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Sample records for cervical rib syndrome

  1. Rare association of hyper IgE syndrome with cervical rib and natal teeth

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    Roshan Anupama

    2009-01-01

    Full Text Available Hyper IgE syndrome (HIES is a rare immunodeficiency syndrome characterized by a triad of cutaneous abscesses, mostly caused by Staphylococus aureus; pneumonia; and raised IgE levels. Nonimmunological associations include course facial features, multiple bone fractures, joint hyperextensibility, and retained primary dentition. Patients require long-term antibiotic therapy. We report here a classical case of HIES with rare associations of natal teeth, bilateral cervical ribs, and conductive deafness. The patient was being treated with monteleukast and dapsone.

  2. Síndrome do desfiladeiro torácico - ressecção de costela cervical por videotoracoscopia Thoracic outlet syndrome - cervical rib resection through videothoracoscopic surgery

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    Mario Claudio Ghefter

    2012-09-01

    Full Text Available A base do tratamento cirúrgico da Síndrome do Desfiladeiro Torácico (SDT é a ressecção da primeira costela, podendo associar-se à escalenectomia ou ainda à ressecção de costela cervical. Esta última é feita tradicionalmente por meio de um acesso supraclavicular ou mesmo axilar, o qual é tecnicamente mais trabalhoso. Pode ser realizada também por meio de acesso paraescapular. Embora tecnicamente atrativa e associada à menor invasividade e maior segurança, com ótimo resultado estético, a ressecção da primeira costela torácica, por intermédio de cirurgia videoassistida transaxilar ou pela técnica videotoracoscópica, é pouco relatada na literatura, e nenhuma referência foi encontrada sobre ressecção de costela cervical mediante essa técnica. Neste artigo, apresentamos essa inovação cirúrgica realizada com sucesso para ressecção de costela cervical em duas pacientes.The basis of Thoracic Outlet Syndrome (TOS surgical treatment is the first rib resection and may be associated with scalenectomy or cervical rib resection. The latter is traditionally done through a supraclavicular or axillary access, which is the most technically challenging. It can also be achieved through parascapular access. Although technically attractive and associated with less invasiveness and increased security, with excellent aesthetic results, the first thoracic rib resection via video-assisted transaxillary surgery or videothoracoscopic technique is seldom reported in the literature, and no reference was found on cervical rib resection through this technique. In this article, we introduced this innovation successfully performed for surgical cervical rib resection in two patients.

  3. Cervical Rib causing Thrombosis of Subclavian Atery

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    P Sharma

    2010-06-01

    Full Text Available We describe here an unusual case of thrombosis of left subclavian artery in a patient with cervical rib. The patient presented with features of ischaemia of left upper limb. X-ray chest revealed bilateral cervical ribs, longer on the left side. Color Doppler studies showed echogenic thrombus within the left subclavian artery. Angiography revealed complete occlusion of left subclavian artery. Embolectomy was done. She was planned for excision of rib. KEYWORDS: cervical rib, thrombosis of subclavian artery.

  4. Poland syndrome with absent ribs

    OpenAIRE

    Rupam Kumar Ta; Kaushik Saha; Arnab Saha; Santanu Ghosh; Mrinmoy Mitra

    2014-01-01

    Poland syndrome is a rare congenital disorder characterized by ipsilateral absence of pectoralis major muscle. This syndrome is associated with various anomalies such as ipsilateral syndactyly, brachidactyly, dextrocardia, herniation of lung, underdevelopment of upper ribs, aplasia or hypoplasia of breast, etc. Only few cases had been reported with absent ribs in Poland syndrome. We report a rare case of Poland syndrome presented to us with mal-development of his right hemithorax and weakness...

  5. Poland syndrome with absent ribs

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    Rupam Kumar Ta

    2014-01-01

    Full Text Available Poland syndrome is a rare congenital disorder characterized by ipsilateral absence of pectoralis major muscle. This syndrome is associated with various anomalies such as ipsilateral syndactyly, brachidactyly, dextrocardia, herniation of lung, underdevelopment of upper ribs, aplasia or hypoplasia of breast, etc. Only few cases had been reported with absent ribs in Poland syndrome. We report a rare case of Poland syndrome presented to us with mal-development of his right hemithorax and weakness of right hand.

  6. Embryonic remnants of intercentra and cervical ribs in turtles

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    Ingmar Werneburg

    2013-09-01

    A broad sample of extant turtles possesses a series of paired bones in the neck that are situated between the cervical vertebrae. These paired bones were originally proposed to be cervical rib remnants, but have more recently been interpreted as vestiges of intercentra. Here, we document, for the first time, the neck development of a pleurodire turtle, Emydura subglobosa, and identify blastematous structures, which partially recapitulate the ribs and intercentra of the plesiomorphic tetrapod condition. We identify blastematous “bridges” between intercentra and the corresponding ribs, which we homologize with the vestiges visible in extant turtles and with the remnant parapophyseal articulation processes of the intercentra of some stem taxa. Only the unpaired, median part of the intercentrum of the atlas is retained in adult turtles, but intercentra are recapitulated along the entire vertebral column during development; they are embedded in the cervical myosepta and serve as attachment sites for neck musculature. We also identify two rib rudiments in the occipital region, which may indicate that at least two vertebrae are integrated into the cranium of turtles in particular, and of amniotes in general.

  7. Sternoplasty and rib distraction in neonatal Jeune syndrome.

    LENUS (Irish Health Repository)

    Conroy, Eimear

    2010-09-01

    A 12-week-old boy with Jeune syndrome (asphyxiating thoracic dystrophy) was referred to the orthopaedic unit with progressive respiratory failure, recurrent respiratory tract infections, and recurrent admissions to the intensive care unit for ventilatory support. His chest x-ray revealed a small and narrow thoracic cage with short broad ribs and abnormal costal cartilages. His chest expansion was impaired by the short, horizontally positioned ribs resulting in alveolar hypoventilation. Without surgical intervention to expand his thoracic cage, he would die of respiratory failure.

  8. Naumoff short-rib polydactyly syndrome compounded with Mohr oral-facial-digital syndrome

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    Young, L.W.; Wilhelm, L.L. [Loma Linda Univ., CA (United States). Medical Center; Zuppan, C.W. [Div. of Pediatric Pathology, Loma Linda University Medical Center, CA (United States); Clark, R. [Div. of Medical Genetics, Loma Linda University Medical Center, CA (United States)

    2001-01-01

    A stillborn baby boy had findings of severe constitutional dwarfism with short limbs, short ribs, and polydactyly that were consistent with Naumoff (type III) short-rib polydactyly syndrome. He also had additional congenital anomalies, including cleft palate, notching of the upper lip, small tongue with accessory sublingual tissue. These oral and pharyngeal anomalies were consistent with Mohr (type II) oral-facial-digital syndrome. We suggest the stillborn infant represented a compound of Naumoff short-rib polydactyly syndrome (SRPS-III) and Mohr oral-facial-digital syndrome (OFDS-II). (orig.)

  9. Extraordinary incidence of cervical ribs indicates vulnerable condition in Late Pleistocene mammoths

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    Jelle W.F. Reumer

    2014-03-01

    Full Text Available The number of cervical vertebrae in mammals is highly conserved at seven. We have shown that changes of this number are selected against due to a coupling with major congenital abnormalities (pleiotropic effects. Here we show that the incidence of abnormal cervical vertebral numbers in Late Pleistocene mammoths from the North Sea is high (33.3% and approximately 10 times higher than that of extant elephants (3.6%. Abnormal numbers were due to the presence of large cervical ribs on the seventh vertebra, which we deduced from the presence of rib articulation facets on sixth (posterior side and seventh (anterior side cervical vertebrae. The incidence of abnormal cervical vertebral numbers in mammoths appears to be much higher than in other mammalian species, apart from exceptional sloths, manatees and dugongs and indicates a vulnerable condition. We argue that the increased incidence of cervical ribs in mammoths is probably caused by inbreeding and adverse conditions that impact early pregnancies in declining populations close to extinction in the Late Pleistocene.

  10. DiGeorge syndrome with vertebral and rib dysplasia

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    Puno-Cocuzza, C.; David, K.; Kogekar, N. [Brooklyn Hospital Center, NY (United States)

    1994-09-01

    DiGeorge syndrome results from defect in the development of the third and fourth pharyngeal pouches, and is characterized by conotruncal heart defects, aplasia or hypoplasia of thymus and parathyroid glands resulting in immune deficiency and hypocalcemia. Other associated abnormalities include renal, thyroid and diaphragmatic defects, oral clefting, etc. Etiologically, it is heterogeneous, with a microdeletion of 22q11 present in over 80% of cases. Our patient was born following a pregnancy complicated by insulin dependent gestational diabetes. There was truncus arteriosus type 2, absense of thymic shadow on CXR with severe deficiency of T cell function, and persistent hypocalcemia with low parathormone. Right kidney was absent. Dysplastic ribs including fused and bifid ribs were noted. Hypoplastic vertebrae and hemivertebrae were present through thoracic and lumbar regions. Chromosome analysis was normal, and metaphase FISH analysis with probe N25 representing locus D22S75 did not show any deletion of 22q11.2. The skeletal findings similar to these have not been previously reported in association with DiGeorge syndrome to our knowledge. Vertebral and rib abnormalities are known to occur with pregestational maternal diabetes. Maternal diabetes has also been suggested to be a possible etiology in a very small proportion of DiGeorge syndrome cases. It is possible that these findings occured together on account of gestational maternal diabetes in our case.

  11. Cervical spine in Treacher Collins syndrome.

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    Pun, Amy Hoi-Ying; Clark, Bruce Eric; David, David John; Anderson, Peter John

    2012-05-01

    Treacher Collins syndrome is a congenital syndrome with characteristic craniofacial malformations, which are well described in the literature. However, the presence of cervical spine dysmorphology in this syndrome has been minimally described. This study reviews cervical spine radiographs of 40 patients with Treacher Collins syndrome. In this sample, 7 of 40 patients displayed cervical spine anomalies, with 3 of these patients displaying multiple cervical spine anomalies. The patterns of spinal anomalies were variable, suggesting that the underlying genetic mutation has variable expressivity in cervical spine development as it does elsewhere in the craniofacial skeleton.

  12. Tourette's syndrome with cervical disc herniation.

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    Lin, Jainn-Jim; Wang, Huei-Shyong; Wong, Mun-Ching; Wu, Chieh-Tsai; Lin, Kuang-Lin

    2007-03-01

    Tourette's syndrome is manifested in a broad spectrum of motor, vocal, and behavioral disturbances. Movement disorders, such as tics, may contribute to the development of cervical myelopathy owing to the effects of involuntary movements on the neck. However, the association of cervical myelopathy with motor tics of the head and neck is rare. We report here a case of a violent, repetitive neck extension due to Tourette's syndrome that developed cervical myelopathy caused by cervical disc herniation.

  13. Thoracic Outlet Syndrome in a Volleyball Player Due to Nonunion of the First Rib Fracture.

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    Puttmann, Kathleen T; Satiani, Bhagwan; Vaccaro, Patrick

    2016-11-01

    Fracture of the first rib with ensuing callus formation is a rare cause of thoracic outlet syndrome. We report a case of a 17-year-old female volleyball player who presented with months of chronic arm pain. Radiographic imaging demonstrated nonunion fracture of the first rib. Physical therapy had been unsuccessful in relieving the pain, and surgical management was performed with resection of the first rib through a transaxillary approach with complete resolution of symptoms. Inflammation surrounding such fractures may destroy tissue planes, making dissection more technically difficult.

  14. EXAMINATION RESULTS OF CHILDREN WITH CERVICAL SYNDROME

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    N. H. Bakhteeva

    2010-01-01

    Full Text Available By the example of examination of 80 children aged from 4 to 18 with cervical syndrome it is indicated, that the diagnosed abnormalities of hemodynamics in vertebrobasilar basin in patients of all age groups are connected both with bone and vascular pathology of the cervical part of the spine. The pathology has functional or congenital character. Early detection of discicirculatory vascular injuries in the cervical part of the spine in children with cervical syndrome will allow to define the therapeutic management of patients and to prolong juvenile osteochondrosis clinical behaviour.

  15. Cronkhite-Canada syndrome associated with rib fractures: a case report

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    Wan Haijun

    2010-10-01

    Full Text Available Abstract Background Cronkhite-Canada syndrome (CCS is a rare multiple gastrointestinal polyposis. Up till now, many complications of CCS have been reported in the literature, but rib fracture is not included. Case Presentation We report a case of a 58-year-old man who was admitted to our hospital with a 6-month history of frequent diarrhea, intermittent hematochezia and a weight loss of 13 kg. On admission, physical examination revealed alopecia of the scalp, hyperpigmentation of the hands and soles, and dystrophy of the fingernails. Laboratory data revealed hypocalcaemia and hypoproteinemia. Esophagogastroduodenoscopy, video capsule endoscopy and colonoscopy revealed various sizes of generalized gastrointestinal polyps. Histological examination of the biopsy specimens obtained from the stomach and the colon showed adenomatous polyp and inflammatory polyp respectively. Thus, a diagnosis of CCS was made. After treatment with corticosteroids for 24 days and nutritional support for two months, his clinical condition improved. Two months later, he was admitted to our hospital for the second time with frequent diarrhea and weight loss. The chest radiography revealed fractures of the left sixth and seventh ribs. Examinations, including emission computed tomography, bone densitometry test, and other serum parameters, were performed, but could not identify the definite etiology of the rib fractures. One month later, the patient suffered from aggravating multiple rib fractures due to the ineffective treatment, persistent hypocalcaemia and malnutrition. Conclusions This is the first case of a CCS patient with multiple rib fractures. Although the association between CCS and multiple rib fractures in this case remains uncertain, we presume that persistent hypocalcaemia and malnutrition contribute to this situation, or at least aggravate this rare complication. Besides, since prolonged corticosteroid therapy will result in an increased risk of osteoporotic

  16. Jaw cyst-Basal cell nevus-Bifid rib syndrome: a case report.

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    Rai, S; Gauba, K

    2007-01-01

    Jaw cyst-Basal cell nevus-Bifid rib syndrome or Gorlin-Goltz syndrome involves multiple organ system. The most common findings include multiple odontogenic keratocysts in the jaws and basal cell nevus on the skin that have an early age onset. These multiple odontogenic keratocysts warrant aggressive treatment at the earliest because of the damage and possible complications associated with them. Recurrence in these lesions is the most characteristic feature that has to be taken in consideration while explaining the prognosis to the patient. A case report of a child affected with Gorlin-Goltz syndrome diagnosed, treated and followed at this hospital is presented here.

  17. Jaw cyst-Basal cell nevus-Bifid rib syndrome: A case report

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    Rai S

    2007-09-01

    Full Text Available Jaw cyst-Basal cell nevus-Bifid rib syndrome or Gorlin-Goltz syndrome involves multiple organ system. The most common findings include multiple odontogenic keratocysts in the jaws and basal cell nevus on the skin that have an early age onset. These multiple odontogenic keratocysts warrant aggressive treatment at the earliest because of the damage and possible complications associated with them. Recurrence in these lesions is the most characteristic feature that has to be taken in consideration while explaining the prognosis to the patient. A case report of a child affected with Gorlin-Goltz syndrome diagnosed, treated and followed at this hospital is presented here.

  18. Supraclavicular scalenectomy for thoracic outlet syndrome--functional outcomes assessed using the DASH scoring system.

    LENUS (Irish Health Repository)

    Glynn, Ronan W

    2012-02-01

    To evaluate supraclavicular scalenectomy ± cervical rib excision for thoracic outlet syndrome (TOS), employing Disability of Arm, Shoulder, and Hand (DASH) scoring for functional assessment post-decompression.

  19. High-definition video-assisted transaxillary first rib resection for thoracic outlet syndrome.

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    Chan, Yiu Che; Gelabert, Hugh A

    2013-04-01

    Transaxillary first rib resection is a well-established effective surgical treatment for patients with symptomatic thoracic outlet syndrome, but surgical access may be limited and visualization is constrained. The use of high-definition video-assisted imaging overcomes these limitations. The use of high-definition video-assisted visualization of the anatomy enhances the surgeon's tactile feedback of the rib from the small open wound and is effective in providing better surgical access and allows clear identification of vital structures for the operating surgical team. This technique enhances the appreciation of anatomic detail, situational awareness of the team, and allows for more efficient assistance to the surgeon. Improved visualization also facilitates effective education of nurses, residents, and students.

  20. Extraordinary incidence of cervical ribs indicates vulnerable condition in Late Pleistocene mammoths

    NARCIS (Netherlands)

    Reumer, J.W.F.; ten Broek, C.M.A.; Galis, F.

    2014-01-01

    The number of cervical vertebrae in mammals is highly conserved at seven. We have shown that changes of this number are selected against due to a coupling with major congenital abnormalities (pleiotropic effects). Here we show that the incidence of abnormal cervical vertebral numbers in Late Pleisto

  1. DYNC2H1 Mutations Cause Asphyxiating Thoracic Dystrophy and Short Rib-Polydactyly Syndrome, Type III

    OpenAIRE

    Dagoneau, Nathalie; Goulet, Marie; Geneviève, David; Sznajer, Yves; Martinovic, Jelena; Smithson, Sarah; Huber, Céline; Baujat, Geneviève; Flori, Elisabeth; Tecco, Laura; Cavalcanti, Denise; Delezoide, Anne-Lise; Serre, Valérie; Le Merrer, Martine; Munnich, Arnold

    2009-01-01

    Jeune asphyxiating thoracic dystrophy (ATD) is an autosomal-recessive chondrodysplasia characterized by short ribs and a narrow thorax, short long bones, inconstant polydactyly, and trident acetabular roof. ATD is closely related to the short rib polydactyly syndrome (SRP) type III, which is a more severe condition characterized by early prenatal expression and lethality and variable malformations. We first excluded IFT80 in a series of 26 fetuses and children belonging to 14 families diagnos...

  2. A Rare Cause of Persistent Pulmonary Hypertension Resistant to Therapy in The Newborn: Short-Rib Polydactyly Syndrome

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    Nihat Demir

    2015-01-01

    Full Text Available Short-rib polydactyly syndrome is an autosomal recessively inherited lethal skeletal dysplasia. The syndrome is characterized by marked narrow fetal thorax, short extremities, micromelia, cleft palate/lip, polydactyly, cardiac and renal abnormalities, and genital malformations. In cases with pulmonary hypoplasia, persistent pulmonary hypertension of the newborn can develop. In this paper, we present a term newborn with persistent pulmonary hypertension of the newborn, which has developed secondary to short-rib polydactyly syndrome and was resistant to therapy with inhaled nitric oxide and oral sildenafil.

  3. The natural history and clinical syndromes of degenerative cervical spondylosis.

    LENUS (Irish Health Repository)

    Kelly, John C

    2012-01-01

    Cervical spondylosis is a broad term which describes the age related chronic disc degeneration, which can also affect the cervical vertebrae, the facet and other joints and their associated soft tissue supports. Evidence of spondylitic change is frequently found in many asymptomatic adults. Radiculopathy is a result of intervertebral foramina narrowing. Narrowing of the spinal canal can result in spinal cord compression, ultimately resulting in cervical spondylosis myelopathy. This review article examines the current literature in relation to the cervical spondylosis and describes the three clinical syndromes of axial neck pain, cervical radiculopathy and cervical myelopathy.

  4. Cervical spondylomyelopathy (wobbler syndrome in the Boerboel

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    M.J. Gray

    2003-07-01

    Full Text Available The Boerboel is a South African large-breed dog resembling a Bullmastiff. The records of Onderstepoort Veterinary Academic Hospital were searched for dogs that had presented, between 1998 and 2003, with symptoms indicative of wobbler syndrome and had undergone survey radiographic and myelographic studies. Ten cases fitted the inclusion criteria. Dogs presented within the first 2 years of life, often with acute onset of symptoms. All presented with pelvic limb and 6 with concomitant thoracic limb ataxia or paresis. Treatment varied and included none (4, prednisolone (2, and dorsal laminectomy (2. Two dogs were euthanased at the time of diagnosis. The breed appears to be affected with a form of spondylomyelopathy that comprises bony malformation of cervical and/or thoracic vertebrae. In 8 dogs, malformations were evident on survey radiographs and were characterised by enlarged, irregular articular facets and associated medial deviation of the pedicles. These changes resulted in axial compression of the spinal cord best seen on ventrodorsal or dorsoventral myelographic studies. Multiple vertebrae were affected in some dogs and lesions were not confined to the caudal area of the cervical spine. Three dogs were alive and without symptoms at follow-up. Four were euthanased as a result of the disease and 1 died as a result of post-operative complications. Two additional dogs presenting with wobbler clinical signs are also described. One had medial deviation of the T5 and T6 caudal pedicles and 1 dog suffered from multiple cervical articular facet synovial cysts.

  5. Multi-detector thoracic CT findings in cerebro-costo-mandibular syndrome: rib gaps and failure of costo-vertebral separation

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    Watson, Tom Anthony; Arthurs, Owen John; Calder, Alistair Duncan [Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Radiology, London (United Kingdom); Muthialu, Nagarajan [Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Cardiothoracic surgery, London (United Kingdom)

    2014-02-15

    Cerebro-costo-mandibular syndrome (CCMS) describes a triad of mandibular hypoplasia, brain dysfunction and posterior rib defects (''rib gaps''). We present the CT imaging for a 2-year-old girl with CCMS that highlights the rib gap defects and shows absent transverse processes with abnormal fusion of the ribs directly to the vertebral bodies. We argue that this is likely to relate to abnormal lateral sclerotome development in embryology, with the failure of normal costo-vertebral junctions compounding impaired thoracic function. The case also highlights the use of CT for specific indications in skeletal dysplasia. (orig.)

  6. Multi-detector thoracic CT findings in cerebro-costo-mandibular syndrome: rib gaps and failure of costo-vertebral separation.

    Science.gov (United States)

    Watson, Tom Anthony; Arthurs, Owen John; Muthialu, Nagarajan; Calder, Alistair Duncan

    2014-02-01

    Cerebro-costo-mandibular syndrome (CCMS) describes a triad of mandibular hypoplasia, brain dysfunction and posterior rib defects ("rib gaps"). We present the CT imaging for a 2-year-old girl with CCMS that highlights the rib gap defects and shows absent transverse processes with abnormal fusion of the ribs directly to the vertebral bodies. We argue that this is likely to relate to abnormal lateral sclerotome development in embryology, with the failure of normal costo-vertebral junctions compounding impaired thoracic function. The case also highlights the use of CT for specific indications in skeletal dysplasia.

  7. Torsion and bending in the neck and tail of sauropod dinosaurs and the function of cervical ribs: insights from functional morphology and biomechanics.

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    Holger Preuschoft

    Full Text Available The long necks of sauropods have been subject to many studies regarding their posture and flexibility. Length of the neck varies among groups. Here, we investigate neck posture and morphology in several clades from a mechanical viewpoint. Emphasis is put on comparing sauropod necks and tails with structures in living archosaurs and mammals. Differences in the use made of necks and tails lead to clear-cut differences in the mechanical loads occurring in the same models. Ways of sustaining loads are identified by theoretical considerations. If the observed skeletal structures are suited to resist the estimated loading in a particular posture, this concordance is taken as an argument that this posture or movement was of importance during the life of the individual. Apart from the often-discussed bending in side view, we analyze the often overlooked torsion. Because torsional stresses in a homogenous element concentrate near the periphery, a cylindrical cross section gives greatest strength, and the direction of forces is oblique. In a vertebrate neck, during e.g. shaking the head and twisting the neck, oblique muscles, like the mm. scaleni, if activated unilaterally initiate movement, counterbalance the torsional moments and keep the joints between neck vertebrae in equilibrium. If activated bilaterally, these muscles keep the neck balanced in an energy-saving upright posture. The tendons of the mm. scaleni may have ossified as cervical ribs The long cervical ribs in brachiosaurids and mamenchisaurids seem to have limited flexibility, whereas the shorter cervical ribs in Diplodocidae allowed free movement. The tails of sauropods do not show pronounced adaptation to torsion, and seem to have been carried more or less in a horizontal, extended posture. In this respect, sauropod tails resemble the necks of herbivorous cursorial mammals. These analyses provide an improved understanding of neck use that will be extended to other sauropods in subsequent

  8. Torsion and bending in the neck and tail of sauropod dinosaurs and the function of cervical ribs: insights from functional morphology and biomechanics.

    Science.gov (United States)

    Preuschoft, Holger; Klein, Nicole

    2013-01-01

    The long necks of sauropods have been subject to many studies regarding their posture and flexibility. Length of the neck varies among groups. Here, we investigate neck posture and morphology in several clades from a mechanical viewpoint. Emphasis is put on comparing sauropod necks and tails with structures in living archosaurs and mammals. Differences in the use made of necks and tails lead to clear-cut differences in the mechanical loads occurring in the same models. Ways of sustaining loads are identified by theoretical considerations. If the observed skeletal structures are suited to resist the estimated loading in a particular posture, this concordance is taken as an argument that this posture or movement was of importance during the life of the individual. Apart from the often-discussed bending in side view, we analyze the often overlooked torsion. Because torsional stresses in a homogenous element concentrate near the periphery, a cylindrical cross section gives greatest strength, and the direction of forces is oblique. In a vertebrate neck, during e.g. shaking the head and twisting the neck, oblique muscles, like the mm. scaleni, if activated unilaterally initiate movement, counterbalance the torsional moments and keep the joints between neck vertebrae in equilibrium. If activated bilaterally, these muscles keep the neck balanced in an energy-saving upright posture. The tendons of the mm. scaleni may have ossified as cervical ribs The long cervical ribs in brachiosaurids and mamenchisaurids seem to have limited flexibility, whereas the shorter cervical ribs in Diplodocidae allowed free movement. The tails of sauropods do not show pronounced adaptation to torsion, and seem to have been carried more or less in a horizontal, extended posture. In this respect, sauropod tails resemble the necks of herbivorous cursorial mammals. These analyses provide an improved understanding of neck use that will be extended to other sauropods in subsequent studies.

  9. Ciliary Abnormalities Due to Defects in the Retrograde Transport Protein DYNC2H1 in Short-Rib Polydactyly Syndrome

    OpenAIRE

    Merrill, Amy E.; Merriman, Barry; Farrington-Rock, Claire; CAMACHO, NATALIA; Sebald, Eiman T.; Funari, Vincent A.; Schibler, Matthew J.; Firestein, Marc H.; Cohn, Zachary A; Priore, Mary Ann; Thompson, Alicia K.; Rimoin, David L.; Nelson, Stanley F.; Cohn, Daniel H.; Krakow, Deborah

    2009-01-01

    The short-rib polydactyly (SRP) syndromes are a heterogenous group of perinatal lethal skeletal disorders with polydactyly and multisystem organ abnormalities. Homozygosity by descent mapping in a consanguineous SRP family identified a genomic region that contained DYNC2H1, a cytoplasmic dynein involved in retrograde transport in the cilium. Affected individuals in the family were homozygous for an exon 12 missense mutation that predicted the amino acid substitution R587C. Compound heterozygo...

  10. NEK1 mutations cause short-rib polydactyly syndrome type majewski.

    Science.gov (United States)

    Thiel, Christian; Kessler, Kristin; Giessl, Andreas; Dimmler, Arno; Shalev, Stavit A; von der Haar, Sigrun; Zenker, Martin; Zahnleiter, Diana; Stöss, Hartmut; Beinder, Ernst; Abou Jamra, Rami; Ekici, Arif B; Schröder-Kress, Nadja; Aigner, Thomas; Kirchner, Thomas; Reis, André; Brandstätter, Johann H; Rauch, Anita

    2011-01-01

    Defects of ciliogenesis have been implicated in a wide range of human phenotypes and play a crucial role in signal transduction and cell-cycle coordination. We used homozygosity mapping in two families with autosomal-recessive short-rib polydactyly syndrome Majewski type to identify mutations in NEK1 as an underlying cause of this lethal osteochondrodysplasia. NEK1 encodes a serine/threonine kinase with proposed function in DNA double-strand repair, neuronal development, and coordination of cell-cycle-associated ciliogenesis. We found that absence of functional full-length NEK1 severely reduces cilia number and alters ciliar morphology in vivo. We further substantiate a proposed digenic diallelic inheritance of ciliopathies by the identification of heterozygous mutations in NEK1 and DYNC2H1 in an additional family. Notably, these findings not only increase the broad spectrum of ciliar disorders, but suggest a correlation between the degree of defective microtubule or centriole elongation and organization and the severity of the resulting phenotype.

  11. Cervical spine involvements in Reiter's syndrome

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    Moilanen, A.; Yli-Kerrtula, U.; Vippula, A.

    1984-07-01

    Cervical spine radiographs of 38 patients orginating from 145 consecutive cases with Reiter's syndrome (RS) were reviewed. Five of these 145 patients (3.4%) had cervical spine manifestations: anterior atlanto-axial dislocation 2, craniovertebral lesions typical for rhreumatoid arthritis (RA), spondylitis typical for ankylosing spondylitis (AS) and anterior ossification, one each. Four of these patients were males. Cervical lesions in RS turned out to be rare. These lesions are alone indistinguisable from those of other chronic rheumatic inflammatory diseases.

  12. Ehler Danlos syndrome with cervical dislocation: An unusual case

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    Neeraj Awasthy

    2008-01-01

    Full Text Available Ehler-Danlos syndrome (EDS is heritable connective tissue disorders with varied manifestations whose primary clinical features include soft, hyperextensible skin, dystrophic scarring, easy bruising, and joint hypermobility. Os odontoideum describes a condition in which the dens is separated from the axis body. The exact frequency is unknown. Known cases are either incidentally detected or are diagnosed when patients become symptomatic. Cervical dislocation has been described with type VI lesions but no association with Os odontoideum was found in the English literature. We describe a case of 5-year-old boy a case of Ehler Danlos syndrome presenting with features of cervical dislocation due to Os odontoideum.

  13. Novel compound heterozygous mutations in DYNC2H1 in a patient with severe short-rib polydactyly syndrome type III phenotype.

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    Okamoto, Toshio; Nagaya, Ken; Kawata, Yumi; Asai, Hiroko; Tsuchida, Etsushi; Nohara, Fumikatsu; Okajima, Kazuki; Azuma, Hiroshi

    2015-08-01

    Short-rib polydactyly syndrome type III is an autosomal recessive lethal skeletal ciliopathy, which is phenotypically similar to nonlethal asphyxiating thoracic dystrophy. Mutations in DYNC2H1 have been identified in both of these disorders, indicating that they are variants of a single disorder. However, short-rib polydactyly syndrome type III is the more severe variant. Here, we report novel compound heterozygous mutations in DYNC2H1 (p.E1894fsX10 and p.R3004C) in a patient with typical short-rib polydactyly syndrome type III phenotype. R3004 is located within the microtubule-binding domain of DYNC2H1, and its substitution is predicted to disrupt the interaction with microtubules. Considering the severe phenotype of our patient, our findings suggest that R3004 may be a key residue for the microtubule-binding affinity of dynein.

  14. DYNC2H1 mutations cause asphyxiating thoracic dystrophy and short rib-polydactyly syndrome, type III.

    Science.gov (United States)

    Dagoneau, Nathalie; Goulet, Marie; Geneviève, David; Sznajer, Yves; Martinovic, Jelena; Smithson, Sarah; Huber, Céline; Baujat, Geneviève; Flori, Elisabeth; Tecco, Laura; Cavalcanti, Denise; Delezoide, Anne-Lise; Serre, Valérie; Le Merrer, Martine; Munnich, Arnold; Cormier-Daire, Valérie

    2009-05-01

    Jeune asphyxiating thoracic dystrophy (ATD) is an autosomal-recessive chondrodysplasia characterized by short ribs and a narrow thorax, short long bones, inconstant polydactyly, and trident acetabular roof. ATD is closely related to the short rib polydactyly syndrome (SRP) type III, which is a more severe condition characterized by early prenatal expression and lethality and variable malformations. We first excluded IFT80 in a series of 26 fetuses and children belonging to 14 families diagnosed with either ATD or SRP type III. Studying a consanguineous family from Morocco, we mapped an ATD gene to chromosome 11q14.3-q23.1 in a 20.4 Mb region and identified homozygous mutations in the cytoplasmic dynein 2 heavy chain 1 (DYNC2H1) gene in the affected children. Compound heterozygosity for DYNC2H1 mutations was also identified in four additional families. Among the five families, 3/5 were diagnosed with ATD and 2/5 included pregnancies terminated for SRP type III. DYNC2H1 is a component of a cytoplasmic dynein complex and is directly involved in the generation and maintenance of cilia. From this study, we conclude that ATD and SRP type III are variants of a single disorder belonging to the ciliopathy group.

  15. The cervical spine in Saethre-Chotzen syndrome.

    Science.gov (United States)

    Anderson, P J; Hall, C M; Evans, R D; Hayward, R D; Harkness, W J; Jones, B M

    1997-01-01

    Twenty patients with a diagnosis of Saethre-Chotzen syndrome had their cervical spine radiographs reviewed. Radiologic abnormalities including vertebral fusion were present in 9 of the 20 patients. Fusion of both the vertebral bodies and the posterior elements was noted, although the latter site was more common. C2-3 was the level most commonly involved, although other levels were recorded. Analysis of sequential radiographs in nine patients revealed evidence of progression in seven patients. In those studies in children aged under 2 years, only 1 of 18 films showed evidence of fusion, while in those over 2 years of age, 10 of 12 showed evidence of fusion. These results reveal that the incidence of cervical anomalies in Saethre-Chotzen syndrome is greater than that in the general population. There is both direct and indirect evidence that the vertebral fusions are progressive during childhood.

  16. Ciliary abnormalities due to defects in the retrograde transport protein DYNC2H1 in short-rib polydactyly syndrome.

    Science.gov (United States)

    Merrill, Amy E; Merriman, Barry; Farrington-Rock, Claire; Camacho, Natalia; Sebald, Eiman T; Funari, Vincent A; Schibler, Matthew J; Firestein, Marc H; Cohn, Zachary A; Priore, Mary Ann; Thompson, Alicia K; Rimoin, David L; Nelson, Stanley F; Cohn, Daniel H; Krakow, Deborah

    2009-04-01

    The short-rib polydactyly (SRP) syndromes are a heterogeneous group of perinatal lethal skeletal disorders with polydactyly and multisystem organ abnormalities. Homozygosity by descent mapping in a consanguineous SRP family identified a genomic region that contained DYNC2H1, a cytoplasmic dynein involved in retrograde transport in the cilium. Affected individuals in the family were homozygous for an exon 12 missense mutation that predicted the amino acid substitution R587C. Compound heterozygosity for one missense and one null mutation was identified in two additional nonconsanguineous SRP families. Cultured chondrocytes from affected individuals showed morphologically abnormal, shortened cilia. In addition, the chondrocytes showed abnormal cytoskeletal microtubule architecture, implicating an altered microtubule network as part of the disease process. These findings establish SRP as a cilia disorder and demonstrate that DYNC2H1 is essential for skeletogenesis and growth.

  17. Ehler Danlos syndrome with cervical dislocation: An unusual case

    OpenAIRE

    2008-01-01

    Ehler-Danlos syndrome (EDS) is heritable connective tissue disorders with varied manifestations whose primary clinical features include soft, hyperextensible skin, dystrophic scarring, easy bruising, and joint hypermobility. Os odontoideum describes a condition in which the dens is separated from the axis body. The exact frequency is unknown. Known cases are either incidentally detected or are diagnosed when patients become symptomatic. Cervical dislocation has been described with type VI les...

  18. Differential diagnosis of cervical nerve compression syndrome of the external intervertebral foramen

    Institute of Scientific and Technical Information of China (English)

    WANG Jinwu; NI Weifeng; LI Qi; XU Jianguang; ZHU Haibo; ZHAO Binghui; GUO Shangchun; ZENG Bingfang

    2007-01-01

    The aim of the present research is to study the mechanism of cervical nerve compression syndrome of the external intervertebral foramen and its difierential diagnosis with cervical spondylosis.Diagnostic treatment with muscle relaxant,vasodilator,neurotrophic medicine and celecoxib (COX)-2 inhibitor were performed in 20 patients with cervical nerve compression syndrome of the external intervertebral foramen and 20 patients with cervical spondylosis confirmed by operation.Diagnostic local block therapy was performed additionally in cases showing little effect after diagnostic treatment.All the patients were followed up postoperatively for more than one year.Fifteen cases with cervical nerve compression syndrome of the external intervertebral foramen were healed by the diagnostic treatment.The other five cases had a short-term remission and there was no recurrence after diagnostic local block therapy.Diagnostic treatment led to short-term alleviation of the symptom in 20 cases with cervical spondylosis confirmed by operation,the results of which was far from satisfactory and operation was undertaken finally in all the 20 cases.The etiology of cervical nerve compression syndrome of the extemal intervertebral foramen lies in the compression of the cervical plexus,brachial plexus and cervical dorsal rami by the tendinous decussating fibers of the scalenus anticus,medius,minimus and the posterior muscles of the neck.Diagnostic treatment was propitious to differentiate cervical nerve compression syndrome of the external intervertebral foramen from cervical spondylosis.

  19. Ribbing disease

    Directory of Open Access Journals (Sweden)

    Mukkada Philson

    2010-01-01

    Full Text Available Ribbing disease is a rare sclerosing dysplasia that involves long tubular bones, especially the tibia and femur. It occurs after puberty and is reported to be more common in women. In this article we describe how Ribbing disease can be differentiated from diseases like Engelmann-Camurati disease, van Buchem disease, Erdheim-Chester disease, osteoid osteoma, chronic osteomyelitis, stress fracture, etc.

  20. Cervical neuro-muscular syndrome: discovery of a new disease group caused by abnormalities in the cervical muscles.

    Science.gov (United States)

    Matsui, Takayoshi; Ii, Kunio; Hojo, Shuntaro; Sano, Keiji

    2012-01-01

    Our previous study of whiplash injury found that abnormalities in the cervical muscles cause autonomic dystonia. Further research has found that abnormalities in the cervical muscles cause headache, chronic fatigue syndrome, vertigo, and dizziness. We named this group of diseases cervical neuro-muscular syndrome. Patients treated within a 2-year period from April 1, 2002 to March 31, 2004 reported good outcomes in 83.8% for headache, 88.4% for vertigo and dizziness, 84.5% for chronic fatigue syndrome, 88.0% for autonomic dystonia, and 83.7% for whiplash-associated disorder. A large number of outpatients present with general malaise, including many general physical complaints without identifiable cause. We propose that treatment of the cervical muscle is effective for general malaise.

  1. Cervical Disc Herniation Causing Brown-Séquard's Syndrome: A Case Report and Literature Review.

    Science.gov (United States)

    Rustagi, Tarush; Badve, Siddharth; Maniar, Hemil; Parekh, Aseem N

    2011-01-01

    Brown-Séquard's syndrome (BSS) is caused by hemisection or hemicompression of the cord leading to ipsilateral motor deficit and contralateral sensory loss. Cervical disc herniation has been reported to be a rare cause of Brown-Séquard's syndrome. We describe a rare case of multilevel cervical disc herniation presenting as BSS. The condition was confirmed by MRI scan. Cervical corpectomy, decompression, and fusion gave a satisfying result. Pertinent literature has been reviewed.

  2. Cervical Disc Herniation Causing Brown-Séquard's Syndrome: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Tarush Rustagi

    2011-01-01

    Full Text Available Brown-Séquard's syndrome (BSS is caused by hemisection or hemicompression of the cord leading to ipsilateral motor deficit and contralateral sensory loss. Cervical disc herniation has been reported to be a rare cause of Brown-Séquard's syndrome. We describe a rare case of multilevel cervical disc herniation presenting as BSS. The condition was confirmed by MRI scan. Cervical corpectomy, decompression, and fusion gave a satisfying result. Pertinent literature has been reviewed.

  3. Cervical Disc Herniation Causing Brown-Séquard's Syndrome: A Case Report and Literature Review

    Science.gov (United States)

    Rustagi, Tarush; Badve, Siddharth; Maniar, Hemil; Parekh, Aseem N.

    2011-01-01

    Brown-Séquard's syndrome (BSS) is caused by hemisection or hemicompression of the cord leading to ipsilateral motor deficit and contralateral sensory loss. Cervical disc herniation has been reported to be a rare cause of Brown-Séquard's syndrome. We describe a rare case of multilevel cervical disc herniation presenting as BSS. The condition was confirmed by MRI scan. Cervical corpectomy, decompression, and fusion gave a satisfying result. Pertinent literature has been reviewed. PMID:23259105

  4. [Cervical myofascial pain syndrome. Narrative review of physiotherapeutic treatment].

    Science.gov (United States)

    Capó-Juan, M A

    2015-01-01

    Pain is a complex and multifactorial phenomenon that depends on the interaction of biopsychosocial factors. Between 15-25% of adults suffer from chronic pain at some point in their lives. Cervical chronic pain is considered a public health problem affecting 9.6% men and 21.9% women, according to the latest National Health Survey 2011-12. A high percentage of medical consultations due to muscle pain turn out to be myofascial pain syndrome (MPS). Its existence implies the presence of myofascial trigger points which can be latent or active throughout the whole population. The aim of this review is to update knowledge in the various therapies applied by the physiotherapist in the treatment of this syndrome at cervical level. From the review it appears that some of the most used techniques that may be useful in the short or medium term are: ischemic compression and/or trigger point pressure release and dry needling. Furthermore, various combinations of treatment modalities are used to treat this syndrome, taking other aspects into account, such as education.

  5. Pharyngeal-cervical-brachial variant of Guillain-Barre syndrome.

    Science.gov (United States)

    Wakerley, Benjamin R; Yuki, Nobuhiro

    2014-03-01

    The pharyngeal-cervical-brachial (PCB) variant of Guillain-Barré syndrome is defined by rapidly progressive oropharyngeal and cervicobrachial weakness associated with areflexia in the upper limbs. Serial nerve conduction studies suggest that PCB represents a localised subtype of Guillain-Barré syndrome characterised by axonal rather than demyelinating neuropathy. Many neurologists are unfamiliar with PCB, which is often misdiagnosed as brainstem stroke, myasthenia gravis or botulism. The presence of additional ophthalmoplegia and ataxia indicates overlap with Fisher syndrome. Half of patients with PCB carry IgG anti-GT1a antibodies which often cross-react with GQ1b, whereas most patients with Fisher syndrome carry IgG anti-GQ1b antibodies which always cross-react with GT1a. Significant overlap between the clinical and serological profiles of these patients supports the view that PCB and Fisher syndrome form a continuous spectrum. In this review, we highlight the clinical features of PCB and outline new diagnostic criteria.

  6. Aggressive cervical neuroblastoma with a rare paraneoplastic syndrome: A therapeutic dilemma

    Science.gov (United States)

    Qureshi, Sajid S.; Bhagat, Monica; Anam, Jay; Vora, Tushar

    2016-01-01

    Neuroblastoma is infrequently associated with paraneoplastic syndromes. Amongst the few, opsomyoclonus (Kinsbourne syndrome) is the most common neurological paraneoplastic syndrome and diarrhea secondary to increased secretion of vasoactive intestinal peptide (Kerner-Morrison syndrome), hormonal paraneoplastic syndrome. Hypothalamic dysfunction (HD) is a rare disorder and its manifestation as a paraneoplastic syndrome of neuroblastoma is uncommonly reported. We present an interesting case of an unrelenting cervical neuroblastoma associated with HD, which posed a therapeutic challenge. PMID:27695211

  7. A Case Report of Multiple Basal Cell Carcinoma Syndrome

    Directory of Open Access Journals (Sweden)

    A. Ansar

    2007-01-01

    Full Text Available Introduction: Nevoid BCC syndrome (Gorline syndrome is a familial disorder with autosomal dominant inheritense. This syndrome is combination of multiple BCC that occurs at an early age, characteristic faces with: frontal bossing, broad nasal bridge and hypertelorism, jaw cysts, palmoplanter pitting, macrocephaly, skeletal and spinal anomalies include bifid ribes, cervical rib and kyphoscoliosis, CNS abnormality include corpus callusom disgenesia , falx cerebri calcification(at early age and mental deficiency.Case Report: This case was a 25-years-old female presented with multiple and progressive skin lesions with different size in neck, upper trunk and axilla (multiple BCC, palmoplantar pitting, jaw cyst, cervical rib, bifid rib and liver haemangioma.Conclusion: With combination of clinical feature, histopathological reports of skin lesions and radiological reports of mandibular cyst and ribs anomalies, this case was diagnosed as nevoid BCC syndrome.

  8. Rib Fractures

    Science.gov (United States)

    ... Commentary Recent News Scientists Working on Solar-Powered Prosthetic Limbs Exercise a Great Prescription to Help Older Hearts Bavencio Approved for Rare Skin Cancer Older Mothers May Raise Better-Behaved Kids, Study ... or a collapsed lung (pneumothorax—see Traumatic Pneumothorax ). An injury that fractures the lower ribs sometimes also damages the liver (see Liver ...

  9. [One case report of SAPHO syndrome and literature review].

    Science.gov (United States)

    Liu, Rui; Liu, Xiang Yuan

    2008-12-18

    To study the clinical features and diagnosis of synovitis, acne, pustulosis, hyperostosis, osteitis syndrome (SAPHO) syndrome. One case of SAPHO syndrome was reported and the related data of SAPHO syndrome were reviewed. The main clinical features of the patient were articulatio carpi synovitis, acne, cervical rib hyperostosis, articulatio sternoclavicularis and osteitis, So the diagnosis of SAPHO syndrome was made. Though SAPHO syndrome is rare with yet unknown prevalence, it still can be seen in clinical practice, and can be diagnosed by careful examination.

  10. MULTIPLE BIFID RIBS: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Dhana Lakshmi

    2014-04-01

    Full Text Available Ribs are twelve pairs of elastic arches which articulate with vertebral column posteriorly and sternum anteriorly forming much of thoracic skeleton which protects the vital organs. Variations of ribs are being reported and this case report is of multiple bifid ribs observed in a male cadaver. Bifidity occurred in right 2nd, 4th ribs and in left 3rd rib. Dimensions of the foramina were measured and its way of fusion with sternum through costal cartilages were observed. Multiple bifid ribs are a rare anomaly with the incidence of 0.15% to 3.4%. Bifid rib can be a feature of Gorlin - Goltz syndrome. Its clinical importance to physicians, surgeons and radiologists were emphasized.

  11. Periodic Fever Accompanied by Aphthous Stomatitis, Pharyngitis and Cervical Adenitis Syndrome (PFAPA Syndrome

    Directory of Open Access Journals (Sweden)

    Aysel Zengin

    2009-12-01

    Full Text Available PFAPA syndrome is a chronic disease of unknown etiology characterized by sudden onset of high fever, aphthous stomatitis, pharyngitis and cervical lymphadenopathy. This syndrome, which usually observes under 5 years of age and common in boys, has a benign course and with no long-term sequelae. Although clinical findings are clear enough, as there is no specific test for these diseases, it is sometimes hard to diagnose. Treatment options; steroid therapy and sometimes tonsillectomy. (Journal of Current Pediatrics 2009; 7: 147-50

  12. Simpson-Golabi-Behmel syndrome type 1 in a 27-week macrosomic preterm newborn: the diagnostic value of rib malformations and index nail and finger hypoplasia.

    Science.gov (United States)

    Garavelli, Livia; Gargano, Giancarlo; Simonte, Graziella; Rosato, Simonetta; Wischmeijer, Anita; Melli, Nives; Braibanti, Silvia; Gelmini, Chiara; Forzano, Francesca; Pietrobono, Roberta; Pomponi, Maria Grazia; Andreucci, Elena; Toutain, Annick; Superti-Furga, Andrea; Neri, Giovanni

    2012-09-01

    The Simpson-Golabi-Behmel syndrome type 1 (SGBS1, OMIM #312870) is an X-linked overgrowth condition comprising abnormal facial appearance, supernumerary nipples, congenital heart defects, polydactyly, fingernail hypoplasia, increased risk of neonatal death and of neoplasia. It is caused by mutation/deletion of the GPC3 gene. We describe a macrosomic 27-week preterm newborn with SGBS1 who presents a novel GPC3 mutation and emphasize the phenotypic aspects which allow a correct diagnosis neonatally in particular the rib malformations, hypoplasia of index finger and of the same fingernail, and 2nd-3rd finger syndactyly.

  13. Cervical instability in Klippel-Feil syndrome:case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Aaron Wessell; Peter DeRosa; Abraham Cherrick; Jonathan H.Sherman

    2015-01-01

    Background: The authors present a case of cervical myelopathy and radiculopathy in the setting of multiple Klippel-Feil syndrome abnormalities treated surgically with a single-level C3-C4 anterior cervical discectomy and fusion.We discuss the clinical presentation, radiographic findings, and various treatment options for cervical spine abnormalities in Klippel-Feil syndrome.Case Presentation: This 22-year-old female with Klippel-Feil syndrome presented with intermittent neck pain, left upper extremity weakness, and paresthesias.Preoperative MRI, CT, and X-rays of the cervical spine revealed anterolisthesis at C3/4 with unstable movement on flexion and extension imaging.In addition, there were multiple segmental fusion abnormalities including hemivertebrae and other congenital fusion abnormalities.A C3-C4 anterior cervical discectomy and fusion was performed with intervertebral disc spacer.Adequate decompression was achieved with postoperative resolution of the patient's symptoms and improvement in neurological exam.Conclusions: Single-level anterior cervical discectomy and fusion can be utilized for treatment of cervical myelopathy and radiculopathy in the setting of multiple congenital Klippel-Feil syndrome abnormalities.

  14. Comorbidity of fibromyalgia and cervical myofascial pain syndrome.

    Science.gov (United States)

    Cakit, Burcu Duyur; Taskin, Suhan; Nacir, Baris; Unlu, Irem; Genc, Hakan; Erdem, Hatice Rana

    2010-04-01

    The aims of this study are to determine the frequency of fibromyalgia syndrome (FMS) in patients with chronic cervical myofascial pain (CMP) and to investigate the FMS characteristics in CMP patients. Ninty-three patients with CMP and 30 age-matched healthy women were included in this study. Main outcome measures included visual analog scale (VAS), Beck Depression Inventory (BDI), and pain pressure thresholds. CMP patients were evaluated for the existence of FMS. The severity of FMS was assessed with total myalgic score (TMS) and control point score (CPS). Most common clinical characteristics of FMS were noted. Of the 93 CMP subjects, 22 (23.6%) patients fulfilled the classification criteria for FMS. Number of tender points were higher (p=0.0), while TMS (p=0.0) and CPS (p=0.0) values were lower in comorbid CMP and FMS patients than regional CMP group. There were statistically significant differences between regional CMP patients and comorbid CMP and FMS patients regarding presence of fatigue (p=0.0) and irritable bowel syndrome (p=0.022). There was no statistically significant difference between patient groups regarding VAS values (p>0.05). BDI values of the regional CMP were significantly lower than comorbid CMP and FMS patients (p=0.011). In conclusion, we found that nearly a quarter of CMP patients were comorbid with FMS, and psychological and comorbid symptoms were more prominent in comorbid patients. We thought that, these two syndromes might be overlapping conditions and as a peripheral pain generator or inducer of central sensitisation, MPS might lead to FMS or precipitate and worsen the FMS symptoms.

  15. EFFECTIVENESS OF CRANIO-CERVICAL TRAINING OVER MYOFACIAL PAIN SYNDROME: A CASE STUDY

    Directory of Open Access Journals (Sweden)

    Jeyanthi. S

    2015-06-01

    Full Text Available Background and Purpose: Myofascial pain syndrome (MPS is a syndrome presenting with acute or chronic regional pain originating from trigger points (TPs localized in the muscles or the fascia. TPs are local points showing high irritability, sensitivity to finger pressure and causing characteristic referred pain. The aim of this case study is to assess the effectiveness of cranio-cervical training on neck disability, endurance of deep cervical muscles and pressure pain threshold in a patient with cervical myofascial pain syndrome. Case description: A 36 year old female who was diagnosed with myofascial pain syndrome. She received cranio cervical training, a low load endurance exercises in order to train and/or to regain muscle control of the cervicoscapular and craniocervical regions. The patient received the treatment program for 10 to 15 minutes. The frequency of treatment is five days in a week for a period of 3 weeks. Outcome: The outcome measures were neck disability index, pressure pain threshold and deep cervical endurance test, which were measured prior to treatment and at the end of third week. Conclusion: The craniocervical training programme for a patient with myofascial pain syndrome found to be effective in reducing neck disability, improving the pressure pain threshold and deep cervical flexor muscle endurance.

  16. Connective tissue, Ehlers-Danlos syndrome(s), and head and cervical pain.

    Science.gov (United States)

    Castori, Marco; Morlino, Silvia; Ghibellini, Giulia; Celletti, Claudia; Camerota, Filippo; Grammatico, Paola

    2015-03-01

    Ehlers-Danlos syndrome (EDS) is an umbrella term for a growing group of hereditary disorders of the connective tissue mainly manifesting with generalized joint hypermobility, skin hyperextensibility, and vascular and internal organ fragility. In contrast with other well known heritable connective tissue disorders with severe cardiovascular involvement (e.g., Marfan syndrome), most EDS patients share a nearly normal life span, but are severely limited by disabling features, such as pain, fatigue and headache. In this work, pertinent literature is reviewed with focus on prevalence, features and possible pathogenic mechanisms of headache in EDSs. Gathered data are fragmented and generally have a low level of evidence. Headache is reported in no less than 1/3 of the patients. Migraine results the most common type in the hypermobility type of EDS. Other possibly related headache disorders include tension-type headache, new daily persistent headache, headache attributed to spontaneous cerebrospinal fluid leakage, headache secondary to Chiari malformation, cervicogenic headache and neck-tongue syndrome, whose association still lacks of reliable prevalence studies. The underlying pathogenesis seems complex and variably associated with cardiovascular dysautonomia, cervical spine and temporomandibular joint instability/dysfunction, meningeal fragility, poor sleep quality, pain-killer drugs overuse and central sensitization. Particular attention is posed on a presumed subclinical cervical spine dysfunction. Standard treatment is always symptomatic and usually unsuccessful. Assessment and management procedures are discussed in order to put some basis for ameliorating the actual patients' needs and nurturing future research.

  17. Scalene myofascial pain syndrome mimicking cervical disc prolapse: a report of two cases.

    Science.gov (United States)

    Abd Jalil, Nizar; Awang, Mohammad Saufi; Omar, Mahamarowi

    2010-01-01

    Scalene myofascial pain syndrome is a regional pain syndrome wherein pain originates over the neck area and radiates down to the arm. This condition may present as primary or secondary to underlying cervical pathology. Although scalene myofascial pain syndrome is a well known medical entity, it is often misdiagnosed as being some other neck pain associated with radiculopathy, such as cervical disc prolapse, cervical spinal stenosis and thoracic outlet syndrome. Because scalene myofascial pain syndrome mimics cervical radiculopathy, this condition often leads to mismanagement, which can, in turn, result in persistent pain and suffering. In the worst-case scenarios, patients may be subjected to unjustifiable surgical intervention. Because the clinical findings in scalene myofascial pain syndrome are "pathognomonic", clinicians should be aware of ways to recognize this disorder and be able to differentiate it from other conditions that present with neck pain and rediculopathy. We present two cases of unilateral scalene myofascial pain syndrome that significantly impaired the patients' functioning and quality of life. This case report serves to create awareness about the existence of the syndrome and to highlight the potential morbidity due to clinical misdiagnosis.

  18. Cervical involvement in SAPHO syndrome: imaging findings with a 10-year follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Tohme-Noun, C.; Krainik, A.; Menu, Y. [Department of Radiology, Hopital Beaujon, AP HP, Universite Paris 7, Faculte de medecine Bichat-Beaujon, Paris (France); Feydy, A. [Department of Radiology, Hopital Beaujon, AP HP, Universite Paris 7, Faculte de medecine Bichat-Beaujon, Paris (France); Department of Radiology, Hopital Beaujon, 100 avenue du General Leclerc, 92118, Clichy (France); Belmatoug, N.; Fantin, B. [Department of Internal Medicine, Hopital Beaujon, AP HP, Universite Paris 7, Faculte de medecine Bichat-Beaujon, Paris (France)

    2003-02-01

    Osteoarticular manifestations of SAPHO syndrome include vertebral lesions, typically in the thoracic segment. Chronic inflammatory changes are well depicted by MRI. We report the imaging findings with a 10-year follow-up in a case of SAPHO syndrome with marked cervical lesions. (orig.)

  19. [Periodic fever, aphtosus stomatitis, pharyngitis, cervical adenopathy syndrome (PFAPA syndrome) in 4-years old girl--case report].

    Science.gov (United States)

    Krzywicka, Agnieszka; Rusek-Zychma, Małgorzata; Barć-Czarnecka, Małgorzata; Roszkowska, Dagmara

    2007-01-01

    Characteristic feature of PFAPA syndrome is periodic episodes of fever recurring in 21-28 days in infants and young children. Fever is accompanied by aphtosus stomatitis, pharyngitis and cervical adenopathy. Diagnosis of this syndrome are based on typical clinical manifestations, because there are no characteristic changes in laboratory findings. The reason of this syndrome is unknown. We described a case of 4 years old girl with typical manifestations of this syndrome. We excluded others reasons of periodic fever. PFAPA syndrome passed after 2 years of duration after adenothomy.

  20. Reports on various anomalies of the ribs

    Energy Technology Data Exchange (ETDEWEB)

    Brinkmann, G.; Brix, F.

    1988-02-01

    Three patients are presented who were suffering from different anomalies of the ribs: There was one each plus and minus variant and a female patient with Gorlin-Goltz syndrome (basal cell nevus syndrome) demonstrating several changes in the ribs as an expression of a genetically determined segmentation disturbance. These presentations are followed by a detailed discussion on the types and causes of such anomalies.

  1. [The trigemino-cervical complex. Integration of peripheral and central pain mechanisms in primary headache syndromes].

    Science.gov (United States)

    Busch, V; Frese, A; Bartsch, T

    2004-10-01

    The activation of the trigeminal nociceptive system is the neural substrate of pain in primary headache syndromes such as migraine and cluster headache. The nociceptive inflow from the meninges to the spinal cord is relayed in brainstem neurones of the trigemino-cervical complex (TCC). Two important mechanisms of pain transmission are reviewed: convergence of nociceptive trigeminal and cervical afferents and sensitization of trigemino-cervical neurones. These mechanisms have clinical correlates such as hyperalgesia, allodynia, spread and referral of pain to trigeminal or cervical dermatomes. Neurones in the TCC are subject to a modulation of pain-modulatory circuits in the brainstem such as the periaqueductal grey (PAG). Recent experimental and clinical findings of a modulation of these pain processes are discussed. The review focuses on TCC neurones as integrative relay neurones between peripheral and central pain mechanisms. The understanding of these mechanisms has implications for the understanding of the clinical phenomenology in primary headache syndromes and the development of therapeutical options.

  2. Pediatric cervical sympathetic chain schwannoma with Horner syndrome: a rare case presentation.

    Science.gov (United States)

    Bhagat, Sanjeev; Varshney, Saurabh; Bist, Sampan S; Gupta, Nitin

    2014-03-01

    Schwannomas are rare, benign, slowly growing neurogenic tumors that originate in peripheral, spinal, or cranial nerves other than the optic and olfactory nerves. In the head and neck, these tumors usually arise from the vagus nerve and the cervical sympathetic chain in the parapharyngeal space. Cervical sympathetic chain schwannomas represent a rare subgroup of schwannomas; fewer than 60 cases have been reported in the literature. These tumors are rarely seen in children and adolescents. Because patients typically present with an asymptomatic neck mass and vague complaints, clinical suspicion is important in making the diagnosis. Neural deficits at presentation are uncommon. The presence of features of Horner syndrome before excision is very rare, having been previously reported in only 10 cases of cervical sympathetic chain schwannoma. We report an extremely rare case of a cervical sympathetic chain schwannoma in a child who presented with Horner syndrome. The lesion was successfully excised.

  3. Operativ behandling af thoracic outlet syndrome

    DEFF Research Database (Denmark)

    Birkeland, Peter; Stiasny, Jerzy

    2012-01-01

    of the brachial plexus. At surgery, we found and severed a fibrous band that compressed the inferior trunk. Postoperatively, the pain subsided and fine hand movements improved. One patient had no cervical rib, however, in the two other cases we found rudimentary cervical ribs. Magnetic resonance imaging......We present three cases with longstanding true neurogenic thoracic outlet syndrome. All patients had aching pain in the shoulder, arm and ulnar border of the hand. On examination, we found atrophy of the hand muscles. Electromyography revealed signs of compromised function of the inferior trunk...

  4. Targeted next-generation sequencing identifies novel compound heterozygous mutations of DYNC2H1 in a fetus with short rib-polydactyly syndrome, type III.

    Science.gov (United States)

    Mei, Libin; Huang, Yanru; Pan, Qian; Su, Wei; Quan, Yi; Liang, Desheng; Wu, Lingqian

    2015-07-20

    A 26-year-old woman with a past history of fetal skeletal dysplasia was referred to our institution at 24weeks of gestation following a routine sonographic diagnosis of short limbs in the fetus. A fetal ultrasound showed short limbs, a narrow thorax, short ribs with marginal spurs, and polydactyly. Conventional cytogenetics analysis of cultured amniocytes demonstrated that the fetal karyotype was normal. Using targeted exome sequencing of 226 known genes implicated in inherited skeletal dysplasia, we identified compound heterozygous mutations in the DYNC2H1 gene in the fetus with short rib-polydactyly syndrome, type III (SRPS III), c.1151 C>T(p.Ala384Val) and c.4351 C>T (p.Gln1451*), which were inherited from paternally and maternally, respectively. These variants were further confirmed using Sanger sequencing and have not been previously reported. To our knowledge, this is the first report of DYNC2H1 mutations causing SRPS III, in the Chinese population. Our findings expand the number of reported cases of this rare disease, and indicate that targeted next-generation sequencing (NGS) is an accurate, rapid, and cost-effective method in the genetic diagnosis of fetal skeletal dysplasia.

  5. The clinical characteristics and therapy of syndrome of craniocerebral- cervical vertebral injury

    Institute of Scientific and Technical Information of China (English)

    LIU Sheng; LIU Yuan-xin; WANG Cheng

    2005-01-01

    Objective: To explore the clinical characteristics and new treatment for syndrome of craniocerebral-cervical vertebral injury. Methods: The clinical data of 52 patients with head injury accompanied by neck injury were analyzed retrospectively. Results: Craniocerebral injury could result in damage to cervical vertebrae, muscles, vessels and nerves, and even cause vertebral artery injury, which may lead to insufficient blood-supply of vertebral-basal artery. All patients were treated with cervical vertebral traction and the results were good. Conclusions: Acute craniocerebral injury with symptom of insufficient blood-supply of vertebral-basal artery, evident neurosis and atlas-axis half-dislocation in X-ray should be treated by cervical vertebral traction, which will yield better outcome.

  6. Cervicitis

    Science.gov (United States)

    ... much growth of normal bacteria in the vagina (bacterial vaginosis) can also cause cervicitis. ... under a microscope (may show candidiasis , trichomoniasis , or bacterial vaginosis) Pap test Tests for gonorrhea or chlamydia Rarely, ...

  7. Identification of novel DYNC2H1 mutations associated with short rib-polydactyly syndrome type III using next-generation panel sequencing.

    Science.gov (United States)

    Chen, L S; Shi, S J; Zou, P S; Ma, M; Chen, X H; Cao, D H

    2016-01-01

    Short rib-polydactyly syndrome type III (SRPS3) is a perinatal lethal skeletal disorder with polydactyly and multisystem organ abnormalities. While ultrasound of the fetus can detect skeletal abnormalities characteristic of SRPS3, the syndrome is often difficult to diagnose before birth. As SRPS3 is an autosomal recessive disorder, identification of the gene mutations involved could lead to the development of prenatal genetic testing as an accurate method of diagnosis. In this study, we describe genetic screening approaches to identify potential abnormalities associated with SRPS3. Karyotype analysis, array comparative genomic hybridization (aCGH), and next-generation panel sequencing were each performed on a fetus showing signs of the disorder, as well as on the mother and father. Karyotype and aCGH results revealed no abnormalities. However, next-generation panel sequencing identified novel mutations in the DYNC2H1 gene. The fetus was compound heterozygous for both a missense mutation c.8313A > T and a frameshift mutation c.10711_10714delTTTA in the DYNC2H1 gene, which were inherited from the mother and father, respectively. These variants were further confirmed using Sanger sequencing and have not been previously reported. Our study indicates the utility of using next-generation panel sequencing in screening for novel disease-associated mutations.

  8. Anterior cervical surgery methods for central cord syndrome without radiographic spinal fracture-dislocation

    Institute of Scientific and Technical Information of China (English)

    Chengwei JING; Qin FU; Xiaojun XU

    2009-01-01

    This study was aimed to explore the anterior cervical surgery methods to treat central cord syndrome without radiographic spinal fracture-dislocation (CCSWORFD), retrospectively analyze the cases of CCSWORFD, and evaluate the curative effect of anterior cervical surgery methods for CCSWORFD. Twenty four cases of CCSWORFD (19 males and 5 females), all suffering from cervical hyperextension injury, between 45-68 (average 59) years old, were operated on by anterior cervical surgery methods. Among these, 18 cases had been followed up for 6-24 (average 15) months; 18 cases, who had anterior decompression and plate fixation with titanium mesh bone grafting or iliac bone grafting achieved reliable effects based on the Japanese Orthopedics Association (JOA) evaluation (improved scores of cases with titanium mesh bone grafting, t = 2.800, P0.05). Most of these cases had degeneration of cervical vertebra. The decompression which relieves the oppression to the spinal cord can help lessen edema of the spinal cord, and early fixation for stability of cervical vertebra is better for the recovery of spinal cord injury. Anterior operation with titanium mesh bone grafting or iliac bone grafting are both reliable curative methods for CCSWORFD, and titanium mesh bone grafting can avoid the trauma of the supplying graft. Mesh bone grafting can also shorten hospital stay.

  9. Klippel-Feil syndrome – the risk of cervical spinal cord injury: A case report

    Directory of Open Access Journals (Sweden)

    Singh Gurpreet

    2002-04-01

    Full Text Available Abstract Background Klippel-Feil syndrome is defined as congenital fusion of two or more cervical vertebrae and is believed to result from faulty segmentation along the embryo's developing axis during weeks 3–8 of gestation. Persons with Klippel-Feil syndrome and cervical stenosis may be at increased risk for spinal cord injury after minor trauma as a result of hypermobility of the various cervical segments. Persons with Klippel-Feil Syndrome often have congenital anomalies of the urinary tract as well. Case presentation A 51-year male developed incomplete tetraplegia in 1997 when he slipped and fell backwards hitting his head on the floor. X-rays of cervical spine showed fusion at two levels: C2 and C3 vertebrae, and C4 and C5 vertebrae. Intravenous urography (IVU revealed no kidneys in the renal fossa on both sides, but the presence of crossed, fused renal ectopia in the left ilio-lumbar region. This patient had a similar cervical spinal cord injury about 15 years ago, when he developed transient numbness and paresis of the lower limbs following a fall. Discussion and Conclusion 1 Persons with Klippel-Feil syndrome should be made aware of the increased risk of sustaining transient neurologic deterioration after minor trauma if there is associated radiographic evidence of spinal stenosis. 2 Patients with Klippel-Feil syndrome often have congenital anomalies of the urinary tract. Our patient had crossed, fused, ectopia of kidney. 3 When patients with Klippel-Feil syndrome sustain tetraplegia they have increased chances of developing urinary tract calculi. Treatment of kidney stones may pose a challenge because of associated renal anomalies. 4 Health professionals caring for cervical spinal cord injury patients with Klippel-Feil syndrome and renal anomalies should place emphasis on prevention of kidney stones. A large fluid intake is recommended for these patients, as a high intake of fluids is still the most powerful and certainly the most

  10. Demographics features, clinical findings and functional status in a group of subjects with cervical myofascial pain syndrome.

    Science.gov (United States)

    Sahin, Nilay; Karataş, Omer; Ozkaya, Murat; Cakmak, Ayşegül; Berker, Ender

    2008-07-01

    Subjects with myofascial pain of muscles of the neck region may present with various clinical symptoms. The aim of this study was to explore the demographics features, clinical findings and functional status in a group of patients presenting with myofascial pain of the cervical muscles. 94 cervical myofascial pain syndrome patients were recruited from the out-patient clinic. Evaluated of patient short form health survey (SF-36), pain, depression, patient demographics and physical examinations. Outcome measures; SF-36 Health Survey, visual analog scale, Beck Depression Inventory, history, physical examination. A total of 82 patients with a diagnosis of cervical myofascial syndrome were included in the study. All patients were in the young age group 37.4+/-9, and 87.8% were females. 53.1% had trigger points in the trapezius muscle with high percentage of autonomic phenomena like skin reddening, lacrimation, tinnitus and vertigo. 58.5% of the series had suffered from former cervical trauma and 40.2% also had fibromyalgia syndrome and 18.5% had benign Joint hypermobility syndrome. Younger female patients presenting with autonomic phenomena and early onset cervical injury should be examined for cervical myofascial pain syndrome and also for fibromyalgia syndrome since this study demonstrated a high percentage of fibromyalgia syndrome in these patients.

  11. Horner syndrome after carotid sheath surgery in a pig: anatomic study of cervical sympathetic chain.

    Science.gov (United States)

    Ding, Peng; Tufano, Ralph P; Campbell-Malone, Regina; Feng, Wallace; Kim, Sang Jun; German, Rebecca Z

    2011-10-01

    In an experimental model, iatrogenic Horner syndrome developed after a right carotid sheath surgery in an infant pig (Sus scrofa). Horner syndrome is a classic clinical triad consisting of ipsilateral eyelid ptosis, pupil miosis, and facial anhydrosis. This syndrome results from cervical sympathetic chain (CSC) paresis and usually is acquired in humans. To determine whether the development of Horner syndrome in this situation could be attributed to pig anatomy, we compared the anatomy of the CSC in pigs and humans, by using 10 infant (age, 1 to 3 wk) pig cadavers. The CSC and cranial cervical sympathetic ganglion (CCG) were dissected bilaterally under a surgical microscope. These structures were consistently within the carotid sheaths of the pigs. In contrast, the CSC and CCG are outside the carotid sheath in humans. Awareness of the anatomic variation of the CSC and CCG within the carotid sheath in the pig and the possibility of the same variation in humans may help surgeons to identify and preserve important structures while performing cervical surgery in pigs and humans. Furthermore, this knowledge can aid in the diagnosis and prognosis of schwannoma.

  12. Peutz-Jeghers syndrome with small intestinal malignancy and cervical carcinoma

    Institute of Scientific and Technical Information of China (English)

    Lian-Jie Li; Zhi-Qing Wang; Bao-Ping Wu

    2008-01-01

    We report a case of 30-year-old woman with PeutzJeghers syndrome (P.1S).Because of small intestinal obstruction,she received the small intestinal polypectomy in 2001,and the pathological diagnosis was Peutz-Jeghers polyp canceration (mucinous adenocarcinoma,infiltrating full-thickness of the intestine).The patient did not feel uncomfortable after 6 mo of chemotherapy and other management.We kept a follow-up study on her and found that she suffered from cervical cancer in 2007,with a pathological diagnosis of cervical adenosquamous carcinoma.The patient presented with typical features of PJS,but without a family history.The PJS accompanied with both small intestinal and cervical malignancies has not been reported so far in the world.

  13. Atraumatic First Rib Fracture

    Directory of Open Access Journals (Sweden)

    Koray Aydogdu

    2014-12-01

    Full Text Available Rib fractures are usually seen after a trauma, while atraumatic spontaneous rib fractures are quite rare. A first rib fracture identified in our 17 years old female patient who had not a history of trauma except lifting a heavy weight was examined in details in terms of the potential complications and followed-up for a long time. We presented our experience on this case with atraumatic first rib fracture that has different views for the etiology in light of the literature.

  14. Genital ulcers as an unusual sign of periodic fever, aphthous stomatitis, pharyngotonsillitis, cervical adenopathy syndrome: a novel symptom?

    Science.gov (United States)

    Lin, Chien-Ming; Wang, Chih-Chien; Lai, Chi-Chieh; Fan, Hueng-Chuen; Huang, Wei-Hsuan; Cheng, Shin-Nan

    2011-01-01

    Periodic fever, aphthous stomatitis, pharyngotonsillitis, cervical adenopathy (PFAPA) syndrome, which is characterized by periodic episodes of high fever, aphthous stomatitis, pharyngitis, and cervical adenitis, is of unknown etiology and manifests usually before 5 years of age. A patient with periodic fever, aphthous stomatitis, pharyngotonsillitis, cervical adenopathy syndrome simultaneously presenting with genital ulcers has not been reported previously. We describe a 12-year-old Chinese girl with a 2-year history of periodic fever, aphthous stomatitis, pharyngotonsillitis, cervical adenopathy syndrome who exhibited vulvar ulcers accompanying an episode of febrile periodic fever, aphthous stomatitis, pharyngotonsillitis, and cervical adenopathy. Although during a 1-year follow-up this girl did not manifest typical symptoms/signs of Behçet's disease except recurrent oral aphthae and genital ulcers, it is possible that periodic fever, aphthous stomatitis, pharyngotonsillitis, cervical adenopathy syndrome and Behçet's disease could have overlapping manifestations. Furthermore, this report would add to the evidence of a wide variation in the clinical symptomatology of PFAPA syndrome.

  15. PFAPA (Periodic fever, aphtous stomatitis, pharingitis, cervical adenitis or Marshall’s syndrome in children

    Directory of Open Access Journals (Sweden)

    N N Kuzmina

    2005-01-01

    Full Text Available PFAPA (periodic fever, aphtous stomatitis, pharingitis, cervical adenitis or Marshall’s syndrome is one of the rare periodic fever conditions appearing in children. Its cause is unknown. This syndrome may continue for several years. During interictal period the child is quite well, grows and develops normally. The disease should be differentiated from Behcet’s disease, cyclic neutropenia, familial Mediterranean fever, familial Ireland fever, hyperimmunoglobulinemia D syndrome, systemic juvenile idiopathic arthritis, chronic tonsillitis, some infectious diseases. Many drugs are used for the treatment of PFAPA syndrome: antibiotics, non-steroidal anti-inflammatory drugs, chloroquin, antiviral drugs, glucocorticoids, cimetidin. Tonsillectomy is used quite often. Analysis of the literature data shows that best results may be achieved with tonsillectomy (sometimes in combination with ade- notomy. PFAPA in a child of 2 years age diagnosed for the first time in Russian pediatric rheumatology is described.

  16. A Rare Cause for Cervical Pain: Eagle's Syndrome

    Directory of Open Access Journals (Sweden)

    Massimo Politi

    2009-01-01

    Full Text Available Patients with pharyngodynia and neck pain symptoms can lead to an extensive differential diagnosis. Eagle's syndrome must be taken in account. Eagle defined “stylalgia” as an autonomous entity related to abnormal length of the styloid process or to mineralization of the stylohyoid ligament complex. The stylohyoid complex derives from Reichert's cartilage of the second branchial arch. The styloyd process is an elongated conical projection of the temporal bone that lies anteriorly to the mastoid process. The incidence of Eagle's syndrome varies among population. Usually asymptomatic, it occurs in adult patients. It is characterized by pharyngodynia localized in the tonsillar fossa and sometimes accompanied by disphagia, odynophagia, foreign body sensation, and temporary voice changes. In some cases, the stylohyoid apparatus compresses the internal and/or the external carotid arteries and their perivascular sympathetic fibers, resulting in a persistent pain irradiating in the carotid territory. The pathogenesis of the syndrome is still under discussion.

  17. Pain, Depression and Quality of Life in Patients with Chronic Cervical Miyofascial Pain Syndrome

    Directory of Open Access Journals (Sweden)

    Ümit Dundar

    2014-03-01

    Aim: The aim of this study was to investigate the levels of depression, pain and disability in patients with chronic cervical miyofascial pain syndrome (MPS and to determine their association with quality of life. Material and Method: Forty patients with Cervical MPS and 40 age and sex-matched healthy controls enrolled in this study. The social and demographic characteristics of the patients and controls were examined. All patients and controls were evaluated with respect to pain (at night, rest and movement and assessed by visual analog scale (VAS. Neck disability index (NDI was used to calculate functional disability. Quality of life was evaluated with the the Short Form 36 Health Survey (SF-36. Also all of the patients and controls underwent Beck depression inventory (BDI. Results: There was no statistical difference between the patients and control cases according to demographical data. The SF-36 scores of the study patients were lower than controls. NDI, BDI and VAS scores were higher in the patients with chronic cervical MPS compared to controls. BDI scores of the patients with chronic cervical MPS  were negatively and closely associated with subparameters of the SF-36 (physical function (r:-0,599, p<0.001, role limitations due to physical functioning (r:-0,558, p<0.001, bodily pain (r:-0.540, p<0.001, general health (r:- 0,708 p<0.001, vitality (r:-0,692, p<0.001, social functioning (r:-0,559, p<0.001, role limitations due to emotional problems (r:-0,537, p<0.001 and mental health (r: -0,787, p<0.001. Discussion: BDI scores are higher in patients with chronic cervical MPS than healthy controls and negatively affect their quality of life. Psychiatric evaluation of the patients with chronic cervical MPS may improve their quality of life and treatments outcome.

  18. Rib fracture - aftercare

    Science.gov (United States)

    ... painful pressure on your ribs. These include doing crunches and pushing, pulling, or lifting heavy objects. Follow- ... that you cough up Shortness of breath Side effects of pain medicine such as nausea, vomiting, or ...

  19. [Gaze-evoked suppression of the vestibular-ocular reflex in patients with posterior cervical sympathetic syndrome].

    Science.gov (United States)

    Likhachev, S A; Pleshko, I V

    2009-01-01

    This vestibulometric (sinusoidal rotation) study included patients with posterior cervical sympathetic syndrome (n=40) and with vestibular neuronitis (n=20) as well as 20 healthy subjects of the control group. Vestibular dysfunction was induced by the method proposed by de Klein. The patients with posterior cervical sympathetic syndrome in the decompensation phase displayed abnormal gaze-evoked suppression of the vestibular-ocular reflex when their head movements lined up with sinusoidal rotation. This symptom is considered to be of primary value for the diagnosis of vestibular dysfunction in these patients.

  20. Cervical Spondylotic Myelopathy Secondary to Dropped Head Syndrome: Report of a Case and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Abolfazl Rahimizadeh

    2016-01-01

    Full Text Available The dropped head syndrome (DHS is a disabling condition caused by severe weakness of the neck extensor muscles causing progressive reducible kyphosis of the cervical spine and the inability to hold the head up. Weakness can occur in isolation or in association with a generalized neuromuscular disorder. Isolated cases are owed to the late onset of noninflammatory myopathy designated as INEM, where persistent chin to chest deformity may gradually cause or aggravate preexisting degenerative changes of the cervical spine and ultimately result in myelopathy. In review of the literature, we could find only 5 cases, with no unique guidelines to address the management of these two concomitant pathologies. Herein, a 69-year-old man who had developed cervical myelopathy 2 years after being affected by isolated dropped head syndrome is presented. Chin to chest deformity and cervical myelopathy were managed through three-level anterior cervical discectomy and fusion (ACDF combined with decompressive cervical laminectomy and stabilization with C2 to C7 pedicle screw-rod construct. At 4-month follow-up, despite recovery in patient’s neurological status, flexion deformity reappeared with recurrence of dropped head due to C7 pedicle screws pull-out. However, this was successfully managed with extension of the construct to the upper thoracic levels.

  1. Failure of cervical arthroplasty in a patient with adjacent segment disease associated with Klippel-Feil syndrome

    Directory of Open Access Journals (Sweden)

    Ioannis D Papanastassiou

    2011-01-01

    Full Text Available Cervical arthroplasty may be justified in patients with Klippel-Feil syndrome (KFS in order to preserve cervical motion. The aim of this paper is to report an arthroplasty failure in a patient with KFS. A 36-year-old woman with KFS underwent two-level arthroplasty for adjacent segment disc degeneration. Anterior migration of the cranial prosthesis was encountered 5 months postoperatively and was successfully revised with anterior cervical fusion. Cervical arthroplasty in an extensively stiff and fused neck is challenging and may lead to catastrophic failure. Although motion preservation is desirable in KFS, the special biomechanical features may hinder arthroplasty. Fusion or hybrid constructs may represent more reasonable options, especially when multiple fused segments are present.

  2. WDR34 mutations that cause short-rib polydactyly syndrome type III/severe asphyxiating thoracic dysplasia reveal a role for the NF-κB pathway in cilia.

    Science.gov (United States)

    Huber, Céline; Wu, Sulin; Kim, Ashley S; Sigaudy, Sabine; Sarukhanov, Anna; Serre, Valérie; Baujat, Genevieve; Le Quan Sang, Kim-Hanh; Rimoin, David L; Cohn, Daniel H; Munnich, Arnold; Krakow, Deborah; Cormier-Daire, Valérie

    2013-11-01

    Short-rib polydactyly (SRP) syndrome type III, or Verma-Naumoff syndrome, is an autosomal-recessive chondrodysplasia characterized by short ribs, a narrow thorax, short long bones, an abnormal acetabulum, and numerous extraskeletal malformations and is lethal in the perinatal period. Presently, mutations in two genes, IFT80 and DYNC2H1, have been identified as being responsible for SRP type III. Via homozygosity mapping in three affected siblings, a locus for the disease was identified on chromosome 9q34.11, and homozygosity for three missense mutations in WDR34 were found in three independent families, as well as compound heterozygosity for mutations in one family. WDR34 encodes a member of the WD repeat protein family with five WD40 domains, which acts as a TAK1-associated suppressor of the IL-1R/TLR3/TLR4-induced NF-κB activation pathway. We showed, through structural modeling, that two of the three mutations altered specific structural domains of WDR34. We found that primary cilia in WDR34 mutant fibroblasts were significantly shorter than normal and had a bulbous tip. This report expands on the pathogenesis of SRP type III and demonstrates that a regulator of the NF-κB activation pathway is involved in the pathogenesis of the skeletal ciliopathies.

  3. Motor Deficit After Cervical Surgery, Parsonage-Turner Syndrome or Root Lesion

    Directory of Open Access Journals (Sweden)

    Ayse Sarifakioglu

    2013-06-01

    Full Text Available A 60 years old male patient was admitted to our outpatient clinic with the complaint of severe pain in right arm after cervical stenosis surgery which had been decreased with the formation of progressive motor weakness. Although clinical and physical evaluation was compatable with Parsonage-Turner syndrome (PTS, C5 root involvement has been detected. The patient was given exercise therapy with TENS for analgesia. The patient%u2019s motor weakness progressed and he had difficulties with daily living activities. With the review of literature, we are presenting a case, whose diagnosis was difficult in terms of differentiating both PTS and root lesion which could only be diagnosed by electroneuromyography.

  4. [Combined surgical and physical treatment in traumatic painful syndromes of the cervical spine].

    Science.gov (United States)

    Stachowski, B; Kaczmarek, J; Nosek, A; Kocur, L

    1976-01-01

    Clinical observations suggest the need for changing therapeutic management to a more active one in cases of cervical spine injury with damage to the spinal cord and nerve roots or brachial plexus. In 248 patients with these injuries treated initially conservatively the incidence of cervicobrachial pain was analysed. Neuralgic pains were present in 31.5% of cases, causalgic pains in 2.4% and sympathalgic pains in 2%. Conservative treatment conducted in these patients (89 cases) during many months after trauma had no effect on return of mobility. Long-term application of physioterapy prevented only temporarily the development of trophic changes and only partially relieved pains. Only surgical decompression of the spinal cord or spinal nerves with stabilization of damaged vertebrae caused disappearance of painful syndromes and improvement in the motor activity of the extremities. These observations show that early surgical intervention for decompression of the spinal cord, roots or brachial plexus should be advocated in these cases.

  5. Esophageal stricture caused by rib osteoma in a cat: case report

    Directory of Open Access Journals (Sweden)

    Simone CS Cunha

    2015-06-01

    Full Text Available Case summary A 6-year-old male domestic shorthair cat presented with frequent food regurgitation and dysphagia. Plain thoracic radiographs revealed a calcified mass overlying the topography of the mediastinum, as well as dilation of the cervical portion of the esophagus due to an accumulation of food. Endoscopic examination showed a severe extraluminal esophageal stricture at the mediastinum entrance. Surgery and a gastric tube were declined by the cat’s owner, with palliative support preferred. However, 1 year later, the cat presented with severe cachexia, dysphagia, salivation, dehydration and inspiratory dyspnea. Thoracic computed tomography was performed to evaluate the possibility of surgical resection. A mass of bone density originating in the second left rib was observed. The mass did not appear to have invaded adjacent structures but marked compression of the mediastinal structures was observed. Surgical resection was performed and a prosthetic mesh was used to reconstruct the thoracic wall. Transient Horner’s syndrome developed in the left eye postoperatively, and was resolved within 4 weeks. Histopathology revealed a benign osteoma. Thirty-two months after surgery, the cat was well and free of disease. Relevance and novel information Rib tumors should be included in a differential diagnosis in cats with extraluminal esophageal stricture. CT should be performed for treatment planning. Surgical treatment was curative in this case.

  6. The influence of physioterapy in adult pacients with flatfoot and chronic vertebrogenic algic syndrome in cervical region

    OpenAIRE

    FIKSLOVÁ, Blanka

    2015-01-01

    This thesis deals with problem of flat foot in adults with the occurrence of chronic pain responses vertebrogenic syndrome in the cervical spine. In the system of motion the foot is the most important part that primarily allows locomotion and provides support for upright posture. Due to the large number of proprioception we get information about the ground in which we are moving in. The foot is through muscular chain segments connected with higher incidence of musculoskeletal and its dysfunct...

  7. Gorham Syndrome - massive osteolysis of the cervical spine; Gorham-Syndrom - massive Osteolyse der HWS

    Energy Technology Data Exchange (ETDEWEB)

    Gissler, H.M. [Stadtische Kliniken Dortmund (Germany). Radiologische Klinik; Schoenekaes, K. [Muenster Univ. (Germany). Klinik und Poliklinik fuer Strahlentherapie - Radioonkologie; Panke, J. [Luebeck Univ. (Germany). Klinik und Poliklinik fuer Strahlentherapie

    2001-07-01

    The Gorham syndrome is identifiable only on the basis of a combination of radiological findings and the clinical pathology. The case history until diagnostic verification very often reveals a long phase of successive tentative diagnoses. Therefore, the radiology expert has to consider this rare bone disease when the case history shows an atypical healing process characterised by progressive osteolysis, negative bacteriology, and non-specific histology. Due to the low incidence and the possibility of spontaneous interruptions, debates about suitable approaches for treatment continue to be controversial. If vertebral bodies are involved, surgery should be applied for stabilisation. A radiotherapy may rapidly reduce the pain and induce recalcification. Therapeutic radiation doses should not be lower than 35-45 Gy. (orig./CB) [German] Die Diagnose des Gorham-Syndroms ist nur in der Zusammenschau von radiologischem und pathologischem Erscheinungsbild zu stellen. Die Patienten durchlaufen zumeist eine Vielzahl von Verdachtsdiagnosen. Radiologischerseits muss bei atypischem Heilungsverlauf mit progredientem osteolytischen Prozess, negativer Bakteriologie und uncharakteristischer Histologie auch an diese seltene Knochenerkrankung gedacht werden. Aufgrund der geringen Inzidenz und der Moeglichkeit des spontanen Sistierens wird die therapeutische Strategie weiterhin kontrovers diskutiert. Bei Befall von Wirbelkoerpern sollte eine chirurgische Stabilisation durchgefuehrt werden. Mit der Strahlentherapie kann eine schnelle Schmerzreduktion sowie eine Rekalzifikation erreicht werden. Dabei sollten Dosen von 35-45 Gy nicht unterschritten werden. (orig.)

  8. Diagnostic Importance of 3D CT Images in Klippel-Feil Syndrome with Multiple Skeletal Anomalies: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Yuksel, Murvet [Kahramanmaras Sutcu Imam University, Radiology Dept. (Turkey); Karabiber, Hamza [Kahramanmaras Sutcu Imam University Pediatrics Dept. (Turkey); Yuksel, K. Zafer [Kahramanmaras Sutcu Imam University Neuroradiology Dept (Turkey); Parmaksiz, Gonul [Kahramanmaras Sutcu Imam University Pediatrics Dept. (Turkey)

    2005-07-01

    We present here the case of a 12-year-old boy who had Klippel-Feil syndrome with renal, cardiac and multiple skeletal anomalies, and we show the relevent three-dimensional computed tomography images. Our patient had a triple renal pelvis, mitral valve prolapsus, multiple cervical vertebrae fusions, cervical ribs, hypoplasia of the right thumb, spina bifida of L5, lumbalization at the right side of S1 and a sacral curved defect. In this study, we discuss the atypical clinical features and the diagnostic value of three-dimensional CT for evaluating the skeletal anomalies of the Klippel-Feil syndrome cases.

  9. Chondroblastoma of rib : case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Hun; Kim, Kyung Rae; Ryu, Sang Wan [Kwangju Hospital, Kwangju (Korea, Republic of)

    2004-07-01

    Chondroblastoma is an uncommon, benign, cartilaginous neoplasm originating in an epiphysis or apophysis of a long tubular bone. The rib is an unusual site for chondroblastoma. The authors describe a case of chondroblastoma of the rib and present a brief review of the literature.

  10. Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Cervical Adenitis (PFAPA) Syndrome: a Review of the Pathogenesis.

    Science.gov (United States)

    Theodoropoulou, Katerina; Vanoni, Federica; Hofer, Michaël

    2016-04-01

    PFAPA syndrome represents the most common cause of recurrent fever in children in European populations, and it is characterized by recurrent episodes of high fever, pharyngitis, cervical adenitis, and aphthous stomatitis. Many possible causative factors have been explored so far, including infectious agents, immunologic mechanisms and genetic predisposition, but the exact etiology remains unclear. Recent findings demonstrate a dysregulation of different components of innate immunity during PFAPA flares, such as monocytes, neutrophils, complement, and pro-inflammatory cytokines, especially IL-1β, suggesting an inflammasome-mediated innate immune system activation and supporting the hypothesis of an autoinflammatory disease. Moreover, in contrast with previous considerations, the strong familial clustering suggests a potential genetic origin rather than a sporadic disease. In addition, the presence of variants in inflammasome-related genes, mostly in NLRP3 and MEFV, suggests a possible role of inflammasome-composing genes in PFAPA pathogenesis. However, none of these variants seem to be relevant, alone, to its etiology, indicating a high genetic heterogeneity as well as an oligogenic or polygenic genetic background.

  11. Cervical sympathetic chain schwannoma masquerading as a carotid body tumour with a postoperative complication of first-bite syndrome.

    LENUS (Irish Health Repository)

    Casserly, Paula

    2012-01-31

    Carotid body tumours (CBT) are the most common tumours at the carotid bifurcation. Widening of the bifurcation is usually demonstrated on conventional angiography. This sign may also be produced by a schwannoma of the cervical sympathetic plexus. A 45-year-old patient presented with a neck mass. Investigations included contrast-enhanced CT, MRI and magnetic resonance arteriography with contrast enhancement. Radiologically, the mass was considered to be a CBT due to vascular enhancement and splaying of the internal and external carotid arteries. Intraoperatively, it was determined to be a cervical sympathetic chain schwannoma (CSCS). The patient had a postoperative complication of first-bite syndrome (FBS).Although rare, CSCS should be considered in the differential diagnosis for tumours at the carotid bifurcation. Damage to the sympathetic innervation to the parotid gland can result in severe postoperative pain characterised by FBS and should be considered in all patients undergoing surgery involving the parapharyngeal space.

  12. The elasticity of cervical-vaginal secretions is abnormal in polycystic ovary syndrome: Case report of five PCOS women

    Directory of Open Access Journals (Sweden)

    Nabila Shamim

    2012-01-01

    Full Text Available Polycystic Ovary Syndrome (PCOS is a leading cause of infertility. We studied the rheological properties of cervical-vaginal secretions in five PCOS patients during variable treatment intervals with metformin. Five ovulatory normal women for a total of thirteen cycles served as control patients. All subjects collected daily cervical-vaginal fluid(CVF samples with an aspirator, and CVF samples were characterized by a flow metric, die swell ratio (B, which measured CVF elasticity. Ovulatory cycles were indexed to the day of positive urine or serum LH (luteinizing hormone. CVF B levels from ovulatory normal women had a characteristic concave parabolic pattern of a minimum near the day of ovulation with higher values outside the periovulatory phase. In contrast, the five PCOS patients with or without metformin treatment had no periodicity of CVF B, and their CVF B levels were typically less compared to those in the early preovulatory and luteal phases of normal patients.

  13. Riboflavin synthesis genes ribE, ribB, ribH, ribA reside in the lux operon of Photobacterium leiognathi.

    Science.gov (United States)

    Lin, J W; Chao, Y F; Weng, S F

    2001-06-15

    Nucleotide sequence of the riboflavin synthesis genes ribE, ribB, ribH, ribA (GenBank Accession No. AF364106) resided in the lux operon of Photobacterium leiognathi PL741 has been determined, and the amino acid sequences of riboflavin synthetase (RibE), DHBP synthetase (RibB), lumazine synthetase (RibH), GTP cyclohydrolase II (RibA) encoded by the riboflavin synthesis genes are deduced. Nucleotide sequence reveals that the ribE gene encodes the riboflavin synthetase responsible for converting lumazine to riboflavin, the ribB gene encodes the DHBP synthetase responsible for 3,4-dihydroxyl-2-butanone 4-phosphate synthesis, the ribH gene encodes the lumazine synthetase responsible for lumazine synthesis, and the ribA gene encodes the GTP cyclohydrolase II responsible for lumazine synthesis. Functional analysis illustrates that the specific segments lay behind the ribH and ribA genes might form potential loops Omega(oT) and Omega(TI)--Omega(TII); Omega(oT) is functioned as mRNA stability loop or/and for subregulation by alternative modulation, and Omega(TI)--Omega(TII) could be the transcriptional terminator of the lux operon. The gene order of the ribE, ribB, ribH, ribA genes resided in the lux operon and linked to the lum operon is luxE-luxG-ribE-ribB-ribH-ribA-ter--> (R&R: regulatory region; ter: transcriptional terminator), whereas the R&R is the regulatory region for the lum and the lux operons, and ter and ter* are the transcriptional terminators for the lux and lum operons.

  14. A comprehensive comparison between pediatric and adult patients with periodic fever, aphthous stomatitis, pharyngitis, and cervical adenopathy (PFAPA) syndrome.

    Science.gov (United States)

    Rigante, Donato; Vitale, Antonio; Natale, Marco Francesco; Lopalco, Giuseppe; Andreozzi, Laura; Frediani, Bruno; D'Errico, Francesca; Iannone, Florenzo; Cantarini, Luca

    2017-02-01

    Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenopathy (PFAPA) syndrome is a mysterious disorder characterized by periodically recurrent fevers, oropharyngeal inflammation, and adenitis, which mainly affects children, though in very recent times, it has been also recognized in adulthood. We enrolled 115 unrelated pediatric and adult patients with history of periodic fevers who fulfilled the current diagnostic criteria for PFAPA syndrome in three Italian referral centers and highlighted differences between children and adults. Eighty-five children and 30 adults were evaluated: the frequency of flares was significantly higher in pediatric cases, while febrile attack duration was significantly longer in adults. Clockwork periodicity of fever and recurrent pharyngitis were more frequently observed in childhood, but no differences were identified for aphthosis and cervical adenopathy. Conversely, joint symptoms, myalgia, headache, fatigue, ocular signs, and rashes were more common in adults. The simultaneous occurrence of two or three cardinal PFAPA signs did not show any statistical difference between the groups, while the occurrence of only one cardinal manifestation was more frequent in adults. Corticosteroids were effective in 98.82 % of children and 88.2 % of adults. Tonsillectomy was rarely performed, resulting effective in only two patients. Our data illustrate the clinical overlap between pediatric and adult cases of PFAPA syndrome. Adults are characterized by a wider repertoire of inflammatory signs, suggesting that onset in adulthood might leave the disease misdiagnosed. Clinicians, not only pediatricians, should take into account this clinical entity in every patient of whatever age suffering from recurrent fevers of unknown origin.

  15. Pre- and post-operative comorbidities in idiopathic carpal tunnel syndrome: cervical arthritis, basal joint arthritis of the thumb, and trigger digit.

    Science.gov (United States)

    Kim, J H; Gong, H S; Lee, H J; Lee, Y H; Rhee, S H; Baek, G H

    2013-01-01

    We retrospectively reviewed 633 hands in 362 patients who had idiopathic carpal tunnel syndrome and underwent carpal tunnel release between 1999 and 2009. Electrophysiological studies and simple radiographs of the wrist, cervical spine, and basal joint of the thumb were routinely checked, and patients were also assessed for the presence of trigger digit or de Quervain's disease before and after surgery. Among 362 patients, cervical arthritis was found in 253 patients (70%), and C5-C6 arthritis was the most common site. Basal joint arthritis of the thumb was observed in 216 (34%) of the 633 hands. Trigger digit or de Quervain's disease was observed in 85 of the 633 hands (13%) before surgery, and developed in 67 hands (11%) after surgery. Cervical arthritis, basal joint arthritis, and trigger digit commonly coexist with idiopathic carpal tunnel syndrome. Patient education about these disorders is very important when they coexist with idiopathic carpal tunnel syndrome.

  16. Syndromes and disorders associated with omphalocele (III): single gene disorders, neural tube defects, diaphragmatic defects and others.

    Science.gov (United States)

    Chen, Chih-Ping

    2007-06-01

    Omphalocele can be associated with single gene disorders, neural tube defects, diaphragmatic defects, fetal valproate syndrome, and syndromes of unknown etiology. This article provides a comprehensive review of omphalocele-related disorders: otopalatodigital syndrome type II; Melnick-Needles syndrome; Rieger syndrome; neural tube defects; Meckel syndrome; Shprintzen-Goldberg omphalocele syndrome; lethal omphalocele-cleft palate syndrome; cerebro-costo-mandibular syndrome; fetal valproate syndrome; Marshall-Smith syndrome; fibrochondrogenesis; hydrolethalus syndrome; Fryns syndrome; omphalocele, diaphragmatic defects, radial anomalies and various internal malformations; diaphragmatic defects, limb deficiencies and ossification defects of skull; Donnai-Barrow syndrome; CHARGE syndrome; Goltz syndrome; Carpenter syndrome; Toriello-Carey syndrome; familial omphalocele; Cornelia de Lange syndrome; C syndrome; Elejalde syndrome; Malpuech syndrome; cervical ribs, Sprengel anomaly, anal atresia and urethral obstruction; hydrocephalus with associated malformations; Kennerknecht syndrome; lymphedema, atrial septal defect and facial changes; and craniosynostosismental retardation syndrome of Lin and Gettig. Perinatal identification of omphalocele should alert one to the possibility of omphalocele-related disorders and familial inheritance and prompt a thorough genetic counseling for these disorders.

  17. Subclavian artery stenosis caused by a prominent first rib

    Directory of Open Access Journals (Sweden)

    Isabelle Claus

    2015-04-01

    Full Text Available Thoracic outlet syndrome is a mechanical space problem in which the brachial plexus and/or subclavian vessels are compressed. Arterial compression is least common and almost always associated with a bony anomaly. We present a case of a 49-year-old woman with a prominent first rib which caused a subclavian artery stenosis. There are many options for subclavian artery repair through open surgery. In high-risk patients, minimal invasive techniques are favorable. To date, few case reports exist on an endovascular artery repair combined with open first rib resection. While long-term follow-up will be necessary, our preliminary results seem promising.

  18. A case of adult periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome associated with endocapillary proliferative glomerulonephritis.

    Science.gov (United States)

    Cazzato, Massimiliano; Neri, Rossella; Possemato, Niccolo; Puccini, Rodolfo; Bombardieri, Stefano

    2013-03-01

    PFAPA is an acronym for periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis. This syndrome has been usually described in pediatric patients and it generally resolves spontaneously. The endocapillary proliferative glomerulonephritis (EPG) is a glomerular injury characterized by hypercellularity in glomerular lumen and is caused by post-infectious or autoimmune diseases. In this paper, we describe the case of a 35-year-old man affected by PFAPA and EPG. To our knowledge this association has never been reported in the literature before.

  19. Skeletal maturation in individuals with Down's syndrome: Comparison between PGS curve, cervical vertebrae and bones of the hand and wrist

    Directory of Open Access Journals (Sweden)

    Glauber Carinhena

    2014-08-01

    Full Text Available INTRODUCTION: This study was conducted with the aim of adapting the methods developed by Martins and Sakima to assess skeletal maturation by cervical vertebrae in the pubertal growth spurt (PGS curve. It also aimed to test the reliability and agreement between those methods and the method of hand and wrist radiograph when compared two by two and all together. METHODS: The sample comprised 72 radiographs, with 36 lateral radiographs of the head and 36 hand-wrist radiographs of 36 subjects with Down's syndrome (DS, 13 female and 23 male, aged between 8 years and 6 months and 18 years and 7 months, with an average age of 13 years and 10 months. RESULTS AND CONCLUSIONS: Results revealed that adapting the methods developed by Martins and Sakima to assess skeletal maturation by cervical vertebrae in the curve of PGS is practical and useful in determining the stage of growth and development of individuals. The stages of maturation evaluated by cervical vertebrae and ossification centers observed in radiographs of the hand and wrist were considered reliable, with excellent level of agreement between the methods by Hassel and Farman as well as Baccetti, Franchi and McNamara Jr and Martins and Sakima. Additionally, results revealed an agreement that ranged between reasonable to good for the three methods used to assess the skeletal maturation, showing statistical significance.

  20. Lower limb compartment syndrome by reperfusion injury after treatment of arterial thrombosis post-laparoscopic radical hysterectomy and pelvic lymph node dissection for cervical cancer

    Science.gov (United States)

    Yeon, Jihee; Jung, Ye Won; Yang, Shin Seok; Kang, Byung Hun; Lee, Mina; Ko, Young Bok; Yang, Jung Bo; Lee, Ki Hwan

    2017-01-01

    Compartment syndrome is a clinical condition associated with decreased blood circulation that can lead to swelling of tissue in limited space. Several factors including lithotomy position, prolonged surgery, intermittent pneumatic compressor, and reperfusion after treatment of arterial thrombosis may contribute to compartment syndrome. However, compartment syndrome rarely occurs after gynecologic surgery. In this case, the patient was diagnosed as compartment syndrome due to reperfusion injury after treatment of arterial thrombosis, which occurred after laparoscopic radical hysterectomy and pelvic lymph node dissection for cervical cancer. Despite its rarity, prevention and identifying the risk factors of complication should be performed perioperatively; furthermore, gynecologist should be aware of the possibility of complications. PMID:28344966

  1. Eight years of follow-up after laminectomy of calcium pyrophosphate crystal deposition in the cervical yellow ligament of patient with Coffin–Lowry syndrome

    Science.gov (United States)

    Morino, Tadao; Ogata, Tadanori; Horiuchi, Hideki; Yamaoka, Shintaro; Fukuda, Mitsumasa; Miura, Hiromasa

    2016-01-01

    Abstract Background: We report 8 years of follow-up after decompression to treat cervical myelopathy in a patient with Coffin–Lowry syndrome (CLS). CLS is a rare X-linked semidominant syndrome associated with growth and psychomotor retardation, general hypotonia, and skeletal abnormalities. In this patient, the spinal cord was compressed by calcium pyrophosphate crystal deposition in the cervical yellow ligament (YL). To date, only 1 report has described clinical features after surgery for calcified cervical YL in CLS. Methods: A 15-year-old male with tetraplegia secondary to compression of the cervical spinal cord induced by a hypoplastic posterior arch of C1 and calcification of the YL from C2 to C7 was treated surgically with laminectomy from C1 to C7. The patient's history, clinical examination, imaging findings, and treatment are reported. The patient was incapable of speech because of mental retardation, so he could not describe his symptoms. Gait disturbance worsened over the 2 months before admission to our hospital. At admission, the patient could not move his extremities, and tendon reflexes of the upper and lower extremities were significantly increased. Computed tomography of the cervical spine showed YL calcification from C2 to C7. Magnetic resonance imaging showed consecutive compression of the cervical spinal cord. We diagnosed quadriplegia secondary to cervical cord damage and performed emergency surgery. Results: During C1–C7 laminectomy, YL calcification in C2–C7 was observed. The calcification was confirmed as calcium pyrophosphate by crystal analysis. Quadriplegia gradually resolved, and almost disappeared by 2 weeks after the operation. Cervical hyperlordosis was observed in radiographs starting from 1 month after the operation, but it has not progressed and is not associated with any symptoms. Conclusions: The efficacy of decompression continued, and no postoperative complications have occurred during at least 8 years of follow-up. PMID

  2. Influence of ribs on train aerodynamic performances

    Institute of Scientific and Technical Information of China (English)

    MIAO Xiu-juan; GAO Guang-jun

    2015-01-01

    The influence of ribs on the train aerodynamic performance was computed using detached eddy simulation (DES), and the transient iteration was solved by the dual-time step lower-upper symmetric Gauss-Seidel (LU-SGS) method. The results show that the ribs installed on the roof have a great effect on the train aerodynamic performance. Compared with trains without ribs, the lift force coefficient of the train with convex ribs changes from negative to positive, while the side force coefficient increases by 110% and 88%, respectively. Due to the combined effect of the lift force and side force, the overturning moment of the train with convex ribs and cutting ribs increases by 140% and 106%, respectively. There is larger negative pressure on the roof of the train without ribs than that with ribs. The ribs on the train would disturb the flow structure and contribute to the air separation, so the separation starts from the roof, while there is no air separation on the roof of the train without ribs. The ribs can also slow down the flow speed above the roof and make the air easily sucked back to the train surface. The vortices at the leeward side of the train without ribs are small and messy compared with those of the train with convex or cutting ribs.

  3. Cryptococcal osteomyelitis in the ribs

    Directory of Open Access Journals (Sweden)

    Sethi Somika

    2010-01-01

    Full Text Available Isolated cryptococcal osteomyelitis, in an immunocompetent, is rare and only a few cases have been reported in literature. We present the case of a 30-year-old man presented with pain on the left side of chest with fever and gradually increasing swelling in left lateral lower aspect of chest. Investigation revealed a lytic lesion in the anterior end of left 6 th rib with normal CD4 count. He was tested negative for HIV antigen. Excision of the sixth rib, morphologically revealed cryptococcal osteomyelitis and the patient was given anti-fungal treatment for six months.

  4. [Equilibrium troubles with cervical syndrome and their relation with otorhinolaryngology (author's transl)].

    Science.gov (United States)

    Gerencsér, F; Gyeney, L

    1977-01-01

    The equilibrium troubles occuring in connection with cervical locomotoric diseases and their otorhino-laryngologic relations have been studied in the ORL Department of National Institute of Rheumatism and Medical Hydrology. It has been found that: a) there is no connection between the seriousness of roentgenologic deformations and equilibrium troubles; b) the damage of the periphery is not characteristic; c) the complaints and symptoms are explained by the hypoxia of vestibular kern-areas as well as by damages of receptors in cervical muscles, bands and joints; d) hypotension and other central vascular damages form an important factor in the development of equilibrium troubles.

  5. The Pathogenesis of Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Cervical Adenitis Syndrome: A Review of Current Research

    Directory of Open Access Journals (Sweden)

    Barbara Kraszewska-Głomba

    2015-01-01

    Full Text Available Background. PFAPA syndrome is a chronic disease that is characterized by recurrent episodes of high fever, aphthous stomatitis, pharyngitis, and cervical adenitis. Knowledge regarding the etiology of PFAPA is limited. Objectives. To provide up-to-date information considering etiology of PFAPA syndrome, by summarizing what has been explored and established in this area so far. Materials and Methods. PubMed, Web of Science, and Scopus databases were searched for pertinent reports. Eventually 19 articles were selected. The results were classified into categories regarding three areas of interest: familial occurrence, genetic basis, and immunological mechanisms of PFAPA. Results. Recent findings suggest that there is a familial tendency to PFAPA but the level of evidence does not warrant definite conclusions. The absence of a clear monogenic trait indicates a heterogenous, polygenic, or complex inheritance of PFAPA syndrome. As two mutations with a possible functional effect on the inflammasomes (MEFV E148Q and NLRP3 Q703K have been found in several PFAPA cohorts, the role of inflammasome-related genes in PFAPA pathogenesis cannot be excluded. Immunological mechanisms of PFAPA involve an abnormal, IL-1β dependent innate immune response to an environmental trigger, which leads to Th1-driven inflammation expressed by recruitment of T-cells to the periphery.

  6. [Cervical ischaemic neuronopathy and cardioembolism: another cause of man-in-the-barrel syndrome].

    Science.gov (United States)

    Gonzalez-Usigli, H; Gandarilla, A; Garcia, J J; Serrato, J; Estrada, N

    2016-12-16

    Introduccion. Los infartos de la medula espinal ocurren aproximadamente en el 1% de todos los infartos del sistema nervioso. El cardioembolismo es una causa rara. Las areas comunmente afectadas en infartos medulares son zonas de circulacion limitrofe en la region dorsal o lumbar; sin embargo, se han descrito previamente infartos medulares en la zona cervical asociados a la diseccion de arterias vertebrales. Caso clinico. Se presenta un nuevo caso de sindrome del hombre en el barril asociado con fibrilacion auricular durante un infarto agudo de miocardio, que causo una neuronopatia cervical isquemica (infarto de astas anteriores). Conclusiones. Los hallazgos clasicos de isquemia medular cervical son tetraplejia aguda, disfuncion vesical, intestinal y cardiovascular, asi como perdida de la sensibilidad disociada. La colateralizacion incompleta y las caracteristicas anatomicas de la arteria espinal anterior en la medula cervical hacen de la porcion C3-C5 la region mas vulnerable de daño isquemico, ya que la irrigacion de las arterias radiculares se inicia debajo de C5 y la fisiopatologia de la lisis rapida de un coagulo fresco produce unicamente daño bilateral de las celulas de las astas neuronales.

  7. Unusual Case of Metastatic Gastrointestinal Adenocarcinoma to the Cervical Spine without a Detectable Primary Source in a Patient with Acquired Immunodeficiency Syndrome: A Case Report

    Directory of Open Access Journals (Sweden)

    Paul E. Kaloostian

    2012-01-01

    Full Text Available The authors report a case of metastatic gastrointestinal adenocarcinoma to the cervical spine in a patient with acquired immunodeficiency syndrome (AIDS being treated with antiretroviral therapy. The source of this tumor could not be identified despite a thorough evaluation. A 49-year-old male being treated for AIDS presents with worsening neck pain and left distal arm weakness. MRI demonstrated an erosive mass within the cervical four vertebral body extending through the pedicle on the left side. Patient underwent needle biopsy followed by combined anterior and posterior fusion procedures. Pathology demonstrated metastatic gastrointestinal adenocarcinoma without known primary origin. He is currently undergoing palliative radiotherapy. This is an unusual case of metastatic gastrointestinal adenocarcinoma to the cervical spine. This should be included on the differential diagnosis of spinal lesions in this patient population and may represent a unique tumor in patients with HIV/AIDS who are on immunosuppressive therapy.

  8. Effect of Wendan Tang Jiajian on sympathetic nerve type of cervical syndrome: 1 case report%温胆汤加味治疗交感型颈椎病1例报告

    Institute of Scientific and Technical Information of China (English)

    周成谷

    2003-01-01

    @@ CASE DATA Patients, femade, 51 years old, worker, hospitalized in December1993. Chief complains: often dizziness complicated with vomiting,occasional numbness of fingers, disease course had been over 1year. Massage treatment was performed, but no effect wasachieved. Examination: cervical vertebrae located at center withoutlateral process, no obvious tenderness at bilateral neck muscles andno limitation of movement of cervical vertebrae. X-ray film showedhypertrophic changes of cervical vertebrae without obvious stenosisof intervertebral space. Diagnosis: cervical syndrome(sympathetictype) . Treatment: Wendan Tang Jiajian: astragalus root 20 g; big-head atractylodes rhizome 9 g; white peony root 9 g; Chuanduan12g; Chuanxiong 9 g; chaenomeles fruit 9 g; Fuling 12 g; Zhiqiao6g; Chao Zhuru; tangerine peel 6 g; Jiangbanxia, 9 g; Zhigancao 6g. 5tie(one tie per day) were administrated continuously until symptomsdisappeared. Patient searched medical service because of itching andno relapse of cervical syndrome was complained.

  9. 椎孔外颈神经卡压综合征与颈椎病的鉴别%Differentiation of cervical nerve entrapment syndrome at extravertebral foramen with cervical spondylopathy

    Institute of Scientific and Technical Information of China (English)

    陈德松; 方有生; 陈琳; 彭峰

    2001-01-01

    Objective To assess reason of misdiagnosis of cervical nerveentrapment syndrome at extravetebral foramen as cervical spondylopathy and their differentiation. Methods 44 cases of cervical nerve entrapment syndrome at extravetebral foramen misdiagnosed as cervical spondylopathy were involved in the study. Differential characteristics showed as follows : (1) Cervical spondylopathy : it was most commonly seen at middle aged and senile patients. The principal symptoms were aching pain at cervical part and shoulder, special pain occurring when rotation of cervical part at a certain angle and patient’s not knowing where to right put his head and neck. Sign presented as tenderness at interspinal areas , sensory disturbance at 1 or 2 nerve root(s) distributing areas and occasionally at posterosuperior medial aspect. Local block at tenderness point at cervical part was inefficient. (2) Cervical nerve entrapment syndrome at extravertebral foramen: it occurred in senile, middle aged , juvernile and adolescent patients. The main symptoms were discomfort at cervical and shoulder areas, tingling of extremity and patients not knowing where to pose his upper extremity. Significant pressure pain point occurred at middle point of posterior edge of sternoleidomastoid muscle. There was pressure pain point at the back at the lateral part of spine, radiating at affected part. Sensory disturbance included commonly C1 to T1 innervating areas and commonly in combination with postosuperior medial aspect of forearm and the face . Immediate efficiency occurred after local block at tenderness point at neck with improved sensation and muscle strength. Results Diagnosing treatment ,i.e. local block of tenderness at neck , was an important procedure for differentiating cervical nerve entrapment syndrome at extravertebral foramen with cervical spondylopathy. Conclusions Cervical nerve entrapment syndrome at extravertebral foramen was commonly confused with cervical spondylopathy . It was

  10. A case of Klippel-Feil syndrome with renal agenesis

    Directory of Open Access Journals (Sweden)

    Mehmet Karakoç

    2010-05-01

    Full Text Available Klippel-Feil syndrome (KFS is is a rare syndrome that characterized by fusion of at least two congenital vertebrae in the cervical region. The most common characteristics of KFS are short neck, low nuchal hair line and restricted joint mobility of the cervical region.Addititonal features are scoliosis, sipina bifida, cervical rib, Sprengel deformity and facial asymmetry, and renal and cardiac anomalies. In this report a 10 years old girl was admitted with complaints of short stature and abnormal neck curvature. Physical examination of the patient revealed short neck, low nuchal hair line, and Sprengel’s deformity, height hard palate, facial asymmetry and torticollis. Cervical paravertebral muscle spasm was found on the left as (+ / right (+ +. Muscle tone, muscle strength, reflexes and sensory examination were found to be normal. Radiological examination of the C4-5 and C6-7 cervical region revealed the loss of inteverebral disc spaces and block vertebra. Also there was hemivertebra anomaly and aplasia of odontoid process. Abdominal and pelvic ultrasound examination revelaed absence of right kidney. Echocardiographical examination gave no abnormality. The case was presented in order to draw attention to KFS with renal agenesia in the light of current literature.

  11. Plastic bowing of the ribs in children

    Energy Technology Data Exchange (ETDEWEB)

    Caro, P.A.; Borden, S. IV

    1988-06-01

    Four cases of plastic bowing of the ribs are presented. In three patients with Werdnig-Hoffman disease, plastic curvatures were associated with chronic pneumonia and atelectasis. We postulate that intrapulmonary retractive forces can deform ribs thinned by muscular atrophy. In turn, thoracic collapse can perpetuate lobar and segmental atelectasis. In one case of osteogenesis imperfecta without pneumonia, we believe normal muscle forces bent ribs weakened by deficiency of normal cortical architecture.

  12. The pattern of skeletal anomalies in the cervical spine, hands and feet in patients with Saethre-Chotzen syndrome and Muenke-type mutation

    Energy Technology Data Exchange (ETDEWEB)

    Trusen, Andreas; Beissert, Matthias; Darge, Kassa [Department of Paediatric Radiology, Institute of Radiodiagnostics, University of Wuerzburg, Josef-Schneider-Str. 2, 97080 Wuerzburg (Germany); Collmann, Hartmut [Department of Paediatric Neurosurgery, University of Wuerzburg, Wuerzburg (Germany)

    2003-03-01

    Saethre-Chotzen syndrome (SCS) and Muenke-type mutation (MTM) are complex syndromes with craniosynostosis and skeletal anomalies including syndactyly, carpal and tarsal fusions, and cervical spine abnormalities. In this study, we analysed radiographs of the cervical spine, hands and feet of a large patient population with genetically proven SCS and MTM. The aim was to describe the pattern of skeletal anomalies and to determine whether specific features are present that could help differentiate between the two entities. Radiographs of 43 patients (23 males, 20 females) with SCS (n=35) or MTM (n=8) were evaluated. The median age was 8 years (range 1 month-36 years). All radiographs were reviewed by two radiologists. In the hands and feet, a variety of anomalies such as brachyphalangy, clinodactyly, partial syndactyly, partial carpal or tarsal fusion, and cone-shaped epiphyses were noted. Duplicated distal phalanx of the hallux (n=12/35) and triangular deformity of the epiphysis of the distal phalanx of the hallux (n=10/35) were detected in SCS only; calcaneo-cuboid fusion (n=2/35) was detected in MTM only. In the cervical spine, fusion of vertebral bodies and/or the posterior elements occurred only in patients with SCS. Pathognomonic signs for SCS are the triangular shape of the epiphysis and duplicated distal phalanx of the hallux. Calcaneo-cuboid fusion was detected in MTM only. These signs may be helpful in the differentiation of SCS from MTM. (orig.)

  13. Scoliosis secondary to an unusual rib lesion.

    LENUS (Irish Health Repository)

    Burke, N G

    2012-04-01

    Tumours of the chest wall are uncommon and are usually malignant. A bone haemangioma is a rare benign vascular neoplasm, which more commonly occurs in middle-aged patients. We present the case of a scoliosis caused by a rib haemangioma in an adolescent male. Other causes of scoliosis secondary to rib lesions are discussed.

  14. Cavernous Hemangioma of the Rib: A Rare Diagnosis

    Directory of Open Access Journals (Sweden)

    Stavros Gourgiotis

    2010-01-01

    Full Text Available Hemangioma of the rib is an uncommon benign vascular tumour. A case of rib hemangioma in a 29-year-old woman is presented. Chest roentgenogram and computed tomography revealed a mass along the inner surface of the 7th left rib with bone destruction. She underwent resection of the 7th rib. The pathologic diagnosis was cavernous hemangioma. Hemangiomas of the rib are rare tumours but should be kept in mind in the differential diagnosis of rib tumours.

  15. [Coffin-Lowry syndrome. Its association with congenitally narrow cervical canal and myelomalacia].

    Science.gov (United States)

    García-Suárez, Adrián; Dansac-Rivera, Arie Benoit

    2014-01-01

    INTRODUCCIÓN: Las características clínicas típicas del síndrome de Coffin-Lowry son facies con hipertelorismo, nariz pequeña, boca amplia, labios amplios y evertidos; estatura corta, retardo mental, deformidad del pectus, disfunción de la válvula mitral, afectación de hipocampo y cerebelo, pérdida de la audición y trastornos de la columna, como cifosis o escoliosis. Debido a su escasa incidencia es difícil realizar el diagnóstico temprano. El objetivo de este informe fue documentar las peculiaridades anatómicas identificadas durante el tratamiento quirúrgico de un paciente con este síndrome. CASO CLÍNICO: varón con síndrome de Coffin-Lowry quien evolucionó con canal cervical estrecho más mielomalacia a corta edad, por lo que fue necesaria descompresión de C3 a C6 e instrumentación de C2 a C7. Durante la cirugía se encontró, además de la calcificación del ligamento amarillo, adherencias a la duramadre desde C4 a C5, color violáceo obscuro en esta área y adelgazamiento en forma de reloj de arena; los extremos en C3 y C6 eran normales. El objetivo de la cirugía fue detener la miopatía. En el posquirúrgico, el paciente presentó complicaciones pulmonares; al sexto día falleció por complicaciones ventilatorias y mal manejo de secreciones.

  16. Dystrophic calcinosis with both a huge calcified mass in the cervical spine and calcification in the chest wall in a patient with rheumatoid overlap syndrome.

    Science.gov (United States)

    Nakamura, Tadashi; Hirakawa, Kei; Takaoka, Hirokazu; Iyama, Ken-Ichi

    2016-05-01

    Dystrophic calcinosis in soft tissue occurs in damaged or devitalized tissues in the presence of normal calcium and phosphorous metabolism. It is often noted in subcutaneous tissues in patients with collagen vascular diseases and may involve a relatively localized area or be widespread. A 74-year-old Japanese woman with an overlap of rheumatoid arthritis, Sjögren's syndrome, and systemic sclerosis developed a huge tumor-like mass at the atlanto-axial vertebral joint region that caused severe cervical pain and difficulty in activities of daily living. She also had subcutaneous dystrophic calcification in the soft tissue of the chest wall. Calcinosis associated with systemic sclerosis is a well-recognized phenomenon, but a destructive paraspinal tumor in the cervical spine associated with overlap syndrome is extremely unique. Because calcinosis in spinal locations can be complicated by neurological involvement, patients with progressive symptoms may require surgical intervention. Surgical resection and biological therapy improved this patient's life and activities of daily living. Calcinosis is common in the conditions reviewed here, and different agents have been used for treatment. However, calcinosis management is poorly organized and lacks an accepted classification, systematic studies, and clinical therapeutic trials. The association of calcinosis and collagen vascular diseases is clinically and etiologically important. Although a combination of calcinosis and rheumatoid overlap syndrome is rare, various collagen vascular diseases may occur simultaneously. A perceptive diagnostic approach toward these diseases is critical, and early diagnosis and treatment are needed to prevent dystrophic calcinosis.

  17. Profile of inflammatory mediators in tonsils of patients with periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome.

    Science.gov (United States)

    Valenzuela, Patricia M; Araya, Andrea; Pérez, Claudio I; Maul, Ximena; Serrano, Carolina; Beltrán, Constanza; Harris, Paul R; Talesnik, Eduardo

    2013-12-01

    The purpose of this study was to analyze the levels of white blood cells and profile of proinflammatory Th1, Th2, Th17, and T regulatory tissue cytokines in the tonsils of periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) patients to contribute to the pathophysiological understanding of the PFAPA syndrome. A cohort of PFAPA patients who had tonsillectomy during 2010 and 2011 was included and compared to control patients who had tonsillectomy for tonsillar hypertrophy. White blood cell counts were measured during flares in PFAPA patients and before tonsillectomy in the control group. Cytokine gene expression was analyzed in removed tonsils by real-time PCR. Nine PFAPA patients with a median age of 5.3 years (1.7-8 years) and 17 hypertrophic tonsils of patients with a median age of 4.8 years (2.3-8.4 years) participated in this study. Tonsillectomy was performed during afebrile period between PFAPA flares. Three of the nine patients had recurrent episodes of aphthous stomatitis without fever after tonsillectomy. Leukocyte and neutrophil counts were higher in PFAPA patients compared to controls (p PFAPA patients during flares (p = 0.006). IL-1β, TNF-α, TGF-β, IL-17, and IFN-γ levels were similar in the tonsils of patients and controls. IL-4 gene expression in the tonsils was lower in PFAPA patients compared to those of the controls (p = 0.04). Proinflammatory, effector, and regulatory cytokine gene expression in tonsil tissue of PFAPA children removed in a noninflammatory asymptomatic interval and in control patients were similar. However, IL-4 cytokine gene expression in the tonsils and peripheral blood eosinophils were lower in the PFAPA patients suggesting a potential pathogenesis pathway based on an inhibition of Th2 responses.

  18. [The role of therapeutic exercises in the correction of the static component of the motor stereotype in the patients presenting with cervical myofascial pain syndrome].

    Science.gov (United States)

    Mel'nikova, E Iu; Khodasevich, L S; Poliakova, A V; Bartashevich, V V

    2014-01-01

    The present study was designed to estimate the influence of various modalities of therapeutic exercises on the static component of the motor stereotype in 200 patients presenting with cervical myofascial pain syndrome. The study was performed with the use of computed optical topography. The course of therapeutic exercises included 10 sessions of the total duration of 14 days. It is concluded based on the data obtained in this study that remedial gymnastics based on the understanding of the internal body model ("body scheme") with the use of static symmetric exercises is 2.7 times as effective as the traditional approach.

  19. Two cases of cervical disc disease with intramedullary pathological changes, which are responsible for their neurological syndromes, on delayed CT myelography

    Energy Technology Data Exchange (ETDEWEB)

    Isu, Toyohiko; Iwasaki, Yoshinobu; Abe, Hiroshi; Tashiro, Kunio; Murai, Hiroshi; Miyasaka, Kazuo

    1987-08-01

    We report two cases of cervical disc disease with myelopathy classified as of motor system syndrome type showing small contrast accumulation within the spinal cord on delayed CT myelography. In our two cases, high density spots on delayed CT myelography were bilaterally localized within the spinal cord, and believed represent pathological changes of the spinal cord, such as collection of microcavities or cystic necrosis. In case 1, the high density areas seemed to be localized in the anterior horn and corticospinal tract, and in case 2, they seemed to be localized in the corticospinal tract. The patient in case 1 produced signs and symptoms resembling motor neurone disease and lesion could not be differentiated from the latter. Delayed CT myelography showed that the cause of the upper limb amyotrophy was attributed to an anterior horn disorder and that of pyramidal tract sign to a corticospinal tract disorder. Therefore, we could differentiate the lesion from motor neurone disease on delayed CT myelography in case 1. In conclusion, we emphasize that delayed CT myelography can demonstrate the intramedullary pathological changes in the cervical disc disease and is useful in distinguishing between cervical disc disease simulating motor neurone disease and the latter.

  20. [Anterior cervical hypertrichosis: case report].

    Science.gov (United States)

    Orozco-Gutiérrez, Mario H; Sánchez-Corona, José; García-Ortiz, José E; Castañeda-Cisneros, Gema; Dávalos-Rodríguez, Nory O; Corona-Rivera, Jorge R; García-Cruz, Diana

    2016-10-01

    The non-syndromic anterior cervical hypertrichosis (OMIM N° 600457) is a genetic disorder characterized by a patch of hair at the level of the laryngeal prominence. We present a 12-year-old boy with anterior cervical hypertrichosis and mild generalized hypertrichosis. He has no neurological, ophthalmological or skeletal anomalies. The clinical follow up is 10 years.

  1. Ribbed vaults of late Gothic in Sardinia

    Directory of Open Access Journals (Sweden)

    Paola Casu

    2012-06-01

    Full Text Available The late Gothic construction practice, settled in the Spanish Mediterranean area, is based on predetermined geometric rules and is shown in religious buildings with ribbed vaults. The proportion between the sides of the area to cover, tracing plan of the ribs as a succession of corner bisectors, stereotomy problems and volumetric aspects, are just some of the elements that can describe the complex construction of a ribbed vault. The aim of this paper is to analyze the dimensional information of the late gothic ribbed vaults of Sardinia, in order to define the geometric and proportional rules for a correct drawing, establishing a standard procedure for the collection of measures and the construction of the 3D model of vaults.

  2. Optimizing rib width to height and rib spacing to deck plate thickness ratios in orthotropic decks

    Directory of Open Access Journals (Sweden)

    Abdullah Fettahoglu

    2016-12-01

    Full Text Available Orthotropic decks are composed of deck plate, ribs, and cross-beams and are frequently used in industry to span long distances, due to their light structures and load carrying capacities. Trapezoidal ribs are broadly preferred as longitudinal stiffeners in design of orthotropic decks. They supply the required stiffness to the orthotropic deck in traffic direction. Trapezoidal ribs are chosen in industrial applications because of their high torsional and buckling rigidity, less material and welding needs. Rib width, height, spacing, thickness of deck plate are important parameters for designing of orthotropic decks. In the scope of this study, rib width to height and rib spacing to deck plate thickness ratios are assessed by means of the stresses developed under different ratios of these parameters. For this purpose a FE-model of orthotropic bridge is generated, which encompasses the entire bridge geometry and conforms to recommendations given in Eurocode 3 Part 2. Afterwards necessary FE-analyses are performed to reveal the stresses developed under different rib width to height and rib spacing to deck plate thickness ratios. Based on the results obtained in this study, recommendations regarding these ratios are provided for orthotropic steel decks occupying trapezoidal ribs.

  3. Turbulent flow in a ribbed channel: Flow structures in the vicinity of a rib

    DEFF Research Database (Denmark)

    Wang, Lei; Salewski, Mirko; Sundén, Bengt

    2010-01-01

    PIV measurements are performed in a channel with periodic ribs on one wall. The emphasis of this study is to investigate the flow structures in the vicinity of a rib in terms of mean velocities, Reynolds stresses, probability density functions (PDF), and two-point correlations. The PDF distribution...... of u′ is bimodal in the separated shear layer downstream of the rib. The maximum Reynolds shear stresses occur at the leading edge of the rib. Based on quadrant analysis, it is found that ejection motions make a dominant contribution to the Reynolds shear stress in this region. Moreover, topology...

  4. Supersonic Wing Optimization Using SpaRibs

    Science.gov (United States)

    Locatelli, David; Mulani, Sameer B.; Liu, Qiang; Tamijani, Ali Y.; Kapania, Rakesh K.

    2014-01-01

    This research investigates the advantages of using curvilinear spars and ribs, termed SpaRibs, to design a supersonic aircraft wing-box in comparison to the use of classic design concepts that employ straight spars and ribs. The objective is to achieve a more efficient load-bearing mechanism and to passively control the deformation of the structure under the flight loads. Moreover, the use of SpaRibs broadens the design space and allows for natural frequencies and natural mode shape tailoring. The SpaRibs concept is implemented in a new optimization MATLAB-based framework referred to as EBF3SSWingOpt. This optimization scheme performs both the sizing and the shaping of the internal structural elements, connecting the optimizer with the analysis software. The shape of the SpaRibs is parametrically defined using the so called Linked Shape method. Each set of SpaRibs is placed in a one by one square domain of the natural space. The set of curves is subsequently transformed in the physical space for creating the wing structure geometry layout. The shape of each curve of each set is unique; however, mathematical relations link the curvature in an effort to reduce the number of design variables. The internal structure of a High Speed Commercial Transport aircraft concept developed by Boeing is optimized subjected to stress, subsonic flutter and supersonic flutter constraints. The results show that the use of the SpaRibs allows for the reduction of the aircraft's primary structure weight without violating the constraints. A weight reduction of about 15 percent is observed.

  5. Effect of Aspect Ratio, Channel Orientation, Rib Pitch-to-Height Ratio, and Number of Ribbed Walls on Pressure Drop Characteristics in a Rotating Channel with Detached Ribs

    Directory of Open Access Journals (Sweden)

    K. Arun

    2007-01-01

    Full Text Available The present work involves experimental investigation of the effects of aspect ratio, channel orientation angle, rib pitch-to-height ratio (P/e, and number of ribbed walls on friction factor in orthogonally rotating channel with detached ribs. The ribs are separated from the base wall to provide a small region of flow between the base wall and the ribs. Experiments have been conducted at Reynolds number ranging from 10000–17000 with rotation numbers varying from 0–0.38. Pitch-to-rib height ratios (P/e of 5 and 10 at constant rib height-to-hydraulic diameter ratio (e/D of 0.1 and a clearance ratio (C/e of 0.38 are considered. The rib angle of attack with respect to mainstream flow is 90∘. The channel orientation at which the ribbed wall becomes trailing surface (pressure side on which the Coriolis force acts is considered as the 0∘ orientation angle. For one-wall ribbed case, channel is oriented from 0∘ to 180∘ about its axis in steps of 30∘ to change the orientation angle. For two-wall ribbed case, the orientation angle is changed from 0∘ to 90∘ in steps of 30∘. Friction factors for the detached ribbed channels are compared with the corresponding attached ribbed channel. It is found that in one-wall detached ribbed channel, increase in the friction factor ratio with the orientation angle is lower for rectangular channel compared to that of square channel for both the pitch-to-rib height ratios of 5 and 10 at a given Reynolds number and rotation number. Friction factor ratios of two-wall detached ribbed rectangular channel are comparable with corresponding two-wall detached ribbed square channel both under stationary and rotating conditions.

  6. 误诊为颈椎病的一组病例分析%THE ANALYSIS ON THE CASES MISDIAGNOSED AS CERVICAL SYNDROME

    Institute of Scientific and Technical Information of China (English)

    俞永林; 吴建国; 张秉文; 蒋励

    2012-01-01

    Objective: To elevate the level of diagnosis and treatment for cervical syndrome, to analyse the cause of misdiagnosis as cervical syndrome. Methods: In the clinical work of orthopedics, 77 cases with various kinds of diseases, such as amyotrophic lateral sclerosis and soft tissues injury of neck-back-shoulder-arm and so on, were misdiagnosed as cervical syndrome. All the patients with wrong diagnosis were corrected after careful inquisition of case history, physical inspection and various kinds of auxiliary examination, and were transferred to different departments for further treatment. Results: 52 cases were excellent, 13 satisfactory, 9 effective, 3 failed. So totle excellent and satisfactory rate was 84.4%. The totle excellent and satisfactory rate was 47.1% for the type of spinal cord, 97.8% for the type of nerve root, 85.7% for the type of sympathizes, 85.7% for the type of mixed (the chi-square test, P < 0.001). There was obvious statistical significance among the four groups. Conclusion: Pain of neck-back-shoulder-arm may be caused by different types of cervical syndrome, so the clinicians should carefully analyz the cause of pain for every patient. The degeneration of cervical discs was universal among the aged and middle-aged patients. Misdiagnosis and mistreatment can be reduced through careful clinical consideration, meticulous physical examination and various kinds of auxiliary examinations for questionable cases.%目的:为提高颈椎疾病的诊治水平,分析其他疾病被误诊为颈椎病并被误治的原因.方法:在骨科门诊工作中,通过仔细询问病史、体格检查和各种辅助检查,使77例肌萎缩侧束硬化症和颈背肩胛臂部软组织损伤等病症被误诊为颈椎病患者的诊断得以纠正.并随访各有关科室治疗后的疗效.结果:确诊后疗效非常满意为52例、满意13例、有效9例、无效3例,总体非常满意和满意率为84.4%.各型颈椎病非常满意和

  7. Isolated rib fractures in geriatric patients

    Directory of Open Access Journals (Sweden)

    Elmistekawy Elsayed

    2007-01-01

    Full Text Available Introduction: The goal of this study was to investigate the short-term outcomes in patients older than 60 years with isolated rib fractures and admitted to emergency hospital. Materials and Methods: This study included patients who were 60 years old or more and sustained blunt chest injury and had isolated rib fractures. The following data were obtained from the medical records: age, gender, number of fracture ribs, side of fracture ribs, mechanism and nature of injury, preexisting medical conditions, complications, admission to intensive care unit (ICU, need for mechanical ventilation, length of ICU and hospital stay and mortality. Results: For the study, 39 patients who were 60 years old or more and admitted to the hospital because of isolated rib fractures were enrolled. There were 28 males (71.7% and 11 females (28.3% with mean age of (66.84 ± 4.7 years. No correlation was found between comorbidities and hospital outcomes except in those who were diabetic (P-value = 0.005 and those with chronic lung disease (P-value = 0.006. Pulmonary complications were the most frequent complications encountered in those patients. Pulmonary complications were: lung contusion in 8 patients (20.5% and pulmonary infection in 6 patients (15.8%. Conclusion: Elderly patients sustaining blunt chest trauma had significant morbidity and potential for mortality.

  8. An uncommon disorder with multiple skeletal anomalies: Gorlin-Goltz syndrome.

    Science.gov (United States)

    Keçeli, Onur; Coskun-Benlidayı, İlke; Benlidayı, M Emre; Erdoğan, Özgür

    2014-01-01

    Gorlin-Goltz syndrome is an uncommon disorder transmitted through autosomal dominant inheritance. This syndrome is characterized by multiple odontogenic keratocysts, along with congenital skeletal anomalies and basal cell carcinomas. A 16-year-old girl was admitted with a complaint of swelling on the lower jaw. She had multiple basal cell nevi on both hands. Multiple lytic bone lesions on radiographs were defined as odontogenic keratocysts following the biopsy. The patient was referred to the Department of Physical Medicine and Rehabilitation for detailed musculoskeletal evaluation. Adam's forward bend test revealed a hump on the right side representing right thoracic scoliosis. Cervical kyphosis, thoracic lordosis and scoliosis, bifid rib and sacral and lumbar spina bifida on plain radiographs led to the diagnosis of Gorlin-Goltz syndrome. Since early diagnosis may provide optimum surveillance for related neoplasms, it is of paramount importance for pediatricians as well as physicians dealing with the musculoskeletal system to be aware of this rare condition.

  9. Chondroblastoma of rib in situs inversus

    Directory of Open Access Journals (Sweden)

    Purwa R Patil

    2014-01-01

    Full Text Available Chondroblastoma is a rare benign cartilaginous tumour accounting for approximately 1% of all bone tumours. It commonly arises from epiphysis of a long bone, particularly the humerus, tibia and femur. Rib is an extremely rare site for this tumour with a few cases reported in the literature. It is commonly seen in children and adults between the ages of 10 - 20 years. Although roentgenographic findings are quite common characteristic of this tumour, it can sometimes be misdiagnosed as giant cell tumour, osteogenic sarcoma and myeloma on histopathology. We report a 26-year-old male patient with situs inversus and chondroblastoma of rib. To the best of our knowledge, this is the first case of chondroblastoma of the rib in a patient of situs inversus. Segmental resection is the treatment of choice. It usually behaves in a benign fashion, but few cases have shown local recurrences and distant metastasis; hence, follow-up of the patient is essential.

  10. Markedly elevated CD64 expressions on neutrophils and monocytes are useful for diagnosis of periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome during flares.

    Science.gov (United States)

    Yamazaki, Takashi; Hokibara, Sho; Shigemura, Tomonari; Kobayashi, Norimoto; Honda, Kimiko; Umeda, Yoh; Agematsu, Kazunaga

    2014-05-01

    Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome is the most commonly encountered autoinflammatory disease in children, but its pathogenesis and diagnostic biomarkers are unknown. In this study, we examined the utility of CD64, a member of the Fcγ receptors, expressions on neutrophils and monocytes in diagnosing patients with PFAPA, along with other autoinflammatory diseases exhibiting periodic fever, and bacterial infections. Although CD64 was expressed at a similar level in the attack-free period of PFAPA and in controls, CD64 expressions on both neutrophils and monocytes were dramatically increased during attacks. Serum IFN-γ also increased in some PFAPA patients during flares, suggesting the involvement of T cell activation. Our findings demonstrate that remarkable CD64 expression during PFAPA flares serves as a potential biomarker for the diagnosis. We also suspect that IFN-γ, possibly from retention of activated T cells in peripheral tissues, increases CD64 synthesis in such cases.

  11. Case of streptococcal toxic shock syndrome caused by rapidly progressive group A hemolytic streptococcal infection during postoperative chemotherapy for cervical cancer.

    Science.gov (United States)

    Nogami, Yuya; Tsuji, Kousuke; Banno, Kouji; Umene, Kiyoko; Katakura, Satomi; Kisu, Iori; Tominaga, Eiichiro; Aoki, Daisuke

    2014-01-01

    Streptococcal toxic shock syndrome (STSS) is a severe infectious disease caused by group A hemolytic streptococcus (Streptococcus pyogenes). This condition is a serious disease that involves rapidly progressive septic shock. We experienced a case of STSS caused by primary peritonitis during treatment with paclitaxel and cisplatin (TP therapy) as postoperative chemotherapy for cervical cancer. STSS mostly develops after extremity pain, but initial influenza-like symptoms of fever, chill, myalgia and gastrointestinal symptoms may also occur. TP therapy is used to treat many cancers, including gynecological cancer, but may cause adverse reactions of neuropathy and nephrotoxicity and sometimes fever, arthralgia, myalgia, abdominal pain and general malaise. The case reported here indicates that development of STSS can be delayed after chemotherapy and that primary STSS symptoms may be overlooked because they may be viewed as adverse reactions to chemotherapy. To our knowledge, this is the first report of a case of STSS during chemotherapy.

  12. [Mucoid webs of the cervical esophagus. Apropos of 38 cases discovered during upper endoscopy at the Hôpital Principal of Dakar. Relationship to Plummer-Vinson syndrome].

    Science.gov (United States)

    Peghini, M; Barabe, P; Jean, P; Griffet, P; Eynard, J P; Mbaye, P S; Wade, B; Houenassi, M

    1989-01-01

    Thirty-eight cervical esophageal mucous diaphragms were discovered in the course of 15,000 high endoscopies carried out over the past 5 years at Dakar General Hospital. Thirty-six of the sufferers were Black Senegalese. The 29 women and 9 men had an average age of 37 years. Dysphagia was diagnosed 29 times, and anemia 22 times. Endoscopic diagnosis readily shows the mucous diaphragm at the level of, or immediately below, KILLIAN's mouth. PLUMMER-VINSON's syndrome affected 16 of these patients. Treatment consists in collapsing the mucous diaphragm by putting the endoscope through it: this happened to 30 of the patients. Endoscopic surveillance is indispensable because of the risk of cancer, but is difficult to perform.

  13. Three-level cervical disc herniation

    Directory of Open Access Journals (Sweden)

    St. Iencean Andrei

    2015-09-01

    Full Text Available Multilevel cervical degenerative disc disease is well known in the cervical spine pathology, with radicular syndromes or cervical myelopathy. One or two level cervical herniated disc is common in adult and multilevel cervical degenerative disc herniation is common in the elderly, with spinal stenosis, and have the same cause: the gradual degeneration of the disc. We report the case of a patient with two level cervical disc herniation (C4 – C5 and C5 – C6 treated by anterior cervical microdiscectomy both levels and fusion at C5 – C6; after five years the patient returned with left C7 radiculopathy and MRI provided the image of a left C6 – C7 disc herniation, he underwent an anterior microsurgical discectomy with rapid relief of symptoms. Three-level cervical herniated disc are rare in adults, and the anterior microdiscectomy with or without fusion solve this pathology.

  14. The Effectiveness of Manual Therapy Versus Surgery on Self-reported Function, Cervical Range of Motion, and Pinch Grip Force in Carpal Tunnel Syndrome: A Randomized Clinical Trial.

    Science.gov (United States)

    Fernández-de-Las-Peñas, César; Cleland, Joshua; Palacios-Ceña, María; Fuensalida-Novo, Stella; Pareja, Juan A; Alonso-Blanco, Cristina

    2017-03-01

    Study Design Randomized parallel-group trial. Background Carpal tunnel syndrome (CTS) is a common pain condition that can be managed surgically or conservatively. Objective To compare the effectiveness of manual therapy versus surgery for improving self-reported function, cervical range of motion, and pinch-tip grip force in women with CTS. Methods In this randomized clinical trial, 100 women with CTS were randomly allocated to either a manual therapy (n = 50) or a surgery (n = 50) group. The primary outcome was self-rated hand function, assessed with the Boston Carpal Tunnel Questionnaire. Secondary outcomes included active cervical range of motion, pinch-tip grip force, and the symptom severity subscale of the Boston Carpal Tunnel Questionnaire. Patients were assessed at baseline and 1, 3, 6, and 12 months after the last treatment by an assessor unaware of group assignment. Analysis was by intention to treat, with mixed analyses of covariance adjusted for baseline scores. Results At 12 months, 94 women completed the follow-up. Analyses showed statistically significant differences in favor of manual therapy at 1 month for self-reported function (mean change, -0.8; 95% confidence interval [CI]: -1.1, -0.5) and pinch-tip grip force on the symptomatic side (thumb-index finger: mean change, 2.0; 95% CI: 1.1, 2.9 and thumb-little finger: mean change, 1.0; 95% CI: 0.5, 1.5). Improvements in self-reported function and pinch grip force were similar between the groups at 3, 6, and 12 months. Both groups reported improvements in symptom severity that were not significantly different at all follow-up periods. No significant changes were observed in pinch-tip grip force on the less symptomatic side and in cervical range of motion in either group. Conclusion Manual therapy and surgery had similar effectiveness for improving self-reported function, symptom severity, and pinch-tip grip force on the symptomatic hand in women with CTS. Neither manual therapy nor surgery resulted

  15. Microtia reconstruction: autologous rib and alloplast techniques.

    Science.gov (United States)

    Cabin, Jonathan A; Bassiri-Tehrani, Michael; Sclafani, Anthony P; Romo, Thomas

    2014-11-01

    Microtia represents a spectrum of maldevelopment of the external ear. Reconstructive techniques may utilize an autogenous rib cartilage framework and require 2-4 stages; alternatively, an alloplastic framework can be used and typically requires 1-2 stages. Successful reconstruction of microtia with either technique can provide a significant quality of life improvement, and both techniques are described in this article.

  16. Síndrome de Brown-Séquard por hérnia discal cervical a duplo nível: caso clínico e revisão da literatura Síndrome de Brown-Séquard por hernia discal cervical en nivel doble: caso clínico y revisión de la literatura Brown-Séquard syndrome by double level cervical disc herniation: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Jorge Miguel Silva Ribeiro Olliveira Alves

    2012-09-01

    paciente con síndrome de Brown-Séquard por hernia de disco cervical.This article presents a case in which Brown-Séquard syndrome resulted from a double level cervical disc herniation. A 40-year-old man without previous history of cervical pathology, presented with insidious right arm and leg paresis associated with associated with decreased pain and thermal sensitivity in the left hemibody after diving which caused indirect trauma of the cervical spine. Magnetic resonance imaging of the cervical spine showed double level disc herniation in C4-C5 and C5-6 with compression of the right half of spinal cord and hyperintensity in T2-weighted images. After a complete decompression of neural structures, a double level interbody fusion was performed. There was partial recovery of neurological status after a long period of physical therapy. Early surgical intervention and prompt rehabilitation are paramount to achieve neurological recovery in patients with Brown-Séquard syndrome resulting from a cervical disc herniation.

  17. Cervical Cancer

    Science.gov (United States)

    ... the place where a baby grows during pregnancy. Cervical cancer is caused by a virus called HPV. The ... for a long time, or have HIV infection. Cervical cancer may not cause any symptoms at first. Later, ...

  18. The Performance of the Vaginal Discharge Syndromic Management in Treating Vaginal and Cervical Infection: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Kiarie, James; Seuc, Armando; Mogasale, Vittal; Latif, Ahmed; Broutet, Nathalie

    2016-01-01

    Background This review aimed to synthesize and analyze the diagnostic accuracy and the likelihood of providing correct treatment of the syndromic approach Vaginal Discharge Flowchart in managing cervical infections caused by Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT), and vaginal infections caused by Trichomonas vaginalis (TV) and Bacterial vaginosis (BV) and Candida albicans. This review will inform updating the WHO 2003 guidelines on Vaginal Discharge syndromic case management. Methods A systematic review was conducted on published studies from 01-01-2000 to 30-03-2015 in multiple databases. Studies evaluating the diagnostic accuracy and validation of the WHO Vaginal Discharge Flowchart were included. Validation parameters including sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) and the 95% confidence intervals for the different types of the flowchart were taken as outcomes, re-calculated, and analysed using a fixed model meta-analysis for data pooling. The level of agreement between the index and reference test were determined by the Cohen’s Kappa co-efficiency test. Each individual study was assessed on quality using the QUADAS-2 tool. Findings The search yielded 2,845 studies of which 16 met the eligibility criteria for final analysis. The diagnostic performance to identify cervical infections was low and resulted in a high proportion of over and missed treatment. The four flowcharts had a sensitivity between 27.37% in history and risk assessment and 90.13% with microscopy, with the inverse in specificity rates. The treatment performances between the flowcharts were inconsistent. The same applies to the use of vaginal discharge flowchart for treating vaginal infections. For vaginal infections the vaginal discharge flowchart had a good performance in flowchart 3 with 91.68% of sensitivity; 99.97% specificity; 99.93% PPV and 0.02% who missed their treatment and 8.32% of women who were over treated

  19. Reduced Number of CD8+ Cells in Tonsillar Germinal Centres in Children with the Periodic Fever, Aphthous Stomatitis, Pharyngitis and Cervical Adenitis Syndrome.

    Science.gov (United States)

    Førsvoll, J; Janssen, E A M; Møller, I; Wathne, N; Skaland, I; Klos, J; Kristoffersen, E K; Øymar, K

    2015-07-01

    The syndrome of periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) is an autoinflammatory disorder of unknown aetiology. Tonsillectomy may cause a prompt resolution of the syndrome. The aim was to study the histologic and immunological aspects of the palatine tonsils in PFAPA, to help understand the pathophysiology of the syndrome. Tonsils from children with PFAPA (n = 11) and children with tonsillar hypertrophy (n = 16) were evaluated histologically after haematoxylin and eosin staining. The number of different cell types was identified immunohistochemically by cluster of differentiation (CD) markers: CD3 (T cells), CD4 (T helper cells), CD8 (cytotoxic T cells), CD15 (neutrophils), CD20 (B cells), CD45 (all leucocytes), CD57 (NK cells) and CD163 (monocytes and macrophages). Tonsils from children with PFAPA showed reactive lymphoid hyperplasia dominated by well-developed germinal centres with many tingible body macrophages. The histologic findings were unspecific, and a similar morphologic appearance was also found in the tonsils from controls. The number of CD8+ cells in germinal centres differed between children with PFAPA [median 9 cells (quartiles: 5, 15)] and controls [18 cells (12, 33) (P = 0.001)] and between children with PFAPA with (median 14 cells; 9, 16) and without (4 cells; 3, 8) aphthous stomatitis (P = 0.015). For the other cell types, no differences in germinal centres were found between children with PFAPA and controls. In conclusion, a lower number of CD8+ cells were found in germinal centres of tonsils in children with PFAPA compared to controls, which may be a feature linked to the aetiology of the syndrome.

  20. Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    2007-03-06

    Did you know that cervical cancer rates differ by race/ethnicity and region? Or that cervical cancer can usually be prevented if precancerous cervical lesions are found by a Pap test and treated? Find out how getting regular Pap tests can save a woman's life.  Created: 3/6/2007 by National Breast and Cervical Cancer Early Detection Program.   Date Released: 4/25/2007.

  1. TREATMENT OF COMPRESSION SYNDROME OF CERVICAL POSTERIOR BRANCH BY CERVICAL NERVE BLOCK OUTSIDE VERTEBRAL CANAL AND MANIPULATION%椎管外颈神经阻滞加手法治疗颈神经后支卡压综合症

    Institute of Scientific and Technical Information of China (English)

    王希; 袁君君

    2001-01-01

    为探讨评价颈神经后支卡压综合症的诊治方法,根据YabukiS等对颈神经解剖学的研究,结合临床回顾性地分析了89例颈神经后支卡压综合症患者椎管外颈神经阻滞及手法治疗的效果。经平均6个月随访,结果47例单纯行颈神经阻滞术者,治愈38例,占80.1%;42例配合手法治疗者,全部治愈,占100%。组间比较(P<0.05),两组治愈率有明显差异。提示对病因不明及无明显神经体征的头、颈肩痛患者,应诊断为颈神经后支卡压综合症,与颈神经后支在关节突出部位的卡压有关。椎管外颈神经阻滞配合手法治疗,是一种针对性强、有效的治疗方法。%To explore the diagnostic and therapeutic methods of compressionsyndrome of cervical posterior branch, according to Yabukis'research about anatomy of cervical nerve, analyze retrospectively the therapeutic effect of compression syndrome of cervical posterior branch(89 cases) with cervical nerve block outside vertebral canal and manipulation. The average follow-up time was half a year. 38 out of 47 patients were cured with cervical nerve block and the curative rate was 80%, but other 42 patients were all cured with cervical nerve block outside vertebral canal and manipulation, the curative rate was 100%. There was a significant difference(P<0.05) in two groups. For head-neck-shoulder pain patients without clear cause and obvious nervous signs, they should be diagnosed as compression syndrome of cervical posterior branch, which related to being compressed of cervical posterior branch at the articular process. It was suggested that cervical nerve block outside vertebral canal with manipulation was a pointed and effective therapeutic method.

  2. Cervical spondylosis: recognition, differential diagnosis, and management.

    Science.gov (United States)

    Voorhies, R M

    2001-04-01

    In contemporary clinical practice, the prevalence of neck pain in the general population is approximately 15%. The challenge for the primary care specialist is to be able to recognize the more serious disorders that require early referral. Additionally, it is important to have the confidence to institute specific treatment for nonurgent conditions in order to avoid unnecessary referral of patients with generally self-limiting conditions.CERVICAL SPONDYLOSIS IS A GENERAL AND NONSPECIFIC TERM THAT ENCOMPASSES A BROAD SPECTRUM OF AFFLICTIONS BUT, FOR PURPOSES OF CLARITY, CAN BE ORGANIZED INTO THREE CLINICAL SYNDROMES: Type I Syndrome (Cervical Radiculopathy); Type II Syndrome (Cervical Myelopathy); and Type III Syndrome (Axial Joint Pain). It is important to remember that shoulder problems can masquerade as cervical problems, and vice versa (e.g. adhesive capsulitis, recurrent anterior subluxation, impingement syndrome, rotator cuff tear, etc.). A number of management options, including pharmaceutical, physical therapy, and psychological therapies, are available once a diagnosis has been made.

  3. Acute cervicitis and vulvovaginitis may be associated with Cytomegalovirus

    OpenAIRE

    Abou, Magali; Dällenbach, Patrick

    2013-01-01

    Cytomegalovirus (CMV) infection in immunocompetent hosts is generally asymptomatic or may present as a mononucleosic syndrome. Its association with acute cervicitis and vulvovaginitis has rarely been reported.

  4. Unilateral fusion of the odontoid process with the atlas in Klippel-Feil syndrome: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Park, So Young; Ryu, Kyung Nam; Park, Ji Seon; Suk, Kyung Soo; Han, Mi Young [Kyunghee Medical Center, Seoul (Korea, Republic of)

    2006-07-15

    Klippel-Feil syndrome (KFS) displays congenital fusion of the cervical vertebrae; it is a relatively common condition and has many associated malformations such as Sprengel's deformity, scoliosis, rib anomalies, congenital defects of the brain or spinal cord, renal anomalies, congenital heart disease, deafness, cleft palate, cranial and facial asymmetry, and enteric cysts. There are various types of cervical fusion observed in KFS. However, fusion of the odontoid process with the atlas is a very rare finding. We report here on a 4-year-old boy with unilateral fusion of a separated odontoid process with the lateral mass of the atlas, and this was associated with a spontaneously closed ventricular septal defect, a small patent ductus arteriosus and a horseshoe kidney.

  5. Rib fractures in infants due to cardiopulmonary resuscitation efforts.

    Science.gov (United States)

    Dolinak, David

    2007-06-01

    Although it is widely known that adults may sustain fractures of the anterior and/or lateral aspects of the ribs due to cardiopulmonary resuscitation (CPR) efforts, relatively little is written about the generation of CPR-related rib fractures in the infant age range. In a series of 70 consecutive autopsies in infants ranging in age from 2 weeks to 8 months, with no history or indications of injury, the parietal pleura of the thoracic cage was stripped and the ribs carefully examined for fracture. Subtle fractures of the anterolateral aspects of the ribs were discovered in 8 (11%) of the 70 cases. In 7 of the 8 cases, multiple ribs were fractured (ranging up to 10 rib fractures), and in 5 of these cases, the rib fractures were bilateral. All of the rib fractures were subtle, had little if any associated blood extravasation, and would have been easily missed had the parietal pleura not been stripped. These anterolateral rib fractures in infants are the likely correlate of anterolateral rib fractures that are not uncommonly seen in the adult population, resulting from resuscitation efforts. The rib fractures are subtle and may not be identified unless the parietal pleura is stripped.

  6. Horner syndrome due to vertebral artery stenosis.

    Science.gov (United States)

    Kim, Chul Han

    2013-11-01

    The author reports a rare case of Horner syndrome in a patient who resulted from stenosis of the vertebral artery after blunt trauma. A 31-year-old man was transferred to our department for evaluation of left medial orbital wall and nasal bone fractures. Five days ago, he was hospitalized due to multiple second to fourth rib fractures of the right chest following blunt trauma of the face, neck, and chest. Surgery was performed. Ten days later, he complained of drooping of the right eyelid. Physical examination revealed a discrete miosis and ptosis with normal levator function in the right eye. A workup for Horner syndrome was performed. Magnetic resonance angiography of the head and neck revealed a stenosis of the distal part of the right vertebral artery without the abnormality of carotid artery. He wore a cervical collar and underwent anticoagulation. However, Horner syndrome was not resolved over the next 12 months. Acute traumatic Horner syndrome may be associated with vertebral artery dissection in which the possibility of life-threatening injury can be masked.

  7. MRI morphometric characterisation of the paediatric cervical spine and spinal cord in children with MPS IVA (Morquio-Brailsford syndrome).

    Science.gov (United States)

    Solanki, Guirish A; Lo, William B; Hendriksz, Christian J

    2013-03-01

    Nearly all children with MPS IVA develop skeletal deformities affecting the spine. At the atlanto-axial spine, odontoid hypoplasia occurs. GAG deposition around the dens, leads to peri-odontoid infiltration. Transverse/alar ligament incompetence causes instability. Atlanto-axial instability is associated with cord compression and myelopathy, leading to major morbidity and mortality. Intervention is often required. Does the presence of widened bullet shaped vertebra in platyspondily encroach on the spinal canal and cause spinal stenosis in MPS IVA? So far, there have been no standardised morphometric measurements of the paediatric MPS IVA cervical spine to evaluate whether there is pre-existing spinal stenosis predisposing to compressive myelopathy or whether this is purely an acquired process secondary to instability and compression. This study provides the first radiological quantitative analysis of the cervical spine and spinal cord in a series of affected children. MRI morphometry indicates that the MPS IVA spine is narrower at C1-2 level giving an inverted funnel shape. There is no evidence of a reduction in the Torg ratio (canal-body ratio) in the cervical spine. The spinal canal does not exceed 11 mm at any level, significantly smaller than normal historical cohorts (14 mm). The sagittal diameter and axial surface area of both spinal canal and cord are reduced. C1-2 level cord compression was evident in the canal-cord ratio but the Torg ratio was not predictive of cord compression. In MPS IVA the reduction in the space available for the cord (SAC) is multifactorial rather than due to congenital spinal stenosis.

  8. Deep cervical infection?

    Directory of Open Access Journals (Sweden)

    Bernardo T

    2012-06-01

    Full Text Available Introduction: Inflammatory cervical swelling may have several causes. The jugular vein thrombosis is a rare entity, often forgotten. Most frequently arises due to a cervical sepsis by the use of a central venous catheter or intravenous drug abuse (drug addicts. Rarely, is secondary to a hypercoagulability state associated with a visceral carcinoma (Trousseau Syndrome. Material and Methods: The authors present the case of a 65 years old male, who used the ENT Emergency Service due to a painful left cervical swelling with local and systemic inflammatory signs of 3 days duration. Results: An cervical ultrasound suggested a neck abscess. CT was performed and confirmed the ultrasound results. Because of its location in the path of the internal jugular vein, we requested re-evaluation by CT with intravenous contrast and doppler ultrasound, obtaining the diagnosis of thrombosis of the internal jugular vein. Further studies were conduct to clarify the hypercoagulability state, since the patient had no known predisposing factor. Finally the diagnosis of unresectable gastric carcinoma was made. Discussion and Conclusion: The ENT must be aware and be able to understand any cervical imagiologic studies. A deep knowledge of the anatomical imagiología is important for the diagnosis of jugular thrombosis. When we have a case of spontaneous jugular thrombosis, we must look for possible visceral carcinoma.

  9. Chondromyxoid fibroma of the second rib.

    Science.gov (United States)

    Long, Kristin L; Absher, Kimberly J; Draus, John M

    2013-06-01

    Chondromyxoid fibromas are benign tumors which are found most frequently in the metaphyses of long bones. They comprise less than 1% of primary bone neoplasms and display a hypermetabolic appearance on PET imaging. Oftentimes, they are misdiagnosed as chondrosarcomas and are excised due to concern for malignancy. We present a case of a condromyxoid fibroma originating from the second rib of a 15-year-old girl.

  10. Cervical Angina

    Science.gov (United States)

    Sussman, Walter I.; Makovitch, Steven A.; Merchant, Shabbir Hussain I.

    2015-01-01

    Cervical angina has been widely reported as a cause of chest pain but remains underrecognized. This series demonstrates the varied clinical presentation of patients with cervical angina, the delay in diagnosis, and the extensive cardiac examinations patients with this condition typically undergo prior to a definitive diagnosis. Recognition of this condition in patients with acute chest pain requires a high index of suspicion and an awareness of the common presenting features and clinical findings of cervical angina. PMID:25553225

  11. Fiberoptic intubation through laryngeal mask airway for management of difficult airway in a child with Klippel–Feil syndrome

    Science.gov (United States)

    Bhat, Ravi; Mane, Rajesh S.; Patil, Manjunath C.; Suresh, S. N.

    2014-01-01

    The ideal airway management modality in pediatric patients with syndromes like Klippel-Feil syndrome is a great challenge and is technically difficult for an anesthesiologist. Half of the patients present with the classic triad of short neck, low hairline, and fusion of cervical vertebra. Numerous associated anomalies like scoliosis or kyphosis, cleft palate, respiratory problems, deafness, genitourinary abnormalities, Sprengel's deformity (wherein the scapulae ride high on the back), synkinesia, cervical ribs, and congenital heart diseases may further add to the difficulty. Fiberoptic bronchoscopy alone can be technically difficult and patient cooperation also becomes very important, which is difficult in pediatric patients. Fiberoptic bronchoscopy with the aid of supraglottic airway devices is a viable alternative in the management of difficult airway in children. We report a case of Klippel-Feil syndrome in an 18-month-old girl posted for cleft palate surgery. Imaging of spine revealed complete fusion of the cervical vertebrae with hypoplastic C3 and C6 vertebrae and thoracic kyphosis. We successfully managed airway in this patient by fiberoptic intubation through classic laryngeal mask airway (LMA). After intubation, we used second smaller endotracheal tube (ETT) to stabilize and elongate the first ETT while removing the LMA. PMID:25191201

  12. Fiberoptic intubation through laryngeal mask airway for management of difficult airway in a child with Klippel-Feil syndrome

    Directory of Open Access Journals (Sweden)

    Ravi Bhat

    2014-01-01

    Full Text Available The ideal airway management modality in pediatric patients with syndromes like Klippel-Feil syndrome is a great challenge and is technically difficult for an anesthesiologist. Half of the patients present with the classic triad of short neck, low hairline, and fusion of cervical vertebra. Numerous associated anomalies like scoliosis or kyphosis, cleft palate, respiratory problems, deafness, genitourinary abnormalities, Sprengel′s deformity (wherein the scapulae ride high on the back, synkinesia, cervical ribs, and congenital heart diseases may further add to the difficulty. Fiberoptic bronchoscopy alone can be technically difficult and patient cooperation also becomes very important, which is difficult in pediatric patients. Fiberoptic bronchoscopy with the aid of supraglottic airway devices is a viable alternative in the management of difficult airway in children. We report a case of Klippel-Feil syndrome in an 18-month-old girl posted for cleft palate surgery. Imaging of spine revealed complete fusion of the cervical vertebrae with hypoplastic C3 and C6 vertebrae and thoracic kyphosis. We successfully managed airway in this patient by fiberoptic intubation through classic laryngeal mask airway (LMA. After intubation, we used second smaller endotracheal tube (ETT to stabilize and elongate the first ETT while removing the LMA.

  13. The NEtherlands Cervical Kinematics (NECK) Trial. Cost-effectiveness of anterior cervical discectomy with or without interbody fusion and arthroplasty in the treatment of cervical disc herniation; A double-blind randomised multicenter study

    NARCIS (Netherlands)

    M.P. Arts (Mark); R. Brand (René); B.W. Koes (Bart); W.C. Peul (Wilco); M.E. van den Akker (Elske)

    2010-01-01

    textabstractBackground. Patients with cervical radicular syndrome due to disc herniation refractory to conservative treatment are offered surgical treatment. Anterior cervical discectomy is the standard procedure, often in combination with interbody fusion. Accelerated adjacent disc degeneration is

  14. Two case reports of an unusual association between Klippel-Feil syndrome and amyotrophic lateral sclerosis: Do they share same genetic defect?

    Directory of Open Access Journals (Sweden)

    Koneru Lakshmi Umamaheshwar

    2013-01-01

    Full Text Available Klippel-Feil syndrome (KFS is an unusual skeletal disorder characterized by congenital fusion of two or more cervical vertebrae which can be sporadic or familial. KFS emerges to be a failure of the normal segmentation and fusion of the mesodermal somites during 3 rd and 8 th weeks of embryonic development. The triad of low posterior hairline, short neck, and restricted neck motion is present only in 50% and often associated with scoliosis, spina bifida, Sprengel′s deformity, cervical ribs, deafness, cleft palate, renal anomalies, congenital heart defects, and so on because of heterogeneous nature of the disease. The significance of KFS lies in the secondary effects produced on the nervous system, which usually presents with features of progressive cord and brain stem compression with relatively minor trauma. We here report two cases of KFS presented in association with amyotrophic lateral sclerosis. Only two such cases have been described in the literature in 1954 and 1975.

  15. The Place of Ultrasonography in the Evaluation of Rib Fractures

    Directory of Open Access Journals (Sweden)

    Fulya Bakılan

    2015-12-01

    Full Text Available Objective: The aim of this study was to investigate whether ultrasonography is superior to chest x-ray in detecting rib fractures in patients with minor blunt chest trauma and chest pain. Materials and Methods: Ultrasonography findings of 32 patients with minor blunt chest trauma showing no evidence of a rib fracture on anteroposterior chest x-rays, were documented. Presence of cortical discontinuities, acoustic shadows, reverberation artifacts, and hematoma by ultrasonography was proposed as the diagnostic criteria for detecting the rib fracture. Results: Rib fracture was detected in 20 patients (62.5% according to ultrasonography results. A mildly displaced fracture was detected in 7 patients (35%, hematoma was detected in 3 patients (15% and multiple fractures (in 5th, 6th, 7th, and 8th ribs were detected in 1 patient (5%. Conclusion: The results of our study showed that ultrasonography is superior to chest x-ray, in detecting rib fractures.

  16. PIV Measurements of Turbulent Flow in a Channel with Solid or Perforated Ribs

    DEFF Research Database (Denmark)

    Wang, Lei; Salewski, Mirko; Sundén, Bengt

    2011-01-01

    Particle image velocimetry measurements are performed in a channel with periodic ribs on one wall. We investigate the flow around two different rib configurations: solid and perforated ribs with a slit. The ribs obstruct the channel by 20% of its height and are arranged 10 rib heights apart....... For the perforated ribs, the slit height is 20% of the rib height, and the open-area ratio is 16%. We discuss the flow in terms of mean velocity, streamlines, vorticity, turbulence intensity, and Reynolds shear stress. We find that the recirculation bubbles after the perforated ribs are significantly smaller than...... those after the solid ribs. The reattachment length after perforated ribs is smaller by about 45% compared with the solid ribs. In addition, the Reynolds shear stresses around the perforated ribs are significantly smaller than in the solid rib case, leading to a reduction of the pressure loss...

  17. Analysis of the genetic basis of periodic fever with aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome.

    Science.gov (United States)

    Di Gioia, Silvio Alessandro; Bedoni, Nicola; von Scheven-Gête, Annette; Vanoni, Federica; Superti-Furga, Andrea; Hofer, Michaël; Rivolta, Carlo

    2015-05-19

    PFAPA syndrome is the most common autoinflammatory syndrome in children from Western countries. In spite of its strong familial clustering, its genetic basis and inheritance pattern are still unknown. We performed a comprehensive genetic study on 68 individuals from 14 families. Linkage analysis suggested a susceptibility locus on chromosome 8, but direct molecular sequencing did not support this initial statistical finding. Exome sequencing revealed the absence of any gene that was mutated in all patients. Exhaustive screening of genes involved in other autoinflammatory syndromes or encoding components of the human inflammasome showed no DNA variants that could be linked to PFAPA molecular pathology. Among these, the previously-reported missense mutation V198M in the NLRP3 gene was clearly shown not to co-segregate with PFAPA. Our results on this relatively large cohort indicate that PFAPA syndrome is unlikely to be a monogenic condition. Moreover, none of the several genes known to be involved in inflammation or in autoinflammatory disorders seem to be relevant, alone, to its etiology, suggesting that PFAPA results from oligogenic or complex inheritance of variants in multiple disease genes and/or non-genetic factors.

  18. Epidemiología y problemática médico forense del síndrome de latigazo cervical en España Epidemiology and forensic problems of the whiplash syndrome in Spain

    Directory of Open Access Journals (Sweden)

    P.M. Garamendi

    2003-04-01

    Full Text Available Presentamos una revisión bibliográfica actualizada y centrada en los aspectos epidemiológicos del síndrome de latigazo cervical. En la revisión, se destaca la variedad y diversidad de conclusiones en los estudios publicados en relación tanto con el esguince cervical en su fase aguda (menos de 6 meses de evolución clínica como en su fase crónica (persistencia sintomática más allá de 6 meses de evolución. Finalmente, se apuntan algunos de los problemas que el trastorno produce en la actividad médico forense en España.We present a review of the current literature on the whiplash syndrome focusing on its epidemiological profiles. The review points out the variety and diversity of conclusions in the studies published on the acute whiplash syndrome (less than 6 months of clinical evolution and the chronic syndrome (symptomatic persistence after 6 months. Finally, we enumerate some of the problems the syndrome generates in forensic practise in Spain.

  19. The effect of gallium arsenide aluminum laser therapy in the management of cervical myofascial pain syndrome: a double blind, placebo-controlled study.

    Science.gov (United States)

    Dundar, U; Evcik, D; Samli, F; Pusak, H; Kavuncu, V

    2007-06-01

    The efficacy of low-level laser therapy (LLLT) in myofascial pain syndrome (MPS) seems controversial. A prospective, double-blind, randomized controlled trial was conducted in patients with chronic MPS in the neck to evaluate the effects of low-level 830-nm gallium arsenide aluminum (Ga-As-Al) laser therapy. The study group consisted of 64 MPS patients. The patients were randomly assigned into two groups. In group 1 (n = 32), Ga-As-Al laser treatment was applied over three trigger points bilaterally for 2 min over each point once a day for 15 days during a period of 3 weeks. In group 2 (n = 32), the same treatment protocol was given, but the laser instrument was switched off during applications. All patients in both groups performed daily isometric exercise and stretching exercises for cervical region. Parameters were measured at baseline and after 4 weeks. All patients were evaluated with respect to pain (at rest, movement, and night) and assessed by visual analog scale, measurement of active range of motion using an inclinometer and a goniometer, and the neck disability index. In both groups, statistically significant improvements were detected in all outcome measures compared with baseline (p 0.05). In conclusion, although the laser therapy has no superiority over placebo groups in this study, we cannot exclude the possibility of effectivity with another treatment regimen including different laser wavelengths and dosages (different intensity and density and/or treatment interval).

  20. Detection and labeling ribs on expiration chest radiographs

    Science.gov (United States)

    Park, Mira; Jin, Jesse S.; Wilson, Laurence S.

    2003-06-01

    Typically, inspiration is preferred when xraying the lungs. The x-ray technologist will ask a patient to be still and to take a deep breath and to hold it. This not only reduces the possibility of a blurred image but also enhances the quality of the image since air-filled lungs are easier to see on x-ray film. However, inspiration causes low density in the inner part of lung field. That means that ribs in the inner part of lung field have lower density than the other parts nearer to the border of the lung field. That is why edge detection algorithms often fail to detect ribs. Therefore to make rib edges clear we try to produce an expiration lung field using a 'hemi-elliptical cavity.' Based on the expiration lung field, we extract the rib edges using canny edge detector and a new connectivity method, called '4 way with 10-neighbors connectivity' to detect clavicle and rib edge candidates. Once the edge candidates are formed, our system selects the best candidates using knowledge-based constraints such as a gradient, length and location. The edges can be paired and labeled as superior rib edge and inferior rib edge. Then the system uses the clavicle, which is obtained in a same method for the rib edge detection, as a landmark to label all detected ribs.

  1. Case report 467: Cystic chondroblastoma left 4th rib

    Energy Technology Data Exchange (ETDEWEB)

    Sundaram, M.; McGuire, M.H.; Naunheim, K.; Schajowicz, F.

    1988-03-01

    A case of chondroblastoma in an 18-year-old female arising from a rib near the costotransverse articulation (presumably from the epiphysis of the articular process) has been described. The destructive pattern noted in the rib, associated with a large soft tissue mass, favored a malignant lesion rather than a benign one. Histologically, this tumor had large cystic and hemorrhagic components, consistent with the diagnosis of a cystic chondroblastoma of a rib. Curiously, this patient, like two others with chondroblastoma in a rib was asymptomatic, and attention to the abnormality was drawn from a routine chest radiography. The patient remains disease-free one and a half-years following surgery.

  2. Stress injury of the rib in a swimmer

    Energy Technology Data Exchange (ETDEWEB)

    Heincelman, Carrie [University of Cincinnati Medical Center, Department of Orthopaedic Surgery, Cincinnati, OH (United States); Brown, Seth; England, Eric; Mehta, Kaushal; Wissman, Robert D. [University of Cincinnati Medical Center, Department of Radiology, Cincinnati, OH (United States)

    2014-09-15

    Rib stress injuries are uncommonly reported but have been documented among athletes, most notably rowers. There have only been two prior case reports of rib stress injuries in swimmers, both of which were young females. Magnetic resonance (MR) imaging was either not obtained or the imaging characteristics were incompletely described. We present a case of an isolated third rib stress injury in a collegiate male swimmer diagnosed via MR imaging. We briefly discuss the possible etiologies for rib stress injuries, their MR appearance, as well as their treatment. (orig.)

  3. Tuina treatment in cervical spondylosis

    Directory of Open Access Journals (Sweden)

    Florin Mihai Hinoveanu

    2010-12-01

    Full Text Available Cervical spondylosis is a common, chronic degenerative condition of the cervical spine that affects the vertebral bodies and intervertebral disks of the neck as well as the contents of the spinal canal. Common clinical syndromes associated with cervical spondylosis include cervical pain, cervical radiculopathy and/or mielopathy. This study show the main principles, indication and side effects of tuina in cervical spondylosis´ treatment; tuina is one of the external methods based on the principles of Traditional Chinese Medicine (TCM, especially suitable for use on the elderly population and on infants. While performing Tuina, the therapist concentrates his mind, regulates his breathing, and actuates the Qi and power of his entire body towards his hands. For a better result is recommended to try to combine acupuncture with tuina treatment. Tuina can help relieve the pain associated with spondylosis. After this kind of treatment, the symptomes produced by irritated nerves and sore muscles can find some relief. Tuina helps patients with cervical spondylosis regain muscle control, nerve function and flexibility, all through the restoration of the life force flow.

  4. Computed tomography measurement of rib cage morphometry in emphysema.

    Directory of Open Access Journals (Sweden)

    Nicola Sverzellati

    Full Text Available BACKGROUND: Factors determining the shape of the human rib cage are not completely understood. We aimed to quantify the contribution of anthropometric and COPD-related changes to rib cage variability in adult cigarette smokers. METHODS: Rib cage diameters and areas (calculated from the inner surface of the rib cage in 816 smokers with or without COPD, were evaluated at three anatomical levels using computed tomography (CT. CTs were analyzed with software, which allows quantification of total emphysema (emphysema%. The relationship between rib cage measurements and anthropometric factors, lung function indices, and %emphysema were tested using linear regression models. RESULTS: A model that included gender, age, BMI, emphysema%, forced expiratory volume in one second (FEV1%, and forced vital capacity (FVC% fit best with the rib cage measurements (R(2 = 64% for the rib cage area variation at the lower anatomical level. Gender had the biggest impact on rib cage diameter and area (105.3 cm(2; 95% CI: 111.7 to 98.8 for male lower area. Emphysema% was responsible for an increase in size of upper and middle CT areas (up to 5.4 cm(2; 95% CI: 3.0 to 7.8 for an emphysema increase of 5%. Lower rib cage areas decreased as FVC% decreased (5.1 cm(2; 95% CI: 2.5 to 7.6 for 10 percentage points of FVC variation. CONCLUSIONS: This study demonstrates that simple CT measurements can predict rib cage morphometric variability and also highlight relationships between rib cage morphometry and emphysema.

  5. Cervical dysplasia - series (image)

    Science.gov (United States)

    ... to detect cervical cancer. Limited or early cervical cancer (carcinoma in situ, or cervical intraepithelial neoplasia, or dysplasia) requires treatment with ablation therapy, usually in the form of ...

  6. SC Cyclotron and RIB Facilities in Kolkata

    CERN Document Server

    Sinha, Bikash; Chakrabarti, Alok

    2005-01-01

    The superconducting cyclotron under construction at this Centre has bending limit (K-bend) of 520 and focusing limit (K-foc) of 160. It is being constructed, primarily, for nuclear physics experiments with heavy ion beams at intermediate energies. The 100-ton main magnet is currently in the commissioning phase with the main coil already at 4.2K temperature. Magnetic field measurements will be carried out over the next several months. All other systems of the cyclotron are in an advanced stage of fabrication or development. We plan to start assembly of the complete cyclotron around the end of 2005. In the phase-I of the project one beam line has been provided. Construction of three more beam lines and various experimental facilities for nuclear physics as well as irradiation experiments has also been funded and the work is well on its way. An ISOL type Radioactive Ion Beam (RIB) facility is being built with the existing K=130 room temperature cyclotron, VEC, as the primary beam source. In-beam RIB production a...

  7. Rib enlargement in premature infants with bronchopulmonary dysplasia

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hye Kyung; Han, Kim Bokyung; Chang, Yun Sil; Choo, In Wook [Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul (Korea, Republic of); Kim, Kyeong Ah [Anyang General Hospital, Anyang (Korea, Republic of)

    2000-04-01

    The purpose of this study is to describe the rib changes seen in patients with brochopulmonary dysplasia (BPD). Serial chest radiographs of nine premature infants with BPD who showed diffuse rib enlargement were reviewed for hyperinflation, which was compared with the observed degree of rib enlargement. Vibrator chest physiotherapy was performed in all cases, and five infants underwent conventional ventilation plus high frequency oscillatory ventilation therapy. Their calcium level was normal whereas alkaline phosphatase and phosphate levels were high. In all infants except one, liver enzyme levels were normal. For the treatment of patent ductus arteriosus, infection, and BPD, medications including indomethacin, antibiotics, and dexamethasone were administered. Vitamin D was given to all patients with total parenteral nutrition. Rib enlargement was found to be severe (n=3D4), moderate (n=3D3), or mild (n=3D2) with undulating margins or posterior tapering (n=3D2). Hyperinflation was noted in eight patients, in seven of whom it was moderate to severe. Among these seven, rib enlargement was severe (n=3D2), moderate (n=3D3), or mild (n=3D2). In one infant with mild hyperinflation, rib enlargement was severe. Bilateral irregular infiltrates and atelectases were noted in all patients. In BPD patients, rib enlargement may be seen. In order to differentiate this process from systemic bone disease or bony dysplasia, an awareness of the rib changes occurring in patients with BPD may be important. (author)

  8. Cervical Laminoplasty

    Science.gov (United States)

    ... spine showing extension of the spine following a cervical laminoplasty. B) Post-operative lateral x-rays of the same patient showing flexion. Note that the range of motion is maintained after the laminoplasty and that no ...

  9. Cervical spondylosis

    Science.gov (United States)

    Cervical osteoarthritis; Arthritis - neck; Neck arthritis; Chronic neck pain; Degenerative disk disease ... therapist). Sometimes, a few visits will help with neck pain. Cold packs and heat therapy may help your ...

  10. [Neurological Signs and Symptoms of True Neurogenic Thoracic Outlet Syndrome].

    Science.gov (United States)

    Higashihara, Mana; Konoeda, Fumie; Sonoo, Masahiro

    2016-05-01

    Thoracic outlet syndrome (TOS) is a well-known disorder, but many aspects of its pathology, including its definition, has been disputed. True neurogenic TOS (TN-TOS) is a rare but well-defined clinical condition. TN-TOS results from the compression of the C8/T1 roots (dominant for the T1 root) or the proximal lower trunk of the brachial plexus by a fibrous band. The band extends from the first rib to either the tip of an elongated C7 transverse process or a rudimentary cervical rib. The most common presenting symptoms of TN-TOS are insidious-onset atrophy and weakness of the intrinsic hand muscles, predominantly in the thenar eminence and radial digit flexors. Nerve conduction studies demonstrate pathognomonic findings: severely attenuated compound muscle action potential of the abductor pollicis brevis muscle, and usually, loss of the sensory nerve action potential of the medial antebrachial cutaneous nerve. Numbness and sensory loss are typically observed, mainly in the medial forearm, although they are usually mild, and may be absent in some patients. Severe pain or paresthesia proximal to the elbow is not observed. The classical concept of TOS underlie nonspecific neurogenic TOS. It has been primarily diagnosed using provocative maneuvers. However, there is controversy regarding its pathological conceptualization and existence, as objective evidence of the disease is still lacking.

  11. Painful rib hump: a new clinical sign for detecting intraspinal rib displacement in scoliosis due to neurofibromatosis

    Directory of Open Access Journals (Sweden)

    Katsalouli Marina

    2006-06-01

    Full Text Available Abstract Background Spinal cord compression and associate neurological impairment is rare in patients with scoliosis and neurofibromatosis. Common reasons are vertebral subluxation, dislocation, angulation and tumorous lesions around the spinal canal. Only twelve cases of intraspinal rib dislocation have been reported in the literature. The aim of this report is to present a case of rib penetration through neural foramen at the apex of a scoliotic curve in neurofibromatosis and to introduce a new clinical sign for its detection. Methods A 13-year-old girl was evaluated for progressive left thoracic kyphoscoliotic curve due to a type I neurofibromatosis. Clinical examination revealed multiple large thoracic and abdominal "cafe-au-lait" spots, neurological impairment of the lower limbs and the presence of a thoracic gibbous that was painful to pressure at the level of the left eighth rib (Painful Rib Hump. CT-scan showed detachment and translocation of the cephalic end of the left eighth rib into the adjacent enlarged neural foramen. The M.R.I. examination of the spine showed neither cord abnormality nor neurogenic tumor. Results The patient underwent resection of the intraspinal mobile eighth rib head and posterior spinal instrumentation and was neurologically fully recovered six months postoperatively. Conclusion Spine surgeons should be aware of intraspinal rib displacement in scoliotic curves in neurofibromatosis. Painful rib hump is a valuable diagnostic tool for this rare clinical entity.

  12. Fractured cervical spine and aortic transection.

    LENUS (Irish Health Repository)

    Griffin, M J

    2012-02-03

    A 17-year-old victim of a road traffic accident presented. Following investigation diagnoses of fractured first cervical vertebra, aortic transection, diffuse cerebral oedema, fractured right ribs 2-4 and pubic rami were made. Management of this case presented a number of anaesthetic dilemmas: management of the airway, use of cross-clamp vs. shunting or heparinization and bypass, cardiovascular and neurological monitoring, maintenance of cardiovascular stability during and post cross-clamp, minimizing the risk of post-operative renal and neurological dysfunction.

  13. Comparison of therapeutic efficacy between acupuncture and low level laser in the treatment of cervical myofascial pain syndrome: a single blinded randomized clinical trial study

    Directory of Open Access Journals (Sweden)

    Fariba Eslamian

    2014-01-01

    Full Text Available Abstract Background: Neck pain is a medical and public problem with a prevalence of 9-18 percent in general population. Myofascial pain syndrome (MPS is a regional pain syndrome that is characterized with muscular tender and triggers points. Laser therapy and acupuncture are two methods applied in the treatment of MPS. The aim of this study was to compare the effects of acupuncture and low level laser in cervical MPS treatment. Material and Methods: In a randomized clinical trial study, during a 15-month period, 60 patients with CMPs, referred to physical medicine and rehabilitation clinic, were divided into three groups Gr1 underwent acupuncture plus drugs, Gr2 laser therapy plus drugs and Gr3 only medication. Pain severity using visual analogue scale (VAS, Range of motion (ROM with goniometry, palpation sensitivity with finger compression and daily function with neck questionnaire were assessed before, immediately after and two months after treatment. The obtained data were analyzed using statistical software SPSS version 16. Results: Sixty patients of CMPs were included in this study. In acupuncture group, 5 male and 15 female (mean age of 38.8±6.36, in laser group, 6 male and 14 female (mean age of 37.7±5.64 and in control group, 8 male and 12 female (mean age of 37.6±5.17 were evaluated. There was significant difference in majority of parameters in two treatment groups compared to control group. But neck ROM in left lateral bending and VAS score, showed better improvement in acupuncture group than the other 2 groups (P<0.001. Nevertheless two months afterwards, no significant difference was detected between laser and acupuncture groups. Conclusion: This study demonstrated that both acupuncture and laser therapy along with exercise and drugs are more effective than routine and only medication treatments in management of CMPs. However, with respect to myofascial pain pathology, acupuncture, at least in short term has more beneficial

  14. The vertebral column, ribs, and sternum of the African giant rat (Cricetomys gambianus waterhouse).

    Science.gov (United States)

    Olude, Matthew Ayokunle; Mustapha, Oluwaseun Ahmed; Ogunbunmi, Temitope Kehinde; Olopade, James Olukayode

    2013-01-01

    Examined bones were obtained from eight adult African giant rats, Cricetomys gambianus Waterhouse. Animals used had an average body mass of 730.00 ± 41.91 gm and body length of 67.20 ± 0.05 cm. The vertebral formula was found to be C7, T13, L6, S4, Ca31-36. The lowest and highest points of the cervicothoracic curvature were at C5 and T2, respectively. The spinous process of the axis was the largest in the cervical group while others were sharp and pointed. The greatest diameter of the vertebral canal was at the atlas (0.8 cm) and the lowest at the caudal sacral bones (2 mm). The diameter of the vertebral foramen was the largest at C1 and the smallest at the S4; the foramina were negligibly indistinct caudal to the sacral vertebrae. There were 13 pairs of ribs. The first seven pairs were sternal, and six pairs were asternal of which the last 2-3 pairs were floating ribs. The sternum was composed of deltoid-shaped manubrium sterni, four sternebrae, and a slender processus xiphoideus. No sex-related differences were observed. The vertebral column is adapted for strong muscular attachment and actions helping the rodent suited for speed, agility, dexterity, and strength which might enable it to overpower prey and escape predation.

  15. The Vertebral Column, Ribs, and Sternum of the African Giant Rat (Cricetomys gambianus Waterhouse

    Directory of Open Access Journals (Sweden)

    Matthew Ayokunle Olude

    2013-01-01

    Full Text Available Examined bones were obtained from eight adult African giant rats, Cricetomys gambianus Waterhouse. Animals used had an average body mass of 730.00±41.91 gm and body length of 67.20±0.05 cm. The vertebral formula was found to be C7, T13, L6, S4, Ca31–36. The lowest and highest points of the cervicothoracic curvature were at C5 and T2, respectively. The spinous process of the axis was the largest in the cervical group while others were sharp and pointed. The greatest diameter of the vertebral canal was at the atlas (0.8 cm and the lowest at the caudal sacral bones (2 mm. The diameter of the vertebral foramen was the largest at C1 and the smallest at the S4; the foramina were negligibly indistinct caudal to the sacral vertebrae. There were 13 pairs of ribs. The first seven pairs were sternal, and six pairs were asternal of which the last 2-3 pairs were floating ribs. The sternum was composed of deltoid-shaped manubrium sterni, four sternebrae, and a slender processus xiphoideus. No sex-related differences were observed. The vertebral column is adapted for strong muscular attachment and actions helping the rodent suited for speed, agility, dexterity, and strength which might enable it to overpower prey and escape predation.

  16. Differential diagnosis of cervical radiculopathy and superior pulmonary sulcus tumor

    Institute of Scientific and Technical Information of China (English)

    GU Rui; KANG Ming-yang; GAO Zhong-li; ZHAO Jian-wu; WANG Jin-cheng

    2012-01-01

    Background The result would be disastrous if the superior pulmonary sulcus tumor (Pancoast tumor) was misdiagnosed as degenerative cervical spine diseases.The aim of this study was to investigate the differential diagnosis methods of cervical radiculopathy and superior pulmonary sulcus tumor.Methods Clinical manifestations,physical,and radiological findings of 10 patients,whose main complaints were radiating shoulder and arm pain and later were diagnosed with superior pulmonary sulcus tumor,were reviewed and compared with those of cervical radiculopathy.Results Superior pulmonary sulcus tumor patients have shorter mean history and fewer complaints of neck pain or limitation of neck movement.Physical examination showed almost normal cervical spine range of motion.Spurling's neck compression test was negative in all patients.Anteroposterior cervical radiographs showed the lack of pulmonary air at the top of the affected lung in all cases and first rib encroachment in one case.The diagnosis of superior pulmonary sulcus tumor can be further confirmed by CT and MRI.Conclusions By the method of combination of history,physical examination,and radiological findings,superior pulmonary sulcus tumor can be efficiently differentiated from cervical radiculopathy.Normal motion range of the cervical spine,negative Spurling's neck compression test,and the lack of pulmonary air at the top of the affected lung in anteroposterior cervical radiographs should be considerad as indications for further chest radiograph examinations.

  17. Titanium plating system with autologous rib graft sternoplasty in the treatment of thoracic inlet compression

    Directory of Open Access Journals (Sweden)

    Matthew Alexander

    2016-01-01

    Full Text Available Narrowing of the thoracic inlet leading to airway compression is a rare and challenging condition in the pediatric population. Reports in the literature have described this variant related to multiple conditions including double crush phenomenon following repair of pectus excavatum, anterior spinal displacement, and straight back syndrome. Underlying genetic conditions such as Marfan's Syndrome and Hurler's Syndrome have also been reported to contribute to clinically significant airway compression independent of dynamic tracheal collapse such as tracheomalacia. The borders of the thoracic inlet are anatomically bound by the body of the first thoracic vertebrae (T1 posteriorly, the posterior surface of the manubrium anteriorly, and the medial aspects of the first ribs on either side laterally. Relief of tracheal compression in this location is complicated by the rigidity of the boney thoracic inlet and limited space for lifting procedures such as anterior aortopexy. Several operative approaches to treat this condition have been described including manubrial/sternal resection, first rib resection, and reconstruction of the thoracic inlet. Described here are three patients where successful reconstruction of the thoracic inlet was achieved using autologous rib graft sternoplasty and a titanium sternal plating system to widen the thoracic inlet and eliminate external compression on the trachea.

  18. Single crystalline silicon solar cells with rib structure

    Science.gov (United States)

    Yoshiba, Shuhei; Hirai, Masakazu; Abe, Yusuke; Konagai, Makoto; Ichikawa, Yukimi

    2017-02-01

    To improve the conversion efficiency of Si solar cells, we have developed a thin Si wafer-based solar cell that uses a rib structure. The open-circuit voltage of a solar cell is known to increase with deceasing wafer thickness if the cell is adequately passivated. However, it is not easy to handle very thin wafers because they are brittle and are subject to warpage. We fabricated a lattice-shaped rib structure on the rear side of a thin Si wafer to improve the wafer's strength. A silicon nitride film was deposited on the Si wafer surface and patterned to form a mask to fabricate the lattice-shaped rib, and the wafer was then etched using KOH to reduce the thickness of the active area, except for the rib region. Using this structure in a Si heterojunction cell, we demonstrated that a high open-circuit voltage (VOC) could be obtained by thinning the wafer without sacrificing its strength. A wafer with thickness of 30 μm was prepared easily using this structure. We then fabricated Si heterojunction solar cells using these rib wafers, and measured their implied VOC as a function of wafer thickness. The measured values were compared with device simulation results, and we found that the measured VOC agrees well with the simulated results. To optimize the rib and cell design, we also performed device simulations using various wafer thicknesses and rib dimensions.

  19. What Accounts for Rib Fractures in Older Adults?

    Directory of Open Access Journals (Sweden)

    Lisa-Ann Wuermser

    2011-01-01

    Full Text Available To address the epidemiology of rib fractures, an age- and sex-stratified random sample of 699 Rochester, Minnesota, adults age 21–93 years was followed in a long-term prospective study. Bone mineral density (BMD was assessed at baseline, and fractures were ascertained by periodic interview and medical record review. During 8560 person-years of followup (median, 13.9 years, 56 subjects experienced 67 rib fracture episodes. Risk factors for falling predicted rib fractures as well as BMD, but both were strongly age-related. After age-adjustment, BMD was associated with rib fractures in women but not men. Importantly, rib fractures attributed to severe trauma were associated with BMD in older individuals of both sexes. Self-reported heavy alcohol use doubled fracture risk but did not achieve significance due to limited statistical power. Bone density, along with heavy alcohol use and other risk factors for falling, contributes to the risk of rib fractures, but no one factor predominates. Older women with rib fractures, regardless of cause, should be considered for an osteoporosis evaluation, and strategies to prevent falling should be considered in both sexes.

  20. Single crystalline silicon solar cells with rib structure

    Directory of Open Access Journals (Sweden)

    Shuhei Yoshiba

    2017-02-01

    Full Text Available To improve the conversion efficiency of Si solar cells, we have developed a thin Si wafer-based solar cell that uses a rib structure. The open-circuit voltage of a solar cell is known to increase with deceasing wafer thickness if the cell is adequately passivated. However, it is not easy to handle very thin wafers because they are brittle and are subject to warpage. We fabricated a lattice-shaped rib structure on the rear side of a thin Si wafer to improve the wafer’s strength. A silicon nitride film was deposited on the Si wafer surface and patterned to form a mask to fabricate the lattice-shaped rib, and the wafer was then etched using KOH to reduce the thickness of the active area, except for the rib region. Using this structure in a Si heterojunction cell, we demonstrated that a high open-circuit voltage (VOC could be obtained by thinning the wafer without sacrificing its strength. A wafer with thickness of 30 μm was prepared easily using this structure. We then fabricated Si heterojunction solar cells using these rib wafers, and measured their implied VOC as a function of wafer thickness. The measured values were compared with device simulation results, and we found that the measured VOC agrees well with the simulated results. To optimize the rib and cell design, we also performed device simulations using various wafer thicknesses and rib dimensions.

  1. Physicians' perspectives on the diagnosis and management of periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome.

    Science.gov (United States)

    Manthiram, Kalpana; Li, Suzanne C; Hausmann, Jonathan S; Amarilyo, Gil; Barron, Karyl; Kim, Hanna; Nativ, Simona; Lionetti, Geraldina; Zeft, Andrew; Goldsmith, Donald; Kimberlin, David; Edwards, Kathryn; Dedeoglu, Fatma; Lapidus, Sivia

    2017-03-07

    To assess the practice patterns of pediatric rheumatology and infectious diseases subspecialists in the diagnosis and treatment of periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome. An online survey assessing diagnostic and treatment approaches was sent to 424 members of the Childhood Arthritis and Rheumatology Research Alliance (CARRA) and 980 members of the Pediatric Infectious Disease Society (PIDS). 277 physicians (123 from CARRA and 154 from PIDS representing 21% of the total membership) completed the survey. To diagnose PFAPA, most respondents agreed that patients must have the following features of the diagnostic criteria: stereotypical fever episodes (95%), asymptomatic intervals between episodes (93%), and normal growth and development (81%). However, 71% of the respondents did not require age of onset <5 years, 33% did not require regular intervals between episodes, and 79% did not require the concomitant signs of aphthous stomatitis, adenitis, or pharyngitis during episodes as long as episodes were regular. Over half (58%) considered episode resolution with steroids to be diagnostic of PFAPA. Corticosteroids, antipyretics, tonsillectomy, and cimetidine were the most commonly prescribed treatments, while steroids and tonsillectomy were most effective. Subspecialists in pediatric rheumatology and infectious diseases showed limited adherence to the complete published criteria for diagnosing PFAPA suggesting heterogeneity in the characteristics of patients diagnosed with the disorder. These findings emphasize the need to develop consensus diagnostic and treatment guidelines in well-characterized patient populations.

  2. Gorlin syndrome: A case report

    Directory of Open Access Journals (Sweden)

    Abbas Darjani

    2016-01-01

    Full Text Available Gorlin syndrome is a rare autosomal dominant disorder which characterize by multi-organ abnormities such as odontogenic keratocysts in the jaw, skeletal abnormities and multiple basal cell carcinoma etc. We report a case of this syndrome in a young man with palmar pits, multiple facial BCC, clacifications of the falx cerebri and bifid rib.

  3. Nuclear Physics with RIB's: How it all started

    Science.gov (United States)

    Tanihata, Isao

    2016-04-01

    Neutron halos were discovered through measurements of interaction cross sections and fragmentation cross sections of nuclei near the neutron drip line. Such measurements became possible with the use of radioactive ion beams (RIBs) produced though projectile fragmentations of high-energy heavy-ion collisions. RIBs were invented 30 years ago at the Bevalac facility in Berkeley. In this article, I describe how they were invented and how neutron halos were discovered. What happened at that time was a series of small serendipities guiding us to the present prosperous field of RIB science.

  4. Treating craniofacial features and brain neurological symptoms resulting from cervical syndrome by knife acupuncture%颈椎综合征致头面五官和颅脑神经症状针刀治疗

    Institute of Scientific and Technical Information of China (English)

    张永锋

    2014-01-01

    目的:探讨针刀治疗颈椎源性头面五官和颅脑神经症状的临床治疗。方法:选取具有头面五官及颅脑神经临床症状且伴颈部症状体征患者,根据患痛部位不同,于寰筋膜、C2横突和关节突关节处以针刀常规治疗。结果:治愈率达78%~95%。结论:针刀治疗本病疗效显著,但要严格选好适应症。%Objective: To study clinical effects of knife acupuncture on craniofacial features and brain neurological symptoms resulting from cervical syndrome. Methods:All patients were given knife acupuncture at C2 transverse process and articular process joints according to the different parts of pain. Results: The curative rate was 78%~95%. Conclusion: Knife acupuncture was effective on craniofacial features and brain neurological symptoms resulting from cervical syndrome.

  5. Effect of rib angle on local heat/mass transfer distribution in a two-pass rib-roughened channel

    Science.gov (United States)

    Chandra, P. R.; Han, J. C.; Lau, S. C.

    1987-01-01

    The naphthalene sublimation technique is used to investigate the heat transfer characteristics of turbulent air flow in a two-pass channel. A test section that resembles the internal cooling passages of gas turbine airfoils is employed. The local Sherwood numbers on the ribbed walls were found to be 1.5-6.5 times those for a fully developed flow in a smooth square duct. Depending on the rib angle-of-attack and the Reynolds number, the average ribbed-wall Sherwood numbers were 2.5-3.5 times higher than the fully developed values.

  6. Rib gap anomaly in partial or mosaic trisomy 8

    Energy Technology Data Exchange (ETDEWEB)

    Kozlowski, K.; Collis, J.; Suter, M.; Sillence, D.

    1988-06-01

    Gaps in the first ribs were observed in two children, one with partial and the other with mosaic trisomy for chromosome 8. The sign may be considered in conjunction with other features as a relative indication for chromosomal studies.

  7. Effects of diaphragm stretching on posterior chain muscle kinematics and rib cage and abdominal excursion: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Francisco J. González-Álvarez

    2016-01-01

    Full Text Available ABSTRACT Background Few studies have explored the effects of stretching techniques on diaphragm and spine kinematics. Objective To determine whether the application of diaphragm stretching resulted in changes in posterior chain muscle kinematics and ribcage and abdominal excursion in healthy subjects. Method Eighty healthy adults were included in this randomized clinical trial. Participants were randomized into two groups: the experimental group, which received a diaphragmatic stretching technique, or the placebo group, which received a sham-ultrasound procedure. The duration of the technique, the position of participants, and the therapist who applied the technique were the same for both treatments. Participant assessment (cervical range of movement, lumbar flexibility, flexibility of the posterior chain, and rib cage and abdominal excursion was performed at baseline and immediately after the intervention by a blinded assessor. Results The mean between-group difference [95% CI] for the ribcage excursion after technique at xiphoid level was 2.48 [0.97 to 3.99], which shows significant differences in this outcome. The remaining between-group analysis showed significant differences in cervical extension, right and left flexion, flexibility of the posterior chain, and ribcage excursion at xiphoid level (p<0.05 in favor of the experimental group. Conclusion Diaphragm stretching generates a significant improvement in cervical extension, right and left cervical flexion, flexibility of the posterior chain, and ribcage excursion at xiphoid level compared to a placebo technique in healthy adults.

  8. Radiologic study of basal cell nevus syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Park, Tae Won [Dept. of Oral Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1988-11-15

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

  9. Post-accelerator LINAC design for the VECC RIB project

    Indian Academy of Sciences (India)

    Arup Bandyopadhyay

    2002-12-01

    Variable Energy Cyclotron Centre (VECC) is presently developing an ISOL post-acclerator type of RIB facility. The scheme utilises the existing = 130 room temperature variable energy cyclotron machine as the primary accelerator for the production of RIBs and radio frequency quadrupole (RFQ) and LINAC modules for the post-acceleration. The design aspects of these postaccelerator LINAC modules will be discussed in this paper.

  10. Lower thoracic rib stress fractures in baseball pitchers.

    Science.gov (United States)

    Gerrie, Brayden J; Harris, Joshua D; Lintner, David M; McCulloch, Patrick C

    2016-01-01

    Stress fractures of the first rib on the dominant throwing side are well-described in baseball pitchers; however, lower thoracic rib fractures are not commonly recognized. While common in other sports such as rowing, there is scant literature on these injuries in baseball. Intercostal muscle strains are commonly diagnosed in baseball pitchers and have a nearly identical presentation but also a highly variable healing time. The diagnosis of a rib stress fracture can predict a more protracted recovery. This case series presents two collegiate baseball pitchers on one team during the same season who were originally diagnosed with intercostal muscle strains, which following magnetic resonance imaging (MRI) were found to have actually sustained lower thoracic rib stress fractures. The first sustained a stress fracture of the posterior aspect of the right 8th rib on the dominant arm side, while the second presented with a left-sided 10th rib stress fracture on the nondominant arm side. In both cases, MRI was used to visualize the fractures as plain radiographs are insensitive and commonly negative early in patient presentation. Patients were treated with activity modification, and symptomatic management for 4-6 weeks with a graduated return to throwing and competition by 8-10 weeks. The repetitive high stresses incurred by pitching may cause either dominant or nondominant rib stress fractures and this should be included in the differential diagnosis of thoracic injuries in throwers. It is especially important that athletic trainers and team physicians consider this diagnosis, as rib fractures may have a protracted course and delayed return to play. Additionally, using the appropriate imaging techniques to establish an accurate diagnosis can help inform return-to-play decisions, which have important practical applications in baseball, such as roster management and eligibility.

  11. An analysis of 214 cases of rib fractures

    Directory of Open Access Journals (Sweden)

    Sule Karadayi

    2011-01-01

    Full Text Available INTRODUCTION: Rib fractures are the most common type of injury associated with trauma to the thorax. In this study, we investigated whether morbidity and mortality rates increased in correlation with the number of fractured ribs. MATERIALS AND METHODS: Data from 214 patients with rib fractures who applied or were referred to our clinic between January 2007 and December 2008 were retrospectively evaluated. The patients were allocated into three groups according to the number of fractures: 1 patients with an isolated rib fracture (RF1 (n = 50, 23.4%, 2 patients with two rib fractures (RF2 (n = 53, 24.8%, and 3 patients with more than two rib fractures (RF3 (n = 111, 51.9%. The patients were evaluated and compared according to the number of rib fractures, mean age, associated chest injuries (hemothorax, pneumothorax, and/or pulmonary contusion, and co-existing injuries to other systems. FINDINGS: The mean age of the patients was 51.5 years. The distribution of associated chest injuries was 30% in group RF1, 24.6% in group RF2, and 75.6% in group RF3 (p<0.05. Co-existing injuries to other systems were 24% in group RF1, 23.2% in group RF2, and 52.6% in group RF3 (p<0.05. Two patients (4% in group RF1, 2 patients (3.8% in group RF2, and 5 patients (4.5% in group RF3 (total n = 9; 4.2% died. CONCLUSION: Patients with any number of rib fractures should be carefully screened for co-existing injuries in other body systems and hospitalized to receive proper treatment.

  12. Rib Fracture Protocol Advancing the Care of the Elderly Patient.

    Science.gov (United States)

    Leininger, Susan

    This article discusses unique factors associated with rib fractures in the elderly patient population and explains the process used in one facility to develop a revised protocol for the management of elderly patients with a rib fracture. The goals were to eliminate gaps in early trauma care management and employ a care routine that would improve outcomes for this vulnerable group of patients with fracture.

  13. Current and emerging treatments and surgical interventions for Morquio A syndrome: a review

    Science.gov (United States)

    Tomatsu, Shunji; Mackenzie, William G; Theroux, Mary C; Mason, Robert W; Thacker, Mihir M; Shaffer, Thomas H; Montaño, Adriana M; Rowan, Daniel; Sly, William; Alméciga-Díaz, Carlos J; Barrera, Luis A; Chinen, Yasutsugu; Yasuda, Eriko; Ruhnke, Kristen; Suzuki, Yasuyuki; Orii, Tadao

    2013-01-01

    Patients with mucopolysaccharidosis type IVA (MPS IVA; Morquio A syndrome) have accumulation of the glycosaminoglycans, keratan sulfate, and chondroitin-6-sulfate, in bone and cartilage, causing systemic spondyloepiphyseal dysplasia. Features include lumbar gibbus, pectus carinatum, faring of the rib cage, marked short stature, cervical instability and stenosis, kyphoscoliosis, genu valgum, and laxity of joints. Generally, MPS IVA patients are wheelchair-bound as teenagers and do not survive beyond the second or third decade of life as a result of severe bone dysplasia, causing restrictive lung disease and airway narrowing, increasing potential for pneumonia and apnea; stenosis and instability of the upper cervical region; high risk during anesthesia administration due to narrowed airway as well as thoracoabdominal dysfunction; and surgical complications. Patients often need multiple surgical procedures, including cervical decompression and fusion, hip reconstruction and replacement, and femoral or tibial osteotomy, throughout their lifetime. Current measures to intervene in disease progression are largely palliative, and improved therapies are urgently needed. A clinical trial for enzyme replacement therapy (ERT) and an investigational trial for hematopoietic stem cell transplantation (HSCT) are underway. Whether sufficient enzyme will be delivered effectively to bone, especially cartilage (avascular region) to prevent the devastating skeletal dysplasias remains unclear. This review provides an overview of historical aspects of studies on MPS IVA, including clinical manifestations and pathogenesis of MPS IVA, orthopedic surgical interventions, and anesthetic care. It also describes perspectives on potential ERT, HSCT, and gene therapy. PMID:24839594

  14. Nail patela elbow syndrome

    Directory of Open Access Journals (Sweden)

    Jain V

    1990-01-01

    Full Text Available A 15 year old male having nail-patella elbow syndrome presented with deficient nail with pterygium formation rudimentry patellae, iliac horn, increased carrying angle of elbow joints and thickened ribs. Family history was suggestive of autosomal dominant inheritance.

  15. VTT's micron-scale silicon rib+strip waveguide platform

    Science.gov (United States)

    Aalto, Timo; Harjanne, Mikko; Cherchi, Matteo

    2016-05-01

    Silicon rib waveguides enable single-mode (SM) operation even with the combination of multi-micron core dimensions and high refractive index contrast. In such large waveguides the optical mode field is almost completely confined inside the Si core, which leads to small propagation losses and small polarization dependency. The unique SM condition of the rib waveguide also enables the use of an ultra-wide wavelength range, for example from 1.2 to <1.7 μm, without sacrificing either SM operation or low propagation loss. This makes micron-scale Si waveguides particularly well-suited for spectroscopy and extensive wavelength division multiplexing. However, rib waveguides require large bending radii, which lead to large circuit sizes. There are two solutions for this. So-called Euler bends in Si strip waveguides enable low-loss bends down to 1 μm bending radius with less than 0.1 dB/90° loss for both polarizations. Another alternative is a total-internal reflection mirror that can have loss as low as 0.1 dB for both polarizations in either strip or rib waveguides. The excitation of higher order modes in large strip waveguides is avoided by using adiabatic rib-strip converters and low-loss components. With rib and strip waveguides it is possible to reach a unique combination of low loss, extremely small footprint, small polarization dependency, ultra-wide bandwidth and tolerance to high optical powers.

  16. Cerebro-costo-mandibular syndrome: prognosis and proposal for classification.

    Science.gov (United States)

    Nagasawa, Hiroyuki; Yamamoto, Yutaka; Kohno, Yoshinori

    2010-09-01

    Cerebro-costo-mandibular syndrome (CCMS) is a very rare syndrome characterized by micrognathia and posterior rib gap, with a poor prognosis. To date, only 75 cases have been reported worldwide. The overall survival rate for patients with this disorder has not been reported, and a classification of the patients on the basis of the prognosis is not yet available. The present study analyzed the figures and prognoses of past patients and documented a new case of CCMS. Formerly published case reports and personal communications were used to reveal the prognosis and classification of CCMS. The occurrence ratios of rib gap defects and of missing ribs were examined. Patients were divided into the following three groups according to their life span: lethal type, where the patients died before 1 month; severe type, where the patients lived for 1-12 months; and mild type, where they survived for more than 1 year. A comparison was made of the number of rib gaps, missing ribs, and the rib gap ratio (defined as the number of rib gaps divided by the number of all existing ribs) among these three groups. A significant difference in the number of rib defects between the lethal type and other types was noted. Short life span of severe type patients, compared to mild type, was attributed to their subjection to severe respiratory infection. CCMS can be classified into three categories--lethal, severe, and mild--according to the severity of the symptoms and prognosis.

  17. Neurogenic bladder in Hunter's syndrome.

    Science.gov (United States)

    Koyama, K; Moda, Y; Sone, A; Tanaka, H; Hino, Y

    1994-01-01

    We encountered a rare patient with Hunter's syndrome who exhibited urinary retention as a result of a neurogenic bladder, uninhibited detrusor contractions, and detrusor-sphincter dyssynergia. Neurological findings were consistent with cervical myelopathy and cervical MR imaging showed very narrow segments at the cord level C2-4. We speculate that this Hunter's syndrome patient has cervical myelopathy and that this neurological dysfunction causes the neurogenic bladder. PMID:8014981

  18. A case report of a patient with Ribbing disease underlines the connections between the skeletal and cardiovascular complications

    Directory of Open Access Journals (Sweden)

    Giuseppe Cocco

    2011-07-01

    Full Text Available A 69-year-old woman suffered from Ribbing disease, a hereditary X autosomal dominant disease with multiple sclerosing dysplasias. However, it is less known that the genetic mutation can often induce cardiovascular complications. The patient had a hypertensive cardiopathy and had been treated with percutaneous coronary angioplasty and stenting because of a myocardial infarction. She was seen because of dyspnea and we detected an aneurysm of the ascending thoracic aorta. The patient underwent surgical repair. In Ribbing disease an up-regulation of genes interferes with the production, processing, or formation of collagen type II and XI. These genetic effects are thought to be specific for osteoblasts and are responsible for the skeletal pathology. However, the defective synthesis of collagen can also induce cardiovascular complications which may be similar to those described in patients with type III Ehlers-Danlos syndrome, with type IV Marfan syndrome, and with osteogenesis imperfecta. Rheumatologists who treat patients with Ribbing disease should seek the advice of cardiologists for the occurrence of cardiovascular complications.

  19. Occult rib fractures and brachial plexus injury following median sternotomy for open-heart operations.

    Science.gov (United States)

    Baisden, C E; Greenwald, L V; Symbas, P N

    1984-09-01

    The incidence and the sites of rib fractures during open-heart operations through a median sternotomy incision were studied in 36 consecutive patients divided into two groups. In Group 1 (24 patients), a conventional Ankeney retractor was used to expose the heart, and in Group 2 (12 patients), a similar retractor was used but with its uppermost pair of blades removed. Thorough physical examinations and preoperative and postoperative chest roentgenograms were obtained, and postoperative bone scans were done in all patients. No rib fractures were detected on the routine chest roentgenograms in patients in either group. Bone scans, however, showed 44 rib fractures (15 of the first rib, 13 of the second rib, 4 of the third rib, 6 of the fourth rib, 3 of the fifth rib, and 3 of the sixth rib) in 16 patients in Group 1. Six patients in Group 2 had 9 rib fractures (2 of the first rib, 4 of the second rib, and 1 each of the third, fifth, and sixth ribs). None of the patients in Group 2 had brachial plexus injury and neither of the first rib fractures in this group were located posteriorly, whereas 3 patients in Group 1 had both brachial plexus injury and posterior first rib fractures.

  20. Segmental anhidrosis with hyporeflexia associated with congenital spinal deformity: A Ross's syndrome variant or inverse Horner's syndrome?

    Directory of Open Access Journals (Sweden)

    Sawhney M

    2004-01-01

    Full Text Available A 39-year-old soldier presented with anhidrosis affecting both upper extremities below the shoulders, the right side of the trunk below the third rib in front and the third vertebra on the back, and the left lower extremity below the inguinal ligament since 1992. Ten years later in 2002, he was also found to have bilateral absence of Achilles reflex and decreased right knee jerk. In addition, the patient was found to have congenital spinal abnormalities in the form of block of vertebrae C3-C4; decreased disc space C4-C5; and break in pars interarticularis L5-S1 with decreased disc space. A total of seven cases of Ross syndrome, Holmes-Adie syndrome (tonic pupil with lost tendon jerks with segmental anhidrosis, have been described in the literature. Our case, however, did not have any pupillary abnormality. A case of progressive isolated segmental anhidrosis has also been described. The association of congenital spinal abnormality, which may be pathognomonic in the causation of this progressive sudomotor degeneration, is quite interesting in our case. The distribution of anhidrosis on the right side is just below the level of sweating loss sometimes described in lesions of superior sympathetic cervical ganglion in Horner's syndrome.

  1. Course prognosis of cervical osteochondrosis

    Directory of Open Access Journals (Sweden)

    Kolesov V.N.

    2012-06-01

    Full Text Available

    Today we can state that in spite of a considerable number of cervical osteochondrosis studies, there is a lack of research devoted to analysis of its course. There is no correlation between initial expert evaluations of cervical osteo-chondrosis cases and further course of pathological process. Goal of the research is to develop system of course prognosis of cervical osteochondrosis taking into account environmental infuence, heredity, living conditions, psychological profle of patient’s personality. Materials and methods. Dynamics of degenerative-dystrophic changes progressing of cervical vertebrae in 236 patients was analyzed. Results. Received data demonstrated that probability of stage I changing to stage II, III and IV depended on patients’ sex, age and type of labour activity, frequent supercooling and stress. Probability of fast progression of cervical osteochondrosis (5-year cycle of stage I changing to stage III and IV was to a great extent associated with heredity, urban living, presence of endocrine system diseases, syndrome of nonspecifc dysplasia of connective tissue and low indices of quality of life. Conclusion. Proposed system allows making prognosis of morphologic changes in spinal cord, and is based on radiation methods of verifcation without taking into consideration dynamics of neurological symptomatology.

  2. Muscle: Bone ratios in beef rib sections.

    Science.gov (United States)

    Dolezal, H G; Murphey, C E; Smith, G C; Carpenter, Z L; McCartor, M

    1982-01-01

    Thirty-eight steers and thirty heifers (14 to 17 months of age, from F(1) Hereford × Brahman cows bred to Angus or Hereford bulls), were either forage-fed for 123 days on millet-bermudagrass pasture or grain-fed for 90 days on a high-concentrate diet and were then commercially slaughtered. Warm carcass weights ranged from 167·8 kg to 324·3 kg. At 24 h post mortem, Texas Agricultural Experiment Station personnel (1) assigned scores or took measurements on each carcass for all factors used in yield grading and quality grading, (2) measured the length of hind leg (HL) and carcass length (CL) and (3) assigned a score for carcass muscling (MS) and, as appropriate, made an adjusted longissimus muscle area (ALA) evaluation. The 9th-10th-11th rib section from one side of each carcass was physically separated into longissimus muscle, fat, 'other soft tissue' and bone and ether extract determinations of the longissimus muscle and 'other soft tissue' components were made and used to adjust the yields of each of these components to a fat-free basis. Muscle to bone ratios ranged from 2·38 to 4·37. With both age and carcass weight held constant, diet, breed and sex explained only 35·8% of the variation in muscle to bone ratio. The best simple correlation with muscle to bone ratio was ALA/CL (r = ·59). Other measures significantly correlated with muscle to bone ratio included ALA (r = 0·55), MS (r = 0·50) and carcass weight (r = 0·49). Multiple regression analyses identified a three-variable subset comprised of ALA, carcass weight and CL which was related (P carcass measures useful for predicting muscle to bone ratio.

  3. Cervical Cancer Stage IVA

    Science.gov (United States)

    ... historical Searches are case-insensitive Cervical Cancer Stage IVA Add to My Pictures View /Download : Small: 756x576 ... Large: 3150x2400 View Download Title: Cervical Cancer Stage IVA Description: Stage IVA cervical cancer; drawing and inset ...

  4. Cerebro-costo-mandibular syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Flodmark, P. [Dept. of Diagnostic Radiology, Central Hospital Halmstad (Sweden); Wattsgaard, C. [Dept. of Diagnostic Radiology, Malmoe Univ. Hospital (Sweden)

    2001-01-01

    Cerebro-costo-mandibular syndrome is a rare disorder characterized by rib malformations, various degrees of cerebral maldevelopment, mental deficiency, palatal defects, and micrognatia. This syndrome was first described in 1966. The majority of cases are sporadic, but a few instances of familial occurrence have been reported, some with an autosomal recessive pattern of inheritance. Mortality in early age has been high, probably mostly due to respiratory insufficiency secondary to rib abnormalities and flail chest. We report a mother and son with this disorder, suggesting autosomal dominant transmission. (orig.)

  5. Analysis of the current rib support practices and techniques in U.S. coal mines

    Institute of Scientific and Technical Information of China (English)

    Mohamed Khaled M.; Murphy Michael M.; Lawson Heather E.; Klemetti Ted

    2016-01-01

    Design of rib support systems in U.S. coal mines is based primarily on local practices and experience. A better understanding of current rib support practices in U.S. coal mines is crucial for developing a sound engineering rib support design tool. The objective of this paper is to analyze the current practices of rib control in U.S. coal mines. Twenty underground coal mines were studied representing various coal basins, coal seams, geology, loading conditions, and rib control strategies. The key findings are:(1) any rib design guideline or tool should take into account external rib support as well as internal bolting;(2) rib bolts on their own cannot contain rib spall, especially in soft ribs subjected to significant load—external rib control devices such as mesh are required in such cases to contain rib sloughing;(3) the majority of the studied mines follow the overburden depth and entry height thresholds recommended by the Program Information Bulletin 11-29 issued by the Mine Safety and Health Administration;(4) potential rib insta-bility occurred when certain geological features prevailed—these include draw slate and/or bone coal near the rib/roof line, claystone partings, and soft coal bench overlain by rock strata;(5) 47%of the stud-ied rib spall was classified as blocky—this could indicate a high potential of rib hazards;and (6) rib injury rates of the studied mines for the last three years emphasize the need for more rib control management for mines operating at overburden depths between 152.4 m and 304.8 m.

  6. Lumbo-costo-vertebral syndrome with posterior spinal dysraphism.

    Science.gov (United States)

    Kumar, G Samson Sujit; Kulkarni, Vaijayantee; Haran, R P

    2005-09-01

    Lumbo-costo-vertebral syndrome, which includes abnormalities of the vertebral bodies, ribs and trunk musculature, is very rare and only few cases have been reported. We report a case of 18-month-old female child with absent ribs, hemivertebrae, superior lumbar hernia (features of lumbo-costo-vertebral syndrome) and posterior spinal dysraphism, which to our knowledge is the first case in the English literature with such a combination of defects. Embryology and management of the case is discussed.

  7. Effect of rib-cage structure on acoustic chest impedance

    DEFF Research Database (Denmark)

    Zimmermann, Niels Henrik; Møller, Henrik; Hansen, John;

    2011-01-01

    When a stethoscope is placed on the surface of the chest, the coupler picks up sound from heart and lungs transmitted through the tissues of the ribcage and from the surface of the skin. If the acoustic impedance of the chest surface is known, it is possible to optimize the coupler for picking up...... even weak sounds originating from e.g. the heart. The acoustic impedance is influenced by the structure of the ribcage; hence the acoustic impedance will change depending on if the coupler has been placed on a top of a rib or between the ribs (the intercostal). The impedance of the chest is measured...... in the frequency range from 40 Hz to 5 kHz using an acoustic impedance tube made specifically for the purpose. The measurements are carried out in a grid pattern on the surface of the chest. The grid is aligned according to the ribs; hence the measurements are either on a top of the ribs or between the ribs...

  8. Fabrication of Barrier Ribs for PDP by Capillary Infiltration Process and Their Sintering Behavior

    Institute of Scientific and Technical Information of China (English)

    Tae Jung Tang; Hak Nynu Choi; Chan Hyoung Kang; Yong Seog Kim

    2004-01-01

    Closed-cell type barrier ribs such as meander, honeycomb, SDR, and waffle types were produced using capillary molding process. Sintering of the ribs revealed that the ribs with asymmetric geometry such as meander and SDR type became distorted severely by the sintering process, but the ribs with symmetric geometry such as honeycomb and waffle type maintained their green state morphology. After sintering, the ribs were coated with green phosphor using osmosis coating process and its luminance characteristics were evaluated. The results indicated that the luminance and its efficiency is improved by using closed-cell type ribs with the new phosphor forming technology.

  9. Efficacy observation on treating vertigo from cervical syndrome in TCM integrative therapy%中医药综合治疗颈椎病眩晕症的疗效观察

    Institute of Scientific and Technical Information of China (English)

    贠霄

    2013-01-01

    Objective:To observe the clinical efficacy of Chinese medicine treatment on vertigo from cervical syndrome. Methods:The patients were orally given TCM herbs and traction and massage. 15 days in a course of treatment. Results:Of all the 86 patients, 26 cases were cured, 35 cases were markedly effective, 20 cases were effective, and 5 cases were invalid, with the total effective rate 94.2%. Conclusion:The TCM integrative trerapy was effective on vertigo from cervical symptoms, worthy a wide clinical application.%  目的:观察中医药综合疗法治疗颈椎病眩晕症状的临床疗效.方法:中药内服、牵引、推拿综合治疗,15d为1疗程,2个疗程后统计疗效.结果:86例患者中,临床结果痊愈26例,显效35例,有效20例,无效5例,总有效率94.2%.结论:中医综合疗法对治疗颈椎病眩晕症状疗效明显,值得临床推广.

  10. [Mucous diaphragm of the cervical esophagus. Apropos of 38 cases discovered during upper endoscopy at the General Hospital of Dakar. Relationship with the Kelly-Paterson or the Plummer-Vinson syndrome].

    Science.gov (United States)

    Peghini, M; Barabe, P G; Jean, P; Griffet, P; Eynard, J P; Mbaye, P S; Wade, B; Houenassi, M

    1989-01-01

    At the occasion of 15,000 high endoscopies performed during the past 5 years at the general Hospital of Dakar (Senegal) 38 mucous diaphragms of cervical esophagus were discovered. 36 patients are Black Senegalese; 29 females and 9 males with a mean age of 37. Dysphagia was present 29 times and anemia 22 times. Endoscopies diagnosis is easy, putting into light a mucous diaphragm at the level or immediately below Killian mouth. 18 of these cases have been classified as Kelly-Paterson syndrome. Performed in 30 patients, the treatment consists in breaking down the mucous diaphragm with an endoscope. It is difficult to keep on endoscopic monitoring, although it is essential because the risk of cancerisation.

  11. Shape Optimization of Inclined Ribs as Heat Transfer Augmentation Device

    Institute of Scientific and Technical Information of China (English)

    Kwang-Yong Kim; Hong-Min Kim

    2006-01-01

    This work presents numerical optimization techniques for the design of a rectangular channel with inclined ribs to enhance turbulent heat transfer.The response surface method with Reynolds-averaged Navier-Stokes analysis is used for optimization.Shear stress transport turbulence model is used as a turbulence closure.Computational results for local heat transfer rate show a reasonable agreement with the experimental data.Width-to-rib height ratio and attack angle of the rib are chosen as design variables.The objective function is defined as a linear combination of heat-transfer and friction-loss related terms with the weighting factor.Full-factorial experimental design method is used to determine the data points.Optimum shapes of the channel have been obtained in a range of the weighting factor.

  12. Cervical spine injury in the elderly: imaging features

    Energy Technology Data Exchange (ETDEWEB)

    Ehara, S. [Dept. of Radiology, Iwate Medical University School of Medicine, Morioka (Japan); Shimamura, Tadashi [Dept. of Orthopedic Surgery, Iwate Medical University School of Medicine, Morioka (Japan)

    2001-01-01

    An increase in the elderly population has resulted in an increased incidence of cervical spine injury in this group. No specific type of cervical spine trauma is seen in the elderly, although dens fractures are reported to be common. Hyperextension injuries due to falling and the resultant central cord syndrome in the mid and lower cervical segments due to decreased elasticity as a result of spondylosis may be also characteristic. The imaging features of cervical spine injury are often modified by associated spondylosis deformans, DISH and other systemic disorders. The value of MR imaging in such cases is emphasized. (orig.)

  13. Cervical vertigo%颈性眩晕

    Institute of Scientific and Technical Information of China (English)

    何及; 樊东升; 孙宇

    2011-01-01

    Cervical vertigo refers to a syndrome with a chief complaint of vertigo arising from cervical verteprae discomfort. In general, cervical vertigo is correlated with but not always caused by cervical spondylopathy,which mainly includes vertebral arterial and sympathetic cervical spondylosis. The vertebral artery insufficiency caused by compression from lateral displacement of the intervertebral dise is very rare, while the sympathetic cervical spondylosis caused by the vertebral instability is much more common. Rigorous criteria have been developed for diagnosis of the latter. Conservative therapy is mainly recommended for treatment of cervical vertigo.%颈性眩晕通常与颈椎病有关,但不一定完全由颈椎病所致.与颈性眩晕有关的主要是椎动脉型和交感型颈椎病.由椎间盘侧突压迫导致的椎动脉供血不足非常罕见,由椎体不稳引起的交感型颈椎病较多,但后者也有其严格的诊断标准.治疗以保守治疗为主.

  14. Acute rib fracture diagnosis in an infant by US: a matter of child protection

    Energy Technology Data Exchange (ETDEWEB)

    Kelloff, Jennifer; Spivey, Maria [Washington University School of Medicine, Department of Pediatrics, Section on Child Abuse and Neglect, St. Louis Children' s Hospital, One Children' s Place, Box 8116, St. Louis, MO (United States); Hulett, Rebecca [Washington University School of Medicine, Department of Radiology, St. Louis Children' s Hospital, St. Louis, MO (United States)

    2009-01-15

    Rib fractures in infants and children are highly specific for inflicted injury in the absence of a major accidental injury or underlying bone disorder. We present a 9-week-old infant diagnosed with an acute rib fracture by US at the site where physicians palpated chest wall crepitus when no rib fractures had been visualized on the skeletal survey, including oblique views of the ribs. Based on the US diagnosis of the acute rib fracture the infant was taken into protective custody. Follow-up skeletal survey 2 weeks later revealed healing fractures of the left 6th and 7th posterolateral ribs and right 7th, 8th and 9th anterolateral ribs. We were unable to locate previous reports describing the diagnosis of rib fractures in infants by US. (orig.)

  15. Microbiological Safety of Commercial Prime Rib Preparation Methods: Thermal Inactivation of Salmonella in Mechanically Tenderized Rib Eye.

    Science.gov (United States)

    Calle, Alexandra; Porto-Fett, Anna C S; Shoyer, Bradley A; Luchansky, John B; Thippareddi, Harshavardhan

    2015-12-01

    Boneless beef rib eye roasts were surface inoculated on the fat side with ca. 5.7 log CFU/g of a five-strain cocktail of Salmonella for subsequent searing, cooking, and warm holding using preparation methods practiced by restaurants surveyed in a medium-size Midwestern city. A portion of the inoculated roasts was then passed once through a mechanical blade tenderizer. For both intact and nonintact roasts, searing for 15 min at 260°C resulted in reductions in Salmonella populations of ca. 0.3 to 1.3 log CFU/g. For intact (nontenderized) rib eye roasts, cooking to internal temperatures of 37.8 or 48.9°C resulted in additional reductions of ca. 3.4 log CFU/g. For tenderized (nonintact) rib eye roasts, cooking to internal temperatures of 37.8 or 48.9°C resulted in additional reductions of ca. 3.1 or 3.4 log CFU/g, respectively. Pathogen populations remained relatively unchanged for intact roasts cooked to 37.8 or 48.9°C and for nonintact roasts cooked to 48.9°C when held at 60.0°C for up to 8 h. In contrast, pathogen populations increased ca. 2.0 log CFU/g in nonintact rib eye cooked to 37.8°C when held at 60.0°C for 8 h. Thus, cooking at low temperatures and extended holding at relatively low temperatures as evaluated herein may pose a food safety risk to consumers in terms of inadequate lethality and/or subsequent outgrowth of Salmonella, especially if nonintact rib eye is used in the preparation of prime rib, if on occasion appreciable populations of Salmonella are present in or on the meat, and/or if the meat is not cooked adequately throughout.

  16. Study on the Value of Displacement Technology in Identifying Carpal Tunnel Syndrome and Cervical SpondylosisRadiculopathy%位移技术对鉴别腕管综合征与神经根型颈椎病的价值

    Institute of Scientific and Technical Information of China (English)

    徐士军; 董晓柳; 李智琳; 杨建国; 孙玉会

    2015-01-01

    Objective To study the value of displacement technique in the identification of carpal tun-nel syndrome and cervical spondylosis radiculopathy.Me thods A total of 200 patients diagnosed as carpal tunnel syndrome or cervical spondylosis radiculopathy in Department of Rehabilitation Medicine , Tangshan People's Hospital from Jan.2010 to Oct.2012 were selected as research objects.Both motor nerve conduction velocity and displacement determination in conventional phase were analyzed .Results After diagnosed by displacement technique,among the 200 patients,73 cases had cervical spondylosis radiculopathy,accounting for 36.5%,75 cases had carpal tunnel syndrome, accounting for 37.5%, three cases had root merger of carpal tunnel syndrome,accounting for 1.5%,four cases had cubital tunnel syndrome,accounting for 2.0%, and there were 45 patients with no abnormality found,accounting for 22.5%.For patients with carpal tunnel syndrome,their sensory nerve conduction velocity of thumb was (28.7 ±0.3) m/s,that of the index finger was (31.5 ±0.4) m/s,and that of the middle finger was (32.2 ±0.5) m/s,the wrist incubation period was (4.8 ±1.9) m/s, the motor nerve conduction velocity was (60 ±5) m/s;for patients with cervical spondy-losis radiculopathy,indicators mentioned above respectively were (43.5 ±9.9) m/s,(46.7 ±15.0) m/s, (45.4 ±16.4) m/s,(3.6 ±0.4) m/s,and (63 ±5) m/s.There were statistically significant differences of those indicators between the two diseases( P<0.05 ) .Conclusion Displacement technology contributes to the identification of nerve block,so as to effectively distinguish carpal tunnel syndrome from cervical spondy-losis radiculopathy.%目的 研究位移技术对于鉴别腕管综合征与神经根型颈椎病的临床应用价值. 方法选取2010年1月至2012年10月唐山市人民医院康复医学科拟诊为神经根型颈椎病或腕管综合征的患者200例,均进行常规阶段的运动神经传导速度和位移技术测定. 结果

  17. 综合康复治疗颈椎病500例%General rehabilitation of the cervical syndrome in 500 cases

    Institute of Scientific and Technical Information of China (English)

    容国安

    2003-01-01

    @@ INTRODUCTION At present, the main therapy method to cure the cervical vertebradisease is the conservative treatment and surgical operation. For thelatter oue, the long-term results show that the post-operation adher-ence occured frequently and difficult to cure. In the recent years, thesynthetic re habilitation therapy has been applied in the treatment ofthe disease, such as traction, massage, medical practice, physiother-apy etc, which lead to good result.

  18. Single-transverse-mode Ti:sapphire rib waveguide laser

    NARCIS (Netherlands)

    Grivas, C.; Shepherd, D.P.; May-Smith, T.C.; Eason, R.W.; Pollnau, M.

    2005-01-01

    Laser operation of Ti:sapphire rib waveguides fabricated using photolithography and ion beam etching in pulsed laser deposited layers is reported. Polarized laser emission was observed at 792.5 nm with an absorbed pump power threshold of 265 mW, which is more than a factor of 2 lower in comparison t

  19. MULTIPLE OSSIFIED COSTAL CARTILAGES FOR 1ST RIB

    Directory of Open Access Journals (Sweden)

    Raghavendra D.R.

    2014-12-01

    Full Text Available Costal cartilages are flattened bars of hyaline cartilages. All ribs except the last two, join with the sternum through their respective costal cartilages directly or indirectly. During dissection for 1st MBBS students in the Department of Anatomy, JJMMC, Davangere, variation was found in a male cadaver aged 45 –50 years. Multiple ossified costal cartilages for 1st rib were present on left side. There were 3 costal cartilages connecting 1st rib to manubrium. There were two small intercostal spaces between them. The lower two small costal cartilages fused together to form a common segment which in turn fused with large upper costal cartilage. The large upper costal cartilage forms costochondral joint with 1st rib. All costal cartilages showed features of calcification. The present variation of multiple ossified costal cartilages are due to bifurcation of costal cartilage. It may cause musculoskeletal pain, intercostal nerve entrapment or vascular compression. Awareness of these anomalies are important for radiologists for diagnostic purpose and for surgeons for performing various clinical and surgical procedures.

  20. Nuclear Physics Programs for the Future RIBs Facility in Korea

    Institute of Scientific and Technical Information of China (English)

    Moon Chang-Bum

    2016-01-01

    We present nuclear physics programs based on the planned experiments using rare isotope beams (RIBs) for the future Korean Rare Isotope Beams Accelerator facility(KRIA). This ambitious facility has both an Isotope Separation On Line (ISOL) and fragmentation capability for producing RIBs and accelerating beams of wide range mass of nuclides with energies of a few to hundreds MeV per nucleon. Low energy RIBs at Elab = 5 to 20 MeV per nucleon are for the study of nuclear structure and nuclear astrophysics toward and beyond the drip lines while higher energy RIBs produced by in-flight fragmentation with the reaccelerated ions from the ISOL enable to explore the neutron drip lines in intermediate mass regions. The planned programs have goals for investigating internal structures of the exotic nuclei toward and beyond the nucleon drip lines by addressing the following issues: how the shell structure evolves in areas of extreme proton to neutron imbalance; whether the isospin symmetry maintains in isobaric mirror nuclei at and beyond the drip lines; how two-proton radioactivity affects abundances of the elements;what the role of the continuum states including resonant states above proton-decay threshold in exotic nuclei is in astrophysical nuclear reaction processes, and how the nuclear reaction rates triggered by unbound proton-rich nuclei make an effect on rapid proton capture processes in a very hot stellar plasma.

  1. Rib fracture in a horse during an endurance race.

    Science.gov (United States)

    Trigo, Pablo; Muñoz, Ana; Castejón, Francisco; Riber, Cristina; Hassel, Diana M

    2011-11-01

    We describe a fatal case, in which a horse suffered a fall and as a consequence, rib fractures. Diagnosis was made postmortem and the horse died without showing clear signs of respiratory dysfunction. The retrospective reports of injuries can be important to reduce these traumatic events and to avoid fatalities.

  2. ["True neurologic thoracic outlet syndrome" -- anatomical features and electrophysiological long-term follow-up of lateral thenar atrophy].

    Science.gov (United States)

    Hug, U; Jung, F J; Guggenheim, M; Wedler, V; Burg, D; Künzi, W

    2006-02-01

    Atrophies of the intrinsic muscles of the hand are considered to be a typical symptom of the "true neurologic" form of thoracic outlet syndrome (TOS). The classical form of this entity was described as early as 1970, consisting of a cervical rib or a prolonged transverse process of C7, complete with a fibrous band to the first thoracic rib, resulting in atrophy of the intrinsic muscles of the hand. All our TOS patients presenting with such atrophy displayed anatomical findings consistent with this definition. Based on this observation, the TOS classification currently in clinical use, which differentiates between "disputed" and "true neurologic" subgroups of the neurologic form, is reviewed. In all cases of "true neurologic TOS" with atrophy of the intrinsic muscles of the hand, the lateral thenar muscles are affected first. We present the electrophysiological long-term results of such thenar atrophies of seven patients with eight operated extremities after brachial plexus decompression. The amplitude of the neurographically measured potential over the opponens pollicis and the abductor pollicis brevis muscle, respectively, was defined as quantitative parameter for muscles atrophy. Neither distinct reinnervation nor progressive denervation was evident in any of the cases after a follow-up period, on average, of more than five years post surgery. These findings are in conflict with clinical observations reporting a major postoperative improvement of the motor deficits.

  3. Síndrome do disco adjacente à fusão (Síndrome de Transição na coluna cervical: resultados segundo critérios clínicos e radiológicos Síndrome del disco adyacente a la fusión (Síndrome de Transición en la columna cervical Adjacent segment disease (Transitional Syndrome in cervical spine: clinical and radiological results

    Directory of Open Access Journals (Sweden)

    Alexandre Meluzzi

    2010-03-01

    adyacente, se mostraron como los grandes factores de riesgo para el seguimiento.OBJECTIVE: the objective of this study was to identify the occurrence of adjacent disc syndrome secondary to intervertebral fusion in the cervical segment, and the predictors of outcome. METHODS: the medical records and imaging studies of 209 patients undergoing surgical treatment of cervical degenerative disease, with 169 cases treated through anterior approach and 40 cases through the posterior approach, at the HC-FMUSP from March 1993 to January 2007. Clinical evaluation was quantified by the scale of Japanese Orthopaedic Association (JOA, with an average follow-up of 80 months. The radiological analysis was based on the criteria of instability by White and Panjabi in all cases. The degeneration was measured by the scale of Kellgren before and after surgery. RESULTS: overall, the syndrome of adjacent disc was diagnosed in 30 cases (17.75%, with a mean time interval of incidence of 28.5 months after the merger, or 2.9 cases per year. There was an increase in degenerative changes in X-rays at levels adjacent to anterior fusion in 41.42% and 52.5% for the posterior without fusion, evaluated by the scale of Kellgren, the degeneration rate of 6.7% per annum, with no correlation with clinical changes. CONCLUSIONS: changes in physiological sagittal alignment of the spine and their severity predispose to the development of the syndrome. There was no incidence of the syndrome in cases of pseudoarthrosis or methacrylate, therefore, where there was a merger. The use of decompression and fusion, anterior, is associated with the possibility of developing a new framework for myeloradiculopathy in the postoperative period. Merger at a level that involve the fifth or sixth cervical vertebra, fixation with plates and pre-existing radiographic evidence of disc degeneration adjacent were factors of high risk for its emergence.

  4. Shanidar 3 Neandertal rib puncture wound and paleolithic weaponry.

    Science.gov (United States)

    Churchill, Steven E; Franciscus, Robert G; McKean-Peraza, Hilary A; Daniel, Julie A; Warren, Brittany R

    2009-08-01

    Since its discovery and initial description in the 1960s, the penetrating lesion to the left ninth rib of the Shanidar 3 Neandertal has been a focus for discussion about interpersonal violence and weapon technology in the Middle Paleolithic. Recent experimental studies using lithic points on animal targets suggest that aspects of weapon system dynamics can be inferred from the form of the bony lesions they produce. Thus, to better understand the circumstances surrounding the traumatic injury suffered by Shanidar 3, we conducted controlled stabbing experiments with replicas of Mousterian and Levallois points directed against the thoraces of pig carcasses. Stabs were conducted under both high and low kinetic energy conditions, in an effort to replicate the usual impact forces associated with thrusting spear vs. long-range projectile weapon systems, respectively. Analysis of the lesions produced in the pig ribs, along with examination of goat ribs subjected primarily to high kinetic energy stabs from an independent experiment, revealed consistent differences in damage patterns between the two conditions. In the case of Shanidar 3, the lack of major involvement of more than one rib, the lack of fracturing of the affected and adjacent ribs, and the lack of bony defects associated with the lesion (such as wastage, hinging, and radiating fracture lines) suggests that the weapon that wounded him was carrying relatively low kinetic energy. While accidental injury or attack with a thrusting spear or knife cannot absolutely be ruled out, the position, angulation, and morphology of the lesion is most consistent with injury by a low-mass, low-kinetic energy projectile weapon. Given the potential temporal overlap of Shanidar 3 with early modern humans in western Asia, and the possibility that the latter were armed with projectile weapon systems, this case carries more than simple paleoforensic interest.

  5. Contribuição ao estudo das malformações occipito-cervical, particularmente da impressão basilar

    Directory of Open Access Journals (Sweden)

    Horacio M. Canelas

    1952-12-01

    Full Text Available The authors outline the development of the spine and skull, particularly of axis, atlas and occipital bone. As neuro-skeletal dysmorphisms, the occipito-cervical malformations belong to the neurodysplastic group. They are classified as skeletal anomalies, associated nervous malformations and meningeal reactions. Vertebralization of the occipital bone and occipitalization of atlas, subluxation of odontoid process, dysplasia of the occipital bone, dystrophia brevicollis and other anomalies are discussed. Special care is given to the study of basilar impression; its concept, history, incidence, clinical and neurological symptoms, radiological characterization (craniographic, perimyelographic and iodoventriculographic aspects and surgical treatment are reviewed. The authors report five cases of occipito-cervical malformations, which are the first references in Brazilian literature. In case 1 the anomalies (manifestation of occipital vertebra and Arnold-Chiari deformity were disclosed at an operation for cisticercosis of the posterior fossa. In the following four cases invagination of the basilar portion of the occipital bone (basilar impression could be radiologically demonstrated; in case 2 a suboccipital craniectomy and a laminectomy of atlas and axis were performed but the patient died a week later and the necroscopic examination confirmed the neuro-skeletal anomalies. In all cases there were several associated malformations. In case 2 there were occipitalization of the atlas, fusion of the first and second cervical vertebrae, supernumerary rib of the seventh cervical vertebra, supernumerary lumbar vertebra, and Arnold-Chiari deformity; at necropsy it was found a syringomyelic cyst on the cervical cord and a fibrous dural ring over the foramen magnum. Case 3 showed the syndrome of Klippel-Feil, besides supernumerary ribs of the seventh cervical and first dorsal vertebrae, Arnold-Chiari malfotmation and probable aplasia of cell groups in the

  6. Cervical cancer - screening and prevention

    Science.gov (United States)

    Cancer cervix - screening; HPV - cervical cancer screening; Dysplasia - cervical cancer screening; Cervical cancer - HPV vaccine ... Almost all cervical cancers are caused by HPV (human papilloma virus). HPV is a common virus that spreads through sexual contact. Certain ...

  7. First rib metamorphosis: its possible utility for human age-at-death estimation.

    Science.gov (United States)

    Kunos, C A; Simpson, S W; Russell, K F; Hershkovitz, I

    1999-11-01

    Human first ribs demonstrate predictable, sequential changes in shape, size, and texture with increasing age, and thus, can be used as an indicator of age at death. Metamorphosis of the first rib's head, tubercle, and costal face was documented in a cross-sectional sample of preadult and adult first ribs of known age at death from the Hamann-Todd skeletal collection (Cleveland Museum of Natural History, Cleveland, Ohio). Blind tests of the usefulness of the first rib as an age indicator were conducted, including tabulation of intraobserver and interobserver inaccuracies and biases. First rib age estimates show inaccuracies and biases by decade comparable to those generated by other aging techniques. Indeed, the first rib method is useful as an isolated age indicator. When used in conjunction with other age indicators, the first rib improves the quality of summary age assessments.

  8. Heat Transfer Augmentation in Developing Flow Through a Ribbed Square Duct

    Institute of Scientific and Technical Information of China (English)

    Khan R K; Ali M.A.T; Akhanda M.A.R

    2006-01-01

    An experimental study is conducted to investigate the heat transfer augmentation in developing turbulent flow through a ribbed square duct. The duct is made of 16mm thick bakelite sheet. The bottom surface of the ribbed wall having rib pitch to height ratio of 10 is heated by passing a c current to the heater placed under it. The uniform heating is controlled using a digital temperature controller and a variac. The results of ribbed duct are compared with the results of a smooth duct under the same experimental conditions. It is observed that the heat transfer augmentation in ribbed duct is better than that of the smooth duct. At Re=5.0 × 104 , the mean temperature of air flowing through the ribbed duct increases by 2.45 percent over the smooth duct, whereas in the ribbed duct Nusselt number increases by 15.14 percent than that of the smooth duct with a 6 percent increase in pressure drop.

  9. Syndrome in question: Gorlin-Goltz syndrome*

    Science.gov (United States)

    Ribeiro, Pauline Lyrio; de Souza Filho, João Basílio; de Abreu, Karina Demoner; Brezinscki, Marisa Simon; Pignaton, Christine Chambo

    2016-01-01

    The Nevoid Basal Cell Carcinoma Syndrome (NBCCS) is an uncommon disorder caused by a mutation in Patched, tumor suppressor gene. It is mainly characterized by numerous early onset basal cell carcinomas, odontogenic cysts of jaw and skeletal abnormalities. Due to the wide clinical spectrum, treatment and management of its modalities are not standardized and should be individualized and monitored by a multidisciplinary team. We report a typical case in a 30-year-old man with multiple basal cell carcinomas, keratotic pits of palmar creases and bifid ribs, with a history of several corrective surgeries for keratocystic odontogenic tumors, among other lesions characteristic of the syndrome. PMID:27579759

  10. 针药并用对风寒阻络证颈型颈椎病患者中医证候及颈痛量表评分的影响%Effects of Acupuncture Combined with Traditional Chinese Medicine on Scores of TCM Syndrome and Neck Pain Questionnaire in Patients with Cervical Spondylosis with Syndrome of Cold Locking the Collaterals

    Institute of Scientific and Technical Information of China (English)

    冯少玲; 李文纯

    2015-01-01

    目的:观察针药并用对风寒阻络证颈型颈椎病患者中医证候评分及颈痛量表(NPQ)评分的影响。方法将90例纳入患者按随机数字表法分为针药组、中药组和针刺组,每组30例。针药组予桂枝加葛根汤加减方和电针治疗,中药组予桂枝加葛根汤加减方治疗,针刺组予电针治疗。观察治疗前后3组患者中医证候评分及NPQ评分变化,进行对比分析。结果针药组治疗前后中医证候评分及NPQ评分差值均高于针刺组、中药组,差异有统计学意义(P<0.05);针刺组和中药组之间中医证候评分及NPQ评分差值比较差异无统计学意义(P>0.05)。结论针药并用能缓解风寒阻络证颈型颈椎病患者的中医证候,减轻颈部疼痛,改善颈部功能状态。%Objective To observe the effects of acupuncture combined with traditional Chinese medicine on scores of TCM syndrome and Neck Pain Questionnaire (NPQ) in patients of cervical spondylosis with syndrome of cold locking the collaterals. Methods Ninety cases of patients were randomly divided into acupuncture combined with TCM group, TCM group, and acupuncture group, 30 cases in each group. The acupuncture combined with TCM group was given modified Guizhi plus Gegen decoction and electro acupuncture;the TCM group was given modified Guizhi plus Gegen decoction only;the acupuncture group was given electro acupuncture only. The scores of TCM syndrome and NPQ of the three groups were observed and analyzed comparatively. Results The deviation scores of TCM syndrome and NPQ before and after treatment of the acupuncture combined with TCM group were higher than the acupuncture group and the TCM group (P0.05). Conclusion Acupuncture combined with traditional Chinese medicine can relieve clinical symptoms of patients with cervical spondylosis with syndrome of cold locking the collaterals, ease their cervical pain, and improve their cervical function.

  11. Cervical Cancer Screening

    Science.gov (United States)

    ... Cancer found early may be easier to treat. Cervical cancer screening is usually part of a woman's health ... may do more tests, such as a biopsy. Cervical cancer screening has risks. The results can sometimes be ...

  12. Cervical Cancer Screening

    Science.gov (United States)

    ... are at increased risk for HPV infections. Other risk factors for cervical cancer include: Giving birth to many children. Smoking cigarettes. Using oral contraceptives ("the Pill"). Having a weakened immune system . Cervical Cancer Screening ...

  13. Cervical Cancer Stage IVB

    Science.gov (United States)

    ... of the body, such as the lymph nodes, lung, liver, intestine, or bone. Stage IVB cervical cancer. Topics/Categories: Anatomy -- Gynecologic Cancer Types -- Cervical Cancer Staging Type: Color, ...

  14. 从痹症论治椎间盘源性颈痛(附病案分析)%Through the Bi Syndrome to Treat the Cervical Discogenic Pain

    Institute of Scientific and Technical Information of China (English)

    陈舰舰; 孙道喜; 周临东; 谢林

    2013-01-01

    [Objective] Through the Bi syndrome to treat the cervical discogenic pain.[Methods] In traditional Chinese medicine theory, through the guid-ance of Huo-Xue-Shu-Jin decoction(spatholobus suberectus, herba lycopodii, myrrh, dipsacus, eupolyphaga etc.) to treat intervertebral discogenic neck pain early. [Results] Using the therapeutic principles of activating blood and relaxing muscle-tendon and dispel ing exogenous pathogen and dredging col-laterals to govern the discogenic neck pain, VAS pain score decreased and obtained the satisfactory effectiveness. [Conclusion] With the premise of concept of wholism and syndrome differentiation treatment, the fundamental therapeutic method of activating blood and relaxing muscle-tendon and dredging channels and col aterals can relieve the cervical discogenic pain.%[目的]探讨以痹症论治椎间盘源性颈痛的机理与疗效。[方法]在中医传统理论指导下,通过分析痹症病因及病机特点、痹症与椎间盘源性颈痛的关系,阐述以痹症治疗椎间盘源性颈痛的机理,并以1个案例举例论证活血舒筋药物(鸡血藤、伸筋草、没药、续断、土鳖虫等)早期干预治疗椎间盘源性颈痛的效果。[结果]运用活血舒筋、祛邪通络治法对椎间盘源性颈痛进行治疗后,VAS疼痛评分降低,取得满意的效果。[结论]在整体观念和辨证论治的前提下,以活血舒筋通络、温通经脉止痛为基本治法能缓解椎间盘源性颈痛。

  15. Nonepiphyseal Giant Cell Tumor of the Rib: A Case Report

    Directory of Open Access Journals (Sweden)

    Hippocrates Moschouris

    2012-01-01

    Full Text Available A case of a 32-year-old female patient with a giant cell tumor originating in the middle part of the left 10th rib is presented. On X-rays and CT, the tumor caused a well-defined osteolysis with nonsclerotic borders. On MRI, it exhibited intermediate signal intensity on T1 sequences and central high signal and peripheral intermediate signal on T2 sequences. On contrast-enhanced MR images both central and peripheral-periosteal enhancement was noted. Thanks to its small size ( cm, the lesion was easily resected en bloc with a part of the affected rib. The patient is free of recurrence for 3 years after the operation.

  16. Gorlin-Goltz syndrome: A rare case

    Directory of Open Access Journals (Sweden)

    Satyaki Ganguly

    2015-01-01

    Full Text Available Gorlin-Goltz syndrome or nevoid basal cell carcinoma syndrome is characterized by multiple basocellular epitheliomas, keratocysts in the jaws, bifid ribs, palmar and/or plantar pits and ectopic calcifications of the falx cerebri. We describe a case of Gorlin-Goltz syndrome illustrating the importance of a thorough examination including the examination of palms and soles and detailed investigations in a patient having lesions suggestive of basal cell carcinoma and multiple naevi.

  17. Gorlin-goltz syndrome: a rare case.

    Science.gov (United States)

    Ganguly, Satyaki; Jaykar, Kranti C; Kumar, Rajesh; Jha, Abhijeet Kumar; Banerjee, P K

    2015-01-01

    Gorlin-Goltz syndrome or nevoid basal cell carcinoma syndrome is characterized by multiple basocellular epitheliomas, keratocysts in the jaws, bifid ribs, palmar and/or plantar pits and ectopic calcifications of the falx cerebri. We describe a case of Gorlin-Goltz syndrome illustrating the importance of a thorough examination including the examination of palms and soles and detailed investigations in a patient having lesions suggestive of basal cell carcinoma and multiple naevi.

  18. Nevoid basal cell carcinoma syndrome

    Directory of Open Access Journals (Sweden)

    Kannan Karthiga

    2006-01-01

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

  19. The effect of spacer ribs on Ledinegg type flow instabilities

    Energy Technology Data Exchange (ETDEWEB)

    Coutts, D.A.

    1993-09-09

    An experimental program has been completed which evaluated the effect of a flow obstruction in a heated channel on the onset of flow instability (OBI). The test channel was rectangular (80 {times} 3 mm), heated on one surface, and equipped with view ports. Tests were conducted in a flow controlled mode at heat fluxes of 370 kW/M{sup 2}, and 610 kW/m{sup 2}. Direct comparisons were made between the demand curve minimum for the unobstructed channel and a channel equipped with a 2.07 mm wide rib that was parallel to the flow and in contact with the heated surface. Data at OFI is presented in the nondimensional terms Of Q{sub ratio} (ratio of heat flux applied to heat flux required to achieve saturated liquid conditions at the exit), and the local Stanton number at the channel exit for each channel arrangement. The Q{sub ratio} and Stanton number values for the unobstructed channel and the rib equipped channel are then compared to produce an estimate of the rib effect.

  20. Cytokeratin - positive rib osteosarcoma metastasizing to the small intestine

    Directory of Open Access Journals (Sweden)

    Hiroko Kuwabara

    2014-01-01

    Full Text Available Osteosarcoma (OS is a malignant tumor in which osteoid or bone is produced directly by tumor cells. Some OS cells are positive for cytokeratin (CK and epithelial membrane antigen by immunohistochemistry (IHC and this may lead to a misdiagnosis of metastatic carcinoma, particularly when the tumor location is unusual. On the other hand, gastrointestinal metastasis of OS is rare. We present the case of a 67-year-old Japanese man with a small intestinal intussusception due to metastasis of a CK-positive rib OS. The tumor cells were positive for CK, osteopontin and osteonectin by IHC and a diagnosis of a CK-positive chest wall OS metastasizing to the small intestine was considered. Osteoid or bone formation was histologically absent and therefore chest wall OS had to be differentially diagnosed from metastatic carcinoma of unknown origin. A postmortem histological analysis confirmed a rib OS. Awareness of CK-positive OS is important for making a correct diagnosis and for disease management and an immunohistochemical analysis of the tumor for expression of osteopontin and osteonectin may be used to support the diagnosis. In addition, this case shows that rib OS can metastasize to the gastrointestinal tract, albeit rarely, which may induce an intestinal intussusception.

  1. LDA - Measurements of Transitional Flows Induced by a Square Rib

    Energy Technology Data Exchange (ETDEWEB)

    Becker, S.; Durst, F.; Stoots, Carl Marcel; Condie, Keith Glenn; McEligot, Donald Marinus

    2002-03-01

    New fundamental measurements are presented for the transition process in flat plate boundary layers downstream of two-dimensional square ribs. By use of laser Doppler anemometry (LDA) and a large Matched-Index-of-Refraction (MIR) flow system, data for wall-normal fluctuations and Reynolds stresses were obtained in the near wall region to y+<0.1 in addition to the usual mean streamwise velocity component and its fluctuation. By varying velocity and rib height, the experiment investigated the following range of conditions: k+ = 5.5 to 21, 0.3rib. For "large" elements, evolution of turbulent statistics of the viscous layer for a turbulent boundary layer (y+<~30) was rapid even in flows where the mean velocity profile still showed laminar behavior.

  2. Heat transfer and friction factors in the ribbed square convergent and divergent channels

    Science.gov (United States)

    Lee, M. S.; Ahn, S. W.

    2016-06-01

    Heat transfer and friction factors are reported for the measurements of turbulent flows in the convergent and divergent square channels with one-sided ribbed wall as well as two opposite in-line ribbed walls. The study covers three different hydraulic diameter ratios between inlet and exit at the test section such as Dho/Dhi = 0.75, 1.0, and 1.33 and Reynolds numbers in the range of 25,000-79,000. The channels, composing of ten isolated copper sections in the length of test section of 1 m, have the hydraulic diameter of 87.5 mm for the straight channel (Dho/Dhi = 1.0); the rib height-to-hydraulic diameter is 0.114; the rib pitch-to-height ratio equals 10. On the contrary to public opinion that the friction factor depends on the portion of the ribbed area, the total friction factor in the two opposite ribbed walls are lower than in the one-sided ribbed wall in the divergent channel of Dho/Dhi = 1.33 because the total pressure, summing positive dynamic and negative static pressures, is acted. The results show that the two opposite ribbed divergent channel of Dho/Dhi = 1.33 provides the best heat transfer enhancement and the two opposite ribbed convergent channel of Dho/Dhi = 0.75 provides the worst friction factor enhancement, and the ribbed divergent channels are generally recommended.

  3. 小儿脊柱侧弯并发剃刀背畸形的矫治%Treatment of rib prominence scoliosis in children

    Institute of Scientific and Technical Information of China (English)

    孙琳; 于凤章; 潘少川; 张学军; 李承鑫; 马军; 赵华

    2001-01-01

    目的 矫正脊柱侧弯患儿的肋骨剃刀背畸形。方法 在实行后路脊柱侧弯矫形及脊柱融合术时,采用凸侧多节短段肋骨切除术同时矫治剃刀背及术后佩带矫形石膏或支具背心,更为有利。结果 1997年9月至1999年6月共有49例脊柱侧弯患儿施行剃刀背矫形术,未发生气胸、胸膜破裂等并发症,有3例患儿遗有残余剃刀背,其余患儿矫形效果均满意。结论 多节短段肋骨切除术是一种简便有效、安全的方法。在矫形剃刀背的同时,还可提供脊柱融合的植骨材料,免去髂骨取骨。%Objective In order to correct the rib prominence scoliosis inchildren .Methods From 1997 to 1999, 49 children with congenital scoliosis(27), idiopathic scoliosis(15), neurofibromatosis with scoliosis(6) and Marfan's syndrome with scoliosis(1) were treated. Rib resection was performed during the posterior spinal fusion on scoliosis, the spinal orthosis was applied postoperatively. Results No pneumothorax was happened postoperatively . All cases got satisfactory cosmetic appearance except 3 had residual rib prominence. Conclusions Multiple short segment costectomy is a safe and effective technique for the rib deformity in children with scoliosis. The resected ribs could provide the bone grafting for spinal fusion.

  4. Unilateral chest wall anomaly in a patient with Gardner' s syndrome: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Song, Eun Hee; Lee, So Yeon; Park, Hee Jin; Kwon, Heon Ju; Kim, Mi Sung; Park, Hae Won; Kwang, Hyon Joo [Dept. of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Hye Jin [Dept. of Radiology, Eulji General Hospital, Eulji University School of Medicine, Seoul (Korea, Republic of)

    2014-05-15

    Gardner syndrome is a familial disease consisting of colonic polyposis, osteomas, and soft tissue tumors. We describe unilateral chest wall anomaly in a 32-year-old man with Gardner syndrome. A chest radiograph showed asymmetric hypertrophy of the right seventh to tenth ribs. CT images showed increased size of the medullary portions of these lesions, but relatively normal thickness of the cortex. Intercostal muscles along the right seventh to tenth ribs were hypertrophied as compared with the contralateral ribs. Both lungs were clear but the volume of right lung showed slightly smaller than left one.

  5. Vestibular Barre Syndrome and Lieou

    OpenAIRE

    Aniya, Julio; Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú

    2014-01-01

    Barré syndrome and Lieou of vestibular origin, is characterized by a vertiginous symptomatology box , accompanied by disorders of neuro- vegetative type ; which is often confused with Meniere's Syndrome and other neurolóciccs entities. The cause of this condition lies in a cervical disc disease at C5- C6 level of understanding that phenomena on the sympathetic peri -arterial -cervical vertebral artery disorders will produce reflections at the maze , preferably ; or of the vestibular nuclei . ...

  6. Diaphragm paralysis from cervical disc lesions.

    Science.gov (United States)

    Cloward, R B

    1988-01-01

    An opera singer, who "made her living with her diaphragm", developed a post-traumatic unilateral radiculopathy due to cervical disc lesions, C3 to C6. During one year of severe neck and left arm pain she gradually lost the ability to sing difficult operatic passages which brought an end to her music career. Following a three level anterior cervical decompression and fusion, the neck and arm pain was immediately relieved. One week later her voice and singing ability returned to its full strength and power permitting her to resume her activities as a vocalist. The diagnosis of paresis of the left hemi-diaphragm as part of the cervical disc syndrome was implied by postoperative retrospective inference.

  7. [PFAPA syndrome].

    Science.gov (United States)

    André, Suzete Costa Anjos; Vales, Fernando; Cardoso, Eduardo; Santos, Margarida

    2009-01-01

    PFAPA syndrome is characterized by periodic fever, pharyngitis, cervical adenitis and aphthous stomatitis. The bouts of fever can last for days or even weeks. Between crises, patients remain asymptomatic for variable periods. It appears before the age of five and has limited duration (4-8 years). Its aetiopathogeny is unknown. Corticoids are the treatment of choice. Tonsillectomy has been proposed as a solution but remains controversial. We present the case of a 4-year-old girl with PFAPA syndrome who underwent tonsillectomy in January, 2008, and we review the literature.

  8. Multimodality imaging of Poland syndrome with dextrocardia and limb anomalies.

    Science.gov (United States)

    Iyer, Ramesh S; Parisi, Marguerite T

    2012-08-01

    Poland syndrome is a rare disorder featuring unilateral anterior thoracic and upper extremity anomalies. These include hypoplasia of the pectoralis major costosternal head, absent pectoralis minor, breast hypoplasia, and absent upper rib cartilage. Pulmonary hypoplasia may occur secondarily. The postulated etiology is underdevelopment of the subclavian artery. Less than 50 cases of Poland syndrome with dextrocardia have been reported. Rib anomalies cause rightward cardiac displacement in fetal life. This case of left-sided Poland syndrome in a young girl is unique not only because of dextrocardia, but also because the condition preferentially afflicts the right side and males.

  9. Anterior cervical plating

    Directory of Open Access Journals (Sweden)

    Gonugunta V

    2005-01-01

    Full Text Available Although anterior cervical instrumentation was initially used in cervical trauma, because of obvious benefits, indications for its use have been expanded over time to degenerative cases as well as tumor and infection of the cervical spine. Along with a threefold increase in incidence of cervical fusion surgery, implant designs have evolved over the last three decades. Observation of graft subsidence and phenomenon of stress shielding led to the development of the new generation dynamic anterior cervical plating systems. Anterior cervical plating does not conclusively improve clinical outcome of the patients, but certainly enhances the efficacy of autograft and allograft fusion and lessens the rate of pseudoarthrosis and kyphosis after multilevel discectomy and fusions. A review of biomechanics, surgical technique, indications, complications and results of various anterior cervical plating systems is presented here to enable clinicians to select the appropriate construct design.

  10. Schwanomma From Cervical Sympathetic Chain Ganglion - A Rare Presentation.

    Science.gov (United States)

    Asma, A Affee; Kannah, E

    2015-10-01

    Schwanommas arising from cervical sympathetic chain are tumours that are rare in occurrence. These lesions are usually difficult to differentiate from a vagal schwanomma and a carotid body tumour during the initial workup. In this report, a rarely seen huge cervical sympathetic chain schwanomma case with partial Horner's syndrome is being presented in detail, which to our known knowledge, is one of the few cases reported in literature.

  11. Rib tumor-induced osteomalacia:1 case report%肋骨肿瘤致低磷性骨软化症一例报告

    Institute of Scientific and Technical Information of China (English)

    沈荣凯; 方凯彬; 张文明; 林建华

    2015-01-01

    Tumor-induced osteomalacia ( TIO ) is a rare paraneoplastic syndrome resulting in renal phosphate wasting and decreased bone mineralization. Nonspeciifc symptoms including fatigue, bone pain, and musculoskeletal weakness make the diagnosis elusive and often lead to a delay in treatment. The prognosis of TIO is excellent following complete resection of the neoplasm, which leads to a rapid and complete reversal of all symptoms. If the tumor cannot be detected, treatment relies on supplementation with phosphate and active vitamin D compounds. We report a case of rib tumors presenting a long history of progressively worsening muscular pain and weakness, and limitation in the motion and function of multiple joints. To our knowledge, this is the ifrst case of rib tumor-related hypophosphatemic osteomalacia reported in the literature. Our aim is to make physicians realize that any patient with unexplained muscular weakness and pain must undergo workup for TIO, including serum phosphate measurement, as this is a rare but potentially curable disease.

  12. Effect of Channel Orientation and Rib Pitch-to-Height Ratio on Pressure Drop in a Rotating Square Channel with Ribs on Two Opposite Surfaces

    Directory of Open Access Journals (Sweden)

    Prabhu S. V.

    2005-01-01

    Full Text Available The effect of channel orientation and rib pitch-to-height ratio on the pressure drop distribution in a rib-roughened channel is an important issue in turbine blade cooling. The present investigation is a study of the overall pressure drop distribution in a square cross-sectioned channel, with rib turbulators, rotating about an axis normal to the free stream. The ribs are configured in a symmetric arrangement on two opposite surfaces with a rib angle of 90 ∘ to the mainstream flow. The study has been conducted for three Reynolds numbers, namely, 13 000, 17 000, and 22 000 with the rotation number varying from 0– 0.38 . Experiments have been carried out for various rib pitch-to-height ratios ( P/e with a constant rib height-to-hydraulic diameter ratio ( e/D of 0.1 . The test section in which the ribs are placed on the leading and trailing surfaces is considered as the base case ( orientation angle= 0 ∘ , Coriolis force vector normal to the ribbed surfaces. The channel is turned about its axis in steps of 15 ∘ to vary the orientation angle from 0 ∘ to 90 ∘ . The overall pressure drop does not change considerably under conditions of rotation for the base case. However, for the other cases tested, it is observed that the overall pressure drop increases with an increase in the rotation number for a given orientation angle and also increases with an increase in the orientation angle for a given rotation number. This change is attributed to the variation in the separation zone downstream of the ribs due to the presence of the Coriolis force—local pressure drop data is presented which supports this idea. At an orientation angle of 90 ∘ (ribs on the top and bottom surfaces, Coriolis force vector normal to the smooth surfaces, the overall pressure drop is observed to be maximum during rotation. The overall pressure drop for a case with a rib pitch-to-height ratio of 5 on both surfaces is found to be the highest

  13. Laparoscopic lumbar hernia repair in a child with lumbocostovertebral syndrome.

    Science.gov (United States)

    Jones, Sarah L; Thomas, Iona; Hamill, James

    2010-02-01

    Lumbocostovertebral syndrome is the association of a congenital lumbar hernia with rib and vertebral anomalies. We report the first case of a laparoscopic repair of a lumbar hernia in a child with lumbocostovertebral syndrome. Laparoscopic lumbar hernia repair appears to be safe and feasible in children.

  14. Anaesthesia for infant with Jarcho Levin syndrome: case report

    Directory of Open Access Journals (Sweden)

    Sukran Geze

    2015-10-01

    Full Text Available ABSTRACTJarcho Levin syndrome is a rare disorder. There are various vertebral and costal anomalies. Severe deformities and abnormal fusion of ribs and vertebrae cause respiratory insufficiency and pneumonia. We present anaesthesia in a patient with Jarcho Levin syndrome for vesicoureteral reflux.

  15. Cerebro-costo-mandibular syndrome: Report of two cases.

    Science.gov (United States)

    Abdalla, Wael; Panigrahy, Ashok; Bartoletti, Stefano C

    2011-01-01

    Cerebro-costo-mandibular syndrome (CCMS) is a rare syndrome that includes a constellation of mandibular hypoplasia and posterior rib defects as its basic features. Additional features can include hearing loss, tracheal cartilage abnormalities, scoliosis, elbow hypoplasia, and spina bifida. Here we report two cases of CCMS and discuss the reported long-term outcome of the disease.

  16. A Rare Entity: Bilateral First Rib Fractures Accompanying Bilateral Scapular Fractures

    Directory of Open Access Journals (Sweden)

    Gultekin Gulbahar

    2015-01-01

    Full Text Available First rib fractures are scarce due to their well-protected anatomic locations. Bilateral first rib fractures accompanying bilateral scapular fractures are very rare, although they may be together with scapular and clavicular fractures. According to our knowledge, no case of bilateral first rib fractures accompanying bilateral scapular fractures has been reported, so we herein discussed the diagnosis, treatment, and complications of bone fractures due to thoracic trauma in bias of this rare entity.

  17. 腕管综合征合并神经根型颈椎病患者神经传导测定特点分析%Nerve conduction characteristics of carpal tunnel syndrome patients with cervical spondylotic radiculopathy

    Institute of Scientific and Technical Information of China (English)

    徐士军; 李智琳; 杨建国; 孙玉会; 董晓柳

    2014-01-01

    Objective To analyze the nerve conduction characteristics of carpal tunnel syndrome patients with cervical spondylotic ra -diculopathy ,and to provide a better way to treat carpal tunnel syndrome .Methods Thirty patients of carpal tunnel syndrome with cer-vical spondylotic radiculopathy admitted to hospital from December 2011 to December 2012 were studied .And 30 healthy people were chosen as the control group .Distal sensory latency ( DSL) ,sensory nerve action potentials ( SNAP) ,cross-wrist sensory conduction ve-locity ( SCV) ,distal motor latency ( DML) and compound muscle action potential ( CMAP) of the median nerve and ulnar nerve were measured .We first tested sensory conduction ,and then measured motor conduction .These indicators were measured again 5 minutes af-ter median nerve compression test .Results Median nerve DSL of observation group was significantly longer than that of control group . The difference was statistically significant (P0.05). Parameters of median nerve and ulnar nerve in both observation group and control group were not significantly changed (P>0.05). Compared with control group,DSL and DML of median nerve in observation group were significantly prolonged (P 0.05).Conclusions DSL of carpal tunnel syndrome patients with cervical spondylotic radiculopathy was sig -nificantly prolonged due to pressure on the median nerve ,therefore,nerve conduction measurement contributes to the early diagnosis of carpal tunnel syndrome .%目的:探讨腕管综合征合并神经根型颈椎病患者神经传导测定特点并进行临床分析,为治疗提供可靠的依据。方法选取该院2010年12月-2012年12月收治的腕管综合征合并神经根型颈椎病患者30例,并选择同期健康体检者30例作为对照研究。测定正中神经和尺神经的感觉传导末端潜伏期( DSL )、感觉神经动作电位( SNAP )、跨腕关节感觉传导速度(SCV)、运动传导末端潜伏期(DML)及复合肌肉动作电

  18. Rib fractures after chest physiotherapy for bronchiolitis or pneumonia in infants

    Energy Technology Data Exchange (ETDEWEB)

    Chalumeau, Martin [Service de Pneumologie et d' Allergologie Pediatriques, Hopital Necker-Enfants Malades, Paris (France); Service de Pediatrie, Hopital Saint-Vincent-de-Paul, Paris (France); Foix-l' Helias, Laurence; Scheinmann, Pierre; Zuani, Pierre [Service de Pneumologie et d' Allergologie Pediatriques, Hopital Necker-Enfants Malades, Paris (France); Gendrel, Dominique [Service de Pediatrie, Hopital Saint-Vincent-de-Paul, Paris (France); Ducou-le-Pointe, Hubert [Service de Radiologie, Hopital d' Enfants Armand-Trousseau, Avenue du Docteur Arnold Netter, 75571 Paris Cedex 12 (France)

    2002-09-01

    Heading AbstractBackground. The reported causes of rib fractures in infants are: child abuse, accidental injury, cardiopulmonary resuscitation, bone fragility, birth trauma and severe cough.Objective. To report chest physiotherapy (CPT) as a new cause of rib fractures in five infants.Materials and methods. We retrospectively identified all infants with rib fractures after CPT for bronchiolitis or pneumonia over a 4-year period in two paediatric and one paediatric radiology units in three university hospitals in Paris.Results. Five boys were identified. Their median age was 3 months. None had any other potential cause of rib fractures. The indication for CPT was bronchiolitis in four cases and pneumonia in one. The median number of rib fractures was four (range 1-5). Fractures were located between the 3rd and 8th ribs; they were lateral in four patients and posterior in one; they were unilateral in four patients and bilateral in one. Evolution was favourable in all cases. The prevalence of rib fractures after CPT during the study period was estimated at 1 in 1,000 infants hospitalised for bronchiolitis or pneumonia.Conclusions. CPT should be considered a potential, but very rare cause of rib fractures in infants. It can be of clinical relevance when rib fractures are the only feature suggestive of child abuse. (orig.)

  19. Plasmacytoma presenting as missing rib on chest film: a case report and review of the literature.

    Science.gov (United States)

    Caffery, Terrell; Foy, Matthew

    2014-01-01

    A 33-year-old man presented to the emergency department (ED) with chief complaint of chest pain, persisting for approximately one year. Chest X-ray revealed he was missing the right posterior fifth rib. Physical examination showed no surgical scars, and he reported no history of chest trauma. A CT of his chest demonstrated a mass involving the posterior aspect of the right fifth rib, and subsequent biopsy revealed plasma cells. Laboratory results indicated the tumor was a solitary plasmacytoma of the rib. He was referred to oncology and treated with radiation therapy. This case report illustrates an unusual presentation of a solitary plasmacytoma of the rib.

  20. Cutoff-mesa isolated rib optical waveguide for III-V heterostructure photonic integrated circuits

    Science.gov (United States)

    Vawter, G.A.; Smith, R.E.

    1998-04-28

    A cutoff mesa rib waveguide provides single-mode performance regardless of any deep etches that might be used for electrical isolation between integrated electrooptic devices. Utilizing a principle of a cutoff slab waveguide with an asymmetrical refractive index profile, single mode operation is achievable with a wide range of rib widths and does not require demanding etch depth tolerances. This new waveguide design eliminates reflection effects, or self-interference, commonly seen when conventional rib waveguides are combined with deep isolation etches and thereby reduces high order mode propagation and crosstalk compared to the conventional rib waveguides. 7 figs.

  1. Quantitative geometric analysis of rib, costal cartilage and sternum from childhood to teenagehood.

    Science.gov (United States)

    Sandoz, Baptiste; Badina, Alina; Laporte, Sébastien; Lambot, Karene; Mitton, David; Skalli, Wafa

    2013-09-01

    Better understanding of the effects of growth on children's bones and cartilage is necessary for clinical and biomechanical purposes. The aim of this study is to define the 3D geometry of children's rib cages: including sternum, ribs and costal cartilage. Three-dimensional reconstructions of 960 ribs, 518 costal cartilages and 113 sternebrae were performed on thoracic CT scans of 48 children, aged 4 months to 15 years. The geometry of the sternum was detailed and nine parameters were used to describe the ribs and rib cages. A "costal index" was defined as the ratio between cartilage length and whole rib length to evaluate the cartilage ratio for each rib level. For all children, the costal index decreased from rib level 1 to 3 and increased from level 3 to 7. For all levels, the cartilage accounted for 45-60 % of the rib length, and was longer for the first years of life. The mean costal index decreased by 21 % for subjects over 3-year old compared to those under three (p < 10(-4)). The volume of the sternebrae was found to be highly age dependent. Such data could be useful to define the standard geometry of the pediatric thorax and help to detect clinical abnormalities.

  2. Cutoff-mesa isolated rib optical waveguide for III-V heterostructure photonic integrated circuits

    Energy Technology Data Exchange (ETDEWEB)

    Vawter, Gregory A. (Albuquerque, NM); Smith, Robert E. (Albuquerque, NM)

    1998-01-01

    A cutoff mesa rib waveguide provides single-mode performance regardless of any deep etches that might be used for electrical isolation between integrated electrooptic devices. Utilizing a principle of a cutoff slab waveguide with an asymmetrical refractive index profile, single mode operation is achievable with a wide range of rib widths and does not require demanding etch depth tolerances. This new waveguide design eliminates reflection effects, or self-interference, commonly seen when conventional rib waveguides are combined with deep isolation etches and thereby reduces high order mode propagation and crosstalk compared to the conventional rib waveguides.

  3. Paraneoplastic SIADH and Dermatomyositis in Cervical Cancer: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Guy Jones

    2009-11-01

    Full Text Available We present the first known case of a patient with cervical squamous cell carcinoma complicated by paraneoplastic syndromes of both dermatomyositis and inappropriate secretion of antidiuretic hormone (SIADH. The patient in this case presented with generalized body pain and vaginal bleeding. Her cervical cancer was diagnosed as stage IIB by physical exam, imaging, and cervical biopsy, her dermatomyositis was confirmed by muscle and skin biopsy, and her SIADH was diagnosed based on laboratory findings.

  4. Poland syndrome with dextrocardia: case report.

    Science.gov (United States)

    Galiwango, G W; Swan, M C; Nyende, R; Hodges, A M

    2010-11-01

    Poland syndrome is a rare congenital condition presentingwith typical features including an absent costosternal head of pectoralis major andipsilateral brachysyndactyly. There are many clinical variations of the syndrome including rib defects, absence of shoulder girdle muscle and breast hypoplasia or agenesis. Dextrocardia is rarely associated with Poland Syndrome with only 22 cases being previously reported in the worldwide literature. Whereas 'classical' Poland syndrome is predominantly right sided, all cases associated with dextrocardia have been left sided. We report a further case of left sided Poland syndrome with dextrocardia which might have important implications for the understanding of the pathogenesis of this unusual condition.

  5. Cervical insufficiency and cervical cerclage.

    Science.gov (United States)

    Brown, Richard; Gagnon, Robert; Delisle, Marie-France; Gagnon, Robert; Bujold, Emmanuel; Basso, Melanie; Bos, Hayley; Brown, Richard; Cooper, Stephanie; Crane, Joan; Davies, Gregory; Gouin, Katy; Menticoglou, Savas; Mundle, William; Pylypjuk, Christy; Roggensack, Anne; Sanderson, Frank; Senikas, Vyta

    2013-12-01

    Objectif : La présente directive clinique a pour but de fournir un cadre de référence que les cliniciens pourront utiliser pour identifier les femmes qui sont exposées aux plus grands risques de connaître une insuffisance cervicale, ainsi que pour déterminer les circonstances en présence desquelles la mise en place d’un cerclage pourrait s’avérer souhaitable. Résultats : La littérature publiée a été récupérée par l’intermédiaire de recherches menées dans PubMed ou MEDLINE, CINAHL et The Cochrane Library en 2012 au moyen d’un vocabulaire contrôlé (p. ex. « uterine cervical incompetence ») et de mots clés appropriés (p. ex. « cervical insufficiency », « cerclage », « Shirodkar », « cerclage », « MacDonald », « cerclage », « abdominal », « cervical length », « mid-trimester pregnancy loss »). Les résultats ont été restreints aux analyses systématiques, aux essais comparatifs randomisés / essais cliniques comparatifs et aux études observationnelles. Aucune restriction n’a été appliquée en matière de date ou de langue. Les recherches ont été mises à jour de façon régulière et intégrées à la directive clinique jusqu’en janvier 2011. La littérature grise (non publiée) a été identifiée par l’intermédiaire de recherches menées dans les sites Web d’organismes s’intéressant à l’évaluation des technologies dans le domaine de la santé et d’organismes connexes, dans des collections de directives cliniques, dans des registres d’essais cliniques et auprès de sociétés de spécialité médicale nationales et internationales. Valeurs : La qualité des résultats est évaluée au moyen des critères décrits dans le rapport du Groupe d’étude canadien sur les soins de santé préventifs (Tableau). Recommandations 1. Les femmes qui sont enceintes ou qui planifient connaître une grossesse devraient faire l’objet d’une évaluation visant les facteurs de

  6. Non-diffuseness of vibration fields in ribbed plates

    DEFF Research Database (Denmark)

    Brunskog, Jonas; Chung, Hyuck

    2011-01-01

    This paper presents numerical simulations of structural intensity in a rib-reinforced plate, investigating the diffuseness. Many prediction models of building and structural acoustics, such as statistical energy analysis or energy flow methods, assume the vibrational wave fields to be diffuse...... the Fourier sine expansion of the transverse displacement of the plate. Hamilton's principle is used in combination with thin plate theory and Euler beam theory. The model takes into account interactions between components. The Fourier sine modes are re-formulated as plane waves in a radial coordinate system...

  7. Cold plate with combined inclined impingement and ribbed channels

    Energy Technology Data Exchange (ETDEWEB)

    Parida, Pritish R.

    2015-12-22

    Heat transfer devices and methods for making the same that include a first enclosure having at least one inlet port; a second enclosure having a bottom plate and one or more dividing walls to establish channels, at least one internal surface of each channel having rib structures to create turbulence in a fluid flow; and a jet plate connecting the first enclosure and the second enclosure having impinging jets that convey fluid from the first enclosure to the channels, said impinging jets being set at an angular deviation from normal to cause local acceleration of fluid and to increase a local heat transfer rate.

  8. Golfer's fracture of the ribs

    Energy Technology Data Exchange (ETDEWEB)

    Lim, J. H. [Seoul District Armed Forces General Hospital, Seoul (Korea, Republic of)

    1980-06-15

    Golfer's fracture is stress fracture of the posterior portion of left 3, 4, 5, 6 or 7th ribs of golfer's, usually beginners,and it is considered due to exposure to unaccustomed severe exercise of this fascinating sport. Healing is usually uneventful, but possible complication may occur, because symptom is mild and golfers continue the exercise with physical therapy such as massage. Author report 4 cases of golfer's fracture, including 1 case complicated by platelike at electasis of lung.

  9. Posterior midline cervical fetal cystic hygroma.

    Directory of Open Access Journals (Sweden)

    Oak S

    1992-04-01

    Full Text Available Posterior midline cervical cystic hygromas (PMC are frequently found associated with chromosomal aberrations and usually do not survive. The present report illustrates diagnosis of this condition by sonography in an 18 weeks old fetus and an amniocentesis revealed 45 x0 karyotype and increased concentration of alpha-fetoproteins. Pregnancy was terminated in view of Turner′s syndrome. The etiology and natural history of the condition is reviewed.

  10. Treatment Option Overview (Cervical Cancer)

    Science.gov (United States)

    ... Cancer Prevention Cervical Cancer Screening Research Cervical Cancer Treatment (PDQ®)–Patient Version General Information About Cervical Cancer ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery) depends on ...

  11. Cervical Total Disc Arthroplasty

    OpenAIRE

    Basho, Rahul; Hood, Kenneth A.

    2012-01-01

    Symptomatic adjacent segment degeneration of the cervical spine remains problematic for patients and surgeons alike. Despite advances in surgical techniques and instrumentation, the solution remains elusive. Spurred by the success of total joint arthroplasty in hips and knees, surgeons and industry have turned to motion preservation devices in the cervical spine. By preserving motion at the diseased level, the hope is that adjacent segment degeneration can be prevented. Multiple cervical disc...

  12. Acupoints for cervical spondylosis

    OpenAIRE

    Zhu, Jihe; Arsovska, Blagica; Vasileva, Dance; Petkovska, Sofija; Kozovska, Kristina

    2015-01-01

    Cervical spondylosis is a chronic degenerative condition of the cervical spine that affects the vertebral bodies and intervertebral disks of the neck, as well as the contents of the spinal canal. This is one of the most common degenerative disorders of the spine. The disease can be symptomatic and asymptomatic. Symptoms that are distinctive for cervical spondylosis are: tingling, numbness and weakness in the limbs, lack of coordination, stiff neck, shoulder pain, occipital pain, vertigo, poor...

  13. Rib Cartilage Assessment Relative to the Healthy Ear in Young Children with Microtia Guiding Operative Timing

    Institute of Scientific and Technical Information of China (English)

    Shen-Song Kang; Ying Guo; Dong-Yi Zhang; Du-Yin Jiang

    2015-01-01

    Background:The optimal age at which to initiate for auricular reconstruction is controversial.Rib cartilage growth is closely related to age and determines the feasibility and outcomes of auricular reconstruction.We developed a method to guide the timing of auricular reconstruction in children with microtia ranging in age from 5 to 10 years.Methods:Rib cartilage and the healthy ear were assessed using low-dose multi-slice computed tomography.The lengths of the eighth rib cartilage and the helix of the healthy ear (from the helical crus to the joint of the helix and the earlobe) were measured.Surgery was performed when the two lengths were approximately equal.Results:The preoperative eighth rib measurements significantly correlated with the intraoperative measurements (P < 0.05).From 5 to 10 years of age,eighth rib growth was not linear.In 76 (62.8%) of 121 patients,the eighth rib length was approximately equal to the helix length in the healthy ear;satisfactory outcomes were achieved in these patients.In 18 (14.9%) patients,the eighth rib was slightly shorter than the helix,helix fabrication was accomplished by adjusting the length of the helical crus of stent,and satisfactory outcomes were also achieved.Acceptable outcomes were achieved in 17 (14.0%) patients in whom helix fabrication was accomplished by cartilage splicing.In 9 (7.4%) patients with insufficient rib cartilage length,the operation was delayed.In one (0.8%) patient with insufficient rib cartilage length,which left no cartilage for helix splicing,the result was unsatisfactory.Conclusions:Eighth rib cartilage growth is variable.Rib cartilage assessment relative to the healthy ear can guide auricular reconstruction and personalize treatment in young patients with microtia.

  14. A novel ICK mutation causes ciliary disruption and lethal endocrine-cerebro-osteodysplasia syndrome

    OpenAIRE

    Kayserili Karabey, Hülya; Oud, M.M.; Bonnard, C.; Mans, D.A.; Altunoğlu, U.; Tohari, S.; Ng, A.Y.J.; Eskin, A.; Lee, H.; Rupar, C.A.; Wagenaar, N.P.; Wu, K.M.; Lahiry, P.; Pazour, G.J.; Nelson, S.F.; Hegele, R.A.; Roepman, R; Venkatesh, B.; Siu, V.M.; Reversade, B.; Arts, H.H.

    2016-01-01

    Background: Endocrine-cerebro-osteodysplasia (ECO) syndrome [MIM:612651] caused by a recessive mutation (p.R272Q) in Intestinal cell kinase (ICK) shows significant clinical overlap with ciliary disorders. Similarities are strongest between ECO syndrome, the Majewski and Mohr-Majewski short-rib thoracic dysplasia (SRTD) with polydactyly syndromes, and hydrolethalus syndrome. In this study, we present a novel homozygous ICK mutation in a fetus with ECO syndrome and compare the effect of this mu...

  15. Preventing cervical cancer globally.

    Science.gov (United States)

    Schmeler, Kathleen M

    2012-11-01

    Cervical cancer is one of the leading causes of cancer and cancer-related deaths among women worldwide. More than 85% of cases and deaths occur in the developing world where the availability of effective screening is limited. In this issue of the journal, Pierce and colleagues (beginning on page 1273) describe a novel technique using a high-resolution microendoscope (HRME) to diagnose cervical dysplasia. This perspective reviews the limitations of existing cervical cancer screening methods currently in use in low-resource settings and the potential for HRME imaging to contribute to cervical cancer prevention in the developing world.

  16. The RIB production target for the SPES project

    Energy Technology Data Exchange (ETDEWEB)

    Monetti, Alberto [viale dell' Universita 2, Laboratori Nazionali di Legnaro, Legnaro (Italy); University of Padua, Department of Industrial Engineering (DII), Padova (Italy); Andrighetto, Alberto; Manzolaro, Mattia; Corradetti, Stefano; Scarpa, Daniele; Rossetto, Francesco; Vasquez, Jesus; Rossignoli, Massimo; Calderolla, Michele; Silingardi, Roberto; Mozzi, Aldo; Vivian, Gianluca; Boratto, Enrico; Ballan, Michele; Prete, Gianfranco [viale dell' Universita 2, Laboratori Nazionali di Legnaro, Legnaro (Italy); Petrovich, Carlo [ENEA, Bologna (Italy); Martinez Dominguez, Fernando [viale dell' Universita 2, Laboratori Nazionali di Legnaro, Legnaro (Italy); ESS Bilbao, Instituto de Fusion Nuclear, Madrid (Spain); Borgna, Francesca [viale dell' Universita 2, Laboratori Nazionali di Legnaro, Legnaro (Italy); University of Padua, Department of Pharmaceutical and Pharmacological Sciences, Padova (Italy); Meneghetti, Giovanni [University of Padua, Department of Industrial Engineering (DII), Padova (Italy)

    2015-10-15

    Facilities making use of the Isotope Separator On-Line (ISOL) method for the production of Radioactive Ion Beams (RIB) attract interest because they can be used for nuclear structure and reaction studies, astrophysics research and interdisciplinary applications. The ISOL technique is based on the fast release of the nuclear reaction products from the chosen target material together with their ionization into short-lived nuclei beams. Within this context, the SPES (Selective Production of Exotic Species) facility is now under construction in Italy at INFN-LNL (Istituto Nazionale di Fisica Nucleare - Laboratori Nazionali di Legnaro). The SPES facility will produce RIBs mainly from n-rich isotopes obtained by a 40 MeV cyclotron proton beam (200 μA) directly impinging on a uranium carbide multi-foil fission target. The aim of this work is to describe and update, from a comprehensive point of view, the most important results obtained by the analysis of the on-line behavior of the SPES production target assembly. In particular an improved target configuration has been studied by comparing different codes and physics models: the thermal analyses and the isotope production are re-evaluated. Then some consequent radioprotection aspects, which are essential for the installation and operation of the facility, are presented. (orig.)

  17. The RIB production target for the SPES project

    Science.gov (United States)

    Monetti, Alberto; Andrighetto, Alberto; Petrovich, Carlo; Manzolaro, Mattia; Corradetti, Stefano; Scarpa, Daniele; Rossetto, Francesco; Martinez Dominguez, Fernando; Vasquez, Jesus; Rossignoli, Massimo; Calderolla, Michele; Silingardi, Roberto; Mozzi, Aldo; Borgna, Francesca; Vivian, Gianluca; Boratto, Enrico; Ballan, Michele; Prete, Gianfranco; Meneghetti, Giovanni

    2015-10-01

    Facilities making use of the Isotope Separator On-Line (ISOL) method for the production of Radioactive Ion Beams (RIB) attract interest because they can be used for nuclear structure and reaction studies, astrophysics research and interdisciplinary applications. The ISOL technique is based on the fast release of the nuclear reaction products from the chosen target material together with their ionization into short-lived nuclei beams. Within this context, the SPES (Selective Production of Exotic Species) facility is now under construction in Italy at INFN-LNL (Istituto Nazionale di Fisica Nucleare — Laboratori Nazionali di Legnaro). The SPES facility will produce RIBs mainly from n-rich isotopes obtained by a 40 MeV cyclotron proton beam (200 μA) directly impinging on a uranium carbide multi-foil fission target. The aim of this work is to describe and update, from a comprehensive point of view, the most important results obtained by the analysis of the on-line behavior of the SPES production target assembly. In particular an improved target configuration has been studied by comparing different codes and physics models: the thermal analyses and the isotope production are re-evaluated. Then some consequent radioprotection aspects, which are essential for the installation and operation of the facility, are presented.

  18. Clavicles, interclavicles, gastralia, and sternal ribs in sauropod dinosaurs: new reports from diplodocidae and their morphological, functional and evolutionary implications.

    Science.gov (United States)

    Tschopp, Emanuel; Mateus, Octávio

    2013-03-01

    Ossified gastralia, clavicles and sternal ribs are known in a variety of reptilians, including dinosaurs. In sauropods, however, the identity of these bones is controversial. The peculiar shapes of these bones complicate their identification, which led to various differing interpretations in the past. Here we describe different elements from the chest region of diplodocids, found near Shell, Wyoming, USA. Five morphotypes are easily distinguishable: (A) elongated, relatively stout, curved elements with a spatulate and a bifurcate end resemble much the previously reported sauropod clavicles, but might actually represent interclavicles; (B) short, L-shaped elements, mostly preserved as a symmetrical pair, probably are the real clavicles, as indicated by new findings in diplodocids; (C) slender, rod-like bones with rugose ends are highly similar to elements identified as sauropod sternal ribs; (D) curved bones with wide, probably medial ends constitute the fourth morphotype, herein interpreted as gastralia; and (E) irregularly shaped elements, often with extended rugosities, are included into the fifth morphotype, tentatively identified as sternal ribs and/or intercostal elements. To our knowledge, the bones previously interpreted as sauropod clavicles were always found as single bones, which sheds doubt on the validity of their identification. Various lines of evidence presented herein suggest they might actually be interclavicles - which are single elements. This would be the first definitive evidence of interclavicles in dinosauromorphs. Previously supposed interclavicles in the early sauropodomorph Massospondylus or the theropods Oviraptor and Velociraptor were later reinterpreted as clavicles or furculae. Independent from their identification, the existence of the reported bones has both phylogenetic and functional significance. Their presence in non-neosauropod Eusauropoda and Flagellicaudata and probable absence in rebbachisaurs and Titanosauriformes shows a

  19. Experimental and Numerical Study on Heat Transfer Enhancement of a Rectangular Channel with Discontinuous Crossed Ribs and Grooves

    Institute of Scientific and Technical Information of China (English)

    唐新宜; 朱冬生

    2012-01-01

    Experimental and numerical investigations have been conducted to study turbulent flow of water and heat transfer characteristics in a rectangular channel with discontinuous crossed ribs and grooves.The tests investigated the overall heat transfer performance and friction factor in ribbed and ribbed-grooved channels with rib angle of 30°.The experimental results show that the overall thermo-hydraulic performance for ribbed-grooved channel is increased by 10%-13.6% when compared to ribbed channel.The investigation on the effects of different rib angles and rib pitches on heat transfer characteristics and friction factor in ribbed-grooved channel was carried out using Fluent with SST(shear-stress transport) k-ω turbulence model.The numerical results indicate that the case for rib angle of 45° shows the best overall thermo-hydraulic performance,about 18%-36% higher than the case for rib angle of 0°.In addition,the flow patterns and local heat transfer characteristics for ribbed and ribbed-grooved channels based on the numerical simulation were also analyzed to reveal the mechanism of heat transfer enhancement.

  20. Efficacy of exercise prescription for treating chronic cervical myofascial pain syndrome%运动处方治疗慢性颈肌筋膜疼痛综合征的早期疗效观察

    Institute of Scientific and Technical Information of China (English)

    蔡春水; 魏鲁青; 尹杰; 曾昭勇; 张毅; 赵新建

    2011-01-01

    [Objective] To investigate the efficacy of exercise prescription for treating chronic cervical myofascial pain syndrome. [Methods] One hundred and forty - four patients were randomly allocated to group I (50 treated by drug) , group II (46 treated by tunia) and group III (48 treated by exercise prescription) . Visual analogue scale (VAS) was used to record the severity of pain before treatment, after one treatment course (two weeks) and three months after the end of treatment. [Results] The marked effective rate, effective rate and relapse rate were 48. 00% (24/50) , 84. 00 % (18/50) and 47. 6% (20/42) respectively in group I , 54.35% (25/46) ,93.48% (18/46) and 41. 86% (18/43) respectively in group II, 58.35% (28/48) ,89.59% (15/48) and 11. 63% (5/43) respectively in group I. Statistical analysis showed no significant difference of the effective rate in group III compared with group I and group II (P > 0. 05 ) , but the relapse rate in group HI was significantly lower than that in group I and group II (P <0. 05) . [Conclusion] Exercise prescription has good efficacy in treating and preventing chronic cervical myofascial pain syndrome.%[目的]探讨运动处方治疗慢性颈肌筋膜疼痛综合征的疗效.[方法]将144名患者随机分为I组、Ⅱ组、Ⅲ组,I组为药物治疗组,Ⅱ组为推拿治疗组,Ⅲ组为运动处方治疗组.在治疗前、治疗1个疗程后、治疗结束后3个月用视觉模拟评分法(visual analogue scale,VAS)记录患者的疼痛程度,并进行评价.[结果]I组50例,治疗后2周:显效24例,有效18例,显效率48.00%,总有效率84.00%.3个月后复发20例,复发率47.6%;Ⅱ组46例,治疗后2周:显效25例,有效18例,显效率54.35%,总有效率93.48%.3个月后复发18例,复发率41.86%;Ⅲ组48例,治疗后2周:显效28例,有效15例,显效率58.35%,总有效率89.59%.3个月后复发5例,复发率11.63%.Ⅲ组总有效率与I组、Ⅱ组相当,经统计学处理,无显著性差异(P>0

  1. Synostosis of first and second thoracic ribs: Anatomical and radiological assessment

    Directory of Open Access Journals (Sweden)

    Gupta V

    2009-10-01

    Full Text Available An unusual specimen showing synostosis of left sided first and second ribs was encountered during scanning of bones in anatomy department. The ribs were partially fused in the region of their neck and tubercles, and displayed an osseous tunnel. The tunnel measured 1.2 cm in length and was directed anterolaterally. The shaft of first rib imperceptibly blended with that of the second and resulted in obliteration of first intercostal space. The maximum width of this conjoint shaft was 3.6 cm. Superior surface of the rib specimen was marked by a large muscular impression for scalenus medius muscle. The groove for subclavian artery on the superior surface of first rib was prominent. The anterior end of the second rib and a portion of its shaft were separated from the anterior end of first rib by a V-shaped notch. The radiograph of the specimen confirmed the presence of a tunnel between the fused portions of neck and tubercle. Such skeletal abnormalities may be associated with segmentation defects of bony tissues and variations in the disposition of neurovascular structures, thus rendering them vulnerable to compression at the thoracic outlet. The fused ribs affect the chest wall expansion and may result in respiratory complications. Precise knowledge and awareness of such anomalies is important for clinicians, especially for thoracic surgeons and radiologists.

  2. Sternum Length and Rib Cage Dimensions Compared with Bodily Proportions in Adults with Cystic Fibrosis

    Directory of Open Access Journals (Sweden)

    Louis-Philippe Laurin

    2012-01-01

    Full Text Available BACKGROUND: A greater structural expansion of the rib cage in females compared with males has been described in cystic fibrosis (CF patients; however, conflicting data exist as to whether an elongation of the bony ribs and sternum contributes to this expansion.

  3. 20 CFR 225.22 - Employee RIB PIA used in survivor annuities.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Employee RIB PIA used in survivor annuities... RETIREMENT ACT PRIMARY INSURANCE AMOUNT DETERMINATIONS PIA's Used in Computing Survivor Annuities and the Amount of the Residual Lump-Sum Payable § 225.22 Employee RIB PIA used in survivor annuities....

  4. The use of nylon cable ties to repair rib fractures in neonatal foals.

    Science.gov (United States)

    Downs, Chris; Rodgerson, Dwayne

    2011-03-01

    Commercially available nylon cable ties were used as a method of internal fixation for displaced rib fractures in 8 equine neonates. The procedure was effective, well-tolerated, rapid, and inexpensive. The use of nylon cable ties as internal fixation for displaced rib fractures in foals is an effective surgical procedure.

  5. Osteomyelitis of sternum and rib after breast prosthesis implantation: A rare or underestimated infection?

    Science.gov (United States)

    Seng, Piseth; Alliez, Antoine; Honnorat, Estelle; Menard, Amelie; Casanova, Dominique; Stein, Andreas

    2014-01-01

    Sternum and rib osteomyelitis complicated from breast implant infection is rare. We report a case of early sternum and rib osteomyelitis occurred during breast implant infection managed in an inter-regional referral center for bone/joint infections in the south of France. PMID:26793446

  6. Osteomyelitis of sternum and rib after breast prosthesis implantation: A rare or underestimated infection?

    Directory of Open Access Journals (Sweden)

    Piseth Seng

    2015-01-01

    Full Text Available Sternum and rib osteomyelitis complicated from breast implant infection is rare. We report a case of early sternum and rib osteomyelitis occurred during breast implant infection managed in an inter-regional referral center for bone/joint infections in the south of France.

  7. Primary Osteoblastic Osteosarcoma of the Rib in an Adult: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jung Ah; Kang, Heung Sik [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Ryoo, In Seon [Dept. of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul (Korea, Republic of); Park, Hyo Ah; Chung, Jin Haeng [Dept. of Patholgy, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Oh, Joo Han [Dept. of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2011-12-15

    We report the CT and magnetic resonance (MR) imaging appearances in an adult case of primary osteoblastic osteosarcoma of the rib. Osteosarcoma of the rib presents a diagnostic challenge because of the rarity of the lesion, especially with plain radiographs. The tumor should be suspected if CT and MR images demonstrate mineralization, suggestive of an osteoid matrix.

  8. Cryptococcal rib osteomyelitis as primary and only symptom of idiopathic CD4 penia

    DEFF Research Database (Denmark)

    Legarth, Rebecca A; Christensen, Merete; Calum, Henrik;

    2014-01-01

    A 59-year old man with idiopathic CD4 lymphopenia presented with extensive disseminated Cryptococcus neoformans infection including a large rib cryptoccocoma, vertebral spondylitis and pleural empyema. Complete resection of the affected part of the rib was necessary after failure of initial antif...

  9. STRESS FRACTURE OF THE FIRST RIB IN A HIGH SCHOOL WEIGHT LIFTER

    Directory of Open Access Journals (Sweden)

    Hiroyuki Fujioka

    2009-06-01

    Full Text Available A 17-year-old boy, who played a weight lifting in high school, sustained stress fracture of the first rib without any causes. We successfully treated first rib stress fracture with limitation of using the upper extremity and with using low-intensity pulsed ultrasound

  10. Development of a self-administered questionnaire to screen patients for cervical myelopathy

    Directory of Open Access Journals (Sweden)

    Sekiguchi Yasufumi

    2010-11-01

    Full Text Available Abstract Background In primary care, it is often difficult to diagnose cervical myelopathy. However, a delay in treatment could cause irreversible aftereffects. With a brief and effective self-administered questionnaire for cervical myelopathy, cervical myelopathy may be screened more easily and oversight may be avoided. As there is presently no screening tool for cervical myelopathy, the aim of this study was to develop a self-administered questionnaire for the screening of cervical myelopathy. Methods A case-control study was performed with the following two groups at our university hospital from February 2006 to September 2008. Sixty-two patients (48 men, 14 women with cervical myelopathy who underwent operative treatment were included in the myelopathy group. In the control group, 49 patients (20 men, 29 women with symptoms that could be distinguished from those of cervical myelopathy, such as numbness, pain in the upper extremities, and manual clumsiness, were included. The underlying conditions were diagnosed as carpal tunnel syndrome, cubital tunnel syndrome, thoracic outlet syndrome, tarsal tunnel syndrome, diabetes mellitus neuropathy, cervical radiculopathy, and neuralgic amyotrophy. Twenty items for a questionnaire in this study were chosen from the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire, which is a new self-administered questionnaire, as an outcome measure for patients with cervical myelopathy. Data were analyzed by univariate analysis using the chi-square test and by multiple logistic regression analysis. According to the resulting odds ratio, β-coefficients, and p value, items were chosen and assigned a score. Results Eight items were chosen by univariate and multiple logistic regression analyses and assigned a score. The Hosmer-Lemeshow statistic showed p = 0.805. The area under the receiver operation characteristic curve was 0.86. The developed questionnaire had a sensitivity of 93.5% and a

  11. The effect of vertical expandable prosthetic titanium rib on growth in congenital scoliosis

    Directory of Open Access Journals (Sweden)

    Mehmet Bulent Balioglu

    2015-01-01

    Full Text Available Aims: In the treatment of thoracic insufficiency syndrome, the main aim is to maintain spinal and thoracic growth in order to continue respiratory functions. Vertical expandable prosthetic titanium rib (VEPTR device application is a method of choice especially in the congenital cases with a thoracic deformity. In our study, we evaluated the effect of VEPTR on growth in congenital scoliosis. Materials and Methods: Four female patients in whom VEPTR was applied were retrospectively evaluated. Anteroposterior (AP and lateral Cobb angles that were measured preoperatively and during the last control, space available for lung (SAL, T1-S1 and T1-T12 distances, coronal and sagittal balances were compared. Results: Four female patients in whom VEPTR was applied were retrospectively evaluated. AP and lateral Cobb angles that were measured preoperatively and during the last control, SAL, T1-S1, and T1-T12 distances, coronal and sagittal balances were compared. Conclusions: VEPTR may provide a good correction, and we observed a growth in the spine height and SAL following the treatment of congenital deformities. Long-term, multicenter, prospective studies that compare the spinal height, respiratory functions, the severity of the deformity, and the spinal balance are required in order to evaluate the efficacy of VEPTR.

  12. Lateral Thoracic Osteoplastic Rib-Sparing Technique Used for Lateral Spine Surgery: Technical Note

    Science.gov (United States)

    Fisahn, Christian; Tubbs, R. Shane; Page, Jeni; Rice, Richard; Paulson, David; Kazemi, Noojan; Hanscom, David; Oskouian, Rod J

    2016-01-01

    Of patients who have undergone lateral approaches to the thoracic spine, surgical site postoperative pain appears to be greater among those who have undergone transection and removal of a rib segment than those who have not. Therefore, techniques that conserve anatomical position and minimize tissue disruption would theoretically result in less pain and a quicker recovery. Herein, we describe a rib-sparing osteoplastic technique used when rib segments need to be displaced in order to create an unobscured corridor to the operative target. Our approach minimizes soft tissue disruption and restores the anatomical function of the rib. Based on our experience, these patients report less pain, mobilize earlier, and are discharged sooner than those who have had rib segments sacrificed as part of a lateral approach to the spine. PMID:27551648

  13. Modification of the rib operon derived from Bacillus subtilis and its expression in Escherichia coli

    Institute of Scientific and Technical Information of China (English)

    Zhang Huitu; Meng Kun; Wang Yaru; Luo Huiying; Yuan Tiezheng; Yang Peilong; Bai Yingguo; Yao Bin; Fan Yunliu

    2007-01-01

    A riboflavin operon(rib operon)derived from Bacillus subtilis 368 was modified on structure and the resulting operons were expressed in various strains of Escherichia coli. The results showed that the optimization of the rib operon and the host strain used for expression are two main factors affecting the riboflavin production. Replacing the promoter l and rfn box of the rib operon with a strong constructive promoter spo l drastically increased the expression of the rib genes. When E. Coli JMl09 was used as the host strain, the highest riboflavin production reached 95.3μg/mL(about eight times higher than that 0f the unmodified rib operon). In addition, when tetracycline(20 μg/mL)was used as the selective pressure, compared with the ampicillin resistant transformants, a higher riboflavin yield Was obtained in tetracycline resistant host strain.

  14. Turbulence and Scale Measurements in a Square Channel with Transverse Square Ribs

    Directory of Open Access Journals (Sweden)

    Richard B. Rivir

    1996-01-01

    and staggered multiple ribs. Test conditions for multiple ribs use p/H = 10, H/D 0.17, and Re⁡D 23,000. Measured results highlight the spatial distribution and evolution of turbulence intensity and integral scale from the flow entrance of the first period to the developed regime near the exit of the third period. The highly turbulent, shear layer initiated near the trailing upper-edge of a rib elevates the turbulence level in the mainstream of the channel. The magnitude of turbulence intensity in the channel core rises from 0.7% in the approaching flow to about 20–25% near the exit of the third period. The integral scale dominating the mainstream flow increases from approximately one-half the rib-height, 0.5H, in the approaching flow to 1.5-2.5H behind the first rib and further downstream.

  15. [Intact cervical pregnancy].

    Science.gov (United States)

    Habek, D; Bobic, M V; Dosen, L

    2003-01-01

    The authors describe a case of intact cervical pregnancy in a 24-year-old secundigravida. The patient was treated successfully with Methotrexate. Conservative treatment is the first choice in the therapy of uncomplicated cervical pregnancy. Conservative and operative therapeutic procedures are discussed.

  16. Scaling of Haversian canal surface area to secondary osteon bone volume in ribs and limb bones.

    Science.gov (United States)

    Skedros, John G; Knight, Alex N; Clark, Gunnar C; Crowder, Christian M; Dominguez, Victoria M; Qiu, Shijing; Mulhern, Dawn M; Donahue, Seth W; Busse, Björn; Hulsey, Brannon I; Zedda, Marco; Sorenson, Scott M

    2013-06-01

    Studies of secondary osteons in ribs have provided a great deal of what is known about remodeling dynamics. Compared with limb bones, ribs are metabolically more active and sensitive to hormonal changes, and receive frequent low-strain loading. Optimization for calcium exchange in rib osteons might be achieved without incurring a significant reduction in safety factor by disproportionally increasing central canal size with increased osteon size (positive allometry). By contrast, greater mechanical loads on limb bones might favor reducing deleterious consequences of intracortical porosity by decreasing osteon canal size with increased osteon size (negative allometry). Evidence of this metabolic/mechanical dichotomy between ribs and limb bones was sought by examining relationships between Haversian canal surface area (BS, osteon Haversian canal perimeter, HC.Pm) and bone volume (BV, osteonal wall area, B.Ar) in a broad size range of mature (quiescent) osteons from adult human limb bones and ribs (modern and medieval) and various adult and subadult non-human limb bones and ribs. Reduced major axis (RMA) and least-squares (LS) regressions of HC.Pm/B.Ar data show that rib and limb osteons cannot be distinguished by dimensional allometry of these parameters. Although four of the five rib groups showed positive allometry in terms of the RMA slopes, nearly 50% of the adult limb bone groups also showed positive allometry when negative allometry was expected. Consequently, our results fail to provide clear evidence that BS/BV scaling reflects a rib versus limb bone dichotomy whereby calcium exchange might be preferentially enhanced in rib osteons.

  17. Osteochondroma of the fifth rib resulting in recurrent hemothorax

    Energy Technology Data Exchange (ETDEWEB)

    Patel, Mital [Cleveland Clinic Foundation, Department of Radiology - Musculoskeletal Imaging Fellowship, Cleveland, OH (United States); Bauer, Thomas W. [The Cleveland Clinic L-25, Departments of Pathology and Orthopaedic Surgery, Cleveland, OH (United States); Santoscoy, Thomas [Cleveland Clinic Foundation, Department of Thoracic and Cardiovascular Surgery, Mayfield Heights, OH (United States); Ilaslan, Hakan [Cleveland Clinic Foundation, Department of Radiology, Musculoskeletal Section, Cleveland, OH (United States)

    2015-12-15

    A 48-year-old man presented with recurrent spontaneous hemothoraces, which ultimately were found to be secondary to a pedunculated costal osteochondroma causing vascular injury. After initially undergoing endovascular coil embolization, he ultimately required segmental rib resection containing the offending lesion for definite treatment. Although a few cases of symptomatic costal osteochondromas have been reported in the literature, as far as we know, no previous reports have provided direct radiologic confirmation of active bleeding or the role of angiographic intervention. In this report, we highlight the importance of CT angiography in establishing a direct link between an osteochondroma and recurrent hemothorax. We also discuss the diagnostic imaging challenges associated with this condition and the use of a multidisciplinary treatment strategy involving both angiographic and operative management. (orig.)

  18. Structure optimization of polymeric Mach-Zehnder rib waveguide

    Institute of Scientific and Technical Information of China (English)

    LU Rong-guo; LiU Yong-zhi; LIAO Jin-kun; LIAO Yi-tao; HAN Wen-jie

    2007-01-01

    A systematic analysis of the polymeric Mach-Zehnder rib waveguide is presented based on the calculation and optimization. The simulation is carried out with the Effective Index Method (EIM) and two-dimensional (2-D)Finite Difference Beam Propagation Method (FD-BPM). The large refractive index step between the consecutive polymer layers is reduced by using EIM and thus the precision of the calculation is ensured. The important parameters of the waveguide such as Y-junction angle and the separation gap are discussed and their relationships with the optical power propagation and the loss characteristics are investigated in this paper. The total loss of the optimized structure is 0.258 dB.

  19. Structural efficiency study of composite wing rib structures

    Science.gov (United States)

    Swanson, Gary D.; Gurdal, Zafer; Starnes, James H., Jr.

    1988-01-01

    A series of short stiffened panel designs which may be applied to a preliminary design assessment of an aircraft wing rib is presented. The computer program PASCO is used as the primary design and analysis tool to assess the structural efficiency and geometry of a tailored corrugated panel, a corrugated panel with a continuous laminate, a hat stiffened panel, a blade stiffened panel, and an unstiffened flat plate. To correct some of the shortcomings in the PASCO analysis when shear is present, a two step iterative process using the computer program VICON is used. The loadings considered include combinations of axial compression, shear, and lateral pressure. The loading ranges considered are broad enough such that the designs presented may be applied to other stiffened panel applications. An assessment is made of laminate variations, increased spacing, and nonoptimum geometric variations, including a beaded panel, on the design of the panels.

  20. Interactive Simulation of Diaphragm Motion Through Muscle and Rib Kinematics

    Science.gov (United States)

    Villard, Pierre-Frédéric; Bourne, Wesley; Bello, Fernando

    Modeling of diaphragm behaviour is of relevance to a number of clinical procedures such as lung cancer radiotherapy and liver access interventions. The heterogeneity in tissue composition of the diaphragm, as well as the various physiological phenomena influencing its behaviour, requires a complex model in order to accurately capture its motion. In this chapter we present a novel methodology based on a heterogenous model composed of mass-spring and tensegrity elements. The physiological boundary conditions have been carefully taken into account and applied to our model. Thus, it incorporates the influence of the rib kinematics, the muscle natural contraction/relaxation and the motion of the sternum. Initial validation results show that the behaviour of the model closely follows that of a real diaphragm.

  1. Lumbo-costo-vertebral syndrome with posterior spinal dysraphism

    Directory of Open Access Journals (Sweden)

    Sujit Kumar G

    2005-01-01

    Full Text Available Lumbo-costo-vertebral syndrome, which includes abnormalities of the vertebral bodies, ribs and trunk musculature, is very rare and only few cases have been reported. We report a case of 18-month-old female child with absent ribs, hemivertebrae, superior lumbar hernia (features of lumbo-costo-vertebral syndrome and posterior spinal dysraphism, which to our knowledge is the first case in the English literature with such a combination of defects. Embryology and management of the case is discussed.

  2. Natural merodiploidy of the lux-rib operon of Photobacterium leiognathi from coastal waters of Honshu, Japan.

    Science.gov (United States)

    Ast, Jennifer C; Urbanczyk, Henryk; Dunlap, Paul V

    2007-09-01

    Sequence analysis of the bacterial luminescence (lux) genes has proven effective in helping resolve evolutionary relationships among luminous bacteria. Phylogenetic analysis using lux genes, however, is based on the assumptions that the lux genes are present as single copies on the bacterial chromosome and are vertically inherited. We report here that certain strains of Photobacterium leiognathi carry multiple phylogenetically distinct copies of the entire operon that codes for luminescence and riboflavin synthesis genes, luxCDABEG-ribEBHA. Merodiploid lux-rib strains of P. leiognathi were detected during sequence analysis of luxA. To define the gene content, organization, and sequence of each lux-rib operon, we constructed a fosmid library of genomic DNA from a representative merodiploid strain, lnuch.13.1. Sequence analysis of fosmid clones and genomic analysis of lnuch.13.1 defined two complete, physically separate, and apparently functional operons, designated lux-rib1 and lux-rib2. P. leiognathi strains lelon.2.1 and lnuch.21.1 were also found to carry lux-rib1 and lux-rib2, whereas ATCC 25521T apparently carries only lux-rib1. In lnuch.13.1, lelon.2.1, lnuch.21.1, and ATCC 25521T, lux-rib1 is flanked upstream by lumQ and putA and downstream by a gene for a hypothetical multidrug efflux pump. In contrast, transposase genes flank lux-rib2 of lnuch.13.1, and the chromosomal location of lux-rib2 apparently differs in lnuch.13.1, lelon.2.1, and lnuch.21.1. Phylogenetic analysis demonstrated that lux-rib1 and lux-rib2 are more closely related to each other than either one is to the lux and rib genes of other bacterial species, which rules out interspecies lateral gene transfer as the origin of lux-rib2 in P. leiognathi; lux-rib2 apparently arose within a previously unsampled or extinct P. leiognathi lineage. Analysis of 170 additional strains of P. leiognathi, for a total of 174 strains examined from coastal waters of Japan, Taiwan, the Philippine Islands, and

  3. Natural Merodiploidy of the lux-rib Operon of Photobacterium leiognathi from Coastal Waters of Honshu, Japan▿ †

    Science.gov (United States)

    Ast, Jennifer C.; Urbanczyk, Henryk; Dunlap, Paul V.

    2007-01-01

    Sequence analysis of the bacterial luminescence (lux) genes has proven effective in helping resolve evolutionary relationships among luminous bacteria. Phylogenetic analysis using lux genes, however, is based on the assumptions that the lux genes are present as single copies on the bacterial chromosome and are vertically inherited. We report here that certain strains of Photobacterium leiognathi carry multiple phylogenetically distinct copies of the entire operon that codes for luminescence and riboflavin synthesis genes, luxCDABEG-ribEBHA. Merodiploid lux-rib strains of P. leiognathi were detected during sequence analysis of luxA. To define the gene content, organization, and sequence of each lux-rib operon, we constructed a fosmid library of genomic DNA from a representative merodiploid strain, lnuch.13.1. Sequence analysis of fosmid clones and genomic analysis of lnuch.13.1 defined two complete, physically separate, and apparently functional operons, designated lux-rib1 and lux-rib2. P. leiognathi strains lelon.2.1 and lnuch.21.1 were also found to carry lux-rib1 and lux-rib2, whereas ATCC 25521T apparently carries only lux-rib1. In lnuch.13.1, lelon.2.1, lnuch.21.1, and ATCC 25521T, lux-rib1 is flanked upstream by lumQ and putA and downstream by a gene for a hypothetical multidrug efflux pump. In contrast, transposase genes flank lux-rib2 of lnuch.13.1, and the chromosomal location of lux-rib2 apparently differs in lnuch.13.1, lelon.2.1, and lnuch.21.1. Phylogenetic analysis demonstrated that lux-rib1 and lux-rib2 are more closely related to each other than either one is to the lux and rib genes of other bacterial species, which rules out interspecies lateral gene transfer as the origin of lux-rib2 in P. leiognathi; lux-rib2 apparently arose within a previously unsampled or extinct P. leiognathi lineage. Analysis of 170 additional strains of P. leiognathi, for a total of 174 strains examined from coastal waters of Japan, Taiwan, the Philippine Islands, and

  4. Fundamentally excited flow past a surface-mounted rib. Part I: Turbulent structure characterisation

    Indian Academy of Sciences (India)

    P K Panigrahi

    2001-10-01

    Different data analysis techniques for characterisation of the turbulent flow past a surface-mounted rib are reviewed. Deficiencies of the existing techniques are explained and modified techniques for determination of coherent structure magnitude and phase jitter are suggested. The effect of fundamental excitation on the flow is studied by using these turbulent signal analysis techniques. The appropriate length scale for characterizing the large-scale structures present in the reattaching shear layer of the surface-mounted rib is found to be the momentum thickness at the downstream edge of the rib, and the corresponding Strouhal number is 0.013. This is in contrast to a rib in the free stream, where the rib height is the correct scaling parameter. The post reattachment region is observed to be dominated by large-scale structures contrary to the traditional belief that large eddies break into small scales at the reattachment location. Low magnitude of phase jitter in the near field region is observed, indicating coherence of the flow structures. Phase decorrelation begins to occur beyond three rib heights from the downstream edge of the rib. From the quadrant analysis results, the outer edge of the shear layer is observed to be dominated by large-scale ejection motions.

  5. Physical mechanisms of active control of sound transmission through rib stiffened double-panel structure

    Science.gov (United States)

    Ma, Xiyue; Chen, Kean; Ding, Shaohu; Yu, Haoxin

    2016-06-01

    This paper presents an analytical investigation on physical mechanisms of actively controlling sound transmission through a rib stiffened double-panel structure using point source in the cavity. The combined modal expansion and vibro-acoustic coupling methods are applied to establish the theoretical model of such active structure. Under the condition of minimizing radiated power of the radiating ribbed plate, the physical mechanisms are interpreted in detail from the point of view of modal couplings similar as that used in existed literatures. Results obtained demonstrate that the rule of sound energy transmission and the physical mechanisms for the rib stiffened double-panel structure are all changed, and affected by the coupling effects of the rib when compared with the analytical results obtained for unribbed double-panel case. By taking the coupling effects of the rib into considerations, the cavity modal suppression and rearrangement mechanisms obtained in existed investigations are modified and supplemented for the ribbed plate case, which gives a clear interpretation for the physical nature involved in the active rib stiffened double-panel structure.

  6. The effects of longitudinal ribs on entropy generation for laminar forced convection in a microchannel

    Directory of Open Access Journals (Sweden)

    Pourmahmoud Nader

    2016-01-01

    Full Text Available This paper deals with fluid flow, heat transfer and entropy generation in an internally ribbed microchannel. Mass, momentum and energy equations for constant heat flux boundary condition are solved using the finite volume method. Average Nusselt number and Fanning friction factor are reported as a function of rib height at different Reynolds numbers. The effects of non-dimensional rib height, wall heat flux and the Reynolds number on the entropy generation attributed to friction, heat transfer and total entropy generation are explored. The first law indicates that rib height has the great effect on the flow filed and heat transfer. The second law analysis reveals that for any values of Reynolds number and wall heat flux, as rib height grows; the frictional irreversibility increases while, there is a rib height which provides the minimum heat transfer irreversibility. It is found that the optimum rib height with the minimum total entropy generation rate depends on Reynolds number and wall heat flux.

  7. FIRST RIB STRESS FRACTURE IN A SIDEARM BASEBALL PITCHER: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Takeshi Sakata

    2005-06-01

    Full Text Available Stress fractures of the first rib in athletes are rare. A 14-year-old male, a baseball pitcher who changed from an overhand to a sidearm style, with a stress fracture of the first rib, was reported. Most Stress fractures in the first rib occur at the subclavian groove, between the attachments of the scalenus anterior and scalenus medius muscles, which is the thinnest and weakest portion of the rib. However, in this case the stress fracture occurred at the uncommon region, posterior to the insertion of the scalenus medius muscle, in the first rib. The motion analysis of the pitching in this case demonstrated that the sidearm style induced much more horizontal abduction in the shoulder at the top position than did the overhand style. The findings of electromyography in the serratus anterior muscle, one of the muscles which insert on the first rib, through the pitching motion did not demonstrate any significant differences between the two styles. In this case, the repetition of horizontal over-abduction of the shoulder when sidearm pitching appears to have been the cause of the unusual stress fracture of the first rib at this site

  8. Notalgia paresthetica associated with cervical spinal stenosis and cervicothoracic disk disease at C4 through C7.

    Science.gov (United States)

    Alai, Nili N; Skinner, Harry B; Nabili, Siamak T; Jeffes, Edward; Shahrokni, Seyed; Saemi, Arash M

    2010-02-01

    Notalgia paresthetica (NP) is a common refractory, sensory, neuropathic syndrome with the hallmark symptom of localized pruritus of the unilateral infrascapular back. It generally is a chronic noncurable condition with periodic remissions and exacerbations. While the dermatologic syndrome may be multifactorial in etiology, a possible association with underlying cervical spine disease should be evaluated for proper treatment. Collaborative multispecialty evaluation by dermatology, radiology, orthopedic surgery, and neurology may be indicated for primary management of this condition. First-line therapy for NP with associated cervical disease may include nondermatologic noninvasive treatments such as spinal manipulation, physical therapy, massage, cervical traction, cervical muscle strengthening, and oral nonsteroidal anti-inflammatory drugs and muscle relaxants. Notalgia paresthetica may in fact be a cutaneous sign of an underlying degenerative cervical spine disease. We report a case of a patient with cervical spinal stenosis that corresponded directly with the clinical findings of NP.

  9. Evolutionary mechanisms of rib loss in anurans: a comparative developmental approach.

    Science.gov (United States)

    Blanco, M J; Sanchiz, B

    2000-04-01

    ABSTRACT The presence of free ribs is presumed to be a primitive morphological character observed only in a few families of Recent anurans, whereas the absence of ribs has been considered to be a derived condition that is widespread within this order. A comparative study of rib development based on representatives of several anuran lineages (Alytes, Bombina, Bufo, Discoglossus, Hyla, Pelobates, Pelodytes, Rana, and Xenopus) reveals a previously undetected diversity of developmental features in the formation and interaction between neural arches and ribs. The absence of free ribs at premetamorphic or later stages is verified in some groups, but we present for the first time evidence of the existence of larval rib rudiments in others, both in the anterior (Rana, Hyla) and posterior (Bufo, Discoglossus, Pelobates) presacral regions. Heterochrony seems to have played a major role in the processes underlying rib reduction. The intracolumnar differences between anterior (V(2)-V(4)) and posterior (V(5)-V(8)) regions are based on perturbations in the timing of early differentiation. Furthermore, a clear shift in the relative timing of ossification among evolutionary lineages was detected. In this respect Xenopus has a highly derived condition. The use of the morphological character of "rib loss" in phylogenetic analyses must be reconsidered due to the different convergent developmental paths described here. The phylogenetic analysis of a "sequence units" matrix of rib development is compared with current anuran phylogenies. Some evolutionary information appears to be clearly present in the ontogenetic data of this "missing morphology," but its value for evolutionary inferences is rather limited.

  10. Carpal tunnel syndrome with cervical spondylotic radiculopathy:a clinical and electrophysiological study%腕管综合征合并神经根型颈椎病的临床与电生理特点

    Institute of Scientific and Technical Information of China (English)

    汪仁斌; 刘尊敬; 汪伟; 董明睿; 孙少杰; 毛坤; 焦劲松; 严莉

    2015-01-01

    Objective To study the clinical and electrophysiological characteristics of carpal tunnel syndrome (CTS) with cervical spondylotic radiculopathy (CSR) and simple-CTS,and compare the effect of double crush with that of simple entrapment on a nerve and investigate the association between CTS and CSR.Method From January 2011 to August 2014,clinical data from 96 patients with double crush syndrome (DCS,CTS with CSR) and 165 patients with simple-CTS were examined,and the electrophysiologic parameters of median nerve in patients with DCS were compared with that in patients with simple-CTS.Results In 96 patients with DCS,most of them were female;neck and shoulder pain or simultaneously accompanied by numbness and pain of upper limb was observed in 34 patients,upper limb symptoms and hand weakness and muscle atrophy were observed in the other 62 patients,124 median nerves with abnormal conduction were found in these DCS patients,including 68 cases with unilateral abnormalities and 28 cases with bilateral abnormalities.Cervical radiculopathies of the C5-7 mainly involved in patients with DCS.223 median nerves with abnormal conduction found in the 165 patients with simple-CTS,including 107 cases with unilateral abnormalities and 58 cases with bilateral abnormalities.The average sensory nerve conduction velocity (SCV),motor nerve conduction velocity (MCV) and distal motor latency (DML) of median nerve for DCS and simple-CTS were(32 ±7) m/s vs (35 ±5) m/s,(55 ±7) m/s vs (57 ±5) m/s and (4.6 ± 1.6) ms vs (4.0 ± 0.8) ms,respectively,and their corresponding amplitudes were 6.4 μV vs 9.5 μV,10.9 mV vs 13.1 mV and 11.3 mV vs 14.1 mV,respectively.The SCV,MCV and DML and their corresponding amplitude of DCS were significantly greater decreased than that of simple-CTS (P < 0.01).Conclusion DCS is a common clinical syndrome,and patients with DCS may have neck and shoulder symptoms in addition to the common manifestations of simple-CTS.Abnormal conduction of median nerve of

  11. Bazex Syndrome with Hypoalbuminemia and Severe Ascites

    OpenAIRE

    2016-01-01

    Bazex syndrome is a rare paraneoplastic dermatosis. The underlying malignancy frequently is squamous cell carcinoma of the upper aerodigestive tract or cervical lymph nodes from an unknown primary site. We report a 63-year-old man with squamous cell carcinoma of cervical lymph nodes from an unknown primary site. He developed a mass on the right side of his neck, cutaneous lesions diagnosed as Bazex syndrome, hypoalbuminemia, and severe ascites. Right neck dissection was performed. After neck ...

  12. Langerhans Cell Histiocytosis of the Rib in an Adult: A Case Report

    Directory of Open Access Journals (Sweden)

    Sung Hyun Kim

    2016-01-01

    Full Text Available Single-site, single-system Langerhans cell histiocytosis (LCH of the rib is one of the rarest causes of bone tumor in adults. Herein, we report a case of a healthy 35-year-old male who presented with upper back pain that was attributed to a solitary osteolytic lesion at the posterolateral aspect of his sixth rib. For diagnostic confirmation and treatment, partial resection of the sixth rib was performed and pathologic finding was consistent with LCH. At the final follow-up after 2 years, no local recurrence or metastasis was observed.

  13. Langerhans Cell Histiocytosis of the Rib in an Adult: A Case Report

    Science.gov (United States)

    Kim, Sung Hyun; Choi, Moon Young

    2016-01-01

    Single-site, single-system Langerhans cell histiocytosis (LCH) of the rib is one of the rarest causes of bone tumor in adults. Herein, we report a case of a healthy 35-year-old male who presented with upper back pain that was attributed to a solitary osteolytic lesion at the posterolateral aspect of his sixth rib. For diagnostic confirmation and treatment, partial resection of the sixth rib was performed and pathologic finding was consistent with LCH. At the final follow-up after 2 years, no local recurrence or metastasis was observed. PMID:26933424

  14. Solar swimming pool heating plants self-constructed with ribbed pipes

    Energy Technology Data Exchange (ETDEWEB)

    Pfenning, R.

    The solar absorber suitable for self-construction consists of ribbed pipes which can be joined together to units of any size with the help of simple plug connections. By using especially developed ribbed pipes for absorbing the insolation an increased surface and, moreover, a greater stability can be achieved. The material used for the ribbed pipes is a special polypropylene which is UV stable and resistant against all chemicals occurring in swimming pool water. The same is valid for the rubber parts of the plug connections which are made of EPDM.

  15. The ribs unfolded - a CT visualization algorithm for fast detection of rib fractures: effect on sensitivity and specificity in trauma patients

    Energy Technology Data Exchange (ETDEWEB)

    Ringl, Helmut; Lazar, Mathias; Toepker, Michael; Woitek, Ramona; Prosch, Helmut; Asenbaum, Ulrika; Balassy, Csilla; Toth, Daniel; Weber, Michael; Mang, Thomas [Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria); Hajdu, Stefan [Medical University of Vienna, Department of Trauma Surgery, Vienna (Austria); Soza, Grzegorz; Wimmer, Andreas [Siemens AG, Healthcare Sector, Computed Tomography, Forchheim (Germany)

    2015-07-15

    To assess a radiologist's detection rate of rib fractures in trauma CT when reading curved planar reformats (CPRs) of the ribs compared to reading standard MPRs. Two hundred and twenty trauma CTs (146 males, 74 females) were retrospectively subjected to a software algorithm to generate CPRs of the ribs. Patients were split into two equal groups. Sixteen patients were excluded due to insufficient segmentation, leaving 107 patients in group A and 97 patients in group B. Two radiologists independently evaluated group A using CPRs and group B using standard MPRs. Two different radiologists reviewed both groups with the inverse methods setting. Results were compared to a standard of reference created by two senior radiologists. The reference standard identified 361 rib fractures in 61 patients. Reading CPRs showed a significantly higher overall sensitivity (P < 0.001) for fracture detection than reading standard MPRs, with 80.9 % (584/722) and 71.5 % (516/722), respectively. Mean reading time was significantly shorter for CPRs (31.3 s) compared to standard MPRs (60.7 s; P < 0.001). Using CPRs for the detection of rib fractures accelerates the reading of trauma patient chest CTs, while offering an increased overall sensitivity compared to conventional standard MPRs. (orig.)

  16. Heat Transfer and Friction Characteristics of the Microfluidic Heat Sink with Variously-Shaped Ribs for Chip Cooling

    Directory of Open Access Journals (Sweden)

    Gui-Lian Wang

    2015-04-01

    Full Text Available This paper experimentally and numerically investigated the heat transfer and friction characteristics of microfluidic heat sinks with variously-shaped micro-ribs, i.e., rectangular, triangular and semicircular ribs. The micro-ribs were fabricated on the sidewalls of microfluidic channels by a surface-micromachining micro-electro-mechanical system (MEMS process and used as turbulators to improve the heat transfer rate of the microfluidic heat sink. The results indicate that the utilizing of micro-ribs provides a better heat transfer rate, but also increases the pressure drop penalty for microchannels. Furthermore, the heat transfer and friction characteristics of the microchannels are strongly affected by the rib shape. In comparison, the triangular ribbed microchannel possesses the highest Nusselt number and friction factor among the three rib types.

  17. Heat transfer and friction characteristics of the microfluidic heat sink with variously-shaped ribs for chip cooling.

    Science.gov (United States)

    Wang, Gui-Lian; Yang, Da-Wei; Wang, Yan; Niu, Di; Zhao, Xiao-Lin; Ding, Gui-Fu

    2015-04-22

    This paper experimentally and numerically investigated the heat transfer and friction characteristics of microfluidic heat sinks with variously-shaped micro-ribs, i.e., rectangular, triangular and semicircular ribs. The micro-ribs were fabricated on the sidewalls of microfluidic channels by a surface-micromachining micro-electro-mechanical system (MEMS) process and used as turbulators to improve the heat transfer rate of the microfluidic heat sink. The results indicate that the utilizing of micro-ribs provides a better heat transfer rate, but also increases the pressure drop penalty for microchannels. Furthermore, the heat transfer and friction characteristics of the microchannels are strongly affected by the rib shape. In comparison, the triangular ribbed microchannel possesses the highest Nusselt number and friction factor among the three rib types.

  18. Basal cell nevus syndrome or Gorlin syndrome.

    Science.gov (United States)

    Thalakoti, Srikanth; Geller, Thomas

    2015-01-01

    Basal cell nevus syndrome (BCNS) or Gorlin syndrome is a rare neurocutaneous syndrome sometimes known as the fifth phacomatosis, inherited in autosomal dominant fashion with complete penetrance and variable expressivity. Gorlin syndrome is characterized by development of multiple basal cell carcinomas (BCCs), jaw cysts, palmar or plantar pits, calcification of falx cerebri, various developmental skeletal abnormalities such as bifid rib, hemi- or bifid vertebra and predisposition to the development of various tumors. BCNS is caused by a mutation in the PTCH1 gene localized to 9q22.3. Its estimated prevalence varies between 1/55600 and 1/256000 with an equal male to female ratio. The medulloblastoma variant seen in Gorlin syndrome patients is of the desmoplastic type, characteristically presenting during the first 3 years of life. Therefore, children with desmoplastic medulloblastoma should be carefully screened for other features of BCNS. Radiation therapy for desmoplastic medulloblastoma should be avoided in BCNS patients as it may induce development of invasive BCCs and other tumors in the skin area exposed to radiation. This syndrome is a multisystem disorder so involvement of multiple specialists with a multimodal approach to detect and treat various manifestations at early stages will reduce the long-term sequelae and severity of the condition. Life expectancy is not significantly altered but morbidity from complications and cosmetic scarring can be substantial.

  19. Cervical spine CT scan

    Science.gov (United States)

    ... defects of the cervical spine Bone problems Fracture Osteoarthritis Disc herniation Risks Risks of CT scans include: ... Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, ...

  20. Cervical Radiculopathy (Pinched Nerve)

    Science.gov (United States)

    ... help relieve pain, strengthen neck muscles, and improve range of motion. In some cases, traction can be used to ... Learn more about surgery for radiculopathy online at Cervical ... a wide range of musculoskeletal conditions and injuries. All articles are ...

  1. Immunotherapy for Cervical Cancer

    Science.gov (United States)

    In an early phase NCI clinical trial, two patients with metastatic cervical cancer had a complete disappearance of their tumors after receiving treatment with a form of immunotherapy called adoptive cell transfer.

  2. Evaluating the point of separation, during carcass fabrication, between the beef wholesale rib and the beef wholesale chuck.

    Science.gov (United States)

    Reuter, B J; Wulf, D M; Shanks, B C; Maddock, R J

    2002-01-01

    This study determined whether there is a logical point of value change, related to either tenderness or consumer acceptance, at which to separate the beef carcass within the rib/chuck region. Rib/chuck rolls (RCR); (n = 30) consisting of the ribeye roll and chuck eye roll subprimals (2nd through 12th rib locations) were cut into 22 steaks each (two steaks per rib location), and Warner-Bratzler shear force and consumer purchase preference were evaluated for steaks at each rib location. Steaks from different locations of the RCR were composed of differing proportions of several muscles: longissimus muscle (LM), spinalis dorsi and multifidus dorsi (SM), and complexus (CO). The LM (4th to 12th rib) contained three tenderness regions: 7th through 12th rib, 5th and 6th ribs, and 4th rib regions (lowest, intermediate, and highest shear force values, respectively; P consumers. Steaks (n = 330) were offered for sale at a retail supermarket and case time was monitored on each steak to determine consumer purchase preference. Steaks from the 2nd through 4th rib locations required more time to sell (P < 0.01) than steaks from the 5th through 12th rib locations. Two alternative locations for the rib/chuck separation point could be between the 6th and 7th ribs, yielding a ribeye subprimal useful in marketing a "premium quality" product, or between the 4th and 5th ribs, which would yield four more 2.5-cm ribeye steaks per carcass.

  3. Dolor cervical incoercible

    Directory of Open Access Journals (Sweden)

    Adrián F Narváez-Muñoz

    2014-03-01

    Astrocytomas are relatively common glial neoplasm of the central nervous system, but only a small percentage of them are located in the spinal cord, with a predilection for the cervical and dorsal regions. In most cases, extend longitudinally, affecting several cord segments. Pain is a frequent symptom of local character bone segments involving the tumor, associated with sensory deficit and / or motor. The following is the case of a 60 year old woman with cervical cord astrocytoma extended to the brainstem.

  4. Revised vertebral count in the "longest-necked vertebrate" Elasmosaurus platyurus Cope 1868, and clarification of the cervical-dorsal transition in Plesiosauria.

    Directory of Open Access Journals (Sweden)

    Sven Sachs

    Full Text Available Elasmosaurid plesiosaurians are renowned for their immensely long necks, and indeed, possessed the highest number of cervical vertebrae for any known vertebrate. Historically, the largest count has been attributed to the iconic Elasmosaurus platyurus from the Late Cretaceous of Kansas, but estimates for the total neck series in this taxon have varied between published reports. Accurately determining the number of vertebral centra vis-à-vis the maximum length of the neck in plesiosaurians has significant implications for phylogenetic character designations, as well as the inconsistent terminology applied to some osteological structures. With these issues in mind, we reassessed the holotype of E. platyurus as a model for standardizing the debated cervical-dorsal transition in plesiosaurians, and during this procedure, documented a "lost" cervical centrum. Our revision also advocates retention of the term "pectorals" to describe the usually three or more distinctive vertebrae close to the cranial margin of the forelimb girdle that bear a functional rib facet transected by the neurocentral suture, and thus conjointly formed by both the parapophysis on the centrum body and diapophysis from the neural arch (irrespective of rib length. This morphology is unambiguously distinguishable from standard cervicals, in which the functional rib facet is borne exclusively on the centrum, and dorsals in which the rib articulation is situated above the neurocentral suture and functionally borne only by the transverse process of the neural arch. Given these easily distinguishable definitions, the maximum number of neck vertebrae preserved in E. platyurus is 72; this is only three vertebrae shorter than the recently described Albertonectes, which together with E. platyurus constitute the "longest necked" animals ever to have lived.

  5. Case report 529: Osteosarcoma of calcaneus with Rothmund-Thompson syndrome (RTS)

    Energy Technology Data Exchange (ETDEWEB)

    Baro, P.R.; Bastart, F.M.; Bartrina, J.R.; Mateo, J.M.; Vidal, M.T.R.

    1989-04-01

    A new case of Rothmund Thomson syndrome (RTS) diagnosed at infancy is described. This patient developed a lesion in the calcaneus classified histologically as an osteosarcoma. Twelve months later she developed metastasic lesions in a rib and in the lungs. This case is the fourth reported osteosarcoma in a patient with the RTS syndrome. (orig./GDG).

  6. Natural replacement of vertically inherited lux-rib genes of Photobacterium aquimaris by horizontally acquired homologues.

    Science.gov (United States)

    Urbanczyk, Henryk; Furukawa, Takashi; Yamamoto, Yuki; Dunlap, Paul V

    2012-08-01

    We report here the first instance of a complete replacement of vertically inherited luminescence genes by horizontally acquired homologues. Different strains of Photobacterium aquimaris contain homologues of the lux-rib genes that have a different evolutionary history. Strain BS1 from the Black Sea contains a vertically inherited lux-rib operon, which presumably arose in the ancestor of this species, whereas the type strain NBRC 104633(T) , from Sagami Bay, lacks the vertically inherited lux-rib operon and instead carries a complete and functional lux-rib operon acquired horizontally from a bacterium related to Photobacterium mandapamensis. The results indicate that the horizontal acquisition of the lux genes expanded the pan-genome of P. aquimaris, but it did not influence the phylogenetic divergence of this species.

  7. Exercise-induced rib stress fractures: influence of reduced bone mineral density

    DEFF Research Database (Denmark)

    Vinther, Anders; Kanstrup, Inge-Lis; Christiansen, Erik;

    2005-01-01

    Exercise-induced rib stress fractures have been reported frequently in elite rowers during the past decade. The etiology of rib stress fractures is unclear, but low bone mineral density (BMD) has been suggested to be a potential risk factor for stress fractures in weight-bearing bones. The present...... study investigated BMD in seven Danish national team rowers with previous rib stress fracture (RSF) and 7 controls (C) matched for gender, age, height, weight and training experience. Total body scan and specific scans of the lumbar spine (L2-L4), femoral neck and distal radius were performed using...... density may be a potential risk factor for the development of exercise-induced rib stress fractures in elite rowers....

  8. Multislice computed tomography of the first rib: a useful technique for bone age assessment.

    Science.gov (United States)

    Moskovitch, Guillaume; Dedouit, Fabrice; Braga, José; Rougé, Daniel; Rousseau, Hervé; Telmon, Norbert

    2010-07-01

    Macroscopic study of the first rib has been described by Kunos et al. as an efficient method of age estimation. We retrospectively reviewed a test sample of 160 first right ribs obtained from multislice computed tomography (MSCT) clinical investigations of living individuals aged 15-30 years old. Based on the descriptions of Kunos et al., we analyzed the morphological appearance of the sternal end of the first rib on two- and three-dimensional MSCT reconstructions and defined changes in appearance in stages (from 2 to 5). We also studied the calcification and ossification of the costal cartilage as an independent feature. By statistical analysis (ANOVA), we determined for each gender the correlation between the estimated stage of the costal face, the appearance of the costal cartilage, and the documented age of the subjects. We demonstrated that MSCT of the first rib appears to be an efficient noninvasive modality for bone age estimation.

  9. Effect of adiabatic square ribs on natural convection in an asymmetrically heated channel

    Science.gov (United States)

    Abidi-Saad, Aissa; Kadja, Mahfoud; Popa, Catalin; Polidori, Guillaume

    2017-02-01

    A 2-D numerical simulation is carried out to investigate the effect of two adiabatic square ribs on laminar flow and heat transfer in an asymmetrically heated channel. The two ribs are symmetrically located on each wall, exactly above the heating zone. The computational procedure is made by solving the unsteady bi-dimensional continuity, momentum and energy equations with the finite volume method. The investigations focused more specifically on the influence of ribs sizes on the flow structure and heat transfer enhancement. The results showed that the variation of ribs sizes significantly alters the heat transfer and fluid flow distribution along the channel, especially in the vicinity of protrusions. Also, the results show that streamlines, isotherms, and the number, sizes and formation of vortex structures inside the channel strongly depend on the size of protrusions. The changes in heat transfer parameters have also been presented.

  10. Schlieren visualization of water natural convection in a vertical ribbed channel

    Science.gov (United States)

    Fossa, M.; Misale, M.; Tanda, G.

    2015-11-01

    Schlieren techniques are valuable tools for the qualitative and quantitative visualizations of flows in a wide range of scientific and engineering disciplines. A large number of schlieren systems have been developed and documented in the literature; majority of applications involve flows of gases, typically air. In this work, a schlieren technique is applied to visualize the buoyancy-induced flow inside vertical ribbed channels using water as convective fluid. The test section consists of a vertical plate made of two thin sheets of chrome-plated copper with a foil heater sandwiched between them; the external sides of the plate are roughened with transverse, square-cross-sectioned ribs. Two parallel vertical walls, smooth and unheated, form with the heated ribbed plate two adjacent, identical and asymmetrically heated, vertical channels. Results include flow schlieren visualizations with colour-band filters, reconstructions of the local heat transfer coefficient distributions along the ribbed surfaces and comparisons with past experiments performed using air as working fluid.

  11. Rib metastases from a non-tonsillar squamous cell carcinoma in a dog.

    Science.gov (United States)

    Clarke, B S; Mannion, P A; White, R A S

    2011-03-01

    Metastatic spread to the ribs in a 15-year-old, male, neutered, Irish setter is reported occurring secondary to an oral squamous cell carcinoma (SCC). The dog presented with a history of a rapidly growing SCC of the right upper incisive region, which was confirmed by histopathology as a SCC. Thoracic radiographs showed bony lesions associated with the body of the right third rib, and the fifth and seventh costal cartilages. A rostral partial maxillectomy was performed as palliative treatment for the oral mass and a core biopsy of the lesion on the third rib was performed. The rib lesion was identified histopathologically as a metastatic SCC. A review of the literature of oropharyngeal SCC and the metastatic potential of non-tonsillar SCC is presented, in particular metastatic bone disease. This case report suggests possible implications of metastatic bone disease for treatment and prognosis for future cases of non-tonsillar SCC.

  12. Posterior rib fractures in a young infant who received chiropractic care.

    Science.gov (United States)

    Wilson, Paria Majd; Greiner, Mary V; Duma, Elena M

    2012-11-01

    We report on a 21-day-old infant with healing posterior rib fractures that were noted after a chiropractic visit for colic. Chiropractors are the third largest group of health care professionals in the United States, and colic is the leading complaint for pediatric chiropractic care. Rib fractures, specifically when posterior, are traditionally considered to be secondary to nonaccidental trauma. Thorough investigation is necessary to rule out bone fragility and genetic disorders, but patient history is key when evaluating unexplained fractures.

  13. Frequency of intrathoracic injuries in children younger than 3 years with rib fractures

    Energy Technology Data Exchange (ETDEWEB)

    Darling, Stephen E. [Kapiolani Children' s Hospital, The Department of Radiology, Honolulu, HI (United States); Done, Stephen L.; Friedman, Seth D. [Seattle Children' s Hospital, The Department' s of Radiology, Seattle, WA (United States); University of Washington School of Medicine, Seattle, WA (United States); Feldman, Kenneth W. [Seattle Children' s Hospital, Pediatrics, General Pediatrics Division, Seattle, WA (United States); Seattle Children' s Protection Program, Children' s Protection Program, M/S M2-10, Seattle, WA (United States); University of Washington School of Medicine, Seattle, WA (United States)

    2014-10-15

    Research documents that among children admitted to trauma intensive care units the number of rib fractures sustained indicates the child's likelihood of having and severity of intrathoracic injury. This has been misused in court to argue that children with multiple rib fractures who lack intrathoracic injury have abnormal bone fragility rather than inflicted injury. To determine frequency of intrathoracic injuries in children younger than 3 years with rib fractures in cases of child abuse and accidental trauma. We conducted a retrospective review of rib fractures caused by documented abuse or accidents from 2003 to 2010 in children treated at Seattle Children's Hospital and Harborview Medical Center. A senior pediatric radiologist and radiology fellow independently reviewed the imaging. Children with bone demineralization were excluded. Descriptive and simple comparative statistics were used. Seventy-two percent (47/65) of infants and toddlers with rib fractures were abused. Abused children had more rib fractures than accidentally injured children (5.55 vs. 3.11, P = 0.012). However intrathoracic injuries as a whole (55.6% vs. 12.8%, P < 0.001) and individual types of intrathoracic injuries were more common with accidents. Rates of other thoracic cage injuries did not differ substantially (27.8% accidents vs. 12.8% abuse, P = 0.064). Intracranial and intra-abdominal injuries and skull fractures were equally frequent, but other extrathoracic fractures were more common with abuse (70.2% vs. 16.7%, P < 0.001). Abused infants and toddlers have fewer intrathoracic injuries but more rib fractures than accidentally injured peers. This likely reflects different injury mechanics. Lack of intrathoracic injuries in abused children with rib fractures does not imply bone fragility. (orig.)

  14. A special dish from traditional Turkish Cuisine: Stuffed lamb ribs

    Directory of Open Access Journals (Sweden)

    Emel Memis Kocaman

    2015-11-01

    Full Text Available Turkish people, who have a long historical background, have a rich culture in terms of cuisine. “Dolma” (meal made by stuffing/wrapping is one of the most important dishes of the Turkish Cuisine. Turks produced very different types of meals made by stuffing or wrapping and by combining herbals, meat and offals products. Stuffed Lamb Ribs (in Turkish; Kaburga Dolması or Sura is a special dish that is known in many regions of Turkey. Since it is a dish whose preparation is hard and requires virtuosity, it is generally cooked as a feast meal on religious holidays, and commonly cooked on the Feast of Sacrifice for Muslims. This study aims to present how “Stuffed Lamb Ribs” are prepared, which is one of the traditional dishes of Turkish Cuisine and is one stuffed dish that has started to become forgotten. In this study, the data was collected by personal interviews with source people who are over 60 years old, live in different provinces of Turkey, and traditionally cook this dish. This study ensures the promotion of a very special taste, which has begun to be forgotten and is not known widely even in Turkey, at an international level.

  15. Image Classification of Ribbed Smoked Sheet using Learning Vector Quantization

    Science.gov (United States)

    Rahmat, R. F.; Pulungan, A. F.; Faza, S.; Budiarto, R.

    2017-01-01

    Natural rubber is an important export commodity in Indonesia, which can be a major contributor to national economic development. One type of rubber used as rubber material exports is Ribbed Smoked Sheet (RSS). The quantity of RSS exports depends on the quality of RSS. RSS rubber quality has been assigned in SNI 06-001-1987 and the International Standards of Quality and Packing for Natural Rubber Grades (The Green Book). The determination of RSS quality is also known as the sorting process. In the rubber factones, the sorting process is still done manually by looking and detecting at the levels of air bubbles on the surface of the rubber sheet by naked eyes so that the result is subjective and not so good. Therefore, a method is required to classify RSS rubber automatically and precisely. We propose some image processing techniques for the pre-processing, zoning method for feature extraction and Learning Vector Quantization (LVQ) method for classifying RSS rubber into two grades, namely RSS1 and RSS3. We used 120 RSS images as training dataset and 60 RSS images as testing dataset. The result shows that our proposed method can give 89% of accuracy and the best perform epoch is in the fifteenth epoch.

  16. Characterizing the dynamics of a flexible rod wrapped by transverse repeated ribs subjected to axial flow

    Energy Technology Data Exchange (ETDEWEB)

    Perets, Y., E-mail: yaronprts@gmail.com [Department of Mechanical Engineering, Ben-Gurion University of the Negev, Beer-Sheva (Israel); Sher, E. [Faculty of Aerospace Engineering, Technion – Israel Institute of Technology, Haifa (Israel); Harari, R. [Nuclear Research Center – Negev (NRCN), Beer-Sheva (Israel)

    2014-04-01

    Highlights: • The dynamic instability of a repeated ribs cylindrical rod in annular axial flow geometry was studied. • The results indicate a strong dependency between rod instability and rib roughness. • The rod dynamics become stabilized when the pitch-to-height ratio of the ribs increases. • Increase of the rib width-to-height ratio destabilizes the rod. • The nonlinear model confirms the existence of post critical instability and the reliability of the linear results. - Abstract: This study focuses on the dynamics of a flexible cylindrical structure wrapped by repeated transverse rectangular ribs, in an annular flow geometry, under two boundary conditions: simply supported ends and clamped ends. The dynamics is predicted by linear and nonlinear theories. Based on the linear equation a straightforward nonlinear equation can be derived. A parametric investigation of the effect of the ribs’ dimensionless geometry characterized by the pitch-to-height and width-to-height ratios, on the fluid-elastic instability characteristics is considered. The results of the present study indicate a strong dependency between rod instability and rib roughness. The nonlinear model confirms the existence of post critical instability and the reliability of the linear results.

  17. Rib head protrusion into the central canal in type 1 neurofibromatosis

    Energy Technology Data Exchange (ETDEWEB)

    Ton, Jimmy; Yen, Philip [University of California, Davis Medical Center and U.C. Davis Children' s Hospital, Department of Radiology, Sacramento, CA (United States); Stein-Wexler, Rebecca [University of California, Davis Medical Center and U.C. Davis Children' s Hospital, Department of Radiology, Sacramento, CA (United States); Shriners Hospital of Northern California, Department of Radiology, Sacramento, CA (United States); Gupta, Munish [University of California, Davis Medical Center and U.C. Davis Children' s Hospital, Department of Orthopedic Surgery, Sacramento, CA (United States); Shriners Hospital of Northern California, Department of Orthopedic Surgery, Sacramento, CA (United States)

    2010-12-15

    Intraspinal rib head dislocation is an important but under-recognized consequence of dystrophic scoliosis in patients with neurofibromatosis 1 (NF1). To present clinical and imaging findings of intraspinal rib head dislocation in NF1. We retrospectively reviewed clinical presentation, imaging, operative reports and post-operative courses in four NF1 patients with intraspinal rib head dislocation and dystrophic scoliosis. We also reviewed 17 cases from the English literature. In each of our four cases of intraspinal rib head dislocation, a single rib head was dislocated on the convex apex of the curve, most often in the mid- to lower thoracic region. Cord compression occurred in half of these patients. Analysis of the literature yielded similar findings. Only three cases in the literature demonstrates the MRI appearance of this entity; most employ CT. All of our cases include both MRI and CT; we review the subtle findings on MRI. Although intraspinal rib head dislocation is readily apparent on CT, sometimes MRI is the only cross-sectional imaging performed. It is essential that radiologists become familiar with this entity, as subtle findings have significant implications for surgical management. (orig.)

  18. DNS Study of the Turbulent Taylor-Vortex Flow on a Ribbed Inner Cylinder

    Directory of Open Access Journals (Sweden)

    Takahiro Tsukahara

    2013-01-01

    Full Text Available Turbulent Taylor-vortex flows over regularly spaced square ribs mounted on a rotating inner cylinder surface were investigated using direct numerical simulations (DNSs for a Reynolds number of 3200 (based on the inner-wall velocity and the gap width between two cylinders in an apparatus with an inner-to-outer radius ratio of 0.617, while varying the streamwise interval of the ribs. We examined the flow and pressure fields around each rib, focusing on the recirculation zone, the frictional drag coefficient, and the pressure (form drag. Our results for the Taylor-Couette flows were compared to DNS for plane Poiseuille flows over ribbed surfaces performed by Leonardi et al. (2003. We determined the qualitative consistency between them with respect to the roughness effect, which depends significantly on the rib interval, but the rate of increase in the flow resistance was remarkably dampened by roughness in the present flows. Taylor vortices remaining over roughened cylinder surfaces were found to induce quick pressure recovery behind each rib, leading to less pressure drag and an enhanced backflow in the recirculation zone.

  19. Regional effects of ovariectomy and cadmium on bone mineral in ribs from aged female beagles

    Energy Technology Data Exchange (ETDEWEB)

    Hurst, D.R. (Miami Univ., Oxford, OH (USA). Dept. of Zoology)

    1991-01-01

    The purpose of this study was to evaluate effects of estrogen depletion and cadmium (Cd) on bone calcium and to determine if these effects were localized in specific regions of ribs. Fourteen female beagles with {sup 45}Ca labeled skeletons were divided into four groups: sham controls (SO{minus}); ovariectomized (OV{minus}); shams exposed to Cd (SO+); ovariecomized exposed to Cd (OV+). Total Cd exposure period was 7 months, including 1 month by capsules and 6 months by drinking H{sub 2}O. Ribs were taken at necropsy from 12 of the 14 dogs, and each rib was quartered. Wet, dry, and ash weights, as well as total Ca and {sup 45}Ca content, were determined for each quarter. Analysis of ribs from control animals demonstrated that a given rib is heterogeneous in composition. One end appears to be less mineralized and more metabolically active than other regions. The OV{minus} and OV+ mid-rib regions had significantly lower dry and ash weights than SO{minus}. Total Ca contents of these same regions were also decreased in the OV{minus} and OV+. The only significant change in Ca/dry and Ca/ash was observed when comparing OV+ to SO{minus}. Analysis of treatment suggests that there are regional effects following ovariectomy increased the loss of bone mineral occurring as a result of ovariectomy. 30 refs., 1 fig.

  20. A Study on the Performance of the Split Reaction Water Turbine with Guide Ribs

    Science.gov (United States)

    Allen, Deuel H.; Villanueva, Eliseo P.

    2015-09-01

    The development of technologies that make use of renewable energy is of great significance presently. A new kind of turbine called Split Reaction Water Turbine (SRWT) using PVC pipes as material is a major contribution towards harnessing the energy potentials of small stream low head water resources. SRWTs of diameter to height ratio (D/H = 110 cm/160 cm) were tested at the MSU-IIT College of Engineering Fluid Engineering Laboratory. Data on volumetric flow and pressure head at the turbine inlet of the SRWT were recorded using National Instrument Data Processing System using LabView software. In later experiments, guide ribs were installed at the vane of the exit nozzles in order to determine the difference in the performance of the ribbed and the non-ribbed SRWT. Simulations of the running SRWT were conducted using SOLIDWORKS software. Results of the simulations aided in the thorough analyses of the data from the experimental runs. A comparison of data from the ribbed and non-ribbed SRWT shows that guide ribs were effective in directing the momentum of the exiting water to improve the speed of rotation. In this study, the increase in the speed of the Split Reaction Water Turbine was as much as 46%.

  1. Correlating first- and second-rib fractures noted on spine computed tomography with major vessel injury.

    Science.gov (United States)

    Khosla, Ankaj; Ocel, Joseph; Rad, Arash Ehteshami; Kallmes, David F

    2010-11-01

    First- and second-rib fractures diagnosed on plain radiographs have been associated with traumatic aortic injury. We examined whether such fractures diagnosed on computed tomography (CT), which is of greater sensitivity than plain radiograms for rib fractures, are associated with traumatic vascular injury. We identified 1,894 patients who had undergone a chest CT angiogram with indication of trauma between 2005 and 2008. Among these, 185 patients were selected at random. The main mechanism of injury was motor vehicle accident or a fall. The patients were divided into two groups: patients with first- and/or second-rib fractures and those without. Proportions of patients with major vessel injury noted on CT angiography were compared between groups. Information regarding displacement of the fracture, location of the fracture, detection upon plain film, and gender of the patients was also evaluated and correlated with incidence of major vessel injury. Fisher's test and χ2 analysis were used to determine significance of the data. Incidence of major vessel injury was similar between patients with and without first- and/or second-rib fractures (7% vs. 9%, respectively; p = 0.59). No subset of type of rib fracture was associated with greater incidence of aortic injury. First- and second-fractures are not associated with greater incidence of aortic injury. Thus, the previous axiom that first- and second-rib fractures should result in increased examination for aortic injury may not hold true.

  2. Atlas-based rib-bone detection in chest X-rays.

    Science.gov (United States)

    Candemir, Sema; Jaeger, Stefan; Antani, Sameer; Bagci, Ulas; Folio, Les R; Xu, Ziyue; Thoma, George

    2016-07-01

    This paper investigates using rib-bone atlases for automatic detection of rib-bones in chest X-rays (CXRs). We built a system that takes patient X-ray and model atlases as input and automatically computes the posterior rib borders with high accuracy and efficiency. In addition to conventional atlas, we propose two alternative atlases: (i) automatically computed rib bone models using Computed Tomography (CT) scans, and (ii) dual energy CXRs. We test the proposed approach with each model on 25 CXRs from the Japanese Society of Radiological Technology (JSRT) dataset and another 25 CXRs from the National Library of Medicine CXR dataset. We achieve an area under the ROC curve (AUC) of about 95% for Montgomery and 91% for JSRT datasets. Using the optimal operating point of the ROC curve, we achieve a segmentation accuracy of 88.91±1.8% for Montgomery and 85.48±3.3% for JSRT datasets. Our method produces comparable results with the state-of-the-art algorithms. The performance of our method is also excellent on challenging X-rays as it successfully addressed the rib-shape variance between patients and number of visible rib-bones due to patient respiration.

  3. The post-natal fate of supernumerary ribs in rat teratogenicity studies.

    Science.gov (United States)

    Wickramaratne, G A

    1988-04-01

    A common occurrence in rat teratology studies, supernumerary ribs, have been considered to be indicative of teratogenicity by some authors but not to be so indicative by others. As a teratogenic event is, by definition a permanent change, a study to follow the fate of supernumerary ribs in the development of adulthood of the rat was undertaken. An established teratogen in the rat, aspirin, was used to increase the frequency of supernumerary ribs. Even though aspirin treatment of the dams doubled the initial frequency of supernumerary ribs the results show that over the first 60 days post-partum their frequency in both control and treated groups decline to essentially zero. This decline in frequency of supernumerary ribs is complemented by an increase in the proportion of foetuses with a fully developed transverse process on the first lumbar vertebra. The proposal that supernumerary ribs in the rat are a result of developmental delays in a labile region of the axial skeleton and not a manifestation of a teratogenic event is presented.

  4. Chest pain in focal musculoskeletal disorders

    DEFF Research Database (Denmark)

    Stochkendahl, Mette Jensen; Christensen, Henrik Wulff

    2010-01-01

    overlapping conditions and syndromes of focal disorders, including Tietze syndrome, costochondritis, chest wall syndrome, muscle tenderness, slipping rib, cervical angina, and segmental dysfunction of the cervical and thoracic spine, have been reported to cause pain. For most of these syndromes, evidence...

  5. Cervical perineural cyst masquerading as a cervical spinal tumor.

    Science.gov (United States)

    Joshi, Vijay P; Zanwar, Atul; Karande, Anuradha; Agrawal, Amit

    2014-04-01

    Tarlov (perineural) cysts of the nerve roots are common and usually incidental findings during magnetic resonance imaging of the lumbosacral spine. There are only a few case reports where cervical symptomatic perineural cysts have been described in the literature. We report such a case where a high cervical perineural cyst was masquerading as a cervical spinal tumor.

  6. Examination of Cervical Spine Histological Sections - A Technical Note

    DEFF Research Database (Denmark)

    Uhrenholt, Lars; Ullerup, Rita; Vesterby, Annie

    2006-01-01

    Detailed knowledge of the cervical spine facet joints morphology and anatomy is increasingly important since improved understanding of clinical syndromes, such as whiplash injuries, and therapeutic interventions is based on this knowledge. So far systematic examination of the age-related morphology...... of these joints has not yet been performed, nor has any generally accepted histological classification system for degenerative changes in the cervical spine facet joints been proposed. In the case of whiplash injuries the presented histological method has particular relevance since it allows detailed description...

  7. Ellis-Van Creveld syndrome

    Directory of Open Access Journals (Sweden)

    Le Merrer Martine

    2007-06-01

    Full Text Available Abstract Ellis-van Creveld syndrome (EVC is a chondral and ectodermal dysplasia characterized by short ribs, polydactyly, growth retardation, and ectodermal and heart defects. It is a rare disease with approximately 150 cases reported worldwide. The exact prevalence is unknown, but the syndrome seems more common among the Amish community. Prenatal abnormalities (that may be detected by ultrasound examination include narrow thorax, shortening of long bones, hexadactyly and cardiac defects. After birth, cardinal features are short stature, short ribs, polydactyly, and dysplastic fingernails and teeth. Heart defects, especially abnormalities of atrial septation, occur in about 60% of cases. Cognitive and motor development is normal. This rare condition is inherited as an autosomal recessive trait with variable expression. Mutations of the EVC1 and EVC2 genes, located in a head to head configuration on chromosome 4p16, have been identified as causative. EVC belongs to the short rib-polydactyly group (SRP and these SRPs, especially type III (Verma-Naumoff syndrome, are discussed in the prenatal differential diagnosis. Postnatally, the essential differential diagnoses include Jeune dystrophy, McKusick-Kaufman syndrome and Weyers syndrome. The management of EVC is multidisciplinary. Management during the neonatal period is mostly symptomatic, involving treatment of the respiratory distress due to narrow chest and heart failure. Orthopedic follow-up is required to manage the bones deformities. Professional dental care should be considered for management of the oral manifestations. Prognosis is linked to the respiratory difficulties in the first months of life due to thoracic narrowness and possible heart defects. Prognosis of the final body height is difficult to predict.

  8. Risks of Cervical Cancer Screening

    Science.gov (United States)

    ... are at increased risk for HPV infections. Other risk factors for cervical cancer include: Giving birth to many children. Smoking cigarettes. Using oral contraceptives ("the Pill"). Having a weakened immune system . Cervical Cancer Screening ...

  9. TCM tincture point massage treatment of cervical insomnia clinical observation and the nursing experience in syndrome differentiation%中药酊剂穴位按摩治疗颈性失眠临床观察与辨证施护体会

    Institute of Scientific and Technical Information of China (English)

    游春艳; 曾立清

    2013-01-01

    Objective:To explore the nursing to the syndrome differentiation of TCM journal sex insomnia clinical curative effect influence. Methods:50 patients diagnosed cervical sex insomnia in TCM acupuncture point massage therapy at the same time; give the differentiation of the nursing program, with no differentiation of the nursing of 50 patients with neck problems, according to the Athens insomnia scale for patients with sleep improvement. Results: in giving the nursing of 50 cases of cervical syndrome differentiation in patients with insomnia, not sleep disorder 39 cases (78%), suspicious insomnia, 8 cases (16%), insomnia, 3 cases (6%), and cervical sex insomnia in patients with sleep disorders than before treatment significantly improved. Conclusion: TCM syndrome differentiation the nursing can help improve neck sex insomnia sleep disorders in patients with symptoms.%  目的:探讨中医辨证施护对颈性失眠临床疗效的影响。方法:50例经确诊的颈性失眠患者在接受中药穴位按摩治疗的同时,给予辨证施护的方案,与未进行辨证施护的50例颈性失眠患者进行比较,最后根据阿森斯失眠量表对患者睡眠改善情况进行记录。结果:在给予辨证施护的50例颈性失眠患者中,无睡眠障碍39例(78%),可疑失眠8例(16%),失眠3例(6%),颈性失眠患者睡眠障碍较治疗前明显改善。结论:中医辨证施护有助于改善颈性失眠患者的睡眠障碍症状。

  10. 椎动脉型颈椎病应用平眩汤加以通络醒脑针刺法的疗效评价%Therapeutic Effect of Pingxuan Decoction with Meridian-regulating and Consciousness-restoring Acupuncture in Treatment of Vertebral Artery Type of Cervical Syndrome

    Institute of Scientific and Technical Information of China (English)

    王永新

    2016-01-01

    Objective To evaluate the therapeutic effect of Pingxuan decoction with meridian-regulating and consciousness-restoring acupuncture in the treatment of vertebral artery type of cervical syndrome.Methods72 patients with vertebral artery type of cervical syndrome were given the treatment of Pingxuan decoction,while 36 patients in the experimental group were given the treatment of meridian-regulating and consciousness-restoring acupuncture. The therapeutic effect and the change in the symptom score before and after the treatment were compared between two groups.Results The overal response rate of patients in the experimental group was 91.7%,which was higher than 66.7% of patients in the control group(P<0.05). The improvement on the symptom score of patients in the experimental group was better than that in the control group(P<0.05).Conclusion Pingxuan decoction with meridian-regulating and consciousness-restoring acupuncture in the treatment of vertebral artery type of cervical syndrome can improve the clinical symptoms with the definite therapeutic effect.%目的:评析平眩汤加以通络醒脑针刺法治疗椎动脉型颈椎病的疗效。方法72例椎动脉型颈椎病患者患者均予以平眩汤治疗,实验组36例加以通络醒脑针刺法治疗,比较两组疗效及治疗前后症状积分变化。结果实验组的临床总有效率为91.7%,高于对照组的66.7%(P<0.05);治疗后实验组的症状积分改善幅度优于对照组(P<0.05)。结论平眩汤加以通络醒脑针刺法治疗椎动脉型颈椎病有助于改善临床症状,疗效确切。

  11. Stroke due to a fusiform aneurysm of the cervical vertebral artery: case report

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, S. [Department of Neurosurgery, Kyushu University Hospital, Fukuoka (Japan)]|[Department of Neurosurgery, Kyushu University Hospital 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-82 (Japan); Inoue, T. [Department of Neurosurgery, Clinical Research Institute, National Kyushu Medical Center, Fukuoka (Japan); Haga, S.; Nishio, S.; Fukui, M. [Department of Neurosurgery, Kyushu University Hospital, Fukuoka (Japan); Kono, S. [First Department of Pathology, Kyushu University Hospital, Fukuoka (Japan); Mizushima, A. [Department of Radiology, Kyushu University Hospital, Fukuoka (Japan)

    1998-01-01

    Aneurysms of the cervical vertebral artery (VA) are uncommon; they are often caused by trauma or spontaneous dissection. A fusiform aneurysm without evidence of atherosclerosis or dissection has not been reported previously. A 46-year-old man presented with a pontine infarct. Imaging revealed a fusiform aneurysm of the left VA at the C5-6 level, with occlusion of the basilar artery. Associated minor anomalies included fusion of the vertebral bodies of C5 and C6, cervical rib and platybasia. The left VA arose directly from the aortic arch and entered the transverse foramen at the C4 level. Hyperextension and left lateral flexion of the neck caused kinking of the VA proximal to the aneurysm. Turbulent flow in the aneurysm lumen was noted on angiography. (orig.) With 4 figs., 10 refs.

  12. Invasive cervical resorption: treatment challenges

    OpenAIRE

    2012-01-01

    Invasive cervical resorption is a relatively uncommon form of external root resorption. It is characterized by invasion of cervical region of the root by fibrovascular tissue derived from the periodontal ligament. This case presents an invasive cervical resorption occurring in maxillary lateral incisor, following damage in cervical cementum from avulsion and intracoronal bleaching procedure. Flap reflection, debridement and restoration with glass ionomer cement were performed in an attempt to...

  13. Bone scintigraphy in costo-iliac impingement syndrome

    DEFF Research Database (Denmark)

    Madsen, Jan L

    2008-01-01

    fractures of several thoracic and lumbar vertebrae. She presented with progressive lower back pain and weight loss. Bone scintigraphy revealed increased uptake in the lower ribs on both sides compatible with the costo-iliac impingement syndrome. There were no signs of bone metastases....

  14. Lumbocostovertebral syndrome with associated VACTERL anomalad: a neonatal case report.

    Science.gov (United States)

    Harris, K; Dorn, C; Bloom, B

    2009-12-01

    We report the first clinical case of a term infant with findings suggestive of lumbocostovertebral syndrome and VACTERL association. Renal agenesis was suspected by prenatal ultrasound, and at birth clinical findings included a large abdominal wall hernia, imperforate anus, vestibular fistula, absent right rib, vertebral anomalies, tethered cord, syringomyelia, and two small sacral dimples.

  15. Thoracic outlet syndrome: a neurological and vascular disorder.

    Science.gov (United States)

    Klaassen, Zachary; Sorenson, Edward; Tubbs, R Shane; Arya, Rahul; Meloy, Patrick; Shah, Rajnil; Shirk, Samuel; Loukas, Marios

    2014-07-01

    Thoracic outlet syndrome (TOS) is a condition arising from compression of the subclavian vessels and/or brachial plexus as the structures travel from the thoracic outlet to the axilla. Despite the significant pathology associated with TOS, there remains some general disagreement among experts on the specific anatomy, etiology, and pathophysiology of the condition, presumably because of the wide variation in symptoms that manifest in presenting patients, and because of lack of a definitive gold standard for diagnosis. Symptoms associated with TOS have traditionally been divided into vascular and neurogenic categories, a distinction based on the underlying structure(s) implicated. Of the two, neurogenic TOS (nTOS) is more common, and typically presents as compression of the brachial plexus; primarily, but not exclusively, involving its lower trunk. Vascular TOS (vTOS) usually involves compression of the vessel, most commonly the subclavian artery or vein, or is secondary to thrombus formation in the venous vasculature. Any anatomical anomaly in the thoracic outlet has the potential to predispose a patient to TOS. Common anomalies include variations in the insertion of the anterior scalene muscle (ASM) or scalenus minimus muscle, the presence of a cervical rib or of fibrous and muscular bands, variations in insertion of pectoralis minor, and the presence of neurovascular structures, which follow an atypical course. A common diagnostic technique for vTOS is duplex imaging, which has generally replaced more invasive angiographic techniques. In cases of suspected nTOS, electrophysiological nerve studies and ASM blocks provide guidance when screening for patients likely to benefit from surgical decompression of TOS. Surgeons generally agree that the transaxillary approach allows the greatest field of view for first rib excision to relieve compressed vessels. Alternatively, a supraclavicular approach is favored for scalenotomies when the ASM impinges on surrounding

  16. Prognostic factors in cervical cancer

    NARCIS (Netherlands)

    Biewenga, P.

    2015-01-01

    Surgery is the standard of care for women with early stage cervical cancer; radiotherapy is the cornerstone in patients with advanced stages of disease. Recent changes in the treatment of cervical cancer involve less radical surgery in early stage cervical cancer, concomitant chemo- and radiotherapy

  17. Dwarf with dual spinal kyphotic deformity at the cervical and dorsal spine unassociated with odontoid hypoplasia: Surgical management

    Directory of Open Access Journals (Sweden)

    Guru Dutta Satyarthee

    2016-01-01

    Full Text Available Morquio's syndrome is associated with systemic skeletal hypoplasia leading to generalized skeletal deformation. The hypoplasia of odontoid process is frequent association, which is responsible for atlantoaxial dislocation causing compressive myelopathy. However, development of sub-axial cervical kyphotic deformity unassociated with odontoid hypoplasia is extremely rare, and coexistence of dorsal kyphotic deformity is not reported in the western literature till date and represents first case. Current case is 16-year-old boy, who presented with severe kyphotic deformity of cervical spine with spastic quadriparesis. Interestingly, he also had additional asymptomatic kyphotic deformity of dorsal spine; however, odontoid proves hypoplasia was not observed. He was only symptomatic for cervical compression, accordingly surgery was planned. The patient was planned for correction of cervical kyphotic deformity under general anesthesia, underwent fourth cervical corpectomy with resection of posterior longitudinal ligament and fusion with autologous bone graft derived from right fibula, which was refashioned approximating to the width of the corpectomy size after harvesting and fixed between C3 and C5 vertebral bodies and further secured with anterior cervical plating. He tolerated surgical procedure well with improvement in power with significant reduction in spasticity. Postoperative X-ray, cervical spine revealed complete correction of kyphotic deformity cervical spine. At follow-up 6 months following surgery, he is doing well. Successful surgical correction of symptomatic cervical kyphotic deformity can be achieved utilizing anterior cervical corpectomy, autologous fibular bone graft, and anterior cervical plating.

  18. The ribB FMN riboswitch from Escherichia coli operates at the transcriptional and translational level and regulates riboflavin biosynthesis.

    Science.gov (United States)

    Pedrolli, Danielle; Langer, Simone; Hobl, Birgit; Schwarz, Julia; Hashimoto, Masayuki; Mack, Matthias

    2015-08-01

    FMN riboswitches are genetic elements that, in many bacteria, control genes responsible for biosynthesis and/or transport of riboflavin (vitamin B2 ). We report that the Escherichia coli ribB FMN riboswitch controls expression of the essential gene ribB coding for the riboflavin biosynthetic enzyme 3,4-dihydroxy-2-butanone-4-phosphate synthase (RibB; EC 4.1.99.12). Our data show that the E. coli ribB FMN riboswitch is unusual because it operates at the transcriptional and also at the translational level. Expression of ribB is negatively affected by FMN and by the FMN analog roseoflavin mononucleotide, which is synthesized enzymatically from roseoflavin and ATP. Consequently, in addition to flavoenzymes, the E. coli ribB FMN riboswitch constitutes a target for the antibiotic roseoflavin produced by Streptomyces davawensis.

  19. Evidence for a myotomal Hox/Myf cascade governing nonautonomous control of rib specification within global vertebral domains.

    Science.gov (United States)

    Vinagre, Tânia; Moncaut, Natalia; Carapuço, Marta; Nóvoa, Ana; Bom, Joana; Mallo, Moisés

    2010-04-20

    Hox genes are essential for the patterning of the axial skeleton. Hox group 10 has been shown to specify the lumbar domain by setting a rib-inhibiting program in the presomitic mesoderm (PSM). We have now produced mice with ribs in every vertebra by ectopically expressing Hox group 6 in the PSM, indicating that Hox genes are also able to specify the thoracic domain. We show that the information provided by Hox genes to specify rib-containing and rib-less areas is first interpreted in the myotome through the regional-specific control of Myf5 and Myf6 expression. This information is then transmitted to the sclerotome by a system that includes FGF and PDGF signaling to produce vertebrae with or without ribs at different axial levels. Our findings offer a new perspective of how Hox genes produce global patterns in the axial skeleton and support a redundant nonmyogenic role of Myf5 and Myf6 in rib formation.

  20. Cervical deciduosis imitating dysplasia.

    Science.gov (United States)

    van Diepen, Diederik Anthony; Hellebrekers, Bart; van Haaften, Anne-Marie; Natté, Remco

    2015-09-22

    Ectopic cervical deciduosis is generally an accidental finding during pregnancy, and usually presents without any symptoms or need for therapeutic intervention. However, it can sometimes imitate dysplasia or carcinoma. We report a case of a 34-year-old G2P0, with a history of cervical dysplasia, presenting at 11 weeks of gestation, with vaginal blood loss. During examination, lesions mimicking dysplasia were found on the cervix. Histological examination reported cervical deciduosis. Deciduosis is a benign change during pregnancy and will resolve spontaneously. With the increasing use of cytology and colposcopy, the reported incidence is growing. When it is hard to differentiate between dysplasia and deciduosis, histological confirmation should be considered.

  1. SpaRibs Geometry Parameterization for Wings with Multiple Sections using Single Design

    Science.gov (United States)

    De, Shuvodeep; Jrad, Mohamed; Locatelli, Davide; Kapania, Rakesh K.; Baker, Myles; Pak, Chan-Gi

    2017-01-01

    The SpaRibs topology of an aircraft wing has a significant effect on its structural behavior and stability as well as the flutter performance. The development of additive manufacturing techniques like Electron Beam Free Form Fabrication (EBF3) has made it feasible to manufacture aircraft wings with curvilinear spars, ribs (SpaRibs) and stiffeners. In this article a new global-local optimization framework for wing with multiple sections using curvilinear SpaRibs is described. A single design space is used to parameterize the SpaRibs geometry. This method has been implemented using MSC-PATRAN to create a broad range of SpaRibs topologies using limited number of parameters. It ensures C0 and C1 continuities in SpaRibs geometry at the junction of two wing sections with airfoil thickness gradient discontinuity as well as mesh continuity between all structural components. This method is advantageous in complex multi-disciplinary optimization due to its potential to reduce the number of design variables. For the global-local optimization the local panels are generated by an algorithm which is totally based on a set algebra on the connectivity matrix data. The great advantage of this method is that it is completely independent of the coordinates of the nodes of the finite element model. It is also independent of the order in which the elements are distributed in the FEM. The code is verified by optimizing of the CRM Baseline model at trim condition at Mach number equal to 0.85 for five different angle of attack (-2deg, 0deg,2deg,4deg and 6deg). The final weight of the wing is 19,090.61 lb. This value is comparable to that obtained by Qiang et al. 6 (19,269 lb).

  2. The Role of Minimally Invasive Plate Osteosynthesis in Rib Fixation: A Review.

    Science.gov (United States)

    Bemelman, Michael; van Baal, Mark; Yuan, Jian Zhang; Leenen, Luke

    2016-02-01

    More than a century ago, the first scientific report was published about fracture fixation with plates. During the 1950's, open reduction and plate fixation for fractures were standardized by the founders of Arbeitsgemeinschaft für osteosynthesefragen/Association for the Study of Internal Fixation. Since the introduction of plate fixation for fractures, several plates and screws have been developed, all with their own characteristics. To accomplice more fracture stability, it was thought the bigger the plate, the better. The counter side was a compromised blood supply of the bone, often resulting in bone necrosis and ultimately delayed or non-union. With the search and development of new materials and techniques for fracture fixation, less invasive procedures have become increasingly popular. This resulted in the minimally invasive plate osteosynthesis (MIPO) technique for fracture fixation. With the MIPO technique, procedures could be performed with smaller incisions and thus with less soft tissue damage and a better preserved blood supply. The last 5 years rib fixation has become increasingly popular, rising evidence has become available suggesting that surgical rib fixation improves outcome of patients with a flail chest or isolated rib fractures. Many surgical approaches for rib fixation have been described in the old literature, however, most of these techniques are obscure nowadays. Currently mostly large incisions with considerable surgical insult are used to stabilize rib fractures. We think that MIPO deserves a place in the surgical treatment of rib fractures. We present the aspects of diagnosis, preoperative planning and operative techniques in regard to MIPO rib fixation.

  3. Enhanced heat transfer of forced convective fin flow with transverse ribs

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Shyy Woei; Chiou, Shyr Fuu [Thermal Fluids Laboratory, National Kaohsiung Institute of Marine Technology, No. 142, Hai-Chuan Road, Nan-Tzu District, Post code 811, Kaohsiung, Taiwan (China); Su, Lo May [Department of Electrical Engineering, Tung Fang Institute of Technology, Taiwan (China); Yang, Tsun Lirng [Department of Electrical Engineering, Fortune Institute of Technology, Taiwan (China)

    2004-02-01

    This experimental study investigates the heat transfers in three side-opened and bottom-sealed rectangular channels with two opposite walls roughened by 90 staggered ribs, which simulate the enhanced cooling passages in the fin-type heat sinks of electronic chip-sets. The various degrees of interactive effects due to the surface ribs, side-profile leakage flows and stream-wise weakened coolant flow are functionally related with Reynolds number (Re) and channel length-to-gap ratio (L/B), which unravel the considerable impacts on local and spatially averaged heat transfers over the rib-roughened fin surfaces. A selection of detailed heat transfer measurements over the rib-roughened fin surfaces illustrates the manner by which the isolated and interactive influences of Re and L/B-ratio affect the local and spatially averaged heat transfers. Relative to the heat transfer results acquired from the smooth-walled test channels, the augmentations of spatially averaged heat transfers generated by the present surface ribs are in the range of 140-200% of the flat fin reference levels. In conformity with the experimentally revealed heat transfer physics, a regression-type analysis is performed to develop the correlation of spatially-averaged Nusselt number over rib-roughened fin surface, which permits the individual and interactive effect of Re and L/B on heat transfer to be evaluated. A criterion for selecting the optimal length-to-gap ratio of a fin channel, which provides the maximum convective heat flux from the rib-roughened fin surface, is formulated as an engineering tool to assist the design activity for the cooling device of electronic chip-sets. (authors)

  4. Archaeal RibL: a new FAD synthetase that is air sensitive.

    Science.gov (United States)

    Mashhadi, Zahra; Xu, Huimin; Grochowski, Laura L; White, Robert H

    2010-10-12

    FAD synthetases catalyze the transfer of the AMP portion of ATP to FMN to produce FAD and pyrophosphate (PP(i)). Monofunctional FAD synthetases exist in eukaryotes, while bacteria have bifunctional enzymes that catalyze both the phosphorylation of riboflavin and adenylation of FMN to produce FAD. Analyses of archaeal genomes did not reveal the presence of genes encoding either group, yet the archaea contain FAD. Our recent identification of a CTP-dependent archaeal riboflavin kinase strongly indicated the presence of a monofunctional FAD synthetase. Here we report the identification and characterization of an archaeal FAD synthetase. Methanocaldococcus jannaschii gene MJ1179 encodes a protein that is classified in the nucleotidyl transferase protein family and was previously annotated as glycerol-3-phosphate cytidylyltransferase (GCT). The MJ1179 gene was cloned and its protein product heterologously expressed in Escherichia coli. The resulting enzyme catalyzes the adenylation of FMN with ATP to produce FAD and PP(i). The MJ1179-derived protein has been designated RibL to indicate that it follows the riboflavin kinase (RibK) step in the archaeal FAD biosynthetic pathway. Aerobically isolated RibL is active only under reducing conditions. RibL was found to require divalent metals for activity, the best activity being observed with Co(2+), where the activity was 4 times greater than that with Mg(2+). Alkylation of the two conserved cysteines in the C-terminus of the protein resulted in complete inactivation. RibL was also found to catalyze cytidylation of FMN with CTP, making the modified FAD, flavin cytidine dinucleotide (FCD). Unlike other FAD synthetases, RibL does not catalyze the reverse reaction to produce FMN and ATP from FAD and PP(i). Also in contrast to other FAD synthetases, PP(i) inhibits the activity of RibL.

  5. 双侧甲状腺切除加双侧颈部淋巴结清扫术后引发吉兰-巴雷综合征一例报告并文献复习%Guillain-Barré Syndrome in a Patient after Bilateral Thyroidectomy plus Bilateral Cervical Lymph Node Dissection:One Case Report and Literature Review

    Institute of Scientific and Technical Information of China (English)

    赵红; 王苏平; 宋品; 李莉; 刘赞华; 李淑敏

    2015-01-01

    双侧甲状腺切除加双侧颈部淋巴结清扫术后并发吉兰-巴雷综合征( Guillain-Barré syndrome,GBS)的病例在临床上较为少见,且GBS发病早期易被漏诊。本文报道了1例甲状腺癌伴甲状旁腺腺瘤患者,行双侧甲状腺切除加双侧颈部淋巴结清扫术后并发GBS的临床诊治经过,并复习相关文献。提示外科手术可以为GBS的诱因,临床医生应警惕术后GBS的发生,避免漏诊和误诊。%Guillain-Barré syndrome( GBS)is clinically rare as a postoperative complication occurs after bilateral thyroidectomy plus bilateral cervical lymph node dissection,and missed diagnosis often occurs at its early stage. The article presents the diagnosis and treatment of GBS as postoperative complication in a patient with thyroid cancer concurrent with parathyroid tumor after bilateral thyroidectomy plus bilateral cervical lymph node dissection. The relevant literature is also reviewed. Surgical operations could induce GBS. More attention should be paid to the diagnosis and treatment of postoperative GBS,preventing its missed diagnosis and misdiagnosis.

  6. Syringomyelia secondary to cervical spondylosis: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Savitr Sastri Bhagavathula Venkata

    2014-01-01

    Full Text Available Syringomyelia secondary to cervical spondylosis is a rare entity to encounter in clinical practice. We discuss the case of a 53-year-old lady who presented with a syringomyelic syndrome and was found to have cervical spondylosis on imaging. Cine-MRI revealed an obstruction of cerebrospinal fluid (CSF flow in the cervical spinal subarachnoid space. Decompression of the same led to clinical and radiological improvement. There is a potential causal association between cervical spondylosis and syringomyelia. MRI CSF flow studies may help in deciding the course of treatment in such cases. A subset of patients with cervical spondylosis and concurrent spinal cord signal intensity changes may show reversal of the same following intervention.

  7. CrossFit-related cervical internal carotid artery dissection.

    Science.gov (United States)

    Lu, Albert; Shen, Peter; Lee, Paul; Dahlin, Brian; Waldau, Ben; Nidecker, Anna E; Nundkumar, Anoop; Bobinski, Matthew

    2015-08-01

    CrossFit is a high-intensity strength and conditioning program that has gained popularity over the past decade. Potential injuries associated with CrossFit training have been suggested in past reports. We report three cases of cervical carotid dissection that are associated with CrossFit workouts. Patient 1 suffered a distal cervical internal carotid artery (ICA) dissection near the skull base and a small infarct in Wernicke's area. He was placed on anticoagulation and on follow-up has near complete recovery. Patient 2 suffered a proximal cervical ICA dissection that led to arterial occlusion and recurrent middle cerebral artery territory infarcts and significant neurological sequelae. Patient 3 had a skull base ICA dissection that led to a partial Horner's syndrome but no cerebral infarct. While direct causality cannot be proven, intense CrossFit workouts may have led to the ICA dissections in these patients.

  8. An experimental investigation of heat transfer and fluid flow in a rectangular duct with inclined discrete ribs

    Directory of Open Access Journals (Sweden)

    K. R. Aharwal, B. K. Gandhi, J. S. Saini

    2010-11-01

    Full Text Available Artificial roughness in the form of repeated ribs is generally used for enhancement of heat transfer heated surface to the working fluid. In the present work experimental investigations has been carried out to study the effect of a gap in the inclined rib on the heat transfer and fluid flow characteristics of heated surface. A rectangular duct of aspect ratio of 5.83 has been used to conduct experiments on one rib roughened surface. Experimental data have been collected to determine Nusselt number (heat transfer coefficient as a function of roughness and flow parameters in the form of repeated ribs. In order to understand the mechanism of heat transfer through a roughened duct having inclined rib with and without gap, the detailed analysis of the fluid flow structure is required. Therefore the detailed velocity structures of fluid flow inside a similar roughened duct as used for the heat transfer analysis were obtained by 2-Dimensional Particle Image Velocimetry (PIV system and the heat transfer results were correlated with the flow structure. It was found that inclined rib with a gap (inclined discrete rib had better heat transfer performance compared to the continuous inclined rib arrangement. Further the inclined discrete rib with relative gap width (g/e of 1.0 gives the higher heat transfer performance compared to the other relative gap width.

  9. CFD Analysis on the Thermal Hydraulic Performance of an SAH Duct with Multi V-Shape Roughened Ribs

    Directory of Open Access Journals (Sweden)

    Anil Kumar

    2016-05-01

    Full Text Available This study presents the heat transfer and fluid flow characteristics in a rib-roughened SAH (solar air heater channel. The artificial roughness of the rectangular channel was in the form of a thin circular wire in discrete multi V-pattern rib geometries. The effect of this geometry on heat transfer, fluid flow, and performance augmentation was investigated using the CFD (computational fluid dynamics. The roughness parameters were a relative discrete distance of 0.69, a relative rib height of 0.043, a relative rib pitch of 10, a relative rib width of 6.0, and a flow-attack-angle of 60°. The discrete width ratios and Reynolds numbers ranged from 0.5 to 2.0 and from 2000 to 20,000, respectively. The CFD results using the renormalization k-epsilon model were in good agreement with the empirical relationship. This model was used to investigate the heat transfer and fluid flow characteristics in the multi V-pattern rib roughened SAH channel. The thermo-hydraulic performance was found to be the best for the discrete width ratio of 1.0. A discrete multi V-pattern rib combined with dimple staggered ribs also had better overall thermal performance compared to other rib shapes.

  10. Heat transfer in a two-pass internally ribbed turbine blade coolant channel with cylindrical vortex generators

    Energy Technology Data Exchange (ETDEWEB)

    Hibbs, R.; Chen, Y.; Nikitopoulos, D. [Louisiana State Univ., Baton Rouge, LA (United States)] [and others

    1995-10-01

    The effect of vortex generators on the mass (heat) transfer from the ribbed passage of a two pass turbine blade coolant channel is investigated with the intent of optimizing the vortex generator geometry so that significant enhancements in mass/heat transfer can be achieved. In the experimental configuration considered, ribs are mounted on two opposite walls; all four walls along each pass are active and have mass transfer from their surfaces but the ribs are non-participating. Mass transfer measurements, in the form of Sherwood number ratios, are made along the centerline and in selected inter-rib modules. Results are presented for Reynolds number in the range of 5,000 to 40,000, pitch to rib height ratios of 10.5 and 21, and vortex generator-rib spacing to rib height ratios of 0.55, and 1.5. Centerline and spanwise averaged Sherwood number ratios are presented along with contours of the Sherwood number ratios. Results indicate that the vortex generators induce substantial increases in the local mass transfer rates, particularly along the side walls, and modest increases in the average mass transfer rates. The vortex generators have the effect of making the inter-rib profiles along the ribbed walls more uniform. Along the side walls, horse-shoe vortices that characterize the vortex generator wake are associated with significant mass transfer enhancements. The wake effects and the levels of enhancement decrease somewhat with increasing Reynolds number and decreasing pitch.

  11. Scapulothoracic Anatomy and Snapping Scapula Syndrome

    Directory of Open Access Journals (Sweden)

    Rachel M. Frank

    2013-01-01

    Full Text Available The scapulothoracic articulation is a sliding junction between the deep aspect of the scapula and thoracic rib cage at the levels of ribs 2 through 7. Motion at this articulation is dynamically stabilized by a variety of muscular attachments, allowing for controlled positioning of the glenoid to assist in glenohumeral joint function. A thorough understanding of the complex anatomic relationships, including the various muscles, and bursa, is critical to the evaluation of patients presenting with scapulothoracic disorders. The snapping scapula syndrome is caused by either osseous lesions or scapulothoracic bursitis and can be difficult to recognize and treat. The purpose of this review is to discuss the anatomy of the scapulothoracic articulation with an emphasis on the pathology associated with snapping scapula syndrome.

  12. Percutaneous radiofrequency ablation for lung tumors beneath the rib under CT fluoroscopic guidance with gantry tilt

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Takanobu; Yamagami, Takuji; Tanaka, Osamu; Yoshimatsu, Rika; Miura, Hiroshi; Nishimura, Tsunehiko (Dept. of Radiology, Graduate School of Medical Science, Kyoto Prefectural Univ. of Medicine, Kamigyo, Kyoto (Japan)), e-mail: yamagami@koto.kpu-m.ac.jp

    2010-05-15

    Background: Radiofrequency (RF) ablation of lung tumors has become a treatment of choice, especially for unresectable cases. However, RF ablation of small lung lesions located just beneath the rib is difficult. Purpose: To evaluate the efficacy and safety of gantry tilting for the performance of RF ablation of peripheral lesions located beneath the rib. Material and Methods: Our study was based on 18 of 293 lesions in the lung for which RF ablation was performed under CT scan fluoroscopic guidance at our institution between October 2004 and March 2009. For these 18 lesions, RF ablation was performed with gantry tilting because a rib blocked visualization of the RF ablation route even after other attempts had been made to change the relationship between the target and the rib. Results: All RF needles, with only one exception, were successfully advanced to hit the tumor. The commonest complication was a pneumothorax, which occurred in seven procedures. No serious complications occurred. The progression-free rates were 82.4% at 6 months, 62.5% at 12 months, and 30% at 24 months. Mean local progression-free duration was 17.6+-11.6 months (range 4-36 months). Conclusion: RF ablation under CT scan fluoroscopic guidance with gantry tilt is a useful and safe technique for RF ablation of lung nodules located beneath the rib

  13. Pitfalls associated with open reduction and internal fixation of fractured ribs.

    Science.gov (United States)

    Sarani, Babak; Schulte, Leah; Diaz, Jose J

    2015-12-01

    Rib fracture is exceedingly common and remains a leading cause of death in patients with chest injury. Probability of death increases by 19% with each broken rib, and the probability of death increases further with age. Treatment is centered on pain control and early mobilization to provide adequate pulmonary hygiene. Multimodality interventions, such as incentive spirometry, postural changes, and coughing, are pivotal in minimizing the risk of pneumonia and death. Recently, many studies have found mortality benefit to operation fixation (ORIF) of ribs in select patients. However, this procedure remains underutilized partly due to lack of familiarity with its technique and pitfalls by trauma surgeons, in particular. Whereas there are publications on operative technique, there are no studies describing pitfalls associated with this procedure. The purpose of this paper is to describe pitfalls on the technical aspects of ORIF of the ribs based on the medical literature where possible and based on our experience in instances where peer reviewed evidence is lacking. The paper is not meant to serve as a protocol for managing rib fractures.

  14. Holographic interferometry as a method to detect welding failures on ribbed iron structures

    Science.gov (United States)

    Vincitorio, F. M.; Budini, N.; Mulone, C.; Freyre, C.; Spector, M.; López Díaz, A. J.; Ramil Rego, A.; Yañez Casal, A.

    2013-11-01

    Metallic structures made of ribbed iron bars (ADN-420) are of common use in sheds and supporting structures. Usually, trusses are constructed with many pieces of ribbed iron bars, combined together through a welding process. Although ribbed iron manufacturers do not recommend this type of structure it is still frequently used. The main weakness of these trusses is the welding point because ribbed iron is not a material suitable for welding. This work presents results obtained from an analysis of welding points between ribbed iron bars extracted from a collapsed truss, by means of conventional (optical) and digital holographic interferometry (HI and DHI, respectively). The experiments were divided in two different series of studies. The first series were performed by HI on metallographic samples while the second series were done by DHI on different welding points. These results were complemented by metallographic analysis made in an external laboratory. DHI indicated that the bars did not have important failures but evidenced defects in one of the welding points under analysis. This information together with metallographic results allowed inferring that the collapse was probably due to an error in the design of the structure, since the iron bars were out of standard compliance.

  15. Optimization of the Interconnect Ribs for a Cathode-Supported Solid Oxide Fuel Cell

    Directory of Open Access Journals (Sweden)

    Wei Kong

    2014-01-01

    Full Text Available A comprehensive mathematical model of the performance of the cathode-supported solid oxide fuel cell (SOFC with syngas fuel is presented. The model couples the intricate interdependency between the ionic conduction, electronic conduction, gas transport, the electrochemical reaction processes in the functional layers and on the electrode/electrolyte interfaces, methane steam reforming (MSR and the water gas shift reaction (WGSR. The validity of the mathematical model is demonstrated by the excellent agreement between the numerical and experimental I-V curves. The effect of anode rib width and cathode rib width on gas diffusion and cell performance is examined. The results show conclusively that the cell performance is strongly influenced by the rib width. Furthermore, the anode optimal rib width is smaller than that for cathode, which is contrary to anode-supported SOFC. Finally, the formulae for the anode and cathode optimal rib width are given, which provide an easy to use guidance for the broad SOFC engineering community.

  16. Generation of Turbulent Inflow Conditions for Pipe Flow via an Annular Ribbed Turbulator

    Science.gov (United States)

    Moallemi, Nima; Brinkerhoff, Joshua

    2016-11-01

    The generation of turbulent inflow conditions adds significant computational expense to direct numerical simulations (DNS) of turbulent pipe flows. Typical approaches involve introducing boxes of isotropic turbulence to the velocity field at the inlet of the pipe. In the present study, an alternative method is proposed that incurs a lower computational cost and allows the anisotropy observed in pipe turbulence to be physically captured. The method is based on a periodic DNS of a ribbed turbulator upstream of the inlet boundary of the pipe. The Reynolds number based on the bulk velocity and pipe diameter is 5300 and the blockage ratio (BR) is 0.06 based on the rib height and pipe diameter. The pitch ratio is defined as the ratio of rib streamwise spacing to rib height and is varied between 1.7 and 5.0. The generation of turbulent flow structures downstream of the ribbed turbulator are identified and discussed. Suitability of this method for accurate representation of turbulent inflow conditions is assessed through comparison of the turbulent mean properties, fluctuations, Reynolds stress profiles, and spectra with published pipe flow DNS studies. The DNS results achieve excellent agreement with the numerical and experimental data available in the literature.

  17. First rib fractures: not always a hallmark of severe trauma-a report of three cases

    Institute of Scientific and Technical Information of China (English)

    Atin Jaiswal; Yashwant S Tanwar; Masood Habib; Vijay Jain

    2013-01-01

    According to medical literature,fracture of the first rib is quite rare and the bilateral condition is especially rare.This type of fracture is usually associated with severe intrathoracic trauma and other bony or neurovascular injuries,thus can be considered as a harbinger of major trauma.However here we present three cases of low velocity first rib fractures without any major trauma or multisystem injuries.All the three patients were treated conservatively and did well on simple analgesics and rest and had no early or late complications.It can be seen that not all the first rib fractures are associated with major trauma or multisystem injuries.There is a variant of first rib fracture with low velocity injuries which is not associated with any major complications in contrast to majority of first rib fractures associated with high velocity injuries.Causative factor of such injuries may be violent muscular contraction of scalenus anterior or serratus anterior,but not direct trauma.

  18. Cervical Cancer Prevention

    Science.gov (United States)

    ... infected with HPV, those who have used oral contraceptives ("the Pill") for 5 to 9 years have a risk of cervical cancer that is 3 times greater than that of women who have never used oral contraceptives. The risk is 4 times greater after 10 ...

  19. Diabetes and cervical myelopathy.

    Science.gov (United States)

    Houten, John K; Lenart, Christopher

    2016-05-01

    Diabetes may affect the typical physical findings associated with cervical spondylotic myelopathy, as coexisting diabetic neuropathy may dampen expected hyperreflexia and also produce non-dermatomal extremity numbness. Most large studies of surgically treated diabetic patients with cervical spondylotic myelopathy have focused upon infection rates rather than exploring any differences in the presenting physical signs. We conducted a retrospective study of the pattern of presenting neurological signs and symptoms and of the clinical outcomes in 438 patients surgically treated for cervical spondylotic myelopathy, 79 of whom had diabetes. Compared with non-diabetic patients, those with diabetes were slightly older and had lower preoperative modified Japanese Orthopaedic Association (mJOA) scores. Those with diabetes also had a significantly higher incidence of hyporeflexia and a higher incidence of a positive Babinski sign, but there was no difference in the appearance of the Hoffman sign. The magnitude of mJOA improvement after surgery was comparable. We conclude that diabetes may alter the typical signs and symptoms of cervical spondylotic myelopathy and suggest that knowledge of the differences may aid in securing a prompt and accurate diagnosis.

  20. Prevent Cervical Cancer!

    Centers for Disease Control (CDC) Podcasts

    2015-01-08

    Cervical cancer can be prevented. Listen as two friends—one a doctor—talk about screening tests and early detection. Learn what test you might need.  Created: 1/8/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 1/8/2015.

  1. Lumbo-costo-vertebral syndrome with congenital lumbar hernia.

    Science.gov (United States)

    Gupta, Lucky; Mala, Tariq Ahmed; Gupta, Rahul; Malla, Shahid Amin

    2014-01-01

    Lumbo-costo-vertebral syndrome (LCVS) is a set of rare abnormalities involving vertebral bodies, ribs, and abdominal wall. We present a case of LCVS in a 2-year-old girl who had a progressive swelling over left lumbar area noted for the last 12 months. Clinical examination revealed a reducible swelling with positive cough impulse. Ultrasonography showed a defect containing bowel loops in the left lumbar region. Chest x-ray showed scoliosis and hemivertebrae with absent lower ribs on left side. Meshplasty was done.

  2. Lumbo-Costo-Vertebral Syndrome with Congenital Lumbar Hernia

    Directory of Open Access Journals (Sweden)

    Lucky Gupta

    2014-02-01

    Full Text Available Lumbo-costo-vertebral syndrome (LCVS is a set of rare abnormalities involving vertebral bodies, ribs, and abdominal wall. We present a case of LCVS in a 2-year-old girl who had a progressive swelling over left lumbar area noted for the last 12 months. Clinical examination revealed a reducible swelling with positive cough impulse. Ultrasonography showed a defect containing bowel loops in the left lumbar region. Chest x-ray showed scoliosis and hemivertebrae with absent lower ribs on left side. Meshplasty was done.

  3. Damage control of multiple injuries headed by cervical spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    LIU Si-hai; WANG Ai-min; DU Quan-yin; ZHAO Yu-feng; WANG Zi-ming; GUO Qing-shan; SHEN Yue

    2008-01-01

    Objective: To explore the strategy of damage control in clinical treatment of multiple injuries headed by cervical spinal cord injury.Methods: A retrospective analysis was performed in 32 patients. Cervical fractures associated with tetraplegia occurred in 18 patients, traumatic intervertebral disk hernia associated with tetraplegia in 2 patients, and cervical fractures and dislocation associated with tetraplegia in 12 patients. Seventeen cases were combined with craniocerebral injury, 7 combined with pulmonary contusion, multi-fractures of rib or hemopneumothorax, 2 combined with pelvic fracture and other 8 combined with fracture of limbs. The neural function was assessed by the American Spinal Injury Association (ASIA) scale.Results:Thirty-one patients were followed up for an average of 14 months. Of them, 10 got complete recovery, 13 obtained improvement of more than one ASIA grade, 8 did not improve, and 1 died.Conclusions: For the emergency treatment of multiple injuries headed by cervical spinal cord injury, the damage control strategy is the principle to follow. The final operations are preferably performed within 5 to 10 days after injury so as to raise the successful rate of remedy.

  4. The forced sound transmission of finite ribbed plates, investigating the influence of point connections and periodicity

    DEFF Research Database (Denmark)

    Brunskog, Jonas

    2015-01-01

    Many engineering structures consist of plates being stiffened by ribs. The ribs can be connected to the plate in a line connection (welded or glued) or in point connections (screwed). It is well known that the rib stiffeners can significantly change the vibration field and the radiation behavior...... been derived, using a variational technique based on integral-differential equations of the fluid loaded plate. In this way an optimal solution is derived, using a very simple initial guess of the vibration field. The finite plate is assumed being mounted in a rigid baffle. The approach is based...... the model. The influence of point versus line connections, as well as periodicity effects, is investigated....

  5. Numerical investigation of turbulent flow and heat transfer in channel with ribs

    DEFF Research Database (Denmark)

    Myllerup, Lisbeth; Larsen, Poul Scheel

    1999-01-01

    The performance of three different low-Reynolds number turbulence models has been explored for the benchmark test of fully developed (periodic) flow in a ribbed plane channel. Results are presented for two values of the Reynolds number (based on mean velocity and hydraulic diameter), Re = 37,200 ......,200 and Re = 12,600, for which experimental data are available for the flow field and heat transfer, respectively. Comparison with experimental data includes the Nusselt number distribution along ribbed surface and profiles of mean velocity.......The performance of three different low-Reynolds number turbulence models has been explored for the benchmark test of fully developed (periodic) flow in a ribbed plane channel. Results are presented for two values of the Reynolds number (based on mean velocity and hydraulic diameter), Re = 37...

  6. Glued Joint Behavior of Ribs for Wood-Based Composite Plates

    Science.gov (United States)

    Frolovs, G.; Rocens, K.; Sliseris, J.

    2015-11-01

    This article presents experimental investigations of composite sandwich plywood plates with cell type core and their connections between skin layers of birch plywood and a core of straight and curved plywood honeycomb-type ribs. This shape of core ribs provides several improvements for these plates in the manufacturing process as well as improves the mechanical properties of plywood plates. This specific form of ribs allows simplifying the manufacturing of these plates although it should be detailed and improved. The most typical cases (series of specimens) were compared to the results obtained from FEM (ANSYS) simulations. All thicknesses of elements are chosen according to plywood supplier assortment. Standard birch plywood (Riga Ply) plates were used - three layer plywood was chosen for skin elements (Surfaces) and three or five layer plywood was chosen for edge elements. Different bond pressures were taken to compare their influence on joint strength and stiffness.

  7. Multi-pass spinning of thin-walled tubular part with longitudinal inner ribs

    Institute of Scientific and Technical Information of China (English)

    JIANG Shu-yong; ZHENG Yu-feng; REN Zheng-yi; LI Chun-feng

    2009-01-01

    Based on the process experiments, micrography analysis was dedicated to advancing the understanding of plastic flow of the metal in backward ball spinning of thin-walled tubular part with longitudinal inner ribs. Micrography analysis reveals that severe plastic deformation leads to grain refinement, grain orientation and grain flow line of the spun part. Based on rigid-plastic finite element method, DEFORME3D finite element code was used to simulate and analyze multi-pass backward ball spinning of thin-walled tubular part with longitudinal inner ribs. Finite element simulation results involve the distributions of the strain, the shape variation of the inner ribs as well as the prediction of the spinning loading.

  8. Cervical Spine Involvement in Mild Traumatic Brain Injury: A Review

    Science.gov (United States)

    Morin, Michael; Langevin, Pierre

    2016-01-01

    Background. There is a lack of scientific evidence in the literature on the involvement of the cervical spine in mTBI; however, its involvement is clinically accepted. Objective. This paper reviews evidence for the involvement of the cervical spine in mTBI symptoms, the mechanisms of injury, and the efficacy of therapy for cervical spine with concussion-related symptoms. Methods. A keyword search was conducted on PubMed, ICL, SportDiscus, PEDro, CINAHL, and Cochrane Library databases for articles published since 1990. The reference lists of articles meeting the criteria (original data articles, literature reviews, and clinical guidelines) were also searched in the same databases. Results. 4,854 records were screened and 43 articles were retained. Those articles were used to describe different subjects such as mTBI's signs and symptoms, mechanisms of injury, and treatments of the cervical spine. Conclusions. The hypothesis of cervical spine involvement in post-mTBI symptoms and in PCS (postconcussion syndrome) is supported by increasing evidence and is widely accepted clinically. For the management and treatment of mTBIs, few articles were available in the literature, and relevant studies showed interesting results about manual therapy and exercises as efficient tools for health care practitioners. PMID:27529079

  9. Eagle's syndrome: a case report

    OpenAIRE

    Moon, Chang-Sig; Lee, Baek-Soo; Kwon, Yong-Dae; Choi, Byung-Jun; Lee, Jung-Woo; Lee, Hyun-Woo; Yun, Sun-Ung; Ohe, Joo-Young

    2014-01-01

    Eagle's syndrome is a disease caused by an elongated styloid process or calcified stylohyoid ligament. Eagle defined the disorder in 1937 by describing clinical findings related to an elongated styloid process, which is one of the numerous causes of pain in the craniofacial and cervical region. The prevalence of individuals with this anatomic abnormality in the adult population is estimated to be 4% with 0.16% of these individuals reported to be symptomatic. Eagle's syndrome is usually charac...

  10. Experimental study of developing turbulent flow and heat transfer in ribbed convergent/divergent rectangular ducts

    Directory of Open Access Journals (Sweden)

    Karthikeyan Sivakumar

    2015-01-01

    Full Text Available The article represents an experimental investigation of friction and heat transfer characteristics of divergent / convergent rectangular ducts with an inclination angle of 1˚ in the y-axis. Measurements were taken for a convergent / divergent rectangular duct of aspect ratio AR at inlet1.25 and outlet in convergent channel 1.35; but in case of divergent duct it can be reversed. The four uniform rib heights, e = 3, 6, 9 and 12 mm the ratio between rib height to hydraulic mean diameter (e/Dm are 34.8, 69.7, 104.6 and 138.7 a constant rib pitch distance, P = 60 mm has been used. The flow rate in terms of average Reynolds number based on the hydraulic mean diameter (Dm is 86 mm of the channel was in a range of 20,000 to 50,000. The two ceramic heating strip of 10 mm thickness is used as a heating element have attached on top and bottom surfaces for the test sections. The heat transfer performance of the divergent / convergent ducts for 3, 6, 9 and 12 mm ribs was conducted under identical mass flow rate based on the Reynolds number. In our experiments has totally 8 different ducts were used. In addition, the acceleration / deceleration caused by the cross section area, the divergent duct generally shows enhanced heat transfer behavior for four different rib sizes, while the convergent duct has an appreciable reduction in heat transfer performance. From result point view divergent duct with 3 mm height ribbed square duct gets maximum heat transfer coefficient with minimum friction loss over the other convergent / divergent ducts.

  11. AUGMENTATION OF RIBS TURBULATORS HEIGHT ON THE HYDROTHERMAL PERFORMANCE OF DOUBLE PIPE HEAT EXCHANGER

    Directory of Open Access Journals (Sweden)

    HUSSAIN H. AL-KAYIEM

    2017-02-01

    Full Text Available Thermal performance of double pipe heat exchanger can be enhanced by imposed turbulence in the annular flow using artificial roughening. This paper presents experimental results on enhancing the heat transfer by artificial roughening using energy promoters installed on the inner surface of the cold flow annulus. An experimental test rig was fabricated having 2.0 m long annular flow test section with 76.2 mm and 34.2 mm outside and inside diameters, respectively. The energy promoters have ribs shape with rectangular cross section. Two cases of rib’s pitch to height ratios, equal to 10 and 15 and three height to hydraulic diameter, equal to 0.0595, 0.083, and 0.107 have been studied. The investigations were carried out at various flow rates within Reynolds number range of 2900 to 21000 in the cold annulus. For each roughening case, the thermal and hydraulic performances wereevaluated by determining Stanton number and the associated pressure drop, respectively. The experimental results showed that enhancement in the heat transfer was combined with a penalty in the pressure drop due to the increase in the friction factor values. The combined hydrothermal enhancement results of the DPHE, in terms of the performance index, indicate that the small height ribs to hydraulic diameter of 0.0595, augmented higher than the large height ribs to hydraulic diameter of 0.107. Hence, it is recommended to use ribs installed on the inner surface of the annulus ribs to hydraulic diameter in the range of 0.06 ± 0.005. Also, it is recommended to investigate further parameters to explore further on the influencing of the ribs on the hydrothermal performance of the DPHE.

  12. Congenital Cases of Concomitant Harlequin and Horner Syndromes.

    Science.gov (United States)

    Miquel, Juliette; Piyaraly, Saguiraly; Dupuy, Alain; Cochat, Pierre; Phan, Alice

    2017-03-01

    We report three pediatric cases of concomitant congenital Horner and Harlequin syndromes. This association suggests a lesion at the superior cervical ganglion or just inferior. Often, no underlying lesion is documented.

  13. Cetuximab, Cisplatin, and Radiation Therapy in Treating Patients With Stage IB, Stage II, Stage III, or Stage IVA Cervical Cancer

    Science.gov (United States)

    2014-12-29

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Small Cell Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage IVA Cervical Cancer

  14. Cisplatin and Radiation Therapy Followed by Paclitaxel and Carboplatin in Treating Patients With Stage IB-IVA Cervical Cancer

    Science.gov (United States)

    2016-03-16

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage IIIA Cervical Cancer; Stage IIIB Cervical Cancer; Stage IVA Cervical Cancer

  15. Flexion/extension cervical spine views in blunt cervical

    OpenAIRE

    Nasir Sadaf; Hussain Manzar; Mahmud Roomi

    2012-01-01

    【Abstract】Objective: To examine the contribution of flexion and extension radiographs in the evaluation of ligamentous injury in awake adults with acute blunt cervical spine trauma, who show loss of cervical lordosis and neck pain. Methods: All patients who presented to our emer-gency department following blunt trauma were enrolled in this study, except those with schiwora, neurological defi-cits or fracture demonstrated on cross-table cervical spine X-rays, and tho...

  16. Optimization in modeling the ribs-bounded contour from computer tomography scan

    Science.gov (United States)

    Bilinskas, M. J.; Dzemyda, G.

    2016-10-01

    In this paper a method for analyzing transversal plane images from computer tomography scans is presented. A mathematical model that describes the ribs-bounded contour was created and the problem of approximation is solved by finding out the optimal parameters of the model in the least-squares sense. Such model would be useful in registration of images independently on the patient position on the bed and on the radio-contrast agent injection. We consider the slices, where ribs are visible, because many important internal organs are located here: liver, heart, stomach, pancreas, lung, etc.

  17. High-Q silicon-on-insulator optical rib waveguide racetrack resonators.

    Science.gov (United States)

    Kiyat, Isa; Aydinli, Atilla; Dagli, Nadir

    2005-03-21

    In this work, detailed design and realization of high quality factor (Q) racetrack resonators based on silicon-on-insulator rib waveguides are presented. Aiming to achieve critical coupling, suitable waveguide geometry is determined after extensive numerical studies of bending loss. The final design is obtained after coupling factor calculations and estimation of propagation loss. Resonators with quality factors (Q) as high as 119000 has been achieved, the highest Q value for resonators based on silicon-on-insulator rib waveguides to date with extinction ratios as large as 12 dB.

  18. Pressure drop and mass transfer in two-pass ribbed channels

    Science.gov (United States)

    Chandra, P. R.; Han, J. C.

    1989-01-01

    The combined effects of the sharp 180-deg turn and of the rib configuration on the pressure drop and mass transfer characteristics in a two-pass square channel with a pair of opposite rib-roughened walls (to simulate turbine airfoil cooling passages) were determined for a Reynolds number range of 10,000-60,000. Heat transfer enhancements were compared for the first pass and for the two-pass channel with the sharp 180-deg turn. Correlations for the fully-developed friction factors and loss coefficients were obtained.

  19. High-Q silicon-on-insulator optical rib waveguide racetrack resonators

    Science.gov (United States)

    Kiyat, Isa; Aydinli, Atilla; Dagli, Nadir

    2005-03-01

    In this work, detailed design and realization of high quality factor (Q) racetrack resonators based on silicon-on-insulator rib waveguides are presented. Aiming to achieve critical coupling, suitable waveguide geometry is determined after extensive numerical studies of bending loss. The final design is obtained after coupling factor calculations and estimation of propagation loss. Resonators with quality factors (Q) as high as 119000 has been achieved, the highest Q value for resonators based on silicon-on-insulator rib waveguides to date with extinction ratios as large as 12 dB.

  20. Cough induced rib fracture, rupture of the diaphragm and abdominal herniation

    Directory of Open Access Journals (Sweden)

    Wurl Peter

    2006-11-01

    Full Text Available Abstract Cough can be associated with many complications. In this article, we present a 59 year old male patient with a very rare combination of a cough related stress fracture of the ninth rib, a traumatic rupture of the diaphragm, and an abdominal wall herniation. The hernia was repaired through surgical treatment without bowel resection, the diaphragm and the internal and oblique abdominal muscle were adapted, and the abdomen was reinforced with a prolene net. Although each individual injury is well documented in the literature, the combination of rib fracture, abdominal herniation and diaphragm rupture has not been reported.

  1. Mechanism of the rib spalling and the controlling in the very soft coal seam

    Energy Technology Data Exchange (ETDEWEB)

    Wang Jia-chen [China University of Mining and Technology, Beijing (China). Laboratory of Coal Resources and Mine Safety Technology

    2007-08-15

    The mechanism of rib spalling was studied and a way of controlling it was proposed by decreasing coal wall pressure and increasing the shear strength of the coal wall. Using the top coal caving technique and increasing the resistance of the support can reduce the pressure on the coal wall. The cohesion and shear strength of the coal wall may be increased by means of water infusion through the coal wall. These are effective ways of preventing rib spalling. The quick advance of the coal wall and having the correct low wall height are also advantageous to wall stability. 2 refs., 11 figs.

  2. Prevalence of human papillomavirus infection, distribution of viral types and risk factors in cervical samples from human immunodeficiency virus-positive women attending three human immunodeficiency virus-acquired immune deficiency syndrome reference centres in northeastern Brazil

    Directory of Open Access Journals (Sweden)

    Albert Eduardo Silva Martins

    2014-09-01

    Full Text Available Human immunodeficiency virus (HIV-positive patients have a greater prevalence of coinfection with human papillomavirus (HPV is of high oncogenic risk. Indeed, the presence of the virus favours intraepithelial squamous cell lesion progression and may induce cancer. The aim of this study was to evaluate the prevalence of HPV infection, distribution of HPV types and risk factors among HIV-positive patients. Cervical samples from 450 HIV-positive patients were analysed with regard to oncotic cytology, colposcopy and HPV presence and type by means of polymerase chain reaction and sequencing. The results were analysed by comparing demographic data and data relating to HPV and HIV infection. The prevalence of HPV was 47.5%. Among the HPV-positive samples, 59% included viral types of high oncogenic risk. Multivariate analysis showed an association between HPV infection and the presence of cytological alterations (p = 0.003, age greater than or equal to 35 years (p = 0.002, number of partners greater than three (p = 0.002, CD4+ lymphocyte count < 200/mm3 (p = 0.041 and alcohol abuse (p = 0.004. Although high-risk HPV was present in the majority of the lesions studied, the low frequency of HPV 16 (3.3%, low occurrence of cervical lesions and preserved immunological state in most of the HIV-positive patients were factors that may explain the low occurrence of precancerous cervical lesions in this population.

  3. Goldenhar syndrome with unusual features

    Directory of Open Access Journals (Sweden)

    Mehta Bijal

    2008-01-01

    Full Text Available We report here the case of a 17 year-old girl with the classic signs of Goldenhar syndrome in the form of multiple accessory tragi, bilateral ocular dermoids, mandibular hypoplasia (micrognathia and cervical lordosis. She also had a high arched palate, gingival hypertrophy and malaligned teeth, features which are as yet unreported.

  4. Performance of Ar+-milled Ti:Sapphire rib waveguides as single transverse mode broadband fluorescence sources

    NARCIS (Netherlands)

    Grivas, C.; Shepherd, D.P.; May-Smith, T.C.; Eason, R.W.; Pollnau, M.; Crunteanu, A.; Jelinek, M.

    2003-01-01

    Rib waveguides have been fabricated in pulsed-laser-deposited Ti:sapphire layers using photolithographic patterning and subsequent Ar+-beam milling. Fluorescence output powers up to 300 W have been observed from the ribs following excitation by a 3-W multiline argon laser. Mode intensity profiles sh

  5. Pressure Loss Through Sharp 180 deg Turn in a Relatively Short Two-Pass Smooth and RibRoughened Channel

    Institute of Scientific and Technical Information of China (English)

    1995-01-01

    The local pressure distributions and resistance coefficients(f1 and f2) through the sharp 180 deg turn in a relatively short (L/De=4) two-pass smooth and rib-roughened channel were investigated for a Reynolds number range of 1.0×103,9.0×103.The rib pitch-to-herght ratios(p/e) were 5,10,and 20,The rib height-to-hydraulic diamter ratios(e/De) were 0.025,0.050 and 0.10,and the rib angles of attack(a) were 90,45,60,-45,and -60 deg.Rids were installed not only in before and after turn regions but also in turn region.The results show that resistance coefficients remain approximately constant when Reynolds number is more than 3.0×104,The effects of the rib configuration(rib spacing,rib height,and rib orientation)on the inlet straight duct resistance coefficient(f2) were significant, however,their effects on the overall resistance coefficient(f1) were diluted by the sharp-180 turn.For this relatively short channel(L/De=4),the overall resistance coefficient(f1) was greatly affected by the sharp turn.Correlations for the overall resistance(f1) and inlet straight duct resistance coefficient (f2) are presented.

  6. Microbiological safety of commercial prime rib preparation methods: thermal inactivation of Salmonella spp. in mechanically tenderized beef roasts

    Science.gov (United States)

    A survey of food service operations in a medium-size Midwestern city was conducted to evaluate the microbiological safety of prime rib preparation methods relative to survival of Salmonella spp. in both intact and tenderized (non-intact) product. All six restaurants visited seared rib eye roasts (ai...

  7. A statistical human rib cage geometry model accounting for variations by age, sex, stature and body mass index.

    Science.gov (United States)

    Shi, Xiangnan; Cao, Libo; Reed, Matthew P; Rupp, Jonathan D; Hoff, Carrie N; Hu, Jingwen

    2014-07-18

    In this study, we developed a statistical rib cage geometry model accounting for variations by age, sex, stature and body mass index (BMI). Thorax CT scans were obtained from 89 subjects approximately evenly distributed among 8 age groups and both sexes. Threshold-based CT image segmentation was performed to extract the rib geometries, and a total of 464 landmarks on the left side of each subject׳s ribcage were collected to describe the size and shape of the rib cage as well as the cross-sectional geometry of each rib. Principal component analysis and multivariate regression analysis were conducted to predict rib cage geometry as a function of age, sex, stature, and BMI, all of which showed strong effects on rib cage geometry. Except for BMI, all parameters also showed significant effects on rib cross-sectional area using a linear mixed model. This statistical rib cage geometry model can serve as a geometric basis for developing a parametric human thorax finite element model for quantifying effects from different human attributes on thoracic injury risks.

  8. Comparing and determining the causes of ribbed mussel nitrogen isotope signatures in three New England sub-watersheds

    Science.gov (United States)

    Geukensia demissa, the ribbed mussel, is a useful indicator of sources of nitrogen input into coastal watersheds as it possesses a slow tissue turnover rate and is a common salt marsh species. During the summer of 2016, we sampled ribbed mussels from three New England sub-watersh...

  9. The riboflavin transporter RibU in Lactococcus lactis : Molecular characterization of gene expression and the transport mechanism

    NARCIS (Netherlands)

    Burgess, CM; Slotboom, DJ; Geertsma, ER; Duurkens, Hinderika; Poolman, B; van Sinderen, D

    2006-01-01

    This study describes the characterization of the riboflavin transport protein RibU in the lactic acid bacterium Lactococcus lactis subsp. cremoris NZ9000. RibU is predicted to contain five membrane-spanning segments and is a member of a novel transport protein family, not described in the Transport

  10. Pourfour Du Petit syndrome after interscalene block.

    Science.gov (United States)

    Santhosh, Mysore Chandramouli Basappji; Pai, Rohini B; Rao, Raghavendra P

    2013-04-01

    Interscalene block is commonly associated with reversible ipsilateral phrenic nerve block, recurrent laryngeal nerve block, and cervical sympathetic plexus block, presenting as Horner's syndrome. We report a very rare Pourfour Du Petit syndrome which has a clinical presentation opposite to that of Horner's syndrome in a 24-year-old male who was given interscalene block for open reduction and internal fixation of fracture upper third shaft of left humerus.

  11. Pourfour Du Petit syndrome after interscalene block

    Directory of Open Access Journals (Sweden)

    Mysore Chandramouli Basappji Santhosh

    2013-01-01

    Full Text Available Interscalene block is commonly associated with reversible ipsilateral phrenic nerve block, recurrent laryngeal nerve block, and cervical sympathetic plexus block, presenting as Horner′s syndrome. We report a very rare Pourfour Du Petit syndrome which has a clinical presentation opposite to that of Horner′s syndrome in a 24-year-old male who was given interscalene block for open reduction and internal fixation of fracture upper third shaft of left humerus.

  12. The Biomechanics of Cervical Spondylosis

    OpenAIRE

    Ferrara, Lisa A.

    2012-01-01

    Aging is the major risk factor that contributes to the onset of cervical spondylosis. Several acute and chronic symptoms can occur that start with neck pain and may progress into cervical radiculopathy. Eventually, the degenerative cascade causes desiccation of the intervertebral disc resulting in height loss along the ventral margin of the cervical spine. This causes ventral angulation and eventual loss of lordosis, with compression of the neural and vascular structures. The altered posture ...

  13. Os Odontoideum: Rare Cervical Lesion

    Science.gov (United States)

    2011-11-01

    the articulation between C1 and the os odontoideum on flexion imaging. The remainder of his cervical vertebral bodies had normal alignment with no...appears normal. Figure 3. Flexion view of plain cervical spine. This image shows abnormal translation of the articulation between C1 and the C2 os...worldwide. Peer Reviewed Title: Os Odontoideum: Rare Cervical Lesion Journal Issue: Western Journal of Emergency Medicine, 12(4) Author: Robson

  14. Chronic Pseudomonas aeruginosa cervical osteomyelitis

    Directory of Open Access Journals (Sweden)

    Sujeet Kumar Meher

    2016-01-01

    Full Text Available Pseudomonas aeruginosa is a rare cause of osteomyelitis of the cervical spine and is usually seen in the background of intravenous drug use and immunocompromised state. Very few cases of osteomyelitis of the cervical spine caused by pseudomonas aeruginosa have been reported in otherwise healthy patients. This is a case presentation of a young female, who in the absence of known risk factors for cervical osteomyelitis presented with progressively worsening neurological signs and symptoms.

  15. Mucopurulent cervicitis: a clinical entity?

    OpenAIRE

    Willmott, F E

    1988-01-01

    Of 297 women attending a sexually transmitted disease clinic who were examined for the presence of mucopurulent cervicitis, 96 (32%) satisfied the diagnostic criteria. Mucopurulent cervicitis was strongly associated with the isolation of Chlamydia trachomatis and Neisseria gonorrhoeae. It was also associated with bacterial vaginosis, the use of oral contraceptives, and sexual contact with men who had non-gonococcal urethritis. Conversely, the presence of opaque cervical secretions did not sho...

  16. An occult cervical spine fracture.

    Science.gov (United States)

    Khosla, R

    1997-12-01

    A 16-year-old athlete developed neck pain after being dropped on his head with his neck flexed while recreationally wrestling. Initial cervical spine radiographs were negative, but he continued to have neck and arm pain, especially after heading a wet soccer ball. Two months after the initial injury, he had a positive Spurling test; cervical spine CT then revealed a parasagittal linear fracture through the body of C-7. The patient avoided contact and collision activities and had no further physical problems. For patients who suffer cervical spine trauma, adequate visualization of the cervical spine can help prevent catastrophic outcomes.

  17. Drugs Approved for Cervical Cancer

    Science.gov (United States)

    ... Human Papillomavirus (HPV) Nonavalent Vaccine Recombinant Human Papillomavirus (HPV) Quadrivalent Vaccine Drugs Approved to Treat Cervical Cancer Avastin (Bevacizumab) Bevacizumab Blenoxane (Bleomycin) Bleomycin Hycamtin (Topotecan ...

  18. Case Studies - Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    2010-10-15

    Dr. Alan Waxman, a professor of obstetrics and gynecology at the University of New Mexico and chair of the American College of Obstetricians and Gynecologists (ACOG) committee for the underserved, talks about several case studies for cervical cancer screening and management.  Created: 10/15/2010 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  19. Future Directions - Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    2009-10-15

    Dr. Alan Waxman, a professor of obstetrics and gynecology at the University of New Mexico and chair of the American College of Obstetricians and Gynecologists (ACOG) committee for the underserved, talks about possible changes in cervical cancer screening and management.  Created: 10/15/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  20. SUPERFICIAL CERVICAL PLEXUS BLOCK

    Directory of Open Access Journals (Sweden)

    Komang Mega Puspadisari

    2014-01-01

    Full Text Available Superficial cervical plexus block is one of the regional anesthesia in  neck were limited to thesuperficial fascia. Anesthesia is used to relieve pain caused either during or after the surgery iscompleted. This technique can be done by landmark or with ultrasound guiding. The midpointof posterior border of the Sternocleidomastoid was identified and the prosedure done on thatplace or on the level of cartilage cricoid.

  1. Preinduction cervical ripening.

    Science.gov (United States)

    Thiery, M

    1983-01-01

    This work reviews the evolution of cervical ripening procedures and discusses the most effective current techniques. Current knowledge of the process of spontaneous ripening of the cervix is briefly assessed, but the review concentrates on methodological aspects and the clinical results of preinduction cervical ripening. The historical development of mechanical and pharmacologic ripening procedures is examined, including enzymes, oxytocin, relaxin, corticosteriods, estrogens administered parenterally or locally, and prostaglandins (PGs) administered intravenously, orally, locally, and intravaginally. 3 effective procedures for preinduction cervical ripening are identified and described in greater detail: the catheter technique and local and vaginal administration of PGs. The extraamniotic catheter technique is simple, effective, and safe and is recommended for patients with not totally unripe cervixes and for whom PGs are unavailable or contraindicated. Single-dose extraamniotic instillation of PGE2 in Tylose gel was found to be highly effective for priming the unfavorable cervix before conventional labor induction. In some patients the procedure induces labor. The technique is easy to use, well accepted by the woman, and safe when applied appropriately to carefully selected patients. PGF2alpha gel has been less thoroughly studied. Electronic monitoring at the ripening stage is recommended for patients at risk, and even in low-risk cases much larger series will require study before conclusions can be reached about safety. Injection of PG gel into the cervical canal is less invasive than extraamniotic instillation, but no definite conclusions about its safety are possible due to small series and dissimilar clinical protocols. Pericervical administration of PGE2 and PGF2 alpha and intracervical and intraamniotic tablets of PGE2 are briefly assessed. Adoption of the intravaginal route has been a major step in the development of ripening techniques. 3 types of media

  2. [Preventing cervical cancer].

    Science.gov (United States)

    Simon, P; Noël, J-C

    2015-09-01

    The incidence of cervical cancer has hopefully been dropping down in our industrialized countries since the introduction of both primary and secondary prevention. Nevertheless, it is still lethal in one out of two affected women though the introduction of cytological screening has dramatically reduced the mortality. Progressive diffusion of anti-HPV vaccination, the broadening of the viral types concerned, its association with existing screening measures and finally the introduction of viral detection as a screening tool must optimize the results already obtained.

  3. Cervical spinal canal narrowing and cervical neurologi-cal injuries

    Directory of Open Access Journals (Sweden)

    ZHANG Ling

    2012-04-01

    Full Text Available 【Abstract】Cervical spinal canal narrowing can lead to injury of the spinal cord and neurological symptoms in-cluding neck pain, headache, weakness and parasthesisas. According to previous and recent clinical researches, we investigated the geometric parameters of normal cervical spinal canal including the sagittal and transverse diameters as well as Torg ratio. The mean sagittal diameter of cervical spinal canal at C 1 to C 7 ranges from 15.33 mm to 20.46 mm, the mean transverse diameter at the same levels ranges from 24.45 mm to 27.00 mm and the mean value of Torg ratio is 0.96. With respect to narrow cervical spinal canal, the following charaterstics are found: firstly, extension of the cervical spine results in statistically significant stenosis as compared with the flexed or neutral positions; secondly, females sustain cervical spinal canal narrowing more easily than males; finally, the consistent narrowest cervical canal level is at C 4 for all ethnicity, but there is a slight variation in the sagittal diameter of cervical spinal stenosis (≤14 mm in Whites, ≤ 12 mm in Japanese, ≤13.7 mm in Chinese. Narrow sagittal cervical canal diameter brings about an increased risk of neurological injuries in traumatic, degenerative and inflam-matory conditions and is related with extension of cervical spine, gender, as well as ethnicity. It is hoped that this re-view will be helpful in diagnosing spinal cord and neuro-logical injuries with the geometric parameters of cervical spine in the future. Key words: Spinal cord injuries; Spinal stenosis; Trauma, nervous system

  4. Cervical spinal canal narrowing and cervical neurological injuries

    Institute of Scientific and Technical Information of China (English)

    ZHANG Ling; CHEN Hai-bin; WANG Yi; ZHANG Li-ying; LIU Jing-cheng; WANG Zheng-guo

    2012-01-01

    Cervical spinal canal narrowing can lead to injury of the spinal cord and neurological symptoms including neck pain,headache,weakness and parasthesisas.According to previous and recent clinical researches,we investigated the geometric parameters of normal cervical spinal canal including the sagittal and transverse diameters as well as Torg ratio.The mean sagittal diameter of cervical spinal canal at C1 to C7 ranges from 15.33 mm to 20.46 mm,the mean transverse diameter at the same levels ranges from 24.45 mm to 27.00 mm and the mean value of Torg ratio is 0.96.With respect to narrow cervical spinal canal,the following charaterstics are found:firstly,extension of the cervical spine results in statistically significant stenosis as compared with the flexed or neutral positions; secondly,females sustain cervical spinal canal narrowing more easily than males;finally,the consistent narrowest cervical canal level is at C4 for all ethnicity,but there is a slight variation in the sagittal diameter of cervical spinal stenosis(≤ 14 mm in Whites,≤12 mm in Japanese,≤ 13.7 mm in Chinese).Narrow sagittal cervical canal diameter brings about an increased risk of neurological injuries in traumatic,degenerative and inflammatory conditions and is related with extension of cervical spine,gender,as well as ethnicity.It is hoped that this review will be helpful in diagnosing spinal cord and neurological injuries with the geometric parameters of cervical spine in the future.

  5. Current and emerging treatments and surgical interventions for Morquio A syndrome: a review

    Directory of Open Access Journals (Sweden)

    Tomatsu S

    2012-12-01

    Full Text Available Shunji Tomatsu,1 William G Mackenzie,1 Mary C Theroux,1 Robert W Mason,1 Mihir M Thacker,1 Thomas H Shaffer,1 Adriana M Montaño,2 Daniel Rowan,2 William Sly,3 Carlos J Alméciga-Díaz,4 Luis A Barrera,4 Yasutsugu Chinen,5 Eriko Yasuda,1 Kristen Ruhnke,1 Yasuyuki Suzuki,6 Tadao Orii71Nemours/Alfred I duPont Hospital for Children, Wilmington, DE, USA; 2Department of Pediatrics, 3Edward A Doisy Department of Biochemistry and Molecular Biology, Saint Louis University, St Louis, MO, USA; 4Institute for the Study of Inborn Errors of Metabolism, Pontificia Universidad Javeriana, Bogotá DC, Colombia; 5Department of Pediatrics, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan; 6Medical Education Development Center, 7Department of Pediatrics, Gifu University, Gifu, JapanAbstract: Patients with mucopolysaccharidosis type IVA (MPS IVA; Morquio A syndrome have accumulation of the glycosaminoglycans, keratan sulfate, and chondroitin-6-sulfate, in bone and cartilage, causing systemic spondyloepiphyseal dysplasia. Features include lumbar gibbus, pectus carinatum, flaring of the rib cage, marked short stature, cervical instability and stenosis, kyphoscoliosis, genu valgum, and laxity of joints. Generally, MPS IVA patients are wheelchair-bound as teenagers and do not survive beyond the second or third decade of life as a result of severe bone dysplasia, causing restrictive lung disease and airway narrowing, increasing potential for pneumonia and apnea; stenosis and instability of the upper cervical region; high risk during anesthesia administration due to narrowed airway as well as thoracoabdominal dysfunction; and surgical complications. Patients often need multiple surgical procedures, including cervical decompression and fusion, hip reconstruction and replacement, and femoral or tibial osteotomy, throughout their lifetime. Current measures to intervene in disease progression are largely palliative, and improved therapies are urgently needed. A

  6. 电针联合桂枝加葛根汤加减治疗风寒阻络型颈型颈椎病临床研究%Effects of acupuncture combined with modified Guizhi-Gegen decoction on the patients ;with cervical spondylosis of cold locking the collaterals syndrome

    Institute of Scientific and Technical Information of China (English)

    王群羊

    2016-01-01

    目的:评价电针联合桂枝加葛根汤为主对风寒阻络型颈型颈椎病的临床疗效。方法选择2013年2月-2015年12月在西安市阎良区人民医院中医康复疼痛科接受诊治的风寒阻络型颈型颈椎病患者96例,按就诊病历尾号随机分为2组各48例。对照组给予桂枝加葛根汤为主治疗,观察组给予电针联合桂枝加葛根汤加减治疗。比较2组患者治疗前后颈痛量表评分、中医证候评分和颈动脉血流状况的变化,评价临床疗效。结果治疗2周后,观察组的有效率[95.83%(46/48)比81.25%(39/48)]高于对照组(χ2=5.031,P<0.05)。观察组头晕头痛[(0.62±0.41)分比(1.56±0.68)分,t=8.202]、颈项疼痛[(0.63±0.53)分比(1.53±0.62)分,t=7.645]、恶心呕吐[(0.39±0.23)分比(0.71±0.32)分,t=5.626],耳鸣[(0.36±0.09)分比(1.15±0.43)分,t=5.626]证候平均分低于对照组(P<0.05)。观察组的颈痛量表评分[(15.23±10.96)分比(24.46±12.15)分,t=3.908]低于对照组(P<0.05);椎动脉内径[(3.45±0.73)mm比(2.96±0.59)mm,t=3.619]、平均血流[(0.72±0.16)m/s比(0.58±0.19)m/s,t=3.905]高于对照组(P<0.05)。结论电针联合桂枝加葛根汤加减可缓解风寒阻络型颈型颈椎病的中医证候、减轻颈部疼痛。%Objective To observe the effects of acupuncture combined with modified Guizhi-Gegen decoction on scores of TCM syndrome and Neck pain questionnaire on the patients with cervical spondylosis of cold locking the collaterals syndrome. Methods A total of 96 patients with cervical spondylosis of cold locking the collaterals syndrome, who were treated in our hospital from February 2013 to December 2015, randomly divided into two groups. The control group was given modified Guizhi-Gegen decoction, and the observation group was given modified Guizhi-Gegen decoction and electro-acupuncture. The scores of traditional Chinese medicine syndrome and Neck pain questionnaire were

  7. Modal density and modal distribution of bending wave vibration fields in ribbed plates

    DEFF Research Database (Denmark)

    Dickow, Kristoffer Ahrens; Brunskog, Jonas; Ohlrich, Mogens

    2013-01-01

    Plates reinforced by ribs or joists are common elements in lightweight building structures, as well as in other engineering structures such as vehicles, ships, and aircraft. These structures, however, are often not well suited for simple structural acoustic prediction models such as statistical e...

  8. Ovariectomy-induced changes in aged beagles: Histomorphometry and mineral content of the rib

    Energy Technology Data Exchange (ETDEWEB)

    Wilson, A.K.; Bhattacharyya, M.H.; Hurst, D. [Argonne National Lab., IL (United States). Center for Mechanistic Biology and Biotechnology; Miller, S. [Univ. of Utah, Salt Lake City, UT (United States). Radiobiology Div.; Sacco-Gibson, N. [Proctor and Gamble Pharmaceuticals, Cincinnati, OH (United States)

    1997-08-01

    The effects of ovariectomy on the aged beagle skeleton were studied by histomorphometric analysis of the cortical bone in sequential rib biopsies. Biopsies were taken from each ovariectomized (OV) or sham-operated (SO) dog at the time of surgery and at 1, 4, and 8.5 months after surgery. Tetracycline, calcein, and xylenol orange, respectively, were administered by a fluorochrome labeling procedure (2d-10d-2d) just prior to each postoperative biopsy to provide markers of bone formation. Analysis of sequential biopsies provided a means to follow the response to ovariectomy over time and compare each animal against its own baseline. Examination of sequential biopsies indicated that cortical porosity increased by the fourth month after ovariectomy and remained high at 8.5 months. Ovariectomy did not influence histomorphometric indices at one month after surgery, but substantial differences were observed at later times. Ovariectomy stimulated a transient increase in bone formation and was increased six-fold over that of SO dogs at four months. Ribs were also analyzed for mineral content at necropsy. The rib was heterogeneous along its length for calcium content and concentration. In the midrib where biopsies for histomorphometric analysis were taken, ovariectomy induced a decrease in mass and mineral content; total calcium was decreased by approximately 31%. These data demonstrate that the rib cortical bone is a responsive site for the effects of ovariectomy in female dogs.

  9. Accuracy and sampling error of two age estimation techniques using rib histomorphometry on a modern sample.

    Science.gov (United States)

    García-Donas, Julieta G; Dyke, Jeffrey; Paine, Robert R; Nathena, Despoina; Kranioti, Elena F

    2016-02-01

    Most age estimation methods are proven problematic when applied in highly fragmented skeletal remains. Rib histomorphometry is advantageous in such cases; yet it is vital to test and revise existing techniques particularly when used in legal settings (Crowder and Rosella, 2007). This study tested Stout & Paine (1992) and Stout et al. (1994) histological age estimation methods on a Modern Greek sample using different sampling sites. Six left 4th ribs of known age and sex were selected from a modern skeletal collection. Each rib was cut into three equal segments. Two thin sections were acquired from each segment. A total of 36 thin sections were prepared and analysed. Four variables (cortical area, intact and fragmented osteon density and osteon population density) were calculated for each section and age was estimated according to Stout & Paine (1992) and Stout et al. (1994). The results showed that both methods produced a systemic underestimation of the individuals (to a maximum of 43 years) although a general improvement in accuracy levels was observed when applying the Stout et al. (1994) formula. There is an increase of error rates with increasing age with the oldest individual showing extreme differences between real age and estimated age. Comparison of the different sampling sites showed small differences between the estimated ages suggesting that any fragment of the rib could be used without introducing significant error. Yet, a larger sample should be used to confirm these results.

  10. Parameter survey of a rib stiffened wooden floor using sinus modes model

    DEFF Research Database (Denmark)

    Sjökvist, Lars-Göran; Brunskog, Jonas; Jacobsen, Finn

    2008-01-01

    of the sound insulation for lightweight buildings have the possibility to speed up the development of new techniques and in the end give tenants better quality of life. This study uses Fourier sinus series to calculate the vibrations on a rib stiffened plate. The beams are modelled as line forces and moments...

  11. Ti:sapphire rib channel waveguide fabricated by reactive ion etching of a planar waveguide

    NARCIS (Netherlands)

    Crunteanu, A.; Jänchen, G.; Salathé, R.P.; Hoffmann, P.; Pollnau, M.; Eason, R.W.; Shepherd, D.P.

    2002-01-01

    We were successful in creating 1.4-µm high ribs in a Ti:sapphire planar waveguide by reactive ion etching. Optical investigations of the obtained structure showed channel-waveguide fluorescence emission of the Ti:sapphire layer after Ar-ion excitation.

  12. Fractured Ribs and the CT Funky Fat Sign of Diaphragmatic Rupture

    Directory of Open Access Journals (Sweden)

    Iclal Ocak

    2016-01-01

    Full Text Available Traumatic diaphragmatic rupture remains a diagnostic challenge for both radiologists and surgeons. In recent years, multidetector CT has markedly improved the diagnosis of diaphragmatic injury in polytrauma patients. Herein, we describe two cases of subacute presentation of traumatic diaphragmatic rupture from a penetrating rib fracture and subsequent intrathoracic herniation of omental fat, representing the CT “funky fat” sign.

  13. Optimised mixing and flow resistance during shear flow over a rib roughened boundary

    NARCIS (Netherlands)

    Arfaie, A.; Burns, A. D.; Dorrell, R. M.; Eggenhuisen, J. T.; Ingham, D. B.; McCaffrey, W. D.

    2014-01-01

    A series of numerical investigations has been performed to study the effect of lower boundary roughness on turbulent flow in a two-dimensional channel. The roughness spacing to height ratio, w/k, has been investigated over the range 0.12 to 402 by varying the horizontal rib spacing. The square rough

  14. Reconstruction of ulnar defect with vascularized rib graft: A case report.

    Science.gov (United States)

    Spiker, Andrea M; Humbyrd, Casey J; Osgood, Greg M; Yang, Stephen C; Deune, E Gene

    2017-02-01

    This case report describes the reconstruction of a segmental ulnar defect using a vascularized rib graft. A 27-year-old man was injured during military service by an improvised explosive device, resulting in bilateral through-the-knee amputations, left hand deformity, and a segmental left ulnar defect. After unsuccessful ulnar reconstruction with nonvascularized autologous bone and allograft bone substitutes, he presented to our institution. We removed the residual allograft fragments from the ulnar defect, harvested a vascularized left sixth rib with the intercostal artery and vein, secured the construct with internal hardware, and performed microanastomoses of the intercostal artery and vein to the posterior interosseous artery and vein. Postoperatively, he had a hematoma at the vascularized graft recipient site caused by anticoagulation therapy for his chronic deep vein thrombosis. Despite this, the rib graft successfully incorporated on the basis of radiographic and clinical examinations at 27 months. He had no pain and good function of the arm. The results of this case suggest that a vascularized rib graft for forearm reconstruction may be a viable option with minimal donor site morbidity. © 2015 Wiley Periodicals, Inc. Microsurgery 37:160-164, 2017.

  15. Spinning Deformation Criteria of Thin-walled Tubular Part with Longitudinal Inner Ribs

    Institute of Scientific and Technical Information of China (English)

    JIANG Shuyong; XUE Kemin; LI Chunfeng; REN Zhengyi

    2006-01-01

    As a successive and local plastic delormation process, backward ball spinning was applied for the purpose of producing thin-walled tubular parts with longitudinal inner ribs. According to the local plastic deformation theory, the application of yield criterion to the spinning process and the influence of the radial spinning force component on the formability of inner ribs were analyzed. Based on yield criterion and plastic mechanics, the stable flow rude of metal material and forming criteria of the inner ribs were obtained and conformed to the experimental results so as to contribute greatly to improving the ball spinning process and optimizing the process variables, such as the diameter of ball, the reduction in a pass and the wall thickness of tubular blank, which have a significant influence on the formability of the inner ribs. The knowledge of the influence of the process variables such as the diameter of ball, the reduction in a pass and the wall thickness of tubular blank on the spinning process is essential to preventing the quality defects of the spun parts and obtaining the desired spun parts.

  16. Process factors influencing spinning deformation of thin-walled tubular part with longitudinal inner ribs

    Institute of Scientific and Technical Information of China (English)

    江树勇; 薛克敏; 宗影影; 喻林

    2004-01-01

    As a successively and locally plastic deformation process, ball backward spinning is applied for the purpose of producing thin-walled tubular parts with longitudinal inner ribs. By simplifying ball backward spinning as forward extrusion mechanics model, slab method is used in order to solve spinning force. Based on plastic mechanics, the influence of the process parameters involved on formability of inner ribs as well as the quality defects of spun parts is analyzed so as to present an approach to acquire the desired parts. The quality of inner ribs is one of the critical tasks in obtaining the desired spun workpieces and the height of inner rib depends greatly on spinning material,ball diameter, feed ratio, and wall thickness of tubular blank. The knowledge of the influence of process variables such as ball diameter, feed ratio, and wall thickness of tubular blank on the spinning process is essential to prevent the quality defects of the spun parts and obtain the desired spun parts.

  17. Fully automatic lung segmentation and rib suppression methods to improve nodule detection in chest radiographs.

    Science.gov (United States)

    Soleymanpour, Elaheh; Pourreza, Hamid Reza; Ansaripour, Emad; Yazdi, Mehri Sadooghi

    2011-07-01

    Computer-aided Diagnosis (CAD) systems can assist radiologists in several diagnostic tasks. Lung segmentation is one of the mandatory steps for initial detection of lung cancer in Posterior-Anterior chest radiographs. On the other hand, many CAD schemes in projection chest radiography may benefit from the suppression of the bony structures that overlay the lung fields, e.g. ribs. The original images are enhanced by an adaptive contrast equalization and non-linear filtering. Then an initial estimation of lung area is obtained based on morphological operations and then it is improved by growing this region to find the accurate final contour, then for rib suppression, we use oriented spatial Gabor filter. The proposed method was tested on a publicly available database of 247 chest radiographs. Results show that this method outperformed greatly with accuracy of 96.25% for lung segmentation, also we will show improving the conspicuity of lung nodules by rib suppression with local nodule contrast measures. Because there is no additional radiation exposure or specialized equipment required, it could also be applied to bedside portable chest x-rays. In addition to simplicity of these fully automatic methods, lung segmentation and rib suppression algorithms are performed accurately with low computation time and robustness to noise because of the suitable enhancement procedure.

  18. 30 CFR 57.3460 - Maintenance between machinery or equipment and ribs.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Maintenance between machinery or equipment and... NONMETAL MINES Ground Control Precautions-Underground Only § 57.3460 Maintenance between machinery or equipment and ribs. Persons shall not perform maintenance work between machinery or equipment and...

  19. 聚类分析与主成分分析在颈椎病中医证型规范化研究中的应用%Cluster analysis and principal component analysis in traditional medical syndrome types and Standardization of cervical spondylosis

    Institute of Scientific and Technical Information of China (English)

    王春晓; 谢兴文; 李宁

    2011-01-01

    BACKGROUND: Recently, the classification of cervical spondylosis is relatively single, lacking the features of Chinese medicinesyndrome types in dialectically treating the disease. The previous methods of classifying cervical spondylosis are Ihe summaries□f personal experiences without objective base. Therefore, il is significant to investigate syndrome classification using clusteranalysis and principal component analysis.OBJECTIVE: To investigate the distribution traits in cervical spondylosis according to different symptom types of traditionalChinese medicine using cluster analysis and principal analysis.METHODS: The questionnaire was designed according to the clinical manifestations in cervical spondylosis patients. Symptoms,clinical signs, tongue, pulsa and other diagnostic messages of 575 patients were collected, to analyze 98 common symptomsusing cluster analysis and principal component analysis.RESULTS AND CONCLUSION: According to the results of cluster analysis, the disease could be divided into eight categories:dampness-heat energizer, phlegm and wet resistance channels and collaterals, deficiency of qi and blood, deficiency ofliver-Kidney yin. Deficiency of (tie spleen and kidney-yang/. Blood stasis and qi stagnation, cold dampness resistance channelsand collaterals, deficiency of liver and spleen. We found that mosl of their disease mechanisms were "state of evil domination",which was caused by qi stagnation, dampness-heat, cold dampness, phlegm-dampness, blood stasis. Meanwhile, because of theexistence of asthenia of healthy 171, the main representation was deficiency of yin, deficiency of yang, deficiency of qi anddeficiency of blood. Cluster analysis and principle component analysis are scientific to some extent used in the research oftraditional Chinese medical syndrome types.%背景:目前对于颈椎病的中医分型相对单一,缺乏各型颈椎病一一分型辨治的中医特色与特点.以往各型颈椎病分型主要是以个人经验

  20. Vascular thoracic outlet syndrome developed after minimally invasive repair of pectus excavatum.

    Science.gov (United States)

    Kılıç, Burcu; Demirkaya, Ahmet; Turna, Akif; Kaynak, Kamil

    2013-09-01

    The Nuss procedure is a minimally invasive surgical repair technique for pectus excavatum with fewer delayed complications compared to open procedures. We report the case of a 22-year-old man with deep pectus excavatum who developed vascular thoracic outlet syndrome after the Nuss procedure. Further evaluation demonstrated that the first rib was causing severe obstruction of the right subclavian artery. The patient showed clinical features of subclavian artery compression. A first rib resection, division of the anterior scalene muscle and fibrous bands provided complete relief of the complaints. The forced structural and spatial changes produced by the elevation of the depressed upper chest might have caused this complication. Vascular thoracic outlet syndrome should be kept in mind as a possible complication in patients who have undergone minimally invasive repair of pectus excavatum, and this complication can be treated by first rib resection.

  1. Clinical significance of conventional rib series in patients with minor thoracic trauma

    Energy Technology Data Exchange (ETDEWEB)

    Hoffstetter, P.; Dornia, C. [Asklepios Medical Center, Bad Abbach (Germany). Radiology; University Medical Center Regensburg (Germany). Radiology; Wagner, M.; Niessen, C.; Dendl, L.M.; Stroszczynski, C.; Schreyer, A.G. [University Medical Center Regensburg (Germany). Radiology; Al Suwaidi, M.H. [Asklepios Medical Center, Bad Abbach (Germany). Rheumatology/Clinical Immmunology

    2014-09-15

    Background: Conventional rib series (RS) represent a dedicated radiographic technique to visualize the bony parts of the chest wall. The method is commonly used to evaluate minor thoracic trauma, frequently in combination with chest radiographs (CRs). The aim of this study is to asses the clinical relevance of rib fractures diagnosed by RS in minor thoracic trauma. Methods: Retrospective study of 669 patients who received RS for the evaluation of minor thoracic trauma. 405 of the 669 patients received an additional CR. Radiological reports were classified into fracture versus no fracture. Patients were divided into four groups depending on the clinical follow-up. The findings of RS and CR were analyzed using the McNemar test. The statistical significance between the results of the radiographic examinations and the clinical follow-up was analyzed by the Chi-Square test and the Kruskal-Wallis test. Results: We included 669 patients (61.4% men, 38.6% women, median age: 51 years, range: 13-92 years). Analyzing the reports of 669 patients who received RS, 157 (23.5%) patients were diagnosed with at least one fractured rib while no fracture was found in 512 (76.5%) patients. Considering the 157 patients with fractured ribs, 73 (46.8%) had a single fracture, 38 (24.4%) and two fractures and 45 (28.8%) had more than two fractures. When assessing the 405 CRs, we detected 69 (17%) fractures while the corresponding RS of the same patients revealed 87 (21.5%) fractures (p < 0.05). Concerning all patients with rib fractures, 63.1% received medical therapy, while 64.5% of those patients without a radiologically documented fracture also received therapy (p = 0.25). Conclusion: Our results suggest a limited clinical value of detected rib fractures based on RS. Despite being superior compared to CR in diagnosing rib fractures, the results from RS seem to have no significant influence on further clinical management and therapeutic measures. Minor thoracic trauma should be evaluated

  2. Significance of cervical length and cervical gland area in cervical maturation

    Directory of Open Access Journals (Sweden)

    Channaveeregowda Savitha

    2016-08-01

    Results: Amongst 160 pregnant women who were induced (20 women were excluded has they underwent LSCS for some other reasons during latent phase cervical length by sonography 4. Cervical length 4. Conclusions: Sonographically detected cervical gland area and cervical length was evaluated in predicting response to induction. Absent CGA and CL < 2cm was associated with greater incidence of successful labor induction. This results show the CL and CGA has significant role in predicting outcome of labor. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000: 2634-2639

  3. Spondilitis Tuberkulosa Cervical

    Directory of Open Access Journals (Sweden)

    Roni Eka Saputra

    2015-05-01

    Full Text Available Abstrak Spondilitis tuberkulosa servikalis adalah penyakit yang cukup jarang dijumpai, hanya berkisar 2-3% dariseluruh kasus spondilitis tuberkulosa. Gambaran klinis sangat bervariasi, mulai dari gejala ringan dan tidak spesifikhingga komplikasi neurologis yang berat. Seorang wanita berusia 29 tahun datang dengan keluhan lemah keempatanggota gerak yang semakin memberat dalam 10 hari terakhir yang didahului oleh nyeri leher yang menjalar ke bahudan lengan sejak 6 bulan sebelumnya. Nyeri awalnya dirasakan sebagai keterbatasan gerakan leher saat menolehkesamping kiri dan kanan serta menundukkan kepala. Nyeri dirasakan semakin berat dengan pergerakan danberkurang jika istirahat. Pasien mengalami penurunan berat badan sejak 2 bulan terakhir. Tidak dijumpai riwayat batukatau nyeri dada. Pemeriksaan neurologis menunjukkan kelemahan  pada keempat ekstremitas. Hasil laboratoriumditemukan peningkatan Laju Endap Darah (LED. Rontgen foto toraks dalam batas normal. Roentgen foto cervicalmenunjukkan destruksi setinggi C5. MRI cervical menunjukkan destruksi pada korpus C5-6 dengan penyempitan padadiscus intervertebrae C5-6 disertai dengan  massa/abses paravertebral dengan penekanan ke posterior. MRI Thorakaltampak destruksi corpus verebre T4,5 dengan diskus intervertebralis yang menyempit. Sugestif suatu spondilitistuberkulosa. Pasien dilakukan tindakan pembedahan anterior corpectomi melalui microscopic surgery dengan graftdari iliac sinistra, serta insersi anterior plate 1 level. Hasil pemeriksaan patologi anatomi menunjukkan spodilitis TBCkaseosa. Pada spondilitis vertebre T4,5 dilakukan laminectomi, debridement costotrasversektomi, dan stabilisasidengan pedicle screw T2, T3, dan T5. Pasien diterapi dengan obat antituberkulosis. Keadaan pasien saat ini, pasiensudah bisa beraktifitas normal dengan motorik dan sensorik baik. Spondilitis tuberkulosa merupakan bentuktuberkulosa tulang yang paling sering dijumpai. Spondilitis tuberkulosa cervical berkisar 2

  4. Flexion/extension cervical spine views in blunt cervical

    Directory of Open Access Journals (Sweden)

    Nasir Sadaf

    2012-06-01

    Full Text Available 【Abstract】Objective: To examine the contribution of flexion and extension radiographs in the evaluation of ligamentous injury in awake adults with acute blunt cervical spine trauma, who show loss of cervical lordosis and neck pain. Methods: All patients who presented to our emer-gency department following blunt trauma were enrolled in this study, except those with schiwora, neurological defi-cits or fracture demonstrated on cross-table cervical spine X-rays, and those who were either obtunded or presented after cervical spine surgery. Adequacy of flexion and exten-sion views was checked by the neurosurgery and radiology team members. All these patients underwent cross-table cervical spine view followed by flexion/extension views based on the loss of lordosis on cross-table imaging and the presence of neck pain. Results: A total of 200 cases were reviewed, of whom 90 (45% underwent repeat X-rays because of either inadequate exposure or limited motion. None of the patients with loss of lordosis on cross-table view had positive flexion and extension views of cervical spine for instability. Conclusions: Our results show that in patients who underwent acute radiographic evaluation of blunt cervical spine trauma, flexion and extension views of the cervical spine are unlikely to yield positive results in the presence of axial neck pain and/or loss of cervical lordosis. We can also hypothesize that performing flexion and extension views will be more useful once the acute neck pain has settled. Key words: X-rays; Cervical vertebrae; Lordosis

  5. MRI and PET Imaging in Predicting Treatment Response in Patients With Stage IB-IVA Cervical Cancer

    Science.gov (United States)

    2017-02-08

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma, Not Otherwise Specified; Cervical Undifferentiated Carcinoma; Recurrent Cervical Carcinoma; Stage IB2 Cervical Cancer; Stage II Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage IIIA Cervical Cancer; Stage IIIB Cervical Cancer; Stage IVA Cervical Cancer

  6. Cognition of cervical spondylosis%颈椎病之我见

    Institute of Scientific and Technical Information of China (English)

    赵定麟

    2015-01-01

    In 1976, Dr. Zhao Dinglin and Dr. Zhang Wenming made the breakthrough. Based on the purpose of releasing bone induced pressure they had completed the first anterior radical cervical decompression and bone grafting + partial rotation. Since then, chinese scholars had continuously explored the pathogenesis, pathological anatomy, pathophysiological features, reasonable classiifcation and many other related issues of cervical spondylosis. In several years from 1970s, the author proposed the concept of cervical nonfusion technology, to accomplish various designs and producing, which was subsequently used in clinical treatment. We brought forward Luschka’s joint diseases and anterior-lateral decompression surgery on the purpose of resecting Luschka’s joints. To reduce the damage to the cervical spine anatomy, we had designed a cervical anterior undermining decompression instrument ( including “L” shape, “T” shape, “Y” shape and single vertebrae ). We cooperated with Shanghai No. Six Surgical Instruments Factory and produced both conventional and special instruments on cervical spine surgery to improve the accuracy and security in operations. After that, we designed cervical hollow threaded ifxator, artiifcial cervical vertebra body and artiifcial vertebra plate. Combined with the research results concluded by three national forums, we elaborated basic concepts and definitions of cervical researches at different periods. On this basis we introduced those crucial issues such as the natural outcome of the cervical spondylosis, pathological anatomy features, pathogenesis and so on. Also, for some related trending topics we expressed personal viewpoints. For instance, selection of operative approach ( anterior or posterior ), origin, choice and effectiveness of nonfusion technique, and operative essentials of less invasion. Furthermore we put forward the main points on more common clinical diseases: Luschka’s joint diseases and anterior central spinal artery

  7. Extreme cervical elongation after sacrohysteropexy

    NARCIS (Netherlands)

    Vierhout, M.E.; Futterer, J.J.

    2013-01-01

    We present a case of extreme cervical elongation with a cervix of 12 cm after an unusual operation in which the uterine corpus was directly fixed to the promontory, and which became symptomatic after 8 years. The possible pathophysiology of cervical elongation is discussed. Diagnosing a case of seve

  8. Incomplete Horner syndrome: Report of a case and description of the sympathetic nervous system anatomy involved in Horner syndrome.

    Science.gov (United States)

    Garbo, Grant M; Harmatz, Alexander J; Isaacson, Glenn

    2011-02-01

    Horner syndrome, in which ptosis, miosis, and anhidrosis occur concomitantly, can arise from injury to the sympathetic nerve pathways anywhere from the brain to the end organs. Incomplete Horner syndrome lacks the sign of anhidrosis. We present a case of incomplete Horner syndrome caused by internal carotid artery dissection and provide a road map of the cervical sympathetic nerves involved in Horner syndrome to explain its etiology. We also discuss the imaging of and therapy for internal carotid artery dissections.

  9. The Biomechanics of Cervical Spondylosis

    Directory of Open Access Journals (Sweden)

    Lisa A. Ferrara

    2012-01-01

    Full Text Available Aging is the major risk factor that contributes to the onset of cervical spondylosis. Several acute and chronic symptoms can occur that start with neck pain and may progress into cervical radiculopathy. Eventually, the degenerative cascade causes desiccation of the intervertebral disc resulting in height loss along the ventral margin of the cervical spine. This causes ventral angulation and eventual loss of lordosis, with compression of the neural and vascular structures. The altered posture of the cervical spine will progress into kyphosis and continue if the load balance and lordosis is not restored. The content of this paper will address the physiological and biomechanical pathways leading to cervical spondylosis and the biomechanical principles related to the surgical correction and treatment of kyphotic progression.

  10. The biomechanics of cervical spondylosis.

    Science.gov (United States)

    Ferrara, Lisa A

    2012-01-01

    Aging is the major risk factor that contributes to the onset of cervical spondylosis. Several acute and chronic symptoms can occur that start with neck pain and may progress into cervical radiculopathy. Eventually, the degenerative cascade causes desiccation of the intervertebral disc resulting in height loss along the ventral margin of the cervical spine. This causes ventral angulation and eventual loss of lordosis, with compression of the neural and vascular structures. The altered posture of the cervical spine will progress into kyphosis and continue if the load balance and lordosis is not restored. The content of this paper will address the physiological and biomechanical pathways leading to cervical spondylosis and the biomechanical principles related to the surgical correction and treatment of kyphotic progression.

  11. Fractures of the cervical spine

    Directory of Open Access Journals (Sweden)

    Raphael Martus Marcon

    2013-11-01

    Full Text Available OBJECTIVES: The aim of this study was to review the literature on cervical spine fractures. METHODS: The literature on the diagnosis, classification, and treatment of lower and upper cervical fractures and dislocations was reviewed. RESULTS: Fractures of the cervical spine may be present in polytraumatized patients and should be suspected in patients complaining of neck pain. These fractures are more common in men approximately 30 years of age and are most often caused by automobile accidents. The cervical spine is divided into the upper cervical spine (occiput-C2 and the lower cervical spine (C3-C7, according to anatomical differences. Fractures in the upper cervical spine include fractures of the occipital condyle and the atlas, atlanto-axial dislocations, fractures of the odontoid process, and hangman's fractures in the C2 segment. These fractures are characterized based on specific classifications. In the lower cervical spine, fractures follow the same pattern as in other segments of the spine; currently, the most widely used classification is the SLIC (Subaxial Injury Classification, which predicts the prognosis of an injury based on morphology, the integrity of the disc-ligamentous complex, and the patient's neurological status. It is important to correctly classify the fracture to ensure appropriate treatment. Nerve or spinal cord injuries, pseudarthrosis or malunion, and postoperative infection are the main complications of cervical spine fractures. CONCLUSIONS: Fractures of the cervical spine are potentially serious and devastating if not properly treated. Achieving the correct diagnosis and classification of a lesion is the first step toward identifying the most appropriate treatment, which can be either surgical or conservative.

  12. CDC Vital Signs: Cervical Cancer is Preventable

    Science.gov (United States)

    ... HPV vaccine can reduce risk of cervical cancer. HPV causes most cervical cancers. Only 1 in 3 girls and 1 in ... Signs – Cervical Cancer [PSA - 0:60 seconds] Cervical Cancer Preteen and Teen Vaccines Human Papillomavirus (HPV)-Associated Cancers What Should I Know About ...

  13. X-Ray Exam: Cervical Spine

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old X-Ray Exam: Cervical Spine KidsHealth > For Parents > X-Ray Exam: Cervical Spine A A A What's ... columna cervical What It Is A cervical spine X-ray is a safe and painless test that ...

  14. Electrodiagnosis of cervical radiculopathy.

    Science.gov (United States)

    Hakimi, Kevin; Spanier, David

    2013-02-01

    Cervical radiculopathy is a common diagnosis with a peak onset in the fifth decade. The most commonly affected nerve root is C7, C6, and C8. The etiology is often compressive, but may arise from noncompressive sources. Patients commonly complain of pain, weakness, numbness, and/or tingling. Examination may reveal sensory or motor disturbance in a dermatomal/myotomal distribution. Neural compression and tension signs may be positive. Diagnostic tests include imaging and electrodiagnostic study. Electrodiagnostic study serves as an extension of the neurologic examination. Electrodiagnostic findings can be useful for patients with atypical symptoms, potential pain-mediated weakness, and nonfocal imaging findings.

  15. Syringomyelia associated with cervical spondylosis: A rare condition.

    Science.gov (United States)

    Landi, Alessandro; Nigro, Lorenzo; Marotta, Nicola; Mancarella, Cristina; Donnarumma, Pasquale; Delfini, Roberto

    2013-06-16

    , finally generating the syrinx. On the other hand in cervical spondylosis the stenotic elements can affect subarachnoid space. These elements rubbing towards spinal cord during movements of the neck can generate arachnoiditis, subarachnoid hemorrhages and arachnoid adhesions. Analyzing the literature these "complications" of cervical spondylosis are described at the origin of syringomyelia. So surgical decompression, enlarging medullary canal prevents rubbings and contacts between the bone-ligament structures of the spine towards spinal cord and subarachnoid space therefore syringomyelia. Perhaps stabilization is also necessary to prevent instability of the cervical spine at the base of central cord syndrome or syringomyelia. Finally although patients affected by central cord syndrome are usually managed conservatively we advocate, also for them, surgical treatment in cases affected by advanced state of the symptoms and MRI.

  16. Multiple Rib Exostoses in a Boy: A Rare CaseResulting in Surgery Secondary to Cosmetic Concerns

    Directory of Open Access Journals (Sweden)

    Seyed Hosein Fattahi Masoum

    2014-09-01

    Full Text Available A seven year-old boy with several painless masses on the ribs and shoulder was referred to our hospital. The masses were so prominent that they prevented the child’s sleep. Since the patient had been ridiculed by his friends due to the rib prominences, he had refused to attend school. After clinical and radiological evaluations, the masses were diagnosed as hereditary multiple exostoses of the shoulder and ribs. He underwent surgery for cosmetic reasons resulting in the patient’s return to a normal life.

  17. Chronic neck pain: making the connection between capsular ligament laxity and cervical instability.

    Science.gov (United States)

    Steilen, Danielle; Hauser, Ross; Woldin, Barbara; Sawyer, Sarah

    2014-01-01

    The use of conventional modalities for chronic neck pain remains debatable, primarily because most treatments have had limited success. We conducted a review of the literature published up to December 2013 on the diagnostic and treatment modalities of disorders related to chronic neck pain and concluded that, despite providing temporary relief of symptoms, these treatments do not address the specific problems of healing and are not likely to offer long-term cures. The objectives of this narrative review are to provide an overview of chronic neck pain as it relates to cervical instability, to describe the anatomical features of the cervical spine and the impact of capsular ligament laxity, to discuss the disorders causing chronic neck pain and their current treatments, and lastly, to present prolotherapy as a viable treatment option that heals injured ligaments, restores stability to the spine, and resolves chronic neck pain. The capsular ligaments are the main stabilizing structures of the facet joints in the cervical spine and have been implicated as a major source of chronic neck pain. Chronic neck pain often reflects a state of instability in the cervical spine and is a symptom common to a number of conditions described herein, including disc herniation, cervical spondylosis, whiplash injury and whiplash associated disorder, postconcussion syndrome, vertebrobasilar insufficiency, and Barré-Liéou syndrome. When the capsular ligaments are injured, they become elongated and exhibit laxity, which causes excessive movement of the cervical vertebrae. In the upper cervical spine (C0-C2), this can cause a number of other symptoms including, but not limited to, nerve irritation and vertebrobasilar insufficiency with associated vertigo, tinnitus, dizziness, facial pain, arm pain, and migraine headaches. In the lower cervical spine (C3-C7), this can cause muscle spasms, crepitation, and/or paresthesia in addition to chronic neck pain. In either case, the presence of

  18. [Cervical spine instability in the surgical patient].

    Science.gov (United States)

    Barbeito, A; Guerri-Guttenberg, R A

    2014-03-01

    Many congenital and acquired diseases, including trauma, may result in cervical spine instability. Given that airway management is closely related to the movement of the cervical spine, it is important that the anesthesiologist has detailed knowledge of the anatomy, the mechanisms of cervical spine instability, and of the effects that the different airway maneuvers have on the cervical spine. We first review the normal anatomy and biomechanics of the cervical spine in the context of airway management and the concept of cervical spine instability. In the second part, we review the protocols for the management of cervical spine instability in trauma victims and some of the airway management options for these patients.

  19. Antiphospholipid Syndrome: primary or secondary to Systemic Lupus Erythematosus? Description of a clinical case of avitaminosis D in premenopausal woman with pseudo-Cushing syndrome

    OpenAIRE

    2014-01-01

    Low vitamin D levels have been described in obese individuals and in some autoimmune diseases, such as Systemic Lupus Erythematosus (SLE) and primary antiphospholipid syndrome (pAPS). In particular, more than 50% of premenopausal women with pAPS have hypovitaminosis D. In this issue we report a case of an obese, premenopausal, and hypertensive woman with pseudo-Cushing syndrome, affected by deep venous thrombosis associated with pulmonary embolism after rib fracture who presented hypovitamino...

  20. Flexion/extension cervical spine views in blunt cervical trauma

    Institute of Scientific and Technical Information of China (English)

    Sadaf Nasir; Manzar Hussain; Roomi Mahmud

    2012-01-01

    Objective: To examine the contribution of flexion and extension radiographs in the evaluation of ligamentous injury in awake adults with acute blunt cervical spine trauma,who show loss of cervical lordosis and neck pain.Methods: All patients who presented to our emergency department following blunt trauma were enrolled in this study,except those with schiwora,neurological deficits or fracture demonstrated on cross-table cervical spine X-rays,and those who were either obtunded or presented after cervical spine surgery.Adequacy of flexion and extension views was checked by the neurosurgery and radiology team members.All these patients underwent cross-table cervical spine view followed by flexion/extension views based on the loss of lordosis on cross-table imaging and the presence of neck pain.Results: A total of 200 cases were reviewed,of whom 90 (45%) underwent repeat X-rays because of either inadequate exposure or limited motion.None of the patients with loss of lordosis on cross-table view had positive flexion and extension views of cervical spine for instability.Conclusions: Our results show that in patients who underwent acute radiographic evaluation of blunt cervical spine trauma,flexion and extension views of the cervical spine are unlikely to yield positive results in the presence of axial neck pain and/or loss of cervical lordosis.We can also hypothesize that performing flexion and extension views will be more useful once the acute neck pain has settled.

  1. Nevoid Basal Cell Carcinoma Syndrome : A Case Report

    Directory of Open Access Journals (Sweden)

    K Rajanikanth

    2004-01-01

    Full Text Available The nevoid basal cell carcinoma syndrome (NBCCS or Gorlin - Goltz syndrome is an autosomal disorder principally characterized by cutaneous basal cell carcinomas, multiple keratocysts, and skeletal anomalies. The major organ systems involved are skin, bones, central nervous system, eyes, gonads and endocrine. This particular syndrome is extensively described in the literature under different names. However, there are only few cases reported in the Indian literature. An unusual case of a 33-year old male with large odontogenic keratocyst involving impacted canine in the mandible, along with multiple cysts and impacted teeth in the maxilla; bifid rib and vertebral anomalies has been described.

  2. Range of motion and cervical myofascial pain.

    Science.gov (United States)

    Wilke, J; Niederer, D; Fleckenstein, J; Vogt, L; Banzer, W

    2016-01-01

    Several studies investigating myofascial pain syndrome include assessments of range of motion (ROM) as a diagnostic criterion. However, the value of ROM in this context has not yet been evaluated in controlled clinical studies. We aimed to examine whether patients with myofascial pain syndrome display alterations of ROM when compared to healthy subjects. Twenty-two individuals (13 females, 9 males; aged 33.4 ± 13.9 yrs) afflicted with active myofascial trigger points in the upper trapezius muscle as well as 22 age and sex matched healthy controls were included. All subjects underwent an examination of maximal active cervical ROM in flexion/extension assessed by means of a 3D ultrasonic movement analysis system (30 Hz; Zebris CMS 70). In the patients group, pressure pain threshold (PPT) of the trigger points was determined using a pressure algometer. Maximum range of motion in the sagittal plane did not differ between individuals with MTrP (125.9 ± 23.2°, 95% CI: 116.2-135.6°) and asymptomatic subjects (128.2 ± 20.4°, 95% CI: 119.7-136.7°; p > .05). In patients, PPT (1.7 ± .6, 95% CI: 1.5-1.9) was not correlated with cervical mobility (r = -.13; p > .05). Based on these pilot data, range of motion in flexion/extension is not a valid criterion for the detection of myofascial trigger points. Additional research incorporating movement amplitudes in other anatomical planes and additional afflicted muscles should be conducted in order to further delineate the relative impact of MTrP on range of motion.

  3. [A paraneoplastic Sharp syndrome reversible after resection of a benign schwannoma: a paraneoplastic syndrome?].

    Science.gov (United States)

    Slimani, S; Sahraoui, M; Bennadji, A; Ladjouze-Rezig, A

    2014-08-01

    Paraneoplastic syndromes commonly occur in malignancies and often precede the first symptoms of the tumor. By definition, paraneoplastic syndromes are only associated with malignancies although some exceptions have been reported, occurring with benign tumors. We report a patient presenting with a clinical and serological Sharp syndrome, followed a few months later by a cervical schwannoma. Curative surgical resection of the mass resulted in a clinical and serological healing from the Sharp syndrome. To our knowledge, this is the first report of a benign schwannoma complicated by a possible paraneoplastic Sharp syndrome.

  4. The NEtherlands Cervical Kinematics (NECK Trial. Cost-effectiveness of anterior cervical discectomy with or without interbody fusion and arthroplasty in the treatment of cervical disc herniation; a double-blind randomised multicenter study

    Directory of Open Access Journals (Sweden)

    van den Akker Elske

    2010-06-01

    Full Text Available Abstract Background Patients with cervical radicular syndrome due to disc herniation refractory to conservative treatment are offered surgical treatment. Anterior cervical discectomy is the standard procedure, often in combination with interbody fusion. Accelerated adjacent disc degeneration is a known entity on the long term. Recently, cervical disc prostheses are developed to maintain motion and possibly reduce the incidence of adjacent disc degeneration. A comparative cost-effectiveness study focused on adjacent segment degeneration and functional outcome has not been performed yet. We present the design of the NECK trial, a randomised study on cost-effectiveness of anterior cervical discectomy with or without interbody fusion and arthroplasty in patients with cervical disc herniation. Methods/Design Patients (age 18-65 years presenting with radicular signs due to single level cervical disc herniation lasting more than 8 weeks are included. Patients will be randomised into 3 groups: anterior discectomy only, anterior discectomy with interbody fusion, and anterior discectomy with disc prosthesis. The primary outcome measure is symptomatic adjacent disc degeneration at 2 and 5 years after surgery. Other outcome parameters will be the Neck Disability Index, perceived recovery, arm and neck pain, complications, re-operations, quality of life, job satisfaction, anxiety and depression assessment, medical consumption, absenteeism, and costs. The study is a randomised prospective multicenter trial, in which 3 surgical techniques are compared in a parallel group design. Patients and research nurses will be kept blinded of the allocated treatment for 2 years. The follow-up period is 5 years. Discussion Currently, anterior cervical discectomy with fusion is the golden standard in the surgical treatment of cervical disc herniation. Whether additional interbody fusion or disc prothesis is necessary and cost-effective will be determined by this trial

  5. Chlamydia trachomatis in cervicitis and urethritis in women.

    Science.gov (United States)

    Paavonen, J; Vesterinen, E

    1982-01-01

    In the Scandinavian countries today, Chlamydia trachomatis seems to be the most important cause of sexually transmitted diseases. Although C. trachomatis is most prevalent in symptomatic women and in persons visiting venereal disease clinics, the asymptomatic carrier rate, particularly in young women, appears to be surprisingly high. In addition to young age and level of sexual activity, the use of oral contraceptives and the presence of cervical ectopy are important risk factors for chlamydial infection. Chlamydial cervicitis often is characterized by a hypertrophic follicular appearance, with severe edema, erythema, friability, and endocervical mucopurulent discharge. On colposcopy, an atypical transformation zone is frequently observed. Papanicolaou smears taken from C. trachomatis culture-positive patients often reveal benign atypias and dyskaryotic changes. C. trachomatis, therefore, being a venereally transmitted intracellular organism, may well play a role in the development of cervical intraepithelial neoplasia (CIN). Future studies on patients with cytological atypias, therefore, also should include tests for C. trachomatis. Prospective studies are needed to determine the natural history and outcome of C. trachomatis-associated atypias and their behavior after adequate therapy. A large proportion of C. trachomatis-infected women also are culture-positive from the urethra. The demonstration that C. trachomatis is a common causative agent of acute urethral syndrome (also called abacterial urethritis, dysuria-pyuria syndrome) in women has been a valuable contribution. The diagnosis of pyuria in a patient with abacterial dysuria is of critical importance, since it suggests a chlamydial etiology and thus is a potentially treatable condition.

  6. Cervical extravasation of bevacizumab.

    Science.gov (United States)

    Dréanic, Johann; Coriat, Romain; Mir, Olivier; Perkins, Géraldine; Boudou-Rouquette, Pascaline; Brezault, Catherine; Dhooge, Marion; Goldwasser, François; Chaussade, Stanislas

    2013-04-01

    Monoclonal antibodies such as bevacizumab are widely used in medical oncology, either alone or in combination with chemotherapy. No specific recommendations on the management of monoclonal antibodies extravasation exist. Incidence rates vary considerably. Estimates of 0.5-6% have been reported in the literature. Also, patient-associated and procedure-associated risk factors of extravasation are multiple, such as bolus injections or poorly implanted central venous access. We report on an 86-year-old woman with colon cancer with liver metastasis who was treated with 5-fluorouracil, folinic acid, and bevacizumab. Extravasation occurred during chemotherapy infusion because of a catheter migration of the port outside of the superior vena cava, causing cervical pain without skin modifications. Diagnosis was confirmed with the appearance of clinical right cervical tumefaction and cervicothoracic computed tomography scan indicated a perijugular hypodense collection, corresponding to the extravasation. Conservative management was proposed. The patient recovered within 3 weeks from all symptoms. Physicians should be aware that in cases of bevacizumab extravasation, a nonsurgical approach might be effective.

  7. Pathogenesis of Cervical Vertigo%颈性眩晕发病机制

    Institute of Scientific and Technical Information of China (English)

    李军; 叶秀兰; 唐占英; 崔学军; 王拥军

    2013-01-01

    颈性眩晕是指椎动脉的颅外段受颈部病变的影响导致血流障碍引起的眩晕综合征,又称椎动脉压迫综合征、椎动脉缺血综合征、颈后交感神经综合征等,发病机制复杂,笔者结合文献将颈性眩晕的发病机制从颈椎病变、血液与血管病变、本体感觉及前庭神经核学说等三个方面作系统阐述.%Cervical vertigo refers to vertigo syndrome,which is casued by blood disorders due to the extracranial vertebral artery neck lesions,and it is also known as the vertebral artery compression syndrome,vertebral artery occlusion syndrome,posterior cervical sympathetic syndrome.The pathogenesis is complex.Combined with the literature,the pathogenesis of cervical vertigo was expained from three apsects systematically:cervical lesions,blood vessel disease,proprioceptive and vestibular nuclear doctrine.

  8. GENETIC INSTABILITY IN CERVICAL CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    赵旻; 伍欣星; 邱小萍; 李晖; 戴天力; 谭云

    2002-01-01

    Objective: The role of human papillomavirus (HPV) in the development of cervical carcinoma has been clearly established but other factors could be involved in cervical tumorigenesis such as loss of heterozygosity (LOH) and microsatellite instability (MI). The aim of the present study was to investigate the genetic instability in cervical carcinoma tissues and provide evidence for discoveringnew tumor suppressor genes and screening diagnostic molecular marker of cervical carcinoma. Methods: Fifty primary cervical carcinoma samples from high-incidence area were analyzed by PCR for HPV16 infection, LOH and microsatellite instability. Results: HPV16 was detected in 88% of the cases. Sixty-six percent of total cases showed LOH with no more than 3 different loci per case. The highest frequency of the allelic loss was found in D18S474 (18q21, 40.5%). MI was detected in 4 cases (8%) only. Conclusion: Different percentages of LOH on specific chromosomal regions were found and MI was very infrequent in cervical carcinoma. The putative suppressor gene(s) could be located on specific chromosome regions such as 18q, and genetic instability could be involved in cervical tumorigenesis.

  9. Improvement of diagnostic confidence for detection of multiple myeloma involvement of the ribs by a new CT software generating rib unfolded images: Comparison with 5- and 1-mm axial images

    Energy Technology Data Exchange (ETDEWEB)

    Homann, Georg; Mustafa, Deedar Farhad; Nikolaou, Konstantin; Horger, Marius [Eberhard Karls University Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); Weisel, Katja [Eberhard Karls University Tuebingen, Department of Internal Medicine II, Tuebingen (Germany); Ditt, Hendrik [Healthcare Sector Imaging and Therapy Division, Siemens AG, Forchheim (Germany)

    2015-04-02

    To investigate the performance of a new CT software generating rib unfolded images for improved detection of rib osteolyses in patients with multiple myeloma. One hundred sixteen patients who underwent whole-body reduced-dose multidetector computed tomography (WBRD-MDCT) for multiple myeloma diagnosis and during follow-up were retrospectively evaluated. Nonenhanced CT scans with 5- and 1-mm slice thickness were interpreted by two readers with focus on detection of rib involvement (location, number, fracture). Image analysis of ''unfolded,'' 1-mm-based CT rib images was subsequently undertaken. We classified the number of lytic bone lesions into 0, 1, 2, <5, <10 and ≥10. For all three data sets the reading time was registered. An approximated sum of 6,727 myeloma-related rib lesions was found. On a patient-based analysis, CT (5 mm), CT (1 mm) and CT (1 mm ''unfolded rib'') yielded a sensitivity, specificity and accuracy of 79.7/94.7/87.1, 88.1/93/90.5 and 98.3/96.5/97.4, respectively. In a lesion-based analysis, the sensitivity, specificity and accuracy of the three evaluations were 69.7/87.2/70.5, 79.8/55.9/78 and 96.5/89.7/96.1. Mean reading time for 5 mm/1 mm axial images and unfolded images was 178.7/215.1/90.8 s, respectively. The generation of ''unfolded rib'' images improves detection of rib involvement in patients with multiple myeloma and significantly reduces reading time. (orig.)

  10. External Pressure Forming and Buckling Analysis of Tubular Parts with Ribs

    Institute of Scientific and Technical Information of China (English)

    Gang LIU; Xuelian YIN; Shijian YUAN

    2006-01-01

    Buckling and forming processes of tubes with varying slenderness ratio(ratio of length to diameter)under external hydraulic pressure were analyzed with three-dimensional finite element method(FEM)for studying tube external pressure forming(EPF). Buckling pressures for different tube blanks without mandrel were predicted, and an EPF of a carbon steel tube onto a mandrel with six ribs was simulated. Both thickness distribution and buckling pressure from the simulations were found to be in agreement with those from experiments. Buckling pressures are shown to be a function of the slenderness ratio. The tubular part with six ribs produced by EPF has a uniform thickness distribution, whose maximum thinning rate is only 5.9%.

  11. Performance estimation of artificially roughened solar air heater duct provided with continuous ribs

    Directory of Open Access Journals (Sweden)

    Mridul Sharma, Varun

    2010-09-01

    Full Text Available The use of an artificial roughness on a surface is an effective technique to enhance the rate of heat transfer to fluid flow in the duct of a solar air heater. This paper presents a comparison of exergetic performance of solar air heaters having different types of geometry of roughness elements (continuous ribs on the absorber plate. The exergy efficiency has been computed by using the correlations for heat transfer and friction factor developed by various investigators within the investigated range of operating and system parameters. The exergy efficiency based criterion shows the better results at lower value of Re. There is not a single roughness geometry which gives best exergetic performance for whole range of Reynolds number. Solar air heater having rib-grooved and arc shaped wire as artificial roughness is found to have better exergy efficiency in the lower range of Reynolds number. However, smooth duct is found suitable in the higher range of Reynolds number.

  12. Rib fractures after reirradiation plus hyperthermia for recurrent breast cancer. Predictive factors

    Energy Technology Data Exchange (ETDEWEB)

    Oldenborg, Sabine; Valk, Christel; Os, Rob van; Voerde Sive Voerding, Paul zum; Crezee, Hans; Tienhoven, Geertjan van; Rasch, Coen [University of Amsterdam, Department of Radiation Oncology, Z1-215, Academic Medical Center, Amsterdam (Netherlands); Oei, Bing; Venselaar, Jack [Institute Verbeeten (BVI), Tilburg (Netherlands); Randen, Adrienne van [University of Amsterdam (AMC), Department of Radiology Academic Medical Center, Amsterdam (Netherlands)

    2016-04-15

    Combining reirradiation (reRT) and hyperthermia (HT) has shown high therapeutic value for patients with locoregional recurrent breast cancer (LR). However, additional toxicity of reirradiation (e.g., rib fractures) may occur. The aim of this study is to determine the impact of potential risk factors on the occurrence of rib fractures. From 1982-2005, 234 patients were treated with adjuvant reRT + HT after surgery for LR. ReRT consisted typically of 8 fractions of 4 Gy twice a week, or 12 fractions of 3 Gy four times a week. A total of 118 patients were irradiated with abutted photon and electron fields. In all, 60 patients were irradiated using either one or alternating combinations of abutted AP electron fields. Hyperthermia was given once or twice a week. The 5-year infield local control (LC) rate was 70 %. Rib fractures were detected in 16 of 234 patients (actuarial risk: 7 % at 5 years). All rib fractures occurred in patients treated with a combination of photon and abutted electron fields (p = 0.000); in 15 of 16 patients fractures were located in the abutment regions. The other significant predictive factors for rib fractures were a higher fraction dose (p = 0.040), large RT fields, and treatment before the year 2000. ReRT + HT results in long-term LC. The majority of rib fractures were located in the photon/electron abutment area, emphasizing the disadvantage of field overlap. Large abutted photon/electron fields combined with 4 Gy fractions increase the number of rib fractures in this study group. However, as these factors were highly correlated no relative importance of the individual factors could be estimated. Increasing the number of HT sessions a week does not increase the risk of rib fractures. (orig.) [German] Der kombinierte Einsatz von Rebestrahlung (reRT) und Hyperthermie (HT) zeigt eine hohe Wirksamkeit bei Patienten mit lokoregional rezidiviertem Brustkrebs (LR). Jedoch koennen zusaetzliche toxische Effekte von reRT (z. B. Rippenfrakturen

  13. Nose and Midface Augmentation by Rib Cartilage Grafts: Methods and Outcome in 32 Cases

    Directory of Open Access Journals (Sweden)

    Adham Farouk

    2015-01-01

    Full Text Available Recession of the midface is a relatively common condition that can have a negative impact on facial and nasal aesthetic appearance, and it poses a challenge to plastic surgeons. In cases with generalized maxillary retrusion and/or malocclusion, bone advancement surgery is required, but in localized cases, mostly seen in cleft lip patients, the quest is for an ideal material and a proper technique that would be used to augment the receding area. Throughout a period of seven years, thirty-two patients with nose and midface retrusion were managed by a construct of rib cartilage grafts designed to compensate the deficiency at the maxillary, piriform, and premaxillary areas. Results were satisfactory for most patients in terms of improved fullness of malar area, improved nasal tip projection and rotation, and improvement of upper lip. The presented technique of rib cartilage grafting is a safe and effective method for nose and midface augmentation.

  14. Mechanics analysis on the conditions of rock burst occurrence in the coal mass of roadway rib

    Institute of Scientific and Technical Information of China (English)

    CHEN Xue-hua; DENG Xiao-lin; LI Zhong-hua

    2008-01-01

    According to the rock burst features occurred in the coal mass of roadway rib in one mine, the mechanics model of coal mass and roof structure system along the edge of goaf was founded to analyze the stress of roof rock layer, so the subside curve of roof rock layer was deduced. Furthermore, the stability of coal and rock system were analyzed, the critical load and critical resistance zone were used to judge the danger degree of rock burst occurrence. The influence of coal mass strength, brittleness degree, coal seam thickness, roof thickness, suspending length, equivalent shear module on the critical load,critical resistance zone was confirmed. So the rock burst occurrence conditions of coal mass in roadway rib mainly depend on mining depth, coal seam thickness and hard roof and floor, which are decided by the above studies, and successfully applied in prediction and prevention of rock burst in this mine.

  15. Technical note: Prediction of chemical rib section composition by dual energy X-ray absorptiometry in Zebu beef cattle.

    Science.gov (United States)

    Prados, L F; Zanetti, D; Amaral, P M; Mariz, L D S; Sathler, D F T; Filho, S C Valadares; Silva, F F; Silva, B C; Pacheco, M C; Alhadas, H M; Chizzotti, M L

    2016-06-01

    It is expensive and laborious to evaluate carcass composition in beef cattle. The objective of this study was to evaluate a method to predict the 9th to 11th rib section (rib) composition through empirical equations using dual energy X-ray absorptiometry (DXA). Dual energy X-ray absorptiometry is a validated method used to describe tissue composition in humans and other animals, but few studies have evaluated this technique in beef cattle, and especially in the Zebu genotype. A total of 116 rib were used to evaluate published prediction equations for rib composition and to develop new regression models using a cross-validation procedure. For the proposed models, 93 ribs were randomly selected to calculate the new regression equations, and 23 different ribs were randomly selected to validate the regressions. The rib from left carcasses were taken from Nellore and Nellore × Angus bulls from 3 different studies and scanned using DXA equipment (GE Healthcare, Madison, WI) in the Health Division at Universidade Federal de Viçosa (Viçosa, Brazil). The outputs of the DXA report were DXA lean (g), DXA fat free mass (g), DXA fat mass (g), and DXA bone mineral content (BMC; g). After being scanned, the rib were dissected, ground, and chemically analyzed for total ether extract (EE), CP, water, and ash content. The predictions of rib fat and protein from previous published equations were different ( g) = 37.082 + 0.907× DXA lean ( = 0.95); fat free mass (g) = 103.224 + 0.869 × DXA fat free mass ( = 0.93); EE mass (g) = 122.404 + 1.119 × DXA fat mass ( = 0.86); and ash mass (g) = 18.722 + 1.016 × DXA BMC ( = 0.39). The equations were validated using Mayer's test, the concordance correlation coefficient, and the mean square error of prediction for decomposition. For both equations, Mayer's test indicated that if the intercept and the slope were equal to 0 and 1 ( > 0.05), respectively, then the equation correctly estimated the rib composition. Comparing observed and

  16. Numerical simulation of effective efficiency of a discrete multi V-pattern rib solar air channel

    Science.gov (United States)

    Kumar, Anil; Saini, R. P.; Saini, J. S.

    2016-10-01

    The use of artificial roughness in the form of repeated ribs has been found to be an efficient method of improving the heat transfer to fluid flowing in the channel. In this study, performance of solar air channel as a function of discrete multi V-pattern rib shapes has been investigated. The e/D was varied from 0.022 to 0.043, Gd/Lv was varied from 0.24 to 0.80, g/e was varied from 0.5 to 1.5, α was varied from 30° to 75°, P/e was varied from 6.0 to 12.0 and W/w was varied from 1.0 to 10.0. A methodology has been developed for the prediction of effective efficiency. Based on the values of effective efficiency, an optimization has been carried out to determine the set of data of roughness shapes parameters that correspond to better effective efficiency for given values of operating parameters of the air channel. Design plots have been represent to depict the data of individual roughness shapes parameters that characterize the optimum condition as a function of performance parameter and intensity of radiation. It was observed that the maximum values of effective efficiency for e/D of 0.043, Gd/Lv of 0.69, g/e of 1.0, α of 60°, P/e of 8.0 and W/w of 6.0. Discrete multi v-rib shape has been found to be better thermohydraulic performance (effective efficiency) as comparison to other rib shapes solar air channels.

  17. The experimental set-up of the RIB in-flight facility EXOTIC

    Science.gov (United States)

    Pierroutsakou, D.; Boiano, A.; Boiano, C.; Di Meo, P.; La Commara, M.; Manea, C.; Mazzocco, M.; Nicoletto, M.; Parascandolo, C.; Signorini, C.; Soramel, F.; Strano, E.; Toniolo, N.; Torresi, D.; Tortone, G.; Anastasio, A.; Bettini, M.; Cassese, C.; Castellani, L.; Corti, D.; Costa, L.; De Fazio, B.; Galet, G.; Glodariu, T.; Grebosz, J.; Guglielmetti, A.; Molini, P.; Pontoriere, G.; Rocco, R.; Romoli, M.; Roscilli, L.; Sandoli, M.; Stroe, L.; Tessaro, M.; Zatti, P. G.

    2016-10-01

    We describe the experimental set-up of the Radioactive Ion Beam (RIB) in-flight facility EXOTIC consisting of: (a) two position-sensitive Parallel Plate Avalanche Counters (PPACs), dedicated to the event-by-event tracking of the produced RIBs and to time of flight measurements and (b) the new high-granularity compact telescope array EXPADES (EXotic PArticle DEtection System), designed for nuclear physics and nuclear astrophysics experiments employing low-energy light RIBs. EXPADES consists of eight ΔE -Eres telescopes arranged in a cylindrical configuration around the target. Each telescope is made up of two Double Sided Silicon Strip Detectors (DSSSDs) with a thickness of 40/60 μm and 300 μm for the ΔE and Eres layer, respectively. Additionally, eight ionization chambers were constructed to be used as an alternative ΔE stage or, in conjunction with the entire DSSSD array, to build up more complex triple telescopes. New low-noise multi-channel charge-sensitive preamplifiers and spectroscopy amplifiers, associated with constant fraction discriminators, peak-and-hold and Time to Amplitude Converter circuits were developed for the electronic readout of the ΔE stage. Application Specific Integrated Circuit-based electronics was employed for the treatment of the Eres signals. An 8-channel, 12-bit multi-sampling 50 MHz Analog to Digital Converter, a Trigger Supervisor Board for handling the trigger signals of the whole experimental set-up and an ad hoc data acquisition system were also developed. The performance of the PPACs, EXPADES and of the associated electronics was obtained offline with standard α calibration sources and in-beam by measuring the scattering process for the systems 17O+58Ni and 17O+208Pb at incident energies around their respective Coulomb barriers and, successively, during the first experimental runs with the RIBs of the EXOTIC facility.

  18. Improving detector spatial resolution using pixelated scintillators with a barrier rib structure

    Science.gov (United States)

    Liu, Langechuan; Lu, Minghui; Cao, Wanqing; Peng, Luke; Chen, Arthur

    2016-03-01

    Indirect conversion flat panel detectors (FPDs) based on amorphous silicon (a-Si) technology are widely used in digital X-ray imaging. In such FPDs a scintillator layer is used for converting X-rays into visible light photons. However, the lateral spread of these photons inside the scintillator layer reduces spatial resolution of the FPD. In this study, FPDs incorporating pixelated scintillators with a barrier rib structure were developed to limit lateral spread of light photons thereby improving spatial resolution. For the pixelated scintillator, a two-dimensional barrier rib structure was first manufactured on a substrate layer, coated with reflective materials, and filled to the rim with the scintillating material of gadolinium oxysulfide (GOS). Several scintillator samples were fabricated, with pitch size varying from 160 to 280 μm and rib height from 200 to 280 μm. The samples were directly coupled to an a-Si flat panel photodiode array with a pitch of 200 μm to convert optical photons to electronic signals. With the pixelated scintillator, the detector modulation transfer function was shown to improve significantly (by 94% at 2 cycle/mm) compared to a detector using an unstructured GOS layer. However, the prototype does show lower sensitivity due to the decrease in scintillator fill factor. The preliminary results demonstrated the feasibility of using the barrier-rib structure to improve the spatial resolution of FPDs. Such an improvement would greatly benefit nondestructive testing applications where the spatial resolution is the most important parameter. Further investigation will focus on improving the detector sensitivity and exploring its medical applications.

  19. Mechanical analysis of the human cadaveric thoracic spine with intact rib cage.

    Science.gov (United States)

    Mannen, Erin M; Anderson, John T; Arnold, Paul M; Friis, Elizabeth A

    2015-07-16

    The goal of this study was to characterize the overall in-plane and basic coupled motion of a cadaveric human thoracic spine with intact true ribs. Researchers are becoming increasingly interested in the thoracic spine due to both the high prevalence of injury and pain in the region and also innovative surgical techniques that utilize the rib cage. Computational models can be useful tools to predict loading patterns and understand effects of surgical procedures or medical devices, but they are often limited by insufficient cadaveric input data. In this study, pure moments to ±5 Nm were applied in flexion-extension, lateral bending, and axial rotation to seven human cadaveric thoracic spine specimens (T1-T12) with intact true ribs to determine symmetry of in-plane motion, differences in neutral and elastic zone motion and stiffness, and significance of out-of-plane rotations and translations. Results showed that lateral bending and axial rotation exhibited symmetric motion, neutral and elastic zone motion and stiffness values were significantly different for all modes of bending (p<0.05), and out-of-plane rotations and translations were greater than zero for most rotations and translations. Overall in-plane rotations were 7.7±3.4° in flexion, 9.6±3.7° in extension, 23.3±8.4° in lateral bending, and 26.3±12.2° in axial rotation. Results of this study could provide inputs or validation comparisons for computational models. Future studies should characterize coupled motion patterns and local and regional level biomechanics of cadaveric human thoracic spines with intact true ribs.

  20. COORDINATION BETWEEN RIBS MOTION AND THORACOABDOMINAL VOLUMES IN SWIMMERS DURING RESPIRATORY MANEUVERS

    OpenAIRE

    Karine J. Sarro; Barros, Ricardo M.L.; Silvatti, Amanda P.

    2008-01-01

    This work aimed to verify if swimmers present better chest wall coordination during breathing than healthy non-athletes analyzing the correlation between ribs motion and the variation of thoracoabdominal volumes. The results of two up-to-date methods based on videogrammetry were correlated in this study. The first one measured the volumes of 4 separate compartments of the chest wall (superior thorax, inferior thorax, superior abdomen and inferior abdomen) as a function of time. The second cal...

  1. The chemical heritage of Aspergillus flavus in A. oryzae RIB 40

    DEFF Research Database (Denmark)

    Rank, Christian; Klejnstrup, Marie Louise; Petersen, Lene Maj

    Aspergillus oryzae is a very important species in biotechnology and has been used for centuries in traditional Asian fermentation. The RIB40 strain is particularly interesting as it was one of the first genome sequenced Aspergilli together with A. flavus, a prominent food and feed contaminant...... with indications to specific genetic changes. Several new metabolites and changes in biosynthetic routes have been found in A. oryzae, indicating subtle changes in the genomic heritage from A. flavus....

  2. Bone images from dual-energy subtraction chest radiography in the detection of rib fractures

    Energy Technology Data Exchange (ETDEWEB)

    Szucs-Farkas, Zsolt, E-mail: zsolt.szuecs@insel.ch [Department of Diagnostic, Interventional and Pediatric Radiology, University Hospital Bern, Freiburgstrasse 4, Bern CH-3010 (Switzerland); Lautenschlager, Katrin, E-mail: katrin@students.unibe.ch [Department of Diagnostic, Interventional and Pediatric Radiology, University Hospital Bern, Freiburgstrasse 4, Bern CH-3010 (Switzerland); Flach, Patricia M., E-mail: patricia.flach@irm.unibe.ch [Institute of Forensic Medicine, University of Bern, Freiburgstrasse 4, Bern CH-3010 (Switzerland); Ott, Daniel, E-mail: daniel.ott@insel.ch [Department of Diagnostic, Interventional and Pediatric Radiology, University Hospital Bern, Freiburgstrasse 4, Bern CH-3010 (Switzerland); Strautz, Tamara, E-mail: tamara.strautz@insel.ch [Department of Diagnostic, Interventional and Pediatric Radiology, University Hospital Bern, Freiburgstrasse 4, Bern CH-3010 (Switzerland); Vock, Peter, E-mail: peter.vock@insel.ch [Department of Diagnostic, Interventional and Pediatric Radiology, University Hospital Bern, Freiburgstrasse 4, Bern CH-3010 (Switzerland); Ruder, Thomas D., E-mail: thomas.ruder@irm.unibe.ch [Institute of Forensic Medicine, University of Bern, Freiburgstrasse 4, Bern CH-3010 (Switzerland)

    2011-08-15

    Objective: To assess the sensitivity and image quality of chest radiography (CXR) with or without dual-energy subtracted (ES) bone images in the detection of rib fractures. Materials and methods: In this retrospective study, 39 patients with 204 rib fractures and 24 subjects with no fractures were examined with a single exposure dual-energy subtraction digital radiography system. Three blinded readers first evaluated the non-subtracted posteroanterior and lateral chest radiographs alone, and 3 months later they evaluated the non-subtracted images together with the subtracted posteroanterior bone images. The locations of rib fractures were registered with confidence levels on a 3-grade scale. Image quality was rated on a 5-point scale. Marks by readers were compared with fracture localizations in CT as a standard of reference. Results: The sensivity for fracture detection using both methods was very similar (34.3% with standard CXR and 33.5% with ES-CXR, p = 0.92). At the patient level, both sensitivity (71.8%) and specificity (92.9%) with or without ES were identical. Diagnostic confidence was not significantly different (2.61 with CXR and 2.75 with ES-CXR, p = 0.063). Image quality with ES was rated higher than that on standard CXR (4.08 vs. 3.74, p < 0.001). Conclusions: Despite a better image quality, adding ES bone images to standard radiographs of the chest does not provide better sensitivity or improved diagnostic confidence in the detection of rib fractures.

  3. Syndrome of periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) in siblings.

    Science.gov (United States)

    Valenzuela, Patricia M; Majerson, Daniela; Tapia, Jose L; Talesnik, Eduardo

    2009-10-01

    PFAPA syndrome is characterized by episodes of periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis. PFAPA syndrome usually begins in children under 5 years old and normally has self-resolution. The etiology of PFAPA syndrome remains unknown. In this paper, we report the cases of two different families with siblings with PFAPA syndrome: two sisters and two brothers. To our knowledge, this is the first report of siblings with PFAPA syndrome.

  4. LECTURE ON ACUPUNCTURE PartⅠ Clinical Acupuncture Lecture Thirty-fiveCervical Spondylopathy

    Institute of Scientific and Technical Information of China (English)

    罗汀; 王卫; 徐力

    2004-01-01

    @@ Cervical spondylopathy, also known as cervical syndrome, is a commonly encountered disease in the middle-aged and elderly people. This disease mostly results from the retrograde affection of the cervical intervertebral disc and hyperosteogeny of the cervical vertebrae. This hyperplastic substance may stimulate and give rise to oppression to the surrounding spinal cord, nerve roots, blood vessels and sympathetic nerves, resulting in a series of symptoms as numbness, pain, etc. in the neck, shoulder and the upper limbs. The cervical vertebra of the human spine is smallest in the size, weakest in the strength, higher in the motor range and frequency, and bigger in the bearing of per unit area. Along with the increasing of people's age and the accumulated aftereffect of chronic and acute injury, the pulpiform nucleus of the cervical intervertebral disc presents retrograde affection, dehydration, bulge and rupture of the fibrous ring, narrowing of the intervertebral space, and reduction in the stability of cervical vertebrae due to injury and slackening of intervertebral ligaments to stretch and to induce compression upon periosteum. All these changes may lead to break of blood vessels to cause bleeding and hematoma. With the organization of hematoma and calcium salt deposit, osteophyte is formed at last. When the protruded intervertebral disc and hyperplastic osteophyte stimulate and oppress the surrounding spinal nerve root, vertebral artery or spinal cord, the resultant injury, aseptic inflammation, reactions after renovation, etc. will generate a series of clinical symptoms of cervical spondylopathy. In Western medicine, there are five types of cervical spondylopathy including stiff-neck type, nerve root type, spinal cord type, vertebral artery type and sympathetic nerve type. The stiff-neck type, nerve root type and vertebral artery type will be introduced in this article.

  5. Acute cervicitis and vulvovaginitis may be associated with Cytomegalovirus.

    Science.gov (United States)

    Abou, Magali; Dällenbach, Patrick

    2013-04-19

    Cytomegalovirus (CMV) infection in immunocompetent hosts is generally asymptomatic or may present as a mononucleosic syndrome. Its association with acute cervicitis and vulvovaginitis has rarely been reported. A 24-year-old woman presented with pelvic pain, vulvodynia, abnormal vaginal discharge, burning with urination, fatigue, fever, vomiting and diarrhoea. The vulva and cervix were red with vesicular lesions on the cervix. Genital herpes simplex infection (HSV) was suspected and valacyclovir was given orally. However, serial viral cultures performed 7 weeks apart did not isolate HSV as suspected, but CMV was confirmed by immunofluorescence and early antigen research. Blood tests confirmed an acute CMV infection. Typical inclusions were found at histology. Symptoms resolved slowly with persistence of cervical lesions at 7 weeks from diagnosis. The frequency of CMV genital infection is probably underestimated. The infection is not always asymptomatic and might be confused with genital HSV infection. The clinical course is longer.

  6. Vibroacoustic Optimization of Stiffening Ribs and Damping Material Distribution on Sheet Metal Parts

    Directory of Open Access Journals (Sweden)

    M. Carfagni

    2004-01-01

    Full Text Available Vehicle noise and vibration levels are basic parameters in passenger comfort. Both static and dynamic stiffness of sheet metal parts is commonly increased by means of stiffening ribs. Vibrations are also reduced by adding a layer of damping material on the floor, the roof, the firewall and other parts of the vehicle. In common practice the panels to be treated are ribbed according to criteria based on the designer’s experience, rather than on well defined design procedures and are uniformly covered by a layer of damping material. However, these are not efficient design solutions, especially with regard to the effectiveness of vibration reduction and to weight containment. In this paper a novel approach to achieve an optimal distribution of stiffening ribs and damping material will be presented. The proposed method is based on a Genetic Algorithm (G.A. procedure which takes into account both the vibroacoustic performance and the weight and cost reduction. A simple case study will be illustrated to demonstrate the capabilities of the developed procedure.

  7. Hybrid RANS/LES of turbulent flow in a rotating rib-roughened channel

    Science.gov (United States)

    Xun, Qian-Qiu; Wang, Bing-Chen

    2016-07-01

    In this paper, we investigate the effect of the Coriolis force on the flow field in a rib-roughened channel subjected to either clockwise or counter-clockwise system rotation using hybrid RANS/LES based on wall modelling. A simplified dynamic forcing scheme incorporating backscatter is proposed for the hybrid simulation approach. The flow is characterized by a Reynolds number of Re = 1.5 × 104 and a rotation number Ro ranging from -0.6 to 0.6. The mean flow speed and turbulence level near the roughened wall are enhanced under counter-clockwise rotation and suppressed under clockwise rotation. The Coriolis force significantly influences the stability of the wall shear layer and the free shear layers generated by the ribs. Consequently, it is interesting to observe that the classification of the roughness type relies not only on the pitch ratio, but also on the rotation number in the context of rotating rib-roughened flows. In order to validate the present hybrid approach, the first- and second-order statistical moments of the velocity field obtained from the simulations are thoroughly compared with the available laboratory measurement data.

  8. Desmoplastic fibroma of the rib with cystic change: a case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Okubo, Taketo [Juntendo University, Department of Orthopaedic Surgery, School of Medicine, Tokyo (Japan); Juntendo University, Department of Human Pathology, School of Medicine, Bunkyo-ku, Tokyo (Japan); Saito, Tsuyoshi [Juntendo University, Department of Human Pathology, School of Medicine, Bunkyo-ku, Tokyo (Japan); Takagi, Tatsuya; Suehara, Yoshiyuki; Kaneko, Kazuo [Juntendo University, Department of Orthopaedic Surgery, School of Medicine, Tokyo (Japan)

    2014-05-15

    Desmoplastic fibroma (DF) is a rare, locally aggressive, solitary tumor microscopically composed of well-differentiated myofibroblasts with abundant dense collagen deposition. The most common sites are the long tubular bones and mandible. To our knowledge, only five cases of DF in the ribs have been reported. Here, we report a case of DF in this rare location with unusual radiological findings. A 40-year-old man presented with a 4-year history of swelling of the right chest wall. Radiographs revealed a mass at the right 9th rib, and computed tomography demonstrated a mass of 14 x 12 x 8 cm at the right 9th rib with expanded cystic change and marked calcification that appeared to have arisen from the bone. Open biopsy suggested DF. Total excision was performed, and the chest wall was reconstructed. The surgical specimen was a yellowish tumor with multilocular cystic change containing a viscous liquid. The tumor was composed of a proliferation of less-atypical spindle-shaped cells in a collagenous background. The cystic change was observed in the extra-osseous lesion. No β-catenin cytoplasmic/nuclear accumulation was detected, and no β-catenin or GNAS genetic mutations were detected. A final diagnosis of DF was made on the basis of the pathological and radiological findings. The patient was successfully treated with total excision of the tumor with no evidence of recurrence 6 months after surgery. (orig.)

  9. Value of postmortem thoracic CT over radiography in imaging of pediatric rib fractures

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Terence S.; Babyn, Paul S. [The Hospital for Sick Children, Department of Diagnostic Imaging, Toronto (Canada); Reyes, Jeanette A.; Chiasson, David A. [The Hospital for Sick Children, Department of Paediatric Laboratory Medicine, Toronto (Canada); Moineddin, Rahim [University of Toronto, Department of Family and Community Medicine, Toronto (Canada); Berdon, Walter E. [Columbia Presbyterian Medical Center, Babies Hospital, Department of Radiology, New York, NY (United States)

    2011-06-15

    Studies have reported that thoracic CT may provide greater sensitivity compared with radiography in detection of pediatric rib fractures and fracture healing. The additional sensitivity afforded by thoracic CT may have medicolegal implications where abuse is suspected. To determine the additional value of postmortem thoracic CT compared with radiography in detecting pediatric rib fractures, and fracture healing, using autopsy findings as a gold standard. We retrospectively reviewed 56 coroner's cases with postmortem radiography and CT thoracic survey. All studies underwent primary interpretation by one or two radiologists. The study radiologist independently reviewed all images from 13 patients with positive findings on radiography, CT or autopsy. Sensitivity and specificity between observers and imaging modalities were compared. Primary interpretation: Fractures were recognized on radiography in 5/12 patients who had fractures found at autopsy, and on CT in 8/12 patients. In total, 29% (24/83) of fractures were reported on radiography, and 51% (52/101) of fractures were reported on CT. Study radiologist: Fractures were recognized on radiography in 7/12 patients who had fractures found at autopsy, and on CT in 11/12 patients. In total, 46% (38/83) of fractures were reported on radiography, and 85% (86/101) of fractures were reported on CT. Postmortem thoracic CT provides greater sensitivity than radiography in detecting pediatric rib fractures, most notably in anterior and posterior fractures. However, the degree of improvement in sensitivity provided by CT might depend on observer experience. (orig.)

  10. Experimental investigation of active rib stitch knitted architecture for flow control applications

    Science.gov (United States)

    Abel, Julianna M.; Mane, Poorna; Pascoe, Benjamin; Luntz, Jonathan; Brei, Diann

    2010-04-01

    Actively manipulating flow characteristics around the wing can enhance the high-lift capability and reduce drag; thereby, increasing fuel economy, improving maneuverability and operation over diverse flight conditions which enables longer, more varied missions. Active knits, a novel class of cellular structural smart material actuator architectures created by continuous, interlocked loops of stranded active material, produce distributed actuation that can actively manipulate the local surface of the aircraft wing to improve flow characteristics. Rib stitch active knits actuate normal to the surface, producing span-wise discrete periodic arrays that can withstand aerodynamic forces while supplying the necessary displacement for flow control. This paper presents a preliminary experimental investigation of the pressuredisplacement actuation performance capabilities of a rib stitch active knit based upon shape memory alloy (SMA) wire. SMA rib stitch prototypes in both individual form and in stacked and nestled architectures were experimentally tested for their quasi-static load-displacement characteristics, verifying the parallel and series relationships of the architectural configurations. The various configurations tested demonstrated the potential of active knits to generate the required level of distributed surface displacements while under aerodynamic level loads for various forms of flow control.

  11. A CASE REPORT OF LATE SURVIVAL IN ELLIS: VAN CREVELD SYNDROME

    Directory of Open Access Journals (Sweden)

    Hemant Narayan

    2014-10-01

    Full Text Available Ellis–van Creveld syndrome (EVC is an autosomal recessive disorder characterized by chondro-dystrophy, polydactyly, ectodermal dysplasia, and cardiac anomalies. Acromelic shortening of upper and lower limbs, genu valgum, multiple frenula, deformed teeth, short ribs and narrow thorax and congenital heart diseases complete the picture. The patients with the syndrome rarely survive into adulthood. Here, we report a lady with EVC presenting for the first time in middle age.

  12. Late survival in Ellis-van Creveld syndrome - a case report.

    Science.gov (United States)

    Mishra, Trinath; Routray, Satya N; Das, Biswajit

    2012-01-01

    Ellis-van Creveld syndrome (EVC) is an autosomal recessive disorder characterized by chondrodystrophy, polydactyly, ectodermal dysplasia, and cardiac anomalies. Acromelic shortening of upper and lower limbs, genu valgum, multiple frenula, deformed teeth, short ribs and narrow thorax and congenital heart diseases complete the picture. The patients with the syndrome rarely survive into adulthood. Here, we report a lady with EVC presenting for the first time in middle age.

  13. Body Stalk Syndrome: A Curiosity

    Directory of Open Access Journals (Sweden)

    Anita Javalgi

    2014-07-01

    Full Text Available Limb body wall complex (LBWC /Body stalk syndrome anomaly refers to a rare complicated polymalformative fetal malformation syndrome of uncertain etiology firstly described by Van Allen et al in 1987. There are very few cases reported in literature and thus we report a rare case of LBWC. Twenty seven years female presented to labour room with 32 weeks of gestation with no prenatal care and delivered a low birth weight still born fetus weighing 1100gms. On fetal autopsy large abdominal wall defect was noted with difficulty in identifying abdomino-pelvic organs and ambiguous genitalia. Placenta weighed 250gms with attached short umbilical cord measuring 7cms, arising from periphery. A cyst noted attached to placental membrane measuring 9x5cms which on dissection retrieved partially maldeveloped organs. Post mortem radiological findings included Absence of right femur with short tibia and right fibula, Complex vestibral malformation, Craniosynostosis and Overcrowding of ribs.

  14. Characteristics of entropy generation and heat transfer in a microchannel with fan-shaped reentrant cavities and internal ribs

    Institute of Scientific and Technical Information of China (English)

    XIA; GuoDong; ZHAI; YuLing; CUI; ZhenZhen

    2013-01-01

    Three-dimensional laminar fluid flow and heat transfer in a micro heat sink with cavities and internal ribs are investigated us-ing numerical methods. Moreover, according to the second law of thermodynamics, the model of entropy generation is also established for variable cross section of the microchannel. The simulation encompasses Reynolds number of 198-600, relative cavity height e1/Dhvalues of 0-0.65, relative rib height e2/Dhrange of 0-0.2167. The results show that the effect of relative rib height on entropy generation is significant, while the relative cavity height has little effect on it. The combined effect of cavities and ribs in the microchannel has better performance of heat transfer than the smooth microchannel under similar conditions. Extensive simulations are conducted to collect data on the characteristics of heat transfer and fluid flow in a micro heat sink with cavities and internal ribs. Using these data, correlations for Nusselt number and friction factor in terms of Reynolds number and the geometry of cavity and rib have been developed.

  15. Study of the temperature rise induced by a focusing transducer with a wide aperture angle on biological tissue containing ribs

    Science.gov (United States)

    Xin, Wang; Jiexing, Lin; Xiaozhou, Liu; Jiehui, Liu; Xiufen, Gong

    2016-04-01

    We used the spheroidal beam equation to calculate the sound field created by focusing a transducer with a wide aperture angle to obtain the heat deposition, and then we used the Pennes bioheat equation to calculate the temperature field in biological tissue with ribs and to ascertain the effects of rib parameters on the temperature field. The results show that the location and the gap width between the ribs have a great influence on the axial and radial temperature rise of multilayer biological tissue. With a decreasing gap width, the location of the maximum temperature rise moves forward; as the ribs are closer to the transducer surface, the sound energy that passes through the gap between the ribs at the focus decreases, the maximum temperature rise decreases, and the location of the maximum temperature rise moves forward with the ribs. Project supported by the National Basic Research Program of China (Grant Nos. 2012CB921504 and 2011CB707902), the National Natural Science Foundation of China (Grant No. 11274166), the Fundamental Research Funds for the Central Universities, China (Grant No. 020414380001), the Fund from State Key Laboratory of Acoustics, Chinese Academy of Sciences (Grant No. SKLA201401), China Postdoctoral Science Foundation (Grant No. 2013M531313), and the Priority Academic Program Development of Jiangsu Higher Education Institutions and SRF for ROCS, SEM.

  16. Glycoprotein and Glycan in Tissue and Blood Samples of Patients With Stage IB-IVA Cervical Cancer Undergoing Surgery to Remove Pelvic and Abdominal Lymph Nodes

    Science.gov (United States)

    2016-10-26

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Small Cell Carcinoma; Cervical Squamous Cell Carcinoma, Not Otherwise Specified; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage IVA Cervical Cancer

  17. Cervical cancer screening at crossroads

    DEFF Research Database (Denmark)

    Lynge, Elsebeth; Rygaard, Carsten; Baillet, Miguel Vazquez-Prada;

    2014-01-01

    Cervical screening has been one of the most successful public health prevention programmes. For 50 years, cytology formed the basis for screening, and detected cervical intraepithelial lesions (CIN) were treated surgically to prevent progression to cancer. In a high-risk country as Denmark......, screening decreased the incidence of cervical cancer from 34 to 11 per 100,000, age-standardized rate (World Standard Population). Screening is, however, also expensive; Denmark (population: 5.6 million) undertakes close to half a million tests per year, and has 6-8 CIN-treated women for each prevented...... cancer case. The discovery of human papillomavirus (HPV) as the cause of cervical cancer dramatically changed perspectives for disease control. Screening with HPV testing was launched around 1990, and preventive HPV vaccination was licensed in 2006. Long-term randomized controlled trials (RCT...

  18. Hemangiopericytoma of the cervical spine

    Directory of Open Access Journals (Sweden)

    Raghvendra V Ramdasi

    2014-01-01

    Full Text Available A 28-year-old male presented with neck pain and dysesthesias in the right upper limb. On examination, he had a firm, well-defined midline posterior cervical mass discernible on palpation at the mid-cervical level. He had no neurological deficit. Neuroradiology revealed a variegated enhancing cervical mass is arising from C3 lamina. The mass extended into the right extradural space eroding the C3 lamina and posteriorly into the intermuscular plane. The tumor was excised totally. Histopathology of the tumor showed features of hemangiopericytoma (HPC. The patient underwent postoperative radiotherapy. Primary osseous spinal HPC are rare malignant extra-axial tumors that tend to recur and metastasize. Only two cases of primary osseous HPC have been reported earlier to involve the cervical spine. The clinical presentation and management of the present case with a review of the literature is presented.

  19. Cervical necrotizing fasciitis.

    Science.gov (United States)

    Maisel, R H; Karlen, R

    1994-07-01

    Nine cases of cervical necrotizing faciitis are presented. Five were odontogenic, three were pharyngeal in origin, and one developed from a soft-tissue spider bite. The bacteriology represented a polyculture of gram-positive, gram-negative, as well as anaerobic bacteria, and initial medical treatment by third-generation cephalosporin and metronidazole or clindamycin was successful and is recommended. Airway control is necessary early, as is a wide exploration of the fascial spaces of the neck, with frequent reexploration in either the operating room or at the bedside to evaluate the effects of treatment and to prevent further progression of the disease. Intensive medical support is crucial, and hyperbaric oxygen is advised for patients who are deteriorating under standard therapy.

  20. Tuberculosis ganglionar cervical

    Directory of Open Access Journals (Sweden)

    Osmany Leonel Mendoza Cruz

    2014-08-01

    Full Text Available La tuberculosis es una enfermedad reemergente en la actual sociedad globalizada y puede presentarse prácticamente ante cualquier especialista. Las formas extrapulmonares pueden representar hasta la cuarta parte de los casos, y entre ellos la afectación ganglionar se ubica entre las más frecuentes. Se reportan dos pacientes estudiados y tratados en el Servicio de Otorrinolaringología del Hospital General de Bata, Litoral de Guinea Ecuatorial, África Central, afectados por tumoraciones laterocervicales subagudas, con escasos síntomas y excelente evolución, tras su diagnóstico de tuberculosis ganglionar cervical y terapéutica antibiótica. Aunque la punción y aspiración con aguja fina no fue concluyente, ambos casos resultaron positivos por medio de la tinción de Ziehl-Neelsen