WorldWideScience

Sample records for cervical rib syndrome

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Case report: Short rib polydactyly syndrome - type 2 (Majewski syndrome)

    International Nuclear Information System (INIS)

    Short rib polydactyly syndrome (SRPS) type 2 (Majewski syndrome) is a rare inherited, autosomal recessive, lethal skeletal dysplasia characterized by horizontally located short ribs, pre- and postaxial polysyndactyly, and micromelia, with characteristic short ovoid tibiae. There may or may not be visceral involvement. We report a case of SRPS type 2 that was diagnosed by antenatal USG at 28 weeks of gestation; the diagnosis was subsequently confirmed by postnatal radiography, fetal autopsy, and histopathology

  3. Slipping Rib Syndrome as Persistent Abdominal and Chest Pain.

    Science.gov (United States)

    Bolaños-Vergaray, Juan Javier; de la Gala García, Francisco; Obaya Rebollar, Juan Carlos; Bové Alvarez, Maria

    2015-11-01

    Slipping rib syndrome is an overlooked cause of persistent abdominal or chest pain. The etiology of this syndrome is not well understood, but the characteristic pain is from hypermobility of the false ribs. Although it is a diagnosis of exclusion, misdiagnosis may lead to an excessive workup. A simple clinical examination via the hooking maneuver is the most significant feature of its diagnosis. We describe the case of a 41-year-old woman with slipping rib syndrome. PMID:26528703

  4. 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.)

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

    International Nuclear Information System (INIS)

    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.)

  6. 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.

  7. 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.

  8. Perinatally lethal short rib-polydactyly syndromes. Pt. 1

    International Nuclear Information System (INIS)

    Thirteen newborns with lethal short rib-polydactyly (SRP) have been reviewed, 11 with SRP type 3 (Verma-Naumoff) and 2 with SRP tye 2 (Majewski). In the former group there were three sets of siblings. The excess of males with SRP type III (Verma-Naumoff) is confirmed in this present study. A high frequency of phenotypic females including sex-reversed constitutional males with SRP type 1 (Saldino-Noonan) is in marked contrast to these findings in SRP type 3. Possible hypotheses include variable expressivity in non-Majewski short rib-polydactyly syndromes with sex-reversed and constitutional female cases tending to show more severe phenotypic expression both in terms of major anomalies and skeletal dysplastic effects. (orig.)

  9. Thoracic outlet syndrome caused by hydatid cyst of the first rib-rare but important.

    Science.gov (United States)

    Levy Faber, Dan; Best, Lael-Anson; Militianu, Daniela; Ben Nun, Alon

    2010-12-01

    Hydatid cysts are usually located in the liver and lungs. Skeletal echinococcosis is relatively rare and that of the rib is exceptional. Less than 50 cases of costal echinococcosis have been reported in the literature so far. To our knowledge, only one case report of thoracic outlet syndrome due to echinococcal cyst in the first rib was described in 1995. Accurate pre-operative diagnosis is important but may be challenging in some cases. Reported here is a case of echinococcosis of the first rib in a young adult who was presented with thoracic outlet syndrome. Plain chest radiograph, CT scan and MRI were performed. The imaging features were suggestive of a solitary aneurysmal bone cyst and the differential diagnosis included echinococcosis of the first rib. The lesion was completely resected and the histopathological examination confirmed the diagnosis of echinococcosis. PMID:22131660

  10. Guillain-Barré Syndrome Combined with Acute Cervical Myelopathy

    OpenAIRE

    Abai, Siez; Kim, Sung Bum; Kim, Joo-Pyung; Lim, Young Jin

    2010-01-01

    Authors describe a patient who developed a myelopathy associated with Guillain-Barré syndrome and cervical myelopathy. We provide radiological evidence of non-compressive herniated cervical intervertebral disc with cord signal changes and show the clinical and electrophysiological result of coexisting Guillain-Barré syndrome and cervical myelopathy. We tried to introduce and review the case of Guillain-Barré syndrome which was combined with cervical myelopathy to let us recollect the presumpt...

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

    OpenAIRE

    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 consideratio...

  12. Thoracic Outlet Syndrome Caused by Hydatid Cyst of the First Rib-Rare But Important

    OpenAIRE

    Levy Faber, Dan; Best, Lael-Anson; Militianu, Daniela; Ben Nun, Alon

    2010-01-01

    Hydatid cysts are usually located in the liver and lungs. Skeletal echinococcosis is relatively rare and that of the rib is exceptional. Less than 50 cases of costal echinococcosis have been reported in the literature so far. To our knowledge, only one case report of thoracic outlet syndrome due to echinococcal cyst in the first rib was described in 1995. Accurate pre-operative diagnosis is important but may be challenging in some cases. Reported here is a case of echinococcosis of the first ...

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

    Directory of Open Access Journals (Sweden)

    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

  14. 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.

  15. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Cervical Syndrome – the Effectiveness of Physical Therapy Interventions

    OpenAIRE

    Kasumovic, Mersija; Gorcevic, Emir; Gorcevic, Semir; Osmanovic, Jasna

    2013-01-01

    ABSTRACT Introduction: The cervical syndrome refers to a set of disorders caused by the changes in the cervical spine and the soft-tissue surrounding it, with pain as the predominant symptom. Sore neck has been a common problem among a large section of today`s population. The factors contributing to this issue include the modern lifestyle, prolonged sitting and incorrect, fixed or constrained working postures. The root of these difficulties is found in the mechanical disorders of the cervical...

  18. Absence of uptake of the rib cage; diagnosis of a Poland's syndrome with the bone SPECT-CT

    International Nuclear Information System (INIS)

    We report the case of a 37-year-old man, investigated for pains of the right upper limb impairing the hand, the wrist and the shoulder after a surgery for fracture of the radius and the scaphoid. The 99mTc-H.D.P. three-phase bone scintigraphy confirmed the diagnosis of acute phase of a reflex sympathetic dystrophy. The delayed images highlighted a focal absence of tracer uptake of the left anterior rib cage. The single photon emission computerized tomography guided by computerized tomography showed that it was related to the absence of the anterior part of the third and the fourth left ribs highlighting an aplasia of the left pectoralis major muscle. These anomalies led to the diagnosis of congenital malformation in connection with a Poland's syndrome. The differential diagnosis of this syndrome resulted in discussing the multiple etiologies of the photopenic lesions of the rib cage. (authors)

  19. 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.)

  20. Concomitance of fibromyalgia syndrome and cervical disc herniation

    OpenAIRE

    GÜLER, MUSTAFA; Aydın, Teoman; Akgöl, Erdal; Taşpınar, Özgür

    2015-01-01

    [Purpose] Fibromyalgia syndrome (FMS) and cervical disc herniation (CDH) are a common diseases commonly encountered in physical therapy clinics. There are also patients who have both of these diseases. In this study we aim to investigated whether FMS is a risk factor for cervical disc herniation and the frequency of their coincident occurrence. [Subjects and Methods] Thirty-five patients having a primary FMS diagnosis according to the American Rheumatism Association criteria are taken into co...

  1. Tapia's Syndrome after Posterior Cervical Spine Surgery under General Anesthesia

    OpenAIRE

    Park, Chang Kyu; Lee, Dong Chan; Park, Chan Joo; Hwang, Jang Hoe

    2013-01-01

    We present a case report to remind surgeons of this unusual complication that can occur in any surgery, even posterior cervical spine surgery under general anesthesia and discuss its causes, treatment methods, and the follow-up results in the literature. The peripheral Tapia's syndrome is a rare complication of anesthetic airway management. Main symptoms are hoarseness of voice and difficulty of tongue movement. Tapia's syndrome after endotracheal general anesthesia is believed to be due to p...

  2. Anterior spinal artery syndrome of the cervical hemicord.

    Science.gov (United States)

    Baumgartner, R W; Waespe, W

    1992-01-01

    Three patients developed signs of a unilateral cervical cord lesion 6 to 36 h after the acute onset of severe cervico-brachial pain. The neurological deficit progressed over 6 to 18 h. On the painful side a central Horner's syndrome, a hemiparesis with plegia of the hand, and a slight pallhypaesthesia were found. On the opposite side thermhypaesthesia and hypalgesia were noted with a level at the dermatome C5 or C6. T2-weighted MR images revealed in one patient a small area of increased signal intensity restricted to one half of the cervical cord, and electromyography in another patient showed after 6 months evidence of segmental chronic denervation. Both abnormalities were found at the clinically expected level. The findings are consistent with a small infarction of the cervical cord in the perfusion territory of a central (sulco-commissural) artery, a duplicated anterior spinal artery or an anterior spinal branch of the vertebral artery. PMID:1315578

  3. Cervical disc herniation manifesting as a Brown-Sequard syndrome

    Directory of Open Access Journals (Sweden)

    Kunio Yokoyama

    2012-01-01

    Full Text Available Brown-Sequard syndrome is commonly seen in the setting of spinal trauma or an extramedullary spinal neoplasm. The clinical picture reflects hemisection of the spinal cord. We report a rare case of Brown-Sequard syndrome caused by a large cervical herniated disc. A 63-year-old man presented with progressive right hemiparesis and disruption of pain and temperature sensation on the left side of the body. Magnetic resonance imaging showed large C3-C4 disc herniation compressing the spinal cord at that level, with severe canal stenosis from C4 through C7. Decompressive cervical laminoplasty was performed. After surgery, complete sensory function was restored and a marked improvement in motor power was obtained.

  4. Rib Fractures

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    ... 2 Diabetes, Heart Disease a Dangerous Combo Are 'Workaholics' Prone to OCD, Anxiety? ALL NEWS > Resources First ... Rib Fractures Traumatic Pneumothorax Tension Pneumothorax Rib fractures cause severe pain, particularly when a person breathes deeply. ...

  5. Eagle Syndrome Causing Vascular Compression with Cervical Rotation: Case Report

    Science.gov (United States)

    Demirtaş, Hakan; Kayan, Mustafa; Koyuncuoğlu, Hasan Rıfat; Çelik, Ahmet Orhan; Kara, Mustafa; Şengeze, Nihat

    2016-01-01

    Summary Background Eagle syndrome is a condition caused by an elongated styloid process. Unilateral face, neck and ear pain, stinging pain, foreign body sensation and dysphagia can be observed with this syndrome. Rarely, the elongated styloid process may cause pain by compressing the cervical segment of the internal carotid and the surrounding sympathetic plexus, and that pain spreading along the artery can cause neurological symptoms such as vertigo and syncope. Case Report In this case report we presented a very rare eagle syndrome with neurological symptoms that occurred suddenly with cervical rotation. The symptoms disappeared as suddenly as they occurred, with the release of pressure in neutral position. We also discussed CT angiographic findings of this case. Conclusions Radiological diagnosis of the Eagle syndrome that is manifested with a wide variety of symptoms and causes diagnostic difficulties when it is not considered in the differential diagnosis is easy in patients with specific findings. CT angiography is a fast and effective examination in terms of showing compression in patients with the Eagle syndrome that is considered to be atypical and causes vascular compression. PMID:27354882

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

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    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.

  7. [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. PMID:25963463

  8. 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. PMID:23804237

  9. Ribbing disease

    International Nuclear Information System (INIS)

    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

  10. Horner´s Syndrome Post-Excision of a Huge Cervical Sympathetic Chain Schwannoma

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    Aydin, Sedat

    2007-01-01

    Schwannoma of the cervical sympathetic chain is a rare nerve tumor. These lesions typically present as an asymptomatic neck mass and are easily mistaken for a carotid body tumor during the initial work-up. In this report, a rarely seen huge cervical sympathetic chain schwannoma case, who experienced partial Horner´s syndrome postoperatively, is presented. We report a case of schwannoma on the cervical sympathetic chain, which to our knowledge is the largest reported in the current literature.

  11. 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.

  12. 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.

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

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    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.

  14. 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. PMID:25655119

  15. 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.)

  16. Cervical ankylosis following Grisel's syndrome in a 14-year-old boy with infectious mononucleosis

    International Nuclear Information System (INIS)

    Non-traumatic atlanto-axial subluxation (Grisel's syndrome) is an uncommon complication of neck space infection or otolaryngologic procedures. It most frequently affects children, although it may occur in adults. We present a 14-year-old boy with Grisel's syndrome as a complication of infectious mononucleosis proceeding to cervical ankylosis. (orig.)

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

    International Nuclear Information System (INIS)

    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.)

  18. Effect of Cervical Length Recovery after Laser Surgery for Twin-Twin Transfusion Syndrome.

    Science.gov (United States)

    Finneran, Matthew; Temming, Lorene; Templin, Megan; Stephenson, Courtney

    2016-03-01

    Objective To evaluate the impact of polyhydramnios on preoperative cervical length and whether cervical length recovery after amnioreduction during selective fetoscopic laser photocoagulation (SFLP) is associated with a greater gestational age at delivery in pregnancies complicated by twin-twin transfusion syndrome (TTTS). Methods Retrospective study of 50 pregnancies complicated by TTTS treated with SFLP between March 2010 and July 2014 at a single center. Preoperative maximum vertical pocket (MVP) was measured along with pre- and postoperative cervical length. A cervical length difference was calculated, with a difference of ± 3 mm considered no change. Results Only 12 (34%) patients showed an increased cervical length after amnioreduction during laser surgery. There was no statistical difference between either negative or positive change in cervical length groups and mean gestational age at delivery (p = 0.82). There also was no correlation between preoperative MVP and preoperative cervical length (p = 0.36) or gestational age at delivery (p = 0.77). However, there was a statistically shorter mean preoperative cervical length in patients who delivered polyhydramnios does not correlate with preoperative cervical length, and variability of the cervix postoperatively does not appear to affect gestational age at delivery. PMID:26989569

  19. Cervical Disc Herniation as a Cause of Brown-Séquard Syndrome

    OpenAIRE

    Choi, Kyeong Bo; Lee, Choon Dae; Chung, Dai-Jin; Lee, Sang-Ho

    2009-01-01

    The possible causes of Brown-Séquard Syndrome (BSS) have been frequently observed with spinal trauma and extramedullary spinal tumors, but the cervical disc herniation to cause BSS is rare. The authors present five cases of patients who were diagnosed with BSS resulting from cervical disc herniation, and the results of the literature in view of their distinctive symptoms and clinical outcomes. Postoperatively, the patients showed complete or almost complete recovery from their motor and senso...

  20. Effect of Cervical Length Recovery after Laser Surgery for Twin-Twin Transfusion Syndrome

    OpenAIRE

    Finneran, Matthew; Temming, Lorene; Templin, Megan; Stephenson, Courtney

    2016-01-01

    Objective To evaluate the impact of polyhydramnios on preoperative cervical length and whether cervical length recovery after amnioreduction during selective fetoscopic laser photocoagulation (SFLP) is associated with a greater gestational age at delivery in pregnancies complicated by twin-twin transfusion syndrome (TTTS). Methods Retrospective study of 50 pregnancies complicated by TTTS treated with SFLP between March 2010 and July 2014 at a single center. Preoperative maximum vertical pocke...

  1. 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.

  2. Cervical Posterior Spinal Artery Syndrome: A Case Report and Literature Review.

    Science.gov (United States)

    Sakurai, Takeo; Wakida, Kenji; Nishida, Hiroshi

    2016-06-01

    We report a case of left upper cervical posterior spinal artery (PSA) syndrome caused by atherosclerosis of the left vertebral artery. A 70-year-old female experienced sudden dizziness and paralysis of the left upper and lower limbs. Diffusion-weighted magnetic resonance imaging (DWI) of the brain showed high signal intensity at the vermis and lower left hemisphere of the cerebellum, and magnetic resonance angiography showed that the entire left vertebral artery was thin. The patient was treated with an intravenous infusion of tissue plasminogen activator 2 hours after symptom onset and made a full recovery. Repeat DWI, fluid-attenuated inversion recovery images, and T2-weighted images showed high signal intensity in the left upper cervical PSA area from the lower medulla oblongata to the C2 level in addition to the cerebellum. Previously reported cases of cervical posterior artery syndrome are reviewed. PMID:27012218

  3. 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.

  4. 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

  5. Maxillo-nasal dysplasia (Binder syndrome) and associated malformations of the cervical spine

    Energy Technology Data Exchange (ETDEWEB)

    Olow-Nordenram, M.A.K.; Raadberg, C.T.

    1984-01-01

    Forty-three patients with maxillo-nasal dysplasia have been subjected to a radiographic examination of the cervical spine. In 44.2 per cent malformations of the cervical vertebrae of a minor or major type were revealed. Dysplasia of the vertebral bodies related to persistence of the chorda dorsalis, a very rare malformation, was found in six cases. No correlation between the incidence or serverity of the malformations and the degree of malocclusion of the jaws and facial deformity, characteristic of Binder syndrome, were noted. The maxillo-nasal dysplasia and the spinal malformations probably have a common cause during the embryologic stage.

  6. Ganglion cyst of the cervical spine presenting with Brown-Sequard syndrome.

    Science.gov (United States)

    Cheng, Wen-Yu; Shen, Chiung-Chyi; Wen, Mei-Chin

    2006-12-01

    Ganglion cysts of the spine are uncommon. They occur mostly in the dorsolateral trunk and arise with the greatest frequency in the lumbar spine. However, they are rarely symptomatic. We report a rare case of a patient with a ganglion cyst of the lower cervical spine presenting with acute Brown-Sequard syndrome. The patient had no history of trauma. Magnetic resonance imaging of the cervical spine showed a cystic lesion connecting to the synovial joint C6-7 and compressing the posterior aspect of the spinal cord. The patient underwent emergent C6-7 laminectomy with total removal of the cyst. Neurological function recovered completely 4 months after operation. Ganglion cysts should be considered in the differential diagnosis of an extradural mass of the cervical spine. Magnetic resonance imaging provides a rapid and correct diagnosis, and laminectomy with removal of the cyst results in good neurological recovery. PMID:17113987

  7. 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.

  8. MRI of anterior spinal artery syndrome of the cervical spinal cord

    International Nuclear Information System (INIS)

    Cervical spinal cord lesions in the anterior spinal artery syndrome were delineated on magnetic resonance images (MRI) in four patients. The lesion was always seen anteriorly in the cervical cord. On T2-weighted images, the lesions appeared hyperintense relative to the normal spinal cord, while on T1-weighted images, two chronic lesions appeared hypointense, with local atrophy of the cord. In one case, repeated T1-weighted images showed no signal abnormality 4 days after the ictus, but the lesion became hypointense 18 days later, when contrast enhancement was also recognized after injection of Gd-DTPA; this sequence of intensity changes was similar to that of cerebral infarction. The extent of the lesion seen MRI correlated closely with neurological findings in all cases. Although the findings may not be specific, MRI is now the modality of choice for confirming the diagnosis in patients suspected of having an anterior spinal artery syndrome. (orig.)

  9. CT-guided periradicular therapy in cervical and lumbar radicular syndromes

    International Nuclear Information System (INIS)

    Objective: To evaluate the effectiveness of CT-guided periradicular therapy (PRT) in cervical and lumber radicular syndromes. Methods: Seventy two cases of cervical and lumbar radicular syndromes were treated by CT-guided PRT. During PRT, 10-20 mg of Triamhexal and 3-4 ml of Carbostesin 0.25%(Bupivacainhydrochlorid) were injected into the space around the corresponding spinal root, once a week, all together six times as a course. Results: Four hundreds and forty six PRT procedures were carried out in 72 patients having a successful puncture and a satisfying spread of Triamhexal and Carbostesin around the spinal nerve root space for every time. After 6 to 24 months follow up, 62 patients showed a significant pain reduction or complete disappearance. Moderate improvement was not noted in 6 and no improvement in 4. The effective rate was 94.4% without any correlative complication. Conclusions: CT-guided PRT is an effective, easy and safe procedure to treat patients with refractory cervical or lumbar radicular pain syndromes. (authors)

  10. ELECTROACUPUNCTURE COMBINED WITH CERVICAL TRACTION AND MASSAGE FOR CORONARY HEART SYNDROME INDUCED BY CERVICAL SPONDYLOSIS%电针配合牵引手法治疗颈椎病性类冠心综合征

    Institute of Scientific and Technical Information of China (English)

    刘清林; 程惠芳; 蔡红玲; 万秀丽

    2007-01-01

    @@ Coronary heart syndrome induced by cervical spondylosis is also named as cervicogenic pseduoangina, it is the syndrome with the similar clinical manifestations of cardiac vascular disease induced by cervical spondylosis.Since 1988, the authors of the paper have treated 32 cases (from the department of internal medicine or the department of cardiac vascular disease) with acupuncture in combination with cervical traction and massage manipulation on neck region and achieved satisfied results. Following is the summary.

  11. 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. PMID:27323140

  12. Cervical ankylosis following Grisel's syndrome in a 14-year-old boy with infectious mononucleosis

    Energy Technology Data Exchange (ETDEWEB)

    Haidar, Salwa; Armstrong, Derek [Hospital for Sick Children, Department of Diagnostic Imaging, Toronto, Ont. (Canada); Drake, James [Hospital for Sick Children, Department of Neurosurgery, Toronto (Canada)

    2005-03-01

    Non-traumatic atlanto-axial subluxation (Grisel's syndrome) is an uncommon complication of neck space infection or otolaryngologic procedures. It most frequently affects children, although it may occur in adults. We present a 14-year-old boy with Grisel's syndrome as a complication of infectious mononucleosis proceeding to cervical ankylosis. (orig.)

  13. 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.

  14. [Pharyngeal-cervical-brachial syndrome: A rare form of Guillain-Barré syndrome with severe acute bulbar palsy].

    Science.gov (United States)

    Lametery, E; Dubois-Teklali, F; Millet, A; Manel, V

    2016-02-01

    The pharyngeal-cervical-brachial (PCB) variant of Guillain-Barré syndrome is rare in children. It is characterized by oropharyngeal, neck, and upper limb muscle involvement, without ataxia and disturbed consciousness. Although associated with anti-GT1a antibodies, there is no single clinical or serological marker of PCB syndrome. We report on two cases in a 14-year-old and a 15-year-old females. The first symptom was acute dysphonia followed by severe bulbar palsy with deglutition disorders, associated with involvement of other cranial nerves and arm and leg weakness. One of the girls had normal deep tendon reflexes. Both had normal cerebral imaging and normal cerebrospinal fluid. No sign of neuropathy was found on nerve conduction studies. The diagnosis of PCB syndrome was established based on the presence of antiganglioside antibodies. Both adolescents had IgG anti-GT1a antibodies. Anti-GQ1b and anti-GT1b antibodies were associated in the first case, anti-GM1 and anti-GD1a in the second case. Clinical improvement was fast after treatment with intravenous immunoglobulin therapy. Recovery was complete. Only a few cases of children and adolescents with PCB syndrome have been reported. The main differential diagnoses were excluded with brain MRI. The neurophysiological findings in PCB syndrome are axonal neuropathy rather than demyelinating neuropathy, which might be normal in the early stages of the disease. Positivity of anti-GT1a IgG antibodies is very helpful for the diagnosis of PCB syndrome. In atypical cases of bulbar palsy with other cranial nerve involvement and normal brain MRI, diagnosis of PCB syndrome should be considered. Recognizing the atypical cases of Guillain-Barré syndrome enables anticipatory monitoring for disease complications and identifies therapeutic options. The short- and long-term outcome of the PCB syndrome after intravenous immunoglobulin treatment seems favorable. PMID:26697812

  15. Case Report: Cervical chondrocalcinosis as a complication of Gitelman syndrome [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Zahra Iqbal

    2016-05-01

    Full Text Available Gitelman syndrome is an inherited tubulopathy leading to a hypokalaemic metabolic alkalosis with hypomagnesaemia and hypocalciuria. Most cases are due to mutations in SLC12A3, encoding the apical thiazide sensitive co-transporter in the distal convoluted tubule. Musculoskeletal effects of Gitelman syndrome are common, including muscle weakness, tetany and cramps. Chronic hypomagnesaemia can lead to chondrocalcinosis, which often affects knees but can affect other joints. Here we present a case of Gitelman syndrome complicated by cervical chondrocalcinosis leading to neck pain and numbness of the fingers. Treatments directed at correcting both hypokalaemia and hypomagnesaemia were initiated and allowed conservative non-surgical management of the neck pain. Recognition of chondrocalcinosis is important and treatments must be individualised to correct the underlying hypomagnesaemia.

  16. Brachioradial pruritus in a patient with cervical disc herniation and Parsonage-Turner syndrome*

    Science.gov (United States)

    Carvalho, Sandrina; Sanches, Madalena; Alves, Rosário; Selores, Manuela

    2015-01-01

    Brachioradial pruritus is a chronic sensory neuropathy of unknown etiology which affects the skin of the shoulders, arms and forearms on the insertion of the brachioradialis muscle. We describe the case of a 60-yearold woman recently diagnosed with multiple myeloma who refers paresis, severe pruritus and itching lesions on the right arm with 6 months of evolution. Investigation led to a diagnosis of Brachioradial pruritus consequent to the presence of cervical disc herniation and Parsonage-Turner syndrome. The patient started gabapentin 900mg/day with good control of itching. Corticosteroids and antihistamines are often ineffective in the treatment of BP. Gabapentin has been used with encouraging results. All patients with Brachioradial pruritus should be evaluated for cervical spine injuries. PMID:26131874

  17. Two Cases of Klippel-Feil Syndrome with Cervical Myelopathy Successfully Treated by Simple Decompression without Fixation

    OpenAIRE

    Kim, Jin Bum; Park, Seung Won; Lee, Young Seok; Nam, Taek Kyun; Park, Yong Sook; Kim, Young Baeg

    2015-01-01

    Klippel-Feil syndrome (KFS) is a congenital developmental disorder of cervical spine, showing short neck with restricted neck motion, low hairline, and high thoracic cage due to multilevel cervical fusion. Radiculopathy or myelopathy can be accompanied. There were 2 patients who were diagnosed as KFS with exhibited radiological and physical characteristics. Both patients had stenosis and cord compression at C1 level due to anterior displacement of C1 posterior arch secondary to kyphotic defor...

  18. Restlessness in right upper limb as sole presentation of restless legs syndrome

    OpenAIRE

    Ravi Gupta; Vivekananda Lahan; Deepak Goel

    2013-01-01

    Restless legs syndrome (RLS) rarely affects the upper limb during the initial course of disease. We present a patient who complained of symptoms suggesting RLS in the right upper limb as the sole manifestation of illness. Bilateral cervical ribs and depression were co-incidental findings. Patient responded well to dopaminergic therapy.

  19. [The question of radiation exposure of the cervical spine in analgesic roentgen irradiation of therapy-resistant humero-scapular periarthritis associated with local cervical syndrome and/or cervicobrachial syndrome].

    Science.gov (United States)

    Hoenle, R

    1985-08-01

    An improvement is achieved by palliative X-ray irradiation in about 70% out of 47 patients with scapulohumeral periarthritis and local cervical syndrome and/or cervicobrachial syndrome which was hitherto resistant to medicomechanical treatment. Higher rates of success (84%) can be achieved if the patients present an identical symptomatology, but less severe alterations of the vertebral column, even if the vertebral column is not irradiated. In case of severe alterations of the vertebral column, the success of palliative irradiation is diminished, even if the cervical vertebral column is additionally irradiated. PMID:2411026

  20. Gorham Syndrome - massive osteolysis of the cervical spine

    International Nuclear Information System (INIS)

    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)

  1. Absence of uptake of the rib cage; diagnosis of a Poland's syndrome with the bone SPECT-CT; Absence de fixation du gril costal: diagnostic d'un syndrome de Poland par la TEMP-TDM osseuse

    Energy Technology Data Exchange (ETDEWEB)

    Granier, P.; Mourad, M. [Centre Hospitalier Antoine-Gayraud, Service de Medecine Nucleaire, 11 - Carcassonne (France)

    2008-09-15

    We report the case of a 37-year-old man, investigated for pains of the right upper limb impairing the hand, the wrist and the shoulder after a surgery for fracture of the radius and the scaphoid. The {sup 99m}Tc-H.D.P. three-phase bone scintigraphy confirmed the diagnosis of acute phase of a reflex sympathetic dystrophy. The delayed images highlighted a focal absence of tracer uptake of the left anterior rib cage. The single photon emission computerized tomography guided by computerized tomography showed that it was related to the absence of the anterior part of the third and the fourth left ribs highlighting an aplasia of the left pectoralis major muscle. These anomalies led to the diagnosis of congenital malformation in connection with a Poland's syndrome. The differential diagnosis of this syndrome resulted in discussing the multiple etiologies of the photopenic lesions of the rib cage. (authors)

  2. Analysis on the Effect of Acupuncture in Treating Cervical Spondylosis with Different Syndrome Types

    Institute of Scientific and Technical Information of China (English)

    符文彬; 梁兆晖; 朱晓平; 于鹏; 张继福

    2009-01-01

    Objective:To observe the clinical effect of acupuncture in treating cervical spondylosis with different syndrome types.Methods:One hundred and seventeen patients were randomized into the treated group (59 cases),treated with normal acupuncture,and the control group(58 cases),treated with sham acupuncture, operated once every other day,9 times in total(in 18 days) as one therapeutic course,and a succeeding 3-month follow-up study was carried out after terminating the therapy.The efficacy of treatment was ...

  3. Informative value of radiological findings recorded from cervical spine with reference to clinical symptoms in patients with cervical syndrome. Aussagewert roentgenologischer Befunde an der Halswirbelsaeule in bezug zur klinischen Symptomatik bei Patienten mit Zervikalsyndrom

    Energy Technology Data Exchange (ETDEWEB)

    Loreck, D.; Kuehn, A. (Humboldt-Univ., Berlin (Germany). Inst. fuer Roentgendiagnostik); Conradi, E. (Humboldt Univ., Berlin (Germany). Poliklinik fuer Physiotherapie)

    Static X-rays recorded at two planes from the cervical spine of 286 patients were evaluated and were compared to findings obtained from 50 probands without complaints. The patients complained about problems relating to vertebrogenic pain syndrome of the cervical spine, including vertigo of cervical origin. They were grouped by four sets of clinical symptoms (cephalgia, vertigo, locally delimited complaints and cervicobrachial syndrome). No statistically significant differences were found to exist among the groups of probands with regard to radiographic morphology, static condition nor impairment of relations. Particular reference is made in this paper to reversible function disorders and their major role among the multifactorial causes of the cervical syndrome. Indications are derived from these observations for primary X-ray examination of the cervical spine. (orig.).

  4. 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.

  5. 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.

  6. Cervical radiculopathy.

    Science.gov (United States)

    Iyer, Sravisht; Kim, Han Jo

    2016-09-01

    Cervical radiculopathy is a common clinical scenario. Patients with radiculopathy typically present with neck pain, arm pain, or both. We review the epidemiology of cervical radiculopathy and discuss the diagnosis of this condition. This includes an overview of the pertinent findings on the patient history and physical examination. We also discuss relevant clinical syndromes that must be considered in the differential diagnosis including peripheral nerve entrapment syndromes and shoulder pathology. The natural history of cervical radiculopathy is reviewed and options for management are discussed. These options include conservative management, non-operative modalities such as physical therapy, steroid injections, and operative intervention. While the exact indications for surgical intervention have not yet been elucidated, we provide an overview of the available literature regarding indications and discuss the timing of intervention. The surgical outcomes of anterior cervical decompression and fusion (ACDF), cervical disc arthroplasty (CDA), and posterior cervical foraminotomy (PCF) are discussed. PMID:27250042

  7. [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. PMID:980212

  8. 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.

  9. Propranolol Use in PHACE Syndrome with Cervical and Intracranial Arterial Anomalies: Collective Experience in 32 Infants

    Science.gov (United States)

    Metry, Denise; Frieden, Ilona J.; Hess, Christopher; Siegel, Dawn; Maheshwari, Mohit; Baselga, Eulalia; Chamlin, Sarah; Garzon, Maria; Mancini, Anthony J.; Powell, Julie; Drolet, Beth A.

    2016-01-01

    1. Objective Combine collective clinical experience using oral propranolol therapy in PHACE syndrome infants with cerebrovascular anomalies. 2. Design Retrospective study of patients evaluated between July 2008 and October 2011. 3. Setting Seven pediatric dermatology centers. 4. Patients 32 infants with definite PHACE syndrome and cervical and/or intracranial arterial anomalies. 5. Intervention Oral propranolol: average dose of 1.8 mg/kg/day divided t.i.d. or b.i.d., for an average duration of 12.3 months. 6. Main Outcome Measure Adverse neurologic events. 7. Results 7/32 (22%) patients were categorized as higher-risk for stroke, defined on MRA as severe, long-segment narrowing or non-visualization of major cerebral or cervical vessels without anatomic evidence for collateral circulation, often in the presence of concomitant cardiovascular comorbidities. Only 1 patient developed a change in neurologic status during propranolol treatment: a mild right hemiparesis that remained static and improved while propranolol was continued. An additional 3 patients had worsening hemangioma ulceration and/or tissue necrosis during therapy. 8. Conclusions This is the largest report thus far of PHACE patients treated with propranolol. While no catastrophic neurologic events occurred, serious complications, particularly severe ulcerations were seen in a minority of patients, and given the sample size we cannot negate the possibility that propranolol could augment the risk of stroke in this population. We continue to advise caution in using systemic beta-blockers, particularly for children with vascular anomalies at higher risk for stroke. Use of the lowest possible dosage, slow dosage titration, and t.i.d. dosing in order to minimize abrupt changes in blood pressure and close follow-up, including neurologic consultation as needed, are recommended. PMID:22994362

  10. Question of radiation exposure of the cervical vertebral column in the palliative X-ray irradiation in case of therapy-resistant scapulohumeral periarthritis with local cervical syndrome and/or cervicobrachial syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Hoenle, R.

    1985-08-01

    An improvement is achieved by palliative X-ray irradiation in about 70% out of 47 patients with scapulohumeral periarthritis and local cervival syndrome and/or cervicobrachial syndrome which was hitherto resistant to medicomechanical treatment. Higher rates of success (84%) can be achieved if the patients present an identical symptomatology, but less severe alterations of the vertebral column, even if the vertebral column is not irradiated. In case of severe alterations of the vertebral column, the success of palliative irradiation is diminished, even if the cervical vertebral column is additionally irradiated.

  11. A Rare Form of Guillan Barre Syndrome: A Child Diagnosed with Anti-GD1a and Anti-GD1b Positive Pharyngeal-Cervical-Brachial Variant

    OpenAIRE

    Uysalol, Metin; Tatlı, Burak; Uzel, Nedret; Çıtak, Agop; Aygün, Erhan; Kayaoğlu, Semra

    2013-01-01

    Background: Pharyngeal-cervical-brachial (PCB) variant is a rare form of Guillan-Barre Syndrome (GBS). Antibodies against other membrane proteins like GM1b and GD1a have been found only in a small number of patients with Guillan Barre syndrome variant. Case Report: Here, we report a 5.5 year-old boy diagnosed early with positive GD1a and GD1b gangliosides of Guillan-Barre syndrome pharyngeal cervical-Brachial variant, who improved and recovered fully in a short period. This is in co...

  12. 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. PMID:26984802

  13. Tuina treatment in cervical spondylosis

    OpenAIRE

    Florin Mihai Hinoveanu

    2010-01-01

    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 princ...

  14. 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.

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

    International Nuclear Information System (INIS)

    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

  16. Treatment of cervical myelopathy in patients with the fibromyalgia syndrome: outcomes and implications

    OpenAIRE

    Heffez, Dan S.; Ross, Ruth E.; Shade-Zeldow, Yvonne; Kostas, Konstantinos; Morrissey, Mary; Elias, Dean A.; Shepard, Alan

    2007-01-01

    Some patients with fibromyalgia also exhibit the neurological signs of cervical myelopathy. We sought to determine if treatment of cervical myelopathy in patients with fibromyalgia improves the symptoms of fibromyalgia and the patients’ quality of life. A non-randomized, prospective, case control study comparing the outcome of surgical (n = 40) versus non-surgical (n = 31) treatment of cervical myelopathy in patients with fibromyalgia was conducted. Outcomes were compared using SF-36, screeni...

  17. Partial tetraplegic syndrome as a complication of a mobilizing/manipulating procedure of the cervical spine in a man with Forestier's disease: a case report

    Directory of Open Access Journals (Sweden)

    Exadaktylos Aristomenis K

    2011-10-01

    Full Text Available Abstract Introduction Even if performed by qualified physical therapists, spinal manipulation and mobilization can cause adverse events. This holds true particularly for the cervical spine. In light of the substantial risks, the benefits of cervical spine manipulation may be outweighed by the possibility of further injury. Case presentation We present the case of a 56-year-old Caucasian man with Forestier's disease who went to see a physiotherapist to relieve his aching neck while on a holiday trip. Following the procedure, he was transferred to a local hospital with a partial tetraplegic syndrome due to a cervical 6/7 luxation fracture. Reportedly, the physiotherapist took neither a detailed history, nor adequate diagnostic measures. Conclusions This case highlights the potentially dangerous complications associated with cervical spine mobilization/manipulation. If guidelines concerning cervical spine mobilization and manipulation practices had been followed, this adverse event could have been avoided.

  18. 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.

  19. 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. PMID:22553311

  20. Two Cases of Klippel-Feil Syndrome with Cervical Myelopathy Successfully Treated by Simple Decompression without Fixation.

    Science.gov (United States)

    Kim, Jin Bum; Park, Seung Won; Lee, Young Seok; Nam, Taek Kyun; Park, Yong Sook; Kim, Young Baeg

    2015-09-01

    Klippel-Feil syndrome (KFS) is a congenital developmental disorder of cervical spine, showing short neck with restricted neck motion, low hairline, and high thoracic cage due to multilevel cervical fusion. Radiculopathy or myelopathy can be accompanied. There were 2 patients who were diagnosed as KFS with exhibited radiological and physical characteristics. Both patients had stenosis and cord compression at C1 level due to anterior displacement of C1 posterior arch secondary to kyphotic deformity of upper cervical spine, which has been usually indicative to craniocervical fixation. One patient was referred due to quadriparesis detected after surgery for aortic arch aneurysmal dilatation. The other patient was referred to us due to paraparesis and radiating pain in all extremities developed during gynecological examinations. Decompressive C1 laminectomy was done for one patient and additional suboccipital craniectomy for the other. No craniocervical fixation was done because there was no spinal instability. Motor power improved immediately after the operation in both patients. Motor functions and spinal stability were well preserved in both patients for 2 years. In KFS patients with myelopathy at the C1 level without C1-2 instability, a favorable outcome could be achieved by a simple decompression without spinal fixation. PMID:26512291

  1. 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.

  2. XROMM analysis of rib kinematics during lung ventilation in the green iguana, Iguana iguana.

    Science.gov (United States)

    Brainerd, Elizabeth L; Moritz, Sabine; Ritter, Dale A

    2016-02-01

    The three-dimensional rotations of ribs during breathing are typically described as bucket-handle rotation about a dorsoventrally oriented axis, pump-handle rotation about a mediolateral axis, and caliper rotation about a rostrocaudal axis. In amniotes with double-headed ribs, rib motion is constrained primarily to one degree-of-freedom (DOF) rotation about an axis connecting the two rib articulations. However, in Squamata, the ribs are single headed and the hemispherical costovertebral joints permit rotations with three DOF. In this study, we used X-ray reconstruction of moving morphology (XROMM ) to quantify rib rotation during deep breathing in four green iguanas. We found that rib rotation was strongly dominated by bucket-handle rotation, thus exhibiting nearly hinge-like motion, despite the potential for more complex motions. The vertebral and sternal segments of each rib did not deform measurably during breathing, but they did move relative to each other at a thin, cartilaginous intracostal joint. While standing still and breathing deeply, four individual iguanas showed variability in their rib postures, with two breathing around a highly inflated posture, and two breathing around a posture with the ribs folded halfway back. Bucket-handle rotations showed clear rostrocaudal gradients, with rotation increasing from the third cervical to the first or second dorsal rib, and then decreasing again caudally, a pattern that is consistent with the intercostal muscles in the rostral intercostal spaces being the primary drivers of inspiration. The constrained, primarily bucket-handle rotations observed here during breathing do not help to explain the evolution of permissive, hemispherical costovertebral joints in squamates from the more constrained, double-headed rib articulations of other amniotes. PMID:26596531

  3. 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

  4. Rib fracture: Different radiographic projections

    International Nuclear Information System (INIS)

    Rib fracture is the most common thoracic injury. It is thought to be present in 10% of all traumatic injuries and in almost 40% of patients who sustained severe non-penetrating trauma. There are 12 pairs of ribs. This study reviews various methods of acquisition and reconstruction of radiographic images of traumatic rib fractures in order to determine the optimal views and to simplify rib fracture diagnostics. Eight different plain radiography pictures of ribs were performed with the patient in an erect position. The following projections were obtained in sequence: oblique at 45° or 30° angle on inspiration, oblique at 45° or 30° angle on expiration as well as 45° and 39° projections during slow and fast breathing. All radiographic examinations were performed using a Philips three-phase scanner installed at the Al- Razi Hospital in Jenin, Palestine. The results demonstrate that the 45° antero-posterior oblique projection performed on expiration is recommended for diagnostics and interpretation of traumatic rib fractures. Conclusion emerging from this study are such that for a 45° oblique view on expiration is recommended for radiographic imaging of patients with clinical signs of fracture, e.g. evaluation of lower rib fractures, while 45° oblique view during fast breathing is recommended for suspected upper rib fractures

  5. 推拿与针刺对神经根型颈椎病的作用%Effect of massage and acupuncture on nerve root type of cervical syndrome

    Institute of Scientific and Technical Information of China (English)

    金国英

    2003-01-01

    @@ INTRODUCTION Nerve root type is the type with highest incidence in cervical syn-drome which therapcutic methods are mainly conservative treat-menit. Comnpared with traction and TDP the effect of massage andacupuncture is satisfying.

  6. Central Cord Syndrome Due to Diffuse Idiopathic Skeletal Hyperostosis of the Cervical Spine

    OpenAIRE

    Aydan KURTARAN; Selcen ÖZDEMİR; Barın SELÇUK; Özge YILDIRIM; İbrahim DEĞİRMENCİ; Müfit AKYÜZ

    2012-01-01

    Diffuse idiopathic skeletal hyperostosis (DISH) is a systemic skeletal disease of unknown etiology characterized by ligamentous ossification of the anterolateral spine and the extraspinal ligaments. In generally, it has been reported to be associated with diabetes mellitus and obesity. The most common symptoms of cervical DISH are compression of the trachea and esophagus, however, neurological deficits are rare. In this article, we present an 85-year-old male patient who had non-traumatic cen...

  7. Design of COSMIC: a randomized, multi-centre controlled trial comparing conservative or early surgical management of incomplete cervical cord syndrome without spinal instability

    OpenAIRE

    Bartels Ronald HMA; Hosman Allard JF; van de Meent Henk; Hofmeijer Jeannette; Vos Pieter E; Slooff Willem Bart; Öner F Cumhur; Coppes Maarten H; Peul Wilco C; Verbeek André LM

    2013-01-01

    Abstract Background Incomplete cervical cord syndrome without spinal instability is a very devastating event for the patient and the family. It is estimated that up to 25% of all traumatic spinal cord lesions belong to this category. The treatment for this type of spinal cord lesion is still subject of discussion. From a biological point of view early surgery could prevent secondary damage due to ongoing compression of the already damaged spinal cord. Historically, however, conservative treat...

  8. Design of COSMIC: a randomized, multi-centre controlled trial comparing conservative or early surgical management of incomplete cervical cord syndrome without spinal instability

    OpenAIRE

    Bartels, R.H.M.A.; Hosman, A.J.F.; Meent, H. van de; Hofmeijer, J.; Vos, P.E.; Slooff, W.B.; Oner, F. C.; Coppes, M.H.; Peul, W.C.; Verbeek, A L M

    2013-01-01

    ABSTRACT: BACKGROUND: Incomplete cervical cord syndrome without spinal instability is a very devastating event for the patient and the family. It is estimated that up to 25% of all traumatic spinal cord lesions belong to this category. The treatment for this type of spinal cord lesion is still subject of discussion. From a biological point of view early surgery could prevent secondary damage due to ongoing compression of the already damaged spinal cord. Historically, however, conservative tre...

  9. Design of COSMIC: a randomized, multi-centre controlled trial comparing conservative or early surgical management of incomplete cervical cord syndrome without spinal instability

    OpenAIRE

    Bartels, R.H.M.; Hosman, A.J.F.; Meent, H. van de; Hofmeijer, J.; Vos, P.E.; Slooff, W.B.; Öner, F.C.; Coppes, M.H.; Peul, W.C.; Verbeek, A L M

    2013-01-01

    Background Incomplete cervical cord syndrome without spinal instability is a very devastating event for the patient and the family. It is estimated that up to 25 % of all traumatic spinal cord lesions belong to this category. The treatment for this type of spinal cord lesion is still subject of discussion. From a biological point of view early surgery could prevent secondary damage due to ongoing compression of the already damaged spinal cord. Historically, however, conservative treatment was...

  10. 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.

  11. 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.

  12. Isolated rib fractures in geriatric patients

    OpenAIRE

    Elmistekawy Elsayed; Hammad Abd Almohsen

    2007-01-01

    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...

  13. Cervical dysplasia

    Science.gov (United States)

    ... by your provider. Make sure to get the HPV vaccine when it is offered to you. This vaccine prevents many cervical cancers. ... Early diagnosis and prompt treatment cures most cases of cervical ... severe cervical dysplasia may change into cervical cancer.

  14. 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.

  15. 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.)

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

    International Nuclear Information System (INIS)

    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.)

  17. 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. PMID:24894107

  18. Golfer's fracture of the ribs

    International Nuclear Information System (INIS)

    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.

  19. Segmentation of ribs in digital chest radiographs

    Science.gov (United States)

    Cong, Lin; Guo, Wei; Li, Qiang

    2016-03-01

    Ribs and clavicles in posterior-anterior (PA) digital chest radiographs often overlap with lung abnormalities such as nodules, and cause missing of these abnormalities, it is therefore necessary to remove or reduce the ribs in chest radiographs. The purpose of this study was to develop a fully automated algorithm to segment ribs within lung area in digital radiography (DR) for removal of the ribs. The rib segmentation algorithm consists of three steps. Firstly, a radiograph was pre-processed for contrast adjustment and noise removal; second, generalized Hough transform was employed to localize the lower boundary of the ribs. In the third step, a novel bilateral dynamic programming algorithm was used to accurately segment the upper and lower boundaries of ribs simultaneously. The width of the ribs and the smoothness of the rib boundaries were incorporated in the cost function of the bilateral dynamic programming for obtaining consistent results for the upper and lower boundaries. Our database consisted of 93 DR images, including, respectively, 23 and 70 images acquired with a DR system from Shanghai United-Imaging Healthcare Co. and from GE Healthcare Co. The rib localization algorithm achieved a sensitivity of 98.2% with 0.1 false positives per image. The accuracy of the detected ribs was further evaluated subjectively in 3 levels: "1", good; "2", acceptable; "3", poor. The percentages of good, acceptable, and poor segmentation results were 91.1%, 7.2%, and 1.7%, respectively. Our algorithm can obtain good segmentation results for ribs in chest radiography and would be useful for rib reduction in our future study.

  20. Late onset of cryptococcal cervical lymphadenitis following immune reconstitution inflammatory syndrome in a patient with AIDS.

    Science.gov (United States)

    Sethupathi, Meenakshi; Yoganathan, Kathir

    2015-01-01

    A 32-year-old woman was diagnosed HIV positive with disseminated cryptococcal infection in May 2006. Her initial CD4 was 7 cells/µL and she had a right supraclavicular nodal mass, which was biopsied and shown to be consistent with cryptococcal lymphadenitis. She was treated for disseminated cryptococcal infection and was started on antiretroviral medications subsequently. Two years later, she developed a left supraclavicular mass. Her CD4 count was 320 cells/µL and HIV RNA level was undetectable. Investigations and biopsy results were consistent with a late presentation of cryptococcal immune reconstitution inflammatory syndrome (IRIS). She was treated with oral corticosteroids and her symptoms resolved completely. IRIS is a recognised complication of HIV treatment and occurs in a significant percentage of patients within the first 3 months of starting antiretroviral therapy. This case report illustrates the importance of recognising late presentations of IRIS. It is vital to differentiate true cryptococcal lymphadenitis from IRIS-induced cryptococcal lymphadenitis. PMID:25564633

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

    International Nuclear Information System (INIS)

    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. (author)

  2. Fabricational morphology of oblique ribs in bivalves.

    Science.gov (United States)

    Checa, Antonio G

    2002-11-01

    The formation of oblique ribs of bivalve shells usually has been attributed to processes of reaction-diffusion of morphogens from cell to cell at the mantle margin or neural activation and lateral inhibition in the mantle. In particular, such ribs appear with high rates of lateral diffusion. Nevertheless, theoretical models fail to explain either partially or wholly some varieties of oblique ribs. After surveying the modes of formation of the shell and oblique ribs by the bivalve mantle and associated fabricational defects, I have determined that the mantle is able to develop an elaborate behavior in order to displace the rib in a particular direction during growth. The mantle margin is, therefore, not only the shell-secreting organ, but also the main morphogenetic unit. In particular, there are two main fabricational strategies. In forms with strict contact guidance (SCG) the mantle is able to project far enough beyond the shell margins so as to feel the already formed reliefs and to align new growth increments of the ribs in the appropriate directions. The shell margin is always strongly reflected. In bivalves with reduced contact guidance plus constant lateral shift (RCG), the margin is usually acute and the information about ribs available to the mantle is reduced. During rib construction the mantle extrudes slightly from the shell edge and then pushes laterally by muscular action; in this way, the new growth increment of the rib is displaced laterally on a small scale. The contact-guidance model is supported also by the homogeneous structure of the shell-secreting mantle. From the morphogenetic standpoint, oblique ribs are related to commarginal ones and both differ completely from other ribbing patterns of bivalves. PMID:12353301

  3. Effect of joint mobilization combined with traction on 82 patients with radicular type of cervical syndrome%关节松动术结合牵引治疗神经根型颈椎病82例

    Institute of Scientific and Technical Information of China (English)

    易文远; 彭仕芳; 张少军

    2003-01-01

    @@ INTRODUCTION In recent years, joint mobilization combining with traction were used totreat 82 patients with the cervical syndrome, while the control group(64 patients) is done only with traction, and observe the effect of thesetwo groups respectively. As result, the effect of trail group is markedly.

  4. 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.

  5. Jet flow on ribbed curved surfaces

    Science.gov (United States)

    Lashkov, Iu. A.; Sokolova, I. N.; Shumilkina, E. A.

    1992-02-01

    The objective of the study was to investigate the possibility of using microribbing to reduce turbulent friction in Coanda flows over curved surfaces. It is shown that ribs make it possible to reduce the effect of a jet impinging on an obstacle and to prevent the Coanda effect when jet attachment is undesirable. The optimal rib parameters are determined.

  6. 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.

  7. Nozzle airfoil having movable nozzle ribs

    Science.gov (United States)

    Yu, Yufeng Phillip; Itzel, Gary Michael

    2002-01-01

    A nozzle vane or airfoil structure is provided in which the nozzle ribs are connected to the side walls of the vane or airfoil in such a way that the ribs provide the requisite mechanical support between the concave side and convex side of the airfoil but are not locked in the radial direction of the assembly, longitudinally of the airfoil. The ribs may be bi-cast onto a preformed airfoil side wall structure or fastened to the airfoil by an interlocking slide connection and/or welding. By attaching the nozzle ribs to the nozzle airfoil metal in such a way that allows play longitudinally of the airfoil, the temperature difference induced radial thermal stresses at the nozzle airfoil/rib joint area are reduced while maintaining proper mechanical support of the nozzle side walls.

  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. PMID:25818966

  9. 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......-based visualization is applied to the separation bubble upstream of the rib. Salient critical points and limit cycles are extracted, which gives clues to the physical processes occurring in the flow....

  10. RIBBED DOUBLE PIPE HEAT EXCHANGER: ANALYTICAL ANALYSIS

    Directory of Open Access Journals (Sweden)

    HUSSAIN H. AL-KAYIEM

    2011-02-01

    Full Text Available This paper presents the findings obtained by modeling a Double Pipe Heat Exchanger (DPHE equipped with repeated ribs from the inside for artificial roughing. An analytical procedure was developed to analyze the thermal and hydraulic performance of the DPHE with and without ribbing. The procedure was verified by comparing with experimental reported results and they are in good agreement. Several parameters were investigated in this study including the effect of ribs pitch to height ratios, P/e= 5, 10, 15, and 20, and ribs to hydraulic diameter ratios, e/Dh= 0.0595, 0.0765, and 0.107. These parameters were studied at various operating Reynolds number ranging from 2500 to 150000. Different installation configurations were investigated, too. An enhan-cement of 4 times in the heat transfer in terms of Stanton number was achieved at the expense of 38 times increase of pressure drop across the flow in terms of friction facto values.

  11. Wrap-rib antenna concept development overview

    Science.gov (United States)

    Woods, A. A., Jr.; Garcia, N. F.

    1983-01-01

    The wrap rib antenna design of a parabolic reflector large space antenna is discussed. Cost estimates, design/mission compatibility, deployment sequence, ground based tests, and fabrication are discussed.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. RIB Production at LNL: the EXOTIC Facility

    Science.gov (United States)

    Marco, Mazzocco

    2016-04-01

    Nuclear reactions involving radioactive isotopes are extremely relevant in several astrophysical scenarios, from the Big-Bang Nucleosynthesis to Supernovae explosions. In this contribution the production of Radioactive Ion Beams (RIBs) by means of the in-flight technique is reviewed. In particular, the use of direct reactions in inverse kinematics for the production of light weakly-bound RIBs by means of the facility EXOTIC at INFN-LNL (Italy) will be described in detail.

  17. 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.

  18. 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, ...

  19. Sliding Couette flow in a ribbed annulus

    Science.gov (United States)

    Moradi, H. V.; Floryan, J. M.

    2016-07-01

    The flow in an annulus driven by the axial movement of one of the cylinders has been studied. The stationary cylinder has been fitted with axisymmetric ribs resulting in the appearance of the centrifugal-force-driven instability which leads to the formation of axial vortices. The critical stability conditions have been determined for a wide range of geometries of practical interest; these conditions include the critical Reynolds number as well as the best vortex packing. It has been shown that a sufficiently large increase of the ribs' wavelength leads to a flow stabilization as the flow becomes nearly rectilinear, thus reducing the strength of the centrifugal force field. It has also been demonstrated that a sufficiently large decrease of the ribs' wavelength similarly results in the flow stabilization as the stream lifts up above the ribs' peaks and becomes more rectilinear. Reduction of the annulus' radius leads to qualitatively different flow responses depending on the position of the moving cylinder. The critical Reynolds number is reduced and the range of the ribs' wave numbers capable of inducing the instability is increased when the outer cylinder drives the flow. The trend is reversed when the inner cylinder drives the flow. Conditions when the ribbed cylinder is unable to induce any instability and, thus, behaves as a hydraulically smooth cylinder have been identified.

  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. 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.

  2. 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. PMID:23404316

  3. 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.

  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. 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

  6. 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.

  7. Mechanical Action of the Intercostal Muscles on the Ribs

    Science.gov (United States)

    de Troyer, Andre; Kelly, Suzanne; Zin, Walter A.

    1983-04-01

    The external and internal interosseous intercostal muscles were separately stimulated at end-expiratory lung volume in anesthetized dogs. These muscles were all found to elevate the ribs into which they insert. By attaching weights to the ribs, it was determined that the nonlinear compliance of the ribs was responsible for this phenomenon.

  8. Cervical Cancer

    Science.gov (United States)

    ... to see your doctor. www.cdc.gov/cancer/knowledge 1-800-CDC-INFO Are there tests that can prevent cervical cancer or find it early? There are two tests that can either help prevent cervical cancer or find it early: • The Pap test (or Pap smear)looks for precancers, cell changes, on the cervix ...

  9. 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.

  10. Factors affecting visualization of posterior rib fractures in abused infants

    International Nuclear Information System (INIS)

    Rib fractures in abused infants commonly occur in the posterior rib arcs. Fractures occurring near the costovertebral articulations are usually identified radiographically only once callus has formed. To assess the factors influencing the visibility of fractures near the costovertical articulations, the authors studied 103 posterior rib fractures occurring in 16 abused infants. Radiologic findings were correlated with CT findings and pathologic material from nine ribs in four patients. The limited visibility of fractures relates to (1) the frequent superimposition of the transverse process over the rib fracture site, (2) a fracture line that crosses at an obliquity to the x-ray beam, and (3) nondisplacement of rib fragments due to preservation of the posterior periosteum. Fresh rib fractures invisible on a frontal projection may be clearly defined on axial CT scans, or on postmortem radiographs. A knowledge of the factors influencing the visibility of these important injuries is useful in planning an appropriate diagnostic evaluation of suspected infant abuse

  11. Chondral Rib Fractures in Professional American Football

    Science.gov (United States)

    McAdams, Timothy R.; Deimel, Jay F.; Ferguson, Jeff; Beamer, Brandon S.; Beaulieu, Christopher F.

    2016-01-01

    Background: Although a recognized and discussed injury, chondral rib fractures in professional American football have not been previously reported in the literature. There currently exists no consensus on how to identify and treat these injuries or the expected return to play for the athlete. Purpose: To present 2 cases of chondral rib injuries in the National Football League (NFL) and discuss the current practice patterns for management of these injuries among the NFL team physicians. Study Design: Case series; Level of evidence, 4. Methods: Two cases of NFL players with chondral rib injuries are presented. A survey regarding work-up and treatment of these injuries was completed by team physicians at the 2014 NFL Combine. Our experience in identifying and treating these injuries is presented in conjunction with a survey of NFL team physicians’ experiences. Results: Two cases of rib chondral injuries were diagnosed by computed tomography (CT) and treated with rest and protective splinting. Return to play was 2 to 4 weeks. NFL Combine survey results show that NFL team physicians see a mean of 4 costal cartilage injuries per 5-year period, or approximately 1 case per year per team. Seventy percent of team physicians use CT scanning and 43% use magnetic resonance imaging for diagnosis of these injuries. An anesthetic block is used acutely in 57% and only electively in subsequent games by 39%. Conclusion: A high index of suspicion is necessary to diagnose chondral rib injuries in American football. CT scan is most commonly used to confirm diagnosis. Return to play can take up to 2 to 4 weeks with a protective device, although anesthetic blocks can be used to potentially expedite return. Clinical Relevance: Chondral rib injuries are common among NFL football players, while there is no literature to support proper diagnosis and treatment of these injuries or expected duration of recovery. These injuries are likely common in other contact sports and levels of

  12. Design of COSMIC: a randomized, multi-centre controlled trial comparing conservative or early surgical management of incomplete cervical cord syndrome without spinal instability

    Directory of Open Access Journals (Sweden)

    Bartels Ronald HMA

    2013-01-01

    Full Text Available Abstract Background Incomplete cervical cord syndrome without spinal instability is a very devastating event for the patient and the family. It is estimated that up to 25% of all traumatic spinal cord lesions belong to this category. The treatment for this type of spinal cord lesion is still subject of discussion. From a biological point of view early surgery could prevent secondary damage due to ongoing compression of the already damaged spinal cord. Historically, however, conservative treatment was propagated with good clinical results. Proponents for early surgery as well those favoring conservative treatment are still in debate. The proposed trial will contribute to the discussion and hopefully also to a decrease in the variability of clinical practice. Methods/Design A randomized controlled trial is designed to compare the clinical outcome of early surgical strategy versus a conservative approach. The primary outcome is clinical outcome according to mJOA. This also measured by ASIA score, DASH score and SCIM III score. Other endpoints are duration of the stay at a high care department (medium care, intensive care, duration of the stay at the hospital, complication rate, mortality rate, sort of rehabilitation, and quality of life. A sample size of 36 patients per group was calculated to reach a power of 95%. The data will be analyzed as intention-to-treat at regular intervals, but the end evaluation will take place at two years post-injury. Discussion At the end of the study, clinical outcomes between treatments attitudes can be compared. Efficacy, but also efficiency can be determined. A goal of the study is to determine which treatment will result in the best quality of life for the patients. This study will certainly contribute to more uniformity of treatment offered to patients with a special sort of spinal cord injury. Trial Registration Gov: NCT01367405

  13. Giant cell tumor of the rib

    International Nuclear Information System (INIS)

    A 27-year-old woman with a giant cell tumor of the rib with a cystic-hemorrhagic appearance underwent surgery consisting of en bloc resection and reconstruction of the thoracic wall with Marlex mesh, reinforced with two titanium plates. When possible this type of tumor requires resection, instead of radiotherapy, since the majority of cases of malignant transformation are linked to prior radiation therapy. (orig.)

  14. Rib stress fractures in elite rowers

    OpenAIRE

    Vinther, Anders

    2009-01-01

    The aim was to investigate potential risk factors and suggested injury mechanisms involved in the development of exercise-induced rib stress fractures (RSF) in elite rowers as well as investigate biomechanical and neuromuscular differences of ergometer rowing in stationary and slide-based ergometers. BMD and muscle strength was assessed as well as EMG of thoracic muscles and rowing technique during ergometer rowing in rowers with previous RSF and controls. The RSF subjects displayed reduc...

  15. Cervical spondylosis

    Science.gov (United States)

    ... Past neck injury (often several years before) Past spine surgery Ruptured or slipped disk Severe arthritis Small fractures ... Kshettry VR. Cervical spondylosis. In: Benzel EC, ed. Spine Surgery . 3rd ed. Philadelphia, PA: Elsevier Saunders; 2012:chap ...

  16. Cervical Cancer

    Science.gov (United States)

    ... 162 KB) This information in Spanish (en español) Female reproductive system Select image to view larger Related ... D., FACS, Captain, U.S. Public Health Service Medical Director, National Breast and Cervical Cancer Early Detection Program, ...

  17. Cervical Stenosis

    Science.gov (United States)

    ... Accumulation of pus in the uterus is called pyometra. Symptoms Before menopause, cervical stenosis may cause menstrual ... present but not cause symptoms. A hematometra or pyometra can cause pain or cause the uterus to ...

  18. General Information about Cervical Cancer

    Science.gov (United States)

    ... Research Cervical Cancer Treatment (PDQ®)–Patient Version General Information About Cervical Cancer Key Points Cervical cancer is ... the NCI website . Cervical Cancer During Pregnancy General Information About Cervical Cancer During Pregnancy Treatment of cervical ...

  19. Genetics Home Reference: Horner syndrome

    Science.gov (United States)

    ... of congenital Horner syndrome result from damage to nerves called the cervical sympathetics. These nerves belong to the part of ... is under the control of the cervical sympathetic nerves. Damage to the cervical sympathetic nerves can be caused by a direct ...

  20. [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. PMID:27156505

  1. 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.

  2. The sound transmission of finite ribbed plates using a variational

    DEFF Research Database (Denmark)

    Brunskog, Jonas

    2012-01-01

    Many lightweight structures consist of plates being stiffened by ribs. The rib stiffeners can significantly change the vibration field and the radiation behavior of the structure. These type of structures has thus often been studied in the past. However, there is a lack of simplified expressions...... for the sound transmission of these structures. Therefore, simplified expressions for the sound transmission of finite single leaf ribbed plates are derived, using a variational technique based on integral equations of the fluid loaded plate....

  3. Intrathoracic Rib Associated with Pulmonary Collapse in a Pediatric Patient

    International Nuclear Information System (INIS)

    The ribs are essential structures of the osseous thorax that provide certain significant information and aid interpretation of radiologic images in daily routine practice. Intrathoracic rib is a rare congenital anomaly that is usually discovered incidentally, but may cause in vain interventions in case of being unaware. We herein report an intrathoracic rib in a girl whose chest X-ray was strange enough to obtain a spiral computed tomography (CT) scanning for a definitive diagnosis afterwards

  4. Predictions for particle deposition from LES of ribbed channel flow

    International Nuclear Information System (INIS)

    Predictions for the deposition of spherical and cylindrical particles from a ribbed channel flow onto adjacent flow boundaries are obtained using large eddy simulation (LES) under the assumption of one-way coupling. Results indicate that spherical particles tend to accumulate on the vertical rib wall facing the mean-flow direction with little particle deposition onto surfaces immediately downstream of the rib. This preferential deposition is not predicted for cylindrical particles

  5. 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.

  6. Eliminating rib shadows in chest radiographic images providing diagnostic assistance.

    Science.gov (United States)

    Oğul, Hasan; Oğul, B Buket; Ağıldere, A Muhteşem; Bayrak, Tuncay; Sümer, Emre

    2016-04-01

    A major difficulty with chest radiographic analysis is the invisibility of abnormalities caused by the superimposition of normal anatomical structures, such as ribs, over the main tissue to be examined. Suppressing the ribs with no information loss about the original tissue would therefore be helpful during manual identification or computer-aided detection of nodules on a chest radiographic image. In this study, we introduce a two-step algorithm for eliminating rib shadows in chest radiographic images. The algorithm first delineates the ribs using a novel hybrid self-template approach and then suppresses these delineated ribs using an unsupervised regression model that takes into account the change in proximal thickness (depth) of bone in the vertical axis. The performance of the system is evaluated using a benchmark set of real chest radiographic images. The experimental results determine that proposed method for rib delineation can provide higher accuracy than existing methods. The knowledge of rib delineation can remarkably improve the nodule detection performance of a current computer-aided diagnosis (CAD) system. It is also shown that the rib suppression algorithm can increase the nodule visibility by eliminating rib shadows while mostly preserving the nodule intensity. PMID:26775736

  7. 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.)

  8. 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.

  9. 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.

  10. 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.

  11. Prototype negative ion sources for RIB generation

    Energy Technology Data Exchange (ETDEWEB)

    Alton, G.D.; Murray, S.N. [Oak Ridge National Lab., TN (United States); Welton, R.F.; Williams, C. [Oak Ridge National Lab., TN (United States)]|[Oak Ridge Inst. of Science and Engineering, TN (United States); Cui, B. [China Inst. of Atomic Energy, Beijing (China)

    1997-12-01

    Radioactive ion beams (RIBs) of {sup 17}F and {sup 18}F are of interest for investigation of astrophysical phenomena such as the hot CNO cycle and the rp stellar nuclear synthesis processes. In order to generate useful beam intensities of atomic F{sup {minus}}, the species must be efficiently and expediently released from the target material, thermally dissociated from fluoride release products during transport to the ionization chamber of the ion source, and efficiently ionized in the source upon arrival. The authors have conceived and evaluated two prototype negative ion sources for potential use for RIB generation: (1) a direct extraction source and (2) a kinetic ejection source. Both sources utilize Cs vapor to enhance F{sup {minus}} formation. The mechanical design features, operational parameters, ionization efficiencies for forming atomic F{sup {minus}} and delay times for transport of F and fluoride compounds for the respective sources are presented. The efficiency {eta} for formation and extraction of F{sup {minus}} for the direct extraction negative ion source is found to be {eta} {approximately} 1.0% while the characteristic delay time {tau} for transport of F and fluorides through the source is typically, {eta} {approximately} 120s; the analogous efficiencies and delay times for the kinetic ejection negative ion source are, respectively: {eta} = {approximately}3.2% and {tau} = {approximately}70s.

  12. Prototype negative ion sources for RIB generation

    International Nuclear Information System (INIS)

    Radioactive ion beams (RIBs) of 17F and 18F are of interest for investigation of astrophysical phenomena such as the hot CNO cycle and the rp stellar nuclear synthesis processes. In order to generate useful beam intensities of atomic F-, the species must be efficiently and expediently released from the target material, thermally dissociated from fluoride release products during transport to the ionization chamber of the ion source, and efficiently ionized in the source upon arrival. The authors have conceived and evaluated two prototype negative ion sources for potential use for RIB generation: (1) a direct extraction source and (2) a kinetic ejection source. Both sources utilize Cs vapor to enhance F- formation. The mechanical design features, operational parameters, ionization efficiencies for forming atomic F- and delay times for transport of F and fluoride compounds for the respective sources are presented. The efficiency η for formation and extraction of F- for the direct extraction negative ion source is found to be η ∼ 1.0% while the characteristic delay time τ for transport of F and fluorides through the source is typically, η ∼ 120s; the analogous efficiencies and delay times for the kinetic ejection negative ion source are, respectively: η = ∼3.2% and τ = ∼70s

  13. Unusual cause of shortness of breath after surgery for thoracic outlet syndrome

    Science.gov (United States)

    Schroeder, Jonathan Ryan; Kumar, Anjan; Savage, Edward; Rahaghi, Franck F

    2012-01-01

    A 31-year-old postal worker was diagnosed with bilateral thoracic outlet syndrome and scheduled for the first of two surgeries. The first procedure involved removal of the right first cervical rib, anterior and middle scalenes. On postoperative day 4, he developed shortness of breath. Chest radiograph showed a new pleural effusion on the right. Thoracentesis revealed a yellowish-red thick effusion. Based on the initial look of the fluid it was thought to be a haemorrhagic effusion with a purulent component, further testing revealed that he had developed a chylothorax. The patient was placed on a medium-chain triglyceride diet followed by chest tube drainage. After one day, the chest tube was removed due to minimal drainage, and he was discharged home the next day. Keeping this patient without food, on total parental nutrition, or pursuing surgical intervention was not necessary, as he had an excellent outcome from a very rare surgical complication. PMID:23047993

  14. 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)

  15. Rib enlargement in premature infants with bronchopulmonary dysplasia

    International Nuclear Information System (INIS)

    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)

  16. Comparison of Postoperative Pain Relief by Intercostal Block Between Pre-rib Harvest and Post-rib Harvest Groups

    International Nuclear Information System (INIS)

    Objective: To compare intercostal nerve block before and after rib harvest in terms of mean postoperative pain score and mean postoperative tramadol usage. Study Design: Randomized controlled trial. Place and Duration of Study: Department of Plastic Surgery, Mayo Hospital, KEMU, Lahore, from January 2011 to July 2012. Methodology: Patients (n = 120) of either gender with ASA class-I and II requiring autogenous costal cartilage graft were inducted. Patients having history of local anaesthetic hypersensitivity and age 60 years were excluded. Subjects were randomly assigned to pre-rib harvest (group-1) and post-rib harvest (group-2). Local anaesthetic mixture was prepared by adding 10 milliliters 2% lidocaine to 10 milliliters 0.5% bupivacaine to obtain a total 20 ml solution. Group-1 received local anaesthetic infiltration along the proposed incision lines and intercostals block before the rib harvest. Group-2 received the infiltration and block after rib harvest. Postoperative consumption of tramadol and pain scores were measured at 6 and 12 hours postoperatively using VAS. Results: Mean age was 31.43 A +- 10.78 years. The mean pain scores at 6 hours postoperatively were 1.033 A +- 0.609 and 2.4667 A +- 0.812 in pre-rib harvest and post-rib harvest groups respectively (p < 0.0001). The mean pain scores at 12 hours postoperatively were 1.45 A +- 0.565 and 3.65 A +- 0.633 in pre-rib harvest and post-rib harvest groups respectively (p < 0.0001). The mean tramadol used postoperatively in first 24 hours was 169 A +- 29.24 mg and 255 A +- 17.70 mg in prerib harvest and post-rib harvest groups respectively (p < 0.0001). Conclusion: Intercostal block administered before rib harvest as preemptive strategy result in decreased postoperative pain scores and narcotic use. (author)

  17. NUMERICAL INVESTIGATION ON FLOW CHARACTERISTICS IN RIBBED BEND

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Previous research[1]by the author has proved that ribbed bend technology is a simple and efficient anti-erosion method. The present paper is a further study to unveil the mechanism of the technology by using numerical method. The flow characteristics in ribbed bend were studied. A k-ε turbulence model was used and the simulations were carried out in the body-fitted coordinates. This procedure was confirmed to be credible by showing the satisfactory agreement between the predications and experimental results. It is concluded that the character of the longitudinal flow in ribbed bend especially in the concave parts between ribs has a beneficial effect on increasing the anti-erosion ability of ribbed bend but the secondary flow will have little effect on determining the particle trajectory.

  18. 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.

  19. 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...

  20. 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.

  1. 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.

  2. Risks of Cervical Cancer Screening

    Science.gov (United States)

    ... Treatment Cervical Cancer Prevention Cervical Cancer Screening Research Cervical Cancer Screening (PDQ®)–Patient Version What is screening? Screening ... These are called diagnostic tests . General Information About Cervical Cancer Key Points Cervical cancer is a disease in ...

  3. Cervical spine CT scan

    Science.gov (United States)

    ... cervical spine; Computed tomography scan of cervical spine; CT scan of cervical spine; Neck CT scan ... Risks of CT scans include: Being exposed to radiation Allergic reaction to contrast dye CT scans expose you to more radiation than ...

  4. Robinow Syndrome

    Directory of Open Access Journals (Sweden)

    Gökhan Gökalp

    2010-05-01

    Full Text Available Introduction: Robinow syndrome is characterized by dwarfism demonstrating short-limbed extremities, vertebral malsegmentation/malformation (hemivertebra, costal dysplasia, genital hypoplasia, and fetal facial appearance (wide and prominent forehead, hypertelorism, small and wide nose, molar hypoplasia, and retrognathia. It is a rare genetic disease which may present with either mild autosomal dominant form or severe recessive form. Vertebral and costal abnormalities are common diagnostic signs that may be severe. The disease presents with kyphoscoliosis and chest abnormalities along with thoracic vertebral fusion and hemivertebral appearance. Ribs may demonstrate fusion. Based on those involvements, the disease can be categorized as spondylothoracic, spondylocostal, ischiovertebral dysplasia, and cervicofaciothoracic syndrome.Diagnosis is established by the help of clinical characteristics. Radiography might contribute to the diagnosis by revealing changes in the skeletal system. Case Report: A three-year-old male patient presented with operated left undescendent testis and buried penis. On physical examination, he also had a dysmorphic face characterized by macrocephaly, hypertelorism, prominent eyes, a flattened nasal bridge, triangular-fish mouth, gingival hypertrophy and left hand clinodactyly. Radiographic examination documented mesomelic shortening of the radius-ulna, malsegmentation of the thoracal spine and the ribs fusion.Conclusion: Robinow syndrome is a rare syndrome which can be diagnosed by typical facial appearance and radiologic findings. (Journal of Current Pediatrics 2010; 8: 44-7

  5. Laminoplasty for Cervical Myelopathy

    OpenAIRE

    Ito, Manabu; Nagahama, Ken

    2012-01-01

    This article reviews cervical laminoplasty. The origin of cervical laminoplasty dates back to cervical laminectomy performed in Japan ~50 years ago. To overcome poor surgical outcomes of cervical laminectomy, many Japanese orthopedic spine surgeons devoted their lives to developing better posterior decompression procedures for the cervical spine. Thanks to the development of a high-speed surgical burr, posterior decompression procedures for the cervical spine showed vast improvement from the ...

  6. Radiation Induced Rib Fractures on Bone Scan after Breast Cancer Surgery and Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hae Won; Won, Kyoung Sook; Zeon, Seok Kil; Kim, Jin Hee [Keimyung University, School of Medicine, Daegu (Korea, Republic of)

    2009-08-15

    This study is to evaluate rib fractures on bone scan in breast cancer patients treated with breast cancer surgery and radiation therapy and to evaluate its relation with radiation therapy and operation modality. Two hundred seventy cases that underwent serial bone scan after breast cancer surgery and radiation therapy were enrolled. Bone scan and chest CT findings of rib fracture were analyzed. The rib uptake was seen in 74 of 270 cases (27.4%) on bone scan and 50 cases (18.5%) were confirmed to have rib fracture by chest CT. The rate of modified radical mastectomy in patients with rib fracture was significantly higher than that in patients without rib fracture (66.0% vs. 27.0%, p=0.000). The rate of additional radiation therapy to axillar or supraclavicular regions in patients with rib fracture was significantly higher than that in patients without rib fracture (62.0% vs. 28.6%, p=0.000). Rib fracture was seen most frequently at 1-2 years after radiation therapy (51.9%) and single rib fracture was seen most frequently (55.2%). Of total 106 rib fractures, focal rib uptake was seen in 94 ribs (88.7%) and diffuse rib uptake was seen in 12 ribs (11.3%). On one year follow-up bone scan, complete resolution of rib uptake was seen in 15 ribs (14.2%). On chest CT, the rate of fracture line in ribs with intense uptake was significantly higher than that in ribs with mild or moderate uptake (p=0.000). The rate of presence of fracture line in ribs with focal uptake was significantly higher than that in ribs with diffuse uptake (p=0.001). Rib fracture in breast cancer patients after radiation therapy was related to radiation portal and operation modality. It should be interpreted carefully as a differential diagnosis of bone metastasis.

  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. Diagnostic accuracy of self-reported symptomatic assessment versus per speculum/per vaginal examination for the diagnosis of vaginal/cervical discharge and lower abdominal pain syndromes among female sex workers

    Science.gov (United States)

    Kosambiya, Jayendrakumar K.; Baria, H. G.; Parmar, Rohit; Mhaskar, Rahul; Emmanuel, Patricia; Kumar, Ambuj

    2016-01-01

    Background: National AIDS Control Organization guidelines on enhanced syndromic case management of sexually transmitted infections (STIs) and reproductive tract infections (RTIs) require per speculum (P/S) and per vaginal (P/V) examinations for diagnosis of STIs. However, it is not known if the addition of P/S and P/V examinations to self-reported symptomatic assessment adds any value for the diagnosis of STI/RTI. Objective: To assess the diagnostic accuracy of P/S and P/V examinations compared with self-reported symptomatic assessment in a cohort of female sex workers (FSWs). Methods: We performed a cross-sectional study from August 2009 to June 2010, among 519 FSWs in Surat city, Gujarat, India. Symptomatic assessment for the presence or absence of vaginal/cervical discharge (VCD) or lower abdominal pain (LAP) was done using a self-administered questionnaire. After completion of the questionnaire, all participants underwent P/S and P/V examinations. Summary diagnostic accuracy measures were calculated. Results: Five hundred and nineteen FSWs between the ages of 18–49 years participated in the study. The median age of participants was 31 years. The prevalence of VCD and LAP syndromes based on vaginal discharge, LAP, or both was 56%, 5,–10%, respectively. The sensitivity of P/S and P/V examinations depending on symptomatic assessment ranged from 47% to 76%. The specificity ranged from 73% to 93%. The positive predictive value ranged from 25% to 83%, and the negative predictive value ranged from 56% to 98%. Conclusion: Symptomatic assessment alone is not adequate for the diagnosis of VCD and LAP syndromes and can lead to a significant number of missed cases (36%). A P/S and P/V examinations is critical for assessment of VCD and LAP syndromes and subsequent treatment.

  9. Diagnostic accuracy of self-reported symptomatic assessment versus per speculum/per vaginal examination for the diagnosis of vaginal/cervical discharge and lower abdominal pain syndromes among female sex workers

    Directory of Open Access Journals (Sweden)

    Jayendrakumar K Kosambiya

    2016-01-01

    Full Text Available Background: National AIDS Control Organization guidelines on enhanced syndromic case management of sexually transmitted infections (STIs and reproductive tract infections (RTIs require per speculum (P/S and per vaginal (P/V examinations for diagnosis of STIs. However, it is not known if the addition of P/S and P/V examinations to self-reported symptomatic assessment adds any value for the diagnosis of STI/RTI. Objective: To assess the diagnostic accuracy of P/S and P/V examinations compared with self-reported symptomatic assessment in a cohort of female sex workers (FSWs. Methods: We performed a cross-sectional study from August 2009 to June 2010, among 519 FSWs in Surat city, Gujarat, India. Symptomatic assessment for the presence or absence of vaginal/cervical discharge (VCD or lower abdominal pain (LAP was done using a self-administered questionnaire. After completion of the questionnaire, all participants underwent P/S and P/V examinations. Summary diagnostic accuracy measures were calculated. Results: Five hundred and nineteen FSWs between the ages of 18–49 years participated in the study. The median age of participants was 31 years. The prevalence of VCD and LAP syndromes based on vaginal discharge, LAP, or both was 56%, 5,–10%, respectively. The sensitivity of P/S and P/V examinations depending on symptomatic assessment ranged from 47% to 76%. The specificity ranged from 73% to 93%. The positive predictive value ranged from 25% to 83%, and the negative predictive value ranged from 56% to 98%. Conclusion: Symptomatic assessment alone is not adequate for the diagnosis of VCD and LAP syndromes and can lead to a significant number of missed cases (36%. A P/S and P/V examinations is critical for assessment of VCD and LAP syndromes and subsequent treatment.

  10. Biometric X-ray-function diagnosis of the cervical spine

    International Nuclear Information System (INIS)

    Subject of this study was the investigation of functional disorders of the cervical spine and their possible causal relation with the symptoms and signs of pathological cervical images. In order to approach this investigation with objectively measurable time criteria, functional X-ray diagnostics results to be the appropriate method. From the results obtained in individual and statistical group examinations as well as in examinations of the longitudinal section the conclusion is drawn that a functional disorder of the cervical spine may provoke a cervical syndrome. (APR)

  11. Self-assembled microsphere gratings on rib waveguides

    OpenAIRE

    Tai, Chao-Yi; Unal, Bayram; Wilkinson, James S.; Mohamed A. Ghanem; Bartlett, Philip N.

    2003-01-01

    We report the spectral transmission of a rib waveguide side-coupled to a self-assembled polystyrene microsphere array. A transmission stopband was observed at ? ~ 1590nm, showing the potential for realising wavelength-selective devices

  12. 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.

  13. Cervical Artery Dissection: Emerging Risk Factors

    OpenAIRE

    Micheli, S.; Paciaroni, M; Corea, F; Agnelli, G.; M. Zampolini; Caso, V

    2010-01-01

    Cervical artery dissection (CAD) represents an increasingly recognized cause of stroke and the most common cause of ischemic stroke in young adults. Many factors have been identified in association with CAD such as primary disease of arterial wall (fibrodysplasia) and other non-specific diseases related to CAD like Ehlers Danlos-syndrome IV, Marfan’s syndrome, vessel tortuosity. Moreover, an underlying arteriopathy which could be in part genetically determined, has been suspected. The rule of...

  14. Carpal tunnel syndrome, syndrome of partial thenar atrophy, and W. Russell Brain: a historical perspective.

    Science.gov (United States)

    Boskovski, Marko T; Thomson, J Grant

    2014-09-01

    This article presents the history of the discovery of compression of the median nerve in the carpal tunnel without an identifiable cause as a distinct clinical entity. By analyzing primary sources, we show that, at the beginning of the twentieth century, physicians described patients with paresthesias and numbness in the hands, most prominent at night, accompanied by bilateral symmetrical atrophy along the radial side of thenar eminence. At the time, the 2 most influential hypotheses regarding etiology were, first, compression of the lower trunk of the brachial plexus by a cervical or first rib, and second, compression of the thenar branch of the median nerve as it passes beneath the anterior annular ligament of the wrist. The condition was named syndrome of partial thenar atrophy and was considered a distinct clinical entity. In 1946, after extensive analysis, neurologist Walter Russell Brain concluded that both sensory and motor symptoms of the syndrome were caused by "compression neuritis" of the median nerve in the carpal tunnel. At his suggestion, surgeon Arthur Dickson Wright performed decompression of the nerve by "an incision of the carpal ligament," with excellent results. Brain presented this work at the Royal Society of Medicine in London in 1946 and published his landmark paper in Lancet the following year. In so doing, he established the basis for the disease we know today as idiopathic carpal tunnel syndrome. Unfortunately, in 1947, Brain did not realize that another "condition" with the same clinical picture but without atrophy of the thenar muscles, known as acroparesthesia at the time, was actually the same disease as syndrome of partial thenar atrophy, but of lesser severity. As a result of Brain's influence, 7 other papers were published by 1950. Between 1946 and 1950, there were at least 10 papers that presented, in total, 31 patients (26 women) who exhibited symptoms of compression of the median nerve without an identifiable cause and underwent

  15. 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.

  16. 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.

  17. Upper extremity and rib stress fractures in a child

    International Nuclear Information System (INIS)

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

  18. 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. PMID:26559562

  19. Unusual rib tumor: Parosteal lipoma with extensive osteochondromatous metaplasia

    Directory of Open Access Journals (Sweden)

    Sathe Pragati

    2008-10-01

    Full Text Available Lipomas of the bone usually occur in the long bones and are seen in the fifth to seventh decade of life. Rib lipomas are rare and those having parosteal location are even rarer. We report a case of parosteal lipoma of the rib in a young male with some unique features. This is the fifth case of its kind to be reported in literature.

  20. 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.

  1. Nasal reconstruction with articulated irradiated rib cartilage

    International Nuclear Information System (INIS)

    Nasal structural reconstruction is a formidable task in cases where there is loss of support to both the nasal dorsum and tip. A multitude of surgical approaches and materials have been used for the correction of the saddle-nose deformity with varying degrees of success. Articulated irradiated rib cartilage inserted through an external rhinoplasty approach was used to reconstruct nasal deformities in 18 patients over a 6-year period. Simultaneous use of a midline forehead flap to reconstruct the overlying soft tissue was required in four cases. Follow-up ranged from 1 to 6 years (mean, 2.8 years). Results were rewarding in most cases with marked improvement in nasal support and airway. Revision and/or replacement secondary to trauma or warping of the graft was required in four cases. None of the patients exhibited infection, extrusion, or noticeable resorption. A description of the surgical technique, review of all the cases, and recommendation for continued use of this graft material are discussed

  2. Nasal reconstruction with articulated irradiated rib cartilage

    Energy Technology Data Exchange (ETDEWEB)

    Murakami, C.S.; Cook, T.A.; Guida, R.A. (Univ. of Washington School of Medicine, Seattle (USA))

    1991-03-01

    Nasal structural reconstruction is a formidable task in cases where there is loss of support to both the nasal dorsum and tip. A multitude of surgical approaches and materials have been used for the correction of the saddle-nose deformity with varying degrees of success. Articulated irradiated rib cartilage inserted through an external rhinoplasty approach was used to reconstruct nasal deformities in 18 patients over a 6-year period. Simultaneous use of a midline forehead flap to reconstruct the overlying soft tissue was required in four cases. Follow-up ranged from 1 to 6 years (mean, 2.8 years). Results were rewarding in most cases with marked improvement in nasal support and airway. Revision and/or replacement secondary to trauma or warping of the graft was required in four cases. None of the patients exhibited infection, extrusion, or noticeable resorption. A description of the surgical technique, review of all the cases, and recommendation for continued use of this graft material are discussed.

  3. WDR35 Mutation in Siblings with Sensenbrenner Syndrome: A Ciliopathy With Variable Phenotype

    OpenAIRE

    Bacino, Carlos A.; Dhar, Shweta U.; Brunetti-Pierri, Nicola; Lee, Brendan; Bonnen, Penelope E

    2012-01-01

    Sensenbrenner syndrome and unclassified short rib-polydactyly conditions are ciliopathies with overlapping phenotypes and genetic heterogeneity. Mutations in WDR35 were identified recently in a sub-group of patients with Sensenbrenner syndrome and in a single family that presented with an unclassified form of short-rib polydactyly (SRP) syndrome. We report on siblings with an unusual combination of phenotypes: narrow thorax, short stature, minor anomalies, developmental delay, and severe hepa...

  4. Relationship between cervical spondylotic radiculopathy and carpal tunnel syndrome%神经根型颈椎病与腕管综合征的关系

    Institute of Scientific and Technical Information of China (English)

    马彦; 崔丽英; 管宇宙; 刘明生; 杜华; 吴双; 林楠

    2015-01-01

    Objective To explore the relationship between cervical spondylotic radiculopathy (CSR) and carpal tunnel syndrome (CTS) by investigating their electrophysiological characteristics and the incidence of CSR root injury and root injury complicating with CTS.Methods One hundred and twenty-four cases of CSR diagnosed in Peking Union Medical College Hospital from September 2013 to February 2014 by electromyography (EMG) were recruited.According to the results of EMG,patients were divided into root injury and root injury complicating with CTS groups.The distal motor latency (DML),motor nerve conduction velocity (MCV),sensory nerve conduction velocity (SCV),sensory nerve action potential (SNAP),compound muscle action potential (CMAP) and spontaneous potential (SP) were compared between the two groups.Results There were 81 (65.3%) cases with root injury,11 cases with double sides injury and 29 cases with normal EMG among these 124 patients.The CMAP,DML,MCV,SCV and SNAP were normal in 76 cases,CMAP lowered 5%-12% in 3 cases,DML extended 3% and 9% in 2 cases.There were 14 cases (11.3%) with concomitant CTS (female 10 cases and male 4 cases,double sides CTS 10 cases).Among the 14 cases with concomitant CTS,there were 9 cases with simply sensory nerve conduction abnormality,SCV slowing down 26%-47%,SNAP reducing 58%-86% or normal,while other 5 cases with motor conduction abnormality as well as sensory nerve conduction abnormality,CMAP reducing 21%-78%,DML extending 27%-39% in 3 cases,MCV slowing down 32% and 40% in 2 cases.Five cases had spontaneous electricity position movement in the abductor pollicis brevis.The incidence of root injury complicating with CTS in C6 (27.4%,9/33),C7 (26.9%,7/26) and C8 (5/7) showed statistically significant difference (x2 =5.96,P < 0.01).Conclusions There is a high incidence of root injury and CTS in CSR patients,indicating a possible double crush between CSR and CTS.%目的 研究神经根型颈椎病(CSR)

  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. 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 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.

  7. 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

  8. 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 < 0·01) to muscle to bone ratio R(2) = 0·41). Data suggest that muscle to bone ratios differ widely among beef carcasses of similar genetic-management history and that there are carcass measures useful for predicting muscle to bone ratio. PMID:22054706

  9. 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 ...

  10. 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, Medical Illustration Source: National Cancer Institute ...

  11. 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....... However, the diffuseness assumption is not always valid. One such example is a rib-reinforced plate typically found in a lightweight floor with wooden joists. Other examples can be found in aircraft and ship structures. The structural intensity of a ribbed plate is computed at low to mid frequencies using...... 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...

  12. Production of high-intensity RIB at SPES

    International Nuclear Information System (INIS)

    The SPES Project at INFN Laboratori Nazionali di Legnaro SPES Technichal Design Report - (www.lnl.infn.it/~spes/TDR2008/) is now in its early construction phase. SPES is an ISOL type Radioactive Ion Beam (RIB) J.Khalili, E. Roeckl, The Euroschool Lect. on Phys. with Exotic Beams, Vol. II, Springer (2006) facility for the production of neutron-rich radioactive nuclei by uranium fission. RIBs will be produced by proton induced fission on a UCx multi foil direct target at a rate of 1013 fps, more than one order of magnitude larger than the currently available beam intensities. The recent developments on the production, ionization and acceleration of RIBs at SPES are hereafter presented.

  13. Rib osteomyelitis in children. Early radiologic and ultrasonic findings

    International Nuclear Information System (INIS)

    The earliest radiographic changes of osteomyelitis in the long bones is deep-seated edema manifesting as soft tissue swelling and obliteration of the intermuscular planes adjacent to the affected bone. Similarly, the early change of rib osteomyelitis is pericostal edema demonstrated by soft tissue swelling of the thoracic wall accompanied by an adjacent inward pleural displacement. In both osteomyelitis of the rib and the long bones, the bony changes will appear 1-2 weeks later. Pericostal edema can be readily diagnosed by ultrasound scan. Pericostal edema, although non specific and can occur in other conditions, yet it is a strong warning sign, set wihin the overall clinical picture of osteomyelitis. (orig.)

  14. Breathing Thorax Simulation based on Pleura Behaviour and Rib Kinematics

    OpenAIRE

    Didier, Anne-Laure; Villard, Pierre-Frédéric; Bayle, Jean-Yves; Beuve, Michaël; Shariat, Behzad

    2007-01-01

    To monitor a lung mechanical model and then predict tumour motion we proposed a approach based on the pleura physiology. By comparing the predictions to landmarks set by medical experts, we observed better results with regards to the one obtained with approaches found in the literature. Beside, we focus on the rib cage kinematics, which play a significant role in the pleura outer-surface motion and therefore in the lung motion. We proposed a kinematic model of the rib cage based on the finite...

  15. Cervical Cancer Stage IA

    Science.gov (United States)

    ... historical Searches are case-insensitive Cervical Cancer Stage IA Add to My Pictures View /Download : Small: 720x576 ... Large: 3000x2400 View Download Title: Cervical Cancer Stage IA Description: Stage IA1 and IA2 cervical cancer; drawing ...

  16. [Thoracic outlet syndrome. Apropos of 112 cases: toward a more refined tactical approach].

    Science.gov (United States)

    Batt, M; Griffet, J; Scotti, L; Le Bas, P

    1983-12-01

    A total of 112 operations were performed in 87 patients with a cervicobrachial syndrome, 25 with bilateral lesions, over a period of 8 years. Surgery was reserved for severe or complicated cases. Presenting signs were complex and intricated in 53 p. cent of cases, with neurological lesions predominating. Absence of radial pulse after 90 degrees abduction of the arm, present in 87 p. cent of patients, is not a specific diagnostic test as positive results are obtained in over one-third of a normal population. Electromyography confirmed clinical lesions of the brachial plexus in only one out of 8 cases. A more precise and more sensitive procedure for electromyographic exploration of the plexus was therefore established. Dynamic arteriography of the upper limbs was not conducted routinely (70 p. cent of cases), but was reserved for arterial, neuro-arterial, and arterial and venous forms. The axillary approach was used exclusively (94 times), between 1974 and 1980. However, the frequency of postoperative complications (10 p. cent), and the high level of poor or incomplete results (19.5 p. cent) led to the reestablishment of the supraclavicular route of approach. The latter is used preferentially in neurological forms (57 p. cent of cases in this series) in cases requiring correction of an arterial lesion (aneurysm, ulcerated plaque), or when a cervical rib or apophysomegalia of the 7th cervical vertebra is associated. PMID:6671997

  17. 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.)

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

    International Nuclear Information System (INIS)

    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.)

  19. 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.

  20. Cervical computed tomography

    International Nuclear Information System (INIS)

    This book describes the possibilities of cervical computed tomography with the apparatus available at present. The normal anatomy of the cervical region as it appears in computed tomography is described with special regard to its compartimental structure and functional aspects; this is supplemented by anatomically normal measures obtained from cervical computed tomograms of 60 healthy individuals of different age and both sexes. The morphology of cervical anomalies obtained via CT and of the various acquired cervical disease processes is discussed and illustrated by means of the authors' own observations; the diagnostic value of the findings obtained by CT is discussed, a diagnosis is set up. (orig./MG)

  1. 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.

  2. 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. PMID:26557566

  3. 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. PMID:22547844

  4. 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

  5. Multi-start helically ribbed fuel pins for CAGR

    International Nuclear Information System (INIS)

    The heat transfer performance of the current reference design CAGR fuel is achieved by roughening the fuel pins with transverse or single-start helical ribs about 0.25 mm high and 2 mm pitch. By machining helical ribs with several starts the so called multi-start helically ribbed fuel pin is produced. These ribs present themselves at a significant angle to the direction of coolant flow and impart a 'swirl' to it. Early test work showed that the multi-start surface could give intrinsically better cluster heat transfer than the reference design surface for a given pressure drop. Furthermore the 'swirl' significantly increases gas mixing, especially when pins of opposite hand are arranged in adjacent positions in the fuel cluster. Thus reduced systematic and random heat transfer factors arise from less sensitivity to variations in dimensions and flux distributions. This leads to lower fuel pin temperatures. This paper shows how the experimental loading of multi-start fuel in Hunterston B was developed and discusses the advantages. It also indicates how further gains can be achieved and puts forward suggestions for the next steps in the development of multi-start fuel. (author)

  6. Comparison of Computed Tomography and Chest Radiography in the Detection of Rib Fractures in Abused Infants

    Science.gov (United States)

    Wootton-Gorges, Sandra L.; Stein-Wexler, Rebecca; Walton, John W.; Rosas, Angela J.; Coulter, Kevin P.; Rogers, Kristen K.

    2008-01-01

    Purpose: Chest radiographs (CXR) are the standard method for evaluating rib fractures in abused infants. Computed tomography (CT) is a sensitive method to detect rib fractures. The purpose of this study was to compare CT and CXR in the evaluation of rib fractures in abused infants. Methods: This retrospective study included all 12 abused infants…

  7. Polarized single-mode condition for SOI rib waveguide with large cross section

    Science.gov (United States)

    Yuan, Dengpeng; Dong, Ying; Liu, Yujin; Li, Tianjian; Zhang, Xudong; Tan, Yushan

    2015-08-01

    In this paper the single mode condition of silicon-on-insulator (SOI) rib waveguide with large cross section is investigated based on the effective index method (EIM) by using numerical computation and analytical derivation with the consideration of the polarization effects. A polarized single-mode condition for SOI rib waveguide with large cross section is presented, the results from analytical derivation are highly concordant with that from numerical computation. For the vertical single-mode condition, the deviations between HE and EH modes correlate oppositely with the total rib height of rib waveguide, and the critical rib height ratio gradually approaches but never equals to 0.5 with the increase of the total rib height. There, HE mode and EH mode are commonly known as quasi-transverse-electric (TE) mode and quasi-transverse-magnetic (TM) mode respectively. The deviation of the critical rib width between HE and EH modes for the lateral single-mode condition is relatively small, which is a function of the rib height ratio but irrelevant to the total rib height for the specified index profile. The fact that the total rib height, index profile, and polarization of modes have effects on the single-mode condition of SOI rib waveguide with large cross section was demonstrated in this work, which was not discussed in the previous works. The results in this work can give guidance to design, simulation and fabrication of SOI rib waveguide with large cross section in practical applications.

  8. Modified steel basket technique for the treatment of equine cervical vertebral stenotic myelopathy - a case report

    OpenAIRE

    Frederico Fernandes Araújo; Monalisa Lukascek Castro; Luciane Laskoski; Mariana Pavelski; Ivan Deconto; Peterson Triches Dornbusch

    2015-01-01

    Cervical vertebral stenotic myelopathy (CVSM), also known as cervical ataxia or wobbler syndrome, is caused by the narrowing of the medullary canal due to a malformation of the cervical vertebrae, resulting in compression of the spinal cord and neurological alterations such as ataxia, hypermetria, weakness, and abnormal stance. The treatment options can be conservative or surgical, with varied effectiveness. The most appropriate surgical technique in the majority of cases is arthrodesis, prov...

  9. Fixation of a human rib by an intramedullary telescoping splint anchored by bone cement.

    Science.gov (United States)

    Liovic, Petar; Šutalo, Ilija D; Marasco, Silvana F

    2016-09-01

    A novel concept for rib fixation is presented that involves the use of a bioresorbable polymer intramedullary telescoping splint. Bone cement is used to anchor each end of the splint inside the medullary canal on each side of the fracture site. In this manner, rib fixation is achieved without fixation device protrusion from the rib, making the splint completely intramedullary. Finite element analysis is used to demonstrate that such a splint/cement composite can preserve rib fixation subjected to cough-intensity force loadings. Computational fluid dynamics and porcine rib experiments were used to study the anchor formation process required to complete the fixation. PMID:26733094

  10. Unsteady flow patterns in the vicinity of heated wall-mounted transverse ribs.

    Science.gov (United States)

    Polidori, Guillaume; Padet, Jacques

    2002-10-01

    This paper deals with experimental modeling of the unsteady junction flow features in the vicinity of an isoflux heated wall with mounted insulated rectangular ribs representing three distinctive ribbed test geometries. Both flow visualizations and surface temperature distributions show that the blockage effect upstream of the ribs, as well as the presence of complex eddy structures inside the open cavities, significantly affect the heat transfer process. All the configurations indicate degraded heat transfer performance in the area close to the ribs and an enhancement just downstream from the last rib. PMID:12496017

  11. 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.

  12. 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.

  13. Get Tested for Cervical Cancer

    Science.gov (United States)

    ... Cervical Cancer Print This Topic En español Get Tested for Cervical Cancer Browse Sections The Basics Overview ... be cured. How often should I get screened (tested)? How often you should get screened for cervical ...

  14. Cervical cancer - screening and prevention

    Science.gov (United States)

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

  15. 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 ...

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

    Science.gov (United States)

    Geze, Sukran; Arslan, Ufuk; Tusat, Mustafa

    2015-01-01

    Jarcho 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. PMID:26323743

  17. [Anaesthesia for infant with Jarcho Levin syndrome: case report].

    Science.gov (United States)

    Geze, Sukran; Arslan, Ufuk; Tusat, Mustafa

    2015-01-01

    Jarcho 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. PMID:26363698

  18. 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.

  19. 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...

  20. Cognitive deficits in patients after soft tissue injury of the cervical spine.

    Science.gov (United States)

    Radanov, B P; Dvorák, J; Valach, L

    1992-02-01

    Fifty-one patients suffering from soft tissue injury of the cervical spine underwent clinical and psychometric examination. Clinical interview evaluated subjective complaints and formal testing of self-estimated cognitive impairment, divided attention, and speed of information processing. Results indicated at least two different syndromes: 1) the "cervicoencephalic syndrome," characterized by headache, fatigue, dizziness, poor concentration, disturbed accommodation, and impaired adaptation to light intensity; and 2) the "lower cervical spine syndrome," which is accompanied by cervical and cervicobrachial pain. When comparing patients with either of these two syndromes, those suffering from cervicoencephalic syndrome had significantly poorer results when tested for divided attention. Speed of information processing was reduced to a comparable extent in both syndromes. These findings were not related to the length of the post-traumatic interval. Reduced processing of working memory is assumed, which may account for more global cognitive problems as well as secondary neurotic reaction. PMID:1553581

  1. Morphometric analysis of variation in the ribs with age and sex.

    Science.gov (United States)

    Weaver, Ashley A; Schoell, Samantha L; Stitzel, Joel D

    2014-08-01

    Rib cage morphology changes with age and sex are expected to affect thoracic injury mechanisms and tolerance, particularly for vulnerable populations such as pediatrics and the elderly. The size and shape variation of the external geometry of the ribs was characterized for males and females aged 0-100 years. Computed tomography (CT) scans from 339 subjects were analyzed to collect between 2700 and 10 400 homologous landmarks from each rib. Rib landmarks were analyzed using the geometric morphometric technique known as Procrustes superimposition. Age- and sex-specific functions of 3D rib morphology were produced representing the combined size and shape variation and the isolated shape variation. Statistically significant changes in the size and shape variation (P < 0.0001) and shape variation (P < 0.0053) of all 24 ribs were found to occur with age in males and females. Rib geometry, location, and orientation varied according to the rib level. From birth through adolescence, the rib cage experienced an increase in size, a decrease in thoracic kyphosis, and inferior rotation of the ribs relative to the spine within the sagittal plane. From young adulthood into elderly age, the rib cage experienced increased thoracic kyphosis and superior rotation of the ribs relative to the spine within the sagittal plane. The increased roundedness of the rib cage and horizontal angling of the ribs relative to the spine with age influences the biomechanical response of the thorax. With the plane of the rib oriented more horizontally, loading applied in the anterior-posterior direction will result in increased deformation within the plane of the rib and an increased risk for rib fractures. Thus, morphological changes may be a contributing factor to the increased incidence of rib fractures in the elderly. The morphological functions derived in this study capture substantially more information on thoracic skeleton morphology variation with age and sex than is currently available

  2. Morphometric analysis of variation in the ribs with age and sex

    Science.gov (United States)

    Weaver, Ashley A; Schoell, Samantha L; Stitzel, Joel D

    2014-01-01

    Rib cage morphology changes with age and sex are expected to affect thoracic injury mechanisms and tolerance, particularly for vulnerable populations such as pediatrics and the elderly. The size and shape variation of the external geometry of the ribs was characterized for males and females aged 0–100 years. Computed tomography (CT) scans from 339 subjects were analyzed to collect between 2700 and 10 400 homologous landmarks from each rib. Rib landmarks were analyzed using the geometric morphometric technique known as Procrustes superimposition. Age- and sex-specific functions of 3D rib morphology were produced representing the combined size and shape variation and the isolated shape variation. Statistically significant changes in the size and shape variation (P < 0.0001) and shape variation (P < 0.0053) of all 24 ribs were found to occur with age in males and females. Rib geometry, location, and orientation varied according to the rib level. From birth through adolescence, the rib cage experienced an increase in size, a decrease in thoracic kyphosis, and inferior rotation of the ribs relative to the spine within the sagittal plane. From young adulthood into elderly age, the rib cage experienced increased thoracic kyphosis and superior rotation of the ribs relative to the spine within the sagittal plane. The increased roundedness of the rib cage and horizontal angling of the ribs relative to the spine with age influences the biomechanical response of the thorax. With the plane of the rib oriented more horizontally, loading applied in the anterior-posterior direction will result in increased deformation within the plane of the rib and an increased risk for rib fractures. Thus, morphological changes may be a contributing factor to the increased incidence of rib fractures in the elderly. The morphological functions derived in this study capture substantially more information on thoracic skeleton morphology variation with age and sex than is currently available in

  3. 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.

  4. Infantile cortical hyperostosis of the ribs (Caffey's disease)

    International Nuclear Information System (INIS)

    Infantile cortical hyperostosis (ICH), or Caffey's disease, first reported by Caffey and Silverman in 1945, is a benign condition characterized radiographically by corticoperiosteal thickening of bone with subperiosteal new bone formation. Sites of occurrence vary, with the mandible being involved in 75%-80% of cases. The following is a cae report of ICH limited to four contiguous ribs with no evidence of mandibular involvement. (orig.)

  5. Stress fracture of the first rib in a weightlifter.

    Science.gov (United States)

    Eng, John; Westcott, James; Better, Nathan

    2008-05-01

    A 20-year-old woman elite weightlifter presented with acute onset debilitating right shoulder pain while attempting the "clean and jerk." There was no previous relevant history, including no prior fracture in the region. Examination confirmed vague tenderness in the right supraclavicular fossa with no discernible neurologic or vascular deficit within the right arm. X-ray was normal. The patient had a bone scan, including SPECT, suggesting a fracture of the right first rib, subsequently confirmed on CT examination. PMID:18431162

  6. Reducing the morbidity involved in harvesting autogenous rib cartilage.

    Science.gov (United States)

    Siegert, Ralf; Magritz, Ralph

    2009-08-01

    Although the use of autogenous cartilage is the gold standard in auricular reconstruction, its main disadvantage is the morbidity due to harvesting the cartilage. This includes postoperative pain, visible scar, and possibly asymmetry and reduced stability of the thorax. To reduce all of these drawbacks, we describe some modifications that reduce pain to a low tolerable level, hide the scar invisibly in the submammary fold in females, and induce regeneration as well reestablish stability of the rib defect. PMID:19809948

  7. 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.

  8. 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.

  9. 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

  10. Circulation, bone scans, and tetracycline labeling in microvascularized and vascular bundle implanted rib grafts

    International Nuclear Information System (INIS)

    The circulation in microvascularized rib grafts has been compared with that in conventional rib grafts and in those augmented by a direct vascular bundle implantation into the bone grafts. A new experimental model has been designed to correlate vascular perfusion, bone scan patterns, tetracycline labeling, and histological findings in these bone grafts. Posterior microvascularized rib grafts were found to have a circulatory pattern identical to that of the normal rib. Failed microvascularized rib grafts were revascularized more slowly than conventional rib grafts. Vascular bundles implanted into rib grafts remained patent and increased the rate of revascularization. The stripping or preservation of periosteum had no observable effects on the rate or pattern of conventional rib graft revascularization. The circulation in rib grafts was accurately reflected in technetium 99 bone scans, as was the patency of the anastomoses of microvascularized rib grafts and of implanted vascular bundles. In contrast, tetracycline labeling was repeatedly observed in avascular areas of bone grafts and, therefore, is not a reliable indicator of bone graft circulation

  11. 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.

  12. 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

    OpenAIRE

    Jorge Miguel Silva Ribeiro Olliveira Alves; Paulo Peixoto; Nuno Ferreira; Rui Martins; João Correia; Fernando Silva; Carlos de Sousa

    2012-01-01

    Descrição do caso clínico de um paciente com síndrome de Brown-Séquard por hérnia de disco cervical em duplo nível, 40 anos, do sexo masculino, sem história de patologia prévia da coluna cervical; teve início insidioso de paresia nos membros direitos, associada à diminuição da sensibilidade dolorosa e térmica do hemicorpo esquerdo, após mergulho que ocasionou trauma indireto da coluna cervical. A RM da coluna cervical mostrou hérnias discais paramedianas direitas nos níveis C4-C5 e C5-C6 com ...

  13. CDC's Cervical Cancer Study

    Science.gov (United States)

    ... in Cancer Moonshot Stay Informed CDC’s Cervical Cancer Study Language: English Español (Spanish) Recommend on Facebook Tweet ... year. As part of CDC’s Cervical Cancer (Cx3) Study, we surveyed a sample of both health care ...

  14. Preliminary study of rib articulated model based on dynamic fluoroscopy images

    Science.gov (United States)

    Villard, Pierre-Frederic; Escamilla, Pierre; Kerrien, Erwan; Gorges, Sebastien; Trousset, Yves; Berger, Marie-Odile

    2014-03-01

    We present in this paper a preliminary study of rib motion tracking during Interventional Radiology (IR) fluoroscopy guided procedures. It consists in providing a physician with moving rib three-dimensional (3D) models projected in the fluoroscopy plane during a treatment. The strategy is to help to quickly recognize the target and the no-go areas i.e. the tumor and the organs to avoid. The method consists in i) elaborating a kinematic model of each rib from a preoperative computerized tomography (CT) scan, ii) processing the on-line fluoroscopy image and iii) optimizing the parameters of the kinematic law such as the transformed 3D rib projected on the medical image plane fit well with the previously processed image. The results show a visually good rib tracking that has been quantitatively validated by showing a periodic motion as well as a good synchronism between ribs.

  15. 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

  16. Abnormal Cervical Cancer Screening Test Results

    Science.gov (United States)

    ... AQ FREQUENTLY ASKED QUESTIONS FAQ187 GYNECOLOGIC PROBLEMS Abnormal Cervical Cancer Screening Test Results • What is cervical cancer screening? • What causes abnormal cervical cancer screening test ...

  17. Complicações arteriais da síndrome do desfiladeiro torácico Arterial complications of thoracic outlet syndrome

    Directory of Open Access Journals (Sweden)

    Fernando Thomazinho

    2008-06-01

    Full Text Available As manifestações clínicas da síndrome do desfiladeiro torácico são predominantemente neurológicas, sendo as complicações arteriais raras, mas potencialmente graves. Entre elas, devemos citar os aneurismas com complicações embólicas e a trombose. Os autores relatam o caso de uma mulher de 37 anos com costela cervical bilateral que apresentou embolia no membro superior direito originada de um aneurisma pós-estenótico da artéria subclávia direita, além de apresentar ectasia da subclávia esquerda também por compressão.The clinical manifestations of thoracic outlet syndrome are mainly neurological. Although arterial complications are rare, they are potentially severe. Among these are aneurysms associated with embolism and thrombosis. The authors report a case of a 37 year-old woman with bilateral cervical rib that developed embolism in the right upper limb from a poststenotic right subclavian artery aneurysm and dilatation of the left subclavian artery, both due to compression.

  18. Diaphragm muscle shortening modulates kinematics of lower rib cage in dogs

    OpenAIRE

    Chu, Iris; Fernandez, Cristina; Rodowicz, Kathleen Allen; Lopez, Michael A.; Lu, Raymond; Hubmayr, Rolf D.; Boriek, Aladin M.

    2010-01-01

    We tested the hypothesis that diaphragm muscle shortening modulates volume displacement and kinematics of the lower rib cage in dogs and that posture and mode of ventilation affect such modulation. Radiopaque markers were surgically attached to the lower three ribs of the rib cage and to the midcostal region of the diaphragm in six dogs of ∼8 kg body masses, and the locations of these markers were determined by a biplane fluoroscopy system. Three-dimensional software modeling techniques were ...

  19. Focusing of high intensity ultrasound through the rib cage using a therapeutic random phased array

    OpenAIRE

    Bobkova, Svetlana; Gavrilov, Leonid; Khokhlova, Vera; Shaw, Adam; Hand, Jeffrey; ,

    2010-01-01

    A method for focusing high intensity ultrasound through a rib cage that aims to minimize heating of the ribs whilst maintaining high intensities at the focus (or foci) is proposed and tested theoretically and experimentally. Two approaches, one based on geometric acoustics and the other accounting for diffraction effects associated with propagation through the rib cage, are investigated theoretically for idealized source conditions. It is shown that for an idealized radiator the diffraction a...

  20. Quantitative analysis of rib movement based on dynamic chest bone images: preliminary results

    Science.gov (United States)

    Tanaka, R.; Sanada, S.; Oda, M.; Mitsutaka, M.; Suzuki, K.; Sakuta, K.; Kawashima, H.

    2014-03-01

    Rib movement during respiration is one of the diagnostic criteria in pulmonary impairments. In general, the rib movement is assessed in fluoroscopy. However, the shadows of lung vessels and bronchi overlapping ribs prevent accurate quantitative analysis of rib movement. Recently, an image-processing technique for separating bones from soft tissue in static chest radiographs, called "bone suppression technique", has been developed. Our purpose in this study was to evaluate the usefulness of dynamic bone images created by the bone suppression technique in quantitative analysis of rib movement. Dynamic chest radiographs of 10 patients were obtained using a dynamic flat-panel detector (FPD). Bone suppression technique based on a massive-training artificial neural network (MTANN) was applied to the dynamic chest images to create bone images. Velocity vectors were measured in local areas on the dynamic bone images, which formed a map. The velocity maps obtained with bone and original images for scoliosis and normal cases were compared to assess the advantages of bone images. With dynamic bone images, we were able to quantify and distinguish movements of ribs from those of other lung structures accurately. Limited rib movements of scoliosis patients appeared as reduced rib velocity vectors. Vector maps in all normal cases exhibited left-right symmetric distributions, whereas those in abnormal cases showed nonuniform distributions. In conclusion, dynamic bone images were useful for accurate quantitative analysis of rib movements: Limited rib movements were indicated as a reduction of rib movement and left-right asymmetric distribution on vector maps. Thus, dynamic bone images can be a new diagnostic tool for quantitative analysis of rib movements without additional radiation dose.

  1. Nevoid basal cell carcinoma syndrome; Naevoid Basalzellkarzinom-Syndrom

    Energy Technology Data Exchange (ETDEWEB)

    Grgic, A.; Heinrich, M.; Heckmann, M.; Kramann, B. [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany). Abt. fuer Diagnostische und Interventionelle Radiologie; Aliani, S. [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany). Klinik fuer Kinder- und Jugendmedizin; Dill-Mueller, D. [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany). Hautklinik und Poliklinik; Uder, M. [Erlange-Nuernberg Univ. (Germany). Inst. fuer Diagnostische Radiologie

    2005-07-01

    Nevoid Basal Cell Carcinoma Syndrome (NBCCS) is an autosomal-dominant disorder characterized by multiple basal cell carcinomas, jaw cysts, palmar/plantar pits, calcification of the falx cerebri, and spine and rib anomalies. The combination of clinical, imaging, and histological findings is helpful in identifying NBCCS patients. Imaging plays a crucial role in evaluation of these patients. We present a wide variety of clinical and radiological findings characteristic of this disease. (orig.)

  2. Cervical intramedullary schwannoma: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Mario Ganau

    2009-12-01

    Full Text Available Intramedullary schwannomas unrelated with neurofibromatosis are uncommon tumors, but if correctly diagnosed and properly treated they may have a good prognosis. They have a wide range of clinical presentations, commonly presenting as a slowly progressive motor or sensory syndrome. We present a case report of a patient without neurofibromatosis with a surgically treated cervical intramedullary schwannoma.

  3. MRI and PET Imaging in Predicting Treatment Response in Patients With Stage IB-IVA Cervical Cancer

    Science.gov (United States)

    2016-06-24

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Cervical Undifferentiated Carcinoma; Recurrent Cervical Carcinoma; Stage IB2 Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage IIIA Cervical Cancer; Stage IIIB Cervical Cancer; Stage IVA Cervical Cancer

  4. Primary rib tumours in children (report of 27 cases with short literature review)

    International Nuclear Information System (INIS)

    27 cases of primary malignant and benign rib tumours are reported. The most common malignant rib tumour in childhood is Ewing sarcoma (20 cases). Some other rare bone tumours and tumorous conditions (reticulosarcoma, aneurysmal bone cyst, monostotic rib eosinophilic granuloma, osteoid osteoma and lymphangioma) are also described. In the authors' opinion Ewing sarcoma presents with characteristic clinico-radiographic findings in most of the cases. Other monostotic, primary rib tumours and tumorous conditions in childhood - with the exception of exchondroma and enchondroma - rarely show diagnostic radiographic features. 26 refs., 21 figs., 3 tabs

  5. Radiological, computertomographic, pathoanatomical and histological examination of the rib cartilage of the dog

    International Nuclear Information System (INIS)

    This study was concerned with the representation and description of the rib cartilage of the dog and the abnormalities of such by means of radiological, computer tomographic, pathoanatomical and histological examinations and the comparison of the results of the various examination methods. The study material consisted of 100 ventral thorax walls of dogs of different ages and breeds. In 39 of the subjects, no abnormalities of rib cartilage other than unremarkable calcification were observed. Among the subjects, there were 11 puppies (0-3 months), whose rib cartilage appeared soft tissue dense due to the absence of calcification, 14 juvenile animals (4-18 months), the rib cartilage of which showed a typical finely granulated structure, and 14 adult dogs (over 18 months), whose rib cartilage exhibited a homogeneous to net-like calcified appearance. In the calcified rib cartilage, the histological section showed a centrally located spongiosa rod surrounded by a hyaline cartilage shell. The calcification tendency of the first pair of rib cartilage was remarkable: in 70 dogs, the first pair of rib cartilage remained uncalcified despite calcification of the other rib cartilage. Sixty-one dogs exhibited rib cartilage abnormalities. According to the radiological appearance of the abnormalities, they were divided into groups and their incidence was calculated. Abnormalities seen included interruption in the continuity of the calcified rib cartilage with and without callus formation, enlargement of rib cartilage, cuff formation, and abnormalities on the Articulationes sternocostales (projections in or around articulations, calcified and fractured joint surfaces). In addition, remarkable calcification patterns were observed. By means of CT examination the densities of the tissue forming the various abnormalities was determined. In the course of the pathoanatomical examination, it was shown that the interruptions in continuity with callus and the various enlarged areas of the

  6. 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.)

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

    International Nuclear Information System (INIS)

    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.)

  8. 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 of...... the structure. These types of structures have thus often been studied in the past. However, there is still a lack of simplified expressions for the sound transmission of these structures. Therefore, simplified expressions for the forced airborne sound transmission of finite size single leaf ribbed...

  9. 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. PMID:20349681

  10. In-target yields for RIB production with EURISOL

    International Nuclear Information System (INIS)

    EURISOL DS (European Isotope Separation On-Line - Design Study) project is the European common effort in planning a next generation RIB factory able to deliver secondary beams up to 1013 pps at energies up to 150 MeV u-1. The proposed schematic layout of the facility is based on four target stations, three direct targets of 100kW of beam power and one multi-MW (MMW) target two stages assembly. Being produced via spallation the RIBs produced in the direct targets are mainly proton rich. While in the multi-MW target high intensity RIBs of neutron rich isotopes are produced by fission in actinide targets placed in the fast neutron spectrum given by a liquid metal spallation source. The purpose of this paper is to summarize a work carried out within Task 11 'Beam Intensity Calculations': estimation of the in-target yield intensities produced in the various target configurations. Benchmark studies were performed initially in order to verify the accurate description of the spallation models used by the MCNPX2.5.0 code and to choose the best options to be used for the present work requirements. Numerous calculations using MCNPX2.5.0 combined with the evolution code CINDER'90 were carried out to assess the performance of the direct targets. The production rates in the case of the MMW-fission targets were obtained with a given and fixed geometry (optimized to reach 1015 fission s-1). Only fissile material, moderator and reflector were free. (author)

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

    OpenAIRE

    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 to their planar counterparts. Measured beam propagation factors $M^{2}_{x}$ and $M^{2}_{y}$ of 1.3 and 1.2, respectively, indicated single-transverse-mode emission. A quasi-cw output power of 27 mW ...

  12. Cold plate with combined inclined impingement and ribbed channels

    Science.gov (United States)

    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.

  13. Supercontinuum generation in dispersion-managed tapered-rib waveguide.

    Science.gov (United States)

    Hu, Hongyu; Li, Wenbo; Dutta, Niloy K

    2013-10-20

    We have designed a tapered-rib waveguide and numerically studied the generation of supercontinuum using such waveguides. The Air-SF57 glass-SiO(2) waveguide is 3 cm long, with a varying etched depth to manage the total dispersion. Numerical simulations are conducted for input pulses at a wavelength of 1.55 μm with a width of 150 fs and peak power of 5 kW. The proposed waveguide geometry greatly broadens the output spectrum, extending from ∼1 to ∼6  μm, caused by the continuous modification of the phase-matching condition for the generated waves. PMID:24216588

  14. Bone scintigraphy in costo-iliac impingement syndrome

    DEFF Research Database (Denmark)

    Madsen, Jan L

    2008-01-01

    Abstract: A syndrome of back pain caused by impingement of the lowest ribs against the iliac crest has been described in patients with osteoporotic vertebral fractures and loss of height of the patient. A case is presented of an 81-year-old woman with a long history of osteoporosis with compression...... 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....

  15. 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.

  16. 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

  17. 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.

  18. Screening for Cervical Cancer

    Science.gov (United States)

    ... cervical cancer: • Cytology: This test, also called a Pap test or Pap smear, looks for abnormal changes in cells in ... women ages 21 to 65, screening with a Pap test every 3 years has the highest benefits ...

  19. Cervical motion segment replacement

    OpenAIRE

    Bryan, Vincent E.

    2002-01-01

    When symptoms bring to light a cervical spine degenerative disc process that requires surgical intervention, a symptom relieving procedure such as decompression, followed by functional restoration, arthroplasty, offers the benefit of prophylaxis of accelerated spondylosis at the operated level. In addition, by altering the biomechanical stress factors at adjacent levels, theoretically it should offer prophylactic benefit at these levels as well. The design requirements for a cervical disc pro...

  20. Rib osteoblastic osteosarcoma in an African hedgehog (Atelerix albiventris).

    Science.gov (United States)

    Benoit-Biancamano, Marie-Odile; D'Anjou, Marc-André; Girard, Christiane; Langlois, Isabelle

    2006-07-01

    A 3-year-old African hedgehog (Atelerix albiventris) was presented to the Exotic Animal Clinic of the University of Montreal for evaluation of a mass growing on the right thoracic wall. The diagnostic workup, which included helical computed tomography, confirmed the presence of a large mass, originating from the right 7th rib, infiltrating the thoracic wall and cavity. The animal was euthanized due to the poor prognosis. At necropsy, a well-demarcated mass penetrated the thoracic wall and incorporated the 6th to 8th ribs. Cut sections of the tumor were white, glistening, firm, and gritty. Microscopically, it was composed of polyhedral to elongated cells with interspersed trabeculae of osteoid and large areas of coagulative necrosis. On the basis of histopathologic findings, a diagnosis of osteoblastic osteosarcoma was made. To the authors' knowledge, this is the first report of an osteoblastic osteosarcoma on the thoracic wall of an African hedgehog, as well as the first report of the use of helical computed tomography in that species. PMID:16921888

  1. 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.)

  2. The RIB production target for the SPES project

    International Nuclear Information System (INIS)

    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.)

  3. 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.

  4. 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.

  5. 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...

  6. Abnormalities of fetal rib number and associated fetal anomalies using three dimensional ultrasonography

    Directory of Open Access Journals (Sweden)

    Sameh Ahmad Khodair

    2014-09-01

    Conclusion: Abnormal number of fetal ribs more to be an isolated finding (4.3% but it may also be seen with other anomalies (3.7% in this study. 3DUS is useful for scanning the fetal ribs in the mid trimester of the pregnancy for early detection of associated genetic aberrations.

  7. Alterations of diaphragm and rib cage morphometry in severe COPD patients by CT analysis.

    Science.gov (United States)

    Salito, C; Luoni, E; Aliverti, A

    2015-08-01

    Although it is known that in patients with COPD acute hyperinflation determines shortening of the inspiratory muscles, its effects on both diaphragm and rib cage morphology are still to be investigated. In this preliminary study the relationships between hyperinflation, emphysema, diaphragm and rib cage geometry were studied in 5 severe COPD patients and 5 healthy subjects. An automatic software was developed to obtain the 3-D reconstruction of diaphragm and rib cage from CT scans taken at total lung capacity (TLC) and residual volume (RV). Dome surface area (Ado), radius of curvature, length (Ld) and position (referred to xiphoid level) of the diaphragm and antero-posterior (A-P) and transverse (T) diameters of rib cage were calculated at both volumes. Ado and Ld were similar in COPD and controls when compared at similar absolute lung volumes. Radius of curvature was significantly higher in COPD than in controls only at TLC. In COPD, the range of diaphragm position was invariantly below the xiphoid level, while in controls the top of diaphragm dome was always above it. Rib cage diameters were not different at TLC. A-P diameter was greater in COPD than in controls at RV, while T diameters were similar. In conclusion, in severe COPD diaphragm and rib cage geometry is altered at RV. The lower position of diaphragm is associated to smaller A-P but not transversal rib cage diameters, such that rib cage adopts a more circular shape. PMID:26737755

  8. 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

  9. 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.

  10. Customized Titanium Implant for Chest Wall Reconstruction in Complex Poland Syndrome

    Directory of Open Access Journals (Sweden)

    Ivan E. Rodriguez

    2014-02-01

    Full Text Available Summary: This report describes a new method for the surgical repair of the chest wall deformity encountered in complex Poland’s syndrome. In this report, we describe the use of a customized titanium implant that was used to replace the missing second through fifth ribs and to provide chest wall stabilization before breast reconstruction. This approach might be considered an alternative to autologous rib grafting in patients who have reached skeletal maturity. It avoids the morbidity and risk associated with rib grafts and improves chest wall symmetry.

  11. 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.

  12. Characterization of Human Rib Biomechanical Responses due to Three-Point Bending.

    Science.gov (United States)

    Kalra, Anil; Saif, Tal; Shen, Ming; Jin, Xin; Zhu, Feng; Begeman, Paul; Yang, King H; Millis, Scott

    2015-11-01

    In the elderly population, rib fracture is one of the most common injuries sustained in motor vehicle crashes. The current study was conducted to predict the biomechanical fracture responses of ribs with respect to age, gender, height, weight and percentage of ash content. Three-point bending experiments were conducted on 278 isolated rib samples extracted from 82 cadaver specimens (53 males and 29 females between the ages of 21 and 87 years) for 6th and 7th levels of ribs. Statistical analyses were carried out to identify differences based on age and gender. It was found that, in comparison to males, females had significantly lower values for maximum bending moments, slopes of bending moment-angle curves, and average cortical-bone thickness (pcrash conditions. Hence, rib-material properties, which are dependent on strain rate, and are needed for wholebody finite element models representing different populations, still require more research. PMID:26660742

  13. Bone and 67Ga scintigraphy in the evaluation of rib lesions in patients with multiple myeloma

    International Nuclear Information System (INIS)

    Rib lesions in 14 patients with multiple myeloma were evaluated by 99mTc-phosphorous compound bone scintigraphy and 67Ga scintigraphy. In the present study, in order to accurately detect rib lesions in multiple myeloma. bone and 67Ga scintigraphy were performed in 14 patients with multiple myeloma. The patterns of radionuclide accumulation in rib lesions on bone scintigraphy were classified by their grade, type, and site, and the findings were compared with the results of 67Ga scintigraphy. Thus, in cases of multiple myeloma, it was important to consider carefully both the intensity and the design of bone scintigraphy in combination with follow-up study by 67Ga scintigraphy. As a result of such consideration, we found that bone and 67Ga scintigraphy were useful in distinguishing invasive lesions from benign degenerative changes in the rib cage in cases with suspected rib involvement of multiple myeloma. (author)

  14. Anterior Cervical Spinal Surgery for Multilevel Cervical Myelopathy.

    OpenAIRE

    Jung-Ju Huang; Lih-Huei Chen; Chi-Chien Niu; Tsai-Sheng Fu; Po-Liang Lai; Wen-Jer Chen

    2004-01-01

    Background: In multilevel spinal cord compression caused by cervical spondylosis, surgeonsface the choice of performing a posterior route as a laminectomy orlaminoplasty, or an anterior route as multiple adjacent interbody decompressionsor corpectomies. The anterior cervical operation is not considered bysome clinicians because of concerns about complications and the complexityof multilevel anterior cervical surgery.Methods: In this retrospective study, 14 patients with multilevel cervical sp...

  15. 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。

  16. Cervical sympathetic chain schwannoma: A case report

    Directory of Open Access Journals (Sweden)

    Inès Nacef

    2014-07-01

    Full Text Available Nerve tumors arising from the sympathetic chain are uncommon slow-growing tumors and represent a diagnosis challenge. Their malignant degeneration is rare. Definitive pre-operative diagnosis may be difficult as investigations are not usually helpful. We report the case of a 23-year old woman who presented with an asymptomatic solitary left cervical swelling. She was evaluated with sonography and computed tomography. Complete surgical excision of the lesion was carried out and histologic examination revealed a schwannoma. Post-operatively, the patient showed clinical findings of Horner’s syndrome. Pathologic and radiological evaluation, differential diagnosis of this neoplasm and its management are discussed.

  17. Cervical cancer - screening and prevention

    Science.gov (United States)

    Cervical cancer is cancer that starts in the cervix. The cervix is the lower part of the uterus ( ... can do to decrease your chance of having cervical cancer. Also, tests done by your health care provider ...

  18. Human Papillomavirus and Cervical Cancer

    OpenAIRE

    D. Jenkins(University of York, UK)

    2003-01-01

    Of the many types of human papillomavirus (HPV), more than 30 infect the genital tract. The association between certain oncogenic (high-risk) strains of HPV and cervical cancer is well established. Although HPV is essential to the transformation of cervical epithelial cells, it is not sufficient, and a variety of cofactors and molecular events influence whether cervical cancer will develop. Early detection and treatment of precancerous lesions can prevent progression to cervical cancer. Ident...

  19. Geomechanical design of a room and rib pillar granite mine

    Institute of Scientific and Technical Information of China (English)

    Daniele Peila; Claudia Guardini; Sebastiano Pelizza

    2008-01-01

    The geomochanical and stability design of an underground granite mine located in Canal San Bovo (Trento district, North- eastern Italy) was described. The exploitation of the granite, which is used in the ceramic industry, was carried out by the rooms and rib pillars method. The rooms are 12 m wide while the pillars are 11 m wide and they cross the main discontinuity set of the rock mass in the perpendicular direction. To verify the stability condition of an underground mine, it is necessary to carry out the calcula- tions that are able to check both the local and global stability of the rock mass. In the studied example, this approach has been applied with the development of analytical and numerical parametric analyses and it has permitted to get the best orientation and to design the size of rooms and pillars.

  20. 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.

  1. 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.

  2. 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.

  3. 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.)

  4. Ellis-van Creveld syndrome.

    Science.gov (United States)

    Baujat, Geneviève; Le Merrer, Martine

    2007-01-01

    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. PMID:17547743

  5. 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.

  6. Guillain-Barré Syndrome in a Patient after Bilateral Thyroidectomy plus Bilateral Cervical Lymph Node Dissection:One Case Report and Literature Review%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

    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

    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.%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。

  7. The degenerative cervical spine.

    Science.gov (United States)

    Llopis, E; Belloch, E; León, J P; Higueras, V; Piquer, J

    2016-04-01

    Imaging techniques provide excellent anatomical images of the cervical spine. The choice to use one technique or another will depend on the clinical scenario and on the treatment options. Plain-film X-rays continue to be fundamental, because they make it possible to evaluate the alignment and bone changes; they are also useful for follow-up after treatment. The better contrast resolution provided by magnetic resonance imaging makes it possible to evaluate the soft tissues, including the intervertebral discs, ligaments, bone marrow, and spinal cord. The role of computed tomography in the study of degenerative disease has changed in recent years owing to its great spatial resolution and its capacity to depict osseous components. In this article, we will review the anatomy and biomechanical characteristics of the cervical spine, and then we provide a more detailed discussion of the degenerative diseases that can affect the cervical spine and their clinical management. PMID:26878769

  8. Cervical artery dissection: emerging risk factors.

    Science.gov (United States)

    Micheli, S; Paciaroni, M; Corea, F; Agnelli, G; Zampolini, M; Caso, V

    2010-01-01

    Cervical artery dissection (CAD) represents an increasingly recognized cause of stroke and the most common cause of ischemic stroke in young adults. Many factors have been identified in association with CAD such as primary disease of arterial wall (fibrodysplasia) and other non-specific diseases related to CAD like Ehlers Danlos-syndrome IV, Marfan's syndrome, vessel tortuosity. Moreover, an underlying arteriopathy which could be in part genetically determined, has been suspected. The rule of emerging risk factors for CAD such as recent respiratory tract infection, migraine and hyperhomocysteinemia are still a matter of research. Other known risks factors for CAD are major head/neck trauma like chiropractic maneuver, coughing or hyperextension injury associated to car. We examined emerging risks factors for CAD detected in the last years, as CAD pathogenesis is still not completely understood and needs further investigations. PMID:21270941

  9. Rheumatoid cervical myelopathy

    International Nuclear Information System (INIS)

    Rheumatoid cervical myelopathy was studied in 14 patients, clinically, radiographically and by computerized tomography with multiplanar reconstruction (CT/MPR). CT/MPR demonstrated significant unsuspected areas of compromise in 9 of the 14 patients, and altered the surgical procedure in 7 of these 9 patients. CT/MPR clearly identifies all levels of involvement including rotary subluxation. CT/MPR also allows assessment of the spinal nerve canal/foramen and the alignment of the foramina transversaria. CT/MPR is an essential addition to the evaluation of rheumatoid cervical myelopathy

  10. CERVICAL NECROTIZING FASCIITIS

    Directory of Open Access Journals (Sweden)

    G. Dimofte

    2009-05-01

    Full Text Available Cervical necrotizing fasciitis is an unusual encounter in the general surgical practice, but is a life-threatening condition requiring early recognition and adequate surgical treatment. We present the case of a 65 year old male patient referred to our department from a General Hospital. Large excisions of both superficial and deep cervical fascia were required together with necrotic skin on a very large surface. Rapid recovery with early sterilization allowed adequate skin grafting with good results. We advocate for aggressive debridment with excision in viable healthy tissue, with no concern for the future reconstruction followe by early grafting of the skin defect.

  11. 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.

  12. 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.

  13. Acute monoplegia associated with non-traumatic intradural cervical disc herniation:

    Directory of Open Access Journals (Sweden)

    Ahmet Menkü

    2014-03-01

    Full Text Available Intradural disc herniation has been reported as a rare and particular type of intervertebral disc herniation. It occurs mostly in the lumbar spine, and rarely in the cervical or thoracic spine. Non-traumatic cervical intradural disc herniation is rare, with only 17 cases reported in English literature at the cervical region and can manifest itself by severe symptoms such as Brown-Sequard syndrome, transverse myelopathy and radiculopathy. We present a unique case of intradural cervical disc herniation only causing lower extremity monoplegia. To our knowledge, this is the first case described in the literature. The patient underwent microsurgical removal of the herniated disc via an anterior approach followed by interbody fixation using a cervical cage. J Clin Exp Invest 2014; 5 (1: 112-114

  14. RESULTS OF SURGICAL TREATMENT IN CERVICAL HERNIATED DISC ANALYSIS OF 275 CASES

    Directory of Open Access Journals (Sweden)

    L. Eva

    2010-02-01

    Full Text Available Background: Problems of surgical treatment of cervical disc hernia are still far from being resolved. It shows variety of surgical procedures it. The operations for cervical level with radiculopatie were quite limited. Limits method were dictated by the absence of accurate diagnosis, microsurgical methods, extensions, sometimes unjustified, conservative treatment. Material and method Complex issue of cervical spine degenerative pathologies, particularly cervical disc hernia with radicular syndrome was studied on a group of 275 patients. Results: From the 275 patients with herniated disc cervical admitted in the study, 182 (66.18% of cases had surgical intervention to a single level disc, 72 patients (26.18% of cases in two levels, 20 patients (7.27% cases at three levels and one case (0.36% at four levels.

  15. 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.

  16. [Clinical and technical assessment of the cervical spine].

    Science.gov (United States)

    Dvorak, J

    1996-11-01

    In analysis of the cervical and cervicobrachial syndrome with or without signs of compression of the nerve root or spinal cord, functional assessment of the cervical spine is of great importance. Comparisons between actively performed and passively induced motion can be verified by using standardized computer-assisted assessment allowing precise documentation of the range of motion and coupled motion. The age-related normal values should be considered. The neurological assessment includes not only the cranial nerves and upper extremities but also lower extremities to avoid overlooking the signs of cervical myelopathy. In patients with compression of nerve roots or the spinal cord neurophysiology might be helpful in identifying or verifying compression. In patients with suspected myelopathy sensory evoked potentials will allow assessment of the function of the ascending spinal pathways and motor evoked potentials, assessment of the function of the descending cortical spinal pathways. PMID:8999404

  17. 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. PMID:25917634

  18. 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

    energy analysis. One reason is that the modal density is not uniformly distributed due to the spatial periodicity introduced by the ribs. This phenomenon is investigated in the present paper, using a modal model of a ribbed plate. The modal model uses the Fourier sine modes, and the coupling between the...... plate and ribs is incorporated using Hamilton's principle. This model is then used to investigate the modal density of the considered spatially periodic structure, and a grouping of the modes in different dominating directions is proposed. Suggestions are also given regarding how to proceed towards a...

  19. 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

  20. Multiple Rib Exostoses in a Boy: A Rare Case Resulting in Surgery Secondary to Cosmetic Concerns

    OpenAIRE

    Masoum, Seyed Hosein Fattahi; Moradi, Ali; Mohammad H. Ebrahimzadeh

    2014-01-01

    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 ...

  1. Neurofibromatosis with ribs meningiomas: a case report; Neurofibromatose com meningeomas costais: relato de um caso

    Energy Technology Data Exchange (ETDEWEB)

    Henrique, Katia; Magalhaes Junior, Mauricio Ricardo; Cardenas, Gloria Pamela Galdames [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Faculdade de Medicina. Hospital Universitario Antonio Pedro; Marchiori, Edson [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Faculdade de Medicina. Dept. de Radiologia

    1996-03-01

    This work shows one case of ribs meningiomas in a 31-year-old male patient who presented a painful and toughened mass of undefined limits, which was located in the level of the third and fourth left anterior ribs. The problem has developed with an increase of the tumoration, more pain and dyspnea appearance. The patient present cafe-au-lait spots on all his body and a familiar neurofibromatosis had been reported. After radiological exams, the patient has been submitted to an exploratory thoracotomy, with a parietal mass resection, what resulted in a histopathological diagnosis of ribs meningiomas. (author). 7 refs., 3 figs.

  2. Chronic Cervicogenic Tinnitus Rapidly Resolved by Intermittent Use of Cervical Collar

    OpenAIRE

    Bechter, Karl; Wieland, Martin; Hamann, Gerhard F

    2016-01-01

    Introduction Cervicogenic tinnitus is not a generally accepted pathogenetic subtype, which might be subsumed under the concept of somatosensory tinnitus. After the personal experience of therapy-resistant tinnitus in context with a cervical pain syndrome (CPS) and successful add-on treatment with cervical collar (CC), the idea was pursued in several individual treatments in patients. Patients and methods Reporting one particular case with chronic tinnitus, considered untreatable, t...

  3. The use of disharmonic motion curves in problems of the cervical spine

    OpenAIRE

    Feipel, V.; Rondelet, B; LePallec, J. P.; Dewitte, O; Rooze, M.

    1999-01-01

    Cervical spine motion was investigated by three-dimensional electrogoniometry in 257 asymptomatic volunteers and in 32 patients with cervical disc hernia or whiplash syndrome. Maximal ranges of main and coupled motions were considered. Motion curves were analysed qualitatively and using fitting of sixth degree polynomials. Motion ranges obtained were in agreement with previous observations. Significant differences between patients and volunteers concerned several primary and coupled component...

  4. Botulinum toxin type A in the treatment of patients with cervical dystonia

    OpenAIRE

    Allison Brashear

    2008-01-01

    Allison BrashearDept of Neurology, Wake Forest University Baptist, Medical Center, Winston Salem, NC, USAAbstract: Dystonia is an involuntary movement involving twisting and turning of agonist and antagonist muscles. Cervical dystonia is isolated to neck musculature. Botulinum toxin type A is a safe and effective treatment of this disabling and often painful syndrome. Three forms of botulinum toxin type A are available worldwide to treat patients with cervical dystonia. This is a review of th...

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

    International Nuclear Information System (INIS)

    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.)

  6. 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.)

  7. 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.

  8. 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

    2015-01-01

    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. PMID:25912351

  9. Prevent Cervical Cancer

    Science.gov (United States)

    ... Risk? What Are the Symptoms? What Should I Know About Screening? Statistics Related Links Inside Knowledge Campaign What CDC Is Doing Research AMIGAS Fighting Cervical Cancer Worldwide Stay Informed Printable Versions Standard quality PDF [PDF-877KB] High-quality PDF for professional ...

  10. Cervical silicone lymphadenopathy.

    Science.gov (United States)

    Gilbert, Latoni Kaysha; Thiruchelvam, Janavikulam

    2016-07-01

    A patient presented to the department of oral and maxillofacial surgery with a rare case of cervical silicone lymphadenopathy. She had a painless ovoid mass in the left side of her neck and had had cosmetic breast augmentation 10 years before. Radiological imaging and core biopsy examination were consistent with silicone lymphadenopathy. PMID:26830068

  11. 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.

  12. Cervical Spine Involvement in Mild Traumatic Brain Injury: A Review.

    Science.gov (United States)

    Morin, Michael; Langevin, Pierre; Fait, Philippe

    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

  13. Cervical pain in the athlete: common conditions and treatment.

    Science.gov (United States)

    Dorshimer, Gary W; Kelly, Michael

    2005-03-01

    In summary, it is important for physicians dealing with neck pain in an athletic population to understand the differences between serious and mild cervical injuries. This is best facilitated by a thorough understanding of the signs and symptoms of serious cervical injury, familiarity with the basic anatomy of the neck and its structures, and a working knowledge of common causes of neck pain and mechanisms of injury. All unconscious athletes should be assumed to have a serious cervical injury until proven otherwise, and preventive measures should be taken to ensure the safety of the athlete. This includes airway management with a jaw thrust only, neck stabilization, and preventing helmet removal. In the conscious athlete who has neck pain, serious cervical injury can often be ruled out with an accurate history and physical examination. In all cases of neck pain, it is imperative that the athlete be protected. This may involve removing the athlete from competition, or transporting him or her to the local emergency room. Often, this decision falls on the shoulders of the doctor in the stands. Thus, a basic understanding of the evaluation and management of neck pain in athletes is an asset for all physicians who frequent athletic events or see athletes in the office. The physician responsible for patients who have Down syndrome or rheumatoid arthritis needs to consider the increased incidence of cervical instability in these patients when evaluating for athletic participation or neck pain. PMID:15831320

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

    DEFF Research Database (Denmark)

    Vinther, Anders; Kanstrup, Inge-Lis; Christiansen, Erik; Alkjaer, T; Larsson, Benny; Magnusson, S Peter; Aagaard, Per

    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 a...... density may be a potential risk factor for the development of exercise-induced rib stress fractures in elite rowers....

  15. 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.

  16. 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

    2016-06-01

    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.

  17. 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...... energy analysis. One reason is that the modal density is not uniformly distributed due to the spatial periodicity introduced by the ribs. This phenomenon is investigated in the present paper, using a modal model of a ribbed plate. The modal model uses the Fourier sine modes, and the coupling between the...... plate and ribs is incorporated using Hamilton's principle. This model is then used to investigate the modal density of the considered spatially periodic structure, and a grouping of the modes in different dominating directions is proposed. Suggestions are also given regarding how to proceed towards a...

  18. DNS of velocity and thermal fields in turbulent channel flow with transverse-rib roughness

    International Nuclear Information System (INIS)

    A detailed knowledge of both velocity and thermal fields in wall turbulence disturbed by a row of ribs on the wall is important for clarifying the chief factors of fluid and thermal dynamics related to the control of heat transfer. In this study, in order to elucidate the effects of roughness on the statistical quantities in the velocity and thermal fields, direct numerical simulations (DNS) of heat transfer in turbulent channel flows with transverse-rib roughness have been performed by varying their spacing, width and height, in which the turbulent heat transfer with k-type and d-type roughness walls are simulated. It is found that since turbulent mixing is promoted by arranging ribs, the distributions of mean velocity and temperature become markedly asymmetric. Systematic variations of secondary flow patterns between ribs are clearly identified. The best heat transfer performance is found to be obtained with the k-type roughness

  19. 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.

  20. Cerebrocostomandibular syndrome in four sibs, two pairs of twins.

    OpenAIRE

    Drossou-Agakidou, V; Andreou, A.; Soubassi-Griva, V; Pandouraki, M

    1991-01-01

    We report four sibs, two pairs of twins, with cerebrocostomandibular syndrome (CCMS). The family history was negative. All four babies had the characteristic features of CCMS, including Pierre-Robin anomalad and rib dysplasia. Cerebral involvement was evident in two of the patients who had suffered perinatal asphyxia. The presence of the syndrome in all four sibs together with the negative family history in previous generations is consistent with Mendelian autosomal recessive inheritance with...

  1. 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.

  2. Cervical vertebral anomalies in skeletal malocclusions: A cross-sectional study on orthodontic patients at the Aga Khan University Hospital, Pakistan

    OpenAIRE

    Saman Faruqui; Mubassar Fida; Attiya Shaikh

    2014-01-01

    Introduction: Morphological deviations of the cervical vertebral column have been described in relation to craniofacial aberrations and syndromes. Furthermore, it has recently been shown that abnormal morphology of upper cervical vertebrae is associated with malformation of the jaws and occlusion. Accordingly, it is relevant to focus on similar associations in patients with skeletal malocclusions. Therefore, the objectives of this study are to: Identify the anomalies of the cervical column...

  3. Enhancement of flow boiling of subcooled water on transverse ribbed surface

    International Nuclear Information System (INIS)

    The present work deals with enhancement of flow boiling heat transfer using transverse ribs of rectangular cross section attached on a flat heating surface. High flux cooling is envisioned in the field of the leading edge technology such as high power laser applications, advanced metallurgical processes, fusion reactors, integrated circuit chips and so forth. In such advanced cooling devices subcooled boiling of water at high velocity is expected as one of most efficient and convenient means for heat removal exceeding 107W/m2. In the present experiment, a sheet of stainless-steel (10mm wide, 0.2mm thick and 80mm in heated length) was flush mounted on one wall of a vertical rectangular channel (a cross-section 20mm x 30 mm) and used as a heating surface by passing a direct current. Transverse-ribs made of plastic plate (0.5mm thick and 30mm in lateral length) were attached at an equal longitudinal spacing on the heating surface. Longitudinal spacing of ribs was varied from 2.5, 5, 10, 20mm to infinity (a flat surface without ribs), and the rib height was 2.5mm and 5.0mm. Experiments were conducted with water at a pressure of 0.12MPa in the range of mass velocity from 500kg/m2s to 2,000kg/m2s (water velocity from 0.5m/s to 2m/s) and subcooling from 20K to 50K. It was found that the ribbed structure strongly affects heat transfer both in the non-boiling and partial nucleate boiling regimes. Enhancement rate of heat transfer coefficient varied from 5% to 50% in excess compared with that for the flat heating plate. According to visual observation of boiling bubbles the circulating flow occurred in a space between each consecutive ribs and seemed to enhance heat transfer. For narrow rib spacing a large coalesced bubble filled up each rib space and impeded the exchange of vapor with liquid, leading to heat transfer deterioration. In the present experimental range of the ribs, a 50% increase of heat transfer coefficient was attained on the ribbed surface with 5mm height

  4. 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.

  5. Enhanced reading time efficiency by use of automatically unfolded CT rib reformations in acute trauma.

    Science.gov (United States)

    Bier, Georg; Schabel, Christoph; Othman, Ahmed; Bongers, Malte N; Schmehl, Jörg; Ditt, Hendrik; Nikolaou, Konstantin; Bamberg, Fabian; Notohamiprodjo, Mike

    2015-11-01

    Rationale of this study was to evaluate whether unfolded rib images enhance time efficiency in detection of rib fractures and time efficiency in patients with acute thoracic trauma. 51 subsequent patients with thoracic trauma underwent 64-slice computed tomography. 1mm thick axial slices were reformatted using a commercially available post-processing software application generating rotatable unfolded rib images. Diagnostic accuracy was evaluated by 3 readers and compared to multiplanar reformations of the original CT images. Reformation and evaluation times were recorded. 116 rib fractures were detected. The multiplanar reformation analysis yielded a sensitivity of 87.9%/93.9%/79.7% with a specificity of 97%/97%/82.2%, whilst the unfolded rib image analysis yielded a sensitivity of 94.8%/94.8%/92.2% and a specificity of 85.2/87.8%/82.4 (p=0.06/0.8/0.04) with high inter-observer agreement (k=0.79-0.85). The mean reading time for the multiplanar reformations was significantly longer (reader 1: 103.7 ± 27.1s/reader 2: 81.8 ± 40.6s/reader 3: 154.3 ± 39.2s) than the evaluation of the unfolded rib images (19.4 ± 4.9s/26.9 ± 15.0s/49.9 ± 18.7s; p<0.01). Concluding, the unfolded rib display reduces reading time for detection of rib fractures in acute thoracic trauma patients significantly and does not compromise the diagnostic accuracy significantly in experienced radiologists. However, unexperienced readers may profit from use of this display. PMID:26226916

  6. Rib fractures after reirradiation plus hyperthermia for recurrent breast cancer. Predictive factors

    International Nuclear Information System (INIS)

    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.)

  7. Rib suppression in chest radiographs to improve classification of textural abnormalities

    Science.gov (United States)

    Hogeweg, Laurens E.; Mol, Christian; de Jong, Pim A.; van Ginneken, Bram

    2010-03-01

    The computer aided diagnosis (CAD) of abnormalities on chest radiographs is difficult due to the presence of overlapping normal anatomy. Suppression of the normal anatomy is expected to improve performance of a CAD system, but such a method has not yet been applied to the computer detection of interstitial abnormalities such as occur in tuberculosis (TB). The aim of this research is to evaluate the effect of rib suppression on a CAD system for TB. Profiles of pixel intensities sampled perpendicular to segmented ribs were used to create a local PCA-based shape model of the rib. The model was normalized to the local background intensity and corrected for gradients perpendicular to the rib. Subsequently rib suppressed images were created by subtracting the models for each rib from the original image. The effect of rib suppression was evaluated using a CAD system for TB detection. Small square image patches were sampled randomly from 15 normal and 35 TB-affected images containing textural abnormalities. Abnormalities were outlined by a radiologist and were given a subtlety rating from 1 to 5. Features based on moments of intensity distributions of Gaussian derivative filtered images were extracted. A supervised learning approach was used to discriminate between normal and diseased image patches. The use of rib suppressed images increased the overall performance of the system, as measured by the area under the receiver operator characteristic (ROC) curve, from 0.75 to 0.78. For the more subtly rated patches (rated 1-3) the performance increased from 0.62 to 0.70.

  8. 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.)

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

    International Nuclear Information System (INIS)

    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.)

  10. Relating the micro- and nano-structure of bone to rib fracture propagation

    OpenAIRE

    Beadle, Nicola

    2016-01-01

    Physical abuse of infants at the hand of a parent or carer is a significant and growing issue worldwide. In particular, rib fractures in the absence of major accidental trauma are highly specific for physical abuse. Despite the serious implications of physical abuse in infants, definitive knowledge regarding the hierarchical structure of the immature rib and how this influences the mechanical failure is lacking. Moreover, the diagnosis of physical abuse is often disputed in a legal setting, a...

  11. A Review of Thoracic Outlet Syndrome and the Possible Role of Botulinum Toxin in the Treatment of This Syndrome

    OpenAIRE

    Andrew Travlos; Jacqueline Mary Foley; Heather Finlayson

    2012-01-01

    The objective of this paper is to discuss the classification, diagnosis, pathophysiology and management of Thoracic outlet syndrome (TOS). Thoracic outlet syndrome (TOS) is a complex entity that is characterized by different neurovascular signs and symptoms involving the upper limb. TOS is defined as upper extremity symptoms due to compression of the neurovascular bundle in the area of the neck just above the first rib. Compression is thought to occur at one or more of the three anatomical co...

  12. Cervical spinal canal narrowing and cervical neurologi-cal injuries

    OpenAIRE

    Zhang, Ling; Chen, Hai-Bin; Wang, Yi; ZHANG Li-ying; Liu, Jing-cheng; WANG Zheng-guo

    2012-01-01

    【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, ...

  13. Design of 9 tesla superconducting solenoid for VECC RIB facility

    International Nuclear Information System (INIS)

    An ISOL post-accelerator type of RIB facility is being developed at our centre. The post acceleration scheme of a Radio Frequency Quadrupole (RFQ) followed by five IH LINAC cavities will provide energy of about 1.05 MeV/u. For further accelerating up to 2 MeV/u Superconducting Quarter Wave Resonators (SCQWR) will be used. The radial defocusing of the beam bunch during the acceleration using SCQWRs will be taken care of by a Superconducting Solenoid (SCS) within the same cryostat. In this report the electromagnetic design of an SCS will be discussed. A 9 T SCS having effective length of 340 mm has been designed with the special requirement that the fringing field should fall sharply to a value less than 100 mT at the surfaces of the adjacent superconducting cavities. The designed solenoid comprise of two co-axial split solenoid conductors surrounded by iron shields and a pair of bucking coils. Optimizations have been carried out for the total current sharing of the main coils and the bucking coils as well as for the relative orientation and dimension of each component of the solenoid. (author)

  14. High-efficiency target-ion sources for RIB generation

    Energy Technology Data Exchange (ETDEWEB)

    Alton, G.D.

    1993-12-31

    A brief review is given of high-efficiency ion sources which have been developed or are under development at ISOL facilities which show particular promise for use at existing, future, or radioactive ion beam (RIB) facilities now under construction. Emphasis will be placed on those sources which have demonstrated high ionization efficiency, species versatility, and operational reliability and which have been carefully designed for safe handling in the high level radioactivity radiation fields incumbent at such facilities. Brief discussions will also be made of the fundamental processes which affect the realizable beam intensities in target-ion sources. Among the sources which will be reviewed will be selected examples of state-of-the-art electron-beam plasma-type ion sources, thermal-ionization, surface-ionization, ECR, and selectively chosen ion source concepts which show promise for radioactive ion beam generation. A few advanced, chemically selective target-ion sources will be described, such as sources based on the use of laser-resonance ionization, which, in principle, offer a more satisfactory solution to isobaric contamination problems than conventional electromagnetic techniques. Particular attention will be given to the sources which have been selected for initial or future use at the Holifield Radioactive Ion Beam Facility now under construction at the Oak Ridge National Laboratory.

  15. Comprehensive knowledge about cervical cancer is low among women in Northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Getahun Frehiwot

    2013-01-01

    Full Text Available Abstract Background Cervical cancer is the first most common cancer in women in sub-Saharan Africa followed by breast cancer. In Ethiopia, the incidence of cervical cancer is high i.e. 35.9 per 100,000 women. Low level of awareness, lack of effective screening programs, overshadowed by other health priorities (such as acquired immune deficiency syndrome, tuberculosis and malaria and insufficient attention to women’s health are the possible factors for the observed higher incidence rate of cervical cancers in the country. Data on knowledge of Ethiopian women regarding cervical cancer is lacking. The aim of this study was to assess the knowledge of women about cervical cancer and associated factors. Methods A community based cross-sectional survey was conducted from April 4-16, 2010 in Gondar town, Northwest Ethiopia. A total of 633 women aged 15 years and above were interviewed using semi-structured questionnaire by 8 trained data collectors and 2 supervisors. SPSS Windows version 15.0 was employed for data entry and analysis. Result Of all the respondents, 495 (78.7% of them had heard about cervical cancer and only 195 (31% of them were knowledgeable about the disease. Conclusion The knowledge of women on cervical cancer was found to be poor. Education about the disease must include information on risk factors, sign and symptoms of cervical cancer.

  16. A comparison of methods for focusing the field of a HIFU array transducer through human ribs

    Science.gov (United States)

    Gélat, P.; ter Haar, G.; Saffari, N.

    2014-06-01

    A forward model, which predicts the scattering by human ribs of a multi-element high-intensity focused ultrasound transducer, was used to investigate the efficacy of a range of focusing approaches described in the literature. This forward model is based on the boundary element method and was described by Gélat et al (2011 Phys. Med. Biol. 56 5553-81 2012 Phys. Med. Biol. 57 8471-97). The model has since been improved and features a complex surface impedance condition at the surface of the ribs. The inverse problem of focusing through the ribs was implemented on six transducer array-rib topologies and five methods of focusing were investigated, including spherical focusing, binarized apodization based on geometric ray tracing, phase conjugation and the decomposition of the time-reversal operator method. The excitation frequency was 1 MHz and the array was of spherical-section type. Both human and idealized rib topologies were considered. The merit of each method of focusing was examined. It was concluded that the constrained optimization approach offers greater potential than the other focusing methods in terms of maximizing the ratio of acoustic pressure magnitudes at the focus to those on the surface of the ribs whilst taking full advantage of the dynamic range of the phased array.

  17. 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%.

  18. 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.

  19. 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. PMID:27156048

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

    International Nuclear Information System (INIS)

    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.)

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

    International Nuclear Information System (INIS)

    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 45Ca labeled skeletons were divided into four groups: sham controls (SO-); ovariectomized (OV-); 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 H2O. 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 45Ca 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- and OV+ mid-rib regions had significantly lower dry and ash weights than SO-. Total Ca contents of these same regions were also decreased in the OV- and OV+. The only significant change in Ca/dry and Ca/ash was observed when comparing OV+ to SO-. 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

  2. Retrospective evaluation and dating of non-accidental rib fractures in infants

    International Nuclear Information System (INIS)

    Aim: To describe the sequential appearance of healing rib fractures on initial and follow-up radiographs using published guidelines in approximating the age of rib fractures in infants with the aim of establishing a more objective method of dating rib fractures by measuring the thickness of the callous formation. Materials and methods: This was a retrospective analysis of initial and follow-up digital skeletal surveys of infants less than 12 months of age performed between January 2008 and January 2012 at the University of California Davis Children's Hospital. Six radiological features of rib fractures evaluating the appearance of the callous formation (C stage) and fracture line (F stage) were assessed. Patients with osteogenesis imperfecta, known vitamin D deficiency, and skeletal or metabolic dysplasia were not included in the study. Thereafter, callous thickness was measured and recorded for each stage. Results: Sixteen infants (age range 1–11 months, seven males and nine females) with 23 rib fractures were analysed. The thickness of the callous formation follows a predictable pattern advancing one stage after a 2-week follow-up with progressive callous thickening starting from stage 2, peaks at around stage 4, and then tapers and remodels until it almost disappears when the fracture is healed at stage 6. Conclusion: It appears that rib fractures in infants follow a predictable pattern of healing. Measuring the thickness of the callous formation is a more objective way of guiding the radiologist in estimating the age of the fracture

  3. A comparison of methods for focusing the field of a HIFU array transducer through human ribs

    International Nuclear Information System (INIS)

    A forward model, which predicts the scattering by human ribs of a multi-element high-intensity focused ultrasound transducer, was used to investigate the efficacy of a range of focusing approaches described in the literature. This forward model is based on the boundary element method and was described by Gélat et al (2011 Phys. Med. Biol. 56 5553–81; 2012 Phys. Med. Biol. 57 8471–97). The model has since been improved and features a complex surface impedance condition at the surface of the ribs. The inverse problem of focusing through the ribs was implemented on six transducer array-rib topologies and five methods of focusing were investigated, including spherical focusing, binarized apodization based on geometric ray tracing, phase conjugation and the decomposition of the time-reversal operator method. The excitation frequency was 1 MHz and the array was of spherical-section type. Both human and idealized rib topologies were considered. The merit of each method of focusing was examined. It was concluded that the constrained optimization approach offers greater potential than the other focusing methods in terms of maximizing the ratio of acoustic pressure magnitudes at the focus to those on the surface of the ribs whilst taking full advantage of the dynamic range of the phased array. (paper)

  4. 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.

  5. Treatment Options by Stage (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 ...

  6. Cervical Cancer Rates by Race and Ethnicity

    Science.gov (United States)

    ... Associated Lung Ovarian Prostate Skin Uterine Cancer Home Cervical Cancer Rates by Race and Ethnicity Language: English Español ( ... Tweet Share Compartir The rate of women getting cervical cancer or dying from cervical cancer varies by race ...

  7. 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.

  8. Lumbo-Costo-Vertebral Syndrome with Congenital Lumbar Hernia

    OpenAIRE

    Lucky Gupta; Tariq Ahmed Mala; Rahul Gupta; Shahid Amin Malla

    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...

  9. Degenerative cervical myelopathy.

    Science.gov (United States)

    Kato, So; Fehlings, Michael

    2016-09-01

    Cervical myelopathy is the most common cause of acquired spinal cord compromise. The concept of degenerative cervical myelopathy (DCM), defined as symptomatic myelopathy associated with degenerative arthropathic changes in the spine axis, is being introduced. Given its progressive nature, treatment options have to be chosen in a timely manner. Surgical options include anterior discectomy and fusion (ACDF), anterior corpectomy and fusion (ACCF), arthroplasty (in highly select cases), posterior laminectomy with/without fusion, and laminoplasty. Indications for each should be carefully considered in individual patients. Riluzole, a sodium-glutamate antagonist, is a promising option to optimize neurologic outcomes post-surgery and is being examined in the CSM-Protect Randomized Controlled Trial. Preoperative risk assessment is mandatory for prognostication. Sagittal alignment is known to play an important role to optimize surgical outcome. Guidelines for optimal management of DCM are in process. In principle, all but the mildest cases of DCM should be offered surgery for optimal outcome. PMID:27250040

  10. 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.

  11. 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.

  12. 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.

  13. [Pediatric orthopedic cervical spine problems].

    Science.gov (United States)

    Helenius, Ilkka

    2016-01-01

    Treatment-requiring diseases of the cervical spine in children are rare. The most common cases requiring medical assessment and treatment are acute torticollis and various accidents. A torticollis having lasted for more than a week should be recognized, because it can be treated by skull traction. Cervical spine fractures in children under school age are very rare, the most common being a fracture of the base of the dens of the second cervical vertebra. Cervical spine instability is almost always associated with an underlying disease. PMID:27400588

  14. Pulmonary nodule registration in serial CT scans based on rib anatomy and nodule template matching

    International Nuclear Information System (INIS)

    An automated method is being developed in order to identify corresponding nodules in serial thoracic CT scans for interval change analysis. The method uses the rib centerlines as the reference for initial nodule registration. A spatially adaptive rib segmentation method first locates the regions where the ribs join the spine, which define the starting locations for rib tracking. Each rib is tracked and locally segmented by expectation-maximization. The ribs are automatically labeled, and the centerlines are estimated using skeletonization. For a given nodule in the source scan, the closest three ribs are identified. A three-dimensional (3D) rigid affine transformation guided by simplex optimization aligns the centerlines of each of the three rib pairs in the source and target CT volumes. Automatically defined control points along the centerlines of the three ribs in the source scan and the registered ribs in the target scan are used to guide an initial registration using a second 3D rigid affine transformation. A search volume of interest (VOI) is then located in the target scan. Nodule candidate locations within the search VOI are identified as regions with high Hessian responses. The initial registration is refined by searching for the maximum cross-correlation between the nodule template from the source scan and the candidate locations. The method was evaluated on 48 CT scans from 20 patients. Experienced radiologists identified 101 pairs of corresponding nodules. Three metrics were used for performance evaluation. The first metric was the Euclidean distance between the nodule centers identified by the radiologist and the computer registration, the second metric was a volume overlap measure between the nodule VOIs identified by the radiologist and the computer registration, and the third metric was the hit rate, which measures the fraction of nodules whose centroid computed by the computer registration in the target scan falls within the VOI identified by the

  15. Dosemetric Parameters Predictive of Rib Fractures after Proton Beam Therapy for Early-Stage Lung Cancer.

    Science.gov (United States)

    Ishikawa, Yojiro; Nakamura, Tatsuya; Kato, Takahiro; Kadoya, Noriyuki; Suzuki, Motohisa; Azami, Yusuke; Hareyama, Masato; Kikuchi, Yasuhiro; Jingu, Keiichi

    2016-01-01

    Proton beam therapy (PBT) is the preferred modality for early-stage lung cancer. Compared with X-ray therapy, PBT offers good dose concentration as revealed by the characteristics of the Bragg peak. Rib fractures (RFs) after PBT lead to decreased quality of life for patients. However, the incidence of and the risk factors for RFs after PBT have not yet been clarified. We therefore explored the relationship between irradiated rib volume and RFs after PBT for early-stage lung cancer. The purpose of this study was to investigate the incidence and the risk factors for RFs following PBT for early-stage lung cancer. We investigated 52 early-stage lung cancer patients and analyzed a total of 215 irradiated ribs after PBT. Grade 2 RFs occurred in 12 patients (20 ribs); these RFs were symptomatic without displacement. No patient experienced more severe RFs. The median time to grade 2 RFs development was 17 months (range: 9-29 months). The three-year incidence of grade 2 RFs was 30.2%. According to the analysis comparing radiation dose and rib volume using receiver operating characteristic curves, we demonstrated that the volume of ribs receiving more than 120 Gy3 (relative biological effectiveness (RBE)) was more than 3.7 cm(3) at an area under the curve of 0.81, which increased the incidence of RFs after PBT (P < 0.001). In this study, RFs were frequently observed following PBT for early-stage lung cancer. We demonstrated that the volume of ribs receiving more than 120 Gy3 (RBE) was the most significant parameter for predicting RFs. PMID:27087118

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

    OpenAIRE

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

    2015-01-01

    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 m...

  17. [Carotidynia and Eagle syndrome: two neck pain syndromes to be rediscovered].

    Science.gov (United States)

    Dulguerov, Pavel; Kohler, Romain; Becker, Minerva

    2011-10-01

    Two classical syndromes of upper cervical pain in the carotid region are discussed: carotidynia and Eagle syndrome. In both cases, after an initial period of enthusiasm, poorly defined diagnostic criteria led to frequent wrong diagnosis and poor treatment responses. This led to doubts about the existence of these syndromes. New radiologic diagnostic criteria have emerged and should allow for a more precise diagnosis. With the correct diagnosis, medical and surgical treatments should be better tailored and more efficient. PMID:22046682

  18. Carotidynie et syndrome d'Eagle : deux syndromes classiques à redécouvrir

    OpenAIRE

    Dulguerov, Pavel; Kohler, Romain Maurice; Becker, Minerva

    2011-01-01

    Two classical syndromes of upper cervical pain in the carotid region are discussed: carotidynia and Eagle syndrome. In both cases, after an initial period of enthusiasm, poorly defined diagnostic criteria led to frequent wrong diagnosis and poor treatment responses. This led to doubts about the existence of these syndromes. New radiologic diagnostic criteria have emerged and should allow for a more precise diagnosis. With the correct diagnosis, medical and surgical treatments should be better...

  19. 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.

  20. A Prospective Study of the Functional Outcome of Anterior Cervical Discectomy With Fusion in Single Level Degenerative Cervical Disc Prolapse

    Science.gov (United States)

    Kamani, Mayur M; Shetty, Vikram; Rai, H. Ravindranath; Hegde, Deepak

    2016-01-01

    Introduction Cervical spondylotic myelo-radiculopathy is a form of spinal cord dysfunction syndrome and usually accompanies age related degeneration of the spine. Aim To determine the functional outcome of anterior cervical discectomy with fusion and plating in single level degenerative cervical disc prolapse. Materials and Methods A total of 20 patients diagnosed with degenerative single level cervical disc prolapse who presented to the Department of Orthopaedic Surgery, Justice KS Hegde Charitable Hospital, Mangalore from the period of November 2012 to May 2014 were enrolled in the study. Complete clinical and radiological evaluation of the patients was done. A trial of conservative management was tried in all these patients for a period of two months. They were taken up for surgery only when conservative management had failed. Scoring of neck function before the surgery was done as per the Modified Japanese Orthopaedic Association (MJOA) score. All patients underwent anterior cervical discectomy and fusion (ACDF) with tricortical iliac crest bone grafting. Fixation was performed with titanium locking cervical plates. All patients were reviewed at 6 weeks and 6 months postoperatively. Assessment of neck function was done as per the MJOA scoring during all the reviews. Radiographic assessment was also done during all the reviews. The complications noted were documented. The statistical analysis was done using percentages; the arithmetic mean was calculated using SPSS software (version 16.0). Results Amongst the 20 patients included in the study, 1 patient died postoperatively due to oesophageal rupture. of the remaining 19 patients reviewed and followed up, all of them had improvement of symptoms and were reported to be in the ‘mild category’ as per the MJOA score. One patient developed dysphonia, in the immediate postoperative period due to recurrent laryngeal nerve palsy which recovered in a period of three months postoperative. Conclusion Single level

  1. Uterine didelphys with cervical incompetence

    OpenAIRE

    Aher Gautam S, Gavali Urmila G, Kulkarni Meghana

    2013-01-01

    Uterine didelphys represents a uterine malformation where the uterus is present as a paired organ. There is presence of double uterine bodies with two separate cervices, and often a double or septate vagina as well. We report a case of single pregnancy in the right sided uterine body of a didelphic uterus with cervical incompetence.

  2. Uterine didelphys with cervical incompetence

    Directory of Open Access Journals (Sweden)

    Aher Gautam S, Gavali Urmila G, Kulkarni Meghana

    2013-04-01

    Full Text Available Uterine didelphys represents a uterine malformation where the uterus is present as a paired organ. There is presence of double uterine bodies with two separate cervices, and often a double or septate vagina as well. We report a case of single pregnancy in the right sided uterine body of a didelphic uterus with cervical incompetence.

  3. 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

  4. Evaluating the Relationship between Rib Fractures and the Probability of Abdominal Trauma; a Brief Report

    Directory of Open Access Journals (Sweden)

    Vahid Monsef Kasmaei

    2015-02-01

    Full Text Available Introduction: Trauma is one of the most important causes of death in patients under 40 years of age and the third common cause of death regardless of age. Rib cage damages are one of the major reasons for death in the early minutes post-trauma. Therefore, the present study aimed to evaluate the frequency of intra-abdominal injury in the patients with rib fracture who were referred to emergency department. Methods: This cross-sectional study included 60 patients with rib fractures who were admitted to the emergency department of Poorsina Hospital, Rasht, Iran, from March 2011 to March2012. A checklist was filled out for all the patients including age, sex, trauma mechanism, side and site of fracture, the number of broken ribs, the results of abdominal ultrasonography, the need for laparotomy and mortality. The collected data were classified based on descriptive statistics and analyzed using SPSS 16. Results: 60 patients with the mean age of 47.26±13.71 years were admitted to the emergency department during this time (81.7% male. The most common mechanism of trauma was car accident [22(36.7%]. Among these 60 patients, 71 rib fractures in 3 levels of chest (upper, middle, lower were detected and 50 (83.3% in the same area. Mean number of fractured ribs was 2.85±2.2 (minimum: 1, maximum 10. In 3 (5% patients, fracture was on both sides. The results of abdominal ultrasonography in 7 (11.7% patients were positive. The number of fractured ribs (p=0.017 and the area of the fracture (p=0.048 showed a significant correlation with the presence of intra-abdominal free fluid. The fracture of more than 2 ribs directly correlated with the possibility of intra-abdominal hemorrhage (p<0.0001. Conclusion: Based on the results of this study, it seems that the number and area of the fractured ribs directly and significantly correlate with the probability of abdominal trauma based on the results of abdominal ultrasonography.

  5. Stress fractures of the rib arising from the manufactory assembly line

    International Nuclear Information System (INIS)

    We investigated stress injuries of the rib arising from the assembly line. The patients, all males, were 20 in number and divided into two groups; those with stress fracture (n=13) and those with ''pre-fracture'' (n=7). The former group with the average age of 37 years was involved by a single fracture in 10 patients and multiple fractures in 3, ranging from 5th to 8th ribs, with the affected side on the right in 9 and the left in 4. All 13 fractures occurred in the posterior half of the rib, in which 5 were located in its lateral portion, 5 in the middle, and 3 in the posterior. The latter group with the average age of 32 years were involved on the right side in 4 and the left in 3. The working pattern causing rib injuries was either repeated raising of the upper extremity or forward pushing of the shoulder girdle. The symptom was back pain, and aggravated especially in elevation of the arm, deep breathing and sneezing. Local tenderness over the fracture site was noted in all cases. X-ray findings at initial examination revealed fractures in most cases and 3D-CT was employed in 9 questionable cases to assess fracture conditions. In the ''pre-fracture'' group, although the fracture was not recognized on X-ray, the diagnosis was made as an impending fracture based on the localized tenderness on the rib. As to treatment, bust band fixation and work load reduction were performed. Stress fractures of the rib have been occasionally reported in sports medicine, but not so much in industrial medicine. This specific injury has been treated in literature as muscle strain because of the absence of apparent trauma. It is important to recognize the underlying pathology to make the correct diagnosis. In the early stage of rib fractures, 3D-CT was more useful than X-ray in making diagnosis and assessing the bony union. As to the pathomechanism of this condition, it was postulated that repeated raising or forward pushing of the arm applying excessive traction to the origin of the

  6. Sand transport in a two pass internal cooling duct with rib turbulators

    International Nuclear Information System (INIS)

    Highlights: • Highest particle impingement observed in the bend and first quarter of 2nd pass. • Average particle impingement per pitch is 28% higher in the second pass. • Rib faces are by far the most susceptible to particle impingement. • Particle impingement is sensitive to particle size. • Particle impingement is sensitive to wall collision model used. - Abstract: Jet engines often operate under dirty conditions where large amounts of particulate matter can be ingested, especially, sand, ash and dirt. Particulate matter in different engine components can lead to degradation in performance. The focus of this study is to investigate the sand transport and deposition in the internal cooling passages of turbine blades. A two pass stationary square duct with rib turbulators subjected to sand ingestion is studied using Large Eddy Simulations (LES). Each pass has ribs on two opposite walls and aligned normal to the main flow direction. The rib pitch to rib height (P/e) is 9.28, the rib height to channel hydraulic diameter (e/Dh) is 0.0625 and calculations have been carried out for a bulk Reynolds number of 25,000. Particle sizes in the range 0.5–25 μm are considered, with the same size distribution as found in Arizona Road Dust (medium). Large Eddy Simulation (LES) with a wall-model is used to model the flow and sand particles are modeled using a discrete Lagrangian framework. Results quantify the distribution of particle impingement density on all surfaces. Highest particle impingement density is found in the first quarter section of the second pass after the 180° turn, where the recorded impingement is more than twice that of any other region. It is also found that the average particle impingement per pitch is 28% higher in the second pass than the first pass. Results show lower particle tendency to impact the region immediately behind the rib in the first pass compared to the second pass where particle impingement is more uniform in the region between

  7. IGRT/ART phantom with programmable independent rib cage and tumor motion

    Energy Technology Data Exchange (ETDEWEB)

    Haas, Olivier C. L., E-mail: o.haas@coventry.ac.uk [Control Theory and Applications Centre, Coventry University, Coventry CV1 2TL (United Kingdom); Mills, John A.; Land, Imke; Mulholl, Pete; Menary, Paul; Crichton, Robert; Wilson, Adrian; Sage, John [Department of Clinical Physics and Bioengineering, University Hospital, Coventry CV2 2DX (United Kingdom); Anna, Morenc [University Hospitals of Leicester NHS Trust, Leicester Royal Infirmary, Leicester, LE1 5WW (United Kingdom); Depuydt, Tom [Radiotherapy, Medical Physics Group, University Hospital UZ Brussel, Laarbeeklaan 101 - 1090 Brussels (Belgium)

    2014-02-15

    Purpose: This paper describes the design and experimental evaluation of the Methods and Advanced Equipment for Simulation and Treatment in Radiation Oncology (MAESTRO) thorax phantom, a new anthropomorphic moving ribcage combined with a 3D tumor positioning system to move target inserts within static lungs. Methods: The new rib cage design is described and its motion is evaluated using Vicon Nexus, a commercial 3D motion tracking system. CT studies at inhale and exhale position are used to study the effect of rib motion and tissue equivalence. Results: The 3D target positioning system and the rib cage have millimetre accuracy. Each axis of motion can reproduce given trajectories from files or individually programmed sinusoidal motion in terms of amplitude, period, and phase shift. The maximum rib motion ranges from 7 to 20 mm SI and from 0.3 to 3.7 mm AP with LR motion less than 1 mm. The repeatability between cycles is within 0.16 mm root mean square error. The agreement between CT electron and mass density for skin, ribcage, spine hard and inner bone as well as cartilage is within 3%. Conclusions: The MAESTRO phantom is a useful research tool that produces programmable 3D rib motions which can be synchronized with 3D internal target motion. The easily accessible static lungs enable the use of a wide range of inserts or can be filled with lung tissue equivalent and deformed using the target motion system.

  8. Onlay Rib Bone Graft in Elevation of Reconstructed Auricle: 17 Years of Experience

    Directory of Open Access Journals (Sweden)

    Taehoon Kim

    2013-05-01

    Full Text Available Background  A cartilage wedge block and covering flap are standard procedures for firmelevation of the ear in microtia correction. However, using costal cartilage for elevation ofthe reconstructed auricle can be insufficient, and the fixed cartilage wedge block may beabsorbed or may slip out. Furthermore, elevating covering flaps is time-consuming and usesup fascia, a potential source of reconstruction material. Therefore, we propose an innovativemethod using autologous onlay rib bone graftfor auricular elevation ofmicrotia.Methods  From February 1995 to August 2012, 77 patients received a first stage operationwith a rib cartilage framework graft. In the second stage operation, a small full thickness ofrib bone was harvested through the previous donor scar. The bihalved rib bone was insertedinto the subperiosteal pocket beneath the cartilage framework.Results  The follow-up time ranged from 1 month to 17 years, with a mean of 3 years. Allof the patients sustained the elevation of their ears very well during the follow-up period.Donorsite problems, exceptfor hypertrophic scars,were not observed. Surgery-related complications,specifically skin necrosis, infection, or hematoma, occurred in 4 cases.Conclusions  Onlay rib bone graft used to elevate the reconstructed auricle is a more anatomically appropriate materialthan cartilage, due to the bone-to-bone contact between thebone graft and the temporal bone. Postoperative minor correction of the elevation degree isstraightforward and the skin graft survives better. Therefore, reconstructed auricle elevationusing onlay rib bone graftis a useful and valuablemethod.

  9. Combined effects of rotation and rib-roughness - a dns study of turbulent channel flow

    Science.gov (United States)

    Andersson, Helge I.; Narasimhamurthy, Vagesh D.

    2014-11-01

    The combined effects of system rotation and rib-roughness on turbulent channel flow have been investigated by means of direct numerical simulations. Square ribs were placed on both walls in a non-staggered arrangement and the channel was subjected to steady rotation about a spanwise axis for a series of rotation numbers up to Ro = 24. A pressure-loss reduction of about 20 per cent resulted from the imposed rotation at Ro = 6. In spite of the 10 per cent blockage due to the wall-mounted ribs, the flow field exhibited statistical streamwise homogeneity in the core region. The mean velocity varied linearly with a slope such that the mean fluid rotation exactly outweighed the imposed system rotation. The flow field in the vicinity of the ribs was affected differently at the two sides of the rotating channel. The separated flow region behind the ribs on the anti-cyclonic pressure side shrinked with increasing Ro due to the enhanced turbulent mixing caused by the Coriolis force. The original d-type roughness was thus turned into a k-type roughness.

  10. Stress fractures of the ribs in elite competitive rowers: a report of nine cases

    International Nuclear Information System (INIS)

    The objective was to report the clinical and imaging patterns of nine cases of stress fractures of the rib diagnosed in Italian Olympic rowers. Nine patients with stress fractures of the rib detected from 103 (8.7%) Italian team rowers competing between May 2000 and May 2006 were identified based on the database of a sports medicine institute. All athletes were male. They were aged between 17 and 31 years (mean: 24.4). Patient weight, fracture location, rowing side and imaging methods employed were noted. The diagnosis was made based on history, clinical examination and Tc-99m MDP bone scintigraphy. Eight of the 9 fractures were located anterolaterally between the fourth and ninth rib. In 1 of the 5 athletes with standard radiographs, a fracture line was visible and in 4 there was callus formation. In 2 athletes sonography was performed, which detected discontinuity of the rib surface and callus formation (1 case each). Stress fractures of the ribs are relatively common in competitive rowers. They are characterized by increasing lateral chest pain and typical scintigraphic, radiographic and sonographic findings. (orig.)

  11. 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

  12. Stress fractures of the ribs in elite competitive rowers: a report of nine cases

    Energy Technology Data Exchange (ETDEWEB)

    Dragoni, S. [Institute of Sport Medicine and Science of the Italian Olympic Committee, Department of Radiology, Rome (Italy); Giombini, A.; Ripani, M. [University of Motor Sciences, Department of Health, Rome (Italy); Di Cesare, A. [University of Rome ' ' La Sapienza' ' , Department of Physical Medicine and Rehabilitation, Rome (Italy); Magliani, G. [Medical Department of the Italian State Police, Rome (Italy)

    2007-10-15

    The objective was to report the clinical and imaging patterns of nine cases of stress fractures of the rib diagnosed in Italian Olympic rowers. Nine patients with stress fractures of the rib detected from 103 (8.7%) Italian team rowers competing between May 2000 and May 2006 were identified based on the database of a sports medicine institute. All athletes were male. They were aged between 17 and 31 years (mean: 24.4). Patient weight, fracture location, rowing side and imaging methods employed were noted. The diagnosis was made based on history, clinical examination and Tc-99m MDP bone scintigraphy. Eight of the 9 fractures were located anterolaterally between the fourth and ninth rib. In 1 of the 5 athletes with standard radiographs, a fracture line was visible and in 4 there was callus formation. In 2 athletes sonography was performed, which detected discontinuity of the rib surface and callus formation (1 case each). Stress fractures of the ribs are relatively common in competitive rowers. They are characterized by increasing lateral chest pain and typical scintigraphic, radiographic and sonographic findings. (orig.)

  13. First-rib stress fracture in two adolescent swimmers: a case report.

    Science.gov (United States)

    Low, Sara; Kern, Michael; Atanda, Alfred

    2016-07-01

    First-rib stress fractures have been described in adolescent athletes in various sports, with only one prior case report of first-rib stress fractures in an adolescent female swimmer. There is a need for research on the cause, management, and prevention of these injuries as they lead to significant morbidity and critical time away from sport for these aspiring athletes. We aimed to describe first-rib stress fractures as a potential cause for non-specific atraumatic chronic shoulder pain in adolescent swimmers and to discuss the different presentations, unique risk factors, treatment, and potential injury prevention strategies of such fractures. We discussed two such cases which were successfully treated with activity modification with restriction of all overhead activity, gradually progressive physical therapy and a return to swimming protocol. First-rib stress fractures can vary in presentation and should be in the differential diagnosis in adolescent swimmers with chronic shoulder pain. These injuries can be successfully managed with rest from overhead activities and physical therapy. Gradual return to competitive swimming can be achieved even with non-union of a first-rib stress fracture. Emphasis on balanced strength training in different muscle groups and proper swimming technique is essential to prevent these injuries. PMID:26539736

  14. 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.

  15. Cervical metastatic glioblastoma multiforme

    International Nuclear Information System (INIS)

    Glioblastoma multiforme (GBM) is the most common and most malignant primary brain tumour in adults. In spite of the hostile nature of glioblastoma multiforme (GBM), extracranial spread is not a common event. With improving management choices and survival times, reports of extracranial occurrence of GBM have increased. Most commonly these metastases are to the lungs, lymph nodes, neck, skull, scalp, liver, and bones; may be evident on routine follow-up images of the original lesion. Head and neck metastasis of GBM can be debilitating. We present a case of cervical metastasis of GBM and discuss possible mechanisms of extraneural spread of this tumour. (author)

  16. Radiotherapy of Cervical Cancer.

    Science.gov (United States)

    Vordermark, Dirk

    2016-01-01

    Curative-intent radical radiotherapy of cervical cancer consists of external-beam radiotherapy, brachytherapy, and concomitant chemotherapy with cisplatin. For each element, new developments aim to improve tumor control rates or treatment tolerance. Intensity-modulated radiotherapy (IMRT) has been shown to reduce gastrointestinal toxicity and can be used to selectively increase the radiotherapy dose. Individualized, image-guided brachytherapy enables better adaptation of high-dose volumes to the tumor extension. Intensification of concomitant or sequential systemic therapy is under evaluation. PMID:27614991

  17. Posterior Cervical Foraminotomy: Indications, Technique, and Outcomes.

    Science.gov (United States)

    Dodwad, Shah-Jahan M; Dodwad, Shah-Nawaz M; Prasarn, Mark L; Savage, Jason W; Patel, Alpesh A; Hsu, Wellington K

    2016-06-01

    Cervical radiculopathy presents with upper extremity pain, decreased sensation, and decreased strength caused by irritation of specific nerve root(s). After failure of conservative management, surgical options include anterior cervical decompression and fusion, disk arthroplasty, and posterior cervical foraminotomy. In this review, we discuss indications, techniques, and outcomes of posterior cervical laminoforaminotomy. PMID:27187617

  18. Horner's syndrome after blunt cervical and chest trauma: case report Síndrome de Horner após trauma cérvico-torácico fechado: relato de caso

    OpenAIRE

    Wellingson Silva Paiva; Robson Luis Oliveira de Amorim; Wagner Malago Tavares; Eduardo Joaquim Lopes Alho; Brasil Ping Jeng; Eberval Gadelha Figueiredo

    2007-01-01

    Horner‘s syndrome is the triad of miosis, ptosis, and anhidrosis, resulting from disruption of the sympathetic pathways. This article describes an uncommon case of Horner‘s syndrome in a 22-year-old man after blunt trauma to the neck and chest without carotid artery dissection. The patient was brought to the emergency service after motorcycle fall. Neurologic examination revealed a patient presenting the score 15 at Glasgow Coma Scale. The left eyelid was 1-2 mm lower than the right. Carotid ...

  19. 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.

  20. Instrumental neutron activation analysis of rib bone samples and of bone reference materials

    International Nuclear Information System (INIS)

    The instrumental neutron activation analysis method was used for the determination of trace elements in rib bone samples taken from autopsies of accident victims. The elements Br, Ca, Cl, Cr, Fe, Mg, Mn, Na, P, Sr, Rb and Zn were determined in cortical tissues by using short and long irradiations with thermal neutron flux of the IEA-R1m nuclear reactor. The reference materials NIST SRM 1400 Bone Ash and NIST SRM 1486 Bone Meal were also analyzed in order to evaluate the precision and the accuracy of the results. It was verified that lyophilization is the most convenient process for drying bone samples since it does not cause any element losses. Comparisons were made between the results obtained for rib samples and the literature values as well as between the results obtained for different ribs from a single individual and for bones from different individuals. (author)

  1. 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. PMID:23262983

  2. [Cervical Spondylotic Amyotrophy].

    Science.gov (United States)

    Sonoo, Masahiro

    2016-05-01

    Keegan (1965) reported a patient who presented with "dissociated motor loss," an acute paralysis of the upper extremity with minimal sensory signs and no long tract signs, and documented an anterior root lesion following autopsy. Sobue et al. (1975) reported similar cases using the term "cervical spondylotic amyotrophy (CSA)," but postulated pathology of the anterior horn. Although Keegan's "dissociated motor loss" surely referred to isolated motor paresis with no or minimal sensory signs, contrary to existing criticism, a more general term, CSA, should be preferred. CSA is divided into proximal and distal types. Distal CSA often presents with a drop finger, and thus may be misdiagnosed as posterior interosseous nerve palsy. Documentation of the involvement of ulnar muscles by clinical signs and EMG would lead to the diagnosis of distal CSA. Proximal CSA may be confused with neuralgic amyotrophy (NA), although the sparing of the serratus anterior and the stereotypic involvement of deltoid, infraspinatus, biceps brachii, and brachioradialis suggest CSA. Cervical MRI is not diagnostic in around half of CSA cases, and denervation in paraspinal EMG is a more sensitive test that can exclude NA. Amyotrophic lateral sclerosis is another important differential diagnosis for CSA. PMID:27156504

  3. CASINO: Surgical or Nonsurgical Treatment for cervical radiculopathy, a randomised controlled trial

    NARCIS (Netherlands)

    Geest, S. de; Kuijper, B.; Oterdoom, M.; Hout, W. van den; Brand, R.; Stijnen, T.; Assendelft, P.; Koes, B.; Jacobs, W.; Peul, W.; Vleggeert-Lankamp, C.

    2014-01-01

    BACKGROUND: Cervical radicular syndrome (CRS) due to a herniated disc can be safely treated by surgical decompression of the spinal root. In the vast majority of cases this relieves pain in the arm and restores function. However, conservative treatment also has a high chance on relieving symptoms. T

  4. CASINO: Surgical or nonsurgical treatment for cervical radiculopathy, a randomised controlled trial

    NARCIS (Netherlands)

    S. van Geest; B. Kuijper (Barbara); M. Oterdoom (Marinus); W.B. van den Hout (Wilbert); R. Brand (René); Th. Stijnen (Theo); P. Assendelft (Pim); B.W. Koes (Bart); W. Jacobs (Wouter); W.C. Peul (Wilco); C.L.A.M. Vleggeert-Lankamp (Carmen)

    2014-01-01

    textabstractBackground: Cervical radicular syndrome (CRS) due to a herniated disc can be safely treated by surgical decompression of the spinal root. In the vast majority of cases this relieves pain in the arm and restores function. However, conservative treatment also has a high chance on relieving

  5. Diffuse idiopathic skeletal hyperostosis of cervical spine - An unusual cause of difficult flexible fiber optic intubation

    Directory of Open Access Journals (Sweden)

    Baxi Vaibhavi

    2010-01-01

    Full Text Available This is a report of anterior osteophytes on the cervical vertebra resulting in distortion of the airway and leading to difficulty during intubation. The osteophytes associated with the syndrome of diffuse idiopathic skeletal hyperostosis were at the C2-3 and C6-7, T1 level and resulted in anterior displacement of the pharynx and the trachea respectively.

  6. Blunt liver injury with intact ribs under impacts on the abdomen: a biomechanical investigation.

    Directory of Open Access Journals (Sweden)

    Yu Shao

    Full Text Available Abdominal trauma accounts for nearly 20% of all severe traffic injuries and can often result from intentional physical violence, from which blunt liver injury is regarded as the most common result and is associated with a high mortality rate. Liver injury may be caused by a direct impact with a certain velocity and energy on the abdomen, which may result in a lacerated liver by penetration of fractured ribs. However, liver ruptures without rib cage fractures were found in autopsies in a series of cases. All the victims sustained punches on the abdomen by fist. Many studies have been dedicated to determining the mechanism underlying hepatic injury following abdominal trauma, but most have been empirical. The actual process and biomechanism of liver injury induced by blunt impact on the abdomen, especially with intact ribs remained, are still inexhaustive. In order to investigate this, finite element methods and numerical simulation technology were used. A finite element human torso model was developed from high resolution CT data. The model consists of geometrically-detailed liver and rib cage models and simplified models of soft tissues, thoracic and abdominal organs. Then, the torso model was used in simulations in which the right hypochondrium was punched by a fist from the frontal, lateral, and rear directions, and in each direction with several impact velocities. Overall, the results showed that liver rupture was primarily caused by a direct strike of the ribs induced by blunt impact to the abdomen. Among three impact directions, a lateral impact was most likely to cause liver injury with a minimum punch speed of 5 m/s (the momentum was about 2.447 kg.m/s. Liver injuries could occur in isolation and were not accompanied by rib fractures due to different material characteristics and injury tolerance.

  7. Biomechanical investigation of impact induced rib fractures of a porcine infant surrogate model.

    Science.gov (United States)

    Blackburne, William B; Waddell, J Neil; Swain, Michael V; Alves de Sousa, Ricardo J; Kieser, Jules A

    2016-09-01

    This study investigated the structural, biomechanical and fractographic features of rib fractures in a piglet model, to test the hypothesis that fist impact, apart from thoracic squeezing, may result in lateral costal fractures as observed in abused infants. A mechanical fist with an accelerometer was constructed and fixed to a custom jig. Twenty stillborn piglets in the supine position were impacted on the thoracic cage. The resultant force versus time curves from the accelerometer data showed a number of steps indicative of rib fracture. The correlation between impact force and number of fractures was statistically significant (Pearson׳s r=0.528). Of the fractures visualized, 15 completely pierced the parietal pleura of the thoracic wall, and 5 had butterfly fracture patterning. Scanning electron microscopy showed complete bone fractures, at the zone of impact, were normal to the axis of the ribs. Incomplete vertical fractures, with bifurcation, occurred on the periphery of the contact zone. This work suggests the mechanism of rib failure during a fist impact is typical of the transverse fracture pattern in the anterolateral region associated with cases of non-accidental rib injury. The impact events investigated have a velocity of ~2-3m/s, approximately 2×10(4) times faster than previous quasi-static axial and bending tests. While squeezing the infantile may induce buckle fractures in the anterior as well as posterior region of the highly flexible bones, a fist punch impact event may result in anterolateral transverse fractures. Hence, these findings suggest that the presence of anterolateral rib fractures may result from impact rather than manual compression. PMID:27310573

  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. 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.

  10. Scintigraphic diagnosis of sport injuries: Multiple fractures of ribs by golf-players

    International Nuclear Information System (INIS)

    Three untrained golf-players suffered from pain in the dorsal region of the left thorax after some training hours. Three to four weeks after the pains had begun serial fractures of ribs were diagnosed by sup(99m)Tc-MDP bonescan-examinations. All fractures were localized near the costal angulus (paravertebral) of these ribs. The fractures are caused by manual tensions. The difficulties in timing the bone-scan and in identifying the morphologic substrate are demonstrated. It is recommended, that golf-players suffering from thoracic pain ought to be examined by bone scan. (orig.)

  11. Turbulent flow in rib-roughened channel under the effect of Coriolis and rotational buoyancy forces

    OpenAIRE

    Coletti, Filippo; Lo Jacono, David; Cresci, Irene; Arts, Tony

    2014-01-01

    The turbulent flow inside a rotating channel provided with transverse ribs along one wall is studied by means of two-dimensional time-resolved particle image ve- locimetry. The measurement set-up is mounted on the same rotating disk with the test section, allowing to obtain the same accuracy and resolution as in a non-rotating rig. The Reynolds number is 15 000, and the rotation number is 0.38. As the ribbed wall is heated, both the Coriolis force and the centrifugal force play a role in the ...

  12. Numerical investigation of turbulent flow and heat transfer in channel with ribs

    DEFF Research Database (Denmark)

    Myllerup, Lisbeth; Larsen, Poul Scheel

    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....

  13. The battered child syndrome

    International Nuclear Information System (INIS)

    The recognition of a battered child represents a challenge for all groups of adults dealing with children. Radiology plays a special role in this setting. By detection typical injuries, imaging is able to confirm the suspicion of a battered child. Recognition of those injuries on films, taken for other reasons, gives the caretaker an important hint, thus maybe preventing a fatal outcome for the child. One of the most important injury types is represented by the so called ''shakin baby syndrome''. The infant is held by the thorax and shaken. Thus causing a repetitive acceleration-deceleration trauma, which leads to the typical paravertebral rib fractures, intracranial bleeding and eye injuries. After shaking the child is thrown away, with subsequent injuries. The aim of this article is the presentation of an overview regarding the radiology of the battered child. Typical examples will be shown. (orig.)

  14. The Vault with Curvilinear Ribs in the "Hall of Arms" in the Albrechtsburg Meissen: Studies on the Concept, Design and Construction of a Complex Late Gothic Rib Vault

    OpenAIRE

    Wendland, David; Aranda Alonso, María; Kobe, Alexander

    2015-01-01

    The current state of research on the design and construction of late Gothic vaults is principally based on the interpretation of sources, but rarely on surveys of existing vaults. In particular the idea for the criteria upon which the radii of the single ribs and arches were determined (so-called "principal arch"), is found to derive from sources dating from later periods when Gothic vaulting was no longer generally practised. In fact, this interpretation cannot be supported by geometric surv...

  15. Maffucci syndrome: Anaesthetic management and review of literature

    Directory of Open Access Journals (Sweden)

    Gyaninder P Singh

    2015-01-01

    Full Text Available Maffucci syndrome is a rare, nonhereditary disorder manifesting early in life. The syndrome is characterized by presence of multiple hemangiomas and enchondromas mostly affecting the extremities. Haemangiomas are usually cutaneous, but may sometimes be visceral as well. Enchondromas commonly affect the long bones of the extremities. However, other areas including skull, ribs, vertebrae, larynx and trachea may also be involved. The presence of these lesions in the trachea and/or oropharynx may compromise the airway and cause difficulty during tracheal intubation. Complete airway examination and investigation is important to rule out any such lesion in a patient of Maffucci syndrome before planning for general anaesthesia with tracheal intubation.

  16. 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

  17. 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

  18. 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.

  19. Rib fracture after stereotactic radiotherapy for primary lung cancer: prevalence, degree of clinical symptoms, and risk factors

    International Nuclear Information System (INIS)

    As stereotactic body radiotherapy (SBRT) is a highly dose-dense radiotherapy, adverse events of neighboring normal tissues are a major concern. This study thus aimed to clarify the frequency and degree of clinical symptoms in patients with rib fractures after SBRT for primary lung cancer and to reveal risk factors for rib fracture. Appropriate α/β ratios for discriminating between fracture and non-fracture groups were also investigated. Between November 2001 and April 2009, 177 patients who had undergone SBRT were evaluated for clinical symptoms and underwent follow-up thin-section computed tomography (CT). The time of rib fracture appearance was also assessed. Cox proportional hazard modeling was performed to identify risk factors for rib fracture, using independent variables of age, sex, maximum tumor diameter, radiotherapeutic method and tumor-chest wall distance. Dosimetric details were analyzed for 26 patients with and 22 randomly-sampled patients without rib fracture. Biologically effective dose (BED) was calculated with a range of α/β ratios (1–10 Gy). Receiver operating characteristics analysis was used to define the most appropriate α/β ratio. Rib fracture was found on follow-up thin-section CT in 41 patients. The frequency of chest wall pain in patients with rib fracture was 34.1% (14/41), and was classified as Grade 1 or 2. Significant risk factors for rib fracture were smaller tumor-chest wall distance and female sex. Area under the curve was maximal for BED at an α/β ratio of 8 Gy. Rib fracture is frequently seen on CT after SBRT for lung cancer. Small tumor-chest wall distance and female sex are risk factors for rib fracture. However, clinical symptoms are infrequent and generally mild. When using BED analysis, an α/β ratio of 8 Gy appears most effective for discriminating between fracture and non-fracture patients

  20. Spinal surgery -- cervical - series (image)

    Science.gov (United States)

    ... on the vertebral bodies (osteophytes), which compress spinal nerves, trauma, and narrowing (stenosis) of the spinal column around the spinal cord. Symptoms of cervical spine problems include: pain that interferes with daily ...

  1. Recurrent intramedullary cervical ependymal cyst

    Directory of Open Access Journals (Sweden)

    Chhabra R

    2003-01-01

    Full Text Available We report a rare case of high cervical intramedullary ependymal cyst in a young boy. This was associated with atlantoaxial dislocation. After partial removal and marsupialization, the cyst recurred and needed radical total resection.

  2. 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...

  3. Beals Syndrome

    Science.gov (United States)

    ... Boards & Staff Annual Report & Financials Contact Us Donate Marfan & Related Disorders What is Marfan Syndrome? What are ... the syndrome. How does Beals syndrome compare with Marfan syndrome? People with Beals syndrome have many of ...

  4. Poland's syndrome revisited.

    Science.gov (United States)

    Fokin, Alexander A; Robicsek, Francis

    2002-12-01

    Poland's syndrome is a rare congenital anomaly characterized by unilateral chest wall hypoplasia and ipsilateral hand abnormalities. Literary data suggest its sporadic nature. The prevailing theory of its cause is hypoplasia of the subclavian artery or its branches, which may lead to a range of developmental changes. The incidence of Poland's syndrome varies between groups (male versus female patients, congenital versus familial cases, and so on) and ranges from 1 in 7,000 to 1 in 100,000 live births. Cases of Poland's syndrome associated with leukemia, carcinoma of the hypoplastic breast, and other conditions, confirm the relationship between developmental defects and tumors, and require oncologic awareness. Various manifestations, age, and gender require different surgical approaches. Our experience, which includes 27 patients (15 male, 12 female), 20 of whom (12 male, 8 female) underwent operation, suggests that the repair should be done in two stages in children and in a single stage in adults. Reconstruction and/or stabilization of the aplastic ribs may be achieved using bone grafts or prosthetic mesh. Muscle flaps and breast implants may be used to correct muscle deficiency and breast hypoplasia and to help achieve a complete cosmetic repair. PMID:12643435

  5. Reoperations Following Cervical Disc Replacement

    OpenAIRE

    Skovrlj, Branko; Lee, Dong-Ho; Caridi, John Michael; Cho, Samuel Kang-Wook

    2015-01-01

    Cervical disc replacement (CDR) has emerged as an alternative surgical option to cervical arthrodesis. With increasing numbers of patients and longer follow-ups, complications related to the device and/or aging spine are growing, leaving us with a new challenge in the management and surgical revision of CDR. The purpose of this study is to review the current literature regarding reoperations following CDR and to discuss about the approaches and solutions for the current and future potential c...

  6. Cervical Disc Disease: Biomechanical Aspects

    OpenAIRE

    Kolstad, Frode

    2011-01-01

    Degenerative disc disease in the cervical spine may cause significant pain and disability. Patients present themselves with neck pain, radiculopathy, and/or myelopathy. When the symptoms do not improve with conservative treatment, surgical treatment is considered. The goal of surgical treatment is to decompress nervous structures and to restore the normal anatomical conditions of disc height, alignment, and stability.The present thesis concerns four studies involving the treatment of cervical...

  7. 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.

  8. 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...

  9. Stable level and phase control circuits for high power VHF transmitters for RIB applications

    International Nuclear Information System (INIS)

    For most applications it is required that the output power level and insertion phase of a high power transmitter remain unchanged against ambient temperature variation and power supply fluctuations. Design schemes for a stable level controller and a phase controller for use in a VHF transmitter that has been indigenously developed for RIB application at VECC is presented in this paper. (author)

  10. 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...

  11. 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.

  12. Flavin binding to the high affinity riboflavin transporter RibU

    NARCIS (Netherlands)

    Duurkens, Hinderika; Tol, Menno B.; Geertsma, Eric R.; Permentier, Hjalmar P.; Slotboom, Dirk Jan

    2007-01-01

    The first biochemical and spectroscopic characterization of a purified membrane transporter for riboflavin ( vitamin B-2) is presented. The riboflavin transporter RibU from the bacterium Lactococcus lactis was overexpressed, solubilized, and purified. The purified transporter was bright yellow when

  13. Effect of rib cage and abdominal restriction on total respiratory resistance and reactance.

    Science.gov (United States)

    van Noord, J A; Demedts, M; Clément, J; Cauberghs, M; Van de Woestijne, K P

    1986-11-01

    In 14 healthy male subjects we studied the effects of rib cage and abdominal strapping on lung volumes, airway resistance (Raw), and total respiratory resistance (Rrs) and reactance (Xrs). Rib cage, as well as abdominal, strapping caused a significant decrease in vital capacity (respectively, -36 and -34%), total lung capacity (TLC) (-31 and -27%), functional residual capacity (FRC) (-28 and -28%), and expiratory reserve volume (-40 and -48%) and an increase in specific airway conductance (+24 and +30%) and in maximal expiratory flow at 50% of control TLC (+47 and +42%). The decrease of residual volume (RV) was significant (-12%) with rib cage strapping only. Abdominal strapping resulted in a minor overall increase in Rrs, whereas rib cage strapping produced a more marked increase at low frequencies; thus a frequency dependence of Rrs was induced. A similar pattern, but with lower absolute values, of Rrs was obtained by thoracic strapping when the subject was breathing at control FRC. Xrs was decreased, especially at low frequencies, with abdominal strapping and even more with thoracic strapping; thus the resonant frequency of the respiratory system was shifted toward higher frequencies. Partitioning Rrs and Xrs into resistance and reactance of lungs and chest wall demonstrated that the different effects of chest wall and abdominal strapping on Rrs and Xrs reflect changes mainly of chest wall mechanics. PMID:3781983

  14. 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.

  15. PENGARUH KEPUASAN KONSUMEN TERHADAP KESETIAN MEREK (Studi Kasus Restoran The Prime Steak & Ribs Surabaya

    Directory of Open Access Journals (Sweden)

    Foedjiawati Foedjiawati

    2005-01-01

    Full Text Available This is a research which observes the relationship between customer satisfaction and their loyalty to The Prime Steak & Ribs Restaurant. The customer satisfaction is measured through some attributes such as, attributes related to the product, attributes related to the service, and attributes related to the purchase. Meanwhile, the loyalty of its brand is measured through habitual behaviour, switching cost, satisfaction, liking of the brand and commitment. The result of the research reveals that customer satisfaction levels to The Prime Steak & Ribs Restaurant tends to be good. Some attributes still have a variety of high grade, and there is a positive causal influence that is significant between the customer satisfaction and the loyalty of the brand. Thus, the result of the research is relevant and at the same time supports the theory of brand loyalty. Abstract in Bahasa Indonesia : Penelitian Pengaruh Kepuasan Konsumen terhadap Kesetiaan Merek pada Restoran the Prime Steak & Ribs, kepuasan konsumen diukur melalui Attributes related to the product, Attributes related to the service, Attributes related to the purchase, kesetiaan merek diukur melalui habitual behaviour, switching cost, satisfaction, liking of the brand, dan commitment. Hasil penelitian mengungkapakan bahwa kepuasan konsumen di The Prime Steak & Ribs mendapat penilaian yang cenderung baik, beberapa atribut masih mempunyai variasi penilaian yang tinggi, dan terdapat hubungan pengaruh positip yang signifikan antara kepuasan konsumen dengan kesetiaan merek, dengan demikian hasil penelitian mendukung konsep teori tentang kesetiaan merek. Kata kunci: kepuasan, kesetiaan merek.

  16. Detection of rib fractures in an abused infant using digital radiography: a laboratory study

    International Nuclear Information System (INIS)

    To assess the diagnostic performance of digital radiography using charge-coupled device (CCD) technology in the detection of rib fracture in infant abuse.Materials and methods. Four fractured posterior rib arcs and eight normal ribs removed at autopsy from a 10-month-old abused infant were radiographed using a CCD prototype, four clinical film-screen systems, and direct-exposure film. Each rib was viewed with these six systems in nine different projections. The resultant 648 images were assessed for probability of fracture (0-100%) by four pediatric radiologists. The calculated area under the resultant ROC curves (Az) for the CCD was compared with those obtained with direct-exposure, high-detail, medium and fast film-screen radiographic systems. The mean Az for the CCD (0.937) fell within the range of the high-detail systems (0.934-0.940) and was significantly higher (p20 line pairs per millimeter) the CCD performance was comparable (Az=0.944 vs. 0.937). The similar performance can be explained by the higher contrast resolution of the digital technology. This study indicates that in the ex vivo setting, digital radiology can perform comparably to high-detail film-screen imaging. The findings suggest that digital radiography has the potential to replace film-screen imaging in the evaluation of inflicted skeletal injury in infants. (orig.)

  17. EFFECTS OF FORAGE SPECIES ON RIB COMPOSITION, COLOR, AND PALATABILITY IN FORAGE-FINISHED BEEF

    Science.gov (United States)

    Forty-seven Angus-crossbred steers were used to evaluate the effects of forage species grazed in the last 41 d of the finishing period on rib composition, color, and palatability in forage-finished beef and compared to traditional high concentrate finished. Steers grazed naturalized pastures (bluegr...

  18. Rib Torque Does Not Assist Resting Tidal Expiration or Most Conversational Speech Expiration

    Science.gov (United States)

    Hixon, Thomas J.

    2006-01-01

    Purpose: This research note discusses a common misconception in speech science and speech-language pathology textbooks that rib torque (i.e., "rotational stress") assists resting tidal expiration and conversational speech production. Method: The nature of this misconception is considered. Conclusion: An alternate conceptualization is offered that…

  19. Medial scapular winging associated with rib fractures and plating corrected with pectoralis major transfer

    Directory of Open Access Journals (Sweden)

    John G. Skedros

    2014-01-01

    CONCLUSION: Although the specific cause of the long thoracic nerve injury could not be determined in our patient, it was associated with chest wall trauma in the setting of rib fracture ORIF. The scapular winging was surgically corrected with a pectoralis major transfer.

  20. Clinical significance of conventional rib series in patients with minor thoracic trauma

    International Nuclear Information System (INIS)

    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

  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. Data Qualification Report For DTN: MO0012RIB00065.002, Parameter Values For Transfer Coefficients

    International Nuclear Information System (INIS)

    A data-qualification evaluation was conducted on Reference Information Base (RIB) data set MOO0 12RIB00065.002, ''Parameter Values for Transfer Coefficients''. The corroborating data method was used to evaluate the data. This method was selected because it closely matches the literature-review method followed to select parameter values. Five criteria were considered when the corroborating method was used: adequacy of the corroborative literature, sufficiency of value-selection criteria, implementation of the selection criteria, documentation of the process, and whether the analysis was conducted in accordance with applicable quality assurance (QA) procedures. Three criteria were used when a literature review was not conducted: appropriate logic used to select parameters, documentation of the process, and whether the analysis was conducted in accordance with applicable QA procedures. The RIB data item, the associated Analysis and Model Report (AMR), the corroborative literature, and the results of an audit revision O/ICN--0 of the AMR were examined. All calculations and the selection process for all values were repeated and confirmed. The qualification team concluded: (1) A sufficient quantity of corroborative literature was reviewed and no additional literature was identified that should have been considered. (2) The selection criteria were sufficient and resulted in valid parameter values. (3) The process was well defined, adequately documented in the AMR, and correctly followed. (4) The analysis was developed in accordance with applicable QA procedures. No negative findings were documented that resulted in questions about the quality of the data. The qualification team therefore recommends that the qualification status of RIB data set MO0012RIB00065.002 be changed to qualified

  3. Modelling of the acoustic field of a multi-element HIFU array scattered by human ribs

    International Nuclear Information System (INIS)

    The efficacy of high-intensity focused ultrasound (HIFU) for the treatment of a range of different cancers, including those of the liver, prostate and breast, has been demonstrated. As a non-invasive focused therapy, HIFU offers considerable advantages over techniques such as chemotherapy and surgical resection in terms of reduced risk of harmful side effects. Despite this, there are a number of significant challenges which currently hinder its widespread clinical application. One of these challenges is the need to transmit sufficient energy through the rib cage to induce tissue necrosis in the required volume whilst minimizing the formation of side lobes. Multi-element random-phased arrays are currently showing great promise in overcoming the limitations of single-element transducers. Nevertheless, successful treatment of a patient with liver tumours requires a thorough understanding of the way in which the ultrasonic pressure field from a HIFU array is scattered by the rib cage. In order to address this, a boundary element approach based on a generalized minimal residual (GMRES) implementation of the Burton-Miller formulation was used in conjunction with phase conjugation techniques to focus the field of a 256-element random HIFU array behind human ribs at locations requiring intercostal and transcostal treatment. Simulations were carried out on a 3D mesh of quadratic pressure patches generated using CT scan anatomical data for adult ribs 9-12 on the right side. The methodology was validated on spherical and cylindrical scatterers. Field calculations were also carried out for idealized ribs, consisting of arrays of strip-like scatterers, demonstrating effects of splitting at the focus. This method has the advantage of fully accounting for the effect of scattering and diffraction in 3D under continuous wave excitation.

  4. HIFU scattering by the ribs: constrained optimisation with a complex surface impedance boundary condition

    International Nuclear Information System (INIS)

    High intensity focused ultrasound (HIFU) enables highly localised, non-invasive tissue ablation and its efficacy has been demonstrated in the treatment of a range of cancers, including those of the kidney, prostate and breast. HIFU offers the ability to treat deep-seated tumours locally, and potentially bears fewer side effects than more established treatment modalities such as resection, chemotherapy and ionising radiation. There remains however a number of significant challenges which currently hinder its widespread clinical application. One of these challenges is the need to transmit sufficient energy through the ribcage to ablate tissue at the required foci whilst minimising the formation of side lobes and sparing healthy tissue. Ribs both absorb and reflect ultrasound strongly. This sometimes results in overheating of bone and overlying tissue during treatment, leading to skin burns. Successful treatment of a patient with tumours in the upper abdomen therefore requires a thorough understanding of the way acoustic and thermal energy is deposited. Previously, a boundary element (BE) approach based on a Generalised Minimal Residual (GMRES) implementation of the Burton-Miller formulation was developed to predict the field of a multi-element HIFU array scattered by human ribs, the topology of which was obtained from CT scan data [1]. Dissipative mechanisms inside the propagating medium have since been implemented, together with a complex surface impedance condition at the surface of the ribs. A reformulation of the boundary element equations as a constrained optimisation problem was carried out to determine the complex surface velocities of a multi-element HIFU array which generated the acoustic pressure field that best fitted a required acoustic pressure distribution in a least-squares sense. This was done whilst ensuring that an acoustic dose rate parameter at the surface of the ribs was kept below a specified threshold. The methodology was tested at an

  5. Heat transfer augmentation for high heat flux removal in rib-roughened narrow channels

    International Nuclear Information System (INIS)

    Heat transfer augmentation in narrow rectangular channels in a target system is a very important method to remove high heat flux up to 12 MW/m2 generated at target plates of a high-intensity proton accelerator of 1.5 GeV and 1 mA with a proton beam power of 1.5 MW. In this report, heat transfer coefficients and friction factors in narrow rectangular channels with one-sided rib-roughened surface were evaluated for fully developed flows in the range of the Reynolds number from 6,000 to 1,00,000; the rib pitch-to-height ratios (p/k) were 10,20 and 30; the rib height-to-equivalent diameter ratios (k/De) were 0.025, 0.03 and 0.1 by means of previous existing experimental correlations. The rib-roughened surface augmented heat transfer coefficients approximately 4 times higher than the smooth surface at Re=10,000, p/k=10 and k/De=0.1; friction factors increase around 22 times higher. In this case, higher heat flux up to 12 MW/m2 could be removed from the rib-roughened surface without flow boiling which induces flow instability; but pressure drop reaches about 1.8 MPa. Correlations obtained by air-flow experiments have showed lower heat transfer performance with the water-flow conditions. The experimental apparatus was proposed for further investigation on heat transfer augmentation in very narrow channels under water-flow conditions. This report presents the evaluation results and an outline of the test apparatus. (author)

  6. Modelling of the acoustic field of a multi-element HIFU array scattered by human ribs

    Science.gov (United States)

    Gélat, Pierre; ter Haar, Gail; Saffari, Nader

    2011-09-01

    The efficacy of high-intensity focused ultrasound (HIFU) for the treatment of a range of different cancers, including those of the liver, prostate and breast, has been demonstrated. As a non-invasive focused therapy, HIFU offers considerable advantages over techniques such as chemotherapy and surgical resection in terms of reduced risk of harmful side effects. Despite this, there are a number of significant challenges which currently hinder its widespread clinical application. One of these challenges is the need to transmit sufficient energy through the rib cage to induce tissue necrosis in the required volume whilst minimizing the formation of side lobes. Multi-element random-phased arrays are currently showing great promise in overcoming the limitations of single-element transducers. Nevertheless, successful treatment of a patient with liver tumours requires a thorough understanding of the way in which the ultrasonic pressure field from a HIFU array is scattered by the rib cage. In order to address this, a boundary element approach based on a generalized minimal residual (GMRES) implementation of the Burton-Miller formulation was used in conjunction with phase conjugation techniques to focus the field of a 256-element random HIFU array behind human ribs at locations requiring intercostal and transcostal treatment. Simulations were carried out on a 3D mesh of quadratic pressure patches generated using CT scan anatomical data for adult ribs 9-12 on the right side. The methodology was validated on spherical and cylindrical scatterers. Field calculations were also carried out for idealized ribs, consisting of arrays of strip-like scatterers, demonstrating effects of splitting at the focus. This method has the advantage of fully accounting for the effect of scattering and diffraction in 3D under continuous wave excitation.

  7. HIFU scattering by the ribs: constrained optimisation with a complex surface impedance boundary condition

    Science.gov (United States)

    Gélat, P.; ter Haar, G.; Saffari, N.

    2014-04-01

    High intensity focused ultrasound (HIFU) enables highly localised, non-invasive tissue ablation and its efficacy has been demonstrated in the treatment of a range of cancers, including those of the kidney, prostate and breast. HIFU offers the ability to treat deep-seated tumours locally, and potentially bears fewer side effects than more established treatment modalities such as resection, chemotherapy and ionising radiation. There remains however a number of significant challenges which currently hinder its widespread clinical application. One of these challenges is the need to transmit sufficient energy through the ribcage to ablate tissue at the required foci whilst minimising the formation of side lobes and sparing healthy tissue. Ribs both absorb and reflect ultrasound strongly. This sometimes results in overheating of bone and overlying tissue during treatment, leading to skin burns. Successful treatment of a patient with tumours in the upper abdomen therefore requires a thorough understanding of the way acoustic and thermal energy is deposited. Previously, a boundary element (BE) approach based on a Generalised Minimal Residual (GMRES) implementation of the Burton-Miller formulation was developed to predict the field of a multi-element HIFU array scattered by human ribs, the topology of which was obtained from CT scan data [1]. Dissipative mechanisms inside the propagating medium have since been implemented, together with a complex surface impedance condition at the surface of the ribs. A reformulation of the boundary element equations as a constrained optimisation problem was carried out to determine the complex surface velocities of a multi-element HIFU array which generated the acoustic pressure field that best fitted a required acoustic pressure distribution in a least-squares sense. This was done whilst ensuring that an acoustic dose rate parameter at the surface of the ribs was kept below a specified threshold. The methodology was tested at an

  8. Modelling of the acoustic field of a multi-element HIFU array scattered by human ribs

    Energy Technology Data Exchange (ETDEWEB)

    Gelat, Pierre [National Physical Laboratory, Hampton Road, Teddington TW11 0LW (United Kingdom); Ter Haar, Gail [Therapeutic Ultrasound Group, Physics Department, Institute of Cancer Research, Sutton SM2 5NG (United Kingdom); Saffari, Nader, E-mail: Pierre.Gelat@npl.co.uk [Department of Mechanical Engineering, University College London, Torrington Place, London WC1E 7JE (United Kingdom)

    2011-09-07

    The efficacy of high-intensity focused ultrasound (HIFU) for the treatment of a range of different cancers, including those of the liver, prostate and breast, has been demonstrated. As a non-invasive focused therapy, HIFU offers considerable advantages over techniques such as chemotherapy and surgical resection in terms of reduced risk of harmful side effects. Despite this, there are a number of significant challenges which currently hinder its widespread clinical application. One of these challenges is the need to transmit sufficient energy through the rib cage to induce tissue necrosis in the required volume whilst minimizing the formation of side lobes. Multi-element random-phased arrays are currently showing great promise in overcoming the limitations of single-element transducers. Nevertheless, successful treatment of a patient with liver tumours requires a thorough understanding of the way in which the ultrasonic pressure field from a HIFU array is scattered by the rib cage. In order to address this, a boundary element approach based on a generalized minimal residual (GMRES) implementation of the Burton-Miller formulation was used in conjunction with phase conjugation techniques to focus the field of a 256-element random HIFU array behind human ribs at locations requiring intercostal and transcostal treatment. Simulations were carried out on a 3D mesh of quadratic pressure patches generated using CT scan anatomical data for adult ribs 9-12 on the right side. The methodology was validated on spherical and cylindrical scatterers. Field calculations were also carried out for idealized ribs, consisting of arrays of strip-like scatterers, demonstrating effects of splitting at the focus. This method has the advantage of fully accounting for the effect of scattering and diffraction in 3D under continuous wave excitation.

  9. Turbulent forced convection in a heat exchanger square channel with wavy-ribs vortex generator☆

    Institute of Scientific and Technical Information of China (English)

    Amnart Boonloi; Withada Jedsadaratanachai

    2015-01-01

    Turbulent forced convective heat transfer and flow configurations in a square channel with wavy-ribs inserted diagonally are examined numerical y. The influences of the 30° and 45° flow attack angles for wavy-ribs, blockage ratio, RB=b/H=0.05–0.25 with single pitch ratio, RP=P/H=1 are investigated for the Reynolds number based on the hydraulic diameter of the square channel, Re=3000–20000. The use of the wavy-ribs, which inserted diagonal in the square channel, is aimed to help to improve the thermal performance in heat exchange systems. The finite volume method and SIMPLE algorithm are applied to the present numerical simulation. The results are presented on the periodic flow and heat transfer profiles, flow configurations, heat transfer characteristics and the performance evaluations. The mathematical results reveal that the use of wavy-ribs leads to a higher heat transfer rate and friction loss over the smooth channel. The heat transfer enhancements are around 1.97–5.14 and 2.04–5.27 times over the smooth channel for 30° and 45° attack angles, respectively. However, the corre-sponding friction loss values for 30° and 45° are around 4.26–86.55 and 5.03–97.98 times higher than the smooth square channel, respectively. The optimum thermal enhancement factor on both cases is found at RB=0.10 and the lowest Reynolds number, Re=3000, to be about 1.47 and 1.52, respectively, for 30° and 45° wavy-ribs.

  10. Congenital Lumbar Hernia with Lumbocostovertebral Syndrome: A Case Report and Review of the Literature

    OpenAIRE

    Ketan Vagholkar; Khojasteh Dastoor

    2013-01-01

    Introduction. Congenital lumbar hernia is one of the rare types of hernias. Anomalies of the ribs, spine, and muscles which constitute the lumbocostovertebral syndrome in association with congenital lumbar hernia make it the rarest of entities. In addition, a multitude of other organ systems may be involved. Case Report. A case of congenital lumbar hernia associated with lumbocostovertebral syndrome is presented in view of its rarity and diagnostic and therapeutic challenges. Discussion. Anat...

  11. Current Concepts of Reiter's Syndrome

    OpenAIRE

    DeCoteau, W. Earle

    1983-01-01

    Reiter's syndrome (RS) is a major rheumatic disease, which is frequently chronic, often difficult to treat, and can cause significant, longterm morbidity. To date, there is no specific diagnostic test for RS. Therefore diagnosis has to be made by clinical acumen. Because of the venereal origin of most cases of RS, urethritis and/or cervicitis are often found. If absent, a thorough search should be made for other extra-articular features, e.g., diarrhea, conjunctivitis and mucocutaneous lesion...

  12. Anterior Cervical Spinal Surgery for Multilevel Cervical Myelopathy.

    Directory of Open Access Journals (Sweden)

    Jung-Ju Huang

    2004-07-01

    Full Text Available Background: In multilevel spinal cord compression caused by cervical spondylosis, surgeonsface the choice of performing a posterior route as a laminectomy orlaminoplasty, or an anterior route as multiple adjacent interbody decompressionsor corpectomies. The anterior cervical operation is not considered bysome clinicians because of concerns about complications and the complexityof multilevel anterior cervical surgery.Methods: In this retrospective study, 14 patients with multilevel cervical spondylosiswho were operated on via an anterior route were enrolled to evaluate thecomplexity, safety, and clinical results. The collected parameters were operationtime, blood loss, hospital days, and early and late complications forevaluating the operative complexity, radiographic follow-up for evaluatingfusion, graft problems, implants problems, and the recovery rate using theJapanese Orthopaedic Association score (JOA score for evaluating the operativeresults.Results: The mean operation time was 363.4 min, and blood loss was 431.4 ml. Anearly complication was noted in 1 patient with combined deep vein thrombosisand a pulmonary embolism. Late complications were screw breakage in1 patient and screw loosening in 5 patients. The mean duration of follow-upwas 21.9 months. The mean recovery rate of the JOA score was 38.8% postoperativelyand 51.9% at the final follow-up. The fusion rate was 100% inthis series.Conclusions: Anterior cervical decompression and fusion for multilevel stenosis requires alonger operation time than posterior procedures; however, the clinical resultsare satisfactory.

  13. Analysis of digitized cervical images to detect cervical neoplasia

    Science.gov (United States)

    Ferris, Daron G.

    2004-05-01

    Cervical cancer is the second most common malignancy in women worldwide. If diagnosed in the premalignant stage, cure is invariably assured. Although the Papanicolaou (Pap) smear has significantly reduced the incidence of cervical cancer where implemented, the test is only moderately sensitive, highly subjective and skilled-labor intensive. Newer optical screening tests (cervicography, direct visual inspection and speculoscopy), including fluorescent and reflective spectroscopy, are fraught with certain weaknesses. Yet, the integration of optical probes for the detection and discrimination of cervical neoplasia with automated image analysis methods may provide an effective screening tool for early detection of cervical cancer, particularly in resource poor nations. Investigative studies are needed to validate the potential for automated classification and recognition algorithms. By applying image analysis techniques for registration, segmentation, pattern recognition, and classification, cervical neoplasia may be reliably discriminated from normal epithelium. The National Cancer Institute (NCI), in cooperation with the National Library of Medicine (NLM), has embarked on a program to begin this and other similar investigative studies.

  14. ANAESTHETIC CHALLENGES IN A PEDIATRIC PATIENT WITH KLIPPEL FEIL SYNDROME UNDERGOING SURGERY IN PRONE POSITION

    Directory of Open Access Journals (Sweden)

    Vishak

    2014-07-01

    Full Text Available Seven years old male child with Klippel Feil syndrome and Sprengel shoulder was posted for Woodwards procedure in prone position. Patients with this syndrome are vulnerable to cervical spinal cord injury and are at high risk for neurological injury not only during laryngoscopy and intubation but thereafter. Paediatric patients with cervical spine instability and limited range of motion are challenge to anaesthesiologists

  15. Relationship between position sense and reposition errors according to the degree of upper crossed syndrome

    OpenAIRE

    Gu, Seo-Yeung; Hwangbo, Gak; Lee, Jeon-Hyeong

    2016-01-01

    [Purpose] The purpose of this study was to compare reposition errors in subjects with upper crossed syndrome to examine the effects of upper crossed syndrome on position senses. [Subjects and Methods] A sample population of 60 subjects was randomly divided into three groups of 20: a normal group, a mild group, a moderate group. A cervical range of motion device was attached to the head of each subject using straps and the reposition errors of cervical flexion, extension, right lateral flexion...

  16. Dermatomyositis related to the relapse of cervical cancer

    Directory of Open Access Journals (Sweden)

    Marta Stawczyk-Macieja

    2015-04-01

    Full Text Available Dermatomyositis (DM is a rare syndrome which belongs to the group of idiopathic inflammatory myopathies (IIM. The diagnosis of DM in adults is an indication for diagnostic evaluation towards malignancy. The exacerbation of clinical symptoms or laboratory markers of DM may indicate the relapse of neoplasm, therefore close follow-up visits of patients are obligatory. We present the case of a woman with a two-month history of progressive muscle weakness, dysphagia and oedemo-erythematous skin lesions limited to the face and trunk. The patient was diagnosed with DM associated with the relapse of cervical cancer.

  17. [Brachioradial pruritus as a symptom of cervical radiculopathy].

    Science.gov (United States)

    Mataix, J; Silvestre, J F; Climent, J M; Pastor, N; Lucas, A

    2008-11-01

    Brachioradial pruritus is characterized by the presence of pruritus on the lateral aspect of the arms. The etiology of this enigmatic entity is the subject of some debate some authors claim that brachioradial pruritus is a photodermatosis whereas others attribute it to the presence of underlying cervical radiculopathy. In these case reports, we present our experience with brachioradial pruritus and discuss the role of underlying neuropathy in its etiology and that of other types of localized pruritus such as notalgia paresthetica, anogenital pruritus, and burning mouth syndrome. PMID:19087811

  18. Prevention program of cervical cancer - Enrique Pouey

    International Nuclear Information System (INIS)

    This work is about the first basic objectives in the prevention of cervical cancer in Uruguay. The Papanicolaou test, the biopsia, and the colposcopy are important studies for the early cervical cancer detection

  19. Preventing Cervical Cancer with HPV Vaccines

    Science.gov (United States)

    Cervical cancer can be prevented with HPV vaccines. NCI-supported researchers helped establish HPV as a cause of cervical cancer. They also helped create the first HPV vaccines, were involved in the vaccine trials, and contribute to ongoing studies.

  20. 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.

  1. Multiple Rib Exostoses in a Boy: A Rare CaseResulting in Surgery Secondary to Cosmetic Concerns

    OpenAIRE

    Seyed Hosein Fattahi Masoum; Ali Moradi; Mohammad Hosein Ebrahimzadeh

    2014-01-01

    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 ...

  2. The role of acoustic nonlinearity in tissue heating behind the rib cage using high intensity focused ultrasound phased array

    OpenAIRE

    Yuldashev, Petr V.; Shmeleva, Svetlana M.; Ilyin, Sergey A.; Sapozhnikov, Oleg A.; Gavrilov, Leonid R.; Khokhlova, Vera A.

    2013-01-01

    The goal of this study was to investigate theoretically the effects of nonlinear propagation in a high intensity focused ultrasound (HIFU) field produced by a therapeutic phased array and the resultant heating of tissue behind a rib cage. Three configurations of focusing were simulated: in water, in water with ribs in the beam path, and in water with ribs backed by a layer of soft tissue. The Westervelt equation was used to model the nonlinear HIFU field and a 1 MHz phased array consisting of...

  3. Anesthetic management in a pediatric patient with Noonan syndrome, hypopituitarism and hypothyroidism: A case report

    Directory of Open Access Journals (Sweden)

    Abdulkadir Yektaş

    2013-06-01

    Full Text Available Noonan syndrome is a genetically transmitted autosomaldominant disorder characterized by various anatomicanomalies and pathophysiologic derangements. Associatedanomalies include hyperthelorism, ptosis, micrognathia,downward sloping palpebral fissures, low-set ears,abnormal helix of ear, deeply grooved philtrum, short and/or webbed neck, low hairline and cervical vertebral anomalies.Patients with Noonan syndrome are known to presentwith challenging airways. Tracheal intubation can bedifficult because of airway and cervical vertebral anomaliesand bag mask ventilation may be difficult because ofasymmetrical face. We present a case of anesthetic managementfor Noonan syndrome. J Clin Exp Invest 2013;4 (2: 238-241Key words: Anesthesia, general, noonan syndrome, airwaymanagement

  4. Laparoscopic Fertility Sparing Management of Cervical Cancer

    OpenAIRE

    Chiara Facchini; Giuseppina Rapacchia; Giulia Montanari; Paolo Casadio; Gianluigi Pilu; Renato Seracchioli

    2014-01-01

    Fertility can be preserved after conservative cervical surgery. We report on a 29-year-old woman who was obese, para 0, and diagnosed with cervical insufficiency at the first trimester of current pregnancy due to a previous trachelectomy. She underwent laparoscopic transabdominal cervical cerclage (LTCC) for cervical cancer. The surgery was successful and she was discharged two days later. The patient underwent a caesarean section at 38 weeks of gestation. Laparoscopic surgery ...

  5. Vertebral artery injuries in cervical spine surgery

    OpenAIRE

    Schroeder, Gregory D.; Hsu, Wellington K.

    2013-01-01

    Background: Vertebral artery injuries during cervical spine surgery are rare, but potentially fatal. When performing cervical spine surgery, it is imperative that the surgeon has a systematic approach for avoiding, and if necessary, dealing with a vertebral artery injury. Methods: This is a review paper. Results: Upper posterior cervical spine surgeries put the vertebral artery at the highest risk, as opposed to anterior subaxial cervical spine procedures, which put the artery at the least ri...

  6. The Effect of the PEEK Cage on the Cervical Lordosis in Patients Undergoing Anterior Cervical Discectomy

    OpenAIRE

    Salih Gulsen

    2015-01-01

    BACKGROUND: Loss of cervical lordosis is a significant factor in the development of degeneration of the spine with aging. This degenerative changings of the cervical spine would cause pressure effect on the cervical root and/or medulla spinalis. AIM: Our goal is to understand the effect of the PEEK cage on cervical lordosis in the early postoperative period. Also, to interpret the effects of one- level, two- level, three-level and four- level disc pathologies on cervical lordosis. MAT...

  7. The LKB1 tumor suppressor differentially affects anchorage independent growth of HPV positive cervical cancer cell lines

    International Nuclear Information System (INIS)

    Infection with high-risk human papillomaviruses is causally linked to cervical carcinogenesis. However, most lesions caused by high-risk HPV infections do not progress to cancer. Host cell mutations contribute to malignant progression but the molecular nature of such mutations is unknown. Based on a previous study that reported an association between liver kinase B1 (LKB1) tumor suppressor loss and poor outcome in cervical cancer, we sought to determine the molecular basis for this observation. LKB1-negative cervical and lung cancer cells were reconstituted with wild type or kinase defective LKB1 mutants and we examined the importance of LKB1 catalytic activity in known LKB1-regulated processes including inhibition of cell proliferation and elevated resistance to energy stress. Our studies revealed marked differences in the biological activities of two kinase defective LKB1 mutants in the various cell lines. Thus, our results suggest that LKB1 may be a cell-type specific tumor suppressor. - Highlights: • LKB1 is a tumor suppressor that is linked to Peutz-Jeghers syndrome. • Peutz-Jeghers syndrome patients have a high incidence of cervical cancer. • Cervical cancer is caused by HPV infections. • This study investigates LKB1 tumor suppressor activity in cervical cancer

  8. The LKB1 tumor suppressor differentially affects anchorage independent growth of HPV positive cervical cancer cell lines

    Energy Technology Data Exchange (ETDEWEB)

    Mack, Hildegard I.D.; Munger, Karl, E-mail: kmunger@rics.bwh.harvard.edu

    2013-11-15

    Infection with high-risk human papillomaviruses is causally linked to cervical carcinogenesis. However, most lesions caused by high-risk HPV infections do not progress to cancer. Host cell mutations contribute to malignant progression but the molecular nature of such mutations is unknown. Based on a previous study that reported an association between liver kinase B1 (LKB1) tumor suppressor loss and poor outcome in cervical cancer, we sought to determine the molecular basis for this observation. LKB1-negative cervical and lung cancer cells were reconstituted with wild type or kinase defective LKB1 mutants and we examined the importance of LKB1 catalytic activity in known LKB1-regulated processes including inhibition of cell proliferation and elevated resistance to energy stress. Our studies revealed marked differences in the biological activities of two kinase defective LKB1 mutants in the various cell lines. Thus, our results suggest that LKB1 may be a cell-type specific tumor suppressor. - Highlights: • LKB1 is a tumor suppressor that is linked to Peutz-Jeghers syndrome. • Peutz-Jeghers syndrome patients have a high incidence of cervical cancer. • Cervical cancer is caused by HPV infections. • This study investigates LKB1 tumor suppressor activity in cervical cancer.

  9. Fusion around cervical disc prosthesis: case report.

    NARCIS (Netherlands)

    Bartels, R.H.M.A.; Donk, R.

    2005-01-01

    OBJECTIVE AND IMPORTANCE: Cervical arthroplasty is a relatively new method to maintain motion after cervical anterior discectomy. Two cases are presented in which bony fusion occurred around a cervical disc prosthesis. CLINICAL PRESENTATION: A 30-year-old man and a 49-year-old woman underwent a righ

  10. Cervical disc hernia operations through posterior laminoforaminotomy

    OpenAIRE

    Coskun Yolas; Nuriye Guzin Ozdemir; Hilmi Onder Okay; Ayhan Kanat; Mehmet Senol; Ibrahim Burak Atci; Hakan Yilmaz; Mustafa Kemal Coban; Mehmet Onur Yuksel; Umit Kahraman

    2016-01-01

    Objective: The most common used technique for posterolateral cervical disc herniations is anterior approach. However, posterior cervical laminotoforaminomy can provide excellent results in appropriately selected patients with foraminal stenosis in either soft disc prolapse or cervical spondylosis. The purpose of this study was to present the clinical outcomes following posterior laminoforaminotomy in patients with radiculopathy. Materials and Methods: We retrospectively evaluated 35 patients ...

  11. Analysis of X-rays of cervical imbalances syndrome before and after the treatment of osteopathy and traction intervention in 187 youth cases%中医整脊手法及牵引治疗187例青年颈椎失衡综合征前后X线分析

    Institute of Scientific and Technical Information of China (English)

    王庆甫; 殷岳杉; 阿迪力江; 张雷; 时宗庭; 黄沪; 杜春林; 李俊海; 陈兆军; 陈黎明; 祁印泽; 马玉峰

    2013-01-01

    Objective:To observe X-ray features of before and after treatment of cervical imbalance syndrome with osteopathy and traction intervention in youth patients, then to investigate the clinical effect of the treatment of the cervical imbalances syndrome in youth by osteopathy. Methods:From September 2007 to December 2010,one hundred and eighty-seven students of 19 to 22 years (means 21 years) with neck pain as the main symptom in Beijing university of Chinese medicine were selected and divide them into osteopathy group and traction groups randomly. In osteopathy group,there were 94 patients including 40 males and 54 females; in traction group, there were 93 patients including 42 males and 51 females. The treatment of osteopathy group lasted for 3 weeks, three times per week; traction group by traction treatment three weeks, three times a week, too. X-ray before treatment and 3 weeks after treatment were collected. Results:The osteopathy group:94 cases,before treatment, abnormal curvature in 57 cases, spinous position change in 45 cases and angular displacement in 44 cases, vertebral sliding in 15 cases,Ruth Jackson line intersect proneness change in 70 cases,stretch change in 47 cases;after treatment,abnormal curvature in 35 cases, spinous position change in 24 cases and angular displacement in 18 cases, vertebral sliding in 3 cases,Ruth Jackson line intersect proneness change in 41 cases,extension change in 33 cases;X-Ray measurement results: cervical curvature improved from (7.070±4.629)° before treatment to (7.660±4.156)° after treatment,angular displacement improved from (13.790±2.590)°before treatment to (11.050±2.560)° after treatment; vertebral sliding improved from (3.770±0.350) mm before treatment to (3.160±0.485) mm after treatment. The change of angular displacement and vertebral sliding were so significant before and after treatment in this group,there were statistical defferences between before and after the treatment (P<0.01) in osteopathy

  12. 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.)

  13. 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

    International Nuclear Information System (INIS)

    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.)

  14. Histomorphological Pattern of Cervical Lymphadenopathy

    Directory of Open Access Journals (Sweden)

    Abdul Mannan Sikder

    2013-01-01

    Full Text Available Background: Enlarged palpable cervical lymph nodes as a primary presenting sign are very common and may be due to inflammatory lesions and tumors. Correlation between clinical findings and laboratory data is essential in arriving at a diagnosis. In patients presenting with cervical lymphadenopathy, excision biopsy provides material to establish an early diagnosis. We designed this study in our population for histological evaluation of cervical lymph node biopsies that might be important in the management of these patients. Objective: Histopathological evaluation of different diseases involving the cervical lymph nodes in relation to age and sex of the study population. Materials and Methods: It was a cross sectional study conducted in the department of Pathology, Enam Medical College & Hospital, Savar, Dhaka during the period from January 2006 to December 2010. A total of 107 patients were evaluated for specific cause of cervical lymphadenopathy in relation to age and sex. Lymph node biopsies of all patients of both sexes and all age groups were included in the study. Results: Among the 107 subjects 58 (54.2% were males and 49 (45.8% were females with a male to female ratio of 1.2:1. The age of the patients ranged from 2 to 85 years with a mean age of 32.68 ± 18.01 years. Of the 107 lymph node biopsies, 34 cases (31.8% were reactive lymphadenitis, 41 cases (38.3% were tuberculosis, 2 cases (1.9% were non-caseous granuloma, 6 cases (5.6% were Hodgkin lymphoma, 8 cases (7.5% were non-Hodgkin lymphoma, 12 cases (11.2% were metastatic neoplasm and 4 cases (3.7% were other specific lesions. Conclusion: The commonest cause of cervical lymphadenopathy was tuberculosis, followed by reactive lymphadenitis, lymphoma and metastatic neoplasm.

  15. Antiphospholipid Syndrome

    Science.gov (United States)

    ... Awards Enhancing Diversity Find People About NINDS NINDS Antiphospholipid Syndrome Information Page Synonym(s): Hughes Syndrome Table of Contents ( ... research is being done? Clinical Trials What is Antiphospholipid Syndrome? Antiphospholipid syndrome (APS) is an autoimmune disorder caused ...

  16. Treatment of cervical dislocation with locked facets

    Institute of Scientific and Technical Information of China (English)

    YU Ze-sheng; James J.Yue; WEI Feng; LIU Zhong-jun; CHEN Zhong-qiang; DANG Geng-ting

    2007-01-01

    Background Lower cervical dislocation with locked facets is common in cervical injury. The locked facets include unilateral and bilateral types. Different successful closed reduction rates has been achieved between unilateral and bilateral types by using rapid skull traction, which was commonly used to reduce the cervical dislocation. It is important to investigate a suitable management specific to patients with different types of cervical locked facets.Methods A total of 38 patients with cervical dislocation with locked facet due to cervical injury treated by rapid skull traction and operation from 1988 to 2005 were reviewed. Rapid skull traction was used in all the patients. Successful closed reduction rate was 88.0% in patients with bilateral cervical locked facets and that was 15.4% in those with unilateral cervical locked facets. These data were then statistically compared by Chi-square test. Patients who were reduced successfully underwent anterior cervical discectomy and fusion at the injured level, and those who failed in closed reduction received posterior open reduction and fixation.Results In this series, there was statistically significant difference (P<0.05) in the rate of successful closed skull traction reduction between unilateral and bilateral locked facets dislocation. Unilateral cervical locked facets dislocation was not easily reduced by skull traction which was suitable for reduction of bilateral cervical locked facets dislocation. However,unilateral cervical locked facets dislocation can be reduced by posterior open reduction.Conclusions Unilateral cervical locked facets dislocation should be treated immediately with posterior open reduction and instrumentation. Bilateral cervical locked facets dislocation can be reduced by rapid skull traction firstly and anterior cervical discectomy and interbody fusion later.

  17. The human superior cervical ganglion

    DEFF Research Database (Denmark)

    Tajti, J; Möller, S; Uddman, R; Bodi, I; Edvinsson, L

    Noradrenaline (NA)- and neuropeptide Y (NPY)-containing cell bodies were found to occur in high numbers (>75% of all cells were positive) in the human superior cervical ganglion and distributed homogeneously throughout the ganglion and showed colocalisation. A few cell bodies were VIP......-immunoreactive (-ir) (less than 5%) but none of them showed NOS-, CGRP- or SP-ir. Receptor mRNA expression was studied with RT-PCR. Total RNA from the superior cervical ganglion was successfully extracted. By using appropriate sense and antisense oligonucleotides designed from the published human sequences, we could...

  18. Radiculopatía cervical

    OpenAIRE

    Adriana Murillo Calderón

    2012-01-01

    La patología cervical traumática y su relación con el quehacer de la medicina legal tiene gran importancia y vigencia, principalmente cuando se hace necesario realizar valoraciones a pacientes con alteraciones cervicales y se debe definir si estas están en relación a un trauma determinado o repetitivo en el tiempo como puede ocurrir en algunos casos de riesgos de trabajo. El médico forense debe estar muy bien preparado, conocer la anatomía cervical y de los miembros superiores, realizar un in...

  19. A combined thermal dissociation and electron impact ionization source for RIB generation

    International Nuclear Information System (INIS)

    The probability for simultaneously dissociating and efficiently ionizing the individual atomic constituents of molecular feed materials with conventional, hot-cathode, electron-impact ion sources is low and consequently, the ion beams from these sources often appear as mixtures of several molecular sideband beams. This fragmentation process leads to dilution of the intensity of the species of interest for RIB applications where beam intensity is at a premium. We have conceived an ion source that combines the excellent molecular dissociation properties of a thermal dissociator and the high ionization efficiency characteristics of an electron impact ionization source that will, in principle, overcome this handicap. The source concept will be evaluated as a potential candidate for use for RIB generation at the Holifield Radioactive Ion Beam Facility (HRIBF), now under construction at the Oak Ridge National Laboratory. The design features and principles of operation of the source are described in this article

  20. Development of the HRIBF 25-MV tandem accelerator as a RIB accelerator

    International Nuclear Information System (INIS)

    The Holifield Facility 25URC tandem accelerator will begin accelerating radioactive ion beams (RIBs) for nuclear structure and astrophysics research in 1996. This paper addresses the development of the accelerator to allow optimum operation with the particular challenges associated with RIBs. New diagnostics for ultra-low-intensity beams are being installed and the terminal potential stabilization system is being studied to optimize control with these low beam intensities. A new resistor-based voltage-grading system has resulted in more stable operation as well as allowing operation at the very low terminal potentials which are required for some astrophysics experiments. Also addressed is beam transmission optimization, particularly at low terminal potentials, and operation of the accelerator at high terminal potentials

  1. A Rare Case of Rib Osteoblastoma: Imaging Features and Review of Literature

    International Nuclear Information System (INIS)

    Osteoblastoma is a rare benign, but locally aggressive bone tumor with rare malignant transformation. It mostly affects the vertebral column and long bones. Radiographically, it is seen as an expansile, oval, sclerotic or lytic mass-like lesion with well-defined borders, although sometimes it may mimic a malignant tumor such as osteogenic sarcoma by its irregular borders. Herein, we report a case of osteoblastoma in a 22 year-old man with a long history of back and neck pain accompanied with neck stiffness. On the routine chest X-ray, the salient lesion appeared as an expansile, oval, sclerotic mass with well-defined borders and speckled calcification without any internal lucency and periosteal reaction, involving the posterolateral aspect of the first left thoracic rib, a rare anatomical site. Despite the unusual location, osteoblastoma should be considered in the differential diagnosis of a solitary rib lesion

  2. 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.

  3. Flow and heat transfer in parallel channel attached with equally-spaced ribs, 3

    International Nuclear Information System (INIS)

    The computer code for analysing the flow and heat transfer characteristics in a parallel channel with equally-spaced ribs, which was reported in the previous paper with numerical results in the range of Reynolds number from 10 to 250, was revised in order to eliminate the wiggles of the solution of finite difference equation contained convective and diffusive terms by the upwind-difference method. Using this code, numerical calculations were carried out in the range of Reynolds number from 150 to 850. The following were the results obtained: (1) The mean Nusselt number of a ribbed channel is about 10 at the upper wall and about 7.5 at the lower wall in the range of Reynolds number from 150 to 850. (2) The upwind-difference method is useful to eliminate the wiggles of the solution of a finite difference equation contained convective and diffusive terms. (author)

  4. 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

  5. Study of heat transfer due to turbulent flow of nanofluids through rib-groove channel

    Science.gov (United States)

    Al-Shamani, A. N.; Sopian, K.; Abed, A. M.; Alghoul, M. A.; Ruslan, M. H.; Mat, S.

    2015-09-01

    Nanofluids for improve characteristics flow in a rib-groove channel are investigate. The continuity, momentum and energy equations were solved by FLUENT program. The bottom wall of channel is heated while the upper wall is symmetry, the left side velocity inlet, and the right side is outlet (pressure out). Four different rib-groove shapes are used. Four different types of nanoparticles, Al2O3, CuO, SiO2, and ZnO with different volumes fractions in the range of 1% to 4% and different nanoparticle diameter in the range of 25 nm to 70 nm, are dispersed in the base fluid water are used. In this paper, several parameters such as different Reynolds numbers in the range of 10000 nanoparticle diameter increases.

  6. A Rare Case of Dacron Graft Rupture due to Friction against a Rib.

    Science.gov (United States)

    Matsuyama, Katsuhiko; Kuinose, Masahiko; Koizumi, Nobusato; Iwahashi, Toru; Toguchi, Kayo; Ogino, Hitoshi

    2014-12-01

    A 54-year-old man underwent aortic repair for the infected thoracoabdominal aneurysm with a woven Dacron graft (Vascutek, Renfrewshire, Scotland) treated with gentian violet. Four months later, he complained of sudden back pain, resulting in preshock status. Computed tomographic scans showed massive hematoma around the Dacron graft, suggesting graft rupture. Initially, emergency thoracic endovascular aortic repair was performed, which was subsequently followed by open repair. The Dacron graft had a small hole, which was completely compatible with the site contacting with the rib. The graft rupture was considered due to its friction against the rib. We report on a rare event of mechanical Dacron graft rupture after the thoracoabdominal aortic replacement. PMID:25798369

  7. Recent results from the TwinSol low-energy RIB facility

    Science.gov (United States)

    Becchetti, F. D.; Kolata, J. J.

    2016-06-01

    We report on some of the recent developments and experimental work done at the twin-solenoid low-energy radioactive-ion-beam (RIB) facility TwinSol installed at the U Notre Dame 10 MV FN tandem accelerator. The TwinSol facility is a joint project of the University of Michigan (UM) and the University of Notre Dame (UND), and includes several U.S. and foreign collaborators. A number of significant experiments including RIB-induced transfer reactions, elastic scattering, resonant scattering, and fusion at energies near and well below the Coulomb barrier have been performed with this facility. Several of these as well as future work and upgrades planned will be described.

  8. Performance of a non-tapered 3D morphing wing with integrated compliant ribs

    International Nuclear Information System (INIS)

    Morphing wings have a high potential for improving the performance and reducing the fuel consumption of modern aircraft. Thanks to its simplicity, the compliant belt-rib concept is regarded by the authors as a promising solution. Using the compliant rib designed by Hasse and Campanile as a starting point, a compliant morphing wing made of composite materials is designed. Innovative methods for optimal placing of the actuation and for the quantification of the morphing are used. The performance of the compliant morphing wing in terms of three-dimensional (3D) structural behaviour and aerodynamic properties, both two- and three-dimensional, is presented and discussed. The fundamental importance of considering 3D coupling effects in the determination of the performance of morphing aerofoils is shown. (paper)

  9. Dynamic Stability of a Cylindrical Shell Reinforced by Longitudinal Ribs and a Hollow Cylinder Under the Action of Axial Forces

    Science.gov (United States)

    Bakulin, V. N.; Volkov, E. N.; Nedbai, A. Ya.

    2016-05-01

    The dynamic stability of a cylindrical orthotropic shell reinforced by longitudinal ribs and a hollow cylinder under the action of axial forces changing harmonically with time was investigated with regard for the axial contact interaction of the shell with the ribs. A solution of the differential equations defining this process has been obtained in the form of trigonometric series in the angular and time coordinates. A two-term approximation of the Mathieu-Hill equations of motion was used for construction of the main region of instability of the shell. As a result, the problem was reduced to a system of algebraic equations for components of displacements of the shell at the locations of the ribs. The problem for uniformly spaced ribs was solved in the explicit form. A numerical example of this solution is presented.

  10. Atlantoaxial arthrodesis using C1-C2 transarticular screw fixation in a case of Morquio syndrome

    OpenAIRE

    Kulkarni, Arvind G; Siddharth M Shah

    2011-01-01

    Prophylactic or therapeutic arthrodesis is recommended for atlantoaxial instability in Morquio syndrome. Occipitocervical fusion, the common approach for upper cervical fusion in Morquio syndrome sacrifices the movements at the occipitoatlantal joints. The use of C1-C2 transarticular screws for achieving C1-C2 arthrodesis, without compromising mobility at the occipitoatlantal joint in Morquio syndrome has not been reported. We report a case of Morquio syndrome with atlantoaxial instability an...

  11. Comparative Evaluation of Prevalence of Upper Cervical Vertebrae Anomalies in Cleft Lip/Palate Patients: A Retrospective Study

    Science.gov (United States)

    Datana, Sanjeev; Kumar, Prasanna; Kumar Roy, Supriya; Londhe, Sanjay

    2014-01-01

    ABSTRACT% Purpose: The patients with cleft lip and palate have a higher risk of cervical vertebrae anomalies than do patients in general population. The aim of present study was to determine the prevalence of various upper cervical spine anomalies in different type of clefts. Procedures: Lateral cephalograms of 128 patients (66 males, 62 females) with cleft lip and palate, and 125 (60 males, 65 females) non syndromic patients without cleft lip and palate were selected at random from archive. Cephalograms of the patients were traced and the diagnosis of any cervical vertebrae anomaly was noted. Anomalies were categorized as either: posterior arch deficiency or fusions. Main findings: Prevalence of cervical vertebrae anomalies in the c lef t group was 20. 3% while it was 6.4% in the control group. Further cervical vertebrae anomalies were 16.6% in the CPO group, 19.1% in the BCLP group, and 22.2% in the UCLP group. Conclusion: A higher prevalence of cervical vertebrae anomalies was observed in cleft lip and palate patients. The prevalenc e obser ved is 3 times more in clef t group than c ontrol group. How to cite this article: Datana S, Bhalla A, Kumar P, Roy SK, Londhe S. Comparative Evaluation of Prevalence of Upper Cervical Vertebrae Anomalies in Cleft Lip/Palate Patients: A Retrospective Study. Int J Clin Pediatr Dent 2014;7(3):168-171. PMID:25709295

  12. The scapulocostal syndrome.

    Science.gov (United States)

    Fourie, L J

    1991-06-15

    The scapulocostal syndrome, a hitherto insufficiently understood condition, was clinically studied in 201 cases. The main findings were: (i) pain was the presenting symptom in all cases and was mainly cervicobrachial (90%); (ii) the syndrome is a definable entity within the wide spectrum of fibromyalgia (fibrositis); (iii) the pain originates mainly from an enthesopathy of the serratus posterior superior muscle; and (iv) physical degeneration was present in 76.5% of patients. Conservative treatment, successful in 95.9% of cases, consisted of an intralesional injection of a steroid-analgesic-mixture of 1 ml Celestone-Soluspan (Scherag) plus 1.8 ml Xylotox E80A (Astra), and physical rehabilitation. It was deducted that the dyskinesia was mainly due to an overload of the scapulocostal articulation, forcing the rib cage down to exert a stretching force on the serratus posterior superior muscle. The operation of 'serratotomy' (severing the serratus posterior superior muscle) was performed with excellent results in 6 patients in whom conservative treatment failed, and is described here for the first time. PMID:2047965

  13. Syndromes Associated with Sexually Transmitted Infections

    Directory of Open Access Journals (Sweden)

    Max Chernesky

    2005-01-01

    Full Text Available Excellent technologies have been developed to identify the specific microbial agents of chlamydia, gonorrhea, syphilis, herpes, chancroid, trichomoniasis, human papillomavirus and HIV infection. However, it is also crucial to recognize syndromes that may be caused by one or more sexually transmitted pathogens. When laboratory services are lacking or are inadequate to provide timely results to enable appropriate treatment, some patients must be managed and treated syndromically. Most Canadian laboratories should be able to provide diagnostic services to determine the etiology of syndromes such as cervicitis, urethritis, pelvic inflammatory disease, prostatitis, genital ulcers, sexually transmitted infection (STI-related enteric infections, epididymitis, hepatitis, ophthalmia neonatorum, vulvovaginitis and vaginosis.

  14. Human papillomavirus testing in cervical cancer screening.

    Science.gov (United States)

    Castle, Philip E; Cremer, Miriam

    2013-06-01

    Human papillomavirus (HPV) testing is more reliable and sensitive but less specific than Papanicolaou (Pap) testing/cervical cytology for the detection of cervical precancer and cancer. HPV-negative women are at lower risk of cervical cancer than Pap-negative women. In high-resource settings, HPV testing can be used to make cervical cancer prevention programs more efficient by focusing clinical attention on women who have HPV. In lower-resource settings, where Pap testing has not been sustained or widespread, new, lower-cost HPV tests may make cervical cancer screening feasible. PMID:23732037

  15. Imaging of cervical spine injuries of childhood

    Energy Technology Data Exchange (ETDEWEB)

    Khanna, Geetika; El-Khoury, Georges Y. [University of Iowa Hospitals and Clinics, Department of Radiology, 3951 JPP, Iowa, IA (United States)

    2007-06-15

    Cervical spine injuries of children, though rare, have a high morbidity and mortality. The pediatric cervical spine is anatomically and biomechanically different from that of adults. Hence, the type, level and outcome of cervical spine injuries in children are different from those seen in adults. Normal developmental variants seen in children can make evaluation of the pediatric cervical spine challenging. This article reviews the epidemiology of pediatric cervical spine trauma, normal variants seen in children and specific injuries that are more common in the pediatric population. We also propose an evidence-based imaging protocol to avoid unnecessary imaging studies and minimize radiation exposure in children. (orig.)

  16. The chemical heritage of Aspergillus flavus in A. oryzae RIB 40

    DEFF Research Database (Denmark)

    Rank, Christian; Klejnstrup, Marie Louise; Petersen, Lene Maj; Frisvad, Jens Christian; Larsen, Thomas Ostenfeld

    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....

  17. Bone images from dual-energy subtraction chest radiography in the detection of rib fractures

    International Nuclear Information System (INIS)

    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.

  18. Turbulent flow in rib-roughened channel under the effect of Coriolis and rotational buoyancy forces

    Science.gov (United States)

    Coletti, Filippo; Jacono, David Lo; Cresci, Irene; Arts, Tony

    2014-04-01

    The turbulent flow inside a rotating channel provided with transverse ribs along one wall is studied by means of two-dimensional time-resolved particle image velocimetry. The measurement set-up is mounted on the same rotating disk with the test section, allowing to obtain the same accuracy and resolution as in a non-rotating rig. The Reynolds number is 15 000, and the rotation number is 0.38. As the ribbed wall is heated, both the Coriolis force and the centrifugal force play a role in the fluid dynamics. The mean velocity fields highlight the major impact of the rotational buoyancy (characterized by a buoyancy number of 0.31) on the flow along the leading side of the duct. In particular, since the flow is directed radially outward, the near-wall layers experience significant centripetal buoyancy. The recirculation area behind the obstacles is enlarged to the point of spanning the whole inter-rib space. Also the turbulent fluctuations are significantly altered, and overall augmented, with respect to the non-buoyant case, resulting in higher turbulence levels far from the rib. On the other hand the centrifugal force has little or no impact on the flow along the trailing wall. Vortex identification, proper orthogonal decomposition, and two-point correlations are used to highlight rotational effects, and in particular to determine the dominant scales of the turbulent unsteady flow, the time-dependent behavior of the shear layer and of the recirculation bubble behind the wall-mounted obstacles, the lifetime and advection velocity of the coherent structures.

  19. Single mode and polarization independence in the strained silicon-on-insulator rib waveguides

    Directory of Open Access Journals (Sweden)

    Milošević Milan M.

    2008-01-01

    Full Text Available In this paper we investigate the most popular silicon waveguide structures in the form of a silicon-on-insulator (SOI rib waveguide. Single mode and birefringence free conditions in these relatively small waveguides are discussed and the influence of the top oxide cladding stress is analyzed. Field profiles for a wide range of waveguide cross section shapes and dimensions are systematically considered. Design guidelines for this type of SOI waveguides are presented.

  20. Performance estimation of artificially roughened solar air heater duct provided with continuous ribs

    OpenAIRE

    Mridul Sharma, Varun

    2010-01-01

    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 investigat...

  1. 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.

  2. Scoliosis Caused by Rib Fusion Following Thoracotomy for Tracheoesophageal Fistula: Case Report

    OpenAIRE

    Dunlay, Ryan P; Jones, Kevin B.; Weinstein, Stuart L.

    2007-01-01

    Scoliosis as a late complication of thoracotomy has been described previously, but reports are rare. We present the case of a 22 year-old female referred for symptomatic scoliosis. Radiographs demonstrated a severe, structural, upper-thoracic scoliosis with associated right-sided rib fusions. Her medical history was noteworthy for a right posterolateral thoracotomy for repair of a tracheoesophageal fistula during infancy. Radiographs from her general surgical treatments during infancy demonst...

  3. A Novel MoM Approach for Obtaining Accurate and Efficient Solutions in Optical Rib Waveguide

    OpenAIRE

    YENER, Namık

    2002-01-01

    The optical rib waveguide (ORW) plays an important role in the design of several integrated optical devices. Various methods have been proposed for obtaining the modal field solutions in ORW. However, to the best of our knowledge none of them is capable of providing accurate full-wave benchmark solutions. Here we present a novel MoM approach wherein the modes of a loaded rectangular waveguide are utilized as basis functions and demonstrate that this approach is very efficient and yie...

  4. Prediction of Turbulent Flow Structure in a Fully Developed Rib-Roughened Narrow Rectangular Channel

    Institute of Scientific and Technical Information of China (English)

    Md. Shafiqul IsIam; M. Kaminaga; R. Hino; M. Monde

    2009-01-01

    Fully developed turbulent water-flow structure over one-side repeated-fibs in narrow two-dimensional rectangular channels was investigated experimentally by Particle Image Velocimetry (PIV) and analytically by the standard κ-εand nonlinear κ-ε turbulent models. Two fib-pitch to height ratios (p/k) of 10 and 20 were investigated while the rib height was held constant at 4 mm. The rib height-to-channel equivalent diameter ratio (k/De) was 0.1. The streamwise mean velocity and turbulent kinetic energy distributions at six selected axial stations from the center fib for the two Reynolds number (Re) of 7,000 and 20,000 were obtained and compared with the predicted one The performance ability in predicting separating and reattaching turbulent water-flow between the standard κ-ε and nonlinear κ-ε models had yielded no clear conclusion. A large-scale turbulent eddy was generated by the rib promoter and then propagated into the mainstream flow, which led to the deformation of the velocity profile. The turbulent kinetic energy was increased about two times higher at p/k = 20 than that at p/k =10 under the two Reynolds numbers. The effect of the p/k value and the Reynolds number (Re) on reattachment length (XR) was investigated and showed that the p/k and Re had no significant effect on the reattachment length beyond a critical value of Re = 15,000 where XR was found to be approximately 4 times of the rib height under water-flow condi-tion.

  5. Nevoid basal cell carcinoma syndrome (Gorlin syndrome

    Directory of Open Access Journals (Sweden)

    Lo Muzio Lorenzo

    2008-11-01

    Full Text Available Abstract Nevoid basal cell carcinoma syndrome (NBCCS, also known as Gorlin syndrome, is a hereditary condition characterized by a wide range of developmental abnormalities and a predisposition to neoplasms. The estimated prevalence varies from 1/57,000 to 1/256,000, with a male-to-female ratio of 1:1. Main clinical manifestations include multiple basal cell carcinomas (BCCs, odontogenic keratocysts of the jaws, hyperkeratosis of palms and soles, skeletal abnormalities, intracranial ectopic calcifications, and facial dysmorphism (macrocephaly, cleft lip/palate and severe eye anomalies. Intellectual deficit is present in up to 5% of cases. BCCs (varying clinically from flesh-colored papules to ulcerating plaques and in diameter from 1 to 10 mm are most commonly located on the face, back and chest. The number of BBCs varies from a few to several thousand. Recurrent jaw cysts occur in 90% of patients. Skeletal abnormalities (affecting the shape of the ribs, vertebral column bones, and the skull are frequent. Ocular, genitourinary and cardiovascular disorders may occur. About 5–10% of NBCCS patients develop the brain malignancy medulloblastoma, which may be a potential cause of early death. NBCCS is caused by mutations in the PTCH1 gene and is transmitted as an autosomal dominant trait with complete penetrance and variable expressivity. Clinical diagnosis relies on specific criteria. Gene mutation analysis confirms the diagnosis. Genetic counseling is mandatory. Antenatal diagnosis is feasible by means of ultrasound scans and analysis of DNA extracted from fetal cells (obtained by amniocentesis or chorionic villus sampling. Main differential diagnoses include Bazex syndrome, trichoepithelioma papulosum multiplex and Torre's syndrome (Muir-Torre's syndrome. Management requires a multidisciplinary approach. Keratocysts are treated by surgical removal. Surgery for BBCs is indicated when the number of lesions is limited; other treatments include laser

  6. Validation of connection details between a UHPFRC ribbed slab and steel girders for a new composite bridge deck type

    OpenAIRE

    Toutlemonde, François; LAUVIN, Ludovic; Renaud, Jean Claude; BABY, Florent; Bouteille, Sébastien; RESPLENDINO, Jacques

    2008-01-01

    Within the French R & D project MIKTI focusing on innovative steel-concrete composite bridges, an exhaustive experimental program was carried out to provide an experimental validation of a new ultra-high performance fibre reinforced concrete (UHPFRC) 2 way-ribbed slab made of segments assembled by post-tensioning. Provisions concerning the realization of connection between the UHPFRC ribbed deck and steel profiles, which are critical for ensuring the composite behavior of the full structure, ...

  7. Mach-Zehnder Interferometer Biochemical Sensor Based on Silicon-on-Insulator Rib Waveguide with Large Cross Section

    Directory of Open Access Journals (Sweden)

    Dengpeng Yuan

    2015-08-01

    Full Text Available A high-sensitivity Mach-Zehnder interferometer (MZI biochemical sensing platform based on Silicon-in-insulator (SOI rib waveguide with large cross section is proposed in this paper. Based on the analyses of the evanescent field intensity, the mode polarization and cross section dimensions of the SOI rib waveguide are optimized through finite difference method (FDM simulation. To realize high-resolution MZI read-out configuration based on the SOI rib waveguide, medium-filled trenches are employed and their performances are simulated through two-dimensional finite-difference-time domain (2D-FDTD method. With the fundamental EH-polarized mode of the SOI rib waveguide with a total rib height of 10 μm, an outside rib height of 5 μm and a rib width of 2.5 μm at the operating wavelength of 1550 nm, when the length of the sensitive window in the MZI configuration is 10 mm, a homogeneous sensitivity of 7296.6%/refractive index unit (RIU is obtained. Supposing the resolutions of the photoelectric detectors connected to the output ports are 0.2%, the MZI sensor can achieve a detection limit of 2.74 × 10−6 RIU. Due to high coupling efficiency of SOI rib waveguide with large cross section with standard single-mode glass optical fiber, the proposed MZI sensing platform can be conveniently integrated with optical fiber communication systems and (opto- electronic systems, and therefore has the potential to realize remote sensing, in situ real-time detecting, and possible applications in the internet of things.

  8. Comparison of the Analgesic Effect of Intravenous Acetaminophen and Morphine Sulfate in Rib Fracture; a Randomized Clinical Trial

    OpenAIRE

    Mehrdad Esmailian; Roshanak Moshiri; Majid Zamani

    2015-01-01

    Introduction: Rib fracture is one of the common causes of trauma disabilities in many events and the outcome of these patients are very extensive from temporary pain management to long-term significant disability. Control and management of the pain in such patients is one of the most important challenges in emergency departments. Thus, the aim of the present study was assessing the efficacy of IV acetaminophen in pain control of patients with rib fracture. Methods: In this double-blind study,...

  9. Fabrication procedure effects on fatigue resistance of rib -to-deck welded joints of steel orthotropic bridge decks

    OpenAIRE

    Sim, Hyoung-Bo

    2010-01-01

    Orthotropic steel bridge decks have been widely used for long- and medium-span bridges due to excellent structural characteristics. However, orthotropic decks have experienced various fatigue problems, resulting from high cyclic stresses in conjunction with inadequate welding details. In particular, crack at rib-to-deck welded joints due to wheel load is a concern because inspection and repair of the back side of this weld for closed ribs is not practical due to lack of access. Fatigue resist...

  10. Evaluation of the iPhone with an acrylic sleeve versus the Scoliometer for rib hump measurement in scoliosis

    OpenAIRE

    Izatt Maree T; Bateman Gary R; Adam Clayton J

    2012-01-01

    Abstract Background Vertebral rotation found in structural scoliosis contributes to trunkal asymmetry which is commonly measured with a simple Scoliometer device on a patient's thorax in the forward flexed position. The new generation of mobile 'smartphones' have an integrated accelerometer, making accurate angle measurement possible, which provides a potentially useful clinical tool for assessing rib hump deformity. This study aimed to compare rib hump angle measurements performed using a Sm...

  11. Mach-Zehnder Interferometer Biochemical Sensor Based on Silicon-on-Insulator Rib Waveguide with Large Cross Section.

    Science.gov (United States)

    Yuan, Dengpeng; Dong, Ying; Liu, Yujin; Li, Tianjian

    2015-01-01

    A high-sensitivity Mach-Zehnder interferometer (MZI) biochemical sensing platform based on Silicon-in-insulator (SOI) rib waveguide with large cross section is proposed in this paper. Based on the analyses of the evanescent field intensity, the mode polarization and cross section dimensions of the SOI rib waveguide are optimized through finite difference method (FDM) simulation. To realize high-resolution MZI read-out configuration based on the SOI rib waveguide, medium-filled trenches are employed and their performances are simulated through two-dimensional finite-difference-time domain (2D-FDTD) method. With the fundamental EH-polarized mode of the SOI rib waveguide with a total rib height of 10 μm, an outside rib height of 5 μm and a rib width of 2.5 μm at the operating wavelength of 1550 nm, when the length of the sensitive window in the MZI configuration is 10 mm, a homogeneous sensitivity of 7296.6%/refractive index unit (RIU) is obtained. Supposing the resolutions of the photoelectric detectors connected to the output ports are 0.2%, the MZI sensor can achieve a detection limit of 2.74 × 10(-6) RIU. Due to high coupling efficiency of SOI rib waveguide with large cross section with standard single-mode glass optical fiber, the proposed MZI sensing platform can be conveniently integrated with optical fiber communication systems and (opto-) electronic systems, and therefore has the potential to realize remote sensing, in situ real-time detecting, and possible applications in the internet of things. PMID:26343678

  12. Horner's syndrome after blunt cervical and chest trauma: case report Síndrome de Horner após trauma cérvico-torácico fechado: relato de caso

    Directory of Open Access Journals (Sweden)

    Wellingson Silva Paiva

    2007-12-01

    Full Text Available Horner‘s syndrome is the triad of miosis, ptosis, and anhidrosis, resulting from disruption of the sympathetic pathways. This article describes an uncommon case of Horner‘s syndrome in a 22-year-old man after blunt trauma to the neck and chest without carotid artery dissection. The patient was brought to the emergency service after motorcycle fall. Neurologic examination revealed a patient presenting the score 15 at Glasgow Coma Scale. The left eyelid was 1-2 mm lower than the right. Carotid Doppler and angiotomography were undertaken and revealed no abnormalities of the carotid artery. CT disclosed a mediastinal hematoma extending to the left apex, compressing the left sympathetic chain. The understanding of this clinical entity may help the surgeon to make a better differential diagnosis in trauma patients in whom prompt diagnosis is critical to stablish the correct treatment.A síndrome de Horner compreende a tríade de miose, ptose e anidrose, resultado de lesão em algum ponto das vias simpáticas. O referido estudo apresenta um caso da referida síndrome em um jovem de 22 anos vitima de queda de moto, com escoriações no tórax e no pescoço, sem dissecção carotídea. Ao exame neurológico, encontrava-se com 15 pontos na Escala de Coma de Glasgow, com miose à esquerda e ptose palpebral ipsilateral. Realizado Doppler de carótidas e angiotomografia dos vasos cérvico-cranianos não sendo evidenciadas anormalidades. A tomografia de tórax mostrou um hematoma no ápice pulmonar esquerdo, comprimindo a cadeia simpática ipsilateral. O conhecimento desta entidade clínica pode ajudar o cirurgião a fazer um diagnóstico diferencial adequado nos pacientes vítimas de traumas, nos quais o diagnóstico correto e eficaz pode ser fundamental para a definição da conduta a ser tomada.

  13. Numerical Simulation and Observational Analysis of the Bora of Pag's Ribs

    Science.gov (United States)

    Trošić, Tanja; Trošić, Živko

    2010-02-01

    The severe bora case that lasted from 13 to 15 November 2004 has been selected for the analysis of the bora of Pag’s ribs, which occurs in the northern part of the eastern Adriatic coast over the Pag island area (Croatia). According to the measurements from automatic stations, the MM5 numerical model is successful in the 10-min mean wind speed prediction at 10-m height. The vertical analysis of the wind speed and potential temperature also gave satisfactory results. At the commencement of the bora the modelled wind had a magnitude of 20ms-1 at 10-m height in the Pag island area, which sharply attenuated in the cross direction and to the open sea. In this way the model has proved successful in predicting the characteristics of the bora of Pag’s ribs. Potential vorticity (PV) at 600m has lower values within PV banners than during the developed bora. The consequence is a strong jet emanating from the nearest gap. The vertical cross-sections through the centre of the gap point out a permanent hydraulic-like flow. At the time of the bora of Pag’s ribs the highest modelled turbulent kinetic energy is found in the jump-like region above the inversion and within the boundary layer along the lower boundary, ranging from 6-8m2 s-2. It is concluded that the dissipation in the hydraulic jumps and the wave breaking regions are the reasons for PV generation.

  14. 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.

  15. Desmoplastic fibroma of the rib with cystic change: a case report and literature review

    International Nuclear Information System (INIS)

    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.)

  16. 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.)

  17. 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.)

  18. Evaluation of characteristics and surgical outcomes in cervical spondylotic amyotrophy

    Directory of Open Access Journals (Sweden)

    Hong-Li Wang

    2014-01-01

    Full Text Available Background: Cervical spondylotic amyotrophy (CSA is a rare clinical syndrome resulting from cervical spondylosis. Surgical treatment includes anterior cervical decompression and fusion (ACDF, and laminoplasty with or without foraminotomy. Some studies indicate that ACDF is an effective method for treating CSA because anterior decompression with or without medial foraminotomy can completely eliminate anterior and/or anterolateral lesions. We retrospectively evaluated outcome of surgical outcome by anterior cervical decompression and fusion (ACDF. Materials and Methods: 28 CSA patients, among whom 12 had proximal type CSA and 16 had distal type CSA, treated by ACDF, were evaluated clinicoradiologically. The improvement in atrophic muscle power was assessed by manual muscle testing (MMT and the recovery rate of the patients was determined on the basis of the Japanese Orthopedic Association (JOA scores. Patient satisfaction was also examined. Results: The percentage of patients, who gained 1 or more grades of muscle power improvement, as determined by MMT, was 91.7% for those with proximal type CSA and 37.5% for those with distal type CSA (P < 0.01. The JOA score-based recovery rates of patients with proximal type and distal type CSA were 60.8% and 41.8%, respectively (P < 0.05. Patient satisfaction was 8.2 for those with proximal type CSA and 6.9 for those with distal type CSA (P < 0.01. A correlation was observed among the levels of improvement in muscle power, JOA score based recovery rate, patient satisfaction and course of disease (P < 0.05. Conclusion: ACDF can effectively improve the clinical function of patients with CSA and result in good patient satisfaction despite the surgical outcomes for distal type CSA being inferior to those for proximal type CSA. Course of disease is the fundamental factor that affects the surgical outcomes for CSA. We recommend that patients with CSA undergo surgical intervention as early as possible.

  19. 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.

  20. The red-eared slider turtle carapace under fatigue loading: The effect of rib-suture arrangement.

    Science.gov (United States)

    Achrai, Ben; Daniel Wagner, H

    2015-08-01

    Biological structures consisting of strong boney elements interconnected by compliant but tough collagenous sutures are abundantly found in skulls and shells of, among others, armadillos, alligators, turtles and more. In the turtle shell, a unique arrangement of alternating rigid (rib) and flexible (suture) elements gives rise to superior mechanical performance when subjected to low and high strain-rate loadings. However, the resistance to repeated load cycling - fatigue - of the turtle shell has yet to be examined. Such repeated loading could approximately simulate the consecutive high-stress bending loads exerted during (a predator) biting or clawing. In the present study flexural high-stress cyclic loads were applied to rib and suture specimens, taken from the top dorsal part of the red-eared slider turtle shell, termed carapace. Subsequently, to obtain a more complete and integrated fatigue behavior of the carapace, specimens containing a complex alternating rib-suture-rib-suture-rib configuration were tested as well. Although the sutures were found to be the least resistant to repeated loads, a synergistic effect was observed for the complex specimens, displaying improved fatigue durability compared to the individual (suture or even rib) constituents. This study may assist in the design of future high-stress fatigue-resistant materials incorporating complex assemblies of rigid and flexible elements. PMID:26042699