA induction. Both the elastic modulus and hardness of the Tb showed a significant decrease from 4 weeks after OA induction. The BP showed a significant decrease in its elastic modulus from 8 weeks and its hardness from 4 weeks. Conclusion: The microarchitecture, mineralization and mechanical

  14. Chronic anterior cruciate ligament tears and associated meniscal and traumatic cartilage lesions: evaluation with morphological sequences at 3.0 T

    International Nuclear Information System (INIS)

    To investigate the diagnostic efficacy of morphological sequences at 3.0 T MR imaging in detecting anterior cruciate ligament (ACL), meniscal pathology and traumatic cartilage legions in young patients with chronic deficient anterior cruciate ligament knees. This prospective study included 43 patients (39 male) between the age of 15 and 37 years (mean age 22.6 years) with a history of knee injury sustained at least 3 months prior to the decision to repair a torn ACL. All patients underwent a 3.0 T MR scan with the same standard protocol, including intermediate-weighted and three-dimensional spoiled gradient-recalled T1-weighted sequences with fat saturation and subsequently surgical reconstruction of the ACL, along with meniscal and cartilage repair, when necessary. All ACL tears were correctly interpreted by 3.0 T MR images. The sensitivity of the MR scans regarding tears of the medial meniscus was 93.7%, the specificity 92.6%, the positive predictive value 88.2% and the negative predictive value 95.8%. The sensitivity of the MR scans regarding tears of lateral meniscus was 85.7%, the specificity was 93.1%, the positive predictive value 85.7% and the negative predictive value 93.1%. With regard to the grading of the cartilage lesions, Cohen's kappa coefficient indicated moderate agreement for grade I and II cartilage lesions (0.5), substantial agreement for grade III and IV cartilage lesions (0.70 and 0.66) and substantial agreement for normal regions (0.75). Regarding location of the cartilage lesions, Cohen's kappa coefficient varied between almost perfect agreement in the lateral femoral condyle and no agreement in the trochlea. In the setting of chronic ACL deficiency, MR imaging at 3.0 T achieves satisfactory diagnostic performance regarding meniscal and ligamentous pathology. In the detection of cartilage lesions MRI is less successful. (orig.)

  15. Chronic anterior cruciate ligament tears and associated meniscal and traumatic cartilage lesions: evaluation with morphological sequences at 3.0 T

    Energy Technology Data Exchange (ETDEWEB)

    Vlychou, Marianna; Fezoulidis, Ioannis V. [University Hospital of Larissa, Department of Radiology, Medical School of Thessaly, Larissa (Greece); Hantes, Michalis; Michalitsis, Sotirios; Malizos, Konstantinos [University Hospital of Larissa, Department of Orthopaedic Surgery, Medical School of Thessaly, Larissa (Greece); Tsezou, Aspasia [University Hospital of Larissa, Department of Molecular Genetics and Cytogenetics, Medical School of Thessaly, Larissa (Greece)

    2011-06-15

    To investigate the diagnostic efficacy of morphological sequences at 3.0 T MR imaging in detecting anterior cruciate ligament (ACL), meniscal pathology and traumatic cartilage legions in young patients with chronic deficient anterior cruciate ligament knees. This prospective study included 43 patients (39 male) between the age of 15 and 37 years (mean age 22.6 years) with a history of knee injury sustained at least 3 months prior to the decision to repair a torn ACL. All patients underwent a 3.0 T MR scan with the same standard protocol, including intermediate-weighted and three-dimensional spoiled gradient-recalled T1-weighted sequences with fat saturation and subsequently surgical reconstruction of the ACL, along with meniscal and cartilage repair, when necessary. All ACL tears were correctly interpreted by 3.0 T MR images. The sensitivity of the MR scans regarding tears of the medial meniscus was 93.7%, the specificity 92.6%, the positive predictive value 88.2% and the negative predictive value 95.8%. The sensitivity of the MR scans regarding tears of lateral meniscus was 85.7%, the specificity was 93.1%, the positive predictive value 85.7% and the negative predictive value 93.1%. With regard to the grading of the cartilage lesions, Cohen's kappa coefficient indicated moderate agreement for grade I and II cartilage lesions (0.5), substantial agreement for grade III and IV cartilage lesions (0.70 and 0.66) and substantial agreement for normal regions (0.75). Regarding location of the cartilage lesions, Cohen's kappa coefficient varied between almost perfect agreement in the lateral femoral condyle and no agreement in the trochlea. In the setting of chronic ACL deficiency, MR imaging at 3.0 T achieves satisfactory diagnostic performance regarding meniscal and ligamentous pathology. In the detection of cartilage lesions MRI is less successful. (orig.)

  16. Evaluation of meniscal tears of the knee: the usefulness of fat-suppressed conventional spin-echo T1-weighted MR imaging

    International Nuclear Information System (INIS)

    To determine the usefulness of the fat-suppressed (FS) conventional spin-echo (CSE) sequence for the diagnosis of meniscal tears. We retrospectively reviewed 323 MR images of the knee, the standard of reference being the findings of arthroscopy. In all knees, fast SE proton density-weighted and T2-weighted sagittal and coronal images and double-echo in steady state (DESS) sagittal images were obtained, and during 202 MR Procedures, FS-CSE T1-weighted sagittal images were also obtained. The results of MR imaging were then correlated with those of arthroscopy, the accuracy with which meniscal tears were diagnosed being compared between two groups: group I (202 knees for which FS-CSE T1-weighted sagittal images were obtained), and group II (121 knees for which these images were not obtained). For statistical analysis the chi-square test was used. In group 1, sensitivity, specificity and accuracy were 94.7%, 92.4% and 93.5%, respectively, for the medial meniscus, and 83.3%, 95.7% and 90.5% for the lateral meniscus. In group II, the corresponding findings were 92.5%, 94% and 93.3%; and 87.3%, 98.2% and 92.5%. The differences between the groups were not statistically significant (ρ >0.05) For meniscal tears of the knee, the addition of FS-CSE T1-weighted MR imaging to the fast SE proton density-weighted, T2-weighted and DESS sequences does not enhance diagnostic accuracy

  17. 前交叉韧带损伤合并半月板损伤的研究进展%Research progress on anterior cruciate ligament lesions with concurrent meniscal tears

    Institute of Scientific and Technical Information of China (English)

    唐聪; 黄长明; 范华强

    2015-01-01

    Anterior cruciate ligament ( ACL ) lesions are common sports injuries in the knee joint, and ACL reconstruction is widely used in the treatment of ACL lesions. However, the patients with ACL lesions often have other associated injuries, among which meniscal tears are the most common. In recent years, arthroscopic doctors pay more and more attention to the combined injuries and carry out a lot of experimental and clinical studies. In this paper, the relationship between meniscal tears and ACL lesions and treatment progress on the combined injuries are summarized.

  18. Diagnostic performance of 3D TSE MRI versus 2D TSE MRI of the knee at 1.5 T, with prompt arthroscopic correlation, in the detection of meniscal and cruciate ligament tears*

    Science.gov (United States)

    Chagas-Neto, Francisco Abaeté; Nogueira-Barbosa, Marcello Henrique; Lorenzato, Mário Müller; Salim, Rodrigo; Kfuri-Junior, Maurício; Crema, Michel Daoud

    2016-01-01

    Objective To compare the diagnostic performance of the three-dimensional turbo spin-echo (3D TSE) magnetic resonance imaging (MRI) technique with the performance of the standard two-dimensional turbo spin-echo (2D TSE) protocol at 1.5 T, in the detection of meniscal and ligament tears. Materials and Methods Thirty-eight patients were imaged twice, first with a standard multiplanar 2D TSE MR technique, and then with a 3D TSE technique, both in the same 1.5 T MRI scanner. The patients underwent knee arthroscopy within the first three days after the MRI. Using arthroscopy as the reference standard, we determined the diagnostic performance and agreement. Results For detecting anterior cruciate ligament tears, the 3D TSE and routine 2D TSE techniques showed similar values for sensitivity (93% and 93%, respectively) and specificity (80% and 85%, respectively). For detecting medial meniscal tears, the two techniques also had similar sensitivity (85% and 83%, respectively) and specificity (68% and 71%, respectively). In addition, for detecting lateral meniscal tears, the two techniques had similar sensitivity (58% and 54%, respectively) and specificity (82% and 92%, respectively). There was a substantial to almost perfect intraobserver and interobserver agreement when comparing the readings for both techniques. Conclusion The 3D TSE technique has a diagnostic performance similar to that of the routine 2D TSE protocol for detecting meniscal and anterior cruciate ligament tears at 1.5 T, with the advantage of faster acquisition. PMID:27141127

  19. Meniscal injury: II. Management.

    Science.gov (United States)

    Greis, Patrick E; Holmstrom, Michael C; Bardana, Davide D; Burks, Robert T

    2002-01-01

    Meniscal repair is a viable alternative to resection in many clinical situations. Repair techniques traditionally have utilized a variety of suture methods, including inside-out and outside-in techniques. Bioabsorbable implants permit all-inside arthroscopic repairs. The success of meniscal repair depends on appropriate meniscal bed preparation and surgical technique and is also influenced by biologic factors such as tear rim width and associated ligamentous injury. Successful repair in >80% of cases has been reported in conjunction with anterior cruciate ligament reconstruction. Success rates are lower for isolated repairs. Complications related to repair include neurologic injury, postoperative loss of motion, recurrence of the tear, and infection. Meniscal allograft transplantation may provide a treatment option when meniscus salvage is not possible or when a previous total meniscectomy has been done. PMID:12041939

  20. Defining the Value of Future Research to Identify the Preferred Treatment of Meniscal Tear in the Presence of Knee Osteoarthritis.

    Directory of Open Access Journals (Sweden)

    Elena Losina

    Full Text Available Arthroscopic partial meniscectomy (APM is extensively used to relieve pain in patients with symptomatic meniscal tear (MT and knee osteoarthritis (OA. Recent studies have failed to show the superiority of APM compared to other treatments. We aim to examine whether existing evidence is sufficient to reject use of APM as a cost-effective treatment for MT+OA.We built a patient-level microsimulation using Monte Carlo methods and evaluated three strategies: Physical therapy ('PT' alone; PT followed by APM if subjects continued to experience pain ('Delayed APM'; and 'Immediate APM'. Our subject population was US adults with symptomatic MT and knee OA over a 10 year time horizon. We assessed treatment outcomes using societal costs, quality-adjusted life years (QALYs, and calculated incremental cost-effectiveness ratios (ICERs, incorporating productivity costs as a sensitivity analysis. We also conducted a value-of-information analysis using probabilistic sensitivity analyses.Calculated ICERs were estimated to be $12,900/QALY for Delayed APM as compared to PT and $103,200/QALY for Immediate APM as compared to Delayed APM. In sensitivity analyses, inclusion of time costs made Delayed APM cost-saving as compared to PT. Improving efficacy of Delayed APM led to higher incremental costs and lower incremental effectiveness of Immediate APM in comparison to Delayed APM. Probabilistic sensitivity analyses indicated that PT had 3.0% probability of being cost-effective at a willingness-to-pay (WTP threshold of $50,000/QALY. Delayed APM was cost effective 57.7% of the time at WTP = $50,000/QALY and 50.2% at WTP = $100,000/QALY. The probability of Immediate APM being cost-effective did not exceed 50% unless WTP exceeded $103,000/QALY.We conclude that current cost-effectiveness evidence does not support unqualified rejection of either Immediate or Delayed APM for the treatment of MT+OA. The amount to which society would be willing to pay for additional information

  1. Relationship between years in the trade and the development of radiographic knee osteoarthritis and MRI-detected meniscal tears and bursitis in floor layers. A cross-sectional study of a historical cohort

    DEFF Research Database (Denmark)

    Jensen, Lilli Kirkeskov; Rytter, Søren; Marott, Jacob Louis;

    2012-01-01

    An increased risk of developing knee disorders including radiographic knee osteoarthritis (OA) have been shown among workers with kneeling working demands. There may also be a dose-related association between duration of employment in occupations with kneeling work and development of radiographic...... knee OA and magnetic resonance imaging (MRI)-detected meniscal tears and bursitis....

  2. Editorial Commentary: Book? … Book Report? … or Just a New Chapter in an Ongoing Story?: Knee Partial Meniscectomy Has Limited Benefit for "Nonobstructive" Meniscal Tears, but We Need to Know if Patients Have Osteoarthritis.

    Science.gov (United States)

    Whelan, Daniel B

    2016-09-01

    Knee partial meniscectomy has limited benefit for "nonobstructive" meniscal tears, but we need to know if included patients have osteoarthritis. Research on outcomes of arthroscopic partial meniscectomy versus nonsurgical treatment must consider not only signs and symptoms but also imaging findings, to determine the indications for surgical versus nonsurgical in a selected patient. PMID:27594333

  3. Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: randomised controlled trial with two year follow-up

    Science.gov (United States)

    Risberg, May Arna; Stensrud, Silje; Ranstam, Jonas; Engebretsen, Lars; Roos, Ewa M

    2016-01-01

    Objective To determine if exercise therapy is superior to arthroscopic partial meniscectomy for knee function in middle aged patients with degenerative meniscal tears. Design Randomised controlled superiority trial. Setting Orthopaedic departments at two public hospitals and two physiotherapy clinics in Norway. Participants 140 adults, mean age 49.5 years (range 35.7-59.9), with degenerative medial meniscal tear verified by magnetic resonance imaging. 96% had no definitive radiographic evidence of osteoarthritis. Interventions 12 week supervised exercise therapy alone or arthroscopic partial meniscectomy alone. Main outcome measures Intention to treat analysis of between group difference in change in knee injury and osteoarthritis outcome score (KOOS4), defined a priori as the mean score for four of five KOOS subscale scores (pain, other symptoms, function in sport and recreation, and knee related quality of life) from baseline to two year follow-up and change in thigh muscle strength from baseline to three months. Results No clinically relevant difference was found between the two groups in change in KOOS4 at two years (0.9 points, 95% confidence interval −4.3 to 6.1; P=0.72). At three months, muscle strength had improved in the exercise group (P≤0.004). No serious adverse events occurred in either group during the two year follow-up. 19% of the participants allocated to exercise therapy crossed over to surgery during the two year follow-up, with no additional benefit. Conclusion The observed difference in treatment effect was minute after two years of follow-up, and the trial’s inferential uncertainty was sufficiently small to exclude clinically relevant differences. Exercise therapy showed positive effects over surgery in improving thigh muscle strength, at least in the short term. Our results should encourage clinicians and middle aged patients with degenerative meniscal tear and no definitive radiographic evidence of osteoarthritis to consider

  4. Meniscal repair using the Polysorb Meniscal Stapler XLS.

    Science.gov (United States)

    Oberlander, Michael A; Chisar, Michael A

    2005-09-01

    We present our technique of repair of meniscal tears in 11 patients using a newly designed stapler, the Polysorb Meniscal Stapler XLS (USS Sports Medicine, Norwalk, CT), to increase the effectiveness and ease of repair of tears in the vascular zone while limiting potential complications. The low-profile stapler comes with a reloadable pistol grip device and a disposable straight or 15 degrees upcurved shaft with a single preloaded 10-mm staple. Standard anteromedial and anterolateral portals were used, along with a superomedial portal for inflow. The portal was enlarged slightly to facilitate introduction of the cannula or the stapler directly into the knee. The nose of the stapler was applied to the superior surface of the inner edge of the meniscal tear. The sharp points on the tip of the nose were used to manipulate the inner edge and coapt the tear site. Firm pressure was applied to the meniscal tissue, and the nose of the stapler was embedded in the inner edge of the meniscus no more than 2 to 3 mm from the tear (as measured along the meniscal surface). The handle was pulled slowly as the staple engaged the meniscal tissue. This step was repeated every 3 to 4 mm to ensure ideal tear stabilization. PMID:16171646

  5. A retrospective analysis of risk factors for meniscal co-morbidities in anterior cruciate ligament injuries

    Directory of Open Access Journals (Sweden)

    Korula Mani Jacob

    2012-01-01

    Conclusion: The single factor that significantly affects incidence of meniscal co-morbidity in ACL injury is the delay in presentation (i.e. the time to surgery. The incidence of lateral meniscal tears as well as medial meniscal tears increased with delay in surgery. This should guide us toward recommending all patients irrespective of age, gender, or mode of injury to undergo early reconstruction, thereby reducing the likelihood of developing meniscal pathology.

  6. Treatment of meniscal injury: a current concept review

    Institute of Scientific and Technical Information of China (English)

    GU Yang-lin; WANG Yu-bin

    2010-01-01

    Meniscal injury is one of the most common injuries to the knee. The menisci are important for normal knee function. And loss of a meniscus increases the risk of subsequent development of degenerative changes in the knee. Now there are different techniques available for meniscal injury. These techniques include expectant treatment, meniscectomy, meniscal repair, meniscal replacement, and meniscal tissue engineering. Expectant treatment is the appropriate treatment for minor tears of the menisci. Meniscectomy being favored at the beginning is now obsolete. Meniscus repair has become a standard procedure. Meniscal replacement and tissue engineering are used to deal with considerable meniscal injuries. The purpose of this paper is to provide current knowledge regarding the anatomy and function of the menisci, incidence,aetiology, symptoms, signs, investigations and treatments of meniscal injury.

  7. Meniscal injury: I. Basic science and evaluation.

    Science.gov (United States)

    Greis, Patrick E; Bardana, Davide D; Holmstrom, Michael C; Burks, Robert T

    2002-01-01

    The patient with meniscal injury may present with pain, swelling, or mechanical symptoms and often requires surgical intervention for symptom resolution. Treatment of such injuries relies on understanding the gross and microanatomic features of the meniscus that are important in maintaining meniscal function. The ability of the meniscus to participate in load bearing, shock absorption, joint lubrication, and joint stability depends on the maintenance of its structural integrity. The diagnosis of meniscal injury often can be made by clinical evaluation utilizing the history, physical examination, and plain radiographs. Magnetic resonance imaging can be useful in confirming the diagnosis when clinical findings are inconclusive. Treatment depends on tear pattern, vascularity, and an assessment of tissue quality. Surgical decision making for the treatment of meniscal injury is based on patient factors and understanding of the meniscal structure, function, and pathology. PMID:12041938

  8. The potential of optical coherence tomography for diagnosing meniscal pathology

    Science.gov (United States)

    Hang-Yin Ling, Carrie; Pozzi, Antonio; Thieman, Kelley M.; Tonks, Catherine A.; Guo, Shuguang; Xie, Huikai; Horodyski, MaryBeth

    2010-04-01

    Meniscal tears are often associated with anterior cruciate ligament (ACL) injury and may lead to pain and discomfort in humans. Maximal preservation of meniscal tissue is highly desirable to mitigate the progression of osteoarthritis. Guidelines of which meniscal tears are amenable to repair and what part of damaged tissues should be removed are elusive and lacking consensus. Images of microstructural changes in meniscus would potentially guide the surgeons to manage the meniscal tears better, but the resolution of current diagnostic techniques is limited for this application. In this study, we demonstrated the feasibility of using optical coherence tomography (OCT) for the diagnosis of meniscal pathology. Torn medial menisci were collected from dogs with ACL insufficiency. The torn meniscus was divided into three tissue samples and scanned by OCT and scanning electron microscopy (SEM). OCT and SEM images of torn menisci were compared. Each sample was evaluated for gross and microstructural abnormalities and reduction or loss of birefringence from the OCT images. The abnormalities detected with OCT were described for each type of tear. OCT holds promise in non-destructive and fast assessment of microstructural changes and tissue birefringence of meniscal tears. Future development of intraoperative OCT may help surgeons in the decision making of meniscal treatment.

  9. Diagnosis and Treatment of a Lateral Meniscal Cyst with Musculoskeletal Ultrasound

    Directory of Open Access Journals (Sweden)

    Hamilton Chen

    2015-01-01

    Full Text Available Meniscal cysts are a relatively uncommon occurrence that may result in pain and disability in the knee. It is widely believed that meniscal cysts are secondary to fluid extrusion from a meniscus tear. Typically, diagnosis of a meniscal cyst typically requires magnetic resonance imaging (MRI to delineate the cyst and any associated injuries. With improvements in sonographic technology, ultrasound has emerged as a sensitive modality for detection of meniscal cysts. We present a patient with a contraindication to MRI who was diagnosed with a lateral meniscal cyst by musculoskeletal ultrasound and treated with an ultrasound-guided lateral meniscal cyst aspiration and injection.

  10. Lateral Meniscal Allograft Transplantation: The Bone Trough Technique.

    Science.gov (United States)

    Chahla, Jorge; Olivetto, Javier; Dean, Chase S; Serra Cruz, Raphael; LaPrade, Robert F

    2016-04-01

    The lateral meniscus plays a critical role in the stability and health of the knee. Treating patients who have undergone a total lateral meniscectomy or functional equivalent is challenging, especially young and active patients. Current literature regarding meniscal tears supports that repair should be the first surgical option. Moreover, it is recommended to preserve as much meniscal tissue as possible. In cases in which a total or functional meniscectomy is a pre-existing condition, a lateral meniscal allograft transplantation is a possible option. The purpose of this surgical technique description was to detail the method of lateral meniscal allograft transplantation using a bone trough. PMID:27462536

  11. 膝关节韧带损伤及伴发半月板损伤的MRI分析%Knee ligaments injuries and associated meniscal tears:a MRI study

    Institute of Scientific and Technical Information of China (English)

    孙百胜; 郑雷; 纪丙军; 姜辉; 何伟华; 李永亮

    2013-01-01

    合损伤,再次为ACL、PCL、MCL联合损伤;MRI诊断多发韧带损伤的敏感性、特异性、准确性均较单发韧带损伤下降;多发韧带损伤较单发韧带损伤更易伴发 MM、LM损伤;多发韧带组与单发韧带组比较,虽然MRI诊断伴发MM、LM损伤敏感性无明显差异,但特异性、准确性均较单发韧带组明显降低。%Objective To evaluate the characteristics of isolated and combined ligament injuries of knee joint, and compare the accuracy of MR imaging between above two type ligament injuries, incidence rate and diagnostic accuracy of concomitant meniscal tear. Methods MR images of 187 patients with ligament injuries proved clinically were reviewed. Results Among 187 patients, isolated ligament injury was seen in 103 cases and combined ligament injury in 84 cases. In isolated ligament injury group, there were 38 cases of anterior cruciate ligament (ACL) tear, 36 cases of medial collateral ligament (MCL) tear, 14 cases of posterior cruciate ligament (PCL) tear, 10 cases of medial patellofemoral ligament (MPFL) tear, 3 cases of patellar tendon (PT) tear, 2 cases of lateral collateral ligament (LCL) tear, which concomitant with 35 cases of medial meniscal (MM) tear and 23 cases of lateral meniscal (LM) tear. In combined ligaments injury group, there were 37 combined ACL and MCL injuries, 21 combined ACL and PCL injuries, 10 combined ACL, PCL, and MCL injuries, 8 combined MPFL and MCL injuries, 4 combined ACL, MCL, and MPFL injuries, 2 combined ACL and PT injuries, 2 combined ACL, PCL, and LCL injuries, which concomitant with 43 cases of MM tear and 35 cases of LM tear. The sensitivity, specificity and accuracy for diagnosing ligament tears to be 90.3%, 97.7%and 96.4%respectively in isolated ligament injury group, and 81.5%, 88.4% and 85.9% respectively significant(P0.05). Conclusions ACL injury is the most common injury in isolated ligament injury group, followed by MCL injury. Combined ACL and MCL injuries are the most common

  12. Clinical Results of All-inside Meniscal Repair Using the FasT-Fix Meniscal Repair System

    Directory of Open Access Journals (Sweden)

    Chih-Wei Chiang

    2011-06-01

    Full Text Available Background: The meniscus plays a key role in the functioning of the knee. At the presenttime, meniscal repair has becomes the main treatment for meniscal tear.Compared to open surgery, arthroscopic meniscal repair has become popularbecause of shorter time need for the operation, the smaller wound, and betteraccessibility to the tear portion, which is particularly difficult during opensurgery. Three arthroscopic techniques are widely used, namely inside-out,outside-in, and all-inside. Arthroscopy all inside meniscal repair has the lowest neurovascular injury rate.Methods: This study prospectively evaluated 31 consecutively treated patients to determine the effectiveness/safety of arthroscopic meniscal repair using the FasTFix repair system. The inclusion criteria for this study were: vertical fullthickness tear > 10 mm in length; location of the meniscal tear < 6 mm fromthe meniscocapsular junction; repair of the meniscus solely with the FasTFix system; no former meniscus surgery; and no evidence of arthritis duringarthroscopy. Anterior cruciate ligament (ACL deficient knees were reconstructed using a hamstring autograft at the time of the meniscal repair.Follow-up examinations consisted of Lysholm knee score, Tegner activityscore and radiographic evaluation.Results: After an average of 3 years follow-up, no symptoms of meniscal tears werefound in 30/31 of the cases. For patients with isolated meniscal repair or concurrent ACL reconstruction, the Lysholm and Tegner activity scores hadsignificantly improved postoperatively. No neurovascular or other majorcomplications were directly associated with the use of the device.Conclusions: Arthroscopic all-inside repair using the FasT-Fix device appears to be a safeand effective procedure

  13. Meniscus tears of the knee: Postarthrogram high resolution CT

    International Nuclear Information System (INIS)

    Thirty-eight knees with clinically suspected meniscal tears were examined with high resolution computed tomography(HRCT) immediately following double contrast arthrography. All subsequently underwent arthroscopy. The findings of postarthrogram HRCT and arthroscopy were compared to evaluated the usefulness of postarthrogram HRCT in diagnosis of the meniscal tears. The sensitivity, specificity and accuracy of HRCT were 96.2%. 83.3% and 92.1% respectively. The anatomic details of the meniscal tears were clearly visible on the HRCT scans. Sagittal and coronal reformation views well visualized the horizontal tears and the relationship of torn meniscal fragments, and well differential the peripheral tears from the synovial recess. Our result indicate that postarthrogram HRCT not only is a sensitive and effective method for the detection and characterization of the meniscal tears, but also provides arthroscopists with the appropriate surgical plans

  14. Meniscal pathology in children: differences and similarities with the adult meniscus

    International Nuclear Information System (INIS)

    The normal meniscus undergoes typical developmental changes during childhood, reaching a mature adult appearance by approximately 10 years of age. In addition to recognizing normal meniscal appearances in children, identifying abnormalities - such as tears and the different types of discoid meniscus and meniscal cysts, as well as the surgical implications of these abnormalities - is vital in pediatric imaging. The reported incidence of meniscal tears in adolescents and young adults has increased because of increased sports participation and more widespread use of MRI. This review discusses the normal appearance of the pediatric meniscus, meniscal abnormalities, associated injuries, and prognostic indicators for repair. (orig.)

  15. Meniscal pathology in children: differences and similarities with the adult meniscus

    Energy Technology Data Exchange (ETDEWEB)

    Francavilla, Michael L.; Restrepo, Ricardo; Zamora, Kathryn W.; Sarode, Vijaya [Department of Radiology, Miami Children' s Hospital, Miami, FL (United States); Swirsky, Stephen M. [Department of Orthopedics, Miami Children' s Hospital, Miami, FL (United States); Mintz, Douglas [Hospital for Special Surgery, New York, NY (United States)

    2014-08-15

    The normal meniscus undergoes typical developmental changes during childhood, reaching a mature adult appearance by approximately 10 years of age. In addition to recognizing normal meniscal appearances in children, identifying abnormalities - such as tears and the different types of discoid meniscus and meniscal cysts, as well as the surgical implications of these abnormalities - is vital in pediatric imaging. The reported incidence of meniscal tears in adolescents and young adults has increased because of increased sports participation and more widespread use of MRI. This review discusses the normal appearance of the pediatric meniscus, meniscal abnormalities, associated injuries, and prognostic indicators for repair. (orig.)

  16. Meniscotibial (coronary) ligament tears

    International Nuclear Information System (INIS)

    Preservation of the meniscus whenever possible is essential in maintaining knee stability and preventing premature osteoarthritis. Peripheral meniscal tears are the most amenable to surgical repair. This study evaluates the peripheral attachments of the medial meniscus and focuses on a specific tear limited to the meniscotibial ligament (coronary ligament). The diagnosis is made arthrographically when the medial meniscus floats above the tibial plateau without separating completely from the capsule. The lateral meniscus is rarely involved in this type of injury. (orig.)

  17. 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 ...

  18. Transosseous Medial Meniscal Root Repair Using a Modified Mason-Allen Suture Configuration.

    Science.gov (United States)

    Lavender, Chad D; Hanzlik, Shane R; Caldwell, Paul E; Pearson, Sara E

    2015-12-01

    Medial meniscal tears are among the most common injuries to the knee joint. Loss of the meniscus has been linked to increased contact pressures on the adjacent articular cartilage and progression of degenerative changes in the knee. A subset of tears known as "root tears" involves the insertion of the posterior horn of the meniscus to the bone. Arthroscopic partial meniscectomy for root tears led to undesirable outcomes, which prompted surgeons to explore restorative procedures. Multiple repair techniques have been presented with an emphasis placed on initial secure fixation and stimulation of potential healing. We present an arthroscopic-assisted technique for medial meniscal root repair with these goals in mind. PMID:27284511

  19. The Value of Sonography in Diagnosis of Meniscal Injury

    Directory of Open Access Journals (Sweden)

    A Forouzmehr

    2004-10-01

    Full Text Available Background: Regarding the high incidence of meniscal injuries, a cost-effective, noninvasive, and also accurate diagnostic modality is highly needed. This study was conducted to assess the diagnostic value of sonography in detecting meniscus tears in comparison with arthrography. Methods: A total of 136 patients with symptoms of meniscal injury were examined with both sonography and arthrography by separate radiologists. The sensitivity, specificity, positive, and negative predictive values of sonography were calculated versus arthrography. Results: The sensitivity of sonography in diagnosing meniscus tear was 75 percent, specificity 88 percent, positive predictive value 80 percent, and negative predictive value 85 percent. Conclusion: Our results show that we can’t yet replace other methods with higher diagnostic value with sonography completely but regarding its advantages, it can be used along with other routine modalities. Keywords: Meniscus Tear, Sonography, Arthrography, Diagnostic Value.

  20. Integrity of articular cartilage on T2 mapping associated with meniscal signal change

    International Nuclear Information System (INIS)

    Objective: The purpose of this study was to investigate the relationship between T2 relaxation values (T2 RVs) within the superficial zone of articular cartilage and different types of meniscal degeneration/tear. Materials and methods: A review of 310 consecutive knee MRIs which included an 8 echo T2 relaxation sequence, in patients referred for standard clinical indications, was performed independently and in blinded fashion by 2 observers. The posterior horns of the medial and lateral menisci were each evaluated and divided into 4 subgroups: Normal (control), Grade I/II meniscal signal, Grade III meniscal signal-simple tear (Grade III-S), and Grade III meniscal signal-complex tear (Grade III-C). After exclusion criteria were applied, the medial meniscal group consisted of 65 controls and 133 patients, while the lateral meniscal group consisted of 143 controls and 55 patients. T2 RVs were measured by an observer blinded to the clinical history and MRI grading. Measurements were obtained over the superficial zone of femoral and tibial articular cartilage adjacent to the center of the posterior horn of each meniscus to ensure consistency between measurements. Analysis of covariance adjusting for age and gender was used to compare T2 RVs between patients and controls. Results: T2 RVs were significantly increased in patients with Grade III-C meniscal tears compared to controls over the medial tibial plateau (MTP; p = 0.0001) and lateral tibial plateau (LTP; p = 0.0008). T2 RVs were not increased in patients with Grade III-C meniscal tears over the medial femoral condyle (MFC; p = 0.11) or lateral femoral condyle (LFC; p = 0.99). Grade I/II meniscal signal was not associated with elevated T2 RVs over the MFC (p = 0.15), LFC (p = 0.69), MTP (p = 0.42), or LTP (p = 0.50). Grade III-S meniscal signal was not associated with elevated T2 RVs over the MFC (p = 0.54), LFC (p = 0.43), MTP (p = 0.30), or LTP (p = 0.38). Conclusion: Grade III-C meniscal tears are associated with

  1. Integrity of articular cartilage on T2 mapping associated with meniscal signal change

    Energy Technology Data Exchange (ETDEWEB)

    Kai, Brian [Department of Radiology, University of British Columbia, UBC Hospital, 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5 (Canada); Mann, Sumeer A. [Department of Radiology, University of Alberta, Walter Mackenzie Health Sciences Center, Edmonton, AB, T6G 2B7 (Canada); King, Chris [Department of Radiology, University of British Columbia, UBC Hospital, 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5 (Canada); Forster, Bruce B., E-mail: bruce.forster@vch.ca [Department of Radiology, University of British Columbia, UBC Hospital, 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5 (Canada)

    2011-09-15

    Objective: The purpose of this study was to investigate the relationship between T2 relaxation values (T2 RVs) within the superficial zone of articular cartilage and different types of meniscal degeneration/tear. Materials and methods: A review of 310 consecutive knee MRIs which included an 8 echo T2 relaxation sequence, in patients referred for standard clinical indications, was performed independently and in blinded fashion by 2 observers. The posterior horns of the medial and lateral menisci were each evaluated and divided into 4 subgroups: Normal (control), Grade I/II meniscal signal, Grade III meniscal signal-simple tear (Grade III-S), and Grade III meniscal signal-complex tear (Grade III-C). After exclusion criteria were applied, the medial meniscal group consisted of 65 controls and 133 patients, while the lateral meniscal group consisted of 143 controls and 55 patients. T2 RVs were measured by an observer blinded to the clinical history and MRI grading. Measurements were obtained over the superficial zone of femoral and tibial articular cartilage adjacent to the center of the posterior horn of each meniscus to ensure consistency between measurements. Analysis of covariance adjusting for age and gender was used to compare T2 RVs between patients and controls. Results: T2 RVs were significantly increased in patients with Grade III-C meniscal tears compared to controls over the medial tibial plateau (MTP; p = 0.0001) and lateral tibial plateau (LTP; p = 0.0008). T2 RVs were not increased in patients with Grade III-C meniscal tears over the medial femoral condyle (MFC; p = 0.11) or lateral femoral condyle (LFC; p = 0.99). Grade I/II meniscal signal was not associated with elevated T2 RVs over the MFC (p = 0.15), LFC (p = 0.69), MTP (p = 0.42), or LTP (p = 0.50). Grade III-S meniscal signal was not associated with elevated T2 RVs over the MFC (p = 0.54), LFC (p = 0.43), MTP (p = 0.30), or LTP (p = 0.38). Conclusion: Grade III-C meniscal tears are associated with

  2. Evaluation of meniscal subluxation of the knee with MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Chul; Park, Jin Gyoon; Kang, Heoung Keun; Kim, Jae Kyu; Seo, Jeong Jin; Kim, Yun Hyeon; Chung, Tae Woong [Chonnam Univ. Medical School, Kwangju (Korea, Republic of)

    2000-12-01

    The purpose of this study was to determine the normal meniscal position and meniscal subluxation by means of MR imaging. The normal position of the meniscus was determined by measuring the distance between the peripheral meniscal borders and the tibial plateau, as seen on coronal, sagittal and oblique MR images of 40 normal knees. For 33 abnormal knees in which outward subluxation of the meniscus from the tibial plateau was noted, the involved site, the predisposing factor, and the frequency of meniscus tearing were analyzed. In normal knees, the peripheral border of the meniscus extruded 3mm or less from the peripheral border of the tibial plateau. Among 33 abnormal knees, in which 5mm or more outward subluxation of the meniscus was seen, 19 menisci were medial and 14 were lateral. Among the 19, the body was involved in 12, the anterior horn in six, and the posterior horn in one. With regard to the 14 lateral subluxations, involvement of the posterior horn occurred in ten, of both the body and posterior horn in two, of the anterior horn in one, and of the body in one. The common predisposing factor in medial meniscus subluxation was osteoarthritis, seen in 89% of such cases, and in lateral subluxation, anterior cruciate ligament tear, which occurred in 79% of cases. Medial meniscus tear was noted in 89% of medial meniscus subluxations and lateral meniscus tear in 43% of lateral subluxations. Meniscal subluxation was easily detected by MR imaging of the knee. The common predisposing factor in medial meniscus subluxation was osteoarthritis, and in lateral meniscus subluxation, anterior cruciate ligament tear. A torn meniscus frequently co-occurred.

  3. Evaluation of meniscal subluxation of the knee with MR imaging

    International Nuclear Information System (INIS)

    The purpose of this study was to determine the normal meniscal position and meniscal subluxation by means of MR imaging. The normal position of the meniscus was determined by measuring the distance between the peripheral meniscal borders and the tibial plateau, as seen on coronal, sagittal and oblique MR images of 40 normal knees. For 33 abnormal knees in which outward subluxation of the meniscus from the tibial plateau was noted, the involved site, the predisposing factor, and the frequency of meniscus tearing were analyzed. In normal knees, the peripheral border of the meniscus extruded 3mm or less from the peripheral border of the tibial plateau. Among 33 abnormal knees, in which 5mm or more outward subluxation of the meniscus was seen, 19 menisci were medial and 14 were lateral. Among the 19, the body was involved in 12, the anterior horn in six, and the posterior horn in one. With regard to the 14 lateral subluxations, involvement of the posterior horn occurred in ten, of both the body and posterior horn in two, of the anterior horn in one, and of the body in one. The common predisposing factor in medial meniscus subluxation was osteoarthritis, seen in 89% of such cases, and in lateral subluxation, anterior cruciate ligament tear, which occurred in 79% of cases. Medial meniscus tear was noted in 89% of medial meniscus subluxations and lateral meniscus tear in 43% of lateral subluxations. Meniscal subluxation was easily detected by MR imaging of the knee. The common predisposing factor in medial meniscus subluxation was osteoarthritis, and in lateral meniscus subluxation, anterior cruciate ligament tear. A torn meniscus frequently co-occurred

  4. Unusual Presentation of Synovial Sarcoma as Meniscal Cyst: A Case Report

    OpenAIRE

    Khodamorad Jamshidi; Hooman Yahazadeh; Abolfazl Bagherifard

    2015-01-01

    Periarticular cyst and cystic soft tissue lesion around the knee are common. Synovial sarcoma is a rare and malignant soft tissue tumor accounting for approximately 5% of soft tissue sarcoma. A case is presented where a lesion adjacent to the joint line of the knee was diagnosed clinically and on imaging as a meniscal cyst. MRI signal was homogenous and no concomitant meniscal tears were seen. The tissue diagnosis was monophasic synovial sarcoma.

  5. 关节镜下全关节内FasT-Fix技术缝合修复半月板损伤36例%Arthroscopic repair of meniscal tears by FasT-Fix technique: a report of 36 cases

    Institute of Scientific and Technical Information of China (English)

    王予彬; 王惠芳; 朱文辉; 崔芳; 袁锋; 卢亮宇; 孙文琳

    2008-01-01

    Objective To assess clinical outcomes of FasT-Fix technique in repair of meniscal injury under arthroscope. Methods A total of 36 cases (37 knees) of mensical tears were repaired with FasF-Fix technique. There were 26 males and 10 females, at mean age of 26 years (14-51 years). Eighteen meniscal tears were located in zone Ⅱ, 16 in zone Ⅲ and 3 in zone Ⅳ. The average length of the tear was 2.2 cm (1.0-3.0 cm). Results There were no any signs of early complications after sur gery. All cases were followed up For 6-26 months (mean 16 months). According to Lysholm scoring scale system ,the average score of operated knees was increased from preoperative 44.13+12.56 to postopera tive 80.24+12.67 (P<0.01). After operation, all the patients could move the knee joint at normal range, except for one case who had a limitation of 20 degree flexion, with no pain or interlocking symptom. All cases returned to original work and/or could continue sports game. Conclusion The FasT-Fix technique is a simple, safe and effective method for repair of properly selected meniscal tears.%目的 探讨关节镜下用FasT-Fix技术全关节内缝合修复半月板损伤的临床应用效果,评价其临床意义.方法 关节镜下用FasT-Fix技术全关节内缝合修复36例患者37个半月板损伤,其中男26例,女10例;年龄14-51岁,平均26岁.半月板损伤分区:Ⅱ区18例,Ⅲ区16例,Ⅳ区3例.撕裂长度平均为2.2 cm(1.0-3.0 cm).结果 所有患者术后均无早期并发症发生.随访时间6-26个月,平均16个月,除1侧膝关节屈曲受限20°外,其余膝关节伸屈功能正常,无疼痛及交锁症状.所有患者均恢复原工作、生活、运动.Lysholm评分:术前(44.13+12.56)分,术后(80.24+12.67)分(P<0.01).结论 对于合适的半月板损伤患者,FasT-Fix缝合系统是一种简便、快速、安全、有效的全关节内缝合方法.

  6. Analysis of meniscal degeneration and meniscal gene expression

    Directory of Open Access Journals (Sweden)

    Norton James H

    2010-01-01

    Full Text Available Abstract Background Menisci play a vital role in load transmission, shock absorption and joint stability. There is increasing evidence suggesting that OA menisci may not merely be bystanders in the disease process of OA. This study sought: 1 to determine the prevalence of meniscal degeneration in OA patients, and 2 to examine gene expression in OA meniscal cells compared to normal meniscal cells. Methods Studies were approved by our human subjects Institutional Review Board. Menisci and articular cartilage were collected during joint replacement surgery for OA patients and lower limb amputation surgery for osteosarcoma patients (normal control specimens, and graded. Meniscal cells were prepared from these meniscal tissues and expanded in monolayer culture. Differential gene expression in OA meniscal cells and normal meniscal cells was examined using Affymetrix microarray and real time RT-PCR. Results The grades of meniscal degeneration correlated with the grades of articular cartilage degeneration (r = 0.672; P HLA-DPA1, integrin, beta 2 (ITGB2, ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1, ankylosis, progressive homolog (ANKH and fibroblast growth factor 7 (FGF7, were expressed at significantly higher levels in OA meniscal cells compared to normal meniscal cells. Importantly, many of the genes that have been shown to be differentially expressed in other OA cell types/tissues, including ADAM metallopeptidase with thrombospondin type 1 motif 5 (ADAMTS5 and prostaglandin E synthase (PTGES, were found to be expressed at significantly higher levels in OA meniscal cells. This consistency suggests that many of the genes detected in our study are disease-specific. Conclusion Our findings suggest that OA is a whole joint disease. Meniscal cells may play an active role in the development of OA. Investigation of the gene expression profiles of OA meniscal cells may reveal new therapeutic targets for OA therapy and also may uncover novel

  7. Failure properties and strain distribution analysis of meniscal attachments.

    Science.gov (United States)

    Villegas, Diego F; Maes, Jason A; Magee, Sarah D; Donahue, Tammy L Haut

    2007-01-01

    The menisci are frequently injured due to both degeneration and traumatic tearing. It has been suggested that the success of a meniscal replacement is dependent on several factors, one of which is the secure fixation and firm attachment of the replacement to the tibial plateau. Therefore, the objectives of the current study were to (1) determine the failure properties of the meniscal horn attachments, and (2) determine the strain distribution over their surfaces. Eight bovine knee joints were used to study the mechanical response of the meniscal attachments. Three meniscal attachments from one knee of each animal were tested in uniaxial tension at 2%/s to determine the load deformation response. During the tests, the samples were marked and local strain distributions were determined with a video extensometer. The linear modulus of the medial anterior attachment (154+/-134 MPa) was significantly less than both the medial posterior (248+/-179 MPa, p=0.0111) and the lateral anterior attachment (281+/-214 MPa, p=0.0007). Likewise, the ultimate strain for the medial anterior attachments (13.5+/-8.8%) was significantly less than the medial posterior (23+/-13%, p0.05). No significant differences in ultimate strain or moduli across the surface of the attachments were noted. Based on the data obtained, a meniscal replacement would need different moduli for each of the different attachments. However, the attachments appear to be homogeneous. PMID:17359982

  8. Value of modern sonography in the assessment of meniscal lesions

    International Nuclear Information System (INIS)

    The aim of this prospective study was to assess the accuracy of modern ultrasonography in diagnostic imaging of meniscal tears. One hundred and sixty menisci were evaluated in 80 patients (42 females, 38 males, mean age = 36.2 years, range = 16–70 years). Inclusion criteria for the study were twofold: clinical suspicion of meniscal injury and clinical indication for arthroscopy. Knee examination was performed with the Voluson 730 Expert ultrasound system (General Electric). After sonographic examination, all patients underwent arthroscopic procedures within 1–4 days. The final diagnosis of meniscal tears was taken from surgical reports. The overall sensitivity, specificity, positive predictive value and negative predictive value of sonographic examination in the assessment of meniscal tears amounted to 85.4%, 85.7%, 67.3% and 94.4%, respectively. The statistical parameters were not statistically different in medial and lateral menisci. Age, sex, body mass index (BMI), weight, physical activity, mechanism on injury, and time lapse from injury did not have a statistically significant impact on the usefulness of ultrasonography. The highest sensitivity (>90%) was obtained in medial menisci and in patients with a BMI > 25. The highest specificity (>90%) was obtained in lateral menisci, in patients after twisting injuries, in sports injuries, and in recent injuries (time lapse from the injury <1 month). The positive predictive value (PPV) of sonographic examination was higher than 90% only in recent injuries (<1 month), however, the negative predictive value of ultrasound is high, being less than 90% in males with lesions of lateral menisci and in sequelae of sports injuries

  9. Value of modern sonography in the assessment of meniscal lesions

    Energy Technology Data Exchange (ETDEWEB)

    Wareluk, Pawel, E-mail: pwareluk@wum.edu.pl [Department of Diagnostic Imaging, Second Faculty of Medicine, Medical University of Warsaw, ul. Kondratowicza 8, 03-242 Warsaw (Poland); Szopinski, Kazimierz T., E-mail: kszopinski@wum.edu.pl [Department of Dental and Maxillofacial Radiology, First Faculty of Medicine, Medical University of Warsaw, ul. Nowogrodzka 59, 02-006 Warsaw (Poland)

    2012-09-15

    The aim of this prospective study was to assess the accuracy of modern ultrasonography in diagnostic imaging of meniscal tears. One hundred and sixty menisci were evaluated in 80 patients (42 females, 38 males, mean age = 36.2 years, range = 16–70 years). Inclusion criteria for the study were twofold: clinical suspicion of meniscal injury and clinical indication for arthroscopy. Knee examination was performed with the Voluson 730 Expert ultrasound system (General Electric). After sonographic examination, all patients underwent arthroscopic procedures within 1–4 days. The final diagnosis of meniscal tears was taken from surgical reports. The overall sensitivity, specificity, positive predictive value and negative predictive value of sonographic examination in the assessment of meniscal tears amounted to 85.4%, 85.7%, 67.3% and 94.4%, respectively. The statistical parameters were not statistically different in medial and lateral menisci. Age, sex, body mass index (BMI), weight, physical activity, mechanism on injury, and time lapse from injury did not have a statistically significant impact on the usefulness of ultrasonography. The highest sensitivity (>90%) was obtained in medial menisci and in patients with a BMI > 25. The highest specificity (>90%) was obtained in lateral menisci, in patients after twisting injuries, in sports injuries, and in recent injuries (time lapse from the injury <1 month). The positive predictive value (PPV) of sonographic examination was higher than 90% only in recent injuries (<1 month), however, the negative predictive value of ultrasound is high, being less than 90% in males with lesions of lateral menisci and in sequelae of sports injuries.

  10. Meniscal position on routine MR imaging of the knee

    Energy Technology Data Exchange (ETDEWEB)

    Miller, T.T. [Department of Radiology, Columbia-Presbyterian Medical Center, Milstein Hospital Building 2-121, 177 Fort Washington Ave., New York, NY 10032 (United States)]|[Department of Radiology, North Shore University Hospital, 300 Community Drive, Manhasset, NY 11030 (United States); Staron, R.B. [Department of Radiology, Columbia-Presbyterian Medical Center, Milstein Hospital Building 2-121, 177 Fort Washington Ave., New York, NY 10032 (United States); Feldman, F. [Department of Radiology, Columbia-Presbyterian Medical Center, Milstein Hospital Building 2-121, 177 Fort Washington Ave., New York, NY 10032 (United States); Cepel, E. [Department of Radiology, Columbia-Presbyterian Medical Center, Milstein Hospital Building 2-121, 177 Fort Washington Ave., New York, NY 10032 (United States)

    1997-07-07

    Objective. To determine the prevalence of meniscal protrusion (i.e. location of the outer edge of a meniscus beyond the tibial articular surface), and to determine its relationship with internal derangement, joint effusion, and degenerative arthropathy. Design and patients. Sagittal and coronal MR images of 111 abnormal and 46 normal knees were evaluated for the presence of meniscal protrusion. We set 25% as the minimum amount of displacement considered abnormal because this was the smallest amount of displacement we could confidently discern. Presence of meniscal tear, anterior cruciate ligament (ACL) injury, joint effusion, or osteophytosis was also recorded. Results and conclusion. Normal examinations demonstrated protrusion of the medial meniscus in 6.5% of sagittal images and 15% of coronal images, and of the lateral meniscus in 2% and 13%, respectively. Fisher`s exact test demonstrated a statistically significant difference between the normal and abnormal groups for the medial meniscus on both sagittal (P<0.0001) and coronal (P=0.01) images, but not for the lateral meniscus in either plane (P>0.2). A protruding medial meniscus was associated with effusion and osteophytosis (P<0.05) but not with meniscal or ACL tear (P>0.1). Posterior protrusion of the lateral meniscus was only associated with ACL injury (P<0.0001); protruding anterior horns and bodies of lateral menisci were not associated with any of the four abnormalities. It is concluded that the medial meniscus may occasionally protrude more than 25% of its width, but protrusion is more often due to effusion and osteophytes. Protrusion of the posterior horn of the lateral meniscus is associated with ACL insufficiency, while protrusion of the body and anterior horn of the lateral meniscus is a normal variant. (orig.). With 4 figs.

  11. 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

  12. Potential pitfalls of a double PCL sign

    Energy Technology Data Exchange (ETDEWEB)

    Venkatanarasimha, Nanda [Derriford Hospital, Department of Radiology, Plymouth (United Kingdom); Kamath, A. [Royal Gwent Hospital, Department of Accident and Emergency, Newport (United Kingdom); Mukherjee, K.; Kamath, S. [University Hospital of Wales, Department of Radiology, Cardiff (United Kingdom)

    2009-08-15

    The double posterior cruciate ligament (PCL) sign is seen on a midline sagittal MR image of the knee as a low-signal-intensity linear band paralleling the antero-inferior part of the PCL. Although the sign has a high specificity for a displaced bucket-handle tear of the medial meniscus, it can be mimicked by several normal and abnormal structures in the intercondylar region. Familiarity with these variants and identifying the other features supportive of meniscal injury will help to make a confident diagnosis of bucket-handle tear of the medial meniscus. (orig.)

  13. Comparison of Medial and Lateral Meniscus Root Tears.

    Directory of Open Access Journals (Sweden)

    Ji Hyun Koo

    Full Text Available The meniscus root plays an essential role in maintaining the circumferential hoop tension and preventing meniscal displacement. Studies on meniscus root tears have investigated the relationship of osteoarthritis and an anterior cruciate ligament tear. However, few studies have directly compared the medial and lateral root tears. To assess the prevalence of meniscal extrusion and its relationship with clinical features in medial and lateral meniscus root tears, we performed a retrospective review of the magnetic resonance imaging (MRI results of 42 knee patients who had meniscus posterior horn root tears and who had undergone arthroscopic operations. The presence of meniscal extrusion was evaluated and the exact extent was measured from the tibial margin. The results were correlated with arthroscopic findings. Clinical features including patients' ages, joint abnormalities, and previous trauma histories were evaluated. Twenty-two patients had medial meniscus root tears (MMRTs and twenty patients had lateral meniscus root tears (LMRTs. Meniscal extrusion was present in 18 MMRT patients and one LMRT patient. The mean extent of extrusion was 4.2mm (range, 0.6 to 7.8 in the MMRT group and 0.9mm (range, -1.9 to 3.4 in the LMRT group. Five patients with MMRT had a history of trauma, while 19 patients with LMRT had a history of trauma. Three patients with MMRT had anterior cruciate ligament (ACL tears, while 19 patients with LMRT had ACL tears. The mean age of the patients was 52 years (range: 29-71 years and 30 years (range: 14-62 years in the MMRT and LMRT group, respectively. There was a significant correlation between a MMRT and meniscal extrusion (p<0.0001, and between an ACL tear and LMRT (p<0.0001. A history of trauma was significantly common in LMRT (p<0.0001. LMRT patients were significantly younger than MMRT patients (p<0.0001. Kellgren-Lawrence (K-L grade differed significantly between MMRT and LMRT group (p<0.0001. Meniscal extrusion is

  14. Repairing Posteromedial Meniscocapsular Separation: A Technique Using Inside-Out Meniscal Repair Needles.

    Science.gov (United States)

    Joshi, Anant; Usman, Sajeer; Sabnis, Bhushan; Kini, Abhishek

    2016-02-01

    Posteromedial meniscocapsular separation of the knee has received renewed interest, with many articles describing a high incidence in association with anterior cruciate ligament injury. Various techniques have been described to address these lesions using all-inside meniscal repair sutures or using rotator cuff repair instruments through the posteromedial portal. Most orthopaedic surgeons are accustomed to using the "inside-out" meniscal repair technique with a double-armed suture. This technique is cost-effective and, in our opinion, more efficient in repairing such tears. We present our technique of repairing peripheral meniscocapsular lesions using an inside-out meniscal repair system. We believe that this technique is easily reproducible, is less time-consuming, and ensures a good "bite" of the capsular tissue, producing a robust repair. PMID:27073773

  15. Large lateral meniscal ganglion cyst extending into the intercondylar fossa of the knee.

    Science.gov (United States)

    Jäger, Alwin; Eberhardt, Christian; Hailer, Nils P

    2004-07-01

    We report the case of a 31-year-old, otherwise healthy man with a large intra-articular meniscal ganglion cyst (27.7 x 13.5 mm) originating from the dorsal horn of the lateral meniscus. Clinically, the patient presented with knee pain in a squatting position. Magnetic resonance imaging revealed a large intra-articular cyst in the posterior compartment. At arthroscopic surgery, the ganglion cyst was found in the intercondylar space posteriorly to the posterior cruciate ligament. After removal of the ganglion cyst, a horizontal tear in the dorsal horn of the lateral meniscus was revealed and treated by partial meniscectomy. To our knowledge, a meniscal ganglion cyst originating from the lateral meniscus and extending into the joint is an extremely rare event, with only two previous reported cases. We review the current literature on the pathogenesis, distribution, and treatment of meniscal ganglion cysts. PMID:15243414

  16. MR imaging of the combined anterior and posterior cruciate ligament tears: focussing on the ratterns of injuries and associated findings

    International Nuclear Information System (INIS)

    To evaluate the patterns of injuries and frequency of associated findings on MR imaging in patients with both anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL)tears;to compare the associated findings, as seen on MR imaging, in cases with both ACL and PCL tears with those with ACL or PCL tears. Ten patients with compbined ACL and PCL tears, 16 with ACL tears and 18 with PCL tears, all confirmed by arthroscopy or open surgery, were involved in this study. To identify the associated knee injuries, MR images were retrospectively evaluated. In ten patients with combined ACL and PCL tears, open surgery led to the identification of six complete ACL tears (60%), four partial ACL tears (40%), eitht complete PCL tears (80%) and two partial PCL tears (20%). Injuries associated with these combined tears, and revealed by MR imaging, comprised six medial collateral ligament injuries (60%), six lateral collateral ligament jnjuries (60%), five medial meniscal injuries (50%), three lateral meniscal injuries (30%), nine bony injuries (90%), two posterior capsular injuries (20%), and three popliteus muscle injuries (30%). The frequency of popliteus muscle injury was significantly different (p<0.05, Fisher's exact test) between the group with both ACL and PCL tears and that with ACL or PCL tears. Associated findings in patients with combined ACL and PCL tears are more frequent than in those with ACL or PCL tears. In cases involving combined ACL and PCL tears, associated findings-as seen on MR images-should thus be carefully examined

  17. Accuracy of MRI patterns in evaluating anterior cruciate ligament tears

    International Nuclear Information System (INIS)

    The purpose of this study was to determine the different patterns of anterior cruciate ligament (ACL) tears on MRI and the prevalence and accuracy of these patterns. Images were obtained on high-tesla and low-tesla units and the results compared to determine whether field strength affects the interpretation using the grading system. In 172 patients who underwent knee MRI (109 knees with high-tesla units and 63 knees with low-tesla units) and arthroscopy, there was a total of 91 arthroscopically proven ACL tears. Five patterns of ACL tears were observed and designated as type 1 (diffuse increase in signal on T2-weighted images and enlargement of the ligament, 48%); type 2 (horizontally oriented ACL, 21%); type 3 (nonvisualization of the ACL, 18%); type 4 (discontinuity of the ACL, 11%); and type 5 (vertically oriented ACL, 2%). The positive predictive value (PPV) for type 2, 4, and 5 patterns was 100% for both field strengths; for type 3 PPV was just above 80% for both field strengths. The PPV value for type 1 was 90% for the high-tesla unit and 79% for the low-tesla, unit, which was not statistically significant. Combining the results of both field strengths, the overall sensitivity and specificity were 93% and 89%, respectively. Arthroscopic results were also used to determine the association between meniscal and ACL tears. Only 13% of ACL tears were isolated, the rest being associated with meniscal tears. Forty-five percent of medial meniscal and 50% of lateral meniscal tears were associated with an ACL tear, and 94% of ACLs were torn when both menisci were torn. (orig.)

  18. Meniscal position on routine MR imaging of the knee

    International Nuclear Information System (INIS)

    Objective. To determine the prevalence of meniscal protrusion (i.e. location of the outer edge of a meniscus beyond the tibial articular surface), and to determine its relationship with internal derangement, joint effusion, and degenerative arthropathy. Design and patients. Sagittal and coronal MR images of 111 abnormal and 46 normal knees were evaluated for the presence of meniscal protrusion. We set 25% as the minimum amount of displacement considered abnormal because this was the smallest amount of displacement we could confidently discern. Presence of meniscal tear, anterior cruciate ligament (ACL) injury, joint effusion, or osteophytosis was also recorded. Results and conclusion. Normal examinations demonstrated protrusion of the medial meniscus in 6.5% of sagittal images and 15% of coronal images, and of the lateral meniscus in 2% and 13%, respectively. Fisher's exact test demonstrated a statistically significant difference between the normal and abnormal groups for the medial meniscus on both sagittal (P0.2). A protruding medial meniscus was associated with effusion and osteophytosis (P0.1). Posterior protrusion of the lateral meniscus was only associated with ACL injury (P<0.0001); protruding anterior horns and bodies of lateral menisci were not associated with any of the four abnormalities. It is concluded that the medial meniscus may occasionally protrude more than 25% of its width, but protrusion is more often due to effusion and osteophytes. Protrusion of the posterior horn of the lateral meniscus is associated with ACL insufficiency, while protrusion of the body and anterior horn of the lateral meniscus is a normal variant. (orig.). With 4 figs

  19. Magnetic resonance imaging of meniscal and anterior cruciate ligament injuries of the knee

    International Nuclear Information System (INIS)

    To categorise discrepancies in findings of the menisci and anterior cruciate ligament (ACL) between arthroscopy and MRI. Materials and methods: The MRIs of 236 patients were retrospectively analysed by an experienced radiologist without knowledge of clinical and/for operative findings. Discrepancies in arthroscopic findings were reevaluated together with the arthroscopist to determine their cause of error. Results: The diagnostic accuracies for injuries of the medial and lateral meniscus and the ACL were 92.4%, 92.4%, and 94.1%. respectively. For the menisci, causes for discrepancies in findings (n=31) were: overinterpretation of central signal intensities with contact to the meniscal surface but without disturbance of the meniscal contour as a tear (n=12), insufficient arthroscopie evaluation of the knee joint (n=11), overlooked tears on MR imaging (n=6), misinterpretation of normal anatomic structures (n=1), ''magic angle'' phenomenon (n=1), and missed tears at MRI (n=1). Causes for discrepancies for the ACL (n=18) were: nearly complete versus complete rupture either at MRI or arthroscopy and vice versa (n=9), insufficient arthroscopic evaluation (n=6), insufficient MRI technique (n=2), and overlooked tear on MR imaging (n=1). Conclusions: Discrepant findings between MRI and arthroscopy may be also due to an insufficient arthroscopic evaluation in clinical routine. The close cooperation between surgeons and radiologists improves the understanding of the methods of each other. (orig.)

  20. Risk factors for medial meniscal pathology on knee MRI in older U.S. adults: A multicenter prospective cohort study

    Science.gov (United States)

    Englund, Martin; Felson, David T.; Guermazi, Ali; Roemer, Frank W.; Wang, Ke; Crema, Michel D.; Lynch, John A.; Sharma, Leena; Segal, Neil A; Lewis, Cora E.; Nevitt, Michael C.

    2016-01-01

    Objectives Knee trauma is a known cause of meniscal tear. However, meniscal pathology where the aetiology is often unclear is a frequent finding on knee magnetic resonance imaging (MRI).Our objective was to investigate potential risk factors for medial meniscal lesions or extrusion in middle-aged and elderly persons. Methods Prospective cohort study using population-based subjects from Birmingham, Alabama and Iowa City, Iowa, United States (the Multicenter Osteoarthritis Study (MOST)). We studied 644 men and women aged 50 to 79 years with or at high risk of knee osteoarthritis (Kellgren and Lawrence grade 0 to 2) but with normal medial meniscal status at baseline. We scored paired baseline and 30-month 1.0T knee MRIs for meniscal lesions and extrusion (pathology) and evaluated the following systemic, knee-specific, and compartment-specific potential risk factors: age, sex, body mass index, bony enlargement of finger joints, knee trauma, leg-length inequality, and knee alignment. Results Of 791 knees, 77 (9.7%) had medial meniscal pathology at 30-months follow-up. Sixty-one of these 77 knees (81%) had no report of trauma during follow-up. Including all potential risk factors in the multivariable model, the adjusted odds ratio (OR) for medial meniscal pathology was 4.14 (95% confidence interval 2.06, 8.31) for knee trauma during follow-up, 1.64 (1.00, 2.70) for ≥5 bony enlargements of finger joints (vs. ≤4), and 2.00 (1.18, 3.40) for varus alignment (vs. not varus) at baseline exam. Further, obesity was a risk factor for the development of meniscal extrusion, OR 3.04 (1.04, 8.93) but not for meniscal lesions, OR 1.15 (0.52, 2.54). Conclusions Apart from knee trauma, possible generalised osteoarthritis, expressed as multiple bony enlargements of finger joints, varus alignment, and obesity are risk factors for medial meniscal pathology. PMID:21646417

  1. Three Tesla MRI for the diagnosis of meniscal and anterior cruciate ligament pathology: a comparison to arthroscopic findings

    International Nuclear Information System (INIS)

    Aim: To assess the accuracy of 3 T magnetic resonance imaging (MRI) in the evaluation of meniscal and anterior cruciate ligament (ACL) injury. Materials and methods: Sixty-one consecutive patients were identified who were referred for evaluation of suspected intra-articular pathology with a 3 T MRI and who, subsequently, underwent an arthroscopic procedure of the knee were included for the study. Two musculoskeletal radiologists interpreted the images. The sensitivity, specificity, positive predictive value, and negative predictive value were then calculated for the MRI versus the arthroscopic findings as a reference standard. Results: The sensitivity and specificity for the overall detection of meniscal tears in this study was 84 and 93%, respectively. The results for the medial meniscus separately were 91 and 93% and for the lateral 77 and 93%. The evaluation of ACL integrity was 100% sensitive and specific. The meniscal tear type was correctly identified in 75% of cases and its location in 94%. Conclusion: This study demonstrates good results of 3 T MRI in the evaluation of the injured knee. Caution should still be given to the interpretation on MRI of a lateral meniscus tear, and it is suggested that the standard diagnostic criteria of high signal reaching the articular surface on two consecutive image sections be adhered to even at these higher field strengths

  2. Three Tesla MRI for the diagnosis of meniscal and anterior cruciate ligament pathology: a comparison to arthroscopic findings

    Energy Technology Data Exchange (ETDEWEB)

    Sampson, M.J. [Department of Radiology Sports Surgery Clinic, Santry Demesne, Dublin (Ireland)], E-mail: allymattsampson@hotmail.com; Jackson, M.P.; Moran, C.J.; Moran, R. [Department of Orthopaedics, Sports Surgery Clinic, Santry Demesne, Dublin (Ireland); Eustace, S.J. [Department of Radiology Sports Surgery Clinic, Santry Demesne, Dublin (Ireland); Shine, S. [Department of Radiology, Cappagh Hospital, Finglas, Dublin (Ireland)

    2008-10-15

    Aim: To assess the accuracy of 3 T magnetic resonance imaging (MRI) in the evaluation of meniscal and anterior cruciate ligament (ACL) injury. Materials and methods: Sixty-one consecutive patients were identified who were referred for evaluation of suspected intra-articular pathology with a 3 T MRI and who, subsequently, underwent an arthroscopic procedure of the knee were included for the study. Two musculoskeletal radiologists interpreted the images. The sensitivity, specificity, positive predictive value, and negative predictive value were then calculated for the MRI versus the arthroscopic findings as a reference standard. Results: The sensitivity and specificity for the overall detection of meniscal tears in this study was 84 and 93%, respectively. The results for the medial meniscus separately were 91 and 93% and for the lateral 77 and 93%. The evaluation of ACL integrity was 100% sensitive and specific. The meniscal tear type was correctly identified in 75% of cases and its location in 94%. Conclusion: This study demonstrates good results of 3 T MRI in the evaluation of the injured knee. Caution should still be given to the interpretation on MRI of a lateral meniscus tear, and it is suggested that the standard diagnostic criteria of high signal reaching the articular surface on two consecutive image sections be adhered to even at these higher field strengths.

  3. MR imaging of the combined anterior and posterior cruciate ligament tears: focussing on the ratterns of injuries and associated findings

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Seon Young; Choi, Chang Lak; Park, Dal Soo; Park, Eun Hee; Lee, Sang Ho; Song, Mun Kab; Lee, Kwang Won [Eulji Medical College, Taejon (Korea, Republic of); Kwon, Soon Tae [Chungnam National Univ. College of Medicine, Taejon (Korea, Republic of)

    1997-09-01

    To evaluate the patterns of injuries and frequency of associated findings on MR imaging in patients with both anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL)tears;to compare the associated findings, as seen on MR imaging, in cases with both ACL and PCL tears with those with ACL or PCL tears. Ten patients with compbined ACL and PCL tears, 16 with ACL tears and 18 with PCL tears, all confirmed by arthroscopy or open surgery, were involved in this study. To identify the associated knee injuries, MR images were retrospectively evaluated. In ten patients with combined ACL and PCL tears, open surgery led to the identification of six complete ACL tears (60%), four partial ACL tears (40%), eitht complete PCL tears (80%) and two partial PCL tears (20%). Injuries associated with these combined tears, and revealed by MR imaging, comprised six medial collateral ligament injuries (60%), six lateral collateral ligament jnjuries (60%), five medial meniscal injuries (50%), three lateral meniscal injuries (30%), nine bony injuries (90%), two posterior capsular injuries (20%), and three popliteus muscle injuries (30%). The frequency of popliteus muscle injury was significantly different (p<0.05, Fisher's exact test) between the group with both ACL and PCL tears and that with ACL or PCL tears. Associated findings in patients with combined ACL and PCL tears are more frequent than in those with ACL or PCL tears. In cases involving combined ACL and PCL tears, associated findings-as seen on MR images-should thus be carefully examined.

  4. MR imaging of the knee following cruciate ligament reconstruction and meniscal surgery

    International Nuclear Information System (INIS)

    Due to the increasing number of surgical procedures performed on the knee, MR imaging of the postoperative knee has gained more and more importance. For the evaluation of anterior cruciate ligament grafts and postoperative menisci, basic knowledge of surgical techniques is essential in order to differentiate normal postoperative findings from transplant failure, retears, and complications. This article reviews technical aspects of MR imaging following knee surgery, basic principles of operative techniques for anterior cruciate ligament reconstruction and therapy of meniscal tears, normal postoperative findings, MR imaging criteria for recurrent lesions, and findings with typical complications. (orig.)

  5. SLAP Tears

    Science.gov (United States)

    ... it is above the level of the shoulder • Shoulder dislocation People who participate in repetitive overhead sports, such as throwing athletes or weightli ers, can experience labrum tears as a result of repeated shoulder motion. This cross-section view of the shoulder ...

  6. MRI evaluation of the posterior meniscus root tear

    International Nuclear Information System (INIS)

    Objective: To determine the value of MRI for diagnosing the posterior meniscus root tear. Methods: MR examinations of 30 patients with tear of the posterior meniscus root confirmed by knee arthroscopies were retrospectively reviewed. Of the 30 patients, 17 with posterior medial meniscus root tear (MMRT) and 13 with posterior lateral meniscus root tear (LMRT). The diagnostic sensitivity of' MRI for the posterior meniscus root tear was analyzed. Fisher's exact test was used to compare the detection rate of MRI for MMRT with that for LMRT. Results: All 17 cases with MMRT and 9 cases out of 13 with LMRT were correctly diagnosed by MRI and the diagnostic sensitivity of MRI for the posterior meniscus root tear was 86.7% (26/30). The main MR appearance of the posterior meniscus root tear was distortion of the meniscal root, with its low signal replaced by abnormal high signal. The detection rate of MRI for MMRT (17/17) was significantly greater than that for LMRT (9/13) (P=0.026). The prevalence of MMRT associated with meniscus extrusion (15/17) was significantly greater than that of LMRT (6/13) (P=0.020), but the prevalence of MMRT associated with anterior cruciate ligament (ACL) injury (5/17) was significantly lower than that of LMRT (11/13) (P=0.004). Conclusion: MRI is a relatively good method for detection of posterior meniscus root tears and associated injuries. (authors)

  7. Arthroscopic all-inside meniscal repair - Does the meniscus heal? A clinical and radiological follow-up examination to verify meniscal healing using a 3-T MRI

    Energy Technology Data Exchange (ETDEWEB)

    Hoffelner, Thomas; Resch, Herbert; Mayer, Michael; Tauber, Mark [Department of Traumatology and Sports Injuries, Salzburg (Austria); Forstner, Rosemarie [University Hospital of Salzburg, Department of Radiology, Salzburg (Austria); Minnich, Bernd [University of Salzburg, Department of Organismic Biology, Salzburg (Austria)

    2011-02-15

    The purpose of this study was to correlate clinical and radiological results using a 3-T MRI to verify meniscal healing after arthroscopic all-inside meniscus repair. We selected 27 patients (14 men and 13 women) with an average age of 31 {+-} 9 years and retrospective clinical examinations and radiological assessments using a 3-T MRI after all-inside arthroscopic meniscal repair were conducted. Repair of the medial meniscus was performed in 19 patients and of the lateral meniscus in eight. In 17 patients (63%), we performed concomitant anterior cruciate ligament reconstruction. The mean follow-up period was 4.5 {+-} 1.7 years. The Lysholm score and Tegner activity index were used for clinical evaluation. Four grades were used to classify the radiological signal alterations within the meniscus: central globular (grade 1); linear horizontal or band-like (grade 2); intrameniscal alterations and linear signal alterations communicating with the articular surface (grade 3); and complex tears (grade 4). At follow-up, the average Lysholm score was 76 {+-} 15 points, with ten of the patients placed in group 6 based on the Tegner activity index. MRI examinations revealed no signal alteration in three patients, grade 1 in 0, grade 2 in five, grade 3 in 13, and grade 4 in six. The MRI findings correlated positively with the clinical scores in 21 patients (78%). Correlation of clinical and radiological examination was performed using 3-T MRI. In spite of satisfactory clinical outcomes at follow-up, a radiological signal alteration may still be visible on MRI, which was believed to be scar tissue, but could not be proven definitively. Imaging with a 3-Tesla MRI after meniscal suture surgery provides good but no definitive reliability on meniscus healing and therefore gives no advantage compared to 1.5-T MRI, with good clinical outcome using an all-inside arthroscopic meniscal repair. 3T-MRI can not substitute diagnostic arthroscopy in patients with persistent complaints after

  8. Arthroscopic all-inside meniscal repair - Does the meniscus heal? A clinical and radiological follow-up examination to verify meniscal healing using a 3-T MRI

    International Nuclear Information System (INIS)

    The purpose of this study was to correlate clinical and radiological results using a 3-T MRI to verify meniscal healing after arthroscopic all-inside meniscus repair. We selected 27 patients (14 men and 13 women) with an average age of 31 ± 9 years and retrospective clinical examinations and radiological assessments using a 3-T MRI after all-inside arthroscopic meniscal repair were conducted. Repair of the medial meniscus was performed in 19 patients and of the lateral meniscus in eight. In 17 patients (63%), we performed concomitant anterior cruciate ligament reconstruction. The mean follow-up period was 4.5 ± 1.7 years. The Lysholm score and Tegner activity index were used for clinical evaluation. Four grades were used to classify the radiological signal alterations within the meniscus: central globular (grade 1); linear horizontal or band-like (grade 2); intrameniscal alterations and linear signal alterations communicating with the articular surface (grade 3); and complex tears (grade 4). At follow-up, the average Lysholm score was 76 ± 15 points, with ten of the patients placed in group 6 based on the Tegner activity index. MRI examinations revealed no signal alteration in three patients, grade 1 in 0, grade 2 in five, grade 3 in 13, and grade 4 in six. The MRI findings correlated positively with the clinical scores in 21 patients (78%). Correlation of clinical and radiological examination was performed using 3-T MRI. In spite of satisfactory clinical outcomes at follow-up, a radiological signal alteration may still be visible on MRI, which was believed to be scar tissue, but could not be proven definitively. Imaging with a 3-Tesla MRI after meniscal suture surgery provides good but no definitive reliability on meniscus healing and therefore gives no advantage compared to 1.5-T MRI, with good clinical outcome using an all-inside arthroscopic meniscal repair. 3T-MRI can not substitute diagnostic arthroscopy in patients with persistent complaints after

  9. MR imaging of anterior cruciate ligament tears: is there a gender gap?

    Energy Technology Data Exchange (ETDEWEB)

    Fayad, Laura M. [Morgan Department of Radiology and Radiological Science, John Hopkins Medical Institutions, Baltimore, MD (United States); Parellada, J.Antoni; Parker, Laurence; Schweitzer, Mark E. [Department of Radiology, Thomas Jefferson University Hospital, Gibbon Building Suite 3390, 111 South 11th St., 19107-5098, Philadelphia, PA (United States)

    2003-11-01

    Clinically, females receive anterior cruciate ligament (ACL) tears more commonly than males. We explored whether gender differences exist in MR imaging patterns of ACL tears. At 1.5T, two observers evaluated MR examinations of 84 consecutive age-matched patients (42 males, 42 females, aged 16-39) with ACL tears, for mechanism of injury, extent and type of tear, the presence of secondary signs and associated osseous, meniscal and ligamentous injuries. The most common mechanism of injury for both females and males was the pivot shift mechanism (67 and 60%, respectively). Females were more commonly imaged in the acute stage of tear than males (98 and 67%, respectively, p=0.001) and more commonly possessed the typical posterolateral tibial bone contusion pattern (88 and 62%, respectively, p=0.0131). Males exhibited a deeper femoral notch sign (2.7 and 2.0 mm, p=0.007) and medial meniscal, lateral collateral ligament and posterior cruciate ligament injuries more commonly than females (48 and 24%, p=0.009, 30 and 7%, p=0.035, 17 and 0%, p=0.035). There was no significant difference between genders for the presence of other secondary signs and contusion patterns, associated lateral meniscal tears, presence of O'Donoghue's triad or associated medial collateral ligament injuries. Gender differences in MR imaging patterns of ACL tears exist: females are more commonly imaged in the acute stage and more commonly possess posterolateral tibial bone contusions; males have a more severe presentation than females, associated with more severe lateral femoral condyle and soft tissue injuries. (orig.)

  10. MR imaging of anterior cruciate ligament tears: is there a gender gap?

    International Nuclear Information System (INIS)

    Clinically, females receive anterior cruciate ligament (ACL) tears more commonly than males. We explored whether gender differences exist in MR imaging patterns of ACL tears. At 1.5T, two observers evaluated MR examinations of 84 consecutive age-matched patients (42 males, 42 females, aged 16-39) with ACL tears, for mechanism of injury, extent and type of tear, the presence of secondary signs and associated osseous, meniscal and ligamentous injuries. The most common mechanism of injury for both females and males was the pivot shift mechanism (67 and 60%, respectively). Females were more commonly imaged in the acute stage of tear than males (98 and 67%, respectively, p=0.001) and more commonly possessed the typical posterolateral tibial bone contusion pattern (88 and 62%, respectively, p=0.0131). Males exhibited a deeper femoral notch sign (2.7 and 2.0 mm, p=0.007) and medial meniscal, lateral collateral ligament and posterior cruciate ligament injuries more commonly than females (48 and 24%, p=0.009, 30 and 7%, p=0.035, 17 and 0%, p=0.035). There was no significant difference between genders for the presence of other secondary signs and contusion patterns, associated lateral meniscal tears, presence of O'Donoghue's triad or associated medial collateral ligament injuries. Gender differences in MR imaging patterns of ACL tears exist: females are more commonly imaged in the acute stage and more commonly possess posterolateral tibial bone contusions; males have a more severe presentation than females, associated with more severe lateral femoral condyle and soft tissue injuries. (orig.)

  11. MRI diagnosis of ACL bundle tears: value of oblique axial imaging

    Energy Technology Data Exchange (ETDEWEB)

    Ng, Alex W.H.; Griffith, James F.; Hung, Esther H.Y. [Chinese University of Hong Kong, Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Shatin, NT, Hong Kong SAR (China); Law, Kan Yip; Yung, Patrick S.H. [Chinese University of Hong Kong, Department of Orthopedics and Traumatology, Prince of Wales Hospital, Shatin, NT, Hong Kong SAR (China)

    2013-02-15

    To investigate the diagnostic accuracy of oblique axial intermediate weighting MR imaging in detecting partial thickness anterior cruciate ligament (ACL) bundle tears. The study protocol was approved by the institutional ethics committee. Sixty-one subjects (43 male, 18 female; mean age 27.4 years; range 9 to 57 years) with clinically suspected ACL tear or meniscal tear between September 2009 and January 2011 were studied with MRI and arthroscopy. Detection of partial tear for the ACL as a whole and for each ACL bundle by protocol A (standard orthogonal sequences) and protocol B (standard orthogonal sequences plus oblique axial intermediate weighted imaging) was compared in a blinded fashion. Performance characteristics for protocol A and protocol B were compared using sensitivity, specificity, accuracy and ROC curves. A two-tailed p value of <0.05 indicated statistical significance. Fifteen (24.6%) normal, 15 (24.6%) partial and 31 complete tears were diagnosed by arthroscopy. Sensitivity, specificity and accuracy of protocol A for the diagnosis of partial tear of the ACL was 33%, 87% and 74%, while for protocol B the values were 87%, 87% and 87% respectively. The area under the curve (AUC) for the diagnosis of partial ACL tear and individual bundle tear was higher for protocol B, although this difference did not reach statistical significance (p > 0.05). The addition of oblique axial imaging to standard MR imaging improves diagnostic accuracy for detecting partial tears of the ACL as well as individual bundle tears of the ACL. (orig.)

  12. MR imaging of meniscal subluxation in the knee

    International Nuclear Information System (INIS)

    Purpose: The aim of this study was to establish diagnostic criteria for meniscal subluxation, and to determine whether there was any connection between meniscal subluxation and other common meniscal and knee-joint abnormalities. Material and Methods: The normal position of the meniscal body was assessed in 10 asymptomatic volunteers. MR signs of meniscal subluxation were evaluated retrospectively in 60 symptomatic patients with pain the knee, impaired mobility, and/or joint swelling who had no clear diagnosis after the evaluation of case history, clinical examination, and radiography. The criterion for subluxation of the meniscus was defined as a distance of ≥3 mm between the peripheral border of the meniscus and the edge of the tibial plateau. Results: In the volunteers, the mean distance form the medial meniscus to the edge of the tibial plateau was 0.07 mm, and that from the lateral meniscus was 0 mm. In 55 symptomatic patients without meniscal subluxation, the mean distance from the meniscus to the edge of the tribial plateau was 0.27 mm. Five patients (8%) had evidence of meniscal subluxation, 4 in the medial meniscus and one in the lateral meniscus. The most commonly associated knee abnormality was joint effusion in 5 knees and osteoarthritis in 2 knees. Conclusion: Meniscal subluxation was not a rare finding with MR imaging in patients with painful knees. Meniscal subluxation was associated with other knee abnormalities such as joint effusion or osteoarthritis. (orig.)

  13. Lesão meniscal por fadiga Meniscal injury due to fatigue

    Directory of Open Access Journals (Sweden)

    Gilberto Luis Camanho

    2009-01-01

    Full Text Available OBJETIVO: O intuito do presente estudo é de analisar um grupo de pacientes portadores de lesão meniscal decorrente da falência estrutural sem relação com trauma ou problemas degenerativos, optando por chamá-la de lesão meniscal por fadiga. MATERIAL E MÉTODO: Foram avaliados 140 pacientes com lesão meniscal sem causa aparente e, portanto, considerados portadores da lesão meniscal por fadiga. Dentre eles, 85 pacientes eram do sexo masculino e 55 do sexo feminino. O menisco medial foi o mais acometido (92% dos casos. RESULTADOS: Todas as lesões foram diagnosticadas através de exame clínico e ressonância magnética. Os pacientes foram submetidos a meniscectomia por via artroscópica e os resultados foram divididos em dois tipos: bons e maus. Foram encontrados 27% de maus resultados dos quais nove pacientes evoluíram para osteonecrose idiopática. CONCLUSÃO: Concluímos que as lesões por fadiga devem ser analisadas como lesões provocadas por falência, portanto uma patologia sindrômica que pode evoluir para uma osteonecrose idiopática..OBJECTIVE: The purpose of the present study was to review a group of patients with meniscal injuries resulting from structural failure unrelated to trauma or degenerative problems to which was given the name "meniscal injury due to fatigue". MATERIAL AND METHOD: Evaluations were made on 140 patients with meniscal injuries without any apparent cause, who were therefore considered to have meniscal injuries due to fatigue. Among these, 85 patients were male and 55 were female. The medial meniscus was the most affected site (92% of the cases. RESULTS: All these injuries were diagnosed by means of clinical examination and magnetic resonance imaging. The patients underwent meniscectomy by means of arthroscopy and the results were divided into two types: good and poor. Poor results were found in 27% of the cases, among which nine patients progressed to idiopathic osteonecrosis. CONCLUSION: We conclude that

  14. The clinical value of magnetic resonance imaging in the evaluation of meniscal disorders.

    Science.gov (United States)

    Raunest, J; Oberle, K; Loehnert, J; Hoetzinger, H

    1991-01-01

    This prospective double-blind study was designed to evaluate the capability of magnetic resonance imaging to serve as a diagnostic tool in patients who have a clinically suspected disorder of the meniscus. The imaging studies provided a diagnostic accuracy of 72 per cent, a sensitivity of 88 per cent, and a specificity of 57 per cent. The positive and negative predictive values were 66 and 83 per cent. The diagnostic sensitivity was 94 per cent for lesions of the medial meniscus; this value differed significantly from that of 78 per cent for lesions of the lateral meniscus (p less than 0.05). The 37 per cent specificity for lesions of the medial meniscus was extremely low compared with the rate of 69 per cent for lesions of the lateral meniscus (p less than 0.01). In the intermediate part of the meniscus, the diagnostic sensitivity was 37 per cent on the medial side and 23 per cent on the lateral side; these values were significantly less than the average of 74 per cent for the other meniscal segments (p less than 0.001). The imaging studies provided an over-all accuracy of 67 per cent in the detection of degeneration of the meniscus, 78 per cent in the identification of meniscal tears, and 82 per cent in the delineation of postoperative lesions. PMID:1985979

  15. Rotator Cuff Tears

    Science.gov (United States)

    .org Rotator Cuff Tears Page ( 1 ) A rotator cuff tear is a common cause of pain and disability among adults. In ... went to their doctors because of a rotator cuff problem. A torn rotator cuff will weaken your ...

  16. Radiological classification of meniscocapsular tears of the anterolateral portion of the lateral meniscus of the knee

    International Nuclear Information System (INIS)

    In an arthroscopic-MRI correlation study of acute injuries to the knee it was found that anterolateral meniscocapsular separations of the lateral aspect of the knee were missed on MRI reporting. Eighty sports-related injuries of the knee were seen by experienced orthopaedic surgeons at the University of Malaya Medical Centre and at the National Sports Centre, Malaysia from January 1996 to July 1997. Fifty of the patients were suspected to have meniscal tears that were either lateral or medial on clinical examination and they were sent for MRI. Many of these patients were tertiary referrals. Magnetic resonance imaging examinations in 27 of the 50 patients were reported as not showing any intrasubstance or obvious meniscocapsular tears, but arthroscopy performed on them revealed anterolateral meniscocapsular tears of the lateral meniscus of varying degrees in nine of these patients. In retrospect the tears could be seen on MRI, and a pattern to the tears was noted and classified as follows. Type 0, normal; type 1, torn inferior or superior meniscocapsular attachment; type 2, both meniscofemoral and meniscotibial ligaments torn but with minimal separation of meniscus and capsule by fluid or synovitis; and type 3, marked separation of meniscus and capsule by fluid (> 3 mm). Ten patients who did not undergo arthroscopy for various personal and financial reasons underwent MRI which showed type 1 and type 2 tears, and were treated conservatively. These patients were all asymptomatic after 4-6 weeks with regard to clinical signs, suggesting a lateral meniscal tear. Magnetic resonance imaging therefore does reveal minor degrees of meniscocapsular tears anterolaterally when one understands the normal anatomy in this region. Copyright (1999) Blackwell Science Pty Ltd

  17. Scaffold architecture and fibrin gels promote meniscal cell proliferation

    International Nuclear Information System (INIS)

    Stability of the knee relies on the meniscus, a complex connective tissue with poor healing ability. Current meniscal tissue engineering is inadequate, as the signals for increasing meniscal cell proliferation have not been established. In this study, collagen scaffold structure, isotropic or aligned, and fibrin gel addition were tested. Metabolic activity was promoted by fibrin addition. Cellular proliferation, however, was significantly increased by both aligned architectures and fibrin addition. None of the constructs impaired collagen type I production or triggered adverse inflammatory responses. It was demonstrated that both fibrin gel addition and optimized scaffold architecture effectively promote meniscal cell proliferation

  18. Scaffold architecture and fibrin gels promote meniscal cell proliferation

    Energy Technology Data Exchange (ETDEWEB)

    Pawelec, K. M., E-mail: pawelec.km@gmail.com, E-mail: jw626@cam.ac.uk; Best, S. M.; Cameron, R. E. [Cambridge Centre for Medical Materials, Materials Science and Metallurgy Department, University of Cambridge, Cambridge CB3 0FS (United Kingdom); Wardale, R. J., E-mail: pawelec.km@gmail.com, E-mail: jw626@cam.ac.uk [Division of Trauma and Orthopaedic Surgery, Department of Surgery, University of Cambridge, Cambridge CB2 2QQ (United Kingdom)

    2015-01-01

    Stability of the knee relies on the meniscus, a complex connective tissue with poor healing ability. Current meniscal tissue engineering is inadequate, as the signals for increasing meniscal cell proliferation have not been established. In this study, collagen scaffold structure, isotropic or aligned, and fibrin gel addition were tested. Metabolic activity was promoted by fibrin addition. Cellular proliferation, however, was significantly increased by both aligned architectures and fibrin addition. None of the constructs impaired collagen type I production or triggered adverse inflammatory responses. It was demonstrated that both fibrin gel addition and optimized scaffold architecture effectively promote meniscal cell proliferation.

  19. Magnetic resonance diagnosis of posterior horn tears of the lateral meniscus using a thin axial plane: the zip sign - a preliminary study

    International Nuclear Information System (INIS)

    The ''zip'' sign is a newly described form of meniscal tear progressing from the distal insertion of menisco-femoral ligaments (MFLs) through the lateral meniscal wall; the tear occurs during anterior cruciate ligament (ACL) rupture. The purpose of this study was to evaluate the zip sign on knee MRI within the context of ACL injuries. From a series of 261 MR examinations for acute knee injury, we selected 97 patients with both MR and arthroscopic data for a retrospective blinded review. The zip sign was defined on axial thin MR sections as a straight line from the distal insertion of MFLs in association with five sagittal images lateral to the posterior cruciate ligament (PCL) where the MFLs were identified. Sensitivity and specificity in detecting lateral meniscal tears before and after having defined the zip sign were calculated. Sensitivity in detecting the tears of the posterior horn of the lateral meniscus (PHLM) reached 87.5% (CI 0.68-0.97) after zip sign criteria were defined. The zip sign has excellent inter-observer agreement, K > 0.90. The zip sign indicates a lesion at the insertion site of MFLs into the PHLM on thin axial images associated with sagittal MR sections that may improve MR sensitivity in detecting PHLM tears. (orig.)

  20. Magnetic resonance diagnosis of posterior horn tears of the lateral meniscus using a thin axial plane: the zip sign - a preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Savoye, P.Y.; Ravey, J.N.; Dubois, C.; Barbier, L.P.; Ferretti, G. [CHU Grenoble, Clinique Universitaire de Radiologie et d' Imagerie Medicale, B.P 217, Grenoble Cedex 09 (France); Courvoisier, A.; Saragaglia, D. [CHU Grenoble, Clinique Universitaire de Chirurgie Orthopedique et Traumatologique, Grenoble (France)

    2011-01-15

    The ''zip'' sign is a newly described form of meniscal tear progressing from the distal insertion of menisco-femoral ligaments (MFLs) through the lateral meniscal wall; the tear occurs during anterior cruciate ligament (ACL) rupture. The purpose of this study was to evaluate the zip sign on knee MRI within the context of ACL injuries. From a series of 261 MR examinations for acute knee injury, we selected 97 patients with both MR and arthroscopic data for a retrospective blinded review. The zip sign was defined on axial thin MR sections as a straight line from the distal insertion of MFLs in association with five sagittal images lateral to the posterior cruciate ligament (PCL) where the MFLs were identified. Sensitivity and specificity in detecting lateral meniscal tears before and after having defined the zip sign were calculated. Sensitivity in detecting the tears of the posterior horn of the lateral meniscus (PHLM) reached 87.5% (CI 0.68-0.97) after zip sign criteria were defined. The zip sign has excellent inter-observer agreement, K > 0.90. The zip sign indicates a lesion at the insertion site of MFLs into the PHLM on thin axial images associated with sagittal MR sections that may improve MR sensitivity in detecting PHLM tears. (orig.)

  1. Iatrogenic tracheal tear.

    LENUS (Irish Health Repository)

    Dias, A

    2010-10-01

    Large post intubation tracheal tears are usually detected intra-operatively due to unstable signs namely impaired ventilation and mediastinal emphysema and often require surgical management. Smaller tracheal tears are often missed during anaesthesia and recognized during the postoperative period. Conservative management should be considered in these latter cases.

  2. Idiopathic Bilateral Bloody Tearing

    Directory of Open Access Journals (Sweden)

    Emrullah Beyazyıldız

    2015-01-01

    Full Text Available Bloody tear is a rare and distinct clinic phenomenon. We report a case presenting with the complaint of recurrent episodes of bilateral bloody tearing. A 16-year-old girl presented to our clinic with complaint of bloody tearing in both eyes for 3 months. Bloody tearing was not associated with her menses. A blood-stained discharge from the punctum was not observed during the compression of both nasolacrimal ducts. Nasolacrimal passage was not obstructed. Imaging studies such as dacryocystography and gradient-echo magnetic resonance imaging (MRI of nasolacrimal canal were normal. Intranasal endoscopic evaluation was normal. We collected samples from bloody tears two times and pathological examination was performed. Pathological analysis showed lots of squamous cells and no endometrial cells; dysplastic cells were found. Further evaluations for underlying causes were unremarkable. No abnormalities were found in ophthalmologic, radiologic, and pathologic investigations. This condition is likely a rare abnormality and the least recognized aetiology for the idiopathic phenomenon.

  3. EFFECTIVENESS OF OPEN KINEMATIC CHAIN EXERCISES VERSUS CLOSED KINEMATIC CHAIN EXERCISES OF KNEE IN MENISCAL INSTABILITY ATHLETES

    Directory of Open Access Journals (Sweden)

    M.Seshagirirao

    2016-02-01

    Full Text Available Background and Purpose: The most common form of meniscal injury is mechanical failure of the tissue due to degeneration or trauma resulting in a tear. In a recent study by Shaji et al (2013 states that OKC and CKC are used often in clinical settings to treat patient’s lower extremity injuries. No study is there on effect of OKC and CKC on strength and stability of knee in meniscal instability. Materials and Methods: Thirty athletes were randomly selected into two groups of fifteen each based on inclusion and exclusion criteria and were given OKC exercises in one group, CKC exercises in another for one month. Pre-treatment and post-treatment values of hamstrings and quadriceps muscle strength and knee function score were measured and analysed statistically. Results: Results showed that P value is < 0.0001 for strength in hamstrings (OKC extremely significant and P value is 0.0080 for quadriceps (OKC very significant and P value is 0.0004 for stability in both groups is extremely significant. Conclusion: OKC and CKC exercises both were effective in improving knee strength and stability, but in OKC strength improvement is better than CKC and in CKC stability is better improved.

  4. MRI diagnosis of ACL bundle tears: value of oblique axial imaging

    International Nuclear Information System (INIS)

    To investigate the diagnostic accuracy of oblique axial intermediate weighting MR imaging in detecting partial thickness anterior cruciate ligament (ACL) bundle tears. The study protocol was approved by the institutional ethics committee. Sixty-one subjects (43 male, 18 female; mean age 27.4 years; range 9 to 57 years) with clinically suspected ACL tear or meniscal tear between September 2009 and January 2011 were studied with MRI and arthroscopy. Detection of partial tear for the ACL as a whole and for each ACL bundle by protocol A (standard orthogonal sequences) and protocol B (standard orthogonal sequences plus oblique axial intermediate weighted imaging) was compared in a blinded fashion. Performance characteristics for protocol A and protocol B were compared using sensitivity, specificity, accuracy and ROC curves. A two-tailed p value of 0.05). The addition of oblique axial imaging to standard MR imaging improves diagnostic accuracy for detecting partial tears of the ACL as well as individual bundle tears of the ACL. (orig.)

  5. Diagnostic accuracy of Magnetic Resonance Imaging in assessment of Meniscal and ACL tear: Correlation with arthroscopy

    OpenAIRE

    Yaqoob, Jamal; Alam, Muhammad Shahbaz; Khalid, Nadeem

    2015-01-01

    Objective: To determine the diagnostic accuracy of magnetic resonance imaging (MRI) in injuries related to anterior cruciate ligament and menisci and compare its effectiveness with that of arthroscopy. Methods: This retrospective cross-sectional study was conducted in the department of Radiology & Medical Imaging of Dallah Hospital, Riyadh, Kingdom of Saudi Arabia from September 2012 to March 2014. Fifty four patients (including 30 men and 24 women) with internal derangement of knee referred ...

  6. Advances and Prospects in Tissue-Engineered Meniscal Scaffolds for Meniscus Regeneration

    Directory of Open Access Journals (Sweden)

    Weimin Guo

    2015-01-01

    Full Text Available The meniscus plays a crucial role in maintaining knee joint homoeostasis. Meniscal lesions are relatively common in the knee joint and are typically categorized into various types. However, it is difficult for inner avascular meniscal lesions to self-heal. Untreated meniscal lesions lead to meniscal extrusions in the long-term and gradually trigger the development of knee osteoarthritis (OA. The relationship between meniscal lesions and knee OA is complex. Partial meniscectomy, which is the primary method to treat a meniscal injury, only relieves short-term pain; however, it does not prevent the development of knee OA. Similarly, other current therapeutic strategies have intrinsic limitations in clinical practice. Tissue engineering technology will probably address this challenge by reconstructing a meniscus possessing an integrated configuration with competent biomechanical capacity. This review describes normal structure and biomechanical characteristics of the meniscus, discusses the relationship between meniscal lesions and knee OA, and summarizes the classifications and corresponding treatment strategies for meniscal lesions to understand meniscal regeneration from physiological and pathological perspectives. Last, we present current advances in meniscal scaffolds and provide a number of prospects that will potentially benefit the development of meniscal regeneration methods.

  7. The usefulness of MRI and arthroscopy in the diagnosis and treatment of soft-tissue injuries associated with split-depression fractures of the lateral tibial condyle.

    Science.gov (United States)

    Parkkinen, M; Madanat, R; Mäkinen, T J; Mustonen, A; Koskinen, S K; Lindahl, J

    2014-12-01

    The role of arthroscopy in the treatment of soft-tissue injuries associated with proximal tibial fractures remains debatable. Our hypothesis was that MRI over-diagnoses clinically relevant associated soft-tissue injuries. This prospective study involved 50 consecutive patients who underwent surgical treatment for a split-depression fracture of the lateral tibial condyle (AO/OTA type B3.1). The mean age of patients was 50 years (23 to 86) and 27 (54%) were female. All patients had MRI and arthroscopy. Arthroscopy identified 12 tears of the lateral meniscus, including eight bucket-handle tears that were sutured and four that were resected, as well as six tears of the medial meniscus, of which five were resected. Lateral meniscal injuries were diagnosed on MRI in four of 12 patients, yielding an overall sensitivity of 33% (95% confidence interval (CI) 11 to 65). Specificity was 76% (95% CI 59 to 88), with nine tears diagnosed among 38 menisci that did not contain a tear. MRI identified medial meniscal injuries in four of six patients, yielding an overall sensitivity of 67% (95% CI 24 to 94). Specificity was 66% (95% CI 50 to 79), with 15 tears diagnosed in 44 menisci that did not contain tears. MRI appears to offer only a marginal benefit as the specificity and sensitivity for diagnosing meniscal injuries are poor in patients with a fracture. There were fewer arthroscopically-confirmed associated lesions than reported previously in MRI studies. PMID:25452365

  8. Fat-suppressed volume isotropic turbo spin echo acquisition (VISTA) MR imaging in evaluating radial and root tears of the meniscus: Focusing on reader-defined axial reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Daekeon; Lee, Young Han; Kim, Sungjun; Song, Ho-Taek; Suh, Jin-Suck, E-mail: jss@yuhs.ac

    2013-12-01

    Objective: To assess the diagnostic value of fat-suppressed (FS) three-dimensional (3D) volume isotropic turbo spin echo acquisition (VISTA) imaging in detecting radial and root tears of the meniscus, including the reader-defined reformatted axial (RDA) plane. Materials and methods: Twenty-three patients with arthroscopically confirmed radial or root tears of the meniscus underwent magnetic resonance imaging (MRI) with 2D and FS 3D VISTA sequences. MRIs were reviewed independently by two musculoskeletal radiologists blinded to the arthroscopic findings. Sensitivity, specificity, accuracy, and interobserver agreement were calculated for radial and root tears. Both radiologists reported confidence scale for the presence of meniscal tears in 2D axial imaging, 3D axial imaging, and RDA imaging, based on a five-point scale. Wilcoxon's signed rank test was used to compare confidence scale. Results: The sensitivity, specificity, and accuracy of FS 3D VISTA MR imaging versus 2D MR imaging were as follows: 96%, 96%, and 96% versus 91%, 91%, and 91%, respectively in reader 1, and 96%, 96%, and 96% versus 83%, 91%, and 87%, respectively, in reader 2. Interobserver agreement for detecting meniscal tears was excellent (κ = 1) with FS 3D VISTA. The confidence scale was significantly higher for 3D axial images than 2D imaging (p = 0.03) and significantly higher in RDA images than 3D axial image in detecting radial and root tears. Conclusions: FS 3D VISTA had a better diagnostic performance in evaluating radial and root tears of the meniscus. The reader-defined reformatted axial plane obtained from FS 3D VISTA MR imaging is useful in detecting radial and root tears of the meniscus.

  9. Fat-suppressed volume isotropic turbo spin echo acquisition (VISTA) MR imaging in evaluating radial and root tears of the meniscus: Focusing on reader-defined axial reconstruction

    International Nuclear Information System (INIS)

    Objective: To assess the diagnostic value of fat-suppressed (FS) three-dimensional (3D) volume isotropic turbo spin echo acquisition (VISTA) imaging in detecting radial and root tears of the meniscus, including the reader-defined reformatted axial (RDA) plane. Materials and methods: Twenty-three patients with arthroscopically confirmed radial or root tears of the meniscus underwent magnetic resonance imaging (MRI) with 2D and FS 3D VISTA sequences. MRIs were reviewed independently by two musculoskeletal radiologists blinded to the arthroscopic findings. Sensitivity, specificity, accuracy, and interobserver agreement were calculated for radial and root tears. Both radiologists reported confidence scale for the presence of meniscal tears in 2D axial imaging, 3D axial imaging, and RDA imaging, based on a five-point scale. Wilcoxon's signed rank test was used to compare confidence scale. Results: The sensitivity, specificity, and accuracy of FS 3D VISTA MR imaging versus 2D MR imaging were as follows: 96%, 96%, and 96% versus 91%, 91%, and 91%, respectively in reader 1, and 96%, 96%, and 96% versus 83%, 91%, and 87%, respectively, in reader 2. Interobserver agreement for detecting meniscal tears was excellent (κ = 1) with FS 3D VISTA. The confidence scale was significantly higher for 3D axial images than 2D imaging (p = 0.03) and significantly higher in RDA images than 3D axial image in detecting radial and root tears. Conclusions: FS 3D VISTA had a better diagnostic performance in evaluating radial and root tears of the meniscus. The reader-defined reformatted axial plane obtained from FS 3D VISTA MR imaging is useful in detecting radial and root tears of the meniscus

  10. All-inside meniscal repair using the RapidLoc device

    OpenAIRE

    Sen, Cengiz; Asik, Mehmet; Yumrukcal, Feridun; Atalar, Ata Can; Erdil, Mehmet; Taser, Omer F.

    2004-01-01

    Objectives: Although conventional suture techniques yield satisfactory results in the treatment of meniscal ruptures, they are inherent with long operative time and high complication rates. The purpose of this study was to evaluate the results of meniscal repair with the use of the RapidLoc device. Methods: The study included 57 consecutive patients (all males; mean age 24 years; range 17 to 33 years) who underwent meniscal repair with the RapidLoc device. The mean time from injury to surg...

  11. Meniscal Allograft Transplantation Does Not Prevent or Delay Progression of Knee Osteoarthritis.

    Directory of Open Access Journals (Sweden)

    Catherine Van Der Straeten

    Full Text Available Meniscal tears are common knee injuries. Meniscal allograft transplantation (MAT has been advocated to alleviate symptoms and delay osteoarthritis (OA after meniscectomy. We investigated (1 the long-term outcome of MAT as a treatment of symptomatic meniscectomy, (2 most important factors affecting survivorship and (3 OA progression.From 1989 till 2013, 329 MAT were performed in 313 patients. Clinical and radiographic results and MAT survival were evaluated retrospectively. Failure was defined as conversion to knee arthroplasty (KA or total removal of the MAT.Mean age at surgery was 33 years (15-57; 60% were males. No-to-mild cartilage damage was found in 156 cases, moderate-to-severe damage in 130. Simultaneous procedures in 118 patients included cartilage procedures, osteotomy or ACL-reconstruction. At a mean follow-up of 6.8 years (0.2-24.3years, 5 patients were deceased and 48 lost (14.6%, 186 MAT were in situ (56.5% whilst 90 (27.4% had been removed, including 63 converted to a KA (19.2%. Cumulative allograft survivorship was 15.1% (95% CI:13.9-16.3 at 24.0 years. In patients <35 years at surgery, survival was significantly better (24.1% compared to ≥35 years (8.0% (p = 0.017. In knees with no-to-mild cartilage damage more allografts survived (43.0% compared to moderate-to-severe damage (6.6% (p = 0.003. Simultaneous osteotomy significantly deteriorated survival (0% at 24.0 years (p = 0.010. 61% of patients underwent at least one additional surgery (1-11 for clinical symptoms after MAT. Consecutive radiographs showed significant OA progression at a mean of 3.8 years (p<0.0001. Incremental Kellgren-Lawrence grade was +1,1 grade per 1000 days (2,7yrs.MAT did not delay or prevent tibiofemoral OA progression. 19.2% were converted to a knee prosthesis at a mean of 10.3 years. Patients younger than 35 with no-to-mild cartilage damage may benefit from MAT for relief of symptoms (survivorship 51.9% at 20.2 years, but patients and healthcare payers

  12. Meniscal Allograft Transplantation Does Not Prevent or Delay Progression of Knee Osteoarthritis

    Science.gov (United States)

    Byttebier, Paul; Eeckhoudt, Annelies; Victor, Jan

    2016-01-01

    Background Meniscal tears are common knee injuries. Meniscal allograft transplantation (MAT) has been advocated to alleviate symptoms and delay osteoarthritis (OA) after meniscectomy. We investigated (1) the long-term outcome of MAT as a treatment of symptomatic meniscectomy, (2) most important factors affecting survivorship and (3) OA progression. Methods From 1989 till 2013, 329 MAT were performed in 313 patients. Clinical and radiographic results and MAT survival were evaluated retrospectively. Failure was defined as conversion to knee arthroplasty (KA) or total removal of the MAT. Results Mean age at surgery was 33 years (15–57); 60% were males. No-to-mild cartilage damage was found in 156 cases, moderate-to-severe damage in 130. Simultaneous procedures in 118 patients included cartilage procedures, osteotomy or ACL-reconstruction. At a mean follow-up of 6.8 years (0.2–24.3years), 5 patients were deceased and 48 lost (14.6%), 186 MAT were in situ (56.5%) whilst 90 (27.4%) had been removed, including 63 converted to a KA (19.2%). Cumulative allograft survivorship was 15.1% (95% CI:13.9–16.3) at 24.0 years. In patients <35 years at surgery, survival was significantly better (24.1%) compared to ≥35 years (8.0%) (p = 0.017). In knees with no-to-mild cartilage damage more allografts survived (43.0%) compared to moderate-to-severe damage (6.6%) (p = 0.003). Simultaneous osteotomy significantly deteriorated survival (0% at 24.0 years) (p = 0.010). 61% of patients underwent at least one additional surgery (1–11) for clinical symptoms after MAT. Consecutive radiographs showed significant OA progression at a mean of 3.8 years (p<0.0001). Incremental Kellgren-Lawrence grade was +1,1 grade per 1000 days (2,7yrs). Conclusions MAT did not delay or prevent tibiofemoral OA progression. 19.2% were converted to a knee prosthesis at a mean of 10.3 years. Patients younger than 35 with no-to-mild cartilage damage may benefit from MAT for relief of symptoms (survivorship

  13. Discrimination of meniscal cell phenotypes using gene expression profiles

    Directory of Open Access Journals (Sweden)

    M Son

    2012-03-01

    Full Text Available The lack of quantitative and objective metrics to assess cartilage and meniscus cell phenotypes contributes to the challenges in fibrocartilage tissue engineering. Although functional assessment of the final resulting tissue is essential, initial characterization of cell sources and quantitative description of their progression towards the natural, desired cell phenotype would provide an effective tool in optimizing cell-based tissue engineering strategies. The purpose of this study was to identify quantifiable characteristics of meniscal cells and thereby find phenotypical markers that could effectively categorize cells based on their tissue of origin (cartilage, inner, middle, and outer meniscus. The combination of gene expression ratios collagen VI/collagen II, ADAMTS-5/collagen II, and collagen I/collagen II was the most effective indicator of variation among different tissue regions. We additionally demonstrate a possible application of these quantifiable metrics in evaluating the use of serially passaged chondrocytes as a possible cell source in fibrocartilage engineering. Comparing the ratios of the passaged chondrocytes and the native meniscal cells may provide direction to optimize towards the desired cell phenotype. We have thus shown that measurable markers defining the characteristics of the native meniscus can establish a standard by which different tissue engineering strategies can be objectively assessed. Such metrics could additionally be useful in exploring the different stages of meniscal degradation in osteoarthritis and provide some insight in the disease progression.

  14. Evaluation of the clinical signs of anterior cruciate ligament and meniscal injuries

    Directory of Open Access Journals (Sweden)

    Jain Dhavalakumar

    2009-01-01

    Full Text Available Background: The diagnostic accuracy of anterior drawer (AD sign, Lachman test and the pivot shift test for anterior cruciate ligament injury and McMurray test for medial and lateral meniscus is varied with sensitivity and specificity ranging from 2 to 100%. Generally, it is accepted that the pivot shift test is the most specific test to diagnose anterior cruciate ligament (ACL tears and that the Lachman test is more sensitive than AD sign. This study was undertaken to calculate the sensitivity, specificity, positive predictive value, negative predictive value, and efficiency for the above-mentioned diagnostic tests. Materials and Methods: Twenty-eight male patients with clinical ACL injury were examined in the outpatient department and under anaesthesia, the findings were compared with arthroscopy. Result: The sensitivity and specificity for the Lachman test, AD sign and pivot shift test performed in the outpatient setting are 78.6 and 100%, 89.3 and 100%, and 75 and 100%, respectively. The sensitivity and specificity for the Lachman test, AD sign, and pivot shift test performed under anesthesia are 92.9 and 100%, 92.9 and 100%, and 100 and 100%, respectively. The sensitivity and specificity of the McMurray test for medial and lateral meniscus were 35.7 and 85.7% and 22.2 and 100%, respectively. Conclusion: The Lachman test, AD sign and pivot shift test are highly specific tests to diagnose ACL laxity in a non-acute setting; pivot shift test under anesthesia is the most sensitive and specific test for diagnosing ACL laxity in a non-acute setting and the McMurray test is not a sensitive test to diagnose meniscal injury in the presence of ACL injury.

  15. MRI follow-up of conservatively treated meniscal knee lesions in general practice

    International Nuclear Information System (INIS)

    To evaluate meniscal status change on follow-up MRI after 1 year, prognostic factors and association with clinical outcome in patients with conservatively treated knee injury. We analysed 403 meniscal horns in 101 conservatively treated patients (59 male; mean age 40 years) in general practice who underwent initial knee MRI within 5 weeks of trauma. We performed ordinal logistic regression analysis to analyse prognostic factors for meniscal change on follow-up MRI after 1 year, and we assessed the association with clinical outcome. On follow-up MRI 49 meniscal horns had deteriorated and 18 had improved. Age (odds ratio [OR] 1.3/decade), body weight (OR 1.2/10 kg), total anterior cruciate ligament (ACL) rupture on initial MRI (OR 2.4), location in the posterior horn of the medial meniscus (OR 3.0) and an initial meniscal lesion (OR 0.3) were statistically significant predictors of meniscal MRI appearance change after 1 year, which was not associated with clinical outcome. In conservatively treated patients, meniscal deterioration on follow-up MRI 1 year after trauma is predicted by higher age and body weight, initial total ACL rupture, and location in the medial posterior horn. Change in MRI appearance is not associated with clinical outcome. (orig.)

  16. MRI follow-up of conservatively treated meniscal knee lesions in general practice

    Energy Technology Data Exchange (ETDEWEB)

    Oei, Edwin H.G.; Hunink, M.G.M. [University Medical Center Rotterdam, Program for the Assessment of Radiological Technology (ART Program), Erasmus MC, Rotterdam (Netherlands); University Medical Center Rotterdam, Department of Radiology, Erasmus MC, Rotterdam (Netherlands); University Medical Center Rotterdam, Department of Epidemiology, Erasmus MC, Rotterdam (Netherlands); Koster, Ingrid M. [University Medical Center Rotterdam, Department of Radiology, Erasmus MC, Rotterdam (Netherlands); Maasstad Ziekenhuis, Department of Radiology, Rotterdam (Netherlands); Hensen, Jan-Hein J.; Vroegindeweij, Dammis [Maasstad Ziekenhuis, Department of Radiology, Rotterdam (Netherlands); Boks, Simone S. [University Medical Center Rotterdam, Department of General Practice, Erasmus MC, Rotterdam (Netherlands); Maasstad Ziekenhuis, Department of Radiology, Rotterdam (Netherlands); Diaconessenhuis Meppel, Department of Radiology, Meppel (Netherlands); Wagemakers, Harry P.A.; Koes, Bart W.; Bierma-Zeinstra, Sita M.A. [University Medical Center Rotterdam, Department of General Practice, Erasmus MC, Rotterdam (Netherlands)

    2010-05-15

    To evaluate meniscal status change on follow-up MRI after 1 year, prognostic factors and association with clinical outcome in patients with conservatively treated knee injury. We analysed 403 meniscal horns in 101 conservatively treated patients (59 male; mean age 40 years) in general practice who underwent initial knee MRI within 5 weeks of trauma. We performed ordinal logistic regression analysis to analyse prognostic factors for meniscal change on follow-up MRI after 1 year, and we assessed the association with clinical outcome. On follow-up MRI 49 meniscal horns had deteriorated and 18 had improved. Age (odds ratio [OR] 1.3/decade), body weight (OR 1.2/10 kg), total anterior cruciate ligament (ACL) rupture on initial MRI (OR 2.4), location in the posterior horn of the medial meniscus (OR 3.0) and an initial meniscal lesion (OR 0.3) were statistically significant predictors of meniscal MRI appearance change after 1 year, which was not associated with clinical outcome. In conservatively treated patients, meniscal deterioration on follow-up MRI 1 year after trauma is predicted by higher age and body weight, initial total ACL rupture, and location in the medial posterior horn. Change in MRI appearance is not associated with clinical outcome. (orig.)

  17. Electronic enhancement of tear secretion

    Science.gov (United States)

    Brinton, Mark; Lim Chung, Jae; Kossler, Andrea; Kook, Koung Hoon; Loudin, Jim; Franke, Manfred; Palanker, Daniel

    2016-02-01

    Objective. To study electrical stimulation of the lacrimal gland and afferent nerves for enhanced tear secretion, as a potential treatment for dry eye disease. We investigate the response pathways and electrical parameters to safely maximize tear secretion. Approach. We evaluated the tear response to electrical stimulation of the lacrimal gland and afferent nerves in isofluorane-anesthetized rabbits. In acute studies, electrical stimulation was performed using bipolar platinum foil electrodes, implanted beneath the inferior lacrimal gland, and a monopolar electrode placed near the afferent ethmoid nerve. Wireless microstimulators with bipolar electrodes were implanted beneath the lacrimal gland for chronic studies. To identify the response pathways, we applied various pharmacological inhibitors. To optimize the stimulus, we measured tear secretion rate (Schirmer test) as a function of pulse amplitude (1.5-12 mA), duration (0.1-1 ms) and repetition rate (10-100 Hz). Main results. Stimulation of the lacrimal gland increased tear secretion by engaging efferent parasympathetic nerves. Tearing increased with stimulation amplitude, pulse duration and repetition rate, up to 70 Hz. Stimulation with 3 mA, 500 μs pulses at 70 Hz provided a 4.5 mm (125%) increase in Schirmer score. Modulating duty cycle further increased tearing up to 57%, compared to continuous stimulation in chronically implanted animals (36%). Ethmoid (afferent) nerve stimulation increased tearing similar to gland stimulation (3.6 mm) via a reflex pathway. In animals with chronically implanted stimulators, a nearly 6 mm increase (57%) was achieved with 12-fold less charge density per pulse (0.06-0.3 μC mm-2 with 170-680 μs pulses) than the damage threshold (3.5 μC mm-2 with 1 ms pulses). Significance. Electrical stimulation of the lacrimal gland or afferent nerves may be used as a treatment for dry eye disease. Clinical trials should validate this approach in patients with aqueous tear deficiency, and

  18. Vertical tears of the cranial horn of the meniscus and its cranial ligament in the equine femorotibial joint: 7 cases and their treatment by arthroscopic surgery

    International Nuclear Information System (INIS)

    Five horses with a vertical tear in the cranial horn and cranial ligament of the medial meniscus and 2 horses with a similar injury in the lateral meniscus were diagnosed from a series of 126 horses which were examined arthroscopically for stifle lameness. All the lesions had similar characteristics. The tear was about 1 cm from the axial border of the meniscus and its ligament and, in all but one case in which it was incomplete, much of the torn tissue was loosely attached in the axial part of the joint from where it was removed. The remaining meniscus, abaxial to the tear, was displaced cranially and abaxially and its torn edges were debrided. Radiographically, 6 cases had proliferative new bone on the cranial aspect of the intercondylar eminence of the tibia and 3 had calcified soft tissue densities in the cranial, medial or lateral femorotibial joint. Following surgery and a 6 month period of rest and controlled exercise, 3 horses returned to full competition work, one was usable for hacking, 2 are convalescing and one is lame after one year. It is postulated that this could be a characteristic meniscal injury in horses which can benefit from arthroscopic surgery. Better techniques for accessing the body and caudal pole of the menisci are needed if a more complete diagnosis and treatment of meniscal injuries are to be achieved

  19. Accuracy of 3-Tesla MR and MR arthrography in diagnosis of meniscal retear in the post-operative knee

    International Nuclear Information System (INIS)

    This study assesses the accuracy of 3-Tesla (3-T) conventional MR imaging, 3-T MR arthrography, and the combined use of conventional MR and MR arthrography in the diagnosis of meniscal retears as compared with arthroscopy. The study also assess whether there are false-negative cases in which injected contrast does not extend into the meniscus despite a meniscal retear being seen on arthroscopy. One hundred consecutive knee MR arthrograms performed on patients with previous knee surgery were reviewed retrospectively. 3-T conventional MR imaging, 3-T MR arthrography, and the combined use of conventional MR and MR arthrography were assessed for meniscal retears as compared with arthroscopy. The criterion used to diagnose a meniscal retear on MR arthrogram was injected contrast tracking into the meniscus. All patients underwent second-look arthroscopy. Seventy-four patients had conventional MR findings consistent with a meniscal retear. In 83 of the 100 patients, intraarticular contrast helped in demonstrating a retear. In ten patients, there were MR findings consistent with a meniscal retear despite intra-articular contrast not tracking into the meniscus. Ninety-four of the 100 patients had meniscal retears on second-look arthroscopy. Three-Tesla conventional MR examination was 78 % sensitive and 75 % specific, MR arthrogram examination was 88 % sensitive and 100 % specific, and the combined use of MR and MR arthrogram imaging was 98 % sensitive and 75 % specific in the diagnosis of a meniscal retear. The combined use of 3-T MR and MR arthrography allows for high sensitivity and specificity in meniscal retear detection. In some patients, intraarticular contrast will not track into a meniscal retear. When MR findings are consistent with a meniscal retear but contrast does not extend into the meniscus, a meniscal retear is likely. (orig.)

  20. Accuracy of 3-Tesla MR and MR arthrography in diagnosis of meniscal retear in the post-operative knee

    Energy Technology Data Exchange (ETDEWEB)

    Magee, Thomas [NSI, Merritt Island, FL (United States); University of Central Florida School of Medicine, Orlando, FL (United States)

    2014-08-15

    This study assesses the accuracy of 3-Tesla (3-T) conventional MR imaging, 3-T MR arthrography, and the combined use of conventional MR and MR arthrography in the diagnosis of meniscal retears as compared with arthroscopy. The study also assess whether there are false-negative cases in which injected contrast does not extend into the meniscus despite a meniscal retear being seen on arthroscopy. One hundred consecutive knee MR arthrograms performed on patients with previous knee surgery were reviewed retrospectively. 3-T conventional MR imaging, 3-T MR arthrography, and the combined use of conventional MR and MR arthrography were assessed for meniscal retears as compared with arthroscopy. The criterion used to diagnose a meniscal retear on MR arthrogram was injected contrast tracking into the meniscus. All patients underwent second-look arthroscopy. Seventy-four patients had conventional MR findings consistent with a meniscal retear. In 83 of the 100 patients, intraarticular contrast helped in demonstrating a retear. In ten patients, there were MR findings consistent with a meniscal retear despite intra-articular contrast not tracking into the meniscus. Ninety-four of the 100 patients had meniscal retears on second-look arthroscopy. Three-Tesla conventional MR examination was 78 % sensitive and 75 % specific, MR arthrogram examination was 88 % sensitive and 100 % specific, and the combined use of MR and MR arthrogram imaging was 98 % sensitive and 75 % specific in the diagnosis of a meniscal retear. The combined use of 3-T MR and MR arthrography allows for high sensitivity and specificity in meniscal retear detection. In some patients, intraarticular contrast will not track into a meniscal retear. When MR findings are consistent with a meniscal retear but contrast does not extend into the meniscus, a meniscal retear is likely. (orig.)

  1. Development and Characterization of UHMWPE Fiber-Reinforced Hydrogels For Meniscal Replacement

    Science.gov (United States)

    Holloway, Julianne Leigh

    Meniscal tears are the most common orthopedic injuries to the human body. The current treatment of choice, however, is a partial meniscectomy that leads to osteoarthritis proportional to the amount of tissue removed. As a result, there is a significant clinical need to develop materials capable of restoring the biomechanical contact stress distribution to the knee after meniscectomy and preventing the onset of osteoarthritis. In this work, a fiber-reinforced hydrogel-based synthetic meniscus was developed that allows for tailoring of the mechanical properties and molding of the implant to match the size, shape, and property distribution of the native tissue. Physically cross-linked poly(vinyl alcohol) (PVA) hydrogels were reinforced with ultrahigh molecular weight polyethylene (UHMWPE) fibers and characterized in compression (0.1-0.8 MPa) and tension (0.1-250 MPa) showing fine control over mechanical properties within the range of the human meniscus. Morphology and crystallinity analysis of PVA hydrogels showed increases in crystallinity and PVA densification, or phase separation, with freeze-thaw cycles. A comparison of freeze-thawed and aged, physically cross-linked hydrogels provided insight on both crystallinity and phase separation as mechanisms for PVA gelation. Results indicated both mechanisms independently contributed to hydrogel modulus for freeze-thawed hydrogels. In vitro swelling studies were performed using osmotic solutions to replicate the swelling pressure present in the knee. Minimal swelling was observed for hydrogels with a PVA concentration of 30-35 wt%, independently of hydrogel freeze-thaw cycles. This allows for independent tailoring of hydrogel modulus and pore structure using freeze-thaw cycles and swelling behavior using polymer concentration to match a wide range of properties needed for various soft tissue applications. The UHMWPE-PVA interface was identified as a significant weakness. To improve interfacial adhesion, a novel

  2. Influence of Energetic Ions on Tearing Modes

    International Nuclear Information System (INIS)

    In contrast with the stability effects of trapped energetic ions on tearing modes, the effects of circulating energetic ions (CEI) on tearing modes depend on the toroidal circulating direction, and are closely related to the momentum of energetic ions. CEI provide an additional source or sink of momentum to affect tearing modes. For co-CEI, tearing modes can be stabilized if the momentum of energetic ions is large enough. On the other hand, the growth of tearing modes can be enhanced by counter-CEI. Further, a possibility to suppress the island growth of neoclassical tearing modes by co-CEI is pointed out.

  3. Anterior cruciate ligament tear: comparison of MR features between complete and partial tear

    Energy Technology Data Exchange (ETDEWEB)

    Song, Ki Young; Lee, Joo Hyuk; Park, Jin Hee; Lee, Yu Jin; Rho, Eun Jin; Kim, Young Hoon [Kangnam General Hospital, Seoul (Korea, Republic of); Yi, Jeong Geun [Hallym Univ. College of Medicine, Seoul (Korea, Republic of); Ahn, Joong Mo [Samsung Medical Center, Seoul (Korea, Republic of)

    1997-04-01

    To determine the MRI features which distinguish complete and partial tear of the anterior cruciate ligament(ACL) and to thus improve MRI interpretation. In 80 patients, we analyzed MR findings of direct and indirect signs of ACL tear (complete tear, 61 cases, partial tear, 19 cases) confirmed by arthroscopy or surgery, and compared the relative incidence of each sign in cases of complete and partial tear. Direct and indirect signs were found in 61 (100%) and 60 cases (98.4%), respectively, in complete tears, but in 16 (84.2%) and 15 cases (78.9%), respectively, in partial tears. Poor visualization, discontinuity and hyperintensity were seen in all complete tears but in only nine cases (47.4%) of partial tear. A wavy or abnormal contour was seen in 53 cases (86.9%) of complete tear and 14 (73.7%) of partial tear. A wavy contour without other direct signs was seen in only five cases (26.3%) of partial tear. Three cases (15.8%) of partial tear showed normal MR finding. Indirect signs, i.e. abnormal ACL angle, abnormal ACL-Blumensaat line angle, abnormal posterior cruciate ligament (PCL) line, abnormal PCL angle, PCL buckling, anterior displacement of tibia, posterior displacement of lateral meniscus, bone bruise, Segond fracture, tear of collateral ligaments, PCL, and tear of meniscus were commoner in complete than in partial tears. Two cases of O'Donoghue's triad and two of popliteus injury were seen only in complete tears. Direct and indirect signs of ACL tear were more commonly noted in complete than in partial tears. The latter showed MR features varying from normal to almost complete tear. We suggest that a wavy contour without other direct signs is indicative of a partial tear, and that O'Donoghue's triad and popliteus muscle injury are indirect signs of a complete tear.

  4. Anterior cruciate ligament tear: comparison of MR features between complete and partial tear

    International Nuclear Information System (INIS)

    To determine the MRI features which distinguish complete and partial tear of the anterior cruciate ligament(ACL) and to thus improve MRI interpretation. In 80 patients, we analyzed MR findings of direct and indirect signs of ACL tear (complete tear, 61 cases, partial tear, 19 cases) confirmed by arthroscopy or surgery, and compared the relative incidence of each sign in cases of complete and partial tear. Direct and indirect signs were found in 61 (100%) and 60 cases (98.4%), respectively, in complete tears, but in 16 (84.2%) and 15 cases (78.9%), respectively, in partial tears. Poor visualization, discontinuity and hyperintensity were seen in all complete tears but in only nine cases (47.4%) of partial tear. A wavy or abnormal contour was seen in 53 cases (86.9%) of complete tear and 14 (73.7%) of partial tear. A wavy contour without other direct signs was seen in only five cases (26.3%) of partial tear. Three cases (15.8%) of partial tear showed normal MR finding. Indirect signs, i.e. abnormal ACL angle, abnormal ACL-Blumensaat line angle, abnormal posterior cruciate ligament (PCL) line, abnormal PCL angle, PCL buckling, anterior displacement of tibia, posterior displacement of lateral meniscus, bone bruise, Segond fracture, tear of collateral ligaments, PCL, and tear of meniscus were commoner in complete than in partial tears. Two cases of O'Donoghue's triad and two of popliteus injury were seen only in complete tears. Direct and indirect signs of ACL tear were more commonly noted in complete than in partial tears. The latter showed MR features varying from normal to almost complete tear. We suggest that a wavy contour without other direct signs is indicative of a partial tear, and that O'Donoghue's triad and popliteus muscle injury are indirect signs of a complete tear

  5. Tearing mode in RFP configurations

    International Nuclear Information System (INIS)

    The tearing mode appearing in RFP configurations is studied both by numerical solution of the exact eigenequations and by using Δ'theory. Systematic parameter studies for force free configurations have been carried out. We find that Δ'theory is a good approximation only when β=0. In general, the growth rate is sensitive to the β value and 3/5 Δ' scaling no longer applies for finite beta. For typical experimental beta values we find that the tearing mode is always unstable within the parametri- zation considered. 17 figs

  6. Acute Medial Plantar Fascia Tear.

    Science.gov (United States)

    Pascoe, Stephanie C; Mazzola, Timothy J

    2016-06-01

    A 32-year-old man who participated in competitive soccer came to physical therapy via direct access for a chief complaint of plantar foot pain. The clinical examination findings and mechanism of injury raised a concern for a plantar fascia tear, so the patient was referred to the physician and magnetic resonance imaging was obtained. The magnetic resonance image confirmed a high-grade, partial-thickness, proximal plantar fascia tear with localized edema at the location of the medial band. J Orthop Sports Phys Ther 2016;46(6):495. doi:10.2519/jospt.2016.0409. PMID:27245491

  7. Bifurcation of steady tearing states

    International Nuclear Information System (INIS)

    We apply the bifurcation theory for compact operators to the problem of the nonlinear solutions of the 3-dimensional incompressible visco-resistive MHD equations. For the plane plasma slab model we compute branches of nonlinear tearing modes, which are stationary for the range of parameters investigated up to now

  8. Plate Tearing by a Cone

    DEFF Research Database (Denmark)

    Simonsen, Bo Cerup

    1997-01-01

    The present paper is concerned with steady-state plate tearing by a cone. This is a scenario where a cone is forced through a ductile metal plate with a constant lateral tip penetration in a motion in the plane of the plate. The considered process could be an idealisaton of the damage, which deve...

  9. Plate Tearing by a Cone

    DEFF Research Database (Denmark)

    Simonsen, Bo Cerup

    1998-01-01

    The present paper is concerned with steady-state plate tearing by a cone. This is a scenario where a cone is forced through a ductile metal plate with a constant lateral tip penetration in a motion in the plane of the plate. The considered process could be an idealisation of the damage, which dev...

  10. Software Simulation of Hot Tearing

    DEFF Research Database (Denmark)

    Andersen, S.; Hansen, P.N.; Hattel, Jesper Henri

    1999-01-01

    tear prone areas. With this additional information, the criteria can, for the first time, be used to their full potential.The purpose of this paper is to first give an introduction to a stress/strain simulation procedure that can be used in any foundry. Then, some results how to predict the hot...

  11. MRI of the knee: how do field strength and radiologist's experience influence diagnostic accuracy and interobserver correlation in assessing chondral and meniscal lesions and the integrity of the anterior cruciate ligament?

    Energy Technology Data Exchange (ETDEWEB)

    Krampla, W.; Roesel, M.; Svoboda, K.; Nachbagauer, A.; Gschwantler, M.; Hruby, W. [Donauspital, Radiology Department, Vienna (Austria)

    2009-06-15

    Accuracy of MRI reports is taken for granted. In this paper the inter-observer reliability in the interpretation of meniscal lesions, degree of chondropathy, and integrity of the ACL was analyzed while taking the radiologist's experience and field strength into account. Fifty-two MRI studies of knees were interpreted by 11 radiologists independently. Twenty-two were acquired on 1.0-T, 20 on 1.5-T, and 10 on 3.0-T systems. Four of the radiologists had more than 5 years and seven had 3 to 5 years of experience in interpreting MRI studies. The findings were compared with the intra-operative findings. Inter-observer variance, specificity, and sensitivity were evaluated for each field strength. Inter-observer correlation ranged between 0.370 for cartilage lesions and 0.597 for meniscal tears. Correlation values did not increase with experience or field strength. The number of false reports was dependent on the observer, but not on field strength. The rate of false interpretations was significantly higher for most criteria in the less experienced group. In conclusion, inter-observer correlation was low, although the diagnostic criteria were defined. The use of the classification scheme should be standardized by uniform training. Radiologist experience seems to be more important than field strength. (orig.)

  12. Major and trace elements in human tears

    International Nuclear Information System (INIS)

    Major elements in tears were determined by ion chromatography. The concentrations of major elements in tears (Cl, Na, K) are in the range from 600 to 4000 ppm. Minor elements in tears (Ca and Mg) were analyzed using ICP-MS and their concentration range is 10 to 80 ppm. All trace elements in tears have concentrations below the ppm range. Two techniques were applied for the determination of trace elements in tears (GFAAS and ICP-MS). The time-dependence of the concentrations of major and minor elements in tears was studied. The concentrations of major elements in tears hardly change with passage of time. However, the concentrations of minor elements (Ca, Mg, Rb) vary with time but in inconsistent manner. Some correlations are found between the concentrations of major elements (Cl and Na, Cl and Na+K) No correlations were observed between K and either Cl or Na. (author)

  13. IETI - Isogeometric Tearing and Interconnecting

    OpenAIRE

    Kleiss, Stefan K.; Pechstein, Clemens; Jüttler, Bert; Tomar, Satyendra

    2012-01-01

    Finite Element Tearing and Interconnecting (FETI) methods are a powerful approach to designing solvers for large-scale problems in computational mechanics. The numerical simulation problem is subdivided into a number of independent sub-problems, which are then coupled in appropriate ways. NURBS- (Non-Uniform Rational B-spline) based isogeometric analysis (IGA) applied to complex geometries requires to represent the computational domain as a collection of several NURBS geometries. Since there ...

  14. Artificial tears potpourri: a literature review

    Directory of Open Access Journals (Sweden)

    Moshirfar M

    2014-07-01

    Full Text Available Majid Moshirfar,1 Kasey Pierson,2,* Kamalani Hanamaikai,3,* Luis Santiago-Caban,1 Valliammai Muthappan,1 Samuel F Passi11Department of Ophthalmology, John A Moran Eye Center, University of Utah, Salt Lake City, UT, USA; 2University of Arizona College of Medicine, Phoenix, Phoenix, AZ, USA; 3A T Still University, School of Osteopathic Medicine in Arizona, Mesa, AZ, USA *These authors contributed equally to this work Abstract: Numerous brands and types of artificial tears are available on the market for the treatment of dysfunctional tear syndrome. Past literature has focused on comparing the components of these products on patient’s clinical improvement. The wide array of products on the market presents challenges to both clinicians and patients when trying to choose between available tear replacement therapies. Different formulations affect patients based on etiology and severity of disease. In order to provide an unbiased comparison between available tear replacement therapies, we conducted a literature review of existing studies and National Institutes of Health clinical trials on commercially available, brand name artificial tears. Outcomes evaluated in each study, as well as the percent of patients showing clinical and symptomatic improvement, were analyzed. Fifty-one studies evaluating different brands of artificial tears, and their efficacy were identified. Out of the 51 studies, 18 were comparison studies testing brand name artificial tears directly against each other. Nearly all formulations of artificial tears provided significant benefit to patients with dysfunctional tear syndrome, but some proved superior to others. From the study data, a recommended treatment flowchart was derived. Keywords: dry eye, tear film, dysfunctional tear syndrome, ophthalmic lubricant, artificial tears, lipid layer, tear osmolarity, TBUT, Systane®, Refresh®, Blink®, GenTeal®, Soothe®, Lacrisert®, ocular surface inflammatory disease, Sjogren

  15. Risk Factors for Giant Retinal Tears

    Directory of Open Access Journals (Sweden)

    Morteza Mehdizadeh

    2010-01-01

    Full Text Available Purpose: To evaluate the risk factors associated with giant retinal tears. Methods: This retrospective study was performed on medical records of 150 patients who had undergone retinal detachment surgery. Age, sex, history of trauma, lens status (phakic, pseudophakic, or aphakic, and high myopia were evaluated in association with giant retinal tears. Results: Of 150 patients with retinal detachments, 99 subjects (66% were older than 30 years while 51 (34% were 30 years of age or younger. Overall, 26 (17.3% patients had giant retinal tears. Controlling for all variables, only age had a significant correlation with giant retinal tears. Each year of advancing age was associated with a 6% decrease in the incidence of giant retinal tears. Conclusion: Young age is a significant risk factor for development of giant retinal tears.

  16. An evaluation of meniscal collagenous structure using optical projection tomography

    International Nuclear Information System (INIS)

    The collagenous structure of menisci is a complex network of circumferentially oriented fascicles and interwoven radially oriented tie-fibres. To date, examination of this micro- architecture has been limited to two-dimensional imaging techniques. The purpose of this study was to evaluate the ability of the three-dimensional imaging technique; optical projection tomography (OPT), to visualize the collagenous structure of the meniscus. If successful, this technique would be the first to visualize the macroscopic orientation of collagen fascicles in 3-D in the meniscus and could further refine load bearing mechanisms in the tissue. OPT is an imaging technique capable of imaging samples on the meso-scale (1-10 mm) at a micro-scale resolution. The technique, similar to computed tomography, takes two-dimensional images of objects from incremental angles around the object and reconstructs them using a back projection algorithm to determine three-dimensional structure. Bovine meniscal samples were imaged from four locations (outer main body, femoral surface, tibial surface and inner main body) to determine the variation in collagen orientation throughout the tissue. Bovine stifles (n = 2) were obtained from a local abattoir and the menisci carefully dissected. Menisci were fixed in methanol and subsequently cut using a custom cutting jig (n = 4 samples per meniscus). Samples were then mounted in agarose, dehydrated in methanol and subsequently cleared using benzyl alcohol benzyl benzoate (BABB) and imaged using OPT. Results indicate circumferential, radial and oblique collagenous orientations at the contact surfaces and in the inner third of the main body of the meniscus. Imaging identified fascicles ranging from 80-420 μm in diameter. Transition zones where fascicles were found to have a woven or braided appearance were also identified. The outer-third of the main body was composed of fascicles oriented predominantly in the circumferential direction. Blood vessels were

  17. The comparison of the failure strength of meniscus arrows (absorbable fixation material) with different meniscal suturing techniques

    OpenAIRE

    Cetinkaya, Sarper M.; Boynuk, Burak; Taser, Omer F.

    2004-01-01

    The importance of preserving meniscal tissue in the knee joint is well established recently. Functionally, the menisci have been shown to play a significant role in the knee. The capacity for meniscal healing and repair has also been well documented. The results of arthroscopic repair have been shown to be ar least as good for open repair. Then different arthroscopic meniscus repair techniques have been started to use. More recently, meniscus arrows (Biofix) whick are made of totally absor...

  18. The effect of hip joint muscle exercise on muscle strength and balance in the knee joint after meniscal injury

    OpenAIRE

    Park, Sun Ja; Kim, Young Mi; Kim, Ha Roo

    2016-01-01

    [Purpose] This study aimed to evaluate the effect of hip muscle strengthening on muscle strength and balance in the knee joint after a meniscal injury. [Subjects and Methods] This randomized control study enrolled 24 patients who had undergone arthroscopic treatment after a meniscal injury and began a rehabilitative exercise program 8 weeks after surgery. Subjects were divided into 2 groups of 12 subjects each: gluteus medius resistance exercise group and control group. This study investigate...

  19. IETI - Isogeometric Tearing and Interconnecting.

    Science.gov (United States)

    Kleiss, Stefan K; Pechstein, Clemens; Jüttler, Bert; Tomar, Satyendra

    2012-11-01

    Finite Element Tearing and Interconnecting (FETI) methods are a powerful approach to designing solvers for large-scale problems in computational mechanics. The numerical simulation problem is subdivided into a number of independent sub-problems, which are then coupled in appropriate ways. NURBS- (Non-Uniform Rational B-spline) based isogeometric analysis (IGA) applied to complex geometries requires to represent the computational domain as a collection of several NURBS geometries. Since there is a natural decomposition of the computational domain into several subdomains, NURBS-based IGA is particularly well suited for using FETI methods. This paper proposes the new IsogEometric Tearing and Interconnecting (IETI) method, which combines the advanced solver design of FETI with the exact geometry representation of IGA. We describe the IETI framework for two classes of simple model problems (Poisson and linearized elasticity) and discuss the coupling of the subdomains along interfaces (both for matching interfaces and for interfaces with T-joints, i.e. hanging nodes). Special attention is paid to the construction of a suitable preconditioner for the iterative linear solver used for the interface problem. We report several computational experiments to demonstrate the performance of the proposed IETI method. PMID:24511167

  20. Deltoid muscle and tendon tears in patients with chronic rotator cuff tears

    Energy Technology Data Exchange (ETDEWEB)

    Ilaslan, Hakan; Recht, Michael P. [Cleveland Clinic, Musculoskeletal Radiology/A21, Division of Radiology, Cleveland, OH (United States); Iannotti, Joseph P. [Cleveland Clinic, Department of Orthopedic Surgery, Cleveland, OH (United States)

    2007-06-15

    To describe the magnetic resonance imaging (MRI) appearances of tears of the deltoid muscle and tendon in patients with rotator cuff tears and without a prior history of shoulder surgery. Deltoid tears diagnosed on MR examinations were prospectively recorded between February 2003 through June 2004. The images of these patients were then retrospectively reviewed to determine the location of the deltoid tear, the presence of rotator cuff tears, tendon retraction, muscle atrophy, degree of humeral head subluxation, bony erosive changes involving the undersurface of the acromion, and the presence of edema or fluid-like signal intensity in the deltoid muscle and overlying subcutaneous tissues. There were 24 (0.3%) patients with deltoid tears; nine men and 15 women. The age range was 54 to 87 (average 73) years. The right side was involved in 20 cases, and the left in four cases. Fifteen patients had full thickness and nine had partial thickness tears of the deltoid. Shoulder pain was the most common presenting symptom. The physical examination revealed a defect in the region of the deltoid in two patients. Nineteen patients had tears in the muscle belly near the musculotendinous junction, and five had avulsion of the tendon from the acromial origin. Full thickness rotator cuff tears were present in all of the patients, and 22 patients had associated muscle atrophy. Subcutaneous edema and fluid-like signal was present in 15 patients. Tears of the deltoid muscle or tendon is an unusual finding, but they can be seen in patients with chronic massive rotator cuff tears. Partial thickness tears tend to involve the undersurface of the deltoid muscle and tendon. Associated findings such as intramuscular cyst or ganglion in the deltoid muscle belly and subcutaneous edema or fluid-like signal overlying the deltoid in a patient with a rotator cuff tear should raise the suspicion of a deltoid tear. (orig.)

  1. The Effects of Hemodialysis on Tear Osmolarity

    Directory of Open Access Journals (Sweden)

    Muhittin Taskapili

    2015-01-01

    Full Text Available Aim. To determine the effects of hemodialysis (HD on tear osmolarity and to define the blood biochemical tests correlating with tear osmolarity among patients with end stage renal disease (ESRD. Material-Method. Tear osmolarity of ESRD patients before and after the hemodialysis program was determined as well as the blood biochemical data including glucose, sodium, potassium, calcium, urea, and creatinine levels. Results. Totally 43 eyes of 43 patients (20 females and 23 males with a mean age of 53.98±18.06 years were included in the study. Tear osmolarity of patients was statistically significantly decreased after hemodialysis (314.06±17.77 versus 301.88±15.22 mOsm/L, p=0.0001. In correlation analysis, pre-HD tear osmolarity was negatively correlated with pre-HD blood creatinine level (r=-0.366,  p=0.016. Post-HD tear osmolarity was statistically significantly correlated with the post-HD glucose levels (r=0.305  p=0.047. Tear osmolarity alteration by HD was negatively correlated with creatinine alteration, body weight alteration, and ultrafiltration (r=-0.426,  p=0.004; r=-0.365,  p=0.016; and r=-0.320, p=0.036, resp.. There was no correlation between tear osmolarity and Kt/V and URR values. Conclusion. HD effectively decreases tear osmolarity to normal values and corrects the volume and composition of the ocular fluid transiently. Tear osmolarity alteration induced by HD is correlated with body weight changes, creatinine alterations, and ultrafiltration.

  2. Acute tears of the anterior cruciate ligament: analysis of the tear site and the degree using MR imaging

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    Jin, Uk; Ryu, Kyung Nam; Kim, Eui Jong; Yoon, Yup; Ahn, Jin Whan [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    1995-05-15

    To evaluate the sensitivity of MR imaging in determining tear sites and degrees in acute anterior cruciate ligament tear. MR imagings were undertaken in 19 patients who had trauma on their knee joints. All imaging studies were performed within 2 weeks after trauma and compared with operative findings. The degree of ligament tear were divided into complete and incomplete, and sites of tears were divided into superior, middle and inferior portions. MR findings were compared with operative findings. There were 14 cases of complete ligament tear and 5 cases of partial ligament tear. We could diagnose correctly in all 14 cases with complete tear and in 3 of 5 cases with partial tear. The tear sites were correctly predicted in 10 of 14 cases with complete tear(71%) and 1 of 5 cases with partial tear(20%). In complete tears, MR findings were transversely or obliquely coursed band-like high signal intensity within the ACL or abrupt switch over to as indistinct signal intensity. In partial tears, the tear sites could not be evaluated mostly and the tear appeared as linear low signal intensity lesions in posterolateral bundles of ACL. MR revealed higher sensitivity in determining the degree and sites of ACL tear in complete tear as compared with partial tear.

  3. Acute tears of the anterior cruciate ligament: analysis of the tear site and the degree using MR imaging

    International Nuclear Information System (INIS)

    To evaluate the sensitivity of MR imaging in determining tear sites and degrees in acute anterior cruciate ligament tear. MR imagings were undertaken in 19 patients who had trauma on their knee joints. All imaging studies were performed within 2 weeks after trauma and compared with operative findings. The degree of ligament tear were divided into complete and incomplete, and sites of tears were divided into superior, middle and inferior portions. MR findings were compared with operative findings. There were 14 cases of complete ligament tear and 5 cases of partial ligament tear. We could diagnose correctly in all 14 cases with complete tear and in 3 of 5 cases with partial tear. The tear sites were correctly predicted in 10 of 14 cases with complete tear(71%) and 1 of 5 cases with partial tear(20%). In complete tears, MR findings were transversely or obliquely coursed band-like high signal intensity within the ACL or abrupt switch over to as indistinct signal intensity. In partial tears, the tear sites could not be evaluated mostly and the tear appeared as linear low signal intensity lesions in posterolateral bundles of ACL. MR revealed higher sensitivity in determining the degree and sites of ACL tear in complete tear as compared with partial tear

  4. Double Meniscal Ossicle, the First Description: CT and MRI Findings—Different Etiologies

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    Puneeth Kumar

    2015-01-01

    Full Text Available We present a case of 2 ossicles in the medial meniscus with emphasis on MRI and CT findings. Meniscal ossicle is a rare entity and is quite uncommon on the medial side. By showing the typical signal characteristics and intrameniscal location, MRI can be helpful in distinguishing this from other more clinically significant abnormalities. It should be kept as differential from synovial chondromatosis or sesamoid bones like fabella as management is different for all of these entities.

  5. Clinical knee findings in floor layers with focus on meniscal status

    OpenAIRE

    Jensen Lilli; Rytter Søren; Bonde Jens

    2008-01-01

    Abstract Background The aim of this study was to examine the prevalence of self-reported and clinical knee morbidity among floor layers compared to a group of graphic designers, with special attention to meniscal status. Methods We obtained information about knee complaints by questionnaire and conducted a bilateral clinical and radiographic knee examination in 134 male floor layers and 120 male graphic designers. After the exclusion of subjects with reports of earlier knee injuries the odds ...

  6. Kinetic theory of tearing instability

    International Nuclear Information System (INIS)

    The guiding-center kinetic equation with Fokker-Planck collision term is used to study, in cylindrical geometry, a class of dissipative instabilities of which the classical tearing mode is an archetype. Variational solution of the kinetic equation obviates the use of an approximate Ohm's law or adiabatic assumption, as used in previous studies, and it provides a dispersive relation which is uniformly valid for any ratio of wave frequency to collision frequency. One result of using the rigorous collision operator is the prediction of a new instability. This instability, driven by the electron temperature gradient, is predicted to occur under the long mean-free path conditions of present tokamak experiments, and has significant features in common with the kink-like oscillations observed in such experiments

  7. Financial impact of radiological reports on medical-legal evaluation of compensation for meniscal lesions.

    Science.gov (United States)

    Lelario, M; Ciuffreda, P; Lupo, P; Bristogiannis, C; Vinci, R; Stoppino, L P; De Filippo, M; Macarini, L

    2013-08-01

    To evaluate any discrepancy between radiological reports for clinical purposes and for medicolegal purposes and to quantify its economic impact on repayments made by private insurance companies for meniscal injuries of the knee. The medical records obtained pertaining to 108 knee injury patients (mean age 43.3 years) assessed over a period of 12 months were analysed. Clinical medical reports, aimed at assessing the lesion, and medicolegal reports, drawn up with a view to quantifying compensation, were compared. Unlike reports for clinical purposes in reports for medicolegal purposes, in the evaluation of meniscal lesions, in addition to morphological features of lesions, chronological, topographical, severity and exclusion criteria were applied. To estimate the economic impact resulting from the biological damage, we consulted an actuarial table based on the 9-point minor incapacity classification system. Meniscal lesions not compatible with a traumatic event and therefore not eligible for an insurance payout were found in 56 patients. Of these, 37 failed exclusion criteria, while 19 failed to meet chronological criteria. This difference resulted in a reduction in compensation made by private insurance companies with savings estimated with a saving between euro 203,715.41 and euro 622,315.39. The use of a clinical report for medicolegal purposes can be a source of valuation error, as chronological and/or dynamic information regarding the trauma mechanism may be lacking. Therefore, the use of a full radiological appraisal allows a better damage's assessment and an adequate compensation for injuries. PMID:23949935

  8. [Basic diagnostics of tear duct diseases].

    Science.gov (United States)

    Förl, M; Busse, H

    2008-04-01

    The two main reasons for tearing are epiphora and excess lacrimation. Epiphora is a result of a failure of tear drainage caused by mechanical obstruction or lacrimal pump failure. Lacrimation is excessive tearing caused by reflex hypersecretion. The goal of the basic examination is to distinguish between epiphora and lacrimation. The clinical history, palpation, inspection, diagnostic probing and syringing are sufficient to evaluate the function of the lacrimal drainage system or to determine location and extension of obstructions in most patients with epiphora. Numerous diagnostic tests are available and the most important tests and their interpretation are described. PMID:18373096

  9. Changes of tear film and tear secretion after phacoemulsification in diabetic patients

    OpenAIRE

    Liu, Xi; Gu, Yang-shun; Xu, Ye-sheng

    2008-01-01

    Objective: To evaluate tear film stability and tear secretion in patients with diabetes after phacoemulsification. Methods: Twenty-five diabetic cataract patients and 20 age-matched non-diabetic cataract patients as control underwent phacoemulsification. Tear film break-up time (TFBUT), Schirmer I test (SIT), corneal fluorescein staining, and dry eye symptoms were measured pre- and postoperatively. Results: Diabetics had a decreased preoperative TFBUT and SIT. TFBUT was reduced on Day 1 and r...

  10. A COMPARATIVE STUDY OF TEAR FILM FUNCTION AND TEAR SECRETION AMONG DIABETICS

    OpenAIRE

    Pai Shobha G, Pai Sheila R, Kini Jyoti, Nayak Madhurima K* and Pai G Ajay

    2014-01-01

    The present work aims to study the changes in tear film function by studying tear film stability, amount of tear secretion and conjunctival impression cytology among diabetics and to compare with that in non-diabetics. In this prospective case control study, 100 eyes of 50 patients with type II Diabetes Mellitus and 100 eyes of 50 normal patients coming to OPD of a tertiary hospital were chosen. The tests done included Tear film Break Up Time, Rose Bengal staining, Schirmer’s test and Conjunc...

  11. An Athlete's Nightmare: Tearing the ACL

    Science.gov (United States)

    ... Issue Past Issues An Athlete's Nightmare : Tearing the ACL Past Issues / Summer 2008 Table of Contents For ... years after successful surgery to repair a torn ACL, Michelle Backus of Gaithersburg, Md., is once again ...

  12. Rotator Cuff Tears: Surgical Treatment Options

    Science.gov (United States)

    .org Rotator Cuff Tears: Surgical Treatment Options Page ( 1 ) The following article provides in-depth information about surgical treatment for rotator cuff injuries, and is a continuation of the article “ ...

  13. Isolated tear of the plantaris tendon: ultrasound and MRI appearance

    Energy Technology Data Exchange (ETDEWEB)

    Bianchi, Stefano [CIM, Cabinet Imagerie Medicale, Geneva (Switzerland); Sailly, Matthieu [CIM, Cabinet Imagerie Medicale, Geneva (Switzerland); Health Center, ASPIRE, Doha (Qatar); Molini, Lucio [Ospedale Galliera, Struttura complessa di Radiodiagnostica, Genova (Italy)

    2011-07-15

    We report a retrospective analysis of the ultrasound and magnetic resonance imaging appearance of five patients with isolated plantaris tendon tears. Both imaging techniques allowed detection of the tear, assessment of its severity and of its location. Compared with magnetic resonance imaging, ultrasound resulted in a less expensive and time-consuming evaluation. Isolated plantaris tendon tears can clinically mimic Achilles tendon tears or thrombophlebitis. Unlike these conditions, plantaris tear has a benign outcome and does not need surgical treatment or anticoagulation. (orig.)

  14. Oral presentation of an oesophageal mucosal tear

    OpenAIRE

    Uppal, S; De P, R

    1999-01-01

    Tears of the oesophageal wall following sudden forceful vomiting are well documented in literature. In Boerhaave's syndrome there is transmural rupture associated with complications including pneumothorax, pneumomediastinum, surgical emphysema and shock. In Mallory-Weiss syndrome mucosal tears are associated with haematemesis and shock. In neither of these conditions has intraluminal obstruction been described as an aetiological factor. We present a case with similar pathophysiology where oes...

  15. Delivery Practices and Perineal Tears: Midwives’ Experiences

    OpenAIRE

    2015-01-01

    Objective: The aim of this study is to explore the experiences and views of midwives regarding third- and fourth-degree perineal tears. Method: Focus group interviews with midwives from a university hospital. Qualitative analysis using principles from ‘grounded theory’. Findings: The participants mentioned several factors that they considered important for the prevention of tears that may cause injury to the anal sphincter. A crucial aspect was the way in which the midwife deals with the phys...

  16. Risk Factors for Giant Retinal Tears

    OpenAIRE

    Morteza Mehdizadeh; Mehrdad Afarid; Mohammad Shabanpour Haqiqi

    2010-01-01

    Purpose: To evaluate the risk factors associated with giant retinal tears. Methods: This retrospective study was performed on medical records of 150 patients who had undergone retinal detachment surgery. Age, sex, history of trauma, lens status (phakic, pseudophakic, or aphakic), and high myopia were evaluated in association with giant retinal tears. Results: Of 150 patients with retinal detachments, 99 subjects (66%) were older than 30 years while 51 (34%) were 30 years of age or you...

  17. Risk Factors for Giant Retinal Tears

    OpenAIRE

    Mehdizadeh, Morteza; Afarid, Mehrdad; Haqiqi, Mohammad Shabanpour

    2010-01-01

    Purpose To evaluate the risk factors associated with giant retinal tears. Methods This retrospective study was performed on medical records of 150 patients who had undergone retinal detachment surgery. Age, sex, history of trauma, lens status (phakic, pseudophakic, or aphakic), and high myopia were evaluated in association with giant retinal tears. Results Of 150 patients with retinal detachments, 99 subjects (66%) were older than 30 years while 51 (34%) were 30 years of age or younger. Overa...

  18. Rotator cuff tear: A detailed update

    Directory of Open Access Journals (Sweden)

    Vivek Pandey

    2015-01-01

    Full Text Available Rotator cuff tear has been a known entity for orthopaedic surgeons for more than two hundred years. Although the exact pathogenesis is controversial, a combination of intrinsic factors proposed by Codman and extrinsic factors theorized by Neer is likely responsible for most rotator cuff tears. Magnetic resonance imaging remains the gold standard for the diagnosis of rotator cuff tears, but the emergence of ultrasound has revolutionized the diagnostic capability. Even though mini-open rotator cuff repair is still commonly performed, and results are comparable to arthroscopic repair, all-arthroscopic repair of rotator cuff tear is now fast becoming a standard care for rotator cuff repair. Appropriate knowledge of pathology and healing pattern of cuff, strong and biological repair techniques, better suture anchors, and gradual rehabilitation of postcuff repair have led to good to excellent outcome after repair. As the healing of degenerative cuff tear remains unpredictable, the role of biological agents such as platelet-rich plasma and stem cells for postcuff repair augmentation is still under evaluation. The role of scaffolds in massive cuff tear is also being probed.

  19. Sonographic evaluation of digital annular pulley tears

    International Nuclear Information System (INIS)

    Objective. To evaluate the sonographic (US) appearance of digital annular pulley (DAP) tears in high-level rock climbers. Design and patients. We performed a retrospective analysis of the US examinations of 16 high-level rock climbers with clinical signs of DAP lesions. MRI and surgical evaluation were performed in five and three patients respectively. The normal US and MRI appearances of DAP were evaluated in 40 and three normal fingers respectively. Results. Nine of 16 patients presented a DAP tear. In eight subjects (seven with complete tears involving the fourth finger and one the fifth finger), US diagnosis was based on the indirect sign of volar bowstringing of the flexor tendons. Injured pulleys were not appreciated by US. Tears concerned the A2 and A3 in six patients and the A3 and A4 in two patients. A2 pulley thickening and hypoechogenicity compatible with a partial tear was demonstrated in one patient. MRI and surgical data correlated well with the US findings. Four patients had tenosynovitis of the flexor tendons but no evidence of pulley disruption. US examinations of three patients were normal. In the healthy subjects US demonstrated DAP in 16 of 40 digits. Conclusion. US can diagnose DAP tears and correlates with the MRI and surgical data. Because of its low cost and non-invasiveness we suggest US as the first imaging modality in the evaluation of injuries of the digital pulley. (orig.)

  20. Magnetic resonance findings in skeletal muscle tears

    International Nuclear Information System (INIS)

    Magnetic resonance (MR) images of skeletal muscle tears can clearly delineate the severity of muscle injury. Although MR imaging is seldom necessary in patients with acute musle trauma, it can be helpful in deciding on clinical management. The two major MR findings in acute muscle tears are deformity of the muscle and the presence of abnormal signal reflecting hemorrhage and edema. In acute tears, methemoglobin within the extravascular blood causes high-signal areas on both T1- and T2-weighted images. With partial tears, the blood may dissect in a distinctive linear pattern along the muscle bundles and fibers. As healing begins, the muscle signal diminishes, first on the T1-weighted images and then on the T2-weighted images. When there is residual abnormal signal on images obtained more than several months after the injury, it is presumed to represent hemorrhage from recurrent tears. In patients with a questionable history of a remote injury, the clinical presentation may be that of persistent pain or a soft tissue mass. In these cases MR imaging may identify the cause of the pain and can exclude a neoplasm by proving that the mass is a hypertrophied or retracted musle. Thus, MR imaging has a limited, but occasionally important role in selected patients with skeletal muscle tears. (orig.)

  1. Arthroscopic partial medial meniscectomy

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    Dašić Žarko

    2011-01-01

    Full Text Available Background/Aim. Meniscal injuries are common in professional or recreational sports as well as in daily activities. If meniscal lesions lead to physical impairment they usually require surgical treatment. Arthroscopic treatment of meniscal injuries is one of the most often performed orthopedic operative procedures. Methods. The study analyzed the results of arthroscopic partial medial meniscectomy in 213 patients in a 24-month period, from 2006, to 2008. Results. In our series of arthroscopically treated medial meniscus tears we noted 78 (36.62% vertical complete bucket handle lesions, 19 (8.92% vertical incomplete lesions, 18 (8.45% longitudinal tears, 35 (16.43% oblique tears, 18 (8.45% complex degenerative lesions, 17 (7.98% radial lesions and 28 (13.14% horisontal lesions. Mean preoperative International Knee Documentation Committee (IKDC score was 49.81%, 1 month after the arthroscopic partial medial meniscectomy the mean IKDC score was 84.08%, and 6 months after mean IKDC score was 90.36%. Six months after the procedure 197 (92.49% of patients had good or excellent subjective postoperative clinical outcomes, while 14 (6.57% patients subjectively did not notice a significant improvement after the intervention, and 2 (0.93% patients had no subjective improvement after the partial medial meniscectomy at all. Conclusion. Arthroscopic partial medial meniscetomy is minimally invasive diagnostic and therapeutic procedure and in well selected cases is a method of choice for treatment of medial meniscus injuries when repair techniques are not a viable option. It has small rate of complications, low morbidity and fast rehabilitation.

  2. Usefulness of meniscal width to transverse diameter ratio on coronal MRI in the diagnosis of incomplete discoid lateral meniscus

    International Nuclear Information System (INIS)

    Aim: To evaluate the clinical utility of the meniscal width to transverse diameter ratio (L/M ratio) of the lateral meniscus in the diagnosis of incomplete discoid lateral meniscus (IDLM) as compared with the arthroscopic diagnosis, meniscal width to tibial diameter ratio (L/T ratio) and conventional lateral meniscus width criteria. Materials and methods: This retrospective study sample included 41 patients with IDLM who underwent knee magnetic resonance imaging (MRI) and arthroscopy, as well as 50 controls with normal lateral menisci. MRI examinations were interpreted independently by two radiologists, both of whom were blinded to clinical information and radiological reports. Assessment of meniscal width (L), maximal transverse diameter of the lateral meniscus (M), and transverse diameter of the tibia (T) was carried out on central coronal sections that were observed to pass through the medial collateral ligament. L/M and L/T ratios were calculated. These results were correlated with arthroscopic findings and analysed statistically using categorical regression analysis and non-parametric correlation analysis. Using arthroscopic findings as the standard of reference, sensitivity and specificity were calculated for: (1) 12, 13, 14, and 15 mm meniscal width thresholds; (2) 40%, 50%, 60%, and 70% L/M ratio thresholds; and (3) 15%, 18%, 20%, and 25% L/T ratio thresholds. Results: The mean L/M ratio of the IDLM was approximately 67% and was statistically significantly higher than the control (44%). The best diagnostic discrimination was achieved using a threshold of 50%. The mean L/T ratio of the IDLM was approximately 23% and was statistically significant. The best diagnostic discrimination was achieved using a threshold of 18%. The threshold of 13 mm of meniscal width also showed high sensitivity and high specificity. Conclusion: The use of the L/M ratio or L/T ratio in combination with meniscal width criteria may be a useful method for evaluating IDLM

  3. Energetic approach for ductile tearing

    International Nuclear Information System (INIS)

    This study focuses on ductile crack initiation and propagation. It aims to propose an approach for the engineer allowing the prediction of the evolution of cracks in large scale components, from parameters determined on laboratory specimens. A crack initiation criterion, defining a Ji tenacity related to crack tip blunting proposed in the literature is validated in the study. This criterion is shown to be transferable from laboratory specimens to structures. The literature review shows that an approach based on the dissipated energy in the fracture process during propagation offers an economical and simple solution to simulate large crack growth. A numerical method is proposed to estimate this fracture energy. The existence of an energy parameter Gfr is shown, by simulating the propagation by the simultaneous release of several elements and by the use of the Rice integral with an original integration path. This parameter represents the needed energy for a unit crack extension and appears to be intrinsic to the material. A global energy statement allows to relate this parameter to a variation of the plastic part of J integral. It offers a second numerical method to simulate the propagation just from stationary numerical calculations, as well as the elaboration of a simplified method. This approach, using two parameters Ji and Gfr, intrinsic to the material and experimentally measurable on specimens, is validated on many tests such as crack pipes subjected to four points bending and cracked rings in compression. For example, this approach allows to model up to 90 mm ductile tearing in a pipe with a circumferential through-wall crack in ferritic steel, or to anticipate the evolution of a semi-elliptical crack in an aged austenitic ferritic steel plate subjected to bending. (author)

  4. Three-dimensional culture of human meniscal cells: Extracellular matrix and proteoglycan production

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    Norton H James

    2008-06-01

    Full Text Available Abstract Background The meniscus is a complex tissue whose cell biology has only recently begun to be explored. Published models rely upon initial culture in the presence of added growth factors. The aim of this study was to test a three-dimensional (3D collagen sponge microenvironment (without added growth factors for its ability to provide a microenvironment supportive for meniscal cell extracellular matrix (ECM production, and to test the responsiveness of cells cultured in this manner to transforming growth factor-β (TGF-β. Methods Experimental studies were approved prospectively by the authors' Human Subjects Institutional Review Board. Human meniscal cells were isolated from surgical specimens, established in monolayer culture, seeded into a 3D scaffold, and cell morphology and extracellular matrix components (ECM evaluated either under control condition or with addition of TGF-β. Outcome variables were evaluation of cultured cell morphology, quantitative measurement of total sulfated proteoglycan production, and immunohistochemical study of the ECM components chondroitin sulfate, keratan sulfate, and types I and II collagen. Result and Conclusion Meniscal cells attached well within the 3D microenvironment and expanded with culture time. The 3D microenvironment was permissive for production of chondroitin sulfate, types I and II collagen, and to a lesser degree keratan sulfate. This microenvironment was also permissive for growth factor responsiveness, as indicated by a significant increase in proteoglycan production when cells were exposed to TGF-β (2.48 μg/ml ± 1.00, mean ± S.D., vs control levels of 1.58 ± 0.79, p

  5. Clinical knee findings in floor layers with focus on meniscal status

    Directory of Open Access Journals (Sweden)

    Jensen Lilli

    2008-10-01

    Full Text Available Abstract Background The aim of this study was to examine the prevalence of self-reported and clinical knee morbidity among floor layers compared to a group of graphic designers, with special attention to meniscal status. Methods We obtained information about knee complaints by questionnaire and conducted a bilateral clinical and radiographic knee examination in 134 male floor layers and 120 male graphic designers. After the exclusion of subjects with reports of earlier knee injuries the odds ratio (OR with 95% confidence intervals (CI of knee complaints and clinical findings were computed among floor layers compared to graphic designers, using logistic regression. Estimates were adjusted for effects of body mass index, age and knee straining sports. Using radiographic evaluations, we conducted side-specific sensitivity analyses regarding clinical signs of meniscal lesions after the exclusion of participants with tibiofemoral (TF osteoarthritis (OA. Results Reports of knee pain (OR = 2.7, 95% CI = 1.5–4.6, pain during stair walking (OR = 2.2, 95% CI = 1.3–3.9 and symptoms of catching of the knee joint (OR = 2.9, 95% CI = 1.4–5.7 were more prevalent among floor layers compared to graphic designers. Additionally, significant more floor layers than graphic designers had clinical signs suggesting possible meniscal lesions: a positive McMurray test (OR = 2.4, 95% CI = 1.1–5.0 and TF joint line tenderness (OR = 5.4, 95% CI = 2.4–12.0. Excluding floor layers (n = 22 and graphic designers (n = 15 with radiographic TF OA did not alter this trend between the two study groups: a positive McMurray test (OR = 2.2, 95% CI = 1.0–4.9, TF joint line tenderness (OR = 5.0, 95% CI = 2.0–12.5. Conclusion Results indicate that floor layers have a high prevalence of both self-reported and clinical knee morbidity. Clinical knee findings suggesting possible meniscal lesions were significant more prevalent among floor layers compared to a group of low

  6. Energetic Ion Interactions with Tearing Mode Stability

    Science.gov (United States)

    Halfmoon, Michael; Brennan, Dylan

    2015-11-01

    This study focuses on the interactions between energetic ions and pressure-driven, slow growing tearing modes in high beta tokamaks. Previous studies have shown that energetic ions interact with and affect the tearing mode stability, in a mechanism similar to those of ideal MHD instabilities and resistive wall modes. The 2/1 tearing mode is found to be damped or stabilized in the presence of energetic ions, with the most significant effects on the slow-growing resistive mode. To gain an understanding of the underlying physics of these effects, we have investigated a combination of reduced analytics and numerical simulations. In the reduced model, a high aspect ratio, step function equilibrium is investigated, where the dynamics of high-energy ions interacting with the tearing mode is implemented through integration over the pressure step. In the simulations, a series of experimentally relevant D-shaped equilibria with fixed monotonic safety factor and varying peaked pressure profiles is analyzed using the δf hybrid kinetic-mhd code in NIMROD. Results show a damping effect from the ions that is consistent between the reduced model and the simulations. The stabilizing effect is mainly due to trapped particle resonance, causing the tearing mode to have a finite frequency. US DOE Grant DE- SC0004125.

  7. A case of recurrent bloody tears

    Directory of Open Access Journals (Sweden)

    Karslıoğlu Ş

    2011-07-01

    Full Text Available Şafak Karslioğlu1, Ilke Bahçeci Şimşek2, Müslime Akbaba11Ìstanbul Oculoplastic and Orbital Surgery and Ocular Oncology Center, 2Ophthalmology Department, Medicine Hospital, Ìstanbul, TurkeyAbstract: Well-known causes of blood-tinged epiphora are conjunctival lesions, tumors of the lacrimal apparatus, and systemic bleeding disorders. We describe an unusual patient who presented with recurrent episodes of bloody tearing which began following an erythema multiforme-like drug eruption. He experienced chronic conjunctivitis which resulted in a few minor symblephara. One year later, the patient developed attacks of bloody tearing. All clinical, radiologic, and laboratory investigations related to bloody epiphora were within normal limits except for a mild, nonspecific chronic inflammatory reaction in the perivascular tissues of the lacrimal gland and orbital soft tissues. Also, an increase in vascular permeability and contrast extravasation on carotid angiography was detected. High-dose vitamin C was administered. The patient continued to have unilateral bloody tears intermittently for two years, but the episodes became much less frequent and had resolved by three years. It is conceivable that increased vascular permeability following the systemic inflammatory process could have played a role in the etiology of recurrent bloody tears in this atypical patient.Keywords: bloody tears, erythema multiforme, drug eruption, vitamin C

  8. HPLC analysis of closed, open, and reflex eye tear proteins

    Directory of Open Access Journals (Sweden)

    Sitaramamma T

    1998-01-01

    Full Text Available Changes in the closed, open and reflex eye tear proteins of normal subjects were compared and analysed. Tear proteins were resolved by high-performance liquid chromatography (HPLC utilising both gel filtration (P-300 SW and reverse-phase (C-18 columns and the HPLC fractions were further analysed by sodium dodecyl sulphate - polyacrylamide gel electrophoresis (SDS-PAGE under reducing and non-reducing conditions. The protein composition of the closed-eye tear was significantly different from that of the open and reflex-eye tear. Secretory IgA (sIgA was the predominant protein in closed eye tears constituting 49% of the total protein compared to 11% in reflex tears, whereas lysozyme was the predominant protein (53% in reflex tears. Levels of lactoferrin, lipocalin and lysozyme were relatively constant in both open and reflex tears. HPLC profiles of the closed-eye tears, upon continuous stimulation of lacrimal glands indicated that sIgA was significantly reduced whereas lactoferrin, lipocalin, and lysozyme were significantly increased. These results indicate that the tear composition upon waking attains that of the open eye within 4 to 5 minutes, and upon continuous stimulation this reflects the reflex-eye tear composition. It also indicates that mechanisms responsible for changes in concentration of constitutive and regulated tear protein with stimulus can be studied successfully using non-invasive methods to collect human tears.

  9. 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

  10. Analysis of tear glucose concentration with electrospray ionization mass spectrometry.

    Science.gov (United States)

    Taormina, Christopher R; Baca, Justin T; Asher, Sanford A; Grabowski, Joseph J; Finegold, David N

    2007-02-01

    We have developed a mass spectrometry-based method that allows one to accurately determine the glucose concentration of tear fluid. We used a 1 microL micro-capillary to collect tear fluid from the tear meniscus with minimal irritation of the eye. We analyzed the 1 muL volume of collected tear fluid with liquid-chromatography electrospray ionization mass spectrometry with the use of D-glucose-6,6-d2 as an internal standard. Repeated measurements and a recovery experiment on pooled, onion-induced tears showed that the analysis of the glucose in tears was precise (4% relative standard deviation) and provided 100% recovery. We found the tear glucose concentration of one fasting nondiabetic subject to be 13 to 51 microM while the onion-induced tear glucose concentration of a different nondiabetic subject to be 211 to 256 microM. PMID:17084090

  11. Langmuir films study on lipid-containing artificial tears.

    Science.gov (United States)

    Torrent-Burgués, J

    2016-04-01

    Lipid-containing artificial tears are a type of artificial tears that use lipid components in order to restore the lipid layer of the tear film. One of these components is lecithin which can be applied in spray solutions containing lecithin liposomes. In this work the behavior of three of these commercial tears based on lecithin, Innoxa, Opticalm and Optrex, are studied using the Langmuir technique. The obtained isotherms are presented, discussed and compared. This technique seems useful in order to see the film behavior of the lipid components of these tears and determine some important parameters such as fluidity and extension at the air-water interface, and allows us to discern differences between these commercial tears. Innoxa and Optrex tears are more similar to each other than to Opticalm tears. Opticalm presents more fluidity, probably due to the presence of more insaturations in the fatty acid chains of the phospholipids of the lecithin used in fabrication. PMID:26764100

  12. Using a statistically calibrated biphasic finite element model of the human knee joint to identify robust designs for a meniscal substitute.

    Science.gov (United States)

    Leatherman, Erin R; Guo, Hongqiang; Gilbert, Susannah L; Hutchinson, Ian D; Maher, Suzanne A; Santner, Thomas J

    2014-07-01

    This paper describes a methodology for selecting a set of biomechanical engineering design variables to optimize the performance of an engineered meniscal substitute when implanted in a population of subjects whose characteristics can be specified stochastically. For the meniscal design problem where engineering variables include aspects of meniscal geometry and meniscal material properties, this method shows that meniscal designs having simultaneously large radial modulus and large circumferential modulus provide both low mean peak contact stress and small variability in peak contact stress when used in the specified subject population. The method also shows that the mean peak contact stress is relatively insensitive to meniscal permeability, so the permeability used in the manufacture of a meniscal substitute can be selected on the basis of manufacturing ease or cost. This is a multiple objective problem with the mean peak contact stress over the population of subjects and its variability both desired to be small. The problem is solved by using a predictor of the mean peak contact stress across the tibial plateau that was developed from experimentally measured peak contact stresses from two modalities. The first experimental modality provided computed peak contact stresses using a finite element computational simulator of the dynamic tibial contact stress during axial dynamic loading. A small number of meniscal designs with specified subject environmental inputs were selected to make computational runs and to provide training data for the predictor developed below. The second experimental modality consisted of measured peak contact stress from a set of cadaver knees. The cadaver measurements were used to bias-correct and calibrate the simulator output. Because the finite element simulator is expensive to evaluate, a rapidly computable (calibrated) Kriging predictor was used to explore extensively the contact stresses for a wide range of meniscal engineering

  13. Large regional differences in incidence of arthroscopic meniscal procedures in the public and private sector in Denmark

    DEFF Research Database (Denmark)

    Hare, Kristoffer Borbjerg; Vinther, Jesper Høeg; Lohmander, L Stefan; Thorlund, Jonas Bloch

    2015-01-01

    arthroscopic meniscus surgery as a primary or secondary procedure in the years 2000 to 2011. Hospital identification codes enabled linkage of performed procedures to specific hospitals. PRIMARY AND SECONDARY OUTCOME MEASURES: Yearly incidence of meniscal procedures per 100 000 inhabitants was calculated with...

  14. Meniscal T1rho and T2 measured with 3.0T MRI increases directly after running a marathon

    International Nuclear Information System (INIS)

    To prospectively evaluate changes in T1rho and T2 relaxation time in the meniscus using 3.0 T MRI in asymptomatic knees of marathon runners and to compare these findings with those of age-matched healthy subjects. Thirteen marathon runners underwent 3.0 T MRI including T1rho and T2 mapping sequences before, 48-72 h after, and 3 months after competition. Ten controls were examined at baseline and after 3 months. All images were analyzed by two musculoskeletal radiologists identifying and grading cartilage, meniscal, ligamentous. and other knee abnormalities with WORMS scores. Meniscal segmentation was performed to generate T1rho and T2 maps in six compartments. No differences in morphological knee abnormalities were found before and after the marathon. However, all marathon runners showed a significant increase in T1rho and T2 values after competition in all meniscus compartments (p < 0.0001), which may indicate changes in the biochemical composition of meniscal tissue. While T2 values decreased after 3 months T1rho values remained at a high level, indicating persisting changes in the meniscal matrix composition after a marathon. T2 values in menisci have the potential to be used as biomarkers for identifying reversible meniscus matrix changes indicating potential tissue damage. T1rho values need further study, but may be a valuable marker for diagnosing early, degenerative changes in the menisci following exercise. (orig.)

  15. Prótese meniscal de polímero bioabsorvível: estudo em coelhos Bioresorbable polymeric meniscal prosthesis: study in rabbits

    Directory of Open Access Journals (Sweden)

    Tulio Pereira Cardoso

    2010-06-01

    Full Text Available OBJETIVO: Obter o crescimento de um neomenisco por entre as porosidades da prótese com objetivo de proteger a cartilagem articular do joelho. MÉTODOS: Foram operados 70 joelhos de 35 coelhos Nova Zelândia com idades entre cinco e sete meses, pesando entre dois e 3,8 quilogramas, sendo 22 machos e 13 fêmeas. Submetidos no mesmo tempo cirúrgico à meniscectomia medial nos dois joelhos, em um lado foi implantada prótese meniscal de polímero bioabsorvível composta por 70% de poli (dioxanona e 30% de poli (L-ácido láctico. Realizada eutanásia com diferentes tempos pós-implante. Os côndilos femorais mediais e o neomenisco foram submetidos à análise histológica, observando-se a degradação e absorção da prótese, o crescimento de tecido meniscal na mesma, e o grau de degradação da cartilagem articular dos côndilos femorais, medido pelo histograma. RESULTADOS: Os dados obtidos avaliaram o crescimento de tecido histologicamente semelhante ao menisco normal, com absorção gradual da prótese e a porcentagem de condrócitos no lado controle e no lado com implante da prótese. CONCLUSÕES: Ocorreu crescimento de tecido por entre os poros da prótese com características histológicas semelhantes a do menisco normal de coelho. A cartilagem articular dos côndilos femorais no lado com implante da prótese apresenta maior número de condrócitos em todas as suas camadas.OBJECTIVE: To induce the ingrowth of a neomeniscus between the pores of the prosthesis in order to protect the articular cartilage of the knee. METHODS: 70 knees of 35 New Zealand rabbits were operated. The rabbits were five to seven months old, weighed 2 to 3.8 kilograms. 22 were male and 13 were female. Each animal underwent medial meniscectomy in both knees during the same time of surgery, having a bioresorbable polymeric meniscal prosthesis composed of 70% polydioxanone and 30% L-lactic acid polymer implanted in one side. They were submitted to euthanasia after

  16. Bovine meniscal tissue exhibits age- and interleukin-1 dose-dependent degradation patterns and composition-function relationships.

    Science.gov (United States)

    Ling, Carrie H-Y; Lai, Janice H; Wong, Ivan J; Levenston, Marc E

    2016-05-01

    Despite increasing evidence that meniscal degeneration is an early event in the development of knee osteoarthritis, relatively little is known regarding the sequence or functional implications of cytokine-induced meniscal degradation or how degradation varies with age. This study examined dose-dependent patterns of interleukin-1 (IL-1)-induced matrix degradation in explants from the radially middle regions of juvenile and adult bovine menisci. Tissue explants were cultured for 10 days in the presence of 0, 1.25, 5, or 20 ng/ml recombinant human IL-1α. Juvenile explants exhibited immediate and extensive sulfated glycosaminoglycan (sGAG) loss and subsequent collagen release beginning after 4-6 days, with relatively little IL-1 dose-dependence. Adult explants exhibited a more graded response to IL-1, with dose-dependent sGAG release and a lower fraction of sGAG released (but greater absolute release) than juvenile explants. In contrast to juvenile explants, adult explants exhibited minimal collagen release over the 10-day culture. Compressive and shear moduli reflected the changes in explant composition, with substantial decreases for both ages but a greater relative decrease in juvenile tissue. Dynamic moduli exhibited stronger dependence on explant sGAG content for juvenile tissue, likely reflecting concomitant changes to both proteoglycan and collagen tissue components. The patterns of tissue degradation suggest that, like in articular cartilage, meniscal proteoglycans may partially protect collagen from cell-mediated degeneration. A more detailed view of functional changes in meniscal tissue mechanics with degeneration will help to establish the relevance of in vitro culture models and will advance understanding of how meniscal degeneration contributes to overall joint changes in early stage osteoarthritis. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:801-811, 2016. PMID:26519862

  17. Treatment for acute anterior cruciate ligament tear

    DEFF Research Database (Denmark)

    Frobell, Richard B; Roos, Harald P; Roos, Ewa M; Roemer, Frank W; Ranstam, Jonas; Lohmander, Stefan

    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...

  18. 49 CFR 178.818 - Tear test.

    Science.gov (United States)

    2010-10-01

    ... IBC design types. (b) Special preparation for the tear test. The flexible IBC must be filled to not...) Test method. Once the IBC is placed on the ground, a 100-mm (4-inch) knife score, completely penetrating the wall of a wide face, is made at a 45° angle to the principal axis of the IBC, halfway...

  19. Medical image of the week: aortic tear

    Directory of Open Access Journals (Sweden)

    Mosier JM

    2013-11-01

    Full Text Available A 56-year old man presented as a trauma victim with the chief complaint of severe back pain. He was hemodynamically acceptable on arrival, but arrested shortly after this portable film was obtained (Figure 1. Emergency Department (ED thoracotomy revealed a 3 cm longitudinal tear of the thoracic aorta and he exsanguinated in the ED.

  20. Medical image of the week: aortic tear

    OpenAIRE

    Mosier JM

    2013-01-01

    A 56-year old man presented as a trauma victim with the chief complaint of severe back pain. He was hemodynamically acceptable on arrival, but arrested shortly after this portable film was obtained (Figure 1). Emergency Department (ED) thoracotomy revealed a 3 cm longitudinal tear of the thoracic aorta and he exsanguinated in the ED.

  1. A Controlled Study on the Correlation between Tear Film Volume and Tear Film Stability in Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Iman M. Eissa

    2016-01-01

    Full Text Available Purpose. To assess the tear film quantity and correlate it with the quality and stability of the tear film in diabetics and compare them to age matched controls. Introduction. Diabetes affects tear film parameters in multiple ways. Poor metabolic control and neuropathy are postulated factors. To further understand how diabetes affects tear film parameters this study was conducted. Subjects and Methods. Tear meniscus height was measured by anterior segment OCT, along with tear thinning time, a subtype of noninvasive tear break-up time, and blinking rate per minute which were all recorded for 22 diabetic patients. Correlations between these tear film parameters were studied and then compared to 16 age matched controls. Results. A statistically significant difference was found in blinking rate between the diabetic and the control group (P=0.002, with higher blinking rate among diabetics. All tear film parameters were negatively correlated with duration of diabetes. A positive correlation was found between tear film volume and stability. Conclusion. Diabetes affects the tear film in various ways. Diabetics should be examined for dry eye signs even in absence of symptoms which may be masked by associated neuropathy. Duration of diabetes has an impact on tear film status.

  2. The Tear Osmolarity Changes After Cataract Surgery

    Directory of Open Access Journals (Sweden)

    Banu Öncel

    2012-01-01

    Full Text Available Pur po se: To determine the tear osmolarity changes in patients who had undergone phacoemulsification surgery. Ma te ri al and Met hod: Tear osmolarity measurements were performed in 30 eyes of 30 patients who had undergone cataract surgery without any complication. Measurements were performed before surgery and consecutively at 1st month, 3rd month, and 6th month after the surgery. TearLab osmometer (TearLab Corporation, San Diego, CA, USA device was used for the measurements and paired ttest was used for statistical analysis. Re sults: The mean age of the patients was 72.3±3.7 (67-78 years. Thirteen patients were men and 17 patients were women. The mean osmolarity values were 305.8±6.5 mOsm/L before the surgery and 312.3±6.4 mOsm/L at 1st month, 307.5±5.1 mOsm/L at 3rd month and 305.1±5.7 at 6th month after the surgery. The difference between the values before surgery and at 1st month was found statistically significant (p=0.001. Dis cus si on: The tear osmolarity increases at the first month after surgery but decreases to the levels measured before surgery at the 3rd month. The increase at the first month may be due to the corneal incisions and medication used after the surgery. We think that we have to take into account this similarity increase in all cataract patients, especially in those who also have dry eye disease. (Turk J Ophthalmol 2012; 42: 35-7

  3. The impact of combined meniscus tear on quality of life after anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Harhaji Vladimir V.

    2016-01-01

    Full Text Available Introduction. An anterior cruciate ligament injury represents a significant epidemiological problem worldwide, especially due to involving young, sporty and active working-age population. This study has been conducted in order to compare the quality of life of patients who had isolated anterior cruciate ligament tear and of those who suffered from an associated meniscal injury. Material and Methods. This study included 185 patients who had undergone reconstruction of the anterior cruciate ligament at the Department of Orthopedic Surgery and Traumatology in Novi Sad from January 1st, 2012 to December 31st, 2012. The patients were divided into 2 groups: group A consisted of patients who had anterior cruciate ligament reconstruction only, and group B consisted of patients who had partial meniscectomy in addition to the anterior cruciate ligament reconstruction. The follow-up period was 12 months. Results. Distribution of patients by gender was significantly in favor of men. In our study, 146 patients were male and 39 patients were female. The average age of patients was 26.1 years overall (16-55 years, being 26.9 years for men, and 23.3 years for female patients. Out of 185 patients, 110 had an isolated anterior cruciate ligament injury, while 75 suffered both meniscus, internal or external, and anterior cruciate ligament injury. Conclusion. The comparison of the quality of life of patients in both groups showed no statistically significant difference. Therefore, we were not able to prove the hypothesis about the superior quality of life of those patients who had suffered from a ruptured anterior cruciate ligament only.

  4. The effects of lasers and electrosurgical devices on human meniscal tissue.

    Science.gov (United States)

    Sherk, H H; Black, J D; Prodoehl, J A; Diven, J

    1995-01-01

    The purpose of this study was to evaluate the effects of various laser wavelengths on human meniscal tissue in vitro and to compare them with the effects of electrosurgical devices. The carbon dioxide (CO2) laser produced the best cutting and ablating effects among the infrared lasers, although the contact neodymium:yttrium-aluminum-garnet (Nd:YAG) and holmium:YAG (Ho:YAG)lasers were nearly as satisfactory, offering the additional advantage of fiberoptic capability and the ability to be used in saline. The free-beam Nd:YAG laser and coagulation mode electrosurgical device produced unacceptably severe thermal changes. The excimer laser at 308 nm produced the best tissue effect and caused no detectable adjacent thermal change in the tissue. PMID:7641430

  5. 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).

  6. 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)

  7. Treatment of the subject of tearing instability

    International Nuclear Information System (INIS)

    A simple approach is taken to the mechanics of potential instability associated with the steady tearing portion of J-Integral R-curves. The analysis is developed from simple examples of structural component (or test specimen) configurations with cracks, examining their instability possibilities individually, in order to draw more general conclusions about elastic-plastic cracking instability as contrasted to linear-elastic behavior. Finally, an attempt is made to model a more local cleavage-like instability for material in the fracture process zone just ahead of a crack tip. Results are then presented of a testing program which clearly demonstrates the appropriateness of the tearing instability analysis and which illustrates its broad potential for future application, as well as presenting guidelines for its further development. The material selected for analysis was Ni-Cr-Mo-V rotor steel

  8. The efficiency of tear substitute therapy at dysfunction tear basic secretion

    Directory of Open Access Journals (Sweden)

    G. S. Polunin

    2014-07-01

    Full Text Available Purpose: to evaluate the efficiency and tolerance of drops replacing tear with hyaluronic acid 0.15% (Hylabak, thea, France for the treatment of tear film diseases, in particular blepharoconjunctival form of dry eye syndrome.Methods: 32 patients (range 38 to 72 years with blepharoconjunctival form of dry eye syndrome were treated lubricant Hylabak 2-4 times a day during 7-30 days.Results: After treatment was detected the elimination of complaints in 30 of 32 people, increasing the stability of the tear film (increasing values of the samples Norn test from 7.3 ±0.5 to 10.1±0.6 seconds, as well as normalization of Schirmer test (from 8.8±0.4 to 15.2±0.5 mm.Conclusion: the study was showed high efficacy of lubricant Hylabak and subjective tolerability at blepharoconjunctival form of dry eye syndrome.

  9. One strategy for arthroscopic suture fixation of tibial intercondylar eminence fractures using the Meniscal Viper Repair System

    Directory of Open Access Journals (Sweden)

    Ochiai Satoshi

    2011-08-01

    Full Text Available Abstract Background Principles for the treatment of tibial intercondylar eminence fracture are early reduction and stable fixation. Numerous ways to treatment of this fracture have been invented. We designed a simple, low-invasive, and arthroscopic surgical strategy for tibial intercondylar eminence fracture utilizing the Meniscal Viper Repair System used for arthroscopic meniscal suture. Methods We studied 5 patients, who underwent arthroscopic suture fixation that we modified. The present technique utilized the Meniscal Viper Repair System for arthroscopic suture of the meniscus. With one handling, a high-strength ultra-high molecular weight polyethylene(UHMWPE suture can be passed through the anterior cruciate ligament (ACL and the loops for suture retrieval placed at both sides of ACL. Surgical results were evaluated by the presence or absence of bone union on plain radiographs, postoperative range of motion of the knee joint, the side-to-side differences measured by Telos SE, and Lysholm scores. Results The reduced position achieved after surgery was maintained and good function was obtained in all cases. The mean distance of tibia anterior displacement and assessment by Lysholm score showed good surgical results. Conclusion This method simplified the conventional arthroscopic suture fixation and increased its precision, and was applicable to Type II fractures that could be reduced, as well as surgically indicated Types III and IV. The present series suggested that our surgical approach was a useful surgical intervention for tibial intercondylar eminence fracture.

  10. Development of Job’s-tears ice cream recipe

    OpenAIRE

    Wiwat Wangcharoen

    2009-01-01

    Job’s tears ice cream recipe was developed by varying proportions of Job’s tears, sucrose, salt and coconut milk. Product positioning mapping was used to identify the sensory attributes that were drivers of preference, which appeared to be sweetness, smoothness, richness, and coconut milk and Job's-tears flavours of the product. Cluster analysis was used to differentiate consumers by their preference direction. Nutritional composition, antioxidant capacity and total phenolic content of th...

  11. Changes in the tear proteins of diabetic patients

    Directory of Open Access Journals (Sweden)

    Augustin A J

    2002-10-01

    Full Text Available Abstract Background Previous studies have shown a significant increase in tear protein peaks in the tears of diabetic patients suffering from dry eye. The aim of this study was to analyze the tear protein patterns from patients with diabetes mellitus who do not suffer from ocular surface diseases (DIA. Methods A total of 515 patients were examined in this study (255 healthy subjects (controls and 260 patients suffering from diabetes mellitus. Tear proteins were separated by sodium-dodecyl-sulfate polyacrylamide gel electrophoresis. After digital image analysis densitometric data files were created and subsequently used for multivariate statistical procedures. Results A significant increase in the number of peaks was detected in diabetic patients compared to controls (P Conclusions The tear protein patterns of diabetic patients are very different in the number and intensity of spots from those of healthy subjects. Furthermore, it could be demonstrated that the differences found in the tear patterns of diabetic patients are not equal to those found in previous studies in patients suffering from dry-eye disease. The alterations in the diabetic tears were correlated with the duration of the diabetic disease. With longer disease, history changes in the tear protein patterns increased. With the course of the disease some protein peaks appeared that are not present in healthy persons. Our study shows that the analysis of electrophoretic tear protein patterns is a new non-invasive approach in the early diagnosis and analysis of the pathogenesis of diabetes induced ocular surface disease.

  12. Analysis of Graves' ophthalmopathy patients' tear protein spectrum

    Institute of Scientific and Technical Information of China (English)

    JIANG Li-hong; WEI Rui-li

    2013-01-01

    Background Graves' ophthalmopathy/orbitopathy (GO) patients often suffer ocular surface damages and tear fluid proteins play a significant role in maintaining healthy ocular surfaces,while changes in tear protein components reflect the changes ocular surface abnormalities.In this study proteomics techniques were used to investigate tear protein compositions in GO patients.Methods We carried out a case-control study by comparing tear fluid contents of GO patients with that of healthy subjects.In the first step the tears were subjected to SDS-PAGE electrophoresis and then single protein bands were analyzed by to in-gel trypsin digestion and nano-flow liquid mass spectrometry (LC-MS/MS) using a MS software.Results In tear samples of GO subjects,the protein fractions of inflammation-related protein immunoglobulin kappa chain C region (IgKC) and serum albumin were essentially reduced,whereas a novel isoform of complement component 3 (C3),which we detected in control subjects,was completely absent in the GO patients' tears.Conclusions Reduced protein concentrations of particularly IgKC and complement C3 as well as albumin in the tears of GO patients may contribute to changes in their ocular surfaces via diminished reactive oxygen species (ROS) depletion and adaptive immune responses.The completely absent of C3 in the GO patients' tears,may imply that an important inflammatory signaling pathway is affected,which needs further investigation.

  13. Superior labrum anterior to posterior tears in throwing athletes.

    Science.gov (United States)

    Lintner, David M

    2013-01-01

    Superior labrum anterior to posterior (SLAP) tears and partial undersurface tears of the rotator cuff are common in experienced throwers, may be adaptive, and are only occasionally symptomatic. Pain in the shoulder of a throwing athlete with an MRI-documented SLAP tear or partial undersurface tear of the rotator cuff can be managed nonsurgically, with attention to posterior capsular contracture, scapular dyskinesia, and rotator cuff strength. The results of the surgical repair of SLAP lesions in the throwing athlete, with or without rotator cuff repair, are inferior to those of nonsurgical treatment. The cause of pain in the throwing athlete must be accurately diagnosed without reliance on MRI findings. PMID:23395053

  14. Stabilization of tearing mode by current drive

    Institute of Scientific and Technical Information of China (English)

    WANG Zhong-tian; SHI Man-li; MAO Guo-ping; ZHAO Shan-zhong; ZHENG Xiao-hu

    2004-01-01

    The major disruption limits the operation of present tokamaks. Experimental evidences point out that the growth of tearing modes or the magnetic islands is primarily responsible for the occurrence. Taking the non-inductive current drive effects into account, a set of 3D nonlinear equation is derived. It is shown from simulation that the growth of the magnetic island is suppressed effectively by RF current drive. It is consistent with recent experiments on the HL-1 tokamak in which the plasma is stabilized by an RF current drive.

  15. Nonlinear growth of strongly unstable tearing modes

    Energy Technology Data Exchange (ETDEWEB)

    Waelbroeck, F.L.

    1993-11-01

    Rutherford`s theory of the tearing instability is extended to cases where current nonlinearities are important, such as long wavelength modes in current slabs and the m = 1 instability in tokamaks with moderately large aspect-ratios. Of particular interest is the possibility that the associated magnetic islands, as a result of secondary instabilities, have a singular response to the Ohmic diffusion of the current. A family of islands is used to test this possibility; it is found that the response remains bounded.

  16. Long-Term MRI Findings in Operated Rotator Cuff Tear

    International Nuclear Information System (INIS)

    Purpose: To describe magnetic resonance imaging (MRI) findings at long-term follow-up after rotator cuff (RC) tear using standard MRI sequences without fat saturation. Material and Methods: Twenty-eight patients aged 55.8±7.6 underwent MRI examination 4.6±2.1 years after surgery for RC tear. Standard sequences in oblique coronal, oblique sagittal, and axial planes were obtained. The RC, including re-tears and tendon degeneration, was independently evaluated by two observers. Thickness of the supraspinatus tendon and narrowing of the subacromial space were measured. The clinical outcome was evaluated with the Constant score and compared with the MRI findings. Results: The RC tear was traumatic in 18 (64%) patients and degenerative in 10 (36%). At follow-up, 11 (39%) had normal RC tendons with good clinical outcome. Four (14%) patients had painful tendinosis without RC tear. A full-thickness RC tear was found in 7 (25%) patients and a partial tear in 6 (21%). In one patient with a full-thickness tear, and in two with partial tear, tendinosis was found in another of the RC tendons. The subacromial space was narrowed in 13 (46%) of the patients. A narrowing of the subacromial space correlated with re-tear (P<0.05). Conclusions: The RC may be evaluated with standard MRI sequences without fat saturation at long-term follow-up. A normal appearance of the RC is correlated with good clinical outcome, while re-tear and tendinosis are associated with pain

  17. IETI – Isogeometric Tearing and Interconnecting

    Science.gov (United States)

    Kleiss, Stefan K.; Pechstein, Clemens; Jüttler, Bert; Tomar, Satyendra

    2012-01-01

    Finite Element Tearing and Interconnecting (FETI) methods are a powerful approach to designing solvers for large-scale problems in computational mechanics. The numerical simulation problem is subdivided into a number of independent sub-problems, which are then coupled in appropriate ways. NURBS- (Non-Uniform Rational B-spline) based isogeometric analysis (IGA) applied to complex geometries requires to represent the computational domain as a collection of several NURBS geometries. Since there is a natural decomposition of the computational domain into several subdomains, NURBS-based IGA is particularly well suited for using FETI methods. This paper proposes the new IsogEometric Tearing and Interconnecting (IETI) method, which combines the advanced solver design of FETI with the exact geometry representation of IGA. We describe the IETI framework for two classes of simple model problems (Poisson and linearized elasticity) and discuss the coupling of the subdomains along interfaces (both for matching interfaces and for interfaces with T-joints, i.e. hanging nodes). Special attention is paid to the construction of a suitable preconditioner for the iterative linear solver used for the interface problem. We report several computational experiments to demonstrate the performance of the proposed IETI method. PMID:24511167

  18. Locking of Tearing Modes by the Error Field

    Institute of Scientific and Technical Information of China (English)

    XU Tao; HU Qi-Ming; HU Xi-Wei; YU Qing-Quan

    2011-01-01

    @@ The locking of tearing modes by the error field is studied by nonlinear numerical modeling.The threshold of mode locking for J-TEXT tokamak plasmas is found.%The locking of tearing modes by the error field is studied by nonlinear numerical modeling. The threshold of mode locking for J-TEXT tokamak plasmas is found.

  19. State Secret: North Carolina and the Cherokee Trail of Tears

    Science.gov (United States)

    Bryant, James

    2008-01-01

    This paper is an analytic essay that examines the treatment of the Cherokee Trail of Tears in a North Carolina fourth grade textbook. I begin by offering a satiric look at an imaginary textbook's treatment of the Holocaust that is based closely on the actual narrative of the Trail of Tears written in the fourth grade text. Following this, close…

  20. A study of re-tear cases after ARCR

    International Nuclear Information System (INIS)

    Recently, good clinical outcomes of arthroscopic rotator cuff repair (ARCR) are reported, but the re-tear rate of massive and large rotator cuff tears is still high. The purpose of this study is to review the clinical outcome and postoperative cuff integrity of ARCR in our hospital. We evaluated 80 shoulders (61 males, 19 females), whose age rauged from 30 to 78 (average: 61.8 years old). The size of tears were 8 small, 22 medium, 36 large, and 14 massive. We evaluated the pre-and postoperative Japanese Orthopedic Association (JOA) scored, and MRI findings 12 months postoperatively. We evaluated the cuff integrity and fatty degeneration of the ruptured cuff by Goutallier's classification. Postoperative MRI findings showed complete repair in 56 shoulders (70%) and re-tear in 24 shoulders (30%). Postoperative JOA score was poor in cases with large re-tears. Retear rates were high in large and massive tears, tears with advanced fatty degeneration, and subscapularis tears. As this operation is not a replacement procedure, the quality of the ruptured rotator cuff is important. Further discussion on the operative indication and method is necessary. (author)

  1. Gyrokinetic Simulation of Low-n Tearing Modes

    Science.gov (United States)

    Chen, Yang

    2015-11-01

    Direct gyrokinetic simulation of the low-n tearing mode in a tokamak plasma has been a great computational challenge, for two reasons. First, low-n tearing modes, unlike the micro-tearing modes, have very small growth rates and very fine mode structure in the tearing layer, which requires a large number of radial grid cells and fine control of numerical dissipation. Second, kinetic electron effects are needed in the tearing layer. Here, we first present linear gyrokinetic simulation of the low-n tearing mode in cylindrical geometry. Ions are gyrokinetic and electrons are either drift kinetic or fluid. New field solvers have been developed in the gyrokinetic code GEM [Chen and Parker, J. Comput. Phys. 220, 839 (2007)] to simulate low-n modes. For the fluid electron model, an eigenmode analysis with finite Larmor radius effects has been developed to study the linear resistive tearing mode. Excellent agreement between eigenmode analysis and initial value gyrokinetic simulation is obtained. The mode growth rate is shown to scale with resistivity as η 1 / 3, the same as the semi-collisional regime in previous kinetic treatments. Simulation of the collisionless and semi-collisional tearing mode with drift kinetic electrons has been carried out with GEM's direct split-weight control-variate algorithm. It is found that a full torus simulation of the m=2, n=1 tearing mode in a present day large tokamak is still difficult with kinetic electrons, but a generalized matching technique can be used to ameliorate the problem. The radial dimension is divided into an external region and the tearing region, with the external region described by a reduced model that gives the boundary condition for the tearing region. The size of the tearing region is small compared with the minor radius, but not arbitrarily small as done in the standard asymptotic matching approach. Gyrokinetic simulation verifies the collisionless tearing mode growth rate with finite electron mass, the semi

  2. Biomechanical Evaluation of Knee Kinematics after ACL Reconstructions in Anatomic SB and DB - Technique with Additional Medial Meniscus Suture

    Science.gov (United States)

    Lorbach, Olaf; Herbort, Mirco; Engelhardt, Martin; Kieb, Matthias

    2013-01-01

    Objectives: Biomechanical evaluation of knee laxity after single- and double-bundle ACL reconstruction with additional medial meniscus suture. Methods: Kinematics of the intact knee were determined in 12 human cadaver specimens in response to a 134-N anterior tibial load (aTT) and a combined rotatory load of 10 Nm valgus and 4 Nm internal tibial rotation using a robotic/universal force moment sensor testing system. Subsequently, the ACL was resected following the creation of a bucket-handle tear of the medial meniscus. A standard repair of the medial meniscus was performed using 3 inside-out horizontal sutures. Finally, The ACL was reconstructed using an anatomic single-bundle (6) or double-bundle technique (6). Knee kinematics were determined following every sub-step. Results: Significant increase of aTT in the ACL-deficient knee was found with significant increase in the ACL-deficient knee with additional medial meniscal injury (p=.003; p=.009). ACL reconstructions significantly decreased aTT compared to the ACL-deficient knee. No significant differences were found between the intact knee and the ACL reconstructed knee with additional meniscal repair. In response to a simulated pivot shift, aTT in the intact knee significantly increased in the ACL-deficient knee as well as in the meniscus injured/meniscus-sutured knee (p=.003;p=.007). No significant differences were found between the ACL-deficient and ACL reconstructed knee with additional meniscal repair. SB as well as DB ACL reconstruction with additional medial meniscal repair restored knee kinematics compared to the intact knee. Comparison of SB versus DB ACL reconstruction did not reveal any significant differences neither in a simulated Lachman test nor in response to a simulated pivot shift (p=.05). Conclusion: aTT as well as aTT in response to a combined rotatory load significantly increased with ACL deficiency compared to the intact knee, additional medial meniscal injury further increased aTT. Anatomic

  3. Retardation of tearing instability by operating structural damping

    International Nuclear Information System (INIS)

    The load-displacement curve of a set of disc springs shows a hysteresis due to structural damping. A method has been proposed to retard tearing instability of structures such as piping systems, by using the disc spring as a supporting member for the structures. The condition has been described theoretically for tearing instability under structural damping. The slope of the curve in unloading has been shown to be a key parameter for the tearing instability. Tensile testings of cracked specimens loaded in series with the spring have shown a tearing instability depending on the structural damping and have verified the condition. It has been proved that the retardation of tearing instability is possible with the use of the disc spring with structural damping. (author)

  4. Eponym of Naso-Jugal Fold and Tear Trough.

    Science.gov (United States)

    Hwang, Kun

    2016-07-01

    The aim of this study is to find out the eponym of the naso-jugal fold and tear trough and to make a suggestion to standardize the terminology.In a PubMed search, the search terms (naso-jugal) and (fold OR groove); (tear trough) and (anatomy) were used, which resulted in 48 and 37 titles, respectively. Eliminating duplicated titles, 80 abstracts were reviewed. Among them, 18 full papers were reviewed. Two papers were excluded and 3 mined papers were added. Finally, 19 papers were reviewed.In a paper published by an ophthalmologist Dr David Miller, "tear trough" was first used for designating the circular trough carved into a scleral contact in 1969. In the remaining 18 papers including 1 conference presentation, 6 terms were used for the same structure; naso-jugal fold (4), naso-jugal groove (4), naso-jugal ditch (1), tear trough (5), tear trough deformity (6), and tear trough depression (1). Whitnall first used "naso-jugal" and 10 other papers stated "naso-jugal." Eight papers cited Whitnall (2), Duke-Elder (2), and Loeb (4) in the origin of the term "naso-jugal." Flowers adapted "tear trough" for the cheek groove and 12 other papers wrote "tear trough." Eleven papers cited Flowers (9), Le Louarn (1), Mendelson (1) when referring to the origin of the term "tear trough."The name of the structure should contain "naso-jugal" rather than "tear trough" because "naso-jugal" was coined earlier and expresses the location of the structure. The recommended term should be "the deepened naso-jugal groove" since it deepens with age. PMID:27315310

  5. Tear glucose analysis for the noninvasive detection and monitoring of diabetes mellitus.

    Science.gov (United States)

    Baca, Justin T; Finegold, David N; Asher, Sanford A

    2007-10-01

    One approach to the noninvasive monitoring of blood glucose concentration is to monitor glucose concentrations in tear fluid. While several methods for sensing glucose in tear fluid have been proposed, controversy remains as to the precise concentrations of tear glucose in normal and diabetic subjects and as to whether tear fluid glucose concentrations correlate with blood glucose concentrations. This review covers the present understanding of the physiology of glucose transport in tears, the regulation of the aqueous tear fraction, and studies of tear glucose concentration over the last 80 years. The various tear collection methods employed greatly influence the measured tear glucose concentrations. Studies that involve mechanical irritation of the conjunctiva during sampling measure the highest tear glucose concentrations, while studies that avoid tear stimulation measure the lowest concentrations. Attempts to monitor tear glucose concentration in situ by using contact lens-based sensing devices are discussed, and new observations are presented of tear glucose concentration obtained by a method designed to avoid tear stimulation. These studies indicate the importance of the sampling method in determining tear glucose concentrations. On the basis of these results, we discuss the future of in vivo tear glucose sensing and outline the studies needed to resolve the remaining questions about the relationship between tear and blood glucose concentrations. PMID:17938838

  6. Idiopathic horseshoe-like macular tear: a case report

    Directory of Open Access Journals (Sweden)

    Kubota M

    2016-07-01

    Full Text Available Masaomi Kubota,1 Tomohiro Shibata,1 Hisato Gunji,1 Hiroshi Tsuneoka2 1Department of Ophthalmology, The Jikei University School of Medicine Kashiwa Hospital, Chiba, 2Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan Background: Although a few cases with idiopathic horseshoe-like macular tear have been reported, the mechanism remains unknown and a standard treatment has yet to be determined. Objective: To report the outcome for a patient with idiopathic horseshoe-like macular tear who underwent vitreous surgery. Case report: A 65-year-old man with no previous injury or ophthalmic disease presented with abnormal vision in his left eye. Best-corrected visual acuity was 0.8 in the right and 0.3 in the left, and the relative afferent pupillary defect was negative. Ophthalmoscopy revealed a horseshoe-like tear on the temporal side of the macula in the left eye. The tear size was 0.75 disc diameters (DD. Optical coherence tomography showed that the focal retinal detachment reached the fovea. A few days after the first visit, there was no longer adhesion of the flap of the tear to the retina and the tear size had increased to 1.5 DD. The patient underwent vitreous surgery similar to large macular hole surgery, with the tear closure repaired using the inverted internal limiting membrane flap technique with 20% SF6 gas tamponade. Although the tear decreased to 0.5 DD after the surgery, complete closure of the tear was not achieved. Conclusion: While cases with horseshoe-like macular tear following trauma and branch retinal vein occlusion have been reported, to the best of our knowledge, this is the first reported idiopathic case. In the present case, there was expansion of the tear until the patient actually underwent surgery. If vertical vitreous traction indeed plays a role in horseshoe-like macular tears, this will need to be taken into consideration at the time of the vitreous surgery in these types of cases. Keywords

  7. Effects of tear gases on the eye.

    Science.gov (United States)

    Kim, Yonwook J; Payal, Abhishek R; Daly, Mary K

    2016-01-01

    Chemical agents that target the eyes have been a popular choice for law enforcement during riots and for military training for nearly a century. The most commonly used agents are chloroacetophenone (formerly sold as Mace), o-chlorobenzylidene malononitrile, and oleoresin capsicum (OC or pepper spray, current ingredient for Mace). Initially, most severe ocular injuries were caused by the explosive force rather than the chemical itself. The development of sprays reduced the mechanical severity of ocular injuries, but resulted in a variety of chemical injuries. The effects on eyes include conjunctival injection, complete corneal epithelial defects, pseudopterygium, corneal neovascularization, persistent conjunctivalization, corneal opacities, and reduced visual acuity. Current management, based on limited human studies, emphasizes decontamination and symptomatic treatment. We review the literature related to clinical and histopathologic effects of tear gas agents on the eye and their management. PMID:26808721

  8. Observation of Spontaneous Neoclassical Tearing Modes

    International Nuclear Information System (INIS)

    We present data in this paper from the Tokamak Fusion Test Reactor (TFTR) which challenges the commonly held belief that extrinsic MHD events such as sawteeth or ELMs [edge localized modes] are required to provide the seed islands that trigger Neoclassical Tearing Modes (NTMs). While sawteeth are reported to provide the trigger for most of the NTMs on DIII-D [at General Atomics in San Diego, California] and ASDEX-U [at Max-Planck-Institut fuer Plasmaphysik in Garching, Germany], the majority of NTMs seen in TFTR occur in plasmas without sawteeth, that is which are above the beta threshold for sawtooth stabilization. Examples of NTMs appearing in the absence of any detectable extrinsic MHD activity will be shown. Conversely, large n=1 modes in plasmas above the NTM beta threshold generally do not trigger NTMs. An alternative mechanism for generating seed islands will be discussed

  9. A new tear pattern of the rotator cuff and its treatment: Fosbury flop tears

    Directory of Open Access Journals (Sweden)

    Alexandre Lädermann

    2015-01-01

    Full Text Available Purpose: The purpose of this report is to describe a new full-thickness tear pattern of the posterosuperior rotator cuff with reversal healing. We describe the specific radiologic signs associated with this tear pattern and the arthroscopic rotator cuff repair technique. Materials and Methods: A prospective radiologic and clinical study collected all patients with a magnetic resonance imaging arthrogram that underwent an arthroscopic rotator cuff repair over a 1 year period. Results: Among 97 patients, five demonstrated a tear of the posterosuperior rotator cuff with reversal healing. Characteristic radiographic findings included a thicker tendon than normal, the presence of a stump and accumulation of liquid in the superior-medial part of the subacromial bursa, and adhesions between the supraspinatus tendon and the wall of the subacromial bursa. Conclusion: Avulsion of the posterosuperior rotator cuff with reversal healing on its bursal-side is a less common condition. This type of lesion and distinct radiographic signs that can be recognized to facilitate anatomic repair of the rotator cuff. Level of evidence: Level IV.

  10. Tear Mediators in Corneal Ectatic Disorders

    Science.gov (United States)

    Pásztor, Dorottya; Kolozsvári, Bence Lajos; Csutak, Adrienne; Berta, András; Hassan, Ziad; Ujhelyi, Bernadett; Gogolák, Péter; Fodor, Mariann

    2016-01-01

    Purpose To compare the concentrations of 11 tear mediators in order to reveal the biochemical difference between pellucid marginal degeneration (PMD) and keratoconus (KC). Methods We have designed a cross-sectional study in which patients with corneal ectasia based on slit-lamp biomicroscopy and Pentacam HR (keratometry values (K1, K2, Kmax), astigmatism, minimal radius of curvature (Rmin), corneal thickness (Apex and Min), indices (surface variation, vertical asymmetry, keratoconus, central keratoconus, height asymmetry and decentration)) were enrolled. Eyes of keratoconic patients were similar to the PMD patients in age and severity (K2, Kmax and Rmin). Non-stimulated tear samples were collected from nine eyes of seven PMD patients, 55 eyes of 55 KC patients and 24 eyes of 24 healthy controls. The mediators’ (interleukin -6, -10, chemokine ligand 5, -8, -10, matrix metalloproteinase (MMP) -9, -13, tissue inhibitor of metalloproteinases (TIMP)-1, tissue plasminogen activator, plasminogen activator inhibitor, nerve growth factor) concentrations were measured using Cytometric Bead Array. Results MMP-9 was the only mediator which presented relevant variances between the two patient groups (p = 0.005). The ratios of MMP-9 and TIMP-1 were 2.45, 0.40 and 0.23 in PMD, KC and the controls, respectively. Conclusion As far as we are aware, this is the first study that aims to reveal the biochemical differences between PMD and KC. Further studies of biomarkers to investigate the precise role of these mediators need to be defined, and it is important to confirm the observed changes in a larger study to gain further insights into the molecular alterations in PMD. PMID:27074131

  11. Correlation between Rotator Cuff Tears and Systemic Atherosclerotic Disease

    International Nuclear Information System (INIS)

    The purpose of this study was to investigate the association of aortic arch calcification, a surrogate marker of atherosclerosis, with rotator cuff tendinosis and tears given the hypothesis that decreased tendon vascularity is a contributing factor in the etiology of tendon degeneration. A retrospective review was performed to identify patients ages 50 to 90 years who had a shoulder MRI and a chest radiograph performed within 6 months of each other. Chest radiographs and shoulder MRIs from 120 patients were reviewed by two sets of observers blinded to the others' conclusions. Rotator cuff disease was classified as tendinosis, partial thickness tear, and full thickness tear. The presence or absence of aortic arch calcification was graded and compared with the MRI appearance of the rotator cuff. The tendon tear grading was positively correlated with patient age. However, the tendon tear grading on MRI was not significantly correlated with the aorta calcification scores on chest radiographs. Furthermore, there was no significant correlation between aorta calcification severity and tendon tear grading. In conclusion, rotator cuff tears did not significantly correlate with aortic calcification severity. This suggests that tendon ischemia may not be associated with the degree of macrovascular disease

  12. Relationships between rotator cuff tear types and radiographic abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Soo Hyun; Chun, Kyung Ah; Lee Soo Jung; Kang, Min Ho; Yi, Kyung Sik; Zhang, Ying [Dept. of Diagnostic Radiology, College of Medicine, Chungbuk National University, Cheongju (Korea, Republic of)

    2014-11-15

    To determine relationships between different types of rotator cuff tears and radiographic abnormalities. The shoulder radiographs of 104 patients with an arthroscopically proven rotator cuff tear were compared with similar radiographs of 54 age-matched controls with intact cuffs. Two radiologists independently interpreted all radiographs for; cortical thickening with subcortical sclerosis, subcortical cysts, osteophytes in the humeral greater tuberosity, humeral migration, degenerations of the acromioclavicular and glenohumeral joints, and subacromial spurs. Statistical analysis was performed to determine relationships between each type of rotator cuff tears and radiographic abnormalities. Inter-observer agreements with respect to radiographic findings were analyzed. Humeral migration and degenerative change of the greater tuberosity, including sclerosis, subcortical cysts, and osteophytes, were more associated with full-thickness tears (p < 0.01). Subacromial spurs were more common for full-thickness and bursal-sided tears (p < 0.01). No association was found between degeneration of the acromioclavicular or glenohumeral joint and the presence of a cuff tear. Different types of rotator cuff tears are associated with different radiographic abnormalities.

  13. Evaluation of Tear Function Tests and Lower Tear Meniscus Height in Keratoconus Patients

    Directory of Open Access Journals (Sweden)

    Özge Saraç

    2012-07-01

    Full Text Available Pur po se: To assess the tear function tests and the lower tear meniscus height (LTMH in keratoconus patients and to evaluate the relationship of these parameters with the progression of keratoconus. Ma te ri al and Met hod: Thirty-eight eyes (group 1 of 21 keratoconus patients and 36 eyes (group 2 of 18 healthy subjects were included in this prospective study. Both groups underwent corneal topographic and keratometric measurements, tear break-up time (T-BUT and Schirmer tests as well as measurement of the LTMH with anterior segment optic coherence tomography (OCT after the ophthalmologic examination. The values obtained from both groups were compared and evaluated for statistical significance and reliability. Re sults: There was no statistically significant difference between the two groups in terms of age and gender (p>0.05. The mean Schirmer test values were 14.87±8.9 mm and 16.77±8.1 mm in group 1 and group 2, respectively (p=0.367. There was not any correlation between the keratometric power and the Schirmer test in group 1 and group 2 (group 1: r=0.114, p=0.548, group 2: r=0.151, p=0.972. The mean TBUT value was 12.83±7.3 sec in group 1, and 18.25±8.5 sec in group 2 (p=0.018. There was a negative correlation between keratometric power and TBUT in group 1, while there was no correlation in group 2 (group 1: r=0.717, p=0.001, group 2: r=0.235, p=0.212. The mean LTMH was 265.30±112 µm in group 1 and 313.29±167 µm in group 2 (p=0.151. There was no correlation between keratometric power and LTMH in both groups (group 1: r=0.001, p=0.997, group 2: r=0.318, p=0.130. Dis cus si on: In this study, it was shown that keratoconus patients have normal tear volume but reduced tear film stability compared to healthy individuals and this reduction is relate to the progression of keratoconus. (Turk J Ophthalmol 2012; 42: 249-52

  14. Development of Job’s-tears ice cream recipe

    Directory of Open Access Journals (Sweden)

    Wiwat Wangcharoen

    2009-10-01

    Full Text Available Job’s tears ice cream recipe was developed by varying proportions of Job’s tears, sucrose, salt and coconut milk. Product positioning mapping was used to identify the sensory attributes that were drivers of preference, which appeared to be sweetness, smoothness, richness, and coconut milk and Job's-tears flavours of the product. Cluster analysis was used to differentiate consumers by their preference direction. Nutritional composition, antioxidant capacity and total phenolic content of the final product were also determined.

  15. Threshold condition for nonlinear tearing modes in tokamaks

    International Nuclear Information System (INIS)

    Low-mode-number tearing, mode nonlinear evolution is analyzed emphasizing the need for a threshold condition, to account for observations in tokamaks. The discussion is illustrated by two models recently introduced in the literature. The models can be compared with the available data and/or serve as a basis for planning some experiments in order to either test theory (by means of beta-limit scaling laws, as proposed in this paper) or attempt to control undesirable tearing modes. Introducing a threshold condition in the tearing mode stability analysis is found to reveal some bifurcation points and thus domains of intrinsic stability in the island dynamics operational space

  16. Dynamic interfacial properties of human tear-lipid films and their interactions with model-tear proteins in vitro.

    Science.gov (United States)

    Svitova, Tatyana F; Lin, Meng C

    2016-07-01

    This review summarizes the current state of knowledge regarding interfacial properties of very complex biological colloids, specifically, human meibum and tear lipids, and their interactions with proteins similar to the proteins found in aqueous part of human tears. Tear lipids spread as thin films over the surface of tear-film aqueous and play crucial roles in tear-film stability and overall ocular-surface health. The vast majority of papers published to date report interfacial properties of meibum-lipid monolayers spread on various aqueous sub-phases, often containing model proteins, in Langmuir trough. However, it is well established that natural human ocular tear lipids exist as multilayered films with a thickness between 30 and 100nm, that is very much disparate from 1 to 2nm thick meibum monolayers. We employed sessile-bubble tensiometry to study the dynamic interfacial and rheological properties of reconstituted multilayered human tear-lipid films. Small amounts (0.5-1μg) of human tear lipids were deposited on an air-bubble surface to produce tear-lipid films in thickness range 30-100nm corresponding to ocular lipid films. Thus, we were able to overcome major Langmuir-trough method limitations because ocular tear lipids can be safely harvested only in minute, sub-milligram quantities, insufficient for Langmuir through studies. Sessile-bubble method is demonstrated to be a versatile tool for assessing conventional synthetic surfactants adsorption/desorption dynamics at an air-aqueous solution interface. (Svitova T., Weatherbee M., Radke C.J. Dynamics of surfactant sorption at the air/water interface: continuous-flow tensiometry. J. Colloid Interf. Sci. 2003;261:1170-179). The augmented flow-sessile-bubble setup, with step-strain relaxation module for dynamic interfacial rheological properties and high-precision syringe pump to generate larger and slow interfacial area expansions-contractions, was developed and employed in our studies. We established that

  17. The effect of hip joint muscle exercise on muscle strength and balance in the knee joint after meniscal injury

    Science.gov (United States)

    Park, Sun Ja; Kim, Young Mi; Kim, Ha Roo

    2016-01-01

    [Purpose] This study aimed to evaluate the effect of hip muscle strengthening on muscle strength and balance in the knee joint after a meniscal injury. [Subjects and Methods] This randomized control study enrolled 24 patients who had undergone arthroscopic treatment after a meniscal injury and began a rehabilitative exercise program 8 weeks after surgery. Subjects were divided into 2 groups of 12 subjects each: gluteus medius resistance exercise group and control group. This study investigated muscle strength and balance in the knee joint flexor, extensor, and abductor during an 8-week period. [Results] Measurements of knee extensor muscle strength revealed no significant difference between the control group and the experimental group. Measurements of abductor muscle strength, however, identified a significant difference between the 2 groups. The groups did not differ significantly with regard to balance measurements. [Conclusion] The results of this study suggest that this subject should be approached in light of the correlation between the hip abductor and injury to the lower extremities.

  18. Diagnoses of meniscal and cruciate ligament injuries using magnetic resonance imaging of the knee. Comparison with the findings of arthroscopy

    International Nuclear Information System (INIS)

    As previously reported, MRI is found to be useful in the evaluation of meniscal and cruciate ligament injuries. But at our institute, however, due to frequent in consistencies between MRI and arthroscopic findings, we investigated problem knees by MRI and compared the findings with those using arthroscopy subsequently performed. Twenty-eight cases with medial and lateral meniscus, and 31 cases with anterior and posterior crucial ligament were examined. The field strength of MRI was 1.0 Tesla, and images were measured by the T2 weighted gradient echo method. Sensitivity for medial meniscus, lateral meniscus, anterior cruciate ligament, and posterior cruciate ligament was 60, 38, 33, and 20 percent respectively, specificity was 78, 90, 91, and 89 percent respectively, and accuracy was 75, 75, 74, and 77 percent respectively. These values are lower compared with other reports. Diagnoses of meniscal and cruciate ligament injuries from magnetic resonance imaging of the knee at our institute are not confidential. For improvement, the scanning and imaging methods, must be changed and a new sophisticated MRI scanner is desirable. (author)

  19. The Effect of Polar Lipids on Tear Film Dynamics

    KAUST Repository

    Aydemir, E.

    2010-06-17

    In this paper, we present a mathematical model describing the effect of polar lipids, excreted by glands in the eyelid and present on the surface of the tear film, on the evolution of a pre-corneal tear film. We aim to explain the interesting experimentally observed phenomenon that the tear film continues to move upward even after the upper eyelid has become stationary. The polar lipid is an insoluble surface species that locally alters the surface tension of the tear film. In the lubrication limit, the model reduces to two coupled non-linear partial differential equations for the film thickness and the concentration of lipid. We solve the system numerically and observe that increasing the concentration of the lipid increases the flow of liquid up the eye. We further exploit the size of the parameters in the problem to explain the initial evolution of the system. © 2010 Society for Mathematical Biology.

  20. Progression from calcifying tendinitis to rotator cuff tear

    International Nuclear Information System (INIS)

    This report documents the clinical, radiographic and histologic findings in a 46-year-old man with calcifying tendinitis in his left shoulder which progressed to rotator cuff tear. The patient had a 1-year history of repeated calcifying tendinitis before being referred to our hospital. On the initial visit, radiographs and magnetic resonance imaging (MRI) revealed calcium deposition localized in the supraspinatus tendon without apparent tear. Three months after the first visit, MRI revealed a partial-thickness rotator cuff tear at the site of calcium deposition. Surgical and histologic findings demonstrated that calcium deposition was the cause of cuff rupture. To our knowledge, based on a review of the English literature, this is the first case report in which the progression from calcifying tendinitis to rotator cuff tear has been serially observed. (orig.)

  1. Progression from calcifying tendinitis to rotator cuff tear

    Energy Technology Data Exchange (ETDEWEB)

    Gotoh, Masafumi; Higuchi, Fujio; Suzuki, Ritsu; Yamanaka, Kensuke [Department of Orthopaedic Surgery, Medical Center of Kurume University, 155-1 Kokubu-machi, Kurume City, Fukuoka 839-0862 (Japan)

    2003-02-01

    This report documents the clinical, radiographic and histologic findings in a 46-year-old man with calcifying tendinitis in his left shoulder which progressed to rotator cuff tear. The patient had a 1-year history of repeated calcifying tendinitis before being referred to our hospital. On the initial visit, radiographs and magnetic resonance imaging (MRI) revealed calcium deposition localized in the supraspinatus tendon without apparent tear. Three months after the first visit, MRI revealed a partial-thickness rotator cuff tear at the site of calcium deposition. Surgical and histologic findings demonstrated that calcium deposition was the cause of cuff rupture. To our knowledge, based on a review of the English literature, this is the first case report in which the progression from calcifying tendinitis to rotator cuff tear has been serially observed. (orig.)

  2. Rotator Cuff Tendinitis and Tear (Beyond the Basics)

    Science.gov (United States)

    ... of Use ©2016 UpToDate, Inc. Patient education: Rotator cuff tendinitis and tear (Beyond the Basics) Authors Stephen ... This topic last updated: Jun 16, 2016. ROTATOR CUFF INJURY OVERVIEW — Tendons are tough bands of tissue ...

  3. Tears of wine: new insights on an old phenomenon

    Science.gov (United States)

    Venerus, David C.; Nieto Simavilla, David

    2015-11-01

    Anyone who has enjoyed a glass of wine has undoubtedly noticed the regular pattern of liquid beads that fall along the inside of the glass, or ‘tears of wine.’ The phenomenon is the result of a flow against gravity along the liquid film on the glass, which is induced by an interfacial tension gradient. It is generally accepted that the interfacial tension gradient is due to a composition gradient resulting from the evaporation of ethanol. We re-examine the tears of wine phenomenon and investigate the importance of thermal effects, which previously have been ignored. Using a novel experiment and simple model we find that evaporative cooling contributes significantly to the flow responsible for wine tears, and that this phenomenon occurs primarily because of the thermodynamic behavior of ethanol-water mixtures. Also, the regular pattern of tear formation is identified as a well-known hydrodynamic instability.

  4. Endoscopic Treatment of Gluteus Medius Tears: A Review.

    Science.gov (United States)

    Lerebours, Frantz R; Cohn, Randy; Youm, Thomas

    2016-03-01

    Greater trochanteric pain syndrome (GTPS) is a term used to describe disorders of the peritrochanteric region. This constellation of conditions includes greater trochanteric bursitis, gluteus medius (GM) tears, and external coxa saltans or snapping hip syndrome. Tears of the abductor mechanism, more specifically gluteus medius tears, have recently gained a considerable amount of interest in the orthopaedic literature. Abductor tears were first described by Bunker and Kagan in the late 1990s. They used the rotator cuff as an analogous structure to describe the pathological process associated with gluteus medius tears. Tears of the gluteus medius tendon can often be difficult to recognize. The clinical presentation is often attributed to trochanteric bursal inflammation, without any further workup. Provocative hip physical examination findings are an important key to proper diagnosis of abductor injuries. Depending on the size of the tear, patients with abductor tendon pathology may present with a Trendelenburg gait and reduced resisted abduction strength accompanied by pain. Initial noninvasive management of greater trochanteric pain syndrome includes oral or topical anti-inflammatory medication and activity modification. Physical therapy or other treatment modalities can be considered, with a focus on core strengthening, truncal alignment, and iliotibial band stretching. Gluteus medius tears have historically been repaired in an open fashion; however, the advent of new endoscopic surgery techniques has allowed for a less invasive approach. Access to the peritrochanteric space affords the surgeon with access to pathology associated with the greater trochanter, iliotibial band, trochanteric bursa, sciatic nerve, short external-rota tors, iliopsoas tendon, and the gluteus medius and minimus tendon attachments. Over the last decade, we have seen rapid technological advances in hip arthroscopy, improved diagnostic imaging and interpretation, and an improved

  5. Saturated tearing modes in tokamaks. Renewal proposal, progress report

    International Nuclear Information System (INIS)

    We have completed a computer code (GTOR) implementing our quasilinear method for determining saturated tearing mode magnetic island widths in axisymmetric toroidal plasmas. With this code we have surveyed the effect of current profile, aspect ratio and plasma elongation on saturated tearing modes. Current peaking within the islands is found to have a particularly large effect. In support of this research, we have developed a direct method for computing Hamada coordinates from harmonics of the inverse Grad-Shafranov equation

  6. Threshold condition for nonlinear tearing modes in tokamaks

    International Nuclear Information System (INIS)

    Low-mode-number tearing mode nonlinear evolution is analyzed emphasizing the need for a threshold condition, to account for observations in tokamaks. The discussion is illustrated by two models recently introduced in the literature. Introducing a threshold condition in the tearing mode stability analysis is found to reveal some bifurcation points and thus domains of intrinsic stability in the island dynamics operational space. (author)

  7. Efecto de la sutura y adición de células troncales mesenquimales adultas en la regeneración meniscal. Estudio de la expresión de factores de crecimiento en conejos

    OpenAIRE

    Comellas Melero, Nerea

    2012-01-01

    Conservar la mayor parte posible de tejido meniscal funcional en la cirugía de las lesiones meniscales es una regla esencial de este tipo de intervenciones sobre todo cuando se trata de pacientes jóvenes. La resección meniscal tiene efectos deletéreos evidentes en la función a largo plazo de la rodilla; 10 4, 341 . Pese a esto, las técnicas actuales de sutura meniscal tienen limitaciones relacionadas con las características mecánicas y bioquímicas del menisco; de manera que las lesiones que s...

  8. Tearing Mode Stability of Evolving Toroidal Equilibria

    Science.gov (United States)

    Pletzer, A.; McCune, D.; Manickam, J.; Jardin, S. C.

    2000-10-01

    There are a number of toroidal equilibrium (such as JSOLVER, ESC, EFIT, and VMEC) and transport codes (such as TRANSP, BALDUR, and TSC) in our community that utilize differing equilibrium representations. There are also many heating and current drive (LSC and TORRAY), and stability (PEST1-3, GATO, NOVA, MARS, DCON, M3D) codes that require this equilibrium information. In an effort to provide seamless compatibility between the codes that produce and need these equilibria, we have developed two Fortran 90 modules, MEQ and XPLASMA, that serve as common interfaces between these two classes of codes. XPLASMA provides a common equilibrium representation for the heating and current drive applications while MEQ provides common equilibrium and associated metric information needed by MHD stability codes. We illustrate the utility of this approach by presenting results of PEST-3 tearing stability calculations of an NSTX discharge performed on profiles provided by the TRANSP code. Using the MEQ module, the TRANSP equilibrium data are stored in a Fortran 90 derived type and passed to PEST3 as a subroutine argument. All calculations are performed on the fly, as the profiles evolve.

  9. Oxygen tension is a determinant of the matrix-forming phenotype of cultured human meniscal fibrochondrocytes.

    Directory of Open Access Journals (Sweden)

    Adetola B Adesida

    Full Text Available BACKGROUND: Meniscal cartilage displays a poor repair capacity, especially when injury is located in the avascular region of the tissue. Cell-based tissue engineering strategies to generate functional meniscus substitutes is a promising approach to treat meniscus injuries. Meniscus fibrochondrocytes (MFC can be used in this approach. However, MFC are unable to retain their phenotype when expanded in culture. In this study, we explored the effect of oxygen tension on MFC expansion and on their matrix-forming phenotype. METHODOLOGY/PRINCIPAL FINDINGS: MFC were isolated from human menisci followed by basic fibroblast growth factor (FGF-2 mediated cell expansion in monolayer culture under normoxia (21%O(2 or hypoxia (3%O(2. Normoxia and hypoxia expanded MFC were seeded on to a collagen scaffold. The MFC seeded scaffolds (constructs were cultured in a serum free chondrogenic medium for 3 weeks under normoxia and hypoxia. Constructs containing normoxia-expanded MFC were subsequently cultured under normoxia while those formed from hypoxia-expanded MFC were subsequently cultured under hypoxia. After 3 weeks of in vitro culture, the constructs were assessed biochemically, histologically and for gene expression via real-time reverse transcription-PCR assays. The results showed that constructs under normoxia produced a matrix with enhanced mRNA ratio (3.5-fold higher; p<0.001 of collagen type II to I. This was confirmed by enhanced deposition of collagen II using immuno-histochemistry. Furthermore, the constructs under hypoxia produced a matrix with higher mRNA ratio of aggrecan to versican (3.5-fold, p<0.05. However, both constructs had the same capacity to produce a glycosaminoglycan (GAG -specific extracellular matrix. CONCLUSIONS: Our data provide evidence that oxygen tension is a key player in determining the matrix phenotype of cultured MFC. These findings suggest that the use of normal and low oxygen tension during MFC expansion and subsequent neo

  10. Comparative study of lubricating properties of tear substitutes Systane® Ultra and Visine® Clear Tears

    Directory of Open Access Journals (Sweden)

    Yu. A. Pavlova

    2014-07-01

    Full Text Available Purpose: To compare tear substitutive properties of Systane® Ultra and Visine® Clear Tears in dry eye therapy.Methods: 20 patients with dry eye due to chronic blepharoconjunctivitis and 20 patients with neurotrophic dry eye following corneal refractive surgery were examined. Treatment schedule was the following: in the first 7 days, Systane® Ultra was instilled in the right eye and Visine® Clear Tears was instilled in the left eye, while from day 8 to day 30, only one medicine selected by the patient was applied. Their efficacy was measured by tear film stability and patients’ subjective sensations.Results: Norn test results improved to day 7 in patients with dry eye following corneal refractive surgery and to day 30 in patients with dry eye due to blepharoconjunctivitis regardless of eye drops used. As to patients’ comfort, Systane® Ultra is preferable to Visine® Clear Tears.Conclusion: Systane® Ultra is therapeutically similar to but preferable to Visine® Clear Tears due to good tolerability.

  11. Arthroscopic Superior Capsule Reconstruction for Irreparable Rotator Cuff Tears

    Science.gov (United States)

    Mihata, Teruhisa; Lee, Thay Q.; Itami, Yasuo; HASEGAWA, Akihiko; Ohue, Mutsumi; Neo, Masashi

    2016-01-01

    Objectives: An arthroscopic superior capsule reconstruction, in which the fascia lata autograft attached medially to the superior glenoid and laterally to the greater tuberosity, restores shoulder stability and muscle balance in patients with irreparable rotator cuff tears; consequently, it improves shoulder function specifically deltoid muscle function and relieves pain. We assessed the clinical outcome of arthroscopic superior capsule reconstruction (Figure 1) in 100 consecutive patients with irreparable rotator cuff tears. Specifically, we focused on the rates of return to sport and work. Methods: From 2007 to 2014, we performed arthroscopic superior capsule reconstruction on 107 consecutive patients (mean 66.7 years; range, 43 to 82) with irreparable rotator cuff tears that had failed conservative treatment. Seven patients were lost to follow-up because of other medical problems or reasons. In the remaining 100 patients there were 56 supraspinatus and infraspinatus tears; 39 supraspinatus, infraspinatus, and subscapularis tears; 3 supraspinatus, infraspinatus, teres minor, and subscapularis tears; and 2 supraspinatus, infraspinatus, and teres minor tears. Physical examination, radiography, and MRI were performed before surgery; at 3, 6, and 12 months after surgery; and yearly thereafter. Rates of return to sport and work were also investigated in those patients who had been employed (34 patients: 21 manual workers, 10 farmers, 1 butcher, 1 cook, and 1 athletic trainer) or played sport (26 patients: 6 golf, 4 table tennis, 4 swimming, 3 martial arts, 2 baseball, 2 yoga, 1 tennis, 1 badminton, 1 skiing, 1 mountain-climbing, and 1 ground golf) before injury. Results: The average preoperative American Shoulder and Elbow Surgeons (ASES) score was 31.6 points (range, 3.3 to 63.3 points) and the average Japanese Orthopaedic Association (JOA) score was 51.6 points (26.5 to 68.5 points). Average postoperative clinical outcome scores all improved significantly at final

  12. Glycan involvement in the adhesion of Pseudomonas aeruginosa to tears.

    Science.gov (United States)

    Kautto, Liisa; Nguyen-Khuong, Terry; Everest-Dass, Arun; Leong, Andrea; Zhao, Zhenjun; Willcox, Mark D P; Packer, Nicolle H; Peterson, Robyn

    2016-04-01

    The human eye is constantly bathed by tears, which protect the ocular surface via a variety of mechanisms. The O-linked glycans of tear mucins have long been considered to play a role in binding to pathogens and facilitating their removal in the tear flow. Other conjugated glycans in tears could similarly contribute to pathogen binding and removal but have received less attention. In the work presented here we assessed the contribution of glycan moieties, in particular the protein attached N-glycans, presented by the broad complement of tear proteins to the adhesion of the opportunistic pathogen Pseudomonas aeruginosa, a leading cause of microbial keratitis and ulceration of the cornea. Our adhesion assay involved immobilising the macromolecular components of tears into the wells of a polyvinyl difluoride (PVDF) microtitre filter plate and probing the binding of fluorescently labelled bacteria. Three P. aeruginosa strains were studied: a cytotoxic strain (6206) and an invasive strain (6294) from eye infections, and an invasive strain (320) from a urinary tract infection (UTI). The ocular isolates adhered two to three times more to human tears than to human saliva or porcine gastric mucin, suggesting ocular niche-specific adaptation. Support for the role of the N-glycans carried by human tear proteins in the binding and removal of P. aeruginosa from the eye was shown by: 1) pre-incubation of the bacteria with free component sugars, galactose, mannose, fucose and sialyl lactose (or combination thereof) inhibiting adhesion of all the P. aeruginosa strains to the immobilised tear proteins, with the greatest inhibition of binding of the ocular cytotoxic 6206 and least for the invasive 6294 strain; 2) pre-incubation of the bacteria with N-glycans released from the commercially available human milk lactoferrin, an abundant protein that carries N-linked glycans in tears, inhibiting the adhesion to tears of the ocular bacteria by up to 70%, which was significantly more

  13. Supraspinatus tendon tears: comparison of 3D US and MR arthrography with surgical correlation

    International Nuclear Information System (INIS)

    The objective of the study was to compare the diagnostic reliability of 3D US with MR arthrography in diagnosing supraspinatus tendon tears, with arthroscopic findings used as the standard. In a prospective study 50 patients who later underwent arthroscopic surgery of the rotator cuff were examined pre-operatively by 3D US with MR arthrography. The presence or absence of a full- or partial-thickness supraspinatus tendon tear and the tear size as demonstrated by each imaging and arthroscopy was recorded. The tear size was divided into three grades: small (3 cm). The arthroscopic diagnosis was a full-thickness tear in 40 patients, partial-thickness tears in 5, and intact supraspinatus tendon in 5. 3D US correctly diagnosed 35 out of 40 full-thickness tears and MR arthrography 39 out of 40 full-thickness tears. Regarding partial-thickness tears, 3D US underestimated 2 cases as no tear and overestimated 1 case as a full-thickness tear. MR arthrography underestimated 1 case as a partial-thickness tear and overestimated 2 cases as full-thickness and partial-thickness tears respectively. 3D US and MR arthrography yield a sensitivity for full-thickness tears of 87.5% and 97.5% with specificity of 90.0% and 90.0%. Based on the grading system, 3D US measurements correctly predicted the tear size of 23 (65.7%) of the 35 full-thickness tears and MR arthrography 30 (75.0%) of the 39 full-thickness tears. Three-dimensional ultrasound seems to be a promising imaging modality comparable to MR arthrography for the assessment of the supraspinatus tendon tears. (orig.)

  14. Intraocular pressure and tear production in five herbivorous wildlife species.

    Science.gov (United States)

    Ofri, R; Horowitz, I H; Raz, D; Shvartsman, E; Kass, P H

    2002-08-31

    The intraocular pressure and rate of tear production were measured in 18 addax antelopes (Addax nasomaculatus), four impalas (Aepyceros melampus), 11 wide-lipped rhinoceroses (Ceratotherium simum), 10 white-tailed wildebeests (Connochaetes gnou) and seven scimitar-horned oryxes (Oryx dammah). The animals were anaesthetised with an intramuscular injection of etorphine hydrochloride and acepromazine maleate, and the Schirmer tear test I was used to evaluate tear production, and applanation tonometry was used to evaluate the intraocular pressure. The mean (sd) rate of tear production ranged from 17.6 (3.1) mm/minute in the rhinoceros to 28.8 (8.3) mm/minute in the addax. The intraocular pressure ranged from 8.0 (1.2) mmHg in the impala to 32.1 (10.4) mmHg in the rhinoceros. The rate of tear production in the addax and the intraocular pressure in the rhinoceros appear to be the highest values of these variables to have been reported in any species. PMID:12233828

  15. Preference direction study of Job’s-tears ice cream

    Directory of Open Access Journals (Sweden)

    Wiwat Wangcharoen

    2007-09-01

    Full Text Available Job's-tears (Coix lachryma-jobi L. is a kind of cereal commonly used in Asia as food and medicine, but it is still not widely consumed in Thailand. Four prototype products of Job’s-tears ice cream were developed by varying 2 levels of glucose syrup (16 and 32% of Job's-tears used and coconut milk (50 and 100 % of Job's-tears used. Their sensory attribute profiles were evaluated by 3 groups of 10 selected panelists using Ratio profile test (RPT, and their acceptances, hedonic scores, were evaluated by 100 consumers. Results showed that there were significant effects of coconut milk quantity on several attributes, such as appearance (whiteness, texture (hardness, smoothness, and flavour (coconut milk aroma, sweetness, saltiness, but the effect of glucose syrup quantity was significant on hardness only. Acceptance data were analyzed by cluster analysis to find out the difference of preference directions and 3 clusters (n1 = 39, n2 = 25, n3 = 36 were found. The first cluster preferred Job's tears ice cream containing high glucose syrup and low coconut milk, whilst the second preferred high level of only one of these two ingredients, and the third preferred high level of both ingredients. External preference maps were created from RPT and acceptance data to express the preference direction of each cluster.

  16. Tear trough deformity: review of anatomy and treatment options.

    Science.gov (United States)

    Stutman, Ross L; Codner, Mark A

    2012-05-01

    The lower eyelid can be a challenging area in facial rejuvenation. While lower eyelid bags are commonly the reason that patients present for lower eyelid rejuvenation, a separate entity known as a tear trough deformity may occur in conjunction with lower eyelid bags or alone. In this article, the authors outline the current understanding of the tear trough anatomy; describe multiple classification systems, which provide an objective means of evaluating the deformity and aid the surgeon in choosing appropriate treatment options; and review surgical and nonsurgical techniques for correcting the tear trough deformity. Treatment options include hyaluronic acid filler, fat grafting, skeletal implants, and fat transposition. Each procedure is associated with advantages and disadvantages, and each should be considered more complex than traditional lower blepharoplasty alone. While lower blepharoplasty removes excess fat and may tighten the anterior lamella, tear trough procedures require the addition of volume to the underlying depression. These procedures requiring release of the ligamentous structures and orbicularis (of which the tear trough is composed), as well as fat transposition or fat grafting, are associated with additional complications, which are also reviewed. PMID:22523096

  17. Tearing resistance of some co-polyester sheets

    International Nuclear Information System (INIS)

    A three-zone model consisting of initial, evolutionary and stabilised plastic zones for tearing resistance was proposed for polymer sheets. An analysis with the model, based on the essential work of fracture (EWF) approach, was demonstrated to be capable for predicting specific total work of fracture along the tear path across all the plastic zones although accuracy of specific essential work of fracture is subject to improvement. Photo-elastic images were used for identification of plastic deformation sizes and profiles. Fracture mode change during loading was described in relation with the three zones. Tearing fracture behaviour of extruded mono- and bi-layer sheets of different types of amorphous co-polyesters and different thicknesses was investigated. Thick material exhibited higher specific total work of tear fracture than thin mono-layer sheet in the case of amorphous polyethylene terephthalate (PET). This finding was explained in terms of plastic zone size formed along the tear path, i.e., thick material underwent larger plastic deformation than thin material. When PET and polyethylene terephthalate glycol (PETG) were laminated with each other, specific total work of fracture of the bi-layer sheets was not noticeably improved over that of the constituent materials

  18. Non invasive assessment of the human tear film dynamics.

    Science.gov (United States)

    Ring, M H; Rabensteiner, D F; Horwath-Winter, J; Boldin, I; Schrödl, F; Reitsamer, H; Haslwanter, T

    2015-11-01

    Dry eye disease, or keratoconjunctivitis sicca, is a multifactorial syndrome with altered tear film homeostasis leading to ocular irritations. These alterations cause discomfort and stress for the patient, but only a few objective parameters allow for proper differential diagnosis into different subtypes of this condition. The mostly invasively performed standard assessment procedures for tear film diagnosis are manifold, but often correlate quite poorly with the subjectively reported symptoms. Due to the inherent limitations, e.g. the subjectivity of the commonly performed invasive tests, a number of devices have been developed to assess the human tear film non-invasively. Since the production, delivery, distribution and drainage of the tear film is a dynamic process, we have focused our review on non-invasive methods which are capable of continuous or repetitive observations of the tear film during an inter-blink interval. These dynamic methods include (1) Interferometry, (2) Pattern Projection, (3) Aberrometry, (4) Thermography; and (5) Evaporimetry. These techniques are discussed with respect to their diagnostic value, both for screening and differential diagnostic of Dry Eye Disease. Many of the parameters obtained from these tests have been shown to have the potential to reliably discriminate patients from healthy subjects, especially when the tests are performed automatically and objectively. The differentiation into subtypes based solely on a single, dynamic parameter may not be feasible, but the combination of non-invasively performed procedures may provide good discrimination results. PMID:26406882

  19. [A woman with a locked knee].

    Science.gov (United States)

    Boersma, A R; van Raay, J J A M

    2015-01-01

    A 25-year-old female presented with locking of the left knee after an assertiveness training. The MRI scan showed a bucket-handle tear of the medial meniscus. The medial meniscus was dislocated into the intercondylar fossa, in which the image of a second posterior cruciate ligament (PCL) was simulated. This is also called a 'double PCL sign'. PMID:26959734

  20. Partial and complete tear of the anterior cruciate ligament. Direct and indirect MR signs

    International Nuclear Information System (INIS)

    Purpose: To analyze MR direct and indirect signs for knees with anterior cruciate ligament (ACL) partial or complete tear. Material and Methods: According to documented MR direct and indirect signs for ACL tear, we retrospectively reviewed the incidence of those signs in 15 partial ACL tear and 17 complete ACL tear patients. The findings were also compared with duration of injury (less or more than 6 weeks, as acute or chronic stages). Results: A residual straight and tight ACL fiber in at least one pulse sequence was more frequently detected in partial ACL tears. The empty notch sign, a wavy contour of ACL, bone contusion at lateral compartment and lateral meniscus posterior horn tear were significantly more frequently seen in complete tear cases. The posterior cruciate ligament angle in chronic complete ACL tear cases (109 deg ±20 deg) had a tendency to be less than in chronic partial ACL tear cases (119 deg ±18 deg). Conclusion: The empty notch sign, a wavy ACL, bone contusion, and posterior horn of lateral meniscus tears are suggestive of a complete ACL tear. A residual straight and tight ACL fiber seen in at least one image section is a helpful sign to diagnosis of partial ACL tear. In the acute ACL injury stage, a focal increase of the ACL signal intensity is more suggestive of a partial ACL tear

  1. Partial and complete tear of the anterior cruciate ligament. Direct and indirect MR signs

    Energy Technology Data Exchange (ETDEWEB)

    Chen, W.T.; Tu, H.Y.; Chen, R.C. [Taipei Municipal Jen-Ai Hospital, TW (China). Dept. of Radiology; Shih, T.T.F. [Medical College and Hospital, National Taiwan Univ., TW (China). Dept. of Radiology; Shau, W.Y. [The Graduate Inst. of Clinical Medicine, National Taiwan Univ., Taipei, TW (China). Dept. of Radiology

    2002-09-01

    Purpose: To analyze MR direct and indirect signs for knees with anterior cruciate ligament (ACL) partial or complete tear. Material and Methods: According to documented MR direct and indirect signs for ACL tear, we retrospectively reviewed the incidence of those signs in 15 partial ACL tear and 17 complete ACL tear patients. The findings were also compared with duration of injury (less or more than 6 weeks, as acute or chronic stages). Results: A residual straight and tight ACL fiber in at least one pulse sequence was more frequently detected in partial ACL tears. The empty notch sign, a wavy contour of ACL, bone contusion at lateral compartment and lateral meniscus posterior horn tear were significantly more frequently seen in complete tear cases. The posterior cruciate ligament angle in chronic complete ACL tear cases (109 deg {+-}20 deg) had a tendency to be less than in chronic partial ACL tear cases (119 deg {+-}18 deg). Conclusion: The empty notch sign, a wavy ACL, bone contusion, and posterior horn of lateral meniscus tears are suggestive of a complete ACL tear. A residual straight and tight ACL fiber seen in at least one image section is a helpful sign to diagnosis of partial ACL tear. In the acute ACL injury stage, a focal increase of the ACL signal intensity is more suggestive of a partial ACL tear.

  2. Rotator cuff tears in children and adolescents: experience at a large pediatric hospital

    International Nuclear Information System (INIS)

    Prior literature, limited to small case series and case reports, suggests that rotator cuff tears are rare in adolescents. However, we have identified rotator cuff tears in numerous children and adolescents who have undergone shoulder MRI evaluation. The purpose of this study is to describe the prevalence and characteristics of rotator cuff tears in children and adolescents referred for MRI evaluation of the shoulder at a large pediatric hospital and to correlate the presence of rotator cuff tears with concurrent labral pathology, skeletal maturity and patient activity and outcomes. We reviewed reports from 455 consecutive non-contrast MRI and magnetic resonance arthrogram examinations of the shoulder performed during a 2-year period, and following exclusions we yielded 205 examinations in 201 patients (ages 8-18 years; 75 girls, 126 boys). Rotator cuff tears were classified by tendon involved, tear thickness (partial or full), surface and location of tear (when partial) and presence of delamination. We recorded concurrent labral pathology when present. Physeal patency of the proximal humerus was considered open, closing or closed. Statistical analysis was performed to evaluate for a relationship between rotator cuff tears and degree of physeal patency. We obtained patient activity at the time of injury, surgical reports and outcomes from clinical records when available. Twenty-five (12.2%) rotator cuff tears were identified in 17 boys and 7 girls (ages 10-18 years; one patient had bilateral tears). The supraspinatus tendon was most frequently involved (56%). There were 2 full-thickness and 23 partial-thickness tears with articular-side partial-thickness tears most frequent (78%). Insertional partial-thickness tears were more common (78%) than critical zone tears (22%) and 10 (43%) partial-thickness tears were delamination tears. Nine (36%) patients with rotator cuff tears had concurrent labral pathology. There was no statistically significant relationship between

  3. Rotator cuff tears in children and adolescents: experience at a large pediatric hospital

    Energy Technology Data Exchange (ETDEWEB)

    Zbojniewicz, Andrew M.; Emery, Kathleen H. [University of Cincinnati College of Medicine, Department of Radiology, Cincinnati Children' s Hospital Medical Center, Cincinnati, OH (United States); Maeder, Matthew E. [University of Cincinnati College of Medicine, Department of Radiology, Cincinnati Children' s Hospital Medical Center, Cincinnati, OH (United States); Lenox Hill Hospital, Department of Radiology, New York, NY (United States); Salisbury, Shelia R. [University of Cincinnati College of Medicine, Division of Biostatistics and Epidemiology, Cincinnati Children' s Hospital Medical Center, Cincinnati, OH (United States)

    2014-06-15

    Prior literature, limited to small case series and case reports, suggests that rotator cuff tears are rare in adolescents. However, we have identified rotator cuff tears in numerous children and adolescents who have undergone shoulder MRI evaluation. The purpose of this study is to describe the prevalence and characteristics of rotator cuff tears in children and adolescents referred for MRI evaluation of the shoulder at a large pediatric hospital and to correlate the presence of rotator cuff tears with concurrent labral pathology, skeletal maturity and patient activity and outcomes. We reviewed reports from 455 consecutive non-contrast MRI and magnetic resonance arthrogram examinations of the shoulder performed during a 2-year period, and following exclusions we yielded 205 examinations in 201 patients (ages 8-18 years; 75 girls, 126 boys). Rotator cuff tears were classified by tendon involved, tear thickness (partial or full), surface and location of tear (when partial) and presence of delamination. We recorded concurrent labral pathology when present. Physeal patency of the proximal humerus was considered open, closing or closed. Statistical analysis was performed to evaluate for a relationship between rotator cuff tears and degree of physeal patency. We obtained patient activity at the time of injury, surgical reports and outcomes from clinical records when available. Twenty-five (12.2%) rotator cuff tears were identified in 17 boys and 7 girls (ages 10-18 years; one patient had bilateral tears). The supraspinatus tendon was most frequently involved (56%). There were 2 full-thickness and 23 partial-thickness tears with articular-side partial-thickness tears most frequent (78%). Insertional partial-thickness tears were more common (78%) than critical zone tears (22%) and 10 (43%) partial-thickness tears were delamination tears. Nine (36%) patients with rotator cuff tears had concurrent labral pathology. There was no statistically significant relationship between

  4. Simulation of tearing mode stabilization by using ECH

    International Nuclear Information System (INIS)

    Nonlinear simulations based on the reduced set of resistive MHD equations with the transport equation of electron temperature are carried out to investigate the effect of electron temperature perturbation induced by local heating of ECH on a tearing mode activity. Effect of poloidal plasma rotation is also considered in the simulations. It is shown that the local heating can suppress low-m tearing mode instability when O-point of the rotating magnetic island is effectively heated. Large parallel heat conduction causes the radially extending heat deposition profile for small width of magnetic island and magnitude of parallel heat conduction determines the heat power necessary for complete stabilization of the tearing mode. (author)

  5. Influence of driven current on resistive tearing mode in Tokamaks

    Science.gov (United States)

    Wang, S.; Ma, Z. W.; Zhang, W.

    2016-05-01

    The influence of driven current on the m /n =2 /1 resistive tearing mode is studied systematically using a three-dimensional toroidal magnetohydrodynamic code. A uniform driven current with Gaussian distribution in the radial direction is imposed around the unperturbed rational surface. It is found that the driven current can locally modify the profiles of the current and safety factor, such that the tearing mode becomes linearly stable. The stabilizing effect increases with the increase of the driven current Icd or the decrease of its width δcd , unless an excessively large driven current reverses the magnetic shear near the rational surface and drives other instabilities such as double or triple tearing modes. The stabilizing effect can be negligible or becomes reversed if the maximum driven current density is not at the unperturbed rational surface.

  6. Magnetic resonance imaging for the diagnosis of chondral, meniscal and cruciate ligaments injuries of the knee

    International Nuclear Information System (INIS)

    Objective: To evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) of the knee. Materials and methods: Seventy-two patients have been submitted to MRI previously to arthroscopy of the knee performed by a single surgeon and utilized as a comparative standard method. Sensitivity, specificity, values of likelihood and rate of interobserver agreement have been evaluated. Results: The kappa agreement coefficient between MRI and arthroscopy was very good for lesions in the anterior cruciate ligament (0.84), good for lateral meniscus (0.75), reasonable for medial meniscus (0.50) and poor for chondral lesions (< 0.50). MRI has demonstrated high sensitivity for tears in the anterior cruciate ligament (94%) and in the medial meniscus (92%), good sensitivity for lesions in the lateral meniscus (80%), and low sensitivity for lesions in all of the chondral zones (< 50%), while the specificity has been excellent for all the chondral, and ligamentous structures, besides the lateral menisci analyzed (more than 97%), and reasonable (65%) for the medial meniscus. Conclusion: MRI is an useful tool in the clinical diagnosis of intra-articular knee lesions, as already demonstrated by similar results reported both in the Brazilian and international literature. (author)

  7. Rotator cuff tears noncontrast MRI compared to MR arthrography

    International Nuclear Information System (INIS)

    To compare the accuracy of indirect magnetic resonance arthrography and noncontrast magnetic resonance imaging for diagnosing rotator cuff tears. In total, 333 patients who underwent noncontrast magnetic resonance imaging or indirect magnetic resonance arthrography were included retrospectively. Two musculoskeletal radiologists evaluated the images for the presence of supraspinatus-infraspinatus and subscapularis tendon tears. The overall diagnostic performance was calculated using the arthroscopic findings as the reference standard. Statistical differences between the diagnostic performances of the two methods were analyzed. Ninety-six and 237 patients who underwent noncontrast magnetic resonance imaging and indirect magnetic resonance arthrography were assigned into groups A and B, respectively. Sensitivity for diagnosing articular-surface partial-thickness supraspinatus-infraspinatus tendon tear was slightly higher in group B than in group A. Statistical significance was confirmed by multivariate analysis using the generalized estimating equation (p = 0.046). The specificity for diagnosing subscapularis tendon tear (85 % vs. 68 %, p = 0.012) and grading accuracy (57 % vs. 40 %, p = 0.005) was higher in group B than in group A; the differences were statistically significant for one out of two readers. Univariate analysis using the generalized estimating equation showed that the accuracy for diagnosing subscapularis tendon tear in group B was higher than in group A (p = 0.042). There were no statistically significant differences between the diagnostic performances of both methods for any other parameters. Indirect magnetic resonance arthrography may facilitate more accurate diagnosis and grading of subscapularis tendon tears compared with noncontrast magnetic resonance imaging. (orig.)

  8. Dorsal Tear of Triangular Fibrocartilage Complex: Clinical Features and Treatment.

    Science.gov (United States)

    Abe, Yukio; Moriya, Atsushi; Tominaga, Yasuhiro; Yoshida, Koji

    2016-03-01

    Background Several different triangular fibrocartilage complex (TFCC) tear patterns have been classified through the use of wrist arthroscopy. A tear of the dorsal aspect of the TFCC has been previously reported, but it is not included in Palmer original classification. Our purpose was to describe this type of tear pattern along with the clinical presentation. Methods An isolated dorsal TFCC tear was encountered in seven wrists of six patients (three men and three women; average age was 31 years). All patients were evaluated by physical exam, X-ray, plain axial computed tomography with pronation, neutral and supination position, magnetic resonance imaging (MRI) with coronal, sagittal, and axial section and arthroscopy. Results The clinical findings varied and included the following: tenderness at the dorsoulnar aspect of the wrist was positive in all wrists, fovea sign was positive in five wrists, and tenderness at the dorsal aspect of the distal radioulnar joint was present in one wrist. Pain with forearm rotation was positive in all wrists. The ulnar head ballottement test induced pain in all wrists, whereas dorsal instability of the ulnar head was present in one wrist with this test. The ulnocarpal stress test was positive in five wrists. Axial and sagittal images on MRI revealed the dorsal tear in five wrists. All wrists were treated with an arthroscopic capsular repair. The final functional outcome at an average follow-up of 16.1 months was four excellent and one good wrist according to the modified Mayo wrist score. Conclusions The aim of this article is to describe our experiences with tears involving the dorsal aspect of the TFCC, which may be misdiagnosed if the surgeon is not cognizant of this injury. Type of study/level of evidence Diagnostic/level IV. PMID:26855835

  9. Rotator cuff tears noncontrast MRI compared to MR arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ji Hyun; Yoon, Young Cheol [Sungkyunkwan University, School of Medicine, Department of Radiology, Samsung Medical Center, Gangnam-gu, Seoul (Korea, Republic of); Jung, Jee Young [Chungang University School of Medicine, Department of Radiology, Chungang University Hospital, Seoul (Korea, Republic of); Yoo, Jae Chul [Sungkyunkwan University, School of Medicine, Department of Orthopedic Surgery, Samsung Medical Center, Seoul (Korea, Republic of)

    2015-12-15

    To compare the accuracy of indirect magnetic resonance arthrography and noncontrast magnetic resonance imaging for diagnosing rotator cuff tears. In total, 333 patients who underwent noncontrast magnetic resonance imaging or indirect magnetic resonance arthrography were included retrospectively. Two musculoskeletal radiologists evaluated the images for the presence of supraspinatus-infraspinatus and subscapularis tendon tears. The overall diagnostic performance was calculated using the arthroscopic findings as the reference standard. Statistical differences between the diagnostic performances of the two methods were analyzed. Ninety-six and 237 patients who underwent noncontrast magnetic resonance imaging and indirect magnetic resonance arthrography were assigned into groups A and B, respectively. Sensitivity for diagnosing articular-surface partial-thickness supraspinatus-infraspinatus tendon tear was slightly higher in group B than in group A. Statistical significance was confirmed by multivariate analysis using the generalized estimating equation (p = 0.046). The specificity for diagnosing subscapularis tendon tear (85 % vs. 68 %, p = 0.012) and grading accuracy (57 % vs. 40 %, p = 0.005) was higher in group B than in group A; the differences were statistically significant for one out of two readers. Univariate analysis using the generalized estimating equation showed that the accuracy for diagnosing subscapularis tendon tear in group B was higher than in group A (p = 0.042). There were no statistically significant differences between the diagnostic performances of both methods for any other parameters. Indirect magnetic resonance arthrography may facilitate more accurate diagnosis and grading of subscapularis tendon tears compared with noncontrast magnetic resonance imaging. (orig.)

  10. Daytime Variations of Tear Osmolarity Measurement in Dry Eye Patients

    Directory of Open Access Journals (Sweden)

    Ulviye Yiğit

    2013-12-01

    Full Text Available Purpose: We have targeted primarily to show the variations of tear osmolarity during the daytime period in subjects with dry eyes and non-dry eyes and, secondarily, to evaluate the relationship of these variations with Schirmer’s test and break-up time (BUT. Material and Method: Twenty newly diagnosed dry eye patients and 20 healthy voluntary subjects with similar age and gender were included in this prospective study. In addition to the full ophthalmic examination, Schirmer’s test and BUT test were applied to all participants. Tear osmolarity measurements were done after pre-examination but in different day. The measurements were registered with TearLab Osmolarity System (TearLab Corporation, San Diego, CA, USA every 3 hours within 8:00 AM and 5:00 PM. The results were evaluated statistically. Results: No statistically significant difference was found between the mean age and gender of dry eye syndrome (DES and control groups (p>0.05. The mean measurements of Schirmer’s test and BUT in the DES group were statistically significantly lower than those in the control group (p=0.0001. The mean measurements of tear osmolarity at 8:00 AM, 11:00 AM, 2:00 PM, and 5:00 PM in the DES group were statistically significantly higher than those in the control group (p=0.001, p=0.0001. No statistically significant difference in tear osmolarity at 8:00 AM, 11: 00 AM, 2:00 PM, and 5:00 PM was found between the groups, and within DES and control groups (p>0.05. Discussion: We did not determine significant change in daytime variations of the tear osmolarity in dry eye patients and healthy subjects. As a secondary result, we can conclude that there is no difference among tear osmolarity, Shirmer’s and BUT tests in the diagnosis of DES. (Turk J Ophthalmol 2013; 43: 437-41

  11. Winging of scapula due to serratus anterior tear

    Directory of Open Access Journals (Sweden)

    Varun Singh Kumar

    2014-10-01

    Full Text Available 【Abstract】Winging of scapula occurs most commonly due to injury to long thoracic nerve supplying serratus anterior muscle. Traumatic injury to serratus anterior muscle itself is very rare. We reported a case of traumatic winging of scapula due to tear of serratus anterior muscle in a 19-year-old male. Winging was present in neutral position and in extension of right shoulder joint but not on "push on wall" test. Patient was managed conservatively and achieved satisfactory result. Key words: Serratus anterior tear; Scapula; Wounds and injuries

  12. Effect of oil based CMYK process inks on tearing characteristics of paper

    Directory of Open Access Journals (Sweden)

    Celil Atik

    2015-01-01

    Full Text Available Every day we use many different kinds of printed materials exposed to tearing stresses. Interactions between paper and printing inks affect the inter-fiber bonds, accordingly the tearing properties of paper. This study was carried out to determine the tearing resistance properties of papers printed with solid tone offset inks, using Cyan, Magenta, Yellow, Black process series. The static tearing resistance of paper was determined by universal tensile testing device and tearing strength patterns was examined. Decrease of tear resistance and relatively close tear index ratios (cross direction / machine direction was observed for printed papers. Application of solid tone inks increases the force required for initiation of tearing of papers.

  13. Etiology of tearing in patients seen in an oculoplastic clinic in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Amal Bukhari

    2013-01-01

    Conclusion: The outcomes of this study indicate the most common cause of tearing is punctal pathology. Therefore, slit lamp evaluation with careful attention to the punctum is warranted in all patients with tearing.

  14. Comparison of dynamic and static tearing resistance of different commercial papers

    OpenAIRE

    Atik, Celil; Engin, Merve

    2010-01-01

    This study was carried out to determine comparability of tearing resistance measured by dynamic and static testing devices. Tearing indices of double tear samples from different commercial paper grades were determined dynamically by using pendulum type Marx-Maller Elmendorf device and statically by using Zwick/Roell universal tensile testing device. Tear resistance values for dynamic and static tests were compared and good correlation was observed (R²-0.96 and 0.99 for MD and CD respectively)...

  15. Contact lens physical properties and lipid deposition in a novel characterized artificial tear solution

    OpenAIRE

    Lorentz, Holly; Heynen, Miriam; Kay, Lise M.M.; Dominici, Claudia Yvette; Khan, Warda; Ng, Wendy W.S.; Jones, Lyndon

    2011-01-01

    Purpose To characterize various properties of a physiologically-relevant artificial tear solution (ATS) containing a range of tear film components within a complex salt solution, and to measure contact lens parameters and lipid deposition of a variety of contact lens materials after incubation in this ATS. Methods A complex ATS was developed that contains a range of salts, proteins, lipids, mucin, and other tear film constituents in tear-film relevant concentrations. This ATS was tested to co...

  16. Morphologic characterization of meniscal root ligaments in the human knee with magnetic resonance microscopy at 11.7 and 3 T

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Eric Y.; Chung, Christine B. [VA San Diego Healthcare System, Department of Radiology, San Diego, CA (United States); University of California, San Diego Medical Center, Department of Radiology, San Diego, CA (United States); Biswas, Reni; DiCamillo, Paul; Statum, Sheronda; Tafur, Monica; Bydder, Graeme M. [University of California, San Diego Medical Center, Department of Radiology, San Diego, CA (United States)

    2014-10-15

    To determine the feasibility of using MR microscopy to characterize the root ligaments of the human knee at both ultra-high-field (11.7 T) and high-field (3 T) strengths. Seven fresh cadaveric knees were used for this study. Six specimens were imaged at 11.7 T and one specimen at 3 T using isotropic or near-isotropic voxels. Histologic correlation was performed on the posteromedial root ligament of one specimen. Meniscal root ligament shape, signal intensity, and ultrastructure were characterized. High-resolution, high-contrast volumetric images were generated from both MR systems. Meniscal root ligaments were predominantly oval in shape. Increased signal intensity was most evident at the posteromedial and posterolateral root ligaments. On the specimen that underwent histologic preparation, increased signal intensity corresponded to regions of enthesis fibrocartilage. Collagen fascicles were continuous between the menisci and root ligaments. Predominantly horizontal meniscal radial tie fibers continued into the root ligaments as vertical endoligaments. MR microscopy can be used to characterize and delineate the distinct ultrastructure of the root ligaments on both ultra-high-field- and high-field-strength MR systems. (orig.)

  17. MR imaging of bone bruise associated with ACL tear

    International Nuclear Information System (INIS)

    The authors reviewed 56 MR studies of the knee performed for suspected cruciate ligament tear at the Tokyo Metropolitan Hiroo Hospital from April 1990 to March 1991. There were 10 patients with abnormal signal in the subcortical bone marrow. Eight of these patients had concomitant anterior cruciate ligament (ACL) tear with no evidence of fracture on plain radiographs of the knee. The abnormal signals were all seen in the lateral compartment, almost invariably in the middle third of the lateral femoral condyle and posterolateral aspect of the tibial plateau, and were of low intensity on T1-weighted and proton density images and of high intensity on T2-weighted images. It was speculated that these abnormalities resulted from impaction of the lateral femoral condyle into the posterior lip of the tibial plateau due to rotary subluxation of the tibia. One patient had a follow-up study three months later, which revealed complete resolution of bone bruise. It was concluded that bone bruise associated with ACL tear is seen specific locations, which may be a useful secondary sign of acute ACL tear. (author)

  18. A Case of Retinal Tear Associated with Use of Sorafenib

    OpenAIRE

    KellyM.Gaertner; OsamaRahma; StephenH.Caldwell

    2014-01-01

    Inhibition of angiogenesis is a target in the treatment of a variety of malignancies. Sorafenib is an oral inhibitor of multiple tyrosine kinases involved in tumor angiogenesis. A related case of ophthalmologic toxicity has been reported with another vascular endothelial growth factor receptor inhibitor, sunitinib. We report the first case of retinal tear possibly associated with sorafenib.

  19. Stop the Tears of Drug and Alcohol Abuse

    Science.gov (United States)

    Shimon, Jane; Gibson, Terry-Ann; Spear, Caile

    2009-01-01

    Objectives: By participating in this Stop the Tears teaching strategy, students will be able to: (1) analyze how alcohol and drug abuse could affect their lives as well as the lives of their friends and family and, (2) create a media message, such as a poster, pamphlet, poem, or song, in which alcohol and drug prevention is advocated specific to…

  20. Nonlinear theory of high-m tearing modes

    International Nuclear Information System (INIS)

    A simplified nonlinear theory of short wavelength (high-m) electron temperature-gradient-driven tearing modes is presented. Saturation of the linear instability results from nonlinear mode coupling in which energy may cascade to both short and long wavelength modes. The resulting electron thermal conductivity exhibits the density scaling and absolute magnitude observed experimentally

  1. Computation of the δ' value for the tearing mode

    International Nuclear Information System (INIS)

    An effective method of computation of the δ' parameter for the tearing mode used for the analysis of reverse-field pinch stability is described. The method provides high computation accuracy even at rough difference grid that simplifies linking up of stability computations with a simulation of transfer processes in a takamak device

  2. Infraspinatus delamination does not affect supraspinatus tear repair.

    Science.gov (United States)

    Zilber, Sébastien; Carillon, Yannick; Lapner, Peter C; Walch, Gilles; Nové-Josserand, Laurent

    2007-05-01

    Supraspinatus full-thickness tears with associated infraspinatus delamination are a frequent lesion, although the results of repair have not been reported. We retrospectively identified 35 patients treated for this cuff lesion among 378 open repaired full-thickness cuff tears. The aim of the study was to assess the subjective, objective, and anatomic outcomes of a subset of patients with supraspinatus tears involving delamination of the whole infraspinatus tendon. Thirty of the 35 patients were reviewed with magnetic resonance imaging at a minimum followup of 2 years (mean, 3.5 years; range, 2-6.5 years). The mean nonweighted Constant-Murley score at followup was 80/100 points, with an average gain of 17 points. Magnetic resonance imaging revealed all supraspinatus tendons but two were continuous. We observed no tear of the infraspinatus tendon, although a persistent delamination was present in 11 cases. One half of the patients had minor weakness in external rotation. One third of the infraspinatus muscles had minor fatty infiltration. Conservation of the infraspinatus tendon after closing the delamination did not seem to compromise the outcome of the supraspinatus repair. Avoiding resection of the infraspinatus delamination and treatment with simple curettage and closure yields satisfactory midterm functional and anatomic results. PMID:17308479

  3. Reconnection dynamics with secondary tearing instability in compressible Hall plasmas

    International Nuclear Information System (INIS)

    The dynamics of a secondary tearing instability is systematically investigated based on compressible Hall magnetohydrodynamic. It is found that in the early nonlinear phase of magnetic reconnection before onset of the secondary tearing instability, the geometry of the magnetic field in the reconnection region tends to form a Y-type structure in a weak Hall regime, instead of an X-type structure in a strong Hall regime. A new scaling law is found that the maximum reconnection rate in the early nonlinear stage is proportional to the square of the ion inertial length (γ∝di2) in the weak Hall regime. In the late nonlinear phase, the thin elongated current sheet associated with the Y-type geometry of the magnetic field breaks up to form a magnetic island due to a secondary tearing instability. After the onset of the secondary tearing mode, the reconnection rate is substantially boosted by the formation of the X-type geometries of magnetic field in the reconnection regions. With a strong Hall effect, the maximum reconnection rate linearly increases with the increase of the ion inertial length (γ∝di)

  4. Compensatory muscle activation in patients with glenohumeral cuff tears

    NARCIS (Netherlands)

    Steenbrink, Franciscus

    2010-01-01

    Patients suffering tendon tears in the glenohumeral cuff muscles show activation of muscles which pull the arm downwards during arm elevation tasks. This so-called co-activation deviates from healthy controls and is triggered by pain. Goal of this thesis was to demonstrate that deviating muscle acti

  5. Immunoglobulin Concentration in Tears of Contact Lens Wearers

    Directory of Open Access Journals (Sweden)

    Rajendra P Maurya

    2014-01-01

    Conclusion: The relation of immunoglobulin concentration with increasing duration of wear and material of contact lens shows that tear immunoglobulin rise accrues due to mechanical stimulation, hence contact lenses should not be used for a long period and lenses of hard nature should be discouraged. The maintenance, cleaning and deproteinization of the lenses are of high importance to avoid immunostimulation.

  6. Reconnection dynamics with secondary tearing instability in compressible Hall plasmas

    Energy Technology Data Exchange (ETDEWEB)

    Ma, Z. W., E-mail: zwma@zju.edu.cn; Wang, L. C.; Li, L. J. [Institute for Fusion Theory and Simulation, Zhejiang University, Hangzhou 310027 (China)

    2015-06-15

    The dynamics of a secondary tearing instability is systematically investigated based on compressible Hall magnetohydrodynamic. It is found that in the early nonlinear phase of magnetic reconnection before onset of the secondary tearing instability, the geometry of the magnetic field in the reconnection region tends to form a Y-type structure in a weak Hall regime, instead of an X-type structure in a strong Hall regime. A new scaling law is found that the maximum reconnection rate in the early nonlinear stage is proportional to the square of the ion inertial length (γ∝d{sub i}{sup 2}) in the weak Hall regime. In the late nonlinear phase, the thin elongated current sheet associated with the Y-type geometry of the magnetic field breaks up to form a magnetic island due to a secondary tearing instability. After the onset of the secondary tearing mode, the reconnection rate is substantially boosted by the formation of the X-type geometries of magnetic field in the reconnection regions. With a strong Hall effect, the maximum reconnection rate linearly increases with the increase of the ion inertial length (γ∝d{sub i})

  7. Tear Resistance of Orthogonal Kevlar-PWF-reinforced TPU Film

    Institute of Scientific and Technical Information of China (English)

    BAI Jiangbo; XIONG Junjiang; CHENG Xu

    2011-01-01

    This work seeks to investigate the notch sensitivity and fracture behaviour of orthogonal Kevlar-plain woven fabric (PWF)reinforced thermoplastic polyurethanes (TPU) film applied to high altitude balloon. Four types of specimens are implemented to measure notched strength and fracture toughness by conducting static tension and tear tests on an MTS system respectively. The damage and failure mechanisms are discussed and the results for notched strength and tear resistance are evaluated and compared with each other. From the experiments, it is found that the notch sensitivity of the film increases with the increase in the size of the hole, but the notch sensitivity and the stress concentration of the notch are insignificant and there is a decrease of only about 4%-10% in tensile strength for the notched specimens with different hole sizes in diameter compared with the unnotched specimen. In contrast, the tear resistance containing a central slit with only 1 mm length is about half of tensile strength of the unnotched film, which implies that the tear resistance exists an significant notch sensitivity. The results of this study provide an insight into notch sensitivity and fracture behaviour of the Kevlar-PWF-reinforced TPU film and constitute a fundamental basis for the design of high altitude balloon.

  8. Aortic bifurcation tear following blunt trauma in childhood

    OpenAIRE

    Shlomo Yellinek; Dimitri Gimelrich; Ofer Merin; Petachia Reissman; Marc Arkovitz

    2015-01-01

    Rupture of the abdominal aorta from blunt trauma is rare and aortic biforcation tear is extremely rare. We will present the management of a 2 year old boy who suffered blunt abdominal trauma and was operated in urgent fashion in our institution.

  9. 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.

  10. Hot tears in niobium stainless steel investment casting

    International Nuclear Information System (INIS)

    Results concerning hot tears in Niobium stainless steel investment castings were analysed. It was observed that solidification mode is the principal parameter in determining the occurrence of this defect: on the other hand, there was no consistent relationship between Creq/Nieq ratio and its occurrence. (author)

  11. Critical Δ' for stability of viscoresistive tearing modes

    Science.gov (United States)

    Grasso, D.; Hastie, R. J.; Porcelli, F.; Tebaldi, C.

    2008-07-01

    An analytic expression for the stability threshold of linear tearing modes is derived. The magnetized plasma is described in terms of a standard viscoresistive magnetohydrodynamic model. The analytic derivation requires an extension of the standard layer equation that represents an approximation of the full model in the vicinity of the reconnecting layer. The analytic result is checked against numerical simulations, showing excellent agreement.

  12. Critical Δ' for stability of viscoresistive tearing modes

    International Nuclear Information System (INIS)

    An analytic expression for the stability threshold of linear tearing modes is derived. The magnetized plasma is described in terms of a standard viscoresistive magnetohydrodynamic model. The analytic derivation requires an extension of the standard layer equation that represents an approximation of the full model in the vicinity of the reconnecting layer. The analytic result is checked against numerical simulations, showing excellent agreement.

  13. Tearing relaxation and the globalization of transport in field-reversed configurations

    International Nuclear Information System (INIS)

    Tearing instability of field-reversed configurations (FRC) is investigated using the method of neighboring equilibria. It is shown that the conducting wall position in experiment lies very close to the location needed for tearing stability. This strongly suggests that vigorous but benign tearing modes, acting globally, are the engine of continual self-organization in FRCs, i.e., tearing relaxation. It also explains the ''profile consistency'' and anomalous loss rate of magnetic flux. In effect, tearing globalizes the effect of edge-driven transport.

  14. Etiology, classification and clinical evaluation of partial-thickness tears of rotator cuff

    Institute of Scientific and Technical Information of China (English)

    TANG Kang-lai 唐康来; Peter Habermeryer; LI Qi-hong 李起鸿; Sven Lichtenberg; YANG Liu 杨柳

    2003-01-01

    @@ Since partial thickness tears of the rotator cuff were described well by Codman 1 in 1934, they have been extensively discussed in all kinds of literatures.Partial thickness tears of the rotator cuff are now considered to play a more significant role than previously in inducing patients disability. Partialthickness cuff tears deserve more clinical attention. Both accurate diagnosis and proper surgical repair are very essential. The cognition of partialthickness tears has been deepened in the last decades. In this paper we will review the etiology, classification and clinical evaluation of partial thickness tears of the rotator cuff.

  15. Chemosignalling effects of human tears revisited : Does exposure to female tears decrease males' perception of female sexual attractiveness?

    NARCIS (Netherlands)

    Gracanin, A.; van Assen, M.A.L.M.; Omrčen, Višnja; Koraj, Ivana; Vingerhoets, A.J.J.M.

    2016-01-01

    Gelstein et al. reported the results of three experiments suggesting a dampening influence of inhalation of female emotional tears on males' arousal and perception of female sexual attractiveness, specifically in non-sexual situations. This prompted the hypothesis that crying exerts its influence on

  16. HUBBLE WATCHES STAR TEAR APART ITS NEIGHBORHOOD

    Science.gov (United States)

    2002-01-01

    NASA's Hubble Space Telescope has snapped a view of a stellar demolition zone in our Milky Way Galaxy: a massive star, nearing the end of its life, tearing apart the shell of surrounding material it blew off 250,000 years ago with its strong stellar wind. The shell of material, dubbed the Crescent Nebula (NGC 6888), surrounds the 'hefty,' aging star WR 136, an extremely rare and short-lived class of super-hot star called a Wolf-Rayet. Hubble's multicolored picture reveals with unprecedented clarity that the shell of matter is a network of filaments and dense knots, all enshrouded in a thin 'skin' of gas [seen in blue]. The whole structure looks like oatmeal trapped inside a balloon. The skin is glowing because it is being blasted by ultraviolet light from WR 136. Hubble's view covers a small region at the northeast tip of the structure, which is roughly three light-years across. A picture taken by a ground-based telescope [lower right] shows almost the entire nebula. The whole structure is about 16 light-years wide and 25 light-years long. The bright dot near the center of NGC 6888 is WR 136. The white outline in the upper left-hand corner represents Hubble's view. Hubble's sharp vision is allowing scientists to probe the intricate details of this complex system, which is crucial to understanding the life cycle of stars and their impact on the evolution of our galaxy. The results of this study appear in the June issue of the Astronomical Journal. WR 136 created this web of luminous material during the late stages of its life. As a bloated, red super-giant, WR 136 gently puffed away some of its bulk, which settled around it. When the star passed from a super-giant to a Wolf-Rayet, it developed a fierce stellar wind - a stream of charged particles released from its surface - and began expelling mass at a furious rate. The star began ejecting material at a speed of 3.8 million mph (6.1 million kilometers per hour), losing matter equal to that of our Sun's every 10

  17. Complete versus partial-thickness tears of the posterior cruciate ligament: differential features at MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Sohn, Kwang Joon; Kim, Hyun Jeong; Juhng, Seon Kwan [Wonkwang University School of Medicine, Iksan (Korea, Republic of)

    1995-07-15

    To evaluate the differential features of complete and partial-thickness tears of the posterior cruciate ligament (PCL) and to describe associated knee injuries at magnetic resonance imaging (MRI). Twenty-four subjects were studied, including 15 with complete PCL tears and 9 with partial PCL tears. The PCL status was determined at arthroscopy in all cases. Knee MRI were performed at 1.0 Tesla using a dedicated knee surface coil. Two radiologists retrospectively reviewed MR images and correlated MRI findings to results of arthroscopy. There was no statistically significant difference between complete tears and partial tears with regard to thickness, margination, and signal intensity of the PCL. However, complete tears were more likely to show focal areas of ligamentous discontinuity (13/15: 3/9, {rho} = 0.0073). Associated knee injuries were seen in 22 (92%) patients and were seen more frequently in patients with complete PCL tears, which were bony injuries (n 16, 67%), tears of the medial collateral ligament (n = 12, 50%) and menisci (n = 11, 46%), and stage III joint effusion (n = 17, 71%). The most useful MRI criteria for distinguishing complete from partial PCL tear is focal area of ligamentous discontinuity, that is complete tears are more likely to show focal areas of discontinuity, whereas partial tears are more likely to show at least some intact fibers.

  18. Complete versus partial-thickness tears of the posterior cruciate ligament: differential features at MR imaging

    International Nuclear Information System (INIS)

    To evaluate the differential features of complete and partial-thickness tears of the posterior cruciate ligament (PCL) and to describe associated knee injuries at magnetic resonance imaging (MRI). Twenty-four subjects were studied, including 15 with complete PCL tears and 9 with partial PCL tears. The PCL status was determined at arthroscopy in all cases. Knee MRI were performed at 1.0 Tesla using a dedicated knee surface coil. Two radiologists retrospectively reviewed MR images and correlated MRI findings to results of arthroscopy. There was no statistically significant difference between complete tears and partial tears with regard to thickness, margination, and signal intensity of the PCL. However, complete tears were more likely to show focal areas of ligamentous discontinuity (13/15: 3/9, ρ = 0.0073). Associated knee injuries were seen in 22 (92%) patients and were seen more frequently in patients with complete PCL tears, which were bony injuries (n 16, 67%), tears of the medial collateral ligament (n = 12, 50%) and menisci (n = 11, 46%), and stage III joint effusion (n = 17, 71%). The most useful MRI criteria for distinguishing complete from partial PCL tear is focal area of ligamentous discontinuity, that is complete tears are more likely to show focal areas of discontinuity, whereas partial tears are more likely to show at least some intact fibers

  19. 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.

  20. 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

  1. Rotator cuff tears: assessment with MR arthrography in 275 patients with arthroscopic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Waldt, S.; Bruegel, M.; Mueller, D.; Holzapfel, K.; Rummeny, E.J.; Woertler, K. [Technische Universitaet Muenchen, Department of Radiology, Munich (Germany); Imhoff, A.B. [Technische Universitaet Muenchen, Department of Sports Orthopedics, Munich (Germany)

    2007-02-15

    We assessed the diagnostic performance of magnetic resonance (MR) arthrography in the diagnosis of articular-sided partial-thickness and full-thickness rotator cuff tears in a large symptomatic population. MR arthrograms obtained in 275 patients including a study group of 139 patients with rotator cuff tears proved by arthroscopy and a control group of 136 patients with arthroscopically intact rotator cuff tendons were reviewed in random order. MR imaging was performed on a 1.0 T system (Magnetom Expert, Siemens). MR arthrograms were analyzed by two radiologists in consensus for articular-sided partial-thickness and full-thickness tears of the supraspinatus, infraspinatus, and subscapularis tendons. At arthroscopy, 197 rotator cuff tears were diagnosed, including 105 partial-thickness (93 supraspinatus, nine infraspinatus, three subscapularis) and 92 full-thickness (43 supraspinatus, 20 infraspinatus, 29 subscapularis) tendon tears. For full-thickness tears, sensitivity, specificity, and accuracy were 96%, 99%, and 98%, respectively, and for partial tears 80%, 97%, and 95%, respectively. False negative and positive assessments in the diagnosis of articular-sided partial-thickness tears were predominantly [78% (35/45)] observed with small articular-sided (Ellman grade1) tendon tears. MR arthrography is highly accurate in the diagnosis of full-thickness rotator cuff tears and is accurate in the diagnosis of articular-sided partial-thickness tears. Limitations in the diagnosis of partial-thickness tears are mainly restricted to small articular-sided tears (Ellman grade 1) due to difficulties in differentiation between fiber tearing, tendinitis, synovitic changes, and superficial fraying at tendon margins. (orig.)

  2. Rotator cuff tears: assessment with MR arthrography in 275 patients with arthroscopic correlation

    International Nuclear Information System (INIS)

    We assessed the diagnostic performance of magnetic resonance (MR) arthrography in the diagnosis of articular-sided partial-thickness and full-thickness rotator cuff tears in a large symptomatic population. MR arthrograms obtained in 275 patients including a study group of 139 patients with rotator cuff tears proved by arthroscopy and a control group of 136 patients with arthroscopically intact rotator cuff tendons were reviewed in random order. MR imaging was performed on a 1.0 T system (Magnetom Expert, Siemens). MR arthrograms were analyzed by two radiologists in consensus for articular-sided partial-thickness and full-thickness tears of the supraspinatus, infraspinatus, and subscapularis tendons. At arthroscopy, 197 rotator cuff tears were diagnosed, including 105 partial-thickness (93 supraspinatus, nine infraspinatus, three subscapularis) and 92 full-thickness (43 supraspinatus, 20 infraspinatus, 29 subscapularis) tendon tears. For full-thickness tears, sensitivity, specificity, and accuracy were 96%, 99%, and 98%, respectively, and for partial tears 80%, 97%, and 95%, respectively. False negative and positive assessments in the diagnosis of articular-sided partial-thickness tears were predominantly [78% (35/45)] observed with small articular-sided (Ellman grade1) tendon tears. MR arthrography is highly accurate in the diagnosis of full-thickness rotator cuff tears and is accurate in the diagnosis of articular-sided partial-thickness tears. Limitations in the diagnosis of partial-thickness tears are mainly restricted to small articular-sided tears (Ellman grade 1) due to difficulties in differentiation between fiber tearing, tendinitis, synovitic changes, and superficial fraying at tendon margins. (orig.)

  3. Predicting rotator cuff tears using data mining and Bayesian likelihood ratios.

    Directory of Open Access Journals (Sweden)

    Hsueh-Yi Lu

    Full Text Available OBJECTIVES: Rotator cuff tear is a common cause of shoulder diseases. Correct diagnosis of rotator cuff tears can save patients from further invasive, costly and painful tests. This study used predictive data mining and Bayesian theory to improve the accuracy of diagnosing rotator cuff tears by clinical examination alone. METHODS: In this retrospective study, 169 patients who had a preliminary diagnosis of rotator cuff tear on the basis of clinical evaluation followed by confirmatory MRI between 2007 and 2011 were identified. MRI was used as a reference standard to classify rotator cuff tears. The predictor variable was the clinical assessment results, which consisted of 16 attributes. This study employed 2 data mining methods (ANN and the decision tree and a statistical method (logistic regression to classify the rotator cuff diagnosis into "tear" and "no tear" groups. Likelihood ratio and Bayesian theory were applied to estimate the probability of rotator cuff tears based on the results of the prediction models. RESULTS: Our proposed data mining procedures outperformed the classic statistical method. The correction rate, sensitivity, specificity and area under the ROC curve of predicting a rotator cuff tear were statistical better in the ANN and decision tree models compared to logistic regression. Based on likelihood ratios derived from our prediction models, Fagan's nomogram could be constructed to assess the probability of a patient who has a rotator cuff tear using a pretest probability and a prediction result (tear or no tear. CONCLUSIONS: Our predictive data mining models, combined with likelihood ratios and Bayesian theory, appear to be good tools to classify rotator cuff tears as well as determine the probability of the presence of the disease to enhance diagnostic decision making for rotator cuff tears.

  4. Assessment of regeneration in meniscal lesions by use of mesenchymal stem cells derived from equine bone marrow and adipose tissue.

    Science.gov (United States)

    González-Fernández, Maria L; Pérez-Castrillo, Saúl; Sánchez-Lázaro, Jaime A; Prieto-Fernández, Julio G; López-González, Maria E; Lobato-Pérez, Sandra; Colaço, Bruno J; Olivera, Elías R; Villar-Suárez, Vega

    2016-07-01

    OBJECTIVE To assess the ability to regenerate an equine meniscus by use of a collagen repair patch (scaffold) seeded with mesenchymal stem cells (MSCs) derived from bone marrow (BM) or adipose tissue (AT). SAMPLE 6 female Hispano-Breton horses between 4 and 7 years of age; MSCs from BM and AT were obtained for the in vitro experiment, and the horses were subsequently used for the in vivo experiment. PROCEDURES Similarities and differences between MSCs derived from BM or AT were investigated in vitro by use of cell culture. In vivo assessment involved use of a meniscus defect and implantation on a scaffold. Horses were allocated into 2 groups. In one group, defects in the medial meniscus were treated with MSCs derived from BM, whereas in the other group, defects were treated with MSCs derived from AT. Defects were created in the contralateral stifle joint but were not treated (control samples). RESULTS Both types of MSCs had universal stem cell characteristics. For in vivo testing, at 12 months after treatment, treated defects were regenerated with fibrocartilaginous tissue, whereas untreated defects were partially repaired or not repaired. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that MSCs derived from AT could be a good alternative to MSCs derived from BM for use in regenerative treatments. Results also were promising for a stem cell-based implant for use in regeneration in meniscal lesions. IMPACT FOR HUMAN MEDICINE Because of similarities in joint disease between horses and humans, these results could have applications in humans. PMID:27347833

  5. Incidence of MRI intensity changes in the knee meniscus. Comparing asymptomatic and symptomatic knees without meniscal lesion

    International Nuclear Information System (INIS)

    MRI has become the most frequently used imaging technique in diagnosing knee joint diseases. However, a number of factors may change the intensity of the meniscus on MR images, even in normal knees. The question remains when and to what degree the change in intensity appears with age, how aging is related to MR image grades, and how the development of symptoms is related to a change in intensity. To answer these questions, the present study investigated MR images of the menisci of asymptomatic volunteers and patients with knee diseases other than meniscal lesions to determine intrameniscal intensity changes. 163 knees in 133 subjects who underwent MRI for the knee joint (s) were examined. The coronal and the sagittal planes were imaged with T1 weighted imaging and GE slice thickness of 5 mm. MR images were classified as Grade 0 to 4. In knees of patients under 40 years of age, a change in intensity was only rarely observed in the menisci of normal knees, though it was frequently observed in those of symptomatic knees. By contrast, in the knees of patients 40 years or older, a change in intensity was frequently observed in the menisci of both normal and symptomatic knees. MRI is useful because of its convenience, low invasiveness, and high diagnostic ability. However, MR images of the meniscus should be read carefully, because the incidence of changes in intensity increases with aging or inflammation, and in symptomatic knees, the intensity change is occasionally exaggerated resulting in incorrect diagnosis. (author)

  6. Turbulence trigger for neoclassical tearing modes in tokamaks

    International Nuclear Information System (INIS)

    Stochastic trigger by microturbulence for neoclassical tearing mode (NTM) is studied. NTM induces topological change of magnetic structure and has subcritical nature. It is found that the NTM can be excited regardless of the presence of seed islands. Transition rate of probability density function for and statistically-averaged amplitude of NTM are obtained. Boundary in the phase diagram is determined as the statistical long time average of the transition conditions. NTM can be excited by crossing this boundary even in the absence of other global instabilities. The boundary is expressed in terms of the poloidal beta value. Its dependence on the ratio between the ion banana width and radius of the rational surface, ρb/rs, is found to vary in the range of ρb/rs and (ρb/rs)2, depending on the linear stability of the tearing mode. (author)

  7. Peroneal tendon tears, surgical management and its complications.

    Science.gov (United States)

    Cerrato, Rebecca A; Myerson, Mark S

    2009-06-01

    Peroneal tendon injuries in the athlete are recognized with increasing frequency as a pathologic entity. Once considered uncommon, they have been attributed to many cases of persistent lateral ankle symptoms after a "typical" ankle sprain. Acute tears of the peroneus brevis, and less commonly the peroneus longus, have been implicated in sport activities and are often coexistent with peroneal instability. Subluxation typically occurs when the foot is in a dorsiflexed position and the peroneal muscles strongly contract, causing an eversion force simultaneously. Peroneal instability, as well as tearing, has been linked to ballet dancing, skiing, soccer, tennis, American football, running, basketball, and ice skating. This article discusses the mechanism of injury, methods of patient evaluation and management, complications, and outcomes. PMID:19501808

  8. Influence of toroidal rotation on resistive tearing modes in tokamaks

    International Nuclear Information System (INIS)

    Influence of toroidal equilibrium plasma rotation on m/n = 2/1 resistive tearing modes is studied numerically using a 3D toroidal MHD code (CLT). It is found that the toroidal rotation with or without shear can suppress the tearing instability and the Coriolis effect in the toroidal geometry plays a dominant role on the rotation induced stabilization. For a high viscosity plasma (τR/τV ≫ 1, where τR and τV represent resistive and viscous diffusion time, respectively), the effect of the rotation shear combined with the viscosity appears to be stabilizing. For a low viscosity plasmas (τR/τV ≪ 1), the rotation shear shows a destabilizing effect when the rotation is large

  9. I.S.Mu.L.T - Rotator Cuff Tears Guidelines

    Science.gov (United States)

    Oliva, Francesco; Piccirilli, Eleonora; Bossa, Michela; Via, Alessio Giai; Colombo, Alessandra; Chillemi, Claudio; Gasparre, Giuseppe; Pellicciari, Leonardo; Franceschetti, Edoardo; Rugiero, Clelia; Scialdoni, Alessandro; Vittadini, Filippo; Brancaccio, Paola; Creta, Domenico; Buono, Angelo Del; Garofalo, Raffaele; Franceschi, Francesco; Frizziero, Antonio; Mahmoud, Asmaa; Merolla, Giovanni; Nicoletti, Simone; Spoliti, Marco; Osti, Leonardo; Padulo, Johnny; Portinaro, Nicola; Tajana, Gianfranco; Castagna, Alex; Foti, Calogero; Masiero, Stefano; Porcellini, Giuseppe; Tarantino, Umberto; Maffulli, Nicola

    2015-01-01

    Despite the high level achieved in the field of shoulder surgery, a global consensus on rotator cuff tears management is lacking. This work is divided into two main sessions: in the first, we set questions about hot topics involved in the rotator cuff tears, from the etiopathogenesis to the surgical treatment. In the second, we answered these questions by mentioning Evidence Based Medicine. The aim of the present work is to provide easily accessible guidelines: they could be considered as recommendations for a good clinical practice developed through a process of systematic review of the literature and expert opinion, in order to improve the quality of care and rationalize the use of resources. PMID:26958532

  10. I.S.Mu.L.T - Rotator Cuff Tears Guidelines.

    Science.gov (United States)

    Oliva, Francesco; Piccirilli, Eleonora; Bossa, Michela; Via, Alessio Giai; Colombo, Alessandra; Chillemi, Claudio; Gasparre, Giuseppe; Pellicciari, Leonardo; Franceschetti, Edoardo; Rugiero, Clelia; Scialdoni, Alessandro; Vittadini, Filippo; Brancaccio, Paola; Creta, Domenico; Buono, Angelo Del; Garofalo, Raffaele; Franceschi, Francesco; Frizziero, Antonio; Mahmoud, Asmaa; Merolla, Giovanni; Nicoletti, Simone; Spoliti, Marco; Osti, Leonardo; Padulo, Johnny; Portinaro, Nicola; Tajana, Gianfranco; Castagna, Alex; Foti, Calogero; Masiero, Stefano; Porcellini, Giuseppe; Tarantino, Umberto; Maffulli, Nicola

    2015-01-01

    Despite the high level achieved in the field of shoulder surgery, a global consensus on rotator cuff tears management is lacking. This work is divided into two main sessions: in the first, we set questions about hot topics involved in the rotator cuff tears, from the etiopathogenesis to the surgical treatment. In the second, we answered these questions by mentioning Evidence Based Medicine. The aim of the present work is to provide easily accessible guidelines: they could be considered as recommendations for a good clinical practice developed through a process of systematic review of the literature and expert opinion, in order to improve the quality of care and rationalize the use of resources. PMID:26958532

  11. Influence of toroidal rotation on resistive tearing modes in tokamaks

    Science.gov (United States)

    Wang, S.; Ma, Z. W.

    2015-12-01

    Influence of toroidal equilibrium plasma rotation on m/n = 2/1 resistive tearing modes is studied numerically using a 3D toroidal MHD code (CLT). It is found that the toroidal rotation with or without shear can suppress the tearing instability and the Coriolis effect in the toroidal geometry plays a dominant role on the rotation induced stabilization. For a high viscosity plasma (τR/τV ≫ 1, where τR and τV represent resistive and viscous diffusion time, respectively), the effect of the rotation shear combined with the viscosity appears to be stabilizing. For a low viscosity plasmas (τR/τV ≪ 1), the rotation shear shows a destabilizing effect when the rotation is large.

  12. The growth of the tearing mode - Boundary and scaling effects

    Science.gov (United States)

    Steinolfson, R. S.; Van Hoven, G.

    1983-01-01

    A numerical model of resistive magnetic tearing is developed in order to verify and relate the results of the principal approximations used in analytic analyses and to investigate the solutions and their growth-rate scalings over a large range of primary parameters which include parametric values applicable to the solar atmosphere. The computations cover the linear behavior for a variety of boundary conditions, emphasizing effects which differentiate magnetic tearing in astrophysical situations from that in laboratory devices. Eigenfunction profiles for long and short wavelengths are computed and the applicability of the 'constant psi' approximation is investigated. The growth rate is computed for values of the magnetic Reynolds number up to a trillion and of the dimensionless wavelength parameter down to 0.001. The analysis predicts significant effects due to differing values of the magnetic Reynolds number.

  13. Influence of toroidal rotation on resistive tearing modes in tokamaks

    Energy Technology Data Exchange (ETDEWEB)

    Wang, S.; Ma, Z. W., E-mail: zwma@zju.edu.cn [Institute for Fusion Theory and Simulation, Zhejiang University, Hangzhou 310027 (China)

    2015-12-15

    Influence of toroidal equilibrium plasma rotation on m/n = 2/1 resistive tearing modes is studied numerically using a 3D toroidal MHD code (CLT). It is found that the toroidal rotation with or without shear can suppress the tearing instability and the Coriolis effect in the toroidal geometry plays a dominant role on the rotation induced stabilization. For a high viscosity plasma (τ{sub R}/τ{sub V} ≫ 1, where τ{sub R} and τ{sub V} represent resistive and viscous diffusion time, respectively), the effect of the rotation shear combined with the viscosity appears to be stabilizing. For a low viscosity plasmas (τ{sub R}/τ{sub V} ≪ 1), the rotation shear shows a destabilizing effect when the rotation is large.

  14. Tear volume estimation using a modified Schirmer test: a randomized, multicenter, double-blind trial comparing 3% diquafosol ophthalmic solution and artificial tears in dry eye patients

    Science.gov (United States)

    Miyake, Hideki; Kawano, Yuri; Tanaka, Hiroshi; Iwata, Akihiro; Imanaka, Takahiro; Nakamura, Masatsugu

    2016-01-01

    Purpose We aimed to evaluate the feasibility of using a modified Schirmer test to determine the increase in tear volume after administration of 3% diquafosol ophthalmic solution (diquafosol 3%) in dry eye patients. Patients and methods A randomized, multicenter, prospective, double-blind clinical study recruited 50 qualified subjects. They received diquafosol 3% in one eye and artificial tears in the other eye. The study protocol comprised a screening and treatment procedure completed within 1 day. The Schirmer test was performed on closed eyes three times a day. The primary efficacy end points were the second Schirmer test scores 10 minutes after the single dose. Secondary end points were the third Schirmer test scores 3 hours and 40 minutes after the single dose and the symptom scores prior to the second and third Schirmer tests. Results According to the Schirmer test, 10 minutes after administration, diquafosol 3% significantly increased tear volume compared to artificial tears. Diquafosol 3% and artificial tears both showed significant improvements in the symptom scores compared to baseline. However, there was no significant difference in the symptoms score between diquafosol 3% and artificial tears. Conclusion The modified Schirmer test can detect a minute change in tear volume in dry eye patients. These findings will be useful in the diagnosis of dry eye, assessment of treatment benefits in daily clinical practice, and the development of possible tear-secreting compounds for dry eye. PMID:27257372

  15. Giant retinal tears resulting from eye gouging in rugby football.

    Science.gov (United States)

    Duguid, I G; Leaver, P K

    2000-02-01

    A 29 year old myopic man sustained two separate giant retinal tears in his right eye following deliberate eye gouging during a rugby tackle. These were successfully repaired by vitrectomy and intraocular silicone oil injection. Although the postoperative course was complicated by pupil block glaucoma, he regained corrected visual acuity of 6/5 after oil removal. This injury highlights the potentially sight threatening nature of this type of rugby injury and the importance of early referral for specialist treatment. PMID:10690454

  16. Nonlinear kinetic theory of a single helicity tearing instability

    International Nuclear Information System (INIS)

    The evolution of a single helicity tearing mode is analyzed by kinetic theory, including modification of the electron orbits by the islands themselves. Using flux coordinates approrpriate to island geometry, analytic solutions for the time-dependent island width are obtained. These describe evolution from linear growth to nonlinear saturation in the collisionless limit, and transition from such saturation to slow Rutherford-type growth for increasing finite collisionality. Previous work is thus unfied and generalized

  17. High conductivity magnetic tearing instability. [of neutral plasma sheets

    Science.gov (United States)

    Cross, M. A.; Van Hoven, G.

    1976-01-01

    Linearized equations of magnetohydrodynamics are used to investigate the tearing mode, for arbitrary values of the conductivity, through a consideration of the additional effect of the electron-inertia contribution to Ohm's law. A description is provided of the equilibrium and subsequent instability in the magnetohydrodynamic approximation. A method for solving the perturbation equations in the linear approximation is discussed and attention is given to the results in the high conductivity limit.

  18. The influence of humidity, temperature, and oral contraceptive in tear

    Science.gov (United States)

    Sousa, Raul A. R. C.; Ribeiro, Tânia L. C.; Moreira, Sandra M. B.; Baptista, António M. G.

    2013-11-01

    The aim of this study is to ascertain whether the quantity and quality of tear and eye subjective comfort are influenced by the temperature, humidity and oral Contraceptives Taking or Non-taking (CTNT). Forty-one students, females, from the University of Minho, Braga, Portugal, aged (mean+/-1standard deviation) of 21.51+/-1.85 years, ranging from 20 to 30 years, participated in this study. The McMonnies Questionnaire (MMQ), Break Up Time (BUT) and Phenol Red Test (PRT) were accessed between 14-17 hours in four sets of visits throughout the year: Visit 1, Visit 2, Visit 3 and Visit 4. The PRT and BUT values (mean+/-1standard deviation) for Visit 1, Visit 2, Visit 3 and Visit 4 were respectively 23.88+/-6.50mm, 22.29+/-8.00mm, 23.61+/-6.75mm, 22.88+/-7.00mm and 6.02+/-1.58s, 5.62+/-1.22s, 5.23+/-0.88s, 5.53+/-1. 42s. The MMQ scores for Visit 1, Visit 2, Visit 3 and Visit 4 ranged from 2-13, 2-15, 1-14 and 2-14 with medians of 6, 7, 6 and 6, respectively. The influence of temperature, humidity and CTNT on PRT, BUT and MMQ were evaluated using generalized linear mixed model. For BUT and MMQ statistical significant effects were found regarding temperature and humidity. The temperature and humidity influenced the tear quality and subjective comfort but did not influence the tear quantity. The CTNT did not influence tear quantity, quality or subjective eye comfort.

  19. Comparison of two methods of tear sampling for protein quantification by Bradford method

    Directory of Open Access Journals (Sweden)

    Eliana Farias

    2013-02-01

    Full Text Available The aim of this study was to compare two methods of tear sampling for protein quantification. Tear samples were collected from 29 healthy dogs (58 eyes using Schirmer tear test (STT strip and microcapillary tubes. The samples were frozen at -80ºC and analyzed by the Bradford method. Results were analyzed by Student's t test. The average protein concentration and standard deviation from tears collected with microcapillary tube were 4.45mg/mL ±0.35 and 4,52mg/mL ±0.29 for right and left eyes respectively. The average protein concentration and standard deviation from tears collected with Schirmer Tear Test (STT strip were and 54.5mg/mL ±0.63 and 54.15mg/mL ±0.65 to right and left eyes respectively. Statistically significant differences (p<0.001 were found between the methods. In the conditions in which this study was conducted, the average protein concentration obtained with the Bradford test from tear samples obtained by Schirmer Tear Test (STT strip showed values higher than those obtained with microcapillary tube. It is important that concentration of tear protein pattern values should be analyzed according the method used to collect tear samples.

  20. Emotional tears facilitate the recognition of sadness and the perceived need for social support.

    Science.gov (United States)

    Balsters, Martijn J H; Krahmer, Emiel J; Swerts, Marc G J; Vingerhoets, Ad J J M

    2013-01-01

    The tearing effect refers to the relevance of tears as an important visual cue adding meaning to human facial expression. However, little is known about how people process these visual cues and their mediating role in terms of emotion perception and person judgment. We therefore conducted two experiments in which we measured the influence of tears on the identification of sadness and the perceived need for social support at an early perceptional level. In two experiments (1 and 2), participants were exposed to sad and neutral faces. In both experiments, the face stimuli were presented for 50 milliseconds. In experiment 1, tears were digitally added to sad faces in one condition. Participants demonstrated a significant faster recognition of sad faces with tears compared to those without tears. In experiment 2, tears were added to neutral faces as well. Participants had to indicate to what extent the displayed individuals were in need of social support. Study participants reported a greater perceived need for social support to both sad and neutral faces with tears than to those without tears. This study thus demonstrated that emotional tears serve as important visual cues at an early (pre-attentive) level. PMID:23531802

  1. Numerical analysis of m = 1 multi-tearing mode

    International Nuclear Information System (INIS)

    Linear stability and nonlinear evolution of m = 1 multi-tearing modes, which become unstable in case there exist more than two resonant surfaces with safety factor q equal one, has been studied by using the reduced set of MHD equations in a low beta and cylindrical plasma. Results of linear calculation show that the eigenfunction corresponding to the largest eigenvalue of m = 1 multi-tearing mode takes finite value from the plasma center to one of the resonant surfaces with q equal one, and the perturbation due to the mode extends to the plasma center region. Results of nonlinear calculation show that there are two different cases of the nonlinear evolution. The first case is magnetic flux exchange including the plasma center region accompanied by the internal disruption. And the second one is the saturation of magnetic flux exchange in the local peripheral region with the plasma center region unchanged. The difference in nonlinear phenomena can be explained by the values of magnetic flux function at plasma center and each resonant surface. This local magnetic flux exchange due to m = 1 multi-tearing mode is considered to be the mechanism of double sawtooth oscillation obserbed in TFTR and Doublet III. (author)

  2. 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

  3. Noninvasive diagnostic devices for diabetes through measuring tear glucose.

    Science.gov (United States)

    Zhang, Jin; Hodge, William; Hutnick, Cindy; Wang, Xianbin

    2011-01-01

    This article reviews the development of a noninvasive diagnostic for diabetes by detecting ocular glucose. Early diagnosis and daily management are very important to diabetes patients to ensure a healthy life. Commercial blood glucose sensors have been used since the 1970s. Millions of diabetes patients have to prick their finger for a drop of blood 4-5 times a day to check blood glucose levels--almost 1800 times annually. There is a strong need to have a noninvasive device to help patients to manage the disease easily and painlessly. Instead of detecting the glucose in blood, monitoring the glucose level in other body fluids may provide a feasible approach for noninvasive diagnosis and diabetes control. Tear glucose has been studied for several decades. This article reviews studies on ocular glucose and its monitoring methods. Attempts to continuously monitor the concentration of tear glucose by using contact lens-based sensors are discussed as well as our current development of a nanostructured lens-based sensor for diabetes. This disposable biosensor for the detection of tear glucose may provide an alternative method to help patients manage the disease conveniently. PMID:21303640

  4. Tear cytokine response to multipurpose solutions for contact lenses

    Directory of Open Access Journals (Sweden)

    Kalsow CM

    2013-06-01

    Full Text Available Carolyn M Kalsow,1 William T Reindel,2 Mohinder M Merchea,2 Kirk M Bateman,2,3 Joseph T Barr21Ocular Research Services, Mendon, NY, USA; 2Bausch and Lomb, Inc, Rochester, NY, USA; 3Statistics and Data Corporation, Tempe, AZ, USAPurpose: An increased risk of corneal infiltrative events has been noted with the use of certain contact lenses and multipurpose solutions (MPS. This study was designed to evaluate tear cytokine assay as a sensitive, objective, and quantitative measure of the ocular surface response to contact lens/MPS and to consider the assay's clinical relevance in the context of other measures of ocular surface response.Methods: Two MPS, ReNu® Fresh™ (RNF and Opti-Free® RepleniSH (OFR, were used with daily wear silicone hydrogel contact lenses in a randomized, prospective crossover study involving 26 subjects. Clinical data collection (conjunctival hyperemia, ocular surface sensitivity, solution induced corneal staining (SICS test score, and subjective responses and tear cytokine assays were conducted masked. Responses were tracked as change from baseline throughout the experimental schedule.Results: Similar response patterns for several inflammatory cytokines were seen throughout both phases: subjects who received OFR in Phase I had mean tear concentrations that were generally higher than those of the RNF Phase I group. OFR Phase I subjects had significant (P < 0.01 increases over baseline at day 1 and/or following washout for 13 cytokines (cc chemokine ligands [CCL] 3, CCL5, CCL11, granulocyte-macrophage colony-stimulating factor [GM-CSF], interferon [INF]-γ, interleukin [IL]-2, IL-4, IL-5, IL-6, IL-13, IL-15, IL-17, tumor necrosis factor [TNF]-α. These changes were not observed in RNF Phase I subjects, even though SICS test scores increased. Phase I OFR subjects also had increased dryness, while RNF Phase I subjects had decreased bulbar hyperemia. No changes were detected with respect to limbal hyperemia or surface

  5. Targeted transplantation of iron oxide-labeled, adipose-derived mesenchymal stem cells in promoting meniscus regeneration following a rabbit massive meniscal defect

    Science.gov (United States)

    QI, YIYING; YANG, ZHIGAO; DING, QIANHAI; ZHAO, TENGFEI; HUANG, ZHONGMING; FENG, GANG

    2016-01-01

    Repair of a massive meniscal defect remains a challenge in the clinic. However, targeted magnetic cell delivery, an emerging technique, may be useful in its treatment. The present study aimed to determine the effect of targeted intra-articular injection of superparamagnetic iron oxide (SPIO)-labeled adipose-derived mesenchymal stem cells (ASCs) in a rabbit model of a massive meniscal defect. ASCs may be directly labeled and almost 100% of the ASCs were labeled with SPIO after 24 h; these SPIO-labeled ASCs may be orientated by magnet. The centrifuged SPIO-labeled ASCs precipitations may be detected by magnetic resonance imaging (MRI). The anterior half of the medial meniscus of 18 New Zealand Rabbits was excised. After 7 days, the rabbits were randomized to injections of 2×106 SPIO-labeled ASCs, 2×106 unlabeled ASCs or saline. Permanent magnets were fixed to the outside of the operated joints for one day, and after 6 and 12 weeks, the knee joints were examined using MRI, gross and histological observation, and Prussian blue staining. Marked hypointense artifacts caused by SPIO-positive cells in the meniscus were detected using MRI. Histological observation revealed that the anterior portion of the meniscus was similar to the native tissue, demonstrating typical fibrochondrocytes surrounded by richer extracellular matrix in the SPIO-ASCs group. Collagen-rich matrix bridging the interface and the neo-meniscus integrated well with its host meniscus. Furthermore, degenerative changes occurred in all groups, but intra-articular injection of SPIO-ASCs or ASCs alleviated these degenerative changes. Prussian blue staining indicated that the implanted ASCs were directly associated with the regenerated tissue. Overall, targeted intra-articular delivery of SPIO-ASCs promoted meniscal regeneration whilst providing protective effects from osteoarthritic damage. PMID:26893631

  6. The effect of N-acetylcysteine on the microscopic fluid dynamics of rat tears.

    Science.gov (United States)

    Tragoulias, Sophia T; Anderton, Philip J

    2001-09-01

    BACKGROUND: The classical view of the tear film is of a 10-micron film of aqueous tears, sandwiched between thin layers of lipid and mucus. This has been challenged recently by the revelation that the tear film may be considerably thicker than 10 microns and that dissolved mucus and protein may play a much more important role than simply promoting tear adherence. In particular, the primary role of mucus may be to form a structured aqueous gel that adheres closely to the corneal surface and evens out its irregularities, thus providing a high-quality optical surface. METHODS: We have used the robust tear film of the rat eye as an animal model to investigate the contribution of mucus and low-molecular-weight (LMW) proteins to tear film structure. The ocular surface was first exposed to saline, which washed away the tear film. Single drops of a tear/saline mixture, treated with various concentrations of the thiol-reducing agent N-acetylcysteine (NAC), were placed on the ocular surface and the resulting fluid behaviour was recorded with video-microscopy. RESULTS: At five per cent concentration, NAC appeared to degrade the gap-filling and anti-evaporative qualities of the tears, features that give the rat tear film its robust characteristics. Lower concentrations had no significant effect. DISCUSSION: In a previous publication, we showed that five per cent NAC alters the profile of LMW proteins in rat tears. The present observations suggest that the robust wetting properties of rat tears depend critically on their mucus and/or LMW protein content and possibly are related to the formation of an aqueous/mucous gel. PMID:12366370

  7. Effect of Time after Anterior Cruciate Ligament Tears on Proprioception and Postural Stability

    OpenAIRE

    Lee, Dae-Hee; Lee, Jin-Hyuck; Ahn, Sung-Eun; Park, Min-Ji

    2015-01-01

    This study was designed to compare proprioception and postural stability in patients with acute (time from injury ≤ 3 months) and chronic (time from injury > 3 months) ACL tears, and to evaluate the correlation between time interval after ACL injury and proprioception. Thigh muscle strength, postural stability, and joint position sense were compared in 48 patients with acute ACL tears and in 28 with chronic ACL tears. Maximal torque (60°/sec) of the quadriceps and hamstring was evaluated usin...

  8. Pectoralis major tears: anatomy, classification, and diagnosis with ultrasound and MR imaging

    International Nuclear Information System (INIS)

    Accurate characterization of pectoralis major tears is important to guide management. Imaging evaluation with ultrasound and MR imaging can be difficult given the complex regional anatomy. In addition, recent literature has redefined the anatomy of the distal pectoralis major. The purpose of this study is to review pectoralis major injuries taking into account new anatomic descriptions using ultrasound and MR imaging, including cadaveric dissection, surgically produced pectoralis tears, and clinical pectoralis tendon tear with surgical correlation. (orig.)

  9. Tears of anterior cruciate ligament and associated injury in the knee joint: MR imaging

    International Nuclear Information System (INIS)

    The objective of the study was to evaluate the characteristic findings in tears of the anterior cruciate ligament(ACL) and associated injury at MR imaging. We reviewed the findings of MR images and the corresponding arthroscopic results of 32 patients with ACL tears. We evaluated the signal intensity and contour of ACL surrounding bony structures, menisci and associated injury of the knee joint. Complete ACL tears were present in 25 patients and partial ACL tears were in 7 patients. Complete ACL tears showed heterogenously increased signal intensity with contour bulging of the ACL in 14 patients (56%) and without bulging or absence in 11 patients(44%). Most patients torn ACL with contour bulging(12/14) had bone bruise, but only one patient torn ACL without bulging contour had bone bruise. ACL with thin continuous low signal band surrounding heterogenously increased signal intensity suggests partial tear which was seen in three patients of seven proved partial ACL tears. Combined bone injury in ACL tear were in 23 patients (73%) and most of these(22/23) were at midportion of lateral notch of femur and/or posterior portion of lateral tibial plateu. Deepening of lateral notch of femur were noted in 17 patients(53%). Associated injuries of the other ligaments of knee joint were buckling of the posterior cruciate ligament(16/32, 50%) and tears of the medial collateral ligament(11/32, 34%). Posterior horns of menisci were more frequent site of combined injury within menisci in patients with ACL tear. Acute tearing of ACL in MRI is seen as heterogenously increased signal intensity with contour bulging of ACL and combined bone bruises. Patients with torn ACL frequently have various combined injury. In patient with knee injury, these associated or ancillary findings suggest that ACL tear is present

  10. Biomechanical Consequences of a Complete Radial Tear Adjacent to the Medial Meniscus Posterior Root Attachment Site

    OpenAIRE

    LaPrade, Robert F.; Padalecki, Jeffrey Ryan; Jansson, Kyle; Smith, Sean; Dornan, Grant; Pierce, Casey; Wijdicks, Coen A

    2014-01-01

    Objectives: Complete radial tears near the medial meniscus posterior root attachment site disrupt the circumferential integrity of the meniscus (similar to a posterior root avulsion). These tears can compromise the circumferential integrity and have been reported in biomechanical studies to simulate the meniscectomized state. The purpose of the study was to quantify the tibiofemoral contact load and contact area changes that occur in cadaveric knees from complete posterior horn radial tears a...

  11. The Effect Of Weave Construction On Tear Strength Of Woven Fabrics

    Directory of Open Access Journals (Sweden)

    Eryuruk Selin Hanife

    2015-09-01

    Full Text Available The tear strength of a woven fabric is very important, since it is more closely related to serviceability of the fabric. Tearing strength of the fabrics depend on the mobility of the yarn within the fabric structure. In this study, the tearing strength of four types of fabrics warp rib, weft rib, ripstop and plain weave were analysed, which were produced in different densities and with filament and texturised polyester yarns.

  12. Evaluation of Tear Malate Dehydrogenase 2 in Mild Dry Eye Disease

    Institute of Scientific and Technical Information of China (English)

    Qing Guo; Houbin Huang; Yuli Pi; Hancheng Zhang

    2014-01-01

    Purpose: To evaluate the effect of tear malate dehydrogenase 2 on monitoring ocular surface injury in mild dry eye (DE) disease. Methods: A total of 15 DE patients (30 eyes) with mild sub-jective symptoms but no ocular surface fluorescein staining signs were enrolled in this study. (DE group)..The control group was 15 healthy age- and sex-matched volunteers (30 eyes)..All subjects were asked to fill out a DE symptoms questionnaire and take different tests including tear MDH and MDH2 activities evaluation,..tear breakup time. (TBUT), Schirmer I,.and slit-lamp examination of the ocular surface. We investigated different changes in tear MDH and MDH2 ac-tivities in the DE group and control group,.discussed the as-sociation between tear MDH2 activity and DE symptoms, and the relationship between tear MDH2 activity and diagnostic tests (Schirmer I and TBUT). We also analyzed the changes in tear MDH2 activities after the treatment with artificial tears. Results:.Tear MDH activities in the DE group and control group were 288 ±102 U/L and 259 ±112 U/L,.respectively, and this difference was not statistically significant (P>0.05). The tear MDH2 activities in DE group were significantly in-creased compared with control group. Tear MDH2 was signif-icantly and negatively correlated with the Schirmer’s value (r=-0.733,P Conclusion: Tear MDH2 activity can indicate ocular surface injury in mild DE patients and may be used to monitor the re-sponse to therapy.

  13. Successful management of retinal tear post-laser in situ keratomileusis retreatment.

    OpenAIRE

    Vakili, Roya; Tauber, Shachar; Lim, Edward S.

    2002-01-01

    PURPOSE: To report a successful case management of a retinal tear post-Laser in situ Keratomileusis (LASIK) and retreatment. RESULTS: A patient with the history of ocular trauma underwent LASIK procedure for myopic astigmatism. Three months post-LASIK, she received additional excimer laser treatment for a symptomatic persistent central island. One month later; the patient experienced a flap tear at the edge of a prior chorioretinal scar. Retinal tear repair was successfully accomplished by in...

  14. Review article: Risk factors for poor outcome following surgical treatment for rotator cuff tear.

    Science.gov (United States)

    Sahni, V; Narang, A M

    2016-08-01

    The Medline database was searched using key words: 'rotator cuff', 'tear', and 'treatment'. 12 studies that involved (1) surgical treatment for rotator cuff tear, (2) measurement of pre- and post-operative pain score, functional score, and/or patient satisfaction, (3) patients that failed to improve functionally or had poor satisfaction, (4) preoperative examination of risk factors that could lead to poor outcome, and (5) a minimum follow-up of 6 months were reviewed to identify risk factors associated with poor outcome following surgical treatment for rotator cuff tear. The most common risk factor was tear size, followed by open compensation claim, age, and time from injury to surgery. PMID:27574276

  15. Radial tear of posterior horn of the medial meniscus and osteonecrosis of the knee

    International Nuclear Information System (INIS)

    We studied the relation between a radial tear of the posterior horn of the medial meniscus and osteonecrosis of the knee. Thirty-eight knees of 37 patients were diagnosed as medial meniscus tear and received arthroscopic knee surgery. We divided them into two groups: knees having radial tear of the posterior horn of the medial meniscus (posterior horn group) and knees containing radial tear except for posterior horn, horizontal tear, degenerative tear, and flap tear of the medial meniscus (non-posterior horn group). The posterior horn group consisted of 14 knees (average age: 65.1 years old) and the non-posterior horn group consisted of 24 knees (average age: 59.6 years old). All cases underwent MRI before arthroscopy. MRI findings were classified into three types (typical osteonecrosis, small osteonecrosis, and non-osteonecrosis). In the posterior horn group, typical osteonecrosis were five knees and small osteonecrosis were five knees, while in the non-posterior horn group only three knees were small osteonecrosis. These findings suggest the relevance between radial tear of the posterior horn of the medial meniscus and osteonecrosis of the knee (Mann-Whitney test p<0.01). The etiology of spontaneous osteonecrosis of the knee joint is unknown, however one etiology could be the radial tear of the posterior horn of the medial meniscus. (author)

  16. Self-monitoring of tear glucose: the development of a tear based glucose sensor as an alternative to self-monitoring of blood glucose.

    Science.gov (United States)

    La Belle, Jeffrey T; Adams, Anngela; Lin, Chi-En; Engelschall, Erica; Pratt, Breanna; Cook, Curtiss B

    2016-07-28

    Tear glucose sensing for diabetes management has long been sought as an alternative to more invasive self-monitoring of blood glucose (SMBG). However, tear glucose sensors were known to have limitations, including correlation issues with blood glucose due to low sample volume, low concentration of glucose in the tear fluid, and evaporation of the tear sample. An engineering design approach to solve these problems led to the development of an integrated device capable of collecting the tear sample from the ocular surface with little to no stress on the eye, with an extremely low limit of detection, broad dynamic range, and rapid detection and analysis of sample. Here we present the development of a prototypical self-monitoring of tear glucose (SMTG) sensor, summarizing bench studies on the enzymes and their specificity, the development of the fluid capture device and its manufacture and performance and results of system testing in an animal study where safety, lag time and tear glucose to blood glucose correlation were assessed. PMID:27327531

  17. Supersonic regime of the Hall-magnetohydrodynamics resistive tearing instability

    OpenAIRE

    Ahedo Galilea, Eduardo; Ramos, Jesús J.

    2012-01-01

    An earlier analysis of the Hall-magnetohydrodynamics (MHD) tearing instability [E. Ahedo and J. J. Ramos, Plasma Phys. Controlled Fusion 51, 055018 (2009)] is extended to cover the regime where the growth rate becomes comparable or exceeds the sound frequency. Like in the previous subsonic work, a resistive, two-fluid Hall-MHD model with massless electrons and zero-Larmor-radius ions is adopted and a linear stability analysis about a force-free equilibrium in slab geometry is carried out. A s...

  18. Transport threshold model of subsonic neoclassical tearing modes in tokamaks

    International Nuclear Information System (INIS)

    A transport threshold model of subsonic neoclassical tearing modes (NTMs) in tokamaks is developed. The basic procedure is to include the velocity-dependent term into the single-fluid heat-conductivity equation and to complement this equation with the single-fluid parallel plasma motion equation. These equations permit the determination of the perturbed plasma temperature and the bootstrap current drive of NTMs, for both strong and weak perpendicular heat transport, which is the precondition for developing the above model. It is shown that the subsonic NTMs transport threshold model can be more realistic than the standard transport model of NTMs suggested by Fitzpatrick [Phys. Plasmas 2, 825 (1995)

  19. Ultrasonographic features of an adductor longus tear: case report

    International Nuclear Information System (INIS)

    Muscle strain of the lower extremities is among the most common injuries in sports. Excessive force, rather than direct trauma, causes disruption of the muscle-tendon unit, usually at the myotendinous junction, and improper rest and rehabilitation of a minor strain can often lead to a far more disabling injury. High-resolution ultrasonography is useful for direct imaging of muscle injuries. We present a case where ultrasonography was used to detect, treat and follow-up an adductor longus tear in a soccer player. (author)

  20. Dynamic modelling of tearing mode stabilization by RF current drive

    International Nuclear Information System (INIS)

    The theory of tearing mode stabilization in toroidal plasmas by RF-driven currents that are modulated in phase with the island rotation is investigated. A time scale analysis of the phenomena involved indicates that transient effects, such as finite time response of the driven currents, island rotation during the power pulses, and the inductive response of the plasma, are intrinsically important. A dynamic model of such effects is developed, based on a 3-D Fokker-Planck code coupled to both the electric field diffusion and the island evolution equations. Extensive applications to both Electron Cyclotron and Lower Hybrid current drive in ITER are presented. (author)

  1. The Changes of Tear Status after Conventional and Wavefront-Guided IntraLASIK

    Science.gov (United States)

    Foo, Say Kiang; Kaur, Sharanjeet; Abd Manan, Faudziah; Low, Aloysius Joseph

    2011-01-01

    Background: IntraLASIK is a LASIK surgery that involved IntraLase femtosecond laser for the corneal flap creating. The objective of this research was to investigate and compare the changes in tear status at 1 and 3 months after undergoing conventional IntraLASIK with Bausch & Lomb PlanoScan (PS) algorithm, Bausch & Lomb Zyoptix Tissue Saving (ZTS) algorithm, and wavefront-guided (WG) IntraLASIK with VISX CustomVue. Methods: Tear status of 36 patients who were divided into 3 groups depending on the type of IntraLASIK they underwent (PS, n = 13; ZTS, n = 9; WG, n = 14) was evaluated. Tear status was determined by classifying the category of the thickness of pre-corneal tear lipid layer, non-invasive tear break-up time, and tear meniscus height. Repeated measures analysis of variance (ANOVA) and one way ANOVA were used for the statistical analyses. Results: The category of the thickness of tear lipid layer, non-invasive tear break up time and tear meniscus height were neither significantly changed after IntraLASIK for all groups nor showed significant difference among groups at 1 and 3 months post-IntraLASIK (P > 0.05). Blinking rate and palpebral aperture also had no significant changed after IntraLASIK. Conclusion: Both conventional (PS and ZTS) and WG IntraLASIK did not affect tear status up to 3 months post-IntraLASIK. WG IntraLASIK did not show superiority in preserving tear status 1 and 3 months post-surgery compared with conventional IntraLASIK. PMID:22135584

  2. Tearing resistance of aged cast austenitic stainless steels

    International Nuclear Information System (INIS)

    CF8 and CF8M type cast stainless steels containing about 10 to 25 % ferrite are used in the primary piping of light water reactors (PWRs and BWRs). It is now recognized that these materials are embrittled by thermal aging at the operating temperature (between 2900C and 3300C), mainly due to precipitation hardening of the ferrite by α', and other phases. Extensive research programs are under way in several countries to better understand the mechanisms of embrittlement and to determine the mechanical properties of components as a function of aging time and temperature. In earlier studies thermal aging embrittlement was mainly characterized by the evolutions of the tensile and Charpy impact properties. However the evaluation of reactor coolant circuit integrity through mechanical analyses requires the knowledge of fracture toughness properties. The first measurements of the tearing resistance of a CF8M type severely aged material were presented in 1983 by SLAMA, PETREQUIN and MAGER. Other contributions to the knowledge of the fracture toughness of aged materials were published, but were relative to medium or high toughness materials. The objective of this paper is to present the results of tearing resistance measurements made on a large spectrum of severely embrittled materials, which allow to give lower bound properties for aged CF8 and CF8M type cast stainless steels

  3. Effect of loading on stable tearing of wide plates

    International Nuclear Information System (INIS)

    A series of wide plate tests using a 0.36% carbon steel have been carried out in the AEA Structural Features Test Facility to determine the stable tearing behaviour of cracks under different loading conditions, typical of pressurized components. The majority of the plates were edge cracked. They were tested in pure in-plane bending, pure ligament tension, nominal tension and cyclic tensile loading. These tests can be compared with large centre cracked wide plates, described in a companion paper at this conference. Small scale fracture toughness tests were also made of the same material. It was found that Failure Assessment Diagrams (FADs) could be used to plot out the results and showed that the assessment line gave a good failure prediction or was conservative. The very conservative evaluation of a plate in bending cannot currently be explained. Where there was combined fatigue and tearing, linearly adding crack growth due to the different processes well predicted the results. For a surface breaking defect, initiation is well predicted from using a local limit load in the FAD, but as loads increase towards net section yield, the global limit load is more appropriate. 4 figs., 1 tab

  4. Spanish Consensus Statement: The Treatment of Muscle Tears in Sport.

    Science.gov (United States)

    Fernandez-Jaén, Tomas F; Rey, Guillermo Álvarez; Cuesta, Jordi Ardevol; Loureda, Rafael Arriaza; España, Fernando Ávila; Matas, Ramón Balius; Pazos, Fernando Baró; de Dios Beas Jiménez, Juan; Rosell, Jorge Candel; Fernandez, César Cobián; Ros, Francisco Esparza; Colmenero, Josefina Espejo; de Prado, Jorge Fernández; Cota, Juan José García; González, Jose Ignacio Garrido; Santander, Manuela González; Munilla, Miguel Ángel Herrador; Ruiz, Francisco Ivorra; Díaz, Fernando Jiménez; Marqueta, Pedro Manonelles; Fernandez, Antonio Maestro; Benito, Juan José Muñoz; Vilás, Ramón Olivé; Teres, Xavier Peirau; Amaro, José Peña; Roque, Juan Pérez San; Parenteu, Christophe Ramírez; Serna, Juan Ribas; Álvarez, Mikel Sánchez; Marchori, Carlos Sanchez; Soto, Miguel Del Valle; Alonso, José María Villalón; García, Pedro Guillen; de la Iglesia, Nicolas Hugo; Alcorocho, Juan Manuel Lopez

    2015-12-01

    On the 21st of March, 2015, experts met at Clínica CEMTRO in Madrid, Spain, under the patronage of The Spanish Society for Sports Traumatology (SETRADE), The Spanish Federation of Sports Medicine (FEMEDE), The Spanish Association of Medical Services for Football Clubs (AEMEF), and The Spanish Association of Medical Services for Basketball Clubs (AEMB) with the aim of establishing a round table that would allow specialists to consider the most appropriate current general actions to be taken when treating muscle tears in sport, based on proven scientific data described in the medical literature. Each expert received a questionnaire prior to the aforementioned meeting comprising a set of questions concerning therapeutic indications generally applied in the different stages present during muscle repair. The present Consensus Document is the result of the answers to the questionnaire and resulting discussion and consensus over which are the best current indications in the treatment of muscle tears in sport. Avoiding immobilization, not taking nonsteroidal anti-inflammatory drugs (NSAIDs) randomly, fostering early mobilization, increasing vascularization of injured, site and regulating inflammatory mechanisms-without inhibiting these from the early stages of the recovery period-all stood out as main points of the Consensus Document. Additionally, there is controversy concerning cell stimulation techniques and the use of growth factors or cell inhibitors. The decision concerning discharge was unanimous, as was the criteria considered when it came to performing sport techniques without pain. PMID:27213161

  5. Fast reconnection in relativistic plasmas: the magnetohydrodynamics tearing instability revisited

    CERN Document Server

    Del Zanna, L; Landi, S; Bugli, M; Bucciantini, N

    2016-01-01

    Fast reconnection operating in magnetically dominated plasmas is often invoked in models for magnetar giant flares, for magnetic dissipation in pulsar winds, or to explain the gamma-ray flares observed in the Crab nebula, hence its investigation is of paramount importance in high-energy astrophysics. Here we study, by means of two dimensional numerical simulations, the linear phase and the subsequent nonlinear evolution of the tearing instability within the framework of relativistic resistive magnetohydrodynamics, as appropriate in situations where the Alfven velocity approaches the speed of light. It is found that the linear phase of the instability closely matches the analysis in classical MHD, where the growth rate scales with the Lundquist number S as S^-1/2, with the only exception of an enhanced inertial term due to the thermal and magnetic energy contributions. In addition, when thin current sheets of inverse aspect ratio scaling as S^-1/3 are considered, the so-called "ideal" tearing regime is retriev...

  6. The "ideal" tearing mode: theory and resistive MHD simulations

    CERN Document Server

    Del Zanna, L; Papini, E; Pucci, F; Velli, M

    2016-01-01

    Classical MHD reconnection theories, both the stationary Sweet-Parker model and the tearing instability, are known to provide rates which are too slow to explain the observations. However, a recent analysis has shown that there exists a critical threshold on current sheet's thickness, namely a/L~S^(-1/3), beyond which the tearing modes evolve on fast macroscopic Alfvenic timescales, provided the Lunquist number S is high enough, as invariably found in solar and astrophysical plasmas. Therefore, the classical Sweet-Parker scenario, for which the diffusive region scales as a/L~S^(-1/2) and thus can be up to ~100 times thinner than the critical value, is likely to be never realized in nature, as the current sheet itself disrupts in the elongation process. We present here two-dimensional, compressible, resistive MHD simulations, with S ranging from 10^5 to 10^7, that fully confirm the linear analysis. Moreover, we show that a secondary plasmoid instability always occurs when the same critical scaling is reached o...

  7. Measurement of tear glucose levels with amperometric glucose biosensor/capillary tube configuration.

    Science.gov (United States)

    Yan, Qinyi; Peng, Bo; Su, Gang; Cohan, Bruce E; Major, Terry C; Meyerhoff, Mark E

    2011-11-01

    An amperometric needle-type electrochemical glucose sensor intended for tear glucose measurements is described and employed in conjunction with a 0.84 mm i.d. capillary tube to collect microliter volumes of tear fluid. The sensor is based on immobilizing glucose oxidase on a 0.25 mm o.d. platinum/iridium (Pt/Ir) wire and anodically detecting the liberated hydrogen peroxide from the enzymatic reaction. Inner layers of Nafion and an electropolymerized film of 1,3-diaminobenzene/resorcinol greatly enhance the selectivity for glucose over potential interferences in tear fluid, including ascorbic acid and uric acid. Further, the new sensor is optimized to achieve very low detection limits of 1.5 ± 0.4 μM of glucose (S/N = 3) that is required to monitor glucose levels in tear fluid with a glucose sensitivity of 0.032 ± 0.02 nA/μM (n = 6). Only 4-5 μL of tear fluid in the capillary tube is required when the needle sensor is inserted into the capillary. The glucose sensor was employed to measure tear glucose levels in anesthetized rabbits over an 8 h period while also measuring the blood glucose values. A strong correlation between tear and blood glucose levels was found, suggesting that measurement of tear glucose is a potential noninvasive substitute for blood glucose measurements, and the new sensor configuration could aid in conducting further research in this direction. PMID:21961809

  8. Review of recent results on the quasilinear evolution of tearing modes

    International Nuclear Information System (INIS)

    A review of recent results on the quasilinear evolution of tearing modes is presented. It is explicitly shown that a spectrum of tearing modes produces a positive anomalous resistivity that causes enhanced flux diffusion and that the resistive equilibrium flow modifies the rate at which a magnetic island grows. (Author)

  9. Nonlinear simulation of tearing mode and m=1 kink mode based on kinetic RMHD model

    International Nuclear Information System (INIS)

    In this paper, we investigate dynamics of sawtooth oscillation and neoclassical tearing modes based on kinetic RMHD model, putting an emphasis on interaction with microscopic and transport processes. The simulation results show that the assumption in the conventional theory of neoclassical tearing mode is rather rude. (author)

  10. Nonlinear tearing mode study using the almost ideal magnetohydrodynamics (MHD) constraint

    International Nuclear Information System (INIS)

    The tearing mode is an important resistive magnetohydrodynamics (MHD) mode. It perturbs the initial equilibrium magnetic flux surfaces through magnetic field line reconnection to form new flux surfaces with magnetic islands. In the study of the tearing mode, usually the initial equilibria are one dimensional with two ignorable coordinates and the perturbed equilibria are two dimensional with one ignorable coordinate. The tearing mode can be linearly unstable and its growth saturates at a fine amplitude. The neoclassical tearing mode theory shows that the mode can be nonlinearly driven by the bootstrap current even when it is linearly stable to the classical tearing mode. It is important to study the nonlinear behavior of the tearing mode. As an intrinsically nonlinear approach, the use of the almost ideal MHD constraint is suited to study the nonlinear properties of the tearing mode. In this paper, as a validation of the method, the authors study two characteristics of the tearing mode using the almost ideal MHD constraint: (1) the linear stability condition for the initial one dimensional equilibrium; and (2) the final saturation level for the unstable case. In this work, they only consider the simplest case where no gradient of pressure or current density exists at the mode resonant surface

  11. Measurement of the Time Course of Optical Quality and Visual Deterioration during Tear Break-Up

    OpenAIRE

    Liu, Haixia; THIBOS, LARRY; Begley, Carolyn G.; Bradley, Arthur

    2010-01-01

    In this study, a new optical system was developed that simultaneously measured optical quality and visual performance during monitoring of tear film instability. The results confirmed that blurry vision symptoms reported by contact lens patients are caused by the poor quality of the retinal image due to tear break-up.

  12. Diagnostic imaging of the nasolacrimal drainage system. Part I. Radiological anatomy of lacrimal pathways. Physiology of tear secretion and tear outflow

    OpenAIRE

    Maliborski, Artur; Różycki, Radosław

    2014-01-01

    Excessive watering of the eye is a common condition in ophthalmological practice. It may be the result of excessive production of tear fluid or obstruction and insufficiency of efferent tear pathways. The differentiation between obstruction and insufficiency of the lacrimal pathways is still clinically questionable. In the diagnostic process it is necessary to perform clinical tests and additional diagnostic imaging is often needed. Dacryocystography, with or without the extension of the dyna...

  13. Significance of tear β2-MG radioimmunoassay in herpes simplex keratitis

    International Nuclear Information System (INIS)

    Levels of tear and serum β2-MG are determined with radioimmunoassay in 35 patients with herpes simplex keratitis and 40 normal subjects. The results show that tear β2-MG levels of patients with herpes simplex keratitis (13.21 +- 6.15 mg/l) and normal subjects (8.43 +- 1.52 mg/l) are significantly different (P2-MG levels of tear and that of serum in normal subjects (P2-MG levels of tear and that of serum in patients with herpes simplex keratitis (P2-MG levels of patients with herpes simplex keratitis and that of normal subjects (P>0.05). The β2-MG levels of tear is higher than that of serum in normal subjects which reflects more correctly immune condition of patients with herpes simplex keratitis than that of serum

  14. The impact of lipid composition on the stability of the tear fluid lipid layer

    DEFF Research Database (Denmark)

    Kulovesi, P.; Telenius, J.; Koivuniemi, A.;

    2012-01-01

    The tear fluid protects the corneal epithelium from drying and pathogens and it also provides nutrients to these cells. Tear fluid is composed of an aqueous layer as well as a lipid layer that resides at the air-tear interface. The function of the lipid layer is to lower the surface tension of the...... tear fluid and probably prevent evaporation. We have studied the impact of lipid composition on the structural and dynamical properties of the tear lipid film using Langmuir films, X-ray diffraction, and coarse-grained molecular dynamics simulations. Based on recently published lipidomic data, we have...... selected a number of model systems comprised of phospholipids, cholesteryl oleates, triglycerides, and free fatty acids to study how the organization, stability, and dynamics of the lipid layer depend on its composition. In particular our aim is to unravel how excess neutral lipids affect the stability and...

  15. Formulation of tearing energy for fatigue life evaluation of rubber material

    International Nuclear Information System (INIS)

    Fatigue life of metal material can be predicted by the use of fracture theory and experimental database. Although prediction of fatigue life of rubber material uses the same way as metal, there are many reasons to make it almost impossible. One of the reasons is that there is not currently used fracture criteria for rubber material because of non-standardization, various way of composition process of rubber and so on. Tearing energy is one of the fracture criteria which can be applied to a rubber. Even if tearing energy relaxes the restriction of rubber composition, it is also not currently used because of complication to apply in. Research material about failure process of rubber and tearing energy was reviewed to define the process of fatigue failure and the applicability of tearing energy in estimation of fatigue life for rubber. Also, finite element formulation of tearing energy which can be used in FE analysis was developed

  16. MRI of lesser metatarsophalangeal joint plantar plate tears and associated adjacent interspace lesions

    International Nuclear Information System (INIS)

    To identify the variety of second and third intermetatarsal space (IS) lesions that may coexist with and without adjacent metatarsophalangeal joint (MTP) plantar plate (PP) tears. One hundred forefoot MRIs in 96 patients with metatarsalgia obtained between 30 September 2011 and 21 July 2012 using 1.5- or 3-T MRI were retrospectively reviewed in consensus by two MSK radiologists and one podiatrist (DPM). MRI was evaluated for second and third MTP PP tear and the presence/nature of second and third IS lesions. Second and third IS neuromas were measured in transverse (trans) dimension. A total of 40 PP tears were identified: 36 at the second and 4 at the third MTP. Second MTP PP tear was identified in 33 % of females and 40.5 % of males. In the 63 female feet there were 21 second MTP PP tears, all of which also had second IS lesions: pericapsular fibrosis (16), bursitis (4), and ganglion (1). In the 37 male feet there were 15 second MTP PP tears, 14 of which had second IS lesions: pericapsular fibrosis (8), bursitis (5), and ganglion (1). There was no definite second IS neuroma adjacent to any second MTP PP tear. In females without PP tear, there were 24 second (3 mm trans average) and 43 third IS neuromas (4.1 mm trans average). In males without PP tear, there were 9 second (3.4 mm trans average) and 16 third IS neuromas (4.1 mm trans average). MTP PP tears occurred in 40 % of our cases, 90 % of which occurred at the second MTP. Almost all coexisted with non-neuromatous second IS lesions. (orig.)

  17. Standard sonography and arthrosonography in the study of rotator cuff tears

    International Nuclear Information System (INIS)

    Purpose. The aim of this study was to evaluate the sensitivity of ultrasonography, integrating standard ultrasound and arthrosonography after injecting a saline solution into the glenohumeral cavity in cases of suspected rotator cuff tears. Materials and methods. We respectively examinated 40 patients awaiting shoulder arthroscopy for suspected or diagnosed tears of the rotator cuff. A radiologist, unaware of the pre-operative diagnosis, performed an ultrasound scan on all the patients before and after the injection of saline solution into the glenohumeral cavity. The parameters considered were presence or absence of a rotator cuff injury; type of injury according to Snyder and its extent along the longitudinal and transverse planes; presence or absence of effusion into the articular cavity; subacromial/subdeltoid bursal distension. All the patients underwent arthroscopy either the same day of the day after the ultrasound examination. Results. Standard sonography showed 26 complete rotator cuff tears (type C according to Snyder), 2 partial tears (type B according to Snyder) and 12 intact rotator cuffs. Arthrosonography detected 31 complete rotator cuff tears (type C according to Snyder), 1 partial tear (type B according to Snyder) and 8 intact rotator cuffs. Arthroscopy identified 32 complete rotator cuff tears (type C according to Snyder), 1 partial tear (type B according to Snyder) and 8 intact rotator cuffs. Analysis of the results shows that, taking arthroscopy as the gold standard, the sensitivity of normal sonography is 81.2%, whereas that of arthosonography is 96.8% (p<0.05). Conclusions. On the basis of the data obtained in this study, standard sonography , integrated with the injection of a saline solution into the glenohumeral cavity, considerably increases the diagnostic sensitivity for rotator cuff tears. The authors suggest that arthrosonography can be used in the event of suspected rotator tears, when MRI is contraindicated

  18. MRI of lesser metatarsophalangeal joint plantar plate tears and associated adjacent interspace lesions

    Energy Technology Data Exchange (ETDEWEB)

    Umans, Hilary [Albert Einstein College of Medicine and Lenox Hill Radiology Imaging and Associates, Bronx, NY (United States); Srinivasan, Ramya; Elsinger, Elisabeth [Albert Einstein College of Medicine, Bronx, NY (United States); Wilde, Gregory E. [Lenox Hill Radiology Imaging and Associates, Bronx, NY (United States)

    2014-10-15

    To identify the variety of second and third intermetatarsal space (IS) lesions that may coexist with and without adjacent metatarsophalangeal joint (MTP) plantar plate (PP) tears. One hundred forefoot MRIs in 96 patients with metatarsalgia obtained between 30 September 2011 and 21 July 2012 using 1.5- or 3-T MRI were retrospectively reviewed in consensus by two MSK radiologists and one podiatrist (DPM). MRI was evaluated for second and third MTP PP tear and the presence/nature of second and third IS lesions. Second and third IS neuromas were measured in transverse (trans) dimension. A total of 40 PP tears were identified: 36 at the second and 4 at the third MTP. Second MTP PP tear was identified in 33 % of females and 40.5 % of males. In the 63 female feet there were 21 second MTP PP tears, all of which also had second IS lesions: pericapsular fibrosis (16), bursitis (4), and ganglion (1). In the 37 male feet there were 15 second MTP PP tears, 14 of which had second IS lesions: pericapsular fibrosis (8), bursitis (5), and ganglion (1). There was no definite second IS neuroma adjacent to any second MTP PP tear. In females without PP tear, there were 24 second (3 mm trans average) and 43 third IS neuromas (4.1 mm trans average). In males without PP tear, there were 9 second (3.4 mm trans average) and 16 third IS neuromas (4.1 mm trans average). MTP PP tears occurred in 40 % of our cases, 90 % of which occurred at the second MTP. Almost all coexisted with non-neuromatous second IS lesions. (orig.)

  19. Water soluble drug releasing soft contact lens in response to pH of tears

    Science.gov (United States)

    Kim, G.; Noh, H.

    2016-06-01

    Human tear characteristics including pH and compositions can vary significantly depending on physical and environmental factors. Contact lenses directly contact with human tears can be swelled or de-swelled depending on the pH of the solution due to the nature of the hydrogel. For examples, anionic hydrogels, when the solution's pH is low, is shrunken due to the electric attraction force within the hydrogel network; the opposite phenomenon appears when the solution is basic. The purpose of this study was to evaluate the extent of water soluble drug, hydroxyl propyl methyl cellulose, released from contact lens according to the pH of the artificial tears. Artificial tears are prepared by mixing lysozyme, albumin, sodium chloride, potassium chloride, and calcium chloride following physiological concentrations. Hydrogel contact lens was thermally polymerized using HEMA, EGDMA, and AIBN. The prepared hydrogel lens was immersed in drug for 3 hours and the eluted drug mass was measured as a function of the time. As a result, the drug was released from the lens for 12 hours in all the pH of artificial tears. At the lower pH of artificial tears (pH 5.8), the total amount of dye emitted from the lens was increased than the total amount of dye emitted at the basic tear (pH 8.4). Also, initial burst at acidic tears was increased within 1 hour. Release pattern of water-soluble drug from hydrogel lens turned out to be different depending on the pH of the artificial tears. When designing drug releasing contact lens, physiological pH of tears should be considered.

  20. Anatomical and visual outcomes of ranibizumab injections in retinal pigment epithelium tears

    Directory of Open Access Journals (Sweden)

    Muhammet Kazım Erol

    2015-06-01

    Full Text Available ABSTRACT Purpose: To report the anatomical and visual results in patients diagnosed as having retinal pigment epithelium (RPE tears after receiving ranibizumab injections. Methods: Eyes diagnosed as having RPE tears with a minimum 6-month follow-up were retrospectively evaluated. Each eye was treated with at least three doses of ranibizumab at monthly intervals. Best-corrected visual acuity (BCVA, anterior segment findings, intraocular pressure, and fundus examination results were evaluated during control visits. Color fundus photography, fundus fluorescein angiographies, fundus autofluorescence, and spectral domain optical coherence tomography (SD-OCT images were obtained. The height of pigment epithelial detachment (PED was measured by SD-OCT. Results: Twelve eyes with RPE tears were studied. Nine eyes (75% developed RPE tears during ranibizumab injections for choroidal neovascularization (eight eyes with vascularized PED and one eye with choroidal osteoma, and tears occurred in three eyes before any injections. The median number of ranibizumab injections after diagnosis of RPE tears was 3 (min 2, max 5. In the most recent follow-up visit, there was no statistically significant correlation between the grade of RPE and logMAR of BCVA (p>0.05, r=0.112. Eight of twelve eyes had PED, and seven of these had irregular PED contours before injection therapy. The mean PED height was 447 ± 122 µm. Conclusions: In this series, RPE tears developed mostly after intravitreal anti-VEGF injections for vascularized PED. Increased vertical height and irregular contours of the PEDs can be risk factors for the formation of RPE tears. The continuation of anti-VEGF therapy after tear formation is beneficial for vision improvement in eyes with RPE tears.

  1. Trabecular microstructure and surface changes in the greater tuberosity in rotator cuff tears

    International Nuclear Information System (INIS)

    Abstract Objective. When planning surgery in patients with rotator cuff tear, strength of bone at the tendon insertion and trabecular bone structure in the greater tuberosity are usually taken into consideration. We investigated radiographic changes in bone structure of the greater tuberosity in rotator cuff tears.Design. Twenty-two human cadaveric shoulders from subjects ranging from 55 to 75 years of age were obtained. The integrity of the rotator cuff was examined by sonography to determine if it is intact without any tear, or torn partially or completely. The humeral head was sectioned in 3 mm thick coronal slab sections and microradiographed. After digitization of the microradiographs and imaging processing with in-house semi-automated image processing software tools developed using software interfaces on a Sun workstation, the trabecular histomorphometrical structural parameters and connectivity in the greater tuberosity were quantified. The degenerative changes on the surface of the greater tuberosity were interpreted blindly by 2 independent readers.Results. Among the 22 shoulder specimens, the rotator cuff was found intact in 10 shoulders, partially in 7 and fully torn in 5. Statistically significant loss in apparent trabecular bone volume fraction, number of trabecular nodes, and number of trabecular branches, and a statistically significant increase in apparent trabecular separation and number of trabecular free ends were found in the greater tuberosity of the shoulders with tears. The loss was greater in association with full tear than in partial tear. Thickening of the cortical margin of the enthesis, irregularity of its surface, and calcification beyond the tidemark were observed in 2 (20%) shoulders with intact rotator cuff, in 6 (86%) shoulders with partial tear, and in 5 (100%) shoulders with full tear.Conclusions. Rotator cuff tears are associated with degenerative changes on the bone surface and with disuse osteopenia of the greater tuberosity

  2. Non-linear numerical studies of the tearing mode

    Energy Technology Data Exchange (ETDEWEB)

    Schnack, D.D. Jr.

    1978-01-01

    A non-linear, time dependent, hydromagnetic model is developed and applied to the tearing mode, one of a class of instabilities which can occur in a magnetically confined plasma when the constraint of infinite conductivity is relaxed. The model is based on the eight partial differential equations of resistive magnetohydrodynamics (MHD). The equations are expressed as a set of conservation laws which conserves magnetic flux, momentum, mass, and total energy. These equations are then written in general, orthogonal, curvilinear coordinates in two space dimensions, so that the model can readily be applied to a variety of geometries. No assumption about the ordering of terms is made. The resulting equations are then solved by the method of finite differences on an Eulerian mesh. The model is applied to several geometries.

  3. Tearing mode stabilization in tokamaks with lower hybrid waves

    International Nuclear Information System (INIS)

    The possibility of using lower hybrid (LH) waves as a source of localized current for the control of MHD instabilities is investigated. A toroidal ray tracing code is used to define the requirements on the launched wave spectrum, in order to drive currents mostly localized inside the magnetic islands. Issues such as the radial diffusion of the non-inductive current, the impact of the radial profile of the power deposition on the stabilization process, the finite time response of the current to RF power modulations and its interplay with the island rotation are addressed by means of a three dimensional (3-D) Fokker-Planck code. It is shown that lower hybrid current drive (LHCD) is a viable option for the control of m = 2 tearing modes in present medium to large tokamaks: the method would be particularly elective in a reactor size machine. (author)

  4. Coupled Simulations of RF Effects on Tearing Modes

    International Nuclear Information System (INIS)

    Full text: We present integrated feedback simulations of neoclassical tearing modes in tokamak plasmas. The implementation relies on the NIMROD and GENRAY codes, along with new codes for calculating a local quasilinear operator, and for performing the code coupling. The mathematical formulation relies on the formulation of a third-order electron drift-kinetic equation that captures the bootstrap current effects and is consistent with ECCD-driven kinetic distortion effects such as the Fisch-Boozer and Ohkawa current drives. Numerically solving the drift-kinetic equation relies on a new high-order continuum discretization scheme suitable for solving the equation in the presence of a macroscopic three-dimensional magnetic field. Implementing these new kinetic closures implicitly, along with the drift-kinetic terms, provides many numerical challenges and requires careful verification. (author)

  5. Observations on Mode I ductile tearing in sheet metals

    DEFF Research Database (Denmark)

    El-Naaman, Salim Abdallah; Nielsen, Kim Lau

    2013-01-01

    Cracked ductile sheet metals, subject to Mode I tearing, have been observed to display a variety of fracture surface morphologies depending on the material properties, and a range of studies on the fracture surface appearance have been published in the literature. Whereas classical fractures such...... as cup-cone, cup-cup and slanting are widely observed, the phenomenon of a slanted crack which systematically "flips" back and forth in a roughly 45 orientation has only recently been reported. The present study aims to add details and understanding to this crack growth phenomenon - through...... experimental testing and comparison with published results. A series of crack propagation tests have been carried out, where cracks are driven many plate thicknesses under global Mode I loading. The current study employs both the edge crack specimen (ECS) loaded in combined in-plane bending and extension, and...

  6. A Simulation Study of Hall Effect on Double Tearing Modes

    Institute of Scientific and Technical Information of China (English)

    ZHANG Chenglong; MA Zhiwei; DONG Jiaqi

    2008-01-01

    A Hall magnetohydrodynamics (MHD) simulation is carried out to study the dy-namic process of double tearing mode. The results indicated that the growth rates in the earlier nonlinear and transition phases agree with the previous results. With further development of reconnection, the current sheet thickness is much smaller than the ion inertia length, which leads to a strong influence of the Hall effects. As a result, the reconnection in the late nonlinear phase exhibits an explosive nature with a time scale nearly independent of resistivity. A localized and severely intensified current density is observed and the maximum kinetic energy is over one order of magnitude higher in Hall MHD than that in resistive MHD.

  7. Tears of a Chinese Premier Hussein Ismail Hussein

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    THE day Premier Wen took office he stated.""Leaders should be closer to the masses."" His visit to comfort and talk with everyday workers in Tongchuan City, Shaanxi Province on January 1, 2005, where a few weeks previously a gas blast in the Chenjiashan Coalmine had killed 166 workers, was by no means his first. But it was the first time he publicly shed tears. In one household that had lost its breadwinner, Wen Jiabao embraced the victim's son and shared his grief. He later had a simple lunch of steamed bread and tea in a tunnel 1,300 meters belowg round as he chatted with workers at another mine in the city.

  8. Descemet′s tear due to injector cartridge tip deformity

    Directory of Open Access Journals (Sweden)

    Partha Biswas

    2012-01-01

    Full Text Available Foldable intraocular lens (IOL implantation using an injector system through 2.8-mm clear corneal incision following phacoemulsification provides excellent speedy postoperative recovery. In our reported case, a Sensar AR40e IOL (Abbott Medical Optics, USA was loaded into Emerald C cartridge, outside the view of the operating microscope, by the first assistant. The surgeon proceeded with the IOL injection through a 2.8-mm clear corneal incision after uneventful phacoemulsification, immediately following which he noted a Descemet′s tear with a rolled out flap of about 2 mm near the incision site. Gross downward beaking of the bevelled anterior end of the cartridge was subsequently noticed upon examination under the microscope. We suggest careful preoperative microscopic inspection of all instruments and devices entering the patient′s eyes to ensure maximum safety to the patient.

  9. Control of neoclassical tearing modes in large tokamaks

    International Nuclear Information System (INIS)

    Some self-consistent effects pertaining to feedback control of neoclassical tearing modes in high temperature large tokamaks are investigated. For the ECRH scheme of local electron heating, it is shown that the self-consistent bootstrap currents created by the driven pressure gradients within the island are comparable to those due to the usually considered resistivity change mechanism. Similar self-consistent currents can also arise from pressure gradients created by density and energy deposition from neutral beams, thereby offering a new possibility of neoclassical mode control. The stabilising current in such an application of neutral beams is estimated. It is further shown that such a feedback scheme can be made even more effective through appropriate modulation of the beam source to match the phase variation arising from the island rotation. (author)

  10. Coupling Between Sawteeth and Tearing Modes in the TCV tokamak

    International Nuclear Information System (INIS)

    Full text: In TCV, sufficiently long sawteeth are found to lead to m/n = 3/2 and 2/1 tearing modes. Recent experiments give a detailed insight into the coupling process that is, thus far, not sufficiently understood. Detailed analysis of the magnetic fluctuation measurements at the crash show that sawteeth may, almost instantaneously, generate magnetic perturbations, which are resonant at q > 1 flux surfaces. The generation of these modes takes place within 10-20 microseconds of the sawtooth crash, which is too short to be resolved by temporal Fourier techniques. Toroidal mode decomposition reveals that the phase velocity of these modes initially differs from the characteristic n = 1 mode, associated with the sawtooth instability. Once the modes couple, energy is usually transferred from the n = 1 to the other modes. These observations are used to discriminate among leading theories such as forced reconnection and 3-wave coupling. (author)

  11. Do Lipids Retard the Evaporation of the Tear Fluid?

    DEFF Research Database (Denmark)

    Rantamaki, A. H.; Javanainen, M.; Vattulainen, I.;

    2012-01-01

    PURPOSE. We examined in vitro the potential evaporation-retarding effect of the tear film lipid layer (TFLL). The artificial TFLL compositions used here were based on the present knowledge of TFLL composition. METHODS. A custom-built system was developed to measure evaporation rates at 35 degrees C....... Lipids were applied to an air-water interface, and the evaporation rate through the lipid layer was defined as water loss from the interface. A thick layer of olive oil and a monolayer of long-chain alcohol were used as controls. The artificial TFLLs were composed of 1 to 4 lipid species: polar...... evaporation by 54% and 45%, respectively. The PC monolayer and the four-component mixtures did not retard evaporation. WE was the most important evaporation-retardant TFLL lipid (similar to 20% decrease). In PC/WE mixtures, an similar to 90% proportion of WE was required for evaporation retardation. Based on...

  12. A tear-free, SPF50 sunscreen product.

    Science.gov (United States)

    Yan, X Sherwin; Riccardi, Grace; Meola, Margaret; Tashjian, Anne; SaNogueira, James; Schultz, Thomas

    2008-01-01

    Sunscreen must provide protection against solar radiation and be safe and non-irritating to skin and eyes, especially for children. A unique water-in-oil emulsion sunscreen formula with a sun protection factor of 50 (SPF50) was developed that minimizes irritation potential through careful selection of ingredients, active combinations, preservatives, and the absence of fragrance. The SPF50 sunscreen formulation reported here is non-irritating to the skin or eyes, with an estimated Draize ocular score of 0.0 for lotion and 3.6 for spray lotion formulations. No eyelid inflammation, lacrimation, or palpebral or bulbar conjunctival irritation was observed in human eye instillation studies. This sunscreen provides a new tear-free formulation that protects from ultraviolet radiation. PMID:18988091

  13. 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.

  14. MRI morphometric hip comparison analysis of anterior acetabular labral tears

    International Nuclear Information System (INIS)

    Anterior (3 o'clock) acetabular labral tears (AALTs) have been reported to be associated with iliopsoas impingement (IPI). However, no study has examined the association between anatomical bony variables of the hip joint and AALTs. The purpose of this study was to evaluate the association between AALTs, femoroacetabular impingement (FAI) and other bony variables of the hip. Seventy-six out of 274 hip MRI records met the inclusion criteria. Two independent blinded investigators evaluated the location of acetabular labral tears (ALTs), edema at the musculotendinous junction of the iliopsoas insertion, femoral neck anteversion angle, femoral neck shaft angle, acetabular anteversion angle, alpha angle, lateral central edge angle (LCEA), acetabular index, and acetabular depth. Comparison analyses between groups were performed. Twenty-two patients had no ALTs (controls), 19 patients had AALTs, and 35 patients had ALTs not isolated at the 3 o'clock position (25 with cam-bony deformities [FAI-cam] and 10 with pincer-bony deformities [FAI-pincer]). The alpha angle mean was significantly higher (p < 0.001) in the FAI-cam group (62.7 , 95 % confidence interval [CI]: 56.2-69.2 ) compared with the AALTs group (46.9 , 95 % CI: 40.1-53.7 ). The LCEA mean was significantly higher (p < 0.001) in FAI-pincer group (41.9 , 95 % CI: 39.3 -44.5 ) compared to AALTs group (29.4 , 95 % CI: 24.2 -34.6 ). There was no statistically significant difference in any of the bony variables between the controls and the AALTs group. Our study demonstrated that AALTs are pathologically distinct and not associated with FAI or other bony abnormalities. This supports the previous studies, which proposed that AALTs are associated with IPI. (orig.)

  15. MRI morphometric hip comparison analysis of anterior acetabular labral tears

    Energy Technology Data Exchange (ETDEWEB)

    Aly, Abdel Rahman [University of Saskatchewan, Department of Physical Medicine and Rehabilitation, Saskatoon, SK (Canada); Saskatoon City Hospital, Saskatoon, SK (Canada); Rajasekaran, Sathish [HealthPointe, Pain, Spine and Sport Medicine, Alberta (Canada); Obaid, Haron [Royal University Hospital, University of Saskatchewan, Department of Medical Imaging, Saskatoon, SK (Canada)

    2013-09-15

    Anterior (3 o'clock) acetabular labral tears (AALTs) have been reported to be associated with iliopsoas impingement (IPI). However, no study has examined the association between anatomical bony variables of the hip joint and AALTs. The purpose of this study was to evaluate the association between AALTs, femoroacetabular impingement (FAI) and other bony variables of the hip. Seventy-six out of 274 hip MRI records met the inclusion criteria. Two independent blinded investigators evaluated the location of acetabular labral tears (ALTs), edema at the musculotendinous junction of the iliopsoas insertion, femoral neck anteversion angle, femoral neck shaft angle, acetabular anteversion angle, alpha angle, lateral central edge angle (LCEA), acetabular index, and acetabular depth. Comparison analyses between groups were performed. Twenty-two patients had no ALTs (controls), 19 patients had AALTs, and 35 patients had ALTs not isolated at the 3 o'clock position (25 with cam-bony deformities [FAI-cam] and 10 with pincer-bony deformities [FAI-pincer]). The alpha angle mean was significantly higher (p < 0.001) in the FAI-cam group (62.7 , 95 % confidence interval [CI]: 56.2-69.2 ) compared with the AALTs group (46.9 , 95 % CI: 40.1-53.7 ). The LCEA mean was significantly higher (p < 0.001) in FAI-pincer group (41.9 , 95 % CI: 39.3 -44.5 ) compared to AALTs group (29.4 , 95 % CI: 24.2 -34.6 ). There was no statistically significant difference in any of the bony variables between the controls and the AALTs group. Our study demonstrated that AALTs are pathologically distinct and not associated with FAI or other bony abnormalities. This supports the previous studies, which proposed that AALTs are associated with IPI. (orig.)

  16. Modeling of Neoclassical Tearing Mode Stability for Generalized Toroidal Geometry

    International Nuclear Information System (INIS)

    Neoclassical tearing modes (NTMs) can lead to disruption and loss of confinement. Previous analysis of these modes used large aspect ratio, low beta (plasma pressure/magnetic pressure) approximations to determine the effect of NTMs on tokamak plasmas. A more accurate tool is needed to predict the onset of these instabilities. As a follow-up to recent theoretical work, a code has been written which computes the tearing mode island growth rate for arbitrary tokamak geometry. It calls PEST-3 [A. Pletzer et al., J. Comput. Phys. 115, 530 (1994)] to compute delta prime, the resistive magnetohydrodynamic (MHD) matching parameter. The code also calls the FLUXGRID routines in NIMROD [A.H. Glasser et al., Plasma Phys. Controlled Fusion 41, A747 (1999)] for Dnc, DI and DR [C.C. Hegna, Phys. Plasmas 6, 3980 (1999); A.H. Glasser et al., Phys. Fluids 18, 875 (1975)], which are the bootstrap current driven term and the ideal and resistive interchange mode criterion, respectively. In addition to these components, the NIMROD routines calculate alphas-H, a new correction to the Pfirsch-Schlter term. Finite parallel transport effects were added and a National Spherical Torus Experiment (NSTX) [M. Ono et al., Nucl. Fusion 40, 557 (2000)] equilibrium was analyzed. Another program takes the output of PEST-3 and allows the user to specify the rational surface, island width, and amount of detail near the perturbed surface to visualize the total helical flux. The results of this work will determine the stability of NTMs in an spherical torus (ST) [Y.-K.M. Peng et al., Nucl. Fusion 26, 769 (1986)] plasma with greater accuracy than previously achieved

  17. Gunnar Optiks Study #2: Electromyography and Tear Volume

    Directory of Open Access Journals (Sweden)

    James Kundart, OD, MEd

    2015-08-01

    Full Text Available Background: This study was conducted to study the difference between the classic Gunnar Optiks computer spectacles and control glasses with small changes in base curve or tint. Methods: Twenty-nine subjects, ages 22-62, completed this study. The two control pairs of eyeglasses were in similar frames, and both sets of lenses were made of similar resin with antireflective coating. One control pair had gray-tinted (neutral density lenses made with the same optical power as the Gunnar Optiks design. The other had the same yellow tint but a flatter base curve and less faceform than the Gunnar design. Under stressful conditions of glare and dry air induced by a fan, electromyography of the eyelid to quantify squinting and blinking experienced with each type of glasses and tear volume measurement using Zone Quick phenol red thread were recorded. Conditions were compared with a mixed-model analysis of variance or covariance. Results: Statistical analysis revealed no significant difference between the Gunnar Optiks design and the control glasses under these conditions. There were no significant differences in squint power (F=1.88, p=0.083 and squint frequency (F=2.065, p=0.057 between the Gunnar Optiks design and the control eyeglasses with a neutral density tint or flatter base curve. There was significantly increased tear volume (F=3.65, p=0.031 and reduced blinking (F=2.57, p=0.019, but a lower blink rate is associated with dry eye. Conclusion: The classic Gunnar Optiks design was not shown to fulfill their claims of reducing asthenopia due to normalization of blink rate or squinting.

  18. Peripheral Neuropathy and Tear Film Dysfunction in Type 1 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Stuti L. Misra

    2014-01-01

    Full Text Available Purpose. To compare tear film metrics in patients with type 1 diabetes mellitus (DM and healthy controls and investigate the association between peripheral neuropathy and ocular surface quality. Methods. Dry eye symptoms were quantified in 53 patients with type 1 DM and 40 age-matched controls. Ocular examination included tear film lipid layer thickness grading, tear film stability and quantity measurement, and retinal photography. DM individuals additionally underwent a detailed neuropathy assessment. Results. Neither mean age nor dry eye symptom scores differed significantly between the DM and control groups (P=0.12 and P=0.33, resp.. Tear lipid thickness (P=0.02, stability (P<0.0001, and quantity (P=0.01 were significantly lower in the DM group. Corneal sensitivity was also reduced in the DM group (P<0.001 and tear film stability was inversely associated with total neuropathy score (r=-0.29, P=0.03. Conclusion. The DM group exhibited significantly reduced tear film stability, secretion, and lipid layer quality relative to the age-matched control group. The negative correlation between tear film parameters and total neuropathy score suggests that ocular surface abnormalities occur in parallel with diabetic peripheral neuropathy.

  19. Magnetic Resonance Imaging of Anterior Cruciate Ligament Tears: Evaluation of Standard Orthogonal and Tailored Paracoronal Images

    Energy Technology Data Exchange (ETDEWEB)

    Duc, S.R.; Zanetti, M.; Kramer, J.; Kaech, K.P.; Zollikofer, C.L.; Wentz, K.U. [Cantonal Hospital, Inst. of Radiology, Winterthur (Switzerland). MR Research Group

    2005-11-01

    Purpose: To evaluate the three standard orthogonal imaging planes and a paracoronal imaging plane for anterior cruciate ligament (ACL) tears. Material and Methods: Ninety patients (91 knees; 29 F and 61 M) aged between 15 and 84 years (mean 36.9{+-}16.4 years) underwent magnetic resonance imaging (MRI) of the knee prior to arthroscopy. At surgery, 32 knees had an intact ACL, 4 a partial tear, and 55 a complete ACL tear. In all patients, axial, sagittal, coronal, and paracoronal T2-weighted turbo-SE images were acquired. The ACL was classified as intact, partially, or completely torn. Partial and complete tears were combined for statistical evaluation. Results: Partial ACL tears (four cases) were not correctly diagnosed at MRI except in one knee by one observer on coronal images. Sensitivity in detecting ACL tears was 95%/63% (reader1/reader2) in the axial, 93%/95% in the sagittal, 93%/86% in the coronal, and 100%/93% in the paracoronal plane. Specificity was 75%/81% in the axial, 72%/81% in the sagittal, 78%/94% in the coronal, and 78%/88% in the paracoronal plane. Conclusion: ACL tears can be diagnosed accurately with each of the standard orthogonal planes. Based on reader confidence and interobserver agreement paracoronal images may be useful in equivocal cases.

  20. Particle-tear energy contribution to the toughness of rubber-modified epoxies

    International Nuclear Information System (INIS)

    A previously developed model for the toughening effect of rubber particles in rubber-modified epoxies is tested. The model predicts a correlation between toughness of rubber-modified epoxies and tear energy of the dispersed rubber phase. Particulate tear energies are obtained from tear strains of the particles measured in-situ during crack propagation through the composite. Two types of rubber-modified epoxy which had been exposed to various levels of gamma radiation are used to determine the effect of radiation-induced crosslinking on tear energy of the rubber particles. The toughness data of the irradiated composites only partially follow the trend predicted by the particle tear energy model. The toughness of the rubber-modified epoxies increases to a maximum and then decreases at high radiation levels whereas the predicted values increase monotonically with radiation level. Tearing rate and viscoelastic effects on tear energy and particle debonding are believed to cause the discrepancies between the predicted and measured behavior. 7 figures

  1. Magnetic Resonance Imaging of Anterior Cruciate Ligament Tears: Evaluation of Standard Orthogonal and Tailored Paracoronal Images

    International Nuclear Information System (INIS)

    Purpose: To evaluate the three standard orthogonal imaging planes and a paracoronal imaging plane for anterior cruciate ligament (ACL) tears. Material and Methods: Ninety patients (91 knees; 29 F and 61 M) aged between 15 and 84 years (mean 36.9±16.4 years) underwent magnetic resonance imaging (MRI) of the knee prior to arthroscopy. At surgery, 32 knees had an intact ACL, 4 a partial tear, and 55 a complete ACL tear. In all patients, axial, sagittal, coronal, and paracoronal T2-weighted turbo-SE images were acquired. The ACL was classified as intact, partially, or completely torn. Partial and complete tears were combined for statistical evaluation. Results: Partial ACL tears (four cases) were not correctly diagnosed at MRI except in one knee by one observer on coronal images. Sensitivity in detecting ACL tears was 95%/63% (reader1/reader2) in the axial, 93%/95% in the sagittal, 93%/86% in the coronal, and 100%/93% in the paracoronal plane. Specificity was 75%/81% in the axial, 72%/81% in the sagittal, 78%/94% in the coronal, and 78%/88% in the paracoronal plane. Conclusion: ACL tears can be diagnosed accurately with each of the standard orthogonal planes. Based on reader confidence and interobserver agreement paracoronal images may be useful in equivocal cases

  2. Nanoparticle-Induced Superior Hot Tearing Resistance of A206 Alloy

    Science.gov (United States)

    Choi, Hongseok; Cho, Woo-hyun; Konishi, Hiromi; Kou, Sindo; Li, Xiaochun

    2013-04-01

    Al- Cu alloys (such as A206) offer high strength and high fracture toughness at both room and elevated temperatures. However, their widespread applications are limited because of their high susceptibility to hot tearing. This article presents a nanotechnology approach to enhance hot-tearing resistance for A206. Specifically, γ-Al2O3 nanoparticles were used, and their effects on the hot-tearing resistance of the as-cast Al-4.5Cu alloy (A206) were investigated. While it is well known that grain refinement can improve the hot-tearing resistance of cast Al alloys, the current study demonstrated that nanoparticles can be much more effective in the case of A206. The hot-tearing susceptibilities (HTSs) of A206 alloy and its Al2O3 nanocomposite were evaluated by constrained rod casting (CRC) with a steel mold. Monolithic A206 and M206 (the Ti-free version of A206) alloys with the B contents of 20, 40, and 300 ppm from an Al-5Ti-1B master alloy addition were also cast under the same conditions for comparison. The results showed that with an addition of 1 wt pct γ-Al2O3 nanoparticles, the extent of hot tearing in A206 alloys was markedly reduced to nearly that of A356, an Al-Si alloy highly resistant to hot tearing. As compared with grain-refined A206 or M206, the hot-tearing resistance of the nanocomposites was significantly better, even though the grain size was not reduced as much. Microstructural analysis suggested that γ-Al2O3 nanoparticles modified the solidification microstructure of the eutectic of θ-Al2Cu and α-Al, as well as refined primary grains, resulting in the enhancement of the hot-tearing resistance of A206 to a level similar to that of A356 alloy.

  3. [Comparison of local acetylcysteine and artificial tears in the management of dry eye syndrome].

    Science.gov (United States)

    Pokupec, Rajko; Petricek, Igor; Sikić, Jakov; Bradić, Mirna; Popović-Suić, Smiljka; Petricek, Goranka

    2005-01-01

    Dry eye syndrome is a common clinical entity causing difficulties to many people, especially the elderly. Standard substitution therapy with artificial tears may frequently prove inadequate, thus any new treatment modality is highly welcome. The syndrome implies lacrimal hyperosmolality, which in turn results in mucus accumulation in the conjunctival sac causing additional irritation. Locally applied acetylcysteine, a mucolytic, regulates mucus secretion and reduces mucus accumulation. The aim of the study was to compare the efficacy of artificial tear therapy and therapy with local acetylcysteine. The study included 32 patients with the symptoms and signs of dry eye attending our department between March 20 and May 9, 2003. All study patients were on long-term substitution therapy with artificial tears. Upon evaluation of subjective discomforts and objective signs, the patients were switched from artificial tear therapy (Isopto-Tears, Alcon, with polyvinyl alcohol as active ingredient) to therapy with locally applied acetylcysteine (Brunac, Bruschettini). All parameters were re-evaluated at 2-week control visit. Thirty of 32 patients (94%) completed the study with control visit. Of these, 18 (60%) patients reported reduction of subjective discomforts, ten (33%) patients observed no change, and two (7%) patients experienced more discomforts with acetylcysteine than with artificial tear therapy. On objective sign evaluation, 12 (40%) patients showed less discomforts, unchanged condition was recorded in 13 (43%) patients, and five (17%) patients had more discomforts as compared with artificial tear therapy. A statistically significant difference (p=0.05) between artificial tear therapy and acetylcysteine therapy was found for the subjective symptom score but not for the objective sign score. Therapy with acetylcysteine proved more efficient than artificial tears in reducing subjective symptoms but had no effect on the objective signs of dry eye syndrome. The

  4. Interrelations between Dry Eye Syndrome and Tear Fluid Phospholipid Transfer Protein

    OpenAIRE

    SetÀlÀ, Niko

    2011-01-01

    The simplified model of human tear fluid (TF) is a three-layered structure composed of a homogenous gel-like layer of hydrated mucins, an aqueous phase, and a lipid-rich outermost layer found in the tear-air interface. It is assumed that amphiphilic phospholipids are found adjacent to the aqueous-mucin layer and externally to this a layer composed of non-polar lipids face the tear-air interface. The lipid layer prevents evaporation of the TF and protects the eye, but excess accumulation of li...

  5. Effect of lodoxamide and disodium cromoglycate on tear eosinophil cationic protein in vernal keratoconjunctivitis

    OpenAIRE

    Leonardi, A.; Borghesan, F.; Avarello, A.; Plebani, M.; Secchi, A.

    1997-01-01

    AIM—To validate the use of tear eosinophil cationic protein (ECP) as a marker for eosinophil activation, and its pharmacological modulation, in addition to evaluating the efficacy of lodoxamide and sodium cromoglycate in the treatment of vernal keratoconjunctivitis (VKC).
METHODS—Tears were collected from 30 patients affected by active mild to moderate VKC before and after therapy with disodium cromoglycate 4% (DSCG) (n=15) or lodoxamide 0.1% (n=15) for 10 days. Tear cytology and ECP measurem...

  6. Comparison of TEAR and TFRC throughput for Drop tail and RED Queue Management Techniques

    Directory of Open Access Journals (Sweden)

    Parminderjeet Singh

    2014-12-01

    Full Text Available The comparison of throughput for TEAR (TCP emulation at receivers and TFRC TCP friendly rate control in MANETs is done with varying Active queue Management Techniques. The analysis reveals that for bandwidth constraint links, TEAR and TFRC perform far better than normal traffic propagation through TCP. In case of TEAR, the processing and route congestion algorithm load is shared by the receiver resulting in lesser load at the transmitters. In TFRC the TCP traffic is propagated via an algorithm to curb acknowledgement congestions. The effect of these two techniques is monitored on Droptail and RED, two of the most common Active Queue Management Techniques.

  7. Tearing mode suppression by using resonant magnetic perturbation coils on J-TEXT tokamak

    International Nuclear Information System (INIS)

    A series of experiments on the interactions between external resonant magnetic perturbations (RMP) and plasmas has recently been conducted, using static resonant magnetic perturbation (SRMP) coils on the Joint Texas Experimental Tokamak (J-TEXT). The tearing mode can be completely suppressed by applying SRMP. However, the locked mode is likely to be stimulated under a larger SRMP field even though the tearing mode has been first suppressed. A numerical simulation shows three typical regimes of RMP's effects on the tearing mode, which are consistent with experimental results.

  8. Tear Film Break-Up Time: Comparison between Patients using Psychiatric Drugs and Healthy Individuals

    Directory of Open Access Journals (Sweden)

    Parvin Dibajnia

    2014-09-01

    Full Text Available Background: Ocular dryness is a well-recognized adverse side effect of many medications. The purpose of this study was to compare tear film stability between psychiatric patients that use lithium carbonate or carbamazepine and normal cases. Materials and Methods: Tear film break up time test was performed in three groups, 30 patients using lithium carbonate, 30 patients using carbamazepine and 30 normal cases. Values of the TBUTs were compared among groups by the independent t-test. Results: Differences between both of patients and control groups were significant (p<0.0001. Conclusion: The results show that these drugs contribute to decrease of tear film break up time.

  9. The effects of a shear flow on nonlinear evolutions of double tearing mode in Hall magnetohydrodynamics

    International Nuclear Information System (INIS)

    The effects of a shear flow on nonlinear evolution of double tearing mode in Hall magnetohydrodynamics are investigated. The parallel shear flow displays a suppressing effect on the double tearing mode. Due to the effect of the shear flow, the relative displacements between the magnetic islands are changed, and therefore their mutual interactions become weak. Furthermore, the nonlinear impulsive growth phase of the double tearing mode is delayed with increasing the shear flow velocity. When the magnetic islands are pushing against each other, the width of current sheets decreases drastically, and therefore the Hall effects are dominant and the magnetic reconnection enhances greatly.

  10. Spectral domain optical coherence tomography features of multiple subfoveal retinal pigment epithelial tears after intravitreal bevacizumab

    Directory of Open Access Journals (Sweden)

    Chalam Kakarla

    2011-01-01

    Full Text Available Retinal pigment epithelial (RPE tear has been described to occur spontaneously, after laser photocoagulation and in recent times, after intravitreal injection of anti-vascular endothelial growth factor (VEGF agents. In the latter case, the rapid contraction of the choroidal vascular membrane underneath a serous RPE detachment is believed to be the underlying cause. Preservation of good visual acuity after the occurrence of RPE tear with continued use of intravitreal VEGF agents has been reported. In this case report, we describe the occurrence of multiple RPE tears with the use of intravitreal bevacizumab and also correlate the preservation of visual acuity with features seen on spectral domain optical coherence tomography.

  11. Acute Concomitant Anterior Cruciate Ligament and Patellar Tendon Tears in a Non-dislocated Knee

    Directory of Open Access Journals (Sweden)

    Robert D Wissman

    2012-01-01

    Full Text Available Anterior cruciate ligament (ACL tears are common and may occur in isolation or with other internal derangements of the joint. Tears of the patellar tendon (PT occur less frequently and are rarely associated with intra-articular pathology. Acute combined tears of both the ACL and PT are known complications of high-energy traumatic knee dislocations. We present a case of an acute concomitant ACL and PT tears in a low-energy non-dislocated knee. To our knowledge, this injury has only been described in a limited number of case reports in the orthopedic literature. We present the imaging findings of this combined injury and discuss the importance of magnetic resonance (MR in diagnosis.

  12. Pre and Post Treatment Comparative Study of Meniscus Tears Treated with Intraarticular Steroid Injection

    Directory of Open Access Journals (Sweden)

    Janak A Rathod, Dhaval I Patel, Vikram Jasoliya

    2014-01-01

    Conclusion: This study support long-term safety of IA steroid injections for patients with symptomatic knee with meniscus tear without any deleterious effects. It is also clinically effective to relive symptoms.

  13. Rotator cuff tears in asymptomatic individuals: a clinical and ultrasonographic screening study

    Energy Technology Data Exchange (ETDEWEB)

    Schibany, N. E-mail: nadja.schibany@univie.ac.at; Zehetgruber, H.; Kainberger, F.; Wurnig, C.; Ba-Ssalamah, A.; Herneth, A.M.; Lang, T.; Gruber, D.; Breitenseher, M.J

    2004-09-01

    Objective: To determine the prevalence and clinical impact of rotator cuff tears in asymptomatic volunteers. Materials and Methods: Sonographic examinations of the shoulder of 212 asymptomatic individuals between 18 and 85 years old were performed by a single experienced operator. The prevalence and location of complete rotator cuff tears were evaluated. The clinical assessment was based on the Constant Score. Magnetic resonance imaging (MRI) of the shoulder was obtained in those patients where US showed rotator cuff pathology. Results: Ultrasound showed a complete rupture of the supraspinatus tendon in 6% of 212 patients from 56 to 83 years of age (mean: 67 years). MRI confirmed a complete rupture of the supraspinatus tendon in 90%. All patients reported no functional deficits, although strength was significantly lower in the patient group with complete supraspinatus tendon tear (P<0.01). Conclusion: There is a higher prevalence in older individuals of rotator cuff tendon tears that cause no pain or decrease in activities of daily living.

  14. Diagnostic accuracy of clinical tests for the diagnosis of hip femoroacetabular impingement/labral tear

    DEFF Research Database (Denmark)

    Reiman, M P; Goode, A P; Cook, C E;

    2015-01-01

    BACKGROUND: Surgery for hip femoroacetabular impingement/acetabular labral tear (FAI/ALT) is exponentially increasing despite lacking investigation of the accuracy of various diagnostic measures. Useful clinical utility of these measures is necessary to support diagnostic imaging and subsequent...

  15. Computational modeling of neoclassical and resistive MHD tearing modes in tokamaks

    International Nuclear Information System (INIS)

    Numerical studies of the nonlinear evolution of MHD-type tearing modes in three-dimensional toroidal geometry with neoclassical effects are presented. The inclusion of neoclassical physics introduces an additional free-energy source for the nonlinear formation of magnetic islands through the effects of a bootstrap current in Ohm's law. The neoclassical tearing mode is demonstrated to be destabilized in plasmas which are otherwise Δ' stable, albeit once an island width threshold is exceeded. The plasma pressure dynamics and neoclassical tearing growth is shown to be sensitive to the choice of the ratio of the parallel to perpendicular diffusivity (Χ parallel/Χ perpendicular). The study is completed with a demonstration and theoretical comparison of the threshold for single helicity neoclassical MHD tearing modes, which is described based on parameter scans of the local pressure gradient, the ratio of perpendicular to parallel pressure diffusivities Χ perpendicular/Χ parallel, and the magnitude of an initial seed magnetic perturbation

  16. Rotator cuff tears in asymptomatic individuals: a clinical and ultrasonographic screening study

    International Nuclear Information System (INIS)

    Objective: To determine the prevalence and clinical impact of rotator cuff tears in asymptomatic volunteers. Materials and Methods: Sonographic examinations of the shoulder of 212 asymptomatic individuals between 18 and 85 years old were performed by a single experienced operator. The prevalence and location of complete rotator cuff tears were evaluated. The clinical assessment was based on the Constant Score. Magnetic resonance imaging (MRI) of the shoulder was obtained in those patients where US showed rotator cuff pathology. Results: Ultrasound showed a complete rupture of the supraspinatus tendon in 6% of 212 patients from 56 to 83 years of age (mean: 67 years). MRI confirmed a complete rupture of the supraspinatus tendon in 90%. All patients reported no functional deficits, although strength was significantly lower in the patient group with complete supraspinatus tendon tear (P<0.01). Conclusion: There is a higher prevalence in older individuals of rotator cuff tendon tears that cause no pain or decrease in activities of daily living

  17. Tearing analysis of a new airship envelope material under uniaxial tensile load

    Science.gov (United States)

    Wang, F. X.; Xu, W.; Chen, Y. L.; Fu, G. Y.

    2016-07-01

    This paper experimentally investigated the tearing properties of a new kind of coated woven fabrics, GQ-6, made of ultra-high molecular weight polyethylene fiber. Such material can be used for the envelope materials of a stratospheric airship. First, the uniaxial tearing tests were carried out. Effects of the stretching rate, the initial crack length, and the initial crack orientation on the material's tearing tensile strength were investigated. Experimental results showed that the initial crack length and the initial crack orientation can be represented by the equivalent initial crack length while the stretching rate has a slight influence on tearing behavior of the uniaxial tensile specimens. Then analytical studies using three methods, i.e. Griffith energy theory, the stress intensity factor theory, and Thiele's empirical theory, among which, the stress intensity factor theory gives the best correlation with the test data. Finally, a 48mm threshold of the equivalent initial crack length was recommended to the envelope material in operation.

  18. A Two-Fluid Study of Oblique Tearing Modes in a Force-Free Current Sheet

    CERN Document Server

    Akcay, Cihan; Lukin, Vyacheslav S; Liu, Yi-Hsin

    2016-01-01

    Kinetic simulations have demonstrated that three-dimensional reconnection in collisionless regimes proceeds through the formation and interaction of magnetic flux ropes, which are generated due to the growth of tearing instabilities at multiple resonance surfaces. Since kinetic simulations are intrinsically expensive, it is desirable to explore the feasibility of reduced two-fluid models to capture this complex evolution, particularly, in the strong guide field regime, where two-fluid models are better justified. With this goal in mind, this paper compares the evolution of the collisionless tearing instability in a force-free current sheet with a two-fluid model and fully kinetic simulations. Our results indicate that the most unstable modes are oblique for guide fields larger than the reconnecting field, in agreement with the kinetic results. The standard two-fluid tearing theory is extended to address the tearing instability at oblique angles. The resulting theory yields a flat oblique spectrum and underest...

  19. The role of pressure flattening in calculating tearing mode stability

    International Nuclear Information System (INIS)

    Calculations of tearing mode stability in tokamaks split conveniently into one in an external region, where marginally stable ideal magnetohydrodynamics (MHD) is applicable, and one in a resonant layer around the rational surface where sophisticated kinetic physics is needed. These two regions are coupled by the stability parameter Δ′. Axisymmetric pressure and current perturbations localized around the rational surface significantly alter Δ′. Equations governing the changes in the external solution and Δ′ are derived for arbitrary perturbations in axisymmetric toroidal geometry. These equations can be used in two ways: (i) the Δ′ can be calculated for a physically occurring perturbation to the pressure or current; (ii) alternatively we can use these equations to calculate Δ′ for profiles with a pressure gradient at the rational surface in terms of the value when the perturbation removes this gradient. It is the second application we focus on here since resistive magnetohydrodynamics (MHD) codes do not contain the appropriate layer physics and therefore cannot predict stability for realistic hot plasma directly. They can, however, be used to calculate Δ′. Existing methods (Ham et al 2012 Plasma Phys. Control. Fusion 54 025009) for extracting Δ′ from resistive codes are unsatisfactory when there is a finite pressure gradient at the rational surface and favourable average curvature because of the Glasser stabilizing effect (Glasser et al 1975 Phys. Fluids 18 875). To overcome this difficulty we introduce a specific artificial pressure flattening function that allows the earlier approach to be used. The technique is first tested numerically in cylindrical geometry with an artificial favourable curvature. Its application to toroidal geometry is then demonstrated using the toroidal tokamak tearing mode stability code T7 (Fitzpatrick et al 1993 Nucl. Fusion 33 1533) which employs an approximate analytic equilibrium. The prospects for applying this

  20. Passive Posterior Tibial Subluxation on Routine Knee MRI as a Secondary Sign of PCL Tear

    OpenAIRE

    Degnan, Andrew J.; Catherine Maldjian; Richard J. Adam; Harner, Christopher D.

    2014-01-01

    The posterior drawer test is an accurate clinical test to diagnose posterior cruciate ligament (PCL), indicating laxity of the PCL that allows posterior tibial translation. This study aimed to determine whether posterior tibial translation relative to the femur on routine MRI could serve as an additional sign of PCL tear. Routine knee MRI in eleven patients (7 males, 4 females) with arthroscopically confirmed isolated PCL tears were reviewed independently by two musculoskeletal radiologists. ...

  1. The preliminary application of magnetic resonance arthrography in the diagnosis of acetabular labrale tears

    International Nuclear Information System (INIS)

    Objective: To investigate the application value of MR arthrography (MRA) in the diagnosis of acetabular lab ral tears. Methods: Fifteen patients with a high degree of suspected acetabular lab ral tears received fluoroscope-guided injection of the contrast media into the hip joint (hip arthrography) and fat-saturated spin-echo T1-weighted images were obtained in the coronal, sagittal, oblique-axial and radial planes. Hip arthroscopy was performed on 12 of them. Results: Lab ral tears which were diagnosed in 11 patients by hip MRA were confirmed at hip arthroscopy. One patient showed no MRA indication of lab ral tear, also showed normal on arthroscopy. Tear in the anterior-superior quadrant 10 cases of 12 joints (12/13), posterior-superior quadrant 1 case of a joint (1/13). In 11 patients who underwent arthroscopy, hip MRA diagnosed 3 (3/13) joints labrale tears in coronal planes, 10 (10/13) joints in sagittal planes and 13 (13/13) labrale tears in axial-oblique and radial planes. In 15 patients with 20 hip joints, 5 cases 6 joints (6/20) with normal acetabular sublabral sulcus were performed. Conclusions: MR arthrography of hip is a reliable method in the diagnosis of acetabular labrale tears. Scanning method should be included fat-saturated spin-echo T1-weighted images in sagittal and oblique-axial planes or sagittal plus radial planes. The diagnosis of torn posterior-inferior quadrant should pay attention to the existence of a normal variation. (authors)

  2. Tear ascorbic acid levels and the total antioxidant status in contact lens wearers: A pilot study

    Directory of Open Access Journals (Sweden)

    Venkata Sai

    2009-01-01

    Full Text Available Aims: The tear ascorbate owing to its high concentration, functions as an effective antioxidant against the oxidative damage of cornea. Contact lens wearers (CLW are prone to oxidative stress due to the lens-induced hypoxic conditions. A pilot study was done to compare the tear ascorbic acid level and the total antioxidant capacity give as in normal and CLW. Materials and Methods: In this study 21 CLW (Mean age 23 ± 3 years ; M-2, F-19, who were daily wear users, with duration of wear not more than four years, along with age-matched 28 controls (Mean age 28 ± 3 ; M-15, F-13 were recruited in the study for collection of reflex tears using Schirmer′s strip. Ascorbic acid in tears was determined using high-performance liquid chromatography (HPLC, total antioxidant capacity (TAC and total protein assay by spectrophotometric analysis. Results: CLW showed no significant change in the tear ascorbic acid levels (0.4 ± 0.26 mM compared to the control subjects (0.61 ± 0.59 mM. The amount of ascorbic acid in tears did not correlate with the TAC or the total protein of the tears. The mean TAC in CLW was 0.69 ± 0.16 mM, with a total protein of 1.35 ± 0.46 mg/ml while in controls it was 0.7 ± 0.18 mM and 1.21 ± 0.47 mg/ml respectively . Conclusions: Soft contact lens wear did not show any significant change in tear ascorbic acid, TAC and total protein levels compared to controls.

  3. Development of Job’s tears ice cream recipes with carrot juice and pumpkin paste

    OpenAIRE

    Wiwat Wangcharoen

    2011-01-01

    Carrot juice and pumpkin paste were used as ingredients in Job’s tears ice cream. Carrot juice or pumpkin paste added at 50% was equally preferred by 100 consumers compared to the original Job’s tears ice cream. The new types of ice cream were lower in antioxidant capacity and higher in total phenolic content but could still be considered as potential antioxidant products. Purchase intent was significantly increased (p

  4. Pharmacokinetic analysis of topical tobramycin in equine tears by automated immunoassay

    OpenAIRE

    Czerwinski Sarah L; Lyon Andrew W; Skorobohach Brian; Léguillette Renaud

    2012-01-01

    Abstract Background Ophthalmic antibiotic therapy in large animals is often used empirically because of the lack of pharmacokinetics studies. The purpose of the study was to determine the pharmacokinetics of topical tobramycin 0.3% ophthalmic solution in the tears of normal horses using an automated immunoassay analysis. Results The mean tobramycin concentrations in the tears at 5, 10, 15, 30 minutes and 1, 2, 4, 6 hours after administration were 759 (±414), 489 (±237), 346 (±227), 147 (±264)...

  5. Spectrum of injuries associated with paediatric ACL tears: an MRI pictorial review

    OpenAIRE

    Jacob L Jaremko; Ghuenter, Zachary D; Jans, Lennart; MacMahon, Peter J

    2013-01-01

    Objective Magnetic resonance imaging (MRI) findings in anterior cruciate ligament (ACL) injury are well known, but most published reviews show obvious examples of associated injuries and give little focus to paediatric patients. Here, we demonstrate the spectrum of MRI appearances at common sites of associated injury in adolescents with ACL tears, emphasising age-specific issues. Methods Pictorial review using images from children with surgically confirmed ACL tears after athletic injury. Res...

  6. Evaluation and Treatment of the Tear Trough Deformity in Lower Blepharoplasty*

    OpenAIRE

    Espinoza, Gabriela Mabel; Holds, John Bryan

    2007-01-01

    The tear trough deformity is a natural consequence of the anatomic attachments of the periorbital tissues. A variety of techniques have evolved to address this cosmetic issue including subtractive blepharoplasty techniques, elevation of ptotic eyelid and midface tissues, and the injection or implantation of autogenous or alloplastic materials to diminish its appearance. Greater anatomic understanding of the pathogenesis of the tear trough deformity has led to more anatomically conservative an...

  7. Correction of tear trough deformity with a cohesive polydensified matrix hyaluronic acid: a case series

    OpenAIRE

    Huber-Vorländer J; Kürten M

    2015-01-01

    Jürgen Huber-Vorländer, Martin KürtenFort Malakoff Klinik, Mainz, GermanyAbstract: The tear trough or infraorbital hollow is a challenging area to treat, and only a few fillers are suitable for this delicate area. We report on a European case series of six subjects with mild to severe tear troughs who received treatment with cohesive polydensified matrix (CPM®) technology hyaluronic acid gel (Belotero® Balance). The product was injected as small depo...

  8. Biophysical characterization of monofilm model systems composed of selected tear film phospholipids.

    Science.gov (United States)

    Patterson, Matthew; Vogel, Hans J; Prenner, Elmar J

    2016-02-01

    The tear film protects the eye from foreign particles and pathogens, prevents excess evaporation, provides lubrication, and maintains a high quality optical surface necessary for vision. The anterior layer of tear film consists of polar and non-polar lipid layers. The polar lipids form a monolayer on the aqueous subphase, acting as surfactants for the non-polar lipid multilayer. A tear film polar lipid biomimetic consisting of dipalmitoyl phosphatidylcholine (DPPC), dipalmitoyl phosphatidylethanolamine (DPPE), palmitoyl glucosylceramide (PGC), and palmitoyl sphingomyelin (PSM) was characterized using Langmuir monolayers and Brewster angle microscopy (BAM). Lipid combinations formed very stable monolayers, especially those containing DPPC or PSM. Surface experiments and elasticity analyses revealed that PGC resulted in more condensed and rigid mixed monolayers. DPPE provided resistance to large changes in lipid ordering over a wide surface pressure range. Ternary mixtures containing DPPE and PGC with either DPPC or PSM experienced the greatest lipid ordering within the natural tear film surface pressure range suggesting that these lipids are important to maintain tear film integrity during the inter-blink period. Finally, BAM images revealed unique structures within monolayers of DPPC, DPPE, and PGC at the natural tear film surface pressure. 3D analysis of these domains suggested either the formation of multilayers or outward protrusions at surface pressures far below the point of irreversible collapse as seen on the isotherm. This entails that the polar lipids of tear film may be capable of multilayer formation or outward folding as a mechanism to prevent rupture of the tear film during a blink. PMID:26657693

  9. Long-term changes in corneal structure and tear inflammatory mediators after orthokeratology and LASIK

    OpenAIRE

    González-Pérez, Javier; Villa-Collar, César; González-Méijome, José Manuel; Garcia-Porta, Nery; Parafita, Manuel A.

    2012-01-01

    PURPOSE: To monitor changes in corneal structure and level of inflammatory mediators in tears of myopic patients following orthokeratology (OK) and laser in situ keratomileusis (LASIK). METHODS: Sixty-two myopic subjects were analyzed in this prospective study. Thirty-two had worn Paragon CRT contact lenses and 30 underwent standard LASIK. Thirty-two control subjects were also recruited. Pachometry and corneal topography were performed 12 months after both interventions. Tears were collec...

  10. Arthroscopic Subacromial Decompression for Small and Medium Size Tears of Rotator Cuff without Tendon Repair

    OpenAIRE

    Suhail Karkabi; Nahum Rosenberg

    2014-01-01

    According to our previous clinical impression, we hypothesized that patients who had symptomatic rotator cuff tendon tear in a diamemter below 3 cm would benefit from arthroscopic subacromial decompression only, without the need for the repair of the thorn tendon. From 1998 to 2003, 160 patients (168 shoulders) had arthroscopic subacromial decompression for impingement syndrome with a torn rotator cuff without repairing the tear of the cuffs (120 males and 40 females). The average patient age...

  11. Sensitive and Real-Time Method for Evaluating Corneal Barrier Considering Tear Flow

    OpenAIRE

    Nakamura, Tadahiro; Teshima, Mugen; Kitahara, Takashi; Sasaki, Hitoshi; Uematsu, Masafumi; Kitaoka, Takashi; Nakashima, Mikiro; Nishida, Koyo; Nakamura, Junzo; Higuchi, Shun

    2010-01-01

    We developed a new electrophysiological method mimicking tear flow to evaluate the epithelial tight junction of rabbit cornea quantitatively. We investigated the effect of tear flow on the corneal damage induced by ophthalmic preservatives using this method. An Ussing chamber system with Ag/AgCl electrodes was used in the electrophysiological experiment. The excised rabbit cornea was mounted in the Ussing chamber and the precorneal solution in the chamber was perfused with a peristaltic pump ...

  12. Spectral domain optical coherence tomography features of multiple subfoveal retinal pigment epithelial tears after intravitreal bevacizumab

    OpenAIRE

    Chalam Kakarla; Murthy Ravi; Gupta Shailesh; Brar Vikram

    2011-01-01

    Retinal pigment epithelial (RPE) tear has been described to occur spontaneously, after laser photocoagulation and in recent times, after intravitreal injection of anti-vascular endothelial growth factor (VEGF) agents. In the latter case, the rapid contraction of the choroidal vascular membrane underneath a serous RPE detachment is believed to be the underlying cause. Preservation of good visual acuity after the occurrence of RPE tear with continued use of intravitreal VEGF agents has been rep...

  13. Tear film inflammatory mediators during continuous wear of contact lenses and corneal refractive therapy

    OpenAIRE

    González-Pérez, Javier; Villa-Collar, César; Sobrino Moreiras, Tomás; Lema Gesto, Isabel; González-Méijome, José Manuel; Rodríguez Ares, María T.; Parafita, Manuel A.

    2012-01-01

    OBJECTIVES: To study changes in tear film inflammatory mediators following continuous wear of silicone-hydrogel lenses and corneal refractive therapy with reverse geometry contact lenses. DESIGN: A prospective, case-control study. METHODS: Twenty-eight subjects had worn silicone-hydrogel lenses on a 30-night continuous wear basis. Thirty-two subjects had worn corneal refractive therapy lenses on an overnight basis. Thirty-two matched control subjects were also recruited. Tear samples ...

  14. Results of reconstruction of massive irreparable rotator cuff tears using a fascia lata allograft

    Directory of Open Access Journals (Sweden)

    Dimitrios Varvitsiotis

    2015-01-01

    Conclusions: Despite advances in surgical methods, there is still not a universally accepted treatment for massive and irreparable rotator cuff tears, because the standard methods have dubious results, with excessive retear rates and poor outcomes, necessitating the need for new repair strategies. We documented significant clinical improvement using fascia lata allograft in the repair of massive irreparable r-c tear, acting as scaffold to bridge the defect, enhancing the healing at the repair site.

  15. Three tesla magnetic resonance imaging of the anterior cruciate ligament of the knee: can we differentiate complete from partial tears?

    International Nuclear Information System (INIS)

    To determine the ability of 3.0T magnetic resonance (MR) imaging to identify partial tears of the anterior cruciate ligament (ACL) and to allow distinction of complete from partial ACL tears. One hundred seventy-two patients were prospectively studied by 3.0T MR imaging and arthroscopy in our institution. MR images were interpreted in consensus by two experienced reviewers, and the ACL was diagnosed as being normal, partially torn, or completely torn. Diagnostic accuracy of 3.0T MR for the detection of both complete and partial tears of the ACL was calculated using arthroscopy as the standard of reference. There were 132 patients with an intact ACL, 17 had a partial, and 23 had a complete tear of the ACL seen at arthroscopy. Sensitivity, specificity, and accuracy of 3.0T MR for complete ACL tears were 83, 99, and 97%, respectively, and, for partial ACL tears, 77, 97, and 95%, respectively. Five of 40 ACL lesions (13%) could not correctly be identified as complete or partial ACL tears. MR imaging at 3.0T represents a highly accurate method for identifying tears of the ACL. However, differentiation between complete and partial ACL tears and identification of partial tears of this ligament remains difficult, even at 3.0T. (orig.)

  16. Three tesla magnetic resonance imaging of the anterior cruciate ligament of the knee: can we differentiate complete from partial tears?

    Energy Technology Data Exchange (ETDEWEB)

    Dyck, Pieter van; Gielen, Jan L.; Parizel, Paul M. [University Hospital Antwerp and University of Antwerp, Department of Radiology, Antwerp (Edegem) (Belgium); Vanhoenacker, Filip M. [University Hospital Antwerp and University of Antwerp, Department of Radiology, Antwerp (Edegem) (Belgium); AZ St-Maarten Duffel/Mechelen, Department of Radiology, Duffel (Belgium); Dossche, Lieven; Gestel, Jozef van [University Hospital Antwerp and University of Antwerp, Department of Orthopedics, Antwerp (Edegem) (Belgium); Wouters, Kristien [University Hospital Antwerp and University of Antwerp, Department of Scientific Coordination and Biostatistics, Antwerp (Edegem) (Belgium)

    2011-06-15

    To determine the ability of 3.0T magnetic resonance (MR) imaging to identify partial tears of the anterior cruciate ligament (ACL) and to allow distinction of complete from partial ACL tears. One hundred seventy-two patients were prospectively studied by 3.0T MR imaging and arthroscopy in our institution. MR images were interpreted in consensus by two experienced reviewers, and the ACL was diagnosed as being normal, partially torn, or completely torn. Diagnostic accuracy of 3.0T MR for the detection of both complete and partial tears of the ACL was calculated using arthroscopy as the standard of reference. There were 132 patients with an intact ACL, 17 had a partial, and 23 had a complete tear of the ACL seen at arthroscopy. Sensitivity, specificity, and accuracy of 3.0T MR for complete ACL tears were 83, 99, and 97%, respectively, and, for partial ACL tears, 77, 97, and 95%, respectively. Five of 40 ACL lesions (13%) could not correctly be identified as complete or partial ACL tears. MR imaging at 3.0T represents a highly accurate method for identifying tears of the ACL. However, differentiation between complete and partial ACL tears and identification of partial tears of this ligament remains difficult, even at 3.0T. (orig.)

  17. Which oblique plane is more helpful in diagnosing an anterior cruciate ligament tear?

    International Nuclear Information System (INIS)

    Aim: To evaluate the diagnostic role of additional oblique coronal and oblique sagittal magnetic resonance imaging (MRI) for an anterior cruciate ligament (ACL) tear. Materials and methods: A total of 101 patients who had undergone preoperative knee MRI examinations with orthogonal and two sets of oblique images were enrolled in the study. Two radiologists evaluated the MRI images by the use of four methods: orthogonal images only (method A); orthogonal and additional oblique coronal images (method B); orthogonal and oblique sagittal images (method C); and orthogonal images with oblique coronal and sagittal images (method D). The status of the ACL (normal or tear) was determined by consensus. The sensitivity, specificity, and accuracy for an ACL tear with the use of each method were calculated in comparison with arthroscopy as the reference standard, and values were statistically analysed using the McNemar test. The diagnostic accuracies were compared using receiver operating characteristic (ROC) analysis. Results: Arthroscopy identified 10 partial ACL tears and 30 complete ACL tears. The specificities and accuracies for methods B, C, and D were significantly higher than the specificities and accuracies for method A (p 0.05). Conclusions: Additional oblique imaging for an ACL tear improved the specificity. Either of the oblique imaging methods is sufficient, and no further improvement in the diagnostic efficacy was achieved by simultaneous use

  18. Can MRI distinguish between acute partial and complete anterior cruciate ligament tear?

    International Nuclear Information System (INIS)

    A study to elucidate the title problem was done. Subjects were 8 patients with partial anterior cruciate ligament (ACL) tear diagnosed by both MRI and arthroscopy within 6 weeks after trauma, 14 patients with complete ACL tear diagnosed similarly and 10 control patients with arthroscopically intact ACL. Proton density-and T2-weighted MRI imaging of the sagittal section of the knee was performed with 1.5 T magnets (Siemens Magnetom H15, Shimadzu SMT150GUX) by using a dedicated knee coil, with slice thickness of 4-5 mm and 14-16 cm field of view. The examination was done on the primary (discontinuity of low signal band, abnormal axis of the ligament and focal or diffuse increased signal intensity) and secondary (bone bruise, anterior translocation of the tibia and PCL curvature value) signs of ACL tear. In proton density-weighted sagittal images, it was found easy to distinguish acute partial ACL tear from normal ligament but not from complete ACL tear. In T2-weighted images, partial ACL tear was suggested to keep continuity of the ligament. (H.O.)

  19. Long Term Effects of Tear Gases on Respiratory System: Analysis of 93 Cases

    Directory of Open Access Journals (Sweden)

    Peri Arbak

    2014-01-01

    Full Text Available Aim. This study aimed to assess the long-term respiratory effects of tear gases among the subjects with history of frequent exposure. Materials and Methods. A questionnaire by NIOSH and pulmonary function tests was performed in 93 males exposed to the tear gases frequently and 55 nonexposed subjects. Results. The mean numbers of total exposure and last 2 years exposure were 8.4±6.4 times, 5.6±5.8 times, respectively. Tear gas exposed subjects were presented with a higher rate for cough and phlegm more than 3 months (24.7% versus 11.3%, P>0.05. Mean FEV1/FVC and % predicted MMFR in smoker exposed subjects are significantly lower than those in smoker controls (81.7% versus 84.1%, P=0.046 and 89.9% versus 109.6%, P=0.0004, resp.. % predicted MMFR in nonsmoker exposed subjects is significantly lower than that in nonsmoker controls (99.4% versus 113.1%, P=0.05. Odds ratios for chest tightness, exercise dyspnea, dyspnea on level ground, winter morning cough, phlegm, and daily phlegm were increased almost 2 to 2.5 folds among tear gas exposed subjects. Conclusion. The rates for respiratory complaints were high in the case of the exposure to the tear gases previously. Tears gas exposed subjects were found to be under the risk for chronic bronchitis.

  20. Acetabular labral tears: contrast-enhanced MR imaging under continuous leg traction

    Energy Technology Data Exchange (ETDEWEB)

    Nishii, T. [Div. of Functional Diagnostic Imaging, Biomedical Research Center, Osaka Univ. Medical School, Suita (Japan); Nakanishi, K. [Dept. of Radiology, Osaka Univ. Medical School, Suita (Japan); Sugano, N. [Dept. of Orthopaedic Surgery, Osaka Univ. Medical School, Suita (Japan); Naito, H. [Div. of Functional Diagnostic Imaging, Biomedical Research Center, Osaka Univ. Medical School, Suita (Japan); Tamura, S. [Div. of Functional Diagnostic Imaging, Biomedical Research Center, Osaka Univ. Medical School, Suita (Japan); Ochi, T. [Dept. of Orthopaedic Surgery, Osaka Univ. Medical School, Suita (Japan)

    1996-05-01

    The objective of this study was to evaluate the effects of continuous leg traction on contrast-enhanced MR imaging of the hip joint and to determine whether MR imaging under these conditions is useful for demonstrating acetabular labral tears. Nineteen hips underwent MR imaging with a T1-weighted spin-echo sequence, followed by MR imaging under continuous leg traction after intravenous injection of gadolinium-DTPA. Joint fluid enhancement and labral contour detection were evaluated. Eleven hips had labral tears shown by conventional arthrography, arthroscopy and macroscopic surgical findings. Assessment of labral tears by MR imaging was correlated with the diagnosis based on these standard techniques. Joint fluid enhancement was obtained in all hips at 30 min after injection. Superior and inferior labral surfaces were completely delineated in 1 hip on the unenhanced MR images, and in 7 and 13 hips, respectively, on the enhanced images under traction. The enhanced images under traction depicted 9 of the 11 labral tears. Comparison between the unenhanced image and the enhanced image under traction avoided mistaking undercutting of the labrum for a tear in 4 hips. Contrast-enhanced MR imaging under traction was valuable for detecting labral tears non-invasively and without radiation. Follow-up examinations using this method in patients with acetabular dysplasia can help to clarify the natural course of labral disorders and enable better treatment planning. (orig./MG)

  1. Comparative Proteomics of Mouse Tears and Saliva: Evidence from Large Protein Families for Functional Adaptation

    Directory of Open Access Journals (Sweden)

    Robert C. Karn

    2015-09-01

    Full Text Available We produced a tear proteome of the genome mouse, C57BL/6, that contained 139 different protein identifications: 110 from a two-dimensional (2D gel with subsequent trypsin digestion, 19 from a one-dimensional (1D gel with subsequent trypsin digestion and ten from a 1D gel with subsequent Asp-N digestion. We compared this tear proteome with a C57BL/6 mouse saliva proteome produced previously. Sixteen of the 139 tear proteins are shared between the two proteomes, including six proteins that combat microbial growth. Among the 123 other tear proteins, were members of four large protein families that have no counterparts in humans: Androgen-binding proteins (ABPs with different members expressed in the two proteomes, Exocrine secreted peptides (ESPs expressed exclusively in the tear proteome, major urinary proteins (MUPs expressed in one or both proteomes and the mouse-specific Kallikreins (subfamily b KLKs expressed exclusively in the saliva proteome. All four families have members with suggested roles in mouse communication, which may influence some aspect of reproductive behavior. We discuss this in the context of functional adaptation involving tear and saliva proteins in the secretions of mouse lacrimal and salivary glands, respectively.

  2. Clinical Outcomes of Conservative Treatment and Arthroscopic Repair of Rotator Cuff Tears: A Retrospective Observational Study

    Science.gov (United States)

    Lee, Woo Hyung; Do, Hyun Kyung; Lee, Joong Hoon; Kim, Bo Ram; Noh, Jee Hyun; Choi, Soo Hyun; Chung, Sun Gun; Lee, Shi-Uk; Choi, Ji Eun; Kim, Seihee; Kim, Min Jee

    2016-01-01

    Objective To compare the clinical outcomes following conservative treatment and arthroscopic repair in patients with a rotator cuff tear. Methods In this retrospective study, patients aged >50 years with a symptomatic rotator cuff tear were reviewed. The rotator cuff tendons were evaluated using ultrasonography, shoulder magnetic resonance imaging or MR arthrography, and the patients with either a high-grade partial-thickness or small-to-medium-sized (≤3 cm) full-thickness tear were included in this study. The primary outcome measures were a pain assessment score and range of motion (ROM) at 1-year follow-up. The secondary outcomes were the rate of tear progression or retear along with the rate of symptom aggravation after the treatments. Results A total of 357 patients were enrolled, including 183 patients that received conservative treatment and 174 patients who received an arthroscopic repair. The pain assessment score (p50 years old with a less than medium-sized rotator cuff tear in a 1-year follow-up period. Further study is warranted to find the optimal combination of conservative treatment for a symptomatic rotator cuff tear. PMID:27152275

  3. Detection of the aortic intimal tears by using 3D digital topology

    Science.gov (United States)

    Lohou, Christophe; Miguel, Bruno

    2011-03-01

    Aortic dissection is a real problem of public health, it is a medical emergency and may quickly lead to death. Aortic dissection is caused by aortal tissue perforation because of blood pressure. It consists of tears (or holes of the intimal tissue) inside lumens. These tears are difficult to detect because they do not correspond to a filled organ to segment; they are usually visually retrieved by radiologists by examining gray level variation on successive image slices, but it remains a very difficult and error-prone task. Our purpose is to detect these intimal tears to help cardiac surgeons in making diagnosis. It would be useful either during a preoperative phase (visualization and location of tears, endoprothesis sizing); or during a peroperative phase (a registration of tears on angiographic images would lead to a more accuracy of surgeon's gestures and thus would enhance care of patient). At this aim, we use Aktouf et al.'s holes filling algorithm proposed in the field of digital topology. This algorithm permits the filling of holes of a 3D binary object by using topological notions - the holes are precisely the intimal tears for our aortic dissection images, after a first preprocessing step. As far as we know, this is the first time that such a proposal is made, even if it is a crucial data for cardiac surgeons. Our study is a preliminary and innovative work; our results are nevertheless considered satisfactory. This approach would also gain to be known to specialists of other diseases.

  4. Morphological changes of roof of subacromial bursa in patients with rotator cuff tear

    Institute of Scientific and Technical Information of China (English)

    ZHU Jin-yu 朱锦宇; ZHU Qing-sheng 朱庆生; Takashi Hashimoto; Katsuya Nobuhara

    2004-01-01

    Objective: To investigate the morphological changes of the roof of the subacromial bursa (SAB) and its involvement extent after rotator cuff tear. Methods: In the experimental group, the roof of SAB was obtained from 30 cases of rotator cuff tear both at the tear site and a site 2.5-3.0 cm distal to the tear site during rotator cuff repair. In the control group, the roof of SAB was obtained from the exposed site of recurrently dislocated shoulder or fractured humeral shaft of 8 cases.The specimens were stained with hematoxylin and eosin and observed under a transmission electron microscope. The cell number was quantitated through counting the bluestained nucleus in SAB with a computer image analysis system.Results: The number of cells increased significantly in the roof of SAB in the experimental group compared with that of the control group. However, no difference of the bursal reaction was found among the type of rotator cuff tear, the bursa thickness and the presence of fluid in the bursa. The great majority of cells were type B cells observed under the transmission electron microscope.Conclusions: The increase in cell number in the roof of SAB in the experimental group is a reactive increase rather than an inflammatory process and the involvement of SAB is not limited in extent. The change of the roof of SAB is a secondary reaction to the rotator cuff tear.

  5. Detection of secretory IgM in tears of IgA deficient individuals.

    Science.gov (United States)

    Kuizenga, A; Stolwijk, T R; van Agtmaal, E J; van Haeringen, N J; Kijlstra, A

    1990-10-01

    Tears from normal (n = 5) and serum IgA deficient (n = 3) individuals were investigated for the presence of secretory Immunoglobulin A (sIgA), sIgM and free secretory component (SC) by sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) using 10-15% gradient minigels (PhastSystem), followed by immunoblotting using various immunological probes. Tear samples were treated in denaturing (SDS) sample buffer under non-reducing as well as reducing conditions, prior to analysis. All normal tear samples contained sIgA as well as free SC (estimated MW: 82kD) but only traces of IgM. Tears from the three serum IgA deficient subjects lacked sIgA but did contain free SC. In two of them sIgM was clearly detected and after treatment of tears with reducing agent, IgM (mu) heavy chain fragments (estimated MW: 78kD) were identified and could be distinguished from other tear proteins after SDS-PAGE. These findings indicate lacrimal secretion of free secretory component, even in the absence of its ligand. On the ocular surface, sIgM may play a compensatory role in IgA deficiency. PMID:2125905

  6. Investigation of interaction between fast ions and tearing modes in MST plasmas using full orbit tracing

    Science.gov (United States)

    Kim, Jungha; Anderson, Jay; Capecchi, William; Bonofiglo, Phillip; Sears, Stephanie; Tsidulko, Yuri

    2015-11-01

    Under proper conditions, global reconnection events generate an anisotropic runaway ion distribution in MST plasmas. Full orbit tracing with time-dependent fluctuating fields, calculated by the nonlinear resistive MHD code DEBS, is used to inform a refined model of ion heating to explain this phenomenon, where tearing modes and ions interact on two distinct scales. There is anisotropic heating of thermal ions (T⊥>T∥), likely through a stochastic heating mechanism that requires high diffusivity and a tearing mode induced radial electric field with correlation length of a few cm. This process does not, however, continuously energize ions into the runaway regime. At sufficient energy, the ion guiding center deviates from the background magnetic field, which reduces the effective diffusivity to classical levels even in a stochastic magnetic field. These ``fast'' ions are accelerated by a parallel electric field (length scale of meters) induced by the equilibrium change accompanying tearing modes. This process relies on multiple global tearing modes; here we focus on a single tearing mode. This is compared to an experimental state where a transition to a single, dominant tearing mode is observed to accelerate fast ions and alter their confinement properties. Work supported by US DOE.

  7. Effect of Time after Anterior Cruciate Ligament Tears on Proprioception and Postural Stability.

    Directory of Open Access Journals (Sweden)

    Dae-Hee Lee

    Full Text Available This study was designed to compare proprioception and postural stability in patients with acute (time from injury ≤ 3 months and chronic (time from injury > 3 months ACL tears, and to evaluate the correlation between time interval after ACL injury and proprioception. Thigh muscle strength, postural stability, and joint position sense were compared in 48 patients with acute ACL tears and in 28 with chronic ACL tears. Maximal torque (60°/sec of the quadriceps and hamstring was evaluated using an isokinetic testing device. Postural stability was determined from the anterior-posterior (APSI, medial-lateral (MLSI, and overall (OSI stability indices using stabilometry. Joint position sense was also tested by reproduction of passive positioning (RPP. Muscle strengths and stability indices on both the involved and uninvolved sides were similar in the acute and chronic ACL tear groups. RPP on the involved side was significantly greater in the chronic than in the acute ACL tear group (7.8° vs. 5.6°, P = 0.041. Two of three stability indices (APSI, OSI and RPP were significantly greater on the involved than the uninvolved side in the chronic ACL tear group.

  8. Standard test method for dynamic tear testing of metallic materials

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    1983-01-01

    1.1 This test method covers the dynamic tear (DT) test using specimens that are 3/16 in. to 5/8 in. (5 mm to 16 mm) inclusive in thickness. 1.2 This test method is applicable to materials with a minimum thickness of 3/16 in. (5 mm). 1.3 The pressed-knife procedure described for sharpening the notch tip generally limits this test method to materials with a hardness level less than 36 HRC. Note 1—The designation 36 HRC is a Rockwell hardness number of 36 on Rockwell C scale as defined in Test Methods E 18. 1.4 The values stated in inch-pound units are to be regarded as standard. The values given in parentheses are mathematical conversions to SI units that are provided for information only and are not considered standard. 1.5 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety and health practices and determine the applicability of regulatory limitations prior to use.

  9. Intermittent bursts induced by double tearing mode reconnection

    Energy Technology Data Exchange (ETDEWEB)

    Wei, Lai; Wang, Zheng-Xiong, E-mail: zxwang@dlut.edu.cn [Key Laboratory of Materials Modification by Beams of the Ministry of Education, School of Physics and Optoelectronic Technology, Dalian University of Technology, Dalian 116024 (China)

    2014-06-15

    Reversed magnetic shear (RMS) configuration is assumed to be the steady-state operation scenario for the future advanced tokamaks like International Thermonuclear Experimental Reactor. In this work, we numerically discover a phenomenon of violent intermittent bursts induced by self-organized double tearing mode (DTM) reconnection in the RMS configuration during the very long evolution, which may continuously lead to annular sawtooth crashes and thus badly impact the desired steady-state operation of the future advanced RMS tokamaks. The key process of the intermittent bursts in the off-axis region is similar to that of the typical sawtooth relaxation oscillation in the positive magnetic shear configuration. It is interestingly found that in the decay phase of the DTM reconnection, the zonal field significantly counteracts equilibrium field to make the magnetic shear between the two rational surfaces so weak that the residual self-generated vortices of the previous DTM burst are able to trigger a reverse DTM reconnection by curling the field lines.

  10. The causes of geometry effects in ductile tearing

    International Nuclear Information System (INIS)

    An adequate understanding of geometry effects in ductile tearing can only be achieved when the different causes of the effects are distinguished and these geometry effects are linked to particular micromechanical fracture processes or global deformation mechanisms. It is shown that the micromechanical process of ductile (fibrous) fracture is dependent on achieving a critical strain, which is only slightly dependent on the stress state for the range of triaxiality conditions in pressure vessels and through-cracked plates. Under certain conditions, the crack tip strain can be shown to scale with the value of the J integral and there is a direct connection between J and the underlying micro mechanical process. This connection is lost for significant crack extension or large-scale plasticity. Nevertheless the J integral may still be use on an empirical basis under some conditions. Under fully-plastic conditions the primary source of geometry dependence in the J-R curves is due to the geometry dependence of the shape and volume of the plastic region that develops around the uncracked ligament. This occurs because J is essentially proportional to the total plastic work done on the specimen. If it can be assured that the fracture mode in both the test specimen and the structure will remain fully fibrous, it is conservative to extrapolate J-R curves generated from small compact specimens for the analysis of pressure vessel crack stability. 132 refs., 12 figs., 3 tabs

  11. 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)

  12. Intermittent bursts induced by double tearing mode reconnection

    International Nuclear Information System (INIS)

    Reversed magnetic shear (RMS) configuration is assumed to be the steady-state operation scenario for the future advanced tokamaks like International Thermonuclear Experimental Reactor. In this work, we numerically discover a phenomenon of violent intermittent bursts induced by self-organized double tearing mode (DTM) reconnection in the RMS configuration during the very long evolution, which may continuously lead to annular sawtooth crashes and thus badly impact the desired steady-state operation of the future advanced RMS tokamaks. The key process of the intermittent bursts in the off-axis region is similar to that of the typical sawtooth relaxation oscillation in the positive magnetic shear configuration. It is interestingly found that in the decay phase of the DTM reconnection, the zonal field significantly counteracts equilibrium field to make the magnetic shear between the two rational surfaces so weak that the residual self-generated vortices of the previous DTM burst are able to trigger a reverse DTM reconnection by curling the field lines

  13. A tearing-based hybrid parallel banded linear system solver

    Science.gov (United States)

    Naumov, Maxim; Sameh, Ahmed H.

    2009-04-01

    A new parallel algorithm for the solution of banded linear systems is proposed. The scheme tears the coefficient matrix into several overlapped independent blocks in which the size of the overlap is equal to the system's bandwidth. A corresponding splitting of the right-hand side is also provided. The resulting independent, and smaller size, linear systems are solved under the constraint that the solutions corresponding to the overlap regions are identical. This results in a linear system whose size is proportional to the sum of the overlap regions which we refer to as the "balance" system. We propose a solution strategy that does not require obtaining this "balance" system explicitly. Once the balance system is solved, retrieving the rest of the solution can be realized with almost perfect parallelism. Our proposed algorithm is a hybrid scheme that combines direct and iterative methods for solving a single banded system of linear equations on parallel architectures. It has broad applications in finite-element analysis, particularly as a parallel solver of banded preconditioners that can be used in conjunction with outer Krylov iterative schemes.

  14. Overview of Neoclassical Tearing Mode Studies in NSTX

    Science.gov (United States)

    Gerhardt, Stefan; La Haye, R. J.; Strait, E. J.; Buttery, R. J.; Brennan, D.; Fredrickson, E.; Gates, D.; Maraschek, M.; Menard, J. E.; Sabbagh, S. A.

    2008-11-01

    Both the m/n=2/1 and 3/2 neoclassical tearing modes have been observed in high-performance plasma regimes in NSTX. These instabilities are observed as fluctuations in the soft X-rays and Mirnov arrays, as sources of strong rotation damping, and as flat regions in the electron temperature profile. The neoclassical nature of the islands is confirmed by the observed linear dependence of the saturated island width on beta-poloidal, and restabilization of the islands as beta-poloidal is reduced. The 2/1 mode is often, but not always, observed to grow without any clear seeding event. The required drive for the 2/1 mode when it strikes, i.e. beta-poloidal or the bootstrap current at q=2, increases with increasing toroidal flow shear. A combination of lithium surface coatings and dynamic error field correction often eliminate the 2/1 mode for the duration of the discharge. The role of error fields in modifying the 2/1 onset threshold will also be described. Modeling efforts and future experimental research plans will be discussed.

  15. Numerical modeling of ductile tearing effects on cleavage fracture toughness

    International Nuclear Information System (INIS)

    Experimental studies demonstrate a significant effect of specimen size, a/W ratio and prior ductile tearing on cleavage fracture toughness values (Jc) measured in the ductile-to-brittle transition region of ferritic materials. In the lower-transition region, cleavage fracture often occurs under conditions of large-scale yielding but without prior ductile crack extension. The increased toughness develops when plastic zones formed at the crack tip interact with nearby specimen surfaces which relaxes crack-tip constraint (stress triaxiality). In the mid-to-upper transition region, small amounts of ductile crack extension (often c-values. Previous work by the authors described a micromechanics fracture model to correct measured Jc-values for the mechanistic effects of large-scale yielding. This new work extends the model to also include the influence of ductile crack extension prior to cleavage. The paper explores development of the new model, provides necessary graphs and procedures for its application and demonstrates the effects of the model on fracture data sets for two pressure vessel steels (A533B and A515)

  16. Partial tearing of the anterior cruciate ligament: diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Eduardo Frois Temponi

    2015-02-01

    Full Text Available Partial tears of the anterior cruciate ligament (ACL are common and represent 10-27% of the total. The main reasons for attending to cases of non-torn bundles are biomechanical, vascular and proprioceptive. Continued presence of the bundle also serves as protection during the healing process. There is controversy regarding the definition of these injuries, which is based on anatomy, clinical examination, translation measurements, imaging examinations and arthroscopy. The way in which it is treated will depend on the existing laxity and instability. Conservative treatment is optional for cases without instability, with a focus on motor rehabilitation. Surgical treatment is a challenge, since it requires correct positioning of the bone tunnels and conservation of the remnants of the torn bundle. The pivot shift test under anesthesia, the magnetic resonance findings, the previous level and type of sports activity and the arthroscopic appearance and mechanical properties of the remnants will aid the orthopedist in the decision-making process between conservative treatment, surgical treatment with strengthening of the native ACL (selective reconstruction and classical (anatomical reconstruction.

  17. Tearing-fatigue interactions in 316L(N) austenitic stainless steel

    Energy Technology Data Exchange (ETDEWEB)

    Sherry, A.H. [University of Manchester, Sackville Street, Manchester M60 1QD (United States)]. E-mail: andrew.sherry@manchester.ac.uk; Wardle, G. [Warhelle Consulting Ltd, 79 Garton Drive, Lowton, Cheshire WA3 2TR (United States); Jacques, S. [Serco Assurance, Birchwood Park, Risley, Warrington WA3 6AT (United States); Hayes, J.P. [Serco Assurance, Birchwood Park, Risley, Warrington WA3 6AT (United States)

    2005-11-01

    This paper presents the results from a programme of tearing, fatigue and tearing-fatigue tests performed on specimens from a 316L(N) stainless steel plate. All tests were carried out at ambient temperature. The experimental results have been compared with assessments performed using current guidance within the R6 defect assessment method. The work has shown that there is some evidence that fatigue cycling modifies the JR-curve behaviour of this material. In most cases, the data lie approximately 20-30% above the base-line JR-curve. However, whilst there may be a modest influence of fatigue crack growth on the ductile tearing characteristics, it is difficult to separate this from experimental scatter. In tearing-fatigue tests performed at a stress ratio, R=0.2, ductile tearing reduces the fatigue crack growth rates by up to 50%. This is likely to result from the presence of a residual compressive zone at the crack-tip, and increased crack closure due to the irregular and non-matching fracture surfaces generated by the ductile crack growth mechanisms. For R=0.1 tearing-fatigue tests, fatigue crack growth rates are apparently enhanced by a factor up to of 10, particularly during the latter stages of the tests when {delta}K>60 MPam. This is likely to result from: (i) loading being in the elastic-plastic regime where the J-integral (rather than K) characterises the crack-tip fields (ii) increments of ductile tearing which may occur during each fatigue cycle, and (iii) crack blunting which reduces crack closure effects. For the R=0.2 tearing-fatigue tests, the linear summation approach described in R6 provides a consistently conservative prediction of ductile, fatigue and total crack growth during the tests. However, for the R=0.1 tearing-fatigue tests, the Paris law under-predicts fatigue crack growth rates. This may be corrected by using the Kaiser equation, which acknowledges loading in the elastic-plastic regime and incorporates incremental growth due to tearing as

  18. Tearing-fatigue interactions in 316L(N) austenitic stainless steel

    International Nuclear Information System (INIS)

    This paper presents the results from a programme of tearing, fatigue and tearing-fatigue tests performed on specimens from a 316L(N) stainless steel plate. All tests were carried out at ambient temperature. The experimental results have been compared with assessments performed using current guidance within the R6 defect assessment method. The work has shown that there is some evidence that fatigue cycling modifies the JR-curve behaviour of this material. In most cases, the data lie approximately 20-30% above the base-line JR-curve. However, whilst there may be a modest influence of fatigue crack growth on the ductile tearing characteristics, it is difficult to separate this from experimental scatter. In tearing-fatigue tests performed at a stress ratio, R=0.2, ductile tearing reduces the fatigue crack growth rates by up to 50%. This is likely to result from the presence of a residual compressive zone at the crack-tip, and increased crack closure due to the irregular and non-matching fracture surfaces generated by the ductile crack growth mechanisms. For R=0.1 tearing-fatigue tests, fatigue crack growth rates are apparently enhanced by a factor up to of 10, particularly during the latter stages of the tests when ΔK>60 MPam. This is likely to result from: (i) loading being in the elastic-plastic regime where the J-integral (rather than K) characterises the crack-tip fields (ii) increments of ductile tearing which may occur during each fatigue cycle, and (iii) crack blunting which reduces crack closure effects. For the R=0.2 tearing-fatigue tests, the linear summation approach described in R6 provides a consistently conservative prediction of ductile, fatigue and total crack growth during the tests. However, for the R=0.1 tearing-fatigue tests, the Paris law under-predicts fatigue crack growth rates. This may be corrected by using the Kaiser equation, which acknowledges loading in the elastic-plastic regime and incorporates incremental growth due to tearing as well

  19. Ultrasound versus Magnetic Resonance Arthrography in Acetabular Labral Tear Diagnostics: A Prospective Comparison in 20 Dysplastic Hips

    Energy Technology Data Exchange (ETDEWEB)

    Troelsen, A.; Jacobsen, S.; Bolvig, L.; Gelineck, J.; Roemer, L.; Soeballe, K. [Orthopedic Research Unit and Dept. of Radiology, Univ. Hospital of Aarhus, A arhus (Denmark)

    2007-11-15

    Background: Acetabular labral tears are highly associated with hip dysplasia. Magnetic resonance arthrography (MR arthrography) is the expensive and time-consuming contemporary gold-standard method in the radiological assessment of acetabular labral tears. Purpose: To assess the diagnostic ability of noninvasive ultrasound (US) examination compared to MR arthrography in diagnosing acetabular labral tears in dysplastic hip joints. Material and Methods: The study compared US examination and MR arthrography diagnosis of labral tears in 20 consecutively referred dysplastic hip joints. Results: The ability to diagnose acetabular labral tears upon US examination was calculated: sensitivity 44%, specificity 75%, positive predictive value 88%, and negative predictive value 25%. Conclusion: The ability of US examination in diagnosing acetabular labral tears is not yet good enough. The technique is still to be developed, and more experience, especially with the interpretation of US examinations, is needed.

  20. Pre-Existing Rotator Cuff Tears as a Predictor of Outcomes in National Football League Athletes

    Science.gov (United States)

    Gibbs, Daniel; Lynch, Thomas Sean; Gomberawalla, M. Mustafa; Schroeder, Greg; LaBelle, Mark; Hollett, Brian P.; Saltzman, Matthew; Nuber, Gordon W.

    2015-01-01

    Objectives: Fifty percent of all athletes at the National Football League (NFL) Combine report having had a shoulder injury at some point during their playing career. Rotator cuff tears are rare injuries in young athletes, but an increasing incidence has been noted amongst competitive football players. It is unknown how pre-existing rotator cuff tears affect career longevity and performance of NFL athletes. In Combine athletes with pre-existing rotator cuff tears, knowledge of outcomes may help athletes and physicians manage expectations of draft potential, career length and performance. Methods: The written medical evaluations of prospective professional American football athletes from 2003-2011 during the NFL Combine were compiled and evaluated. All players were evaluated for the diagnosis of a pre-existing rotator cuff tear and stratified based on whether or not they underwent surgical intervention. Athletes with rotator cuff tears, who were selected in the NFL draft, were matched by age, position, year, and round drafted to control draftees without significant documented shoulder pathology. Career statistics, including a previously established “Performance Score,” were compiled. The continuous variables of each cohort were compared using a Student's t-test. A Chi Squared test was performed to analyze the categorical data. Statistical significance was accepted with a p-value < 0.05. Results: Between the years of 2003 and 2011, 2,965 consecutive athletes were evaluated. Forty-nine athletes were identified with a pre-existing rotator cuff tear; twenty-two of these athletes underwent surgical intervention for their tear and 27 were treated non-operatively. Those who attended the NFL Combine with a history of a rotator cuff tear were significantly less likely to be drafted than those without a previous injury (55.1% vs. 77.5% respectively, p = 0.002) (Table 1A). The 27 drafted athletes with pre-existing rotator cuff tears played significantly fewer years (4.3 vs

  1. Bâkî’de Gözyaşı
    Tear at Bâkî

    OpenAIRE

    Nazmi ÖZEROL

    2012-01-01

    Tears have been elements frequently applied to express emotional intensity in literatural texts. When “love” is concerned, the milestone of classical literature philosophy, the tearsof the lover are the first thingsto flash in one’s mind. Tears are included in textual structures withtheir whole connotational richness to reflect love to the lover and itsbeauty elements, any spiritual state of the lover, his status in thecommunity, his religious viewpoint.Tears are the biggest indicators of bei...

  2. Dermal fillers for the treatment of tear trough deformity: A review of anatomy, treatment techniques, and their outcomes

    OpenAIRE

    Jaishree Sharad

    2012-01-01

    Tear trough deformity is a major concern in a lot of individuals seeking periorbital rejuvenation. A prominent tear trough deformity is characterised by a sunken appearance of the eye that results in the casting of a dark shadow over the lower eyelid, giving the patient a fatigued appearance despite adequate rest, and is refractory to attempts at cosmetic concealment. The tear trough deformity is a natural consequence of the anatomic attachments of the periorbital tissues. A variety of techni...

  3. Gyrokinetic-ion drift-kinetic-electron simulation of the (m = 2, n = 1) cylindrical tearing mode

    Science.gov (United States)

    Chen, Y.; Chowdhury, J.; Maksimovic, N.; Parker, S. E.; Wan, W.

    2016-05-01

    Particle-in-cell simulations of (m =2 ,n =1 ) tearing mode in cylindrical plasmas are carried out with kinetic electrons using the split-weight control-variate algorithm [Y. Chen and S. E. Parker, J. Comput. Phys. 220, 839 (2007)]. Radially, global simulation shows global mode structure in agreement with reduced-magnetohydrodynamic eigenmode calculation. Simulations of the tearing layer are verified with analytic results for the collisionless, semi-collisional, and drift-tearing mode.

  4. Two- and three-dimensional characterizations of hot tears in a Al-Mg-Si alloy laser weld

    International Nuclear Information System (INIS)

    Hot tears in 6xxx aluminium alloy laser welds are characterized. They are shown to be intergranular, originating from fracture of liquid films without plasticity of the surrounding grains. The hot tear initiates on both sides of the fusion zone, follows the liquid films between the columnar grains of the weld line and then propagates around the equiaxed grains of the fusion zone centre. By using three-dimensional X-ray tomography, the exact shape of the hot tears has been visualized

  5. Partial tears of the distal biceps tendon: MR appearance and associated clinical findings

    Energy Technology Data Exchange (ETDEWEB)

    Williams, B.D.; Schweitzer, M.E.; Weishaupt, D.; Miller, L.S. [Thomas Jefferson Univ., Philadelphia, PA (United States). Dept. of Radiology; Lerman, J. [Lerman Imaging, Brooklyn, NY (United States); Rubenstein, D.L. [Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA (United States); Rosenberg, Z.S. [Dept. of Diagnostic Radiology, New York Univ. Medical Center, NY (United States)

    2001-10-01

    Purpose: To describe the magnetic resonance (MR) appearance and associated clinical findings of partial distal biceps tendon tears. Design: Twenty elbow MR images at 1.5 T, performed over a 7 year period, were reviewed for an appearance of partial tears in the distal biceps. These images were assessed by two musculoskeletal radiologists for the extent of: (a) abnormal signal intensity within the tendon, and the presence of (b) bicipitoradial bursitis, and (c) bony microavulsive injury of the radial tuberosity. Medical records for nine of the 20 cases were reviewed for the clinical findings of ecchymosis, trauma, sensation of a ''pop'', loss of function, and acuity of onset. Results: Twenty partial distal biceps tendon tears were seen. All displayed an abnormally increased signal in the distal biceps tendon. Three of 20 (15%) showed a 25% to 50% tear, ten of 20 (50%) showed a 50% tear, and seven of 20 (35%) showed a 75% to 90% tear. Bicipitoradial bursitis was seen in 11 of 20 (55%) cases. Bony microavulsive injury of the radial tuberosity was observed in 10 of 20 (50%). Of the nine cases reviewed for associated clinical findings, surprisingly, only three (33%) experienced an acute traumatic episode with an abrupt onset of pain. An insidious onset was reported in four of nine (44%). Sensation of a ''pop'' was recorded in only two of nine (22%) cases. Ecchymosis and loss of function were not seen in any of the cases. Finally, surgical conformation was obtained for three cases. Conclusion: Partial distal biceps tendon tears have a characteristic MR appearance, demonstrate little functional deficit, and may be attritional in their etiology due to the observation of a low number of patients reporting trauma or an acute onset. (orig.)

  6. Preocular Tear Film Tests in Acute Hemorrhagic Conjunctivitis Caused by Coxsackievirus A24 Variant

    Directory of Open Access Journals (Sweden)

    Gökhan Pekel

    2012-05-01

    Full Text Available Pur po se: Our aim was to evaluate the preocular tear film in patients who had acute hemorrhagic conjunctivitis (AHC caused by coxsackievirus A24 variant (CVA24v. Ma te ri als and Met hod: Seventy-six patients having AHC caused by CVA24v were enrolled in this study. An AHC outbreak was seen in Istanbul during August and September 2010 and lasted for four weeks. All the patients were seen at the first days of their disease period and none of them had received any treatment before. Conjunctival swab specimens were taken from the patients at their first visit. Tear film tests including Schirmer test, tear meniscus height measurement and tear break-up time (TBUT were done in all patients. Re sults: The mean age of the patients was 27.8 years (range: 7-68 years. Forty patients were male (53% and 36 patients were female (47%. In bilateral conjunctivitis cases, the mean Schirmer test result was 23.7±4.7 mm, mean TBUT was 15.1±2.4 seconds and the mean tear meniscus height was 0.37±0.06 mm. In unilateral conjunctivitis cases, the mean Schirmer test result was 24.4±3.6 mm, mean TBUT was 15.1±2.3 seconds and the mean tear meniscus height was 0.38±0.07 mm in the diseased eyes. Dis cus si on: The results of the routine preocular tear film tests did not differ in AHC caused by CVA24v when compared with healthy eyes. (Turk J Ophthalmol 2012; 42: 186-9

  7. Helical temperature perturbations associated with tearing modes in tokamak plasmas

    International Nuclear Information System (INIS)

    An investigation is made into the electron temperature perturbations associated with tearing modes in tokamak plasmas, with a view to determining the mode structure using Electron Cyclotron Emission (ECE) data. It is found that there is a critical magnetic island width below which the conventional picture where the temperature is flattened inside the separatrix is invalid. This effect comes about because of the stagnation of magnetic field lines in the vicinity of the rational surface and the finite parallel thermal conductivity of the plasma. For islands whose widths lie below the critical value there is no flattening of the electron temperature inside the separatrix. Such islands have quite different ECE signatures to conventional magnetic islands. In fact the two island types could, in principle, be differentiated experimentally. It should also be possible to map out the outer ideal magnetohydrodynamical eigenfunctions using ECE data. Islands whose widths are much less than the critical value are not destabilized by the perturbed bootstrap current, unlike conventional magnetic islands. This effect is found to have a number of very interesting consequences and may, indeed, provide an explanation for some puzzling experimental results regarding error field induced magnetic reconnection. All islands whose widths are much greater than the critical width possess a boundary layer on the separatrix which enables heat to be transported from one side of the island to the other via the X-point region. The structure of this boundary layer is described in some detail. Finally, the critical island width is found to be fairly substantial in conventional tokamak plasmas, provided that the long mean free path nature of parallel heat transport and the anomalous nature of perpendicular heat transport are taken into account in the calculation

  8. Verification of gyrokinetic particle simulation of current-driven instability in fusion plasmas. III. Collisionless tearing mode

    International Nuclear Information System (INIS)

    A finite-mass electron fluid model for low frequency electromagnetic fluctuations, particularly the collisionless tearing mode, has been implemented in the gyrokinetic toroidal code. Using this fluid model, linear properties of the collisionless tearing mode have been verified. Simulations verify that the linear growth rate of the single collisionless tearing mode is proportional to De2, where De is the electron skin depth. On the other hand, the growth rate of a double tearing mode is proportional to De in the parameter regime of fusion plasmas

  9. Effect of partial-thickness tear on loading capacities of the supraspinatus tendon: a finite element analysis.

    Science.gov (United States)

    Engelhardt, Christoph; Ingram, David; Müllhaupt, Philippe; Farron, Alain; Becce, Fabio; Pioletti, Dominique; Terrier, Alexandre

    2016-06-01

    Partial-thickness tears of the supraspinatus tendon frequently occur at its insertion on the greater tubercule of the humerus, causing pain and reduced strength and range of motion. The goal of this work was to quantify the loss of loading capacity due to tendon tears at the insertion area. A finite element model of the supraspinatus tendon was developed using in vivo magnetic resonance images data. The tendon was represented by an anisotropic hyperelastic constitutive law identified with experimental measurements. A failure criterion was proposed and calibrated with experimental data. A partial-thickness tear was gradually increased, starting from the deep articular-sided fibres. For different values of tendon tear thickness, the tendon was mechanically loaded up to failure. The numerical model predicted a loss in loading capacity of the tendon as the tear thickness progressed. Tendon failure was more likely when the tendon tear exceeded 20%. The predictions of the model were consistent with experimental studies. Partial-thickness tears below 40% tear are sufficiently stable to persist physiotherapeutic exercises. Above 60% tear surgery should be considered to restore shoulder strength. PMID:26290956

  10. Verification of gyrokinetic particle simulation of current-driven instability in fusion plasmas. III. Collisionless tearing mode

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Dongjian [College of Physical Science and Technology, Sichuan University, Chengdu 610064 (China); Southwestern Institution of Physics, Chengdu 610041 (China); Bao, Jian [Fusion Simulation Center, Peking University, Beijing 100871 (China); Han, Tao; Wang, Jiaqi [College of Physical Science and Technology, Sichuan University, Chengdu 610064 (China); Lin, Zhihong, E-mail: zhihongl@uci.edu [Department of Physics and Astronomy, University of California, Irvine, California 92697 (United States)

    2016-02-15

    A finite-mass electron fluid model for low frequency electromagnetic fluctuations, particularly the collisionless tearing mode, has been implemented in the gyrokinetic toroidal code. Using this fluid model, linear properties of the collisionless tearing mode have been verified. Simulations verify that the linear growth rate of the single collisionless tearing mode is proportional to D{sub e}{sup 2}, where D{sub e} is the electron skin depth. On the other hand, the growth rate of a double tearing mode is proportional to D{sub e} in the parameter regime of fusion plasmas.

  11. Fourier-Domain Optical Coherence Tomography for Monitoring the Lower Tear Meniscus in Dry Eye after Acupuncture Treatment

    Directory of Open Access Journals (Sweden)

    Tong Lin

    2015-01-01

    Full Text Available Dry eye is highly prevalent and has a significant impact on quality of life. Acupuncture was found to be effective to treat dry eye. However, little was known about the effect of acupuncture on different subtypes of dry eye. The objective of this study was to investigate the applicability of tear meniscus assessment by Fourier-domain optical coherence tomography in the evaluation of acupuncture treatment response in dry eye patients and to explore the effect of acupuncture on different subtypes of dry eye compared with artificial tear treatment. A total of 108 dry eye patients were randomized into acupuncture or artificial tear group. Each group was divided into three subgroups including lipid tear deficiency (LTD, Sjögren syndrome dry eye (SSDE, and non-Sjögren syndrome dry eye (Non-SSDE for data analysis. After 4-week treatment, the low tear meniscus parameters including tear meniscus height (TMH, tear meniscus depth (TMD, and tear meniscus area (TMA in the acupuncture group increased significantly for the LTD and Non-SSDE subgroups compared with both the baseline and the control groups (all P values < 0.05, but not for the SSDE. Acupuncture provided a measurable improvement of the tear meniscus dimensions for the Non-SSDE and LTD patients, but not for the SSDE patients.

  12. The use of MRI in the diagnosis of anterior cruciate ligament tears

    International Nuclear Information System (INIS)

    The study was comprised of 143 patients (83 males and 60 females) undergoing arthroscopy for the anterior cruciate ligament (ACL), whose ages ranged from 10 to 82 years with a mean of 34.5. To determine the value of magnetic resonance imaging (MRI) in the diagnosis of ACL tears, the findings of MRI were correlated with arthroscopic findings. Using arthroscopy as the standard, the accuracy, sensitivity, and specificity of MRI were 97.9%, 98.1%, and 99.0%, respectively, for the diagnosis of ACL tears. MRI appearance of the ACL evaluated as normal on arthroscopy fell into three types: (A) hyperintense fibers before and after the hypointense band with clear margin, (B) hypointense band with unclear margin, and (C) slender hypointense band in front of the slightly hypointense thick fiber-like structure. MRI showed abnormal findings even for the ACL with favorable tension. MRI was of limited value in differentiating complete from partial tears and fresh from old tears, although it had the high ability to diagnose ACL tears. (N.K.)

  13. The Significance of alteration of anterior cruciate ligament axis as a secondary sign of tear

    International Nuclear Information System (INIS)

    To assess the significance of alteration of the anterior cruciate ligament(ACL) axis as seen on magnetic resonance imaging of anterior cruciate ligament tear. ACL angle(angle between lateral tibial plateau an ACL) and ACL-Blumensaat line angle(angle between ACL and Blumensaat line) were measured in 76 patients with ACL tear and 55 patients with normal ACL. The significance of the change in orientation of the ACL was evaluated. ACL angle was significantly smaller in the tear group(35.07 deg±10.34 deg, mean±standard deviation) than in the normal group(54.11 deg±4.61 deg)(p<0.001);when cutoff value was less than 45 deg, sensitivity, specificity and accuracy were 85.5%, 98.2% and 90.8%, respectively. The ACL-Blumensaat line angle was significantly greater in the tear group(20.33 deg±9.56 deg) than in the normal group(2.55 deg±4.86 deg)(p<0.001). when cutoff value was more than 10 deg, sensitivity, specificity and accuracy were 90.8%, 94.5%, and 92.4%, repectively. The change in orientation of the ACL was an important associated finding in cases of ACL tear. We suggest that cutoff values should be an ACL angle of less than 45 deg, and an ACL-Blumensaat line angle of more than 10 deg

  14. Determination of loss tangent of human tear film at 9.8 GHz

    Science.gov (United States)

    Bansal, Namita; Dhaliwal, A. S.; Mann, K. S.

    2015-08-01

    Basal (non-stimulated) tears that are produced by accessory lacrimal glands located in conjunctiva of human eye, form tear film which in turn keeps the eye moist and lubricate; nourishes the eye; protects the eye from dust, bacterial infection and shear forces generated during eye movements and blinking; and provides a refractive surface on the corneal epithelium. Film is known to contain water, mucin, lipids, lysozyme, glucose, urea, sodium etc. In present communication, loss tangent of human tear film has been determined at 9.8 GHz microwaves by employing cavity perturbation technique at a temperature of 37°C. The basal tears from a small population comprising six subjects were collected and average value of loss tangent is reported. Slater's technique was used to reduce the error caused in measuring the volume of sample. The determined values are useful to study the biological effects of microwaves on tear film as well as other parts of human eye such as eye lens and lens epithelial cells. To the best of author's knowledge, no such study is available in literature at any radio as well as microwave frequencies; therefore present determinations are first of its kind.

  15. Warping and tearing of misaligned circumbinary disks around eccentric SMBH binaries

    CERN Document Server

    Hayasaki, Kimitake; Okazaki, Atsuo T; Jung, Taehyun; Zhao, Guangyao; Naito, Tsuguya

    2015-01-01

    We study the warping and tearing of a geometrically thin, non-self-gravitating disk surrounding binary supermassive black holes on an eccentric orbit. The circumbinary disk is significantly misaligned with the binary orbital plane, and is subject to the time-dependent tidal torques. In principle, such a disk is warped and precesses, and is torn into mutually misaligned rings in the region, where the tidal precession torques are stronger than the local viscous torques. We derive the tidal-warp and tearing radii of the misaligned circumbinary disks around eccentric SMBH binaries. We find that in disks with the viscosity parameter, alpha, larger than a critical value depending on the disk aspect ratio, the disk warping appears outside the tearing radius. This condition is expressed as alpha > sqrt{H/3r} for H/r ~<0.1, where H is the disk scale height. If alpha < sqrt{H/3r}, only the disk tearing occurs because the tidal warp radius is inside the tearing radius, where most of disk material is likely to rapi...

  16. Immunological and antimicrobial molecules in human tears: a review and preliminary report*

    Directory of Open Access Journals (Sweden)

    R. Schnetler

    2012-12-01

    Full Text Available The human tear film is a multi-layered and chemically complex structure, which performs numerous functions relating to the health of the corneal surface.  One of the core functions of the tear film is to protect the eye against invasion by pathogens.  Thus its middle layer, the ‘core aqueous stratum’, harbours a myriad of immunologicaland antimicrobial proteins. In this review we discuss the most abundant of these proteins (immunoglobulins, toll-like receptors, cytokines, lactoferrin, lysozyme, lipocalins, surfactant protein-Aand -D and defensins.  In order to illustrate how the levels of immunological/antimicrobial proteins in tears change in response to eye disease, we review literature in which levels of these proteins have been measured in tears of patients with dry eye disease (DED and keratoconus (KC.  Finally, we report results of a preliminary study to measure the concentration of secretory immunoglobulin A (sIgA in the tears of DED and KC patients. The study showed a significant decrease of sIgA levels  in DED compared to control. Further analysis must be done to determine whether or not DED and KC may be associated with differential expression of immune proteins. (S Afr Optom 2012 71(3 123-132

  17. Biomedical soft contact-lens sensor for in situ ocular biomonitoring of tear contents.

    Science.gov (United States)

    Chu, MingXing; Shirai, Takayuki; Takahashi, Daishi; Arakawa, Takahiro; Kudo, Hiroyuki; Sano, Kenji; Sawada, Shin-ichi; Yano, Kazuyoshi; Iwasaki, Yasuhiko; Akiyoshi, Kazunari; Mochizuki, Manabu; Mitsubayashi, Kohji

    2011-08-01

    A soft contact-lens biosensor (SCL-biosensor) for novel non-invasive biomonitoring of tear fluids was fabricated and tested. Wearing a biosensor on eye enabled the in situ monitoring of tear contents. The biosensor has an enzyme immobilized electrode on the surface of a polydimethyl siloxane (PDMS) contact lens. The SCL-biosensor was fabricated using microfabrication techniques for functional polymers (PDMS and 2-methacryloyloxyethyl phosphorylcholine (MPC) polymer). In investigation of in vitro characterization, the SCL-biosensor showed excellent relationship between the output current and glucose concentration from 0.03 to 5.0 mmol·L(-1), with a correlation coefficient of 0.994. The calibration range covered the reported tear glucose concentrations (0.14 mmol·L(-1)). Based on the result, ocular biomonitoring with the SCL-biosensor was carried out. The SCL-biosensor well worked both in the static state and the dynamic state. The tear glucose level of rabbit was estimated to 0.12 mmol·L(-1) at first and then the tear turnover was successfully calculated to be 29.6 ± 8.42% min(-1). The result indicated that SCL-biosensor is useful for advanced biomonitoring on eye. PMID:21475940

  18. Aortic dissection with the entrance tear in transverse aorta: analysis of 12 autopsy patients.

    Science.gov (United States)

    Roberts, C S; Roberts, W C

    1990-11-01

    Clinical and autopsy findings are described in 12 patients who had fatal aortic dissection with the entrance tear in the transverse aorta. The 12 patients represent 7% of 182 autopsies of spontaneous aortic dissection studied by us. The ages of the 12 patients at death ranged from 37 to 87 years (mean, 67 years). Eight were men; 8 had a history of systemic hypertension, and 10 had hearts of increased weight. Diagnosis of aortic dissection was made during life in only 4 of the 12 patients. All 12 patients died of rupture of the false channel within 2 weeks of onset of signs or symptoms compatible with dissection. The direction of aortic dissection from the entrance tear was entirely retrograde in 4 patients, entirely anterograde in 4 patients, and in both directions in 4 patients. Hemopericardium occurred in the first group, left hemothorax in the second group, and either in the last group. Of the 8 patients in whom the ascending aorta was involved, the retrograde dissection in each extended to the aortic root, 6 had pulmonary adventitial hemorrhage, and 4 had involvement of the arch arteries by dissection. In the 4 patients with strictly anterograde dissection, none had dissection in the arch arteries. Thus, tear in the transverse aorta causes a dissection that is usually fata, that often dissects retrogradely, and that may mimic dissection from a tear in ascending aorta. Aortic dissection from a tear in transverse aorta requires early operative intervention. PMID:2241339

  19. Organization of lipids in the tear film: a molecular-level view.

    Directory of Open Access Journals (Sweden)

    Alicja Wizert

    Full Text Available Biophysical properties of the tear film lipid layer are studied at the molecular level employing coarse grain molecular dynamics (MD simulations with a realistic model of the human tear film. In this model, polar lipids are chosen to reflect the current knowledge on the lipidome of the tear film whereas typical Meibomian-origin lipids are included in the thick non-polar lipids subphase. Simulation conditions mimic those experienced by the real human tear film during blinks. Namely, thermodynamic equilibrium simulations at different lateral compressions are performed to model varying surface pressure, and the dynamics of the system during a blink is studied by non-equilibrium MD simulations. Polar lipids separate their non-polar counterparts from water by forming a monomolecular layer whereas the non-polar molecules establish a thick outermost lipid layer. Under lateral compression, the polar layer undulates and a sorting of polar lipids occurs. Moreover, formation of three-dimensional aggregates of polar lipids in both non-polar and water subphases is observed. We suggest that these three-dimensional structures are abundant under dynamic conditions caused by the action of eye lids and that they act as reservoirs of polar lipids, thus increasing stability of the tear film.

  20. Study of Hot Tearing During Steel Solidification Through Ingot Punching Test and Its Numerical Simulation

    Science.gov (United States)

    Koshikawa, Takao; Bellet, Michel; Gandin, Charles-André; Yamamura, Hideaki; Bobadilla, Manuel

    2016-08-01

    Experimental and numerical studies of hot tearing formation in steel are reported. On the one hand, an ingot punching test is presented. It consists in the application of a deformation at the surface of a solidifying 450 kg steel ingot. The experimental parameters are the displacement of the pressing tool, together with its velocity, leading to variations of a global strain rate. On the other hand, three-dimensional finite element thermomechanical modeling of the test is used. The time evolution of the strain tensor serves to compute an index to evaluate the susceptibility to create hot tears. It is based on the integration of a hot tearing criterion (HTC) that compares the local accumulation of strain with the expression of a critical value proposed in the literature. The main variable of the criterion is the brittleness temperature range (BTR) that refers to the solidification interval during which strain accumulates and creates hot cracks or tears. Detailed comparison of the simulation results with the measurements reveals the importance of the BTR for the prediction as well as excellent capabilities of the HTC to predict the formation of hot tears.

  1. Noninvasive Continuous Monitoring of Tear Glucose Using Glucose-Sensing Contact Lenses.

    Science.gov (United States)

    Ascaso, Francisco J; Huerva, Valentín

    2016-04-01

    : The incidence of diabetes mellitus is dramatically increasing in the developed countries. Tight control of blood glucose concentration is crucial to diabetic patients to prevent microvascular complications. Self-monitoring of blood glucose is widely used for controlling blood glucose levels and usually performed by an invasive test using a portable glucometer. Many technologies have been developed over the past decades with the purpose of obtaining a continuous physiological glycemic monitoring. A contact lens is the ideal vehicle for continuous tear glucose monitoring of glucose concentration in tear film. There are several research groups that are working in the development of contact lenses with embedded biosensors for continuously and noninvasively monitoring tear glucose levels. Although numerous aspects must be improved, contact lens technology is one step closer to helping diabetic subjects better manage their condition, and these contact lenses will be able to measure the level of glucose in the wearer's tears and communicate the information to a mobile phone or computer. This article reviews studies on ocular glucose and its monitoring methods as well as the attempts to continuously monitor the concentration of tear glucose by using contact lens-based sensors. PMID:26390345

  2. An unusual complication of blunt ocular trauma: A horseshoe-shaped macular tear with spontaneous closure

    Directory of Open Access Journals (Sweden)

    Umut Karaca

    2014-01-01

    Full Text Available A case of horseshoe-shaped macular tear after blunt trauma with the course of the tear and the relevant findings obtained by spectral-domain optical coherence tomography (SD-OCT is described. A 21-year-old man who had suffered blunt trauma 5 days previously visited our clinic complaining of vision loss in his left eye. Ophthalmic examination and SD-OCT images revealed a horseshoe-shaped macular tear. A month later at the second visit, the macular tear was found to have spontaneously closed. There have been many cases reported previously of the spontaneous closure of traumatic macular holes. A horseshoe-shaped macular tear is an atypical clinical presentation. However, the mechanism of spontaneous closure is hypothetically as same as that for a macular hole. High-resolution images and three-dimensional maps taken with SD-OCT can provide more details on macular diseases and are more useful than time-domain OCT images.

  3. Demarcation laser photocoagulation induced retinal necrosis and rupture resulting in large retinal tear formation.

    Science.gov (United States)

    Quezada, Carlos; Pieramici, Dante J; Matsui, Rodrigo; Rabena, Melvin; Graue, Federico

    2015-06-01

    Retinal tears after laser photocoagulation are a rare complication that occurs after intense laser. It is talked about among retina specialist occurring particularly at the end of a surgical case while applying endophotocoagulation; to the best our knowledge, there are no reports in the literature of a large retinal tear induced after attempted in-office demarcation laser photocoagulation (DLP) that simulated a giant retinal tear. DLP has been employed in the management of selected cases of macula sparring rhegmatogenous retinal detachment (RRD). Even though extension of the retinal detachment through the "laser barrier" is considered a failure of treatment, few complications have been described with the use of this less invasive retinal detachment repair technique. We describe a case of a high myopic woman who initially was treated with demarcation laser photocoagulation for an asymptomatic retinal detachment associated with a single horseshoe tear and a full thickness large retinal tear was created where the laser was placed. Intense laser photocoagulation resulted in abrupt laser induced retinal necrosis and rupture creating this large retinal break. Proper laser technique should reduce the risks associated with this procedure. PMID:25770055

  4. Diagnostic criterial to differentiate medial meniscal injury from degenerative changes on {sup 99m}Tc-MDP knee SPECT in patients with chronic knee pain

    Energy Technology Data Exchange (ETDEWEB)

    Paeng, Jin Chul; Chung, June Key; Kang, Won Jun; So, Young; Lee, Dong Soo; Lee, Myung Chul [Seoul National University College of Medicine, Seoul (Korea, Republic of); Yoo, Jae Ho; Lee, Myung Chul [Seoul National University Nuclear Medicine, Seoul (Korea, Republic of); Jeong, Hwan Jeong [Wonkwang University College of Medicine, Iksan (Korea, Republic of)

    2003-04-01

    In patients with chronic knee pain, the diagnostic performance of {sup 99m}Tc-MDP knee SPECT for internal derangement of knee is deteriorated due to degenerative changes. In this study, we tried to establish diagnostic criteria to differentiate medial meniscal injury (MMI) from degenerative change (DC) when the uptake in increased in medial compartment. A total of 49 knee SPECT of the patients with chronic(more than 3 months) knee pain, which showed increased {sup 99m}Tc-MDP uptake in the medial compartment, were included in this study. The diagnosis was confirmed by arthroscopy. On knee SPECT, 3 diagnosic criteria for MMI were investigated. In Criterion, I, MMI was diagnosed when crescentic uptake was observed in the medial tibial plateau. In Criterion II, crescentic uptake was further classified into anterior, mid, posterior, and diffuse patterns, according to the location of maximal uptake; and only crescentic mid, posterior, and diffuse patterns were diagnosed as MMI. In Criterion III, MMI was diagnosed when medial tibial plateau showed higher activity then medial femoral condyle. The diagnostic performance of the 3 criteria was compared. The sensitivity and specificity were 93% and 14% in Criterion I, 89% and 38% in Criterion II, and 75% and 67% in Criterion III, respectively. Criterion III had significantly improve diagnostic performance, especially, specificity. In this study, we established a practical diagnostic criterion to differentiate MMI from DC on knee SPECT. The result is helpful to improve the diagnostic value of knee SPECT as a screening test for chronic knee pain.

  5. Diagnostic criterial to differentiate medial meniscal injury from degenerative changes on 99mTc-MDP knee SPECT in patients with chronic knee pain

    International Nuclear Information System (INIS)

    In patients with chronic knee pain, the diagnostic performance of 99mTc-MDP knee SPECT for internal derangement of knee is deteriorated due to degenerative changes. In this study, we tried to establish diagnostic criteria to differentiate medial meniscal injury (MMI) from degenerative change (DC) when the uptake in increased in medial compartment. A total of 49 knee SPECT of the patients with chronic(more than 3 months) knee pain, which showed increased 99mTc-MDP uptake in the medial compartment, were included in this study. The diagnosis was confirmed by arthroscopy. On knee SPECT, 3 diagnosic criteria for MMI were investigated. In Criterion, I, MMI was diagnosed when crescentic uptake was observed in the medial tibial plateau. In Criterion II, crescentic uptake was further classified into anterior, mid, posterior, and diffuse patterns, according to the location of maximal uptake; and only crescentic mid, posterior, and diffuse patterns were diagnosed as MMI. In Criterion III, MMI was diagnosed when medial tibial plateau showed higher activity then medial femoral condyle. The diagnostic performance of the 3 criteria was compared. The sensitivity and specificity were 93% and 14% in Criterion I, 89% and 38% in Criterion II, and 75% and 67% in Criterion III, respectively. Criterion III had significantly improve diagnostic performance, especially, specificity. In this study, we established a practical diagnostic criterion to differentiate MMI from DC on knee SPECT. The result is helpful to improve the diagnostic value of knee SPECT as a screening test for chronic knee pain

  6. Comparison of conventional MRI and MR arthrography in the evaluation of wrist ligament tears: A preliminary experience

    Directory of Open Access Journals (Sweden)

    Shivani Pahwa

    2014-01-01

    Full Text Available Aims: To compare conventional magnetic resonance imaging (MRI and direct magnetic resonance (MR arthrography in the evaluation of triangular fibrocartilage complex (TFCC and intrinsic wrist ligament tears. Materials and Methods: T1-weighted, fat suppressed (FS proton density plus T2-weighted (FS PD/T2, 3D multiple-echo data image combination (MEDIC sequences and direct MR arthrography were performed in 53 patients with wrist pain. Images were evaluated for the presence and location of TFCC, scapholunate ligament (SLL and lunatotriquetral ligament (LTL tears, and imaging findings were compared with operative findings in 16 patients who underwent arthroscopy or open surgery (gold standard. Results: Sixteen patients underwent arthroscopy/open surgery: 12 TFCC tears were detected arthroscopically out of which 9 were detected on FS PD/T2 sequence, 10 on MEDIC sequence, and all 12 were detected on MR arthrography. The sensitivities of FS PD/T2, MEDIC sequences, and MR arthrography in the detection of TFCC tears were 75%, 83.3%, and 100%, respectively. Out of the eight arthroscopically confirmed SLL tears, three tears were detected on FS PD/T2 sequence, five on MEDIC sequence, and all eight were visualized on MR arthrography. The sensitivities of FS PD/T2, MEDIC sequences, and MR arthrography in detecting SLL tears were 37.5%, 62.5%, and 100%, respectively. One arthroscopically confirmed LTL tear was diagnosed on FS PD/T2 sequence, three on MEDIC sequence, and all five arthroscopically confirmed LTL tears were detected with MR arthrography. The sensitivities of PD, MEDIC sequences, and MR arthrography in detecting LTL tears were 20%, 40%, and 100%, respectively. Conclusions: MR arthrography is the most sensitive and specific imaging modality for the evaluation of wrist ligament tears.

  7. Interplay among solidification, microstructure, residual strain and hot tearing in B206 aluminum alloy

    International Nuclear Information System (INIS)

    Hot tearing is a complex phenomenon attributed to alloy solidification, microstructure and stress/strain development within a casting. In this research, the conditions associated with the formation of hot tears in B206 aluminum alloy were investigated. Neutron diffraction strain mapping was carried out on three B206 castings with varying levels of titanium (i.e. unrefined, 0.02 and 0.05 wt%). Titanium additions effectively reduced grain size and transformed grain morphology from coarse dendrites to fine globular grains. Further, thermal analysis suggested that grain refinement delayed the onset of dendrite coherency in B206 and therefore enhanced the duration of bulk liquid metal feeding for the refined casting conditions. As a result, the interactive effects of such factors resulted in a more uniform distribution of strain, and subsequent higher resistance to hot tearing for the grain refined castings

  8. Melting features along the Ryukyu slab tear, beneath the southwestern Okinawa Trough

    Science.gov (United States)

    Lin, Jing-Yi; Hsu, Shu-Kun; Sibuet, Jean-Claude

    2004-10-01

    The present-day active volcanic front associated with the Ryukyu subduction zone extends from Japan to the Ilan plain (northern Taiwan) and is located within the Okinawa Trough, 80-100 km above the Ryukyu slab. An abnormal amount of arc volcanism, which consists of basalt, andesite and rhyolite occurs within the southwestern Okinawa Trough, above a slab tear of the Ryukyu subduction zone (CBVT). The power spectrum analysis of magnetic data shows the occurrence of a thin crust above the slab tear and a thick crust beneath this volcanic area. We suggest that an excess of H2O-rich fluid might occur at the slab tear and might increase the melt flux. Both are conveyed obliquely to the uppermost mantle and lower crust CBVT magmas. After interactions, basaltic magmas would rise up, accounting for the contrast of magnetization between this volcanic body and the adjacent OT crust.

  9. Stabilization of tearing modes in DIII-D by localized electron cyclotron current drive

    Science.gov (United States)

    Luce, T. C.; La Haye, R. J.; Humphreys, D. A.; Petty, C. C.; Prater, R.

    2001-10-01

    Tearing modes have been shown to limit β and confinement in conventional ELMing H-mode tokamak regimes. The tearing modes grow from a "seed" island due to the destabilizing effect of pressure flattening in the island leading to a reduction in the local bootstrap current. Recent experiments on the DIII-D tokamak have demonstrated stabilization of m=3/n=2 tearing modes in the presence of sawteeth through localized electron cyclotron current drive (ECCD). Variation of the deposition location indicates the ECCD remains localized despite the beam traversing an ELMing edge. The effect of the ECCD on the mode is consistent with predictions that the ECCD must be within the island for stabilization. The calculated EC current density (JEC) is greater than the calculated local bootstrap current density (JBS) also in accord with predictions. A closed-loop feedback scheme has been successfully operated for the first time using position control and magnetic signals as the actuator and sensor, respectively.

  10. Computed tear film and osmolarity dynamics on an eye-shaped domain.

    Science.gov (United States)

    Li, Longfei; Braun, Richard J; Driscoll, Tobin A; Henshaw, William D; Banks, Jeffrey W; King-Smith, P Ewen

    2016-06-01

    The concentration of ions, or osmolarity, in the tear film is a key variable in understanding dry eye symptoms and disease. In this manuscript, we derive a mathematical model that couples osmolarity (treated as a single solute) and fluid dynamics within the tear film on a 2D eye-shaped domain. The model includes the physical effects of evaporation, surface tension, viscosity, ocular surface wettability, osmolarity, osmosis and tear fluid supply and drainage. The governing system of coupled non-linear partial differential equations is solved using the Overture computational framework, together with a hybrid time-stepping scheme, using a variable step backward differentiation formula and a Runge-Kutta-Chebyshev method that were added to the framework. The results of our numerical simulations provide new insight into the osmolarity distribution over the ocular surface during the interblink. PMID:25883248

  11. Effect of electron diamagnetic drifts on cylindrical double-tearing modes

    CERN Document Server

    Abbott, Stephen

    2015-01-01

    Double-tearing modes (DTMs) have been proposed as a driver of `off-axis sawtooth' crashes in reverse magnetic shear tokamak configurations. Recently differential rotation provided by equilibrium sheared flows has been shown capable of decoupling the two DTM resonant layers, slowing the growth the instability. In this work we instead supply this differential rotation using an electron diamagnetic drift, which emerges in the presence of an equilibrium pressure gradient and finite Larmor radius physics. Diamagnetic drifts have the additional benefit of stabilizing reconnection local to the two tearing layers. Conducting linear and nonlinear simulations with the extended MHD code MRC-3d, we consider an m=2, n=1 cylindrical double-tearing mode. We show that asymmetries between the resonant layers and the emergence of an ideal MHD instability cause the DTM evolution to be highly dependent on the location of the pressure gradient. By locating a strong drift near the outer, dominant resonant surface are we able to sa...

  12. Degradation of Uniquely Glycosylated Secretory Immunoglobulin A in Tears From Patients With Pseudomonas aeruginosa Keratitis

    DEFF Research Database (Denmark)

    Lomholt, Jeanet Andersen; Kilian, Mogens

    2008-01-01

    PURPOSE. To investigate the integrity of secretory IgA (S-IgA) in tear fluid during bacterial keratitis and to evaluate the significance of specific Pseudomonas aeruginosa extracellular proteases in the observed degradation of S-IgA. METHODS. The integrity of component chains of S-IgA in tear fluid...... strains and an extent closely correlated with their expression and activity of individual proteases. Experiments using isogenic mutants of P. aeruginosa PAO1 lacking either elastase or alkaline protease indicate that several proteases work in concert. CONCLUSIONS. Surprisingly, SC of tear S-IgA is more...... abundantly glycosylated than SC of S-IgA in other secretions, a difference of potentially great functional significance. Primarily SC and alpha-chains are partially degraded in vivo during pseudomonas keratitis by the concerted action of several proteases including elastase and alkaline protease....

  13. Tear staining in pigs: a potential tool for welfare assessment on commercial farms.

    Science.gov (United States)

    Telkänranta, H; Marchant-Forde, J N; Valros, A

    2016-02-01

    Tear staining or chromodacryorrhea refers to a dark stain below the inner corner of the eye, caused by porphyrin-pigmented secretion from the Harderian gland. It has been shown to be a consistent indicator of stress in rats and to correlate with social stress and a barren environment in pigs. The current study was, to our knowledge, the first to test it on commercial pig farms as a potential welfare indicator. The study was carried out on three commercial farms in Finland, in connection to a larger study on the effects of different types of manipulable objects on tail and ear biting and other behavioural parameters. Farm A was a fattening farm, on which 768 growing-finishing pigs were studied in 73 pens. Farm B had a fattening unit, in which 656 growing-finishing pigs were studied in 44 pens, and a farrowing unit, in which 29 sows and their litters totalling 303 piglets were studied in 29 pens. Farm C was a piglet-producing farm, on which 167 breeder gilts were studied in 24 pens. Data collection included individual-level scoring of tear staining; scoring of tail and ear damage in the growing-finishing pigs and breeder gilts; a novel object test for the piglets; and a novel person test for the growing-finishing pigs on Farm B and the breeder gilts on Farm C. On Farm A, tear staining was found to correlate with tail damage scores (n=768, rs=0.14, Ppigs on Farm B, tear staining of the left eye correlated with tail damage (n=656, rs=0.12, Ptail and ear damage were low, it was concluded that tear staining has promising potential as a new, additional welfare indicator for commercial pig farming. Further research is needed on the mechanisms of tear staining. PMID:26303891

  14. Warping and tearing of misaligned circumbinary disks around eccentric supermassive black hole binaries

    Science.gov (United States)

    Hayasaki, K.; Sohn, B. W.; Okazaki, A. T.; Jung, T.; Zhao, G.; Naito, T.

    2015-07-01

    We study the warping and tearing of a geometrically thin, non-self-gravitating disk surrounding binary supermassive black holes on an eccentric orbit. The circumbinary disk is significantly misaligned with the binary orbital plane, and is subject to the time-dependent tidal torques. In principle, such a disk is warped and precesses, and is torn into mutually misaligned rings in the region, where the tidal precession torques are stronger than the local viscous torques. We derive the tidal-warp and tearing radii of the misaligned circumbinary disks around eccentric SMBH binaries. We find that in disks with the viscosity parameter α larger than a critical value depending on the disk aspect ratio, the disk warping appears outside the tearing radius. This condition is expressed for small amplitude warps as α > √H/(3r) for H/rlesssim0.1, where H is the disk scale height. If α warp radius is inside the tearing radius, where most of disk material is likely to rapidly accrete onto SMBHs. In warped and torn disks, both the tidal-warp and the tearing radii most strongly depend on the binary semi-major axis, although they also mildly depend on the other orbital and disk parameters. This strong dependence enables us to estimate the semi-major axis, once the tidal warp or tearing radius is determined observationally: for the tidal warp radius of 0.1 pc, the semi-major axis is estimated to be ~10-2 pc for 107 Msolar black hole with typical orbital and disk parameters. We also briefly discuss the possibility that central objects of observed warped maser disks in active galactic nuclei are supermassive black hole binaries.

  15. Streaming tearing instability in the current sheet with a super-Alfvenic flow

    International Nuclear Information System (INIS)

    The tearing instability in a current sheet, which has a sub-Alfvenic or super-Alfvenic plasma flow in the current layer, is investigated based on the linearized compressible magnetohydrodynamic (MHD) equations. An initial-value method is employed to obtain the linear growth rate and eigenmode profiles of the fastest growing mode. The results show that for a sub-Alfvenic plasma flow parallel to the neutral sheet, the growth rate of the tearing instability is only slightly larger than that of the pure tearing mode without the flow. On the other hand, a large increase in the growth rate of the most unstable mode is observed, when the streaming speed V0/sub m/ in the central region of the current sheet increases above a critical speed V/sub C/≅1.2V/sub A//sub ∞/. Here V/sub A//sub ∞/ is the Alfven speed far away from the current layer. This study shows that when the electric resistivity eta is zero, the sausage mode is excited because of a super-Alfvenic plasma flow parallel to the current sheet. This flow-induced sausage mode is called the streaming sausage mode. In the presence of a finite resistivity, the streaming sausage mode becomes a mixed sausage--tearing mode, because of the presence of magnetic field line reconnections in the current sheet. This mixed sausage--tearing mode, or simply the streaming tearing mode, has a high growth rate, γ≅0.1tau-1/sub A/, where tau/sub A/ is the Alfven transit time across the current layer

  16. Lessons from the biophysics of interfaces: lung surfactant and tear fluid.

    Science.gov (United States)

    Rantamäki, Antti H; Telenius, Jelena; Koivuniemi, Artturi; Vattulainen, Ilpo; Holopainen, Juha M

    2011-05-01

    The purpose of this review is to provide insight into the biophysical properties and functions of tear fluid and lung surfactant--two similar fluids covering the epithelium of two distinctive organs. Both fluids form a layer-like structure that essentially comprise of an aqueous layer next to the epithelium and an anterior lipid layer at the air-water interface. The aqueous layers contain soluble proteins and metabolites, and they are responsible for the host defence system and nutrition of the organ. However, many proteins also interact with the lipid layer and are important for the surface-active function of the fluid film. The lipid layer of lung surfactant comprises mainly of phospholipids, especially phosphatidylcholines, and only small amounts of non-polar lipids, mainly cholesterol. In contrast, tear fluid lipid layer comprises of a mixture of polar and non-polar lipids. However, the relative proportion and the spectrum of different polar and non-polar lipids seem to be more extensive in tear fluid than in lung surfactant. The differing lipid compositions generate distinctive lipid layer structures. Despite the structural differences, these lipid layers decrease the surface tension of the air-water interface. The structure of the tear film lipid layer also minimises the evaporation of the tear fluid. In lung surfactant surface activity is crucial for the function of the organ, as the lipid layer prevents the collapse of the lung alveoli during the compression-expansion cycle of breathing. Similarly the tear film experiences a compression-expansion cycle during blinking. The dynamics of this cycle have been studied to a lesser extent and are not as clear as those of lung surfactant. The common structure and properties suggest a similar behaviour under rapid compression-expansion for both fluids. PMID:21352946

  17. Tear film concentrations of doxycycline following oral administration in ophthalmologically normal dogs.

    Science.gov (United States)

    Collins, Sean P; Labelle, Amber L; Dirikolu, Levent; Li, Zhong; Mitchell, Mark A; Hamor, Ralph E

    2016-09-01

    OBJECTIVE To determine tear film concentrations of doxycycline in ophthalmologically normal dogs following oral doxycycline administration. DESIGN Crossover study. ANIMALS 10 privately owned dolichocephalic or mesaticephalic dogs free of ophthalmic disease. PROCEDURES Dogs were randomly assigned to receive doxycycline hyclate first at 5 mg/kg (2.3 mg/lb) or 10 mg/kg (4.5 mg/lb), PO, every 12 hours for 5 days, beginning on day 1. Doxycycline was administered 1 hour prior to feeding. Tear samples were collected from days 1 through 10 approximately 3 hours after the morning dose was administered. Following a 3-week washout period, dogs received the alternative dose in the same conditions. Doxycycline concentration in tear samples from 1 eye (same eye used for both sessions) was measured via liquid chromatography-mass spectrometry and compared between the 2 doxycycline doses. RESULTS Doxycycline was detected in tear samples of all dogs from days 1 through 10 for both doxycycline doses. Median peak doxycycline concentrations for the 5 mg/kg and 10 mg/kg doses were 2.19 ng/mL on day 3 and 4.32 ng/mL on day 4, respectively. Concentrations differed significantly with time, but this difference was not influenced by dose, dose order, or eye. A significant positive correlation was identified between doxycycline concentration and body weight (r = 0.22). CONCLUSIONS AND CLINICAL RELEVANCE Detectable doxycycline concentrations were achieved in the tear film of ophthalmologically normal dogs following oral administration of doxycycline at 5 or 10 mg/kg, every 12 hours. Dose had no significant effect on tear film concentration of the drug. PMID:27556265

  18. Extended magneto-hydro-dynamic model for neoclassical tearing mode computations

    Science.gov (United States)

    Maget, Patrick; Février, Olivier; Garbet, Xavier; Lütjens, Hinrich; Luciani, Jean-Francois; Marx, Alain

    2016-08-01

    A self-consistent fluid model for describing neoclassical tearing modes in global magneto-hydro-dynamic simulations is presented. It is illustrated by its application to a simple toroidal configuration unstable to the (2, 1) tearing mode. The island saturation is verified to increase with the bootstrap current fraction. New features that are specific to this model are evidenced, like the unsteady saturated state of the island, and its deformation to a droplet shape, when the magnetic Prandtl number is not too high. Synthetic diagnostics demonstrate that diamagnetic and neoclassical effects should have in this case a measurable impact on the signature of magnetic islands.

  19. Humeral head cysts and rotator cuff tears: an MR arthrographic study

    Energy Technology Data Exchange (ETDEWEB)

    Williams, Martin [Southmead Hospital, Department of Radiology, Westbury-on-Trym, Bristol (United Kingdom); Lambert, Robert G.W.; Jhangri, Gian S.; Grace, Michael; Zelaso, Jay; Wong, Ben; Dhillon, Sukhvinder S. [University of Alberta Hospital, Department of Radiology and Diagnostic Imaging, Edmonton (Canada)

    2006-12-15

    Humeral tuberosity cysts are a common finding, with previous reports suggesting they are related to rotator cuff tear or aging. The aim of this study was to investigate the characteristics of cysts in the tuberosities of the humeral head and their relationship with rotator cuff tear and age. Shoulder MR arthrograms were reviewed in 120 consecutive patients - 83 males (mean age 38.0, range 19-59 years) and 37 females (mean age 41.2, range 15-59 years). Patients were referred for investigation of a variety of conditions, and instability was suspected in only a minority of cases. MR was performed before and after direct arthrography with 0.01% solution of gadolinium. Cysts were defined as well-demarcated circular/ovoid foci in two planes that demonstrated high signal on pre-arthrographic T2W sequences. Location, size and numbers of cysts and post-arthrographic enhancement were documented, along with the location of rotator cuff tears, if present. Cysts in the tuberosities of the humerus were identified in 84 patients (70%), and were seen seven times more frequently in the posterior aspect of the greater tuberosity than anteriorly. Most cysts (94%) demonstrated communication with the joint post-arthrogram. Rotator cuff tears were present in 36 patients, and 79% of all tears occurred in supraspinatus tendon. There was no significant difference in the occurrence of cysts between patients older or younger than age 40 or between genders, but rotator cuff tears were seen significantly more often in the older age group (p<0.01). Tuberosity cysts and rotator cuff tears did not appear to be related (p=0.55). However, whilst this lack of association was quite obvious posteriorly (p=0.84), the trend in the anterior aspect of the greater tuberosity is not as clear (p=0.14). Humeral cysts are most often located in the posterior aspect of the greater tuberosity, communicate with the joint space and, in this location, are not related to aging or rotator cuff tear. (orig.)

  20. Magnetic Resonance Imaging of Rotator Cuff Tears in Shoulder Impingement Syndrome

    International Nuclear Information System (INIS)

    Shoulder joint is a common site of musculoskeletal pain caused, among other things, by rotator cuff tears due to narrowing of subacromial space, acute trauma or chronic shoulder overload. Magnetic resonance imaging (MRI) is an excellent modality for imaging of soft tissues of the shoulder joint considering a possibility of multiplanar image acquisition and non-invasive nature of the study. The aim of this study was to evaluate the prevalence of partial and complete rotator cuff tears in magnetic resonance images of patients with shoulder impingement syndrome and to review the literature on the causes and classification of rotator cuff tears. We retrospectively analyzed the results of 137 shoulder MRI examinations performed in 57 women and 72 men in Magnetic Resonance facility of the Department of Radiology and Diagnostic Imaging at the St. Jadwiga the Queen Regional Hospital No. 2 in Rzeszow between June 2010 and February 2013. Examinations were performed using Philips Achieva 1.5T device, including spin echo and gradient echo sequences with T1-, T2- and PD-weighted as well as fat saturation sequences in transverse, frontal and sagittal oblique planes. Patients were referred from hospital wards as well as from outpatient clinics of the subcarpathian province. The most frequently reported injuries included partial supraspinatus tendon tear and complete tearing most commonly involved the supraspinatus muscle tendon. The smallest group comprised patients with complete tear of subscapularis muscle tendon. Among 137 patients in the study population, 129 patients suffered from shoulder pain, including 57 patients who reported a history of trauma. There was 44% women and 56% men in a group of patients with shoulder pain. Posttraumatic shoulder pain was predominantly reported by men, while women comprised a larger group of patients with shoulder pain not preceded by injury. Rotator cuff injury is a very common pathology in patients with shoulder impingement syndrome

  1. Accuracy of ultrasonography and magnetic resonance imaging for detection of full thickness rotator cuff tears

    Directory of Open Access Journals (Sweden)

    Naqvi Gohar

    2009-01-01

    Full Text Available Background: Rotator cuff problems are frequently seen by orthopedic surgeons and accurate diagnosis is essential for appropriate management. Value of the clinical assessment of a shoulder is often limited, therefore, imaging studies have important implications in the management of rotator cuff pathologies. Aim: The purpose of this retrospective study is to compare the accuracy of ultrasonography (US and magnetic resonance imaging (MRI for detection of full-thickness rotator cuff tears. Materials and Methods: We reviewed 91 consecutive cases of shoulder arthroscopy and open rotator cuff repair, who had undergone preoperative investigation in the form of either an ultrasound or MRI. Thirty-six patients had an ultrasound and 55 had an MRI for their affected shoulders. We compared the accuracy of US and MRI for detection of full-thickness rotator cuff tears, using the operative findings as the ′gold standard′. Data regarding a supraspinatus tear was assessed for the purpose of this study. Results: Ultrasonography correctly diagnosed 15 out of 17 tears (sensitivity of 0.88. There were 17 true-negative and two false-positive ultrasounds (specificity of 0.89. MRI accurately identified 33 of the 36 tears (sensitivity of 0.91. There were 16 true-negative and three false-positive tears on MRI (specificity of 0.84. The positive predictive value (PPV was 88% for US and 92% for MRI. The negative predictive value (NPV was 89% for US and 84% for MRI. The overall accuracy of the ultrasound was 88.89% (95% confidence interval (CI = 74.09 to 96.18 as compared to 89.09% (95% CI = 77.82% to 95.26% for the MRI. Conclusion: Full-thickness rotator cuff tears can be identified using ultrasound and MRI with comparable accuracy. US being a dynamic study and better tolerated by the patient, can therefore be used as the first-line investigation for rotator cuff tear, where appropriate skills are available to reduce the waiting time and cost of investigation.

  2. The Hug-up Test: A New, Sensitive Diagnostic Test for Supraspinatus Tears

    Institute of Scientific and Technical Information of China (English)

    Yu-Lei Liu; Ying-Fang Ao; Hui Yan; Guo-Qing Cui

    2016-01-01

    Background:The supraspinatus tendon is the most commonly affected tendon in rotator cufftears.Early detection ofa supraspinatus tear using an accurate physical examination is,therefore,important.However,the currently used physical tests for detecting supraspinatus tears are poor diagnostic indicators and involve a wide range of sensitivity and specificity values.Therefore,the aim of this study was to establish a new physical test for the diagnosis of supraspinatus tears and evaluate its accuracy in comparison with conventional tests.Methods:Between November 2012 and January 2014,200 consecutive patients undergoing shoulder arthroscopy were prospectively evaluated preoperatively.The hug-up test,empty can (EC) test,full can (FC) test,Neer impingement sign,and Hawkins-Kennedy impingement sign were used and compared statistically for their accuracy in terms of supraspinatus tears,with arthroscopic findings as the gold standard.Muscle strength was precisely quantified using an electronic digital tensiometer.Results:The prevalence of supraspinatus tears was 76.5%.The hug-up test demonstrated the highest sensitivity (94.1%),with a low negative likelihood ratio (NLR,0.08) and comparable specificity (76.6%) compared with the other four tests.The area under the receiver operating characteristic curve for the hug-up test was 0.854,with no statistical difference compared with the EC test (z =1.43 8,P =0.075) or the FC test (z =1.498,P =0.067).The hug-up test showed no statistical difference in terms of detecting different tear patterns according to the position (x2 =0.578,P =0.898) and size (Fisher's exact test,P > 0.999) compared with the arthroscopic examination.The interobserver reproducibility of the hug-up test was high,with a kappa coefficient of 0.823.Conclusions:The hug-up test can accurately detect supraspinatus tears with a high sensitivity,comparable specificity,and low NLR compared with the conventional clinical tests and could,therefore,improve the

  3. Complete and partial-thickness tears of the anterior cruciate ligament: differential features seen on MR imaging

    International Nuclear Information System (INIS)

    To evaluate the differential features of complete and partial-thickness tears of the anterior cruciate ligament, as seen on magnetic resonance imaging (MRI). We retrospectively reviewed MR images of 36 patients with ACL injuries (complete tear 16, incomplete tear 20). In all cases, the presence of an ACL tear was determined by arthroscopy or surgery. Primary and secondary signs of ACL injury and associated injuries were assessed. Ligamentous discontinuity of the ACL was observed in ten complete tears (63%), but in only four (10%) of those that were partial (p=0.009). In addition, complete tears were more likely to show a low degree of ACL axis, less than 45 deg (11/16 : 2/20, p=0.001). There was, however, no statistically significant difference between complete and partial tears with regard to signal intensity of ACL, PCL buckling or angle, anterior displacement of the tibia, uncovered meniscus sign, deep notch sign, empty notch sign, and associated injuries. Ligamentous discontinuity and the ACL axis are features which usefully differentiate between complete and partial tears of the ACL

  4. Anterolateral subluxation of the tibia associated with combined anterior cruciate and medial collateral ligament tears: MR imaging of the knee

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jin Gyoon; Kang, Heoung Keun [Chonnam University Medical School, Kwangju (Korea, Republic of); Lee, Joong K.; Phelps, Carlton T. [Albany Medical College and Albany Medical Center Hospital, Newyork (United States)

    1995-09-15

    To evaluate the passive subluxation of the tibia on MR imaging in patient with both anterior cruciate ligament (ACL) and medial collateral ligament (MCL) tears and to demonstrate the usefulness of its measurement. The authors performed a retrospective study of 123 knees with tears of both ACL (complete, n = 70, partial, n = 53) and MCL (complete, n = 10, partial, n 113). ACL tears were documented at arthroscopy and MCL tears were interpreted by abnormal MR findings. One hundred normal knees were also studied for comparison. Using new internal landmarks, anterior subluxation was measured on an intercondylar sagittal image and lateral subluxation was measured on a mid-coronal image. Anterior subluxation of 3 mm or more was seen in 45/123(37%) abnormal knees, lateral subluxation of 3 mm or more in 20/123(16%), and anterolateral subluxation in 15/123(12%). Anterior subluxation of 5 mm or more was seen in 25/70(36%) complete ACL tears, and no knees with partial ACL tears showed anterior subluxation of 5 mm or more. Static anterolateral subluxation of the tibia occurs in knees with combined ACL and MCL tears, as measured on routine MR imaging. These measurements may help confirm the presence of ligament injuries and differentiate complete from partial ACL tear.

  5. Anterolateral subluxation of the tibia associated with combined anterior cruciate and medial collateral ligament tears: MR imaging of the knee

    International Nuclear Information System (INIS)

    To evaluate the passive subluxation of the tibia on MR imaging in patient with both anterior cruciate ligament (ACL) and medial collateral ligament (MCL) tears and to demonstrate the usefulness of its measurement. The authors performed a retrospective study of 123 knees with tears of both ACL (complete, n = 70, partial, n = 53) and MCL (complete, n = 10, partial, n 113). ACL tears were documented at arthroscopy and MCL tears were interpreted by abnormal MR findings. One hundred normal knees were also studied for comparison. Using new internal landmarks, anterior subluxation was measured on an intercondylar sagittal image and lateral subluxation was measured on a mid-coronal image. Anterior subluxation of 3 mm or more was seen in 45/123(37%) abnormal knees, lateral subluxation of 3 mm or more in 20/123(16%), and anterolateral subluxation in 15/123(12%). Anterior subluxation of 5 mm or more was seen in 25/70(36%) complete ACL tears, and no knees with partial ACL tears showed anterior subluxation of 5 mm or more. Static anterolateral subluxation of the tibia occurs in knees with combined ACL and MCL tears, as measured on routine MR imaging. These measurements may help confirm the presence of ligament injuries and differentiate complete from partial ACL tear

  6. Complete and partial-thickness tears of the anterior cruciate ligament: differential features seen on MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Eo, Geun; Pyo, Hyun Sun; Lee, Hyung Rae; Kim, Jang Min; Kim, Young Sun; Lee, Jung Hee [Kwangmyungsungae Hospital, Kwangmyung (Korea, Republic of)

    1999-07-01

    To evaluate the differential features of complete and partial-thickness tears of the anterior cruciate ligament, as seen on magnetic resonance imaging (MRI). We retrospectively reviewed MR images of 36 patients with ACL injuries (complete tear 16, incomplete tear 20). In all cases, the presence of an ACL tear was determined by arthroscopy or surgery. Primary and secondary signs of ACL injury and associated injuries were assessed. Ligamentous discontinuity of the ACL was observed in ten complete tears (63%), but in only four (10%) of those that were partial (p=0.009). In addition, complete tears were more likely to show a low degree of ACL axis, less than 45 deg (11/16 : 2/20, p=0.001). There was, however, no statistically significant difference between complete and partial tears with regard to signal intensity of ACL, PCL buckling or angle, anterior displacement of the tibia, uncovered meniscus sign, deep notch sign, empty notch sign, and associated injuries. Ligamentous discontinuity and the ACL axis are features which usefully differentiate between complete and partial tears of the ACL.

  7. Bottom–up protein identifications from microliter quantities of individual human tear samples. Important steps towards clinical relevance.

    Directory of Open Access Journals (Sweden)

    Peter Raus

    2015-12-01

    With 375 confidently identified proteins in the healthy adult tear, the obtained results are comprehensive and in large agreement with previously published observations on pooled samples of multiple patients. We conclude that, to a limited extent, bottom–up tear protein identifications from individual patients may have clinical relevance.

  8. A mass and solute balance model for tear volume and osmolarity in the normal and the dry eye

    KAUST Repository

    Gaffney, E.A.

    2010-01-01

    Tear hyperosmolarity is thought to play a key role in the mechanism of dry eye, a common symptomatic condition accompanied by visual disturbance, tear film instability, inflammation and damage to the ocular surface. We have constructed a model for the mass and solute balance of the tears, with parameter estimation based on extensive data from the literature which permits the influence of tear evaporation, lacrimal flux and blink rate on tear osmolarity to be explored. In particular the nature of compensatory events has been estimated in aqueous-deficient (ADDE) and evaporative (EDE) dry eye. The model reproduces observed osmolarities of the tear meniscus for the healthy eye and predicts a higher concentration in the tear film than meniscus in normal and dry eye states. The differential is small in the normal eye, but is significantly increased in dry eye, especially for the simultaneous presence of high meniscus concentration and low meniscus radius. This may influence the interpretation of osmolarity values obtained from meniscus samples since they need not fully reflect potential damage to the ocular surface caused by tear film hyperosmolarity. Interrogation of the model suggests that increases in blink rate may play a limited role in compensating for a rise in tear osmolarity in ADDE but that an increase in lacrimal flux, together with an increase in blink rate, may delay the development of hyperosmolarity in EDE. Nonetheless, it is predicted that tear osmolarity may rise to much higher levels in EDE than ADDE before the onset of tear film breakup, in the absence of events at the ocular surface which would independently compromise tear film stability. Differences in the predicted responses of the pre-ocular tears in ADDE compared to EDE or hybrid disease to defined conditions suggest that no single, empirically-accessible variable can act as a surrogate for tear film concentration and the potential for ocular surface damage. This emphasises the need to measure

  9. Tear volume estimation using a modified Schirmer test: a randomized, multicenter, double-blind trial comparing 3% diquafosol ophthalmic solution and artificial tears in dry eye patients

    OpenAIRE

    Miyake H; Kawano Y; Tanaka H; Iwata A; Imanaka T; Nakamura M

    2016-01-01

    Hideki Miyake,1 Yuri Kawano,2 Hiroshi Tanaka,2 Akihiro Iwata,3 Takahiro Imanaka,1 Masatsugu Nakamura1 1Ophthalmic Disease Area Strategy Department, 2Clinical Operations Department, 3Data Science Department, R&D Division, Santen Pharmaceutical Co., Ltd. Osaka, Japan Purpose: We aimed to evaluate the feasibility of using a modified Schirmer test to determine the increase in tear volume after administration of 3% diquafosol ophthalmic solution (diquafosol 3%) in dry eye patients. Patients ...

  10. Tear volume estimation using a modified Schirmer test: a randomized, multicenter, double-blind trial comparing 3% diquafosol ophthalmic solution and artificial tears in dry eye patients

    OpenAIRE

    Miyake, Hideki

    2016-01-01

    Hideki Miyake,1 Yuri Kawano,2 Hiroshi Tanaka,2 Akihiro Iwata,3 Takahiro Imanaka,1 Masatsugu Nakamura1 1Ophthalmic Disease Area Strategy Department, 2Clinical Operations Department, 3Data Science Department, R&D Division, Santen Pharmaceutical Co., Ltd. Osaka, Japan Purpose: We aimed to evaluate the feasibility of using a modified Schirmer test to determine the increase in tear volume after administration of 3% diquafosol ophthalmic solution (diquafosol 3%) in dry eye patients. Patie...

  11. The natural history of partial rotator cuff tear evaluated by MRI. Can we predict the prognosis of partial rotator cuff tear by MRI?

    International Nuclear Information System (INIS)

    The cause and progress of the tear in the title are not fully understood and its treatment varies dependently on the injured site, depth, accompanied disease and symptom, and imaging profile. The author classified the tears in 4 types in MRI findings, followed their temporal progression and clinical symptom, and found that this classification in MRI finding was helpful to predict the prognosis, which is described in this paper. Subjects are 47 shoulders of 45 patients (M19/F26, av. age 71.0 y) who underwent conservative treatment of the disease during the time May, 2003-Oct. 2008, periodical MRI (2.7 times in av.) for 18.5 mo in av. and follow-up diagnosis until 24.9 mo in av. MRI is conducted with the machine 1.0 T Siemens harmonicdome to acquire the fast spin echo T1, T2 weighted images, and short inversion time inversion recovery (STIR) coronal, axial and sagittal ones. Tears in MRI are classified in Type 1 (abnormal signal type) (25 shoulders), Type 2 (abnormal signal and swelling type) (7 shoulders), Type 3 (cut off end type) (10 shoulders) and Type 4 (tapered end type) (5 shoulders). The partial rotator cuff tear is suggested to be originated from the denaturation of the cuff with a subsequent certain injury or loading to become Type 1 to 2 and to progress to Type 3 to 4 by continuous acrominal impingement. It is suggested that at the first diagnosis the Type 1 does not have so much serious symptom, but which tends to last long while the symptom is serious in Type 2 and 3: the prognosis in Type 4 is good. (K.T)

  12. Temporal effects of intramuscular administration of medetomidine hydrochloride or xylazine hydrochloride to healthy dogs on tear flow measured by use of a Schirmer tear test I.

    Science.gov (United States)

    Kanda, Teppei; Ishihara, Satoko; Oka, Miina; Sako, Kaori; Sato, Yoko; Maeta, Noritaka; Tamura, Katsutoshi; Furumoto, Kayo; Furukawa, Toshinori

    2016-04-01

    OBJECTIVE To determine the temporal effects on tear flow measurements obtained by use of a Schirmer tear test (STT) I after IM administration of various doses of medetomidine or xylazine to healthy dogs. ANIMALS 5 healthy purpose-bred male Beagles. PROCEDURES Each dog received IM injections of 2.0 mL of physiologic saline (0.9% NaCl) solution (control treatment); 0.1% medetomidine hydrochloride (5, 10, 20, and 40 μg/kg), and 2.0% xylazine hydrochloride (0.5, 1.0, 2.0, and 4.0 mg/kg). Treatments were injected into the semimembranosus muscles; there was at least a 1-week interval between successive injections. Order of treatments was determined via a randomized Latin square crossover design. The STT I was performed on both eyes before (baseline) and 0.25, 0.50, 0.75, 1, 2, 3, 4, 5, 6, 7, 8, and 24 hours after each injection. RESULTS STT I values decreased significantly within 45 minutes after injection of medetomidine or xylazine, which was followed by gradual recovery. The lowest mean STT I value was < 10 mm/min for all sedation treatments, except when dogs received 5 μg of medetomidine/kg. Linear regression of the area under the curve for the 8 hours after administration yielded significant effects for all sedation treatments. CONCLUSIONS AND CLINICAL RELEVANCE IM administration of medetomidine or xylazine to dogs reduced tear flow in a dose-related manner. Artificial tear solution or ophthalmic ointment should be used to protect the ocular surface when these drugs are administered to dogs. PMID:27027832

  13. Molecular-Level Organization of the Tear Film Lipid Layer: A Molecular Dynamics Simulation Study

    Czech Academy of Sciences Publication Activity Database

    Wizert, A.; Iskander, D. R.; Jungwirth, Pavel; Cwiklik, Lukasz

    Elsevier. Roč. 106, č. 2 (2014), 710A. ISSN 0006-3495. [Annual Meeting of the Biophysical Society /58./. 15.02.2014-19.02.2014, San Francisco] Institutional support: RVO:61388963 ; RVO:61388955 Keywords : tear film * lipid layer * molecular dynamics simulations Subject RIV: BO - Biophysics

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

    International Nuclear Information System (INIS)

    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.)

  15. Passive Posterior Tibial Subluxation on Routine Knee MRI as a Secondary Sign of PCL Tear

    International Nuclear Information System (INIS)

    The posterior drawer test is an accurate clinical test to diagnose posterior cruciate ligament (PCL), indicating laxity of the PCL that allows posterior tibial translation. This study aimed to determine whether posterior tibial translation relative to the femur on routine MRI could serve as an additional sign of PCL tear. Routine knee MRI in eleven patients (7 males, 4 females) with arthroscopically confirmed isolated PCL tears were reviewed independently by two musculoskeletal radiologists. Measurements of tibial translation were made in the medial and lateral compartments of patients and controls (10 males, 12 females) without clinical or MRI evidence of ligament injury. Significant medial compartment posterior tibial translation was present in patients with PCL tear compared to controls (+2.93 mm versus +0.03 mm, Ρ=0.002) with excellent interobserver agreement (intraclass correlation coefficient (ICC) = 0.94). No significant difference in lateral compartment tibial translation was observed (+0.17 mm versus -0.57 mm, Ρ=0.366) despite excellent interobserver agreement (ICC = 0.96). Posterior tibial translation in the midmedial compartment may be a secondary sign of isolated PCL tear on routine knee MRI with passive extension without manipulation or weight bearing. Additional work in a larger cohort may better address the accuracy of this finding

  16. Use of MR arthrography in detecting tears of the ligamentum teres with arthroscopic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Connie Y.; Gill, Corey M.; Huang, Ambrose J.; Simeone, Frank J.; Torriani, Martin; Bredella, Miriam A. [Massachusetts General Hospital, Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Boston, MA (United States); McCarthy, Joseph C. [Massachusetts General Hospital, Department of Orthopedics, Boston, MA (United States)

    2014-12-20

    To demonstrate the normal appearance of the ligamentum teres on MR arthrography (MRA) and evaluate the accuracy of MRA in detecting ligamentum teres tears with arthroscopic correlation. Institutional Review Board approval was obtained with a waiver for informed consent because of the retrospective study design. A total of 165 cases in 159 patients (111 females, 48 males; mean age 41 ± 12 years) who underwent both MRA and hip arthroscopy were evaluated for appearance of the ligamentum teres, including the size, number of bundles, and ligamentum teres tears. Marrow edema of the fovea capitis adjacent to the ligamentum teres insertion and the presence of hip plicae were also recorded. The mean thickness and length of the ligamentum teres were 3.5 ± 1.5 mm and 25.2 ± 3.8 mm, respectively. Sensitivity, specificity, positive and negative predictive value, and accuracy of MRA for the detection of ligamentum teres tears were 78, 97, 74, 97, and 95 %, respectively. MRA is an accurate method to evaluate the normal morphology and to detect tears of the ligamentum teres. (orig.)

  17. Analytical approach to developing the transport threshold models of neoclassical tearing modes in tokamaks

    International Nuclear Information System (INIS)

    Analytical solutions of the stationary conduction equation are obtained. The solutions are used for developing the transport threshold models (TTM) of the neoclassical tearing modes (NTM) in tokamaks. The following TTM are considered: collisional, convective, inertial and rotational. These TTM may be the fragments of the more general models of NTM

  18. 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

  19. 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.)

  20. Surface Properties of Squalene/Meibum Films and NMR Confirmation of Squalene in Tears

    Directory of Open Access Journals (Sweden)

    Slavyana Ivanova

    2015-09-01

    Full Text Available Squalene (SQ possesses a wide range of pharmacological activities (antioxidant, drug carrier, detoxifier, hydrating, emollient that can be of benefit to the ocular surface. It can come in contact with human meibum (hMGS; the most abundant component of the tear film lipid layer as an endogenous tear lipid or from exogenous sources as eyelid sebum or pharmaceuticals. The aims of this study were to determine (i if SQ is in tear lipids and (ii its influence on the surface properties of hMGS films. Heteronuclear single quantum correlation NMR confirmed 7 mol % SQ in Schirmer’s strips extracts. The properties of SQ/hMGS pseudo-binary films at the air/water interface were studied with Langmuir surface balance, stress-relaxation dilatational rheology and Brewster angle microscopy. SQ does not possess surfactant properties. When mixed with hMGS squalene (i localized over the layers’ thinner regions and (ii did not affect the film pressure at high compression. Therefore, tear SQ is unlikely to instigate dry eye, and SQ can be used as a safe and “inert” ingredient in formulations to protect against dry eye. The layering of SQ over the thinner film regions in addition to its pharmacological properties could contribute to the protection of the ocular surface.