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Sample records for facet joint effusion

  1. MR diagnosis of temporomandibular joint. A study of joint effusion

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    Kaneda, Takashi; Yamashiro, Mitsuaki; Ozawa, Kaoru; Suzuki, Hiromi; Okada, Hiroyuki; Yamamoto, Hirotsugu [Nihon Univ., Matsudo, Chiba (Japan). School of Dentistry

    1998-03-01

    The purposes of this study were to evaluate the relationship between correlation of MR joint effusion of the temporomandibular joint and disk position, to evaluate the relationship between joint effusion and aging, and to assess the frequency of MR joint effusion of bilateral temporomandibular joints. The temporomandibular joints of 192 patients with clinical symptoms of temporomandibular joint disorders were imaged bilaterally using high field, surface-coil MR imaging. Oblique sagittal and coronal proton density-weighted and T2-weighted images were obtained. Imaging findings of joint effusion were correlated with disk position, aging, and bilateral temporomandibular joints. MR showed effusion in 4% of the joints with normal superior disk position, 36% of the joints with disk displacement with reduction, and 45% of the joints with disk displacement without reduction. There were significant differences in the incidence of joint effusion between normal disk position and anterior disk displacement with or without reduction. Younger patients less than 40 years were significant higher the incidence of joint effusion than those of older patients. A significant association was seen between joint effusion and aging. MR showed effusion in 17% of the unilateral temporomandibular joint, 24% of the bilateral temporomandibular joints. There was no significant difference between unilateral and bilateral case. These results indicated that joint effusion using MR imaging was associated with varied temporomandibular joint pathologic states. (author)

  2. Types of subtalar joint facets.

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    Jung, Min-Ho; Choi, Byoung Young; Lee, Ji Yong; Han, Chang Sung; Lee, Jin Suk; Yang, Young Chul; Cho, Byung Pil

    2015-08-01

    Articular facets of the clinical subtalar joint (CSTJ) were analyzed using a total of 118 (right 57, left 61) dry, paired calcanei and tali from 68 Korean adult cadavers. The CSTJ facets were classified into the following three types depending on their continuity: type A, all three facets are separated; type B, the anterior and middle facets are partially connected; and type C, the anterior and middle facets are fused to form a single facet. The continuity between the anterior and middle facets was represented by the degree of separation (DS), which ranged between 2.00 (type A) and 1.00 (type C). Type A was most common (39.0 %) in calcanei and rarest (11.0 %) in tali. Matching of calcaneus-talus pairs yielded five combined types: A-A (11.0 %), A-B (28.0 %), B-B (18.6 %), B-C (13.6 %), and C-C (28.8 %). The mean DS was slightly greater in calcanei (1.53) than in tali (1.32), and decreased in the order of types A-A, A-B, B-B, B-C, and C-C. The intersecting angles between the anterior and middle facets, which are related to the mobility of the CSTJ, were inversely related to the DS. These findings indicate that the anterior and middle facets are fused more frequently in tali than in calcanei, and combinations of different CSTJ facet types (A-B, B-C) exist over 40 % of feet. Our results indicate that types with a smaller DS (such as B-C and C-C) are relatively mobile but less stable compared to those with a greater DS (such as A-A and A-B).

  3. Arthrography of the lumber facet joint and facet block

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    Cho, Hee Kyung; Chung, Tae Sub; Kim, Young Soo; Park, Hyung Chun; Moon, Jae Ho; Suh, Jung Ho; Kim, Dong Ik [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1988-12-15

    In spite of numerous clinical and patho-anatomical studied made in the past, there are still different opinions concerning the mechanism of low back pain. We have focused attention on the posterior structures as an alternative source of low back pain with sciatica. So we have studied and analyzed the finding of arthrography of facet joint and effect of the injection of methyprednisolone acetate suspension (Depomedrol) 20mg into the each facet joint. Our results are as follows: 1. Abnormal findings of facet joint arthrogram were degenerative osteoarthritis of facet joint (70.5%), synovial cyst (11.8%), accessory bone (11.8%), and spondylolysis (5.9%). 2. The mean facet angulations of patients of facet syndrome were abnormal on lower lumbar facet joint in 9 of 13 cases (69.2%). 3. On initial assessment, 11 of 17 cases (64.7%) showed complete relief and one month later, 6 of 11 cases (35.3%) showed continuous relief, after steroid injection.

  4. [Septic arthritis of thoracic facet joint].

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    Ben Abdelghani, K; Gérard-Dran, D; Combe, B

    2009-08-01

    Septic arthritis of the facet joint is a rare condition. We report a case of septic arthritis of both a thoracic facet joint and a wrist. Clinical manifestations were consistent with a spondylodiscitis. Magnetic resonance imaging of the spine demonstrated infection of facet joints of T1 and T2. A surgical biopsy of the wrist isolated a type B streptococcus. The same organism was found in urine culture. The patient had an uneventful recovery on antibiotics.

  5. Computed Tomography of the lumbar facet joints

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    Choi, Mi Ryoung; Kim, Yung Soon; Lee, Joo Hyuk; Jeon, Hae Sang; Kim, Dae Yung [Kang Nam General Hospital, Seoul (Korea, Republic of)

    1989-08-15

    The lumbar facet disease is a frequently overlooked cause of sciatic pain, but the lumbar facet joints are well-recognized source of low back pain and radiating leg pain which can be confused with sciatica due to herniated disc. We measured the angulation of the facet joints on axial spine CT films in 149 cases which contains 41 normal group and 108 abnormal group and studied the relationship between the angulation and degeneration of the facets, the asymmetry of each sided facets and facet degeneration, the asymmetry and disc protrusion, and the asymmetry and annular bulging of the disc. The results were as follows: 1. Facet angulation in abnormal group were more sagittally oriented than the normal group. 2. The angulation of right facet was more sagittally oriented than the left in L4-5 level of abnormal group. 3. Degeneration of facet joints occur asymmetrically, and the more facet joint degenerates, the more it orients sagittally, particularly in L4-5. 4. Asymmetry in facet joint degeneration and unilateral disc protrusion of L5-SI level is greater than the normal gro0008.

  6. Effusion in magnetic resonance imaging of the temporomandibular joint

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    Nah, Kyung Soo [Pusan National University College of Medicine, Busan (Korea, Republic of)

    2003-03-15

    The purpose of this study was to investigate the distribution and frequency of temporomandibular joint (TMJ) effusion in magnetic resonance (MR) images of patients with disc displacements. On T2 weighted MR images of 148 TMJs taken from 74 patients presenting with TMJ pain and dysfunction, we assessed the cases showing TMJ effusion, defined as an amount of fluid that exceeded the maximum amount seen in a control group of asymptomatic volunteers. The amount of TMJ fluid was graded as: I (none or minimal), II (moderate), III (marked), and IV (extensive), according to a standard set by a reference. Disc displacement categories were also recorded. Of the 148 TMJs examined in this study, 52 joints (35.1%) presented with joint effusion, 24 (16.2%) showing bilateral joint effusion. 38 joints showed upper joint space effusion, and 3 showed lower joint space effusion, and 11 showed both upper and lower joint space effusion. 96 joints (64.9%) had grade I joint fluid, 27 (18.2%) grade II, 15 (10.1%) grade III, and 10 (6.8%) grade IV. 80.0% of the joints presenting with grade IV effusion showed disc displacement without reduction. Joint effusion was found not only in upper, but also in lower joint spaces. The higher the effusion grade, the greater the frequency of disc displacement without reduction.

  7. MR assessment of distribution and amount of joint effusion in patients with traumatic knee joint disorders

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    Ko, Mi Gyoung; Yang, Ik; Lee, Kyung Won; Lee, Yul; Chung, Soo Young; Lee, Kwan Seop; Yoo, Jung Han [Hallym Univ. College of Medicine, Chunchon (Korea, Republic of)

    1999-06-01

    To clarify the distribution of joint effusion, and the relationship between type of injury and amount of joint effusion seen in traumatic knee joint magnetic resonance imaging (MRI). We retrospectively reviewed the MR images of 400 patients with traumatic knee joint effusion. The knee joint space was divided into four compartments : central portion (para-ACL, para-PCL), suprapatellar pouch, posterior femoral recess, and subpopliteal recess, and we then compared the amount and distribution of effusion. For statistical analysis, the chi-square test was used. Among 400 MRI examinations of joint effusion, 383 knees (96%) showed homogeneous low intensity on T1-weighted images, and - except for ten cases of fluid-fluid levels- homogeneous high intensity on T2-weighted images. Knee joint effusion was clearly shown to be distributed mainly in the suprapatellar pouch (345, 86%), followed by the central posterior femoral recess, and the subpopliteal recess (P<0.001). Extensive joint effusion was less frequently found in the normal group, but was occasionally found in the combined injury group (P<0.001). The relationship between amount of joint effusion and type of injury was statistically significant (P<0.001), except in the case of medial and lateral collateral ligament injury. The distribution of joint effusion in patients with traumatic knee disorders is a reflection of anatomic communication, and whether the amount of joint effusion was small or large depended on the anatomical location and type of injury.

  8. Magnetic resonance evidence of joint effusion in patients with temporomandibular joint disorders

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    Ko, Jee Young; Kim, Kee Deog; Park, Chang Seo [Yonsei Univ. College of Dentistry, Seoul (Korea, Republic of)

    2001-06-15

    The purpose of this study was to find the relationship among the joint status, pain and effusion in patients with temporomandibular joint disorders. Materials included 406 patients (812 joints) with clinical records and bilateral TMJ MRIs in TMJ clinic, Yongdong Severance Hospital. All joints were classified in 4 groups in MR images according to the disc status of joint; normal disc position, disc displacement with reduction (DDsR), and also 2 groups according to the bony status of joint; normal bony structure and osteoarthrosis. MR evidence of joint effusion was categorized in 4 groups according to its amount. To determine the relationship between joint pain and joint effusion, 289 patients with unilateral TMJ symptoms were selected from total materials. Joint effusion was found 8.0% in normal disc position, 32.6% in DDcR, and 59.2% in DDsR (83.1% in early state and 23.1% in late stage). Joint effusion was found 39.7% in osteoarthrosis and 35.0% in normal bony structure. Joint effusion was more found in the painful joints (49.8%) than in the painless joints (22.4%) (p<0.001). Joint effusion in the early stage of DDsR only was more found significantly in painful joints (91.9%) than in painless joints (62.1%) (p<0.001). MR evidence of joint effusion might be related to disc displacement regardless of the presence of osteoarthrosis, and the early stage of DDsR was found more frequently combined with joint effusion and joint pain.

  9. Sonography for hip joint effusion in adults with hip pain

    NARCIS (Netherlands)

    S.M. Bierma-Zeinstra (Sita); A.M. Bohnen (Arthur); J.A.N. Verhaar (Jan); A. Prins (Ad); J.S. Lameris; A.Z. Ginai (Abida)

    2000-01-01

    textabstractOBJECTIVE: To study the prevalence of ultrasonic hip joint effusion and its relation with clinical, radiological and laboratory (ESR) findings in adults with hip pain. METHODS: Patients (n = 224) aged 50 years or older with hip pain, referred by the general

  10. Facet joint changes after application of lumbar nonfusion dynamic stabilization.

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    Lee, Soo Eon; Jahng, Tae-Ahn; Kim, Hyun Jib

    2016-01-01

    OBJECTIVE The long-term effects on adjacent-segment pathology after nonfusion dynamic stabilization is unclear, and, in particular, changes at the adjacent facet joints have not been reported in a clinical study. This study aims to compare changes in the adjacent facet joints after lumbar spinal surgery. METHODS Patients who underwent monosegmental surgery at L4-5 with nonfusion dynamic stabilization using the Dynesys system (Dynesys group) or transforaminal lumbar interbody fusion with pedicle screw fixation (fusion group) were retrospectively compared. Facet joint degeneration was evaluated at each segment using the CT grading system. RESULTS The Dynesys group included 15 patients, while the fusion group included 22 patients. The preoperative facet joint degeneration CT grades were not different between the 2 groups. Compared with the preoperative CT grades, 1 side of the facet joints at L3-4 and L4-5 had significantly more degeneration in the Dynesys group. In the fusion group, significant facet joint degeneration developed on both sides at L2-3, L3-4, and L5-S1. The subjective back and leg pain scores were not different between the 2 groups during follow-up, but functional outcome based on the Oswestry Disability Index improved less in the fusion group than in the Dynesys group. CONCLUSIONS Nonfusion dynamic stabilization using the Dynesys system had a greater preventative effect on facet joint degeneration in comparison with that obtained using fusion surgery. The Dynesys system, however, resulted in facet joint degeneration at the instrumented segments and above. An improved physiological nonfusion dynamic stabilization system for lumbar spinal surgery should be developed.

  11. Unusual case of paediatric septic arthritis of the lumbar facet joints due to Kingella kingae.

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    Le Hanneur, M; Vidal, C; Mallet, C; Mazda, K; Ilharreborde, B

    2016-11-01

    A 32-month-old boy presented with febrile limping that had developed over 6days, associated with right lumbosacral inflammatory swelling. Magnetic resonance imaging (MRI) showed joint effusion of the right L5-S1 zygapophyseal joint, complicated by destructive osteomyelitis of the L5 articular process and paraspinal abscess. Surgery was decided to evacuate the fluid accumulation and rule out differential diagnoses. The diagnosis of septic arthritis of the facet joint was confirmed intraoperatively; real-time quantitative PCR analysis identified Kingella kingae. This is the first substantiated paediatric case of zygapophyseal joint septic arthritis due to K. kingae. K. kingae is the most common pathogen responsible for invasive osteoarticular infection in children under 4years of age. Since empiric antibiotics are effective in early stages, physicians should consider the possibility of spinal infections due to K. kingae when a limping child under 4years of age presents with a fever.

  12. Uncovertebral joint injury in cervical facet dislocation: the headphones sign

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    Palmieri, Francesco; Cassar-Pullicino, Victor N.; Dell' Atti, Claudia; Lalam, Radhesh K.; Tins, Bernhard J.; Tyrrell, Prudencia N.M.; McCall, Iain W. [Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Department of Radiology, Oswestry, England (United Kingdom)

    2006-06-15

    The purpose of our study is to demonstrate the uncovertebral mal-alignment as a reliable indirect sign of cervical facet joint dislocation. We examined the uncovertebral axial plane alignment of 12 patients with unilateral and bilateral cervical facet joint dislocation (UCFJD and BCFJD, respectively), comparing its frequency to the reverse hamburger bun sign on CT and MR axial images. Of the seven cases with BCFJD, five clearly demonstrated the diagnostic reverse facet joint hamburger bun sign on CT and MR images, but in two cases this sign was not detectable. In the five cases with UCFJD, four demonstrated the reverse hamburger bun sign on both CT and MRI. In one case the reverse hamburger bun sign was not seen adequately with either image modality, but the facet dislocation was identified on sagittal imaging. The uncovertebral mal-alignment was detected in all 12 cases. Normally, the two components of the uncovertebral joint enjoy a concentric relationship that in the axial plane is reminiscent of the relationship of headphones with the wearer's head. We name this appearance the 'headphones' sign. Radiologists should be aware of the headphones sign as a reliable indicator of facet joint dislocation on axial imaging used in the assessment of cervical spine injuries. (orig.)

  13. Non-joint effusion is associated with osteoarthritis in temporomandibular joints with disk displacement.

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    Zheng, Zhi-Wei; Yang, Chi; Wang, Mei-Hao; Zhu, Xing-Hao; Fang, Yi-Ming

    2016-01-01

    The aim of this study was to examine the possible association between different grades of joint effusion (JE) and osteoarthritis (OA) in temporomandibular joint (TMJ) anterior disk displacement without reduction (ADDwoR). A sample of 101 female patients 20-40 years of age with unilateral TMJ ADDwoR were retrospectively reviewed. JE and OA were diagnosed with magnetic resonance imaging (MRI). JE was subdivided into three different grades: grade 0, no or minimal effusion; grade 1, moderate effusion; and grade 2, extensive effusion. Eight categories of degenerative changes were used for screening for the existence of OA. Cases with no less than one type of degenerative change were diagnosed as OA. In all, 71 patients (70.3%) were diagnosed as having OA in the joints with disk displacement. In the univariate analysis, the proportion of subjects with non-JE (grade 0) was higher in the OA group (p = 0.003), while the proportion of subjects with extensive effusion (grade 2) was lower in the OA group (p = 0.02). In the multivariate logistic regression analysis, non-JE was independently associated with the development of OA (odds ratio = 5.68, 95% confidence interval = 1.10-29.37, P = 0.04). The results suggested that non-JE was associated with OA in the joints with ADDwoR. Copyright © 2015. Published by Elsevier Ltd.

  14. Three-dimensional evaluation of the facet joints

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    Folio, Les R.

    1990-04-01

    Computerized tomography and magnetic resonance imaging nave revolurionalized analysis of vertebral anatomy and pathology. Further advances with 3-dimensional imaging have recently become an important adjunct for diagnosis and treatment in structural abnormalities. Facets are intimately related to their surrounding musculature and malalignment may cause pain directly or indirectly. High resolution 3-dimensional reformations of CT Scans give us new insight on structure and function of facet joints, since their motion and architecture are ever complex. It is well documented in the literature that facet joint biomecnanics is a partial contributor to the myriad at causes of low back The term "facet Joint syndrome" was coined in 1933 by GhorMley.3 The osteopathic lesion complex is well defined by LeRoy and McCole and comparison of roentgenographic findings before and after manipulation has teen described by Long and Lioyd.4,5 since alterations in facet biamechanics are an important aspect of osteopathic manipulative therapy (OT), 3-dimensional hign resolution imaging will prove to be a great asset in osteopathic research. Rotating the spine allows for different viewing perspectives to provide optimal and consistent measurements of the facet joint. Rotations are performed on the X, Y and 7, axis and measurements pre and post-manipulation are performed and compared on matching axis and perspectives. Rotation about the X, Y and Z axis help appreciate the 3-dimensionality of the vertebral column to project to the viewer a feeling that the spine is floating in space before them. This does give the viewer a 3-D understanding of the object however, only at a perspective at a Lime.

  15. Augmented reality needle guidance improves facet joint injection training

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    Ungi, Tamas; Yeo, Caitlin T.; U-Thainual, Paweena; McGraw, Robert C.; Fichtinger, Gabor

    2011-03-01

    PURPOSE: The purpose of this study was to determine if medical trainees would benefit from augmented reality image overlay and laser guidance in learning how to set the correct orientation of a needle for percutaneous facet joint injection. METHODS: A total of 28 medical students were randomized into two groups: (1) The Overlay group received a training session of four insertions with image and laser guidance followed by two insertions with laser overlay only; (2) The Control group was trained by carrying out six freehand insertions. After the training session, needle trajectories of two facet joint injections without any guidance were recorded by an electromagnetic tracker and were analyzed. Number of successful needle placements, distance covered by needle tip inside the phantom and procedural time were measured to evaluate performance. RESULTS: Number of successful placements was significantly higher in the Overlay group compared to the Control group (85.7% vs. 57.1%, p = 0.038). Procedure time and distance covered inside phantom have both been found to be less in the Overlay group, although not significantly. CONCLUSION: Training with augmented reality image overlay and laser guidance improves the accuracy of facet joint injections in medical students learning image-guided facet joint needle placement.

  16. Prevalence of cervical facet joint pain in chronic neck pain.

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    Manchikanti, Laxmaiah; Singh, Vijay; Rivera, Jose; Pampati, Vidyasagar

    2002-07-01

    Neck pain is considered to be one of the most common chronic pain conditions in modern society. Various structures identified as capable of transmitting pain in the cervical spine include facet joints, intervertebral discs, nerve root dura, ligaments, fascia, and muscles. The prevalence of cervical facet joint pain in patients with chronic pain after whiplash has been determined as 54% to 60%. However, the prevalence of chronic cervical facet joint pain has not yet been determined in a heterogenous population or in patients with cervical spine pain of idiopathic origin in a controlled environment. This study evaluated 160 patients seen in one interventional pain management practice in a non-university setting. Cervical facet joints were investigated with diagnostic blocks using lidocaine 1% preservative free initially, followed by bupivacaine 0.25%, usually 2 to 4 weeks apart. The study population consisted of 76 women and 30 men aged 43 +/- 13 years of age (mean +/- SD). Mode of onset of neck pain was determined as following a traumatic incident in 48% of the patients, whereas it was with gradual onset without an identifiable specific incident in the remaining 55 patients (52%). Eighty-one or 70% of the patients (70%) reported a definite response to lidocaine blocks. Confirmatory blocks with bupivacaine were performed in 81 patients with 64 patients with 60% of the total sample, or 79%, of the lidocaine-positive group reporting definite response with improvement in their pain. Thus, a prevalence rate of facet joint pain in chronic neck pain was determined to be 60% (95% CI, 50%-70%), with a false positive rate of controlled diagnostic blocks of 40% (95% CI, 34%-46%).

  17. MR findings of bland and proliferative joint effusion in Knee joint

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    Lee, Hak Soo; Joo, Kyung Bin; Yang, Kee Hyuk; Choi, Jung Bin; Kim, Yong Soo; Park, Dong Woo; Park, Choong Ki; Hahm, Chang Kok [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

    2000-05-01

    To determine the MR imaging criteria by which bland and proliferative effusion of the knee may be differentiated. We retrospectively reviewed the MR images of 64 patients (65 cases), in whom T2-weighted sagittal scans revealed anteroposterior distension of the suprapatellar bursa of at least 0.5 cm. The patients were divided into two groups: bland effusion (n=3D36), and proliferative effusion ((n=3D29); pigmented villonodular synovitis (n=3D5), rheumatoid arthritis (n=3D6), septic arthritis (n=3D6), chronic synovitis (n=3D5), gouty arthritis (n=3D3), tuberculous arthritis (n=3D2), and lipoma arborescens (n=3D2)). All conditions were diagnosed on the basis of operative data or clinical criteria. The knee joint space was divided into four compartments: the suprapatellar pouch, central zone, posterior femoral recess, and subpopliteal recess, and the amount and distribution of effusion was then compared between the two groups. The ratios of the width and the length of the lateral recess of the suprapatellar bursa to those of its medial recess were determined, and the findings for the two groups were compared.Abnormality of the intracapular fat pads (prefemoral fat, Hoffa's fat, and quadriceps fat sign) as seen on sagittal scans, is a predictor proliferative effusion, and any such abnormality was evaluated. The synovium was classified as either thin or thick, and as having either a smooth or an irregular margin, as seen on Gadolinium-enhanced T1W1 images. As compared with bland effusion, proliferative effusion involved more prominent joint effusion in the suprapatellar pouch and posterior femoral recess, and in the suprapatellar bursa, the ratio of the width of the lateral recess to that of the medial recess was greater. When comparing the ratio of the length of the lateral recess to that of the medial recess, however, no significant statistical difference was noted. Sensitivity: specificity for proliferative effusion was 58%: 86% on coronal scan and 64%: 93% on

  18. Sensory and sympathetic innervation of cervical facet joint in rats

    Institute of Scientific and Technical Information of China (English)

    ZHOU Hai-yu; CHEN An-min; GUO Feng-jing; LIAO Guang-jun; XIAO Wei-dong

    2006-01-01

    Objective: To explore the patterns of innervation of cervical facet joints and determine the pathways from facet joints to dorsal root ganglions (DRGs) in order to clarify the causes of diffuse neck pain, headache, and shoulder pain.Methods: Forty-two male Sprague-Dawley rats,weighing 250-300 g, were randomly divided into three groups: Group A ( n = 18), Group B ( n = 18), and Group C (n = 6 ). Under anesthesia with intraperitoneal pentobarbital sodium (45 mg/kg body weight), a midline dorsal longitudinal incision was made over the cervical spine to expose the left cervical facet joint capsule of all the rats under a microscope. The rats in Group A underwent sympathectomy, but the rats in Group B and Group C did not undergo sympathectomy. Then 0.6 μl 5 % bisbenzimide (Bb) were injected into the C1-2, C3-4 and C5-6 facet joints of 6 rats respectively in Group A and Group B. The holes were immediately sealed with mineral wax to prevent leakage of Bb and the fascia and skin were closed. But in Group C, 0.9% normal saline was injected into the corresponding joint capsules. Then under deep reanesthesia with intraperitoneal pentobarbital sodium (45 mg/kg body weight), C1-C8 left DRGs in all rats and the sympathetic ganglions in Group B were obtained and the number of the labeled neurons was determined.Results: Neurons labeled with Bb were present in C1-C8 DRGs in both Group A and Group B, and sympathetic ganglions in Group B. In the C1-2 and C3-4 subgroups,labeled neurons were present from C1 to C8 DRGs, while in C5-6 subgroups they were from C, to C8. The number of Bb ( + ) neurons after sympathectomy was not significantly different in the injected level from that without sympathectomy. But in the other levels, the number of Bb ( + ) neurons after sympathectomy was significantly less than that without sympathectomy.Conclusions: The innervation of the cervical facet joints is derived from both sensory and sympathetic nervous system, and DRGs are associated with

  19. Simple facet joint repair with dynamic pedicular system: Technical note and case series

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    Ali Fahir Ozer

    2015-01-01

    Full Text Available Purpose: Facet joints are important anatomical structures for the stability of spine. Surgical or degenerative damage to a facet joint may lead to spinal instability and causes clinical problems. This article explains the importance of facet joints, reviews facet replacement systems, and describes a simple and effective method for facet replacement after surgical removal of facet joints. Materials and Methods: Ten patients were operated with the diagnosis of unilateral nerve root compression secondary to facet degeneration. The hypertrophic facet joints were removed with microsurgical techniques and the roots were decompressed. Then, a unilateral artificial facet joint was created using two hinged screws and a dynamic rod. Results: The clinical outcome of all the patients was determined good or excellent at second and last follow-up (mean 13.3 months controls using visual analog scale (VAS and Oswestry Disability Index (ODI scores. Radiological evaluations also demonstrated no implant-related complications. Conclusions: The authors suggest that, if removal of a facet joint is necessary to decompress the nerve roots, the joint can be replaced by a construct composed of two hinged screws connected by a dynamic rod. This simple system mimics the function of a normal facet joint and is an effective technique for unilateral facet joint replacement.

  20. Isolated Facet Joint Fracture as a Cause of Chronic Low Back Pain and Sciatica

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    Robert W Teasell

    1996-01-01

    Full Text Available A case of facet joint fracture following a rear-end motor vehicle accident who presented with chronic low back pain and sciatica is outlined. Diagnosis was made with 99Tc nuclear bone scan and was confirmed on computed tomographic scan after diagnosis with regular radiographs had failed. Facetectomy relieved pain but led to symptoms related to asymmetric load on the opposite facet joint. Symptoms were substantially relieved with a facet joint deinnervation procedure. Facet joint fracture was felt to occur as a consequence of compression forces on the facet joint at the time of impact.

  1. The effects of knee joint effusion on quadriceps electromyography during jogging.

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    Torry, Michael R; Decker, Michael J; Millett, Peter J; Steadman, J Richard; Sterett, William I

    2005-03-01

    To investigate and describe the influence of intra-articular effusion on knee joint kinematics and electromyographic (EMG) profiles during jogging. Thirteen individuals underwent a 20 cc 0.9% saline insufflation of the knee joint capsule and completed 8 jogging trials. Stance phase, sagittal plane knee joint kinematics and thigh muscular EMG profiles were compared pre- and post-insufflation utilizing a paired t-test ( = 0.05). Mild knee effusion caused a reduction in vastus medialis (p = 0.005) and lateralis (p = 0.006) EMG activity. The rectus femoris, biceps femoris and medial hamstring muscles did not exhibit changes due to this protocol. There were no changes in the sagittal plane knee joint kinematic pattern. Twenty cc effusion can cause quadriceps inhibition in the vastus medialis and the vastus lateralis in otherwise healthy individuals during jogging. This study provides baseline data for the effects of mild knee joint effusion on thigh musculature during jogging. Key Points20 cc of knee effusion can cause vastus medialis and lateralis inhibition as noted by decreases in EMG amplitude.This effusion does not appear to alter sagittal plane knee joint kinematics during jogging.This finding if different from previous work investigating knee joint kinematic changes during a less dynamic activity (gait) with 20 cc of effusion.

  2. Facet joint laser radiation: tissue effects of a new clinical laser application

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    Werkmann, Klaus; Thal, Dietmar R.

    1996-01-01

    Chronic unilateral and bilateral back pain with pseudoradicular symptoms, is a common clinical syndrome, which in many cases can be related to the facet joint syndrome. The pain is caused by mechanical affection of synovial and capsular nerve terminals. Therefore, current therapeutical attempts including physical therapy, intra-articular injection of local anesthetics and steroids and thermocoagulation of the facet joint with a thermocoagulator, are performed. We confirmed laser coagulation of the facet joint. Porcine cadaveric spines were treated immediately after death by intra-articular facet joint laser radiation. With the pulsed Nd:YAG laser (1064 nm) altogether 600 J were applied in three different places 4 mm apart at the top of the facet joint. The results showed that facet joint laser radiation leads to a small (about 1 - 2 mm diameter) lesion restricted to the facet joint cavity and its synovia. Histologically, we found a central carbonization zone and necrosis, including almost the whole cartilage and approximately 0.2 mm of the adjacent bone. These changes are similar to Nd:Yag-laser applications in other skeletal regions. It is suggested that these changes may lead to facet joint denervation by coagulation of the synovial nerve terminals. Cicatration of the laser lesion might cause ankylosis of this joint. In sum, facet joint laser radiation could be an alternative therapeutical tool for lower back pain of the facet joint syndrome type. Therefore, future clinical application of this technique seems to be very promising.

  3. THE EFFECTS OF KNEE JOINT EFFUSION ON QUADRICEPS ELECTROMYOGRAPHY DURING JOGGING

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    William I. Sterett

    2005-03-01

    Full Text Available To investigate and describe the influence of intra-articular effusion on knee joint kinematics and electromyographic (EMG profiles during jogging. Thirteen individuals underwent a 20 cc 0.9% saline insufflation of the knee joint capsule and completed 8 jogging trials. Stance phase, sagittal plane knee joint kinematics and thigh muscular EMG profiles were compared pre- and post-insufflation utilizing a paired t-test (p = 0.05. Mild knee effusion caused a reduction in vastus medialis (p = 0.005 and lateralis (p = 0.006 EMG activity. The rectus femoris, biceps femoris and medial hamstring muscles did not exhibit changes due to this protocol. There were no changes in the sagittal plane knee joint kinematic pattern. Twenty cc effusion can cause quadriceps inhibition in the vastus medialis and the vastus lateralis in otherwise healthy individuals during jogging. This study provides baseline data for the effects of mild knee joint effusion on thigh musculature during jogging.

  4. Utilization of Facet Joint and Sacroiliac Joint Interventions in Medicare Population from 2000 to 2014: Explosive Growth Continues!

    Science.gov (United States)

    Manchikanti, Laxmaiah; Hirsch, Joshua A; Pampati, Vidyasagar; Boswell, Mark V

    2016-10-01

    Increasing utilization of interventional techniques in managing chronic spinal pain, specifically facet joint interventions and sacroiliac joint injections, is a major concern of healthcare policy makers. We analyzed the patterns of utilization of facet and sacroiliac joint interventions in managing chronic spinal pain. The results showed significant increase of facet joint interventions and sacroiliac joint injections from 2000 to 2014 in Medicare FFS service beneficiaries. Overall, the Medicare population increased 35 %, whereas facet joint and sacroiliac joint interventions increased 313.3 % per 100,000 Medicare population with an annual increase of 10.7 %. While the increases were uniform from 2000 to 2014, there were some decreases noted for facet joint interventions in 2007, 2010, and 2013, whereas for sacroiliac joint injections, the decreases were noted in 2007 and 2013. The increases were for cervical and thoracic facet neurolysis at 911.5 % compared to lumbosacral facet neurolysis of 567.8 %, 362.9 % of cervical and thoracic facet joint blocks, 316.9 % of sacroiliac joints injections, and finally 227.3 % of lumbosacral facet joint blocks.

  5. Percutaneous Facet Screw Fixation in the Treatment of Symptomatic Recurrent Lumbar Facet Joint Cyst: A New Technique

    Energy Technology Data Exchange (ETDEWEB)

    Amoretti, Nicolas, E-mail: amorettinicolas@yahoo.fr; Gallo, Giacomo, E-mail: giacomo.gallo83@gmail.com; Bertrand, Anne-Sophie, E-mail: asbertrand3@hotmail.com [Centre Hospitalier Universitaire de Nice (France); Bard, Robert L., E-mail: rbard@cancerscan.com [New York Medical College (United States); Kelekis, Alexis, E-mail: akelekis@med.uoa.gr [University General Hospital “ATTIKON” (Greece)

    2016-01-15

    We present a case of percutaneous treatment of symptomatic recurrent lumbar facet joint cyst resistant to all medical treatments including facet joint steroid injection. Percutaneous transfacet fixation was then performed at L4–L5 level with a cannulated screw using CT and fluoroscopy guidance. The procedure time was 30 min. Using the visual analog scale (VAS), pain decreased from 9.5, preoperatively, to 0 after the procedure. At 6-month follow-up, an asymptomatic cystic recurrence was observed, which further reduced at the 1-year follow-up. Pain remained stable (VAS at 0) during all follow-ups. CT- and fluoroscopy-guided percutaneous cyst rupture associated with facet screw fixation could be an alternative to surgery in patients suffering from a symptomatic recurrent lumbar facet joint cyst.

  6. Percutaneous Facet Screw Fixation in the Treatment of Symptomatic Recurrent Lumbar Facet Joint Cyst: A New Technique.

    Science.gov (United States)

    Amoretti, Nicolas; Gallo, Giacomo; Bertrand, Anne-Sophie; Bard, Robert L; Kelekis, Alexis

    2016-01-01

    We present a case of percutaneous treatment of symptomatic recurrent lumbar facet joint cyst resistant to all medical treatments including facet joint steroid injection. Percutaneous transfacet fixation was then performed at L4-L5 level with a cannulated screw using CT and fluoroscopy guidance. The procedure time was 30 min. Using the visual analog scale (VAS), pain decreased from 9.5, preoperatively, to 0 after the procedure. At 6-month follow-up, an asymptomatic cystic recurrence was observed, which further reduced at the 1-year follow-up. Pain remained stable (VAS at 0) during all follow-ups. CT- and fluoroscopy-guided percutaneous cyst rupture associated with facet screw fixation could be an alternative to surgery in patients suffering from a symptomatic recurrent lumbar facet joint cyst.

  7. Factors affecting results of fluoroscopy-guided facet joint injection: Probable differences in the outcome of treatment between pure facet joint hypertrophy and concomitant diseases

    Directory of Open Access Journals (Sweden)

    Akif Albayrak

    2016-01-01

    Full Text Available Study Design: Retrospective cohort study. Purpose: Facet joints are considered a common source of chronic low-back pain. To determine whether pathogens related to the facet joint arthritis have any effect on treatment failure. Materials and Methods: Facet joint injection was applied to 94 patients treated at our hospital between 2011 and 2012 (mean age 59.5 years; 80 women and 14 men. For the purpose of analysis, the patients were divided into two groups. Patients who only had facet hypertrophy were placed in group A (47 patients, 41 women and 6 men, mean age 55.3 years and patients who had any additional major pathology to facet hypertrophy were placed in group B (47 patients, 39 women and 8 men, mean age 58.9 years. Injections were applied around the facet joint under surgical conditions utilizing fluoroscopy device guidance. A mixture of methylprednisolone and lidocaine was used as the injection ingredient. Results: In terms of Oswestry Disability Index (ODI and visual analog scale (VAS scores, no significant difference was found between preinjection and immediate postinjection values in both groups, and the scores of group A patients were significantly lower (P < 0.005 compared with that of group B patients at the end of the third, sixth, and twelfth month. Conclusion: For low-back pain caused by facet hypertrophy, steroid injection around the facet joint is an effective treatment, but if there is an existing major pathology, it is not as effective.

  8. Association between facet joint osteoarthritis and the Oswestry Disability Index

    Institute of Scientific and Technical Information of China (English)

    Adel; Maataoui; Thomas; J; Vogl; Marcus; Middendorp; Konstantinos; Kafchitsas; M; Fawad; Khan

    2014-01-01

    AIM:To investigate the correlation of facet joint osteoarthritis(FJOA) at lumbar levels L4/L5 and L5/S1 and the Oswestry Disability Index(ODI).METHODS:The study involved lumbar MRIs of 591 patients with a mean age of 47.3 years.The MRIs of the lumbar spine were performed on a 1.5 Tesla scanner(Magnetom Avanto,Siemens AG,Erlangen,Germany) using a dedicated receive only spine coil.After initial blinding,each dataset was evaluated by 2 board certified radiologist with more than 5 years experience in musculoskeletal imaging.In total 2364 facet joints were graded.Degenerative changes of the facet joints were evaluated according to the 4-point scale as proposed by Weishaupt et al Functional status was assessed using the ODI.The index is scored from 0 to 100 and interpreted as follows:0%-20%,minimaldisability; 20%-40%,moderate disability; 40%-60%,severe disability; 60%-80%,crippled; 80%-100%,patients are bedbound.Spearman’s coefficient of rank correlation was used for statistical analysis,with significance set at P < 0.05.RESULTS:In total 2364 facet joints at lumbar levels L4/5 and L5/S1 were analysed in 591 individuals.FJOA was present in 97%(L4/L5) and 98%(L5/S1).At level L4/5(left/right) 17/15(2.9%/2.5%) were described as grade 0,146/147(24.7%/24.9%) as grade 1,290/302(49.1%/51.1%) as grade 2 and 138/127(23.4%/21.5%) as grade 3.At level L5/S1(left/right) 10/11(1.7%/1.9%) were described as grade 0,136/136(23.0%/23.0%) as grade 1,318/325(53.8%/55.0%) as grade 2 and 127/119(21.5%/20.1%) as grade 3.Regarding the ODI scores,patients’ disability had a minimum of 0% and a maximum of 91.11% with an arithmetic mean of 32.77% ± 17.02%.The majority of patients(48.39%) had moderate functional disability(21%-40%).There was no significant correlation between FJOA and ODI on both sides of lumbar level L4/5 and on the left side of lumbar level L5/S1.A weak positive correlation was evaluated between ODI and FJOA on the right side of lumbar level L5/S1.CONCLUSION:The missing

  9. Facet joint injuries in acute cervical spine trauma : evaluation with CT and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Jeon Ju; Kim, Dong Hyun; Lee, Jeong Hwa; Lee, Keon; Kwon, Hyeok Po; Kwon, Jung Hyeok; Yun, Seong Mun [Dongkang General Hospital, Seoul (Korea, Republic of)

    1999-05-01

    To evaluate injury patterns of facet joints and associated soft tissue injuries in patients with acute traumatic cervical facet joint injuries. From among patients with cervical spine trauma, 27 with facet joint injuries, as seen on CT and MRI, were chosen for this study. CT scans were analyzed with regard to the location of facet joint injury, the presence or absence of facet dislocation or fracture, and other associated fractures. MR images were analyzed with regard to ligament injury, intervertebral disc injury, intervertebral disc herniation, and spinal cord injury. The most common location of facet joint injury was C6-7 level(n=10), followed by C5-6(n=8). Among these 27 patients with facet joint injuries, 12(44%) had bilateral injuries and 15(56%) unilateral injuries. Facet fractures were present in 17 cases(63%) and the fracture of inferior facet was more frequent than superior. Patterns of fracture were vertical, transverse, or comminuted, but vertical fracture was the most common. Various degrees of dislocation were observed in patients with facet fractures. Fractures other than facet included pillar(n=11), lamina(n=6), transverse process(n=14), body(n=13), and spinous process(n=3). On MR images, anterior longitudinal ligament injury was found in 8 patients(30%), posterior longitudinal ligament injury in 4(15%), and interspinous ligament injury in 20(74%). Twelve patients(44%) had spinal cord injuries including edema(n=8) and hemorrhage(n=4). Among patients with disc abnormalities, 11(41%) had intervertebral disc injuries, and traumatic disc herniations were found in nine. Traumatic cervical facet joint injuries were manifested as various patterns and frequently associated with other fractures or soft tissue injuries. Analysis of CT and MR findings of these injury patterns helped formulate a therapeutic plan and determine of prognosis.

  10. The Interface of Mechanics and Nociception in Joint Pathophysiology: Insights From the Facet and Temporomandibular Joints.

    Science.gov (United States)

    Sperry, Megan M; Ita, Meagan E; Kartha, Sonia; Zhang, Sijia; Yu, Ya-Hsin; Winkelstein, Beth

    2017-02-01

    Chronic joint pain is a widespread problem that frequently occurs with aging and trauma. Pain occurs most often in synovial joints, the body's load bearing joints. The mechanical and molecular mechanisms contributing to synovial joint pain are reviewed using two examples, the cervical spinal facet joints and the temporomandibular joint (TMJ). Although much work has focused on the macroscale mechanics of joints in health and disease, the combined influence of tissue mechanics, molecular processes, and nociception in joint pain has only recently become a focus. Trauma and repeated loading can induce structural and biochemical changes in joints, altering their microenvironment and modifying the biomechanics of their constitutive tissues, which themselves are innervated. Peripheral pain sensors can become activated in response to changes in the joint microenvironment and relay pain signals to the spinal cord and brain where pain is processed and perceived. In some cases, pain circuitry is permanently changed, which may be a potential mechanism for sustained joint pain. However, it is most likely that alterations in both the joint microenvironment and the central nervous system (CNS) contribute to chronic pain. As such, the challenge of treating joint pain and degeneration is temporally and spatially complicated. This review summarizes anatomy, physiology, and pathophysiology of these joints and the sensory pain relays. Pain pathways are postulated to be sensitized by many factors, including degeneration and biochemical priming, with effects on thresholds for mechanical injury and/or dysfunction. Initiators of joint pain are discussed in the context of clinical challenges including the diagnosis and treatment of pain.

  11. Detailed examination of the lower cervical spine facet joints in a road traffic crash fatality - a case study

    DEFF Research Database (Denmark)

    Uhrenholt, Lars; Nielsen, Edith; Vesterby, Annie

    2005-01-01

    The lower cervical spine facet joints of a road traffic crash fatality were examined using diagnostic imaging and histological techniques. No injuries to the cervical spine facet joints could be identified with diagnostic imaging including conventional radiology, CT and MRI. Examination of stained...... histological sections visualised the morphology and integrity of the facet joints in detail. Occult injuries to and in close proximity of the cervical spine facet joints were identified only on histological examination....

  12. Detailed examination of the lower cervical spine facet joints in a road traffic crash fatality - a case study

    DEFF Research Database (Denmark)

    Uhrenholt, Lars; Nielsen, Edith; Vesterby, Annie

    2005-01-01

    The lower cervical spine facet joints of a road traffic crash fatality were examined using diagnostic imaging and histological techniques. No injuries to the cervical spine facet joints could be identified with diagnostic imaging including conventional radiology, CT and MRI. Examination of stained...... histological sections visualised the morphology and integrity of the facet joints in detail. Occult injuries to and in close proximity of the cervical spine facet joints were identified only on histological examination....

  13. Associations Between Knee Effusion-synovitis and Joint Structural Changes in Patients with Knee Osteoarthritis.

    Science.gov (United States)

    Wang, Xia; Jin, Xingzhong; Blizzard, Leigh; Antony, Benny; Han, Weiyu; Zhu, Zhaohua; Cicuttini, Flavia; Wluka, Anita E; Winzenberg, Tania; Jones, Graeme; Ding, Changhai

    2017-09-01

    To describe the associations between effusion-synovitis and joint structural abnormalities in patients with knee osteoarthritis (OA) over 24 months. A posthoc analysis using data from a randomized controlled trial in 413 patients with symptomatic OA (aged 63 ± 7 yrs, 208 women). Knee effusion-synovitis volume and score, cartilage defects, cartilage volume, and bone marrow lesions (BML) were assessed using magnetic resonance imaging. Joint space narrowing (JSN) and osteophytes were assessed using radiograph. Least significant change criterion was used to define change in effusion-synovitis volume. Knee symptoms were assessed by Western Ontario and McMaster University OA Index. Multivariable linear/logistic regression and multilevel generalized mixed-effects models were used in longitudinal analyses. Total effusion-synovitis volume increased modestly from baseline (8.0 ± 8.5 ml) to followup (9.0 ± 10.5 ml). Baseline BML, cartilage defect, JSN, and osteophyte scores were positively associated with change in effusion-synovitis volume (p < 0.05). Baseline cartilage defects and JSN were also associated with change in effusion-synovitis score (p < 0.05). However, neither baseline effusion-synovitis score nor volume consistently predicted change in the above structures except cartilage volume. In the mixed-effects models, knee effusion-synovitis was positively associated with BML (volume: β = 1.19 ml/grade; score: OR = 1.75/grade) and cartilage defects (volume: β = 1.87 ml/grade; score: OR = 2.22/grade), while negatively associated with cartilage volume loss. Change in effusion-synovitis volume was positively correlated with changes in knee pain and stiffness scores (p < 0.05). Knee cartilage and subchondral bone abnormalities predicted change in effusion-synovitis, but effusion-synovitis did not predict knee structural changes. These findings suggest that synovial inflammation is likely the result of joint structural abnormalities in established OA. Clinical

  14. Associations between joint effusion in the knee and gene expression levels in the circulation: A meta-analysis

    NARCIS (Netherlands)

    Y.F.M. Ramos (Yolande); M.J. Peters (Marjolein); W. den Hollander (Wouter); D. Schiphof (Dieuwke); A. Hofman (Albert); A.G. Uitterlinden (André); E.H.G. Oei (Edwin); P.E. Slagboom (Eline); M. Kloppenburg (Margreet); J.L. Bloem (Johan); S.M. Bierma-Zeinstra (Sita); I. Meulenbelt (Ingrid); J.B.J. van Meurs (Joyce)

    2016-01-01

    textabstractObjective: To identify molecular biomarkers for early knee osteoarthritis (OA), we examined whether joint effusion in the knee associated with different gene expression levels in the circulation. Materials and Methods: Joint effusion grades measured with magnetic resonance (MR) imaging a

  15. Subdural empyema following lumbar facet joint injection: An exceeding rare complication.

    Science.gov (United States)

    Fayeye, Oluwafikayo; Silva, Adikarige Haritha Dulanka; Chavda, Swarupsinh; Furtado, Navin Raoul

    2016-01-01

    Chronic low back pain is extremely common with a life time prevalence estimated at greater than 70%. Facet joint arthrosis is thought to be the causative aetiological substrate in approximately 25% of chronic low back pain cases. Facet joint injection is a routine intervention in the armamentarium for both the diagnostic and therapeutic management of chronic low back pain. In fact, a study by Carrino et al. reported in excess of 94,000 facet joint injection procedures were carried out in the US in 1999. Although generally considered safe, the procedure is not entirely without risk. Complications including bleeding, infection, exacerbation of pain, dural puncture headache, and pneumothorax have been described. We report a rare case of a 47-year-old female patient who developed a left L4/5 facet septic arthrosis with an associated subdural empyema and meningitis following facet joint injection. This case is unique, as to the best of our knowledge no other case of subdural empyema following facet joint injection has been reported in the literature. Furthermore this case serves to highlight the potential serious adverse sequelae of a routine and apparently innocuous intervention. The need for medical practitioners to be alert to and respond rapidly to the infective complications of facet joint injection cannot be understated.

  16. [Rheology and hyaluronic acid in inflammatory joint effusions (author's transl)].

    Science.gov (United States)

    Zeidler, H; Altmann, S

    1977-11-11

    The Weissenberg rheogoniometer was used to measure viscosity, normal force and the number of molecular entanglements, calculated from a shear modulus obtained by prestationary experiments, in inflammatory and non-inflammatory synovial fluid effusions. The rheological properties show greater pathological change in the inflammatory synovial fluid samples than in the non-inflammatory. Variation in the hyaluronic acid concentration is only partly responsible for the pathological rheology. Initial experiments with a normalization method for the viscosity flow curves suggest the possibility of determining changes in polymerization or structure of the hyaluronic acid by rheological measurements.

  17. Bone bruise, lipohemarthrosis, and joint effusion in CT of non-displaced hip fracture

    Energy Technology Data Exchange (ETDEWEB)

    Geijer, Mats (Center for Medical Imaging and Physiology, Skaane University Hospital, Lund University, Lund (Sweden)), Email: mats@geijer.info; Dunker, Dennis; Collin, David; Goethlin, Jan H. (Department of Radiology, Sahlgrenska University Hospital, Moelndal (Sweden))

    2012-03-15

    Background. A suspected occult hip fracture after normal radiography is not uncommon in an elderly person after a fall. Despite a lack of robust validation in the literature, computed tomography (CT) is often used as secondary imaging. Purpose. To assess the frequency and clinical utility of non-cortical skeletal and soft tissue lesions as ancillary fracture signs in CT diagnosis of occult hip fractures. Material and Methods. All fracture signs (cortical and trabecular fractures, bone bruise, joint effusion, and lipohemarthrosis) were recorded in 231 hip low-energy trauma cases with CT performed after normal or equivocal radiography in two trauma centers. Results. There were no fracture signs in 110 patients. Twelve of these had a joint effusion. In 121 patients with 46 cervical hip fractures and 75 trochanteric fractures one or more fracture signs were present. Cortical fractures were found in 115 patients. Bone bruise was found in 119 patients, joint effusion in 35, and lipohemarthrosis in 20 patients. Conclusion. Ancillary signs such as bone bruise and lipohemarthrosis can strengthen and sometimes indicate the diagnosis in CT of occult hip fractures. Joint effusion is a non-specific sign

  18. Bone bruise, lipohemarthrosis, and joint effusion in CT of non-displaced hip fracture.

    Science.gov (United States)

    Geijer, Mats; Dunker, Dennis; Collin, David; Göthlin, Jan H

    2012-03-01

    A suspected occult hip fracture after normal radiography is not uncommon in an elderly person after a fall. Despite a lack of robust validation in the literature, computed tomography (CT) is often used as secondary imaging. To assess the frequency and clinical utility of non-cortical skeletal and soft tissue lesions as ancillary fracture signs in CT diagnosis of occult hip fractures. All fracture signs (cortical and trabecular fractures, bone bruise, joint effusion, and lipohemarthrosis) were recorded in 231 hip low-energy trauma cases with CT performed after normal or equivocal radiography in two trauma centers. There were no fracture signs in 110 patients. Twelve of these had a joint effusion. In 121 patients with 46 cervical hip fractures and 75 trochanteric fractures one or more fracture signs were present. Cortical fractures were found in 115 patients. Bone bruise was found in 119 patients, joint effusion in 35, and lipohemarthrosis in 20 patients. Ancillary signs such as bone bruise and lipohemarthrosis can strengthen and sometimes indicate the diagnosis in CT of occult hip fractures. Joint effusion is a non-specific sign.

  19. Desmoid Type Fibromatosis in the Facet Joint of Lumbar Spine: Case Report and Review of Literature

    Science.gov (United States)

    Kim, So Jung; Lee, Sang Min; Kang, Haeyoun

    2013-01-01

    Desmoid type fibromatosis is a benign fibroblastic tumor arising from the fascia or musculoaponeurosis. It may occur in various locations, but most commonly in the shoulder girdle and neck; to our knowledge, there has been no reported case originating from a facet joint of the spine. We report CT and MR imaging findings of a desmoid type fibromatosis, involving the facet joint of the L3-4 spine with bone involvement. PMID:24043979

  20. Neuronal hyperexcitability in the dorsal horn after painful facet joint injury

    OpenAIRE

    2010-01-01

    Excessive cervical facet capsular ligament stretch has been implicated as a cause of whiplash-associated disorders following rear-end impacts, but the pathophysiological mechanisms that produce chronic pain in these cases remain unclear. Using a rat model of C6/C7 cervical facet joint capsule stretch that produces sustained mechanical hyperalgesia, the presence of neuronal hyperexcitability was characterized 7 days after joint loading. Extracellular recordings of spinal dorsal horn neuronal a...

  1. Simple facet joint repair with dynamic pedicular system: Technical note and case series

    OpenAIRE

    Ali Fahir Ozer; Tuncer Suzer; Mehdi Sasani; Tunc Oktenoglu; Phillip Cezayirli; Hosein Jafari Marandi; Deniz Ufuk Erbulut

    2015-01-01

    Simple facet joint repair with dynamic pedicular system: Technical note and case series Ali Ozer, Tuncer Suzer, Mehdi Sasani, Tunc Oktenoglu, Phillip Cezayirli and Hosein Marandi Journal of Craniovertebral Junction and Spine. 6.2 (April-June 2015): p65. Copyright: COPYRIGHT 2015 Medknow Publications and Media Pvt. Ltd. http://www.jcvjs.com/ Full Text: Byline: Ali. Ozer, Tuncer. Suzer, Mehdi. Sasani, Tunc. Oktenoglu, Phillip. Cezayirli, Hosein. Marandi, Deniz. Erbulut Purpose: Facet joints are...

  2. Desmoid type fibromatosis in the facet joint of lumbar spine: Case report and review of literature

    Energy Technology Data Exchange (ETDEWEB)

    Kim, So Jung; Ha, Doo Hoe; Lee, Sang Min; Kang, Hae Youn [CHA Bundang Medical Center, CHA University, Seongnam (Korea, Republic of)

    2013-10-15

    Desmoid type fibromatosis is a benign fibroblastic tumor arising from the fascia or musculoaponeurosis. It may occur in various locations, but most commonly in the shoulder girdle and neck; to our knowledge, there has been no reported case originating from a facet joint of the spine. We report CT and MR imaging findings of a desmoid type fibromatosis, involving the facet joint of the L3-4 spine with bone involvement.

  3. Load Rate of Facet Joints at the Adjacent Segment Increased After Fusion

    Directory of Open Access Journals (Sweden)

    Hui Li

    2015-01-01

    Full Text Available Background: The cause of the adjacent segment degeneration (ASD after fusion remains unknown. It is reported that adjacent facet joint stresses increase after anterior cervical discectomy and fusion. This increase of stress rate may lead to tissue injury. Thus far, the load rate of the adjacent segment facet joint after fusion remains unclear. Methods: Six C2-C7 cadaveric spine specimens were loaded under four motion modes: Flexion, extension, rotation, and lateral bending, with a pure moment using a 6° robot arm combined with an optical motion analysis system. The Tecscan pressure test system was used for testing facet joint pressure. Results: The contact mode of the facet joints and distributions of the force center during different motions were recorded. The adjacent segment facet joint forces increased faster after fusion, compared with intact conditions. While the magnitude of pressures increased, there was no difference in distribution modes before and after fusion. No pressures were detected during flexion. The average growth velocity during extension was the fastest and was significantly faster than lateral bending. Conclusions: One of the reasons for cartilage injury was the increasing stress rate of loading. This implies that ASD after fusion may be related to habitual movement before and after fusion. More and faster extension is disadvantageous for the facet joints and should be reduced as much as possible.

  4. Load Rate of Facet Joints at the Adjacent Segment Increased After Fusion

    Institute of Scientific and Technical Information of China (English)

    Hui Li; Bao-Qing Pei; Jin-Cai Yang; Yong Hai; De-Yu Li; Shu-Qin Wu

    2015-01-01

    Background:The cause of the adjacent segment degeneration (ASD) after fusion remains unknown.It is reported that adjacent facet joint stresses increase after anterior cervical discectomy and fusion.This increase of stress rate may lead to tissue injury.Thus far,the load rate of the adjacent segment facet joint after fusion remains unclear.Methods:Six C2-C7 cadaveric spine specimens were loaded under four motion modes:Flexion,extension,rotation,and lateral bending,with a pure moment using a 6° robot arm combined with an optical motion analysis system.The Tecscan pressure test system was used for testing facet joint pressure.Results:The contact mode of the facet joints and distributions of the force center during different motions were recorded.The adjacent segment facet joint forces increased faster after fusion,compared with intact conditions.While the magnitude of pressures increased,there was no difference in distribution modes before and after fusion.No pressures were detected during flexion.The average growth velocity during extension was the fastest and was significantly faster than lateral bending.Conclusions:One of the reasons for cartilage injury was the increasing stress rate of loading.This implies that ASD after fusion may be related to habitual movement before and after fusion.More and faster extension is disadvantageous for the facet joints and should be reduced as much as possible.

  5. Intra-articular injection of tenoxicam in osteoarthritic knee joints with effusion.

    Science.gov (United States)

    Oztuna, Volkan; Eskandari, Metin; Bugdayci, Resul; Kuyurtar, Fehmi

    2007-12-01

    Thirty patients who had grade II to III osteoarthritis according to Kellgren-Lawrence system and presenting with acute effusion of the knee joint were randomly assigned to 2 groups. All patients were treated with aspiration of the synovial fluid, cold application, and rest. Fifteen patients received an intra-articular injection of tenoxicam 20 mg following aspiration. The other group was administered oral tenoxicam 20 mg a day for 10 days. Patients were examined at 2, 4, and 8 weeks and then in 3-month intervals. At followup visits, pain was assessed using visual analog scale: range of motion, and effusion of the knee joint were recorded. A repeated measure test was used to determine the significance of changes in pain and mobility between the groups. Student's Neyman Keuls test was used to determine the significance of differences within the groups. Chi-square test was used for the number of episodes. The intra-articular injection group had more rapid pain relief than the oral treatment group (P < .01). At the end of 1 year, the number of effusions was significantly lower in the intra-articular treatment group (P < .01). These results indicate that intra-articular injection of tenoxicam provides rapid pain relief in the patients with acute flare-up of knee osteoarthritis and helps to prevent effusion.

  6. Septic arthritis in a lumbar facet joint: a rare cause of an epidural abscess

    Energy Technology Data Exchange (ETDEWEB)

    Heenan, S.D. [Dept. of Neuroradiology, Atkinson Morley`s Hospital, London (United Kingdom); Britton, J. [Dept. of Neuroradiology, Atkinson Morley`s Hospital, London (United Kingdom)

    1995-08-01

    A 10-year-old boy presented with a 7-day history of back pain and pyrexia. MRI showed an epidural abscess arising from septic arthritis in a lumbar facet joint. To our knowledge, there are only two previously reported cases of septic arthritis of a facet joint leading to an epidural abscess. This case illustrates how infection in a synovial joint may extend into the extradural space and might be the route of infection in more cases than has previously been recognised. (orig.)

  7. Effect of the Japanese herbal medicine, Boiogito, on the osteoarthritis of the knee with joint effusion

    Directory of Open Access Journals (Sweden)

    Majima Tokifumi

    2012-01-01

    Full Text Available Abstract Background Boiogito (Japanese herbal medicine, Tsumura Co. Tokyo, Japan contains sinomenin which inhibits inflammatory reactions. Since sinomenine is a principle component of the Boiogito, there is a possibility of it being effective on osteoarthritis (OA of the knee with joint effusion. However, there is no report concerning the effectiveness of Boiogito on knee OA. The objective of the present study is to investigate the therapeutic effect of Boiogito on OA of the knee associated with joint effusion in a comparative study among randomly assigned groups. Methods Study was performed using 50 patients who were diagnosed with primary osteoarthritis of the knee with joint effusion. The patients were randomly assigned to two groups: one group (25 patients using both loxoprofen (2-{4-[(2-oxocyclopentyl methyl]} propanoic acid and Boiogito and the other group (25 patients using loxoprofen, and were evaluated during a 12 week observation period. The assessment parameters including knee scores in the Knee Society Rating System including Knee score and Functional scores, amount of joint effusion by joint puncture in clinically detected cases, the 36-items short form of the Medical Outcome Study Questionnaire (SF-36 as a measurement of health related quality of life were used. Results The knee scores based on the Knee Society Rating System were improved in both groups. The staircase climbing up and down ability in the Knee society rating system functional score was significantly improved in the group using Boiogito and loxoprofen compared to the loxoprofen group. In the evaluation using SF-36, significant improvements were found in the scores in both groups in physical functioning after 12 weeks. The amount of joint fluid was significantly decreased at 4, 8 and 12 weeks compared to pre-administration baseline in the group using Boiogito and loxoprofen. A side effect of Boiogito, dry mouth, was found in one case. The symptom was mild and improved

  8. Pedicle marrow signal intensity changes in the lumbar spine: a manifestation of facet degenerative joint disease

    Energy Technology Data Exchange (ETDEWEB)

    Morrison, J.L.; Kaplan, P.A.; Dussault, R.G.; Anderson, M.W. [Dept. of Radiology, Univ. of Virginia Health System, Charlottesville, VA (United States)

    2000-12-01

    Objective. Signal intensity changes in lumbar pedicles, similar to those described in vertebral body endplates adjacent to degenerated discs, have been described as an ancillary sign of spondylolysis on MRI. The purpose of this study was to determine whether pedicle marrow signal intensity changes also occur in association with facet degenerative joint disease.Design. Eighty-nine lumbar spine MRI examinations without spondylolysis were reviewed for marrow signal intensity changes in pedicles and vertebral bodies as well as for facet degenerative joint disease.Results. Five percent (46/890) of lumbar pedicles in 23 patients had marrow signal intensity changes. Ninety-one percent (42/46) of the abnormal pedicles had adjacent degenerative joint disease of the facets, while only 21% (189/890) of normal pedicles had adjacent facet degenerative joint disease (p<0.001). Eighty-nine percent (41/46) of the pedicles with marrow signal intensity changes had adjacent degenerative disc disease.Conclusions. Pedicle marrow signal intensity changes are not a specific sign of spondylolysis; they are commonly seen with adjacent facet degenerative joint disease in the absence of spondylolysis. Pedicle marrow signal intensity changes are probably a response to abnormal stresses related to abnormal motion or loading caused by the degenerative changes in the spinal segment. (orig.)

  9. Pressure measurement in the cervical spinal facet joint: considerations for maintaining joint anatomy and an intact capsule.

    Science.gov (United States)

    Jaumard, Nicolas V; Bauman, Joel A; Welch, William C; Winkelstein, Beth A

    2011-07-01

    A novel noninvasive approach to measure facet joint pressure in the cervical spine was investigated using a tip-mounted transducer that can be inserted through a hole in the bony lateral mass. This technique is advantageous because it does not require resection of the joint capsule, but there are potential issues regarding its applicability that are addressed. The objective was to evaluate the effect of a tip-mounted pressure probe's position and orientation on contact pressure measurements in biomechanical experiments. Measurements of direct contact pressure in the facet joint of cadaveric spines have been obtained via pressure-sensitive films. However, that method requires the resection of the facet capsule, which can alter the overall joint's mechanical behavior and can affect the measured contact pressures. Influence of position and orientation on probe measurements was evaluated in companion surrogate and cadaveric investigations. The probe was placed in the facet of an anatomic vertebral C4/5 surrogate undergoing sagittal bending moments. Pressure-sensitive paper was used to map contact regions in the joint of the surrogate and cadaveric cervical segments (n = 3) during extension. The probe also underwent uniaxial compression in cadaveric facets to evaluate the effect of orientation relative to the contact surface on the probe signal. Although experimental and theoretical pressure profiles followed the same trends, measured maximum pressures were half of the theoretical ones. In the orientation study, maximum pressures were not different for probe orientations of 0° and 5°, but no signal was recorded at orientations greater than 15°. This approach to measure pressure was selected to provide a minimally-invasive method to quantify facet joint pressures during clinically relevant applications. Both the position and orientation of the probe are critical factors in monitoring local pressure profiles in this mobile synovial joint.

  10. The prevalence of lumbar facet joint edema in patients with low back pain

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    Friedrich, Klaus M.; Pinker, Katja; Trattnig, Siegfried [Medical University of Vienna, Division of MSK, Department of Radiology, Center of Excellence for High Field MRI, Vienna (Austria); Nemec, Stefan; Peloschek, Philipp; Weber, Michael [Medical University of Vienna, Division of MSK, Department of Radiology, Vienna (Austria)

    2007-08-15

    The objective was to assess the prevalence of lumbar facet joint edema in patients with low back pain. Lumbar spine MR examinations (1.5 T) of 145 consecutive patients (87 women, 58 men; mean age 52.8, range 17-94 years) were retrospectively evaluated with regard to the presence of facet joint edema. The MR protocol included sagittal short-tau inversion recovery (STIR), T1- and T2-weighted as well as transverse T2-weighted images. In 9 patients follow-up MR examinations were performed and results were compared with pain. The agreement between the change in intensity of facet joint edema and the change in intensity of pain was assessed using kappa statistics and Kendall's tau coefficient. In 21 of the 145 patients (14%) edema was found at the facet joints: in 52.4% at L4/5, in 19.0% at L5/S1, in 14.3% at L4/5 and L5/S1, in 9.5% at L3/4 and L4/5, and in 4.8% at L3/4. The agreement between the change in pain score and intensity of edema within the follow-up group was ''almost perfect'' (kappa = 0.81). Kendall's tau coefficient was 0.91, indicating high agreement. Sagittal STIR images detect facet joint edema in 14% of patients with low back pain. This fact may be useful for planning treatment including facet joint injections. (orig.)

  11. Prevalence of facet joint pain in chronic spinal pain of cervical, thoracic, and lumbar regions

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    Pampati Vidyasagar

    2004-05-01

    Full Text Available Abstract Background Facet joints are a clinically important source of chronic cervical, thoracic, and lumbar spine pain. The purpose of this study was to systematically evaluate the prevalence of facet joint pain by spinal region in patients with chronic spine pain referred to an interventional pain management practice. Methods Five hundred consecutive patients with chronic, non-specific spine pain were evaluated. The prevalence of facet joint pain was determined using controlled comparative local anesthetic blocks (1% lidocaine or 1% lidocaine followed by 0.25% bupivacaine, in accordance with the criteria established by the International Association for the Study of Pain (IASP. The study was performed in the United States in a non-university based ambulatory interventional pain management setting. Results The prevalence of facet joint pain in patients with chronic cervical spine pain was 55% 5(95% CI, 49% – 61%, with thoracic spine pain was 42% (95% CI, 30% – 53%, and in with lumbar spine pain was 31% (95% CI, 27% – 36%. The false-positive rate with single blocks with lidocaine was 63% (95% CI, 54% – 72% in the cervical spine, 55% (95% CI, 39% – 78% in the thoracic spine, and 27% (95% CI, 22% – 32% in the lumbar spine. Conclusion This study demonstrated that in an interventional pain management setting, facet joints are clinically important spinal pain generators in a significant proportion of patients with chronic spinal pain. Because these patients typically have failed conservative management, including physical therapy, chiropractic treatment and analgesics, they may benefit from specific interventions designed to manage facet joint pain.

  12. [CORRELATION OF LUMBAR FACET JOINT DEGENERATION AND SPINE-PELVIC SAGITTAL BALANCE].

    Science.gov (United States)

    Lo, Xin; Zhang, Bin; Liu, Yuan; Dai, Min

    2015-08-01

    To investigate the relationship between lumbar facet joint degeneration of each segment and spine-pelvic sagittal balance parameters. A retrospective analysis was made the clinical data of 120 patients with lumbar degenerative disease, who accorded with the inclusion criteria between June and November 2014. There were 58 males and 62 females with an average age of 53 years (range, 24-77 years). The disease duration ranged from 3 to 96 months (mean, 6.6 months). Affected segments included L3,4 in 32 cases, L4,5 in 47 cases, and L5, S1 in 52 cases. The CT and X-ray films of the lumbar vertebrae were taken. The facet joint degeneration was graded based on the grading system of Pathria. The spine-pelvic sagittal balance parameters were measured, including lumbar lordosis (LL), upper lumbar lordosis (ULL), lower lumbar lordosis (LLL), pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS). According to normal range of PI, the patients were divided into 3 groups: group A (PI was less than normal range), group B (PI was within normal range), and group C (PI was more than normal range). The facet joint degeneration was compared; according to the facet joint degeneration degree, the patients were divided into group N (mild degeneration group) and group M (serious degeneration group) to observe the relationship of lumbar facet joint degeneration of each segment and spine-pelvic sagittal balance parameters. At L4,5 and L5, S1, facet joint degeneration showed significant difference among groups A, B, and C (P 0.05). There was no significant difference in the other spine-pelvic sagittal balance parameters between groups N and M at each segment (P > 0.05) except for PT (P spine.

  13. Ultrasound-guided facet joint injection to treat a spinal cyst

    Directory of Open Access Journals (Sweden)

    Tung-Liang Lin

    2014-04-01

    Full Text Available Lumbar spinal cysts often present with backache and may be accompanied by lower extremity weakness as well as radiation pain if root compression occurs. The treatment regimens include anti-inflammatory drugs, physical therapy, procedures guided by fluoroscopy or computed tomography, and surgery. We report the case of a patient with a symptomatic lumbar spinal cyst at the L4–L5 facet joint. The symptoms immediately remitted after ultrasound-guided steroid–lidocaine injection into the L4–L5 facet joint. Magnetic resonance imaging follow up 4 months after injection showed complete resolution of the cyst.

  14. Osteochondroma arising from a lumbar facet joint in a 16-year-old.

    Science.gov (United States)

    Hancock, Graeme E; Mariathas, Chrishan; Fernandes, James A; Breakwell, Lee M; Cole, Ashley A; Michael, Antony L R

    2015-05-01

    Osteochondromas are benign tumours of bony or cartilaginous origin, which may be solitary or multiple. They are rare in the axial skeleton and have previously been reported to arise from facet joints only in four cases in the English literature. We report the case of a 16-year-old girl who presented with a palpable bony lump and a short history of back pain. Imaging showed a bony lesion arising from a left-sided facet joint in the lumbar spine. Following excision biopsy, there was complete resolution of symptoms. The literature on the origin and management of spinal osteochondromas is discussed.

  15. Delayed onset of a spinal epidural hematoma after facet joint injection

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    Mirko Velickovic

    2016-10-01

    Full Text Available The treatment of chronic back pain is a challenging problem. Facet joint infiltration is an established treatment for chronic low back pain caused by arthrosis of the lumbar facet joints. Due to the increasing number of patients with chronic low back pain, this therapy has become more frequent. We treated a 51-year-old male patient, who developed an epidural hematoma 2 months after infiltration therapy. Our case shows that even a delayed onset of spinal epidural hematoma is possible and should be kept in mind as a possible cause of acute myelopathy after spinal intervention.

  16. MR imaging of lumbar facet joint synovial cysts

    Energy Technology Data Exchange (ETDEWEB)

    Apostolaki, E.; Davies, A.M.; Evans, N. [Royal Orthopaedic Hospital, Birmingham (United Kingdom). Dept. of Radiology; Cassar-Pullicino, V.N. [Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry (United Kingdom)

    2000-04-01

    The increasing application of magnetic resonance (MR) imaging of the spine has raised the awareness of lumbar facet synovial cysts (LFSC). This well recognised, yet uncommon condition, presents with low back pain and radiculopathy due to the presence of an extradural mass. The commonest affected level is L4/5 with a mild degenerative spondylolisthesis a frequent associated finding. MR imaging is the technique of choice to detect and diagnose a LFSC. This pictorial essay, drawing on experience of 43 cases seen in 40 patients, illustrates the spectrum of appearances that can be encountered and suggest differing causes for the variable signal characteristics exhibited. Computed tomography (CT) can be of value in some cases to aid interpretation of the MR images. In addition, CT facet arthrography by injection of air or iodinated non-ionic contrast medium may be used to confirm the diagnosis in doubtful cases as well as noting whether the patients presenting symptoms can be provoked. A comprehensive review of the existing literature is presented. (orig.)

  17. Quantitative in vivo MRI evaluation of lumbar facet joints and intervertebral discs using axial T2 mapping

    Energy Technology Data Exchange (ETDEWEB)

    Stelzeneder, David; Messner, Alina; Scheurecker, Georg; Goed, Sabine; Friedrich, Klaus M.; Trattnig, Siegfried [Medical University of Vienna, Department of Radiology, MR Centre-High Field MR, Vienna (Austria); Vlychou, Marianna [Medical University of Vienna, Department of Radiology, MR Centre-High Field MR, Vienna (Austria); University Hospital of Larissa, Department of Radiology, Larissa (Greece); Welsch, Goetz H. [Medical University of Vienna, Department of Radiology, MR Centre-High Field MR, Vienna (Austria); University of Erlangen, Department of Trauma Surgery, Erlangen (Germany); Pieber, Karin; Pflueger, Verena [Medical University of Vienna, Department of Physical Medicine and Rehabilitation, Vienna (Austria)

    2011-11-15

    To assess the feasibility of T2 mapping of lumbar facet joints and intervertebral discs in a single imaging slab and to compare the findings with morphological grading. Sixty lumbar spine segments from 10 low back pain patients and 5 healthy volunteers were examined by axial T2 mapping and morphological MRI at 3.0 Tesla. Regions of interest were drawn on a single slice for the facet joints and the intervertebral discs (nucleus pulposus, anterior and posterior annulus fibrosus). The Weishaupt grading was used for facet joints and the Pfirrmann score was used for morphological disc grading (''normal'' vs. ''abnormal'' discs). The inter-rater agreement was excellent for the facet joint T2 evaluation (r = 0.85), but poor for the morphological Weishaupt grading (kappa = 0.15). The preliminary results show similar facet joint T2 values in segments with normal and abnormal Pfirrmann scores. There was no difference in mean T2 values between facet joints in different Weishaupt grading groups. Facet joint T2 values showed a weak correlation with T2 values of the posterior annulus (r = 0.32) This study demonstrates the feasibility of a combined T2 mapping approach for the facet joints and intervertebral discs using a single axial slab. (orig.)

  18. Septic arthritis of a lumbar facet joint; Arthrite septique interapophysaire posterieure lombaire

    Energy Technology Data Exchange (ETDEWEB)

    Ben Hamouda, M.; Rajhi, H.; Golli, M.; Ganouni, A.; Bergaoui, N. [Centre Hospitalier Universitaire de Monastir (Tunisia); Chaouch, A. [Centre Hospitalier Universitaire de Mahdia (Tunisia); Hassine, H. [Centre Hospitalier Universitaire de Sahloul, Sousse (Tunisia)

    1997-05-01

    Septic arthritis of the posterior lumbar joints is extremely rare. The clinical picture of the unusual site of infection can easily lead to confusion with spondylo-discitis which is more common. We report a case of a 50-year-old women with Staphylococcus aureus septic arthritis of the left L5-S1 lumbar facet joint. CT scan was helpful to establish the diagnosis and to guide the percutaneous needle biopsy. (authors). 10 refs.

  19. Talocalcaneal Joint Middle Facet Coalition Resection With Interposition of a Juvenile Hyaline Cartilage Graft.

    Science.gov (United States)

    Tower, Dyane E; Wood, Ryan W; Vaardahl, Michael D

    2015-01-01

    Talocalcaneal joint middle facet coalition is the most common tarsal coalition, occurring in ≤2% of the population. Fewer than 50% of involved feet obtain lasting relief of symptoms after nonoperative treatment, and surgical intervention is commonly used to relieve symptoms, increase the range of motion, improve function, reconstruct concomitant pes planovalgus, and prevent future arthrosis from occurring at the surrounding joints. Several approaches to surgical intervention are available for patients with middle facet coalitions, ranging from resection to hindfoot arthrodesis. We present a series of 4 cases, in 3 adolescent patients, of talocalcaneal joint middle facet coalition resection with interposition of a particulate juvenile hyaline cartilaginous allograft (DeNovo(®) NT Natural Tissue Graft, Zimmer, Inc., Warsaw, IN). With a mean follow-up period of 42.8 ± 2.9 (range 41 to 47) months, the 3 adolescent patients in the present series were doing well with improved subtalar joint motion and decreased pain, and 1 foot showed no bony regrowth on a follow-up computed tomography scan. The use of a particulate juvenile hyaline cartilaginous allograft as interposition material after talocalcaneal middle facet coalition resection combined with adjunct procedures to address concomitant pes planovalgus resulted in good short-term outcomes in 4 feet in 3 adolescent patients. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  20. Severe Facet Joint Arthrosis Caused C7/T1 Myelopathy: A Case Report

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    Toshimi Aizawa

    2009-01-01

    Full Text Available Cervical myelopathy is caused by degenerative processes of the spine including intervertebral disc herniation and posterior spur usually developing at C3/4 to C5/6. C7/T1 single level myelopathy is very rare because of the anatomical characteristics. Facet joint arthrosis can be a cause of cervical myelopathy but only a few cases have been reported. The authors report an extremely rare case of C7/T1 myelopathy caused by facet joint arthrosis. A 58-year-old male presented with hand and gait clumsiness. The radiological examinations revealed severe C7/T1 facet joint arthrosis with bony spur extending into the spinal canal, which compressed the spinal cord laterally. The T1 spinous process indicated nonunion of a “clay-shoveler's” fracture, which suggested that his cervico-thoracic spine had been frequently moved, and thus severe arthrosis had occurred in the facet joints. A right hemilaminectomy of C7 and C7/T1 facetectomy with single level spinal fusion led to complete neurological improvement.

  1. Arthrofibrosis involving the middle facet of the talocalcaneal joint in children and adolescents.

    Science.gov (United States)

    El Rassi, George; Riddle, Eric C; Kumar, S Jay

    2005-10-01

    Pain over the anterolateral aspect of the ankle in a patient with a history of repeated ankle sprains and with restricted subtalar movement may be associated with a tarsal coalition. Nineteen patients presented with such a history, but conventional imaging did not reveal a cartilaginous or osseous coalition. Since symptoms persisted despite nonoperative treatment, the middle facet was explored surgically. The purpose of this study was to discuss the operative findings and to report the results of treatment. Nineteen patients (twenty-three feet) with pain over the anterolateral aspect of the ankle or a history of repeated ankle sprains had restricted subtalar joint motion and inconclusive findings on diagnostic imaging, except for bone-scanning. Their ages ranged from 9.1 to 18.5 years. The middle facet of the subtalar joint was explored surgically through a 3 to 4-cm-long incision centered over the sustentaculum tali. The results at a mean of 5.8 years were classified as good, fair, or poor on the basis of pain, talocalcaneal joint motion, and shoe wear. Routine radiographs, computed tomography, and magnetic resonance imaging revealed no major abnormality, whereas technetium-99m bone scintigraphy consistently showed slightly increased isotope uptake in the middle facet. Surgical removal of a hypervascular and thickened capsule and synovium in the area of the middle facet of the subtalar joint decreased pain and improved subtalar motion. The final result was good in seventeen patients (twenty feet) and fair in two patients (three feet). There were no poor results. A diagnosis of inflammatory arthrofibrosis should be considered when a patient with a painful rigid flatfoot has normal findings on radiographs and hematological studies but increased isotope uptake in the middle facet of the talocalcaneal joint on bone scintigraphy. Excision of the hypervascular capsule and synovium from this area can result in resolution of the symptoms. Therapeutic Level IV.

  2. CHANGES FACETS JOINTS IN TRAUMA AND DEGENERATIVE DISEASES OF THE LUMBAR SPINE

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    V. V. Shchedrenok

    2011-01-01

    Full Text Available Produced spondilometric measurements of the lumbosacral spine is normal (20 cases and in patients with spinal cord injury and degenerative-dystrophic diseases of the spine (43 cases. The width of the facet joint space joints on both sides, its relation to the longitudinal axis of the body in degrees and another on the same level were studied. The width of the facet joint space at the lumbosacral level of 3.5–4.0 mm, the area of the intervertebral foramen varies from 96–132 mm2. Among the changes in the parameters of the vertebral-motor segment can distinguish moderate, marked and significant extent that is important in determining the amount of the alleged operation.

  3. Does joint effusion influence the clinical response to a single Hylan GF-20 injection for hip osteoarthritis?

    Science.gov (United States)

    Rennesson-Rey, Bénédicte; Rat, Anne-Christine; Chary-Valckenaere, Isabelle; Bettembourg-Brault, Isabelle; Juge, Nadine; Dintinger, Hervé; Pourel, Jacques; Loeuille, Damien

    2008-03-01

    To evaluate the influence of a joint effusion on the clinical response to a single injection of Hylan GF-20 for hip osteoarthritis. We prospectively included patients scheduled for intraarticular Hylan GF-20 injection to treat hip osteoarthritis. Disease severity was assessed based on the Kellgren-Lawrence radiological grade. Ultrasonography was performed to look for a joint effusion. The pain score on a visual analog scale, Lequesne algofunctional index, and WOMAC scores were recorded at baseline and 1, 3, and 6 months postinjection. The proportions of patients who met OARSI response criteria and who achieved Patient Acceptable Symptom State (PASS) thresholds were determined in the overall population and in the groups with and without a joint effusion at baseline. Of 55 included patients, 24 (44%) had an effusion at baseline. The baseline Lequesne index was significantly higher in the group with an effusion (11.9+/-3.6 versus 8.4+/-4.5) (p=0.003). The proportions of OARSI responders in the overall population were 31.8%, 39.4%, and 14.8% after 1, 3, and 6 months, respectively. The proportions of patients who achieved the PASS for pain and function were 52.4% and 50.0% after 1 month, 67.7% and 54.5% after 3 months, and 60.0% and 50.0% after 6 months, respectively. Presence of an effusion at baseline had no effect on any of the clinical response parameters. Presence of a joint effusion is associated with worse pain and functional impairment at baseline but has no influence on the clinical response to Hylan GF-20 in patients with hip osteoarthritis.

  4. Navigated Pin-Point Approach to Osteoid Osteoma Adjacent to the Facet Joint of Spine

    Science.gov (United States)

    Neo, Masashi; Takemoto, Mitsuru; Nishizawa, Kazuya; Imai, Shinji

    2016-01-01

    Osteoid osteoma (OO) is a benign osteoblastic tumor. Its curative treatment is complete removal of the nidus, where intraoperative localization of the nidus governs clinical results. However, treatment can be difficult since the lesion is often invisible over the bony surface. Accordingly, establishment of an ideal less invasive surgical strategy for spinal OO remains yet unsettled. We illustrate the efficacy of a computed tomography (CT)-based navigation system in excising OO located adjacent to the facet joint of spine. In our 2 cases, complete and pin-point removal of the nidus located close to the facet joint was successfully achieved, without excessive removal of the bone potentially leading to spinal instability and possible damage of nearby neurovascular structures. We advocate a less invasive approach to spinal OO, particularly in an environment with an available CT-based navigation system. PMID:26949472

  5. Evaluation of Facet Joint Arthrosis in Stenotic and Normal Lumbar Spines with MRI

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    Ebru Ozan

    2013-10-01

    Full Text Available Aim: To reveal the prevalence of lumbar facet joint arthrosis in normal and stenotic lumbar spines with magnetic resonance imaging. Material and Method: Study group consisted of 30 patients with complaints and findings of lower back pain, neurologic claudicatio and lumbar spinal stenosis detected at L3-4, L4-5 and/or L5-S1 with magnetic resonance imaging (cross section area of the dural sac

  6. Lumbar facet joint septic arthritis presenting atypically as acute abdomen – A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Aysha Rajeev

    2016-01-01

    Conclusion: The atypical presentation of facet joint septic arthritis is one of the reasons why early diagnosis is elusive. Definitive diagnoses with MRI and bacterial culture as well as prolonged antibiotic therapy are recommended in this condition.

  7. Negative magnetic resonance imaging in femoral neck stress fracture with joint effusion: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Seki, Nobutoshi; Okuyama, Koichiro; Kamo, Keiji; Chiba, Mitsuho [Akita Rosai Hospital, Department of Orthopedic Surgery, Odate, Akita (Japan); Shimada, Yoichi [Akita University School of Medicine, Department of Orthopedic Surgery, Akita (Japan)

    2016-06-15

    Femoral neck stress fracture (FNSF) is well documented in the orthopedic literature and is generally associated with strenuous activities such as long-distance running and military training. The diagnostic yield of magnetic resonance imaging (MRI) for FNSF was reported to be 100 %, and early MRI is recommended when this fracture is suspected. We encountered a 16-year-old male long-distance runner with FNSF in whom the left femoral neck showed no signal changes on MRI although an effusion was detected in the left hip joint. One month later, roentgenograms revealed periosteal callus and oblique consolidation of the left femoral neck, confirming the diagnosis of compression FNSF. Because FNSF with a normal bone marrow signal on MRI is very rare, this patient is presented here. (orig.)

  8. Geometry of the articular facets of the lateral atlanto-axial joints in the case of occipitalization.

    Science.gov (United States)

    Ryniewicz, A M; Skrzat, J; Ryniewicz, A; Ryniewicz, W; Walocha, J

    2010-08-01

    This study investigates if atlanto-occipital fusion affects the size and geometrical configuration of the articular facets of the atlanto-axial joint. Morphometric analysis was performed on the male adult skull, the occipital bone of which is assimilated with the first cervical vertebrae (the atlas). The perimeter, Feret's diameter, surface area, and circularity of the inferior articular fa-cets were measured. However, we did not observe significant bilateral differences in size of the inferior articular facets of the assimilated atlas compared to normal first cervical vertebrae. Geometrical conformation of the articular facets of the atlas and axis was assessed using a coordinate measuring machine (PMM - 12106, Leitz). The results obtained from this machine indicated that the inferior articular facets of the assimilated atlas presented asymmetrical orientation compared to the normal anatomy of the atlas. Hence, in the case of occipitalization, the gap between the articulating facets of the atlas and the axis was measured to be greater than in the normal atlanto-axial joint. Computer assisted tomography was applied to visualise the anatomical relationship between the inferior articular facets of the assimilated atlas and the corresponding facets located on the axis. In this case, radiographic examination revealed that the bilaterally articulating facets (inferior and superior) showed disproportion in their adjustment within the lateral atlanto-axial joints. Thus, we concluded that the fusion of the atlas with the occipital bone altered the geometry of the inferior articular facets of the atlas and influenced the orientation of the superior articular facets of the axis.

  9. Chronic suppurative joint effusion due to burkholderia pseudomallei: A case report

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    Madhavi Deshmukh

    2013-01-01

    Full Text Available Burkholderia pseudomallei, a Gram-negative bacillus is the causative agent of Melioidosis, a glanders-like disease, primarily a disease of animals. Melioidosis has been only a rare and sporadic disease in humans outside its endemic region. Currently, diagnosis of B. pseudomallei in the clinical laboratory is very difficult, owing to low awareness of physicians to the nonspecific clinical manifestations, lack of responsiveness among microbiologists outside endemic areas, identification systems in the average sentinel laboratory, and the biosafety conditions necessary to process these organisms. We report a case of chronic left hip joint effusion in a known case of diabetes mellitus. Gram stain of computed tomography (CT-guided aspirate from the joint revealed Gram-negative bacilli along with pus cells. Culture was confirmed as Burkholderia pseudomallei on Vitek2C, which was sensitive to ceftazidime and trimethoprim/sulfmethoxazole. Unfortunately, patient could not be started on appropriate antibiotics due to delay in detection and patient succumbed to severe septicemia. This case is reported to highlight importance of automated identification and sensitivity especially in nonendemic areas and unusual antibiogram of this organism for which disc diffusion method is not standardized.

  10. Septic arthritis of a lumbar facet joint: Detection with bone SPECT imaging

    Energy Technology Data Exchange (ETDEWEB)

    Swayne, L.C.; Dorsky, S.; Caruana, V.; Kaplan, I.L. (Morristown Memorial Hospital, NJ (USA))

    1989-08-01

    We present a rare case of septic arthritis of a lumbar facet joint with an associated epidural abscess resulting from Staphylococcus aureus. The infection was initially detected with planar bone scintigraphy and precisely localized with single photon emission computed tomography bone scintigraphy, despite an initially negative radiologic evaluation that included radiographs of the lumbar spine, lumbar myelography, and a postmyelography x-ray computed tomography scan. In the appropriate clinical setting, a bone scan demonstrating unilateral increased activity within the spine should raise the suspicion of inflammatory involvement of the posterior elements.

  11. Pseudomeningocele in communication with the facet joint: demonstration by computerized tomography-arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Ganiyusufoglu, Kursat; Ozturk, Cagatay; Sirvanci, Mustafa; Aksu, Neslihan; Hamzaoglu, Azmi [Florence Nightingale Hospital, Istanbul Bilim University, Istanbul Spine Center, Istanbul (Turkey)

    2008-08-15

    Pseudomeningocele is an uncommon but well-known complication of lumbar spine operations. Although it is mostly asymptomatic and managed conservatively in most cases, it is claimed as a causative factor of failed back surgery syndrome and requires surgery in some cases. Usually, its diagnosis is confidently done with imaging modalities such as magnetic resonance imaging, computed tomography and myelography. In this report, we describe a case of pseudomeningocele that communicated with a facet joint. The diagnostic approach for this unusual lesion and its probable causes are discussed. (orig.)

  12. Idiopathic septic arthritis of a lumbar facet joint associated with paraspinal abscess.

    Science.gov (United States)

    Kitova-John, Margarita Borislavova; Azim-Araghi, Ali; Sheikh, Faraz Tariq; Kitov, Borislav Dimitrov

    2015-08-13

    A 48-year-old woman presented with a 1-month history of severe lower back pain on a background of 24 h of mild fever and general tiredness with an associated right-sided foot drop. Five weeks after the onset and with no improvement in symptoms in spite of analgesia and physiotherapy, the patient had a lumbar spine MRI which demonstrated a collection extending from the facet joints of L5 and L6 to the iliacus muscle on the right. A CT-guided aspiration was performed with a lengthy hospital stay for intravenous antibiotic treatment. The culture and sensitivity study of the aspirate isolated Streptococcus pneumoniae.

  13. Relationships between disk displacement, joint effusion, and degenerative changes of the TMJ in TMD patients based on MRI findings.

    Science.gov (United States)

    Roh, Hee-Seok; Kim, Wook; Kim, Young-Ku; Lee, Jeong-Yun

    2012-04-01

    This study was performed to investigate the relationships between disk displacement, joint effusion, and degenerative changes in patients with temporomandibular disorders using MRI. Randomly selected MRIs of 508 temporomandibular joints of 254 patients (92 males and 162 females, mean age was 30.5±12.0 years) were reviewed retrospectively. Seventy-eight percent (198 out of 254) of the patients complained of joint pain. Compared with joints with a normal disk position, the joints with anterior disk displacement with reduction showed a 2.01 odds ratio (Pdegenerative changes and a 2.85 odds ratio (Pdegenerative changes and a 4.61 odds ratio (Pdegenerative changes and joint effusions increase with displacement of the disk position in patients with temporomandibular disorders. Although all disk displacement situations do not progress to painful joints and/or degenerative joint diseases, the possibility of an increased risk of progression by a breakdown in the balance between a patient's adaptive capacity and functional loading of the TMJ should be assessed in each and every patient through comprehensive evaluation of various contributing factors.

  14. Does therapist’s attitude affect clinical outcome of lumbar facet joint injections?

    Institute of Scientific and Technical Information of China (English)

    Marcus Middendorp; Konstantinos Kollias; Hanns Ackermann; Annina Splettst??er; Thomas J Vogl; M Fawad Khan; Adel Maataoui

    2016-01-01

    AIM: To investigate if the clinical outcome of intraarticular lumbar facet joint injections is affected by the therapist’s attitude. METHODS: A total of 40 patients with facet jointassociated chronic low back pain were randomly divided into two groups. All patients received computed tomography-guided, monosegmental intra-articular facet joint injections. Following the therapeutic procedure, the patients of the experimental group(EG) held a conversation with the radiologist in a comfortable atmosphere. During the dialog, the patients were encouraged to ask questions and were shown four images. The patients of the control group(CG) left the clinic without any further contact with the radiologist. Outcome was assessed using a pain-based Verbal Numeric Scale at baseline, at 1 wk and at 1, 3, and 6 mo after first treatment. RESULTS: The patient demographics showed no differences between the groups. The patients of the EG received 57 interventional procedures in total, while the patients of the CG received 70 interventional procedures. In both groups, the pain scores decreased significantly over the entire observation period. Compared to the CG, the EG showed a statistically significant reduction of pain at 1 wk and 1 mo post-treatment, while at 3 and 6 mo after treatment, there were no significant differences between both groups. CONCLUSION: Our results show a significant effect on pain relief during the early post-interventional period in the EG as compared to the CG. The basic principle behind the higher efficacy might be the phenomenon of hetero-suggestion.

  15. Pigmented villonodular synovitis originating from the lumbar facet joint: a case report

    Science.gov (United States)

    Oe, Kenichi; Yoshida, Yugo; Ohnari, Hiroyuki; Iida, Hirokazu; Sakaida, Noriko; Uemura, Yoshiko

    2007-01-01

    The authors successfully treated a rare case of pigmented villonodular synovitis (PVNS) that originated from the lumbar facet joint (L4-5). A 43-year-old man presented with a complaint of left severe sciatica causing difficulty in walking. Magnetic resonance imaging (MRI) demonstrated an extradural mass on the left side at L4 and the mass compressed the dural tube and was continuous with the left L4-5 facet joint. A computed tomography myelogram revealed an extradural defect of contrast medium at the L4 level and an erosion of the L4 lamina. A total synovectomy with unilateral osteoplastic laminectomy was performed. The histological findings were a diagnosis of PVNS. The patient’s symptoms resolved completely and the MRI at postoperative 3 years demonstrated no recurrence of PVNS. It is important to totally remove the synovium, which is the origin of PVNS in order to prevent the recurrence. We think that our procedure is reasonable and adequate for lumbar PVNS. PMID:17566795

  16. The Variation in the Lumbar Facet Joint Orientation in an Adult Asian Population and Its Relationship with the Cross-Sectional Area of the Multifidus and Erector Spinae

    Science.gov (United States)

    Katayose, Masaki; Watanabe, Kota

    2016-01-01

    Study Design Cross-sectional study of healthy volunteers. Purpose We aimed to investigate the variation in the lumbar facet joint orientation in an adult Asian population. The relationship between the facet joint orientation and muscle cross-sectional area (CSA) of multifidus and erector spinae was also clarified. Overview of Literature Several studies have reported that lumbar pathologies, such as lumbar spondylolysis and degenerative spondylolisthesis, were related to the horizontally shaped lumbar facet joint orientation at the lower lumbar level. However, data regarding variations in the facet joint orientation in asymptomatic subjects have not been well documented. Methods In 31 healthy male adult Asian volunteers, the facet joint orientation and CSA of multifidus and erector spinae were measured using magnetic resonance imaging at the L4–5 and L5–S1 levels. Variation in the facet joint orientation was examined using coefficients of variation (CV). Pearson's product-moment coefficient was used to investigate the relationship between the facet joint orientation and CSA of multifidus and erector spinae. Results Lumbar facet joint orientation had a wider range of variation at L5–S1 (CV=0.30) than at L4–5 (CV=0.18). The L4–5 facet joint orientation had a weak but significant correlation with the CSA of erector spinae (r=0.40; p=0.031). The CSA of the multifidus had no relationship with the facet joint orientation at the L4–5 (r=0.19; p=0.314) and the L5–S1 level (r=0.19; p=0.312). Conclusions The lumbar facet joint orientation was found to have a wide variation, particularly at the L5–S1 in the Asian adult population, and the facet joint orientation had a relationship with the CSA of the erector spinae at the L4–5.

  17. Giant solitary thoracic osteochondroma arising from the facet joint: A case report and review of the literature

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    Turgut, Mehmet [Department of Neurosurgery, Adnan Menderes University School of Medicine, TR-09100 Aydin (Turkey)], E-mail: drmturgut@yahoo.com; Meteoglu, Ibrahim; Erdogdu, Ibrahim Halil [Department of Pathology, Adnan Menderes University School of Medicine, TR-09100 Aydin (Turkey)

    2008-08-15

    The authors report a relatively rare case of a giant thoracic solitary osteochondroma arising from the facet joint of T9 vertebra and involving the corresponding transverse process and rib. A 39-year-old woman presented with pain in the back. Neuroradiological evaluation of the spine showed a giant mass lesion involving the facet joint of T9 vertebra and concomitant corresponding transverse process and rib on the left side. At surgery, a firm and cartilaginous tumour originating from the facet joint was radically excised and surgical curettage of the lesion was performed. Histological examination revealed that the lesion was osteochondroma. It is concluded that accurate and prompt diagnosis requires high index of suspicion followed by surgical treatment to prevent severe morbidity in cases of primary spinal column tumours.

  18. Delayed surgical treatment for a traumatic bilateral cervical facet joint dislocation using a posterior-anterior approach: a case report

    Directory of Open Access Journals (Sweden)

    Shimada Takashi

    2013-01-01

    Full Text Available Abstract Introduction There have been few reports of patients with bilateral cervical facet dislocations that remain untreated for eight weeks or more. We report the case of a 76-year-old man with an old bilateral cervical facet joint dislocation fracture that was treated by posterior-anterior reduction and fixation. Case presentation A 76-year-old Asian man was involved in a road traffic accident. He presented with neck pain and arm pain on his right side, but motor weakness and paralysis were not observed. He was treated conservatively; however, instability and spondylolisthesis at the C5 to C6 joint increased eight weeks after the injury. We performed a posterior-anterior reduction and fixation. After surgery, bony union was achieved, and his neck pain and arm pain disappeared. Conclusion We recommend reduction and fixation surgery if a patient has an old bilateral facet joint dislocation fracture in the cervical spine.

  19. Lumbar facet joint synovial cysts: does T2 signal intensity predict outcomes after percutaneous rupture?

    Science.gov (United States)

    Cambron, S C; McIntyre, J J; Guerin, S J; Li, Z; Pastel, D A

    2013-08-01

    Lumbar facet synovial cysts are a cause of back pain and radiculopathy with facet joint degeneration, the most common cause for cyst formation. Typically, LFSCs are T2 hyperintense on MR imaging, but the signal intensity is variable. Treatment options include percutaneous rupture and surgical resection. This study evaluates the relationship between LFSC signal intensity on MR imaging and outcomes as it relates to percutaneous rupture success and need for subsequent surgery. A retrospective review of 110 patients who underwent CT fluoroscopic-guided rupture of symptomatic LFSCs was performed. The LFSCs were characterized by their T2 signal intensity on MR imaging and divided into 3 groups: high, intermediate, and low T2 signal intensity. The rates of successful cyst rupture and need for subsequent surgery were recorded. Percutaneous LFSC rupture was technically successful in 87% of all cases. Cyst rupture was successful in 89% and 90% of high and intermediate signal intensity cysts, respectively, and in 65% of low signal intensity cysts (P = .017, .030). High signal intensity cysts had lower postprocedural surgical rates (29%) when compared with intermediate and low signal cyst as a group (P = .045). T2 hyperintense and intermediate signal intensity LFSCs are easier to rupture, perhaps because the cysts contain a higher proportion of fluid and are less gelatinous or calcified than T2 hypointense cysts. Patients with T2 hyperintense LFSCs are less likely to need surgery.

  20. Internal morphology of human facet joints: comparing cervical and lumbar spine with regard to age, gender and the vertebral core.

    Science.gov (United States)

    Wilke, Hans-Joachim; Zanker, Daniel; Wolfram, Uwe

    2012-03-01

    Back pain constitutes a major problem in modern societies. Facet joints are increasingly recognised as a source of such pain. Knowledge about the internal morphology and its changes with age may make it possible to include the facets more in therapeutic strategies, for instance joint replacements or immobilisation. In total, 168 facets from C6/7 and L4/5 segments were scanned in a micro-computed tomography. Image analysis was used to investigate the internal morphology with regard to donor age and gender. Additional data from trabecular bone of the vertebral core allowed a semi-quantitative comparison of the morphology of the vertebral core and the facets. Porosity and pore spacing of the cortical sub-chondral bone does not appear to change with age for either males or females. In contrast, bone volume fraction decreases in females from approximately 0.4 to 0.2 , whereas it is constant in males. Trabecular thickness decreases during the ageing process in females and stays constant in males , whereas trabecular separation increases during the ageing process in both genders. The results of this study may help to improve the understanding of pathophysiological changes in the facet joints. Such results could be of value for understanding back pain and its treatment.

  1. A novel approach to symptomatic lumbar facet joint synovial cyst injection and rupture using iGuide navigational software: A case report and review.

    Science.gov (United States)

    Wang, David J; Lownie, Stephen P; Pelz, David; Pandey, Sachin

    2016-10-01

    Spinal synovial cysts are benign protrusions of facet joint capsules caused by degenerative spondylosis, most frequently involving the L4-5 level, and commonly lead to symptoms of back pain, radiculopathy and neurogenic claudication. Although percutaneous treatment via facet joint steroid injection with cyst rupture can provide significant symptom relief, cyst rupture is not always achievable via an indirect trans-facet approach due to limited access from severe degenerative changes. In this case, we describe a successful approach to direct cyst access using a laser-guided navigational software in a patient with severe facet joint osteophytosis. We provide a brief review of literature. © The Author(s) 2016.

  2. Is sustained natural apophyseal glides combined with conventional physiotherapy effective for patients with facet joint syndrome? – A case series

    Directory of Open Access Journals (Sweden)

    Deepak B. Anap, Subhash Khatri, Zambre BR

    2014-11-01

    Full Text Available Background: Chronic back pain has been the nemesis of the human race since the time they evolved and began walking on their two legs; leaving aside the 4 limb locomotion of their predecessors. Varied are the causes of low back ache and facet joint syndrome is one amongst them. Hence this study was undertaken to find out the effectiveness of SNAGS and conventional physiotherapy in patients with lumbar facet joint syndrome. Purpose: To describe the management and outcomes of 4 patients with lumbar facet joint syndrome treated with Sustained Natural apophyseal glides (SNAGs, Therapeutic Ultrasound and lumbar stabilization exercises. Study Design : A case series of consecutive patients with Lumbar facet syndrome Case Description: Four consecutive patients (mean age 52 years who presented with lumbar facet syndrome were treated with two weeks protocol which included Sustained Natural apophyseal glides, Therapeutic Ultrasound (Cont. 1-MHz , 2.0-W/cm2, 10min and lumbar stabilization exercises. Follow up was taken 1 week after the end of active intervention. All patients completed Visual analogue Scale (VAS, Modified Oswestery Disability Questionnaire (MODQ, Sorensen Test hold Timing and spinal Range of motion on initial assessment, immediately at the end of active intervention (2 weeks and at the end of follow up. Outcome: All four patients showed the mean percentage change in score of VAS 49.87 %, MODQ 61.14 %, Sorensen test scores 19.63 %, Flexion range 9.21 % and extend range 17.07 % at the end of follow up. Conclusion: All four patients with Lumbar facet joint syndrome treated with sustained natural apophyseal glides (SNAGS, Therapeutic Ultrasound and lumbar stabilisation exercises exhibited reduced pain, reduced disability, improved endurance of back muscles and range of motion at the time follow-up.

  3. Management of low back pain with facet joint injections and nerve root blocks under computed tomography guidance. A prospective study

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    Fotiadou, Anastasia; Wojcik, Andrew; Shaju, Antony [Hinchingbrooke Hospital NHS Trust, Huntingdon, Cambridge (United Kingdom)

    2012-09-15

    The aim of this work was to assess the performance of facet joint and nerve root infiltrations under computed tomography guidance for the management of low back pain and to investigate the complications and patient tolerance. The study was board-certified and informed consent was obtained from all patients. In 1 year, 86 consecutive patients (47 male, 39 female, age range 47-87 years, mean age 63) with low back pain for more than 2 years were included. All patients were clinically examined and had cross-sectional imaging performed before the procedure. Fifty-five facet joint infiltrations and 31 nerve blocks were performed under computed tomography guidance. All patients completed two valid pain questionnaires before and 3 months after the procedures. At the same time, they were clinically examined by the referring Orthopaedic Surgeon. The pain response was assessed by comparing the scores of the questionnaires. The improvement in clinical examination findings was assessed as well. In patients who underwent facet joint infiltrations, long-term pain improvement was achieved in 79% and in those with nerve blocks in 85%. Immediate pain relief was demonstrated in 83% of patients with nerve infiltrations. No complications were observed. All procedures were very well tolerated by patients. Facet joint and nerve infiltrations under computed tomography guidance constitute an accurate and safe method that could be used to relieve low back pain and minimize the risk of disability. (orig.)

  4. Diagnostic value of lumbar facet joint injection: a prospective triple cross-over study.

    Directory of Open Access Journals (Sweden)

    Uwe Schütz

    Full Text Available The diagnosis "lumbar facet syndrome" is common and often indicates severe lumbar spine surgery procedures. It is doubtful whether a painful facet joint (FJ can be identified by a single FJ block. The aim of this study was to clarify the validity of a single and placebo controlled bilateral FJ blocks using local anesthetics. A prospective single blinded triple cross-over study was performed. 60 patients (31 f, 29 m, mean age 53.2 yrs (22-73 with chronic low back pain (mean pain persistance 31 months, 6 months of conservative treatment without success admitted to a local orthopaedic department for surgical or conservative therapy of chronic LBP, were included in the study. Effect on pain reduction (10 point rating scale was measured. The 60 subjects were divided into six groups with three defined sequences of fluoroscopically guided bilateral monosegmental lumbar FJ test injections in "oblique needle" technique: verum-(local anaesthetic-, placebo-(sodium chloride- and sham-injection. Carry-over and periodic effects were evaluated and a descriptive and statistical analysis regarding the effectiveness, difference and equality of the FJ injections and the different responses was performed. The results show a high rate of non-response, which documents the lack of reliable and valid predictors for a positive response towards FJ blocks. There was a high rate of placebo reactions noted, including subjects who previously or later reacted positively to verum injections. Equivalence was shown among verum vs. placebo and partly vs. sham also. With regard to test validity criteria, a single intraarticular FJ block with local anesthetics is not useful to detect the pain-responsible FJ and therefore is no valid and reliable diagostic tool to specify indication of lumbar spine surgery. Comparative FJ blocks with local anesthetics and placebo-controls have to be interpretated carefully also, because they solely give no proper diagnosis on FJ being main pain

  5. Changes in voluntary quadriceps activation predict changes in muscle strength and gait biomechanics following knee joint effusion.

    Science.gov (United States)

    Pietrosimone, Brian; Lepley, Adam S; Murray, Amanda M; Thomas, Abbey C; Bahhur, Nael O; Schwartz, Todd A

    2014-09-01

    It has been hypothesized that arthrogenic muscle inhibition is responsible for altering physical function following knee injury. The association between the onset of arthrogenic muscle inhibition, measured using voluntary quadriceps activation, and changes in muscle strength and gait biomechanics are unknown. Outcomes were collected before and following a 60 ml experimental knee effusion in eighteen healthy participants. Voluntary quadriceps activation was the predictor variable, while the criterion variable included, maximal voluntary isometric strength, peak knee flexion angle, peak internal knee extension moment, and peak vertical ground reaction forces during the first half of stance phase upon stair descent. Percent change scores (Δ) were imputed into linear regression equations to determine associations between predictor and criterion variables. The variance in Δ voluntary quadriceps activation significantly predicted 87% the variance in the Δ strength (R(2)=0.87, Pknee flexion angle, Δ voluntary quadriceps activation predicted an additional 29% (Δ R(2)=0.29, P=0.007) of the variance in the Δ knee extension moment (R(2)=0.54, P=0.003, Δ knee extension moment=-10.79+0.74Δ knee flexion angle+1.64Δ voluntary quadriceps activation) following knee effusion. Immediate quadriceps activation deficits following joint effusion result in immediate alterations in muscle strength, knee extensor moment and vertical ground reaction force during gait. Published by Elsevier Ltd.

  6. Metaphyseal osteomyelitis in children: how often does MRI-documented joint effusion or epiphyseal extension of edema indicate coexisting septic arthritis?

    Energy Technology Data Exchange (ETDEWEB)

    Schallert, Erica K.; Kan, J.H.; Monsalve, Johanna; Zhang, Wei; Bisset, George S. [Texas Children' s Hospital, Department of Pediatric Radiology, Houston, TX (United States); Rosenfeld, Scott [Texas Children' s Hospital, Department of Pediatric Orthopedic Surgery, Houston, TX (United States)

    2015-08-15

    Joint effusions identified by MRI may accompany osteomyelitis and determining whether the joint effusion is septic or reactive has important implications on patient care. Determine the incidence of epiphyseal marrow edema, joint effusions, perisynovial edema and epiphyseal non-enhancement in the setting of pediatric metaphyseal osteomyelitis and whether this may be used to predict coexisting septic arthritis. Following IRB approval, we retrospectively evaluated children who underwent MRI and orthopedic surgical consultation for suspected musculoskeletal infection between January 2011 and September 2013. Criteria for inclusion in the study were microbiologically/pathologically proven infection, MRI prior to surgical intervention, long bone involvement and age 0-18 years. MRI exams were independently reviewed by two faculty pediatric radiologists to confirm the presence of appendicular metaphyseal osteomyelitis, to evaluate extent of edema, to determine subjective presence of a joint effusion and to assess perisynovial edema and epiphyseal non-enhancement. Any discrepant readings were reviewed in consensus. Charts and operative notes were reviewed to confirm the diagnosis of osteomyelitis and septic arthritis. One hundred and three joints with metaphyseal osteomyelitis were identified (mean age: 7.1 years; M:F 1.3:1), of whom 53% (55/103) had joint effusions, and of those, 75% (41/55) had surgically confirmed septic arthritis. The incidence of coexisting septic arthritis was 40% in the setting of epiphyseal edema, 74% in epiphyseal edema and effusion, 75% with perisynovial edema, 76% with epiphyseal non-enhancement and 77% when all four variables were present. Of these, the only statistically significant variable, however, was the presence of a joint effusion with a P-value of <0.0001 via Fisher exact test. Statistical significance for coexisting septic arthritis was also encountered when cases were subdivided into intra-articular vs. extra-articular metaphyses (P

  7. Finite element lumbar spine facet contact parameter predictions are affected by the cartilage thickness distribution and initial joint gap size.

    Science.gov (United States)

    Woldtvedt, Daniel J; Womack, Wesley; Gadomski, Benjamin C; Schuldt, Dieter; Puttlitz, Christian M

    2011-06-01

    Current finite element modeling techniques utilize geometrically inaccurate cartilage distribution representations in the lumbar spine. We hypothesize that this shortcoming severely limits the predictive fidelity of these simulations. Specifically, it is unclear how these anatomically inaccurate cartilage representations alter range of motion and facet contact predictions. In the current study, cadaveric vertebrae were serially sectioned, and images were taken of each slice in order to identify the osteochondral interface and the articulating surface. A series of custom-written algorithms were utilized in order to quantify each facet joint's three-dimensional cartilage distribution using a previously developed methodology. These vertebrae-dependent thickness cartilage distributions were implemented on an L1 through L5 lumbar spine finite element model. Moments were applied in three principal planes of motion, and range of motion and facet contact predictions from the variable thickness and constant thickness distribution models were determined. Initial facet gap thickness dimensions were also parameterized. The data indicate that the mean and maximum cartilage thickness increased inferiorly from L1 to L5, with an overall mean thickness value of 0.57 mm. Cartilage distribution and initial facet joint gap thickness had little influence on the lumbar range of motion in any direction, whereas the mean contact pressure, total contact force, and total contact area predictions were altered considerably. The data indicate that range of motion predictions alone are insufficient to establish model validation intended to predict mechanical contact parameters. These data also emphasize the need for the careful consideration of the initial facet joint gap thickness with respect to the spinal condition being studied.

  8. Whiplash-like facet joint loading initiates glutamatergic responses in the DRG and spinal cord associated with behavioral hypersensitivity

    Science.gov (United States)

    Dong, Ling; Quindlen, Julia C.; Lipschutz, Daniel E.; Winkelstein, Beth A.

    2012-01-01

    The cervical facet joint and its capsule are a common source of neck pain from whiplash. Mechanical hyperalgesia elicited by painful facet joint distraction is associated with spinal neuronal hyperexcitability that can be induced by transmitter/receptor systems that potentiate the synaptic activation of neurons. This study investigated the temporal response of a glutamate receptor and transporters in the dorsal root ganglia (DRG) and spinal cord. Bilateral C6/C7 facet joint distractions were imposed in the rat either to produce behavioral sensitivity or without inducing any sensitivity. Neuronal metabotropic glutamate receptor-5 (mGluR5) and protein kinase C-epsilon (PKCε) expression in the DRG and spinal cord were evaluated on days 1 and 7. Spinal expression of a glutamate transporter, excitatory amino acid carrier 1 (EAAC1), was also quantified at both time points. Painful distraction produced immediate behavioral hypersensitivity that was sustained for 7 days. Increased expression of mGluR5 and PKCε in the DRG was not evident until day 7 and only following painful distraction; this increase was observed in small-diameter neurons. Only painful facet joint distraction produced a significant increase (p<0.001) in neuronal mGluR5 over time, and this increase also was significantly elevated (p ≤ 0.05) over responses in the other groups at day 7. However, there were no differences in spinal PKCε expression on either day or between groups. Spinal EAAC1 expression was significantly increased (p<0.03) only in the nonpainful groups on day 7. Results from this study suggest spinal glutamatergic plasticity is selectively modulated in association with facet-mediated pain. PMID:22578356

  9. The effect of augmented reality training on percutaneous needle placement in spinal facet joint injections.

    Science.gov (United States)

    Yeo, Caitlin T; Ungi, Tamas; U-Thainual, Paweena; Lasso, Andras; McGraw, Robert C; Fichtinger, Gabor

    2011-07-01

    The purpose of this study was to determine if augmented reality image overlay and laser guidance systems can assist medical trainees in learning the correct placement of a needle for percutaneous facet joint injection. The Perk Station training suite was used to conduct and record the needle insertion procedures. A total of 40 volunteers were randomized into two groups of 20. 1) The Overlay group received a training session that consisted of four insertions with image and laser guidance, followed by two insertions with laser overlay only. 2) The Control group received a training session of six classical freehand insertions. Both groups then conducted two freehand insertions. The movement of the needle was tracked during the series of insertions. The final insertion procedure was assessed to determine if there was a benefit to the overlay method compared to the freehand insertions. The Overlay group had a better success rate (83.3% versus 68.4%, p=0.002), and potential for less tissue damage as measured by the amount of needle movement inside the phantom (3077.6 mm(2) versus 5607.9 mm(2) , p =0.01). These results suggest that an augmented reality overlay guidance system can assist medical trainees in acquiring technical competence in a percutaneous needle insertion procedure. © 2011 IEEE

  10. A CT-Based Simulation Study to Compare the Risk of Facet Joint Violation by the Cervical Pedicle Screw Between Degenerative and Nondegenerative Cervical Spines.

    Science.gov (United States)

    Lee, Dong-Ho; Noh, Hyounmin; Hwang, Chang Ju; Lee, Choon Sung; Abumi, Kuniyoshi; Cho, Jae Hwan

    2017-02-01

    A retrospective case-control study. This study aimed (A) to compare entry points and trajectories of the cervical pedicle screw (CPS) between degenerative and nondegenerative spines, and (B) to evaluate the risk of facet joint violation by the CPS according to the degree of facet degeneration. Entry point, trajectories, and risk of misplacement of the CPS have been widely researched; however, its application to degenerative cervical spine has to be elucidated. Sixty patients who underwent cervical surgeries at our institution were classified into two groups according to cervical facet joint degeneration. A simulation program with 0.7-mm thickness axial computed tomographic images was used to evaluate facet joint violation by the CPS from C3 to C6. Horizontal and vertical offsets of entry points were measured from two different anatomical landmarks on lateral mass, namely the lateral notch and the center of the superior ridge. The transverse and sagittal angles of the screws were also measured. Facet joint violation was evaluated and classified into either "minor" (cervical spine group at all levels (P = 0.001-0.026). In addition, facet joint violation was more frequently found in severely degenerated facet joints than in mild to moderately degenerated facet joints (P = 0.011). The entry point of CPS was moved more superiorly in the degenerative cervical spine in this study, which increased the risk of facet joint violation in our patients. Thus, surgeons need to modify the insertion technique of the CPS or to insert lateral mass screw instead of the CPS when it is considered to insert screws at the uppermost vertebra in the degenerative cervical spine. 4.

  11. Systematic review of patient history and physical examination to diagnose chronic low back pain originating from the facet joints.

    Science.gov (United States)

    Maas, E T; Juch, J N S; Ostelo, R W J G; Groeneweg, J G; Kallewaard, J W; Koes, B W; Verhagen, A P; Huygen, F J P M; van Tulder, M W

    2017-03-01

    Patient history and physical examination are frequently used procedures to diagnose chronic low back pain (CLBP) originating from the facet joints, although the diagnostic accuracy is controversial. The aim of this systematic review is to determine the diagnostic accuracy of patient history and/or physical examination to identify CLBP originating from the facet joints using diagnostic blocks as reference standard. We searched MEDLINE, EMBASE, CINAHL, Web of Science and the Cochrane Collaboration database from inception until June 2016. Two review authors independently selected studies for inclusion, extracted data and assessed the risk of bias. We calculated sensitivity and specificity values, with 95% confidence intervals (95% CI). Twelve studies were included, in which 129 combinations of index tests and reference standards were presented. Most of these index tests have only been evaluated in single studies with a high risk of bias. Four studies evaluated the diagnostic accuracy of the Revel's criteria combination. Because of the clinical heterogeneity, results were not pooled. The published sensitivities ranged from 0.11 (95% CI 0.02-0.29) to 1.00 (95% CI 0.75-1.00), and the specificities ranged from 0.66 (95% CI 0.46-0.82) to 0.91 (95% CI 0.83-0.96). Due to clinical heterogeneity, the evidence for the diagnostic accuracy of patient history and/or physical examination to identify facet joint pain is inconclusive. Patient history and physical examination cannot be used to limit the need of a diagnostic block. The validity of the diagnostic facet joint block should be studied, and high quality studies are required to confirm the results of single studies.

  12. Symptomatic lumbar facet joint cysts treated by CT-guided intracystic and intra-articular steroid injections

    Energy Technology Data Exchange (ETDEWEB)

    Amoretti, Nicolas; Huwart, Laurent; Amoretti, Marie-Eve; Pellegrin, Amelie; Marcy, Pierre-Yves [Centre Hospital-Universitaire de Nice, Hopital Archet 2, Department of Radiology, Nice (France); Foti, Pauline [Centre Hospital-Universitaire de Nice, Departments of Epidemiology, Nice (France); Boileau, Pascal [Centre Hospital-Universitaire de Nice, Orthopaedic Surgery, Nice (France); Hauger, Olivier [Hopital Pellegrin, Centre Hospitalo-Universitaire de Bordeaux, Department of Radiology, Bordeaux (France)

    2012-12-15

    To evaluate percutaneous computed tomography (CT)-guided intracystic and intra-articular steroid injections for the treatment of lumbar facet joint cyst causing radicular pain. A single-centre prospective study involving 120 consecutive patients with symptomatic lumbar facet joint cyst-induced radicular pain was done (72 women, 48 men). The average age was 68.2 years (52-84). Patients were treated by percutaneous CT-guided intracystic and intra-articular steroid injections. The clinical course of nerve root pain was evaluated after 1 day, and 1, 3 and 6 months, with long-term follow-up after 12 months. Patient follow-ups in our series show supportive results: within 120 patients, 54% of patients were satisfied with a long-lasting result from the first intra-cystic and intra-articular steroid injections (n = 65), while 20.8% were satisfied with a long-lasting result from a second intervention. Combining these two results shows that 75% of patients were satisfied with a long-lasting result. Our results showed that percutaneous treatment of vertebral lumbar facet joint cysts by double injections is an effective and economic therapeutic technical management among 75% of our patients. Thus we recommend that it should be considered as a first choice of treatment. (orig.)

  13. Treatment of lumbar facet joint syndrome by CT-guided intraarticular infiltration of fact joints; Behandlung des lumbalen Facettensyndroms durch CT-gesteuerte Infiltration der Zwischenwirbelgelenke

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    Schleifer, J. [Knappschaftsklinik Puettlingen/Saar (Germany). Orthopaedische Abteilung; Fenzl, G. [Knappschaftsklinik Puettlingen/Saar (Germany). Orthopaedische Abteilung; Wolf, A. [Knappschaftsklinik Puettlingen/Saar (Germany). Radiologische Abteilung; Diehl, K. [Knappschaftsklinik Puettlingen/Saar (Germany). Radiologische Abteilung

    1994-11-01

    In 62 patients with facet syndrome a total of 205 joints were infiltrated, CT monitoring being used in all cases. Each facet joint was infiltrated with 0.3 ml bupivacaine and 0.8 ml methylprednisolone. The patients were divided into three groups. Group 1 consisted of 24 persons who had undergone lumbar disc surgery, group 2 of 23 patients with spondylarthrosis of the facet joints, and group 3 of 15 patients who had undergone lumbar disc surgery but hat additional spondylarthrosis. Very good results were defined as pain relief for longer than 4 weeks, good results as pain relief for up to 4 weeks and poor results as brief pain relief or none at all. In 27 patients facet infiltration was performed for the purpose of diagnosis. Results were significantly in group 2 than in group 1. In group 3 results were better than in group 1, but worse than in group 2. These differences were not statistical by significant. Seven patients in the diagnostic group had no pain relief, and facet syndrome was excluded. (orig.) [Deutsch] Bei 62 Patienten mit lumbalem Facettensyndrom wurden insgesamt 205 Zwischenwirbelgelenke (Facettengelenke) perkutan CT-gesteuert infiltriert. Je Gelenk wurden 0,3 ml Bupivacain und 0,8 ml Methylprednisolon intraartikulaer infiziert. Die Patienten wurden in 3 Gruppen unterteilt. Die 1. Gruppe umfasste 24 Patienten mit Postnukleotomiesyndrom, die 2. Gruppe 23 Patienten mit spondylarthrotischen Veraenderungen, die 3. Gruppe 15 bandscheibenoperierte Patienten mit zusaetzlicher Spondylarthrose. In Gruppe 2 fanden sich signifikant bessere Ergebnisse als in Gruppe 1. Gute Resultate ergab auch die dritte Gruppe, sie waren jedoch nicht signifikant besser als die der Gruppe 1. Die sorgfaeltige Auswahl der Patienten ist fuer den Erfolg der Behandlung entscheidend. Die Infiltrationsbehandlung der Zwischenwirbelgelenke hat nahezu keine Nebenwirkungen. Ausser zur Therapie wird das Verfahren diagnostisch zum Ausschluss eines Facettensyndromes im Rahmen der Abklaerung

  14. Significance of interfacet distance, facet joint orientation, and lumbar lordosis in spondylolysis.

    Science.gov (United States)

    Chung, Sang-Bong; Lee, Sungjoon; Kim, Hoon; Lee, Sun-Ho; Kim, Eun Sang; Eoh, Whan

    2012-04-01

    The aim of this study is to reveal the association between lumbar spondylolysis and several radiologic parameters, which had been suggested to be significant. The authors examine interfacet distance (IFD), facet joint orientation (FJO), and lumbar segmental lordosis (LSL) all together on the basis of lumbar computed tomography (CT) scan of 35 patients with L5 spondylolysis and 36 unaffected control groups. Thirty-five Korean military recruits, aged 19-23 (mean 20.9 years), were diagnosed as L5 spondylolysis by lumber CT scans. As a control group, 36 male Korean military recruits, aged 18-25 (mean 21.3 years), were reconfirmed as not affected by lumbar spondylolysis by CT scan when they visited our hospital complaining of back pain. This study compares IFD, FJO, and LSL for each lumbar segment between the spondylolytic and unaffected groups. We also propose the use of normal mean data of IFD, FJO, and LSL of lumbar vertebrae from 36 Korean young military recruits because each measurement has power as an absolute value, like data from an osteologic collection in other studies. Comparison of IFD between spondylolytic and unaffected individuals reveals significant differences at the L3, L4, and L5 level (P = 0.0384, P = 0.0219, and P lordosis were significantly different between patients with L5 spondylolysis and individuals without pars defect on L5. In the spondylolysis group, and the increase of IFD from L4 to S1 was less pronounced and the LSL at L5-S1 was more lordotic. Copyright © 2011 Wiley Periodicals, Inc.

  15. How to Reduce Bilateral Cervical Facet Joint Dislocation in Anterior Approach: A Trick to Avoid Anterior-Posterior-Anterior Surgical Procedures

    National Research Council Canada - National Science Library

    Jaeger, Martin

    2015-01-01

    .... These flexion distraction lesions in cervical spine occur as a subluxation or unilateral/bilateral dislocation of the facet joints, which often be accompanied by direct spinal cord and nerve root injury...

  16. Associations between joint effusion in the knee and gene expression levels in the circulation: a meta-analysis [version 1; referees: 3 approved

    Directory of Open Access Journals (Sweden)

    Marjolein J. Peters

    2016-01-01

    Full Text Available Objective: To identify molecular biomarkers for early knee osteoarthritis (OA, we examined whether joint effusion in the knee associated with different gene expression levels in the circulation. Materials and Methods: Joint effusion grades measured with magnetic resonance (MR imaging and gene expression levels in blood were determined in women of the Rotterdam Study (N=135 and GARP (N=98. Associations were examined using linear regression analyses, adjusted for age, fasting status, RNA quality, technical batch effects, blood cell counts, and BMI. To investigate enriched pathways and protein-protein interactions, we used the DAVID and STRING webtools. Results: In a meta-analysis, we identified 257 probes mapping to 189 unique genes in blood that were nominally significantly associated with joint effusion grades in the knee. Several compelling genes were identified such as C1orf38 and NFATC1. Significantly enriched biological pathways were: response to stress, gene expression, negative regulation of intracellular signal transduction, and antigen processing and presentation of exogenous pathways. Conclusion: Meta-analyses and subsequent enriched biological pathways resulted in interesting candidate genes associated with joint effusion that require further characterization. Associations were not transcriptome-wide significant most likely due to limited power. Additional studies are required to replicate our findings in more samples, which will greatly help in understanding the pathophysiology of OA and its relation to inflammation, and may result in biomarkers urgently needed to diagnose OA at an early stage.

  17. Fluoroscopy-guided intrA-articular facet joint steroid injection for the management of low back pain: Therapeutic effectiveness and arthrographic pattern

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Su Jin; Lee, Jun Woo; Lee, Guen Young; You, Ja Yeon; Kang, Heung Sik [Dept. of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam (Korea, Republic of); Chai, Jae Won [Dept. of Radiology, SMG-SNU Boramae Medical Center, Seoul (Korea, Republic of); Ahn, Joong Mo [Dept. of Radiology, University of Pittsburgh Medical Center, Pittsburgh (United States)

    2015-09-15

    To evaluate the effectiveness of fluoroscopy-guided intra-articular facet joint steroid injection for the management of low back pain, and to document the incidence of epidural leakage. In total, 320 facet joint injections of 244 consecutive patients were included in this study. All patients had undergone an intra-articular facet joint steroid injection in 2007 and had follow-up post-treatment medical records. The response to treatment was analyzed on the basis of chart documentation (aggravated, no change, slightly improved, much improved, no pain). Fluoroscopic arthrograms of the injections were retrospectively analyzed by two radiologists. Of the 244 patients, 85.2% (n = 208) showed improvement after an initial intra-articular facet joint steroid injection. A total of 77.9% (n = 162) of the patients showed symptom recurrence, with a median of a 69 day symptom-free interval, while 30.3% (n = 74) of the patients showed symptom-free intervals of more than six months. Overall, 74 (33.3%) of the 222 cases of intra-articular facet joint steroid injections without concomitant epidural steroid injection showed epidural leakage in fluoroscopic arthrograms. Fluoroscopy-guided intra-articular facet joint injection is a reliable technique for the management of low back pain, with excellent immediate effectiveness and good prolonged (> 2 months) pain relief. Epidural leakage during injection was detected in one-third of the cases.

  18. Determination of contact force at facet joint with different sagittal orientation under shearing loads:a finite element analysis

    Institute of Scientific and Technical Information of China (English)

    刘耀升; 陈其昕; 刘蜀彬

    2008-01-01

    with different facet joint angle.[Conclusion]The spatial orientation and geometric forms of the coronal facet articular surfaces are more effective in restricting motion in transversal and sagittal planes while assuming a minor role in resisting axial force or motion than sagittal facet articular surface.It Was presumed that anterior shear force play a more prominent contribution on the degeneration of the facet joint with coronal articular surface compared with posterior shear force.

  19. Biomechanical analysis of press-extension technique on degenerative lumbar with disc herniation and staggered facet joint.

    Science.gov (United States)

    Du, Hong-Gen; Liao, Sheng-Hui; Jiang, Zhong; Huang, Huan-Ming; Ning, Xi-Tao; Jiang, Neng-Yi; Pei, Jian-Wei; Huang, Qin; Wei, Hui

    2016-05-01

    This study investigates the effect of a new Chinese massage technique named "press-extension" on degenerative lumbar with disc herniation and facet joint dislocation, and provides a biomechanical explanation of this massage technique. Self-developed biomechanical software was used to establish a normal L1-S1 lumbar 3D FE model, which integrated the spine CT and MRI data-based anatomical structure. Then graphic technique is utilized to build a degenerative lumbar FE model with disc herniation and facet joint dislocation. According to the actual press-extension experiments, mechanic parameters are collected to set boundary condition for FE analysis. The result demonstrated that press-extension techniques bring the annuli fibrosi obvious induction effect, making the central nucleus pulposus forward close, increasing the pressure in front part. Study concludes that finite element modelling for lumbar spine is suitable for the analysis of press-extension technique impact on lumbar intervertebral disc biomechanics, to provide the basis for the disease mechanism of intervertebral disc herniation using press-extension technique.

  20. Termocoagulación facetaria lumbar: Experiencia en 252 pacientes Thermocoagulation of lumbar facet joints: Experience in 252 patients

    Directory of Open Access Journals (Sweden)

    J. E. Martínez-Suárez

    2005-10-01

    Full Text Available Se presentan 252 pacientes con el diagnóstico de dolor lumbar facetario a los que se le realizó la técnica quirúrgica de termocoagulación percutánea de la faceta articular. Nuestro propósito principal fue aliviar el dolor en estos pacientes, evaluamos la eficacia de la técnica con un 74,7% de resultados quirúrgicos satisfactorios, así como la descripción de diferentes aspectos como: edad, sexo, causas y la topografía segmentaria del dolor.Two hundred fifty two patients with diagnosis of lumbar facet joint pain underwent the surgical technique of percutaneous thermocoagulation of the facet joint. Our major aim was to relief pain in those patients. We assess the effectiveness of the technique, with 74.7% of surgical success, and we also describe different aspects such as: age, sex, causes and segmentary pain topography.

  1. Fluoroscopic caudal epidural injections in managing chronic axial low back pain without disc herniation, radiculitis, or facet joint pain

    Directory of Open Access Journals (Sweden)

    Manchikanti L

    2012-10-01

    Full Text Available Laxmaiah Manchikanti,1,2 Kimberly A Cash,1 Carla D McManus,1 Vidyasagar Pampati11Pain Management Center of Paducah, Paducah, 2Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY, USABackground: Chronic low back pain without disc herniation is common. Various modalities of treatments are utilized in managing this condition, including epidural injections. However, there is continued debate on the effectiveness, indications, and medical necessity of any treatment modality utilized for managing axial or discogenic pain, including epidural injections.Methods: A randomized, double-blind, actively controlled trial was conducted. The objective was to evaluate the ability to assess the effectiveness of caudal epidural injections of local anesthetic with or without steroids for managing chronic low back pain not caused by disc herniation, radiculitis, facet joints, or sacroiliac joints. A total of 120 patients were randomized to two groups; one group did not receive steroids (group 1 and the other group did (group 2. There were 60 patients in each group. The primary outcome measure was at least 50% improvement in Numeric Rating Scale and Oswestry Disability Index. Secondary outcome measures were employment status and opioid intake. These measures were assessed at 3, 6, 12, 18, and 24 months after treatment.Results: Significant pain relief and functional status improvement (primary outcome defined as a 50% or more reduction in scores from baseline, were observed in 54% of patients in group 1 and 60% of patients in group 2 at 24 months. In contrast, 84% of patients in group 1 and 73% in group 2 saw significant pain relief and functional status improvement in the successful groups at 24 months.Conclusion: Caudal epidural injections of local anesthetic with or without steroids are effective in patients with chronic axial low back pain of discogenic origin without facet joint pain, disc herniation, and

  2. Lumbar facet syndromes.

    Science.gov (United States)

    Beresford, Zach M; Kendall, Richard W; Willick, Stuart E

    2010-01-01

    Low back pain is a common presenting complaint to sports medicine providers. The lumbar spine is a complex anatomic structure with multiple potential pain generators. Epidemiologic studies have shown that the intervertebral disc is the most common pain generator in all patients with low back pain. The facet joints may account for 15%-40% of low back pain. It can be challenging at times to establish a firm diagnosis of facet pain. Facet pain can have different presentations, and pain emanating from other lumbopelvic structures can present similarly as facet joint pain. This article reviews the anatomy and biomechanics of the lumbar facet joints, presenting symptoms and physical examination findings seen with facet pain. We also will discuss diagnostic and treatment paradigms that are helpful to the clinician treating low back pain in athletes.

  3. Bloqueos diagnóstico-terapéuticos de carillas articulares cervicales Diagnostic-therapeutic cervical facet joint blocks

    Directory of Open Access Journals (Sweden)

    M.L. Franco

    2009-03-01

    Full Text Available El 66% de los adultos experimenta dolor cervical a lo largo de su vida y el 54% lo ha experimentado durante los pasados 6 meses. Sólo el 5% presentará dolor crónico intenso acompañado de incapacidad funcional. El 80% del dolor cervical se produce por lesiones óseas o musculares como consecuencia de la degeneración discal y facetaria, a lo que se pueden sumar agentes externos, como traumatismo, sobrepeso, sobrecargas laborales, estrés, etc. El diagnóstico del dolor cervical se basa, fundamentalmente, en la exploración física y en la clínica del paciente. Ante la presencia de dolor cervical irradiado a nuca, cintura escapulohumeral y miembro superior derecho sin patrón radicular con exploración positiva en carillas articulares, están indicados los bloqueos diagnóstico-terapéuticos de éstas. En el trabajo se describe la anatomía de la región cervical, cuyo conocimiento es imprescindible tanto para garantizar los buenos resultados, como para minimizar los riesgos, así como las indicaciones y práctica de la técnica.Cervical pain is experienced by 66% of adults during their lifetime and by 54% in the previous 6 months. Only 5% will experience intense chronic pain with functional disability. Eighty percent of cervical pain is produced by skeletal or muscular lesions as a result of disc and facet degeneration. External causative agents include trauma, overweight, occupational demands, stress, etc. Diagnosis of cervical pain is mainly based on physical examination and clinical findings. In cervical pain radiating to the neck, scapulohumeral girdle and upper right arm without a radicular pattern and positive examination of the facet joints, diagnostic-therapeutic facet joint blocks are indicated. The present article describes the anatomy of the cervical region. Knowledge of this region is essential to guarantee good results and to minimize risks. The indications and practical features of the technique are also discussed.

  4. A critical evaluation of subtalar joint arthrosis associated with middle facet talocalcaneal coalition in 21 surgically managed patients: a retrospective computed tomography review. Investigations involving middle facet coalitions-part III.

    Science.gov (United States)

    Kernbach, Klaus J; Barkan, Howard; Blitz, Neal M

    2010-01-01

    Symptomatic middle facet talocalcaneal coalition is frequently associated with rearfoot arthrosis that is often managed surgically with rearfoot fusion. However, no objective method for classifying the extent of subtalar joint arthrosis exists. No study has clearly identified the extent of posterior facet arthrosis present in a large cohort treated surgically for talocalcaneal coalition through preoperative computerized axial tomography. The authors conducted a retrospective review of 21 patients (35 feet) with coalition who were surgically treated over a 12-year period for coalition on at least 1 foot. Using a predefined original staging system, the extent of the arthrosis was categorized into normal or mild (Stage I), moderate (Stage II), and severe (Stage III) arthrosis. The association of stage and age is statistically significant. All of the feet with Stage III arthrosis had fibrous coalitions. No foot with osseous coalition had Stage III arthrosis. The distribution of arthrosis staging differs between fibrous and osseous coalitions. Only fibrous coalitions had the most advanced arthrosis (Stage III), whereas osseous coalitions did not. This suggests that osseous coalitions may have a protective effect in the prevention of severe degeneration of the subtalar joint. Concomitant subtalar joint arthrosis severity progresses with age; surgeons may want to consider earlier surgical intervention to prevent arthrosis progression in patients with symptomatic middle facet talocalcaneal coalition.

  5. Lumbar Facet Joint Compressive Injury Induces Lasting Changes in Local Structure, Nociceptive Scores, and Inflammatory Mediators in a Novel Rat Model

    Directory of Open Access Journals (Sweden)

    James L. Henry

    2012-01-01

    Full Text Available Objective. To develop a novel animal model of persisting lumbar facet joint pain. Methods. Sprague Dawley rats were anaesthetized and the right lumbar (L5/L6 facet joint was exposed and compressed to ~1 mm with modified clamps applied for three minutes; sham-operated and naïve animals were used as control groups. After five days, animals were tested for hind-paw sensitivity using von Frey filaments and axial deep tissue sensitivity by algometer on assigned days up to 28 days. Animals were sacrificed at selected times for histological and biochemical analysis. Results. Histological sections revealed site-specific loss of cartilage in model animals only. Tactile hypersensitivity was observed for the ipsi- and contralateral paws lasting 28 days. The threshold at which deep tissue pressure just elicited vocalization was obtained at three lumbar levels; sensitivity at L1>L3/4>L6. Biochemical analyses revealed increases in proinflammatory cytokines, especially TNF-α, IL-1α, and IL-1β. Conclusions. These data suggest that compression of a facet joint induces a novel model of local cartilage loss accompanied by increased sensitivity to mechanical stimuli and by increases in inflammatory mediators. This new model may be useful for studies on mechanisms and treatment of lumbar facet joint pain and osteoarthritis.

  6. Evaluation of a Robotic Assistance-System For Percutaneous Computed Tomography-Guided (CT-Guided) Facet Joint Injection: A Phantom Study.

    Science.gov (United States)

    Beyer, Lukas Philipp; Michalik, Katharina; Niessen, Christoph; Platz Batista da Silva, Natascha; Wiesinger, Isabell; Stroszczynski, Christian; Wiggermann, Philipp

    2016-09-20

    BACKGROUND The aim of this study was to compare robotic assisted and freehand facet joint puncture on a phantom model in regards to time requirements and puncture accuracy. MATERIAL AND METHODS Forty facet joints were punctured, 20 using a robotic guidance system and 20 using a freehand procedure. Side and height of the facet joints were randomized and identical for both groups. Procedural accuracy, defined as axial and sagittal deviation, as well as the number of corrections were assessed. Procedure times for each step were documented and time requirements for pre-positioning, reconstruction, planning, and total intervention were calculated. RESULTS Total procedure time for robotic guidance was 259±111 seconds versus 119±77 seconds for freehand procedure (p=1.0). Procedural accuracy for robotic guidance was significantly higher with 0 corrections versus 1.3 corrections for freehand procedure (p=0.02). Needle deviation in the robotics arm was 0.35±1.1 mm in the axial and 2.15±1.2 mm in the sagittal reconstruction. CONCLUSIONS Robotic assisted puncture of the facet joint allowed accurate positioning of the needle with a lower number of needle readjustments. Higher procedural accuracy was marginally offset by a slightly longer intervention time.

  7. Parent versus professional views of the developmental impact of a multi-faceted condition at school age: otitis media with effusion ('glue ear').

    Science.gov (United States)

    Higson, Josephine; Haggard, Mark

    2005-12-01

    Several aspects of children's health and development are known from empirical studies to be associated with otitis media with effusion (OME; 'glue ear'). The 'diffuse image' has been an obstacle to defining a core set of impacts about which inter-profession and parent-professional communication can be effective. The study quantifies similarities and differences in how the signs, symptoms, and developmental impact of OME are attributed and construed, between teachers, parents, and ear, nose, and throat (ENT)surgeons. Convenience samples were achieved of 118 teachers and 154 parents of affected children; 178 ENT surgeons from a professional sampling frame (association membership) responded. Questionnaires elicited the perceived frequency and concern-value of over 30 manifestations of OME--the various signs, symptoms, and behaviours suggested by the literature. Factor scores derived on the combined sample were compared between respondent groups. Teachers assign high importance to education and language problems but, relative to parents, they accord lower importance to continuing hearing problems. Teachers and parents weighted behaviour and balance problems similarly, placing behaviour higher, but balance lower, than the ENT specialists did. (1) A four-factor reduction of simple questionnaire items well defines the domains of impact of OME, and can express the ways in which views of impact differ between teachers, ENT specialists and parents.(2) Considerable differences of perspective exist between the groups examined. (3) In valuing a set of measured outcomes on actual children, or for other policy research, sets of weights are now available to represent the differing perspectives of parents and professionals (e.g. in testing robustness of a conclusion across differing stakeholder perspectives). (4) The research and development need in respect of teachers' involvement with OME could profitably play to existing strengths. This implies the systematic and structured

  8. Lumbar disc degeneration was not related to spine and hip bone mineral densities in Chinese: facet joint osteoarthritis may confound the association.

    Science.gov (United States)

    Pan, Jianjiang; Lu, Xuan; Yang, Ge; Han, Yongmei; Tong, Xiang; Wang, Yue

    2017-12-01

    A sample of 512 Chinese was studied and we observed that greater disc degeneration on MRI was associated with greater spine DXA BMD. Yet, this association may be confounded by facet joint osteoarthritis. BMD may not be a risk factor for lumbar disc degeneration in Chinese. Evidence suggested that lumbar vertebral bone and intervertebral disc interact with each other in multiple ways. The current paper aims to determine the association between bone mineral density (BMD) and lumbar disc degeneration using a sample of Chinese. We studied 165 patients with back disorders and 347 general subjects from China. All subjects had lumbar spine magnetic resonance (MR) imaging and dual- energy X-ray absorptiometry (DXA) spine BMD studies, and a subset of general subjects had additional hip BMD measurements. On T2-weighted MR images, Pfirrmann score was used to evaluate the degree of lumbar disc degeneration and facet joint osteoarthritis was assessed as none, slight-moderate, and severe. Regression analyses were used to examine the associations between lumbar and hip BMD and disc degeneration, adjusting for age, gender, body mass index (BMI), lumbar region, and facet joint osteoarthritis. Greater facet joint osteoarthritis was associated with greater spine BMD (P  0.05). No statistical association was observed between spine BMD and lumbar disc degeneration in patients with back disorders (P > 0.05), and between hip BMD and disc degeneration in general subjects (P > 0.05). BMD may not be a risk factor for lumbar disc degeneration in Chinese. Facet joint osteoarthritis inflates DXA spine BMD measurements and therefore, may confound the association between spine BMD and disc degeneration.

  9. An analysis on risk factors for lumbar facet joint osteoarthritis%腰椎小关节骨性关节炎危险因素分析

    Institute of Scientific and Technical Information of China (English)

    王庆华

    2012-01-01

    [Objective]To investigate the risk factors of lumbar facet joint osteoarthritis.[Methods]The ris factors of lumbar facet joint osteoarthritis were analyzed and summarized.[Results]Men aged 50 or older,postmenopausal women,lumbar facet joints tended to the sagittal plane,and lumbar intervertebral disc degeneration of L4 and 5 were the risk factors for lumbar facet joint osteoarthritis.[Conclusion]s The understanding of the risk factors for lumbar facet joint osteoarthritis can help in the diagnosis and treatment of low back pain,with social and economic benefits.%探讨腰椎小关节骨性关节炎危险因素.对以往腰椎小关节骨性关节炎的危险因素进行分析、归纳、研究、总结.研究发现,年龄在50岁以上的男性、绝经之后的女性以及腰椎小关节偏向矢状面和腰椎间盘退变、L4-5节段等为腰椎小关节骨性关节炎的危险因素.通过对腰椎小关节骨性关节炎的危险因素进行研究,能够对下腰痛的诊治提供有效的帮助,具有社会效益与经济效益.

  10. Cervical Facet Joint Infection and Associated Epidural Abscess with Streptococcus intermedius from a Dental Infection Origin A Case Report and Review.

    Science.gov (United States)

    Kaye, Ian David; Protopsaltis, Themistocles S

    2016-09-01

    Pyogenic cervical facet joint infections are rare and such infections from a dental origin are even less common. Of these few cases, none have described infection with Streptococcus intermedius as the pathogen. A 65-year-old orthopaedic surgeon complained of fevers, right-sided radiating neck pain, stiffness, swelling, erythema, and right upper extremity weakness one month after he had broken a crown over his right mandibular premolar, a continued source of pain. Imaging of the cervical spine showed a right C4-C5 facet inflammatory arthropathy and a small epidural abscess that was cultured and initially treated with intravenous antibiotics. The oral maxillofacial surgery team performed an extraction of the infected, symptomatic tooth. For continued right upper extremity weakness, the patient underwent C4-C5 laminoforaminotomy and irrigation and debridement of the right C4-C5 facet joint. After 6 weeks of intravenous antibiotics, the patient's infectious and inflammatory markers had normalized. By 4 months, he had regained full strength at his upper extremity and a painless and full range of motion of his cervical spine.Pyogenic cervical facet joint infection is very rare and potentially dangerous. A high clinical suspicion and appropriate imaging, including magnetic resonance imaging, are important for correct diagnosis. Prompt medical and surgical treatment may avert complications, and although the patient presented made a complete recovery, patients may be left with neurological compromise.

  11. Differences Regarding Branded HA in Italy, Part 2: Data from Clinical Studies on Knee, Hip, Shoulder, Ankle, Temporomandibular Joint, Vertebral Facets, and Carpometacarpal Joint

    Science.gov (United States)

    Migliore, A.; Bizzi, E.; De Lucia, O.; Delle Sedie, A.; Tropea, S.; Bentivegna, M.; Mahmoud, A.; Foti, C.

    2016-01-01

    OBJECTIVES The aim of the current study is to collect scientific data on all branded hyaluronic acid (HA) products in Italy that are in use for intra-articular (IA) injection in osteoarthritis (OA) compared with that reported in the leaflet. METHODS An extensive literature research was performed for all articles reporting data on the IA use of HA in OA. Selected studies were taken into consideration only if they are related to products based on HAs that are currently marketed in Italy with the specific joint indication for IA use in patients affected by OA. RESULTS Sixty-two HA products are marketed in Italy: 30 products are indicated for the knee but only 8 were proved with some efficacy; 9 products were effective for the hip but only 6 had hip indication; 7 products proved to be effective for the shoulder but only 3 had the indication; 5 products proved effective for the ankle but only one had the indication; 6 products were effective for the temporomandibular joint but only 2 had the indication; only 2 proved effective for vertebral facet joints but only 1 had the indication; and 5 products proved effective for the carpometacarpal joint but only 2 had the indication. CONCLUSIONS There are only a few products with some evidences, while the majority of products remain without proof. Clinicians and regulators should request postmarketing studies from pharmaceuticals to corroborate with that reported in the leaflet and to gather more data, allowing the clinicians to choose the adequate product for the patient. PMID:27279754

  12. A New CT Method for Assessing 3D Movements in Lumbar Facet Joints and Vertebrae in Patients before and after TDR

    Directory of Open Access Journals (Sweden)

    Per Svedmark

    2015-01-01

    Full Text Available This study describes a 3D-CT method for analyzing facet joint motion and vertebral rotation in the lumbar spine after TDR. Ten patients were examined before and then three years after surgery, each time with two CT scans: provoked flexion and provoked extension. After 3D registration, the facet joint 3D translation and segmental vertebral 3D rotation were analyzed at the operated level (L5-S1 and adjacent level (L4-L5. Pain was evaluated using VAS. The median (±SD 3D movement in the operated level for the left facet joint was 3.2 mm (±1.9 mm before and 3.5 mm (±1.7 mm after surgery and for the right facet joint was 3.0 mm (±1.0 mm before and 3.6 mm (±1.4 mm after surgery. The median vertebral rotation in the sagittal plane at the operated level was 5.4° (±2.3° before surgery and 6.8° (±1.7° after surgery and in the adjacent level was 7.7° (±4.0° before and 9.2° (±2.7° after surgery. The median VAS was reduced from 6 (range 5–8 to 3 (range 2–8 in extension and from 4 (range 2–6 to 2 (range 1–3 in flexion.

  13. MRI-guided focused ultrasound (MRgFUS) to treat facet joint osteoarthritis low back pain - case series of an innovative new technique

    Energy Technology Data Exchange (ETDEWEB)

    Weeks, Evan M.; Platt, Michael W. [St Mary' s Hospital, Imperial College Healthcare NHS Trust, Department of Anaesthesia and Pain Medicine, London (United Kingdom); Gedroyc, Wladyslaw [St Mary' s Hospital, Imperial College Healthcare NHS Trust, Department of Radiology, London (United Kingdom)

    2012-12-15

    To evaluate the safety and efficacy of magnetic resonance-guided focused ultrasound (MRgFUS) to treat facet joint osteoarthritis pain. Patients with a positive response to facet joint interventions were recruited from Pain and Spinal Clinics. Treatments were performed at the levels of pain according to symptomatology, previous invasive treatment and MRI grading of facet joint osteoarthritis. Both safety and efficacy data were collected. Pain palliation was evaluated using a validated pain numerical rating scale (NRS), Oswestry disability questionnaire (ODQ), Brief Pain Inventory (BPI) and the EuroQol (EQ-5D) health state score Eighteen patients were treated. There were no major adverse events. At 6/12 we found a reduction in both the NRS (average/worst) pain scores (60.2 %/51.2 %). This was associated with 45.9 % improvement in the ODQ score and 61.9 % reduction in the BPI interference score. We observed an improvement in the EuroQol (EQ-5D) health state score based on UK coefficients of +0.379 (0.317 to 0.696). Our phase I observational pilot study has evaluated an innovative new technique that is both non-invasive and radiation free. It is the first description of this procedure in the literature. In all patients the technique was safe, free of complications, effective and well tolerated. (orig.)

  14. Power Doppler sonography with and without echo-enhancing contrast agent and contrast-enhanced MRI for the evaluation of rheumatoid arthritis of the shoulder joint: differentiation between synovitis and joint effusion

    Energy Technology Data Exchange (ETDEWEB)

    Wamser, G. [Department of Diagnostic Radiology, Klinikum Augsburg, Augsburg (Germany); Diagnostic Radiology, Klinik Dr. Schindlbeck, Seestrasse 43, 82211, Herrsching (Germany); Bohndorf, K.; Vollert, K.; Buecklein, W. [Department of Diagnostic Radiology, Klinikum Augsburg, Augsburg (Germany); Schalm, J. [Department of Internal Medicine I, Klinikum Augsburg, Augsburg (Germany)

    2003-06-01

    To evaluate patients with clinically active rheumatoid arthritis (RA) of the shoulder for joint effusion and synovitis using conventional sonography, power Doppler (PD) sonography with and without echo-enhancing contrast agent, and contrast-enhanced MRI.Design and patients Twenty-four patients (mean age 64 years) with known RA had one symptomatic shoulder evaluated by conventional gray-scale sonography and PD sonography before and after intravenous administration of the echo-enhancing contrast agent Levovist (300 mg/ml, 2.5 g). The degree and extent of the altered echo pattern in the subacromial bursa, axillary recess and glenohumeral joint seen by conventional gray-scale sonography and the intensity of vascular signals of PD sonography were compared with the findings of MRI obtained with T2-weighted turbo spin-echo sequences and contrast-enhanced T1-weighted fat-saturated spin-echo sequences. MRI was evaluated by two readers in consensus without knowledge of the sonographic findings. MRI, which was used as the reference examination, detected joint effusion in 71% (17/24) and synovitis in 92% (22/24) of the patients. Conventional sonography revealed an abnormal articular echo pattern in 96% (23/24) of the patients, especially in the axillary recess and subacromial bursa, but failed to attribute the altered echo pattern to either fluid or specific synovitis. PD sonography allowed a specific diagnosis of synovitis in 33% (8 patients), which increased to 50% (12 patients) after administration of an echo-enhancing contrast agent. In 42% (10/24) of the patients, the findings of synovitis demonstrated by MRI corresponded to an altered echo pattern by conventional sonography, but vascular signals were absent by PD sonography with or without echo-enhancing contrast agent. Using MRI as the ''gold standard,'' PD sonography with and without echo-enhancing contrast agent cannot reliably identify synovitis or distinguish synovial inflammation from effusion

  15. Pan-regional (cervico-thoraco-lumbo-sacral spinal epidural abscess with multi-level discitis, vertebral body osteomyelitis and facet joint septic arthritis: complete resolution with non-operative management

    Directory of Open Access Journals (Sweden)

    Appukutty Manickam, MRCS

    2014-12-01

    Conclusion: Even pan-regional CTLS SEA with multi-level discitis, vertebral body osteomyelitis and facet joint septic arthritis can be managed non-operatively. A complete clinical and radiological resolution can be achieved with antibiotics alone.

  16. The relationship between the prevalance and size of lumbar ossified ligamentum flavum and the presence and degree of facet joint degeneration

    Energy Technology Data Exchange (ETDEWEB)

    Ergun, Tarkan, E-mail: tarkanergun@yahoo.com [Baskent University School Medicine, Departments of Radiology, Alanya Teaching and Medical Research Center, 07400 Alanya, Antalya (Turkey); Lakadamyali, Hatice, E-mail: adviyesalman@yahoo.com [Baskent University School Medicine, Departments of Radiology, Alanya Teaching and Medical Research Center, 07400 Alanya, Antalya (Turkey)

    2012-11-15

    Objectives: To investigate whether there is any relationship between the prevalence and the dimension of OLF and the presence and degree of facet joint degeneration. In addition, it revealed the prevalence and distribution of lumbar OLF with regard to age and spinal levels. Methods: The stone protocol abdominal CT images of 114 patients were retrospectively analyzed. Presence of OLF, degenerative changes in the posterior vertebral elements was evaluated on axial CT images and incidence for each finding was determined. Additionally, the degree of facet joint degeneration and size of OLF was evaluated and recorded. All findings were also grouped based on age and lumbar level. Results: OLF has been observed in 40 (35%) individuals at 76 (13%) lumbar levels. OLF has been most frequently encountered at the upper lumbar levels. Its frequency and size showed correlation to increased age. Frequency of OLF correlated with the presence of degenerative changes of in the posterior elements (p < 0.001). There was an association between the OLF size and the presence (p = 0.001) and degree of the degeneration in the posterior elements. There was no lumbar level case where the degree of OLF would lead to enough narrowing to be symptomatic. Conclusions: OLF prevalence and sizes increase parallel to age. Posterior elements' degenerative changes facilitate OLF development. A close relation exists between OLF size and facet joint degeneration. A direct relationship exists between OLF size and the degree of posterior elements degeneration. It is highly probable for lumbar level OLF size to be insufficient to cause any symptoms.

  17. A review of percutaneous techniques for low back pain and neuralgia: current trends in epidural infiltrations, intervertebral disk and facet joint therapies.

    Science.gov (United States)

    Filippiadis, Dimitrios K; Kelekis, Alexis

    2016-01-01

    Low back pain and neuralgia due to spinal pathology are very common symptoms debilitating numerous patients with peak prevalence at ages between 45 and 60 years. Intervertebral discs and facet joints act as pain sources in the vast majority of the cases. Diagnosis is based on the combination of clinical examination and imaging studies. Therapeutic armamentarium for low back pain and neuralgia due to intervertebral discs and/or facet joints includes conservative therapy, injections, percutaneous therapeutic techniques and surgical options. Percutaneous, therapeutic techniques are imaging-guided, minimally invasive treatments which can be performed as outpatient procedures. In cases of facet joint syndrome, they include, apart from injections, neurolysis with radiofrequency/cryoablation, MR-guided high-intensity focused ultrasound and percutaneous fixation techniques. In case of discogenic pain, apart from infiltrations, therapeutic techniques can be classified in to two main categories: decompression (mechanical, thermal, chemical) techniques and biomaterials implantation/disc cell therapies. Strict sterility measures are a prerequisite and should include extensive local sterility and antibiotic prophylaxis. This article will report clinical and imaging findings for each pathology type and the association with treatment decision. In addition, we will describe in detail all possible treatment techniques for low back pain and neuralgia, and we will report recently published results of these techniques summarizing the data concerning safety and effectiveness as well as the level of evidence. Finally, we will try to provide a rational approach for the therapy of low back pain and neuralgia by means of minimally invasive imaging-guided percutaneous techniques.

  18. Critical Values of Facet Joint Angulation and Tropism in the Development of Lumbar Degenerative Spondylolisthesis: An International, Large-Scale Multicenter Study by the AOSpine Asia Pacific Research Collaboration Consortium

    Science.gov (United States)

    Samartzis, Dino; Cheung, Jason Pui Yin; Rajasekaran, Shanmuganathan; Kawaguchi, Yoshiharu; Acharya, Shankar; Kawakami, Mamoru; Satoh, Shigenobu; Chen, Wen-Jer; Park, Chun-Kun; Lee, Chong-Suh; Foocharoen, Thanit; Nagashima, Hideki; Kuh, Sunguk; Zheng, Zhaomin; Condor, Richard; Ito, Manabu; Iwasaki, Motoki; Jeong, Je Hoon; Luk, Keith D. K.; Prijambodo, Bambang; Rege, Amol; Jahng, Tae-Ahn; Luo, Zhuojing; Tassanawipas, Warat; Acharya, Narayana; Pokharel, Rohit; Shen, Yong; Ito, Takui; Zhang, Zhihai; Aithala P, Janardhana; Kumar, Gomatam Vijay; Jabir, Rahyussalim Ahmad; Basu, Saumyajit; Li, Baojun; Moudgil, Vishal; Goss, Ben; Sham, Phoebe; Williams, Richard

    2015-01-01

    Study Design  An international, multicenter cross-sectional image-based study performed in 33 institutions in the Asia Pacific region. Objective  The study addressed the role of facet joint angulation and tropism in relation to L4–L5 degenerative spondylolisthesis (DS). Methods  The study included 349 patients (63% females; mean age: 61.8 years) with single-level DS; 82 had no L4–L5 DS (group A) and 267 had L4–L5 DS (group B). Axial computed tomography and magnetic resonance imaging were utilized to assess facet joint angulations and tropism (i.e., asymmetry between facet joint angulations) between groups. Results  There was a statistically significant difference between group A (left mean: 46.1 degrees; right mean: 48.2 degrees) and group B (left mean: 55.4 degrees; right mean: 57.5 degrees) in relation to bilateral L4–L5 facet joint angulations (p < 0.001). The mean bilateral angulation difference was 7.4 and 9.6 degrees in groups A and B, respectively (p = 0.025). A critical value of 58 degrees or greater significantly increased the likelihood of DS if unilateral (adjusted OR: 2.5; 95% CI: 1.2 to 5.5; p = 0.021) or bilateral facets (adjusted OR: 5.9; 95% CI: 2.7 to 13.2; p < 0.001) were involved. Facet joint tropism was found to be relevant between 16 and 24 degrees angulation difference (adjusted OR: 5.6; 95% CI: 1.2 to 26.1; p = 0.027). Conclusions  In one of the largest studies assessing facet joint orientation in patients with DS, greater sagittal facet joint angulation was associated with L4-L5 DS, with a critical value of 58 degrees or greater increasing the likelihood of the condition for unilateral and bilateral facet joint involvement. Specific facet joint tropism categories were noted to be associated with DS. PMID:27433424

  19. Virtual reality imaging with real-time ultrasound guidance for facet joint injection: a proof of concept.

    Science.gov (United States)

    Clarke, Collin; Moore, John; Wedlake, Christopher; Lee, Donald; Ganapathy, Su; Salbalbal, Maher; Wilson, Timothy; Peters, Terry; Bainbridge, Daniel

    2010-05-01

    Facet interventions continue to be used in pain management. Computed tomographic (CT) images can be registered into a virtual world that includes images generated by an ultrasound (US) probe tracked in real time, permitting guidance of tracked needles. We acquired CT-generated 3-dimensional (3D) images of 2 models and a cadaver. Three-dimensional representations of a US probe and needle were generated. A magnetic system tracked the needle and US probe. Using the US, 3D CT images were registered to the model/cadaver. Images were fused on a single interface. Facet injections were performed in the models and cadaver with radio-opaque markers. A postprocedure CT image determined appropriate placement. The virtual reality system described demonstrates technical innovations that may lead to future advancements in the area of percutaneous interventions in the management of pain.

  20. Kinesiographic recordings of jaw movements are not accurate to detect magnetic resonance-diagnosed temporomandibular joint (TMJ) effusion and disk displacement: findings from a validation study.

    Science.gov (United States)

    Manfredini, Daniele; Favero, Lorenzo; Federzoni, Elvis; Cocilovo, Francesco; Guarda-Nardini, Luca

    2012-10-01

    The aim of this study was to perform a validation study assessing the correlation between magnetic resonance (MR) findings of temporomandibular joint (TMJ) disk displacement and effusion and some parameters drawn from kinesiographic (KG) recordings of jaw motion, i.e., deflection, deviations, incisures. Thirty-one patients with TMJ disorders underwent a kinesiographic recording in the same day in which the MR was performed. Regression analysis was performed to assess the correlation between the MR and KG findings. MR findings were not correlated with KG parameters (P > .05). The accuracy of all KG variables for diagnosing MR-detected signs was low. KG deflection ranged from 38.7% to 54.8%, KG deviation from 42% to 54.8%, and KG incisures from 9.6% to 71%. Specificity and positive predictive values were far from acceptable levels for all KG variables. The findings do not support the usefulness of jaw-tracking devices in dental practices that diagnose and manage temporomandibular disorders. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. Faceted Search

    CERN Document Server

    Tunkelang, Daniel

    2009-01-01

    We live in an information age that requires us, more than ever, to represent, access, and use information. Over the last several decades, we have developed a modern science and technology for information retrieval, relentlessly pursuing the vision of a "memex" that Vannevar Bush proposed in his seminal article, "As We May Think." Faceted search plays a key role in this program. Faceted search addresses weaknesses of conventional search approaches and has emerged as a foundation for interactive information retrieval. User studies demonstrate that faceted search provides more

  2. 腰椎小关节内注射倍他米松治疗腰椎小关节病变所致慢性腰痛%Effects of Injecting Betamethasone to Lumbar Facet Joints on Patients with Chronic Low-Back Pain from the Disfunction of Lumbar Facet Joints

    Institute of Scientific and Technical Information of China (English)

    张光明; 唐坤; 陈俊峰

    2011-01-01

    目的:评估C型臂X光机引导下腰椎小关节内注射倍他米松对腰椎小关节病变所致慢性腰痛的疗效.方法:腰痛时间长于3个月,腰痛症状和体征符合腰椎小关节病变临床表现,经影像学和小关节内注射局麻药诊断性治疗后诊断为腰椎小关节病变的40例患者随机分为小关节注射组(n=20)和消炎镇痛药组(n=20).小关节注射组患者在C型臂X光机引导下行腰椎小关节内注射倍他米松,消炎镇痛药组患者口服双氯芬酸钠.腰痛程度采用视觉模拟评分法(visual analogue scale,VAS)评分.观察时间点定为治疗前(T0)和治疗后3个月(T1).主要观察患者的生命体征和VAS评分.根据治疗过程中VAS改善程度统计疗效(分为显效、有效和无效).结果:治疗后3个月注射组总有效率为92%,消炎镇痛药组总有效率为46%;注射组显效率为74%,消炎镇痛药组显效率为26%.注射组的总有效率和显效率均显著高于消炎镇痛药组(P<0.01).结论:C型臂X光机引导下腰椎小关节内注射倍他米松能有效缓解腰椎小关节病变所致慢性腰痛,疗效优于口服药物治疗.%Objective:To investigate the effects of injecting Betamethasone to lumbar facet joints under the guidance of C-arm X-ray machine on patients with chronic low-back pain from the disfunction of lumbar facet joints. Methods: A total of 40 patients with low-back pain from the disfunction of lumbar facet joints more than 3 months were enrolled in this study. The patients were randomly divided into 2 groups(n = 20, each). The injection group received the injecting Betamethasone to lumbar facet joints under the guidance of C-arm X-ray machine; while the medcine group received taking diclofenac sodium. The vital signs and visual analogue scale were recorded before the treatment(T0) and 3 months after the treatment(Ti ). The effects of treatment were evaluated according to the changes of visual analogue scale (VAS) and were divided into

  3. Muscular response to physiologic tensile stretch of the caprine c5/6 facet joint capsule: dynamic recruitment thresholds and latencies.

    Science.gov (United States)

    Azar, Nadia R; Kallakuri, Srinivasu; Chen, Chaoyang; Cavanaugh, John M

    2011-11-01

    This study examined the cervical muscle response to physiologic, high-rate (100 mm/s) tensile facet joint capsule (FJC) stretch. Six in-vivo caprine C5/6 FJC preparations were subjected to an incremental tensile loading paradigm. EMG activity was recorded from the right trapezius (TR) and multifidus (MF) muscle groups at the C5 and C6 levels; and from the sternomastoid (SM) and longus colli (LC) muscle groups bilaterally at the C5/6 level; during FJC stretch. Capsule load during the displacement applications was recorded via a miniature load cell, and 3D capsule strains (based on stereoimaging of an array of markers on the capsule surface) were reconstructed using finite element methods. EMG traces from each muscle were examined for onset of muscular activity. Capsule strains and loads at the time of EMG onset were recorded for each muscle, as was the time from the onset of FJC stretch to the onset of muscle activity. All muscles were responsive to physiologic high-rate FJC stretch. The deep muscles (MF and LC) were recruited at significantly smaller capsule loads and onset latencies than the superficial muscles (TR and SM). MF activation strain was significantly smaller than LC and TR activation strains. These data were also compared to previously published low-rate data. MF was the first muscle group to be recruited regardless of the activation criterion under consideration (i.e. strain, load, or latency) or the rate of FJC stretch. LC recruitment occurred significantly sooner under high-rate vs. low-rate FJC stretch. The results of this study provide further evidence of extensive ligamento-muscular reflex pathways between the FJC and the cervical musculature, which are responsive to both low-rate and high-rate FJC stretch. These data add to our knowledge of the dynamic response of paraspinal muscles relative to facet joint motion and provide a unique contribution to enhance the precision of computer-simulated impacts.

  4. Fluoroscopic cervical epidural injections in chronic axial or disc-related neck pain without disc herniation, facet joint pain, or radiculitis

    Directory of Open Access Journals (Sweden)

    Manchikanti L

    2012-07-01

    Full Text Available Laxmaiah Manchikanti, Kimberly A Cash, Vidyasagar Pampati, Yogesh MallaPain Management Center of Paducah, Paducah, KY, USABackground: While chronic neck pain is a common problem in the adult population, with a typical 12-month prevalence of 30%–50%, there is a lack of consensus regarding its causes and treatment. Despite limited evidence, cervical epidural injections are one of the commonly performed nonsurgical interventions in the management of chronic neck pain.Methods: A randomized, double-blind, active, controlled trial was conducted to evaluate the effectiveness of cervical interlaminar epidural injections of local anesthetic with or without steroids for the management of chronic neck pain with or without upper extremity pain in patients without disc herniation, radiculitis, or facet joint pain.Results: One hundred and twenty patients without disc herniation or radiculitis and negative for facet joint pain by means of controlled diagnostic medial branch blocks were randomly assigned to one of two treatment groups, ie, injection of local anesthetic only (group 1 or local anesthetic mixed with nonparticulate betamethasone (group 2. The primary outcome of significant pain relief and improvement in functional status (≥50% was demonstrated in 72% of group 1 and 68% of group 2. The overall average number of procedures per year was 3.6 in both groups with an average total relief per year of 37–39 weeks in the successful group over a period of 52 weeks.Conclusion: Cervical interlaminar epidural injections of local anesthetic with or without steroids may be effective in patients with chronic function-limiting discogenic or axial pain.Keywords: chronic neck pain, cervical disc herniation, cervical discogenic pain, cervical epidural injections, epidural steroids, local anesthetics

  5. GEORG-SCHMORL-PRIZE OF THE GERMAN SPINE SOCIETY (DWG) 2016: Comparison of in vitro osteogenic potential of iliac crest and degenerative facet joint bone autografts for intervertebral fusion in lumbar spinal stenosis.

    Science.gov (United States)

    Geurts, Jeroen; Ramp, Daniela; Schären, Stefan; Netzer, Cordula

    2017-05-01

    The promotion of spinal fusion using bone autografts is largely mediated by the osteoinductive potential of progenitors/mesenchymal stem cells (MSC) that reside in the marrow spaces of cancellous bone. Iliac crest is the common autograft donor site, but its use presents an increased risk for donor site pain, morbidity and infection. Degenerative bone samples harvested during facetectomy might provide an alternative viable source of osteoinductive autografts. In this study, we conducted an intra-individual comparison of the osteogenic potential of isolated low passage MSC from both sources. Iliac crest and degenerative facet joints were harvested from eight consecutive patients undergoing transforaminal lumbar interspinal fusion due to lumbar spinal stenosis. MSC were isolated by collagenase digestion, selected by plastic adherence and minimally expanded for downstream assays. Clonogenic and osteogenic potential was evaluated by colony formation assays in control and osteogenic culture medium. Osteogenic properties, including alkaline phosphatase (ALP) induction, matrix mineralization and type I collagen mRNA and protein expression were characterized using quantitative histochemical staining and reverse transcription PCR. Spontaneous adipogenesis was analysed by adipocyte enumeration and gene expression analysis of adipogenic markers. Average colony-forming efficiency in osteogenic medium was equal between iliac crest (38 ± 12%) and facet joint (36 ± 11%). Osteogenic potential at the clonal level was 55 ± 26 and 68 ± 17% for iliac crest and facet joint MSC, respectively. Clonogenic and osteogenic potential were significantly negatively associated with donor age. Osteogenic differentiation led to significant induction of ALP activity in iliac crest (sixfold) and facet joint (eightfold) MSC. Matrix mineralization quantified by Alizarin red staining was increased by osteogenic differentiation, yet similar between both MSC sources. Protein expression of type

  6. Facet analysis

    DEFF Research Database (Denmark)

    Hjørland, Birger

    2013-01-01

    The facet-analytic paradigm is probably the most distinct approach to knowledge organization within Library and Information Science, and in many ways it has dominated what has be termed “modern classification theory”. It was mainly developed by S.R. Ranganathan and the British Classification Rese...

  7. Lumbar spine superior-level facet joint violations: percutaneous versus open pedicle screw insertion using intraoperative 3-dimensional computer-assisted navigation

    Institute of Scientific and Technical Information of China (English)

    Tian Wei; Xu Yunfeng; Liu Bo; Liu Yajun; He Da; Yuan Qiang; Lang Zhao

    2014-01-01

    Background Percutaneous pedicle screw use has a high rate of cranial facet joint violations (FVs) because of the facet joint being indirectly visualized.Computer-assisted navigation shows the anatomic structures clearly,and may help to lower the rate of FVs during pedicle screw insertion.This study used computed tomography (CT) to evaluate and compare the incidence of FVs between percutaneous and open surgeries employing computer-assisted navigation for the implantation of pedicle screw instrumentation during lumbar fusions.Methods A prospective study,including 142 patients having lumbar and lumbosacral fusion,was conducted between January 2013 and April 2014.All patients had bilateral posterior pedicle screw-rod instrumentation (top-loading screws) implanted by the same group of surgeons; intraoperative 3-dimensional computer navigation was used during the procedures.All patients underwent CT examinations within 6 months postoperation.The CT scans were independently reviewed by three reviewers blinded to the technique used.Results The cohort comprised 68 percutaneous and 74 open cases (136 and 148 superior-level pedicle screw placements,respectively).Overall,superior-level FVs occurred in 20 patients (20/142,14.1%),involving 27 top screws (27/284,9.5%).The percutaneous technique (7.4% of patients,3.7% of top screws) had a significantly lower violation rate than the open procedure (20.3% of patients,14.9% of top screws).The open group also had significantly more serious violations than did the percutaneous group.Both groups had a higher violation rate when the cranial fixation involved the L5.A 1-level open procedure had a higher violation rate than did the 2-and 3-level surgeries.Conclusions With computer-assisted navigation,the placement of top-loading percutaneous screws carries a lower risk of adjacent-FVs than does the open technique; when FVs occur,they tend to be less serious.Performing a single-level open lumbar fusion,or the fusion of the L5-S1

  8. Correction of post-traumatic kyphosis using intermediate facet joints as fulcrum in dorso-lumbar spine injuries

    Directory of Open Access Journals (Sweden)

    Agrawal Amit

    2006-01-01

    Full Text Available Background : Post traumatic kyphotic deformity are managed by different methods. Posterior stabilization of dorso-lumbar fractures with transpedicular screws and rods using intermediate facets as fulcrum can restore body height. Methods and material : In a retrospective clinical study 6 consecutive patients with complete or incomplete neurological deficits as a result of the dorso-lumbar fractures were included. Local kyphosis was measured as the angle between the upper and lower end plates of the collapsed vertebrae preoperatively, postoperatively and at the last follow-up visit. The neurological condition of the patients was recorded in the pre-op and follow up period according to Frankel grading systems. Stabilization with pedicle screw fixation and posterior fusion with autogenous bone chips were done after decompression in all 6 patients included in this study. The outcome of the study was evaluated with regard to the correction of kyphotic deformity and increase in vertebral body height after adequate neural canal decompression and fusion. Results : Of the 6 patients 4 were Frankel A and 2 Frankel C pre-operatively. Three patients sustained wedge fracture and three sustained burst fracture. The most commonly affected vertebra was L 1 with 4 cases followed by L 2 . The preoperative mean kyphotic angle was 23.3° (17°-28°, and was corrected to 15.8 (12° - 22° with a correction rate of 32.3% (21.4 - 43.5 % in the post-operative period and this correction was improved at three months follow up and the final correction was measured to be 46.3% (22.7-59.0 %. Serial postoperative radiographic follow-up assessment showed maintenance of kyphotic correction. Minimum correction of body height was .05 cm (correction rate-1.8% and maximum correction was .65 cm (correction rate-28.9% in post-operative period with a mean of 0.29 cm (correction rate-13.1%. Conclusions : Preserved the intermediate articular processes can be used as fulcrum to reduce

  9. Distribution of ultrasound-detected knee joint effusion in arthritis patients%超声下关节炎患者膝关节积液分布特点

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

      目的通过超声检查了解关节炎患者膝关节积液分布情况。方法收取2012年7-12月于本院风湿科就诊的膝关节疼痛患者,应用高频超声探查患者髌上囊外侧区、中区及内侧区的积液情况,评估不同区域积液深度、长度及横截面积的差异。结果共纳入38例68个膝关节,膝关节外侧区及中区的积液深度分别为(4.8±4.5) mm及(4.5±4.3) mm,显著高于膝关节内侧区域的(3.1±4.3) mm(P<0.001);膝关节外侧区及正中区积液长度分别为(26.5±18.1) mm及(28.5±19.7) mm,显著高于膝关节内侧区的(18.7±20.5) mm(P<0.001),而外侧区及中区积液深度、长度间差异无统计学意义(P>0.05)。根据积液量分组后,少量积液组髌上囊外侧区及中区积液显著高于内侧区(P<0.001),大量积液组中区与内侧区的差异无统计学意义(P=0.133)。类风湿关节炎(rheumatoid arthritis,RA)积液量(405.6±325.4) mm2显著高于脊柱关节炎(spondyloarthritis, SpA)(213.5±241.6) mm2(P=0.004)及骨关节炎(osteoarthritis,OA)(74.6±72.3) mm2(P=0.005)。结论膝关节少量积液主要分布于外侧区及正中区,行膝关节穿刺等操作优先选择外侧区及正中区,有助于提高操作的成功率。%Objective To investigate the distribution of ultrasound (US)-detected knee joint effusion in arthritis patients. Methods Lateral, midline and medial regions of suprapatellar pouch effusion and its depth, length, cross section area in arthritis patients admitted to our department from July 2012 to December 2012 were detected by high resolution ultrasound examination. Results Thirty-eight arthritis patients with 68 knee joints involved were enrolled in this study. The maximal effusion depth and length were significantly higher in lateral and midline regions of knee joint than in medial region of knee joint (4.8±4.5) mm and (4.5±4.3)mm vs (3.1±4.3) mm, (P 0.05). The amount of effusion was significantly

  10. Advances in neurobiological mechanism of cervical facet joint pain%颈椎小关节源性疼痛机制的神经生物学研究进展

    Institute of Scientific and Technical Information of China (English)

    唐峰

    2015-01-01

    Diseases of cervical facet joint is a common source of chronic neck pain.Clinically,the accuracy and stability of the diagnosis of cervical facet joint-induced pain is often been concerned,whereas the pathophysiology and pain mechanism,especially the related neurobiological information were still not recognized adequately.In this paper,researches in pain from cervical facet joint,which is a integrated reaction regulated and maintained by all kinds of inflammatory factors and neurotransmitters,were reviewed from the aspect of cytological level of pain induction: the innervation and the distribution of pain receptors of cervical facet joint were introduced,irreversible neuropathological changes of cervical facet joint after chronic injuries were discussed which involved neuron activation,inflammatory cytokines release and changes of neuronal phenotype,at the same time,neurotransmitters and peptides involved in starting and sustaining the facet joint pain were emphasized which including the following three categories: pain neurotransmitters,stress-related proteins and local inflammatory factors,as well as spinal glutamate.%颈椎小关节疾病是颈部慢性疼痛的常见来源,临床上较为关注其诊断的精确性和稳定性,而对病理生理及疼痛机制,特别是相关神经生物学研究缺乏足够的认识.该文从疼痛产生的细胞学水平层面对颈椎小关节源性疼痛这一由多种炎性因子及神经递质参与调节及维持的综合反应进行综述:介绍颈椎小关节神经支配及其疼痛感受器的分布情况,阐述慢性损伤后小关节发生的不可逆的神经病理变化(包括神经元激活、炎性因子释放和神经元免疫表型改变等),并重点介绍其中参与疼痛启动与维持的疼痛传入递质、应激相关蛋白和局部炎性因子、脊髓谷氨酸等三大类神经递质和肽类.

  11. Strain and load thresholds for cervical muscle recruitment in response to quasi-static tensile stretch of the caprine C5-C6 facet joint capsule.

    Science.gov (United States)

    Azar, Nadia R; Kallakuri, Srinivasu; Chen, Chaoyang; Lu, Ying; Cavanaugh, John M

    2009-12-01

    The aim of this study was to investigate the response of cervical muscles to physiologic tensile stretch of cervical facet joint capsule (FJC) at a quasi-static displacement rate of 0.5mm/s. In vivo caprine left C5-C6 FJC preparations were subjected to an incremental tensile displacement paradigm. EMG activity was recorded during FJC stretch from the right trapezius (TR) and multifidus (MF) muscle groups at the C5 and C6 levels and bilaterally from the sternomastoid (SM) and longus colli (LC) muscle groups at the C5-C6 level. Onset of muscular activity was later analyzed using visual and computer-based methods. Capsule load and strain at the time of onset were recorded and compared between the muscle groups. Results indicated capsule load was a better indicator of the tensile stretch thresholds for muscular recruitment than capsule strain. MF responded at significantly smaller capsule loads than TR and LC, while TR and LC activation loads were not significantly different. SM did not respond to physiologic FJC stretch. Muscle group recruitment order reflected the muscles' fiber type compositions and functional roles in the spine. This study provides the first evidence that the cervical ligamento-muscular reflex pathways are activated via tensile FJC stretch and extend to superficial and deep musculature on the anterior and posterior aspects of the neck, ipsilateral and contralateral to the side of FJC stretch.

  12. Bending stresses in Facetted Glass Shells

    DEFF Research Database (Denmark)

    Bagger, Anne; Jönsson, Jeppe; Almegaard, Henrik

    2008-01-01

    A shell structure of glass combines a highly effective structural principle with a material of optimal permeability to light. A facetted shell structure has a piecewise plane geometry, and together the facets form an approximation to a curved surface. A distributed load on a plane-based facetted...... structure will locally cause bending moments in the loaded facets. The bending stresses are dependent on the stiffness of the joints. Approximate solutions are developed to estimate the magnitude of the bending stresses. A FE-model of a facetted glass shell structure is used to validate the expressions...

  13. Tuberculous Pleural Effusion

    Directory of Open Access Journals (Sweden)

    Shira A. Schlesinger

    2012-09-01

    Full Text Available Pleural effusions are a common finding in emergency departments, with cytologic analysis traditionally required for definitive diagnosis. This article describes a classic sonographic appearance of tuberculous pleural effusion.

  14. Persistent benign pleural effusion.

    Science.gov (United States)

    Porcel, J M

    In this narrative review we describe the main aetiologies, clinical characteristics and treatment for patients with benign pleural effusion that characteristically persists over time: chylothorax and cholesterol effusions, nonexpansible lung, rheumatoid pleural effusion, tuberculous empyema, benign asbestos pleural effusion and yellow nail syndrome. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  15. Changes in synovial membrane and joint effusion volumes after intraarticular methylprednisolone. Quantitative assessment of inflammatory and destructive changes in arthritis by MRI

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Stoltenberg, M; Gideon, P

    1996-01-01

    , 7, 30 and 180 days after intraarticular methylprednisolone injection until clinical relapse. Intraobserver, interobserver, and inter-MRI variations were determined from 2 successive MRI of another 6 knees. RESULTS: In all knees synovial membrane and effusion volumes decreased within the first...

  16. CT Manifestations of Sacroiliac Joint, Facet Joint of Lumbar and Hip Joint in Patients with Ankylosing Spodylitis%强直性脊柱炎骶髂关节、腰椎小关节及髋关节的CT表现

    Institute of Scientific and Technical Information of China (English)

    赵菁

    2012-01-01

    Objective To investigate CT features of sacroiliac joint, facet joint of lumbar and hip joint in patients with ankylosing spodylitis (AS), so as to improve the accuracy of diagnosis and differential diagnosis. Methods Between January and October 2011, CT scan was performed for 86 patients with AS, involving sacroiliac joint in 44 cases, lumbar vertebra in 28, and hip joint in 14. Their CT findings were retrospectively analyzed. Results CT findings of AS showed that the disease mainly involved iliac side of synovial section in sacroiliac joint, facet joint of lumbar and hip joint, and the main manifestations of the disease included altered joint space, coarse articular surface or cystic destruction, subchondral sclerosis and erosion. Conclusion CT manifestations of ankylosing spodylitis in sacroiliac joint, facet joint of lumbar and hip joint have some special characteristic signs, thus CT can play an important role in diagnosis and differential diagnosis of the disease.%目的 探讨强直性脊柱炎(AS)受累骶髂关节、腰椎小关节及髋关节的病变CT表现特点,以提高诊断与鉴别诊断水平.方法 2011年1月-10月对临床确诊的强直性脊柱炎患者44例骶髂关节、28例腰椎及14例髋关节行CT扫描,回顾性分析骶髂关节、腰椎小关节及髋关节的CT表现.结果 AS患者的CT表现特点为病变主要累及骶髂关节滑膜部的髂骨侧,腰椎小关节及髋关节则表现为关节间隙改变、关节面毛糙及囊状破坏、面下骨硬化或吸收等改变.结论 AS骶髂关节、腰椎小关节及髋关节的CT表现具有一定特征,CT具有重要的诊断及鉴别诊断价值.

  17. Vacuum facet phenomenon: a computed tomographic sign of degenerative spondylolisthesis

    Energy Technology Data Exchange (ETDEWEB)

    Lefkowitz, D.M.; Quencer, D.M.

    1982-08-01

    A vacuum facet phenomenon, seen on computed tomography as a lens-shaped lucency within a lumbar facet joint, was observed as a consequence of degenerative spondylolisthesis. The significance of this finding is discussed.

  18. Effusion under the microscope.

    LENUS (Irish Health Repository)

    Chong, S G

    2012-03-01

    Pseudochylothorax is a very rare form of pleural effusion. It is also called chyliform or cholesterol pleural effusion. It is usually a unilateral process and approximately one-third of patients are asymptomatic at presentation. We report a case of a 60 year old man with a background of rheumatoid arthritis who presented with progressive dyspnea. Chest X-ray revealed a new left pleural effusion and a small persistent right pleural effusion. He presented 5 years prior due to recurrent pleural effusion and no diagnosis was made. Repeat thoracentesis yielded 350 milliliters of thick, milky, tan-colored fluid.

  19. 腰椎关节突关节骨性关节炎的病因学%The etiology of the osteoarthritis of the facet joints in the lumbar spine

    Institute of Scientific and Technical Information of China (English)

    严望军; 李家顺; 贾连顺

    2003-01-01

    @@ 腰椎关节突关节骨性关节炎(lumbar facet joint osteoarthritis,LFOA或lumbar zygapophyseal joint osteoarthritis,LZOA)是常见的腰椎退行性疾病,其基本病理特点为关节突关节软骨损害、关节边缘和软骨下骨反应性增生.Goldthwait[1]最先认为部分下腰痛可能由关节突关节病变引起.

  20. Facets: Ersatz, Resource and Tag

    Science.gov (United States)

    Frické, Martin H.

    2013-01-01

    Introduction: Faceted classification appears to be of utmost importance. Ersatz facets, resource faceting and tag faceting: The distinctions are drawn between facets and ersatz facets, and between faceted resources and faceted tags. Single tag resource faceting and multiple tag information object faceting: The basic features are explored of single…

  1. Facet analysis

    DEFF Research Database (Denmark)

    Hjørland, Birger

    2013-01-01

    Research Group, but it is mostly based on principles of logical division developed more than two millennia ago. Colon Classification (CC) and Bliss 2 (BC2) are among the most important systems developed on this theoretical basis, but it has also influenced the development of other systems......The facet-analytic paradigm is probably the most distinct approach to knowledge organization within Library and Information Science, and in many ways it has dominated what has be termed “modern classification theory”. It was mainly developed by S.R. Ranganathan and the British Classification......, such as the Dewey Decimal Classification (DDC) and is also applied in many websites. It still has a strong position in the field and it is the most explicit and “pure” theoretical approach to knowledge organization (KO) (but it is not by implication necessarily also the most important one). The strength...

  2. FacetGist: Collective Extraction of Document Facets in Large Technical Corpora

    Science.gov (United States)

    Siddiqui, Tarique; Ren, Xiang; Parameswaran, Aditya; Han, Jiawei

    2017-01-01

    Given the large volume of technical documents available, it is crucial to automatically organize and categorize these documents to be able to understand and extract value from them. Towards this end, we introduce a new research problem called Facet Extraction. Given a collection of technical documents, the goal of Facet Extraction is to automatically label each document with a set of concepts for the key facets (e.g., application, technique, evaluation metrics, and dataset) that people may be interested in. Facet Extraction has numerous applications, including document summarization, literature search, patent search and business intelligence. The major challenge in performing Facet Extraction arises from multiple sources: concept extraction, concept to facet matching, and facet disambiguation. To tackle these challenges, we develop FacetGist, a framework for facet extraction. Facet Extraction involves constructing a graph-based heterogeneous network to capture information available across multiple local sentence-level features, as well as global context features. We then formulate a joint optimization problem, and propose an efficient algorithm for graph-based label propagation to estimate the facet of each concept mention. Experimental results on technical corpora from two domains demonstrate that Facet Extraction can lead to an improvement of over 25% in both precision and recall over competing schemes.

  3. 脊柱小关节紊乱影像学诊断与整脊疗法效果分析%Analysis of imaging diagnosis of spinal facet joint disorder and effect of spinal rotation massage

    Institute of Scientific and Technical Information of China (English)

    余任辉; 林家伟; 王晓国

    2013-01-01

    Objective To investigate the pathogenetic rmechanism of the spinal facet joint disorder and improve the accuracy of imaging diagnosis to reduce the possibility of spinal degenerative osteoarthropathy(DO).Methods The spinal X-ray plain film,CT and MRI images of 300 cases from 15 to 45 years old with muscle soreness in neck,chest and back caused by spinal small joint disorder were retrospectively analyzed.Results The results showed that this disease was mainly caused by improper posture,long-term spinal joint chronic strain,scoliosis by spinal or small joint developmental malformation and joint change resulted by spinal joint asymmetry,which had clinical manifestation shown by the imaging like typical spinal joint asymmetry,pen type hyperostosis oseosclerosis for articular surface and nonspecific inflammation of its surrounding soft tissue.Moreover,the facet joint will be deteriorated with the age of the patients.Conclusions The imaging could be used for spinal facet joint disorder diagnosis (definite diagnosis and differential diagnosis),and X-ray examination is still a very important method.Meanwhile,CT and MRI images can show us the change of spinal facet joint and the surrounding soft tissue more clearly and identify the change of the herniated disk as well as the diseases caused by other reasons.And the spinal rotation massage method has good effects.%目的 探索脊柱小关节紊乱的发生机制,提高脊柱小关节紊乱影像学诊断的准确性,减慢脊柱退行性骨关节病的发生.方法 回顾性分析300例15~45岁年龄组脊柱小关节紊乱引起颈、胸、腰背部酸痛患者的脊椎X线平片或CT平扫或MRI资料.结果 脊柱小关节紊乱主要是姿势不当、长期慢性劳损或脊柱或小关节发育畸形致脊柱侧弯畸形或先天椎小关节不对称造成小关节病变所致,有其典型椎小关节不对称、关节面笔样增生硬化及周围软组织非特异炎性改变等影像学表现,随着年龄增长

  4. The effect of different design concepts in lumbar total disc arthroplasty on the range of motion, facet joint forces and instantaneous center of rotation of a L4-5 segment.

    Science.gov (United States)

    Schmidt, Hendrik; Midderhoff, Stefan; Adkins, Kyle; Wilke, Hans-Joachim

    2009-11-01

    Although both unconstrained and constrained core lumbar artificial disc designs are in clinical use, the effect of their design on the range of motion, center of rotations, and facet joint forces is not well understood. It is assumed that the constrained configuration causes a fixed center of rotation with high facet forces, while the unconstrained configuration leads to a moving center of rotation with lower loaded facets. The authors disagree with both assumptions and hypothesized that the two different designs do not lead to substantial differences in the results. For the different implant designs, a three-dimensional finite element model was created and subsequently inserted into a validated model of a L4-5 lumbar spinal segment. The unconstrained design was represented by two implants, the Charité disc and a newly developed disc prosthesis: Slide-Disc. The constrained design was obtained by a modification of the Slide-Disc whereby the inner core was rigidly connected to the lower metallic endplate. The models were exposed to an axial compression preload of 1,000 N. Pure unconstrained moments of 7.5 Nm were subsequently applied to the three anatomical main planes. Except for extension, the models predicted only small and moderate inter-implant differences. The calculated values were close to those of the intact segment. For extension, a large difference of about 45% was calculated between both Slide-Disc designs and the Charité disc. The models predicted higher facet forces for the implants with an unconstrained core compared to an implant with a constrained core. All implants caused a moving center of rotation. Except for axial rotation, the unconstrained and constrained configurations mimicked the intact situation. In axial rotation, only the Slide- Disc with mobile core reproduced the intact behavior. Results partially support our hypothesis and imply that different implant designs do not lead to strong differences in the range of motion and the location

  5. Severe osteoarthritis of the knee joint effusion biochemical analysis and clinical treatment%重度膝关节骨关节炎关节积液生化分析与临床治疗

    Institute of Scientific and Technical Information of China (English)

    潘炜

    2014-01-01

    To i nvestigate the intra-articular injection of sodium hyaluronate for irrigation combined with the actual effect of severe knee osteoarthritis . Methods: 92 cases of severe osteoarthritis of the knee were randomly divided into observation group 46 cases , the use of intra-articular injection of sodium hyaluronate flush joint treatment , and 46 cases in the control group , a single flush with intra-articular treatment , recording two patients efficiently , joint effusion CRP and LDH , a comparative analysis of the data . Results: The study group and the control group was present , there are significant differences (P<0 . 05) between CRP and joint effusion LDH group . Conclusion: Intra-articular injection of sodium hyaluronate for irrigation combined with severe knee osteoarthritis significant effect , worthy of clinical application .%目的:观察关节腔内冲洗联合玻璃酸钠注射用于重度膝关节骨关节炎的实际疗效。方法:选择92例重度膝关节骨关节炎患者,随机分为观察组46例,采用关节腔内冲洗联合玻璃酸钠注射进行治疗,以及对照组46例,单用关节腔内冲洗治疗,记录两组患者有效率、关节积液CRP及LDH,对数据进行比较分析。结果:观察组及对照组有效率、关节积液CRP及LDH组间均存在统计学差异(P<0.05)。结论:关节腔内冲洗联合玻璃酸钠注射用于重度膝关节骨关节炎疗效显著,值得临床推广应用。

  6. Evaluation of the Effusion within Biceps Long Head Tendon Sheath Using Ultrasonography

    OpenAIRE

    Park, In; Lee, Hyo-Jin; Kim, Sung-Eun; Bae, Sung-Ho; Lee, Kwang-Yeol; Park, Kwang-Sun; Kim, Yang-Soo

    2015-01-01

    Background Many shoulder diseases are related to glenohumeral joint synovitis and effusion. The purpose of the present study is to detect effusion within the biceps long head tendon sheath as the sign of glenohumeral joint synovitis using ultrasonography, and to evaluate the clinical meaning of effusion within the biceps long head tendon sheath. Methods A consecutive series of 569 patients who underwent ultrasonography for shoulder pain were reviewed retrospectively and ultimately, 303 patien...

  7. Quantitative assessment of lumber facet joints and intervertebral discs with axial MR T 2 star mapping%轴位 MRT2*m apping 对腰椎小关节和椎间盘的定量研究

    Institute of Scientific and Technical Information of China (English)

    曹观美; 赵斌

    2014-01-01

    目的:探讨轴位腰椎小关节和椎间盘M R T2*mapping成像的可行性,明确T2*mapping定量成像技术对小关节和椎间盘早期退变的评估价值。方法收集慢性下腰痛患者22名作为病例组,性别和年龄匹配的健康志愿者20名为正常对照组,采用3.0T M RI对两组行T2*mapping及常规T2 WI成像,根据Weishaupt分级法、Pfirrmann分级法分别对L2~ S1各节段小关节和椎间盘进行形态学分级,并测量小关节和椎间盘的 T2*值,进行对比分析。结果不同Weishaupt分级小关节的T2*值差异无统计学意义( P>0.05)。不同Pfirrmann分级椎间盘髓核的T2*值差异有统计学意义( P <0.05)。小关节与后纤维环的T 2*值呈弱相关性( r‐0.3874)。病例组与对照组小关节的 T 2*值很相近,而髓核的T2*值差异有统计学意义( P <0.05)。在小关节评价的组间一致性方面,T2*值的一致性很好( r =0.835,P <0.05);形态学Weishaupt分级一致性较差(kappa=0.327)。结论此研究表明T2* mapping可用于软骨的定量研究,且轴位的腰椎小关节和椎间盘T2*mapping联合成像是可行的。%Objective To value the feasibility of MR T2 star mapping of lumbar facet joints and intervertebral discs ,and to evaluate the diagnostic value of T 2 star mapping in early‐stage degeneration of lumbar facet joints and intervertebral discs .Methods 22 patients with low back pain and 20 age‐and sex‐matched volunteers were examined .T2 star mapping and fast spin echo T2WI of lumber facet joints and intervertebral discs were evaluated with a 3 .0 T MR imaging spectrom‐eter in 42 subjects .The Weishaupt grading was used for L2 ~S1 facet joints and the pfirrmann score was used for morpho‐logical disc grading .T2 star value in the facet joints and the intervertebral discs were measured respectively in T 2 star map‐ping imaging ,and the correlation of them and variance in

  8. Endoscopic Facet Debridement for the treatment of facet arthritic pain - a novel new technique

    Directory of Open Access Journals (Sweden)

    Scott M.W. Haufe, Anthony R. Mork

    2010-01-01

    Full Text Available Study design: Retrospective, observational, open label. Objective: We investigated the efficacy of facet debridement for the treatment of facet joint pain. Summary of background data: Facet joint disease, often due to degenerative arthritis, is common cause of chronic back pain. In patients that don't respond to conservative measures, nerve ablation may provide significant improvement. Due to the ability of peripheral nerves to regenerate, ablative techniques of the dorsal nerve roots often provide only temporary relief. In theory, ablation of the nerve end plates in the facet joint capsule should prevent reinnervation. Methods: All patients treated with endoscopic facet debridement at our clinic from 2003-2007 with at least 3 years follow-up were included in the analysis. Primary outcome measure was percent change in facet-related pain as measured by Visual Analog Scale (VAS score at final follow-up visit. Results: A total of 174 people (77 women, 97 men; mean age 64, range 22-89 were included. Location of facet pain was cervical in 45, thoracic in 15, and lumbar in 114 patients. At final follow-up, 77%, 73%, and 68% of patients with cervical, thoracic, or lumbar disease, respectively, showed at least 50% improvement in pain. Mean operating time per joint was 17 minutes (range, 10-42. Mean blood loss was 40 ml (range, 10-100. Complications included suture failure in two patients, requiring reclosure of the incision. No infection or nerve damage beyond what was intended occurred. Conclusions: Our results demonstrate a comparable efficacy of endoscopic facet debridement compared to radiofrequency ablation of the dorsal nerve branch, with durable results. Large scale, randomized trials are warranted to further evaluate the relative efficacy of this surgical treatment in patients with facet joint disease.

  9. 手法整复胸腰椎后关节紊乱治疗腰背肌筋膜疼痛综合征%TREATING BACK MYOFASCIAL PAIN SYNDROME BY MAINPULATION OF THORACOLUMBAR FACET JOINT DISORDER

    Institute of Scientific and Technical Information of China (English)

    马永健; 王强; 张丽娜

    2012-01-01

    Objective To observe the clinical effect of the mainpulation of thoracolumbar facet joint disorder in treating back myofascial pain syndrome and its influence on the serum level of interleukin -1( IL - 1 ). Methods A total of 120 patients were randomly divided into treatment and control groups, the treatment group was treated by mainpulation and the control group was treated with oral Ibuprofen and Eperisone, the changes of clinical symptoms 、signs and the serum level IL - 1 were observed. Results The treatment group had obvious advantages in the total clinical effect, but not very different from the control group in lowering the serum level IL -1. Conclusion The thoracolumbar facet joint disorder is a major pathological change of back myofascial pain syndrome, and the mainpulation of thoracolumbar facet joint disorder has a good and lasting effect.%目的 观察手法整复胸腰椎后关节紊乱治疗腰背肌筋膜疼痛综合征的临床疗效及对血清白细胞介素(interleukin-1,IL-1)含量的影响.方法 患者120例,随机分成治疗组和对照组,分别采用手法整复胸腰椎后关节紊乱治疗和精氨酸布洛芬颗粒+乙哌立松片治疗,观察治疗前后临床症状、体征及血清IL-1含量的变化.结果 治疗组总疗效优于对照组(P<0.01),在降低血清IL-1含量方面与对照组差异无统计学意义(P>0.05).结论 胸腰椎后关节紊乱是腰背肌筋膜疼痛综合征一个重要病理改变,手法整复胸腰椎后关节紊乱在临床取得良好疗效且作用持久.

  10. An observational feasibility study to assess the safety and effectiveness of intranasal fentanyl for radiofrequency ablations of the lumbar facet joints

    Science.gov (United States)

    Bartoszek, Michael W; McCoart, Amy; Hong, Kyung-soo Jason; Haley, Chelsey; Highland, Krista Beth; Plunkett, Anthony R

    2017-01-01

    Purpose The purpose of the present observational, feasibility study is to assess the preliminary safety and effectiveness of intranasal fentanyl for lumbar facet radiofrequency ablation procedures. Patients and methods This cohort observational study included 23 adult patients. Systolic and diastolic blood pressures, heart rate, oxygen saturation percent, Pasero Opioid-Induced Sedation Scale score, and the Defense and Veterans Pain Rating Scale pain score were assessed prior to the procedure and intranasal fentanyl (100 μg) administration and every 15 minutes after administration, up to 60 minutes post administration. Follow-up of patient satisfaction with pain control and treatment was assessed 24 hours after discharge. The primary outcome was safety as evidenced by adverse events. Secondary outcomes included the above-mentioned vital signs and pain ratings. Results No adverse events occurred in the present study and all participants maintained an acceptable level of awareness throughout the assessment period. One-way repeated measures analyses of covariance tests with Bonferroni-adjusted means indicated that oxygen saturation, blood pressure, and heart rate changed from baseline, whereas pain scores were lower at post-administration levels compared with baseline. Finally, the majority of participants reported being satisfied with pain control and treatment. Conclusion Preliminary evidence indicates that intranasal fentanyl is safe and effective for lumbar facet radiofrequency ablation procedures. Future rigorous randomized control trials are needed to confirm the present results and to examine the effects of intranasal fentanyl on intraoperative and postoperative opioid use.

  11. Clinical Observation on the Efficacy of Thoracic Facet Joint Disorder Treated with Electroacupuncture and Manual Reduction%电针联合手法整复对胸椎小关节紊乱患者临床观察

    Institute of Scientific and Technical Information of China (English)

    杨炎珠; 李子勇

    2015-01-01

    Objective To compare the efficacy and pain alleviation of thoracic facet joint disorder treated with electroacupuncture combined with manual reduction and merely manual reduction, so as to provide clinical evidence for treating thoracic facet joint disor-der with electroacupuncture and manual reduction. Methods 84 patients with thoracic facet joint disorder in our hospital from April 2013 to June 2014 were randomly divided into the observation group ( treated with electroacupuncture and manual reduction) and the control group ( treated merely with manual reduction) , with 42 cases in each group respectively. Differences of clinic efficacy and pain alleviation of the two groups were compared. Results The curative rate and the total effective rate of the observation group were 54. 76% and 95. 24% respectively, higher than that (19. 05% and 76. 19%) of the control group. PRI, VAS, PPI differed before and after treatment of the two groups, with statistically significant difference (P<0. 05). Conclusion As for treating thoracic facet joint disorder, the method of electroacupuncture combined with manual reduction proves to be more efficient than merely manual reduc-tion, and can reduce the pain of patients, which is worthy of clinical application and promotion.%目的:比较电针联合手法整复治疗与单纯手法治疗胸椎小关节紊乱患者的临床疗效及疼痛改善情况,为电针联合手法整复治疗胸椎小关节紊乱提供临床依据。方法将2013年4月至2014年6月于我院针灸科门诊进行治疗的84例胸椎小关节紊乱患者随机分为对照组和观察组各42例,对照组采用单纯手法治疗,观察组使用电针联合手法整复治疗。比较两者患者在临床疗效及治疗前后疼痛改善情况的差异。结果观察组治愈率和总有效率分别为54.76%和95.24%,显著高于对照组的19.05%及76.19%(P<0.05);观察组患者PRI、 VAS、 PPI治疗前后差值与对照组PRI、 VAS、 PPI治疗前

  12. 成人颈椎小关节间隙穿刺路径的应用解剖%Clinical anatomy of the facet joint puncture in adult cervical vertebra

    Institute of Scientific and Technical Information of China (English)

    张贵源; 朱文仁; 杨兵; 闫军浩; 王建伟; 张卫光

    2012-01-01

    Objective To study the type, the angle and the obliquity of facet joints and to identify the approach for the facet joint puncture in adult cervical vertebra. Methods Thirty eight spines of 27 male and 11 female cadavers were used to observe the type and angle of C2-3-C6-7 on the transverse section. The obliquity and shape of the facet joint were also studied in 40 adult cadaveric spines. Results The joints in C2-3-C6-7 were classified as the plane oval(79. 2% ) or curved surface(20. 8% ) types. The joint angles and articular processes were gradually increased from C2-3 to C6-7. The obliquities of joint planes were C3 > C4 > C5 < C6 < C7 , and their values were distributed as a " U" shape. The middle part of the joints was located at the outside of the posterior midline and at the midpoints between spinous processes of cervical vertebra. The distance from the middle part to the posterior midline increased gradually downward from 17. 19mm, 17.51mm, 18.76mm, 19.83mm to 20.52mm. The tissue layers during the puncture approach went through skin, superficial fascia, ligamentum nuchae, splenius capitis muscle and the posterior of joint capsule. Conclusion In adult cervical vertebra, facet joint puncture should be performed at the outside ( 17. 2-20. 5mm) of the midpoint between corresponding cervical space according to the type, the angle and the obliquity of joint plane. The puncture direction should be caudally tilted at 55°-67°( average 60°)and advanced obliquely cranially.%目的 探讨颈椎小关节的关节类型、关节角大小、关节面倾角等,为临床行颈椎间隙穿刺提供可参考的路径.方法 采用正常成人脊柱标本38例(男27、女11),通过断层解剖方法,从横断面上对C2-3~C6-7关节类型、关节角进行观测,并对40套成人椎骨标本的颈椎小关节关节面倾角及形态进行观测.结果 C2-33~C6-7关节类型主要为平面椭圆形(79.2%)和曲面形(20.8%);自C2-3至C6-7颈椎关节突的关节角

  13. Tuberculous pleural effusion.

    Science.gov (United States)

    Ferreiro, Lucía; San José, Esther; Valdés, Luis

    2014-10-01

    Tuberculous pleural effusion (TBPE) is the most common form of extrapulmonary tuberculosis (TB) in Spain, and is one of the most frequent causes of pleural effusion. Although the incidence has steadily declined (4.8 cases/100,000population in 2009), the percentage of TBPE remains steady with respect to the total number of TB cases (14.3%-19.3%). Almost two thirds are men, more than 60% are aged between 15-44years, and it is more common in patients with human immunodeficiency virus. The pathogenesis is usually a delayed hypersensitivity reaction. Symptoms vary depending on the population (more acute in young people and more prolonged in the elderly). The effusion is almost invariably a unilateral exudate (according to Light's criteria), more often on the right side, and the tuberculin test is negative in one third of cases. There are limitations in making a definitive diagnosis, so various pleural fluid biomarkers have been used for this. The combination of adenosine deaminase and lymphocyte percentage may be useful in this respect. Treatment is the same as for any TB. The addition of corticosteroids is not advisable, and chest drainage could help to improve symptoms more rapidly in large effusions. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

  14. A case of Lemierre's syndrome with septic shock and complicated parapneumonic effusions requiring intrapleural fibrinolysis

    Directory of Open Access Journals (Sweden)

    Daniel P. Croft

    2015-01-01

    Full Text Available Lemierre's syndrome is a septic thrombophlebitis of the internal jugular vein, which can lead to severe systemic illness. We report a case of an otherwise healthy 26-year-old man who suffered from pharyngitis followed by septic shock requiring intubation and vasopressor support from Fusobacterium necrophorum bacteremia. The septic emboli to his lungs caused complicated bilateral parapneumonic effusions, which recurred after initial drainage. He required bilateral chest tubes and intrapleural tPA to successfully drain his effusions. His fever curve and overall condition improved with the resolution of his effusions and after a 33-day hospitalization, he recovered without significant disability. The severity of his illness and difficult to manage complicated parapneumonic effusions were the unique facets of this case. Using an evidence-based approach of tPA and DNase for complicated parapneumonic effusions in Lemierre's syndrome can be safe and effective.

  15. Evaluation and Treatment of Lumbar Facet Cysts.

    Science.gov (United States)

    Boody, Barrett S; Savage, Jason W

    2016-12-01

    Lumbar facet cysts are a rare but increasingly common cause of symptomatic nerve root compression and can lead to radiculopathy, neurogenic claudication, and cauda equina syndrome. The cysts arise from the zygapophyseal joints of the lumbar spine and commonly demonstrate synovial herniation with mucinous degeneration of the facet joint capsule. Lumbar facet cysts are most common at the L4-L5 level and often are associated with spondylosis and degenerative spondylolisthesis. Advanced imaging studies have increased diagnosis of the cysts; however, optimal treatment of the cysts remains controversial. First-line treatment is nonsurgical management consisting of oral NSAIDs, physical therapy, bracing, epidural steroid injections, and/or cyst aspiration. Given the high rate of recurrence and the relatively low satisfaction with nonsurgical management, surgical options, including hemilaminectomy or laminotomy to excise the cyst and decompress the neural elements, are typically performed. Recent studies suggest that segmental fusion of the involved levels may decrease the risks of cyst recurrence and radiculopathy.

  16. An Unexplored Facet of International Business in Greece: Foreign and Diaspora Shareholders in Joint Stock Company Start-Ups, 1833-1920

    Directory of Open Access Journals (Sweden)

    Ioanna Sapfo Pepelasis

    2016-07-01

    Full Text Available This paper focuses on an unexplored aspect of the history of international business in Greece, the presence of international shareholders in Greek Joint stock company start-ups. Our main findings are that these investors participated in numerous such firms usually as minority shareholders in capital and or knowledge intensive firms. Rarely did they opt for the exclusive international ownership of a joint stock company in Greece and the dividing line  between foreign direct investment and foreign portfolio investment was not always clear. It is also the case that international capital inflow into the nascent corporate sector involved a mosaic of collaborating actors including not only the foreign but also the diasporic.

  17. Characteristics and clinical significance of declination angles on the lower cervical facet joints%颈椎关节突关节面倾角测量特点及临床意义

    Institute of Scientific and Technical Information of China (English)

    王怀云; 何海龙; 李华; 张桦; 朱云荣; 叶晓健

    2011-01-01

    Objective To measure the angle of declination on the lower cervical facet joints ( C3_7) in normal adults, and to investigate the range of normal values and the clinical significance. Methods A total of 500 X-ray films in cervical lateral position were randomly selected from normal outpatients. The angles of declination on the lower cervical facet joints ( C3-7 ) were measured by Unisight system. Results The angles of declination from C3 to C7 were 61. 9° ± 5. 4°, 54. 8° ± 4. 7°, 50.7° ±4.9°, 55.8° ±5.1°, and 63.4° ±5.3°, respectively. The distribution of angle values from C3 to C7 appeared in a " U" shape with the minimum value at C5 and the maximum values at C7. The mean angles of declination were above 45°. Statistical analysis indicated that the values of declination angle were as follows: C7 > C3 > C4 = C6 > C5. Conclusion The distribution characteristics of declination angles on the lower cervical facet joints can help to comprehend the biomechanics of cervical vertebra and the pathogenesis of diseases and trauma related to cervical vertebrae.%目的 观察正常成年人下颈椎关节突关节面倾斜角度测量特点,探讨其正常值范围及临床意义.方法 随机抽取门诊正常成年人颈椎侧位X线片500张,利用Unisight放射影像处理软件逐个测量其C3~7小关节突关节面倾角.结果 C3-7倾角大小依次分别为:61.9°±5.4°、54.8°±4.7°、50.7°±4.9°、55.8°±5.1°、63.4°±5.3°.C3~7倾角值大小呈“U”形分布,以C5最小,C7最大,各倾角均值>45°.经统计分析,各个下颈椎小关节突关节面倾角大小比较可以概括为C7>C3 >C4 =C6 >C5.结论 下颈椎小关节突关节面倾角不同,了解其分布特点有利于理解颈椎生物力学特性及相关颈椎疾病、颈椎外伤的发病机制.

  18. 针刺联合推拿手法治疗胸椎小关节紊乱的临床观察%Clinical observation on acupuncture combined with tuina manipulation for thoracic facet joint disorder

    Institute of Scientific and Technical Information of China (English)

    周光明; 姜军; 章燕

    2015-01-01

    目的:观察针刺联合推拿手法治疗胸椎小关节紊乱的临床疗效。方法:选取符合胸椎小关节紊乱诊断标准的患者93例,按就诊先后顺序随机分为观察组和对照组。观察组46例予以针刺联合推拿手法治疗,对照组47例予以单独推拿手法治疗。每日治疗1次,治疗3次后,以患者的症状及体征积分作为观察指标,进行临床疗效评价。结果:治疗后,两组患者8个症状或体征积分均与本组治疗前有统计学差异(均P<0.01);两组间评分差异亦均有统计学意义(均P<0.05)。治疗3次后,观察组治愈率为54.4%,对照组为25.4%,两组治愈率差异有统计学意义(P<0.05)。结论:针刺联合推拿手法治疗胸椎小关节紊乱疗效优于单独推拿手法治疗,值得临床推广。%Objective:To observe the clinical effect of acupuncture combined with tuina manipulation for thoracic facet joint disorder. Methods:A total of 93 eligible cases were randomly allocated into an observation group and a control group. Patients in the observation group (n=46) were treated with acupuncture combined with tuina manipulation, whereas patients in the control group (n=47) were treated with tuina manipulation alone. The treatment was done once a day, for a total of 3 times. Therapeutic efficacies were then evaluated according to scores on signs and symptoms. Results:After treatment, there were intra-group statistically significant differences in scores of eight signs and symptoms (all P Conclusion:Acupuncture combined with tuina manipulation can obtain better effects than tuina manipulation alone for thoracic facet joint disorder and is therefore worth further clinical application.

  19. The Application and Effect of Acupuncture and Moxibustion in Treatment of Cervical Facet Joints%中医针灸疗法在颈椎小关节错缝治疗中的应用及效果

    Institute of Scientific and Technical Information of China (English)

    王宏刚

    2015-01-01

    目的:评价中医针灸疗法在颈椎小关节错缝治疗中的效果。方法本次选取研究对象60例,均为我院2014年6~12月接受治疗的颈椎小关节错缝患者。将60例颈椎小关节错缝患者随机分为对照组(n=30例)和实验组(n=30例)。对照组给予西医治疗,包括理疗、局部制动、药物治疗、颈椎牵引。实验组在此基础上给予中医针灸治疗。比较分析实验组和对照组患者的治疗效果。患者活动能力。结果(1)实验组住院时间短于对照组,患者活动能力优于对照组,P <0.05,差异有统计学意义。(2)实验组治疗效果优于对照组,P <0.05,差异具有统计学意义。结论中医针灸治疗对于治疗颈椎小关节错缝的患者具有重要的意义。%Objective To evaluate acupuncture therapy in the treatment of Cervical Small Joint in effect. Methods The study selected 60 patients in our hospital in June 2014 to December treated cervical Small Joint patients. 60 cases of cervical Small Joint patients were randomly divided into control group (n = 30 patients) and the experimental group (n=30 patients). The control group received Western medicine treatment, including physical therapy, immobilization, drug therapy, cervical traction. Experimental group received acupuncture treatment on this basis. Comparative analysis of the experimental treatment group and the control group of patients. Patient mobility. Results (1) Experimental group than the control group, shorter hospital stay, patient activity than the control group, P<0.05, The difference was statistically significant. (2) Treatment experimental group than the control group, P <0.05, The difference was statistically significant. Conclusion Acupuncture therapy for the treatment of patients with cervical facet joint dislocation seam has important significance.

  20. Faceted Semantic Search for Personalized Social Search

    CERN Document Server

    Mas, Massimiliano Dal

    2012-01-01

    Actual social networks (like Facebook, Twitter, Linkedin, ...) need to deal with vagueness on ontological indeterminacy. In this paper is analyzed the prototyping of a faceted semantic search for personalized social search using the "joint meaning" in a community environment. User researches in a "collaborative" environment defined by folksonomies can be supported by the most common features on the faceted semantic search. A solution for the context-aware personalized search is based on "joint meaning" understood as a joint construal of the creators of the contents and the user of the contents using the faced taxonomy with the Semantic Web. A proof-of concept prototype shows how the proposed methodological approach can also be applied to existing presentation components, built with different languages and/or component technologies.

  1. 综合手法治疗胸椎小关节紊乱520例临床分析%Clinical analysis on 520 cases of thoracic facet joint disorder treated with comprehensive manipulation

    Institute of Scientific and Technical Information of China (English)

    姜山

    2016-01-01

    ObjectiveTo study the effect of manipulative reduction in the treatment of thoracic facet joint disorders.Methods According to the position of the small joint disorder of thoracic vertebrae, 5 different methods were used to observe the curative effect. Results In this group, 520 cases, 1 cases were cured, 112 cases were cured, 98 cases were markedly effective, 46 cases were improved, 0 cases were ineffective, the cure rate was 72.3%, the total effective rate was 100%.Conclusion The treatment of 520 cases of this group by the above methods, the curative effect is remarkable, the method is simple and easy, and it is worth to be popularized and applied.%目的:研究胸椎小关节紊乱手法复位治疗效果。方法:根据患者胸椎小关节紊乱的位置不同采用5种方法进行治疗观察其疗效。结果:本组520例,1次治愈264例,2~6次治愈112例,显效98例,好转46例,无效0例,治愈率72.3%,总有效率100%。结论:通过上述手法对本组520例患者的治疗,疗效显著,其方法简单易行,值得临床推广运用。

  2. Multiwalled nanotube faceting unravelled

    Science.gov (United States)

    Leven, Itai; Guerra, Roberto; Vanossi, Andrea; Tosatti, Erio; Hod, Oded

    2016-12-01

    Nanotubes show great promise for miniaturizing advanced technologies. Their exceptional physical properties are intimately related to their morphological and crystal structure. Circumferential faceting of multiwalled nanotubes reinforces their mechanical strength and alters their tribological and electronic properties. Here, the nature of this important phenomenon is fully rationalized in terms of interlayer registry patterns. Regardless of the nanotube identity (that is, diameter, chirality, chemical composition), faceting requires the matching of the chiral angles of adjacent layers. Above a critical diameter that corresponds well with experimental results, achiral multiwalled nanotubes display evenly spaced extended axial facets whose number equals the interlayer difference in circumferential unit cells. Elongated helical facets, commonly observed in experiment, appear in nanotubes that exhibit small interlayer chiral angle mismatch. When the wall chiralities are uncorrelated, faceting is suppressed and outer layer corrugation, which is induced by the Moiré superlattice, is obtained in agreement with experiments. Finally, we offer an explanation for the higher incidence of faceting in multiwalled boron nitride nanotubes with respect to their carbon-based counterparts.

  3. Management of malignant pleural effusions.

    LENUS (Irish Health Repository)

    Uzbeck, Mateen H

    2010-06-01

    Malignant pleural effusions are a common clinical problem in patients with primary thoracic malignancy and metastatic malignancy to the thorax. Symptoms can be debilitating and can impair tolerance of anticancer therapy. This article presents a comprehensive review of pharmaceutical and nonpharmaceutical approaches to the management of malignant pleural effusion, and a novel algorithm for management based on patients\\' performance status.

  4. Etiologies of bilateral pleural effusions

    Science.gov (United States)

    Puchalski, Jonathan T.; Argento, A. Christine; Murphy, Terrence E.; Araujo, Katy L.B.; Oliva, Isabel B.; Rubinowitz, Ami N.; Pisani, Margaret A.

    2017-01-01

    Summary Background To evaluate the safety, etiology and outcomes of patients undergoing bilateral thoracentesis. Methods This is a prospective cohort study of 100 consecutive patients who underwent bilateral thoracenteses in an academic medical center from July 2009 through November 2010. Pleural fluid characteristics and etiologies of the effusions were assessed. Mean differences in levels of fluid characteristics between right and left lungs were tested. Associations between fluid characteristics and occurrence of bilateral malignant effusions were evaluated. The rate of pneumothorax and other complications subsequent to bilateral thoracentesis was determined. Results Exudates were more common than transudates, and most effusions had multiple etiologies, with 83% having two or more etiologies. Bilateral malignant effusions occurred in 19 patients, were the most common single etiology of exudative effusions, and were associated with higher levels of protein and LDH in the pleural fluid. Among 200 thoracenteses performed with a bilateral procedure, seven resulted in pneumothoraces, three of which required chest tube drainage and four were ex vacuo. Conclusions More often than not, there are multiple etiologies that contribute to pleural fluid formation, and of the combinations of etiologies observed congestive heart failure was the most frequent contributor. Exudative effusions are more common than transudates when bilateral effusions are present. Malignancy is a common etiology of exudative effusions. This study suggests that the overall complication rate following bilateral thoracentesis is low and the rate of pneumothorax subsequent to bilateral thoracentesis is comparable to unilateral thoracentesis. PMID:23219348

  5. Relationship between pain and effusion on magnetic resonance imaging in temporomandibular disorder patients

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ha Na; Kim, Kyoung A; Koh, Kwang Joon [Dept. of Oral and Maxillofacial Radiology, School of Dentistry and Institute of Oral Bioscience, Chonbuk National University, Jeonju (Korea, Republic of)

    2014-12-15

    This study was performed to find the relationship between pain and joint effusion using magnetic resonance imaging (MRI) in temporomandibular disorder (TMD) patients. The study subjects included 232 TMD patients. The inclusion criteria in this study were the presence of spontaneous pain or provoked pain on one or both temporomandibular joints (TMJs). The provoked pain was divided into three groups: pain on palpation (G1), pain on mouth opening (G2), and pain on mastication (G3). MRI examinations were performed using a 1.5-T MRI scanner. T1- and T2-weighted images with para-sagittal and para-coronal images were obtained. According to the T2-weighted image findings, the cases of effusions were divided into four groups: normal, mild (E1), moderate (E2), and marked effusion (E3). A statistical analysis was carried out using the chi2 test with SPSS (version 12.0, SPSS Inc., Chicago, IL, USA). Spontaneous pain, provoked pain, and both spontaneous and provoked pain were significantly related to joint effusion in TMD patients (p<0.05). However, among the various types of provoked pain, pain on palpation of the masticatory muscles and TMJ (G1) was not related to joint effusion in TMD patients (p>0.05). Spontaneous pain was related to the MRI findings of joint effusion; however, among the various types of provoked pain, pain on palpation of the masticatory muscles and TMJ was not related to the MRI findings of joint effusion. These results suggest that joint effusion has a significant influence on the prediction of TMJ pain.

  6. [Sarcoid pleural effusion].

    Science.gov (United States)

    Rodríguez-Núñez, Nuria; Rábade, Carlos; Valdés, Luis

    2014-12-09

    Pleural effusion (PE) is a very uncommon manifestation of sarcoidosis. It is equally observed in men and women, can appear at any age and in all radiologic stages, though it is more common in stages i and ii. Effusions have usually a mild or medium size and mainly involve the right side. Various mechanisms can be implicated. PE will be a serous exudate if there is an increase in the capillary permeability due to direct involvement of the pleural membrane, a chylothorax if mediastinum lymph nodes compress the thoracic duct and/or the lymphatic drainage from the pleural cavity, an hemothorax if granuloma compress or invade pleural small vessels or capillaries, and even a transudate if there is compression of the inferior vena cava, atelectasis due to complete bronchial obstruction or when the resolution of the PE is incomplete with chronic thickening of visceral pleura (trapped lung). It manifests biochemically as a pauci-cellular exudate with a predominance of lymphocytes, though there can be a preponderance of eosinophils or neutrophils. Protein concentrations are usually proportionately higher than lactate dehidrogenase, adenosine deaminase is normally low and it is possible to find increased levels of CA-125 in women. The tuberculin test is negative and pleural or lung biopsies yield the diagnosis by confirming the presence of non-caseating granulomata. These PE can have a favorable self-limited outcome, even though in most cases treatment with corticosteroids is needed, while surgery is required in a few cases. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  7. Trans-facet joints approach to treat thoracic degenerative diseases with anterior compression%经关节突入路治疗前方骨性压迫型胸椎退行性疾患

    Institute of Scientific and Technical Information of China (English)

    马学晓; 陈伯华; 张岩; 张国庆; 胡有谷

    2010-01-01

    Objective To investigate the clinical outcomes of trans-facet joints approach to treat thoracic degenerative disease with anterior compression.Methods From January 2003 to December 2009,22 patients with thoracic myelopathy caused by anterior compression were studied retrospectively.The patients included 16 males and 6 females,aged from 36 to 72 years(average 54.2 years).There were thoracic ossification of posterior longitudinal ligament(OPLL)in 11 cases,thoracic disc protrusion with ossification in 8 cases,thoracic vertebra posterior osteophytes in 2 cases,ankylosing spondylitis with thoracic pseudoarthrosis in 1 cases.Preoperative Japanese Orthopaedic Association(JOA)score was 5.2(range,2-9).The characteristic of thoracic degeneration was analyzed by CT and MRI examination.Posterior decompressive laminectomies were performed by the technique of "cap uncovering".The facet joints were removed bilaterally.Anterior ossified compressions were cut via posterior-lateral approach,and then intervertebral bone graft and bilateral pedicle screws were implanted.Results All patients were followed up for 8 to 38 months.According to the revised Epstein standard,there were excellent in 7 patients,good in 9,fair in 4,and poor in 2.The total effective rate was 90.9%(20/22).The excellent and good rate was 72.7%(16/22).The mean postoperative JOA score was 8.7(range,2-11).Surgical complications included dural laceration in 1 patient,pleura injury in 1 patient,epidural hematoma in 2 patients.There were no cases of spinal instability or deep infection.Conclusion The anterior compression can be solved completely via trans-facet joints approach in thoracic degenerative disease patients.%目的 探讨经关节突入路治疗前方骨性致压型胸椎退行性疾患的手术方法和治疗效果.方法 2003年1月至2009年12月,收治前方骨性致压型胸椎退行性疾患患者22例,男16例,女6例;年龄36~72岁,平均54.2岁;胸椎后纵韧带骨化11

  8. Thoracoscopy in undiagnosed pleural effusions

    African Journals Online (AJOL)

    diagnostic thoracoscopy for pleural effusions of unknown origin. Design. Retrospective review of consecutive patients referred for diagnostic thoracoscopy ... symptoms such as fever and sweats is highly associated with a final diagnosis of ...

  9. Pericardial effusion in celiac disease

    Directory of Open Access Journals (Sweden)

    Farzaneh Ashrafi

    2014-01-01

    Full Text Available Celiac disease is an autoimmune disorder that affected 1% of all population in United State. Classic manifestations of disease consist of early childhood diarrhea, malabsorption, steatorrhea and growth retardation but disease can affects adult at any age. In adult anemia is a more frequent finding. This patient was a 40-year-old lady with progressive fatigue and lower extremities pitting edema. Iron deficiency anemia and celiac disease were diagnosed on the basis of low serum ferritin, elevated serum level of IgA endomysial and tissue transglutaminase anti-bodies and histologic findings in small bowel biopsies. Pericardial effusion in her evaluation was detected incidentally. Asymptomatic pericardial effusion in this patient was only detectable with imaging. After starting of gluten free diet and iron supplement fatigue, peripheral edema and pericardial effusion on echocardiography decreased. It should be noted that asymptomatic pericardial effusion may be seen in adults with celiac disease.

  10. Investigation of stresses in facetted glass shell structures

    DEFF Research Database (Denmark)

    Bagger, Anne; Jönsson, Jeppe; Wester, Ture

    2007-01-01

    The typical use of triangular and quadrangular facets in doubly curved facetted shells requires the use of triangulated truss systems or quadrangular truss framing with diagonals or cross tension cabling. In such a structure, the load carrying ability is based on concentrated forces in the framing...... system, while the glass merely serves as a separation of the inside environment from the outside. In this paper facetted glass shell structures with three way vertices, i.e. with three adjoining edges in each vertex are considered, since the load carrying ability of such a structure is achieved primarily...... by in-plane forces in the facets and the transfer of distributed in-plane forces across the joints. It is described how these facets work structurally, specifically how bending moments develop and cause possible stress concentrations in the corners, which are subjected to uplift. Apart from local...

  11. Minoxidil-associated exudative pleural effusion.

    Science.gov (United States)

    Siddiqui, Atif; Ansari, Mohammed; Shakil, Jawairia; Chemitiganti, Rama

    2010-05-01

    Recurrent pleural effusions are associated with significant morbidity and mortality. Drug-related reactions causing pleural effusions are not common, but their identification can potentially improve patient outcome. Minoxidil has been implicated in pleuropericardial effusions in patients with chronic kidney disease. The exact mechanism by which pleural effusion occurs is still unclear. We report a case of isolated exudative pleural effusion associated with minoxidil in a patient without underlying kidney disease that almost completely resolved after the drug was discontinued.

  12. Facets of Subjectification

    Science.gov (United States)

    Visconti, Jacqueline

    2013-01-01

    Subjectification, as the diachronic facet of subjectivity, has raised in the last two decades a number of interesting questions in grammaticalization and semantic change theory. In this paper I shall reflect on the nature and construal of subjectification, focusing on the question, formulated by Traugott (2010a, p. 58), "whether it is possible to…

  13. EFFECTS OF NOVEL ANGLED CERVICAL DISC REPLACEMENT ON FACET JOINT STRESS%角度人工颈椎间盘置换对关节突应力的影响

    Institute of Scientific and Technical Information of China (English)

    柏传毅; 张维杰; 凌伟; 田振兴; 党晓谦; 王坤正

    2012-01-01

    Objective To analyze the biomechanical changes of the adjacent cervical facet joints when the angled 'cervical prosthesis is replaced. Methods A total of 400 northwestern people were involved, with an age of 40 years or older. The cervical vertebra lateral X-ray films were taken, and the cervical angles were measured by professional computer aided design software, then the cervical intervertebral disc prosthesis with 10° angle was designed. The finite element models of G, 5 and C4-6 segments with intact cervical discs were developed; the C*, 5 disc was replaced by the cervical prosthesis with 0° and 10° angle respectively; and then all models were subjected to axial loading, flexion/extension, lateral bending, and torsion loading conditions; the stress effects on adjacent facet joints after replacement were observed by comparing with that of the intact model. Results The cervical angles were (9.97 ± 3.64)° in C3,4, (9.95 + 4.34)° in G, 5) (8.59 ± 3.75)° in C5,6, and (8.49 ± 3.39)° in C6,7, showing no significant difference between C3,4 and C4,5, Cs, 6 and C6,7 (P > 0.05) and showing significant differences between the other cervical angles (P < 0.05). When C4,5 model was axially loaded, no significant difference in equivalent shearing stress were observed in intact, 0°, and 10° groups; at flexion/extension loading, the stress was biggest in intact group, and was smallest in 10° group; at lateral bending, the stress got the high rank in intact group, and was minimum in 10° group; at torsion loading, the stress state of 10° group approached to the intact one condition. When C4-6 model was loaded, the facet joint stress of the replaced segment (C4,5) decreased significantly at axial loading, flexion/extension, and lateral bending; while no obvious decrease was observed at torsion loading; the stress of the adjacent inferior disc (Cs. 6) decreased significantly at axial loading and lateral bending condition, while less decrease was observed at torsion

  14. Short-term outcome of fluoroscopic-guided steroid injection therapy of lumber facet cyst-induced radicular pain

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Mi Ri; Kwon, Jong Won; Lee, Jong Seo; Kim, Eu Sang [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2015-04-15

    To determine the short-term effect of fluoroscopic-guided steroid injection therapy of lumbar facet cyst-induced radicular pain. Seventeen patients with radiculopathy due to lumbar synovial cysts, who were treated with fluoroscopically guided injection, were retrospectively evaluated. All plain radiographic images and MR images before the therapy were reviewed. Five patients underwent only the facet joint injection, whereas twelve patients underwent the facet joint injection with perineural injection therapy. The clinical course of pain was evaluated on the first follow-up after therapy. Effective pain relief was achieved in 11 (64.7%) of the 17 patients. Among 12 patients who underwent facet joint injection with perineural injection, 9 patients (75%) had an effective pain relief. Of 5 patients, 2 (40%) patients only took the facet joint injection and had an effective pain relief. Fluoroscopic-guided steroid injection therapy shows a good short-term effect in patients with symptomatic lumbar facet joint synovial cysts.

  15. LOFAR facet calibration

    CERN Document Server

    van Weeren, R J; Hardcastle, M J; Shimwell, T W; Rafferty, D A; Sabater, J; Heald, G; Sridhar, S S; Dijkema, T J; Brunetti, G; Brüggen, M; Andrade-Santos, F; Ogrean, G A; Röttgering, H J A; Dawson, W A; Forman, W R; de Gasperin, F; Jones, C; Miley, G K; Rudnick, L; Sarazin, C L; Bonafede, A; Best, P N; Bîrzan, L; Cassano, R; Chyży, K T; Croston, J H; Ensslin, T; Ferrari, C; Hoeft, M; Horellou, C; Jarvis, M J; Kraft, R P; Mevius, M; Intema, H T; Murray, S S; Orrú, E; Pizzo, R; Simionescu, A; Stroe, A; van der Tol, S; White, G J

    2016-01-01

    LOFAR, the Low-Frequency Array, is a powerful new radio telescope operating between 10 and 240 MHz. LOFAR allows detailed sensitive high-resolution studies of the low-frequency radio sky. At the same time LOFAR also provides excellent short baseline coverage to map diffuse extended emission. However, producing high-quality deep images is challenging due to the presence of direction dependent calibration errors, caused by imperfect knowledge of the station beam shapes and the ionosphere. Furthermore, the large data volume and presence of station clock errors present additional difficulties. In this paper we present a new calibration scheme, which we name facet calibration, to obtain deep high-resolution LOFAR High Band Antenna images using the Dutch part of the array. This scheme solves and corrects the direction dependent errors in a number of facets that cover the observed field of view. Facet calibration provides close to thermal noise limited images for a typical 8 hr observing run at $\\sim$ 5arcsec resolu...

  16. Translaminar facetal screw (magerl′s fixation

    Directory of Open Access Journals (Sweden)

    Rajasekaran S

    2005-01-01

    Full Text Available Translaminar facet screw fixation (TLFS achieves stabilization of the vertebral motion segment by screws inserted at the base of the spinous process, through the opposite lamina, traversing the facet joint, and ending in the base of the transverse process. It is simple, does not require any specialized equipment, and has the advantages of being a procedure of lesser magnitude, lesser operative time, less cost and few complication rate. Recently there is growing interest in this technique to augment the anterior lumbar fusions to achieve global fusion less invasively. In this review article, we discuss the clinical and biomechanical considerations, surgical technique, indications, contraindications and recent developments of TLFS fixation in lumbar spine fusion.

  17. Nonchylous idiopathic pleural effusion in the newborn

    Directory of Open Access Journals (Sweden)

    Geeta Gathwala

    2011-01-01

    Full Text Available Congenital isolated pleural effusion is a rare cause of respiratory distress in neonates. It is usually chylous. Herein, we report a rare case of nonchylous congenital idiopathic pleural effusion.

  18. Pleuropericardial effusion associated with minoxidil administration

    Science.gov (United States)

    Webb, D. B.; Whale, R. J.

    1982-01-01

    A patient on minoxidil developed pericardial and pleural effusions with a high protein content. This finding is not compatible with the view that such effusions in patients taking minoxidil are transudates. PMID:7111124

  19. Pleural effusion following ovarian hyperstimulation.

    Science.gov (United States)

    Junqueira, Jader Joel Machado; Bammann, Ricardo Helbert; Terra, Ricardo Mingarini; Castro, Ana Cristina P; Ishy, Augusto; Fernandez, Angelo

    2012-01-01

    Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication that occurs in the luteal phase of an induced hormonal cycle. In most cases, the symptoms are self-limited and spontaneous regression occurs. However, severe cases are typically accompanied by acute respiratory distress. The objective of the present study was to describe the clinical presentation, treatment, and outcome of pleural effusion associated with OHSS in three patients undergoing in vitro fertilization. The patients ranged in age from 27 to 33 years. The onset of symptomatic pleural effusion (bilateral in all cases) occurred, on average, 43 days (range, 27-60 days) after initiation of hormone therapy for ovulation induction. All three patients required hospitalization for massive fluid resuscitation, and two required noninvasive mechanical ventilation. Although all three patients initially underwent thoracentesis, early recurrence of symptoms and pleural effusion prompted the use of drainage with a pigtail catheter. Despite the high output from the pleural drain (mean, 1,000 mL/day in the first week) and prolonged drainage (for 9-22 days), the outcomes were excellent: all three patients were discharged from hospital. Although pleural effusion secondary to OHSS is probably underdiagnosed, the associated morbidity should not be underestimated, especially because it affects potentially pregnant patients. In this study, early diagnosis and appropriate supportive measures yielded favorable results, limiting the surgical approach to adequate pleural drainage.

  20. The Many Facets of PISA

    Science.gov (United States)

    Berliner, David C.

    2015-01-01

    Trying to understand PISA is analogous to the parable of the blind men and the elephant. There are many facets of the PISA program, and thus many ways to both applaud and critique this ambitious international program of assessment that has gained enormous importance in the crafting of contemporary educational policy. One of the facets discussed in…

  1. Faceted Taxonomy-Based Sources

    Science.gov (United States)

    Tzitzikas, Yannis

    The objective of this chapter is to explain the underlying mathematical structure of faceted taxonomy-based sources and to provide some common notions and notations that are used in some parts of the book. Subsequently, and on the basis of the introduced formalism, this chapter describes the interaction between a user and an information source that supports dynamic taxonomies and faceted search.

  2. Etiological diagnosis of pericardial effusion.

    Science.gov (United States)

    Levy, Pierre-Yves; Habib, Gilbert; Collart, Fréderic; Lepidi, Hubert; Raoult, Didier

    2006-08-01

    Detection and treatment of pericarditis remains a challenging problem and the etiology is unknown in 40-85% of cases. As a result, a large proportion of cases are labeled idiopathic pericarditis. The advent of echocardiography, an accurate noninvasive method for the detection of effusion, has clarified the definition from pericarditis to pericardial effusion, which is a standardized and clear entity. A systematic approach to diagnostic testing based on standardized practice guidelines has been proposed. This strategy has led to a decrease in the number of cases classified as idiopathic and to the identification of treatable conditions. Percutaneous pericardiocentesis, guided by fluoroscopy or echocardiography, can now be carried out safely and rapidly and has also allowed the intrapericardial instillation of drugs, representing a new treatment strategy. The inclusion of flexible pericardioscopy, immunohistochemistry and contemporary molecular biology tools has improved the diagnostic value of the biopsy.

  3. Pleural effusion in liver disease.

    Science.gov (United States)

    Alonso, José Castellote

    2010-12-01

    Hepatic hydrothorax is the paradigmatic pleural effusion in liver cirrhosis. It is defined as a pleural effusion in a patient with portal hypertension and no cardiopulmonary disease. The estimated prevalence of this complication in patients with liver cirrhosis is 5 to 6%. Its pathophysiology involves movement of ascitic fluid from the peritoneal cavity into the pleural space through diaphragmatic defects. Thoracentesis and pleural fluid analysis are necessary for diagnosis. Initial management consists of sodium restriction, diuretics, and therapeutic thoracentesis. A transjugular intrahepatic portosystemic shunt may provide a bridge prior to liver transplantation. Spontaneous bacterial empyema is the infection of a preexisting hydrothorax. The more frequent bacteria involved are ENTEROBACTERIACEAE and gram-positive cocci. Antibiotic therapy is the cornerstone of therapy. This article reviews etiology, clinical manifestations, and therapy of these two complications of liver cirrhosis and portal hypertension.

  4. Uveal effusion syndrome (clinical case

    Directory of Open Access Journals (Sweden)

    Yu. A. Belyy

    2015-01-01

    Full Text Available The purpose — to evaluate the effectiveness of the posterior sclerectomy with the corneal trepan in a uveal effusion syndrome.Patients and methods. Patient 1. The man, 61 years, complained about a blindness of the right eye and the progressing decrease in vision of the left eye. According to data of examinations the diagnosis was: uveal effusion syndrome, detachment of the choroid, exudative retinal detachment, the complicated cataract of both eyes. Patient 2. The man, 62 years, with complaints to low vision of the right eye and a blindness of the left-hand eye. Diagnosis: uveal effusion syndrome, detachment of the choroid, exudative retinal detachment, the initial complicated cataract of the right eye. Subatrophy operated retinal detachment, complicated cataract, silicone into the vitreal cavity of the left eye. Both patients underwent trepanation posterior sclera. Results. The patient 1noted significant improvement of vision in both eyes at the last examination. Мisual acuity with correction was OD — 0,2, OS — 0.3. Intraocular pressure was normal, improvement of electrical sensitivity and lability was diagnosed. On ultrasound examination of the retina belonged, moderate swelling of the choroid remained. Patient 2. Visual acuity was 0,1 + 3,0 D at the time of the last inspection. According to the ultrasonic B-scan of the right eye retinal detachment decreased to 3,8 mm, moderate swelling of the choroid remained. The OСT has showed detachment of the neuroepithelium in the macula to 60 μm. In ultrasonic biomicroscopy circular, ciliochoroidal detachment to 0,15 mm was diagnised.Conclusion. Described clinical cases confirmed the almost complete recovery of patients with the uveal effusion syndrome. Sclerectomy with the use of corneal trepan is a technically simple procedure and helps to define the path of the outflow suprachoroidal fluid subtenon space.

  5. Management of malignant pleural effusion

    OpenAIRE

    Boshuizen, R.C.

    2017-01-01

    The first part of this thesis focuses on IPCs (indwelling pleural catheters) in malignant pleural effusion (MPE) management. In an invited review, the (dis)advantages and prejudices of IPCs are described (Chapter1.1). Since costs and reimbursement issues are the main reasons in the Netherlands to withhold patients from IPCs, we performed a retrospective analysis of a prospectively collected database. In this database, we registered patient characteristics (gender, tumor type), survival data a...

  6. Diagnostic Value of History Taking and Physical Examination to Assess Effusion of the Knee in Traumatic Knee Patients in General Practice

    NARCIS (Netherlands)

    Kastelein, Marlous; Luijsterburg, Pim A.; Wagemakers, Harry A.; Bansraj, Santusha C.; Berger, Marjolein Y.; Koes, Bart W.; Bierma-Zeinstra, Sita M.

    2009-01-01

    Objective: To assess the diagnostic value of history taking and physical examination for knee joint effusion in patients with a knee injury who consult their general practitioner (GP). In addition, to determine the association between effusion seen on magnetic resonance imaging (MRI) and internal de

  7. Quantitative morphometric analysis of the lumbar vertebral facets and evaluation of feasibility of lumbar spinal nerve root and spinal canal decompression using the Goel intraarticular facetal spacer distraction technique: A lumbar/cervical facet comparison

    Directory of Open Access Journals (Sweden)

    Savni R Satoskar

    2014-01-01

    Full Text Available Objective : The authors evaluate the anatomic subtleties of lumbar facets and assess the feasibility and effectiveness of use of ′Goel facet spacer′ in the treatment of degenerative spinal canal stenosis. Materials and Methods : Twenty-five lumbar vertebral cadaveric dried bones were used for the purpose. A number of morphometric parameters were evaluated both before and after the introduction of Goel facet spacers within the confines of the facet joint. Results : The spacers achieved distraction of facets that was more pronounced in the vertical perspective. Introduction of spacers on both sides resulted in an increase in the intervertebral foraminal height and a circumferential increase in the spinal canal dimensions. Additionally, there was an increase in the disc space or intervertebral body height. The lumbar facets are more vertically and anteroposteriorly oriented when compared to cervical facets that are obliquely and transversely oriented. Conclusions : Understanding the anatomical peculiarities of the lumbar and cervical facets can lead to an optimum utilization of the potential of Goel facet distraction arthrodesis technique in the treatment of spinal degenerative canal stenosis.

  8. Rapidly Regressive Unilateral Fetal Pleural Effusion

    Directory of Open Access Journals (Sweden)

    Tuncay Yuce

    2015-03-01

    Full Text Available Intrauterine pleural effusion of fetal lungs rarely regresses without intervention. In our case we treated a women at 32th weeks of gestation. Her pregnancy was complicated with fetal pleural effusion and polyhydramniosis. A therapeutic thoracocentesis was planned and she received two courses of betamethasone prior to procedure. On the day of planned procedure, a substantial regression of pleural effusion was observed and procedure was postponed. During her antenatal follow-up a complete regression of pleural effusion was observed. After delivery pleural effusion did not relapse. These findings hint there may be a role of antenatal steroids in treatment of fetal pleural effusion, which is known to be resistant to treatment modalities both during antenatal and postnatal period. [Cukurova Med J 2015; 40(Suppl 1: 25-28

  9. Rheumatoid pleural effusion with nodular pleuritis. A rare presentation of rheumatoid arthritis.

    Science.gov (United States)

    Emmungil, H; Yıldız, F; Gözükara, M Y; Açıkalın, A

    2015-02-01

    Rheumatoid pleural effusion and lung nodules are unusual complications of rheumatoid disease that typically present subsequently to other more common manifestations of rheumatoid illness. However, these complications may occasionally occur before or concurrently with the development of joint manifestations of disease. We report the case of a 41-year-old female patient with rheumatoid pleural effusion and lung nodule arising simultaneously with the onset of joint symptoms. The patient underwent thoracentesis followed by video-assisted thoracoscopic biopsy to result in a diagnosis of rheumatoid pleuritis and nodular disease. A high index of suspicion and coexistence of the cytologic and histopathologic effusion picture characteristic of rheumatoid pleuritis are of clinical importance in making a diagnosis.

  10. A Study on Significance of Serum Effusion Albumin Gradient in The Differential Diagnosisof Pleural Effusion

    OpenAIRE

    Arijit Kumar Das; Krishna Baruah

    2009-01-01

    To evaluate serum pleural effusion albumin gradient (SEAG) as method of differentiating pleural transudatesfrom exudates.Cases admitted in AMCH with diagnosed pleural effusion were divided into 2 groups basedon etiology. Group I (transudates): Comprising 14 patients of congestive heart failure (n=6) and nephroticsyndrome (n=3), Cirrhosis (n=4), pericardial effusion (n=1). Group II (exudates): comprising 26 cases oftuberculous (n=15), malignant (n=8) and parapneumonic effusion (n=2), rheumatoi...

  11. Targeted Radiofrequency Ablation as an Adjunct in Treatment of Lumbar Facet Cysts.

    Science.gov (United States)

    Hatgis, Jesse; Granville, Michelle; Berti, Aldo; Jacobson, Robert E

    2017-06-06

    Lumbar facet cysts are frequently found in patients with facet degeneration and segmental instability. When the facet cyst is localized in the neural foramina and lateral recess or becomes large, it can cause radiculopathy or neurogenic claudication. These symptomatic cysts are typically treated interventionally with drainage and a corticosteroid injection or attempts via overinflation to rupture the cyst; however, these procedures have a significant recurrence rate (up to 50%) and often need to be repeated or lead to lumbar surgery if unsuccessful.   This is the first report of using targeted radiofrequency (RF) current as an adjunct to cyst drainage. Although RF has been used for years to treat facet pain indirectly by targeting the medial facet nerve branches, with this technique, under image guidance, the actual cyst is percutaneously drained and then cauterized along with the associated facet capsule, where the original cyst developed. This has improved overall results with less cyst recurrence than previous percutaneous methods and was documented with both intermediate and long-term followup clinically and with magnetic resonance imaging (MRI) scans. This report reviews the underlying anatomy and pathology of the facet joint relating to the development of facet cysts and how current percutaneous treatments for lumbar facet cysts can be supplemented and improved by adding targeted RF ablation to the percutaneous options available to treat a lumbar facet cyst.

  12. Acupuncture Treatment of Synovitis with Effusion-A Report of 50 Cases

    Institute of Scientific and Technical Information of China (English)

    Wang Anxiang; Zhao Yuntao; Mao Shuzhang

    2005-01-01

    @@ Synovitis of the knee joint is a commonly encountered disease found in the middle-aged and old people. The disease is usually painful, particularly on motion, and is characterized by fluctuating swelling due to effusion within the synovial sacs in case there is trauma, inflammation or rheumatism.

  13. 痞满脾胃虚弱证临床症状与胸椎小关节紊乱的关系与手法治疗研究%Research of the manual therapy and the relationship between clinical symptoms of weak spleen and stomach and thoracic facet joint disorders

    Institute of Scientific and Technical Information of China (English)

    周学龙; 王明杰; 韦明; 何建红; 孙刚; 孙利伟

    2013-01-01

    Objective:To investigate the the relationship between clinical symptoms of weak spleen and stomach and thoracic facet joint disorders and the effect of the manual therapy. Methods: The patients who meet the diagnostic criteria as subjects, survey the probability of concurrent thoracic facet joint disorders in patients, and used manual therapy to treat the local signs, evaluated the efficacy before and after treatment. Results: In 100 patients, there are 32 cases with thoracic spinous process skew, prominent and paraspinal tenderness or muscle tension and other local signs, accounted for 32% of those surveyed; which 32 patients with thoracic facet joint disorders were given manipulation therapy, the main symptom scores before and after treatment there was a significant difference (P<0.01), total efficiency was 87.5%. Conclusion:Weak spleen and stomach related with thoracic facet joint disorders, manual therapy can effectively improve the clinical syndrome of weak spleen and stomach, but the exact mechanism remains to be further studied.%目的:调查痞满脾胃虚弱证临床症状与胸椎小关节紊乱的关系和观察手法整复胸椎小关节紊乱对痞满脾胃虚弱证临床症状的影响。方法:以符合痞满脾胃虚弱证诊断标准者为调查对象,统计调查对象中并发胸椎小关节紊乱的机率,并对具有胸椎小关节紊乱局部体征者进行手法治疗,以治疗前后的症状积分情况评价疗效。结果:在调查的100例痞满脾胃虚弱证患者中,有32例具有胸椎棘突偏歪、后突和棘旁压痛或肌紧张等局部体征,占调查人数的32%;其中32例痞满脾胃虚弱证并胸椎小关节紊乱患者经手法整复其胸椎小关节紊乱后,治疗前后主要症状积分比较有显著性差异(P<0.01),总有效率为87.5%。结论:痞满脾胃虚弱证与胸椎小关节紊乱有关,手法整复胸椎小关节紊乱可有效地改善痞满脾胃虚弱证患者的临床症

  14. 针刺夹脊穴联合推拿手法治疗胸椎小关节紊乱的临床观察%Clinical observation on acupuncture at Jiaji (EX-B 2) points plus tuina in treating thoracic facet joint disorder

    Institute of Scientific and Technical Information of China (English)

    周伟成; 诸剑芳

    2016-01-01

    目的:观察针刺夹脊穴联合推拿整复手法治疗胸椎小关节紊乱的临床疗效,为本病的针灸治疗提供新的临床证据。方法:将106例符合纳入标准的胸椎小关节紊乱患者按随机数字表随机分为观察组和对照组。对照组予以单纯的推拿整复手法治疗,观察组在对照组推拿整复手法前予以针刺夹脊穴治疗。两组均每日1次,治疗3次后观察症状、体征的改善情况及疗效。结果:治疗后,两组患者8个症状、体征积分均与本组治疗前均有统计学差异(P<0.01);观察组患者的各个症状、体征积分均明显低于对照组,组间差异均有统计学意义(P<0.05)。观察组治愈率为50.9%,对照组为26.4%,两组治愈率差异有统计学意义(P<0.05)。结论:针刺联合手法整复治疗胸椎小关节紊乱能使胸椎重新达到生物力学平衡,充分发挥针灸推拿的联合作用,显著地提高临床疗效。%Objective:To observe the clinical effects of acupuncture at Jiaji (EX-B 2) points plus tuina manipulation for thoracic facet joint disorder, and get new clinical evidence for treatment of thoracic facet joint disorder. Methods:Totally 106 patients with thoracic facet joint disorder were randomly allocated into an observation group and a control group based on the random number table. Patients in the control group were treated by tuina manipulation, while those in the observation group were treated by acupuncture at Jiaji (EX-B 2) points before tuina manipulation. Patients in the two groups were treated once a day. The improvements of signs and symptoms and the efficacy were observed after 3 treatments. Results:After treatment, there were intra-group statistical differences in scores of 8 signs and symptoms in both groups (P<0.01); the score of each item in the observation group was lower than that in the control group, and there was statistical significance in the inter-group difference (P<0

  15. Joint ventures in medical services.

    Science.gov (United States)

    Rublee, D A

    1987-01-01

    This paper is an overview of joint-venture activity in healthcare, describing trends in joint ventures and raising issues for physicians. The purposes are to discuss the major current facets of joint-venture alliances in healthcare and to identify policy issues that arise from the trend to use joint ventures as an organizational tool. Speculation is made about the future role of joint ventures in the organization of healthcare.

  16. Postoperative pleural effusion following upper abdominal surgery

    DEFF Research Database (Denmark)

    Nielsen, P H; Jepsen, S B; Olsen, A D

    1989-01-01

    Of 128 patients who underwent upper abdominal surgery, examined by standard preoperative and postoperative chest roentgenograms for the formation of postoperative pleural effusions, 89 had postoperative pleural effusions. Their presence was not related to the type of operation, infection, serum a...

  17. Postoperative pleural effusion following upper abdominal surgery

    DEFF Research Database (Denmark)

    Nielsen, P H; Jepsen, S B; Olsen, A D

    1989-01-01

    Of 128 patients who underwent upper abdominal surgery, examined by standard preoperative and postoperative chest roentgenograms for the formation of postoperative pleural effusions, 89 had postoperative pleural effusions. Their presence was not related to the type of operation, infection, serum a...

  18. Diagnosis exjuvantibus of a persistent pleural effusion

    Directory of Open Access Journals (Sweden)

    José M. Porcel

    2013-12-01

    Full Text Available The diagnosis of uremia-associated effusion is one of exclusion. A patient with an unexplained chronic pleural exudate, which cleared with dialysis, is reported. The differential diagnosis of pleural effusions in patients with chronic kidney disease and the management of uremic pleuritis is briefly discussed.

  19. Vascular endothelial growth factor in diagnosis of pleural effusion

    Directory of Open Access Journals (Sweden)

    Nasr H. Khalil

    2017-01-01

    Conclusion: VEGF pleural fluid level could differentiate between malignant and non malignant effusion, while could not differentiate between tuberculous and nontuberculous, or between parapneumonic and nonparapneumonic exudative effusions.

  20. Pleural effusion: diagnosis, treatment, and management

    Directory of Open Access Journals (Sweden)

    Karkhanis VS

    2012-06-01

    Full Text Available Vinaya S Karkhanis, Jyotsna M JoshiDepartment of Respiratory Medicine, TN Medical College and BYL Nair Hospital, Mumbai, IndiaAbstract: A pleural effusion is an excessive accumulation of fluid in the pleural space. It can pose a diagnostic dilemma to the treating physician because it may be related to disorders of the lung or pleura, or to a systemic disorder. Patients most commonly present with dyspnea, initially on exertion, predominantly dry cough, and pleuritic chest pain. To treat pleural effusion appropriately, it is important to determine its etiology. However, the etiology of pleural effusion remains unclear in nearly 20% of cases. Thoracocentesis should be performed for new and unexplained pleural effusions. Laboratory testing helps to distinguish pleural fluid transudate from an exudate. The diagnostic evaluation of pleural effusion includes chemical and microbiological studies, as well as cytological analysis, which can provide further information about the etiology of the disease process. Immunohistochemistry provides increased diagnostic accuracy. Transudative effusions are usually managed by treating the underlying medical disorder. However, a large, refractory pleural effusion, whether a transudate or exudate, must be drained to provide symptomatic relief. Management of exudative effusion depends on the underlying etiology of the effusion. Malignant effusions are usually drained to palliate symptoms and may require pleurodesis to prevent recurrence. Pleural biopsy is recommended for evaluation and exclusion of various etiologies, such as tuberculosis or malignant disease. Percutaneous closed pleural biopsy is easiest to perform, the least expensive, with minimal complications, and should be used routinely. Empyemas need to be treated with appropriate antibiotics and intercostal drainage. Surgery may be needed in selected cases where drainage procedure fails to produce improvement or to restore lung function and for closure of

  1. Bilateral pleural effusion with APLA positivity in a case of rhupus syndrome

    Directory of Open Access Journals (Sweden)

    Kaushik Saha

    2014-01-01

    Full Text Available Rhupus syndrome is a rare syndrome characterized by overlap of rheumatoid arthritis (RA and systemic lupus erythematosus (SLE. Our patient was a diagnosed case of RA and developed SLE 2 years after. She was a middle-aged woman, presented with bilateral pleural effusion with exacerbation of skin and joint symptoms of SLE. We diagnosed the case as tubercular pleural effusion by positive Mycobacterium tuberculosis in bactec 460 culture. She had also anti-phospholipid antibody positivity without any symptoms and signs of thrombosis.

  2. Bilateral pleural effusion with APLA positivity in a case of rhupus syndrome.

    Science.gov (United States)

    Saha, Kaushik; Saha, Arnab; Mitra, Mrinmoy; Panchadhyayee, Prabodh

    2014-10-01

    Rhupus syndrome is a rare syndrome characterized by overlap of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Our patient was a diagnosed case of RA and developed SLE 2 years after. She was a middle-aged woman, presented with bilateral pleural effusion with exacerbation of skin and joint symptoms of SLE. We diagnosed the case as tubercular pleural effusion by positive Mycobacterium tuberculosis in bactec 460 culture. She had also anti-phospholipid antibody positivity without any symptoms and signs of thrombosis.

  3. Prevalence, hemodynamics, and cytokine profile of effusive-constrictive pericarditis in patients with tuberculous pericardial effusion.

    Directory of Open Access Journals (Sweden)

    Mpiko Ntsekhe

    Full Text Available BACKGROUND: Effusive constrictive pericarditis (ECP is visceral constriction in conjunction with compressive pericardial effusion. The prevalence of proven tuberculous ECP is unknown. Whilst ECP is distinguished from effusive disease on hemodynamic grounds, it is unknown whether effusive-constrictive physiology has a distinct cytokine profile. We conducted a prospective study of prevalence and cytokine profile of effusive-constrictive disease in patients with tuberculous pericardial effusion. METHODS: From July 2006 through July 2009, the prevalence of ECP and serum and pericardial levels of inflammatory cytokines were determined in adults with tuberculous pericardial effusion. The diagnosis of ECP was made by combined pericardiocentesis and cardiac catheterization. RESULTS: Of 91 patients evaluated, 68 had tuberculous pericarditis. The 36/68 patients (52.9%; 95% confidence interval [CI]: 41.2-65.4 with ECP were younger (29 versus 37 years, P=0.02, had a higher pre-pericardiocentesis right atrial pressure (17.0 versus 10.0 mmHg, P 15 mmHg (odds ratio [OR] = 48, 95%CI: 8.7-265; P 200 pg/ml (OR=10, 95%CI: 1.1, 93; P=0.04 were independently associated with ECP. CONCLUSION: Effusive-constrictive disease occurs in half of cases of tuberculous pericardial effusion, and is characterized by greater elevation in the pre-pericardiocentesis right atrial pressure and pericardial and serum IL-10 levels compared to patients with effusive non-constrictive tuberculous pericarditis.

  4. Acute subdural effusion in vasculitis

    Directory of Open Access Journals (Sweden)

    Raghavendra Seetharam

    2008-01-01

    Full Text Available We report a 29-year-old man with a unique presentation of vasculitis as acute unilateral subdural effusion and meningoencephalitis. Magnetic resonance imaging showed a brainstem lesion that spread to the thalamus over time. There were no systemic features of vasculitis other than a positive pathergy test. Histopathological examination from the pathergy site showed neutrophilic infiltrate and leucocytoclastic vasculitis. The condition was steroid responsive and he remained in remission at two years′ follow-up. The anatomy of the brainstem lesion, absence of other inflammatory and infective conditions on evaluation suggests a vasculitic pathology either as primary central nervous system angiitis or as neurological presentation of systemic vasculitis like Behηet′s disease although the international diagnostic criteria for Behηet′s were not fulfilled.

  5. Faceting diagram for sticky steps

    Directory of Open Access Journals (Sweden)

    Noriko Akutsu

    2016-03-01

    Full Text Available Faceting diagrams for the step-faceting zone, the step droplet zone, and the Gruber-Mullins-Pokrovsky-Talapov (GMPT zone for a crystal surface are obtained by using the density matrix renormalization group method to calculate the surface tension. The model based on these calculations is the restricted solid-on-solid (RSOS model with a point-contact-type step-step attraction (p-RSOS model on a square lattice. The point-contact-type step-step attraction represents the energy gain obtained by forming a bonding state with orbital overlap at the meeting point of the neighboring steps. In the step-faceting zone, disconnectedness in the surface tension leads to the formation of a faceted macrostep on a vicinal surface at equilibrium. The disconnectedness in the surface tension also causes the first-order shape transition for the equilibrium shape of a crystal droplet. The lower zone boundary line (ZBL, which separates the step-faceting zone and the step droplet zone, is obtained by the condition γ 1 = lim n → ∞ γ n / n , where γn is the step tension of the n-th merged step. The upper ZBL, which separates the GMPT zone and the step droplet zone, is obtained by the condition Aq,eff = 0 and Bq,eff = 0, where Aq,eff and Bq,eff represent the coefficients for the | q → | 2 term and the | q → | 3 term, respectively, in the | q → | -expanded form of the surface free energy f eff ( q → . Here, q → is the surface gradient relative to the (111 surface. The reason why the vicinal surface inclined in the 〈101〉 direction does not exhibit step-faceting is explained in terms of the one-dimensional spinless quasi-impenetrable attractive bosons at absolute zero.

  6. Mast cells mediate malignant pleural effusion formation

    Science.gov (United States)

    Giannou, Anastasios D.; Marazioti, Antonia; Spella, Magda; Kanellakis, Nikolaos I.; Apostolopoulou, Hara; Psallidas, Ioannis; Prijovich, Zeljko M.; Vreka, Malamati; Zazara, Dimitra E.; Lilis, Ioannis; Papaleonidopoulos, Vassilios; Kairi, Chrysoula A.; Patmanidi, Alexandra L.; Giopanou, Ioanna; Spiropoulou, Nikolitsa; Harokopos, Vaggelis; Aidinis, Vassilis; Spyratos, Dionisios; Teliousi, Stamatia; Papadaki, Helen; Taraviras, Stavros; Snyder, Linda A.; Eickelberg, Oliver; Kardamakis, Dimitrios; Iwakura, Yoichiro; Feyerabend, Thorsten B.; Rodewald, Hans-Reimer; Kalomenidis, Ioannis; Blackwell, Timothy S.; Agalioti, Theodora; Stathopoulos, Georgios T.

    2015-01-01

    Mast cells (MCs) have been identified in various tumors; however, the role of these cells in tumorigenesis remains controversial. Here, we quantified MCs in human and murine malignant pleural effusions (MPEs) and evaluated the fate and function of these cells in MPE development. Evaluation of murine MPE-competent lung and colon adenocarcinomas revealed that these tumors actively attract and subsequently degranulate MCs in the pleural space by elaborating CCL2 and osteopontin. MCs were required for effusion development, as MPEs did not form in mice lacking MCs, and pleural infusion of MCs with MPE-incompetent cells promoted MPE formation. Once homed to the pleural space, MCs released tryptase AB1 and IL-1β, which in turn induced pleural vasculature leakiness and triggered NF-κB activation in pleural tumor cells, thereby fostering pleural fluid accumulation and tumor growth. Evaluation of human effusions revealed that MCs are elevated in MPEs compared with benign effusions. Moreover, MC abundance correlated with MPE formation in a human cancer cell–induced effusion model. Treatment of mice with the c-KIT inhibitor imatinib mesylate limited effusion precipitation by mouse and human adenocarcinoma cells. Together, the results of this study indicate that MCs are required for MPE formation and suggest that MC-dependent effusion formation is therapeutically addressable. PMID:25915587

  7. /facet: A Generic Facet Browser Including Temporal and Spatial Visualization

    NARCIS (Netherlands)

    Hildebrand, M.

    2007-01-01

    A generic facet browser including temporal and spatial visualization. The existing MultimediaN Eculture demo is updated in two ways: improved visualization of the semantic timeline and added a natural language sentence generator for cluster headers. Relation search interface is also implemente

  8. The microbiome of otitis media with effusion.

    Science.gov (United States)

    Chan, Chun Ling; Wabnitz, David; Bardy, Jake Jervis; Bassiouni, Ahmed; Wormald, Peter-John; Vreugde, Sarah; Psaltis, Alkis James

    2016-12-01

    The adenoid pad has been considered a reservoir for bacteria in the pathogenesis of otitis media with effusion. This study aimed to characterize the middle ear microbiota in children with otitis media with effusion and establish whether a correlation exists between the middle ear and adenoid microbiota. Prospective, controlled study. Middle ear aspirates adenoid pad swabs were collected from 23 children undergoing ventilation tube insertion. Adenoid swabs from patients without ear disease were controls. Samples were analyzed using 16S rRNA sequencing on the Illumina MiSeq platform. Thirty-five middle ear samples were collected. The middle ear effusion microbiota was dominated by Alloiococcus otitidis (23% mean relative abundance), Haemophilus (22%), Moraxella (5%), and Streptococcus (5%). Alloiococcus shared an inverse correlation with Haemophilus (P = .049) and was found in greater relative abundance in unilateral effusion (P = .004). The microbiota of bilateral effusions from the same patient were similar (P otitis media with effusion microbiota were found to be dissimilar to that of the adenoid (P = .01), whereas the adenoid microbiota of otitis media with effusion and control patients were similar (P > .05) (permutational multivariate analysis of the variance). Dissimilarities between the local microbiota of the adenoid and the middle ear question the theory that the adenoid pad is a significant reservoir to the middle ear in children with otitis media with effusion. A otitidis had the greatest cumulative relative abundance, particularly in unilateral effusions, and shares an inverse correlation with the relative abundance of Haemophilus. NA Laryngoscope, 126:2844-2851, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  9. Effusion plate using additive manufacturing methods

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, Thomas Edward; Keener, Christopher Paul; Ostebee, Heath Michael; Wegerif, Daniel Gerritt

    2016-04-12

    Additive manufacturing techniques may be utilized to construct effusion plates. Such additive manufacturing techniques may include defining a configuration for an effusion plate having one or more internal cooling channels. The manufacturing techniques may further include depositing a powder into a chamber, applying an energy source to the deposited powder, and consolidating the powder into a cross-sectional shape corresponding to the defined configuration. Such methods may be implemented to construct an effusion plate having one or more channels with a curved cross-sectional geometry.

  10. Recurrent Uveal Effusion after Laser Iridotomy

    Science.gov (United States)

    Sakai, Hiroshi; Yonahara, Michiko; Sakai, Miyako

    2017-01-01

    A 59-year-old woman was seen by an ophthalmologist for blurred vision, ocular pain, headache, and nausea. She was diagnosed with acute primary angle closure (APAC) and successfully treated with medications. Using ultrasound biomicroscopy (UBM), engorged episcleral vein was observed and small uveal effusion was diagnosed after laser peripheral iridotomy (LPI). The uveal effusion disappeared and was again diagnosed by UBM together with anterior segment inflammation with ocular pain. Iritis caused by LPI after APAC might be a cause of uveal effusion in this specific case. PMID:28203193

  11. Effusion plate using additive manufacturing methods

    Science.gov (United States)

    Johnson, Thomas Edward; Keener, Christopher Paul; Ostebee, Heath Michael; Wegerif, Daniel Gerritt

    2016-04-12

    Additive manufacturing techniques may be utilized to construct effusion plates. Such additive manufacturing techniques may include defining a configuration for an effusion plate having one or more internal cooling channels. The manufacturing techniques may further include depositing a powder into a chamber, applying an energy source to the deposited powder, and consolidating the powder into a cross-sectional shape corresponding to the defined configuration. Such methods may be implemented to construct an effusion plate having one or more channels with a curved cross-sectional geometry.

  12. Recurrent Uveal Effusion after Laser Iridotomy

    Directory of Open Access Journals (Sweden)

    Hiroshi Sakai

    2017-01-01

    Full Text Available A 59-year-old woman was seen by an ophthalmologist for blurred vision, ocular pain, headache, and nausea. She was diagnosed with acute primary angle closure (APAC and successfully treated with medications. Using ultrasound biomicroscopy (UBM, engorged episcleral vein was observed and small uveal effusion was diagnosed after laser peripheral iridotomy (LPI. The uveal effusion disappeared and was again diagnosed by UBM together with anterior segment inflammation with ocular pain. Iritis caused by LPI after APAC might be a cause of uveal effusion in this specific case.

  13. TRANSFORMATION OF EFFUSION AND FORMATION OF GRANULATION TISSUE IN PATHOLOGIC PROCESS OF OTITIS MEDIA WITH EFFUSION

    Institute of Scientific and Technical Information of China (English)

    韦俊荣; 张青; 张全安

    2003-01-01

    Objective To explore the diversity of stagnant effusions and the pathologic processes leading to granulation tissue formation in otitis media with effusion(OME). Methods Temporal bone slides from 306 ears with OME were studied histopathologically under the light microscope. Results Results of this study revealed a pathologic process in witch the type and the condition of stagnant effusion in the middle ear cleft was a variable in the dynamics of OME progression from an early stage to an advanced stage. The location of granulation tissue and retentive effusion were found to be closely related. Conclusion Early stage granulation tissue formation exhibited a pathologic process in which granulation tissue formation occurred only in areas where effusion had stagnated or was absorbed. The incidence of the retentive effusion and formation of granulation tissue was much higher and the pathologic changes most extensive in the area around the ossicular chain.

  14. THEORY OF INCOMMENSURATE CRYSTAL FACETS

    NARCIS (Netherlands)

    VANSMAALEN, S

    1993-01-01

    The morphology of incommensurately modulated crystals is considered. A surface free energy model is constructed which interprets the stabilization of the incommensurate facets as due to surface pinning of the phase of the modulation wave. The stepped nature of the true crystal surface restricts the

  15. THEORY OF INCOMMENSURATE CRYSTAL FACETS

    NARCIS (Netherlands)

    VANSMAALEN, S

    1993-01-01

    The morphology of incommensurately modulated crystals is considered. A surface free energy model is constructed which interprets the stabilization of the incommensurate facets as due to surface pinning of the phase of the modulation wave. The stepped nature of the true crystal surface restricts the

  16. Proclus and Mulla Sadra on First Effusion

    Directory of Open Access Journals (Sweden)

    Zahra Eskandari

    2013-12-01

    Full Text Available Mulla Sadra Mulla Sadra's philosophical system is built upon the belief in unique origin of world to which all diversities can be reduced. Then First Effusion debate can be taken on in this system. According to the principle which reads "from the One nothing is effused but One", contingent beings could not have been emanated from the Necessary Being in a horizontal fashion due to their diversity. Rather they have been effused from the Necessary in a vertical fashion and through a hierarchy of causes and effects. The first stage of the hierarchy is being represented by the First Effusion. Pre-Sadraeian theosophers regarded the First Effusion the first intellect in vertical chain of intellects. Mulla Sadra have two theories of the First Effusion. In some of his books he introduces the first intellect as the first entity effused from the Necessary keeping his pace with his own predecessors. But in some other works like Asfar he describes the Ever-unfolding existence as the First Effusion and takes it to be his final position. Having replaced existential gradation with causation and also individual unity of existence with existential gradation, Mulla Sadra asserts that the First Effusion could only be the Ever-unfolding Existence which is a manifestation of Divine Essence not an independent existence. It is indeed nothing but the Divine Essence although in the form of its first manifestation. Thus the Ever-unfolding Existence has three distinguished attributes which make it qualified to stand in direct relationship with Divine Essence, Existential (and not conceptual universality and comprehensiveness which enables this existence to include the other manifestions. Lack of particular limitation and determination; this is why it can reveal itself to every being in its own peculiar existential terms. Having unity while being imbued in diversity and being diversed while having unity (due to its true but shadowy unity (Rahimian, 1383: 187. First

  17. [The enhancement phenomenon of serous cavity effusions].

    Science.gov (United States)

    Gaeta, M; Volta, S; Stroscio, S; Carella, I; Mantineo, G; Bartiromo, G; Pandolfo, I

    1990-01-01

    The enhancement of ascites following a high dose of contrast medium has been recently described. The CT behavior of 26 peritoneal, pleural or pericardial effusions has been studied in 23 patients after the administration of a high dose of urographic contrast medium. The effusions were enhanced in all patients but one. No difference between malignant and non-malignant effusions could be observed with ionic and non-ionic contrast medium. Low molecular weight of the urographic contrast medium (600-800 daltons) can explain the free passage of the solute through peritoneum, pleura, and pericardium. The knowledge of such a phenomenon is mandatory to avoid misdiagnosing hematic effusion or urinary-peritoneal fistula.

  18. Proclus and Mulla Sadra on First Effusion

    Directory of Open Access Journals (Sweden)

    Saeed Rahimiyan

    2014-01-01

    Full Text Available Mulla Sadra Mulla Sadra's philosophical system is built upon the belief in unique origin of world to which all diversities can be reduced. Then First Effusion debate can be taken on in this system. According to the principle which reads "from the One nothing is effused but One", contingent beings could not have been emanated from the Necessary Being in a horizontal fashion due to their diversity. Rather they have been effused from the Necessary in a vertical fashion and through a hierarchy of causes and effects. The first stage of the hierarchy is being represented by the First Effusion. Pre-Sadraeian theosophers regarded the First Effusion the first intellect in vertical chain of intellects. Mulla Sadra have two theories of the First Effusion. In some of his books he introduces the first intellect as the first entity effused from the Necessary keeping his pace with his own predecessors. But in some other works like Asfar he describes the Ever-unfolding existence as the First Effusion and takes it to be his final position. Having replaced existential gradation with causation and also individual unity of existence with existential gradation, Mulla Sadra asserts that the First Effusion could only be the Ever-unfolding Existence which is a manifestation of Divine Essence not an independent existence. It is indeed nothing but the Divine Essence although in the form of its first manifestation. Thus the Ever-unfolding Existence has three distinguished attributes which make it qualified to stand in direct relationship with Divine Essence, Existential (and not conceptual universality and comprehensiveness which enables this existence to include the other manifestions. Lack of particular limitation and determination; this is why it can reveal itself to every being in its own peculiar existential terms. Having unity while being imbued in diversity and being diversed while having unity (due to its true but shadowy unity (Rahimian, 1383: 187. First

  19. MID-FACETS OF A SIMPLEX

    Institute of Scientific and Technical Information of China (English)

    李小燕; 何斌吾; 冷岗松

    2004-01-01

    The mid-facet of a simplex in n-dimensional Euclidean space which was introduced quite recently is an important geometric element.An analytic expression for the mid-facet area of a simplex is firstly given.In order to obtain the expression,the exterior differential method was presented.Furthermore,the properties of the mid-facets of a simplex analogous to median lines of a triangle(such as for all mid-facets of a simplex,there exists another simplex such that its edge-lengths equal to these mid-facets area respectively,and all of the mid-facets of a simplex have a common point)were proved.Finally,by applying the analytic expression,a number of inequalities which combine edge-lengths,circumradius,median line,bisection area and facet area with the mid-facet area for a simplex were established.

  20. Preamble to marine microbiology: Facets and opportunities

    Digital Repository Service at National Institute of Oceanography (India)

    Ramaiah, N.

    The book titled 'Marine Microbiology: Facets & Opportunities' is an attempt to bring together some facets of marine microbiology as have been made out by many contemporaries in particular from the tropical marine regions. There are 18 contributed...

  1. Lumbar facet injection for the treatment of chronic piriformis myofascial pain syndrome: 52 case studies.

    Science.gov (United States)

    Huang, Jen-Ting; Chen, Han-Yu; Hong, Chang-Zern; Lin, Ming-Ta; Chou, Li-Wei; Chen, Hsin-Shui; Tsai, Chien-Tsung; Chang, Wen-Dien

    2014-01-01

    The aim of this study was to demonstrate the effectiveness of lumbar facet joint injection for piriformis myofascial pain syndrome. Fifty-two patients with chronic myofascial pain in the piriformis muscle each received a lumbar facet injection into the ipsilateral L5-S1 facet joint region, using the multiple insertion technique. Subjective pain intensity, trunk extension range, and lumbar facet signs were measured before, immediately after, and 2 weeks after injection. Thirty-six patients received follow-up for 6 months. Immediately after the injection, 27 patients (51.9%) had complete pain subsidence, 19 patients (36.5%) had pain reduction to a tolerable level, and only 6 patients (11.5%) had no pain relief to a tolerable level. Mean pain intensity was reduced from 7.4±0.9 to 1.6±2.1 after injection (Pmyofascial pain syndrome. If this pain is related to lumbar facet lesions, lumbar facet joint injection can immediately suppress piriformis myofascial pain symptoms. This effectiveness may last for at least 6 months in most patients. This study further supports the importance of eliminating the underlying etiological lesion for complete and effective relief of myofascial pain syndrome.

  2. Juxta-facet cysts: MR imaging; Juxtafacettenzysten: Magnetresonanztomographische Diagnostik

    Energy Technology Data Exchange (ETDEWEB)

    Hagen, T.; Daschner, H. [Radiologische Gemeinschaftspraxis, Salewahaus, Augsburg (Germany); Lensch, T. [Radiologische Praxis am Krankenhaus Friedberg (Germany)

    2001-12-01

    The term juxta-facet cyst summarizes synovial cysts, arising from degenerated facet joints and ganglion cysts, developing from mucinous degeneration of periarticular connective tissue. Most juxta-facet cysts are observed at the L4/5 level, which generally has the most motion within the lumbar spine. In this retrospective study 31 juxta-facet cysts in 28 patients were detected within 2898 lumbar MRI studies over a 2-year period (frequency 1%). 24 patients complained of back and lower extremity pain, the other 4 patients had unilateral back pain. In 7 cases radicular symptoms were observed, in 6 patients a neurogenic claudication. In 78% of the patients juxta-facet cysts were responsible for clinical symptoms. MRI is the diagnostic imaging technique of choice due to a high sensitivity. The juxta-facet cysts were located extradural, laterally to the thecal sack and adjacent to a degenerated facet joint. In all but one cases the cysts showed a signal intensity equivalent to cerebrospinal fluid. T2-weighted pulse sequences in sagittal orientation were very useful in delineating the hypointense cyst wall. In 1 patient with acute radicular pain MRI demonstrated a subacute hemorrhage within a juxta-facet cyst. Calcifications and gas-filled cysts can be missed with MRI, but will be demonstrated by computed tomography. 45% of the juxta-facet cysts showed an enhancement of the cyst wall after injection of Gd-DTPA. Spontaneous reduction or resolution of the cyst may occur during rest. Injection of corticosteroids into the corresponding facet joint may reduce the inflammatory process and resolve the symptoms in up to 70%. Surgical resection of the cyst is indicated in case of intractable pain and significant neurologic deficit and generally produces good relief from radicular symptoms. (orig.) [German] Der Begriff Juxtafacettenzyste subsumiert Synovialzysten, die von degenerativ veraenderten Intervertebralgelenken ausgehen, und Ganglionzysten, die durch mukoide Degeneration von

  3. Bilateral locked facets in the thoracic spine

    NARCIS (Netherlands)

    M.H.A. Willems; Braakman, R. (Reinder); B. van Linge (Bert)

    1984-01-01

    textabstractTwo cases of traumatic bilateral locked facets in the thoracic spine are reported. Both patients had only minor neurological signs. They both made a full neurological recovery after surgical reduction of the locked facets. Bilateral locked facets are very uncommon in the thoracic spine.

  4. Slamming Testing of Facetted Bottom

    Science.gov (United States)

    2013-11-26

    Technical Report DATES COVERED (From - To) 01 May 2010-31 Aug2013 4. TITLE AND SUBTITLE Slamming Testing of Facetted Bottom 5a. CONTRACT NUMBER...of fast craft are due to slamming , or hydrodynamic impact. A 9 meter long steel / composite hybrid slamming load test facility has been employed for...the purpose of furthering understanding of the slamming phenomenon. This craft is heavily instrumented with strain gages, accelerometers, cameras, an

  5. Design of a lattice-based faceted classification system

    Science.gov (United States)

    Eichmann, David A.; Atkins, John

    1992-01-01

    We describe a software reuse architecture supporting component retrieval by facet classes. The facets are organized into a lattice of facet sets and facet n-tuples. The query mechanism supports precise retrieval and flexible browsing.

  6. Can extra-articular strains be used to measure facet contact forces in the lumbar spine? An in-vitro biomechanical study.

    Science.gov (United States)

    Zhu, Q A; Park, Y B; Sjovold, S G; Niosi, C A; Wilson, D C; Cripton, P A; Oxland, T R

    2008-02-01

    Experimental measurement of the load-bearing patterns of the facet joints in the lumbar spine remains a challenge, thereby limiting the assessment of facet joint function under various surgical conditions and the validation of computational models. The extra-articular strain (EAS) technique, a non-invasive measurement of the contact load, has been used for unilateral facet joints but does not incorporate strain coupling, i.e. ipsilateral EASs due to forces on the contralateral facet joint. The objectives of the present study were to establish a bilateral model for facet contact force measurement using the EAS technique and to determine its effectiveness in measuring these facet joint contact forces during three-dimensional flexibility tests in the lumbar spine. Specific goals were to assess the accuracy and repeatability of the technique and to assess the effect of soft-tissue artefacts. In the accuracy and repeatability tests, ten uniaxial strain gauges were bonded to the external surface of the inferior facets of L3 of ten fresh lumbar spine specimens. Two pressure-sensitive sensors (Tekscan) were inserted into the joints after the capsules were cut. Facet contact forces were measured with the EAS and Tekscan techniques for each specimen in flexion, extension, axial rotation, and lateral bending under a +/- 7.5 N m pure moment. Four of the ten specimens were tested five times in axial rotation and extension for repeatability. These same specimens were disarticulated and known forces were applied across the facet joint using a manual probe (direct accuracy) and a materials-testing system (disarticulated accuracy). In soft-tissue artefact tests, a separate set of six lumbar spine specimens was used to document the virtual facet joint contact forces during a flexibility test following removal of the superior facet processes. Linear strain coupling was observed in all specimens. The average peak facet joint contact forces during flexibility testing was greatest in

  7. The clinical aspects of the acute facet syndrome

    DEFF Research Database (Denmark)

    Hestbaek, Lise; Kongsted, Alice; Jensen, Tue Secher;

    2009-01-01

    group of chiropractic practitioners was seen to be a useful contribution. METHODS: During the annual congress of The European Chiropractors Union (ECU) in 2008, the authors conducted a workshop involving volunteer chiropractors. Topics were decided upon in advance, and the participants were asked...... of four topics relating to the presentation of pain: 1. location, 2. severity, 3. aggravating factors, and 4. relieving factors. Second, the groups were asked to agree on three orthopaedic and three chiropractic tests that would aid in diagnosing pain from the facet joints. Finally, they were asked...... to agree on the number, frequency and duration of chiropractic treatment. RESULTS: Thirty-four chiropractors from nine European countries participated. They described the characteristics of an acute, uncomplicated facet syndrome as follows: local, ipsilateral pain, occasionally extending into the thigh...

  8. Pleural effusion and sarcoidosis: an unusual combination.

    Science.gov (United States)

    Ferreiro, Lucía; San José, Esther; González-Barcala, Francisco Javier; Suárez-Antelo, Juan; Toubes, M Elena; Valdés, Luis

    2014-12-01

    Pleural involvement in sarcoidosis is uncommon and appears in several forms. To document the incidence and characteristics of pleural effusion in sarcoidosis patients, a review of the cases diagnosed in our centre between January 2001 and December 2012 was carried out. One hundred and ninety-five patients with sarcoidosis were identified; three (two men and one woman) presented with unilateral pleural effusion (1.5%): one in the right side and two in the left. Two were in stageii and one was in stageiv. The pleural fluid of the two patients who underwent thoracocentesis was predominantly lymphocytic. One of these patients presented chylothorax and the other had high CA-125levels. In general, these effusions are lymphocyte-rich, paucicellular, serous exudates (sometimes chylothorax) and contain proportionally higher levels of protein than LDH. Most cases are treated with corticosteroids, although it may resolve spontaneously. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

  9. Massive pleural effusion in a young woman

    Directory of Open Access Journals (Sweden)

    Paolo Ghiringhelli

    2012-12-01

    Full Text Available Pleural effusion is a clinical manifestation shared by several underlying pathologies. The differential diagnosis is based on the clinical history, the physical examination, the analysis of the pleural fluid, and the laboratory data (mainly blood tests. There are cases, such as the patient described, where TC is not enough, and unusual imaging techniques are required for the study of pleural effusion, i.e. magnetic resonance cholangiography, cholangiopancreatography (MRCP and endoscopic retrograde cholangiopancreatography (ERCP.This case analyses a 42-year-old female patient who arrived with progressive dyspnoea, chest pain, cough, a history of alcohol abuse, and a recent episode of acute pancreatitis. The physical examination revealed signs of right-sided pleural effusion. These features, together with laboratory data, made it possible to pose the diagnosis of pancreaticopleural fistula, to treat it, and to obtain a complete healing in a two-month period.

  10. Clinical Observation on the Treatment of Lumbar Facet Joint Disorders with Three-Dimensional Reduction Method Combined with Lumbar Lateral Recess Injection of Xiangdan and Huangqiinjecta%腰椎三维复位法配合侧隐窝注射香丹、黄芪注射液治疗腰椎小关节紊乱疗效观察

    Institute of Scientific and Technical Information of China (English)

    丘宏龙; 陈海鹏; 林桦楠; 陈凯

    2014-01-01

    Objective:To observe the clinical effects of treating 34 cases of lumbarfacet joint disorders with three-dimensional reduction method combined with lumbar lateral recessinjection ofXiang-dan andHuangqi injecta.Methods:68 cases of lumbar facet joint disorders were randomly divided into a treatment group and a control group,34 cases in each group.The control group was treated with three-dimensional reduction method,for manipulation therapy once a day,while the treatment group was treated with lumbar lateral recess injec-tion ofXiangdanandHuangqi injecta on the ifrst,fourth,and seventh days based on the treatment of the control group. The clinical observation of the two groups were made on the tenth day.Results:In the treatment group,10 cases were cured,20 cases were markedly effective,4 cases were ineffective,the efficiency being 88.24%;while in the control group,6 cases were cured,16 cases were markedly effective,12 cases were ineffective,the efifciency being 64.71%.The difference between the two groups was statistically significant(P< 0.01).The PRI,VAS and PPI scores of the treatment group were significantly lower than those of the control group,the difference being statistically significant(P< 0.01).Conclusion:The effect of the three-dimensional reduction method combined with lumbar lateral recess injection is obvious in the treatment of lumbar facet joint disorders,worthy of being clinically promoted.%目的:观察腰椎三维复位法配合侧隐窝注射香丹、黄芪注射液治疗腰椎小关节紊乱的临床疗效。方法:将68例腰椎小关节紊乱患者随机分为治疗组和对照组,每组34例。对照组予腰椎三维复位法治疗,每日1次;治疗组在对照组治疗基础上,于治疗的第1,4,7天行香丹、黄芪注射液腰椎侧隐窝注射,两组均于第10天观察临床疗效。结果:治疗组治愈10例,显效20例,无效4例,有效率88.24%;对照组治愈6例,显效16例,无效12例,有效率64

  11. Factors influencing pleural drainage in parapneumonic effusions.

    Science.gov (United States)

    Porcel, J M; Valencia, H; Bielsa, S

    2016-10-01

    The identification of parapneumonic effusions (PPE) requiring pleural drainage is challenging. We aimed to determine the diagnostic accuracy of radiological and pleural fluid findings in discriminating between PPE that need drainage (complicated PPE (CPPE)) and those that could be resolved with antibiotics only (uncomplicated PPE (UPPE)). A retrospective review of 641 consecutive PPE, of which 393 were categorized as CPPE and 248 as UPPE. Demographics, radiological (size and laterality on a chest radiograph) and pleural fluid parameters (pus, bacterial cultures, biochemistries) were compared among groups. Logistic regression was performed to determine variables useful for predicting chest drainage, and receiver-operating characteristic curves assisted in the selection of the best cutoff values. According to the likelihood ratios (LR), findings increasing the probability of chest tube usage the most were: effusions occupying ≥1/2 of the hemithorax (LR 13.5), pleural fluid pH ≤7.15 (LR 6.2), pleural fluid glucose ≤40mg/dL (LR 5.6), pus (LR 4.8), positive pleural fluid cultures (LR 3.6), and pleural fluid lactate dehydrogenase >2000U/L (LR 3.4). In the logistic regression analysis only the first two were selected as significant predictors of CPPE. In non-purulent effusions, the effusion's size and pleural fluid pH retained their discriminatory properties, in addition to a pleural fluid C-reactive protein (CRP) level >100mg/L. Large radiological effusions and a pleural fluid pH ≤7.15 were the best predictors for chest drainage in patients with PPE. In the subgroup of patients with non-purulent effusions, pleural fluid CRP also contributed to CPPE identification. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  12. Observation of 144 Treatments of Cervical Facet Joints Typo by Cervical Repositioning Plus Fuyang Cans%114例颈椎定点复位法加扶阳罐治疗颈椎小关节微错缝的临床观察

    Institute of Scientific and Technical Information of China (English)

    孙大桥; 冯高基; 王德燕

    2016-01-01

    目的:探讨颈椎定点复位法加扶阳罐治疗颈椎小关节微错缝的临床疗效。方法:114例患者均采用颈椎定点复位法加扶阳罐治疗。具体分四步。手法定位;松解肌肉;颈椎定点旋转复位;扶阳罐理筋温熨。5次一疗程。若还有症状,休息二天后,重复一疗程。结果:治愈率89.47%,总有效率99.12%。结论:此法可纠正颈椎紊乱的关节,缓解痉挛的肌肉,解除神经、血管的刺激和压迫,改善局部血液循环,使颈椎各关节保持相对的稳定。疗效好,安全易行,值得推广。%The paper discusses the cervical repositioning Fu Yang cans clinical effects of cervical facet joints micro wrong treatment. Method: 114 cases of patients were treated by cervical repositioning Fu Yang cans treatment. Specifically in four steps. Positioning techniques, Releasing muscle, cervical rotation reset, Fu Yang Management warm iron bars, 5 times a course of treatment. If there are symptoms, the patient takes two days of rest, and repeats a course. Result: cure rate of 89.47%, the total efficiency of 99.12%. Conclusion: this method corrects cervical joint disorders, relieves muscle spasm, relieves nerves and blood vessels and stimulate the oppression, and improve local blood circulation, making each joint of cervical remained relatively stable. Effective, safe and easy, it is worthy to promotion.

  13. Toxocariasis: An unusual cause of pleural effusion.

    Science.gov (United States)

    Vallentin, Blandine; Carsin, Ania; Dubus, Jean-Christophe

    2015-10-01

    Toxocara canis, one of the most frequent parasites worldwide, rarely triggers respiratory symptoms. We report the case of a 5-year-old girl hospitalized for a unilateral eosinophilic pleural effusion due to Toxocara canis. Besides the fact that she was living in a squat, no other medical condition was reported. There was no other site of infection caused by the parasite and she was successfully treated with albendazole. This case report is obviously unique as very few cases of pleural effusion due to Toxocara canis are reported in literature, all in adult patients.

  14. Large pericardial effusion :a clinical dilemma!

    Science.gov (United States)

    Ramalingam, Rangaraj; Kadako, Nitinkumar S; Pati, Shivanand; Manjunath, C N

    2013-07-01

    A 55yr old gentleman known diabetic and hypertensive presented with breathlessness and tingling sensation of both upper and lower limbs with strong family history of similar neurological problems. On extensive evaluation he was found to have amyloidic peripheral neuropathy with large pericardial effusion. Tubercular etiology was confirmed by pericardial fluid PCR and culture. Here the diagnostic dilemma was whether Amloidosis is primary, secondary to Tubercular pericardial effusion or Hereditary Amyloidosis. In the end, how we have arrived at the diagnosis of Hereditary Amyloidosis based upon the strong family history and nerve biopsy is interestingly presented in the following case report.

  15. Pleural effusion: An unusual cause and association

    Directory of Open Access Journals (Sweden)

    Alam K Navaz

    2013-01-01

    Full Text Available Filaria has a wide spectrum of presentation. We hereby present a case of Filarial pleural effusion that is a rarity in itself. Filarial lung involvement is usually in the form of tropical pulmonary eosinophilia with pulmonary infiltrates and peripheral eosinophilia, unlike our case where isolated pleural effusion of Filarial etiology was detected. Microfilaria has been isolated from Pleural fluid in very few cases, and ours was one such. Of late, there have been many incidental detections of Filarial parasites from varied anatomical sites in association with malignancy. Even in our case, we had one such unusual association.

  16. Coexistent transient pulmonary edema and pericardial effusion

    Energy Technology Data Exchange (ETDEWEB)

    Newman, B.; Oh, K.S.; Park, S.C.

    1988-09-01

    Eight (23%) of 35 children with acute pericardial effusions due to infection or juvenile rheumatoid arthritis (JRA) had associated transient pulmonary edema demonstrated on plain chest radiographs. The presence or absence of radiographic pulmonary edema correlated well with clinical and hemodynamic parameters in patients with JRA but not in those with infectious pericarditis. There was no definite relationship between radiographic edema and amount of pericardial fluid as estimated echocardiographically or removed at pericardiocentesis. Rapidity of pericardial fluid accumulation could not be assessed in this study. Children of young age with underlying JRA were the most likely subjects to have radiographic pulmonary edema in conjunction with an acute pericardial effusion.

  17. Allergic rhinitis is associated with otitis media with effusion

    DEFF Research Database (Denmark)

    Kreiner-Møller, E; Chawes, B L K; Thomasen, Per Caye

    2012-01-01

    Childhood otitis media with effusion is a common disease and a link to allergic diseases has been suggested.......Childhood otitis media with effusion is a common disease and a link to allergic diseases has been suggested....

  18. Isolated posterior uveal effusion: expanding the spectrum of the uveal effusion syndrome

    Directory of Open Access Journals (Sweden)

    Pautler SE

    2014-12-01

    Full Text Available Scott E Pautler,1 David J Browning2 1Department of Ophthalmology, University of South Florida, Morsani College of Medicine, Tampa, FL, USA; 2Charlotte Ear Eye Nose and Throat Associates, Charlotte, NC, USA Abstract: Uveal effusion syndrome usually causes peripheral chorioretinal detachment, but posterior effusion may present as isolated macular edema with serous macular detachment in the setting of hyperopia and a thickened posterior choroid. Carbonic anhydrase inhibitors may be effective to treat this condition. Keywords: uveal effusion, serous, macular detachment, macular edema

  19. Primary effusion lymphomas in AIDS: CT findings in two cases

    Energy Technology Data Exchange (ETDEWEB)

    Ferrozzi, F.; Tognini, G.; Mulonzia, N.W.; Pavone, P. [Ist. di Scienze Radiologiche, Univ. di Parma (Italy); Bova, D.

    2001-04-01

    Primary effusion lymphomas represent an unusual subset of AIDS-related non-Hodgkin's lymphomas. They are associated with herpes virus 8 and Epstein-Barr virus and characterized by predominant involvement of the serous body cavities (pleura, pericardium, peritoneum) as lymphomatous effusion without any identifiable tumour mass. We report herein CT findings in two patients with primary effusion lymphoma emphasizing the possible neoplastic nature of a pleural effusion in a patient with AIDS. (orig.) (orig.)

  20. Avaliação clínica da infiltração facetaria no tratamento da dor lombar crônica por síndrome facetaria: estudo prospectivo Evaluación clínica de la infiltración de las facetas en el tratamiento del dolor crónico de espalda baja por el síndrome de faceta síndrome: estudio prospectivo Clinical evaluation of the lumbar facet joint blocks in treatment of chronic low back pain: a prospective study

    Directory of Open Access Journals (Sweden)

    Thiago Miller Santana Silva

    2011-01-01

    Full Text Available OBJETIVO: Avaliar os resultados do bloqueio facetário lombar com anestésico local e corticóide em pacientes com lombalgia crônica por síndrome facetária. MÉTODOS: Realizou-se um estudo prospectivo em 30 pacientes com lombalgia crônica por síndrome facetária, os quais foram submetidos à infiltração facetária com bupivacaína a 0,25% e acetato de metilpredinisolona sob controle radioscópico, e foram seguidos e avaliados seguindo as escalas Visual Analógica da Dor, Oswestry Disability Index e os Critérios de MacNab nos quais 17 foram do sexo feminino e 13 do sexo masculino. RESULTADOS: Foi observada diminuição significativa (pOBJETIVO: Evaluar los resultados del bloqueo facetario lumbar, con anestésico local y corticoide, en pacientes con dorsalgia crónica por síndrome facetario. MÉTODOS: Se realizó un estudio prospectivo en 30 pacientes, 17 del sexo femenino y 13 del sexo masculino, con dorsalgia crónica por síndrome facetario, quienes fueron sometidos a la infiltración facetaria con bupivacaína a 0,25% y acetato de metilpredinisolona bajo control radioscópico, y fueron acompañados y evaluados siguiendo las escalas Visual Analógica del Dolor, Oswestry Disability Index y los Criterios de MacNab. RESULTADOS: Se observó una disminución significativa (pOBJECTIVE: To evaluate the lumbar facet block with local anesthetics and corticosteroids in patients with chronic low back pain of facet joint origin. METHODS: We conducted a prospective study on 30 patients with chronic low back pain in facet syndrome who underwent facet infiltration with bupivacaine 0.25% and methylprednisolone acetate under radioscopic control; the subjects were followed and evaluated following the Visual Analogue Scale of Pain , Oswestry Disability Index and MacNab criteria; 17 of them were female and 13 male. RESULTS: Reduction of pain was found by Visual Analogue Scale significant (p <0.05. We obtained 73.3% of satisfactory results in the first

  1. Treatment of cervical dislocation with locked facets

    Institute of Scientific and Technical Information of China (English)

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

    2007-01-01

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

  2. Cerebral cysticercus granuloma associated with a subdural effusion.

    Directory of Open Access Journals (Sweden)

    Rajshekhar V

    2001-04-01

    Full Text Available The association of a solitary cerebral cysticercus granuloma with a subdural effusion is being reported. The granuloma and the effusion resolved following albendazole therapy. We speculate that the spread of the inflammatory changes around the granuloma to the subdural space could have led to the development of the subdural effusion.

  3. Recurrent pleural effusion as a clinical manifestation of multiple myeloma

    Directory of Open Access Journals (Sweden)

    Marcelo Torquato Toneline

    2013-12-01

    Multiple myeloma is a hematologic malignant tumor of plasma cells, sometimes associated with pleural effusion. This, in most cases, is associated to infectious complications. Pleural effusion as the onset or progression of the disease itself is rare. This case reports a young male, who presented recurrent pleural effusions, diagnosed with multiple myeloma at diagnosis.

  4. Evaluation of CT findings for diagnosis of pleural effusions

    Energy Technology Data Exchange (ETDEWEB)

    Arenas-Jimenez, J.; Alonso-Charterina, S.; Fernandez-Latorre, F.; Gil-Sanchez, S. [Hospital General Universitario de Alicante (Spain). Dept. of Radiology; Sanchez-Paya, J. [Hospital General Universitario de Alicante (Spain). Dept. of Preventive Medicine; Lloret-Llorens, M. [Hospital Universitario La Fe, Valencia (Spain). Dept. of Radiology

    2000-04-01

    Computed tomography studies are usually used to assess patients with pleural effusions, and radiologists should be aware of the significance of different CT findings for the diagnosis of the effusion. The purpose of this study was to evaluate CT findings for etiological diagnosis of pleural effusions. Contrast-enhanced CT of the chest of 211 patients with pleural effusion of definite diagnosis were evaluated. The CT images were evaluated for the presence and extent of pleural effusion, thickening or nodules, extrapleural fat and other changes in the mediastinum or lung. The CT scans were read by two independent observers and correlation between them was evaluated. Comparison of CT findings between benign and malignant effusions, between exudates and transudates, and between empyemas and the other parapneumonic effusions were carried out. Kappa values for most CT findings were >0.85. Loculation, pleural thickening, pleural nodules, and extrapleural fat of increased density were only present in exudative effusions. Multiple pleural nodules and nodular pleural thickening were the only pleural findings limited to malignant pleural effusions. The signs were also more frequently seen in empyemas than in other parapneumonic effusions. Computed tomography findings can help to distinguish between transudates and exudates. Although there is some overlap between benign and malignant pleural effusions, pleural nodules and nodular pleural thickening were present almost exclusively in the latter. Although differences between CT findings of empyemas and the other parapneumonic effusions exist, there is no finding which can definitely differentiate between them. (orig.)

  5. Two Facets of Narcissism and Compulsive Buying

    National Research Council Canada - National Science Library

    Sunghwan Yi; Roisin O'Connor

    2015-01-01

      Although recent psychology research indicates that overt and covert narcissism are distinct facets of narcissism, the association between covert narcissism and compulsive buying has not been recognized...

  6. Palliative Treatment of Malignant Pleural Effusion

    Directory of Open Access Journals (Sweden)

    Chenyang Liu

    2015-01-01

    Full Text Available Malignant pleural effusion (MPE is a common clinical problem caused by cancers. Pleural effusion can be the first sign of cancer in more than 25% of patients. Lung cancer and breast cancer are the most common cancers that metastasize to the pleura in men and women, respectively. Other cancers, including, but not limited to, lymphomas, ovarian cancer, stomach cancer, and several unknown primary cancers can also lead to MPE. Dyspnea and chest pain are the most common symptoms of MPE along with other symptoms such as a cough, weight loss, anorexia, fatigue, and weakness. Aggravation of these symptoms is closely related to the rate of accumulation of pleural effusion. Treatment options to MPE are determined by the type and extent of the underlying malignancy. The major goals of the treatment are to relieve symptoms, restore functions, improve the quality of life, and minimize the duration of hospital stay and costs. Although some patients can be treated with systemic therapies, most of these treatments are temporary, and MPE would recur soon. Hence, further palliative treatments to effectively control pleural effusions and relieve symptoms are necessary. This review addresses the pathophysiology of MPE and the treatment options for patients with MPE.

  7. Diaphragmatic hernia masquerading as pleural effusion

    Directory of Open Access Journals (Sweden)

    Z Nalladaru

    2012-01-01

    Full Text Available Rupture of the diaphragm is almost always due to major trauma. We present here an unusual and rare case of late presentation of diaphragmatic hernia after an innocuous injury. The patient was initially misdiagnosed as a left pleural effusion on the basis of chest X-ray and ultrasound findings. Finally, the diagnosis was confirmed on computerized scanning.

  8. Effusion cytomorphology of small round cell tumors

    Directory of Open Access Journals (Sweden)

    Katsuhide Ikeda

    2016-01-01

    Conclusion: We believe that it might be possible to diagnose DLBL and SCLC from cytologic analysis of effusion samples but it is very difficult to use this method to distinguish EWS, synovial sarcoma, and rhabdomyosarcoma. Statistical and mathematical analyses indicated that nuclear density and dispersion of nuclear and cytoplasmic sizes are useful adjuncts to conventional cytologic diagnostic criteria, which are acquired from experience.

  9. Cytology of Pericardial Effusion due to Malignancy

    Directory of Open Access Journals (Sweden)

    Kalogeraki Alexandra

    2016-09-01

    Full Text Available Background. Malignant pericardial effusion occurs in one tenth of all cancers. It is a very serious disorder that is mainly a secondary process due to metastasis because primary neoplasms of the pericardium such as mesotheliomas, sarcomas being exceedingly rare.

  10. Pericardial effusion in a mixed breed dog.

    OpenAIRE

    2001-01-01

    A 7-year-old, spayed female mixed breed dog was evaluated for labored breathing, lethargy, and a distended abdomen. Pericardial effusion was diagnosed after radiographic and echocardiographic interpretation. Treatment consisted of thoracocentesis and a single pericardiocentesis. Follow-up examinations indicate that the dog's condition has remained stable.

  11. Pleural fluid MDA and serum-effusion albumin gradient in pleural effusion

    OpenAIRE

    Mangaraj, Manaswini; Kumari, S.; Nanda, R; Pattnaik, M. R.; Mohapatra, P. C.

    2008-01-01

    Pleural fluid malondialdehyde (PMDA) and serum effusion albumin gradient(SEAG) were estimated in 60 patients of pleural effusion of diverse etiologies. The results were compared with Light’s criteria to distinguish between transudates and exudates. The mean PMDA level was 0.68±0.24nmol/ml and 1.17±0.25nmol/ml in transudates and exudates respectively showing a statistically significant (p

  12. Expression of soluble Toll-like receptors in pleural effusions

    Institute of Scientific and Technical Information of China (English)

    YANG Hai-bo; XIE Kai-qing; DENG Jing-min; QIN Shou-ming

    2010-01-01

    Background The Toll-like receptors (TLRs) represent a group of single-pass transmembrane receptors expressed on sentinel cells that are central to innate immune responses.The aim of this study was to investigate the presence of soluble TLRs in pleural effusions, and the diagnostic values of TLRs for pleural effusion with various etiologies.Methods Pleural effusion and serum samples were collected from 102 patients (36 with malignant pleural effusion, 36with tuberculous pleural effusion, 18 with bacterial pleural effusion, and 12 with transudative pleural effusion).The concentrations of TLR1 to TLR10 were determined in effusion and serum samples by enzyme linked immunosorbent assay.Four classical parameters (protein, lactate dehydrogenase, glucose and C-reactive protein (CRP)) in the pleural fluid were also assessed.Receiver-operating characteristic curves were used to assess the sensitivity and specificity of pleural fluid TLRs and biochemical parameters for differentiating bacterial pleural effusion.Results The concentrations of TLR1, TLR3, TLR4, TLR7 and TLR9 in bacterial pleural effusion were significantly higher than those in malignant, tuberculous, and transudative groups, respectively.Analysis of receiver operating characteristic curves revealed that the area under the curves of TLR1, TLR3, TLR4, TLR7 and TLR9 were 0.831, 0.843,0.842, 0.883 and 0.786, respectively, suggesting that these TLRs play a role in the diagnosis of bacterial pleural effusion.Also, the diagnostic value of TLRs for bacterial pleural effusions was much better than that of biochemical parameters (protein, lactate dehydrogenase, glucose and CRP).Conclusions The concentrations of TLR1, TLR3, TLR4, TLR7 and TLR9 appeared to be increased in bacterial pleural effusion compared to non-bacterial pleural effusions.Determination of these pleural TLRs may improve the ability of clinicians to differentiate pleural effusion patients of bacterial origin from those with other etiologies.

  13. Observations on the Efficacy of Warm Needling plus Palm Pressing Spine Reduction Technique in Treating Postpartum Thoracic Facet Joint Disorder%针灸配合脊柱复位手法治疗产后胸椎小关节紊乱疗效观察

    Institute of Scientific and Technical Information of China (English)

    卓缘圆; 吴家满

    2015-01-01

    Objective To investigate the clinical efficacy of warm needling plus palm pressing spine reduction technique in treating postpartum thoracic facet joint disorder.Methods Forty patients with postpartum thoracic facet joint disorder were randomly allocated to treatment and control groups, 20 cases each. The treatment group received warm needling plus palm pressing spine reduction technique and the control group, warm needling alone. The numeric pain rating scale (NPRS) score, the Oswestry Disability Index (ODI) score and the Quality of Life Scale score were recorded in the two groups before and after treatment and the clinical therapeutic effects were compared between the two groups.Results The total efficacy rate was 95.0% in the treatment group and 75.0% in the control group; there was a statistically significant difference between the two groups (P<0.01). There were statistically significant pre-/post-treatment differences in the NPRS score and the ODI score in the treatment group (P<0.01). There was a statistically significant pre-/post-treatment difference in the NPRS score in the control group (P<0.01). There were statistically significant post-treatment differences in the NPRS score and the ODI score between the treatment and control groups (P<0.01,P<0.05). There were statistically significant pre-/post-treatment differences in the SF-36 PF, RP, BP, VT, SF and MH scores in the treatment group (P<0.01,P<0.05). There were statistically significant pre-/post-treatment differences in the SF-36 PF BP, SF and MH scores in the control group (P<0.01,P<0.05).Conclusion Warm needling plus palm pressing spine reduction technique is an effective way to treat postpartum thoracic facet joint disorder.%目的:观察针灸配合掌按脊柱复位手法治疗产后胸椎小关节紊乱的临床疗效。方法将40例产后胸椎小关节紊乱患者随机分为治疗组和对照组,每组20例。治疗组采用针灸配合掌按脊柱复位手法治疗,对照组采用单纯

  14. Evaluation of pleural and pericardial effusions by magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Tscholakoff, D.; Sechtem, U.; De Geer, G.; Schmidt, H.; Higgins, C.B.

    1987-08-01

    MR examinations of 36 patients with pleural and/or pericardial effusions were retrospectively evaluated. The purpose of this study was to determine of MR imaging is capable of differentiating between pleural and pericardial effusions of different compositions using standard electrocardiogram (ECG)-gated and nongated spin echo pulse sequences. Additional data was obtained from experimental pleural effusions in 10 dogs. The results of this study indicate that old haemorhages into the pleural or pericardial space can be differentiated from other pleural or pericardial effusions. However, further differentiation between transudates, exudates and sanguinous effusions is not possible on MR images acquired with standard spin echo pulse sequences. (orig./MG)

  15. Different facets of market orientation

    DEFF Research Database (Denmark)

    Ormrod, Robert P.; Henneberg, Stephan C.

    2009-01-01

    it was found that there was a marketplace-determined 'gravitational centre effect' that limited the political market orientation of the manifesto, whilst this was less pronounced in Germany. This leads to the hypothesis that certain aspects of political market orientation may be mediated by structural......In this study we employ the concept of political market orientation to better understand how the main political parties in the UK and Germany relate to other stakeholders in the political sphere through an exploratory content analysis of their core election offering, the manifesto. This study has...... two aims: firstly, we will discuss the different facets of the market orientation of the main UK and German parties in their respective 2005 General Elections through an exploratory content analysis, and secondly, we will compare characteristics of market orientation between the two countries. Whilst...

  16. Different facets of market orientation

    DEFF Research Database (Denmark)

    Ormrod, Robert P.; Henneberg, Stephan C.

    2009-01-01

    In this study we employ the concept of political market orientation to better understand how the main political parties in the UK and Germany relate to other stakeholders in the political sphere through an exploratory content analysis of their core election offering, the manifesto. This study has...... two aims: firstly, we will discuss the different facets of the market orientation of the main UK and German parties in their respective 2005 General Elections through an exploratory content analysis, and secondly, we will compare characteristics of market orientation between the two countries. Whilst...... the UK parties generally exhibited similar levels of market orientation on each of the relevant construct dimensions, the German parties had more distinct profiles; thus the applied dimensions of political market orientation show discriminatory power within and across electoral systems. In the UK...

  17. Effective and Efficient Multi-Facet Web Image Annotation

    Institute of Scientific and Technical Information of China (English)

    Jia Chen; Yi-He Zhu; Hao-Fen Wang; Wei Jin; Yong Yu

    2012-01-01

    The vast amount of images available on the Web request for an effective and efficient search service to help users find relevant images.The prevalent way is to provide a keyword interface for users to submit queries.However,the amount of images without any tags or annotations are beyond the reach of manual efforts.To overcome this,automatic image annotation techniques emerge,which are generally a process of selecting a suitable set of tags for a given image without user intervention.However,there are three main challenges with respect to Web-scale image annotation:scalability,noiseresistance and diversity.Scalability has a twofold meaning:first an automatic image annotation system should be scalable with respect to billions of images on the Web; second it should be able to automatically identify several relevant tags among a huge tag set for a given image within seconds or even faster.Noise-resistance means that the system should be robust enough against typos and ambiguous terms used in tags.Diversity represents that image content may include both scenes and objects,which are further described by multiple different image features constituting different facets in annotation.In this paper,we propose a unified framework to tackle the above three challenges for automatic Web image annotation.It mainly involves two components:tag candidate retrieval and multi-facet annotation.In the former content-based indexing and concept-based codebook are leveraged to solve scalability and noise-resistance issues.In the latter the joint feature map has been designed to describe different facets of tags in annotations and the relations between these facets.Tag graph is adopted to represent tags in the entire annotation and the structured learning technique is employed to construct a learning model on top of the tag graph based on the generated joint feature map.Millions of images from Flickr are used in our evaluation.Experimental results show that we have achieved 33% performance

  18. Morphometry of the lumbar zygapophyseal facet capsule and cartilage with special reference to degenerative osteoarthritic changes: an anatomical study using fresh cadavers of elderly Japanese and Korean subjects.

    Science.gov (United States)

    Tanno, Iwao; Murakami, Gen; Oguma, Hiroshi; Sato, Shu-Ichi; Lee, U-Young; Han, Seung-Ho; Yamashita, Toshihiko

    2004-01-01

    Morphometric data were obtained from fresh cadaver dissections, and observations of degenerative changes in the joint cartilage (DCs) were analyzed to determine whether the morphometric parameters of the lumbar zygapophyseal joint capsule varied according to the presence and severity of DCs. There have been no previous morphometric studies of the facet capsule that describe age-related DCs. Using 23 fresh osteoligamentous lumbar spines from donated cadavers, we performed morphometric investigations of the surface areas of the joints and their capsules and measured the capsular thickness. We hypothesized that the ratio of the inner capsular area to the joint surface area for each facet (the capsule/facet index) could serve as an index showing a functional aspect of a large or small capsule. Our results showed that the joint surface area increased significantly with increasing severity of DCs, according to Grogan's classification. Facets with advanced DCs tended to have a small inner capsular surface. The capsule/facet index generally correlated positively with capsular thickness, especially the dorsal portion; however, this was not true for the ventral portion. The index also correlated negatively with DC progression. Thus, lumbar facet DCs were strongly linked to reconstructive alterations in capsular size, thickness, and looseness. The occurrence and progression of DCs narrowed the joint capsule, especially the dorsal portion, and this seemed to decrease the potential looseness of the joint. Conversely, these capsular alterations seemed to accelerate DC progression. A negative adaptation cycle seemed to occur.

  19. Facet selective etching of Au microcrystallites

    Institute of Scientific and Technical Information of China (English)

    Gangaiah Mettela and Giridhar U. Kulkarni

    2015-01-01

    High-symmetry crystals exhibit isotropic properties. Inducing anisotropy, e.g., by facet selective etching, is considered implausible in face-centered cubic (FCC) metals, particularly gold, which, in addition to being an FCC, is noble. We report for the first time the facet selective etching of Au microcrystals obtained in the form of cuboctahedra and pentagonal rods from the thermolysis of a gold- organic precursor. The selective etching of {111} and {100} facets was achieved using a capping method in which tetraoctylammonium cations selectively cap the {111} facets while Br- ions protect the {100} facets. The exposed facets are oxidized by O2/C1-, yielding a variety of interesting geometries. The facet selective etching of the Au microcrystallites is governed only by the nature of the facets; the geometry of the microcystallite does not appear to play a significant role. The etched surfaces appear rough, but a closer examination reveals well-defined corrugations that are indexable to high hkl values. Such surfaces exhibit enhanced Raman activity.

  20. Facets of the balanced minimal evolution polytope.

    Science.gov (United States)

    Forcey, Stefan; Keefe, Logan; Sands, William

    2016-08-01

    The balanced minimal evolution (BME) method of creating phylogenetic trees can be formulated as a linear programming problem, minimizing an inner product over the vertices of the BME polytope. In this paper we undertake the project of describing the facets of this polytope. We classify and identify the combinatorial structure and geometry (facet inequalities) of all the facets in dimensions up to five, and classify even more facets in all dimensions. A full set of facet inequalities would allow a full implementation of the simplex method for finding the BME tree-although there are reasons to think this an unreachable goal. However, our results provide the crucial first steps for a more likely-to-be-successful program: finding efficient relaxations of the BME polytope.

  1. Search Result Diversification Based on Query Facets

    Institute of Scientific and Technical Information of China (English)

    胡莎; 窦志成; 王晓捷; 继荣

    2015-01-01

    In search engines, different users may search for different information by issuing the same query. To satisfy more users with limited search results, search result diversification re-ranks the results to cover as many user intents as possible. Most existing intent-aware diversification algorithms recognize user intents as subtopics, each of which is usually a word, a phrase, or a piece of description. In this paper, we leverage query facets to understand user intents in diversification, where each facet contains a group of words or phrases that explain an underlying intent of a query. We generate subtopics based on query facets and propose faceted diversification approaches. Experimental results on the public TREC 2009 dataset show that our faceted approaches outperform state-of-the-art diversification models.

  2. Numerical simulation of facet dendrite growth

    Institute of Scientific and Technical Information of China (English)

    CHEN Zhi; CHEN Chang-le; HAO Li-mei

    2008-01-01

    Numerical simulation based on phase field method was performed to describe the solidification of silicon. The effect of anisotropy, undercooling and coupling parameter on dendrite growth shape was investigated. It is indicated that the entire facet dendrite shapes are obtained by using regularized phase field model. Steady state tip velocity of dendrite drives to a fixed value when γ≤0.13. With further increasing the anisotropy value, steady state tip velocity decreases and the size is smaller. With the increase in the undercooling and coupling parameter, crystal grows from facet to facet dendrite. In addition, with increasing coupling parameter, the facet part of facet dendrite decreases gradually, which is in good agreement with Wulff theory.

  3. Traumatic unilateral lumbosacral jumped facet without fracture in a child - presentation of a safe treatment strategy for a rare injury.

    Science.gov (United States)

    Szentirmai, Oszkar; Seinfeld, Joshua; Beauchamp, Kathryn; Patel, Vikas

    2008-11-10

    The vast majority of pediatric lumbosacral spondylolisthesis have developmental etiology. Of the very rare type of pediatric lumbosacral facet dislocations, there are only three reported cases of a pediatric unilateral jumped facet injury. All of these cases are associated with fracture dislocation of L5-S1. Hyperflexion with rotation is thought to provoke this uncommon type of spine injury.The authors report the first pediatric patient reported in literature to date with a traumatic unilateral jumped facet at the lumbosacral joint without fracture. The presentation, surgical treatment, hospital course, outcome and management options with the review of the literature is summarized.

  4. Septic arthritis in the temporomandibular joint

    Directory of Open Access Journals (Sweden)

    Hassan Mahdi Al-Khalisy

    2015-01-01

    Full Text Available Septic arthritis of the temporomandibular joint (TMJ is a rare event that has only been reported a few dozen times worldwide. This case is remarkable for septic arthritis of the TMJ joint in an otherwise healthy male. Case Report: A 24-year-old male presented to the emergency department with periauricular swelling, erythema, fever, myalgia′s and generalized joint pain. He had previously sought medical attention and was placed on ciprofloxacin. However, he developed facial swelling and a rash and had to discontinue the antibiotic. On physical exam the patient had a large swelling and tenderness in his left periauricular area, with erythema and deviation of the right mandible which limited his ability to open the mouth. A computed tomography showed mild asymmetric soft tissue swelling in the left pharyngeal region but did not show joint effusion. Subsequent magnetic resonance imaging did show effusion of the joint space. The effusion was drained, and the synovial fluid was submitted for gram stain, culture, and sensitivity. The cultures grew menthicillin sensitive Staphyloccocus Aureus. The patient was discharged to complete a two week course of intravenous (IV Ceftriaxone and IV Vancomycin via home infusion. Conclusion: Septic Arthritis of the TMJ is a rare event with very specific clinical symptoms. Due to the low sensitivity of the computed tomography scan, magnetic resonance imaging should be considered when computed tomography scan is negative for TMJ effusion.

  5. A case of tuberculous pericardial effusion.

    Science.gov (United States)

    Suman, Appukuttan; Sarin, Jawahar L; Grant, Simon C; Bazaraa, Talal A

    2003-07-01

    We report a case of an 80-year-old caucasian female in the UK who presented with weight loss and was found to have a pericardial effusion. There was neither previous exposure to tuberculosis nor any suggestion of immunosuppression. Repeated analysis of pericardial fluid established a tuberculous origin. Search of medical literature did not reveal any similar cases in the elderly in the UK.

  6. Bicavitary effusion secondary to liver lobe torsion in a dog

    Directory of Open Access Journals (Sweden)

    Khan Z

    2016-04-01

    Full Text Available Zaheda Khan,1 Kathryn Gates,2 Stephen A Simpson,31Emergency and Critical Care, Animal Specialty and Emergency Center, Los Angeles, CA, 2Emergency and Critical Care, Advanced Critical Care, Emergency and Specialty Services, Culver City, CA 3Emergency and Critical Care, Southern California Veterinary Specialty Hospital, Irvine, CA, USA Abstract: We described the diagnosis and successful treatment of pleural and peritoneal effusion secondary to liver lobe torsion in a dog. A 12-year-old female spayed Borzoi dog was referred for heart failure. Emergency room thoracic and abdominal ultrasound showed a large volume of pleural effusion with mild peritoneal effusion and an abdominal mass. Pleural fluid analysis classified the effusion as exudative. A complete ultrasound revealed mild peritoneal effusion and decreased blood flow to the right liver lobe. Other causes of bicavitary effusion were ruled out based on blood work, ultrasound, echocardiogram, and computed tomography. The patient was taken to surgery and diagnosed with caudate liver lobe torsion and had a liver lobectomy. At the 2-week postoperative recheck, the patient was doing well and there was complete resolution of the pleural effusion. Liver lobe torsion is a rare occurrence in dogs and can be difficult to diagnose. Clinical signs are nonspecific for liver lobe torsion and patients may present in respiratory distress with significant pleural fluid accumulation. When assessing patients with pleural and peritoneal effusion, liver lobe torsion should be considered as a differential diagnosis.Keywords: pleural effusion, peritoneal effusion, hepatic torsion

  7. MASSIVE PLEURAL EFFUSION: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Putu Bayu Dian Tresna Dewi

    2013-03-01

    Full Text Available Pleural effusion is abnormal fluid accumulation within pleural cavity between the parietal pleura and visceralis pleura, either transudation or exudates. A 47 year-old female presented with dyspneu, cough, and decreased of appetite. She had history of right lung tumor. Physical examination revealed asymmetric chest movement where right part of lung was lagged during breathing, vocal fremitus on the right chest was decreased, dullness at the right chest, decreased vesicular sound in the right chest, enlargement of supraclavicular and colli dextra lymph nodes, and hepatomegali. Complete blood count showed leukocytosis. Clinical chemistry analysis showed hipoalbumin and decreased liver function. Blood gas analysis showed hypoxemia. Pleural fluid analysis showed an exudates, murky red liquid color filled with erythrocytes, number of cells. Cytological examination showed existence of a non-small cell carcinoma tends adeno type. From chest X-ray showed massive right pleural effusion. Based on history, physical examination and investigations, she was diagnosed with massive pleural effusion et causa suspected malignancy. She had underwent pleural fluid evacuation and treated with analgesics and antibiotics.

  8. Clinical Investigation of Benign Asbestos Pleural Effusion.

    Science.gov (United States)

    Fujimoto, Nobukazu; Gemba, Kenichi; Aoe, Keisuke; Kato, Katsuya; Yokoyama, Takako; Usami, Ikuji; Onishi, Kazuo; Mizuhashi, Keiichi; Yusa, Toshikazu; Kishimoto, Takumi

    2015-01-01

    There is no detailed information about benign asbestos pleural effusion (BAPE). The aim of the study was to clarify the clinical features of BAPE. The criteria of enrolled patients were as follows: (1) history of asbestos exposure; (2) presence of pleural effusion determined by chest X-ray, CT, and thoracentesis; and (3) the absence of other causes of effusion. Clinical information was retrospectively analysed and the radiological images were reviewed. There were 110 BAPE patients between 1991 and 2012. All were males and the median age at diagnosis was 74 years. The median duration of asbestos exposure and period of latency for disease onset of BAPE were 31 and 48 years, respectively. Mean values of hyaluronic acid, adenosine deaminase, and carcinoembryonic antigen in the pleural fluid were 39,840 ng/mL, 23.9 IU/L, and 1.8 ng/mL, respectively. Pleural plaques were detected in 98 cases (89.1%). Asbestosis was present in 6 (5.5%) cases, rounded atelectasis was detected in 41 (37.3%) cases, and diffuse pleural thickening (DPT) was detected in 30 (27.3%) cases. One case developed lung cancer (LC) before and after BAPE. None of the cases developed malignant pleural mesothelioma (MPM) during the follow-up.

  9. Clinical Investigation of Benign Asbestos Pleural Effusion

    Directory of Open Access Journals (Sweden)

    Nobukazu Fujimoto

    2015-01-01

    Full Text Available There is no detailed information about benign asbestos pleural effusion (BAPE. The aim of the study was to clarify the clinical features of BAPE. The criteria of enrolled patients were as follows: (1 history of asbestos exposure; (2 presence of pleural effusion determined by chest X-ray, CT, and thoracentesis; and (3 the absence of other causes of effusion. Clinical information was retrospectively analysed and the radiological images were reviewed. There were 110 BAPE patients between 1991 and 2012. All were males and the median age at diagnosis was 74 years. The median duration of asbestos exposure and period of latency for disease onset of BAPE were 31 and 48 years, respectively. Mean values of hyaluronic acid, adenosine deaminase, and carcinoembryonic antigen in the pleural fluid were 39,840 ng/mL, 23.9 IU/L, and 1.8 ng/mL, respectively. Pleural plaques were detected in 98 cases (89.1%. Asbestosis was present in 6 (5.5% cases, rounded atelectasis was detected in 41 (37.3% cases, and diffuse pleural thickening (DPT was detected in 30 (27.3% cases. One case developed lung cancer (LC before and after BAPE. None of the cases developed malignant pleural mesothelioma (MPM during the follow-up.

  10. Management of Parapneumonic Pleural Effusion in Adults.

    Science.gov (United States)

    Ferreiro, Lucía; San José, María Esther; Valdés, Luis

    2015-12-01

    Pleural infections have high morbidity and mortality, and their incidence in all age groups is growing worldwide. Not all infectious effusions are parapneumonic and, in such cases, the organisms found in the pleural space are not the same as those observed in lung parenchyma infections. The diagnostic difficulty lies in knowing whether an infectious effusion will evolve into a complicated effusion/empyema, as the diagnostic methods used for this purpose provide poor results. The mainstays of treatment are to establish an early diagnosis and to commence an antibiotic regimen and chest drain as soon as possible. This should preferably be carried out with fine tubes, due to certain morphological, bacteriological and biochemical characteristics of the pleural fluid. Fluid analysis, particularly pH, is the most reliable method for assessing evolution. In a subgroup of patients, fibrinolytics may help to improve recovery, and their combination with DNase has been found to obtain better results. If medical treatment fails and surgery is required, video-assisted thoracoscopic surgery (VATS) is, at least, comparable to decortication by thoracotomy, so should only undertaken if previous techniques have failed. Further clinical trials are needed to analyze factors that could affect the results obtained, in order to define new evidence-based diagnostic and therapeutic strategies that provide more effective, standardized management of this disease. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

  11. Method for partially coating laser diode facets

    Science.gov (United States)

    Dholakia, Anil R. (Inventor)

    1990-01-01

    Bars of integral laser diode devices cleaved from a wafer are placed with their p regions abutting and n regions abutting. A thin BeCu mask having alternate openings and strips of the same width as the end facets is used to mask the n region interfaces so that multiple bars can be partially coated over their exposed p regions with a reflective or partial reflective coating. The partial coating permits identification of the emitting facet from the fully coated back facet during a later device mounting procedure.

  12. Accuracy and repeatability of a new method for measuring facet loads in the lumbar spine.

    Science.gov (United States)

    Wilson, Derek C; Niosi, Christina A; Zhu, Qingan A; Oxland, Thomas R; Wilson, David R

    2006-01-01

    We assessed the repeatability and accuracy of a relatively new, resistance-based sensor (Tekscan 6900) for measuring lumbar spine facet loads, pressures, and contact areas in cadaver specimens. Repeatability of measurements in the natural facet joint was determined for five trials of four specimens loaded in pure moment (+/- 7.5 N m) flexibility tests in axial rotation and flexion-extension. Accuracy of load measurements in four joints was assessed by applying known compressive loads of 25, 50, and 100 N to the natural facet joint in a materials testing machine and comparing the known applied load to the measured load. Measurements of load were obtained using two different calibration approaches: linear and two-point calibrations. Repeatability for force, pressure, and area (average of standard deviation as a percentage of the mean for all trials over all specimens) was 4-6% for axial rotation and 7-10% for extension. Peak resultant force in axial rotation was 30% smaller when calculated using the linear calibration method. The Tekscan sensor overestimated the applied force by 18 +/- 9% (mean+/-standard deviation), 35 +/- 7% and 50 +/- 9% for compressive loads of 100, 50, and 25 N, respectively. The two-point method overestimated the loads by 35 +/- 16%, 45 +/- 7%, and 56 +/- 10% for the same three loads. Our results show that the Tekscan sensor is repeatable. However, the sensor measurement range is not optimal for the small loads transmitted by the facets and measurement accuracy is highly dependent on calibration protocol.

  13. 后前入路治疗下颈椎骨折脱位伴双侧关节突绞锁%Decompression via posterior-anterior approach and anterior fixation in treatment of fracture-dislocation of the lower cervical spine with bilateral facet joints dislocation

    Institute of Scientific and Technical Information of China (English)

    李鹏; 雪原; 王沛; 马信龙; 赵华健; 赵晓涛; 卢旭亚

    2011-01-01

    Objective To evaluate the surgical strategy of decompression via posterior-anterior approach and anterior fixation in treatment fracture-dislocation of the lower cervical spine with bilateral facet joints dislocation. Methods This study retrospectively reviewed 37 cases of lower cervical spine fracture with bilateral joints dislocation. There were 21 males and 16 females with an average age of 42 years (19-58). Distraction-flexion stage 3(DFS 3) were found in 24 cases and DFS 4 in 13 cases. All the cases were diagnosed by X-ray, CT and MRI and confirmed during the surgery. Decompression via posterior-anterior approach and anterior fixation had been adapted as the surgical strategy. The NASCIS and IMSOP standard were applied to definite the level of cervical spinal cord injury. The ASIA grading was used for evaluation the spinal cord function and the recovery rate. The X-ray and CT were used to observe reduction and bone fusion. Results The mean operative time was (4.5:±0.5) h, and the mean amount of blood loss was 360 ml (200-500 ml). All the incision healed. The two segments fixation was used in 23 cases, 3 segments fixation in 13 cases, and 4 segments fixation in 1 case. The mean follow-up period was 32 months (16-45 months).Postoperative X-ray and CT showed that bone fusion was achieved in all patients within 4-8 months, without graft displacement, or failure of implants. Spinal cord function did not aggravate, and sensory recovery ranged from 7 to 20 levels (averaged, 12.7). The ASIA grade were improved with an average of one grade. Conclusion To treat fracture-dislocation of the lower cervical spine with bilateral facet joints dislocation, the posterlor-anterior approach and anterior fixation/fusion was benefit to preservation the cervical spinal cord function and reconstruction biomechanical stability of the cervical spine.%目的 探讨后前路减压、前路固定治疗下颈椎骨折脱位伴双侧关节突绞锁的可行性及临床效果.方法 2000

  14. 一期后路保留部分关节突开窗病灶清除短节段椎弓根螺钉内固定治疗腰骶椎结核%ONE-STAGE POSTERIOR RETAINING PART FACET JOINT IN LAMINECTOMY AND DEBRIDEMENT COMBINED WITH SHORT SEGMENTAL PEDICLE SCREW FIXATION FOR LUMBOSACRAL SPINAL TUBERCULOSIS

    Institute of Scientific and Technical Information of China (English)

    陈林; 覃建朴; 敖俊; 廖文波; 蔡玉强

    2016-01-01

    effectiveness of one-stage posterior retaining part facet joint in laminectomy,bone graft and debridement combined with short segmental pedicle screw fixation for lumbosacral spinal tuberculosis.Methods Between January 2010 and December 2014,32 cases of lumbosacral spinal tuberculosis (L4-S1) were treated by one-stage posterior retaining part facet joint in laminectomy,bone graft and debridement combined with short segmental pedicle screw fixation.There were 20 males and 12 females,aged 17-62 years (mean,43 years).The disease duration was 12-48 months (mean,18 months).The involved segments included L5,S1 level in 19 cases and L4.5 level in 13 cases.The effectiveness was evaluated by Oswestry disability index (ODI) and imaging parameters (lumbarsacral angle correction and Bridwel1 classification and CT fusion criteria) after operation.Results The operation was successfully completed in all patients;the average operation time was 180 minutes,and the average intraoperative blood loss was 400 mL.All cases were followed up 12 to 67 months (mean,15.6 months).At last follow-up,common toxic symptom of tuberculosis disappeared,and no internal fixation failure occurred.Neurological function was recovered to normal in 7 patients with neurological symptoms,and American Spinal Injury Association (ASIA) scale was improved to grade E from grade C (2 cases) and grade D (5 cases) before operation.At 1 year and last follow-up,the ODI scores were significantly improved when compared with preoperative score (P<0.05),but no significant difference was found between at 1 year and last follow-up (P>0.05).The lumbarsacral angle was significantly increased at 7 days,1 year and last follow-up when compared with preoperative one (P<0.05),but there was no significant difference between different time points after operation (P>0.05).The bone graft fusion time was 9-24 months (mean,12 months).At 1 year after operation and last follow-up,X-ray Bridwill bone fusion rates were 87.50% (28/32) and 93

  15. Facet injection trends in the Medicare population and the impact of bundling codes.

    Science.gov (United States)

    Beckworth, William Jeremy; Jiang, Miao; Hemingway, Jennifer; Hughes, Danny; Staggs, Donald

    2016-09-01

    Interventional spine procedures have seen a steady increase in utilization over the last 10 to 20 years. In 2010, the Current Procedural Terminology (CPT) codes for facet injections were bundled with image guidance (fluoroscopic or computed tomography) and limited billing to a maximum of three levels. This was done in part because of increased utilization and to ensure that procedures were done appropriately with image guidance. The study aimed to evaluate if the CPT code changes correlated with a decreased utilization of facet injections. This is a retrospective time series study. The sample was composed of 100% Medicare Part B claims submitted for facet joint injections from 2000 to 2012, as documented in the Centers for Medicare & Medicaid Services (CMS) Physician Supplier Procedure Summary (PSPS) master files. Procedure numbers and trends were the outcome measures. The trends of facet injections were analyzed from 2000 to 2012 using the CMS PSPS master files. The total number of lumbosacral and cervical-thoracic facet injections was noted. Changes over those years were calculated with specific attention to 2010, when CPT were bundled with image guidance and injections were limited to no more than three levels. Also, to account for the growth in the Medicare population, a calculation was done of injections per 100,000 Medicare enrollees. No funding was used for this study. Facet injection utilization increased from 2000 to 2012, with an average growth rate of 11% per year for lumbosacral facet injections and 15% for cervical-thoracic facet injections (per 100,000 Medicare enrollees). The largest growth occurred from 2000 to 2006 (25% growth per year for lumbosacral and 32% for cervical-thoracic injections per 100,000 Medicare enrollees) and this leveled off from 2007 to 2012 (-3% growth per year for lumbosacral and -2% for cervical-thoracic injections per 100,000 Medicare enrollees). The biggest drop in these procedures was in 2010, when there was a drop of 14

  16. Increased Pelvic Incidence is Associated With a More Coronal Facet Orientation in the Lower Lumbar Spine: A Cadaveric Study of 599 Lumbar Spines.

    Science.gov (United States)

    Weinberg, Douglas S; Xie, Katherine K; Liu, Raymond W; Gebhart, Jeremy J; Gordon, Zachary L

    2016-10-01

    An anatomic study of facet angle orientation and morphology of the lumbar spine was performed. The aim of this study was to determine how age, gender, race, and pelvic incidence (PI) correlate with facet orientation in the lumbar spine. Lumbar facet orientation has important implications in the development of numerous pathologies of the spine, including arthritis, spondylolisthesis, and adult spinal deformity. Preliminary reports have suggested that sagittal balance of the spine may contribute to facet joint orientation. We therefore designed an anatomic study to investigate the relationship between PI and facet orientation, within the context of age, gender, and race. Five hundred ninety-nine cadaveric lumbar spines were obtained from the Hamann-Todd osteological collection. It was determined that facet angle was most reliably assessed by measuring the angle between the superior articular facet and the spinous process. Facet angles were measured bilaterally at each level from T12-L1 through L5-S1 in every specimen. Multivariate regression analysis was used to determine independent predictors of facet angle at each level. Facet angle increased rostrally to caudally, from 22.6 ± 8.3° at T12-L1 to 49.1 ± 12.4° at L5-S1. Cadaver age was an independent predictor of a more sagittal facet angle at lower spinal levels. Caucasian race was an independent predictor of increasing facet angle. Increased PI had no effect on facet angle at T12-L1, L1-L2, L2-L3, or L3-L4, although was a significant predictor of more coronally oriented facet joints at L4-L5 (standardized beta 0.096, P = 0.009) and L5-S1 (standardized beta 0.079, P = 0.032). The results of this study provide important data regarding differences in facet angle that exists between individuals. Moreover, the results of this study suggest that facet joints do possess the ability to remodel over time, perhaps in response to perturbations of sagittal balance, osteophyte formation, or other yet to be

  17. STUDY OF CUSTOMERS’ LOYALTY: DIMENSIONS AND FACETS

    Directory of Open Access Journals (Sweden)

    Claudia BOBÂLCĂ

    2013-06-01

    Full Text Available The purpose of this study is to identify the main aspects investigated in the study of customer loyalty regarding different dimensions and facets of loyalty. Analyzing the academic literature on this subject, we identified two main directions: (a the approachings of loyalty on its dimensions (one, two or four dimensions; (b the approachings of loyalty on its facets (effects. The main facets of loyalty are repatronage intentions, word-of-mouth intentions and buying frequency. Our approach is a theoretical one and we used documentary research. Identifying and analyzing the dimensions and facets of loyalty are important stages for any loyalty program that a company should implement, regardless of its field of activity.

  18. FACET: SLAC___s New User Facility

    Energy Technology Data Exchange (ETDEWEB)

    Clarke, C.I.; Decker, F.-J.; England, R.J.; Erickson, R.A.; Hast, C.; Hogan, M.J.; Li, S.Z.; Litos, M.D.; Nosochkov, Y.; Seeman, J.T.; Sheppard, J.; Wienands, U.; Woodley, M.; Yocky, G.; /SLAC

    2012-05-16

    FACET (Facility for Advanced Accelerator Experimental Tests) is a new User Facility at SLAC National Accelerator Laboratory. The first User Run started in spring 2012 with 20 GeV, 3 nC electron beams. The facility is designed to provide short (20 {micro}m) bunches and small (20 {micro}m wide) spot sizes, producing uniquely high power beams. FACET supports studies from many fields but in particular those of Plasma Wakefield Acceleration and Dielectric Wakefield Acceleration. The creation of drive and witness bunches and shaped bunch profiles is possible with 'Notch' Collimation. FACET is also a source of THz radiation for material studies. Positrons will be available at FACET in future user runs. We present the User Facility and the available tools and opportunities for future experiments.

  19. FACET: Future ATM Concepts Evaluation Tool

    Science.gov (United States)

    Bilmoria, Karl D.; Banavar, Sridhar; Chatterji, Gano B.; Sheth, Kapil S.; Grabbe, Shon

    2000-01-01

    FACET (Future ATM Concepts Evaluation Tool) is an Air Traffic Management research tool being developed at the NASA Ames Research Center. This paper describes the design, architecture and functionalities of FACET. The purpose of FACET is to provide E simulation environment for exploration, development and evaluation of advanced ATM concepts. Examples of these concepts include new ATM paradigms such as Distributed Air-Ground Traffic Management, airspace redesign and new Decision Support Tools (DSTs) for controllers working within the operational procedures of the existing air traffic control system. FACET is currently capable of modeling system-wide en route airspace operations over the contiguous United States. Airspace models (e.g., Center/sector boundaries, airways, locations of navigation aids and airports) are available from databases. A core capability of FACET is the modeling of aircraft trajectories. Using round-earth kinematic equations, aircraft can be flown along flight plan routes or great circle routes as they climb, cruise and descend according to their individual aircraft-type performance models. Performance parameters (e.g., climb/descent rates and speeds, cruise speeds) are obtained from data table lookups. Heading, airspeed and altitude-rate dynamics are also modeled. Additional functionalities will be added as necessary for specific applications. FACET software is written in Java and C programming languages. It is platform-independent, and can be run on a variety of computers. FACET has been designed with a modular software architecture to enable rapid integration of research prototype implementations of new ATM concepts. There are several advanced ATM concepts that are currently being implemented in FACET airborne separation assurance, dynamic density predictions, airspace redesign (re-sectorization), benefits of a controller DST for direct-routing, and the integration of commercial space transportation system operations into the U.S. National

  20. FACET: Future ATM Concepts Evaluation Tool

    Science.gov (United States)

    Bilmoria, Karl D.; Banavar, Sridhar; Chatterji, Gano B.; Sheth, Kapil S.; Grabbe, Shon

    2000-01-01

    FACET (Future ATM Concepts Evaluation Tool) is an Air Traffic Management research tool being developed at the NASA Ames Research Center. This paper describes the design, architecture and functionalities of FACET. The purpose of FACET is to provide E simulation environment for exploration, development and evaluation of advanced ATM concepts. Examples of these concepts include new ATM paradigms such as Distributed Air-Ground Traffic Management, airspace redesign and new Decision Support Tools (DSTs) for controllers working within the operational procedures of the existing air traffic control system. FACET is currently capable of modeling system-wide en route airspace operations over the contiguous United States. Airspace models (e.g., Center/sector boundaries, airways, locations of navigation aids and airports) are available from databases. A core capability of FACET is the modeling of aircraft trajectories. Using round-earth kinematic equations, aircraft can be flown along flight plan routes or great circle routes as they climb, cruise and descend according to their individual aircraft-type performance models. Performance parameters (e.g., climb/descent rates and speeds, cruise speeds) are obtained from data table lookups. Heading, airspeed and altitude-rate dynamics are also modeled. Additional functionalities will be added as necessary for specific applications. FACET software is written in Java and C programming languages. It is platform-independent, and can be run on a variety of computers. FACET has been designed with a modular software architecture to enable rapid integration of research prototype implementations of new ATM concepts. There are several advanced ATM concepts that are currently being implemented in FACET airborne separation assurance, dynamic density predictions, airspace redesign (re-sectorization), benefits of a controller DST for direct-routing, and the integration of commercial space transportation system operations into the U.S. National

  1. Facets of Emotional Clarity and Suspiciousness

    OpenAIRE

    Boden, Matthew Tyler; Berenbaum, Howard

    2012-01-01

    In a college student sample, we explored the relations between individual differences in facets of emotional clarity and suspiciousness. Previous theory and research has treated emotional clarity as a one-dimensional construct. Boden and Berenbaum (2011) proposed that a second facet of emotional clarity, source awareness (a general understanding of the cause of their emotions), could be distinguished from type awareness (a general understanding of the type of emotions [anger, fear] experience...

  2. Superior facet syndrome. Findings on metrizamide CT myelography

    Energy Technology Data Exchange (ETDEWEB)

    Kubo, Yoshichika; Igarashi, Seishi; Koyama, Tsunemaro

    1985-02-01

    Sciatica caused by root entrapment in the lateral recess was named superior facet syndrome by Epstein in 1972. Few reports on this subject based on large numbers of cases have been documented to date. Of the patients with sciatica, 32 patients were diagnosed to have root entrapment at the lateral recess L5 or/and S1 lumbar spine. Out of 32 patients, 20 patients were operated on and the lateral entrapment was recognized in all of surgical cases. Neuroradiological findings, especially of metrizamide CT (met. CT), were documented in detail. Thirty two patients were classified in three types according to radiological findings. They were congenital or developmental, degenerative, and combined type, respectively. Fourteen cases belonged to the congenital type, 13 to the degenerative and 5 to the combined type. Each group had the mean ages of 23.4, 53.8, and 36.8 years old, respectively. Of 32 cases the entrapment occured in 47 L5 roots and 11 S1 roots. There was no remarkable laterality. In operation the unroofing of the lateral recess were done and the sciatica subsided postoperatively in all of surgical cases. Met. CT revealed extreme medial protrusion of the superior articular joint in 18 of 24 cases(75%) and none filling of the root in the lateral recess in 21 of 24 cases (87.5%). In the degenerative type, met. CT showed some degenerative changes that were hypertrophy or deformity of the articular joints and spur formation of the vertebral body. In contrast to met. CT, metrizamide myelography revealed only slight changes, which were poor filling of the root before it turned out the pedicle of lateral compression of the root. In plain films or lumbar spine articular joints at Lsub(4/5) were formed in coronal plane in 69% of cases of the L5 root entrapment. Met. CT using ReView technique was of great diagnostic value in superior facet syndrome.

  3. VEGF Correlates with Inflammation and Fibrosis in Tuberculous Pleural Effusion

    Directory of Open Access Journals (Sweden)

    Mauo-Ying Bien

    2015-01-01

    Full Text Available Objective. To investigate the relationship among angiogenic cytokines, inflammatory markers, and fibrinolytic activity in tuberculous pleural effusion (TBPE and their clinical importance. Methods. Forty-two patients diagnosed with TBPE were studied. Based on chest ultrasonography, there were 26 loculated and 16 nonloculated TBPE patients. The effusion size radiological scores and effusion vascular endothelial growth factor (VEGF, interleukin- (IL- 8, plasminogen activator inhibitor type-1 (PAI-1, and tissue type plasminogen activator (tPA were measured. Treatment outcome and pleural fibrosis, defined as radiological residual pleural thickening (RPT, were assessed at 6-month follow-up. Results. The effusion size and effusion lactate dehydrogenase (LDH, VEGF, IL-8, PAI-1, and PAI-1/tPA ratio were significantly higher, while effusion glucose, pH value, and tPA were significantly lower, in loculated than in nonloculated TBPE. VEGF and IL-8 correlated positively with LDH and PAI-1/tPA ratio and negatively with tPA in both loculated and nonloculated TBPE. Patients with higher VEGF or greater effusion size were prone to develop RPT (n=14; VEGF, odds ratio 1.28, P=0.01; effusion size, odds ratio 1.01, P=0.02, and VEGF was an independent predictor of RPT in TBPE (receiver operating characteristic curve AUC=0.985, P<0.001. Conclusions. Effusion VEGF correlates with pleural inflammation and fibrosis and may be targeted for adjunct therapy for TBPE.

  4. Presumed hydrochlorothiazide-associated immunologic-hypersensitivity-induced pericardial effusion

    Directory of Open Access Journals (Sweden)

    Michael J Chaskes

    2013-08-01

    Full Text Available A 50-year-old Caucasian female presented for a second opinion regarding a newly diagnosed pericardial effusion. Seven months previously, hydrochlorothiazide was introduced into her pharmacologic regimen to aid in the management of her hypertension. A routine echocardiogram indicated a large pericardial effusion with signs of early cardiac tamponade. The patient subsequently underwent successful pericardiocentesis with complete drainage of the pericardial effusion. The effusion was empirically attributed to a viral etiology. Repeat echocardiograms showed recurrence of the pericardial effusion. Prior to undergoing a second pericardiocentesis with pericardial biopsy, as her physicians recommended, the patient sought a second opinion. While obtaining the patient’s history, an allergy to sulfa was elicited. The possibility that the pericardial effusion may be secondary to an immunologic-hypersensitivity reaction was considered. It was recommended the patient discontinue the use of hydrochlorothiazide. Nine days following discontinuation of hydrochlorothiazide and without any other intervention, an echocardiogram was reported to show the size of the pericardial effusion had subsided substantially. Nine weeks following discontinuation, almost complete resolution of the pericardial effusion was reported. It is hypothesized that when treated with hydrochlorothiazide, the patient had an immune response leading to the pericardial effusion.

  5. 热敏灸配合手法复位治疗胸椎小关节紊乱症随机对照观察%Randomized Controlled Trial of Heat-sensitive Point Moxibustion plus Manipulative Reduction for the Treatment of Thoracic Facet Joint Disorder

    Institute of Scientific and Technical Information of China (English)

    郑锦清; 吴峰; 黄漫为; 郑昌岳; 陈宣煌; 黄志华; 李南华

    2015-01-01

    Objective To investigate the clinical efficacy of heat-sensitive point moxibustion plus manipulative reduction in treating thoracic facet joint disorder. Method A single-blind randomized controlled trial was carried out. Eighty-two patients meeting the criteria were randomly allocated to an observation group of 42 cases and a control group of 40 cases. The observation group received heat-sensitive point moxibustion plus manipulative reduction and the control group, TDP plus manipulative reduction. Both groups were treated five times a week, five times as a course for a total of two courses (including the patients cured after less than two courses). The therapeutic effects were evaluated by using the McGill Pain Questionnaire the as the observation index, comparing pre-/post-treatment Pain Rating Index (PRI) scores, Visual Analogous Scale (VAS) scores and Present Pain Intensity (PPI) scores and referring to the Criteria of the Diagnosis of and the Therapeutic Effect on Syndromes in Traditional Chinese Medicine. Result After treatment, the PRI, VAS and PPI scores decreased significantly in both groups (P<0.01) and were lower in the observation group than in the control group (P<0.01). The cure rate was 57.1% (24/42) in the observation group, which was significantly higher than 27.5% in the control group (11/40,P<0.01). The total efficacy rate was 95.2% (40/42) in the observation group, which was significantly higher than 80.0% in the control group (32/40,P<0.01). Conclusion Heat-sensitive point moxibustion plus manipulative reduction has a very good therapeutic effect on thoracic facet joint disorder. The effect is significantly better than that in the control group.%目的:观察热敏灸配合手法复位治疗胸椎小关节紊乱症的临床疗效,探索一种新的组合疗法。方法采用单盲、随机、对照研究方法,将符合条件的82例患者随机分为两组,观察组42例,给予热敏灸配合手法复位治疗;对照组40例,给予TDP 配

  6. All that Curves is Not Effusion

    Directory of Open Access Journals (Sweden)

    Suhas H. S

    2017-07-01

    Full Text Available Endobronchial tuberculosis is a peculiar variant of tuberculosis hallmarked by involvement of the tracheobronchial tree and contributes to a sizable proportion to the overall morbidity due to the disease. Bronchostenotic variety is the predominant pattern with clinical spectrum ranging from asymptomatic affection to significant life threatening luminal compromise. The radiological features could be deceptive leading to a diagnostic delay. Awareness of the spectrum of the clinical manifestations and heterogeneity in radiological patterns is therefore vital for an accurate diagnosis. We hereby narrate a case of bronchostenotic variant of endobronchial tuberculosis overtly seeming like a pleural effusion on the basis of a chest radiograph.

  7. Management of Otitis Media with Effusion

    Institute of Scientific and Technical Information of China (English)

    LIU Li-min; DONG Min-ming

    2008-01-01

    Otitis media with effusion is one of the most common diseases in children. Its treatment remains controversial. Clinical practice guidelines of OME allow watchful waiting for 3 months before treatment if the child with OME is not at risk for speech/language/or learning problems. Tympanostomy tube insertion is the preferred initial procedure when a child becomes a surgical candidate. Complementary or alternative medicine is not recommended as a treatment for OME. This paper provides a systematic review of management of OME, which we hope will be helpful for clinicians.

  8. Large pericardial effusion induced by minoxidil.

    Science.gov (United States)

    Çilingiroğlu, Mehmet; Akkuş, Nuri; Sethi, Salil; Modi, Kalgi A

    2012-04-01

    A 53-year-old male admitted with increased shortness of breath. In the physical examination, he had dyspnea, tachycardia and tachypnea. An echocardiogram showed large pericardial effusion (PE) as well as significant pulmonary hypertension. He had been started recently on minoxidil for blood pressure control. PE was reported to occur with minoxidil treatment both in patients undergoing dialysis and those with normal renal function. Pulmonary hypertension has been reported to affect the cardiac tamponade physiology. Because of significant pulmonary hypertension in our patient, a right heart catheterization was also done, which prevented cardiac tamponade. He was treated conservatively without any intervention, and PE resolved spontaneously after discontinuation of minoxidil.

  9. Symptomatic Pericardial Effusion After Chemoradiation Therapy in Esophageal Cancer Patients

    Energy Technology Data Exchange (ETDEWEB)

    Fukada, Junichi, E-mail: fukada@rad.med.keio.ac.jp [Department of Radiology, School of Medicine, Keio University, Tokyo (Japan); Shigematsu, Naoyuki [Department of Radiology, School of Medicine, Keio University, Tokyo (Japan); Takeuchi, Hiroya [Department of Surgery, School of Medicine, Keio University, Tokyo (Japan); Ohashi, Toshio [Department of Radiology, School of Medicine, Keio University, Tokyo (Japan); Saikawa, Yoshiro [Department of Surgery, School of Medicine, Keio University, Tokyo (Japan); Takaishi, Hiromasa [Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo (Japan); Hanada, Takashi; Shiraishi, Yutaka [Department of Radiology, School of Medicine, Keio University, Tokyo (Japan); Kitagawa, Yuko [Department of Surgery, School of Medicine, Keio University, Tokyo (Japan); Fukuda, Keiichi [Department of Cardiology, School of Medicine, Keio University, Tokyo (Japan)

    2013-11-01

    Purpose: We investigated clinical and treatment-related factors as predictors of symptomatic pericardial effusion in esophageal cancer patients after concurrent chemoradiation therapy. Methods and Materials: We reviewed 214 consecutive primary esophageal cancer patients treated with concurrent chemoradiation therapy between 2001 and 2010 in our institute. Pericardial effusion was detected on follow-up computed tomography. Symptomatic effusion was defined as effusion ≥grade 3 according to Common Terminology Criteria for Adverse Events v4.0 criteria. Percent volume irradiated with 5 to 65 Gy (V5-V65) and mean dose to the pericardium were evaluated employing dose-volume histograms. To evaluate dosimetry for patients treated with two-dimensional planning in the earlier period (2001-2005), computed tomography data at diagnosis were transferred to a treatment planning system to reconstruct three-dimensional plans without modification. Optimal dosimetric thresholds for symptomatic pericardial effusion were calculated by receiver operating characteristic curves. Associating clinical and treatment-related risk factors for symptomatic pericardial effusion were detected by univariate and multivariate analyses. Results: The median follow-up was 29 (range, 6-121) months for eligible 167 patients. Symptomatic pericardial effusion was observed in 14 (8.4%) patients. Dosimetric analyses revealed average values of V30 to V45 for the pericardium and mean pericardial doses were significantly higher in patients with symptomatic pericardial effusion than in those with asymptomatic pericardial effusion (P<.05). Pericardial V5 to V55 and mean pericardial doses were significantly higher in patients with symptomatic pericardial effusion than in those without pericardial effusion (P<.001). Mean pericardial doses of 36.5 Gy and V45 of 58% were selected as optimal cutoff values for predicting symptomatic pericardial effusion. Multivariate analysis identified mean pericardial dose as the

  10. Reconstructions and faceting of H-covered Al(111)

    CERN Document Server

    Stumpf, R

    1996-01-01

    First principles calculations show that H overlayers induce a honeycomb vacancy reconstruction on Al(111). Above one ML H coverage, Al(111) facets into surfaces vicinal to (111), with {100} faceted single and double steps and vacancies on the {111} terraces. These H induced reconstructions are stable because H binds more strongly to {100} than to {111} facets. Faceting of Al(111) explains step bunching in H-mediated epitaxy of Al(111). H-covered Al(100) is stable against faceting.

  11. Choroidal findings in idiopathic uveal effusion syndrome

    Directory of Open Access Journals (Sweden)

    Harada T

    2011-11-01

    Full Text Available Tomomi Harada, Shigeki Machida, Takamistu Fujiwara, Yasunori Nishida, Dajiro KurosakaDepartment of Ophthalmology, Iwate Medical University School of Medicine, Iwate, JapanPurpose: We report choroidal findings by means of enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT in a patient with idiopathic uveal effusion syndrome (IUES.Case report: A 41-year-old man was referred to us with ciliochoroidal and non-rhegmatogenous retinal detachments. Sclerectomies and sclerostomies were performed at the equator in the lower quadrants, resulting in resolution of the ciliochoroidal and retinal detachments. EDI-OCT demonstrated low-reflective areas in the outer choroid. The subfoveal choroidal thickness measured vertically from the outer border of the RPE to the inner border of the sclera was 787 µm which was significantly thicker than the normal value (272 ± 90 µm, n = 131 obtained from age-matched normal controls.Conclusions: The findings made by EDI-OCT have provided additional evidence that choroidal alterations play a role in the pathological process in IUES.Keywords: uveal effusion syndrome, spectral-domain optical coherence tomography, EDI-OCT, OCT, choroid

  12. Hydrogen effusion from tritiated amorphous silicon

    Science.gov (United States)

    Kherani, N. P.; Liu, B.; Virk, K.; Kosteski, T.; Gaspari, F.; Shmayda, W. T.; Zukotynski, S.; Chen, K. P.

    2008-01-01

    Results for the effusion and outgassing of tritium from tritiated hydrogenated amorphous silicon (a-Si:H:T) films are presented. The samples were grown by dc-saddle field glow discharge at various substrate temperatures between 150 and 300°C. The tracer property of radioactive tritium is used to detect tritium release. Tritium effusion measurements are performed in a nonvacuum ion chamber and are found to yield similar results as reported for standard high vacuum technique. The results suggest for decreasing substrate temperature the growth of material with an increasing concentration of voids. These data are corroborated by analysis of infrared absorption data in terms of microstructure parameters. For material of low substrate temperature (and high void concentration) tritium outgassing in air at room temperature was studied, and it was found that after 600h about 0.2% of the total hydrogen (hydrogen+tritium) content is released. Two rate limiting processes are identified. The first process, fast tritium outgassing with a time constant of 15h, seems to be related to surface desorption of tritiated water (HTO) with a free energy of desorption of 1.04eV. The second process, slow tritium outgassing with a time constant of 200-300h, appears to be limited by oxygen diffusivity in a growing oxide layer. This material of lowest H stability would lose half of the hydrogen after 60years.

  13. [Benign pleural effusion caused by asbestos exposure].

    Science.gov (United States)

    Vieira, J R; Alfarroba, E; Viegas, J; Freitas e Costa, M

    1992-05-01

    The Authors present the first case described among us of benign pleural effusion of an asbestotic origin. They stress the importance of thoracoscopy (pleuroscopy) in the diagnosis of this situation. Attention is drawn to the fact that asbestotic lesions and asbestotic bodies have been found in the lung and, in particular, in the parietal pleura as well. They emphasize the fact that exposure to asbestos was not realized by the patient, which made the clarification of the situation more difficult. It was a CT scan that showed the signs suggestive of exposure to asbestos which raised the diagnostic suspicion. They conclude that every patient with a pleural effusion must be thoroughly questioned about exposure to asbestos. Even if the exposure is accepted, they consider that one should proceed to a pleuro-pulmonar biopsy by thoracoscopy. This biopsy allows demonstration of the characteristic histopathological lesions and rule out other etiologies, namely malignancy and tuberculosis. They suggest that these patients must be highly motivated to stop any smoking and kept under periodic surveillance.

  14. External radiotherapy in the management of malignant pericardial effusion

    Energy Technology Data Exchange (ETDEWEB)

    Fairlamb, D.J. (The Royal Hospital, Wolverhampton (UK))

    1989-05-01

    Malignant pericardial effusions that are not causing tamponade can be effectively treated by external beam irradiation - a readily available non-invasive treatment. In a consecutive series six out of eight patients achieved good palliation of their effusions as a result of this treatment. (author).

  15. Pericardial effusion and cardiac tamponade in a dog with hypothyroidism

    Directory of Open Access Journals (Sweden)

    J Ojeda

    2015-01-01

    Full Text Available The relationship between hypothyroidism and cardiovascular diseases in dogs is frequently associated with clinical signs like sinusal bradicardia, myocardial alterations and ECG findings such as low voltage QRS and inverted T wave. Echocardiographic studies in hypothyroid dogs have not identified pericardial effusion. Hypothyroidism in human patients is a well-known cause of pericardial effusion, but cardiac tamponade is not a frequent clinical sign. A Golden Retriever was presented with a clinical history of progressive lethargy, exercise intolerance, cold intolerance and increased respiratory effort for 3 weeks. At the clinical examination the dog presented dyspnea, muffled heart sound and hypertension. Echocardiography showed fluid in the pericardial sac and cardiac tamponade and pericardiocentesis was performed. Analyses of the fluid showed a non-neoplastic etiology. The information given by the owners, the alopecia zones detected in tail and abdomen and the clinical response, led to analise the thyroid hormones, and hypothyroidism was confirmed. Following two pericardiocentesis and levothyroxine supplementation, the effusion resolved. Although the etiology of pericardial effusion was not clear, it is possible that the pericardial effusion had been caused by hypothyroidism or the dog had idiophatic pericardial effusion and coincidental hypothyroidism. However, according to the clinical signs and the evolution of the dog, an evaluation of thyroid hormones in dogs with pericardial effusion must be considered even though pericardial effusion is a non-described sign in canine hypothyroidism.

  16. Dynesys dynamic stabilization-related facet arthrodesis.

    Science.gov (United States)

    Fay, Li-Yu; Chang, Peng-Yuan; Wu, Jau-Ching; Huang, Wen-Cheng; Wang, Chun-Hao; Tsai, Tzu-Yun; Tu, Tsung-Hsi; Chang, Hsuan-Kan; Wu, Ching-Lan; Cheng, Henrich

    2016-01-01

    OBJECTIVE Dynamic stabilization devices are designed to stabilize the spine while preserving some motion. However, there have been reports demonstrating limited motion at the instrumented level of the lumbar spine after Dynesys dynamic stabilization (DDS). The causes of this limited motion and its actual effects on outcomes after DDS remain elusive. In this study, the authors investigate the incidence of unintended facet arthrodesis after DDS and clinical outcomes. METHODS This retrospective study included 80 consecutive patients with 1- or 2-level lumbar spinal stenosis who underwent laminectomy and DDS. All medical records, radiological data, and clinical evaluations were analyzed. Imaging studies included pre- and postoperative radiographs, MR images, and CT scans. Clinical outcomes were measured by a visual analog scale (VAS) for back and leg pain, the Oswestry Disability Index (ODI), and Japanese Orthopaedic Association (JOA) scores. Furthermore, all patients had undergone postoperative CT for the detection of unintended arthrodesis of the facets at the indexed level, and range of motion was measured on standing dynamic radiographs. RESULTS A total of 70 patients (87.5%) with a mean age of 64.0 years completed the minimum 24-month postoperative follow-up (mean duration 29.9 months). Unintended facet arthrodesis at the DDS instrumented level was demonstrated by CT in 38 (54.3%) of the 70 patients. The mean age of patients who had facet arthrodesis was 9.8 years greater than that of the patients who did not (68.3 vs 58.5 years, p = 0.009). There were no significant differences in clinical outcomes, including VAS back and leg pain, ODI, and JOA scores between patients with and without the unintended facet arthrodesis. Furthermore, those patients older than 60 years were more likely to have unintended facet arthrodesis (OR 12.42) and immobile spinal segments (OR 2.96) after DDS. Regardless of whether unintended facet arthrodesis was present or not, clinical

  17. [Diagnostic value of tumor markers in pleural effusions].

    Science.gov (United States)

    Botte, G; Laferrere, L; Etchepare, S; Dalurzo, D; Duhart, J E; Adaro, F V

    1990-01-01

    In order to discriminate between benign and malignant effusions, the value of alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA) and beta subunit of human chorionic gonadotropin (GNCH Sub-beta) has been estimated in pleural exudates. A sample of 65 patients, 33 with a malignant (histologically and/or cytologically established) and 32 with a benign effusion was analysed. Only mean CEA in malignant effusions was significantly higher than in benign effusions (p less than 0.01). In the detection of malignant effusion CEA showed a sensitivity of 57% and a specificity of 97%; AFP a sensitivity of 9% and a specificity of 97% and GNCH Sub beta a sensitivity of 9% and a specificity of 90%.

  18. Rheologic studies on middle ear effusions and their mucus glycoproteins.

    Science.gov (United States)

    FitzGerald, J E; Green, G G; Birchall, J P; Pearson, J P

    1989-04-01

    The properties of pooled thick and thin middle ear effusions, from children with otitis media with effusion, were studied by viscometry. Mucus glycoproteins were responsible for effusion viscosity. Their percentage by weight in thick and thin effusions was 25% and 8.2%, respectively. N-acetylcysteine and 0.2 mol/L of mercaptoethanol caused a 39% viscosity drop in a 5-mg/mL glycoprotein solution, whereas S-carboxymethylcysteine had no effect. Treatment of thick effusions with 0.2 mol/L of mercaptoethanol initially caused a viscosity decrease followed by a gradual increase. Higher reducing agent concentrations (0.5 mol/L) caused a more rapid decrease followed by a rapid increase, presumably by causing nonspecific aggregation of reduced protein molecules. These results suggest that the concentration of and the time that a mucolytic is in the middle ear would be of prime importance in achieving the desired decrease in viscosity.

  19. Facet development for a faceted stretched-membrane dish by Solar Kinetics, Inc

    Energy Technology Data Exchange (ETDEWEB)

    Schertz, P.T.; Brown, D.C.; Konnerth, A. III (Solar Kinetics, Inc., Dallas, TX (United States))

    1991-07-01

    A 3.6-meter diameter stretched-membrane optical facet for a parabolic dish has been successfully designed and demonstrated under contract with Sandia National Laboratories. Twelve facets identical to them will be used to make the lightweight reflector of the dish. The project goal of 2.5-mrad surface accuracy was met with each of the two full-sized prototypes, and accuracies of as low as 1.1 mrad were achieved. The facet weight is 11.7 kg/m{sup 2} (2.4lbs/ft{sup 2}). The facet is similar in construction to the successful stretched-membrane heliostat; it has two thin metal membranes attached to a ring. However, the front membrane for this facet is plastically formed at the factor in order to achieve a shorter facet f/D (approximately 3.0). A passive tether restrains the from membrane when not in operation, that is, when the stabilizing vacuum is off. The optical surface is achieved with a silvered-acrylic film laminated to the metal membrane. The facet is expected to cost $55.40/m{sup 2} at a production rate of 10,000 facets per year and $115, 000/m{sup 2}-at a production rate of 500 facets a year. Several key issues have been resolved. Stress concentrations due to seams in the reflective laminate did not cause membrane rupture during forming as they have for dishes with lower focal length-to-diameter ratios. The laminate survived the forming process and simulated operation without deterioration. The optical effect of the tether on the membrane was tested and found to be very small. Most important, highly accurate shapes were obtained using a simple forming procedure. Additional tests are needed to demonstrate process repeatablility and facet performance in typical operating conditions. 18 refs., 36 figs., 11 tabs.

  20. Facet development for a faceted stretched-membrane dish by Solar Kinetics, Inc.

    Science.gov (United States)

    Schertz, P. T.; Brown, D. C.; Konnerth, A., III

    1991-07-01

    A 3.6-meter diameter stretched-membrane optical facet for a parabolic dish has been successfully designed and demonstrated under contract with Sandia National Laboratories. Twelve facets identical to them will be used to make the lightweight reflector of the dish. The project goal of 2.5-mrad surface accuracy was met with each of the two full-sized prototypes, and accuracies of as low as 1.1 mrad were achieved. The facet weight is 11.7 kg/sq m (2.4 lbs/sq ft). The facet is similar in construction to the successful stretched-membrane heliostat; it has two thin metal membranes attached to a ring. However, the front membrane for this facet is plastically formed at the factor in order to achieve a shorter facet f/D (approximately 3.0). A passive tether restrains the front membrane when not in operation, that is, when the stabilizing vacuum is off. The optical surface is achieved with a silvered-acrylic film laminated to the metal membrane. The facet is expected to cost $55.40/sq m at a production rate of 10,000 facets per year and $115,000/sq m at a production rate of 500 facets a year. Several key issues have been resolved. Stress concentrations due to seams in the reflective laminate did not cause membrane rupture during forming as they have for dishes with lower focal length-to-diameter ratios. The laminate survived the forming process and simulated operation without deterioration. The optical effect of the tether on the membrane was tested and found to be very small. Most important, highly accurate shapes were obtained using a simple forming procedure. Additional tests are needed to demonstrate process repeatability and facet performance in typical operating conditions.

  1. The local cytokine and chemokine milieu within malignant effusions.

    Science.gov (United States)

    Atanackovic, Djordje; Cao, Yanran; Kim, Ji-Won; Brandl, Stephan; Thom, Ina; Faltz, Christiane; Hildebrandt, York; Bartels, Katrin; de Weerth, Andreas; Hegewisch-Becker, Susanna; Hossfeld, Dieter Kurt; Bokemeyer, Carsten

    2008-01-01

    Malignant effusions offer a unique opportunity for the study of interactions between the human immune system and cancer. We have recently demonstrated that malignant effusions are characterized by an accumulation of T cells expressing chemokine receptors such as CCR4, which is commonly found on Th2 cells. In contrast, effector T cells expressing chemokine receptors typical for Th1 cells, such as CCR5, showed a diminished homing into malignant effusions. We analyzed concentrations of 12 different cytokines and 9 chemokines within malignant and nonmalignant effusions and investigated cytokine expression by effusion-infiltrating leukocytes. We observed that concentrations of the immunoregulatory cytokine TGF-beta(1) and of angiogenic factors VEGF and IL-8 were markedly increased within effusions caused by malignancies. However, we did not observe signs of a typical Th1 or Th2 milieu. Analyzing concentrations of 9 different chemokines, we found elevated concentrations of the chemokines MDC, eotaxin, I-TAC, and MCP-1 in malignant effusions. Interestingly, tumor-infiltrating leukocytes themselves seemed to contribute strongly to the creation of a distinct cytokine/chemokine pattern within cancer-related effusions. Additional analyses suggested that this cytokine/chemokine milieu might support an enrichment of immunosuppressive leukocytes. The local cytokine and chemokine milieu within malignant effusions seems to promote angiogenesis and to block an efficient immune-mediated antitumor response. An elimination of such tumor-promoting influences will be necessary in order to transform local immunotolerance into clinically relevant immune recognition of tumors causing malignant effusions. (c) 2008 S. Karger AG, Basel

  2. Clinical Observation of Glucosamine Hydrochloride Combined with Chondroitin Sulfate in the Treatment of Lumbar Facet Joint Osteoarthritis%盐酸氨基葡萄糖联合硫酸软骨素治疗腰椎小关节骨关节炎的临床观察

    Institute of Scientific and Technical Information of China (English)

    杨勇; 陈旭; 昝中学; 苟金平; 吴万军; 古其军

    2012-01-01

    目的 观察比较盐酸氨基葡萄糖单独使用及与硫酸软骨素联合使用治疗腰椎小关节骨关节炎(LFOA)的临床疗效.方法 2009年1月-2011年1月,将80例LFOA患者随机分成两组,A组口服盐酸氨基葡萄糖,B组口服盐酸氨基葡萄糖和硫酸软骨素两种药物,6周为1个疗程,间断治疗4个疗程.分别比较用药前与用药后3、6周及5、8、11个月时的日本骨科协会(JOA)评分、晨僵和压痛程度变化.结果 治疗后,两组的JOA评分在各观察时点均增加,与治疗前比较差异有统计学意义(P<0.05).组间行JOA评分治疗改善率的比较,在各观察时点差异均有统计学意义(P<0.05),B组JOA评分改善率优于A组.治疗3周后,两组晨僵和压痛评分均降低,与本组治疗前比较差异有统计学意义(P<0.05);组间比较,差异亦有统计学意义(P<0.05),B组晨僵和压痛程度均低于A组.第6周,第5、8、11个月,两组组间比较晨僵和压痛程度差异均无统计学意义(P>0.05),但各疗程结束后两组晨僵和压痛程度均呈持续降低趋势.结论 单独应用盐酸氨基葡萄糖及盐酸氨基葡萄糖与硫酸软骨素的联合应用治疗LFOA疗效确切,联合用药优于单独应用盐酸氨基葡萄糖.%Objective To observe the clinical effect of glucosamine hydrochloride or glucosamine hydrochloride and chondroitin sulfate in combination on the treatment of lumbar facet joint osteoarthritis (LFOA). Methods From January 2009 to January 2011, 80 patients with LFOA were randomly divided into 2 groups: group A with medication of glucosamine hydrochloride and group B with medication of glucosamine hydrochloride and chondroitin sulfate in combination. Each group was treated for 4 courses and 6 weeks for every course. The clinical effect from the change of score of the items observed at each point of each group was compared with its' pretreatment, and the clinical effect was compared in the two groups at the same point

  3. [Analysis and discussion on the facet of the spinal column, spiral CT lock multiplanar reconstruction and 
3D reconstruction].

    Science.gov (United States)

    Zheng, Zhifeng; Wang, Shuhang; Si, Donglei

    2015-10-01

    To investigate the imaging appearances and diagnostic value of axial CT scanning, spiral CT multiplanar reconstruction (MPR) and three-dimensional (3D) reconstruction in vertebral facet joints locking.
 A total of 31 cases of vertebral facet joints locking, with injuries in different parts, were recruited to explore their CT features, and to evaluate their advantages in diagnosis against each other.
 Among the CT images of 31 cases with "Hamburger" sign in axial view, there were 21 cases of cervical spine and 10 cases of thoracolumbar segment; in vertical plane of MPR, "top to top" form was formed below the inferior and the superior articular process, accompanied by I° spondylolisthesis and inferior articular process tip fracture; 5 cases were unilateral locked cervical spine; none case for thoracolumbar segment. The inferior articular process was crossed with the superior articular process below and moved forward, formed "back to back" form, accompanied by II°-III° spondylolisthesis. 9 or 6 cases were bilateral or unilateral locking cervical spine, 10 cases were thoracolumbar segment, accompanied by teardrop fracture in the vertebral body below cervical spine. In coronal plane of MPR, inferior articular process showed ingression in different extent, and relied on the superior articular process below or locked in the articular fossa (21 cases for cervical spine); inferior articular process displayed upward displacement or appeared with the superior articular process at the same time, which meant joint structure disappearing thoracolumbar segment (10 cases). In 3D reconstruction, 31 cases displayed clearly in the spatial form of vertebral facet joints locking and the degree of spondylolisthesis of vertebral body.
 MPR and 3D image were more clear and intuitive in vertebral facet joints locking comparing to axial CT scan image. Spiral CT MPR and 3D reconstruction contributed to the diagnosis of vertebral facet joints locking and the reduction of misdiagnoses

  4. Faceting oscillations in nano-ferroelectrics

    Energy Technology Data Exchange (ETDEWEB)

    Scott, J. F., E-mail: jfs32@cam.ac.uk, E-mail: ashok553@nplindia.org [Cavendish Laboratory, Cambridge University, Cambridge (United Kingdom); Kumar, Ashok, E-mail: jfs32@cam.ac.uk, E-mail: ashok553@nplindia.org [CSIR-National Physical Laboratory, Delhi (India)

    2014-08-04

    We observe periodic faceting of 8-nm diameter ferroelectric disks on a 10 s time-scale when thin Pb(Zr{sub 0.52}Ti{sub 0.48})O{sub 3} film is exposed to constant high-resolution transmission electron microscopy beams. The oscillation is between circular disk geometry and sharply faceted hexagons. The behavior is analogous to that of spin structure and magnetic domain wall velocity oscillations in permalloy [Bisig et al., Nat. Commun. 4, 2328 (2013)], involving overshoot and de-pinning from defects [Amann et al., J. Rheol. 57, 149–175 (2013)].

  5. Relationship between anterior disc displacement with/without reduction and effusion in temporomandibular disorder patients using magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Koh, Kwang Joon; Park, Ha Na; Kim, Kyoung A [Dept. of Oral and Maxillofacial Radiology, School of Dentistry and Institute of Oral Bioscience, Chonbuk National University, Jeonju (Korea, Republic of)

    2013-12-15

    This study was performed to evaluate the relationship between anterior disc displacement and effusion in temporomandibular disorder (TMD) patients using magnetic resonance imaging (MRI). The study subjects included 253 TMD patients. MRI examinations were performed using a 1.5 T MRI scanner. T1- and T2-weighted images with para-sagittal and para-coronal images were obtained. According to the MRI findings, temporomandibular joint (TMJ) disc positions were divided into 3 subgroups: normal, anterior disc displacement with reduction (DWR), and anterior disc displacement without reduction (DWOR). The cases of effusion were divided into 4 groups: normal, mild (E1), moderate (E2), and marked effusion (E3). Statistical analysis was made by the Fisher's exact test using SPSS (version 12.0, SPSS Inc., Chicago, IL, USA). The subjects consisted of 62 males and 191 females with a mean age of 28.5 years. Of the 253 patients, T1- and T2-weighted images revealed 34 (13.4%) normal, DWR in 103 (40.7%), and DWOR in 116 (45.9%) on the right side and 37 (14.6%) normal, DWR in 94 (37.2%), and DWOR in 122 (48.2%) joints on the left side. Also, T2-images revealed 82 (32.4%) normal, 78 (30.8%) E1, 51 (20.2%) E2, and 42 (16.6%) E3 joints on the right side and 79 (31.2%) normal, 85 (33.6%) E1, 57 (22.5%) E2, and 32 (12.7%) E3 on the left side. There was no difference between the right and left side. Anterior disc displacement was not related to the MRI findings of effusion in TMD patients (P>0.05).

  6. Alignment and focus of mirrored facets of a heliosat

    Energy Technology Data Exchange (ETDEWEB)

    Yellowhair, Julius E; Ho, Clifford Kuofei; Diver, Richard B; Moss, Timothy A

    2013-11-12

    Various technologies pertaining to aligning and focusing mirrored facets of a heliostat are described herein. Updating alignment and/or focus of mirrored facets is undertaken through generation of a theoretical image, wherein the theoretical image is indicative of a reflection of the target via the mirrored facets when the mirrored facets are properly aligned. This theoretical image includes reference points that are overlaid on an image of the target as reflected by the mirrored facets of the heliostat. A technician adjusts alignment/focus of a mirrored facet by causing reflected reference markings to become aligned with the reference points in the theoretical image.

  7. Percutaneous fusion of lumbar facet with bone allograft

    Directory of Open Access Journals (Sweden)

    Félix Dolorit Verdecia

    2015-03-01

    Full Text Available OBJECTIVE: To assess the evolution of the cases treated with percutaneous facet fusion with bone allograft in lumbar facet disease. METHOD: Between 2010 and 2014, 100 patients (59 women and 41 men diagnosed with lumbar facet disease underwent surgery. RESULTS: The lumbar facet fusion with bone allograft shows good clinical results, is performed on an outpatient basis, and presents minimal complications and rapid incorporation of the patient to the activities of daily living. CONCLUSIONS: The lumbar facet fusion with bone allograft appears to be an effective treatment for lumbar facet disease.

  8. Anticardiac Antibodies in Patients with Chronic Pericardial Effusion

    Directory of Open Access Journals (Sweden)

    Konstantinos Karatolios

    2016-01-01

    Full Text Available Objectives. Chronic pericardial effusion may be challenging in terms of diagnosis and treatment. Specific laboratory parameters predicting the frequency and severity of recurrences after initial drainage of pericardial effusion are lacking. Materials and Methods. Pericardial fluid (PF and serum (SE samples from 30 patients with chronic pericardial effusion (PE who underwent pericardiocentesis and pericardioscopically guided pericardial biopsy were compared with SE and PF samples from 26 control patients. The levels of antimyolemmal (AMLA and antifibrillary antibodies (AFA in PE and SE from patients with pericardial effusion as well as PF and SE from controls were determined and compared. Results. AMLAs and AFAs in PF and SE were significantly higher in patients with chronic pericardial effusion than in the control group (AMLAs: p = 0,01 for PF and p = 0,004 for serum; AFAs: p < 0,001 for PF and p = 0,003 for serum. Patients with recurrence of PE within 3 months after pericardiocentesis had significantly higher levels of AMLAs in SE (p = 0,029 than patients without recurrence of PE. Conclusions. The identification of elevated anticardiac antibodies in PE and SE indicates increased immunological reactivity in chronic pericardial effusion. High titer serum levels of AMLAs also correlate with recurrence of pericardial effusion.

  9. Allergic bronchopulmonary aspergillosis: a rare cause of pleural effusion.

    LENUS (Irish Health Repository)

    O'Connor, T M

    2012-02-03

    Aspergillus fumigatus is one of the most ubiquitous of the airborne saprophytic fungi. Allergic bronchopulmonary aspergillosis (ABPA) is a syndrome seen in patients with asthma and cystic fibrosis, and is characterized by hypersensitivity to chronic colonization of the airways with A. fumigatus. We report the case of a patient with ABPA presenting with pleural effusion. A 27-year-old male was referred with recurrent right pleural effusion. Past medical history was remarkable for asthma, allergic sinusitis, and recurrent pleurisy. Investigations revealed peripheral eosinophilia with elevated serum immunoglobulin E and bilateral pleural effusions with bilateral upper lobe proximal bronchiectasis. Precipitating serum antibodies to A. fumigatus were positive and the A. fumigatus immediate skin test yielded a positive reaction. A diagnosis of ABPA associated with bilateral pleural effusions was made and the patient was commenced on prednisolone. At review, the patient\\'s symptoms had considerably improved and his pleural effusions had resolved. ABPA may present with diverse atypical syndromes, including paratracheal and hilar adenopathy, obstructive lung collapse, pneumothorax and bronchopleural fistula, and allergic sinusitis. Allergic bronchopulmonary aspergillosis is a rare cause of pleural effusion and must be considered in the differential diagnosis of patients presenting with a pleural effusion, in particular those with a history of asthma.

  10. Long-term Outcome of Patients With Undiagnosed Pleural Effusion.

    Science.gov (United States)

    Gunluoglu, Gulsah; Olcmen, Aysun; Gunluoglu, Mehmet Zeki; Dincer, Ibrahim; Sayar, Adnan; Camsari, Gungor; Yilmaz, Veysel; Altin, Sedat

    2015-12-01

    The cause of exudative pleural effusion cannot be determined in some patients. The longterm outcomes of patients with undiagnosed pleural effusion were analyzed. Patients with exudative pleural effusion whose diagnostic procedures included pleural biopsy using video-assisted thoracoscopic surgery carried out between 2008 and 2012 were evaluated retrospectively. Patients diagnosed with non-specific pleuritis were included. Fifty-three patients with available follow-up data were included in the study. Forty men and 13 women (mean age 53.9±13.9 years) were included. Median follow-up time was 24 months. No diagnosis was given in 27 patients (51%), and a clinical diagnosis was given in 26 patients (49%) during the follow-up period. Malignant disease (malignant mesothelioma) was diagnosed in 2 (3.7%) patients. Other diseases were parapneumonic effusion in 12, congestive heart failure in 8, and miscellaneous in 4 patients. Volume of effusion at the time of initial examination and re-accumulation of fluid after video-assisted thoracoscopic surgery were associated with malignant disease (P=.004 and .0001, respectively). Although the probability is low, some patients with exudative pleural effusion undiagnosed after pleural biopsy via video-assisted thoracoscopic surgery may have malignant disease. Patients with an initially large volume of effusion that re-accumulates after examination should be closely monitored. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

  11. Is facet analysis based on rationalism?

    DEFF Research Database (Denmark)

    Hjørland, Birger

    2014-01-01

    , rationalism, historicism/hermeneutics, or pragmatism/critical theory (of which only the last position fully acknowledges the non-neutrality of knowledge organisation). Ranganathan – and the whole facet-analytic school – has formerly been exemplified as a rather clear example of rationalism. Some have objected...

  12. Problem of time: facets and Machian strategy.

    Science.gov (United States)

    Anderson, Edward

    2014-10-01

    The problem of time is that "time" in each of ordinary quantum theory and general relativity are mutually incompatible notions. This causes difficulties in trying to put these two theories together to form a theory of quantum gravity. The problem of time has eight facets in canonical approaches. I clarify that all but one of these facets already occur at the classical level, and reconceptualize and re-name some of these facets as follows. The frozen formalism problem becomes temporal relationalism, the thin sandwich problem becomes configurational relationalism, via the notion of best matching. The problem of observables becomes the problem of beables, and the functional evolution problem becomes the constraint closure problem. I also outline how each of the global and multiple-choice problems of time have their own plurality of facets. This article additionally contains a local resolution to the problem of time at the conceptual level and which is actually realizable for the relational triangle and minisuperspace models. This resolution is, moreover, Machian, and has three levels: classical, semiclassical, and a combined semiclassical-histories-timeless records scheme. I end by delineating the current frontiers of this program toward resolution of the problem of time in the cases of full general relativity and of slightly inhomogeneous cosmology.

  13. A Case of Haemorrhagic Constrictive Pericarditis with Bilateral Pleural Effusions

    Science.gov (United States)

    Islam, Julie; Talebi, Soheila; Cativo, Eder; Mushiyev, Savi; Pekler, Gerald; Visco, Ferdinand

    2016-01-01

    Presentation of pericardial disease is diverse, with the viral aetiology being the most common cause; however, when haemorrhagic pericardial effusion is present, these causes are narrowed to few aetiologies. We present a case of a young female of African descent who presented with diffuse abdominal pain and vomiting. Initial work-up showed pericardial effusion with impending echocardiographic findings of cardiac tamponade and bilateral pleural effusions. Procedures included a left video-assisted thoracoscopic surgery (VATS) with pericardial window. We consider that it is important for all physicians to be aware of not only typical presentation but also atypical and unusual clinical picture of pericardial disease.

  14. Delayed internal pancreatic fistula with pancreatic pleural effusion postsplenectomy

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    The occurrence of pancreatic pleural effusion,secondary to an internal pancreatic fistula,is a rare clinical syndrome and diagnosis is often missed.The key to the diagnosis is a dramatically elevated pleural fluid amylase.This pancreatic pleural effusion is also called a pancreatic pleural fistula.It is characterized by profuse pleural fluid and has a tendency to recur.Here we report a case of delayed internal pancreatic fistula with pancreatic pleural effusion emerging after splenectomy.From the treatment ...

  15. Otitis media with effusion:diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Ozgur Surmelioglu

    2013-04-01

    Full Text Available Otitis media with effusion (serous otitis media is characterised by an accumulation of fluid in the middle ear behind an intact tympanic membrane, without the symptoms or signs of acute infection. Serous otitis media is the most common cause of hearing loss in children in the developed world. Hearing loss may be affected speech, cognitive, and psychological development of the childeren. In addition, otitis media with effusion is not only seen in children, this sign may present with signs of nasopharyngeal diseases. For this reason, especially in childhood otitis media with effusion should be treated by early diagnosis. [Archives Medical Review Journal 2013; 22(2.000: 194-208

  16. A Case of Haemorrhagic Constrictive Pericarditis with Bilateral Pleural Effusions

    Directory of Open Access Journals (Sweden)

    Hans A. Reyes

    2016-01-01

    Full Text Available Presentation of pericardial disease is diverse, with the viral aetiology being the most common cause; however, when haemorrhagic pericardial effusion is present, these causes are narrowed to few aetiologies. We present a case of a young female of African descent who presented with diffuse abdominal pain and vomiting. Initial work-up showed pericardial effusion with impending echocardiographic findings of cardiac tamponade and bilateral pleural effusions. Procedures included a left video-assisted thoracoscopic surgery (VATS with pericardial window. We consider that it is important for all physicians to be aware of not only typical presentation but also atypical and unusual clinical picture of pericardial disease.

  17. Efficacy of needle-placement technique in radiofrequency ablation for treatment of lumbar facet arthropathy

    Directory of Open Access Journals (Sweden)

    Loh JT

    2015-10-01

    Full Text Available Jeffrey T Loh,1 Andrea L Nicol,1 David Elashoff,2 F Michael Ferrante,1 1Department of Anesthesiology, David Geffen School of Medicine, 2Department of Biomathematics, University of California Los Angeles, Los Angeles, CA, USA Background: Many studies have assessed the efficacy of radiofrequency ablation to denervate the facet joint as an interventional means of treating axial low-back pain. In these studies, varying procedural techniques were utilized to ablate the nerves that innervate the facet joints. To date, no comparison studies have been performed to suggest superiority of one technique or even compare the prevalence of side effects and complications. Materials and methods: A retrospective chart review was performed on patients who underwent a lumbar facet denervation procedure. Each patient's chart was analyzed for treatment technique (early versus advanced Australian, preprocedural visual numeric scale (VNS score, postprocedural VNS score, duration of pain relief, and complications. Results: Pre- and postprocedural VNS scores and change in VNS score between the two groups showed no significant differences. Patient-reported benefit and duration of relief was greater in the advanced Australian technique group (P=0.012 and 0.022, respectively. The advanced Australian technique group demonstrated a significantly greater median duration of relief (4 months versus 1.5 months, P=0.022. Male sex and no pain-medication use at baseline were associated with decreased postablation VNS scores, while increasing age and higher preablation VNS scores were associated with increased postablation VNS scores. Despite increasing age being associated with increased postablation VNS scores, age and the advanced Australian technique were found to confer greater patient self-reported treatment benefit. Conclusion: The advanced Australian technique provides a significant benefit over the early Australian technique for the treatment of lumbar facet pain, both in

  18. Usefulness of pleural effusion antinuclear antibodies in the diagnosis of lupus pleuritis.

    Science.gov (United States)

    Toworakul, C; Kasitanon, N; Sukitawut, W; Wichinun, R; Louthrenoo, W

    2011-10-01

    We performed this study to determine sensitivity and specificity of pleural effusion antinuclear antibodies (ANA) at a titer of ≥1 : 160, and the ratio of pleural effusion to serum ANA of ≥1, to distinguish between pleural fluid from lupus pleuritis and other causes. A prospective study of 54 patients with pleural effusion (12 lupus pleuritis, seven parapneumonic effusion, 26 malignancy-associated pleural effusions, nine transudative effusions) was performed. ANA at a titer of ≥1 : 160 were found in 11 of 12 lupus pleuritis samples, and in four of 42 pleural effusions from non-systemic lupus erythematosus (SLE) patients. The pleural effusion ANA at a titer of ≥1 : 160 gave a sensitivity of 91.67% for lupus pleuritis, with a specificity of 83.33% when compared with all other pleural effusions, 90.91% when compared with exudative effusion (parapneumonic effusion and malignancy-associated effusion) and 55.56% when compared with the transudative pleural effusion group. Using the ratio of pleural effusion to serum ANA of ≥1, the sensitivity and the specificity decreased to 75.00% and 78.57%, respectively. This study provides further evidence that the pleural effusion ANA at a titer of ≥1 : 160 is a sensitive and specific diagnostic biomarker for lupus pleuritis in patients with lupus. However, pleural effusion ANA can occasionally be found in other conditions.

  19. 顺铂IL-2胸腔内灌注联合培美曲塞全身化疗治疗老年晚期肺腺癌恶性胸腔积液%Clinical Observation of Cisplatin+IL-2 Intrathoracic Perfusion Joint Pemetrexed Disodium Systemic Chemotherapy for Elderly Patients with Advanced Malignant Pleural Effusion of Lung Cancer

    Institute of Scientific and Technical Information of China (English)

    王永明; 荆丽君; 冯桂新; 李同源; 李志杰

    2012-01-01

      Objective:Observation on cisplatin and IL-2 intrathoracic perfusion combined with pemetrexed disodium systemic chemotherapy for elderly patients with advanced malignant pleural effusion of lung adenocarcinoma’s clinical efficacy and side effects.Method:The lung adenocarcinoma in elderly patients with pleural effusion a total of 51 cases,the intrathoracic injection of cisplatin(40 mg/m2)and IL-2(1.5 million U)once a week for 2 weeks were given. At the same time,pemetrexed disodium for injection(500 mg/m2),the first day,every 3 weeks repeated,two cycles. The 4th week for evaluating efficacy and side effects.Result:51 patients could be evaluated the effects,16 cases were completely alleviated,a part of the mitigation in 25 cases,6 cases ineffective. Then its effective rate of 80.39%,complete remission rate 31.37%.Conclusion:Cisplatin and IL-2 intrathoracic perfusion combined with pemetrexed disodium systemic chemotherapy is a effective treatment method for elderly lung adenocarcinoma patients with advanced malignant pleural effusion which were light toxicity and safe clinical use.%  目的:观察顺铂+IL-2胸腔内灌注联合培美曲塞全身化疗治疗老年晚期肺腺癌恶性胸腔积液的临床疗效及毒副反应.方法:老年肺腺癌并胸腔积液患者共51例,采用顺铂40 mg/m2及IL-2150万U胸腔灌注保留,每周一次,共2周,同时应用培美曲塞,第1天,每3周重复,完成2个周期.治疗第4周评价疗效及毒副作用.结果:51例患者均可评价疗效,完全缓解者16例,部分缓解者25例,无效者6例,其有效率为80.39%,完全缓解率31.37%.结论:顺铂+IL-2胸腔内灌注联合培美曲塞全身化疗治疗老年晚期肺腺癌恶性胸腔积液治疗的方法疗效显著,毒性反应轻,临床使用安全.

  20. A Study on Tuberculous Pleural Effusion

    Directory of Open Access Journals (Sweden)

    Zay Soe

    2010-03-01

    Full Text Available Background: Nearly one third of the global population i.e. two billion people are infected with mycobacteria tuberculosis and are at risk of developing the disease. Pleural effusion is one of the common complications of pulmonary tuberculosis. In this study, the clinical features, the positivity rate of microbiological procedures and blind pleural biopsies, radiological manifestations, biochemical and hematological profiles of serum and pleural fluid were analyzed. Objectives: To report our experience of 108 patients with tuberculous pleural effusion and discuss the clinical features, radiological findings, biochemical, cytological and microbiological analysis of pleural fluid, hematological and biochemical profiles of serum and positivity rate of microbiological procedures and blind pleural biopsies in these patients. Methods: This study was a hospital based descriptive cross sectional study performed at Chest Medical Ward, Yangon General Hospital, Myanmar, of study period from January 2004 through January 2005. A total of 108 patients were included. Thorough history taking and physical examinations, radiological findings, hematological and serum biochemical profiles were recorded. Pleural aspiration and biopsy were also performed. At least two pieces of pleural tissue were taken and one piece of each sample of pleural tissue was cultured for mycobacteria and the rest was sent for histological examination. Macroscopic findings, cytological, microbiological and biochemical analysis of pleural fluid were analyzed. Results: A total of 108 patients, 74 males and 34 females were included. Their mean age was 42.60 ± 16.34 (range 12-81 years. Common presentations were breathlessness (82.4%, cough (81.5%, fever (80.6%, and night sweat (78.7%, loss of appetite (74.1%, significant weight loss (72.2% and chest pain (67.6%. Only 39.3% of TB patients produced sputum in their history. Haemoptysis was present in only 7.4% of the patients. Regarding the

  1. Faceting of curved surfaces using the curvature coordinate system

    DEFF Research Database (Denmark)

    Almegaard, Henrik

    2008-01-01

    In many situations, a curved surface has to be approximated by a facetted surface, i.e., as a network with planar meshes. Most often this is done by triangulation of the surface. Points are chosen on the surface and the points are connected by straight lines so that these lines make a network...... this is by tangent faceting. Tangent points are chosen on the surface and the tangent planes at these points are connected along lines of intersection so that these lines make a network with planar meshes and so that no normal to the curved surface intersect more than one facet. The result is a faceted surface...... of triangular meshes and so that no normal to the curved surface intersect more than one mesh/facet. The result is a faceted surface, with vertices, edges and triangular facets. But faceting a curved surface can also be done using planes as the basic geometrical element instead of points. One way of doing...

  2. Eosinophilic Pleural Effusion: A Rare Manifestation of Hypereosinophilic Syndrome

    Directory of Open Access Journals (Sweden)

    Ndubuisi C. Okafor

    2009-01-01

    Full Text Available Several causes of eosinophilic pleural effusions have been described with malignancy being the commonest cause. Hypereosinophilic syndrome (HES is a rare disease and very few cases have been reported of HES presenting as eosinophilic pleural effusion (EPE. We report a case of a 26-year-old male who presented with shortness of breath. He had bilateral pleural effusions, generalized lymphadenopathy, splenomegaly, and leukocytosis with marked peripheral blood eosinophilia. The pleural fluid was exudative, with 25%–30% eosinophilis, and absence of neoplastic cells. Hypereosinophilic syndrome was diagnosed after other causes of eosinophilia were excluded. He continued to be dyspneic with persistent accumulation of eosinophilic pleural fluid, even after his peripheral eosinophil count had normalized in response to treatment. This patient represents a very unusual presentation of HES with dyspnea and pleural effusions and demonstrates that treatment based on response of peripheral eosinophil counts, as is currently recommended, may not always be clinically adequate.

  3. INVESTIGATION ON MODEL OF INFLAMMATORY PLEURAL EFFUSION IN GUINEA PIGS

    Institute of Scientific and Technical Information of China (English)

    冯源; 殷凯生; 王祥

    2002-01-01

    Objective To establish an animal model of inflammatory pleural effusion.Methods Forty guinea pigs were divided into two groups: experimental group with 7 subgroups and control group. In the experimental group the right chest cavity of each guinea pig was injected with 0.8~1.0 ml of 1% carrageenan, and guinea pigs of each subgroup were killed and observed respectively on day 1, 2, 3, 5, 7, 10 and day 14 after injection.Results Occurring on day 1(within 24 hours), pleural effusion reached the maximum on day 2~3 after injection, so did the neutrophil count in pleural effusion and inflammation of both pleura and lungs and then gradually decreased. The fibrosis and adhesion of pleura appeared on day 7 and were obvious on day 10. The encysted pleurisy was formed on day 14.Conclusion The carrageenan is an ideal pleural inflammatory inducer. This animal model is useful for studying pleural effusion.

  4. Parapneumonic pleural effusion: early versus late thoracoscopy.

    Science.gov (United States)

    Pereira, Rodrigo Romualdo; Alvim, Cristina Gonçalves; Andrade, Cláudia Ribeiro de; Ibiapina, Cássio da Cunha

    2017-07-31

    To evaluate the best time to perform thoracoscopy for the treatment of complicated parapneumonic pleural effusion in the fibrinopurulent phase in patients ≤ 14 years of age, regarding the postoperative evolution and occurrence of complications. This was a retrospective comparative study involving patients with parapneumonic pleural effusion presenting with septations or loculations on chest ultrasound who underwent thoracoscopy between January of 2000 and January of 2013. The patients were divided into two groups: early thoracoscopy (ET), performed by day 5 of hospitalization; and late thoracoscopy (LT), performed after day 5 of hospitalization. We included 60 patients, 30 in each group. The mean age was 3.4 years; 28 patients (46.7%) were male; and 47 (78.3%) underwent primary thoracoscopy (no previous simple drainage). The two groups were similar regarding gender, age, weight, and type of thoracoscopy (p > 0.05 for all). There was a significant difference between the ET and the LT groups regarding the length of the hospital stay (14.5 days vs. 21.7 days; p sexo masculino, e 47 (78,3%) foram submetidos à toracoscopia primária, sem realização de drenagem simples prévia. Os grupos TP e TT foram semelhantes quanto ao sexo, idade, peso e tipo de toracoscopia (p > 0,05 para todos). Observou-se uma diferença significativa quanto à média de duração da internação nos grupos TP e TT (14,5 dias vs. 21,7 dias; p < 0,001). Houve também diferenças significativas entre os grupos quanto ao total de dias com febre, total de dias entre internação e início da drenagem e total de dias com dreno. Oito pacientes (13,6%) apresentaram alguma complicação após a toracoscopia, sem diferença entre os grupos. Não houve óbitos. A TP, realizada até o 5º dia da admissão hospitalar, associou-se a menor duração da internação, menor tempo de drenagem e menor duração da febre, sem estar associada a maior frequência de complicações, necessidade de CTI ou

  5. Comprehensive drilling of the C1-2 facets to achieve direct posterior reduction in irreducible atlantoaxial dislocation.

    Science.gov (United States)

    Salunke, Pravin; Sahoo, Sushanta K; Deepak, Arsikere N; Ghuman, Mandeep S; Khandelwal, Niranjan K

    2015-09-01

    The cause of irreducibility in irreducible atlantoaxial dislocation (AAD) appears to be the orientation of the C1-2 facets. The current management strategies for irreducible AAD are directed at removing the cause of irreducibility followed by fusion, rather than transoral decompression and posterior fusion. The technique described in this paper addresses C1-2 facet mobilization by facetectomies to aid intraoperative manipulation. Using this technique, reduction was achieved in 19 patients with congenital irreducible AAD treated between January 2011 and December 2013. The C1-2 joints were studied preoperatively, and particular attention was paid to the facet orientation. Intraoperatively, oblique C1-2 joints were opened widely, and extensive drilling of the facets was performed to make them close to flat and parallel to each other, converting an irreducible AAD to a reducible one. Anomalous vertebral arteries (VAs) were addressed appropriately. Further reduction was then achieved after vertical distraction and joint manipulation. Adequate facet drilling was achieved in all but 2 patients, due to VA injury in 1 patient and an acute sagittal angle operated on 2 years previously in the other patient. Complete reduction could be achieved in 17 patients and partial in the remaining 2. All patients showed clinical improvement. Two patients showed partial redislocation due to graft subsidence. The fusion rates were excellent. Comprehensive drilling of the C1-2 facets appears to be a logical and effective technique for achieving direct posterior reduction in irreducible AAD. The extensive drilling makes large surfaces raw, increasing fusion rates.

  6. Influence of higher order modes on angled-facet amplifiers

    DEFF Research Database (Denmark)

    Wang, Z.; Mikkelsen, B.; Stubkjær, Kristian

    1991-01-01

    The influence of the first-order mode on the residual reflectivity of angled-facet amplifiers is analyzed. For a 7 degrees angled-facet ridge waveguide amplifier with a single-layer antireflective (AR) coating, a gain ripple lower than 1-dB at 25-dB gain can be obtained independent...... by increasing the facet angles to 10 degrees...

  7. /facet: A browser for heterogeneous semantic web repositories

    NARCIS (Netherlands)

    Hildebrand, M.; Ossenbruggen, J.R. van; Hardman, L.

    2006-01-01

    Facet browsing has become popular as a user friendly interface to data repositories. We extend facet browsing of Semantic Web data in four ways. First, users are able to select and navigate through facets of resources of any type and to make selections based on properties of other, semantically rela

  8. Pericardiocentesis with cisplatin for malignant pericardial effusion and tamponade

    Institute of Scientific and Technical Information of China (English)

    Takatsugu; Oida; Kenji; Mimatsu; Hiso; Kano; Atsushi; Kawasaki; Youichi; Kuboi; Nobutada; Fukino; Sadao; Amano

    2010-01-01

    AIM:To evaluate the role and outcome of pericardiocentesis with intrapericardial cisplatin instillation for malignant pericardial effusion resulting from esophageal cancer. METHODS:We retrospectively studied 7 patients who underwent pericardiocentesis with intrapericardial cisplatin instillation for malignant pericardial effusion resulting from esophageal cancer.After pericardiocentesis,we performed catheterization of the pericardial space under ultrasonogram guidance.Malignant etiology of the pericardial f...

  9. Severe iritis and choroidal effusion following selective laser trabeculoplasty.

    Science.gov (United States)

    Kim, Danny Y; Singh, Anna

    2008-01-01

    A patient with uncontrolled primary open-angle glaucoma underwent selective laser trabeculoplasty and developed a significant anterior chamber reaction, shallow anterior chamber, and choroidal effusion. Common complications associated with selective laser trabeculoplasty include conjunctival injection, mild anterior chamber reaction, and post-treatment intraocular pressure elevation. The authors believe this is the first reported case of severe iritis and choroidal effusion following selective laser trabeculoplasty.

  10. Eosinophilic Endomyocarditis Combined With Pericardial and Pleural Effusion

    OpenAIRE

    You, Sung-Hye; Hong, Soon Jun; Ahn, Chul Min; Lim, Do-Sun

    2009-01-01

    Eosinophilic endomyocarditis is a manifestation of hypereosinophilic syndrome, characterized by prolonged (>6 months), unexplained peripheral blood eosinophilia (>1,500 cells/mm3) with end-organ damage in unknown causes. We report a case of a 42-year-old patient who developed eosinophilic endomyocarditis following upper respiratory tract symptoms for 2 months. Additionally, endomyocarditis was combined with massive pleural effusion and pericardial effusion, which have not been reported in Korea.

  11. Pleural Fluid Cholesterol in Differentiating Exudative and Transudative Pleural Effusion

    OpenAIRE

    Hamal, A. B.; Yogi, K. N.; N. Bam; Das, S. K.; Karn, R.

    2013-01-01

    Objectives. To study the diagnostic value of pleural fluid cholesterol in differentiating transudative and exudative pleural effusion. To compare pleural fluid cholesterol level for exudates with Light's criteria. Design. Cross sectional descriptive study. Settings. Medical wards of Tribhuvan University Teaching Hospital. Methods. Sixty two cases of pleural effusion with definite clinical diagnosis admitted in TUTH were taken and classified as transudates (19) and exudates (43). The parameter...

  12. Zeroing In on Mindfulness Facets: Similarities, Validity, and Dimensionality across Three Independent Measures.

    Science.gov (United States)

    Siegling, Alex B; Petrides, K V

    2016-01-01

    The field of mindfulness has seen a proliferation of psychometric measures, characterised by differences in operationalisation and conceptualisation. To illuminate the scope of, and offer insights into, the diversity apparent in the burgeoning literature, two distinct samples were used to examine the similarities, validity, and dimensionality of mindfulness facets and subscales across three independent measures: the Five Facet Mindfulness Questionnaire (FFMQ), Philadelphia Mindfulness Scale (PHLMS), and Toronto Mindfulness Scale (TMS). Results revealed problematic associations of FFMQ Observe with the other FFMQ facets and supported a four-factor structure (omitting this facet), while disputing the originally envisaged five-factor model; thus, solidifying a pattern in the literature. Results also confirmed the bidimensional nature of the PHLMS and TMS subscales, respectively. A joint Confirmatory Factor Analysis showed that PHLMS Acceptance could be assimilated within the FFMQ's four-factor model (as a distinct factor). The study offers a way of understanding interrelationships between the available mindfulness scales, so as to help practitioners and researchers make a more informed choice when conceptualising and operationalising mindfulness.

  13. Analysis of The Xx Century Effusive Activity At Mount Etna To Assess The Potential Effusive Hazard.

    Science.gov (United States)

    Andronico, D.; Lodato, L.; Neri, M.

    We examined older documents and publications together with more recent and de- tailed reports related to the 20th century effusive activity (terminal and flank eruptions) at Mt. Etna, with the primary objective of creating a single data-base of volcanologi- cal data, at present lacking in the literature. The restitution in digital form of the maps of the lava fields allowed to measure, with great precision compared with previous estimations, the area and length of every lava flow, allowing improved estimates of volumes and effusive rates. The quantity and the quality of the collected bibliographic information of the studied eruptions improve progressively from the beginning of the century up to the present, and can be considered complete for the flank activity. The data of each single eruption have been inserted into a relational database, that pro- vides both ease of use and the potential of upgrading with information from new or more ancient eruptions. By examining the collected data (e.g. maximum length of lava flows, altitude reached, eruption duration) we obtained some useful relationships, that allowed us to characterise some eruption typologies at Etna. The improvement of the volcanic data related to the effusive activity of the last century represents an impor- tant contribution in terms of volcanic hazard, suggesting for example the areas most at risk by opening of eruptive fractures and lava covering. Statistical observations can be a useful contribution to the planning required by civil defense in a strongly urban- ized area, such as the etnean one; assessment hazard, in particular, should be focused particularly on the southeastern foot of the volcanic belt, in which the volcanic risk in- creases due to the presence of several populated centers that amount to approximately 500.000 people.

  14. Black Pleural Effusion: A Unique Presentation of Metastatic Melanoma

    Directory of Open Access Journals (Sweden)

    Akansha Chhabra

    2015-05-01

    Full Text Available Metastatic melanoma is a rare form of skin cancer, but one that comes with a high mortality rate. Pulmonary involvement is frequently seen in metastatic melanoma with only 2% of malignant melanoma patients with thorax metastasis presenting with pleural effusions. Herein, we report an extremely rare case of black pleural effusion from thoracic metastasis of cutaneous malignant melanoma. A 74-year-old man with known metastatic melanoma presented with a 1-month history of worsening lower back and hip pain and was found to have extensive osseous metastatic disease and multiple compression fractures. The patient underwent an uneventful kyphoplasty; however, the following day, he became acutely hypoxic and tachypneic with increased oxygen requirements. Radiographic evaluation revealed new bilateral pleural effusions. Bedside thoracentesis revealed a densely exudative, lymphocyte-predominant black effusion. Cytological examination showed numerous neoplastic cells with melanin deposition. A diagnosis of thoracic metastasis of malignant melanoma was established based on the gross and microscopic appearance of the pleural fluid. To the best of our knowledge, this is the first reported case of black pleural effusions secondary to metastatic melanoma in the United States. Despite the rarity of this presentation, it is important to determine the etiology of the black pleural effusion and to keep metastatic melanoma as a differential diagnosis.

  15. A Faceted Query Engine Applied to Archaeology

    Directory of Open Access Journals (Sweden)

    Kenneth A. Ross

    2007-04-01

    Full Text Available In this article we present the Faceted Query Engine, a system developed at Columbia University under the aegis of the inter-disciplinary project Computational Tools for Modeling, Visualizing and Analyzing Historic and Archaeological Sites. Our system is based on novel Database Systems research that has been published in Computer Science venues (Ross and Janevski, 2004 and Ross et al., 2005. The goal of this article is to introduce our system to the target user audience - the archaeology community. We demonstrate the use of the Faceted Query Engine on a previously unpublished dataset: the Thulamela (South Africa collection. This dataset is comprised of iron-age finds from the Thulamela site at the Kruger National Park. Our project is the first to systematically compile and classify this dataset. We also use a larger dataset, a collection of ancient Egyptian artifacts from the Memphis site (Giddy,1999, to demonstrate some of the features of our system.

  16. Facets of Emotional Clarity and Suspiciousness.

    Science.gov (United States)

    Boden, Matthew Tyler; Berenbaum, Howard

    2012-09-01

    In a college student sample, we explored the relations between individual differences in facets of emotional clarity and suspiciousness. Previous theory and research has treated emotional clarity as a one-dimensional construct. Boden and Berenbaum (2011) proposed that a second facet of emotional clarity, source awareness (a general understanding of the cause of their emotions), could be distinguished from type awareness (a general understanding of the type of emotions [anger, fear] experienced). We found that source and type awareness were incrementally, inversely associated with suspiciousness when statistically accounting for the extent to which emotions are attended to, and gender. Additionally, source awareness significantly predicted suspiciousness after accounting for anger, anxious arousal, and social anxiety, whereas type awareness did not. Findings are consistent with the hypothesis that, among individuals with low source and type awareness, suspicious beliefs are formed to make sense of and explain emotional arousal.

  17. Neurophysiological markers of multiple facets of impulsivity.

    Science.gov (United States)

    Neal, Lauren B; Gable, Philip A

    2016-03-01

    Human behavior is influenced by three core personality systems: approach, avoidance, and supervisory control. The supervisory control system is inversely related to impulsivity. Although past research has related some aspects of impulsivity to frontal hemispheric asymmetry, impulsivity as a multi-faceted construct has not been studied in relation with frontal asymmetry. In addition, past work has potentially confounded impulsivity with approach-motivation. In the current study, greater relative left frontal activity was related to multiple facets of impulsivity: negative urgency, lack of premeditation, lack of perseverance, and positive urgency. Regressing both positive and negative urgency on frontal asymmetry revealed that approach-related positive urgency related to greater left frontal activity, but withdrawal-related negative urgency marginally related to greater right frontal activity. These results suggest that impulsivity, independent of affective valence, relates to greater left frontal activity. When controlling for trait approach motivation, the relationship between impulsivity and left frontal activity is unchanged.

  18. Effect of Retrograde Reaming for Tibiotalocalcaneal Arthrodesis on Subtalar Joint Destruction: A Cadaveric Study.

    Science.gov (United States)

    Lowe, Jason A; Routh, Lucas K; Leary, Jeffrey T; Buzhardt, Paul C

    2016-01-01

    Recent published data have suggested successful union of subtalar and tibiotalar joints without formal debridement during tibiotalocalcaneal (TTC) fusion procedures. Although previous studies have reported on the importance of the proper guidewire starting point and trajectory to obtain appropriate hindfoot alignment for successful fusion, to our knowledge, no studies have quantified the amount of articular damage to the subtalar joint with retrograde reaming. We hypothesized that reaming would destroy >50% of the posterior facet of the subtalar joint. The bilateral lower extremities of 5 cadavers were obtained and the subtalar joints exposed. Retrograde TTC nail guidewires were inserted, and a 12-mm reamer was passed through the subtalar and ankle joints. Pre- and postreaming images of the subtalar joint were obtained to compare the amount of joint destruction after reaming. We found an average of 5.89% articular destruction of the talar posterior facet and an average of 4.01% articular destruction of the posterior facet of the calcaneus. No damage to the middle facets of the subtalar joint was observed. TTC nailing is a successful procedure for ankle and subtalar joint fusion. Published studies have reported successful subtalar union using TTC nailing without formal open debridement of the subtalar joint, preserving the soft tissue envelope. TTC nail insertion using a 12-mm reamer will destroy 5.89% and 4.01% of the respective talar and calcaneal posterior facets of the subtalar joint. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  19. FACET: The New User Facility at SLAC

    Energy Technology Data Exchange (ETDEWEB)

    Clarke, C.I.; Decker, F.J.; Erikson, R.; Hast, C.; Hogan, M.J.; Iverson, R.; Li, S.Z.; Nosochkov, Y.; Phinney, N.; Sheppard, J.; Wienands, U.; Woodley, M.; Yocky, G.; /SLAC; Seryi, A.; /Oxford U., JAI; Wittmer, W.; /Michigan State U.

    2011-12-13

    FACET (Facility for Advanced Accelerator and Experimental Tests) is a new User Facility at SLAC National Accelerator Laboratory. Its high power electron and positron beams make it a unique facility, ideal for beam-driven Plasma Wakefield Acceleration studies. The first 2 km of the SLAC linac produce 23 GeV, 3.2 nC electron and positron beams with short bunch lengths of 20 {mu}m. A final focusing system can produce beam spots 10 {mu}m wide. User-aided Commissioning took place in summer 2011 and FACET will formally come online in early 2012. We present the User Facility, the current features, planned upgrades and the opportunities for further experiments. Accelerators are our primary tool for discovering the fundamental laws to the universe. Each new frontier we probe requires a new, more powerful method. Accelerators are therefore increasing in size and cost. The future of this field requires new accelerating techniques that can reach the high energies required over shorter distances. New concepts for high gradient acceleration include utilizing the wakes in plasma and dielectric and metallic structures. FACET was built to provide a test bed for novel accelerating concepts with its high charge and highly compressed beams. As a test facility unlike any other, it has also attracted groups interested in beam diagnostic techniques and terahertz studies. The first phase of the construction was completed in May 2011. Beam commissioning began in June and was interleaved with the installation of five experiments. Users were invited to aid with the commissioning for the month of August during which time experimental hardware and software were checked out and some first measurements were taken. FACET is currently in the process of becoming a Department of Energy User Facility for High Energy Physics.

  20. Studying the various facets of emotional aging

    OpenAIRE

    2014-01-01

    To study emotional aging is to study a very multi-faceted concept. In particular, the study of emotion and aging covers a wide range of topics. Taking a closer look, domains of functioning can be differentiated such as pertaining to the experiential nature of emotion or its regulation, as well as social-cognitive processes associated with the perception of emotion in others or emotion-related attention and memory retrieval. Importantly, evidence over the last two decades suggests that not all...

  1. Clinical feature of pleural effusion in 78 patients with rheumatoid arthritis%78例类风湿关节炎胸腔积液临床特点分析

    Institute of Scientific and Technical Information of China (English)

    陈文玉; 王娟娟; 王智明

    2016-01-01

    Objective To investigate the feature of pleural effusion in patients with rheumatoid arthritis for the recognition of the disease.Methods The clinical feature of pleural effusion in patients with rheumatoid arthritis was retrospectively analyzed.Results There was no pleural effusion in patients with remission of rheumatoid arthritis,all patients with pleural effusion were in active phase of the disease,especially in moderate and high active phase, significant difference in the number of patients was detected in low,moderate and high active phases of rheumatoid arthritis between groups (P <0.05).The average levels of erythrocyte sedimentation rate and C-reactive protein were significantly higher in pleural effusion group than in non-pleural effusion group.The positive rates of rheumatoid factor and anti-cyclic citrullinated peptide antibody were significantly higher in pleural effusion group than in non-pleural effusion group (P < 0.05 ).The average number of joint tenderness and swollen joint was significantly higher in pleural effusion group than in non-pleural effusion group and the average time of morning stiffness was significantly longer in pleural effusion group than in non-pleural effusion group (P <0.05 ).Compared with non-pleural effusion group,the remission number of patients was significantly decreased in pleural effusion group (P < 0.05 ),and the number of new joint deformity was significantly increased in pleural effusion group (P < 0.05 ).Conclusion Rheumatoid arthritis patients present pleural effusion as an active signal of disease,which was positively correlated with immune index and clinical symptom and should get rigorously treated.%目的:探讨类风湿关节炎胸腔积液的特点,提高对该病的认识。方法回顾分析类风湿关节炎胸腔积液的特点。结果类风湿关节炎缓解状态下无胸腔积液出现,胸腔积液发生在疾病活动期,且集中在疾病中度、高度活动期,两组低、中、高度患者构

  2. Kinetics of faceting of crystals in growth, etching, and equilibrium

    Science.gov (United States)

    Vlachos, D. G.; Schmidt, L. D.; Aris, R.

    1993-03-01

    The faceting of crystals in equilibrium with the gas phase and also during crystal growth and etching conditions is studied using the Monte Carlo method. The dynamics of the transformation of unstable crystallographic orientations into hill and valley structures and the spatial patterns that develop are examined as functions of surface temperature, crystallographic orientation, and strength of interatomic potential for two transport processes: adsorption-desorption and surface diffusion. The results are compared with the continuum theory for facet formation. Thermodynamically unstable orientations break into hill and valley structures, and faceting exhibits three time regimes: disordering, facet nucleation, and coarsening of small facets to large facets. Faceting is accelerated as temperature increases, but thermal roughening can occur at high temperatures. Surface diffusion is the dominant mechanism at short times and small facets but adsorption-desorption becomes important at long times and large facets. Growth and etching promote faceting for conditions close to equilibrium but induce kinetic roughening for conditions far from equilibrium. Simultaneous irreversible growth and etching conditions with fast surface diffusion result in enhanced faceting.

  3. Improving personality facet scores with multidimensional computer adaptive testing

    DEFF Research Database (Denmark)

    Makransky, Guido; Mortensen, Erik Lykke; Glas, Cees A W

    2013-01-01

    Narrowly defined personality facet scores are commonly reported and used for making decisions in clinical and organizational settings. Although these facets are typically related, scoring is usually carried out for a single facet at a time. This method can be ineffective and time consuming when...... personality tests contain many highly correlated facets. This article investigates the possibility of increasing the precision of the NEO PI-R facet scores by scoring items with multidimensional item response theory and by efficiently administering and scoring items with multidimensional computer adaptive...... testing (MCAT). The increase in the precision of personality facet scores is obtained from exploiting the correlations between the facets. Results indicate that the NEO PI-R could be substantially shorter without attenuating precision when the MCAT methodology is used. Furthermore, the study shows...

  4. Diagnostic importance of zinc in the clarification of pleural effusions etiology

    Directory of Open Access Journals (Sweden)

    Ranković Boško

    2002-01-01

    Full Text Available Concentration of zinc in blood serum and effusion was determined in 104 patients with the pleural effusion of different etiology. The importance of zinc concentration in serum and effusion was analyzed, as well as their relation regarding the differential diagnosis of pleural effusion. It was established that the isolated zinc concentrations in serum and pleural effusion could not be used separately either in differing transudates from exudates or in the diagnosis of the pleural diseases. The average value of zinc in the pleural effusion in relation to the serum value in patients with tuberculosis effusion was 1.37, higher than 1 in all patients and was significantly different from the average value of the ratio 0,74 in patients with nonspecific and malignant pleural effusions. The relation of zinc concentration in the effusion and serum higher than 1.0 reliably indicated the presence of tuberculous pleurisy.

  5. Failed Radiation Synovectomy in Diseased Knee Joint with Missed Tuberculous Synovitis

    Science.gov (United States)

    Sood, Ashwani; Sharma, Aman; Chouhan, Devendra Kumar; Gupta, Kirti; Parghane, Rahul; Shukla, Jaya; Mittal, Bhagwant Rai

    2016-01-01

    The authors in this case report highlight the poor outcome of radiation synovectomy (RSV) for repeated knee joint effusion in a patient with histopathologically proven nonspecific arthritis. There was partial response initially following RSV but later follow-up showed recurrence in joint effusion with limited and painful mobility of the knee joint. Subsequent surgical synovectomy and histopathological examination showed it to be tubercular in origin. Thus in a country endemic for tuberculosis, an alternative infective etiology should also be kept in mind before subjecting the patient to RSV. PMID:27651744

  6. [Otitis media with effusion in children younger than 1 year].

    Science.gov (United States)

    Di Francesco, Renata Cantisani; Barros, Vivian Boschesi; Ramos, Rafael

    2016-06-01

    To determine the prevalence of otitis media with effusion in children younger than 1 year and its association with the season of the year, artificial feeding, environmental and perinatal factors. Retrospective study of 184 randomly included medical records from a total of 982 healthy infants evaluated for hearing screening tests. Diagnosis of otitis media with effusion was based on otoscopy (amber-gold color, fluid level, handle of malleus position), type B tympanometric curves and absence of otoacoustic emissions. Incomplete medical records or those describing acute otitis media, upper respiratory tract infections on the assessment day or in the last 3 months, neuropathies and craniofacial anomalies were excluded. Data such as gestational age, birth weight, Apgar score, type of feeding and day care attendance were compared between children with and without otitis media with effusion through likelihood tests and multivariate analysis. 25.3% of 184 infants had otitis media with bilateral effusion; 9.2% had unilateral. In infants with otitis media, the following were observed: chronological age of 9.6±1.7 months; gestational age >38 weeks in 43.4% and birth weight >2,500g in 48.4%. Otitis media with effusion was associated with winter/fall, artificial feeding, Apgar score otitis media with effusion. Otitis media with effusion was found in about one third of children younger than 1 year and was mainly associated with artificial feeding. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  7. Otitis media with effusion in children younger than 1 year

    Directory of Open Access Journals (Sweden)

    Renata Cantisani Di Francesco

    2016-06-01

    Full Text Available Abstract Objective: To determine the prevalence of otitis media with effusion in children younger than 1 year and its association with the season of the year, artificial feeding, environmental and perinatal factors. Methods: Retrospective study of 184 randomly included medical records from a total of 982 healthy infants evaluated for hearing screening tests. Diagnosis of otitis media with effusion was based on otoscopy (amber-gold color, fluid level, handle of malleus position, type B tympanometric curves and absence of otoacoustic emissions. Incomplete medical records or those describing acute otitis media, upper respiratory tract infections on the assessment day or in the last 3 months, neuropathies and craniofacial anomalies were excluded. Data such as gestational age, birth weight, Apgar score, type of feeding and day care attendance were compared between children with and without otitis media with effusion through likelihood tests and multivariate analysis. Results: 25.3% of 184 infants had otitis media with bilateral effusion; 9.2% had unilateral. In infants with otitis media, the following were observed: chronological age of 9.6±1.7 months; gestational age >38 weeks in 43.4% and birth weight >2500g in 48.4%. Otitis media with effusion was associated with winter/fall, artificial feeding, Apgar score <7 and day care attendance. The multivariate analysis showed that artificial feeding is the factor most often associated to otitis media with effusion. Conclusions: Otitis media with effusion was found in about one third of children younger than 1 year and was mainly associated with artificial feeding.

  8. Otitis media with effusion in children younger than 1 year

    Science.gov (United States)

    Di Francesco, Renata Cantisani; Barros, Vivian Boschesi; Ramos, Rafael

    2016-01-01

    Abstract Objective: To determine the prevalence of otitis media with effusion in children younger than 1 year and its association with the season of the year, artificial feeding, environmental and perinatal factors. Methods: Retrospective study of 184 randomly included medical records from a total of 982 healthy infants evaluated for hearing screening tests. Diagnosis of otitis media with effusion was based on otoscopy (amber-gold color, fluid level, handle of malleus position), type B tympanometric curves and absence of otoacoustic emissions. Incomplete medical records or those describing acute otitis media, upper respiratory tract infections on the assessment day or in the last 3 months, neuropathies and craniofacial anomalies were excluded. Data such as gestational age, birth weight, Apgar score, type of feeding and day care attendance were compared between children with and without otitis media with effusion through likelihood tests and multivariate analysis. Results: 25.3% of 184 infants had otitis media with bilateral effusion; 9.2% had unilateral. In infants with otitis media, the following were observed: chronological age of 9.6±1.7 months; gestational age >38 weeks in 43.4% and birth weight >2500g in 48.4%. Otitis media with effusion was associated with winter/fall, artificial feeding, Apgar score <7 and day care attendance. The multivariate analysis showed that artificial feeding is the factor most often associated to otitis media with effusion. Conclusions: Otitis media with effusion was found in about one third of children younger than 1 year and was mainly associated with artificial feeding. PMID:26559603

  9. Biceps tendon sheath effusion as a diagnostic clue to rotator cuff pathology.

    Science.gov (United States)

    Yadav, Pankaj K; Shah, Bhavin; Shende, Amol; Rajesh, S

    2014-02-01

    The objective of this study was to evaluate the role of biceps tendon sheath effusion detected on ultrasound as a diagnostic clue to rotator cuff pathology. Despite being the most common cause of shoulder pain in adults early sonographic changes of rotator cuff tendinopathy are easy to miss. A total of 31 patients out of whom 27 had unilateral shoulder pain and 4 had bilateral complaints under- went ultrasonographic examination of shoulder joint using high frequency linear array transducer. Any fluid surrounding the long head of biceps tendon was noted followed by a careful search for any associated sonographic abnormality involving the rotator cuff. Eighteen out of the 35 had presence of fluid in their biceps tendon sheath. Twelve had presence of both biceps tendon sheath effusion and rotator cuff pathologies. Among 17 patients, who had no fluid in their biceps tendon sheath, only 2 had rotator cuff involvement whereas rest 15 had neither biceps tendon sheath fluid nor rotator cuff pathologies. A significant association was found between presence of fluid in long head of biceps tendon sheath and rotator cuff pathologies. Thus the most common finding observed in association with the presence of fluid around the long head of biceps tendon sheath in this study was tendinosis of rotator cuff. On ultrasonography simple presence of fluid around the long head of biceps tendon sheath demands careful examination of rotator cuff.

  10. CLINICO-PATHOLOGICAL STUDY OF INFLAMMATORY SYNOVIAL LESIONS OF KNEE JOINT

    Directory of Open Access Journals (Sweden)

    Mamatha

    2015-12-01

    Full Text Available INTRODUCTION Synovial joints account for most of body’s articulation and characterised by wide range of almost frictionless movements. Synovium is the central area of pathology in a number of inflammatory joint diseases. Joint effusions present as diagnostic challenge to physicians and need careful evaluation and interpretation of both clinical and laboratory findings to make accurate diagnosis and avoid unnecessary hospital stay. Joint effusions present as diagnostic challenge to physicians and requiring careful evaluation and interpretation of both clinical and laboratory findings to make accurate diagnosis to avoid unnecessary hospital stay. AIM OF THE STUDY Is to study the diagnostic features joint effusion in cases of inflammatory synovitis of the knee joint. MATERIALS AND METHODS Prospective study was done over a period of two years in the Department of Pathology in a tertiary care hospital. Joint fluid was obtained by arthrocentesis in patients with joint effusions. Gross, microscopic, microbiological and biochemical parameters were examined in 50 samples of synovial fluids with synovial biopsy correlation. RESULTS Out of 50 cases, 20 cases were rheumatoid arthritis, 12 cases of chronic inflammatory arthritis not specified. 10 cases tuberculous arthritis, septic arthritis in 7 cases and gout 1 case. CONCLUSION Combination of clinical, radiological, serological, biochemical and microbiologic findings along with synovial fluid and biopsy findings help in diagnosis of specific inflammatory lesions of the synovium and treating the particular condition.

  11. Extravasation of joint fluid into the mediastinum and the deep neck during atthoscopic shoulder surgery

    Energy Technology Data Exchange (ETDEWEB)

    Han, Ji Yeon; Lee, Ki Nam [Dept. of Radiology, Dong-A University Hospital, Dong-A University College of Medicine, Busan (Korea, Republic of)

    2014-01-15

    Extravasation of shoulder joint fluid into the surrounding muscles during shoulder arthroscopic surgery is common and inevitable. Here, we report a case of massive extravasation of shoulder joint fluid leading to mediastinal and retrotracheal effusion after arthroscopic shoulder surgery. We will discuss the anatomical basis of fluid leakage from the shoulder to the mediastinum and to the deep neck on CT.

  12. MR findings of the temporomandibular joint with crepitus

    Energy Technology Data Exchange (ETDEWEB)

    Sano, Tsukasa; Yamamoto, Mika; Yamaga, Takayoshi; Takahashi, Koji; Masuda, Saeko; Tagaya, Atsuko; Michi, Ken-ichi; Okano, Tomohiro [Showa Univ., Tokyo (Japan). School of Dentistry

    1997-06-01

    Crepitus is an important sign for diagnosis of arthrosis of the temporomandibular joint (TMJ). The presence of crepitus can be evaluated by the listening test previously proposed by our group. However, TMJ can be diagnosed by MR imaging showing the disc position and related findings including bony changes and joint effusion. This study investigated the relationship between the presence of crepitus and pathology of the joint. Fourteen joints with crepitus diagnosed by the listening test were examined in this study. TMJ was categorized into four types based on findings on double spin echo MR images. The results were as follows: Of fourteen joints with crepitus, five (36%) were showed as normal superior disc position. The remaining 9 joints (64%) were diagnosed with disc displacement, of which, 6 showed reduction, one was without reduction and 2 without reduction were associated with arthrosis. Statistical analysis using the data obtained here and other data showed that the joints with crepitus tended to show disk displacement. There was no significant difference between the degree of certainty about the presence of the crepitus and the distribution of joint pathology. Joint effusion was observed only in the joints with displacement. These results indicated that TMJ with crepitus is associated with varied joint pathology. (author)

  13. Faceted to non-faceted transition of solid-liquid interface in binary alloys

    Energy Technology Data Exchange (ETDEWEB)

    Yumoto, H.; Hasiguti, R.R.; Kaneko, T.

    1987-03-01

    Jackson's theory on the interfacial roughening transition of pure materials is extended to that of AB binary alloys. In this model, the concept of quasi-dangling bonds is introduced. The bonds are produced by the difference between the number of the interfacial component of nearest neighbors of the A atom and that of the B atom. The roughening temperatures calculated from this model coincide with the faceted - non-faceted transition temperatures obtained experimentally by Miller and Chadwick and by the present authors.

  14. The role of bedside ultrasound in the diagnosis of pericardial effusion and cardiac tamponade

    Directory of Open Access Journals (Sweden)

    Adam Goodman

    2012-01-01

    Full Text Available This review article discusses two clinical cases of patients presenting to the emergency department with pericardial effusions. The role of bedside ultrasound in the detection of pericardial effusions is investigated, with special attention to the specific ultrasound features of cardiac tamponade. Through this review, clinicians caring for patients with pericardial effusions will learn to rapidly diagnose this condition directly at the bedside. Clinicians will also learn to differentiate between simple pericardial effusions in contrast to more complicated effusions causing cardiac tamponade. Indications for emergency pericardiocentesis are covered, so that clinicians can rapidly determine which group of patients will benefit from an emergency procedure to drain the effusion.

  15. Vestibular evaluation in children with otitis media with effusion.

    Science.gov (United States)

    Kolkaila, E A; Emara, A A; Gabr, T A

    2015-04-01

    Fifty per cent of children with serous otitis media may have some balance disturbances. To evaluate vestibular function in children with otitis media with effusion. The control group comprised 25 children with bilateral normal hearing and middle-ear function. The study group consisted of 30 children with bilateral otitis media with effusion; these were divided into 2 subgroups according to air-bone gap size. Measures included the Arabic Dizziness Handicap Inventory, an imbalance evaluation sheet for children, vestibular bedside tests for children, and air- and bone-conducted vestibular-evoked myogenic potential testing. Arabic Dizziness Handicap Inventory scores and some vestibular bedside test results were significantly abnormal, with normal video-nystagmography results, in children with otitis media with effusion. Air-conducted vestibular-evoked myogenic potentials were recorded in 73 per cent of children with otitis media with effusion, with significantly delayed latencies. Bone-conducted vestibular-evoked myogenic potentials were successfully detected in 100 per cent of children with otitis media with effusion with similar results to the control group. The Arabic Dizziness Handicap Inventory and vestibular bedside tests are valuable tools for detecting vestibular impairment in children. Bone-conducted vestibular-evoked myogenic potentials are useful for vestibular system evaluation.

  16. Thoracoscopic evaluation of 129 cases having undiagnosed exudative pleural effusions

    Directory of Open Access Journals (Sweden)

    Chetan Basavaraj Patil

    2016-01-01

    Full Text Available Background: Medical thoracoscopy is a minimally invasive procedure used in diagnostic and therapeutic applications for pleural diseases. In this study, we describe our experience in the outcome and analysis of thoracoscopy in undiagnosed pleural effusion presenting to our center. Materials and Methods: This is a prospective study conducted over last 2 years. We performed thoracoscopy in 129 cases of undiagnosed exudative pleural effusions using rigid thoracoscope. Clinical, radiological, cyto and histopathological data of the patients were collected prospectively and analyzed. Results: The overall diagnostic yield of thoracoscopic pleural biopsy was 110/129 (85.2% in patients with undiagnosed pleural effusion, and 19/129 (14.8% patients remained unexplained. Histopathological diagnosis confirmed malignancy in 66.4% patients (both primary and metastatic pleural carcinoma, tuberculosis in 28.2%, others including parapneumonic effusion in 4 cases followed by multiple myeloma, lupus pleuritis, and pulmonary langerhans cell histiocytosis in one case each. Procedure-related mortality was nil. Minor complications related to the procedure include hemorrhage, subcutaneous emphysema, etc. Conclusion: Thoracoscopy is relatively a safe and well-tolerated procedure with high diagnostic accuracy in undiagnosed pleural effusions, decreasing the need of formal diagnostic thoracotomy. Every chest physician must, therefore, consider this procedure to decrease the time lag in achieving the final diagnosis and to initiate the treatment as early as possible.

  17. FIRO-B: factors and facets.

    Science.gov (United States)

    Macrosson, W D

    2000-02-01

    10 FIRO-B intercorrelation matrices were factor analysed; one matrix was derived from new FIRO-B data, all the other matrices were found in the literature. The correlation matrices were also subjected to meta-analysis. The findings suggested that the four FIRO-B scales associated with Inclusion and Affection are facets of the ubiquitous interpersonal superfactor, Nurturance, but the two FIRO-B Control scales each express an orthogonal construct both of which relate to the super-factor, Dominance.

  18. Multiquark hadrons. A new facet of QCD

    Energy Technology Data Exchange (ETDEWEB)

    Ali, Ahmed

    2016-05-15

    I review some selected aspects of the phenomenology of multiquark states discovered in high energy experiments. They have four valence quarks (called tetraquarks) and two of them are found to have five valence quarks (called pentaquarks), extending the conventional hadron spectrum which consists of quark-antiquark (q anti q) mesons and qqq baryons. Multiquark states represent a new facet of QCD and their dynamics is both challenging and currently poorly understood. I discuss various approaches put forward to accommodate them, with emphasis on the diquark model.

  19. Multiquark Hadrons - A New Facet of QCD

    CERN Document Server

    Ali, Ahmed

    2016-01-01

    I review some selected aspects of the phenomenology of multiquark states discovered in high energy experiments. They have four valence quarks (called tetraquarks) and two of them are found to have five valence quarks (called pentaquarks), extending the conventional hadron spectrum which consists of quark-antiquark $(q\\bar{q})$ mesons and $qqq$ baryons. Multiquark states represent a new facet of QCD and their dynamics is both challenging and currently poorly understood. I discuss various approaches put forward to accommodate them, with emphasis on the diquark model.

  20. FACETS -- Infrastructure for Integrated Fusion Modeling

    Science.gov (United States)

    Shasharina, Svetlana; Cary, John; Carlsson, Johan; Hakim, Ammar; Kruger, Scott; Miah, Mahmood; Pletzer, Alexander; Vadlamani, Srinath; Wade-Stein, David; Balay, Satish; McInnes, Lois; Zhang, Hong; Candy, Jeff; Fahey, Mark; Cohen, Ron; Epperly, Tom; Rognlien, Tom; Estep, Don; Pankin, Alexei; Malony, Allen; Morris, Alan; Shende, Sameer; Indireshkumar, Keshavamurthy; McCune, Douglas; Pigarov, Alexander

    2009-11-01

    It is desirable that an infrastructure for integrated fusion modeling has support for: legacy and new components used interchangeably; consistent management of components lifecycle; allocating parallel resources consistent with the nature of participating components and the problem scope; components written in multiple programming languages; composition of sequentially and concurrently executing components respecting dependencies; tight and loose coupling of components; testing and validation of separate and integrated components; and use of multiple platforms from desktops to LCFs. In this poster we will describe the status of the FACETS with respect to these features.

  1. Control to Facet for Polynomial Systems

    DEFF Research Database (Denmark)

    Sloth, Christoffer; Wisniewski, Rafael

    2014-01-01

    for the controller design are solved by searching for polynomials in Bernstein form. This allows the controller design problem to be formulated as a linear programming problem. Examples are provided that demonstrate the efficiency of the method for designing controls for polynomial systems.......This paper presents a solution to the control to facet problem for arbitrary polynomial vector fields defined on simplices. The novelty of the work is to use Bernstein coefficients of polynomials for determining certificates of positivity. Specifically, the constraints that are set up...

  2. Diagnostic Utility of Pleural Effusion and Serum Cholesterol, Lactic Dehydrogenase and Protein Ratios in the Differentiation between Transudates and Exudates

    National Research Council Canada - National Science Library

    O. Fagere, Muaz

    2015-01-01

    ...) ratios in the differentiation between exudate and transudate pleural effusion. As a part of the investigation, 135 serum and pleural effusion samples were collected from patients with accumulated plural effusion...

  3. MR imaging of the temporomandibular joint in patient with acute mandibular condylar fracture

    Energy Technology Data Exchange (ETDEWEB)

    Park, Il Soon; Na, Jae Boem; Kang, Su Jin; Kim, Jae Hyoung; You, Jin Jong; Lee, Sang Hwy; Kim, Il Hyun [Gyeongsang National Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-09-01

    To analyze various MR imaging findings and thus evaluate the usefulness of MR imaging of the temporomandibular joint in patient with acute mandibular condylar fracture. MR imaging was performed within 1 week after trauma in 25 patients (total joints studied = 31) in whom condylar fracture had been diagnosed by simple radiographs. We analyzed the signal intensity of bone marrow and disk, displacement of bone fragment and disk, deformity. In addition, MRI findings of retrodiskal tissue, joint capsule and joint effusion were evaluated. No abnormal signal intensity was noted in bone marrow or disk. Displacement of a condylar fracture fragment was observed in 24 joints(77 %) (anteromedial, 63 %; medial, 25 %; anterior, 4 %; anterolateral, 4 %; and lateral, 4 %). Disk displacement occurred in 23 joints(74 %) (anteromedial, 65 %; medial, 9 %; anterior, 18 %; anterolateral, 4 %; and lateral, 4%). In 17 joints (55 %) the disk was displaced along with the fractured condylar fragment, and disk deformity was noted in five joints(16 %). MR imaging (T2WI) revealed a capsular tear(n=1), joint effusion(n=26), and high signal intensity in the retrodiskal tissue(n=6). MR imaging provided information concerning condylar fragments, disk, retrodiskal tissue, capsules, and joint effusion. In patients with acute mandibular condylar fracture, MRI is therefore useful for evaluation of the temporomandibular joint.

  4. Circumscribed Ciliochoroidal Effusion Presenting as an Acute Angle Closure Attack

    Science.gov (United States)

    Lipa, Roslyn Kathryn Manrique; Sánchez, María Eugenia González; Ordovas, Carlos Antonio Hijar; Aragües, Abel Rojo; Borque, Carmen Garcia

    2017-01-01

    Purpose: To report a case of choroidal effusion probably caused by angiotensin receptor II blocker. Case Report: A 52-year-old man with aplastic anemia and high blood pressure who developed unilateral acute angle closure glaucoma after receiving oral cyclosporine and angiotensin II receptor blocker (losartan). Ophthalmic examination revealed visual acuity of 20/30 in the left eye, mild mydriasis, iris bombe, no anterior chamber reaction, mild conjunctival hyperemia, and the intraocular pressure of 30 mmHg. After laser YAG iridotomy, funduscopy was performed showing a choroidal circumscribed lesion at the inferotemporal quadrant. Diagnostic tests ruled out any inflammatory or malignancy process, and the choroidal lesion spontaneously disappeared. After 20 months of follow-up, patient's ocular remained stable. Conclusion: This is the third case of choroidal effusion associated with angiotensin II receptor blockers. Since idiosyncratic ciliochoroidal effusion is a diagnosis of exclusion, it is mandatory to rule out more frequent causes, such as inflammatory or malignant processes. PMID:28299016

  5. Derrame pleural de origem indeterminada Undiagnosed pleural effusion

    Directory of Open Access Journals (Sweden)

    Eduardo Genofre

    2006-08-01

    Full Text Available Apesar do progresso nos métodos diagnósticos, cerca de 20% dos derrames pleurais podem permanecer sem diagnóstico etiológico definido após os exames convencionais. Para tentar determinar a origem destes derrames, métodos não convencionais e procedimentos mais invasivos devem ser utilizados com o objetivo de tentar esclarecer a etiologia do derrame pleural e instituir a terapêutica mais adequada.In spite of the progress in the diagnostic methods, about 20% of the pleural effusions may remain without a proper diagnosis after the use of conventional exams. In order to determine the origin of these effusions, alternative methods and invasive procedures shall be used aiming to determine the etiology of the undiagnosed pleural effusions and institute the most appropriate therapeutics.

  6. Pericardial Effusion in Langerhans Cell Histiocytosis: A Case Report

    Science.gov (United States)

    Gholami, Narges

    2016-01-01

    Introduction Langerhans cell histiocytosis (LCH) is a proliferative disorder of histiocytes in multiple organs. Langerhans cell histiocytosis involves bones, skin, lung and other organs. Case Presentation This study describes a seven-month-old Iranian girl who presented with skin rash and cervical lymphadenopathy. Langerhans cell histiocytosis was suspected when it was associated with anemia, splenomegaly and lytic bone lesions. A skin biopsy confirmed the diagnosis of Langerhans cell histiocytosis. During hospitalization, the patient looked ill with respiratory distress. A chest X-ray showed a ground glass view, and echocardiography showed moderate pericardial effusion. Conclusions Pericardial effusion was a rare finding in this case of Langerhans cell histiocytosis. Pericardial effusion in Langerhans cell histiocytosis, which is an unusual presentation, should be considered when the patient experiences respiratory distress. PMID:27621925

  7. Pleural, peritoneal and pericardial effusions – a biochemical approach

    Science.gov (United States)

    Kopcinovic, Lara Milevoj; Culej, Jelena

    2014-01-01

    The pathological accumulation of serous fluids in the pleural, peritoneal and pericardial space occurs in a variety of conditions. Since patient management depends on right and timely diagnosis, biochemical analysis of extravascular body fluids is considered a valuable tool in the patient management process. The biochemical evaluation of serous fluids includes the determination of gross appearance, differentiation of transudative from exudative effusions and additional specific biochemical testing to assess the effusion etiology. This article summarized data from the most relevant literature concerning practice with special emphasis on usefulness of biochemical tests used for the investigation of pleural, peritoneal and pericardial effusions. Additionally, preanalytical issues concerning serous fluid analysis were addressed and recommendations concerning acceptable analytical practice in serous fluid analysis were presented. PMID:24627721

  8. Ciliochoroidal effusion with persistent hypotony after trabectome surgery

    Directory of Open Access Journals (Sweden)

    Essam A Osman

    2015-01-01

    Full Text Available The trabectome is a novel form of ab interno trabeculectomy that ablates and remove the trabecular meshwork and the inner wall of Schlemm′s canal and subsequently expose the natural drainage pathway (the collector channels to aqueous humor. Complications associated with the trabectome are few and among them is transient hypotony. We report a case of a prolonged ciliochoroidal effusion with hypotony after ab interno trabeculectomy using the trabectome with cyclodialysis cleft detected by 80 MHz ultrasound biomicroscopy in a previously neither nonoperated nor traumatized eye. Transient hypotony has been reported after the trabectome surgery. Very few cases were associated with inadvertent intraoperative cyclodialysis, but there are no cases of prolonged hypotony with ciliochoroidal effusion with cyclodialysis. In our case, associated transient intraoperative and postoperative hypotony with a history of chronically high pressure along with the possible contribution of low-grade postoperative inflammation may have precipitated the ciliochoroidal effusion with prolonged hypotony associated with cyclodialysis.

  9. Morphometric analysis of the cervical facets and the feasibility, safety, and effectiveness of Goel inter-facet spacer distraction technique

    Directory of Open Access Journals (Sweden)

    Abhidha Shah

    2014-01-01

    Full Text Available Aim: Quantitative anatomy of the facets of the sub-axial cervical spine was performed. The purpose of the evaluation was to determine the feasibility of insertion of Goel inter-facetal articular spacers in the sub-axial cervical spine. Only few studies detailing the morphometry of the facets are available in the literature. Materials and Methods: Ten cervical vertebrae from C3 to C7 with a total of 20 facets were evaluated by the author. The anatomic parameters studied were the height, width, thickness, shape, orientation, and inclination of each of the superior and inferior facets. The alterations in a number of intervertebral segmental distances were measured before and after spacer insertion. The distance of the inferior facet from the foramen tranversarium, spinal canal, and neural foramina was measured to assess safety of spacer insertion with respect to the vertebral artery and neural structures. Results: The height, width and thickness of the superior facets from C3 to C7 ranged from 6 to 12 mm, 8 to 12 mm, and 2.5 to 6 mm, respectively. The inferior facets had an average height of 10.5 mm, average width of 11.2 mm and average thickness of 3.5 mm. The inclination of the superior facets with respect to the transverse plane ranged from 22° to 45° and that of the inferior facets ranged from 29° to 53°. The distance of the anterior margin of the inferior facet from the posterior border of the foramen transversium ranged from 5 to 7 mm. This distance was maximum at C3 level, then decreased at C4 and remained constant from C5 to C7. Conclusion: This anatomic evaluation aided in understanding the morphology of the cervical facets and the suitability of the cervical facetal articular cavity for insertion of spacers.

  10. Spontaneous septic arthritis of the lumbar facet caused by methicillin-resistant Staphylococcus aureus in an otherwise healthy adolescent.

    Science.gov (United States)

    Papaliodis, Dean N; Roberts, Timothy T; Richardson, Nicholas G; Lawrence, James B

    2014-07-01

    We report the case of a 16-year-old boy with isolated septic arthritis of a lumbar facet. This rare presentation of an infection in a lumbar facet joint occurred after minor trauma sustained in a football game. Septic arthritis of the spinal facet joint is an uncommon phenomenon. Only 5 cases have been reported in immunocompromised pediatric patients. To our knowledge, no case of septic arthritis in an immunocompetent pediatric patient has been reported. An otherwise healthy 16-year-old boy presented with 4 weeks of escalating back pain after a minor athletics-related trauma. Evaluation showed incapacitating pain, lumbar musculature spasms, and the absence of fever, hemodynamic, or neurologic changes. Laboratory values were within normal limits. Magnetic resonance images showed a fluid collection within the L3-L4 facet and a localized abscess. Computed tomographic-guided aspiration showed methicillin-resistant Staphylococcus aureus infection, for which the patient received 6 weeks of vancomycin with complete resolution of symptoms. Refractory lumbago in an adolescent requires careful evaluation.

  11. Facet-Engineered Surface and Interface Design of Photocatalytic Materials.

    Science.gov (United States)

    Bai, Song; Wang, Lili; Li, Zhengquan; Xiong, Yujie

    2017-01-01

    The facet-engineered surface and interface design for photocatalytic materials has been proven as a versatile approach to enhance their photocatalytic performance. This review article encompasses some recent advances in the facet engineering that has been performed to control the surface of mono-component semiconductor systems and to design the surface and interface structures of multi-component heterostructures toward photocatalytic applications. The review begins with some key points which should receive attention in the facet engineering on photocatalytic materials. We then discuss the synthetic approaches to achieve the facet control associated with the surface and interface design. In the following section, the facet-engineered surface design on mono-component photocatalytic materials is introduced, which forms a basis for the discussion on more complex systems. Subsequently, we elucidate the facet-engineered surface and interface design of multi-component photocatalytic materials. Finally, the existing challenges and future prospects are discussed.

  12. Modeling Reusable and Interoperable Faceted Browsing Systems with Category Theory.

    Science.gov (United States)

    Harris, Daniel R

    2015-08-01

    Faceted browsing has become ubiquitous with modern digital libraries and online search engines, yet the process is still difficult to abstractly model in a manner that supports the development of interoperable and reusable interfaces. We propose category theory as a theoretical foundation for faceted browsing and demonstrate how the interactive process can be mathematically abstracted. Existing efforts in facet modeling are based upon set theory, formal concept analysis, and lightweight ontologies, but in many regards, they are implementations of faceted browsing rather than a specification of the basic, underlying structures and interactions. We will demonstrate that category theory allows us to specify faceted objects and study the relationships and interactions within a faceted browsing system. Implementations can then be constructed through a category-theoretic lens using these models, allowing abstract comparison and communication that naturally support interoperability and reuse.

  13. Foundations of reusable and interoperable facet models using category theory.

    Science.gov (United States)

    Harris, Daniel R

    2016-10-01

    Faceted browsing has become ubiquitous with modern digital libraries and online search engines, yet the process is still difficult to abstractly model in a manner that supports the development of interoperable and reusable interfaces. We propose category theory as a theoretical foundation for faceted browsing and demonstrate how the interactive process can be mathematically abstracted. Existing efforts in facet modeling are based upon set theory, formal concept analysis, and light-weight ontologies, but in many regards, they are implementations of faceted browsing rather than a specification of the basic, underlying structures and interactions. We will demonstrate that category theory allows us to specify faceted objects and study the relationships and interactions within a faceted browsing system. Resulting implementations can then be constructed through a category-theoretic lens using these models, allowing abstract comparison and communication that naturally support interoperability and reuse.

  14. Facets of Dispositional Mindfulness and Health Among College Students.

    Science.gov (United States)

    Bodenlos, Jamie S; Wells, Stephanie Y; Noonan, Marleah; Mayrsohn, Aubreyanne

    2015-10-01

    The purpose of the current study was to examine the relationship between the facets of trait mindfulness with psychological and physical health while controlling for health behaviors in college students. 310 students from a small, private college in the Northeastern United States. Students completed self-report measures, including the Perceived Stress Scale (PSS-14), the Five Facet Mindfulness Questionnaire (FFMQ), Medical Outcomes Short-Form Health Survey (SF-36), and the Rutgers Alcohol Problems Index (RAPI). After controlling for other health behaviors, the observation facet of mindfulness was negatively associated with physical health. Both acting with awareness and nonjudging facets were positively associated with emotional well-being. For social functioning, nonjudging was a significant positive facet for this domain of health. Tailoring mindfulness-based interventions to enhance these facets may be beneficial to young adults.

  15. Usability Studies of Faceted Browsing: A Literature Review

    Directory of Open Access Journals (Sweden)

    Jody Condit Fagan

    2010-06-01

    Full Text Available Faceted browsing is a common feature of new library catalog interfaces. But to what extent does it improve user performance in searching within today’s library catalog systems? This article reviews the literature for user studies involving faceted browsing and user studies of “next-generation” library catalogs that incorporate faceted browsing. Both the results and the methods of these studies are analyzed by asking, What do we currently know about faceted browsing? How can we design better studies of faceted browsing in library catalogs? The article proposes methodological considerations for practicing librarians and provides examples of goals, tasks, and measurements for user studies of faceted browsing in library catalogs.

  16. Behaviour of nucleated cells in various types of pleural effusion.

    Science.gov (United States)

    Ferreiro, L; Pereiro, T; San José, E; Toubes, M E; Suárez-Antelo, J; Álvarez Dobaño, J M; González Barcala, F J; Rodríguez Núñez, N; Lama, A; Valdés, L

    2017-04-01

    To know the behavior of cellular components of pleural fluid can help focus the differential diagnosis of a pleural effusion. Our objective was to assess their composition in different types of pleural effusions and assess whether it provides relevant clinical information. Observational, cross-sectional and retrospective study in which the cellular components of pleural effusions of different etiology were analyzed. Pleural effusions were classified as neutrophilic, lymphocytic (≥50% of each one of them), eosinophilic (≥10%) or mesothelial (>5%) and were grouped into six diagnostic categories RESULTS: 1.467 patients were studied (354 heart failure; 59 other transudates; 349 paraneumonic; 133 tuberculous; 397 malignant and 175 other exudates). The predominance cell was lymphocytic in heart failure (44,4%), uncomplicated parapneumonic (29,2%), tuberculosis (88%) and malignant (49,6%); neutrophilic in parapneumonic (57%) and malignant (9,6%); eosinophilic in malignant (6,3%) and mesotelial in tuberculosis (12%). The most frequent etiologies with lymphocyte count ≥80% were tuberculosis (35,1%) and malignant (23,3%). Parameters with higher discriminating accuracy were: leukocytes (transudates: AUC 0,835) and percentage of neutrophils (empyemas: AUC 0,906 and complicated parapneumonic+empyemas: AUC 0,907). Nucleated cell counts will help focus the etiology of pleural effusions, since each etiology often have a characteristic cell predominance. The percentage of nucleated cells in pleural fluid not ruled out tuberculosis if there is a high count of mesothelial cells, nor a parapneumonic effusion with lymphocytic predominance, or malignancy with ≥80% lymphocytes. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  17. Pleural effusion: characterization with CT attenuation values and CT appearance.

    Science.gov (United States)

    Abramowitz, Yigal; Simanovsky, Natalia; Goldstein, Michael S; Hiller, Nurith

    2009-03-01

    The purpose of this study was to assess the utility of CT in characterizing pleural effusions on the basis of attenuation values and CT appearance. We retrospectively analyzed 100 pleural effusions in patients who underwent chest CT and diagnostic thoracentesis within 48 hours of each other. On the basis of Light's criteria, effusions were classified as exudates or transudates using laboratory biochemistry markers. The mean value in Hounsfield units of an effusion was determined using a region of interest on the three slices with the greatest quantity of fluid. All CT scans also were reviewed for the presence of additional pleural features such as fluid loculation, pleural thickening, and pleural nodules. Twenty-two of the 100 pleural effusions were transudates and 78 were exudates. The mean attenuation of the exudates (7.2 HU; [SD] 9.4 HU; range, 21-28 HU) was not significantly lower than the mean attenuation of the transudates (10.1 HU; 6.9 HU; range, 0.3-32 HU), (p = 0.24). None of the additional CT features accurately differentiated exudates from transudates (p > 0.1). Fluid loculation was found in 58% of exudates and in 36% of transudates. Pleural thickening was found in 59% of exudates and in 36% of transudates. The clinical use of CT attenuation values to characterize pleural fluid is not accurate. Although fluid loculation, pleural thickness, and pleural nodules were more commonly found in patients with exudative effusions, the presence of these features does not accurately differentiate between exudates and transudates.

  18. Preliminary design of large reflectors with flat facets

    Science.gov (United States)

    Agrawal, P. K.; Anderson, M. S.; Card, M. F.

    1981-01-01

    A concept for approximating curved antenna surfaces using flat facets is discussed. A preliminary design technique for determining the size of the reflector surface facets necessary to meet antenna surface accuracy requirements is presented. A proposed large microwave radiometer satellite (MRS) is selected as an application, and the far-field electromagnetic response of a faceted reflector surface is compared with that from a spherical reflector surface.

  19. Faceted ceramic fibers, tapes or ribbons and epitaxial devices therefrom

    Science.gov (United States)

    Goyal, Amit

    2013-07-09

    A crystalline article includes a single-crystal ceramic fiber, tape or ribbon. The fiber, tape or ribbon has at least one crystallographic facet along its length, which is generally at least one meter long. In the case of sapphire, the facets are R-plane, M-plane, C-plane or A-plane facets. Epitaxial articles, including superconducting articles, can be formed on the fiber, tape or ribbon.

  20. Faceted ceramic fibers, tapes or ribbons and epitaxial devices therefrom

    Energy Technology Data Exchange (ETDEWEB)

    Goyal, Amit (Knoxville, TN)

    2012-07-24

    A crystalline article includes a single-crystal ceramic fiber, tape or ribbon. The fiber, tape or ribbon has at least one crystallographic facet along its length, which is generally at least one meter long. In the case of sapphire, the facets are R-plane, M-plane, C-plane or A-plane facets. Epitaxial articles, including superconducting articles, can be formed on the fiber, tape or ribbon.

  1. Ultrasound-guided facet block to low back pain: a case report

    Directory of Open Access Journals (Sweden)

    Ana Ellen Q. Santiago

    2014-07-01

    Full Text Available BACKGROUND: Osteoarthrosis is a common cause of low back pain. The diagnosis is clinical and can be confirmed by imaging studies. Pain treatment and confirmation of diagnosis are made by intra-articular injection of corticosteroid and by local anesthetic use, due to clinical improvement. A direct monitoring of the procedure can be done under fluoroscopy, a classic technique, or else by an ultrasound-guided procedure. CASE REPORT: Female patient, 88 years old, 1.68 m and 72 kg, with facet osteoarthrosis at L2-L3, L3-L4 and L4-L5 for two years. On physical examination, she exhibited pain on lateralization and spinal extension. We opted in favor of an ultrasound-guided facet joint block. A midline spinal longitudinal scan was obtained, with identification of the desired joint space at L3-L4. A 25 G needle was inserted into the skin by the echographic off-plane ultrasound technique. 1 mL of contrast was administered, with confirmation by fluoroscopy. After aspiration of the contrast, 1 mL of solution containing 0.25% bupivacaine hydrochloride and 10 mg of methylprednisolone acetate was injected. Injections into L3-L4, L2-L3 and L1-L2 to the right were applied. CONCLUSIONS: The visualization of the facet joint by ultrasound involves minimal risk, besides reduction of radiation. This option is suitable for a large part of the population. However, fluoroscopy and computed tomography remain as monitoring techniques indicated for patients with specific characteristics, such as obesity, severe degenerative diseases and anatomical malformations, in which the ultrasound technique is still in need of further study.

  2. Cytomorphological profile of neoplastic effusions: An audit of 10 years with emphasis on uncommonly encountered malignancies

    Directory of Open Access Journals (Sweden)

    Sanjay Gupta

    2012-01-01

    Conclusions: Cytology is a useful tool to detect malignant effusions. However, in uncommon malignancies presenting as effusions, a detailed clinical history and ancillary investigations are often required to make a correct diagnosis.

  3. [Loculated pericardial effusion leading to functional tricuspid stenosis in a case of rheumatoid arthritis].

    Science.gov (United States)

    Galli, C A; Alimento, M; Pepi, M

    1995-09-01

    We describe a case of loculated pericardial effusion, occurring in a women affected by rheumatoid arthritis. Because of its peculiar location, close to the atrioventricular plane, the effusion caused a haemodynamic pattern resembling tricuspid valve stenosis.

  4. AETIOLOGICAL STUDY OF PLEURAL EFFUSION BY CONVENTIONAL METHODS-ITS CLINICAL PRESENTATION ALONG WITH RADIOLOGICAL, BIOCHEMICAL AND CYTOLOGICAL CORRELATION OF 60 CASES OF PLEURAL EFFUSION

    Directory of Open Access Journals (Sweden)

    Midde Ranga

    2016-06-01

    Full Text Available BACKGROUND Pleural effusion is the excessive or abnormal accumulation of fluid in the pleural space. Pleural effusion is routinely facing problem in practice by general physician and chest physician. Pleural effusion often present as common diagnostic dilemma as no cause can be found in many cases in spite of careful evaluation. For better management of cases to obtain knowledge of clinical history and clinical signs of pleural effusion along with radiological, biochemical, and cytological evaluation of pleural fluid help in narrowing the diagnosis. METHODS In this prospective study of 60 patients with pleural effusion with respect to age, sex, presenting complaint, clinical history with radiological, biochemical, and cytological examination of pleural fluid are considered. RESULTS In this prospective study of 60 patients with pleural effusion, their age is 11 to 75 years and two third were men. The most common type of pleural effusion is exudative effusion. The most common cause of exudative effusion in this study were tuberculosis (36, followed by malignancy (9, transudative (8, synpneumonic (5, and 2 cases of empyema (2. Pleural effusion was commonly seen in male patient with maximum number of cases in age group 31-50. Pleuritic chest pain, fever, cough, and breathlessness were common presenting complaint. The commonest clinical sign was stony dullness to percussion. Right-sided effusions were more common. Majority had moderate amount of pleural effusions. Blood count and ESR were significantly elevated in exudatives. Pleural fluid cytology revealed elevated lymphocytes in tubercular and polymorphs in acute infections. Cytology for malignant cells were diagnostic in 4 cases. ADA was significantly elevated in tubercular pleural effusion. Exudatives had decreased glucose, but increased protein, LDH, and cholesterol compared to transudatives. CONCLUSION Tubercular effusion remains the commonest aetiology of all exudative effusions in our study

  5. A STUDY ON ETIOLOGY AND PROFILE OF PLEURAL EFFUSION IN CHRONIC KIDNEY DISEASE

    Directory of Open Access Journals (Sweden)

    Prem Kumar

    2015-08-01

    Full Text Available BACKGROUND: Chronic Kidney disease is characterized by decreased glomerular filteration rate. Most pleural effusions occurring in CKD are attributed to renal failure & heart failure and are left alone, but there are other causes responsible for many effusions such as parapneumonic effusion, atelectasis, tuberculosis and other infections and malignancies due to immunosuppression, hence presence of pleural effusion in CKD deserves further evaluation. Our study is conducted to find the etiology and profile of patients with chronic Kidney disease developing pleural effusion. MATERIALS AND METHODS: Study was conducted among 35 patients with CKD and pleural effusion who attended Government hospital for chest and communicable diseases affiliated to Andhra Medical College, from M arch 2013 to September 2014. The clinical course of pleural effusions and their biochemical characteristics were studied together with radiographs and other relevant investigations. Study design - hospital based prospective study. OBSERVATIONS AND RESULTS: Of the 35 patients, 57% developed unilateral effusi on, 43% bilateral effusion. Among unilateral effusions - minimal effusions were 25%, moderate were 60%, massive were 15%. Patients with transudative effusion were 31%, exudative were 69%. Causes of effusion were as follows: Cardiac failure 31%, Tuberculosis 28%, Malignancy 9%, uremic effusion 14%, parapneumonic 11%, connective tissue disorders 2%. CONCLUSIONS: Apart from cardiac failure, tuberculosis is a major cause of pleural effusion in CKD patients, especially if the effusion is unilateral, exudative in nature, blood tinged, and lymphocyte predominant. ATT produced improvement in clinical and radiological status in these patients. KEYWORDS: CKD (C hronic K idney D isease, P leural effusion, C ardiac failure, T uberculosis.

  6. Eosinophilic pleural effusion and giardiasis: A causal or a casual relationship?

    Science.gov (United States)

    Singh, Urvinderpal; Garg, Nishi; Chopra, Vishal

    2013-01-01

    A case of bilateral eosinophilic pleural effusion with coincidental intestinal infestation of giardia lamblia is being reported. After reviewing the possible causes of this type of pleural effusion, no clinical or laboratory data were obtained which could explain this condition except giardiasis. Moreover the clearance of pleural effusion with the treatment of giardia with metronidazole suggests giardia as the probable cause of bilateral eosinophilic pleural effusion.

  7. Untargeted mass spectrometry-based metabolomic profiling of pleural effusions: fatty acids as novel cancer biomarkers for malignant pleural effusions.

    Science.gov (United States)

    Lam, Ching-Wan; Law, Chun-Yiu

    2014-09-05

    Untargeted mass spectrometry-based metabolomic profiling is a powerful analytical method used for broad-spectrum identification and quantification of metabolites in biofluids in human health and disease states. In this study, we exploit metabolomic profiling for cancer biomarker discovery for diagnosis of malignant pleural effusions. We envisage the result will be clinically useful since currently there are no cancer biomarkers that are accurate enough for the diagnosis of malignant pleural effusions. Metabolomes of 32 malignant pleural effusions from lung cancer patients and 18 benign effusions from patients with pulmonary tuberculosis were analyzed using reversed-phase liquid chromatography tandem mass spectrometry (LC-MS/MS) using AB SCIEX TripleTOF 5600. MS spectra were analyzed using XCMS, PeakView, and LipidView. Metabolome-Wide Association Study (MWAS) was performed by Receiver Operating Characteristic Curve Explorer and Tester (ROCCET). Insignificant markers were filtered out using a metabolome-wide significance level (MWSL) with p-value < 2 × 10(-5) for t test. Only compounds in Human Metabolome Database (HMDB) will be used as cancer biomarkers. ROCCET analysis of ESI positive and negative MS spectra revealed free fatty acid (FFA) 18:1 (oleic acid) had the largest area-under-ROC of 0.96 (95% CI = 0.87-1.00) in malignant pleural effusions. Using a ratio of FFA 18:1-to-ceramide (d18:1/16:0), the area-under-ROC was further increased to 0.99 (95% CI = 0.91-1.00) with sensitivity 93.8% and specificity 100.0%. Using untargeted metabolomic profiling, the diagnostic cancer biomarker with the largest area-under-ROC can be determined objectively. This lipogenic phenotype could be explained by overexpression of fatty acid synthase (FASN) in cancer cells. The diagnostic performance of FFA 18:1-to-ceramide (d18:1/16:0) ratio supports its use for diagnosis of malignant pleural effusions.

  8. The functional anatomy of the cricothyroid joint.

    Science.gov (United States)

    Windisch, Gunther; Hammer, Georg Philipp; Prodinger, Peter Michael; Friedrich, Gerhard; Anderhuber, Friedrich

    2010-02-01

    Postoperative long-term treatment problems of male-to-female transsexuals can be caused by the underestimated mobility of the cricothyroid joint. One hundred cadaveric larynges were analysed to reveal the morphological and functional anatomy of the CTJ focusing on possible horizontal and vertical gliding movements. Furthermore, the distance of the cricothyroid space for rotational movements was measured. The articular surface of the cricothyroid joint showed three different possibilities: a well-defined facet (Type 1 61%), no definable facet (Type 2 22%) or a flat surface with or without a tiny protuberance (Type 3 17%). Side different statements and intraindividual differences between male and female specimens were included. These different types affect horizontal and vertical gliding movements, besides rotational movements. The mobility between Type 1 and the others was highly significant (P < 0.001). Regarding different motions in the cricothyroid joint, rotational movements caused significant elongation of the vocal folds, which should be taken into consideration for phonosurgical methods.

  9. Eosinophilic pleural or peritoneal effusions in dogs and cats: 14 cases (1986-1992).

    Science.gov (United States)

    Fossum, T W; Wellman, M; Relford, R L; Slater, M R

    1993-06-01

    Case records of 9 dogs and 5 cats with eosinophilic effusions were reviewed. The animals ranged from 11 months to 13 years old. Seven animals had pleural effusions, 5 had peritoneal effusions, and 2 had pleural and peritoneal effusions. Neoplasia was confirmed in 6 animals and suspected in 1. Eosinophilic pleural effusion was diagnosed 2 days after pneumothorax developed as a consequence of thoracic tube placement in a cat, and pneumothorax was diagnosed in another cat with eosinophilic peritoneal effusion. Other abnormalities seen in 1 or 2 animals associated with eosinophilic effusion were radiographic signs of interstitial or peribronchial pulmonary infiltrates, a history of allergic respiratory tract and skin disease, intestinal lymphangiectasia and lung lobe torsion, chylothorax, bite wounds causing intestinal perforation, and feline leukemia virus infection. Based only on the protein concentration of the effusion, 7 effusions were classified as transudates and 7 were classified as exudates. Five of the 14 animals had eosinophilia (> 1,200 eosinophils/microliters); 3 of these animals had neoplastic disease. Mean eosinophil count in blood samples was not significantly different between animals with neoplasia and those without. Eosinophil counts in blood samples were not linearly related to counts in effusions; however, in some animals the number of eosinophils in the effusion was much higher than the eosinophil count in blood, suggesting concentration of eosinophils in the effusion.

  10. Dissecting aneurysm of arch and descending thoracic aorta presenting as a left sided hemorrhagic pleural effusion

    Directory of Open Access Journals (Sweden)

    Shamim Shelley

    2010-01-01

    Full Text Available The most common cause of massive hemorrhagic effusion is malignancy. Herein we present a case of dissecting aneurysm of descending thoracic aorta presenting initially with shortness of breath due to left sided massive pleural effusion. Effusion was hemorrhagic in nature with high hematocrit value. CT scan of thorax with CT angiogram was done and that revealed the diagnosis.

  11. File list: NoD.Lng.20.AllAg.Pleural_Effusion [Chip-atlas[Archive

    Lifescience Database Archive (English)

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    Lifescience Database Archive (English)

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    Lifescience Database Archive (English)

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    Lifescience Database Archive (English)

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    Lifescience Database Archive (English)

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  18. File list: ALL.Lng.10.AllAg.Pleural_Effusion [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  19. Fluctuation theorem for the effusion of an ideal gas.

    Science.gov (United States)

    Cleuren, B; Van den Broeck, C; Kawai, R

    2006-08-01

    The probability distribution of the entropy production for the effusion of an ideal gas between two compartments is calculated explicitly. The fluctuation theorem is verified. The analytic results are in good agreement with numerical data from hard disk molecular dynamics simulations.

  20. Eccentric pericardial effusion after radiation therapy of left breast carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Green, B.; Zornoza, J.; Ricks, J.P.

    1977-01-01

    Pericardial damage is one of the consequences of cardiac radiation and may lead to chronic pericarditis and/or tamponade. In three patients treated with radiation for carcinoma of the left breast, the effusions were loculated on the right side of the pericardium resulting in a peculiar cardiac silhouette. The importance of recognizing this entity and possible treatment is stressed.

  1. [Fusarium pleural effusion after a ventricular assist device].

    Science.gov (United States)

    Villacorta, J; Blancard, A; Kerbaul, F; Guidon, C; Gouin, F

    2002-05-01

    We report the case of a 36-year-old man with a pleural effusion that complicates the postoperative period after the implantation of a ventricular assist device (VAD). The epidemiological, etiologic and therapeutic features of Fusarium infections were reviewed. Complete recovery of the infection was obtained after a treatment by liposomal amphotericine B (AmBisome) and 5 fluorocytosine.

  2. Economic evaluation of ventilation tubes in otitis media with effusion.

    NARCIS (Netherlands)

    Moret-Hartman, M.; Rovers, M.M.; Ingels, K.J.A.O.; Zielhuis, G.A.; Severens, J.L.; Wilt, G.J. van der

    2001-01-01

    OBJECTIVE: To determine the costs and effectiveness of treatment with ventilation tubes as compared with watchful waiting in children with persistent otitis media with effusion. DESIGN: Randomized controlled trial. SETTING: Institutional practice. PATIENTS: A total of 187 young children (19 months o

  3. The Differential Diagnostic Values of Cytokine Levels in Pleural Effusions

    Science.gov (United States)

    Akarsu, Saadet; Kurt, A. Nese Citak; Dogan, Yasar; Yilmaz, Erdal; Godekmerdan, Ahmet; Aygun, A. Denizmen

    2005-01-01

    The aim is to examine whether the changes in pleural fluid interleukin (IL)-1β, IL-2, IL-6, and IL-8 levels were significant in differential diagnosis of childhood pleural effusions. IL-1β, IL-2, IL-6, and IL-8 levels in pleural fluids of all 36 patients were measured. The levels of IL-1β, IL-2, IL-6, and IL-8 in pleural fluids were statistically significantly higher in the transudate group compared with those of the exudate group. The levels of IL-1β, IL-6, and IL-8 were also found to be statistically significantly higher in the empyema group compared with both the parapneumonic and the tuberculous pleural effusion groups. The levels of IL-2 and IL-6 were detected to be statistically significantly higher in the tuberculous pleural effusion group in comparison with those of the parapneumonic effusion group. The results showed that pleural fluids IL-1β, IL-2, IL-6, and IL-8 could be used in pleural fluids exudate and transudate distinction. PMID:15770060

  4. [Usefulness of bronchofiberscopy in the study of pleural effusion].

    Science.gov (United States)

    Jurado Gámez, B; Sánchez Osuna, L; Sánchez Simón-Talero, R; García Gil, F L; Cosano Povedano, A; Muñoz Cabrera, L

    1995-05-01

    We revised our own experience in 208 patients with pleural effusion to whom fiberoptic bronchoscopy was made in part of the diagnostic study. In our population the most frequent cause was neoplastic origen, observing that in 97 patients (46%), 60 of them were due to bronchogenic carcinoma. In relation to the presentation symptoms, just when haemoptysis was present bronchoscopy exhibited bigger diagnostic profitability (17 of 29), p < 0.001. There were 106 patients (51%) who had some or several parenchymatic injuries going with the pleural effusion. In this group, in 55 cases, fiberoptic bronchoscopy was useful to the diagnosis; on the contrary when the only radiologic abnormality was pleural effusion, 102 cases, in 96 of them the procedure was not diagnostic, p < 0.001. A close relationship was noticed between diagnostic profitability of bronchoscopy with the existence of pulmonary neoplasm; about the 61 diagnosed patients using bronchoscopy, 53 of them had bronchogenic carcinoma, p < 0.001. We conclude then in our experience bronchoscopy is useful to the diagnosis of pleural effusion if it goes with haemoptysis or parenchymatic lesions in the radioly. Its diagnostic profitability has close relationship with the existence of bronchogenic carcinoma.

  5. Weak layer fracture: facets and depth hoar

    Directory of Open Access Journals (Sweden)

    I. Reiweger

    2013-09-01

    Full Text Available Understanding failure initiation within weak snow layers is essential for modeling and predicting dry-snow slab avalanches. We therefore performed laboratory experiments with snow samples containing a weak layer consisting of either faceted crystals or depth hoar. During these experiments the samples were loaded with different loading rates and at various tilt angles until fracture. The strength of the samples decreased with increasing loading rate and increasing tilt angle. Additionally, we took pictures of the side of four samples with a high-speed video camera and calculated the displacement using a particle image velocimetry (PIV algorithm. The fracture process within the weak layer could thus be observed in detail. Catastrophic failure started due to a shear fracture just above the interface between the depth hoar layer and the underlying crust.

  6. Diagnostics Challenges for FACET-II

    Energy Technology Data Exchange (ETDEWEB)

    Clarke, Christine

    2015-10-07

    FACET-II is a prospective user facility at SLAC National Accelerator Laboratory. The facility will focus on high-energy, high-brightness beams and their interaction with plasma and lasers. The accelerator is designed for high-energy-density electron beams with peak currents of approximately 50 kA (potentially 100 kA) that are focused down to below 10x10 micron transverse spot size at an energy of 10 GeV. Subsequent phases of the facility will provide positron beams above 10 kA peak current to the experiment station. Experiments will require well characterised beams; however, the high peak current of the electron beam can lead to material failure in wirescanners, optical transition radiation screens and other instruments critical for measurement or delivery. The radiation environment and space constraints also put additional pressure on diagnostic design.

  7. Problem of Time: Facets and Machian Strategy

    CERN Document Server

    Anderson, Edward

    2013-01-01

    The Problem of Time in Quantum Gravity is that `time' in GR and `time' in ordinary quantum theory are mutually incompatible notions, which is problematic in trying to put these two theories together to form a theory of Quantum Gravity. It has 8 facets, of which I reconceptualize and re-name the following. The Frozen Formalism Problem as Temporal Relationalism, the Thin Sandwich Problem as Configurational Relationalism via Best Matching, the Problem of Observables as the Problem of Beables, the Functional Evolution Problem as the Constraint Closure Problem, and I point out multiplicity of the Global and Multiple-Choice Problems of Time. This article contains a local resolution to the Problem of Time at the conceptual level and which is actually realizable for the relational triangle and minisuperspace models. This resolution is, moreover, Machian, and has three levels: classical, semiclassical and combined semiclassical-histories-records. The current frontiers of this program toward resolution of the Problem o...

  8. Weak layer fracture: facets and depth hoar

    Directory of Open Access Journals (Sweden)

    I. Reiweger

    2013-05-01

    Full Text Available Understanding the fracture behavior of weak snow layers is essential for modeling and predicting dry-snow slab avalanches. We therefore performed laboratory experiments with snow samples containing a weak layer consisting of either faceted crystals or depth hoar. During these experiments the samples were loaded with different loading rates and at various tilt angles until fracture. The strength of the samples decreased with increasing loading rate and increasing tilt angle. Additionally, we took pictures of the side of the samples with a high-speed video camera and calculated the displacement using a particle image velocimetry (PIV algorithm. The fracture process within the weak layer could thus be studied in detail. We found a fracture in shear immediately followed by a collapse of the weak layer.

  9. Explorations in statistics: statistical facets of reproducibility.

    Science.gov (United States)

    Curran-Everett, Douglas

    2016-06-01

    Learning about statistics is a lot like learning about science: the learning is more meaningful if you can actively explore. This eleventh installment of Explorations in Statistics explores statistical facets of reproducibility. If we obtain an experimental result that is scientifically meaningful and statistically unusual, we would like to know that our result reflects a general biological phenomenon that another researcher could reproduce if (s)he repeated our experiment. But more often than not, we may learn this researcher cannot replicate our result. The National Institutes of Health and the Federation of American Societies for Experimental Biology have created training modules and outlined strategies to help improve the reproducibility of research. These particular approaches are necessary, but they are not sufficient. The principles of hypothesis testing and estimation are inherent to the notion of reproducibility in science. If we want to improve the reproducibility of our research, then we need to rethink how we apply fundamental concepts of statistics to our science.

  10. Artificial Dendritic Cells: Multi-faceted Perspectives

    CERN Document Server

    Greensmith, Julie

    2009-01-01

    Dendritic cells are the crime scene investigators of the human immune system. Their function is to correlate potentially anomalous invading entities with observed damage to the body. The detection of such invaders by dendritic cells results in the activation of the adaptive immune system, eventually leading to the removal of the invader from the host body. This mechanism has provided inspiration for the development of a novel bio-inspired algorithm, the Dendritic Cell Algorithm. This algorithm processes information at multiple levels of resolution, resulting in the creation of information granules of variable structure. In this chapter we examine the multi-faceted nature of immunology and how research in this field has shaped the function of the resulting Dendritic Cell Algorithm. A brief overview of the algorithm is given in combination with the details of the processes used for its development. The chapter is concluded with a discussion of the parallels between our understanding of the human immune system a...

  11. Intervention for pleural effusions and ascites following liver transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Adetiloye, V.A. [Radiology Department, Birmingham Children`s Hospital NHS Trust, Ladywood Middleway, Birmingham B16 8ET (United Kingdom)]|[Radiology Department, College of Health Sciences, Obafemi Awolowo University, Ile-Ife (Nigeria); John, P.R. [Radiology Department, Birmingham Children`s Hospital NHS Trust, Ladywood Middleway, Birmingham B16 8ET (United Kingdom)

    1998-07-01

    Background. Small volumes of fluid in the pleural and peritoneal cavities are common after paediatric liver transplantation. Occasionally, larger fluid collections develop and need intervention by aspiration or insertion of a drain. Objective. To assess the incidence of moderate and large pleural and peritoneal fluid collections following paediatric liver transplantation, the need for intervention and the outcome following radiological and non-radiological treatment, with the ultimate objective of recommending a treatment protocol for such post-operative fluid collections. Materials and methods. A total of 184 consecutive liver grafts in 164 children were reviewed. Results. Of 184 grafts, 31 (16.8 %) developed excessive fluid collections requiring intervention (19 pleural effusions, 8 ascites and 4 effusions and ascites). The effusions were first diagnosed between days 1 and 44 after transplant and the ascites between days 1 and 14. The initial diagnosis was made radiologically in 21 (91 %) of 23 pleural effusions and in 10 (83 %) of 12 ascites. No identifiable cause or association was seen in 18 (58 %) of 31 cases. The mean duration of the pleural effusions and ascites, from onset of treatment to resolution, ranged from 33 {+-} 42 days (SD) to 35 {+-} 48 days and from 36 {+-} 47 days to 39 {+-} 46 days respectively. Comparison of the modes of interventional treatment (i. e. unguided, radiological and surgical) showed no statistically significant difference in the outcome of the management. Conclusions. Post-transplantation pleural effusions and ascites requiring intervention are often without definite cause. They are more common with reduced grafts, but this cannot completely explain the occurrence or the protracted duration of accumulation in spite of combined interventional management. The outcome of treatment is not significantly influenced by the mode of intervention except in cases where surgical intervention is indicated. Patients could be managed

  12. Lumbar facet injection for the treatment of chronic piriformis myofascial pain syndrome: 52 case studies

    Directory of Open Access Journals (Sweden)

    Huang JT

    2014-08-01

    Full Text Available Jen-Ting Huang,1 Han-Yu Chen,2 Chang-Zern Hong,2 Ming-Ta Lin,3 Li-Wei Chou,4,5 Hsin-Shui Chen,6,7 Chien-Tsung Tsai,8 Wen-Dien Chang9  1Department of Orthopedic Surgery, Taichung Veterans General Hospital, 2Department of Physical Therapy, Hung-Kuang University, Sha Lu, 3Kuan-Ta Rehabilitation and Pain Clinic, Taichung, Taiwan; 4Department of Physical Medicine and Rehabilitation, China Medical University Hospital, 5School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; 6Department of Rehabilitation Medicine, Bei-Gang Hospital, School of Medicine, China Medical University, Yun-Lin, Taiwan; 7School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; 8Department of Rehabilitation Medicine, Da-Chien Hospital, Miao-Li City, Taiwan; 9Department of Sports Medicine, China Medical University, Taichung, Taiwan Background and aims: The aim of this study was to demonstrate the effectiveness of lumbar facet joint injection for piriformis myofascial pain syndrome. Methods: Fifty-two patients with chronic myofascial pain in the piriformis muscle each received a lumbar facet injection into the ipsilateral L5–S1 facet joint region, using the multiple insertion technique. Subjective pain intensity, trunk extension range, and lumbar facet signs were measured before, immediately after, and 2 weeks after injection. Thirty-six patients received follow-up for 6 months. Results: Immediately after the injection, 27 patients (51.9% had complete pain subsidence, 19 patients (36.5% had pain reduction to a tolerable level, and only 6 patients (11.5% had no pain relief to a tolerable level. Mean pain intensity was reduced from 7.4±0.9 to 1.6±2.1 after injection (P<0.01. This effectiveness lasted for 2 weeks in 49 patients (94.2%, and lasted for approximately 6 months in 35 (97.2% of 36 patients. The mean range of motion increased from 13.4±6.8 degrees to 22.1±6.0 degrees immediately

  13. Value of ultrasound in the determination of drainage methods in patients with tuberculous pleural effusion

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Eun Young; Suh, Bo Kyoung; Shim, Jae Jeong [Korea Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-01-01

    To evaluate the utility of ultrasonography (US) as a guide in deciding drainage methods and as a prognostic factor in the prediction of pleural fibrosis, and to compare the effects of drainage methods in patients with tuberculous pleural effusions. In 51 patients with tuberculous pleural effusion, US patterns of pleural effusion were classified according to degree of septa into three groups, as follows : anechoic (n=5), linear septa (n=15), and honeycomb septa (n=31). US-guided drainage methods, including thoracentesis (n=17), percutaneous catheter insertion (n=12), catheter insertion with urokinase instillation (n=22) were employed. Therapeutic effects were evaluated with follow-up chest radiographs after 3 and 6 months. Three months after the procedure, 43 of 51 effusions had drained effectively. US guided drainage failed in eight patients including two of six with linear septated effusion treated with thoracentesis, four of seven with honeycomb septated effusion treated with thoracentesis, and two of six with honeycomb septated effusion treated with catheter drainage. There was no drainage failure in patients with anechoic effusions and in patients with urokinase instillation. Late effects were assessed in 39 patients after 6 months. Follow-up radiographs available in 39 patients demonstrated pleural fibrosis with intercostal space narrowing in 7 patients with honeycomb septated effusion, 3 patients with linear septated effusion, and none of the patients with anechoic effusions. The pattern of septa seen on US could be a useful factor for determining drainage methods and predicting late results in tuberculous pleural effusion. Percutaneous catheter drainage with urokinase instillation was a good drainage modality for patients with septated pleural effusions. Pleural fibrosis is more frequently induced by septated pleural effusion than by anechoic pleural effusion.

  14. Possible burst-like facet growth mode at high temperatures

    Science.gov (United States)

    Lovrić, Davorin; Vučić, Zlatko; Gladić, Jadranko

    2008-07-01

    A decade ago, a burst-like growth mode of c-facets of 4He crystals growing at mK temperatures, characterized by the alternation of time intervals during which the facet does not advance with the intervals of its fast advancement, was found [J.P. Ruutu, P.J. Hakonen, A.V. Babkin, A.Y. Parshin, J.S. Penttilä, J.P. Saramäki, G. Tvalashvili, Phys. Rev. Lett. 76 (1996) 4187]. We investigate the possibility that a similar facet growth mode exists for facets at high growth temperatures. We have applied the digital laser interferometry for monitoring facet kinetics of spherical copper selenide single crystals during their growth at constant volume growth rate around 800 K. Our analysis of directly measured (1 1 1) facet advancement curves has revealed that they consist of time intervals during which the facet does not advance vertically alternating with the time intervals of enhanced growth, resembling the burst-like facet growth mode. The results are discussed in terms of the enhancement of the local supersaturation induced by the existence of nucleation barrier.

  15. Search Interface Design Using Faceted Indexing for Web Resources.

    Science.gov (United States)

    Devadason, Francis; Intaraksa, Neelawat; Patamawongjariya, Pornprapa; Desai, Kavita

    2001-01-01

    Describes an experimental system designed to organize and provide access to Web documents using a faceted pre-coordinate indexing system based on the Deep Structure Indexing System (DSIS) derived from POPSI (Postulate based Permuted Subject Indexing) of Bhattacharyya, and the facet analysis and chain indexing system of Ranganathan. (AEF)

  16. Proximal attrition facets: morphometric, demographic, and aging characteristics.

    Science.gov (United States)

    Sarig, Rachel; Hershkovitz, Israel; Shvalb, Nir; Sella-Tunis, Tatiana; May, Hila; Vardimon, Alexander D

    2014-08-01

    Although interproximal attrition is considered to be limited in modern populations, it has important clinical implications. However, in contrast to occlusal attrition, proximal attrition receives limited scientific attention. The main purpose of the current study was to fill this void. Seven-hundred and sixty-five teeth were collected from 255 skulls of subjects 18-75 yr of age. For each individual, three mandibular teeth (the first and second premolars and the first molar) were examined for proximal attrition facets (PAFs). The results provide detailed information on the size, shape, and location of the facets according to age cohort, gender, and ethnicity. The validity of the method used to measure the facets was also examined. The major findings were as follows: PAFs are usually located on the upper half of the crown proximal aspect; in each tooth, the mesial facet is more lingually positioned and the distal facet is more buccally positioned; the majority of the facets are subrectangular in shape; the size of the facets tends to increase in an anteroposterior direction (from premolars to molars); and facet size and location are age- and sex-dependent and ethnicity-independent. It is our recommendation that dentists bear in mind that interproximal attrition is a dynamic, long-term process and needs to be considered in many clinical scenarios.

  17. A note on clique-web facets for multicut polytopes

    DEFF Research Database (Denmark)

    Sørensen, Michael Malmros

    2002-01-01

    In this note we provide a previously undiscovered necessary condition for the facet-defining property of clique-web inequalities for the multicut polytope. This condition imposes a minimum cardinality requirement on the node set of the clique, thus implying, in general, that clique-web inequalities...... associated with relatively small cliques are not facet-defining for multicut polytopes....

  18. A Note on Clique-Web Facets for Multicut Polytopes

    DEFF Research Database (Denmark)

    Sørensen, Michael Malmros

    2002-01-01

    In this note we provide a previously undiscovered necessary condition for the facet defining property of clique-web inequalities for the multicut polytope. This condition imposes a minimum cardinality requirement on the node set of the clique, thus implying that clique-web inequalities associated...... with relatively small cliques are not facet defining in general for multicut polytopes....

  19. /facet: A Browser for Heterogeneous Semantic Web Repositories

    NARCIS (Netherlands)

    Hildebrand, M.; Ossenbruggen, J.R. van; Hardman, L.

    2006-01-01

    Facet browsing has become popular as a user friendly interface to data repositories. The Semantic Web raises new challenges due to the heterogeneous character of the data. First, users should be able to select and navigate through facets of resources of any type and to make selections based on prope

  20. FacetAtlas: multifaceted visualization for rich text corpora.

    Science.gov (United States)

    Cao, Nan; Sun, Jimeng; Lin, Yu-Ru; Gotz, David; Liu, Shixia; Qu, Huamin

    2010-01-01

    Documents in rich text corpora usually contain multiple facets of information. For example, an article about a specific disease often consists of different facets such as symptom, treatment, cause, diagnosis, prognosis, and prevention. Thus, documents may have different relations based on different facets. Powerful search tools have been developed to help users locate lists of individual documents that are most related to specific keywords. However, there is a lack of effective analysis tools that reveal the multifaceted relations of documents within or cross the document clusters. In this paper, we present FacetAtlas, a multifaceted visualization technique for visually analyzing rich text corpora. FacetAtlas combines search technology with advanced visual analytical tools to convey both global and local patterns simultaneously. We describe several unique aspects of FacetAtlas, including (1) node cliques and multifaceted edges, (2) an optimized density map, and (3) automated opacity pattern enhancement for highlighting visual patterns, (4) interactive context switch between facets. In addition, we demonstrate the power of FacetAtlas through a case study that targets patient education in the health care domain. Our evaluation shows the benefits of this work, especially in support of complex multifaceted data analysis.

  1. Concurrent, parallel, multiphysics coupling in the FACETS project

    Science.gov (United States)

    Cary, J. R.; Candy, J.; Cobb, J.; Cohen, R. H.; Epperly, T.; Estep, D. J.; Krasheninnikov, S.; Malony, A. D.; McCune, D. C.; McInnes, L.; Pankin, A.; Balay, S.; Carlsson, J. A.; Fahey, M. R.; Groebner, R. J.; Hakim, A. H.; Kruger, S. E.; Miah, M.; Pletzer, A.; Shasharina, S.; Vadlamani, S.; Wade-Stein, D.; Rognlien, T. D.; Morris, A.; Shende, S.; Hammett, G. W.; Indireshkumar, K.; Pigarov, A. Yu; Zhang, H.

    2009-07-01

    FACETS (Framework Application for Core-Edge Transport Simulations), is now in its third year. The FACETS team has developed a framework for concurrent coupling of parallel computational physics for use on Leadership Class Facilities (LCFs). In the course of the last year, FACETS has tackled many of the difficult problems of moving to parallel, integrated modeling by developing algorithms for coupled systems, extracting legacy applications as components, modifying them to run on LCFs, and improving the performance of all components. The development of FACETS abides by rigorous engineering standards, including cross platform build and test systems, with the latter covering regression, performance, and visualization. In addition, FACETS has demonstrated the ability to incorporate full turbulence computations for the highest fidelity transport computations. Early indications are that the framework, using such computations, scales to multiple tens of thousands of processors. These accomplishments were a result of an interdisciplinary collaboration among computational physics, computer scientists and applied mathematicians on the team.

  2. Performance appraisal process and system facets: relationship with contextual performance.

    Science.gov (United States)

    Findley, H M; Giles, W F; Mossholder, K W

    2000-08-01

    Because appraisal-related interactions between supervisors and employees may influence more than task performance, the authors considered the potential effects of social and interpersonal processes in performance appraisal on contextual performance. They hypothesized that performance appraisal process and system facets were associated with employees' contextual performance as well as with their perceptions of appraisal accuracy. After controlling relevant variables, they found that appraisal process facets explained variance in contextual performance and perceived accuracy beyond that accounted for by the system facets. However, when the order of entry for the process and system variable sets was reversed, only for perceived appraisal accuracy, as hypothesized, did the system facets account for variance beyond that explained by the appraisal process facets.

  3. Reliability of knee joint range of motion and circumference measurements after total knee arthroplasty: does tester experience matter?

    DEFF Research Database (Denmark)

    Jakobsen, Thomas Linding; Christensen, Malene; Christensen, Stine Sommer

    2010-01-01

    BACKGROUND AND PURPOSE: Two of the most utilized outcome measures to assess knee joint range of motion (ROM) and intra-articular effusion are goniometry and circumference, respectively. Neither goniometry nor circumference of the knee joint have been examined for both intra-tester and inter-teste...

  4. Diagnostic value of interferon gamma and adenosine deaminase for tuberculous pleural effusion

    Institute of Scientific and Technical Information of China (English)

    Hou-rongCai; Chen-hongSun; Lin-juenDai; Zai-rongCheng

    2001-01-01

    To explore the significance of interferon gamma(IFN-γ) and adenosine deaminase (ADA)in differential diagnosis of pleural effusions. Methods: Levels of IFN-γ was measured by enzyme-linked immunosorbent assay, ADA activity was measured by colorimetric method. 37 patients with tuberculous pleural effusion and 36 patients with non-tuberculous pleurai effusions including 25 patients with malignant pleural effusions and 8 patients with pleural transudates were studied. Results: The levels of IFN-γ in patients with tuberculous pleural effusions(490.83±384.67 pg.mL-1) were higher than those with malignant pleural effusions(36.40±90.85 pg. mL-1) and pleural transudates(14.87±5.96 pg. mL-1) (P<0.01). Mean ADA activity was 52.69±17.78 U. L-1 in tuberculous pleural effusion; 19.53±13.59 in malignant pleural effusions; 9.43±4.06 inpleural transudates. The difference is significant (P<0.001). The diagnostic sensitivity of IFN-γ for tuberculous pleural effusions is 81%, specifity is 97%, the over accuracy is 90.4%. The diagnostic efficiency of ADA as following: sensitivity 89%, specifity 97%, and the over accuracy 94.5%. Conclusions: Assessments of IFN-γ and ADA in pleural effusions are of clinically diagnostic value in distinguishing tuberculous from non-tuberculous pleural effusions.

  5. High incidence and spontaneous resolution of mastoid effusion after craniotomy on early postoperative magnetic resonance images

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, T.; Saito, N.; Takahashi, A.; Fujimaki, H.; Tosaka, M.; Sasaki, T. [Department of Neurosurgery, Gunma University School of Medicine, 3-39-22 Showa-machi, 371-8511, Maebashi, Gunma (Japan); Sato, N. [Department of Diagnostic Radiology, Gunma University School of Medicine, Maebashi, Gunma (Japan)

    2003-07-01

    Mastoid effusion is a poorly understood complication after craniotomy. The incidence and severity of postoperative mastoid effusion were retrospectively examined on postoperative magnetic resonance (MR) images to assess any association with craniotomy procedures, time course, and neuro-otological complications. We evaluated the early postoperative MR images (within 4 days of craniotomy) and medical records of 74 patients who underwent 77 operations for the treatment of various intracranial diseases from January 2000 to December 2001. Mastoid effusion was classified into four grades: none, partial, moderate, and severe diffuse effusion in the mastoid air cells. Thirty-three follow-up MR images from 26 patients were also reviewed. Postoperative mastoid effusion occurred ipsilateral to the craniotomy site in 62 cases and contralateral in 56 cases. Mastoid effusion was significantly more severe ipsilateral than contralateral to craniotomy with exposure of the mastoid air cells (P<0.0001). There was no significant difference in severity between the contralateral and ipsilateral sides after craniotomy without mastoid air cell opening (P=0.437). Mastoid effusion following craniotomy without exposure of mastoid air cells resolved within 3 months. However, otitis media with effusion developed in six patients with severe mastoid effusion ipsilateral to craniotomy with exposure of the mastoid air cells. Mastoid effusion frequently developed on both sides. Any grade of mastoid effusion on the ipsilateral side to craniotomy without exposure of mastoid air cells, or on the contralateral side, was asymptomatic or had a benign course, and disappeared within 3 months. (orig.)

  6. Associations of sonographic abnormalities of the shoulder with various grades of biceps peritendinous effusion (BPE).

    Science.gov (United States)

    Chang, Ke-Vin; Chen, Wen-Shiang; Wang, Tyng-Guey; Hung, Chen-Yu; Chien, Kuo-Liong

    2014-02-01

    Bicipital peritendinous effusion (BPE), a common ultrasonographic finding of the long head of the biceps tendon, may be associated with shoulder joint derangement, but supporting evidence from large-scale studies is lacking. The aim of this cross-sectional study was to determine the strength of the association between BPE and sonographic abnormalities of the shoulder joint. We reviewed the sonographic reports of patients with suspected shoulder disorders investigated ultrasonographically between January 2011 and January 2012. BPE was graded according to its measured thickness as absent (3 mm). The associations between BPE and sonographic abnormalities were examined using multinomial logistic regression adjusted for age, gender, affected side and clinical diagnosis of frozen shoulder. The prevalence rates of absent, mild, moderate and severe BPE among the 907 shoulders examined were 64.1%, 17.8%, 10.4% and 7.7%, respectively. Frozen shoulder was associated with mild BPE (relative risk [RR] vs. participants without BPE = 1.83, 95% confidence interval [CI] = 1.28-2.50). Sonographic findings of biceps tendinopathy, subdeltoid bursitis and full-thickness tears of the supraspinatus tendon were significantly associated with the entire spectrum of BPE, whereas subscapularis tendon tears were significantly associated with moderate (RR = 2.47, 95% CI = 1.29-4.69) and severe (RR = 3.11, 95% CI = 1.51-6.33) BPE. Severe BPE was associated with articular-sided partial-thickness tears of the supraspinatus tendon (RR = 14.32, 95% CI = 4.30-34.35), posterior recess effusion (RR, 7.98, 95% CI = 1.44-34.93) and biceps medial subluxation (RR = 7.25, 95% CI = 1.90-22.33). Our study indicates that BPE is related to various shoulder abnormalities and that the strengths of these associations depend on the severity of BPE. Clinicians encountering BPE should grade its severity and be alert for hidden lesions of the shoulder joint.

  7. Cervical facet dislocation adjacent to the fused motion segment.

    Science.gov (United States)

    Yokoyama, Kunio; Kawanishi, Masahiro; Yamada, Makoto; Tanaka, Hidekazu; Ito, Yutaka; Kuroiwa, Toshihiko

    2016-01-01

    This study reports on a case that forces re-examination of merits and demerits of anterior cervical fusion. A 79-year-old male was brought to the emergency room (ER) of our hospital after he fell and struck the occipital region of his head following excessive alcohol consumption. Four years prior, he had undergone anterior cervical discectomy and fusion of C5/6 and a magnetic resonance imaging (MRI) performed 3 years after this surgery indicated that he was suffering from degeneration of C6/7 intervertebral discs. After arriving at the ER, he presented motor impairment at level C7 and lower of manual muscle testing grade 1 as well as moderate loss of physical sensation from the trunk and peripheries of both upper limbs to the peripheries of both lower limbs (Frankel B). Cervical computed tomography (CT) indicated anterior dislocation of C6/7, and MRI indicated severe spinal cord edema. We performed manipulative reduction of C6/7 with the patient under general anesthesia. Next, we performed laminectomy on C5-T1 and posterior fusion on C6/7. Postoperative CT indicated that cervical alignment had improved, and MRI indicated that the spinal cord edema observed prior to surgery had been mitigated. Three months after surgery, motor function and sensory impairment of the lower limbs had improved, and the patient was ambulatory upon discharge from the hospital (Frankel D). In the present case, although C5 and 6 were rigidly fused, degeneration of the C6/7 intervertebral disc occurred and stability was compromised. As a result, even slight trauma placed a severe dynamic burden on the facet joint of C6/7, which led to dislocation.

  8. Cervical facet dislocation adjacent to the fused motion segment

    Directory of Open Access Journals (Sweden)

    Kunio Yokoyama

    2016-01-01

    Full Text Available This study reports on a case that forces re-examination of merits and demerits of anterior cervical fusion. A 79-year-old male was brought to the emergency room (ER of our hospital after he fell and struck the occipital region of his head following excessive alcohol consumption. Four years prior, he had undergone anterior cervical discectomy and fusion of C5/6 and a magnetic resonance imaging (MRI performed 3 years after this surgery indicated that he was suffering from degeneration of C6/7 intervertebral discs. After arriving at the ER, he presented motor impairment at level C7 and lower of manual muscle testing grade 1 as well as moderate loss of physical sensation from the trunk and peripheries of both upper limbs to the peripheries of both lower limbs (Frankel B. Cervical computed tomography (CT indicated anterior dislocation of C6/7, and MRI indicated severe spinal cord edema. We performed manipulative reduction of C6/7 with the patient under general anesthesia. Next, we performed laminectomy on C5-T1 and posterior fusion on C6/7. Postoperative CT indicated that cervical alignment had improved, and MRI indicated that the spinal cord edema observed prior to surgery had been mitigated. Three months after surgery, motor function and sensory impairment of the lower limbs had improved, and the patient was ambulatory upon discharge from the hospital (Frankel D. In the present case, although C5 and 6 were rigidly fused, degeneration of the C6/7 intervertebral disc occurred and stability was compromised. As a result, even slight trauma placed a severe dynamic burden on the facet joint of C6/7, which led to dislocation.

  9. Iliacus pyomyositis mimicking septic arthritis of the hip joint.

    Science.gov (United States)

    Chen W-S; Wan Y-L

    1996-01-01

    The iliacus muscle is closely associated with the psoas muscle, femoral nerve, hip joint, pelvic and intraabdominal structures; thus, its disorders may present as lower abdominal pain, hip pain, or femoral neuropathy. Iliacus pyomyositis, a primary bacterial infection of the skeletal muscle not secondary to a contiguous skin, bone, or soft-tissue infection, presenting as hip pain, femoral neuropathy, and sympathetic effusion of the hip joint in an 8-year-old boy mimicked septic arthritis of the hip joint. Computed tomography was helpful in delineating the accurate location of the lesion. Surgical drainage and appropriate antibiotic therapy led to complete resolution and full functional recovery.

  10. Transarticular invasion of joints by bone tumors: Hypothesis

    Energy Technology Data Exchange (ETDEWEB)

    Abdelwahab, I.F.; Miller, T.T.; Hermann, G. (Dept. of Radiology, Mount Sinai Medical Center, New York, NY (USA)); Klein, M.J. (Dept. of Pathology, Mount Sinai Medical Center, New York, NY (USA)); Kenan, S.; Lewis, M.M. (Dept. of Orthopedic Surgery, Mount Sinai Medical Center, New York, NY (USA))

    1991-05-01

    Eight bone tumors with associated transarticular invasion of the sacroiliac joints are described. All invaded the true synovial joint and spread to the opposing bone. One tumor was benign, and the other seven were malignant. Five of the seven were primary and two were metastatic cancer. One, a myeloma, invaded the disc spaces between the fourth and fifth lumbar vertebrae and the fifth lumbar vertebra and sacrum as well as the sacroiliac joint. The right facet joints of the two vertebrae were also invaded. After a thorough search of the literature, we find that the sacroiliac joints is the most common joint to be invaded by tumors. This is followed by the vertebral disc spaces and, last, the facet joints. Apart from these joints we were unable to find any radiographic documentation of other joints being transarticularly invaded by tumors. We noted that there is a direct relation between transarticular tumor spread and joints that lack mobility and that certain tumors, benign and malignant, tend to invade these joints. (orig.).

  11. Advance of Therapeutic Methods for Malignant Pleural Effusion

    Institute of Scientific and Technical Information of China (English)

    XU Tao-tao

    2016-01-01

    Malignant pleural effusion (MPE) is a condition caused by primary malignant tumors in the pleura or other malignant tumors metastasis to the pleura. It is also one of common serious complications of middle-late malignant tumor, which has severe impact on the quality of life, even threatening the life of the patients. The selection of treatments for MPE depends on many factors, including the symptoms, performance status, primary tumor types, response to systemic therapy, and degree of lung recruitment maneuvers (LRM) after drainage of pleural effusion. Generally, the treatment methods include thoracentesis, indwelling pleural catheter, pleurodesis, intrapleural injection of drugs, chemotherapy, radiotherapy, anti-angiogenesis therapy, surgery, and thermotherapy. With the in-depth study on pathogenesis of MPE, the treatments of MPE have continuous improvements. This study mainly reviewed the treatment methods for MPE so as to provide the basis for clinical practice in the future.

  12. Lyme Disease Presenting as a Spontaneous Knee Effusion.

    Science.gov (United States)

    Matzkin, Elizabeth; Suslavich, Kaytelin; Curry, Emily J

    2015-11-01

    Musculoskeletal complaints, which are frequently associated with Lyme disease, often prompt patients to see a physician. In particular, transient episodes of spontaneous knee effusion are common early in the progression of Lyme disease, and, if left untreated, 60% of patients diagnosed with the disease develop Lyme arthritis. This disease is easily treated with antibiotics; therefore, inclusion of Lyme disease in the differential diagnosis as a potential cause of a spontaneous knee effusion can prevent the development of more severe symptoms associated with the disease. However, the time required to receive test results and the inconsistencies between serum and synovial tests can complicate diagnosis of the disease. Copyright 2015 by the American Academy of Orthopaedic Surgeons.

  13. Right Pleural Effusion in Fitz-Hugh-Curtis Syndrome

    Directory of Open Access Journals (Sweden)

    Tajiri,Takuma

    2006-10-01

    Full Text Available Right pleural effusion was diagnosed in a 36-year-old woman with right upper quadrant pain and fever. Enhanced pelvic computed tomography performed because of irregular genital bleeding revealed the pelvic inflammatory disease. Upon further questioning, the patient confirmed that she had recently undergone therapy for Chlamydia trachomatis infection. Therefore she was given an injection of tetracycline because we suspected Fitz-Hugh-Curtis syndrome (FHCS, a pelvic inflammatory disease characterized by perihepatitis associated with chlamydial infection. A remarkable clinical response to antibiotics was noted. The right upper quadrant pain was due to perihepatitis, and the final diagnosis was FHCS. Right pleural effusion may be caused by inflammation of the diaphragm associated with perihepatitis. Once chlamydial infection reaches the subphrenic liver, conditions in the closed space between the liver and diaphragm due to inflammatory adhesion may be conductive to chlamydial proliferation. The possibility of FHCS should be considered in patients and carefully distinguished from other abdominal diseases.

  14. Recommendations of diagnosis and treatment of pleural effusion. Update.

    Science.gov (United States)

    Villena Garrido, Victoria; Cases Viedma, Enrique; Fernández Villar, Alberto; de Pablo Gafas, Alicia; Pérez Rodríguez, Esteban; Porcel Pérez, José Manuel; Rodríguez Panadero, Francisco; Ruiz Martínez, Carlos; Salvatierra Velázquez, Angel; Valdés Cuadrado, Luis

    2014-06-01

    Although during the last few years there have been several important changes in the diagnostic or therapeutic methods, pleural effusion is still one of the diseases that the respiratory specialist have to evaluate frequently. The aim of this paper is to update the knowledge about pleural effusions, rather than to review the causes of pleural diseases exhaustively. These recommendations have a longer extension for the subjects with a direct clinical usefulness, but a slight update of other pleural diseases has been also included. Among the main scientific advantages are included the thoracic ultrasonography, the intrapleural fibrinolytics, the pleurodesis agents, or the new pleural drainages techniques. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

  15. Intrapleural instillation of radioactive chromic phosphate in malignant pleural effusion

    Energy Technology Data Exchange (ETDEWEB)

    Nori, D.; Moorthy, C.R.; Hilaris, B.S.; Batata, M.A.; Chu, F.; Martini, N. (Memorial Sloan-Kettering Cancer Center, New York (USA))

    1981-12-01

    Eighty-five patients with pleural effusion were analyzed to determine the degree of response to intrapleural instillation of /sup 32/P colloidal suspension. Worthwhile palliation of either complete fluid suppression or definite diminution in the rate of accumulation was achieved in slightly more than one-half of the patients (51/85). It is not evident whether the primary site and histologic nature of the neoplasm are important or not in predicting the results of treatment. Patients with pleural adhesions and those with sanguinous effusions, are less likely to be benefited by the /sup 32/P instillation. The beneficial effect appears quite promptly in some patients, while in others, it may be delayed for several weeks.

  16. Bilateral pleural effusion after central venous catheterization- A rare complication.

    Directory of Open Access Journals (Sweden)

    Reyaz Ahmed Para

    2015-12-01

    Full Text Available Central venous Catherization (CVC is rarely complicated by pleural effusion. It is usually due to malpositioned catheter. Our patient was a 35-year-old man admitted with Menningoencephalitis.A cervical central vein catheter was placed into his right jugular vein after induction of anaesthesia in Emergency Room. In chest x ray we encountered bilateral pleural effusion and drained it with a chest tube. During following days the patient has daily drainage of almost 1.7 liter of clear yellowish fluid from chest tube. Fluid analysis was not diagnostic. We removed the central vein catheter and plural drainage was stopped. [Natl J Med Res 2015; 5(4.000: 329-331

  17. Advance of Therapeutic Methods for Malignant Pleural Effusion

    Directory of Open Access Journals (Sweden)

    Tao-tao XU

    2016-06-01

    Full Text Available Malignant pleural effusion (MPE is a condition caused by primary malignant tumors in the pleura or other malignant tumors metastasis to the pleura. It is also one of common serious complications of middle-late malignant tumor, which has severe impact on the quality of life, even threatening the life of the patients. The selection of treatments for MPE depends on many factors, including the symptoms, performance status, primary tumor types, response to systemic therapy, and degree of lung recruitment maneuvers (LRM after drainage of pleural effusion. Generally, the treatment methods include thoracentesis, indwelling pleural catheter, pleurodesis, intrapleural injection of drugs, chemotherapy, radiotherapy, anti-angiogenesis therapy, surgery, and thermotherapy. With the in-depth study on pathogenesis of MPE, the treatments of MPE have continuous improvements. This study mainly reviewed the treatment methods for MPE so as to provide the basis for clinical practice in the future.

  18. Impact of Project Leadership Facets on Project Outcome

    Directory of Open Access Journals (Sweden)

    Arslan Ayub

    2015-08-01

    Full Text Available The study analyzes the role of project leadership facets on effective project outcome. Numerous such initiatives have already been taken on project outcome/performance in the context of apposite leadership styles or project management. However, the current study is unique in the milieu of project outcome that it introduces a new leadership approach, which throws light on the significance of variant leadership facets on project outcome. The study uses explanatory approach; primary data is collected from project management professionals working in different project organizations. The study uses structural equation model (SEM technique to test the hypothesis. The study found a positive relationship between project leadership facets and project outcome.

  19. Ewing’s Sarcoma Presenting as Pleural Effusion

    Directory of Open Access Journals (Sweden)

    Nuzhat Husain

    2011-09-01

    Full Text Available  A 20-year-old female presented to the Pulmonary Medicine Department with complaints of fever, left sided chest pain and progressive dyspnoea of four months duration. Radiological examination revealed a mass lesion with massive pleural effusion and rib erosion. Histopathology showed neoplastic cells with scanty cytoplasm, hyperchromatic nuclei and rosette formation suggestive of Ewing sarcoma. The rarity of this tumor and its unusual presentation prompted this report.

  20. Pleuropulmonary blastoma presenting as a complicated pleural effusion.

    LENUS (Irish Health Repository)

    O'Brien, J

    2012-02-01

    Pleuropulmonary blastoma (PPB) is a rare tumour of mesenchymal cells. We present a case of PPB in a child, which presented to the emergency department with an extensive pleural effusion. We discuss the radiological features, pathology, classification and treatment of this condition. This case reiterates the importance of considering this diagnosis prior to surgical intervention, to improve the long term prognosis of this aggressive disease.

  1. Lava effusion rate definition and measurement--A review

    Science.gov (United States)

    Calvari, Sonia; Dehn, Jonathan; Harris, A.

    2007-01-01

    Measurement of effusion rate is a primary objective for studies that model lava flow and magma system dynamics, as well as for monitoring efforts during on-going eruptions. However, its exact definition remains a source of confusion, and problems occur when comparing volume flux values that are averaged over different time periods or spatial scales, or measured using different approaches. Thus our aims are to: (1) define effusion rate terminology; and (2) assess the various measurement methods and their results. We first distinguish between instantaneous effusion rate, and time-averaged discharge rate. Eruption rate is next defined as the total volume of lava emplaced since the beginning of the eruption divided by the time since the eruption began. The ultimate extension of this is mean output rate, this being the final volume of erupted lava divided by total eruption duration. Whether these values are total values, i.e. the flux feeding all flow units across the entire flow field, or local, i.e. the flux feeding a single active unit within a flow field across which many units are active, also needs to be specified. No approach is without its problems, and all can have large error (up to ∼50%). However, good agreement between diverse approaches shows that reliable estimates can be made if each approach is applied carefully and takes into account the caveats we detail here. There are three important factors to consider and state when measuring, giving or using an effusion rate. First, the time-period over which the value was averaged; second, whether the measurement applies to the entire active flow field, or a single lava flow within that field; and third, the measurement technique and its accompanying assumptions.

  2. Eosinophilia in Pleural Effusions: a Speculative Negative Predictor for Malignancy.

    Science.gov (United States)

    Chu, Fang-Yeh; Liou, Ching-Biau; Sun, Jen-Tang; Bei, Chia-Hao; Liou, Tse-Hsuan; Tan, N-Chi; Yu, Yun-Chieh; Chang, Chih-Chun; Yen, Tzung-Hai; Su, Ming-Jang

    2016-01-01

    Eosinophilic pleural effusion (EPE) is an eosinophil count more than 10% on cytology of pleural samples. Recently, it was reported that malignancy had been the most prevalent cause inducing EPE. Therefore, we conducted an analysis on the prevalence and etiology of EPE and investigated the relationship between EPE and malignancy. Data for pleural cell differential count from patients receiving thoracentesis during the period from January 2008 to December 2013 were compared with clinical data and established diagnosis of patients obtained via electronic chart review. A total of 6,801 requests of pleural cytology from 3,942 patients with pleural effusion who had received thoracentesis were available at Far Eastern Memorial Hospital from 2008 to 2013, and of these subjects, 115 (2.9%) were found to have EPE. The most frequent cause of EPE was malignancy (33.0%, n=38), followed by parapneumonic effusions (27.8%, n=32), tuberculosis pleuritis (13.9%, n=16), transudate effusions (12.2%, n=14) and the presence of blood or air in pleural space (10.4%, n=12). Additionally, an inverse relationship of eosinophilia in pleural fluid was identified in patients with malignancy and EPE. The cut-off eosinophil count in pleural fluid was 15% for the most accurate discrimination between malignancy and benign disorders in patients with EPE. At the cut-off level, the sensitivity and specificity were 65.8% and 67.5%, respectively. Pleural fluid eosinophilia was a speculative negative predictor for malignancy, despite the fact that cancers, including lung cancers and metastatic cancers to lung, were the most leading cause of pleural fluid eosinophilia. An inverse correlation was observed between the pleural eosinophil percentage and the likelihood of malignancy in patients with EPE.

  3. Pleural effusions in patients with acute leukemia and myelodysplastic syndrome.

    Science.gov (United States)

    Faiz, Saadia A; Bashoura, Lara; Lei, Xiudong; Sampat, Keeran R; Brown, Tiffany C; Eapen, George A; Morice, Rodolfo C; Ferrajoli, Alessandra; Jimenez, Carlos A

    2013-02-01

    Pleural effusions are rarely observed in patients with acute myelogenous leukemia (AML), acute lymphocytic leukemia (ALL) and myelodysplastic syndrome (MDS)/myeloproliferative neoplasm (MPN). Therefore the underlying etiology of pleural effusions and the efficacy and safety of pleural procedures in this population has not been well studied. In a retrospective review of cases from 1997 to 2007, we identified 111 patients with acute leukemia or MDS/MPN who underwent pleural procedures. Clinical characteristics were reviewed, and survival outcomes were estimated by Kaplan-Meier methods. A total of 270 pleural procedures were performed in 111 patients (69 AML, 27 ALL, 15 MDS/MPN). The main indications for pleural procedures were possible infection (49%) and respiratory symptoms (48%), and concomitant clinical symptoms included fever (34%), dyspnea (74%), chest pain (24%) and cough (37%). Most patients had active disease (61%). The most frequent etiology of pleural effusions was infection (47%), followed by malignancy (36%). Severe thrombocytopenia (platelet count < 20 × 10(3)/µL) was present in 43% of the procedures, yet the procedural complication rate was only 1.9%. Multivariate analysis revealed that older age, AML, MDS/MPN and active disease status were associated with a shorter median overall survival. Infection and malignant involvement are the most common causes of pleural effusion in patients with acute leukemia or MDS. After optimizing platelet count and coagulopathy, thoracentesis may be performed safely and with high diagnostic yield in this population. Survival in these patients is determined by the response to treatment of the hematologic malignancy.

  4. Unusual complication of otitis media with effusion: facial nerve paralysis.

    Science.gov (United States)

    Vayisoglu, Yusuf; Gorur, Kemal; Ozcan, Cengiz; Korlu, Savaş

    2011-07-01

    Facial nerve paralysis (FNP) is a very rare complication of otitis media with effusion (OME). There are few patients with OME and FNP in the literature. A 5-year-old girl was admitted to our department with right facial weakness. Right FNP and right OME were diagnosed on the examination. After medical treatment and ventilation tube insertion, FNP completely resolved. The symptoms, signs, and management of this patient are presented.

  5. Otitis Media with Effusion: Its Significance in the Deaf Student.

    Science.gov (United States)

    1982-06-01

    therefore, is an exudate rather than a transudate . This theory has its pro- ponents supported by studies such as Sades.38 He reported that his studies showed...chronic negative pressure in the middle ear which results in a transudate in the middle ear space. Pro- ponents of this theory postulate two types of...middle ear space. This lack of ventilation results in a negative middle ear pressure followed by a transudate (effusion) into the middle ear space. The

  6. Differentiating Pleural Effusions: Criteria Based on Pleural Fluid Cholesterol

    OpenAIRE

    Srinath Dhandapani; Sivakumar Reddy; Rajalakshmi Rajagopalan

    2016-01-01

    Objective: To assess the efficacy of pleural fluid cholesterol in differentiating transudates and exudates as compared with Light’s criteria. Methods: Patients with pleural effusion during a 6-month period were enrolled in the study and underwent thoracentesis. Pleural fluid was analyzed for the levels of protein, lactate dehydrogenase (LDH), and cholesterol. Etiological diagnosis, which was established after considering clinical and biochemical factors, was the gold standard for com...

  7. Atypical presentation of Boerhaave's syndrome as Enterococcal bacterial pericardial effusion.

    Science.gov (United States)

    Saha, Arin; Jarvis, Martin; Thorpe, James A C; O'Regan, David J

    2007-02-01

    Boerhaave's perforation is a serious condition describing spontaneous transmural perforation of the oesophagus. The classical presentation of this condition is vomiting, lower thoracic pain and subcutaneous emphysema. However, the condition often presents atypically and it is important to reach the correct diagnosis quickly. We present the case of a 54-year-old woman with a Boerhaave's perforation that presented as Enterococcal bacterial pericardial effusion.

  8. Craniofacial morphology and otitis media with effusion in children.

    Science.gov (United States)

    Di Francesco, Renata; Paulucci, Bruno; Nery, Claudio; Bento, Ricardo Ferreira

    2008-08-01

    Otitis media with effusion (OME) affects 28-38% of pre-school children, and it occurs due to the dysfunction of the auditory tube. Anatomical development of the auditory tube depends on the craniofacial growth and development. Deviations of normal craniofacial morphology and growth using cephalometric studies, may predict the evolution of otitis. Our goal in this paper is to determine if there are differences in craniofacial morphology between children with adenoid enlargement, with and without otitis media with effusion. This is a prospective study in which the sample consisted of 67 children (male and female) from 5 to 10 years old. All patients presented chronic upper airway obstruction due to tonsil and adenoid enlargement (>80% degree of obstruction). Thirty-three patients presented otitis media with effusion, for more than 3 months and 34 did not. The latter composed the control group. Standardized lateral head radiographs were obtained for all subjects. Radiographs were taken with patient positioned by a cephalostat and stayed with mandibles in centric occlusion and lips at rest. Radiographs were digitalized and specific landmarks were identified using a computer program Radiocef 2003, 5th edition. Measurements, angles and lines were taken of the basicranium, maxilla and mandible according to the modified Ricketts analysis. In addition, facial height and facial axis were determined. Children with otitis media with effusion present differences in the morphology of the face, regarding these measures: N-S (anterior cranial base length), N-ANS (upper facial height), ANS-PNS (size of the hard palate), Po-Or.N-Pog (facial depth), Ba-N.Ptm-Gn (facial axis), Go-Me (mandibular length) and Vaia--Vaip (inferior pharyngeal airway).

  9. Extramedullary Acute Myeloid Leukemia (AML: Leukemic Pleural Effusion, Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Naveen ePemmaraju

    2014-06-01

    Full Text Available Objective and Importance: Malignant pleural effusions occur in the setting of both solid and hematologic malignancies. Pleural effusion caused by leukemic infiltration is an unusual extramedullary manifestation of acute myeloid leukemia (AML with fewer than 20 cases reported.1-11 We report a case of pericardial and pleural effusions in a patient with AML and review the literature. Clinical presentation: In this case, a 55 year old man with previous history of myeloproliferative neoplasm (MPN experienced transformation AML, heralded by appearance of leukemic pleural effusions. The patient was identified to have leukemic pleural effusion based upon extended cytogenetic analysis of the pleural fluid, as morphologic analysis alone was insufficient. Intervention: The patient was treated with hypomethylator-based and intensive chemotherapy strategies, both of which maintained resolution of the effusions in the remission setting. Conclusion: Due to the rarity of diagnosis of leukemic pleural effusions, both cytogenetic and fluorescence in situ hybridization (FISH testing are recommended. Futhermore, systemic chemotherapy directed at the AML can lead to complete resolution of leukemic pleural effusions. Objective and ImportancePleural effusion caused by leukemic infiltration is an unusual extramedullary manifestation of acute myeloid leukemia (AML, but may be more common than previously thought. Fewer than 20 cases have been reported.1-11 We report a case of pericardial and pleural effusions in a patient with AML and review the literature.

  10. Video-assisted pericardial fenestration for effusions after cardiac surgery.

    Science.gov (United States)

    Georghiou, Georgios P; Porat, Eyal; Fuks, Avi; Vidne, Bernardo A; Saute, Milton

    2009-10-01

    Delayed-onset pericardial effusion following cardiac surgery can give rise to significant morbidity due to its presentation as well as management by traditional surgical techniques. An institutional experience of a video-assisted thoracoscopic technique to create a pericardial window, with the advantages of a minimally invasive approach combined with excellent visualization in such patients, was reviewed. A retrospective analysis was conducted on all patients undergoing video-assisted thoracoscopic for delayed pericardial effusion after cardiac surgery from January 2001 to January 2006 at our center. Seven patients with echocardiographically diagnosed delayed tamponade underwent video-assisted thoracoscopy; 5 were receiving anticoagulants after valve replacement, and 2 had undergone heart transplantation. Pericardial windows were created under general anesthesia and single-lung ventilation using 2 to 3 trocars. Mean operative time was 45 min. There were no complications of the thoracoscopic technique. Video-assisted thoracoscopic creation of a pericardial window is safe and effective treatment for loculated pericardial effusions secondary to cardiac surgery.

  11. Perirenal effusion in dogs and cats with acute renal failure.

    Science.gov (United States)

    Holloway, Andrew; O'Brien, Robert

    2007-01-01

    Perirenal fluid accumulation has been described as an ultrasonographic feature of urine leakage, hemorrhage, abscessation, or neoplasia. The purpose of this retrospective study was to report perirenal effusion as an additional ultrasonographic finding in canine and feline patients with acute renal failure. The causes of acute renal failure in 18 patients included nephrotoxicity (4), leptospirosis (3), ureteral obstruction (2), renal lymphoma (2), ureteronephrolithiasis (2), prostatic urethral obstruction (1) and interstitial nephritis and ureteritis (1). An underlying cause was not identified in three patients. The sonographic finding of perirenal fluid was bilateral in 15 patients. Unilateral perirenal fluid was identified ipsilateral to the site of ureteric obstruction in two patients. Large effusions extended into the caudal retroperitoneal space. Additional sonographic findings suggestive of renal parenchymal disease included mild (5), moderate (5) or severe (2) pyelectasia, increased renal echogenicity (11), increased (9) or decreased renal size (2) and ureteral and/or renal calculi (3). There did not appear to be an association between the volume of perirenal fluid and the severity of renal dysfunction. All patients with large effusions underwent euthanasia. Perirenal fluid developing in acute renal failure is thought to be an ultrafiltrate associated with tubular back-leak into the renal interstitium that overwhelms lymphatic drainage within the perirenal and retroperitoneal connective tissues although obstruction to urine flow may also play a role. Localized perirenal retroperitoneal free fluid may be a useful ultrasonographic feature to assist with the characterization of, and determination of prognosis in, patients with suspected renal disease.

  12. Pleural Fluid Cholesterol in Differentiating Exudative and Transudative Pleural Effusion

    Directory of Open Access Journals (Sweden)

    A. B. Hamal

    2013-01-01

    Full Text Available Objectives. To study the diagnostic value of pleural fluid cholesterol in differentiating transudative and exudative pleural effusion. To compare pleural fluid cholesterol level for exudates with Light’s criteria. Design. Cross sectional descriptive study. Settings. Medical wards of Tribhuvan University Teaching Hospital. Methods. Sixty two cases of pleural effusion with definite clinical diagnosis admitted in TUTH were taken and classified as transudates (19 and exudates (43. The parameters pleural fluid protein/serum protein ratio (pfP/sP, pleural fluid LDH/ serum LDH ratio, pleural fluid LDH (pfLDH and pleural fluid cholesterol (pCHOL were compared with clinical diagnosis with regard to their usefulness for distinguishing between pleural exudates and transudates. Results. The pCHOL values determined were for exudates, for transudates, the differences between the transudates and others are statistically significant (. It is seen that pfP/sP ratio has a sensitivity of 81.4% and specificity of 82.6%; pfLDH/sLDH ratio has a sensitivity of 86% and specificity of 94.7% and pCHOL with sensitivity of 97.7% and specificity of 100% for differentiating exudative and transudative PE. Conclusion. The determination of pCHOL is of great value for distinguishing between pleural exudates and transudates and should be included in routine laboratory analysis of pleural effusion.

  13. Pleural Fluid Cholesterol in Differentiating Exudative and Transudative Pleural Effusion

    Science.gov (United States)

    Hamal, A. B.; Yogi, K. N.; Bam, N.; Das, S. K.; Karn, R.

    2013-01-01

    Objectives. To study the diagnostic value of pleural fluid cholesterol in differentiating transudative and exudative pleural effusion. To compare pleural fluid cholesterol level for exudates with Light's criteria. Design. Cross sectional descriptive study. Settings. Medical wards of Tribhuvan University Teaching Hospital. Methods. Sixty two cases of pleural effusion with definite clinical diagnosis admitted in TUTH were taken and classified as transudates (19) and exudates (43). The parameters pleural fluid protein/serum protein ratio (pfP/sP), pleural fluid LDH/ serum LDH ratio, pleural fluid LDH (pfLDH) and pleural fluid cholesterol (pCHOL) were compared with clinical diagnosis with regard to their usefulness for distinguishing between pleural exudates and transudates. Results. The pCHOL values determined were 1.92 ± 0.75 for exudates, 0.53 ± 0.28 for transudates, the differences between the transudates and others are statistically significant (P exudative and transudative PE. Conclusion. The determination of pCHOL is of great value for distinguishing between pleural exudates and transudates and should be included in routine laboratory analysis of pleural effusion. PMID:23365740

  14. Joint ventures

    DEFF Research Database (Denmark)

    Sørensen, Karsten Engsig

    Afhandlingen analysere de konkurrenceretlige og selskabsretlige regler som er bestemmende for hvordan et joint venture samarbejde er struktureret......Afhandlingen analysere de konkurrenceretlige og selskabsretlige regler som er bestemmende for hvordan et joint venture samarbejde er struktureret...

  15. Joint swelling

    Science.gov (United States)

    ... chap 275. Raftery AT, Lim E, Ostor AJK. Joint disorders. In: Raftery AT, Lim E, Ostor AJK, eds. ... A.M. Editorial team. Related MedlinePlus Health Topics Joint Disorders Browse the Encyclopedia A.D.A.M., Inc. ...

  16. Hydrothermal growth of multi-facet anatase spheres

    Science.gov (United States)

    Wu, Jin-Ming; Song, Xiao-Mei; Ma, Lu-Yao; Wei, Xiao-Dan

    2011-03-01

    Titania with various nanostructures can be synthesized by several F --mediated procedures. In this paper, we report the synthesis of a novel multi-facet microsphere consisting of etched single-crystalline anatase by simply immersing metallic Ti plates in an HF aqueous solution under hydrothermal conditions. The etched multi-facet sphere was found to grow through the nucleation and growth of truncated bipyramids on a previously precipitated one to assemble a microsphere, and its subsequent etching by HF to expose the thermodynamic stable {1 0 1} facets. The photocatalytic activity of such etched multi-facet sphere thin films was evaluated utilizing rhodamine B and sulfonic salicylic acid in water as target molecules and compared with commercial Degussa P25 titania nanoparticles.

  17. Diagnostic accuracy of Ber-EP4 for metastatic adenocarcinoma in serous effusions: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Bo Wang

    Full Text Available Numerous studies have investigated the utility of Ber-EP4 in differentiating metastatic adenocarcinoma (MAC from malignant epithelial mesothelioma (MM and/or reactive mesothelial cells (RM in serous effusions. However, the results remain controversial. The aim of this study is to determine the overall accuracy of Ber-EP4 in serous effusions for MAC through a meta-analysis of published studies. Publications addressing the accuracy of Ber-EP4 in the diagnosis of MAC were selected from the Pubmed, Embase and Cochrane Library. Data from selected studies were pooled to yield summary sensitivity, specificity, positive and negative likelihood ratio (LR, diagnostic odds ratio (DOR, and receiver operating characteristic (SROC curve. Statistical analysis was performed by Meta-Disc 1.4 and STATA 12.0 softwares. 29 studies, based on 2646 patients, met the inclusion criteria and the summary estimating for Ber-EP4 in the diagnosis of MAC were: sensitivity 0.8 (95% CI: 0.78-0.82, specificity 0.94 (95% CI: 0.93-0.96, positive likelihood ratio (PLR 12.72 (95% CI: 8.66-18.7, negative likelihood ratio (NLR 0.18 (95% CI: 0.12-0.26 and diagnostic odds ratio 95.05 (95% CI: 57.26-157.77. The SROC curve indicated that the maximum joint sensitivity and specificity (Q-value was 0.91; the area under the curve was 0.96. Our findings suggest that BER-EP4 may be a useful diagnostic adjunctive tool for confirming MAC in serous effusions.

  18. Diagnostic accuracy of Ber-EP4 for metastatic adenocarcinoma in serous effusions: a meta-analysis.

    Science.gov (United States)

    Wang, Bo; Li, Diandian; Ou, Xuemei; Yi, Qun; Feng, Yulin

    2014-01-01

    Numerous studies have investigated the utility of Ber-EP4 in differentiating metastatic adenocarcinoma (MAC) from malignant epithelial mesothelioma (MM) and/or reactive mesothelial cells (RM) in serous effusions. However, the results remain controversial. The aim of this study is to determine the overall accuracy of Ber-EP4 in serous effusions for MAC through a meta-analysis of published studies. Publications addressing the accuracy of Ber-EP4 in the diagnosis of MAC were selected from the Pubmed, Embase and Cochrane Library. Data from selected studies were pooled to yield summary sensitivity, specificity, positive and negative likelihood ratio (LR), diagnostic odds ratio (DOR), and receiver operating characteristic (SROC) curve. Statistical analysis was performed by Meta-Disc 1.4 and STATA 12.0 softwares. 29 studies, based on 2646 patients, met the inclusion criteria and the summary estimating for Ber-EP4 in the diagnosis of MAC were: sensitivity 0.8 (95% CI: 0.78-0.82), specificity 0.94 (95% CI: 0.93-0.96), positive likelihood ratio (PLR) 12.72 (95% CI: 8.66-18.7), negative likelihood ratio (NLR) 0.18 (95% CI: 0.12-0.26) and diagnostic odds ratio 95.05 (95% CI: 57.26-157.77). The SROC curve indicated that the maximum joint sensitivity and specificity (Q-value) was 0.91; the area under the curve was 0.96. Our findings suggest that BER-EP4 may be a useful diagnostic adjunctive tool for confirming MAC in serous effusions.

  19. Framework Application for Core Edge Transport Simulation (FACETS)

    Energy Technology Data Exchange (ETDEWEB)

    Malony, Allen D; Shende, Sameer S; Huck, Kevin A; Mr. Alan Morris, and Mr. Wyatt Spear

    2012-03-14

    The goal of the FACETS project (Framework Application for Core-Edge Transport Simulations) was to provide a multiphysics, parallel framework application (FACETS) that will enable whole-device modeling for the U.S. fusion program, to provide the modeling infrastructure needed for ITER, the next step fusion confinement device. Through use of modern computational methods, including component technology and object oriented design, FACETS is able to switch from one model to another for a given aspect of the physics in a flexible manner. This enables use of simplified models for rapid turnaround or high-fidelity models that can take advantage of the largest supercomputer hardware. FACETS does so in a heterogeneous parallel context, where different parts of the application execute in parallel by utilizing task farming, domain decomposition, and/or pipelining as needed and applicable. ParaTools, Inc. was tasked with supporting the performance analysis and tuning of the FACETS components and framework in order to achieve the parallel scaling goals of the project. The TAU Performance System® was used for instrumentation, measurement, archiving, and profile / tracing analysis. ParaTools, Inc. also assisted in FACETS performance engineering efforts. Through the use of the TAU Performance System, ParaTools provided instrumentation, measurement, analysis and archival support for the FACETS project. Performance optimization of key components has yielded significant performance speedups. TAU was integrated into the FACETS build for both the full coupled application and the UEDGE component. The performance database provided archival storage of the performance regression testing data generated by the project, and helped to track improvements in the software development.

  20. Smallest Archimedean Screw: Facet Dynamics and Friction in Multiwalled Nanotubes.

    Science.gov (United States)

    Guerra, Roberto; Leven, Itai; Vanossi, Andrea; Hod, Oded; Tosatti, Erio

    2017-08-28

    We identify a new material phenomenon, where minute mechanical manipulations induce pronounced global structural reconfigurations in faceted multiwalled nanotubes. This behavior has strong implications on the tribological properties of these systems and may be the key to understand the enhanced interwall friction recently measured for boron-nitride nanotubes with respect to their carbon counterparts. Notably, the fast rotation of helical facets in these systems upon coaxial sliding may serve as a nanoscale Archimedean screw for directional transport of physisorbed molecules.

  1. Joint ventures

    NARCIS (Netherlands)

    M.N. Hoogendoorn (Martin)

    2009-01-01

    textabstractEen veel voorkomende wijze van samenwerking tussen ondernemingen is het uitvoeren van activiteiten in de vorm van een joint venture. Een joint venture is bijna altijd een afzonderlijke juridische entiteit. De partners in de joint venture voeren gezamenlijk de zeggenschap uit. In internat

  2. Joint ventures

    NARCIS (Netherlands)

    M.N. Hoogendoorn (Martin)

    2009-01-01

    textabstractEen veel voorkomende wijze van samenwerking tussen ondernemingen is het uitvoeren van activiteiten in de vorm van een joint venture. Een joint venture is bijna altijd een afzonderlijke juridische entiteit. De partners in de joint venture voeren gezamenlijk de zeggenschap uit. In internat

  3. Thoracoscopic pericardial fenestration for persistent pericardial effusion after radiotherapy for esophageal cancer. Report of a case

    Energy Technology Data Exchange (ETDEWEB)

    Sakamoto, Kazuhiro; Tsuchida, Kazuhito; Ariga, Takamitsu [Yokohama Rosai Hospital (Japan)

    2002-11-01

    We performed thoracoscopic pericardial fenestration for persistent pericardial effusion after radiotherapy for esophageal cancer. An 85-year-old man who had radiation therapy (70.2 Gy) for esophageal cancer was admitted for shortness of breath. Chest computed tomography showed a pericardial effusion. During the 6 months prior to this admission, the patient had undergone percutaneous pericardial drainage 3 times for cardiac tamponade. We performed thoracoscopic partial pericardiectomy with creation of a pleuropericardial window via one access port. Histopathologically, no malignant cells were found in either the resected pericardium or the pericardial effusion. Therefore, we believe the persistent pericardial effusion was secondary to radiotherapy. There was no recurrence of the pericardial effusion for 7 months postoperatively. In summary, thoracoscopic pericardial fenestration is useful in both the diagnosis and treatment of persistent pericardial effusion. (author)

  4. Facet-selective photodeposition of gold nanoparticles on faceted ZnO crystals for visible light photocatalysis.

    Science.gov (United States)

    Wang, Xuewen; Wang, Wuyou; Miao, Yuanquan; Feng, Gang; Zhang, Rongbin

    2016-08-01

    Hexagonal prism-like ZnO crystals dominated with polar facets were synthesized using a hydrothermal method. The Gold (Au) nanoparticles were selectively photodeposited on the polar surfaces of faceted ZnO crystals as a result of anisotropic photocatalytic activities of the polar and nonpolar facets. The size of Au nanoparticles uniformly dispersed on the polar facets increased with increasing Au-loading amount. These Au-loaded ZnO crystals showed an additional visible light absorption band from 400nm to 800nm. The 0.1wt% Au-loaded ZnO crystals with visible light absorption peak at approximately 690nm exhibited the highest photocatalytic activity under visible light irradiation.

  5. High IL-35 Pleural Expression in Patients with Tuberculous Pleural Effusion

    OpenAIRE

    2015-01-01

    Background IL-35 is a novel anti-inflammatory and immunosuppressive cytokine primarily produced by Treg cells, and is involved in inflammatory diseases and autoimmune diseases. However, its roles in tuberculous pleural effusion (TPE) remain unknown. We aimed to investigate the potential involvement of IL-35 in TPE. Material/Methods Thirty TPE patients and 20 lung cancer patients with malignant pleural effusion (MPE) were recruited. Samples of pleural effusion (100 mL) were collected after tra...

  6. Video-Assisted Thoracoscopic Pericardial Window in the Treatment of Pericardial Effusion: Report of Two Cases

    OpenAIRE

    2013-01-01

    A 54-year-old man had a history of subxiphoid pericardial window due to suspected tuberculous effusions. Seventeen years later, following chronic heart failure and implantation of a pacemaker, he again developed pericardial and pleural effusion, requiring repeated percutaneous pericardiocentesis, pleurocentesis and chest tube drainage. A 5×5-cm section of pericardium was successfully resected with video-assisted thoracic pericardial window. No recurrence of pericardial effusion has since been...

  7. [Systematization of the articular surfaces of the carpometacarpal joints (author's transl)].

    Science.gov (United States)

    el Bacha, A; Maillot, C

    1977-01-01

    A study, done on 100 hands, of the systematization of the articular surfaces of the carpometacarpal joints, clearly delineates the variability of circumference, dimesions, and relief of the articular facets. An attempt to draw general conclusions from this morphological study, in terms of arthrokinetics, leads to an understanding of the nature of the joints and the movements that are performed at this site.

  8. Publication Ethics: Many Facets, Collaboration Required

    Directory of Open Access Journals (Sweden)

    Viroj Wiwanitkit

    2013-05-01

    Full Text Available Sir, the recent publication on “Publication Ethics” is very interesting (1. The article by Fazly Bazzaz and Sadeghi demonstrated many interesting cases                   of misconducts. Indeed, the misconducts can be seen  in many ways. As mentioned in the present publication, both author and editor can perform publication misconducts. Nevertheless, the problem has many more facets. Sometimes, the misconducts                      are generated by the third parties. For example, the publisher can perform publication misconduct.                  In fact, the editor takes the role in control of                   the materials to be published in the journal. However, the publisher sometimes interferes with the process. Some unethical publication can be seen in some “predator” online publisher. “Pay then publish” without control of its quality can be seen                      (see also http://www.nature.com/news/predatory-publishers-are-corrupting-open-access-1.11385 and scholarlyoa.com/2012/12/06/bealls-list-of-edatory-publishers-2013. In the present era of rapidly increased number of open access journal, this problem is expected to increase. Another example is the criminal case of “one disguising to be the other person” to perform misconduct aiming at discrediting or destroying others. An interesting case was previously published in Hepatitis Monthly; an author performed plagiarized articles behind the name of another person and finally was charged by the IT investigation (2. Finally, the institute sometimes also performs misconduct. This can be supporting of their members who perform scientific misconduct by acts which do not correspond to the problem (this problem is usually seen in the problematic case generated by senior faculties or administrators, dealing with publisher to “buy” supplementary volume for publication of the works

  9. Gas effusion of full-mechanized top coal caving in Jiaoping Mine Area

    Institute of Scientific and Technical Information of China (English)

    XU Man-gui; WANG Guo-qi; MIN Long

    2008-01-01

    According to the gas observational data, the gas spatiotemporal distributionswere analyzed in full-mechanized top coal caving in thick, hard and high-gas seams. Thefactors influencing gas effusion were researched and the rules of gas effusion under thespecial conditions were educed, for example, the underground pressure, the output inten-sity, the working surface advancement, and the amount of ventilation in the working faceon gas effusion, and so on. The research results can be the base of forecasting gas effu-sion and controlling gas in these special conditions, which can guarantee the safety ofhighly efficient full-mechanized top coal caving.

  10. Very large incidental pericardial effusion attributable to minoxidil: resolution without drainage.

    Science.gov (United States)

    Nautiyal, Amit; Wong, Timothy; Kumar, Sanjay; Mukherjee, Jayanta T; Schick, Edgar C

    2011-03-01

    We present a case of drug-induced pericardial effusion in a patient with end-stage renal disease. Hypertension is frequent among patients with chronic renal failure and sometimes it is necessary to use agents, like minoxidil. Many papers have reported the association between minoxidil and pericardial effusion, both in dialysis patients and those with normal renal function. These effusions sometimes require drainage because of tamponade, but usually disappear after discontinuation of the drug, which is what happened in our patient. In any patient on dialysis treated with minoxidil, the appearance of pericardial effusion unresponsive to ultrafiltration should launch the suspicion of this complication and the drug should be withdrawn.

  11. Diagnostic yield of cytopathology in evaluating pericardial effusions: Clinicopathologic analysis of 419 specimens.

    Science.gov (United States)

    Saab, Jad; Hoda, Rana S; Narula, Navneet; Hoda, Syed A; Geraghty, Brian E; Nasar, Abu; Alperstein, Susan A; Port, Jeffrey L; Giorgadze, Tamar

    2017-02-01

    Pericardial effusions can cause considerable morbidity and potentially may lead to mortality. Malignant pericardial effusions are uncommon, and data on malignancies encountered in pericardial effusion cytology specimens are limited. Relevant records of all pericardial effusions from January 2008 to September 2014 were examined and compared with pericardial biopsy results when performed. Discrepant cases were reviewed to determine the cause of the disagreement. In total, 419 pericardial effusion specimens obtained from 364 patients were examined. Cytologic diagnostic categories included: negative for malignancy (332 specimens; 79%), equivocal (25 specimens; 6%), and positive (62 specimens from 51 patients; 15%). Forty-seven patients who had positive effusions were known to have malignancy. The most common primary malignancies were breast (39.3%) and lung (39.3%) cancers in women and lung cancer (47.4%) in men. A concurrent pericardial biopsy was performed in 46% of patients. Excluding equivocal cytologic diagnoses, cytology and biopsy were concordant in 153 of 173 paired samples (88.4%). The sensitivity of cytology in diagnosing malignancy was 92.1% compared with 55.3% for pericardial biopsy. Cytologic examination has significant diagnostic utility in the evaluation of pericardial effusions and exhibits a lower false-negative rate compared with pericardial biopsy. Submission of pericardial biopsy alongside effusion cytology is associated with increased sensitivity for detecting malignancy and may be especially useful in the setting of low-volume pericardial effusion. Cancer Cytopathol 2017;125:128-137. © 2016 American Cancer Society. © 2016 American Cancer Society.

  12. Transudative vs exudative pleural effusions: differentiation using Gd-DTPA-enhanced MRI

    Energy Technology Data Exchange (ETDEWEB)

    Frola, C. [IV Divisione Radiologica, Ospedale S. Martino, V. le Benedetto XV, 10, I-16132 Genova (Italy); Cantoni, S. [IV Divisione Radiologica, Ospedale S. Martino, V. le Benedetto XV, 10, I-16132 Genova (Italy); Turtulici, I. [IV Divisione Radiologica, Ospedale S. Martino, V. le Benedetto XV, 10, I-16132 Genova (Italy); Leoni, C. [Divisione di Chirurgia Toracica, Ospedale S. Martino, V. le Benedetto XV, 10, I-16132 Genova (Italy); Loria, F. [IV Divisione Radiologica, Ospedale S. Martino, V. le Benedetto XV, 10, I-16132 Genova (Italy); Gaeta, M. [Servizio di Radiologia, Ospedale Piemonte, I-98100 Messina (Italy); Derchi, L.E. [Cattedra di Radiologia, Universita degli Studi, V. le Benedetto XV, 10, I-16132 Genova (Italy)

    1997-08-01

    The aim of this study was to investigate the capability of Gd-DTPA-enhanced MRI to differentiate between exudative and transudative pleural effusions. An MRI examination was performed on 22 patients with different types of pleural effusion (10 transudative and 12 exudative effusions). T1-weighted SE images were obtained before and 20 min after administration of Gd-DTPA (0.1 mmol/kg). The degree of enhancement of pleural effusions was evaluated both by visual assessement and by quantitative analysis of images. None of 10 transudative effusions showed significative enhancement, whereas 10 of 12 exudative effusions showed enhancement (sensitivity 83 %, specificity 100 %, positive predictive value 100 %). The postcontrast signal intensity ratios (SIRs) of exudates were significantly higher than corresponding precontrast ratios (P = 0.0109) and the postcontrast SIRs of exudates were significantly higher than those of transudates (P = 0.0300). Exudative pleural effusions show a significant enhancement following administration of Gd-DTPA. We presume that this may be caused by increased pleural permeability and more rapid passage of a large amount of Gd-DTPA from the blood into the pleural fluid in case of exudative effusions. In our limited group of patients, signal enhancement proved the presence of an exudative effusion. Absence of signal enhancement suggests a transudate, but does not exclude an exudate. (orig.). With 5 figs., 2 tabs.

  13. Eye Tracking the Use of a Collapsible Facets Panel in a Search Interface

    NARCIS (Netherlands)

    M.J. Kemman (Max); M. Kleppe (Martijn); J. Maarseveen (Jim)

    2013-01-01

    textabstractAbstract. Facets can provide an interesting functionality in digital libraries. However, while some research shows facets are important, other research found facets are only moderately used. Therefore, in this exploratory study we compare two search interfaces; one where the facets panel

  14. A faceted eye on intellectual giftedness: Examining the personality of gifted students using FFM domains and facets

    Directory of Open Access Journals (Sweden)

    Altaras-Dimitrijević Ana

    2012-01-01

    Full Text Available The study examines the personality profile of gifted vs. average-ability students from the perspective of the FFM. The issue was approached by (1 reviewing the literature for well-established personality characteristics of the gifted, (2 establishing correspondences between these traits and FFM domains/facets, and (3 formulating a domain and a facet-level model which were hypothesized to discriminate significantly between gifted and nongifted students. The domain-level model consisted of Openness and Agreeableness. The facet-level model included 14 traits: Anxiety, Impulsiveness, Gregariousness, Assertiveness, Fantasy, Feelings, Aesthetics, Ideas, Compliance, Modesty, Tendermindedness, Order, Achievement, and Deliberation. The models were tested on three samples (N1=515 high-school students, 155 gifted; N2=132 psychology students, 28 gifted; N3=443 psychology students, 91 gifted. Results indicate that the domain-level model does not discriminate significantly between gifted and nongifted students in each sample, whereas the proposed 14-facet model yields a significant discrimination across all samples. The latter model may be further adjusted by removing facets which proved inconsistent or unsubstantial in distinguishing between the two groups. This yields a 7-facet discriminant function, which is also significant across samples, indicating that gifted students are consistently distinguished by a combination of high Ideas, Fantasy, Aesthetics, and Assertiveness, but low Gregariuosness, Modesty, and Tendermindeness. Educational implications and limitations are discussed. [Projekat Ministarstva nauke Republike Srbije, br. 179018

  15. Use of land facets to design linkages for climate change.

    Science.gov (United States)

    Brost, Brian M; Beier, Paul

    2012-01-01

    Least-cost modeling for focal species is the most widely used method for designing conservation corridors and linkages. However, these linkages have been based on current species' distributions and land cover, both of which will change with large-scale climate change. One method to develop corridors that facilitate species' shifting distributions is to incorporate climate models into their design. But this approach is enormously complex and prone to error propagation. It also produces outputs at a grain size (km2) coarser than the grain at which conservation decisions are made. One way to avoid these problems is to design linkages for the continuity and interspersion of land facets, or recurring landscape units of relatively uniform topography and soils. This coarse-filter approach aims to conserve the arenas of biological activity rather than the temporary occupants of those arenas. In this paper, we demonstrate how land facets can be defined in a rule-based and adaptable way, and how they can be used for linkage design in the face of climate change. We used fuzzy c-means cluster analysis to define land facets with respect to four topographic variables (elevation, slope angle, solar insolation, and topographic position), and least-cost analysis to design linkages that include one corridor per land facet. To demonstrate the flexibility of our procedures, we designed linkages using land facets in three topographically diverse landscapes in Arizona, USA. Our procedures can use other variables, including soil variables, to define land facets. We advocate using land facets to complement, rather than replace, existing focal species approaches to linkage design. This approach can be used even in regions lacking land cover maps and is not affected by the bias and patchiness common in species occurrence data.

  16. Role of therapeutic thoracentesis in tuberculous pleural effusion

    Directory of Open Access Journals (Sweden)

    Sourin Bhuniya

    2012-01-01

    Full Text Available Context: Prevalence of tuberculous pleural effusion is very high in the Asian subcontinent but very few studies have come up from this part of the world about the course of recovery of pulmonary functions after institution of anti-tubercular therapy (ATT and thoracentesis. Aims: To study initial lung function impairment, changes over time after institution of ATT and thoracentesis and residual abnormalities left at the end of six months of treatment. Settings and Design: Randomized open level interventional study over two years in 52 patients at a tertiary level teaching hospital. Methods: The study population was divided into two equal groups, A (therapeutic thoracentesis and B (diagnostic thoracentesis. Spirometry, chest radiograph and ultrasonography of thorax were done initially and at each follow-up visit up to six months. Statistical analysis was done (P value < 0.05 considered significant. Results: Both groups were comparable initially. After six months none in group A and five patients in group B had minimal pleural effusion. During follow up, mean percentage predicted of FEV1 and FVC increased more in A than in B and the differences were statistically significant (P < 0.05. Pleural thickening, initially absent in both groups, was found to be more in B as compared to A at subsequent follow-up visits and this was statistically significant (P < 0.05. Conclusions: Thoracentesis should be considered in addition to anti-TB treatment, especially in large effusions, in order to relieve dyspnea, avoid possibility of residual pleural thickening and risk of developing restrictive functional impairment.

  17. CLINICAL PROFILE OF PLEURAL EFFUSION PATIENTS: A TERTIARY CARE HOSPITAL STUDY

    Directory of Open Access Journals (Sweden)

    Harish

    2016-02-01

    Full Text Available OBJECTIVE Pleural effusion refers to the excessive or abnormal accumulation of fluid in the pleural space. Pleural effusion is commonly encountered medical problem and caused by a variety of underlying pathological conditions. It is important to establish an accurate etiological diagnosis, so that the patient may be treated in the most appropriate and rational manner. METHODS This was a prospective study of 56 pleural effusion patients who are attending OPD and admitted cases in the Pulmonary Medicine department in Bhagwan Mahaveer Jain Hospital, Bangalore. The patients were subjected to through clinical history and examination. Thoracocentesis did under aseptic conditions and pleural fluid sent for investigations like protein, sugar, LDH (Lactate Dehydrogenase, ADA (Adenosine Deaminase, gram staining, AFB smear and culture by BACTEC method, cell type, cell count, and malignant cytology. Pleural biopsy was done for those who are willing for the same. Depending upon the history and clinical examinations and laboratory investigations, patients were classified as having exudates and transudates. RESULTS The total of 56 patients with pleural effusion was studied. Mean age of the study group was 43±14.6 years. 39(69.42% patients were male and 17(30.58% patients were female. The commonest type of effusion being tuberculosis (34 followed by malignancy (8, transudative effusion (7, synpneumonic (5 and 2 cases of empyema. The commonest presenting complaints were cough (78.32% and breathlessness (74.76%. Polymorphs were predominant in synpneumonic effusion and empyema and lymphocytes in tubercular effusion. Pleural fluid cytology revealed elevated lymphocytes in tubercular and polymorphs in acute infections. Cytology for malignant cells was positive in 4 cases. The mean increase in ADA level in tubercular pleural effusion, malignant pleural effusion and transudative pleural effusion were 79±19.9 IU/L, 42.6±9.3 and 28.4±8.2 respectively and it was

  18. A rare pleural effusion in a young male

    Directory of Open Access Journals (Sweden)

    Shabana Begum

    2015-01-01

    Full Text Available A 28-year-old male presented with fever with right-sided chest pain for 2 weeks. Clinicoradiological picture was suggestive of right-sided pleural effusion. He had history of polytrauma following a road traffic accident and had to undergo emergency laparotomy a month ago. Microscopic and culture examination of the pleural fluid showed neutrophilia, high bilirubin content and presence of gram-negative bacilli. Ultrasound of the abdomen showed the presence of biloma in the liver and right subdiaphragmatic space with fistulous communication into the right thoracic cavity. The patient was managed successfully with complete recovery.

  19. Effusive Atomic Oven Nozzle Design Using a Microcapillary Array

    CERN Document Server

    Senaratne, Ruwan; Geiger, Zachary A; Fujiwara, Kurt M; Lebedev, Vyacheslav; Weld, David M

    2014-01-01

    We present a simple and inexpensive design for a multichannel effusive oven nozzle which provides improved atomic beam collimation and thus extended oven lifetimes. Using this design we demonstrate an atomic lithium source suitable for trapped-atom experiments. At a nozzle temperature of 525$^{\\circ}$C the total atomic beam flux directly after the nozzle is $1.2 \\times 10^{14}$ atoms per second with a peak beam intensity greater than $5.0 \\times 10^{16}$ atoms per second per steradian. This suggests an oven lifetime of several centuries of continuous operation.

  20. Contemporary management of pericardial effusion: practical aspects for clinical practice.

    Science.gov (United States)

    Imazio, Massimo; Gaido, Luca; Battaglia, Alberto; Gaita, Fiorenzo

    2017-03-01

    A pericardial effusion (PE) is a relatively common finding in clinical practice. It may be either isolated or associated with pericarditis with or without an underlying disease. The aetiology is varied and may be either infectious (especially tuberculosis as the most common cause in developing countries) or non-infectious (cancer, systemic inflammatory diseases). The management is essentially guided by the hemodynamic effect (presence or absence of cardiac tamponade), the presence of concomitant pericarditis or underlying disease, and its size and duration. The present paper reviews the current knowledge on the aetiology, classification, diagnosis, management, therapy, and prognosis of PE in clinical practice.

  1. Clozapine-induced liver injury and pleural effusion

    Directory of Open Access Journals (Sweden)

    Joseph P.M. Kane

    2014-09-01

    Full Text Available Clozapine, whilst associated commonly with a transient and benign increase in liver enzymes, has also been associated with varying presentations of hepatitis in existing case reports. This report describes what we believe to be the first documented case of acute liver injury and pleural effusion associated with clozapine, resolving after cessation of the agent. The case supports existing literature in advocating a high index of suspicion, particularly in the 4-5 weeks following clozapine initiation, when considering nonspecific clinical symptoms and signs.

  2. Vaporization Studies of Olivine via Knudsen Effusion Mass Spectrometry

    Science.gov (United States)

    Costa, G. C. C.; Jacobson, N. S.

    2014-01-01

    Olivine is the major mineral in the Earth's upper mantle occurring predominantly in igneous rocks and has been identified in meteorites, asteroids, the Moon and Mars. Among many other important applications in planetary and materials sciences, the thermodynamic properties of vapor species from olivine are crucial as input parameters in computational modelling of the atmospheres of hot, rocky exoplanets (lava planets). There are several weight loss studies of olivine vaporization in the literature and one Knudsen Effusion Mass Spectrometry (KEMS) study. In this study, we examine a forsterite-rich olivine (93% forsterite and 7% fayalite, Fo93Fa7) with KEMS to further understand its vaporization and thermodynamic properties.

  3. E-cadherin and calretinin as immunocytochemical markers to differentiate malignant from benign serous effusions

    Institute of Scientific and Technical Information of China (English)

    Dong-Nan He; Hua-Sheng Zhu; Kun-He Zhang; Wen-Jian Jin; Wei-Ming Zhu; Ning Li; Jie-Shou Li

    2004-01-01

    AIM: To investigate the expressions of E-cadherin and calretinin in exfoliated cells of serous effusions and evaluate their values in distinguishing malignant effusions from benign ones.METHODS: Fresh serous effusion specimens werecentrifuged and exfoliated cells were collected. Cells were then processed with a standardized procedure, including paraformaldehyde fixation, BSA-PBS solution washing and smears preparation. E-cadherin and calretinin were detected by immunocytochemistry (ICC).RESULTS: In the exfoliated cells of serous effusions, most of carcinoma cells only expressed E-cadherin, and most of mesothelial cells only expressed calretinin, and benign cells (lymphocytes and granulocytes) did not express either of them. For E-cadherin, 85.7% (30/35) of malignant effusions and 8.1% (3/37) of benign fluids were ICC-positive (P<0.001).The sensitivity of E-cadherin ICC in the diagnosis of malignant effusions was 85.7%, specificity 91.9%, and diagnostic rate 88.9%. For calretinin, 94.6% (35/37) of benign effusions and 11.4% (4/35) of malignant effusions were ICC-positive (P<0.001). The sensitivity of calretinin ICC in the diagnosis of benign effusions was 94.6%,specificity 88.6%, and diagnostic rate 91.7%. For diagnosis of benign and malignant effusions by combining E-cadherin ICC and calretinin ICC, the specificities were up to 100%and 97.1%, respectively.CONCLUSION: E-cadherin ICC and calretinin ICC are sensitive and specific in differential diagnosis of benign and malignant serous effusion specimens and specificities are evidently improved when both markers are combined.

  4. Surgical considerations and safety of cochlear implantation in otitis media with effusion.

    Science.gov (United States)

    Cevizci, Rasit; Dilci, Alper; Celenk, Fatih; Karamert, Recep; Bayazit, Yildirim

    2017-07-26

    To evaluate the effects of otitis media with effusion on surgical parameters, patient safety, perioperative and postoperative complications. Total 890 children who underwent cochlear implantation between 2006 and 2015 were included. The ages ranged from 12 months to 63 months (mean: 32 months). The patients were divided into two groups according to the presence or absence of otitis media with effusion; otitis media with effusion group and non-otitis media group. Of 890 children, 105 had otitis media with effusion prior to surgery. In non-otitis media with group, there were 785 children. The average duration of surgery was 60min (ranged from 28 to 75min) in non-otitis media group, and 90min (ranged from 50 to 135min) in otitis media with effusion group (potitis media with effusion during the surgery. There was no significant difference between the complications of groups with or without otitis media with effusion (p>0.05). In 5 of 105 patients, there was a ventilation tube inserted before cochlear implantation, which did not change the outcome of implantation. There is no need for surgical treatment for otitis media with effusion before implantation since otitis media with effusion does not increase the risks associated with cochlear implantation. Operation duration is longer in the presence of otitis media with effusion. However, otitis media with effusion leads to intraoperative difficulties like longer operation duration, bleeding, visualization of the round window membrane, cleansing the middle ear granulations as well as mastoid and petrous air cells. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Identifying and Determining Facets in the Associative Relationships Within and Outside Domain of Islamic Ethics Thesaurus

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    Roghayeh Mohammadi Pilehruod

    2015-09-01

    Full Text Available This research was done with the aim of identifying and determining facets in network of correlated relationships of inside and outside field of Islamic Ethic Thesaurus using content analysis method. The research society consisted of 3316 published terms in Islamic Ethic Thesaurus which have correlated relationship together. The method of data collecting was documentary (Library. According to the findings Personality Facet, with 23 lateral and subset facets and 78.55 percent usage, has the most usage in correlated relationships of Islamic Ethic Thesaurus. The Space Facet without subset facet and 0.05 percent usage, has the minimum usage in correlated relationships of Islamic Ethic Thesaurus. Thus, it can be said that ‘Personality’ Facet has the most frequency, and ‘Space’ Facet has the minimum frequency between facets of network of correlated relationships in concepts of inside and outside field of Islamic Ethic Thesaurus. In this study according to the requirements of Islamic Ethic Thesaurus 6 facets were described which include facets of love and friendship, facets of foundation/basis, facets of pests and damages, facets of internal characteristics/sense, facets of signs and symptoms, and facets of ranks and grade.

  6. Facets of the childhood anxiety sensitivity index among Serbian youth.

    Science.gov (United States)

    Stevanovic, Dejan S; Silverman, Wendy K; Nichols-Lopez, Kristin A; Popovic-Deusic, Smiljka D; Pejovic-Milovancevic, Milica M

    2013-01-01

    Data from factor analytic studies using the Child Anxiety Sensitivity Index (CASI) suggest that global anxiety sensitivity (AS) is best represented by three or four underlying factors or facets. The aim of this study was to identify facets best representing the CASI structure in its Serbian version. Confirmatory factor analysis was used on data collected from 456 non-referred children in Serbia. A 13-item version of the CASI provided a better fit to the data than the original 18-item version. The four-factor model of the CASI-13 with disease, unsteady, mental incapacitation, and social concerns facets provided the best fits for the data and it was found to be fully invariant (configural, metric, and scalar invariance) across gender and age. Among Serbian children, hierarchical structure was found for a 13-item CASI version with a single higher-order factor of global AS represented by four underlying facets. Future research will consider these AS facets and their role in the development, maintenance, and exacerbation of anxiety symptoms in children.

  7. Noble-Metal Nanocrystals with Controlled Facets for Electrocatalysis.

    Science.gov (United States)

    Hong, Jong Wook; Kim, Yena; Kwon, Yongmin; Han, Sang Woo

    2016-08-19

    Noble-metal nanocrystals (NCs) show excellent catalytic performance for many important electrocatalysis reactions. The crystallographic properties of the facets by which the NCs are bound, closely associated with the shape of the NCs, have a profound influence on the electrocatalytic function of the NCs. To develop an efficient strategy for the synthesis of NCs with controlled facets as well as compositions, understanding of the growth mechanism of the NCs and their interaction with the chemical species involved in NC synthesis is quite important. Furthermore, understanding the facet-dependent catalytic properties of noble-metal NCs and the corresponding mechanisms for various electrocatalysis reactions will allow for the rational design of robust electrocatalysts. In this review, we summarize recently developed synthesis strategies for the preparation of mono- and bimetallic noble-metal NCs by classifying them by the type of facets through which they are enclosed and discuss the electrocatalytic applications of noble-metal NCs with controlled facets, especially for reactions associated with fuel-cell applications, such as the oxygen reduction reaction and fuel (methanol, ethanol, and formic acid) oxidation reactions.

  8. The perceived quality of working life and job facet satisfaction

    Directory of Open Access Journals (Sweden)

    E. A. Coster

    1992-06-01

    Full Text Available To improve our understanding of the influence of the domains of the quality of working life on job satisfaction, recent research suggests that job facet satisfaction may be more strongly related to specific job domains than to overall job satisfaction. This study examined the relationships between job facet satisfaction, in eleven specific job facets, overall satisfaction and the perceived quality of working life. The results supported the hypothesis. Similar results were obtained after factor analysing the specific job facets indicating the use of studying specific job domains and their respective job facet satisfactions. Opsomming Ter uitbreiding van ons begrip van watter uitwerking die domeine van die gehalte van werklewe op werkbevrediging het, dui onlangse navorsing daarop dat werkfasetbevrediging moontlik 'n sterker verband met spesifieke werkdomeine as met algemene werkbevrediging toon. In hierdie studie is die verhouding tussen werkfasetbevrediging t.o.v. elf spesifieke werkfasette, algehele bevrediging en die waargenome gehalte van werklewe ondersoek. Die bevindinge ondersteun die gestelde hipotese. Soortgelyke resultate is verkry na faktoranalise van die spesifieke werkfasette, wat daarop dui dat dit nuttig kan wees om spesifieke werkdomeine en die ooreenstemmende werkfasetbevrediging daaraan verbonde te bestudeer.

  9. Facet tropism: comparison of plain film and computed tomography examinations.

    Science.gov (United States)

    Cox, J M; Aspegren, D D; Trier, K K

    1991-01-01

    This study compares the findings of plain film X-ray and computed CT examination in the diagnosis of facet orientation and the presence of tropism. Twenty consecutive patients having lumbar disc disease with sciatica were studied utilizing plain X-ray as well as CT scanning. A chiropractic radiologist read the films to determine if facet facings were sagittally, semi-sagittally or coronally oriented on both CT and plain X-ray study. CT was accepted as the most accurate method to determine the true facet orientation, and plain X-ray interpretation of facet orientation was compared to the CT reading. There was a statistically significant relationship in diagnosing tropism between plain film X-ray and CT readings, with a predictive accuracy that ranged from 58-84% across the three segmental levels. However, the exact concordance of plain film X-ray and CT readings for right and left facet facings was very low. This raises the question of how the profession defines diagnostic accuracy.

  10. Faceted Ranking of Egos in Collaborative Tagging Systems

    CERN Document Server

    Orlicki, Jose Ignacio; Alvarez-Hamelin, José Ignacio

    2008-01-01

    Multimedia uploaded content is tagged and recommended by users of collaborative systems, resulting in informal classifications also known as folksonomies. Faceted web ranking has been proved a reasonable alternative to a single ranking which does not take into account a personalized context. In this paper we analyze the online computation of rankings of users associated to facets made up of multiple tags. Possible applications are user reputation evaluation (ego-ranking) and improvement of content quality in case of retrieval. We propose a solution based on PageRank as centrality measure: (i) a ranking for each tag is computed offline on the basis of the corresponding tag-dependent subgraph; (ii) a faceted order is generated by merging rankings corresponding to all the tags in the facet. The fundamental assumption, validated by empirical observations, is that step (i) is scalable. We also present algorithms for part (ii) having time complexity O(k), where k is the number of tags in the facet, well suited to o...

  11. Modeling of Anomalous Transport in Tokamaks with FACETS code

    Science.gov (United States)

    Pankin, A. Y.; Batemann, G.; Kritz, A.; Rafiq, T.; Vadlamani, S.; Hakim, A.; Kruger, S.; Miah, M.; Rognlien, T.

    2009-05-01

    The FACETS code, a whole-device integrated modeling code that self-consistently computes plasma profiles for the plasma core and edge in tokamaks, has been recently developed as a part of the SciDAC project for core-edge simulations. A choice of transport models is available in FACETS through the FMCFM interface [1]. Transport models included in FMCFM have specific ranges of applicability, which can limit their use to parts of the plasma. In particular, the GLF23 transport model does not include the resistive ballooning effects that can be important in the tokamak pedestal region and GLF23 typically under-predicts the anomalous fluxes near the magnetic axis [2]. The TGLF and GYRO transport models have similar limitations [3]. A combination of transport models that covers the entire discharge domain is studied using FACETS in a realistic tokamak geometry. Effective diffusivities computed with the FMCFM transport models are extended to the region near the separatrix to be used in the UEDGE code within FACETS. 1. S. Vadlamani et al. (2009) %First time-dependent transport simulations using GYRO and NCLASS within FACETS (this meeting).2. T. Rafiq et al. (2009) %Simulation of electron thermal transport in H-mode discharges Submitted to Phys. Plasmas.3. C. Holland et al. (2008) %Validation of gyrokinetic transport simulations using %DIII-D core turbulence measurements Proc. of IAEA FEC (Switzerland, 2008)

  12. Otitis media with effusion (OME in primary care: follow-up protocol

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    José Ignacio BENITO-OREJAS

    2016-07-01

    Full Text Available Introduction and objective: With the intention of improving the quality of care of children with otitis media with effusion (OME, the pediatricians of primary care (PAP have been provided procedures diagnostic and training media, establishing a rule of consensus action. In this paper we present the Protocol developed for the monitoring of OME in children. Method: A team of pediatricians and otolaryngologists from the same Healthcare Area, who have worked to achieve this consensus. Through the published guides and review of the literature on OME, we find his best adaptation to our environment. Results: We expose the necessary steps for the diagnosis, follow-up, referral and documentation of OME in children. Discussion: A correct therapeutic intervention for OME in children involves documenting patient characteristics and clinical findings of the pneumatic otoscopy and tympanometry, perform periodic and vigilant monitoring of potential disruptions, know and apply the reasons for referral to specialized care and maintaining good communication between pediatricians and ENT. Conclusions: The agreement between pediatricians and ENT has helped establish a joint guide of action in children for OME, which together with the improvement of diagnosis, will result in a greater degree of efficiency in the childhood care of OME.

  13. Longitudinal assessment of cyst-like lesions of the knee and their relation to radiographic osteoarthritis and MRI-detected effusion and synovitis in patients with knee pain

    Science.gov (United States)

    2010-01-01

    Introduction The purpose of the present study was to determine the prevalence of cystic lesions and cyst-like bursitides in subjects with frequent knee pain and to assess their relation to radiographic osteoarthritis (OA) severity; to describe bilaterality and size fluctuation of the lesions over 6 months; and to assess relations between the prevalence of synovium-lined lesions communicating with the joint capsule and severity of magnetic resonance imaging (MRI)-detected effusion and synovitis. Methods One hundred and sixty-three subjects (total 319 knees) aged 35 to 65 with chronic, frequent knee pain were included. Imaging with 3 Tesla MRI was performed at baseline and 6-month follow-up with the same protocols as those used in the Osteoarthritis Initiative. Severity of radiographic OA was assessed using the Kellgren-Lawrence grade (0 to 4). Severity of effusion and synovitis was graded 0 to 3 based on the Whole Organ Magnetic Resonance Imaging Score system. The associations of cysts and cyst-like bursitides and severity of radiographic OA, MRI-detected effusion and synovitis were analyzed using logistic regression controlling for clustering by person. The Wilcoxon signed-rank test was used to determine whether there was a significant change in the size of lesions between baseline and follow-up. Results At least one lesion (any type) was present in 222 (70%) knees. The most prevalent lesions were popliteal cysts (40%, 128/319), followed by subgastrocnemius bursitis (15%, 49/319) and proximal tibiofibular joint cysts (8%, 26/319). Bilateral lesions were seen in 49% of the subjects. Only popliteal cysts and subgastrocnemius bursitis showed a significant change in size (P bursitis was associated with increasing severity of effusion (P = 0.0072) and synovitis (P = 0.0033). Conclusions None of the cyst-like lesions analyzed seems to be a marker of radiographic OA severity in knees with chronic frequent pain. Subgastrocnemius bursitis may be used as a marker of effusion

  14. Preliminary impact assessment of effusive eruptions at Etna volcano

    Science.gov (United States)

    Cappello, Annalisa; Michaud-Dubuy, Audrey; Branca, Stefano; De Beni, Emanuela; Del Negro, Ciro

    2016-04-01

    Lava flows are a recurring and widespread form of volcanic activity that threaten people and property around the world. The growing demographic congestion around volcanic structures increases the potential risks and costs that lava flows represent, and leads to a pressing need for faster and more accurate assessment of lava flow impact. To fully evaluate potential effects and losses that an effusive eruption may cause to society, property and environment, it is necessary to consider the hazard, the distribution of the exposed elements at stake and the associated vulnerability. Lava flow hazard assessment is at an advanced state, whereas comprehensive vulnerability assessment is lacking. Cataloguing and analyzing volcanic impacts provide insight on likely societal and physical vulnerabilities during future eruptions. Here we quantify the lava flow impact of two past main effusive eruptions of Etna volcano: the 1669, which is the biggest and destructive flank eruption to have occurred on Etna in historical time, and the 1981, lasting only 6 days, but characterized by an intense eruptive dynamics. Different elements at stake are considered, including population, hospitals, critical facilities, buildings of historic value, industrial infrastructures, gas and electricity networks, railways, roads, footways and finally land use. All these elements were combined with the 1669 and 1981 lava flow fields to quantify the social damage and economic loss.

  15. Delayed Diaphragmatic Herniation Masquerading as a Complicated Parapneumonic Effusion

    Directory of Open Access Journals (Sweden)

    John Tsang

    1999-01-01

    Full Text Available Injury to the diaphragm following blunt or penetrating thoraco-abdominal trauma is not uncommon. Recognition of this important complication of trauma continues to be a challenge because of the lack of specific clinical and plain radiographic features, the frequent presence of other serious injuries and the potential for delayed presentation. Delayed diaphragmatic herniation often presents with catastrophic bowel obstruction or strangulation. Early recognition of diaphragmatic injury is required to avoid this potentially lethal complication. The case of a 35-year-old man with a history of a knife wound to the left flank 15 years previously, who presented with unexplained acute hypoxemic respiratory failure and a unilateral exudative pleural effusion that was refractory to tube thoracostomy drainage, is reported. After admission to hospital, he developed gross dilation of his colon; emergency laparotomy revealed an incarcerated colonic herniation into the left hemithorax. Interesting clinical features of this patient's case included the patient's hobby of weightlifting, a persistently deviated mediastinum despite drainage of the pleural effusion and deceptive pleural fluid biochemical indices.

  16. Derrame pleural neoplásico Malignant pleural effusion

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    Lisete Ribeiro Teixeira

    2006-08-01

    Full Text Available O derrame pleural neoplásico é uma complicação freqüente nos pacientes portadores de tumores avançados. A presença de células malignas no líquido pleural ou na biópsia da pleura é indicativa de disseminação da doença primária, com conseqüente redução da expectativa de vida. O diagnóstico e tratamento precoce do derrame pleural maligno são fundamentais para promover uma melhor qualidade de vida aos pacientes portadores de câncer avançado.The malignant pleural effusion is a frequent complication in patients with of advanced tumors. The presence of malignant cells in the pleural fluid or in the pleural biopsy is indicative of dissemination of the primary disease, with consequent reduction of life expectancy. The early diagnosis and treatment of the malignant effusion is pivotal in promoting a better quality of life to patients with advanced cancer.

  17. MRI findings of prepatellar Morel-Lavallee effusions

    Energy Technology Data Exchange (ETDEWEB)

    Borrero, Camilo G.; Maxwell, Norman; Kavanagh, Eoin [University of Pittsburgh Medical Center, Department of Radiology, Pittsburgh, PA (United States)

    2008-05-15

    To describe MR imaging characteristics and treatment options for prepatellar closed degloving injuries or Morel-Lavallee effusions. Imaging features are discussed that may aid in the distinguishing of this entity from 'housemaid's knee' or prepatellar bursitis. MR images of four young wrestlers were reviewed by two attending radiologists and one fellow, and correlative clinical data were collected using the electronic medical database. MR images in all cases showed a unilocular, T2 hyperintense prepatellar collection extending beyond the normal boundaries of the prepatellar bursa. No necrotic fat or blood products were identified in the collections. Surgical pathology proving the absence of synovial tissue was available for one case, and differentiation of the collection from the adjacent bursa was confirmed visually by the surgeon in a second case. Although prepatellar hemorrhagic bursitis and Morel-Lavallee effusions share many imaging features, making a specific diagnosis in most cases is not necessary, as treatment is often similar for both entities. (orig.)

  18. The Stress Distribution on the Zygapophyseal Joint of Lumbar Vertebra by ANSYS Program

    Directory of Open Access Journals (Sweden)

    Summer S. M. Mukhtar

    2010-01-01

    Full Text Available Zygapophyseal joints (or facet joints, are a plane synovial joint which located between the articular facet processes of the vertebral arch which is freely guided movable joints. Ten dried vertebrae were used for the lumbar region and taking (L4 as a sample to reveal stress pathways across the joints by using ANSYS program under different loading conditions which used Finite Elements Analysis model. Results obtained from the ANSYS program are important in understanding the boundary conditions for load analysis and the points of stress concentration which explained from the anatomical point of view and linked to muscle and ligament attachments. This model used as a computational tool to joint biomechanics and to prosthetic implant analysis.

  19. Severe “sweet” pleural effusion in a continuous ambulatory peritoneal dialysis patient

    Directory of Open Access Journals (Sweden)

    Rapeephan R. Maude

    2014-01-01

    Conclusion: A high glucose concentration in the pleural fluid is pathognomonic for hydrothorax from dialysis fluid after rule out other possible causes of pleural effusion. Patients who are on CAPD presenting with marked pleural effusion should prompt clinicians to consider the differential diagnosis of pleuroperitoneal communications.

  20. Acute fatal pericardial effusion induced by accidental ingestion of cigarette butts in a dog.

    Science.gov (United States)

    Kim, Jung-Hyun; Lim, Jae-Hyun

    2016-02-01

    A dog was referred for collapse and tachypnea after ingesting cigarette butts. Thoracic radiography and echocardiography indicated pericardial effusion, and an electrocardiogram showed tachycardia, variable QRS complexes, and ventricular premature complexes. This is the first description of fatal pericardial effusion associated with cigarette butt ingestion in a veterinary patient.