Sample records for extensive posterolateral exposure

  1. Clinicopathologic analysis of extracapsular extension in prostate cancer: Should the clinical target volume be expanded posterolaterally to account for microscopic extension?

    International Nuclear Information System (INIS)

    Chao, K. Kenneth; Goldstein, Neal S.; Yan Di; Vargas, Carlos E.; Ghilezan, Michel I.; Korman, Howard J.; Kernen, Kenneth M.; Hollander, Jay B.; Gonzalez, Jose A.; Martinez, Alvaro A.; Vicini, Frank A.; Kestin, Larry L.


    Purpose: We performed a complete pathologic analysis examining extracapsular extension (ECE) and microscopic spread of malignant cells beyond the prostate capsule to determine whether and when clinical target volume (CTV) expansion should be performed. Methods and Materials: A detailed pathologic analysis was performed for 371 prostatectomy specimens. All slides from each case were reviewed by a single pathologist (N.S.G.). The ECE status and ECE distance, defined as the maximal linear radial distance of malignant cells beyond the capsule, were recorded. Results: A total of 121 patients (33%) were found to have ECE (68 unilateral, 53 bilateral). Median ECE distance = 2.4 mm [range: 0.05-7.0 mm]. The 90th-percentile distance = 5.0 mm. Of the 121 cases with ECE, 55% had ECE distance ≥2 mm, 19% ≥4 mm, and 6% ≥6 mm. ECE occurred primarily posterolaterally along the neurovascular bundle in all cases. Pretreatment prostrate-specific antigen (PSA), biopsy Gleason, pathologic Gleason, clinical stage, bilateral involvement, positive margins, percentage of gland involved, and maximal tumor dimension were associated with presence of ECE. Both PSA and Gleason score were associated with ECE distance. In all 371 patients, for those with either pretreatment PSA ≥10 or biopsy Gleason score ≥7, 21% had ECE ≥2 mm and 5% ≥4 mm beyond the capsule. For patients with both of these risk factors, 49% had ECE ≥2 mm and 21% ≥4 mm. Conclusions: For prostate cancer with ECE, the median linear distance of ECE was 2.4 mm and occurred primarily posterolaterally. Although only 5% of patients demonstrate ECE >4 to 5 mm beyond the capsule, this risk may exceed 20% in patients with PSA ≥10 ng/ml and biopsy Gleason score ≥7. As imaging techniques improve for prostate capsule delineation and as radiotherapy delivery techniques increase in accuracy, a posterolateral CTV expansion should be considered for patients at high risk

  2. Posterolateral elbow joint instability

    DEFF Research Database (Denmark)

    Olsen, Bo Sanderhoff; Søjbjerg, Jens Ole; Nielsen, K K


    Thirty-five osteoligamentous elbows were included in a study on the kinematics of posterolateral elbow joint instability during the pivot shift test (PST) before and after separate ligament cuttings in the lateral collateral ligament complex (LCLC). Division of the annular ligament or the lateral...... ulnar collateral ligament caused no laxity during the PST. Division of the lateral collateral ligament caused maximal laxity of 4 degrees and 23 degrees during forced PST in valgus and external rotation (supination), respectively. Cutting of the LCLC at the ulnar or the humeral insertion was necessary...... for any PST stressed elbow joint laxity to occur. Total division of the LCLC induced a maximal laxity of 7.9 degrees and 37 degrees during forced PST in valgus and external rotation (supination), respectively. This study suggests the lateral collateral ligament to be the primary soft tissue constraint...

  3. Combined anterolateral posterolateral rotary instability: Is posterolateral complex reconstruction necessary?

    Directory of Open Access Journals (Sweden)

    Khalilahah Nazem


    Full Text Available

    • BACKGROUND: The treatment of combined anterolateral posterolateral rotary instability has been done by correcting knee alignment, anterior cruciate ligament (ACL reconstruction plus repair or reconstruction of the posterolateral complex. Because of the technical difficulties encountered in these operations and the need for more than two stages, and considering the controversy among the role of posterolateral complex (PLC in valgus knees, this study was designed to observe the results of treating this instability by ACL-reconstruction alone, after correction of varus, without reconstruction of the posterolateral complex or further extra-articular manipulation.
    • METHODS: This was a clinical trial performed on 29 patients (29 knees with combined anterolateral posterolateral rotary nstability. Subjective and objective instability signs were recorded. Arthroscopy was then performed and a valgus osteotomy was done to correct alignment. Then in a second stage, an ACL-reconstruction was carried out. Results, after a mean of 23 months follow-up, were compared to the conditions before surgery. Fisher exact test, X2 and Wilcoxon tests were used to analyze the data. P<0.05 was considered to be meaningful.
    • RESULTS: Pain was relieved in more than half and locking was improved in all of the patients. Giving way of the knee was diminished from 79.3% to 6.9%. Special instability tests showed a significant improvement after surgery (P<0.001. Most of the patients returned to the preinjury level of work or sports.
    • CONCLUSIONS: Based on the results of this study, ACL-reconstruction alone, after correction of varus, can be sufficient to address this combined knee instability without farther procedures on extra-articular structures and posterolateral complex, thus avoiding unnecessary complications and longer rehabilitation.
    • Key words

    • Extensive calvarial exposure and full thickness sequestration ...

      African Journals Online (AJOL)

      Background: Calvarial osteomyelitis is an uncommon complication of burn injury due to electricity. Patient: A case of electrical injury that progressed from full thickness scalp loss to calvarial osteomyelitis and sequestration of outer and inner tables seen after one year of calvarial exposure is presented. Result: The patient ...

    • Importance of the different posterolateral knee static stabilizers: biomechanical study

      Directory of Open Access Journals (Sweden)

      Rodrigo Campos Pace Lasmar


      Full Text Available PURPOSE: The purpose of this study was to evaluate the relative importance of the different static stabilizers of the posterolateral corner of the knee in cadavers. METHODS: Tests were performed with the application of a varus and external rotation force to the knee in extension at 30 and 60 degrees of flexion using 10 cadaver knees. The forces were applied initially to an intact knee and then repeated after a selective sectioning of the ligaments into the following: section of the lateral collateral ligament; section of the lateral collateral ligament and the popliteofibular complex; and section of the lateral collateral ligament, the popliteofibular complex and the posterolateral capsule. The parameters studied were the angular deformity and stiffness when the knees were submitted to a 15 Newton-meter varus torque and a 6 Newton-meter external tibial torque. Statistical analysis was performed using the ANOVA (Analysis of Variance and Tukey's tests. RESULTS AND CONCLUSION: Our findings showed that the lateral collateral ligament was important in varus stability at 0, 30 and 60 degrees. The popliteofibular complex was the most important structure for external rotation stability at all angles of flexion and was also important for varus stability at 30 and 60 degrees. The posterolateral capsule was important for varus stability at 0 and 30 degrees and for external rotation stability in extension. Level of evidence: Level IV (cadaver study.

    • Anterior Versus Posterolateral Approach for Total Laparoscopic Splenectomy: A Comparative Study (United States)

      Ji, Bai; Wang, Yingchao; Zhang, Ping; Wang, Guangyi; Liu, Yahui


      Objective: Although the anterior approach is normally used for elective laparoscopic splenectomy (LS), the posterolateral approach may be superior. We have retrospectively compared the effectiveness and safety of these approaches in patients with non-severe splenomegaly scheduled for elective total LS. Methods: Patients with surgical spleen disorders scheduled for elective LS between March 2005 and June 2011 underwent laparoscopic splenic mobilization via the posterolateral or anterior approach. Main outcome measures included operation time, intraoperative blood loss, frequency of postoperative pancreatic leakage, and length of hospital stay. Results: During the study period, 203 patients underwent LS, 58 (28.6%) via the posterolateral and 145 (71.4%) via the anterior approach. Three patients (1.5%) required conversion to laparotomy due to extensive perisplenic adhesions. The posterolateral approach was associated with significantly shorter operation time (65.0 ± 12.3 min vs. 95.0 ± 21.3 min, P 0.05) Conclusions: The posterolateral approach is more effective and safer than the anterior approach in patients without severe splenomegaly (< 30 cm). PMID:23372427

    • Coverage of extensive tibial bone exposure in burn patients with ...

      African Journals Online (AJOL)

      Covering tibial bone exposure from third degree burns to the lower limbs is a challenging task for the plastic surgeon. We present our experience of covering tibial exposure from burns in three different patients, where four limbs were involved and three muscular flaps were used in conjunction with one another; i.e. the ...

    • [Myxoma involving posterolateral leaflet: about a case]. (United States)

      Nya, Fouad; Abdou, Abdessamad; Bamous, Mehdi; Moutakiallah, Younes; Atmani, Noureddine; Seghrouchni, Aniss; Aithoussa, Mahdi; Boulahya, Abdellatif


      Cardiac myxomas are the most common type of primary cardiac tumors. They mainly affect the interatrial septum and exceptionally the heart valves. Surgical excision remains the only therapeutic alternative. We here report the case of a 69-year old patient with no significant pathological history suffering from NYHA class II-III dyspnea associated with lipothymia. Transthoracic echocardiography showed a tight calcified aortic narrowing with aortic valve gradient of 58 mmHg. A sessile mass of 15mm diameter inserted into the posterolateral leaflet, without stenosis or mitral regurgitation evoking an atypical localization of myxomaor or fibroelastoma was detected at the level of the mitral valve. The examination was supplemented by ETO which confirmed the diagnosis of a mass involving the posterolateral leaflet. The patient underwent surgery via median sternotomy, under conventional extracorporeal circulation. Left atriotomy allowed to objectify a sessile mass of 15mm of diameter involving the auricular wall of the friable and easily cleavable posterolateral leaflet. Cauterization of the implant base via electric scalpel was then performed without any additional gesture on the posterolateral leaflet. Anatomopathologic analysis of the surgical specimen confirmed the diagnosis of myxoma. The patient also underwent aortic valve replacement with mechanical prosthesis. The postoperative course was uneventful. The patient was discharged on postoperative day 8. Cardiac myxoma involving the mitral leaflet is very rare. Surgical procedure attempting to resect the widest possible surgical margins remains the only therapeutic option to avoid the risk of recurrence.

    • Radiographic classification of the femoral intercondylar notch posterolateral rim. (United States)

      Farrow, Lutul D; Chen, Michael R; Cooperman, Daniel R; Goodfellow, Donald B; Robbin, Mark S


      The purpose of this study was to determine whether posterolateral rim morphology can be delineated on plain radiographic images. We obtained 20 femora from the Cleveland Museum of Natural History (10 each with distinct and indistinct posterolateral rims). Four blinded reviewers evaluated radiographic posterolateral rim morphology on lateral radiographs. The reviewers included a musculoskeletal radiologist, a fellowship-trained sports medicine surgeon, a pediatric orthopaedic surgeon, and a junior orthopaedic resident. Interobserver and intraobserver reliability was determined. Radiographically, posterolateral rim morphology was classified into 2 types. Type 1 rims have a defined transition from Blumensaat's line to the posterior femoral cortex. Type 2 rims have an indistinct transition. Interobserver reliability showed substantial agreement during the first (kappa = 0.65) and second (kappa = 0.70) sessions. Intraobserver reliability was nearly perfect, with kappa values ranging from 0.8 to 1.0. It has been shown anatomically that the posterolateral rim has variable morphology. We have shown that posterolateral rim morphology can be delineated on lateral plain film images. Radiographic type 1 rims correlate with distinct posterolateral rim morphology. Radiographic type 2 rims correlate with indistinct posterolateral rim morphology. For surgeons who reference the posterolateral rim for femoral tunnel placement during anterior cruciate ligament reconstruction, indistinct posterolateral rim morphology may result in errant tunnel placement. Improved awareness of posterolateral rim morphology preoperatively may help avoid technical errors with placement of the femoral tunnel.

    • Closed Reduction of ?Irreducible? Posterolateral Knee Dislocation - A Case Report


      Tateda, Satoshi; Takahashi, Atsushi; Aizawa, Toshimi; Umehara, Jutaro


      Introduction: Posterolateral rotary knee dislocation is a rare orthopedic injury that is considered to be irreducible by closed reduction because of soft tissue incarceration. Here, we present a case of posterolateral rotary knee dislocation, which was reduced by closed manipulation. Case report: The patientwas a 33-year-old man who sustained a twisting injury to his right knee that was diagnosed as posterolateral rotary knee dislocation by plain radiographs and the characteristic physical fi...

    • Reliability analysis of radiographic methods for determination of posterolateral lumbossacral fusion

      International Nuclear Information System (INIS)

      Gotfryd, Alberto Ofenhejm; Moraes Pomar, Felipe de; Carneiro, Nicola Jorge Neto; Franzin, Fernando José; Rodrigues, Luciano Miller Reis; Poletto, Patricia Rios


      To analyze intra and interobserver agreement of two radiographic methods for evaluation of posterolateral lumbar arthrodesis. Twenty patients undergoing instrumented posterolateral fusion were evaluated by anteroposterior and dynamic lateral radiographs in maximal flexion and extension. The images were evaluated initially by 6 orthopedic surgeons, and after 8 weeks, reassessed by 4 of them, totaling 400 radiographic measurements. Intra and interobserver reliability were analyzed using the Kappa coefficient and Landis and Koch criteria. Intra and interobserver agreement regarding anteroposterior radiographs were, respectively, 76 and 63%. On lateral views, these values were 78 and 84%, respectively. However, the Kappa analysis showed poor intra and interobserver agreement in most cases, regardless of the radiographic method used. There was poor intra and interobserver agreement in the evaluation of lumbosacral fusion by plain film in anteroposterior and dynamic lateral views, with no statistical superiority between the methods

    • Anatomical knee postero-lateral corner reconstruction: The "Versailles" technique. (United States)

      Murgier, J; Boisrenoult, P; Steltzlen, C; Beaufils, P; Pujol, N


      Postero-lateral knee instability raises surgical challenges. Of the many available reconstruction techniques, few ensure anatomical reconstruction of the postero-lateral corner (PLC). The "Versailles" technique ensures the anatomical reconstruction of the three main PLC stabilisers (lateral collateral ligament, popliteus tendon, and popliteo-fibular ligament) by using either a hamstring autograft or a tendon allograft. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

    • Sniff to see. Comparing sniffing position versus simple head extension position for glottic exposure - A prospective, randomized cross over study

      Directory of Open Access Journals (Sweden)

      Nishant Sahay


      Conclusion: Sniffing position provides better glottis exposure and it is easier to intubate a patient in the sniffing position as compared to simple head extension position. Sniffing position should therefore be used as initial position when attempting intubation.

    • The treatment of recurrent posterolateral instability of the elbow

      DEFF Research Database (Denmark)

      Olsen, Bo Sanderhoff; Søjbjerg, Jens Ole


      This study describes the surgical technique used for reconstruction and reinforcement of the lateral collateral ligament complex in patients with posterolateral instability of the elbow and the results. A triceps tendon graft from the ipsilateral elbow which was inserted through bone tunnels...

    • Areally Extensive Surface Bedrock Exposures on Mars: Many Are Clastic Rocks, Not Lavas (United States)

      Rogers, A. Deanne; Warner, Nicholas H.; Golombek, Matthew P.; Head, James W.; Cowart, Justin C.


      Areally extensive exposures of intact olivine/pyroxene-enriched rock, as well as feldspar-enriched rock, are found in isolated locations throughout the Martian highlands. The petrogenetic origin(s) of these rock units are not well understood, but some previous studies favored an effusive volcanic origin partly on the basis of distinctive composition and relatively high thermal inertia. Here we show that the regolith development, crater retention, and morphological characteristics for many of these "bedrock plains" are not consistent with competent lavas and reinterpret the high thermal inertia orbital signatures to represent friable materials that are more easily kept free of comminution products through eolian activity. Candidate origins include pyroclastic rocks, impact-generated materials, or detrital sedimentary rocks. Olivine/pyroxene enrichments in bedrock plains relative to surrounding materials could have potentially formed through deflation and preferential removal of plagioclase.

    • A cell kinetic model of granulopoiesis under radiation exposure: Extension from rodents to canines and humans

      International Nuclear Information System (INIS)

      Hu, S.; Cucinotta, F. A.


      As significant ionising radiation exposure will occur during prolonged space travel in future, it is essential to understand their adverse effects on the radiosensitive organ systems that are important for immediate survival of humans, e.g. the haematopoietic system. In this paper, a bio-mathematical model of granulopoiesis is used to analyse the granulocyte changes seen in the blood of mammalians under acute and continuous radiation exposure. This is one of a set of haematopoietic models that have been successfully utilised to simulate and interpret the experimental data of acute and chronic radiation on rodents. Extension to canine and human systems indicates that the results of the model are consistent with the cumulative experimental and empirical data from various sources, implying the potential to integrate them into one united model system to monitor the haematopoietic response of various species under irradiation. The suppression of granulocytes' level of a space traveller under chronic stress of low-dose irradiation as well as the granulopoietic response when encountering a historically large solar particle event is also discussed. (authors)

    • [Occlusion of the posterolateral ciliary artery--preceding cerebral stroke]. (United States)

      Popiela, G; Rogala, E; Swiebocka, H; Bielicka, E


      A case of acute occlusion of the posterolateral ciliary artery which occurred in a 57 years old man, habitual smoker, with II. obesity is presented. Diagnosis was made during emergency basing on fluorescein angiographic examination. The authors concluded that in each case of vascular accident there is a necessity to explore its cause. In the presented case it had been insufficiency of the internal carotid artery which in a short time, after ocular accident, caused a cerebral stroke.

    • Exposure of extensively farmed wild boars (Sus scrofa scrofa) to selected pig pathogens in Greece. (United States)

      Marinou, K A; Papatsiros, V G; Gkotsopoulos, E K; Odatzoglou, P K; Athanasiou, L V


      Increased density and distribution of wild boar populations are likely to promote interactions and transmission of certain pathogens, not only among wild boar but also from wild boar to livestock or humans and vice versa. The purpose of this study was to determine seroprevalence against seven selected pathogens in wild boar living in four different areas in Greece. In total, 359 serum samples were collected from extensively farmed wild boar (Sus scrofa scrofa) originating from four distinct geographical areas throughout Greece from April 2012 to August 2013. Samples were tested for antibodies to Actinobacillus pleuropneumoniae, African swine fever virus (ASFV), Aujeszky's disease virus (ADV), classical swine fever virus (CSFV), Erysipelothrix rhusiopathiae, Mycoplasma hyopneumoniae and porcine reproductive and respiratory syndrome virus (PRRSV). Prevalence was compared among the four regions using Fisher's exact test. Low overall seropositivities of 2.4% and 5.6% were detected for E. rhusiopathiae and PRRSV, respectively, higher ones for ADV (32.0%) and the highest (72.5% and 90.5%) for M. hyopneumoniae and A. pleuropneumoniae, respectively. All sera tested were found negative for antibodies directed against CSFV and ASFV. This is the first report of exposure of wild boars to selected pig pathogens in Greece. These results are indicative of the circulation of these pathogens in Greece with the exception of CSFV and ASFV and suggestive of the potential role of wild boars on their maintenance and transmission to their domestic counterparts and vice versa.

    • Simple strategy to assess linezolid exposure in patients with multi-drug-resistant and extensively-drug-resistant tuberculosis

      NARCIS (Netherlands)

      Kamp, Jasper; Bolhuis, Mathieu S.; Tiberi, Simon; Akkerman, Onno W.; Centis, Rosella; de lange, Wiel C.; Kosterink, Jos G.; van der Werf, Tjip S.; Migliori, Giovanni B.; Alffenaar, Jan-Willem C.

      Linezolid is used increasingly for the treatment of multi-drug-resistant (MDR) and extensively-drug-resistant (XDR) tuberculosis (TB). However, linezolid can cause severe adverse events, such as peripheral and optical neuropathy or thrombocytopenia related to higher drug exposure. This study aimed

    • Comparison of complications and functional results of standard posterolateral thoracotomy with muscle sparing thoracotomy

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      Peiravy Sereshke H


      Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Standard thoracotomy necessitates division of thoracic large muscles leading to pain and impaired respiratory movements; muscle sparing postero-lateral thoracotomy has been suggested as an alternative to reduce the aforementioned effect. The aim of this study was to compare muscle saving posterolateral thoracotomy with standard thoracotomy."n"nMethods: This study was a clinical trial. All patients who were candidates for elective thoracotomy were included and divided into two groups of muscle saving thoracotomy and standard thoracotomy randomly. Required time for opening and closing the chest, amount of prescribed narcotics, shoulder movements (flexion, extension, abduction and internal rotation, pulmonary function (FVC, FEV1, VC, development of seroma, and duration of hospitalization were assessed. Shoulder movements and pulmonary function were measured immediately before operation and 7 days later while pain measured in 1st and 7th post-operative days."n"nResults: 60 patients (42 males entered the study and there were no significant differences regarding age and sex distribution between two groups (p>0.05. Mean duration of opening the chest in muscle saving thoracotomy was significantly longer than

  1. Anatomical reconstruction of posterolateral corner and combined injuries of the knee

    NARCIS (Netherlands)

    Wal, W.A. van der; Heesterbeek, P.J.; Tienen, T.G. van; Busch, V.J.; Ochten, J.H. van; Wymenga, A.B.


    PURPOSE: The goal of this study was to present a 2- to 5-year prospective follow-up of an anatomical posterolateral corner reconstruction in a series of 16 patients with symptomatic instability and pain complaints of the knee. METHODS: All 16 patients underwent a posterolateral corner reconstruction

  2. Chronic aflatoxin exposure in children living in Bhaktapur, Nepal: Extension of the MAL-ED study. (United States)

    Mitchell, Nicole J; Riley, Ronald T; Egner, Patricia A; Groopman, John D; Wu, Felicia


    Exposure to aflatoxin, a mycotoxin common in maize and groundnuts, has been associated with childhood stunting in sub-Saharan Africa. In an effort to further our understanding of growth impairment in relation to mycotoxins and other risk factors, biospecimens from a cohort of children enrolled in the Bhaktapur, Nepal MAL-ED study were assessed for aflatoxin exposure at 15, 24, and 36 months of age. Exposure was assessed through a well-established serum biomarker, the AFB 1 -lysine adduct. In this manuscript, the levels of aflatoxin exposure in the Nepal cohort were compared with those observed in aflatoxin studies, with child growth parameters as a health outcome. Results from this preliminary analysis demonstrated chronic aflatoxin exposure in children residing in Bhaktapur with a geometric mean of 3.62 pg AFB 1 -lysine/mg albumin. The range of exposure in this population is similar to those in African populations where associations with aflatoxin biomarkers and poor child growth have been observed. Future work will analyze the relationships between aflatoxin levels, growth, and other risk factors collected by the MAL-ED study.

  3. Exposure therapy augmentation: A review and extension of techniques informed by an inhibitory learning approach. (United States)

    Weisman, Jaclyn S; Rodebaugh, Thomas L


    Although exposure therapy is often considered a gold standard behavioral intervention for pathological anxiety, questions remain surrounding the mechanisms underlying exposure interventions, and some individuals are characterized by suboptimal treatment outcomes. Recently, a formulation known as the inhibitory learning theory, which is grounded in basic science principles of extinction learning and memory, has been proposed to provide a more parsimonious mechanistic explanation for the effects of exposure than previous, habituation-based models [Craske, M.G., Kircanski, K., Zelikowsky, M., Mystkowski, J., Chowdhury, N., & Baker, A. 2008. Optimizing inhibitory learning during exposure therapy. Behaviour Research and Therapy, 46, 5-27; Craske, M.G., Treanor, M., Conway, C.C., Zbozinek, T., & Vervliet, B. 2014. Maximizing exposure therapy: An inhibitory learning approach. Behaviour Research and Therapy, 58, 10-23]. Strategies informed by this theory are proposed to maximize extinction learning by fostering the development of new, non-threat associations between stimuli in memory and enhancing the accessibility and retrieval of these safety-based associations. This comprehensive review serves as a critical examination of the empirical literature regarding major tenets of inhibitory learning theory and the potential for such techniques to augment exposure therapy for anxiety disorders. Limitations of the extant research, as well as potential future directions, are explored. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Radiographic and functional outcome of posterolateral lumbosacral fusion for low grade isthmic spondylolisthesis in children and adolescents. (United States)

    Tsirikos, A I; Sud, A; McGurk, S M


    We reviewed 34 consecutive patients (18 female-16 male) with isthmic spondylolysis and grade I to II lumbosacral spondylolisthesis who underwent in situ posterolateral arthodesis between the L5 transverse processes and the sacral ala with the use of iliac crest autograft. Ten patients had an associated scoliosis which required surgical correction at a later stage only in two patients with idiopathic curves unrelated to the spondylolisthesis. No patient underwent spinal decompression or instrumentation placement. Mean surgical time was 1.5 hours (1 to 1.8) and intra-operative blood loss 200 ml (150 to 340). There was one wound infection treated with antibiotics but no other complication. Radiological assessment included standing posteroanterior and lateral, Ferguson and lateral flexion/extension views, as well as CT scans. A solid posterolateral fusion was confirmed in all patients at mean latest follow-up of 4.7 years (3.4 to 9.8) beyond skeletal maturity into early adult life. Fusion of the isthmic lesion was documented in nine patients bilaterally and eight patients unilaterally. The poor fusion rate across the spondylolysis has not affected the excellent functional results of the procedure, which in our series depended on achieving a stable lumbosacral junction. Quality of life assessment demonstrated significant improvement in all functional scores and high patient satisfaction with 28 patients returning to previous sports activities at an elite competitive level. Posterolateral arthrodesis in situ with autologous iliac crest bone without instrumentation has achieved a solid fusion between the L5 transverse processes and the sacral ala in patients with grade I to II isthmic lumbosacral spondylolisthesis and this has produced excellent clinical outcomes and high patient satisfaction. ©2016 The British Editorial Society of Bone & Joint Surgery.

  5. Transcriptome profiling of brown adipose tissue during cold exposure reveals extensive regulation of glucose metabolism

    DEFF Research Database (Denmark)

    Hao, Qin; Yadav, Rachita; Basse, Astrid L.


    We applied digital gene expression profiling to determine the transcriptome of brown and white adipose tissues (BAT and WAT, respectively) during cold exposure. Male C57BL/6J mice were exposed to cold for 2 or 4 days. A notable induction of genes related to glucose uptake, glycolysis, glycogen...... exposure, we propose a model for the intermediary glucose metabolism in activated BAT: 1) fluxes through glycolysis and the pentose phosphate pathway are induced, the latter providing reducing equivalents for de novo fatty acid synthesis; 2) glycerol synthesis from glucose is increased, facilitating...

  6. Circumferential fusion improves outcome in comparison with instrumented posterolateral fusion

    DEFF Research Database (Denmark)

    Videbaek, Tina S; Christensen, Finn B; Soegaard, Rikke


    fusion (titanium Cotrel-Dubousset) or circumferential lumbar fusion (instrumented posterolateral fusion with anterior intervertebral support by a Brantigan cage). The primary outcome measure was the Dallas Pain Questionnaire (DPQ). The secondary outcome measures were the Oswestry Disability Index, the SF...... with respect to all four DPQ categories: daily activities, work/leisure, anxiety/depression, and social interest. The Oswestry Disability Index supported these results (P ...STUDY DESIGN: Prospective randomized clinical study with a 5- to 9-year follow-up period. OBJECTIVE: The aim of the present study was to analyze the long-term outcome with respect to functional disability, pain, and general health of patients treated by means of circumferential lumbar fusion...

  7. Microsurgical Posterolateral Foraminotomy on Patients with Adult Isthmic Spondylolisthesis. (United States)

    Chang, Han Soo


    The standard surgical treatment for adult isthmic spondylolisthesis consists of various techniques of arthrodesis supplemented with instrumentation. However, the superiority of this strategy has not been irrefutably proved. Considering the risk associated with the instrumentation surgery, examining a less invasive approach is justified. We describe a series of 9 patients with adult isthmic spondylolisthesis, in whom we microsurgically decompressed the responsible nerve root in the intervertebral foramen through the posterolateral intermuscular approach. Technical details specific to isthmic spondylolisthesis were reviewed. The 2-year outcome was assessed with Short Form 36 and visual analog scale scores. The mean age of the patients was 68 ± 7 years (standard deviation [SD]). The mean slip rate of spondylolisthesis measured on the preoperative lumbar radiography was 20% ± 12% (SD). All patients successfully underwent the procedure without complications. All the examined scores remained significantly better than the preoperative values 2 years after surgery; the mean visual analog scale score decreased from 7.8 ± 2.8 (SD) preoperatively to 2.8 ± 1.4 (SD) at 2 years (P = 0.008), average physical score of Short Form 36 improved from 33.1 ± 9.7 to 52.5 ± 9.4 (P = 0.001), and the bodily pain score improved from 28.0 ± 13.5 to 55.1 ± 9.7 (P = 0.001). Microsurgical decompression through the posterolateral intermuscular approach was effective in producing good 2-year outcome in patients with adult isthmic spondylolisthesis. This procedure may be considered as a less invasive alternative in the surgical treatment of adult isthmic spondylolisthesis. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Injuries to posterolateral corner of the knee: a comprehensive review from anatomy to surgical treatment☆ (United States)

    Crespo, Bernardo; James, Evan W.; Metsavaht, Leonardo; LaPrade, Robert F.


    Although injuries to the posterolateral corner of the knee were previously considered to be a rare condition, they have been shown to be present in almost 16% of all knee injuries and are responsible for sustained instability and failure of concomitant reconstructions if not properly recognized. Although also once considered to be the “dark side of the knee”, increased knowledge of the posterolateral corner anatomy and biomechanics has led to improved diagnostic ability with better understanding of physical and imaging examinations. The management of posterolateral corner injuries has also evolved and good outcomes have been reported after operative treatment following anatomical reconstruction principles. PMID:26401495

  9. Inestabilidad posterolateral crónica de codo. Reconstrucción ligamentaria. [Chronic posterolateral elbow instability. Ligament reconstruction].

    Directory of Open Access Journals (Sweden)

    Gerardo Luis Gallucci


    Full Text Available Introducción El objetivo de este trabajo es evaluar los resultados de una serie de pacientes con inestabilidad posterolateral crónica de codo tratados con reconstrucción del ligamento colateral cubital con injerto tendinoso. Material y métodos Se presentan 10 pacientes, con una edad promedio de 47 años. El tiempo entre la luxación y la cirugía fue de 16 meses. El test de Pivot Shift bajo anestesia fue positivo en todos los pacientes. Siete pacientes presentaron bajo control radioscópico un estadio 1 de Hori, un paciente un estadío 2 y 2 pacientes presentaron un estadio 3. En la mayoría de los casos se utilizó el tendón del palmar menor. El seguimiento promedio fue de 21 meses. Resultados La flexo-extensión fue de 126-3º. El dolor según EVA fue de 0 en reposo y de 1 en actividad. El DASH promedio fue de 12 y el SCM promedio de 95. Ningún paciente reportó sensación de inestabilidad. El Test de Pivot Shift despierto fue negativo en todos los pacientes. Conclusión La reconstrucción del ligamento lateral del codo con injerto tendinoso para pacientes con inestabilidad posterolateral crónica es efectiva para lograr la estabilidad articular. Los mejores resultados se evidenciaron en pacientes con estadíos 1 y 2 de inestabilidad. No se presentaron casos de inestabilidad residual.

  10. MRI of the posterolateral corner of the knee, please have a look

    African Journals Online (AJOL)

    Mahmoud Agha


    Sep 23, 2016 ... MCL, medial collateral ligament; PACS, picture achieving and communicating system; PCL, posterior cruciate ligament; PFL, popliteofibular ligament; PM, popliteus muscle; PLC, posterolateral corner; PHLM, posterior horn of lateral meniscus. * Address: Diagnostic Imaging, Medical Research Institute,.

  11. Femoral Head Avascular Necrosis Is Not Caused by Arthroscopic Posterolateral Femoroplasty. (United States)

    Rupp, Robert E; Rupp, Sasha N


    This study was conducted to identify the risk of avascular necrosis of the femoral head after arthroscopic femoroplasty extending to the posterolateral femoral neck, the source of the primary blood supply to the femoral head. Cam lesions of femoroacetabular impingement are typically anterior along the junction of the femoral head and neck. However, anatomic variations can involve the posterolateral vascular region of the femoral head and neck. Femoroplasty involving this vascular region can lead to injury to the blood supply to the femoral head, with subsequent avascular necrosis. If the posterolateral portion of the cam lesion is preserved, persistent femoroacetabular impingement may occur. A retrospective review identified 112 patients who underwent arthroscopic femoroplasty for femoroacetabular impingement over a 2-year period. Of these patients, 14 had femoroplasty that extended to the posterolateral femoral head. Of this group, 5 had undergone magnetic resonance imaging (MRI) after femoroplasty and the other 9 were contacted to undergo MRI of the hip to evaluate for avascular necrosis. A radiologist and the senior author evaluated all MRI scans specifically for avascular necrosis of the femoral head. All procedures were performed by the senior author. Mean age of the 14 patients (8 women and 6 men) with femoroplasty that extended into the posterolateral vascular region of the femoral head was 44 years (range, 23-69 years). All 14 patients underwent MRI evaluation of the affected hip a mean of 25 months (range, 7-44 months) after femoroplasty. No MRI scans showed evidence of avascular necrosis of the femoral head. Femoroplasty of the posterolateral vascular region of the femoral head is not associated with avascular necrosis. Patients with femoroacetabular impingement and a cam lesion extending to the posterolateral femoral head can undergo femoroplasty of this region without the development of avascular necrosis. [Orthopedics. 2016; 39(3):177-180.]. Copyright

  12. Local bone graft harvesting and volumes in posterolateral lumbar fusion: a technical report. (United States)

    Carragee, Eugene J; Comer, Garet C; Smith, Micah W


    In lumbar surgery, local bone graft is often harvested and used in posterolateral fusion procedures. The volume of local bone graft available for posterolateral fusion has not been determined in North American patients. Some authors have described this as minimal, but others have suggested the volume was sufficient to be reliably used as a stand-alone bone graft substitute for single-level fusion. To describe the technique used and determine the volume of local bone graft available in a cohort of patients undergoing single-level primary posterolateral fusion by the authors harvesting technique. Technical description and cohort report. Consecutive patients undergoing lumbar posterolateral fusion with or without instrumentation for degenerative processes. Local bone graft volume. Consecutive patients undergoing lumbar posterolateral fusion with or without instrumentation for degenerative processes of were studied. Local bone graft was harvested by a standard method in each patient and the volume measured by a standard procedure. Twenty-five patients were studied, and of these 11 (44%) had a previous decompression. The mean volume of local bone graft harvested was measured to be 25 cc (range, 12-36 cc). Local bone graft was augmented by iliac crest bone in six of 25 patients (24%) if the posterolateral fusion bed was not well packed with local bone alone. There was a trend to greater local bone graft volumes in men and in patients without previous decompression. Large volumes of local bone can be harvested during posterolateral lumbar fusion surgery. Even in patients with previous decompression the volume harvested is similar to that reported harvested from the posterior iliac crest for single-level fusion. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. Posterolateral fusion with interbody for lumbar spondylolisthesis is associated with less repeat surgery than posterolateral fusion alone. (United States)

    Macki, Mohamed; Bydon, Mohamad; Weingart, Robby; Sciubba, Daniel; Wolinsky, Jean-Paul; Gokaslan, Ziya L; Bydon, Ali; Witham, Timothy


    Posterior or transforaminal lumbar interbody fusions (PLIF/TLIF) may improve the outcomes in patients with lumbar spondylolisthesis. This study aims to compare outcomes after posterolateral fusion (PLF) only versus PLF with interbody fusion (PLF+PLIF/TLIF) in patients with spondylolisthesis. We retrospectively reviewed103 patients who underwent first-time instrumented lumbar fusions for degenerative or isthmic spondylolisthesis. Anterior techniques and multilevel interbody fusions were excluded. All patients were followed for at least 2 years postoperatively. Clinical outcomes including back pain, radiculopathy, weakness, sensory deficits, and loss of bowel/bladder function were ascertained from clinic notes. Radiographic measures were calculated with Tillard percentage of spondylolisthesis. Reoperation for progression of degenerative disease, a primary endpoint, was indicated for all patients with (1) persistent or new-onset neurological symptoms; and (2) radiographic imaging that correlated with clinical presentation. Of the 103 patients, 56.31% were managed with PLF and 43.69% with PLF+PLIF/TLIF. On radiographic studies, spondylolisthesis improved by a mean of 13.06% after PLF+PLIF/TLIF versus 5.67% after PLF (pspondylolisthesis. Patients with interbody fusions were less likely to undergo reoperation for degenerative disease progression compared to non-interbody fusions. However, greater listhesis correction and decreased reoperation in the PLF+PLIF/TLIF cohort should be weighed with favorable clinical outcomes in the PLF cohort. Copyright © 2015 Elsevier B.V. All rights reserved.

  14. Neurogenic lesions after posterolateral thoracotomy in young children. (United States)

    Emmel, M; Ulbach, P; Herse, B; Dalichau, H; Haupt, W F; Schumann, D; Mennicken, U


    In follow-up examinations of young patients we often noticed upward displacement of the left shoulder in cases where left-sided posterolateral thoracotomy had been carried out. Finding little discussion of this side-effect in the literature, we undertook the present study. The shoulder girdle of 69 patients who had undergone surgery for coarctation of the aorta between 1964 and 1984 was carefully examined to assess displacements and dysfunctions. In addition, in 24 of the patients electrodiagnostic examination was carried out of the associated muscles and nerves which were affected by the operation. We found disturbances of the muscular apparatus of the shoulder girdle in 80% of the cases: upward displacement of the shoulder (55%), downward displacement of the shoulder (8.7%), deviation of the scapula at rest (72.5%) and maximal elevated arms (40.6%), scapula alata (56.5%), and alterations of the posterior axillary line (39.1%). When considering only the cases of distinct upward or downward displacement of the shoulder, at least 25% of the operated children were affected. Children operated early (surgery during the first year of life) had more distinct alterations (47.6%) than those with later surgery (14.6%). Electromyographic examinations indicate that mainly disorders of the peripheral nerves caused by the operation led to these alterations of the shoulder girdle musculature. Although, except for one patient, no functional disorders were found, there were several cases in which the alteration caused quite severe cosmetic problems. One should pay more attention to positioning for surgery and do careful preparation to reduce these sequelae.


    Directory of Open Access Journals (Sweden)



    Full Text Available OBJECTIVE: Aim of this study is to assess and compare the outcomes of posterior lumbar interbody fusion (PLIF and posterolateral fusion (PLF in adult isthmic spondylosthesis. BACKGROUND: Posterolateral fusion has been considered the best method and widely been used for surgical treatment of adult spondylolisthesis.Superior results have subsequently been reported with interbody fusion with cages and posterior instrumentation MATERIALS AND METHODS: Thirty six patients with isthmic spondylolisthesis were operated. One group (20 patients had decompression and posterolateral fusion (PLF with a pedicle screw system; other group (16 patients was treated by decompression, posterior lumbar interbody fusion (PLIF and a Pedicle screw system. In both groups adequate decompression was done RESULTS: Seventy seven percent of the patients had a good result with (PLIF and 68 percent with posterolateral fusion (PLF. However there was no statistical difference in cases with low grade slipping, whereas the difference was significant for cases with high grade slipping. Fusion rate was 93% with (PLIF and 68% with (PLF, but without any significant incidence in the functional outcome. 78% has relief of sciatica and neurogenic claudication. CONCLUSION: Based on these findings we found that for high grade spondylolisthesis which requires reduction or if the disc space is still high posterior lumbar inter body fusion is preferable. For low grade spondylolisthesis or if the disc space is narrow posterolateral fusion is preferable. A successful result of fusion operation depends on adequate decompression which relieves radicular symptoms.

  16. A posterolateral approach to occipitoatlantoaxial ventral lesions: a report of the long-term follow-up of 23 cases. (United States)

    Limin, Liu; Chunguang, Zhou; Yueming, Song; Siqing, Huang; Hao, Liu; Quan, Gong; Tao, Li; Jiancheng, Zeng; Faming, Luo


    A retrospective study of consecutive patient series. To report a technique of odontoidectomy using a transoccipitocervical posterolateral approach for occipitoatlantoaxial ventral lesions in a long-term follow-up study. Occipitoatlantoaxial malformation and old traumatic dislocation usually cause compression of the high cervical spinal cord from a variety of different directions and angles, leading to high morbidity. The main objective of treatment is to relieve the anteroposterior compression and to restore the stability of the occipitocervical region. Currently, there are 2 approaches to perform the surgical procedure: (1) posterior decompression by suboccipital and occipitocervical fusion and internal fixation; and (2) decompression by a transoral approach to an odontoid resection. However, there are some short points, which need to be changed, such as the incomplete decompression (the former), narrow view, cerebrospinal fluid leakage, and the high infection rates. From 1999 to 2006, 23 patients with occipitoatlantoaxial ventral lesions were treated using a transoccipitocervical posterolateral approach for decompression. The procedure included an expansion of the foramen magnum, a resection of the posterior arch of atlas, a lateral occipitocervical epidural exposure to the odontoid and the C2 vertebra, and an excision of the odontoid. Thus, an anteroposterior decompression and occipitocervical spinal fusion was achieved. Neurological function, daily living ability, and the work ability of patients were assessed in a follow-up study. A 28-year-old woman died of respiratory and circulatory failure 10 hours after operation. The remaining patients survived without postoperative infection. The neurological injury in 17 patients did not deteriorate, whereas 5 patients had decreased sensation in the upper limbs, and the elbow flexor muscle strength in 2 patients declined by 1 grade on the operation side. Short-term follow-up (3-6 mo, 22 cases) indicated that 19

  17. Posterolateral Bochdalek diaphragmatic hernia in adults Hernia diafragmática posterolateral de Bochdalek en el adulto

    Directory of Open Access Journals (Sweden)

    José Maximiliano Garófano-Jerez


    Full Text Available Bochdalek hernias (BHs are produced in the posterolateral area of the diaphragm. They are generally congenital, appearing in childhood, but are also detected in asymptomatic adult patients seeking medical attention for other reasons. Computed tomography (CT or magnetic resonance imaging (MRI is used for the correct diagnosis of the hernia type and for its localization, facilitating its management and the choice of treatment. We describe three cases of Bochdalek hernia, two on the right side and one bilateral, which was larger on the right than left side. All of these hernias contained only omental fat. In one patient, the right kidney was adjacent to the diaphragmatic defect but remained within the abdomen. The patients showed no symptoms and were not surgically treated. Examination by multi-slice CT with the possibility of coronal and sagittal reconstruction should be considered the standard method for diagnosing this entity. MRI in T1 is highly valuable to evaluate fat-containing chest lesions. The incidental finding of BH in asymptomatic adults is increasing, thanks to the wider application of new imaging techniques.Las hernias de Bochdalek se producen a través de la zona posterolateral del diafragma. Generalmente son congénitas y se presentan en la infancia, pero pueden verse también en la edad adulta en pacientes asintomáticos, que consultan por patologías diversas. El uso de tomografía computarizada o resonancia magnética permite el diagnóstico correcto del tipo y localización de la hernia, lo cual facilitará su manejo y la elección del tratamiento. Presentamos 3 casos clínicos, dos tenían una hernia de Bochdalek derecha, y, el otro caso es bilateral, siendo mayor la situada en el lado derecho. En todos nuestros casos, el contenido ha sido únicamente grasa omental. No obstante, en uno de ellos, el riñón derecho se situaba adyacente al defecto diafragmático, pero dentro del abdomen. Debido a la ausencia de sintomatolog

  18. Anterior ST segment depression in acute inferior myocardial infarction as a marker of greater inferior, apical, and posterolateral damage

    International Nuclear Information System (INIS)

    Ruddy, T.D.; Yasuda, T.; Gold, H.K.; Leinbach, R.C.; Newell, J.B.; McKusick, K.A.; Boucher, C.A.; Strauss, H.W.


    The clinical significance of anterior precordial ST segment depression during acute inferior myocardial infarction was evaluated in 67 consecutive patients early after onset of symptoms with gated blood pool scans, thallium-201 perfusion images, and 12-lead ECGs. Patients with anterior ST depression (n = 33) had depressed mean values for left ventricular ejection fraction (54 +/- 2% [mean +/- S.E.M.] vs 59 +/- 2%; p = 0.02), cardiac index (3.1 +/- 0.2 vs 3.6 +/- 0.2 L/m2; p = 0.03), and ratio of systolic blood pressure to end-systolic volume (2.0 +/- 0.1 vs 2.5 +/- 0.3 mm Hg/ml; p = 0.04) compared to patients with no anterior ST depression (n = 34). Patients with anterior ST depression had (1) lower mean wall motion values for the inferior, apical, and inferior posterolateral segments (p less than 0.05) and (2) greater reductions in thallium-201 uptake in the inferior and posterolateral regions (p less than 0.05). However, anterior and septal (1) wall motion and (2) thallium-201 uptake were similar in patients with and without ST depression. Thus, anterior precordial ST segment depression in patients with acute inferior wall myocardial infarction represents more than a reciprocal electrical phenomenon. It identifies patients with more severe wall motion impairment and greater hypoperfusion of the inferior and adjacent segments. The poorer global left ventricular function in these patients is a result of more extensive inferior infarction and not of remote septal or anterior injury

  19. Cervical radicular block using the CT-guided posterolateral approach

    International Nuclear Information System (INIS)

    Marchegiani, Silvio; Secchi, Adrian; Marangoni, Alberto; Surur, Alberto


    Objective: This presentation's goal is to define the indications of the procedure, to describe a new way to access to the foramen, and to evaluate the results. Material and method: Between November 2000 and October 2004, we performed 12 blockades of cervical nerves roots in 11 patients (5 female and 6 males, aged from 37 to 62 years old) with cervical pain without resolution under conventional treatment. The cause of the symptoms included: 7 patients with cervical disc protrusion and 4 patients with cervical degenerative processes diagnosed by previous Magnetic Resonance Imaging (MRI) studies. The levels of the procedure were: 1 in C3, on the right side (8.3%); 2 in C5, on the left side (16.6%); 6 in C6 (5 on the right side and 1 on the left), (50%); and 3 in C7 (25%), under CT guidance alone, with a posterior-lateral access. Results: The first clinical control after 1 hour showed a complete pain remission in all the 11 patients (100%). The second control (15 days after) showed 9 patients (81.9%) without pain, one patient (9,1%) with partial pain relief without medication, and one patient (9,1%) with pain relapse. Finally, in the third control (3 months later) based on ten patients (one of them was not yet on the period of the third control), 7 of them (70%), continued without pain, one patient (10%) showed a partial resolution of the pain without medication, one patient (10%) presented a partial resolution with medication, and one patient (10%), continued with pain and was treated surgically. There was no complication of the procedure in our patients. Conclusion: The cervical nerves root blockade with steroids and anesthetic under CT guidance, with posterolateral access is a safe, minimally invasive procedure, with no complications, that provides a quick solution to the cervical pain. Therefore, this procedure must be considered as a preliminary step before other aggressive treatments such as surgical therapy in a medical decision context. (author)

  20. Biceps tenodesis with Clancy method for chronic posterolateral rotary instability of the knee

    Directory of Open Access Journals (Sweden)

    Motamedi M.


    Full Text Available Background: Posterolateral rotatory instability is one of the most complex problems in ligamentous injuries of the knee. It represents a challenging diagnostic and therapeutic problem for the orthopaedic surgeon. We present the results of biceps tenodesis in chronic posterolateral rotatory instabilily of the knee.Methods: In this case series we included all of the patients with positive reverse pivot shift test and prone external rotation test at least 3 weeks after their trauma. We excluded the patients with varus malalignment of the knee and concomitant anterior cruciate ligament (ACL rupture. Biceps tenodesis (Clancy method was performed. We did not reconstruct posterior cruciate ligament (PCL if its insufficiency was diagnosed in addition to posterolateral rotatory instability. Knee scoring scale of Lysholm was used during and after follow ups. The results were statistically compared using Wilcoxon signed rank test (WSRT, paired samples t-test and friedman test. Data analysis was done using SPSS (version 11.5 and Stata (version 8 computer softwares.Results: Our series consists of 13 patients (12 male and one female. 31% of the patients had isolated posterolateral injury and 69% of the patients had combined posterolateral and PCL injuries. The patients were between 17 to 45 years old (mean 30.25 years. Follow up was between 4 to 44 months (mean: 31 months. At the end of follow up 85% of patients had negative reverse pivot shift test. Prone external rotation test at 30° of knee flexion was negative in 92% of patients. In 92% of patients giving way was negative and in 77% of patients pain was decreased. Before operation the average Knee scoring scale of Lysholm was 73 and at the end of the follow up it increased to 85 (p value<0.001.Conclusions: Biceps tenodesis using Clancy method is a safe, effective and reliable method in management of chronic posterolateral rotatory instability of the knee. During surgery careful exploration of the common

  1. Delayed diagnosis of an isolated posterolateral corner injury: a case report. (United States)

    Welsh, Patrick; DeGraauw, Christopher; Whitty, David


    Isolated injuries to the posterolateral corner of the knee are a rare and commonly missed injury associated with athletic trauma, motor vehicle accidents, and falls. Delayed or missed diagnoses can negatively impact patient prognosis, contributing to residual instability, chronic pain, and failure of surgical repair to other ligaments. A 44-year-old male CrossFit athlete presented with a history of two non-contact hyperextension injuries to his left knee while walking on ice. The only positive finding was the Dial Test at 30 degrees of knee flexion, indicative of an isolated posterolateral corner injury. After a delay in diagnosis, the patient underwent a reconstruction of the posterolateral corner and subsequent rehabilitation. Early recognition of this injury is important as this can affect the prognosis and activities of daily living of the patient. This case will discuss the clinical presentation, diagnostic procedures, and management of an isolated posterolateral corner injury and highlight the importance of early recognition and referrals from primary contact healthcare practitioners.


    NARCIS (Netherlands)



    19 consecutive patients underwent a posterolateral neck dissection (PLND) in continuity with a wide excision of the primary melanoma on the posterior scalp. After a mean follow-up of 74 months, 5 patients are alive with minimal morbidity. PLND can safely be performed, even bilaterally, as an

  3. The posterolateral mid-forearm perforator flap: anatomical study and clinical application. (United States)

    Zhuang, Yue-Hong; Lin, Jian; Fu, Fei-Huan; Cai, Zhen-De; Huang, Hui-Mei; Zheng, He-Ping


    Defects sustained at the distal forearm are common and pedicled perforator flaps have unique advantages in resurfacing it. The purpose of this study is to reappraise the anatomy of the perforator in the posterolateral aspect of the mid-forearm and present our clinical experience on using perforator flaps based on it for reconstruction of defects in the distal forearm. This study was divided into anatomical study and clinical application. In the anatomical study, 30 preserved upper limbs were used. Clinically, 11 patients with defects at the forearm underwent reconstruction with the posterolateral mid-forearm perforator flaps. The defects, ranging from 4.5 × 2.5 cm to 10.5 × 4.5 cm, were located at the dorsal aspect of the distal forearm in 6 cases and at the volar aspect of the distal forearm in 5 cases. Three patterns of the perforator were observed in the posterolateral aspect of the mid-forearm, which originated from the posterior interosseous artery, the proximal segment of the radial artery or the radial recurrent artery, and the middle segment of the radial artery, respectively. The perforator was located 11.8 ± 0.2 cm to 15.8 ± 0.4 cm inferior to the lateral humeral epicondyle. Clinically, flaps in 8 cases survived uneventfully, while the other 3 cases suffered mild marginal epidermal necrosis, which was cured with continuous dress changing. The location of the perforator at the posterolateral aspect of the mid-forearm is consistent; the posterolateral mid-forearm perforator flap is particularly suitable to cover defects in the distal one-third of the forearm. Copyright © 2013 Wiley Periodicals, Inc.

  4. A modified Larson’s method of posterolateral corner reconstruction of the knee reproducing the physiological tensioning pattern of the lateral collateral and popliteofibular ligaments

    Directory of Open Access Journals (Sweden)

    Niki Yasuo


    Full Text Available Abstract Background Consensus has been lacking as to how to reconstruct the posterolateral corner (PLC of the knee in patients with posterolateral instability. We describe a new reconstructive technique for PLC based on Larson's method, which reflects the physiological load-sharing pattern of the lateral collateral ligament (LCL and popliteofibular ligament (PFL. Findings Semitendinosus graft is harvested, and one limb of the graft comprises PFL and the other comprises LCL. Femoral bone tunnels for the LCL and popliteus tendon are made at their anatomical insertions. Fibular bone tunnel is prepared from the anatomical insertion of the LCL to the proximal posteromedial portion of the fibular head, which corresponds to the insertion of the PFL. The graft end for popliteus tendon is delivered into the femoral bone tunnel and secured on the medial femoral condyle. The other end for LCL is passed through the fibular tunnel from posterior to anterior. While the knee is held in 90 of flexion, the graft is secured in the fibular tunnel using a 5 mm interference screw. Then, the LCL end is passed into the femoral bone tunnel and secured at the knee in extension. Conclusions Differential tension patterns between LCL and PFL is critical when securing these graft limbs. Intrafibular fixation of the graft using a small interference screw allows us to secure these two graft limbs independently with intended tension at the intended flexion angle of the knee.

  5. Management of combined anterior or posterior cruciate ligament and posterolateral corner injuries: a systematic review. (United States)

    Rochecongar, G; Plaweski, S; Azar, M; Demey, G; Arndt, J; Louis, M-L; Limozin, R; Djian, P; Sonnery-Cottet, B; Bousquet, V; Bajard, X; Wajsfisz, A; Boisrenoult, P


    Combined injuries to the posterolateral corner and cruciate ligaments are uncommon. The heterogeneity of injury patterns in many studies complicates the assessment of outcomes. To assess the prognosis and functional outcomes after surgery for combined injuries to the posterolateral corner and to the anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL). We systematically reviewed the literature for articles reporting outcomes 1 year or more after surgery for combined injuries to the posterolateral corner and ACL (n=4) or PCL (n=9). Patients with bicruciate injuries were not studied. Overall, 65% of patients were IKDC A or B after surgery. The mean Lysholm score improved from 67 to 90. Mean time to surgery was 4.43 months in the group with ACL tears and 18.4 months in the group with PCL tears, and mean follow-up was 34.4 and 40.7 months in these two groups, respectively. In the groups with ACL and PCL tears, the proportions of patients classified as IKDC A or B at last follow-up were 81.6% and 81.0%, respectively, whereas 88% and 99% of patients, respectively, were IKDC grade C or D before surgery. The mean Lysholm score improved from 77 to 92 in the group with ACL tears and from 65 to 89 in the group with PCL tears. Improvements in laxity ranged from 28% to 79% in the group with PCL tears. Most of the articles selected for our review provided level III or IV evidence. Functional outcomes were satisfactory but less good than those reported after surgical reconstruction of isolated cruciate ligament tears. Full reconstruction seems the best strategy in patients with combined ACL/posterolateral corner injuries. Outcomes were also good but more variable in the group with PCL/posterolateral corner injuries. The time to surgery, which reflected the time to diagnosis, was shorter in patients with ACL than with PCL tears in addition to the posterolateral corner injury. Level III (systematic literature review). Copyright © 2014 Elsevier Masson SAS. All

  6. Posterolateral Corner Reconstruction Alone Using a Fibular-Based Technique in a Patient with Persistent Unstable Revision Total Knee Arthroplasty

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    Joseph T. Cline


    Full Text Available Posterolateral rotatory instability is a relatively uncommon cause of unstable total knee arthroplasty (TKA. In most cases, surgical treatment requires revision TKA into a more constrained design or thicker polyethylene liner. We present a case of a patient with unstable TKA who remained unstable after increasing thickness of the polyethylene liner and undergoing more constrained TKA. After several revision surgeries, the patient was still unstable. Posterolateral corner reconstruction with a fibular-based technique using a tibialis anterior allograft was performed. At 1-year follow-up, the patient was stable and asymptomatic and with excellent function. A soft-tissue procedure only (fibular-based posterolateral corner reconstruction can be effective at restoring posterolateral rotatory stability in a patient with persistent instability after revision TKA.

  7. HER-2/neu and CD117 (c-kit overexpression in patients with pesticide exposure and extensive stage small cell lung carcinoma (ESSCLC

    Directory of Open Access Journals (Sweden)

    Potti Anil


    Full Text Available Abstract Background The rate of detection of HER-2/neu and CD117 (c-kit overexpression in small cell lung cancer (SCLC has varied widely; between 5–35% and 21–70% respectively. Methods To evaluate the relationship between pesticide exposure and HER-2/neu and CD117 overexpression in extensive stage SCLC (ESSCLC, we identified patients with ESSCLC and assessed pesticide exposure using a predetermined questionnaire. An exposure index (hours/day × days/year × years ≥ 2400 hours was considered as 'exposed.' HER-2/neu overexpression was evaluated on archival tissue using the DAKO Hercep test, and CD117 testing was performed using immunohistochemistry (A4052 polyclonal antibody. Results 193 ESSCLC patients were identified. Pesticide exposure data could be obtained on 174 patients (84 females and 109 males with a mean age of 68.5 years. 53/174 (30.4% revealed HER-2/neu overexpression. 54/174 (31.03% specimens showed CD117 overexpression by IHC. On multivariate analysis, HER-2/neu overexpression was associated with diminished survival (p neu overexpression and 47/121 (38.8% patients without overexpression had exposure to pesticides (odds ratio: 5.38; p Conclusion Pesticide exposure affects HER-2/neu but not CD117 overexpression. Future studies are needed to determine specific pesticide(s/pesticide components that are responsible for HER-2/neu overexpression in ESSCLC, and to validate our findings in other solid tumors that overexpress HER-2/neu.

  8. Results of instrumented posterolateral fusion in treatment of lumbar spondylolisthesis with and without segmental kyphosis: A retrospective investigation

    Directory of Open Access Journals (Sweden)

    Szu-Yuan Chen


    Full Text Available Background: Treatment by posterolateral fusion (PLF with pedicle-screw instrumentation can be unsuccessful in one-segment and low-grade lumbar spondylolisthesis. Segmental kyphosis, either rigid or dynamic, was hypothesized to be one of the factors interfering with the fusion results. Methods: From 2004 to 2005, 239 patients with single-segment and low-grade spondylolisthesis were recruited and divided into two groups: Group 1 consisting of 129 patients without segmental kyphosis and group 2 consisting of 110 patients with segmental kyphosis. All patients underwent instrumented PLF at the same medical institute, and the average follow-up period was 31 ± 19 months. We obtained plain radiographs of the lumbosacral spine with the anteroposterior view, the lateral view, and the dynamic flexion-extension views before the operation and during the follow-ups. The results of PLF in the two groups were then compared. Results: There was no significant difference in the demographic data of the two groups, except for gender distribution. The osseous fusion rates were 90.7% in group 1 and 68.2% in group 2 (p < 0.001. Conclusion: Instrumented PLF resulted in significantly higher osseous fusion rate in patients without segmental kyphosis than in the patients with segmental kyphosis. For the patients with sagittal imbalance, such as rigid or dynamic kyphosis, pedicle-screw fixation cannot ensure successful PLF. Interbody fusion by the posterior lumbar interbody fusion or transforaminal lumbar interbody fusion technique might help overcome this problem.

  9. Arthroscopic all-inside ramp lesion repair using the posterolateral transseptal portal view. (United States)

    Keyhani, Sohrab; Ahn, Jin Hwan; Verdonk, René; Soleymanha, Mehran; Abbasian, Mohammadreza


    The purpose of this study was to evaluate and describe the clinical results and outcomes of a novel method for all-inside suture repair of medial meniscus ramp lesions through posteromedial and posterolateral transseptal portals during anterior cruciate ligament (ACL) reconstruction. Further, this investigation compared the posterolateral view to the notch view for diagnosis and repair. Between 2011 and 2014, 166 patients had ramp lesions concomitantly with ACL injury; 128 patients (107 men and 21 women) were enrolled in the study after qualification. All patients underwent repair of the posterior horn ramp lesion of the medial meniscus, using a suture hook device with PDS No. 1 through a posteromedial portal while viewing from the posterolateral transseptal portal during ACL reconstruction, with a minimum of a 2-year follow-up. Patients were followed up for a minimum of 2 years (range 24-47 months). Their average Lysholm score increased from 61.7 ± 3.2 preoperatively to 87.8 ± 3.9 at last follow-up (p < 0.001). Moreover, their average IKDC scores also improved from 53.6 ± 2.1 (pre-op) to 82.1 ± 3.5 (at last follow-up) (p < 0.001). The peroneal nerve and the popliteal neurovascular bundle were not damaged in any of the patients. This study provides evidence that the posterolateral transseptal technique protects neurovascular structures. This technique may be used safely and easily for repair of the posterior horn ramp lesion of the medial meniscus during ACL reconstruction. IV.

  10. Previous extensive sun exposure and subsequent vitamin D production in patients with basal cell carcinoma of the skin, has no protective effect on internal cancers. (United States)

    Lindelöf, Bernt; Krynitz, Britta; Ayoubi, Shiva; Martschin, Christoph; Wiegleb-Edström, Desiree; Wiklund, Kerstin


    It has been suggested that sunlight through production of vitamin D might have a protective effect on a number of internal cancers. Consequently, in spite of the well known skin cancer risks, some researchers advocate more exposure to ultraviolet radiation, supported by the solarium industry. We estimated the risk of internal cancer before the patient contracted a basal cell carcinoma (BCC) of the skin, the most common cancer in white populations and strongly associated with extensive sun exposure. A nested case control study was undertaken in the whole Swedish population. 115,016 patients with BCC and 987,893 controls were linked to population based registers. The cases had an increased risk of getting another form of cancer before the BCC diagnosis: odds ratio (OR)=1.84; 95% confidence interval (CI) 1.81-1.86. This risk was mainly due to skin cancer: OR=4.95; 95% CI 4.81-5.09 but also non-skin cancer risk was elevated: OR=1.37; 95% CI 1.35-1.39. We adjusted the estimates for age, level of income, occupational status in national censuses, place of living and sex, where appropriate. Of the cancers specifically suggested to be related to vitamin D status: colon, prostate, breast, and ovary cancer, all had slightly increased ORs whilst for pancreatic and gastric cancer no increased OR was found. Patients with BCC, a proxy for extensive sun exposure, run an increased risk of other forms of cancer prior to the diagnosis of BCC. The findings in this study contradict that vitamin D production through extensive sun exposure has any protective effect on internal cancer but emphasise the increased risk for skin cancer. Copyright © 2011 Elsevier Ltd. All rights reserved.

  11. Normal and pathological NMR imaging aspects of the posterolateral corner (PLC) of the knee

    International Nuclear Information System (INIS)

    Tardieu, M.; Lazennec, J.Y.; Christel, P.; Brasseur, J.L.; Roger, B.; Grenier, P.


    The purpose of the study is to compare normal PLC (limits lateral condyle anterior sub luxation) anatomy and its magnetic resonance imaging (MRI) appearance, with the various lesions observed in MRI, from the simple popliteus tendinous contusion to the complete PLC rupture. For this specific work on PLC lesions, we selected 61 examinations among the traumatic knees explored during the last 3 years. Surgical correlation is obtained for the 61 patients. MRI examinations are performed on a 0.5 T. unit. Normal PLC anatomy is compared to the dissection of 4 anatomic subjects. Normal MRI slices are evaluated with this reference analysis. The principle anatomical structures of the PLC include the lateral collateral ligament, the popliteus tendon, the arcuate ligament, the fabello fibular ligament, the posterolateral condylar capsule, and the posterior horn of the lateral meniscus. Surgical findings confirm PLC lesion for 58 patients with 3 false positive. Diagnosis of these lesions is important because chronical posterolateral laxity is secondary to the destabilization of lateral condyle. Unrecognized and untreated posterolateral instability may result in failure of ACL (limits lateral condyle posterior sub-luxation) reconstruction. When clinical tests are doubtful or complex, or the examination very painful, MRI evaluates completely the traumatic knee and particularly the PLC. (authors). 3 refs., 26 figs

  12. Posterior malleolar fracture: technique and clinical ex-perience of the posterolateral approach

    Directory of Open Access Journals (Sweden)

    HUANG Ruo-kun


    Full Text Available 【Abstract】Objective: To introduce the postero-lateral surgical approach to the posterior malleolar fracture and report its clinical outcomes in 32 cases. Methods: This study consisted of 32 cases, 22 males and 10 females with the mean age of 48 years (range, 21-63 years, suffering from posterior malleolar fracture. All cases were treated with the posterolateral surgical approach to the ankle. The average follow-up period was 28 months (range, 24-35 months. The clinical outcomes of these cases were evaluated on the basis of the Olerud-Molander Ankle (OMA score and plain radiographs. Results: All cases showed radiological evidence of bony union at follow-up. The average OMA score was 82 points; 21 cases had excellent scores (90-100 points, 9 good (61-90 points, and 2 fair (31-60 points. The excellent-to-good rate was 93.8%. Although most cases did not show any wound dehiscence or necrosis, one patient had a su-perficial infection which healed after using antibiotic dress-ing and one had sural cutaneous nerve injury that under-went spontaneous remission without any treatment after three months. In addition, one presented with mild symp-toms of peroneal tendonitis that disappeared after plate removal. Conclusion: The posterolateral approach offers an effective technique for fracture reduction and fixation of large posterior malleolar fragments. Key words: Ankle injuries; Dislocations; Fracture fixation, internal

  13. Anomalies of ossification in the posterolateral femoral condyle: assessment by MRI

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    Nawata, K.; Teshima, Ryota; Morio, Yasuo; Hagino, Hiroshi [Department of Orthopaedic Surgery, Faculty of Medicine, Tottori University, Yonaga (Japan)


    Background. Anomalies of ossification in the lower femoral epiphysis are often radiographically indistinguishable from juvenile osteochondritis dissecans. Objective. To clarify the MRI characteristics of the anomalies of ossification in the posterolateral femoral condyle that distinguish it from juvenile osteochondritis dissecans. Materials and methods. We retrospectively examined the medical records, plain radiographs (n = 4), MRI (n = 4) and follow-up MRI (n = 2) of four boys (age 8-11 years) with anomalies of ossification in the posterolateral femoral condyle. Results. Plain radiography showed symmetrical marginal irregularity of the posterolateral femoral condyles of both knees. These lesions were asymptomatic, and the areas of irregular radiographic appearances reduced in size or disappeared without treatment within a mean observation period of 3.5 months. MRI showed a clearly demarcated low-intensity islet with the same signal intensity as subchondral bone (which was considered to be an accessory ossification nucleus) in a high-signal area in which the signal intensity was equal to that of normal articular cartilage. The areas observed as radiolucent zones on plain radiography were visualised at the same signal intensity as articular cartilage, and were continuous with articular cartilage on MRI; thus they were regarded as uncalcified cartilage. These MR findings are different from MR images of osteochondritis dissecans. Conclusions. MRI is considered to be the most effective non-invasive diagnostic method for these two conditions. (orig.) With 3 figs., 1 tab., 10 refs.

  14. 78 FR 55114 - Access to Employee Exposure and Medical Records; Extension of the Office of Management and Budget... (United States)


    ... Courier Service: When using this method, you must submit a copy of your comments and attachments to the... and costs associated with exposure monitoring and measurement, medical surveillance, and the other... occupationally-related health impairment and disease. Providing the Agency with access to the records permits it...

  15. 75 FR 21662 - Access to Employee Exposure and Medical Records; Extension of the Office of Management and Budget... (United States)


    ..., express mail, messenger, or courier service: When using this method, you must submit three copies of your... costs associated with exposure monitoring and measurement, medical surveillance, and the other... occupationally-related health impairment and disease. Providing the Agency with access to the records permits it...

  16. The results of decompressive surgery and instrumented posterolateral fusion in refractory degenerative spondylolisthesis

    Directory of Open Access Journals (Sweden)

    Behtash H


    Full Text Available "nBackground: Degenerative spondylolisthesis is a common disease of the lumbar spine especially in older ones. The disease represents a challenge to the treating physician. At present, for those patients that deteriorate clinically, there are many proposed algorithms for the surgical treatment. This before and after study was undertaken to assess the surgical results of decompression and instrumented posterolateral fusion in these patients. "nMethods: The study population consisted of 23 patients who had undergone no prior surgery for degenerative spondylolisthesis on the lumbar spine. These patients were treated by decompression, bilateral posterolateral fusion, and segmental (pedicle screw instrumentation with mean follow-up of 29 months (range, 13-73 months. Finally, The clinical results were evaluated for all patients by means of an Oswestry Disability Index (ODI version 2.1, the Henderson's functional capacity, and persistence of leg symptoms, low back pain or claudication. Mann-Whitney and Chi-Square tests were used to assess the average values and comparison, respectively. "nResults: Henderson's functional capacity at the last visit session was excellent in 14 (60.9%, good in 7 (30.4%, fair in 2 (8.7% cases. ODI decreased from 72.2% (50-88% preoperatively to 14.4% (0-54% at the latest follow-up visit. A history of leg pain or claudication was correlated significantly with the amount of decline in ODI score and Henderson's functional capacity (p<0.05. "nConclusion: In spite of limited number of our patients, decompressive surgery plus instrumented posterolateral fusion is a safe, reliable, and satisfactory procedure for treating degenerative lumbar spondylolisthesis. This procedure may be done when conservative treatment was failed and psychological problems can be ruled out.

  17. Risk factors for L5-S1 disk height reduction after lumbar posterolateral floating fusion surgery. (United States)

    Inoue, Gen; Takaso, Masashi; Miyagi, Masayuki; Kamoda, Hiroto; Ishikawa, Tetsuhiro; Nakazawa, Toshiyuki; Imura, Takayuki; Ueno, Masaki; Saito, Wataru; Uchida, Kentaro; Toyone, Tomoaki; Takahashi, Kazuhisa; Ohtori, Seiji


    This is a retrospective study. To investigate the risk factors for radiographic L5-S1 disk height reduction after lumbar posterolateral floating fusion surgery. We investigated data from 86 patients (45 men) who underwent posterolateral floating fusion surgery from 2007 to 2010. The follow-up was from 2 to 6 years. The mean age of the patients was 65.4 years. L5-S1 disk height was calculated and >2 mm reduction was defined as significant. Age, sex, height, weight, body mass index, number of fused levels, grade of disk degeneration, disk height and diameter, sacrolumbar alignment, alignment of fused level, achievement of union, and proximal adjacent segment disorder at final follow-up were compared. Univariate and multivariate logistic regressions were performed. L5-S1 disk height reduction occurred in 14 patients (30.2%). The number of fused levels was significantly greater (1.8±0.8 vs. 1.4±0.6) in patients without disk height reduction. Radiology showed a significant change of L1-S1 sacrolumbar alignment after surgery in patients without disk height reduction (0.3±6.6 vs. -4.5±7.6 degrees). The height of the disk posterior to the L5-S1 intervertebral disk before surgery was significantly greater (7.3±2.1 vs. 6.1±2.1 mm) in patients without disk height reduction. In multivariate logistic regression analysis, fusion of >3 levels was a significant risk factor for L5-S1 disk height reduction. In posterolateral floating fusion surgery, there was a higher risk of L5-S1 disk height reduction and consequent foraminal stenosis in patients with multiple-level fusion. Surgical methods and fusion levels should be chosen after considering their association with L5-S1 disk height reduction.

  18. Relationship between exposure to Fasciola hepatica in roe deer (Capreolus capreolus) and cattle extensively reared in an endemic area. (United States)

    Arias, M S; Piñeiro, P; Sánchez-Andrade, R; Suárez, J L; Hillyer, G V; Díez-Baños, P; Paz-Silva, A; Morrondo, P


    The aim of this work is to know the prevalence of Fasciola hepatica in 301 roe deer and in 676 beef cattle kept in an endemic area. Detection of antibodies was determined in roe deer using a homemade ELISA with excretory/secretory antigens (FhES) and a recombinant protein (FhrAPS). None of the deer passed eggs by faeces and none flukes in their livers were found. The seroprevalence of F. hepatica was 29% using FhES, with significantly higher values in the oldest ones (36%). Twenty-eight percent of the samples were positive to FhrAPS. Twenty-three percent of the cows eliminated eggs of F. hepatica and the seroprevalence was 67% using FhrAPS. No relationship between the seropositivity values of deer and cattle was demonstrated. The role of wild ruminants as reservoirs of F. hepatica is discussed. We encourage the use of ELISA to know the possibility of exposure to trematodes in wild ruminants. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Surgery for ventral intradural thoracic spinal tumors with a posterolateral transpedicular approach. (United States)

    Ito, Kiyoshi; Aoyama, Tatsuro; Miyaoka, Yoshinari; Seguchi, Tatsuya; Horiuchi, Tetsuyoshi; Hongo, Kazuhiro


    Surgery for ventrally seated thoracic tumors requires an anatomically specific approach that is distinct from cervical or lumbar spinal cord surgery as the narrower spinal canal of the thoracic spinal cord makes it sensitive to surgical procedures. However, reports describing this operative technique are few. To obtain a wide operative field and minimize thoracic spinal cord retraction, we employed a posterolateral transpedicular approach in ventral-located tumors and investigated the efficacy and limitations of this technique. Eighteen patients with lesions (meningioma or neurinoma) located in the ventral intradural thoracic region were surgically treated between 2009 and 2014. The relationship among the clinical outcome, tumor location, and postoperative spinal alignment was analyzed. Postoperative neurological function improved in all patients, namely those with meningioma (p = 0.012) and schwannoma (p = 0.018). One patient who underwent removal of two facet joints suffered a postoperative compression fracture. Removal of two facet joints and pedicles resulted in a worsening of spinal alignment (p = 0.03), while this was not the case for the removal of one facet joint and pedicle (p = 0.72). This case series clarified the benefits of the posterolateral transpedicular approach for resection of ventral intradural extramedullary tumors. Removal of one pedicle and facet joint seems to be more beneficial.

  20. Evaluation of Posterolateral Lumbar Fusion in Sheep Using Mineral Scaffolds Seeded with Cultured Bone Marrow Cells (United States)

    Cuenca-López, María D.; Andrades, José A.; Gómez, Santiago; Zamora-Navas, Plácido; Guerado, Enrique; Rubio, Nuria; Blanco, Jerónimo; Becerra, José


    The objective of this study is to investigate the efficacy of hybrid constructs in comparison to bone grafts (autograft and allograft) for posterolateral lumbar fusion (PLF) in sheep, instrumented with transpedicular screws and bars. Hybrid constructs using cultured bone marrow (BM) mesenchymal stem cells (MSCs) have shown promising results in several bone healing models. In particular, hybrid constructs made by calcium phosphate-enriched cells have had similar fusion rates to bone autografts in posterolateral lumbar fusion in sheep. In our study, four experimental spinal fusions in two animal groups were compared in sheep: autograft and allograft (reference group), hydroxyapatite scaffold, and hydroxyapatite scaffold seeded with cultured and osteoinduced bone marrow MSCs (hybrid construct). During the last three days of culture, dexamethasone (dex) and beta-glycerophosphate (β-GP) were added to potentiate osteoinduction. The two experimental situations of each group were tested in the same spinal segment (L4–L5). Spinal fusion and bone formation were studied by clinical observation, X-ray, computed tomography (CT), histology, and histomorphometry. Lumbar fusion rates assessed by CT scan and histology were higher for autograft and allograft (70%) than for mineral scaffold alone (22%) and hybrid constructs (35%). The quantity of new bone formation was also higher for the reference group, quite similar in both (autograft and allograft). Although the hybrid scaffold group had a better fusion rate than the non-hybrid scaffold group, the histological analysis revealed no significant differences between them in terms of quantity of bone formation. The histology results suggested that mineral scaffolds were partly resorbed in an early phase, and included in callus tissues. Far from the callus area the hydroxyapatite alone did not generate bone around it, but the hybrid scaffold did. In nude mice, labeled cells were induced to differentiate in vivo and monitored by

  1. Evaluation of Posterolateral Lumbar Fusion in Sheep Using Mineral Scaffolds Seeded with Cultured Bone Marrow Cells

    Directory of Open Access Journals (Sweden)

    María D. Cuenca-López


    Full Text Available The objective of this study is to investigate the efficacy of hybrid constructs in comparison to bone grafts (autograft and allograft for posterolateral lumbar fusion (PLF in sheep, instrumented with transpedicular screws and bars. Hybrid constructs using cultured bone marrow (BM mesenchymal stem cells (MSCs have shown promising results in several bone healing models. In particular, hybrid constructs made by calcium phosphate-enriched cells have had similar fusion rates to bone autografts in posterolateral lumbar fusion in sheep. In our study, four experimental spinal fusions in two animal groups were compared in sheep: autograft and allograft (reference group, hydroxyapatite scaffold, and hydroxyapatite scaffold seeded with cultured and osteoinduced bone marrow MSCs (hybrid construct. During the last three days of culture, dexamethasone (dex and beta-glycerophosphate (β-GP were added to potentiate osteoinduction. The two experimental situations of each group were tested in the same spinal segment (L4–L5. Spinal fusion and bone formation were studied by clinical observation, X-ray, computed tomography (CT, histology, and histomorphometry. Lumbar fusion rates assessed by CT scan and histology were higher for autograft and allograft (70% than for mineral scaffold alone (22% and hybrid constructs (35%. The quantity of new bone formation was also higher for the reference group, quite similar in both (autograft and allograft. Although the hybrid scaffold group had a better fusion rate than the non-hybrid scaffold group, the histological analysis revealed no significant differences between them in terms of quantity of bone formation. The histology results suggested that mineral scaffolds were partly resorbed in an early phase, and included in callus tissues. Far from the callus area the hydroxyapatite alone did not generate bone around it, but the hybrid scaffold did. In nude mice, labeled cells were induced to differentiate in vivo and monitored

  2. Projections from the posterolateral olfactory amygdala to the ventral striatum: neural basis for reinforcing properties of chemical stimuli

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    Lanuza Enrique


    Full Text Available Abstract Background Vertebrates sense chemical stimuli through the olfactory receptor neurons whose axons project to the main olfactory bulb. The main projections of the olfactory bulb are directed to the olfactory cortex and olfactory amygdala (the anterior and posterolateral cortical amygdalae. The posterolateral cortical amygdaloid nucleus mainly projects to other amygdaloid nuclei; other seemingly minor outputs are directed to the ventral striatum, in particular to the olfactory tubercle and the islands of Calleja. Results Although the olfactory projections have been previously described in the literature, injection of dextran-amines into the rat main olfactory bulb was performed with the aim of delimiting the olfactory tubercle and posterolateral cortical amygdaloid nucleus in our own material. Injection of dextran-amines into the posterolateral cortical amygdaloid nucleus of rats resulted in anterograde labeling in the ventral striatum, in particular in the core of the nucleus accumbens, and in the medial olfactory tubercle including some islands of Calleja and the cell bridges across the ventral pallidum. Injections of Fluoro-Gold into the ventral striatum were performed to allow retrograde confirmation of these projections. Conclusion The present results extend previous descriptions of the posterolateral cortical amygdaloid nucleus efferent projections, which are mainly directed to the core of the nucleus accumbens and the medial olfactory tubercle. Our data indicate that the projection to the core of the nucleus accumbens arises from layer III; the projection to the olfactory tubercle arises from layer II and is much more robust than previously thought. This latter projection is directed to the medial olfactory tubercle including the corresponding islands of Calleja, an area recently described as critical node for the neural circuit of addiction to some stimulant drugs of abuse.

  3. Posterolateral Corner Injury Associated with a Schatzker Type 2 Tibial Plateau Fracture

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    Boris A. Zelle


    Full Text Available Isolated posterolateral corner (PLC injuries are rarely seen with tibial plateau fractures and can be missed during the initial assessment. The objective of this paper is to present a case of a Schatzker type 2 tibial plateau fracture with associated isolated PLC injury and give a discussion on physical exam, diagnostic studies, and treatment options. A twenty-five-year-old female sustained a concomitant Schatzker type 2 fracture and PLC injury. Magnetic Resonance Imaging showed an isolated PLC disruption. Open reduction-internal fixation was performed with subsequent PLC repair. At sixteen months postoperatively, the patient had full range of motion and strength of her knee and no signs of laxity. This case emphasizes the importance of physical exam and appropriate imaging modalities in order to diagnose and treat this significant injury in a prompt fashion. In this case, surgical fracture fixation and subsequent repair of the PLC provided a good clinical outcome.

  4. Posterolateral elbow dislocation with entrapment of the medial epicondyle in children: a case report (United States)

    Mazzini, Juan Pretell


    Introduction Elbow dislocations in children are uncommon injuries. Dislocations with associated fractures or so-called complex dislocations of the elbow can be challenging to diagnose and treat. Case presentation A 14-year-old male had a posterolateral elbow dislocation after a fall. Closed reduction with traction was performed. Radiographs after initial reduction showed a fragment entrapped into the humero-cubital joint. Computerized tomography scan showed the fragment belonging to the medial epicondyle. Open reduction and internal fixation with a 3.0 millimeter cannulated screw was performed, with restoring of the normal function of the elbow at final follow up. Conclusion Elbow dislocations in children can be associated with bone lesions. These injuries must be suspected to avoid misleading diagnosis and achieve good results. PMID:19829829

  5. Rotational profile alterations after anatomic posterolateral corner reconstructions in multiligament injured knees. (United States)

    Tardy, Nicolas; Mouton, Caroline; Boisrenoult, Philippe; Theisen, Daniel; Beaufils, Philippe; Seil, Romain


    Injuries of the posterolateral corner (PLC) are rare and severe knee injuries, resulting in posterolateral rotatory instability and an increase in external rotation. Surgical reconstruction techniques reproducing the normal anatomy showed promising results. In vivo evaluations of static rotational knee laxity at 30° of knee flexion have not been reported so far. The purpose of this study was to evaluate static rotational knee laxity after anatomic PLC reconstructions. This is a retrospective clinical cohort study. Twenty patients with PLC reconstructions with an average follow-up time of 39 ± 22 months and no history of knee trauma or surgery of the contralateral knee were included in the study. They underwent a routine clinical examination and static rotational laxity measurements at 30° of knee flexion in the prone position. Side-to-side differences were recorded and compared to a group of matched controls. The postoperative IKDC score was graded A for 8 patients, B for 16, C for 6 and D for one patient. The primary goal of the surgical procedure which consists in reducing excessive external tibiofemoral rotation could be reached in 18 of the 20 patients (90%). Anatomic PLC reconstructions yielded a comparable rotational profile in operated and healthy knees in 7 patients (35%). Thirteen patients (65%) presented a significantly altered rotational profile in comparison with a healthy control group. Unexpected increases in internal rotation were found in 8 patients (40%). Anatomic PLC reconstructions reduced excessive external tibiofemoral rotation in a vast majority of patients. Static rotational laxity measurements allowed for a determination of the patients' individual rotational profile after PLC reconstructions. This profile was normalised in only one-third of the patients. The understanding of this finding needs further investigation as well as the clinical impact of rotational profile alterations on knee function. Diagnostic studies, Level III.

  6. Biomechanical comparison of a lateral polyaxial locking plate with a posterolateral polyaxial locking plate applied to the distal fibula. (United States)

    Hallbauer, Jakob; Klos, Kajetan; Rausch, Sascha; Gräfenstein, Andreas; Wipf, Felix; Beimel, Claudia; Hofmann, Gunther; Mückley, Thomas


    Polyaxial locking plates are becoming popular for the fixation of distal fibula fractures. This study establishes how construct stiffness and plate loosening, measured as range of motion, differs between lateral and posterolateral plate location. Seven matched pairs of cadaver fibulae were osteotomized in standardized fashion to produce a Weber type B distal fibula fracture. The fragments were fixated with an interfragmentary lag screw and polyaxial locking plates, with one fibula in each pair receiving a posterolateral anti-glide-plate, and the other a lateral neutralization-plate. In a biomechanical test, the bending and torsional stiffnesses of the constructs and the ranges of motion (ROM) were measured and subjected to a paired comparison. The laterally plated group had a higher median (interquartile range) bending stiffness (29.2 (19.7) N/mm) and a smaller range of motion (2.06 (1.99) mm) than the posterolaterally plated group (14.6 (20.6) N/mm, and 4.11 (3.28) mm, respectively); however, the results were not statistically significant (pbending=0.314; pROM=0.325). Similarly, the torsional stiffness did not differ significantly between the two groups (laterally plated: 426 (259) Nmm/°; posterolaterally plated: 248 (399) Nmm/°; ptorsion=0.900). The range of motion measurements between the two groups under torsional loading were also statistically insignificant (laterally plated: 8.88 (6.30) mm; posterolaterally plated: 15.34 (12.64) mm; pROM=0.900). In biomechanical cadaver-model tests of Weber type B fracture fixation with polyaxial locking plates, laterally plated constructs and posterolaterally plated constructs performed without significantly difference. Therefore, other considerations, such as access morbidity, associated injuries, patient anatomy, or surgeon's preference, may guide the choice of plating pattern. Further clinical studies will be needed for the establishment of definitive recommendations. Information on the behavior of polyaxial locking

  7. Randomized Controlled Trial for Efficacy of Capsular Distension for Adhesive Capsulitis: Fluoroscopy-Guided Anterior Versus Ultrasonography-Guided Posterolateral Approach


    Bae, Jae Hyun; Park, Young Sook; Chang, Hyun Jung; Kim, Min Jung; Park, Kang Young; Jin, Seung Hwan; Lee, Eun Hee


    Objective To find the most effective procedure to treat adhesive capsulitis of the shoulder, we evaluated the clinical effects of an ultrasonographic-guided anterior approach capsular distension and a fluoroscopy-guided posterolateral approach capsular distension. We expected the anterior approach to be better than the posterolateral approach because the rotator interval, a triangular anatomic area in the anterosuperior aspect of the shoulder, which is considered an important component of the...

  8. Reliability and Validity of the Hip Stability Isometric Test (HipSIT): A New Method to Assess Hip Posterolateral Muscle Strength. (United States)

    Almeida, Gabriel Peixoto Leão; das Neves Rodrigues, Helena Larissa; de Freitas, Bruno Wesley; de Paula Lima, Pedro Olavo


    Study Design Cross-sectional study. Background The Hip Stability Isometric Test (HipSIT) evaluates the strength of the hip posterolateral stabilizers in a position that favors greater activation of the gluteus maximus and gluteus medius and lower activation of the tensor fascia lata. Objectives To check the validity and reliability of the HipSIT and to evaluate the HipSIT in women with patellofemoral pain (PFP). Methods The HipSIT was evaluated with a handheld dynamometer. During testing, the participants were sidelying, with their legs positioned at 45° of hip flexion and 90° of knee flexion. Participants were instructed to raise the knee of the upper leg while keeping the upper and lower heels in contact. To establish reliability and validity, 49 women were tested with the HipSIT by 2 different evaluators on day 1, and then again 7 days later. The strength of the hip extensors, abductors, and external rotators was also evaluated. Twenty women with unilateral PFP were also evaluated. Results The HipSIT has excellent intrarater and interrater reliability. The standard error of measurement was 0.01 kgf/kg, and the minimal detectable change was 0.036 kgf/kg. The HipSIT showed good validity in isolated hip abduction, external rotation, and extension (Pstrength deficits in women with PFP. J Orthop Sports Phys Ther 2017;47(12):906-913. Epub 9 Oct 2017. doi:10.2519/jospt.2017.7274.

  9. Anterior lumbar inter-body fusion with instrumentation compared with posterolateral fusion for low grade isthmic-spondylolisthesis. (United States)

    Chandra, Varun; Singh, Raj Kumar


    Spondylolisthesis presenting as low back pain is not an uncommon condition. Many of such patients are treated conservatively. For those that require surgical management, various treatment options are in vogue e.g. Postero-lateral fusion (PLF) with decompression or posterior fusion with instrumentation and anterior lumbar inter-body fusion (ALIF). Each technique has produced satisfactory outcome with benefits and disadvantages. To compare the outcome of surgical management of low grade spondylolisthesis with two treatments modalities--Postero-lateral fusion (PLF) and Anterior lumbar inter-body fusion (ALIF) with posterior instrumentation in similar patient profile. Prospective study to compare the results of two surgical treatment modalities. The selected group of patients for surgery based on definite criteria was operated by the same surgeon by two modalities: Postero-lateral fusion with decompression and Anterior Lumbar Inter-body fusion with posterior instrumentation. The outcomes were compared. Analysis of variance (ANOVA) test. Follow up was done at twelve weekly intervals up to 2 years. Both groups showed good recovery in pain as seen in Visual analogue scale (VAS) and Oswestry low back pain scoring. Intra-operative bleeding was observed to be higher in Postero-lateral fusion group. Average length of hospital stay for the patients of PLF group was 6.6 days (Range: 4-7 days) as compared to 12.5 days (Range: 10-16 days) in case of ALIF group. Treatment cost was found to be higher in patients who undergone ALIF with instrumentation. ALIF with posterior instrumentation in low grade isthmic spondylolisthesis provides satisfactory outcome in patients requiring surgical treatment. The results of pain relief and disability index are comparable to time tested posterolateral fusion. ALIF shows a tendency to faster pain relief and return to activity with less intraoperative blood requirement in low grade isthmic spondylolisthesis.

  10. Increasing the Resolution of Chronic Obstructive Pulmonary Disease Definition. Lessons from a Cohort with Remote but Extensive Exposure to Secondhand Tobacco Smoke. (United States)

    Arjomandi, Mehrdad; Zeng, Siyang; Blanc, Paul D; Gold, Warren M


    The Global Initiative for Chronic Obstructive Lung Disease criteria require a ratio of forced expiratory volume in 1 second (FEV 1 ) to forced vital capacity (FVC) (FEV 1 /FVC) of less than 0.70 for the diagnosis of chronic obstructive pulmonary disease, whereas other criteria emphasize a lower limit of normal approach. However, the use of Global Initiative for Chronic Obstructive Lung Disease (or lower limit of normal) criteria may result in classification of many smokers with respiratory morbidities as not having chronic obstructive pulmonary disease. Additional accuracy in defining chronic obstructive pulmonary disease could improve its management. To determine whether in a cohort with remote but longstanding exposure to secondhand tobacco smoke, air trapping as measured by ratio of residual volume to total lung capacity (RV/TLC) can identify a subgroup at risk for respiratory morbidity among those without chronic obstructive pulmonary disease defined by Global Initiative for Chronic Obstructive Lung Disease (or lower limit of normal) criteria. We performed an observational study of symptoms and lung function in a cohort of 256 subjects with a history of extensive occupational exposure to secondhand tobacco smoke but with preserved spirometry (FEV 1 /FVC and FEV 1  ≥ lower limit of normal). We elicited symptom prevalence by structured questionnaire, and estimated the correlations between plethysmography-measured RV/TLC and spirometry-measured FEV 1 /FVC and FEV 1 . In subgroups of the cohort, we examined the association of maximum oxygen consumption ([Formula: see text]o 2 max) on exercise testing with RV/TLC (n = 179), dynamic hyperinflation (exercise-induced changes in fraction of tidal breathing that is flow-limited on expiration [percentage of expiratory flow limitation, %EFL] and end-expiratory lung volume) (n = 32), and radiographic gas trapping (percent low attenuation area in -860 to -950 Hounsfield units at end-expiration on computerized

  11. Clinical results of posterolateral fusion for degenerative lumbar spinal diseases. A follow-up study of more than 10 years

    International Nuclear Information System (INIS)

    Kuroki, Hiroshi; Tajima, Naoya; Kubo, Shinichiro


    The objective of this retrospective study was to evaluate the long-term clinical outcomes and the effects on unfused motion segments of posterolateral fusion. This study involved 35 cases (37 intervertebral levels) of posterolateral fusion performed to treat degenerative lumbar spinal diseases. There were 20 male and 15 female patients ranging in age from 30 to 67 years, with a mean age of 49 years. The postoperative period ranged from 10 years to 17 years and 8 months, with a mean period of 13 years. The clinical outcomes were evaluated using the Japanese Orthopaedic Association (JOA) score for assessment of treatment for low back pain. The effects on unfused motion segments were investigated with radiographic and magnetic resonance (MR) imaging. Postoperative satisfactory improvement (mean recovery rate, 66.9%) reached a plateau at 1 year and was maintained at final follow-up. Radiographically, the union rate was 86.5%. There were few cases of induced instability of unfused motion segments. On MR imaging, increased signal intensity in both T 1 - and T 2 -weighted images was seen in the paravertebral muscles in 15 of 20 cases (75.0%). Posterolateral fusion is a useful technique for the treatment of degenerative lumbar spinal diseases. Clinical outcomes were stable throughout follow-up. Instability of unfused motion segments rarely occurred. (author)

  12. Differences in the microstructural properties of the anteromedial and posterolateral bundles of the anterior cruciate ligament. (United States)

    Skelley, Nathan W; Castile, Ryan M; York, Timothy E; Gruev, Viktor; Lake, Spencer P; Brophy, Robert H


    Tissue properties of the anteromedial (AM) and posterolateral (PL) bundles of the anterior cruciate ligament (ACL) have not been previously characterized with real-time dynamic testing. The current study used a novel polarized light technique to measure the material and microstructural properties of the ACL. The AM and PL bundles of the ACL have similar material and microstructural properties. Controlled laboratory study. The AM and PL bundles were isolated from 16 human cadaveric ACLs (11 male, 5 female; average age, 41 years [range, 24-53 years]). Three samples from each bundle were loaded in uniaxial tension, and a custom-built polarized light imaging camera was used to quantify collagen fiber alignment in real time. A bilinear curve fit was applied to the stress-strain data of a quasistatic ramp-to-failure to quantify the moduli in the toe and linear regions. Fiber alignment was quantified at zero strain, the transition point of the bilinear fit, and in the linear portion of the stress-strain curve by computing the degree of linear polarization (DoLP) and angle of polarization (AoP), which are measures of the strength and direction of collagen alignment, respectively. Data were compared using t tests. The AM bundle exhibited significantly larger toe-region (AM 7.2 MPa vs. PL 4.2 MPa; P ligament microstructure can be used to assess graft options for ACL reconstruction and optimize surgical reconstruction techniques. © 2015 The Author(s).

  13. Coblation nucleoplasty for adjacent segment degeneration after posterolateral fusion surgery: a case report. (United States)

    Zhu, Hui; Zhou, Xiao-Zhong; Cheng, Mao-Hua; Luo, Zong-Ping; Ai, Hong-Zhen


    Symptomatic ASD after lumbar spinal fusion surgery occurs most commonly in the cranial segment. The surgery for ASD contains anterior lumbar interbody fusion, posterior lumbar interbody fusion, decompression alone (laminotomy) and so on. But coblation nucleoplasty for ASD has not been reported previously. In this study, a case of coblation nucleoplasty after posterolateral fusion surgery at L4-L5 for adjacent segment degeneration (ASD) was reported and the clinical results were examined. A 32-year-old male patient who had discectomy and fusion on the L4-L5 level seven years ago complained of chronic back pain for four months with numbness on his right leg for a month. X-ray revealed mild lumbar instability on L3-L4 segment. Magnetic resonance imaging confirmed a right-sided L3-L4 herniated disc compressing the L4 nerve root. He underwent L3-L4 coblation nucleoplasty. The visual analog scale (VAS) was adopted to assess the relief of back pain, leg pain and numbness. The operation was performed successfully and the symptoms were relieved significantly at the follow-up of more than twenty-four months. Although coblation nucleoplasty is not a regular therapy for ASD, the excellent outcome of this case suggests that this technique might be an option before a complicated revision surgery.

  14. Repair or Reconstruction in Acute Posterolateral Instability of the Knee: Decision Making and Surgical Technique Introduction. (United States)

    Stannard, James P; Stannard, James T; Cook, James L


    Complex knee injury surgeons must frequently decide whether to repair or reconstruct an acute posterolateral corner (PLC) injury. If repair is not feasible or fails, reconstruction is often necessary. Several studies have found that reconstruction has better outcomes and lower failure rates. Careful studies of the anatomy of the corner have led to the development of "two-tailed" reconstruction techniques which are becoming widely used in the field. Repair should not be completely disregarded as there are times when it is necessary, especially when no donor allograft tissue is readily available or when aggressive postoperative rehabilitation will not be performed. Optimally, if the patient has high quality tissue available for repair, it is best to combine reconstruction with repair. The authors have developed a new PLC reconstruction technique which applies the functional anatomy that has been increasingly defined. We detail these methods here, which include the use of cortical button suspensory fixation and interference screw fixation of allografts in sockets. This allows for individual and sequential intraoperative tensioning of the grafts to obtain optimal knee stability and motion. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  15. Aflatoxin exposure during the first 36 months of life was not associated with impaired growth in Nepalese children: An extension of the MAL-ED study.

    Directory of Open Access Journals (Sweden)

    Nicole J Mitchell

    Full Text Available Exposure to aflatoxin, a mycotoxin common in many foods, has been associated with child growth impairment in sub-Saharan Africa. To improve our understanding of growth impairment in relation to aflatoxin and other risk factors, we assessed biospecimens collected in Nepalese children at 15, 24, and 36 months of age for aflatoxin exposure. Children (N = 85 enrolled in the Bhaktapur, Nepal MAL-ED study encompassed the cohort analysed in this study. Exposure was assessed through a plasma biomarker of aflatoxin exposure: the AFB1-lysine adduct. The aflatoxin exposures in the study participants were compared to anthropometrics at each time period (length-for-age [LAZ], weight-for-age [WAZ], and weight-for-length [WLZ] z-scores, growth trajectories over time, age, and breastfeeding status. Results demonstrated chronic aflatoxin exposure in this cohort of children, with a geometric mean of 3.62 pg AFB1-lysine/mg albumin. However, the chronic aflatoxin exposure in this cohort was not significantly associated with anthropometric z-scores, growth trajectories, age, or feeding status, based on the available time points to assess aflatoxin exposure. Low mean levels of aflatoxin exposure and infrequent occurrence of stunting, wasting, or underweight z-score values in this cohort are possible contributing factors to a lack of evidence for an association. Further research is needed to examine whether a threshold dose of aflatoxin exists that could induce child growth impairment.

  16. Aflatoxin exposure during the first 36 months of life was not associated with impaired growth in Nepalese children: An extension of the MAL-ED study (United States)

    Hsu, Hui-Husan; Chandyo, Ram Krishna; Shrestha, Binob; Bodhidatta, Ladaporn; Tu, Yu-Kang; Gong, Yun-Yun; Egner, Patricia A.; Ulak, Manjeswori; Groopman, John D.; Wu, Felicia


    Exposure to aflatoxin, a mycotoxin common in many foods, has been associated with child growth impairment in sub-Saharan Africa. To improve our understanding of growth impairment in relation to aflatoxin and other risk factors, we assessed biospecimens collected in Nepalese children at 15, 24, and 36 months of age for aflatoxin exposure. Children (N = 85) enrolled in the Bhaktapur, Nepal MAL-ED study encompassed the cohort analysed in this study. Exposure was assessed through a plasma biomarker of aflatoxin exposure: the AFB1-lysine adduct. The aflatoxin exposures in the study participants were compared to anthropometrics at each time period (length-for-age [LAZ], weight-for-age [WAZ], and weight-for-length [WLZ] z-scores), growth trajectories over time, age, and breastfeeding status. Results demonstrated chronic aflatoxin exposure in this cohort of children, with a geometric mean of 3.62 pg AFB1-lysine/mg albumin. However, the chronic aflatoxin exposure in this cohort was not significantly associated with anthropometric z-scores, growth trajectories, age, or feeding status, based on the available time points to assess aflatoxin exposure. Low mean levels of aflatoxin exposure and infrequent occurrence of stunting, wasting, or underweight z-score values in this cohort are possible contributing factors to a lack of evidence for an association. Further research is needed to examine whether a threshold dose of aflatoxin exists that could induce child growth impairment. PMID:28212415

  17. Trochanteric osteotomy versus posterolateral approach: function the first year post surgery. A pilot study

    Directory of Open Access Journals (Sweden)

    van Biezen Frans C


    Full Text Available Abstract Background Although no prospective studies have compared functional results of trochanteric osteotomy and a non-trochanteric approach, most surgeons feel that trochanteric osteotomy is outdated in simple hip arthroplasty. Reasons not to perform an osteotomy include the fear of longer rehabilitation and worse (final functional outcome. Method This prospective study examines differences in rehabilitation between posterolateral and trochanteric approach one year post-surgery using questionnaires (WOMAC, SF-36, HHS and functional tests (walking, climbing stairs, rising from sitting, and strength tests. Of the 109 patients 24 had a trochanteric osteotomy: the selected approach was based on the surgeon's preference. The trochanteric osteotomy group included more patients with developmental dysplasia of the hip. Before the start of the study no power analysis was performed. Results Data from the questionnaires showed no significant differences between the two groups at 3, 6 and 12-months follow-up. At 3-months follow-up patients in the trochanteric osteotomy group scored lower on the functional tests. This difference had disappeared at 6 and 12-months follow-up, except for abduction force which remained lower in the trochanteric osteotomy group in patients with a non union of the TO. Conclusion For simple hip arthroplasty an approach without osteotomy seems a logical choice. Although the power of this study is low, in experienced hands trochanteric osteotomy seems to give good functional results at 6-12 months post surgery if trochanteric union is obtained. Therefore, one should not hesitate to perform an osteotomy in difficult cases.

  18. MRI injury patterns in surgically confirmed and reconstructed posterolateral corner knee injuries. (United States)

    Collins, Mark S; Bond, Jeffery R; Crush, Andrew B; Stuart, Michael J; King, Alexander H; Levy, Bruce A


    The posterolateral corner (PLC) of the knee is anatomically complex with similarly complex MR imaging findings in acutely injured knees. The purpose of this study was to define the MRI pattern of injury in cases of PLC disruption requiring surgery because of clinical instability. The knee MRIs of 22 patients who underwent surgical repair and/or reconstruction of PLC injury were retrospectively reviewed. The fibular collateral ligament (FCL), popliteus tendon (PT), biceps femoris (BF), popliteofibular ligament (PFL), arcuate ligament (AL), and fabellofibular ligament (FFL) were evaluated and graded as follows: complete tear, high-grade partial tear, low-grade partial tear, and normal. In the 22 cases of PLC injury that necessitated surgery, a constellation of findings involving the larger structures of the PLC was identified. Of the FCL, PT, and BF (considered larger structures), at least two were abnormal in all 22 injury cases. Of the PFL, AL, and FFL (considered smaller structures), the PFL appeared abnormal in 19 cases, yet neither the AL nor FFL were confidently characterized in the injury group. The larger structures of the PLC are easily evaluated using standard MRI techniques. This study identified a predictable pattern of imaging findings involving these more easily assessed structures in those patients who were felt to be clinically unstable and underwent surgical reconstruction, as at least two were abnormal in all 22 cases. The smaller structures of the PLC are difficult to assess with MRI; however, direct visualization of their involvement on MRI is not necessary to report a clinically unstable PLC injury. Emphasis of this simplified but critical analysis of the FCL, BF and PT on MRI scans reviewed by radiologists and orthopaedic surgeons may help to prevent delayed diagnosis of unstable PLC injuries. III.

  19. Tridimensional computer-assisted anatomic dissection of posterolateral prostatic neurovascular bundles. (United States)

    Alsaid, Bayan; Karam, Ibrahim; Bessede, Thomas; Abdlsamad, Issam; Uhl, Jean-François; Delmas, Vincent; Benoît, Gérard; Droupy, Stéphane


    Detailed knowledge of nerve distribution in the neurovascular bundle (NVB) is essential to preserve sexual function after prostatic surgery. To identify the location as well as the type (adrenergic, cholinergic, and sensory) of nerve fibres within the NVB and to provide a three-dimensional (3D) representation of their structural relationship in the human male foetus. Serial transverse sections were performed every 150-200 microm in the pelvic portion of six human male foetuses (15-20 wk of gestation). Sections were treated with histologic and immunohistochemical methods (hematin-eosin-safran, Luxol Fast Blue, immunolabelling of protein S100, vesicular acetylcholine transporter, tyrosine hydroxylase, calcitonin gene-related peptide, and substance P). The 3D pelvic reconstruction was obtained from digitised serial sections using WinSurf software. NVB nerve location and type were evaluated qualitatively. The 3D reconstruction allowed precise identification of pelvic organ innervation. Nerve fibres derived from the inferior hypogastric plexus followed two courses: posterior and lateral, providing cholinergic, adrenergic, and sensory innervation to seminal vesicles, vas deferens, prostate, and urethral sphincter. Cavernous nerve fibres did not strictly follow the NVB course; they were distributed at several levels, in a fanlike formation. The main limitations of this study were the limited number of specimens available due to legal restriction and the time-consuming nature of the manually performed stages in the method. The distribution of nerve fibres within the posterolateral prostatic NVB and the existence of mixed innervation in the posterior and lateral fibre courses at the level of the prostate and seminal vesicles give us an insight into how to minimise effects on sexual function during prostatic surgery. The 3D computer-assisted anatomic dissection represents an original method of applying anatomic knowledge to surgical technique to improve nerve preservation

  20. Anatomic position of the asterion in Kenyans for posterolateral surgical approaches to cranial cavity. (United States)

    Mwachaka, P M; Hassanali, J; Odula, P O


    The asterion, defined as the junction between lambdoid, parietomastoid, and occipitomastoid sutures, has been used as a landmark in posterolateral approaches to the posterior fossa. Its reliability however has been put into question due to its population-specific variability in position, using external palpable landmarks and its relation to the transverse-sigmoid sinus complex. This study aimed at determining the anatomic position of the asterion in a Kenyan population. Measurements from the asterion to the root of zygoma and the tip of mastoid process, respectively were taken on both left and right sides of 90 (51 male, 39 female) human skulls. The relation of the asterion to the transverse-sigmoid sinus junction was also determined. The distances on the right and left sides from the asterion to the root of the zygoma were 58.85 +/- 2.50 mm and 58.44 +/- 2.12 mm, respectively. The asterion was 47.89 +/- 3.72 mm above the tip of mastoid process on the right side and 47.62 +/- 2.87 mm on the left side. This point was significantly higher in males (48.36 +/- 2.72 mm) than in females (46.62 +/- 3.37 mm) with a P-value of 0.041. Regarding its position from the transverse-sigmoid sinus junction, it was at the junction in 72 cases, below it in 17 cases (average 3.68 mm) and only one case had the asterion above this junction (2.57 mm). The asterion therefore can reliably be ascertained using the parameters from the root of the zygoma and the tip of the mastoid process. The safest approach would be posteroinferior to the asterion so as to avoid lacerating the transverse-sigmoid sinus complex.

  1. Surface and superficial surgical anatomy of the posterolateral cranial base: significance for surgical planning and approach. (United States)

    Day, J D; Kellogg, J X; Tschabitscher, M; Fukushima, T


    We have performed an anatomic study, 15 using fixed cadaveric preparations, with the goal of identifying surface landmarks that will reliably locate the underlying transverse and sigmoid sinus complex. Simple morphometric relationships were first determined on both sides of each specimen to yield 30 sides measured. The following relationships were determined: 1) zygoma root-asterion, 2) asterion-mastoid tip, 3) zygoma root-suprameatal spine (Henle's spine), 4) asterion-suprameatal spine, 5) mastoid tip-suprameatal spine. The relationship of the asterion to the transverse-sigmoid junction was determined by bone removal. Also, the distances from the asterion to the sigmoid sinus-superior petrosal sinus junction and the superior margin of the transverse sinus were studied. Surface and marks were found to have definitive relationships to underlying anatomic substrates in all specimens studied. The critical relationships that were concluded from this study can be described in terms of two easily identified lines between bony surface structures. A line drawn from the zygoma root to the inion, i.e., the superior nuchal line, reliably located the rostrocaudal level of the transverse sinus in all specimens. Although the asterion did not consistently fall on this line, the transverse-sigmoid junction could reliably be placed at the anteroposterior level of the asterion. Further, a line drawn from the squamosal-parietomastoid suture junction to the mastoid tip reliably defined the axis of the sigmoid sinus through the mastoid. We also found that the junction of the squamosal and parietomastoid sutures lay over the anterior border of the upper curve of the sigmoid sinus. The anterior portion of the supramastoid crest correlated with the level of the middle fossa. These surface relationships all have significance for posterolateral approaches to the cranial base. Since performing this study, these relationships have been found reliable for operative planning in our clinical

  2. Posterolateral Trajectories Favor a Longer Motor Domain in Subthalamic Nucleus Deep Brain Stimulation for Parkinson Disease. (United States)

    Tamir, Idit; Marmor-Levin, Odeya; Eitan, Renana; Bergman, Hagai; Israel, Zvi


    The clinical outcome of patients with Parkinson disease (PD) who undergo subthalamic nucleus (STN) deep brain stimulation (DBS) is, in part, determined by the length of the electrode trajectory through the motor STN domain, the dorsolateral oscillatory region (DLOR). Trajectory length has been found to correlate with the stimulation-related improvement in patients' motor function (estimated by part III of the United Parkinson's Disease Rating Scale [UPDRS]). Therefore, it seems that ideally trajectories should have maximal DLOR length. We retrospectively studied the influence of various anatomic aspects of the brains of patients with PD and the geometry of trajectories planned on the length of the DLOR and STN recorded during DBS surgery. We examined 212 trajectories and 424 microelectrode recording tracks in 115 patients operated on in our center between 2010 and 2015. We found a strong correlation between the length of the recorded DLOR and STN. Trajectories that were more lateral and/or posterior in orientation had a longer STN and DLOR pass, although the DLOR/STN fraction length remained constant. The STN target was more lateral when the third ventricle was wider, and the latter correlated with older age and male gender. Trajectory angles correlate with the recorded STN and DLOR lengths, and should be altered toward a more posterolateral angle in older patients and atrophied brains to compensate for the changes in STN location and geometry. These fine adjustments should yield a longer motor domain pass, thereby improving the patient's predicted outcome. Copyright © 2017 Elsevier Inc. All rights reserved.

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

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


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

  4. Evaluation of cell binding peptide (p15) with silk fibre enhanced hydroxyappatite bone substitute for posterolateral spinal fusion in sheep

    DEFF Research Database (Denmark)

    Axelsen, M.; Jespersen, Stig; Overgaard, Søren


    's gold standard are highly desired. Uninstrumented posterolateral fusion (PLF) is one of the most challenging bone graft procedures because of large graft size and lack of external stability. P15 is a synthetic 15 amino acid peptide sequence, identical to the biding site for alpha2-beta1 integrin...... on the surface of bone forming cells. The binding initiates natural intra- and extracellular signalling pathways, inducing production of growth factors, bone morphogenic proteins and cytokines. P15 peptide has previously shown to improve osteoinductive properties when coated on graft materials. Purpose...

  5. Circumferential fusion is dominant over posterolateral fusion in a long-term perspective: cost-utility evaluation of a randomized controlled trial in severe, chronic low back pain

    DEFF Research Database (Denmark)

    Soegaard, Rikke; Bünger, Cody E; Christiansen, Terkel


    OF BACKGROUND DATA: The cost-effectiveness of circumferential fusion in a long-term perspective is uncertain but nonetheless highly relevant as the ISSLS prize winner 2006 in clinical studies reported the effect of circumferential fusion superior to the effect of posterolateral fusion. A recent trial found...... no significant difference between posterolateral and circumferential fusion reporting cost-effectiveness from a 2-year viewpoint. METHODS: A total of 146 patients were randomized to posterolateral or circumferential fusion and followed 4 to 8 years after surgery. The mean age of the cohort was 46 years (range...... of the labor market due to sickness. The EQ-5D instrument was applied for the measurement of health-related quality of life and costs (2004 U.S. dollars) were measured in a full-scale societal perspective. Productivity costs were valued by the Friction Cost method, and both costs and effects were discounted...

  6. Long-term Radiological and Clinical Outcomes After Using Bone Marrow Mesenchymal Stem Cells Concentrate Obtained With Selective Retention Cell Technology in Posterolateral Spinal Fusion. (United States)

    Yousef, Mohamed Abdelhamid Ali; La Maida, Giovanni Andrea; Misaggi, Bernardo


    Retrospective study. The aim of this study was to evaluate the long-term clinical and radiological outcomes of the use of bone marrow mesenchymal stem cell concentrate obtained with selective cell retention technology using Cellect with a particular collagen scaffold, Healos for posterolateral spinal fusion. With the increasing rate of spinal fusion, the problem of pseudarthrosis, which contributes to recurrent pain with patient disability, is considered to be the most common cause of revision lumbar spine surgery. Intensive research is being carried out to develop an alternative source of bone grafting and improve the spinal fusion rate. A retrospective review of hospital records was performed. Identified patients were contacted to have a clinical and radiological evaluation follow-up. Clinical outcome was evaluated using visual analog scales for the back pain (VAS), Oswestry Disability Index (ODI) scores, and quality of life (EQ-5D) questionnaire. Radiological outcome was evaluated by performing dynamic flexion/extension lateral views and calculation of segmental Cobb angle. Any implant-associated complication was reported. Computed tomography (CT) scans were also performed. Twenty-one patients were included and all patients achieved successful fusion. The mean difference of the segmental Cobb angle was 0.48° (range 0.3°-0.7°). Computed tomography scans showed solid bilateral fusion with bridging bone (Grade I) in all patients, but solid unilateral fusion with bridging bone (Grade II) was detected for one patient at one level. Patients started to resume working activities within a mean period of 3.5 months. The VAS score for the residual back pain was 4.1 ± 2.1, whereas the ODI was 10.5 ± 5.6 points, and the mean disability index was 21.1%. The use of bone marrow mesenchymal stem cell concentrate obtained with selective cell retention technology could be considered as an effective means for augmenting spinal fusion. 3.

  7. Platelet-rich plasma enhances bone union in posterolateral lumbar fusion: A prospective randomized controlled trial. (United States)

    Kubota, Go; Kamoda, Hiroto; Orita, Sumihisa; Yamauchi, Kazuyo; Sakuma, Yoshihiro; Oikawa, Yasuhiro; Inage, Kazuhide; Sainoh, Takeshi; Sato, Jun; Ito, Michihiro; Yamashita, Masaomi; Nakamura, Junichi; Suzuki, Takane; Takahashi, Kazuhisa; Ohtori, Seiji


    Platelet-rich plasma (PRP) accelerates bone union in vivo in a rodent model of spinal fusion surgery. However, PRP's effect on bone union after spinal surgery remains unclear. The objective of this study was to evaluate the efficacy of PRP after posterolateral lumbar fusion (PLF) surgery. Single-center prospective randomized controlled clinical trial with 2-year follow-up. The patient sample included a total 62 patients (31 patients in the PRP group or 31 patients in the control group). The outcome measures included the bone fusion rate, the area of bone fusion mass, the duration of bone fusion, and the clinical score using the visual analog scale (VAS). We randomized 62 patients who underwent one- or two-level instrumented PLF for lumbar degenerative spondylosis with instability to either the PRP (31 patients) or the control (31 patients) groups. Platelet-rich plasma-treated patients underwent surgery using an autograft bone chip (local bone), and PRP was prepared from patient blood samples immediately before surgery; patients from the control group underwent PLF without PRP treatment. We assessed platelet counts and growth factor concentrations in PRP prepared immediately before surgery. The duration of bone union, the postoperative bone fusion rate, and the area of fusion mass were assessed using plain radiography every 3 months after surgery and by computed tomography at 12 or 24 months. The duration of bone fusion and the clinical scores for low back pain, leg pain, and leg numbness before and 3, 6, 12, and 24 months after surgery were evaluated using VAS. Data from 50 patients with complete data were included. The bone union rate at the final follow-up was significantly higher in the PRP group (94%) than in the control group (74%) (p=.002). The area of fusion mass was significantly higher in the PRP group (572 mm 2 ) than in the control group (367 mm 2 ) (p=.02). The mean period necessary for union was 7.8 months in the PRP group and 9.8 months in the

  8. [Comparative study of posterolateral conventional and minimally invasive total hip arthroplasty]. (United States)

    Sun, Shihua; Wang, Shuanke; Zhao, Lin; Wang, Xu


    To compare the clinical effect of total hip arthroplasty (THA) using posterolateral conventional or minimally invasive incision. From January 2007 to November 2007, 38 patients (41 hips) were treated with minimally invasive THA (mini-incision group), and 15 patients (15 hips) underwent conventional THA (conventional incision group). Mini-incision group: 23 males (25 hips) and 15 females (16 hips) aged (53.2 +/- 15.5) years old; body mass index (BMI) was 23.4 +/- 3.3; there were 20 cases (20 hips) of femoral neck fracture, 2 cases (2 hips) of primary osteoarthritis, 14 cases (16 hips) of stage III or IV aseptic necrosis of the femoral head, 2 cases (3 hips) of ankylosing spondylitis involving hip joint; Harris hip score was 47.7 +/- 5.5 and the course of disease was (4.5 +/- 4.3) years. Conventional incision group: 7 males (7 hips) and 8 females (8 hips) aged (54.8 +/- 10.8) years old; BMI was 26.1 +/- 5.1; there were 8 cases (8 hips) of femoral neck fracture, 1 case (1 hip) of primary osteoarthritis, 5 cases (5 hips) of stage III or IV aseptic necrosis of the femoral head, 1 case (1 hip) of ankylosing spondylitis involving hip joint; Harris hip score was 51.2 +/- 4.3 and the course of disease was (3.8 +/- 3.7) years. There were no statistically significant differences between two groups in the general information (P > 0.05). There were statistical differences between two groups in terms of incision length, perioperative blood loss, drainage volume and blood transfusion volume (P 0.05). All incisions healed by first intention and no early postoperative complications occurred. Two groups were followed for 12-22 months (average 18.3 months). All patients walked without the crutch at 2-3 months after operation. The Harris score of the mini-incision group and the conventional incision group 6 months after operation was 88.6 +/- 3.6 and 85.8 +/- 3.3, respectively, indicating there was no significant difference between two groups (P > 0.05), but there was significant

  9. The utility of preoperative laboratories in predicting postoperative complications following posterolateral lumbar fusion. (United States)

    Lakomkin, Nikita; Goz, Vadim; Cheng, Joseph S; Brodke, Darrel S; Spiker, William Ryan


    Several studies have suggested that laboratory results have minimal impact on clinical decision making in surgery. Despite the widespread use of preoperative testing in spine surgery and the large volume of posterolateral lumbar fusions (PLFs) being performed each year, no study has assessed the ability of preoperative laboratories to predict adverse events following PLF. The purpose of this study was to explore the relationship between commonly obtained preoperative laboratory results and postoperative complications following one- to two-level PLF. This is a retrospective study of prospectively collected data. The 2006-2013 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was employed to identify all patients who underwent one- to two-level PLF. The outcome variables of interest were 30-day postoperative complications, which were assessed as major complications, minor adverse events, and total complications. Demographics, comorbidities, and perioperative characteristics were collected for each patient. Preoperative laboratories included sodium, blood urea nitrogen, creatinine, albumin, bilirubin, serum glutamic oxaloacetic transaminase, alkaline phosphatase, white blood cell count, hematocrit, platelet count, prothrombin time, international normalized ratio, and partial thromboplastin time. Bivariate analysis and multivariate logistic regression modeling were used to explore the relationship between abnormal preoperative laboratories and the incidence of postoperative complications. After controlling for age, ASA score, length of surgery, and all significant comorbidities, abnormal sodium (odds ratio [OR]=2.47, 95% confidence interval [CI]: 1.45-4.19, p=.001) and abnormal INR (OR=2.33, 95% CI: 1.09-4.98, p=.029) were significantly associated with the development of any complication. Sodium (OR=1.61, 95% CI: 1.01-2.54, p=.04) and platelets (OR=1.58, 95% CI: 1.02-2.44, p=.04) were associated with minor complications


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    Full Text Available ABSTRACT Objective: To assess the effect of pulsed electromagnetic field (PEMF on the consolidation of instrumented lumbar posterolateral arthrodeses in patients who have been surgically treated for degenerative spine disease. Methods: Forty cases were recruited from 163 consecutive patients undergoing lumbar arthrodesis at the same center. The patients were randomized into two groups of 20 patients: Active Group, who were exposed to PEMF for 4 hours a day for 90 days after surgery, and Inactive Group, who received an identical device, with the same instructions for use but without the ability to generate PEMF. The patients underwent computed tomography scans at 45, 90, 180 and 360 days after surgery to check for the occurrence of arthrodesis at each operated spinal level. Results: In the course of the study, two patients were excluded from each group. There were no significant differences between the groups with respect to age, gender, smoking habit, or the number of vertebral levels included in the arthrodesis. The percentage of consolidation of the vertebral levels increased at 90, 180 and 360 days compared to 45 days (p<0.001 in both groups. The Active Group had a 276% greater chance of consolidation in the vertebral levels (OR = 3.76; 95% CI: 1.39-10.20, regardless of the time of evaluation. Patients in the Active Group presented 16% more consolidation than patients in the inactive group (p=0.018. Conclusions: Post-operative exposure to PEMF following instrumented arthrodesis of the lumbar spine for degenerative spine disease increased consolidation in the first year after surgery.

  11. Effect of modulating dietary vitamin D on the general bone health of rats during posterolateral spinal fusion. (United States)

    Bhamb, Neil; Kanim, Linda; Maldonado, Ruben; Svet, Mark; Metzger, Melodie


    Vitamin D plays a significant role in musculoskeletal health by regulating calcium, phosphate, and promoting new bone mineralization. The purpose of this study was to understand the effect of dietary vitamin D on general bone health during peri-operative bone healing via an in vivo dosing study of vitamin D in a rat posterolateral fusion model using autograft. Vitamin D Deficient (DD), vitamin D Insufficient (ID), Control vitamin D (CD), and Hyper-vitamin D (HD) groups were studied. Increasing dietary vitamin D improved quantitative measures of femoral geometry, including femoral strength, stiffness, and density. Femoral biomechanics, cortical thickness, moment of inertia, cross-sectional area, and measures from bone ashing were all greater in the HD group versus the CD. This suggests that additional dietary vitamin D above normal levels during spinal fusion may lead to improvement in bone health. Serum vitamin D levels were also observed to decrease during fusion healing. These results demonstrate that dietary vitamin D improves general bone health in the femur of a rat model during posterolateral spinal fusion. This suggests a role for further clinical evaluation of vitamin D dietary intake during the peri-operative period, with the possibility of avoiding adverse consequences to general bone health. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  12. Surface anatomy of the posterolateral cranium regarding the localization of the initial burr-hole for a retrosigmoid approach. (United States)

    Bozbuga, Mustafa; Boran, Burak O; Sahinoglu, Kayihan


    Knowing the location of the venous sinuses is essential for the localization of the initial burr-hole for a retrosigmoid approach, in order to avoid inadvertent entry into the venous sinuses and limitation of the size of the bony opening. In this anatomic study, external landmarks of the posterolateral cranium have been studied, in order to reveal the relationship with the venous sinuses. Eighty-four dried adult human skulls were studied and study of both sides yielded 168 sides. Morphometric measurements of the posterolateral cranium have been performed and relations of the external landmarks with the venous sinuses have been studied. The anatomic position of the asterion was variable. The superior nuchal line was roughly parallel and below the lower margin of the sulcus of transverse sinus in all specimens. The sigmoid sinus, between the superior and inferior bends, seemed to descend along an axis defined by the junction of the squamosal-parietomastoid suture and the mastoid tip, in a slightly oblique fashion. In conclusion, a burr-hole placed just below the superior nuchal line and posterior to the axis defined by the mastoid tip and the squamosal-parietomastoid suture junction is appropriate for both avoiding inadvertent entry into the sinus and limiting the size of the craniotomy.

  13. Does adding interbody fusion to posterolateral fusion increase success in the surgical management of degenerative lumbar spondylolisthesis?

    Directory of Open Access Journals (Sweden)

    Arturo Meissner-Haecker


    Full Text Available Resumen INTRODUCCIÓN Frecuentemente se agrega una artrodesis intersomática a la artrodesis posterolateral en el tratamiento quirúrgico de la espondilolistesis degenerativa. Sin embargo, la real utilidad de esta medida no está clara. MÉTODOS Para responder esta pregunta utilizamos Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante búsquedas en múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, reanalizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES Identificamos cuatro revisiones sistemáticas que en conjunto incluyen nueve estudios primarios, de los cuales ninguno corresponde a un ensayo aleatorizado. Concluimos que agregar una artrodesis intersomática a una artrodesis posterolateral en el tratamiento quirúrgico de la espondilolistesis degenerativa podría asociarse a una disminución en el deslizamiento del cuerpo vertebral y a una leve mejoría de la calidad de vida de los pacientes, pero asociado también a un mayor costo.

  14. Fast-tracked Rehabilitation and Return to Sport of an Elite Rugby Player with a Complicated Posterolateral Corner Injury and Associated Peroneal Paralysis

    NARCIS (Netherlands)

    Paget, L. D. A.; Kuijer, P. P. F. M.; Maas, M.; Kerkhoffs, G. M. M. J.


    Acute posterolateral corner injuries of the knee with associated hamstring avulsions and peroneal paralysis are rare in rugby. Regain of motor function following a complete paralysis is documented to be 38%. To our knowledge, only one case describes return to preinjury level of competitive sport

  15. The positive effect of posterolateral lumbar spinal fusion is preserved at long-term follow-up: a RCT with 11-13 year follow-up

    DEFF Research Database (Denmark)

    Andersen, Thomas; Videbaek, Tina S; Hansen, Ebbe S


    patients originally randomised to posterolateral lumbar spinal fusion with or without pedicle screw instrumentation. Follow-up included Dallas Pain Questionnaire (DPQ), Oswestry Disability Index (ODI), SF-36 and a question regarding willingness to undergo the procedure again knowing the result as global...

  16. Ankle and subtalar synovitis in a ball-and-socket ankle joint causing posterolateral painful coarse crepitus: a case report. (United States)

    Fan, Ka Yuk; Lui, Tun Hing


    A 17-year-old girl with bilateral ball-and-socket ankles reported left medial heel pain. Her left heel had gone into a varus position on tiptoeing, and a painful clunk had occurred when returning to normal standing. The clunk persisted after physiotherapy and treatment with an orthosis. Subtalar arthroscopy and peroneal tendoscopy showed mild diffuse synovitis of the ankle joint, especially over the posterior capsule, and a patch of inflamed and fibrotic synovium at the posterolateral corner of the subtalar joint. The clunk subsided immediately after arthroscopic synovectomy and had not recurred during 5 years of follow-up. We found no other reported cases of ankle and subtalar synovitis occurring in patients with a ball-and-socket ankle joint. Copyright © 2014 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  17. Posterolateral fusion versus Dynesys dynamic stabilization: Retrospective study at a minimum 5.5years' follow-up. (United States)

    Bredin, S; Demay, O; Mensa, C; Madi, K; Ohl, X


    Lumbar fusion is one of the most widespread techniques to treat degenerative lumbar pathology. To prevent complications such as non-union or adjacent segment degeneration, dynamic stabilization techniques were developed, but with controversial results. The aim of the present study was to compare long-term radiologic and clinical results between fusion and dynamic stabilization. A single-center retrospective study included patients with recurrent lumbar discal hernia or lumbar canal stenosis managed by posterolateral fusion or by dynamic stabilization associated to neurologic release. Patients were seen in follow-up for radiological and clinical assessment: visual analog pain scale (VAS), Oswestry Disability Index (ODI), Short Form-12 (SF-12), adjacent segment disease (ASD), and intervertebral range of motion (ROM). Fifty-eight patients were included: 25 in the fusion group (FG), and 33 in the Dynesys ® group (DG). VAS scores were significantly lower in DG than FG. ODI was 14.6±2.8 in DG, versus 19.4±3.3 in FG (P=0.0001). SF-12 physical subscore was significantly higher in DG. ROM was 4.1±2° in DG, vs. 0.7±0.5° in FG (P=0.001). Radiologic ASD was significantly greater in FG than DG (36% vs. 12.1%; P=0.012), without difference in clinical expression (DG, 1 case; FG, 2 cases). Dynamic stabilization provided clinical and radiological results comparable to those of posterolateral fusion in these indications (although level L5-S1 was not studied). IV. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  18. Surgical management of combined anterior or posterior cruciate ligament and posterolateral corner tears: for what functional results? (United States)

    Wajsfisz, A; Bajard, X; Plaweski, S; Djian, P; Demey, G; Limozin, R; Bousquet, V; Rocheconcar, G; Louis, M-L; Arndt, J; Azar, M; Sonnery-Cottet, B; Boisrenoult, P


    Management of combined anterior or posterior cruciate ligament and posterolateral corner tears is still poorly codified. The aim of this study was to evaluate functional outcome after complete surgical treatment. This retrospective multicenter study included 53 patients. Mean age was 29.8 yrs. (15-49). The anterior and posterior cruciate ligaments were involved in respectively 48 and 5 cases. Mean time to surgery was 25.6 months (0-184), and in 10 cases less than 21 days. Nine patients were sedentary workers and 29 non-sedentary (13 laborers). All ligament injuries were treated surgically. Mean follow-up was 49 months (12-146). Last follow-up assessment used IKDC, Lysholm and KOOS scores. At last follow-up, IKDC score graded 14 patients A, 25 B, 8 C and 6 D, versus 0 A, 4 B, 25 C, 22 D and 2 ungraded preoperatively. Mean subjective IKDC and Lysholm scores were respectively 72.8 (11.5-100) and 77.5 (37-100). Mean KOOS scores (pain, symptoms, daily life, sports, quality of life) were respectively 78 (3-100), 70 (25-100), 88 (47-100), 53 (0-100) and 50 (0-100). Posterolateral laxity was corrected in all but two cases. All sedentary workers and 86.7% of non-sedentary workers could return to work. The job had to be changed in 10% of cases overall, but in 25% of cases for laborers. The present results are comparable with those of the literature. The strategy of combined surgical treatment showed functional efficacy, usually associated with return to work except for some laborers. There was a non-significant trend in favor of acute-phase ligament reconstruction. IV (retrospective series). Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  19. Arcuate sign of posterolateral knee injuries: anatomic, radiographic, and MR imaging data related to patterns of injury

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    Lee, Josephine; Trudell, Debra; Resnick, Donald L. [Department of Radiology, Veterans Affairs Medical Center, University of California, San Diego, CA (United States); Papakonstantinou, Olympia [Department of Radiology, Veterans Affairs Medical Center, University of California, San Diego, CA (United States); Department of Radiology/MRI Unit, University Hospital of Heraklion (Greece); Brookenthal, Keith R. [Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA (United States)


    The ''arcuate sign'' is considered a pathognomonic sign for injuries of the posterolateral (PL) corner of the knee. The purpose of our study was to identify different patterns of injury to the fibular head that may associate with injuries to specific ligaments and tendons of the PL corner of the knee. The anatomic relations between the insertions of fibular collateral ligament (FCL), biceps femoris tendon (BFT), popliteofibular ligament (PFL), and arcuate ligament in normal cadaveric knees were also investigated. Magnetic resonance imaging was performed in two cadaveric knees which subsequently were dissected. Radiopaque markers were placed upon the fibular insertions of the FCL, BFT, PFL, and arcuate ligament in the dissected knees, and knee radiographs were then obtained. Twelve patients with radiographic or MR imaging evidence of isolated injury to the PL corner of the knee were retrospectively reviewed, with regard to avulsion fractures and marrow edema in the fibular head and the integrity of the ligaments of the PL corner of the knee. The PFL and arcuate ligament were seen to attach directly to the posterior and medial aspect of the styloid process of the fibular head. The FCL and BFT attached as a conjoined structure on the lateral aspect of the fibular head lateral, anterior and inferior to the attachment site of the PFL and arcuate ligament. Injury to the arcuate ligament or PFL was diagnosed in 8 patients who presented with a small avulsion fracture of the styloid process of the fibula (n=2), bone marrow edema in the medial aspect of the fibular head (n=3), or both (n=3). In 4 patients with injury to the conjoined tendon or FCL, a larger avulsion fragment and more diffuse proximal fibular edema were seen. Radiographic and MR imaging findings in injuries of the posterolateral corner of the knee may suggest injury to specific structures inserting in the fibular head. (orig.)

  20. A Novel Percutaneous Screw Fixation of Postero-lateral Tibial Plateau Fracture using Posterior Cruciate Ligament Reconstruction Femoral Template: Technical Note

    Directory of Open Access Journals (Sweden)

    Angus Chao Kun Chan


    Full Text Available Percutaneous fixation method has been applied in Schatzker type III joint depressed-type lateral tibial plateau fracture. We report a 76-year-old man suffering from a small joint depressed-type posterolateral tibial plateau fracture with surgical reduction and fixation with a novel guidance of posterior cruciate ligament (PCL reconstruction femoral template under X-ray and arthroscopic assistance. The concept of sequential tunnel drilling in ligament reconstruction has been applied in bone impaction tunnel creation beneath the articular step with the PCL jig. Avoidance of multiple bone guide pin drilling and accurate guide pin insertion and hence screw fixation was also achieved by use of the PCL template. As illustrated, we believe that the PCL jig is a good armamentarium and adjunct equipment to achieve a more precise minimally invasive operation in special anatomical positions such as the postero-lateral tibial plateau under careful surgical planning.

  1. Mesenchymal stem cells expressing baculovirus-engineered BMP-2 and VEGF enhance posterolateral spine fusion in a rabbit model. (United States)

    Fu, Tsai-Sheng; Chang, Yu-Han; Wong, Chak-Bor; Wang, I-Chun; Tsai, Tsung-Ting; Lai, Po-Liang; Chen, Lih-Huei; Chen, Wen-Jer


    Mesenchymal stem cell (MSC)-based cell therapy and gene transfer have converged and show great potential for accelerating bone healing. Gene therapy can provide more sustained expression of osteogenic factors such as bone morphogenetic protein-2 (BMP-2). We previously demonstrated that low-dose BMP-2 enhanced spinal posterolateral fusion by MSCs in a rabbit model. Herein, we genetically modified rabbit MSCs with a recombinant baculovirus encoding BMP-2 (Bac-CB) and vascular endothelial growth factor (Bac-VEGF) seeded into porous scaffolds to enhance spinal fusion. This study evaluates the success rate of the MSC-based cell therapy and gene transfer approach for single-level posterolateral spine fusion. We hypothesize that combining three-dimensional tricalcium phosphate (TCP) scaffolds and genetically modified allogeneic MSCs with baculovirus-mediated growth factor expression would increase the success rate of spinal fusion. The study design was based on an animal model (approved by the Institutional Animal Care and Use Committee) using 18 adult male New Zealand rabbits. This study included 18 male New Zealand rabbits, weighing 3.5 to 4 kg. Allogeneic bone marrow-derived MSCs were isolated and genetically modified with Bac-CB and Bac-CV seeded onto TCP scaffolds (MSC/Bac/TCP). The animals were divided into three groups according to the material implanted into the bilateral L4-L5 intertransverse space: TCP scaffold (n=6), MSC/TCP (n=6), and MSC/Bac/TCP (n=6). After 12 weeks, the rabbits were euthanized for radiographic examination, manual palpation, and histologic study. Bilateral fusion areas in each animal were evaluated independently. The radiographic fusion rates at 12 sites were 0 of 12 in the TCP scaffold group, 4 of 12 in the MSC/TCP group, and 10 of 12 in the MSC/Bac/TCP group. By manual palpation, there were zero solid fusions in the TCP scaffold group, two solid fusions in the MSC/TCP group, and five solid fusions in the MSC/Bac/TCP group. Fusion rates

  2. The anterolateral supra-fibular-head approach for plating posterolateral tibial plateau fractures: A novel surgical technique. (United States)

    Hu, Sun-Jun; Chang, Shi-Min; Zhang, Ying-Qi; Ma, Zhuo; Du, Shou-Chao; Zhang, Kai


    The posterolateral (PL) tibial plateau quadrant is laterally covered by the fibular head and posteriorly covered by a mass of muscle ligament and important neurovascular structures. There are several limitations in exposing and fixing the PL tibial plateau fractures using a posterior approach. The aim of this study is to present a novel anterolateral supra-fibular-head approach for plating PL tibial plateau fractures. Five fresh and ten preserved knee specimens were dissected to measure the following parameters:1) the vertical distance from the apex of the fibular head to the lateral plateau surface, 2) the transverse distance between the PL platform and fibula collateral ligament (FCL), and 3) the tension of the FCL in different knee flexion positions. Clinically, isolated PL quadrant tibial plateau fractures were treated via an anterolateral supra-fibular-head approach and lateral rafting plate fixation. The outcome of the patients was assessed after a short to medium follow-up period. The distance from the apex of the fibular head to the lateral condylar surface was 12.2 ± 1.6 mm on average. With the knee extended and the FCL tensioned, the transverse distance between the PL platform and the FCL was 6.7 ± 1.1 mm. With the knee flexed to 60° and the FCL was in the most relaxed position, the distance increased to 21.1 ± 3.0 mm. Clinically, a series of 7 cases of PL tibial plateau fractures were treated via this anterolateral supra-fibular-head approach. The patient was placed in a lateral decubitus position with the knee flexed to approximately 60 degrees. After the posterior retraction of the FCL, the plate was placed more posteriorly to provide a raft or horizontal belt fixation of the PL tibial plateau fragment. After an average of 14.3 months of follow up, the knee range of motion(ROM) was 121.4° ± 8.8° (range: 105°-135°), the HSS score was 96.7 ± 2.6 (range: 90-100), and the SMFA dysfunction score was 22.4 ± 3.8 (range: 16-28) points. The

  3. Randomized controlled trial for efficacy of capsular distension for adhesive capsulitis: fluoroscopy-guided anterior versus ultrasonography-guided posterolateral approach. (United States)

    Bae, Jae Hyun; Park, Young Sook; Chang, Hyun Jung; Kim, Min Jung; Park, Kang Young; Jin, Seung Hwan; Lee, Eun Hee


    To find the most effective procedure to treat adhesive capsulitis of the shoulder, we evaluated the clinical effects of an ultrasonographic-guided anterior approach capsular distension and a fluoroscopy-guided posterolateral approach capsular distension. We expected the anterior approach to be better than the posterolateral approach because the rotator interval, a triangular anatomic area in the anterosuperior aspect of the shoulder, which is considered an important component of the pathology of adhesive capsulitis. PARTICIPANTS WERE RANDOMLY ASSIGNED TO TWO GROUPS: 27 patients in group A were injected by an anterior approach with 2% lidocaine (5 mL), contrast dye (5 mL), triamcinolone (40 mg), and normal saline (9 mL) under fluoroscopic guidance in the operating room. Twenty-seven patients in group B were injected using a posterolateral approach with 2% lidocaine (5 mL), triamcinolone (40 mg), and normal saline (14 mL) under ultrasonographic guidance. After injection, all patients received physiotherapy four times in the first postoperative week and then two times each week for eight more weeks. Treatment effects were assessed using the shoulder pain and disability index (SPADI), visual numeric scale (VNS), passive range of motion (PROM), hand power (grip and pinch) at baseline and at one week, five and nine weeks after injection. SPADI, VNS, PROM, and hand power improved in one week, five and nine weeks in both groups. Statistically significant differences were not observed in SPADI, VNS, PROM, or hand power between groups. Ultrasonography-guided capsular distension by a posterolateral approach has similar effects to fluoroscopy-guided capsular distension by an anterior approach.

  4. Randomized Controlled Trial for Efficacy of Capsular Distension for Adhesive Capsulitis: Fluoroscopy-Guided Anterior Versus Ultrasonography-Guided Posterolateral Approach (United States)

    Bae, Jae Hyun; Chang, Hyun Jung; Kim, Min Jung; Park, Kang Young; Jin, Seung Hwan; Lee, Eun Hee


    Objective To find the most effective procedure to treat adhesive capsulitis of the shoulder, we evaluated the clinical effects of an ultrasonographic-guided anterior approach capsular distension and a fluoroscopy-guided posterolateral approach capsular distension. We expected the anterior approach to be better than the posterolateral approach because the rotator interval, a triangular anatomic area in the anterosuperior aspect of the shoulder, which is considered an important component of the pathology of adhesive capsulitis. Methods Participants were randomly assigned to two groups: 27 patients in group A were injected by an anterior approach with 2% lidocaine (5 mL), contrast dye (5 mL), triamcinolone (40 mg), and normal saline (9 mL) under fluoroscopic guidance in the operating room. Twenty-seven patients in group B were injected using a posterolateral approach with 2% lidocaine (5 mL), triamcinolone (40 mg), and normal saline (14 mL) under ultrasonographic guidance. After injection, all patients received physiotherapy four times in the first postoperative week and then two times each week for eight more weeks. Treatment effects were assessed using the shoulder pain and disability index (SPADI), visual numeric scale (VNS), passive range of motion (PROM), hand power (grip and pinch) at baseline and at one week, five and nine weeks after injection. Results SPADI, VNS, PROM, and hand power improved in one week, five and nine weeks in both groups. Statistically significant differences were not observed in SPADI, VNS, PROM, or hand power between groups. Conclusion Ultrasonography-guided capsular distension by a posterolateral approach has similar effects to fluoroscopy-guided capsular distension by an anterior approach. PMID:25024960

  5. Local effect of zoledronic acid on new bone formation in posterolateral spinal fusion with demineralized bone matrix in a murine model. (United States)

    Zwolak, Pawel; Farei-Campagna, Jan; Jentzsch, Thorsten; von Rechenberg, Brigitte; Werner, Clément M


    Posterolateral spinal fusion is a common orthopaedic surgery performed to treat degenerative and traumatic deformities of the spinal column. In posteriolateral spinal fusion, different osteoinductive demineralized bone matrix products have been previously investigated. We evaluated the effect of locally applied zoledronic acid in combination with commercially available demineralized bone matrix putty on new bone formation in posterolateral spinal fusion in a murine in vivo model. A posterolateral sacral spine fusion in murine model was used to evaluate the new bone formation. We used the sacral spine fusion model to model the clinical situation in which a bone graft or demineralized bone matrix is applied after dorsal instrumentation of the spine. In our study, group 1 received decortications only (n = 10), group 2 received decortication, and absorbable collagen sponge carrier, group 3 received decortication and absorbable collagen sponge carrier with zoledronic acid in dose 10 µg, group 4 received demineralized bone matrix putty (DBM putty) plus decortication (n = 10), and group 5 received DBM putty, decortication and locally applied zoledronic acid in dose 10 µg. Imaging was performed using MicroCT for new bone formation assessment. Also, murine spines were harvested for histopathological analysis 10 weeks after surgery. The surgery performed through midline posterior approach was reproducible. In group with decortication alone there was no new bone formation. Application of demineralized bone matrix putty alone produced new bone formation which bridged the S1-S4 laminae. Local application of zoledronic acid to demineralized bone matrix putty resulted in significant increase of new bone formation as compared to demineralized bone matrix putty group alone. A single local application of zoledronic acid with DBM putty during posterolateral fusion in sacral murine spine model increased significantly new bone formation in situ in our model. Therefore, our

  6. Surgical outcome of posterior decompression, posterolateral fusion and stabilization by pedicle screw and rod in thoracolumbar tuberculosis

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    Md. Anowarul Islam


    Full Text Available Spinal tuberculosis causes severe complications like neurological and spinal deformity which may lead to respiratory distress, costo-pelvic impingement, paraplegia and consequent reduction in the quality and longevity of life. The aim of the present treatment is to avoid the consequence of neural complications and gain near-normal spine. Mechanical factor causes pathological fracture or dislocation of an affected vertebral body. Surgical decompression ensues further instability. Reconstruction of spinal column by pedicle screw and rod provide stability and prevents secondary neural damage and deformity thereby helps in early mobilization. Prospective study was done to evaluate the results in 20 cases of spinal tuberculosis in thoracolumbar region associated with neurological deficit. We operated our cases (12 males and 8 females by posterolateral decompression, fusion and stabilization by pedicle screw and rod along with antitubercular drug treatment. All patients were with neurological deficit, single level involvement and 10 to 30 degree of mild kyphosis. After surgery, kyphosis improved from 20.7 ± 5.5 degrees to 12.5 ± 3.9 degree. Bony fusion was in 65.0% cases. Neurological improvement and pain subsided in all the patients.

  7. rhBMP-2 (ACS and CRM formulations) overcomes pseudarthrosis in a New Zealand white rabbit posterolateral fusion model. (United States)

    Lawrence, James P; Waked, Walid; Gillon, Thomas J; White, Andrew P; Spock, Christopher R; Biswas, Debdut; Rosenberger, Patricia; Troiano, Nancy; Albert, Todd J; Grauer, Jonathan N


    The study design consisted of a New Zealand white rabbit model of pseudarthrosis repair. Study groups consisting of no graft, autograft, or recombinant human bone morphogenetic protein-2 (rhBMP-2) with absorbable collagen sponge (ACS) or compression resistant matrix (CRM) were evaluated. To evaluate the relative efficacy of bone graft materials (autograft, ACS, and CRM). rhBMP-2 has been shown to have a 100% fusion rate in a primary rabbit fusion model, even in the presence of nicotine, which is known to inhibit fusion. Seventy-two New Zealand white rabbits underwent posterolateral lumbar fusion with iliac crest autograft. To establish pseudarthroses, nicotine was administered to all animals. At 5 weeks, the spines were explored and all pseudarthroses were redecorticated and implanted with no graft, autograft, rhBMP-2/ACS, or rhBMP-2/CRM. At 10 weeks, fusions were assessed by manual palpation and histology. Eight rabbits (11%) were lost to complications. At 5 weeks, 66 (97%) had pseudarthroses. At 10 weeks, attempted pseudarthrosis repairs were fused in 1 of 16 of no graft rabbits (6%), 5 of 17 autograft rabbits (29%), and 31 of 31 rhBMP-2 rabbits (with ACS or CRM) (100%). Histologic analysis demonstrated more mature bone formation in the rhBMP-2 groups. The 2 rhBMP-2 formulations led to significantly higher fusion rates and histologic bone formation than no graft and autograft controls in this pseudarthrosis repair model.

  8. Posterior lumbar interbody fusion and posterolateral fusion: Analogous procedures in decreasing the index of disability in patients with spondylolisthesis. (United States)

    Alijani, Babak; Emamhadi, Mohamahreza; Behzadnia, Hamid; Aramnia, Ali; Chabok, Shahrokh Yousefzadeh; Ramtinfar, Sara; Leili, Ehsan Kazemnejad; Golmohamadi, Shabnam


    The purpose of this study was to evaluate the disability in patients with spondylolisthesis who assigned either to posterolateral fusion (PLF) or posterior lumbar interbody fusion (PLIF) and to compare it between two groups. In a prospective observational study, 102 surgical candidates with low-grade degenerative and isthmic spondylolisthesis enrolled from 2012 to 2014, and randomly assigned into two groups: PLF and PLIF. Evaluation of disability has been done by a questionnaire using Oswestry Disability Index (ODI). The questionnaire was completed by all patients before the surgery, the day after surgery, after 6 months and after 1-year. There were no statistically significant differences in terms of age and sex distribution and pre-operation ODI between groups (P > 0.05). Comparison of the mean ODI scores of two groups over the whole study period showed no significant statistical difference (P = 0.074). ODIs also showed no significant differences between two groups the day after surgery, 6(th) months and 1-year after surgery (P = 0.385, P = 0.093, P = 0.122 and P = 433) respectively. Analyzing the course of ODI over the study period, showed a significant descending pattern for either of groups (P disability of patients with spondylolisthesis, and none of the fusion techniques were related to a better outcome in terms of disability.

  9. MR imaging of meniscal cysts: evaluation of location and extension using a three-layer approach

    International Nuclear Information System (INIS)

    Maeseneer, Michel de; Shahabpour, Maryam; Vanderdood, Kurt; Machiels, Freddy; Ridder, Filip de; Osteaux, Michel


    Purpose: To analyze the extension of medial and lateral meniscal cysts relative to the capuloligamentous planes of the knee. Materials and methods: The MR images of 32 patients with meniscal cysts were reviewed. The location and extension of the meniscal cysts with reference to the capsule and ligaments were recorded. Results: Most medial meniscal cysts were located posteromedially. Posteromedial meniscal cysts usually penetrated the capsule and were located between layer I and the fused layers II+III. From this site some extended anteriorly and then became located superficial to the superficial MCL. The location of lateral meniscal cysts was more varied. Anteriorly the cysts were located deep to the iliotibial band, whereas posterolateral cysts were located deep to the lateral collateral ligament. Conclusion: Although the site of capsular penetration of meniscal cysts is determined by the location of meniscal tears, the possible pathways of extension appear to be determined by the capsuloligamentous planes of the knee

  10. Abordagem cirúrgica posterior e posterolateral para neurinomas cervicais em ampulheta da raiz de C2 Posterior y posterolateral enfoque quirúrgico para los neurinomas de la raíz cervical C2 Posterior and posterior-lateral surgical approach for C2 hourglass-shaped cervical neurinomas

    Directory of Open Access Journals (Sweden)

    Asdrubal Falavigna


    Full Text Available OBJETIVO: os autores relatam a experiência cirúrgica de 11 neurinomas em ampulheta de C2 comparando à via de acesso posterior com a posterolateral. MÉTODOS: onze pacientes com neurinomas em ampulheta de raiz cervical de C2 foram tratados cirurgicamente. A via de acesso utilizada para a remoção dos tumores foi a abordagem posterior em sete pacientes, e a posterolateral em quatro pacientes. RESULTADOS: houve predominância do sexo feminino (n=6 e a média de idade foi de 55,9±8,16 anos. O tempo médio de sintoma até o diagnóstico foi de 16,3 meses (±8,02 meses. Houve ressecção completa do tumor em todos os pacientes. O tempo cirúrgico médio na abordagem posterior foi de 180 minutos (±39,15 e de 192 minutos (±22,17 pela via posterolateral (p=0,52. Não houve diferença estatisticamente significativa entre as abordagens em relação ao sangramento transoperatório (posterior: 70,71±16,93; posterolateral: 65,00±24,15; p=0,64. Ocorreu uma complicação com a via de acesso posterior ligada à presença de uma fístula de líquor, sendo necessária nova intervenção e reconstrução da dura-máter utilizando a fáscia lata. CONCLUSÃO: a retirada completa do tumor em ampulheta da raiz de C2 é possível através das abordagens posterior e posterolateral, entretanto, a abordagem posterior é preferível por ser a via de acesso mais familiar ao cirurgião.OBJETIVO: os autores describen la experiencia quirúrgica de 11 neurinomas en reloj de arena de la raíz de C2 comparando el camino de acceso posterior y el postero-lateral. MÉTODOS: se trataron con cirugía 11 pacientes con neurinoma en reloj de arena de raíz cervical de C2. El camino de acceso utilizado para la retirada de los tumores fue la aproximación posterior en siete pacientes, y la aproximación postero-lateral, en 4. RESULTADOS: hubo predominio del sexo femenino (n=6, siendo la edad promedio de 55,9 ± 8,16 años. El tiempo medio de los síntomas hasta su diagnóstico fue

  11. Posterolateral fusion (PLF) versus transforaminal lumbar interbody fusion (TLIF) for spondylolisthesis: a systematic review and meta-analysis. (United States)

    Levin, Jay M; Tanenbaum, Joseph E; Steinmetz, Michael P; Mroz, Thomas E; Overley, Samuel C


    Lumbar fusion is an effective and durable treatment for symptomatic lumbar spondylolisthesis; however, the current literature provides insufficient evidence to recommend an optimal surgical fusion strategy. The present study aims to compare the clinical outcomes, fusion rates, blood loss, and operative times between open posterolateral lumbar fusion (PLF) alone and open transforaminal lumbar interbody fusion (TLIF) + posterolateral fusion for spondylolisthesis. This is a systematic literature review and meta-analysis of English language studies for the treatment of spondylolisthesis with PLF versus PLF + TLIF. Data were obtained from published randomized controlled trials (RCTs) and retrospective cohort studies. Clinical outcomes included Oswestry Disability Index (ODI), back pain, leg pain, and health-related quality of life (HRQOL) scores. Fusion rate, operative time, blood loss, and infection rate were also assessed. A literature search of three electronic databases was performed to identify investigations performed comparing PLF alone with PLF + TLIF for treatment of low-grade lumbar spondylolisthesis. The summary effect size was assessed from pooling observational studies for each of the outcome variables, with odds ratios (ORs) used for fusion and infection rate, mean difference used for improvement in ODI and leg pain as well as operative time and blood loss, and standardized mean difference used for improvement in back pain and HRQOL outcomes. Studies were weighed based on the inverse of the variance and heterogeneity. Heterogeneity was assessed using the I 2 -an estimate of the error caused by between-study variation. Effect sizes from the meta-analysis were then compared with data from the RCTs to assess congruence in outcomes. The initial literature search yielded 282 unique, English language studies. Seven were determined to meet our inclusion criteria and were included in our qualitative analysis. Five observational studies were included in

  12. [Comparison of the effects of total hip arthroplasty via direct anterior approach and posterolateral piriformis-sparing approach]. (United States)

    Xu, J; Zhuang, W D; Li, X W; Yu, G Y; Lin, Y; Luo, F Q; Xiao, Y H


    To compare the clinical effects of direct anterior approach (DAA) and posterolateral piriformis-sparing approach (Mis-PLA) for minimally invasive surgery of total hip arthroplasty. The patients who had total hip arthroplasty from March 2015 to February 2016 were randomly divided into 2 groups: DAA group and Mis-PLA group. In the study, 43 patients (45 hips) were performed with total hip replacement via the direct anterior approach (DAA group). As comparison, 39 patients (42 hips) were performed with total hip replacement via the posterolateral piriformis-sparing approach (Mis-PLA group) at the same period. DAA group: 27 male patients (27 hips), and 16 female patients (18 hips), with an average age of (57.4±7.3) years, preoperative Harris score (41.4±8.7), body mass index (BMI) (24.3±2.2) kg/m 2 ; Mis-PLA group: 25 male patients (26 hips), 14 female patients (16 hips), with an average age of (59.2±7.3) years, preoperative Harris score (39.6±8.4), BMI (24.7±2.5) kg/m 2 . The length of incision, operation time, blood loss, postoperative Harris score were observed and specially the hip functional recovery was fully assessed. (1) All the incisions healed by first intention. No complications were found in both groups. The length of incision:DAA group: (9.2±0.7) cm and Mis-PLA group: (9.5±0.6) cm. No statistical significant differences were found (P=0.053). The operation time:DAA group (74.3±10.1) min and Mis-PLA group (37.5±4.3) min, which showed statistically significant differences (Pgroup (229.6±79.2) mL and Mis-PLA group (215.7±56.0) mL. No statistical significant differences were found (P=0.366). (2) The patients in both groups were followed up for 6-12 months. The Harris hip scores for 6 weeks' follow-up: (85.5±4.1) in DAA group and (79.0±4.4) in Mis-PLA group, which indicated statistically significant differences (Pgroup and (95.2±1.9) in Mis-PLA group. No statistically significant differences were found (P=0.125). The basic daily hip function

  13. Comparison of Early Functional Recovery After Total Hip Arthroplasty Using a Direct Anterior or Posterolateral Approach: A Randomized Controlled Trial. (United States)

    Zhao, Hai-Yan; Kang, Peng-De; Xia, Ya-Yi; Shi, Xiao-Jun; Nie, Yong; Pei, Fu-Xing


    Controversy exists as to whether early functional outcomes differ after total hip arthroplasty performed using the direct anterior approach (DAA) or the posterolateral approach (PLA). One hundred twenty patients were enrolled in this study and were divided into 2 groups based on surgical approach. Group A included patients who had a total hip arthroplasty with a DAA, whereas group B included those with a PLA. Patients were randomized into the DAA or PLA groups (n = 60), and perioperative and postoperative outcomes were recorded. When compared with the PLA, the DAA had a shorter incision length (9.1 vs 13.1 cm; P group. However, the PLA had shorter operative times (65.5 vs 83.3 min, P = .03) and less intraoperative blood loss (123.8 vs 165.9 mL, P = .04). The DAA had significantly lower variance in cup inclination and anteversion. Similar rates of intraoperative complications were identified in the 2 groups. The DAA was associated with better functional recovery at 3 months based on the Harris hip score, University of California Los Angeles activity score, and gait analysis; however, functional recovery at 6 months was similar between the 2 groups. We found functional advantages in early recovery after the DAA compared with the PLA. The DAA can offer rapid functional recovery with less muscle damage, greater pain relief, and lower variance in cup inclination and anteversion. However, no functional difference was found at 6 months follow-up. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Finite Element Analysis of the Biomechanical Effects of 3 Posterolateral Corner Reconstruction Techniques for the Knee Joint. (United States)

    Kang, Kyoung-Tak; Koh, Yong-Gon; Son, Juhyun; Kim, Sung-Jae; Choi, Sungryul; Jung, Moonki; Kim, Sung-Hwan


    To compare the forces exerted on the cruciate ligaments and the contact stresses on the tibiofemoral (TF) and patellofemoral (PF) joints with respect to 3 different tibial- and fibular-based posterolateral corner (PLC) reconstructions under dynamic loading conditions. A subject-specific finite element knee model was developed by using 3-dimensional anatomic data from motion captures in gait and squat activities, including in vivo knee joint kinematics and muscle forces for the single subject. Cruciate ligament forces and contact stresses on the TF and PF joints under 3 PLC reconstruction techniques (tibial-based, TBR; modified fibular-based, mFBR; conventional fibular-based, cFBR) and PLC-deficient models were compared with those of the intact model in gait and squat loading conditions. The cruciate ligament forces in the 3 surgical models differed from those in the intact model. The greatest differences in ligament forces from the intact model were found in the cFBR model, whereas there were no remarkable differences between the TBR and mFBR models in both gait and squat loading conditions. Contact stresses on the lateral TF and PF joints of the 3 surgical models were greater than those of the intact model under the squat loading condition. The biomechanical effects achieved using the anatomic reconstruction technique were found to be improved compared with those using nonanatomic reconstruction techniques. However, the ligament forces and contact stresses under normal conditions could not be restored through any of the 3 techniques. Anatomic TBR and FBR for grade III PLC injuries could restore better biomechanics in the knee joint compared with nonanatomic reconstruction. However, discrepancy with the normal condition requires further modification of surgical techniques. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  15. BWR operation for life extension

    International Nuclear Information System (INIS)

    Stancavage, P.


    Most nuclear power plant life extension studies conducted to date focus on the technology, licensing, and economics of extended service life. The most significant factor in plant longevity, however, is proper operation and maintenance. This paper highlights the benefits of boiling water reactor (BWR) operation for life extension and discusses specific recommendations that will enhance the prospects for safe, reliable, and economic power production in the long term. The benefits of BWR operation for life extension include a lower cost of electric energy production, increased capacity and availability factors, a lower forced outage rate, and reduced occupational exposure to radiation. Operating experience and advanced in technology have provided a wealth of knowledge that can be used to develop specific recommendations for adding years to the expected life of BWR plants. This paper discusses key factors in operation for life extension

  16. Comparison of functional outcomes following surgical decompression and posterolateral instrumented fusion in single level low grade lumbar degenerative versus isthmic spondylolisthesis. (United States)

    Omidi-Kashani, Farzad; Hasankhani, Ebrahim Ghayem; Rahimi, Mohammad Dawood; Khanzadeh, Reza


    The two most common types of surgically treated lumbar spondylolisthesis in adults include the degenerative and isthmic types. The aim of this study was to compare the functional outcomes of surgical decompression and posterolateral instrumented fusion in patients with lumbar degenerative and isthmic spondylolisthesis. In this retrospective study, we reviewed the clinical outcomes in surgically treated patients with single level, low grade lumbar degenerative, and isthmic spondylolisthesis (groups A and B, respectively) from August 2007 to April 2011. We tried to compare paired settings with similar initial conditions. Group A included 52 patients with a mean age of 49.2 ± 6.1 years, and group B included 52 patients with a mean age of 47.3 ± 7.4 years. Minimum follow-up was 24 months. The surgical procedure comprised neural decompression and posterolateral instrumented fusion. Pain and disability were assessed by a visual analog scale (VAS) and the Oswestry Disability Index (ODI), respectively. The Wilcoxon and Mann-Whitney U-tests were used to compare indices. The most common sites for degenerative and isthmic spondylolisthesis were at the L4-L5 (88.5%) and L5-S1 (84.6%) levels, respectively. Surgery in both groups significantly improved VAS and ODI scores. The efficacy of surgery based on subjective satisfaction rate and pain and disability improvement was similar in the degenerative and isthmic groups. Notable complications were also comparable in both groups. Neural decompression and posterolateral instrumented fusion significantly improved pain and disability in patients with degenerative and isthmic spondylolisthesis. The efficacy of surgery for overall subjective satisfaction rate and pain and disability improvement was similar in both groups.

  17. [Histologic and biomechanic evaluation of posterolateral arthrodesis using a biphasic ceramic of calcium phosphate as bone substitute. Experimental study with sheep]. (United States)

    Guigui, P; Hardouin, P


    The effectiveness of a macroporous biphasic calcium phosphate ceramic was studied after laterovertebral arthrodesis in sheep. A ceramic with a TCP/HAP ratio of 35/65 was compared with autologous bone graft in an histomorphometric and biomechanical point of view. Quantitative analysis of the results indicated that the biphasic ceramic allows an arthrodesis after 12 months, although control graft is effective after six months. A large decrease of flexibility in all directions was obtained with the ceramic, similarly to autologous graft. No nonfusion case was observed. In conditions very close to the human surgery, a posterolateral fusion can be obtained using biphasic phosphate ceramic as bone substitute.

  18. Transforaminal lumbar interbody fusion vs. posterolateral instrumented fusion: cost-utility evaluation along side an RCT with a 2-year follow-up

    DEFF Research Database (Denmark)

    Christensen, Ann Demant; Hoy, K.; Bunger, C.


    -utility of transforaminal lumbar interbody fusion (TLIF) compared to posterolateral instrumented fusion (PLF) from the societal perspective. 100 Patients were randomized to TLIF or PLF (51/49) and followed for 2 years. Cost data were acquired from national registers, and outcomes were measured using the Oswestry Disability...... Index and SF-6D questionnaires. Conventional cost-effectiveness methodology was employed to estimate net benefit and to illustrate cost-effectiveness acceptability curves. The statistical analysis was based on means and bootstrapped confidence intervals. Results showed no statistically significant...

  19. Restoration of the spinopelvic sagittal balance in isthmic spondylolisthesis: posterior lumbar interbody fusion may be better than posterolateral fusion. (United States)

    Feng, Yu; Chen, Liang; Gu, Yong; Zhang, Zhi-Ming; Yang, Hui-Lin; Tang, Tian-Si


    More and more orthopedic surgeons recognize the importance of the sagittal balance of the spine. To analyze the pre- and postoperative sagittal and deformity parameters of low-grade isthmic spondylolisthesis and evaluate the effect of posterolateral fusion (PLF) and posterior lumbar interbody fusion (PLIF) on spinopelvic sagittal balance. Nonrandomized controlled prospective study with a historical control. A total of 99 patients with low-grade L5-S1 isthmic spondylolisthesis were treated surgically; 36 patients (mean age, 60.2±5.2 years) received the PLF operation, and 63 patients (mean age, 57.1±6.9 years) chose the PLIF operation. The healthy control group was composed of 60 volunteers (mean age, 44.5±8.4 years). The pre- and postoperative spinopelvic and deformity parameters. All patients had radiographs that allowed measurement of spinopelvic parameters before and after the operation. All the spinopelvic and deformity parameters were measured. Two radiologists measured the parameters with the Cobb method. All of the preoperative spinopelvic parameters showed no difference between the PLIF and PLF groups in this study (p>.05). In both of the operation groups, the preoperative pelvic incidence, pelvic tilt (PT), sacral slope, lumbar lordosis (LL), and L5 incidence (L5I) were significantly higher than in the control group (p.05). LL increased in the PLIF group and decreased in the PLF group. The slip degree (SD) and L5I were restored significantly in both groups. The HOD of the PLIF group increased 5.04 mm, the postoperative HOD of the PLF group had no significant change. In both PLIF and PLF groups, the correction of SD was correlated with the change of LL (r=-0.398, p=.007; r=0.365, p=.022). The restoration of HOD in the PLIF group correlated with the change of LL (r=0.334, p=.011). No significant differences could be found between the short-term clinical outcomes of the PLF and PLIF. Either PLF or PLIF would lead a great change in spinopelvic parameters and

  20. Incidence and MRI characterization of the spectrum of posterolateral corner injuries occurring in association with ACL rupture

    Energy Technology Data Exchange (ETDEWEB)

    Frois Temponi, Eduardo [Hospital Madre Teresa, Belo Horizonte, Minas Gerais (Brazil); Honorio de Carvalho, Lucio Jr. [Hospital Madre Teresa, Belo Horizonte, Minas Gerais (Brazil); Universidade Federal de Minas Gerais, Departamento do Aparelho Locomotor, Faculdade de Medicina, Belo Horizonte, Minas Gerais (Brazil); Saithna, Adnan [Southport and Ormskirk Hospitals, Southport (United Kingdom); University of Liverpool, Department of Clinical Engineering, Liverpool (United Kingdom); Thaunat, Mathieu; Sonnery-Cottet, Bertrand [Centre Orthopedic Santy, FIFA Medical Center of Excellence, Ramsay-Generale de Sante, Hopital Prive Jean Mermoz, Lyon (France)


    To determine the incidence and MRI characteristics of the spectrum of posterolateral corner (PLC) injuries occurring in association with anterior cruciate ligament (ACL) rupture. We carried out a level IV, retrospective case series study. All patients clinically diagnosed with an ACL rupture between July 2015 and June 2016 who underwent MRI of the knee were included in the study. In addition to standard MRI knee reporting, emphasis was placed on identifying injury to the PLC and a description of involvement of these structures by two musculoskeletal radiologists. Association with PLC involvement was sought with concomitant injuries using correlation analysis and logistic regression. One hundred sixty-two patients with MRI following ACL rupture were evaluated. Thirty-two patients (19.7%) had an injury to at least one structure of the PLC, including the inferior popliteomeniscal fascicle (n = 28), arcuate ligament (n = 20), popliteus tendon (n = 20), superior popliteomeniscal fascicle (n = 18), lateral collateral ligament (n = 8), popliteofibular ligament (n = 7), biceps tendon (n = 4), iliotibial band (n = 3), and fabellofibular ligament (n = 1). Seventy-five percent of all patients with combined ACL and PLC injuries had bone contusions involving the lateral compartment of the knee. The presence of these contusions strongly correlated with superior popliteomeniscal fascicle lesions (p < 0.05). There was no correlation between injuries to other structures of the PLC and other intra-articular lesions. Missed injuries of the PLC lead to considerable morbidity. The relevance of this study is to highlight that these injuries occur more frequently than previously described and that an appropriate index of suspicion, clinical examination, and MRI are all required to reduce the risk of missed diagnoses. The results of this study support previous suggestions that the rate of concomitant PLC injury in the ACL-deficient knee is under-reported. The rate of combined injuries in

  1. Sociologists in Extension (United States)

    Christenson, James A.; And Others


    The article describes the work activities of the extension sociologist, the relative advantage and disadvantage of extension roles in relation to teaching/research roles, and the relevance of sociological training and research for extension work. (NQ)

  2. Fabella Syndrome as an Uncommon Cause of Posterolateral Knee Pain after Total Knee Arthroplasty: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Eriko Okano


    Full Text Available The fabella is a sesamoid bone that is located in the lateral head of the gastrocnemius muscle and has been identified on magnetic resonance imaging in 31% of Japanese people. In the present case, a 65-year-old woman experienced posterolateral knee pain, accompanied by a clicking “sound” during active knee flexion, after undergoing total knee arthroplasty for knee osteoarthritis. Eight months of conservative therapy failed to produce an improvement, with progressive osteoarthritic change of the fabella identified on plain radiography. Based on this evidence, a diagnosis of fabella syndrome was made and the patient underwent a fabellectomy. Fabellectomy provided immediate resolution of posterolateral knee pain and the clicking sound with knee flexion, with the patient remaining symptom-free 18 months after fabellectomy and with no limitations in knee function. Fabellectomy eliminated symptoms in all of five case reports that have been previously published and is regarded as an effective first choice for treating fabella syndrome after total knee arthroplasty.

  3. Trayectoria de los tornillos pediculares lumbares y sacros: Comparación entre el abordaje por linea media versus el abordaje posterolateral tipo wiltse (United States)

    Gagliardi, Martín; Guiroy, Alfredo; Molina, Federico Fernández; Fasano, Francisco; Ciancio, Alejandro Morales; Mezzadri, Juan José; Jalón, Pablo


    Resumen Objetivos: El objetivo de este estudio fue comparar, en fusiones lumbosacras cortas, el ángulo de convergencia de los tornillos pediculares entre el abordaje posterolateral tipo Wiltse y el abordaje mediano convencional. Método: Se revisaron en forma retrospectiva los controles en tomografía axial computada (TAC) de 76 tornillos pediculares lumbares y sacros colocados por vía posterior, mediante un abordaje mediano convencional (n: 38) o por vía posterolateral transmuscular tipo Wiltse (n: 38). Se incluyeron fusiones lumbosacras cortas desde L3 a S1, en pacientes adultos, con patología degenerativa. Se excluyeron los tornillos con una brecha ósea >4 mm en cualquier dirección, los casos con instrumentaciones pediculares previas y aquellos con curvas en el plano coronal mayores de 20°. Resultados: Considerando la totalidad de los implantes, el ángulo de convergencia fue de 23,3° (+/- 15,82). La angulación promedio, en el grupo AW, fue de 29,3° (+/- 9,72). En el grupo AC, el grado de convergencia de los implantes fue de 17,2° (+/- 10,58). Esta diferencia fue estadísticamente significativa (P trabajos prospectivos randomizados para determinar la misma. PMID:29142777

  4. [Morphometric characteristics of the asterion and the posterolateral surface of the skull: its relationship with dural venous sinuses and its neurosurgical importance]. (United States)

    Galindo-de León, Salvador; Hernández-Rodríguez, Alejandra Nohemí; Morales-Ávalos, Rodolfo; Theriot-Girón, María Del Carmen; Elizondo-Omaña, Rodrigo Enrique; Guzmán-López, Santos


    The knowledge of the location and morphometric of the lateral venous sinus (transverse and sigmoid), and their relationship with the asterion and other surface anatomical landmarks, it is imperative for posterolateral approaches to the posterior cranial fossa to avoid vascular structures injury and surgical complications. Determine an anatomical area security for a drill that allows entry into the posterior cranial fossa without damaging adjacent structures, and study the morphometric characteristics asterion, the lateral sinus and bony landmarks of the posterolateral surface of the skull. With a 1.3 mm drill drilled both sides of 88 dry skulls (176 hemicranias). The anatomical landmarks studied were the asterion, the apex of the mastoid process, spina suprameatal, the Frankfurt horizontal plane, the posterior root of the zygomatic arch, the external occipital protuberance and its relationship with the sinus transversus. The asterion type I prevails in 74.4% of the pieces. In 82.4% of the skulls asterion level is, sinus transversus in less than 12.5% and above this at 5.1%. With the data obtained from this and other research, the initial trephine should be placed below the 15 mm and 15 mm asterion post this to reduce the risk of injury from sinus transversus.

  5. Effect of Oxy133, an osteogenic oxysterol, on new bone formation in rat two-level posterolateral fusion model. (United States)

    Buser, Zorica; Drapeau, Susan; Stappenbeck, Frank; Pereira, Renata C; Parhami, Farhad; Wang, Jeffrey C


    The aim of our study was to determine the effect of Oxy133 and rhBMP2 on fusion rates and new bone formation in a rat posterolateral fusion (PLF) model. Furthermore, we examined whether Oxy133 could inhibit the adipogenesis that is often present in rhBMP2-induced fusions. Sixty-four male Lewis rats underwent two levels PLF (L3-L5). All animals were randomly divided into eight groups based on the test compound that they received: control (DMSO), low-dose rhBMP2 (0.5 µg), high-dose rhBMP2 (5 µg), low-dose Oxy133 (5 mg), high-dose Oxy133 (20 mg), low rhBMP2 + high Oxy133, high rhBMP2 + high Oxy133, and low rhBMP2 + low Oxy133. Fusion rates were assessed 8 weeks after surgery with manual palpation and plain radiographs. Bone parameters were measured using microCT. Histology was used to evaluate adipogenesis. No fusion was observed in the control group. Based on the manual palpation, 100% fusion was observed in all other groups except in the low-dose rhBMP2 group (69%). At 8 weeks based on X-rays, 100% fusion was observed in the following groups: high-dose rhBMP2, low-dose Oxy133, and low rhBMP2 + low Oxy133. In the other groups, the fusion rates were between 95 and 97%, except for the low rhBMP2 group (72%). We observed similar values in BV/TV ratio at L3-4 when Oxy133 groups were compared to rhBMP2 groups alone (44.62% in high-dose Oxy133 vs. 41.47% in high-dose rhBMP2 and 47.18% in low-dose Oxy133 vs. 54.98% in low-dose rhBMP2). Trabecular thickness was slightly lower in Oxy133 groups compared to rhBMP2 when comparing low- and high-dose groups from each group (118.44 µm for high-dose Oxy133 vs. 122.39 µm for high-dose rhBMP2 and 123.51 µm for low-dose Oxy133 vs. 135.74 µm for low-dose rhBMP2). At the same time, trabecular separation was lower in Oxy133 groups compared to rhBMP2 groups. Similar trends in bone parameters were observed at the L4-5 levels. Fusion masses with low- and high-dose Oxy133 had significantly less adipocytes than rhBMP2

  6. Comparison of three calcium phosphate bone graft substitutes from biomechanical, histological, and crystallographic perspectives using a rat posterolateral lumbar fusion model

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Ming-Hsien [Department of Biomedical Engineering, National Cheng Kung University, Tainan 701, Taiwan (China); Department of Orthopedics, Show-Chwan Memorial Hospital, Changhua 50544, Taiwan (China); Department of Orthopedic Surgery, Faculty of Medicine, National Yang-Ming University, Taipei 112, Taiwan (China); Lee, Pei-Yuan [Department of Biomedical Engineering, National Cheng Kung University, Tainan 701, Taiwan (China); Department of Orthopedics, Show-Chwan Memorial Hospital, Changhua 50544, Taiwan (China); Chen, Wen-Cheng, E-mail: [Department of Fiber and Composite Materials, College of Engineering, Feng Chia University, Taichung 40724, Taiwan (China); Hu, Jin-Jia, E-mail: [Department of Biomedical Engineering, National Cheng Kung University, Tainan 701, Taiwan (China); Medical Device Innovation Center, National Cheng Kung University, Tainan 701, Taiwan (China)


    This study evaluated the effectiveness of three calcium phosphate bone graft substitutes with different chemical compositions on spinal fusion using a rat posterolateral lumbar fusion model. Specifically, two recently developed non-dispersive tetracalcium phosphate/dicalcium phosphate anhydrous-based calcium phosphate cements (CPCs), namely a CPC consisting of equimolar amounts of the two compounds (nd-CPC) and a CPC consisting of a two-fold greater amount of dicalcium phosphate anhydrous (DCP-rich CPC), were compared with a commercial calcium phosphate bone graft (c-CPG) consisting of hydroxyapatite (60%) and β-tricalcium phosphate (40%). Single-level posterolateral lumbar fusion was performed at the L4–L5 vertebrae in fifteen adult rats (n = 5 for each group). Spinal fusion was evaluated with radiographs, manual palpation, mechanical testing, micro-CT, and histology 8 weeks post-surgery. In particular, the crystallographic phases in the three substitutes were identified before and 8 weeks after their implantation. Manual palpation revealed stable constructs in nearly all of the spine specimens. The stiffness and bending load of fused spines in the two CPC groups were comparable to those in the c-CPG group. The radiographs specifically revealed implant resorption and bone remodeling in the DCP-rich CPC group. Analysis of 3D micro-CT images revealed that the bone volume ratio in the DCP-rich CPC group was significantly greater than those in the nd-CPC and c-CPG groups. Histology showed that the DCP-rich CPC group exhibited the highest degree of bone regeneration and osseointegration. Notably, DCP-rich CPC led to a pronounced phase transformation, generating the greatest amount of poorly crystalline apatite among the three groups, which together with adequate resorption may explain the aforementioned positive findings. We therefore conclude that of the bone graft substitutes considered, DCP-rich CPC has the greatest potential to be used in spinal fusion

  7. Bone marrow-derived mesenchymal stem cells assembled with low-dose BMP-2 in a three-dimensional hybrid construct enhances posterolateral spinal fusion in syngeneic rats. (United States)

    Hu, Tao; Abbah, Sunny Akogwu; Toh, Soo Yein; Wang, Ming; Lam, Raymond Wing Moon; Naidu, Mathanapriya; Bhakta, Gajadhar; Cool, Simon M; Bhakoo, Kishore; Li, Jun; Goh, James Cho-Hong; Wong, Hee-Kit


    The combination of potent osteoinductive growth factor, functional osteoblastic cells, and osteoconductive materials to induce bone formation is a well-established concept in bone tissue engineering. However, supraphysiological dose of growth factor, such as recombinant human bone morphogenetic protein 2 (rhBMP-2), which is necessary in contemporary clinical application, have been reported to result in severe side effects. We hypothesize that the synergistic osteoinductive capacity of low-dose bone morphogenetic protein 2 (BMP-2) combined with undifferentiated bone marrow-derived stromal cells (BMSCs) is comparable to that of osteogenically differentiated BMSCs when used in a rodent model of posterolateral spinal fusion. A prospective study using a rodent model of posterolateral spinal fusion was carried out. Thirty-six syngeneic Fischer rats comprised the patient sample. Six groups of implants were evaluated as follows (n=6): (1) 10 µg BMP-2 with undifferentiated BMSCs; (2) 10 µg BMP-2 with osteogenic-differentiated BMSCs; (3) 2.5 µg BMP-2 with undifferentiated BMSCs; (4) 2.5 µg BMP-2 with osteogenic-differentiated BMSCs; (5) 0.5 µg BMP-2 with undifferentiated BMSCs; and (6) 0.5 µg BMP-2 with osteogenic-differentiated BMSCs. Optimal in vitro osteogenic differentiation of BMSCs was determined by quantitative real-time polymerase chain reaction (qRT-PCR) gene analysis whereas in vivo bone formation capacity was evaluated by manual palpation, micro-computed tomography, and histology. Rat BMSCs cultured in fibrin matrix that was loaded into the pores of medical-grade poly epsilon caprolactone tricalcium phosphate scaffolds differentiated toward osteogenic lineage by expressing osterix, runt-related transcription factor 2, and osteocalcium mRNA when supplemented with dexamethasone, ascorbic acid, and β-glycerophosphate. Whereas qRT-PCR revealed optimal increase in osteogenic genes expression after 7 days of in vitro culture, in vivo transplantation study showed

  8. Posterolateral instrumented fusion with and without transforaminal lumbar interbody fusion for the treatment of adult isthmic spondylolisthesis: A randomized clinical trial with 2-year follow-up

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Etemadifar


    Full Text Available Background: Spondylolisthesis is a common cause of surgery in patients with lower back pain. Although posterolateral fusion and pedicle screw fixation are a relatively common treatment method for the treatment of spondylolisthesis, controversy exists about the necessity of adding interbody fusion to posterolateral fusion. The aim of our study was to assess the functional disability, pain, and complications in patients with spondylolisthesis treated by posterolateral instrumented fusion (PLF with and without transforaminal lumbar interbody fusion (TLIF in a randomized clinical trial. Materials and Methods: From February 2007 to February 2011, 50 adult patients with spondylolisthesis were randomly assigned to be treated with PLF or PLF+TLIF techniques (25 patients in each group by a single surgeon. Back pain, leg pain, and disability were assessed before treatment and until 2 years after surgical treatment using visual analog scale (VAS and oswestry disability index (ODI. Patients were also evaluated for postoperative complications such as infection, neurological complications, and instrument failure. Results: All patients completed the 24 months of follow-up. Twenty patients were females and 30 were males. Average age of the patients was 53 ± 11 years for the PLF group and 51 ± 13 for the PLF + TLIF group. Back pain, leg pain, and disability score were significantly improved postoperatively compared to preoperative scores (P < 0.001. At 3 months of follow-up, there was no statistically significant difference in VAS score for back pain and leg pain in both groups; however, after 6 months and 1 year and 2 years follow-up, the reported scores for back pain and leg pain were significantly lower in the PLF+TLIF group (P < 0.05. The ODI score was also significantly lower in the PLF+TLIF group at 1 year and 2 years of follow-up (P < 0.05. One screw breakage and one superficial infection occurred in the PLF+TLIF group, which had no statistical

  9. Comparison of adjacent segment degeneration after successful posterolateral fusion with unilateral or bilateral pedicle screw instrumentation: a minimum 10-year follow-up. (United States)

    Kim, Tae-Hwan; Lee, Byung H; Moon, Seong-Hwan; Lee, Seung-Hwan; Lee, Hwan-Mo


    In the instrumented fusion, adjacent segment facet joint violation or impingement by pedicle screws is unavoidable especially in cephalad segment, despite taking specific intraoperative precautions in terms of surgical approach. In such circumstances, unlike its original purpose, unilateral pedicle screw instrumentation can contribute to reduce the degeneration of cephalad adjacent segment by preventing contralateral cephalad adjacent facet joint from the unavoidable injury by pedicle screw insertion. However, to our knowledge, no long-term follow-up study has compared adjacent segment degeneration (ASD) between unilateral and bilateral pedicle screw instrumented fusion. To compare ASD after successful posterolateral fusion using either unilateral or bilateral pedicle screw instrumentation for patients with lumbar spinal stenosis and/or Grade 1 spondylolisthesis. Retrospective case-control study. One hundred forty-seven patients who had undergone one- or two-level posterolateral fusion with unilateral or bilateral pedicle screw instrumentation for lumbar spinal stenosis with or without low-grade spondylolisthesis and achieved successful fusion, with a minimum 10-year follow-up. The occurrence of radiologic ASD, Oswestry disability index (ODI) scores, and revision rates. A total of 194 consecutive patients were contacted and encouraged to visit our hospital and to participate in our study. Radiologic ASD was evaluated at three motion segments: cephalad adjacent segment (first cephalad adjacent segment), one cephalad to cephalad adjacent segment (second cephalad adjacent segment), and caudal adjacent segment. Clinical outcomes were compared by ODI scores and revision rates. In total, 147 of 194 (75.8%) patients were available for at least 10 years of radiologic and clinical follow-up. Adjacent segment degeneration (in first cephalad or caudal adjacent segment) was noted in 55.9% (33 of 59 patients) of the unilateral group and 72.7% (64 of 88 patients) of the

  10. Retrospective analysis of extra-articular distal humerus shaft fractures treated with the use of pre-contoured lateral column metaphyseal LCP by triceps-sparing posterolateral approach

    Directory of Open Access Journals (Sweden)

    Yatinder Kharbanda


    Full Text Available Abstract Management of extra-articular distal humerus fractures presents a challenge to the treating surgeon due to the complex anatomy of the distal part of the humerus and complicated fracture morphology. Although surgical treatment has shown to provide a more stable reduction and alignment and predictable return to function, it has been associated with complications like iatrogenic radial nerve palsy, infection, non-union and Implant failure. We in the present series retrospectively analysed 20 patients with extra-articular distal humerus shaft fractures surgically treated using the extra-articular distal humeral locking plate approached by the triceps-sparing posterolateral approach. The outcome was assessed using the DASH score, range of motion at the elbow and the time to union. The mean time to radiographic fracture union was 12 weeks.

  11. Retrospective analysis of extra-articular distal humerus shaft fractures treated with the use of pre-contoured lateral column metaphyseal LCP by triceps-sparing posterolateral approach. (United States)

    Kharbanda, Yatinder; Tanwar, Yashwant Singh; Srivastava, Vishal; Birla, Vikas; Rajput, Ashok; Pandit, Ramsagar


    Management of extra-articular distal humerus fractures presents a challenge to the treating surgeon due to the complex anatomy of the distal part of the humerus and complicated fracture morphology. Although surgical treatment has shown to provide a more stable reduction and alignment and predictable return to function, it has been associated with complications like iatrogenic radial nerve palsy, infection, non-union and Implant failure. We in the present series retrospectively analysed 20 patients with extra-articular distal humerus shaft fractures surgically treated using the extra-articular distal humeral locking plate approached by the triceps-sparing posterolateral approach. The outcome was assessed using the DASH score, range of motion at the elbow and the time to union. The mean time to radiographic fracture union was 12 weeks.

  12. Randomized radiostereometric study comparing osteogenic protein-1 (BMP-7) and autograft bone in human noninstrumented posterolateral lumbar fusion: 2002 Volvo Award in clinical studies. (United States)

    Johnsson, Ragnar; Strömqvist, Björn; Aspenberg, Per


    Randomized efficacy trial comparing two types of noninstrumented posterolateral fusion between L5 and S1 in patients with L5 spondylolysis and vertebral slip less than 50%, as evaluated by radiostereometric analysis. To determine whether osteogenic protein-1 (BMP-7) in the OP-1 Implant yields better stabilizing bony fusion than autograft bone. Animal studies of osteoinductive proteins in noninstrumented posterolateral fusions have shown high fusion rates. No similar conclusive study on humans has been performed. For this study, 20 patients were randomized to fusion with either OP-1 Implant or autograft bone from the iliac crest, 10 in each group. The patients were instructed to keep the trunk straight for 5 months after surgery with the aid of a soft lumbar brace. At surgery 0.8-mm metallic markers were positioned in L5 and the sacrum, enabling radiostereometric follow-up analysis during 1 year. The three-dimensional vertebral movements, as measured by radiostereometric analysis induced by positional change from supine posture to standing and sitting, were calculated with an accuracy of 0.5 to 0.7 mm and 0.5 degrees to 2.0 degrees. Conventional radiography was added. No significant difference was noted between the radiostereometric and radiographic results of fusion with the OP-1 Implant and fusion with autograft bone. There was a significant relation between reduced vertebral movements and better bone formation. No adverse effects of the OP-1 Implant occurred. Persistent minor pain at the iliac crest was noticed in one patient. There was no significant difference between the two fusion versions. Thus, the OP-1 Implant did not yield better stabilizing bony fusion than autograft bone.

  13. Pseudo Algebraically Closed Extensions (United States)

    Bary-Soroker, Lior


    This PhD deals with the notion of pseudo algebraically closed (PAC) extensions of fields. It develops a group-theoretic machinery, based on a generalization of embedding problems, to study these extensions. Perhaps the main result is that although there are many PAC extensions, the Galois closure of a proper PAC extension is separably closed. The dissertation also contains the following subjects. The group theoretical counterpart of pseudo algebraically closed extensions, the so-called projective pairs. Applications to seemingly unrelated subjects, e.g., an analog of Dirichlet's theorem about primes in arithmetic progression for polynomial rings in one variable over infinite fields.

  14. OP-1 compared with iliac crest autograft in instrumented posterolateral fusion a randomized, multicenter non-inferiority trial

    NARCIS (Netherlands)

    Delawi, Diyar; Jacobs, Wilco; Van Susante, Job L C; Rillardon, Ludovic; Prestamburgo, Domenico; Specchia, Nicola; Gay, Emmanuel; Verschoor, Nico; Garcia-Fernandez, Carlos; Guerado, Enrique; Van Ufford, Henriette Quarles; Kruyt, Moyo C.; Dhert, Wouter J A; Cumhur Oner, F.


    Background: Spinal fusion with the use of autograft is a commonly performed procedure. However, harvesting of bone from the iliac crest is associated with complications. Bone morphogenetic proteins (BMPs) are extensively used as alternatives, often without sufficient evidence of safety and efficacy.

  15. OP-1 Compared with Iliac Crest Autograft in Instrumented Posterolateral Fusion : A Randomized, Multicenter Non-Inferiority Trial

    NARCIS (Netherlands)

    Delawi, Diyar; Jacobs, Wilco; van Susante, Job L C; Rillardon, Ludovic; Prestamburgo, Domenico; Specchia, Nicola; Gay, Emmanuel; Verschoor, Nico; Garcia-Fernandez, Carlos; Guerado, Enrique; Quarles van Ufford, Henriette; Kruyt, Moyo C; Dhert, Wouter J A; Oner, F Cumhur


    BACKGROUND: Spinal fusion with the use of autograft is a commonly performed procedure. However, harvesting of bone from the iliac crest is associated with complications. Bone morphogenetic proteins (BMPs) are extensively used as alternatives, often without sufficient evidence of safety and efficacy.

  16. Less extensive surgery compared to extensive surgery

    DEFF Research Database (Denmark)

    Lauszus, Finn F; Petersen, Astrid Christine; Neumann, Gudrun


    in postmenopausal women was associated with surgery including hysterectomy and bilateral oophorectomy (pcarcinoma was found 138 times (95% CI: 48, 275) more prevalent than the expected rate. CONCLUSION......: The survival of women was better in AGCT than in epithelial ovarian tumor. Age and type of surgery, besides stage, influenced survival. Total abdominal hysterectomy and bilateral salpingo-oophorectomy is the recommended treatment with advancing age. At younger age less extensive surgery was associated...

  17. Marketing Extension Needs for Sustainable Extension Practices ...

    African Journals Online (AJOL)

    However, Age (ƒÓ2 =39.33;ƒâ>0.05), religion (ƒÓ2 =2.752; ƒâ >0.05) and cassava association membership (ƒÓ2= 3.438, ƒâ>0.05) were not significant. Therefore, agricultural marketing techniques should be incorporated into agricultural extension delivery packages to ensure continuous farming practices and adoption of ...

  18. Use of recombinant human bone morphogenetic protein-2 to achieve posterolateral lumbar spine fusion in humans: a prospective, randomized clinical pilot trial: 2002 Volvo Award in clinical studies. (United States)

    Boden, Scott D; Kang, James; Sandhu, Harvinder; Heller, John G


    A prospective randomized clinical study was conducted. To determine whether the dose and carrier that were successful in rhesus monkeys could induce consistent radiographic spine fusion in humans. Preclinical studies have demonstrated that recombinant human bone morphogenetic protein-2 (rhBMP-2), an osteoinductive bone morphogenetic protein, is successful at generating spine fusion in rabbits and rhesus monkeys. For this study, 25 patients undergoing lumbar arthrodesis were randomized (1:2:2 ratio) based on the arthrodesis technique: autograft/Texas Scottish Rite Hospital (TSRH) pedicle screw instrumentation (n = 5), rhBMP-2/TSRH (n = 11), and rhBMP-2 only without internal fixation (n = 9). On each side, 20 mg of rhBMP-2 were delivered on a carrier consisting of 60% hydroxyapatite and 40% tricalcium phosphate granules (10 cm /side). The patients had single-level disc degeneration, Grade 1 or less spondylolisthesis, mechanical low back pain with or without leg pain, and at least 6 months failure of nonoperative treatment. All 25 patients were available for follow-up evaluation (mean, 17 months; range 12-27 months). The radiographic fusion rate was 40% (2/5) in the autograft/TSRH group and 100% (20/20) with rhBMP-2 group with or without TSRH internal fixation ( = 0.004). A statistically significant improvement in Oswestry score was seen at 6 weeks in the rhBMP-2 only group (-17.6; = 0.009), and at 3 months in the rhBMP-2/TSRH group (-17.0; = 0.003), but not until 6 months in the autograft/TSRH group (-17.3; = 0.041). At the final follow-up assessment, Oswestry improvement was greatest in the rhBMP-2 only group (-28.7, < 0.001). The SF-36 Pain Index and PCS subscales showed similar changes. This pilot study is the first with at least 1 year of follow-up evaluation to demonstrate successful posterolateral spine fusion using a BMP-based bone graft substitute, with radiographs and CT scans as the determinant. Consistently, rhBMP-2 was able to induce bone in the

  19. Efficacy comparison of Accell Evo3 and Grafton demineralized bone matrix putties against autologous bone in a rat posterolateral spine fusion model. (United States)

    Brecevich, Antonio T; Kiely, Paul D; Yoon, B Victor; Nguyen, Joseph T; Cammisa, Frank P; Abjornson, Celeste


    Spinal fusion procedures are intended to stabilize the spinal column for a multitude of disorders including abnormal curvature, traumatic instability, degenerative instability, and damage from infections or tumors. As an aid in the bone healing response, bone graft materials are used to bridge joints for arthrodesis and promote unions in pseudoarthrosis. Currently, the gold standard for stabilizing fusion masses in spinal procedures involves using the osteogenic, osteoinductive, and osteoconductive properties of autologous iliac crest corticocancellous bone. However, considerable morbidity is associated with harvesting the autologous graft. Donor site complications including infection, large hematomas, and pain have been reported at rates as high as 50% (Boden and Jeffrey, 1995). Biologically, the rate of bone repair dictates the rate at which the fusion mass will unite under autologous graft conditions. The purpose of this study is to compare the quality and rate of fusion between Accell Evo3 and Grafton demineralized bone matrix (DBM), with the gold standard iliac crest bone graft (ICBG) as the control, in athymic rat posterolateral fusion. This study was a randomized, controlled study in a laboratory setting at the Hospital for Special Surgery in New York City. Blinded observations were made, which created an assessment of outcomes for successful fusions between each method. Forty-eight (48) athymic rats were used in this study and underwent posterolateral lumbar fusion. They were assessed at either 3 weeks or 9 weeks to see the rate and efficacy of fusion. Outcome measures will be the efficacy of the different bone grafts and their success rates of fusion in the rats. A comparison of the quality and rate of fusion between Accell Evo3® (DBM A) and Grafton (DBM B), with the gold standard iliac crest bone graft (ICBG) as the control, was performed using the established posterolateral intertransverse process on an athymic rat model. Materials were evaluated for

  20. Priorities for Extension. (United States)

    Hayward, J. A.

    Agricultural extension is one component in an array including research, training, education, marketing, international trade, etc. which develop together to bring about growth, and sustained growth determines the priorities for extension. These priorities depend inevitably on the stage of development of a country or region, and on the current…

  1. Comparison of the osteogenesis and fusion rates between activin A/BMP-2 chimera (AB204) and rhBMP-2 in a beagle's posterolateral lumbar spine model. (United States)

    Zheng, Guang Bin; Yoon, Byung-Hak; Lee, Jae Hyup


    Activin A/BMP-2 chimera (AB204) could promote bone healing more effectively than recombinant bone morphogenetic protein 2 (rhBMP-2) with much lower dose in a rodent model, but there is no report about the effectiveness of AB204 in a large animal model. The purpose of this study was to compare the osteogenesis and fusion rate between AB204 and rhBMP-2 using biphasic calcium phosphate (BCP) as a carrier in a beagle's posterolateral lumbar fusion model. This is a randomized control animal study. Seventeen male beagle dogs were included. Bilateral posterolateral fusion was performed at the L1-L2 and L4-L5 levels. Biphasic calcium phosphate (2 cc), rhBMP-2 (50 µg)+BCP (2 cc), or AB204 (50 µg)+BCP (2 cc) were implanted into the intertransverse space randomly. X-ray was performed at 4 and 8 weeks. After 8 weeks, the animals were sacrificed, and new bone formation and fusion rate were evaluated by manual palpation, computed tomography (CT), and undecalcified histology. The AB204 group showed significantly higher fusion rate (90%) than the rhBMP-2 group (15%) or the Osteon group (6.3%) by manual palpation. On x-ray and CT assessment, fusion rate and the volume of newly formed bone were also significantly higher in AB204 group than other groups. In contrast, more osteolysis was found in rhBMP-2 group (40%) than in AB204 group (10%) on CT study. In histologic results, new bone formation was sufficient between transverse processes in AB204 group, and obvious trabeculation and bone remodeling were observed. But in rhBMP-2 group, new bone formation was less than AB204 group and osteolysis was observed between the intertransverse spaces. A low dose of AB204 with BCP as a carrier significantly promotes the fusion rate in a large animal model when compared with the rhBMP-2. These findings demonstrate that AB204 could be an alternative to rhBMP-2 to improve fusion rate. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Type extension trees

    DEFF Research Database (Denmark)

    Jaeger, Manfred


    We introduce type extension trees as a formal representation language for complex combinatorial features of relational data. Based on a very simple syntax this language provides a unified framework for expressing features as diverse as embedded subgraphs on the one hand, and marginal counts...... of attribute values on the other. We show by various examples how many existing relational data mining techniques can be expressed as the problem of constructing a type extension tree and a discriminant function....

  3. Spacetime extensions Pt. 1

    International Nuclear Information System (INIS)

    Racz, I.


    The problem of the existence of local extensions of spacetime is considered. It is shown that for a spacetime including an incomplete inextendible non-coiling causal geodesic curve there exists a particular C k (resp. C k- ) local extension provided that the curvature and its covariant derivatives are well behaved up to order k + 1 (resp. k) along a family of causal geodetics (around the chosen one). (R.P.) 15 refs

  4. Freeze-Dried Platelet-Rich Plasma Accelerates Bone Union with Adequate Rigidity in Posterolateral Lumbar Fusion Surgery Model in Rats (United States)

    Shiga, Yasuhiro; Orita, Sumihisa; Kubota, Go; Kamoda, Hiroto; Yamashita, Masaomi; Matsuura, Yusuke; Yamauchi, Kazuyo; Eguchi, Yawara; Suzuki, Miyako; Inage, Kazuhide; Sainoh, Takeshi; Sato, Jun; Fujimoto, Kazuki; Abe, Koki; Kanamoto, Hirohito; Inoue, Masahiro; Kinoshita, Hideyuki; Aoki, Yasuchika; Toyone, Tomoaki; Furuya, Takeo; Koda, Masao; Takahashi, Kazuhisa; Ohtori, Seiji


    Fresh platelet-rich plasma (PRP) accelerates bone union in rat model. However, fresh PRP has a short half-life. We suggested freeze-dried PRP (FD-PRP) prepared in advance and investigated its efficacy in vivo. Spinal posterolateral fusion was performed on 8-week-old male Sprague-Dawley rats divided into six groups based on the graft materials (n = 10 per group): sham control, artificial bone (A hydroxyapatite-collagen composite) -alone, autologous bone, artificial bone + fresh-PRP, artificial bone + FD-PRP preserved 8 weeks, and artificial bone + human recombinant bone morphogenetic protein 2 (BMP) as a positive control. At 4 and 8 weeks after the surgery, we investigated their bone union-related characteristics including amount of bone formation, histological characteristics of trabecular bone at remodeling site, and biomechanical strength on 3-point bending. Comparable radiological bone union was confirmed at 4 weeks after surgery in 80% of the FD-PRP groups, which was earlier than in other groups (p < 0.05). Histologically, the trabecular bone had thinner and more branches in the FD-PRP. Moreover, the biomechanical strength was comparable to that of autologous bone. FD-PRP accelerated bone union at a rate comparable to that of fresh PRP and BMP by remodeling the bone with thinner, more tangled, and rigid trabecular bone.

  5. Medium-term (5-year) comparison of the functional outcomes of combined anterior cruciate ligament and posterolateral corner reconstruction compared with isolated anterior cruciate ligament reconstruction. (United States)

    Cartwright-Terry, Matthew; Yates, Jonny; Tan, Chin K; Pengas, Ioannis P; Banks, Joanne V; McNicholas, Michael J


    To present a 5-year comparison of the functional outcomes of combined anterior cruciate ligament (ACL) and posterolateral corner (PLC) reconstruction with those of isolated ACL reconstruction. All patients were reviewed clinically and completed knee function questionnaires prospectively, by use of the International Knee Documentation Committee (IKDC) 2000, Knee Injury and Osteoarthritis Outcome Score (KOOS), and Lysholm scoring systems, preoperatively and at 1, 2, and 5 years postoperatively. Patients who underwent combined ACL-PLC reconstruction were identified and reviewed. These patients had intact lateral collateral ligaments. A comparison group was created from a group of patients who underwent isolated ACL reconstruction. The ACL group was selected to have the same profile with regard to age, sex, and meniscal procedure. There were 25 patients in the ACL-PLC group and 100 in the ACL group. All patients underwent restoration of their PLC function as shown on dial testing. The preoperative values for all KOOS measures and the Lysholm score were significantly lower in the ACL-PLC group than in the ACL group (P reconstruction. The KOOS for sport outcomes suggests that sports were resumed at lower functional levels. Level III, case-control study. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  6. Within patient radiological comparative analysis of the performance of two bone graft extenders utilized in posterolateral lumbar fusion: a retrospective case series

    Directory of Open Access Journals (Sweden)

    Geoffrey eStewart


    Full Text Available Two bone graft extenders differing in chemical composition were implanted contralaterally in 27 consecutive patients undergoing instrumented posterolateral lumbar fusion as standard of care. Bone marrow aspirate and autogenous bone graft were equally combined either with β-tricalcium phosphate (β-TCP or a hybrid biomaterial (containing hyaluronic acid but lacking a calcium salt and implanted between the transverse processes. Fusion status on each side of the vertebrae was retrospectively graded (1-5 scale on AP planar X-ray at multiple visits as available, through approximately month 12. Additionally, consolidation or resorption since prior visit for each treatment was recorded. Sides receiving β-TCP extender showed marked resorption prior to bone consolidation during the first 6 months. By contrast, sides receiving the hybrid biomaterial containing integrated hyaluronic acid showed rapid bone consolidation by week 6-8, with maintenance of initial bone volume through month 12. Fusion grade was superior for the hybrid biomaterial, differing significantly from β-TCP at day 109 and beyond. Fusion success at >month 12 was 92.9% vs 67.9% for the hybrid biomaterial and β-TCP-treated sides, respectively. The hybrid biomaterial extender demonstrated a shortened time to fusion compared to the calcium-based graft. Mode of action has been demonstrated in the literature to differ between these compositions. Therefore, choice of synthetic biomaterial composition may significantly influence mode of action of cellular events regulating appositional bone growth.

  7. Contribution of thin slice (1 mm) oblique coronal proton density-weighted MR images for assessment of anteromedial and posterolateral bundle damage in anterior cruciate ligament injuries

    Energy Technology Data Exchange (ETDEWEB)

    Gokalp, Gokhan, E-mail: [Department of Radiology, Uludag University Medical Faculty, Gorukle, Bursa (Turkey); Demirag, Burak, E-mail: [Department of Orthopedy, Uludag University Medical Faculty, Gorukle, Bursa (Turkey); Nas, Omer Fatih, E-mail: [Department of Radiology, Uludag University Medical Faculty, Gorukle, Bursa (Turkey); Aydemir, Mehmet Fatih, E-mail: [Department of Orthopedy, Uludag University Medical Faculty, Gorukle, Bursa (Turkey); Yazici, Zeynep, E-mail: [Department of Radiology, Uludag University Medical Faculty, Gorukle, Bursa (Turkey)


    Purpose: To evaluate the diagnostic efficacy of using additional oblique coronal 1 mm proton density-weighted (PDW) MR imaging of the knee for detection and grading anterior cruciate ligament (ACL), anteromedial bundle (AMB) and posterolateral bundle (PLB) injuries. Materials and methods: We prospectively assessed preoperative MR images of 50 patients (36 men, 14 women; age range, 18–62 years). First, we compared the diagnostic performance of routine sagittal (3 mm) and additional oblique coronal images (1 mm) for ACL tears. Then, we compared the tear types (AMB or PLB) and grade presumed from oblique coronal MR imaging with arthroscopy. Results: Arthroscopy revealed ACL tear in 24 (48%) patients. There was significant difference between sagittal images and arthroscopy results for ACL tear recognition (p < 0.001). No significant difference was detected for oblique coronal images when compared with arthroscopy results (p = 0.180). Sensitivity and specificity values for ACL tear diagnosis were 37.04% and 95.65% for sagittal images; 74.07% and 91.30% for oblique coronal images. There was no significant difference between arthroscopy and oblique coronal MR images in grading AMB and PLB injuries (p > 0.05). Conclusion: Addition of thin slice oblique coronal images to conventional sequences could better contribute to better verifying the presence of ACL tear and in determining its grade.

  8. Android Access Control Extension

    Directory of Open Access Journals (Sweden)

    Anton Baláž


    Full Text Available The main objective of this work is to analyze and extend security model of mobile devices running on Android OS. Provided security extension is a Linux kernel security module that allows the system administrator to restrict program's capabilities with per-program profiles. Profiles can allow capabilities like network access, raw socket access, and the permission to read, write, or execute files on matching paths. Module supplements the traditional Android capability access control model by providing mandatory access control (MAC based on path. This extension increases security of access to system objects in a device and allows creating security sandboxes per application.

  9. Homomorphisms between C∗ -algebra extensions

    Indian Academy of Sciences (India)

    C∗. -algebra extensions, Ext groups do not classify extension algebras. So one has to study the isomorphism equivalence of extensions. In fact, a homomorphism between two extension algebras may not map the essential ideal into the other in general, so we have to consider properties of extension homomorphisms.

  10. Mobile Applications for Extension (United States)

    Drill, Sabrina L.


    Mobile computing devices (smart phones, tablets, etc.) are rapidly becoming the dominant means of communication worldwide and are increasingly being used for scientific investigation. This technology can further our Extension mission by increasing our power for data collection, information dissemination, and informed decision-making. Mobile…

  11. Extensions of tempered representations

    NARCIS (Netherlands)

    Opdam, E.; Solleveld, M.


    Let π, π′ be irreducible tempered representations of an affine Hecke algebra H with positive parameters. We compute the higher extension groups Ext nH(π,π′) explicitly in terms of the representations of analytic R-groups corresponding to π and π′. The result has immediate applications to the

  12. Journal of Agricultural Extension

    African Journals Online (AJOL)

    Mission Statement The mission of the "Journal of Agricultural Extension" is to publish conceptual papers and empirical research that tests, extends, or builds ... Symbol recognition and interpretation of HIV/AIDS pictorial messages among rural women in Abia State Nigeria · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

  13. Posterior lumbar interbody fusion with instrumented posterolateral fusion in adult spondylolisthesis: description and association of clinico-surgical variables with prognosis in a series of 36 cases (United States)

    Gomez-Moreta, Juan A.; Hernandez-Vicente, Javier


    Background We present our experience in the treatment of patients with isthmic or degenerative spondylolisthesis, by means of a posterior lumbar interbody fusion (PLIF) and instrumented posterolateral fusion (IPLF), and we compare them with those published in the literature. We analyse whether there exists any statistical association between the clinical characteristics of the patient, radiological characteristics of the disease and our surgical technique, with the complications and the clinical-radiological prognosis of the cases. Method We designed a prospective study. A total of 36 cases were operated. The patients included were 14 men and 22 women, with an average age of 57.17±27.32 years. Our technique consists of PLIF+IPLF, using local bone for the fusion. The clinical results were evaluated with the Visual Analogical Scale (VAS) and the Kirkaldy-Willis criteria. The radiological evaluation followed the Bratingan (PLIF) and Lenke (IPLF) methodology. A total of 42 variables were statistically analysed by means of SPSS18. We used the Paired Student's T-test, logistic regression and Pearson's Chi-square-test. Results The spondylolisthesis was isthmic in 15 cases and degenerative in 21 cases. The postoperative evaluations had excellent or good results in 94.5% (n = 34), with a statistically significant improvement in the back pain and sciatica (p spondylolisthesis, isthmic or degenerative, refractory to conservative treatment, for the obtaining the best clinical results and rates of fusion, with similar risks to those of the other published techniques. Our statistical analysis could contribute to improve outcomes after surgery. PMID:26196029

  14. Outcomes of Revision Surgery Following Instrumented Posterolateral Fusion in Degenerative Lumbar Spinal Stenosis: A Comparative Analysis between Pseudarthrosis and Adjacent Segment Disease. (United States)

    Suh, Seung-Pyo; Jo, Young-Hoon; Jeong, Hae Won; Choi, Won Rak; Kang, Chang-Nam


    Retrospective study. We examined the clinical and radiological outcomes of patients who received revision surgery for pseudarthrosis or adjacent segment disease (ASD) following decompression and instrumented posterolateral fusion (PLF). At present, information regarding the outcomes of revision surgery for complications such as pseudarthrosis and ASD following instrumented PLF is limited. This study examined 60 patients who received PLF for degenerative lumbar spinal stenosis and subsequently developed pseudarthrosis or ASD leading to revision surgery. Subjects were divided into a group of 21 patients who received revision surgery for pseudarthrosis (Group P) and a group of 39 patients who received revision surgery for ASD (Group A). Clinical outcomes were evaluated using the visual analogue scales for back pain (VAS-BP) and leg pain (VAS-LP), the Korean Oswestry disability index (K-ODI), and each patient's subjective satisfaction. Radiological outcomes were evaluated from the extent of bone union, and complications in the two groups were compared. VAS-LP at final follow-up was not statistically different between the two groups ( p =0.353), although VAS-BP and K-ODI at final follow-up were significantly worse in Group P than in Group A (all p <0.05), and only 52% of the patients in Group P felt that their overall well-being had improved following revision surgery. Fusion rates after the first revision surgery were 71% (15/21) in Group P and 95% (37/39) in Group A ( p =0.018). The rate of reoperation was significantly higher in Group P (29%) than in Group A (5%) ( p =0.021) due to complications. Clinical and radiological outcomes were worse in patients who had received revision surgery for pseudarthrosis than in those who had revision surgery for ASD. Elderly patients should be carefully advised of the risks and benefits before planning revision surgery for pseudarthrosis.

  15. A comparative analysis of 7.0-Tesla magnetic resonance imaging and histology measurements of knee articular cartilage in a canine posterolateral knee injury model: a preliminary analysis. (United States)

    Pepin, Scott R; Griffith, Chad J; Wijdicks, Coen A; Goerke, Ute; McNulty, Margaret A; Parker, Josh B; Carlson, Cathy S; Ellermann, Jutta; LaPrade, Robert F


    There has recently been increased interest in the use of 7.0-T magnetic resonance imaging for evaluating articular cartilage degeneration and quantifying the progression of osteoarthritis. The purpose of this study was to evaluate articular cartilage cross-sectional area and maximum thickness in the medial compartment of intact and destabilized canine knees using 7.0-T magnetic resonance images and compare these results with those obtained from the corresponding histologic sections. Controlled laboratory study. Five canines had a surgically created unilateral grade III posterolateral knee injury that was followed for 6 months before euthanasia. The opposite, noninjured knee was used as a control. At necropsy, 3-dimensional gradient echo images of the medial tibial plateau of both knees were obtained using a 7.0-T magnetic resonance imaging scanner. Articular cartilage area and maximum thickness in this site were digitally measured on the magnetic resonance images. The proximal tibias were processed for routine histologic analysis with hematoxylin and eosin staining. Articular cartilage area and maximum thickness were measured in histologic sections corresponding to the sites of the magnetic resonance slices. The magnetic resonance imaging results revealed an increase in articular cartilage area and maximum thickness in surgical knees compared with control knees in all specimens; these changes were significant for both parameters (P .1). These results demonstrate that 7.0-T magnetic resonance imaging provides an alternative method to histology to evaluate early osteoarthritic changes in articular cartilage in a canine model by detecting increases in articular cartilage area. The noninvasive nature of 7.0-T magnetic resonance imaging will allow for in vivo monitoring of osteoarthritis progression and intervention in animal models and humans for osteoarthritis.

  16. Dimension and extensions

    CERN Document Server

    Aarts, JM


    Two types of seemingly unrelated extension problems are discussed in this book. Their common focus is a long-standing problem of Johannes de Groot, the main conjecture of which was recently resolved. As is true of many important conjectures, a wide range of mathematical investigations had developed, which have been grouped into the two extension problems. The first concerns the extending of spaces, the second concerns extending the theory of dimension by replacing the empty space with other spaces. The problem of de Groot concerned compactifications of spaces by means of an adjunction of a set of minimal dimension. This minimal dimension was called the compactness deficiency of a space. Early success in 1942 lead de Groot to invent a generalization of the dimension function, called the compactness degree of a space, with the hope that this function would internally characterize the compactness deficiency which is a topological invariant of a space that is externally defined by means of compact extensions of a...

  17. Traumatic C1-2 posterolateral dislocation with dens fracture, injury of the transverse atlantal ligament, and unilateral facet fracture with subluxation of C6-7: A case report. (United States)

    Park, Jong-Beom; Kang, Sung Shik; Yeom, Jin S


    Traumatic C1-2 dislocation associated with contiguous or noncontiguous cervical spine injury is rare. Moreover, there have been no reports describing traumatic C1-2 dislocation associated with multiple contiguous and noncontiguous cervical injuries. The authors present a case of a 20-year-old male with painful limitation of motion of the neck. This complex cervical injury occurred due to hyperextension of the head in a rotated position. The patient complained of neck pain that radiated to the left shoulder and arm, but he did not exhibit any neurological abnormalities. The diagnosis of the patients was traumatic C1-2 posterolateral dislocation associated with type II dens fracture (Anderson and D'Alonzo classification), type II injury of the transverse atlantal ligament (Dickman classification), and unilateral facet fracture with subluxation of C6-7. The C1-2 posterolateral dislocation with type II dens fracture was successfully reduced by skull traction. The patient underwent anterior discectomy, open reduction, and fusion with plate fixation of C6-7 followed by posterior segmental fixation and fusion of C1-2. At his postoperative 1-year follow-up, solid fusion was noted with improvement of clinical symptoms. This is the first report of traumatic C1-2 posterolateral dislocation associated with multiple C2 injuries and noncontiguous subaxial cervical injury. A high index of suspicion and careful evaluation of entire cervical spine should be considered as the key to the proper diagnosis and treatment of traumatic C1-2 dislocation associated with contiguous and noncontiguous cervical injuries.

  18. 1997 Volvo Award winner in clinical studies. The effect of pedicle screw instrumentation on functional outcome and fusion rates in posterolateral lumbar spinal fusion: a prospective, randomized clinical study. (United States)

    Thomsen, K; Christensen, F B; Eiskjaer, S P; Hansen, E S; Fruensgaard, S; Bünger, C E


    A prospective randomized clinical study. To evaluate supplementary pedicle screw fixation (Cotrel-Dubousset) in posterolateral lumbar spinal fusion. The rationale behind lumbar fusion is to eliminate pathologic motion to relieve pain. To improve fusion rates and to allow reduction, a rigid transpedicular screw fixation may be beneficial, but the positive effect of this may be counter-balanced by an increase in complications. The inclusion criteria were severe, chronic low back pain from spondylolisthesis Grades 1 and 2 or from primary or secondary degenerative segmental instability. One hundred thirty patients were randomly allocated to receive no instrumentation (n = 66) or Cotrel-Dubousset instrumentation (n = 64) in posterolateral lumbar fusion. Variables were registered at the time of surgery and at 1 and 2 years after surgery. Follow-up was achieved in 97.7% of the patients. Fusion rates deduced from plain radiographs were not significantly different between instrumented and noninstrumented groups. The functional outcome assessed by the Dallas Pain Questionnaire improved significantly in both groups, and there were no significant differences in results between the two groups, except for significantly better (P < 0.06) functional outcome in relation to daily activities in the instrumented group when neural decompression had been performed. The global patients' satisfaction was 82% in the instrumented group versus 74% in the noninstrumented group (not significant). Fixation of instrumentation increased operation time, blood loss, and early reoperation rate significantly. Patients experienced only a few minor postoperative complications; none were major. Two infections appeared in the Cotrel-Dubousset group. Significant symptoms from misplacement of pedicle screws were seen in 4.8% of the instrumented patients. Lumbar posterolateral fusion with pedicle screw fixation increases the operation time, blood loss, and reoperation rate, and leads to a significant risk

  19. Extensive air showers

    CERN Document Server

    Rao, M V S


    Ultrahigh energy cosmic rays carry information about their sources and the intervening medium apart from providing a beam of particles for studying certain features of high energy interactions currently inaccessible at man-made accelerators. They can at present be studied only via the extensive air showers (EAS's) they generate while passing through the Earth's atmosphere, since their fluxes are too low for the experiments of limited capability flown in balloons and satellites. The EAS is generated by a series of interactions of the primary cosmic ray and its progeny with the atmospheric nucle

  20. Selecting Extensive Reading Materials

    Directory of Open Access Journals (Sweden)

    George M Jacobs


    Full Text Available This article offers guidance to teachers and students in selecting materials for extensive reading (ER. First, the article explains characteristics of ER and reviews some of the potential gains for students who do ER. Second, the article considers criteria for teachers to bear in mind when selecting ER materials. Third, the article then suggests ways that teachers and students can find ER materials. Fourth, guidance is provided to students for when they select what to read from among the ER materials available to them. Finally, advice is given on integrating ER with course textbooks.

  1. Continuous multivariate exponential extension

    International Nuclear Information System (INIS)

    Block, H.W.


    The Freund-Weinman multivariate exponential extension is generalized to the case of nonidentically distributed marginal distributions. A fatal shock model is given for the resulting distribution. Results in the bivariate case and the concept of constant multivariate hazard rate lead to a continuous distribution related to the multivariate exponential distribution (MVE) of Marshall and Olkin. This distribution is shown to be a special case of the extended Freund-Weinman distribution. A generalization of the bivariate model of Proschan and Sullo leads to a distribution which contains both the extended Freund-Weinman distribution and the MVE

  2. Exposure Forecaster (United States)

    U.S. Environmental Protection Agency — The Exposure Forecaster Database (ExpoCastDB) is EPA's database for aggregating chemical exposure information and can be used to help with chemical exposure...

  3. Efficacy of Escherichia coli-derived recombinant human bone morphogenetic protein-2 in posterolateral lumbar fusion: an open, active-controlled, randomized, multicenter trial. (United States)

    Cho, Jae Hwan; Lee, Jae Hyup; Yeom, Jin Sup; Chang, Bong-Soon; Yang, Jae Jun; Koo, Ki Hyoung; Hwang, Chang Ju; Lee, Kwang Bok; Kim, Ho-Joong; Lee, Choon-Ki; Kim, Hyoungmin; Suk, Kyung-Soo; Nam, Woo Dong; Han, Jumi


    The efficacy and safety of recombinant human bone morphogenetic protein-2 (rhBMP-2) as a bone graft substitute in spinal fusion has been widely researched. However, no study of the efficacy and safety of Escherichia coli-derived rhBMP-2 (E.BMP-2) with a hydroxyapatite (HA) carrier has been proposed. This study aimed to compare the efficacy and safety of fusion materials between E.BMP-2 and autogenous iliac bone graft in posterolateral fusion (PLF). An open, active-controlled, randomized, multicenter trial was carried out. This study included 93 patients who underwent single-level lumbar or lumbosacral PLF. The primary outcome measure was computed tomography (CT)-based fusion rate at 12 and 24 weeks. Secondary outcome measures were fusion grade by radiographs and CT at 12 and 24 weeks and changes in Oswestry Disability Index (ODI), Short Form-36 (SF-36) Health Survey, and visual analogue scale (VAS). Patients who underwent 1-level PLF (between L1 and S1) for severe spinal stenosis or grade 1 spondylolisthesis were randomized to receive E.BMP-2 with an HA carrier (E.BMP-2 group) or autogenous iliac bone graft (AIBG group). Thin-section CT (fusion rates were 100.0% (41/41) for the E.BMP-2 group and 90.2% (46/51) for the AIBG group (p=.062) at 12 weeks and 100.0% (41/41) and 94.1% (48/51) (p=.251) at 24 weeks, respectively. Fusion grade based on radiographs and CT showed non-inferiority of the E.BMP-2 group compared with the AIBG group. All clinical parameters improved postoperatively. However, there was no difference in changes in VAS, ODI, or SF-36 between the groups. No serious adverse event related to E.BMP-2 was found. The fusion rate of E.BMP-2 was comparable with that of AIBG following PLF. Good clinical efficacy and safety of E.BMP-2 in spinal fusion were also revealed. It was also suggested that HA shows suitability as a carrier for E.BMP-2. Thus, E.BMP-2 with an HA carrier can be an alternative bone graft material in spinal fusion. Copyright © 2017 The

  4. Transforaminal lumbar interbody fusion versus instrumented posterolateral fusion In degenerative spondylolisthesis: An attempt to evaluate the superiority of one method over the other. (United States)

    Ghasemi, Amir Abbas


    Various surgical procedures have been recommended for the treatment of degenerative spondylolisthesis,but Controversy still exists regarding the optimal surgical technique . In this study,we compared the clinical and radiologic outcome of the Transforaminal lumbar interbody fusion(TLIF) method with the Instrumented Posterolateral fusion(PLF) in these patients. The study population in this retrospective study consisted of 145 consecutive patients of degenerative spondylolisthesis who had undergone lumbar fusion in our institute between September 2010 and October 2013. The patients were divided into two treatment groups, where either instrumented PLF with pedicle screw(180° fusion) or TLIF procedure(360° fusion) was done. The follow-up was performed clinically using the Oswestry Disability Index (ODI), visual analogue scale (VAS)and global outcome. Outcome scores were assessed at 3, 6, 12, and 24 months after surgery. Radiographs were obtained postoperatively and at regular intervals for 24 months. Perioperative outcomes such as surgery time, blood loss, length of hospital stay and incidence of surgical complications were also recorded. 80 patients underwent TLIF procedure and 65 patients were included in the instrumented PLF group. There were no significant differences between the groups with respect to age,gender,Body Mass Index,smoking and comorbid conditions(p>0.05). No significant difference existed in Pre-operative VAS for back pain,VAS for leg pain and ODI between the two groups(p>0.05). There were no significant group differences in the operation level,hospital stay and surgical complications(all p>0.05). Blood loss, operation time and fusion success rate were significantly greater in the TLIF group than in the PLF group (all P<0.05). Significant differences between groups concerning VAS for back pain,ODI and Global outcome were present at final follow-up. There was no significant difference between the two groups with respect to VAS for leg pain. Our study

  5. Artrodese posterolateral vs artrodese circunferencial no tratamento da espondilolistese degenerativa: avaliação clínica e impacto do IMC nos resultados

    Directory of Open Access Journals (Sweden)

    Filipe Rodrigues Duarte


    Full Text Available OBJETIVO: O tratamento cirúrgico da espondilolistese degenerativa (ED apresenta vantagens quando comparado com o tratamento conservador. As técnicas cirúrgicas evoluíram no sentido de optimizar a fixação vertebral após descompressão, com o intuito de aumentar a taxa de artrodese. A fixação pedicular associada à fusão intersomática permite aumentar a área de contacto ósseo e assim a taxa de fusão, mas serão os resultados clínicos e funcionais superiores? MÉTODOS: Estudo retrospectivo incluindo 51 indivíduos (idade média de 61,2 anos submetidos a artrodese posterolateral (APL (19 e artrodese circunferencial (360º (32 de 1996 até 2009 com acompanhamento médio de 5,8 anos (2 a 14 anos. Incluídas apenas descompressões de um nível. Avaliação clínica (VAS - Visual Analogue Pain Score, satisfação global e avaliação funcional (Oswestry disability Index modificado. Cálculo do IMC (índice de massa corporal - avaliação clínica e funcional IMC ≥30 vs IMC <30. Estudo estatístico com SPSS®. RESULTADOS: Os resultados mostram franca melhoria clínica e funcional no tratamento cirúrgico da espondilolistese degenerativa, independentemente das técnicas estudadas. A taxa de satisfação é igualmente elevada. No confronto entre as duas técnicas de fixação não houve diferenças estatisticamente significativas. Relativamente ao IMC, os pacientes não obesos tiveram melhores resultados clínicos (p<0,05, não havendo diferenças relativas à função entre os dois grupos. CONCLUSÃO: A descompressão seguida de instrumentação vertebral é um tratamento eficaz para os pacientes com espondilolistese degenerativa. A técnica de artrodese utilizada não influencia os resultados clínicos e funcionais

  6. The difference in superior adjacent segment pathology after lumbar posterolateral fusion by using 2 different pedicle screw insertion techniques in 9-year minimum follow-up. (United States)

    He, Baorong; Yan, Liang; Guo, Hua; Liu, Tuanjiang; Wang, Xiaodong; Hao, Dingjun


    A prospective study was performed. To test the hypothesis that different pedicle screw insertion positions would increase the likelihood of superior adjacent segment degeneration (ASD). Lumbar fusion surgery is a widely accepted treatment of lumbar diseases, such as lumbar stenosis, trauma, tumor, and spondylolisthesis. Fusion and clinical success rates have increased because of improvements in instrumentation and bone graft material. In contrast, numerous complications and problems of fusion surgery have been reported, with ASD being one of the most important. This prospective study included 210 patients with low-grade isthmic spondylolisthesis. From January 1999 to December 2003, patients were randomized underwent posterolateral fusion using 2 different pedicle screw insertion positions. The patients were followed up postoperatively and were assessed with regard to radiological and clinical outcomes. Radiological outcomes were assessed mainly on the basis of disc degeneration, facet joint degeneration, and bone fusion. Clinical outcomes were evaluated mainly with the use of visual analogue scale for pain and the Oswestry Disability Index. A total of 178 of 210 (84.7%) patients were available for at least 9-year radiological and clinical follow-up data: 85.3% (87/102) patients in group A and 84.3% (91/108) patients in group B. Bone fusion was achieved in all patients at the last follow-up. ASD was proven in 110 (61.8%) of 178 patients. The incidences of radiographical and symptomatic ASD were 57.9% (103/178) and 3.9% (7/178), respectively. The incidence of ASD in group B was significantly lower than that in group A. Results of clinical outcomes showed lower visual analogue scale and Oswestry Disability Index scores in 2 groups than preoperative scores, but group B had greater improvement on the Oswestry Disability Index scores than group A in patients with ASD. The degeneration of superior adjacent segment is closely related to the position of the pedicle screws

  7. Risk factors of adjacent segment disease requiring surgery after lumbar spinal fusion: comparison of posterior lumbar interbody fusion and posterolateral fusion. (United States)

    Lee, Jae Chul; Kim, Yongdai; Soh, Jae-Wan; Shin, Byung-Joon


    A retrospective study. To determine the incidence and risk factors of adjacent segment disease (ASD) requiring surgery among patients previously treated with spinal fusion for degenerative lumbar disease and to compare the survivorship of adjacent segment according to various risk factors including comparison of fusion methods: posterior lumbar interbody fusion (PLIF) versus posterolateral fusion (PLF). One of the major issues after lumbar spinal fusion is the development of adjacent segment disease. Biomechanically, PLIF has been reported to be more rigid than PLF, and therefore, patients who undergo PLIF are suspected to experience a higher incidence of ASD than those who underwent PLF. There have been many studies analyzing the risk factors of ASD, but we are not aware of any study comparing PLIF with PLF in incidence of ASD requiring surgery. A consecutive series of 490 patients who had undergone lumbar spinal fusion of 3 or fewer segments to treat degenerative lumbar disease was identified. The mean age at index operation was 53 years, and the mean follow-up period was 51 months (12-236 mo). The number of patients treated by PLF and PLIF were 103 and 387, respectively. The incidence and prevalence of revision surgery for ASD were calculated by Kaplan-Meier method. For risk factor analysis, we used log-rank test and Cox regression analysis with fusion methods, sex, age, number of fused segments, and presence of laminectomy adjacent to index fusion. After index spinal fusion, 23 patients (4.7%) had undergone additional surgery for ASD. Kaplan-Meier analysis predicted a disease-free survival rate of adjacent segments in 94.2% of patients at 5 years and 89.6% at 10 years after the index operation. In the analysis of risk factors, PLIF was associated with 3.4 times higher incidence of ASD requiring surgery than PLF (P = 0.037). Patients older than 60 years at the time of index operation were 2.5 times more likely to undergo revision operation than those younger

  8. Extensions of string theories

    Energy Technology Data Exchange (ETDEWEB)

    Amorim, R.; Barcelos-Neto, J. (Universidade Federal do Rio de Janeiro, RJ (Brazil). Inst. de Fisica)


    With the motivation that critical dimensions D[ne]4 might be suggeting that string theories have not been completely formulated, we study more general alternatives. We first consider a direct extension in the world-sheet formulation with N[sub B] bosons and N[sub F] fermions and analyze the conditions for canceling the anomaly in all possible combinations of N[sub B], N[sub F] and D. Later on we incorporate degrees of freedom of antisymmetric tensors to the previous model. The only possibility to cancel the anomaly in this case is with N[sub B]=N[sub F]=1 and the our everyday spacetime dimension D=4. (orig.).

  9. Ground System Extensibility Considerations (United States)

    Miller, S. W.; Greene, E.


    The National Oceanic and Atmospheric Administration (NOAA) and National Aeronautics and Space Administration (NASA) are jointly acquiring the next-generation civilian weather and environmental satellite system: the Joint Polar Satellite System (JPSS). The Joint Polar Satellite System will replace the afternoon orbit component and ground processing system of the current Polar-orbiting Operational Environmental Satellites (POES) managed by NOAA. The JPSS satellites will carry a suite of sensors designed to collect meteorological, oceanographic, climatological and geophysical observations of the Earth. The ground processing system for JPSS is known as the JPSS Common Ground System (JPSS CGS). Developed and maintained by Raytheon Intelligence, Information and Services (IIS), the CGS is a multi-mission enterprise system serving NOAA, NASA and their national and international partners, such as NASA's Earth Observation System (EOS), NOAA's current POES, the Japan Aerospace Exploration Agency's (JAXA) Global Change Observation Mission - Water (GCOM-W1), and DoD's Defense Meteorological Satellite Program (DMSP). The CGS provides a wide range of support to a number of national and international missions, including command and control, mission management, data acquisition and routing, and environmental data processing and distribution. The current suite of CGS-supported missions has demonstrated the value of interagency and international partnerships to address global observation needs. With its established infrastructure and existing suite of missions, the CGS is extensible to a wider array of potential new missions. This paper will describe how the inherent scalability and extensibility of the CGS enables the addition of these new missions, with an eye on global enterprise needs in the 2020's and beyond.

  10. Attitude Of Extension Personnel To Training And Visit Extension ...

    African Journals Online (AJOL)

    In order to make the attitudes of extension workers more affirmative, the paper recommended, inter alia, staff motivation, minimizing political and administrative interference in staff work and a reasonable reduction in the work load of extension staff. Key words: attitude, extension personnel, training and visit. Journal of ...

  11. test with extensions

    Directory of Open Access Journals (Sweden)

    J. C. W. Rayner


    Full Text Available The data for the tests considered here may be presented in two-way contingency tables with all marginal totals fixed. We show that Pearson's test statistic XP2 (P for Pearson may be partitioned into useful and informative components. The first detects location differences be tween the treatments, and the subsequent components detect dispersion and higher order moment differences. For Kruskal-Wallis-type data when there are no ties, the location component is the Kruskal-Wallis test. The subsequent components are the extensions. Our approach enables us to generalise to when there are ties, and to when there is a fixed number of categories and a large number of observations. We also propose a generalisation of the well-known median test. In this situation the location-detecting first component of XP2 reduces to the usual median test statistic when there are only two categories. Subsequent components detect higher moment departures from the null hypothesis of equal treatment effects

  12. Web Extensible Display Manager

    Energy Technology Data Exchange (ETDEWEB)

    Slominski, Ryan [Thomas Jefferson National Accelerator Facility (TJNAF), Newport News, VA (United States); Larrieu, Theodore L. [Thomas Jefferson National Accelerator Facility (TJNAF), Newport News, VA (United States)


    Jefferson Lab's Web Extensible Display Manager (WEDM) allows staff to access EDM control system screens from a web browser in remote offices and from mobile devices. Native browser technologies are leveraged to avoid installing and managing software on remote clients such as browser plugins, tunnel applications, or an EDM environment. Since standard network ports are used firewall exceptions are minimized. To avoid security concerns from remote users modifying a control system, WEDM exposes read-only access and basic web authentication can be used to further restrict access. Updates of monitored EPICS channels are delivered via a Web Socket using a web gateway. The software translates EDM description files (denoted with the edl suffix) to HTML with Scalable Vector Graphics (SVG) following the EDM's edl file vector drawing rules to create faithful screen renderings. The WEDM server parses edl files and creates the HTML equivalent in real-time allowing existing screens to work without modification. Alternatively, the familiar drag and drop EDM screen creation tool can be used to create optimized screens sized specifically for smart phones and then rendered by WEDM.

  13. Extensions panach\\'ees autoduales


    Bertrand, Daniel


    We study self-duality of Grothendieck's blended extensions (extensions panach\\'ees) in the context of a tannakian category. The set of equivalence classes of symmetric, resp. antisymmetric, blended extensions is naturally endowed with a torsor structure, which enables us to compute the unipotent radical of the associated monodromy groups in various situations

  14. A Two-stage procedure for the treatment of a neglected posterolateral knee dislocation: Gradual reduction with an Ilizarov external fixator followed by arthroscopic anterior and posterior cruciate ligament reconstruction. (United States)

    Polyzois, Vasilios D; Stathopoulos, Ioannis P; Benetos, Ioannis S; Pneumaticos, Spyros G


    Neglected knee dislocations are extremely uncommon and their management cannot be evidence-based since only a few case reports have been published describing different treatment methods. We present the case of a young man with a neglected posterolateral knee dislocation and a concomitant sciatic nerve injury. A two-stage treatment strategy with gradual reduction using the Ilizarov technique and subsequent arthroscopic anterior and posterior cruciate ligament reconstruction was followed. The two-stage treatment approach led to a satisfactory clinical outcome. At the latest follow-up evaluation the patient was fully ambulatory and the knee was painless with no anteroposterior instability. In neglected knee dislocations treatment optios are guided by the severity of the concomitant injuries and the status of articulating surfaces. Gradual reduction with the Ilizarov technique and subsequent arthroscopic ligamentous reconstruction is a reliable alternative to open surgical procedures. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Robotic hand with modular extensions (United States)

    Salisbury, Curt Michael; Quigley, Morgan


    A robotic device is described herein. The robotic device includes a frame that comprises a plurality of receiving regions that are configured to receive a respective plurality of modular robotic extensions. The modular robotic extensions are removably attachable to the frame at the respective receiving regions by way of respective mechanical fuses. Each mechanical fuse is configured to trip when a respective modular robotic extension experiences a predefined load condition, such that the respective modular robotic extension detaches from the frame when the load condition is met.

  16. Think - Baltic Extension / Kalle Kask

    Index Scriptorium Estoniae

    Kask, Kalle


    Tallinna TÜ Rehabilitatsiooni tehnoloogia keskus korraldas pressikonverentsi, kus tutvustati osalemist EL V raamprogrammis Think - Baltic Extension, mis on suunatud puuetega inimeste tööhõive tagamisele


    African Journals Online (AJOL)

    The primary purpose of the study was to determine extension worker's opinions regarding the influence of the National Maize Competition (NAMCOM) on the farmers' agricultural practices and experiences in the Manzini region. A census population of front-line extension workers in charge of the participating areas in ...

  18. Journal of Agricultural Extension: Submissions

    African Journals Online (AJOL)

    Publication Ethics Articles published in the Journal of Agricultural Extension must be relevant to extension practice and should not have been published or under ... COI involves using your position as an author, editor, or reviewer to promote your interests (business or financial), or those of your external relationships (family ...

  19. Quotient semigroups and extension semigroups

    Indian Academy of Sciences (India)

    the viewpoint of C∗-algebra and apply them to a survey of extension semigroups. Cer- tain interrelations ... -algebra extension theory and K K-theory, it is crucial to study the theory of quotient semigroups from the ... Similar to the construction of quotient group and quotient linear space, quotient semi- group may be induced ...

  20. Repeat Customer Success in Extension (United States)

    Bess, Melissa M.; Traub, Sarah M.


    Four multi-session research-based programs were offered by two Extension specialist in one rural Missouri county. Eleven participants who came to multiple Extension programs could be called "repeat customers." Based on the total number of participants for all four programs, 25% could be deemed as repeat customers. Repeat customers had…

  1. Hom-associative Ore extensions (United States)

    Bäck, P.; Richter, J.; Silvestrov, S.


    We introduce hom-associative Ore extensions as non-associative, non-unital Ore extensions with a hom-associative multiplication, as well as give some necessary and sufficient conditions when such exist. Within this framework, we also construct a family of hom-associative Weyl algebras as generalizations of the classical analogue, and prove that they are simple.

  2. Research-extension-farmer linkages

    African Journals Online (AJOL)

    i Training extension staff and farmers . ..ii Producing fry for satellite centres at the regions and for fish fanners; and iii Conducting experiments on fish production, productivity and water quality. Restructuring of Agricultural Research and Extension services. The organisation ofUganda's national agricultural research.

  3. Frames and extension problems I

    DEFF Research Database (Denmark)

    Christensen, Ole


    In this article we present a short survey of frame theory in Hilbert spaces. We discuss Gabor frames and wavelet frames and set the stage for a discussion of various extension principles; this will be presented in the article Frames and extension problems II (joint with H.O. Kim and R.Y. Kim)....

  4. Extension and the Practicing Veterinarian (United States)

    Meyerholz, G. W.


    In order for Extension programs of veterinary medicine to succeed, good relationships are needed among university veterinarians, practicing local veterinarians, county Extension agents and the clientele. This author attempts to define some roles and relationships and offer some suggestions for the improvement of relationships to increase…

  5. Avaliação dos pacientes submetidos à descompressão e artrodese póstero-lateral devido à espondilolistese degenerativa com dois anos de acompanhamento Evaluación de los pacientes sometidos a descompresión y artrodesis posterolateral debido a la espondilolistesis degenerativa con dos años de seguimiento Evaluation of patients undergoing decompression and posterolateral arthrodesis because of degenerative spondylolisthesis with two years of follow up

    Directory of Open Access Journals (Sweden)

    Fernando William Figueiredo da Rosa


    Full Text Available OBJETIVO: Avaliar os resultados da descompressão e da artrodese póstero-lateral na espondilolistese degenerativa em pacientes que têm como sintoma principal a claudicação neurogênica. MÉTODO: Foram selecionados 21 pacientes com espondilolistese degenerativa, com indicação de tratamento cirúrgico. Foram avaliados 8 homens e 13 mulheres com idades entre 36 e 77 anos. O procedimento cirúrgico padronizado foi a artrodese póstero-lateral com instrumentação e descompressão associada. Os pacientes foram avaliados por VAS, índice de Oswestry e Roland-Morris no pré-operatório, com um mês, seis meses, um ano e dois anos de seguimento. Os dados foram analisados estatisticamente com nível de significância de 5%. RESULTADOS: O nível mais frequentemente operado foi L4-L5, com 52,38%. A VAS teve melhora significativa de 53,48% nos 6 meses após o procedimento. O Índice de Incapacidade de Oswestry apresentou piora no primeiro mês, evolução para melhora da capacidade até o sexto mês, e permaneceu constante até o fim do acompanhamento. Segundo o questionário de Incapacidade de Roland-Morris, houve melhora progressiva significativa até o sexto mês e, por último, uma leve piora. CONCLUSÃO: Os pacientes com espondilolistese degenerativa submetidos à artrodese póstero-lateral instrumentada e descompressão apresentaram melhora significativa da qualidade de vida e da dor após dois anos de acompanhamento.OBJETIVO: Evaluar los resultados de la descompresión y de la artrodesis posterolateral en la espondilolistesis degenerativa en pacientes que tienen, como síntoma principal, la claudicación neurogénica. MÉTODO: Se seleccionaron 21 pacientes con espondilolistesis degenerativa, con indicación de tratamiento quirúrgico. Se evaluaron 8 hombres y 13 mujeres, con edades de 36 a 77 años. El procedimiento quirúrgico estandarizado fue la artrodesis posterolateral con instrumentación y descompresión vinculada. Los pacientes fueron

  6. Programming Reactive Extensions and LINQ

    CERN Document Server

    Liberty, Jesse


    Pro Reactive Extensions and LINQ is a deep dive into the next important technology for .NET developers: Reactive Extensions. This in-depth tutorial goes beyond what is available anywhere else to teach how to write WPF, Silverlight, and Windows Phone applications using the Reactive Extensions (Rx) to handle events and asynchronous method calls. Reactive programming allows you to turn those aspects of your code that are currently imperative into something much more event-driven and flexible. For this reason, it's sometimes referred to as LINQ for Events. Reactive programming hinges on the concep

  7. Learning Joomla! 3 extension development

    CERN Document Server

    Plummer, Tim


    A practical guide with step-by-step examples that build on each other so you can learn by doing and get hands-on knowledge about creating your plugins, modules, and components in Joomla.""Learning Joomla! 3 Extension Development, Third Edition"" is for developers who want to create their own Joomla extensions. It is assumed you will have some basic PHP, HTML, and CSS knowledge, but you don't need any prior Joomla programming experience. This book will also be useful to people who just want to make minor customizations to existing Joomla extensions and build on the work of others in the open so

  8. Extensions of the Standard Model

    CERN Document Server

    Zwirner, Fabio


    Rapporteur talk at the International Europhysics Conference on High Energy Physics, Brussels (Belgium), July 27-August 2, 1995. This talk begins with a brief general introduction to the extensions of the Standard Model, reviewing the ideology of effective field theories and its practical implications. The central part deals with candidate extensions near the Fermi scale, focusing on some phenomenological aspects of the Minimal Supersymmetric Standard Model. The final part discusses some possible low-energy implications of further extensions near the Planck scale, namely superstring theories.

  9. Extension agents and conflict narratives

    DEFF Research Database (Denmark)

    Bond, Jennifer Lauren


    conflict. Originality: This work contributes to a growing body of literature interested in the role of extension agents in conflict management. By applying Q methodology, this work has shown that while extension agents are involved in conflict management, their perceptions of these conflicts are subjective......Purpose: This work investigated the narratives of development extensionists in relation to natural resource conflict, in order to understand the competing discourses surrounding the wicked problems of natural resource management in Laikipia County, Kenya. Methodology: Q methodology was used...... to elicit the conflict narratives present among extension professionals. A concourse of 221 statements were devised from interviews and group discussions with key informants and a final sample of 49 statements was used for the sorting. Thirteen Q-sorts were undertaken with among rural extension...

  10. Boiler-turbine life extension

    Energy Technology Data Exchange (ETDEWEB)

    Natzkov, S. [TOTEMA, Ltd., Sofia (Bulgaria); Nikolov, M. [CERB, Sofia (Bulgaria)


    The design life of the main power equipment-boilers and turbines is about 105 working hours. The possibilities for life extension are after normatively regulated control tests. The diagnostics and methodology for Boilers and Turbines Elements Remaining Life Assessment using up to date computer programs, destructive and nondestructive control of metal of key elements of units equipment, metal creep and low cycle fatigue calculations. As well as data for most common damages and some technical decisions for elements life extension are presented.

  11. Agricultural extension and mass media. (United States)

    Perraton, H


    To learn more about the use of the mass media for agricultural extension, the World Bank has considered the efforts of 2 units: INADES-formation in West Africa and the Extension Aids Branch of Malawi. The INADES-formation study focuses on Cameroon but also considers work in Rwanda and the Ivory Coast. Some general conclusions emerge from a comparison of the 2 organizations. Malawi operates an extension service which reaches farmers through extension agents, through farmer training centers, and through mass media. The Extension Aids Branch (EAB) has responsibility for its media work and broadcasts 4 1/2 hours of radio each week. Its 6 regular radio programs include a general program which interviews farmers, a music request program in which the music is interspersed with farming advice, a farming family serial, and a daily broadcast of agricultural news and information. The 17 cinema vans show some agricultural films, made by EAB, some entertainment films, and some government information films from departments other than the ministry of agriculture. EAB also has a well-developed program of research and evaluation of its own work. INADES-formation, the training section of INADES, works towards social and economic development of the population. It teaches peasant farmers and extension agents and does this through running face-to-face seminars, by publishing a magazine, "Agripromo," and through correspondence courses. In 1978-79 INADES-formation enrolled some 4500 farmers and extension agents as students. Both of these organizations work to teach farmers better agriculture techniques, and both were created in response to the fact that agricultural extension agents cannot meet all the farmers in their area. Despite the similarity of objective, there are differences in methods and philosophy. The EAB works in a single country and uses a variety of mass media, with print playing a minor role. INADES-formation is an international and nongovernmental organization and its

  12. Radiography exposure

    International Nuclear Information System (INIS)

    Abdul Nassir Ibrahim; Azali Muhammad; Ab. Razak Hamzah; Abd. Aziz Mohamed; Mohamad Pauzi Ismail


    This chapter, the reader will introduce with basic knowledge on radiography exposure. All the code and standard must give a specification on density or their range that can accepted. So the result outside the specification usually will be unacceptable and this can effected the time, cost and energy of the radiographer. So, for radiographer, they must work carefully to produce a good result and one way to solve this problem is through good exposure. The more the exposure can make a film darker while the less exposure can make the radiograph not enough density. So, through this chapter, the reader can know detailed how to manage this problem. As mention earlier, this technique is a combination between theories and practical, so, here theory is a main part to make the practical successful.

  13. Military Exposures (United States)

    ... the Media Room Public Affairs News Releases Speeches Videos Publications National Observances Veterans Day Memorial Day Celebrating America's Freedoms Special Events Adaptive Sports Program Creative Arts Festival Golden Age Games Summer Sports Clinic Training - Exposure - Experience (TEE) Tournament ...

  14. Extension Agents\\' Commitment To Extension Work In Abia And ...

    African Journals Online (AJOL)

    A structured and validated inventory scale titled: “Job Commitment Inventory Scale” was administered to 89 and 61 respondents randomly selected from a population of 112 and 117 extension agents in Abia and Rivers States ADPs. respectively. The data collected were analyzed using descriptive statistical tools such as ...

  15. verbal extensions: valency decreasing extensions in the basà ...

    African Journals Online (AJOL)


    London: Hodder. Education. Imoh, P.M., 2013. Verbal extensions: Valency increasing operations in Basà verbal system. Paper presented at the West African Languages Congress (WALC) and 26th Annual. Conference of the Linguistic Association of Nigeria (26th CLAN), 29th July to 2nd August. 2013, University of Ibadan, ...

  16. NDE and plant life extension

    International Nuclear Information System (INIS)

    Liu, S.N.; Ammirato, F.V.; Nottingham, L.D.


    Component life extension is the process of making run-repair-replace decisions for plant components and includes a thorough analysis of the capability of the component to perform throughout the projected lifetime. For many critical plant components, nondestructive evaluation (NDE) is essential in determining whether the component can be operated safely and economically in the extended life period and to help utilities determine safe and economic inspection intervals. NDE technology is required for not only detecting defects that could grow to a size of concern during extended lifetimes, but also will be called upon to measure and monitor accumulating material degradation that strongly affects component reliability. This paper discusses the role of NDE in life extension by reviewing three examples--a reactor pressure vessel, steam turbine-generator rotors, and generator retaining rings. In each example, the contribution of NDE to life extension decisions is described. (author)

  17. The difference in centre position in the ACL femoral footprint inclusive and exclusive of the fan-like extension fibres. (United States)

    Iriuchishima, Takanori; Ryu, Keinosuke; Aizawa, Shin; Fu, Freddie H


    The purpose of this study was to compare the centre position of each anterior cruciate ligament bundle in its femoral footprint in measurements including and excluding the fan-like extension fibres. Fourteen non-paired human cadaver knees were used. All soft tissues around the knee were resected except the ligaments. The ACL was divided into antero-medial (AM) and postero-lateral (PL) bundles according to the difference in tension patterns. The ACL was carefully dissected, and two outlines were made of the periphery of each bundle insertion site: those which included and those which excluded the fan-like extension fibres. An accurate lateral view of the femoral condyle was photographed with a digital camera, and the images were downloaded to a personal computer. The centre position of each bundle, including and excluding the fan-like extension fibres, was measured with ImageJ software (National Institution of Health). Evaluation of the centre position was performed using the modified quadrant method. The centre of the femoral AM bundle including the fan-like extension was located at 28.8% in a shallow-deep direction and 37.2% in a high-low direction. When the AM bundle was evaluated without the fan-like extension, the centre was significantly different at 34.6% in a shallow-deep direction (p = 0.000) and 36% in a high-low direction. The centre of the PL bundle including the fan-like extension was found at 37.1% in a shallow-deep direction and 73.4% in a high-low direction. When the PL bundle was evaluated without the fan-like extension, the centre was significantly different at 42.7% in a shallow-deep direction (p = 0.000) and 69.3% in a high-low direction (p = 0.000). The centre position of the AM and PL bundles in the femoral ACL footprint was significantly different depending on the inclusion or exclusion of the fan-like extension fibres. For the clinical relevance, to reproduce the direct femoral insertion in the anatomical ACL reconstruction, tunnels should be

  18. Extension properties of states on operator algebras (United States)

    Hamhalter, Jan


    We summarize and deepen some recent results concerning the extension problem for states on operator algebras and general quantum logics. In particular, we establish equivalence between the Gleason extension property, the Hahn-Banach extension property, and the universal state extension property of projection logics. Extensions of Jauch-Piron states are investigated.

  19. Extension Resources for International Trade (United States)

    Seal, Susan D.


    With the opening of additional trade partnerships, the reduction of global transportation and communication costs, and the increase in demand for U.S. agricultural products and services, international trade is an area of great importance to more and more Extension clients and stakeholders. This article provides information about the primary…

  20. Invertible extensions and growth conditions

    Czech Academy of Sciences Publication Activity Database

    Badea, C.; Müller, Vladimír


    Roč. 339, - (2004), s. 21-26 ISSN 1631-073X R&D Projects: GA ČR GA201/03/0041; GA AV ČR KSK1019101 Institutional research plan: CEZ:AV0Z1019905 Keywords : invertible extensions * growth conditions Subject RIV: BA - General Mathematics Impact factor: 0.284, year: 2004

  1. African Journal of Livestock Extension

    African Journals Online (AJOL)

    African Journal of Livestock Extension aims to bring to the fore the role and significance of livestock in maintaining rural, peri-urban and urban households, vis-à-vis its impact on poverty alleviation, household nutritional status, economic coping strategy and provision of employment. The focus of the journal relates to all ...

  2. Managing Diversity within Cooperative Extension. (United States)

    Ewert, D. Merrill; Rice, Jennifer A. King


    Six focus groups analyzed findings of a literature review on cultural diversity's effects on productivity and effectiveness. Action steps for Cooperative Extension were outlined: implementing affirmative action, valuing diversity, managing diversity, creating new management structures, and establishing a more supportive environment. (SK)

  3. intensive and extensive feeding regimes

    African Journals Online (AJOL)

    production and reproduction parameters in ram lambs, under intensive and extensive feeding regimes. J.P.C. Greyling* and G.J. Taylor. Department of Animal Science, University of the Orange Free State, PO. Box 339, Bloemfontein,. 9300, South Africa. Received revised 1 July 1999; accepted 28 July 1999. Forty Dorper ...

  4. Extensions of the standard model

    International Nuclear Information System (INIS)

    Ramond, P.


    In these lectures we focus on several issues that arise in theoretical extensions of the standard model. First we describe the kinds of fermions that can be added to the standard model without affecting known phenomenology. We focus in particular on three types: the vector-like completion of the existing fermions as would be predicted by a Kaluza-Klein type theory, which we find cannot be realistically achieved without some chiral symmetry; fermions which are vector-like by themselves, such as do appear in supersymmetric extensions, and finally anomaly-free chiral sets of fermions. We note that a chiral symmetry, such as the Peccei-Quinn symmetry can be used to produce a vector-like theory which, at scales less than M/sub W/, appears to be chiral. Next, we turn to the analysis of the second hierarchy problem which arises in Grand Unified extensions of the standard model, and plays a crucial role in proton decay of supersymmetric extensions. We review the known mechanisms for avoiding this problem and present a new one which seems to lead to the (family) triplication of the gauge group. Finally, this being a summer school, we present a list of homework problems. 44 references

  5. Extensiveness of Farmers' Buying Process

    NARCIS (Netherlands)

    Kool, M.; Meulenberg, M.T.G.; Broens, D.F.


    In this article we study farmers' buying processes, in particular the selection of a supplier for a given farm input. Extensiveness of farmers' buying processes is defined as the degree information acquisition and alternative evaluation effort carried out to prepare that selection. Hypotheses,

  6. Journal of Agricultural Extension submitted to Agricultural Extension ...

    African Journals Online (AJOL)


    followed by lack of contact with extension agents (71.7%) and gender discrimination in obtaining land on lease for farming (39.2). Majority (65.8%) of .... The study area was Osun State, a tropical state in South west; Nigeria lying within coordinates 7. 0. 30ʹN and 4. 030ʹE. The state comprised of 30 Local Government ...

  7. Exposure Prophylaxis

    African Journals Online (AJOL)


    health care workers who report exposure to HIV at work whether given PEP or not ... breast milk, amniotic fluid, cerebrospinal fluid, pericardial fluid ... or skin lesions [1]. Other body fluid like sweat, tears, saliva, urine and stool do not contain significant quantities of HIV unless there is blood mixed with them[1,2]. HIV is not ...

  8. Linear programming foundations and extensions

    CERN Document Server

    Vanderbei, Robert J


    Linear Programming: Foundations and Extensions is an introduction to the field of optimization. The book emphasizes constrained optimization, beginning with a substantial treatment of linear programming, and proceeding to convex analysis, network flows, integer programming, quadratic programming, and convex optimization. The book is carefully written. Specific examples and concrete algorithms precede more abstract topics. Topics are clearly developed with a large number of numerical examples worked out in detail. Moreover, Linear Programming: Foundations and Extensions underscores the purpose of optimization: to solve practical problems on a computer. Accordingly, the book is coordinated with free efficient C programs that implement the major algorithms studied: -The two-phase simplex method; -The primal-dual simplex method; -The path-following interior-point method; -The homogeneous self-dual methods. In addition, there are online JAVA applets that illustrate various pivot rules and variants of the simplex m...

  9. Managing BWR plant life extension

    International Nuclear Information System (INIS)

    Ianni, P.W.; Kiss, E.


    Recent studies have confirmed that extending the useful life of a large nuclear plant can be justified with very high cost benefit ratio. In turn, experience with large power plant systems and equipment has shown that a well-integrated and -managed plan is essential in order to achieve potential economic benefits. Consequently, General Electric's efforts have been directed at establishing a life extension plan that considers alternative options and cost-effective steps that can be taken in early life, those appropriate during middle life, and those required in late life. This paper briefly describes an approach designed to provide the plant owner a maximum of flexibility in developing a life extension plan

  10. Extensive Reading and Learning Style


    Kawachi, Tomoko; 河内, 智子


    Extensive reading (ER) has been shown to be an effective approach to both improving students’ language skills and nurturing positive attitudes toward language reading and learning. However, although the approach has proven to be effective for many learners, as with any teaching approach, it does not seem to work equally well for all learners. The current study hypothesized that learning style might be a factor influencing learners’ achievement in and attitude toward ER, and investigated the r...

  11. Rosacea with extensive extrafacial lesions


    Pereira, TM; Vieira, AP; Sousa-Basto, A


    Rosacea is a very common skin disorder in the clinical practice that primarily affects the convex areas of the face. Extrafacial rosacea lesions have occasionally been described, but extensive involvement is exceptional. In the absence of its typical clinical or histological features, the diagnosis of extrafacial rosacea may be problematic. We describe an unusual case of rosacea with very exuberant extrafacial lesions, when compared with the limited involvement of the face.

  12. Recall in extensive form games


    Klaus Ritzberger


    This paper considers characterizations of perfect recall in extensive form games. It is shown that perfect recall can be expressed in terms of choices without any reference to infomation sets. When information sets are taken into account, it is decomposable into an ordering of information sets and that players do not forget what they knew nor what they did. Thus, if information sets are partially ordered, then perfect recall is implied by the player's inability to refine her information from ...

  13. Safety lock for radiography exposure device

    International Nuclear Information System (INIS)

    Gaines, T.M.


    A safety lock for securing a radiation source in a radiography exposure device is disclosed. The safety lock prevents the inadvertent extension of the radiation source from the exposure device. The exposure devices are used extensively in industry for nondestructive testing of metal materials for defect. Unnecessary exposure of the radiographer or operator occurs not infrequently due to operator's error in believing that the radiation source is secured in the exposure device when, in fact, it is not. The present invention solves this problem of unnecessary exposure by releasingly trapping the radiation source in the shield of the radiography exposure device each time the source is retracted therein so that it is not inadvertently extended therefrom without the operator resetting the safety lock, thereby releasing the radiation source. Further, the safety lock includes an indicator which indicates when the source is trapped in the exposure device and also when it is untrapped. The safety lock is so designed that it does not prevent the return of the source to the trapped, shielded position in the exposure device. Further the safety lock includes a key means for locking the radiation source in the trapped position. The key means cannot be actuated until said radiation source is in said trapped position to further insure the safety lock cannot be inadvertently locked with the source untrapped and thus still extendable from the exposure device

  14. Exposures series


    Stimson, Blake


    Reaktion Books’ Exposures series, edited by Peter Hamilton and Mark Haworth-Booth, is comprised of 13 volumes and counting, each less than 200 pages with 80 high-quality illustrations in color and black and white. Currently available titles include Photography and Australia, Photography and Spirit, Photography and Cinema, Photography and Literature, Photography and Flight, Photography and Egypt, Photography and Science, Photography and Africa, Photography and Italy, Photography and the USA, P...

  15. Journal of Agricultural Extension: Editorial Policies

    African Journals Online (AJOL)

    Mission Statement: The mission of the Journal of Agricultural Extension is to publish conceptual papers and empirical research that tests, extends, or builds ... research and methodological issues; nutrition extension; extension youth programme; women-in-agriculture; extension, Climate Change and the environment, ICT, ...

  16. Professional development and extension programs

    International Nuclear Information System (INIS)

    Bereznai, G.


    Professional Development (PD) refers to the means by which people acquire, develop, maintain and enhance the specialist knowledge and skills needed to practice in their profession. Extension Programs (aka Continuing Education) are offered by most post-secondary degree/diploma/certificate granting institutions.The courses are typically taken on a part-time basis, and course delivery often includes distance learning technology. An important implementation of PD is via workplace training, industry specific seminars, workshops and non-credit courses offered by a wide range of service providers.

  17. Coal Combustion Products Extension Program

    Energy Technology Data Exchange (ETDEWEB)

    Tarunjit S. Butalia; William E. Wolfe


    This final project report presents the activities and accomplishments of the ''Coal Combustion Products Extension Program'' conducted at The Ohio State University from August 1, 2000 to June 30, 2005 to advance the beneficial uses of coal combustion products (CCPs) in highway and construction, mine reclamation, agricultural, and manufacturing sectors. The objective of this technology transfer/research program at The Ohio State University was to promote the increased use of Ohio CCPs (fly ash, FGD material, bottom ash, and boiler slag) in applications that are technically sound, environmentally benign, and commercially competitive. The project objective was accomplished by housing the CCP Extension Program within The Ohio State University College of Engineering with support from the university Extension Service and The Ohio State University Research Foundation. Dr. Tarunjit S. Butalia, an internationally reputed CCP expert and registered professional engineer, was the program coordinator. The program coordinator acted as liaison among CCP stakeholders in the state, produced information sheets, provided expertise in the field to those who desired it, sponsored and co-sponsored seminars, meetings, and speaking at these events, and generally worked to promote knowledge about the productive and proper application of CCPs as useful raw materials. The major accomplishments of the program were: (1) Increase in FGD material utilization rate from 8% in 1997 to more than 20% in 2005, and an increase in overall CCP utilization rate of 21% in 1997 to just under 30% in 2005 for the State of Ohio. (2) Recognition as a ''voice of trust'' among Ohio and national CCP stakeholders (particularly regulatory agencies). (3) Establishment of a national and international reputation, especially for the use of FGD materials and fly ash in construction applications. It is recommended that to increase Ohio's CCP utilization rate from 30% in 2005 to

  18. JESS: Java extensible snakes system (United States)

    McInerney, Tim; Akhavan Sharif, M. Reza; Pashotanizadeh, Nasrin


    Snakes (Active Contour Models) are powerful model-based image segmentation tools. Although researchers have proven them especially useful in medical image analysis over the past decade, Snakes have remained primarily in the academic world and they have not become widely used in clinical practice or widely available in commercial packages. A number of confusing and specialized variants exist and there has been no standard open-source implementation available. To address this problem, we present a Java Extensible Snakes System (JESS) that is general, portable, and extensible. The system uses Java Swing classes to allow for the rapid development of custom graphical user interfaces (GUI's). It also incorporates the Java Advanced Imaging(JAI) class library, which provide custom image preprocessing, image display and general image I/O. The Snakes algorithm itself is written in a hierarchical fashion, consisting of a general Snake class and several subclasses that span the main variants of Snakes including a new, powerful, robust subdivision-curve Snake. These subclasses can be easily and quickly extended and customized for any specific segmentation and analysis task. We demonstrate the utility of these classes for segmenting various anatomical structures from 2D medical images. We also demonstrate the effectiveness of JESS by using it to rapidly build a prototype semi-automatic sperm analysis system. The JESS software will be made publicly available in early 2005.

  19. Skin exposure to isocyanates: reasons for concern. (United States)

    Bello, Dhimiter; Herrick, Christina A; Smith, Thomas J; Woskie, Susan R; Streicher, Robert P; Cullen, Mark R; Liu, Youcheng; Redlich, Carrie A


    Isocyanates (di- and poly-), important chemicals used worldwide to produce polyurethane products, are a leading cause of occupational asthma. Respiratory exposures have been reduced through improved hygiene controls and the use of less-volatile isocyanates. Yet isocyanate asthma continues to occur, not uncommonly in settings with minimal inhalation exposure but opportunity for skin exposure. In this review we evaluate the potential role of skin exposure in the development of isocyanate asthma. We reviewed the published animal and human literature on isocyanate skin-exposure methods, workplace skin exposure, skin absorption, and the role of skin exposure in isocyanate sensitization and asthma. We selected relevant articles from computerized searches on Medline, U.S. Environmental Protection Agency, Occupational Safety and Health Administration, National Institute for Occupational Safety and Health, and Google databases using the keywords "isocyanate," "asthma," "skin," "sensitization," and other synonymous terms, and our own extensive collection of isocyanate publications. Isocyanate production and use continues to increase as the polyurethane industry expands. There is substantial opportunity for isocyanate skin exposure in many work settings, but such exposure is challenging to quantify and continues to be underappreciated. Isocyanate skin exposure can occur at work, even with the use of personal protective equipment, and may also occur with consumer use of certain isocyanate products. In animals, isocyanate skin exposure is an efficient route to induce sensitization, with subsequent inhalation challenge resulting in asthma-like responses. Several lines of evidence support a similar role for human isocyanate skin exposure, namely, that such exposure occurs and can contribute to the development of isocyanate asthma in certain settings, presumably by inducing systemic sensitization. Integrated animal and human research is needed to better understand the role of skin

  20. Fluorescein-related extensive jaundice. (United States)

    Kalkan, Asim; Turedi, Suleyman; Aydin, Ibrahim


    Fluorescein is a chemical dye frequently used in eye diseases to assess blood flow in the retina, choroid tissue, and iris. Although it has many known adverse effects, it has not previously been reported to lead to jaundice. The purpose of this case report was to emphasize that for patients presenting at the emergency department with jaundice symptoms, it should not be forgotten by emergency physicians that jaundice can develop after fluorescein angiography. Case: A 65-year-old woman presented at the emergency department with extensive jaundice that had developed on her entire body a few hours after fluorescein angiography applied because of vision impairment. The test results for all the diseases considered to cause jaundice were normal,and fluorescein-related jaundice was diagnosed. Conclusion: A detailed anamnesis should be taken when jaundice is seen in patients who have undergone fluorescein angiography, and it should not be forgotten that fluorescein dye is a rare cause of jaundice.

  1. Extensive Renovation of Heritage Buildings

    DEFF Research Database (Denmark)

    Rasmussen, Torben Valdbjørn; Møller, Eva B.; Buch-Hansen, Thomas Cornelius


    In the debate on whether or not heritage buildings should be included in work to mitigate climate change impacts, it is important to assess the impact of these buildings. Therefore the results of an extensive energy upgrading of a listed complex was studied. Climate change and measures to mitigate...... existing, older and heritage buildings. However, heritage buildings possess heritage values that need to be protected while on the other hand the buildings need to remain part of the attractive building stock, as many of these buildings will otherwise deteriorate. Based on an example, this paper identifies...... feasible energy-upgrading measures for implementation including measures to provide an acceptable indoor climate. The energy savings as well as the reduction of CO2 emissions are calculated. Furthermore, it is discussed how measures can affect the durability of a heritage building, as measures may create...

  2. An Expressive Extension of TLC

    DEFF Research Database (Denmark)

    Henriksen, Jesper Gulmann


    A temporal logic of causality (TLC) was introduced by Alur, Penczek and Peled in [1]. It is basically a linear time temporal logic interpreted over Mazurkiewicz traces which allows quantification over causal chains. Through this device one can directly formulate causality properties of distributed...... systems. In this paper we consider an extension of TLC by strengthening the chain quantification operators. We show that our logic TLC* adds to the expressive power of TLC. We do so by defining an Ehrenfeucht-Fraïssé game to capture the expressive power of TLC. We then exhibit a property and by means...... of this game prove that the chosen property is not definable in TLC. We then show that the same property is definable in TLC*. We prove in fact the stronger result that TLC* is expressively stronger than TLC exactly when the dependency relation associated with the underlying trace alphabet is not transitive....

  3. Industrial extension, the Oklahoma way (United States)

    Farrell, Edmund J.


    Oklahoma has established a customer-driven industrial extension system. A publicly-chartered, private non-profit corporation, the Oklahoma Alliance for Manufacturing Excellence, Inc. (`the Alliance') coordinates the system. The system incorporates principles that Oklahoma manufacturers value: (1) decentralization and local accessibility; (2) coordinated existing resources; (3) comprehensive help; (4) interfirm cooperation; (5) pro-active outreach; (6) self- help and commitment from firms; (7) customer governance; and (8) performance accountability. The Oklahoma system consists of: (1) a network of locally-based broker/agents who work directly with manufacturers to diagnose problems and find appropriate assistance; (2) a group of industry sector specialists who collect and disseminate sector specific technological and market intelligence to the broker/agents and their clients; (3) all the specialized public and private sector resources coordinated by the system; and (4) a customer- driven coordination and evaluation mechanism, the Alliance.

  4. Respiratory symptoms, sensitization, and exposure-response relationships in spray painters exposed to isocyanates

    NARCIS (Netherlands)

    Pronk, A.; Preller, L.; Raulf-Heimsoth, M.; Jonkers, I.C.L.; Lammers, J.-W.; Wouters, I.M.; Doekes, G.; Wisnewski, A.V.; Heederik, D.


    Rationale: Associations between oligomeric isocyanate exposure, sensitization, and respiratory disease have received little attention, despite the extensive use of isocyanate oligomers. Objectives: To investigate exposure-response relationships of respiratory symptoms and sensitization in a large

  5. 78 FR 54279 - Proposed Information Collection; Health Standards for Diesel Particulate Matter Exposure... (United States)


    ... provided in the desired format, reporting burden (time and financial resources) is minimized, collection... Information Collection; Health Standards for Diesel Particulate Matter Exposure (Underground Coal Mines... extension of the information collection for Health Standards for Diesel Particulate Matter Exposure...

  6. Competency Modeling in Extension Education: Integrating an Academic Extension Education Model with an Extension Human Resource Management Model (United States)

    Scheer, Scott D.; Cochran, Graham R.; Harder, Amy; Place, Nick T.


    The purpose of this study was to compare and contrast an academic extension education model with an Extension human resource management model. The academic model of 19 competencies was similar across the 22 competencies of the Extension human resource management model. There were seven unique competencies for the human resource management model.…

  7. Extension contact and professional competencies needed by ...

    African Journals Online (AJOL)

    Extension contact and professional competencies needed by extension agents in the Central Region of Ghana for effective transfer of fish-processing technologies to small-scale women in fish processing - Provisional Communication.

  8. Strengthening Agricultural Research Capacity for Viable Extension ...

    African Journals Online (AJOL)

    Strengthening Agricultural Research Capacity for Viable Extension Policies in Nigeria: An Exploration of Ricoeur's Hermeneutic Theory for Analysing Extension Research. ... Progressively more, researchers use hermeneutic philosophy to inform the conduct of interpretive research. Analogy between the philosophical ...

  9. Livestock extension programmes participation and impact on ...

    African Journals Online (AJOL)

    Livestock extension programmes participation and impact on smallholder cattle productivity in Kwazulu-Natal: A propensity score matching approach. ... The study concludes with some policy implications. Keywords: Agricultural Extension, Cattle production, Impact evaluation, Propensity Score Matching, South Africa.

  10. Extensions of cutting problems: setups

    Directory of Open Access Journals (Sweden)

    Sebastian Henn


    Full Text Available Even though the body of literature in the area of cutting and packing is growing rapidly, research seems to focus on standard problems in the first place, while practical aspects are less frequently dealt with. This is particularly true for setup processes which arise in industrial cutting processes whenever a new cutting pattern is started (i.e. a pattern is different from its predecessor and the cutting equipment has to be prepared in order to meet the technological requirements of the new pattern. Setups involve the consumption of resources and the loss of production time capacity. Therefore, consequences of this kind must explicitly be taken into account for the planning and control of industrial cutting processes. This results in extensions to traditional models which will be reviewed here. We show how setups can be represented in such models, and we report on the algorithms which have been suggested for the determination of solutions of the respective models. We discuss the value of these approaches and finally point out potential directions of future research.

  11. Presentation Extensions of the SOAP (United States)

    Carnright, Robert; Stodden, David; Coggi, John


    A set of extensions of the Satellite Orbit Analysis Program (SOAP) enables simultaneous and/or sequential presentation of information from multiple sources. SOAP is used in the aerospace community as a means of collaborative visualization and analysis of data on planned spacecraft missions. The following definitions of terms also describe the display modalities of SOAP as now extended: In SOAP terminology, View signifies an animated three-dimensional (3D) scene, two-dimensional still image, plot of numerical data, or any other visible display derived from a computational simulation or other data source; a) "Viewport" signifies a rectangular portion of a computer-display window containing a view; b) "Palette" signifies a collection of one or more viewports configured for simultaneous (split-screen) display in the same window; c) "Slide" signifies a palette with a beginning and ending time and an animation time step; and d) "Presentation" signifies a prescribed sequence of slides. For example, multiple 3D views from different locations can be crafted for simultaneous display and combined with numerical plots and other representations of data for both qualitative and quantitative analysis. The resulting sets of views can be temporally sequenced to convey visual impressions of a sequence of events for a planned mission.

  12. Logic regression and its extensions. (United States)

    Schwender, Holger; Ruczinski, Ingo


    Logic regression is an adaptive classification and regression procedure, initially developed to reveal interacting single nucleotide polymorphisms (SNPs) in genetic association studies. In general, this approach can be used in any setting with binary predictors, when the interaction of these covariates is of primary interest. Logic regression searches for Boolean (logic) combinations of binary variables that best explain the variability in the outcome variable, and thus, reveals variables and interactions that are associated with the response and/or have predictive capabilities. The logic expressions are embedded in a generalized linear regression framework, and thus, logic regression can handle a variety of outcome types, such as binary responses in case-control studies, numeric responses, and time-to-event data. In this chapter, we provide an introduction to the logic regression methodology, list some applications in public health and medicine, and summarize some of the direct extensions and modifications of logic regression that have been proposed in the literature. Copyright © 2010 Elsevier Inc. All rights reserved.

  13. Effectiveness Of Communication Outreach Strategies Of Extension ...

    African Journals Online (AJOL)

    Communication is a major component of agricultural extension and extension agents utilize various methods to deliver messages to their clienteles. The paper focused on the effectiveness of communication outreach strategies of extension agents in Imo State, Nigeria. Data for the study was collected with the aid of ...

  14. Towards a National Educational Extension Service. (United States)

    Lessinger, Leon M.


    Describes major elements of an extension system for education based on those essential for one in agriculture, as exemplified by the U.S. Department of Agriculture Cooperative Extension Service. Like the agricultural system, an educational extension service would be driven by customer needs, employ county agents to facilitate client/service…

  15. User contributions and public extension delivery modes ...

    African Journals Online (AJOL)

    The high recurrent costs faced by the public extension service constraint the number of visits farmers receive. This study examined a number of extension communication channels through which farmers received farm management services/information from the public extension agent. The idea was, first, to find out the ...

  16. Purdue Extension: Employee Engagement and Leadership Style (United States)

    Abbott, Angela R.


    The purpose of this quantitative study was to assess the Purdue Extension county directors' level of engagement and leadership style and to examine the relationship between these two variables. The study aimed to inform a professional development training program for all Purdue Extension county extension directors. Survey data were collected from…

  17. Flexion/extension cervical spine views in blunt cervical

    Directory of Open Access Journals (Sweden)

    Nasir Sadaf


    Full Text Available 【Abstract】Objective: To examine the contribution of flexion and extension radiographs in the evaluation of ligamentous injury in awake adults with acute blunt cervical spine trauma, who show loss of cervical lordosis and neck pain. Methods: All patients who presented to our emer-gency department following blunt trauma were enrolled in this study, except those with schiwora, neurological defi-cits or fracture demonstrated on cross-table cervical spine X-rays, and those who were either obtunded or presented after cervical spine surgery. Adequacy of flexion and exten-sion views was checked by the neurosurgery and radiology team members. All these patients underwent cross-table cervical spine view followed by flexion/extension views based on the loss of lordosis on cross-table imaging and the presence of neck pain. Results: A total of 200 cases were reviewed, of whom 90 (45% underwent repeat X-rays because of either inadequate exposure or limited motion. None of the patients with loss of lordosis on cross-table view had positive flexion and extension views of cervical spine for instability. Conclusions: Our results show that in patients who underwent acute radiographic evaluation of blunt cervical spine trauma, flexion and extension views of the cervical spine are unlikely to yield positive results in the presence of axial neck pain and/or loss of cervical lordosis. We can also hypothesize that performing flexion and extension views will be more useful once the acute neck pain has settled. Key words: X-rays; Cervical vertebrae; Lordosis

  18. 75 FR 17164 - Asbestos in General Industry; Extension of the Office of Management and Budget's (OMB) Approval... (United States)


    ... Occupational Safety and Health Administration Asbestos in General Industry; Extension of the Office of... requirements specified in its Standard on Asbestos in General Industry (29 CFR 1910.1001). DATES: Comments must... workers with protection from hazardous asbestos exposure. Asbestos exposure results in asbestosis, an...

  19. Morphological size evaluation of the mid-substance insertion areas and the fan-like extension fibers in the femoral ACL footprint. (United States)

    Suruga, Makoto; Horaguchi, Takashi; Iriuchishima, Takanori; Yahagi, Yoshiyuki; Iwama, Genki; Tokuhashi, Yasuaki; Aizawa, Shin


    The purpose of this study was to evaluate the detailed anatomy of the femoral anterior cruciate ligament (ACL) insertion site, with special attention given to the morphology of the mid-substance insertion areas and the fan-like extension fibers. Twenty-three non-paired human cadaver knees were used (7 Males, 16 Females, median age 83, range 69-96). All soft tissues around the knee were resected except the ligaments. The ACL was divided into antero-medial (AM) and postero-lateral (PL) bundles according to the difference in macroscopic tension patterns. The ACL was carefully dissected and two outlines were made of the periphery of each bundle insertion site: those which included and those which excluded the fan-like extension fibers. An accurate lateral view of the femoral condyle was photographed with a digital camera, and the images were downloaded to a personal computer. The area of each bundle, including and excluding the fan-like extension fibers, was measured with Image J software (National Institution of Health). The width and length of the mid-substance insertion sites were also evaluated using same image. The femoral ACL footprint was divided into four regions (mid-substance insertion sites of the AM and PL bundles, and fan-like extensions of the AM and PL bundles). The measured areas of the mid-substance insertion sites of the AM and PL bundles were 35.5 ± 12.5, and 32.4 ± 13.8 mm 2 , respectively. Whole width and length of the mid-substance insertion sites were 5.3 ± 1.4, and 15.5 ± 2.9 mm, respectively. The measured areas of the fan-like extensions of the AM and PL bundles were 27 ± 11.5, and 29.5 ± 12.4 mm 2 , respectively. The femoral ACL footprint was divided into quarters of approximately equal size (mid-substance insertion sites of the AM and PL bundles, and fan-like extensions of the AM and PL bundles). For clinical relevance, to perform highly reproducible anatomical ACL reconstruction, the presence of the fan-like extension

  20. Norm Attaining Arens Extensions on ℓ1

    Directory of Open Access Journals (Sweden)

    Javier Falcó


    Full Text Available We study norm attaining properties of the Arens extensions of multilinear forms defined on Banach spaces. Among other related results, we construct a multilinear form on ℓ1 with the property that only some fixed Arens extensions determined a priori attain their norms. We also study when multilinear forms can be approximated by ones with the property that only some of their Arens extensions attain their norms.

  1. Current Research and Opportunities to Address Environmental Asbestos Exposures (United States)

    Asbestos-related diseases continue to result in approximately 120,000 deaths every year in the United States and worldwide.Although extensive research has been conducted on health effects of occupational exposures to asbestos, many issues related to environmental asbestos exposur...

  2. Control and Modeling of Extensible Continuum Robots (United States)

    National Aeronautics and Space Administration — The goal of this research is to develop fundamental control theory, dynamic modeling, and control technology for extensible continuum robotic manipulators. These...

  3. Improving exposure estimates by combining exposure information. (United States)

    Neitzel, Richard L; Daniell, William E; Sheppard, Lianne; Davies, Hugh W; Seixas, Noah S


    Any exposure estimation technique has inherent strengths and limitations. In an effort to improve exposure estimates, this study developed and evaluated the performance of several hybrid exposure estimates created by combining information from individual assessment techniques. Construction workers (n = 68) each completed three full-shift noise measurements over 4 months. Three single exposure assessment techniques [trade mean (TM), task-based (TB), and subjective rating (SR)] were used to estimate exposures for each subject. Hybrid techniques were then developed which incorporated the TM, SR, and TB noise exposure estimates via arithmetic mean combination, linear regression combination, and modification of TM and TB estimates using SR information. Exposure estimates from the single and hybrid techniques were compared to subjects' measured exposures to evaluate accuracy. Hybrid estimates generally were more accurate than estimates from single techniques. The best-performing hybrid techniques combined TB and SR estimates and resulted in improvements in estimated exposures compared to single techniques. Hybrid estimates were not improved by the inclusion of TM information in this study. Hybrid noise exposure estimates performed better than individual estimates, and in this study, combination of TB and SR estimates using linear regression performed best. The application of hybrid approaches in other contexts will depend upon the exposure of interest and the nature of the individual exposure estimates available.

  4. Technologically modified exposures to natural radiation. Annex C

    International Nuclear Information System (INIS)


    This Annex deals with some examples of technologically modified exposures to natural radiation. Radiation exposures due to coal-fired power plants, geothermal energy production, exploitation of phosphate rock, aircraft travel, and consumer products are discussed. The present state of knowledge does not allow an accurate estimate of the collective effective dose equivalent from technologically modified exposures to natural radiation to be made. This annex has an extensive bibliography with at least 200 references.

  5. Strengthening Agricultural Research Capacity for Viable Extension

    African Journals Online (AJOL)


    under discussion. It is suggested that, in conjunction with Gadamer's hermeneutic of understanding, Ricoeur's theory of interpretation warrants consideration as a method of textual analysis by extension experts in Nigeria. Key words: Ricoeur Hermeneutics, textual analysis, extension. Introduction. There is increasing interest ...

  6. Towards professionalism in agricultural extension: The professional ...

    African Journals Online (AJOL)

    Towards professionalism in agricultural extension: The professional registration of Extensionists in South Africa – A dream or a reality? The role of the South African Society of Extensionists in South Africa – A dream or a reality? The role of the South African Society of Agricultural Extension (SASAE)

  7. An Effective Aquaculture Extension System from Farmers ...

    African Journals Online (AJOL)

    Government and projects extension professionals should support the system through technical training, study tours, publications and networking. Likewise, since educated and well-off farmers in peri-urban areas can access information, government offices should be equipped with well-trained extension personnel and ...

  8. Forestry Extension: An Indispensable Service for Sustainable ...

    African Journals Online (AJOL)

    It is effective forestry extension that can enlighten and educate the forest communities on the inherent dangers their activities pose to the enviroment.This is the premise on which the challenges facing effective forestry extension delivery in Nigeria and suggested solutions to the highlighted challenges is the focus of this write ...

  9. assessment of extension agents' communication methods

    African Journals Online (AJOL)


    ABSTRACT. The need to improve aquaculture production through enhanced technology transfer necessitated this study to assess extension agents' use of communication methods and its impact on linkage. A structured questionnaire was administered to 44 extension agents who were randomly selected from Lagos State ...

  10. Introduction To Natural Resources Management Extension System ...

    African Journals Online (AJOL)

    Introduction To Natural Resources Management Extension System (Nrmes); Rethinking In Extension Systems For 21st Century. ... Growing food demands, soil nutrient depletion is occurring in many tropical and subtropical countries, and land degradation and desertification continues to progress in many other countries.


    NARCIS (Netherlands)

    Sandovici, Adrian; Davidson, KR; Gaspar, D; Stratila, S; Timotin, D; Vasilescu, FH


    The concept of canonical extension of Hermitian operators has been recently introduced by A. Kuzhel. This paper deals with a generalization of this notion to the case of symmetric linear relations. Namely, canonical regular extensions of symmetric linear relations in Hilbert spaces are studied. The

  12. 7 CFR 15b.27 - Extension education. (United States)


    ..., written scripts, or interpreters. Recipients need not provide individually prescribed devices, readers for... Education § 15b.27 Extension education. (a) General. A recipient to which this subpart applies that provides extension education may not, on the basis of handicap, exclude qualified handicapped persons. A recipient...

  13. Creating Teams Increases Extension Educator Productivity (United States)

    Chalker-Scott, Linda; Daniels, Catherine H.; Martini, Nicole


    The Garden Team at Washington State University is a transdisciplinary group of faculty, staff, and students with expertise in applied plant and soil sciences and an interest in Extension education. The team's primary mission is to create current, relevant, and peer-reviewed materials as Extension publications for home gardeners. The average yearly…

  14. Extension Sustainability Camp: Design, Implementation, and Evaluation (United States)

    Brain, Roslynn; Upton, Sally; Tingey, Brett


    Sustainability Camps provide an opportunity for Extension educators to be in the forefront of sustainability outreach and to meet the growing demand for sustainability education. This article shares development, implementation, and evaluation of an Extension Sustainability Camp for youth, grades 4-6. Camp impact was measured via daily pre-and…

  15. Agricultural extension officers' perceptions of integrated pest ...

    African Journals Online (AJOL)

    On the basis of the positive perceptions of the extension officers regarding IPM, the government of Kenya should establish a supportive policy that will enable the extension officers to promote and educate farmers on the various IPM practices. International Journal of Agriculture and Rural Development Vol. 7(2) 2006: 125- ...

  16. Effective Use of Facebook for Extension Professionals (United States)

    Mains, Mark; Jenkins-Howard, Brooke; Stephenson, Laura


    As the use of social media increases, Extension is challenged to stay relevant with cliental by using digital tools. This article illustrates how Facebook can be part of Extension's repertoire of methods for communication, program implementation, education, and marketing. This allows professionals to build social networking capacity with…

  17. Linkage activities amongst researchers, extension agents, farmers ...

    African Journals Online (AJOL)

    This paper examined the research- extension- farmer- input dealer and marketer linkage activities in the North West Province of South Africa. A simple random sampling technique was used to select researchers, extension agents, farmers, agricultural input dealers and marketers. Their responses in linkage activities were ...

  18. Communication for Strengthening Agricultural Extension and Rural ...

    African Journals Online (AJOL)


    estate sub-sector, which accounts for less than 30% of gross domestic product. The smallholder agricultural sector .... d) extension agents' views on the decentralization process; and e) assess extension workers' access to .... consistency or unanimity of agreement that the gap is real and needs to be closed. From the table,.

  19. 10 CFR 905.33 - Extension formula. (United States)


    ... 10 Energy 4 2010-01-01 2010-01-01 false Extension formula. 905.33 Section 905.33 Energy DEPARTMENT OF ENERGY ENERGY PLANNING AND MANAGEMENT PROGRAM Power Marketing Initiative § 905.33 Extension... × project-specific percentage × marketable resource determined to be available at the time future resource...

  20. agricultural research and extension linkage in ethiopia

    African Journals Online (AJOL)


    aimed at strengthening research and extension linkages will differ from country to country depending on historical working relationships between research and extension organisations as well as their organizational structures, responsiveness to the ever- growing challenges and how divergent or convergent their goals are ...

  1. Agricultural extension, research, and development for increased ...

    African Journals Online (AJOL)

    The challenges of food security and agricultural development in South Africa cannot simply be solved by limiting extension and research development to the public sector. However, if shortcomings arise in the public sector while addressing extension, research and development, the potential involvement of the private sector ...

  2. Job satisfaction of extension agents towards innovation ...

    African Journals Online (AJOL)

    The study assessed job satisfaction of extension agents towards innovation dissemination to fish farmers in Lagos State, Nigeria. A simple random sampling technique was used to select 44 extension officers from which data were collected. A structured questionnaire consisting of 6 personal characteristics, 23 management ...

  3. Beneficiary Perceptions of Gender Specific Extension Delivery ...

    African Journals Online (AJOL)

    Women play major roles in agricultural production although only an estimated 5 percent actually benefit from mainstream extension activities. The Gender Specific Extension Delivery Service was instituted to remedy this trend. This study was an attempt to document women beneficiaries' perceptions on the effectiveness of ...

  4. Extension Service Delivery Of Agricultural Development ...

    African Journals Online (AJOL)

    The study was conducted to assess the extension service delivery within the Agricultural Development Programmes of Southwest Nigeria after the cessation of the World Bank funding between 1996 and 2013. Primary data were collected from 201 extension agents across 50% of the states in the area of study using ...

  5. 77 FR 33002 - Proposed Extension of Existing Information Collection; Health Standards for Diesel Particulate... (United States)


    ... information in accordance with the Paperwork Reduction Act of 1995. This program helps to assure that requested data can be provided in the desired format, reporting burden (time and financial resources) is... Extension of Existing Information Collection; Health Standards for Diesel Particulate Matter Exposure...

  6. 75 FR 17163 - Formaldehyde Standard; Extension of the Office of Management and Budget's (OMB) Approval of... (United States)


    ... Occupational Safety and Health Administration Formaldehyde Standard; Extension of the Office of Management and... specified in the Standard on Formaldehyde (29 CFR 1910.1048). The standard protects workers from the adverse health effects from occupational exposure to Formaldehyde. DATES: Comments must be submitted (postmarked...

  7. Extension through Partnerships: Research and Education Center Teams with County Extension to Deliver Programs (United States)

    Mullahey, J. Jeffrey


    Budget reductions have severely affected resources available to deliver agriculture and natural resource Extension programs in Florida. University of Florida/Institute of Food and Agricultural Sciences delivers Extension programming through a unique partnership between research and education centers and county Extension. Science-based information…

  8. Examining eXtension: Diffusion, Disruption, and Adoption among Iowa State University Extension and Outreach Professionals (United States)

    Taylor, Cayla; Miller, Greg


    As eXtension unveils its new membership model, Iowa State University Extension and Outreach must determine how best to support professionals and clientele using the technology. This article reports on a study that used the diffusion of innovations and disruptive innovation theories to assess Iowa Extension professionals' adoption and perceptions…

  9. The Brazilian Experience with Agroecological Extension: A Critical Analysis of Reform in a Pluralistic Extension System (United States)

    Diesel, Vivien; Miná Dias, Marcelo


    Purpose: To analyze the Brazilian experience in designing and implementing a recent extension policy reform based on agroecology, and reflect on its wider theoretical implications for extension reform literature. Design/methodology/approach: Using a critical public analysis we characterize the evolution of Brazilian federal extension policy…

  10. Extension versus Bending for Continuum Robots

    Directory of Open Access Journals (Sweden)

    George Grimes


    Full Text Available In this paper, we analyze the capabilities of a novel class of continuous-backbone ("continuum" robots. These robots are inspired by biological "trunks, and tentacles". However, the capabilities of established continuum robot designs, which feature controlled bending but not extension, fall short of those of their biological counterparts. In this paper, we argue that the addition of controlled extension provides dual and complementary functionality, and correspondingly enhanced performance, in continuum robots. We present an interval-based analysis to show how the inclusion of controllable extension significantly enhances the workspace and capabilities of continuum robots.

  11. Generalized extensions and blocking factors for FITS (United States)

    Grosbol, P.; Harten, R. H.; Greisen, E. W.; Wells, D. C.


    A general design for extending the Flexible Image Transport System (FITS) tape format is proposed. The present design is shown to preserve compatibility with existing FITS tapes and software (including the 'random groups'), while being general enough to permit a wide variety of new extension files to be designed in the future. Rules are given for the blocking of FITS logical records. The rules for the generalized extension of FITS ensure that extensions can be located and decoded by standard routines without interfering with each other.

  12. Personal exposure control system

    International Nuclear Information System (INIS)

    Tanabe, Ken-ichi; Akashi, Michio


    Nuclear power stations are under strict radiation control. Exposure control for nuclear workers is the most important operation, and so carefully thought out measures are taken. This paper introduces Fuji Electric's personal exposure control system that meets strict exposure control and rationalizes control operations. The system has a merit that it can provide required information in an optimum form using the interconnection of a super minicomputer and exposure control facilities and realizes sophisticated exposure control operations. (author)

  13. Integrated Composite Rocket Nozzle Extension Project (United States)

    National Aeronautics and Space Administration — ORBITEC proposes to develop and demonstrate an Integrated Composite Rocket Nozzle Extension (ICRNE) for use in rocket thrust chambers. The ICRNE will utilize an...

  14. 40 CFR 52.2322 - Extensions. (United States)


    ..., by authority delegated under section 188(d) of the Clean Air Act, as amended in 1990, extends for two... PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Utah § 52.2322 Extensions. (a) The Administrator, by authority...

  15. Fundamentally Flawed: Extension Administrative Practice (Part 1). (United States)

    Patterson, Thomas F., Jr.


    Extension's current administrative techniques are based on the assumptions of classical management from the early 20th century. They are fundamentally flawed and inappropriate for the contemporary workplace. (SK)

  16. ERP extension - Supply Chain Management (SCM)


    Vasile LUPSE; Ovidiu COSMA


    This article presents an extension of a ERP (Enterprise Resource Planning), more precisely the Supply Chain Management (SCM), together with some personal considerations and contributions of the authors, regarding the presented concepts.

  17. Extensive Reading: A Means of Reconciliation. (United States)

    Kutiper, Karen


    Cites research suggesting that extensive reading is as effective as intensive reading in developing general reading ability and is more effective in promoting good attitudes among elementary and secondary school students toward reading. (MM)

  18. Bandwidth extension of speech using perceptual criteria

    CERN Document Server

    Berisha, Visar; Liss, Julie


    Bandwidth extension of speech is used in the International Telecommunication Union G.729.1 standard in which the narrowband bitstream is combined with quantized high-band parameters. Although this system produces high-quality wideband speech, the additional bits used to represent the high band can be further reduced. In addition to the algorithm used in the G.729.1 standard, bandwidth extension methods based on spectrum prediction have also been proposed. Although these algorithms do not require additional bits, they perform poorly when the correlation between the low and the high band is weak. In this book, two wideband speech coding algorithms that rely on bandwidth extension are developed. The algorithms operate as wrappers around existing narrowband compression schemes. More specifically, in these algorithms, the low band is encoded using an existing toll-quality narrowband system, whereas the high band is generated using the proposed extension techniques. The first method relies only on transmitted high-...


    Abdellatief, Amro; Pulido, Jose S; Bartley, George B; Salomao, Diva R; Quinn, Timothy A


    Case report describing a patient who developed intracranial extension of a uveal melanoma through the optic nerve. We reviewed the patient's medical history and images. A 41-year-old woman who was blind in one eye had a uveal melanoma that extended through the optic nerve into the optic chiasm and involved the hypophysis. The patient then developed metastasis. The patient developed uveal melanoma extension into the optic chiasm through the optic nerve resulting in a visual field defect in the fellow eye. Uveal melanoma extension through the optic nerve is a devastating complication, which occurs anywhere from 0.6% to 3.7% in patients with uveal melanoma. If enucleation of the affected eye is performed, a representative portion of the optic nerve should be excised to decrease the risk of extension. Patients with phthisical eyes should undergo appropriate imaging techniques to prevent a missed diagnosis of optic nerve involvement.

  20. 76 FR 79665 - Agency Information Collection Extension (United States)


    ... 1995. The information collection package requests a three-year extension of ``Industrial Relations... request contains: (1) OMB No. 1910-0600; (2) Information Collection Request Title: Industrial Relations...

  1. ERP extension - Supply Chain Management (SCM

    Directory of Open Access Journals (Sweden)

    Vasile LUPSE


    Full Text Available This article presents an extension of a ERP (Enterprise Resource Planning, more precisely the Supply Chain Management (SCM, together with some personal considerations and contributions of the authors, regarding the presented concepts.

  2. Offshore extension of Gomati river, Dwarka

    Digital Repository Service at National Institute of Oceanography (India)

    Vora, K.H.; Naik, D.K.; Ganesan, P.; Moraes, C.

    information. Attempts have been made to identify the submerged extension of Gomati River by diving inspection and based on the results obtained such as findings like stone and iron anchors, circular bastions, etc. While many features reported earlier...

  3. Economic modeling for life extension decision making

    International Nuclear Information System (INIS)

    Farber, M.A.; Harrison, D.L.; Carlson, D.D.


    This paper presents a methodology for the economic and financial analysis of nuclear plant life extension under uncertainty and demonstrates its use in a case analysis. While the economic and financial evaluation of life extension does not require new analytical tools, such studies should be based on the following three premises. First, the methodology should examine effects at the level of the company or utility system, because the most important economic implications of life extension relate to the altered generation system expansion plan. Second, it should focus on the implications of uncertainty in order to understand the factors that most affect life extension benefits and identify risk management efforts. Third, the methodology should address multiple objectives, at a minimum, both economic and financial objectives

  4. Integrated Composite Rocket Nozzle Extension, Phase I (United States)

    National Aeronautics and Space Administration — ORBITEC proposes to develop and demonstrate an Integrated Composite Rocket Nozzle Extension (ICRNE) for use in rocket thrust chambers. The ICRNE will utilize an...

  5. Virtual reality exposure therapy for anxiety disorders: the state of the art

    NARCIS (Netherlands)

    Meyerbröker, K.; Emmelkamp, P.M.G.; Brahnam, S.; Jain, L.C.


    In the past 10 years virtual reality exposure therapy (VRET) has become a viable alternative for exposure in vivo, the gold standard for the treatment of anxiety disorders. VRET is often regarded as a natural extension of the systematic exposure component of (cognitive) behavior therapy. The

  6. An Overview of English Extensive Reading Program


    Fujikami , Ryuji; Nagasaka, Tatsuhiko Paul; Yoshino, Yasuko; Jones, Andrew


    In this paper, we review the changes in attitude toward reading English shown by students as a result of participating in an extensive reading program. The top classes for each department studying Integrated English in the first semester of 2012 were given the challenge of reading extensively in English, using simple readers from leading publishers. Before and after the program, the non-English majors were asked to answer a questionnaire designed to reveal their attitudes toward reading Engli...

  7. Alcohol Exposure In Utero and Child Academic Achievement


    Stephanie von Hinke Kessler Scholder; George L. Wehby; Sarah Lewis; Luisa Zuccolo


    We examine the effect of alcohol exposure in utero on child academic achievement. As well as studying the effect of any alcohol exposure, we investigate the effect of the dose, pattern, and duration of exposure. We use a genetic variant in the maternal alcohol-metabolism gene ADH1B as an instrument for alcohol exposure, whilst controlling for the child's genotype on the same variant. We show that the instrument is unrelated to an extensive range of maternal and paternal characteristics and be...

  8. Extension for prevention: is it relevant today? (United States)

    Osborne, J W; Summitt, J B


    Extension for prevention has been an integral part of dentistry for over 100 years. Because this concept advocated the removal of sound tooth structure, it was not totally accepted at the turn of the century. The advent of the gold casting catapulted extension for prevention into general acceptance. In 1883, Webb presented a concept of "prevention of extension of decay". This concept advocated a proximal cavity preparation extending toward the buccal and lingual aspects of the tooth so that contact with adjacent teeth would not be at the margins. The separation of the margins, along with proper restoration contours, was thought to promote natural cleansing of the embrasures with saliva and fluids in the diet. GV Black's 1891 idea of "extension for prevention" was to provide extension of the preparation to the facial and lingual line angles in order to bring about "self-cleansing" margins via food excursion. Black's concept also included extending preparations through fissures to allow cavosurface margins to be on non-fissured enamel. Black integrated the extension of the proximal margins with his concept of an occlusal isthmus for a Class II amalgam preparation one-third the faciolingual width of the occlusal surface. Challenges to this concept of extension for prevention were immediate; and, by the 1950's, narrower, more conservative preparations were seen by a few as being more effective in preserving teeth. Not only occlusal width was reassessed, but the need to routinely extend proximal margins to the buccal and lingual line angles was also questioned. By the mid-1960's and early 1970's a more conservative approach to amalgam preparation was advocated and was being taught in some dental schools. Today, a standardized outline form should not be used or taught as a principle of cavity preparation. In areas where fissure caries has necessitated a preparation extending into dentin, a composite resin or dental amalgam restoration should be placed, and a fissure

  9. Upper Stage Engine Composite Nozzle Extensions (United States)

    Valentine, Peter G.; Allen, Lee R.; Gradl, Paul R.; Greene, Sandra E.; Sullivan, Brian J.; Weller, Leslie J.; Koenig, John R.; Cuneo, Jacques C.; Thompson, James; Brown, Aaron; hide


    Carbon-carbon (C-C) composite nozzle extensions are of interest for use on a variety of launch vehicle upper stage engines and in-space propulsion systems. The C-C nozzle extension technology and test capabilities being developed are intended to support National Aeronautics and Space Administration (NASA) and United States Air Force (USAF) requirements, as well as broader industry needs. Recent and on-going efforts at the Marshall Space Flight Center (MSFC) are aimed at both (a) further developing the technology and databases for nozzle extensions fabricated from specific CC materials, and (b) developing and demonstrating low-cost capabilities for testing composite nozzle extensions. At present, materials development work is concentrating on developing a database for lyocell-based C-C that can be used for upper stage engine nozzle extension design, modeling, and analysis efforts. Lyocell-based C-C behaves in a manner similar to rayon-based CC, but does not have the environmental issues associated with the use of rayon. Future work will also further investigate technology and database gaps and needs for more-established polyacrylonitrile- (PAN-) based C-C's. As a low-cost means of being able to rapidly test and screen nozzle extension materials and structures, MSFC has recently established and demonstrated a test rig at MSFC's Test Stand (TS) 115 for testing subscale nozzle extensions with 3.5-inch inside diameters at the attachment plane. Test durations of up to 120 seconds have been demonstrated using oxygen/hydrogen propellants. Other propellant combinations, including the use of hydrocarbon fuels, can be used if desired. Another test capability being developed will allow the testing of larger nozzle extensions (13.5- inch inside diameters at the attachment plane) in environments more similar to those of actual oxygen/hydrogen upper stage engines. Two C-C nozzle extensions (one lyocell-based, one PAN-based) have been fabricated for testing with the larger

  10. Exposure scenarios for workers

    NARCIS (Netherlands)

    Marquart, H.; Northage, C.; Money, C.


    The new European chemicals legislation REACH (Registration, Evaluation, Authorisation and restriction of Chemicals) requires the development of Exposure Scenarios describing the conditions and risk management measures needed for the safe use of chemicals. Such Exposure Scenarios should integrate

  11. Dioxin Exposure Initiative (United States)

    The Dioxin Exposure Initiative (DEI) is no longer active. This page contains a summary of the dioxin exposure initiative with illustrations, contact and background information.Originally supported by scientist Matthew Lorber, who retired in Mar 2017.

  12. Occupational Noise Exposure (United States)

    ... Safety and Health Topics / Occupational Noise Exposure Occupational Noise Exposure This page requires that javascript be enabled ... interprets the signal as sound. x What is noise? Noise and vibration are both fluctuations in the ...

  13. Virtual reality exposure therapy


    Rothbaum, BO; Hodges, L; Kooper, R


    It has been proposed that virtual reality (VR) exposure may be an alternative to standard in vivo exposure. Virtual reality integrates real-time computer graphics, body tracking devices, visual displays, and other sensory input devices to immerse a participant in a computer- generated virtual environment. Virtual reality exposure is potentially an efficient and cost-effective treatment of anxiety disorders. VR exposure therapy reduced the fear of heights in the first control...

  14. Occupational exposures. Annex H

    International Nuclear Information System (INIS)


    This Annex focuses on significant changes in the pattern of occupational exposure which have appeared since the 1972 and 1962 reports, and presents information on trends or particular causes of high exposures. A further objective is to clarify the reasons for which the Committee requires data on occupational exposure, and to suggest areas in which better data collection or analysis may be performed. Data are also reviewed on accidents involving the exposure of workers to substantial radiation doses.

  15. How to make agricultural extension demand-driven?: The case of India's agricultural extension policy


    Birner, Regina; Anderson, Jock R.


    "Many countries have recognized the need to revive agricultural advisory or extension services (the terms are used interchangeably here) as a means of using agriculture as an engine of pro-poor growth; reaching marginalized, poor, and female farmers; and addressing new challenges, such as environmental degradation and climate change. In spite of ample experience with extension reform worldwide, identifying the reform options most likely to make extension more demand-driven remains a major cha...

  16. abc: An extensible AspectJ compiler

    DEFF Research Database (Denmark)

    Avgustinov, Pavel; Christensen, Aske Simon; Hendren, Laurie


    Research in the design of aspect-oriented programming languages requires a workbench that facilitates easy experimentation with new language features and implementation techniques. In particular, new features for AspectJ have been proposed that require extensions in many dimensions: syntax, type...... checking and code generation, as well as data flow and control flow analyses. The AspectBench Compiler (abc) is an implementation of such a workbench. The base version of abc implements the full AspectJ language. Its frontend is built, using the Polyglot framework, as a modular extension of the Java...... language. The use of Polyglot gives flexibility of syntax and type checking. The backend is built using the Soot framework, to give modular code generation and analyses. In this paper, we outline the design of abc, focusing mostly on how the design supports extensibility. We then provide a general overview...

  17. Supersymmetric extension of the Snyder algebra

    Energy Technology Data Exchange (ETDEWEB)

    Gouba, L., E-mail: [Abdus Salam International Centre for Theoretical Physics (ICTP), Strada Costiera 11, 34014 Trieste (Italy); Stern, A., E-mail: [Dept. of Physics and Astronomy, Univ. of Alabama, Tuscaloosa, Al 35487 (United States)


    We obtain a minimal supersymmetric extension of the Snyder algebra and study its representations. The construction differs from the general approach given in Hatsuda and Siegel ( (arXiv:hep-th/0311002)) and does not utilize super-de Sitter groups. The spectra of the position operators are discrete, implying a lattice description of space, and the lattice is compatible with supersymmetry transformations. -- Highlights: Black-Right-Pointing-Pointer A new supersymmetric extension of the Snyder algebra is constructed. Black-Right-Pointing-Pointer The extension is minimal and the construction does not involve supersymmetric de Sitter algebras. Black-Right-Pointing-Pointer An involution is defined for the system and discrete representations are constructed. Black-Right-Pointing-Pointer The representations imply a spatial lattice and the lattice spacing is half that of the bosonic case. Black-Right-Pointing-Pointer A differential operator representation is given for fields on super-momentum space.

  18. Timeability in Extensive-Form Games

    DEFF Research Database (Denmark)

    Jakobsen, Sune K.; Sørensen, Troels Bjerre; Conitzer, Vincent


    Extensive-form games constitute the standard representation scheme for games with a temporal component. But do all extensive-form games correspond to protocols that we can implement in the real world? We often rule out games with imperfect recall, which prescribe that an agent forget something...... that she knew before. In this paper, we show that even some games with perfect recall can be problematic to implement. Specifically, we show that if the agents have a sense of time passing (say, access to a clock), then some extensive-form games can no longer be implemented; no matter how we attempt...... to time the game, some information will leak to the agents that they are not supposed to have. We say such a game is not exactly timeable. We provide easy-to-check necessary and sufficient conditions for a game to be exactly timeable. Most of the technical depth of the paper concerns how to approximately...

  19. Symmetric Functional Model for Extensions of Hermitian

    CERN Document Server

    Ryzhov, V


    This paper offers the functional model of a class of non-selfadjoint extensions of a Hermitian operator with equal deficiency indices. The explicit form of dilation of a dissipative extension is offered and the symmetric form of Sz.Nagy-Foia\\c{s} model as developed by B.~Pavlov is constructed. A variant of functional model for a general non-selfadjoint non-dissipative extension is formulated. We illustrate the theory by two examples: singular perturbations of the Laplace operator in~$L_2(\\Real^3)$ by a finite number of point interactions, and the Schr\\"odinger operator on the half axis~$(0, \\infty)$ in the Weyl limit circle case at infinity.

  20. Bayesian optimization for computationally extensive probability distributions. (United States)

    Tamura, Ryo; Hukushima, Koji


    An efficient method for finding a better maximizer of computationally extensive probability distributions is proposed on the basis of a Bayesian optimization technique. A key idea of the proposed method is to use extreme values of acquisition functions by Gaussian processes for the next training phase, which should be located near a local maximum or a global maximum of the probability distribution. Our Bayesian optimization technique is applied to the posterior distribution in the effective physical model estimation, which is a computationally extensive probability distribution. Even when the number of sampling points on the posterior distributions is fixed to be small, the Bayesian optimization provides a better maximizer of the posterior distributions in comparison to those by the random search method, the steepest descent method, or the Monte Carlo method. Furthermore, the Bayesian optimization improves the results efficiently by combining the steepest descent method and thus it is a powerful tool to search for a better maximizer of computationally extensive probability distributions.

  1. A novel decision diagrams extension method

    International Nuclear Information System (INIS)

    Li, Shumin; Si, Shubin; Dui, Hongyan; Cai, Zhiqiang; Sun, Shudong


    Binary decision diagram (BDD) is a graph-based representation of Boolean functions. It is a directed acyclic graph (DAG) based on Shannon's decomposition. Multi-state multi-valued decision diagram (MMDD) is a natural extension of BDD for the symbolic representation and manipulation of the multi-valued logic functions. This paper proposes a decision diagram extension method based on original BDD/MMDD while the scale of a reliability system is extended. Following a discussion of decomposition and physical meaning of BDD and MMDD, the modeling method of BDD/MMDD based on original BDD/MMDD is introduced. Three case studies are implemented to demonstrate the presented methods. Compared with traditional BDD and MMDD generation methods, the decision diagrams extension method is more computationally efficient as shown through the running time

  2. On Central Extensions of Associative Dialgebras (United States)

    Rakhimov, Isamiddin S.


    The concept of central extensions plays an important in constructing extensions of algebras. This technique has been successfully used in the classification problem of certain classes of algebras. In 1978 Skjelbred and Sund reduced the classification of nilpotent Lie algebras in a given dimension to the study of orbits under the action of automorphism group on the space of second degree cohomology of a smaller Lie algebra with coefficients in a trivial module. Then W. de Graaf applied the Skjelbred and Sund method to the classification problem of low-dimensional nilpotent Lie and associative algebras over some fields. The main purpose of this note is to establish elementary properties of central extensions of associative dialgebras and apply the above mentioned method to the classification of low dimensional nilpotent associative dialgebras.

  3. Prospective of the agricultural extension in Colombia

    International Nuclear Information System (INIS)

    David Hinestrosa, A.


    The situation of the agricultural extension is described in next twenty years, together with the regional programs of investigation and technology transfer, based in the rational use of the natural resources, the exploitation of markets, the former evaluation before and the expert systems. It proves the dynamic participation of producing leaders and their operation inside an outline of decentralization, privatization, sustainability, competitiveness, justness and invigoration and rural signification. It is supposed that the extension rural functional, bound to the investigation processes, transfer, development, technological development and markets. Institutionally it is expected that the extension is a service of regional and private character with an opportune and enough assignment of resources for the improvement of the quality of the rural population's life

  4. Assessment of human exposures

    Energy Technology Data Exchange (ETDEWEB)

    Lebret, E. [RIVM-National Inst. of Public Health and Environmental Protection (Netherlands)


    This article describes some of the features of the assessment of human exposure to environmental pollutants in epidemiological studies. Since exposure assessment in air pollution epidemiology studies typically involve professionals from various backgrounds, interpretation of a concepts like `exposure` may vary. A brief descriptions is therefore given by way of introduction

  5. A Technique: Exposure Therapy

    Directory of Open Access Journals (Sweden)

    Serkan AKKOYUNLU


    Full Text Available Introduction: Exposure with response prevention is an effective treatment for all anxiety disorders. According to the behavioral learning theories, fears which are conditioned via classical conditioning are reinforced by respondent conditioning. Avoidance and safety seeking behaviors prevent disconfirmation of anxious beliefs. In exposure client faces stimulates or cues that elicit fear or distress, by this avoidance is inhibited. Clients are also encouraged to resists performing safety seeking behaviors or rituals that they utilize to reduce fear or distress. Accomplishing these habituation or extinction is achieved. In addition to this clients learn that feared consequences does not realize or not harmful as they believed by experiencing. Emotional processing is believed to be the mechanism of change in exposure.Objective: The aim of this review is to provide a definition of exposure and its effectiveness briefly, and describe how to implement exposure, its steps and remarkable aspects using. Exposure therapies and treatments that involve exposure are proved to be effective in all anxiety disorders. Exposure therapy can be divided in three parts: Assessment and providing a treatment rationale, creating an exposure hierarchy and response prevention plan, implementing exposure sessions. Clients must also continue to perform exposure between sessions. Therapy transcripts are also provided to exemplify these parts. Conclusion: Exposure with response prevention is a basic and effective technique. Every cognitive behavior therapist must be able to implement this technique and be cognizant of pearls of this procedure.

  6. Extensive keloidal healing of pemphigus vulgaris

    Directory of Open Access Journals (Sweden)

    Khanna Neena


    Full Text Available Bullae of pemphigus vulgaris heal without scarring. We here report a patient of pemphigus vulgaris whose lesions healed with a one-month history of extensive flaccid bullae and uninfected erosions on the trunk and extremities along with superficial erosions in the oral mucosa. The clinical suspicion of pemphigus vulgaris was confirmed by histopathological and immunohistological examination. Pulse therapy with monthly parenteral dexamethasone and cyclophosphamide pulse was instituted. The cutaneous lesions on healing formed extensive keloidal scars despite high dose of monthly corticosteroid therapy.

  7. Extension of the nuclear power plant lifetime

    International Nuclear Information System (INIS)

    Keramsi, Alain


    After a presentation of the French nuclear context (history of the reactor fleet, choice of reactor type, PWR operation principle, competitiveness, environmental performance), this Power Point presentation addresses the context and challenges of the operation lifetime (average fleet age in different countries, examples of extensions, case of the United States, what is at stake with lifetime extension, decennial visits, EDF strategy), discusses the EDF's safety objectives (definition of the three main safety functions, impact of the operation duration and of the coexistence of two generations for the safety functions), discusses how to manage the ageing phenomenon for replaceable and non-replaceable components

  8. On loop extensions and cohomology of loops


    Benítez, Rolando Jiménez; Meléndez, Quitzeh Morales


    In this paper are defined cohomology-like groups that classify loop extensions satisfying a given identity in three variables for association identities, and in two variables for the case of commutativity. It is considered a large amount of identities. This groups generalize those defined in works of Nishigori [2] and of Jhonson and Leedham-Green [4]. It is computed the number of metacyclic extensions for trivial action of the quotient on the kernel in one particular case for left Bol loops a...

  9. Mathematics for common entrance three (extension) answers

    CERN Document Server

    Alexander, Serena


    This book contains answers to all exercises featured in the accompanying textbook Mathematics for Common Entrance Three (Extension) , which provides essential preparation for Level 3 of the ISEB 13+ Mathematics exam, as well as for CASE and other scholarship exams. - Clean, clear layout for easy marking. - Includes examples of high-scoring answers with diagrams and workings. Also available to purchase from the Galore Park website :. - Mathematics for Common Entrance Three (Extension). - Mathematics for Common Entrance One. - Mathematics for Common Entrance One Answers. - M

  10. Global Approaches to Extension Practice: A Journal of Agricultural ...

    African Journals Online (AJOL)

    Global Approaches to Extension Practice (GAEP), A publication of the Department of Agricultural Extension, Federal University of Technology, Owerri, Imo State, Nigeria is an international journal which considers articles from all areas of Agricultural Extension: rural sociology, environmental extension, extension ...

  11. Software extension and integration with type classes

    DEFF Research Database (Denmark)

    Lämmel, Ralf; Ostermann, Klaus


    expressiveness, by using the language concept of \\emph{type classes}, as it is available in the functional programming language Haskell. A detailed comparison with related work shows that type classes provide a powerful framework in which solutions to known software extension and integration problems can...... be provided. We also pinpoint several limitations of type classes in this context....

  12. Integrating Reading and Writing through Extensive Reading (United States)

    Park, Jeongyeon


    This study explores whether an extensive reading (ER) approach can enhance L2 learners' writing performance in an English for Academic Purposes context. Two classes were compared in terms of writing improvement after one semester: a 'traditional' writing class primarily focused on writing practice and grammar instruction, and an ER class in which…

  13. Design Extension in Post Fukushima Scenario

    International Nuclear Information System (INIS)

    Kumar, Prabhat


    Post Fukushima Flooding Review and Design Extension: • Increased tsunami height; • Increased tsunami wall;• Increased size of storm water drains; • Non return gates in storm water drains; • Wall around fore bay and sea water pump house; • Sealing of NIB penetrations for a higher tsunami; • Alternative approach road; • NICB elevation; • Perpendicular to coast line

  14. On an extension of a combinatorial identity

    Indian Academy of Sciences (India)

    On an extension of a combinatorial identity. M RANA and A K AGARWAL. Center for Advanced Study in Mathematics, Panjab University, Chandigarh 160 014,. India. E-mail: MS received 22 August 2007. Abstract. Using Frobenius partitions we extend the main results of [4]. This leads to an infinite family of ...

  15. Equivalence relations of AF-algebra extensions

    Indian Academy of Sciences (India)

    In this paper, we consider equivalence relations of *-algebra extensions and describe the relationship between the isomorphism equivalence and the unitary equivalence. We also show that a certain group homomorphism is the obstruction for these equivalence relations to be the same.

  16. newspapers' agricultural agenda setting and extension agents ...

    African Journals Online (AJOL)


    issue 'agendas' there is need, as asserted by McQuail (1987:75) for a combination of content analysis showing media attention to different issues in the relevant period and some indication of relevant media used by the public concerned, in this study, the extension agents. Agenda-setting according to Davis and Robinson ...

  17. Seroprevalence Study Of Bovine Brucellosis In Extensive ...

    African Journals Online (AJOL)

    The prevalence of bovine brucellosis was measured in cross sectional study in Jimma zone, Western Ethiopia using Rose Bengal Plate Test (RBT) and CFT from October 2003 to April 2004. The study animals consisted of 1305 local breed found in extensive system in five districts of in the zone. The overall individual animal ...

  18. Obstructions to Clifford system extensions of algebras

    Indian Academy of Sciences (India)

    Springer Verlag Heidelberg #4 2048 1996 Dec 15 10:16:45

    The problem of Clifford system extensions resides in the classification and the construction ... The construction of T ( ) is closely analogous to a construction by Kanzaki [9], for a description of the. Chase-Harrison-Rosenberg seven term exact sequence [2] about the Brauer group. .... Cliffk(G, R; ) = χ−1( ) the fiber of χ over.


    African Journals Online (AJOL)

    The study attempts to assess the current trends, impact and constraints of fisheries extension services to artisanal fishers in Ogun Waterside Local Government Area of Ogun State. The survey approach was used to generate the needed data using 120 structured questionnaires. Simple statistical techniques such as means ...


    African Journals Online (AJOL)

    The study focuses on fisheries extension activities among women in Epe local Government area of Lagos State. A total 106 questionnaires were obtained from 120 randomly administered questionnaires. The result shows that majority of the women are sole owners of the businesses and they obtained fishing skills from their ...

  1. Journal of Environmental Extension: Editorial Policies

    African Journals Online (AJOL)

    Focus and Scope. Journal of Environmental Extension is to be published annually to generate ideas on formulation, packaging, dissemination and consequential impacts of ideas/policies relating to the quality and sustainability of the environment. Focus of the Journal is on: Health Agriculture Technology

  2. ANTLR Tree Grammar Generator and Extensions (United States)

    Craymer, Loring


    A computer program implements two extensions of ANTLR (Another Tool for Language Recognition), which is a set of software tools for translating source codes between different computing languages. ANTLR supports predicated- LL(k) lexer and parser grammars, a notation for annotating parser grammars to direct tree construction, and predicated tree grammars. [ LL(k) signifies left-right, leftmost derivation with k tokens of look-ahead, referring to certain characteristics of a grammar.] One of the extensions is a syntax for tree transformations. The other extension is the generation of tree grammars from annotated parser or input tree grammars. These extensions can simplify the process of generating source-to-source language translators and they make possible an approach, called "polyphase parsing," to translation between computing languages. The typical approach to translator development is to identify high-level semantic constructs such as "expressions," "declarations," and "definitions" as fundamental building blocks in the grammar specification used for language recognition. The polyphase approach is to lump ambiguous syntactic constructs during parsing and then disambiguate the alternatives in subsequent tree transformation passes. Polyphase parsing is believed to be useful for generating efficient recognizers for C++ and other languages that, like C++, have significant ambiguities.

  3. Effectively Communicating Science to Extension Audiences (United States)

    Robinson, Patrick


    This article discusses the concept of "framing" within the context of relevant communication and psychological research and considers its potential applicability to Extension science communication. Examples of research-based support for the framing of scientific issues are presented, along with a literature-based discussion of the…

  4. Banana Algebra: Compositional Syntactic Language Extension

    DEFF Research Database (Denmark)

    Andersen, Jacob; Brabrand, Claus; Christiansen, David Raymond


    We propose an algebra of languages and transformations as a means of compositional syntactic language extension. The algebra provides a layer of high-level abstractions built on top of languages (captured by context-free grammars) and transformations (captured by constructive catamorphisms). The ...

  5. Principles Guiding Vocabulary Learning through Extensive Reading (United States)

    Nation, Paul


    Extensive reading is one of a range of activities that can be used in a language learning course. Ideally, the choice of activities to go into a course should be guided by principles which are well supported by research. Similarly, the way each of those activities is used should be guided by well-justified principles. In this article, we look at…

  6. Improving Generation Y Volunteerism in Extension Programs (United States)

    Andrews, Kevin B.; Lockett, Landry L.


    Members of Generation Y have many positive attributes that make them attractive to Extension volunteer administrators as a potential source of labor. However, they think differently, have unique needs, require new management styles, and have less tolerance for unpleasant working conditions than previous generations. Additionally, they are engaged…

  7. Equivalence relations of AF-algebra extensions

    Indian Academy of Sciences (India)

    Home; Journals; Proceedings – Mathematical Sciences; Volume 120; Issue 2. Equivalence Relations of -Algebra Extensions. Changguo Wei. Volume 120 Issue 2 April 2010 ... Author Affiliations. Changguo Wei1. School of Mathematical Sciences, Ocean University of China, Qingdao 266071, People's Republic of China ...

  8. Issues for Agricultural Extension Policy in Nigeria

    African Journals Online (AJOL)


    Agriculture is the bedrock of economic development in Nigeria. However, the development of the ... This policy direction placed additional responsibilities on extension by including sustainable development ... years and the recent trends in agricultural development world wide have necessitated the formulation of more ...

  9. Supersymmetric Extension of Technicolor & Fermion Mass Generation

    DEFF Research Database (Denmark)

    Antola, Matti; Di Chiara, Stefano; Sannino, Francesco


    We provide a complete extension of Minimal Walking Technicolor able to account for the standard model fermion masses. The model is supersymmetric at energies greater or equal to the technicolor compositeness scale. We integrate out, at the supersymmetry breaking scale, the elementary Higgses. We...

  10. On Viviani's Theorem and Its Extensions (United States)

    Abboud, Elias


    Viviani's theorem states that the sum of distances from any point inside an equilateral triangle to its sides is constant. Here, in an extension of this result, we show, using linear programming, that any convex polygon can be divided into parallel line segments on which the sum of the distances to the sides of the polygon is constant. Let us say…

  11. Emergency Food Programs: Untapped Opportunities for Extension? (United States)

    Mobley, Amy R.


    This article reports results from a questionnaire that assessed the frequency and type of nutrition questions asked at emergency food programs to determine if Extension professionals need to increase direct outreach efforts. Emergency food program workers (n = 460) were recruited via mail to complete a self-administered survey. More than one-third…

  12. Extending the Agricultural Extension Model. Preliminary Draft. (United States)

    Rogers, Everett M.; And Others

    The purposes of this report are: to describe the main elements of the U.S. agricultural extension model and its effects on the agricultural revolution; to analyze attempts to extend this model to non-agricultural technology and/or to less developed countries; and to draw general conclusions about the diffusion of technological innovations, with…

  13. Need for Methamphetamine Programming in Extension Education (United States)

    Beaudreault, Amy R.; Miller, Larry E.


    The study reported sought to identify the prevention education needs involving methamphetamine through survey methodology. The study focused on a random sample of U.S. states and the Extension Directors within each state, resulting in a 70% response rate (n = 134). Findings revealed that 11% reported they had received methamphetamine user…


    CERN Multimedia

    Human Resources Division


    In accordance with the provisions agreed by the Finance Committee and Council in March and June 2000, respectively, the Director-General has approved the extension of the Progressive Retirement Programme with effect from 1 April 2001, for one year. Human Resources Division Tel. 72808/74128

  15. A Graph Library Extension of SVG

    DEFF Research Database (Denmark)

    Nørmark, Kurt


    be aggregated as a single node, and an entire graph can be embedded in a single node. In addition, a number of different graph animations are described. The starting point of the SVG extension is a library that provides an exact of mirror of SVG 1.1 in the functional programming language Scheme. Each element...

  16. Assessment Of Shell Petroleum Development Company Extension ...

    African Journals Online (AJOL)

    The study assessed Shell Petroleum Development Company Extension Services in Etche Local Government Area of Rivers State, Nigeria. Data were gathered form four categories of respondents drawn from the Company\\'s staff and the communities. A total of 180 respondents participated in the study. means scores and ...

  17. Communication for Rural Innovation : rethinking agricultural extension

    NARCIS (Netherlands)

    Leeuwis, C.; Ban, van den A.W.


    This important book is the re-titled third edition of the extremely well received and widely used Agricultural Extension (van den Ban & Hawkins, 1988, 1996). Building on the previous editions, Communication for Rural Innovation maintains and adapts the insights and conceptual models of value

  18. 77 FR 35366 - Agency Information Collection Extension (United States)


    ... following Web site: . SUPPLEMENTARY INFORMATION... DEPARTMENT OF ENERGY Office of Energy Efficiency and Renewable Energy Agency Information... Department of Energy (DOE) has submitted an information collection request to the OMB for extension under the...

  19. Women Empowerment And Agricultural Extension Policy: The ...

    African Journals Online (AJOL)

    This paper examined the role and challenges of extension agents in empowering women in a bid to revamp the agricultural sector. The activities of women in agricultural production are reviewed against the backdrop of global shift to gender sensitivity, particularly the emphasis on the role of women in agriculture. The paper ...

  20. Developing Students' Reading Ability through Extensive Reading (United States)

    Meng, Fanshao


    A good reading competence is a necessity for those studying English for academic and occupational purposes. Based on the results of previous research, theory and practice on L2 Extensive Reading, this paper analyses current situation for teaching and learning reading in our Chinese universities and proposes practical applications of extensive…

  1. Dialogic Reading Aloud to Promote Extensive Reading (United States)

    Jacobs, George M.


    How can teachers motivate students to read extensively in a second language? One strategy is for teachers to read aloud to students to promote the joys of reading generally, to build students' language skills and to introduce students to specific authors, book series, genres, websites, etc. This article begins by discussing why teachers might want…

  2. Does Extensive Reading Promote Reading Speed? (United States)

    He, Mu


    Research has shown a wide range of learning benefits accruing from extensive reading. Not only is there improvement in reading, but also in a wide range of language uses and areas of language knowledge. However, few research studies have examined reading speed. The existing literature on reading speed focused on students' reading speed without…

  3. African Journal of Livestock Extension: Contact

    African Journals Online (AJOL)

    Principal Contact. DR. G.R.K. Sharma Editor-in-Chief Dept. of Vet & A. H. Extension College of Vet. Science A.N.G.R. Agricultural University Tirupati – 517502 Andhra Pradesh India Email: ...

  4. Subintegrality, invertible modules and Laurent polynomial extensions

    Indian Academy of Sciences (India)

    In [4], Roberts and Singh have introduced the group 그(A,B) to generalize a result of. Dayton. The relation between the group 그(A,B) and subintegral extensions has been investigated by Reid, Roberts and Singh in a series of papers. Recently in [5], Sadhu and. Singh have proved that A is subintegrally closed in B if and ...

  5. Paramecium: An Extensible Object-Based Kernel

    NARCIS (Netherlands)

    van Doorn, L.; Homburg, P.; Tanenbaum, A.S.


    In this paper we describe the design of an extensible kernel, called Paramecium. This kernel uses an object-based software architecture which together with instance naming, late binding and explicit overrides enables easy reconfiguration. Determining which components reside in the kernel protection

  6. 77 FR 70995 - Agency Information Collection Extension (United States)


    ... NWPA-830G is an Appendix to the Standard Contract for Disposal of Spent Nuclear Fuel and/or High-Level... Title: Standard Contract for Disposal of Spent Nuclear Fuel and/or High-Level Radioactive Waste... DEPARTMENT OF ENERGY Energy Information Administration Agency Information Collection Extension...

  7. Transforming agriculture through contracted extension service ...

    African Journals Online (AJOL)

    Transformation of small holder agriculture from subsistence farming to agribusiness focused systems, is paramount towards attainment of Kenya's vision 2030 and the Millennium Development Goals. This requires extension service delivery systems that focus on addressing challenges within agricultural product value ...

  8. Constructing Natural Extensions of Propositional Logics

    Czech Academy of Sciences Publication Activity Database

    Přenosil, Adam


    Roč. 104, č. 6 (2016), s. 1179-1190 ISSN 0039-3215 R&D Projects: GA ČR GA13-14654S Institutional support: RVO:67985807 Keywords : abstract algebraic logic * consequence relations * propositional logic * natural extensions * transfer theorems Subject RIV: BA - General Mathematics Impact factor: 0.589, year: 2016

  9. Extension agents' technical knowledge requirements for effective ...

    African Journals Online (AJOL)

    Technical knowledge requirements of extension agents were investigated in this study. Data for the study was collected with the aid of structured questionnaire administered to the 78 respondents. It was found that respondents were mainly males, were married, were in the middle age category, had BSc/HND, made ...

  10. Department of Agricultural Extension and Rural Development ...

    African Journals Online (AJOL)



    262. Ethiopian Journal of Environmental Studies & Management 10(2): 262 – 275, 2017. ISSN:1998-0507 doi: Submitted: January 27, 2017. Accepted: March 20, 2017. Department of Agricultural Extension and Rural Development, University of Ilorin, Ilorin. Nigeria. Abstract.

  11. Rural Development And Agricultural Extension Administration In ...

    African Journals Online (AJOL)

    This paper reviewed the wide range of policies and approaches formulated and implemented to effect agricultural and rural development in Nigeria. The paper reveals that the common feature of all the strategies is the use of institutionalized agricultural extension service, devoted principally to augment smallholder ...

  12. Ethics and morals in the extension work

    Directory of Open Access Journals (Sweden)

    Fátima Lourdes Morales Intriago


    Full Text Available One of the main discussions about agents that provide rural extension is the lack of adequate proposals for the reality of farmers. The exyensionists work according to ethics and morals. Was carried out a theoretical search by made analyzing concepts about these terms and that are applied by extension agents. In This paper discusses how agents act with respect to the aforementioned notions and the conflicts they can cause with rural communities. It was found that the extensionist’s behavior is based on its values, norms and sanctions formation that can be object, which determines the changes that occur in the communities served. On the other hand, farmers do not receive appropriate attention by organisms that facilitate the Rural Extension, ignoring their interests and priorities. In addition, agents, as servants of institutions that provide assistance and extension, lose autonomy during the contact with communities. It was concluded that agents act correctly according to morality, as well as what concerns to ethics, since lowing the rules of the institution to which they belong, which does not always match with what rural people pursued.

  13. Particle Swarm Optimisation with Spatial Particle Extension

    DEFF Research Database (Denmark)

    Krink, Thiemo; Vesterstrøm, Jakob Svaneborg; Riget, Jacques


    In this paper, we introduce spatial extension to particles in the PSO model in order to overcome premature convergence in iterative optimisation. The standard PSO and the new model (SEPSO) are compared w.r.t. performance on well-studied benchmark problems. We show that the SEPSO indeed managed to...

  14. Entrepreneurial Extension Conducted via Social Media (United States)

    Cornelisse, Sarah; Hyde, Jeffrey; Raines, Christopher; Kelley, Kathleen; Ollendyke, Dana; Remcheck, James


    The widespread availability of and access to the Internet have led to the development of new forms of communication. Collectively termed "social media," these new communication tools have created vast opportunities for Extension professionals in how they perform their work and how businesses interact with consumers. This article outlines currently…

  15. Subintegrality, invertible modules and Laurent polynomial extensions

    Indian Academy of Sciences (India)

    Indian Acad. Sci. (Math. Sci.) Vol. 125, No. 2, May 2015, pp. 149–160. c Indian Academy of Sciences. Subintegrality, invertible modules and Laurent polynomial extensions. VIVEK SADHU. Department of Mathematics ...... comments which have improved the exposition. Further, he would like to thank CSIR,. India for financial ...

  16. Communication for strengthening agricultural extension and rural ...

    African Journals Online (AJOL)

    This paper argues that extension workers need training in Communication for Development (C4D), an emerging body of knowledge for addressing problems, such as participation, integration and capacity building for them to relate more effectively with development partners. Thus, this paper proposes a C4D framework for ...

  17. Catastrophic failure of polymer melts during extension

    DEFF Research Database (Denmark)

    Rasmussen, Henrik K.


    Numerical flow modeling has been applied to study the break of monodisperse polymer melts during extension. These continuum mechanical based computations are within the ideas of the microstructural ’interchain pressure’ theory. Calculated breaks, a result of small initial sample imperfections, ag...

  18. Extension Procedures for Confirmatory Factor Analysis (United States)

    Nagy, Gabriel; Brunner, Martin; Lüdtke, Oliver; Greiff, Samuel


    We present factor extension procedures for confirmatory factor analysis that provide estimates of the relations of common and unique factors with external variables that do not undergo factor analysis. We present identification strategies that build upon restrictions of the pattern of correlations between unique factors and external variables. The…

  19. Livestock extension practice and competency among agricultural ...

    African Journals Online (AJOL)

    The test-retest technique was used to pre-test the instrument, yielding a coefficient r=0.91. Descriptive, correlation and t-test statistics were used to analyze data. Results revealed that about 40% of respondents engaged in livestock extension activities in the last two years, while about 16% actually specialized in Animal ...

  20. Testing Extension Services through AKAP Models (United States)

    De Rosa, Marcello; Bartoli, Luca; La Rocca, Giuseppe


    Purpose: The aim of the paper is to analyse the attitude of Italian farms in gaining access to agricultural extension services (AES). Design/methodology/approach: The ways Italian farms use AES are described through the AKAP (Awareness, Knowledge, Adoption, Product) sequence. This article investigated the AKAP sequence by submitting a…

  1. Towards professionalism in agricultural extension: The professional ...

    African Journals Online (AJOL)

    Towards professionalism in agricultural extension: The professional registration of Extensionists in South Africa – A dream or a reality? The role of the ... The PDF file you selected should load here if your Web browser has a PDF reader plug-in installed (for example, a recent version of Adobe Acrobat Reader). If you would ...

  2. 78 FR 31885 - Patent Term Extension (United States)


    ... DEPARTMENT OF COMMERCE Patent and Trademark Office Patent Term Extension ACTION: Proposed collection; comment request. SUMMARY: The United States Patent and Trademark Office (USPTO), as part of its... States Patent and Trademark Office, P.O. Box 1450, Alexandria, VA 22313-1450. Federal Rulemaking Portal...

  3. Extensively Drug-Resistant Tuberculosis, Burkina Faso


    Saleri, Nuccia; Badoum, Gisèle; Ouedraogo, Martial; Dembélé, Sary M.; Nacanabo, Rachel; Bonkoungou, Victor; Cirillo, Daniela; Pinsi, Gabriele; Matteelli, Alberto


    Because data from countries in Africa are limited, we measured the proportion of extensively drug-resistant (XDR) tuberculosis (TB) cases among TB patients in Burkina Faso for whom retreatment was failing. Of 34 patients with multidrug-resistant TB, 2 had an XDR TB strain. Second-line TB drugs should be strictly controlled to prevent further XDR TB increase.

  4. Non extensive considerations on a Machian Universe

    Energy Technology Data Exchange (ETDEWEB)

    Abreu, Everton M.C.; Ananias Neto, Jorge [Universidade Federal Rural do Rio de Janeiro (UFRRJ), Seropedica, RJ (Brazil); Universidade Federal de Juiz de Fora, MG (Brazil)


    Full text: There is an extension of the usual Boltzmann-Gibbs theory (BG) that is called Tsallis statistical theory (TT). To sum up, the formalism initially considers the entropy formula as a non extensive (NE) quantity where there is a parameter q that measures the so-called degree of nonextensivity. This formalism has been successfully applied in many physical models. An important feature is that when q —> 1 we recover the usual Boltzmann- Gibbs theory, i.e., we have an extensive theory The dependence of the mass of a particle on the rest of the universe was argued by Mach in the nineteenth century itself in what is now famous as Machs Principle. The Principle is counterintuitive in that we tend to consider the mass which represents the quantity of matter in a particle to be an intrinsic property of the particle. But the following statement of Machs Principle shows it to be otherwise thus going counter to ideas of locality and causality. The purpose of this paper is to use the non extensive concept in order to analyze the Machian view of the Universe. We will calculate the Machian components of the theory as functions of the nonextensivity parameter q and we will discuss its consequences. We will also show the influence of the asymptotic behavior in these Machian q-parameters. (author)

  5. South African Journal of Agricultural Extension

    African Journals Online (AJOL)

    The South African Journal of Agricultural Extensionaims to: * advance and apply the science of extension and of rural development as scientific discipline by stimulating thought, study, research, discussion and the publication and exchange of knowledge both nationally and internationally. * promote the professionalism ...

  6. Extension Study Group Members View Their Clubs and Extension Home Economists. ANREI Publication No. 28. (United States)

    Miller, Mason E.

    The data presented in this report were selected from a 1972 study of Michigan Extension Study Group (ESG) members. Included are data descriptive of the women themselves and their situation (area and type of home, age, income, ESG experience, and especially their attitudes toward their ESG and their Extension Home Economists). Selected findings are…

  7. Collaboration of Extension and Grape Industry Members to Create a New Extension Publication (United States)

    Stafne, Eric T.; Ingels, George; Ingels, Jane; Carroll, Becky


    Collaboration is an important part of the interaction between Extension and industry. Successful sharing of workload can provide benefits for both parties. A project to create a workbook to address vineyard sustainability was initiated by members of the Oklahoma grape industry with assistance from land-grant university Extension. Productive…

  8. The Changing Nature of the Cooperative Extension System: Views of Leading Extension Administrators. (United States)

    Ladewig, Howard


    Four administrators of the Cooperative Extension System share their views concerning recent substantial changes in the system's focus of programing, sources of funding, and organizational structures; the need for all disciplines involved in extension to grapple with societal problems; and relationships with institutions of higher education. (LP)

  9. Tampa Bay Extension Agents’ Views of Urban Extension: Philosophy and Program Strategies

    Directory of Open Access Journals (Sweden)

    Amy Harder


    Full Text Available The purpose of this article was to explore the concept of urban Extension as perceived by Extension agents within the Tampa Bay area, one of Florida’s fastest growing metropolitan areas. From a theoretical perspective, it is critical to understand Extension agents’ beliefs about urban Extension because behaviors are directly related to attitudes (Ajzen, 2012. In 2016, a qualitative investigation was undertaken to explore the perspectives of 23 agents working within the Tampa Bay area. Results showed the majority of agents believed that context and client needs are unique for urban Extension, and that to a lesser extent, unique agent expertise is required. Further, these beliefs impacted how agents reported their approach to programming, with an emphasis on providing convenience and seeking partnerships. Difficulties were identified related to identifying the role of Extension in a resource-rich environment of service providers, which contributed to the existence of a perceived disconnect between urban audiences and Extension. Opportunities exist for Extension leadership to provide strategic organizational support that will enhance agents’ abilities to succeed in the metropolitan environment.

  10. 75 FR 79033 - Proposed Extension of Existing Information Collection; Radiation Sampling and Exposure Records... (United States)


    ... steps into other radioactive elements, which are solids, called radon daughters. Radon and radon... uranium mine and can exist in several other mining commodities. Radon is radioactive gas. It diffuses into...

  11. 75 FR 80072 - Proposed Extension of Existing Information Collection; Radiation Sampling and Exposure Records (United States)


    ... series of steps into other radioactive elements, which are solids, called radon daughters. Radon and... every uranium mine and can exist in several other mining commodities. Radon is radioactive gas. It...

  12. Extension of the principles of radiation protection to sources of potential exposure

    International Nuclear Information System (INIS)


    The principles of radiation protection recommended by the International Commission on Radiological Protection for the normal operation of a radiation source constitute a dose limitation system that has three components; namely, the justification of a practice, the optimization of radiation protection and the limitation of individual doses. This report describes how the application of these principles may be extended to unexpected or accidental situations by changing from the dose based system of radiation protection to a unified approach within a probabilistic framework. The key conceptual link in this transition is the recognition that the receipt of a given dose by an individual confers a corresponding probability of harm, as represented by a dose-response curve. The concept of limitation of individual doses may therefore be transformed relatively straightforwardly into the concept of limitation of the probability of harm to an individual. The other two principles, the justification principle and the optimization principle, can also be translated to the probabilistic framework, but the procedure for so doing is not as straightforward as that for the principle of limitation of individual doses, owing in part to the fact that the other two principles are not as simple to apply in practice. 13 refs

  13. Expanded target-chemical analysis reveals extensive mixed-organic-contaminant exposure in USA streams (United States)

    Bradley, Paul M.; Journey, Celeste A.; Romanok, Kristin; Barber, Larry B.; Buxton, Herbert T.; Foreman, William; Furlong, Edward T.; Glassmeyer, Susan T.; Hladik, Michelle L.; Iwanowicz, Luke R.; Jones, Daniel K.; Kolpin, Dana W.; Kuivila, Kathryn M.; Loftin, Keith A.; Mills, Marc A.; Meyer, Michael T.; Orlando, James L.; Reilly, Timothy J.; Smalling, Kelly L.; Villeneuve, Daniel L.


    Surface water from 38 streams nationwide was assessed using 14 target-organic methods (719 compounds). Designed-bioactive anthropogenic contaminants (biocides, pharmaceuticals) comprised 57% of 406 organics detected at least once. The 10 most-frequently detected anthropogenic-organics included eight pesticides (desulfinylfipronil, AMPA, chlorpyrifos, dieldrin, metolachlor, atrazine, CIAT, glyphosate) and two pharmaceuticals (caffeine, metformin) with detection frequencies ranging 66–84% of all sites. Detected contaminant concentrations varied from less than 1 ng L–1 to greater than 10 μg L–1, with 77 and 278 having median detected concentrations greater than 100 ng L–1 and 10 ng L–1, respectively. Cumulative detections and concentrations ranged 4–161 compounds (median 70) and 8.5–102 847 ng L–1, respectively, and correlated significantly with wastewater discharge, watershed development, and toxic release inventory metrics. Log10 concentrations of widely monitored HHCB, triclosan, and carbamazepine explained 71–82% of the variability in the total number of compounds detected (linear regression; p-values: environment application (pesticides), designed-bioactive organics (median 41 per site at μg L–1 cumulative concentrations) in developed watersheds present aquatic health concerns, given their acknowledged potential for sublethal effects to sensitive species and lifecycle stages at low ng L–1.

  14. 77 FR 16865 - Proposed Extension of Existing Information Collection; Occupational Noise Exposure (United States)


    ... profound physical impairment in mining, with far- reaching psychological and social effects. NIHL can be... Health Administration, the military, and other organizations around the world have established and...

  15. 76 FR 25376 - Occupational Exposure to Hazardous Chemicals in Laboratories Standard; Extension of the Office of... (United States)


    ... DEPARTMENT OF LABOR Occupational Safety and Health Administration [Docket No. OSHA-2011-0059... Safety and Health Administration (OSHA), Labor. ACTION: Request for public comments. SUMMARY: OSHA... your comments, including attachments, are not longer than 10 pages, you may fax them to the OSHA Docket...

  16. Clementine auto exposure control software

    Energy Technology Data Exchange (ETDEWEB)

    Arnold, E. [Lawrence Livermore National Lab., CA (United States)


    The primary mission of the Clementine program was to test technology developed under the auspices of BMDO (the Ballistic Missile Defense Organization). A secondary goal of the program was to provide astronomical data to the scientific and educational community. The mission plan developed to accomplish these goals included complete mapping of the lunar surface and a close fly-by of a near-Earth asteroid, 1620 Geographos. Exposure control for the Clementine mission was driven by mission phase requirements and sensor characteristics. Thus, there were a total of twelve algorithms developed for three primary mission phases and the four imaging sensors (two additional sensors operated as star trackers). The three mission phases in question were lunar mapping, distant observation of the asteroid for the purpose of tracking, and close-up viewing (as close as 100 Km) of Geographos. The four non-star tracker sensors consisted of an Ultra Violet/Visible (UV/Vis) camera, a High Resolution (HiRes) camera with a built-in LIDAR (Light Detection And Ranging) unit, a Near Infrared (NIR) camera, and a Long Wave InfraRed (LWIR) camera. Due to lack of test time and uncertainties about the imaging environment, numerous input parameters were provided in the algorithms to allow extensive tuning of the exposure control during the mission.

  17. Dirac Triplet Extension of the MSSM

    CERN Document Server

    Alvarado, C.; Martin, A.; Ostdiek, B.


    In this paper we explore extensions of the Minimal Supersymmetric Standard Model involving two $SU(2)_L$ triplet chiral superfields that share a superpotential Dirac mass yet only one of which couples to the Higgs fields. This choice is motivated by recent work using two singlet superfields with the same superpotential requirements. We find that, as in the singlet case, the Higgs mass in the triplet extension can easily be raised to $125\\,\\text{GeV}$ without introducing large fine-tuning. For triplets that carry hypercharge, the regions of least fine tuning are characterized by small contributions to the $\\mathcal T$ parameter, and light stop squarks, $m_{\\tilde t_1} \\sim 300-450\\,\\text{GeV}$; the latter is a result of the $\\tan\\beta$ dependence of the triplet contribution to the Higgs mass. Despite such light stop masses, these models are viable provided the stop-electroweakino spectrum is sufficiently compressed.

  18. Geometric extension through Schwarzschild r = 0

    International Nuclear Information System (INIS)

    Lynden-Bell, D.; Katz, J.; Hebrew Univ., Jerusalem


    Singularities in space-time are not necessarily cancers in the manifold but can herald interesting topological change in the space-time at places where there are several different tangent Minkowski spaces. Most discussions of gravitational collapse cease when space-time becomes singular. In the 'hour-glass' universe we have an example where the singularity develops in empty space; here we give a geometrical extension through the singularity in which geodesics that enter it emerge into a new space. The result extends Schwarzschild space and is periodic in 'extended' Penrose coordinates. There is a topological singularity but no mass at r = 0. The extension is mildly nonanalytic but unique. It is based on the concept that time does not stop and that empty space-times which develop singularities must still have zero Ricci tensors even where the Riemann tensor becomes infinite. (author)

  19. EPRI nuclear plant life extension program overview

    International Nuclear Information System (INIS)

    Rubio, A.; Carey, J.J.; Lapides


    In 1978-1979, EPRI undertook a series of studies which suggested that extending the operation of current nuclear generating units beyond their nominal 40-year license term was both technically feasible and economically attractive. In 1984, these results were reviewed and confirmed and more detailed evaluations initiated. Major elements include: a) identification of life extension as a strategic element of the EPRI Nuclear Division program; b) formulation of a joint EPRI/DOE program plan to culminate in the licensing of a generating unit(s) for extended life; and, c) initiation of two extensive studies, by and with utilities, to provide guidelines for such achievement. The pilot studies began in early 1985. This paper describes the background and status of these efforts to date

  20. [Juvenile nasopharyngeal angiofibroma with orbital extension]. (United States)

    Hervás Ontiveros, A; España Gregori, E; Climent Vallano, L; Rivas Rodero, S; Alamar Velázquez, A; Simal Julián, J A


    The case is presented of a 21 year-old male with a history of left proptosis and diplopia of two weeks of onset. The MRI showed an ethmoid-orbital vascular lesion with anterior skull base invasion and orbital extension. Biopsy of the ethmoid confirmed fibrovascular tissue, which supported the diagnosis of angiofibroma. It is a benign neoplasm with local characteristics of malignancy due to its ability to invade adjacent areas. In this case, the debut presented with manifestations of orbital extension. A broad and multidisciplinary approach is needed in order to improve prognosis. Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  1. States On Orthocomplemented Difference Posets (Extensions) (United States)

    Hroch, Michal; Pták, Pavel


    We continue the investigation of orthocomplemented posets that are endowed with a symmetric difference (ODPs). The ODPs are orthomodular and, therefore, can be viewed as "enriched" quantum logics. In this note, we introduced states on ODPs. We derive their basic properties and study the possibility of extending them over larger ODPs. We show that there are extensions of states from Boolean algebras over unital ODPs. Since unital ODPs do not, in general, have to be set-representable, this result can be applied to a rather large class of ODPs. We then ask the same question after replacing Boolean algebras with "nearly Boolean" ODPs (the pseudocomplemented ODPs). Making use of a few results on ODPs, some known and some new, we construct a pseudocomplemented ODP, P, and a state on P that does not allow for extensions over larger ODPs.

  2. Controleum - an independently extensible control system

    DEFF Research Database (Denmark)

    Jensen, Martin Lykke Rytter


    - hard concerns are constraints that must always be met, while soft concerns describe desirable goals that may be prioritized by the system's user. The extensible controller uses a genetic algorithm to continuously resolve conflicts among independently developed control concerns. Both new software...... to introduce a new component without performing a global integrity check. Avoiding a global integrity check relies on anticipating what kind of extensions are required in the future and designing a suitable interface and coordination mechanism, so that conflicts among mutually unaware components can...... be resolved automatically. Typical control system components are concerned with the way in which actuators are controlled. Combining mutually unaware control system components that share interest in the same actuators are likely to lead to complex conflicts, thus making control systems a particularly...

  3. Annual exposure report

    International Nuclear Information System (INIS)

    Murphy, B.L.; Mann, J.C.


    All DOE facilities annually submit occupational radiation exposure data to a central repository. The data include a summary of whole-body exposures, a summary of internal depositions of radioactive materials above specified limits, and occupational exposure reports for termination employees. The 1981 data were received in August 1982 and have been incorporated into a report format, established in 1980, that includes technical discussions and data illustrations

  4. Mathematical model of subscriber extension line


    Petříková, Iva; Diviš, Zdeněk; Tesař, Zdeněk


    The paper focuses on measurement properties of metallic subscriber extension lines to build regression mathematical model for a symmetric pair cable. The regression model is compared with an analytical model based on a theoretical description of transfer parameters for this type of line. The output of the paper should demonstrate the impact of electromagnetic interference on the symmetric pair. The paper also describes the method to identify the interference sources and ...

  5. Emergence of Extensively Drug Resistant Tuberculosis

    Centers for Disease Control (CDC) Podcasts


    Extensively drug-resistant tuberculosis (XDR TB) outbreaks have been reported in South Africa, and strains have been identified on 6 continents. Dr. Peter Cegielski, team leader for drug-resistant TB with the Division of Tuberculosis Elimination at CDC, comments on a multinational team's report on this emerging global public health threat.  Created: 3/1/2007 by Emerging Infectious Diseases.   Date Released: 3/26/2007.

  6. Learning PrimeFaces extensions development

    CERN Document Server

    Jonna, Sudheer


    This book provides a step by step approach that explains the most important extension components and their features. All the major features are explained by using the JobHub application with supporting screenshots.If you are an intermediate to advanced level user (or developer) who already has a basic working knowledge of PrimeFaces, then this book is for you.The only thing you need to know is Java Server Faces(JSF).

  7. Equivalence relations of AF-algebra extensions

    Indian Academy of Sciences (India)

    classifications of C*-algebras together with K-theory and index theory (see [2]). The available classification results of C∗ ... Let ei: 0 → B αi. → Ei βi. → A → 0 be two extensions of A by B with Busby invariants τi for i = 1, 2. Then (E1,α1,β1) and (E2,α2,β2) are called congruent (called 'strongly isomorphic' in [2]), denoted by e1 ...

  8. Stable Extensions with(out) Gravity

    DEFF Research Database (Denmark)

    Antipin, Oleg; Krog, Jens; Mojaza, Matin


    We investigate the vacuum stability as well as the gravitational corrections in extensions of the Standard Model featuring a new complex scalar, and two Dirac fermions for different choices of the hypercharge of the scalar and one of the two fermions. The neutral fermion acquires loop-induced mag...... and discover that the models can be compatible with the asymptotically safe gravity scenario at the price of a heavier Higgs and lighter top mass...

  9. Extensions and degeneration of spectral triples

    DEFF Research Database (Denmark)

    Christensen, Erik; Ivan, Cristina


    To a compact non commutative metric space associated to a C*-algebra A and an extension E of A, we construct 2-parameter family of compact non commutative metric spaces associated to E. It is shown that under certain limits along paths in the parameter space the corresponding spaces converge...... in the quantum Gromov-Hausdorff metric towards either the given non commutative metric space or towards a compact non commutative metric space associated to the compact operators....

  10. Definable maximal discrete sets in forcing extensions

    DEFF Research Database (Denmark)

    Törnquist, Asger Dag; Schrittesser, David


    Let  be a Σ11 binary relation, and recall that a set A is -discrete if no two elements of A are related by . We show that in the Sacks and Miller forcing extensions of L there is a Δ12 maximal -discrete set. We use this to answer in the negative the main question posed in [5] by showing...

  11. Deformed Fredkin spin chain with extensive entanglement (United States)

    Salberger, Olof; Udagawa, Takuma; Zhang, Zhao; Katsura, Hosho; Klich, Israel; Korepin, Vladimir


    We introduce a new spin chain which is a deformation of the Fredkin spin chain and has a phase transition between bounded and extensive entanglement entropy scaling. In this chain, spins have a local interaction of three nearest neighbors. The Hamiltonian is frustration-free and its ground state can be described analytically as a weighted superposition of Dyck paths that depends on a deformation parameter t. In the purely spin 1/2 case, whenever t\

  12. Radurisation of broilers for shelf life extension

    International Nuclear Information System (INIS)

    Bok, H.E.; Holzapfel, W.H.; Van der Linde, H.J.


    Radurization is discussed as a method for the shelf life extension of refrigerated chicken carcasses. One of the advantages is that radurization eliminates potential food pathogenic bacteria like Salmonella in the chicken carcasses. Materials and methods for the radurization of chicken are discussed. The objective of the investigation was to determine the influence of different irradiation doses and storage conditions on the microbiological shelf life and organoleptic quality of fresh broilers

  13. Mucocele and pyocele with marked intracranial extension

    Energy Technology Data Exchange (ETDEWEB)

    Tsuchiya, Kazuhiro; Machida, Tohru; Iio, Masahiro


    Two cases are presented with frontal sinus pyocele and fronto-ethmoid sinus mucocele in which marked intracranial extension is shown. Their intracranial part appeared as a large biconvex mass, which showed iso or slightly low density homogeneously and had gross calcification in the posterior rim. The findings of the paranasal sinuses and the orbit in tomograms and CT scans are thought to be useful in the differential diagnosis of chronic subdural hematoma.

  14. Applications and extensions of degradation modeling

    International Nuclear Information System (INIS)

    Hsu, F.; Subudhi, M.; Samanta, P.K.; Vesely, W.E.


    Component degradation modeling being developed to understand the aging process can have many applications with potential advantages. Previous work has focused on developing the basic concepts and mathematical development of a simple degradation model. Using this simple model, times of degradations and failures occurrences were analyzed for standby components to detect indications of aging and to infer the effectiveness of maintenance in preventing age-related degradations from transforming to failures. Degradation modeling approaches can have broader applications in aging studies and in this paper, we discuss some of the extensions and applications of degradation modeling. The application and extension of degradation modeling approaches, presented in this paper, cover two aspects: (1) application to a continuously operating component, and (2) extension of the approach to analyze degradation-failure rate relationship. The application of the modeling approach to a continuously operating component (namely, air compressors) shows the usefulness of this approach in studying aging effects and the role of maintenance in this type component. In this case, aging effects in air compressors are demonstrated by the increase in both the degradation and failure rate and the faster increase in the failure rate compared to the degradation rate shows the ineffectiveness of the existing maintenance practices. Degradation-failure rate relationship was analyzed using data from residual heat removal system pumps. A simple linear model with a time-lag between these two parameters was studied. The application in this case showed a time-lag of 2 years for degradations to affect failure occurrences. 2 refs

  15. Applications and extensions of degradation modeling

    Energy Technology Data Exchange (ETDEWEB)

    Hsu, F.; Subudhi, M.; Samanta, P.K. [Brookhaven National Lab., Upton, NY (United States); Vesely, W.E. [Science Applications International Corp., Columbus, OH (United States)


    Component degradation modeling being developed to understand the aging process can have many applications with potential advantages. Previous work has focused on developing the basic concepts and mathematical development of a simple degradation model. Using this simple model, times of degradations and failures occurrences were analyzed for standby components to detect indications of aging and to infer the effectiveness of maintenance in preventing age-related degradations from transforming to failures. Degradation modeling approaches can have broader applications in aging studies and in this paper, we discuss some of the extensions and applications of degradation modeling. The application and extension of degradation modeling approaches, presented in this paper, cover two aspects: (1) application to a continuously operating component, and (2) extension of the approach to analyze degradation-failure rate relationship. The application of the modeling approach to a continuously operating component (namely, air compressors) shows the usefulness of this approach in studying aging effects and the role of maintenance in this type component. In this case, aging effects in air compressors are demonstrated by the increase in both the degradation and failure rate and the faster increase in the failure rate compared to the degradation rate shows the ineffectiveness of the existing maintenance practices. Degradation-failure rate relationship was analyzed using data from residual heat removal system pumps. A simple linear model with a time-lag between these two parameters was studied. The application in this case showed a time-lag of 2 years for degradations to affect failure occurrences. 2 refs.

  16. Applications and extensions of degradation modeling

    Energy Technology Data Exchange (ETDEWEB)

    Hsu, F.; Subudhi, M.; Samanta, P.K. (Brookhaven National Lab., Upton, NY (United States)); Vesely, W.E. (Science Applications International Corp., Columbus, OH (United States))


    Component degradation modeling being developed to understand the aging process can have many applications with potential advantages. Previous work has focused on developing the basic concepts and mathematical development of a simple degradation model. Using this simple model, times of degradations and failures occurrences were analyzed for standby components to detect indications of aging and to infer the effectiveness of maintenance in preventing age-related degradations from transforming to failures. Degradation modeling approaches can have broader applications in aging studies and in this paper, we discuss some of the extensions and applications of degradation modeling. The application and extension of degradation modeling approaches, presented in this paper, cover two aspects: (1) application to a continuously operating component, and (2) extension of the approach to analyze degradation-failure rate relationship. The application of the modeling approach to a continuously operating component (namely, air compressors) shows the usefulness of this approach in studying aging effects and the role of maintenance in this type component. In this case, aging effects in air compressors are demonstrated by the increase in both the degradation and failure rate and the faster increase in the failure rate compared to the degradation rate shows the ineffectiveness of the existing maintenance practices. Degradation-failure rate relationship was analyzed using data from residual heat removal system pumps. A simple linear model with a time-lag between these two parameters was studied. The application in this case showed a time-lag of 2 years for degradations to affect failure occurrences. 2 refs.

  17. Extension of life of nuclear power stations

    International Nuclear Information System (INIS)

    Takahashi, Hideaki


    At the time of designing nuclear power stations, as their service life, generally 40 years are taken, and the basic design specifications of machinery and equipment are determined. In USA where atomic energy has been developed, the new construction of nuclear power stations is cased for a while, however, if this situation continues as it is, since old power stations reach the service life of 40 years and are retired in near future, it is feared that the circumstance of the total amount of power generation becoming short will occur. As one of the countermeasures to this, the research on the extension of life of nuclear power stations has been carried out in many fields in USA, and it is expected that the application for extending the life for the power stations constructed in the initial period of development is submitted in 1991. The researches that have been carried out for solving the technical problems in this extension of life and the situation in Japan are reported. The NEC of USA decided that the operation period of nuclear power stations in USA, which is considered to be 40 years so far, can be extended up to the limit of 20 years. The background and circumstances of this problem in USA, Nuclear Plant Aging Research Program, Plant Life Extension Program and so on are reported. (K.I.)

  18. The programs for lifetime extension by AREVA

    International Nuclear Information System (INIS)

    Knoche, P.


    In 2011 AREVA launched 2 worldwide programs to meet the demands of its customers: 'AREVA Safety Alliance' that proposes a set of measures for post-Fukushima safety upgrading and 'AREVA Forward Alliance' that is dedicated to lifetime extension projects. Concerning 'AREVA Safety Alliance' about 150 projects have been carried out for 53 customers in 19 countries, as for 'AREVA Forward Alliance' 60% of the lifetime extension projects in the US have been performed by AREVA. In the framework of lifetime extension projects, upgrading measures and services are proposed such as the installation of hydrogen recombiner units, of filtered ventilation systems for severe accidents, or the upgrading of the reactor control system through the implementation of the digital Teleperm XS technology, or recommendations about the methodology to follow for the repair or replacement of important components. The replacement of steam generators and of the pressurizer and with other upgrading works led to a gain of 18.5% on the output power of the Ringhals-4 unit. (A.C.)

  19. LIMB Demonstration Project Extension and Coolside Demonstration

    Energy Technology Data Exchange (ETDEWEB)

    Goots, T.R.; DePero, M.J.; Nolan, P.S.


    This report presents results from the limestone Injection Multistage Burner (LIMB) Demonstration Project Extension. LIMB is a furnace sorbent injection technology designed for the reduction of sulfur dioxide (SO[sub 2]) and nitrogen oxides (NO[sub x]) emissions from coal-fired utility boilers. The testing was conducted on the 105 Mwe, coal-fired, Unit 4 boiler at Ohio Edison's Edgewater Station in Lorain, Ohio. In addition to the LIMB Extension activities, the overall project included demonstration of the Coolside process for S0[sub 2] removal for which a separate report has been issued. The primary purpose of the DOE LIMB Extension testing, was to demonstrate the generic applicability of LIMB technology. The program sought to characterize the S0[sub 2] emissions that result when various calcium-based sorbents are injected into the furnace, while burning coals having sulfur content ranging from 1.6 to 3.8 weight percent. The four sorbents used included calcitic limestone, dolomitic hydrated lime, calcitic hydrated lime, and calcitic hydrated lime with a small amount of added calcium lignosulfonate. The results include those obtained for the various coal/sorbent combinations and the effects of the LIMB process on boiler and plant operations.

  20. Monitoring of radiation exposure

    Energy Technology Data Exchange (ETDEWEB)



    The guide specifies the requirements for the monitoring of radiation exposure in instances where radiation is used. In addition to workers, the guide covers students, apprentices and visitors. The guide shall also apply to exposure from natural radiation. However, the monitoring of radiation exposure in nuclear power plants is dealt with in YVL Guide 7.10 and 7.11. The guide defines the concepts relevant to the monitoring of radiation exposure and provides guidelines for determining the necessity of monitoring and subsequently arranging such in different operations. In addition, the guide specifies the criteria for the approval and regulatory control of the dosimetric service.

  1. EXTENSION EDUCATION SYMPOSIUM: Getting the most out of your extension appointment and still having a life. (United States)

    Powers, W; Cockett, N; Lardy, G


    Managing the demands of an academic appointment in extension can be a challenging task. Demands from constituent groups, expectations of supervisors, and rigors of promotion and tenure processes can create pressures that young faculty did not expect. Throw in spousal and family duties and you have created a situation that many will find hard to navigate. However, there are ways to cope and, even better news, there are ways to excel in meeting the demands of an academic appointment and enjoying life. Because many new extension faculty members do not have prior experience in extension, best practices in documenting programs and extension scholarship over the pretenure period are provided in this paper. Appointments that include both research and extension are quite common at many land grant universities. The advantages of joint appointments are numerous and include the fact that more and more grant agencies are seeking integrated research, teaching, and/or extension projects. However, the time demands of joint appointments can be challenging. Joint appointments can be designed to help faculty members conduct important translational research and have it be applied in a production setting. By seeking commonalities in research and extension efforts, joint appointments can be very synergistic. Development of highly successful programs requires planning on the front end with an emphasis on an in-depth needs assessment to determine stakeholder needs for both research and extension. Impact assessment should be part of this planning effort. Performing as a successful extension faculty member while maintaining relationships outside of work is challenging and requires deliberate effort on the part of employees and supervisors to realize there is more to life than work. Some authors have referred to this as work-life balance, but it may be more helpful to think of it as work-life effectiveness. To do this, one needs to 1) define what success looks like, 2) set boundaries and

  2. Electron beam radiotherapy for the management of recurrent extensive ocular surface squamous neoplasia with orbital extension


    Ramesh Murthy; Himika Gupta; Rahul Krishnatry; Siddhartha Laskar


    Recurrent extensive ocular surface squamous neoplasia (OSSN) with orbital invasion can be successfully managed with external radiotherapy using electrons resulting in eye and vision salvage. We report a case of right eye recurrent OSSN in an immunocompetent adult Indian male, with extensive orbital involvement. The patient had two previous surgical excisions with recurrent disease. At this stage, conventionally exenteration is considered the treatment modality. However, he was treated with 50...

  3. Exposures and reactions to allergens among hairdressing apprentices and matched controls

    DEFF Research Database (Denmark)

    Bregnhøj, Anne; Søsted, Heidi; Menné, Torkil


    Early and extensive exposures to chemical substances such as are found in hair dyes, perfumes and nickel are known risk factors for allergic reactions. Hairdressing apprentices belong to a high-risk group, as they are exposed both occupationally and personally.......Early and extensive exposures to chemical substances such as are found in hair dyes, perfumes and nickel are known risk factors for allergic reactions. Hairdressing apprentices belong to a high-risk group, as they are exposed both occupationally and personally....

  4. The Relationship between Ultraviolet Radiation Exposure and Vitamin D Status

    Directory of Open Access Journals (Sweden)

    Ola Engelsen


    Full Text Available This paper reviews the main factors influencing the synthesis of vitamin D, with particular focus on ultraviolet radiation exposure. On the global level, the main source of vitamin D is the sun. The effect of solar radiation on vitamin D synthesis depends to some extent on the initial vitamin D levels. At moderate to high latitudes, diet becomes an increasingly important source of vitamin D due to decreased solar intensity and cold temperatures, which discourage skin exposure. During the mid-winter season, these factors result in decreased solar radiation exposure, hindering extensively the synthesis of vitamin D in these populations.

  5. Aggregate Exposure Pathway Workshop (United States)

    Recognizing the growing demands for conducting rapid, cost-effective, and reliable exposure assessment on the thousands of chemicals in commerce, a committee convened by the National Research Council (NRC) developed its vision for exposure science in the 21st century. A necessary...

  6. Fetal exposure to pimozide

    DEFF Research Database (Denmark)

    Bjarnason, Nina H; Rode, Line; Dalhoff, Kim


    Pimozide is an antidopaminergic, antipsychotic drug. Exposure during human pregnancy has not been reported previously, and recommendations on its use are based on extrapolation from other antipsychotics with antidopaminergic activity.......Pimozide is an antidopaminergic, antipsychotic drug. Exposure during human pregnancy has not been reported previously, and recommendations on its use are based on extrapolation from other antipsychotics with antidopaminergic activity....

  7. Conflict exposure and competitiveness

    NARCIS (Netherlands)

    Cecchi, Francesco; Leuveld, Koen; Voors, Maarten


    We use data from a street football tournament and a series of lab-in-field experiments in postconflict Sierra Leone to examine the impact of exposure to conflict violence on competitive behavior. We find that football players who experienced more intense exposure to violence are more likely to get a

  8. Exposure to natural radiation

    International Nuclear Information System (INIS)

    Green, B.M.R.


    A brief report is given of a seminar on the exposure to enhanced natural radiation and its regulatory implications held in 1985 at Maastricht, the Netherlands. The themes of the working sessions included sources of enhanced natural radiation, parameters influencing human exposure, measurement and survey programmes, technical countermeasures, risk and assessment studies, philosophies of dose limitations and national and international policies. (U.K.)

  9. Assessing asbestos exposure potential in nonindustrial settings. (United States)

    Chang, S N; White, L E; Scott, W D


    The presence of asbestos containing materials (ACM) in office and commercial buildings is a significant environmental problem. Asbestosis, mesothelioma and lung cancer have been linked with industrial exposure to airborne asbestos. The extensive use of asbestos products in buildings has raised concerns about the widespread exposure of the general public to asbestos in nonoccupational settings. The presence of asbestos in a building does not necessarily mean that significant exposure of the occupants of the building has occurred, but it is important that the asbestos be monitored regularly to ensure that fibers do not become airborne. If ACM are contained within a matrix and not disturbed, exposure is unlikely. However, if the asbestos becomes friable (crumbling) or if building maintenance, repair, renovation or other activities disturb ACM, airborne asbestos fibers may be a source of exposure to the occupants of the building. Currently, asbestos exposure assessment is conducted by a phase contrast light microscope (PCM) technique. Due to its inherent limitation in resolution and the generic counting rules used, analysis by the PCM method underestimates the airborne asbestos fiber concentration as compared to analysis by transmission electron microscopy (TEM). It is important that the air monitoring results analyzed by PCM be interpreted carefully in conjunction with a survey by a professional to judge the physical condition of the ACM in buildings. Exposure levels to airborne asbestos fibers vary from day to day and depend on the physical condition of the material involved and the type of operating and maintenance program in place.(ABSTRACT TRUNCATED AT 250 WORDS)

  10. Radiation camera exposure control

    International Nuclear Information System (INIS)

    Martone, R.J.; Yarsawich, M.; Wolczek, W.


    A system and method for governing the exposure of an image generated by a radiation camera to an image sensing camera is disclosed. The exposure is terminated in response to the accumulation of a predetermined quantity of radiation, defining a radiation density, occurring in a predetermined area. An index is produced which represents the value of that quantity of radiation whose accumulation causes the exposure termination. The value of the predetermined radiation quantity represented by the index is sensed so that the radiation camera image intensity can be calibrated to compensate for changes in exposure amounts due to desired variations in radiation density of the exposure, to maintain the detectability of the image by the image sensing camera notwithstanding such variations. Provision is also made for calibrating the image intensity in accordance with the sensitivity of the image sensing camera, and for locating the index for maintaining its detectability and causing the proper centering of the radiation camera image

  11. 76 FR 4944 - Ionizing Radiation Standard; Extension of the Office of Management and Budget's (OMB) Approval of... (United States)


    ...] Ionizing Radiation Standard; Extension of the Office of Management and Budget's (OMB) Approval of... Radiation Standard (29 CFR 1910.1096). The information collection requirements contained in the Ionizing... exposure to ionizing radiation including tissue damage and cancer. DATES: Comments must be submitted...

  12. Determinants of dermal exposure relevant for exposure modelling in regulatory risk assessment. (United States)

    Marquart, J; Brouwer, D H; Gijsbers, J H J; Links, I H M; Warren, N; van Hemmen, J J


    Risk assessment of chemicals requires assessment of the exposure levels of workers. In the absence of adequate specific measured data, models are often used to estimate exposure levels. For dermal exposure only a few models exist, which are not validated externally. In the scope of a large European research programme, an analysis of potential dermal exposure determinants was made based on the available studies and models and on the expert judgement of the authors of this publication. Only a few potential determinants appear to have been studied in depth. Several studies have included clusters of determinants into vaguely defined parameters, such as 'task' or 'cleaning and maintenance of clothing'. Other studies include several highly correlated parameters, such as 'amount of product handled', 'duration of task' and 'area treated', and separation of these parameters to study their individual influence is not possible. However, based on the available information, a number of determinants could clearly be defined as proven or highly plausible determinants of dermal exposure in one or more exposure situation. This information was combined with expert judgement on the scientific plausibility of the influence of parameters that have not been extensively studied and on the possibilities to gather relevant information during a risk assessment process. The result of this effort is a list of determinants relevant for dermal exposure models in the scope of regulatory risk assessment. The determinants have been divided into the major categories 'substance and product characteristics', 'task done by the worker', 'process technique and equipment', 'exposure control measures', 'worker characteristics and habits' and 'area and situation'. To account for the complex nature of the dermal exposure processes, a further subdivision was made into the three major processes 'direct contact', 'surface contact' and 'deposition'.

  13. Supervisory skills of extension managers in Sekhukhune District of ...

    African Journals Online (AJOL)

    ... namely at the supervisory level (Sub-District Extension Coordinators) and the top extension management level (Extension Heads). These are the two management levels that can potentially have the biggest influence on the efficiency of extension delivery. Keywords: management, leadership skills, differential perception, ...

  14. A Comparison of Agricultural Extension in Five States. (United States)

    Rogers, Everett M.

    The nature of the Cooperative Extension Service in agriculture was examined to identify aspects that could be applied to the design of an educational extension service. To learn about the organization, programs, and priorities of Cooperative Extension, employees of the state extension services in California, Colorado, New Mexico, New York, and…

  15. Coping with changes in agricultural extension in Uganda and ...

    African Journals Online (AJOL)

    It is suggested that a national extension co-ordination organisation be formed, with the public extension system taking the lead, to co-ordinate extension activities until such a time when farmers' associations and other private organisations can take the lead in delivery and co-ordination of agricultural extension services in ...

  16. Challenges for extension service to render efficient post-transformer ...

    African Journals Online (AJOL)


    from Agricultural Extension to Rural Development and Agricultural Extension. This was soon after they appointed a new Head of Extension who had just returned with a PhD from. Pretoria University. Makerere University in Uganda changed their Bachelor of Agricultural. Extension and Education (BAEE) program to Bachelor ...

  17. Expanding Agricultural and Rural Extension Roles for Sustainable ...

    African Journals Online (AJOL)

    The effect of globalization and the attendant privatization of the public sector of national economies of developing nations has profound effect on extension service delivery. This paper reviews present concept and challenges of extension and proposes future concerns of extension service. It concludes that extension ...

  18. Job satisfaction of extension workers in Edo State Agricultural ...

    African Journals Online (AJOL)

    ... of extension agents so as to be abreast of new developments, improve their knowledge and skills in new extension methodologies. With this, extension agents will be motivated and be satisfied with their jobs. Keywords: job satisfaction, extension workers. International Journal of Agriculture and Rural Development Vol.

  19. Suggesting a new paradigm for agricultural extension policy: the ...

    African Journals Online (AJOL)

    In terms of approaches and functions, the study found that public sector extension in West Africa is undergoing transformation including decentralization and outsourcing extension services in the context of adopting a pluralistic system of extension delivery. While up to six models of extension are a commonly applied in the ...

  20. Extension of operational limits on EAST

    International Nuclear Information System (INIS)

    Gao Xiang; Li Jiangang; Wan Baonian; Zhao Junyu; Hu Liqun; Liu Haiqing; Jie Yinxian; Xu Qiang; Wu Zhenwei; Yang Yu; Gong Xianzu; Shen Biao; Hu Jiansheng; Shi Yuejiang; Ling Bili; Wang Jun; Sajjad, S.; Zang Qing; Gao Wei; Zhang Tao; Yu Yaowei; Yang Yao; Han Xiaofeng; Shi Nan; Ming Tingfeng; Ti Ang; Zhang Wenyang; Xu Guosheng; Chen Junling; Luo Guangnan; Zhang Xiaodong; Mao Jianshan; Wan Yuanxi


    The first plasma has been achieved successfully in the Experimental Advanced Superconducting Tokamak (EAST). Boronization by the glow discharge (GDC) method was studied in experiments. The plasma performance was obviously improved by GDC boronization. Extension of the operational region and improvement in the plasma performance were obtained. Sawtooth discharges were observed by means of soft x-ray signals, electron cyclotron emission signals and line averaged electron density after boronization. Lower q a and more stable operation were also achieved following GDC boronization. The plasma current ramp-up rate was also improved as a result of decreased impurity content and low averaged loop voltage due to boronization

  1. Extension of p-local finite groups


    Broto, Carles; Castellana, Natalia; Grodal, Jesper; Levi, Ran; Oliver, Bob


    A p-local finite group consists of a finite p-group S, together with a pair of categories which encode ``conjugacy'' relations among subgroups of S, and which are modelled on the fusion in a Sylow p-subgroup of a finite group. It contains enough information to define a classifying space which has many of the same properties as p-completed classifying spaces of finite groups. In this paper, we study and classify extensions of p-local finite groups, and also compute the fundamental group of the...

  2. Extensive Epidermoid Cyst and Breathing Difficulty

    Directory of Open Access Journals (Sweden)

    Ciro Dantas Soares


    Full Text Available Epidermoid cysts are common cystic lesions in the skin, ovaries, and testicles, but their occurrence in the oral cavity is uncommon. They consist of cysts delimited by a fibrous capsule without cutaneous annexes and are lined by stratified squamous epithelium. The differential diagnosis includes ranula, dermoid cysts, and lingual thyroid. Despite their benign presentation, these cysts can cause functional limitations, requiring special clinical attention for extensive lesions located in regions that preserve vital structures. This paper aims to report a case of epidermoid cyst in patient with swallowing and breathing difficulty, highlighting the clinical and surgical planning.

  3. Emergency Anaesthetic Management of Extensive Thoracic Trauma

    Directory of Open Access Journals (Sweden)

    H C Chandola


    Full Text Available High speed vehicles, drug abuse, alcohol and easy availability of handguns are the main reasons of increasing number of trauma especially thoracic trauma. Anaesthesiologist plays an important role in the management of extensive thoracic trauma. Thoracic trauma, penetrating or blunt, may cause damage to organs suspended in thorax viz. pleura, lungs, heart, great vessels, trachea and oesophagus. It may lead to pneumothorax, cardiac tamponade or life threatening haemorrhage. With aggressive care and management of these factors, majority of patients can survive and return to normal life.

  4. Extensive utilization of training reactor VR-1

    International Nuclear Information System (INIS)

    Karel, Matejka; Lubomir, Sklenka


    This paper describes one of the main purposes of the VR-1 training reactor utilisation - i.e. extensive educational programme. The educational programme is intended for the training of university students (all technical universities in Czech Republic) and selected nuclear power plant personnel. At the present, students can go through more than 20 different experimental exercises. An attractive programme including demonstration of reactor operation is prepared also for high school students. Moreover, research and development works and information programmes proceed at the VR-1 reactor as well

  5. Analytic extension of the nuclear algebraic potential

    Energy Technology Data Exchange (ETDEWEB)

    Lichtenthaeler, R. (Departamento de Fisica Nuclear, Laboratorio do Pelletron, Universidade de Sao Paulo, Caixa Postal 20516, 01452-990 Sao Paulo, Sao Paulo (Brazil)); Gomes, L.C. (Grupo de Fisica Nuclear Teorica e Fenomenologia de Particulas Elementares Instituto de Fisica Universidade de Sao Paulo, Caixa Postal 20516, 01498-970 Sao Paulo, Sao Paulo (Brazil))


    An analytic extension of the nuclear algebraic potential in the complex energy and angular momentum planes is discussed and an approximation for the algebraic potential in agreement with the known analytic properties of the [ital S]-matrix is proposed. The invariance of the energy spectrum of the Coulomb part of the interaction is established. The results are applied to the Regge pole analysis of the [sup 12]C+[sup 24]Mg elastic collision at [ital E][sub [ital l][ital a][ital b

  6. CT of perineural tumor extension: pterygopalatine fossa

    Energy Technology Data Exchange (ETDEWEB)

    Curtin, H.D.; Williams, R.; Johnson, J.


    Tumors of the oral cavity and paranasal sinuses can spread along nerves to areas apparently removed from the primary tumor. In tumors of the palate, sinuses, and face, this perineural spread usually involves the maxillary division of the trigeminal nerve. The pterygopalatine fossa is a pathway of the maxillary nerve and becomes a key landmark in the detection of neural metastasis by computed tomography (CT). Obliteration of the fat in the fossa suggests pathology. Case material illustrating neural extension is presented and the CT findings are described.

  7. Radar reflection off extensive air showers

    Directory of Open Access Journals (Sweden)

    Werner F.


    Full Text Available We investigate the possibility of detecting extensive air showers by the radar technique. Considering a bistatic radar system and different shower geometries, we simulate reflection of radio waves off the static plasma produced by the shower in the air. Using the Thomson cross-section for radio wave reflection, we obtain the time evolution of the signal received by the antennas. The frequency upshift of the radar echo and the power received are studied to verify the feasibility of the radar detection technique.

  8. Radio detection of extensive air showers (United States)

    Huege, Tim


    Radio detection of extensive air showers initiated in the Earth's atmosphere has made tremendous progress in the last decade. Today, radio detection is routinely used in several cosmic-ray observatories. The physics of the radio emission in air showers is well-understood, and analysis techniques have been developed to determine the arrival direction, the energy and an estimate for the mass of the primary particle from the radio measurements. The achieved resolutions are competitive with those of more traditional techniques. In this article, I shortly review the most important achievements and discuss the potential for future applications.

  9. Shift versus Extension in Refined Partition Functions

    CERN Document Server

    Krefl, Daniel


    We have recently shown that the global behavior of the partition function of N=2 gauge theory in the general Omega-background is captured by special geometry in the guise of the (extended) holomorphic anomaly equation. We here analyze the fate of our results under the shift of the mass parameters of the gauge theory. The preferred value of the shift, noted previously in other contexts, restores the Z_2 symmetry of the instanton partition function under inversion of the Omega-background, and removes the extension. We comment on various connections.

  10. A Practice of English Extensive Reading


    Yasuko, Yoshino; Tatsuhiko, Nagasaka; Ryuji, Fujikami; Andrew, Jones


    The Foreign Language Center(FLC)of Jissen Women's University offers an Integrated English course required for the first-year students. The aim of this course is to enhance motivation for the students to acquire English and help the students to be autonomous learners. On a trial basis, a practice of English extensive reading project was adopted in 2006 and has been improved year by year. The reason whywe focused on reading was that reading is both a thinking process and a productiveactivity. I...

  11. Extension planning for electrical energy supply systems

    International Nuclear Information System (INIS)

    Bieselt, R.


    In the future as well as in the past, and in particular in the next decade a considerable increase in electrical energy demand can be expected. To satisfy this demand in a reliable and sufficient manner will force the utilities to invest large sums of money for the operation and the extension of power generation and distribution plants. The size of these investments justifies the search for more and more comprehensive and at the same time more detailed planning methods. With the help of system analysis a planning model for the electricity supply industry of a major supply area will be designed. (orig./RW) [de

  12. Extensive Variation in Chromatin States Across Humans

    KAUST Repository

    Kasowski, M.


    The majority of disease-associated variants lie outside protein-coding regions, suggesting a link between variation in regulatory regions and disease predisposition. We studied differences in chromatin states using five histone modifications, cohesin, and CTCF in lymphoblastoid lines from 19 individuals of diverse ancestry. We found extensive signal variation in regulatory regions, which often switch between active and repressed states across individuals. Enhancer activity is particularly diverse among individuals, whereas gene expression remains relatively stable. Chromatin variability shows genetic inheritance in trios, correlates with genetic variation and population divergence, and is associated with disruptions of transcription factor binding motifs. Overall, our results provide insights into chromatin variation among humans.

  13. Extensive spinal epidural abscess complicated with hydrocephalus

    Directory of Open Access Journals (Sweden)

    Balan Corneliu


    Full Text Available Spinal epidural abscess is a rare but severe infection requiring prompt recognition in order to have a favorable outcome and appropriate treatment, mainly surgical. We present one of the largest extensions of such abscess in literature, involving the whole spine. No surgical treatment was tempted due to the involvement of 19 levels but antibiotics. The evolution of the lesion was complicated with hydrocephalus, by mechanism of cervical block of CSF flow, and needed first external derivation and later ventriculo-peritoneal drainage.

  14. Effective, Efficient Online Training in Cooperative Extension

    Directory of Open Access Journals (Sweden)

    Jane Chin Young


    Full Text Available In order to keep pace with media and communications trends in education, Cooperative Extension (CE faces the need to shift from traditional face-to-face delivery to online alternatives. This exploratory study focused on evaluating the effectiveness of on-demand, interactive online training compared to its face-to-face counterpart. Targeted for CE staff and volunteers whose work impacts youth, families and communities, the design centered on the university’s cost-effective in-house technology tools. The study results make the case for online delivery as effective and efficient. Strategies for developing a process for online delivery in CE are also offered.


    International Nuclear Information System (INIS)



    The deployment of the Unified Accelerator Library (UAL) environment on the parallel cluster is presented. The approach is based on the Message-Passing Interface (MPI) library and the Perl adapter that allows one to control and mix together the existing conventional UAL components with the new MPI-based parallel extensions. In the paper, we provide timing results and describe the application of the new environment to the SNS Ring complex beam dynamics studies, particularly, simulations of several physical effects, such as space charge, field errors, fringe fields, and others


    Energy Technology Data Exchange (ETDEWEB)



    The deployment of the Unified Accelerator Library (UAL) environment on the parallel cluster is presented. The approach is based on the Message-Passing Interface (MPI) library and the Perl adapter that allows one to control and mix together the existing conventional UAL components with the new MPI-based parallel extensions. In the paper, we provide timing results and describe the application of the new environment to the SNS Ring complex beam dynamics studies, particularly, simulations of several physical effects, such as space charge, field errors, fringe fields, and others.

  17. Cosmic-ray exposure records and origins of meteorites

    International Nuclear Information System (INIS)

    Reedy, R.C.


    The cosmic-ray records of meteorites can be used to infer much about their origins and recent histories. Some meteorites had simple cosmic-ray exposure histories, while others had complex exposure histories with their cosmogenic products made both before and after a collision in space. The methods used to interpret meteorites' cosmic-ray records, especially identifying simple or complex exposure histories, often are inadequate. Besides spallogenic radionuclides and stable nuclides, measurements of products that have location-sensitive production rates, such as the tracks of heavy cosmic-ray nuclei or neutron-capture nuclides, are very useful in accurately determining a meteorite's history. Samples from different, known locations of a meteorite help in studying the cosmic-ray record. Such extensive sets of meteorite measurements, plus theoretical modeling of complex histories, will improve our ability to predict the production of cosmogenic nuclides in meteorites, to distinguish simple and complex exposure histories, and to better determine exposure ages

  18. Improved Extension Neural Network and Its Applications

    Directory of Open Access Journals (Sweden)

    Yu Zhou


    Full Text Available Extension neural network (ENN is a new neural network that is a combination of extension theory and artificial neural network (ANN. The learning algorithm of ENN is based on supervised learning algorithm. One of important issues in the field of classification and recognition of ENN is how to achieve the best possible classifier with a small number of labeled training data. Training data selection is an effective approach to solve this issue. In this work, in order to improve the supervised learning performance and expand the engineering application range of ENN, we use a novel data selection method based on shadowed sets to refine the training data set of ENN. Firstly, we use clustering algorithm to label the data and induce shadowed sets. Then, in the framework of shadowed sets, the samples located around each cluster centers (core data and the borders between clusters (boundary data are selected as training data. Lastly, we use selected data to train ENN. Compared with traditional ENN, the proposed improved ENN (IENN has a better performance. Moreover, IENN is independent of the supervised learning algorithms and initial labeled data. Experimental results verify the effectiveness and applicability of our proposed work.

  19. Dynamic extension and configuration of multimedia terminals (United States)

    Schaefer, Ralf; Finger, Ulrich


    In this paper, we present an implementation of an MPEG-4 decoder using Java for dynamic processing, i.e. providing flexibility and extensibility. The advantage of Java is its platform independent paradigm using a virtual machine. This enables us to provide downloading of tools and also dynamic configuration of already downloaded tools. However, the disadvantage of Java is its low performance. Therefore we propose a hybrid implemented approach using Java implementations only for flexibility and extensibility. All the rest of the decoder is implemented in native code, providing the high performance necessary for real time issues. We use Java only where Java is necessary. To integrate Java with the native code implementations we utilize the Java native interface (JNI). We use the JNI to create an instance of the Java virtual machine (JVM) in the running MPEG-4 application. This JVM instance handles all Java decoder tool implementations as well as incoming Java bit streams. All the other data streams are handled by the native implemented part.

  20. Radial Extension, Prototypicality, and Tectonic Equivalence

    Directory of Open Access Journals (Sweden)

    Shaver Stephen R.


    Full Text Available In his book “Without Metaphor, No Saving God: Theology After Cognitive Linguistics”, Robert Masson describes a metaphoric process by which newly accepted truths emerge: for example, in the assertion “Jesus is the Messiah,” Christians reconfigure the field of meanings associated with an existing concept from the Hebrew scriptures (messiah by asserting its identification with Jesus. Masson dubs this process a “tectonic equivalence” or “tectonic shift.” In this paper I build on Masson‘s work by examining some of the shifts he describes as tectonic through the lens of the cognitive linguistics concepts of radial extension and polysemy. I propose that a lasting tectonic shift may be understood as a blend creating a radial extension that substantially alters the category structure of the original source frame so that the blended space comes to be understood as a central instance of that category. Such an approach allows a fruitful analysis of the similarities and differences among three example blends: god is a rock, jesus is the messiah, and jesus is god.

  1. Life extension by calorie restriction in humans. (United States)

    Everitt, Arthur V; Le Couteur, David G


    Long-term reduction in energy intake in the diet (calorie restriction [CR]) extends the life of the laboratory rat by about 25%. However, in humans there are no life-long studies of CR, but only short-term trials which indicate that 20% CR acting over periods of 2-6 years is associated with reduced body weight, blood pressure, blood cholesterol, and blood glucose--risk factors for the major killer diseases of cardiovascular disease and diabetes. In addition, recent research has shown that CR for 6 months is able to improve biomarkers for longevity (deep body temperature and plasma insulin) and thus should increase life expectancy. The magnitude of the life-extension effect of CR in humans can only be estimated. The Okinawans, the longest-lived people on earth, consume 40% fewer calories than the Americans and live only 4 years longer. Similarly, women in United States consume 25% fewer calories than men and live 5 years longer. From the survival studies of overweight and obese people, it is estimated that long-term CR to prevent excessive weight gain could add only 3-13 years to life expectancy. Thus the effects of CR on human life extension are probably much smaller than those achieved by medical and public health interventions, which have extended life by about 30 years in developed countries in the 20th century, by greatly reducing deaths from infections, accidents, and cardiovascular disease.

  2. [Extensive swelling reaction after a pentavalent vaccination]. (United States)

    Gébus, M; Barbier, C; Bost-Bru, C; Michard-Lenoir, A P; Plantaz, D


    Injection site reactions (ISRs) are quite common side effects defined by a local adverse drug reaction directly caused by a vaccine. Twenty-four hours after an intramuscular injection (in the deltoid muscle) of the diphtheria, tetanus, acellular pertussis, inactivated poliomyelitis, Haemophilus influenza type b (DTPCa-Hib) combined vaccine, a 3-year-old boy developed fever. A few hours later, local redness and swelling appeared at the injection site, with rapid extension to the entire limb, it was pain-free, and no other clinical anomalies were present. The patient received intravenous antibiotics for suspected cellulitis. The progression was favorable in 12h (apyrexia and decreased limb swelling), allowing the intravenous antibiotic treatment to be discontinued. Since the child was in excellent general health and recovery was fast, an ISR was diagnosed. Extensive limb swelling is frequent, mostly after the fourth dose of DTPCa-Hib. Deltoid muscle injection of DTP vaccine increases the risk of ISR compared to injection in the thigh, before the age of 3 years. The introduction of acellular pertussis vaccine decreased the risk of general side effects but may increase the risk of ISR. These reactions disappear with symptomatic treatment and do not contraindicate the product. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  3. Extensive Growth of an Anaplastic Meningioma

    Directory of Open Access Journals (Sweden)

    Hajrullah Ahmeti


    Full Text Available We present the case of a 30-year-old male patient with an almost complete destruction of the calvarial bone through an anaplastic meningioma diagnosed in line with dizziness. Neuroimaging revealed an extensive growing, contrast enhancing lesion expanding at the supra- and infratentorial convexity, infiltrating and destroying large parts of the skull, and infiltrating the skin. Due to progressive ataxia and dysarthria with proven tumor growth in the posterior fossa in the continuing course, parts of the tumor were resected. A surgical procedure with the aim of complete tumor resection in a curative manner was not possible. Six months after the first operation, due to a new tumor progression, most extensive tumor resection was performed. Due to the aggressive and destructive growth with a high rate of recurrence and tendency of metastases, anaplastic meningiomas can be termed as malignant tumors. The extrinsic growth masks the tumor until they reach a size, which makes these tumors almost unresectable. In the best case scenarios, the five-year survival is about 50%. With the presented case, we would like to show the aggressive behavior of anaplastic meningiomas in a very illustrative way. Chemotherapy, radiotherapy, and surgery reach their limits in this tumor entity.

  4. Microcanonical ensemble extensive thermodynamics of Tsallis statistics

    International Nuclear Information System (INIS)

    Parvan, A.S.


    The microscopic foundation of the generalized equilibrium statistical mechanics based on the Tsallis entropy is given by using the Gibbs idea of statistical ensembles of the classical and quantum mechanics.The equilibrium distribution functions are derived by the thermodynamic method based upon the use of the fundamental equation of thermodynamics and the statistical definition of the functions of the state of the system. It is shown that if the entropic index ξ = 1/q - 1 in the microcanonical ensemble is an extensive variable of the state of the system, then in the thermodynamic limit z bar = 1/(q - 1)N = const the principle of additivity and the zero law of thermodynamics are satisfied. In particular, the Tsallis entropy of the system is extensive and the temperature is intensive. Thus, the Tsallis statistics completely satisfies all the postulates of the equilibrium thermodynamics. Moreover, evaluation of the thermodynamic identities in the microcanonical ensemble is provided by the Euler theorem. The principle of additivity and the Euler theorem are explicitly proved by using the illustration of the classical microcanonical ideal gas in the thermodynamic limit

  5. Microcanonical ensemble extensive thermodynamics of Tsallis statistics

    International Nuclear Information System (INIS)

    Parvan, A.S.


    The microscopic foundation of the generalized equilibrium statistical mechanics based on the Tsallis entropy is given by using the Gibbs idea of statistical ensembles of the classical and quantum mechanics. The equilibrium distribution functions are derived by the thermodynamic method based upon the use of the fundamental equation of thermodynamics and the statistical definition of the functions of the state of the system. It is shown that if the entropic index ξ=1/(q-1) in the microcanonical ensemble is an extensive variable of the state of the system, then in the thermodynamic limit z-bar =1/(q-1)N=const the principle of additivity and the zero law of thermodynamics are satisfied. In particular, the Tsallis entropy of the system is extensive and the temperature is intensive. Thus, the Tsallis statistics completely satisfies all the postulates of the equilibrium thermodynamics. Moreover, evaluation of the thermodynamic identities in the microcanonical ensemble is provided by the Euler theorem. The principle of additivity and the Euler theorem are explicitly proved by using the illustration of the classical microcanonical ideal gas in the thermodynamic limit

  6. Extension of yeast chronological lifespan by methylamine.

    Directory of Open Access Journals (Sweden)

    Sanjeev Kumar

    Full Text Available BACKGROUND: Chronological aging of yeast cells is commonly used as a model for aging of human post-mitotic cells. The yeast Saccharomyces cerevisiae grown on glucose in the presence of ammonium sulphate is mainly used in yeast aging research. We have analyzed chronological aging of the yeast Hansenula polymorpha grown at conditions that require primary peroxisome metabolism for growth. METHODOLOGY/PRINCIPAL FINDINGS: The chronological lifespan of H. polymorpha is strongly enhanced when cells are grown on methanol or ethanol, metabolized by peroxisome enzymes, relative to growth on glucose that does not require peroxisomes. The short lifespan of H. polymorpha on glucose is mainly due to medium acidification, whereas most likely ROS do not play an important role. Growth of cells on methanol/methylamine instead of methanol/ammonium sulphate resulted in further lifespan enhancement. This was unrelated to medium acidification. We show that oxidation of methylamine by peroxisomal amine oxidase at carbon starvation conditions is responsible for lifespan extension. The methylamine oxidation product formaldehyde is further oxidized resulting in NADH generation, which contributes to increased ATP generation and reduction of ROS levels in the stationary phase. CONCLUSION/SIGNIFICANCE: We conclude that primary peroxisome metabolism enhanced chronological lifespan of H. polymorpha. Moreover, the possibility to generate NADH at carbon starvation conditions by an organic nitrogen source supports further extension of the lifespan of the cell. Consequently, the interpretation of CLS analyses in yeast should include possible effects on the energy status of the cell.

  7. Some extensions in continuous models for immunological correlates of protection. (United States)

    Dunning, Andrew J; Kensler, Jennifer; Coudeville, Laurent; Bailleux, Fabrice


    A scaled logit model has previously been proposed to quantify the relationship between an immunological assay and protection from disease, and has been applied in a number of settings. The probability of disease was modelled as a function of the probability of exposure, which was assumed to be fixed, and of protection, which was assumed to increase smoothly with the value of the assay. Some extensions are here investigated. Alternative functions to represent the protection curve are explored, applications to case-cohort designs are evaluated, and approaches to variance estimation compared. The steepness of the protection curve must sometimes be bounded to achieve convergence and methods for doing so are outlined. Criteria for evaluating the fit of models are proposed and approaches to assessing the utility of results suggested. Models are evaluated by application to sixteen datasets from vaccine clinical trials. Alternative protection curve functions improved model evaluation criteria for every dataset. Standard errors based on the observed information were found to be unreliable; bootstrap estimates of precision were to be preferred. In most instances, case-cohort designs resulted in little loss of precision. Some results achieved suggested measures for utility. The original scaled logit model can be improved upon. Evaluation criteria permit well-fitting models and useful results to be identified. The proposed methods provide a comprehensive set of tools for quantifying the relationship between immunological assays and protection from disease.

  8. Genetic analysis of presbycusis by arrayed primer extension. (United States)

    Rodriguez-Paris, Juan; Ballay, Charles; Inserra, Michelle; Stidham, Katrina; Colen, Tahl; Roberson, Joseph; Gardner, Phyllis; Schrijver, Iris


    Using the Hereditary Hearing Loss arrayed primer extension (APEX) array, which contains 198 mutations across 8 hearing loss-associated genes (GJB2, GJB6, GJB3, GJA1, SLC26A4, SLC26A5, 12S-rRNA, and tRNA Ser), we compared the frequency of sequence variants in 94 individuals with early presbycusis to 50 unaffected controls and aimed to identify possible genetic contributors. This cross-sectional study was performed at Stanford University with presbycusis samples from the California Ear Institute. The patients were between ages 20 and 65 yr, with adult-onset sensorineural hearing loss of unknown etiology, and carried a clinical diagnosis of early presbycusis. Exclusion criteria comprised known causes of hearing loss such as significant noise exposure, trauma, ototoxic medication, neoplasm, and congenital infection or syndrome, as well as congenital or pediatric onset. Sequence changes were identified in 11.7% and 10% of presbycusis and control alleles, respectively. Among the presbycusis group, these solely occurred within the GJB2 and SLC26A4 genes. Homozygous and compound heterozygous pathogenic mutations were exclusively seen in affected individuals. We were unable to detect a statistically significant difference between our control and affected populations regarding the frequency of sequence variants detected with the APEX array. Individuals who carry two mild mutations in the GJB2 gene possibly have an increased risk of developing early presbycusis.

  9. Occupational exposure in MRI. (United States)

    McRobbie, D W


    This article reviews occupational exposure in clinical MRI; it specifically considers units of exposure, basic physical interactions, health effects, guideline limits, dosimetry, results of exposure surveys, calculation of induced fields and the status of the European Physical Agents Directive. Electromagnetic field exposure in MRI from the static field B(0), imaging gradients and radiofrequency transmission fields induces electric fields and currents in tissue, which are responsible for various acute sensory effects. The underlying theory and its application to the formulation of incident and induced field limits are presented. The recent International Commission on Non-Ionizing Radiation Protection (ICNIRP) Bundesministerium für Arbeit und Soziales and Institute of Electrical and Electronics Engineers limits for incident field exposure are interpreted in a manner applicable to MRI. Field measurements show that exposure from movement within the B(0) fringe field can exceed ICNIRP reference levels within 0.5 m of the bore entrance. Rate of change of field dB/dt from the imaging gradients is unlikely to exceed the new limits, although incident field limits can be exceeded for radiofrequency (RF) exposure within 0.2-0.5 m of the bore entrance. Dosimetric surveys of routine clinical practice show that staff are exposed to peak values of 42 ± 24% of B(0), with time-averaged exposures of 5.2 ± 2.8 mT for magnets in the range 0.6-4 T. Exposure to time-varying fields arising from movement within the B(0) fringe resulted in peak dB/dt of approximately 2 T s(-1). Modelling of induced electric fields from the imaging gradients shows that ICNIRP-induced field limits are unlikely to be exceeded in most situations; however, movement through the static field may still present a problem. The likely application of the limits is discussed with respect to the reformulation of the European Union (EU) directive and its possible implications for MRI.

  10. A novel approach for exposure assessment in air pollution epidemiological studies using neuro-fuzzy inference systems: Comparison of exposure estimates and exposure-health associations. (United States)

    Blanes-Vidal, Victoria; Cantuaria, Manuella Lech; Nadimi, Esmaeil S


    Many epidemiological studies have used proximity to sources as air pollution exposure assessment method. However, proximity measures are not generally good surrogates because of their complex non-linear relationship with exposures. Neuro-fuzzy inference systems (NFIS) can be used to map complex non-linear systems, but its usefulness in exposure assessment has not been extensively explored. We present a novel approach for exposure assessment using NFIS, where the inputs of the model were easily-obtainable proximity measures, and the output was residential exposure to an air pollutant. We applied it to a case-study on NH 3 pollution, and compared health effects and exposures estimated from NFIS, with those obtained from emission-dispersion models, and linear and non-linear regression proximity models, using 10-fold cross validation. The agreement between emission-dispersion and NFIS exposures was high (Root-mean-square error (RMSE) =0.275, correlation coefficient (r)=0.91) and resulted in similar health effect estimates. Linear models showed poor performance (RMSE=0.527, r=0.59), while non-linear regression models resulted in heterocedasticity, non-normality and clustered data. NFIS could be a useful tool for estimating individual air pollution exposures in epidemiological studies on large populations, when emission-dispersion data are not available. The tradeoff between simplicity and accuracy needs to be considered. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Exposure to Conflict and Violence across Contexts: Relations to Adjustment among Palestinian Children (United States)

    Dubow, Eric F.; Boxer, Paul; Huesmann, L. Rowell; Shikaki, Khalil; Landau, Simha; Gvirsman, Shira Dvir; Ginges, Jeremy


    Despite extensive literatures on the impact on children of exposure to violence in families, neighborhoods, and peer groups, there has been relatively little effort evaluating their cumulative impact. There also has been less attention to the effects of exposure to political conflict and violence. We collected data from a representative sample of…

  12. Overview of EPA CSS Intramural Research on Life Cycle and Human Exposure Modeling (United States)

    Improved human exposure modeling in life cycle assessmentsModeling and assessment for chemicals/products with less extensive dataMore rapid and higher throughput assessmentsLife Cycle-Human Exposure Modeling (LC-HEM) tool usable by Offices/Regions and by external stakeholders

  13. Noise Exposure Summary And Comparitive Analyses

    Energy Technology Data Exchange (ETDEWEB)

    Bumala, Philip A. [Tulane Univ., New Orleans, LA (United States). School of Public Health


    This paper summarizes and compares facility Operations and Maintenance (O&M) noise Dosimetry data to industry wide construction data. Dosimetry data has been compiled from a noise exposure assessment at a DOE national research facility Maintenance, Utilities, and Service Department (MUSD). This facility is the Lawrence Livermore National Laboratory (LLNL). The laboratory consists of ten O&M craft and trade shops responsible for a fifty year old infrastructure including over 300 buildings, and a worker population of approximately 7,000. The facility includes an extensive variety of noise generating activities throughout a one square mile site.

  14. Insecticide Exposure in Parkinsonism

    National Research Council Canada - National Science Library

    Bloomquist, Jeffrey


    Behavioral, neurochemical, and immunocytochemical studies characterized the possible role of insecticide exposure in the etiology of Parkinson's disease as it may relate to Gulf War Syndrome. Chlorpyrifos (CP) and permethrin (PM...

  15. Insecticide Exposure in Parkinsonism

    National Research Council Canada - National Science Library

    Bloomquist, Jeffrey


    Behavioral, neurochemical, and immunocytochemical studies characterized the possible role of insecticide exposure in the etiology of Parkinson's disease as it may relate to Gulf War Syndrome. Chlorpyrifos (CP) and permethrin (PM...

  16. Pregnancy and Radiation Exposure (United States)

    ... pregnant women. Ionizing radiation is the kind of electromagnetic radiation produced by x-ray machines, radioactive isotopes (radionuclides), ... and conceive is quite low. Studies of the atomic bomb survivors indicate even in the high-exposure ...

  17. Poinsettia plant exposure (United States)

    Christmas flower poisoning; Lobster plant poisoning; Painted leaf poisoning ... Leaves, stem, sap of the poinsettia plant ... Poinsettia plant exposure can affect many parts of the body. EYES (IF DIRECT CONTACT OCCURS) Burning Redness STOMACH AND ...

  18. Contamination vs. Exposure (United States)

    ... Health Matters Information on Specific Types of Emergencies Contamination vs. exposure Recommend on Facebook Tweet Share Compartir ... contaminate their surroundings and personal property. Types of Contamination Internal Contamination Internal contamination occurs when people swallow ...

  19. Insecticide Exposure in Parkinsonism

    National Research Council Canada - National Science Library

    Bloomquist, Jeffrey


    Behavioral, neurochemical, and immunocytochemical studies are characterizing the possible role of insecticide exposure in the etiology of Parkinson's disease as it may relate to Gulf War Syndrome. Chlorpyrifos (CP) and/or permethrin (PM...

  20. Natural Weathering Exposure Station (United States)

    Federal Laboratory Consortium — The Corps of Engineers' Treat Island Natural Weathering Exposure Station is a long-term natural weathering facility used to study concrete durability. Located on the...

  1. Personal Chemical Exposure informatics (United States)

    Chemical Exposure science is the study of human contact with chemicals (from manufacturing facilities, everyday products, waste) occurring in their environments and advances knowledge of the mechanisms and dynamics of events that cause or prevent adverse health outcomes. (adapted...

  2. Extension of association models to complex chemicals

    DEFF Research Database (Denmark)

    Avlund, Ane Søgaard

    ; CPA and sPC-SAFT. Phase equilibrium and monomer fraction calculations with sPC-SAFT for methanol are used in the thesis to illustrate the importance of parameter estimation when using SAFT. Different parameter sets give similar pure component vapor pressure and liquid density results, whereas very......Summary of “Extension of association models to complex chemicals”. Ph.D. thesis by Ane Søgaard Avlund The subject of this thesis is application of SAFT type equations of state (EoS). Accurate and predictive thermodynamic models are important in many industries including the petroleum industry...... not account for steric self-hindrance for tree-like structures. An important practical problem is how to obtain optimal and consistent parameters. Moreover, multifunctional associating molecules represent a special challenge. In this work two equations of state using the SAFT theory for association are used...

  3. A Moodle extension to book online labs

    Directory of Open Access Journals (Sweden)

    Antonio C. Cardoso


    Full Text Available The social constructivist philosophy of Moodle makes it an excellent choice to deliver e-learning contents that require collaborative activities, such as those that are associated with online labs. In the case of online labs that enable web access to real devices (remote workbenches, access time should be reserved beforehand. A booking tool will avoid access conflicts and at the same time will help the students to organise their time and activities. This paper presents a Moodle extension that was developed within the Leonardo da Vinci MARVEL project, with the objective of meeting this requirement. The booking tool presented enables resource sharing in general and may be used to organise access to any type of scarce resources, such as to online labs and to the videoconferencing rooms that are needed to support collaborative activities.

  4. BB-CLIPS: Blackboard extensions to CLIPS (United States)

    Orchard, Robert A.; Diaz, Aurora C.


    This paper describes a set of extensions made to CLIPS version 4.3 that provide capabilities similar to the blackboard control architecture described by Hayes-Roth. There are three types of additions made to the CLIPS shell. The first extends the syntax to allow the specification of blackboard locations for CLIPS facts. The second implements changes in CLIPS rules and the agenda manager that provide some of the powerful features of the blackboard control architecture. These additions provide dynamic prioritization of rules on the agenda allowing control strategies to be implemented that respond to the changing goals of the system. The final category of changes support the needs of continuous systems, including the ability for CLIPS to continue execution with an empty agenda.

  5. Requirement Generation For The Habitation Extension Module (United States)

    Hempsell, M.

    As part of a debate within United Kingdom regarding its policy to avoid project involving human space flight, a study design was produced to explore the implications of a late entry as a full partner in the International Space Station (ISS). This objective generates many diverse requirements from the two primary stakeholders, the existing ISS partners and United Kingdom itself. It was found that a Soyuz/Fregat launched Habitation Extension Module with a logistic supply capability could meet all these requirements. It is unusual for a system to successfully meet such a wide range of requirements, but in this case the ability to scope the requirements in a single objective and the flexibility inherent in the wide design space created by the many options have made it possible.

  6. Energy Extension Service Program planning manual

    Energy Technology Data Exchange (ETDEWEB)

    Liersch, Judith M.


    The manual is the first revision of the EES Program Planning Manual. At the states' request, there have been a number of changes to the state EES contacts list, and an updated list is included in this package as the revised Appendix D. Part I, Introduction, presents: How to Use the State Program Planning Manual and The Energy Extension Service Program. Part II, Applying for an EES Grant, presents: The Annual State Application for Financial Assistance; State Financial Assistance and Associated Requirements; Preparing the State Plan. Part III, Operating a State EES, presents: Start-Up Considerations; State Program Reporting; Recordkeeping and Financial Management. Part IV, DOE's Role, presents DOE Functions and Responsibilities and Special Cases: Development and Implementation of a State Plan by the EES Director and Administrative Review.

  7. Covariant extensions and the nonsymmetric unified field

    International Nuclear Information System (INIS)

    Borchsenius, K.


    The problem of generally covariant extension of Lorentz invariant field equations, by means of covariant derivatives extracted from the nonsymmetric unified field, is considered. It is shown that the contracted curvature tensor can be expressed in terms of a covariant gauge derivative which contains the gauge derivative corresponding to minimal coupling, if the universal constant p, characterizing the nonsymmetric theory, is fixed in terms of Planck's constant and the elementary quantum of charge. By this choice the spinor representation of the linear connection becomes closely related to the spinor affinity used by Infeld and Van Der Waerden (Sitzungsber. Preuss. Akad. Wiss. Phys. Math. Kl.; 9:380 (1933)) in their generally covariant formulation of Dirac's equation. (author)

  8. Complex singlet extension of the standard model

    International Nuclear Information System (INIS)

    Barger, V.; Langacker, P.; McCaskey, M.; Ramsey-Musolf, M.; Shaughnessy, G.


    We analyze a simple extension of the standard model (SM) obtained by adding a complex singlet to the scalar sector (cxSM). We show that the cxSM can contain one or two viable cold dark matter candidates and analyze the conditions on the parameters of the scalar potential that yield the observed relic density. When the cxSM potential contains a global U(1) symmetry that is both softly and spontaneously broken, it contains both a viable dark matter candidate and the ingredients necessary for a strong first order electroweak phase transition as needed for electroweak baryogenesis. We also study the implications of the model for discovery of a Higgs boson at the Large Hadron Collider

  9. Analytical extension of curved shock theory (United States)

    Emanuel, G.


    Curved shock theory (CST) is limited to shock waves in a steady, two-dimensional or axisymmetric (2-Ax) flow of a perfect gas. A unique feature of CST is its use of intrinsic coordinates that result in an elegant and useful formulation for flow properties just downstream of a shock. For instance, the downstream effect of upstream vorticity, shock wave curvature, and the upstream pressure gradient along a streamline is established. There have been several attempts to extend CST, as mentioned in the text. Removal of the steady, 2-Ax, and perfect gas limitations, singly or in combination, requires an appropriate formulation of the shock wave's jump relations and the intrinsic coordinate Euler equations. Issues discussed include flow plane versus osculating plane, unsteady flow, vorticity, an imperfect gas, etc. The extension of CST utilizes concepts from differential geometry, such as the osculating plane, streamline torsion, and the Serret-Frenet equations.

  10. Extensive hypertrophic lupus erythematosus: Atypical presentation

    Directory of Open Access Journals (Sweden)

    Tarun Narang


    Full Text Available Lupus erythematosus (LE is a disease with a wide spectrum of cutaneous and systemic manifestations. Clinical features of patients with LE show a great variation, and for this reason it is difficult to develop a unifying concept of this disease. Our objective is to present a case of hypertrophic LE with atypical morphology and extensive involvement, who responded favorably to isotretinoin. Diagnosis of hypertrophic lupus erythematosus (HLE was confirmed by characteristic histopathological findings. Combination therapy with isotretinoin and hydroxychloroquine resulted in flattening and repression of previously refractory skin lesions. Sometimes, HLE lesions may present a diagnostic and therapeutic dilemma. In long standing lesions, squamous cell carcinoma may arise. Therefore, HLE requires adequate therapy with clinical and histopathological follow up.

  11. Holomorphic extension of generalizations of Hp functions

    Directory of Open Access Journals (Sweden)

    Richard D. Carmichael


    Full Text Available In recent analysis we have defined and studied holomorphic functions in tubes in ℂn which generalize the Hardy Hp functions in tubes. In this paper we consider functions f(z, z=x+iy, which are holomorphic in the tube TC=ℝn+iC, where C is the finite union of open convex cones Cj, j=1,…,m, and which satisfy the norm growth of our new functions. We prove a holomorphic extension theorem in which f(z, z ϵ TC, is shown to be extendable to a function which is holomorphic in T0(C=ℝn+i0(C, where 0(C is the convex hull of C, if the distributional boundary values in 𝒮′ of f(z from each connected component TCj of TC are equal.

  12. Learning investment indicators through data extension (United States)

    Dvořák, Marek


    Stock prices in the form of time series were analysed using single and multivariate statistical methods. After simple data preprocessing in the form of logarithmic differences, we augmented this single variate time series to a multivariate representation. This method makes use of sliding windows to calculate several dozen of new variables using simple statistic tools like first and second moments as well as more complicated statistic, like auto-regression coefficients and residual analysis, followed by an optional quadratic transformation that was further used for data extension. These were used as a explanatory variables in a regularized logistic LASSO regression which tried to estimate Buy-Sell Index (BSI) from real stock market data.

  13. Radiology and Enterprise Medical Imaging Extensions (REMIX). (United States)

    Erdal, Barbaros S; Prevedello, Luciano M; Qian, Songyue; Demirer, Mutlu; Little, Kevin; Ryu, John; O'Donnell, Thomas; White, Richard D


    Radiology and Enterprise Medical Imaging Extensions (REMIX) is a platform originally designed to both support the medical imaging-driven clinical and clinical research operational needs of Department of Radiology of The Ohio State University Wexner Medical Center. REMIX accommodates the storage and handling of "big imaging data," as needed for large multi-disciplinary cancer-focused programs. The evolving REMIX platform contains an array of integrated tools/software packages for the following: (1) server and storage management; (2) image reconstruction; (3) digital pathology; (4) de-identification; (5) business intelligence; (6) texture analysis; and (7) artificial intelligence. These capabilities, along with documentation and guidance, explaining how to interact with a commercial system (e.g., PACS, EHR, commercial database) that currently exists in clinical environments, are to be made freely available.

  14. Production Flexibility in Extensive Beef Farming Systems

    Directory of Open Access Journals (Sweden)

    Laura Astigarraga


    Full Text Available The aim of this work is to assess the flexibility of production allowed by extensive production conditions faced with variations in the environment, i.e., market variations and climatic fluctuations, of Limousin beef systems. The study used a case-based methodology in which seven beef farms with less than 1 LU/ha were chosen. Data collection was based on three interviews using a semistructured questionnaire and on the analysis of productive and economic results over a 15-year period (1991-2005. The main evolution of these farms is related to a rise in work productivity associated with an increase in herd size. Herd increase was made possible by enlarging the area, the margin of intensification being limited in these regions. To take advantage of the enlarged land area, females were reared for fattening or for reproduction instead of selling them at weaning. The Limousin female provides a wide product mix because of its plasticity, as has been studied by several researchers. This mix flexibility is achieved by delaying product differentiation, a form of production flexibility that can reduce the risk of under-producing or over-producing varied product configurations. On the other hand, calves sold to the Italian market after weaning are generic products, associated with a flexible production process to overcome fluctuations in forage availability due to climatic variations. The introduction of maize silage for feeding acts as an alternative route, actual and potential, through the system to overcome unexpected forage shortage from natural grasslands as a result of droughts. The study shows that extensive farming systems have developed types of flexibility to match different factors of uncertainty from the environment. Finally, the issue of farm system performance is thus not so much a question of whether a farm is fit at a specific moment in time, but whether it transforms into a less or more sustainable orientation.

  15. The association between phthalate exposure and asthma

    Directory of Open Access Journals (Sweden)

    Ming-Ju Tsai


    Full Text Available Asthma is a chronic inflammatory disorder of the airway, characterized by airway hyperresponsiveness. It is a disabling disease with an increasing prevalence, resulting in heavy social and economic burdens worldwide. Humans are extensively exposed to phthalates, and many epidemiological studies have shown a relationship between phthalate exposure and asthma in recent decades. Earlier experimental studies focused on inflammatory cells, demonstrating the adjuvant effects, immunomodulatory effects, or immunosuppressive effects related to phthalate exposure. Recent studies have shown that phthalates may have a direct effect on airway epithelial cells and contribute to airway remodeling, which is the cardinal pathologic characteristic of chronic asthma, with a high correlation with disease severity. Through these efforts, phthalates have been recognized as important environmental factors in the pathogenesis of asthma, but further studies are still required to elucidate the detailed mechanism. This review discusses the current status of human exposure to phthalates in Taiwan and summarizes the epidemiological and experimental evidence related to the roles of phthalate exposure in the development of asthma and associated diseases.

  16. Meshed split skin graft for extensive vitiligo

    Directory of Open Access Journals (Sweden)

    Srinivas C


    Full Text Available A 30 year old female presented with generalized stable vitiligo involving large areas of the body. Since large areas were to be treated it was decided to do meshed split skin graft. A phototoxic blister over recipient site was induced by applying 8 MOP solution followed by exposure to UVA. The split skin graft was harvested from donor area by Padgett dermatome which was meshed by an ampligreffe to increase the size of the graft by 4 times. Significant pigmentation of the depigmented skin was seen after 5 months. This procedure helps to cover large recipient areas, when pigmented donor skin is limited with minimal risk of scarring. Phototoxic blister enables easy separation of epidermis thus saving time required for dermabrasion from recipient site.

  17. Alcohol Exposure In Utero and Child Academic Achievement. (United States)

    von Hinke Kessler Scholder, Stephanie; Wehby, George L; Lewis, Sarah; Zuccolo, Luisa


    We examine the effect of alcohol exposure in utero on child academic achievement. As well as studying the effect of any alcohol exposure, we investigate the effect of the dose, pattern , and duration of exposure. We use a genetic variant in the maternal alcohol-metabolism gene ADH1B as an instrument for alcohol exposure, whilst controlling for the child's genotype on the same variant. We show that the instrument is unrelated to an extensive range of maternal and paternal characteristics and behaviours. OLS regressions suggest an ambiguous association between alcohol exposure in utero and children's academic attainment, but there is a strong social gradient in maternal drinking, with mothers in higher socio-economic groups more likely to drink. In stark contrast to the OLS, the IV estimates show negative effects of prenatal alcohol exposure on child educational attainment. These results are very robust to an extensive set of model specifications. In addition, we show that that the effects are solely driven by the maternal genotype, with no impact of the child's genotype.

  18. Electron beam radiotherapy for the management of recurrent extensive ocular surface squamous neoplasia with orbital extension

    Directory of Open Access Journals (Sweden)

    Ramesh Murthy


    Full Text Available Recurrent extensive ocular surface squamous neoplasia (OSSN with orbital invasion can be successfully managed with external radiotherapy using electrons resulting in eye and vision salvage. We report a case of right eye recurrent OSSN in an immunocompetent adult Indian male, with extensive orbital involvement. The patient had two previous surgical excisions with recurrent disease. At this stage, conventionally exenteration is considered the treatment modality. However, he was treated with 5040 cGy radiotherapy (15eV electrons resulting in complete disease regression. At the end of 3 years follow-up, the patient was disease free, maintained a vision of 20/25, with mild dry eye, well-managed with topical lubricants. Extensive OSSN with orbital invasion does not always need exenteration. External beam electron radiotherapy provides a noninvasive cure with organ and vision salvage and should be considered in extensive OSSN not amenable to simple excision biopsies. Long-term studies to evaluate the effect of radiation on such eyes are suggested.

  19. Electron beam radiotherapy for the management of recurrent extensive ocular surface squamous neoplasia with orbital extension. (United States)

    Murthy, Ramesh; Gupta, Himika; Krishnatry, Rahul; Laskar, Siddhartha


    Recurrent extensive ocular surface squamous neoplasia (OSSN) with orbital invasion can be successfully managed with external radiotherapy using electrons resulting in eye and vision salvage. We report a case of right eye recurrent OSSN in an immunocompetent adult Indian male, with extensive orbital involvement. The patient had two previous surgical excisions with recurrent disease. At this stage, conventionally exenteration is considered the treatment modality. However, he was treated with 5040 cGy radiotherapy (15eV electrons) resulting in complete disease regression. At the end of 3 years follow-up, the patient was disease free, maintained a vision of 20/25, with mild dry eye, well-managed with topical lubricants. Extensive OSSN with orbital invasion does not always need exenteration. External beam electron radiotherapy provides a noninvasive cure with organ and vision salvage and should be considered in extensive OSSN not amenable to simple excision biopsies. Long-term studies to evaluate the effect of radiation on such eyes are suggested.

  20. A Needs Assessment of Aquaculture Extension Agents, Specialists, and Program Administrators in Extension Programming (United States)

    Schwarz, Michael H.; Gibson, Jerry


    The study reported here identified continuing education and training needs of aquaculture Extension agents, specialists, and program administrators in 10 competency areas relating to the need for continuing education or training. Fourteen resources on the AquaNIC Web site were also evaluated, as was the efficacy of the AQUA-EXT listserv. Data were…

  1. Using Non-Extension Volunteering as an Experiential Learning Activity for Extension Professionals (United States)

    Andrews, Kevin B.; Lockett, Landry L.


    Extension professionals can gain much-needed competencies in volunteer administration through experiential learning by participating in volunteer activities. Experiential learning is a means of behavior change that allows the individual learner to reflect on, abstract, and apply their experiences to new situations. This article expands on…

  2. Pesticide Exposure in Children (United States)

    Roberts, James R.; Karr, Catherine J.


    Pesticides are a collective term for a wide array of chemicals intended to kill unwanted insects, plants, molds, and rodents. Food, water, and treatment in the home, yard, and school are all potential sources of children’s exposure. Exposures to pesticides may be overt or subacute, and effects range from acute to chronic toxicity. In 2008, pesticides were the ninth most common substance reported to poison control centers, and approximately 45% of all reports of pesticide poisoning were for children. Organophosphate and carbamate poisoning are perhaps the most widely known acute poisoning syndromes, can be diagnosed by depressed red blood cell cholinesterase levels, and have available antidotal therapy. However, numerous other pesticides that may cause acute toxicity, such as pyrethroid and neonicotinoid insecticides, herbicides, fungicides, and rodenticides, also have specific toxic effects; recognition of these effects may help identify acute exposures. Evidence is increasingly emerging about chronic health implications from both acute and chronic exposure. A growing body of epidemiological evidence demonstrates associations between parental use of pesticides, particularly insecticides, with acute lymphocytic leukemia and brain tumors. Prenatal, household, and occupational exposures (maternal and paternal) appear to be the largest risks. Prospective cohort studies link early-life exposure to organophosphates and organochlorine pesticides (primarily DDT) with adverse effects on neurodevelopment and behavior. Among the findings associated with increased pesticide levels are poorer mental development by using the Bayley index and increased scores on measures assessing pervasive developmental disorder, inattention, and attention-deficit/hyperactivity disorder. Related animal toxicology studies provide supportive biological plausibility for these findings. Additional data suggest that there may also be an association between parental pesticide use and adverse birth

  3. Lightweight Nozzle Extension for Liquid Rocket Engines Project (United States)

    National Aeronautics and Space Administration — The ARES J-2X requires a large nozzle extension. Currently, a metallic nozzle extension is being considered with carbon-carbon composite as a backup. In Phase 1,...

  4. The XML approach to implementing space link extension service management (United States)

    Tai, W.; Welz, G. A.; Theis, G.; Yamada, T.


    A feasibility study has been conducted at JPL, ESOC, and ISAS to assess the possible applications of the eXtensible Mark-up Language (XML) capabilities to the implementation of the CCSDS Space Link Extension (SLE) Service Management function.

  5. Hunger in Virginia : Extension's response ability : a resource guide


    Taper, L. Janette


    Provides information to educate Extension professionals on the issue of hunger and malnutrition in Virginia. This guide will allow Extension professionals to conduct nutrition education programs in low income communities to help them improve their diets.

  6. On non-extensive nature of thermal conductivity

    Indian Academy of Sciences (India)

    Abstract. In this paper we study non-extensive nature of thermal conductivity. It is observed that there is similarity between non-extensive entropic index and fractal dimension obtained for the silica aerogel thermal conductivity data at low temperature.

  7. 76 FR 4350 - Health Information Technology Extension Program (United States)


    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Information Technology Extension Program ACTION: Public Notice. SUMMARY: This notice announces changes to the Health Information Technology Extension... of the National Coordinator for Health Information Technology, 200 Independence Ave, SW., Suite 729D...

  8. Extensible automated dispersive liquid–liquid microextraction

    Energy Technology Data Exchange (ETDEWEB)

    Li, Songqing; Hu, Lu; Chen, Ketao; Gao, Haixiang, E-mail:


    Highlights: • An extensible automated dispersive liquid–liquid microextraction was developed. • A fully automatic SPE workstation with a modified operation program was used. • Ionic liquid-based in situ DLLME was used as model method. • SPE columns packed with nonwoven polypropylene fiber was used for phase separation. • The approach was applied to the determination of benzoylurea insecticides in water. - Abstract: In this study, a convenient and extensible automated ionic liquid-based in situ dispersive liquid–liquid microextraction (automated IL-based in situ DLLME) was developed. 1-Octyl-3-methylimidazolium bis[(trifluoromethane)sulfonyl]imide ([C{sub 8}MIM]NTf{sub 2}) is formed through the reaction between [C{sub 8}MIM]Cl and lithium bis[(trifluoromethane)sulfonyl]imide (LiNTf{sub 2}) to extract the analytes. Using a fully automatic SPE workstation, special SPE columns packed with nonwoven polypropylene (NWPP) fiber, and a modified operation program, the procedures of the IL-based in situ DLLME, including the collection of a water sample, injection of an ion exchange solvent, phase separation of the emulsified solution, elution of the retained extraction phase, and collection of the eluent into vials, can be performed automatically. The developed approach, coupled with high-performance liquid chromatography–diode array detection (HPLC–DAD), was successfully applied to the detection and concentration determination of benzoylurea (BU) insecticides in water samples. Parameters affecting the extraction performance were investigated and optimized. Under the optimized conditions, the proposed method achieved extraction recoveries of 80% to 89% for water samples. The limits of detection (LODs) of the method were in the range of 0.16–0.45 ng mL{sup −1}. The intra-column and inter-column relative standard deviations (RSDs) were <8.6%. Good linearity (r > 0.9986) was obtained over the calibration range from 2 to 500 ng mL{sup −1}. The proposed

  9. Cauchy-Kovalevskaya extension theorem in fractional Clifford analysis


    Vieira, Nelson


    In this paper, we establish the fractional Cauchy-Kovalevskaya extension (FCK-extension) theorem for fractional monogenic functions defined on R^d. Based on this extension principle, fractional Fueter polynomials, forming a basis of the space of fractional spherical monogenics, i.e. fractional homogeneous polynomials, are introduced. We studied the connection between the FCK-extension of functions of the form x^\\alpha P_l and the classical Gegenbauer polynomials. Finally we present two examp...

  10. Prenatal and postnatal cocaine exposure predict teen cocaine use (United States)

    Delaney-Black, Virginia; Chiodo, Lisa M.; Hannigan, John H.; Greenwald, Mark K.; Janisse, James; Patterson, Grace; Huestis, Marilyn A.; Partridge, Robert T.; Ager, Joel; Sokol, Robert J.


    Preclinical studies have identified alterations in cocaine and alcohol self-administration and behavioral responses to pharmacological challenges in adolescent offspring following prenatal exposure. To date, no published human studies have evaluated the relation between prenatal cocaine exposure and postnatal adolescent cocaine use. Human studies of prenatal cocaine-exposed children have also noted an increase in behaviors previously associated with substance use/abuse in teens and young adults, specifically childhood and teen externalizing behaviors, impulsivity, and attention problems. Despite these findings, human research has not addressed prior prenatal exposure as a potential predictor of teen drug use behavior. The purpose of this study was to evaluate the relations between prenatal cocaine exposure and teen cocaine use in a prospective longitudinal cohort (n = 316) that permitted extensive control for child, parent and community risk factors. Logistic regression analyses and Structural Equation Modeling revealed that both prenatal exposure and postnatal parent/caregiver cocaine use were uniquely related to teen use of cocaine at age 14 years. Teen cocaine use was also directly predicted by teen community violence exposure and caregiver negativity, and was indirectly related to teen community drug exposure. These data provide further evidence of the importance of prenatal exposure, family and community factors in the intergenerational transmission of teen/young adult substance abuse/use. PMID:20609384

  11. Prenatal and postnatal cocaine exposure predict teen cocaine use. (United States)

    Delaney-Black, Virginia; Chiodo, Lisa M; Hannigan, John H; Greenwald, Mark K; Janisse, James; Patterson, Grace; Huestis, Marilyn A; Partridge, Robert T; Ager, Joel; Sokol, Robert J


    Preclinical studies have identified alterations in cocaine and alcohol self-administration and behavioral responses to pharmacological challenges in adolescent offspring following prenatal exposure. To date, no published human studies have evaluated the relation between prenatal cocaine exposure and postnatal adolescent cocaine use. Human studies of prenatal cocaine-exposed children have also noted an increase in behaviors previously associated with substance use/abuse in teens and young adults, specifically childhood and teen externalizing behaviors, impulsivity, and attention problems. Despite these findings, human research has not addressed prior prenatal exposure as a potential predictor of teen drug use behavior. The purpose of this study was to evaluate the relations between prenatal cocaine exposure and teen cocaine use in a prospective longitudinal cohort (n=316) that permitted extensive control for child, parent and community risk factors. Logistic regression analyses and Structural Equation Modeling revealed that both prenatal exposure and postnatal parent/caregiver cocaine use were uniquely related to teen use of cocaine at age 14 years. Teen cocaine use was also directly predicted by teen community violence exposure and caregiver negativity, and was indirectly related to teen community drug exposure. These data provide further evidence of the importance of prenatal exposure, family and community factors in the intergenerational transmission of teen/young adult substance abuse/use. Copyright © 2010 Elsevier Inc. All rights reserved.

  12. Asbestos Exposure Assessment Database (United States)

    Arcot, Divya K.


    Exposure to particular hazardous materials in a work environment is dangerous to the employees who work directly with or around the materials as well as those who come in contact with them indirectly. In order to maintain a national standard for safe working environments and protect worker health, the Occupational Safety and Health Administration (OSHA) has set forth numerous precautionary regulations. NASA has been proactive in adhering to these regulations by implementing standards which are often stricter than regulation limits and administering frequent health risk assessments. The primary objective of this project is to create the infrastructure for an Asbestos Exposure Assessment Database specific to NASA Johnson Space Center (JSC) which will compile all of the exposure assessment data into a well-organized, navigable format. The data includes Sample Types, Samples Durations, Crafts of those from whom samples were collected, Job Performance Requirements (JPR) numbers, Phased Contrast Microscopy (PCM) and Transmission Electron Microscopy (TEM) results and qualifiers, Personal Protective Equipment (PPE), and names of industrial hygienists who performed the monitoring. This database will allow NASA to provide OSHA with specific information demonstrating that JSC s work procedures are protective enough to minimize the risk of future disease from the exposures. The data has been collected by the NASA contractors Computer Sciences Corporation (CSC) and Wyle Laboratories. The personal exposure samples were collected from devices worn by laborers working at JSC and by building occupants located in asbestos-containing buildings.

  13. Lateral Distribution Functions of Extensive Air Showers (United States)

    Geranios, A.; Fokitis, E.; Maltezos, S.; Koutsokosta, D.; Antoniadou, I.; Malandraki, O.; Mastichiadis, A.; Antonopoulou, E.; Gika, V.; Dimitrakoudis, S.

    The energy is among the characteristics of Ultra High Energy Cosmic Rays (E>5 x 1019 eV) which could be estimated experimentally. The following paper attempts to estimate the energy of an UHECR proton by applying a Monte Carlo simulation code. A number of extensive air showers, vertical and inclined, is simulated to derive the Lateral Distribution Functions of the shower muons. The scenario of simulations is adopted to the Cerenkov surface detector of the P. AUGER Observatory. Due to the fact that the Lateral Distribution Functions show minimal fluctuations of the muon density at a distance larger than 800 m from the core of the showers, and due to the fact that at a distance of 900 m the distribution functions for inclined showers coincide (which means that it does not change with the zenith angle of the showers), we select the muon density at 900 m to derive the energy of the primary protons. (The project is co-funded by the European Social Fund and National Resources (EPEAEK II) PYTHAGORAS II.)

  14. Latest results of the Tunka Radio Extension

    Directory of Open Access Journals (Sweden)

    Kostunin D.


    Full Text Available The Tunka Radio Extension (Tunka-Rex is an antenna array consisting of 63 antennas at the location of the TAIGA facility (Tunka Advanced Instrument for cosmic ray physics and Gamma Astronomy in Eastern Siberia, nearby Lake Baikal. Tunka-Rex is triggered by the air-Cherenkov array Tunka-133 during clear and moonless winter nights and by the scintillator array Tunka-Grande during the remaining time. Tunka-Rex measures the radio emission from the same air-showers as Tunka-133 and Tunka-Grande, but with a higher threshold of about 100 PeV. During the first stages of its operation, Tunka-Rex has proven, that sparse radio arrays can measure air-showers with an energy resolution of better than 15% and the depth of the shower maximum with a resolution of better than 40 g/cm2. To improve and interpret our measurements as well as to study systematic uncertainties due to interaction models, we perform radio simulations with CORSIKA and CoREAS. In this overview we present the setup of Tunka-Rex, discuss the achieved results and the prospects of mass-composition studies with radio arrays.

  15. Extensive Mandibular Ameloblastic Fibro-Odontoma. (United States)

    Ribeiro, Cínthia Magalhães; Santos, Tatiana Tavares Marcelino Dos; de Castro, Sérgio Roberto; de Carli, Marina Lara; Sperandio, Felipe Fornias; Hanemann, João Adolfo Costa; Pereira, Alessandro Antônio Costa


    Ameloblastic fibro-odontoma (AFO) is a mixed odontogenic tumor that presents epithelial and mesenchymal components. Ameloblastic fibro-odontoma is generally diagnosed between the first and second decades of life and normally shows a slow clinical growth in the posterior portion of the maxilla or mandible, being mostly associated with 1 or more impacted teeth. Radiographic features of AFO show a radiolucent well-defined, uni, or multilocular defect due to containing variable amounts of calcified material. The enucleation of the tumor is the usual conduct and should be followed up for a long period of time. Here, the authors report the case of 17-year-old male patient who presented an extensive AFO on the right posterior side of the mandible. The panoramic radiograph and the tomographic examination revealed a multilocular radiolucent lesion with impacted teeth. Histological examination revealed connective tissue resembling the dental papilla along with epithelial strands or islands, as well as dental hard tissue such enamel and dentin. Enucleation and curettage was performed and led to good outcome. There was no recurrence after an 8-year follow-up, and oral rehabilitation was performed with dental implants.

  16. Molecular regulation of plant cell wall extensibility (United States)

    Cosgrove, D. J.


    Gravity responses in plants often involve spatial and temporal changes in cell growth, which is regulated primarily by controlling the ability of the cell wall to extend. The wall is thought to be a cellulose-hemicellulose network embedded in a hydrated matrix of complex polysaccharides and a small amount of structural protein. The wall extends by a form of polymer creep, which is mediated by expansins, a novel group of wall-loosening proteins. Expansins were discovered during a molecular dissection of the "acid growth" behavior of cell walls. Expansin alters the rheology of plant walls in profound ways, yet its molecular mechanism of action is still uncertain. It lacks detectable hydrolytic activity against the major components of the wall, but it is able to disrupt noncovalent adhesion between wall polysaccharides. The discovery of a second family of expansins (beta-expansins) sheds light on the biological role of a major group of pollen allergens and implies that expansins have evolved for diverse developmental functions. Finally, the contribution of other processes to wall extensibility is briefly summarized.

  17. Greater trochanteric fracture with occult intertrochanteric extension. (United States)

    Reiter, Michael; O'Brien, Seth D; Bui-Mansfield, Liem T; Alderete, Joseph


    Proximal femoral fractures are frequently encountered in the emergency department (ED). Prompt diagnosis is paramount as delay will exacerbate the already poor outcomes associated with these injuries. In cases where radiography is negative but clinical suspicion remains high, magnetic resonance imaging (MRI) is the study of choice as it has the capability to depict fractures which are occult on other imaging modalities. Awareness of a particular subset of proximal femoral fractures, namely greater trochanteric fractures, is vital for both radiologists and clinicians since it has been well documented that they invariably have an intertrochanteric component which may require surgical management. The detection of intertrochanteric or cervical extension of greater trochanteric fractures has been described utilizing MRI but is underestimated with both computed tomography (CT) and bone scan. Therefore, if MRI is unavailable or contraindicated, the diagnosis of an isolated greater trochanteric fracture should be met with caution. The importance of avoiding this potential pitfall is demonstrated in the following case of an elderly woman with hip pain and CT demonstrating an isolated greater trochanteric fracture who subsequently returned to the ED with a displaced intertrochanteric fracture.

  18. Supersymmetric extensions of Schrodinger-invariance

    International Nuclear Information System (INIS)

    Henkel, Malte; Unterberger, Jeremie


    The set of dynamic symmetries of the scalar free Schrodinger equation in d space dimensions gives a realization of the Schrodinger algebra that may be extended into a representation of the conformal algebra in d+2 dimensions, which yields the set of dynamic symmetries of the same equation where the mass is not viewed as a constant, but as an additional coordinate. An analogous construction also holds for the spin-12 Levy-Leblond equation. An N=2 supersymmetric extension of these equations leads, respectively, to a 'super-Schrodinger' model and to the (3 vertical bar 2)-supersymmetric model. Their dynamic supersymmetries form the Lie superalgebras osp(2 vertical bar 2)-bar sh(2 vertical bar 2) and osp(2 vertical bar 4), respectively. The Schrodinger algebra and its supersymmetric counterparts are found to be the largest finite-dimensional Lie subalgebras of a family of infinite-dimensional Lie superalgebras that are systematically constructed in a Poisson algebra setting, including the Schrodinger-Neveu-Schwarz algebra sns (N) with N supercharges. Covariant two-point functions of quasiprimary superfields are calculated for several subalgebras of osp(2 vertical bar 4). If one includes both N=2 supercharges and time-inversions, then the sum of the scaling dimensions is restricted to a finite set of possible values

  19. No imagination effect on boundary extension. (United States)

    Munger, Margaret P; Multhaup, Kristi S


    Boundary extension (BE) occurs when people falsely remember perceiving beyond the edges of a presented scene. Theorists argue that BE occurs because people mistakenly attribute information they have generated to the study stimulus-that is, they make a source memory error. Inspired by this idea, in six experiments we tested whether scene details resulting from explicit imagination would be misremembered as actual visual perceptions, resulting in increased BE as compared with standard instructions. In four experiments, undergraduates completed a BE task with separate study and test blocks; in two further experiments, undergraduates completed a trial-by-trial BE task (N = 290). Half of the participants elaborated on the study pictures (imagined smells and sounds, or what was to the left and right of the scene, or what a photographer would see by zooming in or out). Robust BE was found in all experiments, but none of the elaborations modified the size of BE; therefore, BE is not to be affected by explicit elaboration and may be related to spatial rather than visual imagery ability.

  20. Computers make rig life extension an option

    Energy Technology Data Exchange (ETDEWEB)



    The worldwide semisubmersible drilling rig fleet is approaching retirement. But replacement is not an attractive option even though dayrates are reaching record highs. In 1991, Schlumberger Sedco Forex managers decided that an alternative might exist if regulators and insurers could be convinced to extend rig life expectancy through restoration. Sedco Forex chose their No. 704 semisubmersible, an 18-year North Sea veteran, to test their process. The first step was to determine what required restoration, meaning fatigue life analysis of each weld on the huge vessel. If inspected, the task would be unacceptably time-consuming and of questionable accuracy. Instead a suite of computer programs modeled the stress seen by each weld, statistically estimated the sea states seen by the rig throughout its North Sea service and calibrated a beam-element model on which to run their computer simulations. The elastic stiffness of the structure and detailed stress analysis of each weld was performed with ANSYS, a commercially available finite-element analysis program. The use of computer codes to evaluate service life extension is described.